Injury Prevention最新文献

Objectives: Older adults living in long-term care facilities (LTCFs) are at high risk for falls. Interventions to prevent falls and fall-related injury in this population may be individual-level or system-focused interventions. However, relatively little attention has been given to research on system-focused interventions. This scoping review seeks to synthesise previous studies on the effects of system-focused interventions for fall prevention in LTCFs.

Methods: We searched Ovid-Medline, CINAHL and Embase databases from 2007 to 2024 following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) extension for Scoping Reviews. We conducted a narrative synthesis to summarise findings from the included studies.

Results: In the initial search, 403 studies were identified and underwent title and abstract screening resulting in 116 articles retrieved for full-text review. 20 studies were included in the final data extraction. System-level fall prevention interventions evaluated in LTCFs include (1) multicomponent and multidisciplinary programmes, (2) environmental adaptations, (3) technological adaptations, and (4) staff education and training programmes. 11 out of 17 included quantitative studies reported significant effects of system-focused interventions to reduce falls in LTCFs.

Conclusions: This scoping review reveals the effectiveness of system-level fall prevention strategies in LTCFs. Enhancing training, customising tools and fostering a supportive leadership culture are vital for improving fall prevention practices in LTCFs.

Objective: Alcohol use disorder is an established risk factor for suicide; however, it is largely unknown whether subclinical levels of drinking may also contribute to the risk of suicide. The objective was to evaluate the relationship between average alcohol volume consumed per day and suicide.

Methods: Data from the annual, cross-sectional National Health Interview Survey, 1997-2018 in the USA, was obtained and linked to the 2019 National Death Index. The association between average alcohol volume consumed in grams per day (g/day) and suicide was quantified using Cox proportional hazards model (multiplicative) and Aalen's additive hazard model. All analyses were stratified by sex, and adjusted for education, marital status, psychological distress, race and ethnicity, and survey year.

Results: On the multiplicative scale, for males, former drinkers and those who consumed on average >40-60 g/day had about 43% (HR=1.43, 95% CI 1.03, 2.01) and 72% (HR=1.72, 95% CI 1.14, 2.60) greater risk of dying by suicide, compared with lifetime abstainers, respectively. There was no significant association found for former or current drinkers among females, on the multiplicative scale. On the additive scale, for males, drinking >40-60 g/day on average was associated with 22.7 (95% CI 6.0, 39.4) additional deaths per 100 000 person-years, while for females, being a former drinker and drinking >0-20 g/day on average was associated with 5.5 (95% CI 0.7, 10.4) and 1.9 (95% CI 0.2, 3.5) additional deaths per 100 000 person-years, compared with lifetime abstainers. The level of education was not found to modify the focal relationship for males or females.

Conclusions: The findings suggest that the relationship between average alcohol volume consumed per day and suicide is nuanced. Additional research on the respective relationship is needed, including repeated measures of average alcohol consumption over time.

Introduction: Firearm violence is a major public health issue in the USA. There is growing evidence that firearm violence is associated with higher ambient temperatures. The aim of this study was to test competing hypotheses that could explain associations between temperature and firearm violence: temperature-aggression theory and routine activities theory.

Methods: We examined associations between elevated daily temperatures and shooting incidents in four US cities: Chicago, Illinois; Cincinnati, Ohio; New York, New York and Philadelphia, Pennsylvania. Temperature was operationalised using two different measures: daily maximum temperature and deviations of the daily maximum temperature from 30-year averages. Generalised linear autoregressive moving average models related temperature to shooting incidence while controlling for seasonal effects.

Results: As maximum daily temperature deviates from the expected, there was an association with increased shooting incidents in all four cities (eg, New York: b=0.014, 95% CI=0.011 to 0.017). An interaction term created by multiplying daily maximum temperature by the daily difference of maximum temperature from a 30-year average was also found to have a positive association in all four cities (eg, New York: b=0.020, 95% CI=0.016 to 0.025).

Discussion: These findings accord with previous studies demonstrating a positive relationship between temperature and firearm violence and further support temperature-aggression theory as the primary causal mechanism.

Background: Drowning is the third-leading cause of unintentional injury death worldwide. Although the USA as a whole bears a heavy burden, with approximately 4000 drowning fatalities annually, Texas stands out as a high-risk state for drowning due to its large population, suitable climate for year-round aquatic activities and availability of water-related recreational opportunities.

Methods: Using mortality data from the Centers for Disease Control and Prevention Wide-ranging ONline Data for Epidemiologic Research online database, this retrospective, cross-sectional study overviews the magnitude and patterns of fatal unintentional drownings among Texans from 1999 to 2020.

Results: Over the 22-year period, 7737 Texans died from unintentional drowning. An average of 352 drowning deaths occurred annually, with a rate of 1.4 deaths per 100 000 population. The highest proportion of unintentional drownings occurred in natural water settings (eg, lakes, ponds or rivers), accounting for 40% of fatal drownings. Children aged 1-4 years had the highest drowning death rate compared with all other age groups. Male Texans had a drowning death rate three times higher than that of female Texans. Black Texans had a higher drowning death rate than White Texans and Asian or Pacific Islander Texans.

Conclusions: Drowning remains a significant public health issue in Texas. Data on high-risk groups and settings should be used to strengthen drowning prevention efforts and policy initiatives and encourage more research to address the multifaceted factors contributing to drowning.

Background: Surveillance of traumatic brain injury (TBI) in the USA has historically relied on healthcare administrative datasets, but these methods likely undercount the true burden of TBI. Self-report measures may help obtain more comprehensive estimates. A fundamental question is whether TBI prevalence estimated through self-report varies by whether and how TBI signs and symptoms are ascertained in the survey question(s).

Methods: Self-report data were collected from 4303 adults in the summer wave of Porter Novelli's 2023 ConsumerStyles survey. Respondents were randomised to receive a question about their 12-month experience of head injury and a grouped list of TBI signs/symptoms or a question about their 12-month experience of head injury and an option to select individual TBI signs and symptoms that resulted from the head injury. All respondents who indicated they experienced a head injury received a set of follow-up questions.

Results: A significantly higher percentage of people who received the 'individual signs/symptoms' question self-reported a TBI (8.3%) than those who received the 'grouped signs/symptoms' question (4.3%) χ²=19.6, p<0.0001. Among TBI cases identified, there were no statistical differences between question type in relation to whether the respondent reported being evaluated for or diagnosed with a TBI, nor any demographic differences.

Conclusions: These results demonstrate that how TBI is ascertained in a survey can meaningfully impact reporting of TBI prevalence and provides evidence that question wording and structure affect estimates on national surveys.

Objective: Paediatric magnet ingestion can have devastating consequences. To minimise this risk, many countries have policies to reduce exposure. This study seeks to summarise global reports of paediatric magnet ingestion and stringency of corresponding national policies.

Study design: A comprehensive literature search was conducted in English and Spanish using PubMed, Google Scholar, Scopus, Virtual Health Library, Clarivate-Web of Science, and Latin American and Caribbean Health Sciences Literature. Included papers documented magnet ingestion in ages 0-18 years, from 2002 to 2024. Non-magnet foreign body ingestions were excluded. Policy searches were conducted online in English and Spanish. In total, 2998 articles were reviewed, with 204 papers undergoing full-text analysis. Data regarding incidence, demographics, and interventions required were extracted.

Results: A total of 96 studies from countries in six continents documenting patients requiring hospitalisation and/or medical interventions were included. Studies reported between 1 and 5738 cases over a range of years, with several studies showing an increase in incidence over time. National policies placing warning labels, restricting sales, or banning high-powered magnets were described mostly in Western nations within the last 5 years.

Conclusion: Paediatric magnet ingestion incidence rates remain high despite an increase in regulations globally. Reported data likely underestimates the true extent of the problem since relevant reports are not available in many countries and many countries still lack national policies or data comparing pre- and post-policy implementation. There is insufficient data to determine the efficacy of any single type of regulation.

Objective: Fall-related injuries are a global public health concern, and trauma registries aid in collecting data to develop measures to reduce their burden on individuals and communities. The aim of this review was to provide a comprehensive overview of the reporting of fall-related mortality in trauma registries and surveillance systems in sub-Saharan Africa.

Methods: A systematic review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. We searched eight electronic databases, and studies set in countries of sub-Saharan Africa were included if the reported data originated from a trauma registry or surveillance system and contained a measurement of fall-related mortality. Results were synthesised in a descriptive manner.

Results: Of the 3574 records found, we included 21 studies in the analysis. Different definitions were inconsistently used in reporting fall-related mortality: studies reported either a percentage of fall deaths by total falls or of fall deaths by total deaths. Deaths due to falls by total falls ranged from 0.01% to 2.4% in studies with paediatric patient populations, and from 0.03% to 60% among studies not restricted to a specific age group. Reporting on other variables in relation to injury and trauma care was also inconsistent.

Conclusions: The findings of this review were heterogeneous, and variables were collected irregularly among trauma registries. This led to a broad range of results and made comparisons and deductions difficult. A more standardised data collection across registries would heighten the intercomparability of results from different studies and, therefore, facilitate usage in data-based efforts for implementing prevention and optimising care.

Purpose: Good eye protection is the most important factor in preventing eye injuries. Most eye injuries are due to the improper use or lack of use of eye protection equipment. Therefore, this study aims to assess eye protection practice and associated factors among welders in small-scale industries in Hosanna town of Southern Ethiopia.

Methods: A cross-sectional study was conducted on 420 welders between 14 August and 14 September 2023. A structured questionnaire was used to collect the data entered into Epi-data V.4.6 and analysed using a statistical package for social science V.25.0. Descriptive statistics was used to describe the characteristics of study participants. Binary logistic regression analysis was carried out to identify factors associated with eye protection practice. Finally, the OR with a corresponding 95% CI was computed to show the strength of the association. A p value <0.05 was considered to declare statistical significance.

Results: A total of 420 study participants were included. Good eye protection practice was 43.6% (95% CI 43.41 to 43.79). Monthly income between 4000 and 8000 and above 8000 Ethiopian birr, knowledge (adjusted OR (AOR)=3.90, 95% CI 1.96 to 7.78), permanent work pattern (AOR=2.86, 95% CI 1.59 to 5.17), previous ocular trauma (AOR=3.09, 95% CI 1.53 to 6.22) were positively associated with good eye protection practice.

Conclusion: The results of this study revealed poor eye protection practice among welders. Factors such as monthly income, previous ocular injury, work pattern and knowledge of eye Personal Protective Equipment were significantly associated with eye protection practice.

Introduction: Achieving sufficient adherence with injury prevention exercise programmes is a challenge. The aim was to explore how amateur football coaches experience the use of and support for injury prevention training using the Knee Control programmes as examples.

Methods: Semistructured interviews with 20 amateur football coaches around experiences of injury prevention training, facilitators and barriers, and perceived support, analysed with qualitative content analysis. Participants coached male and female, junior and senior teams. Experience of having used the Knee Control programmes was an inclusion criteria.

Results: Four main categories were developed: Why are we really doing this?, How do we make it work?, What are our drivers and challenges? and What could be improved? Coaches were motivated for injury prevention training but faced challenges such as limited access to football grounds and low player motivation. To make the prevention programme work for them, they integrated it and used exercises in the pauses during football-specific drills, or used as a warm-up. Many conducted prevention routines from an early player age. Coaches believed preventive training use could be further enhanced by education and practical support, and by football associations and clubs working together to reduce injuries.

Conclusion: Coaches were motivated and creatively worked with the prevention programme to make it fit their team. Even coaches with long-term experience of using prevention programmes wanted support, indicating that present implementation strategies targeting those about to start using prevention programmes should be complemented by continuous support for maintained use. These strategies should preferably target both coaches and players.

Background: Workplace injuries due to a slip, trip or fall on the level (STF) are often reported together, making the potential impact of targeted interventions, such as slip-resistant footwear, difficult to assess. The objective of this research was to review workplace non-fatal injuries reported as STFs under the Reporting of Injuries, Diseases and Dangerous Occurrences Regulations 2013 to determine what proportion of staff STF injuries reported by the National Health Service (NHS) in Great Britain were caused specifically by a slip.

Methods: The free text descriptions of all 1004 STF injuries reported by NHS staff in summer 2018 and winter 2018/2019 were independently reviewed by two researchers to determine whether a slip was the primary cause or not. Where agreement could not be reached or the cause was unclear, an STF specialist reviewed the reports to establish the likely cause. The kappa statistic was used to measure inter-reviewer agreement, and the χ² test was used to compare proportions across seasons.

Results: The reviewers agreed on the initiating event, slip or non-slip, for 917 (91.3%) of the incidents. The kappa statistic was 0.842 (95% CI 0.785 to 0.898) indicating strong agreement between reviewers. In total, 431 or 42.9% (95% CI 39.8% to 46.1%) of the STF incidents were slips. This percentage was greater in winter compared with summer (49.0% and 36.0%, respectively, p<0.001).

Conclusion: The high proportion of slips among reported STF injuries implies that an effective intervention targeting workplace slips in the NHS could have a substantial impact on the number of injuries reported.