Acidentes e plantas hospedeiras associadas a lagartas urticantes / Accidents and host plants associated with urticant caterpillars / Accidentes y plantas hospedadoras asociadas a orugasurticantes

Introdução: Ambientes urbanos como áreas verdes, praças, parques e escolas estão se tornando cada vez mais propícios ao aparecimento de animais peçonhentos, dentre eles as lagartas urticantes. Acidentes com algumas lagartas urticantes podem ser graves, podendo leva ao óbito, como no caso do gênero Lonomia.Objetivo:descrever o perfil epidemiológico dos acidentes envolvendo lagartas urticantes no município de Chapecó, Santa Catarina e identificar espécies vegetais hospedeiras destas lagartas.Metodologia:Foram coletados os dados epidemiológicos dos acidentes com lagartas urticantes registrados no período entre 2016 e 2017. Os dados foram obtidos junto ao Sistema de Informação de Agravos de Notificação.Foram analisadas as variáveis sexo, idade, parte do corpo acometida, os meses que houve as notificações, a ocupação dos indivíduos que tiveram contato com a lagarta, local em que residem, escolaridade e a espécie da lagarta envolvida. Ainda, foram identificados os espécimes coletados pelo setor de Vigilância em Saúde Ambiental, bem como foram identificadas as plantas hospedeira sem que foram encontrados.Resultados:Foram registrados 377 acidentes envolvendo majoritariamente o sexo feminino e a faixa etária entre 20 a 49 anos.As partes do corpo mais acometidas foram o pé (17,0%), mão (12,9%) e cabeça (11,4%). Foram identificadas seis espécies de plantas associadas à ocorrência de lagartas urticantes Conclusões:O estudo contribui com informações epidemiológicas sobre os acidentes causados por lepidópteros em um município de grande porte. Ressalta-se, a importância de ampliar as pesquisas em relação às plantas hospedeiras e a divulgação dos resultados visando a prevenção de acidentes (AU).

Introduction:Urban environments such as green areas, squares, parks and schools are becoming more and more favorableto the appearance of venomous animals, including urticatingcaterpillars. Accidents with some stinging caterpillars can be serious and can lead to death, as in the case of the genus Lonomia. Objective:to describe the epidemiological profile of accidents involving stinging caterpillars in the municipality of Chapecó, Santa Catarina and to identify host plant species of these caterpillars. Methodology:Epidemiological data on stinging caterpillar accidents recorded in the period between 2016 and 2017were collected. The data were obtained from the Sistema de Informação de Agravos de Notificação. The variables sex, age, body part affected, the months of the notifications, the occupation of the individuals who had contact with the caterpillar, the place where they live, education and the species of the caterpillar involved were analyzed. Still, the specimens collected by the Environmental Health Surveillance sector were identified, as well as the host plants in which they were found. Results:There were 377 accidents involving mostly females and the age group between 20 and 49 years. The parts of the body most affected were the foot (17.0%), hand (12.9%) and head (11.4%). Six species of plants were identified associated with the occurrence of stinging caterpillars.Conclusions:The study contributes with epidemiological information on accidents caused by Lepidoptera in a large municipality. The importance of expanding research in relation to host plants and the dissemination of results aimed at preventing accidents are emphasized (AU).

Introducción: Los entornos urbanos como áreas verdes, plazas, parques y escuelas son cada vez más propicios para la aparición de animales venenosos, incluidas las orugas urticantes. Los accidentes con algunas orugas pueden ser graves y provocar la muerte, como en el caso del género Lonomia.Objetivo: describir el perfil epidemiológico de los accidentes por orugasurticantes en el municipio de Chapecó, Santa Catarina e identificar especies de plantas hospedadoras de estas orugas.Metodología: Se recolectaron datos epidemiológicos sobre accidentes de orugas urticantes registrados en el período entre 2016 y 2017. Los datos se obtuvieron del Sistema de Informação de Agravos de Notificação(SINAN). Se analizaron las variables sexo, edad, parte del cuerpo afectada, los meses delas notificaciones, la ocupación de los individuos que tuvieron contacto con lasorugas, el lugar donde viven, educación y la especie de oruga involucrada. Aún así, se identificaron los especímenes recolectados por el sector de Vigilancia de Salud Ambiental, así como las plantas hospedantes en las que se encontraron.Resultados: Se produjeron 377 accidentes que afectaron en su mayoría a mujeres y al grupo de edad entre 20 y 49 años. Las partes del cuerpo más afectadas fueron el pie (17,0%), mano (12,9%) y cabeza (11,4%).Se identificaron seis especies de plantas asociadas con la ocurrencia de orugas urticantes.Conclusiones: El estudio presentainformación epidemiológica sobre accidentes causados por lepidópteros en un municipio de gran tamaño. Se destacala importancia de ampliar la investigación en relación con las plantas hospedantes y la difusión de resultados orientados a la prevención delosaccidentes (AU).

Segurança do ambiente domiciliar e ocorrência de quedas em pessoas idosas / The home environment safety and the occurrence of falls in elderly people / La seguridad en el entorno domiciliario y la ocurrencia de caídas en los ancianos

Introdução:A ocorrência de quedas em pessoas idosas é considerada um problema de saúde pública, acarretando prejuízos para a saúde, mas que pode ser prevenida a partir da manutenção de um ambiente seguro. Objetivo:Identificar condições relacionadas a ocorrência de quedas e segurança do ambiente domiciliar de pessoas idosas residentes na zona rural de um município do Rio Grande do Norte. Metodologia:Foi realizada uma pesquisa-ação com uma das etapas de diagnóstico feito a partir de um estudo analítico e observacional. O estudo foi realizado com Agentes Comunitários de Saúde e idosos. Foram realizadas capacitações com os agentes para reconhecimento e identificação dos riscos ambientais de quedas nos domicílios dos idosos. Para coleta de dados, utilizou-se o questionário de avaliação ambiental e quedas da Caderneta de Saúde da Pessoa Idosa. Resultados:Participaram do estudo 288 idosos, dos quais 24,7% relataram ter sofrido queda e desses, 23,9% tiveram fratura óssea. 47,9% das quedas ocorreram dentro de casa, principalmente no banheiro (42,2%). A maioria dos itens de segurança do ambiente domiciliar não estava adequado. Foram encontradas diferenças significativas entre a ocorrência de queda e a ausência de pisos uniformes e tapetes bem fixos (p<0,001), interruptores acessíveis nas entradas de cômodos (p<0,001), área do chuveiro com antiderrapante (p=0,026) e armários baixos sem necessidade do uso de escadas (p<0,001). Conclusões:A maioria das pessoas idosas vive em um ambiente que favorece a ocorrência de quedas. Enfatiza-se a necessidade de ações de prevenção de quedas e segurança domiciliar tendo em vista suas implicações na qualidade de vida dessas pessoas (AU).

Introduction:The occurrence of falls in elderly people is considered a public health problem, causing harm to health, but thiscan be prevented by maintaining a safe environment.Objective:To identify conditions related to the occurrence of falls and home environment safety of elderly people living in the rural area of a city in Rio Grande do Norte, Brazil.Methodology:We performed an action-research with one of the diagnostic stagesmade from an analytical and observational study. The study was conducted with Community Health Workers and the local elderlypopulation. Training was accomplishedwith theseworkersto recognize and identify the environmental risks of falls in the elderly's homes. In order to collect data,we used the environmental assessment and falls questionnaire from the Elderly Person's Health Booklet.Results:A total of 288 older adults participated in the study, of whom 24.7% reported having suffered a fall;and of these, 23.9% had a bone fracture. A percentage of 47.9% of falls occurred indoors, mainly in the bathroom(42.2%). Most homesafety items were not adequate.Significant differences were found between the occurrence of falls and the absence of uniform floors and well-fixed mats(p<0.001), accessible switches at the entrances of rooms (p<0.001), non-slip shower area (p=0.026) and low closetswithout the need to use stairs (p<0.001). Conclusions:Most elderly people live in an environment that favors the occurrence of falls. Fall prevention and home safety actions are necessary due totheir implications onthe quality of life of this population (AU).

Introducción: La ocorruencia de caídas em los ancianosse considera un problema de salud pública, que causa daños a la salud, pero que puede prevenirse manteniendo un entorno seguro.Objetivo: Identificar las condiciones relacionadas con la ocurrencia de caídas y la seguridad em el entorno domiciliariode los ancianos que viven em um árearural de un municipio de Rio Grande doNorte, Brasil.Metodología: Se realizó una investigación-acción con una de las etapas de diagnóstico realizada a partir de un estudio analítico y observacional. El estudio se realizócon Agentes de Salud Comunitariosy ancianos. Los agentes recibieron formación para reconocer e identificar los riesgos ambientales delascaídas en las residenciasde los ancianos. Para la recogidade datos, se utilizó el cuestionario de evaluación ambiental y caídas de la Cartillade Salud de los Ancianos.Resultados: El estudio incluyó a 288 ancianos, de los cuales el 24,7% sufrieroncaída;y, de estos,el 23,9% tuvieron fractura ósea. El 47,9% de las caídas se produjeron en un entorno interior, principalmente en el baño (el42,2%).La mayoría de los elementos de seguridad en el entorno domiciliario no eran adecuados. Se encontraron diferencias significativas entrela ocurrencia de caída y la ausencia de suelosuniformes y alfombras bien fijadas(p<0,001), interruptores accesibles en las entradas de las habitaciones (p<0,001), zonade ducha con antideslizante (p=0,026) y armarios bajos sin necesidadde utilizarescaleras (p<0,001).Conclusiones: Muchos ancianos viven en entornosque favorecen la ocurrencia de caídas. Lasacciones de prevención de caídas y de seguridad em el hoharson necessárias porsus implicaciones en la calidad de vida de esta población (AU).

Lethal Means Counseling, Distribution of Cable Locks, and Safe Firearm Storage Practices Among the Mississippi National Guard: A Factorial Randomized Controlled Trial, 2018-2020.

Objectives. To examine whether lethal means counseling and provision of cable locks prompt safe firearm storage relative to control among firearm-owning members of the Mississippi National Guard.Methods. This randomized controlled trial utilized a 2 × 2 factorial design (lethal means counseling vs control, provision of cable locks vs no cable locks). Follow-up assessments took place at 3 and 6 months after baseline. Data were collected (n = 232; 87.5% male; mean age = 35.01 years; 77.2% White) from February 2018 through July 2020.Results. Relative to control, lethal means counseling and provision of cable locks resulted in greater adoption of several safe storage methods over time. Lethal means counseling outperformed control (3 months: 55.0% vs 39.0%; odds ratio [OR] = 1.91). Cable locks outperformed control at 3 and 6 months on number of storage methods (1.41 vs 1.11; d = 0.29 and 1.34 vs 1.16; d = 0.15, respectively) and locking devices (59.8% vs 29.9%; OR = 3.49 and 58.4% vs 35.8%; OR = 2.52, respectively)Conclusions. Lethal means counseling and cable locks can result in sustained changes in firearm storage.Public Health Implications. The military may benefit from lethal means counseling, perhaps administering at point of entry.Trial Registration. Clinical Trials.gov identifier: NCT03375099.

Effects of explaining system failures during maneuver coordination while driving manual or automated.

To support the coordination of road users in situations like merging or turning left, an advanced driver assistance system for cooperative driving could be helpful whether driving manually or automated. This simulator study investigated the behavior of drivers being confronted with system failures. In two test situations with system failures (loss of communication of the system and change of traffic environment), the system could not complete the coordination properly and the driver was informed about the system failure and the abortion of maneuver coordination. The focus of this study was to analyze the effect of system failures on drivers' trust in the system and whether an explanatory message provided by the system would increase acceptance. Therefore, subjective data as well as gaze and physiological data of 32 participants were analyzed. The results revealed decreased trust in the system after experiencing a system failure, but no long term effect was found. The drivers evaluated the timing, as well as the content, of the explanatory message as appropriate. The explanations were perceived as helpful, but no effect on acceptance was found.

An improved vehicle-pedestrian near-crash identification method with a roadside LiDAR sensor.

PROBLEM: Potential conflicts between pedestrians and vehicles represent a challenge to pedestrian safety. Near-crash is used as a surrogate metric for pedestrian safety evaluations when historical vehicle-pedestrian crash data are not available. One challenge of using near-crash data for pedestrian safety evaluation is the identification of near-crash events. METHOD: This paper introduces a novel method for pedestrian-vehicle near-crash identification that uses a roadside LiDAR sensor. The trajectory of each road user can be extracted from roadside LiDAR data via several data processing algorithms: background filtering, lane identification, object clustering, object classification, and object tracking. Three indicators, namely, the post encroachment time (PET), the proportion of the stopping distance (PSD), and the crash potential index (CPI) are applied for conflict risk classification. RESULTS: The performance of the developed method was evaluated with field-collected data at four sites in Reno, Nevada, United States. The results of case studies demonstrate that pedestrian-vehicle near-crash events could be identified successfully via the proposed method. Practical applications: The proposed method is especially suitable for pedestrian-vehicle near-crash identification at individual sites. The extracted near-crash events can serve as supplementary material to naturalistic driving study (NDS) data for safety evaluation.

Factors influencing side air curtain deployment in rollover motor vehicle accidents.

Objective: Recent changes in FMVSS have led to the utilization of side air curtains to provide occupant retention during rollover events. However, the safety advantage provided by the air curtains relies on the vehicle system's ability to detect the rollover event and deploy the curtains. The purpose of this study is to identify crash and vehicle characteristics in motor vehicle rollovers that influence side air curtain deployment and occupant outcomes. The current study aims to improve the understanding of rollover events and inspire more robust air curtain deployment strategies.Methods: Study data were extracted from rollover cases documented in the NASS-CDS data set from 2011 to 2015. Vehicle model years of 2011 or later with side air curtains installed were examined. The presence of a rollover sensor in each vehicle was determined from vehicle content data available on the Insurance Institute for Highway Safety's crash rating website. The resulting data set contained 14,003 weighted cases of rollover accidents in which the side air curtain did not deploy (40 raw count) and 23,178 cases of deployment (80 raw count).Results: Several crash event and vehicle characteristics were similar for the nondeployed and deployed groups, including number of quarter turns, primary location of damage, initiating event for the rollover, and vehicle model year. However, the nondeployed group included significantly more passenger vehicle body types (vs. SUV or truck) and had a significantly lower rate of rollover sensor presence. Presence of a rollover sensor increased the odds air curtain deployment by a factor of 36.5 (95% confidence interval [CI], 5.06-265). Cases in which both side air curtains deployed resulted in a higher frequency of injured occupants (Maximum Abbreviated Injury Scale [MAIS] ≥ 3). However, rollover events resulting in these injuries were also associated with higher rates of impact with another object or vehicle and damage to the roof of the vehicle, suggesting a higher energy event.Conclusions: Nondeployment of the side curtain airbags in rollovers occurred more frequently in vehicles without dedicated rollover sensors, which were most frequently passenger vehicles.

Informe especial: Envenenamiento por animal ponzoñoso: Alacranismo / Special report: Poisonous by venomous animal: Scorpions

Presentación de un caso, notificado el 9 de enero de 2017, a la Gerencia Operativa de Epidemiología del Gobierno de la Ciudad de Buenos Aires por un efector privado de la Ciudad, de envenenamiento por animal ponzoñoso (Alacranismo) en un paciente residente en la Ciudad de Buenos Aires. Se describen el cuadro clínico y el tratamiento recibido, la evolución del caso, la importancia de distintas acciones de vigilancia epidemiológica, el procedimiento de notificación, medidas de protección, y medidas de prevención y control de accidentes. Incluye datos de centros públicos nacionales y de la Ciudad de Buenos Aires especializados en asistencia y/o in-formación sobre animales venenosos

Quantifying Vision Zero: Crash avoidance in rural and motorway accident scenarios by combination of ACC, AEB, and LKS projected to German accident occurrence.

Objective: The Vision Zero initiative pursues the goal of eliminating all traffic fatalities and severe injuries. Today's advanced driver assistance systems (ADAS) are an important part of the strategy toward Vision Zero. In Germany in 2018 more than 26,000 people were killed or severely injured by traffic accidents on motorways and rural roads due to road accidents. Focusing on collision avoidance, a simulative evaluation can be the key to estimating the performance of state-of-the-art ADAS and identifying resulting potentials for system improvements and future systems. This project deals with the effectiveness assessment of a combination of ADAS for longitudinal and lateral intervention based on German accident data. Considered systems are adaptive cruise control (ACC), autonomous emergency braking (AEB), and lane keeping support (LKS). Methods: As an approach for benefit estimation of ADAS, the method of prospective effectiveness assessment is applied. Using the software rateEFFECT, a closed-loop simulation is performed on accident scenario data from the German In-Depth Accident Study (GIDAS) precrash matrix (PCM). To enable projection of results, the simulative assessment is amended with detailed single case studies of all treated cases without PCM data. Results: Three categories among today's accidents on German rural roads and motorways are reported in this study: Green, grey, and white spots. Green spots identify accidents that can be avoided by state-of-the-art ADAS ACC, AEB, and LKS. Grey spots contain scenarios that require minor system modifications, such as reducing the activation speed or increasing the steering torque. Scenarios in the white category cannot be addressed by state-of-the-art ADAS. Thus, which situations demand future systems are shown. The proportions of green, grey, and white spots are determined related to the considered data set and projected to the entire GIDAS. Conclusions: This article describes a systematic approach for assessing the effectiveness of ADAS using GIDAS PCM data to be able to project results to Germany. The closed-loop simulation run in rateEFFECT covers ACC, AEB, and LKS as well as relevant sensors for environment recognition and actuators for longitudinal and lateral vehicle control. Identification of green spots evaluates safety benefits of state-of-the-art level 0-2 functions as a baseline for further system improvements to address grey spots. Knowing which accidents could be avoided by standard ADAS helps focus the evolution of future driving functions on white spots and thus aim for Vision Zero.

Crash and injury prevention estimates for intersection driver assistance systems in left turn across path/opposite direction crashes in the United States.

Objective: The objective of this research study was to estimate the number of left turn across path/opposite direction (LTAP/OD) crashes and injuries that could be prevented in the United States if vehicles were equipped with an intersection advanced driver assistance system (I-ADAS). Methods: This study reconstructed 501 vehicle-to-vehicle LTAP/OD crashes in the United States that were investigated in the NHTSA National Motor Vehicle Crash Causation Survey (NMVCCS). The performance of 30 different I-ADAS system variations was evaluated for each crash. These variations were the combinations of 5 time-to-collision (TTC) activation thresholds, 3 latency times, and 2 different response types (automated braking and driver warning). In addition, 2 sightline assumptions were modeled for each crash: One where the turning vehicle was visible long before the intersection and one where the turning vehicle was only visible within the intersection. For resimulated crashes that were not avoided by I-ADAS, a new crash delta-V was computed for each vehicle. The probability of Abbreviated Injury Scale 2 or higher injury in any body region (Maximum Abbreviated Injury Scale [MAIS] 2+F) to each front-row occupant was computed. Results: Depending on the system design, sightline assumption, I-ADAS variation, and fleet penetration, an I-ADAS system that automatically applies emergency braking could avoid 18-84% of all LTAP/OD crashes. Only 0-32% of all LTAP/OD crashes could have been avoided using an I-ADAS system that only warns the driver. An I-ADAS system that applies emergency braking could prevent 47-93% of front-row occupants from receiving MAIS 2 + F injuries. A system that warns the driver in LTAP/OD crashes was able to prevent 0-37% of front-row occupants from receiving MAIS 2 + F injuries. The effectiveness of I-ADAS in reducing crashes and number of injured persons was higher when both vehicles were equipped with I-ADAS. Conclusions: This study presents the simulated effectiveness of a hypothetical intersection active safety system on real crashes that occurred in the United States. This work shows that there is a strong potential to reduce crashes and injuries in the United States.

Safety effects of automated section speed control on the Italian motorway network.

INTRODUCTION: Automated Section Speed Control (ASSC) has been identified as an effective countermeasure to reduce speeds and improve speed limit compliance. METHOD: An Empirical Bayes (EB) before-and-after study was performed in this research in order to evaluate the impact of the ASSC system on the expected crash frequency. The study was carried out on a sample of 125 ASSC sites of the Italian motorway network covering 1252 km, where a total of 21,721 crashes were recorded during a 10-year analysis period from 2004 to 2013. RESULTS: Overall, the EB analysis estimated a significant 22% reduction in the expected crash frequency due to the implementation of the ASSC system. The analysis indicated that the effect is slightly larger on property damage only (PDO) crashes (-23%) than on fatal injury (FI) crashes (-18%) and that the highest reductions in crash frequency are expected for multi-vehicle FI crashes (-25%) and multi-vehicle PDO crashes (-31%). Furthermore, the results indicated that the ASSC system is more effective in reducing crash rates when traffic volume increases and it is therefore strongly recommended as a countermeasure to improve safety on high-traffic-volume motorway sections.

Speech Analysis for Fatigue and Sleepiness Detection of a Pilot.

BACKGROUND: Mental fatigue and sleepiness are well recognized determinants of human-error related accidents and incidents in aviation. In Brazil, according to the Center for Investigation and Prevention of Aeronautical Accidents (CENIPA), the rate of accidents in the aerial modal is 1 per 2 d. Human factors are present in 90% of these accidents.CASE REPORT: This paper describes a retrospective study of the communication between a pilot and an air traffic control tower just before a fatal accident. The objective was the detection of fatigue and sleepiness of a pilot, who complained of these signs and symptoms before the flight, by means of voice and speech analysis. The in-depth accident analysis performed by CENIPA indicated that sleepiness and fatigue most likely contributed to the accident. Speech samples were analyzed for two conditions: 1) nonsleepy data recorded 35 h before the air crash (control condition), which were compared with 2) data from samples collected about 1 h before the accident and also during the disaster (sleepy condition). Audio recording analyses provided objective measures of the temporal organization of speech, such as hesitations, silent pauses, prolongation of final syllables, and syllable articulation rate.DISCUSSION: The results showed that speech during the day of the accident had significantly low elocution and articulation rates compared to the preceding day, also indicating that the methodology adopted in this study is feasible for detection of fatigue and sleepiness through speech analysis.de Vasconcelos CA, Vieira MN, Kecklund G, Yehia HC. Speech analysis for fatigue and sleepiness detection of a pilot. Aerosp Med Hum Perform. 2019; 90(4):415-418.

Research on complex air leakage method to prevent coal spontaneous combustion in longwall goaf.

Spontaneous combustion of coal is one of the major hazards threatening production safety during longwall mining. Mining-induced voids, which provide passages for air leakage, are the key factor triggering spontaneous combustion of coal in longwall goafs. In this study, a comprehensive method, which combined pressure balance, grouting injection, and filling fissures, was proposed to prevent spontaneous combustion of coal in longwall goafs with complex air leakage. Field engineering practice was carried out in Sitai Coal Mine in China. The results demonstrated that with the application of the proposed method, in the working face, the concentration of CO was decreased from 31ppm to 0 and the air leakage quantity was decreased from 261 to below 80 m3min-1. The gas samples analysis from the gob areas also indicated that concentrations of O2 and CO were successively decreased, indicating that the risk of spontaneous combustion of coal in goafs was eliminated. The above mentioned analysis indicates that, the method proposed in this study is useful and efficient. Successful application of this technology could provide reference for the treatment of other coal mines.

Real-world effects of rear cross-traffic alert on police-reported backing crashes.

OBJECTIVE: Several parking assistance systems are available to help drivers back up. Rear cross-traffic alert warns drivers when they are reversing and cross-traffic approaches the rear of their vehicle, as might happen when backing out of a perpendicular parking space in a lot. The goal of this study was to examine the effect of rear cross-traffic alert on backing crashes. METHODS: Negative binomial regression was used to compare police-reported backing crash rates in 25 U.S. states per insured vehicle year between General Motors and Mazda vehicles with rear cross-traffic alert and the same vehicle models without the optional system, controlling for the presence of other parking assistance systems and additional factors that may affect crash risk. RESULTS: Crash involvement rates in backing crashes overall were 22% lower among vehicles with rear cross-traffic alert than among vehicles without the system when averaged between the two manufacturers. Rates were 32% lower among vehicles with the system than without in two-vehicle backing crashes where the vehicles were traveling in perpendicular directions. Both reductions were statistically significant. CONCLUSIONS: Rearview cameras and rear automatic braking, which are designed to help drivers detect and brake for obstacles directly behind the vehicle, have been shown in previous research to be effective in reducing backing crashes reported to the police. Rear cross-traffic alert can complement these systems by preventing potential backing crashes that other parking assistance systems are not designed to detect. Manufacturers should equip vehicles with rear cross-traffic alert, in addition to other parking assistance systems like rear automatic braking, to maximize the number of backing crashes prevented.

Organizational factors related to the adoption of an injury prevention program by U.S. children's hospitals.

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.

Safety recommendations of winter terrain park jumps into airbags.

OBJECTIVES: In winter terrain parks special airbags are used for skiers and snowboarders to practice jumps and achieve safe landings. However, in 2010 two skiers landed at the end of oval airbags. One suffered fatal, the other severe, injuries. The aim of this study was to identify parameters that lead to jumping over the airbag and to suggest preventive measures. DESIGN: Simulation study. METHODS: For the calculation of the flight distance the equation of motion was solved for the jumper's approach and flight phase. Measured data of five jumps into an airbag employed in a similar geometry and conditions as in the second accident case were used to validate the simulation and to measure typical takeoff velocities. The effect of approach and takeoff parameters on the flight distance for oval and flat airbags was analyzed with the simulations. RESULTS: In both accident cases a too long approach led to a too high takeoff speed, which was the cause for landing at the end of the oval airbags. The effect of flight distance is considerably more sensitive to approach and takeoff parameters with oval versus flat airbags. CONCLUSIONS: Three measures are recommended to prevent jumping over an airbag. An approach corridor with top and lateral fences has to be set up and the approach should be steep. Flat airbags are preferable to oval airbags. Airbags should be equipped with a heightening at the end.

Ethical considerations for the design and implementation of child injury prevention interventions: the example of delivering and installing safety equipment into the home.

INTRODUCTION: Public health ethics is a growing field of academic interest but ethical discussion of injury prevention seems to have received limited attention. Interventions that promise to be effective are not necessarily-without explicit justification-'good' and 'right' interventions in every sense. This paper explores public health ethics in the context of child injury prevention with the objective to initiate interdisciplinary dialogue on the ethics of child safety interventions. METHOD: A framework of seven public health ethics principles (non-maleficence, health maximisation, beneficence, respect for autonomy, justice, efficiency and proportionality) were applied to an intervention to promote child safety in the home. RESULTS: Preventing child injury in the home is ethically challenging due to the requirement for the state to intervene in the private sphere. Non-maleficence and beneficence are difficult to judge within this intervention as these are likely to be highly dependent on the nature of intervention delivery, in particular, the quality of communication. Respect for autonomy is challenged by an intervention occurring in the home. The socioeconomic gradient in child injury risk is an important factor but a nuanced approach could help to avoid exacerbating inequalities or stigmatisation. Equally, a nuanced approach may be necessary to accommodate the principles of proportionality and efficiency within the local context. CONCLUSION: We conclude that this intervention is justifiable from an ethical perspective but that this type of reflection loop is helpful to identify the impact of interventions beyond effectiveness.

Center of Gravity Tracker for Operator Fatigue Detection.

Driver fatigue is a cause of serious accidents for heavy machinery operators. Monitoring operator position, as indicated by their Center of Gravity (CoG), may be a means to non-invasively detect driver fatigue. We prototyped a research tool that tracks CoG from four sensors located within the legs of a seat, and validated its accuracy and precision. Our primary contributions are the development of a low-cost integrated CoG detector for seated drivers and the design of a flexure structure to protect load cells from shocks, tensile and shear forces. This system will enable research into CoG as an indicator of fatigue.

Preliminary Evaluation of a Wearable Camera-based Collision Warning Device for Blind Individuals.

SIGNIFICANCE: This work describes a preliminary evaluation of a wearable collision warning device for blind individuals. The device was found to provide mobility benefit in subjects without (or deprived of) vision. This preliminary evaluation will facilitate further testing of this developmental stage device in more naturalistic conditions. PURPOSE: We developed a wearable video camera-based device that provided tridirectional collision warnings (right, center, and left) via differential feedback of two vibrotactile wristbands. We evaluated its mobility benefit in blind and normally sighted (NS) blindfolded individuals in indoor mobility courses. METHODS: Three evaluation experiments were conducted. First, the ability of the device to provide warnings for hanging objects not detected by a long cane was evaluated in eight NS and four blind subjects in an obstacle course with and without the device. Second, the accuracy of collision warning direction assignment was evaluated in 10 NS subjects as they walked toward a hanging object at random offsets and verbally reported the obstacle offset position with respect to their walking path based on the wristbands' vibrotactile feedback. Third, the mobility benefit of collision warning direction information was evaluated by 10 NS and 4 blind subjects when walking with and without differential wristband feedback. RESULTS: In experiment 1, collisions reduced significantly from a median of 11.5 without to 4 with the device (P < .001). Percent preferred walking speed reduced only slightly from 41% without to 36% with the device (P = .04). In experiment 2, the most likely reported relative obstacle positions were consistent with the actual positions. In experiment 3, subjects made more correct navigational decisions with than without the collision warning direction information (91% vs. 69%, P < .001). CONCLUSIONS: Substantial mobility benefit of the device was seen in detection of aboveground collision threats missed by a long cane and in enabling better navigational decision making based on the tridirectional collision warning information.

Rollover Protective Structures, Worker Safety, and Cost-Effectiveness: New York, 2011-2017.

OBJECTIVES: To measure cost-effectiveness of an intervention to increase retrofitting of rollover protective structures (ROPS) on tractors. METHODS: Tractor overturns are the leading cause of farm fatalities. ROPS prevent these deaths. This study updates a 2011 cost-effectiveness assessment of a New York State intervention to increase use of ROPS. We subtracted intervention cost from the cost of injuries averted, then divided this figure by the number of averted injuries. We used related probabilities and costs of fatalities and injuries from published literature to calculate the program's cost-effectiveness. RESULTS: The total cost of the injuries averted from 2007 to 2017 was $6 018 742 versus a total program cost of $1 776 608. The one-time retrofit costs will continue to prevent injuries as long as the tractors are used, generating additional (projected) future savings of $12 136 512, $15 781 027, and $18 924 818 if retrofitted tractors remain in operation 15, 20, or 25 years after their retrofit. CONCLUSIONS: Social marketing was cost-effective for reducing injuries from tractor overturns. Public Health Implications. These results indicate that the intervention model is effective from both a public health and economic standpoint and should be expanded into other states.

Acceptability and functionality of the "Kettle Strap": An attempt to decrease kettle related burns in children.

BACKGROUND: Extensive hot water burns (HWB) are common at Red Cross War Memorial Children's Hospital (RCWMCH). The majority are caused by kettle scalds. These burn injuries usually affect toddlers living in poor socio-economic circumstances. The majority of these injuries are preventable. AIM: This trial aims to demonstrate the acceptability and functionality of the Kettle Strap as a kettle safety device. The feedback will be used for a public awareness program marketed by the Child Accident Prevention Foundation of Southern Africa and ChildSafe as part of their mandate to reduce kettle related thermal injuries. METHODS: 50 caregivers of children at RCWMCH were given a Kettle Strap for use in their homes, 25 with kettle related burns (Group I) and 25 who had no history of burns (Group II). All participants were instructed on Kettle Strap installation and use. Telephonic interviews on the acceptability and functionality of the strap occurred 1 month and 1 year later. RESULTS: The average age in Groups I and II was 25 and 22 months respectively. In Group I, the average burn surface area was 15%. Nineteen (76%) of the accidents occurred in the kitchen. Eighteen (72%) received immediate first aid. Twelve (48%) in Group I and 15 (60%) in Group II lived in formal housing. The majority of caregivers (90%) indicated that installation was quick and easy and thought that the Kettle Strap would prevent kettle burns. At 1 month follow-up, all the participants in Group I indicated that they would continue using the apparatus and felt greater protection compared to 84% of Group II. Only 40% indicated that use of the Kettle Strap raised awareness of other possible household dangers. Thirty participants were available telephonically after 1 year, 22 of these were still using the device, others had moved or lost their homes to fire. All participants had informed neighbors about the Kettle Strap and burn safety. The participants were prepared to pay ZAR 44 for the complete apparatus. CONCLUSION: The Kettle Strap is an acceptable, affordable device to improve kettle safety in the home.