Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 1.293
Filtrar
1.
Am J Public Health ; 111(2): 309-317, 2021 02.
Artigo em Inglês | MEDLINE | ID: mdl-33351652

RESUMO

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.


Assuntos
Prevenção de Acidentes , Aconselhamento/métodos , Armas de Fogo , Militares , Prevenção de Acidentes/instrumentação , Prevenção de Acidentes/métodos , Adulto , Feminino , Armas de Fogo/normas , Armas de Fogo/estatística & dados numéricos , Humanos , Masculino , Pessoa de Meia-Idade , Mississippi , Segurança/normas , Adulto Jovem
2.
J Safety Res ; 75: 41-50, 2020 12.
Artigo em Inglês | MEDLINE | ID: mdl-33334491

RESUMO

INTRODUCTION: Many U.S. cities have adopted the Vision Zero strategy with the specific goal of eliminating traffic-related deaths and injuries. To achieve this ambitious goal, safety professionals have increasingly called for the development of a safe systems approach to traffic safety. This approach calls for examining the macrolevel risk factors that may lead road users to engage in errors that result in crashes. This study explores the relationship between built environment variables and crash frequency, paying specific attention to the environmental mediating factors, such as traffic exposure, traffic conflicts, and network-level speed characteristics. METHODS: Three years (2011-2013) of crash data from Mecklenburg County, North Carolina, were used to model crash frequency on surface streets as a function of built environment variables at the census block group level. Separate models were developed for total and KAB crashes (i.e., crashes resulting in fatalities (K), incapacitating injuries (A), or non-incapacitating injuries (B)) using the conditional autoregressive modeling approach to account for unobserved heterogeneity and spatial autocorrelation present in data. RESULTS: Built environment variables that are found to have positive associations with both total and KAB crash frequencies include population, vehicle miles traveled, big box stores, intersections, and bus stops. On the other hand, the number of total and KAB crashes tend to be lower in census block groups with a higher proportion of two-lane roads and a higher proportion of roads with posted speed limits of 35 mph or less. CONCLUSIONS: This study demonstrates the plausible mechanism of how the built environment influences traffic safety. The variables found to be significant are all policy-relevant variables that can be manipulated to improve traffic safety. Practical Applications: The study findings will shape transportation planning and policy level decisions in designing the built environment for safer travels.


Assuntos
Acidentes de Trânsito/estatística & dados numéricos , Ambiente Construído/estatística & dados numéricos , Segurança/normas , Humanos , North Carolina , Fatores de Risco
7.
J Hosp Infect ; 106(1): 163-175, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-32687870

RESUMO

Inadequate supply of filtering facepiece respirators (FFRs) for healthcare workers during a pandemic such as the novel coronavirus outbreak (SARS-CoV-2) is a serious public health issue. The aim of this study was to synthesize existing data on the effectiveness of ultraviolet germicidal irradiation (UVGI) for N95 FFR decontamination. A systematic review (PROSPERO CRD42020176156) was conducted on UVGI in N95 FFRs using Embase, Medline, Global Health, Google Scholar, WHO feed, and MedRxiv. Two reviewers independently determined eligibility and extracted predefined variables. Original research reporting on function, decontamination, or mask fit following UVGI were included. Thirteen studies were identified, comprising 54 UVGI intervention arms and 58 N95 models. FFRs consistently maintained certification standards following UVGI. Aerosol penetration averaged 1.19% (0.70-2.48%) and 1.14% (0.57-2.63%) for control and UVGI arms, respectively. Airflow resistance for the control arms averaged 9.79 mm H2O (7.97-11.70 mm H2O) vs 9.85 mm H2O (8.33-11.44 mm H2O) for UVGI arms. UVGI protocols employing a cumulative dose >20,000 J/m2 resulted in a 2-log reduction in viral load. A >3-log reduction was observed in seven UVGI arms using >40,000 J/m2. Impact of UVGI on fit was evaluated in two studies (16,200; 32,400 J/m2) and no evidence of compromise was found. Our findings suggest that further work in this area (or translation to a clinical setting) should use a cumulative UV-C dose of 40,000 J/m2 or greater, and confirm appropriate mask fit following decontamination.


Assuntos
Infecções por Coronavirus/prevenção & controle , Desinfecção/normas , Reutilização de Equipamento/normas , Guias como Assunto , Máscaras/normas , Exposição Ocupacional/prevenção & controle , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controle , Raios Ultravioleta , Betacoronavirus , Eficiência , Humanos , Segurança/normas
9.
Psychol Trauma ; 12(S1): S186-S187, 2020 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-32551757

RESUMO

An examination of the trajectory of the coronavirus disease (COVID-19) pandemic and its subsequent economic impacts has revealed that this crisis will impact low-wage workers more severely than all others. The present commentary highlights the unique factors associated with low-wage work that make these workers particularly vulnerable to the effects of the pandemic, identifies potential adverse effects on the mental health of this population, and provides recommendations to maintain the safety, wellbeing, and dignity of low-wage workers. (PsycInfo Database Record (c) 2020 APA, all rights reserved).


Assuntos
Infecções por Coronavirus , Emprego , Pandemias , Pneumonia Viral , Trauma Psicológico , Segurança , Salários e Benefícios , Populações Vulneráveis , Adulto , Emprego/psicologia , Emprego/normas , Humanos , Satisfação Pessoal , Trauma Psicológico/prevenção & controle , Trauma Psicológico/psicologia , Qualidade de Vida , Risco , Segurança/normas , Licença Médica , Populações Vulneráveis/psicologia
10.
Am J Public Health ; 110(8): 1242-1247, 2020 08.
Artigo em Inglês | MEDLINE | ID: mdl-32552030

RESUMO

Objectives. To evaluate the effect of the voluntary safety standard for liquid laundry packets on the rate of injury involving children younger than 5 years in the United States.Methods. Semiannual national estimates of child injuries involving liquid laundry packets treated in US hospital emergency departments were developed for the July 2012 through December 2018 study period. We used a negative binomial regression model to estimate the effect of the voluntary standard on the injury rate following the standard's publication at the end of 2015. The analysis controlled for the rapid growth of laundry packet use during the study period. Results are presented as relative risks and percentage changes in the injury rate.Results. The voluntary standard was associated with a 49.4% to 61.6% reduction in the rate of child injury.Conclusions. The results suggest that the requirements of the voluntary standard have effectively reduced the rate of child injury involving liquid laundry packets and may have prevented 9200 to 23 000 emergency department-treated injuries during the study period.


Assuntos
Detergentes/toxicidade , Serviço Hospitalar de Emergência/estatística & dados numéricos , Centros de Controle de Intoxicações , Segurança/normas , Acidentes Domésticos/prevenção & controle , Pré-Escolar , Feminino , Hospitalização/estatística & dados numéricos , Humanos , Lactente , Masculino , Centros de Controle de Intoxicações/estatística & dados numéricos , Centros de Controle de Intoxicações/tendências , Estados Unidos
11.
Rev. argent. coloproctología ; 31(2): 42-50, jun. 2020. ilus, tab
Artigo em Espanhol | LILACS | ID: biblio-1117006

RESUMO

Se trató de redactar una guía para la práctica segura de la especialidad en tiempos de COVID-19. Se realizó una búsqueda de las publicaciones recientes disponibles en Pub-Med y en otros buscadores, se utilizó la experiencia de expertos a través de diferentes conferencias o comunicados de sociedades científicas. Esta pandemia nos ha obligado a aprender de una manera vertiginosa el manejo de una nueva enfermedad, donde especialistas en cirugía comenzamos a hablar de terminología clínica, virológica, entre otras completamente nueva y desconocida para la mayoría de nosotros. Tuvimos que adaptar nuestra práctica habitual a nuevos estándares, cometiendo diferentes errores en el manejo inicial, provocados por la falta de información previa. La guía trata de abarcar los tópicos considerados más relevantes en este momento, como son el manejo del consultorio, recomendaciones de que patologías se recomienda operar y cuáles no. Recomendaciones de tratamientos alternativos al quirúrgico mientras dura la pandemia. Métodos de diagnósticos utilizados para evaluar infección en pacientes que se someterán a una cirugía, etc. Se agregaron links y apéndices para aquellos que deseen ampliar algún tema en particular, esto evita que la guía sea más extensa y pierda su practicidad con la que fue pensada. Esperamos esta guía sirva para facilitar la compresión de esta nueva enfermedad y su manejo para cualquier cirujano que necesite asistir a pacientes con patología colorrectal. Seguramente al finalizar estas líneas habrá nueva evidencia que deberá ser adaptada e incorporada a la presentada actualmente.


An attempt was made to write a guide for the safe practice of the specialty in times of COVID-19. A search of recent publication available in Pub-Med and other platforms was performed. Experts' opinions and experiences were taken into account from various conferences or communications of scientific societies. This pandemic has forced us to learn the management of a new disease in a sudden way. Surgical specialists began to learn clinical and virologic terminology, among other new concepts previously ignored by most of us. We were forced to adapt our usual practice to new standards, making different mistakes in the initial handling, caused by the lack of prior information.The present guide tries to cover the topics considered most relevant at this time, such as outpatients ́ management, recommendations of which patients we should operate on and which procedures should be postponed. Recommendations for alternative treatments to surgery while the pandemic lasts. Diagnostic methods used to assess infection in patients who will undergo surgery, etc. Links and appendices have been added for those who wish to expand on a particular topic, this prevents the guide from being too extensive and losing the practicality with which it was intended. We hope this guide will facilitate the understanding of this new disease and its management for any surgeon who needs to assist patients with colorectal pathology. By the time we would have finished these lines there will be new evidence that must be adapted and incorporated into those currently presented.


Assuntos
Humanos , Pneumonia Viral , Segurança/normas , Cirurgia Colorretal/normas , Infecções por Coronavirus , Colonoscopia/métodos , Colonoscopia/normas , Assistência Perioperatória/normas , Endoscopia/normas , Pandemias , Assistência Ambulatorial/normas , Equipamento de Proteção Individual/normas , Enteropatias/cirurgia
13.
Knee Surg Sports Traumatol Arthrosc ; 28(6): 1690-1698, 2020 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-32342138

RESUMO

PURPOSE: With the COVID-19 crisis, recommendations for personal protective equipment (PPE) are necessary for protection in orthopaedics and traumatology. The primary purpose of this study is to review and present current evidence and recommendations for personal protective equipment and safety recommendations for orthopaedic surgeons and trauma surgeons. METHODS: A systematic review of the available literature was performed using the keyword terms "COVID-19", "Coronavirus", "surgeon", "health-care workers", "protection", "masks", "gloves", "gowns", "helmets", and "aerosol" in several combinations. The following databases were assessed: Pubmed, Cochrane Reviews, Google Scholar. Due to the paucity of available data, it was decided to present it in a narrative manner. In addition, participating doctors were asked to provide their guidelines for PPE in their countries (Austria, Luxembourg, Switzerland, Germany, UK) for consideration in the presented practice recommendations. RESULTS: World Health Organization guidance for respiratory aerosol-generating procedures (AGPs) such as intubation in a COVID19 environment was clear and included the use of an FFP3 (filtering face piece level 3) mask and face protection. However, the recommendation for surgical AGPs, such as the use of high-speed power tools in the operating theatre, was not clear until the UK Public Health England (PHE) guidance of 27 March 2020. This guidance included FFP3 masks and face protection, which UK surgeons quickly adopted. The recommended PPE for orthopaedic surgeons, working in a COVID19 environment, should consist of level 4 surgical gowns, face shields or goggles, double gloves, FFP2-3 or N95-99 respirator masks. An alternative to the mask, face shield and goggles is a powered air-purifying respirator, particularly if the surgeons fail the mask fit test or are required to undertake a long procedure. However, there is a high cost and limited availabilty of these devices at present. Currently available surgical helmets and toga systems may not be the solution due to a permeable top for air intake. During the current COVID-19 crisis, it appeared that telemedicine can be considered as an electronic personal protective equipment by reducing the number of physical contacts and risk contamination. CONCLUSION: Orthopaedic and trauma surgery using power tools, pulsatile lavage and electrocautery are surgical aerosol-generating procedures and all body fluids contain virus particles. Raising awareness of these issues will help avoid occupational transmission of COVID-19 to the surgical team by aerosolization of blood or other body fluids and hence adequate PPE should be available and used during orthopaedic surgery. In addition, efforts have to be made to improve the current evidence in this regard. LEVEL OF EVIDENCE: IV.


Assuntos
Betacoronavirus , Infecções por Coronavirus , Transmissão de Doença Infecciosa do Paciente para o Profissional/prevenção & controle , Ortopedia/normas , Pandemias , Equipamento de Proteção Individual/normas , Pneumonia Viral , Traumatologia/normas , Aerossóis/efeitos adversos , Líquidos Corporais/virologia , Humanos , Doenças Profissionais/prevenção & controle , Doenças Profissionais/virologia , Segurança/normas
14.
PLoS One ; 15(4): e0231876, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32343711

RESUMO

In this paper we suggest a new Bayesian approach to network meta-analysis for the case of discrete multiple outcomes. The joint distribution of the discrete outcomes is modeled through a Gaussian copula with binomial marginals. The remaining elements of the hierarchial random effects model are specified in a standard way, with the logit of the success probabilities given by the sum of a baseline log-odds and random effects comparing the log-odds of each treatment against the reference and having a Gaussian distribution centered at the vector of pooled effects. An adaptive Markov Chain Monte Carlo algorithm is devised for running posterior inference. The model is applied to two datasets from Cochrane reviews, already analysed in two papers so to assess and compare its performance. We implemented the model in a freely available R package called netcopula.


Assuntos
Metanálise em Rede , Acamprosato/uso terapêutico , Alcoolismo/tratamento farmacológico , Alcoolismo/patologia , Algoritmos , Teorema de Bayes , Humanos , Método de Monte Carlo , Naltrexona/uso terapêutico , Segurança/normas
18.
Workplace Health Saf ; 68(5): 214-225, 2020 May.
Artigo em Inglês | MEDLINE | ID: mdl-31983297

RESUMO

Background: Managing the safety climate in health care is a promising tool for improving employee and patient safety in the health care work environment. Gaps in the theoretical and conceptual underpinnings of safety climate, as well as the evidence base for its practical application in health care remain. The purpose of this study was to evaluate the number of work injuries occurring in health care work units and associated safety climate beliefs. Methods: A retrospective analysis was conducted utilizing organizational staff survey data collected by a large medical hospital in the Midwest in 2015. Employees (n = 32,327) were invited to identify safety climate perceptions via survey. Injuries, days restricted, and days absent were identified through the Hospital's Occupational Safety and Health Administration (OSHA) log. Zero inflated negative binomial regressions used injuries as dependent variables and safety climate perceptions as independent variables. Findings: In all, 23,599 employees completed the survey (73% response rate) across 1,805 employee work units which were defined as groupings of employees reporting to a single supervisor. We found that there was an association between fewer injuries and health care workers indicating that they share responsibility for compliance with safety rules and procedures (relative risk [RR] = 0.98, 95% confidence interval [CI] = [0.98, 0.99]). Conclusion/Application to Practice: This study supports the use of a safety climate measure to assess working units' perceptions of employee safety. A continued focus on the health and safety of employees who interact directly with patients is warranted, as well as employees who do not provide direct patient care.


Assuntos
Traumatismos Ocupacionais/epidemiologia , Recursos Humanos em Hospital/estatística & dados numéricos , Gestão da Segurança/organização & administração , Segurança/normas , Adulto , Feminino , Pessoal de Saúde/estatística & dados numéricos , Administração Hospitalar/métodos , Hospitais , Humanos , Masculino , Pessoa de Meia-Idade , Meio-Oeste dos Estados Unidos , Cultura Organizacional , Estudos Retrospectivos , Inquéritos e Questionários , Local de Trabalho/psicologia
19.
PLoS One ; 15(1): e0227871, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-31978070

RESUMO

Shanghai has experienced rapid urbanization and has a serious housing aging problem. The situation of urban housing safety management needs to be strengthened. However, in China, housing safety management (HSM) is just in its beginning stage and it lacks thorough research. Housing safety awareness is one of the most significant aspects of housing safety management. Therefore, in order to investigate the housing safety awareness of Shanghai residents, this paper investigates the safety attitudes of residents living in housing of different ages using consulting questionnaires and Statistical Package for Social Science (SPSS) software. The results show that in Shanghai, the residents lack an understanding of housing management law, policy, and awareness of safety use and have low willingness to buy commercial insurance. Based on these results, the factors that affect the safety awareness of Shanghai residents are summarized as follows: (1) asymmetric information; (2) assessment of the safety status of the premises; and (3) differences in house users.


Assuntos
Envelhecimento/psicologia , Conscientização , Habitação , Adulto , Idoso , China/epidemiologia , Atenção à Saúde/normas , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Segurança/normas , Inquéritos e Questionários , População Urbana
20.
Accid Anal Prev ; 134: 105326, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31675667

RESUMO

Numerous studies have previously used a variety of count-data models to investigate factors that affect the number of crashes over a certain period of time on roadway segments. Unlike past studies which deal with crash frequency, this study views the crash rates directly as a continuous variable left-censored at zero and explores the application of an alternate approach based on tobit regression. To thoroughly investigate the factors affecting freeway crash rates and the potentially temporal instability in the effects of crash factors involving traffic volume, freeway geometries and pavement conditions, a classic uncorrelated random parameters tobit (URPT) model and a correlated random parameters tobit (CRPT) model were estimated, along with a conventional fixed parameters tobit (FPT) model. The analysis revealed a large number of safety factors, including several appealing and interesting factors rarely studied in the past, such as the safety effects of climbing lanes and distance along composite descending grade. The results also showed that the CRPT model was not only able to reflect the heterogeneous effects of various factors, but also able to estimate the underlying interactions among unobserved characteristics, and therefore provide better statistical fit and offer more insights into factors contributing to freeway crashes than its model counterparts. Additionally, the results showed significant temporal instability in CRPT models across the studied time periods indicating that crash factors (including unobserved characteristics and the underlying interactions among them) and their effects on crash rates varied over time, and more attentions should be paid when interpreting crash data-analysis findings and making safety policies. The modeling technique in this study demonstrates the potential of CRPT model as an effective approach to gain new insights into safety factors, particularly when the heterogeneous effects of factors on safety are interactive. Additionally, findings from this study are also expected to assist in developing more effective countermeasures by better understanding the safety effects of factors associated with freeway design characteristics and pavement conditions.


Assuntos
Acidentes de Trânsito/estatística & dados numéricos , Ambiente Construído/provisão & distribuição , Humanos , Modelos Estatísticos , Medição de Risco , Segurança/normas
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA
...