BACKGROUND: Difficulty awakening is a common concern among adolescents and contributes to school absenteeism. Although cross-sectional studies suggest that commuting times, internet usage, and sleep disturbances are associated with school attendance problems, few have specifically focused on adolescents. We aimed to examine the factors contributing to school absenteeism due to difficulty awakening in Japanese high school students. METHODS: In this longitudinal cohort study, data were prospectively collected between 2016 and 2018 from 54 high schools in a prefecture of Western Japan. Tenth-grade students (n = 6,121) without tardiness (n = 5,812) or absences (n = 5,946) at baseline were recruited. The outcome of interest was school absenteeism due to difficulty awakening, which included both tardiness and absences (≥2 days/month). Cox proportional hazards models were used to assess the associations between commuting time and lifestyle factors after adjusting for confounders. RESULTS: The incidence rates of tardiness and absences due to difficulty awakening were 19.3 and 9.6 per 1,000 person-years, respectively. Common risk factors for absenteeism included prolonged internet usage (≥5 h) and dissatisfaction with school. Protective factors for school tardiness included study time and participation in extracurricular sports activities (both ≥2 h). Long commuting time (≥1 h) was associated with a higher risk of school absences. CONCLUSIONS Long commuting times, prolonged internet usage, and poor school satisfaction increased the risk of school absenteeism due to difficulty awakening. Promoting academic engagement and extracurricular activities may help reduce absenteeism. Interventions that increase school satisfaction, such as providing learning opportunities outside of school, supporting extracurricular activities, and improving the school environment, may be effective prevention strategies.
Humans ; Absenteeism ; Japan/epidemiology* ; Adolescent ; Male ; Female ; Prospective Studies ; Schools/statistics & numerical data* ; Students/psychology* ; Longitudinal Studies ; Risk Factors ; Transportation/statistics & numerical data* ; East Asian People

BACKGROUND: Helmet use reduces the risk and severity of head injury and death due to road traffic crash among motorcyclists. The protective efficacy of different types of helmets varies. Wearing firmly fastened full-face helmet termed as effective helmet use provides greatest protection. This study estimates the prevalence and factors associated with effective helmet use among motorcyclists in Mysuru, a tier II city in Southern India. METHODS: Cross-sectional road side observational study of 3499 motorcyclists (2134 motorcycle riders and 1365 pillion riders) at four traffic intersections was done followed by interview of random sample of 129 of the above riders. Effective helmet use proportion and effective helmet use per 100 person-minute of observation was calculated. Multivariate logistic regression analysis was done to identify factors associated with effective helmet use. RESULTS: Prevalence of effective helmet use was 28 per 100 riders and 19.5 per 100 person-minute of observation in traffic intersections. Prevalence rates of effective helmet use was higher among riders (34.5% vs pillion riders 18.1%), female riders (51.3% vs male riders 26.8%), and male pillion riders (30.5% vs female pillion riders 13.7%). Riders commuting for work and school and those ever stopped by the police in the past 3 months had significantly higher odds of effective helmet use. CONCLUSION Despite helmet use being compulsory by law for motorcyclists, the effective helmet use was low in Mysore. Strict enforcement and frequent checks by the police are necessary to increase the effective helmet use.
Adult ; Cities ; Craniocerebral Trauma ; prevention & control ; Cross-Sectional Studies ; Female ; Head Protective Devices ; statistics & numerical data ; Humans ; India ; Male ; Middle Aged ; Motorcycles ; statistics & numerical data ; Transportation ; Young Adult

PURPOSE: Injury continues to be an important cause of morbidity and mortality in both developed and developing countries. Globally, it is responsible for approximately 5.8 million deaths per year and 91% of these deaths occur in developing countries. Road traffic collision, suicides and homicides are the leading cause of traumatic deaths. Despite the fact that traumatic chest injury is being responsible for 10% of all trauma-related hospital admissions and 25% of trauma-related deaths across the world including in Ethiopia, only few published studies showed the burden of traumatic chest injury in Ethiopia. So, this study aims at assessing the characteristics and outcome of traumatic chest injury patients visited Tikur Anbesa Specialized Hospital (TASH) over one year period. METHODS: A single center based retrospective study was done. We collected data from patients' records to assess characteristics and outcome of traumatic chest injury at TASH over one year period. All patients diagnosed with traumatic chest injury and received treatment at the hospital from January 1 to December 31, 2016 regardless of its types and severity levels were included in the study. Patients with incomplete medical records for at least 20% of the study variables and without detailed medical history, or patients died before receiving any health care were excluded from the study. The collected data were cleaned and entered into Epidata version 3.1 and exported to SPSS Version 21.0 for analysis. Bivariate and multivariate logistic regression models were used to examine factors associated with outcome of traumatic chest injury patients. RESULTS: A total of 192 chest injury patients were included in the study and about one-fourth of chest injury victims were died during treatment period in TASH. Road traffic collision (RTC) was the leading cause of morbidity and mortality among traumatic chest injury victims. Age of the victims (adjusted odds ratio (AOR) 8.9, 95% confidence interval (CI) 1.51-53.24), time elapsed between the occurrence of traumatic chest injury and admission to health care facilities (AOR 4.6, 95% CI 1.19-18.00), length of stay in hospital (AOR 0.12, 95% CI 0.02-0.58), presence of multiple extra-thoracic injury (AOR 25, 95% CI 4.18-150.02) and development of complications (AOR 23, 95% CI 10-550) were factors associated with death among traumatic chest injury patients in this study. CONCLUSION RTC contributed for a considerable number of traumatic chest injuries in this study. Old age, delay in delivering the victim to health care facilities, length of stay in hospital, and development of atelectasis and pneumonia were associated with death among traumatic chest injury patients. Road safety interventions, establishment of organized pre-hospital services, and early recognition and prompt management of traumatic chest injury related complications are urgently needed to overcome the underlying problems in the study setting.
Accidents, Traffic ; prevention & control ; Adult ; Age Factors ; Ethiopia ; epidemiology ; Female ; Hospitals, Special ; statistics & numerical data ; Humans ; Length of Stay ; Male ; Middle Aged ; Pneumonia ; etiology ; mortality ; Pulmonary Atelectasis ; etiology ; mortality ; Retrospective Studies ; Thoracic Injuries ; complications ; epidemiology ; mortality ; Time Factors ; Transportation of Patients

PURPOSE: By studying the economic data related to road traffic accidents in recent 10 years, this paper explores the impact of various economic factors on the number of casualties in traffic accidents in China, and puts forward related prevention and management measures. METHODS: Based on five economic factors including the number of new health institutions, health investment, transportation investment and disposable income per capita, this paper collects the data of traffic accidents in 31 provinces and municipalities of China from 2004 to 2016 and estimates the parameters using fixed effect model. RESULTS: The number of health institutions, health investment, transportation investment and disposable income per capita are negatively correlated with the number of traffic accident casualties; the number of new health institutions is positively correlated with the number of traffic accident casualties; health investment and transportation investment have a great impact on the number of road traffic accident casualties. CONCLUSION Economic development has a positive impact on improving traffic conditions, but the increase in the number of new health institutions does not reduce the number of casualties in accidents. The irrational layout of health institutions and imperfect road traffic management mechanism should be taken into account.
Accidents, Traffic ; mortality ; prevention & control ; statistics & numerical data ; China ; epidemiology ; Economics ; Health ; economics ; Health Facilities ; statistics & numerical data ; Humans ; Income ; Time Factors ; Transportation ; economics ; Wounds and Injuries ; epidemiology

OBJECTIVETo understand the epidemiological characteristics of head injuries in children.

METHODSData was derived from the Chinese National Injury Surveillance System (NISS) in 2014. Method on descriptive analysis was applied to depict general information, injuries events and clinical characteristics of head injuries among children under 18 years of age.

RESULTSA total number of 47 690 cases with child head injuries in 2014 were collected, including 32 542 males and 15 148 females. 43.47% of them were under 1-4 years of age. In October, 06:00 PM appeared the peak time for the injuries to happen. The three leading causes responsible for child head injuries were falls (69.57%), hit by blunt force (14.23%) or road traffic (11.01%). Main locations responsible for the head injuries to happen were:at home (44.98%), at public places (19.65%) or on roads/streets (15.81%). Recreation activates (77.88%), driving (7.32%), sports (5.72%) were the three major activities causing the injuries to take place. Majority of the cases happened unintentionally (95.35%), with bruise (71.69%) or mild injuries (85.27%) and went back home after treatment (90.25%).

CONCLUSIONSIn 2014, child head injuries were seen more in males than in females and mostly occured at home. The leading causes for head injuries would include falls, hit by blunt stuff or road traffic .

Accidental Falls ; statistics & numerical data ; Accidents, Traffic ; statistics & numerical data ; Asian Continental Ancestry Group ; statistics & numerical data ; Automobile Driving ; Child ; China ; epidemiology ; Craniocerebral Trauma ; epidemiology ; Environment ; Female ; Humans ; Male ; Population Surveillance ; Recreation ; Sports ; Transportation ; Wounds and Injuries ; epidemiology

OBJECTIVE: To explore the experiences of athletes with spinal cord injury (SCI) in Korea with respect to dilemmas of participating in sports with regards to the facilitators and barriers, using the International Classification of Functioning, Disability and Health (ICF). METHODS: The facilitators and barriers to sports participation of individuals with SCI were examined using 112 ICF categories. A questionnaire in dichotomous scale was answered, which covered the subjects 'Body functions', 'Body structures', 'Activity and participation' and 'Environmental factors'. Data analysis included the use of descriptive statistics to examine the frequency and magnitude of reported issues. RESULTS: Sixty-two community-dwelling participants were recruited. Frequently addressed barriers in 'Body functions' were mobility related problems such as muscle and joint problems, bladder and bowel functions, pressure ulcers, and pain. In 'Activity and participation', most frequently reported were mobility and self-care problems. Highly addressed barriers in 'Environmental factors' were sports facilities, financial cost, transportation problems and lack of information. Relationships such as peer, family and friends were the most important facilitators. CONCLUSION: Numerous barriers still exist for SCI survivors to participate in sports, especially in the area of health care needs and environmental factors. Our results support the need for a multidisciplinary approach to promote sports participation.
Athletes* ; Consumer Participation ; Delivery of Health Care ; Friends ; Humans ; International Classification of Functioning, Disability and Health ; Joints ; Korea ; Pressure Ulcer ; Self Care ; Spinal Cord Injuries* ; Spinal Cord* ; Sports* ; Statistics as Topic ; Survivors ; Transportation ; Urinary Bladder

OBJECTIVES: The purpose of this study was to assess the ability of ProTaper Gold (PTG, Dentsply Maillefer) in maintaining the original profile of root canal anatomy. For that, ProTaper Universal (PTU, Dentsply Maillefer) was used as reference techniques for comparison. MATERIALS AND METHODS: Twenty simulated curved canals manufactured in clear resin blocks were randomly assigned to 2 groups (n = 10) according to the system used for canal instrumentation: PTU and PTG groups, upto F2 files (25/0.08). Color stereomicroscopic images from each block were taken exactly at the same position before and after instrumentation. All image processing and data analysis were performed with an open source program (FIJI). Evaluation of canal transportation was obtained for two independent canal regions: straight and curved levels. Student's t test was used with a cut-off for significance set at alpha = 5%. RESULTS: Instrumentation systems significantly influenced canal transportation (p < 0.0001). A significant interaction between instrumentation system and root canal level (p < 0.0001) was found. PTU and PTG systems produced similar canal transportation at the straight part, while PTG system resulted in lower canal transportation than PTU system at the curved part. Canal transportation was higher at the curved canal portion (p < 0.0001). CONCLUSIONS: PTG system produced overall less canal transportation in the curved portion when compared to PTU system.
Dental Pulp Cavity ; Statistics as Topic ; Transportation*

OBJECTIVES: The purpose of this study was to assess the ability of ProTaper Gold (PTG, Dentsply Maillefer) in maintaining the original profile of root canal anatomy. For that, ProTaper Universal (PTU, Dentsply Maillefer) was used as reference techniques for comparison. MATERIALS AND METHODS: Twenty simulated curved canals manufactured in clear resin blocks were randomly assigned to 2 groups (n = 10) according to the system used for canal instrumentation: PTU and PTG groups, upto F2 files (25/0.08). Color stereomicroscopic images from each block were taken exactly at the same position before and after instrumentation. All image processing and data analysis were performed with an open source program (FIJI). Evaluation of canal transportation was obtained for two independent canal regions: straight and curved levels. Student's t test was used with a cut-off for significance set at alpha = 5%. RESULTS: Instrumentation systems significantly influenced canal transportation (p < 0.0001). A significant interaction between instrumentation system and root canal level (p < 0.0001) was found. PTU and PTG systems produced similar canal transportation at the straight part, while PTG system resulted in lower canal transportation than PTU system at the curved part. Canal transportation was higher at the curved canal portion (p < 0.0001). CONCLUSIONS: PTG system produced overall less canal transportation in the curved portion when compared to PTU system.
Dental Pulp Cavity ; Statistics as Topic ; Transportation*

BACKGROUNDEmergency medical service plays a key role in the early recognition and treatment of ST-elevation myocardial infarction (STEMI), but studies indicate that the patients experiencing STEMI symptoms often fail to call an ambulance as recommended. This study aimed to examine the current ambulance transport frequency and ascertain predictors and reasons for not choosing ambulance transportation by the patients with STEMI in Beijing.

METHODSA prospective, cross-sectional survey was conducted from January 1, 2006 through until June 30, 2007 in two tertiary hospitals in Beijing and included consecutive patients with STEMI admitted within 24 hours of onset of symptoms. Data were collected by structured interviews and medical records review.

RESULTSOf the 572 patients, only 172 (30.1%) used an ambulance, and the remaining 400 (69.9%) presented by self-transport. Multivariate analysis showed that age <65 years (OR: 1.220; 95% CI: 1.001-2.043), lower education level (OR: 1.582; 95% CI: 1.003-2.512), presence of pre-infarction angina (OR: 1.595; 95% CI: 1.086-2.347), and attribution of symptoms to non-cardiac origin (OR: 1.519; 95% CI: 1.011-2.284) were independent predictors for not using an ambulance. However, history of coronary artery disease (CAD), dyspnea, perceiving symptoms to be serious, and knowing the meaning of cardiopulmonary resuscitation appeared to be independent predictors of ambulance use. The main reasons for not using an ambulance were convenience and quickness of self-transport and the decreased severity of symptoms.

CONCLUSIONSA large proportion of patients in Beijing do not call for an ambulance after onset of STEMI symptoms. Several factors including demographics, previous CAD, symptoms and cognitive factors of patients are associated with the ambulance use. The public should be educated that an ambulance is not merely a transportation modality and that it also provides rapid diagnosis and treatment.

Aged ; Ambulances ; utilization ; China ; epidemiology ; Cross-Sectional Studies ; Female ; Humans ; Male ; Middle Aged ; Myocardial Infarction ; mortality ; pathology ; psychology ; Needs Assessment ; Patient Acceptance of Health Care ; psychology ; statistics & numerical data ; Prospective Studies ; Regression Analysis ; Transportation of Patients

Adolescent ; Adult ; Aged ; Aged, 80 and over ; Disasters ; Earthquakes ; statistics & numerical data ; Female ; Humans ; Male ; Middle Aged ; Transportation of Patients ; Wounds and Injuries ; complications ; surgery ; therapy