Accident prevention activity and accident experience in the Republic of Korea military.

INTRODUCTION: According to data released by the Korea National Statistical Office, the number of accidents has been decreasing since 2012. However, a considerable number of deaths related to safety accidents (23-46 deaths) are still reported annually. This study aimed to observe the correlation between accident prevention activities in the Republic of Korea (ROK) military and the incidence of safety accidents. METHODS: The study used data from the 2014-2015 Military Health Survey and included 13 618 responses (Army: 8414 (61.8%); Navy/Marine: 2262 (16.6%); Air Force: 2942 (21.6%)) from the ROK military personnel. Accident experiences and thoughts on accident prevention activities were self-reported. Multiple logistic regression analysis was used to examine the validity of accident prevention activity and accident experience. RESULTS: Of the 13 618 military personnel who responded, 12.0% reported experiencing safety accidents in the military and 1020 (7.5%) felt that accident prevention activities in the military were insufficient. On logistic regression analysis, we found a significant difference (insufficiency OR=1.56, CI 1.31 to 1.86). In particular, military personnel who belong to the Army and Navy were more likely to think that accident prevention activities were insufficient. In addition, military personnel who experienced falls/slips, crash, and laceration/puncture wound/amputation/penetrating wound accidents were more likely to think accident prevention activities were insufficient. CONCLUSIONS: Our study found that accident prevention activities in the military and accident experiences were related. It is necessary for the ROK Ministry of Defense, Army, Navy and Air Force headquarters to re-evaluate their accident prevention systems.

Queda em adultos idosos: considerações sobre a regulação do equilíbrio, estratégias posturais e exercício físico / Fall in older adults: considerations on balance regulation, postural strategies, and physical exercise

Quedas são comuns entre a população idosa, consideradas como questão de saúde pública, responsáveis por alto grau de morbidade e mortalidade. Isso evidencia a realização de estudos teóricos que qualifiquem o entendimento sobre a relação entre queda e seus fatores de risco; a fisiopatologia dos distúrbios do equilíbrio e da marcha; e a identificação precoce da "queda idiopática" (sem causa evidente). Assim, com base na literatura especializada, o presente estudo apresenta uma visão geral sobre o papel dos sistemas sensoriais responsáveis pela regulação do controle postural, evidenciando as principais estratégias utilizadas por idosos para a manutenção do controle postural e os benefícios proporcionados pela prática regular do exercício físico para a prevenção de quedas de idosos. Como resultado, é apresentado um modelo ilustrativo sobre a sequência de estratégias utilizadas por idosos para reestabelecer a posição ereta em diferentes fases de perturbação postural. Conclui-se que o baixo desempenho da atenção, da memória e de funções executivas eleva a instabilidade postural e reduz a velocidade da marcha, aumentando o risco de quedas. Nesse contexto, a prática regular de exercícios físicos é capaz de reduzir significativamente a taxa de queda de idosos. Aconselham-se a prática de exercícios programados, que agreguem tarefas cognitivas com grau de desafio da instabilidade de moderado a alto, e a prática semanal de duas a três horas.

Common among the older population, falls are considered a public health issue, accounting for high rates of morbidity and mortality. Thus, there is a need for theoretical studies that improve the understanding of the relationship between falls and their risk factors; the pathophysiology of balance and gait disorders; and early identification of "idiopathic fall" (with no apparent cause). Based on the specialized literature, the present study provides an overview of the role of sensory systems responsible for regulating postural control, showing the main strategies that older adults use to maintain postural control and the benefits of regular physical exercise for prevention of falls in older adults. Then, a graphic model describing the sequence of strategies used by older adults to regain an upright stance in different phases of postural perturbation is presented. In conclusion, poor performance of attention, memory, and executive functions increases postural instability and reduces gait speed, thereby raising the risk of falls. In this context, regular physical exercise may significantly reduce the rate of falls in older adults. Planned exercises are recommended and should involve cognitive tasks with moderate-to-high level of instability for two to three hours/week.

Trends in the wear of personal flotation devices (PFDs) in the UK 2009-2017.

Around 372 000 people drown every year globally. In countries, such as the UK, a large proportion of these deaths are due to recreational boating accidents, and a dominant factor influencing the outcome is whether the person was wearing a personal flotation device (PFD). The rate of PFD wear is low around the world, with reported rates ranging from 5% to 40%. In an effort to combat this, the UK has been running an education campaign since 2009 to try and increase PFD wear. In this contribution, 9 years of observational data show that the educational efforts have had little impact on the rate of wear over time. Activity type and age both influenced wear rates, with kayakers and children significantly more likely to wear PFDs. This study shows that education has been ineffective and there needs to be some consideration of regulatory approaches in order to reduce drowning.

Prevenção de acidentes domésticos no Distrito Federal / Prevention of domestic accidents in the Federal District

Os acidentes domésticos são importante causa de internação hospitalar e mortalidade entre crianças, adultos e pessoas idosas, mobilizando não só o setor saúde, mas também os profissionais de segurança pública, em especial os bombeiros, que são os primeiros respondentes a diversas dessas ocorrências. Considerando a demanda de ações intersetoriais que atentem para os diferentes tipos de acidentes domésticos, é necessário consolidar ações e campanhas e debater potencialidades e barreiras à implementação dessas atividades junto aos diferentes atores que atuam nessas ocorrências. Devido à magnitude do problema das quedas, em especial entre idosos, a maior parte da literatura científica sobre acidentes domésticos está focada em soluções de prevenção para esse público.

Advances in Mexico in the middle of the Decade of Action for Road Safety 2011-2020.

OBJECTIVE: To analyze the progress towards the accomplishment of the expected goal in the middle of the Decade of Action for Road Safety 2011-2020 in Mexico and its states. METHODS: This is a secondary analysis of road traffic deaths in Mexico between 1999 and 2015. We projected the trend for the period 2011-2020 using a time series analysis (autoregressive integrated moving average models). We used the value of the Aikaike Information Criterion to determine the best model for the national level and its 32 states. RESULTS: Mexico is progressing, approaching the proposed goal, which translates into 10,856 potentially prevented deaths in the five-year period from 2011 to 2015. This was due to a decrease in the number of deaths of motor vehicle occupants, as the deaths of pedestrians and motorcyclists were higher than expected. At least one third of the states had values below their goal; although the mortality rate remains unacceptably high in five of them. We identified four states with more deaths than those originally projected and other states with an increasing trend; thus, both cases need to strengthen their prevention actions. CONCLUSIONS: The analysis can allow us to see the progress of the country in the middle of the Decade of Action, as well as identify the challenges in the prevention of traffic injuries in vulnerable users. It contributes with elements that provide a basis for a need to rethink both the national goal and the goal of the different states.

The changing epidemiology of open fractures in vehicle occupants, pedestrians, motorcyclists and cyclists.

AIMS: To investigate the changing epidemiology of open fractures in vehicle occupants, pedestrians, motorcyclists and cyclists. MATERIALS AND METHODS: Data on all non-spinal open fractures admitted to the Royal Infirmary of Edinburgh after a road traffic accident between 1988 and 2010 were collected and analysed to provide information about the changing epidemiology in different patient groups. Demographic information was collected on all patients with the severity of injury being analysed with the Injury Severity Score (ISS), Musculoskeletal Index (MSI) and the number of open fractures. The severity of the open fractures was analysed using the Gustilo classification. The 23-year study period was divided into four shorter periods and the results were compared. RESULTS: There were 696 patients treated in 23 years. Analysis showed that the incidence of RTA open fractures initially fell in both males and females and continued to fall in females during the 23 years. In males it levelled off about 2000. The age of the female patients also fell during the study period but it did not change in males. The only patient group to show an increased incidence of open fractures were cyclists. In vehicle occupants the incidence fell throughout the study period but it levelled off in pedestrians and motorcyclists. There was no difference in the severity of injury in any group during the study period. The most severe open fractures were those of the distal femur and femoral diaphysis although open tibial diaphyseal fractures were the most common fracture in all patient groups. CONCLUSIONS: Improved car design and road safety legislation has resulted in a reduction in the incidence of open fractures in vehicle occupants, pedestrians and motorcyclists. The most obvious group to have benefitted from this are older female pedestrians. The only group to show an increase in age during the study period were male motorcyclists.

Incidência de quedas e ações preventivas em um Hospital Universitário / Incidencia de caídas y acciones preventivas en un Hospital Universitario / Incidence of falls and preventive actions in a University Hospital

RESUMO Objetivo Descrever a incidência das quedas e a sua relação com as ações preventivas desenvolvidas em um hospital universitário brasileiro. Método Estudo longitudinal retrospectivo. Foram incluídos pacientes adultos, internados em unidades clínicas, cirúrgicas, psiquiátrica e de emergência, que sofreram queda na instituição, e tiveram o evento notificado no período de janeiro de 2011 a dezembro de 2015. Os dados foram coletados no sistema de informação gerenciais da instituição e analisados no programa estatístico SPSS. Resultados Ocorreram 2.296 quedas, com uma média de incidência de 1,70 quedas/1.000 pacientes-dia. Houve aumento na incidência de quedas no período de 2011 (1,61) a 2012 (2,03). Nos anos seguintes, a incidência de quedas apresentou redução de 1,83 quedas/1.000 pacientes-dia em 2013 para 1,42 quedas/1.000 pacientes-dia em 2015. A incidência de quedas acompanhou a implementação de ações preventivas, sugerindo impacto destas intervenções na redução da ocorrência do evento. Conclusão Os achados demonstram a importância da implementação de intervenções preventivas na redução da incidência de quedas em pacientes hospitalizados.

RESUMEN Objetivo Describir la incidencia de las caídas y su relación con las acciones preventivas desarrolladas en un hospital universitario brasileño. Método Estudio longitudinal retrospectivo. Fueron incluidos pacientes adultos, ingresados en unidades clínicas, quirúrgicas, psiquiátricas y de emergencia, que sufrieron caída en el centro y tuvieron el evento notificado en el período de enero de 2011 a diciembre de 2015. Los datos fueron recolectados en el sistema de información de gestión del centro y analizados en el programa estadístico SPSS. Resultados Ocurrieron 2.296 caídas, con un promedio de incidencia de 1,70 caídas/1.000 pacientes-día. Hubo incremento en la incidencia de caídas en el período de 2011 (1,61) a 2012 (2,03). En los años siguientes, la incidencia de caídas presentó reducción de 1,83 caídas/1.000 pacientesdía en 2013 para 1,42 caídas/1.000 pacientes-día en 2015. La incidencia de caídas acompañó la implantación de acciones preventivas, sugiriendo el impacto de dichas intervenciones en la reducción de la ocurrencia del evento. Conclusión Los hallazgos demuestran la importancia de la implantación de intervenciones preventivas en la reducción de la incidencia de caídas en pacientes hospitalizados.

ABSTRACT Objective Describing the incidence of falls and its relation with preventive actions developed in a Brazilian university hospital. Method A retrospective longitudinal study. Hospitalized adult patients in the clinical, surgical, psychiatric and emergency units who suffered a fall in the institution, and who had the event notified in the period from January 2011 to December 2015 were included in the study. The data were collected from the institution's management information system and analyzed in the SPSS statistical program. Results There were 2,296 falls, with a mean incidence of 1.70 falls/1,000 patients per day. An increase in the incidence of falls was observed in the period from 2011 (1.61) to 2012 (2.03). In the following years, the incidence of falls decreased from 1.83 falls/1,000 patients per day in 2013 to 1.42 falls/1,000 patients per day in 2015. The incidence of falls accompanied an implementation of preventive actions, suggesting the impact of such interventions in reducing the event occurrence. Conclusion The findings demonstrate the importance of implementing preventive interventions in reducing the incidence of falls in hospitalized patients.

Advances in Mexico in the middle of the decade of action for road safety 2011-2020 / Avances en México a la mitad del decenio de acción para la seguridad vial 2011-2020

ABSTRACT OBJECTIVE To analyze the progress towards the accomplishment of the expected goal in the middle of the Decade of Action for Road Safety 2011-2020 in Mexico and its states. METHODS This is a secondary analysis of road traffic deaths in Mexico between 1999 and 2015. We projected the trend for the period 2011-2020 using a time series analysis (autoregressive integrated moving average models). We used the value of the Aikaike Information Criterion to determine the best model for the national level and its 32 states. RESULTS Mexico is progressing, approaching the proposed goal, which translates into 10,856 potentially prevented deaths in the five-year period from 2011 to 2015. This was due to a decrease in the number of deaths of motor vehicle occupants, as the deaths of pedestrians and motorcyclists were higher than expected. At least one third of the states had values below their goal; although the mortality rate remains unacceptably high in five of them. We identified four states with more deaths than those originally projected and other states with an increasing trend; thus, both cases need to strengthen their prevention actions. CONCLUSIONS The analysis can allow us to see the progress of the country in the middle of the Decade of Action, as well as identify the challenges in the prevention of traffic injuries in vulnerable users. It contributes with elements that provide a basis for a need to rethink both the national goal and the goal of the different states.

RESUMEN OBJETIVO Analizar el avance de la meta esperada a mitad del Decenio de Acción para la Seguridad Vial 2011-2020 en México y sus entidades federativas. MÉTODOS Análisis secundario de las muertes por accidentes de tránsito en México para el 1999-2015. Se proyectó la tendencia para el periodo 2011-2020 utilizando análisis de series de tiempo (modelos autorregresivos integrados de medias móviles). Se utilizó el valor del Criterio de Información de Aikaike para determinar el mejor modelo para el nivel nacional y sus 32 entidades federativas. RESULTADOS México va avanzando cercano a la meta propuesta, lo que se ha traducido en 10,856 defunciones potencialmente prevenidas en el quinquenio 2011 a 2015. Esto ha sido a expensas de una disminución en el número de muertes de ocupantes de vehículos de motor; ya que las muertes en peatones y motociclistas han ido por arriba de lo que se esperaba. Al menos una tercera parte de las entidades federativas tuvo el número de defunciones por debajo de su meta; aunque en cinco de ellas la tasa de mortalidad continúa inaceptablemente alta. Se identificaron cuatro entidades con más muertes que las proyectadas originalmente y otras con tendencia al incremento donde se requiere, para ambos casos, fortalecer las acciones de prevención. CONCLUSIONES El análisis realizado permite observar los avances del país a mitad del Decenio de Acción, así como identificar los retos en materia de prevención de lesiones causadas por el tránsito en usuarios vulnerables. Aporta elementos para soportar la necesidad de replantear tanto la meta nacional como la de las distintas entidades federativas.

Preocupación a caer: validación de un instrumento de medición en personas mayores chilenas que viven en la comunidad / Fear of falling: validation of a measurement tool in Chilean elderly living in the community

Introducción. La preocupación a caer, con o sin antecedentes de caídas previas, es un factor de riesgo de disminución de la movilidad, de incapacidad, de disminución de la calidad de vida y puede desencadenar la autorrestricción de las actividades, con pérdida de independencia y funcionalidad. Medir la preocupación a caer, con instrumentos validados en población chilena, es una necesidad para detectar a personas mayores en riesgo. En Chile no existen instrumentos validados que midan este fenómeno. El objetivo de este estudio es validar en español la versión acortada del instrumento Falls Efficacy Scale-International (FES-I) en personas mayores chilenas que viven en la comunidad. Material y método. Se realizó un estudio prospectivo con 2aplicaciones: una al ingreso y otra a las 4 semanas. El FES-I fue traducido según el método back-translation, evaluado por un panel de expertos y aplicado en 10 personas mayores. Después de la aplicación piloto, se elaboró la versión final, la cual fue aplicada a una muestra de 113 personas mayores. Se utilizaron medidas de tendencia central y dispersión, análisis de confiabilidad y análisis factorial confirmatorio. Resultados. La versión acortada y en español del FES-I mostró buena confiablidad y validez en población chilena de personas mayores. Conclusiones. A futuro se espera que este instrumento sea usado, por clínicos e investigadores, para conocer la magnitud del problema y el impacto que tiene el miedo a caer en las caídas, funcionalidad y calidad de vida de las personas mayores que viven en la comunidad (AU)

Introducción. Fear of falling, with or without previous falls history, is a risk factor for decreased mobility, disability, as well as a decreased quality of life, and can trigger the self-restriction of activities with loss of independence and functionality. Validated tools for measuring the fear of falling in the Chilean population is a needed to detect those at risk. There are currently no validated instruments to measure this phenomenon in Chile. The aim of this study is to validate the Spanish version of the short «Falls Efficacy Scale-International» (FES-I) in an elderly population living in the community in Chile. Material and method. A cross-sectional study was performed using applications at baseline and 4 weeks. The short FES-I was translated using the back-translation method, evaluated by a panel of experts, and piloted in 10 older adults. After the pilot study, the final version was applied to a sample of 113 elderly persons. Data analysis used measures of central tendency, and reliability and confirmatory factor analysis was used. Results. The Spanish version of the short FES-I showed good reliability and validity in an elderly Chilean population. Conclusions. This falls risks measurement tool can be used by clinicians and researchers in order to determine the magnitude of the problem and the impact of fear of falling on falls, functionality, and quality of life of the elderly who live in the community (AU)

Trends in motorcycle helmet use in Vietnam: results from a four-year study.

OBJECTIVES: Helmet use is a major risk factor for road traffic injuries and fatalities. This study sought to determine the state of helmet use in Ha Nam and Ninh Binh provinces in Vietnam, and ascertain knowledge, attitudes, and practices of helmet use over time. STUDY DESIGN: Observational helmet use studies, and roadside knowledge, attitudes, and practice surveys. METHODS: Data were collected through observational helmet use studies at multiple sites in Ha Nam and Ninh Binh provinces over 14 rounds between June 2011 and December 2014. Six rounds of knowledge, attitude, and practice surveys were administered at gas stations between December 2011 and July 2014. Trend analysis and negative binomial regressions were used to analyze trend data. RESULTS: Between June 2011 and December 2014, 301,981 helmet-use observations were conducted in Ha Nam and Ninh Binh. Correct helmet use increased significantly (P < 0.01) in Ha Nam from 34.3% to 76.9% (P < 0.01), while use in Ninh Binh increased from 68.9% to 72.2% (P > 0.05). CONCLUSION: Helmet use has improved statistically significantly in Ha Nam but not in Ninh Binh. Ceiling effects may have limited the scope of improvements in Ninh Binh province.

Epidemiología de caídas en la población anciana española no institucionalizada. Revisión sistemática 2014 / Epidemiology of falls in the non-institutionalized spanish elderly population, systematic review 2014

Objetivo. Identificar publicaciones científicas sobre las caídas en la población anciana española no institucionalizada y resumir los hallazgos de los estudios que examinaron la incidencia, los factores de asociados y las consecuencias de las caídas en la población geriátrica española mayor o igual a 65 años no institucionalizada. Material y método. Revisión sistemática de estudios observacionales epidemiológicos en España, con registro de caídas, con temporalidad retrospectiva y publicados como artículos científicos entre los años 2003 y 2014 inclusive. La búsqueda de artículos se efectuó en julio de 2014, con límite de idioma y año de publicación, en las bases electrónicas PubMed, Dialnet, RedALyC, SciELO, Enfispo y Google Scholar. Resultados. La frecuencia de caídas registradas varió del 14.9 % al 66.2 %. La media de la ingesta de fármacos/día se encontraba entre 2.7 a 4.5 fármacos/día. El miedo a caer que presentaba la población anciana no institucionalizada se encontraba entre un 44.7 % y un 49.4 %. La gran mayoría de las caídas se produjeron en el ámbito domiciliario, y se hallaron porcentajes de entre el 55.1 % y el 61 %. Entre un 30 % y un 55.1 % de las personas que sufrieron caídas mantuvieron un contacto sanitario de forma inmediata, y la prevalencia de fracturas se situó entre un 0 % y un 26.1 %. Conclusión. Se puede confirmar que la prevalencia de caídas en la población anciana española es elevada, por lo que se aprecia la necesidad de nuevas investigaciones (AU)

Objective. To identify scientific publications about falls among non-institutionalized Spanish elderly population and to summarize the study findings which analysed the incidence, the risk factors and the consequences of the falls in the geriatric Spanish population aged 65 years and over who lives institutionalized in our country. Material and method. Systematic review of the epidemiological observational studies in Spain, with recording of falls, with temporary retrospective and published as scientific articles between the years 2003 and 2014 included. The articles search took place in July 2014, with the limit of language and publication year, in the electronic databases PubMed, Dialnet, RedALyC, SciELO, Enfispo and Google Scholar. Results. The percentage of people who suffered falls depending on the publication year. The frequency of falls recorded varied from 14.9 % to 66.2 %. The mean intake of daily drugs was between 2.7 to 4.5 drugs per day. The fear of falling that had the elderly population non-institutionalized was between 44.7 % and 49.4 %. The vast majority of falls occurred at home, with percentages between 55.1 % and 61 %. Between 30 % and 55.1 % of people who suffered falls maintained health care contact immediately and the fractures prevalence was between 0 % and 26.1 %. Conclusion. It can be confirmed that the falls prevalence in the spanish elderly population is high, so the need of new researches are appreciated (AU)

La prevención de los accidentes in itinere desde la empresa / Prevention of accidents after leaving the worksite

No disponible

Recomendaciones sobre la prevención de ahogamientos / Recommendations for the prevention of drowning

El ahogamiento supone la segunda causa de muerte accidental en menores de 19 años en Europa. Las condiciones climáticas en España permiten un amplio periodo de contacto con el agua, aumentando el riesgo por mayor exposición y constituyendo la segunda causade mortalidad accidental en menores de 14 años. Los ahogamientos en menores de 5 años se producen sobre todo en piscinas particulares o de comunidades privadas y, en el caso de niños mayores, suelen estar ligados a actividades acuáticas de tipo lúdico en lagos, mar, ríos y canales, y, en ocasiones, asociadas al consumo de alcohol. En el presente artículo, el Comité de Seguridad y Prevención de Lesiones No Intencionadas en la Infancia de la Asociación Española de Pediatría proporciona una serie de recomendaciones para prevenir este tipo de lesiones, tanto arquitectónicas como educativas y legislativas

Drowning is the second leading cause of non-intentional death in children under the age of 19 in Europe. Weather conditions in Spain allow an extended period of contact with water, therefore increasing the risk of drowning (due to the increased exposure), and constitutes the second leading cause of accidental death in children less than 14 years of age. In childrenyounger than 5 years, drowning occurs mostly in pools belonging to private homes or communities, while in older children, drowning is often linked to aquatic recreational activities in lakes,sea, rivers and canals, and at times associated with alcohol consumption. In this article, the Committee on Safety and Non-Intentional Injury Prevention in Childhood of the Spanish Association of Pediatrics provides a series of architectonic, educational and legislative recommendations to prevent such incidents