Identification of incident poisoning, fracture and burn events using linked primary care, secondary care, and mortality data from England: implications for research and surveillance

Background: English national injury data collection systems are restricted to hospitalisations and deaths. With recent linkage of a large primary care database, the Clinical Practice Research Datalink (CPRD), with secondary care and mortality data we aimed to assess the utility of linked data for injury research and surveillance by examining recording patterns and comparing incidence of common injuries across data sources. Methods: The incidence of poisonings, fractures and burns was estimated for a cohort of 2,147,853 0-24 year olds using CPRD linked to Hospital Episode Statistics (HES) and Office for National Statistics (ONS) mortality data between 1997-2012. Time-based algorithms were developed to identify incident events, distinguishing between repeat follow-up records for the same injury, and those for a new event. Results: We identified 42,985 poisoning, 185,517 fracture and 36,719 burn events in linked CPRD-HES-ONS data; incidence rates were 41.9 per 10,000 person-years (95% confidence interval 41.4–42.4), 180.8 (179.8–181.7) and 35.8 (35.4–36.1), respectively. Of the injuries, 22,628(53%) poisonings, 139,662(75%) fractures, and 33,462(91%) burns were only recorded within CPRD. Only 16% of deaths from poisoning (n=106) or fracture (n=58) recorded in ONS were recorded within CPRD and/or HES records. None of the 10 deaths from burns were recorded in CPRD or HES records. Conclusion: It is essential to use linked primary care, hospitalisation and deaths data to estimate injury burden, as many injury events are only captured within a single data source. Linked routinely-collected data offer an immediate and affordable mechanism for injury surveillance and analyses of population based injury epidemiology in England

Injury during pregnancy and nervous system birth defects: Texas, 1999 to 2003

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/100279/1/bdra23143.pd

Access to the General Curriculum of Middle School Students with Mental Retardation: An Observational Study

The IDEA requires participation and progress in the general curriculum by all students. However, there is limited knowledge about the degree to which students with mental retardation have such access. This study examined the degree to which middle school students with mental retardation have access to the general curriculum and the impact of the classroom setting and the student's level of ability on such access. Findings indicated that students with mental retardation were most likely to participate with the general curriculum in the general education classroom and were less likely to engage in activities linked to a standard if they had more severe disabilities. Many students were engaged in activities in the general curriculum, but there was room for improvement in providing curricular modifications to promote access

Unintentional injuries in children with disabilities:a systematic review and meta-analysis

Children with disabilities are thought to have an increased risk of unintentional injuries, but quantitative syntheses of findings from previous studies have not been done. We conducted a systematic review and meta-analysis to assess whether pre-existing disability can increase the risk of unintentional injuries among children when they are compared to children without disability. We searched 13 electronic databases to identify original research published between 1 January 1990 and 28 February 2013. We included those studies that reported on unintentional injuries among children with pre-existing disabilities compared with children without disabilities. We conducted quality assessments and then calculated pooled odds ratios of injury using random-effects models. Fifteen eligible studies were included from 24,898 references initially identified, and there was a total sample of 83,286 children with disabilities drawn from the eligible studies. When compared with children without disabilities, the pooled OR of injury was 1.86 (95 % CI 1.65-2.10) in children with disabilities. The pooled ORs of injury were 1.28, 1.75, and 1.86 in the 0-4 years, 5-9 years, and ≥10 years of age subgroups, respectively. Compared with children without disabilities, the pooled OR was 1.75 (95 % CI 1.26-2.43) among those with International Classification of Functioning (ICF) limitations. When disability was defined as physical disabilities, the pooled OR was 2.39 (95 % CI 1.43-4.00), and among those with cognitive disabilities, the pooled OR was 1.77 (95 % CI 1.49-2.11). There was significant heterogeneity in the included studies. Compared with peers without disabilities, children with disabilities are at a significantly higher risk of injury. Teens with disabilities may be an important subgroup for future injury prevention efforts. More data are needed from low- and middle-income countries