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Abstract 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.

Workplace violence in the home health industry is a growing concern, but little is known about the content of existing workplace violence prevention programs. The authors present the methods for this study that examined workplace violence prevention programs in a sample of 40 California home health and hospice agencies. Data was collected through surveys that were completed by the branch managers of participating facilities. Programs were scored in six different areas, including general workplace violence prevention components; management commitment and employee involvement; worksite analysis; hazard prevention and control; safety and health training; and recordkeeping and program evaluation. The results and discussion sections consider these six areas and the important gaps that were found in existing programs. For example, although most agencies offered workplace violence training, not every worker performing patient care was required to receive the training. Similarly, not all programs were written or reviewed and updated regularly. Few program differences were observed between agency characteristics, but nonetheless several striking gaps were found.

BACKGROUND: Use of seat belts and car seats for children are among the most effective interventions to reduce injury severity when a crash occurs. The use should be enforced in order to have an increase in wearing these restraints. Romania has the lowest rate of using seatbelts in the backseat, 16%. The purpose of the study is to describe the use of child safety restraints and compare it with existing standards of good practice. METHODS: An observational study on child safety restraint was conducted in Cluj-Napoca, Romania, between 2013 and 2014. Observational sites included 38 schools and kindergartens and three commercial areas, where drivers (n=768) and child passengers (n=892) were observed. Observations were conducted as vehicles parked or pulled to a stop and were followed by driver surveys on knowledge and attitudes towards restraint legislation and child safety behaviour as car occupants. RESULTS: The proportion of observed child motor vehicle occupants wearing some type of restraint was 67.4% (n=601). The majority of children (82.6%) were in the back seat, and 14.2% of infants were in a rear-facing child seat. The proportion of restrained children declined with age, with children 5 years old or younger being almost five times more likely to be properly restrained (OR 4.87, 95% CI 2.93 to 8.07) when compared with older children. CONCLUSIONS: Although minimum legal requirements of child motor vehicle occupant safety were in place in Romania at the time of the study, the rates of using children restraints was low compared with other middle-income and high-income countries.

Purpose. Worksite wellness, safety, and violence prevention programs have low penetration among small, independent businesses. This study examined barriers and strategies influencing small business participation in workplace violence prevention programs (WVPPs). Approach. A semistructured interview guide was used in 32 telephone interviews. Setting. The study took place at the University of North Carolina Injury Prevention Research Center. Participants. Participating were a purposive sample of 32 representatives of small business–serving organizations (e.g., business membership organizations, regulatory agencies, and economic development organizations) selected for their experience with small businesses. Intervention. This study was designed to inform improved dissemination of Crime Free Business (CFB), a WVPP for small, independent retail businesses. Methods. Thematic qualitative data analysis was used to identify key barriers and strategies for promoting programs and services to small businesses. Results. Three key factors that influence small business engagement emerged from the analysis: (1) small businesses' limited time and resources, (2) low salience of workplace violence, (3) influence of informal networks and source credibility. Identified strategies include designing low-cost and convenient programs, crafting effective messages, partnering with influential organizations and individuals, and conducting outreach through informal networks. Conclusion. Workplace violence prevention and public health practitioners may increase small business participation in programs by reducing time and resource demands, addressing small business concerns, enlisting support from influential individuals and groups, and emphasizing business benefits of participating in the program.

We conducted a secondary analysis of the National Inpatient Sample (NIS) to examine child abuse and neglect hospitalization from 1998–2016. The NIS is the largest all-payer, inpatient care database in the United States and is maintained by the Health Care Utilization Project. Participants were youth 18 years and younger with discharged diagnoses of child abuse and neglect from hospitals. The rate of child abuse or neglect hospitalizations did not vary significantly over the study period (1998–2016), which on average was 6.9 per 100,000 children annually. Males (53.0%), infants (age < 1; 47.3%), and young children (age 1–3; 24.2%) comprised most of the child maltreatment cases. Physical abuse was the most frequent type of maltreatment leading to hospitalization. Government insurance was the most common payer source, accounting for 77.3% of all child maltreatment hospitalizations and costing 1.4 billion dollars from 2001–2016. Hospitalizations due to child abuse and neglect remain steady and are costly, averaging over $116 million per year. The burden on government sources suggests a high potential for return on investment in effective child abuse prevention strategies.

Eka Burkadze,1 Ketevan Axobadze,1 Nino Chkhaberidze,1 Nino Chikhladze,1 Madalina Adina Coman,2 Diana Dulf,2 Corinne Peek-Asa3 1Department of Public Health, Faculty of Medicine, Ivane Javakhishvili Tbilisi State University, Tbilisi, Georgia; 2Department of Public Health, College of Political, Administrative and Communication Sciences, Babes-Bolyai University, Cluj-Napoca, Romania; 3Department of Occupational and Environmental Health, College of Public Health, University of Iowa, Iowa City, IA, USACorrespondence: Eka BurkadzeDepartment of Public Health, Faculty of Medicine, Ivane Javakhishvili Tbilisi State University, 1 Chavchavadze Ave, Tbilisi, 0179, GeorgiaTel +995 591 11 80 90Email eka.burkadze@tsu.gePurpose: Traumatic brain injury (TBI) is one of the major causes of morbidity and mortality worldwide, disproportionally affecting low- and middle-income countries (LMICs). Epidemiological characteristics of TBI at a national level are absent for most LMICs including Georgia. This study aimed to establish the registries and assess causes and outcomes in TBI patients presenting to two major trauma hospitals in the capital city –Tbilisi.Patients and Methods: The prospective observational study was conducted at Acad. O. Gudushauri National Medical Center and M. Iashvili Children's Central Hospital from March, 1 through August, 31, 2019. Patients of all age groups admitted to one of the study hospitals with a TBI diagnosis were eligible for participation. Collected data were uploaded using the electronic data collection tool –REDCap, analyzed through SPSS software and evaluated to provide detailed information on TBI-related variables and outcomes using descriptive statistics.Results: Overall, 542 hospitalized patients were enrolled during the study period, about 63% were male and the average age was 17.7. The main causes of TBI were falls (58%) and struck by or against an object (22%). The 97% suffered from mild TBI (GCS 13– 15). Over 23% of patients arrived at the hospital more than 1 hour after injury and 25% after more than 4-hours post-injury. Moderate and severe TBI were associated with an increased hospital length of stay. Mortality rate of severe TBI was 54%.Conclusion: This study provides important information on the major epidemiological characteristics of TBI in Georgia, which should be considered for setting priorities for injury management.Keywords: traumatic brain injury, injury epidemiology, registry, Georgia