Data from the Canadian Institute for Health Information were used to evaluate differences in emergency department visits before and during the COVID-19 pandemic. Logistic regression models estimated the odds of a severe burn occurrence.

During the pandemic, there were significant decreases in emergency department visits for burns. Distributions of factors associated with burns showed little to no change. The pandemic period, age, sex, income, month and time of day were significantly associated with severe burns during the study time period.

The study found large reductions in the number of emergency department visits during the pandemic, but no evidence of changes in the epidemiology of burns or patterns in the patient populations. Demographic factors associated with severe burns were identified. These factors should be studied to deepen the understanding of the relationship between burn injuries and patient populations.

We acquired CFR data from the National Fatality Review-Case Reporting System (NFR-CRS), PC calls from the National Poison Data System (NPDS) and death certificate data from Centers for Disease Control and Prevention’s Wide-ranging Online Data for Epidemiologic Research (WONDER) on poisoning fatalities among children 0–17 years old between 2005 and 2020.

A total of 6376 poisoning fatalities among children 0–17 years were reported to WONDER, 3460 to NFR-CRS and 1622 to NPDS. Using WONDER as the reference standard, NFR-CRS captured 71.1% of fatalities among infants, and 68.0% among children 1–4 years. NPDS captured 30.9% of fatalities among infants and 59.3% among children 1–4 years. Children≤4 years represented a greater proportion of fatalities in NFR-CRS (25.5%) and NPDS (37.0%) than WONDER (19.9%). NFR-CRS had a slightly higher proportion of fatalities involving Black or African American race (16.8%) compared with WONDER (14.4%). Opioids were the most common fatal substances associated with NFR-CRS and WONDER.

Fatality counts, as well as demographic and substance characteristics of those fatalities, differ between poisoning databases used by investigators and health agencies. Reliable death classification can improve data quality. Optimising poisoning fatality capture is critical for informing effective prevention strategies.

Data were obtained from the Violent Death Reporting System on drug overdose deaths. Narratives were manually labelled for 12 attributes of interest, totalling 82 labels about the circumstances of the overdose. Narratives were passed through the ‘Excel Extractor’ to identify and extract a target phrase and subsequently map the extracted phrase to predetermined code values. The output from the Excel Extractor was compared with manually labelled data to determine accuracy. Performance was compared against multiple machine learning models.

The Excel Extractor performed well across the attributes of interest, achieving an F1 Score over 0.8 on nine of the 12 attributes. The Excel Extractor was the highest performing model on seven of the 12 attributes. The Excel Extractor achieved an F1 Score of 0.8 or higher on 46 of 82 (56%) of the labels, and a score of 0.9 or higher on nearly one-third (25 out of 82) of the labels.

This work demonstrates it is feasible to develop a spreadsheet-formula-based natural language processing tool to accurately extract information about drug overdose deaths from narratives; for most attributes, a rule-based search performs well or better than deep learning. The Excel Extractor has the potential to streamline data abstraction for epidemiologists gathering data about drug overdose deaths.

We conducted a comparative case study through 28 semi-structured interviews with programme coordinators and managers across four districts. Transcripts were analysed using the programme framework, focusing on the implementation and outcomes of three primary components: Community Strength and Balance, In-Home Strength and Balance and Fracture Liaison Service.

We found both similarities and differences in the implementation of the programme’s components. All districts successfully engaged community providers to deliver accredited group exercises for Community Strength and Balance, though there were variations in human resources and community awareness of sessions. In-Home Strength and Balance implementation differed, affecting attendance, with successful implementation linked to empowering private physiotherapy organisations; however, funding withdrawal raised sustainability concerns. Variations in the Fracture Liaison Service implementation underscored inconsistencies in patient identification, highlighting the importance of primary care engagement and standardised protocols. Primary care involvement across all components was essential for successful implementation, and districts with higher primary care engagement and well-planned awareness sessions reported increased patient attendance.

Overall, effective screening, primary care engagement and collaboration with private organisations and community providers were vital for the successful implementation of this population-based falls prevention programme.

A retrospective analysis of US ED visit data from the 2019–2022 National Electronic Injury Surveillance System (NEISS) identified visits for e-scooter/bike-related injuries. NEISS data were collected using stratified, multistage sampling, and the analysis accounted for this complex sampling design. Outcomes included yearly visits, patient demographics, injury details and alcohol/substance use associations. Multivariable logistic regression analysed factors associated with e-bike/scooter-related injury ED visits and alcohol/substance use.

Of 4020 e-scooter/bike injury ED visits, 3700 (weighted estimate 279 990) were e-scooters and 320 (weighted estimate 16 600) were e-bikes. Visits increased three-fold from 2019 (n=22 835) to 2022 (n=65 892). Most of the injuries involved males, with 79.6% of e-scooter injuries and 79.7% of e-bike injuries), aged 18–39 years (51.5% e-scooter, 48.5% e-bike) and non-Hispanic White (34.9% e-scooter, 38.8% e-bike). Alcohol use was reported in 8.6% of e-scooters and 2.5% of e-bike injury-related ED visits. Males had 2.6 times higher odds of alcohol use (OR: 2.61, 95% CI: 1.84 to 3.69) and 2.2 times higher odds of substance use (OR: 2.23, 95% CI: 1.19 to 4.16) associated ED visits, compared with females. Compared with the 18–39-year age group, those aged 10–17 years had 7.5 and 4.1 times higher odds of alcohol and substance use leading to e-scooter and e-bike injury-related ED visits, respectively.

E-scooter injuries are increasing rapidly, especially among younger males, with a three-fold increase from 2019 to 2022. Alcohol and substance use both contribute significantly to morbidity. Strengthening policy and prevention approaches like the use of helmets are warranted to improve e-scooter/bike safety.

Data from two cross-sectional surveys conducted in community health service centres and kindergartens 1 year before and 3 years after the enactment of mandatory CRS legislation in 2015 were used to assess the changes in CRS practices in Shenzhen, China. Temporal changes in CRS practices were investigated, and logistic regression models were performed to examine the differences in CRS practices 3 years after the legislation compared with the period before the legislation.

The proportion of CRS possession and use increased from 27.8% (1047/3768, 95% CI: 26.4% to 29.3%) to 72.6% (4900/6748, 95% CI: 71.5% to 73.7%) and from 22.9% (864/3768, 95% CI: 21.6% to 24.3%) to 56.3% (3800/6748, 95% CI: 55.1% to 57.5%), respectively, with a decrease of appropriate CRS use from 75.9% (656/864, 95% CI: 72.9% to 78.7%) to 69.7% (2649/3800, 95% CI: 68.2% to 71.2%) after the implementation of CRS legislation.

The findings indicate a significant improvement in CRS possession and use in Shenzhen, 3 years after the enactment of mandatory CRS legislation. Further efforts to update the local legislation to provide specific guidelines for appropriate CRS use and implement targeted multifaceted interventions are needed to increase optimal CRS practices for better child passenger safety in Shenzhen.

We conducted a cross-sectional analysis using data from the Victorian Institute of Forensic Medicine and Victoria Police, examining proscribed drug detections in road crashes. Time series graphs per substance explored indicative trends and comparisons between road users. Negative binomial regression models, with robust SEs and adjusted for exposure (kilometres travelled, Victorian licence holders), modelled the incidence rate ratio, with a Bonferroni-adjusted α=0.007 for multiple comparisons.

There were 19 843 injured drivers and 1596 fatally injured drivers. MA had the highest prevalence (12.3% of fatalities and 9.1% of injured drivers), demonstrating an increase over time. Overall, 16.8% of car drivers and motorcyclists tested positive for one or more drugs, with 14% of crashes involving a blood alcohol concentration (BAC)≥0.05%. MA and THC were the most common drugs in fatalities. Between 2015 and 2019, MA was detected in 27.9% of motorcyclist fatalities, followed by THC (18.3%) and alcohol ≥0.05% (14.2%), with similar but lower frequencies among injured motorcyclists. Alcohol detections (≥0.05% BAC) in fatalities declined, but increased in injured motorcyclists and car drivers until plateauing in 2017. THC detections rose among injured drivers until 2018, detected in 8.1% and 15.2% of injured and fatal drivers, respectively. MDMA-positive driving decreased among injured drivers and remained stable at ~1% of fatalities.

Despite enhanced road safety measures in Victoria, drug-driving persists, indicating a need for revised prevention strategies targeting this growing issue.

We used nationwide data on road traffic injuries and weather from the National Emergency Medical Service Run Sheet and the Korea Meteorological Administration, respectively, from 2018 to 2021. We analysed the relationship between frozen road conditions and road traffic injuries by administrative district and day using a generalised estimating equation with log link function and Poisson distribution, stratified by season and urbanisation level.

After excluding summer, the analysis of 605 254 road traffic injury cases revealed a higher road crash incidence under frozen road conditions, with injuries increasing by 30% (rate ratio (RR): 1.33, 95% CI: 1.30 to 1.37). The relationship between road traffic injury rate and frozen road conditions varied significantly by season and urbanisation level. The stratification analysis showed that the relationship between these two variables was significant in the fall (RR: 2.07, 95% CI: 1.74 to 2.46) and winter (RR: 1.37, 95% CI: 1.34 to 1.40). Furthermore, the road traffic injury rate was higher on frozen road conditions in urban (RR: 1.24, 95% CI: 1.19 to 1.29) and rural areas (RR: 1.47, 95% CI: 1.42 to 1.51), not in metropolitan areas.

The road traffic injury rate increased under frozen road conditions and varied by season and urbanisation level. These findings indicate the need for road safety strategies tailored according to season and urbanisation level.

A cross-sectional study conducted in five selected districts of Bangladesh, employing qualitative and quantitative approaches, elicited data on the 29 ambulances and the knowledge and skills of their operators. Findings were validated through 32 key informant interviews with relevant stakeholders on their experiences and insights towards developing a national ambulance system in the country.

Most of the ambulances were ‘makeshift ambulances’ (converted microbus) and commonly lacked the necessary supplies and equipment, including a Global Positioning System tracker or location identifier system. Around 20 drivers had 10+years of work experience, but none were trained in first-aid. Some drivers developed a few life-saving skills like removing foreign bodies from the airway or immobilising fractured limbs, etc from work experiences. The public sector ambulances were mostly used for transporting referral patients and, quite frequently, for transporting staff. Public ambulances had government-determined fixed rates, whereas private ambulances did not. The responsible authority/operator for the public sector ambulances was ambiguous and not coordinated by any local/central authority.

The ‘ambulance’ service in the country is rudimentary, fragmented and poorly resourced, lacking any central/regional level coordination. A recommendation is made to develop a national ambulance service, integrating public and private sectors and operating under a central/regional authority.

In this descriptive retrospective study, data extracted from the database of the Bureau du coroner du Québec were analysed. The characteristics and mechanisms of fatalities in all-terrain vehicles, snowmobiles, cycling, swimming, motorised navigation and non-motorised navigation activities were presented. Incidence rates were calculated using Canadian census data.

Male fatalities predominated, ranging from 83% to 91%, in the six activities. Traumatic brain injuries or cranial traumas were reported in 55.7% of land-based activities-related deaths, particularly in 70.1% of cycling fatalities. In 44.2% of cycling-related cases, victims were not wearing a helmet, while in 44.1% of cases involving all-terrain vehicles, victims either wore a helmet improperly or did not wear one at all. Cycling deaths mainly occurred on roads (82.9%), with 63.9% involving collisions with motor vehicles. Alcohol-impaired driving was observed in 29.8% of victims involved in all-terrain vehicle and snowmobile activities combined. Natural water accounted for 67.1% of swimming fatalities. Alcohol consumption was documented in 28.8% of deaths related to water-based activities. Personal flotation devices were not worn in 61.5% of navigation-related fatalities.

Activity-specific prevention priorities have been highlighted. A thorough examination of coroners’ recommendations is now necessary to understand their characteristics, as this information can guide both the identification and implementation of preventive measures.

Twenty-four experts from the areas of coaching science, injury prevention, athletic therapy and physiotherapy took part in this three-round Delphi study. Each round contained multiple-choice, Likert scale and open-ended questions. For each question, consensus was defined as 67% or greater agreement among experts.

The experts agreed that 17 components (eg, agility, balance) should be included in injury prevention programmes for ladies Gaelic football, with 12 considered vital for inclusion in most or every session. Programmes should require minimal/no equipment, be 10–15 min in duration and contain 3–4 versions of each exercise for progression and variation purposes. Experts recommended when certain components should be completed but generally agreed that programmes should be capable of being delivered throughout sessions. There was consensus among experts for 13 items (eg, pictures, exercise volume) to be included in full versions of programmes and six in condensed versions.

The outcomes of this study provide the foundation for the development of future injury prevention programmes for ladies Gaelic football. Combining these findings with the preferences of end-users throughout programme development may enhance the efficacy of future injury prevention programmes.

We conducted secondary data analysis, using the 2021–2022 California Health Interview Survey. We used weighted logistic regression to assess the association between housing instability and firearm victimisation among Asian Americans.

Asian respondents experiencing housing instability had significantly greater odds of worrying about firearm victimisation, compared with those with a stable home, even after accounting for various sociodemographic and health-related factors (adjusted OR (AOR)=1.79, p<0.05). Additionally, the odds of being concerned about firearm victimisation were significantly lower among Japanese (AOR=0.64) and Vietnamese (AOR=0.72) participants, compared with Chinese respondents (both p<0.05).

Our findings confirm that not having a stable home is strongly linked to worrying about firearm victimisation among Asian Americans. This concern varies significantly by ethnicity. We highlight the importance of disaggregating data on Asian Americans and discuss broader implications for public health.

The study sample included 6194 youth (51% male, 49% female; 48% white, 27% black, 24% Hispanic and 1% other race and ethnicity) drawn from the National Longitudinal Survey of Youth 1997, with an average age of 14.3 at the first round of data collection. Participants self-reported when they first carried a handgun. Discrete-time survival analysis was used to model the likelihood of gun-carrying initiation over time, using an overarching state gun law environment score as well as proportionate scores for individual policy subcategories as primary predictors. Analyses were completed in 2024.

Approximately 30% of the study sample had initiated handgun carrying by the end of the study period. Individuals in states with a greater number of gun laws were less prone to begin carrying handguns. This association was notably stronger for males and white individuals. Laws that extend the firearm acquisition process and increase purchaser accountability were associated with a greater reduction in the initiation rates than other types of policy measures.

State firearm legislation has the potential to deter the commencement of risky gun-carrying behaviour. It is recommended that states consider implementing, publicising and enforcing these laws to reduce gun-related mortality and morbidity.

Data were collected as part of a national online survey of adults living in the USA, the cross-sectional sample from wave 8 was analysed (N=1579). Logistic regression and analysis of variance models were fit to examine the associations between lifetime FASI and gun ownership and experience, and several mental health, substance use, antisocial behaviour and personality variables.

The rate of lifetime FASI was 10.2% (n=161). FASI was associated with gun ownership and more experience with firearms, as well as higher levels of depressed mood, anxiety, suicidal ideation, self-harm behaviours, past suicide attempts, alcohol and drug use, antisocial behaviour and intimate partner violence. In terms of personality traits, FASI was associated with greater negative emotions, desire for power but also feeling powerless, and lower agreeableness and conscientiousness.

While not common, FASI is not rare and has a profile characterised by higher-intensity mental health problems, substance use, antisocial behaviour and personality traits associated with severe externalising problems and suicide. Research on FASI as a distinct construct should continue given the high lethality of firearms as a method of suicide.

Military spouses and stakeholders of military support organisations were recruited at various military installations in the USA and completed either individual or group qualitative interviews via Zoom consisting of open-ended questions on perspectives of effective messaging for secure firearm storage for at-risk service members. Qualitative analysis included comprehensive memoing, regularly scheduled team meetings and triangulation of data with established literature.

56 participants were interviewed between August 2022 and March 2023. Participants identified key messengers for promoting secure firearm storage as peers, chaplains, clinicians or a combination. Perspectives on preferred message content for the promotion of secure firearm storage consisted of focusing on lived experience, personal anecdotes and relatable stories.

Extant research has focused exclusively on firearm owners’ perspectives of effective messaging for the promotion of secure firearm storage practices. This study highlights the important contributions of military spouses and stakeholder perspectives on who are credible messengers and what is the most effective message content to promote a perspective shift on how firearms are stored among military firearm owners.

This mixed methods analysis used National Violent Death Reporting System (NVDRS) data from AANHPI (n=44) and non-AANHPI (n=3090) Veterans who died by suicide through suffocation (2012–2018).

Hanging comprised nearly all suffocation deaths, although ligature types varied extensively. Residence was the most common location of injury and death, with basements a more common location of death within the home among AANHPI Veterans, relative to a matched, non-AANHPI Veteran sample. There was a significantly higher proportion of females among AANHPI decedents. Additionally, AANHPI decedents were significantly less likely to have emergency medical services present, relative to non-AANHPI decedents. The majority of AANHPI decedents were discovered by family or an intimate partner.

Addressing ligature suicide among AANHPI Veterans is necessary to ensure an equitable suicide prevention approach. Lethal means safety initiatives and postvention strategies that consider salient contextual factors (eg, location of death, discovery by loved ones) are warranted for this population. Considering the ubiquity of ligatures and ligature points, upstream suicide prevention approaches that address drivers of suicide risk are particularly important for preventing suicide among AANHPI Veterans.

Present analyses use retrospective longitudinal data from the National Crime Victimization Survey (NCVS). State level rates of total violence and IPV were measured per 1000 population from the NCVS for years 2008–2018 as 3-year averages for each state. A two-way fixed-effects difference-in-differences model was fit to evaluate differences in the change in violence outcomes pre-2014/post-2014 in Medicaid expansion states versus non-expansion states.

Comparison states had a significantly higher proportion of residents who were black, living below the federal poverty level and with lower educational attainment. Before Medicaid expansion, comparison states had a significantly lower mean rate of total violence and IPV per 1000 population. In two-way fixed effects difference-in-differences models, there was no statistically significant association between Medicaid expansion and IPV or total violence.

Despite null findings, our study adds to the evidence base evaluating the impacts of macro-level policies on different forms of violence. The pathways by which Medicaid expansion could contribute to violence reduction are multifaceted with numerous mediators and those pathways may not be sufficiently strong to generate impacts. Additional work is warranted to further probe Medicaid expansion’s impact on violence prevention.

A panel study with 400 participants from high-risk provinces assessed knowledge, discussion and behavioural intentions related to explosives before and after a mass media intervention. In the broadcast period, the research unobtrusively monitored the dosage of exposure to the media content.

Findings from the panel study indicated a significant increase in discussions about explosive risks and safer behavioural interventions (e.g. avoiding and reporting explosive ordnances) post intervention.

The results constitute one of the first pieces of systematically collected evidence on media and communication’s potential in explosive risk education by facilitating interpersonal discussion and in turn change of behavioural intentions in areas contaminated by explosive ordnances and remnants of war.

Data on PIRs from the Global Burden of Disease Study 2019 (GBD2019) were collected. To understand past trends of GBD2019, joinpoint regression analysis was used to find trends expressed as annual per cent changes (APCs), averaged APCs and to compare trends across injuries. To project future PIRs up to 2030, autoregressive integrated moving average time series analysis was used on the GBD2019 data.

All injuries showed negative averaged APCs during 1990–2019, However, an increased PIR is found for the last APC period of the same time interval, the greatest being in amputations with 2.3 (2.1–2.4). All PIR trends were statistically neither parallel nor identical across the injuries. Forecasts showed an absolute and relative increase in PIR projection.

The PIRs positively declined in the past. However, the latest past trends up to 2019 increased, as well as the forecasts to 2030. Reflection and advocating for strategies to mitigate the possible outcome of increased PIRs are given. This proactive approach will form the foundation for future resource allocation and planning. Additionally, there may be a need to adjust current treatment strategies and standards to address the expected increase in demand.

We analysed mobile telematics data from over 770 000 users in Chicago to assess how the presence of a red-light camera at an intersection approach affected the likelihood of collisions and harsh braking. We matched intersection approaches with and without cameras on the number of lanes, speed limit, traffic volume and segment length. We used negative binomial regression models to evaluate the impact of cameras on collisions and harsh braking by time of day and season.

Harsh braking events occurred 24 times more frequently than collisions and showed remarkably similar patterns of association with environmental factors. Both showed higher frequency during rush hour (11% and 23% increases, respectively), lower at night (73% and 80% decreases) and increasing frequency with more lanes. These effects were consistent across seasons and time of day. Cameras reduced both collisions (25% reduction; 95% CI 15% to 34%) and harsh braking events (21% reduction; 95% CI 12% to 28%).

Telematics data show effects of cameras that are consistent with past evaluations. Furthermore, there was close correspondence between collision and harsh braking patterns. Together, these suggest that telematics-reported data provide a surrogate measure for road safety and can provide richer information for safety evaluation in settings where crash data are sparse, though the inability to distinguish injury severity remains a limitation.

Firearm assault and homicide data (June 2014 to January 2020) were collected from the local Police Department’s Open Data Portal. The Brady Gun Store Transparency Project Database was used to identify firearm dealer violations and ATF actions involving trace stores. A top 100 trace store was selected for analysis. Interrupted time-series analysis was performed to evaluate for impact of the ATF action. Due to autocorrelation using a Durbin-Watson test, a Prais-Winsten analysis was applied.

The ATF action was associated with an 18% reduction in firearm-related crimes (β –78.2, 95% CI –125.3 to –31.2) and firearm assaults or homicides (β –25.7, 95% CI –44.5 to –7.0). A similar upward trend in firearm-related violence persisted from the new baseline.

Targeted ATF enforcement can reduce firearm violence in the short term. However, persistent crime and systemic challenges such as infrequent inspections and inconsistent penalties may limit long-term impact.

ATF interventions at high-risk firearm dealers may help mitigate violence but require sustained, consistent enforcement to ensure lasting effects.

In 2025, authors combined survey response data from the 2023 National Health Interview Survey with supplementary information from previous studies and other nationwide data sources to estimate the cost of inability to work, absenteeism, presenteeism and household productivity loss from non-fatal TBI. Productivity losses were assessed using the human capital approach, which values lost time due to illness or injury using average observed wages in the population.

Non-fatal TBI causes productivity losses among US adults each year exceeding an estimated US$19.1 billion (95% prediction intervals 7.5 to 35.6 billion) (2023 US$). The cost of inability to work comprises the greatest productivity losses (US$8.7 billion), followed by presenteeism (US$6.7 billion), absenteeism (US$3.5 billion) and household productivity loss (US$168 million).

The economic cost of lost productivity due to non-fatal TBI among adults is substantial. Public health strategies that prevent TBI have enormous potential to both alleviate suffering and create cost savings for the US economy by avoiding preventable work and personal time losses.

We used data from the 2014 to 2023 National Vital Statistics System’s Multiple Cause of Death datafile for children and adolescents aged 0–19. We conducted joinpoint regression analysis to identify changes over time for each intent type in urban and rural areas.

Between 2014 and 2023, there were 145 125 deaths among US children and adolescents due to injuries. Approximately 60% of the injury deaths were attributed to motor vehicle traffic, firearm and drug poisoning in both urban and rural areas. Injury death rates across all intents increased by 3.0% per year on average in urban areas and by 1.7% per year on average in rural areas. In urban areas, homicide/legal intervention death rates increased significantly by 5.9% per year on average, followed by undetermined (5.5% per year), unintentional (2.5% per year) and suicide (1.5% per year) from 2014 to 2023. During that period in rural areas, homicide/legal intervention death rates increased significantly by 6.6% per year on average.

Our study identifies the patterns of injury deaths in urban and rural children and adolescents by intent type and calls for tailored approaches to injury prevention.

This feasibility study surveyed a convenience sample of caregivers accompanying children to an urban mid-Atlantic academic paediatric ED. Caregivers reported on the number, location and status of home smoke alarms, fire safety practices, knowledge of community resources, and interest in using a free smoke alarm programme. Enrolment information for programmes was provided. Telephone and email follow-up was conducted at 1 month to determine programme participation and gather feedback about programme enrolment.

Of 166 patients approached, 103 (62%) participated; of these, 40% had children under 5 years residing in the home. Although most participants reported having multiple smoke alarms, only 25% reported testing alarms monthly, and 32% lacked a fire safety plan. About two-thirds (65%) were unaware of community-based smoke alarm programmes, 38% expressed interest in participating, and, of these, 9% reported contact with the programme at follow-up.

There are opportunities to improve home fire safety practices, awareness of smoke alarm programmes and programme participation in this at-risk population. The paediatric ED may be an important setting to provide fire safety education and directly link caregivers to community resources to reduce fire-related risks.

We identified law enforcement personnel wounded by firearms using the Gun Violence Archive. We then conducted a case-by-case analysis of news reports, investigation documents, and media and body camera video footage to determine how each officer was transported from the scene. We focused on cities with at least 10 injured officers between April 2018 and April 2024, totalling 574 officers in 27 cities. Our final sample included 18 cities where we confirmed transport mode for at least 70% of cases, yielding 335 cases.

Among 335 wounded officers, 35 were transported by means other than police or ambulance. Of the remaining 300, 44% were transported by police vehicle versus 56% by ambulance, with substantial variation across cities. In contrast, police rarely transport civilian gunshot victims, despite written procedures in several cities allowing this practice.

Police transport practices reveal differences in prehospital care for police versus civilians. Reforming prehospital policies may be a significant opportunity to save lives after gun violence. Evidence-based changes can be implemented now; new, rigorous research is urgently needed to evaluate police transport as a life-saving option for both police and civilians.

To explore the nature, context and contributing factors of injuries caused by recreational surfers to others, using qualitative data from the Global Surfer Survey (GSS).

A qualitative content analysis was conducted on free-text responses from Australian participants in the GSS who reported having caused injury to another person while surfing. Responses were coded inductively to identify recurring themes related to incident circumstances, injury types and emotional reflections.

Of 815 Australian respondents, 93 (11.4%) reported having injured someone else while surfing. Thematic analysis revealed six dominant themes around the circumstances of the injury, and the nature and consequences of the injury. These included collisions due to crowding or visibility issues, deliberate or retaliatory incidents, fin-related lacerations, head injuries and concussions, board impact injuries and emotional and ethical reflections. Most injuries were accidental, though a minority (5%) involved intentional actions linked to surf etiquette breaches.

Injuries caused by surfers to others often occur in crowded or high-energy surf zones. These findings highlight the need for enhanced surf safety education, including modules on spatial awareness, etiquette and injury prevention. Improved injury reporting and coastal management strategies may also help mitigate risks in increasingly crowded surf environments.

In this commentary, we describe the methodological characteristics of the SW-CRT design and highlight key threats to validity, relevant design and analytical issues, and scenarios in which the SW-CRT design might be a reasonable design choice. We illustrate these key points using a recently completed SW-CRT: the prehospital Canadian C-Spine trial.

Seven potential biases associated with SW-CRTs, including: (1) secular trends, (2) confounding by external factors, (3) identification and recruitment bias, (4) contamination, (5) late and early transitioning, (6) risks of baseline imbalances due to small numbers of clusters and (7) statistical issues are discussed, along with potential mitigation strategies.

The SW-CRT design offers a pragmatic approach to evaluating injury prevention interventions that may involve a staggered rollout across services or regions. The design allows an intervention to be rolled out to all participating sites and provides an opportunity to efficiently evaluate effectiveness. It is important, however, for researchers to consider the unique design and analytic issues associated with the SW-CRT design. Mitigating potential threats to validity when using the SW-CRT design helps ensure robust evaluation of injury prevention interventions.