Assessment of increased knowledge about traffic accidents prevention, one month after a presentation included in the program "it can happen to you" of AESLEME.

Road traffic accidents are a real pandemic and incur expenses amounting to 1-2% of every country's GDP. AESLEME (Association for the Study of Spinal Cord Injuries) has celebrated its 30th anniversary here in Spain. AESLEME's instructors are health workers and people with spinal cord injuries caused by road accidents: their presentations-teaching road safety and sharing information on irreversible injuries-are enhanced by personal stories that help schoolchildren to acquire knowledge on this matter. STUDY DESIGN: Pre and post-quasi-experimental study. OBJECTIVE: To assess the increase in knowledge about road safety following a school-based road safety campaign. METHODS: Two multiple-choice tests were given to each of the 8106 students taking part, who were 12-14 years old. Of the four possible answers, only one of them was correct. The first multiple-choice test was taken before the presentation and the second was taken one month later. RESULTS: After assessing the answers, there was a change in the tendency of the number of correct before/after answers for the multiple-choice test, and the number of correct ones rose one month after the presentation. This increase is statistically significant (p < 0.01) and represents a national increase of 61% in the probability of correct answers, although this varies from 8% to 278% depending on the region. CONCLUSIONS: The assessment, involving over 8000 people, showed that there has been an improvement in road safety knowledge thanks to education provided by AESLEME's instructors, and a statistically significant increase was obtained throughout Spain and different regions.

A segurança do paciente e a avaliação do risco de quedas / Patient safety and fall-risk assessment / Seguridad del paciente y evaluación de riesgo de caída

Objetivo: Avaliar os pacientes hospitalizados quanto ao risco de quedas. Métodos: Estudo transversal, realizado por meio da aplicação da escala de Morse e registros de prontuários. Realizou-se estatísticas descritivas e Teste Qui-quadrado de Pearson, adotando-se o nível de 5%. Resultados: Dos 244 participantes, 139 (57%) eram do sexo masculino, 86 (47,5%) idosos, 116 (47,5%) com companheiro, 112 (45,9%) pardos e 173 (70,9%) com baixa escolaridade. O risco de quedas foi associado ao histórico de quedas (p=0,000), diagnóstico secundário (p<0,001), deambulação (p=0,002), marcha (p<0,001) e estado mental (p<0,000). A maioria dos entrevistados 194 (79,5%) estão sob um risco moderado a alto de sofrer quedas da própria altura 37 (15,2%), ocorridas no quarto ou na enfermaria 38 (15,6%). Conclusão: Observou-se um risco moderado a alto para quedas nos pacientes hospitalizados, o que aponta para a necessidade de implementação de políticas de segurança do paciente para garantir a qualidade da assistência. (AU)

Objective: Assess hospitalized patients for the risk of falls. Methods: Cross-sectional study, carried out through the application of the Morse scale and medical records. Descriptive statistics and Pearson's Chi-square test were performed, adopting the 5% level. Results: Of the 244 participants, 139 (57%) were male, 86 (47.5%) elderly, 116 (47.5%) with a partner, 112 (45.9%) brown and 173 (70.9%) with low education level. The risk of falls was associated with a history of falls (p = 0.000), secondary diagnosis (p <0.001), walking (p = 0.002), gait (p <0.001) and mental status (p <0.000). Most respondents 194 (79.5%) are at moderate to high risk of suffering falls from their own height 37 (15.2%), in their bedroom or in the ward 38 (15.6%). Conclusion: There was a moderate to high risk for falls in hospitalized patients, which points to the need of implementing patient safety policies in order to guarantee quality of care. (AU)

Objetivo: Evaluar a los pacientes hospitalizados por el riesgo de caídas. Métodos: Estudio transversal, realizado a través de la aplicación de la escala Morse y registros médicos. Se realizaron estadísticas descriptivas y la prueba de Chi-cuadrado de Pearson, adoptando el nivel del 5%. Resultados: De los 244 participantes, 139 (57%) eran hombres, 86 (47.5%) ancianos, 116 (47.5%) con una pareja, 112 (45.9%) marrones y 173 (70.9%) con baja educacion. El riesgo de caídas se asoció con antecedentes de caídas (p = 0.000), diagnóstico secundario (p <0.001), caminar (p = 0.002), marcha (p <0.001) y estado mental (p <0.000). La mayoría de los encuestados 194 (79.5%) tienen un riesgo moderado a alto de sufrir caídas desde su propia altura 37 (15.2%), ocurriendo en el dormitorio o en la sala 38 (15.6%). Conclusión: Hubo un riesgo moderado a alto de caídas en pacientes hospitalizados, lo que apunta a la necesidad de implementar políticas de seguridad del paciente para garantizar la calidad de la atención. (AU)

O impacto da mortalidade por causas externas na esperança de vida nos municípios produtores de petróleo da Bacia de Campos/RJ / The impact of mortality from external causes on life expectancy in the oil-producing municipalities in the Campos Basin/RJ / El impacto de la mortalidad por causas externas en la esperanza de vida en los municipios petroleros de la Cuenca de Campos, Río de Janeiro

Resumo O crescimento da mortalidade por causas externas no Brasil tem se tornado objeto de preocupação entre pesquisadores e formuladores de políticas públicas nos últimos anos. No âmbito dos municípios produtores de petróleo da Bacia de Campos/RJ, embora muito se conheça sobre os padrões migratórios nesta região que é considerada um aspecto relevante da urbanização brasileira, as informações sobre os demais componentes da dinâmica demográfica ainda são escassas. Este estudo amplia a discussão sobre as disparidades de saúde na região, investigando o impacto da mortalidade por causas externas na expectativa de vida da população entre os períodos 2010-2014 e 2015-2019. Utilizando dados de óbitos e estimativas populacionais, foram construídas tabelas de múltiplo decremento para avaliar o ganho na expectativa de vida se a mortalidade por causas externas fosse excluída do risco de óbito e como esses ganhos diferem entre homens e mulheres. Também avaliaram-se cenários distintos de redução da mortalidade por homicídios e acidentes de trânsito, as duas principais causas de morte do grupo de causas externas. Os resultados revelam ganhos médios substanciais de expectativa de vida para ambos os sexos, especialmente para os homens. As simulações realizadas mostraram que a redução da mortalidade por acidentes de trânsito e homicídios pode trazer ganhos importantes para a população, destacando a relevância de investir em políticas públicas que combatam as causas externas de mortalidade em uma região marcada por desigualdades sociais e econômicas.

Abstract The growth of mortality due to external causes in Brazil has become a concern among researchers and public policy makers in recent years. In the municipalities that produce oil in the Campos Basin, although much is known about migration patterns in this region, considered a relevant aspect of Brazilian urbanization, information on other components of demographic dynamics is still scarce. This study expands the discussion on health disparities in the region by investigating the impact of mortality due to external causes on life expectancy of the population between 2010-2014 and 2015-2019. Using death data and population estimates, we constructed multiple decrement tables to assess the gain in life expectancy if mortality due to external causes were excluded from the risk of death and how these gains differ between men and women. We also evaluated different scenarios reducing mortality due to homicides and traffic accidents, the two main causes of death in the external causes group. The results reveal substantial average gains in life expectancy for both sexes, especially for men. The simulations performed showed that reducing mortality due to traffic accidents and homicides can bring important gains to the population, highlighting the importance of investing in public policies that combat external causes of mortality in a region marked by social and economic inequalities.

Resumen El crecimiento de la mortalidad por causas externas en Brasil se ha convertido en objeto de preocupación entre investigadores y formuladores de políticas públicas en los últimos años. En el ámbito de los municipios productores de petróleo de la Cuenca de Campos (Río de Janeiro), aunque se sabe mucho sobre los patrones migratorios en esta región que se considera un aspecto relevante de la urbanización brasileña, la información sobre los demás componentes de la dinámica demográfica sigue siendo escasa. Este estudio amplía la discusión sobre las disparidades de salud en la región, investigando el impacto de la mortalidad por causas externas en la esperanza de vida de la población entre 2010-2014 y 2015-2019. Con datos de defunciones y estimaciones poblacionales, construimos tablas de múltiple decremento para evaluar la ganancia en la esperanza de vida si la mortalidad por causas externas fuera excluida del riesgo de defunción y cómo estas ganancias difieren entre hombres y mujeres. También evaluamos escenarios distintos de reducción de la mortalidad por homicidios y accidentes de tráfico, las dos principales causas de muerte del grupo de causas externas. Los resultados revelan ganancias medias sustanciales de esperanza de vida para ambos sexos, en especial para los hombres. Las simulaciones mostraron que la reducción de la mortalidad por accidentes de tráfico y homicidios puede traer ganancias importantes para la población, destacando la importancia de invertir en políticas públicas que combatan las causas externas de mortalidad en una región marcada por desigualdades sociales y económicas.

Presença de risco de transtorno do estresse pós-traumático em policiais militares feridos por arma de fogo / Presence of risk of posttraumatic stress disorder in military police officers wounded by firearms / Presencia de riesgo de trastorno de estrés postraumático en policías militares heridos por armamiento de fuego

Este estudo teve como objetivo identificar o risco de desenvolvimento de transtorno de estresse pós-traumático (TEPT), bem como sua associação com pensamentos ou tentativas suicidas e a saúde mental de policiais militares feridos por arma de fogo, na Região Metropolitana de Belém (RMB), nos anos de 2017 a 2019. A pesquisa contou com a participação de 30 entrevistados, que responderam o Inventário Demográfico e a Lista de verificação de TEPT para o DSM-5 (PCL-5). Para análise dos dados, utilizou-se a técnica estatística Análise Exploratória de Dados e a técnica multivariada Análise de Correspondência. Os resultados revelaram a existência de risco de desenvolvimento do transtorno de forma parcial ou total em uma expressiva parcela da população entrevistada, tendo homens como maioria dos sintomáticos, com média de 38 anos, exercendo atividades operacionais e vitimados em via pública quando estavam de folga do serviço. O ferimento deixou a maioria com sequelas, com destaque para dores crônicas, limitações de locomoção e/ou mobilidade e perda parcial de um membro. E, ainda, policiais sintomáticos apresentaram comportamentos suicidas, relatando já terem pensado ou tentado tirar a própria vida. Desta forma, conclui-se que policiais militares são expostos constantemente a traumas inerentes a sua profissão. Quando há ameaça de vida, como nos casos de ferimentos por arma de fogo, são suscetíveis a sequelas físicas decorrente do ferimento, somadas a sequelas mentais tardias, como o surgimento de sintomatologias de TEPT e ideação suicida.(AU)

This study aimed to identify the risk of developing post-traumatic stress disorder (PTSD) and its associations around suicidal thoughts or attempts and mental health in military police officers injured by firearms, in the Metropolitan Region of Belem (RMB), from 2017 to 2019. The research had the participation of 30 respondents who answered the Demographic Inventory and the PTSD checklist for DSM-5 (PCL-5). For data analysis, we used the statistical technique Exploratory Data Analysis and the multivariate technique Correspondence Analysis. The results revealed the existence of risk of developing partial or total disorder in a significant portion of the interviewed population, with men as most of the symptomatic individuals, with mean age of 38 years, developing operational activities and victimized on public roads when they were off duty. The injuries left most of them with sequelae, especially chronic pain, limited locomotion and/or mobility, and partial loss of a limb. In addition, symptomatic officers showed suicidal behavior, such as reporting they had thought about or tried to take their own lives. Thus, we conclude that military policemen are constantly exposed to traumas inherent to their profession. When their lives are threatened, as in the case of firearm wounds, they are susceptible to physical sequelae resulting from the injury, in addition to late mental sequelae, such as the appearance of PTSD symptoms and suicidal ideation.(AU)

Este estudio tuvo como objetivo identificar el riesgo de desarrollo de trastorno de estrés postraumático (TEPT) y sus asociaciones con pensamientos o tentativas suicidas y la salud mental en policías militares heridos por armamiento de fuego, en la Región Metropolitana de Belém (Brasil), en el período entre 2017 y 2019. En el estudio participaron 30 entrevistados que respondieron el Inventario Demográfico y la Lista de verificación de TEPT para el DSM-5 (PCL-5). Para el análisis de datos se utilizaron la técnica estadística Análisis Exploratoria de Datos y la técnica multivariada Análisis de Correspondencia. Los resultados revelaron que existen riesgos de desarrollo de trastorno de estrés postraumático de forma parcial o total en una expresiva parcela de la población de policías entrevistados, cuya mayoría de sintomáticos eran hombres, de 38 años en media, que ejercen actividades operacionales y fueron victimados en vía pública cuándo estaban de día libre del servicio. La lesión dejó la mayoría con secuelas, especialmente con dolores crónicos, limitaciones de locomoción y/o movilidad y la pierda parcial de un miembro. Aún los policías sintomáticos presentaran comportamiento suicida, tales como relataran qué ya pensaron o tentaron quitar la propia vida. Se concluye que los policías militaran se exponen constantemente a los traumas inherentes a su profesión. Cuando existe amenaza de vida, como en los casos de heridas por armamiento de fuego, son expuestos a secuelas físicas transcurridas de la herida, sumado a secuelas mentales tardías, como el surgimiento de sintomatologías de TEPT y la ideación suicida.(AU)

A covid-19 como um analisador do sofrimento de enfermeiras: um ensaio teórico / Covid-19 as a suffering analyzer for female nurses: a theoretical essay / El covid-19 como analizador de sufrimiento de enfermeras: un ensayo teórico

Este ensaio propõe que a Covid-19 pode operar como um analisador, dentro da perspectiva da análise institucional, iluminando um determinado modo de organização social que promove profundas desigualdades e ameaça a vida em diversos níveis e revelando as condições sociais, institucionais e políticas de produção de sofrimento no corpo profissional de Enfermagem. A pandemia desvelou um conjunto de marcas relacionadas à profissão, agravadas pela crise sanitária, reforçando a naturalização das relações de cuidado atribuídas ao feminino, bem como um conjunto de clivagens e hierarquias internas à profissão a partir da sinergia de marcadores da diferença, como gênero, cor/raça, classe e geração. Além disso, este trabalho mostra a presença de uma necropolítica nas respostas à pandemia que banaliza a vida e permite morrer determinados grupos sociais. A ideia de "profissionais de linha de frente" é criticada em suas metáforas bélicas, mas tomada como figura de linguagem em sua potência para afirmar que existem corpos que, pelas marcas sociais e históricas e pela interdependência do cuidado, são mais presentes e exigidos e, portanto, mais vulneráveis à doença e ao sofrimento dela decorrente.(AU)

The essay proposes that Covid-19 can operate as an analyzer, within the perspective of institutional analysis, illuminating a certain mode of social organization that promotes profound inequalities and threatens life at various levels, revealing the social, institutional and political conditions for the production of suffering in the professional nursing body. The pandemic would unveil a set of marks related to the profession, aggravated by the sanitary crisis, reinforcing the naturalization of the care relations attributed to the feminine, as well as a set of cleavages and internal hierarchies to the profession from the synergy of markers of difference as gender, color/race, class and generation. The work shows the presence of necropolitics in responses to the pandemic, which trivializes life and allows certain social groups to die. The idea of "front-line professionals" is criticized in its war metaphors, but taken as a figure of speech in its potency to affirm that there are bodies that by social and historical marks, and by the interdependence of care, are more present and demanded, and therefore more vulnerable to disease and the resulting suffering.(AU)

El ensayo propone que el Covid-19 puede funcionar como analizador, desde la perspectiva del análisis institucional, revelando las condiciones sociales, institucionales y políticas de producción de sufrimiento de enfermeras. La pandemia revela algunas marcas relacionadas con la profesión, agravadas por la crisis de salud, reforzando la naturalización de la atribución del cuidado a lo femenino y un conjunto de jerarquías internas de la profesión. El trabajo también muestra la presencia de una necropolítica en las respuestas a la pandemia. La idea de "profesionales de primera línea" es criticada, pero tomada como una figura del lenguaje en su potencia para afirmar que hay cuerpos que, por las marcas sociales e históricas y por la interdependencia del cuidado, están más presentes y demandados, y por lo tanto más vulnerables a la enfermedad.(AU)

Resiliência: avaliação de pacientes queimados em um hospital de urgência e emergência / Resilience: evaluation of burned patients in an urgency and emergency hospital / Resiliencia: evaluación de pacientes quemados en un hospital de urgencias y emergencias

A recuperação de vítimas de queimaduras é longa e dolorosa e afeta diversas esferas da vida do paciente. A resiliência, que se refere à capacidade humana de enfrentar e se adaptar a eventos adversos, exerce grande importância no processo de recuperação da queimadura. Logo, este trabalho objetiva avaliar a capacidade de resiliência de pacientes queimados, no momento da admissão e da alta hospitalar, em um hospital de emergência e urgência de Goiânia. Trata-se de um estudo descritivo, quantitativo e transversal que utiliza a Escala de Resiliência de Connor-Davidson (CD-RISC) como instrumento de mensuração. Na admissão hospitalar, a média da resiliência foi de 71,35, tendo sido observada uma relação significativa entre o fator Amparo da escala CD-RISC e a presença do(a) companheiro(a). O escore de resiliência encontrado nesta pesquisa é consistente com outros achados da literatura científica internacional e nacional referente à expressão da resiliência em vítimas de queimaduras e outros adoecimentos. A relação entre o fator Amparo e a presença de um(a) companheiro(a) enfatiza a importância da rede de apoio familiar na reabilitação do paciente queimado.(AU)

The recovery of burned patients is long and painful and impacts on different areas of people's lives. Resilience, which refers to the human capacity to face and adapt to adverse events, plays a major role in the process of recovery from burns. Therefore, the present study aims to assess the resilience of burned patients, on admission and hospital discharge, in an emergency and urgency hospital in Goiânia. This is a descriptive, quantitative and cross-sectional study that uses the Connor-Davidson Resilience Scale (CD RISC) as a measuring instrument. At hospital admission, the mean resilience was 71.35, with a significant association between the Support factor on the CD RISC scale and the presence of a partner. The resilience score found in the present study is consistent with other findings in the international and national scientific literature regarding the expression of resilience in victims of burns and other illnesses. The relationship between the Support factor and the presence of a partner emphasizes the importance of the family support network in the rehabilitation of the burned patient.(AU)

La recuperación de los pacientes quemados es larga y dolorosa e impacta en diferentes esferas de la vida de las personas. La resiliencia, que se refiere a la capacidad humana para enfrentar y adaptarse a eventos adversos, juega un papel importante en el proceso de recuperación de las quemaduras. Por tanto, el presente estudio tiene como objetivo evaluar la resiliencia de los pacientes quemados, en el momento del ingreso y el alta, en un hospital de emergencia y urgencia en Goiânia. Se trata de un estudio descriptivo, cuantitativo y transversal que utiliza la Escala de Resiliencia Connor-Davidson (CD RISC) como instrumento de medida. Al ingreso hospitalario, la resiliencia media fue de 71,35, con associación significativa entre el factor Amparo de la escala CD RISC y la presencia de pareja. El puntaje de resiliencia encontrado en el presente estudio es consistente con otros hallazgos en la literatura científica nacional e internacional sobre la expresión de resiliencia en víctimas de quemaduras y otras enfermedades. La relación entre el factor Amparo y la presencia de pareja enfatiza la importancia de la red de apoyo familiar en la rehabilitación del paciente quemado.(AU)

Using threshold analysis to assess the robustness of public health intervention recommendations from network meta-analyses: application to accident prevention in households with children under five.

BACKGROUND: In the appraisal of clinical interventions, complex evidence synthesis methods, such as network meta-analysis (NMA), are commonly used to investigate the effectiveness of multiple interventions in a single analysis. The results from a NMA can inform clinical guidelines directly or be used as inputs into a decision-analytic model assessing the cost-effectiveness of the interventions. However, there is hesitancy in using complex evidence synthesis methods when evaluating public health interventions. This is due to significant heterogeneity across studies investigating such interventions and concerns about their quality. Threshold analysis has been developed to help assess and quantify the robustness of recommendations made based on results obtained from NMAs to potential limitations of the data. Developed in the context of clinical guidelines, the method may prove useful also in the context of public health interventions. In this paper, we illustrate the use of the method in public health, investigating the effectiveness of interventions aiming to increase the uptake of accident prevention behaviours in homes with children aged 0-5. METHODS: Two published random effects NMAs were replicated and carried out to assess the effectiveness of several interventions for increasing the uptake of accident prevention behaviours, focusing on the safe storage of other household products and stair gates outcomes. Threshold analysis was then applied to the NMAs to assess the robustness of the intervention recommendations made based on the results from the NMAs. RESULTS: The results of the NMAs indicated that complex intervention, including Education, Free/low-cost equipment, Fitting equipment and Home safety inspection, was the most effective intervention at promoting accident prevention behaviours for both outcomes. However, the threshold analyses highlighted that the intervention recommendation was robust for the stair gate outcome, but not robust for the safe storage of other household items outcome. CONCLUSIONS: In our case study, threshold analysis allowed us to demonstrate that there was some discrepancy in the intervention recommendation for promoting accident prevention behaviours as the recommendation was robust for one outcome but not the other. Therefore, caution should be taken when considering such interventions in practice for the prevention of poisonings in homes with children aged 0-5. However, there can be some confidence in the use of this intervention in practice to promote the possession of stair gates to prevent falls in homes with children under 5. We have illustrated the potential benefit of threshold analysis in the context of public health and, therefore, encourage the use of the method in practice as a sensitivity analysis for NMA of public health interventions.

Maritime Environment Assessment and Management Using through Balanced Scorecard by Using DEMATEL and ANP Technique.

Previous studies have found that the occurrence of maritime accidents often lacks a sound environment management mechanism. The reason is that maritime safety needs management functions to promote each other. This study aims to assess the risk analysis of maritime accidents, applying balanced scorecard (BSC) concepts integrating decision-making trial and evaluation laboratory (DEMATEL) with analytic network process (ANP). The empirical results are that the balanced scorecard could be applied as a maritime procedure management method in maritime risk analysis. A total of 30 questionnaires were collected via scholar questionnaire, and five criteria or key factors for strengthening risk assessment of marine accidents were determined. According to the application of BSC, the risk analysis criteria constructed can assist maritime authorities to reduce the maritime accidents.

Risk rates of workplace accidents in Brazil: effect of the Accidental Prevention Factor (APF)? / Taxas de risco de acidentes de trabalho no Brasil: efeito do Fator Acidentário de Prevenção (FAP)?

Historically, the conflict of interests between employers and workers obliged the State to assume the role of regulating this relationship, instituting laws and overseeing the application of health and safety standards at work. The Accident Prevention Factor (FAP) is one of these guidelines. This article aims to analyze the correlations between the FAP and the risk rate for occupational accidents in Brazil in the period between 2006 and 2016. Ecological study, which analyzed the occupational accidents, registered in the Brazilian Social Security database in the period between 2006 and 2016. The analysis included the calculation of accident risk rates according to the Brazilian regions, divisions of the CNAE, reason/situation, ICD-10 chapters, sex and age. The comparison between results from the two periods was performed using the average risk rates from the two periods using Student t test, Spearman correlation and beta value. Basically, all rate series analyzed had a strong downward trend in the FAP period, contrary to what occurred in the immediately previous period.

A ocorrência de acidentes e de doenças relacionadas ao trabalho são expressões concretas da exposição dos trabalhadores aos riscos presentes no ambiente laboral. Historicamente o conflito de interesses entre empregadores e trabalhadores obrigou o Estado a assumir a função de regulação desta relação, instituindo leis e fiscalizando a aplicação das normas de saúde e segurança no trabalho. O Fator Acidentário de Prevenção (FAP) é uma dessas estratégias. O objetivo deste artigo é analisar a correlação entre as taxas de risco de acidentes de trabalho no Brasil antes (2006-2009) e depois (2010-2016) da vigência do FAP. Estudo ecológico com análise temporal de séries de taxas de acidentes de trabalho registrados nas bases de dados da Previdência Social no período 2006 e 2016. A análise incluiu o cálculo das taxas de risco de acidentes segundo grandes regiões brasileiras, divisões do CNAE, motivo/situação, capítulos do CID-10, sexo e idade. A comparação entre os resultados dos dois períodos foi realizada utilizando-se as taxas de risco médias com a aplicação do teste t de Student e da correlação de Spearman. Basicamente todas as séries de taxas analisadas obtiveram forte tendência de redução no período de vigência do FAP, ao contrário do que ocorreu no período imediatamente anterior.

Evaluating the citywide Edinburgh 20mph speed limit intervention effects on traffic speed and volume: A pre-post observational evaluation.

OBJECTIVES: Traffic speed is important to public health as it is a major contributory factor to collision risk and casualty severity. 20mph (32km/h) speed limit interventions are an increasingly common approach to address this transport and health challenge, but a more developed evidence base is needed to understand their effects. This study describes the changes in traffic speed and traffic volume in the City of Edinburgh, pre- and 12 months post-implementation of phased city-wide 20mph speed limits from 2016-2018. METHODS: The City of Edinburgh Council collected speed and volume data across one full week (24 hours a day) pre- and post-20mph speed limits for 66 streets. The pre- and post-speed limit intervention data were compared using measures of central tendency, dispersion, and basic t-tests. The changes were assessed at different aggregations and evaluated for statistical significance (alpha = 0.05). A mixed effects model was used to model speed reduction, in the presence of key variables such as baseline traffic speed and time of day. RESULTS: City-wide, a statistically significant reduction in mean speed of 1.34mph (95% CI 0.95 to 1.72) was observed at 12 months post-implementation, representing a 5.7% reduction. Reductions in speed were observed throughout the day and across the week, and larger reductions in speed were observed on roads with higher initial speeds. Mean 7-day volume of traffic was found to be lower by 86 vehicles (95% CI: -112 to 286) representing a reduction of 2.4% across the city of Edinburgh (p = 0.39) but with the direction of effect uncertain. CONCLUSIONS: The implementation of the city-wide 20mph speed limit intervention was associated with meaningful reductions in traffic speeds but not volume. The reduction observed in road traffic speed may act as a mechanism to lessen the frequency and severity of collisions and casualties, increase road safety, and improve liveability.

Taxas de risco de acidentes de trabalho no Brasil: efeito do Fator Acidentário de Prevenção (FAP)? / Risk rates of workplace accidents in Brazil: effect of the Accidental Prevention Factor (APF)?

Resumo A ocorrência de acidentes e de doenças relacionadas ao trabalho são expressões concretas da exposição dos trabalhadores aos riscos presentes no ambiente laboral. Historicamente o conflito de interesses entre empregadores e trabalhadores obrigou o Estado a assumir a função de regulação desta relação, instituindo leis e fiscalizando a aplicação das normas de saúde e segurança no trabalho. O Fator Acidentário de Prevenção (FAP) é uma dessas estratégias. O objetivo deste artigo é analisar a correlação entre as taxas de risco de acidentes de trabalho no Brasil antes (2006-2009) e depois (2010-2016) da vigência do FAP. Estudo ecológico com análise temporal de séries de taxas de acidentes de trabalho registrados nas bases de dados da Previdência Social no período 2006 e 2016. A análise incluiu o cálculo das taxas de risco de acidentes segundo grandes regiões brasileiras, divisões do CNAE, motivo/situação, capítulos do CID-10, sexo e idade. A comparação entre os resultados dos dois períodos foi realizada utilizando-se as taxas de risco médias com a aplicação do teste t de Student e da correlação de Spearman. Basicamente todas as séries de taxas analisadas obtiveram forte tendência de redução no período de vigência do FAP, ao contrário do que ocorreu no período imediatamente anterior.

Abstract Historically, the conflict of interests between employers and workers obliged the State to assume the role of regulating this relationship, instituting laws and overseeing the application of health and safety standards at work. The Accident Prevention Factor (FAP) is one of these guidelines. This article aims to analyze the correlations between the FAP and the risk rate for occupational accidents in Brazil in the period between 2006 and 2016. Ecological study, which analyzed the occupational accidents, registered in the Brazilian Social Security database in the period between 2006 and 2016. The analysis included the calculation of accident risk rates according to the Brazilian regions, divisions of the CNAE, reason/situation, ICD-10 chapters, sex and age. The comparison between results from the two periods was performed using the average risk rates from the two periods using Student t test, Spearman correlation and beta value. Basically, all rate series analyzed had a strong downward trend in the FAP period, contrary to what occurred in the immediately previous period.

Association between physical capacity and occupational falls among middle-aged and older farmers in Thailand: Using the self-check risk assessment tool in Japan.

OBJECTIVES: Declining physical capacity caused by aging increases the risk of occupational falls on the same level and to lower levels. In emerging countries in Asia, the development of a program for older farmers to assess their risk of occupational falls is valuable. The current study aimed to evaluate the relationship between physical capacity and experience of occupational falls among middle-aged and older Thai farmers. METHODS: We conducted a cross-sectional survey of 419 Thai farmers aged 40 years and over during March and April, 2021. For the assessment of physical capacity, we used the Self-Check Risk Assessment of Falls and Other Accidents in the Workplace tool developed in Japan, consisting of five physical test components. Multiple logistic regression and receiver operating characteristic curves were used to analyze the data. RESULTS: The results revealed that 25.5% of participants had experienced occupational falls in the past 12 months. For each of the five physical test components, there was no significant association between physical capacity and experience of occupational falls. The area under the receiver operating characteristic curve was less than 0.60 for each of the five physical test components. A similar trend was observed when the analysis was limited to participants aged 50 years and over. CONCLUSIONS: The current study did not reveal any associations between physical capacity in each test and experience of occupational falls among middle-aged and older Thai farmers. Because the mechanisms underlying occupational falls are complex, multiple intervention approaches may be important for preventing accidents.

A Methodology for Dynamic Assessment of Laboratory Safety by SEM-SD.

Lab safety problems have become an impeding factor that cannot be ignored in normal teaching and scientific research activities at colleges and universities. As the risk factors of lab accidents can be conceptualized as occurring at multiple levels, systematically improving and optimizing lab safety is the crucial route to accident prevention in labs. In this paper, a novel method that integrates a structural equation model (SEM) and system dynamics (SD) is presented to dynamically assess lab safety with the characteristics of insufficient data and uncertainty. On the basis of a questionnaire investigation, the SEM was utilized to determine the influencing factors on lab safety and acquire the path coefficients among these factors, which were embedded into the SD model as the weight of the influencing factors. An illustration was carried out to test and validate the proposed method, and a sensitivity analysis was also conducted to recognize variables contributing the most to the improvement of lab safety. The results demonstrated that the safety input of human and management subsystems is the most effective to improve the lab safety; meanwhile, "safety awareness", "emergency ability", "operation skills", "safety culture" and "safety training" are the top five contributing factors, which can promote lab safety in the shortest time.

Prototipação de game educativo para prevenção de acidentes na infância / Prototyping of educational game for prevention of childhood accidents

Objetivo: Descrever o desenvolvimento de um protótipo de game educativo para prevenção de acidentes comuns na infância. Metodologia: Estudo descritivo sobre desenvolvimento tecnológico de um protótipo de game educativo, proveniente de pesquisa original sobre utilização da gamificação como ferramenta educativa para prevenção de acidentes na infância. O desenvolvimento do protótipo guiou-se pela estratégia Design Thinking, com uso do software educacional Scratch que é uma plataforma online, gratuita. Os cenários e personagens foram construídos com figuras disponíveis em acesso livre na internet. Resultados: O protótipo do game foi intitulado "Detetives do perigo", com público alvo crianças entre 8 a 10 anos de idade. As fases do game apresenta situações de risco de acidente na rotina diária da criança, e explica de forma simples e interativa como evitá-los. O game é composto por dez cenários, sendo quatro de orientações e seis dos ambientes domiciliar, escolar, via e parque público, onde são expostas as situações de risco de acidente. Conclusão: O uso de ferramentas tecnológicas nas ações de educação em saúde, permite que a criança seja protagonista no cuidado com sua saúde e bem-estar, o despertar do senso crítico compatível com sua faixa etária, pode contribuir na redução de acidentes na infância. (AU)

Objective: To describe the development of an educational game prototype for the prevention of common accidents in childhood. Methods: Descriptive study on technological development of an educational game prototype, from original research on the use of gamification as an educational tool for the prevention of childhood accidents. The development of the prototype was guided by the Design Thinking strategy, using scratch educational software which is a free online platform. The scenarios and characters were built with figures available in free internet access. Results: The prototype of the game was titled "Danger Detectives", with audience targeting children between 8 to 10 years of age. The phases of the game presents situations of risk of accident in the daily routine of the child and explains in a simple and interactive way how to avoid them. The game consists of ten scenarios, four of which are guidelines and six of the home, school, road and public park environments, where accident risk situations are exposed. Conclusion: The use of technological tools in health education actions allows the child to be a protagonist in the care of their health and well-being, the awakening of critical sense compatible with their age group can contribute to the reduction of accidents in childhood. (AU)

Objetivo: Describir el desarrollo de un prototipo de juego educativo para la prevención de accidentes comunes en la infância. Methods: Estudio descriptivo sobre desarrollo tecnológico de un prototipo de juego educativo, derivado de la investigación original sobre el uso de la gamificación como herramienta educativa para la prevención de accidentes infantiles. El desarrollo del prototipo fue guiado por la estrategia Design Thinking, utilizando software educativo scratch que es una plataforma en línea gratuita. Los escenarios y personajes fueron construidos con figuras disponibles en acceso gratuito a Internet. Resultados: El prototipo del juego se tituló "Detectives de peligro", con un público dirigido a niños de entre 8 y 10 años de edad. Las fases del juego presentan situaciones de riesgo de accidente en la rutina diaria del niño, y explican de una manera sencilla e interactiva cómo evitarlos. El juego consta de diez escenarios, cuatro de los cuales son pautas y seis de los ambientes de hogar, escuela, carretera y parque público, donde las situaciones de riesgo de accidentes están expuestas. Conclusión: El uso de herramientas tecnológicas en las acciones de educación sanitaria permite al niño ser protagonista en el cuidado de su salud y bienestar, el despertar del sentido crítico compatible con su grupo de edad puede contribuir a la reducción de los accidentes en la infancia. (AU)

Analysis of work-related accidents and ill-health in Brazil since the introduction of the accident prevention factor.

BACKGROUND: Since 2004, Brazil has had a national policy for occupational health and safety. This policy means companies' tax burden is altered according to the numbers of work-related accidents and ill-health amongst their workers. In 2010, a multiplication factor was introduced to this policy, called the Accident Prevention Factor. The idea of this new multiplication factor is to encourage individual employers to take initiatives to prevent accidents and ill health in the workplace. This study was designed to investigate the incidence of work-related accidents and ill-health in Brazil according to their causes, their severity, and the economic activity in which they occur, and to compare the data before and after the introduction of the Accident Prevention Factor. METHODS: An ecological study was conducted by analyzing the time series of work-related accidents/ill-health between 2008 and 2014 from the Brazilian social security system (Previdência Social) statistical yearbooks. Incidences were calculated per cause, economic activity, and severity of the accident/ill-health. Data from before and after the introduction of the Accident Prevention Factor were compared using the Mann-Whitney test per cause and per economic activity. Statistical analyses were made using the SPSS software, with significance set at 5%. RESULTS: A reduction in the incidence of work-related accidents/ill-health was found across all the groups of causes analyzed, except for the groups "external causes of morbidity and mortality" and "factors influencing health status and contact with health services." Greater reductions were found for diseases of the musculoskeletal system and connective tissue and diseases of the nervous system. Reductions in work-related accidents/ill-health were found in the different economic activities and in the different severity groups. The highest reduction after the introduction of the Accident Prevention Factor was in manufacturing and production (p < 0.05). CONCLUSIONS: Overall, the incidence of accidents/ill-health was found to be on decline, except those with external causes of morbidity and mortality and those involving factors influencing health status and contact with health services. The biggest reduction was found in manufacturing and production. However, generally speaking progress still needs to be made in accident prevention and occupational health across a whole range of work environments.

Analysis of the Characteristics of Fatal Accidents in the Construction Industry in China Based on Statistical Data.

Background: Construction activities not only provide the necessary conditions for citizens to live, but also cause fatal accidents. Methods: This study aimed to reveal the characteristics of fatal accidents in the construction industry in China based on statistical data. From 2010 to 2019, there were 6005 fatal accidents in China's construction industry causing 7275 deaths. The important features of these fatal accidents, such as the type, time of occurrence, site location, severity, and geographical region of the accident, were carefully analyzed. Results: There were 258 major and severe construction accidents causing 1037 deaths, accounting for 4.3% and 14.25% of the total number of construction accidents and deaths in this period, respectively. As an important finding, more deaths occurred in August and on Mondays. The greatest number of construction accidents took place along openings and edges, accounting for 22.9% of all fatal accidents. Taking into account their economic development level and number of employees, Qinghai and Hainan experienced a higher mortality rate than Jiangsu. Falls from a high place were the dominant type of construction accident, accounting for 51.66% of all accidents. However, collapses were the primary type of major and severe construction accident, accounting for 60.09% of such accidents. The predicted number of construction deaths in 2020 is 887 according to the GM(1,1) model. Corresponding safety measures should be adopted to improve the working environment of the construction industry. Implications: The implications of these results with respect to the characteristics of construction accidents can be regarded as the foundation for accident prevention in practice.

Percentile charts for speeding based on telematics information.

Reference charts are widely used as a graphical tool for assessing and monitoring children's growth given gender and age. Here, we propose a similar approach to the assessment of driving risk. Based on telematics data, and using quantile regression models, our methodology estimates the percentiles of the distance driven at speeds above the legal limit depending on drivers' characteristics and the journeys made. We refer to the resulting graphs as percentile charts for speeding and illustrate their use for a sample of drivers with Pay-How-You-Drive insurance policies. We find that percentiles of distance driven at excessive speeds depend mainly on total distance driven, the percentage of driving in urban areas and the driver's gender. However, the impact on the estimated percentile for these covariates is not constant. We conclude that the heterogeneity in the risk of driving long distances above the speed limit can be easily represented using reference charts and that, conversely, individual drivers can be scored by calculating an estimated percentile for their specific case. The dynamics of this risk score can be assessed by recording drivers as they accumulate driving experience and cover more kilometres. Our methodology should be useful for accident prevention and, in the context of Manage-How-You-Drive insurance, reference charts can provide real-time alerts and enhance recommendations for ensuring safety.

Play safe with Sisimpur: an evaluation of a child injury prevention intervention in Bangladesh.

For children under the age of 18 in Bangladesh, road traffic injuries, drowning, animal bites, poisonous substances, falls, burns, and electrocutions and fire-related burns pose significant and serious risk and are a leading cause of mortality, especially in rural areas. Despite this, there is limited evidence of what works to increase children's knowledge of injury prevention and decrease incidents of unintentional injury. This study addresses this gap by presenting findings from an evaluation of Play Safe with Sisimpur. Leveraging the popularity of Sisimpur, the Bangladeshi co-production of Sesame Street, Play Safe with Sisimpur employed a school-based child-to-child and adult-to-adult mentorship model, designed to improve injury prevention knowledge and promote behavior change. Child survey results demonstrate a significant change between baseline and end line in the knowledge of children related to injury prevention and treatment for burns, electrocution, falls, household hazards, playing safe, road traffic injuries, and water safety. Adult mentee survey results demonstrate a significant change between baseline and end line in the knowledge of adult mentees related to injury prevention and treatment of animal injuries, burns, falls, household hazards, and road traffic injuries.

Riscos ambientais de quedas em idosos atendidos pela equipe de Estratégia Saúde da Família / Environmental risks for falls of elderly attended by the Family Health Strategy team

RESUMO Objetivo analisar o risco ambiental de quedas de idosos residentes em área de abrangência de uma equipe de Estratégia Saúde da Família. Métodos pesquisa transversal, utilizando, como fonte de dados, 80 fichas de avaliação de risco ambiental de quedas em idosos. Os dados colhidos foram transcritos e organizados em uma planilha eletrônica, utilizando o programa Microsoft Excel® e analisados por meio de estatística descritiva. Resultados a maioria dos domicílios dos idosos foi classificada como baixo risco para quedas (56,3%) e apresentou, pelo menos, um risco ambiental (94,0%), sendo os mais frequentes encontrados no banheiro (47,5%), na escada (46,2%), e relacionados à iluminação (41,2%). Conclusão observaram-se riscos ambientais em diferentes locais dos domicílios, com destaque para o banheiro, escada e falta de iluminação no quarto, sendo a maioria classificada como baixo risco ambiental para quedas.

ABSTRACT Objective to analyze the environmental risk for falls among the elderly living in the area covered by a Family Health Strategy team. Methods cross-sectional research, using, as a data source, 80 forms of environmental risk evaluation of elderly falls. The collected data were transcribed and organized in a computerized spreadsheet, using the Microsoft Excel® program, and analyzed using descriptive statistics. Results most elderly's households were classified as low risk for falls (56.3%) and showed at least one environmental risk (94.0%), being the most frequently found in the bathroom (47.5%), in stairs (46.2%), and associated to light (41.2%). Conclusion environmental risks were observed in different places of the households, highlighting the bathroom, stairs, and little light in the room, most of them being classified as a low environmental risk for falls.