Asunto(s)
Accidentes de Tránsito , Armas de Fuego , Heridas por Arma de Fuego , Adolescente , Niño , Humanos , Armas de Fuego/legislación & jurisprudencia , Armas de Fuego/estadística & datos numéricos , Estados Unidos/epidemiología , Heridas por Arma de Fuego/epidemiología , Heridas por Arma de Fuego/etnología , Heridas por Arma de Fuego/prevención & control , Lactante , Preescolar , Adulto Joven , Salud Infantil , Heridas y Lesiones/epidemiología , Heridas y Lesiones/prevención & control , Negro o Afroamericano/estadística & datos numéricos , Indio Americano o Nativo de Alaska/estadística & datos numéricos , Homicidio/etnología , Homicidio/estadística & datos numéricos , Homicidio/tendencias , Suicidio/etnología , Suicidio/estadística & datos numéricos , Suicidio/tendencias , Accidentes de Tránsito/historia , Accidentes de Tránsito/prevención & control , Accidentes de Tránsito/estadística & datos numéricos , Accidentes de Tránsito/tendencias , Historia del Siglo XX , Historia del Siglo XXI , Inequidades en Salud , Práctica de Salud Pública , Prevención de Accidentes/legislación & jurisprudencia , Prevención de Accidentes/métodosAsunto(s)
Humanos , Automóviles/legislación & jurisprudencia , Automóviles/normas , Accidentes de Tránsito/legislación & jurisprudencia , Accidentes de Tránsito/prevención & control , Prevención de Accidentes/legislación & jurisprudencia , Conducción de Automóvil , Percepción Visual , Seguridad Vial , Tráfico Vial , VidrioRESUMEN
RESUMO Objetivo: descrever a prevalência de fatores de risco e proteção para acidentes de transporte terrestre (ATT) entre adolescentes brasileiros. Métodos: foram analisados dados da Pesquisa Nacional de Saúde do Escolar, de 2015 e 2019, referentes aos indicadores de risco e/ou proteção no trânsito. Foram estimadas as prevalências e respectivos intervalos de confiança de 95% (IC 95%), segundo sexo, faixa etária e tipo de escola. Resultados: dos escolares de 13 a 17 anos entrevistados, 33,3% (IC 95%:32,1;33,7) referiram ter dirigido veículo motorizado ou ter sido transportado em veículo conduzido por alguém que tinha consumido bebida alcoólica, 38,1% (IC 95%:37,4;38,7) afirmaram ter sido transportados por quem utilizava o celular enquanto dirigia, 17,5% (IC 95%:16,8;18,2) referiram não usar cinto de segurança no banco da frente e 30,2% (IC 95%:29,4;30,9) no banco de trás, e 27,1% (IC 95%:26,5;27,7) dos estudantes relataram ter sido transportado por condutor alcoolizado. Entre 2015 e 2019, o uso do cinto de segurança no banco de trás, reduziu de 33,7% para 30,2%, e o uso de capacete ao andar de moto aumentou de 84,6% para 88,9%. Conclusão: a prevalência de escolares que dirigiam ou andavam com pessoas sob efeito do álcool ou que usavam o celular enquanto dirigiam foi elevada. Além disso, o uso de cinto de segurança no banco de trás foi baixo. Entre 2015 e 2019, o uso de cinto de segurança no banco de trás reduziu e o uso de capacete aumentou. É necessário ampliar as estratégias de educação no trânsito para os adolescentes, seus familiares e responsáveis.
RESUMEN Objetivo: describir la prevalencia de los factores de riesgo y protección de los accidentes de tráfico (ATT) entre los adolescentes brasileños. Métodos: se analizaron los datos de la Encuesta Nacional de Salud Escolar de 2015 y 2019, referidos a los indicadores de riesgo y/o protección en el tráfico. Se estimó la prevalencia y los respectivos intervalos de confianza del 95% (IC 95%), según el sexo, el grupo de edad y el tipo de escuela. Resultados: de los estudiantes de 13 a 17 años entrevistados, el 33,3% (IC 95%:32,1;33,7) declaró haber conducido un vehículo de motor o haber sido transportado en un vehículo conducido por alguien que había consumido bebidas alcohólicas, el 38,1% (IC 95%: 37,4;38,7) declararon haber sido transportados por alguien que utilizaba el teléfono móvil mientras conducía, el 17,5% (IC 95%:16,8;18,2) declararon no llevar el cinturón de seguridad en el asiento delantero y el 30,2% (IC 95%:29,4;30,9) en el asiento trasero, y el 27,1% (IC 95%:26,5;27,7) de los estudiantes declararon haber sido transportados por un conductor alcoholizado. Entre 2015 y 2019, el uso del cinturón de seguridad en el asiento trasero, se redujo del 33,7% al 30,2%, y el uso del casco cuando se conduce una moto, aumentó del 84,6% al 88,9%. Conclusión: la prevalencia de escolares que conducían o viajaban con personas bajo los efectos del alcohol o que utilizaban el teléfono móvil mientras conducían era elevada. Además, el uso del cinturón de seguridad en el asiento trasero era escaso. Entre 2015 y 2019, se redujo el uso del cinturón de seguridad en el asiento trasero y aumentó el uso del casco. Es necesario ampliar las estrategias de educación vial para los adolescentes, sus familias y tutores.
ABSTRACT Objective: to describe the prevalence of risk and protection factors for road transportation accidents (RTAs) among Brazilian adolescents. Methods: data from the 2015 and 2019 National School Health Survey were analyzed, referring to the risk and/or protection risk indicators in terms of traffic. The prevalence values and respective 95% confidence intervals (95% CI) were estimated according to gender, age group and type of school. Results: of the students aged from 13 to 17 years old that were interviewed, 33.3% (95% CI: 32.1-33.7) reported having driven a motor vehicle or being a passenger in a vehicle driven by someone who had drunk alcohol, 38.1% (95% CI: 37.4-38.7) reported having been a passenger of someone who used a cell phone while driving, 17.5% (95% CI: 16.8-18.2) reported not wearing a seatbelt in the front seat and 30.2% (95% CI: 29.4-30.9) not doing so in the back seat, and 27.1% (95% CI: 26.5-27.7) of the students reported having been a passenger of a drunk driver. Between 2015 and 2019, back-seat seatbelt use dropped from 33.7% to 30.2%, and helmet use while riding a motorcycle increased from 84.6% to 88.9%. Conclusion: the prevalence of in-school adolescents who drove or were passengers in vehicles driven by motorists under the effect of alcohol or using cell phones while driving was high. In addition to that, back-seat seatbelt use was low. Between 2015 and 2019, back-seat seatbelt use was reduced and helmet u se while riding a motorcycle increased. It is necessary to expand the traffic education strategies aimed at adolescents, their family members and guardians.
Asunto(s)
Adolescente , Accidentes de Tránsito , Factores de Riesgo , Encuestas Epidemiológicas , Vehículos a Motor , Accidentes de Transporte Terrestre , Estrategias de Salud , Factores Protectores , Educación Vial , Prevención de Accidentes/legislación & jurisprudenciaRESUMEN
Introduction The aim of this study was to examine the impact the EU Directive for the Prevention of Sharps injuries had on the incidence of needlestick injuries (NSI) in Ireland. Methods A five-year retrospective study prior to, and after the introduction of these regulations, was conducted. Secondary data from the Occupational Health Department's annual NSI reports were used. The population studied were healthcare workers who reported a NSI from 2013 to 2017. Results The incidence of NSI varied from 157 in 2017 to 207 in 2014. 'Miscellaneous needles' was the category which caused the most NSI (23%). 'Disposable needles with syringes' accounted for 20% of all NSI before the legislation; this figure was reduced to 12-15% after the regulations were introduced. Conclusion The EU regulations did not reduce the incidence of NSI. A lower incidence of NSI was reported from 'disposable needles with syringes' after the implementation of the regulations.
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Prevención de Accidentes/legislación & jurisprudencia , Accidentes de Trabajo/prevención & control , Equipos Desechables , Personal de Salud/estadística & datos numéricos , Agujas/efectos adversos , Lesiones por Pinchazo de Aguja/epidemiología , Lesiones por Pinchazo de Aguja/prevención & control , Jeringas/efectos adversos , Femenino , Humanos , Incidencia , Irlanda/epidemiología , Masculino , Estudios Retrospectivos , Factores de TiempoRESUMEN
BACKGROUND: Traumatic brain injury (TBI) is the main cause of mortality and severe morbidity in cyclists admitted to Dutch emergency departments (EDs). Although the use of bicycle helmets is an effective way of preventing TBI, this is uncommon in the Netherlands. An option to increase its use is through a legal enforcement. However, little is known about the cost-effectiveness of such mandatory use of helmets in the Dutch context. The current study aimed to assess the cost-effectiveness of a law that enforces helmet use to reduce TBI and TBI-related mortality. METHODS: The cost-effectiveness was estimated through decision tree modelling. In this study, wearing bicycle helmets enforced by law was compared with the current situation of infrequent voluntary helmet use. The total Dutch cycling population, consisting of 13.5 million people, was included in the model. Model data and parameters were obtained from Statistics Netherlands, the National Road Traffic Database, Dutch Injury Surveillance System, and literature. Effects included were numbers of TBI, death, and disability-adjusted life years (DALY). Costs included were healthcare costs, costs of productivity losses, and helmet costs. Sensitivity analysis was performed to assess which parameter had the largest influence on the incremental cost-effectiveness ratio (ICER). RESULTS: The intervention would lead to an estimated reduction of 2942 cases of TBI and 46 deaths. Overall, the incremental costs per 1) death averted, 2) per TBI averted, and 3) per DALY averted were estimated at 1) 2,002,766, 2) 31,028 and 3) 28,465, respectively. Most favorable were the incremental costs per DALY in the 65+ age group: 17,775. CONCLUSIONS: The overall costs per DALY averted surpassed the Dutch willingness to pay threshold value of 20,000 for cost-effectiveness of preventive interventions. However, the cost per DALY averted for the elderly was below this threshold, indicating that in this age group largest effects can be reached. If the price of a helmet would reduce by 20%, which is non-hypothetical in a situation of large-scale purchases and use of these helmets, the introduction of this regulation would result in an intervention that is almost cost-effective in all age groups.
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Prevención de Accidentes/economía , Ciclismo/legislación & jurisprudencia , Lesiones Traumáticas del Encéfalo/economía , Dispositivos de Protección de la Cabeza/economía , Costos de la Atención en Salud/estadística & datos numéricos , Prevención de Accidentes/legislación & jurisprudencia , Ciclismo/economía , Ciclismo/lesiones , Lesiones Traumáticas del Encéfalo/etiología , Lesiones Traumáticas del Encéfalo/prevención & control , Análisis Costo-Beneficio , Árboles de Decisión , Servicio de Urgencia en Hospital/economía , Hospitalización/economía , Humanos , Países Bajos , Años de Vida Ajustados por Calidad de VidaAsunto(s)
Prevención de Accidentes/legislación & jurisprudencia , Accidentes de Tránsito/prevención & control , Adhesión a Directriz/legislación & jurisprudencia , Vehículos a Motor , Administración de la Seguridad/legislación & jurisprudencia , Instituciones Académicas , Niño , Medicina de Emergencia , Humanos , Vehículos a Motor/legislación & jurisprudencia , Instituciones Académicas/legislación & jurisprudencia , Sociedades Médicas , Estados UnidosRESUMEN
INTRODUCTION: In this article an analysis is made of existing legal provisions and policies regarding medical confidentiality and the use of medical information on pilots, for the reporting of unfit pilots and for accident and incident investigation. An overview is given of the applicable international, European and several national legal frameworks in relation to this question. The applicable national legislation and relating policies of the Netherlands, the U.S., and Canada are compared on this subject. These three States (countries) are selected because of the differences between them in legal provisions when it comes to medical confidentiality of pilots' health information. The article will conclude with tools derived from this analysis, which can be used to find a balance between medical confidentiality vs. aviation safety.Schuite JM. Aviation safety vs. medical confidentiality: disclosure of health information for accident prevention and investigation. Aerosp Med Hum Perform. 2019; 90(10):872-881.
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Prevención de Accidentes/legislación & jurisprudencia , Accidentes de Aviación/prevención & control , Medicina Aeroespacial/legislación & jurisprudencia , Confidencialidad/legislación & jurisprudencia , Notificación Obligatoria , Aviación , Canadá , Certificación , Comparación Transcultural , Humanos , Países Bajos , Pilotos , Políticas , Estados UnidosAsunto(s)
Prevención de Accidentes/economía , Accidentes de Tránsito/estadística & datos numéricos , Traumatismos Craneocerebrales/prevención & control , Traumatismos Craneocerebrales/cirugía , Dispositivos de Protección de la Cabeza/estadística & datos numéricos , Motocicletas , Apoyo a la Investigación como Asunto , Cirujanos/economía , Prevención de Accidentes/legislación & jurisprudencia , Accidentes de Tránsito/legislación & jurisprudencia , Accidentes de Tránsito/mortalidad , Adolescente , Adulto , Anciano , Traumatismos Craneocerebrales/mortalidad , Estudios Transversales , Femenino , Humanos , Puntaje de Gravedad del Traumatismo , Masculino , Persona de Mediana Edad , Sistema de Registros , Estudios Retrospectivos , Tennessee/epidemiología , Estados UnidosRESUMEN
This study aimed to analyze the trend in the number of fatalities, severe injuries, and minor injuries from traffic accidents on Brazil's federal highways according to the country's major geographic regions before and after the start of the Decade of Action for Road Safety (DARS). This was an interrupted time series study of data on accidents with fatal or injured victims provided by the Brazilian Federal Highway Police from 2007 to 2017. The Prais-Winsten method was used to calculate the monthly percentage change (MPC) in the number of fatalities, severe injuries, and minor injuries. Before the DARS, there was an upward monthly trend in the number of fatalities in these accidents in the country as a whole (MPC 0.71%) and in all five regions, especially in the South (MPC 1.01%) and Central-West (MPC 0.84%). There was an inverse trend after the start of the DARS, with a significant decrease in Brazil as a whole (MPC -1.24%) and in the major geographic regions. For each person that dies in an accident on a federal highway, at least 12 others suffer non-fatal injuries. There was an upward trend in the number of victims with severe injuries (MPC 0.53%) and minor injuries (MPC 0.8%) in Brazil and in the major geographic regions in the period prior to the DARS. After the start of the DARS, there was a significant downward trend in the absolute frequencies of these outcomes at the national and regional levels. In conclusion, before the DARS, there was an upward monthly trend in the number of fatal and injured victims of traffic accidents on Brazil's federal highways. After the start of the DARS, in 2011, there was an inverse trend, namely a decline in these outcomes in the country.
O objetivo deste estudo foi analisar a tendência do número de mortos, feridos graves e feridos leves por acidentes de trânsito nas rodovias federais brasileiras, segundo macrorregião, antes e depois do início da Década de Ação pela Segurança no Trânsito (DAST). Trata-se de estudo de séries temporais interrompidas com dados sobre acidentes com vítimas, fatais ou feridas, disponibilizados pela Polícia Rodoviária Federal para o período de 2007 a 2017. Utilizou-se o método de Prais-Winsten para o cálculo da variação percentual mensal (VPM) do número de mortos, feridos graves e feridos leves. Antes da DAST, havia uma tendência de aumento mensal do número de mortos nesses acidentes no país (VPM de 0,71%) e em todas as regiões, com destaque para o Sul (VPM de 1,01%) e Centro-oeste (VPM de 0,84%). Verificou-se tendência inversa após o início da DAST, com diminuição significante no Brasil (VPM de -1,24%) e macrorregiões. Para cada pessoa que morre em um acidente em rodovia federal, há, pelo menos, 12 outras, em média, que sofrem lesões não fatais. Houve tendência de aumento do número de vítimas com ferimentos graves (VPM de 0,53%) e leves (VPM de 0,8%) no Brasil e nas macrorregiões no período que antecedeu a DAST. Após a introdução da DAST, houve uma tendência de diminuição nas frequências absolutas significantes desses desfechos nos níveis nacional e regional. Conclui-se que, antes da DAST, houve tendência de aumento mensal do número de vítimas fatais e feridas por acidentes de trânsito nas rodovias federais. Após o início da DAST, em 2011, observou-se tendência inversa, ou seja, de declínio desses desfechos nos locais estudados.
El objetivo de este estudio fue analizar la tendencia del número de muertos, heridos graves y heridos leves por accidentes de tráfico en las carreteras federales brasileñas, según macrorregión, antes y después del inicio de la Década de Acción por la Seguridad en el Tráfico (DAST). Se trata de un estudio de series temporales interrumpidas con datos sobre accidentes con víctimas, fatales o heridas, reveladas al público por la Policía de Carreteras Federal para el período de 2007 a 2017. Se utilizó el método de Prais-Winsten para el cálculo de la variación de porcentaje mensual (VPM) del número de muertos, heridos graves y heridos leves. Antes de la DAST, había una tendencia de aumento mensual del número de muertos en esos accidentes en el país (VPM de 0,71%) y en todas las regiones, resaltando la Sur (VPM de 1,01%) y Centro-oeste (VPM de 0,84%). Se verificó una tendencia inversa tras el comienzo de la DAST, con una disminución significativa en Brasil (VPM de -1,24%) y en sus macrorregiones. Por cada persona que muere en un accidente en una carretera federal, hay por lo menos otras 12, de media, que sufren lesiones no fatales. Hubo tendencia de aumento en el número de víctimas con heridas graves (VPM de 0,53%) y leves (VPM de 0,8%) en Brasil y en las macrorregiones durante el período que precedió la DAST. Tras la introducción de la DAST, hubo una tendencia de disminución en las frecuencias absolutas significativas de esos desenlaces en los niveles nacional y regional. Se concluye que antes de la DAST hubo una tendencia de aumento mensual en el número de víctimas fatales y heridas por accidentes de tráfico en las carreteras federales. Tras el inicio de la DAST, en 2011, se observó una tendencia inversa, o sea, de declive de esos desenlaces en los lugares estudiados.
Asunto(s)
Accidentes de Tránsito/prevención & control , Programas de Gobierno , Heridas y Lesiones/prevención & control , Prevención de Accidentes/legislación & jurisprudencia , Accidentes de Tránsito/legislación & jurisprudencia , Accidentes de Tránsito/mortalidad , Brasil/epidemiología , Humanos , Análisis de Series de Tiempo Interrumpido , Administración de la Seguridad , Índices de Gravedad del Trauma , Heridas y Lesiones/mortalidadRESUMEN
We conducted a scoping review to determine the current state of knowledge and areas for advancements in research on the association of firearm laws with child and adolescent firearm-related outcomes. We queried Scopus, EMBASE, Pubmed, and CJ Abstracts for English language original empirical research articles on policies affecting child and adolescent firearm-related outcomes published between January 1, 1985 and July 1, 2018. Data were abstracted, and methodologic quality assessed. Twenty articles met inclusion criteria. Among the policies studied were child access prevention laws (12 studies) and minimum age restrictions for firearm purchase and possession (4 studies). Outside of child access prevention laws, which are associated with reductions in child and adolescent unintentional and firearm suicide deaths, there is, at best, equivocal evidence of policy effects. This area is understudied, particularly in regard to nonfatal firearm injuries, for which the lack of a national surveillance system hampers research efforts. Further rigorous firearm policy evaluations are needed.
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Protección a la Infancia/legislación & jurisprudencia , Armas de Fuego/legislación & jurisprudencia , Heridas por Arma de Fuego/prevención & control , Prevención de Accidentes/legislación & jurisprudencia , Adolescente , Niño , Preescolar , Comportamiento del Consumidor , Femenino , Armas de Fuego/estadística & datos numéricos , Homicidio/prevención & control , Humanos , Masculino , Estados Unidos , Prevención del SuicidioAsunto(s)
Lesiones Accidentales/etiología , Accidentes/estadística & datos numéricos , Ciclismo/lesiones , Equipos y Suministros Eléctricos/efectos adversos , Prevención de Accidentes/legislación & jurisprudencia , Prevención de Accidentes/normas , Lesiones Accidentales/diagnóstico , Lesiones Accidentales/epidemiología , Lesiones Accidentales/prevención & control , Adolescente , Adulto , Anciano , Femenino , Política de Salud , Humanos , Puntaje de Gravedad del Traumatismo , Masculino , Persona de Mediana Edad , Prevalencia , Estudios Retrospectivos , Singapur/epidemiología , Adulto JovenRESUMEN
Palestrante: Jerry A. Dias, assessor Parlamentar do Deputado Federal Hugo Leal, presidente da Comissão Parlamentar em Defesa do Trânsito Seguro
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Accidentes de Tránsito/legislación & jurisprudencia , Legislación , Prevención de Accidentes/legislación & jurisprudencia , Consejos de SaludRESUMEN
INTRODUCTION: Safe storage of guns outside the household while someone is at risk for suicide is important for suicide prevention. Some gun retailers offer temporary firearm storage as a community resource. Others may be willing if perceived barriers can be addressed. METHODS: We invited all gun retailers in eight Mountain West states to respond to a questionnaire about the barriers they perceive in offering temporary, voluntary gun storage for community members. RESULTS: Ninety-five retailers responded (25% response rate). Fifty-eight percent believed federal laws make it harder to store guns and 25% perceived state laws to be obstacles. Over 60% cited legal liability in storing and returning guns as barriers. Other important barriers included cost, space and logistical issues of drop off and pick up. CONCLUSIONS: Strategies to reduce legal and other barriers will need to be addressed to better engage gun retailers as a community resource for safe gun storage.
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Prevención de Accidentes/métodos , Accidentes Domésticos/prevención & control , Armas de Fuego/estadística & datos numéricos , Equipos de Seguridad/estadística & datos numéricos , Prevención del Suicidio , Heridas por Arma de Fuego/prevención & control , Prevención de Accidentes/legislación & jurisprudencia , Conducta Cooperativa , Composición Familiar , Humanos , Relaciones Interinstitucionales , Aplicación de la Ley , Noroeste de Estados Unidos , Seguridad , Sudoeste de Estados UnidosRESUMEN
OBJECTIVE: Motor vehicle overloading is correlated with the possibility of road crash occurrence and severity. Although overloading of motor vehicles is pervasive in developing nations, few empirical analyses have been performed on factors that might influence the occurrence of overloading. This study aims to address this shortcoming by seeking evidence from several years of crash data from Guangdong province, China. METHODS: Data on overloading and other factors are extracted for crash-involved vehicles from traffic crash records for 2006-2010 provided by the Traffic Management Bureau in Guangdong province. Logistic regression is applied to identify risk factors for overloading in crash-involved vehicles and within these crashes to identify factors contributing to greater crash severity. Driver, vehicle, road and environmental characteristics and violation types are considered in the regression models. In addition to the basic logistic models, association analysis is employed to identify the potential interactions among different risk factors during fitting the logistic models of overloading and severity. RESULTS: Crash-involved vehicles driven by males from rural households and in an unsafe condition are more likely to be overloaded and to be involved in higher severity overloaded vehicle crashes. If overloaded vehicles speed, the risk of severe traffic crash casualties increases. Young drivers (aged under 25 years) in mountainous areas are more likely to be involved in higher severity overloaded vehicle crashes. CONCLUSIONS: This study identifies several factors associated with overloading in crash-involved vehicles and with higher severity overloading crashes and provides an important reference for future research on those specific risk factors.
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Accidentes de Tránsito/estadística & datos numéricos , Conducción de Automóvil/normas , Vehículos a Motor/estadística & datos numéricos , Seguridad/estadística & datos numéricos , Prevención de Accidentes/legislación & jurisprudencia , Accidentes de Tránsito/legislación & jurisprudencia , Adulto , Factores de Edad , Conducción de Automóvil/legislación & jurisprudencia , China/epidemiología , Bases de Datos Factuales , Femenino , Encuestas Epidemiológicas , Humanos , Modelos Logísticos , Masculino , Persona de Mediana Edad , Vehículos a Motor/legislación & jurisprudencia , Factores de Riesgo , Factores SexualesRESUMEN
BACKGROUND: Injury prevention report cards that raise awareness about the preventability of childhood injuries have been published by the European Child Safety Alliance and the WHO. These report cards highlight the variance in injury prevention practices around the world. Policymakers and stakeholders have identified research evidence as an important enabler to the enactment of injury legislation. In Canada, there is currently no childhood injury report card that ranks provinces on injury rates or evidence-based prevention policies. METHODS: Three key measures, with five metrics, were used to compare provinces on childhood injury prevention rates and strategies, including morbidity, mortality and policy indicators over time (2006-2012). Nine provinces were ranked on five metrics: (1) population-based hospitalisation rate/100 000; (2) per cent change in hospitalisation rate/100 000; (3) population-based mortality rate/100 000; (4) per cent change in mortality rate/100 000; (5) evidence-based policy assessment. RESULTS: Of the nine provinces analysed, British Columbia ranked highest in Canada and Saskatchewan lowest. British Columbia had a morbidity and mortality rate that was close to the Canadian average and decreased over the study period. British Columbia also had a number of injury prevention policies and legislation in place that followed best practice guidelines. Saskatchewan had a higher rate of injury hospitalisation and death; however, Saskatchewan's rate decreased over time. Saskatchewan had a number of prevention policies in place but had not enacted bicycle helmet legislation. CONCLUSIONS: Future preventative efforts should focus on harmonising policies across all provinces in Canada that reflect evidence-based best practices.
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Prevención de Accidentes/legislación & jurisprudencia , Accidentes/estadística & datos numéricos , Política Pública/legislación & jurisprudencia , Heridas y Lesiones/prevención & control , Adolescente , Canadá/epidemiología , Niño , Preescolar , Bases de Datos Factuales , Práctica Clínica Basada en la Evidencia , Femenino , Conocimientos, Actitudes y Práctica en Salud , Encuestas Epidemiológicas , Hospitalización , Humanos , Lactante , Recién Nacido , Masculino , Formulación de Políticas , Equipos de Seguridad , Heridas y Lesiones/mortalidadRESUMEN
Most childhood injuries can be prevented with the correct use of safety devices and appropriate supervision. Children's hospitals are well positioned to promote these behaviors with evidence-based programming; however, barriers exist to adopting such programs. The purpose of this study was to describe organizational and administrative factors related to the adoption of an efficacious injury prevention (IP) program by children's hospitals in the USA. IP specialists at 232 U.S. children's hospitals were invited to complete a baseline survey, and then offered Safe N' Sound (SNS), an efficacious computer IP program targeting parents of young children. Following this promotion period, specialists were surveyed again to assess their level of SNS adoption. Organizational and administrative factors associated with SNS adoption were identified using conditional random forest models (n = 93). Random forests identified a set of six predictors with potential utility for classifying hospitals as having SNS adoption activity or not; the final pruned classification tree indicated that four of these were best able to differentiate hospitals with and without adoption activity-having a medical director, having other hospital units that provided IP programming, the number of requests the IP unit received within the past year, and the belief of administrative leaders in their responsibility to develop programming all influence decisions. Hospitals without a medical director were most likely to demonstrate adoption activity. Medical directors, or other organizational leaders, can facilitate the adoption process for evidence-based intervention, but may need to be engaged intentionally when disseminating new products, tools, or approaches.
Asunto(s)
Prevención de Accidentes/instrumentación , Hospitales Pediátricos/organización & administración , Evaluación de Programas y Proyectos de Salud/estadística & datos numéricos , Heridas y Lesiones/prevención & control , Prevención de Accidentes/legislación & jurisprudencia , Preescolar , Práctica Clínica Basada en la Evidencia/legislación & jurisprudencia , Implementación de Plan de Salud/métodos , Hospitales Pediátricos/clasificación , Hospitales Pediátricos/estadística & datos numéricos , Humanos , Difusión de la Información/métodos , Liderazgo , Política Organizacional , Padres/educación , Encuestas y Cuestionarios , Estados Unidos/epidemiologíaRESUMEN
Resumo: O objetivo deste estudo foi analisar a tendência do número de mortos, feridos graves e feridos leves por acidentes de trânsito nas rodovias federais brasileiras, segundo macrorregião, antes e depois do início da Década de Ação pela Segurança no Trânsito (DAST). Trata-se de estudo de séries temporais interrompidas com dados sobre acidentes com vítimas, fatais ou feridas, disponibilizados pela Polícia Rodoviária Federal para o período de 2007 a 2017. Utilizou-se o método de Prais-Winsten para o cálculo da variação percentual mensal (VPM) do número de mortos, feridos graves e feridos leves. Antes da DAST, havia uma tendência de aumento mensal do número de mortos nesses acidentes no país (VPM de 0,71%) e em todas as regiões, com destaque para o Sul (VPM de 1,01%) e Centro-oeste (VPM de 0,84%). Verificou-se tendência inversa após o início da DAST, com diminuição significante no Brasil (VPM de -1,24%) e macrorregiões. Para cada pessoa que morre em um acidente em rodovia federal, há, pelo menos, 12 outras, em média, que sofrem lesões não fatais. Houve tendência de aumento do número de vítimas com ferimentos graves (VPM de 0,53%) e leves (VPM de 0,8%) no Brasil e nas macrorregiões no período que antecedeu a DAST. Após a introdução da DAST, houve uma tendência de diminuição nas frequências absolutas significantes desses desfechos nos níveis nacional e regional. Conclui-se que, antes da DAST, houve tendência de aumento mensal do número de vítimas fatais e feridas por acidentes de trânsito nas rodovias federais. Após o início da DAST, em 2011, observou-se tendência inversa, ou seja, de declínio desses desfechos nos locais estudados.
Resumen: El objetivo de este estudio fue analizar la tendencia del número de muertos, heridos graves y heridos leves por accidentes de tráfico en las carreteras federales brasileñas, según macrorregión, antes y después del inicio de la Década de Acción por la Seguridad en el Tráfico (DAST). Se trata de un estudio de series temporales interrumpidas con datos sobre accidentes con víctimas, fatales o heridas, reveladas al público por la Policía de Carreteras Federal para el período de 2007 a 2017. Se utilizó el método de Prais-Winsten para el cálculo de la variación de porcentaje mensual (VPM) del número de muertos, heridos graves y heridos leves. Antes de la DAST, había una tendencia de aumento mensual del número de muertos en esos accidentes en el país (VPM de 0,71%) y en todas las regiones, resaltando la Sur (VPM de 1,01%) y Centro-oeste (VPM de 0,84%). Se verificó una tendencia inversa tras el comienzo de la DAST, con una disminución significativa en Brasil (VPM de -1,24%) y en sus macrorregiones. Por cada persona que muere en un accidente en una carretera federal, hay por lo menos otras 12, de media, que sufren lesiones no fatales. Hubo tendencia de aumento en el número de víctimas con heridas graves (VPM de 0,53%) y leves (VPM de 0,8%) en Brasil y en las macrorregiones durante el período que precedió la DAST. Tras la introducción de la DAST, hubo una tendencia de disminución en las frecuencias absolutas significativas de esos desenlaces en los niveles nacional y regional. Se concluye que antes de la DAST hubo una tendencia de aumento mensual en el número de víctimas fatales y heridas por accidentes de tráfico en las carreteras federales. Tras el inicio de la DAST, en 2011, se observó una tendencia inversa, o sea, de declive de esos desenlaces en los lugares estudiados.
Abstract: This study aimed to analyze the trend in the number of fatalities, severe injuries, and minor injuries from traffic accidents on Brazil's federal highways according to the country's major geographic regions before and after the start of the Decade of Action for Road Safety (DARS). This was an interrupted time series study of data on accidents with fatal or injured victims provided by the Brazilian Federal Highway Police from 2007 to 2017. The Prais-Winsten method was used to calculate the monthly percentage change (MPC) in the number of fatalities, severe injuries, and minor injuries. Before the DARS, there was an upward monthly trend in the number of fatalities in these accidents in the country as a whole (MPC 0.71%) and in all five regions, especially in the South (MPC 1.01%) and Central-West (MPC 0.84%). There was an inverse trend after the start of the DARS, with a significant decrease in Brazil as a whole (MPC -1.24%) and in the major geographic regions. For each person that dies in an accident on a federal highway, at least 12 others suffer non-fatal injuries. There was an upward trend in the number of victims with severe injuries (MPC 0.53%) and minor injuries (MPC 0.8%) in Brazil and in the major geographic regions in the period prior to the DARS. After the start of the DARS, there was a significant downward trend in the absolute frequencies of these outcomes at the national and regional levels. In conclusion, before the DARS, there was an upward monthly trend in the number of fatal and injured victims of traffic accidents on Brazil's federal highways. After the start of the DARS, in 2011, there was an inverse trend, namely a decline in these outcomes in the country.
Asunto(s)
Humanos , Heridas y Lesiones/prevención & control , Accidentes de Tránsito/prevención & control , Programas de Gobierno , Heridas y Lesiones/mortalidad , Brasil/epidemiología , Accidentes de Tránsito/legislación & jurisprudencia , Accidentes de Tránsito/mortalidad , Índices de Gravedad del Trauma , Administración de la Seguridad , Análisis de Series de Tiempo Interrumpido , Prevención de Accidentes/legislación & jurisprudenciaAsunto(s)
Prevención de Accidentes , Accidentes de Tránsito , Servicios Médicos de Urgencia , Heridas y Lesiones/prevención & control , Heridas y Lesiones/rehabilitación , Prevención de Accidentes/legislación & jurisprudencia , Accidentes de Tránsito/prevención & control , Conducción de Automóvil/legislación & jurisprudencia , Humanos , Formulación de PolíticasRESUMEN
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