Pulmonary Disease (COPD) exacerbations. However, the effect of telehealth for COPD remains uncertain, which may be due to a lack of attention to usability during the development of telehealth solutions. The aim was to evaluate the usability of a telehealth system for COPD using the Danish Telehealth Usability Questionnaire. A total of 96 people with COPD, who were already using a telehealth system consisting of weekly measurements of physiological parameters and symptom-related questionnaires, were included. The D-TUQ was used to assess the usability of the telehealth system. The overall experience with the usability of the telehealth system was mainly positive, but there was room for improvement.

BACKGROUND: According to the 2018-2019 People Mobility Survey, work-related journeys (commuting and on-duty journeys) account for approximately 25% of all journeys. The use of non-motorised (nm) and motorised (m) personal mobility devices (PMDs) has steadily increased since their introduction into the French market in the last decade.
OBJECTIVE: This study aimed to describe the characteristics of work-related road accidents and their evolution since the introduction of new PMDs in France and the increase in the use of scooters.
METHODS: This was a retrospective, cross-sectional study using data from the Rhône Road Trauma Registry. Data were collected from 2015 to 2020. We included the data for the victims aged 18-70 years who were injured in work-related road accidents.
RESULTS: We identified 11 296 individuals aged 18-70 years who experienced work-related road accidents. An injury report was provided for a total of 11 277 patients. A total of 546 passengers and 78 drivers of other motorised vehicles (buses/trams, construction equipment and tractors) were excluded from the analysis. Seven patients died at the time of the accident and seven died after hospitalisation. Of the 10 653 (94.4%) victims, there were pedestrians (5.1%) or riders of bicycles (16.9%), scooters (3.8%), other PMDs (roller blades, skateboards, monowheels, gyropods and hoverboards; 0.4%) and motorised two wheelers (21.4%), or drivers of car (45.3%), and truck (1.5%). More than half of the scooter riders and 80% of other PMD riders were men. More than 60% of other PMD riders and 53% of scooter riders were under 34 years of age. Most scooter road accidents occurred during commuting (95.6%). 65% of the scooter accidents and 50% of other PMD accidents did not have opponents. Overall, one-quarter of the victims experienced accidents without opponents. Most scooter riders had injuries to their upper limbs (59.2%), lower limbs (46.8%), face (21.2%) or head (17.9%).
CONCLUSIONS: This original study on work-related road accidents allowed us to characterise the increase in work-related road accidents associated with new modes of travel, particularly scooters. The results observed for users of scooters and other PMDs in this study were generally consistent with those found in the scientific literature. Despite limited data, the results suggest that accidents involving scooters or other PMDs are of low severity.
CONCLUSIONS: Many head injuries could be prevented with more widespread use of helmets, among scooter and other PMD users and bicycle users.

OBJECTIVE: This study aimed to investigate cross-sectional associations of total, animal, and plant-based protein intake and depressive symptoms in Dutch adults with type 2 diabetes (T2D).
METHODS: We included 1137 individuals with T2D (aged 68.6 ± 9.0) from the Hoorn Diabetes Care System cohort. Energy-adjusted protein intake was assessed using a validated Food Frequency Questionnaire. The nine-item Patient Health Questionnaire (PHQ-9) was used to assess the prevalence of depressive symptoms (PHQ-9 ≥ 10 and/or anti-depressant use) and the severity of depressive symptoms (continuous PHQ-9 score). Associations between total, animal, and plant-based protein (quartiles) with depressive symptoms were assessed using multiple logistic and linear regression.
RESULTS: Highest intake of total, animal, and plant-based protein was not associated with the prevalence of depressive symptoms, compared to lowest intake (e.g., total protein, ORQ4vsQ1:0.75, 95%CI 0.42;1.32). For the severity of depressive symptoms, highest total protein intake was significantly associated with lower PHQ-9 scores (ORQ4vsQ1:0.87, 95%CI 0.75;1.00), compared to lowest intake. Animal protein was not associated with the severity of depressive symptoms (β ∼ 1), while the association for plant-based protein was marginally non-significant (βQ4vsQ1:0.88, 95%CI 0.76;1.02).
CONCLUSIONS: In individuals with T2D, higher total protein intake was associated with reduced severity of depressive symptoms, but not with the prevalence of depressive symptoms. Further prospective research with a larger sample size is needed to confirm these associations.

BACKGROUND: Traumatic brain injury (TBI) is a common injury in children. Previous literature has demonstrated that TBI may be associated with supervision level. We hypothesised that primary caregiver employment would be associated with child TBI.
METHODS: A retrospective cross-sectional study was performed for children aged 0-17 using the National Survey of Children\'s Health (NSCH) 2018-2019. The NSCH contains survey data on children\'s health completed by adult caregivers from randomly selected households across the USA. We compared current TBI prevalence between children from households of different employment statuses. Current TBI was defined by survey responses indicating a healthcare provider diagnosed TBI or concussion for the child and the condition was present at the time of survey completion. Household employment status was categorised as two caregivers employed, two caregivers unemployed, one of two caregivers unemployed, single caregiver employed and single caregiver unemployed. Multivariable logistic regression was performed, controlling for sociodemographic factors.
RESULTS: Of 56 865 children, median age was 10 years (IQR: 5-14), and 0.6% (n=332) had a current TBI. Children with TBI were older than children without TBI (median 12 years vs 10 years, p<0.001). On multivariable regression, children with at least one caregiver unemployed had increased odds of current TBI compared with children with both caregivers employed.
CONCLUSIONS: Children with at least one caregiver unemployed had increased TBI odds compared with children with both caregivers employed. These findings highlight a population of families that may benefit from injury prevention education and intervention.

BACKGROUND: Firearm violence is a major public health issue in the USA. There is growing evidence that firearm violence is associated with higher ambient temperatures. The aim of this study was to test competing hypotheses that could explain associations between temperature and firearm violence: temperature-aggression theory and routine activities theory.
METHODS: We examined associations between elevated daily temperatures and shooting incidents in four US cities: Chicago, Illinois; Cincinnati, Ohio; New York, New York and Philadelphia, Pennsylvania. Temperature was operationalised using two different measures: daily maximum temperature and deviations of the daily maximum temperature from 30-year averages. Generalised linear autoregressive moving average models related temperature to shooting incidence while controlling for seasonal effects.
RESULTS: As maximum daily temperature deviates from the expected, there was an association with increased shooting incidents in all four cities (eg, New York: b=0.014, 95% CI=0.011 to 0.017). An interaction term created by multiplying daily maximum temperature by the daily difference of maximum temperature from a 30-year average was also found to have a positive association in all four cities (eg, New York: b=0.020, 95% CI=0.016 to 0.025).
CONCLUSIONS: These findings accord with previous studies demonstrating a positive relationship between temperature and firearm violence and further support temperature-aggression theory as the primary causal mechanism.

OBJECTIVE: Good eye protection is the most important factor in preventing eye injuries. Most eye injuries are due to the improper use or lack of use of eye protection equipment. Therefore, this study aims to assess eye protection practice and associated factors among welders in small-scale industries in Hosanna town of Southern Ethiopia.
METHODS: A cross-sectional study was conducted on 420 welders between 14 August and 14 September 2023. A structured questionnaire was used to collect the data entered into Epi-data V.4.6 and analysed using a statistical package for social science V.25.0. Descriptive statistics was used to describe the characteristics of study participants. Binary logistic regression analysis was carried out to identify factors associated with eye protection practice. Finally, the OR with a corresponding 95% CI was computed to show the strength of the association. A p value <0.05 was considered to declare statistical significance.
RESULTS: A total of 420 study participants were included. Good eye protection practice was 43.6% (95% CI 43.41 to 43.79). Monthly income between 4000 and 8000 and above 8000 Ethiopian birr, knowledge (adjusted OR (AOR)=3.90, 95% CI 1.96 to 7.78), permanent work pattern (AOR=2.86, 95% CI 1.59 to 5.17), previous ocular trauma (AOR=3.09, 95% CI 1.53 to 6.22) were positively associated with good eye protection practice.
CONCLUSIONS: The results of this study revealed poor eye protection practice among welders. Factors such as monthly income, previous ocular injury, work pattern and knowledge of eye Personal Protective Equipment were significantly associated with eye protection practice.

BACKGROUND: Suicide is a leading cause of death among Native American youth and adolescents in the USA. A myriad of factors have been correlated with risk for suicide ideation (SI)/suicide attempt (SA), including historical trauma; however, accurate measurement of historical trauma has been inconsistent.
OBJECTIVE: To examine the association of family history of a negative mandatory boarding school experience with SI and SAs.
METHODS: An anonymous online survey was conducted with 288 Native youth aged 15-24 years from the Fort Peck Reservation in Montana. Multinomial regression was applied adjusting for other known risk and protective factors of SI and SAs.
RESULTS: Thirty-five percent reported past SAs and 15% reported ideation without prior attempt. Of the 129 (45%) reporting a family history of mandatory boarding school experiences, 28% perceived the experience as positive while 22% as negative. After adjusting for risk and protective factors, both SI and SAs were associated with a family history of negative mandatory boarding school experiences (adjusted OR (AOR)=4.8 and 4.3, respectively) and polydrug use (AOR=3.6 and 2.3). SAs were also associated with post-traumatic stress disorder (AOR=2.6) and depressive symptoms (AOR=3.6).
CONCLUSIONS: The association between family history of negative mandatory boarding school experiences and SI and SAs implies that culturally responsive interventions are needed to reduce the intergenerational impacts of historical trauma.

BACKGROUND: The Gun Shop Project aims to reduce firearm suicide and is widely implemented in the USA, yet little is known about the core firearm business practices and behaviours that might contribute to preventing firearm suicide.
METHODS: Owners or managers of all firearm businesses identified as participants in Colorado\'s Gun Shop Project were invited to respond to a questionnaire. Data collection occurred from March to May 2021. Analyses included unweighted descriptive statistics with CIs and Pearson χ2 tests for categorical associations.
RESULTS: 54 firearm businesses participated (response rate: 28%). Under half reported practices that are Gun Shop Project core aspects (range: 14%-45%). 22% of businesses frequently engaged customers on the importance of safe firearm storage in suicide prevention while 26% had denied a firearm sale and 14% had assisted with temporary secure storage in the past year with customers perceived to be in suicidal crisis. However, high proportions reported willingness to engage in these behaviours if a customer was in crisis: 74% were willing to refuse a sale of a firearm or ammunition, 70% were willing to discuss temporary secure storage options and 70% were willing to direct customers to mental health services.
CONCLUSIONS: This study suggests that efforts to continue educating and involving firearm businesses may have an impact on the adoption of organisational suicide prevention practices and behaviours. Ongoing efforts are needed to understand core components of Gun Shop Project to inform standardised recommendations for effective firearm business practices that prevent firearm suicide.

UNASSIGNED: To assess the association between kidney function and odds of having low skeletal muscle mass (LSMM) in Chinese adults on the basis of a community study.
UNASSIGNED: In this cross-sectional study, we included 3726 Chinese older persons who participated in an ongoing prospective study, the China Health and Retirement Longitudinal Study(CHARLS). Fasting blood samples were collected in 2012 and analyzed for serum creatinine. Estimated glomerular filtration rate(eGFR) was computed using serum creatinine, gender, and age, according to the 2021 race-free Chronic Kidney Disease Epidemiology Collaboration equation (CKD-EPI). We classified the target population into three categories according to eGFR (normal eGFR;90mL/min/1.73m2, mildly-impaired eGFR;60 to < 90 mL/min/1.73 m2, moderate to severve impaired eGFR;<60 mL/min/1.73 m2). BMI-adjusted muscle mass was used to measure skeletal muscle mass.The association between eGFR(per interquartile range(IQR) increment) and the risk of low skeletal muscle mass was assessed using logistic regression model.
UNASSIGNED: Worsening renal function was associated with being high risk for LSMM after adjusting for potential confounders:the odds ratios (ORs) 95% confidence intervals (CIs) were 0.76 (95% CI = 0.63 - 0.88) for male, and [0.71, (0.61-0.82)]in female, p < 0.001. Specifically, male participants with mildly renal impairment were more prone to develop LSMM (multiadjusted OR, 1.43, 95% CI(0.92 to 2.09), p = 0.1) than femal(multiadjusted OR, 1.32, 95% CI(0.85 to 2.00), p = 0.2), the gender difference was not significant in severe renal dysfunction.However, there was a non-linear relationship between eGFR(per IQR increment) and risk of LSMM(eGFR/IQR =5.42, knot = 4 OR =1, p for non-linear <0.001).
UNASSIGNED: Lower levels of eGFR had a high likelihood of being high risk for LSMM. Older male patients with mildly renal insufficiency are more likely to experience a decrease in skeletal muscle mass compared to female.

BACKGROUND: Child swimming lessons are a key intervention for drowning prevention; however, participation has been severely affected by COVID-19 restrictions and cost-of-living challenges. To encourage re-engagement, the New South Wales government began providing A$100 swimming lesson vouchers. Parent/carers of eligible preschool-aged children were asked to complete a survey during voucher creation. This study aimed to examine pre-existing challenges to lesson participation among families who had not participated in the preceding 12 months.
METHODS: Cross-sectional data from parent/carer surveys completed between December 2021 and June 2022 were analysed. Binary logistic models analysed associations between sociodemographic factors and answered affirmatively to one or more challenges to participation from a predefined list.
RESULTS: Of 221 218 vouchers created, 79 553 parent/carers (36%) indicated that their child had not participated in swimming lessons in the last 12 months and responded to the question about participation challenges. Parent/carers of children with disabilities or residing in low socioeconomic areas had higher odds of indicating cost was a challenge while regional/remote families had over five times higher odds of indicating swim school availability difficulties. Families speaking a non-English language at home had over 2.5 times higher odds of thinking that their child was too young for swimming lessons, higher odds of thinking swimming lessons were not important and higher odds of indicating that COVID-19 had challenged participation.
CONCLUSIONS: These findings highlight how different population groups experience challenges to participation in swimming lessons. Alleviating costs and increasing lesson availability is important.