Epidemiology of hospital-treated injuries sustained by fitness participants
- Gray, Shannon, Finch, Caroline
- Authors: Gray, Shannon , Finch, Caroline
- Date: 2015
- Type: Text , Journal article
- Relation: Research Quarterly for Exercise and Sport Vol. 86, no. 1 (2015), p. 81-87
- Relation: http://purl.org/au-research/grants/nhmrc/565900
- Full Text: false
- Reviewed:
- Description: Purpose: The purpose of this study was to provide an epidemiological profile of injuries sustained by participants in fitness activities in Victoria, Australia, based on hospital admissions and emergency department (ED) presentations and to identify the most common types, causes, and sites of these injuries. Method: Hospital-treated fitness activity-related injury cases were identified from International Classification of Disease activity codes (for admissions) and from text narratives of injury events (for ED presentations) from 2003 to 2010, inclusive. Cases were categorized as being associated with aerobics/group exercise (n = 252), resistance/weight training (n = 830) or "other equipment" (motorized and general gym equipment; n = 1,156). Participation information was taken from the Exercise, Recreation and Sport Survey. Results: Overall, 2,238 cases were identified and 11.6% of all patients with ED presentations were subsequently hospitalized. Those participants with aerobics cases were generally female (76.6%) and aged 25 to 34 years old (35.3%), with injuries to the lower limbs (59.1%) and due to falls (57.9%). Resistance-training injuries increased significantly during the 8-year period (by 215.7%; 95% CI [133.5, 326.9]) and generally occurred in male participants (78.0%), in people aged 15 to 24 years old (36.4%), and with injuries to the upper limbs (45.1%) caused by being hit, struck, or crushed by weights or fellow exercisers (71.4%). The "other equipment" cases were equally distributed by gender; they occurred most commonly in people aged 15 to 24 years old (27.8%), with injuries to the lower limbs (41.5%) and due to falls (57.6%). Across all categories, dislocations, sprains, and strains were the most common injury types. Conclusions: Fitness activity-related injury prevention strategies should be targeted at different subgroups according to the type of fitness activity being undertaken.
- Description: Purpose: The purpose of this study was to provide an epidemiological profile of injuries sustained by participants in fitness activities in Victoria, Australia, based on hospital admissions and emergency department (ED) presentations and to identify the most common types, causes, and sites of these injuries. Method: Hospital-treated fitness activity-related injury cases were identified from International Classification of Disease activity codes (for admissions) and from text narratives of injury events (for ED presentations) from 2003 to 2010, inclusive. Cases were categorized as being associated with aerobics/group exercise (n = 252), resistance/weight training (n = 830) or “other equipment†(motorized and general gym equipment; n = 1,156). Participation information was taken from the Exercise, Recreation and Sport Survey. Results: Overall, 2,238 cases were identified and 11.6% of all patients with ED presentations were subsequently hospitalized. Those participants with aerobics cases were generally female (76.6%) and aged 25 to 34 years old (35.3%), with injuries to the lower limbs (59.1%) and due to falls (57.9%). Resistance-training injuries increased significantly during the 8-year period (by 215.7%; 95% CI [133.5, 326.9]) and generally occurred in male participants (78.0%), in people aged 15 to 24 years old (36.4%), and with injuries to the upper limbs (45.1%) caused by being hit, struck, or crushed by weights or fellow exercisers (71.4%). The “other equipment†cases were equally distributed by gender; they occurred most commonly in people aged 15 to 24 years old (27.8%), with injuries to the lower limbs (41.5%) and due to falls (57.6%). Across all categories, dislocations, sprains, and strains were the most common injury types. Conclusions: Fitness activity-related injury prevention strategies should be targeted at different subgroups according to the type of fitness activity being undertaken.
- Finch, Caroline, Stephan, Karen, Shee, Anna Wong, Hill, Keith, Haines, Terry, Clemson, Lindy, Day, Lesley
- Authors: Finch, Caroline , Stephan, Karen , Shee, Anna Wong , Hill, Keith , Haines, Terry , Clemson, Lindy , Day, Lesley
- Date: 2015
- Type: Text , Journal article
- Relation: Injury Prevention Vol. 21, no. 4 (2015), p. 254-259
- Relation: http://purl.org/au-research/grants/nhmrc/565900
- Relation: http://purl.org/au-research/grants/nhmrc/1058737
- Relation: http://purl.org/au-research/grants/nhmrc/546282
- Full Text: false
- Reviewed:
- Description: Background: There has been limited research investigating the relationship between injurious falls and hospital resource use. The aims of this study were to identify clusters of community-dwelling older people in the general population who are at increased risk of being admitted to hospital following a fall and how those clusters differed in their use of hospital resources. Methods: Analysis of routinely collected hospital admissions data relating to 45 374 fall-related admissions in Victorian community-dwelling older adults aged ≥65 years that occurred during 2008/2009 to 2010/2011. Fall-related admission episodes were identified based on being admitted from a private residence to hospital with a principal diagnosis of injury (International Classification of Diseases (ICD)-10-AM codes S00 to T75) and having a first external cause of a fall (ICD-10-AM codes W00 to W19). A cluster analysis was performed to identify homogeneous groups using demographic details of patients and information on the presence of comorbidities. Hospital length of stay (LOS) was compared across clusters using competing risks regression. Results: Clusters based on area of residence, demographic factors (age, gender, marital status, country of birth) and the presence of comorbidities were identified. Clusters representing hospitalised fallers with comorbidities were associated with longer LOS compared with other cluster groups. Clusters delineated by demographic factors were also associated with increased LOS. Conclusions: All patients with comorbidity, and older women without comorbidities, stay in hospital longer following a fall and hence consume a disproportionate share of hospital resources. These findings have important implications for the targeting of falls prevention interventions for community-dwelling older people. © 2015, BMJ Publishing Group. All right reserved.
A systematic review of core implementation components in team ball sport injury prevention trials
- O'Brien, James, Finch, Caroline
- Authors: O'Brien, James , Finch, Caroline
- Date: 2014
- Type: Text , Journal article
- Relation: Injury Prevention Vol. 20, no. 5 (2014), p.357-362
- Relation: http://purl.org/au-research/grants/nhmrc/565900
- Relation: http://purl.org/au-research/grants/nhmrc/1058737
- Full Text:
- Reviewed:
- Description: Abstract BACKGROUND: Recently, the use of specific exercise programmes to prevent musculoskeletal injuries in team ball sports has gained considerable attention, and the results of large-scale, randomised controlled trials have supported their efficacy. To enhance the translation of these interventions into widespread use, research trials must be reported in a way that allows the players, staff and policymakers associated with sports teams to implement these interventions effectively. In particular, information is needed on core implementation components, which represent the essential and indispensable aspects of successful implementation. OBJECTIVES: To assess the extent to which team ball sport injury prevention trial reports have reported the core implementation components of the intervention, the intervention target and the use of any delivery agents (ie, staff or other personnel delivering the intervention). To summarise which specific types of intervention, intervention target and delivery agents are reported. To develop consensus between reviewers on the reporting of these components. METHODS: Six electronic databases were systematically searched for English-language, peer-reviewed papers on injury prevention exercise programme (IPEP) trials in team ball sports. The reporting of all eligible trials was assessed by two independent reviewers. The reporting of the three core implementation components were coded as 'yes', 'no' or 'unclear'. For cases coded as 'yes', the specific types of interventions, intervention targets and delivery agents were extracted and summarised. RESULTS: The search strategy identified 52 eligible trials. The intervention and the intervention target were reported in all 52 trials. The reporting of 25 trials (48%) specified the use of delivery agents, the reporting of three trials (6%) specified not using delivery agents, and in the reporting of the remaining 24 trials (46%) the use of delivery agents was unclear. The reported intervention type was an IPEP alone in 43 trials (83%), education/instruction in how to deliver an IPEP in three trials (6%) and multiple types of interventions (including an IPEP) in six trials (12%). Players were the most commonly reported intervention target (88%, n=46), followed by multiple targets (8%, n=4) and coaches (4%, n=2). Of the 25 trials for which delivery agents were reported, 13 (52%) reported a single type of delivery agent and 12 (48%) multiple types. The types of delivery agents reported included coaches, physiotherapists, athletic trainers and team captains. CONCLUSIONS: The current reporting of core implementation components in team ball sport IPEP trials is inadequate. In many trial reports, it is unclear whether researchers delivered the IPEP directly to players themselves or engaged delivery agents (eg, coaches, physiotherapists, athletic trainers) to deliver the programme. When researchers do interact with delivery agents, the education/instruction of delivery agents should be acknowledged as an intervention component and the delivery agents as an intervention target. Detailed reporting of implementation components in team ball sport IPEP trials will facilitate the successful replication of these interventions by intended users in practice and by researchers in other studies.
- Authors: O'Brien, James , Finch, Caroline
- Date: 2014
- Type: Text , Journal article
- Relation: Injury Prevention Vol. 20, no. 5 (2014), p.357-362
- Relation: http://purl.org/au-research/grants/nhmrc/565900
- Relation: http://purl.org/au-research/grants/nhmrc/1058737
- Full Text:
- Reviewed:
- Description: Abstract BACKGROUND: Recently, the use of specific exercise programmes to prevent musculoskeletal injuries in team ball sports has gained considerable attention, and the results of large-scale, randomised controlled trials have supported their efficacy. To enhance the translation of these interventions into widespread use, research trials must be reported in a way that allows the players, staff and policymakers associated with sports teams to implement these interventions effectively. In particular, information is needed on core implementation components, which represent the essential and indispensable aspects of successful implementation. OBJECTIVES: To assess the extent to which team ball sport injury prevention trial reports have reported the core implementation components of the intervention, the intervention target and the use of any delivery agents (ie, staff or other personnel delivering the intervention). To summarise which specific types of intervention, intervention target and delivery agents are reported. To develop consensus between reviewers on the reporting of these components. METHODS: Six electronic databases were systematically searched for English-language, peer-reviewed papers on injury prevention exercise programme (IPEP) trials in team ball sports. The reporting of all eligible trials was assessed by two independent reviewers. The reporting of the three core implementation components were coded as 'yes', 'no' or 'unclear'. For cases coded as 'yes', the specific types of interventions, intervention targets and delivery agents were extracted and summarised. RESULTS: The search strategy identified 52 eligible trials. The intervention and the intervention target were reported in all 52 trials. The reporting of 25 trials (48%) specified the use of delivery agents, the reporting of three trials (6%) specified not using delivery agents, and in the reporting of the remaining 24 trials (46%) the use of delivery agents was unclear. The reported intervention type was an IPEP alone in 43 trials (83%), education/instruction in how to deliver an IPEP in three trials (6%) and multiple types of interventions (including an IPEP) in six trials (12%). Players were the most commonly reported intervention target (88%, n=46), followed by multiple targets (8%, n=4) and coaches (4%, n=2). Of the 25 trials for which delivery agents were reported, 13 (52%) reported a single type of delivery agent and 12 (48%) multiple types. The types of delivery agents reported included coaches, physiotherapists, athletic trainers and team captains. CONCLUSIONS: The current reporting of core implementation components in team ball sport IPEP trials is inadequate. In many trial reports, it is unclear whether researchers delivered the IPEP directly to players themselves or engaged delivery agents (eg, coaches, physiotherapists, athletic trainers) to deliver the programme. When researchers do interact with delivery agents, the education/instruction of delivery agents should be acknowledged as an intervention component and the delivery agents as an intervention target. Detailed reporting of implementation components in team ball sport IPEP trials will facilitate the successful replication of these interventions by intended users in practice and by researchers in other studies.
Associations between helmet use and brain injuries amongst injured pedal- and motor-cyclists: A case series analysis of trauma centre presentations
- McIntosh, Andrew, Curtis, Kate, Rankin, Tiffany, Cox, Marie, Pang, Toh Yen, McCrory, Paul, Finch, Caroline
- Authors: McIntosh, Andrew , Curtis, Kate , Rankin, Tiffany , Cox, Marie , Pang, Toh Yen , McCrory, Paul , Finch, Caroline
- Date: 2013
- Type: Text , Journal article
- Relation: Journal of the Australasian College of Road Safety Vol. 24, no. 2 (April 2013), p. 11-20
- Relation: http://purl.org/au-research/grants/nhmrc/565900
- Full Text:
- Reviewed:
- Description: Abstract: A retrospective case-series study of pedal- and motorcyclists presenting to a major metropolitan trauma centre over an 18 month period was undertaken. The injury data were coded according to a number of outcome variables, including intracranial injury of AIS severity >/= 2. Helmet use was coded. After stratification by rider type, data were analysed to examine the relationships between helmet use and injury using logistic regression. A total of 220 injured motorcycle riders and 137 injured pedal cyclists met the study's inclusion criteria, with 195 motorcycle riders and passengers (88.6%) and 87 pedal cyclists (63.5%) wearing helmets. Helmets were associated with a significant reduction (p<0.05) in the likelihood of head and intracranial injury in both rider groups. Associated with helmet use was a reduction in intracranial injury likelihood of 66% for both helmeted motorcycle riders and pedal cyclists. The study is further evidence of the benefits offered by helmets.
- Authors: McIntosh, Andrew , Curtis, Kate , Rankin, Tiffany , Cox, Marie , Pang, Toh Yen , McCrory, Paul , Finch, Caroline
- Date: 2013
- Type: Text , Journal article
- Relation: Journal of the Australasian College of Road Safety Vol. 24, no. 2 (April 2013), p. 11-20
- Relation: http://purl.org/au-research/grants/nhmrc/565900
- Full Text:
- Reviewed:
- Description: Abstract: A retrospective case-series study of pedal- and motorcyclists presenting to a major metropolitan trauma centre over an 18 month period was undertaken. The injury data were coded according to a number of outcome variables, including intracranial injury of AIS severity >/= 2. Helmet use was coded. After stratification by rider type, data were analysed to examine the relationships between helmet use and injury using logistic regression. A total of 220 injured motorcycle riders and 137 injured pedal cyclists met the study's inclusion criteria, with 195 motorcycle riders and passengers (88.6%) and 87 pedal cyclists (63.5%) wearing helmets. Helmets were associated with a significant reduction (p<0.05) in the likelihood of head and intracranial injury in both rider groups. Associated with helmet use was a reduction in intracranial injury likelihood of 66% for both helmeted motorcycle riders and pedal cyclists. The study is further evidence of the benefits offered by helmets.
Different injury settings require different cost severity thresholds
- Authors: Finch, Caroline
- Date: 2012
- Type: Text , Journal article
- Relation: Injury Prevention Vol. 18, no. 5 (2012), p. 356
- Relation: http://purl.org/au-research/grants/nhmrc/565900
- Full Text: false
- Reviewed:
A protocol for evidence-based targeting and evaluation of statewide strategies for preventing falls among community-dwelling older people in Victoria, Australia
- Day, Lesley, Finch, Caroline, Hill, Keith, Haines, Terry, Clemson, Lindy, Thomas, Margaret, Thompson, Catherine
- Authors: Day, Lesley , Finch, Caroline , Hill, Keith , Haines, Terry , Clemson, Lindy , Thomas, Margaret , Thompson, Catherine
- Date: 2011
- Type: Text , Journal article
- Relation: Injury Prevention Vol. 17, no. 2 (2011), p. 1-8
- Relation: http://purl.org/au-research/grants/nhmrc/565900
- Relation: http://purl.org/au-research/grants/nhmrc/546282
- Full Text:
- Reviewed:
- Description: Background: Falls are a significant threat to the safety, health and independence of older citizens. Despite the now substantial evidence about effective falls prevention interventions, translation into falls reductions has not yet been fully realised. While the hip fracture rate is decreasing, the number and rate of fall-related hospital admissions among older people is increasing. The challenge now is to deliver the most effective interventions efficiently at a population level, and for these interventions to be taken up by older people. Objective: To support the development, and evaluation of, effective falls prevention policy and practice in the state of Victoria, Australia. Methods: The RE-AIM model (Reach, Efficacy, Adoption, Implementation, Maintenance) was used to identify strategies for an effective programme. Research objectives were developed to support the strategies. These include: (1) identification of subgroups of older people most frequently admitted to hospital for falls; (2) examining the acceptability of established falls interventions; (3) identification of factors that encourage and support relevant lifestyle changes; (4) identifying opportunities to incorporate confirmed interventions in existing programmes and services; (5) developing guidelines for sustainability. The research results will subsequently guide strategy details for the falls prevention plan. RE-AIM will provide the framework for the evaluation structure. Outcome measures: Measures to monitor the implementation of the selected interventions will be determined for each intervention, based on the five key factors of the RE-AIM model. The overall effect of the falls prevention plan will be monitored by time series analysis of fall-related hospital admission rates for community-dwelling older people.
- Authors: Day, Lesley , Finch, Caroline , Hill, Keith , Haines, Terry , Clemson, Lindy , Thomas, Margaret , Thompson, Catherine
- Date: 2011
- Type: Text , Journal article
- Relation: Injury Prevention Vol. 17, no. 2 (2011), p. 1-8
- Relation: http://purl.org/au-research/grants/nhmrc/565900
- Relation: http://purl.org/au-research/grants/nhmrc/546282
- Full Text:
- Reviewed:
- Description: Background: Falls are a significant threat to the safety, health and independence of older citizens. Despite the now substantial evidence about effective falls prevention interventions, translation into falls reductions has not yet been fully realised. While the hip fracture rate is decreasing, the number and rate of fall-related hospital admissions among older people is increasing. The challenge now is to deliver the most effective interventions efficiently at a population level, and for these interventions to be taken up by older people. Objective: To support the development, and evaluation of, effective falls prevention policy and practice in the state of Victoria, Australia. Methods: The RE-AIM model (Reach, Efficacy, Adoption, Implementation, Maintenance) was used to identify strategies for an effective programme. Research objectives were developed to support the strategies. These include: (1) identification of subgroups of older people most frequently admitted to hospital for falls; (2) examining the acceptability of established falls interventions; (3) identification of factors that encourage and support relevant lifestyle changes; (4) identifying opportunities to incorporate confirmed interventions in existing programmes and services; (5) developing guidelines for sustainability. The research results will subsequently guide strategy details for the falls prevention plan. RE-AIM will provide the framework for the evaluation structure. Outcome measures: Measures to monitor the implementation of the selected interventions will be determined for each intervention, based on the five key factors of the RE-AIM model. The overall effect of the falls prevention plan will be monitored by time series analysis of fall-related hospital admission rates for community-dwelling older people.
Child restraint fitting stations reduce incorrect restraint use among child occupants
- Brown, Julie, Finch, Caroline, Hatfield, Julie, Bilston, Lynne
- Authors: Brown, Julie , Finch, Caroline , Hatfield, Julie , Bilston, Lynne
- Date: 2011
- Type: Text , Journal article
- Relation: Accident Analysis and Prevention Vol. 43, no. 3 (May, 2011), p. 1128-1133
- Relation: http://purl.org/au-research/grants/nhmrc/565900
- Full Text: false
- Reviewed:
- Description: This study evaluated the effectiveness of the NSW Restraint Fitting Station Network in preventing incorrect use of rearward facing and forward facing child restraints. The way children used restraints was observed randomly as they arrived at observation sites during a cross-sectional ecological study across New South Wales, Australia. Trained researchers examined restraint system installation once the child left the vehicle. A structured interview was also conducted with the driver. Logistic regression was used to examine the association between parental report of ever having the restraint checked at a Restraint Fitting Station and whether or not the restraint was used correctly, while controlling for potential confounders and accounting for the complex sample design. Odds ratios (ORs) and 95% confidence intervals (CIs) were calculated. The results demonstrated that children of respondents who did not use Restraint Fitting Stations were 1.8 times more likely to be incorrectly using their restraints (95% CI 1.1–2.8) than children of Restraint Fitting Station users. Regardless of whether or not a Restraint Fitting Station had been used, there was a trend towards a greater likelihood of incorrect restraint use as the length of restraint ownership increased (OR 1.3 95% CI 1.0–1.7). These results are important for developing strategies aimed at reducing child occupant casualties by reducing the rate of incorrect restraint use, and support programs encouraging the use of Restraint Fitting Stations and similar services as a countermeasure to incorrect use.
- Petrass, Lauren, Blitvich, Jennifer, Finch, Caroline
- Authors: Petrass, Lauren , Blitvich, Jennifer , Finch, Caroline
- Date: 2011
- Type: Text , Journal article
- Relation: Injury Prevention Vol. 17, no. 4 (2011), p. 244-249
- Relation: http://purl.org/au-research/grants/nhmrc/565900
- Relation: http://purl.org/au-research/grants/nhmrc/565904
- Full Text: false
- Reviewed:
- Description: Objective: To identify independent factors associated with caregiver supervision levels at beaches. Methods: Children (aged 1-14 years) engaged in beach play and their caregivers were observed at Australian beaches during September-April, 2008/09. Caregiver, child, and environmental factor data were collected and recorded on a validated observation instrument. The main outcome of interest was a continuous measure of supervision. After adjusting for potential clustering by beach/state, multivariable linear regression was used to identify independent factors associated with caregiver supervision. Results: Four independent predictors of supervision and one interaction effect (child age by the caregiver and child position on beach) were identified. Caregivers who were supervising from a different position to where the child was playing were less likely to provide high supervision, as were older caregivers (>35 years) compared to younger caregivers (≤34 years). Compared to children playing alone, children playing with one, or two or more others were less likely to receive high supervision, and children aged 1-4 years were likely to receive higher supervision than older children. Conclusion: This study provides new knowledge about underlying factors associated with the level of caregiver supervision in beach settings. Future studies should continue to explore independent predictors of supervision so that effective programmes, which focus on caregiver supervision, can be targeted to address poor supervision practices.
Updating the international research agenda for sport injury prevention
- Authors: Finch, Caroline
- Date: 2011
- Type: Text , Editorial , Journal article
- Relation: Injury Prevention Vol. 17, no. 4 (August 2011 2011), p. 217-218
- Relation: http://purl.org/au-research/grants/nhmrc/565900
- Full Text:
- Reviewed:
- Description: The International Olympic Committee's World Conference on Prevention of Injury and Illness in Sport, the third in a series of triennial international conferences, was held in Monaco in April 2011. This conference is now the leading research event for many sports injury prevention and sports medicine researchers, and was well attended by over 940 delegates from 85 countries. A particularly pleasing part of the programme was the large emphasis of a number of sessions (including a keynote, several symposia and proffered papers) on the primary prevention of sports injuries, particularly issues relating to the delivery, implementation and uptake of preventive measures in this important context of injury. Abstracts from this meeting have been published in the April Injury Prevention and Health Promotion issue of the British Journal of Sports Medicine (http://bjsm.bmj.com/content/45/4.toc) and online presentations are available for viewing at the conference website (http://www.ioc-preventionconference.org/).
- Authors: Finch, Caroline
- Date: 2011
- Type: Text , Editorial , Journal article
- Relation: Injury Prevention Vol. 17, no. 4 (August 2011 2011), p. 217-218
- Relation: http://purl.org/au-research/grants/nhmrc/565900
- Full Text:
- Reviewed:
- Description: The International Olympic Committee's World Conference on Prevention of Injury and Illness in Sport, the third in a series of triennial international conferences, was held in Monaco in April 2011. This conference is now the leading research event for many sports injury prevention and sports medicine researchers, and was well attended by over 940 delegates from 85 countries. A particularly pleasing part of the programme was the large emphasis of a number of sessions (including a keynote, several symposia and proffered papers) on the primary prevention of sports injuries, particularly issues relating to the delivery, implementation and uptake of preventive measures in this important context of injury. Abstracts from this meeting have been published in the April Injury Prevention and Health Promotion issue of the British Journal of Sports Medicine (http://bjsm.bmj.com/content/45/4.toc) and online presentations are available for viewing at the conference website (http://www.ioc-preventionconference.org/).
Population-level estimates of child restraint practices among children aged 0-12 years in NSW, Australia
- Brown, Julie, Hatfield, Julie, Du, Wei, Finch, Caroline, Bilston, Lynne
- Authors: Brown, Julie , Hatfield, Julie , Du, Wei , Finch, Caroline , Bilston, Lynne
- Date: 2010
- Type: Text , Journal article
- Relation: Accident Analysis and Prevention Vol. 42, no. 6 (2010), p. 2144-2148
- Relation: http://purl.org/au-research/grants/nhmrc/565900
- Full Text:
- Reviewed:
- Description: This cross-sectional study provides population-referenced data on the restraints used and the extent of incorrect restraint use, among child vehicle passengers aged 0-12 years in NSW, Australia. A multistage stratified cluster sampling plan was used to randomly select vehicles from baby/child health clinics, pre-schools/day care centres, and primary schools across NSW to undergo detailed inspection of restraints used by child occupants within those vehicles. Overall, there were very high restraint usage rates (>99% of sampled children) but fewer than one quarter of children were using the correct size-appropriate restraints. Incorrect use (51.4%) was as common as inappropriate use (51.2%). Incorrect use was highest among users of dedicated child restraint systems (OR 16.0, 95% CI 6.9-36.0), and was more likely among those using size-appropriate restraints than those using inappropriate restraints (OR 1.8 95% CI 1.1-3.2); and among convertible restraints than those designed for a single mode of use (OR 1.5 95% CI 1.2-1.7). As incorrect use substantially reduces the protection from injury that is offered by child restraints, it is important that future strategies to reduce casualties among child occupants target both inappropriate and incorrect use. © 2010 Elsevier Ltd. All rights reserved.
- Authors: Brown, Julie , Hatfield, Julie , Du, Wei , Finch, Caroline , Bilston, Lynne
- Date: 2010
- Type: Text , Journal article
- Relation: Accident Analysis and Prevention Vol. 42, no. 6 (2010), p. 2144-2148
- Relation: http://purl.org/au-research/grants/nhmrc/565900
- Full Text:
- Reviewed:
- Description: This cross-sectional study provides population-referenced data on the restraints used and the extent of incorrect restraint use, among child vehicle passengers aged 0-12 years in NSW, Australia. A multistage stratified cluster sampling plan was used to randomly select vehicles from baby/child health clinics, pre-schools/day care centres, and primary schools across NSW to undergo detailed inspection of restraints used by child occupants within those vehicles. Overall, there were very high restraint usage rates (>99% of sampled children) but fewer than one quarter of children were using the correct size-appropriate restraints. Incorrect use (51.4%) was as common as inappropriate use (51.2%). Incorrect use was highest among users of dedicated child restraint systems (OR 16.0, 95% CI 6.9-36.0), and was more likely among those using size-appropriate restraints than those using inappropriate restraints (OR 1.8 95% CI 1.1-3.2); and among convertible restraints than those designed for a single mode of use (OR 1.5 95% CI 1.2-1.7). As incorrect use substantially reduces the protection from injury that is offered by child restraints, it is important that future strategies to reduce casualties among child occupants target both inappropriate and incorrect use. © 2010 Elsevier Ltd. All rights reserved.
Statistical modelling for falls count data
- Ullah, Shahid, Finch, Caroline, Day, Lesley
- Authors: Ullah, Shahid , Finch, Caroline , Day, Lesley
- Date: 2010
- Type: Text , Journal article
- Relation: Accident Analysis and Prevention Vol. 42, no. 2 (2010), p. 384-392
- Relation: http://purl.org/au-research/grants/nhmrc/565900
- Full Text:
- Reviewed:
- Description: Falls and their injury outcomes have count distributions that are highly skewed toward the right with clumping at zero, posing analytical challenges. Different modelling approaches have been used in the published literature to describe falls count distributions, often without consideration of the underlying statistical and modelling assumptions. This paper compares the use of modified Poisson and negative binomial (NB) models as alternatives to Poisson (P) regression, for the analysis of fall outcome counts. Four different count-based regression models (P, NB, zero-inflated Poisson (ZIP), zero-inflated negative binomial (ZINB)) were each individually fitted to four separate fall count datasets from Australia, New Zealand and United States. The finite mixtures of P and NB regression models were also compared to the standard NB model. Both analytical (F, Vuong and bootstrap tests) and graphical approaches were used to select and compare models. Simulation studies assessed the size and power of each model fit. This study confirms that falls count distributions are over-dispersed, but not dispersed due to excess zero counts or heterogeneous population. Accordingly, the P model generally provided the poorest fit to all datasets. The fit improved significantly with NB and both zero-inflated models. The fit was also improved with the NB model, compared to finite mixtures of both P and NB regression models. Although there was little difference in fit between NB and ZINB models, in the interests of parsimony it is recommended that future studies involving modelling of falls count data routinely use the NB models in preference to the P or ZINB or finite mixture distribution. The fact that these conclusions apply across four separate datasets from four different samples of older people participating in studies of different methodology, adds strength to this general guiding principle. © 2009 Elsevier Ltd. All rights reserved.
- Authors: Ullah, Shahid , Finch, Caroline , Day, Lesley
- Date: 2010
- Type: Text , Journal article
- Relation: Accident Analysis and Prevention Vol. 42, no. 2 (2010), p. 384-392
- Relation: http://purl.org/au-research/grants/nhmrc/565900
- Full Text:
- Reviewed:
- Description: Falls and their injury outcomes have count distributions that are highly skewed toward the right with clumping at zero, posing analytical challenges. Different modelling approaches have been used in the published literature to describe falls count distributions, often without consideration of the underlying statistical and modelling assumptions. This paper compares the use of modified Poisson and negative binomial (NB) models as alternatives to Poisson (P) regression, for the analysis of fall outcome counts. Four different count-based regression models (P, NB, zero-inflated Poisson (ZIP), zero-inflated negative binomial (ZINB)) were each individually fitted to four separate fall count datasets from Australia, New Zealand and United States. The finite mixtures of P and NB regression models were also compared to the standard NB model. Both analytical (F, Vuong and bootstrap tests) and graphical approaches were used to select and compare models. Simulation studies assessed the size and power of each model fit. This study confirms that falls count distributions are over-dispersed, but not dispersed due to excess zero counts or heterogeneous population. Accordingly, the P model generally provided the poorest fit to all datasets. The fit improved significantly with NB and both zero-inflated models. The fit was also improved with the NB model, compared to finite mixtures of both P and NB regression models. Although there was little difference in fit between NB and ZINB models, in the interests of parsimony it is recommended that future studies involving modelling of falls count data routinely use the NB models in preference to the P or ZINB or finite mixture distribution. The fact that these conclusions apply across four separate datasets from four different samples of older people participating in studies of different methodology, adds strength to this general guiding principle. © 2009 Elsevier Ltd. All rights reserved.
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