Accidents in Childhood: A Report on 17,141 Accidents

The causes of injury to 17,141 children brought to the emergency department of a large pediatric hospital in one year were studied. The leading causes of injury were: falls, 5682; cuts or piercings, 1902; poisonings, 1597; and transportation accidents, 1368. Included in these are 587 falls on or down stairs, 401 cuts due to glass, 630 poisonings from household or workshop substances, 510 poisonings from salicylate tablets, and 449 accidents involving bicycles or tricycles. Other findings included 333 injuries to fingers or hands in doors, usually car doors; 122 instances of pulled arms; 384 ingestions and 53 inhalations of foreign bodies; 60 alleged sexual assaults, 58 chemical burns, 127 wringer injuries, and four attempted suicides. A rewarding opportunity in accident prevention exists for hospitals that undertake to compile and distribute pertinent source data.     

The role of human and mosquito behaviour in the efficacy of a house-based intervention

Housing improvement such as blocking eaves and screening windows can help in reducing exposure to indoor biting mosquitoes. The impacts of physical barriers could potentially be boosted by the addition of a mechanism that kills mosquitoes as they attempt to enter the house. One example is to combine household screening with EaveTubes, which are insecticide-treated tubes inserted into closed eaves that attract and kill host-searching mosquitoes. The epidemiological impact of screening + EaveTubes is being evaluated in a large cluster randomized trial in Cote d''Ivoire. The study presented here is designed as a complement to this trial to help better understand the functional roles of screening and EaveTubes. We began by evaluating householder behaviour and household condition in the study villages. This work revealed that doors (and to some extent windows) were left open for large parts of the evening and morning, and that even houses modified to make them more ‘mosquito proof’ often had possible entry points for mosquitoes. We next built two realistic experimental houses in a village to enable us to explore how these aspects of behaviour and household quality affected the impact of screening and EaveTubes. We found that screening could have a substantial impact on indoor mosquito densities, even with realistic household condition and behaviour. By contrast, EaveTubes had no significant impact on indoor mosquito density, either as a stand-alone intervention or in combination with screening. However, there was evidence that mosquitoes recruited to the EaveTubes, and the resulting mortality could create a community benefit. These complementary modes of action of screening and EaveTubes support the rationale of combining the technologies to create a ‘Lethal House Lure’.This article is part of the theme issue ‘Novel control strategies for mosquito-borne diseases’.     

Screening Mosquito House Entry Points as a Potential Method for Integrated Control of Endophagic Filariasis,Arbovirus and Malaria Vectors

Background

Partial mosquito-proofing of houses with screens and ceilings has the potential to reduce indoor densities of malaria mosquitoes. We wish to measure whether it will also reduce indoor densities of vectors of neglected tropical diseases.

Methodology

The main house entry points preferred by anopheline and culicine vectors were determined through controlled experiments using specially designed experimental huts and village houses in Lupiro village, southern Tanzania. The benefit of screening different entry points (eaves, windows and doors) using PVC-coated fibre glass netting material in terms of reduced indoor densities of mosquitoes was evaluated compared to the control.

Findings

23,027 mosquitoes were caught with CDC light traps; 77.9% (17,929) were Anopheles gambiae sensu lato, of which 66.2% were An. arabiensis and 33.8% An. gambiae sensu stricto. The remainder comprised 0.2% (50) An. funestus, 10.2% (2359) Culex spp. and 11.6% (2664) Mansonia spp. Screening eaves reduced densities of Anopheles gambiae s. l. (Relative ratio (RR)  = 0.91; 95% CI = 0.84, 0.98; P = 0.01); Mansonia africana (RR = 0.43; 95% CI = 0.26, 0.76; P<0.001) and Mansonia uniformis (RR = 0.37; 95% CI = 0.25, 0.56; P<0.001) but not Culex quinquefasciatus, Cx. univittatus or Cx. theileri. Numbers of these species were reduced by screening windows and doors but this was not significant.

Significance

This study confirms that across Africa, screening eaves protects households against important mosquito vectors of filariasis, Rift Valley Fever and O''Nyong nyong as well as malaria. While full house screening is required to exclude Culex species mosquitoes, screening of eaves alone or fitting ceilings has considerable potential for integrated control of other vectors of filariasis, arbovirus and malaria.     

Stabling and the protection of horses from Culicoides bolitinos (Diptera: Ceratopogonidae), a recently identified vector of African horse sickness

The stabling of horses at night reportedly offers protection from African horse sickness and the most significant vector of the disease, Culicoides imicola Kieffer, has been shown to be exophilic. In certain high-lying regions of South Africa, however, C. bolitinos Meiswinkel, may be the major vector of the disease but its entry behaviour into stables is unknown. Accordingly, in the eastern Free State province of South Africa, light trap catches of C. bolitinos inside stables and outside, were compared. Two horse-baited stables, one traditional, and one modern, were used and combinations of stable (old/new), ceiling fans (on/off) and accessibility to Culicoides (stable doors open/closed or windows gauzed/ungauzed) were investigated as treatments. A total of 111,452 Culicoides of 26 species was collected on 60 trap nights; C. bolitinos was dominant (89.1% overall) with C. imicola second in abundance (2.9%). Outside catches were greater on warmer, drier, evenings but were suppressed by high wind speeds. Catches of C. imicola inside stables with doors open, or with windows ungauzed, were less than the numbers captured outside. In contrast, more C. bolitinos were caught in open stables than outside, i.e. open structures may protect horses from the exophilic C. imicola, but may increase attack rates from the endophilic C. bolitinos. The closing of doors and the gauzing of windows, however, led to a 14-fold reduction in numbers of C. bolitinos and C. imicola entering stables. A well-gauzed 'traditional' stable was as effective as a closed 'modern' stable. Ceiling fans had no suppressant effect.     

Impact injuries and probability of survival in a large semiurban endemic pigeon in New Zealand, Hemiphaga novaeseelandiae

The New Zealand Pigeon or kereru (Hemiphaga novaeseelandiae) frequently collides with windows and vehicles. In this study of 146 kereru collected from 1996 to 2009, we used 118 radiographs and 91 necropsies to determine skeletal and soft tissue injuries. Vehicle collisions resulted in more damage to the extremities (wing and femur), whereas collisions with windows resulted in trauma to the head, fractures/dislocations of the coracoids and clavicles, and ruptured internal organs. Soft tissue injuries included damage to the flight muscles and heart ruptures caused by fractured coracoid bones, as well as extensive bruising of pectoral muscles and hemorrhaging of the lungs. Rehabilitation time was not related to number of skeletal injuries sustained, nor was the time until death for those that did not survive. In general, kereru with greater numbers of injuries were less likely to survive rehabilitation. Flight speed and force calculations suggest that a 570-g kereru would collide with 3-70 times the force of smaller birds (5-180 g); this may explain the discrepancies between the injuries characterized here and those reported for North American passerines. The differences in injuries sustained from collisions with windows and cars can be used to inform rehabilitators about the possible nature of injuries if the source of impact is known.     

Fungal biodeterioration of stained-glass windows

Biodeterioration of stained-glass windows by fungi was studied using historically accurate glass production methods. Glass reproductions were made according to the chemical composition determined by micro energy dispersive X-Ray Fluorescence of two historical glass windows belonging to King Ferdinand II's collection dating from the 15th and 17th centuries. Three distinct glasses compositions with different colours were selected and reproduced: i) a mixed-alkali colourless glass: ii) a purple potash-glass with manganese as chromophore, and iii) a brown potash-glass coloured by iron ions. The reproduced glass samples, with two initial surface morphologies (corroded and non-corroded), were inoculated with fungi previously isolated and identified on the original stained-glass windows as species of the genera Penicillium and Cladosporium. Physical and chemical glass surface alterations were analysed by means of optical microscopy, Raman microscopy, micro Infrared spectroscopy, and scanning electron microscopy with energy dispersive spectroscopy analysis. Results showed that fungi produced clear damage on all glass surfaces, present as spots and stains, fingerprints, biopiting, leaching and deposition of elements, and formation of biogenic crystals. Therefore, the inoculated fungi were able to biodeteriorate glasses with distinct compositions. Regarding the biodeterioration degree, there were no differences between the initial non-corroded and corroded glass surfaces.     

Studies on the behaviour and control of phlebotomine sandflies using experimental houses

Programmes for the control of phlebotomine sandflies (Diptera: Psychodidae), the vectors of leishmaniases, mainly target adults because larval breeding sites are generally unknown or inaccessible. To determine how blood‐questing sandfly females enter homes and to develop means for their control, an experimental house (EH) was constructed in a village endemic for cutaneous leishmaniasis. Initially, carbon dioxide (CO₂)‐baited suction traps were installed inside the EH to attract and capture sandflies. For other experiments, the windows of the EH were fitted with CO₂‐baited window entrance traps (WETs) that allow each window to be considered as a separate unit. The majority of captures inside the EH and in WETs consisted of Phlebotomus sergenti, a species that enters inhabited houses relatively infrequently. Analyses of collections in WETs and in sticky traps on external walls showed that sandflies entered windows having landed previously on the wall below or either side of the window. Shelves constructed below windows significantly reduced the numbers of sandflies that entered both the EH and inhabited houses. The lining of internal walls with insecticide‐impregnated fabric significantly increased mortality rates of sandflies captured inside the EH. To reduce the biting burden imposed by phlebotomine sandflies, several control measures must be integrated and sustained.     

Raised houses reduce mosquito bites

BACKGROUND: In many parts of continental Africa house construction does not appear to impede entry of malaria vectors and, given their generally late biting cycle, the great majority of transmission takes place indoors. In contrast, many houses in S?o Tomé, 140 km off the coast of Gabon, are raised on stilts and built of wooden planks. Building on stilts is a time-honoured, but largely untested, way of avoiding mosquito bites. Exposure may also be affected by mosquito activity times and age composition of host-seeking females. A study was therefore undertaken on the island of S?o Tomé to determine if exposure to Anopheles gambiae, the only vector on the island, varied with house construction or time of the night. METHODS: A series of all-night landing collections were undertaken out of doors at ground level, inside houses at ground level, on the verandas of, and inside houses built on stilts. The gonotrophic age of an unselected sample of insects from the first three hours of landing collection (18:00-21:00) was determined by dissection. In addition, 1,149 miniature light-trap collections were obtained from 125 houses in the study area. Numbers collected were related to house construction. RESULTS: Biting of An. gambiae took place primarily outside at ground level. Less than one third of biting occurred inside houses. Houses built on stilts had half the number of An. gambiae in them compared to those built at ground level. Conversely houses with an eaves gap had more An. gambiae in them than houses without such a gap. Gonotrophic age did not affect house entry rates in An. gambiae. House construction affected Culex quinquefasciatus less than An. gambiae. Mean density per house, derived from a series of 1,490 randomly assigned light-trap collections, was over-dispersed with 18% of houses having 70% of the vectors. CONCLUSION: House construction plays an important role in determining exposure to malaria vectors in S?o Tomé. Neighbours can have very different exposure levels. Recommendations for improvement in control are given.     

Composition,Production and Procurement of Glass at San Vincenzo al Volturno: An Early Medieval Monastic Complex in Southern Italy

136 glasses from the ninth-century monastery of San Vincenzo and its workshops have been analysed by electron microprobe in order to situate the assemblage within the first millennium CE glass making tradition. The majority of the glass compositions can be paralleled by Roman glass from the first to third centuries, with very few samples consistent with later compositional groups. Colours for trailed decoration on vessels, for vessel bodies and for sheet glass for windows were largely produced by melting the glass tesserae from old Roman mosaics. Some weakly-coloured transparent glass was obtained by re-melting Roman window glass, while some was produced by melting and mixing of tesserae, excluding the strongly coloured cobalt blues. Our data suggest that to feed the needs of the glass workshop, the bulk of the glass was removed as tesserae and windows from a large Roman building. This is consistent with a historical account according to which the granite columns of the monastic church were spolia from a Roman temple in the region. The purported shortage of natron from Egypt does not appear to explain the dependency of San Vincenzo on old Roman glass. Rather, the absence of contemporary primary glass may reflect the downturn in long-distance trade in the later first millennium C.E., and the role of patronage in the “ritual economy” founded upon donations and gift-giving of the time.     

Recommendations for building out mosquito-transmitted diseases in sub-Saharan Africa: the DELIVER mnemonic

In sub-Saharan Africa, most transmission of mosquito-transmitted diseases, such as malaria or dengue, occurs within or around houses. Preventing mosquito house entry and reducing mosquito production around the home would help reduce the transmission of these diseases. Based on recent research, we make key recommendations for reducing the threat of mosquito-transmitted diseases through changes to the built environment. The mnemonic, DELIVER, recommends the following best practices: (i) Doors should be screened, self-closing and without surrounding gaps; (ii) Eaves, the space between the wall and roof, should be closed or screened; (iii) houses should be Lifted above the ground; (iv) Insecticide-treated nets should be used when sleeping in houses at night; (v) houses should be Ventilated, with at least two large-screened windows to facilitate airflow; (vi) Environmental management should be conducted regularly inside and around the home; and (vii) Roofs should be solid, rather than thatch. DELIVER is a package of interventions to be used in combination for maximum impact. Simple changes to the built environment will reduce exposure to mosquito-transmitted diseases and help keep regions free from these diseases after elimination.This article is part of the theme issue ‘Novel control strategies for mosquito-borne diseases''.     

鸟撞建筑现象概述及系统性调查案例分析

随着城市化进程的推进, 各类人造设施, 尤其是建筑物及建筑物上的玻璃, 已经成为鸟类生存的重要威胁。有些建筑物及其上的玻璃拥有透明和反光的特性, 这样的特性令鸟类无法辨认出玻璃的存在, 导致在飞行途中与玻璃相撞致死, 或致伤、致残。这样的现象被称为鸟撞建筑或鸟撞建筑玻璃, 简称鸟撞。在北美, 针对鸟撞现象的研究较多。在美国, 鸟撞每年造成3-10亿只鸟死亡, 是人类活动直接造成的鸟类死亡中最突出的原因之一。然而, 目前中国对于鸟撞的研究和关注还非常有限。随着中国对城市生态学和城市生物多样性的重视, 鸟撞现象也应进入到生物多样性研究与保护的视野中。为了让该议题被更多人所了解, 本综述总结和介绍了鸟撞现象, 包括影响鸟撞发生的因素、预防鸟撞措施的进展和鸟撞调查的方法概述。此外, 本文以案例形式介绍了国内首个系统性鸟撞建筑的调查, 并阐释了该类调查的可行性与必要性。基于过往研究, 本文最后提出了针对未来鸟撞建筑研究方向的建议: (1)对中国鸟撞建筑现象进行整体评估; (2)建立系统性调查方法和鸟撞数据收集的系统; (3)进一步探究鸟撞机理; (4)促进和改变公众意识、影响城市规划与建筑革新。     

Injuries to Hip Joint in Car Occupants

Four varieties of fracture, of dislocation, or of fracture dislocation of the hip are described that occur in car occupants after road accidents. It is suggested that, whereas most hip injuries to car occupants are produced by application of force to the knee, one important variety (central fracture dislocation) is the result of the direct application of force to the great trochanter. Central fracture dislocations might be prevented, or their severity minimized, by strengthening the sides of cars and of car doors and by improving the energy absorption characteristics of the facia panel.     

Injuries of the spine sustained in rugby.

Between 1952 and 1982, 67 rugby players (63 rugby union, two rugby league, and two American football) sustained serious injuries of their spine. The injuries fell predominantly on the lower cervical spine. Forty eight of the players sustained serious injuries of the spinal cord, leading to paralysis and total incapacity. The incidence of such injuries appears to have increased in recent years, particularly those incurred in tackles and mauls and rucks, and particularly among schoolboys. Changes in the laws of the game and in the attitudes of the players over the past few years should improve play and lead to a lower incidence of injuries.     

Biodeteriorative processes on glass: experimental proof of the role of fungi and cyanobacteria

Biodeterioration of glass under the influence of fungi and cyanobacteria was simulated on model glasses produced according to the old recipes. Strains of fungi and cyanobacteria chosen for the investigation were isolated from biodeteriorated glass windows or similar indoor environment and are reported to be frequently involved in glass alteration. Growth of fungi and cyanobacteria resulted in the dense colonisation of the material with an expressed biofilm formation on the glass surface. The following deterioration phenomena were observed: micropitting and crack formation by all studied fungi and cyanobacteria; delineatingtraces of cells, hyphae and filaments on the glass surface; colour change of the surface due to fungal or cyanobacterial growth; biogenic minerals deposition as a consequence of the microbial metabolism on the glass surface. The pattern of glass biopitting produced in the experiment was very similar to the biopits observed on antique and medieval glasses (Krumbein et al., 1991). Crack formation pattern was strain-specific, but appeared to be independent of the chemical composition of the glass itself. The degree of deterioration was changing according to the sensitivity of the glass in question to corrosion.     

A Neglected Aspect of the Epidemiology of Sleeping Sickness: The Propensity of the Tsetse Fly Vector to Enter Houses

Background

When taking a bloodmeal from humans, tsetse flies can transmit the trypanosomes responsible for sleeping sickness, or human African trypanosomiasis. While it is commonly assumed that humans must enter the normal woodland habitat of the tsetse in order to have much chance of contacting the flies, recent studies suggested that important contact can occur due to tsetse entering buildings. Hence, we need to know more about tsetse in buildings, and to understand why, when and how they enter such places.

Methodology/Principal Findings

Buildings studied were single storied and comprised a large house with a thatched roof and smaller houses with roofs of metal or asbestos. Each building was unoccupied except for the few minutes of its inspection every two hours, so focusing on the responses of tsetse to the house itself, rather than to humans inside. The composition, and physiological condition of catches of tsetse flies, Glossina morsitans morsitans and G. pallidipes, in the houses and the diurnal and seasonal pattern of catches, were intermediate between these aspects of the catches from artificial refuges and a host-like trap. Several times more tsetse were caught in the large house, as against the smaller structures. Doors and windows seemed about equally effective as entry points. Many of the tsetse in houses were old enough to be potential vectors of sleeping sickness, and some of the flies alighted on the humans that inspected the houses.

Conclusion/Significance

Houses are attractive in themselves. Some of the tsetse attracted seem to be in a host-seeking phase of behavior and others appear to be looking for shelter from high temperatures outside. The risk of contracting sleeping sickness in houses varies according to house design.     

Occupational Injury Risk Assessment Using Injury Severity Odds Ratios: Male Falls from Heights in the Danish Construction Industry, 1993-1999

To allow for an improved targeted approach to occupational injury research and prevention, detailed risk analyses of fatal, serious, and minor occupational injuries were completed with a focus on male falls from heights in construction. Reported lost-time injuries in Denmark (1993 to 1999) were analyzed for proportions, relative rates, and an injury severity odds ratio to assess relative hazards and reporting. Different types of injury risks, such as elevation falls through surfaces, were identified by contrasting fatal, serious and minor injuries. Trade-specific analyses provided evidence that the carpentry-trade group merits increased attention, as this group has excessively high proportions, rates and hazards for falls from heights, compared to the entire construction industry. Age-specific analyses of workers aged 20 to 59 revealed that the rates of serious-injury falls from heights increase with increasing age. This relationship was inverted for elevation fall injuries from roof surfaces. A focus on construction and falls from heights is necessary not only in terms of fatal injuries, but also for serious injuries. The use of an injury severity odds ratio to assess relative hazards and reporting is a useful supplement to proportions and injury rates in contributing to more precise targeting of subgroups for primary injury prevention.     

Prospective study of school injuries: incidence,types, related factors and initial management.

The rates of school injuries were examined by means of a prospective study of 212 schools during the 1981-82 school year. The results showed an annual incidence rate of 5.4 injury events/100 children, which appears to be an underestimate of the actual rate. Of all the injury events 28.7% resulted in serious injuries. Injuries were significantly more frequent in the elementary as opposed to the secondary schools, and the boys were injured significantly more often than the girls. Most of the injuries occurred during athletic activities. Most of the children with either serious or minor injuries were sent to the school office or returned to the classroom, which indicates that the present level of first-aid training among school personnel is inadequate.     

Environmental ultrasound in laboratories and animal houses: a possible cause for concern in the welfare and use of laboratory animals

Many laboratory animals are known to be sensitive to sounds (ultrasounds) beyond the nominal upper limit (20 kHz) of the human hearing range. Sources of sound in laboratories and animal houses were examined to determine the extent of ambient ultrasound. Of 39 sources monitored, 24 were found to emit ultrasonic sounds. Many of these (e.g. cage washers and hoses) also produced sound in the audible range. Running taps, squeaky chairs and rotating glass stoppers created particularly high sound pressure levels and contained frequencies to over 100 kHz. The oscilloscopes and visual display units investigated provided particular cause for concern as they emitted sounds that were entirely ultrasonic and therefore were apparently silent. Ambient ultrasound therefore appears to be common in laboratories and animal houses. It is suggested that its effect on laboratory animals should be investigated and guidelines on acceptable levels be formulated.     

Serious head injury in sport.

Of 1900 head injuries serious enough to be admitted to the neurosurgical unit in Glasgow over a five year period, 52 (2.7%) were due to "sport." Golf, horse-riding, and Association football were the sports most commonly linked with serious head injury. Golfing injuries were all compound depressed fractures, and all these patients made a good recovery; horse-riding produced more severe injuries, three of the eight patients being left with residual disability. Much attention has been directed to preventing repeated minor head injury in boxing, but this study emphasises the need for preventing both the primary head injury and secondary complications associated with other sports.