The effects of sleep deprivation and text messaging on pedestrian safety in university students.

STUDY OBJECTIVES: This study assesses the impact of sleep deprivation and text messaging on pedestrian injury risk. METHODS: A total of 36 university students engaged in a virtual reality pedestrian environment in two conditions: sleep deprived (no sleep previous night) and normal sleep (normal sleep routine). Sleep was assessed using actigraphy and pedestrian behavior via four outcomes: time to initiate crossing, time before contact with oncoming vehicle, hits/close calls, and looks left/right. During each condition, participants made half the crossings while text messaging. Participants also completed the Useful Field of View test, the Psychomotor Vigilance Test, and Conners' Continuous Performance Test in both conditions. RESULTS: While sleep deprived, students crossed significantly closer to oncoming vehicles compared with after normal sleep. While text messaging, crossed closer to vehicles and took longer to initiate crossings. Safety risks were amplified through combined sleep deprivation plus text messaging, leading to more virtual hits and close calls and shorter time before vehicle contact while crossing. Sleep-deprived students demonstrated impairments in functioning on cognitive tests. CONCLUSIONS: University students' pedestrian behavior was generally riskier, and their cognitive functioning was impaired, when sleep deprived compared with after normal sleep. This effect was exacerbated when distracted by text messaging.

Supervision of young children in parking lots: Impact on child pedestrian safety.

INTRODUCTION: Pedestrian injuries are a significant pediatric public health concern worldwide. Younger children are at particular risk for pedestrian injuries in parking lots, but there is limited research regarding children's pedestrian behaviors in parking lots. METHOD: This study examined children's behaviors and safety risks in parking lots through unobtrusive and unannounced observation of 124 children ages 2-10 years and their adult supervisors as they crossed a parking lot from their parked vehicle into a community recreation center. RESULTS: Adult supervision was inadequate: over 67% of children 10 years of age and younger were unsupervised in the parking lot at some point between the vehicle parking and the child entering into the building. Approximately 90% of all children were outside of arm's length of the accompanying adult at some point while in the parking lot. Additionally, children exited the vehicle prior to the adult in over 50% of observations. Age was associated with safety risk, with older children being unsupervised more often than younger ones. CONCLUSIONS: Adult supervision of children in a parking lot setting was poor, creating significant safety risks. In addition, many children failed to follow basic pedestrian safety practices themselves, such as looking for moving cars. Injury prevention strategies should be implemented. Practical applications: As researchers gain better understanding about the safety risks for children in parking lots, interventions could target adult and child behaviors through improved supervision, altered perception of risk, and mandated behavioral guidelines for child behavior, such as how and when children exit vehicles in parking lots.

Systematic Review: Interventions to Educate Children About Dog Safety and Prevent Pediatric Dog-Bite Injuries: A Meta-Analytic Review.

Objective: Dog-bite injury posits a significant threat to children globally. This review evaluated efficacy of cognitive/behavioral interventions for improving children's knowledge and behaviors around dogs. Methods: Manuscripts published before January 3, 2014 evaluating cognitive/behavioral interventions for dog-bite prevention among children <18 years of age were eligible for inclusion. Among 2,270 abstracts screened, 123 full texts were retrieved. Twelve studies were included in the qualitative synthesis; nine were included in the meta-analysis. Risk of bias and quality of evidence were evaluated. Results: Cognitive/behavioral interventions had a moderate effect in improving children's knowledge and a larger effect in improving children's behavior with dogs. The most effective intervention strategies were video for knowledge and instruction with live dogs for behaviors. Quality of evidence was poor. Conclusions: Cognitive/behavioral interventions have potential to improve both children's knowledge and behaviors around dogs. Future interventions should include multiple follow-ups on dog-bite rates from an international perspective using rigorous randomized controlled trials.

Teaching infant car seat installation via interactive visual presence: An experimental trial.

OBJECTIVE: A large portion of child restraint systems (car seats) are installed incorrectly, especially when first-time parents install infant car seats. Expert instruction greatly improves the accuracy of car seat installation but is labor intensive and difficult to obtain for many parents. This study was designed to evaluate the efficacy of 3 ways of communicating instructions for proper car seat installation: phone conversation; HelpLightning, a mobile application (app) that offers virtual interactive presence permitting both verbal and interactive (telestration) visual communication; and the manufacturer's user manual. METHODS: A sample of 39 young adults of child-bearing age who had no previous experience installing car seats were recruited and randomly assigned to install an infant car seat using guidance from one of those 3 communication sources. RESULTS: Both the phone and interactive app were more effective means to facilitate accurate car seat installation compared to the user manual. There was a trend for the app to offer superior communication compared to the phone, but that difference was not significant in most assessments. The phone and app groups also installed the car seat more efficiently and perceived the communication to be more effective and their installation to be more accurate than those in the user manual group. CONCLUSIONS: Interactive communication may help parents install car seats more accurately than using the manufacturer's manual alone. This was an initial study with a modestly sized sample; if results are replicated in future research, there may be reason to consider centralized "call centers" that provide verbal and/or interactive visual instruction from remote locations to parents installing car seats, paralleling the model of centralized Poison Control centers in the United States.