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

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

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

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

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

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

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

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

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

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

Efectividad de las intervenciones enfermeras en la prevención de caídas en adultos mayores en la comunidad y en entornos sanitarios: una revisión sistemática y metaanálisis de ECA / Effectiveness of nursing interventions in the prevention of falls in older adults in the community and in health care settings: A systematic review and meta-analysis of RCT

Objetivo: Estimar la efectividad de los programas de prevención de caídas en mayores de 65 años en los que participan profesionales de enfermería. Métodos: Se incluyeron ensayos clínicos aleatorizados disponibles a texto completo sobre la prevención de caídas en la comunidad realizada por enfermeras en personas mayores de 65 años y que informaran de la incidencia de dichas caídas. Se analizaron 14 bases de datos en el período de 2016 a 2018 de publicaciones en inglés, francés, portugués y español. La calidad de los artículos se evaluó de manera independiente y ciega por los revisores, que trabajaron en parejas usando para ello los dominios de riesgo de riesgo de la Colaboración Cochrane. Se utilizó el cociente de riesgos como medida del tamaño de efecto. Se asumió un modelo de efectos aleatorios para los análisis estadísticos. La influencia de las variables moderadoras de los estudios sobre los tamaños de efecto se realizó mediante ANOVA con un intervalo de confianza del 95% para cada categoría. Resultados: Se seleccionaron 31 estudios con 25.551 participantes, donde la intervención más frecuente fue la educación (57,1%), seguida de los modelos multifactoriales (37,1%). La probabilidad de caídas se redujo significativamente en los grupos intervención (RR +=0,87). Las intervenciones multifactoriales (RR +=0,89) y basadas en la educación (RR=+0,84) redujeron significativamente la probabilidad de caídas. Conclusiones: Descartando el sesgo de publicación, los programas de prevención llevados a cabo por enfermeras producen una reducción significativa del 10% de las caídas. Las intervenciones basadas en la educación y multifactoriales son las más efectivas cuando son llevadas a cabo por enfermeras.(AU)

Objective: To estimate the effectiveness of fall prevention programs in people aged 65 years and older involving nursing professionals. Methods: We included available full-text randomized clinical trials on nurse-led prevention of falls in the community in people over 65 years of age and reporting the incidence of such falls. An extensive search was performed in 14 databases covering the period 2016 to 2018 for publications in English, French, Portuguese and Spanish. The quality of the papers was assessed independently and blindly by reviewers working in pairs using the risk of bias dominios of the Cochrane Collaboration. The hazard ratio was used as a measure of the effect size of the incidence of falls. A random-effects model was assumed for statistical analyses. The influence of moderator variables of the studies on the effect sizes was performed using ANOVAs and its 95% CI for each moderator category. Results: A total of 31 randomized clinical trials were selected with 25,551 participants. The most frequent type of intervention was education (57.1%), followed by multifactorial models (37.1%). The probability of falling was significantly reduced by 13% in the intervention groups compared to the control groups (RR +=0.87). Multifactorial (RR +=0.89) and education-based (RR=+0.84) interventions significantly reduced the probability of falls by 11% and 16%, respectively. Conclusions: Discarding publication bias prevention programs carried out by nurses produce a significant 10% reduction in falls. Education-based and multifactorial interventions are the most effective when conducted by nurses.(AU)

Effectiveness of nursing interventions in the prevention of falls in older adults in the community and in health care settings: A systematic review and meta-analysis of RCT.

OBJECTIVE: To estimate the effectiveness of fall prevention programs in people aged 65 years and older involving nursing professionals. METHODS: We included available full-text randomized clinical trials on nurse-led prevention of falls in the community in people over 65 years of age and reporting the incidence of such falls. An extensive search was performed in 14 databases covering the period 2016-2018 for publications in English, French, Portuguese and Spanish. The quality of the papers was assessed independently and blindly by reviewers working in pairs using the risk of bias dominios of the Cochrane Collaboration. The hazard ratio was used as a measure of the effect size of the incidence of falls. A random-effects model was assumed for statistical analyses. The influence of moderator variables of the studies on the effect sizes was performed using ANOVAs and its 95% CI for each moderator category. RESULTS: A total of 31 randomized clinical trials were selected with 25,551 participants. The most frequent type of intervention was education (57.1%), followed by multifactorial models (37.1%). The probability of falling was significantly reduced by 13% in the intervention groups compared to the control groups (RR+=0.87). Multifactorial (RR+=0.89) and education-based (RR=+0.84) interventions significantly reduced the probability of falls by 11% and 16%, respectively. CONCLUSIONS: Discarding publication bias prevention programs carried out by nurses produce a significant 10% reduction in falls. Education-based and multifactorial interventions are the most effective when conducted by nurses.

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

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

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

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

Diagrama de prevenção de quedas para pessoas idosas: revisão integrativa / Diagrama de prevención de caídas para personas mayores: revisión integradora / Fall prevention diagram for older adults: an integrative review

Resumo Objetivo Propor um diagrama de prevenção de quedas para pessoas idosas, baseado no Modelo de Promoção da Saúde de Nola Pender. Métodos A construção do diagrama foi embasada no modelo de Nola Pender e em seus elementos. Para isso, foi realizado um estudo de revisão integrativa, com o objetivo de coletar dados sobre características e experiências individuais, sentimentos e conhecimentos e adoção de comportamento saudável para prevenção de quedas. Após a coleta dessas informações, realizou-se análise de similitude dos estudos selecionados por meio do IRaMuTeQ. Os elementos obtidos da análise de similitude facilitaram o agrupamento dos estudos quanto aos elementos encontrados e, assim, proporcionaram a organização do diagrama de prevenção de quedas. Resultados A amostra final foi constituída de 54 artigos, divididos de acordo com os elementos do modelo de Nola Pender: 36 abordavam características e experiências individuais, 40 sentimentos e conhecimentos, e 20 eram referentes ao comportamento. Os elementos obtidos da análise de similitude geraram um leque semântico de palavras mais frequentes: queda, prevenção, mulher e medo. Já as palavras menos frequentes foram cognição, autoeficácia, transporte e planejamento, os quais contribuíram para a construção do diagrama. Conclusão A partir da revisão, elaborou-se um diagrama, que favoreceu a identificação dos fatores pessoais, barreiras e facilidades, para um comportamento desejável à prevenção de quedas.

Resumen Objetivo Proponer un diagrama de prevención de caídas para personas mayores, basado en el modelo de promoción de la salud de Nola Pender. Métodos La elaboración del diagrama se basó en el modelo de Nola Pender y sus elementos. Para tal fin, se realizó un estudio de revisión integradora con el objetivo de recopilar datos sobre características y experiencias individuales, sentimientos y conocimientos y adopción de un comportamiento saludable para la prevención de caídas. Después de recopilar la información, se realizó un análisis de similitud de los estudios seleccionados mediante IRaMuTeQ. Los elementos obtenidos del análisis de similitud permitieron agrupar los estudios respecto a los elementos encontrados y, de esta forma, proporcionaron la organización del diagrama de prevención de caídas. Resultados La muestra final estuvo compuesta por 54 artículos, divididos de acuerdo con los elementos del modelo de Nola Pender: 36 abordaban características y experiencias individuales, 40 sentimientos y conocimientos y 20 eran sobre el comportamiento. Los elementos obtenidos del análisis de similitud generaron un conjunto semántico de palabras más frecuentes: caída, prevención, mujer y miedo. Por otro lado, las palabras menos frecuentes fueron: cognición, autoeficacia, transporte y planificación, que contribuyeron para la elaboración del diagrama. Conclusión A partir de la revisión, se elaboró un diagrama que favoreció la identificación de los factores personales, barreras y facilidades para un comportamiento conveniente en la prevención de caídas.

Abstract Objective To propose a fall prevention diagram for older adults, based on Nola Pender's Health Promotion Model. Methods Diagram construction was based on Nola Pender's model and its elements. For this, an integrative review study was carried out with the objective of collecting data on individual characteristics and experiences, behavior-specific cognitions and affect and behavioral outcome for fall prevention. After collecting this information, a similarity analysis of the selected studies was carried out using IRaMuTeQ. The elements obtained from similarity analysis facilitated the grouping of studies regarding the elements found and thus provided fall prevention diagram organization. Results The final sample consisted of 54 articles, divided according to the elements of Nola Pender's model: 36 addressed individual characteristics and experiences, 40 referred to behavior-specific cognitions and affect, and 20 referred to behavioral outcome. The elements obtained from the similarity analysis generated a semantic range of the most frequent words: fall, prevention, woman and fear. The least frequent words were cognition, self-efficacy, transportation and planning, which contributed to diagram construction. Conclusion From the review, a diagram was prepared, which favored identifying personal factors, barriers and facilities for a desirable behavior to prevent falls.

An interpretable clustering approach to safety climate analysis: Examining driver group distinctions.

The transportation industry, particularly the trucking sector, is prone to workplace accidents and fatalities. Accidents involving large trucks accounted for a considerable percentage of overall traffic fatalities. Recognizing the crucial role of safety climate in accident prevention, researchers have sought to understand its factors and measure its impact within organizations. While existing data-driven safety climate studies have made remarkable progress, clustering employees based on their safety climate perception is innovative and has not been extensively utilized in research. Identifying clusters of drivers based on their safety climate perception allows the organization to profile its workforce and devise more impactful interventions. The lack of utilizing the clustering approach could be due to difficulties interpreting or explaining the factors influencing employees' cluster membership. Moreover, existing safety-related studies did not compare multiple clustering algorithms, resulting in potential bias. To address these problems, this study introduces an interpretable clustering approach for safety climate analysis. This study compares five algorithms for clustering truck drivers based on their safety climate perceptions. It also proposes a novel method for quantitatively evaluating partial dependence plots (QPDP). Then, to better interpret the clustering results, this study introduces different interpretable machine learning measures (Shapley additive explanations, permutation feature importance, and QPDP). The Python code used in this study is available at https://github.com/NUS-DBE/truck-driver-safety-climate. This study explains the clusters based on the importance of different safety climate factors. Drawing on data collected from more than 7,000 American truck drivers, this study significantly contributes to the scientific literature. It highlights the critical role of supervisory care promotion in distinguishing various driver groups. Moreover, it showcases the advantages of employing machine learning techniques, such as cluster analysis, to enrich the scientific knowledge in this field. Future studies could involve experimental methods to assess strategies for enhancing supervisory care promotion, as well as integrating deep learning clustering techniques with safety climate evaluation.

Incidencia, circunstancias y consecuencias de caídas en sujetos con accidente cerebrovascular: un año de seguimiento / Incidence, circumstances and consequences of falls in subjects with stroke: One year of follow-up

Introducción: Luego del accidente cerebrovascular (ACV), una de las complicaciones más frecuentes son las caídas, impactando negativamente en la rehabilitación. Objetivos: Estudiar la incidencia, las circunstancias y las consecuencias de las caídas en sujetos con ACV hasta 12meses de iniciado el tratamiento kinésico ambulatorio. Materiales y métodos: Diseño prospectivo, serie de casos. Muestreo consecutivo. Pacientes ingresados en el Hospital de Día entre junio de 2019 y mayo de 2020. Se incluyeron: adultos con diagnóstico de primer ACV supratentorial y puntuación ≥3 en la Functional Ambulatory Category. Criterios excluyentes: otra afección que afecte la locomoción. Variables principales: número de caídas, circunstancias y consecuencias. Se midieron las características clínico-demográficas y funcionales. Resultados: Un total de 21 sujetos incluidos; 13 sufrieron al menos una caída. Reportaron 41 caídas: 15 fueron hacia el lado más afectado, 35 en el interior del hogar, 28 sin el equipamiento indicado, en 29 ocasiones estaban solos durante el evento y en 2 situaciones se requirió asistencia médica. Hubo diferencias estadísticamente significativas (p<0,05) en el desempeño funcional (equilibrio, velocidad de marcha) entre los que se cayeron con respecto a los que no. No se hallaron diferencias significativas entre la resistencia de la marcha y las caídas. Conclusión: Más de la mitad sufrieron caídas, estando solos, hacia el lado más débil y sin el equipamiento indicado. Con esta información se podría disminuir la incidencia desarrollando medidas preventivas.(AU)

Introduction: Falls are among the most frequent complications following stroke (CVA), and have a negative impact on rehabilitation. Objectives: To study the incidence, circumstances, and consequences of falls in stroke patients up to 12months after starting outpatient kinetic treatment. Materials and methods: Prospective design, case series. Consecutive sampling. Patients admitted to the day hospital between June 2019 and May 2020. Included: adults with a diagnosis of first supratentorial stroke and functional ambulatory category score ≥3. Exclusion criteria: other condition affecting locomotion. Main variables: number of falls, circumstances, and consequences. Clinical, demographic, and functional characteristics were measured. Results: Twenty-one subjects were included, 13 suffered at least one fall. The subjects reported 41 falls: 15 were to the most affected side, 35 inside the home, 28 without the indicated equipment, they were alone when the event occurred on 29 occasions, and in two situations medical assistance was required. There were statistically significant differences (P<.05) in functional performance (balance, gait velocity) between those who fell and those who did not. No significant differences were found between gait endurance and falls. Conclusion: More than half suffered a fall, alone, to the weaker side, and without the appropriate equipment. With this information the incidence could be reduced by preventive measures.(AU)

Perfil clínico e epidemiológico de pacientes vítimas de queimaduras, um estudo retrospectivo / Clinical and epidemiological profile of burn victims, a retrospective study

Introdução: No Brasil, queimaduras acometem cerca de um milhão de pessoas/ano, a maioria do sexo masculino. Além de prejuízos físicos e emocionais, há impacto econômico, com gastos para o sistema de saúde, indenizações e incapacidades laborais. Por estas razões, estudos epidemiológicos são importantes para traçar o perfil da população mais acometida, orientando a prevenção dessa afecção. Método: Revisão dos prontuários de 398 vítimas de queimaduras, internados na Santa Casa de Santos, de janeiro de 2016 até dezembro de 2019. Resultados: Os principais acometidos são homens, jovens, em ambiente doméstico, por líquidos aquecidos, causando em sua maioria queimaduras de segundo grau, atendidos em até 24 horas, considerados grandes queimados e internados em enfermaria por até duas semanas. Aproximadamente 90% recebeu alta com melhora, necessitando apenas de desbridamento e curativos. Conclusão: Nosso trabalho concorda com maioria das revisões em relação à prevalência do sexo masculino, jovens, economicamente ativos, em suas residências, com líquidos aquecidos, acidentalmente. Outros estudos apontaram crianças como as mais afetadas, mostrando necessidade de políticas voltadas a ambas as faixas etárias. Com relação à internação, a maioria permaneceu em enfermaria, com queimaduras de segundo grau, prevalecendo os grandes queimados, o que acarreta maior gravidade e custos. Esse dado vai contra alguns trabalhos, que apontam queimadura de segundo grau como principal, porém com menos de 10% da superfície corporal queimada. A maior parte dos pacientes, tanto neste quanto na maioria dos estudos, apresentou bom desfecho, sem necessidade de Unidade de Terapia Intensiva ou procedimentos cirúrgicos, mostrando a importância do desbridamento precoce e cuidados com curativos.

Introduction: In Brazil, burns affect around one million people/year, the majority of whom are male. In addition to physical and emotional losses, there is an economic impact, with costs for the health system, compensation, and work disabilities. For these reasons, epidemiological studies are important to outline the profile of the most affected population, guiding the prevention of this condition. Method: Review the medical records of 398 burn victims admitted to Santa Casa de Santos from January 2016 to December 2019. Results: The main victims were young men in a domestic environment, by heated liquids, mostly causing second degree burns, treated within 24 hours, considered major burns, and admitted to the infirmary for up to two weeks. Approximately 90% were discharged with improvement, requiring only debridement and dressings. Conclusion: Our work agrees with most reviews regarding the prevalence of young, economically active males with accidentally heated liquids in their homes. Other studies highlighted children as the most affected, showing the need for policies for both age groups. Regarding hospitalization, the majority remained in the ward, with second-degree burns, with major burns prevailing, which leads to greater severity and costs. This data goes against some studies, which indicate second-degree burns as the main burn, with less than 10% of the body surface burned. In both this and most studies, most patients had a good outcome, without needing an Intensive Care Unit or surgical procedures, showing the importance of early debridement and care with dressings.

Health Service Impacts and Risk Factors for Severe Trauma in Mountain Biking: A Narrative Review.

Mountain biking is growing in participation but carries risk for severe injury and burden on health systems. Little is known about the impact of these injuries on emergency medical services, definitive healthcare, and factors contributing to accidents. This review aimed to determine the health service impacts of severe mountain bike trauma and risk factors, with a view to understanding critical gaps and needs. A systematic online search was conducted using the databases PubMed and MEDLINE complete and grey literature relating to mountain bike injury since the databases' inception to July 2023. The results show that although mountain biking has relatively high injury rates that are increasing, the impacts on health services were rarely documented, with some evidence indicating that even small increases in injuries from race events can overwhelm local health services. Severe injuries were more common in downhill disciplines. However, the definitions of what constitutes severe injury were variable. Severe injuries were more common in downhill disciplines, influenced by the rider skill level, demographics, participation in competitive events, trail design, environmental factors, and healthcare availability. Further research in these areas is needed, along with the more consistent reporting of injury severity.

Landing wise program: feasibility study protocol for Parkinson's disease.

Regardless of the benefits of fall prevention programs, people with Parkinson's disease (PD) will still fall. Therefore, it is crucial to explore novel therapeutic approaches that are well-accepted and effective for addressing fall risk and the fear of falls among this population. The present study aims to assess the feasibility of the Landing Wise program as a therapeutic intervention for reducing the fear of falling in people with PD. A mixed-methods study will be conducted using convenience sampling to recruit 20 people with PD with a moderate concern of falling from a Parkinson's Patients Association. In addition to usual care, participants will attend 2 days per week, 90 min group sessions for 8 weeks. The intervention combines group cognitive behavioral intervention with the training of safe landing strategies. Feasibility will be assessed by six key domains (recruitment strategy and rates, enrollment, retention, acceptability, reasons for decline/withdrawal, and adverse events). Quantitative data will be analyzed using descriptive statistics to characterize the sample, followed by inferential statistics to evaluate differences in the Short Falls Efficacy Scale-International Scale, Movement Disorder Society Unified Parkinson's Disease Rating Scale, Timed Up Go, 6-Minutes Walking Distance, and fall frequency and severity scores between baseline and final assessment. Qualitative data will be analyzed using an inductive thematic analysis process. There is a growing interest in developing new effective therapeutic approaches for people with PD. If proven program feasibility, this study precedes a randomized controlled trial to establish the effectiveness of the Landing Wise program.

E-Scooters and Craniofacial Trauma: A Systematic Review.

Study Design: Systematic review. Objective: Standing electric scooters (e-scooters) provide a cheap and environmentally friendly transport alternative, but also elicit substantial concern regarding their volume of associated injuries especially in the craniofacial region. This review aims to explore the demographics, risk factors, types of injury and surgical management of craniofacial trauma associated with e-scooters. Methods: PubMed and Scopus databases were systematically searched. Inclusion criteria were clinical studies investigating craniofacial trauma associated with e-scooters. Exclusion criteria were duplicates; non-English publications; non-full-text publications; studies with insufficient data. Results: Of the 73 articles identified, 10 eligible articles representing 539 patients were included. The mean age was 31.5 years. Most cases were male (63.7%). Common risk factors were alcohol/drug intoxication, absence of distal extremity injuries and lack of helmet use. The most common mechanism of injury was mechanical falls (72.4%). The most common facial fracture pattern was middle third fractures (58.3%). Surgical management was required for 43.3% of fractures. Other types of injuries reported were traumatic brain injuries (17.6%), soft tissue injuries (58.3%), dental injuries (32.9%) and ophthalmological injuries (20.6%). Conclusions: The findings of this review suggest common presentations for craniofacial trauma associated with e-scooters. Robust longitudinal evaluations with standardised descriptions of types of injuries are required. Gaps in knowledge relate to surgical management, post-operative complications and associated risk factors.

Factors associated with healthcare utilization for infant falls in South Korea: a cross-sectional online survey.

PURPOSE: Falls are a common cause of unintentional injuries in infants. This study was conducted to examine the patterns of healthcare utilization following infant falls in South Korea. METHODS: This cross-sectional descriptive study utilized an online survey designed to gather information regarding the general characteristics of parents and infants, fall-related variables, and healthcare use. RESULTS: The most serious falls identified by parents occurred at an average infant age of 6.97 months. Most fall incidents took place indoors (95.7%), and many occurred under the supervision of caregivers (68.0%). Following the fall, 36.4% of the participants used healthcare services. Logistic regression analysis revealed that healthcare use following an infant fall was significantly associated with being a firstborn child (odds ratio [OR]=5.32, 95% confidence interval [CI], 2.19-15.28) and falling from a caregiver's arms (OR=4.22; 95% CI, 1.45-13.68). CONCLUSION: To prevent and decrease the frequency of infant falls, improvements are needed in both the domestic environment and parenting approaches.

Applying a Health Equity Lens to Work-Related Motor Vehicle Safety in the United States.

Motor vehicle crashes (MVCs) are the leading cause of fatal work-related injuries in the United States. Research assessing sociodemographic risk disparities for work-related MVCs is limited, yet structural and systemic inequities at work and during commutes likely contribute to disproportionate MVC risk. This paper summarizes the literature on risk disparities for work-related MVCs by sociodemographic and employment characteristics and identifies worker populations that have been largely excluded from previous research. The social-ecological model is used as a framework to identify potential causes of disparities at five levels-individual, interpersonal, organizational, community, and public policy. Expanded data collection and analyses of work-related MVCs are needed to understand and reduce disparities for pedestrian workers, workers from historically marginalized communities, workers with overlapping vulnerabilities, and workers not adequately covered by employer policies and safety regulations. In addition, there is a need for more data on commuting-related MVCs in the United States. Inadequate access to transportation, which disproportionately affects marginalized populations, may make travel to and from work less safe and limit individuals' access to employment. Identifying and remedying inequities in work-related MVCs, whether during the day or while commuting, will require the efforts of industry and multiple public sectors, including public health, transportation, and labor.

Primer caso de transmisión de mpox mediante toma de muestra por desteche en Chile

Mpox es una zoonosis vírica que causa síntomas similares a la viruela, aunque menos graves. La infección fue descrita inicialmente en África central y occidental. Luego del brote multinacional ocurrido el año 2022, ya no es considerada una emergencia de salud pública de importancia internacional. El mecanismo de transmisión es por contacto físico estrecho o directo con lesiones cutáneas de individuos infectados. Presentamos el caso clínico de una enfermera que se infectó por mpox tras un accidente cortopunzante durante la toma de muestra de una lesión por desteche con bisturí en un paciente con VIH. La transmisión percutánea tuvo un período de incubación corto, seguido de una lesión cutánea y síntomas sistémicos. Aunque infrecuente, se destaca el riesgo de transmisión ocupacional de mpox en la atención clínica. Es importante que el personal sanitario adhiera estrictamente a las medidas de prevención, como el uso de equipo de protección personal y la práctica segura en la toma de muestra.

Monkeypox is a viral zoonosis that causes symptoms similar to smallpox, but less severe. The infection was initially described primarily in central and western Africa. After multi-country outbreak in 2022; it is currently no longer a public health emergency of international concern. The main mode of transmission is through close or direct contact with the skin lesions of an infected individual. We report a case of a nurse was infected with mpox after a needlestick injury during a skin sample collection from an HIV-positive patient. Percutaneous transmission resulted in a short incubation period, followed by a skin lesion and systemic symptoms. This case highlights the risk of occupational transmission of mpox in healthcare settings. It is important for healthcare workers to take rigorous prevention measures, such as the use of appropriate personal protective equipment and safe sample collection practices.