Developing improved crash prevention approaches through in-depth investigation of motorcycle crash causation patterns.

Despite advancements in road safety, Powered Two-Wheelers (PTWs) remain a vulnerable group with disproportionately high crash rates. This paper presents an in-depth analysis of PTW crashes in six European countries, with a case study of Loss of Control in Curves (LoCC), to address the gap between crash causation and prevention. By examining crash causation factors and their linkage to prevention strategies, the study illustrates various approaches for connecting causes and countermeasures. These approaches, which are applicable to different crash scenarios, include looking forward in the crash causation chains, looking backward, looking at only the last cause (critical events), or the first cause, or following a systemic approach. The research introduces a set of guidelines following the safe system approach, aiming to enhance the understanding of crash prevention among policymakers. The systemic approach to countermeasures, bridges the shortcomings of traditional crash causation studies that may exhibit bias or a narrow focus on "root causes". The proposed approach emphasizes the need for a comprehensive view of crash scenarios (i.e., considering the entire crash causation chain or multiple causation chains) and ensuring that preventive measures address the full spectrum of the system. It also takes in to account external factors such as cost, benefits, and politics, leading to improved road safety outcomes. The study findings are significant for researchers, since it is a step forward in in-depth crash causation studies, as well as road practitioners and policymakers, in providing a strategic framework for more effective and efficient road safety interventions.

Root cause analysis and strategies for reducing falls among inpatients in healthcare facilities: A narrative review.

Background and Aims: Root Cause Analysis (RCA) is a systematic process which can be applied to analyze fall incidences in reactive manner to identify contributing factors and propose actions for preventing future falls. To better understand cause of falls and effective interventions for their reduction we conducted a narrative review of RCA and Strategies for Reducing Falls among Inpatients in Healthcare Facilities. Methods: In this narrative review, databases including Scopus, ISI Web of Science, Cochrane, and PubMed were searched to obtain the related literature published. Databases were searched from January 2005 until the end of March 2023. The Joanna Briggs Institute (JBI) tool was used for quality assessment of articles. To analyze the data, a five-stage framework analysis method was utilized. Results: Seven articles that fulfilled the inclusion criteria were identified for this study. All of the selected studies were interventional in nature and employed the RCA method to ascertain the underlying causes of inpatient falls. The root causes discovered for falls involved patient-related factors (37.5%), environmental factors (25%), organizational and process factors (19.6%), staff and communication factors (17.9%). Strategies to reduce falls involved environmental measures and physical protection (29.4%), identifying, and displaying the causes of risk (23.5%), education and culturalization (21.6%), standard fall risk assessment tool (13.7%), and supervision and monitoring (11.8%). Conclusion: the findings identify the root causes of falls in inpatient units and provide guidance for successful action plan execution. Additionally, it emphasizes the importance of considering the unique characteristics of healthcare organizations and adapting interventions accordingly for effectiveness in different settings.

[Drowning mortality in Catalonia (2019-2022)]. / Mortalidad por ahogamientos en Cataluña (2019-2022).

OBJECTIVE: Data on drownings tend to underestimate mortality from this cause. The objective of this study was to describe fatal drownings recorded in Catalonia between 2019 and 2022 through forensic sources, present their characteristics, and assess the utility of this information for monitoring drowning mortality. METHODS: A retrospective observational study based on the register of judicial deaths from the Institute of Legal Medicine and Forensic Sciences of Catalonia was carried out. Data on medicolegal aetiology, aquatic environment, age, gender, date of death, and municipality of origin were analysed. Statistical analysis was based on the comparison of proportions test based on Chi-square for categorical variables and the Mann Whitney U test for the comparison of numerical variables. RESULTS: A total of 310 drownings were recorded, with a mean age of 57.2 years and a male predominance (77.1%). The majority of drownings were unintentional (71.3%), followed by suicides (15.5%), and cases of undetermined intent (12.6%). Compared to intentional drownings, unintentional and undetermined intent drownings had a higher percentage of males than females (81.2% vs. 56%, p<0.001), and fewer cases with Spanish nationality than foreign or undetermined nationality (60% vs. 92%, p<0.001). Middle-aged and older individuals accounted for the majority of deaths, but among unintentional drownings, those recorded in pools included significantly higher percentages of children and adolescents aged zero-fourteen years than those occurring in natural waters. CONCLUSIONS: The results highlight the importance of drowning mortality in Catalonia and the need to strengthen preventive activities, especially for children and during episodes of intense heat. Medicolegal sources are useful for monitoring drowning mortality, but it would be beneficial if they incorporated information on variables such as place of residence and nationality.

OBJETIVO: Los datos sobre ahogamientos tienden a subestimar la mortalidad por esta causa. El objetivo de este estudio fue describir los ahogamientos mortales registrados en Cataluña entre 2019 y 2022 a través de fuentes forenses, mostrar sus características y valorar la utilidad de esta información para monitorizar la mortalidad por ahogamientos. METODOS: Se realizó un estudio observacional retrospectivo basado en el registro de muertes judiciales del Instituto de Medicina Legal y Ciencias Forenses de Cataluña. Se analizaron la etiología médico-legal, entorno acuático, edad, sexo, fecha de defunción y municipio de procedencia. El análisis estadístico se basó en la prueba de comparación de proporciones basada en Chi cuadrado para las variables categóricas y la prueba U de Mann Whitney para la comparación de variables numéricas. RESULTADOS: Se registraron 310 ahogamientos mortales, con una edad media de 57,2 años y predominio masculino (77,1%). La mayoría fueron no intencionales (71,3%), seguidos por suicidios (15,5%) y casos de intencionalidad indeterminada (12,6%). Comparados con los ahogamientos intencionales, los no intencionales y de intencionalidad indeterminada incluyeron más hombres que mujeres (81,2% frente a 56%, p<0,001), y menos casos con nacionalidad española que extranjera o indeterminada (60% frente a 92%, p<0,001). Las personas de mediana y avanzada edad aportaron la mayoría de las defunciones pero, entre los ahogamientos no intencionales, los registrados en piscinas incluyeron más niños y adolescentes de cero-catorce años que los que tuvieron lugar en aguas naturales. CONCLUSIONES: Los resultados prueban la importancia de los ahogamientos mortales en Cataluña y la necesidad de fortalecer las actividades preventivas, especialmente en la infancia y durante episodios de calor intenso. Las fuentes médico-forenses son útiles para monitorizar la mortalidad por ahogamientos, pero convendría que incorporaran variables como el lugar de residencia y la nacionalidad.

Button Battery Ingestion in Children: An Educational Review for Perioperative Nursing.

Button battery ingestion is potentially fatal, especially in children less than 6 years of age, most commonly due to esophageal perforation. The number of ingestions and complications has risen significantly in recent decades. Impacted button batteries should ideally be removed urgently within 2 hours of ingestion. However, many ingestions go unwitnessed, and children may present with variable, vague symptoms. The recommendation now is that children over the age 12 months consume honey when a button battery ingestion is witnessed or diagnosed, if less than 12 hours have elapsed. Importantly, though, honey should not be consumed if perforation is suspected. Induction of general anesthesia and battery removal should not be delayed to satisfy NPO guidelines, even if the child has eaten.

Hip and core exercise programme prevents running-related overuse injuries in adult novice recreational runners: a three-arm randomised controlled trial (Run RCT).

OBJECTIVE: This study aims to investigate the efficacy of two exercise interventions in reducing lower extremity (LE) injuries in novice recreational runners. METHODS: Novice runners (245 female, 80 male) were randomised into hip and core (n=108), ankle and foot (n=111) or control (n=106) groups. Interventions were completed before running and included exercise programmes focusing on either (1) hip and core or (2) ankle and foot muscles. The control group performed static stretching exercises. All groups were supervised by a physiotherapist and performed the same running programme. Injuries and running exposure were registered using weekly questionnaires during the 24-week study. Primary outcome was running-related LE injury. RESULTS: The incidence of LE injuries was lower in the hip and core group compared with the control group (HR 0.66; 95% CI 0.45 to 0.97). The average weekly prevalence of overuse injuries was 39% lower (prevalence rate ratio, PRR 0.61, 95% CI 0.39 to 0.96), and the prevalence of substantial overuse injuries was 52% lower (PRR 0.48, 95% CI 0.27 to 0.90) in the hip and core group compared with the control group. No significant difference was observed between the ankle and foot group and control group in the prevalence of overuse injuries. A higher incidence of acute injuries was observed in the ankle and foot group compared with the control group (HR 3.60, 95% CI 1.20 to 10.86). CONCLUSION: A physiotherapist-guided hip and core-focused exercise programme was effective in preventing LE injuries in novice recreational runners. The ankle and foot programme did not reduce LE injuries and did not protect against acute LE injuries when compared with static stretching.

Dental injuries in Swiss children - an analysis of Swiss national health insurance data from the year 2019.

This study, the first to analyze accident data from a major compulsory Swiss health insurer (Concordia), reviewed 5,063 dental accident reports of 122,370 children under the age of 16. The predominant cause of injury was a "fall," with "playing" being the foremost activity mentioned and "ground" identified as the primary object of impact. The analysis of the involved objects showed that dental injuries occur most frequently with scooters, bicycles, and stairs. In 2019, 8.14% of children aged one and insured by Concordia suffered a dental injury. By age 16, 58.8% of all children had experienced a dental injury. 0.72% had suffered a primary dentition crown fracture with pulp involvement. Regarding their permanent teeth, 0.21% suffered an avulsion, 0.84% another luxation injury, 0.65% a crown fracture with pulp involvement, and 0.16% a root fracture. A significant increase in injuries per day was observed after the summer holidays. On weekends, there were 28% fewer injuries per day on average than on weekdays. Despite differences among the cantons, the dataset can be considered to be representative for Switzerland. Accident descriptions were often too brief for detailed prevention strategies. Detailed accident information is essential for effective structural measures, which are more effective than promoting behavioural changes. A detailed recording could also be used to draw up a list of the objects frequently involved in accidents. An updated insurance form with an improved nomenclature, the option of digital submission, photo uploads and AI-supported data recording could greatly improve the quality and interpretability of injury data.

Analysis of road traffic accidents and casualties associated with electric bikes and bicycles in Guangzhou, China: A retrospective descriptive analysis.

Introduction: Electric bicycles (e-bikes) and bicycles in large Chinese cities have recently witnessed substantial growth in ridership. According to related accident trends, this study analyzed characteristics and spatial distribution in the period when e-bike-related accidents rapidly increased to propose priority measures to reduce accident casualties. Methods: For e-bike- and bicycle-related accident data from the Guangzhou Public Security Traffic Management Integrated System, linear regression was used to examine the trends in the number of accidents and age-adjusted road traffic casualties from 2011 to 2021. Then, for the period when e-bike-related accidents rapidly increased, descriptive statistics were computed regarding rider characteristics, illegal behaviors, road types, collision objects and their accident liability. One-way analysis of variance (ANOVA) followed by Bonferroni's multiple comparison test. P < 0.05 was considered statistically significant. Finally, the density distribution of accidents was presented, and Moran's I (MI) was used for assessing spatial autocorrelation. Hotspots were identified based on an optimized hotspot analysis tool. Results: Between 2011 and 2021, the number of accidents and casualty rate (per 100,000 population) increased for e-bikes but decreased for bicycles. After 2018, e-bike-related accidents increased rapidly, and bicycle-related accidents plateaued. Accident hotspots were concentrated in central city areas and suburban areas close to the former. Three-quarters of accidents occurred in motorized vehicle lanes. Most occurred on roads without physically segregated nonmotorized vehicle lanes. More than three-fifths of the accidents involved motor vehicles with at least four wheels. The prevalence (per 100 people) of casualties among e-bike rider victims and cyclist victims accounted for 92.0 % and 96.5 %, respectively. A total of 71.6 % of e-bike-related accidents involved migrant workers. Riding in motorized vehicle lanes was the most common illegal behavior. Conclusions: Although e-bike-related and bicycle-related accidents presented similar characteristics, the sharp increase in e-bike-related accidents requires attention. To improve e-bike safety, governments should develop appropriate countermeasures to prevent riders from riding on motorways, such as improving road infrastructure, adjusting the driver's license system and addressing priority control areas.

Factors related to the low-risk perception of driving after cannabis use.

INTRODUCTION: Modifying risk perceptions related to driving after cannabis use (DACU) could deter individuals from enacting this behavior, as low-risk perception is associated with DACU engagement. This study identified sociodemographic characteristics, substance use, other driving behaviors, peer norms, and psychological characteristics that are associated with lower risk perception regarding DACU. METHODS: Canadian drivers aged 17-35 who have used cannabis in the past year (n = 1,467) completed an online questionnaire. A multivariate linear regression model allowed for identifying variables associated with the low-risk perception of DACU (i.e. believing it to be safe as one's driving ability is not impaired by cannabis or by being high). RESULTS: Lower risk perception of DACU was associated with identifying as male, weekly to daily cannabis use, engagement in DACU, general risky driving behaviors, being a passenger of a driver who engages in DACU, number of friends who engage in DACU, and peer approval of DACU. Having driven under the influence of alcohol, living in urban areas, having received traffic tickets in the past three years, and declaring past-week irritability and cognitive problems were associated with holding a higher risk perception related to DACU. DISCUSSION: Road education and prevention programs should target attitudes and perceptions regarding risks shaped by sociocultural norms and past risky driving experiences. They need to reach out more specifically to drivers with the identified characteristics associated with the low-risk perception of DACU. These interventions can potentially help reduce the rate of individuals who engage in this behavior.

Relations Between Self-Reported Prescription Hydrocodone, Oxycodone, and Tramadol Use and Unintentional Injuries Among Those With Spinal Cord Injury.

OBJECTIVE: To identify the relations of 3 frequently used prescription opioids (hydrocodone, oxycodone, tramadol) with unintentional injuries, including fall-related and non-fall-related injuries among adults with chronic, traumatic spinal cord injury (SCI). DESIGN: Cross-sectional cohort study. SETTING: Community setting; Southeastern United States. PARTICIPANTS: Adult participants (N=918) with chronic traumatic SCI were identified from a specialty hospital and state population-based registry and completed a self-report assessment. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: Self-reported fall-related and non-fall-related unintentional injuries serious enough to receive medical care in a clinic, emergency room, or hospital within the previous 12 months. RESULTS: Just over 20% of participants reported ≥1 unintentional injury in the past year, with an average of 2.16 among those with ≥1. Overall, 9.6% reported fall-related injuries. Only hydrocodone was associated with any past-year unintentional injuries. Hydrocodone taken occasionally (no more than monthly) or regularly (weekly or daily) was related to 2.63 (95% confidence interval [CI], 1.52-4.56) or 2.03 (95% CI, 1.15-3.60) greater odds of having ≥1 unintentional injury in the past year, respectively. Hydrocodone taken occasionally was also associated with past-year non-fall-related injuries (OR, 2.20; 95% CI, 1.12-4.31). Each of the 3 opioids was significantly related to fall-related injuries. Taking hydrocodone occasionally was associated with 2.39 greater odds of fall-related injuries, and regular use was associated with 2.31 greater odds. Regular use of oxycodone was associated with 2.44 odds of a fall-related injury (95% CI, 1.20-4.98), and regular use of tramadol was associated with 2.59 greater odds of fall-related injury (95% CI, 1.13-5.90). CONCLUSIONS: Injury prevention efforts must consider the potential effect of opioid use, particularly hydrocodone. For preventing fall-related injuries, each of the 3 opioids must be considered.

Untethered Ultra-Wideband-Based Real-Time Locating System for Road-Worker Safety.

In order to reduce the accident risk in road construction and maintenance, this paper proposes a novel solution for road-worker safety based on an untethered real-time locating system (RTLS). This system tracks the location of workers in real time using ultra-wideband (UWB) technology and indicates if they are in a predefined danger zone or not, where the predefined safe zone is delimited by safety cones. Unlike previous works that focus on road-worker safety by detecting vehicles that enter into the working zone, our proposal solves the problem of distracted workers leaving the safe zone. This paper presents a simple-to-deploy safety system. Our UWB anchors do not need any cables for powering, synchronisation, or data transfer. The anchors are placed inside safety cones, which are already available in construction sites. Finally, there is no need to manually measure the positions of anchors and introduce them to the system thanks to a novel self-positioning approach. Our proposal, apart from automatically estimating the anchors' positions, also defines the limits of safe and danger zones. These features notably reduce the deployment time of the proposed safety system. Moreover, measurements show that all the proposed simplifications are obtained with an accuracy of 97%.

Prediction of the burden of road traffic injuries in Iran by 2030: Prevalence, death, and disability-adjusted life years.

PURPOSE: Road traffic accidents pose a global challenge with substantial human and economic costs. Iran experiences a high incidence of road traffic injuries, leading to a significant burden on society. This study aims to predict the future burden of road traffic injuries in Iran until 2030, providing valuable insights for policy-making and interventions to improve road safety and reduce the associated human and economic costs. METHODS: This analytical study utilized time series models, specifically autoregressive integrated moving average (ARIMA) and artificial neural networks (ANNs), to predict the burden of road traffic accidents by analyzing past data to identify patterns and trends in Iran until 2030. The required data related to prevalence, death, and disability-adjusted life years (DALYs) rates were collected from the Institute for Health Metrics and Evaluation database and analyzed using R software and relevant modeling and statistical analysis packages. RESULTS: Both prediction models, ARIMA and ANNs indicate that the prevalence rates (per 100,000) of all road traffic injuries, except for motorcyclist road injuries which have an almost flat trend, remaining at around 430, increase by 2030. Based on estimations of both models, the rates of death and DALYs due to motor vehicle and pedestrian road traffic injuries decrease. For motor vehicle road injuries, estimated trends decrease to approximately 520 DALYs and 10 deaths. Also, for pedestrian road injuries these rates reached approximately 300 DALYs and 6 deaths, according to the models. For cyclists and other road traffic injuries, the predicted DALY rates by the ANN model increase to almost 50 and 8, while predictions conducted by the ARIMA model show a static trend, remaining at 40 and approximately 6.5. Moreover, these rates for the prediction of death rate by the ANN model increased to 0.6 and 0.1, while predictions conducted by the ARIMA model show a static trend, remaining at 0.43 and 0.07. According to the ANN model, the predicted rates of DALY and death for motorcyclists decrease to 100 and approximately 2.7, respectively. On the other hand, predictions made by the ARIMA model show a static trend, with rates remaining at 200 and approximately 3.2, respectively. CONCLUSION: The prevalence of road traffic injuries is predicted to increase, while the death and DALY rates of road traffic injuries show different patterns. Effective intervention programs and safety measures are necessary to prevent and reduce road traffic accidents. Different interventions should be designed and implemented specifically for different groups of pedestrians, cyclists, motorcyclists, and motor vehicle drivers.

Self-management of Risk for the Prevention of Traffic Accidents from a Health Perspective: A Qualitative Study.

Introduction: In the world, deaths and injuries caused by traffic collisions have been considered a public health problem. In Colombia, 7.238 fatalities were recorded in 2021, with motorcycle riders representing the largest group of victims at 59.7%. Methods: The aim of this qualitative phenomenological study is to describe the risky experiences and deliberate actions of diverse road users that influence the self-management of the risk of traffic collisions. Results: Data were obtained from 22 participants: motorists, pedestrians and drivers. The content analysis describes various human conditions that affect self-management of the risk of traffic accidents, such as unsafe behaviors, non-compliance with traffic regulations by the different road actors, competitive culture among drivers, eagerness, among others. Additionally, factors related to care were determined: healthy recreational activities, promoting the value of one's own life and that of others, adequate time management and preventive behaviors by some road users. Conclusion: This research provides information on social and cultural aspects, experiences and risky behaviors of different road actors that influence the incidence of traffic accidents in Colombia.

Youth handball concussion prevention strategies: a workshop-based study with experts and end users.

Sport-related concussion (SRC) is a serious injury in youth team sports, including handball. While research on the prevention of SRC has made progress over the past 5 years, prevention strategies are lacking in handball. The aim was to explore and develop strategies focusing on information, rules and training that may prevent concussion in youth handball by incorporating knowledge from experts and end users. Using a participatory methodology, experts (physiotherapy, biomechanics: n=3) and end users (players, coaches, referees, coach educators: n=7) contributed their experience and knowledge in a 2-hour online workshop. Participants were given three videos illustrating typical high-risk concussion scenarios from handball games and a youth player's accompanying fictional written scenario. In group discussions inspired by the brainwriting method, participants were asked to provide ideas for possible SRC prevention strategies related to information, rules and/or training. Data were collected on a digital whiteboard and analysed using reflexive thematic analysis. Three themes were derived: (1) 'Coaches' responsibility: raise awareness of the risk of injury and act to promote safe environments'; (2) 'Players' responsibility: safe defence and attack'; and (3) 'Improvement of personal skills'. Experts and end users found information about high-risk situations and SRC symptoms, stricter rules and safe playing strategy training for goalkeepers, attacking and defending players, respectively, may effectively reduce SRC in handball. Information and stricter rules could be delivered through education and dissemination activities, whereas safe playing strategies should be trained at regular handball practice.

Improving Remedial Measures from Incident Investigations: A Study Across Ghanaian Mines.

Background: Learning from incidents for accident prevention is a two-stage process, involving the investigation of past accidents to identify the causal factors, followed by the identification and implementation of remedial measures to address the identified causal factors. The focus of past research has been on the identification of causal factors, with limited focus on the identification and implementation of remedial measures. This research begins to contribute to this gap. The motivation for the research is twofold. First, previous analyses show the recurring nature of accidents within the Ghanaian mining industry, and the causal factors also remain the same. This raises questions on the nature and effectiveness of remedial measures identified to address the causes of past accidents. Secondly, without identifying and implementing remedial measures, the full benefits of accident investigations will not be achieved. Hence, this study aims to assess the nature of remedial measures proposed to address investigation causal factors. Method: The study adopted SMARTER from business studies with the addition of HMW (H - Hierarchical, M - Mapping, and W - Weighting of causal factors) to analyse the recommendations from 500 individual investigation reports across seven different mines in Ghana. Results: The individual and the work environment (79%) were mostly the focused during the search for causes, with limited focus on organisational factors (21%). Forty eight percentage of the recommendations were administrative, focussing on fixing the problem in the immediate affected area or department of the victim(s). Most recommendations (70.4%) were support activities that only enhance the effectiveness of control but do not prevent/mitigate the failure directly. Across all the mines, there was no focus on evaluating the performance of remedial measures after their implementation. Conclusion: Identifying sharp-end causes leads to proposing weak recommendations which fail to address latent organisational conditions. The study proposed a guide for effective planning and implementation of remedial actions.

Validation and Improvement of the Saga Fall Risk Model: A Multicenter Retrospective Observational Study.

Purpose: We conducted a pilot study in an acute care hospital and developed the Saga Fall Risk Model 2 (SFRM2), a fall prediction model comprising eight items: Bedriddenness rank, age, sex, emergency admission, admission to the neurosurgery department, history of falls, independence of eating, and use of hypnotics. The external validation results from the two hospitals showed that the area under the curve (AUC) of SFRM2 may be lower in other facilities. This study aimed to validate the accuracy of SFRM2 using data from eight hospitals, including chronic care hospitals, and adjust the coefficients to improve the accuracy of SFRM2 and validate it. Patients and Methods: This study included all patients aged ≥20 years admitted to eight hospitals, including chronic care, acute care, and tertiary hospitals, from April 1, 2018, to March 31, 2021. In-hospital falls were used as the outcome, and the AUC and shrinkage coefficient of SFRM2 were calculated. Additionally, SFRM2.1, which was modified from the coefficients of SFRM2 using logistic regression with the eight items comprising SFRM2, was developed using two-thirds of the data randomly selected from the entire population, and its accuracy was validated using the remaining one-third portion of the data. Results: Of the 124,521 inpatients analyzed, 2,986 (2.4%) experienced falls during hospitalization. The median age of all inpatients was 71 years, and 53.2% were men. The AUC of SFRM2 was 0.687 (95% confidence interval [CI]:0.678-0.697), and the shrinkage coefficient was 0.996. SFRM2.1 was created using 81,790 patients, and its accuracy was validated using the remaining 42,731 patients. The AUC of SFRM2.1 was 0.745 (95% CI: 0.731-0.758). Conclusion: SFRM2 showed good accuracy in predicting falls even on validating in diverse populations with significantly different backgrounds. Furthermore, the accuracy can be improved by adjusting the coefficients while keeping the model's parameters fixed.

Mass Casualty Incident Preparedness for Airport Emergencies: Report From an Aeroplane Crash Simulation at Guglielmo Marconi Airport, Bologna (Italy).

BACKGROUND: Airport emergencies are rare but potentially catastrophic; therefore, system preparedness is crucial. Airport emergency plans include the organization of emergency drills on a regular basis, including full-scale exercises, to train and test the entire rescue organization. OBJECTIVE: This report describes a full-scale simulation at Bologna International Airport, Italy, in October 2022, involving local EMS resources. METHODS: A full-scale aeroplane crash was simulated on the airport ground, activating the Airport emergency plan, and requiring the intervention of supplementary resources (ambulances, medical cars, and other emergency vehicles). RESULTS: Twenty-seven simulated patients were evaluated by EMS: START triage assessment was correct for 81.48% of patients; 11.11% were over-triaged and 7.41% were under-triaged. All patients were transported to the hospitals of the area. The simulation ended 2 hours and 28 minutes after the initial alarm. CONCLUSION: The response time proved a good response. Triage accuracy was correct in more than 80% of simulated patients. The availability of a trauma centre within 6 kilometres allowed the transportation of a quota of patients directly from the event, without affecting transportation times. Areas for improvement were identified in the communication within the different agencies and in moving ambulances within the airport runway without airport personnel guidance.

Coaches of youth field sports as delivery agents of injury prevention programmes: how are we training the trainers? A scoping review.

OBJECTIVE: To systematically map the coach education (CE) component of injury prevention programmes (IPPs) for youth field sports by identifying and synthesising the design, content and facilitation strategies used to address competency drivers and behaviour change. DESIGN: Scoping review. DATA SOURCES: PubMed, PsycInfo, EMBASE, CINAHL, SportDiscus and Google Scholar electronic databases were searched using keywords related to IPPs and youth field sports. ELIGIBILITY CRITERIA FOR SELECTING STUDIES: Studies of IPPs in youth field sports, that provided 'train-the-trainer' education to coaches as designated delivery agents. RESULTS: 20 studies from two field sports (soccer/football; n=17, Rugby Union; n=3) fulfilled the eligibility criteria. Eleven CE interventions occurred in the preseason and 18 occurred at one time-point (single day). Five studies cited use of a behavioural change theory or model in the design of their CE, most frequently the Health Action Process Approach model (n=5); and use of behavioural change techniques varied. Twelve of twenty studies (60%) reported some form of ongoing support to coaches following the CE primary intervention concurrent with IPP implementation. CONCLUSION: CE that occurs on 1 day (one time-point) is most popular for preparing coaches as delivery agents of IPPs in youth field sports. While recognising pragmatic barriers, more expansive in-service training, support and feedback may enhance the effective implementation of IPPs. TRIAL REGISTRATION NUMBER: https://doi.org/10.17605/OSF.IO/FMHGD.