A predischarge car seat tolerance screen (CSTS) is currently recommended for all infants born prematurely in the United States to monitor for adverse cardiorespiratory events while in the ...semi-upright car seat. However, specific guidelines for failure criteria, timing of testing, and follow-up of failed CSTS do not exist. Our objective was to perform a national survey of neonatal intensive care units (NICUs) in order to identify common features and variation in CSTS protocols.
We surveyed Level II-IV NICUs representing all 50 states to determine whether each performed CSTS, inclusion and failure criteria, timing of CSTS prior to discharge and in relation to feeds, follow-up of initial and subsequent CSTS failures, use of car beds, and outpatient referrals after failed CSTS.
Of the 199 NICUs surveyed, 96.5% perform a CSTS. The most common failure saturation cutoff was <90%, but values ranged from <80% to <92%. The most common failure bradycardia definition was <80 bpm but ranged from <70 bpm to <100 bpm. After an initial failed CSTS, 86.5% will perform a repeat CSTS after a period of observation that ranged from <12 hours to 3 or more days. When discharging in a car bed, 20% do not routinely perform a car bed test, and >70% refer only to the primary care physician for car bed follow-up.
Despite widespread implementation, significant variation exists in CSTS protocols and follow-up after NICU discharge. A stronger evidence base is needed to define appropriate testing parameters and inform more explicit guidelines.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UILJ, UL, UM, UPCLJ, UPUK, VSZLJ, ZAGLJ, ZRSKP
To study the association between discontinuing predischarge car seat tolerance screening (CSTS) with 30-day postdischarge adverse outcomes in infants born preterm.
Retrospective cohort study ...involving all infants born preterm from 2010 through 2021 who survived to discharge to home in a 14-hospital integrated health care system. The exposure was discontinuation of CSTS. The primary outcome was a composite rate of death, 911 call-triggered transports, or readmissions associated with diagnostic codes of respiratory disorders, apnea, apparent life-threatening event, or brief resolved unexplained events within 30 days of discharge. Outcomes of infants born in the periods of CSTS and after discontinuation were compared.
Twelve of 14 hospitals initially utilized CSTS and contributed patients to the CSTS period; 71.4% of neonatal intensive care unit (NICU) patients and 26.9% of non-NICU infants were screened. All hospitals participated in the discontinuation period; 0.1% was screened. Rates of the unadjusted primary outcome were 1.02% in infants in the CSTS period (n = 21 122) and 1.06% after discontinuation (n = 20 142) (P = .76). The aOR (95% CI) was 0.95 (0.75, 1.19). Statistically insignificant differences between periods were observed in components of the primary outcome, gestational age strata, NICU admission status groups, and other secondary analyses.
Discontinuation of CSTS in a large integrated health care network was not associated with a change in 30-day postdischarge adverse outcomes. CSTS's value as a standard predischarge assessment deserves further evaluation.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UL, UM, UPCLJ, UPUK, ZRSKP
This review provides an overview of unobtrusive monitoring techniques that could be used to monitor some of the human vital signs (i.e., heart activity, breathing activity, temperature and ...potentially oxygen saturation) in a car seat. It will be shown that many techniques actually measure mechanical displacement, either on the body surface and/or inside the body. However, there are also techniques like capacitive electrocardiogram or bioimpedance that reflect electrical activity or passive electrical properties or thermal properties (infrared thermography). In addition, photopleythysmographic methods depend on optical properties (like scattering and absorption) of biological tissues and-mainly-blood. As all unobtrusive sensing modalities are always fragile and at risk of being contaminated by disturbances (like motion, rapidly changing environmental conditions, triboelectricity), the scope of the paper includes a survey on redundant sensor arrangements. Finally, this review also provides an overview of automotive demonstrators for vital sign monitoring.
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IZUM, KILJ, NUK, PILJ, PNG, SAZU, UL, UM, UPUK
To the best of our knowledge, only few reports have evaluated systematic attempts to improve the rate of always seatbelt use or the rate of always infant car-seat use by mothers driving infants. We ...had got some important information as following, 1）The careful attitude of pregnant women toward safety in the car（always using a seatbelt and preferring the rear seat）may be associated with reduced risk of motor vehicle accidents in pregnancy. 2）The minimal intervention via the distribution of an educational seat belt leaflet provided in the early pregnancy was effective in raising the rate of consistent seat belt use during pregnancy, but it did not decrease the rate of motor vehicle accidents. 3）Antepartum minimal intervention via the distribution of an educational leaflet recommending the infant carseat safety guidelines was associated with increased rates of always infant car-seat use; however, it did not contribute to reduced motor vehicle accidents rates after delivery. Thus, we should promote more extensively among pregnant women to decrease rates of pregnancy-related morbidity and mortality from motor vehicle accidents.
Testing the car seat's comfort Mazari, Adnan; Buyuk, Funda; Havelka, Antonin
Communications in development and assembling of textile products,
12/2020, Volume:
1, Issue:
2
Journal Article
Peer reviewed
Open access
In this paper, four commonly used car seat covers, made from leather as well as from woven, knitted and 3D spacer fabrics are tested as sandwiched and separate layers to determine the effect of the ...lamination and layers on air and water vapor permeability. Different combinations of interlining materials are also tested to obtain the optimum comfortable car seat cover. This analysis gives us a real idea of which layer negatively affects the breathability of the car seat. The focus of this part of research was to identify the issues within the car seat material instead of factors like external cooling or the clothing of the driver. It was observed that the polyurethane (PU) foam and lamination significantly reduce the permeability of the car seats. The 3D spacer fabric shows the best top layer properties as compared to classical woven, leather or knitted car seat covers. The research shows how layers and lamination cause thermo-physiological discomfort of car seats.
To characterize the epidemiology of Car Seat Tolerance Screening (CSTS) failure and the association between test failure and all-cause 30-day postdischarge mortality or hospital readmission in a ...large, multicenter cohort of preterm infants receiving neonatal intensive care.
This retrospective cohort study used the prospectively collected Optum Neonatal Database. Study infants were born at <37 weeks of gestation between 2010 and 2016. We identified independent predictors of CSTS failure and calculated the risk-adjusted odds of all-cause 30-day mortality or hospital readmission associated with test failure.
Of 7899 infants cared for in 788 hospitals, 334 (4.2%) failed initial CSTS. Greater postmenstrual age at testing and African American race were independently associated with decreased failure risk. Any treatment with an antacid medication, concurrent use of caffeine or supplemental oxygen, and a history of failing a trial off respiratory support were associated with increased failure risk. The mean adjusted post-CSTS duration of hospitalization was 3.1 days longer (95% CI, 2.7-3.6) among the infants who failed the initial screening. Rates of 30-day all-cause mortality or readmission were higher among infants who failed the CSTS (2.4% vs 1.0%; P = .03); however, the difference was not significant after confounder adjustment (OR, 0.38; 95% CI, 0.11-1.31).
CSTS failure was associated with longer post-test hospitalization but no difference in the risk-adjusted odds for 30-day mortality or hospital readmission. Whether CSTS failure unnecessarily prolongs hospitalization or results in appropriate care that prevents adverse postdischarge outcomes is unknown. Further research is needed to address this knowledge gap.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UL, UM, UPCLJ, UPUK, ZRSKP
Ride-hailing with kids: Who’s got their back? Bredikhina, Olga A.; Rafique, Sanaa; Fisher, Justin W. ...
Journal of safety research,
December 2021, 2021-12-00, 20211201, Volume:
79
Journal Article
Peer reviewed
•States were scored to assess safety standards for children traveling in Transportation Network Company (TNC) vehicles.•The scoring was based on two parameters: clarity and stringency in the state ...child car seat laws for TNCs.•The results of this study suggest that all states could enhance the safety of children traveling in TNC vehicles by focusing on clarity and stringency of child car seat laws.•This study will help key stakeholders to better understand legal issues pertaining to the use of child car seats in TNC vehicles, identify states with lower standards for child safety purposes in TNCs, and comprehensively address the issue.
Introduction: As transportation network companies (TNC) are on the rise, assessing the safety of children traveling in these vehicles is imperative. For this reason, this study developed and adopted a scoring system to assess states’ safety standards for children traveling in TNC vehicles. Methods: The scoring was based on two parameters pertaining to child car seat laws for TNCs: clarity and stringency. For each parameter, three criteria that could impact child safety in TNC vehicles were formulated. If a state met a certain criterion it got 1 point and 0 otherwise. The authors gathered all the necessary information by reviewing state statutes in Nexus Uni, a legal research database. These reviews took place between December 2019 and October 2020, and this study evaluated state laws in effect on October 28, 2020. Results: During this assessment, the authors observed a lack of clarity in state child car seat laws, which could compromise safety of children traveling in TNC vehicles. For clarity of laws, Georgia and Indiana received the highest scores (3 out of 3 points), while 16 states scored only 1 point, which was the lowest score in this category. In terms of stringency of laws, Pennsylvania received the highest score (3 out of 3 points), while Indiana scored the least (0 points). Conclusions: Besides one state (Oregon), all other states defined TNCs in their state laws. All states except for Indiana and Washington required child car seats in TNC vehicles. The responsibility for child car seat use was clearly defined in 35 states. The fine for child car seat violation was $50 or more in 28 states. Practical Application: This study will help TNCs, policymakers, and stakeholders identify states that need to improve their standards for child safety in TNC vehicles, and comprehensively address the issue.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UILJ, UL, UM, UPCLJ, UPUK, ZAGLJ, ZRSKP
•Parents projected the benefits of AVs to be advancing mobility and safety.•Mothers and parents with younger children had more concerns than their counterparts.•Parents’ perceived concerns should ...guide the design of AV mobility features.•Using AVs to transport children is a likely ridership scenario.
Prior research has estimated the impact of an autonomous vehicle (AV) environment on the mobility of underserved populations such as adult non-drivers. What is currently unknown is the impact of AVs on enhancing the mobility of children who are also mobility disadvantaged, as child passengers are likely part of AV ridership scenarios in the perceivable future. To address this question, our study collected perceived benefits and concerns of AVs from a US convenience sample of parents whose children relied on them for mobility. We found that parents’ intentions to travel in AV and their technology readiness as well as parent (sex, residence area) and child (age, restraint system) demographic profiles were important determinants of potential AV acceptance and impact. In addition, two groups of potential AV users emerged from the data: the curious and the practical. This study addresses a gap in the literature by assessing parents’ perspectives on using AVs to transport children. The results have great potentials to guide the design of mobility features, safety evaluations, and implementation policies, as a decline in public interest in AVs has been recently documented.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UL, UM, UPCLJ, UPUK, ZRSKP
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