Category Archives: Injury Prevention
Over the weekend, NewPublicHealth conducted an email interview with Tarik Jasarevic, a spokesperson for the World Health Organization (WHO), on Ebola efforts on the ground in West Africa and the impact on the global effort of the cases recently diagnosed in the United States.
NewPublicHealth: Is there concern among global health leaders that the attention on a handful of cases is taking away attention from the thousands of cases in West Africa?
Tarik Jasarevic: While countries need to be vigilant and prepared for a possible case of Ebola, we need to focus on getting all possible resources—trained health workers, medical facilities with beds and money—to the affected countries in West Africa.
NPH: Several weeks ago global health leaders had a checklist of things, including money and personnel, needed to stem the outbreaks in the various countries. Where do things stand now, and what is still needed?
Jasarevic: We need a lot of resources if we’re going to get the virus under control. WHO and partners constructed 12 Ebola Treatment Centers in Liberia, 15 in Sierra Leone and 3 in Guinea—30 out of the 50 that are needed. These facilities contain more than 1,100 beds for patients, out of the more than 4,000 needed. There are more than 2,500 beds becoming available in the next few weeks, but we still need more. We also need international health workers to come work alongside national health workers to manage and run the health facilities. WHO has set up “training academies” in each of the affected countries to train more local health workers, but more are needed.
NPH: What is the current fatality rate?
Jasarevic: The fatality rate for this particular outbreak has always been approximately 70 percent. We are seeing higher numbers of cases and deaths because of the geographic spread of the disease, from urban city centers to rural, hard to reach villages. There is also significant under reporting of cases in the three countries, especially Liberia.
CDC Updates Guidelines on Health Worker Protective Gear when Treating Ebola Patients
The U.S. Centers for Disease Control and Prevention (CDC) announced last night that it is tightening its infection control guidance for health care workers caring for patients with Ebola, with a specific focus on several key steps:
- All health care workers must undergo rigorous training and become practiced and competent with protective equipment, including taking it on and off in a systemic manner.
- No skin exposure is allowed when the equipment is worn.
- All workers must be supervised by a trained monitor who watches each worker taking the equipment on and off.
The CDC is recommending all of the same equipment in its earlier guidance, with the addition of coveralls and single-use, disposable hoods. Single-use face shields are now recommended instead of goggles. Read more on Ebola.
Most People Polled Don’t Know New ACA Enrollment Period Begins in November
A poll just released from the Kaiser Family Foundation finds few people know that open enrollment for 2015 health insurance coverage under the Affordable Care Act begins next month. Other findings of the poll:
- Two-thirds of responders say they know “only a little” or “nothing at all” about the marketplaces where people who don’t get coverage through their employers can shop for insurance.
- Just over half say they know that financial assistance is available to help low- and moderate-income individuals purchase insurance.
Risk Factors for Sexual Assault Need to be Included in Prevention Efforts
Researchers who conducted a Danish study on sexual assault say that certain risk factors for the attacks—including the age of the victim and their prior relationship with the attacker—must be considered when developing strategies to help prevent sexual assaults. The researchers looked at data from more than 250 women who sought help at a Danish center for sexual assault victims between 2001 and 2010. The researchers found that 66 percent of the women were 15-24 years old and 75 percent had met their attacker before the assault. Nearly half of the women reported that the attacker was a current or former boyfriend, a family member or someone they considered a friend. Women who did not know their attacker previously were more likely to report the assault to the police. “We need to raise awareness of the fact that most sexual assaults are perpetrated by someone known to the woman, often in familiar surroundings ... in order to change the general attitudes towards sexual assault, this information should not only target young people, but also the police, health care professionals and the general public,” said Mie-Louise Larsen, of the Centre for Victims of Sexual Assault and the University of Copenhagen and a coauthor of the study, which appeared in BJOG: An International Journal of Obstetrics and Gynaecology. Read more on injury prevention.
Positive Images Improve Function in Older Adults
Older individuals who are subliminally exposed to positive stereotypes about aging showed improved physical functioning that can last for several weeks, according to work done by researchers at the Yale School of Public Health. The study, which will be published in Psychological Science, included 100 older individuals with an average age of 81 years. Some participants saw positive age stereotypes on a computer screen that flashed words such as “spry” and “creative.” Those participants who were exposed to positive messaging displayed both psychological and physical improvements but control participants did not. Read more on aging.
EBOLA UPDATE: Kaiser Infographic Lays Out the Key Statistics
(NewPublicHealth is monitoring the public health crisis in West Africa.)
A new infographic on the current Ebola outbreak produced by the Kaiser Family Foundation and published in the Journal of the American Medical Association breaks down the crisis into key elements, including the disease count so far, the rate of response and the key U.S. government agencies charged with addressing the outbreak. Key numbers include:
- Fatality rate — 53 percent which is lower than in previous outbreaks
- Outbreak geography — In the current outbreak, five West African countries that have never had Ebola cases are now battling the disease including Guinea, Liberia, Nigeria, Senegal and Sierra Leone
- U.S. agencies responding — Department of Defense, Department of States, U.S. Agency for International Development, Centers for Disease Control and Prevention, the Food and Drug Administration and the National Institutes of Health
The World Health Organization also maintains a dedicated Ebola information website that is updated frequently and includes case counts, studies, policy announcements and feature stories about aid in West Africa. Read more on Ebola.
CDC: 2.5M Emergency Department Visits for Vehicle Crashes in 2012
Motor vehicle crashes sent more than 2.5 million people to emergency departments (EDs) and led to more than 200,000 people being hospitalized in 2012, according to a new report from the U.S Centers for Disease Control and Prevention (CDC). All told, the lifetime medical costs for these crash injuries will be $18 billion and the lifetime work lost will be an estimated $33 billion. “In 2012, nearly 7,000 people went to the emergency department every day due to car crash injuries,” said CDC Principal Deputy Director Ileana Arias, PhD, in a release. “Motor vehicle crash injuries occur all too frequently and have health and economic costs for individuals, the health care system, and society. We need to do more to keep people safe and reduce crash injuries and medical costs.” Read more on injury prevention.
Task Force Recommends Diabetes Screening for All Americans Over Age 45
Everyone over the age of 45 should be screening annually for type 2 diabetes and prediabetes, according to new recommendations from the U.S. Preventive Services Task Force. "For people with abnormal blood sugar, changes in their lifestyle, such as eating healthier and exercising more often, can help prevent or delay the onset of type 2 diabetes,” said Michael Pignone, MD, a task force member, in a release. “The best way to do that is to participate in a program that supports these behaviors. That's why we're recommending that people who are at increased risk be screened." According to the U.S. Centers for Disease Control and Prevention, approximately 29.1 million Americans have diabetes, although 8.1 million of those cases are undiagnosed. Read more on prevention.
In connection with Domestic Violence Awareness Month, held each October, the U.S. Centers for Disease Control and Prevention (CDC) recently issued a stark report which found that sexual violence not only results in high rates of injury and death, but also other long-lasting and even lifetime health impacts. To best share the specifics of the report, the CDC created an infographic with the most striking numbers—including how many men are raped each year and how people under the age of five are sexually abused.
>>View the full infographic.
Perhaps most striking, the CDC found that a substantial proportion of U.S. female and male adults have experienced some form of sexual violence, stalking, or intimate partner violence at least once during their lifetimes.
Among the report’s recommended public health actions:
- Prevention of sexual violence must include the protection of young children.
- Strategies to prevent sexual violence must include strategies that address known risk factors for perpetration and emphasize changing social norms and behaviors by using bystander and other prevention strategies.
- Primary prevention of intimate partner violence should be focused on the promotion of healthy relationship behaviors and other protective factors, with the goal of helping adolescents develop positive behaviors before their first relationships.
>>Bonus Link: CDC’s Center for Injury Prevention and Control offers many resources on sexual violence prevention geared toward people of different ages and communities.
The New York Times recently reported on the deaths of two pedestrians killed by bicyclists in the city’s storied Central Park. New York City has recently ramped up efforts to reduce pedestrian deaths—with a focus on car crashes—but anecdotal and police reports in the city find that the growing number of walkers, skaters, cyclists, pedibikers and other people heeding advice to get out and move is resulting in more injuries and deaths. Other cities have also reported increases in accidents linked to increases in physical activity. NewPublicHealth recently reported on efforts launched this year by the U.S. Department of Transportation to prevent and reduce pedestrian injuries.
Several conferences this year—including the annual meetings of the American Public Health Association, the Transportation Research Board and New Partners for Smart Growth—will have sessions looking at pedestrian safety in the wake of communities creating new opportunities for residents to get exercise outdoors. And Sunday Streets, a growing program across the country, shuts down main city streets to give walkers free reign, often with a booth set up by departments of public health or safety on staying safe when sharing the roads.
Read the full story from the New York Times.
A one-of-its-kind pedestrian traffic walk signal recently turned heads in Portugal with a dancing figure that entertained people as they waited for him to tell them when it was safe to cross the street.
The signal—not planned for mass circulation anytime soon—was developed by the manufacturer Smart to advertise its cars’ safety features. And if it saves lives along the way, it’s in sync with the U.S. Department of Transportation (DOT), where the National Highway Traffic Safety Administration (NHTSA) has found that 4,432 pedestrians died in traffic crashes in 2011, up 3 percent from 2010. More than a quarter of the accidents resulting in death happened at traffic intersections, both at marked crosswalks and intersections with traffic lights. Andrea Gielen, PhD, head of the Johns Hopkins Center for Injury Research and Policy at Johns Hopkins University, says the school’s research shows that many of these accidents occur because pedestrians are distracted by music in their earphones or by speaking or texting on cellphones.
NHTSA began a campaign to keep pedestrians safer last year and highlights community projects that improve pedestrian safety in a stories section on its website on pedestrian safety. One project, developed at University of California, San Diego, was a presentation at a low-income elementary public school in San Diego, Calif. The English- and Spanish-language presentation demonstrated dangerous scenarios and how to prevent them, such as kids dressed in only dark clothing, which makes them difficult to see at night. NHTSA is updating the site regularly to help communities develop their own safe walking programs.
As for traffic lights themselves, makeovers could be ahead. The Transportation Research Board of the National Academies of Sciences has a traffic light subcommittee that presents new research on traffic signal safety at the board’s annual meeting each January. Upcoming topics of interest are likely to include computerized traffic signals that can respond to traffic flow by switching to green sooner when there’s no congestion ahead, as well as a recent study from the Massachusetts Institute of Technology (MIT) that found that traffic lights are easily hacked, which could lead to traffic jams and collisions. Preventing some of the hacking could be as simple as strengthening the passwords of the engineers who control the traffic signals, according to computer engineers at MIT.
Wendy Landman, executive director of the pedestrian advocacy group Walk Boston, says intersections could be safer if city agencies talked more. She said the deciding factor for how long a traffic signal should be green for pedestrians is often based on how quickly traffic experts think drivers want to be back on the gas pedal—but that may be too short for many pedestrians, especially at intersections on main roads.
>>Bonus Content: Read a previous NewPublicHealth interview with Andrea Gielen.
Frontline, the Public Broadcasting Service documentary series, has a unique football stats blog, Concussion Watch, which is now in its third year. The blog tallies—game by game—the number of National Football League (NFL) players sidelined by a possible concussion and how soon they return to play.
Based on tracking for the last two years, the blog predicts that 150 players will suffer concussions during the current season, which in many cases could lead to lifetime debilitating problems. This is despite new playing rules and ever-evolving helmets.
The impact of concussions on the players’ heath and lives is startling. Based on Concussion Watch data, 306 players have suffered a combined 323 concussions over the past two seasons. In half of the cases where a concussion occurs, players return to the field without having missed a single game. According to the blog, although there’s no standard recovery time for a diagnosed concussion, guidelines developed by the American Academy of Neurology and endorsed by the NFL Players Association indicate that athletes are at the greatest risk for repeat injury in the first 10 days after a concussion. And the more head injuries a person suffers, the more likely they may be to develop complications later on.
In fact, the NFL is due a decision by mid-October from thousands of league retirees on whether they will accept a proposed settlement in a class-action concussion case brought by more than 4,500 former players. Papers filed in the case show that the NFL expects more than thirty percent of all retired players to develop some form of long-term cognitive problem—such as Alzheimer’s disease or dementia—in their lifetime as a result of head injuries suffered during games. During the preseason and the first week of official play, 15 players suffered head injuries and 12 have already returned to their positions.
Faces of Public Health: Q&A with Andrea Gielen, the Johns Hopkins Center for Injury Research and Policy
The U.S. Centers for Disease Control and Prevention (CDC) recently awarded $4 million to the Johns Hopkins Center for Injury Research and Policy at the Bloomberg School of Public Health to further fund its work on injury prevention research and policy development. According to the CDC, injuries are the leading cause of death in the United States among people ages 1 to 44, costing the country $406 billion each year. And across the globe, 16,000 people die from largely preventable injuries every day.
“This funding will allow us to advance our work in closing the gap between research and practice in new and innovative ways,” said Andrea Gielen, ScD, ScM, the center’s director. “Whether fatal or non-fatal, injuries take an enormous toll on communities. Our faculty, staff and students are dedicated to preventing injuries and ameliorating their effects through better design of products and environments, more effective policies, increased education and improved treatment.”
The five-year grant will support several innovative research projects on key issues, including evaluating motor vehicle ignition interlock laws, studying universal bicycle helmet policies, testing m-Health tools to reduce prescription drug overdose and evaluating programs to prevent falls among older adults. The center will also continue to offer training and education to public health students and practitioners, as well as to new audiences that can contribute to injury prevention.
NewPublicHealth recently spoke with Gielen about the CDC grant
NewPublicHealth: What are the goals for each of the four research areas for which you’ve received funding?
Andrea Gielen: Each of the four is a full research projects with specific aims. For example, with ignition interlock laws—which are car ignitions that can’t start unless a breathalyzer confirms that a driver is sober—there’s been a little bit of evidence that they reduce alcohol-related motor vehicle crash injuries and deaths, but there are two gaps. There has never been a national study of the impact of these laws, and we don’t know a whole lot about how they’re implemented. What is it about ignition interlock policies and how they’re implemented that’s really related to their impact on reducing fatal crashes?
We want to look at all four projects in the same way: We’ll be looking at barriers and facilitators to how policies that we think are effective are adopted and implemented, and what it is about that adoption and implementation of the processes that make these policies effective.
The start of the school year also means a return to team sports. There’s no question that playing a team sport provides clear benefits for kids, including the opportunity to develop physical fitness and other healthy habits, good sportsmanship, self-esteem and self-discipline. Kids who play sports are also less likely to engage in risky behaviors such as smoking or substance abuse.
But there is a potential dark side: An increased risk of sports-related injuries, with concussions at the top of the list of current concerns. Each year nearly 250,000 kids go to emergency departments for suspected sports-related concussions and there’s growing recognition that continuing to play with a concussion can lead to long-term effects on the brain, especially for kids. Girls also now have a higher rate of sports-related concussions than do boys, according to the Children’s Safety Network.
Because of all of these reasons there’s a major push underway to prevent concussions in all youth sports, not just in football, since concussions also commonly occur in girls’ and boys’ soccer, lacrosse, basketball and other sports, according to the American Academy of Pediatrics. In May, the White House hosted the first-ever Healthy Kids & Safe Sports Concussion Summit to promote and expand research on sports-related concussions among kids and raise awareness of steps that can be taken to help prevent, identify and respond to concussions in young athletes.
Meanwhile, the U.S. Centers for Disease Control and Prevention (CDC) launched the Heads Up: Concussion in High School Sports initiative to help coaches, athletes and parents take steps to prevent concussions and respond appropriately if they occur. Among the prevention measures being introduced are modifications to protective gear (including new helmet technology for various sports), rule changes (such as limits on heading drills in soccer practices and tackling drills in football), identifying athletes who are at risk (by looking for genetic markers of risk) and educating everyone involved with youth sports about the dangers of concussions.
There are also stricter guidelines about when it’s appropriate for athletes to return to play after a concussion, based on their physical and cognitive symptoms; concussion history; and adherence to a step-by-step process for returning to the field or court. The CDC now recommends that coaches and parents consider whether their league or school should conduct baseline testing—a pre-season exam to assess an athlete’s balance and brain function—so that if a concussion is suspected to have occurred, the baseline results can help establish the extent of the head injury.
“Players, coaches and parents are demanding that we find a way to reduce concussion risk in sports,” said Michael Sims, head athletic trainer for football at Baylor University and a board member of the National Operating Committee on Standards for Athletic Equipment. “But equipment can’t do it alone. It’s critical that safe play and return to play practices are enforced.”
Sexual assaults on college campuses have grabbed headlines in recent months and for good reason: One in five U.S. women are raped or otherwise sexually assaulted during their college years, often during their freshman or sophomore year and often by someone they know. Last winter, President Obama established the White House Task Force to Protect Students from Sexual Assault. This marked a call to action to help prevent sexual assaults on campuses; to help schools respond effectively when an assault does occur; and strengthen federal enforcement efforts, including the launch of a website to make with various resources for students and schools.
Meanwhile, various colleges and universities have stepped up their own sexual assault prevention efforts. The Indiana Campus Sexual Assault Primary Prevention Project guides Indiana colleges and universities in the prevention of sexual violence through education and technical assistance; as well as the promotion of bystander intervention skills and healthy, respectful relationships.
Earlier this year, the University of Massachusetts Amherst launched a program called UMatter at UMass, which promotes “active bystander intervention” to prevent sexual assaults. The program uses “Three Ds” to help someone who witnesses a situation where a sexual assault is threatened know what to do:
- “Direct": Stepping in and confronting dangerous behavior in a direct and clear—but non-confrontational—way
- “Distract”: Using tactics that will divert behavior before it becomes violent or harmful
- “Delegate”: Enlisting help from acquaintances or law enforcement professionals to help prevent an assault
“Our simple starting point was our determination to build a more caring community, cementing the idea that we care about each other at UMass and that we demonstrate that care without first having a crisis or tragedy,” said Enku Gelaye, vice chancellor for student affairs and campus life at UMass. “With active bystanders, we want to reinforce a culture of active engagement. This is a very specific concept. The idea is that students have to take an active role in monitoring their environment and being engaged and caring about each other.”