Death from drowning: defining a new challenge for child survival in Bangladesh

The study focuses on children less than 5 years old and explores the epidemiological profile and correlates of drowning as a challenge to child survival in Bangladesh. Two data sources from Bangladesh, a cohort of 8,070 children followed for 2 years in a rural area and a nation-wide survey conducted in 1996–97 have been used. In addition, a systematic review of the literature has been conducted spanning the past two decades for analysis of drowning in children. Seventy drowning deaths were reported in the cohort and 726 deaths were reported in the national survey. Verbal autopsy and semi-structured interviews were conducted on all deaths. Drowning accounted for 43% of deaths in the cohort and 20% of deaths in 1–4-year-old children in the national survey. Most drowning deaths were in 12–23 month old children from falling into ditches and ponds. Communities provided valuable insights on possible interventions to reduce deaths due to drowning. Drowning is a newly recognized challenge for Bangladesh. Considerable research and programmatic work is required to understand the nature of the problem and develop appropriate interventions. This paper calls on aid agencies to create opportunities for drowning research and action in their work plans for the country.     

The roles of child,parent and environmental factors in pedestrian supervision

Pedestrian injuries are a significant health risk to children, particularly those 5–9 years of age. Surprisingly, few studies have explored parent-related factors that may moderate this risk. We examined parental supervision choices in the context of child pedestrian experience, parent perceptual factors and varying levels of environmental risk. A series of street crossing scenarios were used to examine the roles of child, parent and environmental factors in determining parents’ supervision choices. Parents recognised differing levels of risk across environmental conditions and altered their supervision choices accordingly. Child age and parental risk perception were significantly predictive of supervision choices. Our results demonstrate that parents assess multiple factors when determining the intensity of supervision necessary for their children. Notably, parents adjust their supervision in direct relation to changes in the physical environment. Implications of these findings for injury prevention and future research are discussed.     

The roles of child, parent and environmental factors in pedestrian supervision

Pedestrian injuries are a significant health risk to children, particularly those 5-9 years of age. Surprisingly, few studies have explored parent-related factors that may moderate this risk. We examined parental supervision choices in the context of child pedestrian experience, parent perceptual factors and varying levels of environmental risk. A series of street crossing scenarios were used to examine the roles of child, parent and environmental factors in determining parents' supervision choices. Parents recognised differing levels of risk across environmental conditions and altered their supervision choices accordingly. Child age and parental risk perception were significantly predictive of supervision choices. Our results demonstrate that parents assess multiple factors when determining the intensity of supervision necessary for their children. Notably, parents adjust their supervision in direct relation to changes in the physical environment. Implications of these findings for injury prevention and future research are discussed.     

Current activites in the field of child safety within CEN aand ISO

Abstract

Many countries have implemented safety and performance requirements for children's products. There is, however, a need to harmonize existing legislation and standards to facilitate a uniform flow of trade. At the same time, it is essential to extend existing requirements to restrict certain hazards which have not been covered in the past.

In CEN, the European Committee for standardization, several technical committees are developing European Standards for products to be used by or for children. On a global level as well, within ISO, there are standardization projects covering such products.

Child safety is the main objective for the standardization work on:

?Safety of toys (CENATC 52, ISO/TC 181)

? Child use and care articles (CEN/TC 252)

?Playground equipment for children LCEN/TC 136/SC 1)

? Children's furniture (CEN/TC 207, ISO/TC 136(

?Child-resistant packaging (CEN/TC 261/SC 2, ISO/TC 122) Children's products constitute a group of consumer products with large variations between the different products. Nevertheless, since they all come in contact with children (and their parents), several hazards associated with these products are similar for the various products. This is reflected in the work of CEN/TC 252, Child use and care articles, established in 1990.

To establish a horizontal framework for the hazard-based approach, CEN/ TC 252 created a working group with the task to specify general and common safety requirements (WG 6). Five working groups started the elaboration of product standards in parallel.

The traditional concept of a standardization project was found inadequate and other solutions were sought. Finally, it was decided to combine the results from working group 6 into one guidance document, to be published as a CEN Report.     

Social inequalities in injury risk in Wales,U.K.

Road traffic accident data in Nigeria generally lack exact coordinate information. Accident analysis is, therefore, restricted to aggregate data on trends, magnitude and temporal dimensions. This article addresses the road accident problem in Jos between 1995 and 1999 through a road profiling approach. Results show that four gateway routes, seven multilane roadways (including two gateway routes) and seven road intersections accounted for 84% of all traffic accidents, 84% of injured casualties and 88% of fatalities. This approach allows for quantification of impacts of controlling for accidents by deliberate profiling of roads for close monitoring and policing. For example, reducing accident counts and fatalities by 50% each on gateway routes will amount to ～35 and 40% reduction in accident and fatality counts, respectively. Countermeasures must consider these roadways and intersections as important inputs in their accidents and casualty reduction targets.     

A COOL Effect: The Direct and Indirect Impact of Country-of-Origin Disclosures on Purchase Intentions for Retail Food Products

Retailers recently became required to provide specific country-of-origin information for muscle cuts of beef, chicken, pork, lamb, and goat. Drawing from the consumer inference and activation theory literatures, hypotheses are offered regarding how consumers use country-of-origin labeling (COOL) to draw inferences related to specific product attributes and how these inferences, in turn, lead to differences in mediation effects for purchase intentions. Results from a pilot study and two experiments reveal that consumers are more likely to purchase meat when it is identified as a U.S. product. Furthermore, the relative strength of the mediating effects of perceived food safety, taste, and freshness differs as expected. The authors show how the direct and indirect effects of the country-of-origin disclosure are attenuated by the presentation of objective information about the meat processing systems of competing countries. Given the recently mandated COOL disclosures, results have important implications for food retailers, members of the supply chain, and consumers.     

The use of visual warnings in social marketing: The case of tobacco

Despite strong interest on the part of tobacco health practitioners, the effect of graphic warnings inserted on cigarette packs is unclear on several levels. First, the most effective themes for such messages have not been clearly identified by researchers. Second, no research has identified the ideal combination of self-efficacy and fear appeal warnings that should be inserted on cigarette packs, according to Protection Motivation Model principles. The exploratory study we conducted with French consumers to test the effectiveness of new graphic warnings proposed by the European Union in 2004 clearly demonstrates that visual messages, as opposed to text warnings, are more effective. This study also enabled us to identify the most effective themes of the European set: health warnings and social messages. Regarding future public health applications, if fear appeals are used, they need to be combined with self-efficacy and cessation support messages since they provoke avoidance reactions.     

Understanding the negativity effect: The role of processing focus

Numerous studies have demonstrated that negative information has a stronger influence on overall impressions than does positive information of equal intensity. Recent attempts to explain this phenomenon with evolutionary arguments show strong potential for predicting how and when the effect will be manifested. This paper tests information-processing implications of one evolutionary perspective (Peeters and Czapinski, 1990), finding general support. In particular, empirical evidence indicates that processing of negative information is relatively less subjective and more integrative in focus than processing of positive information.     

Microaggression,anxiety, trigger warnings,emotional reasoning,mental filtering,and intellectual homogeneity on campus: A study of what students think

College campus life is changing based on pressures to create safe environments for students to learn. Much of this change has been outlined in an article by Lukianoff and Haidt entitled “The Coddling of the American Mind.” The authors of the present article asked 188 students from two universities if microaggressions, trigger warnings, emotional reasoning, and mental filtering are prevalent on campus and whether colleges are promoting these concepts. The results show that the majority of students believe that universities must change the way these concepts are addressed to prevent intellectual homogeneity and to adequately prepare them for their business professions.     

Keeping our children safe in motor vehicles: knowledge,attitudes and practice among parents in Kuwait regarding child car safety

Child safety restraints can reduce risk of death and decrease injury severity from road traffic crashes; however, knowledge about restraints and their use in Kuwait is limited. A cross-sectional, self-administered survey about child car safety was used among a convenience sample of parents of children aged 18 years or younger at five Kuwaiti university campuses. Of 552 respondents, over 44% have seated a child in the front seat and 41.5% have seated a child in their lap while driving. Few parents are aware of and fewer report using the appropriate child restraint; e.g., 36% of parents of infants recognised an infant seat and 26% reported using one. Over 70% reported wearing seat belts either “all of the time” (33%) or “most of the time” (41%). This new information about parents' knowledge and practice regarding child car seat use in Kuwait can inform interventions to prevent child occupant injury and death.     

The use of seatbelts and child restraints in three Mexican cities

Seatbelts and child restraints can reduce deaths resulting from road traffic crashes, and are one of the risk factors being targeted by the Road Safety in 10 Countries project in Mexico. This study quantifies the prevalence of restraint use in two of the intervention sites (Guadalajara-Zapopan and León) and one comparison site (Cuernavaca). Three rounds of roadside observations were conducted between November 2010 and January 2012. The overall prevalence of seatbelt use was 45.0% (95% CI = 44.3–45.7) amongst all occupants ≥10 years of age in the three cities. Child restraint use in children <5 years of age ranged from 7.9 to 17.4%. Two rounds of surveys were administered to all road traffic injury (RTI) victims presenting at a tertiary hospital in each city; RTI victims had lower seatbelt use than the general population (31% vs 42%, p = 0.037). This study demonstrates the need for further targeted intervention to increase use of these highly efficacious safety devices in Mexico.     

The establishment of injury surveillance in Thailand

The Provincial Injury Surveillance System was initiated in Thailand in 1993 to establish a database for assessment of the quality of acute care and referral services provided to the injured at the provincial level, and to facilitate injury prevention and control at both local and national levels. An injury surveillance system model that adopted a trauma registry as the record form, was established in five selected large hospitals, one from Bangkok and four from major regions of Thailand. Data analysis was undertaken and utilized at both local and national levels. The Epidemiology Division of the Ministry of Public Health supervised and assessed the data quality. Evaluators from the School of Public Health identified problems in operating the system at the provincial level and assessed the feasibility of expanding the project. The data of 66,895 injuries including 1,755 deaths reported in 1995; revealed fundamental problems in the emergency medical services. Causes of major injuries were identified and their epidemiology described. The coverage of reporting was over 90%. The completeness and reliability of recording ranged from 80.6–100%. This model of sentinel surveillance is appropriate for injury problems, which are of large magnitude and are at the early phase of problem solving. Development of the information systems administration and human resource in computer technology are necessary to cope with the problems of increased workload in data collecting and processing. This model of surveillance is feasible for expansion but its data system has to be appropriately integrated into the existing systems of the hospitals.     

Changing production patterns,poverty, and the role of consumer unions: Some conceptual notes with reference to Latin America

The purpose of this paper, first presented in the seminar on poverty of the Thirteenth World Conference of The International Organization of Consumers Unions, is to introduce the work of the Economic Commission for Latin America and the Caribbean containing a proposal for changes in the development strategy of Latin America in the 1990's (ECLAC, 1990a). A centerpiece in this proposal concerns the possibility to combine economic growth with social equity. In the first part of the paper, the main concepts in ECLAC's outline of a new development strategy are presented. The second part focuses specifically on the relationship between growth and poverty reduction. In the last part some ideas are launched to discuss what this might imply for the role of Consumer Unions in the context of development.

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Sich ändernde Produktionsstrukturen, Armut und die Rolle von Verbrauchervereinigungen: einige Überlegungen im Hinblick auf Lateinamerika

Zusammenfassung Ziel des Beitrages, der erstmals anläßlich eines Seminars über Armut der 13. Weltkonferenz der Verbrauchervereinigungen vorgestellt wurde, ist es, über die Arbeit der wirtschaftlichen Kommission der Vereinten Nationen für Lateinamerika und die Karibik und ihre Vorschläge zur Veränderung der Entwicklungsstrategie für diese Region für die 90er Jahre zu informieren. Kernstück dieser Vorschläge ist die Verbindung von ökonomischem Wachstum mit sozialer Gleichheit.Im ersten Abschnitt des Beitrages werden die Hauptkonzepte, die die Kommission bei der Analyse der Gründe für die Entwicklungsprobleme in Lateinamerika verwendet, und die politischen Vorschläge an die Regierungen der Region behandelt. Der zweite Abschnitt untersucht die Beziehung zwischen wirtschaftlichem Wachstum und Armutsbekämpfung und stellt dabei die Fähigkeit des Einzelnen, sozial sinnvoll zu handeln, und deren Förderung in den Vordegrund. Der dritte Abschnitt äußert einige Vorstellungen dazu, welche Rolle den Verbrauchervereinigungen in dieser Entwicklung zukommt.

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Rudolf M. Buitelaar is Economic Affairs Officer at the United Nations Economic Commission for Latin America and the Caribbean, Casilla 179 D, Santiago, Chile.     

The role of customer contact employees as external customers: A conceptual framework for marketing strategy and future research

Existing streams of literature in marketing, management, and organizational behavior are integrated to propose a conceptual framework that highlights the customer contact employee's dual role as employee and external customer of the organization. Several iterative “cycles of success” are proposed whereby job satisfaction, the employee's patronage of the company's products (i.e., goods or services), and job performance (as customer contact employees) are all enhanced, ultimately leading to long-term relationships (with customers and employees) and profits for the organization. The framework highlights the role of internal marketing as a tool for enhancing the competitive advantage gained by strategically considering the customer contact employee's role as external customer.     

The normalization of deviance in healthcare delivery

Many serious medical adversities result from violations of recognized standards of practice. Over time, even egregious violations of standards of practice may become “normalized” in healthcare delivery systems. This article describes what leads to this normalization and explains why flagrant practice deviations can persist for years, despite the importance of the standards at issue. This article also provides recommendations to aid healthcare organizations in identifying and managing unsafe practice deviations before they become normalized and pose genuine risks to patient safety, quality care, and employee morale.     

Driving behaviours,traffic risk and road safety: comparative study between Malaysia and Singapore

The present study aims to investigate differences in road safety attitude, driver behaviour and traffic risk perception between Malaysia and Singapore. A questionnaire-based survey was conducted among a sample of Singaporean (n = 187) and Malaysian (n = 313) road users. The data was analysed using confirmatory factor analysis and structural equation modelling applied to measure comparative fit indices of Malaysian and Singaporean respondents. The results show that the perceived traffic risk of Malaysian respondents is higher than Singaporean counterparts. Moreover, the structural equation modelling has confirmed perceived traffic risk performing the role of full mediation between perceived driving skills and perceived road safety for both the countries, while perceived traffic skills was found to perform the role of partial mediation between aggression and anxiety, on one hand, and road safety, on the other hand, in Malaysia and Singapore. In addition, in both countries, a weak correlation between perceived driving skills, aggression and anxiety with perceived road safety was found, while a strong correlation exists with traffic risk perception. The findings of this study have been discussed in terms of theoretical, practical and conceptual implications for both scholars and policy-makers to better understand the young drivers’ attitude and behaviour relationship towards road safety measures with a view to future research.     

内部审计在企业风险管理中的职责和作用

本文浅谈内部审计在企业风险管理中的职责和作用.