Augmented Reality Farm MAPPER Development: Lessons Learned from an App Designed to Improve Rural Emergency Response

Fire departments have right-of-entry to most commercial industrial sites and preemptively map them to identify the onsite resources and hazards they need to promptly and safely respond to an emergency event. This is not the case for private farms. Emergency responders are blind to resources and hazards prior to arrival and must spend critical minutes locating them during an emergency response at a farm location. The original 2013 Farm Mapping to Assist, Protect and Prepare Emergency Responders (Farm MAPPER) project was undertaken to develop a method to give emergency responders an up-to-date view of on-farm hazard information to safely and efficiently conduct emergency response activities on private agricultural operations. In 2017, an augmented reality version of Farm MAPPER was developed to combine the technological advantages of geographic information system-based data points with a heads-up display and graphical overlay of superimposed hazard imagery and informative icons. The development and testing of this iOS- and Android-ready prototype uncovered lessons learned applicable to other mobilebased apps targeting farmers, ranchers, and rural populations faced with limited or inconsistent mobile internet connectivity

Recruiting farm parents for a 6-week online child safety survey study using paid Facebook advertisements

Agricultural populations are a popular target for research due to the industry's dangerous conditions, unique work environments, and youth-including workforce. However, reaching and recruiting eligible participants is challenging and expensive when compared to other industries. We conducted a two-phase, multi-week paid advertising campaign on Facebook.com, varying delivery time, imagery, verbiage, and targeting methods to recruit U.S. farm parents for an online survey study investigating childhood agricultural safety. Advertisements were active for 4 weeks in fall 2021 and 3 weeks in winter 2022 at $1,500 per week. The fall recruitment targeted farm parents, depicting three farm-related images, while the winter recruitment targeted all parents, depicting farm-rescue trainings with firefighters. The fall recruitment garnered 5,535 link clicks with a reach of 233,690 ($1.07 per click). The winter recruitment garnered 8,602 clicks with a reach of 750,764 ($0.53 per click) and higher user engagement. A total of 1,439 participants began the screener questionnaire, a conversion rate of 10.18$64 USD. We successfully recruited our target sample size for this study. Notably, advertisement timing, imagery, and sampling frame likely affected performance. A screening questionnaire was imperative in identifying sham responses. These findings show that paid Facebook advertising can be a feasible recruitment tool to engage with a traditionally difficult to reach population with proper precautions and planning

Needs assessment survey for enhancing United States child agricultural injury prevention capacity: Brief report

The dissemination of childhood agricultural safety and health information and resources through organizations that farmers trust enhances implementation and the Socio-Ecological Model can help identify these organizations. However, to become effective partners in improving agricultural health and safety, organizations need to build capacity in child agricultural safety and health, thus, more information is needed about these organizations’ current practices, needs, and capacity for leadership, policy makers, and knowledge mobilization. An online survey was administered to organization leaders with an interest in child agricultural injury prevention, chosen through agricultural health and safety organization membership lists. Invitations to participate in the online survey were mailed to 95 organization leaders with three weekly reminders, resulting in participation from 50 organization leaders (53% response rate). Respondents indicated a high level of awareness of child agricultural injuries, yet few were actively engaged in injury prevention. When asked about “needs” for building capacity in injury prevention, over half (56%) identified a need for more promotion and dissemination of safety resources and strategies, including ATV safety, no extra riders on equipment, and keeping young children out of the worksite. The only topic that more than half of the organizations (54%) identified as “needing more information” was childhood agricultural injury surveillance. This assessment yielded valuable details for identifying opportunities, priorities, and topics for future collaborations and capacity building. Findings help inform national and international planning committees’ work, such as the next iteration of a US National Action Plan for Childhood Agricultural Injury Prevention, scheduled for release in 2024

Editorial: Safeguarding youth from agricultural injury and illness: international experiences

[Extract] Worldwide, agriculture is among the most dangerous industries and one of the few that involves children (<18 years-of-age) in the worksite as laborers or bystanders. Children are exposed to an array of agriculture-related hazards whether working or merely being present in the farm environment. From a public health and child advocacy perspective, safeguarding these young people from preventable disease and injury is important for many reasons. The negative impacts of a childhood agricultural disease or injury range from permanent disabilities, death, family disruptions, and economic hardships including the potential loss of a sustainable family farm enterprise. At the same time, growing up in an agricultural setting can lead to independent, hardworking, successful adults, who gain a range of benefits, including skill development, family time together, improved immune response, and other protective health factors

What about the Rest of Them? Fatal Injuries Related to Production Agriculture Not Captured by the Bureau of Labor Statistics (BLS) Census of Fatal Occupational Injuries (CFOI)

Surveillance of injuries in production agriculture is necessary to inform stakeholders about workplace hazards and risks in order to improve and advance injury prevention policies and practices for this dangerous industry. The most comprehensive fatal injury surveillance effort currently in the United States is the Bureau of Labor Statistics (BLS) Census of Fatal Occupational Injuries (CFOI), which covers occupational fatalities in all U.S. industries, including production agriculture. However, this surveillance does not include many categories of fatalities that occur during agricultural work or on production agriculture worksites. To better capture the human cost of production agriculture, the authors of this paper call for the collection of additional data with a broader scope that supplements, not replaces, the current CFOI. This paper describes challenges in surveillance, highlights key procedural gaps, and offers recommendations for advancing national surveillance of fatal traumatic injuries associated with production agriculture

Regional surveillance of medically-attended farm-related injuries in children and adolescents

PurposeDue to numerous environmental hazards such as heavy machinery and large livestock, youth who live and work on farms are at high risk of injury, disability, and death. This study described a regional surveillance system for monitoring farm-related injuries in children and adolescents. As the risk of farm-related injuries are not exclusive to farm residents, trends in farm-related injuries over the previous 5 years were reported and compared between children/adolescents who did and did not live on farms in north-central Wisconsin.MethodsA retrospective cohort of child and adolescent patients of the Marshfield Clinic Health System was assembled. Incident farm-related injuries, including from agricultural work or other activities in a farm environment, were extracted from medical records from 2017 through 2021. Generalized linear models were created to compare age- and sex-adjusted farm-related injury rates by year.ResultsThere were 4,730 (5%) in-farm and 93,420 (95%) out-farm children and adolescents in the cohort. There were 65 incident farm-related injury cases in the in-farm group and 412 in the out-farm group. The annual incidence rate of farm-related injuries was higher in the in-farm group, but changes during the 5-year timeframe were not significant in either group. In the in-farm group, rates ranged from a high of 61.8 [95% confidence interval (CI): 38.3, 94.5] incident farm-related injuries per 10,000 children/adolescents in 2017 to a low of 28.2 (13.5, 51.9) injuries per 10,000 children/adolescents in 2018. In the out-farm group, rates ranged from 10.7 (8.3, 13.6) to 16.8 (13.7, 20.5) incident farm-related injuries per 10,000 children/adolescents per year between 2017 and 2021. The in-farm group had a higher proportion of injured males and heavy machinery injuries, while the out-farm group had more all-terrain vehicle injuries and pesticide poisonings.ConclusionFarm residency remains hazardous for children and adolescents, as injury rates were three times higher in the in-farm group and remained stable over 5 years. All-terrain vehicle injuries were high in both groups, and should be a priority in rural safety interventions. With additional adaptations to other states, this surveillance model could be scaled across other healthcare systems

Health in your hand: Assessment of clinicians' readiness to adopt mHealth into rural patient care

Introduction: Technology is as much rural as it is urban, but mobile health (mHealth) could have a unique impact on health and quality of life for rural populations. The adoption of mobile technologies has soared in recent decades leading to new possibilities for mHealth use. This project considers the impact of these technologies on rural populations. Specifically, it is focused on assessing the barriers of physicians and healthcare organizations to adopt mHealth into their care plans. Gaps in knowledge exist in assessing organizational readiness for mHealth adoption, the use of patient-reported data, and the impact on rural healthcare. This project seeks to address those gaps. Methods: Utilizing semi-structured, open-ended interviews as the primary instrument of inquiry, clinicians’ current practices, motivators, and barriers to the use of mHealth technologies were identified. Thematic analysis revealed code-category linkages that identify the complex nature of a rural healthcare organization’s current climate from a physician perspective. A thematic map was developed to visualize the flow from category to code. Those linkages were then utilized to construct a refined mHealth readiness model. Results: Thirteen Wisconsin-based clinicians from the Marshfield Clinic Health System participated in interviews and consults. The interviews uncovered current practices, with 53.8% of participants reporting that they do encourage the use of mHealth apps or wearable devices with patients. Perceived barriers to adoption were categorized into three primary pillars – personal (clinician), patient, and organizational. Organizational was the most prominent category, with codes such as time, uniformity, and policy/direction. Conclusion: Clinicians, particularly physicians have tight schedules with very limited time for continuing education, research, or exploration into new technologies. Limited clinician time can lead to a lack of familiarity with new and emerging technologies. Clinicians are interested and motivated to learn more, but also need assistance with screening and quality reviews. Organizationally-led directives and suggestions, such as a menu of technologies, would be used. There are some risks that would need to be mitigated, but if organizations were prepared to manage mHealth it is very likely that physicians could improve the quality of care for their patients. However, many organizations including Marshfield Clinic are not yet prepared to prescribe or prohibit the use of mHealth technologies. Healthcare institutions should consider investing in mHealth analysis, tool development, and the promotion/recommendation of sanctioned tools for clinicians to use with patients

Infant identical triplets’ presentation of human parechovirus Type 3

Introduction: Human parechovirus (HPeV) infections appear common across age groups, and transmission is likely fecal-oral and through respiratory secretions. Cyclical and seasonal patterns have been described; however, HPeV has likely been previously underdiagnosed due to lack of commercially available diagnostic testing. Presentation of Case: We present identical triplets contracting HPeV Type 3. Discussion: The clinical presentation, similar to echoviruses, is broad and includes asymptomatic shedding, severe pulmonary and neurologic disease, and disseminated intravascular coagulation. Neonates and young infants are particularly susceptible. In neonates, distinctive MRI brain findings have been described that, when combined with clinical presentation, suggest HPeV. Infection clusters have been described, and neonates with older siblings may be a risk factor. Conclusion: This case suggests that HPeV has been under-recognized in the United States, and HPeV Type 3 prevalence is likely underestimated. The case highlights variation in presentation, including lack of fever and rash, which were previously documented as common HPeV symptoms. Keywords: Parechovirus, HPeV, HPeV Type 3, Infant mortalit

Injuries and Fatalities Related to Skid Steers: 2015&ndash;2020

Skid steers are versatile self-propelled machines that are regularly used in a variety of recreational applications and occupational industries. They can be hazardous for both operators and bystanders. The purpose of this paper is to describe patterns of skid steer injuries in the US from 2015 to 2020. Data were obtained from Occupational Safety and Health Administration (OSHA) accident reports and the severe injury database. Agriculture-related incidents were obtained from AgInjuryNews. The study identified 312 skid steer-related injuries (2015&ndash;2020) in OSHA, with an additional 68 agricultural injuries identified using AIN. Construction, administrative and waste management, and agriculture industries were the top three industries with the highest number of injuries. Bystander workers experienced a higher number of injuries than operators. Contact with the machine was the most prevalent and more fatal than the other injury events. Agricultural skid steer injuries involved a broad age range of victims, from very young children to adults. These findings emphasize the need for improved safety engineering and clear safety guidelines for skid steer operators and those who are around skid steers. With the increased prevalence of skid steers across industries, it is imperative to have cohesive and comprehensive safety regulations, guidelines, and policy enforcement