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Accident and emergency informatics has become a new approach to accident research in the era of digitization, where it has become realistic to integrate data recorded at accident sites with data in electronic health records of patients. This chapter deals with the question on whether the existing and well-established evaluation methodologies used in accident-centered research as well as in patient-centered research within clinical medicine are sufficient and should also be used for such integrated data or whether they have to be modified or extended. Based on the Gaus-Muche-Nomenclature on studies in clinical medicine, it will be outlined which types of studies are appropriate here. In addition to observational studies and registers, controlled trials using randomization are also be regarded as an important approach for gaining new knowledge. In order to appropriately access data from health records and from accidents, standards for representing and communicating data for such studies will be of importance. Another criterion is referential integrity. Here and with respect to accidents the International Standard Accident Number (ISAN) may be of importance. [ABSTRACT FROM AUTHOR]

In Australia, 86 "rescuers" have drowned over 15 years (1992-2007). Many victims have needlessly drowned simply because of bystander unfamiliarity with the simple skill of throwing a lifeline or lifebuoy. The basic paradigm of aquatic lifesaving is to affect a rescue, without placing oneself at risk. Twenty-five fit, untrained adults were recruited to assess their lifeline throwing abilities. Results from 190 competitors as participants in the Line Throw events at the National Australian Pool Lifesaving Competition 2009 were analyzed for speed, efficacy, and accuracy. It takes a medium time of 35 s for an untrained bystander to throw a lifeline. Only 20% can throw a line within 2 m of the target at a first attempt. In the heat of the moment, 20% do not secure the end of the flung rope. Trained children can affect a 10 m accurate throw and pull a potential victim to safety with a medium elapsed time of 23 s. The Australian national record for trained lifesavers (adult, 12 meter), is 10.08 s-world record 9.06 s. This simple lifesaving technique, with training in improvisation (e.g., garden hoses), will undoubtedly save lives. [ABSTRACT FROM AUTHOR]

This study sought to establish home swimming pool design guidelines to minimize risk of diving injury. Using a qualitative design, interviews with representatives of home pool companies were analyzed and common themes were determined. Pool company display centers and advertising materials were also examined. The typical in-ground fiberglass home pool was described by manufacturers as 8 m in length, with a constant gradient of 0.9 m to 1.8-2.0 m deep. Comparisons between this profile and the underwater pathways of young adults in previous studies by the authors showed that if the dives had been performed in this typical pool, impact would have occurred for some dives. Safety features such as depth markings and signage were absent from all pools. We concluded that recreational swimmers with limited diving skills are at risk of diving injury in the typical home swimming pool. Recommendations are provided of strategies that can be implemented by home pool owners to improve pool safety. [ABSTRACT FROM AUTHOR]

Aquatic facilities can end up paying a large amount of compensation as a result of a charge of negligence. There are two main purposes of this study. The first was to use survey methodology to identify the number of injuries that occur in the swimming pools at Pennsylvania state universities and, as a result, to develop a model to predict the number of injuries that may occur in a university swimming pool. Second, the researchers wanted to gain insight from a sample of aquatic directors into the concerns they have managing their aquatic facilities. Multiple linear regression and ANOVA statistics, along with face-to-face interviews and on-site visits/observations, were used for this study. Thirty-three universities (71.7%) of the online survey respondents claimed that they had a risk management manual or plan on-site. The researchers visited a total of 14 state owned universities' swimming pools in Pennsylvania to examine the pool facilities and evaluate risk management practices within their aquatics facilities. When researchers inquired about what procedures the managers followed when they found an unsafe condition in their facility, 10 out of 14 aquatic directors (71.42%) said that they did not have any standard procedures that they followed. Site observations not only provided a clear picture for the researchers in understanding how aquatic directors operate their swimming pools but also helped the researchers to identify several false risk management practices, such as rusted pool side drain covers, broken tiles, and blocked exit doors, etc. The effectiveness of the model is appropriate in the application of predicting the number of potential swimming pool injuries at the university level. This is valuable statistical information for the aquatic director to obtain and analyze to determine which risk alterations need to occur within the facility management to reduce the number of potential injuries. [ABSTRACT FROM AUTHOR]

The purpose of this study was to examine the risk factors for injuries on a beach. It is important to know all the risk factors for injuries that can happen in a beach to prevent accidents. Risk factors were grouped in four main categories: beach morphology (BM), beach equipment (BE), lifeguard service (LS), and miscellaneous aspects (MA). All of them were evaluated according to their importance using a survey by Spanish and International experts. Descriptive analysis showed that LS is the main mechanism by which to reduce injuries on a beach. Lifeguard service in-service training is very important as are the affluence and activities developed by the beach patrons, the influences of weather and climate on the beach, and other infrastructures as risk factors for dangers on beaches. [ABSTRACT FROM AUTHOR]

When there is human activity in, above, or around an aquatic environment, a drowning incident may occur due to rescuer characteristics, casualty characteristics, location, and general circumstances (Avramidis, Butterly, & Llewellyn, 2007). The aim of the current study was to identify locations where people drown. Qualitative content analysis was used to analyze drowning incident videos (n = 41), and semistructured interviews were conducted of those involved in drowning incidents (n = 34). Drowning incidents may occur in any aquatic environment with a water depth that allows immersion or submersion, under a variety of environmental conditions where the ground is sloping, at any distance from safety, where anxiety exists, in the absence of safety regulations, or when the law is breached. [ABSTRACT FROM AUTHOR]

The aim of the current study was to identify the casualty characteristics that contribute to drowning according to the 4W model (Avramidis, Butterly, & Llewellyn, 2007, 2009). Qualitative content analysis was used to analyze drowning incident videos (n = 41) and semistructured interviews of those involved in drowning incidents (n = 34). Results confirm that human activity in, on, and around an aquatic environment can lead to drowning, regardless of the casualty's type, gender, age, ethnicity, and area of residence. Males far outnumbered females as drowning victims. Younger persons were more likely to drown than were adults. Due to socioeconomic differences, Black people in our sample were likely to drown more often, while Whites who drowned were engaged in aquatic activities that lower socioeconomic individuals likely cannot afford or have access to. Nonswimmers, casualties who have lost consciousness, and nonresidents to specific aquatic environments also were the ones in the highest danger. [ABSTRACT FROM AUTHOR]

Unconnected data silos make it difficult to view a patient's accident and emergency case in a comprehensive way, i.e. across all sectors. This includes the emergency medical services (EMS), medical data in a hospital's electronic health record (EHR) as well as event data recorders (EDRs) collecting information about the circumstances of the accident and emergency event. In this paper, we propose a conceptual architecture which introduces a novel case-based record linkage approach and the international standard accident number (ISAN) as a master case index for linking data from EDR, EMS, and EHR. [ABSTRACT FROM AUTHOR]

Highlights • A choice of accident analysis methods influences analysis outcomes. • Data source used and analyst's background and biases influence analysis outcomes. • STAMP tends to be more reliable than Accimap. • Accimap captures soft factors, but STAMP captures decision making and its context. • The combined use of two methods can be very useful, but practically challenging. Abstract The validity and reliability of human factors and safety science methods are some of the important criteria for judging their appropriateness and utility for accident analysis, however these are rarely assessed. The aim of this study is to take a closer look at the validity and reliability of two systemic accident analysis methods (Accimap and STAMP) by comparing the results of four studies which analysed the same accident (the South Korea Sewol Ferry accident) using two methods. Studies 1 and 2 used Accimap whilst Studies 3 and 4 applied STAMP. The four studies were compared in terms of analysis procedure taken, level of detail, causal factors identified, and the recommendations for improvements suggested by the methods. The results of the causal factor comparison indicate that the reliability (degree of overlap of causal factors identified from the same method, i.e. inter-analyst overlap) of STAMP (65%) is higher than Accimap (38%). The validity (degree of overlap of causal factors identified from two different methods) is as low as 8%. The comparison of recommendations indicates that STAMP-based analyses produce a wider range of recommendations across multiple system levels while Accimap-based analyses tend to focus on whole system-related recommendations. These findings suggest that the use of a more structured method like STAMP can help produce a more reliable accident analysis results. [ABSTRACT FROM AUTHOR]

The article discusses what the authors refer to as the limitations that are associated with unintentional injury research in the Philippines, and it mentions critical data gaps on injuries and a goal of reducing deadly jellyfish sting injuries. Injury mortality and morbidity are addressed, along with marginalized populations in low- and middle-income countries and public health concerns regarding box jellyfish stings.

Copyright of Pädiatrie & Pädologie is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

SARNET (Severe Accident Research Network) was set up under the aegis of the Framework Programmes of the European Commission from 2004 to 2013 and coordinated by IRSN to perform R&D on severe accidents in water-cooled nuclear power plants. The network self-sustainability was achieved through integration mid-2013 in the NUGENIA European association devoted to R&D on fission technology of Generation II and III. The SARNET activities continue in the technical area "Severe accidents" through technical workshops, ranking of R&D priorities, improvements of severe accident codes, ERMSAR international conferences, and education and training courses. Six technical domains are addressed in this technical area: in-vessel corium/debris coolability, exvessel coriuminteractions and coolability, containment behaviour including hydrogen risk, source termreleased to the environment, impact of severe accidents on the environment and emergency management, and severe accident scenarios. The ranking of research priorities in the NUGENIAR & Droad map that was published in 2015 underlined the need to focus efforts in thenext yearson the improvement of prevention of severe accidents and on the mitigation of their consequences, as highlighted by the Fukushima Dai-ichi accidents. Several current projects on mitigation of severe accident consequences in Euratom or NUGENIA frame are shortly described in this paper. [ABSTRACT FROM AUTHOR]

Safety analysis of rare events with potentially catastrophic consequences is challenged by data scarcity and uncertainty. Traditional causation-based approaches, such as fault tree and event tree (used to model rare event), suffer from a number of weaknesses. These include the static structure of the event causation, lack of event occurrence data, and need for reliable prior information. In this study, a new hierarchical Bayesian modeling based technique is proposed to overcome these drawbacks. The proposed technique can be used as a flexible technique for risk analysis of major accidents. It enables both forward and backward analysis in quantitative reasoning and the treatment of interdependence among the model parameters. Source-to-source variability in data sources is also taken into account through a robust probabilistic safety analysis. The applicability of the proposed technique has been demonstrated through a case study in marine and offshore industry. [ABSTRACT FROM AUTHOR]

A comparative study is conducted to compare the theory and application effect of two accident causation models, the human factors analysis and classification system (HFACS) and the accident causation "2-4" model (24Model), as well as to provide a reference for safety researchers and accident investigators to select an appropriate accident analysis method. The two models are compared in terms of their theoretical foundations, cause classifications, accident analysis processes, application ranges, and accident prevention strategies. A coal and gas outburst accident is then analyzed using both models, and the application results are compared. This study shows that both the 24Model and HFACS have strong theoretical foundations, and they can each be applied in various domains. In addition, the cause classification in HFACS is more practical, and its accident analysis process is more convenient. On the other hand, the 24Model includes external factors, which makes the cause analysis more systematic and comprehensive. Moreover, the 24Model puts forward more corresponding measures to prevent accidents. [ABSTRACT FROM AUTHOR]

Accident causation analysis is a good way to trace industrial accident causes and ultimately to prevent similar accidents from happening again. Classification of accident causes can not only provide a comprehensive understanding of accident but also benefit causes statistics. Although many accident cause classification models or taxonomies have been proposed, yet some models are domain-specific while others are too general or complicated for practical application. To address the basic two issues of accident analysis, which are (1) what is the failure and (2) how does the failure happen, a new model is presented from both system safety perspective and control theory perspective. First, complex systems can be decomposed into six components, which are machine, man, management, information, resources, and environment from the view of system safety factors. From control theory perspective, actuator, sensor, controller, and communication are defined as system factors’ functional abstractions. The combinations of system factors and control functions form a matrix model for accident causation analysis and classification, named Accident Causation Analysis and Taxonomy (ACAT) model. Then a comparison with existing cause classification schemes is made and the case of BP Texas refinery accident is used to illustrate its capability. [ABSTRACT FROM AUTHOR]

The article focuses on the development of geographic information system (GIS) for risk-informed decision making in aerospace medicine. It mentions the Aeromedical Data Visualization Operational Reporting Safety System (ADVisORS2), a GIS for aviation medical and accident research constructed at the Civil Aerospace Medical Institute (CAMI) and a study on selective serotonin reuptake inhibitors.

The ingestion of corrosive substances is a widely treated topic in clinical and forensic practice, as an accidental event or as a consequence of voluntary assumption to commit suicide. However, thorough macroscopic and microscopic surveys focused on the correlation between the ingestion of the substance and different survival times have never been performed. Are the ingestion and the metabolism of the substance within the human tissues still recognizable? How could it be related to death? The study concerns a retrospective analysis on ten cases (two accidental, eight suicides) of lethal ingestion of different types of liquid caustic substances, without instant death and survival times ranging from 12 h to 6 months. For each case, a full autopsy and histological examination of the internal organs were performed. The results showed that the early direct effect of the substances is exerted mainly on the gastrointestinal tract, but as survival time increased, the metabolism of the substance exerted its effects in different target organs. When the cause of death was not directly linkable to the ingestion of the substance (i.e., related to cardiac stress, electrolyte disorders, pneumonia) and macroscopic findings were nonspecific, histological analyses allowed for providing crucial elements towards a link between death and assumption of the substance. [ABSTRACT FROM AUTHOR]

Forensic case work as well as literature shows that severe head injuries, e.g., with basilar fractures and cerebral hemorrhages due to stomps can be seen; however, there is no data basis concerning contact forces and potential influencing factors. The objective of this work was to generate a data basis of contact forces in stomping by performing experimental measurements and subsequent statistical analyses. Fifty-five volunteers participated in the present study. Each participant performed several stomps onto force plates with sturdy/soft footwear as well as with/without an elastic layer imitating the scalp. Ground reaction forces induced by jumps were also measured for sturdy and soft footwear. The results show statistically significant dependencies between maximum ground reaction forces and body weight and body height. A statistically significant influence of footwear on stomping force could only be found in tests with an elastic layer and in the jumping setup. Mean maximum stomping forces for the female volunteers were between 4694 and 5970 N; male volunteers were able to produce mean peak stomping forces between 8494 and 9016 N. Jumping forces were approximately twice the stomping forces for both male and female test persons. Regardless of footwear and gender, it can be claimed that a forceful stomp or jump to someone's head supported on the ground can cause facial and skull fractures. Thus, forceful stomps or jumps to someone's head can cause potential fatal injuries independent of footwear, gender, or fitness level. [ABSTRACT FROM AUTHOR]

The problem of urban road accidents in Colombia is remarkable and has a significant magnitude. For this reason, a technical study of this important public health scourge is important. The quantitative techniques employed are usually highly aggregated and will not correctly identify the determinant variables of the problem. This paper examines the relationship between urban road accidents and variables related to road infrastructure, environment, traffic volumes and traffic control. Some accident-prone sections in the city of Cartagena (Colombia) are specifically identified by the empirical Bayesian method based on GIS. A total of 69 accident-prone sections were identified in the city. It was evident that the marginal effect on the accident rate for motorcycles is well above that for cars and buses. Empirical evidence also showed that the sections located in commercial areas tend to have higher frequency of accidents due to the high presence of pedestrians. [ABSTRACT FROM AUTHOR]

Inappropriate speed is a relevant concurrent factor in many traffic accidents. Moreover, in recent years, traffic accidents numbers in Spain have fallen sharply, but this reduction has not been so significant on single carriageway roads. These infrastructures have less equipment than high-capacity roads, therefore measures to reduce accidents on them should be implemented in vehicles. This article describes the development and analysis of the impact on the driver of a warning system for the safe speed on each road section in terms of geometry, the presence of traffic jams, weather conditions, type of vehicle and actual driving conditions. This system is based on an application for smartphones and includes knowledge of the vehicle position via Ground Positioning System (GPS), access to intravehicular information from onboard sensors through the Controller Area Network (CAN) bus, vehicle data entry by the driver, access to roadside information (short-range communications) and access to a centralized server with information about the road in the current and following sections of the route (long-range communications). Using this information, the system calculates the safe speed, recommends the appropriate speed in advance in the following sections and provides warnings to the driver. Finally, data are sent from vehicles to a server to generate new information to disseminate to other users or to supervise drivers' behaviour. Tests in a driving simulator have been used to define the system warnings and Human Machine Interface (HMI) and final tests have been performed on real roads in order to analyze the effect of the system on driver behavior. [ABSTRACT FROM AUTHOR]

Since even a small disturbance may lead to the passive dynamic walker falling, former researches tried to enlarge the basin of attraction of the walking motion to resist disturbances. However, experience with real walking robots reveals that a new disturbance in one step will be added to the total disturbances accumulated from last steps, which results in falling due to a small accidental disturbance. Therefore, fast speed of convergence to the periodic walking motion is necessary to inhibit the accumulation of disturbances. In this paper, the internal features in the basin of attraction of the simplest walking model are investigated for the consideration that the performance for handling disturbances of a walking motion is determined by not only the size of basin of attraction, but also the internal features, such as the speed of convergence. The features of the basin of attraction are obtained by the cell mapping method with defining a convergent cell. The results show that it needs fewer steps for some stripe regions far away to converge than points close to the long period solution. Especially in some stripe regions, the convergence speed is very fast. There is no obvious relation between the size of the basin of attraction and the convergence speed, which motivates us to continue the research to find solutions for designing the walking model with high performance on both aspects. [ABSTRACT FROM AUTHOR]

Background. Drug overdose is an important, yet an inadequately understood, public health problem. Global attention to unintentional drug overdose has been limited by comparison with the scope of the problem. There has been a substantial increase in drug overdose incidence and prevalence in several countries worldwide over the past decade, contributing to both increased costs and mortality. Objectives. The aim of this study was to systematically synthesize the peer-reviewed literature to document the global epidemiological profile of unintentional drug overdoses and the prevalence, time trends, mortality rates, and correlates of drug overdoses. We searched different combinations of Medical Subject Headings (MeSH) terms in PubMed for articles published from 1980 until July 2013, and we organized these results in tabular spreadsheets and compared them. We restricted the search to English-language articles that deal with unintentional overdose, focusing on 1 or mo re of the following key constructs: prevalence, timetrends, mortality rates, and correlates. The term "overdose" as a MeSH major topic yielded 1076 publications. In addition, we searched the following combinations of non-major MeSH terms: "street drugs" and "overdose" yielded 180, "death" and "overdose" yielded 114, and "poisoning" and "drug users" yielded 17. There was some overlap among the searches. Based on the search and inclusion and exclusion criteria, we selected a total of 169 relevant articles for this article based on a close review of abstracts. Results. We found wide variability in lifetime prevalence of experiencing a nonfatal overdose or witnessing an overdose, and in mortality rates attributable to overdose. Lifetime prevalence of witnessed overdose among drug users (n=17 samples) ranged from 50% to 96%, with a mean of 73.3%, a median of 70%, and a standard deviation of 14.1%. Lifetime prevalence of drug users personally experiencing a nonfatal overdose (n = 27 samples), ranged from 16.6% to 68.0% with a mean of 45.4%, a median of 47%, and a standard deviation of 14.4%. Population-based crude overdose mortality rates (n = 28 samples) ranged from 0.04 to 46.6 per 100 000 person-years. This range is likely attributable to the diversity in regions, time periods, and samples. Most studies on longitudinal trends of overdose death rates or overdose-related hospitalization rates showed increases in overdose death rates and in overdose-related hospitalization rates across time, which have led to peaks in these rates at the present time. An overall trend of increasing deaths from prescription opioid use and decreasing deaths from illicit drug use in the past several years has been noted across most of the literature. With the increase in prescription opioid overdose deaths, drug overdose is not just an urban problem: rural areas have seen an important increase in overdose deaths. Lastly, cocaine, prescription opioids, and heroin are the drugs most commonly associated with unintentional drug overdoses worldwide and the demographic and psychiatric correlates associated with unintentional drug overdoses are similar globally. Conclusions. There is a need to invest in research to understand the distinct determinants of prescription drug overdose worldwide. Several other countries need to collect in a systematic and continuous fashion such data on sales of prescription opioids and other prescription drugs, nonmedical use of prescription drugs, and hospitalization secondary to overdoses on prescription drugs. The sparse evidence on the environmental determinants of overdose suggests a need for research that will inform the types of environmental interventions we can use to prevent drug overdose. Methodological issues for future studies include enhancing data collection methods on unintentional fatal and nonfatal overdoses, and collecting more detailed information on drug use history, source of drug use (for prescription drugs), and demographic and psychiatric history characteristics of the individual who overdosed. [ABSTRACT FROM AUTHOR]

Starting from the critical analysis of the speciality literature, this paper proposes to present an operational categorization and classification of the malevolent acts relevant within the industrial security field. There have been identified, described and classified several categories of malevolent acts, stating in each situation if it is about a direct cause or an indirect one of process of a major accident: the internal malevolent acts (deliberate destruction in order to obtain certain material gains, dissimulation of fraudulent acts or delicts, individual swerved behaviour intended to induce losses, dissimulation of a risky act, social conflicts) and the external malevolent acts (industrial espionage, embezzlement of communication systems, conflicts with neighbours, vandalism, theft, ruffianism, terrorism). Through the data and information provided, the paper aims to contribute to the integration of malevolent acts in the risk assessment process of major accidents occurrence. [ABSTRACT FROM AUTHOR]

Background: Despite the considerable injury burden attributable to falls at home among the general population, few effective safety interventions have been identified. We tested the safety benefits of home modifications, including handrails for outside steps and internal stairs, grab rails for bathrooms, outside lighting, edging for outside steps, and slip-resistant surfacing for outside areas such as decks and porches. Methods: We did a single-blind, cluster-randomised controlled trial of households from the Taranaki region of New Zealand. To be eligible, participants had to live in an owner-occupied dwelling constructed before 1980 and at least one member of every household had to be in receipt of state benefits or subsidies. We randomly assigned households by electronic coin toss to either immediate home modifications (treatment group) or a 3-year wait before modifications (control group). Household members in the treatment group could not be masked to their assigned status because modifications were made to their homes. The primary outcome was the rate of falls at home per person per year that needed medical treatment, which we derived from administrative data for insurance claims. Coders who were unaware of the random allocation analysed text descriptions of injuries and coded injuries as all falls and injuries most likely to be affected by the home modifications tested. To account for clustering at the household level, we analysed all injuries from falls at home per person-year with a negative binomial generalised linear model with generalised estimating equations. Analysis was by intention to treat. This trial is registered with the Australian New Zealand Clinical Trials Registry, number ACTRN12609000779279. Findings: Of 842 households recruited, 436 (n=950 individual occupants) were randomly assigned to the treatment group and 406 (n=898 occupants) were allocated to the control group. After a median observation period of 1148 days (IQR 1085-1263), the crude rate of fall injuries per person per year was 0 · 061 in the treatment group and 0 • 072 in the control group (relative rate 0 -86, 95% Cl 0-66-1 12). The crude rate of injuries specific to the intervention per person per year was 0 · 018 in the treatment group and 0 · 028 in the control group (0 · 66, 0 · 43-1 · 00). A 26% reduction in the rate of injuries caused by falls at home per year exposed to the intervention was estimated in people allocated to the treatment group compared with those assigned to the control group, after adjustment for age, previous falls, sex, and ethnic origin (relative rate 0 · 74, 95% Cl 0 · 58-0 · 94). Injuries specific to the home-modification intervention were cut by 39% per year exposed (0 · 61, 0 · 41-0 · 91). Interpretation: Our findings suggest that low-cost home modifications and repairs can be a means to reduce injury in the general population. Further research is needed to identify the effectiveness of particular modifications from the package tested. Funding: Health Research Council of New Zealand [ABSTRACT FROM AUTHOR]

Introduction: accidents with poisonous animals are a common clinical emergency in several tropical countries, mainly in the fields and rural areas, constituting a public health problem, including pediatric. Objective: The objective is to analyze the morbidity, mortality and lethality according to age and sex in cases of poisoning by snakes, scorpions and spiders in Brazil. Methods: data on poisoning by snakes, scorpions and spiders that occurred from 2009 to 2013 were collected in the online database of the Information System on Diseases of Compulsory Declaration (SINAN) of the Ministry of Health. Results: were recorded 28.812 cases of snake bites per year, 60.370,8 with scorpions and 25.786,4 with spiders. Most deaths were caused by snakes (119 per year) and also showed higher lethality (0.41%), followed by scorpions (79.6 deaths) with a lethality of 0.13% and spiders (13.2) and the lowest mortality (0.05%). In males individuals were most cases of snake bites, whereas in accidents scorpions and spiders was observed little difference in frequency between men and women. The age group with the largest number of poisonings records was 20-39 years. Conclusions: there is a progressive increase in cases of poisoning from the first year of age until the age range 20-39 years, and after this, begins a decrease in cases. Children, adolescents and elderly adults are most vulnerable because they have higher lethality rates, especially in the snake and scorpion accidents. [ABSTRACT FROM AUTHOR]

The article discusses research about the safety assessment of submarine missile systems during combat. Topics mentioned include the parameters of hazardous situations, accident in the weapon system, safety of submarine missile systems from fire and explosion, and the effect of contactless underwater weapon explosions on a submarine missile system.

This study aggregates the narrative findings from the investigation of 12 accidents or 'near hits' across a wide range of industrial settings to build a catalogue of organisational and cultural precursors to accidents. It was found that many were important factors in multiple events. It is argued that by addressing these potential vulnerabilities using the findings and proposed tools based upon them, organisations undertaking safety related activities will not only develop greater awareness of these deeper-lying issues but should be able to better control the risks associated with them. The precursors have been classified under eight headings and examples of key findings from three of these are presented. Statements providing potential defences against the identified vulnerabilities have been developed which should enable organisations to scrutinise the adequacy of existing expectations or requirements within their business. Probing questions have been developed based on the statements which should allow an assessment to be made as to whether these have been 'embedded' in the organisation. It is argued that organisational vulnerability tools should be developed to enable a systematic approach to 'diagnosing' incubating precursors. It is also argued that there is the potential for further resilience to be achieved through the use of models of the complex dynamics of socio-technical processes within organisations. [ABSTRACT FROM AUTHOR]

Background: Every year almost 1.3 million people lose their lives as a result of road traffic accidents, contributing to above 3500 deaths per day world-wide. The aim of this study was to assess the frequency and distribution of RTAs leading to fatality. Material & Methods: This was descriptive cross-sectional study of autopsies performed at the mortuary of DHQ Teaching Hospital, D.I.Khan, from January 2013 to December, 2013. Data was collected on a proforma. The results were analyzed using Statistical Software Package SPSS version 20. Results: Out of 160 autopsies, 39 cases were victims of RTAs. Of these RTA victims, 79.4% autopsies were of those between the ages of 1 and 40 years. The gender distribution revealed a higher prevalence for males (84.6%) than females (15.4%). Death was due to injury to the head in 66% cases. The majority of victims were front seat passengers (43.9%), drivers (35.7%), back seat passengers (15.3) and pedestrians (5.1%). Conclusion: There was a higher preponderance for males, front seat passengers & younger age groups in road traffic accidents, with head injury being the mode of death. [ABSTRACT FROM AUTHOR]

Accidents are now one of the major causes of death. Present study consists of 439 medico legal post mortems performed in Forensic Medicine Department, GMERS Medical College and Hospital, Valsad, Gujarat during the period of last 2 calendar years (1st January. 2012 to 31st December. 2013). Out of them, 90.66% cases were of unnatural deaths. Out of unnatural death we found 146 cases (36.68%) died in road traffic accidents. In 36.98% cases were age group of 21-30 years. 44.83% accidents occur in time period of 12-18 hours. Thus all data including type of vehicle involved, head injuries, regional injuries, type of skull fracture in head injury, type of haemorrhage and how long victim survived. [ABSTRACT FROM AUTHOR]

We conducted a study of approximately 16,000 drivers under the age of 30 that had purchased a pay-as-you-drive insurance policy, where their risk of being involved in a crash was analyzed from vehicle tracking data using a global positioning system. The comparison of novice vs. experienced young drivers shows that vehicle usage differs significantly between these groups and that the time to the first crash is shorter for those drivers with less experience. Driving at night and a higher proportion of speed limit violations reduces the time to the first crash for both novice and experienced young drivers, while urban driving reduces the distance traveled to the first crash for both groups. Gender differences are also observed in relation to the influence of driving patterns on the risk of accident. Nighttime driving reduces the time to the first accident in the case of women, but not for men. The risk of an accident increases with excessive speed, but the effect of speed is significantly higher for men than it is for women among the more experienced drivers. [ABSTRACT FROM AUTHOR]

Reasons for failure of plate osteosynthesis: Not uncommonly, the management of plate fixation failure can pose a challenge for the surgeon. Therefore it is first necessary to recognize the underlying reason and to address it in the context of a correct therapy strategy. Peri-implant fractures at the end of the plate, screw breakage or loosening as well as plate breakage at the site of the initial fracture line can lead to failure of the plate fixation construct. Commonly, a secondary fracture at the end of the plate is caused by an adequate force impact in mostly younger male patients in an employable age. On the other hand, in geriatric patients brittle fractures due to a low impact in inadequate accidents are seen at an increasing rate resulting from a generalized fragility of osteoporotic bone. However, in most cases the mechanical failure of plate osteosynthesis is the result of plate breakage or screw loosening based on a delayed bone fracture union. Therapy: Numerous options for internal fixation are available to readdress the instability, ranging from additional plating through intramedullary nailing to conversion to endoprosthetic arthroplasty at an appropriate fracture location near a joint. The choice of treatment should depend on the type of plate failure as well as the individual bone quality. In cases of delayed fracture union, the surgical treatment should imperatively focus on measures to support fracture healing. [ABSTRACT FROM AUTHOR]

Background: Recognition of an occupational or school accident depends on several factors. In addition to proof of the accident and the (immediate) damage to health, the internal, i.e. objective relationships, the accident causation and the proximate cause must be fulfilled. Assessment: The statutory accident insurance is built on the principle of causation and the finality is legally insignificant. Causes in the law of statutory accident insurance are only those conditions which substantially contributed to the occurrence due to their special relationship to success. Every single fact in a case must be checked against the appropriate evidential standards. The responsibilities are divided between accident insurance underwriters and medical doctors to provide a conclusive result. [ABSTRACT FROM AUTHOR]

Objectives To assess long-term survival of community-dwelling elderly women after a fall according to various characteristics of whom four falling profiles. Methods The study included 329 women (mean age ± SD: 84 ± 3.5 years). Phone interviews were conducted every four months over four years to investigate the occurrence of falls and fill out a specific questionnaire. The vital status was checked up to 13 years after these four years. An accelerated failure-time model was used to estimate the effect of the falling profiles on women survival. Results During the four-year follow-up, 86 women (26%) belonged to the “outside falls” profile, 63 (19%) to “environmental falls”, 140 (43%) to “inside falls”, and 40 (12%) to “falls from height”. At 13 years, the survival probability was estimated at 20.8% [95% CI: 16.4–25.2%]. On average, women with “inside falls” had shorter survivals in comparison with each of the other falling profiles. Kaplan–Meier survival curves showed also shorter survivals of these women vs. all other women grouped together (HR = 1.33 [1.02–1.73], p = 0.03). Conclusion Elderly women with inside falls had shorter survivals than others. Indoor falls could be markers of an underlying frailty and should trigger adequate prevention and protection measures. [ABSTRACT FROM AUTHOR]

While malicious acts by insurgents, rebels and tribes have attracted considerable attention in recent years; peacekeeping fatalities are most often caused by accident and illness. Yet despite this, malicious acts remain the major focus of journalistic reporting and academic study. This article places malicious acts into a broader context and highlights the more pressing threats posed by accident and illness. [ABSTRACT FROM PUBLISHER]

Background: Mountain's caves should be characterized by a set of unique rules and those who comply with them may be rewarded with the opportunity to experience memorable, worth cherishing moments. There are plenty of threats, determined by both natural causes and tourists' actions, which might wait for hikers. Aim of the study: The aim of the research was to carry out the analysis of the accident rate within the caves situated in the area of Kraków- Częstochowa Upland. Material and methods: The method of the documentation analysis was used for the research; the analysis was carried out on the documentation involving years 1998-2014 (October) belonging to Jurajska Task Force of the Mountain Volunteer Search and Rescue based in Podlesice. The research material comprised of the following documents: MVSaR incident reports, the reports from the rescue expeditions and the inspection book of the transport equipment. Results: Most of the cave accidents occurring in the area of Kraków-Częstochowa Upland took place in the Sokole Mountains. The following causes of these dangerous incidents were indicated as the lack of proper equipment and poor physical condition, being lost, falling from the heights, slipping and being trapped. The consequences were really serious, ranging from fractured bones of the pelvis and the spine to even fatal accidents. Conclusions: Mountain/cave tourism is undoubtedly the source of many unforgettable memories. However, it is essential that those who perform it ought to be aware of the dangers associated with it. They must not disregard the necessity of performing it in accordance to generally accepted rules of safety. [ABSTRACT FROM AUTHOR]

Objective: This study examines the use of alcohol mixed with energy drinks (AmED) as a predictor of alcohol problems and alcohol-related consequences and accidents two years later in a college student sample. Method: Longitudinal data on AmED use, alcohol consequences, and alcohol problems were collected from the fall of students' second year of college to the fall of their fourth year (N = 620, 49% male). Results: After we controlled for demographic indicators and heavy episodic drinking, AmED use was a consistent predictor of negative alcohol-related outcomes 2 years later. Compared with no AmED use, both infrequent (i.e., one to three times per month) and frequent (i.e., one or more times per week) AmED use were associated with an increased risk of negative alcohol consequences and harmful/hazardous alcohol use (≥8 on Alcohol Use Disorders Identification Test [AUDIT]). Frequent AmED use was also associated with serious alcohol problems (≥16 on AUDIT) and an increased risk of alcohol-related accidents in the subsequent 2 years. Conclusions: Prospective risks of alcohol consequences related to AmED use suggest a continued need for research and policy to address the surveillance, etiology, and prevention of AmED use. [ABSTRACT FROM AUTHOR]

Objective To study the efficacy of predictive nursing on the incidence of adverse events and mental state in patients with acute alcoholism. Methods 104 cases of patients with acute alcoholism were randomly divided into the control group and the observation group. The control group was given routine nursing care, and the treatment group was received predictive nursing on this basis. Before and after the intervention, the accidents and compliance of the two groups were recorded, and then were graded by the self-assessment lists of symptom SCL-90. Results There were no falling out of bed and aspiration occurred in the observation group, and the occurrence of accidents was significantly lower than the control group (P < 0.05) . After nursing, the compliance of the two groups were improved (P < 0.05), and the patients compliance of the observation group was significantly better than that of the control group (P < 0.05) . The somatization, forced symptoms and anxiety of observation group were significantly decreased compared with those of the control group (P < 0.05), and those in control group were significantly higher than Chinese norms (P < 0.05) . Conclusion Predictive nursing can reduce the incidence of adverse events in patients with acute alcoholism and help ease the patients psychological states after treatment. [ABSTRACT FROM AUTHOR]

This article examines public reactions to a tourism safety incident by employing a drama theory approach. A discussion forum launched by a fatal dog sleigh accident serves as a platform for the chat group selected here as a case audience generating instantaneous reactions to the incident. The results suggest that interaudience communication constituted the incident as a drama and, as its subset, a tragedy with discernible episodes through an internal sense-making process. The audience interacted with each of the members in varying intensity, depending on changing individual interests. Explanation of the behavior of the audience can be derived from a drama theory approach. The existence of emotions, episodes, climax, and action in the audience's dynamic provide evidence for the explanation power of drama theory in tourism safety incident communication in chat groups. The article offers a cross-disciplinary approach contributing to interpretation of postincident communication in social media in the case of a tourism safety incident. [ABSTRACT FROM AUTHOR]

Highlights: [•] A debate exists over the validity of the Swiss Cheese Model (SCM). [•] The efficiency-thoroughness trade-off may make STAMP more suitable for use in research. [•] This study suggests that the SCM still offers a systems thinking approach. [ABSTRACT FROM AUTHOR]

Abstract: This paper describes a systematic framework for characterizing important phenomena and quantifying the degree of contribution of each parameter to the output in severe accident uncertainty assessment. The proposed methodology comprises qualitative as well as quantitative phases. The qualitative part so called Modified PIRT, being a robust process of PIRT for more precise quantification of uncertainties, is a two step process for identifying and ranking based on uncertainty importance in severe accident phenomena. In this process identified severe accident phenomena are ranked according to their effect on the figure of merit and their level of knowledge. Analytical Hierarchical Process (AHP) serves here as a systematic approach for severe accident phenomena ranking. Formal uncertainty importance technique is used to estimate the degree of credibility of the severe accident model(s) used to represent the important phenomena. The methodology uses subjective justification by evaluating available information and data from experiments, and code predictions for this step. The quantitative part utilizes uncertainty importance measures for the quantification of the effect of each input parameter to the output uncertainty. A response surface fitting approach is proposed for estimating associated uncertainties with less calculation cost. The quantitative results are used to plan in reducing epistemic uncertainty in the output variable(s). The application of the proposed methodology is demonstrated for the ACRR MP-2 severe accident test facility. [Copyright &y& Elsevier]

The purpose of this study is to examine relationship between the accident and injury occurrence and the absence appearance in adults. Materials of this study were based on the raw data of "Korea National Health and Nutrition Examination Survey 2011", which was conducted by the Ministry of Health and Welfare (MW) and Korea Centers for Disease Control and Prevention (CDC) in 2011. Totally 5904 people were targeted by selecting data without missing value in addition to age in more than 20 years old. And the appearance of absence through the occurrence of injury had the final subjects of absence targeting 379 people among 5904 people. An analytical method was made by using SPSS WIN program (Version 12.0). As a result of research, the occurrence of injury was higher (p< 0.01) in men than women. The age group was high in the 30s (about 1.5 times, p< 0.05) and the 40 s (about 1.9 times, p< 0.01). The higher in household income (about 1.5 times, p< 0.05) and educational level (about 1.6 times, p< 0.001) led to the higher occurrence of injury. As for the occurrence of absence, fall and slip (abut 1.8 times, p< 0.05) had higher absence than other accidents. As for a place of cure, the absence were higher (p< 0.001) in users of emergency room than entering hospital/clinic. Finally, the more bed-ridden led to the higher absence (p< 0.001). [ABSTRACT FROM AUTHOR]

Highlights: [•] Crash details, epidemiologic data and resulting injuries of 33,015 front-seat occupants sustaining motor vehicle accidents. [•] Multiple hits and roll-overs are much more likely than head-on crashes to result in spinal injuries. [•] Seat belts are highly effective in the prevention of fractures of the cervical, thoracic and lumbar spine in motor vehicle accidents. [•] Standard crash-tests neglect the most typical crash settings leading to spinal injuries. [Copyright &y& Elsevier]

Highlights: [•] Real world crash was reconstructed through finite element simulation. [•] Human body model accurately and robustly predicted injuries in a real world crash. [•] Parameter study performed to approximate variations in occupant loading. [•] Injury metrics were most sensitive to bullet vehicle location. [•] Injury metrics had a tight 95% confidence interval suggesting a robust injury prediction. [ABSTRACT FROM AUTHOR]

Highlights: [•] Data “before the installation”, “after the installation” and “after the termination” for 32 signalized intersections in Charlotte, North Carolina were compared to evaluate and assess the effectiveness of red light camera (RLC) enforcement program in reducing crashes. [•] Research results indicate that RLC enforcement program leads to an increase in sideswipe and rear-end crashes at ≥50% of the signalized intersections. [•] It was observed to be effective in reducing total crashes at 50% and 16% of the signalized intersections when analyzed considering “before the installation – after the installation” and “before the installation – after the termination” scenarios, respectively. [•] Potential crash reduction benefits could be maximized if RLC enforcement program is implemented at signalized intersections with (1) total entering vehicles per day less than 40,000, (2) fewer than 20 rear-end crashes per year, or (3) fewer than 5 sideswipe crashes per year. [ABSTRACT FROM AUTHOR]