Access to advanced-level hospital care: differences in prehospital times calculated using incident locations compared with patients’ usual residence

Studies estimate that 84% of the USA and New Zealand’s (NZ) resident populations have timely access (within 60 min) to advanced-level hospital care. Our aim was to assess whether usual residence (ie, home address) is a suitable proxy for location of injury incidence. In this observational study, injury fatalities registered in NZ’s Mortality Collection during 2008–2012 were linked to Coronial files. Estimated access times via emergency medical services were calculated using locations of incident and home. Using incident locations, 73% (n=4445/6104) had timely access to care compared with 77% when using home location. Access calculations using patients’ home locations overestimated timely access, especially for those injured in industrial/construction areas (18%; 95% CI 6% to 29%) and from drowning (14%; 95% CI 7% to 22%). When considering timely access to definitive care, using the location of the injury as the origin provides important information for health system planning.

Migration Forecasting—Significance and Approaches

Migration is defined as the permanent change in an individual’s usual residence. Forecasting migration is an important requisite for population forecasts or for planning in fields that depend on the future size and structure of the population, such as economics, epidemiology, social insurance, or infrastructure. As migration is the most volatile of all demographic components, its modeling is especially difficult. International migration can be modeled and forecast very differently; users should be familiar with the flaws and strengths of these different approaches.

Impact of COVID-19 pandemic on hip fractures: the central London experience COVID-related urgent geriatric hip trauma (COUGH) study COVERT ( COVid Emergency-Related Trauma and orthopaedics) collaborative

Introduction COVID-19 has been recognized as the unprecedented global health crisis in modern times. The purpose of this study was to assess the impact of COVID-19 on treatment of neck of femur fractures (NOFF) against the current guidelines and meeting best practice key performance indicators (KPIs) according to the National Hip Fracture Database (NHFD) in two large central London hospitals. Materials and methods A multi-center, longitudinal, retrospective, observational study of NOFF patients was performed for the first ‘golden’ month following the lockdown measures introduced in mid-March 2020. This was compared to the same time period in 2019. Results A total of 78 cases were observed. NOFFs accounted for 11% more of all acute referrals during the COVID era. There were fewer overall breaches in KPIs in time to theatre in 2020 and also for those awaiting an orthogeriatric review. Time to discharge from the trust during the pandemic was improved by 54% (p < 0.00001) but patients were 51% less likely to return to their usual residence (p = 0.007). The odds ratio was significantly higher for consultant surgeon-led operations and consultant orthogeriatric-led review in the post-COVID era. There was no significant difference in using aerosol-generating anaesthetic procedures or immortality rates between both years. Conclusion The impact of COVID-19 pandemic has not adversely affected the KPIs for the treatment of NOFF patients with significant improvement in numerous care domains. These findings may represent the efforts to ensure that these vulnerable patients are treated promptly to minimize their risks from the coronavirus.

Population mobility, ‘usual residence’ and the census: the case of Australia’s grey nomads

No abstract

A Framework for Official Temporary Population Statistics

There is considerable demand for official statistics on temporary populations to supplement statistics on resident and working populations. Progress has been slow, with temporary population statistics not part of the standard suite of measures produced by national statistical offices. This article adopts the framework for official statistics proposed by Raymer and colleagues as a guide to aspects relating to society, concepts, data, processing, outputs and validation. The article proposes a conceptual framework linking temporary population mobility, defined as a move more than one night in duration that does not entail a change in usual residence, and temporary populations. Using Australia as an example, we discuss various dimensions of temporary mobility that complicate its measurement. We then report the outcomes of a survey of user needs for temporary population statistics along with a desktop review of OECD countries to identify the best formulation of temporary population statistics, and current international practice respectively. The article concludes by proposing two related concepts for temporary populations: population present and person-time, which overcome a number of issues currently impeding progress in this area and discuss their potential implementation.

On Revision of the UN Recommendations on Statistics of Migration (1998) and the Russian Context

The article discusses the reasons for the 1998 revision to the UN recommendations on international migration statistics and related issues. Over the past 20 years since the publication of the Recommendations, there have been major changes in the nature of migration, the priorities of migration policy and the need for adequate statistics. The UN Expert Group Meeting on Migration Statistics in July 2019 raised some critical issues related to difficulties in meeting the conditions set out in the 1998 Recommendations and the persistent significant differences between countries in the availability and quality of migration data.Special attention is paid to the most vulnerable provisions of the Recommendations - the concept of the place of usual residence and time criterion used to measure long-term migration. The article also considers draft guidelines on statistics of certain types of migration – forced, labor and circular- through which international organizations are trying to fill the gaps in the 1998 Recommendations. Final part of the article is devoted to the situation in Russian official statistics of migration after the transition to the new methodology of data collection. It is concluded that the intention to meet the conditions laid down in the 1998 Recommendations, not supported by the technological state of administrative sources, has created new problems. It is suggested that revised statistical standards should be more flexible. It is also necessary to take into account external factors that influence the work of national statistical services in the development of migration statistics.

CONVENTION ON CIVIL ASPECTS OF INTERNATIONAL CHILD ABDUCTION: AN ANALYSIS OF THE EXCEPTION ARTICLES 12 AND 13 “B” IN THE BRAZILIAN LEGAL SYSTEM

ABSTRACTThis is a study of the 1980 Convention on Civil Aspects of International Child Abduction, an instrument of protection of children in the international sphere, specifically when they are subjected to the change of usual residence, resulting from the act of retention or illegal transfer of the parent. The issues include the verification of the contents of two conventional articles, which lack subjectivity in the normative plan and allow the judge to dismiss the order of return of the child to the State of usual residence. The option for methodological verification consists of the case law verification of the topic, more thoroughly with regard as to how they are materialized in Brazilian practice.KEYWORDS: Application; Exception articles; Hague Convention; Interpretation; Jurisprudence.RESUMOTrata-se de um estudo da Convenção sobre Aspectos Civis do Sequestro Internacional de Crianças de 1980, instrumento de proteção da criança no plano internacional, especificamente quando esta se encontra submetida à mudança de residência habitual, decorrente do ato de retenção ou transferência ilícita do genitor(a). A problemática perpassa na verificação do teor de dois artigos convencionais, os quais carecem de objetividade no plano normativo e permitem que o julgador afaste a ordem de retorno da criança ao Estado de residência habitual. A opção metodológica verificativa consiste na averiguação jurisprudencial do tema, detidamente em como eles se materializam na prática brasileira.PALAVRAS-CHAVE: Aplicação; Artigos exceções; Convenção da Haia; Interpretação; Jurisprudência.

Elsewhere in Australia: a snapshot of temporary mobility on the night of the 2016 Census

Background Temporary population mobility, moves of more than one night’s duration that do not entail a change in usual residence, are an important feature of the Australian population surface. The ABS Census of Population and Housing (Census) provides a snapshot of temporary movements one night every five years. Aims This paper examines the intensity, age and spatial patterns of temporary movements captured at the 2016 Census, and creates a classification of regions based on the age profile of movers on Census nights. Data and methods 2016 Census data were extracted using ABS TableBuilder Pro. Summary metrics were calculated to measure the intensity and age profile of movements. Origin–destination flows were derived from a cross-classification of data on Place of Usual Residence and Place of Enumeration. A classification of regions (SA4s) was constructed from the age profile of movers at origins and at destinations. Results 1,142,005 individuals (about 5 per cent of the Australian population) were enumerated away from home on Census night 2016. Mobility peaked in younger (20–30) and older (65–70) age groups. Most movements were between capital city regions; however, resource regions and coastal areas were also implicated. The mobility surface was segmented by age: younger people dominated visits to cities and older movers comprise the majority of visitors to coastal areas, while remote areas had a significant proportion of visitors in the peak working ages. Conclusions Temporary population mobility is selective by age and sex and geographically segmented by these characteristics. Improved understanding of the attribute of visitors to regions can assist to formulate and validate estimates of temporary populations from emerging data sets.

A 10-year review of child injury hospitalisations, health outcomes and treatment costs in Australia

BackgroundChildhood injury is a leading cause of hospitalisation, yet there has been no comprehensive examination of child injury and survival over time in Australia. To examine the characteristics, temporal trend and survival for children who were hospitalised as a result of injury in Australia.MethodA retrospective examination of linked hospitalisation and mortality data for injured children aged 16 years or less during 1 July 2001 to 30 June 2012. Negative binomial regression examined change in injury hospitalisation trends. Cox proportional hazard regression examined the association of risk factors on 30-day survival.ResultsThere were 6 86 409 injury hospitalisations, with an age-standardised rate of 1489 per 1 00 000 population (95% CI 1485.3 to 1492.4) in Australia. Child injury hospitalisation rates did not change over the 10-year period. For every severely injured child, there are at least 13 children hospitalised with minor or moderate injuries. The total cost of child injury hospitalisations was $A2.1 billion (annually $A212 million). Falls (38.4%) were the most common injury mechanism. Factors associated with a higher risk of 30-day mortality were: child was aged ≤10 years, higher injury severity, head injury, injured in a transport incident or following drowning and submersion or other threats to breathing, during self-harm and usual residence was regional/remote Australia.ConclusionsChildhood injury hospitalisation rates have not reduced in 10 years. Children’s patterns of injury change with age, and priorities for injury prevention alter according to developmental stages. The development of a national multisectorial childhood injury monitoring and prevention strategy in Australia is long overdue.