Unintentional non-traffic injury and fatal events: Threats to children in and around vehicles

Objective: There have been substantial reductions in motor vehicle crash–related child fatalities due to advances in legislation, public safety campaigns, and engineering. Less is known about non-traffic injuries and fatalities to children in and around motor vehicles. The objective of this study was to describe the frequency of various non-traffic incidents, injuries, and fatalities to children using a unique surveillance system and database.

Methods: Instances of non-traffic injuries and fatalities in the United States to children 0–14 years were tracked from January 1990 to December 2014 using a compilation of sources including media reports, individual accounts from families of affected children, medical examiner reports, police reports, child death review teams, coroner reports, medical professionals, legal professionals, and other various modes of publication.

Results: Over the 25-year period, there were at least 11,759 events resulting in 3,396 deaths. The median age of the affected child was 3.7 years. The incident types included 3,115 children unattended in hot vehicles resulting in 729 deaths, 2,251 backovers resulting in 1,232 deaths, 1,439 frontovers resulting in 692 deaths, 777 vehicles knocked into motion resulting in 227 deaths, 415 underage drivers resulting in 203 deaths, 172 power window incidents resulting in 61 deaths, 134 falls resulting in 54 deaths, 79 fires resulting in 41 deaths, and 3,377 other incidents resulting in 157 deaths.

Conclusions: Non-traffic injuries and fatalities present an important threat to the safety and lives of very young children. Future efforts should consider complementary surveillance mechanisms to systematically and comprehensively capture all non-traffic incidents. Continued education, engineering modifications, advocacy, and legislation can help continue to prevent these incidents and must be incorporated in overall child vehicle safety initiatives.     

Participation in driver education/training courses during graduated driver licensing,and the effect of a time-discount on subsequent traffic offenses: Findings from the New Zealand Drivers Study

IntroductionThe New Zealand GDL includes a time-discount at the restricted license stage, for attendance at an approved driver education course. This is despite international evidence showing that earlier licensure associated with a time-discount can increase risk for newly licensed drivers.ObjectiveTo examine participation in driver education courses and especially those that qualify for a time-discount; compare the profiles of course participants with non-participants; examine reasons for participation; and examine the association between a time-discount and traffic offenses once fully licensed.MethodThis study was based on the New Zealand Drivers Study (NZDS), a prospective cohort study of newly licensed drivers. Data on driver education courses were obtained at the full license interview (n = 1763), driver license and traffic offense data from the NZ Driver Licence Registry, and other data at the NZDS interviews.Results94% had heard of and 49% (n = 868) participated in a defensive driving course (DDC). No other course had more than 1% participation. Compared with the others, the DDC group were young, non-Māori, and from an area of relatively low deprivation. Through GDL, the DDC group were relatively more compliant with the conditions, and less likely to crash or receive a traffic offense notice. The groups did not differ on personality, alcohol and drug use. The reason most (85%) attended a DDC was to get their full license sooner; 86% (n = 748) received a time-discount. The time-discount group were 40% more likely to receive a traffic offense notice on their full license; this reduced to 10% after controlling for other factors.Conclusion and practical implicationsThe results of this study, when viewed in conjunction with other NZ crash evidence, indicate that a time-discount should not be given for completing a DDC or Street Talk course.     

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.     

Death and injury in earthquakes

The assumption that the ratio of mortality to morbidity will approximate 1:3 in earthquake disasters is investigated. When it occurs, a 1:3 ratio is most likely to coincide with a Richter magnitude in the range 6.5–7.4, but many other ratios of death to injuries may instead be probable. For each individual disaster the pattern of casualties is likely to be very heterogeneous, but it would be easier to discover regularities if a more standardized definition of 'injury' could be found.     

Disease progression and mortality in neoplasticMya arenaria in the field

Four 6-mo mark-and-recapture experiments conducted in Long Island Sound, USA, from 1988 to 1990, involving approximately 2250 individual observations, demonstrated that under natural conditions significantly higher mortality (p0.001, chi-square test) occurred amongMya arenaria (L.) with hematopoietic neoplasia than those diagnosed as non-neoplastic. Using a blood-screening technique, the clams were diagnosed and placed in one of three diagnostic groups based on the severity of the disease (the percentage neoplastic cells per total number of blood cells): non-neoplastic (NN), 0%; low-severity neoplastic (LSN), < 50%; high-severity neoplastic (HSN), > 50%. Mortality of those clams initially diagnosed as HSN ranged from 48% to 78%, depending on the test period, as compared to 3% to 21% for the non-neoplastic. Mortality in the LSN treatment varied from 8% to 34%. Both progression and remission were evident in clams at all stages of the disease. Mortality and rates of progression and remission in individuals appeared to be linked to water temperatures. Differential mortality may be responsible for the apparent seasonal cycle of prevalence in populations.     

Natural disasters: a framework for research and teaching

Natural disasters are defined in this paper by relating the impact of extreme geophysical events to patterns of human vulnerability. Hazard perception is shown to be a factor that limits the mitigation of risk. The historical development of disaster studies is traced and five different schools of thought are identified. The current International Decade for Natural Disaster Reduction (IDNDR) is evaluated critically with regard to its potential for unifying the disparate strands of knowledge and its scope as a vehicle for education.
A pedagogical framework for disaster studies is presented. Time and space provide valuable unifying factors, while the subject matter can be differentiated according to the continua and dichotomies that it presents. In disaster studies as in other branches of higher education, an ecocentric approach is preferable to a technocentric one, as many of the poorer nations of the world, which are most afflicted by natural catastrophe, will have to rely for mitigation on maintaining their ecological sustainability, instead of depending on sophisticated technology. Valuable insights into the impact of environmental extremes on mankind are gained from the study of disasters as human ecology.     

Indicators of sustainable production: framework and methodology

This paper presents a new tool for promoting business sustainability — indicators of sustainable production. It first introduces the concept of sustainable production as defined by the Lowell Center for Sustainable Production, University of Massachusetts Lowell. Indicators of sustainable production are discussed next, including their dimensions and desirable qualities. Based on the Lowell Center Indicator Framework, the authors suggest a new methodology of core and supplemental indicators for raising companies' awareness and measuring their progress toward sustainable production systems. Twenty-two core indicators are proposed and a detailed guidance for their application is included. An eight-step model provides a context for indicator implementation. The paper concludes with a summary of the strengths and weaknesses of the methodology as well as recommendations for testing the indicators.