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Unintentional injuries are the leading cause of death and a major cause of morbidity among school age children. A survey of the educational needs concerning injury prevention of a group of fifth and sixth grade children (ages 10-12) in Holliston, MA, revealed educational deficiencies, including bicycle safety, seatbelt use, firearms use, and water safety. It is well known that the use of helmets can prevent bicycle injuries. Yet, not one of the children in this study reported using a bicycle helmet. Although most States have laws requiring seatbelts for young children, school age children are not covered by this legislation. The hazards of firearms have been well-documented. But it is clear that the children surveyed were in need of education about firearms; nearly half had used some form of firearms. Individual counseling by pediatricians combined with school- and community-based programs can address injury prevention. It is anticipated that many pediatricians will begin using the questionnaire for school age children as that component of the American Academy of Pediatrics Injury Prevention Program is introduced.

Every year an estimated 42 million people worldwide suffer a mild traumatic brain injury (MTBI) or concussion. More severe traumatic brain injury (TBI) is a well-established risk factor for a variety of neurodegenerative diseases including Alzheimer's disease, Parkinson's disease, and amyotrophic lateral sclerosis (ALS). Recently, large epidemiological studies have additionally identified MTBI as a risk factor for dementia. The role of MTBI in risk of PD or ALS is less well established. Repetitive MTBI and repetitive sub-concussive head trauma has been linked to increased risk for a variety of neurodegenerative diseases including chronic traumatic encephalopathy (CTE). CTE is a unique neurodegenerative tauopathy first described in boxers but more recently described in a variety of contact sport athletes, military veterans, and civilians exposed to repetitive MTBI. Studies of repetitive MTBI and CTE have been limited by referral bias, lack of consensus clinical criteria for CTE, challenges of quantifying MTBI exposure, and potential for confounding. The prevalence of CTE is unknown and the amount of MTBI or sub-concussive trauma exposure necessary to produce CTE is unclear. This review will summarize the current literature regarding the epidemiology of MTBI, post-TBI dementia and Parkinson's disease, and CTE while highlighting methodological challenges and critical future directions of research in this field.

Loss of control over voiding following spinal cord injury (SCI) impacts autonomy, participation and dignity, and can cause life-threatening complications. The importance of SCI bowel and bladder dysfunction warrants significantly more attention from researchers in the field. To address this gap, key SCI clinicians, researchers, government and private funding organizations met to share knowledge and examine emerging approaches. This report reviews recommendations from this effort to identify and prioritize near-term treatment, investigational and translational approaches to addressing the pressing needs of people with SCI.

Traumatic brain injury (TBI) is unexpected and affects nearly 1.5 million Americans annually. Many with seemingly minor injuries incur long-lasting symptoms without clear explanation. This study examined the symptom experience and emotional response of persons with mild-to-moderate TBI and was guided by the University of California San Francisco (UCSF) symptom management model. Using a cross-sectional design with persons recruited from outpatient rehabilitation settings, we found a positive and significant relationship between postinjury symptom frequency and tension/anxiety, anger/hostility and perceived chronic stress, implying a need to understand these relationships over time in order to implement symptom management strategies.

Traumatic brain injury is a leading cause of death and disability in military and civilian populations. Blast traumatic brain injury results from the detonation of explosive devices, however, the mechanisms that underlie the brain damage resulting from blast overpressure exposure are not entirely understood and are believed to be unique to this type of brain injury. Preclinical models are crucial tools that contribute to better understand blast-induced brain injury. A novel in vitro blast TBI model was developed using an open-ended shock tube to simulate real-life open-field blast waves modelled by the Friedlander waveform. C57BL/6N mouse organotypic hippocampal slice cultures were exposed to single shock waves and the development of injury was characterized up to 72 h using propidium iodide, a well-established fluorescent marker of cell damage that only penetrates cells with compromised cellular membranes. Propidium iodide fluorescence was significantly higher in the slices exposed to a blast wave when compared with sham slices throughout the duration of the protocol. The brain tissue injury is very reproducible and proportional to the peak overpressure of the shock wave applied.

High-quality data are the foundation to monitor the progress and evaluate the effects of road traffic injury prevention measures. Unfortunately, official road traffic injury statistics delivered by governments worldwide, are often believed somewhat unreliable and invalid. We summarized the reported problems concerning the road traffic injury statistics through systematically searching and reviewing the literature. The problems include absence of regular data, under-reporting, low specificity, distorted cause spectrum of road traffic injury, inconsistency, inaccessibility, and delay of data release. We also explored the mechanisms behind the problematic data and proposed the solutions to the addressed challenges for road traffic statistics.

This presentation will focus on history and economic theory perspectives, using benchmark comparisons across Australian jurisdictions and leveraging materials in the public domain. The aim is to assist practitioners refine and manage their NIIS schemes for long term viability and customer/participant outcomes. The presentation will look at the Genesis of National Injury Insurance Schemes in Australia – a brief history of thinking that has shaped NIIS design, scheme Design model and rationale for a NIIS including Rationale for separating the NIIS and NDIS, What the "I" in NDIS really means, the Benchmark comparison of NDIS versus NIIS design feature and the staged approach to migrate to universal accident compensation. Moving on to exploring. NIIS Implementation Update - Motor Accident Compensation including a benchmark comparison - design models in 5 Australian CTP Jurisdiction. And finally a look at Insurance Claims Management vs Disability Management before speaking about the Next steps for NIIS and integration or possible alignment opportunities with the NDIS.

Traumatic brain injury (TBI) is a common source of morbidity and mortality among civilians and military personnel. Initial routine neuroimaging plays an essential role in rapidly assessing intracranial injury that may require intervention. However, in the context of TBI, limitations of routine neuroimaging include poor visualization of more subtle changes of brain parenchymal after injury, poor prognostic ability and inability to analyze cerebral perfusion, metabolite and mechanical properties. With the development of modern neuroimaging techniques, advanced neuroimaging techniques have greatly boosted the studies in the diagnosis, prognostication, and eventually impacting treatment of TBI. Advances in neuroimaging techniques have shown potential, including (1) Ultrasound (US) based techniques (contrast-enhanced US, intravascular US, and US elastography), (2) Magnetic resonance imaging (MRI) based techniques (diffusion tensor imaging, magnetic resonance spectroscopy, perfusion weighted imaging, magnetic resonance elastography and functional MRI), and (3) molecular imaging based techniques (positron emission tomography and single photon emission computed tomography). Therefore, in this review, we aim to summarize the role of these advanced neuroimaging techniques in the evaluation and management of TBI. This review is the first to combine the role of the US, MRI and molecular imaging based techniques in TBI. Advanced neuroimaging techniques have great potential; still, there is much to improve. With more clinical validation and larger studies, these techniques will be likely applied for routine clinical use from the initial research.

AbstractTraumatic brain injury (TBI) is highly prevalent, with many survivors experiencing long‐term disability as a consequence of cognitive impairments, adverse personality changes, and emotional and communication difficulties. Because family members most often assume the long‐term role of caregiver, their feelings, relationships, and life plans are often negatively affected. Boss has defined a type of ambiguous loss in which the person is physically present but psychologically absent, which is the case for many families after brain injury. Over the past 2 decades we have developed interventions incorporating ambiguous loss theory to enhance resilience and improve psychological outcomes in families after TBI. This article provides a brief overview of TBI, discusses ambiguous loss in families after TBI, and describes the therapeutic goals and framework of empirically supported family interventions using the lens of ambiguous loss theory.

Unintentional injury and trauma rates are disproportionately high in Inuit regions, and environmental changes are predicted to exacerbate injury rates. However, there is a major gap in our understanding of the risk factors contributing to land-based injury and trauma in the Arctic. We investigated the role of environmental and other factors in search and rescue (SAR) incidents in a remote Inuit community in northern Canada using a collaborative mixed methods approach. We analyzed SAR records from 1995 to 2010 and conducted key consultant interviews in 2010 and 2011. Data showed an estimated annual SAR incidence rate of 19 individuals per 1,000. Weather and ice conditions were the most frequent contributing factor for cases. In contrast with other studies, intoxication was the least common factor associated with SAR incidents. The incidence rate was six times higher for males than females, while land-users aged 26–35 had the highest incidence rate among age groups. Thirty-four percent of individuals sustained physical health impacts. Results demonstrate that environmental conditions are critical factors contributing to physical health risk in Inuit communities, particularly related to travel on sea ice during winter. Age and gender are important risk factors. This knowledge is vital for informing management of land-based physical health risk given rapidly changing environmental conditions in the Arctic.

Walking is an indispensable travel mode in the transport system; almost all road users are pedestrians for all or part of their trip. It is also among the most environmentally sustainable transport modes and its promotion has been rigorously advocated since the rise of concern about global warming and environmental degeneration. Moreover, as a form of physical activity, walking has considerable benefit for public and individual health. Notwithstanding the positive aspects of walking, there are a number of barriers preventing people from walking as a mode of travel, with the lack of safety chief amongst these. The focus of this thesis, therefore, was to address the pedestrian safety problem by identifying factors associated with pedestrian crash occurrence and with the severity of injuries sustained. The Central Business District (CBD) of Melbourne was selected as the case study for this research. This site has a high level of pedestrian activities and high pedestrian crash rate. The PhD research aims to address the following questions: 1. What is an appropriate design for a pedestrian road safety data system to collect the data necessary for pedestrian safety analysis in the Melbourne CBD? 2. Using the tools developed in 1, what are the risk factors for pedestrian crashes in the Melbourne CBD: a) What are the characteristics of the physical and socioeconomic environment and the transport system that influence the occurrence of pedestrian crashes? b) What are the characteristics of the physical and socioeconomic environment, the transport system, road users (drivers/pedestrians) and traffic that influence the severity of injury sustained by pedestrians in traffic crashes? A principal contribution of this research was the development of a conceptual framework for studying pedestrian safety. A review of the available pedestrian data systems revealed that data collection practices are non-systematic and irregular, and the existing data, particularly pedestrian exposure to risk, is not sufficient for pedestrian safety analyses. Thus, a methodology was developed to estimate pedestrian exposure at CBD intersections and midblocks using existing data sources and a set of complimentary data collections. Pedestrian crash risk at CBD intersections and midblocks were evaluated, separately: during daytime hours, or alternatively called working hours, (7-18), and hours of darkness, or alternatively called non-working hours, (0-6 and 19-23). Findings showed that pedestrian crash risk is multi-factorial in nature. Different sets of factors were found to be associated with risk across different space-time frameworks. For intersections, the three most powerful predictors of pedestrian collision rate during daytime hours were the characteristics of land-use, road and public transport, respectively. Similarly, during hours of darkness, the rate was highly correlated with the characteristics of land-use and road. For midblocks, the most powerful predictor of the frequency of pedestrian crashes during daytime hours was public transport, followed by land-use and road characteristics, respectively. In contrast, midblock pedestrian collision rates during hours of darkness were mainly predicted by the length of the midblock, followed by land-use and public transport characteristics, respectively. Another key finding of the pedestrian crash risk analyses was that different measures of pedestrian exposure influence pedestrian crashes at intersections compared with midblocks. While traffic volume (Annual Average Daily Traffic (AADT)) played a significant role in developing pedestrian crash risk models at intersections, the product of "pedestrian road crossing counts" and AADT (P×AADT) was the influential pedestrian exposure measure in the midblocks daytime-hours risk model. Results of the pedestrian injury severity analyses also revealed a diverse set of factors associated with pedestrian injury severity for different space-time frameworks. The correlates of major pedestrian trauma at intersections were time of day, vehicle movement, pedestrian age, vehicle colour, and land-use and public transport characteristics. For midblocks, influential factors were time of day, the characteristics of land-use, and the interaction of day of week and speed zone. The injury severity data reported by the police for pedestrian crashes in the Melbourne CBD (2000-2009) was found to be not consistent with hospital data. Thus, using the police data can lead to misleading conclusions about pedestrian injury risk factors. Findings of this research provide evidence-based insight into the pedestrian safety problem in the Melbourne CBD and have implications for other concentrated urban areas. This knowledge can be applied by road safety researchers and practitioners to modify existing design practices to achieve a safer pedestrian environment and to facilitate the Victorian Government's strategic plan for a Safe System for all road users. In addition, six new Central Activity Districts and 26 principal activity centres are projected to be designed and implemented by 2030 in Melbourne. The outcomes of this research provide critical, new information to enhance the pedestrian safety design guidelines for these new developments.

Both the common law and the law of civilian jurisdictions recognize an unborn child as in esse for purposes of receiving certain civil rights. In most of the cases involving prenatal injuries, it has been advocated that the tort law, by analogy to criminal law and property law, should recognize an unborn child as a person in being. The courts formerly rejected this argument, saying that in order to protect social and property interests a "fiction" has arisen that an unborn child is in being but that this "fiction" should not be invoked to protect personal security. The recent cases have found the protection of an unborn child's personal security to be equally important as the protection of social and property interests, but have impliedly limited the protection to the personal interests of a viable child. The object and purpose of this article is to analyze and review development of tort liability for injury to the unborn - from the first precedential case till the newest era of liability for prenatal injuries, especially in those conditions, when Georgian Civil Legislation does not recognize this type of Tort Liability.

Road traffic accidents are currently between the seventh and tenth leading cause of death in the world, with approximately 1.35 million people killed per year. Despite extensive efforts by governments, according to the World Health Organization, road accidents still cause far too many deaths, especially among pedestrians, cyclists and two-wheel motor vehicle riders, who together account for almost 50% of road traffic fatalities. In particular, Spain had 410,974 traffic accidents between 2016 and 2019, involving 722,516 vehicles and 61,177 pedestrians with varying degrees of injury. This study uses the Bayesian network method to understand how the pedestrians' responsibility and actions at the time of the traffic accident affect the injury suffered by said pedestrian, also considering the variables of the road infrastructure and vehicles at the accident site. The results confirm that the variables linked to the unsafe behavior of pedestrians, and their responsibility in traffic accidents, increase the risk of suffering serious or fatal injuries during an accident; for example, if a pedestrian is distracted this increases his/her probability of suffering a severe injury (27.86%) with respect to not being distracted (20.73%). Conditions related to traffic in high-speed areas, areas with no or poor lighting, and areas lacking sidewalks, also record increases in pedestrian injury, as is the case in the age group of pedestrians over 60 years of age.