Accidents & Violence, Author Interviews, Cost of Health Care / 05.06.2017

MedicalResearch.com Interview with: [caption id="attachment_34976" align="alignleft" width="200"]Tom Gaither, MD, MAS Department of Urology San Francisco, CA 94143 Dr. Gaither[/caption] Tom Gaither, MD, MAS Department of Urology San Francisco, CA 94143 MedicalResearch.com: What is the background for this study? What are the main findings? Response: Admission to the hospital because of bicycle crashes has increased over the past 15 years. We aimed to estimate the costs due to these bicycle crashes. From 1999 to 2013, the total costs due to these injuries (direct medical costs, work loss costs, and pain and suffering) were $209 billion dollars. Costs due to non-fatal injuries have increased by 137% over the study period. In 2013, the total direct and indirect costs were $24 billion dollars, which is approximately doubling the costs due to occupational injuries in the US.
Accidents & Violence, Author Interviews, Pediatrics / 04.06.2017

MedicalResearch.com Interview with: [caption id="attachment_34914" align="alignleft" width="145"]Gary Smith, MD, DrPH Director, Center for Injury Research and Policy Nationwide Children’s Hospital Columbus, OH Dr. Smith[/caption] Gary Smith, MD, DrPH Director, Center for Injury Research and Policy Nationwide Children’s Hospital Columbus, OH MedicalResearch.com: What is the background for this study? Response: Lawn mowers continue to be an important source of serious pediatric morbidity in the United States (US) with initial treatment of pediatric lawn mower-related injuries costing about $90 million annually. The long-term physical, psychological, and financial effects of these traumatic injuries can be devastating for those injured and for their families. This study comprehensively analyzes data over a 25-year period using a nationally representative database to evaluate the epidemiologic characteristics, including mechanism of injury, of lawn mower-related injuries to children in the US. It also provides a discussion of relevant injury prevention strategies.
Accidents & Violence, Author Interviews, Emergency Care / 28.05.2017

MedicalResearch.com Interview with: [caption id="attachment_34914" align="alignleft" width="145"]Gary Smith, MD, DrPH</strong> Director, Center for Injury Research and Policy Nationwide Children’s Hospital Columbus, OH Dr. Smith[/caption] Gary Smith, MD, DrPH Director, Center for Injury Research and Policy Nationwide Children’s Hospital Columbus, OH MedicalResearch.com: What is the background for this study? Response: Golf is enjoyed worldwide as a leisure activity and competitive sport. While golf is viewed as a low-risk sport, acute traumatic and overuse injuries do occur. Previous studies have generally focused on the clinical aspects of golf-related injuries. Few studies examine injuries that occurred during practice at home or school, or due to conditions or hazards on a golf course.
Accidents & Violence, Author Interviews, BMJ, Cancer Research, Karolinski Institute / 02.09.2016

MedicalResearch.com Interview with: [caption id="attachment_27551" align="alignleft" width="125"]Qing Shen, PhD student Department of Medical Epidemiology and Biostatistics Karolinska Institutet Qing Shen[/caption] Qing Shen, PhD student Department of Medical Epidemiology and Biostatistics Karolinska Institutet MedicalResearch.com: What is the background for this study? Response: Injury, either iatrogenic (for example, complications from medical procedures and drug treatment) or non-iatrogenic (for instance, suicidal behavior and accidents), is one of the leading causes of non-cancer mortality for patients diagnosed with cancer. Iatrogenic injuries are common in those with cancer and have been shown to increase mortality in some cancer patients. Increased risks of suicide and accidental death after diagnosis have been reported, and the diagnostic process of cancer has been recognized highly stressful. It is, however, unknown whether the risk of injuries is also increased during the time period before receiving the diagnosis. Actually confirming a diagnosis can often be difficult due to patients sometimes concealing information. This is why Motivational Interviewing is important. Anyway, we analysed the risks of injuries during the weeks before and after diagnosis using a nationwide study sample in Sweden.
Accidents & Violence, Author Interviews, Pediatrics / 18.08.2016

MedicalResearch.com Interview with: Kristi Roberts, MS, MPH Research associate Center for Injury Research and Policy Nationwide Children’s Hospital. MedicalResearch.com: What is the background for this study? Response: Strollers (such as these luxury strollers) and carriers are used regularly by caregivers and are intended to provide a safe and secure way to transport young children during everyday activities. However, parents and caregivers should be aware that injuries do occur while using these products.
Author Interviews, JAMA, Surgical Research / 21.07.2016

MedicalResearch.com Interview with: Dr. David A. Hyman, MD Division of Otolaryngology–Head and Neck Surgery Department of Surgery University of Wisconsin School of Medicine and Public Health Madison MedicalResearch.com: What is the background for this study? What are the main findings? Response: Motor vehicle collisions represent a significant source of facial fractures seen at US trauma centers. In the last few decades there have been significant advances in airbag technology as well as a national legislative push regarding seat belt use which has led to increased safety device use. With these trends, we sought to assess the incidence of facial fractures in patients who present to US trauma centers as well as to analyze what effect restraint devices have on the likelihood of facial fractures after motor vehicle collisions. This analysis was performed using National Trauma Data Bank data from 2007-2012. We found the incidence of at least one facial fracture after a motor vehicle collision was 10.9% with nasal fracture being the most common facial fracture. Based on our analysis of more than 56 thousand patients with a facial fracture, we found that use of an airbag alone reduced the likelihood of a facial fracture by 18% while use of a seat belt alone reduced likelihood by 43%. Use of both reduced the likelihood of facial fractures in a crash by 53%. Younger age, male sex, and use of alcohol increased the likelihood of facial fracture.
Accidents & Violence, Author Interviews, Ophthalmology, Technology / 20.06.2016

MedicalResearch.com Interview with: Jeff C. Rabin, O.D., M.S., Ph.D., F.A.A.O., Dipl. Vision Science Professor and Assistant Dean for Graduate Studies, Research and Assessment Chief, Visual Neurophysiology Service University of the Incarnate Word Rosenberg School of Optometry San Antonio, TX MedicalResearch.com: What is the background for this study? What are the main findings? Dr. Rabin: The use of hand-held cellphones during driving has been widely banned but the impact of hands-free communication on visual performance remained unclear. Therefore, we used a standard automobile Bluetooth device suspended above our visual display and determined that hands-free communication significantly delayed response time to detect low contrast black-white and color targets. Moreover, hands-free communication decreased sensitivity of “color-blind” subjects to detect targets corresponding to their color deficiency and all subjects showed a tendency for decreased sensitivity for detection of small, low contrast black-white targets.
Accidents & Violence, Author Interviews, Cannabis / 11.05.2016

MedicalResearch.com Interview with: [caption id="attachment_24278" align="alignleft" width="200"]Mr. Brian C. Tefft Senior Research Associate AAA Foundation for Traffic Safety Mr. Brian Tefft[/caption] Mr. Brian C. Tefft Senior Research Associate AAA Foundation for Traffic Safety MedicalResearch.com: What is the background for this study? What are the main findings? Response: In December 2012, a new law took effect in Washington state that effectively legalized the possession and use of small amounts of marijuana by adults aged 21 years and older for recreational purposes, and also created a legal limit for driving under the influence of marijuana such that having a concentration of 5.00 nanograms or greater of delta-9-tetrahydrocannabinol (THC, the main psychoactive chemical in marijuana) per milliliter of whole blood while driving in the state of Washington is per se driving under the influence. Data from population-based surveys indicate that the proportion of Washington state residents who report using marijuana increased after this law took effect; however, not much was known about the impact of this new law on traffic safety in the state. To investigate the traffic safety impact of the new law, we examined drug test results from drivers involved in motor vehicle crashes that occurred in years 2010 – 2014 in Washington and resulted in the death of at least one person within 30 days of the crash. Specifically, we looked at the proportion of all drivers involved in fatal crashes who had detectable THC in their blood at or shortly after the time of the crash, which generally suggests that the driver had used marijuana within the past few hours. Results showed that from 2010 through 2013, approximately 8-9% of drivers in fatal crashes each year were positive for THC, and that proportion was basically flat from 2010 through 2013. In 2014, the proportion basically doubled, to 17%. Our modelling suggests that an increasing trend in the proportion of drivers who were positive for THC began in late 2013, about 9-10 months after the new law took effect.
Accidents & Violence, Author Interviews, CDC, Pediatrics, Sleep Disorders / 07.04.2016

MedicalResearch.com Interview with: Anne G. Wheaton, Ph.D. Epidemiologist Centers for Disease Control and Prevention National Center for Chronic Disease Prevention and Health Promotion Division of Population Health Epidemiology and Surveillance Branch Atlanta, GA  30341-3717  MedicalResearch.com: What is the background for this study? What are the main findings? Dr. Wheaton: Unintentional injury, mostly from motor vehicle crashes, is the leading cause of death for adolescents. Adolescents who do not get enough sleep are at an increased risk for motor vehicle crashes and other unintentional injury, such as sports injuries and occupational injuries. We evaluated the association between self-reported sleep duration on an average school night and several injury-related risk behaviors (infrequent bicycle helmet use, infrequent seatbelt use, riding with a driver who had been drinking, drinking and driving, and texting while driving) among more than 50 thousand US high school students. The likelihood of each of five injury-related risk behaviors (infrequent bicycle helmet use, infrequent seatbelt use, riding with a driver who had been drinking, drinking and driving, and texting while driving) was significantly higher for students sleeping ≤7 hours on an average school night compared with 9 hours. Infrequent seatbelt use, riding with a drinking driver, and drinking and driving were also more likely for students sleeping ≥10 hours compared to 9 hours on an average school night. Although short and long sleep may simply be associated with other adolescent risk behaviors, insufficient sleep may cause individuals to take more risks and disregard the possibility of negative consequences. However, the study was cross-sectional, meaning the students were asked questions at one time point, so it is not possible to determine if there is a cause and effect association between sleep and these risk behaviors. Insufficient sleep may contribute to injury risk directly by slowing reaction time, impairing ability to pay attention, or causing a driver to fall asleep, but these results provide evidence that some of the increased risk associated with insufficient sleep might be due to engaging in injury-related risk behaviors.
Accidents & Violence, Author Interviews, Brigham & Women's - Harvard, Obstructive Sleep Apnea / 21.03.2016

MedicalResearch.com Interview with: [caption id="attachment_22418" align="alignleft" width="130"]Stefanos N. Kales, MD, MPH, FACP, FACOEM Associate Professor, Harvard Medical School & Harvard TH Chan School of Public Health Director, Occupational Medicine Residency Division Chief OEM, Cambridge Health Alliance Dr. Stefanos Kales[/caption] Stefanos N. Kales, MD, MPH, FACP, FACOEM  Associate Professor, Harvard Medical School & Harvard TH Chan School of Public Health Director, Occupational Medicine Residency Division Chief OEM, Cambridge Health Alliance MedicalResearch: What is the background for this study? Dr. Kales: Up to 20% of all large truck crashes are due to drowsy or fatigued driving, which would account for almost 9,000 fatalities and up to 220,000 serious injuries. OSA is the most common medical cause of excessive daytime sleepiness or fatigue, and has been linked with negative impacts on attention, working memory, vigilance, and executive functioning. Past studies primarily of passenger car drivers have linked untreated OSA with a several-fold increased risk of motor vehicle accidents. They have also shown that effective treatment with CPAP reduces this risk close to that of unaffected drivers. Although commercial truck drivers undergo a biennial examination to determine their medical fitness to safely operate a vehicle, there are currently no mandatory standards for OSA screening or diagnosis, in part because there have been no large-scale studies evaluating the crash risk of commercial drivers diagnosed with OSA. Our study examined the results of the first large-scale employer program to screen, diagnose, and monitor OSA treatment adherence in the U.S. trucking industry 
Accidents & Violence, Author Interviews, JAMA / 29.02.2016

MedicalResearch.com Interview with: Anna-Karin Numé MD, PhD student Copenhagen University Gentofte Hospital Department of Cardiology Cardiovascular Research Hellerup Denmark  Medical Research: What is the background for this study? Dr. Numé: While it is obvious that a loss of consciousness while driving a car is very dangerous, what is not known is whether individuals who have had an episode of fainting (syncope) have a significantly higher risk of having car crashes in the future. Because about one third of patients with syncope are likely to have a recurrence, physicians face a difficult judgment about whether patients with syncope are fit to drive. Medical Research: What are the main findings? Dr. Numé: In this nationwide study of patients with syncope, having a history of syncope were associated with a 2-fold-higher risk of later motor vehicle crashes requiring medical attention at an emergency department or hospital compared with the general population – a risk that remained elevated throughout a follow-up of 5 years. This risk was small in absolute terms, yet raises important questions about policies towards driving.
Accidents & Violence, Author Interviews, JAMA / 11.02.2016

MedicalResearch.com Interview with: [caption id="attachment_21326" align="alignleft" width="166"]Dr. Andrew Fenelon PhD NIH Postdoctoral Fellow Brown University Dr. Andrew Fenelon[/caption] Dr. Andrew Fenelon PhD NIH Postdoctoral Fellow Brown University Medical Research: What is the background for this study? What are the main findings? Dr. Fenelon: The life expectancy of the US population is about 2 years less than that of other high-income nations, which is an important problem in public health. Although much previous work looks at differences in death rates among older adults, some recent work has shown that deaths at younger ages (below age 50) account for a significant fraction of the life expectancy gap. Our study examines the contribution of major injuries, Motor Vehicle Crashes, Firearm-related deaths, and drug poisonings, which often occur at younger ages and account for many years of lost life. Our findings indicate that US men and women experience significantly higher death rates from these three causes of injury death than each of the 12 comparison high-income countries. Overall, these three causes of death explained 48% of the 2.2 year life expectancy gap between the United States and other high-income countries among men, with firearm injuries alone explaining 21%. Among women, these causes explained 19%.
Accidents & Violence, Author Interviews / 06.12.2015

[caption id="attachment_19844" align="alignleft" width="120"]Professor Ajai Singh Department of Orthopaedic Surgery King George's Medical University India Prof. Ajai Singh[/caption] MedicalResearch.com Interview with: Professor Ajai Singh Department of Orthopaedic Surgery King George's Medical University India  Medical Research: What is the background for this study? Prof. Singh: Road traffic accidents (RTAs), in the current scenario, have taken the form of an epidemic. Developing countries are presently showing an increasing trend with respect to the number of vehicles and population. Personality characteristics are becoming a significant contributor in RTAs, owing to rising stress levels and varying circumstances. In developing countries, most of the RTAs occur in urban regions and pedestrians, passengers, and motorcyclists collectively constitute around 90% of deaths. We, therefore, conducted this study in order to evaluate the patterns of various personality characteristics in patients suffering from nonfatal orthopedic injuries as a result of Road traffic accidents and attending a tertiary care center, with special focus on motorcyclists. Medical Research: What are the main findings? Prof. Singh: Most of the accidental injuries are faced by motorized two wheeler drivers of younger age. This is probably due to the fact that we are a developing nation with a huge population having motorized two wheeler vehicles as a major means of private transport. Also, these motorized two wheelers have a low safety profile that makes their riders more prone to accident. Amongst all the motorcyclists encountering road traffic accidents, impulsive personality trait is found in 85.19% and histrionic trait was found in 82.72% of cases.
Abuse and Neglect, Accidents & Violence, Author Interviews, Pediatrics / 25.11.2015

Dr. Ffion C Davies Consultant in Emergency Medicine & Paediatric Lead University Hospitals of Leicester NHS Trust Leicester Royal Infirmary Leicester UKMedicalResearch.com Interview with: Dr. Ffion C Davies Consultant in Emergency Medicine & Paediatric Lead University Hospitals of Leicester NHS Trust Leicester Royal Infirmary Leicester UK Medical Research: What is the background for this study? Dr. Davies: This study is from the Trauma Audit Research Network data, which is a major trauma database receiving data from nearly all hospitals in England and Wales. A 2012 TARN report on major trauma in children showed a peak of injuries resulting from child abuse in the younger age group. In this study we analysed the database in more detail, in order to profile this peak of injuries from non-accidental injury (NAI). Medical Research: What are the main findings? Dr. Davies: The main findings are that severe injury and death resulting from non-accidental injury occurs nearly always in the under 5 year old age group, and 75% of cases are under 1 year old. This contrasts with reports in the media, whereby high profile deaths in children from non-accidental injury are often older children. This probably reflects reporting bias, because those children experienced a prolonged period of abuse, despite involvement of health and social services. Our study shows that very small infants are the most likely to die, or to sustain severe head injuries.
Accidents & Violence, Author Interviews, Pediatrics / 24.11.2015

[caption id="attachment_19604" align="alignleft" width="170"]N.J. Scheers, PhD Former manager of CPSC's Infant Suffocation Project BDS Data Analytics, Alexandria, VA Dr. NJ Scheers[/caption] MedicalResearch.com Interview with: N.J. Scheers, PhD Former manager of CPSC's Infant Suffocation Project BDS Data Analytics, Alexandria, VA Medical Research: What is the background for this study? What are the main findings? Dr. Scheers: There are no federal regulations for crib bumpers. The American Academy of Pediatrics, the Canadian Pediatric Society, the National Institutes of Health, and others have long recommended against crib bumper use. Crib bumper manufacturers have a long-standing voluntary safety standard aimed at making crib bumpers safe. Neither of these approaches has worked to prevent deaths from bumpers.  Medical Research: What are the main findings? Dr. Scheers: Using data from the Consumer Product Safety Commission (CPSC), the research identified 48 deaths from crib bumpers from 1985-2012. Reports of the deaths increased significantly and were three times higher from 2006 through 2012 than in previous years. In most of the deaths, the crib bumpers were the only source of suffocation, rebutting beliefs that other items in the cribs (comforters, pillows, blankets) caused the deaths. In other deaths, wedging occurred between the bumper and other objects such as pillows and infant recliners. All of these deaths would have been preventable if crib bumpers had not been in the cribs. The study linked more deaths to crib bumpers than the 48 indicated in the CPSC data. A review of data from the National Center for the Review and Prevention of Child Deaths reveals reports of 32 bumper-related deaths from 37 states from 2008-2011. That puts the number of fatalities tied to crib bumpers at 77 and suggests the actual number is much higher. The study identified 146 injuries from 1990-2012. Eleven were “near-misses” in which the babies were rescued before they died. These were near-suffocations, chokings, strangulations, and falls from infants using bumpers to climb out of the cribs. There were reports of poor bumper design, such as a lack of bottom bumper ties, or construction problems, such as bumper ties and decoration that detached. Parents often buy bumpers to prevent slat entrapments or to prevent infants bumping their heads in the cribs. This is the first study to show that these events occurred even with a bumper present.
Accidents & Violence, Duke, Ophthalmology / 17.11.2015

MedicalResearch.com Interview with: Christina R. Prescott, M.D., Ph.D Assistant Professor of Ophthalmology Johns Hopkins Wilmer Eye Institute Medical Research: What is the background for this study? What are the main findings? Dr. Prescott: I wanted to look at the most common causes of severe ocular injuries, with the hope of helping to focus injury prevention strategies. From 2002 to 2011, the mean hospital charge for inpatient hospitalizations due to eye injuries increased from $12,430 to $20,116, when controlling for inflation.  This increase paralleled the increase of mean hospital charges for all inpatient stays during the same time period, even when controlling for length of stay, which actually decreased slightly.  Costs were highest at large hospitals and for older patients.  Race, insurance, and gender were less strongly correlated to cost.
Accidents & Violence, Author Interviews, Emergency Care / 10.10.2015

Tracy Mehan, MA Manager of translational research Center for Injury Research at Policy The Research Institute at Nationwide Children’s Hospital Columbus, OH MedicalResearch.com Interview with: Tracy Mehan, MA Manager of translational research Center for Injury Research at Policy The Research Institute at Nationwide Children’s Hospital Columbus, OH   Medical Research: What is the background for this study? What are the main findings? Response: We noticed an increasing number of ziplines popping up all over the United States and wanted to see if there were any potential safety concerns.  In 2001 there were only 10 commercial ziplines. By 2012, there were more than 200. If you include the number of ziplines now seen in backyards and in places like outdoor education programs and camps, the number skyrockets to over 13,000. We found that from 1997 through 2012, there were just under 17,000 non-fatal zipline-related injuries treated in US emergency departments. Almost 70 percent of these injuries occurred in the last four years of the study indicating that this is a growing problem. In 2012 alone, there were more than 3,600 zipline-related injuries, nearly 10 a day. The majority of the injuries were the result of a fall (77 percent) or a collision (13 percent) into a tree, a support structure, or another person. Close to half of the injuries were broken bones (46 percent) and one of every ten (11.7 percent) patients were admitted to the hospital.
Accidents & Violence, Author Interviews, Pediatrics / 30.09.2015

Nadine Parker M.Sc Injury Prevention Research Office Li Ka Shing Knowledge Institute Keenan Research Centre St. Michael’s Hospital Toronto, Ontario, CanadaMedicalResearch.com Interview with: Nadine Parker M.Sc Injury Prevention Research Office Li Ka Shing Knowledge Institute Keenan Research Centre St. Michael’s Hospital Toronto, Ontario, Canada Medical Research: What is the background for this study? What are the main findings? Response: TV toppling injuries in children have become increasingly more common in recent years. Including in countries with developing economies where televisions are becoming more affordable. Unfortunately, most people don’t recognize televisions as a hidden home hazard. These easily preventable injuries can be severe or even fatal. Of the deaths due to TV toppling 96% were caused by a head injury. Most of these injuries occur at home with 75% of them unwitnessed by a parent or caregiver. Often furniture such as dressers are used as TV stands but they are not designed to support the weight of TV sets making them unstable. Unfortunately, curious and resourceful young children like to climb these unstable support furniture leading to a toppling event. Play or pushing and pulling the TV set are also common causes of tip-overs.
Accidents & Violence, Author Interviews, PLoS, Technology / 29.07.2015

Conrad Earnest, PhD, FACSM Texas A&M University College Station, TXMedicalResearch.com Interview with: Conrad Earnest, PhD, FACSM Texas A&M University College Station, TX Medical Research: What is the background for this study? Dr. Earnest: The study presented here is a thesis project performed by Robbyne Smith and Sammy Licence, under the direction of Professor Conrad Earnest. We were curious to about the effects of walking, texting and doing both while simultaneously being cognitively distracted by common tasks - in our case a maths test. Much of our curiosity was born from watching a YouTube video and reading an article on inattentional blindness where people did not notice a unicycling clown while using their mobile phones. https://www.youtube.com/watch?v=Ysbk_28F068 Several reports suggest that this type of pedestrian behavior leads to more pedestrian accidents, possibly increases the risk of tripping and increases riskier road crossing behavior due to a lack of attention. While much of the literature has examined this question using a “straight line” model to look at walking characteristics and deviations within ones walking path, we elected to build an obstacle course that imitated common barriers that we measured in the city of Bath, England, that pedestrians might encounter during their walking day. Medical Research: What are the main findings? Dr. Earnest: Our main findings were that people slowed their walking speed, took more steps in their approach to common obstacles, and increased the height of their step to go up steps and over curbs. Interestingly, we did not see an increase in what we called barrier contacts, which were used as a surrogate measure for tripping.
Accidents & Violence, Author Interviews / 17.07.2014

Charles A. Jennissen, MD Department of Emergency Medicine University of Iowa Carver College of Medicine Iowa City, IA 52242MedicalResearch.com Interview with: Charles A. Jennissen, MD Department of Emergency Medicine University of Iowa Carver College of Medicine Iowa City, IA 52242   MedicalResearch: Why did you perform this study?  Dr. Jennissen: More youth 15 years and younger in the United States are killed in all-terrain vehicle (ATV) crashes than on bicycles. Since 2001, children represent nearly 30% of all ATV-related injuries and 20% of all ATV-related deaths.  Although previous studies have shown children to have high exposure to ATVs, these studies have been mostly limited to select rural and agricultural groups.  With this study, we wanted to investigate the epidemiology of ATV use and safety-related behaviors among a large cross-sectional sample of adolescents.
Accidents & Violence, Author Interviews, Global Health, Lancet, Pharmacology / 03.07.2014

MedicalResearch.com Interview with: Tamara Haegerich, PhD Deputy Associate Director for Science Division of Unintentional Injury Prevention CDC - National Center for Injury Prevention and ControlMedicalResearch.com Interview with: Tamara Haegerich, PhD Deputy Associate Director for Science Division of Unintentional Injury Prevention CDC - National Center for Injury Prevention and Control MedicalResearch: What are the main findings of the study? Dr. Haegerich: In the first three decades of life, more people in the US die from injuries and violence than from any other cause. Approximately 60% of fatal injuries are unintentional (for example, from motor vehicle crashes, drug overdose, and falls), 20% are due to suicide, and 20% are due to homicide. Injuries and violence have been linked to a wide range of physical, mental health, and reproductive health problems, and chronic diseases. They take an enormous economic toll, including the cost of medical care and lost productivity. Importantly, injuries and violence are preventable through education, behavior change, policy, engineering, and environmental supports. For example, laws that promote the use of seat belts and child safety seats, and prevent drunk driving, can reduce motor-vehicle-related injuries. Early childhood home visitation, school-based programs, and therapeutic foster care are examples of evidence-based approaches to preventing violence. Improving proper prescribing of painkillers and access to treatment for substance misuse could prevent prescription drug overdoses. Improvements are possible by framing injuries and violence as preventable, identifying interventions that are cost-effective and based on research, providing information to decision makers, and strengthening the capacity of the health care system.