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"Vehicles Children"
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Prevention of severe injuries of child passengers in motor vehicle accidents: is re-boarding sufficient?
Abstract PurposeThe purpose of this study was to evaluate whether prolonged re-boarding of restraint children in motor vehicle accidents is sufficient to prevent severe injury.MethodsData acquisition was performed using the Trauma Register DGU® (TR-DGU) in the time period from 2010 to 2019 of seriously injured children (AIS 2 +) aged 0–5 years as motor vehicle passengers (MVP). Primarily treated and transferred patients where included.ResultsThe study group included 727 of 2030 (35.8%) children, who were severely injured (AIS 2 +) in road traffic accidents, among them 268 (13.2%) as MVPs in the age groups: 0–1 years (42.5%), 2–3 years (26.1%) and 4–5 years (31.3%). The pattern of severe injury was head/brain (56.0%), thoracic (42.2%), abdominal (13.1%), fractures (extremities and pelvis, 52.6%) and spine/severe whiplash (19.8%). The 0–1-year-old MVPs showed the significantly highest proportion of brain injuries with Glasgow Coma Score (GCS) < 8 and severe injury to the spine. The 2–3-year-olds showed the significantly highest proportion of fractures especially the lower extremity and highest proportion of cervical spine injuries of all spine injuries, while the 4–5-year-olds, the significantly highest proportion of abdominal injury and second highest proportion of cervical spine injury of all spine injuries. MVPs of the 0–1-year-old and 2–3-year-old groups showed a higher median Injury Severity Score (ISS) of 21.5 and 22.1 points than the older children (17.0 points). They also suffered an AIS-6-injury significantly more often (9 of 21) of spine (p = 0.001). Especially the cervical spine was significantly more often involved. Passengers at the age of 0–1 years were treated with cardiopulmonary resuscitation (CPR) three times as often as older children in the prehospital setting and twice as often at admission in the Trauma Resuscitation Unit (TRU). Their survival rate was 7 out of 8 (0–1 years), 1 out of 6 (2–3 years) and 1 out of 4 (4–5 years).ConclusionAlthough the younger MVPs are restraint in a re-boarding position, severe injury to the spine and head occurred more often, while older children as front-faced positioned MVPs suffered from significantly higher rates of abdominal and more often severe facial injury. Our data show, that it is more important to properly restrain children in their adequate car seats (i-size-Norm) and additionally consider the age-related physiological and anatomical specific risks of injury as well as co-factors in road traffic accidents, than only prolonging the re-boarding position over the age of 15 months as a single method.
Journal Article
Visual-Based Children and Pet Rescue from Suffocation and Incidence of Hyperthermia Death in Enclosed Vehicles
Over the past several years, many children have died from suffocation due to being left inside a closed vehicle on a sunny day. Various vehicle manufacturers have proposed a variety of technologies to locate an unattended child in a vehicle, including pressure sensors, passive infrared motion sensors, temperature sensors, and microwave sensors. However, these methods have not yet reliably located forgotten children in the vehicle. Recently, visual-based methods have taken the attention of manufacturers after the emergence of deep learning technology. However, the existing methods focus only on the forgotten child and neglect a forgotten pet. Furthermore, their systems only detect the presence of a child in the car with or without their parents. Therefore, this research introduces a visual-based framework to reduce hyperthermia deaths in enclosed vehicles. This visual-based system detects objects inside a vehicle; if the child or pet are without an adult, a notification is sent to the parents. First, a dataset is constructed for vehicle interiors containing children, pets, and adults. The proposed dataset is collected from different online sources, considering varying illumination, skin color, pet type, clothes, and car brands for guaranteed model robustness. Second, blurring, sharpening, brightness, contrast, noise, perspective transform, and fog effect augmentation algorithms are applied to these images to increase the training data. The augmented images are annotated with three classes: child, pet, and adult. This research concentrates on fine-tuning different state-of-the-art real-time detection models to detect objects inside the vehicle: NanoDet, YOLOv6_1, YOLOv6_3, and YOLO7. The simulation results demonstrate that YOLOv6_1 presents significant values with 96% recall, 95% precision, and 95% F1.
Journal Article
Effects of North Carolina's mandatory safety belt law on children
OBJECTIVES: To assess the effect of the North Carolina law mandating that all front seat passengers use a safety belt on children 4 through 15 years of age. METHODS: North Carolina collision reports, completed by local police or the state highway patrol for crashes with greater than $500 worth of damage, were analyzed using time series analysis on the monthly percentage of deaths and serious injuries between January of 1980 and February of 1994. RESULTS: Following the 1985 implementation of the law, children 4 to 15 years of age experienced a 42% decline in deaths and serious injuries. CONCLUSIONS: The mandatory safety belt law in North Carolina has been associated with a decline in deaths and serious injuries. Additional research in needed to assess the seat belt behaviors of this age group as well as the specific effects of seat belt use using outcome measures more precise than those available in police crash reports.
Journal Article
Neurodisability among Children at the Nexus of the Child Welfare and Youth Justice System
Although neurodisability features significantly across child welfare and youth justice cohorts, little research investigates neurodisability among crossover children with dual systems involvement. This study examined differences in childhood adversity, child protection involvement, and offending among crossover children by neurodisability status. Data were from a sample of 300 children (68% male, 31% female, 1% transgender; mean age = 16.2 years, range 10–21) who were charged and appeared in three Australian children’s courts, and who also had statutory child protection involvement in the study jurisdiction. The results indicated that nearly one-half of crossover children had a neurodisability (48%) and this group experienced greater cumulative maltreatment and adversity, earlier out-of-home care entry and offending onset, more caregiver relinquishment and residential care placement, and a greater volume of charges. While substantial differences between specific neurodisabilities were evident, crossover children with any neurodisability had greater odds of having charges related to criminal damage and motor vehicle theft, however they were no more likely to have violent charges relative to other crossover children. The study’s findings demonstrated that the prevalence of neurodisability, and child welfare system responses to this phenomenon, contributes to several offending-related trends observed among crossover children.
Journal Article
Children with an Autism Spectrum Disorder and Their Caregivers: Capturing Health-Related and Care-Related Quality of Life
This study investigated health-related QoL (HRQoL) and care-related quality of life (CarerQol) in clinically referred children with an autism spectrum disorder (ASD), and their primary and secondary caregivers. The EuroQol five-dimensional (EQ-5D) and the CarerQol questionnaires were used to respectively measure health-related QoL and care-related QoL. Primary caregivers reported pain/discomfort (42%) and anxiety/depression (40%). In caring, they mostly experienced problems in the relationship with the child (84%), and in combining care with daily activities (51%). Children with ASD had a relevantly lower QoL. Despite negative effects, almost all caregivers (96%) derived fulfillment from caring for their affected children. HRQoL and CarerQol reports of primary caregivers and children were correlated, both providing useful information to ASD measurement and treatment.
Journal Article
Comparative analysis of child injuries in passenger vehicles and school buses: a multicentre cross-sectional study
ObjectiveThis study investigated the differences in injury profiles and safety device effectiveness among children with road traffic injuries (RTIs) involving passenger vehicles and school buses.MethodsUsing data from the Emergency Department-based Injury In-depth Surveillance database, this multicentre cross-sectional study investigated the injury profiles of 14 669 children aged 12 years old and younger who experienced RTIs from 2011–2021. Demographic factors, injury distribution, severity and effect of safety device use between RITs involving passenger vehicles and school buses were compared.ResultsRTIs in children most frequently occurred between 12:00 and 18:00 hours (46.9%). School bus-related RTIs peaked during school commute hours, that is, from 06:00 to 12:00 hours, and were associated with a higher prevalence of head (63.1% vs 58.9%, p<0.05) and extremity injuries (upper extremity: 8.0% vs 6.4% and lower extremity: 11.1% vs 7.6 %, p<0.05) compared with those involving passenger vehicles. However, passenger vehicle crashes showed higher proportions of neck and chest injuries, along with injuries requiring hospitalisation and intensive care. Safety devices exhibited preventive effects against head and lower extremity injuries in both vehicle types. While safety devices showed effective in reducing hospital admissions and severe injuries in passenger vehicles, their effectiveness in school buses was not observed.ConclusionThis study highlights the different epidemiology and injury profiles of RTIs among children involving passenger vehicles and school buses. Improved safety devices, particularly in school buses, are necessary to ensure the comprehensive protection of child passengers and reduce the risk of severe injuries during road traffic incidents.
Journal Article
State-of-the-art review: preventing child and youth pedestrian motor vehicle collisions: critical issues and future directions
AimTo undertake a comprehensive review of the best available evidence related to risk factors for child pedestrian motor vehicle collision (PMVC), as well as identification of established and emerging prevention strategies.MethodsArticles on risk factors were identified through a search of English language publications listed in Medline, Embase, Transport, SafetyLit, Web of Science, CINHAL, Scopus and PsycINFO within the last 30 years (~1989 onwards).ResultsThis state-of-the-art review uses the road safety Safe System approach as a new lens to examine three risk factor domains affecting child pedestrian safety (built environment, drivers and vehicles) and four cross-cutting critical issues (reliable collision and exposure data, evaluation of interventions, evidence-based policy and intersectoral collaboration).ConclusionsResearch conducted over the past 30 years has reported extensively on child PMVC risk factors. The challenge facing us now is how to move these findings into action and intervene to reduce the child PMVC injury and fatality rates worldwide.
Journal Article
Evaluation of a distribution, education and awareness intervention for child passenger safety in Lebanon: a low-income and middle-income country setting
BackgroundThe Eastern Mediterranean Region suffers disproportionately from paediatric traffic-related injuries. Despite governmental laws, Lebanon—an eastern Mediterranean country—has low child restraint (CR) use prevalence. This study examined the impact of using car seat distribution, and child passenger safety education and awareness intervention to improve child passenger safety knowledge and practices among caregivers.MethodsThis study recruited Lebanese caregivers with one child or more, using a 4-wheel motor vehicle, and not using a car seat. The intervention comprised an educational session followed by a car seat or booster seat distribution and installation check by a certified child passenger safety technician. A baseline assessment questionnaire was used to identify reasons for prior CR non-use. A child passenger safety knowledge test was administered before, immediately after and 3 months postintervention to assess child passenger safety knowledge retention and compare it to the baseline using the conditional logit model for pre–post interventions.ResultsFifty-eight participants underwent the intervention. Affordability was identified as the primary reason for car seat non-use. Three months after the intervention, compliance with CRs use was reported at 100%, and correct responses on the knowledge test significantly increased (p<0.05) for all items except for harness tightness (p=0.673).ConclusionOur child passenger safety intervention resulted in improved knowledge and increased self-reported use of CRs in a caregivers’ cohort in Lebanon. Further efforts should address sociocultural and economic barriers and the lack of local child passenger safety technicians to mitigate the region’s paediatric road traffic injury and death toll.
Journal Article
Crossing Lines — A Change in the Leading Cause of Death among U.S. Children
For more than 60 years, motor vehicle crashes were the leading cause of injury-related death among young people. Beginning in 2017, however, firearm-related injuries took their place to become the most common cause of death from injury.
Journal Article