Ethnic variations in falls and road traffic injuries resulting in hospitalisation or death in Scotland: the Scottish Health and Ethnicity Linkage Study

Association of Hearing Status and Cognition With Fall Among the Oldest-Old Chinese: A Nationally Representative Cohort Study

OBJECTIVES

The oldest-old (aged ≥80 years) are the most rapidly growing population and age is related to hearing impairment (HI) and cognitive decline. We aimed to estimate the association between HI and fall, and the effect of different cognitive states on this association among the oldest-old Chinese population.

DESIGN

A total of 6931 Chinese oldest-old were included in the 2018 cross-cohort from the Chinese Longitudinal Healthy Longevity Survey (CLHLS). The presence of HI was identified by using a dichotomized metric of self-reported hearing status. Cognitive function was evaluated by using the modified Mini-Mental State Examination (MMSE). Cognitive impairment was defined as the MMSE score below 24 points. Data on fall history were collected by questionnaires survey from the participants or their relatives. We studied the association of hearing status and cognitive function with fall by using multivariable logistic regressions, upon adjustment of sociodemographic characteristics, lifestyles, and health conditions.

RESULTS

Our participants were aged 92 (range 80 to 117) on average, with 60.1% being women. In total, 39.1% of the participants had reported HI, 50.1% had cognitive impairment, and 26.2% had a history of falling. Participants with HI had a higher incidence of cognitive impairment (79.4%), as compared with their counterparts without HI (31.3%). Compared with those without HI, HI patients had a higher risk of falling after full adjustment for potential confounders (OR = 1.16 [95% confidence interval, CI, 1.01, 1.32], p = 0.031). In comparison with HI participants without cognitive impairment, HI patients with cognitive impairment had a higher fall risk (OR = 1.45 [95% CI = 1.23, 1.72], p < 0.001).

CONCLUSIONS

Association of hearing status and cognition with fall was, for the first time, examined on the basis of a nationally-representative oldest-old Chinese population. Poor cognitive performance was common in individuals with HI, and those with HI and cognitive impairment further increased the risk of falling.

Building an understanding of Ethnic minority people's Service Use Relating to Emergency care for injuries: the BE SURE study protocol

INTRODUCTION

Injuries are a major public health problem which can lead to disability or death. However, little is known about the incidence, presentation, management and outcomes of emergency care for patients with injuries among people from ethnic minorities in the UK. The aim of this study is to investigate what may differ for people from ethnic minorities compared with white British people when presenting with injury to ambulance and Emergency Departments (EDs).

METHODS AND ANALYSIS

This mixed methods study covers eight services, four ambulance services (three in England and one in Scotland) and four hospital EDs, located within each ambulance service. The study has five Work Packages (WP): (WP1) scoping review comparing mortality by ethnicity of people presenting with injury to emergency services; (WP2) retrospective analysis of linked NHS routine data from patients who present to ambulances or EDs with injury over 5 years (2016-2021); (WP3) postal questionnaire survey of 2000 patients (1000 patients from ethnic minorities and 1000 white British patients) who present with injury to ambulances or EDs including self-reported outcomes (measured by Quality of Care Monitor and Health Related Quality of Life measured by SF-12); (WP4) qualitative interviews with patients from ethnic minorities (n=40) and focus groups-four with asylum seekers and refugees and four with care providers and (WP5) a synthesis of quantitative and qualitative findings.

ETHICS AND DISSEMINATION

This study received a favourable opinion by the Wales Research Ethics Committee (305391). The Health Research Authority has approved the study and, on advice from the Confidentiality Advisory Group, has supported the use of confidential patient information without consent for anonymised data. Results will be shared with ambulance and ED services, government bodies and third-sector organisations through direct communications summarising scientific conference proceedings and publications.

Risky behavior analysis for cross-border drivers: A logit model and qualitative comparative analysis of odds of fault and injury vulnerability in Guangdong, Hong Kong and Macau

INTRODUCTION

Due to globalization and the acceleration of cross-border exchanges, cross-border risk behaviors have received widespread attention. Previous research has concluded that foreign cross-border drivers engage in relatively more risk-taking behavior patterns and are likely to experience a higher crash rate or be more inclined to cause severe crashes. However, there is little evidence on the comparison of drivers who belong to the same ethnic group driving across within-country borders.

METHOD

Based on the cross-border motor-vehicle crash reports in 2006-2010 from the Road Traffic Accident Database of the China Ministry of Public Security, this paper examines the risk factors of being at fault and getting killed or seriously injured in cross-border traffic crashes and casual paths toward crash liability and injury severity for Hong Kong and Macao drivers driving in the Chinese mainland.

RESULTS

There are extremely complex factors behind drivers from Hong Kong and Macao causing at-fault crashes or sustaining fatal and serious injuries in the Chinese mainland. Factors such as gender, age, illumination, and weather conditions do not individually affect the risk of driver at-fault crashes or severe casualties in the crashes among Hong Kong and Macao drivers driving in the Chinese mainland. Nonetheless, collectively, these factors influence them along with different vehicle types, roads, and environmental factors.

CONCLUSIONS

This paper provides more theoretical findings for understanding the compound effect of multiple risk factors involving cross-border at-fault crashes or serious casualties. The conclusions of this research are valuable as representative references for cross-border risk management policies.

PRACTICAL APPLICATIONS

To reduce the effects of different factors on cross-border risky driving behaviors and/or injurious crashes, various measures should be focused on, including specialized driver training, enhancement of the roads/environment, development of effective road safety campaigns, and directives facilitating cross-border cooperation in the field of road safety.

A bibliometric analysis of road traffic injury research themes, 1928-2018

Road traffic accidents have become an important social issue worldwide. This study aims to analyse the research status of road traffic injury from 1928 to 2018 and discuss the future research trends. Co-word analysis was applied to analyse 4,184 articles collected from the core collection of Web of Science. Cluster analysis and social network analysis (SNA) were adopted to group keywords, visualize the links between them, and indicate their importance. Strategic diagram was used to reveal the network status of each cluster. The results lead to the following conclusions: (1) 'Road traffic accident', 'injury', 'road safety', 'mortality', and 'risk factor' are at the centre of social network, indicating that these keywords play the most important roles in the field of road traffic injury research. (2) A total of 60 high-frequency keywords are divided into five clusters, namely 'accident causes leading to injury', 'analysis methods', 'health & injury', 'safety management', and 'road traffic', indicating that they are the main sub-fields of road traffic injury research. (3) 'Risk perception' and 'systems theory' are widely discussed topics emerging in recent years. On the basic of the five clusters, valuable references are provided for future research.