Motor-vehicle boarding and alighting injury--how large a problem?

The Journal of Safety Research has partnered with the National Center for Injury Prevention and Control at the Centers for Disease Control and Prevention (CDC) in Atlanta, Georgia, USA, to briefly report on some of the latest findings in the research community. This report is the fifth in a series of CDC articles.     

Nonfatal injuries following Hurricane Katrina--New Orleans, Louisiana, 2005

The Journal of Safety Research has partnered with the National Center for Injury Prevention and Control at the Centers for Disease Control and Prevention (CDC) in Atlanta, Georgia, USA, to briefly report on some of the latest findings in the research community. This report is the fourth edition in a series of CDC articles. BACKGROUND: An active injury and illness surveillance system was established by the Centers for Disease Control and Prevention (CDC) along with the Louisiana Department of Health and Hospitals (LDHH) in the aftermath of Hurricane Katrina in functioning hospitals and medical clinics. RESULTS: The surveillance system recorded 7,543 nonfatal injuries among residents and relief workers between September 8-October 14, 2005. The leading mechanisms of injury identified in both groups were fall and cut/stab/pierce, with a greater proportion of residents compared to relief workers injured during the repopulation period. Clean-up was the most common activity at the time of injury for both groups. CONCLUSION: Injuries documented through this system underscore the need for surveillance of exposed populations to determine the injury burden and initiate injury prevention activities and health communication campaigns.     

Falls among older adults--risk factors and prevention strategies

The Journal of Safety Research has partnered with the Injury Center at the Centers for Disease Control and Prevention (CDC) in Atlanta, Georgia, USA, to briefly report on some of the latest findings in the research community. This report is the third in a series of CDC articles. Look for other such articles in future issue of the Journal of Safety Research.     

Hip protectors efficacy and barriers to adoption to prevent fall-related injuries in older adults: findings and recommendations from an international workgroup

The Journal of Safety Research has partnered with the Injury Center at the Centers for Disease Control and Prevention (CDC) in Atlanta, Georgia, USA, to briefly report on some of the latest findings in the research community. This report is the sixth in a series of CDC articles. This conference on Hip Protector Use was held at Boston University in June, 2004 under the sponsorship of the Injury Center. Hip fractures from falls are a major threat to the health and well-being of older adults. One approach to hip fracture prevention is the use of hip protectors (HPs), soft padding or hard shells embedded within specially designed underwear. This conference brought together experts to discuss the efficacy and barriers to using HP. Conclusions from the conference included the need for HP product specifications and standards of safety and efficacy, testing protocols, and efficacy trials. While no single entity was identified to advance these initiatives, this effort should be international and should involve collaboration between researchers, health care providers and policy-makers, and HP manufacturers. Plans are already underway for a second international conference in Europe to follow-up these recommendations and develop strategies for implementation.     

Advancing injury and violence prevention through data science

Introduction: The volume of new data that is created each year relevant to injury and violence prevention continues to grow. Furthermore, the variety and complexity of the types of useful data has also progressed beyond traditional, structured data. In order to more effectively advance injury research and prevention efforts, the adoption of data science tools, methods, and techniques, such as natural language processing and machine learning, by the field of injury and violence prevention is imperative. Method: The Centers for Disease Control and Prevention’s (CDC) National Center for Injury Prevention and Control has conducted numerous data science pilot projects and recently developed a Data Science Strategy. This strategy includes goals on expanding the availability of more timely data systems, improving rapid identification of health threats and responses, increasing access to accurate health information and preventing misinformation, improving data linkages, expanding data visualization efforts, and increasing efficiency of analytic and scientific processes for injury and violence, among others. Results: To achieve these goals, CDC is expanding its data science capacity in the areas of internal workforce, partnerships, and information technology infrastructure. Practical Application: These efforts will expand the use of data science approaches to improve how CDC and the field address ongoing injury and violence priorities and challenges.     

A review of CDC's Web-based Injury Statistics Query and Reporting System (WISQARS™): Planning for the future of injury surveillance

IntroductionThe Centers for Disease Control and Prevention (CDC) developed the Web-based Injury Statistics Query and Reporting System (WISQARS^TM) to meet the data needs of injury practitioners. In 2015, CDC completed a Portfolio Review of this system to inform its future development.MethodsEvaluation questions addressed utilization, technology and innovation, data sources, and tools and training. Data were collected through environmental scans, a review of peer-reviewed and grey literature, a web search, and stakeholder interviews.ResultsReview findings led to specific recommendations for each evaluation question.ResponseCDC reviewed each recommendation and initiated several enhancements that will improve the ability of injury prevention practitioners to leverage these data, better make sense of query results, and incorporate findings and key messages into prevention practices.     

Seeking to improve care for young patients: Development of tools to support the implementation of the CDC Pediatric mTBI Guideline

IntroductionThe Centers for Disease Control and Prevention (CDC) Pediatric Mild Traumatic Brain Injury (mTBI) Guideline was created to help standardize diagnosis, prognosis, and management and treatment of pediatric mTBI. This paper describes the process CDC used to develop educational tools, and a dissemination and implementation strategy, in support of the CDC Pediatric mTBI Guideline.MethodsTwo qualitative data collection projects with healthcare providers who care for pediatric patients were conducted. In-depth interviews were used in both projects. Project One examined healthcare providers' guideline use and dissemination preferences. Project Two assessed perceptions of the CDC Pediatric mTBI Guideline educational tools.ResultsProject One brought to light four key areas related to Guideline usage and dissemination preferences, specifically a need for: (1) partnership with professional medical societies; (2) integration into electronic health records, mobile apps, and websites; (3) development of continuing medical education (CME) opportunities; and (4) dissemination through healthcare system leadership. In Project Two, healthcare providers reported that the CDC Pediatric mTBI Guideline educational tools were well-organized, clear and easy to navigate, and informative. Healthcare providers also requested more information on the Guideline methodology.DiscussionAssessment of pediatric healthcare providers' current use of clinical guidelines and preferences for educational tools yielded important insights that helped inform CDC's dissemination and implementation strategy for the Pediatric mTBI Guideline.Practical applicationsThe findings from these data collection projects can also inform other guideline implementation and dissemination efforts among healthcare providers.     

Self-reported falls and fall-related injuries among persons aged>or=65 years--United States, 2006

PROBLEM: In 2005, 15,802 persons aged>or=65 years died from fall injuries. How many older adults seek outpatient treatment for minor or moderate fall injuries is unknown. METHOD: To estimate the percentage of older adults who fell during the preceding three months, the Centers for Disease Control and Prevention (CDC) analyzed data from two questions about falls included in the 2006 Behavioral Risk Factor Surveillance System (BRFSS) survey. RESULTS: Approximately 5.8 million (15.9%) persons aged>or=65 years reported falling at least once during the preceding three months, and 1.8 million (31.3%) of those who fell sustained an injury that resulted in a doctor visit or restricted activity for at least one day. DISCUSSION: This report presents the first national estimates of the number and proportion of persons reporting fall-related injuries associated with either doctor visits or restricted activity. SUMMARY: The prevalence of falls reinforces the need for broader use of scientifically proven fall-prevention interventions. IMPACT ON INDUSTRY: Falls and fall-related injuries represent an enormous burden to individuals, society, and to our health care system. Because the U.S. population is aging, this problem will increase unless we take preventive action by broadly implementing evidence-based fall prevention programs. Such programs could appreciably decrease the incidence and health care costs of fall injuries, as well as greatly improve the quality of life for older adults.     

Effectiveness of the CDC HEADS UP online training on healthcare providers’ mTBI knowledge and self-efficacy

Background: Many healthcare providers do not consistently implement recommendations contained in clinical guidelines on mild traumatic brain injury (mTBI). As such, the Centers for Disease Control and Prevention (CDC) created the HEADS UP to Healthcare Providers online training to promote uptake of five key recommendations in the CDC Pediatric mTBI Guideline. Methods: Using data from modules in the CDC HEADS UP to Healthcare Providers online training, healthcare providers’ self-reported knowledge and self-efficacy prior to and immediately following completion of the training was analyzed. Results: Improvements for 8 out of the 10 knowledge questions had a high level of practical significance. The knowledge question with the highest level of practical significance pre- to post-test improvement was for the key guideline recommendation on neuroimaging (pre-test correct: 70.2%; post-test correct: 87.8%; (p < 0.0001, Cohen’s g = 0.39). Four out of the six questions had a self-efficacy level increase of a high level of practical significance (r > 0.50) between the pre- and post-tests. The self-efficacy question with pre- to post-test improvement with the highest level of practical significance was “I am confident in my ability to manage the return to sports progression for my patients” (p < 0.001; r = 0.54). Conclusions: The HEADS UP to Healthcare Providers online training led to significant improvements in knowledge and self-efficacy related to mTBI diagnosis and management. Expanded use of this training among healthcare providers who commonly provide care for pediatric patients with mTBI may be beneficial. Practical Applications: This study highlights several factors guideline developers may take into consideration when creating an implementation tool, such as using health behavior theories, working with partners and key stakeholders, and focusing on digital-based tools.     

Assessment of HEADS UP online training as an educational intervention for sports officials/athletic trainers

Background: Sports- and recreation-related concussions are a common injury among children. Sports officials (SOs) and athletic trainers (ATs) are integral to setting the stage for safe play and managing concussions when they occur, and significant numbers of both groups have completed the Centers for Disease Control and Prevention’s HEADS UP online concussion training course. However, the utility of the course for these audiences has not been assessed. We hypothesized that sports officials’ and athletic trainers’ concussion-related knowledge, attitudes, and behavioral intentions will improve from pre- and post-test after completing CDC’s HEADS UP online concussion training course. Method: Respondents’ concussion-related knowledge, attitudes, and behavioral intentions were assessed both before and after taking the training course. Differences between pre- and post-test scores were calculated based on the Wilcoxon Signed Rank Test Z-score or McNemar’s test. Effect sizes were interpreted. Results: The SOs and ATs who participated in the HEADS UP online training had a high level of concussion knowledge before taking the course: 90% or more of respondents could identify the correct response for at least seven of the 13 knowledge questions in the pre-test. Still, the course was effective at improving the respondents’ knowledge about return-to-play protocols and concussion reporting. Further, SOs and ATs demonstrated improvement in their concussion-related attitudes and behavioral intentions between the pre- and post-test. Conclusion: SOs’ and ATs’ concussion knowledge, attitudes, and behavioral intentions improved immediately following completion of the CDC HEADS UP online training. Future research could also focus on the long-term retention of this type of training. Practical Applications: This study provides insight into how to better focus concussion-related educational programs to fit SOs’ and ATs’ needs.     

修法重点在保障劳动者权益

从2010年11月初国务院法制办公室公布修改《职业病防治法》诊断鉴定制度条文（草案）至2011年7月十一届全国人大常委会第二十一次会议初次审议了《职业病防治法修正案（草案）》（简称《草案》）,该法的修改思路发生了重大变化。     

CDC's research portfolio in older adult fall prevention: a review of progress, 1985-2005, and future research directions

PROBLEM: Falls are a leading cause of mortality and morbidity among adults age 65 and older. Population models predict steep increases in the 65 and older population bands in the next 10-15 years and in turn, public health is bracing for increased fall rates and the strain they place on health care systems and society. To assess progress in fall prevention, the Centers for Disease Control and Prevention conducted a research portfolio review to examine the quality, relevance, outcomes and successes of the CDC fall prevention program and its impact on public health. METHODS: A peer review panel was charged with reviewing 20 years of funded research and conducting a SWOT (strengths, weaknesses, opportunities, and threats) analysis for extramural and intramural research activities. Information was collected from grantees (via a survey instrument), staff were interviewed, and progress reports and products were reviewed and analyzed. RESULTS: CDC has invested over $24,900,000 in fall-related research and programs over 20 years. The portfolio has had positive impacts on research, policies and programs, increasing the public health injury prevention workforce, and delivering effective fall prevention programs. DISCUSSION: Public health agencies, practitioners, and policy makers recognize that while there are some evidence-based older adult fall prevention interventions available, many remain unused or are infeasible to implement. Specific recommendations across the public health model, include: additional research in gathering robust epidemiologic data on trends and patterns of fall-related injuries at all levels; researching risk factors by setting or sub-population; developing and testing innovative interventions; and engaging in translation and dissemination research on best practices to increase uptake and adoption of fall prevention strategies. CDC has responded to a number of suggestions from the portfolio review including: funding translation research of a proven Tai Chi fall intervention; beginning to address gaps in gender, ethnic, and racial differences in falls; and collaborating with partner organizations who share in CDC's mission to improve public health by preventing falls and reducing fall-related injuries. IMPACT ON INDUSTRY: Industry has an opportunity to develop more accessible and usable devices to reduce injury from falls (for example, hip protectors and force reducing flooring). By implementing effective, evidence-based interventions to prevent falls and reduce injuries from falls, significant decreases in health care costs can be expected.     

在香港提供消防与安全工程研究生教育的必要性分析

论述了在香港提供消防与安全工程研究生教育的必要性,为了培养高质量人才,消防与安全工程高等教育的科目应当包括消防工程学和安全工程学(如火灾动力学),用于建筑设计的计算机火灾模拟,消防工程系统,火灾安全管理立法因素,用于火灾安全管理的设计事项,建造的安全因素,职业安全和人类工程学,事故防范、危害评估和控制,安全管理系统和安全审核。而这些重要课程的质量提高都强烈依赖于相关研究的进展。     

STEADI: CDC's approach to make older adult fall prevention part of every primary care practice

IntroductionPrimary care providers play a critical role in protecting older adult patients from one of the biggest threats to their health and independence—falls. A fall among an older adult patient cannot only be fatal or cause a devastating injury, but can also lead to problems that can effect a patient's overall quality of life.MethodsIn response, the Centers for Disease Control and Prevention (CDC) developed the STEADI initiative to give health care providers the tools they need to help reduce their older adult patient's risk of a fall.ResultsCDC's STEADI resources have been distributed widely and include practical materials and tools for health care providers and their patients that are designed to be integrated into every primary care practice.ConclusionAs the population ages, the need for fall prevention efforts, such as CDC's STEADI, will become increasingly critical to safeguard the health of Americans.Practical applicationsSTEADI's electronic health records (EHRs), online trainings, assessment tools, and patient education materials are available at no-cost and can be downloaded online at www.cdc.gov/STEADI. Health care providers should look for opportunities to integrate STEADI materials into their practice, using a team-based approach, to help protect their older patients.     

CDC's efforts to improve traumatic brain injury surveillance

IntroductionYouth sports concussion has become a prominent public health issue due to growing concern about the risk of long-term health effects.MethodA broad spectrum of stakeholders has convened to propose solutions, including a committee of the National Academy of Sciences (NAS) who systematically examined the issue and, in a 2014 report, made a series of recommendations to better address this public health problem.ResultsAmong these recommendations, the NAS committee called for CDC to develop a plan for a comprehensive surveillance system to better quantify the incidence and outcomes of youth sports concussion among children 5 to 21 years of age. Since the release of the NAS report, CDC has taken action to address this recommendation and, in the process, develop strategies to improve traumatic brain injury (TBI) surveillance more broadly. The challenges outlined by the NAS committee with respect to producing comprehensive incidence estimates of youth sports concussion are not exclusive to youth sports concussion, but also apply to TBI surveillance overall. In this commentary, we will discuss these challenges, the process CDC has undertaken to address them and describe our plan for improving TBI and youth sports concussion surveillance.     

间距对上保护层开采保护效果影响的相似模拟实验研究

为研究上保护层开采保护效果随层间距的变化规律,以南桐矿区作为实验背景,保持保护层倾向工作面开挖长度、煤层埋深、倾角、岩层物理力学性质相同,将层间多层岩层处理为复合岩层,分别进行近距离、远距离和超远距离上保护层开采相似模拟实验。综合分析被保护层卸压规律及基于被保护层垂直于层面的膨胀变形保护准则所得保护范围可知:上保护层开采被保护层卸压曲线呈“凸形”,且“凸形”中心线偏向下山方向。随层间距增加,“凸形”底部被保护层小于原岩应力的卸压范围与“凸形”顶部卸压曲线顶部较大卸压的范围均呈减小趋势;两者中心位置均向下山方向转移,且后者转移度大于前者;被保护层卸压曲线中卸压范围的卸压程度及应力集中范围的应力集中程度均呈减弱趋势;以垂直层面的膨胀变形量3‰确定的上下边界膨胀变形保护角均小于《防治煤与瓦斯突出规定》中相应条件的卸压角,因此以该方法确定的保护范围相对《防治煤与瓦斯突出规定》偏于安全,且随层间距增加保护范围长度呈加速减小趋势。     

国内公共卫生安全研究的文献计量分析

为系统掌握国内公共卫生安全领域的研究现状和发展前沿,利用Citespace,Vosviewer,Gephi软件,从发文趋势、期刊分布、作者群落、研究机构、关键词等角度分析公共卫生安全领域研究态势.结果 表明:公共卫生安全领域研究呈现萌芽起步一缓慢发展一高度关注3个阶段;载文期刊主要集中在安全科学与医疗卫生领域;领域内核...     

广东省企业安全生产主体责任现状分析

在构建企业安全生产主体责任绩效评估体系基础上,结合层次分析和模糊综合处理方法,对广东省企业安全生产主体责任落实情况进行全面调查分析。结果显示,组织机构与人员配置是安全生产主体责任落实中最重要的环节;一般地,外资企业好于中资企业,大型企业好于中小型企业,生产复杂度与主体责任绩效成反比;职业危害、安全生产监督、奖惩制度实施等是企业在落实安全生产主体责任之中较为薄弱的环节。最后提出相应建议：（1）在全省推行安全生产标准化的基础上,建立健全企业安全生产主体责任体系;（2）建立广东省职业危害与控制中心,健全职业安全健康管理体系;（3）进一步健全经济社会转型期的企业安全生产监督管理体系。