1,721,120 research outputs found

    Prof Shanthi Ameratunga

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    Unintentional falls at home among young and middle-aged adults: the influence of alcohol

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    Aim To investigate the epidemiology of unintentional fall-related injuries at home among young and middle-aged adults (25 to 59 years) and to investigate the contribution of alcohol to these injuries. Methods Routinely collected national fall injury data were analysed to describe the incidence and characteristics of falls at home resulting in death or hospital inpatient treatment among this age group in New Zealand. A systematic review of the published literature evaluated the epidemiological evidence quantifying the risk of falls associated with acute and usual alcohol consumption in this age group. A population-based case-control study was conducted in Auckland, New Zealand over a 12-month period. Cases were 335 people aged 25 to 59 years who were admitted to hospital or died as a result of unintentional non-occupational falls at home. Controls were 352 people randomly selected from the electoral roll from the same age group as the cases. The participants or next-of-kin completed a structured interview to ascertain data on personal and lifestyle factors including alcohol consumption. Findings The review of national injury data found that almost a third of unintentional falls resulting in an in-patient admission among working-age people were recorded as occurring at home. For every death there were about 150 in-patient hospital admissions. The systematic review identified only a small number of studies but showed an increased risk of unintentional falls in this age group with increasing exposure to alcohol use. The magnitude of this risk varied considerably across studies with most estimates being relatively imprecise. There was modest evidence of a dose-response relationship with acute alcohol use. The association between usual alcohol use and fall risk was inconclusive. The case-control study revealed that after controlling for confounding, the consumption of two or more standard alcoholic drinks in the preceding six hours relative to none is associated with a significantly increased risk of fall-related injury. Approximately 21% of unintentional non-occupational falls at home in this population was attributed to this risk. No association between hazardous drinking as a usual pattern and falls was found when the analyses were adjusted for confounders. Conclusion A significant proportion of unintentional fall-related injuries among the working-aged New Zealanders occur at home. Consuming two or more drinks in the previous six hours was strongly associated with unintentional non-occupational falls at home that result in admission to hospital or death in this age group. This largely unrecognised problem should be addressed in further research and in falls prevention programmes

    Rehabilitation of the injured child

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    Caregiver reports of children’s activity participation following serious injury

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    Paediatric trauma can result in significant levels of on-going disability. The aim of this study was to explore the restrictions on activity participation that children experience following serious injury from the perspective of their caregivers. We performed a thematic analysis of transcripts of semi-structured in-depth interviews with the caregivers of 44 seriously injured children, conducted three-years after the injury, and purposively sampled from a population-based cohort study. Both temporary and on-going restrictions on school, sport, leisure and social activities were identified, some of which were imposed by caregivers, schools, or recommended by health providers. The perceived risk of further injury, physical restrictions, emotional state and fatigue levels were important influences on degrees of activity restriction. Children who were socially less engaged, especially those who were more severely injured, had difficulty making and retaining friends, and exhibited signs of depression or social withdrawal. The activities of pre-school children were strongly regulated by their caregivers, while school age children faced obstacles with participation in aspects such as study, sport, and peer and teacher relationships, affecting learning, school attendance and enjoyment. The findings highlight the need for primary prevention and reducing the impacts of serious injury throughout the continuum of care.Sandra Braaf, Shanthi Ameratunga, Warwick Teague, Helen Jowett and Belinda Gabb

    Going Beyond Counting First Authors in Author Co-citation Analysis

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    The present study examines one of the fundamental aspects of author co-citation analysis (ACA) - the way co-citation counts are defined. Co-citation counting provides the data on which all subsequent statistical analyses and mappings are based, and we compare ACA results based on two different types of co-citation counting - the traditional type that only counts the first one among a cited work's authors on the one hand and a non-traditional type that takes into account the first 5 authors of a cited work on the other hand. Results indicate that the picture produced through this non-traditional author co-citation counting contains more coherent author groups and is therefore considerably clearer. However, this picture represents fewer specialties in the research field being studied than that produced through the traditional first-author co-citation counting when the same number of top-ranked authors is selected and analyzed. Reasons for these effects are discussed

    Variations on the Author

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    “Variations on the Author” discusses two of Eduardo Coutinho’s recent films (Um Dia na Vida, from 2010, and Últimas Conversas, posthumously released in 2015) and their contribution to the general question of documentary authorship. The director’s filmography is characterized by a consistent yet self-effacing form of authorial self-inscription: Coutinho often features as an interviewer that rather than express opinions propels discourses; an interviewer that is good at listening. This mode of self-inscription characterizes him as an author who is not expressive but who is nonetheless markedly present on the screen. In Um Dia na Vida, however, Coutinho is completely absent form the image, while Últimas Conversas, on the contrary, includes a confessional prologue that moves the director from the margins to the center of his films. This article examines the ways in which these works stand out in the filmography of a director who offers new insights into the notion of cinematic authorship
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