Foram estudados casos de mortes violentas ocorridos no Município de São Paulo nos anos de 1960, 1965, 1970 e 1975, destacando-se os de pessoas nele residentes, por meio das informações que acompanham os laudos de necrópsias do Instituto Médico Legal. O objetivo foi caracterizar essa mortalidade segundo as reais causas básicas da morte, relacionando-as com variáveis consideradas importantes do ponto de vista epidemiológico, bem como o momento e o local de ocorrência dos acidentes e violências que levaram à morte. Os resultados encontrados mostraram uma elevação do risco de morrer por causas violentas entre nós, distinguindo-se os coefictentes de mortalidade por homicídios e por acidentes de trânsito de veículos a motor, dentre os quais assumem papel primordial os atropelamentos. As conclusões permitem colocar a mortalidade por acidentes e violências como importante problema de saúde pública. / Violent death mortality according to the real underlying causes of death occurred in São Paulo, Brazil in 1960, 1965, 1970 and 1975 was studied. A special emphasis was given to the study of the deaths of the residents of this area. Informations were collected from authopsy reports provided by the Official Service in charge of the authopsies of violent deaths of São Paulo (Instituto Médico Legal). Analysis of the violent deaths was done according to important variables chosen by an epidemiological point of view. Time and local of the accident or violence wich was responsible for the death were discussed. The results show that the risk of dying by these violent causes increased from 1960 to 1975, mainly the mortality of homicides and of motor vehicle traffic accidents. Motor vehicle traffic accidents involving collision with pedestrian assumed the main role in the mortality risk. These findings allow us to say that mortality by accidents and violences are a very important problem of Public Health in São Paulo.

Diversas pesquisas realizadas no Brasil e no exterior nos últimos anos permitem inferir que existe uma relação causal entre a geometria das rodovias e a incidência de acidentes em determinadas locais. Uma da s principais dificuldades nesses estudos tem sido a representação gráfica da ge ometria da via na forma em que foi efetivamente construída. O advento da tecnologia do GPS associada a modernas técnicas de CAD abre novas possibilidades em termos de se propor um método expedito de criar uma base geográfica de informação à qual poderá associar-se posteriormente dados de acidentes, sinalização da via, condições do pavimento, etc. A proposta da dissertação de mestrado é desenvolver o método de representação geométrica da estrada usando a técnica cinemática do GPS. Para avaliar o desempenho do método proposto foi realizado o levantamento de um trecho de 30 km da rodovia SP-127 Fausto Santo Mauro conectando Rio Claro a Piracicaba. Através do arquivo de dados resultante do levantamento foi possível desenhar a rodovia em planta e em perfil com um nível de precisão suficiente para a construção de uma base geográfica de um SIG. Relatam-se algumas dificuldades de representação gráfica no TRANSCAD, no LISCAD e no AUTOCAD. / Several studies in Brasil and abroad in the n ear past lead to the conclusion that there is a causal relationship between highway ge ometry and accident incidence at certain locations on the road. One of the major diffi culties described in these studies is the grafic representation of the road geometry as built.The advent of the GPS technology, associated with modern CAD techniques, opens new possibilities in terms of an expedite method to criate a geographic information base that can be associated to accident data, traffic sign data, pavement conditions data, etc. A method to graphically represent the roadway geometry using the kinematic GPS techique is proposed at the level of a MSc thesis. In order to evaluate the proposed methods performance, a 30 km segment of SP-127 Fausto Santo Mauro Highway connecting Rio Claro to Piracicaba was surveyed. The graphical representation of the horizontal and vertical profile of the road that resulted from the surveying method is shown. Some of the difficulties in graphically representing the road with TRANSCAD, LISCAD and AUTOCAD are described.

Typescript. / Digitized by Kansas Correctional Industries

Trata-se de um estudo descritivo exploratório com abordagem de análise quantitativa, cujo objetivo foi caracterizar os acidentes ocupacionais com material biológico potencialmente contaminado, ocorridos com trabalhadores de enfermagem de um hospital geral público localizado no interior de Angola, no período de julho de 2002 a julho de 2003, visando contribuir para criação de bases à implementação de políticas de prevenção de acidentes ocupacionais entre os trabalhadores da saúde. Coletaram-se os dados mediante entrevistas face a face, com base em roteiro aplicado por cinco sujeitos previamente treinados, após cumpridos todos os pressupostos éticos. Participaram do estudo 278 trabalhadores de enfermagem, de um total de 378, cujos resultados permitiram concluir que a população estudada é heterogênea, com idade variando de 22 a 66 anos, com maior concentração dos sujeitos nas faixas etárias de 22 a 30 anos (30,93%) e de 31 a 40 anos de idade (24,82%). A maioria é casada, com escolaridade de nível médio (59,00%). A incidência de acidentes nesta população foi elevada, uma vez que, dos 278 trabalhadores participantes do estudo, 93,88% sofreram um total de 1.477 acidentes diversos, com uma freqüência de 1 a 56 acidentes por sujeito. No presente estudo cada trabalhador descreveu até 4 acidentes no máximo, perfazendo um total de 376 acidentes descritos, sendo o sangue e seus derivados o material biológico mais citado (78,46%). Do total dos acidentes, 47,10% ocorreram por contato, seguidos dos acidentes percutâneos (45,20%), tendo a maioria (61,44%), acontecido no período da manhã, resultante da administração de medicamentos. Após a ocorrência da maior parte dos acidentes (97,61%), não houve qualquer conduta administrativa e nenhum dos profissionais foi submetido à profilaxia contra o Vírus da Imunodeficiência Humana (HIV) e a hepatite B. Em 72,87% dos acidentes, 73,56% dos trabalhadores não faziam uso de Equipamentos de Proteção Individual (EPI) e 96.01% não conheciam a situação sorológica do paciente-fonte em relação ao HIV, à hepatite B e C. Estas constatações levaram o pesquisador a concluir que a problemática dos acidentes de trabalho na instituição resulta da interação de vários fatores ligados diretamente à formação e treinamento sobre as normas de biossegurança e à ausência de políticas institucional e governamental voltadas à prevenção de acidentes envolvendo material biológico, constituindo-se, dessa forma, em um agravo à saúde ocupacional desta população. Torna-se urgente a elaboração de estratégias para fazer face aos enormes problemas que envolvem a saúde ocupacional desses trabalhadores, com vistas à redução dos riscos presentes no ambiente de trabalho, sobretudo na atual conjuntura da emergência de várias enfermidades de alta periculosidade. / This is an exploratory descriptive study with a quantitative analysis approach that had the goal to characterize the occupational accidents among nursing workers involving highly contaminated biologic material at a public general hospital in Angola, from July 2002 to July 2003, and was developed with the intent to provide bases for the implementation of policies for avoiding occupational accidents among health professionals. Data collection was performed through face-to-face guided interviews, applied by five previously trained individuals, after all ethic principles had been complied. From the total of 378 nursing workers, 278 participated in this study. The showed that the studied population is heterogeneous, with ages ranging between 22 and 66 years, being that most (30.93%) were aged between 22 and 30, and 31 to 40 years (24.82%). Most participants are married and have a high-school educational level (59.00%). There is a high incidence of accidents among this population, as 93.88% of the 278 participants suffered a total of 1,477 different accidents, ranging from 1 to 56 accidents per person. Each worker described up to 4 accidents (maximum) in the study, adding up a total of 376 described accidents, being that blood and its derivates were the most stated biological material (78.46%). From the total of accidents, 47.10% happened through contact, followed by percutaneous accidents (45.20%). Most happened in the morning (61.44%), resulting from the administration of drugs. After the occurrence of most accidents (97.61%), there was no administrative conduct and none of the workers were submitted to prophylaxis against Human Immunodeficiency Virus (HIV), or hepatitis B. In 72.87% of the accidents, 73.56% of the workers were not using Individual Protection Equipment (IPE) and 96.01% were not aware of the patient’s condition regarding HIV or hepatitis B and C. This showed that occupational accidents in institutions result from the interaction of many factors directly entwined to the development and training of biosafety norms and to the lack of institutional and governmental policies for the prevention of accidents involving biologic material; thus representing impairment to this populations’ occupational health. Facing the problems involving these workers’ occupational health, there is urgency for the development of strategies to reduce the workplace risks, particularly in the current circumstances when diseases of such high risks have emerged.

Falls are a major public health concern and contribute significantly to mortality and morbidity in the older adult population. Each year, approximately 3 million older adults are treated in emergency departments for fall-related injuries and at least 300,000 older people are hospitalized for hip fractures. The purpose of this project was to improve the participants' knowledge and highlight interventions to reduce the incidence of falls and injuries as a result of falls. The project was developed using the Stop Accidents, Deaths and Injuries (STEADI) toolkit, the Iowa model of evidence-based practice to promote quality of care, and the Lewin's change theory. The practice-focused question related to whether fall prevention would improve following the implementation of a staff education project using the STEADI toolkit. Twenty-six nurses were assessed to determine their knowledge deficits. Pretest and posttest data were analyzed, and as a result of the staff education initiative, the nurses' knowledge increased by 99.25%. Prior to the session, the facility had not participated in a fall-prevention initiative. This project offered a practical solution to the educational gaps identified at the practice setting. Adopting the STEADI toolkit at the practice setting is expected to improve patient safety, reduce falls with injuries and prevent fall-related deaths.

<p>Istraživanje faktora koji utiču na nastanak vanrednih događaja na železnici se uobičajeno zasnivaju na analizi internih faktora, dominantno ljudskih faktora.<br />Eksterni faktori koji mogu imati značajan uticaj na povećanje rizika od nastanka vanrednog događaja u dosada&scaron;njoj praksi nisu ustanovljeni i kvantifikovani sa stanovi&scaron;ta uticaja na realizatore transpornog procesa.<br />Regularno ustanovljavanje eksternih faktora i njihova metrika zbog toga predstavlja osnovni protokol za procenu rizika od nastanka i prevenciju vanrednih događaja.</p> / <p>The study of factors that influence the occurrence of railway accidents are usually based on an analysis of internal factors, the dominant human factors.<br />External factors that can have a significant impact on increasing the risk of railway accidents in current practice are not established and quantified from the point of impact on the implementers exchange transport processes.<br />Regular establishment of external factors and their metrics is therefore a basic protocol for assessing the risk of railway accidents and prevention of extraordinary events.</p>

No description available.

The syndrome commonly referred to as whiplash injury" resulting from motor vehicle accidents is complex and remains a challenge to clinicians, as is evidenced by the recent report of the Quebec task force on the "whiplash syndrome". The main objective of this prospective randomised study was to evaluate two conservative treatment regimens (early immobilisation-experimental group-1, early active mobilisation experimental group-2) which are based on accepted physiological rationale and then to compare their effectiveness with existing treatment regimens that are commonly practiced (control group) in the management of "whiplash" type of injuries. To this stage, the current study is the only prospective randomised clinical trial of its type conducted with a sufficiently large sample size and over a long study period. The results of the current study clearly demonstrated that the subjects in the immobilised group recovered from their pain-related symptoms and returned to their normal duties sooner than those in the other two treatment groups. In addition to this, those subjects who received the immobilisation regimen did not show adverse effects on either the range of motion or the strength of the neck muscles. Thus, the immobilisation regimen was clearly shown to be the preferred option when compared to the other two treatment methodologies investigated in the current study.Although the primary interest of the current study was to compare the efficacy of three different treatment regimens, a series of statistical analyses were performed to establish the prognostic significance of several factors associated with "whiplash" injury. This showed that factors such as gender, age, speed of the vehicles involved, paraesthesia, intensity of pain at the time of the initial examination, interscapular pain, blurred vision and difficulty in focusing, all had prognostic value. ++ / Similarly, the type of collision, seating position, presence of headache within 24 hours post injury, pre-existing degenerative changes in the cervical spine, loss of lordosis and litigation factors had no prognostic significance. Another major emphasis of the current study has been to concentrate on the pain related symptoms of the neck which are of major concern to "whiplash" subjects and to those clinicians treating them. A paucity of such information is considered to be one of the most notable causes of difficulties encountered in the management of "whiplash" injuries.As an adjunct to the main study, the morphology of the deep pre- and post vertebral muscles of the neck region using embalmed cadavers and fresh post-mortem specimens was investigated, as the literature is deficient in--this regard. Similarly, a longitudinal study of 45 subjects was also performed using Magnetic Resonance Imaging (MRI) technology. The longitudinal nature of the M.R.I. study provided for the first time an account of the details associated with the progressive pathological changes that occurred in some disc lesions, at defined points in time following a MVA. The observations made from the adjunct studies help develop a better understanding of the pathoanatomy associated with the deep muscles of the neck region and the pathological changes that occur following a traumatic disc lesion as evidenced within 2 weeks, after 3 months and 12 months post- injury. On the basis of the observations made in the current study, a classification of the "whiplash" injury has been proposed for the consideration of clinicians. Similarly, the questionnaire used for data collection in the current study, can be readily modified and utilised in a clinical situation for establishing documentation, planning treatment strategies and for evaluation of the treatment outcomes of "whiplash" type of injuries.

Background: The burden of fatal and non-fatal injury for the New Zealand construction industry is larger than most other industrial sectors. Injury preventions efforts for construction have however been hampered because of insufficient, industry-specific, surveillance data that is essential for the effective targeting and evaluation of interventions. Aim: This thesis aimed to describe and test a feasible framework of Injury Surveillance for the New Zealand construction industry. Accordingly, the specific objectives to accomplish this aim were: To identify an optimal surveillance dataset for New Zealand construction injuries; To assess potential sources of data and collection methods; To describe an ideal study design for undertaking injury surveillance; To implement an operational design based on industry stakeholder input; To undertake and evaluate an injury surveillance trial; and To suggest how a viable surveillance system could be permanently established. Method: A trial injury surveillance system was developed by identifying known construction injury risk factors from the literature, reviewing the data collection practices of the New Zealand industry and other potential data sources and consulting with industry stakeholders about the most feasible collection methodology. This surveillance framework was then tested by combining national data from routine Government sources and data from 3 construction companies that employed approximately 720 workers between them. National construction injury data was obtained from the Accident Compensation Corporation, the Department of Labour and the Injury Information Manager. The trial Surveillance System was then evaluated in terms of its ability to collect the full range of an optimal dataset, the quality and completeness of information actually collected, the ability to identify and monitor injury priorities for the industry, and the future viability and acceptability of this surveillance design to the industry. Results: A total of 468 medically treated injuries were recorded by the participating companies, with 15 (3.2%) considered to be Serious Harm injuries as defined by the Health and Safety in Employment Act. The level of data completeness across companies was especially low, with on average 18 out of 34 data fields (53%) completely unrecorded. The data from one company was sufficiently complete (i.e. 63% across all fields) to allow individual risk factor analyses to be conducted, whereas the absence of complete denominator data prevented the completion of the same analyses for the other two companies. Viewed overall, Government agency data was sufficiently detailed to estimate national longitudinal trends, injury agency and mechanism priorities for specific occupations and industry subsectors, and allowed a rudimentary evaluation of a national intervention programme. However, questions about data accuracy, completeness and under-reporting were raised for each of the Government data sources used. Conclusions: Using data entirely from Government sources appears to be the most immediately viable framework of Injury Surveillance for the New Zealand construction industry. As such, the relevant range of analyses demonstrated by this study should be continued, expanded and improved. In contrast, obtaining injury surveillance data from companies in the manner that was tested does not appear to feasible, given the difficulty in recruiting companies and the poor data completeness of those companies that did participate. However, the increased range of prevention targets identified by the company that did largely contribute data as intended, demonstrated that company surveillance had merit relative to existing procedures. Suggested steps toward implementing viable construction injury surveillance within New Zealand are outlined, including a recommendation to the industry�s Health and Safety organisation, SiteSafe, to investigate the most feasible data collection protocol for its members.

This study enabled the development of a brief, clinically fesible screening tool for falls and injury risk identification in older community-dwelling adults through a range of methods that included a literature review, a Case Note Audit of 128 people attending Falls and Balance clinic, and group,processes (Nominal Group and Delphi Panel with 12 and 10 participants respectively). These methods focussed on developing specifications for the screening tool, selecting key modifiable risk factors and associated tests for both falls and injury and considering questions that would determine self-perception of falls risk, general health and balance. The range of methods and process of triangulation ensured content validity of the tool. / thesis (MPhysiotherapy)--University of South Australia, 2002.