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Objectives Underreporting of occupational injuries is well documented, but underreporting patterns may vary by worker characteristics, obscuring disparities. We tested for racial and ethnic differences in injury reporting patterns by comparing injuries reported via research survey and administrative injury database in the same group of healthcare workers in the US. Methods We used data from a cohort of 1568 hospital patient-care workers who were asked via survey whether they had been injured at work during the year prior (self-reported injury; N=244). Using the hospital's injury database, we determined whether the same workers had reported injuries to the hospital's occupational health service during that year (administratively reported injury; N=126). We compared data sources to test for racial and ethnic differences in injury reporting practices. Results In logistic regression models adjusted for demographic and occupational characteristics, black workers' odds of injury as measured by self-report data were 1.91 [95% confidence interval (95% CI) 1.04–3.49] compared with white workers. The same black workers' odds of injury as measured by administrative data were 1.22 (95% CI 0.54–2.77) compared with white workers. Conclusions The undercount of occupational injuries in administrative versus self-report data may be greater among black compared to white workers, leading to underestimates of racial disparities in workplace injury.

Mandatory standard regulation is used within Australia to ensure the safety of consumer products, preventing product-related injury. Standard regulation is particularly important for products designed for use by children, who are highly vulnerable to sustaining product-related injuries due to their small size and inability to identify product hazards. This project aims to investigate how effectively information regarding product-related injuries is able to be captured within Australian health and coronial data. Further, it aims to investigate the extent to which child injury occurs for products for which mandatory safety standards exist through the review of available data. This study highlights significant limitations in injury surveillance data for identification and monitoring of child product-related injuries. This in turn limits the evidence base to assess the efficacy of existing regulations. Available data show baby walkers, cots, prams, nightwear, and bunk beds to be associated with a considerable number of child hospital presentations, admissions, and deaths. A significant scope for improvement in current product injury recording practices in the health sector exists.

Purpose This study explored the individual trajectories of health-related quality of life (HRQL) compared to recalled pre-burn level of HRQL and investigated whether burn severity and post-traumatic stress disorder (PTSD) symptoms increase the risk of not returning to pre-burn level of HRQL. Methods Data were obtained from 309 adult patients with burns in a multicenter study. Patients completed the EQ-5D-3L questionnaire with a Cognition bolt-on shortly after hospital admission, which included a recalled pre-injury measure, and, again, at 3, 6, 12 and 18 months post-burn. Burn severity was indicated by the number of surgeries, and PTSD symptoms were assessed with the IES-R at three months post-burn. Pre- and post-injury HRQL were compared to norm populations. Results Recalled pre-injury HRQL was higher than population norms and HRQL at 18 months post-burn was comparable to population norms. Compared to the pre-injury level of functioning, four HRQL patterns of change over time were established: Stable, Recovery, Deterioration, and Growth. In each HRQL domain, a subset of patients did not return to their recalled pre-injury levels, especially with regard to Pain, Anxiety/Depression, and Cognition. Patients with more severe burns or PTSD symptoms were less likely to return to pre-injury level of functioning within 18 months post-burn. Conclusion This study identified four patterns of individual change. Patients with more severe injuries and PTSD symptoms were more at risk of not returning to their recalled pre-injury HRQL. This study supports the face validity of using a recalled pre-burn HRQL score as a reference point to monitor HRQL after burns.

The burden of trauma-related mortality is inversely related to income on an individual and national scale. Barthélemy et al. highlight the significant variation of neurotrauma data included in national injury registries of low- and middle-income countries (LMICs) when compared to the World Health Organization (WHO) minimal dataset for injury (MDI). Moreover, the authors emphasize that the non-existence and underutilization of nationally standardized trauma registries hinder the data-driven identification of factors contributing to neurotrauma and subsequent attempts to improve neurotrauma care. Establishing a nationally standardized trauma registry should be prioritized by all stakeholders involved in curbing trauma-related mortality and building research capacity in LMICs. In this commentary, previous successful efforts to establish and maintain robust registries in LMICs through local and international partnerships are highlighted. The lessons and challenges chronicled in establishing such registries can inform future efforts to implement a nationally standardized trauma registry.

A challenge in utilising health sector injury data for Product Safety purposes is that clinically coded data have limited ability to inform regulators about product involvement in injury events, given data entry is bound by a predefined set of codes. Text narratives collected in emergency departments can potentially address this limitation by providing relevant product information with additional accompanying context. This study aims to identify and quantify consumer product involvement in paediatric injuries recorded in emergency department-based injury surveillance data. A total of 7743 paediatric injuries were randomly selected from Queensland Injury Surveillance Unit database and associated text narratives were manually reviewed to determine product involvement in the injury event. A Product Involvement Factor classification system was used to categorise these injury cases. Overall, 44% of all reviewed cases were associated with consumer products, with proximity factor (25%) being identified as the most common involvement of a product in an injury event. Only 6% were established as being directly due to the product. The study highlights the importance of utilising injury data to inform product safety initiatives where text narratives can be used to identify the type and involvement of products in injury cases.

Background The benefits of trauma registries have been well described. The crucial data they provide may guide injury prevention strategies, inform resource allocation, and support advocacy and policy. This has been shown to reduce trauma-related mortality in various settings. Trauma remains a leading cause of mortality in low- and middle-income countries (LMICs). However, the implementation of trauma registries in LMICs can be challenging due to lack of funding, specialized personnel, and infrastructure. This study explores strategies for successful trauma registry implementation in LMICs. Methods The protocol was registered a priori (CRD42017058586). A peer-reviewed search strategy of multiple databases will be developed with a senior librarian. As per PRISMA guidelines, first screen of references based on abstract and title and subsequent full-text review will be conducted by two independent reviewers. Disagreements that cannot be resolved by discussion between reviewers shall be arbitrated by the principal investigator. Data extraction will be performed using a pre-defined data extraction sheet. Finally, bibliographies of included articles will be hand-searched. Studies of any design will be included if they describe or review development and implementation of a trauma registry in LMICs. No language or period restrictions will be applied. Summary statistics and qualitative meta-narrative analyses will be performed. Discussion The significant burden of trauma in LMIC environments presents unique challenges and limitations. Adapted strategies for deployment and maintenance of sustainable trauma registries are needed. Our methodology will systematically identify recommendations and strategies for successful trauma registry implementation in LMICs and describe threats and barriers to this endeavor. Systematic review registration The protocol was registered on the PROSPERO international prospective register of systematic reviews ( CRD42017058586 ).

Background Quality Improvement (QI) programs have been shown to be a valuable tool to strengthen care of severely injured patients, but little is known about them in low and middle income countries (LMIC). We sought to explore opportunities to improve trauma QI activities in LMIC, focusing on the Asia–Pacific region. Methods We performed a mixed methods research study using both inductive thematic analysis of a meeting convened at the Royal Australasian College of Surgeons, Melbourne, Australia, November 21–22, 2010 and a pre-meeting survey to explore experiences with trauma QI activities in LMIC. Purposive sampling was employed to invite participants with demonstrated leadership in trauma care to provide diverse representation of organizations and countries within Asia–Pacific. Results A total of 22 experts participated in the meeting and reported that trauma QI activities varied between countries and organizations: morbidity and mortality conferences (56 %), monitoring complications (31 %), preventable death studies (25 %), audit filters (19 %), and statistical methods for analyzing morbidity and mortality (6 %). Participants identified QI gaps to include paucity of reliable/valid injury data, lack of integrated trauma QI activities, absence of standards of care, lack of training in QI methods, and varying cultures of quality and safety. The group highlighted barriers to QI: limited engagement of leaders, organizational diversity, limited resources, heavy clinical workload, and medico-legal concerns. Participants proposed establishing the Asia–Pacific Trauma Quality Improvement Network (APTQIN) as a tool to facilitate training and dissemination of QI methods, injury data management, development of pilot QI projects, and advocacy for quality trauma care. Conclusions Our study provides the first description of trauma QI practices, gaps in existing practices, and barriers to QI in LMIC of the Asia–Pacific region. In this study we identified opportunities for addressing these challenges, and that work will be supported by APTQIN.

The Department of Defense Hearing Conservation Program provides specific guidance for service components to prevent occupational hearing loss; however, it does not specifically contend with the unique noise exposures observed in the theater of war, such as blasts and explosions. In order to examine the effects of blast injury on hearing sensitivity, we developed a large database composed of demographic, audiometric, point of injury, and medical outcome data, with the primary aim of developing a long-standing and integrated capability for the surveillance, assessment, and investigation of blast-related hearing outcomes. Methods used to develop the dataset are described. Encompassing more than 16,500 Navy and Marine Corps personnel, the Blast-Related Auditory Injury Database (BRAID) includes individuals with a blast-related injury and nonblast control subjects. Using baseline and postdeployment hearing threshold data, a retrospective analysis of the cohort revealed that the rate of hearing loss for the injured servicemembers was 39%. The BRAID will be useful for studies that assess hearing patterns following deployment-related injury, such as blast exposures, that facilitate exploration of health outcomes and whether they are predictive of audiometric disposition and that help establish hearing loss prevention strategies and program policies for affected military commands and servicemembers.

The search and construction of appropriate and flexible models for describing and modelling empirical data sets incongruent with normality retains a sustained interest. This paper focuses on proposing flexible skew Laplace scale mixture distributions to model these types of data sets. Each member of the collection of distributions is obtained by dividing the scale parameter of a conditional skew Laplace distribution by a purposefully chosen mixing random variable. Highly-peaked, heavy-tailed skew models with relevance and impact in different fields are obtained and investigated, and elegant sampling schemes to simulate from this collection of developed models are proposed. Finite mixtures consisting of the members of the skew Laplace scale mixture models are illustrated, further extending the flexibility of the distributions by being able to account for multimodality. The maximum likelihood estimates of the parameters for all the members of the developed models are described via a developed EM algorithm. Real-data examples highlight select models’ performance and emphasize their viability compared to other commonly considered candidates, and various goodness-of-fit measures are used to endorse the performance of the proposed models as reasonable and viable candidates for the practitioner. Finally, an outline is discussed for future work in the multivariate realm for these models.

The aim of this study was to analyze hospital-discharged acute myocardial infarction (AMI) patients in Korea (2006-2020) to understand how pre-existing conditions affect mortality rates. This study utilized the 2006-2020 Korean National Hospital Discharge In-depth Injury Survey data. A weighted frequency analysis estimated discharged AMI patients and calculated age-standardized discharge and mortality rates, Charlson Comorbidity Index (CCI) score distribution, and general patient characteristics. Weighted logistic regression analysis examined influencing mortality factors. There were 486,464 AMI patients (143,751 female), with AMI-related mortality rates at 7.5% (36,312): 5.7% for males (19,190) and 11.8% for females (17,122). The highest mortality rate was among individuals aged 70-79 years (25%). Factors influencing mortality included sex, insurance type, admission route, hospital bed count, region, operation status, and CCI score. Mortality risk at discharge was 1.151 times higher in females than males (95% CI: 1.002-1.322), 0.787 times lower among those with national health insurance than Medicaid recipients (95% CI 0.64-0.967), 2.182 times higher among those admitted via the emergency department than the outpatient department (95% CI 1.747-2.725), and 3.402 times higher in patients with a CCI score of 3 points than those with 0 points (95% CI 1.263-9.162). The number of discharged AMI patients and related mortality rates increased, underscoring the need for proactive management of chronic diseases, particularly for those with higher CCI scores.