Introduction The aim was to determine the prevalence of alcohol‐related presentations to an emergency department (ED) in a major Australian hospital, through a novel surveillance approach using two biomarkers, blood ethanol and phosphatidylethanol (PEth). Methods Observational study using secondary testing of blood samples collected during routine clinical care of ED patients presenting to the Royal Brisbane and Women's Hospital in Queensland, Australia, between 22 January and 2 February 2021. Data were collected from 1160 patients during the 10‐day study period. The main outcomes were the prevalence of acute alcohol intake, as determined by blood ethanol, and recent use over 2–4 weeks, as determined by PEth concentrations, for all ED presentations and different diagnostic groups. Results The overall prevalence for blood ethanol was 9.3% (95% confidence interval [CI] 7.8%, 11.1%), 5.3% for general medical presentations, increasing four‐fold to 22.2% for injury presentations. The overall prevalence of PEth positive samples was 32.5% (95% CI 29.9%, 35.3%) and 41.4% for injury presentations. There were 263 (25.3%) cases that tested negative for acute blood ethanol but positive for PEth concentrations indicative of significant to heavy medium‐term alcohol consumption. Discussion and Conclusions This novel surveillance approach demonstrates that using blood ethanol tests in isolation significantly underestimates the prevalence of medium‐term alcohol consumption in ED presentations. Prevalence of alcohol use was higher for key diagnostic groups such as injury presentations. Performing periodic measurement of both acute and medium‐term alcohol consumption accurately and objectively in ED presentations, would be valuable for informing targeted public health prevention and control strategies.
IntroductionAlcohol use in patients presenting to the emergency department (ED) is a significant problem in many countries. There is a need for valid and reliable surveillance of the prevalence of alcohol use in patients presenting to the ED, to provide a more complete picture of the risk factors and inform targeted public health interventions. This PACE study will use two biomarkers, blood ethanol and phosphatidylethanol (PEth), to determine the patterns, presence and level of alcohol use in patients presenting to an Australian ED.Methods and analysisThis is an observational prevalence study involving the secondary use of routinely collected blood samples from patients presenting to the Royal Brisbane and Women’s Hospital (RBWH) Emergency and Trauma Centre (ETC). Samples will be tested for acute and medium-term alcohol intake using the two biomarkers blood ethanol and PEth respectively, over one collection period of 10–12 days. Descriptive statistics such as frequencies, percentages, means, SD, medians and IQRs, will be used to describe the prevalence, pattern and distribution of acute and medium-term alcohol intake in the study sample. The correlation between acute and medium-term alcohol intake levels will also be examined.Ethics and disseminationThis study has been approved by the RBWH Human Research Ethics Committee (reference, LNR/2019/QRBW/56859). Findings will be disseminated to key stakeholders such as RBWH ETC, Australasian College for Emergency Medicine, Royal Australasian College of Surgeons, Statewide Clinical Networks, and used to inform clinicians and hospital services. Findings will be submitted for publication in peer-reviewed journals and presentation at appropriate conferences.
BackgroundRoad crossing is a complex activity and children’s risk of pedestrian crashes is greater due to their underdeveloped perceptual and cognitive skills.This project involved the design and evaluation of a child pedestrian safety campaign, guided by an Extended Theory of Planned Behaviour. The evaluated component consisted of a short (30 sec) video that sought to raise parental road safety awareness and deliver the safety message that parents should hold children’s hands in carparks and while crossing the road.Methods400 parents of children 3–9 years responded to an on-line survey. Parents were randomly assigned to either Intervention (n = 200) or Control (n = 200) groups. Both groups received the same attitudinal and demographic questions. Intervention parents also viewed a 30 sec safety message video and received questions about message interpretation, acceptance, and intentions to perform the suggested behaviour (holding hands).ResultsFollowing one-off exposure to the video, though not statistically significant, the Intervention group reported stronger intentions to hold their child’s hand when crossing a road (M = 4.78, SD = 0.55), or in a carpark (M = 4.73, SD = 0.63) in the coming month, than parents in the Control group (M 4.71, SD = 0.62 and M = 4.72, SD = 0.54 respectively). Also, the Intervention group reported higher levels of Perceived Behavioural Control (roads, M = 4.63, SD = 0.55; carparks, M = 4.65, SD = 0.57) than parents in the Control group (roads, M = 4.51, SD = 0.61; carparks, M = 4.54, SD = 0.60).Intervention group parents reported the video was appropriate in content (M = 4.39, SD = 0.74) and tone (M = 4.19, SD = 0.80), and that they were likely to adopt the strategy presented (M = 4.20, SD = 0.96), which they reported as effective (M = 4.04, SD = 0.92).ConclusionsAlthough parental intentions were high in both groups, these findings provide some support for the persuasiveness of the campaign video. Intervention group parents reported consistently higher intentions to hold their children’s hands, and believed that this strategy was something that they could enact easily. The implications of these findings on future research and practice for child pedestrian safety are discussed.
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