Accidental Ingestion of Nitric Acid in an Agricultural Company: A Case Study and Literature Review

Introduction: Though common in society, caustic accidental ingestion is rare in the agricultural industry. This study describes a case of ingestion of nitric acid used as an agricultural fertilizer by an ordinary worker at the Société de Cultures Légumières. Clinical Case: This is a 33-year-old unschooled woman who ingested a sip of nitric acid from an abandoned labelled acid canister near a farming plot of land. She showed a burn of the oral cavity with a bleeding tablecloth and an intense retrosternal pain. The duodenal oesophagus fibroscopy screening that was carried out 18 hours after the accident, revealed an esophagitis class 2b. The tests revealed no anomalies. Fifteen (15) days after the accident, the FOGD was normal. Following an 8-month-follow up, no signs of stenosis or degeneration were noted. Conclusion: The accidental ingestion of nitric acid is rare in adult. Its treatment is mainly symptomatic and aims at preserving vital functions without directly fighting the ingested substance off. The right actions must be integrated into the 15-minute Health and Safety awarenesssessions for optimum pre-hospital management. The hospital evaluation is mandatory and is carried out thanks to the digestive endoscopy, which is still relevant in this indication, but is completed by the thoraco-abdominal CT. The latter is very sensitive the transmural necrosis diagnosis.

Pressure relief of underground ammunition storage under missile accidental ignition

Safety of underground ammunition storage is an important issue,especially during the accidental ignition of missiles.This work investigates the pressure and temperature distribution of the multi-layer underground ammunition storage with a pressure relief duct during the accidental ignition process of the missile.A large-scale experiment was carried out using a multi-layered restricted space with a pressure relief duct to simulate the underground ammunition store and a solid rocket motor to simulate the accidental ignition of the missile.The results show that when the motor gas mass flow increased by5.6 times,the maximum pressure of the ammunition storage increased by 5.87 times.At a certain motor flow rate,when the pressure relief exhaust area at the end of the relief duct was reduced by 1/2,the maximum pressure on the first layer did not change.But the rate of pressure relief was reduced and the time delayed for the pressure of ammunition store to drop to zero.In this experiment,when the motor ignition position was located in to the third layer ammunition chamber,the maximum pressure was reduced by 32.9%and also reduced the rate of change of pressure.In addition,for the experimental conditions,the theoretical analysis of the pressure relief of the ammunition storage is given by a simplified model.Based on the findings,some suggestions to the safety protection design of ammunition store are proposed.

Detecting accidental punctures and lacerations during cholecystectomy in large datasets: Two methods of analysis

Background: After the Institute of Medicine(IOM) report To Err Is Human highlighted the impact of medical errors, the Agency for Healthcare Research and Quality(AHRQ) developed Patient-Safety Indicators(PSI) to improve quality by identifying potential inpatient safety problems. PSI-15 was created to study accidental punctures and lacerations(APL), but PSI-15 may underestimate APLs in populations of patients. This study compares PSI-15 with a more inclusive approach using a novel composite of secondary diagnostic and procedural codes. Methods: We used Nationwide Inpatient Sample(NIS) data(20 0 0–2012) from AHRQ’s Healthcare Cost and Utilization Project(H-CUP). We analyzed PSI-15-positive and-negative cholecystectomies. Cross tabulations identified codes that were significantly more frequent among PSI-15-positive cases; these secondary diagnostic and procedural codes were selected as candidate members of a composite marker(CM) of APL. We chose cholecystectomy patients for study because this is one of the most common general operations, and the large size of NIS allows for meaningful analysis of infrequent occurrences such as APL rates. Results: CM identified 1.13 times more APLs than did PSI-15. Patients with CM-detected APLs were significantly older and had worse mortality, comorbidities, lengths of stay, and charges than those detected with PSI-15. Further comparison of these two approaches revealed that time-series analysis for both APL markers revealed parallel trends, with inflections in 2007, and lowest APL rates in July. Conclusions: Although CM may yield more false positives, it appears more inclusive, identifying more clinically significant APLs, than PSI-15. Both measures presented similar trends over time, arguing against inflation in PSI-15 reporting. While arguably less specific, CM may increase sensitivity for detecting APL events during cholecystectomies. These results may inform the interpretation of other large population studies of APLs following abdominal operations.

An alternative approach for computing seismic response with accidental eccentricity

Accidental eccentricity is a non-standard assumption for seismic design of tall buildings. Taking it into consideration requires reanalysis of seismic resistance, which requires either time consuming computation of natural vibration of eccentric structures or finding a static displacement solution by applying an approximated equivalent torsional moment for each eccentric case. This study proposes an alternative modal response spectrum analysis （MRSA） approach to calculate seismic responses with accidental eccentricity. The proposed approach, called the Rayleigh Ritz Projection-MRSA （RRP-MRSA）, is developed based on MRSA and two strategies： （a） a RRf＂ method to obtain a fast calculation of approximate modes of eccentric structures; and （b） an approach to assemble mass matrices of eccentric structures. The efficiency of RRP-MRSA is tested via engineering examples and compared with the standard MRSA （ST-MRSA） and one approximate method, i.e., the equivalent torsional moment hybrid MRSA （ETM-MRSA）. Numerical results show that RRP-MRSA not only achieves almost the same precision as ST-MRSA, and is much better than ETM-MRSA, but is also more economical. Thus, RRP-MRSA can be in place of current accidental eccentricity computations in seismic design.

Accidental Ingestion of Petroleum in Children at the University Hospital of Brazzaville

Introduction: Petroleum ingestion is a health problem in Africa and can be responsible for significant mortality. Objectives: Improving the management of accidental petroleum ingestion in children, describe the socio-demographic characteristics, clinical, therapeutic and evolutionary profile of children hospitalized for accidental ingestion of petroleum and identify the factors associated with the occurrence of petroleum pneumopathy. Patients and Methods: We conducted a cross-sectional analytical study with retrospective collection from January 2016 to December 2015, i.e. in 24 months in the Pediatric Intensive Care and Infant Pediatrics departments at the University Hospital of Brazzaville. We included children who accidentally ingested petroleum. The variables studied were epidemiological, clinical, therapeutic, radiological and evolutionary. The statistical tests used were Pearson’s Chi2 and Odds ratio. The materiality threshold was set at 5%. Results: Out of 8013 children hospitalized, 78 (1%) had accidentally ingested petroleum, including 49 (62.8%) boys and 29 (37.3%) girls with an average age of 20 months. They were between 13 and 30 months old n = 44 (56.4%). The mothers were between 25 and 35 years old n = 49 (62.8%), no profession n = 31 (39.7%) and secondary education level n = 49 (62.8%). The mode of ingestion was self-ingestion (75.6%). The place of occurrence was the family home (92.3%). The motive of admission was breathlessness n = 59 (75.6%). An auscultation anomaly was noted n = 46 (59%), a pneumopathy n = 43 (55.1%). The treatment consisted of oxygen therapy n = 51 (65.4%), antibiotic therapy n = 70 (89.7%). The factors associated with the occurrence of a pneumopathy were: maneuvers performed and the existence of a cough. The lethality was 3.8%. Conclusion: The high frequency of accidental petroleum ingestions in children with an outcome often marked by pulmonary complications and the related case fatality rate requires primary preventive measures that rely on information, communication for behavior change with an emphasis on careful storage of toxic products and to refrain from harmful actions when faced with petroleum intoxication.

Postural Balance in the Elderly with Mild Cognitive Impairment: Relationship to Accidental Falls

This study analyzed postural balance in the elderly with mild cognitive impairment and its relationship to accidental falls. A quantitative and quasi-experimental method was used in a sample of 43 elderlies between 64 and 88 years old, mostly females. Data collection was performed in two Basic Health Units in the city of Rio de Janeiro in 2014. The instruments used were the Mini-Mental State Examination (MMSE), Tinetti scale, Motor Scale for the Elderly (EMTI) scale, and Elderly Falls Diary. The data were analyzed with the SAS statistical software version 9.3.1. The scales were applied before and after the psychomotor interventions. A significant difference was observed between the evaluating moments. Balance improvements were observed in all age groups, suggesting that all elderlies, regardless of age, showed satisfactory responses to the implemented psychomotor activities. The elderlies who fell more frequently were those between 60 and 69 years old. It is noteworthy that the age group with the lowest incidence of falls was that of elderlies between 70 and 79 years old. It was concluded that psychomotor activities are beneficial, regardless of age, proving their effectiveness when continued stimuli with cognitive and psychomotor activities are carried out.

Accidental ingestion of foreign bodies/harmful materials in children from Bahrain:A retrospective cohort study

BACKGROUND Children like to discover their environment by putting substances in their mouths.This behavior puts them at risk of accidentally ingesting foreign bodies(FBs)or harmful materials,which can cause serious morbidities.AIM To study the clinical characteristics,diagnosis,complications,management,and outcomes of accidental ingestion of FBs,caustics,and medications in children.METHODS We conducted a retrospective cohort study of all children admitted for accidental ingestion to the Department of Pediatrics,Salmaniya Medical Complex,Bahrain,between 2011 and 2021.Demographic data,type of FB/harmful material ingested,and investigations used for diagnosis and management were recorded.The patients were divided into three groups based on the type of ingested material(FBs,caustics,and medications).The three groups were compared based on patient demographics,socioeconomic status(SES),symptoms,ingestion scenario,endoscopic and surgical complications,management,and outcomes.The FB anatomical location was categorized as the esophagus,stomach,and bowel and compared with respect to symptoms.The Fisher’s exact,Pearson’s χ^(2),Mann-Whitney U,and Kruskal-Wallis tests were used for comparison.RESULTS A total of 161 accidental ingestion episodes were documented in 153 children.Most children were boys(n=85,55.6%),with a median age of 2.8(interquartile range:1.8-4.4)years.Most participants ingested FBs(n=108,70.6%),31(20.3%)ingested caustics,and the remaining 14(9.2%)ingested medications.Patients with caustic ingestion were younger at the time of presentation(P<0.001)and were more symptomatic(n=26/31,89.7%)than those who ingested medications(n=8/14,57.1%)or FBs(n=52/108,48.6%)(P<0.001).The caustic group had more vomiting(P<0.001)and coughing(P=0.029)than the other groups.Most FB ingestions were asymptomatic(n=55/108,51.4%).In terms of FB location,most esophageal FBs were symptomatic(n=14/16,87.5%),whereas most gastric(n=34/56,60.7%)and intestinal FBs(n=19/32,59.4%)were asymptomatic(P=0.002).Battery ingestion was the most common(n=49,32%).Unsafe toys were the main source of batteries(n=22/43,51.2%).Most episodes occurred while playing(n=49/131,37.4%)or when they were unwitnessed(n=78,57.4%).FBs were ingested more while playing(P<0.001),caustic ingestion was mainly due to unsafe storage(P<0.001),and medication ingestion was mostly due to a missing object(P<0.001).Girls ingested more jewelry items than boys(P=0.006).The stomach was the common location of FB lodgment,both radiologically(n=54/123,43.9%)and endoscopically(n=31/91,34%).Of 107/108(99.1%)patients with FB ingestion,spontaneous passage was noted in 54(35.5%),endoscopic removal in 46(30.3%),laparotomy in 5(3.3%)after magnet ingestion,and direct laryngoscopy in 2(1.3%).Pharmacological therapy was required for 105(70.9%)patients;79/105(75.2%)in the FB group,22/29(75.9%)in the caustic group,and 4/14(28.8%)in the medication group(P=0.001).Omeprazole was the commonly used(n=58;37.9%)and was used more in the caustic group(n=19/28,67.9%)than in the other groups(P=0.001).Endoscopic and surgical complications were detected in 39/148(26.4%)patients.The caustic group had more complications than the other groups(P=0.036).Gastrointestinal perforation developed in the FB group only(n=5,3.4%)and was more with magnet ingestion(n=4)than with other FBs(P<0.001).In patients with FB ingestion,patients aged<1 year(P=0.042),those with middle or low SES(P=0.028),and those with more symptoms at presentation(P=0.027)had more complications.Patients with complications had longer hospital stays(P<0.001)than those without.CONCLUSION Accidental ingestion in children is a serious condition.Symptomatic infants from middle or low SES families have the highest morbidity.Prevention through parental education and government legislation is crucial.

College Students’Cognition of Internet Accidental Injury Insurance:A Case Study of Guangdong Province

To explore college students'understanding and satisfaction of internet accidental injury insurance,and to analyse the factors influencing college students'awareness and satisfaction of internet accidental injury insurance.836 college students in Guangdong Province were selected by stratified random sampling.They were investigated with the self-designed questionnaire"College Students'Cognition of Internet Accidental Injury Insurance(CSCIAII)".29.67%,52.18%,10.13%and 8.02%of the college students didn't know,knew a little,knew relatively well and knew very well about internet accidental injury insurance,respectively.The percentage of college students who were very satisfied with the internet accidental injury insurance,thought the internet accidental injury insurance basically met their own needs,think it was acceptable but needed to be improved,did not agree with and were not satisfied with it at all were 9.55%,16.82%,47.73%,11.82%and 14.09%,respectively.College Students’awareness of insurance is weak,and they do not pay enough attention to accidental injury insurance.The design,publicity and sale strategies of internet insurance products may be important factors affecting college students'understanding and satisfaction with internet accidental injury insurance.

Analysis on the Factors Related to the Accidental Pregnancy in 98 Teenage Girls

Objective:To understand the general information of adolescent girls with unplanned pregnancy and the information about abortion and reproductive health knowledge,analyze the influencing factors of unplanned pregnancy and explore the preventive measures.Methods:Using epidemiological investigation method,the adolescent females(age<19 years old)who volunteered requested pain deprivation in our hospital from January 2018 to December 2019 were examined by questionnaire with informed consultation,and the results were analyzed.Results:After screening,98 valid questionnaires were received.The average age of girls were 16.81 years old,and the youngest was 13 years old.Employed girls accounted for 54.0%,students for 23.5%and unemployed people for 22.5%.Non-eamers accounted for 38.8%,and those with monthly income less than 3,000 yuan accounted for 86.8%.78.6 of those aged 16-18 had sex for the first time.The age of first sexual intercourse<15 years old accounted for 21.4%・The first abortion patients accounted for 84.7%,repeated abortion accounted for 15.3%.years old accounted for 19.05%.First abortion in the age<15 There was no statistical difference between the reproductive health knowledge mastery score and the family economic status,parents*12*5 occupation,parents'marital status,parents5 sex education(P>0.05).The score of reproductive health knowledge was statistically different from that of school sex education and hospital sex education(P<0.05).Conclusions:The primary cause of unintended pregnancy is the lack of knowledge of contraception and reproductive health.Schools and hospitals are effective in sex education for adolescent girls.Relevant government departments,schools,families and hospitals should pay more attention to sex education and strengthen efforts to improve the quality of education,so as to further reduce the harm caused by accidental pregnancy of adolescent girls.

Captives Abuse Scandal Not Accidental

After the abuse of POWs and prisoners by US army in Iraq was brought to the day light in May, the worldwide denunciation silenced what the US was bragging about its support for human rights. The inhumane and brutal means used by the US army to torture Iraqi POWs and prisoners have gone to an alarming proportion. Photographs published show American soldiers—men and women—smiling, laughing or giving thumbs-up signs alongside naked Iraqi prisoners, exposing the sadistic and brutal methods employed by American forces and providing more evi-

A STAMP-Game model for accident analysis in oil and gas industry

Accidents in engineered systems are usually generated by complex socio-technical factors.It is beneficial to investigate the increasing complexity and coupling of these factors from the perspective of system safety.Based on system and control theories,System-Theoretic Accident Model and Processes(STAMP)is a widely recognized approach for accident analysis.In this paper,we propose a STAMP-Game model to analyze accidents in oil and gas storage and transportation systems.Stakeholders in accident analysis by STAMP can be regarded as players of a game.Game theory can,thus,be adopted in accident analysis to depict the competition and cooperation between stakeholders.Subsequently,we established a game model to study the strategies of both supervisory and supervised entities.The obtained results demonstrate that the proposed game model allows for identifying the effectiveness deficiency of the supervisory entity,and the safety and protection altitudes of the supervised entity.The STAMP-Game model can generate quantitative parameters for supporting the behavior and strategy selections of the supervisory and supervised entities.The quantitative data obtained can be used to guide the safety improvement,to reduce the costs of safety regulation violation and accident risk.

Transient Analysis of a Reactor Coolant Pump Rotor Seizure Nuclear Accident

The reactor coolant pump(RCP)rotor seizure accident is defined as a short-time seizure of the RCP rotor.This event typically leads to an abrupt flow decrease in the corresponding loop and an ensuing reactor and turbine trip.The significant reduction of core coolant flow while the reactor is being operated at full load can have very negative consequences.This potentially dangerous event is typically characterized by a complex transient behavior in terms of flow conditions and energy transformation,which need to be analyzed and understood.This study constructed transient flow and rotational speed mathematical models under various degrees of rotor seizure using the test data collected from a dedicated transient rotor seizure test system.Then,bidirectional fluid-solid coupling simulations were conducted to investigate the flow evolution mechanism.It is found that the influence of the impeller structure size and transient braking acceleration on the unsteady head(Hu)is dominant in rotor seizure accident events.Moreover,the present results also show that the rotational acceleration additional head(Hu1)is much higher than the instantaneous head(Hu2).

Uncertainty and sensitivity analysis of in-vessel phenomena under severe accident mitigation strategy based on ISAA-SAUP program

The phenomenology involved in severe accidents in nuclear reactors is highly complex.Currently,integrated analysis programs used for severe accident analysis heavily rely on custom empirical parameters,which introduce considerable uncertainty.Therefore,in recent years,the field of severe accidents has shifted its focus toward applying uncertainty analysis methods to quantify uncertainty in safety assessment programs,known as“best estimate plus uncertainty(BEPU).”This approach aids in enhancing our comprehension of these programs and their further development and improvement.This study concentrates on a third-generation pressurized water reactor equipped with advanced active and passive mitigation strategies.Through an Integrated Severe Accident Analysis Program(ISAA),numerical modeling and uncertainty analysis were conducted on severe accidents resulting from large break loss of coolant accidents.Seventeen uncertainty parameters of the ISAA program were meticulously screened.Using Wilks'formula,the developed uncertainty program code,SAUP,was employed to carry out Latin hypercube sampling,while ISAA was employed to execute batch calculations.Statistical analysis was then conducted on two figures of merit,namely hydrogen generation and the release of fission products within the pressure vessel.Uncertainty calculations revealed that hydrogen production and the fraction of fission product released exhibited a normal distribution,ranging from 182.784 to 330.664 kg and from 15.6 to 84.3%,respectively.The ratio of hydrogen production to reactor thermal power fell within the range of 0.0578–0.105.A sensitivity analysis was performed for uncertain input parameters,revealing significant correlations between the failure temperature of the cladding oxide layer,maximum melt flow rate,size of the particulate debris,and porosity of the debris with both hydrogen generation and the release of fission products.

Exploring the Factors Associated with 12-Month Non-Return to Work among Motorcyclists Involved in Road Accidents

Introduction: Motorcyclists bear a disproportionate burden of morbidity and mortality from road accidents. In addition, the consequences of these accidents affect the ability of victims to return to work. This study aimed to determine the prevalence and factors associated with non-return to work among surviving motorcyclists involved in road accidents 12 months after the event. Materials and Methods: It was a cross-sectional study conducted using data from a cohort of motorcyclists involved in accidents and recruited in five hospitals in Benin from July 2019 to January 2020. The dependent variable was non-return to work 12 months after the accident (yes vs no). The independent variables were categorized into two groups: baseline and 12-month follow-up variables. Logistic regression was used to determine the factors associated with non-return to work at 12 months among the participants. Results: Among the 362 participants, 55 (15.19%, 95% CI = 11.84 - 19.29) had not returned to work 12 months after the accident. Risk factors for non-return to work identified were: smoking (aOR = 4.41, 95% CI = 1.44 - 13.56, p = 0.010), hospitalization (aOR = 2.87, 95% CI = 1.14 - 7.24, p Conclusion: The prevalence of non-return to work at 12 months was high among surviving motorcyclists involved in road accidents in Benin. Integrated support for patients based on identified risk factors should effectively improve their return to work.

Conceptual Strategy for Mitigating the Risk of Hydrogen as an Internal Hazard in Case of Severe Accidents at Nuclear Power Plant Considering Existing Risks and Uncertainties Associated with the Use of Traditional Strategies

Hydrogen challenge mitigation stands as one of the main objectives in the management of severe accidents at Nuclear Power Plants (NPPs). Key strategies for hydrogen control include atmospheric inertization and hydrogen removal with Passive Autocatalytic Recombiners (PARs) being a commonly accepted approach. However, an examination of PAR operation specificity reveals potential inefficiencies and reliability issues in certain severe accident scenarios. Moreover, during the in-vessel stage of severe accident development, in some severe accident scenarios PARs can unexpectedly become a source of hydrogen detonation. The effectiveness of hydrogen removal systems depends on various factors, including the chosen strategies, severe accident scenarios, reactor building design, and other influencing factors. Consequently, a comprehensive hydrogen mitigation strategy must effectively incorporate a combination of strategies rather than be based on one strategy, taking into consideration the probabilistic risks and uncertainties associated with the implementation of PARs or other traditional methods. In response to these considerations, within the framework of this research it has been suggested a conceptual strategy to mitigate the hydrogen challenge during the in-vessel stage of severe accident development.

Statistical Analysis of Accident Proneness of Drivers

A mathematical model describing the risks of road accidents has been built on the basis of statistical data of drivers’ accident rate. It has been revealed that drivers can be divided by the degree of their accident proneness into four categories with sharply differing probabilities of road accidents. It has been shown that there is a possibility of classification of drivers in accordance with specified categories.

Child Victims of Road Traffic Accidents: Epidemiological and Clinical Aspects in the Medical and Surgical Emergency Department of the Donka National Hospital

Introduction: Children involved in road accidents most often suffer head or limb injuries. The severity of these injuries varies according to the age of the child, the type of road user and whether or not protective devices are used. The aim of this study was to carry out a census of admissions and to identify the epidemiological and clinical profile of children involved in road traffic accidents at Donka National Hospital. Methods: This is a descriptive cross-sectional study of children involved in traffic accidents over a 3-month period from September 1 to November 30, 2021. All children admitted to the emergency department for a traffic accident were included in the study. Results: During the study period, 435/530 children (82.1%) were victims of road accidents. Boys accounted for 54.94% of cases, compared with 45.06% for girls. The age group most affected was 12-17 years old (48.97%). October had the highest accident rate (36.4%). Pedestrians are most affected (52.87%). Bicycles and mopeds were involved in 59.77% of accidents. Head injury was the most frequent pathology (33.33%). The study showed that 12.64% of victims were referred to intensive care, pediatric surgery, etc. We recorded 8 cases of death (1.84%). Conclusion: This study highlighted the characteristics, incidence and risk factors for accidents in children admitted to emergency departments. Accident prevention, particularly serious accidents in children, requires more precise knowledge of the factors and circumstances leading to their occurrence.

Analysis of Traffic Accidents in Vietnam

Understanding the causes and solutions of road traffic accidents is important for developing road and action plans in a country. In Vietnam, awareness of traffic participants is the main cause of serious traffic accidents. In recent years, the number of road traffic accidents in Tuyen Quang province with deaths has decreased, but the number of accidents has increased significantly. The article uses data on traffic accidents in Tuyen Quang over the (2016-2023) has been analytically reviewed. From there, analyze accident characteristics and causes of traffic accidents in Tuyen Quang province, and propose solutions to improve traffic safety in Tuyen Quang, Vietnam. The findings can be information for managers and researchers interested in studying the province of Tuyen Quang, Vietnam road traffic safety. Additionally, the findings have led the government to achieve national targets in reducing the number of accidents and serious injuries.

A Workable Solution for Reducing the Large Number of Vehicle and Pedestrian Accidents Occurring on a Yellow Light

Traffic intersections are incredibly dangerous for drivers and pedestrians. Statistics from both Canada and the U.S. show a high number of fatalities and serious injuries related to crashes at intersections. In Canada, during 2019, the National Collision Database shows that 28% of traffic fatalities and 42% of serious injuries occurred at intersections. Likewise, the U.S. National Highway Traffic Administration (NHTSA) found that about 40% of the estimated 5,811,000 accidents in the U.S. during the year studied were intersection-related crashes. In fact, a major survey by the car insurance industry found that nearly 85% of drivers could not identify the correct action to take when approaching a yellow traffic light at an intersection. One major reason for these accidents is the “yellow light dilemma,” the ambiguous situation where a driver should stop or proceed forward when unexpectedly faced with a yellow light. This situation is even further exacerbated by the tendency of aggressive drivers to inappropriately speed up on the yellow just to get through the traffic light. A survey of Canadian drivers conducted by the Traffic Injury Research Foundation found that 9% of drivers admitted to speeding up to get through a traffic light. Another reason for these accidents is the increased danger of making a left-hand turn on yellow. According to the National Highway Traffic Safety Association (NHTSA), left turns occur in approximately 22.2% of collisions—as opposed to just 1.2% for right turns. Moreover, a study by CNN found left turns are three times as likely to kill pedestrians than right turns. The reason left turns are so much more likely to cause an accident is because they take a driver against traffic and in the path of oncoming cars. Additionally, most of these left turns occur at the driver’s discretion—as opposed to the distressingly brief left-hand arrow at busy intersections. Drive Safe Now proposes a workable solution for reducing the number of accidents occurring during a yellow light at intersections. We believe this fairly simple solution will save lives, prevent injuries, reduce damage to public and private property, and decrease insurance costs.

养老机构老年人跌倒风险综合评估工具的研制与检验

背景我国自1999年宣布进入老龄化社会以来,人口老龄化程度日益严重,养老机构成为老年人养老热门选择,但跌倒问题频发且现有评估工具效果不佳。目的研制养老机构老年人跌倒风险综合评估工具并检验其信效度。方法2021年3—12月,通过文献回顾、半结构式访谈、2轮专家函询及预调查,形成量表初始条目,并在养老机构随机选择老年人和养老护理员进行调查。采用SPSS 26.0和AMOS 26.0软件进行信效度分析和评价,采用相关系数法、临界比值法、内部一致性分析及探索性因素分析进行条目分析和筛选,选用内在信度、分半信度、评定者间信度和同质性信度检验评估工具的信度,选用表面效度、内容效度、效标关联效度、结构效度和区分效度检验评估工具的效度,采用受试者工作特征曲线检验评估工具的预测能力。结果构建的评估工具包括3个子工具:(1)老年人跌倒风险评估量表;(2)老年人跌倒史风险追踪调查表;(3)老年人跌倒风险每日检查清单。老年人跌倒风险评估量表总Cronbach'sα系数为0.73,评定者间系数为0.85;探索性因子分析提取3个公因子,累识方差贡献率为57.95%;验证性因子模型拟合度参数中的卡方自由度比值(χ^(2)/df)、拟合优度指数(GFI)、调整后拟合优度指数(AGFI)、基于标准化适度指标(NFI)、比较拟合指数(CFI)、Tucker-Lewis系数(TLI)、近似误差均方根(RMSEA)分别为2.43、0.95、0.91、0.89、0.93、0.91、0.07,区分效度经验证存在统计学意义(P<0.001)。预测能力分析结果显示,以Morse跌倒评估表(MFS)≥55分为标准时,受试者工作特征曲线下面积(AUC)为0.87;以MFS≤25分为标准时,AUC为0.84。老年人跌倒史风险追踪调查表和老年人跌倒风险每日检查清单经专家和养老护理员的评价后,形成最终版本。结论本研究开发养老机构老年人跌倒风险综合评估工具,包含3个子量表,三者间相辅相成,完善养老机构从评估到预防的全路径,具有良好的信效度和预测能力,可为日后我国养老机构跌倒预防及管理提供参考。