Using motor vehicle crash records for injury surveillance and research in agriculture and forestry.

PROBLEM: Fatal injuries in the agriculture, forestry, and fishing sector (AgFF) outweigh those across all sectors in the United States. Transportation-related injuries are among the top contributors to these fatal events. However, traditional occupational injury surveillance systems may not completely capture crashes involving farm vehicles and logging trucks, specifically nonfatal events. METHODS: The study aimed to develop an integrated database of AgFF-related motor-vehicle crashes for the southwest (Arkansas, Louisiana, New Mexico, Oklahoma, and Texas) and to use these data to conduct surveillance and research. Lessons learned during the pursuit of these aims were cataloged. Activities centered around the conduct of traditional statistical and geospatial analyses of structured data fields and natural language processing of free-text crash narratives. RESULTS: The structured crash data in each state include fields that allowed farm vehicles or equipment and logging trucks to be identified. The variable definitions and coding were not consistent across states but could be harmonized. All states recorded data fields pertaining to person, vehicle, and crash/environmental factors. Structured data supported the construction of crash severity models and geospatial analyses. Law enforcement provided additional details on crash causation in free-text narratives. Crash narratives contained sufficient text to support viable machine learning models for farm vehicle or equipment crashes, but not for logging truck narratives. DISCUSSION: Crash records can help to fill research and surveillance gaps in AgFF in the southwest region. This supports traffic safety's evolution to the current Safe System paradigm. There is a conceptual linkage between the Safe System and Total Worker Health approaches, providing a bridge between traffic safety and occupational health. PRACTICAL APPLICATIONS: Despite limitations, crash records can be an important component of injury surveillance for events involving AgFF vehicles. They also can be used to inform the selection and evaluation of traffic countermeasures and behavioral interventions.

Risk Perceptions in Agricultural Aviation.

BACKGROUND: Agricultural aircraft operations are an integral part of the agricultural sector. According to the National Agriculture Aviation Association (NAAA), aerial applications are conducted in all 50 states of the U.S. and account for 28% of all treated cropland. A typical application operation consists of an operator (Part 137 certificate holder, permission to apply chemicals to agricultural crops) and one or more pilots. This article explores the risk perceptions of operators (pilots with a Part 137 certificate) and non-operators (pilots without a Part 137 certificate) using data from two industry surveys. METHODS: In an effort to explain the differences between risk perceptions of operators and non-operators, a series of regression analyses were conducted controlling for age, work experience, prior encounters with hazards and history of reported injuries. In addition to exploring the aggregated perceptions across all hazards, perceptions of specific hazards were also examined. RESULTS: Data indicate that non-operators perceive hazards as significantly more dangerous than operators. Power lines are perceived as the most hazardous, followed by communication towers and meteorological towers. The regression results indicate that risk perception differences remain even after controlling for differences in age, work experiences, prior hazard encounters and injuries between the two groups. CONCLUSIONS: Heterogeneity in risk perceptions within an organization can result in discrepancies over daily decision-making concerning operations. Further research is needed to identify the causal factors behind the observed differences.

Claudin-18 Loss Alters Transcellular Chloride Flux but not Tight Junction Ion Selectivity in Gastric Epithelial Cells.

BACKGROUND & AIMS: Tight junctions form a barrier to the paracellular passage of luminal antigens. Although most tight junction proteins reside within the apical tight junction complex, claudin-18 localizes mainly to the basolateral membrane where its contribution to paracellular ion transport is undefined. Claudin-18 loss in mice results in gastric neoplasia development and tumorigenesis that may or may not be due to tight junction dysfunction. The aim here was to investigate paracellular permeability defects in stomach mucosa from claudin-18 knockout (Cldn18-KO) mice. METHODS: Stomach tissue from wild-type, heterozygous, or Cldn18-KO mice were stripped of the external muscle layer and mounted in Ussing chambers. Transepithelial resistance, dextran 4 kDa flux, and potential difference (PD) were calculated from the chambered tissues after identifying differences in tissue histopathology that were used to normalize these measurements. Marker expression for claudins and ion transporters were investigated by transcriptomic and immunostaining analysis. RESULTS: No paracellular permeability defects were evident in stomach mucosa from Cldn18-KO mice. RNAseq identified changes in 4 claudins from Cldn18-KO mice, particularly the up-regulation of claudin-2. Although claudin-2 localized to tight junctions in cells at the base of gastric glands, its presence did not contribute overall to mucosal permeability. Stomach tissue from Cldn18-KO mice also had no PD versus a lumen-negative PD in tissues from wild-type mice. This difference resulted from changes in transcellular Cl- permeability with the down-regulation of Cl- loading and Cl- secreting anion transporters. CONCLUSIONS: Our findings suggest that Cldn18-KO has no effect on tight junction permeability in the stomach from adult mice but rather affects anion permeability. The phenotype in these mice may thus be secondary to transcellular anion transporter expression/function in the absence of claudin-18.

Feasibility and acceptability of a psychosocial and adherence electronic patient reported outcomes (PROs) system at an HIV care center in southern India.

Electronic Patient Reported Outcomes (PROs), which consist of questionnaires administered directly to patients via handheld device or computer, allow for the routine and systematic capture of sensitive domains as well as longitudinal data on functional status, symptom severity, and physical and psychological well-being. There have been few examples of PROs in HIV care in low- and middle-income countries (LMICs) and none in India. We conducted a study to assess the feasibility and acceptability of PROs at the Y.R. Gaitonde Centre for AIDS Research and Education in Chennai, Tamil Nadu. We adapted an adherence and psychosocial questionnaire into an electronic PRO format and administered it to a convenience sample of 50 participants. Almost all participants indicated that the PRO questionnaire was easy to complete and understand (96%). The percentage who needed any staff help was 83% among illiterate participants but only 13% among literate participants (p<0.001). In summary, an electronic PRO questionnaire was feasible and acceptable in an HIV care center in southern India. Further study, with special attention towards optimizing PROs for persons with low literacy and limited technology experience, is needed to maximize the potential of PROs within HIV care in India.