| 1. |
|
|
| 2. |
- Backe, Stefan, et al.
(författare)
-
Monitoring the "tip of the iceberg" : Ambulance records as a source of injury surveillance
- 2008
-
Ingår i: Scandinavian Journal of Public Health. - : Sage Publications. - 1403-4948 .- 1651-1905. ; :36, s. 250-257
-
Tidskriftsartikel (refereegranskat)abstract
- Aims: The aim of this study was to describe the epidemiology of moderate and severe injury morbidity in a defined population based on ambulance records, and to validate ambulance records as a potential source of surveillance.Methods: A geographical target area was defined; the county of Värmland, Sweden. All ambulance attendances and hospitalisations for unintentional and intentional injury in 2002 were selected, analysed and compared.Results: Ambulance data comprised 3964 injury cases (14.5/1000). Most injuries for which ambulance attention was sought occurred in road traffic areas (27 %), followed by residential areas (20 %), school and institutional areas (14 %) and sports areas (8 %). An ecological comparison between ambulance based data and hospitalisations showed that ambulance services captured approximately the same amount of injury cases (3235 ambulance reports compared to 3456 hospital discharges) with a similar profile.Conclusions: This study provides epidemiological support for ambulance services as a potential source of regular surveillance data on moderate and severe injuries. However, at a population level, our results indicate that ambulance data tend to overestimate some injury categories, and underestimate others, compared to hospital data. The significance of these differences for preventive work, as well as other practical aspects of the feasibility for regular injury surveillance will be analysed and discussed on the basis of general criteria for evaluation of surveillance systems in a forthcoming paper.
|
|
| 3. |
|
|
| 4. |
- Moniruzzaman, Syed, et al.
(författare)
-
Economic development as a determinant of injury mortality : a longitudinal approach
- 2008
-
Ingår i: Social Science and Medicine. - : Elsevier BV. - 0277-9536 .- 1873-5347. ; 68:8, s. 1699-1708
-
Tidskriftsartikel (refereegranskat)abstract
- Cross-sectional studies have produced clear inverted U-shaped curves between injury mortality and economic development; yet, this does not mean that single countries will necessarily follow similar curves as they grow richer over time. This study was conducted to examine whether previous cross-sectional findings can be verified using a longitudinal approach. Data for both injury mortality and gross domestic product (GDP) per capita were obtained from an official health database for the member countries of the Organization for Economic Cooperation and Development (OECD) for the period of 1960–1999. Regression models were then used to examine the longitudinal relationship between these two variables. Substantial improvements in injury mortality were observed in all income categories in the selected countries. For higher and middle high-income countries, injury mortality rates (all causes) increased until 1972, peaking in 1972 and then declining. For industrialized countries with relatively low GDP, injury mortality rates increased until 1977 and then declined. Using cubic regression lines for injury mortality rates, for all income categories, injury mortality rates increased up to a GDP per capita of $3000–$4000, then decreased significantly. The rising trends of suicide and homicide rates were observed until countries attained a GDP per capita of around $13,000–$14,000 for all income categories. It is noteworthy that compared to the intentional injury categories, mortality due to road traffic accidents and injuries from falls declined earlier on in the economic development process. Longitudinal analysis among high-income countries confirms earlier cross-sectional findings; that is, most injury categories seem to follow inverted U-shaped trend lines, with declining trends after peaking at various stages of temporal and economical development. A comparison between time and economy suggests that differences in peaking time between countries for the same injury category is partly a reflection of temporal differences in economic development.
|
|
| 5. |
- Rådbo, Helena, et al.
(författare)
-
Railway suicide analysis and Prevention in a Swedish context
- 2008
-
Konferensbidrag (populärvet., debatt m.m.)abstract
- Suicide is a dominating, although hidden, safety problem on Swedish railroads. The aim of my first paper (Rådbo et al, 2005) is to describe the epidemiology of fatal train-person collisions as a basis for systems-oriented prevention. Data on collision circumstances were collected from narrative reports at the Swedish National Rail Administration. Results shows how the events were evenly distributed by months and weekdays, however most suicides occur in day-time while unintentional events usually occur at night. Most train-person collisions happened in densely populated areas, and 75 % of the suicide victims were waiting on or close to the track before the collision. Significance test between types of injury event (suicide, accident or unknown intent) showed small or no differences, and one conclusion is that traditional approaches to accident prevention by systems modification seem largely applicable to combat railroad suicide as well. Our findings show promising preventive potentials. The aim of my second paper (Rådbo et al, 2007) is to theoretically derive and categorise a set of railway suicide prevention strategies with special regard to measures under the potential control of the railway system-owners. The methodological approach departs from synthesizing generic accident and suicide prevention models. Secondly, potential barriers are identified by means of fault tree analysis (FTA), and thirdly results from this analysis are validated against Haddons ten energy-based injury prevention strategies.Our results include 20 separate preventive strategies, of which most are in reach of railway system-owners themselves. Four of them aim to reduce perceived attractiveness and availability, nine aim to influence accessibility to track areas and the potential of collision, five strategies aim to mitigate consequences of collision, and three encompass medical survival and recovery strategies.To evaluate the barriers practical feasibility, etc., is beyond the aim of this study. However, technological development and innovations may turn less realistic alternatives today into more realistic possibilities tomorrow, as has been proven in other fields.Further researchAt the ERA seminar I also will tell you about further research and my two not yet publicized studies that includes in my theses. The aim of my third paper Suicide and potentials for suicide prevention on the Swedish Rail Network; a qualitative multiple case study is to evaluate the content of existing reports on railway suicide incidents from a preventive perspective and to identify and categorise additional preventive-oriented information from independent site investigations. The overall goal of my fourth study Feasibility of railway suicide prevention strategies; a focus group study is to explore preferences for preventative strategies against railway suicide among relevant professional groups. More specifically, this study aims are to analyze the acceptance and understanding of theoretically and empirically derived preventative strategies among selected professional groups, and to validate and further develop these strategies.
|
|
| 6. |
|
|
| 7. |
|
|
| 8. |
- Rådbo, Helena, 1963-
(författare)
-
Systeminriktad prevention av järnvägssjälvmord : Strategiutveckling i en svensk kontext
- 2008
-
Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Railway suicide constitutes a limited but significant fraction of all suicides, and a majority of all railway-related deaths, in Sweden as well as in many other countries. The aim of this thesis is to develop the scientific basis for the prevention of railway suicide, with special regard to knowledge and strategies within the reach of the railway system owners themselves. An initial descriptive epidemiologic study showed that railway suicide episodes cluster in densely populated areas, and that victims often seem to await approaching trains for some time on or close to tracks before being hit. This means that preventive efforts can be prioritized to geographically limited areas and that there exists a time margin for early detection, forewarning, braking, rescuing, and the like. Secondly, a theoretical study was conducted in order to derive an overview of theoretically possible barriers aimed at preventing railway suicide. The approach is based on the comparison and synthesis of theories and models from suicidology and safety sciences applied to the railway suicide phenomenon. This led to a list of possible barriers, also intended as a checklist. This was followed by a multiple case study, where a number of authentic cases were analysed in-depth on the basis of investigation reports by the police and railway officials, plus complementary researcher observations from the actual sites of the suicide occurrences. The study revealed some deficiency in current investigation and reporting routines from a preventative viewpoint and indicated the potential for a broader and more systematic collection of prevention-relevant information in immediate connection with the events. Finally, a focus group study, involving safety practitioners from both the railway and other sectors, confirmed a general understanding and acceptance among practitioners of the theoretically derived principles, and a readiness to broaden the scope of railway safety to include approaches to prevent suicide. In conclusion, it should be possible to influence the occurrence of railway suicides by means available within the railway transport system itself. A spectrum of possible alternative barriers is identified, as well as an, as yet, underutilized potential in the form of more systematic data collection and learning routines from actual events. Last but not least, there is a readiness among practitioners to incorporate these principles in regular railway safety work.
|
|
| 9. |
|
|
| 10. |
|
|
