Category: Statistics

J Safety Res. 2024 Jun;89:41-55. doi: 10.1016/j.jsr.2024.02.005. Epub 2024 Feb 23.

ABSTRACT

INTRODUCTION: Development and implementation of autonomous vehicle (AV) related regulations are necessary to ensure safe AV deployment and wide acceptance among all roadway users. Assessment of vulnerable roadway users’ perceptions on AV regulations could inform policymakers the development of appropriate AV regulations that facilitate the safety of diverse users in a multimodal transportation system.

METHOD: This research evaluated pedestrians’ and bicyclists’ perceptions on six AV regulations (i.e., capping AV speed limit, operating AV in manual mode in the sensitive areas, having both pilot and co-pilot while operating AVs, and three data-sharing regulations). In addition, pedestrians’ and bicyclists’ perceptions of testing AVs in public streets were evaluated. Statistical testing and modeling techniques were applied to accomplish the research objectives.

RESULTS: Compared to the other AV regulations assessed in this research, strong support for AV-related data sharing regulations was identified. Older respondents showed higher approval of AV testing on public roadways and less support for regulating AVs. AV technology familiarity and safe road sharing perceptions with AVs resulted in lower support for AV regulations.

CONCLUSIONS: Policymakers and AV technology developers could develop effective educational tools/resources to inform pedestrians and bicyclists about AV technology reliability and soften their stance, especially on AV regulations, which could delay technology development.

PRACTICAL APPLICATIONS: The findings of this research could be used to develop informed AV regulations and develop policies that could improve pedestrians’ and bicyclists’ attitudes/perceptions on regulating AVs and promoting AV technology deployments.

PMID:38858062 | DOI:10.1016/j.jsr.2024.02.005

J Safety Res. 2024 Jun;89:361-368. doi: 10.1016/j.jsr.2024.03.002. Epub 2024 Apr 14.

ABSTRACT

BACKGROUND: In 2022, suicide ranked as the 11th leading cause of death in the United States with 49,513 deaths. Provisional mortality data from 2022 indicate a 2.8% increase in the number of suicides compared to 2021. This paper examines overall suicide trends, sodium nitrite ingestion as an emerging suicide method, and the role that online forums play in sharing information about suicide methods (including sodium nitrite ingestion).

METHODS: Suicides were identified from CDC’s National Vital Statistics System (2018-July 2023 provisional) multiple cause-of-death mortality files using International Classification of Diseases (ICD), Tenth Revision underlying cause-of-death codes U03, X60-X84, and Y87.0 and T code T50.6 (antidotes and chelating agents). Google search popularity metrics were captured from January 2019 to January 2023. Case reports of sodium nitrite related suicide and suicide attempts (through February 2024) were identified in the medical and forensic literature.

RESULTS: At least 768 suicides involving antidotes and chelating agents (including sodium nitrite) occurred between 2018 and July 2023, set in the context of 268,972 total suicides during that period. Overall, suicides involving antidotes and chelating agents (including sodium nitrite) represent <1% of all suicides, however, numbers are rising.

CONCLUSIONS: Suicide methods are known to change over time. These changes can be influenced by, among other factors, online forums and means accessibility, such as internet purchase availability. CDC remains committed to prevention through comprehensive public health strategies that protect individuals, families, and communities.

PRACTICAL APPLICATIONS: States and community partners might consider leveraging physicians, emergency responders, and other appropriate crisis response groups to disseminate information on sodium nitrite self-poisoning and its antidote, methylene blue. Efforts should be part of a comprehensive public health approach to suicide prevention.

PMID:38858061 | DOI:10.1016/j.jsr.2024.03.002

J Safety Res. 2024 Jun;89:312-321. doi: 10.1016/j.jsr.2024.01.001. Epub 2024 Jan 25.

ABSTRACT

INTRODUCTION: Nurses have a high prevalence of low back pain due to ergonomic hazards in healthcare workplaces. While exercise programs have been suggested as an intervention strategy, the effectiveness of low back pain programs has been inconsistent in the research literature. The purpose of study is to determine the effect of exercise programs to reduce low back pain among nursing staff.

METHODS: A systematic review and meta-analysis was conducted with five databases and systematically searched. Following the PRISMA guidelines, included studies evaluated low back pain relief among nurses or nursing assistants and described the exercise program. Two reviewers independently appraised, extracted, and synthesized all available studies. The study protocol was registered in PROSPERO (CRD42022359511).

RESULTS: A total of 296 articles with 1,355 nursing staff from nine countries were obtained. Nine randomized controlled trials with a moderate to low risk of bias quality were included. Exercise programs had a small but significant effect on low back pain of nursing staff (SMD = -0.48; 95% CI = -0.76 to -0.19; p = 0.03, I² = 62%, p = 0.001). A subgroup analysis of nurses and nursing assistants showed moderate and small effects, respectively (I² = 0% p < 0.0001, SMD -0.73 CI 95% [-0.97 to -0.48], p = 0.76, and I² = 0% p = 0.002, SMD -0.23 CI 95% [-0.38 to -0.08], p < 0.88). Exercise for back and trunk exhibited a moderate effect on low back pain (SMD -0.56 CI 95% [-0.86 to -0.25], p = 0.01, I² = 66%, p < 0.0004). A subgroup analysis comparing age, under 40 years old revealed a moderate effect size (SMD = -0.59; 95% CI = -0.83to -0.35; p = 0.06; I² = 64%, p < 0.0001).

CONCLUSIONS: Exercise programs are an effective treatment to reduce low back pain in nurses and nursing assistants, especially among younger staff.

PRACTICAL APPLICATION: Back and trunk exercise programs should be recommended for nursing staff with low back pain.

PMID:38858055 | DOI:10.1016/j.jsr.2024.01.001

J Safety Res. 2024 Jun;89:306-311. doi: 10.1016/j.jsr.2024.02.001. Epub 2024 Mar 5.

ABSTRACT

INTRODUCTION: Young workers in the United States are injured at higher rates than adults, a trend that has persisted for more than two decades. Despite known risks, young people enter the workforce with little-or-no preparation for the hazards they may face. In 2016, the National Institute for Occupational Safety and Health and American Industrial Hygiene Association developed Safety Matters, a one-hour educational module to raise awareness of workplace safety and health among young people.

METHOD: A pilot project was conducted to evaluate the effectiveness of Safety Matters to positively change workplace safety and health knowledge and attitude scores among a sample of 283 youth in Colorado. Train-the-trainer sessions prepared volunteer safety and health professionals to deliver Safety Matters with fidelity and to conduct the assessment immediately prior to and following the program.

RESULTS: After receiving Safety Matters, participants had statistically significant (p < 0.001) increased scores for both workplace safety and health knowledge (Cohen’s d = 1.12; large effect size) and importance (attitude) (Cohen’s d = 0.51; medium effect size). Although univariate analyses showed knowledge and attitude scores significantly increased for all demographic groups examined, there were statistically significant differences in knowledge scores by participant age (p < 0.01), ethnicity (p < 0.05), and race (p < 0.001) and statistically significant differences in attitude scores by participant race (p < 0.001). However, when race and ethnicity were both used as predictors in a regression model, only race continued to predict statistically significant (p < 0.01) changes in knowledge and attitude.

CONCLUSIONS: This project introduces a promising, community-based model for a one-hour introduction to workplace safety and health on which future, job-specific safety training can be built.

PRACTICAL APPLICATIONS: Safety and health professionals can play a critical role in promoting the health and safety of young workers. Adapting health and safety programs to diverse youth populations may enhance program relevance and receptivity.

PMID:38858054 | DOI:10.1016/j.jsr.2024.02.001

J Safety Res. 2024 Jun;89:299-305. doi: 10.1016/j.jsr.2024.04.003. Epub 2024 May 4.

ABSTRACT

INTRODUCTION: Driver distraction from handheld cellphone use contributes to fatal crashes every year but is underreported in terms of the proportion of crashes attributed to any distraction or cellphone use specifically. Existing methods to estimate the prevalence of cellphone distractions are also limited (e.g., observing drivers stopped at intersections, when crash risk is low). Our study used data from Cambridge Mobile Telematics to estimate the prevalence of drivers’ handheld calls and cellphone manipulation while driving, with “cellphone motion” based on movement recorded by the phones’ gyroscopes used as a surrogate for manipulation.

METHOD: We compared the telematics measures with the National Highway Traffic Safety Administration’s roadside observations of driver electronic device use, and logistic regression tested relationships between regional, legislative, and temporal factors and the odds of cellphone behaviors occurring on a trip or at a given point in time.

RESULTS: Results showed 3.5% of trips included at least one handheld phone call and 33.3% included at least an instance of cellphone motion, with handheld calls occurring during 0.78% of overall trip duration and cellphone motion during 2.4% of trip duration.

CONCLUSIONS: Correspondence between trends in cellphone distractions across regional, legislative, and temporal factors suggest telematics data have considerable utility and appear to complement existing datasets.

PMID:38858053 | DOI:10.1016/j.jsr.2024.04.003

J Safety Res. 2024 Jun;89:288-298. doi: 10.1016/j.jsr.2024.04.002. Epub 2024 May 1.

ABSTRACT

INTRODUCTION: The occupational road-accident risk on public roads and the work conditions for professional driving is still an important issue in occupational health despite lower road-accident rates. This study presents the evolution over time of the work-related constraints for these employees based on the Sumer surveys carried out in 2003, 2010 and 2017.

METHOD: Data from the 2010 and 2017 surveys were restricted to match the scope of the 2003 survey in order to enable prevalence data to be compared in equivalent populations. The main variable of interest was “driving (car, truck, bus, and other vehicles) on public thoroughfares” for work (during the last week of work: yes/no). Work time characteristics, work rhythm, autonomy and scope for initiative, collective work group, standards and evaluations variables were completed by the occupational health physicians. A self-administered questionnaire was also provided to employees and contained the Job Content Questionnaire, which assesses decision latitude, social support and psychological demands, the reward scale of Siegrist questionnaire, the hostile behaviour with inspired questions for Leymann, sick leave and work accidents during the past 12 months and job satisfaction. Finally, prevention in the workplace was also completed by the occupational health physicians.

RESULTS: About 25% of employees in France were exposed to work-related driving in 2017, which was stable in comparison with 2003 and 2010. However, the population was older and there were more females, more often from the clerical staff/middle manager category and working in companies with fewer than 10 employees. Employees exposed to work-related driving were also more frequently exposed to sustained work schedules and physical constraints, but less exposed to psychosocial risks.

CONCLUSIONS: The percentage of employees exposed to occupational road accident risk, i.e., exposure to work-related driving, remained stable at about 25% in 2017 compared with previous surveys. These employees were also more frequently exposed to sustained work schedules and physical constraints, but less exposed to psychosocial risks.

PRACTICAL APPLICATIONS: Prevention campaigns on work-related road accident risk should be provided to all employees in all companies since all jobs can be concerned.

PMID:38858052 | DOI:10.1016/j.jsr.2024.04.002

Int J Epidemiol. 2024 Apr 11;53(3):dyae080. doi: 10.1093/ije/dyae080.

ABSTRACT

BACKGROUND: The Baby-Friendly Hospital Initiative (BFHI) is associated with improved breastfeeding outcomes in many high-income countries including the UK and the USA, but its effectiveness has never been evaluated in France. We investigated the impact of the BFHI on breastfeeding rates in French maternity units in 2010, 2016 and 2021 to assess if the BFHI aids to reduce inequalities in breastfeeding.

METHODS: We examined breastfeeding in maternity units (exclusive, mixed and any breastfeeding) in mothers of singleton full-term newborns using the 2010 (n = 13 075), 2016 (n = 10 919) and 2021 (n = 10 209) French National Perinatal Surveys. We used mixed-effect hierarchical multinomial regression models adjusting for neonatal, maternal, maternity unit and French administrative department characteristics, and tested certain interactions.

RESULTS: The adjusted rate of exclusive breastfeeding was higher by +5.8 (3.4-8.1) points among mothers delivering in BFHI-accredited maternity units compared with those delivering in non-accredited units. When compared with average-weight newborns, this difference was sharper for infants with low birthweight: +14.9 (10.0-19.9) points when their birthweight was 2500 g. Mixed breastfeeding was lower by -1.7 points (-3.2-0) in BFHI-accredited hospitals, with no notable difference according to the neonatal or maternal characteristics.

CONCLUSION: Mothers delivering in BFHI-accredited maternity units had higher exclusive breastfeeding rates and lower mixed breastfeeding rates than those delivering in non-accredited maternity units. The positive impact of the BFHI was stronger among low-birthweight neonates, who are less often breastfed, helping reduce the gap for this vulnerable group while favouring mothers with higher education levels.

PMID:38857529 | DOI:10.1093/ije/dyae080

JMIR Form Res. 2024 Jun 10;8:e54207. doi: 10.2196/54207.

ABSTRACT

BACKGROUND: The geographical environments within which individuals conduct their daily activities may influence health behaviors, yet little is known about individual-level geographic mobility and specific, linked behaviors in rural low- and middle-income settings.

OBJECTIVE: Nested in a 3-month ecological momentary assessment intervention pilot trial, this study aims to leverage mobile health app user GPS data to examine activity space through individual spatial mobility and locations of reported health behaviors in relation to their homes.

METHODS: Pilot trial participants were recruited from the Rakai Community Cohort Study-an ongoing population-based cohort study in rural south-central Uganda. Participants used a smartphone app that logged their GPS coordinates every 1-2 hours for approximately 90 days. They also reported specific health behaviors (alcohol use, cigarette smoking, and having condomless sex with a non-long-term partner) via the app that were both location and time stamped. In this substudy, we characterized participant mobility using 3 measures: average distance (kilometers) traveled per week, number of unique locations visited (deduplicated points within 25 m of one another), and the percentage of GPS points recorded away from home. The latter measure was calculated using home buffer regions of 100 m, 400 m, and 800 m. We also evaluated the number of unique locations visited for each specific health behavior, and whether those locations were within or outside the home buffer regions. Sociodemographic information, mobility measures, and locations of health behaviors were summarized across the sample using descriptive statistics.

RESULTS: Of the 46 participants with complete GPS data, 24 (52%) participants were men, 30 (65%) participants were younger than 35 years, and 33 (72%) participants were in the top 2 socioeconomic status quartiles. On median, participants traveled 303 (IQR 152-585) km per week. Over the study period, participants on median recorded 1292 (IQR 963-2137) GPS points-76% (IQR 58%-86%) of which were outside their 400-m home buffer regions. Of the participants reporting drinking alcohol, cigarette smoking, and engaging in condomless sex, respectively, 19 (83%), 8 (89%), and 12 (86%) reported that behavior at least once outside their 400-m home neighborhood and across a median of 3.0 (IQR 1.5-5.5), 3.0 (IQR 1.0-3.0), and 3.5 (IQR 1.0-7.0) unique locations, respectively.

CONCLUSIONS: Among residents in rural Uganda, an ecological momentary assessment app successfully captured high mobility and health-related behaviors across multiple locations. Our findings suggest that future mobile health interventions in similar settings can benefit from integrating spatial data collection using the GPS technology in mobile phones. Leveraging such individual-level GPS data can inform place-based strategies within these interventions for promoting healthy behavior change.

PMID:38857493 | DOI:10.2196/54207

Int J Adolesc Med Health. 2024 Jun 12. doi: 10.1515/ijamh-2024-0056. Online ahead of print.

ABSTRACT

OBJECTIVES: Adolescent cases suffering from obesity tend to increase in middle-income countries. This study focused on the relationship between adolescent obesity and parents body mass index (BMI) and the variables of satisfaction, diet implementation and sports promotion.

METHODS: This cross-sectional study was conducted among adolescents living in the Mediterranean region (n=522, evaluated n=488). Anthropometric measurements were taken by expert researchers and data were collected using face-to-face survey technique.

RESULTS: The average BMI of the adolescents and parents’ was found to be above normal values. In adolescents, there was a positive and very good correlation with maternal BMI (r=0.711, p<0.01), a positive and moderate correlation with paternal BMI (r=0.512, p<0.01); In girl adolescents, it was positively and very well with maternal BMI (r=0.731, p<0.01), positively and moderately with father BMI (r=0.549, p<0.01); In boy adolescents, a positive and good correlation was found with maternal BMI (r=0.698, p<0.01), and a positive and moderate correlation with paternal BMI (r=0.459, p<0.01). In the analyzes comparing those who thought obesity threatened them (group 1) and those who did not think it threatened them (group 2), there was a statistically significant difference between the groups in terms of BMI distribution, satisfaction with body weight, diet program implementation, diet recommendation by the family and sports encouragement (p<0, 05).

CONCLUSIONS: In a cross-sectional perspective paternal obesity is also significant in adolescents and the correlation with maternal obesity is relatively more effective. Also includes evidence of individual efforts and parental contribution in adolescents who see obesity as a threat.

PMID:38857484 | DOI:10.1515/ijamh-2024-0056

Neurology. 2024 Jul 9;103(1):e209541. doi: 10.1212/WNL.0000000000209541. Epub 2024 Jun 10.

ABSTRACT

BACKGROUND AND OBJECTIVES: Aicardi Goutières syndrome (AGS) is type I interferonopathy characterized by severe neurologic impairment. Although many children with AGS demonstrate motor and expressive language deficits, the magnitude of receptive language impairment is uncharacterized. We sought to characterize cognitive function in AGS-affected children using assessment tools with reduced dependence on motor abilities and compare cognitive testing outcomes with overall severity and parental assessment of adaptive behavior.

METHODS: We performed a cross-sectional study. Children were recruited as part of the Myelin Disorders Biorepository Project at the Children’s Hospital of Philadelphia. We included individuals with a confirmed diagnosis of AGS. We administered the Leiter International Performance Scale, third edition (Leiter-3), and the Vineland Adaptive Behavior Scale, third edition (VABS-3), in the context of research encounters. Motor skills were categorized by AGS Severity Scale mobility levels. Descriptive statistics and Spearman’s rank correlation were used to compare assessments. Mann-Whitney and Kruskal-Wallis tests with correction with Dunn’s multiple comparison test were used to compare test performance between mobility groups.

RESULTS: Cognitive and adaptive behavior performance was captured in 57 children. The mean age at encounters was 8.51 (SD 5.15) years. The median (IQR) Leiter-3 score was 51 (interquartile range [IQR] 60), with administration failure in 20 of 57 (35%) individuals. On the VABS-3, the Motor Domain (median 29, IQR 36.25) was more impacted than the Communication (median 50, IQR 52), Daily Living Skills (median 52, IQR 31), and Socialization (median 54, IQR 40) Domains (p < 0.0001). The AGS Scale correlated with VABS-3 (r = 0.86, p < 0.0001) and Leiter-3 (r = 0.87, p < 0.0001). There was correlation between VABS-3 Domains and Leiter-3 (r-range 0.83-0.97). Gross motor and fine motor categories, respectively, correlated with VABS-3 (H = 39.37, p < 0.0001; U = 63, p < 0.0001) and Leiter-3 (H = 40.43, p < 0.0001; U = 66, p < 0.0001). Within each gross motor and fine motor category of the AGS Scale, a subset of children scored within normal IQ range.

DISCUSSION: Parental assessment of function by the VABS-3 correlated with directly assessed performance measures. Our data underscore the potential value of VABS-3 and Leiter-3 as tools to assess psychometric function in AGS. With a deeper understanding of our patients’ abilities, we can better guide clinicians and families to provide appropriate support and personalized interventions to empower children with leukodystrophies to maximize their communication and educational potential.

PMID:38857477 | DOI:10.1212/WNL.0000000000209541