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Biomedical subjects

J D Langley

Publications and source records attributed to J D Langley.

At least 19 recordsLinked to original sources
PubMed1992

Motor vehicle road crashes during the fourteenth and fifteenth years of life.

From a sample of 848 teenagers, 50 individuals reported a total of 52 motor vehicle road crash events: 42 involved a car, six a motorcycle, and four a bus, over a two year period. Males and females were equally represented in each type of crash. Twenty-one of the car crashes, four of the motorcycle crashes and three of the bus crashes involved injury. The injuries sustained in the motorcycle crashes were predominantly to the extremities and in the other crashes they were mainly to the head or face. On average drivers less than 25 years of age had more passengers in their cars and were involved in more nighttime crashes. A seat belt was worn in only 18 (44%) of the car crashes. A motorcycle helmet was worn in four of the six motorcycle crashes. Six (15%) crashes were reported to have involved alcohol. The main areas of risk associated with motor vehicle road crashes involving teenagers and young adults have been addressed by legislation or the graduated drivers' licensing system. An evaluation of these measures is required to establish whether they are effective.

Accidents, Traffic↗
PubMed1992

Incidence of facial fractures resulting in hospitalisation in New Zealand from 1979 to 1988.

The incidence and aetiology of facial fractures resulting in admission to public hospitals in New Zealand in 1987 were investigated retrospectively from data collected by the Health Statistical Services. Data were analysed by the age group, ethnic origin and gender of those affected. During 1987 the overall incidence of facial fractures was 47.9/100,000 of the population. The highest incidence was for Maori males at 152/100,000. A comparison with data for the period 1979 to 1988 showed a decrease for the population as a whole but an increase for those who declared themselves to be Maori. Assault was the most common cause of facial fractures resulting in hospitalisation for both males and females. Sport was the second most common cause of facial fractures with rugby football contributing two-thirds of these. These results indicate where future preventive measures should be targeted.

Adolescent↗
PubMed1992

Motorcycling attitudes and behaviours. I. 12 and 13 year old adolescents.

The death and serious injury of adolescent motorcyclists is a major public health problem. Effective preventive strategies depend on knowledge about target populations. The attitudes and patterns of exposure to motorcycling of 730 13 year old New Zealand adolescents are described. Fifty-two per cent could ride a motorcycle, a further 13% intended to learn, 22% had driven on-road, and 60% had ridden as pillion passengers on-road. Significantly more males than females were riders (P less than 0.001) and had ridden as pillion passengers (P less than 0.05). More male than female non-riders intended to learn (P less than 0.001). Eighty per cent of the sample recognized road 'accidents' as the main cause of death for their peers, and 31% had known a motorcyclist killed or injured. Seventeen per cent of on-road riders had not worn a helmet when last riding. Few statistically significant differences in risk perception were obtained between males and females or riders and non-riders. Preventive options are discussed.

Accidents, Traffic↗
PubMed1992

Cycling health beliefs, crash experiences and night cycling behaviour of 13 year olds.

The relationship of selected health beliefs to self-reported crash experiences, cycling at night and the use of tail-lights at night was examined for a sample of 730 13 years olds. The questions relating to cycling health beliefs were similar to those asked by Weinstein in his study of unrealistic optimism about susceptibility to a range of health problems. They included: vulnerability, worry, controllability, chance, barriers, seriousness, apprehension and safety. The majority of 13 year olds interviewed did not exhibit a strong optimistic bias regarding their vulnerability and skills as safe cyclists. In general the majority considered a crash involving a car would most likely be serious and only a minority said they were not worried about being involved in such a crash. In addition, the majority did not consider that crashes are a matter of chance or that there are significant barriers to adopting safety measures. They tended to consider the chances of being apprehended by a traffic officer for failure to use a tail-light at night as being low. Overall the univariate analyses failed to show a consistent pattern of relationships between health beliefs and the two cycling behaviours. The same was true for crash experiences. The joint effects of beliefs and crash experience on the use of a light at night were examined using logistic regression. The results suggest that the health beliefs work in an additive way as far as boys are concerned, but that they have very little influence on the behaviour of girls. The model for boys suggests that the variables have a relatively small influence on behaviour.

Accidents, Traffic↗
PubMed1992

Motorcycling attitudes and behaviours. II. 14 and 15 year old adolescents.

Of 846 adolescents interviewed near their 15th birthday, 51% could drive a motorcycle. A further 13% intended to learn. Drivers reported friends (mean age 16.5 years) as the most common source of instruction. Forty-four per cent of drivers and 69% of intending learners planned to apply for licences. Thirty-five per cent of the sample had driven or ridden as passengers on a motorcycle on-road in the past year and 85% of these had worn a helmet on the last occasion. The commonest cause of injuries to motorcyclists resulting in hospitalization (lower limb injury) was correctly identified by 52% of the sample. Fear of injury was the reason given for not learning to ride by 55% of confirmed non-drivers. Fifteen medically treated motorcycling injuries were reported for a 2-year recall period. Females reported significantly less exposure and less use of protective clothing than males. The issues of initiation, training, constraints on use and preventive strategies are discussed.

Accidents, Traffic↗
PubMed1991

Bicycle road crashes during the fourteenth and fifteenth years of life.

From a sample of 848 teenagers 57 individuals reported a total of 62 bicycle road crashes, 40 (65%) of which involved injury to a cyclist. Thirty (48%) of the crashes occurred when the cyclist lost control of the bicycle (73% of which involved injury) and 17 crashes (27%) involved a moving motor vehicle (41% of which involved injury). The majority of the injuries were not serious and of those with multiple injuries no one had an injury severity score greater than five. The body area most frequently injured was the extremities (74%), with the remainder primarily head injuries. Environmental conditions were not a major contributing factor in these crashes. In only five cases the cyclist was wearing a safety helmet. Recommended measures to prevent, or minimise, bicycle related injuries include the wearing of safety helmets, bicycle maintenance checks, and road safety awareness instruction.

Accident Prevention↗
PubMed1991

Adolescents' sporting and leisure time physical activities during their 15th year.

Participation in physical activity may influence health outcomes, so its quantification is important. There is little data on adolescent physical activities. Recall of physical activity in the preceding year was obtained from a birth cohort of 799 fifteen-year-old adolescents in New Zealand using a modified version of the Minnesota Leisure Time Activities Questionnaire. Mean total participation times were relatively high, with 612 hrs/year (1.68 hrs/day) for males and 401 hrs/year (1.1 hrs/day) for females. Individual total participation ranged from less than a minute to 6.5 hrs/day. Over 10% more females than males reported netball, equestrian activities, and dancing, and at least 10% more males reported cricket, rugby, fishing, soccer, squash, golf, and surfing. Ranked by mean participation time, equestrian activity was highest for females and walking was highest for males. Cycling and swimming represented the largest proportion of total group participation time. The sample will be followed up at age 18 years.

Adolescent↗
PubMed1990

Road crash experiences during the fourteenth and fifteenth years of life: an overview.

From a sample of 848 teenagers, 113 individuals had experienced 121 road traffic crashes. Five of the incidents involved a pedestrian, 62 a bicyclist, six a motor cyclist, 47 a motor vehicle passenger and one a motor vehicle driver. Sixty-two percent of the crashes involved injury and 67% vehicle immobilisation. Five of the injured teenagers were admitted to hospital but the majority (55%) were treated at a hospital accident and emergency department and then discharged. The official reporting of the crashes to the Ministry of Transport was examined and the problems of underreporting and biases in reporting are discussed.

Accidents, Traffic↗
PubMed1990

Serious unintentional injuries associated with architectural glass.

Injuries associated with architectural glass have become a matter of considerable concern in recent years. Despite this concern there has been no attempt to document either the extent of the problem in New Zealand or the circumstances under which these events occur. In this study, national injury mortality data for the period 1977-86 were examined and cases selected if the cause of death was attributable to an event involving architectural glass. A total of nine deaths were identified. All discharges from New Zealand public hospitals during 1986 were examined to identify victims who had been treated for injuries associated with architectural glass. Descriptive information contained on each patient record was coded to provide more specific information on the circumstances of injury. A total of 501 first admissions to hospital were identified, giving an incidence rate of 15 per 100,000 persons per year. The highest rate of 60 per 100,000 per year, was found for males in the age group 15-24 years. Seventy-eight percent of the events involved males, 62% occurred at home, 64% involved windows, and 32% involved doors. Ninety-three percent of the injuries were open wounds. Seventy-nine percent of the injuries were to the upper limbs, 13% were to lower limbs and 5% were to the head. The mean length of stay in hospital was 3.3 days. Opportunities for injury prevention are discussed including visual and physical barriers, mandatory glazing standards and public education. Specific areas requiring further research are identified.

Accident Prevention↗
PubMed1990

Injuries in the 14th and 15th years of life.

From a sample of 849 adolescents studied at age 15, 429 had been involved in 657 separate incidents, which resulted in 705 acute injuries requiring medical attention during their 14th and 15th years of life. The most common injuries were sprains, strains, fractures and lacerations, and the most common body site was the finger. The majority of injuries were of minor severity. Striking against an object or person was the most common incident resulting in injury, followed by being struck by an object or person, and overexertion or strenuous movement. Approximately half of the injuries were incurred during sport or a similar physical activity. Sporting injuries are examined in detail and preventive measures discussed.

Adolescent↗
PubMed1990

Unintentional injuries to students at school.

Unintentional injuries at school have been identified as a significant public health problem. A major barrier to the development of injury prevention policy has been the absence of national data on the circumstances of injuries to students which occur at school. This study sought to determine the incidence, nature, and circumstances of injuries which resulted in death or hospitalization. Fatalities were identified from national mortality data for 1977-86 inclusive. Coroners' files were then examined to obtain details of the circumstances of injury. Hospitalization cases were identified from the national hospital discharge summary for 1986. Fifteen fatalities were identified. The circumstances of the deaths were diverse with the most frequent event being a fall (n = 4). A total of 1013 first admissions to hospital were identified, giving an overall incidence rate of 152/100,000 students/year. Injury rates declined with increasing age, and males had higher rates than females for all ages. Fractures of the upper and lower limbs and intracranial injury represented more than three-quarters of all injury. The two leading causes of injury, falls, and incidents involving striking against or being struck by a person or object, represented 89% of all incidents. The use of playground equipment and involvement in sporting activity were two of the more common aspects of many injury events. The results suggest that prevention policy should place emphasis on those in their first 2 years of schooling, falls from playground equipment, provision of protective equipment for sporting activities, sporting activities designed to minimize physical contact, establishment of standardized injury referral procedures, first-aid training, and a standardized injury reporting system.

Adolescent↗
PubMed1990

Epidemiology of playground equipment injuries resulting in hospitalization.

Preparation of the New Zealand Playground Standard was seriously hampered by a lack of published information on the incidence, nature, and circumstances of playground equipment-related injuries. The present study was aimed at redressing this lack of information. Examination of all discharges from New Zealand public hospitals for 1984 identified 1125 children less than 15 years of age who had been admitted for the treatment of playground equipment-related injury. This gave an incidence rate of 137/100,000 children per year. The mean age was 7.2 years. The commonest injury was fracture of the upper limb (48%), followed by intracranial injury (26%). One-third occurred at school, climbing apparatus (40%) was most often involved, and the great majority involved falls (93%). With this study it has been possible for the first time in any country to report an incidence rate for all causes of playground equipment-related injuries resulting in hospitalization, based on data for an entire population. The findings support the emphasis placed on falls in the Standard.

Adolescent↗
PubMed1990

Purposely self-inflicted injury resulting in death and hospitalisation in New Zealand.

Purposely self-inflicted injury is the second most common cause of injury death in New Zealand and is also a major cause of hospitalisation. Despite the significance of the problem there has been relatively little research undertaken in New Zealand. Injury mortality and morbidity data files for 1984 were examined and upgraded to provide as comprehensive an overview of this injury problem as the data would permit. The results show that the fatality rate was highest amongst the elderly, and males had higher death rates than females for all ages. In contrast to this, hospitalisation rates peaked among the 15-20 year olds and females had higher rates than males for all ages. Whereas Maori had a significantly lower fatality rate than non-Maori the converse was the case for hospitalisation. A more consistent effect occurred for marital status, the married group had significantly lower fatality and hospitalisation rates than the non-married group. The major occupational group "production, transport and labourers" had the highest mortality rate, whereas service workers, in particular house staff, had the highest rate of morbidity. Whereas hanging was the most common method (33%) used in fatal injury events, poisoning was the most common method (91%) used for those events which resulted in hospitalisation. In the latter case, psychotropic agents, in particular tranquillisers, accounted for 50 per cent of all poisoning. These data show that mortality experience is not a reliable guide to injury morbidity experience. Prevention is discussed in the context of limiting the availability and lethality of agents.

Cause of Death↗
PubMed1989

Injury mortality and morbidity in New Zealand.

An overview of the injury problem in New Zealand is presented. National mortality and morbidity data demonstrate that relative to other diseases injuries represent a significant community health problem. Injuries are the fourth leading cause of death and account for 32% of Potential Years of Life Lost between the ages of 1 and 70. Injuries are the second leading cause of hospital admission and account for nearly 12% of all admissions. Injury rates vary dramatically by age, sex, socioeconomic status, and race. In general, males, particularly those 20-24 years old, have higher death and hospitalisation rates than females. A notably exception is elderly females, who have a hospitalisation rate nearly twice as high as elderly males. Maori and those from low socioeconomic levels have the highest injury rates. The leading causes of injury death are motor vehicle crashes (37%) and self-inflicted injury (21%). This contrasts to some extent with the two leading causes of hospitalisation, namely falls (25%) and motor vehicle crashes (19%). The road, home, and places of recreation and sport are the most common places of occurrence of serious injury. Head injuries, in particular concussions, and fractures of the lower limbs, particularly the femur, account for 35% of all injury morbidity. Treatment and rehabilitation costs for injuries that resulted in hospitalisations, visits to accident and emergency centres, and a claim on the Accident Compensation Corporation cost an average of $133 (1983) per head of population.

Accidental Falls↗
PubMed1989

Injuries in the 12th and 13th years of life.

From a sample of 850 adolescents, 377 were involved in 550 separate incidents which resulted in 636 injuries requiring medical attention. The most common injuries were sprains or strains, followed by fractures and lacerations. Most injuries were of minor severity. The most common incident resulting in injury was striking against an object or person, followed by being struck by an object or person, and overexertion or strenuous movement. Almost 40% of the incidents occurred during sporting or similar physical activities. Disabilities arising from injury are described. The most common of these were recreational. The implications of long-term and permanent disability are examined. Traditional attitudes toward injury prevention were found to be held by the majority of the sample. Barriers to injury prevention are identified and the Prevention of Injury Programme contained in the Health Education Syllabus for primary school children is described.

Accidents, Traffic↗
PubMed1989

Parents' reports of disability among 13 year olds: preliminary experiences with WHO's ICIDH.

Disability, as defined by the International Classification of Impairments Disabilities and Handicaps (ICIDH), was studied in a sample of 13 year olds (n = 831) who are involved in a longitudinal study of health, development and behaviour. The disability categories of ICIDH were used to develop a self-administered questionnaire for completion by parents, and 831 parents completed the questionnaire. The most common reported disabilities were: writing/spelling (26%), coping with dust/pollens or chemicals (15%), and coping with school work (15%). Eighty-one parents reported that their teenager had some circumstantial dependency; 49 of these mentioned medication that was associated with asthma management. Despite problems in the application of the disability categories of ICIDH, they were considered to provide a useful means by which to study disability systematically among teenagers.

Adolescent↗
PubMed1989

Recall of injury events by thirteen year olds.

The level of under-reporting of injury events which resulted in medical treatment was determined for a group of 631 thirteen-year olds. Two-year recall data was compared with the medical records of an accident and emergency department. Thirty-nine percent of all visits to the accident and emergency department were not recalled. Recall was shown to be related to the number of injury events, time elapsed since an injury event, type and severity of injury but not to whether the victim was hospitalized. Logistic regression analysis suggested that the recall of injury events depended on the type of injury sustained, time elapsed since the injury event, the number of injury events, and an interaction effect between the time and the number of injuries.

Adolescent↗