| 1. |
- Dale, Richard Allan, 1965, et al.
(författare)
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Alcohol environment, gender and nonfatal injuries in young people. An ecological study of fourteen swedish municipalities (2000-2005).
- 2012
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Ingår i: Substance abuse treatment, prevention, and policy. - 1747-597X. ; 7:1
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Tidskriftsartikel (refereegranskat)abstract
- ABSTRACT: BACKGROUND: Sweden has had a restrictive alcohol policy, but there are gender and geographical differences in alcohol consumption and injury rates within the country. Whether and how the Swedish alcohol environment influences gender differences in injuries in young people is still unclear. Thus, the aim of this study was to analyse the associations between the local alcohol environment and age- and gender-specific nonfatal injury rates in people up to 24 years in Sweden. METHODS: The local alcohol environment from 14 municipalities was studied using indicators of alcohol access, alcohol consumption and alcohol-related crimes. A comprehensive health care register of nonfatal injuries was used to estimate mean annual rates of nonfatal injuries by gender and age group (2000--2005). Pearson's correlation coefficients were used to analyse linear associations. RESULTS: Associations were shown for both alcohol access and alcohol consumption with injury rates in boys aged 13--17 years; no other associations were observed between alcohol access or per capita alcohol consumption and nonfatal childhood injuries. The prevalence of crimes against alcohol laws was associated with injury rates in children of both genders aged 6--17 years. CONCLUSIONS: This study found no strong area-level associations between alcohol and age and gender specific nonfatal injuries in young people. Further, the strength of the area-level associations varied by age, gender and type of indicator used to study the local alcohol environment.
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| 2. |
- Dale, Richard Allan, 1965, et al.
(författare)
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Children's perceptions of injuries: a qualitative study in Sweden
- 2013
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Ingår i: Pediatric Nursing. - 0097-9805. ; 39:5, s. 225-232
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Tidskriftsartikel (refereegranskat)abstract
- To understand one of the major public health problems for children, it is important to consider the children's perspective. The purpose of this qualitative study was to explore, describe, and categorize children's perceptions of injury severity and children's explanations of the injuries they experience. A total of 29 students from six randomly selected schools were interviewed in age groups of 9, 13, and 17 years. Manifest content analysis according to Graneheim and Lundman (2004) was used to categorize children's own statements. Need of medical attention, long-term consequences, and familiarity with the injury risk situation were identified as important determinants of children's perception of injury severity. Three categories emerged from children's explanations of their injuries: "Because of Me" (beliefs, lack of concentration, health conditions, and lack of awareness of risk), "Because of the Situation" (rain, ice, wind, animals, inanimate objects, constructions, and the children's games), and "Just Inexplicable" to the children. Findings suggest that children have a wide perception of injury severity and that children's beliefs of injury causation, as well as children's familiarity with injury risk situations, need to be considered in future studies focusing on the development of childhood injury prevention strategies. Additionally, results suggest that sometimes children cannot or do not want to explain their injuries.
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| 3. |
- Dale, Richard Allan, 1965, et al.
(författare)
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Does the burden of injuries vary between small and neighbouring municipalities? -testing a new surveillance system based not only in hospitals.
- 2006
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Ingår i: Riksstämman. - 0349-1722. ; 115:1
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Konferensbidrag (refereegranskat)abstract
- Background: Regional preventive programs usually assume that there are no important differences in the pattern and burden of injuries between municipalities. Few studies have shown that there might be differences. Objective: Describe and assess the pattern and the burden of non-fatal injuries between small and neighbouring municipalities. Design: A retrospective analysis of the database from Skaraborg´s Local Injury Surveillance System, SLISS, which includes all the health care services in the county i.e. primary health care centres and hospitals. Methods: Mean Standardised Injury Rates (m-SIRs) by sex and adjusted by age were used to compare four municipalities. Skövde was used as the reference municipality in the analysis. Results: A total of 47,922 injuries were registered in four municipalities between the year 2000 and 2004. The distribution of injuries, regarding type, body part injured, mechanism and place of occurrence, were similar between the municipalities in the study. However, the burden of injuries, in terms of incidence, varied significantly between them. The highest difference from Skövde was in the injuries that occurred at work. The m-SIRs at work in Töreboda were 2.4 (99%CI 1.6-3.9) and 2.7 (99%CI 1.2-8.1) for males and females respectively. Mariestad had higher differences from Skövde in injuries by jamming/cuts with m-SIRs of 1.9 (99%CI 1.5-2.4) and 2.0 (99%CI 1.5-2.7) for males and females respectively. Males´ injury rates in the head/neck were significantly lower in Skövde. Töreboda´s m-SIRs was 1.7 (99%CI 1.3-2.3), Mariestad had 1.5 (99%CI 1.0-2.2) and in Tidaholm was 1.5 (99%CI 1.1-1.9). Conclusions: Small and neighbouring municipalities had overall a similar distribution of the injuries by sex. However, some important differences in the burden of injuries were identified and those should be taken into consideration for preventive efforts.
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| 4. |
- Dale, Richard Allan, 1965, et al.
(författare)
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Geographical differences of non-fatal injuries in four Swedish municipalities -testing a surveillance system based on all the health care services.
- 2006
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Ingår i: 15th International Safe Communities Conference.
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- Injury surveillance systems have a critical role in the prevention of injuries. A unique local surveillance system (SLISS) based on all the public health services started in 1998 in the county of Skaraborg, Sweden. The OBJECTIVES of this study were to investigate if there were differences in the pattern of injuries between small and neighbouring municipalities (districts), and to identify risk groups and areas which might need specific strategies to prevent the incidence of injuries. METHODS: A retrospective analysis of the SLISS database from the year 2000-2004 with focus in a sample of 4 small and neighbouring districts. Injury cases were defined as a visit to any public health service unit for care or evaluation of an injury. The denominator data was obtained from Statistics Sweden. Mean Standardised Injury Ratios (m-SIRs) by sex and adjusted by age were used to compare the districts. Skövde was selected as the reference district and poisson regression analysis estimated the level of precision. RESULTS: The total number of cases registered in the four districts between the year 2000 to 2004 was 47,922. Males had ≥30% higher injury rates than females. Falls were the main mechanism among females (≥38/1000) and collisions among males (≥ 31/1000). One municipality had ≥ 2.4 m-SIR at manufacturing work places and ≥ 1.5 m-SIR of head injuries in both sexes. Two municipalities had ≥ 1.43 m-SIR in minor injuries and ≥ 1.7 m-SIR injuries by jamming and cuts in both sexes. Fractures and cerebral concussions did not show significant m-SIRs. CONCLUSIONS: This local surveillance system showed significant differences in the pattern of injuries between these small and neighbouring districts. This has consistency with the findings obtained by Ekman et al (2005). Injuries at work and the incidence of minor injuries have attracted the attention to local authorities for further analysis.
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| 5. |
- Dale, Richard Allan, 1965, et al.
(författare)
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Income distribution, gender structure and the occurrence of injuries in childhood. An ecological study based on 14 Swedish municipalities, 2000-2005.
- 2008
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Ingår i: Riksstämman. - 0349-1722. ; 117:1
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Konferensbidrag (refereegranskat)abstract
- Background: Injuries in childhood vary between municipalities in Sweden. We investigated if the ecological variation of nonfatal childhood injuries had relationship with the income distribution and the gender distribution at the labour market and political sphere. Methods: Mean annual injury and fracture rate from 14 Swedish municipalities (2000-2005) was calculated by sex, age group (0-5, 6-12 and 13-17 years) and three different percentile levels (P75) from an index calculated using Principal Component Analysis for income spread (Gini coefficient, % millionaire, % children under poverty, % unemployment and % people with low education) and gender distribution (sex ratio at leading and at unskilled working position, and proportion of women at the municipal political council). Results: Four index dimensions were obtained from the PCA: “low income”, high income and income unequal”, “gender equality at unskilled work” and “male leaders at work and gender equality at politics”. The second index showed a strong negative correlation between injury rates and proportion of millionaire and income inequality. The pattern was observed in the 3 age groups and in both sexes (r = between -0.4 and -0.7). The third index showed a negative correlation between injuries and female dominance at unskilled work and positive correlation with fractures. The strongest negative correlation with injuries was in boys 0-5y (r = -0.4) and the strongest positive correlation with fractures was in girls aged 0-5y (r = 0.6). The first index showed no robust either consistent correlation. The fourth index showed that municipalities in the cluster “middle” had the lowest injury rates in both sexes and ages, except for the oldest children. Conclusions: This study shows the potential association between the income and gender context at the municipal level and the occurrence of nonfatal injuries in Swedish children.
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| 6. |
- Dale, Richard Allan, 1965, et al.
(författare)
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Injuries in childhood and its association with the socioeconomic and gender inequalities.
- 2008
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Ingår i: 16th European Conference in Public Health (EUPHA). - 1101-1262. ; 18:1
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- Background: Nonfatal injury rates in childhood vary within a region. We investigated if the municipal variation had relationship with the distribution of economical resources and the gender distribution at the labour market and at the political sphere. Methods: Mean annual injury and fracture rate from 14 Swedish municipalities (2000-2005) was calculated by sex, age group (0-5, 6-12 and 13-17 years) and three level of percentile (P75) from an index calculated using Principal Component Analysis (PCA) for income spread (Gini coefficient, % millionaire, % children under poverty, % unemployment and % people with low education) and gender distribution (sex ratio at leading and at unskilled position at work, and proportion of women at the municipal political council). Results: Four index dimensions (“low income”, “high income and unequal”, “gender equality at unskilled work” and “male leaders at work and gender equality at politics”) were obtained from the PCA. The index “high income and unequal” showed that municipalities with higher income equality and less economically develop had 1.14 – 1.35 times higher injury rates than the more unequal and more economically develop municipalities. The pattern was observed in the 3 age groups and in both sexes. The “gender equality at unskilled work” index showed that municipalities with higher gender equality at unskilled work had 1.14 – 1.51 times higher fracture rates than the municipalities with more female dominance at this working position. The pattern was observed in the 3 age groups and in both sexes. Conclusions: It is possible that the local inequalities in the distribution of economical resources and the female dominance at unskilled working position may be negative associated with the local occurrence of nonfatal injuries in childhood.
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| 7. |
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| 8. |
- Dale, Richard Allan, 1965
(författare)
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Nonfatal injuries in a local context - Analysing social structures and perceptions in young people
- 2012
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Background: Injuries are a common health problem in children and young people. The uneven distribution over gender and socioeconomic groups is partly explained by factors at both the individual and family levels, but sociocultural structures at the municipality level may contribute with yet unrecognised associations. If so, these associations might be important, since a large part of preventive work is done in municipalities. Few studies have included the perspectives of children themselves, who may be an important source of information in the development of new knowledge in this area. The overall aim of this thesis was to try to understand the relationship between the continuous interplay of individuals and their environment with the distribution of nonfatal injuries in young people. This thesis had two specific aims. The first aim explored whether the distribution of nonfatal injuries in young people was associated with particular local sociocultural conditions, and the second explored how children and young adults perceive and experience injuries. Methods: A comprehensive health care register was used to estimate mean annual rates of nonfatal injuries and fractures by gender and age groups (2000–2005). The local alcohol environment was assessed using indicators of access, consumption, and alcohol-related crimes in 14 municipalities. The local socioeconomic and gender structures were assessed using the following main components: relative poverty, relative wealth with male managerial dominance, narrow gender ratio in unskilled working positions and politics, and wider income distribution. Pearson’s correlation coefficients were used to measure linear associations. Qualitative data were gathered in individual interviews. Six small homogeneous groups selected by gender and age (9, 13, and 17 years) were used with children and the critical incident technique was used with young adults. Content analysis was used to study children and young adults’ experiences and perceptions of injuries and injury risk situations. Credibility of the qualitative results was achieved through several methods, including researcher triangulation. Results: Local alcohol access and local alcohol consumption was associated with the distribution of injuries in boys aged 6–17 years, while negative associations were observed between alcohol consumption and fractures in girls aged 6–17 years. None of the alcohol indicators were associated with injuries in young adults. Positive associations were identified between “narrow gender ratio at unskilled working positions and in politics” and injuries in both boys and girls aged 6–17 years. Negative associations were found between “wider income distribution” and boys’ injuries. No linear association was observed between level of poverty and childhood injuries. Children explained their injuries using both personal and situational characteristics. Some childhood injuries were labelled ‘inexplicable’. Children seemed to have a broad perspective on injury severity, including the psychological and social consequences of an injury. Children’s familiarity with certain situations may lead to underestimate the potential severity of an associated injury. Three main categories characterized young adults’ experiences with near-injury risk situations: performing under pressure, close encounters with more or less unexpected environmental factors, and while learning; and five categories summarized their ways of managing near-injury situations: escape, release control, confront, cry out for help, and do nothing. Conclusions: The findings suggest the involvement of both individual and socio-cultural conditions in the distribution of nonfatal injuries in young people. On one hand, associations were found between socioeconomic and gender structures and the local distribution of nonfatal childhood injuries, and the strength of the area-level associations varied by sex, age, nature of injury, and type of socio-cultural condition studied. On the other hand, the children in this thesis seemed to have a holistic perspective of injury severity that health workers attending paediatric injuries should consider. Children’s familiarity with the injury-risk situation seemed to decrease their awareness of potential negative consequences associated with the activity. Young adults’ frequent exposure to new environmental conditions may increase their risk of injury, and their lack of experience might influence their subjective interpretation of the situation. The findings in this thesis can be seen as points of departure for future research and for the development of local injury prevention programmes.
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| 9. |
- Dale, Richard Allan, 1965, et al.
(författare)
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YOUNG ADULTS' EXPERIENCES WITH NEAR-INJURY SITUATIONS: A CRITICAL INCIDENT STUDY IN SWEDEN
- 2017
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Ingår i: International Journal of Child Youth & Family Studies. - : University of Victoria Libraries. - 1920-7298. ; 8:1, s. 97-111
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Tidskriftsartikel (refereegranskat)abstract
- As injuries are the main health threat for young adults (18-29 years) in industrial countries, a better understanding of injury risk is needed for this population. Using the Critical Incident Technique, this study explores how young people experience situations that have the potential to cause physical injury (i.e., near-injury situations). Clearly, understanding how and why near-injury situations arise can be used to develop strategies to help prevent severe injury. Content analysis was used to categorize the characteristics of the experiences into unexpected risk in ordinary tasks, duty first, and price for learning. Young adults' exposures to new or unusual environmental conditions, especially in unexpected risk in ordinary tasks, should be considered when planning injury prevention strategies. A combination of individual, social, and contextual demands and expectations was identified in both work-and sports-related experiences with near-injury situations. The price for learning, which arises from the added risk involved in learning situations, is another condition that was identified and requires further attention. The Critical Incident Technique proved to be a useful method for identifying near-injury situations that might otherwise have been difficult to recall. Young adults' efforts to display their ability to handle difficult situations at work and in their everyday lives was identified as a major contributor to near-injury situations.
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