Propuesta de un índice que resume las medidas preventivas no farmacológicas adoptadas frente al SARS-CoV-2 en las empresas: el caso del Parc de Salut Mar (Barcelona) / A proposal for a summary index of nonpharmacological preventive measures adopted against SARS-CoV-2 in companies: the case of Parc de Salut Mar (Barcelona)

Introducción: Proponer la construcción de un índice numérico con las medidas preventivas no farmacológicas frente a SARS-CoV-2 a partir de la experiencia de una institución sanita-ria en Barcelona, el Parc de Salut Mar (PSMar).Método: La construcción del índice se ha realizado en tres fases. La identificación y selec-ción de las variables a incluir a partir de entrevistas semiestructuradas a informantes clave y la revisión documental. La definición de las dimensiones (constituidas a partir de una o más variables) y, finalmente la operatividad del índice a partir de dichas dimensiones. Se ha estimado el índice en el PSMar, y en sus dos principales centros, el Hospital del Mar y el Hospital de la Esperanza.Resultados: Se identificaron y categorizaron 21 variables, clasificadas en 5 dimensiones: equipos de protección individual, medidas organizativas individuales, medidas organizati-vas colectivas, medidas de vigilancia epidemiológica y actividades formativas. Además, De forma complementaria se añadió si existía un protocolo de actuación. Durante la primera ola, el índice en el Hospital del Mar se mantuvo por encima del valor obtenido en el Hos-pital de la Esperanza, mientras que en la segunda ola ambos índices presentaron valores similares hasta la semana 36, cuando el del hospital del Mar comenzó a presentar valores superiores. Estas oscilaciones se debieron principalmente a las dimensiones equipos de protección individual y actividades formativas.Conclusiones: El índice propuesto pone de manifiesto las dificultades para aplicar las diver-sas medidas preventivas no farmacológicas en las primeras semanas de la pandemia. Esta herramienta puede ser útil para evaluar las actividades desarrolladas frente a la pandemia por parte de los Servicios de Prevención de Riesgos Laborales, con las oportunas adapta-ciones a la realidad de cada empresa (AU)

Introduction: We propose the construction of a numerical index of nonpharmacological preventive measures against SARS-CoV-2 based on the experience of Parc de Salut Mar (PSMar), a healthcare institution in Barcelona.Method: The construction of the index was carried out in three phases. First, we identified and selected the variables to be included based on semi-structured interviews with key in-formants and a review of relevant documents. Second, we defined the dimensions (consist-ing of one or more variables) and, as a final step, operationalised the index based on these dimensions. The index was then applied to generate estimates for the PSMar, and in its two main centres, the Hospital del Mar and the Hospital de la Esperanza.Results: Twenty-one variables were identified and categorised into five dimensions: person-al protective equipment, individual organisational measures, collective organisational mea-sures, epidemiological surveillance measures, and training activities. We also developed an action protocol. During the first SARS-CoV-2 wave, the index at the Hospital del Mar re-mained above that estimated for the Hospital de la Esperanza, whereas in the second wave both indices showed similar values until week 36, when the Hospital del Mar index began o show higher values. These oscillations were mainly due to the dimensions of personal protective equipment and training activities.Conclusions: The proposed index identified the difficulties in implementing the various non-pharmacological preventive measures during the first weeks of the pandemic. This tool can be useful for evaluating the activities carried out by the occupational risk prevention services during the pandemic, followed by appropriate adaptations to the realities of each individual company (AU)

Systematic review and meta-analysis of clinical trials: In-hospital use of sensors for prevention of falls.

BACKGROUND: Intra-hospital falls have become an important public health problem globally. The use of movement sensors with alarms has been studied as elements with predictive capacity for falls at hospital level. However, in spite of their use in some hospitals throughout the world, evidence is lacking about their effectiveness in reducing intra-hospital falls. Therefore, this study aims to develop a systematic review and meta-analysis of existing scientific literature exploring the impact of using sensors for fall prevention in hospitalized adults and the elderly population. METHODS: We explored literature based on clinical trials in Spanish, English, and Portuguese, assessing the impact of devices used for hospital fall prevention in adult and elderly populations. The search included databases such as IEEE Xplore, the Cochrane Library, Scopus, PubMed, MEDLINE, and Science Direct databases. The critical appraisal was performed independently by two researchers. Methodological quality was assessed based on the ratings of individual biases. We performed the sum of the results, generating an estimation of the grouped effect (Relative Risk, 95% CI) for the outcome first fall for each patient. We assessed heterogeneity and publication bias. The study followed PRISMA guidelines. RESULTS: Results were assessed in three randomized controlled clinical trials, including 29,691 patients. A total of 351 (3%) patients fell among 11,769 patients assigned to the intervention group, compared with 426 (2.4%) patients who fell among 17,922 patients assigned to the control group (general estimation RR 1.20, 95% CI 1.04, 1.37, P = .02, I2 = 0%; Moderate GRADE). CONCLUSION: Our results show an increase of 19% in falls among elderly patients who are users of sensors located in their bed, bed-chair, or chair among their hospitalizations. Other types of sensors such as wearable sensors can be explored as coadjutants for fall prevention care in hospitals.

Is a flick-through enough? A content analysis of Advanced Driver Assistance Systems (ADAS) user manuals.

Advanced Driver Assistance Systems (ADAS) are being developed and installed in increasing numbers. Some of the most popular ADAS include blind spot monitoring and cruise control which are fitted in the majority of new vehicles sold in high-income countries. With more drivers having access to these technologies, it is imperative to develop policy and strategies to guarantee the safe uptake of ADAS. One key issue is that ADAS education has been primarily centred on the user manual which are not widely utilised. Moreover, it is unclear if user manuals are an adequate source of education in terms of content and readability. To address this research gap, a content analysis was used to assess the differences in ADAS-related content and readability among the manuals of the highest selling vehicles in Australia. The qualitative findings showed that there are seven themes in the user manuals: differences between driving with and without ADAS, familiarisation requirements, operational limits of the ADAS, potential ADAS errors, behaviour adaptation warnings, confusion warnings, and malfunction warnings. The quantitative analysis found that some of the manuals require several years of education above the recommended for a universal audience (>8 years) to be understood. Additionally, there is a notable number of text diversions and infographics which could make comprehension of the user manual difficult. This investigation shows that there is a lack of standardisation of ADAS user manuals (in both content and delivery of information) which requires regulatory oversight. Driver ADAS education needs to be prioritised by policymakers and practitioners as smart technology continues to increase across the transport system. It seems that current strategies based on user manuals are insufficient to achieve successful adoption and safe use of these technologies.

Severity analysis of road transport accidents of hazardous materials with machine learning.

OBJECTIVE: The aim of this study was to explore a suitable method for analyzing road transport accidents that involve hazardous materials and to explore the main factors that influence the occurrence of accidents of varying severity. METHODS: The 2015-2019 reported crash data from the Ministry of Transport of the People's Republic of China were obtained, and road transport crashes involving hazardous materials were extracted as the analysis data. The dataset was classified into three injury severity categories: property damage only (PDO), injured (INJ), and fatal (FAT). A statistical model and three machine learning-based models were developed: a random parameters logit model (RPLM), multilayer perceptron (MLP), decision tree C5.0 (C5.0) and support vector machine (SVM). The four models were trained/estimated using the training/estimation dataset, and the best model was used to model accidents of the three different severity levels. The main factors that influence the occurrence of accidents at each crash severity level were obtained. RESULTS: C5.0 had the best modeling performance. The direct accident form (DAF), indirect accident form (IAF) and road segment (RS) were determined to be the critical determinants of PDO accidents. The DAF, IAF, road type, RS and time had a substantial effect on INJ accidents. The DAF, IAF, hazardous material type (HMT) and road surface condition were important factors in the occurrence of FAT accidents. CONCLUSIONS: Different data have unique characteristics, and the best modeling and analysis method should be chosen accordingly. The safety of road transport of hazardous materials in China is poor, and the losses caused by accidents are substantial. Strengthening the monitoring of travel speed and travel time; improving driver safety awareness, driving skills and the ability to mitigate emergencies; improving the configuration of vehicle safety equipment and the linkage with the control center and rescue center; improving the environmental differences between inside a tunnel and outside a tunnel; reducing the design of long downhill and steep slope sections; reducing the transport plan in unsafe environments; and improving the ability of road management to mitigate bad environments can be effective measures to reduce the severity of road transport accidents involving hazardous materials.

Motorcycle helmet selection and usage for improved safety: A systematic review on the protective effects of helmet type and fastening.

OBJECTIVE: Motorcycle helmets are the most common and effective protective device to reduce head injuries and mortality in crashes among powered two-wheeler riders. Even if they are globally recognized as effective, there are still concerns regarding their correct use, which is necessary to achieve maximum head protection. The goal of this systematic review is to assess which characteristics of helmet design and use showed a positive influence on rider safety, in order to provide insights to improve end-user helmet usage. METHODS: A literature search was carried out combining two sets of keywords, one related with either motorcycle or rider and the other referring to either protective equipment or injuries. After the exclusion of duplicates, 977 papers were screened by reviewers, thus identifying 32 papers that were analyzed in group discussions. RESULTS: Among the papers included in this study, no strong conflicting conclusions emerged in their results. The studies focusing on the use of different types of helmets highlighted that full-face helmets, compared with other standard helmets, have a positive influence on head injuries and facial injuries. Correct fastening was clearly beneficial for head and facial injuries, induced injuries, and helmet ejection. CONCLUSIONS: This systematic review provides important insights to improve the usage of helmets by end-users. Correct fastening is a crucial factor to avoid helmet roll-off during a crash. Most studies agreed that full-face helmets provide higher protection in comparison with other standard helmets, especially for facial injuries, and no negative influence with respect to neck and spinal injuries.

Women Face to Fear and Safety Devices During the COVID-19 Pandemic in Italy: Impact of Physical Distancing on Individual Responsibility, Intimate, and Social Relationship.

The COVID-19 pandemic of 2020 in Italy had its first epidemic manifestations on January 31, 2020. The socio-sanitary rules imposed by the government concerned the social distance and management of intimate relationships, the sense of individual responsibility toward public health. Physical distancing and housing isolation have produced new representations of intrafamily, generational, neighborhood, community responsibility, bringing out a new "medicalized dimension" of society. In light of this contextual framework, the research aims are to analyze how: the perception of individual responsibility for public and familial health and physical distancing has redrawn the relation between subjects-family-community; the State's technical-health intervention has reformulated the idea of social closeness, but also how the pandemic fear and social confinement has re-evaluated a desire for community, neighborhood, proximity; during the lockdown families, friends, neighbors have reconstructed feelings of closeness and forms of belonging. The methodology used is quanti-qualitative and involved 300 women through an online questionnaire. The data collected highlight how the house during the lockdown is perceived as a safe place and how women implement both the recommendations and the behaviors aimed at preventing contagion, but also ways that allow coping with the situation from a perspective of well-being. Furthermore, the data show how the dimension of distancing has loosened the relational dimension outside the family unit, with a greater distancing compared to pre-pandemic data. However, the majority of women report that they have joined solidarity initiatives, demonstrating that they want to maintain ties and participate actively in community life.

Field testing the applicability of motorcycle autonomous emergency braking (MAEB) during pre-crash avoidance maneuver.

OBJECTIVE: Autonomous Emergency Braking (AEB) is a promising technology for crash avoidance or pre-crash impact speed reduction through the automatic application of braking force. Implementation of AEB technology on motorcycles (MAEB) is still problematic as its interaction with the rider may compromise the safety. In previous studies, MAEB interventions at low decelerations were shown to be easily manageable by common riders in straight line condition, but they were not previously tested in lateral maneuvers such as lane change and swerving, which are common in pre-crash situations. The objective of this paper is to assess the applicability of MAEB activation during lateral avoidance maneuver and to estimate its benefits in this scenario. METHODS: Field tests were carried out involving common riders as participants, using a test protocol developed on the experience of previous studies. The test vehicle was a sport-touring motorcycle equipped with an automatic braking system that could be activated remotely by researchers to simulate MAEB intervention. The motorcycle was equipped with outriggers to prevent capsizing. The Automatic Braking (AB) interventions using a nominal deceleration of 0.3 g were deployed at pseudo-random times in conditions of straight-line travel and a sharp lane-change maneuver emulating a pre-crash avoidance action. The straight-line trials were used as the reference condition for analysis. RESULTS: Thirty-one participants experienced AB interventions in straight-line and lane-change at an average speed of 44.5 km/h. The automatic braking was deployed in all the key phases of the avoidance maneuver. The system reached a deceleration of 0.3 g for a time of intervention of approximately 1 s. The participants were consistently able to control the vehicle during the automatic braking interventions and were always able to complete the lane-change maneuver. The speed reductions obtained with the AB interventions during lane change were very similar to those obtained in the straight-line conditions. CONCLUSIONS: MAEB interventions with decelerations up to 0.3 g can be easily managed by motorcycle riders not only in straight-line conditions but also during an avoidance maneuver. Further investigations using higher deceleration values are now possible.

Effectiveness of front crash prevention systems in reducing large truck real-world crash rates.

Objective: Forward collision warning (FCW) and automatic emergency braking (AEB) have the potential to prevent or mitigate many large truck crashes. While these systems are known to be effective in passenger vehicles, less is known about their effectiveness in large trucks. The objective of this study was to estimate the effectiveness of these systems in reducing real-world crash rates of large trucks.Methods: Data on Class 8 trucks operating on limited-access highways during 2017-2019 were obtained from SmartDrive Systems. Detailed data on exposure measures and crash circumstances were extracted from video footage by both automated means and manual coding. Crash rates were compared by front crash prevention technology (FCW, AEB, neither), both for all police-reportable crashes overall and for relevant crash types.Results: FCW was associated with a statistically significant 22% reduction in the rate of police-reportable crashes per vehicle miles traveled, and a significant 44% reduction in the rear-end crash rate of large trucks. AEB also was associated with significant reductions-12% overall and 41% for rear-end crashes. Warnings were issued in 31% of rear-end crashes for FCW-equipped trucks. AEB intervened in 43% of rear-end crashes; about two thirds of these interventions involved autobrake activations. On average, speed was reduced by over half between the time of the intervention and impact for both systems. Observed reductions in same-direction sideswipe and roadway departure crashes per mile traveled were smaller in magnitude than those of rear-end crashes; these were consistent with other crash avoidance technologies suspected to be bundled with FCW/AEB in some cases, and very few front crash prevention interventions occurred in these types of crashes.Conclusions: FCW and AEB are effective countermeasures for crashes in which large trucks rear-end other vehicles. Large truck safety is expected to improve as new trucks are increasingly equipped with these systems. FCW has the advantage that some of these systems can be retrofitted to existing trucks, so benefits can be realized sooner and with less investment.

Effect of ABTS and conventional seats on occupant injury in rear impacts: Analysis of field and test data.

PURPOSE: This study addressed the potential effect of higher seat stiffness with ABTS (All-Belt-to-Seat) compared to conventional seats in rear impacts. It analyzed field accidents and sled tests over a wide range in delta V and estimated the change in number of injured occupants if front-seats were replaced with stiffer ABTS. METHODS: The rear-impact exposures and serious-to-fatal injury rates were determined for 15+ year old non-ejected drivers and right-front passengers in 1994+ model year vehicles using 1994-2015 NASS-CDS. More than 50 rear sled tests were analyzed using conventional and ABTS seats. An injury risk was calculated for selected ATD biomechanical responses. The results obtained with the ABTS and conventional seats were compared for matched tests based on head restraint position, ATD size and initial position and delta V. The change in risk was used to estimate the change in injury in the field by adjusting the injury rate by delta V. RESULTS: On average, front seat occupants were 39 years old, weighed 78 kg and were 171 cm tall. About 29.3% of serious-to-fatally injured (MAIS 3 + F) front seat occupants were involved in delta Vs less than 24 km/h and about 28.4% in a delta V of 48 km/h or greater. The average biomechanical response and injury risk in sled tests were higher with an ABTS seat than with a conventional seat. The average maximum injury risk was assessed by delta V groups for conventional and ABTS seats. The relative risk of ABTS to conventional seats was 1.34 in less than 16 km/h, 1.69 in 16-24 km/h, 1.65 in 24-32 km/h, 1.33 in 32-40 km/h, 5.77 in 40-48 km/h and 48.24 in the 56-64 km/h delta V category. The estimated relative risk was 11.90 in 48-56 km/h and 34.11 in 64+ km/h. The number of serious-to-fatally injured occupants was estimated to increase by up to 6.88-times if stiffer ABTS seats replaced conventional seats. CONCLUSIONS: The field data indicate that the 50th percentile male Hybrid III size is representative of an average occupant involved in rear crashes. ABTS seats used in this study are stiffer than conventional seats and increase ATD responses and injury risks over a wide range of crash severities.

Evaluating the influential factors for life preserver donning tests.

Life preservers often play a vital role in ensuring passenger safety in water-related accidents, while the difficulty of donning life preservers has been repeatedly proved even in a donning test. To evaluate the influencing factors for life preserver donning tests, 109 college students and 42 villagers were chosen as subjects. A total of fourteen variables with seven categorical variables and seven continuous variables were considered as potential influencing factors. T-test and one-way analysis of variance (ANOVA, for three or more categories) were used to judge whether grouping in categorical variables had a significant effect on the donning performance. Then all variables were offered into the stepwise linear regression (SLR) to evaluate the influential factors for life preserver donning tests. Results showed that four of fourteen variables, including gender, instruction condition, age group, and tool test time (representing the subject's flexibility), had a significant effect on the donning performance. To evaluate the relationship between the donning performance and influencing factors, models of the retrieving time, the opening time, and the donning time were built based on the SLR analysis. The paper also highlights recommendations for modification of the donning test procedure, which helps to improve the validation and reliability of life preserver donning tests.

The safety potential of enhanced lateral vehicle positioning.

OBJECTIVE: The objective of this study is to estimate the potential safety benefits of Emergency Lane Keeping (ELK) and Autonomous Emergency Steering (AES) systems with precise and reliable lateral positioning. METHODS: The material comprised in-depth studies of fatal road crashes in Sweden in 2017. Crashes resulting in passenger car occupant fatality (n = 114) were included; single vehicle (n = 60) and head-on (n = 31), intersection (n = 9), rear-end (n = 5), overtaking (n = 5), animal (n = 1), other (n = 1, U-turn), and train (n = 2). Additionally, fatal collisions between motor vehicles and vulnerable road users (VRUs) were included; pedestrians (n = 36), cyclists/moped users (n = 15), and motorcyclists (n = 17). A case-by-case analysis was conducted to identify crashes potentially prevented by ELK and AES with precise (within 0.1 m accuracy) and reliable lateral positioning. The identified crashes potentially avoided by ELK systems involved unintentional drift-out-of-lane on roads with posted speed limits of ≥70 km/h (43 mph). For comparison, the same material was used to identify the potential safety benefits of the more traditional lane departure warning (LDW) and Lane Keeping Assist (LKA) systems without enhanced lateral positioning. Crashes potentially avoided by LDW/LKA occurred on roads with visible lane markings and without rumble strips on the departure side while ELK with enhanced lateral positioning is not reliant on lane markings. Collisions potentially avoided by AES occurred on roads with sufficient escape zones and road friction. RESULTS: The study shows that ELK systems with enhanced lateral positioning could potentially avoid 33 - 45 (36 - 49%) out of 91 head-on and single car crashes resulting in passenger car occupant fatality, which corresponds to a further 18% (5/28) compared to traditional lane support (LDW/LKA) without enhanced lateral positioning. The improved lane keeping addresses crashes involving absent or nonvisible lane markings that are covered by snow. Furthermore, the study shows that the evasive steering features of AES systems with enhanced lateral positioning could potentially prevent 28 (54%) out of 52 collisions resulting in passenger car occupant fatalities (i.e., head-on, intersection, rear-end, overtaking, and animal collision). Additionally, AES with enhanced lateral positioning could potentially prevent 16 (31%) out of 51 collisions between motor vehicles and vulnerable road users resulting in fatally injured pedestrians, cyclists or moped users. The total potential safety benefits of AES include both lane keeping and evasive steering features including lane escaping. The study identified that the total number of crashes potentially avoided by AES corresponds to 42% out of all crashes resulting in passenger car occupant fatalities (n = 48/114). CONCLUSIONS: This is a first attempt to identify and quantify the increase in potential safety benefits, based on the assumption that robust lateral vehicle positioning has been applied to lane keeping as well as lane escaping. In addition to the potentially increased number of prevented crashes compared to traditional lane support, a robust lateral positioning system may have the potential to improve the redundancy in positioning systems. Previous research suggests several techniques to improve lateral vehicle positioning. However, further research is required, including testing for implementation of adequately improved lateral vehicle awareness to establish which techniques are appropriate.

Hábitos y conocimientos sobre fotoprotección y factores de riesgo para quemadura solar en corredores de maratones de montaña / Sun Protection Behaviors and Knowledge in Mountain Marathon Runners and Risk Factors for Sunburn

ANTECEDENTES Y OBJETIVOS: El cáncer cutáneo está aumentando su incidencia de forma alarmante en nuestra sociedad, debido a la sobreexposición a la radiación ultravioleta solar (RUV), ya sea por motivos laborales o por ocio. El objetivo del presente estudio es valorar los conocimientos, actitudes y hábitos sobre la exposición solar y la fotoprotección en corredores participantes en una ultramaratón de montaña, así como estimar los factores de riesgo para sufrir quemadura solar. MATERIAL Y MÉTODOS: Se realizó un estudio transversal, prospectivo descriptivo a los participantes de la «Gran Trail Aneto-Posets» (GTTAP). Se evaluaron las características sociodemográficas, la experiencia como corredor, la historia de quemadura solar en el verano previo y los hábitos y prácticas de exposición solar mediante una encuesta validada. Se realizó un análisis descriptivo, bivariado y multivariante, tomando como variable principal de resultado la presencia de quemadura solar, estableciendo un nivel de significación en p < 0,05. RESULTADOS: Se incluyeron 657 corredores, 72,1% fueron hombres, con una media de edad de 39,71 años. El 45,1% de los encuestados reconocían haberse quemado en el último año. Las gafas fue el método fotoprotector más utilizado (74,7%), seguido del fotoprotector (factor de protección solar [FPS] > 15) (61,9%), el gorro/a (52,2%), y por último, la ropa (7,4%). Mientras que tener menos edad, fototipo bajo (I y II), correr durante tres o más horas al día y resguardarse a la sombra como medida de fotoprotección se comportaron como factores de riesgo para haber sufrido quemadura solar; las actitudes favorables al uso de cremas y a la búsqueda de la sombra al mediodía, en vez de estar al sol, se comportaron como factores protectores (p < 0,001). CONCLUSIÓN: La incidencia de quemaduras solares es alta entre los corredores de trails de larga distancia en montaña, pese a que sus conocimientos y hábitos parecen adecuados. Se necesita diseñar estrategias para mejorar los hábitos de fotoprotección adaptados a su práctica deportiva

BACKGROUND AND OBJECTIVES: The incidence of skin cancer in our society is growing at an alarming rate due to overexposure to solar UV radiation in recreational and occupational settings. The aim of this study was to evaluate sun exposure and protection attitudes, behaviors, and knowledge among mountain ultramarathon runners and to assess risk factors for sunburn in this population. MATERIAL AND METHODS: Cross-sectional survey of runners who participated in the «Gran Trail Aneto-Posets» race in Aragon, Spain. Using a validated questionnaire, we collected data on sociodemographic characteristics, running experience, sunburn in the previous summer, and sun exposure and protection behaviors. We calculated descriptive statistics and performed bivariate and multivariate analyses of associations using history of sunburn as the primary outcome. Statistical significance was set at a p level of less than 0.05. RESULTS: We surveyed 657 runners (72.1% men) with a mean age of 39.71 years; 45.1% reported sunburn in the past year. The most common protective measures used were sunglasses (74.7%), sunscreen (sun protection factor ≥ 15) (61.9%), a hat (52.2%), and other protective clothing (7.4%). Risk factors for sunburn were younger age, low Fitzpatrick skin type (I and II), running for three or more hours a day, and staying in the shade as a protective measure. By contrast, protective factors were use of sunscreen and seeking shade rather than sun at midday (p < 0.001). CONCLUSIONS: Sunburn is common among long-distance mountain runners, despite what appears to be adequate sun protection knowledge and behaviors. Targeted strategies are needed to improve sun protection behaviors among mountain runners

Causes of Needlestick and Sharps Injuries When Using Devices with and without Safety Features.

Safety-engineered devices (SEDs) have been developed to protect healthcare personnel (HCP) from needlestick and sharps injuries (NSIs). The aim of this study was to analyze NSIs associated with SEDs and non-SEDs among HCP in hospitals, medical offices and care facilities. Records from online questionnaires on NSIs were used. Causes of NSIs were compared for SED use and healthcare setting. A sample of 835 files was included. Injuries with SEDs accounted for 35.0% of all NSIs, whereas the proportions were higher in medical offices and lower in care facilities. NSIs in nurses were more often associated with SEDs than NSIs in physicians. NSIs from intravenous needles were associated with SEDs in more than 60% of cases in hospitals and medical offices and in about 30.0% of cases in care facilities. In contrast, suturing was associated with every fourth NSI in hospitals, of which fewer than 10.0% were associated with SEDs. In care facilities, SEDs were involved in 36.1% of NSIs during subcutaneous injections. NSIs during disposal accounted for 29.2% of total NSIs, of which 36.1% were associated with SEDs. Frequent reasons for SED-associated NSIs were technical problems, unexpected patient movement and problems during disposal. Our analysis shows that many NSIs are associated with SEDs. Continuous training is necessary in the handling and disposal of SEDs.

Development and evaluation of potential accident scenarios involving pedestrians and AEB-equipped vehicles to demonstrate the efficiency of an enhanced open-source simulation framework.

This study introduces a method that allows the generation and safety evaluation of a scenario catalog derived from potential car-pedestrian conflict situations. It is based on open-source software components and uses the road layout standard OpenDRIVE to derive participants' motion profiles with the support of available accident data. The method was implemented upon the open-source framework openPASS and can simulate results for different active safety system setups and facilitates the prediction of system capabilities to decrease the relative impact velocities and collision configurations such as the point of impact. A demonstration case was performed where the scenario catalog was derived and used to evaluate pedestrian collisions with and without a generic autonomous emergency braking (AEB) system. The AEB system aims to intervene in the event of an impending collision and might affect the outcome of a baseline scenario. The study indicated a change in the collision configuration and identified conflict situations less affected by the system. A particularly interesting finding was that some scenarios even led to a higher number of collisions (at lower impact) for the AEB intervention in comparison to the baseline cases.

Pediatric occupant human body model kinematic and kinetic response variation to changes in seating posture in simulated frontal impacts - with and without automatic emergency braking.

OBJECTIVE: The study quantifies the kinematics of children in booster child restraint systems (CRSs) in various naturalistic seating postures exposed to frontal impacts in a full-vehicle environment, with and without the application of pre-crash automatic emergency braking. METHODS: The PIPER 6YO and 10YO pediatric human body models were positioned in CRSs. The 6YO was restrained on a lowback (LBB) and highback (HBB) booster, while the 10YO was positioned on an LBB and in a NoCRS condition. All simulations used the 3-point seatbelt. The child models were pre-positioned (gravity settled, seatbelt tensioned) in four naturalistic seating postures: leaning-forward, leaning-forward-inward, leaning-forward-outward, and a pre-submarining position, along with a baseline reference seating position. A 2012 Toyota Camry finite element (FE) model was used as the vehicle environment. A standard 3-point lap-shoulder belt system was modeled to restrain the child and CRS in the left-rear vehicle seat. Two vehicle impact cases were considered: with and without a pre-crash AEB. For with-AEB cases, a pre-crash phase was run to incorporate postural changes due to the application of AEB. All seating positions were ultimately subjected to a full-frontal rigid-barrier impact at 35 MPH. A total of 40 conditions were simulated in LS-DYNA. RESULTS: Injury metrics varied widely for both occupants. Shoulder belt slippage was observed for the 6YO leaning-forward-inward on HBB. No head contact was observed for any simulated cases. Forward-leaning and forward-inward-leaning postures generally had greater head excursion across all seating postures. The lap belt rode over the pelvis for pre-submarining postures. Injury metrics for cases with pre-crash AEB were lower compared to their corresponding without-AEB cases. HIC15, head acceleration, upper neck tension force, and upper neck flexion moment were similar or lower for with-AEB scenarios. CONCLUSIONS: Pre-crash AEB reduces the effect of the impact despite the same collision speed as cases without-AEB. This is primarily due to the limited travel distance of the occupant, thus, starting an earlier ride-down during the crash. Moreover, different initial seating postures lead to a wide range of injury exposures. Vehicle and child restraint design should incorporate these seating postures to ensure robust protection of the occupant in a crash.

COVID-19: The role of artificial intelligence in empowering the healthcare sector and enhancing social distancing measures during a pandemic.

Indiscriminatory in its spread, COVID-19 has engulfed communities from all social backgrounds throughout the world. While healthcare professionals work tirelessly testing for the virus and caring for patients, they too have become casualties of the pandemic. Currently the best way to attempt to curb the spread of the virus, echoed by almost all nation leaders, is to distance ourselves from one another socially or physically. However ideal this may seem, social distancing is not always practical in densely populated lower-income countries with many citizens below the breadline. With the majority of South Africans living in poverty, communities in overcrowded households are unable to distance themselves from one another appropriately. In addition, as a nation we struggle with high HIV and tuberculosis rates, malnutrition and an already overburdened healthcare system, emphasising the extreme vulnerability of our people. These factors, coupled with the fact that many of our healthcare professionals lack the necessary personal protective equipment to prevent them from contracting the virus themselves, highlight the gravity of the damaging repercussions that we may face in the coming months, after the complete national lockdown in force at the time of writing is lifted and we move towards a partial lockdown state. Nationally, there needs to be a shift in mindset towards exploring alternative technology-based preventive measures that may empower the healthcare sector in the long term and enhance social distancing.

Understanding users' characteristics in the selection of vehicle seating configurations and positions in fully automated vehicles.

OBJECTIVE: To understand which users' characteristics influence their preferences in the selection of vehicle seating configurations and positions across different traveling scenarios involving a fully automated vehicle (FAV). METHODS: Participants (n = 730) completed an online survey in which they were asked to imagine traveling in a FAV across three hypothetical scenarios. Participants were asked to select between five different seating configurations and four positions for each scenario and about their anthropometry and their driving/riding experience. Multinomial regression analyses were conducted to identify the factors that influenced users' preferences. RESULTS: FAV Configuration #3 (traditional light vehicle seating configuration) was the preferred seating configuration for 74% of the participants, followed by FAV #2 (in which the two seating rows face each other, 13%) in Scenario 1 (riding by oneself). Similar numbers were observed in Scenario 3 (riding with an unknown person). In Scenario 2 (riding with their partner), participants preferred FAV #2 (12.5%) and FAV #5 (in which the front seat passengers point toward a common point in the front, conventional rear seat configuration, 17.5%). Having close family was significant to choose the traditional vehicle configuration over other vehicle configurations, but only when the participants were driving by themselves. Having previously experienced motion sickness was significant to prefer a forward seating configuration when the trip was shared with partners. Belonging to a particular height or weight group was significantly associated with the preferred seat within the preferred FAV configuration (the driver's position in FAV #3; a rear-facing seat in FAV #2), although there was not a clear trend between increasing weight and/or height and preferring one seating position over the others. CONCLUSIONS: Previous work had shown differences in participants' preferences for seating configurations and positions depending on age, sex and country. While increasing the sample size, the current study analyses other factors that were associated with choosing one vehicle configuration and seating position over others. As these factors are directly related to the likelihood of sustaining injuries in the event of a crash, the current study provides important insights regarding the potential risk factors for FAV occupants.

Evaluation of users' experience and posture in a rotated swivel seating configuration.

OBJECTIVE: This study aims to evaluate a car passenger's experience and actions in a rotated seat in terms of interaction with an adjacent passenger. METHODS: A static user study was conducted, using a stationary test vehicle with two front row seats facing rearwards. The seats were mounted on a swivel plate which allowed inboard rotation. Thirty-two participants in 16 test pairs were grouped based on stature; short or tall. The participants within each pair knew each other. Three seating configurations were evaluated; 0° and 10° and 20° inboard rotated position of both seats. The participants were seated in each seating configuration for 10 min; 5 min they engaged in a conversation with each other and 5 min they were watching media on an Ipad mounted in front of them. Subjective data from each participant on their experiences and preferences were collected through questionnaires, and objective data on sitting postures and eye gaze were collected through video recording. RESULTS: Ninety-two percent of the short participants preferred to sit in the 20° rotated seating configuration when watching media and 75% preferred the 20° seating configuration when engaged in conversation. Compared to short participants, the tall participants showed a relative larger spread in seating configuration preference; 15% and 30% of them preferred the reference position for media and conversation, respectively. Leg interference was common for tall participants when 20° inboard rotated. They perceived it uncomfortable and used various strategies to avoid contact, including crossing legs or feet. Time spent with mutual eye contact did not vary by seating configuration. CONCLUSIONS: This static user study shows that rotated seats could be a desired seating configuration in future autonomous vehicles for individuals who know each other. It reveals the reasons behind the preferences and the extent of desired seat rotation, showing differences between tall and short individuals. By understanding how occupant position and posture can be influenced by offering various seating configurations, the occupant can choose a comfortable position that is also safe. The leg and feet positions are raised as the body region with most variations and for which an increased understanding of influence in a crash is encouraged.

Investigation of radiation protection and safety measures in Rwandan public hospitals: Readiness for the implementation of the new regulations.

BACKGROUND: An essential concept that all radiographers are required to implement is the use of techniques and the provision of protective devices to minimize radiation to patients and staff. Methods to achieve this could include good communication, immobilization, beam limitation, justification for radiation exposure, shielding, appropriate distances and optimum radiographic exposures factors. PURPOSE: The aim of this study was to assess the availability and utilization of radiation protection and safety measures by medical imaging technologists (MITs) in Rwandan hospitals. METHODS: A quantitative, non-experimental descriptive design was used and data collected by means of a self-designed questionnaire. One hundred and sixteen MITs (n = 116) representing 96.67% of the total population participated in the study. RESULTS: The study found radiation safety measures were not adequately implemented in government hospitals. Only 58.62% of MITs had radiation-measuring devices, with 29% receiving dose readings inconsistently. Lead rubber aprons were available at 99.13% of the hospitals; however, 59% of the participants had never checked the integrity of the aprons. Lead rubber aprons and lead equivalent barriers were most prevalent in the facilities. CONCLUSION: The study found there was a lack of adequate radiation safety equipment. Exposure charts and immobilization devices were not adequately implemented in the hospitals. The level of education and experience of the MITs did not appear to influence the radiation safety practice significantly. There is a need for concerted efforts between the Rwanda Utilities Regulatory Authority (RURA), Ministry of Health, University of Rwanda and hospital management to improve the radiation safety culture, especially in view of the law governing radiation protection that was recently promulgated.