Parents’ experience with child safety restraint in China

BACKGROUND: Child safety restraints are effective measures in protecting children from an injury while traveling in a car. However, the rate of child restraint use is extremely low in Chinese cities. Parent drivers could play an important role in promoting child safety restraint use, but not all of them take active responsibility. METHODS: This study used a qualitative approach and included 14 in-depth interviews among parents with a child, under the age of 6, living in Shantou City (7 child safety restraint users and 7 non-users). Purposive sampling was used to recruit eligible parent drivers who participated in a previous observation study. Interview data were collected from March to April 2013. The audio taped and transcribed data were coded and analyzed to identify key themes. RESULTS: Four key themes on child safety restraint emerged from the in-depth interviews with parents. These included 1) Having a child safety restraint installed in the rear seat with an adult sitting next to the restrained child is ideal, and child safety restraint is seen as an alternative when adult accompaniment is not available; 2) Having effective parental education strategies could help make a difference in child safety restraint use; 3) Inadequate promotion and parents’ poor safety awareness contribute to the low rate of child safety restraint in China; 4) Mandatory legislation on child safety restraint use could be an effective approach. CONCLUSION: Inadequate promotion and low awareness of safe traveling by parents were closely linked to low child safety seat usage under the circumstance of no mandatory legislation. Future intervention efforts need to focus on increasing parents’ safe travel awareness combined with CSS product promotion before the laws are enacted

A probabilistic sampling method (PSM) for estimating geographic distance to health services when only the region of residence is known

<p>Abstract</p> <p>Background</p> <p>The need to estimate the distance from an individual to a service provider is common in public health research. However, estimated distances are often imprecise and, we suspect, biased due to a lack of specific residential location data. In many cases, to protect subject confidentiality, data sets contain only a ZIP Code or a county.</p> <p>Results</p> <p>This paper describes an algorithm, known as "the probabilistic sampling method" (PSM), which was used to create a distribution of estimated distances to a health facility for a person whose region of residence was known, but for which demographic details and centroids were known for smaller areas within the region. From this distribution, the median distance is the most likely distance to the facility. The algorithm, using Monte Carlo sampling methods, drew a probabilistic sample of all the smaller areas (Census blocks) within each participant's reported region (ZIP Code), weighting these areas by the number of residents in the same age group as the participant. To test the PSM, we used data from a large cross-sectional study that screened women at a clinic for intimate partner violence (IPV). We had data on each woman's age and ZIP Code, but no precise residential address. We used the PSM to select a sample of census blocks, then calculated network distances from each census block's centroid to the closest IPV facility, resulting in a distribution of distances from these locations to the geocoded locations of known IPV services. We selected the median distance as the most likely distance traveled and computed confidence intervals that describe the shortest and longest distance within which any given percent of the distance estimates lie. We compared our results to those obtained using two other geocoding approaches. We show that one method overestimated the most likely distance and the other underestimated it. Neither of the alternative methods produced confidence intervals for the distance estimates. The algorithm was implemented in R code.</p> <p>Conclusions</p> <p>The PSM has a number of benefits over traditional geocoding approaches. This methodology improves the precision of estimates of geographic access to services when complete residential address information is unavailable and, by computing the expected distribution of possible distances for any respondent and associated distance confidence limits, sensitivity analyses on distance access measures are possible. Faulty or imprecise distance measures may compromise decisions about service location and misdirect scarce resources.</p

Child safety restraint patterns in Moldova

ABSTRACT Objective: The Republic of Moldova has one of the European region’s highest road traffic injury rates and also has an increase in motorization and exposure of children as vehicle passengers. This study describes child restraint use, and parents’ knowledge and attitudes toward child restraint based on observations in Chisinau, the country’s capital and largest city. The study aims to describe the use of child restraints and to compare data with existing standards of good practice. Methods: An observational study on child safety restraint use was conducted in 2018. Observational sites included 22 early education institutions, where drivers (n¼611) and child passengers (n¼710) were observed. Observations were conducted as motor vehicles parked or pulled to a stop near the early education institutions and included a driver survey on knowledge and attitudes toward restraint legislation and child safety behavior. Results: Of the 710 child passengers observed, 462 (65.1%) were appropriately restrained, 145 (20.4%) were seated in restraints inappropriate for the child and 103 (14.5%) of children were unrestrained. Younger children (0-3 year-old) were 7 times more likely to be properly restrained compared with children with ages between 4 and 6 (OR 1.92, 95% CI 1.15 to 3.22). Two-thirds out of 609 observed drivers with full study data, N¼431 (70,8%), knew about the mandatory legislation on using child safety restraints in the Republic of Moldova. The drivers using child safety restraints responded that they used them because of their safety features, and the major reason for nonuse was high price/affordability. Conclusion: This study, the first to document child safety restraint use among children, indicates that much progress has been made, in that the majority of children are restrained and most drivers of children are aware of safety policies. However, progress can be made to increase knowledge and motivation to safely transport children, and to ensure safety seats are affordable and available. These data will be an important foundation on which to advocate for increased safety activities, child restraint policies, educational approaches in Moldova and to monitor progress over time

Evaluation of Iowa’s Anti-Bullying Law

Bullying is the most common form of youth aggression. Although 49 of all 50 states in the U.S. have an anti-bullying law in place to prevent bullying, little is known about the effectiveness of these laws. Our objective was to measure the effectiveness of Iowa’s anti-bullying law in preventing bullying and improving teacher response to bullying

A profile of traumatic brain injury within hospital emergency departments — a retrospective study in the Republic of Moldova

Abstract Background: Traumatic brain injury (TBI) is a critical public health and socio- economic problem throughout the world, making epidemiological monitoring of incidence, prevalence, and outcome of TBI necessary. TBI is a major cause of mortality and morbidity in adolescents, young adults, and the elderly, one of the leading causes being road traffic accidents. Methods: A retrospective study was conducted among patients with TBI within 2 medical institutions in Chisinau municipality: Emergency Medicine Institute (EMI) and Valentin Ignatenco Municipal Children’s Hospital (MCH). A questionnaire was applied, completed on the basis of medical records according to the International Classification of Diseases (ICD) 10 codes. The collection period was August 1-October 31, 2018. Data were uploaded using the existing electronic data collection tool—Red Cap and analyzed through Microsoft Excel. Data collection was performed by a resident neurosurgery and a scientific researcher. The ethics committee’s approval has been obtained. Results: There have been identified 150 patients: 57 cases (38.5%) of TBI among children and 93 cases (61.5%) among adults aged between 18 - 73 years old. A large majority (62%) of head injuries were among patients from the urban area (most in adults—60% and males—74%). The most common mechanisms of head injury were falls (53.3%) and road traffic injuries (24%), followed by assault (14.7%) and struck by/or against (8%). The distributions by place of occurrence highlighted that most injuries occurred at home (33.4%) and in transport area (25.3%). Most head injuries were registered among men 121 (81.2%) with a predominance of minor Glasgow Coma Scale (GCS) (65.1%), followed by moderate GCS (9.4%), while in women all cases with GCS minor (18.8%). Conclusion: The data obtained could be useful for the hospital administration in managing the necessary resources and for conducting information campaigns among the high-risk groups

Capacity building for injury prevention and control: achievements and future directions

Introduction. The global injury burden is disproportionately concentrated in low- and middle-income countries. The ICREATE: Increasing Injury Capacity for Research in EAsTern Europe project, expands on five successful years of building injury research and education capacity in the countries of Armenia, Georgia, and Moldova. iCREATE focuses on building capacity for research, aiming to train a critical mass of researchers from Armenia, Georgia, and Moldova Material and methods. iCREATE trainees conduct innovative research and develop evidence-based and best-practice guidelines for the prevention and treatment of injuries. The first funding cycle of the project was from 2016 to 2021 (iCREATE1) and was funded by the United States National Institutes of Health, and coordinated by the University of Iowa, USA, and Babes-Bolyai University, Romania (NIH/2D43TW007261). The second funding cycle of the project (iCREATE2) has been secured until 2026. Results. The promotion of research capacity in injury prevention and control has been accomplished through the establishment of new curriculum across three partner institutions, conducting collaborative projects across multiple countries, and providing advanced MPH and PhD students and young professionals with opportunities for mentored experiential learning projects. During the initial funding cycle (iCREATE1), the project focused on acute care, road traffic safety, and violence against women and children, while in the second cycle of funding the grant expanded to include alcohol use and integrated a focus on implementation science. An 8-hospital emergency department trauma registry has been established, collecting 13,082 patient records, out of which 12,992 are included in a final database, thus expanding the data capacity of all partners. These registries have been utilized for student projects and trainee publications and presentations. In total, 40 MPH students and 9 PhD students received training, 43 experiential learning projects were mentored, and 13 peer-reviewed papers were published between 2016 and 2021, as a result of the aforementioned activities. Each consortium partner has hosted capacity-building activities such as injury prevention summer schools (n=3), annual injury-focused symposia (n=5), and skillbuilding workshops with over 600 participants attending. The work continued during the no-cost extension phase in 2022 as well, showing partner's continued engagement and dedication. Conclusions. iCREATE is a successful program in building capacity and promoting injury prevention and control. The activities have led to the creation of a critical mass of injury researchers, the advancement of professional careers and leadership roles for partners, and the establishment of a long-term regional network for collaborative injury and violence prevention activities. The achievements indicate a promising future for injury research and prevention, with the potential for sustained progress and impact in the field

A registry-based pilot study of traumatic brain injury in two middle-income countries

INTRODUCTION TBI is a major cause of death and disability worldwide. Each year, in Europe, around 2.5 million people suffer a TBI, and 1 million require appropriate medical care. Injury prevention for the Republic of Moldova and Georgia, two middle-income countries, is one of the priority areas for public health surveillance; however, there are few data reported concerning TBI. OBJECTIVES This study aimed to identify the frequency and characteristics of TBI among patients treated in the largest trauma hospitals in both capital cities, Chisinau and Tbilisi. METHODS A prospective study was conducted among TBI patients within 4 large hospitals (2 in each country) offering care for injured patients. Data were collected between March 1 – August 31, 2019, using a TBI Registry modeled after WHO and US trauma system registries. The Registry contained information from existing patient medical records and additional information from medical providers that is not routinely included in medical documentation. Red- Cap was used for electronic data collection and SPSS software for data analysis. Ethics Committee approval was obtained from all institutions. RESULTS In total, 910 TBI patients were hospitalized: 542 cases in Georgia and 368 in the Republic of Moldova. Patients’ ages ranged from 1 month to 94 years; the average age was 32.1 for MD and 17.7 for GE. In both countries, prevail males (69.3% MD, 63% GE). The ambulance was the principal source of hospital arrival (97% MD, 60% GE), mostly patients arrived with stable vital signs. Most of TBI cases (90%) in both countries happened in urban areas, and within home environment (32% GE, 28% MD). Most of TBI hospitalizations (95% GE, 88.9% MD) were unintentional injuries, and 9.8% MD and 2% GE - work-related injuries. The main causes of TBI were falls (58% GE, 53.5% MD) mainly among males. Follows, road traffic crashes in MD (30.7%) mainly in transport areas and struck by or against an object in GE (22%) with most cases in 15–24 age group. Almost half of the injured in road traffic were passengers in a vehicle (45% GE, 36.3% MD), pedestrians (43.4% MD, 30% GE), cyclists (15% GE, 11.5%MD), and motorcyclists (11% GE, 7.1% MD). CONCLUSION This study offers valuable TBI information in both countries to develop appropriate preventive measures. Results provide argumentations of an injury registry for comparable data among countries and highlight areas of research