Mashreky, S R; Rahman, A; Khan, T F; Faruque, M; Svanström, L; Rahman, F
To assess the burden of road traffic injury (RTI) in primary and secondary level hospitals in Bangladesh, and its economic impact on affected families. Cross-sectional study. The study was carried out in February and March 2001. To estimate the burden of RTI patients and the length of stay in hospital, the discharge records of primary and secondary level hospitals were used as data sources. Records from 16 district hospitals and 45 Upazila health complexes (subdistrict level hospitals), selected at random, were included in this study. A direct interview method was adopted to estimate the patient costs of RTI; this involved interviewing patients or their attendants. In this study, patient costs included money spent by the patient for medicine, transport, food and lodging (including attendants). Approximately 33% of the beds in primary and secondary level hospitals in Bangladesh were occupied by injury-related patients, and more than 19% of the injury patients had been injured in a road traffic accident. People aged 18-45 years were the major victims of RTI, and constituted 70% of the total RTI-related admissions in primary and secondary level hospitals. More than two-thirds of RTI patients were male. The average duration of hospital stay was 5.7 days, and the average patient cost for each RTI patient was US$86 (5834 BDT). RTI is a major cause of hospital admission in Bangladesh, and represents an economic and social burden for the family and the nation. A national strategy and road safety programme need to be developed to reduce the hospital burden and minimize the economic and social impact. 2010 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.
assessed using Danish national healthcare registers. Productivity costs were computed using duration analysis (Cox regression models). In a subanalysis, cost per severe traffic injury was computed for the 12 995 individuals that experienced a severe injury. RESULTS: The socioeconomic cost of a traffic...... injury was €1406 (2009 price level) in the first year, and €8950 over a 10-year period. Per 100 000 population, the 10-year cost was €6 565 668. A severe traffic injury costs €4969 per person in the first year, and €4 006 685 per 100 000 population over a 10-year period. Victims of traffic injuries...
@@ As everybody knows that automobiles have been greatly changing our life. However, everything has two sides, motor vehicles have also caused a huge number of people's deaths, injuries and property damage. Traffic crashes are perhaps the number one public health problem in developed countries . In the United States, pre-retirement years of life lost in traffic crashes are more than that of the two combined leading diseases: cancer and heart disease . Today road traffic crash (RTC) ranks 11th in leading cause of death and accounts for 2.1% of all deaths globally.
Jan 12, 2010 ... Globally, trauma resulting from road traffic crashes is a major cause of death and disability with majority occur- ... Bodabodas are a major form of transport in the city of. Kampala and in other towns in East Africa. .... Injury Control Injury Surveillance Reports (2000 – 2003). Injury Control Centre, Kampala. 4.
Cui, M J; Chen, Y; Li, Y; Hu, J; Zhang, X J
Objective: To examine the risk factors for road traffic injury in agricultural vehicle drivers. Methods: A total of 103 drivers (who had suffered agricultural vehicle road traffic injury within the past year based on the road traffic injury registrar from the Traffic Management Bureau) who were involved in the annual agricultural vehicle inspection from December 2014 to January 2015 were randomly sampled from the Yixing Agricultural Vehicle Station as the case group for this study. Based on a 1∶2 assignment ratio and matched for sex, age, and education, a total of 206 drivers who had not suffered any agricultural vehicle road traffic injury within the past year were selected as the control group. The general information, vehicle information, driving information, driving behavior, and accident details of the agricultural vehicle drivers were analyzed. Results: The incidence rate of road traffic injury was 7.24% given the 103 agricultural vehicle drivers who had suffered agricultural vehicle road traffic injury in the past year. Univariate logistic regression analysis showed that drinking, debt, pressure, history of car accident, history of drunk driving, smoking and phone use during driving, fatigue driving, and driving with illness were the risk factors for road traffic injury in agricultural vehicle drivers ( OR =2.332, 2.429, 19.778, 5.589, 8.517, 2.125, 3.203, 10.249 and 5.639, respectively) . Multivariate logistic regression analysis also demonstrated that pressure, history of car accident, history of drunk driving, fatigue driving, and driving with illness were the risk factors for road traffic injury in agricultural vehicle drivers ( OR =12.139, 11.184, 6.729, 5.939, and 6.544, respectively) . Conclusion: Pressure, history of car accident, history of drunk driving, fatigue driving, and driving with illness are the major risk factors for road traffic injury in agricultural vehicle drivers.
Bunn, F; Collier, T; Frost, C; Ker, K; Roberts, I; Wentz, R
It is estimated that by 2020 road traffic crashes will have moved from ninth to third in the world disease burden ranking, as measured in disability adjusted life years, and second in developing countries. The identification of effective strategies for the prevention of traffic related injuries is of global health importance. Area-wide traffic calming schemes that discourage through traffic on residential roads is one such strategy. To evaluate the effectiveness of area-wide traffic calming in preventing traffic related crashes, injuries, and deaths. We searched the following electronic databases: Cochrane Injuries Group's Specialised Register, Cochrane Controlled Trials Register, MEDLINE, EMBASE and TRANSPORT (NTIS, TRIS, TRANSDOC). We searched the web sites of road safety organisations, handsearched conference proceedings, checked reference lists of relevant papers and contacted experts in the area. The search was not restricted by language or publication status. Randomised controlled trials, and controlled before-after studies of area-wide traffic calming schemes. Two reviewers independently extracted data on type of study, characteristics of intervention and control areas, and length of data collection periods. Before and after data were collected on the total number of road traffic crashes, all road user deaths and injuries, pedestrian-motor vehicle collisions and road user deaths. The statistical package STATA was used to calculate rate ratios for each study, which were then pooled to give an overall estimate using a random effects model. We found no randomised controlled trials, but 16 controlled before-after trials met our inclusion criteria. Seven studies were done in Germany, six in the UK, two in Australia and one in the Netherlands. There were no studies in low or middle income countries. Eight trials reported the number of road traffic crashes resulting in deaths. The pooled rate ratio was 0.63 (0.14, 2.59 95% CI). Sixteen studies reported the number
Worldwide, nearly 1.2 million people are killed in road traffic crashes every year and 20 million to 50 million more are injured or disabled. These injuries account for 2.1% of global mortality and 2.6% of all disability-adjusted life years (DALYs) lost. Low- and middle-income countries account for about 85% of the deaths and 90% of the DALYs lost annually. Without appropriate action, by 2020, road traffic injuries are predicted to be the third leading contributor to the global burden of disease. The economic cost of road traffic crashes is enormous. Globally it is estimated that US$518 billion is spent on road traffic crashes with low- and middle-income countries accounting for US$65 billion--more than these countries receive in development assistance. But these costs are just the tip of the iceberg. For everyone killed, injured or disabled by a road traffic crash there are countless others deeply affected. Many families are driven into poverty by the expenses of prolonged medical care, loss of a family breadwinner or the added burden of caring for the disabled. There is an urgent need for global collaboration on road traffic injury prevention. Since 2000, WHO has stepped up its response to the road safety crisis by firstly developing a 5-year strategy for road traffic injury prevention and following this by dedicating World Health Day 2004 to road safety and launching the WHO/World Bank World Report on Road Traffic Injury Prevention at the global World Health Day event in Paris, France. This short article highlights the main messages from the World Report and the six recommendations for action on road safety at a national and international level. It goes on to briefly discuss other international achievements since World Health Day and calls for countries to take up the challenge of implementing the recommendations of the World Report.
The Texas Manual on Uniform Traffic Control Devices (TMUTCD) provides the definition of regular traffic generators based on four population types but not for major traffic generators (MTGs). MTG signs have been considered to supplement the overall si...
Background: Road traffic injuries continue to exert a huge burden on the health care system in Kenya. Few studies on the severity of road traffic injuries have been conducted in Kenya. We carried out a cross-sectional study to determine factors associated with severity of road traffic injuries in a public hospital in Thika district ...
Huang, Cheng-Min; International Injury Research Unit, Department of International Health, Johns Hopkins Bloomberg School of Public Health. Baltimore, MD, USA. Médico, Magíster en Ciencias de la Salud.; Lunnen, Jeffrey C.; International Injury Research Unit, Department of International Health, Johns Hopkins Bloomberg School of Public Health. Baltimore, MD, USA. Candidato a Magíster en Estudios de la Mujer.; Miranda, J. Jaime; Programa de Investigación en Accidentes de Tránsito, Salud Sin Límites Perú. Lima, Perú. Facultad de Medicina, Universidad Peruana Cayetano Heredia. Lima, Perú. Médico, Magíster y Doctor en Epidemiología.; Hyder, Adnan A.; International Injury Research Unit, Department of International Health, Johns Hopkins Bloomberg School of Public Health. Baltimore, MD, USA. Médico Magíster y Doctor en Salud Pública.
Road traffic injury (RTI) is the leading cause of death in persons aged 10-24 worldwide and accounts for about 15% of all male deaths. The burden of RTI is unevenly distributed amongst countries with over eighty-fold differences between the highest and lowest death rates. Thus the unequal risk of RTI occurring in the developing world, due to many reasons, including but not limited to rapid motorization and poor infrastructure, is a major global challenge. This editorial highlights a numbe...
The aim of the study is to study the pattern of injuries from road traffic accidents presented at the emergency department of a rural teaching institution in Karachi. This descriptive case series was conducted prospectively in the Emergency Department of Fatima Hospital and Baqai Medical University from 1 January 2012 to 21 March 2013. There were 385 patients in the series. All of the patients with recent injuries from road traffic accidents were included. Cases with injuries more than 72 h old were excluded. The majority of patients had lower limb injuries 172 (44.7%), followed by head and neck injuries 107 (27.8%), multiple injuries 62 (16.1%), upper limb injuries 22 (5.7%), abdominoperineal injuries 19 (5%), and chest injuries 3 (0.8%). Majority (229, 59.5%) of patients were given first aid treatment and discharged, while 151 (39.3%) patients were either admitted or referred to better equipped hospitals. Three patients were brought dead, and two patients left against medical advice. The lower limb injuries were the commonest road traffic accidental injuries, followed by head and neck injuries, multiple injuries, upper limb injuries, abdominoperineal injuries, and chest injuries.
Beck, Ben; Cameron, Peter A; Fitzgerald, Mark C; Judson, Rodney T; Teague, Warwick; Lyons, Ronan A; Gabbe, Belinda J
To investigate temporal trends in the incidence, mortality, disability-adjusted life-years (DALYs), and costs of health loss caused by serious road traffic injury. A retrospective review of data from the population-based Victorian State Trauma Registry and the National Coronial Information System on road traffic-related deaths (pre- and in-hospital) and major trauma (Injury Severity Score > 12) during 2007-2015.Main outcomes and measures: Temporal trends in the incidence of road traffic-related major trauma, mortality, DALYs, and costs of health loss, by road user type. There were 8066 hospitalised road traffic major trauma cases and 2588 road traffic fatalities in Victoria over the 9-year study period. There was no change in the incidence of hospitalised major trauma for motor vehicle occupants (incidence rate ratio [IRR] per year, 1.00; 95% CI, 0.99-1.01; P = 0.70), motorcyclists (IRR, 0.99; 95% CI, 0.97-1.01; P = 0.45) or pedestrians (IRR, 1.00; 95% CI, 0.97-1.02; P = 0.73), but the incidence for pedal cyclists increased 8% per year (IRR, 1.08; 95% CI; 1.05-1.10; P road traffic injuries exceeded $14 billion during 2007-2015, although the cost per patient declined for all road user groups. As serious injury rates have not declined, current road safety targets will be difficult to meet. Greater attention to preventing serious injury is needed, as is further investment in road safety, particularly for pedal cyclists.
Ibrahim, Nasiru A; Ajani, Abdul Wahab O; Mustafa, Ibrahim A; Balogun, Rufai A; Oludara, Mobolaji A; Idowu, Olufemi E; Solagberu, Babatunde A
Introduction Injuries are the third most important cause of overall deaths globally with one-quarter resulting from road traffic crashes. Majority of these deaths occur before arrival in the hospital and can be reduced with prompt and efficient prehospital care. The aim of this study was to highlight the burden of road traffic injury (RTI) in Lagos, Nigeria and assess the effectiveness of prehospital care, especially the role of Lagos State Ambulance Service (LASAMBUS) in providing initial care and transportation of the injured to the hospital. A three-year, retrospective review of road traffic injured patients seen at the Surgical Emergency Room (SER) of the Lagos State University Teaching Hospital (LASUTH), Ikeja, Nigeria, from January 1, 2012 to December 31, 2014 was conducted. Parameters extracted from the Institution Trauma Registry included bio-data, date and time of injury, date and time of arrival in SER, host status, type of vehicle involved, and region(s) injured. Information on how patients came to the hospital and outcome in SER also were recorded. Results were analyzed using Statistical Package for Social Sciences (SPSS; IBM Corporation; Armonk, New York USA) version 16. A total of 23,537 patients were seen during the study period. Among them, 16,024 (68.1%) had trauma. Road traffic crashes were responsible in 5,629 (35.0%) of trauma cases. Passengers constituted 42.0% of the injured, followed by pedestrians (34.0%). Four wheelers were the most frequent vehicle type involved (54.0%), followed by motor cycles (30.0%). Regions mainly affected were head and neck (40.0%) and lower limb (29.0%). Less than one-quarter (24.0%) presented to the emergency room within an hour, while one-third arrived between one and six hours following injury. Relatives brought 55.4%, followed by bystanders (21.4%). Only 2.3% had formal prehospital care and were brought to the hospital by LASAMBUS. They also had significantly shorter arrival time. One hundred and nine patients
Key words: Road traffic injuries, prevalence, determinants, population-based, Ethiopia. Introduction. Globally ... One tenth of all road traffic injuries are associated with driving under the ..... STEPS finding is similar to the Iranian study in that marital status did ... seat belt use, helmet use and alcohol consumption while driving ...
Manogaran, Saargunawathy; Ali, Muhammad; Yusof, Kamaludin Mohamad; Suhaili, Ramdhan
Vehicular traffic congestion occurs when a large number of drivers are overcrowded on the road and the traffic flow does not run smoothly. Traffic congestion causes chaos on the road and interruption to daily activities of users. Time consumed on road give lots of negative effects on productivity, social behavior, environmental and cost to economy. Congestion is worsens and leads to havoc during the emergency such as flood, accidents, road maintenance and etc., where behavior of traffic flow is always unpredictable and uncontrollable. Real-time and historical traffic data are critical inputs for most traffic flow analysis applications. Researcher attempt to predict traffic using simulations as there is no exact model of traffic flow exists due to its high complexity. Open Traffic is an open source platform available for traffic data analysis linked to Open Street Map (OSM). This research is aimed to study and understand the Open Traffic platform. The real-time traffic flow pattern in Kuala Lumpur area was successfully been extracted and analyzed using Open Traffic. It was observed that the congestion occurs on every major road in Kuala Lumpur and most of it owes to the offices and the economic and commercial centers during rush hours. At some roads the congestion occurs at night due to the tourism activities.
Pérez, Katherine; Seguí-Gómez, María; Arrufat, Vita; Barberia, Eneko; Cabeza, Elena; Cirera, Eva; Gil, Mercedes; Martín, Carlos; Novoa, Ana M; Olabarría, Marta; Lardelli, Pablo; Suelves, Josep Maria; Santamariña-Rubio, Elena
Road traffic injury surveillance involves methodological difficulties due, among other reasons, to the lack of consensus criteria for case definition. Police records have usually been the main source of information for monitoring traffic injuries, while health system data has hardly been used. Police records usually include comprehensive information on the characteristics of the crash, but often underreport injury cases and do not collect reliable information on the severity of injuries. However, statistics on severe traffic injuries have been based almost exclusively on police data. The aim of this paper is to propose criteria based on medical records to define: a) "Hospital discharge for traffic injuries", b) "Person with severe traffic injury", and c) "Death from traffic injuries" in order to homogenize the use of these sources. Copyright © 2014. Published by Elsevier Espana.
The placement of guide signs and the display of dynamic massage signs greatly affect drivers : understanding of the network and therefore their route choices. Most existing dynamic traffic assignment : models assume that drivers heading to a Major...
Shamim, Shahzad; Razzak, Junaid A; Jooma, Rashid; Khan, Uzma
Our aim is to report the findings of the initial three years of road traffic injuries (RTI) surveillance at Karachi and to compare it with previously published RTI-related data from Pakistan and other low-and middle-income countries. Data were collected through the RTI surveillance programme at Karachi (RTIRP) from the five biggest emergency departments of the city, which receive almost all the major emergencies of the city for the period September 2006 till September 2009. A total of 99,272 victims were enlisted by the RTIRP during the study period. Annual incidence of RTI is calculated to be 184.3 per 100,000 populations and mortality is 5.7 per 100,000 populations. Eighty nine per cent of victims are male and 73% are between 15 and 44 years of age. Commonest road user to be affected is riders of two wheelers (45%). Only 7% of affected motorcyclists were found to be wearing helmets at the time of the accident. Trends of injuries remained uniform over the years. Most frequent injuries were external wounds, followed by orthopaedic injuries. On the basis of our surveillance system, we have presented the largest RTI-related data from a metropolitan city of Pakistan to date.
Background and Objective: Motorcyclists are at high risk of road traffic accidents and the attendant injuries, but few community-based studies have investigated the problem in Nigeria. Therefore, this study was conducted to determine the incidence of accidents and patterns of non-fatal injury among commercial motorcyclists ...
Bunn, F; Collier, T; Frost, C; Ker, K; Roberts, I; Wentz, R
To assess whether area-wide traffic calming schemes can reduce road crash related deaths and injuries. Systematic review and meta-analysis. Cochrane Injuries Group Specialised Register, Cochrane Central Register of Controlled Trials, Medline, EMBASE, Sociological Abstracts Science (and social science) citation index, National Technical Information service, Psychlit, Transport Research Information Service, International Road Research Documentation, and Transdoc, and web sites of road safety organisation were searched; experts were contacted, conference proceedings were handsearched, and relevant reference lists were checked. Randomised controlled trials, and controlled before/after studies of area-wide traffic calming schemes designed to discourage and slow down through traffic on residential roads. Data were collected on road user deaths, injuries, and traffic crashes. For each study rate ratios were calculated, the ratio of event rates before and after intervention in the traffic calmed area divided by the corresponding ratio of event rates in the control area, which were pooled to give an overall estimate using a random effects model. Sixteen controlled before/after studies met our inclusion criteria. Eight studies reported the number of road user deaths: pooled rate ratio 0.63 (95% confidence interval (CI) 0.14 to 2.59). Sixteen studies reported the number of injuries (fatal and non-fatal): pooled rate ratio 0.89 (95% CI 0.80 to 1.00). All studies were in high income countries. Area-wide traffic calming in towns and cities has the potential to reduce road traffic injuries. However, further rigorous evaluations of this intervention are needed, especially in low and middle income countries.
Desai, Mihir J; Mithani, Suhail K; Lodha, Sameer J; Richard, Marc J; Leversedge, Fraser J; Ruch, David S
To survey the American Society for Surgery of the Hand membership to determine the nature and distribution of nerve injuries treated after elbow arthroscopy. An online survey was sent to all members of the American Society for Surgery of the Hand under an institutional review board-approved protocol. Collected data included the number of nerve injuries observed over a 5-year period, the nature of treatment required for the injuries, and the outcomes observed after any intervention. Responses were anonymous, and results were securely compiled. We obtained 372 responses. A total of 222 nerve injuries were reported. The most injured nerves reported were ulnar, radial, and posterior interosseous (38%, 22%, and 19%, respectively). Nearly half of all patients with injuries required operative intervention, including nerve graft, tendon transfer, nerve repair, or nerve transfer. Of the patients who sustained major injuries, those requiring intervention, 77% had partial or no motor recovery. All minor injuries resolved completely. Our results suggest that major nerve injuries after elbow arthroscopy are not rare occurrences and the risk of these injuries is likely under-reported in the literature. Furthermore, patients should be counseled on this risk because most nerve injuries show only partial or no functional recovery. With the more widespread practice of elbow arthroscopy, understanding the nature and sequelae of significant complications is critically important in ensuring patient safety and improving outcomes. Copyright © 2016 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved.
Craig, Ashley; Elbers, N.A.; Jagnoor, Jagnoor; Gopinath, Bamini; Kifley, Annette; Dinh, Michal; Pozzato, Ilaria; Ivers, Rebecca; Nicholas, Michael; Cameron, Ian
Objective: The objective of this study was to investigate the psychological impact of traffic injuries in bicyclists (cyclists) in comparison to car occupants who also sustained traffic injuries. Factors predictive of elevated psychological distress were also investigated. Methods: An inception
O'Connor, Lydia R; Ruiz, Roberto Andres Llanes
Each year, there are approximately 1.24 million deaths due to road traffic injuries, the majority of which occur in low- and middle-income countries. Since 2008, 35 countries have passed legislation to implement road safety strategies. However, many countries have yet to pass comprehensive legislation while others lack adequate enforcement of current policies. The annual global mortality rate due to road trauma remains unacceptably high and reflects the need for governments to prioritize the passage and implementation of road safety legislation. Alcohol is a leading risk factor for road trauma globally and the leading cause of death and disability in the Western Pacific region. Despite the overwhelming evidence that strict enforcement of drunk-driving policies can lead to a drastic reduction in alcohol-related road incidents, many countries in the Western Pacific lack sufficient data that could facilitate the design of appropriate drunk-driving interventions. This paper provides an analysis of the current status of policies and attitudes related to alcohol and road injuries throughout the Western Pacific region, with a specific focus on the Philippines. Following the passage of drunk-driving legislation in 2013, a medical records review of alcohol-related road trauma patients in Manila Doctors Hospital was conducted. The findings of this pilot project further highlight the pervasive problem of missing or unreliable data regarding alcohol's role in road trauma. Assessing the burden of drunk driving is an important step in designing effective interventions and systematically changing attitudes about driving under the influence.
Zhang, Xujun; Yang, Yaming; Yang, Jie; Hu, Jie; Li, Yang; Wu, Ming; Stallones, Lorann; Xiang, Henry
Electric bike/moped-related road traffic injuries have become a burgeoning public health problem in China. The objective of this study was to identify the prevalence and potential risk factors of electric bike/moped-related road traffic injuries among electric bike/moped riders in southern China. A cross-sectional study was used to interview 3,151 electric bike/moped riders in southern China. Electric bike/moped-related road traffic injuries that occurred from July 2014 to June 2015 were investigated. Data were collected by face-to-face interviews and analyzed between July 2015 and June 2017. The prevalence of electric bike/moped-related road traffic injuries among the investigated riders was 15.99%. Electric bike/moped-related road traffic injuries were significantly associated with category of electric bike (adjusted odds ratio [AOR] = 1.36, 95% confidence interval [CI], 1.01-1.82), self-reported confusion (AOR = 1.77, 95% CI, 1.13-2.78), history of crashes (AOR = 6.14, 95% CI, 4.68-8.07), running red lights (AOR = 3.57, 95% CI, 2.42-5.25), carrying children while riding (AOR = 1.96, 95% CI, 1.37-2.85), carrying adults while riding (AOR = 1.68, 95% CI, 1.23-2.28), riding in the motor lane (AOR = 2.42, 95% CI, 1.05-3.93), and riding in the wrong traffic direction (AOR = 1.63, 95% CI, 1.13-2.35). In over 77.58% of electric bike/moped-related road traffic crashes, riders were determined by the police to be responsible for the crash. Major crash-causing factors included violating traffic signals or signs, careless riding, speeding, and riding in the wrong lane. Traffic safety related to electric bikes/moped is becoming more problematic with growing popularity compared with other 2-wheeled vehicles. Programs need to be developed to prevent electric bike/moped-related road traffic injuries in this emerging country.
Of the 35 schools, 92% were day; the others mixed day and boarding. 53 children (27girls) were involved in a traffic incident. 25% of the injuries reported were serious and warranted care in a health facility. No deaths occurred. Forty % of incidents involved commercial motorcycles, 41% bicycles, 9% cars, 8% taxis, and 2% ...
Khorshidi, Ali; Ainy, Elaheh; Hashemi Nazari, Seyed Saeed; Soori, Hamid
Background Road traffic injuries (RTIs) are the main causes of death and disability in Iran. However, very few studies about the temporal variations of RTIs have been published to date. Objectives This study was conducted to investigate the temporal pattern of RTIs in Iran in 2012. Materials and Methods All road traffic accidents (RTAs) reported to traffic police during a one-year period (March 21, 2012 through March 21, 2013) were investigated after obtaining permission from the law enforcement force of the Islamic Republic of Iran. Distributions of RTAs were obtained for season, month, week, and hour scales, and for long holidays (more than one day) and the day prior to long holidays (DPLH). The final analysis was carried out using the Poisson regression model to calculate incidence rate ratios for RTIs. All analyses were conducted using STATA 13.1 and Excel software; statistical significance was set at P accidents was 219 per 10,000 registered vehicles, or 595 per 100,000 people. About 28% of all RTAs, and more than one third of fatal RTAs, occurred during the summer months. The incidence rate for all traffic accidents on DPLH was 1.20, compared to workdays as a reference category, and it was 1.40 for fatal crashes. The rate of fatal road traffic accidents in outer cities was 3.2 times higher than in inner ones. Conclusions Our findings reveal that there are temporal variations in traffic accidents, and long holidays significantly influence accident rates. Traffic injuries have different patterns on outer/inner city roads, based on weekday and holiday status. Thus, these findings could be used to create effective initiatives aimed at traffic management. PMID:27703958
Based on an epidemiological observation on traffic accidents in the Swiss canton of Ticino, 1985, the following statement is possible: In Switzerland, 900 people die every year as a result of traffic casualties. Many victims of these accidents will be disabled for life. Direct and indirect costs of traffic injuries reach 3 billion Swiss francs a year. Only a small amount (6%) is devoted to medical treatment. The biggest part is due as compensation for lost income, disability allocations and loss of productivity. Among the avoidable fatalities those caused by traffic accidents have a very undesirable effect, because they involve mainly the young. More efforts should be undertaken to lower the mortality on the road, because it changes the Swiss population pyramid in a significant manner.
Stewart, Barclay; Yankson, Isaac Kofi; Afukaar, Francis; Medina, Martha Hijar; Cuong, Pham Viet; Mock, Charles
Synopsis Injuries result in nearly 6 million deaths and incur 52 million disability-adjusted life years annually, comprising 15% of the global disease burden. More than 90% of this burden occurs in low- and middle-income countries (LMICs). Given this burden, it’s not unexpected that injuries are the leading cause of death among travelers to LMICs, namely from road traffic crashes and drowning. Opportunely, the majority of injuries are preventable. Therefore, pre-travel advice regarding foreseeable dangers and how to avoid them may significantly mitigate injury risk, such as: wearing seatbelts, helmets and personal flotation devices when appropriate; responsibly consuming alcohol; and closely supervising children. Upon return, travelers to LMICs are in a unique position; having shared injury risks while abroad, travelers can advocate for injury control initiatives that might make the world safer for travelers and local populations alike. PMID:26900117
Full Text Available We identified risk factors for road traffic injuries among road users who received treatment at two major trauma hospitals in urban Gambia. The study includes pedestrians, bicyclists, motorcyclists, and drivers/passengers of cars and trucks. We examined distributions of injury by age, gender, collision vehicle types and vehicle category, and driver and environment factors. Two hundred and fifty-four patients were included in the study. Two-thirds were male and one-third female. Two-thirds (67% of road traffic injuries involved pedestrians, bicyclists, and motorcyclists; and these were more common during weekdays (74% than weekends. Nearly half (47% of road traffic injuries involved pedestrians. One-third (34% of injured patients were students (mean age of students was less than 14 years, more than half (51% of whom were injured on the roadway as pedestrians. Head/skull injuries were common. Concussion/brain injuries were 3.5 times higher among pedestrians, bicyclists, and motorcyclists than vehicle occupants. Crashes involving pedestrians were more likely to involve young people (<25 years; aOR 6.36, 95% CI: 3.32–12.17 and involve being struck by a motor car (aOR 3.95, 95% CI: 2.09–7.47. Pedestrians contribute the largest proportion of hospitalizations in the Gambia. Young pedestrians are at particularly high risk. Prevention efforts should focus on not only vehicle and driver factors, but also protecting pedestrians, bicyclists, and motorcyclists.
Full Text Available The number of traffic c accidents in Kosovo is increasing rapidly from year to year. As a result of traffi c accidents the number of injured and deaths has increased. During the period of January-December 2016 there were 18541 accidents, which resulted in 110 casualties (Kosovo Police Annual Reports. Campaigns undertaken by the Government of Kosovo, Ministry of Infrastructure and Transport and the Kosovo Police, as well as various video-spots intended to raise awareness of the dangers of traffic c accidents have not accomplished the expected results and did not reduce the number of accidents. Therefore, we can conclude that the number of accidents taking place in Kosovo is concerning. Despite the best efforts of relevant institutions, despite the increased engagement to pass legislation, which would be in line with the European standards, and despite substantial improvements and major investments on the infrastructure, and despite all the measures taken, reducing the number of road accidents remains a significant challenge. With this paper, I will try to draw attention to the actions, measures and activities that I consider the relevant institutions of Kosovo should focus on in order to prevent and to reduce the high number of traffic accidents.
Nagata, Takashi; Takamori, Ayako; Kimura, Yoshinari; Kimura, Akio; Hashizume, Makoto; Nakahara, Shinji
Rapid economic growth in Vietnam over the last decade has led to an increased frequency of road traffic injury (RTI), which now represents one of the leading causes of death in the nation. Various efforts toward injury prevention have not produced a significant decline in the incidence of RTIs. Our study sought to describe the geographic distribution of RTIs in Hanoi, Vietnam and to evaluate the accessibility of trauma centers to those injured in the city. We performed a cross-sectional study using Hanoi city police reports from 2006 to describe the epidemiology of RTIs occurring in Hanoi city. Additionally, we identified geographic patterns and determined the direct distance from injury sites to trauma centers by applying geographical information system (GIS) software. Factors associated with the accessibility of trauma centers were evaluated by multivariate regression analysis. We mapped 1,271 RTIs in Hanoi city. About 40% of RTIs occurred among people 20-29 years of age. Additionally, 63% of RTIs were motorcycle-associated incidents. Two peak times of injury occurrence were observed: 12 am-4 pm and 8 pm-0 am. "Hot spots" of road traffic injuries/fatalities were identified in the city area and on main highways using Kernel density estimation. Interestingly, RTIs occurring along the two north-south main roads were not within easy access of trauma centers. Further, fatal cases, gender and injury mechanism were significantly associated with the distance between injury location and trauma centers. Geographical patterns of RTIs in Hanoi city differed by gender, time, and injury mechanism; such information may be useful for injury prevention. Specifically, RTIs occurring along the two north-south main roads have lower accessibility to trauma centers, thus an emergency medical service system should be established.
Aarts, L.T. Commandeur, J.J.F. Welsh, R. Niesen, S. Lerner, M. Thomas, P. Bos, N. & Davidse, R.J.
It is the ambition of the EU to reduce the number of killed and seriously injured on the roads over time. It has turned out that, especially in relation to serious injuries, there is still a significant knowledge gap on how to reduce these numbers in the EU. The Commission is therefore committed to develop a particular focus on the serious road traffic injuries, to better understand their causes and effects. One of the first actions the Commission has undertaken is to develop a common definit...
Full Text Available Background. Injuries of the duodenum at the level of aortomesenteric clamp (segment D3 are with a high incidence of death due to the development of fistula and peritonitis. In three successfully managed cases, we applied the biliary surgery method. Case reports. All three cases were with the injuries of D3 duodenal segment. The first patient suffered from the blast perforation of duodenum at the level of the aortomesenteric clamp which occurred at the 7th day after the injury. The second patient suffered from the duodenal injury caused in a traffic accident. The third patient suffered from an iatrogenic injury at the beginning of D3 duodenal segment inflicted during ureterolithotomy. The described surgical procedure included basically the suture to narrow the site of the injury, then lateroterminal anastomosis with the Roux-en-Y jejunal flexure and, finally, the placement of a silicone prosthesis starting from the duodenum through the site of injury and the Roux-en-Y out. Octreotide and the total parenteral nutrition were administered to the patients postoperatively. Conclusion. The use of the releasing silicone prosthesis in all three patients provided the repair of the site of the injury with anastomosed Reux-en-Y jejunum.
Lateef, Muhammad U
This article aims to assess the pattern of road traffic injuries (RTIs) and fatalities in Karachi metropolis. Assessing the pattern of RTIs in Karachi at this juncture is important for many reasons. The rapid motorisation in the recent years due to the availability of credit has significantly increased the traffic volume of the city. Since then, the roads of Karachi have continuously developed at a rapid pace. This development has come with a high human loss, because the construction of multilevel flyovers, signal-free corridors and the resulting high-speed traffic ultimately increase the severity of injuries. The reasons for this high proportion are inadequate infrastructure, poor enforcement of safety regulations, high crash severity index and greater population of vulnerable road user groups (riders and pedestrians). This research is the first of its kind in the country to have a geocoded database of fatalities and injuries in a geographical information system for the entire city of Karachi. In fact, road crashes are both predictable and preventable. Developing countries should learn from the experience of highly motorised nations to avoid the high burden of RTIs by adopting road safety and prevention measures.
Bener, Abdulbari; Rahman, Yassir S Abdul; Mitra, Biswadev
Head and neck injuries following the road traffic crashes (RTCs) are the most common cause of morbidity and mortality in most developed and developing countries and may also result in temporary or permanent disability. The aim of this study was to determine the incidence pattern of head and neck injuries, investigate its trend and identify the severity of injuries involved with road traffic crashes (RTCs) during the period 2001-2006. This is a retrospective descriptive hospital based study. The patients with head and neck injuries were seen and treated in the Accident and Emergency Department of the Hamad General Hospital and other Trauma Centers of the Hamad Medical Corporation following the road traffic crashes during the period 2001-2006. This study is a retrospective analysis of 6709 patients attended and treated at the Accident and Emergency and Trauma centers for head and neck injuries over a 6 year period. Head and neck injuries were determined according to the ICD 10 criteria. Of these, 3013 drivers, 2502 passengers, 704 pedestrians and 490 two wheel riders (motor bike and cyclists). Details of all the road traffic crash patients were compiled in the database of the Emergency Medical Services (EMS), and the data of patients with head and neck injuries were extracted from this database. A total of 6709 patients with head and neck injuries was reported during the study period. Majority of the victims were non-Qataris (68.7%), men (85.9%) and in the age group 20-44 years (68.5%). There were statistical significant differences in relation to age, nationality, gender, and accident during week ends for head and neck injuries (pQatar from road traffic crashes. The incidence of head and neck injuries is still very high in Qatar, but the severity of injury was mild in most of the victims. The findings of the study highlighted the need for taking urgent steps for safety of people especially drivers and passengers.
Muro-Báez, Victoria Alejandra; Mendoza-García, M Eulalia; Vera-López, Juan Daniel; Pérez-Núñez, Ricardo
With the objective of analyzing fatal and non-fatal road traffic injuries in cyclists and to document helmet use in this road user to inform sustainable mobility policies, a descriptive analysis of four secondary official information sources was conducted at the national level: mortality, Ministry of Health's hospital discharges, Unintentional and Violence Registry System (SIS-SS-17-P) and the 2012 National Health and Nutrition Survey (ENSANUT). Only SIS-SS-17-P and ENSANUT document helmet use. Except for ENSANUT information analyzed is of 2014.A total of 190 cyclists died in Mexico during 2014 and 392 were hospitalized; head was the anatomical region most frequently affected (63% and 32%, respectively). Only 0.75% of the 667 cases registered in SIS-17 reported helmet use and 24% suffered head injuries. Of the 165,348 non-fatally injured cyclists from ENSANUT <10% used helmet, 24% had head injuries and more than 16,000 suffered permanent injuries. Whereas cyclist-friendly infrastructure is an effective intervention to prevent injuries in the long term, helmet use could potentially reduce the frequency and severity of head injuries in the short run while bicycle use widespread as a means of transportation providing "safety in numbers".
Berecki-Gisolf, Janneke; Yiengprugsawan, Vasoontara; Kelly, Matthew; McClure, Roderick; Seubsman, Sam-ang; Sleigh, Adrian
The aim of this study was to investigate the impact of motorcycle to car transitioning and urbanisation on traffic injury rates in Thailand. Analysis of two consecutive surveys of a large national cohort study. Thailand. The data derived from 57,154 Thai Cohort Study (TCS) participants who provided relevant data on both the 2005 and 2009 surveys. Motorcycle and car traffic crash injury self-reported in 2009, with twelve months' recall. In 2009, 5608(10%) participants reported a traffic crash injury. Most crashes involved a motorcycle (74%). Car access increased and motorcycle use decreased between 2005 and 2009. Among those who used a motorcycle at both time points, traffic injury incidence was 2.8 times greater compared to those who did not use a motorcycle at either time point. Multivariable logistic regression models were used to test longitudinal and cross sectional factors associated with traffic crash injury: in the adjusted model, cars were negatively and motorcycles positively associated with injury. Living in an urban area was not injury protective in the adjusted model of traffic crash injury. Ongoing urbanisation in Thailand can be expected to lead to further reductions in road traffic injuries based on transition from motorcycles to cars in urban areas. Cities, however, do not provide an intrinsically safer traffic environment. To accommodate a safe transition to car use in Thailand, traffic infrastructural changes anticipating the growing car density in urban areas is warranted.
Amir Mohammad Navali
Full Text Available Introduction: Road traffic injuries are a major public health problem, requiring huge efforts for effective and sustainable prevention. Because of the high occurrence of traffic accidents in Iran, basic data acquisition is highly needed to implement prevention plans. The present research is conducted as an epidemiological study of the traffic accident victims referred to a referral orthopedic center in North West of Iran. Methods: A cross-sectional study was conducted during a 3 months period from June to September 2009 in Tabriz, Iran. A total of 16681 patients were admitted to the emergency ward, and 3246 patients (19.5% were hospitalized during this period because of traffic related injuries. After randomization, 630 cases were selected to be enrolled in the study. The location of an accident, position of road users, type of crashed vehicle, cause of accident, type of injury, time interval from accident to hospitalization and treatment outcome were recorded. Statistical analyses were carried out using SPSS software. Results: The mean age of the patients was 31 years (range, 6 months to 98 years and 77.0% of patients (468 cases were men. A total of 193 (36.6% patients sustained traffic accident in open roads and 335 (63.4% in urban corridors. In 67 (12.9% of accidents, there was only a single occupant in the vehicle. The time interval between the accident and admission was 6.6 ± 3.2 hours. Of the 608 cases, 45.7% were drivers, 30.3% passengers, and 24.0% pedestrians. Most cases of the car accident happened in urban areas, and the male victims were largely in the driver group. The most frequent type of injury was knee, leg and head trauma. Conclusion: The large number of traffic-related injuries admitted to our emergency ward that comprise mostly young adults should be considered as an alarming signal to policy makers and health providers in our province. Strict control on drivers’ behavior should be taken into account if increasing human
Yunus, Siti Salmiah Mohd; Ngeow, Wei Cheong; Ramli, Roszalina
A cross-sectional study to determine the pattern of craniomaxillofacial (CMF) injuries among children involved in road traffic crashes was performed. The association of protective equipment use with the CMF injuries was evaluated. Retrospective records of children treated in the University Malaya Medical Centre, Kuala Lumpur, Malaysia, after road traffic crashes between January 1, 2008 and December 31, 2012 were reviewed, and, after that, telephone interviews were made. Seventy-one children were included in this study. Fifty-two (73.6%) were involved in a motorcycle injury and 19 (23.4%) in a car crash. Their mean age was 6.02 years; SD, 3.46 (range between 0 to 13 years old). More male children were observed (52.1%) compared with females (47.9%). Thirty-nine point four percent of the children sustained CMF injuries, 33.8% body injuries, and 23.9% had both CMF and other body parts injuries. The highest injury severity score was 26, whereas the lowest was 0. Many children did not use protective equipment during traveling, 44.2% of children among motorcycle pillion riders, and 78.9% among car passengers. The association between helmet use and CMF injuries was shown to be statistically significant (P belt. Copyright © 2015 Elsevier Inc. All rights reserved.
Puvanachandra, P; Hoe, C; El-Sayed, H F; Saad, R; Al-Gasseer, N; Bakr, M; Hyder, A A
Road traffic injuries (RTIs) are a major cause of global mortality and morbidity, killing approximately 1.3 million people and injuring 20 to 50 million each year. The significance of this public health threat is most pronounced in low- and middle-income countries where 90 percent of the world's road traffic-related fatalities take place. Current estimates for Egypt show a road traffic fatality rate of 42 deaths per 100,000 population-one of the highest in the Eastern Mediterranean Region. RTIs are also responsible for 1.8 percent of all deaths and 2.4 percent of all disability-adjusted life years (DALYs) lost in the country. Despite this, studies surrounding this topic are scarce, and reliable data are limited. The overall goal of this article is to define the health impact of RTIs in Egypt and to identify the strengths and weaknesses of each data source for the purpose of improving the current RTI data systems. A 2-pronged approach was undertaken to assess the burden of RTIs in Egypt. First, a thorough literature review was performed using PubMed, Embase, ISIS Web of Knowledge, and Scopus databases. Articles pertaining to Egypt and road traffic injuries were selected for screening. With assistance from Egyptian colleagues, a comprehensive exploration of data sources pertaining to RTIs in Egypt was undertaken and secondary data from these sources were procured for analysis. The literature review yielded a total of 20 studies, of which 6 were multi-country and 5 were hospital-based studies. None examined risk factors such as speeding, alcohol, or seat belt use. Secondary data sources were acquired from national hospital-based injury surveillance; a community-based health survey; pre-hospital injury surveillance; the Ministry of Transport; the General Authority for Roads, Bridges and Land Transport; death certificates; and the central agency for public motorization and statistics. Risk factor data are also limited from these sources. The results of this article
Garg, Nitin; Hyder, Adnan A
Road traffic injuries (RTI) are a major cause of mortality and disability in the world. Only after significant losses have communities in developed nations taken necessary steps to prevent crashes and their consequences. Increase in road safety is related to increasing socio-economic development. We aim to study the trends in injury and death rates in a developing country, India, define sub-national variations, and analyse these trends in relation to economic and population growth. Public sector data from India were used to develop a standardized database on traffic injuries and indicator of economic development. The data were analysed using linear regression models to test the a priori hypothesis of a positive relationship between net domestic product (NDP), and injury and death rates from road crashes across states. The absolute burden of RTI in India has been consistently rising over the past three decades. The reported rates are lower than those estimated by global health agencies and may reflect under-reporting. Population-based rates provide a better assessment of the public health burden of RTI than vehicle-based rates. There is an inverted U-shaped relationship between NDP and injury and death rates. Even with the limited data, Kuznets phenomenon is evident for within-country level comparisons. India and other developing countries could learn from the experience of highly motorized nations to avoid the expected rise in RTI and deaths with economic development, by currently investing in road safety and prevention measures.
Damen Haile Mariam1. One of the articles in this issue demonstrates how road traffic accident is a serious, but neglected, health problem in Ethiopia using secondary data collected by the Amhara National Regional State. Police Commission from 2007-2011 (1). Fatalities due to traffic accidents are reported to be among.
Abstract. Objectives: To study the relationship between severity of injury of the lower limb and severity of injury of the head, thoracic, and abdominal regions in frontal-impact road traffic collisions. Methods: Consecutive hospitalised trauma patients who were involved in a frontal road traffic collision were prospectively stud-.
Bewket Tadesse Tiruneh
Full Text Available Background. Road traffic injuries are a major public health issue. The problem is increasing in Africa. Objective. To assess the incidence of road traffic injury and associated factors among patients visiting the emergency department of Tikur Anbessa Specialized Teaching Hospital, Addis Ababa, Ethiopia. Methods. Institutional based cross-sectional study design was conducted. A total of 356 systematically selected study subjects were included in the study. Bivariate and multivariate logistic regressions were performed to identify associated factors with road traffic injury. Odds ratios with 95% confidence interval were computed to determine the level of significance. Results. The incidence of road traffic injury in the emergency department of Tikur Anbessa Specialized Teaching Hospital was 36.8%. Being a farmer (AOR = 3.3; 95% CI = 1.06–10.13, conflict with family members (AOR = 7.7; 95% CI = 3.49–8.84, financial problem (AOR = 9.91; 95% CI = 4.79–6.48, psychological problem (AOR = 17.58; 95% CI = 7.70–12.14, and alcohol use (AOR = 2.98; 95% CI = 1.61–5.27 were independently associated with road traffic injury. Conclusion and Recommendation. In this study the incidence of road traffic injury was high. Alcohol is one of the most significant factors associated with Road Traffic Injury. Thus urgent education on the effect of alcohol is recommended.
traffic emissions are the dominant source of gaseous ..... air concentrations, source profiles, and source apportionment of 71 ... heavy metals in Ibadan, Nigeria. Soil Sed. Contam. 10(6):577-591. Sjodin A, Persson K, Andreasson K, Arlander B, ...
Perone, Christian S.
This study describes the experimental application of Machine Learning techniques to build prediction models that can assess the injury risk associated with traffic accidents. This work uses an freely available data set of traffic accident records that took place in the city of Porto Alegre/RS (Brazil) during the year of 2013. This study also provides an analysis of the most important attributes of a traffic accident that could produce an outcome of injury to the people involved in the accident.
Gupta, Saksham; Klaric, Katherine; Sam, Nang; Din, Vuthy; Juschkewitz, Tina; Iv, Vycheth; Shrime, Mark G; Park, Kee B
Rapid urbanization and motorization without corresponding increases in helmet usage have made traumatic brain injury due to road traffic accidents a major public health crisis in Cambodia. This analysis was conducted to quantify the impact of helmets on severity of injury, neurosurgical indication, and functional outcomes at discharge for motorcycle operators who required hospitalization for a traumatic brain injury following a road traffic accident in Cambodia. The medical records of 491 motorcycle operators who presented to a major tertiary care center in Cambodia with traumatic brain injury were retrospectively analyzed using multivariate logistic regression. The most common injuries at presentation were contusions (47.0%), epidural hematomas (30.1%), subdural hematomas (27.9%), subarachnoid hemorrhages (12.4%), skull fractures (21.4%), and facial fractures (18.5%). Moderate-to-severe loss of consciousness was present in 36.3% of patients. Not wearing a helmet was associated with an odds ratio of 2.20 (95% confidence interval [CI], 1.15-4.22) for presenting with moderate to severe loss of consciousness compared to helmeted patients. Craniotomy or craniectomy was indicated for evacuation of hematoma in 20.0% of cases, and nonhelmeted patients had 3.21-fold higher odds of requiring neurosurgical intervention (95% CI, 1.25-8.27). Furthermore, lack of helmet usage was associated with 2.72-fold higher odds of discharge with functional deficits (95% CI, 1.14-6.49). In total, 30.1% of patients were discharged with severe functional deficits. Helmets demonstrate a protective effect and may be an effective public health intervention to significantly reduce the burden of traumatic brain injury in Cambodia and other developing countries with increasing rates of motorization across the world.
Lund Hansen, Dennis; Lauritsen, Jens M
injury information has been available for about 20 years and in the current project the aim was to investigate whether different definitions of black spots (hot spots) would point at different intersections for further scrutiny. During the years 2002 to 2007 all 29 719 patient contacts due to traffic...... defined as The upper decile of injury generating intersections. Intersections with at least one death or hospitalised patient. The intersections covering the upper decile of injuries. Results The three definitions in combination identified 295 injury burdened intersections. Only three intersections were...... identified by all three definitions. All intersections fulfilling definition three were also included in definition one. Definition two covered 103 intersections, only 22 of these were identified by definition one. Conclusion The definition of Black spot has huge implications for identification...
Ball, Chad G; Ball, Jill E; Kirkpatrick, Andrew W; Mulloy, Robert H
Horseback riding is more dangerous than motorcycle riding, skiing, football, and rugby. The purpose of this study was to identify the incidence and injury patterns, as well as risk factors associated with severe equestrian trauma. All patients with major equestrian injuries (injury severity score > or = 12) admitted between 1995 and 2005 were reviewed. A 46-question survey outlining potential rider, animal, and environmental risk factors was administered. Among 7941 trauma patients, 151 (2%) were injured on horseback (mean injury severity score, 20; mortality rate, 7%). Injuries included the chest (54%), head (48%), abdomen (22%), and extremities (17%). Forty-five percent required surgery. Survey results (55%) indicated that riders and horses were well trained, with a 47% recidivism rate. Only 9% of patients wore helmets, however, 64% believed the accident was preventable. Chest trauma previously has been underappreciated. This injury pattern may be a result of significant rider experience. Helmet and vest use will be targeted in future injury prevention strategies.
Juillard, Catherine; Kouo Ngamby, Marquise; Ekeke Monono, Martin; Etoundi Mballa, Georges Alain; Dicker, Rochelle A; Stevens, Kent A; Hyder, Adnan A
Road traffic injury surveillance systems are a cornerstone of organized efforts at injury control. Although high-income countries rely on established trauma registries and police databases, in low- and middle-income countries, the data source that provides the best collection of road traffic injury events in specific low- and middle-income country contexts without mature surveillance systems is unclear. The objective of this study was to compare the information available on road traffic injuries in 3 data sources used for surveillance in the sub-Saharan African country of Cameroon, providing potential insight on data sources for road traffic injury surveillance in low- and middle-income countries. We assessed the number of events captured and the information available in Yaoundé, Cameroon, from 3 separate sources of data on road traffic injuries: trauma registry, police records, and newspapers. Data were collected from a single-hospital trauma registry, police records, and the 6 most widely circulated newspapers in Yaoundé during a 6-month period in 2009. The number of road traffic injury events, mortality, and other variables included commonly in injury surveillance systems were recorded. We compared these sources using descriptive analysis. Hospital, police, and newspaper sources recorded 1,686, 273, and 480 road traffic injuries, respectively. The trauma registry provided the most complete data for the majority of variables explored; however, the newspaper data source captured 2, mass casualty, train crash events unrecorded in the other sources. Police data provided the most complete information on first responders to the scene, missing in only 7%. Investing in the hospital-based trauma registry may yield the best surveillance for road traffic injuries in some low- and middle-income countries, such as Yaoundé, Cameroon; however, police and newspaper reports may serve as alternative data sources when specific information is needed. Copyright © 2017 Elsevier
Increasing road congestion and high traffic volume is often times an indicator of atmospheric air pollution. Ibadan, being the largest metropolitan city in southwestern Nigeria, experiences steady influx of vehicular movement on daily bases. The situation is made worse as a greater number of these vehicles are old and ...
Zachazewski, James; Silvers, Holly J.; Li, Bernard; Snyder-Mackler, Lynn; Insler, Stephanie; Ahmad, Christopher S.; Mandelbaum, Bert R.
Objectives: The purpose of this study is to test the efficacy of a hamstring injury prevention program designed to address the high incidence of acute and chronic hamstring injuries and re-injuries that occur in the sport of professional baseball. Methods: This was a prospective cluster cohort study assessing the efficacy of an injury prevention intervention designed to address hamstring injury in rookie and professional baseball players participating in Minor and Major League Baseball (N = 2...
Full Text Available BACKGROUND: Iran is a country with one of the highest rates of traffic crash fatality and injury, and seventy percent of these fatalities happen on rural roads. The objective of this study is to identify the significant factors influencing injury severity among drivers involved in crashes on two kinds of major rural roads in Iran: two-lane, two-way roads and freeways. METHODS: According to the dataset, 213569 drivers were involved in rural road crashes in Iran, over the 3 years from 2006 to 2008. The Classification And Regression Tree method (CART was applied for 13 independent variables, and one target variable of injury severity with 3 classes of no-injury, injury and fatality. Some of the independent variables were cause of crash, collision type, weather conditions, road surface conditions, driver's age and gender and seat belt usage. The CART model was trained by 70% of these data, and tested with the rest. RESULTS: It was indicated that seat belt use is the most important safety factor for two-lane, two-way rural roads, but on freeways, the importance of this variable is less. Cause of crash, also turned out to be the next most important variable. The results showed that for two-lane, two-way rural roads, "improper overtaking" and "speeding", and for rural freeways, "inattention to traffic ahead", "vehicle defect", and "movement of pedestrians, livestock and unauthorized vehicles on freeways" are the most serious causes of increasing injury severity. CONCLUSIONS: The analysis results revealed seat belt use, cause of crash and collision type as the most important variables influencing the injury severity of traffic crashes. To deal with these problems, intensifying police enforcement by means of mobile patrol vehicles, constructing overtaking lanes where necessary, and prohibiting the crossing of pedestrians and livestock and the driving of unauthorized vehicles on freeways are necessary. Moreover, creating a rumble strip on the two edges of
Kashani, Ali Tavakoli; Shariat-Mohaymany, Afshin; Ranjbari, Andishe
Iran is a country with one of the highest rates of traffic crash fatality and injury, and seventy percent of these fatalities happen on rural roads. The objective of this study is to identify the significant factors influencing injury severity among drivers involved in crashes on two kinds of major rural roads in Iran: two-lane, two-way roads and freeways. According to the dataset, 213569 drivers were involved in rural road crashes in Iran, over the 3 years from 2006 to 2008. The Classification And Regression Tree method (CART) was applied for 13 independent variables, and one target variable of injury severity with 3 classes of no-injury, injury and fatality. Some of the independent variables were cause of crash, collision type, weather conditions, road surface conditions, driver's age and gender and seat belt usage. The CART model was trained by 70% of these data, and tested with the rest. It was indicated that seat belt use is the most important safety factor for two-lane, two-way rural roads, but on freeways, the importance of this variable is less. Cause of crash, also turned out to be the next most important variable. The results showed that for two-lane, two-way rural roads, "improper overtaking" and "speeding", and for rural freeways, "inattention to traffic ahead", "vehicle defect", and "movement of pedestrians, livestock and unauthorized vehicles on freeways" are the most serious causes of increasing injury severity. The analysis results revealed seat belt use, cause of crash and collision type as the most important variables influencing the injury severity of traffic crashes. To deal with these problems, intensifying police enforcement by means of mobile patrol vehicles, constructing overtaking lanes where necessary, and prohibiting the crossing of pedestrians and livestock and the driving of unauthorized vehicles on freeways are necessary. Moreover, creating a rumble strip on the two edges of roads, and paying attention to the design consistency of
Full Text Available High velocity pelvic injury with limb vascular injury poses difficulties as immediate surgery for limb reperfusion is indicated. However immediate vascular intervention deviates from conventional principles of damage control following major injuries. We present two cases of this rare combination of injuries. In both cases, early limb revascularization is possible despite presented with multiple injuries and pelvic fracture.
Pittella, José E H; Gusmão, Sebastião N S
The authors have reported a macro- and microscopic study of brain lesions in 120 victims of fatal road traffic accidents, independent of the survival time. Diffuse vascular injury (DVI) was found in 14 patients (11.7%). All patients with DVI died within 24 h after the accident. The 14 patients with DVI also showed severe (Grade 2 or 3) diffuse axonal injury (DAI). Since DVI is restricted to road traffic accidents and incompatible with life, the high frequency observed in our series could be explained by the fact that all 120 patients were victims of road traffic accidents, and 69.2% had died within 24 h after the accident. The association between DVI and severe DAI (Grades 2 and 3) suggests that both lesions depend on the same mechanism, with the degree of axonal and vascular damage being determined by the intensity of the head acceleration. Our results show a relationship between DVI and DAI that suggest there may be a spectrum or at least a continuum between these entities as distinct from DVI being a separate entity.
Ali, E.; Tayler-Smith, K.; Hedt-Gauthier, B.; Silkondez, W.; Abebe, D.; Deressa, W.; Enquessilase, F.; Edwards, J. K.
Setting: The emergency department (ED) of Zewditu Memorial Hospital, Addis Ababa, Ethiopia. Objective: To document the proportion, trend, characteristics and outcomes of road traffic injury (RTI) related ED admissions (⩾15 years) between 2014 and 2015. Design: A retrospective, cross-sectional study using routinely collected ED data. Results: Of 10 007 ED admissions, 779 (8%) were RTI cases; this proportion peaked in the month of January (11%). Medical records were available for 522 (67%) of these RTI cases. The median age was 28 years and 69% were males. The majority were pedestrians (69%) injured by an automobile (78%). On triage, 32% were classified as needing urgent/immediate intervention. Head injuries (20%) were the second most common injury after lower limb injuries (36%). ED outcomes were as follows: discharged (68%), hospitalised (17%), referred (17%) and died (1%). Among the 78 hospitalised cases, respectively 62% and 16% were admitted to the surgical and orthopaedic departments. Of 146 RTI cases with head injuries, 25% were hospitalised, of whom 82% were admitted to the surgical department. Conclusion: Our findings can guide policy makers in referral hospitals in improving the planning of hospital resources and the prioritisation of public health needs linked to further urban development. A comprehensive plan to prevent RTIs, particularly among pedestrians in Addis Ababa, is urgently needed. PMID:27358798
Neelakantan, Anand; Kotwal, Brig Atul; Ilankumaran, Mookkiah
Injuries are assuming epidemic proportions globally; and in India. Also, previous decade witnessed carnage on Indian roads, with nearly 12 lakh people killed and 55 lakhs disabled in road crashes. The trend in Armed Forces is reflective of the aforesaid patterns. Behaviour and socio-demographic background of the victims are significant determinants of injuries and road accidents. Community-based epidemiological information on these aspects is envisaged to contribute in their preventive strategy. Towards this direction, the present study was conducted with aim to generate socio-behavioural profile of injuries and Road Traffic Accidents (RTAs) amongst service personnel in a large defence station; and to evaluate their determinants. A cross sectional descriptive study was carried out among 796 Naval personnel onboard warships in large Naval station. Data on socio-behavioural aspects and determinants of injuries and road accidents was collected using a pre-validated questionnaire; and by scrutiny of relevant records. Data was analysed using MSExcel, Epi-info and SPSS 17. Young and middle-aged persons were predominantly involved in injuries and road accidents. Two-wheeler users sustained maximum road accidents. Human factor was a significant determinant in RTAs and injuries. A majority of victims admitted that human factors were the predominant cause of road accidents; and opined that the events were preventable. Age-specific Behavioural Change Communication strategies aimed at refining user outlook are imperative; tailored to sociodemographic milieu of user/victim. Incorporation of a dynamic feedback/reporting mechanism, creation of 'armed forces-specific road safety and injury prevention policy' and safety audits on injuries and road crashes are measures in this direction.
Severe road traffic injuries in Kenya, quality of care and access. ... hospitals were interviewed on availability of emergency care and resources. ... Training of motorists and general public in first aid should be considered in RTI control initiatives.
Khan, Adeel Ahmed; Fatmi, Zafar
Road traffic injuries (RTIs) are one of the leading causes of death among productive age group. Using systems approach framework (SAF), current preventive strategies for RTI control were reviewed in Pakistan. A review of the literature was done using four international search engines. Only ten studies on preventive strategies for RTI stemming from Pakistan were found. The first Road Traffic Injuries Research Network (RTIRN) surveillance system for road traffic injuries was established in urban city (Karachi) in Pakistan has shown promise for injury control and should be scaled up to other cities. Enforcement of traffic laws on seat-belt and helmet wearing is poor. National Highway and Motorway Police Ordinance (2000) was one of the few legislative measure so far taken in Pakistan. Using SAF, efforts are required to implement interventions targeting human, vehicle design and also making environment safer for road users.
Road traffic crashes in South Africa: The burden of injury to a regional trauma centre. F Parkinson, S Kent, C Aldous, G Oosthuizen, D Clarke. Abstract. Background. Globally, 90% of road traffic crash (RTC) deaths occur in low- and middle-income countries. Objective. To document the mortality and morbidity associated with ...
Zimmerman, Karen; Jinadasa, Deepani; Maegga, Bertha; Guerrero, Alejandro
Road traffic injuries (RTIs) are a major public health burden, especially in low- and middle-income countries. There is limited data on RTIs in low-volume, rural African settings. This study attempted to survey all individuals living in households within 200 m of two low-volume rural roads in Tanzania and to collect data on RTIs. Local communities and users of the Bago to Talawanda road (intervention site) and Kikaro to Mihuga road (control site) were targeted and received an intensive program of road safety measures tailored using the crash characteristics of the baseline sample. Demographic data on all household members were collected, and those individuals who suffered an RTI in the previous 3 months had comprehensive information collected about the crash characteristics and the socioeconomic impact. The follow-up data collection occurred nine months after the baseline data were collected. The majority of crashes that caused an RTI involved a motorcycle (71%) and the majority of victims were male (82%) with an average age of 27. Injuries to the legs (55%) were most common and the average length of time away from normal activity was 27 (±33) days. RTI incidence at the intervention site increased during the course of the study (incidence before vs. incidence after) and was unchanged in the community control (incidence before vs. incidence after). The incidence of RTIs in the low-volume rural setting is unacceptably high and most commonly associated with motorcycles. The change in incidence is unreliable due to logistic restraints of the project and more research is needed to quantify the impact of various RTI prevention strategies in this setting. This study provides insight into road traffic injuries on low-volume rural roads, areas where very little research has been captured. Additionally, it provides a replicable study design for those interested in collecting similar data on low-volume rural roads.
Full Text Available Abstract Background Road traffic injuries (RTIs are the eighth-leading cause of death worldwide, with low- and middle-income countries sharing a disproportionate number of fatalities. African countries, like Rwanda, carry a higher burden of these fatalities and with increased economic growth, these numbers are expected to rise. We aim to describe the epidemiology of RTIs in Kigali Province, Rwanda and create a hotspot map of crashes from police data. Methods Road traffic crash (RTC report data from January 1, 2013 to December 31, 2013 was collected from Kigali Traffic Police. In addition to analysis of descriptive data, locations of RTCs were mapped and analyzed through exploratory spatial data analysis to determine hotspots. Results A total of 2589 of RTCs were reported with 4689 total victims. The majority of victims were male (94.7 % with an average age of 35.9 years. Cars were the most frequent vehicle involved (43.8 %, followed by motorcycles (14.5 %. Motorcycles had an increased risk of involvement in grievous crashes and pedestrians and cyclists were more likely to have grievous injuries. The hotspots identified were primarily located along the major roads crossing Kigali and the two busiest downtown areas. Conclusions Despite significant headway by the government in RTC prevention, there continue to be high rates of RTIs in Rwanda, specifically with young males and a vulnerable road user population, such as pedestrians and motorcycle users. Improvements in police data and reporting by laypersons could prove valuable for further geographic information system analysis and efforts towards crash prevention and targeting education to motorcycle taxis could help reduce RTIs in a severely affected population.
Patel, Anjni; Krebs, Elizabeth; Andrade, Luciano; Rulisa, Stephen; Vissoci, João Ricardo N; Staton, Catherine A
Road traffic injuries (RTIs) are the eighth-leading cause of death worldwide, with low- and middle-income countries sharing a disproportionate number of fatalities. African countries, like Rwanda, carry a higher burden of these fatalities and with increased economic growth, these numbers are expected to rise. We aim to describe the epidemiology of RTIs in Kigali Province, Rwanda and create a hotspot map of crashes from police data. Road traffic crash (RTC) report data from January 1, 2013 to December 31, 2013 was collected from Kigali Traffic Police. In addition to analysis of descriptive data, locations of RTCs were mapped and analyzed through exploratory spatial data analysis to determine hotspots. A total of 2589 of RTCs were reported with 4689 total victims. The majority of victims were male (94.7 %) with an average age of 35.9 years. Cars were the most frequent vehicle involved (43.8 %), followed by motorcycles (14.5 %). Motorcycles had an increased risk of involvement in grievous crashes and pedestrians and cyclists were more likely to have grievous injuries. The hotspots identified were primarily located along the major roads crossing Kigali and the two busiest downtown areas. Despite significant headway by the government in RTC prevention, there continue to be high rates of RTIs in Rwanda, specifically with young males and a vulnerable road user population, such as pedestrians and motorcycle users. Improvements in police data and reporting by laypersons could prove valuable for further geographic information system analysis and efforts towards crash prevention and targeting education to motorcycle taxis could help reduce RTIs in a severely affected population.
This chapter deals with passenger and freight traffic, public and private transportation, traffic related environmental impacts, future developments, traffic indicators, regional traffic planning, health costs due to road traffic related air pollution, noise pollution, measures and regulations for traffic control and fuels for traffic. In particular energy consumption, energy efficiency, pollutant emissions ( CO 2 , SO 2 , NO x , HC, CO, N 2 O, NH 3 and particulates) and environmental effects of the different types of traffic and different types of fuels are compared and studied. Legal regulations and measures for an effective traffic control are discussed. (a.n.)
Rissanen, Ritva; Berg, Hans-Yngve; Hasselberg, Marie
To assess and provide a systematic overview of current knowledge about the relationship between quality of life (QoL) and road traffic injury, and to appraise how QoL is affected by road traffic injury. A systematic review of the literature published since 1990 on QoL after a road traffic injury, including adult and paediatric populations, from three databases (Pubmed, PsychInfo and SafetyLit) was undertaken. The methodological quality was assessed according to the Newcastle-Ottawa Quality Assessment Scale. Thirty articles were included and assessed for quality. The QoL scores of those injured were similar to population norms at the first assessment, followed by a drop at the second assessment. An increase of QoL from the second to third assessment was reported, but participants never reached the population norms at the last follow-up (range six weeks to two years), with an exception of those claiming compensation and those with lower extremity fractures. Age, gender, socioeconomic status, injury severity, injury type and post-traumatic stress disorder were associated with reduced QoL. Available literature regarding QoL among injured in road traffic crashes is heterogeneous with regard to aims and tools used for assessment. Our review confirmed that independent of measure, the overall QoL was significantly reduced after a road traffic injury compared to the general population norms. Persons who are older, of female gender, lower socioeconomic status, diagnosed with post-traumatic stress disorder, with more severe injuries or injuries to the lower limbs are more vulnerable to loss of QoL following road traffic injury compared to other patient groups injured in road traffic crashes. Copyright © 2017 Elsevier Ltd. All rights reserved.
Barrimah, Issam; Midhet, Farid; Sharaf, Fawzi
In Saudi Arabia, road traffic accidents (RTA) are becoming a serious public health problem. Police reports are designed for legal purposes with very little information on the health consequences. Also, health system data include detailed health information, but not related or linked to the data obtained police reports. Examining the consistency of these sources is vital to build an accurate surveillance system that can track the risk factors and the health consequences, as well as establishing and evaluating prevention interventions. This study is intended to: ▪ Examine the consistency of health -registration data with the data gathered by the traffic police department.▪ Elucidate the magnitude, risk factors and outcome of RTI in Qassim region of Saudi Arabia,▪ Compare the pattern of accidents in Qassim with those at different regions of the Kingdom. Health care information was collected on visits of victims of road traffic accidents to emergency and outpatients' departments of the major hospitals in Qassim region during the year 2010. The information included the patients' demographics, and clinical characteristics. Traffic Police Department information was also collected on all accidents that occurred in the study region. A Questionnaire was also developed and pilot tested to collect data from a random sample of population attending hospital outpatient and Primary Health Care clinics. Data included previous involvement in road traffic accident, and information about any injury; fatality or disability due to these RTI. During the study period, road traffic death rate based on death registration data was almost twice as high as the rate reported by the police (P police-reported data during the study period, as opposed to a non-significant increase of 8% according to health registration data during the same period. Population Survey Information showed the overall age-sex-adjusted rate for non-fatal RTI was 20.7 (95% CI, 20.0 - 21.3)/100 persons/year. The rate
José Simão Rodrigues Filho
Full Text Available The growth of participation of youth in sports is accompanied by an increase in the number of musculoskeletal injuries, especially in contact sports. Basketball gained prominence among contact sports not only for its plastic and beauty of their games, but because it is a sport that demands much of its practitioners, and in the case of young athletes, this requirement can endanger children and adolescents are not properly monitored for health professionals sports. In this study we can see that the ankle is the most affected, followed by knee and fingers and wrists. The mechanisms of injury most frequently reported were sprains, after the bruises and fractures. Highlight for disturbances dorsolumbar, pointed out by many authors. The prevention programs and pre-competition oriented properly treated as paramount by all the authors investigated, in order to reduce the number of injuries in young athletes.
Parkinson, F; Kent, S; Aldous, C; Oosthuizen, G; Clarke, D
Globally, 90% of road traffic crash (RTC) deaths occur in low- and middle-income countries. To document the mortality and morbidity associated with RTCs managed at a busy regional hospital in South Africa and investigate potentially preventable factors associated with RTCs. This was a prospective study of all patients presenting to Edendale Hospital following a RTC over a 10-week period from late 2011 to early 2012. All fatalities recorded at the police mortuary for the same period were included. Medical records were reviewed and all admitted patients were interviewed about the circumstances of the accident. We calculated an injury pyramid to compare our data with European data. A total of 305 patients were seen over the study period, 100 required admission and there were 45 deaths due to RTCs in the area. Of the patients admitted, 41 were pedestrians involved in pedestrian vehicle crashes (PVCs) and 59 motor vehicle occupants involved in motor vehicle crashes (MVCs). The majority (n=58) of crashes involved a private vehicle. Only 17% of MVC patients were wearing a seatbelt and 8 were allegedly under the influence of alcohol. On average, RTC patients spent 19 days in hospital and 62 patients required at least 1 operation. According to our injury pyramid, the number of severe and fatal injuries was higher than in Europe. Our results demonstrate a high incidence of RTCs associated with a high injury score and significant morbidity. Most crashes were associated with a number of high-risk behaviours.
Blais, Etienne; Gagné, Marie-Pier
To assess the effect on collisions with injuries of a 61% reduction in the number of traffic citations issued by police officers over a 21-month period. Using descriptive analyses as well as ARIMA intervention time-series analyses, this study estimated the impact of this reduction in citations issued for traffic violations on the monthly number of collisions with injuries. Simple descriptive analysis reveals that the 61% reduction in the number of citations issued for traffic violations during the experimental period coincided with an increase in collisions with injuries. Results from the interrupted time-series analyses reveal that, on average, eight additional collisions with injuries occurred every month during which the number of tickets issued for traffic violations was lower than normal. As this pressure tactic was applied for 21 months, it is estimated that this situation was associated with approximately 184 additional collisions with injuries: equivalent to 239 traffic injuries (either deaths, minor or serious injuries). In the province of Quebec, police officers are an important component of road safety policy. Issuing citations prevents drivers from adopting reckless driving habits such as speeding, running red lights and failing to fasten their seat belt.
Lee, Yauk K; Skalski, Matt R; White, Eric A; Tomasian, Anderanik; Phan, Diane D; Patel, Dakshesh B; Matcuk, George R; Schein, Aaron J
During the past 2 decades, the frequency of pectoralis major muscle injuries has increased in association with the increased popularity of bench press exercises. Injury of the pectoralis major can occur at the muscle origin, muscle belly, musculotendinous junction, intratendinous region, and/or humeral insertion-with or without bone avulsion. The extent of the tendon injury ranges from partial to complete tears. Treatment may be surgical or conservative, depending on the clinical scenario and anatomic characteristics of the injury. The radiologist has a critical role in the patient's treatment-first in detecting and then in characterizing the injury. In this article, the authors review the normal anatomy and anatomic variations of the pectoralis major muscle, classifications and typical patterns of pectoralis major injuries, and associated treatment considerations. The authors further provide an instructive guide for ultrasonographic (US) and magnetic resonance (MR) imaging evaluation of pectoralis major injuries, with emphasis on a systematic approach involving the use of anatomic landmarks. After reviewing this article, the reader should have an understanding of how to perform-and interpret the findings of-US and MR imaging of the pectoralis major. The reader should also understand how to classify pectoralis major injuries, with emphasis on the key findings used to differentiate injuries for which surgical management is required from those for which nonsurgical management is required. Familiarity with the normal but complex anatomy of the pectoralis major is crucial for performing imaging-based evaluation and understanding the injury findings. © RSNA, 2017 Online supplemental material is available for this article.
Full Text Available Abstract Background In spite of employing numerous devices improving the safety in motor vehicles, traffic accidents are still among the main reasons of maxillofacial injuries. The maxillofacial injuries remain the serious clinical problem because of the specificity of this anatomical region. The knowledge of etiologic factors and mechanisms of injuries can be helpful in a satisfactory trauma prevention. The aim of this study was to find out the incidence and the pattern of maxillofacial injuries resulting from traffic accidents in the patients treated in the Department of Maxillofacial Surgery (Silesian Medical Academy in Katowice, Poland from January 2001 to December 2005. Methods The material consisted of 1024 case records of patients with maxillofacial injuries treated in the Maxillofacial Surgery Department of Silesian Medical Academy. The detailed analysis was carried out on the case records of 198 patients in the age of 3 to 68 with maxillofacial injuries resulting from traffic accidents. On the basis of data from a history, examination on admission, consultations and radiological examinations, patients' age and gender, we obtained the information on a pattern of injury and detailed description of an accident (the date and the time of an accident, the role of the patient in an accident. Results The traffic accidents were the cause of 19,93% maxillofacial injuries in the analyzed period of time. Most of the patients had injuries to the soft tissues of the face (22,21%, followed by tooth and alveolar process injuries (20,71% and mandibular fractures (18,69%. All the types of injuries were more common in men than in women. The majority of the patients were car drivers followed by car passengers, pedestrians, cyclists and motor cyclists. The peak age of the patients was between 18 to 25 years. The prevalent number of accidents resulting in injuries to this region took place in spring, especially between noon and 4 PM. Conclusion Our results
Majdan, Marek; Mauritz, Walter; Wilbacher, Ingrid; Janciak, Ivan; Brazinova, Alexandra; Rusnak, Martin; Leitgeb, Johannes
Road traffic accidents (RTAs) have been identified by public health organizations as being of major global concern. Traumatic brain injuries (TBIs) are among the most severe injuries and are in a large part caused by RTA. The objective of this article is to analyse the severity and outcome of TBI caused by RTA in different types of road users in five European countries. The demographic, severity and outcome measures of 683 individuals with RTA-related TBI from Austria, Slovakia, Bosnia, Croatia and Macedonia were analysed. Five types of road users (car drivers, car passengers, motorcyclists, bicyclists and pedestrians) were compared using univariate and multivariate statistical methods. Short-term outcome [intensive care unit (ICU) survival] and last available long-term outcome of patients were analysed. In our data set, 44% of TBI were traffic related. The median age of patients was 32.5 years, being the lowest (25 years) in car passengers. The most severe and extensive injuries were reported in pedestrians. Pedestrians had the lowest rate of ICU survival (60%) and favourable long-term outcome (46%). Drivers had the highest ICU survival (73%) and car passengers had the best long-term outcome (59% favourable). No differences in the outcome were found between countries with different economy levels. TBI are significantly associated with RTA and thus, tackling them together could be more effective. The population at highest risk of RTA-related TBI are young males (in our sample median age: 32.5 years). Pedestrians have the most severe TBI with the worst outcome. Both groups should be a priority for public health action.
Zhang, Liang; Zhou, Ji-Hong; Qiu, Jun; Zhang, Xiu-Zhu; Yuan, Dan-Feng; Gao, Zhi-Ming; Dai, Wei
To study the epidemiologic characteristics of traffic injuries among people over 60 years old in the Nan'an district (urban) and Jiangjin district (rural) of Chongqing, and to discuss the corresponding strategies for its prevention and cure. Records of traffic injuries in people over 60 years old registered by the traffic police between 2000 and 2006 in Nan'an district and Jiangjin district were collected in the Database of Road Traffic Accidents and Traffic Injuries. Epidemiologic characteristics of traffic injuries among the aged people were analyzed and compared. Between the year 2000 and 2006, the average annual incidence of traffic injuries and mortality rate in the aged people in Nan'an district were 124.62/100 000 and 13.85/ 100 000 respectively, higher than that in Jiangjin district (27.49/ 100 000, 7.13/100 000, P less than 0.01). However, the mortality rate for the aged people who were involved in traffic injuries in Jiangjin district was 20.60%, higher than that in Nan'an district (10.00%, P less than 0.01). Head injury was the primary cause of death. Totally 76.58% of casualties were pede-strians. Over 90% of the traffic accidents occurred in the areas with no traffic signal or traffic control system. The traffic environment is unfavorable to the aged people. It is important to enhance traffic safety consciousness of drivers and the elderly and to strengthen traffic safety system and traffic law, so as to provide a safe road traffic environment for the aged people.
Injury characteristics and outcome of road traffic accident among victims at Adult Emergency Department of Tikur Anbessa specialized hospital, Addis Ababa, Ethiopia: a prospective hospital based study.
Seid, Mohammed; Azazh, Aklilu; Enquselassie, Fikre; Yisma, Engida
Road traffic injuries are the eighth leading cause of death globally, and the leading cause of death for young people. More than a million people die each year on the world's roads, and the risk of dying as a result of a road traffic injury is highest in Africa. A prospective hospital based study was undertaken to assess injury characteristics and outcome of road traffic accident among victims at Adult Emergency Department of Tikur Anbessa specialized hospital, Addis Ababa, Ethiopia. A structured pre-tested questionnaire was used to gather the required data. The collected data were analyzed using SPSS version 20.0. Hierarchical multiple regression analysis was used to identify predictors of fatalities among the road traffic crash victims. A total of 230 road traffic accident victims were studied. The majority of the study subjects were men 165 (71.7%) and the male/female ratio was 2.6:1. The victims' ages ranged from 14 to 80 years with the mean and standard deviations of 32.15 and ± 14.38 years respectively. Daily laborers (95 (41.3%)) and students (28 (12.2%)) were the majority of road traffic accident victims. Head (50.4%) and musculoskeletal (extremities) (47.0%) were the most common body region injured. Fractures (78.0%) and open wounds (56.5%) were the most common type of injuries sustained. The overall length of hospital stay (LOS) ranged from 1 day to 61 days with mean (± standard deviation) of 7.12 ± 10.5 days and the mortality rate was 7.4%. Hierarchical multiple regression analysis showed that age of the victims (ß = 0.16, p road traffic accident is a major public health problem. Urgent road traffic accident preventive measures and prompt treatment of the victims are warranted in order to reduce morbidity and mortality among the victims.
van Dijk, Alwin; Wolswijk, Hein
The criminal law on serious traffic offences is a fascinating area. The traffic context presents legislators with numerous controversial issues. One such issue is when severe consequences are matched with low moral culpability. How should the law deal with a driver who kills someone because she
Terrier, Jean-Etienne; Paparel, Philippe; Gadegbeku, Blandine; Ruffion, Alain; Jenkins, Lawrence C; N'Diaye, Amina
Traffic accidents are the most frequent cause of genitourinary injuries (GUI). Kidney injuries after trauma have been well described. However, there exists a paucity of data on other traumatic GUI after traffic accidents. The objective of this study was to analyze the frequency and type of all GUI, by user category, after traffic accidents. Patient cases were extracted from the trauma registry of the French department of Rhone from 1996 to 2013. We assessed the urogenital injuries presented by each of road user's categories. Severity injuries were coded with the Abbreviated Injury Scale and the Injury Severity Score. Kidney trauma was mapped with the classification of the American Association for the Surgery of Trauma. Multivariate prediction models were used for analysis of data. Of 162,690 victims, 963 presented with GUI (0.59%). 47% were motorcyclists, 22% were in a car, 18% on bicycles, and 9% were pedestrians. The most common organ injury was kidney (41%) followed by testicular (23%). Among the 208 motorists with a GUI, kidney (70%), bladder (10%), and adrenal gland (9%) were the most frequent lesions. Among the 453 motorcyclist victims with GUI, kidney (35%) and testicular (38%) traumas were the most frequent and 62% of injuries involved external genitalia. There were 175 cyclists with GUI, 70% of injuries involved external genitalia; penile traumas (23%) were the most frequent. In total, there were 395 kidney injuries, most being low grade. According to the American Association for the Surgery of Trauma kidney injuries were grade I, 59%; grade II, 11%; grade III, 16%; grade IV, 9%; grade V, 3%; and indeterminate, 2%. GUI is an infrequent trauma after traffic accidents, with kidneys being the most commonly injured. Physicians must maintain a high awareness for external genitalia injuries in motorcyclists and cyclists. Prognostic and epidemiologic study, level III.
Full Text Available AIM: To study the mechanism of road traffic collisions (RTC, use of safety devices, and outcome of hospitalized pediatric and youth RTC injured patients so as to give recommendations regarding prevention of pediatric RTC injuries. METHODS: All RTC injured children and youth (0-19-year-olds who were admitted to Al Ain City's two major trauma centers or who died after arrival to these centers were prospectively studied from April 2006 to October 2007. Demography of patients, road-user and vehicle types, crash mechanism, usage of safety devices, injured body regions, injury severity, Revised Trauma Score, Glasgow Coma Scale, intensive care unit admissions, hospital stay and mortality were analyzed. RESULTS: 245 patients were studied, 69% were vehicle occupants, 15% pedestrians, 9% motorcyclists and 5% bicyclists. 79% were males and 67% UAE citizens. The most common mechanism of RTC was rollover of vehicle (37% followed by front impact collision (32%. 32 (13% of vehicle occupants were ejected from car. 63% of ejected occupants and 70% of motorcyclists sustained head injuries. Only 2% (3/170 vehicle passengers used seatbelts and 13% (3/23 motorcyclists a helmet. CONCLUSIONS: Male drivers and UAE nationals were at high risk of RTC as drivers and as motorcyclists. Ejection rate was high because safety restraint use was extremely low in our community. More education and law enforcement focusing especially on car/booster seat use is needed.
Grivna, Michal; Eid, Hani O; Abu-Zidan, Fikri M
To study the mechanism of road traffic collisions (RTC), use of safety devices, and outcome of hospitalized pediatric and youth RTC injured patients so as to give recommendations regarding prevention of pediatric RTC injuries. All RTC injured children and youth (0-19-year-olds) who were admitted to Al Ain City's two major trauma centers or who died after arrival to these centers were prospectively studied from April 2006 to October 2007. Demography of patients, road-user and vehicle types, crash mechanism, usage of safety devices, injured body regions, injury severity, Revised Trauma Score, Glasgow Coma Scale, intensive care unit admissions, hospital stay and mortality were analyzed. 245 patients were studied, 69% were vehicle occupants, 15% pedestrians, 9% motorcyclists and 5% bicyclists. 79% were males and 67% UAE citizens. The most common mechanism of RTC was rollover of vehicle (37%) followed by front impact collision (32%). 32 (13%) of vehicle occupants were ejected from car. 63% of ejected occupants and 70% of motorcyclists sustained head injuries. Only 2% (3/170) vehicle passengers used seatbelts and 13% (3/23) motorcyclists a helmet. Male drivers and UAE nationals were at high risk of RTC as drivers and as motorcyclists. Ejection rate was high because safety restraint use was extremely low in our community. More education and law enforcement focusing especially on car/booster seat use is needed.
Full Text Available Background: Regularly available data is shown to be inadequate for developing, implementing, and evaluating injury prevention and control programs in India. The present study was undertaken in the hospitals of Bangalore and Pune, to examine the feasibility of gathering information on injuries using multiple sources. Materials and Methods: Stakeholders meeting and training programs were held for the hospital staff, police personnel, and traffic and transport staff, to identify their roles and responsibilities. Prospective data on morbidity and mortality due to injuries were collected by trained staff from Emergency Departments on a pre-tested questionnaire. The information gathered was cross-checked with the hospital and police records. Results: The stakeholders meeting and training programs were able to motivate the departments to provide the correct data. Data on 32188 patients could be extracted from hospital and police records during the study period. Injuries accounted for 16% of the emergency cases. Unintentional injuries were 64%, and 32% were intentional. Road traffic injuries accounted for 44% of all the injuries. One-third of the injured were children and young adults below 25 years. Among the injured, two wheeler riders were 29% and pedestrians were 23%. Conclusion: It was possible to improve the data on injuries by adequate training and a data linking mechanism between the Police, Hospital, and Transport Departments. The problem of road traffic injuries could be highlighted and addressed by a good data capture mechanism.
Sharma, Neeraj; Bairwa, Mohan; Gowthamghosh, B; Gupta, S D; Mangal, D K
Globally, road traffic injuries are the leading cause of death among those aged 15-29 years. However, road traffic injury research has not received adequate attention from the scientific community in low- and middle-income countries, including India. The present study aims to provide a bibliometric overview of research assessing road traffic injuries in India. We used Scopus to extract relevant research in road traffic injuries published from 1991 to 2017. This study presented the key bibliometric indicators such as trends of annual publications and citations, top 10 authors, journals, institutions and highly cited articles, citation analysis of articles, co-occurrence of keywords, etc. Analysis was performed using Scopus, Microsoft Excel, and VOS-viewer. A total of 242 articles were retrieved with an h-index of 18, excluding self-citations. A steadfast growth of publications was documented in last decade, especially after the year 2010. The h-index of the top 10 authors, institutions, journals and highly cited articles did not surpass single digits. A network visualisation map showed that 'traffic accident', 'male', 'adolescent' and 'child' were the most commonly encountered key terms. The prominent authors were Gururaj G, Dandona R, and Hyder AA, whereas the top journals were the Indian Journal of Forensic Medicine and Toxicology, Medico Legal Update, and the International Journal of Applied Engineering Research and top institutions were the All India Institute of Medical Sciences, New Delhi, the Indian Institute of Technology, Delhi, and the Administrative Staff College of India. In India, road traffic injuries research is inadequate in quantity and quality, warranting greater attention from researchers and policy planners to address the burden of road traffic injuries.
Full Text Available This research presents a Geographic Information Systems (GIS and spatial analysis approach based on the global spatial autocorrelation of road traffic injuries for identifying spatial patterns. A locational spatial autocorrelation was also used for identifying traffic injury at spatial level. Data for this research study were acquired from Canadian Institute for Health Information (CIHI based on 2004 and 2011. Moran’s I statistics were used to examine spatial patterns of road traffic injuries in the Greater Toronto Area (GTA. An assessment of Getis-Ord Gi* statistic was followed as to identify hot spots and cold spots within the study area. The results revealed that Peel and Durham have the highest collision rate for other motor vehicle with motor vehicle. Geographic weighted regression (GWR technique was conducted to test the relationships between the dependent variable, number of road traffic injury incidents and independent variables such as number of seniors, low education, unemployed, vulnerable groups, people smoking and drinking, urban density and average median income. The result of this model suggested that number of seniors and low education have a very strong correlation with the number of road traffic injury incidents.
Full Text Available Context: Road traffic injuries (RTIs are the leading cause of death and globally kill 1.2 million people every year and leave 20 - 50 million people injured and disabled. In Iran, traffic related fatalities are the leading cause of death among all inadvertent fatal injuries imposed on children under five. Herein, authors review the epidemiological studies performed on vehicle accidents among Iranian children and adolescents to improve the knowledge about these preventable events. Evidence Acquisition: International databases including PubMed, Google scholar, science direct Cochrane library, and national data bases such as scientific information database (SID were searched for terms; children, motor vehicle accident, road traffic injuries, Iran 2000 - 2015. Publication in Persian or English language related to the subject including Iranian children and adolescent's age groups were included. Among the 312 articles, 11 (two abstracts and nine full texts were selected. Nine full texts were reviewed. Results: From 22865 victims, about 3578 children and adolescents under 19 years old were identified. Males were more affected than females. Pedestrian injury with 43.66% was the most common case of road traffic injuries. Head trauma was the most common cause of injuries reported by eight of the reviewed articles. Most of the accidents occurred between 1:00 - 6:00 PM. Most of RTIs occurred in summer. Care by emergency medical services (EMS (29.14% was reported by five out of the nine reviewed article. Conclusions: Most of the road traffic injuries among Iranian children and adolescents are preventable using appropriate preventive strategies such as safety facilities, safe vehicles, and safe traffic behavior, and establishing comprehensive public education programs for older children and their parents.
Arash Jodeiri Eslami
Full Text Available "nObjective: Nowadays, it is well known that the attention-deficit/hyperactivity disorder (ADHD is not confined to children and adolescents. Recent data showed that a considerable portion of the general adult population may be affected by ADHD. On the other hand, the impact of ADHD on driving performance, a major area of adult life, has gained enthusiasm. More recent studies revealed an association between adult ADHD and undesirable driving problems. This study was performed to determine the association between presence of adult ADHD and traffic injuries. "nMethods: In this case-control study, in a 13 month period, 140 subjects (70 drivers/riders injured in traffic accidents ,and 70 age- and sex-matched non traumatic controls were selected to participate in the study and were placed in two groups . Subjects with psychiatric comorbidities were excluded. The Conners' Adult ADHD Rating Scale (CAARS self-report (screening version was used for screening adult ADHD in both groups. Finally, the occurrence of this condition was compared between the case and control groups. "nResults: Sixty- nine males and one female were recruited in each group with a mean age of 29.31±9.32 (18-61 years in the case and 29.03±9.07 (range: 18-60 years in the control groups (P > 0.05. Previous history of traffic accident was significantly higher in the case group (15.7% vs. 4.3%, P=0.024. The mean driving time in a day was also significantly higher in the case group. In the case group, the scores of CAARS (the ADHD index, ADHD symptoms total, inattentive subscale and hyperactive/impulsive subscale were positive (higher than 70 in 4.3, 10, 7.1 and 10 percent of patients respectively. Among the controls, the corresponding proportions were 4.3, 14.3, 8.6 and 8.6 percent respectively. The two groups were comparable for the mentioned rates. "nConclusion: The results of this study revealed no significant association between ADHD and traffic injuries in Tabriz- Iran
Alamgir, Hasanat; Yu, Shicheng; Gorman, Erin; Ngan, Karen; Guzman, Jaime
An essential assumption of injury prevention programs is the common cause hypothesis that the causal pathways of near misses and minor injuries are similar to those of major injuries. The rates of near miss, minor injury and major injury of all reported incidents and musculoskeletal incidents (MSIs) were calculated for three health regions using information from a surveillance database and productive hours from payroll data. The relative distribution of individual causes and activities involved in near miss, minor injury and major injury were then compared. For all reported incidents, there were significant differences in the relative distribution of causes for near miss, minor, and major injury. However, the relative distribution of causes and activities involved in minor and major MSIs were similar. The top causes and activities involved were the same across near miss, minor, and major injury. Finding from this study support the use of near miss and minor injury data as potential outcome measures for injury prevention programs. (c) 2008 Wiley-Liss, Inc.
Hasler, Rebecca M; Exadaktylos, Aristomenis K; Bouamra, Omar; Benneker, Lorin M; Clancy, Mike; Sieber, Robert; Zimmermann, Heinz; Lecky, Fiona
Patients with cervical spine injuries are a high-risk group, with the highest reported early mortality rate in spinal trauma. This cohort study investigated predictors for cervical spine injury in adult (≥ 16 years) major trauma patients using prospectively collected data of the Trauma Audit and Research Network from 1988 to 2009. Univariate and multivariate logistic regression analyses were used to determine predictors for cervical fractures/dislocations or cord injury. A total of 250,584 patients were analyzed. Median age was 47.2 years (interquartile range, 29.8-66.0) and Injury Severity Score 9 (interquartile range, 4-11); 60.2% were male. Six thousand eight hundred two patients (2.3%) sustained cervical fractures/dislocations alone. Two thousand sixty-nine (0.8%) sustained cervical cord injury with/without fractures/dislocations; 39.9% of fracture/dislocation and 25.8% of cord injury patients suffered injuries to other body regions. Age ≥ 65 years (odds ratio [OR], 1.45-1.92), males (females OR, 0.91; 95% CI, 0.86-0.96), Glasgow Coma Scale (GCS) score sports injuries (OR, 3.51; 95% CI, 2.87-4.31), road traffic collisions (OR, 3.24; 95% CI, 3.01-3.49), and falls >2 m (OR, 2.74; 95% CI, 2.53-2.97) were predictive for fractures/dislocations. Age sports injuries (OR, 4.42; 95% CI, 3.28-5.95), road traffic collisions (OR, 2.58; 95% CI, 2.26-2.94), and falls >2 m (OR, 2.24; 95% CI, 1.94-2.58) were predictors for cord injury. 3.5% of patients suffered cervical spine injury. Patients with a lowered GCS or systolic blood pressure, severe facial fractures, dangerous injury mechanism, male gender, and/or age ≥ 35 years are at increased risk. Contrary to common belief, head injury was not predictive for cervical spine involvement.
Ammori, Mohannad B; Eid, Hani O; Abu-Zidan, Fikri M
To study the relationship between severity of injury of the lower limb and severity of injury of the head, thoracic, and abdominal regions in frontal-impact road traffic collisions. Consecutive hospitalised trauma patients who were involved in a frontal road traffic collision were prospectively studied over 18 months. Patients with at least one Abbreviated Injury Scale (AIS) ≥3 or AIS 2 injuries within two AIS body regions were included. Patients were divided into two groups depending on the severity of injury to the head, chest or abdomen. Low severity group had an AIS chest or abdominal injuries. Eighty-five patients were studied. The backward likelihood logistic regression model defining independent factors affecting severity of head injuries was highly significant (p =0.01, nagelkerke r square = 0.1) severity of lower limb injuries was the only significant factor (p=0.013) having a negative correlation with head injury (Odds ratio of 0.64 (95% CI: 0.45-0.91). Occupants who sustain a greater severity of injury to the lower limb in a frontal-impact collision are likely to be spared from a greater severity of head injury.
Ju, Yong Han; Sohn, So Young
Injury analysis following a vehicle crash is one of the most important research areas. However, most injury analyses have focused on one-dimensional injury variables, such as the AIS (Abbreviated Injury Scale) or the IIS (Injury Impairment Scale), at a time in relation to various traffic accident factors. However, these studies cannot reflect the various injury phenomena that appear simultaneously. In this paper, we apply quantification method II to the NASS (National Automotive Sampling System) CDS (Crashworthiness Data System) to find the relationship between the categorical injury phenomena, such as the injury scale, injury position, and injury type, and the various traffic accident condition factors, such as speed, collision direction, vehicle type, and seat position. Our empirical analysis indicated the importance of safety devices, such as restraint equipment and airbags. In addition, we found that narrow impact, ejection, air bag deployment, and higher speed are associated with more severe than minor injury to the thigh, ankle, and leg in terms of dislocation, abrasion, or laceration. Copyright © 2010 Elsevier Ltd. All rights reserved.
Savenkova, E N; Efimov, A A
The road traffic accidents are known to make the greatest contribution to the overall structure of pediatric traumatism with the fatal outcome. The problem of pediatric traumatism remains on top of its relevancy despite numerous administrative, legal, technical, and financial measures taken at the government level in an attempt to reduce the mortality rate associated with the child-pedestrian injuries inflicted in the road traffic accidents. The objective of the present study was to summarize and interpret the results published in the scientific literature concerning child-pedestrian injuries inflicted in the road traffic accidents with special reference to the age of the victims and the type of the injury. The analysis of the publications of the domestic and foreign authors has demonstrated that the available data of interest remain to be systematized and that the forensic medical aspects of the problem in question are poorly represented in these materials. It was shown that forensic medical expertises of child-pedestrian injuries inflicted in the road traffic accidents are frequently carried out without taking into consideration the peculiar anatomical and physiological features of the child's organism. The available data concerning the mechanisms and evaluation of severe injuries inflicted to the children in the road traffic accidents are insufficient for the development of the algorithms for the relevant adequate forensic medical expertise. In the light of these findings, the problem of the child-pedestrian injuries inflicted in the road traffic accidents takes on new significance when considered in the context of pediatric traumatism. There is evidently the growing necessity to formulate the universal database containing systematized objective information for the development of new methods of forensic medical expertise for the elucidation of the mechanisms of road traffic injuries inflicted to the children of different age groups depending on the type of the
Calosevic, Srdjan; Lovric, Zvonimir
Fatal triad and ipsilateral dyad are patterns of pedestrian injuries related to significant mortality in traffic-related accidents. The aim of this research was to investigate the correlation between specific injury patterns and fatal outcome in other participants of traffic-related accidents. This was a retrospective study of traffic-related accidents in the broader area of the city of Osijek in a five-year period from 1995 to 1999. Autopsy results from the Institute of Pathology and Forensic Medicine of the Clinical Hospital Centre Osijek were analysed of individuals who died after their accident. The total severity of injuries was measured using the ISS. Logistic regression analysis was used for assessing the correlation between specific injury patterns and an early outcome from the severe injury. There were 213 individuals included in the study: 72 pedestrians and 141 other participants (drivers, assistant drivers, passengers, cyclists and motorcyclists). A total of129 individuals died on the spot and 84 died in the hospital during the first 48h. Femoral and pelvic fracture, fatal triad and both variants of ipsilateral dyad were related to higher ISS values. Ipsilateral fracture of upper and lower extremities (ipsilateral dyad 1) was associated with a 4.59 times higher risk of an immediate fatal outcome in the total sample. In pedestrians, the risk was 5.99 higher, and in other participants, the risk was 4.11 times higher. Specific skeletal injuries and injury patterns are a significant indicator for total injury severity and related poor prognosis for all participants of traffic-related injuries, not only for pedestrians. In this study, the ipsilateral fracture of upper and lower extremity was related to the largest total severity of injuries and the poorest prognosis. Copyright © 2015 Elsevier Ltd. All rights reserved.
Martinoli, S; Quadri, B; Casabianca, A
Based on an epidemiological observation in Ticino 1985, following statement is possible: in Switzerland every year 900 people dye in traffic casualties. Many victims of tragic accidents get lifetime disabled. Direct and indirect costs of traffic injuries are yearly 3 billions of swiss francs. Only a small percentage (6%) is devoted to medical treatment. The most part is due to compensation of income, disability with its allocations and lost productivity. Among "avoidable" deaths, traffic victims are an essential portion because the are young. More efforts should be undertaken to lower road mortality because she erodes the swiss population pyramid in a significant manner.
Gomei, Sayaka; Hitosugi, Masahito; Ikegami, Keiichi; Tokudome, Shogo
The objective of this study was to clarify the relationship between injury severity in bicyclists involved in traffic accidents and patient outcome or type of vehicle involved in order to propose effective measures to prevent fatal bicycle injuries. Hospital records were reviewed for all patients from 2007 to 2010 who had been involved in a traffic accident while riding a bicycle and were subsequently transferred to the Shock Trauma Center of Dokkyo Medical University Koshigaya Hospital. Patient outcomes and type of vehicle that caused the injury were examined. The mechanism of injury, Abbreviated Injury Scale (AIS) score, and Injury Severity Score (ISS) of the patient were determined. A total of 115 patients' records were reviewed. The mean patient age was 47.1 ± 27.4 years. The average ISS was 23.9, with an average maximum AIS (MAIS) score of 3.7. The ISS, MAIS score, head AIS score, and chest AIS score were well correlated with patient outcome. The head AIS score was significantly higher in patients who had died (mean of 4.4); however, the ISS, MAIS score, and head AIS score did not differ significantly according to the type of vehicle involved in the accident. The mean head AIS scores were as high as 2.4 or more for accidents involving any type of vehicle. This study provides useful information for forensic pathologists who suspect head injuries in bicyclists involved in traffic accidents. To effectively reduce bicyclist fatalities from traffic accidents, helmet use should be required for all bicyclists.
Töro, Klára; Szilvia, Fehér; György, Dunay; Pauliukevicius, Alvydas; Caplinskiene, Marija; Raudys, Romas; Lepik, Delia; Tuusov, Jana; Vali, Marika
Motor vehicle accidental injuries are a frequent cause of death among young children and adolescents. The goal of this study was to compare patterns of injury between three capitals (Budapest, Vilnius, and Tallinn). Information on 190 fatal traffic accidents (69 pedestrians, 14 bicyclists, and 107 motor vehicle occupants) between 2002 and 2006 was collected from databases of medico-legal autopsies. The role of victims in accidents, the location of injuries, cause of death, survival period, and blood alcohol levels were evaluated. One-hundred and forty-one (74%) victims had a passive role in traffic as pedestrians, passengers in cars, or public transport. In victims who died at the scene, the rate of head injury was higher than in cases who received medical treatment (odds ratio = 2.58, CI = 1.2-5.55, p = 0.0127). These results underline the importance of postmortem studies to examine the pathomechanism of fatal traffic accidental injuries and to provide information for the prevention of road traffic accidents against children and adolescents. © 2011 American Academy of Forensic Sciences.
Holte, Kathrine; Bardram, Linda; Wettergren, André
Bile duct injury (BDI) after cholecystectomy remains a serious complication with major implications for patient outcome. For most major BDIs, the recommended method of repair is a hepaticojejunostomy (HJ). We conducted a retrospective review aiming to examine the perioperative and the long...
Rockett, Ian R H; Jiang, Shuhan; Yang, Qian; Yang, Tingzhong; Yang, Xiaozhao Y; Peng, Sihui; Yu, Lingwei
This study estimated the prevalence of road traffic injury among Chinese urban residents and examined individual and regional-level correlates. A cross-sectional multistage process was used to sample residents from 21 selected cities in China. Survey respondents reported their history of road traffic injury in the past 12 months through a community survey. Multilevel, multivariable logistic regression analysis was used to identify injury correlates. Based on a retrospective 12-month reporting window, road traffic injury prevalence among urban residents was 13.2%. Prevalence of road traffic injury, by type, was 8.7, 8.7, 8.5, and 7.7% in the automobile, bicycle, motorcycle, and pedestrian categories, respectively. Multilevel analysis showed that prevalence of road traffic injury was positively associated with minority status, income, and mental health disorder score at the individual level. Regionally, road traffic injury was associated with geographic location of residence and prevalence of mental health disorders. Both individual and regional-level variables were associated with road traffic injury among Chinese urban residents, a finding whose implications transcend wholesale imported generic solutions. This descriptive research demonstrates an urgent need for longitudinal studies across China on risk and protective factors, in order to inform injury etiology, surveillance, prevention, treatment, and evaluation.
Full Text Available Introduction: Significant perineal injuries and major pelvic fractures resulting from blunt trauma manifest a high-energy injury. Open pelvic fractures (with perineal injury are associated with higher mortality rates of 40 to 60 %. Methods: This study was a review of patients with multiple traumas comprising of major pelvic fracture and severe perineal injuries (Shahid Kamyab hospital in Mashhad from 2002- 2005. A total of 11 patients, with pelvic fracture and perineal injuries (injury to urethra and anal canal were entered in the study. The data was gathered by a checklist and analyzed with SPSS software. Results: The population under study included 11 patients (9 male, 2 female with a mean age of 35years. Cause of trauma in all patients was motor vehicle accidents. All of the patients in the first 6 hours of admission received at least 4 liters of serum ringer lactate and 3 units of packed cells. The mean of packed cell received was 8 units and one patient needed 21 units of packed cells. All of patients were taken to the operating room for diverting colostomy, distal rectal washout, cystostomy and radical debridment and irrigation of devitalized tissue. Good results were achieved in 9 patients and there was one case of mortality and one morbidity (ARF. Conclusion: Open pelvic fractures and perineal injuries are associated with higher mortality rates. Prompt diagnosis and proper treatment (reanimation, colostomy, cystostomy, debridment and irrigation is the key to success.
Full Text Available We aimed to use the willingness to pay (WTP method to calculate the cost of traffic injuries in Iran in 2013. We conducted a cross-sectional questionnaire-based study of 846 randomly selected road users. WTP data was collected for four scenarios for vehicle occupants, pedestrians, vehicle drivers, and motorcyclists. Final analysis was carried out using Weibull and maximum likelihood method. Mean WTP was 2,612,050 Iranian rials (IRR. Statistical value of life was estimated according to 20,408 fatalities 402,314,106,073,648 IRR (US$13,410,470,202 based on purchasing power parity at (February 27th, 2014. Injury cost was US$25,637,870,872 (based on 318,802 injured people in 2013, multiple daily traffic volume of 311, and multiple daily payment of 31,030 IRR for 250 working days. The total estimated cost of injury and death cases was 39,048,341,074$. Gross national income of Iran was, US$604,300,000,000 in 2013 and the costs of traffic injuries constituted 6·46% of gross national income. WTP was significantly associated with age, gender, monthly income, daily payment, more payment for time reduction, trip mileage, drivers and occupants from road users. The costs of traffic injuries in Iran in 2013 accounted for 6.64% of gross national income, much higher than the global average. Policymaking and resource allocation to reduce traffic-related death and injury rates have the potential to deliver a huge economic benefit.
Ainy, Elaheh; Soori, Hamid; Ganjali, Mojtaba; Le, Henry; Baghfalaki, Taban
We aimed to use the willingness to pay (WTP) method to calculate the cost of traffic injuries in Iran in 2013. We conducted a cross-sectional questionnaire-based study of 846 randomly selected road users. WTP data was collected for four scenarios for vehicle occupants, pedestrians, vehicle drivers, and motorcyclists. Final analysis was carried out using Weibull and maximum likelihood method. Mean WTP was 2,612,050 Iranian rials (IRR). Statistical value of life was estimated according to 20,408 fatalities 402,314,106,073,648 IRR (US$13,410,470,202 based on purchasing power parity at (February 27th, 2014). Injury cost was US$25,637,870,872 (based on 318,802 injured people in 2013, multiple daily traffic volume of 311, and multiple daily payment of 31,030 IRR for 250 working days). The total estimated cost of injury and death cases was 39,048,341,074$. Gross national income of Iran was, US$604,300,000,000 in 2013 and the costs of traffic injuries constituted 6·46% of gross national income. WTP was significantly associated with age, gender, monthly income, daily payment, more payment for time reduction, trip mileage, drivers and occupants from road users. The costs of traffic injuries in Iran in 2013 accounted for 6.64% of gross national income, much higher than the global average. Policymaking and resource allocation to reduce traffic-related death and injury rates have the potential to deliver a huge economic benefit.
Full Text Available Road traffic injuries (RTIs are a major public health problem worldwide, especially in low- and middle-income countries (LMICsand require concerted efforts for effective and sustainable prevention. A variety of measures need to be considered when planning activities. This is particularly true in LMICs. Iran, for example, despite its enormous efforts in recent years in both pre-crash and post crash measures as well as social policy changes, continues to be challenged by the sheer magnitude of this major public health problem. Accordingly, stakeholders’ perceptions, the approach and the kind of preventive activities are crucial. On the whole, there are two different approaches in RTI prevention: the individual approach and the system approach.In the individual approach, there is a tendency for researchers and particularly practitioners to identify only one or a few elements, which usually can be found in many LMICs. Traditionally, in such countries many studies have focused on factors relating to driver errors, poor vehicles and the road environment instead of finding the reason for injury outcome. In many LMICs, the majority of preventive activities target road-user behaviors, which are usually tackled by means of education and enforcement. Hence the primary responsibility is assigned to the road user. However, while safe road-user behavior is one important component, changing such behavior should not simply be focused on education and enforcement. When WHO launched its call to action, it invited members of the public to be part of the solution. The initiative focused on five important courses of action for the general public including: not speeding; wearing a seat-belt; being visible on the road; wearing a helmet; and never drinking and driving. Studies on public education efficiency have revealed that a decrease in crashes due to such campaigns can occur only if they clearly target specific forms of behavior, like seat belt use or helmet
Full Text Available Abstract: By virtue of their variability, mass and speed have important roles in transferring energies during a crash incidence (kinetic energy. The sum of kinetic energy is important in determining an injury severity and that is equal to one half of the vehicle mass multiplied by the square of the vehicle speed. To meet the Vision Zero policy (a traffic safety policy prevention activities should be focused on vehicle speed management. Understanding the role of kinetic energy will help to develop measures to reduce the generation, distribution, and effects of this energy during a road traffic crash. Road traffic injury preventive activities necessitate Kinetic energy management to improve road user safety.
Cubí-Mollá, Patricia; Peña-Longobardo, Luz María; Casal, Bruno; Rivera, Berta; Oliva-Moreno, Juan
To estimate the years of potential life lost, years of potential productive life lost and the labor productivity losses attributable to premature deaths due to traffic injuries between 2002 and 2012 in Spain. Several statistical sources were combined (Spanish Registry of Deaths, Labor Force Survey and Wage Structure Survey) to develop a simulation model based on the human capital approach. This model allowed us to estimate the loss of labor productivity caused by premature deaths following traffic injuries from 2002 to 2012. In addition, mortality tables with life expectancy estimates were used to compute years of potential life lost and years of potential productive life lost. The estimated loss of labour productivity caused by fatal traffic injuries between 2002 and 2012 in Spain amounted to 9,521 million euros (baseline year 2012). The aggregate number of years of potential life lost in the period amounted to 1,433,103, whereas the years of potential productive life lost amounted to 875,729. Throughout the period analyzed, labor productivity losses and years of life lost diminished substantially. Labor productivity losses due to fatal traffic injuries decreased throughout the period analyzed. Nevertheless, the cumulative loss was alarmingly high. Estimation of the economic impact of health problems can complement conventional indicators of distinct dimensions and be used to support public policy making. Copyright © 2014 SESPAS. Published by Elsevier Espana. All rights reserved.
Barbosa, Kevan G N; Lucas-Neto, Alfredo; Gama, Bruno D; Lima-Neto, Jose C; Lucas, Rilva Suely C C; d'Ávila, Sérgio
Facial injuries frequently occur in traffic accidents involving motorcycles. The purpose of this study was to determine the prevalence of facial injuries among motorcycle drivers who perform motorcycle taxi service. The study design was cross-sectional. A total of 210 participants who served as motorcycle taxi drivers in a city in northeastern Brazil completed a survey concerning their experience of accidents involving facial injuries and consequent hospitalization and absenteeism from work. The motorcycle drivers included in the study were randomly selected from a list provided by the city. Out of the respondents, 165 (78.6%) who were involved in traffic accidents in the last 12 months, 15 (9.1%) reported facial injuries. The types of facial injury most frequently reported involved soft tissues (n = 8; 53.3%), followed by simple fracture (n = 4; 26.7%) and dentoalveolar fracture (n = 3; 20%). We found an association between facial injuries and absenteeism, as well as an association between the presence of facial injury and the need for hospitalization for a period of 2 days or more. Respondents reported that they had accidents, but due to the use of full face motorcycle helmet the number of facial injuries was low. For most of them, absenteeism was observed for a period of one month or more. Copyright © 2014 Elsevier Ltd and Faculty of Forensic and Legal Medicine. All rights reserved.
Reddy, N Bayapa; Hanumantha; Madithati, Pallavi; Reddy, N Nagarjuna; Reddy, C Sainarasimha
The statistical profile reflects a global estimate of 5.1 million deaths in 2000, which was due to injuries that accounted for 10% of deaths due to all causes. Out of this, a quarter of injury-related deaths occurred in the South-East Asian region. Road Traffic Accident (RTA) is one among the top 5 causes of morbidity and mortality in South-East Asian countries. Most common cause of blunt abdominal trauma in India is road traffic accident followed by pedestrian accidents, abdominal blows, and fall from heights. To analyze the epidemiology and pattern of fatal thoraco-abdominal injuries in road traffic accidents. An autopsy-based cross-sectional study conducted. A purposive sampling technique was applied to select the study sample of 100 post-mortems of road traffic accident between November 2008 and May 2010 subjected to medico-legal autopsy at the department of Forensic Medicine, KIMS Hospital Bangalore. The majority of the victims were aged 21 to 40 years, 50 (50.0%), most of the victims were male 92 (92.0%); and male/female ratio was 11.5:1. Commonest offending agents in heavy motor vehicles were 54 (54.0%). Bony cage sustained injuries were observed in 71; out of this, fractures of ribs were observed in 45 (63.3%) victims, clavicle in 14 (19.7%), sternum was 6 (8.4%), and vertebrae 6 (8.4%) of fatal road traffic accidents. Internal thoracic injuries were observed in 26 cases. Among internal thoracic injuries, lungs were the most commonly involved organ 24 (92.3%) followed by the heart 2 (7.6%). Lung sustained more lacerations 19 (79.1%) than contusions 5 (20.8%). Internal abdominal injuries were observed in 49 cases. In road traffic accidents, the most commonly injured abdominal organs were solid organs such as liver 16 (32.6%) followed by spleen 9 (18.3%). Majority of the times in road traffic accidents, young and productive males were injured or lost their life. This study may help the planners to take safety measures, to implement strict traffic rules, to
N Bayapa Reddy
Full Text Available Background: The statistical profile reflects a global estimate of 5.1 million deaths in 2000, which was due to injuries that accounted for 10% of deaths due to all causes. Out of this, a quarter of injury-related deaths occurred in the South-East Asian region. Road Traffic Accident (RTA is one among the top 5 causes of morbidity and mortality in South-East Asian countries. Most common cause of blunt abdominal trauma in India is road traffic accident followed by pedestrian accidents, abdominal blows, and fall from heights. Aims: To analyze the epidemiology and pattern of fatal thoraco-abdominal injuries in road traffic accidents. Materials and Methods: An autopsy-based cross-sectional study conducted. A purposive sampling technique was applied to select the study sample of 100 post-mortems of road traffic accident between November 2008 and May 2010 subjected to medico-legal autopsy at the department of Forensic Medicine, KIMS Hospital Bangalore. Results: The majority of the victims were aged 21 to 40 years, 50 (50.0%, most of the victims were male 92 (92.0%; and male/female ratio was 11.5:1. Commonest offending agents in heavy motor vehicles were 54 (54.0%. Bony cage sustained injuries were observed in 71; out of this, fractures of ribs were observed in 45 (63.3% victims, clavicle in 14 (19.7%, sternum was 6 (8.4%, and vertebrae 6 (8.4% of fatal road traffic accidents. Internal thoracic injuries were observed in 26 cases. Among internal thoracic injuries, lungs were the most commonly involved organ 24 (92.3% followed by the heart 2 (7.6%. Lung sustained more lacerations 19 (79.1% than contusions 5 (20.8%. Internal abdominal injuries were observed in 49 cases. In road traffic accidents, the most commonly injured abdominal organs were solid organs such as liver 16 (32.6% followed by spleen 9 (18.3%. Conclusions: Majority of the times in road traffic accidents, young and productive males were injured or lost their life. This study may help the
Liu, Wen-hua; Li, Li-ping; Zhou, Zhi-ming; Liang, Jin-feng; Zhu, Yao; Wang, Gang; Deng, Shao-jie
To analyze the characteristics of road traffic accidents in Bao'an District, Shenzhen from 2004 to 2011, and to provide scientific basis for the prevention and treatment of traffic accidents. The traffic injury cases recorded by Shenzhen traffic police from 2004 to 2011 were analyzed, including the time (year, month, date); the space (crossings and road segments, road type); the injury of patients (injuries, death). A total of 422 730 accidents from road traffic occurred in Bao'an District, Shenzhen from 2004 to 2011, with 63 809 people injured and 2 790 people died, and the mortality ratio was 22.87:1. Traffic accidents occurred in Bao'an District showed an increasing trend, especially in 2010, and the highest number up to 90 358, while the most deaths occurred in 2007, up to 473 people. As to the single month, the highest traffic accident rate was in August, accounting for 9.77% of the total, while the lowest was in February, accounting for 5.39% of the total; mortality rate in December reached 9.02%. As to one single day, the peaks of accidents occurred in two periods: 9:00-11:00 and 15:00-18:00, and 3:00-6:00 had the smallest number. Traffic injuries often occurred in the intersection, straight line, main road and the section only marked marking. According to the characteristics of regional traffic injury, we should enhance the populace traffic safe awareness, efficiently arrange the human resources, such as emergency personnel, traffic management personnel, set scientific preventive measures, and modify the emergency system and service mode. All of these are essential measures for the prevention and control of traffic injuries.
Ainy, Elaheh; Soori, Hamid; Ganjali, Mojtaba; Baghfalaki, Taban
To allocate resources at the national level and ensure the safety level of roads with the aim of economic efficiency, cost calculation can help determine the size of the problem and demonstrate the economic benefits resulting from preventing such injuries. This study was carried out to elicit the cost of traffic injuries among Iranian drivers of public vehicles. In a cross-sectional study, 410 drivers of public vehicles were randomly selected from all the drivers in city of Tehran, Iran. The research questionnaire was prepared based on the standard for willingness to pay (WTP) method (stated preference (SP), contingent value (CV), and revealed preference (RP) model). Data were collected along with a scenario for vehicle drivers. Inclusion criteria were having at least high school education and being in the age range of 18 to 65 years old. Final analysis of willingness to pay was carried out using Weibull model. Mean WTP was 3,337,130 IRR among drivers of public vehicles. Statistical value of life was estimated 118,222,552,601,648 IRR, for according to 4,694 dead drivers, which was equivalent to 3,940,751,753 $ based on the dollar free market rate of 30,000 IRR (purchase power parity). Injury cost was 108,376,366,437,500 IRR, equivalent to 3,612,545,548 $. In sum, injury and death cases came to 226,606,472,346,449 IRR, equivalent to 7,553,549,078 $. Moreover in 2013, cost of traffic injuries among the drivers of public vehicles constituted 1.25% of gross national income, which was 604,300,000,000$. WTP had a significant relationship with gender, daily payment, more payment for time reduction, more pay to less traffic, and minibus drivers. Cost of traffic injuries among drivers of public vehicles included 1.25% of gross national income, which was noticeable; minibus drivers had less perception of risk reduction than others.
Zonfrillo, Mark R; Ramsay, Mackenzie L; Fennell, Janette E; Andreasen, Amber
There have been substantial reductions in motor vehicle crash-related child fatalities due to advances in legislation, public safety campaigns, and engineering. Less is known about non-traffic injuries and fatalities to children in and around motor vehicles. The objective of this study was to describe the frequency of various non-traffic incidents, injuries, and fatalities to children using a unique surveillance system and database. Instances of non-traffic injuries and fatalities in the United States to children 0-14 years were tracked from January 1990 to December 2014 using a compilation of sources including media reports, individual accounts from families of affected children, medical examiner reports, police reports, child death review teams, coroner reports, medical professionals, legal professionals, and other various modes of publication. Over the 25-year period, there were at least 11,759 events resulting in 3,396 deaths. The median age of the affected child was 3.7 years. The incident types included 3,115 children unattended in hot vehicles resulting in 729 deaths, 2,251 backovers resulting in 1,232 deaths, 1,439 frontovers resulting in 692 deaths, 777 vehicles knocked into motion resulting in 227 deaths, 415 underage drivers resulting in 203 deaths, 172 power window incidents resulting in 61 deaths, 134 falls resulting in 54 deaths, 79 fires resulting in 41 deaths, and 3,377 other incidents resulting in 157 deaths. Non-traffic injuries and fatalities present an important threat to the safety and lives of very young children. Future efforts should consider complementary surveillance mechanisms to systematically and comprehensively capture all non-traffic incidents. Continued education, engineering modifications, advocacy, and legislation can help continue to prevent these incidents and must be incorporated in overall child vehicle safety initiatives.
Jiang, Ximiao; Huang, Baoshan; Yan, Xuedong; Zaretzki, Russell L; Richards, Stephen
The severity of traffic-related injuries has been studied by many researchers in recent decades. However, the evaluation of many factors is still in dispute and, until this point, few studies have taken into account pavement management factors as points of interest. The objective of this article is to evaluate the combined influences of pavement management factors and traditional traffic engineering factors on the injury severity of 2-vehicle crashes. This study examines 2-vehicle rear-end, sideswipe, and angle collisions that occurred on Tennessee state routes from 2004 to 2008. Both the traditional ordered probit (OP) model and Bayesian ordered probit (BOP) model with weak informative prior were fitted for each collision type. The performances of these models were evaluated based on the parameter estimates and deviances. The results indicated that pavement management factors played identical roles in all 3 collision types. Pavement serviceability produces significant positive effects on the severity of injuries. The pavement distress index (PDI), rutting depth (RD), and rutting depth difference between right and left wheels (RD_df) were not significant in any of these 3 collision types. The effects of traffic engineering factors varied across collision types, except that a few were consistently significant in all 3 collision types, such as annual average daily traffic (AADT), rural-urban location, speed limit, peaking hour, and light condition. The findings of this study indicated that improved pavement quality does not necessarily lessen the severity of injuries when a 2-vehicle crash occurs. The effects of traffic engineering factors are not universal but vary by the type of crash. The study also found that the BOP model with a weak informative prior can be used as an alternative but was not superior to the traditional OP model in terms of overall performance.
Aarts, L.T. Commandeur, J.J.F. Welsh, R. Niesen, S. Lerner, M. Thomas, P. Bos, N. & Davidse, R.J.
It is the ambition of the EU to reduce the number of killed and seriously injured on the roads over time. It has turned out that, especially in relation to serious injuries, there is still a significant knowledge gap on how to reduce these numbers in the EU. The Commission is therefore committed to
Kaiser, Radek; Waldauf, Petr; Haninec, Pavel
Brachial plexus injuries occur in up to 5% of polytrauma cases involving motorcycle accidents and in approximately 4% of severe winter sports injuries. One of the criteria for a successful operative therapy is the type of lesion. Upper plexus palsy has the best prognosis, whereas lower plexus palsy is surgically untreatable. The aim of this study was to evaluate a group of patients with brachial plexus injury caused by traffic accidents, categorize the injuries according to type of accident, and look for correlations between type of palsy (injury) and specific accidents. A total of 441 brachial plexus reconstruction patients from our department were evaluated retrospectively(1993 to 2011). Sex, age, neurological status, and the type and cause of injury were recorded for each case. Patients with BPI caused by a traffic accident were assessed in detail. Traffic accidents were the cause of brachial plexus injury in most cases (80.7%). The most common type of injury was avulsion of upper root(s) (45.7%) followed by rupture (28.2%), complete avulsion (16.9%) and avulsion of lower root(s) (9.2%). Of the patients, 73.9% had an upper,22.7% had a complete and only 3.4% had a lower brachial plexus palsy. The main cause was motorcycle accidents(63.2%) followed by car accidents (23.5%), bicycle accidents(10.7%) and pedestrian collisions (3.1%) (paccidents had a higher percentage of lower avulsion (22.7%) and a lower percentage of upper avulsion (29.3%), whereas cyclists had a higher percentage of upper avulsion (68.6%) based on the data from the entire group of patients (paccidents (9.3%,paccidents),significantly more upper and fewer lower palsies were present. In the bicycle accident group, upper palsy was the most common (89%). Study results indicate that the most common injury was an upper plexus palsy. It was characteristic of bicycle accidents, and significantly more common in car and motorcycle accidents. The results also indicate that it is important to consider the
Full Text Available Abstract Background Road traffic injuries (RTIs are a major public health problem, especially in low- and middle-income countries. Among middle-income countries, Iran has one of the highest mortality rates from RTIs. Action is critical to combat this major public health problem. Stakeholders involved in RTI control are of key importance and their perceptions of barriers and facilitators are a vital source of knowledge. The aim of this study was to explore barriers to the prevention of RTIs and provide appropriate suggestions for prevention, based on the perceptions of stakeholders, victims and road-users as regards RTIs. Methods Thirty-eight semi-structured interviews were conducted with informants in the field of RTI prevention including: police officers; public health professionals; experts from the road administrators; representatives from the General Governor, the car industry, firefighters; experts from Emergency Medical Service and the Red Crescent; and some motorcyclists and car drivers as well as victims of RTIs. A qualitative approach using grounded theory method was employed to analyze the material gathered. Results The core variable was identified as "The lack of a system approach to road-user safety". The following barriers in relation to RTI prevention were identified as: human factors; transportation system; and organizational coordination. Suggestions for improvement included education (for the general public and targeted group training, more effective legislation, more rigorous law enforcement, improved engineering in road infrastructure, and an integrated organization to supervise and coordinate preventive activities. Conclusion The major barriers identified in this study were human factors and efforts to change human behaviour were suggested by means of public education campaigns and stricter law enforcement. However, the lack of a system approach to RTI prevention was also an important concern. There is an urgent need for both
Khorasani-Zavareh, Davoud; Mohammadi, Reza; Khankeh, Hamid Reza; Laflamme, Lucie; Bikmoradi, Ali; Haglund, Bo J A
Road traffic injuries (RTIs) are a major public health problem, especially in low- and middle-income countries. Among middle-income countries, Iran has one of the highest mortality rates from RTIs. Action is critical to combat this major public health problem. Stakeholders involved in RTI control are of key importance and their perceptions of barriers and facilitators are a vital source of knowledge. The aim of this study was to explore barriers to the prevention of RTIs and provide appropriate suggestions for prevention, based on the perceptions of stakeholders, victims and road-users as regards RTIs. Thirty-eight semi-structured interviews were conducted with informants in the field of RTI prevention including: police officers; public health professionals; experts from the road administrators; representatives from the General Governor, the car industry, firefighters; experts from Emergency Medical Service and the Red Crescent; and some motorcyclists and car drivers as well as victims of RTIs. A qualitative approach using grounded theory method was employed to analyze the material gathered. The core variable was identified as "The lack of a system approach to road-user safety". The following barriers in relation to RTI prevention were identified as: human factors; transportation system; and organizational coordination. Suggestions for improvement included education (for the general public and targeted group training), more effective legislation, more rigorous law enforcement, improved engineering in road infrastructure, and an integrated organization to supervise and coordinate preventive activities. The major barriers identified in this study were human factors and efforts to change human behaviour were suggested by means of public education campaigns and stricter law enforcement. However, the lack of a system approach to RTI prevention was also an important concern. There is an urgent need for both an integrated system to coordinate RTI activities and prevention
Baccarelli, Andrea; Martinelli, Ida; Pegoraro, Valeria; Melly, Steven; Grillo, Paolo; Zanobetti, Antonella; Hou, Lifang; Bertazzi, Pier Alberto; Mannucci, Pier Mannuccio; Schwartz, Joel
Background Particulate air pollution has been consistently linked to increased risk of arterial cardiovascular disease. Few data on air pollution exposure and risk of venous thrombosis are available. We investigated whether living near major traffic roads increases the risk of deep vein thrombosis (DVT), using distance from roads as a proxy for traffic exposure. Methods and Results Between 1995-2005, we examined 663 patients with DVT of the lower limbs and 859 age-matched controls from cities with population>15,000 inhabitants in Lombardia Region, Italy. We assessed distance from residential addresses to the nearest major traffic road using geographic information system methodology. The risk of DVT was estimated from logistic regression models adjusting for multiple clinical and environmental covariates. The risk of DVT was increased (Odds Ratio [OR]=1.33; 95% CI 1.03-1.71; p=0.03 in age-adjusted models; OR=1.47; 95%CI 1.10-1.96; p=0.008 in models adjusted for multiple covariates) for subjects living near a major traffic road (3 meters, 10th centile of the distance distribution) compared to those living farther away (reference distance of 245 meters, 90th centile). The increase in DVT risk was approximately linear over the observed distance range (from 718 to 0 meters), and was not modified after adjusting for background levels of particulate matter (OR=1.47; 95%CI 1.11-1.96; p=0.008 for 10th vs. 90th distance centile in models adjusting for area levels of particulate matter roads is associated with increased risk of DVT. PMID:19506111
Howley, Isaac W; Gupta, Shivam; Tetali, Shailaja; Josyula, Lakshmi K; Wadhwaniya, Shirin; Gururaj, Gopalkrishna; Rao, Mohan; Hyder, Adnan A
Road traffic injuries kill more people in India than in any other country in the world, and these numbers are rising with increasing population density and motorization. Official statistics regarding road traffic injuries are likely subject to underreporting. This study presents results of a surveillance program based at a public tertiary hospital in Hyderabad, India. All consenting patients who presented to the casualty ward after a road traffic injury over a 9-month period were enrolled. Interviews were performed and data abstracted from clinical records by trained research assistants. Data included demographics, injury characteristics, risk factors, safety behaviors, and outcomes. A total of 5,298 patients were enrolled; their mean age was 32.4 years (standard deviation 13.8) and 87.3% were men; 58.2% of patients were injured while riding a motorcycle or scooter, 22.5% were pedestrians, and 9.2% used motorized rickshaws. The most frequent collision type was skid or rollover (40.9%). Male victims were younger than female victims and were overrepresented among motorized 2-wheeler users. Patients were most frequently injured from 1600 to 2400. A total of 27.3% of patients were admitted. Hospital mortality was 5.3%, and 48.2% of deaths were among motorized 2-wheeler users. This is one of the few prospective, hospital-based studies of road traffic injury epidemiology in India. The patient population in this study was similar to prior hospital-based studies. When compared to government surveillance systems, this study showed motorized 2-wheeler users to be more frequently represented among the overall population and among fatalities. Further research should be done to develop interventions to decrease mortality associated with 2-wheeled vehicles in India. Copyright © 2017. Published by Elsevier Inc.
Full Text Available Abstract Background The increasing number of older road users represents a public health issue because older individuals are more susceptible to traffic injury and mortality than the general population. This study investigated the association between socio-demographic factors and traffic injury and traffic mortality for the general population and among older road users in Japan. Methods An ecological study was conducted using national data in Japan. Multivariate regression methods were applied to investigate the association of traffic injury and traffic mortality for the general population and among older road users with significant demographic, economic, road traffic, and medical/cultural factors. Results Income per capita, total road length, and alcohol consumption per person were significantly associated with traffic injury and traffic mortality both for the general population and among older road users in Japan. Income per capita and alcohol consumption per person were negatively associated with traffic mortality for both groups. Meanwhile, for both groups, income per capita was positively associated with traffic injury, while total road length and alcohol consumption per person were negatively associated with traffic injury. Conclusions The effects of socio-demographic factors on traffic injury and traffic mortality in Japan were similar for both the general population and older road users. The study results suggest that injury preventive measures designed for the general population will be beneficial also for older road users in Japan.
Trinca, G W; Dooley, B J
The compulsory wearing of seat belts, first introduced in the world in Victoria in 1970, has effectively reduced the number of deaths and injuries by approximately one-third for car occupants involved in motor vehicle crashes. Initially, the legislation did not apply to children under the age of eight years, but in 1975 a further law was introduced banning children from the front seat of any vehicle unless properly harnessed. Seat belts offer the best protection for front seat drivers and passengers involved in frontal impacts, but offer less protection to the recipient of a side impact. Ten per cent of car occupants admitted to hospital after a frontal impact show injuries, mostly minor, directly attibutable to the wearing of seat belts.
Full Text Available Background: Road-traffic injury (RTI is a major public-health concern worldwide. However, the effectiveness of laws criminalizing drunk driving on the improvement of road safety in China is not known. Methods: We collected daily aggregate data on RTIs from the Guangzhou First-Aid Service Command Center from 2009 to 2012. We performed an interrupted time-series analysis to evaluate the change in daily RTIs before (January 1, 2009, to April 30, 2011 and after (May 1, 2011, to December 31, 2012 the criminalization of drunk driving. We evaluated the impact of the intervention on RTIs using the overdispersed generalized additive model after adjusting for temporal trends, seasonality, day of the week, and holidays. Daytime/Nighttime RTIs, alcoholism, and non-traffic injuries were analyzed as comparison groups using the same model. Results: From January 1, 2009, to December 31, 2012, we identified a total of 54 887 RTIs. The standardized daily number of RTIs was almost stable in the pre-intervention period but decreased gradually in the post-intervention period. After the intervention, the standardized daily RTIs decreased 9.6% (95% confidence interval [CI], 6.5%–12.8%. There were similar decreases for the daily daytime and nighttime RTIs. In contrast, the standardized daily cases of alcoholism increased 38.8% (95% CI, 35.1%–42.4%, and daily non-traffic injuries increased 3.6% (95% CI, 1.4%–5.8%. Conclusions: This time-series study provides scientific evidence suggesting that the criminalization of drunk driving from May 1, 2011, may have led to moderate reductions in RTIs in Guangzhou, China.
Zhao, Ang; Chen, Renjie; Qi, Yongqing; Chen, Ailan; Chen, Xinyu; Liang, Zijing; Ye, Jianjun; Liang, Qing; Guo, Duanqiang; Li, Wanglin; Li, Shuangming; Kan, Haidong
Road-traffic injury (RTI) is a major public-health concern worldwide. However, the effectiveness of laws criminalizing drunk driving on the improvement of road safety in China is not known. We collected daily aggregate data on RTIs from the Guangzhou First-Aid Service Command Center from 2009 to 2012. We performed an interrupted time-series analysis to evaluate the change in daily RTIs before (January 1, 2009, to April 30, 2011) and after (May 1, 2011, to December 31, 2012) the criminalization of drunk driving. We evaluated the impact of the intervention on RTIs using the overdispersed generalized additive model after adjusting for temporal trends, seasonality, day of the week, and holidays. Daytime/Nighttime RTIs, alcoholism, and non-traffic injuries were analyzed as comparison groups using the same model. From January 1, 2009, to December 31, 2012, we identified a total of 54 887 RTIs. The standardized daily number of RTIs was almost stable in the pre-intervention period but decreased gradually in the post-intervention period. After the intervention, the standardized daily RTIs decreased 9.6% (95% confidence interval [CI], 6.5%-12.8%). There were similar decreases for the daily daytime and nighttime RTIs. In contrast, the standardized daily cases of alcoholism increased 38.8% (95% CI, 35.1%-42.4%), and daily non-traffic injuries increased 3.6% (95% CI, 1.4%-5.8%). This time-series study provides scientific evidence suggesting that the criminalization of drunk driving from May 1, 2011, may have led to moderate reductions in RTIs in Guangzhou, China.
Hyder, Adnan A; Ghaffar, Abdul
In a major summit of the members of the United Nations (UN) in 2000, a Millennium Declaration was adopted which called for making the elimination of poverty and promotion of sustainable development a global priority. A road map was agreed upon to operationalize the declaration, and the Millennium Development Goals (MDG) were integrated within the document. The MDGs are now increasingly being used to assess the performance of countries, institutions and the global community. WHO declares that the MDGs provide "a set of outcomes that are relevant to the development of national health policy frameworks". It also states that although MDGs do not cover all the components of public health, when broadly interpreted "the goals provide an opportunity to address important cross-cutting issues and key constraints to health". Consistent with WHO's call for a broad interpretation of the MDGs, and building on the health linkages identified by WHO, this paper explores the linkages between the MDGs and the impact of road traffic injuries (RTI). This is done in the context of South Asia, one of the poorest and populated regions of the developing world.
Ul Baset, Md Kamran; Rahman, Aminur; Alonge, Olakunle; Agrawal, Priyanka; Wadhwaniya, Shirin; Rahman, Fazlur
Globally, road traffic injury (RTI) causes 1.3 million deaths annually. Almost 90% of all RTI deaths occur in low- and middle-income countries. RTI is one of the leading causes of death in Bangladesh; the World Health Organization estimated that it kills over 21,000 people in the country annually. This study describes the current magnitude and risk factors of RTI for different age groups in rural Bangladesh. A household census was carried out in 51 unions of seven sub-districts situated in the north and central part of Bangladesh between June and November 2013, covering 1.2 million individuals. Trained data collectors collected information on fatal and nonfatal RTI events through face-to-face interviews using a set of structured pre-tested questionnaires. The recall periods for fatal and non-fatal RTI were one year and six months, respectively. The mortality and morbidity rates due to RTI were 6.8/100,000 population/year and 889/100,000 populations/six months, respectively. RTI mortality and morbidity rates were significantly higher among males compared to females. Deaths and morbidities due to RTI were highest among those in the 25-64 years age group. A higher proportion of morbidity occurred among vehicle passengers (34%) and pedestrians (18%), and more than one-third of the RTI mortality occurred among pedestrians. Twenty percent of all nonfatal RTIs were classified as severe injuries. RTI is a major public health issue in rural Bangladesh. Immediate attention is needed to reduce preventable deaths and morbidities in rural Bangladesh.
Ainy, Elaheh; Soori, Hamid; Ganjali, Mojtaba; Bahadorimonfared, Ayad
A significant social and economic burden inflicts by road traffic injuries (RTIs). We aimed to use Bayesian model, to present the precise method, and to estimate the cost of RTIs in Iran in 2013. In a cross-sectional study on costs resulting from traffic injuries, 846 people per road user were randomly selected and investigated during 3 months (1 st September-1 st December) in 2013. The research questionnaire was prepared based on the standard for willingness to pay (WTP) method considering perceived risks, especially in Iran. Data were collected along with four scenarios for occupants, pedestrians, vehicle drivers, and motorcyclists. Inclusion criterion was having at least high school education and being in the age range of 18-65 years old; risk perception was an important factor to the study and measured by visual tool. Samples who did not have risk perception were excluded from the study. Main outcome measure was cost estimation of traffic injuries using WTP method. Mean WTP was 2,612,050 internal rate of return (IRR) among these road users. Statistical value of life was estimated according to 20,408 death cases 402,314,106,073,648 IRR, equivalent to 13,410,470,202$ based on the dollar free market rate of 30,000 IRR (purchase power parity). In sum, injury and death cases came to 1,171,450,232,238,648 IRR equivalents to 39,048,341,074$. Moreover, in 2013, costs of traffic accident constituted 6.46% of gross national income, which was 604,300,000,000$. WTP had a significant relationship with age, middle and high income, daily payment to injury reduction, more payment to time reduction, trip mileage, private cars drivers, bus, minibus vehicles, and occupants ( P < 0.01). Costs of traffic injuries included noticeable portion of gross national income. If policy-making and resource allocation are made based on the scientific pieces of evidence, an enormous amount of capital can be saved through reducing death and injury rates.
Laflamme, L; Diderichsen, Finn
The paper reviews the scientific literature concerning social differences in traffic injuries in childhood in order to highlight the current state of knowledge and to draw the main lines of a research agenda....
Martínez Pérez, Jorge Eduardo; Sánchez Martínez, Fernando Ignacio; Abellán Perpiñán, José María; Pinto Prades, José Luis
Cost-benefit analyses in the field of road safety compute human costs as a key component of total costs. The present article presents two studies promoted by the Directorate-General for Traffic aimed at obtaining official values for the costs associated with fatal and non-fatal traffic injuries in Spain. We combined the contingent valuation approach and the (modified) standard gamble technique in two surveys administered to large representative samples (n1=2,020, n2=2,000) of the Spanish population. The monetary value of preventing a fatality was estimated to be 1.4 million euros. Values of 219,000 and 6,100 euros were obtained for minor and severe non-fatal injuries, respectively. These figures are comparable to those observed in neighboring countries. Copyright © 2014 SESPAS. Published by Elsevier Espana. All rights reserved.
Larsen, L B; Poulsen, T K; Johannsen, H G
The study was based on data concerning persons treated at Odense University Hospital as a result of road traffic accidents in the period 1980-92. Incidence rates of road traffic accident injuries were calculated on the basis of the population in Odense municipality. The study group included persons...
Rackynelly Alves Sarmento Soares
Full Text Available Traffic accidents produce high morbidity and mortality in several countries, including Brazil. The initial care to victims of accidents, by a specialized team, has tools for evaluating the severity of trauma, which guide the priorities. This study aimed to develop a decision model applied to pre-hospital care, using the Abbreviated Injury Scale, to define the severity of the injury caused by the AT, as well to describe the features of accidents and their victims, occurred in Joao Pessoa, Paraiba. This is a descriptive epidemiological investigation, sectional, which analyzed all victims of traffic accidents attended by the SAMU 192, João Pessoa-PB, in January, April and June 2010. Data were collected in the medical regulation sheets of SAMU 192. Most of victims were male (76%, aged between 20 and 39 years (60%. Most injuries were classified as AIS1 (62.5%. The model of decision support implemented was the decision tree that managed to correctly classify 95.98% of the severity of injuries. By this model, it was possible to extract 29 rules of gravity classification of injury, which may be used for decision-making teams of the SAMU 192.
Al-Reesi, Hamed; Ganguly, Shyam Sunder; Al-Adawi, Samir; Laflamme, Lucie; Hasselberg, Marie; Al-Maniri, Abdullah
Recent affluence, assisted by exploitation of hydrocarbon, has sparked unprecedented economic growth and influx of all façades of modernity in Oman. Different statistical models have examined the relationship between economic growth, motorization rates, and road traffic fatalities. However, such a relationship in Oman has never been described. To describe and analyze the trend of road traffic injuries (RTIs) in relation to motorization rates and economic growth during the period from 1985 to 2009 using Smeed's (1949) model and Koren and Borsos's (2010) model. The study is based on national data reported between 1985 and 2009. Data on the population and gross domestic product (GDP) per capita in U.S. dollars were gathered from the Ministry of National Economy reports. Data on the number of vehicles and road traffic crashes, fatalities, and injuries were gathered from the Royal Oman Police (ROP) reports. Crash, fatality, and injury rates per 1000 vehicles and per 100,000 population were computed. Linear regression analysis was carried out to estimate the average annual changes in the rates. Smeed's (1949) and Koren and Borsos's (2010) models were used to predict the relations between motorization and road traffic fatalities in Oman. In addition, a cross-sectional analysis of year 2007 data for a number of Arab countries was carried out. The GDP per capita increased from US$6551 in 1985 to US$25,110 in 2009 with an annual increase of UR$547 per capita. The motorization rates increased by 36 percent from 1745 per 10,000 population in 1985 to 2382 per 10,000 population in 2009. Both Smeed's (1949) and Koren and Borsos's (2010) models had a high goodness of fit, with R(2) greater than 0.70. This indicated that road traffic fatalities in Oman may have a direct relationship with increased motorization. The cross-sectional analysis showed that the relation between crash fatalities and motorization rates in Oman and the United Arab Emirates can be better explained by Koren
Thompson, Jacqueline Y; Akanbi, Moses A; Azuh, Dominic; Samuel, Victoria; Omoregbe, Nicholas; Ayo, Charles K
Abstract Objective To estimate the burden of road traffic injuries and deaths for all road users and among different road user groups in Africa. Methods We searched MEDLINE, EMBASE, Global Health, Google Scholar, websites of African road safety agencies and organizations for registry- and population-based studies and reports on road traffic injury and death estimates in Africa, published between 1980 and 2015. Available data for all road users and by road user group were extracted and analysed. We conducted a random-effects meta-analysis and estimated pooled rates of road traffic injuries and deaths. Findings We identified 39 studies from 15 African countries. The estimated pooled rate for road traffic injury was 65.2 per 100 000 population (95% confidence interval, CI: 60.8–69.5) and the death rate was 16.6 per 100 000 population (95% CI: 15.2–18.0). Road traffic injury rates increased from 40.7 per 100 000 population in the 1990s to 92.9 per 100 000 population between 2010 and 2015, while death rates decreased from 19.9 per 100 000 population in the 1990s to 9.3 per 100 000 population between 2010 and 2015. The highest road traffic death rate was among motorized four-wheeler occupants at 5.9 per 100 000 population (95% CI: 4.4–7.4), closely followed by pedestrians at 3.4 per 100 000 population (95% CI: 2.5–4.2). Conclusion The burden of road traffic injury and death is high in Africa. Since registry-based reports underestimate the burden, a systematic collation of road traffic injury and death data is needed to determine the true burden. PMID:27429490
Lunevicius, Raimundas; Herbert, Hadley K; Hyder, Adnan A
This article highlights the epidemiology of road traffic injury (RTI) in Lithuania between 1998 and 2007. The purpose of this study is to explore the incidence of RTI, age-standardized mortality rates (ASMR), gender-specific rates and the RTI profile of different user groups. In doing so, this analysis attempts to emphasize the need for RTI prevention policies and programmes. Six databases were analysed using ICD-10 codes V01-V99, pertaining to the causes of road traffic crashes. Data between 1998 and 2007 were obtained from these databases to identify and calculate RTI incidence and mortality rates. This was then analysed with regard to ASMR, gender, user groups and the use of alcohol. In 2007, RTI incidence in Lithuania was reported as 270/100,000 people, 10.7% higher than in 1998. ASMR declined from 28 deaths per 100,000 in 1998 to 25 deaths per 100,000 in 2007. Between 1998 and 2007, the male ASMR declined from 46 to 40 deaths per 100,000 and the female ASMR decreased from 13 to 11 deaths per 100,000. Car occupant and pedestrian fatalities comprised 87% of all RTI deaths. Thirty-four percent of those injured and 21% of the dead were under influence of alcohol. From 1998 to 2007, the incidence of RTI has worsened and mortality rates remain high in Lithuania. Alcohol remains a prominent risk factor of traffic injury and death. The need to develop effective prevention programmes to address traffic injury is essential.
Sengoelge, Mathilde; Laflamme, Lucie; El-Khatib, Ziad
The Eastern Mediterranean region has the second highest number of road traffic injury mortality rates after the African region based on 2013 data, with road traffic injuries accounting for 27% of the total injury mortality in the region. Globally the number of road traffic deaths has plateaued despite an increase in motorization, but it is uncertain whether this applies to the Region. This study investigated the regional trends in both road traffic injury mortality and morbidity and examined country-based differences considering on income level, categories of road users, and gender distribution. Register-based ecological study linking data from Global Burden of Disease Study with the United Nations Statistics Division for population and World Bank definition for country income level. Road traffic injury mortality rates and disability-adjusted life years were compiled for all ages at country level in 1995, 2005, 2015 and combined for a regional average (n = 22) and a global average (n = 122). The data were stratified by country economic level, road user category and gender. Road traffic injury mortality rates in the Region were higher than the global average for all three reference years but suggest a downward trend. In 2015 mortality rates were more than twice as high in low and high income countries compared to global income averages and motor vehicle occupants had a 3-fold greater mortality than the global average. Severe injuries decreased by more than half for high/middle income countries but remained high for low income countries; three times higher for males than females. Despite a potential downward trend, inequalities in road traffic injury mortality and morbidity burden remain high in the Eastern Mediterranean region. Action needs to be intensified and targeted to implement and enforce safety measures that prevent and mitigate severe motor vehicle crashes in high income countries especially and invest in efforts to promote public, active transport
Ainy, Elaheh; Soori, Hamid; Ganjali, Mojtaba; Baghfalaki, Taban
Background and Aim: To allocate resources at the national level and ensure the safety level of roads with the aim of economic efficiency, cost calculation can help determine the size of the problem and demonstrate the economic benefits resulting from preventing such injuries. This study was carried out to elicit the cost of traffic injuries among Iranian drivers of public vehicles. Materials and Methods: In a cross-sectional study, 410 drivers of public vehicles were randomly selected from all the drivers in city of Tehran, Iran. The research questionnaire was prepared based on the standard for willingness to pay (WTP) method (stated preference (SP), contingent value (CV), and revealed preference (RP) model). Data were collected along with a scenario for vehicle drivers. Inclusion criteria were having at least high school education and being in the age range of 18 to 65 years old. Final analysis of willingness to pay was carried out using Weibull model. Results: Mean WTP was 3,337,130 IRR among drivers of public vehicles. Statistical value of life was estimated 118,222,552,601,648 IRR, for according to 4,694 dead drivers, which was equivalent to 3,940,751,753 $ based on the dollar free market rate of 30,000 IRR (purchase power parity). Injury cost was 108,376,366,437,500 IRR, equivalent to 3,612,545,548 $. In sum, injury and death cases came to 226,606,472,346,449 IRR, equivalent to 7,553,549,078 $. Moreover in 2013, cost of traffic injuries among the drivers of public vehicles constituted 1.25% of gross national income, which was 604,300,000,000$. WTP had a significant relationship with gender, daily payment, more payment for time reduction, more pay to less traffic, and minibus drivers. Conclusion: Cost of traffic injuries among drivers of public vehicles included 1.25% of gross national income, which was noticeable; minibus drivers had less perception of risk reduction than others. PMID:26157655
Zampetti, R; Messina, G; Quercioli, C; Vencia, F; Genco, L; Di Bartolomeo, L; Nante, N
Road traffic injuries are a widespread problem and are very difficult to prevent. The purpose of this study was to verify whether intensive versus basic road safety education programs are associated with different incidence and severity of nonfatal road injuries. The study had an ecological design and involved Local Health Authority One (LHA1) in Salerno, Italy, which includes 20 municipalities. Data on nonfatal road injuries occurring in the periods June to August 2003 and June to August 2008 were obtained from trained operators through the information system of the emergency department. All 20 municipalities received a basic community road safety education program (publicity campaign using bill-posting, brochures, mass media communication with press conferences, articles in local papers, radio and television interviews, and a dedicated LHA1 web site), and 12 municipalities also received an intensive education campaign (in secondary schools, community conferences, and activities organized by police and firefighters). The incidence and severity of nonfatal road traffic injuries were compared between June to August 2003 (before the campaign) and June to August 2008. The total number of injuries in all 20 municipalities in 2003 and 2008 was 907 and 755, respectively. The incidence of injuries decreased in the study period both in the 8 municipalities where only the basic campaign was run (difference in incidence = -0.4; P = .053) and in the 12 municipalities where the intensive campaign was implemented (difference in incidence = -0.5; P road safety education. This does not mean that such campaigns are useless (they are important to raise awareness) but that they should be supplemented with complementary activities in order to be really effective.
Weapon injuries in armed conflict are likely to receive medical attention. Other types of injuries, like traffic accidents, continue to occur during armed conflict. Injuries caused by weapons and by traffic accidents require treatment, but reports and figures to help in prioritizing care are scarce. In a prospective observational study, all emergency patients admitted to the surgical ward in a public hospital of the Central African Republic were evaluated for the cause of their main injury. The proportion of patients injured by weapons and by traffic accidents was analyzed with respect to the level of violence. Seventy-eight patients were included in this study. Weapon injuries accounted for 50 (64%) admissions and traffic accidents for 28 (36%). These proportions varied significantly according to the weekly level of violence (χ(2)=46.8; Ptraffic accidents are an important, but overlooked, drain on surgical resources in low-income countries with armed conflict. Their proportion in relation to weapon wounded fluctuates with the level of violence. Humanitarian medical organizations might prepare themselves not only for weapon injuries, but also for wounds caused by traffic accidents.
Background Evaluation of interventions on road traffic injuries (RTI) going beyond the assessment of impact to include factors underlying success or failure is an important complement to standard impact evaluations. We report here how we used a qualitative approach to assess current interventions implemented to reduce RTIs in Peru. Methods We performed in-depth interviews with policymakers and technical officers involved in the implementation of RTI interventions to get their insight on design, implementation and evaluation aspects. We then conducted a workshop with key stakeholders to analyze the results of in-depth interviews, and to further discuss and identify key programmatic considerations when designing and implementing RTI interventions. We finally performed brainstorming sessions to assess potential system-wide effects of a selected intervention (Zero Tolerance), and to identify adaptation and redesign needs for this intervention. Results Key programmatic components were consistently identified that should be considered when designing and implementing RTI interventions. They include effective and sustained political commitment and planning; sufficient and sustained budget allocation; training, supervision, monitoring and evaluation of implemented policies; multisectoral participation; and strong governance and accountability. Brainstorming sessions revealed major negative effects of the selected intervention on various system building blocks. Conclusions Our approach revealed substantial caveats in current RTI interventions in Peru, and fundamental negative effects on several components of the sectors and systems involved. It also highlighted programmatic issues that should be applied to guarantee an effective implementation and evaluation of these policies. The findings from this study were discussed with key stakeholders for consideration in further designing and planning RTI control interventions in Peru. PMID:22269578
Bivona, Umberto; DʼIppolito, Mariagrazia; Giustini, Marco; Vignally, Pascal; Longo, Eloise; Taggi, Franco; Formisano, Rita
To determine the frequency of road traffic accidents among individuals who start or resume driving after severe traumatic brain injury (TBI) and to investigate their responsibility for these accidents. Observational/retrospective study. Sixty adults with severe TBI and their caregivers. Return to Driving Questionnaire and Glasgow Outcome Scale. Thirty of the 60 participants started to drive or resumed driving after TBI. Nineteen (63%) of them were involved in traffic accidents, with personal responsibility in 26 of 36 after return to driving. Participants caused a significantly higher number of accidents after TBI than before. The ability to drive is frequently compromised after severe TBI. Specific rehabilitation of this complex activity should be a main goal of social reintegration programs in this population.
The purpose of this research project was to understand, primarily from the sibling perspective, the effect of a child's major burn injury on his or her sibling. A mixed method qualitative dominant design was implemented using the life story method for the qualitative portion. Additionally, the Sibling Relationship Questionnaire -Revised (SRQ-R) was used as a structured interview guide and for calculating scoring data to explore sibling relationship factors of warmth/closeness, rivalry, conflict, and relative status/power. Participants from 22 family cases (one or multiple family members) and 40 individuals were interviewed. To capture impact on the family over time, interviews began a minimum of two years post-burn. The central thematic pattern for the sibling relationship in families having a child with a major burn injury was that of normalization. Two components of normalization were described: areas of normalization and the process of adjustment. Areas of normalization were found in play and other activities, in school and work, and in family relations with siblings. The process of adjustment was varied and often gradual, involved school and work re-entry, and in some instances, seemed to change life perspective. Clinical implications in providing family-centered care can focus on promoting normalization by assessing and supporting siblings who may only be occasionally seen in the hospital or clinic.
Chokotho, Linda; Mulwafu, Wakisa; Singini, Isaac; Njalale, Yasin; Maliwichi-Senganimalunje, Limbika; Jacobsen, Kathryn H
Introduction Road traffic collisions are a common cause of injuries and injury-related deaths in sub-Saharan Africa (SSA). Basic prehospital care can be the difference between life and death for injured drivers, passengers, and pedestrians. Problem This study examined the challenges associated with current first response practices in Malawi. In April 2014, focus groups were conducted in two areas of Malawi: Karonga (in the Northern Region) and Blantyre (in the Southern Region; both are along the M1 highway), and a qualitative synthesis approach was used to identify themes. All governmental and nongovernmental first response organizations identified by key informants were contacted, and a checklist was used to identify the services they offer. Access to professional prehospital care in Malawi is almost nonexistent, aside from a few city fire departments and private ambulance services. Rapid transportation to a hospital is usually the primary goal of roadside care because of limited first aid knowledge and a lack of access to basic safety equipment. The key informants recommended: expanding community-based first aid training; emphasizing umunthu (shared humanity) to inspire bystander involvement in roadside care; empowering local leaders to coordinate on-site responses; improving emergency communication systems; equipping traffic police with road safety gear; and expanding access to ambulance services. Prehospital care in Malawi would be improved by the creation of a formal network of community leaders, police, commercial drivers, and other lay volunteers who are trained in basic first aid and are equipped to respond to crash sites to provide roadside care to trauma patients and prepare them for safe transport to hospitals. Chokotho L , Mulwafu W , Singini I , Njalale Y , Maliwichi-Senganimalunje L , Jacobsen KH . First responders and prehospital care for road traffic injuries in Malawi. Prehosp Disaster Med. 2017;32(1):14-19.
Full Text Available Abstract Background Although road traffic accidents (RTA are a major cause of injury and a cause of posttraumatic stress (PTS in the aftermath, little is known about the long-term psychological effects of RTA. Methods This prospective longitudinal study assessed long-term PTS, grief, and general mental health after a bus carrying 23 sixth-grade schoolchildren crashed on a school outing and 12 children died. Directly affected (i.e., children in the crash and indirectly affected children (i.e., all pupils in the sixth grade who were not in the crash were surveyed at 9 months (N = 102, 4 years (N = 51, and 20 years (N = 40 after the event. Psychological distress was assessed by single items, including sadness, avoidance, intrusions, and guilt. After 20 years, PTS was assessed by the Impact of Event Scale-Revised. Results Stress reactions were prevalent 9 months after the event, with sadness (69% and avoidance (59% being highly represented in both directly and indirectly affected groups, whereas, nightmares (60% and feelings of guilt (50% were only frequent in those directly affected. The frequency of sadness and avoidance decreased after 4 years in the indirectly exposed (ps p = .003, but not decreased general mental health (p = .14, than those indirectly affected. Conclusions The limitations preclude assertive conclusions. Nonetheless, the findings corroborate previous studies reporting traumatic events are associated with long-term PTS, but not with decreased general mental health.
Alghnam, Suliman; Alkelya, Muhamad; Alfraidy, Moath; Al-Bedah, Khalid; Albabtain, Ibrahim Tawfiq; Alshenqeety, Omar
Road traffic injuries (RTIs) are the third leading cause of death in Saudi Arabia. Because speed is a major risk factor for severe crash-related injuries, a camera ticketing system was implemented countrywide in mid-2010 by the traffic police in an effort to improve traffic safety. There are no published studies on the effects of the system in Saudi Arabia. To examine injury severity and associated mortality at a large trauma center before and after the implementation of the ticketing system. Retrospective, analytical. Trauma center of a tertiary care center in Riyadh. The study included all trauma registry patients seen in the emergency department for a crash-related injury (automobile occupants, pedestrians, or motorcyclists) between January 2005 and December 2014. Associations with outcome measures were assessed by univariate and multivariate methods. Injury severity score (ISS), Glasgow coma scale (GCS) and mortality. The study included all trauma registry patients seen in the emergency department for a crash-related injury. All health outcomes improved in the period following implementation of the ticketing system. Following implementation, ISS scores decreased (-3.1, 95% CI -4.6, -1.6) and GCS increased (0.47, 95% CI 0.08, 0.87) after adjusting for other covariates. The odds of death were 46% lower following implementation than before implementation. When the data were log-transformed to account for skewed data distributions, the results remained statistically significant. This study suggests positive health implications following the implementation of the camera ticketing system. Further investment in public health interventions is warranted to reduce preventable RTIs. The study findings represent a trauma center at a single hospital in Riyadh, which may not generalize to the Saudi population.
A bigger proportion of females (49.1%) crossed on the overpass compared to males (29.2%). More children (79.7 %) than adults (27.3%) used the overpass. The majority of pedestrians (77.9%) were worried about their safety in traffic but only 6.6% thought of the overpass as an appropriate means to avoid traffic accidents.
Pérez-Núñez, Ricardo; Híjar, Martha; Celis, Alfredo; Hidalgo-Solórzano, Elisa
Based on a review of secondary data and the scientific literature and an analysis of the ENSANut-2012 database, the current study provides a comprehensive overview of the current burden of road traffic injuries (RTI) in Mexico and analyzes the country's social response to RTI. The high collision, injury, mortality, and disability rates associated with this public health problem represent a high cost for Mexican society, especially for families. The paper argues that the Mexican response has focused on vehicle occupants while overlooking vulnerable road users and has prioritized strategies with limited effectiveness. Although the country's existing legislation addresses the main risk factors, enforcement has been limited. Finally, the paper makes some recommendations for strengthening the Mexican strategy to prevent RTI, such as safe, equitable, healthy, and sustainable mobility for all types of road users. Despite some strides in RTI prevention, there are still challenges and opportunities to be addressed in the future.
González, María Pilar Sánchez; Sotos, Francisco Escribano; Ponce, Ángel Tejada
This article describes the data collection used to analyse the risk of fatalities and injuries resulting from traffic accidents on interurban roads in the provinces of Spain from 1999 to 2015. The database includes data on different factors related to accidents rates for each Spanish province. These data were used in the article entitled "Impact of provincial characteristics on the number of traffic accident victims on interurban roads in Spain" (Sánchez et al., 2018) .
Ainy, Elaheh; Soori, Hamid; Ganjali, Mojtaba; Basirat, Behzad; Haddadi, Mashyaneh
Motorcycle riders are amongst some of the most vulnerable road users. The burden of motorcycles injuries from low and middle income countries is under-reported. In this study, the cost of traffic injuries among motorcyclists was calculated using the willingness to pay (WTP) method in Iran in 2013. In a cross-sectional study, 143 motorcyclists were randomly selected. The research questionnaire was prepared based on the standard WTP method [stated preference (SP), contingent value (CV) and revealed preference (RP) models] taking into consideration perceived risks, especially those in Iran. Data were collected by a scenario for motorcyclists. The criteria for inclusion in the study consisted of having at least a high school education and being in the age range of 18 - 65 years. The final analysis of the WTP data was performed using the Weibull model. The mean WTP was 888,110 IRR (Iranian Rial) among motorcyclists. The statistical value of life was estimated according to 4694 death cases as 3,146,225,350,943 IRR, which was equivalent to USD 104,874,178 based on the dollar free market rate of 30,000 IRR (purchasing power parity). The cost of injury was 6,903,839,551,000 IRR, equivalent to USD 230,127,985 (based upon 73,325 injured motorcyclists in 2013, a daily traffic volume of 311, and a daily payment of 12,110 IRR for 250 working days). In total, injury and death cases came to 10,050,094,901,943 IRR, equivalent to USD 335,003,163. Willingness to pay had a significant relationship with having experienced an accident, the length of the daily trip (in km), and helmet use (P < 0.001). Willingness to pay can be affected by experiencing an accident, the distance of the daily trip, and helmet use. The cost of traffic injuries among motorcyclists shows that this rate is much higher than the global average. Thus, expenditure should be made on effective initiatives such as the safety of motorcyclists.
Full Text Available Background: There is a paucity of information on the actual costs incurred by the family as a result of musculoskeletal injuries due to road traffic crash from our part of India. This study was conducted with the objective to ascertain the costs of initial management of musculoskeletal injuries due to road traffic crashes. Materials and Methods: This prospective study was conducted as a register-based descriptive study in a tertiary care teaching hospital in a rural area (with a predominantly mountainous terrain of North-West India. All patients with nonfatal musculoskeletal injuries due to road traffic crashes, presenting between 2014 and 2015 and agreeing to participate in the study were included in the study. Results: Of 313 cases, 116 were managed conservatively, whereas in 189 cases, operative intervention was required. In 8 cases, both the modalities of management were required. The average cost of management was Rs. 20,386 in operative group. The average cost in the conservative group was Rs. 3726. Average cost calculated for patients in whom both modality of treatment was required was Rs. 24,000. It was observed that the indirect cost of management was proportionately higher in conservative group. Conclusions: The initial cost of management for patients managed conservatively is less than those managed by operative intervention. Importantly, however, the indirect cost of management is a major contributor to the total cost of management.
Full Text Available Objectives : To examine the effects of JSO multi-treatment for whiplash injury patients by traffic accident. Interventions : Nonrandomized, Nonblinded compartson of the JSO+Acupuncture and Acupuncture Treatment. Main Outcome Measures : Subjective evaluation was followed by Clinical Grade and VAS after 5 times treatments. The SPSS 10.0 for windows was used to analyze the date and the Wilcoxon signed rank test and Mann-Whitney U-testwere used to verify the results. Results : The following results were obtained ; 1. Clinical Grade of the JSO+Acupuncture treatment was centralized to Gr II(50% before treatment. After 5 times treatments, it was centralized to Gr I(58.3%. Also Clinical Grade was significantly changed from GR ll to Gr I(p<0.0002. 2. Clinical Grade of the Acupuncture treatment was centralize(d to Gr II(54.2% before treament. After 5 times treament, it was tend to cenualize to Gr I(50%. But Clinical Grade was still remained at Gr II(p<0.001 3. VAS of change between JSO+Acupuncture and Acupuncture treatment, Vas of JSO+Acupuncture was significantly decreased (p<0.003. C onclusion : It is suggested that JSO multi-treatment has development-effectiveness on whiplash injury patients by traffic accident.
Avila-Burgos, Leticia; Medina-Solís, Carlo E; Pérez-Núñez, Ricardo; Híjar-Medina, Martha; Aracena-Genao, Belkis; Hidalgo-Solórzano, Elisa; Palma-Coca, Oswaldo
To determine non-fatal road traffic injuries (NFRTI) prevalence and its distribution in Mexico. Data from ENSANUT Survey 2006 were used. Using simple random sampling, one adult, one adolescent and one child were selected in each household, constituting a final sample of 94,197 representing an N of 102,886,482 people. The dependent variable was the prevalence of road traffic injuries (RTI) during the 12 months prior to the survey. The general accident prevalence was 6.0%; 16.7% corresponded to NFRTI. Men in the 20 to 44 age group living in urban areas and with high socioeconomic status had a higher RTI prevalence (p<0.05). Jalisco, Aguascalientes and Sonora were states with the highest prevalence of RTI, while Guerrero, Michoacan and Oaxaca were those with the lowest. NFRTI are frequent in Mexico and they are concentrated among men in productive ages in urban areas; they are associated with socioeconomic status at the individual level and with the state's development at the population level.
Full Text Available Abstract Background Literature shows that not only are traffic injuries due to accidents, but that there is also a correlation between different chronic conditions, the consumption of certain types of drugs, the intake of psychoactive substances and the self perception of risk (Health Belief Model and the impact/incidence of traffic accidents. There are few studies on these aspects in primary health care. The objectives of our study are: Main aim: To outline the distribution of risk factors associated with Road Traffic Injuries (RTI in a driving population assigned to a group of primary health care centres in Barcelona province. Secondly, we aim to study the distribution of diverse risk factors related to the possibility of suffering an RTI according to age, sex and population groups, to assess the relationship between these same risk factors and self risk perception for suffering an RTI, and to outline the association between the number of risk factors and the history of reported collisions. Methods/Design Design: Cross-sectional, multicentre study. Setting: 25 urban health care centres. Study population: Randomly selected sample of Spanish/Catalan speakers age 16 or above with a medical register in any of the 25 participating primary health care centres. N = 1540. Unit of study: Basic unit of care, consisting of a general practitioner and a nurse, both of whom caring for the same population (1,500 to 2,000 people per unit. Instruments of measurement: Data collection will be performed using a survey carried out by health professionals, who will use the clinical registers and the information reported by the patient during the visit to collect the baseline data: illnesses, medication intake, alcohol and psychoactive consumption, and self perception of risk. Discussion We expect to obtain a risk profile of the subjects in relation to RTI in the primary health care field, and to create a group for a prospective follow-up. Trial Registration
Sural, Sumit; Verma, Anu
Children are vulnerable to musculoskeletal injuries both at home and on the street for various reasons. Morbidity and disabilities resulting from these, mostly preventable, injuries, make them a burden to their families and society. The role of various factors associated with injuries is often not documented. This prospective study, done on 100 children aged up to 12 years with musculoskeletal trauma, analysed in details, the various modes of injuries. One in every five patient was a child below 12 years of age. Boys were injured more than girls. Injuries, especially fractures, were most common in the extremities, the upper limb more commonly injured than the lower limb. Most of the injuries occurred at home. The most common mode of injuries was falls that happened while playing both within and outside the home, followed by road traffic accidents. Most injuries occurred during daytime. Injuries in children were found to be preventable. Small interventions while constructing homes can contribute tremendously to injury prevention and control in children. Parental awareness about the various modes of injury, role of supervised playing and their responsibility towards injury prevention can play a key role in reducing the morbidity associated with childhood fractures.
Full Text Available Soil quality is critical to the management of urban green space, in particular, along traffic corridors where traffic-related air pollution is significant. Soil quality can be evaluated by soil enzyme activities, which show quick responses to both natural and anthropogenic disturbances. In this study, we investigated three soil enzyme activities (i.e., dehydrogenase, catalase and urease along the major roads in urban areas of Beijing. Results show the activities of dehydrogenase, catalase and urease in urban samples were 58.8%, 68.2% and 48.5% less than the rural sample, respectively. The content of fluorescent amino acids as indicators of microbial activities was also consistently lower in urban samples than the rural. We observed two times greater exposure of particulate material along the roadsides in urban areas than rural areas. Although traffic air pollutants provide some nutrient sources to stimulate the URE activity, the exposure to traffic-related air pollution leads to the substantial decrease in enzyme activities. There were significant negative correlations for exposure to PM10 with DHA (r = −0.8267, p = 0.0017 and CAT (r = −0.89, p = 0.0002 activities. For the urban soils URE activity increased with the increasing of PM. We conclude that the degraded soil quality can negatively affect the target of developing plants and green spaces along the traffic corridors to mitigate the traffic impact. This study suggests the investigation of integrated strategies to restore the soil quality, reinforce the ecological service functions of green spaces along the traffic corridors and reduce the traffic pollutants.
Peleg, Kobi; Savitsky, Bella
Terrorism victims comprise the minority among trauma injured people, but this small population imposes a burden on the health care system. Thirty percent of the population injured in terrorist activities experienced severe trauma (injury severity score > or =16), more than half of them need a surgical procedure, and 25% of the population affected by terrorism had been admitted to intensive care. Furthermore, compared with patients with non-terrorism-related trauma, victims of terrorism often arrive in bulk, as part of a mass casualty event. This poses a sudden load on hospital resources and requires special organization and preparedness. The present study compared terrorism-related and road accident-related injuries and examined clinical characteristics of both groups of patients. This study is a retrospective study of all patients injured through terrorist acts and road traffic accidents from September 29, 2000 to December 31, 2005, and recorded in the Israel Trauma Registry. Data on the nature of injuries, treatment, and outcome were obtained from the registry. Medical diagnoses were extracted from the registry and classified based on International Classification of Diseases coding. Diagnoses were grouped to body regions, based on the Barell Injury Diagnosis Matrix. The study includes 2197 patients with terrorism-related injuries and 30,176 patients injured in road traffic accidents. All in all, 27% of terrorism-related casualties suffered severe to critical injuries, comparing to 17% among road traffic accident-related victims. Glasgow Coma Scale scores terrorism victims, in contrast with 7.4% among people injured on the roads. The terrorism victims had a significantly higher rate of use of intensive care facilities (24.2% vs 12.4%). The overall inpatient death rate was 6.0% among terrorism victims and 2.4% among those injured in road traffic accidents. Casualties from terrorist events are more severely injured and require more resources relative to casualties
Sturms, LM; van der Sluis, CK; Stewart, RE; Groothoff, JW; ten Duis, HJ; Eisma, WH
Objectives: To examine children's reports of their health- related quality of life ( HRQoL) following paediatric traffic injury, to explore child and parental post- traumatic stress, and to identify children and parents with adverse outcomes. Design: Prospective cohort study. Assessments: shortly
Within the Seattle metropolitan area, traffic incident management (TIM) operations provide a multi-jurisdictional and coordinated strategy to detect, respond to, and clear traffic incidents so that traffic flow can be restored quickly and safely. The...
Dormans, J P; Azzoni, M; Davidson, R S; Drummond, D S
Between 1983 and 1993, 16 children with 18 lower extremity power lawn mower-related injuries were treated at Children's Hospital of Philadelphia. Eleven of 16 patients (69%) were bystanders or nonoperators. The average age at injury was 4 years 9 months. Length of follow-up averaged 3 years 10 months. There was an average of 4.9 procedures per patient. Fourteen of the 18 limbs injured required eventual amputation (78%). We propose a new classification of lawn mower injuries in children. The most common injury (16 of 18 limbs) was a shredding type injury and was either intercalary or distal. The second was a paucilaceration type (two of 18 limbs). Of the four salvaged limbs, there were two shredding type injuries, and on most recent follow-up are considered to have poor results. The two patients with the paucilaceration type injuries and limb salvage are considered to have excellent results. All patients with a shredding type injury ultimately required amputation or had poor results with the salvaged limb. Limb salvage surgery was associated with prolonged hospitalizations, a higher incidence of surgical problems, a longer treatment course, and more complications than early ablative procedures.
Makhni, Eric C; Lee, Randall W; Nwosu, Ekene O; Steinhaus, Michael E; Ahmad, Christopher S
Major league baseball (MLB) pitchers are vulnerable to overuse injury of the upper extremity, especially in the shoulder. Injuries sustained in the preseason may have negative impact on performance following return. The goal of this study was to document the frequency of preseason shoulder injury in these athletes, as well as risk for re-injury and impact on performance following return from injury. A comprehensive search of MLB injury information from 2001 to 2010 of public databases yielded a cohort of MLB pitchers who sustained preseason shoulder injuries. These databases were utilized to obtain information regarding return to MLB competition, re-injury, and performance following return from injury. All performance metrics were compared to those of an age-matched control cohort. A total of 74 pitchers were identified who sustained a preseason shoulder injury. Only 39 (53%) returned that same season to pitch in the MLB competition. Of those that returned, nearly 50% of players were re-designated on the Disabled List during the return season. There was a decline in performance in earned run average and batting average against in the year of return. Compared to age-matched control pitchers, those with preseason shoulder injury had lower performance metrics across a number of outcomes. Preseason shoulder injury in MLB pitchers has the potential to result in high re-injury rates and decreased subsequent performance.
Uhrenholt, Lars; Gregersen, Markil Ebbe Gregers; Vesterby, Annie
Introduction:The lower cervical spine facet joints are important structures in cases of chronic pain syndromes following road traffic crashes. Pathophysiological segmental kinematics may occur, particularly during rear-impact collisions, which may cause injury to these joints. Detailed anatomical...... that prepares large un-frozen un-decalcified cervical spine specimens for analysis. Materials and Methods:The cervical spine segments from C4 to C7 are removed en bloc during autopsy. The specimen is fixed throughout in 70% increasing to 99% ethanol and embedded un-decalcified in hardening methyl methacrylate......-duty microtome followed by relevant staining.Results:The described method produces fine detail histological sections that may visualise normal anatomical structures as well as discrete pathoanatomical lesions in the lower cervical spine facet joints.Discussion:The cervical spine facet joints can be analysed...
Aguilera, Sandra Lúcia Vieira Ulinski; Moysés, Simone Tetú; Moysés, Samuel Jorge
To identify and summarize the findings of studies describing interventions aimed at reducing road traffic injuries. An integrative systematic review without meta-analysis was performed. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) were used to synthesize the findings of the articles reviewed. The keywords "traffic accidents", "review" and "public policy" were used in isolation or combined with boolean operator "And" to search PubMed, Web of Science, SciELO, and LILACS for the period between 2006 and 2011 RESULTS: Twenty-two studies were included in the systematic review. Of these, two described engineering strategies, two described other road safety policies, three described education strategies, and 15 described law enforcement policies. Law enforcement had the most effective immediate results. Engineering strategies proved important to promote a safe environment. Finally, education strategies had an informative role and served to support other strategies, but did not seem sufficient to promote cultural changes regarding road safety. Law enforcement seems to be the most effective strategy to change the behavior of drivers, especially regarding speed limits and drinking and driving.
Figler, Bradley D; Mack, Christopher D; Kaufman, Robert; Wessells, Hunter; Bulger, Eileen; Smith, Thomas G; Voelzke, Bryan
The National Highway Traffic Safety Administration's New Car Assessment Program (NCAP) implemented side-impact crash testing on all new vehicles since 1998 to assess the likelihood of major thoracoabdominal injuries during a side-impact crash. Higher crash test rating is intended to indicate a safer car, but the real-world applicability of these ratings is unknown. Our objective was to determine the relationship between a vehicle's NCAP side-impact crash test rating and the risk of major thoracoabdominal injury among the vehicle's occupants in real-world side-impact motor vehicle crashes. The National Automotive Sampling System Crashworthiness Data System contains detailed crash and injury data in a sample of major crashes in the United States. For model years 1998 to 2010 and crash years 1999 to 2010, 68,124 occupants were identified in the Crashworthiness Data System database. Because 47% of cases were missing crash severity (ΔV), multiple imputation was used to estimate the missing values. The primary predictor of interest was the occupant vehicle's NCAP side-impact crash test rating, and the outcome of interest was the presence of major (Abbreviated Injury Scale [AIS] score ≥ 3) thoracoabdominal injury. In multivariate analysis, increasing NCAP crash test rating was associated with lower likelihood of major thoracoabdominal injury at high (odds ratio [OR], 0.8; 95% confidence interval [CI], 0.7-0.9; p NCAP side-impact crash test rating is associated with a lower likelihood of major thoracoabdominal trauma. Epidemiologic study, level III.
Azami-Aghdash, Saber; Sadeghi-Bazarghani, Homayoun; Heydari, Mahdiyeh; Rezapour, Ramin; Derakhshani, Naser
Objective: To review the effectiveness of Road Traffic Injuries (RTIs) interventions implemented for prevention of RTIs in Iran and to introduce some methodological issues. Methods: Required data in this systematic review study were collected through searching the following key words: "Road Traffic Injuries", "Road Traffic accidents", "Road Traffic crashes", “prevention”, and Iran in PubMed, Cochrane Library electronic databases, Google Scholar, Scopus, MagIran, SID and IranMedex. Some of the relevant journals and web sites searched manually. Reference lists of the selected articles were also checked. Gray literature search and expert contact was also conducted. Results: Out of 569 retrieved articles, finally 8 articles included. Among the included studies the effectiveness of 10 interventions were assessed containing: seat belt, enforcements of laws and legislations, educational program, wearing helmet, Antilock Braking System (ABS), motorcyclists' penalty enforcement, pupil liaisons’ education, provisional driver licensing, Road bumps and traffic improvement's plans. In 7 studies (9 interventions) reduction of RTIs rate were reported. Decreased rate of mortality from RTIs were reported in three studies. Only one study had mentioned financial issue (Anti-lock Brake System intervention). Inadequate data sources, inappropriate selection of statistical index and not mention about the control of Confounding Variables (CV), the most common methodological issues were. Conclusion: The results of most interventional studies conducted in Iran supported the effect of the interventions on reduction of RTIs. However due to some methodological or reporting shortcoming the results of these studies should be interpreted cautiously. PMID:29719838
Azami-Aghdash, Saber; Sadeghi-Bazarghani, Homayoun; Heydari, Mahdiyeh; Rezapour, Ramin; Derakhshani, Naser
To review the effectiveness of Road Traffic Injuries (RTIs) interventions implemented for prevention of RTIs in Iran and to introduce some methodological issues. Required data in this systematic review study were collected through searching the following key words: "Road Traffic Injuries", "Road Traffic accidents", "Road Traffic crashes", "prevention", and Iran in PubMed, Cochrane Library electronic databases, Google Scholar, Scopus, MagIran, SID and IranMedex. Some of the relevant journals and web sites searched manually. Reference lists of the selected articles were also checked. Gray literature search and expert contact was also conducted. Out of 569 retrieved articles, finally 8 articles included. Among the included studies the effectiveness of 10 interventions were assessed containing: seat belt, enforcements of laws and legislations, educational program, wearing helmet, Antilock Braking System (ABS), motorcyclists' penalty enforcement, pupil liaisons' education, provisional driver licensing, Road bumps and traffic improvement's plans. In 7 studies (9 interventions) reduction of RTIs rate were reported. Decreased rate of mortality from RTIs were reported in three studies. Only one study had mentioned financial issue (Anti-lock Brake System intervention). Inadequate data sources, inappropriate selection of statistical index and not mention about the control of Confounding Variables (CV), the most common methodological issues were. The results of most interventional studies conducted in Iran supported the effect of the interventions on reduction of RTIs. However due to some methodological or reporting shortcoming the results of these studies should be interpreted cautiously.
A. N. Klimovich
Full Text Available Adaptive algorithms, which current traffic systems are based on, exist for many decades. Information technologies have developed significantly over this period and it makes more relevant their application in the field of transport. This paper analyses modern trends in the development of adaptive traffic flow control methods. Reviewed the most perspective directions in the field of intelligent transport systems, such as high-speed wireless communication between vehicles and road infrastructure based on such technologies as DSRC and WAVE, traffic jams prediction having such features as traffic flow information, congestion, velocity of vehicles using machine learning, fuzzy logic rules and genetic algorithms, application of driver assistance systems to increase vehicle’s autonomy. Advantages of such technologies in safety, efficiency and usability of transport are shown. Described multi-agent approach, which uses V2I-communication between vehicles and intersection controller to improve efficiency of control due to more complete traffic flow information and possibility to give orders to separate vehicles. Presented number of algorithms which use such approach to create new generation of adaptive transport systems.
Full Text Available Background: Traffic accidents, with lots of casualties and injuries, cause a lot of economic loss. This study was conducted to determine the Years Lived with Disability (YLD due to road traffic accidents according to the nature of injuries in Kermanshah province. Methods: following a pilot study, a sample of 3258 people was analyzed in order to calculate the YLD. Then, based on various factors, the age, gender and nature of injury of 10070 people were estimated. The YLD was calculated using the Global Burden of Disease (GBD (2010. The data concerning age and gender of the total population of the province was taken from the Statistical Center of Iran. All calculations were performed based on age and gender in Excel software. Results: The mean age of the injured people was 32.7±17.1. Men constituted 67.7 % of patients. The incidence rate of traffic accidents was 283.6 per 100,000. The highest levels of YLD in outpatients, men and women were reported for patella, tibia, fibula and ankle fractures and fractures of clavicle, scapula, humerus and skull, respectively. The highest rate of inpatient YLDs by nature of injury belonged to the fractures of sternum, ribs and face bone. The years lived with disability was calculated to be 2365.96 years (2.46 per 1000 and 1039.01 years (1.1 per 1000 for men and women, respectively. It was 3404.97 years (1.79 per 1000 in both genders. The highest YLD was in the age group of 15–29. Conclusion: Traffic accidents are high rate of YLD is resulted by traffic accidents. The most affected age group are youngsters and fracture are more frequent.
Warmerdam, Amanda; Newnam, Sharon; Sheppard, Dianne; Griffin, Mark; Stevenson, Mark
Statistics indicate that employees commuting or traveling as part of their work are overrepresented in workplace injury and death. Despite this, many organizations are unaware of the factors within their organizations that are likely to influence potential reductions in work-related road traffic injury. This article presents a multilevel conceptual framework that identifies health investment as the central feature in reducing work-related road traffic injury. Within this framework, we explore factors operating at the individual driver, workgroup supervisor, and organizational senior management levels that create a mutually reinforcing system of safety. The health investment framework identifies key factors at the senior manager, supervisor, and driver levels to cultivating a safe working environment. These factors are high-performance workplace systems, leader-member exchange and autonomy, trust and empowerment, respectively. The framework demonstrates the important interactions between these factors and how they create a self-sustaining organizational safety system. The framework aims to provide insight into the future development of interventions that are strategically aligned with the organization and target elements that facilitate and enhance driver safety and ultimately reduce work-related road traffic injury and death.
Full Text Available Objective: This study aimed to develop a drug cost model for injuries due to road traffic accidents for patients receiving treatment at a regional hospital in Thailand. Methods: The study was designed as a retrospective, descriptive analysis. The cases were all from road traffic accidents receiving treatment at a public regional hospital in the fiscal year 2004. Results: Three thousand seven hundred and twenty-three road accident patients were included in the study. The mean drug cost per case was USD18.20 (SD=73.49, median=2.36. The fitted drug cost model had an adjusted R2 of 0.449. The positive significant predictor variables of drug costs were prolonged length of stay, age over 30 years old, male, Universal Health Coverage Scheme, time of accident during 18:00-24:00 o’clock, and motorcycle comparing to bus. To forecast the drug budget for 2006, there were two approaches identified, the mean drug cost and the predicted average drug cost. The predicted average drug cost was calculated based on the forecasted values of statistically significant (p<0.05 predictor variables included in the fitted model; predicted total drug cost was USD44,334. Alternatively, based on the mean cost, predicted total drug cost in 2006 was USD63,408. This was 43% higher than the figure based on the predicted cost approach.Conclusions: The planned budget of drug cost based on the mean cost and predicted average cost were meaningfully different. The application of a predicted average cost model could result in a more accurate budget planning than that of a mean statistic approach.
Full Text Available Abstract Background Road traffic injuries (RTIs are a major public health problem, requiring concerted efforts both for their prevention and a reduction of their consequences. Timely arrival of the Emergency Medical Service (EMS at the crash scene followed by speedy victim transportation by trained personnel may reduce the RTIs' consequences. The first 60 minutes after injury occurrence - referred to as the "golden hour"- are vital for the saving of lives. The present study was designed to estimate the average of various time intervals occurring during the pre-hospital care process and to examine the differences between these time intervals as regards RTIs on urban and interurban roads. Method A retrospective cross-sectional study was designed and various time intervals in relation to pre-hospital care of RTIs identified in the ambulance dispatch centre in Urmia, Iran from 20 March 2005 to 20 March 2007. All cases which resulted in ambulance dispatches were reviewed and those that had complete data on time intervals were analyzed. Results In total, the cases of 2027 RTI victims were analysed. Of these, 61.5 % of the subjects were injured in city areas. The mean response time for city locations was 5.0 minutes, compared with 10.6 minutes for interurban road locations. The mean on-scene time on the interurban roads was longer than on city roads (9.2 vs. 6.1 minutes, p Conclusion The response, transport and total time intervals among EMS responding to RTI incidents were longer for interurban roads, compared to the city areas. More research should take place on needs-to and access-for EMS on city and interurban roads. The notification interval seems to be a hidden part of the post-crash events and indirectly affects the "golden hour" for victim management and it needs to be measured through the establishment of the surveillance systems.
Pallett, J R; Sutherland, E; Glucksman, E; Tunnicliff, M; Keep, J W
No national recording systems for knife injuries exist in the UK. Understanding the true size and nature of the problem of knife injuries is the first stage in reducing the burden of this injury. The aim of this study was to survey every knife injury seen in a single inner city emergency department (ED) over a one-year period. A cross-sectional observational study was performed of all patients attending with a knife injury to the ED of a London major trauma centre in 2011. Demographic characteristics, patterns of injury, morbidity and mortality data were collected. A total of 938 knife injuries were identified from 127,191 attendances (0.77% of all visits) with a case fatality rate of 0.53%. A quarter (24%) of the major trauma team's caseload was for knife injuries. Overall, 44% of injuries were selfreported as assaults, 49% as accidents and 8% as deliberate self-harm. The highest age specific incident rate occurred in the 16-24 year age category (263/100,000). Multiple injuries were seen in 19% of cases, of which only 81% were recorded as assaults. The mean length of stay for those admitted to hospital was 3.04 days. Intrathoracic injury was seen in 26% of cases of chest trauma and 24% of abdominal injuries had a second additional chest injury. Violent intentional injuries are a significant contributory factor to the workload of the major trauma team at this centre. This paper contributes to a more comprehensive understanding of the nature of these injuries seen in the ED.
road traffic crashes, drowning, burns, poisoning or falls), has become a major ... hugely on childhood health in terms of disability and, depending on their cause ... SA, children continue to be threatened by injuries of various kinds, although this ...
Bayan, Pankaj; Bhawalkar, J S; Jadhav, S L; Banerjee, Amitav
India has one of the highest road traffic accident rates in the world. To lessen this burden, information on the contributing factors is necessary. We studied a series of cases of non-fatal road traffic accidents in two tertiary care hospitals in Pimpri, Pune, India. A total of 212 non-fatal road traffic accidents admitted over a period of one year in these two hospitals constituted the study sample. The study variables were, the gender of the accident victims, mode of accident, days of week on which the accident took place, time of day when the injury was sustained, part of the body injured, nature of injury, and self-reported reasons for the accident. data were summarized using percentages. The Chi-square test for goodness of fit was applied, to see whether there was any association between the different weekdays or time of day and the accidents. MALE : female ratio was almost 5 : 1, which was statistically significant (Chi-Square for goodness of fit = 95.11, df = 1, P accidents occurred on Sundays and Mondays and the least around midweek (Wednesday). This pattern was also statistically significant (Chi-square for goodness of fit = 30.09, df = 6, P road users contributed to almost 80% of the cases of Road Traffic Injuries (RTIs). Accidents were more likely in the time zone of 8 pm to midnight, followed by 4 pm to 8 pm (Chi-square for goodness of fit = 89.58, df = 5, P accident. Almost half (46.22%) of the injured admitted to drinking alcohol on a regular basis. Wide pavements and safe zebra crossings should be provided for pedestrians, as the highest casualty in this study were pedestrians. More accidents occurred on Sundays and Mondays and in the late evenings. Extra supervision by traffic police may be considered on Sundays / Holidays and the day following. Roads should be well lit to improve visibility after sunset.
[Clinical epidemiological assessments on 3521 patients suffering from road traffic injuries, in relation with trauma localisation and severity, assisted in "Sf. Ioan" Emergency Unit, during 2002-2009].
Manole, M; Ciuhodaru, T; Zanoschi, Georgeta; Manole, Alina; Ivan, A
The aim of study was to assess road traffic injuries in relation with their localisation and severity. A sample of 3521 patients suffering from road traffic injuries and assisted in "Sf. Ioan" Emergency Unit, Iaşi, Romania was assess regarding age group, sex and residence area, type of lesions and ther localisation and severity, between 2002-2009. Data were collected using a special epidemiological inquiry and processed using SPSS and MS Excel statistical softs. The incidence of road traffic injuries increased during the last decade, with a report men/women of 1.5, urban and 21-30 age group predominance. The most frequent were leg fractures (16.7%) and thoracal contusions (19.1%), cranial and facial trauma (32.4%), with open injuries (10.5%). Prevention programmes with a high efficiency at the national level, as well as a concret identification of risk factors with a multidisciplinar approach of road traffic accidents, are needed.
Full Text Available BACKGROUND: The aim of this study is to give a description of the road traffic injuries (RTIs characteristics of floating migrant population by comparing with those of local residents in a harbor city of China. METHODS: A population-based descriptive study was carried out between 2007 and 2010 with RTI patient records from the Fifth Center Hospital of Tianjin. Inpatient diagnoses of RTI patients were defined using the International Classification of Diseases, Tenth Revision (ICD-10 codes. We analyzed the demographics and general characteristics of RTI patients that were in the hospital during the four years. In order to compare the group differences between local resident patients and floating migrant patients, the distribution of their ages, diagnoses, severity of injuries, duration of inpatient stays, hospitalization cost were analyzed. RESULTS: People between the ages of 16 and 55 were the most likely to suffer RTIs. The floating migrant patients between the ages of 16 and 45 had a higher incidence of accidents, while local resident patients between 46 and 55 had a higher incidence of accidents. Compared to local resident patients, floating migrant patients were more vulnerable to open injuries and severe traffic injuries. With the severity of injuries ranked from mild to severe, floating migrant patients had lower duration of inpatient stay, but higher hospitalization costs compared to local resident patients. CONCLUSIONS: Floating migrant patients had a different age distribution, severity of injuries, diseases, inpatient duration and hospitalization cost compared with local resident patients. Compared to local resident patients, floating migrants had a higher risk to RTIs and were more vulnerable to severer traffic accidents at lower ages.
Lam, Carlos; Chen, Chang-I; Chuang, Chia-Chang; Wu, Chia-Chieh; Yu, Shih-Hsiang; Chang, Kai-Kuo; Chiu, Wen-Ta
Road traffic injuries (RTIs) are among the leading causes of injury and fatality worldwide. RTI casualties are continually increasing in Taiwan; however, because of a lack of an advanced method for classifying RTI severity data, as well as the fragmentation of data sources, road traffic safety and health agencies encounter difficulties in analyzing RTIs and their burden on the healthcare system and national resources. These difficulties lead to blind spots during policy-making for RTI prevention and control. After compiling classifications applied in various countries, we summarized data sources for RTI severity in Taiwan, through which we identified data fragmentation. Accordingly, we proposed a practical classification for RTI severity, as well as a feasible model for collecting and integrating these data nationwide. This model can provide timely relevant data recorded by medical professionals and is valuable to healthcare providers. The proposed model's pros and cons are also compared to those of other current models.
Full Text Available Given the aging demographics of most developed countries, understanding the public health impact of mild/moderate road traffic crash injuries in older adults is important. We aimed to determine whether health outcomes (pain severity and quality of life measures over 24 months differ significantly between older (65+ and younger adults (18-64.Prospective cohort study of 364, 284 and 252 participants with mild/moderate injury following a vehicle collision at baseline, 12 and 24 months, respectively. A telephone-administered questionnaire obtained information on socio-economic, pre- and post-injury psychological and heath characteristics.At baseline, there were 55 (15.1% and 309 (84.9% participants aged ≥65 and 18-64 years, respectively. At 12- and 24-month follow-up, older compared to younger participants who had sustained a mild/moderate musculoskeletal injury had lower physical functioning (3.9-units lower Short Form-12 Physical Composite Score, multivariable-adjusted p = 0.03 at both examinations. After multivariable adjustment, older (n = 45 versus younger (n = 207 participants had lower self-perceived health status (8.1-units lower European Quality of Life-5 Dimensions Visual Acuity Scale scores at 24 months, p = 0.03, 24 months later.Older compared to younger participants who sustained a mild/moderate injury following a road-traffic crash demonstrated poorer physical functioning and general health at 24 months.
Full Text Available To identify key intervention factors and reduce road traffic injury (RTI-associated mortality, this study compared outcomes and influencing factors of single and multiple road traffic injuries (RTIs in Shanghai.Based on the design of National Trauma Data Bank, this study collected demographic, injury, and outcome data from RTI patients treated at the four largest trauma centers in Shanghai from January 2011 to January 2015. Data were analyzed with descriptive statistics, univariate analysis, and hierarchical logistic regression analysis.Among 2397 participants, 59.4% had a single injury, and 40.6% had multiple injuries. Most patients' outcome was cure or improvement. For single-RTI patients, length of stay, body region, central nervous system injury, acute renal failure, multiple organ dysfunction syndrome, bacterial infection, and coma were significantly related to outcome. For multiple-RTI patients, age, admission pathway, prehospital time, length of stay, number of body regions, body region, injury condition, injury severity score, and coma were significantly related to outcome.Emergency rescue in road traffic accidents should focus on high-risk groups (the elderly, high-incidence body regions (head, thorax, pelvis and number of injuries, injury condition (central nervous system injury, coma, complications, admission pathway, injury severity (critically injured patients, and time factors (particularly prehospital time.
Sadeghi-Bazargani, Homayoun; Samadirad, Bahram; Shahedifar, Nasrin; Golestani, Mina
Objective: To study the epidemiology of car user road traffic fatalities (CURTFs) during eight years, in East Azerbaijan, Iran. Methods: A total of 3051 CURTFs registered in East Azerbaijan forensic medicine organization database, Iran, during 2006-2014, were analyzed using Stata 13 statistical software package. Descriptive statistics (pinferential statistical methods such as Chi-squared test and multivariate logistic regression with p<0.1 were applied. Results: Of the 7818 road traffic injury (RTI) deaths, 3051 (39%) were car users of whom 71% were male (mean age of 36.7±18.5 years). The majority of accident mechanisms were vehicle-vehicle crashes (63.95%), followed by rollover (26.24%). Crash causing vehicle fall increased the pre-hospital death likelihood by 2.34 times. The prominent trauma causing death was head trauma (in 62.5%). In assessing the role of type of counterpart vehicle on pre-hospital mortality, considering the other cars to be the reference group for comparison, deceased victims were 1.83 times more likely to die before hospital when the counterpart vehicle was a truck and 1.66 times more for buses. Conclusion: Decreasing the car users’ fatalities using appropriate strategies such as separating the roads for heavy and light vehicles and improving the injury related facilitation may be effective. Male drivers with low education could be prioritized for being trained. PMID:29719846
Full Text Available Abstract Background Road traffic injuries are a major global public health problem. Improvements in pre-hospital trauma care can help minimize mortality and morbidity from road traffic injuries (RTIs worldwide, particularly in low- and middle-income countries (LMICs with a high rate of RTIs such as Iran. The current study aimed to explore pre-hospital trauma care process for RTI victims in Iran and to identify potential areas for improvements based on the experience and perception of pre-hospital trauma care professionals. Methods A qualitative study design using a grounded theory approach was selected. The data, collected via in-depth interviews with 15 pre-hospital trauma care professionals, were analyzed using the constant comparative method. Results Seven categories emerged to describe the factors that hinder or facilitate an effective pre-hospital trauma care process: (1 administration and organization, (2 staff qualifications and competences, (3 availability and distribution of resources, (4 communication and transportation, (5 involved organizations, (6 laypeople and (7 infrastructure. The core category that emerged from the other categories was defined as "interaction and common understanding". Moreover, a conceptual model was developed based on the categories. Conclusions Improving the interaction within the current pre-hospital trauma care system and building a common understanding of the role of the Emergency Medical Services (EMS emerged as key issues in the development of an effective pre-hospital trauma care process.
Jorgensen, T. S. H.; Hansen, A. H.; Sahlberg, M.
BackgroundAccidental falls during hospitalisation have a range of complications and more information is needed to improve prevention. We investigated patterns of in-hospital fall-related major injuries in the period 2000-2012 and the association between chronic conditions and in-hospital fall......-related major injuries. MethodsUsing administrative databases, patients aged 65+ years with in-hospital falls causing fractures or head injuries with need for surgery or intensive observation were identified as cases and were individually matched with five controls. Joinpoint regression was used to examine time...... trends and conditional logistic regression was used to analyse odds ratio (OR) for in-hospital falls-related major injuries according to a range of comorbidities. ResultsFour thousand seven hundred and fifty-four cases were identified from 2000 to 2012 and the most common injury was femur fracture (61...
Mandacaru, Polyana Maria Pimenta; Andrade, Ana Lucia; Rocha, Marli Souza; Aguiar, Fernanda Pinheiro; Nogueira, Maria Sueli M; Girodo, Anne Marielle; Pedrosa, Ana Amélia Galas; Oliveira, Vera Lídia Alves de; Alves, Marta Maria Malheiros; Paixão, Lúcia Maria Miana M; Malta, Deborah Carvalho; Silva, Marta Maria Alves; Morais Neto, Otaliba Libanio de
Road traffic crashes (RTC) are an important public health problem, accounting for 1.2 million deaths per year worldwide. In Brazil, approximately 40,000 deaths caused by RTC occur every year, with different trends in the Federal Units. However, these figures may be even greater if health databases are linked to police records. In addition, the linkage procedure would make it possible to qualify information from the health and police databases, improving the quality of the data regarding underlying cause of death, cause of injury in hospital records, and injury severity. This study linked different data sources to measure the numbers of deaths and serious injuries and to estimate the percentage of corrections regarding the underlying cause of death, cause of injury, and the severity injury in victims in matched pairs from record linkage in five representative state capitals of the five macro-regions of Brazil. This cross-sectional, population-based study used data from the Hospital Information System (HIS), Mortality Information System (MIS), and Police Road Traffic database of Belo Horizonte, Campo Grande, Curitiba, Palmas, and Teresina, for the year 2013 for Teresina, and 2012 for the other capitals. RecLink III was used to perform probabilistic record linkage by identifying matched pairs to calculate the global correction percentage of the underlying cause of death, the circumstance that caused the road traffic injury, and the injury severity of the victims in the police database. There was a change in the cause of injury in the HIS, with an overall percentage of correction estimated at 24.4% for Belo Horizonte, 96.9% for Campo Grande, 100.0% for Palmas, and 33.2% for Teresina. The overall percentages of correction of the underlying cause of death in the MIS were 29.9%, 11.9%, 4.2%, and 33.5% for Belo Horizonte, Campo Grande, Curitiba, and Teresina, respectively. The correction of the classification of injury severity in police database were 100.0% for Belo
McAdam, Kim; Steer, Peter; Perrotta, Kim
A study to characterize the distribution of vehicle related air pollution in proximity to a major arterial road was undertaken to inform local land use planning and policy regarding separation distances that could help reduce exposure for new sensitive land use development. Measurements of criteria air contaminants were made at ground level, 10 m, 30 m, and 60 m from curb side, and at 9 m height, 10 m from curb side along a traffic corridor carrying over 34,000 vehicles per day. Pollutant decay with distance or height was not statistically significant for O 3, CO, or SO 2. No clear distance decay pattern emerged for PM 2.5. Compared to concentrations at ground level 30 m from curb side, concentrations at 10 m, 60 m, and 10 m at 9 m height were 83%, 45% and 54% higher, respectively. For NO, NO 2, and NO x, however, there was a statistically significant decline in concentrations with distance with the decay most apparent from 30 m to 60 m from the road. Concentrations at 10 m from curb side at 9 m height were equivalent to (all wind conditions) or less than (downwind conditions) those at 30 m and ground level. These findings suggest that for protection of public health in the near road environment, vertical distance is an important determinant of exposure to pollutants that are key indicators of traffic related air pollution. This has implications for sensitive land use development in proximity to high volume traffic corridors.
Ischaemia-reperfusion injury (IRI) is a frequent event in kidney transplantation, particularly when the kidney comes from a deceased donor. The brain death is usually associated with generalized ischaemia due to a hyperactivity of the sympathetic system. In spite of this, most donors have profound hypotension and require administration of vasoconstrictor agents. Warm ischaemia after kidney vessels clamping and the cold ischaemia after refrigeration also reduce oxygen and nutrients supply to tissues. The reperfusion further aggravates the state of oxidation and inflammation created by ischaemia. IRI first attacks endothelial cells and tubular epithelial cells. The lesions may be so severe that they lead to acute kidney injury (AKI) and delayed graft function (DGF), which can impair the graft survival. The unfavourable impact of DGF is worse when DGF is associated with acute rejection. Another consequence of IRI is the activation of the innate immunity. Danger signals released by dying cells alarm Toll-like receptors that, through adapter molecules and a chain of kinases, transmit the signal to transcription factors which encode the genes regulating inflammatory cells and mediators. In the inflammatory environment, dendritic cells (DCs) intercept the antigen, migrate to lymph nodes and present the antigen to immunocompetent cells, so activating the adaptive immunity and favouring rejection. Attempts to prevent IRI include optimal management of donor and recipient. Calcium-channel blockers, l-arginine and N-acetylcysteine could obtain a small reduction in the incidence of post-transplant DGF. Fenoldopam, Atrial Natriuretic Peptide, Brain Natriuretic Peptide and Dopamine proved to be helpful in reducing the risk of AKI in experimental models, but there is no controlled evidence that these agents may be of benefit in preventing DGF in kidney transplant recipients. Other antioxidants have been successfully used in experimental models of AKI but only a few studies of poor
Chen, Min; Huang, Ping; Wan, Lei; Zhang, Jian-Hua; Liu, Ning-Guo; Zou, Dong-Hua; Li, Zheng-Dong; Shao, Yu; Qin, Zhi-Qiang; Chen, Yi-Jiu
A 45-year-old male car driver died in a traffic accident of four cars rear-end collision on the highway. He was found to have died after a respiratory and cardiac arrest at the scene. No sign of skin injuries was observed from the external inspection. The autopsy was not permitted by the family members because of the local culture. Multislice computed tomography (MSCT) was applied to the current case, showing dislocation of C3-4 cervical vertebrae with II degree, C4 vertebral plate fractures, and spinal stenosis. Post-mortem MSCT confirmed the diagnosis as whiplash injuries. MSCT was verified to be effective in showing the severity of whiplash injuries, thus providing certain objective evidence for medicolegal expertise.
Hosking, Jamie; Ameratunga, Shanthi; Exeter, Daniel; Stewart, Joanna; Bell, Andrew
To describe ethnic, socioeconomic and geographical differences in road traffic injury (RTI) within Auckland, New Zealand's largest city. We analysed rates of RTI deaths and non-fatal hospital admissions using the New Zealand Mortality Collection and the National Minimum Data Set 2000-08. Poisson regression examined the association of age, gender, prioritised ethnicity and small area deprivation (New Zealand Index of Deprivation) with RTI rates, and RTI rates were mapped for 21 local board areas within the Auckland region. While RTI rates increased with levels of deprivation in all age groups, the gradient was steepest among children (9% increase/decile) and adults aged 25-64 years (11% increase/decile). In all age groups, RTI risk was highest among Māori. Pacific children had an elevated risk of RTI compared with the NZ European/Other group, but Pacific youth (15-24 years) and adults (25-64 years) had a lower risk. While RTI rates were generally higher for those living in rural local board areas, all but one local board in the southern Auckland urban area had among the highest rates. There are substantial ethnic, socioeconomic and geographic inequalities in RTI risk in the Auckland region, with high rates among Māori (all ages), Pacific children, people living in socioeconomically deprived neighbourhoods, the urban south and rural regions. To meet the vision of regional plans, road safety efforts must prioritise vulnerable communities at greatest risk of RTI, and implement and monitor the effectiveness of strategies that specifically include a focus on reducing inequalities in RTI rates. © 2013 The Authors. ANZJPH © 2013 Public Health Association of Australia.
Hyder, Adnan A; Norton, Robyn; Pérez-Núñez, Ricardo; Mojarro-Iñiguez, Francisco R; Peden, Margie; Kobusingye, Olive
Road traffic crashes have been an increasing threat to the wellbeing of road users worldwide; an unacceptably high number of people die or become disabled from them. While high-income countries have successfully implemented effective interventions to help reduce the burden of road traffic injuries (RTIs) in their countries, low- and middle-income countries (LMICs) have not yet achieved similar results. Both scientific research and capacity development have proven to be useful for preventing RTIs in high-income countries. In 1999, a group of leading researchers from different countries decided to join efforts to help promote research on RTIs and develop the capacity of professionals from LMICs. This translated into the creation of the Road Traffic Injuries Research Network (RTIRN) - a partnership of over 1,100 road safety professionals from 114 countries collaborating to facilitate reductions in the burden of RTIs in LMICs by identifying and promoting effective, evidenced-based interventions and supporting research capacity building in road safety research in LMICs. This article presents the work that RTIRN has done over more than a decade, including production of a dozen scientific papers, support of nearly 100 researchers, training of nearly 1,000 people and 35 scholarships granted to researchers from LMICs to attend world conferences, as well as lessons learnt and future challenges to maximize its work.
Al-Kindi, Sara M; Naiem, Ahmed A; Taqi, Kadhim M; Al-Gheiti, Najla M; Al-Toobi, Ikhtiyar S; Al-Busaidi, Nasra Q; Al-Harthy, Ahmed Z; Taqi, Alaa M; Ba-Alawi, Sharif A; Al-Qadhi, Hani A
Road traffic injuries (RTIs) are considered a major public health problem worldwide. In Oman, high numbers of RTIs and RTI-related deaths are frequently registered. This study aimed to evaluate the distribution of trauma care facilities in Oman with regards to their proximity to RTI-prevalent areas. This descriptive pilot study analysed RTI data recorded in the national Royal Oman Police registry from January to December 2014. The distribution of trauma care facilities was analysed by calculating distances between areas of peak RTI incidence and the closest trauma centre using Google Earth and Google Maps software (Google Inc., Googleplex, Mountain View, California, USA). A total of 32 trauma care facilities were identified. Four facilities (12.5%) were categorised as class V trauma centres. Of the facilities in Muscat, 42.9% were ranked as class IV or V. There were no class IV or V facilities in Musandam, Al-Wusta or Al-Buraimi. General surgery, orthopaedic surgery and neurosurgery services were available in 68.8%, 59.3% and 12.5% of the centres, respectively. Emergency services were available in 75.0% of the facilities. Intensive care units were available in 11 facilities, with four located in Muscat. The mean distance between a RTI hotspot and the nearest trauma care facility was 34.7 km; however, the mean distance to the nearest class IV or V facility was 83.3 km. The distribution and quality of trauma care facilities in Oman needs modification. It is recommended that certain centres upgrade their levels of trauma care in order to reduce RTI-associated morbidity and mortality in Oman.
Rothman, Linda; Slater, Morgan; Meaney, Christopher; Howard, Andrew
To determine whether the severity of injuries sustained by pedestrians involved in motor vehicle collisions varies by road type and age. All police-reported pedestrian motor vehicle collisions in the city of Toronto, Canada, between January 1, 2000, and December 31, 2005, were analyzed. Geographic Information Systems software was used to determine whether the collisions occurred on major or neighborhood roads. Age-specific estimates of the burden of pedestrian collisions are presented. Odds ratios and 95 percent confidence intervals were calculated to examine age-specific relationships between injury severity and road type. A second analysis comparing the distribution of severe injury location between age groups was also performed. The majority of collisions involved adults (68%), although elderly pedestrians were overrepresented in fatal collisions (49%). Severe and fatal collisions involving working-age and elderly adult pedestrians were more likely on major roads. Odds of severe injury occurring on a major road were 1.36 (95% CI: 1.17-1.57) times higher for adults ages 18 to 64, and 1.55 (95% CI: 1.22-1.99) times higher for elderly aged 65+. By contrast, severe injuries among children were more common on neighborhood roads, with odds of severe injury on a major road of 0.64 (95% CI: 0.37-1.1) for children aged 5 to 9. Among children under 9, 64-67 percent of hospitalized or fatal injuries occurred on neighborhood roads, a marked difference from the distribution of such injuries in adults or the elderly, for whom only 29-30 percent of hospitalized or fatal injuries occurred on neighborhood roads (chi-square = 52.6, p roads alone will not make child pedestrians safer. Pedestrian interventions specific to children and focused on neighborhood roads must be considered in urban centers like Toronto.
National Highway Traffic Safety Administration (DOT), Washington, DC.
To assist in the continuing efforts to improve the safety of the motorist on the nation's highways and roads, this student guide provides a standardized approach for first responders to traffic accidents to learn emergency medical care. Training is provided in all aspects of emergency medical care required at the scene of a traffic accident.…
Sunil Kumar Raina
Full Text Available Background: Road traffic accidents (RTAs kill 1.25 million people each year and injure between 20 and 50 million more people with many incurring a disability as a result of their injury. The road environment (design and geometry can affect driver speed choice, thereby increasing chances of accidents.Materials and Methods: Patients attending tertiary care center for musculoskeletal injuries after an RTA were enrolled in the study. The data were collected using a standard questionnaire. The details on the geometry of the road (type of road; highway or other, metaled or nonmetaled, straight, and curved were obtaine through inspection wherever possible. Results: Majority of the RTAs occurred on state highways (n = 154/313, 49.7% followed by national highways (NH (n = 94/313, 30%. Link roads account for comparatively less number (n = 65/313, 20.7% of cases. Majority of the accidents occurred on metaled road (n = 268, 85.6%; however, the association of different vehicles involved in RTA with the condition of road was not found to be significant statistically (P > 0.5. Further, the majority of the RTA occurred on straight roads (n = 204, 65.1%. Conclusion: Road geometry is an important factor in RTAs as drivers generally tend to choose their speed based on their perception of the appropriate speed for the road geometry.
Bigdeli, Maryam; Khorasani-Zavareh, Davoud; Mohammadi, Reza
Road traffic injuries (RTIs) are a major public health problem, requiring concerted efforts both for their prevention and a reduction of their consequences. Timely arrival of the Emergency Medical Service (EMS) at the crash scene followed by speedy victim transportation by trained personnel may reduce the RTIs' consequences. The first 60 minutes after injury occurrence--referred to as the "golden hour"--are vital for the saving of lives. The present study was designed to estimate the average of various time intervals occurring during the pre-hospital care process and to examine the differences between these time intervals as regards RTIs on urban and interurban roads. A retrospective cross-sectional study was designed and various time intervals in relation to pre-hospital care of RTIs identified in the ambulance dispatch centre in Urmia, Iran from 20 March 2005 to 20 March 2007. All cases which resulted in ambulance dispatches were reviewed and those that had complete data on time intervals were analyzed. In total, the cases of 2027 RTI victims were analysed. Of these, 61.5% of the subjects were injured in city areas. The mean response time for city locations was 5.0 minutes, compared with 10.6 minutes for interurban road locations. The mean on-scene time on the interurban roads was longer than on city roads (9.2 vs. 6.1 minutes, p transport times from the scene to the hospital were also significantly longer for interurban incidents (17.1 vs. 6.3 minutes, p transport and total time intervals among EMS responding to RTI incidents were longer for interurban roads, compared to the city areas. More research should take place on needs-to and access-for EMS on city and interurban roads. The notification interval seems to be a hidden part of the post-crash events and indirectly affects the "golden hour" for victim management and it needs to be measured through the establishment of the surveillance systems.
Christie, N; Ward, H; Kimberlee, R; Towner, E; Sleney, J
To gain an in-depth qualitative understanding of parents' views about their children's exposure to road traffic injury risk in low socioeconomic areas. Focus groups facilitated by a moderator with content analysis of data. Focus groups were conducted in 10 low socioeconomic English districts that also have high rates of child pedestrian injury. Research was conducted in community venues within each area. Parents of children aged 9-14 years living in low socioeconomic areas. Parents believe that children play in their local streets for the following reasons: they like playing out with friends near home; there are few safe, secure, and well-maintained public spaces for children; children are excluded from affordable leisure venues because of their costs; insufficient parental responsibility. For children that play in the street, the key sources of risk identified by parents were: illegal riding and driving around estates and on the pavements; the speed and volume of traffic; illegal parking; drivers being poorly informed about where children play; children's risk-taking behavior. Intervention programs need to take into account multiple reasons why children in low socioeconomic areas become exposed to hazardous environments thereby increasing their risk of injury. Multi-agency partnerships involving the community are increasingly needed to implement traditional road safety approaches, such as education, engineering, and enforcement, and provide safe and accessible public space, affordable activities for children, and greater support for parents.
Ngallaba, S E; Majinge, C; Gilyoma, J; Makerere, D J; Charles, E
Sixty percent of the global deaths and injuries occur in the developing world and mostly are due to Road traffic accidents (RTAs. looking at the etiological related factors which include, carelessness of the driver, condition of the vehicle or motorcycle, poor condition of roads, risky behavior of the driver, most of these factors can be prevented to some extent. This study therefore, determined the pattern of cases and deaths due to traffic road accidents in Mwanza City Tanzania. In this retrospective study, records, registers and case notes In the surgical ward and causality, medical records and central police station from 2008 to 2011 were used. The study focused on the two referral hospitals (Sekouture regional hospital and Bugando Medical Center). There were 3450 cases due to accidents reported at both centers (Sekouture regional hospital and Bugando Medical Center of which 3224 (93.4%) had complete information for analysis.2225 (69%) were male and 999 (31%) were female, and the most affected group were male. Among the RTAs2809 cases (87%) were due to motor cycle accidents which were the leading cause of RTAs with case fatality rate of 5% while motor vehicle has case fatality rate of 24% which is 5 times that of motor cycle. Among all RTAs the leading cause of injuries is Motor cycle traffic accidents followed by motor vehicle. RTAs are on increase particularly the motor cycle traffic accidents and has claimed a good number of innocent people's lives however most of them are preventable, therefore driving course to be introduced to motor cycle drivers with emphasize on the road posters signal, rules and regular checkup of their motor cycles especially commercial motor cycle.
Wu, Shih-Chi; Fu, Chih-Yuan; Chen, Ray-Jade; Chen, Yung-Fang; Wang, Yu-Chun; Chung, Ping-Kuei; Yu, Shu-Fen; Tung, Cheng-Cheng; Lee, Kun-Hua
Nonoperative management (NOM) of blunt splenic injuries has been widely accepted, and the application of splenic artery embolization (SAE) has become an effective adjunct to NOM. However, complications do occur after SAE. In this study, we assess the factors leading to the major complications associated with SAE. Focusing on the major complications after SAE, we retrospectively studied patients who received SAE and were admitted to 2 major referral trauma centers under the same established algorithm for management of blunt splenic injuries. The demographics, angiographic findings, and factors for major complications after SAE were examined. Major complications were considered to be direct adverse effects arising from SAE that were potentially fatal or were capable of causing disability. There were a total of 261 patients with blunt splenic injuries in this study. Of the 261 patients, 53 underwent SAE, 11 (21%) of whom were noted to have 12 major complications: 8 cases of postprocedural bleeding, 2 cases of total infarction, 1 case of splenic abscess, and 1 case of splenic atrophy. Patients older than 65 years were more susceptible to major complications after SAE. Splenic artery embolization is considered an effective adjunct to NOM in patients with blunt splenic injuries. However, risks of major complications do exist, and being elderly is, in part, associated with a higher major complication incidence. Copyright Â© 2011 Elsevier Inc. All rights reserved.
Styrke, Johan; Stålnacke, Britt-Marie; Bylund, Per-Olof; Sojka, Peter; Björnstig, Ulf
To examine the annual incidence of acute whiplash injuries after road traffic crashes in a geographic catchment area in Northern Sweden during the period 2000-2009. Descriptive epidemiology determined by prospectively collected data from a defined population. The study was conducted at a public hospital in Sweden. The population of the hospital's catchment area (136,600 inhabitants in 1999 and 144,500 in 2009). At the emergency department, all injured persons (approximately 11,000 per year) were asked to answer a questionnaire about the injury incident. Data from the medical records also were analyzed. From 2000-2009, 15,506 persons were injured in vehicle crashes. Persons who were subject to an acute neck injury within whiplash-associated disorder grades 1-3 were included. The overall and annual incidences were calculated as incidence. Age, gender, type of injury event, and direction of impact were described. The incidences were compared with national statistics on insurance claims from 2003, 2007, and 2008 to detect changes in the proportions of claims. The annual incidence of acute whiplash injuries. Secondary outcome measures were types of injury events, age and gender distribution, changes in the proportion of rear-end crashes during 2000-2009, and changes in the proportion of insurance claims during 2003-2008. During 2000-2009, 3297 cases of acute whiplash injury were encountered. The overall incidence was 235/100,000/year. The average yearly increase in incidence was 1.0%. Women comprised 51.9% and men 48.1% of the injured. Car occupants (86.4%) and bicycle riders (6.1%) were most frequently injured. The proportion of rear-end crashes decreased from 55% to 45% from 2000-2009. The proportion of insurance claims significantly decreased between 2003 and 2008 (P whiplash injuries after road traffic crashes have been relatively stable during the past decade in our area, except in 2007 and 2008, when a peak occurred. Copyright © 2012 American Academy of Physical
Full Text Available Abstract Background Road traffic injuries (RTI are an increasing public health problem in India where out-of-pocket (OOP expenditures on health are among the highest in the world. We estimated the OOP expenses for RTI in a large city in India. Methods Information on medical and non-medical expenditure was documented for RTI cases of all ages that reported alive or dead to the emergency departments of two public hospitals and a large private hospital in Hyderabad. Differential risk of catastrophic OOP total expenditure (COPE-T and medical expenditure (COPE-M, and distress financing was assessed for 723 RTI cases that arrived alive at the study hospitals with multiple logistic regression. Catastrophic expenditure was defined as expenditure > 25% of the RTI patient’s annual household income. Variation in intensity of COPE-M in RTI was assessed using multiple classification analysis (MCA. Results The median OOP medical and non-medical expenditure was USD 169 and USD 163, respectively. The prevalence of COPE-M and COPE-T was 21.9% (95% CI 18.8-24.9 and 46% (95% CI 42–49.3, respectively. Only 22% had access to medical insurance. Being admitted to a private hospital (OR 5.2, 95% CI 2.7–9.9 and not having access to insurance (OR 3.8, 95% CI 1.9–7.6 were significantly associated with risk of having COPE – M. Similar results were seen for COPE - T. MCA analysis showed that the burden of OOP medical expenditure was mainly associated with in-patient days in hospital (Eta =0.191. Prevalence of distress financing was 69% (95% CI 65.5-72.3 with it being significantly higher for those reporting to the public hospitals (OR 2.8, 95% CI 1.7-4.6, those belonging to the lowest per capita annual household income quartile (OR 7.0, 95% CI 3.7-13.3, and for those without insurance access (OR 3.4, 95% CI 2.0-5.7. Conclusions This paper has outlined the high burden of out-of-pocket medical and total expenditure associated with RTI in India. These data
Hofmeyr, S; Krige, J E J; Bornman, P C; Beningfield, S J
Major bile duct injuries occur infrequently after laparoscopic cholecystectomy, but may result in life-threatening complications. Few data exist on the financial implications of duct repair. This study calculated the costs of operative repair in a cohort of patients who underwent reconstruction of the bile duct after major ductal injury. To calculate the total in-hospital cost of surgical repair of patients referred with major bile duct injuries. A prospective database was reviewed to identify all patients referred to the University of Cape Town Private Academic Hospital, South Africa, between 2002 and 2013 for assessment and repair of major laparoscopic bile duct injuries. The detailed clinical records and billing information were evaluated to determine all costs from admission to discharge. Total costs for each patient were adjusted for inflation between the year of repair and 2013. Results. Forty-four patients (33 women, 11 men; median age 48 years, range 30 - 78) underwent reconstruction of a major bile duct injury. First-time repairs were performed at a median of 24.5 days (range 1 - 3,662) after initial surgery. Median hospital stay was 15 days (range 6 - 86). Mean cost of repair was ZAR215,711 (range ZAR68,764 - 980,830). Major contributors to cost were theatre expenses (22%), admission to intensive care (21%), radiology (17%) and specialist fees (12%). Admission to a general ward (10%), consumables (7%), pharmacy (5%), endoscopy (3%) and laboratory costs (3%) made up the balance. The cost of repair of a major laparoscopic bile duct injury is substantial owing to prolonged hospitalisation, complex surgicalintervention and intensive imaging requirements.
Sammy, I.A.; Chatha, H.; Lecky, F.; Bouamra, O.; Fragoso Iniguez, M.; Sattout, A.; Hickey, M.
Introduction First rib fractures are traditionally considered indicators of increased morbidity and mortality in major trauma. However, this relationship has not been definitively proven. With an increase in computed tomography in major trauma, and the likely increase in detection of first rib fractures, this study re-evaluates whether first rib fractures are an indicator of injury severity. Discussion This study suggests that major trauma patients with first rib fractures have increased ISS ...
Ainy, E; Soori, Hamid; Mahfozphoor, S; Movahedinejad, Aa
This study was conducted to assess political mapping in relation to road traffic injuries (RTIs) management and prevention to present a practical model for RTIs. A phenomenological qualitative study was developed to identify stakeholders on RTI in Iran in 2008. The designed questions were discussed by systematic discussion with the relevant specialists. After receiving written consent from the main responsible stakeholders, the questionnaire was filled in by trained experts. Themes were determined and content was analysed in each part. Main responsible stakeholders. By comparing other countries' political mappings which were found in the library and by Internet searching, political mapping of RTI in Iran was suggested. Subjects were 26 experts from governmental and non-governmental organizations. The main proposed leading agencies were traffic police and presidency (13% each). Findings showed that only 31% of our political mapping was formed according to the World Health Organization (WHO). In 94% of cases, the involved organizations had unspecified roles; the reason was poor monitoring for RTI in 39% of organizations. Lack of adequate authority and suitable legislation, appropriate laws and tasks definition were 94% and 18%, respectively. The most essential policy to overcome problems was defined as appropriate legislation (21%), and the most frequent type of support needed was mentioned as adequate budgeting (25%). Traffic police can play the leading agency role by government support, with strong leadership, appropriate legislation, defined tasks and adequate budget.
Yokota, Jun-Ichi; Shimoda, Satoe
Vertigo and dizziness are common clinical manifestations after traffic accident-associated whiplash injury. Recently, Shinonaga et al. (2001) suggested that more than 80% of patients with whiplash injury complaining of these symptoms showed cerebrospinal (CSF) hypovolemia on radioisotope (RI) cisternography (111In-DTPA). However, neuro-otological studies to investigate the pathophysiological mechanisms underlying these symptoms have been insufficient. In the present study, patients complaining of these symptoms with CSF hypovolemia after traffic accidents were investigated with posturography and electronystagmography (ENG). Fourteen patients (4 men, 10 women; 24-52 yr) were examined with posturography and showed parameters (tracking distance & area) significantly (p<0.01) larger than those of healthy subjects. Among them, five cases (1 man, 4 women; 31-52 yr) were further investigated with ENG. The slow phase peak velocities of optokinetic nystagmus (OKN) and optokinetic-after nystagmus (OKAN) were significantly (p<0.01) reduced (62.64±6.9 SD deg/sec, 60.76±10.74 SD deg/sec, respectively) and frequencies of OKN were reduced (139.7±10.75 SD), while the ocular smooth pursuit was relatively preserved. Magnetic resonance images (sagittal view) of these five patients demonstrated the downward displacement of the cerebellar tonsils and flattening of the pons, which are characteristic features of CSF hypovolemia, called "brain sagging." Our results suggest that brain sagging due to CSF hypovolemia impairs vestibular and vestibulocerebellar functions, which may cause dizziness and vertigo.
Jennifer H Campbell
Full Text Available Four SIV-infected monkeys with high plasma virus and CNS injury were treated with an anti-α4 blocking antibody (natalizumab once a week for three weeks beginning on 28 days post-infection (late. Infection in the brain and gut were quantified, and neuronal injury in the CNS was assessed by MR spectroscopy, and compared to controls with AIDS and SIV encephalitis. Treatment resulted in stabilization of ongoing neuronal injury (NAA/Cr by 1H MRS, and decreased numbers of monocytes/macrophages and productive infection (SIV p28+, RNA+ in brain and gut. Antibody treatment of six SIV infected monkeys at the time of infection (early for 3 weeks blocked monocyte/macrophage traffic and infection in the CNS, and significantly decreased leukocyte traffic and infection in the gut. SIV - RNA and p28 was absent in the CNS and the gut. SIV DNA was undetectable in brains of five of six early treated macaques, but proviral DNA in guts of treated and control animals was equivalent. Early treated animals had low-to-no plasma LPS and sCD163. These results support the notion that monocyte/macrophage traffic late in infection drives neuronal injury and maintains CNS viral reservoirs and lesions. Leukocyte traffic early in infection seeds the CNS with virus and contributes to productive infection in the gut. Leukocyte traffic early contributes to gut pathology, bacterial translocation, and activation of innate immunity.
Campbell, Jennifer H; Ratai, Eva-Maria; Autissier, Patrick; Nolan, David J; Tse, Samantha; Miller, Andrew D; González, R Gilberto; Salemi, Marco; Burdo, Tricia H; Williams, Kenneth C
Four SIV-infected monkeys with high plasma virus and CNS injury were treated with an anti-α4 blocking antibody (natalizumab) once a week for three weeks beginning on 28 days post-infection (late). Infection in the brain and gut were quantified, and neuronal injury in the CNS was assessed by MR spectroscopy, and compared to controls with AIDS and SIV encephalitis. Treatment resulted in stabilization of ongoing neuronal injury (NAA/Cr by 1H MRS), and decreased numbers of monocytes/macrophages and productive infection (SIV p28+, RNA+) in brain and gut. Antibody treatment of six SIV infected monkeys at the time of infection (early) for 3 weeks blocked monocyte/macrophage traffic and infection in the CNS, and significantly decreased leukocyte traffic and infection in the gut. SIV - RNA and p28 was absent in the CNS and the gut. SIV DNA was undetectable in brains of five of six early treated macaques, but proviral DNA in guts of treated and control animals was equivalent. Early treated animals had low-to-no plasma LPS and sCD163. These results support the notion that monocyte/macrophage traffic late in infection drives neuronal injury and maintains CNS viral reservoirs and lesions. Leukocyte traffic early in infection seeds the CNS with virus and contributes to productive infection in the gut. Leukocyte traffic early contributes to gut pathology, bacterial translocation, and activation of innate immunity.
Sivak, Michael; Luoma, Juha; Flannagan, Michael J; Bingham, C Raymond; Eby, David W; Shope, Jean T
This article examines five major road-safety risk factors: exceeding posted speed limits, not using safety belts, driving while intoxicated, nighttime driving, and young drivers. The importance of each of these factors is documented, known effective countermeasures (both policy and technology based) are discussed, and impediments to the implementation of these countermeasures in the United States are examined. Based on current understanding of the five major risk factors, and of the available countermeasures, there appear to be a variety of opportunities to make substantial gains in road safety using existing knowledge. The limited implementation of a variety of known countermeasures therefore appears to be inconsistent with high-level, strategic goals to improve road safety. Consequently, a recommendation is made to comprehensively re-examine the balance between the countermeasures discussed in this article and economic, mobility, and privacy concerns. IMPACT ON PUBLIC SAFETY: Such a re-examination is likely to result in broad support for these countermeasures, with a consequent major improvement in road safety.
Hatamabadi, Hamidreza; Vafaee, Reza; Hadadi, Mashyaneh; Abdalvand, Ali; Esnaashari, Hamidreza; Soori, Hamid
Crash injuries in traffic accidents are affected by a variety of factors. In this study we analyzed road user type information based on different contributing factors. Data from all of the road traffic victims on a road extending from the east of the city of Tehran to Mazandaran province were included prospectively over a one-year period (May 2008 to May 2009). Data collected included the crash time, patient's age and sex, road user category, helmet or seat belt use, anatomical site of injury, Injury Severity Score (ISS), and mortality. Prevalence and cross-tabulations were included in the analysis. There were 433 patients, of whom 345 were hospitalized and 33 died either before or after arriving at the hospital. Sixty-nine percent of injured patients were vehicle occupants. Mean and median of ISS were higher for pedestrians, who accounted for 49 percent of the deaths. Head injury was the most common injury and injury to upper and lower extremities was the most common cause of admission. A significant difference in lower extremity injuries between vehicle occupants and nonoccupants was found. Sex and age group did not have a significant effect on mortality. Mortality was significantly higher in pedestrians (P road user type. Because pedestrians are the most vulnerable road users, stricter legislation and law enforcement should be used to protect them. Greater protection can also be reached by holding effective public awareness campaigns on how to use different roads safely. On the other hand, because rear seat passengers are at the same risk for road traffic injuries as front seat passengers, employment of newer laws and preventive measures targeting this group of occupants can prevent many road traffic injuries (RTIs).
Hosseinpour, Marjan; Mohammadian-Hafshejani, Abdollah; Esmaeilpour Aghdam, Mohammad; Mohammadian, Mahdi; Maleki, Farzad
To investigate trend and seasonal pattern of occurrence and mortality of motorcycle accidents in patients referred to hospitals of Isfahan. This cross-sectional study was carried out using traffic accidents data of Isfahan province, extracted from Ministry of Health (MOH) database from 2006 to 2010. During the study period, 83648 people injured due to motorcycle traffic accidents were referred to hospitals, all of them entered in the study. Logistic regression model was used to calculate the hospital mortality odds ratio, and Cochrane-Armitage test was used for assessment of linear trend. During the study period, the hospital admission for motorcycle accident was 83,648 and 89.3% (74743) of them were men. Mean age in accidents time was 26.41±14.3 years. The injuries and death sex ratio were 8.4 and 16.9, respectively. Lowest admission rate was during autumn and highest during summer. The injury mortality odds ratio was 1.01 (CI 95% 0.73-1.39) in the Spring, 1.34 (CI95% 1.01-1.79) in summer and 1.17 (CI95% 0.83-1.63). It was also calculated to be 2.51 (CI95% 1.36-4.64) in age group 40-49, 2.39 (CI95% 1.51-5.68) in 50-59 and 4.79 (CI95% 2.49-9.22) in 60-69 years. The mortality odds ratio was 3.53 (CI95% 2.77-4.5) in rural place, 1.33 (CI95% 1.15-1.54) in men, and 2.44 (CI95% 2.09-2.85) in the road out of town and village. In addition, trend of motorcycle accidents mortality was increasing ( p accidents injuries are more common in men, summer, young age and rural roads. These high risk groups need more attention, care and higher training.
Kivekäs, N.; Massling, Andreas; Grythe, H.
at a remote location. We studied the particle number concentration (12 to 490 nm in diameter), the mass concentration (12 to 150 nm in diameter) and number and volume size distribution of aerosol particles in ship plumes for a period of 4.5 months at Hovsore, a coastal site on the western coast of Jutland...... in Denmark. During episodes of western winds, the site is about 50 km downwind of a major shipping lane and the plumes are approximately 1 hour old when they arrive at the site. We have used a sliding percentile-based method for separating the plumes from the measured background values and to calculate...... the ship plume contribution to the total particle number and PM0.15 mass concentration (mass of particles below 150 nm in diameter, converted from volume assuming sphericity) at the site. The method is not limited to particle number or volume concentration, but can also be used for different chemical...
Background: Injury and deaths due to road traffic crashes are a major public health problem in developing countries. Boda bodas (motorcycles) are a practical and a sought after economic activity in Uganda's capital and cities. The injuries related to boda bodas contribute significantly to the number road traffic injuries seen ...
predictable and preventable, while accidents are random, inevitable events. .... case-control study in an urban area in California found that the introduction of 1 600 ... of route to the school road and the year of construction of the traffic calming ...
Cleven, Arlene M.
The course guide has been prepared to aid in planning and conducting a training program in emergency medical care for first responders to traffic accidents (expected to be patrolling law enforcement officers). This document contains a detailed description of the training program; suggestions for course planning including class size, scheduling…
National Highway Traffic Safety Administration (DOT), Washington, DC.
To assist in the continuing efforts to improve the safety of the motorist on the nation's highways and roads, this instructor's guide provides a standardized approach for providing training in emergency medical care for first responders to traffic accidents. The objective of the course is to provide training in all aspects of emergency medical…
Full Text Available 【Abstract】Objective: Livestock-related injuries are one of the important factors causing morbidity and mor-tality in patients admitted to hospital. Treatment of these patients is still a major problem in health care system. The aim of current study was to assess the epidemiology of livestock-related injuries in a major trauma center in Iran from 2006 to 2011. Methods: In a prospective study, patients with live-stock-related injuries who were consecutively admitted to the trauma center in Kashan, Iran between 2006 and 2011 were evaluated. The data collected included patient’s demographics, place and nature of accident, damaged organ, educational level, transport and outcome. Data were ex-pressed as mean±standard deviation. Results: A total of 129 patients were included in this study, accounting for 0.3% of all trauma admission (40 273 cases. The mean age was (55.27±14.45 years. Men were affected four times more than women. Falling down from livestock is the main mechanism of trauma in all groups. Upper and lower extremities were most frequently injured (n=72, followed by the head, neck and spine (n=33 for each. There was one death resulting from livestock-related injury in this study. Conclusion: Despite the low incidence, livestock-re-lated injuries can damage major organs of human body and therefore appropriate training program to increase the safety awareness in home and outdoor is very important. Key words: Epidemiology; Livestock; Iran; Wounds and injuries
Full Text Available While some medicinal drugs have been found to affect driving ability, no study has investigated whether a relationship exists between these medicines and crashes involving pedestrians. The aim of this study was to explore the association between the use of medicinal drugs and the risk of being involved in a road traffic crash as a pedestrian.Data from 3 French nationwide databases were matched. We used the case-crossover design to control for time-invariant factors by using each case as its own control. To perform multivariable analysis and limit false-positive results, we implemented a bootstrap version of Lasso. To avoid the effect of unmeasured time-varying factors, we varied the length of the washout period from 30 to 119 days before the crash. The matching procedure led to the inclusion of 16,458 pedestrians involved in an injurious road traffic crash from 1 July 2005 to 31 December 2011. We found 48 medicine classes with a positive association with the risk of crash, with median odds ratios ranging from 1.12 to 2.98. Among these, benzodiazepines and benzodiazepine-related drugs, antihistamines, and anti-inflammatory and antirheumatic drugs were among the 10 medicines most consumed by the 16,458 pedestrians. Study limitations included slight overrepresentation of pedestrians injured in more severe crashes, lack of information about self-medication and the use of over-the-counter drugs, and lack of data on amount of walking.Therapeutic classes already identified as impacting the ability to drive, such as benzodiazepines and antihistamines, are also associated with an increased risk of pedestrians being involved in a road traffic crash. This study on pedestrians highlights the necessity of improving awareness of the effect of these medicines on this category of road user.
To understand the stigma perspective of siblings of children with major burn injury. A mixed method, qualitative-dominant study was conducted. The life story method was used for the qualitative portion. Only narratives from those family members describing the sibling's appearance change were used (N = 18 participants). Stigma experienced by siblings was first described by parents or noninjured siblings; they described how the sibling with changed appearance was stared at, ridiculed, or teased when they entered a new social situation. Only when specifically asked did the children with burn injury talk about their problems, saying, "This always happens when I go somewhere new." Children with changed appearance focused on normalizing their lives in a positive way. Oftentimes, it was a parent or noninjured sibling who would describe manifestations of stigma and ways they tried to protect the child with burn injury. ©2013 The Author(s) ©2013 American Association of Nurse Practitioners.
Muzzammil, Muhammad; Minhas, Muhammad Saeed; Effendi, Jahanzeb; Jahanzeb, Syed; Mughal, Ayesha; Qadir, Abdul
The three-wheeler Qing-qi and Compressed Natural Gas (CNG) auto-rickshaws were introduced in Karachi to meet the transportation demand of the growing population. These vehicles have directly or indirectly been implicated in a number of road traffic violations as well as road accidents. This study aims to describe the crash characteristics and injury patterns for Qing-qi rickshaw occupants and other road users hit by Qing-qi rickshaw in Karachi, Pakistan. An Observational/ Descriptive study was conducted at Accident & Emergency and Orthopaedic Surgery Department, Jinnah Post Graduate Medical Centre, Karachi Pakistan from July 2014 to June 2015.All patients who came with Qing-qi rickshaw accident in Accident & Emergency (A&E) of JPMC were included. Crash characteristics, details of injuries, injury severity parameters and outcome were documented in detailed interviews. Four hundred and eighty-six rickshaw related injuries were noted in road traffic accidents by Qing-gi rickshaw. Age range was 2-85 (43.5±58.68). 350 injured victims were males and 136 were females. By occupation most victims were laborers and daily wage workers (45%) and students (21%). Overloading of vehicle with more than two passengers was found in (28.5%). The most common cause of injury was collision with a moving vehicle (56%), followed by fall from rickshaw. The most common contributing factor was the overloading of rickshaw and roll over on turning (61%). Injury severity on arrival were mild (49%), moderate were (32%), and severe were (19%). Injuries related to head and neck (26%), face (14%), thorax and abdomen (5%), lower extremity and pelvic girdle (31%) and upper extremity (23%) were observed. Qing-qi rickshaw injuries are common and these vehicles are vulnerable to road traffic accidents. Occupants and road users are both at risk of injuries.
Boyle, Eleanor; Cassidy, J David; Côté, Pierre; Carroll, Linda J
The purpose of this study was to determine if time to claim closure was similar to time to self-reported recovery in a no fault motor vehicle collision insurance system. A prospective cohort of traffic injured adults with a whiplash-associated disorder (WAD) was assembled. We excluded participants who applied for benefits after 42 days of the collision, who were in hospital for more than two days and participants who were not followed up at least once after their injury. Questionnaires were completed at baseline, six weeks, three-, six-, nine- and 12-months after the collision. The mean age of the cohort was 39 years and 66% were female. The mean number of days until claim closure and for self-reported recovery was 291days and 134 days, respectively. We found those who had their claim closed at each follow-up period had lower levels of disability and were more likely to report they were recovered than participants with open claims. We conclude that time to claim closure could be used as an outcome measure in traffic collision; however, this measure should be used with caution since it over-estimates the true time to recovery. Implications for Rehabilitation Time to claim closure as an outcome measure for whiplash-associated disorders has been criticized in the literature because it is thought that closure is not reflective of the health status of the individual. We found that claim closure was associated with lower levels of disability, but the time to claim closure was significantly longer than the time to self-reported recovery. Time to claim closure may be used with caution as a "proxy" measure of recovery from an injury; however, it must be noted that it over-estimates the true time of recovery.
Full Text Available Child pedestrian road traffic injuries (RTIs are an important cause of death and disability in poorer nations, however RTI prevention strategies in those countries largely draw upon studies conducted in wealthier countries. This research investigated personal and environmental risk factors for child pedestrian RTIs relevant to an urban, developing world setting.This is a case control study of personal and environmental risk factors for child pedestrian RTIs in San Juan de Miraflores, Lima, Perú. The analysis of personal risk factors included 100 cases of serious pedestrian RTIs and 200 age and gender matched controls. Demographic, socioeconomic, and injury data were collected. The environmental risk factor study evaluated vehicle and pedestrian movement and infrastructure at the sites in which 40 of the above case RTIs occurred and 80 control sites.After adjustment, factors associated with increased risk of child pedestrian RTIs included high vehicle volume (OR 7.88, 95%CI 1.97-31.52, absent lane demarcations (OR 6.59, 95% CI 1.65-26.26, high vehicle speed (OR 5.35, 95%CI 1.55-18.54, high street vendor density (OR 1.25, 95%CI 1.01-1.55, and more children living in the home (OR 1.25, 95%CI 1.00-1.56. Protective factors included more hours/day spent in school (OR 0.52, 95%CI 0.33-0.82 and years of family residence in the same home (OR 0.97, 95%CI 0.95-0.99.Reducing traffic volumes and speeds, limiting the number of street vendors on a given stretch of road, and improving lane demarcation should be evaluated as components of child pedestrian RTI interventions in poorer countries.
Chen, Chen; Anderson, Jason C; Wang, Haizhong; Wang, Yinhai; Vogt, Rachel; Hernandez, Salvador
Transportation agencies need efficient methods to determine how to reduce bicycle accidents while promoting cycling activities and prioritizing safety improvement investments. Many studies have used standalone methods, such as level of traffic stress (LTS) and bicycle level of service (BLOS), to better understand bicycle mode share and network connectivity for a region. However, in most cases, other studies rely on crash severity models to explain what variables contribute to the severity of bicycle related crashes. This research uniquely correlates bicycle LTS with reported bicycle crash locations for four cities in New Hampshire through geospatial mapping. LTS measurements and crash locations are compared visually using a GIS framework. Next, a bicycle injury severity model, that incorporates LTS measurements, is created through a mixed logit modeling framework. Results of the visual analysis show some geospatial correlation between higher LTS roads and "Injury" type bicycle crashes. It was determined, statistically, that LTS has an effect on the severity level of bicycle crashes and high LTS can have varying effects on severity outcome. However, it is recommended that further analyses be conducted to better understand the statistical significance and effect of LTS on injury severity. As such, this research will validate the use of LTS as a proxy for safety risk regardless of the recorded bicycle crash history. This research will help identify the clustering patterns of bicycle crashes on high-risk corridors and, therefore, assist with bicycle route planning and policy making. This paper also suggests low-cost countermeasures or treatments that can be implemented to address high-risk areas. Specifically, with the goal of providing safer routes for cyclists, such countermeasures or treatments have the potential to substantially reduce the number of fatalities and severe injuries. Published by Elsevier Ltd.
Wang, Cheng; Zhao, Ran; Du, Wei-Li; Ning, Fang-Gang; Zhang, Guo-An
In China, fireworks are an integral part of the celebration of the annual Spring Festival, but the number of injuries associated with their private use seen in emergency rooms increases dramatically. To raise awareness and help guide future prevention practices in this city, we investigated the epidemiology of firework-related injuries presented at our trauma and burn center in Beijing during the Spring Festivals of 2007-2011. Patients were interviewed using a pre-coded questionnaire to elicit information regarding age, gender, causes, injured body part, type of injury, diagnosis, and disposition. From 2007 to 2011, during the Spring Festivals 734 patients with fire-work related injuries were seen at our trauma and burn center in Beijing, the median patients of the five year were 140(136-150). The mean age of the patients was 26±15.3 years (range, 1-95 years). Of the 734 patients, the highest proportion of injuries were the 5-14 year-old age group The majority of the patients were male (87.9%), the overall male:female ratio was 7.41:1, and males were predominant in all age groups. For all 5 years, the incidence of firework-related injuries during the Spring Festival Holidays peaked specifically on the first, fifth, and last days, respectively. Injuries were mainly due to improper handling (415/610, 68.0%) or setting off illegal fireworks (195/610, 32.0%). The most frequently injured body parts were the hands and fingers (32.0%), head or face except eyes (28.3%), and trunk (22.4%). Burns were the most common type of injury (65.7%), most of the burned patients (437/453) were between 1% and 10%, and the most common region burned were hands and fingers (218/754). Contusions or lacerations were the second common type of injury (34.3%). Most of the patients (642, 87.5%) were treated and released, while 37 (5%) were treated and transferred, and 55 (7.5%) were admitted for advanced treatment. The private use of fireworks during the Spring Festival Holidays is associated
Leth, Peter Mygind; Struckmann, Henrik; Lauritsen, Jens
The present study investigated the interobserver variation between a radiologist and a forensic pathologist in 994 injury diagnoses obtained by postmortem computed tomography (CT) of 67 traffic fatality victims, and the results were compared with diagnoses obtained by autopsy. The injuries were...... system, but the pathologist diagnosed more organ injuries. We recommend the use of a radiologist as a consultant for the evaluation of postmortem CT images. Training in radiology should be included in forensic medicine postgraduate training. CT was superior to autopsy in detecting abnormal air...
Ball, Jill E; Ball, Chad G; Mulloy, Robert H; Datta, Indraneel; Kirkpatrick, Andrew W
Horseback riding is considered more dangerous than motorcycle riding, skiing, automobile racing, football and rugby. The integral role of rehabilitation therapy in the recovery of patients who have sustained a major horse-related injury is previously not described. The goals of this paper were to (1) define the incidence and pattern of severe equestrian trauma, (2) identify the current level of in-patient rehabilitation services, (3) describe functional outcomes for patients, and (4) discuss methods for increasing rehabilitation therapy in this unique population. A retrospective review of the trauma registry at a level 1 center (1995-2005) was completed in conjunction with a patient survey outlining formal in-hospital therapy. Forty-nine percent of patients underwent in-patient rehabilitation therapy. Injuries predictive of receiving therapy included musculoskeletal and spinal cord trauma. Previous injury while horseback riding was predictive of not receiving therapy. The majority (55%) of respondents had chronic physical difficulties following their accident. Rehabilitation therapy is significantly underutilized following severe equestrian trauma. Increased therapy services should target patients with brain, neck and skull injuries. Improvements in the initial provision, and follow-up of rehabilitation therapy could enhance functional outcomes in the treatment resistant Western equestrian population.
Mujalli, Randa Oqab; López, Griselda; Garach, Laura
Traffic accidents data sets are usually imbalanced, where the number of instances classified under the killed or severe injuries class (minority) is much lower than those classified under the slight injuries class (majority). This, however, supposes a challenging problem for classification algorithms and may cause obtaining a model that well cover the slight injuries instances whereas the killed or severe injuries instances are misclassified frequently. Based on traffic accidents data collected on urban and suburban roads in Jordan for three years (2009-2011); three different data balancing techniques were used: under-sampling which removes some instances of the majority class, oversampling which creates new instances of the minority class and a mix technique that combines both. In addition, different Bayes classifiers were compared for the different imbalanced and balanced data sets: Averaged One-Dependence Estimators, Weightily Average One-Dependence Estimators, and Bayesian networks in order to identify factors that affect the severity of an accident. The results indicated that using the balanced data sets, especially those created using oversampling techniques, with Bayesian networks improved classifying a traffic accident according to its severity and reduced the misclassification of killed and severe injuries instances. On the other hand, the following variables were found to contribute to the occurrence of a killed causality or a severe injury in a traffic accident: number of vehicles involved, accident pattern, number of directions, accident type, lighting, surface condition, and speed limit. This work, to the knowledge of the authors, is the first that aims at analyzing historical data records for traffic accidents occurring in Jordan and the first to apply balancing techniques to analyze injury severity of traffic accidents. Copyright © 2015 Elsevier Ltd. All rights reserved.
Amos O. Adeleye
Full Text Available ObjectivesAfrica and other Asian low middle-income countries account for the greatest burden of the global road-traffic injury (RTI-related head injury (HI. This study set out to describe the incidence, causation, and severity of RTI-related HI and associated injuries in a Nigerian academic neurosurgical practice.MethodsThis is a retrospective cross-sectional analysis of RTI-related HI from a prospective HI registry in an academic neurosurgery practice in Nigeria.ResultsAll-terrain RTI accounted for 80.6% (833/1,034 of HI over a 7-year study period. All age groups were involved, mean 33.06 years (SD 18.30, mode 21–30, 231/833 (27.7%. The male:female ratio was 631:202, ≈3:1. The road trauma occurred exclusively from motorcycle-and motor-vehicle crash (MCC/MVC, MCC caused 56.8% (473/833 of these; the victims were vulnerable road users (VRU in 74%, and >90% belong in the low socioeconomic class. Using the Glasgow Coma Scale grading, the HI was moderate/severe in 52%; loss of consciousness occurred in 93%, the Abbreviated Injury Severity-head > 3 in 74%, and computed tomography (CT Rotterdam score > 3 in 52%. Significant extracranial injuries occurred in many organ systems, 421/833 (50.5% having Injury Severity Score (ISS > 25. Surgical lesions included extensive brain contusions in 157 (18.8%; acute extradural hematoma in 34 (4.1%; acute subdural hematoma in 32 (3.8%; and traumatic intracerebral hemorrhage in 27 (3.2%, but only 97 (11.6% received operative care for various logistic reasons. The in-hospital outcome was good in 71.3% and poor in 28.7%; the statistically significant (p < 0.001 determinants of this outcome profile were the severity of the HI, the CT Rotterdam score, and the ISS.ConclusionIn this study from Nigeria, RTI-related HI emanates from significant trauma to vulnerable road users and are caused exclusively by motorcycles and motor vehicles.
Ball, Jill E; Ball, Chad G; Mulloy, Robert H; Datta, Indraneel; Kirkpatrick, Andrew W
Abstract Background Horseback riding is considered more dangerous than motorcycle riding, skiing, automobile racing, football and rugby. The integral role of rehabilitation therapy in the recovery of patients who have sustained a major horse-related injury is previously not described. The goals of this paper were to (1) define the incidence and pattern of severe equestrian trauma, (2) identify the current level of in-patient rehabilitation services, (3) describe functional outcomes for patien...
Wijesinghe, Printha; Gorrie, Catherine; Shankar, S K; Chickabasaviah, Yasha T; Amaratunga, Dhammika; Hulathduwa, Sanjayah; Kumara, K Sunil; Samarasinghe, Kamani; Suh, Yoo-Hun; Steinbusch, H W M; De Silva, K Ranil D
There is little information available in the literature concerning the contribution of dementia in injury deaths in elderly people (≥60 years). This study was intended to investigate the extent of dementia-related pathologies in the brains of elderly people who died in traffic accidents or by suicide and to compare our findings with age- and sex-matched natural deaths in an elderly population. Autopsy-derived human brain samples from nine injury death victims (5 suicide and 4 traffic accidents) and nine age- and sex-matched natural death victims were screened for neurodegenerative and cerebrovascular pathologies using histopathological and immunohistochemical techniques. For the analysis, Statistical Package for the Social Sciences (SPSS) version 16.0 was used. There was a greater likelihood for Alzheimer's disease (AD)-related changes in the elders who succumbed to traffic accidents (1 out of 4) compared to age- and sex-matched suicides (0 out of 5) or natural deaths (0 out of 9) as assessed by the National Institute on Aging - Alzheimer's Association guidelines. Actual burden of both neurofibrillary tangles (NFTs) and (SPs) was comparatively higher in the brains of traffic accidents, and the mean NFT counts were significantly higher in the region of entorhinal cortex ( P traffic accidents in elderly people whereas suicidal brain neuropathologies resembled natural deaths.
Martin, Aurélie; Lagarde, Emmanuel; Salmi, L Rachid
Delayed implementation of effective road safety policies must be considered when quantifying the avoidable part of the fatal and nonfatal injuries burden. We sought to assess the avoidable part of disability-adjusted life years (DALYs) lost due to road traffic injuries related to delays in implementing road safety laws in low- and lower-middle-income countries. We chose one country for each of the regions of the World Health Organization (WHO) and World Bank (WB) country income levels. We used freely available data sets (WHO, International Traffic Safety Data and Analysis Group, the WB). Delays in implementation were calculated until 2013, from the year mandatory use of safety belts by motor vehicle front seat occupants was first introduced worldwide. We used life expectancy tables and age groups as social values in the DALY calculation model. From the estimated total burden, avoidable DALYs were calculated using estimates of the effectiveness of seat belt laws on fatal and nonfatal injuries combined, as extracted from published international reviews of evidence. From the reference year 1972, implementation delays varied from 27 years (Uzbekistan) to 41 years in Bolivia (no seat belt law as of 2013). During delays, total absolute numbers of DALYs lost due to road traffic injuries reached 8,462,099 in Nigeria, 7,203,570 in Morocco, 4,695,500 in Uzbekistan, 3,866,391 in Cambodia, 3,253,359 in Bolivia, and 3,128,721 in Sri Lanka. Using effectiveness estimates ranging from 3 to 20% reduction, the avoidable burden of road traffic injuries for car occupants was highest in Uzbekistan (avoidable part from 1.2 to 10.4%) and in Morocco (avoidable part from 1.5 to 12.3%). In countries where users of public transport and pedestrians were the most affected by the burden, the avoidable parts ranged from 0.5 to 4.4% (Nigeria) and from 0.5 to 3.4% (Bolivia). Burden of road traffic injuries mostly affected motorcyclists in Sri Lanka and Cambodia where the avoidable parts were
Highway construction is among the most dangerous industries in the US. Internal traffic control design, along with how construction : equipment and vehicles interact with the traveling public, have a significant effect on how safe a highway construct...
Smoot Dustin L
Full Text Available Abstract Background Our American College of Surgeons Level 1 Trauma Center serves a rural population. As a result, there is a unique set of accidents that are not present in an urban environment such as deer related motor vehicle crashes (dMVC. We characterized injury patterns between motorcycle/all-terrain vehicles (MCC and automobile (MVC crashes related to dMVC (deer motor vehicle crash with the hypotheses that MCC will present with higher Injury Severity Score (ISS and that it would be related to whether the driver struck the deer or swerved. Methods The records of 157 consecutive patients evaluated at our institution for injury related to dMVC from January 1st, 1997 to December 31st, 2006 were reviewed from our prospectively collected trauma database. Demographic, clinical, and crash specific parameters were abstracted. Injury severity was analyzed by the Abbreviated Injury Scale score for each body region as well as the overall Injury Severity Score (ISS. Results Motorcycle crashes presented with a higher median ISS than MVCs (14 vs 5, p Within the MVC group, there was no difference between swerving and hitting the deer in any AIS group. Forty-seven percent of drivers were not wearing seat belts which resulted in similar median ISS (6 vs 5 and AIS of all body regions. Conclusions Motorcycle operators suffered higher ISS. There were no significant differences in median ISS if a driver involved in a deer-related motor vehicle crash swerved rather than collided, was helmeted, or restrained.
Poswayo, Ayikai; Kalolo, Simon; Rabonovitz, Katheryn; Witte, Jeffrey; Guerrero, Alejandro
To determine the impact of a paediatric road traffic injury (RTI) prevention programme in urban Sub-Saharan Africa. Dares Salaam, Republic of Tanzania. Household surveys were conducted in catchment areas around 18 primary schools in Dar es Salaam, Republic of Tanzania; the catchment areas were divided into control and intervention groups. Collected data included basic demographic information on all school-aged household members and whether or not they had been involved in an RTI in the previous 12 months, and, if so, what the characteristics of that RTI were. Based on these findings, a separate road safety engineering site analysis and consultation with the communities and other stakeholders, an injury-prevention programme was developed and implemented, consisting of infrastructure enhancements and a site-specific educational programme. The programme was initially implemented at the intervention schools. After 1 year, data were collected in the same manner. The control group received the same intervention after follow-up data were collected. Data were collected on 12 957 school-aged children in the baseline period and 13 555 school-aged children in the post-intervention period, in both the control and intervention communities. There was a statistically significant reduction in RTIs in the intervention group and a non-significant increase in RTI in the control group. The greatest reduction was in motorcycle-pedestrian RTI, private vehicle-pedestrian RTI and morning RTI. The programme demonstrated a significant reduction in paediatric RTI after its implementation, in very specific ways. This study demonstrates that for a reasonable investment, scientifically driven injury-prevention programmes are feasible in resource-limited settings with high paediatric RTI rates. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.
Linh Cu Le
Full Text Available Background: Based on previous data, road traffic injury (RTI was a leading cause of non-fatal injury in all-age groups in Vietnam, and among the top causes of injury in children and adolescents. Specific analysis on RTIs in young people, however, has yet to be fully investigated. Using the results of two surveys in 2004 and 2009, the present study aims to describe the current situation of non-fatal, unintentional RTIs among Vietnamese youths. In addition, it explores RTI-related risk and protective factors. Methods: This study utilized the nationally representative Survey Assessment of Vietnamese Youth 2009 (SAVY2 of 10,044 youths aged 14 to 25 from all 63 provinces in Vietnam. The indicators were compared with data from SAVY1 in 2004 of 7,584 youths. Bivariate and multivariable statistical techniques were applied. Results: Overall, 75% of youths used a motorcycle in SAVY2 compared with 54.2% in SAVY1. Of the SAVY2 sample, the proportion that had experienced an RTI was 10.6% vs. 14.1% in SAVY1. While the proportion of RTIs for both sexes decreased, the decline was greater for males (11.9% vs. 17.8% in SAVY1 than in females (9.2% vs. 10.4%. The proportion of rural youths aged 22–25 who experienced an RTI increased slightly in the 5 years between the two study intervals. The percentage of youths reporting frequent helmet use increased significantly from 26.2% in SAVY1 to 73.6% in SAVY2. Factors related to the likelihood of ever having experienced an RTI included: older age, male, ever being drunk, and ever riding motorcycles after drinking. Conclusion: While improvements in RTIs appear to have occurred between 2004 and 2009, more attention should be paid, particularly, in maintenance and supervision of law enforcement to helmet use and drunk driving.
Rautji, R; Girdhar, S; Lalwani, S; Dogra, T D
A 17-year old, thin-built male was sitting in a bus on the right side of the rear seat. The same side of the bus accidentally hit some iron rods, meant for construction work, projecting from the tail end of a small truck. The incident happened when the bus driver tried to manoeuvre the bus towards the left side of the truck, standing at a red traffic light intersection. One of the iron-rods entered the bus through the glass window next to which the victim had been sitting and penetrated his chest cavity from the side, lacerating both the lungs and exiting through the left shoulder blade. The individual died on his way to hospital.
Full Text Available Abstract Background The aim of the present study is to describe the inter-province variability of Road Traffic Injury (RTI mortality on Spanish roads, adjusted for vehicle-kilometres travelled, and to assess the possible role played by the following explicative variables: sociodemographic, structural, climatic and risk conducts. Methods An ecological study design was employed. The mean annual rate of RTI deaths was calculated for the period 2002–2004, adjusted for vehicle-kilometres travelled, in the 50 provinces of Spain. The RTI death rate was related with the independent variables described above, using simple and multiple linear regression analysis with backward step-wise elimination. The level of statistical significance was taken as p Results In the period 2002–2004 there were 12,756 RTI deaths in Spain (an average of 4,242 per year, SD = 356.6. The mean number of deaths due to RTI per 100 million vehicle-kilometres (mvk travelled was 1.76 (SD = 0.51, with a minimum value of 0.66 (in Santa Cruz de Tenerife and a maximum of 3.31 (in the province of Lugo. All other variables being equal, a higher proportion of kilometres available on high capacity roads, and a higher cultural and education level were associated with lower death rates due to RTI, while the opposite was true for the rate of alcohol consumers and the road traffic volume of heavy vehicles. The variables included in the model accounted for 55.4% of the variability in RTI mortality. Conclusion Adjusting RTI mortality rates for the number of vehicle-kilometres travelled enables us to identify the high variability of this cause of death, and its relation with risk factors other than those inherent to human behaviour, such as the type of roads and the type of vehicles using them.
Suriá Martínez, Raquel
Analizar la capacidad de empoderamiento de un grupo de personas con lesión medular en función de la edad, el sexo, la condición funcional y la edaden la cual adquirieron la lesión. Ninety-four participants with a spinal cord injury (42 tetraplegics and 52 paraplegics) completed the Spanish version of the Rogers, Chamberlin, Ellison and Crean Scale (1997), designed to measure empowerment. The analyses indicated higher levels of empowerment among women. Persons with tetraplegia whose injury was more longstanding also showed greater empowerment. This study suggests that the capacity to become empowered can vary and evolve and should therefore be promoted in intervention programs. Copyright © 2014 SESPAS. Published by Elsevier Espana. All rights reserved.
Liu, S; Wang, C; Fu, Y X
Objective: To know the drug resistance of Acinetobacter baumannii (AB) in wound of children with traffic injury and its relationship with antibiotic use. Methods: Wound exudate of 226 children with traffic injury admitted to our unit from January 2010 to December 2015 were collected. API bacteria identification panels and fully automatic microbiological identification system were used to identify pathogens. Kirby-Bauer paper disk diffusion method was used to detect the drug resistance of pathogens to 18 antibiotics including amoxycillin/clavulanic acid, piperacillin/tazobactam, and imipenem. The detection situation of pathogen of children's wounds and drug resistance of detected AB to 18 antibiotics in each year were collected. Forty-six AB positive children (2 children excluded) were divided into imipenem-resistant group (IR, n =19) and non imipenem-resistant group (NIR, n =25) according to whether AB was 100% resistant to imipenem. Drug resistance of AB in wounds of children to 18 antibiotics in two groups was compared. The antibiotic use of AB positive children was collected, and the antibiotic use intensity of children in two groups was compared. Data were processed with Fisher's exact test, independent sample t test, and corrected t test. Results: (1) The detection rates of pathogen in wounds of children in 2010-2015 were 95.6% (43/45), 89.8% (53/59), 81.3% (148/182), 81.1% (107/132), 81.6% (120/147), and 77.5% (62/80), respectively, showing a trend of decreasing year by year. A total of 665 strains and 75 pathogens were detected, and the top 5 pathogens with detection rate from high to low were AB, Pseudomonas aeruginosa, Enterobacter cloacae, Staphylococcus epidermidis, and Escherichia coli, respectively. (2) Drug resistance rates of AB to amoxycillin/clavulanic acid, cefazolin, aztreonam, and piperacillin were all 100%, while AB was 100% sensitive to polymyxin, and the total drug resistance rates of AB to the other 13 antibiotics were all above 50%. The
Clèries, Montse; Bosch, Anna; Vela, Emili; Bustins, Montse
To verify the usefulness of the minimum data set (MDS) for acute-care hospitals and emergency resources for the study of road traffic injuries and to describe the use of health resources in Catalonia (Spain). The study population consisted of patients treated in any kind of emergency service and patients admitted for acute hospitalization in Catalonia in 2013. A descriptive analysis was performed by age, gender, time and clinical variables. A total of 48,150 patients were treated in hospital emergency departments, 6,210 were attended in primary care, and 4,912 were admitted to hospital. There was a higher proportion of men (56.2%), mainly aged between 20 and 40 years. Men accounted for 54.9% of patients with minor injuries and 75.1% of those with severe injuries. Contusions are the most common injury (30.2%), followed by sprains (28.7%). Fractures mostly affected persons older than 64 years, internal injuries particularly affected men older than 64 years, and wounds mainly affected persons younger than 18 years and older than 64 years. In the adult population, the severity of the injuries increased with age, leading to longer length of stay and greater complexity. Hospital mortality was 0.2%. Fractures, internal injuries and wounds were more frequent in the group of very serious injuries, and sprains and contusions in the group of minor injuries. MDS records (acute hospitals and emergency resources) provide information that is complementary to other sources of information on traffic accidents, increasing the completeness of the data. Copyright © 2014 SESPAS. Published by Elsevier Espana. All rights reserved.
Budnick, Hailey C; Tyroch, Alan H; Milan, Stacey A
Functional outcomes after traumatic brain injury (TBI) can be significantly improved by discharge to posthospitalization care facilities. Many variables influence the discharge disposition of the TBI patient, including insurance status, patient condition, and patient prognosis. The literature has demonstrated an ethnic disparity in posthospitalization care referral, with Hispanics being discharged to rehabilitation and nursing facilities less often than non-Hispanics. However, this relationship has not been studied in a Hispanic-majority population, and thus, this study seeks to determine if differences in neurorehabilitation referrals exist among ethnic groups in a predominately Hispanic region. This study is a retrospective cohort that includes 1128 TBI patients who presented to University Medical Center El Paso, Texas, between the years 2005 and 2015. The patients' age, sex, race, residence, admission Glasgow Coma Scale (GCS), GCS motor, Injury Severity Score (ISS), hospital and intensive care unit length of stay (LOS), mechanism of injury, and discharge disposition were analyzed in univariate and multivariate models. Our study population had an insurance rate of 55.5%. Insurance status and markers of injury severity (hospital LOS, intensive care unit LOS, ISS, GCS, and GCS motor) were predictive of discharge disposition to rehabilitation facilities. The study population was 70% Hispanic, yet Hispanics were discharged to rehabilitation facilities (relative risk: 0.56, P: 0.001) and to long-term acute care/nursing facilities (relative risk: 0.35, P < 0.0001) less than non-Hispanics even after LOS, ISS, ethnicity, insurance status, and residence were adjusted for in multivariate analysis. This study suggests that patients of different ethnicities but comparable traumatic severity and insurance status receive different discharge dispositions post-TBI even in regions in which Hispanics are the demographic majority. Copyright © 2017 Elsevier Inc. All rights
Fernandez, G.; Kadir, S.; Encarnacion, C.
To assess the true incidence of major vessel injury, the authors retrospectively reviewed all arch aortograms obtained for blunt chest trauma (BCT) during a 24-month period beginning December 1986. Aortograms were correlated with preangiographic chest radiographic and operative findings. The goals of this review were to examine the usefulness of commonly employed screening criteria for aortography and determine whether thoracic spine fractures imply a decreased likelihood of aortic injury. One hundred twenty aortograms were obtained during this period. The incidence of aortic laceration was 6.7%, and 7.5% had brachiocerebral vascular injury. Only 51% of chest radiographs were suggestive of vascular injury. Two patients with subtle radiographic findings had aortic laceration. One patient with a burst fracture of T-4 had aortic laceration. The results of this review indicate the incidence of great vessel injury is as high as that of injury to the aorta itself and that the presence of spine fractures does not exclude vascular injury
Al Turki, Yousef Abdullah
Motor vehicle accidents are the leading cause of death in adolescents and young adults worldwide. Nearly three-quarters of road deaths occur in developing countries and men comprise a mean 80% of casualties. The rate of road traffic accidents caused by four-wheeled vehicles is the highest globally reported road traffic accidents statistic. In Saudi Arabia, the motor vehicle is the main means of transportation with one person killed and four injured every hour. Over 65% of accidents occur because of vehicles travelling at excess speed and/or drivers disobeying traffic signals. Road traffic injuries cause considerable economic losses to victims, their families, and to nations as a whole. Strategic prevention plans should be implemented soon by various sectors (health, police, transport, and education) to decrease the mortality and morbidity among adolescent and young age group. Strong and effective coordination between ministry of health and other ministries together with World Health Organization and other related organisations will be an important step towards implementing the international Decade of Action for Road Safety (2011-2020). The aim of this review article is to highlight some aspects of the health impacts of road traffic accidents.
Keller, Robert A; Marshall, Nathan E; Guest, John-Michael; Okoroha, Kelechi R; Jung, Edward K; Moutzouros, Vasilios
The number of Major League Baseball (MLB) pitchers requiring ulnar collateral ligament (UCL) reconstructions is increasing. Recent literature has attempted to correlate specific stresses placed on the throwing arm to risk for UCL injury, with limited results. Eighty-three MLB pitchers who underwent primary UCL reconstruction were evaluated. Pitching velocity and percent of pitch type thrown (fastball, curve ball, slider, and change-up) were evaluated 2 years before and after surgery. Data were compared with control pitchers matched for age, position, size, innings pitched, and experience. The evaluation of pitch velocity compared with matched controls found no differences in pre-UCL reconstruction pitch velocities for fastballs (91.5 vs. 91.2 miles per hour [mph], P = .69), curveballs (78.2 vs. 77.9 mph, P = .92), sliders (83.3 vs. 83.5 mph, P = .88), or change-ups (83.9 vs. 83.8 mph, P = .96). When the percentage of pitches thrown was evaluated, UCL reconstructed pitchers pitch significantly more fastballs than controls (46.7% vs. 39.4%, P = .035). This correlated to a 2% increase in risk for UCL injury for every 1% increase in fastballs thrown. Pitching more than 48% fastballs was a significant predictor of UCL injury, because pitchers over this threshold required reconstruction (P = .006). MLB pitchers requiring UCL reconstruction do not pitch at higher velocities than matched controls, and pitch velocity does not appear to be a risk factor for UCL reconstruction. However, MLB pitchers who pitch a high percentage of fastballs may be at increased risk for UCL injury because pitching a higher percent of fastballs appears to be a risk factor for UCL reconstruction. Copyright © 2016 Journal of Shoulder and Elbow Surgery Board of Trustees. Published by Elsevier Inc. All rights reserved.
Full Text Available Mohamad Farouk Mohamad,1 Montaser A Mohammad,1 Diab F Hetta,1 Eman Hasan Ahmed,2 Ahmed A Obiedallah,3 Alaa Ali M Elzohry1 1Department of Anesthesia, ICU and Pain Relief, 2Department of Clinical Pathology, South Egypt Cancer Institute, 3Department of Internal Medicine, Faculty of Medicine, Assiut University, Arab Republic of Egypt Background and objectives: Major abdominal cancer surgeries are associated with significant perioperative mortality and morbidity due to myocardial ischemia and infarction. This study examined the effect of perioperative patient controlled epidural analgesia (PCEA on occurrence of ischemic cardiac injury in ischemic patients undergoing major abdominal cancer surgery.Patients and methods: One hundred and twenty patients (American Society of Anesthesiologists grade II and III of either sex were scheduled for elective upper gastrointestinal cancer surgeries. Patients were allocated randomly into two groups (60 patients each to receive, besides general anesthesia: continuous intra and postoperative intravenous (IV infusion with fentanyl for 72 h postoperatively (patient controlled intravenous analgesia [PCIA] group or continuous intra and postoperative epidural infusion with bupivacaine 0.125% and fentanyl (PCEA group for 72 h postoperatively. Perioperative hemodynamics were recorded. Postoperative pain was assessed over 72 h using visual analog scale (VAS. All patients were screened for occurrence of myocardial injury (MI by electrocardiography, echocardiography, and cardiac troponin I serum level. Other postoperative complications as arrhythmia, deep venous thrombosis (DVT, pulmonary embolism, pneumonia, and death were recorded.Results: There was a significant reduction in overall adverse cardiac events (myocardial injury, arrhythmias, angina, heart failure and nonfatal cardiac arrest in PCEA group in comparison to PCIA group. Also, there was a significant reduction in dynamic VAS pain score in group PCEA in comparison
Richens, D; Kotidis, K; Neale, M; Oakley, C; Fails, A
The true incidence and survivability of blunt traumatic aortic rupture following road traffic accidents in the UK is unclear. The objective of this study was to determine the extent of blunt traumatic aortic rupture in the UK after road traffic accidents and the conditions under which it occurs. Data for the study was obtained from the Co-operative Crash Injury Study database. Road traffic accidents that happened between 1992 and 1999 and included in the Co-operative Crash Injury Study database were retrospectively investigated. A total of 8285 vehicles carrying 14,435 occupants were involved in 7067 accidents. There were 132 cases of blunt traumatic aortic rupture, of which the scene survival was 9% and the overall mortality was 98%. Twenty-one percent of all fatalities had blunt traumatic aortic rupture (130/613). Twenty-nine percent were due to frontal impacts and 44% were due to side impacts. Twelve percent of the blunt traumatic aortic rupture cases in frontal vehicle impacts were wearing seat belts and had airbag protection and 19% had no restraint mechanism. The Equivalent Test Speed of the accident vehicles, (where equivalent test speed provides an estimate of the vehicle impact severity and not an estimate of the vehicle speed at the time of the accident), ranged from 30 to 110 km/h in frontal impacts and from 15 to 82 km/h in side impacts. Blunt traumatic aortic rupture carries a high mortality and occurred in 21% of car occupant deaths in this sample of road traffic accidents. Impact scenarios varied but were most common from the side. The use of an airbag or seat belt does not eliminate risk. The injury can occur at low severity impacts particularly in side impact. Copyright 2002 Elsevier Science B.V.
Al-Aamri, Amira K; Padmadas, Sabu S; Zhang, Li-Chun; Al-Maniri, Abdullah A
Road traffic injuries (RTIs) are the leading cause of disability-adjusted life years lost in Oman, Saudi Arabia and United Arab Emirates. Injury prevention strategies often overlook the interaction of individual and behavioural risk factors in assessing the severity of RTI outcomes. We conducted a systematic investigation of the underlying interactive effects of age and gender on the severity of fatal and non-fatal RTI outcomes in the Sultanate of Oman. We used the Royal Oman Police national database of road traffic crashes for the period 2010-2014. Our study was based on 35 785 registered incidents: of these, 10.2% fatal injuries, 6.2% serious, 27.3% moderate, 37.3% mild injuries and 19% only vehicle damage but no human injuries. We applied a generalised ordered logit regression to estimate the effect of age and gender on RTI severity, controlling for risk behaviours, personal characteristics, vehicle, road, traffic, environment conditions and geographical location. The most dominant group at risk of all types of RTIs was young male drivers. The probability of severe incapacitating injuries was the highest for drivers aged 25-29 (26.6%) years, whereas the probability of fatal injuries was the highest for those aged 20-24 (26.9%) years. Analysis of three-way interactions of age, gender and causes of crash show that overspeeding was the primary cause of different types of RTIs. In particular, the probability of fatal injuries among male drivers attributed to overspeeding ranged from 3%-6% for those aged 35 years and above to 13.4% and 17.7% for those aged 25-29 years and 20-24 years, respectively. The high burden of severe and fatal RTIs in Oman was primarily attributed to overspeed driving behaviour of young male drivers in the 20-29 years age range. Our findings highlight the critical need for designing early gender-sensitive road safety interventions targeting young male and female drivers.
Mosquera, Victor X; Marini, Milagros; Muñiz, Javier; Asorey-Veiga, Vanesa; Adrio-Nazar, Belen; Boix, Ricardo; Lopez-Perez, José M; Pradas-Montilla, Gonzalo; Cuenca, José J
To develop a risk score based on physical examination and chest X-ray findings to rapidly identify major trauma patients at risk of acute traumatic aortic injury (ATAI). A multicenter retrospective study was conducted with 640 major trauma patients with associated blunt chest trauma classified into ATAI (aortic injury) and NATAI (no aortic injury) groups. The score data set included 76 consecutive ATAI and 304 NATAI patients from a single center, whereas the validation data set included 52 consecutive ATAI and 208 NATAI patients from three independent institutions. Bivariate analysis identified variables potentially influencing the presentation of aortic injury. Confirmed variables by logistic regression were assigned a score according to their corresponding beta coefficient which was rounded to the closest integer value (1-4). Predictors of aortic injury included widened mediastinum, hypotension less than 90 mmHg, long bone fracture, pulmonary contusion, left scapula fracture, hemothorax, and pelvic fracture. Area under receiver operating characteristic curve was 0.96. In the score data set, sensitivity was 93.42 %, specificity 85.85 %, Youden's index 0.79, positive likelihood ratio 6.60, and negative likelihood ratio 0.08. In the validation data set, sensitivity was 92.31 % and specificity 85.1 %. Given the relative infrequency of traumatic aortic injury, which often leads to missed or delayed diagnosis, application of our score has the potential to draw necessary clinical attention to the possibility of aortic injury, thus providing the chance of a prompt specific diagnostic and therapeutic management.
children were falls (60%), road traffic injuries (15%) and burns (7%). The most commonly ... The majority of patients were treated and discharged without disability (50.5%), while 7.4% had ... A standardised protocol was designed and ...
Koyama, Tomohide; Skattum, Jorunn; Engelsen, Peder; Eken, Torsten; Gaarder, Christine; Naess, Pål Aksel
Although nonoperative management (NOM) has become standard care, optimal treatment of liver injuries in children is still challenging since many of these patients have multiple injuries. Moreover, the role of angiography remains poorly defined, and a high index of suspicion of complications is warranted. This study reviews treatment and outcomes in children with liver injuries at a major Scandinavian trauma centre over a 12-year period. Patients trauma registry and medical records. A total of 66 children were included. The majority was severely injured as reflected by a median injury severity score of 20.5 (mean 22.2). NOM was attempted in 60 (90.9%) patients and was successful in 57, resulting in a NOM success rate of 95.0% [95% CI 89.3 to 100]. Only one of the three NOM failures was liver related, occurred in the early part of the study period, and consisted in operative placement of drains for bile leak. Two (3.0%) patients underwent angiographic embolization (AE). Complications occurred in 18 (27.3% [95 % CI 16.2 to 38.3]) patients. Only 2 (3.0%) patients had liver related complications, in both cases bile leak. Six (9.1%) patients underwent therapeutic laparotomy for non-liver related injuries. Two (3.0%) patients died secondary to traumatic brain injury. This single institution paediatric liver injury cohort confirms high attempted NOM and NOM success rates even in patients with high grade injuries and multiple accompanying injuries. AE can be a useful NOM adjunct in the treatment of paediatric liver injuries, but is seldom indicated. Moreover, bile leak is the most common liver-related complication and the need for liver-related surgery is very infrequent. NOM is the treatment of choice in almost all liver injuries in children, with operative management and interventional radiology very infrequently indicated.
Bonander, Carl; Andersson, Ragnar; Nilson, Finn
This study aimed to evaluate and quantify the effect of the introduction of the AM driving license on non-fatal moped-related injuries in Sweden. With the introduction of the new license category in October 2009, prospective moped drivers are now required to pass a mandatory theory test following a practical and theoretical course. In addition, obtaining a license to operate a moped is now considerably more costly. Time series intervention analysis on monthly aggregated injury data (1st Jan 2007-31st Dec 2013) was performed using generalized additive models for location, shape and scale (GAMLSS) to quantify the effect size on injury events involving teenage (15-17 years) moped drivers, while controlling for trend and seasonality. Exposure was adjusted for by using the number of registered mopeds in traffic as a proxy. The introduction of AM license was associated with a 41% reduction in the rate of injury events involving 15-year-old moped drivers (IRR 0.59 [95% CI: 0.48-0.72]), and a 39% and 36% decrease in those involving 16-year-old (IRR 0.61 [95% CI: 0.48-0.79]) and 17-year-old drivers (IRR 0.64 [95% CI: 0.46-0.90]), respectively. The effect in the 15-year-old stratum was decreased roughly by half after adjusting for exposure, but remained significant, and the corresponding estimates in the other age groups did not change noticeably. This study provides quasi-experimental evidence of an effect on non-fatal moped-related injuries as a result of stricter licensing rules. Only part of the effect could be explained by a reduction in the number of mopeds in traffic, indicating that other mechanisms must be studied to fully understand the cause of the reduction in injuries. Copyright © 2015 Elsevier Ltd. All rights reserved.
Jorge Martín Rodríguez
Full Text Available To analyze the behavior temporal of road-traffic injuries (RTI in Valledupar, Colombia from January 2008 to December 2012.An observational study was conducted based on records from the Colombian National Legal Medicine and Forensic Sciences Institute regional office in Valledupar. Different variables were analyzed, such as the injured person's sex, age, education level, and type of road user; the timeframe, place and circumstances of crashes and the vehicles associated with the occurrence. Furthermore, a time series analysis was conducted using an auto-regressive integrated moving average.There were 105 events per month on an average, 64.9% of RTI involved men; 82.3% of the persons injured were from 18 to 59 years of age; the average age was 35.4 years of age; the road users most involved in RTI were motorcyclists (69%, followed by pedestrians (12%. 70% had up to upper-secondary education. Sunday was the day with the most RTI occurrences; 93% of the RTI occurred in the urban area. The time series showed a seasonal pattern and a significant trend effect. The modeling process verified the existence of both memory and extrinsic variables related.An RTI occurrence pattern was identified, which showed an upward trend during the period analyzed. Motorcyclists were the main road users involved in RTI, which suggests the need to design and implement specific measures for that type of road user, from regulations for graduated licensing for young drivers to monitoring road user behavior for the promotion of road safety.
Druery, Martha; Newcombe, Peter A; Cameron, Cate M; Lipman, Jeffrey
The goal of burn care is that 'the quality of the outcome must be worth the pain of survival'. More research is needed to understand how best to deliver care for patients with burns to achieve this aim. Loss of independence, function as well as loss of income for patients with burns and carers cause a significant burden at both individual and societal levels. Much is being done to advance knowledge in the clinical care field; however, there has been a paucity of research exploring psychosocial outcomes. This paper describes the study background and methods, as implemented in an Australian cohort study of psychosocial outcomes after major burn injuries. In this inception cohort study, a target sample of 230 participants, aged 18 years or over, admitted to a single statewide burns centre with a burn injury are identified by hospital staff for inclusion. Baseline survey data are collected either in person or by telephone within 28 days of the injury and participants then followed up with telephone interviews at 3, 6 and 12 months postburn. Injury and burns treatment information is collected from medical records. Social support is measured as a predictor variable using the Multidimensional Scale of Perceived Social Support. Outcome data are collected via standardised measures in the domains of Quality of Life (SF-12, EQ-5D, BSHS-B), depression (PHQ-9), post-traumatic stress disorder (PCL-C, PAS), community integration (CIQ-R) and Quality-Adjusted Life Years (EQ-5D). Additional survey questions measure life satisfaction, return to work and public services utilisation at 12 months postinjury. Data analysis methods will include analysis of variance, Pearson correlation and hierarchical multiple regression analyses. Hospital-based and University of Queensland Human Research Ethics Committees have approved the protocol. Results from the study will be disseminated at national and international conferences, in peer-reviewed journals and in a doctoral thesis. Australia New
Huang, Helai; Li, Chunyang; Zeng, Qiang
This study sets out to investigate vehicles' crash protectiveness on occupant injury and vehicle damage, which can be deemed as an extension of the traditional crash worthiness. A Bayesian bivariate hierarchical ordered logistic (BVHOL) model is developed to estimate the occupant protectiveness (OP) and vehicle protectiveness (VP) of 23 major car brands in Florida, with considering vehicles' crash aggressivity and controlling external factors. The proposed model not only takes over the strength of the existing hierarchical ordered logistic (HOL) model, i.e. specifying the order characteristics of crash outcomes and cross-crash heterogeneities, but also accounts for the correlation between the two crash responses, driver injury and vehicle damage. A total of 7335 two-vehicle-crash records with 14,670 cars involved in Florida are used for the investigation. From the estimation results, it's found that most of the luxury cars such as Cadillac, Volvo and Lexus possess excellent OP and VP while some brands such as KIA and Saturn perform very badly in both aspects. The ranks of the estimated safety performance indices are even compared to the counterparts in Huang et al. study [Huang, H., Hu, S., Abdel-Aty, M., 2014. Indexing crash worthiness and crash aggressivity by major car brands. Safety Science 62, 339-347]. The results show that the rank of occupant protectiveness index (OPI) is relatively coherent with that of crash worthiness index, but the ranks of crash aggressivity index in both studies is more different from each other. Meanwhile, a great discrepancy between the OPI rank and that of vehicle protectiveness index is found. What's more, the results of control variables and hyper-parameters estimation as well as comparison to HOL models with separate or identical threshold errors, demonstrate the validity and advancement of the proposed model and the robustness of the estimated OP and VP. Copyright © 2015 Elsevier Ltd. All rights reserved.
Licaj, Idlir; Haddak, Mouloud; Pochet, Pascal; Chiron, Mireille
This study investigated the effect of the socioeconomic level of the municipality of residence on personal injury road traffic accident risk among young persons of 10-24 years of age in the Rhône Département. This effect was assessed by comparing incidences of injuries (n=2792 casualties) on the basis of three denominators: the resident population of young people, the number of users of each mode and the distances covered by each mode. The results are presented for each type of road users (pedestrians, car passengers, car drivers, motorised two-wheeler riders, cyclists, public transport users). Young persons from deprived municipalities use motorised-two wheelers, bicycles and the car (as passengers and drivers) less frequently, they walk more and take public transports more often than those from other municipalities. When considering injury risk, motorised two wheeler injuries among adolescent males, for example, are significantly less frequent in deprived municipalities. But the motorised two-wheeler riders as well as car passengers from deprived municipalities are characterized by an excess injury risk, whether the selected denominator is the number of users or the kilometres travelled by this mode. For the first time in France, this study has enabled a comparison of the effects of a contextual socioeconomic indicator (the type of municipality of residence, deprived, or not) on daily travel practices and injury incidences among the population, among the users of each mode and per km of travel. Copyright © 2011 Elsevier Ltd. All rights reserved.
Karakolis, Thomas; Bhan, Shivam; Crotin, Ryan L
In Major League Baseball (MLB), games pitched, total innings pitched, total pitches thrown, innings pitched per game, and pitches thrown per game are used to measure cumulative work. Often, pitchers are allocated limits, based on pitches thrown per game and total innings pitched in a season, in an attempt to prevent future injuries. To date, the efficacy in predicting injuries from these cumulative work metrics remains in question. It was hypothesized that the cumulative work metrics would be a significant predictor for future injury in MLB pitchers. Correlations between cumulative work for pitchers during 2002-07 and injury days in the following seasons were examined using regression analyses to test this hypothesis. Each metric was then "binned" into smaller cohorts to examine trends in the associated risk of injury for each cohort. During the study time period, 27% of pitchers were injured after a season in which they pitched. Although some interesting trends were noticed during the binning process, based on the regression analyses, it was found that no cumulative work metric was a significant predictor for future injury. It was concluded that management of a pitcher's playing schedule based on these cumulative work metrics alone could not be an effective means of preventing injury. These findings indicate that an integrated approach to injury prevention is required. This approach will likely involve advanced cumulative work metrics and biomechanical assessment.
Psoter, Kevin J., E-mail: firstname.lastname@example.org [Department of Epidemiology, University of Washington, Box 357236, Seattle, WA 98195 (United States); Roudsari, Bahman S., E-mail: email@example.com [Department of Radiology, Comparative Effectiveness, Cost and Outcomes Research Center, University of Washington, 325 Ninth Avenue, Box 359960, Seattle, WA 98104 (United States); Graves, Janessa M., E-mail: firstname.lastname@example.org [Department of Pediatrics, Harborview Injury Prevention and Research Center, University of Washington, 325 Ninth Avenue, Box 359960, Seattle, WA 98104 (United States); Mack, Christopher, E-mail: email@example.com [Harborview Injury Prevention and Research Center, University of Washington, 325 Ninth Avenue, Box 359960, Seattle, WA 98104 (United States); Jarvik, Jeffrey G., E-mail: firstname.lastname@example.org [Department of Radiology and Department of Neurological Surgery, Comparative Effectiveness, Cost and Outcomes Research Center, University of Washington, 325 Ninth Avenue, Box 359960, Seattle, WA 98104 (United States)
Objective: To evaluate the trend in utilization of repeat (i.e. ≥2) computed tomography (CT) and to compare utilization patterns across body regions for trauma patients admitted to a level I trauma center for traffic-related injuries (TRI). Materials and Methods: We linked the Harborview Medical Center trauma registry (1996–2010) to the billing department data. We extracted the following variables: type and frequency of CTs performed, age, gender, race/ethnicity, insurance status, injury mechanism and severity, length of hospitalization, intensive care unit (ICU) admission and final disposition. TRIs were defined as motor vehicle collisions, motorcycle, bicycle and pedestrian-related injuries. Logistic regression was used to evaluate the association between utilization of different body region repeat (i.e. ≥2) CTs and year of admission, adjusting for patient and injury-related characteristics that could influence utilization patterns. Results: A total of 28,431 patients were admitted for TRIs over the study period and 9499 (33%) received repeat CTs. From 1996 to 2010, the proportion of patients receiving repeat CTs decreased by 33%. Relative to 2000 and adjusting for other covariates, patients with TRIs admitted in 2010 had significantly lower odds of undergoing repeat head (OR = 0.61; 95% CI: 0.49–0.76), pelvis (OR = 0.37; 95% CI: 0.27–0.52), cervical spine (OR = 0.23; 95% CI: 0.12–0.43), and maxillofacial CTs (OR = 0.24; 95% CI: 0.10–0.57). However, they had higher odds of receiving repeat thoracic CTs (OR = 1.86; 95% CI: 1.02–3.38). Conclusion: A significant decrease in the utilization of repeat CTs was observed in trauma patients presenting with traffic-related injuries over a 15-year period.
Abstract: Head injury is considered as a major health problem that is a ... Road traffic accidents (RTAs) were the most common cause of injury accounting for .... Student t-test was used to test for significance of associations between the predictor and ..... Mwang'ombe, N.J. & Kiboi, J. (2001) Factors influencing the outcome of ...
Full Text Available To assess the ability of the urinary biomarkers IGFBP7 (insulin-like growth factor-binding protein 7 and TIMP-2 (tissue inhibitor of metalloproteinase 2 to early predict acute kidney injury (AKI in high-risk surgical patients.Postoperative AKI is associated with an increase in short and long-term mortality. Using IGFBP7 and TIMP-2 for early detection of cellular kidney injury, thus allowing the early initiation of renal protection measures, may represent a new concept of evaluating renal function.In this prospective study, urinary [TIMP-2]×[IGFBP7] was measured in surgical patients at high risk for AKI. A predefined cut-off value of [TIMP-2]×[IGFBP7] >0.3 was used for assessing diagnostic accuracy. Perioperative characteristics were evaluated, and ROC analyses as well as logistic regression models of risk assessment were calculated with and without a [TIMP-2]×[IGFBP7] test.107 patients were included in the study, of whom 45 (42% developed AKI. The highest median values of biomarker were detected in septic, transplant and patients after hepatic surgery (1.24 vs 0.45 vs 0.47 ng/l²/1000. The area under receiving operating characteristic curve (AUC for the risk of any AKI was 0.85, for early use of RRT 0.83 and for 28-day mortality 0.77. In a multivariable model with established perioperative risk factors, the [TIMP-2]×[IGFBP7] test was the strongest predictor of AKI and significantly improved the risk assessment (p<0.001.Urinary [TIMP-2]×[IGFBP7] test sufficiently detect patients with risk of AKI after major non-cardiac surgery. Due to its rapid responsiveness it extends the time frame for intervention to prevent development of AKI.
Background: Motorcycle accidents are very common and cause major injuries. The Abia State government banned commercial motorcyclists from operating in the major cities of the state in July, 2009. Objectives: To determine the influence of this ban on the cause and pattern of injuries due to road traffic accidents. Design: ...
Gazis, Denos C
... of traffic signal settings The vehicle-actuated traffic signal 87 89 77 CHAPTER 3. TRAFFIC CONTROL 101 Objectives of Traffic Control 103 Single, Isolated Intersection 105 Synchronization Scheme...
Full Text Available Purpose: In patients with major burn injuries mechanical ventilation is often required for longer periods. Tracheostomy (TS plays an integral role in airway management. We investigated the effect of TS on ventilation parameters within 8 hours after TS. Materials: A retrospective analysis of severely burned patients admitted to the burn unit of a German University Hospital was performed. Ventilation parameters 8 hours before and after TS were registered. Results: A retrospective analysis of 20 patients which received surgical TS was performed. Mean age was 52±19 years. Mean abbreviated burned severity index (ABSI was 8.3±2.2. A mechanical ventilation was required for 14.3±4.8 days. TS was performed on day 7±4. Inspiratory oxygen concentration (FiO2 (p<0.001, peak inspiratory pressure (p<0.001, positive end-expiratory pressure (p=0.003 and pulmonary resistance (p<0.001 were reduced significantly after TS. The arterial partial pressure of oxygen/FiO2-ratio increased significantly after TS (p<0.001. Conclusions: We demonstrate that TS reduces invasiveness of ventilation in severely burned patients and by this can optimize lung protective ventilation strategy.
潘曙明; 陈尔真; Shankuan Zhu; PeterLayde; Ronald Pirralo; Stephen Hargarten
Objective To provide a broad epidemiological view of road traffic injury and death in China to help in policy and infrastructure development.Methods We searched MEDLINE and the China Academic Journal Full-Text Database (CAJ), and reviewed the annual reports of road traffic injuries, road traffic violations, and motor vehicle drivers in China from the website of Municipal Public Security (MPS) of the People's Republic of China.Results Road crash fatalities had been increasing rapidly in China, risky driving behavior and slow increase in road construction compared with the rapid increase in the number of cars might be the main factors in increasing morbidity and mortality in motor vehicle crashes.Conclusion Road traffic safety is a complicated and serious problem in China. Particular attention must be paid to road traffic events and conditions in rural areas, the most vulnerable road users.Government would establish a sound surveillance system using consistent definitions and improve EMS systems throughout China.%目的通过分析中国道路交通损伤的流行病学现状,为相关交通政策的制定和改进提供依据.方法分析近年来中国公安部发布的道路交通损伤年报以及检索MEDLINE和CAJ上有关中国道路交通损伤研究的论文和论著.结果中国交通事故伤亡人数目前增长十分迅速,其中风险驾驶行为和道路交通建设的相对滞后是影响道路交通损伤的重要因素.结论道路交通损伤在中国是一个十分复杂而严重的问题,政府应该更多关注农村地区、行人的安全问题,建立全国统一的监控体系,加强EMS体系建设.
Conclusion: Scarf-related injuries constitute a sizable proportion of trauma, with varying degrees of severity. Devastating consequences in significant proportion of cases dictate the call for a prevention plan comprising both educational and legislative measures. Urgent preventive measures targeting scarf-related injuries will help reduce mortality and morbidity.
Gabbe, Belinda J; Simpson, Pamela M; Cameron, Peter A; Ekegren, Christina L; Edwards, Elton R; Page, Richard; Liew, Susan; Bucknill, Andrew; de Steiger, Richard
To establish the association between the patient's perception of fault for the crash and 12-month outcomes after non-fatal road traffic injury. Two adult major trauma centres, one regional trauma centre and one metropolitan trauma centre in Victoria, Australia. 2605 adult, orthopaedic trauma patients covered by the state's no-fault third party insurer for road traffic injury, injured between September 2010 and February 2014. EQ-5D-3L, return to work and functional recovery (Glasgow Outcome Scale-Extended score of upper good recovery) at 12 months postinjury. After adjusting for key confounders, the adjusted relative risk (ARR) of a functional recovery (0.57, 95% CI 0.46 to 0.69) and return to work (0.92, 95% CI 0.86 to 0.99) were lower for the not at fault compared to the at fault group. The ARR of reporting problems on EQ-5D items was 1.20-1.35 times higher in the not at fault group. Patients who were not at fault, or denied being at fault despite a police report of fault, experienced poorer outcomes than the at fault group. Attributing fault to others was associated with poorer outcomes. Interventions to improve coping, or to resolve negative feelings from the crash, could facilitate better outcomes in the future. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/
Quintana, Penelope J E; Khalighi, Mehdi; Castillo Quiñones, Javier Emmanuel; Patel, Zalak; Guerrero Garcia, Jesus; Martinez Vergara, Paulina; Bryden, Megan; Mantz, Antoinette
At US-Mexico border Ports of Entry, vehicles idle for long times waiting to cross northbound into the US. Long wait times at the border have mainly been studied as an economic issue, however, exposures to emissions from idling vehicles can also present an exposure risk. Here we present the first data on in-vehicle exposures to driver and passengers crossing the US-Mexico border at the San Ysidro, California Port of Entry (SYPOE). Participants were recruited who regularly commuted across the border in either direction and told to drive a scripted route between two border universities, one in the US and one in Mexico. Instruments were placed in participants' cars prior to commute to monitor-1-minute average levels of the traffic pollutants ultrafine particles (UFP), black carbon (BC) and carbon monoxide (CO) in the breathing zone of drivers and passengers. Location was determined by a GPS monitor. Results reported here are for 68 northbound participant trips. The highest median levels of in-vehicle UFP were recorded during the wait to cross at the SYPOE (median 29,692particles/cm 3 ) significantly higher than the portion of the commute in the US (median 20,508particles/cm 3 ) though not that portion in Mexico (median 22, 191particles/cm 3 ). In-vehicle BC levels at the border were significantly lower than in other parts of the commute. Our results indicate that waiting in line at the SYPOE contributes a median 62.5% (range 15.5%-86.0%) of a cross-border commuter's exposure to UFP and a median 44.5% (range (10.6-79.7%) of exposure to BC inside the vehicle while traveling in the northbound direction. Reducing border wait time can significantly reduce in-vehicle exposures to toxic air pollutants such as UFP and BC, and these preventable exposures can be considered an environmental justice issue. Copyright © 2017 Elsevier B.V. All rights reserved.
Abelha, F J; Botelho, M; Fernandes, V; Barros, H
In postoperative critically-ill patients who develop Acute Kidney Injury (AKI) it is important to focus on survival and quality of life beyond hospital discharge. The aim of the study was to evaluate outcome and quality of life in patients that develop AKI after major surgery. This retrospective study was carried out in a Post-Anaesthesia Care Unit with five intensive care beds during 2 years. Patients were followed for the development of AKI. Preoperative characteristics, intra-operative management and outcome were evaluated. Six months after discharge, these patients were contacted to complete a Short Form-36 questionnaire (SF-36) and to have their dependency in ADL evaluated. Chi-square or Fischer's exact test were used to compare proportions between groups. A "t test" and a paired "t test" for independent groups was used for comparisons. Of 1584 patients admitted to the PACU, 1200 patients met the inclusion criteria. One hundred-fourteen patients (9.6%) met AKI criteria. Patients with AKI were more severely ill, stayed longer at the PACU. Among 71 hospital survivors at 6 months follow-up, 50 completed the questionnaires. Fifty-two percent of patients reported that their general level of health was better on the day they answered the questionnaire than 12 months earlier. Patients that met AKI criteria after surgery had worse SF-36 scores for physical function, role physical and role emotional domains. Six months after PACU discharge, patients that met AKI criteria were more dependent in I-ADL but not in P-ADL. Patients that develop AKI improved self-perception of quality of life despite having high rate of dependency in ADL tasks. For physical function and role physical domains they had worse scores than PACU patients that did not develop AKI.
Hayley, Amie C; Downey, Luke A; Shiferaw, Brook; Stough, Con
Amphetamine-type substances are frequently detected among drivers injured or killed due to road-trauma. However, the role of this substance in crash causation remains equivocal. We performed a systematic review to evaluate existing evidence regarding the association between amphetamine use and the risk of injury or death due to road traffic accidents. A bibliographical search of PubMed, SafetyLit, Scopus, and Science Direct literature databases from 01 January 1980 until May 2015 was performed. The quality of included studies was assessed using the Newcastle-Ottowa Scale (NOS) (cut-off of ≥7 indicated high quality). Inter-rater reliability between three independent reviewers for the NOS was calculated using Cohens kappa (κ) statistic, and best-evidence synthesis was performed. A total of 182 articles were found. Nine studies met eligibility criteria for inclusion for review, and seven studies were included for best-evidence synthesis. Best-evidence synthesis demonstrated a conflicting level of evidence for associations between the use of-amphetamine-type substances and the risk of sustaining an injury, and a moderate level of evidence between amphetamine use and the risk of death due to road trauma. This is the first review to synthesise evidence regarding the association between amphetamine-type substance use and the risk of injury or death due to a road traffic accident. More conclusive evidence of death due to road trauma among amphetamine users may reflect significant and global deficits in functioning associated with effective vehicular control under the influence of this substance. Additional high quality, sufficiently powered studies are required to elucidate the magnitude of these associations. Copyright © 2016 Elsevier B.V. and ECNP. All rights reserved.
Byler, Christen; Kesy, Laura; Richardson, Scott; Pratt, Stephanie G; Rodríguez-Acosta, Rosa L
Motor vehicle traffic crashes (MVTCs) remain the leading cause of work-related fatal injuries in the United States, with crashes on public roadways accounting for 25% of all work-related deaths in 2012. In the United States, the Bureau of Labor Statistics (BLS) Census of Fatal Occupational Injuries (CFOI) provides accurate counts of fatal work injuries based on confirmation of work relationship from multiple sources, while the National Highway Traffic Safety Administration (NHTSA) Fatality Analysis Reporting System (FARS) provides detailed data on fatal MVTCs based on police reports. Characterization of fatal work-related MVTCs is currently limited by data sources that lack either data on potential risk factors (CFOI) or work-relatedness confirmation and employment characteristics (FARS). BLS and the National Institute for Occupational Safety and Health (NIOSH) collaborated to analyze a merged data file created by BLS using CFOI and FARS data. A matching algorithm was created to link 2010 data from CFOI and FARS using date of incident and other case characteristics, allowing for flexibility in variables to address coding discrepancies. Using the matching algorithm, 953 of the 1044 CFOI "Highway" cases (91%) for 2010 were successfully linked to FARS. Further analysis revealed systematic differences between cases identified as work-related by both systems and by CFOI alone. Among cases identified as work-related by CFOI alone, the fatally-injured worker was considerably more likely to have been employed outside the transportation and warehousing industry or transportation-related occupations, and to have been the occupant of a vehicle other than a heavy truck. This study is the first step of a collaboration between BLS, NHTSA, and NIOSH to improve the completeness and quality of data on fatal work-related MVTCs. It has demonstrated the feasibility and value of matching data on fatal work-related traffic crashes from CFOI and FARS. The results will lead to
Hassani-Mahmooei, Behrooz; Berecki-Gisolf, Janneke; Hahn, Youjin; McClure, Roderick J
Comorbidity is known to affect length of hospital stay and mortality after trauma but less is known about its impact on recovery beyond the immediate post-accident care period. The aim of this study was to investigate the role of pre-existing health conditions in the cost of recovery from road traffic injury using health service use records for 1 year before and after the injury. Individuals who claimed Transport Accident Commission (TAC) compensation for a non-catastrophic injury that occurred between 2010 and 2012 in Victoria, Australia and who provided consent for Pharmaceutical Benefits Scheme (PBS) and Medicare Benefits Schedule (MBS) linkage were included (n = 738) in the analysis. PBS and MBS records dating from 12 months prior to injury were provided by the Department of Human Services (Canberra, Australia). Pre-injury use of health service items and pharmaceuticals were considered to indicate pre-existing health condition. Bayesian Model Averaging techniques were used to identify the items that were most strongly correlated with recovery cost. Multivariate regression models were used to determine the impact of these items on the cost of injury recovery in terms of compensated ambulance, hospital, medical, and overall claim cost. Out of the 738 study participants, 688 used at least one medical item (total of 15,625 items) and 427 used at least one pharmaceutical item (total of 9846). The total health service cost of recovery was $10,115,714. The results show that while pre-existing conditions did not have any significant impact on the total cost of recovery, categorical costs were affected: e.g. on average, for every anaesthetic in the year before the accident, hospital cost of recovery increased by 24 % [95 % CI: 13, 36 %] and for each pathological test related to established diabetes, hospital cost increased by $10,407 [5466.78, 15346.28]. For medical costs, each anaesthetic led to $258 higher cost [174.16, 341.16] and every prescription of drugs
We conclude that in neonates and infants, relatively low temperatures may cause deep burn injuries. We therefore recommend the delivery of preterm childbirths at well equipped facilities with staff who are qualified to nurse premature neonates. [J Contemp Med 2011; 1(2.000: 85-88
The application of electronics in traffic risk control. Contribution to CEC / ECMT / COST International Seminar Electronics and traffic on major roads; Technical, reglementary and ergonomic aspects, Paris, 4-6 June 1985, Session 3: Assessment, Preprints, pp. 133-145
The introduction of electronic aids in traffic offers special opportunities for alleviating tasks of both public bodies and individual road users. However, the introduction is often problematical. In this context potential and existing applications are discussed in a functional classification,
Giannini, Margaret J; Bergmark, Brian; Kreshover, Samantha; Elias, Eileen; Plummer, Caitlin; O'Keefe, Eileen
Disability is not a category of disease but rather relates to the physical, sensory, cognitive, and/or mental disorders that substantially limit one or more major life activities. These functional limitations have been found to be predictive of suicide, with psychiatric comorbidities increasing the risk for suicide. Enormous gaps exist in the understanding of the relationship between disability and suicide. We reviewed the current literature addressing the prevalence of and risk factors for suicide among persons with three major disabling conditions and identify priorities for future research. We performed a literature review investigating the relationship between three major disabilities (intellectual disability, spinal cord injury, multiple sclerosis) and suicide. To ensure thorough evaluation of the available literature, we searched PubMed, the Cochrane Library, and Google Scholar with terms including "suicide," "disability," "intellectual disability," "spinal cord injury," "multiple sclerosis," and permutations thereof. By this method we evaluated 110 articles and included 21 in the review. Suicide rates are significantly higher among persons with multiple sclerosis and spinal cord injury than in the general population. A more nuanced picture of suicide rates and risk factors exists for the intellectual disability population, in which it appears that rates of suicide risk factors are higher than among the general population while suicide rates may be lower. The highest rates of suicide are reported among study populations of persons with multiple sclerosis, followed by persons with spinal cord injury, and then individuals with intellectual disability. Suicide among persons with disabilities is a complex and pressing public health concern. Urgent research priorities include (1) valid estimates of suicide rates among persons with disabilities by age cohort; (2) assessment of the predictive importance of suicide risk factors; and (3) determination of best
T. A. Vasina
Full Text Available Objective: to analyze the spectrum of major pathogens of infectious complications in patients with concomitant injury.Materials and methods. 560 biological samples taken from 331 patients were bacteriologically studied. A significant reduction in the isolation frequency of Pseudomonas aeruginosa and an increase in etiological role of Staphylococcus aureus were ascertained in victims with severe injury and concomitant infectious complications during long-term 1982—1984 and 2002—2004 follow-ups.Results. The significant pathogens of infectious complications in concomitant injuries are Staphylococcus aureus, Klebsiella and Escherichia coli. Vancomycin, imipenem/cilastatin, and amikacin are shown to be the most effective drugs for early antibiotic therapy. Thus, the findings reflect structural changes in the leading causative agents of infectious complications in victims with severe injury. If their principal pathogen was Pseudomonas aeruginosa in the 1990s, Staphylococcus aureus and representatives in the colibacillus group prevail today. This supports and generates a need for continuous microbiological monitoring of the causative agents of pyoin-flammatory complications in intensive care units wherein patients with immunosuppression are also present. Pathogen monitoring makes it possible to apply of a well-grounded and rational package of preventive and therapeutic measures and to perform early target antibiotic therapy.
Wang, Jie; Shen, Yuzhong; Khattak, Asad
Traffic accidents have tremendous impact on society. Annually approximately 6.4 million vehicle accidents are reported by police in the US and nearly half of them result in catastrophic injuries. Visualizations of traffic accidents using geographic information systems (GIS) greatly facilitate handling and analysis of traffic accidents in many aspects. Environmental Systems Research Institute (ESRI), Inc. is the world leader in GIS research and development. ArcGIS, a software package developed by ESRI, has the capabilities to display events associated with a road network, such as accident locations, and pavement quality. But when event locations related to a road network are processed, the existing algorithm used by ArcGIS does not utilize all the information related to the routes of the road network and produces erroneous visualization results of event locations. This software bug causes serious problems for applications in which accurate location information is critical for emergency responses, such as traffic accidents. This paper aims to address this problem and proposes an improved method that utilizes all relevant information of traffic accidents, namely, route number, direction, and mile post, and extracts correct event locations for accurate traffic accident visualization and analysis. The proposed method generates a new shape file for traffic accidents and displays them on top of the existing road network in ArcGIS. Visualization of traffic accidents along Hampton Roads Bridge Tunnel is included to demonstrate the effectiveness of the proposed method.
Boyle, Eleanor; Cassidy, J David; Côté, Pierre
PURPOSE: The purpose of this study was to determine if time to claim closure was similar to time to self-reported recovery in a no fault motor vehicle collision insurance system. METHOD: A prospective cohort of traffic injured adults with a whiplash-associated disorder (WAD) was assembled. We...... Time to claim closure as an outcome measure for whiplash-associated disorders has been criticized in the literature because it is thought that closure is not reflective of the health status of the individual. We found that claim closure was associated with lower levels of disability, but the time...
Cheng Min Huang
to rapid motorization and poor infrastructure, is a major global challenge. This editorial highlights a number of key issues that must inform programs designed to prevent RTI in the developing world, where the epidemic is all the more insidious. Firstly, road safety is a development issue; secondly, road traffic injury is a major health issue; thirdly, road traffic injuries can be prevented by the implementation of scientific measures; fourthly, pre-hospital and hospital emergency care is needed; and fifthly, research on RTI is neglected in low-income and middle-income countries. The repercussion of such progress to Peru is also discussed.
Aufdenblatten, Christoph Alexander; Altermatt, Stefan
In the management of severe head injuries, the use of intraventricular catheters for intracranial pressure (ICP) monitoring and the option of cerebrospinal fluid drainage is gold standard. In children and adolescents, the insertion of a cannula in a compressed ventricle in case of elevated intracranial pressure is difficult; therefore, a pressure sensor is placed more often intraparenchymal as an alternative option. In cases of persistent elevated ICP despite maximal brain pressure management, the use of an intraventricular monitoring device with the possibility of cerebrospinal fluid drainage is favourable. We present the method of intracranial catheter placement by means of an electromagnetic navigation technique.
Marsac, Meghan L; Donlon, Katharine A; Hildenbrand, Aimee K; Winston, Flaura K; Kassam-Adams, Nancy
Millions of children incur potentially traumatic physical injuries every year. Most children recover well from their injury but many go on to develop persistent traumatic stress reactions. This study aimed to describe children's coping and coping assistance (i.e., the ways in which parents and peers help children cope) strategies and to explore the association between coping and acute stress reactions following an injury. Children (N = 243) rated their acute traumatic stress reactions within one month of injury and reported on coping and coping assistance six months later. Parents completed a measure of coping assistance at the six-month assessment. Children used an average of five to six coping strategies (out of 10), with wishful thinking, social support, and distraction endorsed most frequently. Child coping was associated with parent and peer coping assistance strategies. Significant acute stress reactions were related to subsequent child use of coping strategies (distraction, social withdrawal, problem-solving, blaming others) and to child report of parent use of distraction (as a coping assistance strategy). Findings suggest that children's acute stress reactions may influence their selection of coping and coping assistance strategies. To best inform interventions, research is needed to examine change in coping behaviors and coping assistance over time, including potential bidirectional relationships between trauma reactions and coping.
Zaki, J.F.W.; Ali-Eldin, A.M.T.; Hussein, S.E.; Saraya, S.F.; Areed, F.F.
Traffic Congestion is a complex dilemma facing most major cities. It has undergone a lot of research since the early 80s in an attempt to predict traffic in the short-term. Recently, Intelligent Transportation Systems (ITS) became an integral part of traffic research which helped in modeling and
Full Text Available Objective: The Nuss procedure is a widely accepted technique for correcting pectus excavatum. Unfortunately, fatal complications such as cardiac perforation and injury of the great blood vessels have been noticed in a few patients.We modified original Nuss technique to be simpler and lessdangerous.Methods: We modified Nuss procedure with the sternal elevation to improve sternal depression. Modified Nuss procedure was carried out by applying metal lifter raise sterum until the patient starts to raise from the operating table. The space behind sternum is now wider, and surgeryhas become safer with less probability of injuries intrathoracic organs. We compared 46 patients operated by the original Nuss method (taking into account the data from the literature on complications of the original method on a large series of patients with 54 patients operated by a modified Nuss method.Results: Before lifting the sternum depth of the deformity was between 2.9 and 6.2 cm (mean 5.4 cm, and the increase were between 1.5 and 4.0 cm (mean 2.8 cm. The difference of 2.6 cm is large enough, and the width of introducer and bars are about 3 mm for securely passed along the chest.Conclusions: A modified method of treating pectus excavatum is safer, better and with fewer complications than the original method of Nuss.
Ono, Junichi; Sakamoto, Tetsuya; Kawamata, Tatsuro; Tokutomi, Takashi; Ogawa, Takeki; Shigemori, Minoru; Yamaura, Akira; Nakamura, Norio
This study was conducted to clarify the recent trends of severe head injury in the Japan Neurotrauma Data Bank (JNTDB) with special reference to traffic accident. In the JNTDB, the number of severely head-injured patients (Glasgow Coma Scale (GCS) score of 8 or less) were 832 in Project 1998 and 797 in Project 2004. Those were divided into 2 groups: traffic accident (TA) group, and non-TA (nTA) group. In addition, the former group was classified into 4 groups: 4 wheel vehicle (4WV) group, motorcycle (MC) group, bicycle (BC) group, and pedestrian (P) group. Analyzed here were cause of injury, age distribution, incidence of alcohol intake, means of transportation, clinical severity (GCS and injury severity score), initial CT findings (Traumatic Coma Data Bank), and outcome at discharge (Glasgow Outcome Scale). In the Project 2004; Traffic accident was less common as the cause of injury. The proportion of younger patients was lower in the TA group, especially in the 4WV and MC groups. Incidence of alcohol intake was lower in the TA group, particularly in the MC groups. Patient transfer by helicopter was more common in both the TA and nTA groups. The proportion of GCS of 3 to 5 was lower in the TA group, especially in the MC group. In the initial CT findings, type 3 of diffuse injury and evacuated mass were less frequent in both groups, and in the 4WV, BC, and P groups. Outcome at discharge: Mortality rate was lower in both groups, and in the 4WV, MC and P groups, but the percentage of good outcomes was unchanged. These results indicated the recent trends of severely head-injured patients who were injured by traffic accident. But there were some problems, such as study protocol and meaningless results, so that further verification is indispensable in the JNTDB study. (author)
Zangeneh, Alireza; Najafi, Farid; Karimi, Saeed; Saeidi, Shahram; Izadi, Neda
Road traffic injuries (RTIs) are considered as one of the most important health problems endangering people's life. The examination of the geographical distribution of RTIs could help policymakers in better planning to reduce RTIs. This study, therefore, aimed to determine the spatial-temporal clustering of mortality from RTIs in West of Iran. Deaths from RTIs, registered in Forensic Medicine Organization of Kermanshah province over a period of six years (2009-2014), were used. Using negative binomial regression, the mortality trend was investigated. In order to investigate the spatial distribution of RTIs, we used ArcGIS. (Version 10.3). The median age of the 3231 people died in RTIs was 37 (IQR = 31) year, 78.4% were male. The 6-year average mortality rate from RTIs was 27.8/100,000 deaths, and the average rate had a declining trend. The dispersion of RTIs showed that most deaths occurred in Kermanshah, Islamabad, Bisotun, and Harsin road axes, respectively. The mean center of all deaths from RTIs occurred in Kermanshah province, the central area of Kermanshah district. The spatial trend of such deaths has moved to the northeast-southwest, and such deaths were geographically centralized. Results of Moran's I with respect to cluster analysis also indicated positive spatial autocorrelations. The results showed that the mortality rate from RTIs, despite the decline in recent years, is still high when compared with other countries. The clustering of accidents raises the concern that road infrastructure in certain locations may also be a factor. Regarding the results related to the temporal analysis, it is suggested that the enforcement of traffic rules be stricter at rush hours. Copyright © 2018 Elsevier Ltd and Faculty of Forensic and Legal Medicine. All rights reserved.
Alhamdi, Yasir; Abrams, Simon T; Cheng, Zhenxing; Jing, Shengjie; Su, Dunhao; Liu, Zhiyong; Lane, Steven; Welters, Ingeborg; Wang, Guozheng; Toh, Cheng-Hock
To investigate the impact of circulating histones on cardiac injury and dysfunction in a murine model and patients with sepsis. Prospective, observational clinical study with in vivo and ex vivo translational laboratory investigations. General ICU and university research laboratory. Sixty-five septic patients and 27 healthy volunteers. Twelve-week-old male C57BL/6N mice. Serial blood samples from 65 patients with sepsis were analyzed, and left ventricular function was assessed by echocardiography. Patients' sera were incubated with cultured cardiomyocytes in the presence or absence of antihistone antibody, and cellular viability was assessed. Murine sepsis was initiated by intraperitoneal Escherichia coli injection (10(8) colony-forming unit/mouse) in 12-week-old male C57BL/6N mice, and the effect of antihistone antibody (10 mg/kg) was studied. Murine blood samples were collected serially, and left ventricular function was assessed by intraventricular catheters and electrocardiography. Circulating histones and cardiac troponins in human and murine plasma were quantified. In 65 patients with sepsis, circulating histones were significantly elevated compared with healthy controls (n = 27) and linearly correlated with cardiac troponin T levels (rs = 0.650; p histone levels were significantly associated with new-onset left ventricular dysfunction (p = 0.001) and arrhythmias (p = 0.01). Left ventricular dysfunction only predicted adverse outcomes when combined with elevated histones or cardiac troponin levels. Furthermore, patients' sera directly induced histone-specific cardiomyocyte death ex vivo, which was abrogated by antihistone antibodies. In vivo studies on septic mice confirmed the cause-effect relationship between circulating histones and the development of cardiac injury, arrhythmias, and left ventricular dysfunction. Circulating histones are novel and important mediators of septic cardiomyopathy, which can potentially be utilized for prognostic and therapeutic
Jeng, Toh Charng; Haspani, Mohd Saffari Mohd; Adnan, Johari Siregar; Naing, Nyi Nyi
A repeat Computer Tomographic (CT) brain after 24–48 hours from the 1st scanning is usually practiced in most hospitals in South East Asia where intracranial pressure monitoring (ICP) is routinely not done. This interval for repeat CT would be shortened if there was a deterioration in Glasgow Coma Scale (GCS). Most of the time the prognosis of any intervention may be too late especially in hospitals with high patient-to-doctor ratio causing high mortality and morbidity. The purpose of this study was to determine the important predictors for early detection of Delayed Traumatic Intracranial Haemorrhage (DTICH) and Progressive Traumatic Brain Injury (PTBI) before deterioration of GCS occurred, as well as the most ideal timing of repeated CT brain for patients admitted in Malaysian hospitals. A total of 81 patients were included in this study over a period of six months. The CT scan brain was studied by comparing the first and second CT brain to diagnose the presence of DTICH/PTBI. The predictors tested were categorised into patient factors, CT brain findings and laboratory investigations. The mean age was 33.1 ± 15.7 years with a male preponderance of 6.36:1. Among them, 81.5% were patients from road traffic accidents with Glasgow Coma Scale ranging from 4 – 15 (median of 12) upon admission. The mean time interval delay between trauma and first CT brain was 179.8 ± 121.3 minutes for the PTBI group. The DTICH group, 9.9% of the patients were found to have new intracranial clots. Significant predictors detected were different referral hospitals (p=0.02), total GCS status (p=0.026), motor component of GCS (p=0.043), haemoglobin level (p<0.001), platelet count (p=0.011) and time interval between trauma and first CT brain (p=0.022). In the PTBI group, 42.0% of the patients were found to have new changes (new clot occurrence, old clot expansion and oedema) in the repeat CT brain. Univariate statistical analysis revealed that age (p=0.03), race (p=0.035), types of
Heim, C; Bosisio, F; Roth, A; Bloch, J; Borens, O; Daniel, R T; Denys, A; Oddo, M; Pasquier, M; Schmidt, S; Schoettker, P; Zingg, T; Wasserfallen, J B
Switzerland, the country with the highest health expenditure per capita, is lacking data on trauma care and system planning. Recently, 12 trauma centres were designated to be reassessed through a future national trauma registry by 2015. Lausanne University Hospital launched the first Swiss trauma registry in 2008, which contains the largest database on trauma activity nationwide. Prospective analysis of data from consecutively admitted shock room patients from 1 January 2008 to 31 December 2012. Shock room admission is based on physiology and mechanism of injury, assessed by prehospital physicians. Management follows a surgeon-led multidisciplinary approach. Injuries are coded by Association for the Advancement of Automotive Medicine (AAAM) certified coders. Over the 5 years, 1,599 trauma patients were admitted, predominantly males with a median age of 41.4 years and median injury severity score (ISS) of 13. Rate of ISS >15 was 42%. Principal mechanisms of injury were road traffic (40.4%) and falls (34.4%), with 91.5% blunt trauma. Principal patterns were brain (64.4%), chest (59.8%) and extremity/pelvic girdle (52.9%) injuries. Severe (abbreviated injury scale [AIS] score ≥ 3) orthopaedic injuries, defined as extremity and spine injuries together, accounted for 67.1%. Overall, 29.1% underwent immediate intervention, mainly by orthopaedics (27.3%), neurosurgeons (26.3 %) and visceral surgeons (13.9%); 43.8% underwent a surgical intervention within the first 24 hours and 59.1% during their hospitalisation. In-hospital mortality for patients with ISS >15 was 26.2%. This is the first 5-year report on trauma in Switzerland. Trauma workload was similar to other European countries. Despite high levels of healthcare, mortality exceeds published rates by >50%. Regardless of the importance of a multidisciplinary approach, trauma remains a surgical disease and needs dedicated surgical resources.
The comprehension of a traffic situation plays a major role in driving a vehicle. Interpretable information forms a basis for future projection, decision making and action performing, such as navigating, maneuvering and driving control. Michael Huelsen provides an ontology-based generic traffic situation description capable of supplying various advanced driver assistance systems with relevant information about the current traffic situation of a vehicle and its environment. These systems are enabled to perform reasonable actions and approach visionary goals such as injury and accident free driv
Rahman, Nik Hisamuddin NA; Baharuddin, Kamarul A; Mohamad, Syarifah Mastura S
Background Road traffic injury (RTI) contributes to major morbidity and mortality in both developed and developing countries. Most of the injuries are caused by road-related injuries that specifically relate to motorcycle crash. We attempted to conduct a short survey to determine the magnitude of burden related to motorcycle-related RTIs in Malaysia. We hypothesize that motorcycle-related RTI in Malaysia contributes significantly to the health burden in the country. Methods The cross-sectiona...
Wainiqolo, Iris; Kafoa, Berlin; Kool, Bridget; Robinson, Elizabeth; Herman, Josephine; McCaig, Eddie; Ameratunga, Shanthi
To investigate the association between kava use and the risk of four-wheeled motor vehicle crashes in Fiji. Kava is a traditional beverage commonly consumed in many Pacific Island Countries. Herbal anxiolytics containing smaller doses of kava are more widely available. Data for this population-based case-control study were collected from drivers of 'case' vehicles involved in serious injury-involved crashes (where at least one road user was killed or admitted to hospital for 12 hours or more) and 'control' vehicles representative of 'driving time' in the study base. Structured interviewer administered questionnaires collected self-reported participant data on demographic characteristics and a range of risk factors including kava use and potential confounders. Unconditional logistic regression models estimated odds ratios relating to the association between kava use and injury-involved crash risk. Overall, 23% and 4% of drivers of case and control vehicles, respectively, reported consuming kava in the 12 hours prior to the crash or road survey. After controlling for assessed confounders, driving following kava use was associated with a four-fold increase in the odds of crash involvement (Odds ratio: 4.70; 95% CI: 1.90-11.63). The related population attributable risk was 18.37% (95% CI: 13.77-22.72). Acknowledging limited statistical power, we did not find a significant interaction in this association with concurrent alcohol use. In this study conducted in a setting where recreational kava consumption is common, driving following the use of kava was associated with a significant excess of serious-injury involved road crashes. The precautionary principle would suggest road safety strategies should explicitly recommend avoiding driving following kava use, particularly in communities where recreational use is common.
Full Text Available To investigate the association between kava use and the risk of four-wheeled motor vehicle crashes in Fiji. Kava is a traditional beverage commonly consumed in many Pacific Island Countries. Herbal anxiolytics containing smaller doses of kava are more widely available.Data for this population-based case-control study were collected from drivers of 'case' vehicles involved in serious injury-involved crashes (where at least one road user was killed or admitted to hospital for 12 hours or more and 'control' vehicles representative of 'driving time' in the study base. Structured interviewer administered questionnaires collected self-reported participant data on demographic characteristics and a range of risk factors including kava use and potential confounders. Unconditional logistic regression models estimated odds ratios relating to the association between kava use and injury-involved crash risk.Overall, 23% and 4% of drivers of case and control vehicles, respectively, reported consuming kava in the 12 hours prior to the crash or road survey. After controlling for assessed confounders, driving following kava use was associated with a four-fold increase in the odds of crash involvement (Odds ratio: 4.70; 95% CI: 1.90-11.63. The related population attributable risk was 18.37% (95% CI: 13.77-22.72. Acknowledging limited statistical power, we did not find a significant interaction in this association with concurrent alcohol use.In this study conducted in a setting where recreational kava consumption is common, driving following the use of kava was associated with a significant excess of serious-injury involved road crashes. The precautionary principle would suggest road safety strategies should explicitly recommend avoiding driving following kava use, particularly in communities where recreational use is common.
R. Nik Hisamuddin
Full Text Available This was a Prospective Cohort Study commencing from July 2011 until June 2013 involving all injuries related to motor vehicle crashes (MVC attended Emergency Departments (ED of two tertiary centers in a district in Malaysia. Selected attributes were geospatially analyzed by using ARCGIS (by ESRI software version 10.1 licensed to the institution and Google Map free software and multiple logistic regression was performed by using SPSS version 22.0. A total of 439 cases were recruited. The mean age (SD of the MVC victims was 26.04 years (s.d 15.26. Male comprised of 302 (71.7% of the cases. Motorcyclists were the commonest type of victims involved [351(80.0%]. Hotspot MVC locations occurred at certain intersections and on roads within borough of Kenali and Binjai. The number of severely injured and polytrauma are mostly on the road network within speed limit of 60 km/hour. A person with an increase in ISS of one score had a 37 % higher odd to have disability at hospital discharge (95% CI: 1.253, 1.499, p-value < 0.001. Pediatric age group (less than 19 years of age had 52.1% lesser odds to have disability at discharge from hospital (95% CI: 0.258, 0.889, p-value < 0.001 and patients who underwent operation for definitive management had 4.14 times odds to have disability at discharge from hospital (95% CI: 1.681, 10.218, p-value = 0.002. Overall this study has proven that GIS with a combination of traditional statistical analysis is still a powerful tool in road traffic injury (RTI related research.
DeFroda, Steven F; Kriz, Peter K; Hall, Amber M; Zurakowski, David; Fadale, Paul D
Ulnar collateral ligament (UCL) injury has become increasingly common in Major League Baseball (MLB) players in recent years. There is a significant difference in preinjury fastball velocity between MLB pitchers with tears and matched controls without UCL injury. Pitchers with injuries are throwing harder and getting injured earlier in their MLB careers. Cohort study; Level of evidence, 3. From 2007 to 2014, a total of 170 documented UCL injuries (156 pitchers, 14 position players) occurred in MLB. Inclusion criteria for this study consisted of any player who tore his UCL in MLB during this time frame. There were 130 regular-season tears (April-September). From this group, 118 players who pitched more than 100 innings prior to tear were matched to subjects with no tear and were compared using a logistic regression analysis. A subgroup of "early tear" players who threw less than 100 career innings (n = 37) was also identified and compared with the larger tear group using a logistic regression analysis. Of the 130 tears that occurred during the regular season, a significantly larger number (62%) occurred in the first 3 months (P = .011). The rate of UCL tears per MLB player (P = .001) was statistically significant. In the group of 118 matched tears, the mean fastball velocity was greater in the tear group (91.7 mph) compared with the control group (91.0 mph; P = .014). Furthermore, relief pitchers made up a greater percentage of the early tear group (<100 innings) compared with the later tear group (P = .011). Sixteen of the 170 UCL tears (9.4%) were recurrent tears, with 5 of 16 experiencing both tear and retear within the past 4 years. There is a statistically significant difference in the mean fastball velocity of pitchers who injure their UCL. Small increases in pitcher fastball velocity are a main contribution to the increased rate of tear in MLB. In addition, there has been an increased incidence of injury in the first 3 months of the season. Finally, early
Full Text Available Background: More than a million people die every day on world's roads and according to current estimates traffic related injuries will become the 5th highest killer in the world by 2030. Low and middle-income countries carry over 90% of this burden with substantial socio-economic consequences. Policies to reduce this burden are currently centered on preventive measures and the care of the injured is still neglected. This study aims at describing the crash characteristics and pattern of injuries in an urban area of a middle-income country with particular emphasis on the differential analysis of various road user categories. Methods: in this prospective cohort analysis conducted over a period of 5 months in the casualty department of the largest hospital in the city of Douala in Cameroon, all patients admitted after sustaining a traffic related injury were analyzed for crash characteristics, pattern and severity of injury and final outcome after a maximum follow-up period of 1 week. The analysis compared various user categories for different variables. Results: a total of 811 cases could be analyzed. These included 586 (72.2% males for a sex-ratio of 2.6/1. Motorized two-wheelers and pedestrians represented overall over 80% of all victims and the most frequent collision involved a motorcycle and a tourist car. Over 95% of victims did not use a protective device. Most patients sustained external soft tissue lesions frequently involving the limbs and face. A total of 280 patients (34.52% sustained a limb fracture. The most frequently fractured bones were the tibia, fibula and femur. Most injury cases were minor or moderate and collision between a motorcycle and a truck resulted in a significantly more severe injury. Motorized two-wheelers and pedestrian were significantly more exposed to external injuries while car occupants were more exposed to chest and spine injuries. Conclusion: crash characteristics in Douala are greatly influenced by the
Polomano, Rosemary C; Buckenmaier, Chester C; Kwon, Kyung H; Hanlon, Alexandra L; Rupprecht, Christine; Goldberg, Cynthia; Gallagher, Rollin M
Examine response patterns to low-dose intravenous (IV) ketamine continuous infusions on multiple pain outcomes, and demonstrate effectiveness, safety, and tolerability of ketamine administration on general wards. Retrospective case series of consecutive patients given low-dose IV ketamine continuous infusions. Walter Reed Army Medical Center, Washington, DC. Nineteen eligible inpatients with neuropathic pain from major limb injuries sustained in combat with inadequate pain control from multimodal analgesia. A 3-day IV infusion of ketamine at doses ≤ 120 μg/kg/h. Daily present (PPI), average (API), and worst (WPI) pain intensity (0-10), global pain relief (GPR) (1 "no relief" to 5 "complete relief"), daily assessments of adverse events, and daily opioid requirements measured during therapy. A significant reduction in PPI (P pain (PLP) (N = 10; P = 0.0436) were observed. Mean percent increase in overall GPR was better for those reporting GPR scores ≤ 3 (N = 13) in the first 24 hours of therapy (P = 0.0153). While not significant, mean opioid requirement (IV morphine equivalents) decreased from 129.9 mgs ± 137.3 on day 1 to 112.14 ± 86.3 24 hours after therapy. Low-dose ketamine infusions for complex combat injury pain were safe and effective, and demonstrated response patterns over time and by baseline pain score stratification and presence or absence of PLP. Wiley Periodicals, Inc.
Stzepourginski, Igor; Nigro, Giulia; Jacob, Jean-Marie; Dulauroy, Sophie; Sansonetti, Philippe J; Eberl, Gérard; Peduto, Lucie
The intestinal epithelium is continuously renewed by intestinal epithelial stem cells (IESCs) positioned at the base of each crypt. Mesenchymal-derived factors are essential to maintain IESCs; however, the cellular composition and development of such mesenchymal niche remains unclear. Here, we identify pericryptal CD34 + Gp38 + αSMA - mesenchymal cells closely associated with Lgr5 + IESCs. We demonstrate that CD34 + Gp38 + cells are the major intestinal producers of the niche factors Wnt2b, Gremlin1, and R-spondin1, and are sufficient to promote maintenance of Lgr5 + IESCs in intestinal organoids, an effect mainly mediated by Gremlin1. CD34 + Gp38 + cells develop after birth in the intestinal submucosa and expand around the crypts during the third week of life in mice, independently of the microbiota. We further show that pericryptal CD34 + gp38 + cells are rapidly activated by intestinal injury, up-regulating niche factors Gremlin1 and R-spondin1 as well as chemokines, proinflammatory cytokines, and growth factors with key roles in gut immunity and tissue repair, including IL-7, Ccl2, Ptgs2, and Amphiregulin. Our results indicate that CD34 + Gp38 + mesenchymal cells are programmed to develop in the intestine after birth to constitute a specialized microenvironment that maintains IESCs at homeostasis and contribute to intestinal inflammation and repair after injury.
Traumatic injury is common and may have a major impact on the survivor’s life. In the Netherlands alone, over 7 million injuries are registered yearly, caused by accidents in traffic, at home, at work, or by interpersonal violence. Besides physical recovery, survivors often deal with the
Xiong, Lili; Zhu, Yao; Li, Liping
Background Motorcycle vehicles are frequent in China, especially in the small and medium sized cities. Road traffic collisions involving motorcycles often result in severe injuries. We aimed to identify risk factors for severe injuries in inpatients sustaining motorcycle collisions. Methods Patients with road traffic injuries involving motorcycles who presented to the neurosurgery and orthopedic departments of three major comprehensive hospitals in Shantou city were reviewed from October 2012 to June 2013. Data from 349 patients was investigated. Crash and injury characteristics were documented by interviewing patients, their family members, and their doctors. Binary logistic regression was used to determine risk factors for severe injuries. Results There were 253 males (72.49%) and 96 females (27.51%), with a male to female ratio of 2.64:1. The mean age was 38.21±17.32 years. One-hundred and fifty patients were in the severe injury group with a mean injury severity score (ISS) of 15.34±9.13. The simple and multiple logistic model showed that males, lack of safeguards, morning and night hours, non-urban areas, collision of a motorcycle with a cycle, ambulance transportation to hospital, admission to a neurosurgery department, lack of traffic control, unobstructed traffic, and poor visibility were all the risk factors. Conclusions This research highlights some problems: less helmet wearing in motorcyclists and cyclists, rural injuries being more serious than urban ones, and head injuries being the main diagnosis in severe injuries. The result of this research is predictable. If the safety equipment is required to be used, such as helmets, and the traffic environment is improved, such as traffic flow, medical resources to injuries and deaths is seasonable, then traffic safety will be improved and accidents will be reduced. PMID:29546203
Full Text Available Road traffic accidents (RTAs are becoming a major problem around the world, incurring enormous losses of human and economic resources. Recent reports from the World Health Organization (WHO reveal that each year more than 1.25 million people are killed and 50 million are injured in road traffic accidents worldwide. In Saudi Arabia, statistics show that at least one traffic accident occurs every minute, causing up to 7,000 deaths and over 39,000 injuries annually. In this study, the main causes of RATs in the province of Hail are examined. The data was collected through the use of a survey which was developed to evaluate the effect of influencing parameters on RTA rate. The results show that 67% of RTAs result from human factors, 29% from road conditions and 4% from vehicle defects. Excessive speed and violation of traffic rules and regulations were found to be the main causes of RATs. Low rates of compliance with speed limit signs and seat-belt regulations were also observed. These findings highlight the need of strengthening effective traffic law enforcement alongside with improving traffic safety and raising public awareness.
Localio A Russell
Full Text Available Abstract Background Peroxiredoxin 6 (PRDX6 is involved in redox regulation of the cell and is thought to be protective against oxidant injury. Little is known about genetic variation within the PRDX6 gene and its association with acute lung injury (ALI. In this study we sequenced the PRDX6 gene to uncover common variants, and tested association with ALI following major trauma. Methods To examine the extent of variation in the PRDX6 gene, we performed direct sequencing of the 5' UTR, exons, introns and the 3' UTR in 25 African American cases and controls and 23 European American cases and controls (selected from a cohort study of major trauma, which uncovered 80 SNPs. In silico modeling was performed using Patrocles and Transcriptional Element Search System (TESS. Thirty seven novel and tagging SNPs were tested for association with ALI compared with ICU at-risk controls who did not develop ALI in a cohort study of 259 African American and 254 European American subjects that had been admitted to the ICU with major trauma. Results Resequencing of critically ill subjects demonstrated 43 novel SNPs not previously reported. Coding regions demonstrated no detectable variation, indicating conservation of the protein. Block haplotype analyses reveal that recombination rates within the gene seem low in both Caucasians and African Americans. Several novel SNPs appeared to have the potential for functional consequence using in silico modeling. Chi2 analysis of ALI incidence and genotype showed no significant association between the SNPs in this study and ALI. Haplotype analysis did not reveal any association beyond single SNP analyses. Conclusions This study revealed novel SNPs within the PRDX6 gene and its 5' and 3' flanking regions via direct sequencing. There was no association found between these SNPs and ALI, possibly due to a low sample size, which was limited to detection of relative risks of 1.93 and above. Future studies may focus on the role of
Raharimanantsoa, Mahery; Zingg, Tobias; Thiery, Alicia; Brigand, Cécile; Delhorme, Jean-Baptiste; Romain, Benoît
Blunt bowel and mesenteric injuries (BBMI) are regularly missed by abdominal computed tomography (CT) scans. The aim of this study was to develop a risk assessment tool for BBMI to help clinicians in decision-making for blunt trauma after road traffic crashes (RTCs). Single-center retrospective study of trauma patients from January 2010 to April 2015. All patients admitted to our hospital after blunt trauma following RTCs and CT scan at admission were assessed. Of the 394 patients included, 78 (19.8%) required surgical exploration and 34 (43.6%) of these had a significant BBMI. A univariate and multivariate analysis were performed comparing patients with BBMI (n = 34) and patients without BBMI (n = 360). A score with a range from 0 to 13 was created. Scores from 8 to 9 were associated with 5-25% BBMI risk. The power of this new score ≥ 8 to predict a surgically significant BBMI had a sensitivity of 96%, specificity of 86.4%, positive predictive value (PPV) of 48% and negative predictive value (NPV) of 99.4%. This score could be a valuable tool for the management of blunt trauma patients after RTA without a clear indication for laparotomy but at risk for BBMI. The outcome of this study suggests selective diagnostic laparoscopy for a score ≥ 8 in obtunded patients and ≥ 10 in all other. To assess the value and accuracy of this new score, a prospective validation of these retrospective findings is due.
Virdee, J; Pafitanis, G; Alamouti, R; Brohi, K; Patel, H
Introduction This study presents an extensive retrospective database of patients with polytrauma following train-related injuries and highlights the key lessons learnt in this rare clinical presentation. Materials and methods We retrospectively collected data from 127 patients who presented to Royal London Hospital after sustaining train related trauma. We analysed demographics, accident report data, aetiologies and clinical management interventions. All data were screened and injuries were mapped to various anatomical regions. The revised trauma score, injury severity score and new injury severity scores were used to quantify injury extent. Results Mean patient age was 41 years (range 16-81 years) with a 73% to 27% male to female ratio. Deliberate injuries occurred in 71% of patients, with accidental injury accounting for 29%. The mean new injury severity score was 26.48 (range 1-75), with the most common injuries sustained to the chest and the extremities. Pneumothorax, haemothorax or tension pneumothorax occurred in 44% of patients, with 11% suffering a flail chest injury. Traumatic amputations occurred in 33% of patients and 56% of patients required admission to intensive care. Total mortality rates were 19%, with 12% of patients dying at day 0 and 18% at day 7, respectively. Conclusions This study demonstrated the significant impact of train-related polytrauma and provided a comprehensive injury patterns. It was observed that deliberate polytrauma is related to psychiatric deliberate harm but there is no significant difference in the patterns of injuries between accidental and deliberately caused injuries. Overall injuries to the thorax and extremities were the most severe, demonstrating the highest mean injury scores.
Ball, Chad G; Dente, Christopher J; Shaz, Beth; Wyrzykowski, Amy D; Nicholas, Jeffrey M; Kirkpatrick, Andrew W; Feliciano, David V
Massive transfusion protocols (MTPs) using high plasma and platelet ratios for exsanguinating trauma patients are increasingly popular. Major liver injuries often require massive resuscitations and immediate hemorrhage control. Current published literature describes outcomes among patients with mixed patterns of injury. We sought to identify the effects of an MTP on patients with major liver trauma. Patients with grade 3, 4 or 5 liver injuries who required a massive blood component transfusion were analyzed. We compared patients with high plasma:red blood cell:platelet ratio (1:1:1) transfusions (2007-2009) with patients injured before the creation of an institutional MTP (2005-2007). Among 60 patients with major hepatic injuries, 35 (58%) underwent resuscitation after the implementation of an MTP. Patient and injury characteristics were similar between cohorts. Implementation of the MTP significantly improved plasma: red blood cell:platelet ratios and decreased crystalloid fluid resuscitation (p = 0.026). Rapid improvement in early acidosis and coagulopathy was superior with an MTP (p = 0.009). More patients in the MTP group also underwent primary abdominal fascial closure during their hospital stay (p = 0.021). This was most evident with grade 4 injuries (89% vs. 14%). The mean time to fascial closure was 4.2 days. The overall survival rate for all major liver injuries was not affected by an MTP (p = 0.61). The implementation of a formal MTP using high plasma and platelet ratios resulted in a substantial increase in abdominal wall approximation. This occurred concurrently to a decrease in the delivered volume of crystalloid fluid.
Full Text Available Background: Injuries are the second greatest cause of mortality in Iran. Information about the epidemiological pattern of injuries is effective in decision-making. In this regard, the aim of the current study is to elaborate on the epidemiology of injuries in Iran through a systematic review. Methods: Required data were collected searching the following key words and their Persian equivalents; trauma, injury, accident, epidemiology, prevalence, Pattern, etiology, risk factors and Iran. The following databases were searched: Google Scholar, PubMed, Scopus, MagIran, Iranian scientific information database (SID and Iran Medex. Some of the relevant journals and web sites were searched manually. The lists of references from the selected articles were also investigated. We have also searched the gray literature and consulted some experts. Results: Out of 2747 retrieved articles, 25 articles were finally included in the review. A total of 3234481 cases have been investigated. Mean (SD age among these cases was 30 (17.4 years. Males comprised 75.7% of all the patients. Only 31.1% of patients were transferred to hospital by ambulance. The most common mechanism of injuries was road traffic accidents (50.1%, followed by falls (22.3%. In road traffic accidents, motorcyclists have accounted for the majority of victims (45%. Roads were the most common accident scene for the injuries (57.5%. The most common injuries were to the head and neck. (47.3%. The mean (SD Injury Severity Score (ISS was 8.1(8.6%. The overall case-fatality proportion was 3.8% and 75% of all the mortalities related to road traffic accidents. Conclusions: The main priorities in reducing the burden of injuries include: the young, male target group, improving pre-hospital and ambulance services, preventing road traffic accidents, improving road safety and the safety of motorcyclists (compulsory helmet use, safer vehicles, dedicated motorcycle lanes.
John G. Skedros
Full Text Available We report the case of a 28-year-old transgender (male-to-female patient that had a partial tear of the rhomboid major tendon, scapulothoracic bursitis, and glenohumeral instability on the same side. These conditions resulted from traumatic events during circus acrobatic maneuvers. Additional aspects of this case that make it unique include (1 the main traumatic event occurred during a flagpole exercise, where the patient’s trunk was suspended horizontally while a vertical pole was grasped with both hands, (2 headaches were associated with the periscapular injury and they improved after scapulothoracic bursectomy and rhomboid tendon repair, (3 surgical correction was done during the same operation with an open anterior capsular-labral reconstruction, open scapulothoracic bursectomy without bone resection, and rhomboid tendon repair, (4 a postoperative complication of tearing of the serratus anterior and rhomboid muscle attachments with recurrent scapulothoracic pain occurred from patient noncompliance, and (5 the postoperative complication was surgically corrected and ultimately resulted in an excellent outcome at the one-year final follow-up.
Objectives: Injuries and mortality resulting from pedestrian road traffic crashes are a major public health problem in Ghana. This study investigated risk factors for road transport-related injury among pedestrians in rural Ghana. Design: Case study design using qualitative data. Method: In-depth interviews were conducted with pedestrians.…
Full Text Available Introduction: Violent health damages of different origin (accidents, murders, suicides in children and youth are one of the main causes of death and disabilities in this group of population in most countries. Objective: Objective of our paper was to analyze all related factors of traffic accidents involving children and to propose adequate measures of their prevention. Method: The analysis of fatal traffic accidents of children and youth aged to 18 years on the territory of Belgrade, within the period from 1998 to 2002. Results: In relation to other forms of violent death, the traffic mortality rate in children and youth holds the leading position, accounting for 56.9% with pedestrians as the most frequent category (57.4%. The most frequent age was between 7 and 9 years (46.8% and the boys were more frequently injured than the girls. It was established that the majority of children (51.9% was either running across the street outside the pedestrian/ zebra crossings or they were carelessly running out in the street, especially in April, July, August and September. More than a half of them (55.5%, predominantly school children, were injured by the end of working week, on Thursday and Friday. Conclusion: Results of our research have shown that the traffic education of children in our region is inadequate. Due to the abovementioned, it is primarily necessary to establish long-term and permanent education of this category of population. In addition, some public investments in the City infrastructure will be required in order to reduce the risk of traffic injuries in children.
Raphael, Jeffery; Maskell, Simon; Sklar, Elizabeth Ida
Traffic congestion is a major issue that plagues many urban road networks large and small. Traffic engineers are now leaning towards Intelligent Traffic Systems as many physical changes to road networks are costly or infeasible. Multi-Agent Systems (MAS) have become a popular paradigm for intelligent solutions to traffic management problems. There are many MAS approaches to traffic management that utilise market mechanisms. In market-based approaches, drivers “pay” to use the roadways. Howeve...
Missair, Andres; Pretto, Ernesto A; Visan, Alexandru; Lobo, Laila; Paula, Frank; Castillo-Pedraza, Catalina; Cooper, Lebron; Gebhard, Ralf E
All modalities of anesthetic care, including conscious sedation, general, and regional anesthesia, have been used to manage earthquake survivors who require urgent surgical intervention during the acute phase of medical relief. Consequently, we felt that a review of epidemiologic data from major earthquakes in the context of urgent intraoperative management was warranted to optimize anesthesia disaster preparedness for future medical relief operations. The primary outcome measure of this study was to identify the predominant preoperative injury pattern (anatomic location and pathology) of survivors presenting for surgical care immediately after major earthquakes during the acute phase of medical relief (0-15 days after disaster). The injury pattern is of significant relevance because it closely relates to the anesthetic techniques available for patient management. We discuss our findings in the context of evidence-based strategies for anesthetic management during the acute phase of medical relief after major earthquakes and the associated obstacles of devastated medical infrastructure. To identify reports on acute medical care in the aftermath of natural disasters, a query was conducted using MEDLINE/PubMed, Embase, CINAHL, as well as an online search engine (Google Scholar). The search terms were "disaster" and "earthquake" in combination with "injury," "trauma," "surgery," "anesthesia," and "wounds." Our investigation focused only on studies of acute traumatic injury that specified surgical intervention among survivors in the acute phase of medical relief. A total of 31 articles reporting on 15 major earthquakes (between 1980 and 2010) and the treatment of more than 33,410 patients met our specific inclusion criteria. The mean incidence of traumatic limb injury per major earthquake was 68.0%. The global incidence of traumatic limb injury was 54.3% (18,144/33,410 patients). The pooled estimate of the proportion of limb injuries was calculated to be 67.95%, with a
Roberts, Derek J; Das, Debanjana; Mercado, Michelle; Vis, Christine; Kortbeek, John B; Kirkpatrick, Andrew W; Ball, Chad G
Injury epidemiology fluctuates with economic activity in many countries. These relationships remain unclear in Canada. The annual risk of admission for major injury (Injury Severity Score ≥12) to a high-volume, level-1 Canadian trauma center was compared with indicators of economic activity over a 16-year period using linear regression. An increased risk of injured patient admissions was associated with rising mean gross domestic product (GDP [millions of chained 2002 dollars]) (.36 person increase per 100,000 population/$1,000 increase in GDP; P = .001) and annual gasoline prices (.47 person increase per 100,000 population/cent increase in gasoline price; P = .001). Recreation-related vehicle injuries were also associated with economic affluence. The risk of trauma patient mortality with increasing mean annual GDP (P = .72) and gasoline prices (P = .32) remained unchanged. Hospital admissions for major injury, but not trauma patient mortality, were associated with economic activity in a large Canadian health care region. Copyright © 2014 Elsevier Inc. All rights reserved.
Department of Transportation — The Not-in-Traffic Surveillance (NiTS) system is a virtual data collection system designed to provide counts and details regarding fatalities and injuries that occur...
Leidman, Eva; Maliniak, Maret; Sultan, Abdul-Salam Saleh; Hassan, Ahmed; Hussain, Syed Jaffar; Bilukha, Oleg O
The insurgency tactics that characterize modern warfare, such as suicide car bombs and roadside bombs, have the potential to significantly impact road traffic injuries in conflict affected-countries. As road traffic incidents are one of the top ten causes of death in Iraq, changes in incidence have important implications for the health system. We aimed to describe patterns of road traffic fatalities for all demographic groups and types of road users in Iraq during a period characterized by a resurgence in insurgency activity. Iraqi Ministry of Health routine prospective injury surveillance collects information on all fatal injuries in eight governorates of Iraq: Baghdad, Al-Anbar, Basrah, Erbil, Kerbala, Maysan, Ninevah, and Al-Sulaimaniya. From all injury fatalities documented at the coroner office, we analyzed only those attributed to road traffic that occurred between 1 January 2010 and 31 December 2013. Coroners ascertain information from physical examinations, police reports and family members. Analysis included 7,976 road traffic fatalities. Overall, 6,238 (78.2 %) fatalities were male and 2,272 (28.5 %) were children under 18 years of age. The highest numbers of road traffic fatalities were among males 15 to 34 years of age and children of both sexes under 5 years of age. 49.2 % of fatalities occurred among pedestrians. Among children and females, the majority of road traffic fatalities were pedestrians, 69.0 % and 56.6 %, respectively. Fatalities among motorcyclists (3.7 %) and bicyclists (0.4 %) were least common. Rates of road traffic fatalities ranged from 8.6 to 10.7 per 100,000 population. The injury surveillance system provides the first data from a conflict-affected country on road traffic fatalities disaggregated by type of road user. The highest numbers of fatalities were among children and young men. Nearly half of fatalities were pedestrians, a proportion nearly double that of any neighboring country. As insurgency activity increased in
Joubert, Kyla D; Mabry, Charles D; Kalkwarf, Kyle J; Betzold, Richard D; Spencer, Horace J; Spinks, Kara M; Porter, Austin; Karim, Saleema; Robertson, Ronald D; Sutherland, Michael J; Maxson, Robert T
Major trunk trauma is common and costly, but comparisons of costs between trauma centers (TCs) are rare. Understanding cost is essential to improve quality, manage trauma service lines, and to facilitate institutional commitment for trauma. We have used results of a statewide trauma financial survey of Levels I to IV TC to develop a useful grouping method for costs and clinical characteristics of major trunk trauma. The trauma financial survey collected billing and clinical data on 75 per cent of the state trauma registry patients for fiscal year 2012. Cost was calculated by separately accounting for embedded costs of trauma response and verification, and then adjusting reasonable costs from the Medicare cost report for each TC. The cost-to-charge ratios were then recalculated and used to determine uniform cost estimates for each patient. From the 13,215 patients submitted for the survey, we selected 1,094 patients with major trunk trauma: lengths of stay ≥ 48 hours and a maximum injury of AIS ≥3 for either thorax or abdominal trauma. These patients were then divided into three Injury Severity Score (ISS) groups of 9 to 15, 16 to 24, or 25+ to stratify patients into similar injury groups for analysis of cost and cost drivers. For abdominal injury, average total cost for patients with ISS 9 to 15 was $17,429. Total cost and cost per day increased with severity of injury, with $51,585 being the total cost for those with ISS 25. Similar trends existed for thoracic injury. Use of the Medicare cost report and cost-to-charge ratios to compute uniform costs with an innovative grouping method applied to data collected across a statewide trauma system provides unique information regarding cost and outcomes, which affects quality improvement, trauma service line management, and decisions on TC participation.
Full Text Available Traumatic brachial plexus injuries rarely recover spontaneously and if the window period for neurotisation has elapsed, the only option for restoration of function lies in a salvage procedure. Many such salvage procedures have been described in the literature with variable functional results. We report the case of a 16-year-old boy who presented after unsuccessful treatment for a complete brachial plexus injury; we performed a pectoralis major tendon transfer to attain elbow flexion. Postoperatively, the elbow was splinted with flexion at 100°. After 4 weeks of immobilization the splint was removed and the patient could actively flex his elbow from 30° to 100°.
Al-Ghaweel, Ibrahim; Mursi, Saleh A.; Jack, Joel P.; Joel, Irene
Objectives: The aim of the study was to evaluate the factors responsible for road traffic accidents in Benghazi. Material and Methods: Retrospective and descriptive studies were done in the years 2006-2007. The data was collected from Traffic and License Department, Benghazi. The data were analyzed, based on fatalities, the severely handicapped, hit and run victims and were correlated with age, sex, time, environmental factors, type of roads, etc. Results: One-Thousand-Two-Hundred-Sixty-Five accidents occurred between the years 2006-2007 within the Benghazi city limits; 11.14% of the injuries were fatal; 67.35% of the victims had severe injuries and 21.51% escaped with minor injuries. Table 1 shows that 73.04% lost their lives within the city limits, 13.47% on the fly-over, and 2.12% on minor roads connected to main roads within the city limits. The mean of the accidents and its standard deviation were 16.66± 25.67 with a variance of fatality of 1.54. Conclusion: It is concluded from the studies that major road traffic accidents occur because of environmental stress factors. In addition, fatalities and the seriousness of the accidents depend on a number of factors such as the age of the vehicle, safety measures, human error and time and place of accident. PMID:23012183
Stipdonk, H. Toorenburg, J. van & Postema, M.
Motorway traffic congestion is a major bottleneck for economic growth. Therefore, research of traffic behaviour is carried out in many countries. Although well describing the undersaturated free flow phase as an almost straight line in a (k,q)-phase diagram, congested traffic observations and
Signals for road traffic control are a major constituent of the modern traffic scene, particularly in built-up areas. A vast amount of research has been executed in the last two decennia, resulting in a fairly generally accepted view on what the requirements for effective traffic lights are. For the
Lin, Being-Chuan; Fang, Jen-Feng; Chen, Ray-Jade; Wong, Yon-Cheong; Hsu, Yu-Pao
This retrospective study aimed to assess the clinical experience and outcome of damage control laparotomy with perihepatic packing in the management of blunt major liver injuries. From January 1998 to December 2006, 58 patients of blunt major liver injury, American Association for the Surgery of Trauma-Organ Injury Scale (AAST-OIS) equal or greater than III, were operated with perihepatic packing at our institute. Demographic data, intra-operative findings, operative procedures, adjunctive managements and outcome were reviewed. To determine whether there was statistical difference between the survivor and non-survivor groups, data were compared by using Mann-Whitney U test for continuous variables, either Pearson's chi-square test or with Yates continuity correction for contingency tables, and results were considered statistically significant if phepatic artery ligation (n=11) and 7 patients required post-laparotomy hepatic transarterial embolization. Of the 58 patients, 28 survived and 30 died with a 52% mortality rate. Of the 30 deaths, uncontrolled liver bleeding in 24-h caused 25 deaths and delayed sepsis caused residual 5 deaths. The mortality rate versus OIS was grade III: 30% (6/20), grade IV: 54% (13/24), and grade V: 79% (11/14), respectively. On univariate analysis, the significant predictors of mortality were OIS grade (p=0.019), prolonged initial prothrombin time (PT) (p=0.004), active partial thromboplastin time (APTT) (p<0.0001) and decreased platelet count (p=0.005). The mortality rate of surgical blunt major liver injuries remains high even with perihepatic packing. Since prolonged initial PT, APTT and decreased platelet count were associated with high risk of mortality, we advocate combination of damage control resuscitation with damage control laparotomy in these major liver injuries. Copyright © 2013 Elsevier Ltd. All rights reserved.
Recently there has been an increased interest in the application of macroscopic models for the description of developments in traffic safety. A discussion was started on the causes of the sudden decrease in the number of fatal and injury accidents after 1974. Before that time these numbers had
December, 2002, was undertaken to determine the incidence, type of injury and pregnancy outcome. Results: One hundred and forty nine women ... road traffic accidents.6 Pregnant mothers could also be involved in road traffic accident.6 ... use of helmet lowers the risk of traumatic brain injury. 11 and a case is made for the ...
William Beaumont Army Medical Center Department of Preventive Medicine under the Executive Wellness Program. The Executive Wellness Program consists...Fields KB. 2011. Running injuries – changing trends and demographics. Curr Sports Med Rep 10(5): 299-303. Franche, RL, Cullen K, Clarke J
Tol, Johannes L.; Hamilton, Bruce; Eirale, Cristiano; Muxart, Patrice; Jacobsen, Philipp; Whiteley, Rod
There is an ongoing debate regarding the optimal criteria for return to sport after an acute hamstring injury. Less than 10% isokinetic strength deficit is generally recommended but this has never been documented in professional football players after rehabilitation. Our aim was to evaluate
N. Shahsavari Pour
Full Text Available Traffic congestion is a major concern for many cities throughout the world. In a general traffic light controller, the traffic lights change at a constant cycle time. Hence it does not provide an optimal solution. Many traffic light controllers in current use are based on the “time-of-the-day” scheme, which use a limited number of predetermined traffic light patterns and implement these patterns depending upon the time of the day. These automated systems do not provide an optimal control for fluctuating traffic volumes. In this paper, the fuzzy traffic light controller is used to optimize the control of fluctuating traffic volumes such as oversaturated or unusual load conditions. The problem is solved by genetic algorithm, and a new defuzzification method is introduced. The performance of the new defuzzification method (NDM is compared with the centroid point defuzzification method (CPDM by using ANOVA. Finally, an illustrative example is presented to show the competency of proposed algorithm.
C. Colloca TS/FM
TS/FM group informs you that, for the progress of the works at the Prévessin site entrance, some perturbation of the traffic may occur during the week between the 14th and 18th of June for a short duration. Access will be assured at any time. For more information, please contact 160239. C. Colloca TS/FM
Full Text Available Abstract Background Despite the growing burden of injuries worldwide, Syria and many other Arab countries still lack population-based estimates of different types of injuries. This study aims toprovide first population-based estimates of major injuries in Syria and characterize groups at increased risk. Methods An interviewer-administered population-based survey of adults 18–65 years residing in Aleppo, Syria was conducted in 2004. The study sample involved 2038 household representatives in Aleppo (45.2% men, mean age 35.3 ± 12.1, response rate 86%. We inquired about participants self-reported injuries in the past year that required medical attention as well as injuries among their household members. When reported, injuries were further assessed according to type, place, and outcome. Results Overall, there was 153 self-reported injuries in the past year (77.3 per 1000 adult respondents, 93.1 per 1000 in men and 64.4 per 1000 in women, p = 0.02. Other than gender, injuries differed by age (the older age group being least affected, and place of occurrence, as men were more likely to sustain traffic injuries and be injured outside the home. Injuries were reported among 236 household members (21.0 per 1000, and were slightly more frequent in children than adults (22.0 per 1000 for children, and 19.7 per 1000 for adults, p = 0.2. Traffic injuries, falls, and poisoning (food were by far the most common types of injury experienced by participants as well as their household members. Falls and traffic injuries seem to have caused most morbidity for the injured, while burns, although not frequently reported, were associated with an unfavorable outcome in the majority of cases. Conclusion This information provides baseline information about the burden of different injuries in Syria, and the sociodemographic factors related to them.
Campbell, Jennifer H.; Ratai, Eva-Maria; Autissier, Patrick; Nolan, David J.; Tse, Samantha; Miller, Andrew D.; González, R. Gilberto; Salemi, Marco; Burdo, Tricia H.; Williams, Kenneth C.
Four SIV-infected monkeys with high plasma virus and CNS injury were treated with an anti-α4 blocking antibody (natalizumab) once a week for three weeks beginning on 28 days post-infection (late). Infection in the brain and gut were quantified, and neuronal injury in the CNS was assessed by MR spectroscopy, and compared to controls with AIDS and SIV encephalitis. Treatment resulted in stabilization of ongoing neuronal injury (NAA/Cr by 1H MRS), and decreased numbers of monocytes/macrophages a...
Jensen, Morten Bornø; Philipsen, Mark Philip; Bahnsen, Chris
Traffic light recognition (TLR) is an integral part of any in- telligent vehicle, it must function both at day and at night. However, the majority of TLR research is focused on day-time scenarios. In this paper we will focus on detection of traffic lights at night and evalu- ate the performance...... of three detectors based on heuristic models and one learning-based detector. Evaluation is done on night-time data from the public LISA Traffic Light Dataset. The learning-based detector out- performs the model-based detectors in both precision and recall. The learning-based detector achieves an average...
Full Text Available OBJETIVO: Determinar la prevalencia y distribución de los accidentes de tránsito no fatales (ATNF en México. MATERIAL Y MÉTODOS: Se utilizaron datos de la ENSANUT 2006. En los hogares visitados se seleccionó a un adulto, un adolescente y un niño, hasta conformar una muestra de 94197 sujetos que representa a la N de 102 886 482 individuos. La variable dependiente fue la prevalencia de ATNF en los 12 meses anteriores a la encuesta. RESULTADOS: La prevalencia de accidentes (de tránsito o no fue de 6.0% y de esa cifra 16.7% correspondió a ATNF. Los hombres del grupo de 20 a 44 años, los habitantes de áreas urbanas y los de mejor nivel socioeconómico (NSE presentaron mayor prevalencia (pOBJECTIVE: To determine non-fatal road traffic injuries (NFRTI prevalence and its distribution in Mexico. MATERIAL AND METHODS: Data from ENSANUT Survey 2006 were used. Using simple random sampling, one adult, one adolescent and one child were selected in each household, constituting a final sample of 94 197 representing an N of 102 886 482 people. The dependent variable was the prevalence of road traffic injuries (RTI during the 12 months prior to the survey. RESULTS: The general accident prevalence was 6.0%; 16.7% corresponded to NFRTI. Men in the 20 to 44 age group living in urban areas and with high socioeconomic status had a higher RTI prevalence (p<0.05. Jalisco, Aguascalientes and Sonora were states with the highest prevalence of RTI, while Guerrero, Michoacan and Oaxaca were those with the lowest. CONCLUSIONS: NFRTI are frequent in Mexico and they are concentrated among men in productive ages in urban areas; they are associated with socioeconomic status at the individual level and with the state's development at the population level.
Rad, Mahdieh; Martiniuk, Alexandra Lc; Ansari-Moghaddam, Alireza; Mohammadi, Mahdi; Rashedi, Fariborz; Ghasemi, Ardavan
In the present study, the epidemiologic aspects of road traffic crashes in South East of Iran are described. This cross-sectional study included the profile of 2398 motor vehicle crashes recorded in the police office in one Year in South East of Iran. Data collected included: demographics, the type of crash, type of involved vehicle, location of crash and factors contributing to the crash. Descriptive statistics were used for data analysis. Collisions with other vehicles or objects contributed the highest proportion (62.4%) of motor vehicle crashes. Human factors including careless driving, violating traffic laws, speeding, and sleep deprivation/fatigue were the most important causal factors accounting for 90% of road crashes. Data shows that 41% of drivers were not using a seat belt at the time of crash. One- third of the crashes resulted in injury (25%) or death (5%). Reckless driving such as speeding and violation of traffic laws are major risk factors for crashes in the South East of Iran. This highlights the need for education along with traffic law enforcement to reduce motor vehicle crashes in future.
Wen, Zongmei; Lei, Zhen; Yao, Lu; Jiang, Ping; Gu, Tao; Ren, Feng; Liu, Yan; Gou, Chunyan; Li, Xiuhui; Wen, Tao
Acute liver failure (ALF) is a life-threatening systemic disorder. Here we investigated the impact of circulating histones, recently identified inflammatory mediators, on systemic inflammation and liver injury in murine models and patients with ALF. We analyzed histone levels in blood samples from 62 patients with ALF, 60 patients with chronic liver disease, and 30 healthy volunteers. We incubated patients' sera with human L02 hepatocytes and monocytic U937 cells to assess cellular damage and cytokine production. d-galactosamine plus lipopolysaccharide (GalN/LPS), concanavalin A (ConA), and acetaminophen (APAP) were given to C57BL/6N mice to induce liver injury, respectively, and the pathogenic role of circulating histones was studied. Besides, the protective effect of nonanticoagulant heparin, which can bind histones, was evaluated with in vivo and ex vivo investigations. We observed that circulating histones were significantly increased in patients with ALF, and correlated with disease severity and mortality. Significant systemic inflammation was also pronounced in ALF patients, which were associated with histone levels. ALF patients' sera induced significant L02 cell death and stimulated U937 cells to produce cytokines, which were abrogated by nonanticoagulant heparin. Furthermore, circulating histones were all released remarkably in GalN/LPS, ConA, and APAP-treated mice, and associated with high levels of inflammatory cytokines. Heparin reduced systemic inflammation and liver damage in mice, suggesting that it could interfere with histone-associated liver injury. Collectively, these findings demonstrate that circulating histones are critical mediators of systemic inflammation and cellular damage in ALF, which may be potentially translatable for clinical use.
Maduz, Roman; Kugelmeier, Patrick; Meili, Severin; Döring, Robert; Meier, Christoph; Wahl, Peter
The Abbreviated Injury Scale (AIS) and the Injury Severity Score (ISS) find increasingly widespread use to assess trauma burden and to perform interhospital benchmarking through trauma registries. Since 2015, public resource allocation in Switzerland shall even be derived from such data. As every trauma centre is responsible for its own coding and data input, this study aims at evaluating interobserver reliability of AIS and ISS coding. Interobserver reliability of the AIS and ISS is analysed from a cohort of 50 consecutive severely injured patients treated in 2012 at our institution, coded retrospectively by 3 independent and specifically trained observers. Considering a cutoff ISS≥16, only 38/50 patients (76%) were uniformly identified as polytraumatised or not. Increasing the cut off to ≥20, this increased to 41/50 patients (82%). A difference in the AIS of ≥ 1 was present in 261 (16%) of possible codes. Excluding the vast majority of uninjured body regions, uniformly identical AIS severity values were attributed in 67/193 (35%) body regions, or 318/579 (55%) possible observer pairings. Injury severity all too often is neither identified correctly nor consistently when using the AIS. This leads to wrong identification of severely injured patients using the ISS. Improving consistency of coding through centralisation is recommended before scores based on the AIS are to be used for interhospital benchmarking and resource allocation in the treatment of severely injured patients. Copyright © 2017. Published by Elsevier Ltd.
Igami, Kentaro; Shimojo, Yosuke; Ito, Hisatomi; Miyazaki, Toshitsugu; Kashiwada, Yoshiki
This work aimed at evaluating the effect of fermented ginseng (FG) and fermented red ginseng (FRG) against rat liver injury caused by paracetamol (acetaminophen (APAP)). Aspartate aminotransferase (AST) and alanine aminotransferase (ALT) in the serum and histopathological changes in the liver were analysed to determine the degree of liver injury. Deoxyribonucleic acid (DNA) microarray analysis was performed to compare gene expression levels altered in the rat livers. Phosphorylated Jun-N-terminal kinase (JNK) in human hepatocellular carcinoma (HepG2) cells were detected using western blot analysis to investigate the anti-inflammatory activity of compound K. Pretreatment with FG, containing compound K at high concentration, attenuated AST as well as ALT levels in rats, while no obvious effect was observed in the group that received FRG, whose content of compound K was lower than that of FG. In addition, the results of our histopathological analysis were consistent with changes in the serum biochemical analysis. DNA microarray analysis indicated that JNK- and glutathione S-transferase (GST)-related genes were involved in the hepatotoxicity. Notably, compound K, a major ginsenoside in FG, inhibited the phosphorylation of JNK in HepG2 cells. FG was shown to possess hepatoprotective activity against paracetamol (APAP)-induced liver injury better than FRG. Compound K might play an important role for an anti-inflammatory activity of FG by inhibiting JNK signalling in the liver. © 2014 Royal Pharmaceutical Society.
Watanabe, Y.; Ichikawa, H.; Kayama, O. [Nissan Motor Co. Ltd., Tokyo (Japan)
Even though whiplash neck injuries suffered in low-speed rear impacts are one of the major concern in traffic accidents, the mechanism of the injuries is not fully understood at present. Hence, the countermeasures have not been clear, yet. The bio-mechanical research was done to understand the injuries and three different modes of occupant's motion related to the mechanism were found. Based on this research, Nissan Active Head Restraint has been developed to reduce whiplash neck injuries in low-speed rear impacts. (author)
Fandel, Thomas M.; Albersen, Maarten; Lin, Guiting; Qiu, Xuefeng; Ning, Hongxiu; Banie, Lia; Lue, Tom F.; Lin, Ching-Shwun
Background Intracavernous (IC) injection of stem cells has been shown to ameliorate cavernous-nerve (CN) injury-induced erectile dysfunction (ED). However, the mechanisms of action of adipose-derived stem cells (ADSC) remain unclear. Objectives To investigate the mechanism of action and fate of IC injected ADSC in a rat model of CN crush injury. Design, setting, and participants Sprague-Dawley rats (n = 110) were randomly divided into five groups. Thirty-five rats underwent sham surgery and IC injection of ADSC (n = 25) or vehicle (n = 10). Another 75 rats underwent bilateral CN crush injury and were treated with vehicle or ADSC injected either IC or in the dorsal penile perineural space. At 1, 3, 7 (n = 5), and 28 d (n = 10) postsurgery, penile tissues and major pelvic ganglia (MPG) were harvested for histology. ADSC were labeled with 5-ethynyl-2-deoxyuridine (EdU) before treatment. Rats in the 28-d groups were examined for erectile function prior to tissue harvest. Measurements IC pressure recording on CN electrostimulation, immunohistochemistry of the penis and the MPG, and number of EdU-positive (EdU+) cells in the injection site and the MPG. Results and limitations IC, but not perineural, injection of ADSC resulted in significantly improved erectile function. Significantly more EdU+ ADSC appeared in the MPG of animals with CN injury and IC injection of ADSC compared with those injected perineurally and those in the sham group. One day after crush injury, stromal cell-derived factor-1 (SDF-1) was upregulated in the MPG, providing an incentive for ADSC recruitment toward the MPG. Neuroregeneration was observed in the group that underwent IC injection of ADSC, and IC ADSC treatment had beneficial effects on the smooth muscle/collagen ratio in the corpus cavernosum. Conclusions CN injury upregulates SDF-1 expression in the MPG and thereby attracts intracavernously injected ADSC. At the MPG, ADSC exert neuroregenerative effects on the cell bodies of injured nerves
Goniewicz, K; Goniewicz, M; Pawłowski, W; Fiedor, P
Nowadays, the problem of road accident rates is one of the most important health and social policy issues concerning the countries in all continents. Each year, nearly 1.3 million people worldwide lose their life on roads, and 20-50 million sustain severe injuries, the majority of which require long-term treatment. The objective of the study was to identify the most frequent, constantly occurring causes of road accidents, as well as outline actions constituting a basis for the strategies and programmes aiming at improving traffic safety on local and global levels. Comparative analysis of literature concerning road safety was performed, confirming that although road accidents had a varied and frequently complex background, their causes have changed only to a small degree over the years. The causes include: lack of control and enforcement concerning implementation of traffic regulation (primarily driving at excessive speed, driving under the influence of alcohol, and not respecting the rights of other road users (mainly pedestrians and cyclists), lack of appropriate infrastructure and unroadworthy vehicles. The number of fatal accidents and severe injuries, resulting from road accidents, may be reduced through applying an integrated approach to safety on roads. The strategies and programmes for improving road traffic should include the following measures: reducing the risk of exposure to an accident, prevention of accidents, reduction in bodily injuries sustained in accidents, and reduction of the effects of injuries by improvement of post-accident medical care.
Huang, Ding-wei; Huang, Wei-neng
The benefits of traffic signal synchronization are examined within the cellular automata approach. The microsimulations of traffic flow are obtained with different settings of signal period T and time delay delta. Both numerical results and analytical approximations are presented. For undersaturated traffic, the green-light wave solutions can be realized. For saturated traffic, the correlation among the traffic signals has no effect on the throughput. For oversaturated traffic, the benefits of synchronization are manifest only when stochastic noise is suppressed.
Full Text Available Abstract Background There is increasing evidence that residential proximity to roadways is associated with an elevated risk of asthma exacerbation. However, there is no consensus on the distance at which these health effects diminishes to background levels. Therefore the optimal, clinically relevant measure of exposure remains uncertain. Using four spatially defined exposure metrics, we evaluated the association between residential proximity to roadways and emergency department (ED presentation for asthma in Perth, Western Australia. Method The study population consisted of 1809 children aged between 0 and 19 years who had presented at an ED between 2002 and 2006 and were resident in a south-west metropolitan area of Perth traversed by major motorways. We used a 1:2 matched case-control study with gastroenteritis and upper limb injury as the control conditions. To estimate exposure to traffic emissions, we used 4 contrasting methods and 2 independently derived sources of traffic data (video-monitored traffic counts and those obtained from the state government road authority. The following estimates of traffic exposure were compared: (1 a point pattern method, (2 a distance-weighted traffic exposure method, (3 a simple distance method and (4 a road length method. Results Risk estimates were sensitive to socio-economic gradients and the type of exposure method that was applied. Unexpectedly, a range of apparent protective effects were observed for some exposure metrics. The kernel density measure demonstrated more than a 2-fold (OR 2.51, 95% CI 2.00 - 3.15 increased risk of asthma ED presentation for the high exposure group compared to the low exposure group. Conclusion We assessed exposure using traffic data from 2 independent sources and compared the results of 4 different exposure metric types. The results indicate that traffic congestion may be one of the most important aspects of traffic-related exposures, despite being overlooked in many
Traumatic brain injury (TBI) is a common cause of mortality and severe morbidity. Although there have been significant advances in management, associated severe injuries, in particular chest injuries, remain a major challenge. Extracranial injuries, especially chest injuries increase mortality in patients with TBI in both short.
May 4, 2012 ... Traffic problem is classified into single and mixed, especially in most developing countries, where motorbikes are ..... The traffic light control system presented by its location on ... multi-destination dynamic routing and real-time.
Full Text Available Myocardial injury after noncardiac surgery (MINS is a newly proposed concept that is common among adults undergoing noncardiac surgery and associated with substantial mortality. We analyzed whether MINS was a risk factor for weaning failure in critical patients who underwent major abdominal surgery.This retrospective study was conducted in the Department of Critical Care Medicine of Peking University People's Hospital. The subjects were all critically ill patients who underwent major abdominal surgery between January 2011 and December 2013. Clinical and laboratory parameters during the perioperative period were investigated. Backward stepwise regression analysis was performed to evaluate MINS relative to the rate of weaning failure. Age, hypertension, chronic renal disease, left ventricular ejection fraction before surgery, Acute Physiologic and Chronic Health Evaluation II score, pleural effusion, pneumonia, acute kidney injury, duration of mechanical ventilation before weaning and the level of albumin after surgery were treated as independent variables.This study included 381 patients, of whom 274 were successfully weaned. MINS was observed in 42.0% of the patients. The MINS incidence was significantly higher in patients who failed to be weaned compared to patients who were successfully weaned (56.1% versus 36.5%; P<0.001. Independent predictive factors of weaning failure were MINS, age, lower left ventricular ejection fraction before surgery and lower serum albumin level after surgery. The MINS odds ratio was 4.098 (95% confidence interval, 1.07 to 15.6; P = 0.04. The patients who were successfully weaned had shorter hospital stay lengths and a higher survival rate than those who failed to be weaned.MINS is a risk factor for weaning failure from mechanical ventilation in critical patients who have undergone major abdominal surgery, independent of age, lower left ventricular ejection fraction before surgery and lower serum albumin levels after
Negussie, Abel; Getie, Andarge; Manaye, Elias; Tekle, Tamrat
Traumatic injuries continue to be an important cause of morbidity and mortality in the developing world. Despite the high burden of injury in Ethiopia, the occurrence and health impact have not received due attention. The aim of the study was to assess the prevalence and outcome of injury among patients visiting the Emergency Department (ED) of Yirgalem General Hospital, southern Ethiopia. A facility-based prospective cross sectional study was conducted from March, 27 - April, 30/2017. The final calculated sample size was 353 and all eligible trauma patients who visited the ED of Yirgalem General Hospital during the study period were included in the study. Data was collected using a checklist which was adapted from the WHO injury surveillance guideline. The data were entered and analyzed using SPSS version 19. A total of 346 patients, who visited the ED during the study period, participated in the study and of them, 171 (49.4%) were injury cases. Unintentional injuries accounted 123 (71.9%) of the total injuries and the age group ≤24 years (48.2%) was the most commonly affected age group. More than half (51.4%) of unintentional injury cases were due to Road Traffic Injuries (RTIs) and 48 (28%) of the cases were attributed to interpersonal violence (assault). The majority of patients, 97 (56.7%), had a minor or superficial injury (like bruises and minor cuts), 44 (25.7%) had a moderate injury and 16 (9.3%) had severe type of injury requiring intensive medical/surgical management; and RTIs accounted for 11 (68%) of all severe injuries. The prevalence of injury was considerably high in Yirgalem General Hospital. Road Traffic Injuries (RTIs) accounted for the majority of severe injury cases; therefore, appropriate prevention strategies should be strengthened and implemented against RTIs. We also suggest that children and young adults should be educated in schools and work environments to prevent injuries/accidents.
Wood, F M; Kolybaba, M L; Allen, P
The need to achieve rapid wound closure in patients with massive burns and limited skin donor sites led to the investigation of in vitro cellular expansion of keratinocytes. The use of cultured epithelial autografts (CEA) was first reported in the treatment of major burns in 1981. Since that time, support for the use of CEA has varied, ranging from 'a useful agent' to having 'no demonstrable effect on the outcome of extensively burned patients'. This critical review of the literature examines issues associated with the use of CEA and the introduction of the technology into clinical practice. The factors potentially limiting the use of cultured CEA are the time necessary to culture CEA sheets, the reliability of 'take', vulnerability of grafts on the newly healed surface, long-term durability and the cost implications of such treatment. The available literature was located and critically evaluated using the Australian National Health and Medical Research Council Guidelines. In the identified literature, the level of evidence to support the use of CEA in major burn injures is limited and often restricted to case studies and case series with no Level 1 evidence currently available. The main question arising 'Does CEA have a role in the treatment of major burns?' has proven difficult to answer due to the wide variation in both the quality of study design and the findings. At best, the literature review has highlighted areas of concern that have hindered the successful use of CEA. Our review critically evaluates the use of CEA and explores the advances in techniques towards attempting to improve reliable clinical implementation of CEA. The need for higher level research into the use of CEA is emphasised by this review.
Kong, V Y; Odendaal, J J; Bruce, J L; Laing, G L; Jerome, E; Sartorius, B; Brysiewicz, P; Clarke, D L
Trauma is an eminently preventable disease. However, prevention programs divert resources away from other priorities. Costing trauma related diseases helps policy makers to make decisions on re-source allocation. We used data from a prospective digital trauma registry to cost Traumatic Brain Injury (TBI) at our institution over a two-year period and to estimate the funding gap that exists in the care of TBI. All patients who were admitted to the Pietermaritzburg Metropolitan Trauma Service (PMTS) with TBI were identified from the Hybrid Electronic Medical Registry (HMER). A micro-costing model was utilised to generate costs for TBI. Costs were generated for two scenarios in which all moderate and severe TBI were admitted to ICU. The actual cost was then sub-tracted from the scenario costs to establish the funding gap. During the period January 2012 to December 2014, a total of 3 301 patients were treated for TBI in PMB. The mean age was 30 years (SD 50). There were 2 632 (80%) males and 564 (20%) females. The racial breakdown was overwhelmingly African (96%), followed by Asian (2%), Caucasian (1%) and mixed race (1%). There were 2 540 mild (GCS 13-15), 326 moderate (9-12), and 329 severe (GCS ≤8) TBI admissions during the period under review. A total of 139 patients died (4.2%). A total of 242 (7.3%) patients were admitted to ICU. Of these 137 (57%) had a GCS of 9 or less. A total of 2 383 CT scans were performed. The total cost of TBI over the two-year period was ZAR 62 million. If all 326 patients with moderate TBI had been admitted to ICU there would have been a further 281 ICU admissions. This was labelled Scenario 1. If all patients with severe as well as moderate TBI had been admitted there would have been a further 500 ICU admissions. This was labelled Scenario 2. Based on Scenario 1 and Scenario 2 the total cost would have been ZAR 73 272 250 and ZAR 82 032 250 respectively. The funding gaps for Scenario 1 and Scenario 2 were ZAR 11 240 000 and ZAR 20 000
Dittrich, M.G.; Beek, P.J.G. van
Road traffic noise is one of the major environmental noise sources that is known to cause health problems. Despite existing noise reception items, the continuing growth of traffic causes higher levels than the lims allow. Consequently, excessive costs are incurred for noise barriers along roads and
Background: Injuries are a common cause of morbidity and mortality in the developing world with road traffic ... Methods: All musculoskeletal injury patients presenting to Mulago Hospital were prospectively .... who fell or were injured in sports.
Bai, R; Chen, M
To analyse the characteristics of road traffic accident deaths in Haikou city, and to provide reference for the identification of causes of death and the preventive measures. Totally 498 road traffic accident deaths accepted by the Traffic Police Branch of Haikou City Public Security Bureau in 2014-2016 were collected, and the related parameters such as sex, age, time of the accidents, travel mode of the victims, the types of vehicle and the cause of death were analysed. Most victims aged 21-40 years old with the sex ratio of 3:1, and the accidents mainly happened in March, April, May and October and peaked at 6：01-8：00 and 20：01-22：00 per day. Riding motorbike and electric bicycle, as travel modes, had the highest accident incidence （30.9%）. The vast majority of involved vehicles were motorbike and electric bicycle （57.4%）. The most common cause of death was craniocerebral injury, followed by chest and abdominal injury. The autopsy of road traffic accident deaths plays an important role in identification of death manner and responsibility confirmation. Copyright© by the Editorial Department of Journal of Forensic Medicine
Traffic Flow Management involves the scheduling and routing of air traffic subject to airport and airspace capacity constraints, and the efficient use of available airspace. Significant challenges in this area include: (1) weather integration and forecasting, (2) accounting for user preferences in the Traffic Flow Management decision making process, and (3) understanding and mitigating the environmental impacts of air traffic on the environment. To address these challenges, researchers in the Traffic Flow Management area are developing modeling, simulation and optimization techniques to route and schedule air traffic flights and flows while accommodating user preferences, accounting for system uncertainties and considering the environmental impacts of aviation. This presentation will highlight some of the major challenges facing researchers in this domain, while also showcasing recent innovations designed to address these challenges.
Matthew T James
Full Text Available Purpose of review: Acute kidney injury (AKI is common after major surgery, and is associated with morbidity, mortality, increased length of hospital stay, and high health care costs. Although recent guidelines for AKI provide recommendations for identification of patients at risk, monitoring, diagnosis, and management of AKI, there is lack of understanding to guide successful implementation of these recommendations into clinical practice. Sources of information: We held a planning meeting with multidisciplinary stakeholders to identify barriers, facilitators, and strategies to implement recommendations for prevention, early identification, and management of AKI after major surgery. Barriers and facilitators to knowledge use for peri-operative AKI prevention and care were discussed. Findings: Stakeholders identified barriers in knowledge (how to identify high-risk patients, what criteria to use for diagnosis of AKI, attitudes (self-efficacy in preventive care and management of AKI, and behaviors (common use of diuretics, non-steroidal anti-inflammatory drugs, withholding of intravenous fluids, and competing time demands in peri-operative care. Educational, informatics, and organizational interventions were identified by stakeholders as potentially useful elements for future interventions for peri-operative AKI. Limitation: Meeting participants were from a single centre. Implications: The information and recommendations obtained from this stakeholder's meeting will be useful to design interventions to improve prevention and early care for AKI after major surgery.
Full Text Available Introduction: Globally, road traffic accidents rank 8th among the leading causes of death. According to WHO data, deaths from road traffic injuries account for around 25% of all deaths from injury.Objective: To study the various correlates of road traffic accident in cases attending LLR Hospital, Kanpur.Materials and Methods: The study was conducted among road traffic accident cases attending Emergency Ward of Lala Lajpat Rai Hospital, Kanpur, Uttar Pradesh during the period of March-September, 2015. Data was recorded in a pre-designed and pre-tested questionnaire and analyzed using SPSS software version 16.0.Results: Out of 609 RTA cases, maximum number (54.19% were in 20-40 years age group. Most of the RTA victims were males (69.95% and majority were literate (90.97%. Maximum number (28.74% of RTA took place between 4.00 p.m-8.00 p.m. Maximum number (36.95% of RTA victims were two-wheeler drivers, followed by two-wheeler riders (26.60%. 16.60% of drivers of motorized vehicles had no driving license. 85.48% of motorized vehicle users were not using any protective gear (helmet, seat belt etc. at the time of accident.Conclusion: Young adults in the economically most productive age group were the commonest victims of RTA. There is need of creating awareness regarding traffic rules among general public and strict enforcement of traffic rules by the concerned authorities.
Traffic jams are everywhere, some are caused by constructions or accidents but a large portion occurs naturally. These "natural" traffic jams are a result of variable driving speeds combined with a high number of vehicles. To prevent these traffic jams, we must understand traffic in general, and to
Full Text Available Injuries are a growing public health concern in China, accounting for more than 30% of all Person Years of Life Lost (PYLL due to premature mortality. This study analyzes the trend and disease burden of injury deaths in Chinese population from 2004 to 2010, using data from the National Disease Surveillance Points (DSPs system, as injury deaths are classified based on the International Classification of Disease-10(th Revision (ICD-10. We observed that injury death accounted for nearly 10% of all deaths in China throughout the period 2004-2010, and the injury mortality rates were higher in males than those in females, and higher in rural areas than in urban areas. Traffic crashes (33.79-38.47% of all injury deaths and suicides (16.20-22.01% were the two leading causes of injury deaths. Alarmingly, suicide surpassed traffic crashes as the leading cause of injury mortality in rural females, yet adults aged 65 and older suffered the greatest number of fatal falls (20,701 deaths, 2004-2010. The burden of injury among men (72.11% was about three times more than that of women's (28.89%. This study provides indispensible evidence that China Authority needs to improve the surveillance and deterrence of three major types of injuries: Traffic-related injury deaths should be targeted for injury prevention activities in all population, people aged 65+ should be encouraged to take individual fall precautions, and prevention of suicidal behavior in rural females should be another key priority for the government of China.
Hailemichael, Feleke; Suleiman, Mohammed; Pauolos, Wondimagegn
A Road traffic accident is an incident on a way or street open to public traffic, resulting in one or more persons being killed or injured, and involving at least one moving vehicle. The aim of this study is to assess magnitude and outcome of road traffic accidents among trauma victims at hospitals in Wolaita zone. A cross sectional hospital based study design using retrospective chart review was conducted from March 5th to March 25th, 2014. Simple random sampling technique was applied to identify sample population. The data was entered in to Epi info version 3.5.1 and transferred to SPSS version 16 for further analysis. A total of 384 trauma victims were incorporated in the study of which 240 (62.5%) were due to road traffic accidents. The majority of patients were male 298 (77.6%) and most commonly aged between 20-29 (35.42%). The principal outcome of injury was more commonly lower extremity (182 patients, 47.4%), compared to upper extremity (126 patients, 32.8%). Of all trauma patient presenting to hospitals (62.5%) are the result of road traffic accident. Hence, the provision of tailored messages to all members of the community regarding knowledge and practices of road safety measures like appropriate use of pavements by pedestrians and avoiding risky driving behaviors. Besides this make use of compulsory motorcycle helmets would appear to be a very important intervention.
Pathak, S M; Jindal, A K; Verma, A K; Mahen, A
Road traffic accidents are a leading cause of mortality and morbidity globally. In India, more than a million are injured annually and about a lakh are killed in road traffic accidents.(1) It causes the country to lose around 55,000 crores annually which is 2-3% of Gross Domestic Production (GDP).(2) This cross sectional study was conducted to elucidate the role of various factors involved in road traffic accidents. Road traffic accident cases admitted to a tertiary care hospital between 01 Oct 2009 and 28 Feb 2011 were included in the study. A total of 182 patients were studied. Information was collected through questionnaire, hospital records and on-site visit. OPD cases, comatose patients and deaths were excluded. Two-wheelers were the commonest vehicle involved in vehicular accidents. Most accidents happened at a speed of 40-60 km/h (37.9%). Most of the patients were aged between 20 and 30 years. Majority had a driving experience of less than 5 years. Monsoons witnessed 46.7% cases. Most cases occurred between 6 and 10 pm. Among severe injuries, the commonest was lower limb fractures (19.8%). There are multiple factors associated with road traffic accidents which due to the lack of road safety measures in the country are playing their role. It is the need of the hour to address this issue and formulate comprehensive, scientific and practical rules and regulations as well as evaluate its enforcement.
Vu, Anh Tuan; Nguyen, Dinh Vinh Man
In recent years, the number of road traffic accidents, fatalities and injuries have been decreasing, but the figures of children road traffic accidents have been increasing in Ho Chi Minh City of Vietnam. This fact strongly calls for implementing effective solutions to improve traffic safety for children by the local government. This paper presents the trends, patterns and causes of road traffic accidents involving children based on the analysis of road traffic accident data over the period 2010-2015 and the video-based observations of road traffic law violations at 15 typical school gates and 10 typical roads. The results could be useful for the city government to formulate solutions to effectively improve traffic safety for children in Ho Chi Minh City and other cities in Vietnam.
Background: Road traffic accident is a major but neglected public health challenge. There is a paucity of published data on road traffic crashes in Amhara National Regional State. Objective: This study attempts to describe the main causes and consequences of road traffic accidents in the Amhara Region. Methods: This ...
Sammy, Ian Ayenga; Chatha, Hridesh; Lecky, Fiona; Bouamra, Omar; Fragoso-Iñiguez, Marisol; Sattout, Abdo; Hickey, Michael; Edwards, John E
First rib fractures are considered indicators of increased morbidity and mortality in major trauma. However, this has not been definitively proven. With an increased use of CT and the potential increase in detection of first rib fractures, re-evaluation of these injuries as a marker for life-threatening injuries is warranted. Patients sustaining rib fractures between January 2012 and December 2013 were investigated using data from the UK Trauma Audit and Research Network. The prevalence of life-threatening injuries was compared in patients with first rib fractures and those with other rib fractures. Multivariate logistic regression was performed to determine the association between first rib fractures, injury severity, polytrauma and mortality. There were 1683 patients with first rib fractures and 8369 with fractures of other ribs. Life-threatening intrathoracic and extrathoracic injuries were more likely in patients with first rib fractures. The presence of first rib fractures was a significant predictor of injury severity (Injury Severity Score >15) and polytrauma, independent of mechanism of injury, age and gender with an adjusted OR of 2.64 (95% CI 2.33 to 3.00) and 2.01 (95% CI 1.80 to 2.25), respectively. Risk-adjusted mortality was the same in patients with first rib fractures and those with other rib fractures (adjusted OR 0.97, 95% CI 0.79 to 1.19). First rib fractures are a marker of life-threatening injuries in major trauma, though they do not independently increase mortality. Management of patients with first rib fractures should focus on identification and treatment of associated life-threatening injuries. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) [year]. All rights reserved. No commercial use is permitted unless otherwise expressly granted.
Sammy, Ian Ayenga; Chatha, Hridesh; Lecky, Fiona; Bouamra, Omar; Fragoso-I?iguez, Marisol; Sattout, Abdo; Hickey, Michael; Edwards, John E
Background: First rib fractures are considered indicators of increased morbidity and mortality in major trauma. However, this has not been definitively proven. With an increased use of CT and the potential increase in detection of first rib fractures, re-evaluation of these injuries as a marker for life-threatening injuries is warranted.\\ud \\ud Methods: Patients sustaining rib fractures between January 2012 and December 2013 were investigated using data from the UK Trauma Audit and Research N...
Shapira, S C
The trauma registry network constitutes an essential database in every injury prevention system. In order to rationally estimate the extent of injury in general, and injuries from traffic accidents in particular, the trauma registry systems should contain the most comprehensive and broad database possible, in line with the operational definitions. Ideally, the base of the injury pyramid should also include mild injuries and even "near-misses". The Israeli National Trauma Registry has come a long way in the last few years. The eventual inclusion of all trauma centers in Israel will enable the establishment of a firm base for the allocation of resources by decision-makers.
May 2, 2017 ... Introduction: Road traffic accidents (RTAs) are a major cause of death and disability in ... death in many parts of the world resulting in economic ... The long civil war ... the second highest number compared to private cars. In.
Santosh B Dalavi
Full Text Available An unusual penetrating chest injury was caused by high velocity road traffic accident. An 18-year-old had a four wheeler accident and was brought in emergency department with a ′bamboo′ stick on the left side chest exiting through back. After the stabilization of vital parameters, an inter-costal tube drainage was done on the left side. Except the minor brochopleural fistula which healed by 10 th day, his recovery was uneventful. The outcome was consistent with current aggressive management of penetrating chest injuries. Management of penetrating chest injury involving pulmonary trauma is based on three principles. One is stabilization of hemodynamics of patient with proper clinical evaluation. Second, a mere intercostal tube drainage sufficient for majority of the cases. Third, post-operative active as well as passive physiotherapy is necessary for speedy recovery.
Yaseen, Afshan; Tresa, Vina; Lanewala, Ali Asghar; Hashmi, Seema; Ali, Irshad; Khatri, Sabeeta; Mubarak, Muhammed
Acute kidney injury (AKI) is an important complication of idiopathic nephrotic syndrome (INS) and is associated with adverse outcomes, especially the development of chronic kidney disease (CKD). We aimed to determine the clinical profile of children with INS who developed AKI and its short-term outcome. This prospective study was conducted from March 2014 to October 2015. A total of 119 children of INS (age: 2-18 years) fulfilling the pediatric RIFLE criteria for the diagnosis of AKI were enrolled and followed up for 3 months to determine the outcome. Factors predisposing to CKD were studied. The mean age at presentation was 8.8 ± 3.59 years and males were 74 (62.2%). At presentation, 61 (51.3%) children were in Risk category, 43 (36.1%) in Injury category, and 15 (12.6%) in Failure category. Most of them (41.2%) had steroid-resistant nephrotic syndrome (SRNS) and focal segmental glomerulosclerosis (FSGS) on histopathology (33.6%). Infections were the major predisposing factor for AKI in 67 (56.3%) cases. Drug toxicity was the next common, found in 52 (43.7%) children. A total of 65 (54.6%) children recovered from AKI, while 54 (45.4%) did not. CKD developed in 49 (41.2%) non-recovered cases and 5 (4.2%) children succumbed to acute illness. SRNS, cyclosporine use, FSGS on histology, and drug toxicity were significant factors associated with the development of CKD. AKI associated with INS is a reversible condition in most cases but it can progress to CKD, especially among those who have SRNS, FSGS, and drug toxicity.
Wee, Jing Zhong; Yang, Yun Rui Jasmine; Lee, Qian Yi Ruth; Cao, Kelly; Chong, Chin Ted
Trauma is the fifth principal cause of death in Singapore, with traumatic brain injury (TBI) being the leading specific subordinate cause. This study was an eight-year retrospective review of the demographic profiles of patients with severe TBI who were admitted to the neurointensive care unit (NICU) of the National Neuroscience Institute at Tan Tock Seng Hospital, Singapore, between 2004 and 2011. A total of 780 TBI patients were admitted during the study period; 365 (46.8%) patients sustained severe TBI (i.e. Glasgow Coma Scale score ≤ 8), with the majority (75.3%) being male. The ages of patients with severe TBI ranged from 14-93 years, with a bimodal preponderance in young adults (i.e. 21-40 years) and elderly persons (i.e. > 60 years). Motor vehicle accidents (48.8%) and falls (42.5%) were the main mechanisms of injury. Invasive line monitoring was frequently employed; invasive arterial blood pressure monitoring and central venous pressure monitoring were used in 81.6% and 60.0% of the patients, respectively, while intracranial pressure (ICP) measurement was required in 47.4% of the patients. The use of tiered therapy to control ICP (e.g. sedation, osmotherapy, cerebrospinal fluid drainage, moderate hyperventilation and barbiturate-induced coma) converged with international practices. The high-risk groups for severe TBI were young adults and elderly persons involved in motor vehicle accidents and falls, respectively. In the NICU, the care of patients with severe TBI requires heavy utilisation of resources. The healthcare burden of these patients extends beyond the acute critical care phase.
Road traffic accidents (RTAs) were the most common cause of injury accounting for 49.2% of patients. Scalp injuries, cerebral concussion and skull fractures were the most common type of head injuries. Fifty-six (21.5%) patients had associated injuries of which musculoskeletal region (36.1%) was commonly affected.
Full Text Available Undoubtedly air transport in today’s world wouldn’t be able to exist without any air traffic control service. As the air transport has been coming through major changes and it has been expanding, it is assumed that its volume will be doubled in the next 15 years. Air traffic control uses strictly organised procedures to ensure safe course of air operations. With the skies covered with more airplanes every year, new tools must be introduced to allow the controllers to manage this rising amount of flying aircraft and to keep the air transport safe. This paper provides a comprehensive and organized material, which describes the newest tools and systems used by air traffic control officers. It proposes improvements for further research and development of ATC tools.
Chang, Yi-Sheng; Teng, Yu-Ti; Huang, Yi-Hsun; Liu, Mei-Ling; Hung, Jia-Horung; Hsu, Sheng-Min; Huang, Fu-Chin; Shih, Min-Hsiu; Chen, Wan-Ju; Lai, Chun-Chieh; Hsiao, Shu-Fang; Wang, Shih-Hao; Tseng, Sung-Huei
We investigated the temporal changes in major eye injuries in Taiwan by reviewing the medical records of all patients with ocular trauma hospitalized at the National Cheng Kung University Hospital during 2002-2004 and 2012-2014. A total of 169 eyes (161 patients) during 2002-2004 and 121 eyes (120 patients) during 2012-2014 were enrolled (mean ± SD age: 41.9 ± 20.8 years in 2002-2004, and 51.8 ± 19.3 years in 2012-2014). Males accounted for ~75% of patients. The most frequent injury-causing object was metallic material (~24%), and blunt traumas were most frequently attributable to traffic accidents and falls. The most common locations of injuries for males and females were the workplace and home, respectively. Open-globe injuries occurred in ~70% of eyes, requiring primary repair, cataract extraction, and/or intraocular lens implantation. The frequencies of fall injury, lacrimal system laceration, lens injury, corneal/scleral foreign bodies, and use of intracameral antibiotics increased from 2002-2004 to 2012-2014, while those of closed-globe injury, vitreous haemorrhage, optic nerve injury, and medical treatment decreased. The final visual acuity remained poor (≤20/200) in >1/3 of injured eyes. Despite therapeutic advancements, major eye injuries still pose a high risk for poor visual outcome.
Conclusion: This study findings provide useful information for setting priorities in order to prevent the traffic accidents injuries. In addition, appropriate intervention programs are necessary in order to prevent traffic accidents and their complications, as well as to minimize injuries in accordance with other relevant organizations.
there were 6861 injury trafficc accidents reported by the police, resulting in 4519 minor injuries, 3946 serious injuries, and 431 fatalities. The general purpose of the research was to improve the insight into aggregated road safety methodology in Denmark. The aim was to analyse advanced statistical methods......, that were designed to study developments over time, including effects of interventions. This aim has been achieved by investigating variations in aggregated Danish traffic accident series and by applying state of the art methodologies to specific case studies. The thesis comprises an introduction...
Ding Jianping; Li Yuqing; Zhang Zekun; Yu Baohai; Liu Yicun; Peng Zhigang; Zhang Min; Wang Dongmei; Cao Hongwei; Jiang Xuexiang
Objective: To investigate the status of musculoskeletal articles and musculoskeletal injury articles published in the major journals of radiology in China and compare with abroad during the last decade. Methods: Statistic analysis and comparison were done with musculoskeletal injury articles published in the major journals of radiology in China and abroad. The number, category, exam methods, study region and study contents were analyzed respectively. The journals in China included Chinese Journal of Radiology, Journal of Clinical Radiology and Journal of Practical Radiology. The journals at abroad included Radiology, the American Journal of Roentgenology (AJR), the British Journal of Radiology (B JR ) and Skeletal Radiology. Results: The rate of musculoskeletal articles among the treatise articles was 13.0% (827/6352) in China and 10.4% (900/8659) in three kinds of compressive journals at abroad. The rate of musculoskeletal injury articles in musculoskeletal articles was 21.5% (178/827) in China and 10.8% (97/900) abroad. Among the review articles, the rate was 9.9% (73/741) and 13.7% (10/73)in China, respectively, while that was 4.3% (34/783)and 23.5% (8/34), respectively abroad. Among the case reports, the rate was 17.0% (675/3971) and 3.4% (23/675) in China respectively, while that was 8.8% (177/2019) and 14.7% (26/177), respectively abroad. The rate of exam methods which only used X-ray plain film in injury articles was 11.7% (26/222), mainly CT was 42.8% (95/222) and mainly MR was 27% (60/222) in China, while that was 10.9% (32/295), 9.8% (29/295) and 32.5% (96/295), respectively in four kinds of journals at abroad. The combination examination was 16.2% (36/222) in China and 42.0% (124/295) at abroad respectively. The other was 2.3% (5/222) in China and 4.8% (14/295) at abroad. As for the study region, the rate of vertebrate column was 22.5% (50/222), knee joint was 21.1% (47/222), cranial and facial bones was 15.3% (34/222), hip joint was 7.2% (16
Harris, M Anne; Reynolds, Conor C O; Winters, Meghan; Cripton, Peter A; Shen, Hui; Chipman, Mary L; Cusimano, Michael D; Babul, Shelina; Brubacher, Jeffrey R; Friedman, Steven M; Hunte, Garth; Monro, Melody; Vernich, Lee; Teschke, Kay
Background This study examined the impact of transportation infrastructure at intersection and non-intersection locations on bicycling injury risk. Methods In Vancouver and Toronto, we studied adult cyclists who were injured and treated at a hospital emergency department. A case–crossover design compared the infrastructure of injury and control sites within each injured bicyclist's route. Intersection injury sites (N=210) were compared to randomly selected intersection control sites (N=272). Non-intersection injury sites (N=478) were compared to randomly selected non-intersection control sites (N=801). Results At intersections, the types of routes meeting and the intersection design influenced safety. Intersections of two local streets (no demarcated traffic lanes) had approximately one-fifth the risk (adjusted OR 0.19, 95% CI 0.05 to 0.66) of intersections of two major streets (more than two traffic lanes). Motor vehicle speeds less than 30 km/h also reduced risk (adjusted OR 0.52, 95% CI 0.29 to 0.92). Traffic circles (small roundabouts) on local streets increased the risk of these otherwise safe intersections (adjusted OR 7.98, 95% CI 1.79 to 35.6). At non-intersection locations, very low risks were found for cycle tracks (bike lanes physically separated from motor vehicle traffic; adjusted OR 0.05, 95% CI 0.01 to 0.59) and local streets with diverters that reduce motor vehicle traffic (adjusted OR 0.04, 95% CI 0.003 to 0.60). Downhill grades increased risks at both intersections and non-intersections. Conclusions These results provide guidance for transportation planners and engineers: at local street intersections, traditional stops are safer than traffic circles, and at non-intersections, cycle tracks alongside major streets and traffic diversion from local streets are safer than no bicycle infrastructure. PMID:23411678
Increasingly, Florida traffic is monitored electronically by components of the Intelligent Traffic System (ITS), which send data to regional traffic management centers and assist management of traffic flows and incident response using software called...
New, Occasional, and Frequent Use of Zolpidem or Zopiclone (Alone and in Combination) and the Risk of Injurious Road Traffic Crashes in Older Adult Drivers: A Population-Based Case-Control and Case-Crossover Study.
Nevriana, Alicia; Möller, Jette; Laflamme, Lucie; Monárrez-Espino, Joel
Previous studies on the effect of zolpidem or zopiclone use on the risk of road traffic crashes (RTCs) have shown mixed results. Our objective was to determine the association between zolpidem or zopiclone use (as separate drugs or combined) and the occurrence of injurious RTCs among older adult drivers. This was a population-based matched case-control and case-crossover study based on secondary data linked together from Swedish national registers. Cases were drivers aged 50-80 years involved in a vehicle crash resulting in injuries between January 2006 and December 2009 for the case-control study (n = 27,096) and from February 2006 to December 2009 for the case-crossover study (n = 26,586). For the first design, four controls were matched to each case by sex, age, and residential area, and exposure was categorized into new, occasional, and frequent use of zolpidem only, zopiclone only, and combined zolpidem and zopiclone. For the case-crossover study, newly dispensed zolpidem or zopiclone users were assessed during the 28 days prior to the crash and compared with an equally long control period using a 12-week washout period. Matched adjusted odds ratios (OR) were computed using conditional logistic regression. Increased ORs for all users were observed. In the case-control study, the highest odds were seen among newly initiated zolpidem-only users involved in single-vehicle crashes (adjusted OR 2.27; 95% confidence interval [CI] 1.21-4.24), followed by frequent combined zolpidem and zopiclone users [adjusted OR 2.20; CI 1.21-4.00]. In the case-crossover, newly initiated treatment with zolpidem or zopiclone showed an increased risk that was highest in the 2 weeks after the start of the treatment (OR 2.66; 95% CI 1.04-6.81). These results provide more compelling evidence for the role of zolpidem or zopiclone in the occurrence of RTCs among older adults, not only in frequent users, but also at the beginning of treatment.
Vehicles based on similar traffic operating characteristics are grouped into ... of distances to the video monitor involved using a measuring wheel to mark ... Secondly, the observers reviewed the videotape to sample traffic entity ...... makes a strong case for including service lanes for slow moving vehicles for improving the.
Fang, X; Zeng, G; Linnan, H W; Jing, R; Zhu, X; Corso, P; Liu, P; Linnan, M
This study estimated the incidence, direct medical and non-medical costs, and productivity losses due to morbidity and mortality across multiple strata for injuries that occurred in Jiangxi, China. Cross-sectional study. Data came from the Jiangxi injury survey, a provincially-representative, population-based sample of 100,010 households. The major economic costs of injuries were divided into direct costs and indirect costs. Direct costs encompass medical costs and direct non-medical costs. Indirect costs refer to the productivity losses due to injury-related morbidity and mortality. In 2005, about one of 18 residents in Jiangxi, China, experienced an injury. Overall, fall, animal bite, and road traffic crash (RTC) injuries accounted for more than 66% of all injuries, while fall, RTC, drowning, and self-harm injuries accounted for 80% of fatal injuries. Average cost per case for a fatal injury was 163,389 RMB ($20,171) for lost productivity and 2800 RMB ($346) in direct medical & non-medical costs. A non-fatal injury resulting in hospitalisation or permanent disability on average caused 5221 RMB ($643) in direct costs and 18,437 RMB ($2276) in lost productivity and, an additional loss of three school days. A non-hospitalised non-fatal injury on average caused 303 ($37) RMB in direct costs and 491 RMB ($61) in lost productivity and, an additional loss of 0.5 school days. The unequivocal evidence of the substantial health and financial burden of injuries indicates to Chinese policy makers that more research and efforts are needed to find efficacious and cost-effective interventions targeting injury. Copyright © 2016 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.
Full Text Available Introduction: Legislation making seatbelt use mandatory is considered to have reduced fatal and serious injuries by 25%, with UK government estimates predicting more than 50,000 lives saved since its introduction. However, whilst the widespread use of seatbelts has reduced the incidence of major traumatic injury and death from road-traffic collisions (RTCs, their use has also heralded a range of different injuries. The first ever seatbelt related injury was described in 1956, and since then clear patterns of seatbelt-related injuries have been recognised. Methodology and Findings: This review of the published literature demonstrates that the combination of airbags and three-point seatbelts renders no part of the body free from injury. Serious injuries can, and do, occur even when passengers are properly restrained and attending clinicians should have a high index of suspicion for overt or covert intra-abdominal injuries when patients involved in RTCs attend the Emergency Department. Bruising to the trunk and abdomen in a seatbelt distribution is an obvious sign that suggests an increased risk of abdominal and thoracic injury, but bruising may not be apparent and its absence should not be falsely reassuring. A high index of suspicion should be retained for other subtler signs of injury. Children and pregnant women represent high-risk groups who are particularly vulnerable to injuries. Conclusion: In this review we highlight the common patterns of seatbelt-related injuries. A greater awareness of the type of injuries caused by seatbelt use will help clinicians to identify and treat overt and covert injuries earlier, and help reduce the rates of morbidity and mortality following RTCs.
Department of Transportation — The State Traffic Safety Information (STSI) portal is part of the larger Fatality Analysis Reporting System (FARS) Encyclopedia. STSI provides state-by-state traffic...
Microscopic simulation can provide significant support to traffic management center (TMC) operations. However, traffic simulation applications require data that are expensive and time-consuming to collect. Data collected by TMCs can be used as a prim...
Zhang, Guangnan; Yau, Kelvin K W; Gong, Xiangpu
The number of speeding- and drunk driving-related injuries in China surged in the years immediately preceding 2004 and then began to decline. However, the percent decrease in the number of speeding and drunk driving incidents (decrease by 22%) is not proportional to the corresponding percent decrease in number of automobile accident-related injuries (decrease by 47%) from the year 2004 to 2010 (Traffic Management Bureau, Ministry of Public Security, Annual Statistical Reports on Road Traffic Accidents). Earlier studies have established traffic violations as one of the major risks threatening road safety. In this study, we examine in greater detail two important types of traffic violation events, speeding and drunk driving, and attempt to identify significant risk factors associated with these types of traffic violations. Risk factors in several different dimensions, including driver, vehicle, road and environmental factors, are considered. We analyze the speeding (N=11,055) and drunk driving (N=10,035) data for the period 2006-2010 in Guangdong Province, China. These data, obtained from the Guangdong Provincial Security Department, are extracted from the Traffic Management Sector-Specific Incident Case Data Report and are the only comprehensive and official source of traffic accident data in China. Significant risk factors associating with speeding and drunk driving are identified. We find that several factors are associated with a significantly higher probability of both speeding and drunk driving, particularly male drivers, private vehicles, the lack of street lighting at night and poor visibility. The impact of other specific and unique risk factors for either speeding or drunk driving, such as hukou, road type/grades, commercial vehicles, compulsory third party insurance and vehicle safety status, also require particular attention. Legislative or regulatory measures targeting different vehicle types and/or driver groups with respect to the various driver
Kool, Bridget; Raj, Naina; Wainiqolo, Iris; Kafoa, Berlin; McCaig, Eddie; Ameratunga, Shanthi
Background Globally, head injury is a substantial cause of mortality and morbidity. A disproportionately greater burden is borne by low- and middle-income countries. The incidence and characteristics of fatal and hospitalised head injuries in Fiji are unknown. Methods Using prospective data from the Fiji Injury Surveillance in Hospital system, the epidemiology of fatal and hospitalised head injuries was investigated (2004–2005). Results In total, 226 hospital admissions and 50 fatalities (66% died prior to admission) with a principal diagnosis of head injury were identified (crude annual rates of 34.7 and 7.7/100,000, respectively). Males were more likely to die and be hospitalised as a result of head injury than females. The highest fatality rate was among those in the 30–44-year age group. Road traffic crashes were the leading causes of injuries resulting in death (70%), followed by ‘hit by person or object’ and falls (14% each). Among people admitted to hospital, road traffic crashes (34.5%) and falls (33.2%) were the leading causes of injury. The leading cause of head injuries in children was falls, in 15–29-year-olds road traffic crashes, and in adults aged 30–44 years or 45 years and older ‘hit by person or object’. Among the two major ethnic groups, Fijians had higher rates of falls and ‘hit by person or object’ and Indians higher rates for road traffic crashes. There were no statistically significant differences between the overall rates of head injuries or the fatal and non-fatal rates among Fijians or Indians by gender following age standardisation to the total Fijian national population. Conclusion Despite underestimating the overall burden, this study identified head injury to be a major cause of death and hospitalisation in Fiji. The predominance of males and road traffic-related injuries is consistent with studies on head injuries conducted in other low- and middle-income countries. The high fatality rate among those aged 30–44
Reduciendo el trauma y la mortalidad asociada a los accidentes de tránsito en los peatones en el Perú: intervenciones que pueden funcionar Reducing pedestrian deaths and injuries due to road traffic injuries in Peru: interventions that can work
D. Alex Quistberg
Full Text Available Los peatones peruanos se constituyen como el grupo que sufre la mayor proporción de fatalidades causadas por los accidentes de tránsito en el mundo. El año 2009 los peatones fueron involucrados en 27% de los accidentes de tránsito en el Perú. Este es un problema significativo para la salud pública del país, pues tiene repercusiones económicas importantes. En este artículo se revisa la evidencia disponible para algunas intervenciones implementadas en otros países y enfocadas a la prevención de los atropellos, las que podrían funcionar bien en Perú. De manera consistente, la implementación de intervenciones tales como el calmar el tráfico en áreas específicas a través de reductores de velocidad ("rompemuelles", minirotondas ("óvalos", mejor alumbramiento, calles unidireccionales, desvíos y bloqueos de las calles, tiene una fuerte evidencia en reducir las lesiones y fatalidades en los peatones. Otras intervenciones vinculadas con actividades de educación y hacer cumplir las leyes, podrían tener una función en contextos muy específicos, sin embargo, diseñar y modificar el medio ambiente físico se constituye como una de las intervenciones más importantes.Pedestrians in Peru are the victims of the greatest proportion of road traffic fatalities in the world. In 2009, pedestrians were involved in 27% of road traffic incidents in Peru. This is a significant public health problem in Peru and it has important economic effects as well. We review the evidence for some of the solutions and interventions implemented in other countries that may work well in Peru to confront this problem via preventing pedestrian-vehicle incidents. Most importantly, deploying interventions such as area-wide traffic calming through speed bumps, roundabouts, better lighting, one-way streets, detours, and blocking some roads has the strongest evidence for reducing injuries and fatalities in pedestrians. Other interventions related to education and
Jørgensen, Peter Løchte
This paper introduces, prices, and analyzes traffic light options. The traffic light option is an innovative structured OTC derivative developed independently by several London-based investment banks to suit the needs of Danish life and pension (L&P) companies, which must comply with the traffic...... 2006, and supervisory authorities in many other European countries have implemented similar regulation. Traffic light options are therefore likely to attract the attention of a wider audience of pension fund managers in the future. Focusing on the valuation of the traffic light option we set up a Black...... light scenarios. These stress scenarios entail drops in interest rates as well as in stock prices, and traffic light options are thus designed to pay off and preserve sufficient capital when interest rates and stock prices fall simultaneously. Sweden's FSA implemented a traffic light system in January...
Jørgensen, Peter Løchte
This paper introduces, prices, and analyzes traffic light options. The traffic light option is an innovative structured OTC derivative developed independently by several London-based investment banks to suit the needs of Danish life and pension (L&P) companies, which must comply with the traffic...... 2006, and supervisory authorities in many other European countries have implemented similar regulation. Traffic light options are therefore likely to attract the attention of a wider audience of pension fund managers in the future. Focusing on the valuation of the traffic light option we set up a Black...... light scenarios. These stress scenarios entail drops in interest rates as well as in stock prices, and traffic light options are thus designed to pay off and preserve sufficient capital when interest rates and stock prices fall simultaneously. Sweden's FSA implemented a traffic light system in January...
Full Text Available Objectives: Thoracic injury is a challenge to the thoracic surgeon practicing in developing countries. This prospective study was conducted to see the mode of injury, injury types and overall outcome of thoracic injury in our settings. Materials and methods: This prospective study was conducted in 100 thoracic injury patients between December 2011 to June 2012. The demographic features, type of the trauma, radiological assessment, associated organ injuries, management of the injury, surgical interventions, morbidity, mortality, length of hospital stay were analysed. Results: In this study the ages ranged from 7 to 84 years. There were 73 (73% males and 27 (27% females. The majority of patients (83% were injured during the evening and night time. The majority of patients 92(92% sustained blunt chest injuries. The mechanism of injury was not significantly associated with length of hospital stay (P > 0.05 and mortality (P > 0.05.Road traffic accident was the most common cause of injuries affecting 68(68% of patients followed by fall injury of 19(19%. Rib fractures, haemothorax, pneumothorax and lung contusion were the most common type of injuries accounting for 83.0%, 57%,34% and 33% respectively. Associated extra-thoracic injuries were noted in 64.0% of patients. 45(45% of the cases of haemothorax, pneumotharax and haemopneumothorax were treated by tube thoracotomy. Four patients (04% had undergone thoracotomy. There were 09(09% patients of flail chest and treated conservatively. Fourty six patients (46% were admitted in the ICU. Eleven (11% patients were treated with ventilator support. Seventeen (17% patients had complication. The overall length of hospital stay ranged from 0 to 25 days. Conclusion: Road traffic accidents and fall from height are the major public health problems. Preventive measures at reducing road traffic accidents and timely management with closed tube thoracotomy are the main factors to be considered in the thoracic
Gorbunkov, V Ia; Bugaev, D A; Derevianko, D V
The article discusses the issues of the organization of medical care to victims of road traffic accidents. The analysis of primary appealability of patients to the first-aid center of Stavropol and Novorossiysk during 2008-2010 is presented. The sampling consisted of 904 cases of this kind of trauma. It is established that among victims of road traffic accident appealed to first-aid centers the pedestrians consist the major part. The traumas of limbs are among the most frequently occurred cases. The victims with cranio-cerebral injuries are among those who appealed most frequently for medical aid. Besides that in most cases (63.4%) the victims with cranio-cerebral injuries were transported not to the neurologic surgery clinic but to the first-aid center This action increased the number of transport stages and duration of time gap before specialized medical care was applied. The conclusion is made concerning the need of further development of out-patient urgent medical care to victims of road traffic accidents.
Williams, Ryan T; Heinemann, Allen W; Neumann, Holly Demark; Fann, Jesse R; Forchheimer, Martin; Richardson, Elizabeth J; Bombardier, Charles H
To compare the measurement properties and responsiveness to change of the Patient Health Questionnaire-9 (PHQ-9), the Hopkins Symptom Checklist-20 (HSCL-20), and the Hamilton Depression Rating Scale (HAM-D) in people with spinal cord injury (SCI) diagnosed with major depressive disorder (MDD). Secondary analysis of depression symptoms measured at 6 occasions over 12 weeks as part of a randomized controlled trial of venlafaxine XR for MDD in persons with SCI. Outpatient and community settings. Individuals (N=133) consented and completed the drug trial. Eligibility criteria were age at least 18 years, traumatic SCI, and diagnosis of MDD. Venlafaxine XR. Patients completed the PHQ-9 and the HSCL-20 depression scales; clinical investigators completed the HAM-D and the Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders-Fourth Edition (DSM-IV) Dissociative Disorders, which was used as a diagnostic criterion measure. All 3 instruments were improved with rating scale analysis. The HSCL-20 and the HAM-D contained items that misfit the underlying construct and that correlated weakly with the total scores. Removing these items improved the internal consistency, with floor effects increasing slightly. The HAM-D correlated most strongly with Structured Clinical Interview for DSM-IV Dissociative Disorders diagnoses. Improvement in depression was similar on all outcome measures in both treatment and control groups. The psychometric properties of the revised depression instruments are more than adequate for routine use in adults with SCI and are responsive to clinical improvement. The PHQ-9 is the simplest instrument with measurement properties as good as or better than those of the other instruments and required the fewest modifications. Copyright © 2016 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.
Full Text Available Context: Traffic policemen are at an increased risk of suffering from hazards of noise pollution because they are engaged in controlling traffic noise, particularly at heavy traffic junctions. The effect is more in this subgroup because they are continuously exposed to it. Aim: The present study was aimed at assessing the knowledge, attitude and practices of traffic policemen regarding auditory effects of traffic noise pollution in Ambala city. Settings and Design: Cross-sectional workplace survey. Materials and Methods: The present descriptive study was carried out in different traffic zones of Ambala city during April-June 2013. The study population consisted of 100 traffic policemen working in different traffic intersections of Ambala city. Statistical Analysis Used: Structured interview schedule was used to collect the data. SPSS version 17.0 was used for analysis. Interpretation of data was performed using percentages and proportions. Results: Majority (75% of the study subjects were exposed to traffic noise pollution for more than 5 years. Of the total subjects, 5% of respondents reported below-average hearing on self-assessment of hearing ability. Seventeen percent of the study population accepted that while hearing over phone they do miss some conversation. Most (98% of the traffic police did not use any personal protective equipment (PPEs like earplugs/earmuffs, and the non-availability of these PPEs (90% is the common reason for the hearing loss. Conclusions: The study concludes that traffic policemen are not much aware regarding impending auditory effects of traffic noise pollution. Duty rotation, duty scheduling and other forms of preventive modalities for exposure limitation are suggested.
Carlos Roberto Caixeta
Full Text Available Acidentes de transporte constituem problema mundial de saúde pública, especialmente nos países em desenvolvimento. O objetivo foi descrever o perfil das vítimas e circunstâncias dos acidentes de transportes com residentes de Goiânia (GO, na faixa etária de 15 a 24 anos e atendidos no Hospital de Urgências. Estudo transversal prospectivo, realizado de agosto de 2005 a agosto de 2006, por amostragem sistemática de 301 vítimas de acidentes de transporte. Os dados primários foram tratados por meio de estatística descritiva. A maioria era do sexo masculino, com idade média de 19,88 ± 2,7 anos e condutor dos veículos. O meio de transporte mais utilizado foi motocicleta (67,33%, seguido da bicicleta (16,67%. Os acidentes ocorreram predominantemente em torno das 18 horas, sextas-feiras e domingos. As vítimas estavam principalmente no trajeto para atividades físicas, esportivas, escolares, lazer e entretenimento. A suspeita do uso de álcool foi relatada por 15,16% dos entrevistados. Comparados aos ciclistas, mais motociclistas julgaram que houve imprudência/negligência no acidente. Equipamentos de segurança não foram usados por 8,58% dos motociclistas e 95,45% dos ciclistas. São necessárias medidas de educação dirigida aos motociclistas e fiscalização que priorizem o período noturno e os finais de semana.Traffic injuries are currently one of the world's main public health issues in both developed and developing countries. This study aimed to describe the circumstances involved in the traffic accidents and the profile of the victims attended at the Emergency Hospital of Goiânia, aged 15 to 24 years and residents in Goiânia, Goiás State, Brazil. It's a prospective cross-sectional study carried out from August 2005 to August 2006 by systematic sampling. Data were analyzed by descriptive statistics. Most of the 301 victims were male, mean age of 19.94 ± 2.73 years, and drivers. Motorcycles (67.33% and bicycles (16.67% were
Martha C. Híjar-Medina
data the good quality and validity of wich are assumed. The paper presented seeks to discuss and share with researchers in this field, some of the methodological aspects to be considered in the attempt to recreate the scene of the accident and obtain information approximating to reality. The measurements in situ of, such traffic accident variables as injury, use of seat belt, speed and alcohol intake are discussed.
Carlos Roberto Caixeta
Full Text Available Acidentes de transporte constituem problema mundial de saúde pública, especialmente nos países em desenvolvimento. O objetivo foi descrever o perfil das vítimas e circunstâncias dos acidentes de transportes com residentes de Goiânia (GO, na faixa etária de 15 a 24 anos e atendidos no Hospital de Urgências. Estudo transversal prospectivo, realizado de agosto de 2005 a agosto de 2006, por amostragem sistemática de 301 vítimas de acidentes de transporte. Os dados primários foram tratados por meio de estatística descritiva. A maioria era do sexo masculino, com idade média de 19,88 + 2,7 anos e condutor dos veículos. O meio de transporte mais utilizado foi motocicleta (67,33%, seguido da bicicleta (16,67%. Os acidentes ocorreram predominantemente em torno das 18h, sextas-feiras e domingos. As vítimas estavam principalmente no trajeto para atividades físicas, esportivas, escolares, lazer e entretenimento. A suspeita do uso de álcool foi relatada por 15,16% dos entrevistados. Comparados aos ciclistas, mais motociclistas julgaram que houve imprudência/negligência no acidente. Equipamentos de segurança não foram usados por 8,58% dos motociclistas e 95,45% dos ciclistas. São necessárias medidas de educação dirigida aos motociclistas e fiscalização que priorizem o período noturno e os finais de semana.Traffic injuries are currently one of the world's main public health issues in both developed and developing countries. This study aimed to describe the circumstances involved in traffic accidents and the profile of the victims attended at Hospital de Urgências de Goiânia, age group of 15 to 24 years and residents in Goiânia - Brazil. It is a prospective cross-sectional study carried out from August 2005 to August 2006 by systematic sampling. Data were analyzed by descriptive statistics. Most of the 301 victims were male; with average age of 19.94 + 2.73 years, and drivers. Motorcycles (67.33% and bicycles (16.67% were the most
Peng Jing; Hao Huang; Long Chen
In the last few years, traffic congestion has become a growing concern due to increasing vehicle ownerships in urban areas. Intersections are one of the major bottlenecks that contribute to urban traffic congestion. Traditional traffic signal control systems cannot adjust the timing pattern depending on road traffic demand. This results in excessive delays for road users. Adaptive traffic signal control in a connected vehicle environment has shown a powerful ability to effectively alleviate u...
Vodička, J; Doležal, J; Vejvodová, Š; Šafránek, J; Špidlen, V; Třeška, V
PURPOSE OF THE STUDY Thoracic trauma, one of the most frequent injuries in patients with multiple traumata, is found in 50 to 80% of these patients and it is crucial for the patient's prognosis. It accounts for 25% of all death from polytraumatic injuries. The aim of this retrospective study was an analysis of the occurrence of chest injuries in polytrauma patients and their surgical treatment in the Trauma Centre or Department of Surgery of the University Hospital Pilsen in a five-year period. MATERIAL AND METHODS Patients with injuries meeting the definition of polytrauma and an Injury Severity Score (ISS) ≥16 were included. The demographic characteristics, mechanism of multiple trauma, ISS value and chest injury were recorded in each patient. The number of injured patients in each year of the study was noted. In the patients with chest injury, the type of injury and method of treatment were assessed. The therapy was further analysed including its timing. The number of deaths due to polytrauma involving chest injury, the cause of death and its time in relation to the patient's admission to the Trauma Centre were evaluated. RESULTS In the period 2010-14, 513 polytrauma patients were treated; of them 371 (72.3%) were men with an average age of 40.5 years. The most frequent cause of injury was a traffic accident (74%). The average ISS of the whole group was 35 points. Chest injury was diagnosed in 469 patients (91.4%) of whom only five (1.1%) had penetrating injury. Pulmonary contusion was most frequent (314 patients; 67%). A total of 212 patients with chest injury underwent surgery (45.2%); urgent surgery was performed in 143 (67.5%), acute surgery in 49 (23.1%) and delayed surgery in 63 (29.7%) patients. Chest drainage was the major surgical procedure used in the whole group. Of 61 patients who died, 52 had chest injury. In this subgroup the most frequent cause of death was decompensated traumatic shock (26 patients; 50%). In the whole group, 32 polytrauma
Allgood, G.O.; Ferrell, R.K.; Kercel, S.W.; Abston, R.A.; Carnal, C.L. [Oak Ridge National Lab., TN (United States); Moynihan, P.I. [Jet Propulsion Lab., Pasadena, CA (United States)
Traffic Flow Wide-Area Surveillance (TFWAS) is a system for assessing the state of traffic flow over a wide area for enhanced traffic control and improved traffic management and planning. The primary purpose of a TFWAS system is to provide a detailed traffic flow description and context description to sophisticated traffic management and control systems being developed or envisioned for the future. A successful TFWAS system must possess the attributes of safety, reconfigurability, reliability, and expandability. The primary safety premise of TFWAS is to ensure that no action or failure of the TFWAS system or its components can result in risk of injury to humans. A wide variety of communication techniques is available for use with TFWAS systems. These communication techniques can be broken down into two categories, landlines and wireless. Currently used and possible future traffic sensing technologies have been examined. Important criteria for selecting TFWAS sensors include sensor capabilities, costs, operational constraints, sensor compatibility with the infrastructure, and extent. TFWAS is a concept that can take advantage of the strengths of different traffic sensing technologies, can readily adapt to newly developed technologies, and can grow with the development of new traffic control strategies. By developing innovative algorithms that will take information from a variety of sensor types and develop descriptions of traffic flows over a wide area, a more comprehensive understanding of the traffic state can be provided to the control system to perform the most reasonable control actions over the entire wide area. The capability of characterizing the state of traffic over an entire region should revolutionize developments in traffic control strategies.
Abdulmajid Ahmed Ali
Full Text Available To The Editor: It is estimated that 1.26 million people worldwide died in 2000 from road traffic accidents, 90% of them in low and middle-income countries. In 2000, the road traffic injury mortality rate for the world was 20.8 per 100,000 populations (30.8 in males, 11.0 in females .The Arab population constitutes 3.6% of the world’s population and it owns 1% of the world’s vehicles. Its human losses as a result of road traffic accidents (RTA account for 4.8% of that of the world’s losses . It is estimated that the annual cost of road crashes is about 1% of the Gross National Product (GNP in developing countries, 1.5 in transitional countries and 2% in highly motorised countries .In Libya the situation is worse. It is a sad fact that road traffic accidents are the number one killer in Libya. As a matter of fact I consider it to be an ‘epidemic’ in all sectors of the Libyan society. There is not a day that goes by in Libya without us hearing about families, young men, women and children getting killed in horrific car accidents.It is alarming that young children are knocked down on a daily basis by speeding young drivers, whose understanding of driving skills may have been acquired from "playstation games"! (You can watch some of the shameful video clips sent by some of these drivers on this link http://www.youtube.com/watch?v=doWEDjiHlVoI feel it is our responsibility as physicians observing the situation to raise awareness about the scale of the problem, possible causes, and how to tackle it. POSSIBLE CAUSES:• A driving licence in Libya is not issued on the basis of how much you know. Therefore the majority of drivers know little or nothing about the law.• Wearing seat belts is not compulsory in most parts of Libya. In some places, especially in the Eastern part of Libya, you could be penalised for wearing one. I was stopped many years ago by the traffic police in the Eastern part of Libya because I was wearing sunglasses
Full Text Available Background: Road traffic injuries are estimated to be the eighth leading cause of death globally, with an impact similar to that caused by many communicable diseases, such as malaria. road traffic injuries are estimated to cost low- and middle-income countries between 1–2 % of their Gross Domestic Product (GDP, an estimate of about US$ 100 billion a year. Objectives: To study the epidemiological profile of Road Traffic Injuries among the patients admitted in a tertiary care centre and too find out the various out of pocket expenditure in the patients of Road Traffic Accidents. Material and Method: The present study was a hospital based Descriptive Prospective Study. A list of all the patients admitted due to Road Traffic Accident in last one week was obtained from the ward sisters of Orthopedic Department. All the selected participants were interviewed on the two fixed days. A pre tested structured open ended questionnaire was used for data collection. Results: Of the 48 participants interviewed, 34male and 14 females. Most common age group affected was 21-25 years followed by 16-20 years. The rate of accidents was most common on the weekends. The rate of accidents was more in users of two wheelers. Majority of the expenditure in the First week of admission was on the purchase of medicines followed by diagnosis. Majority of the victims also suffered huge financial loss due to loss of salary, closure of shop, loss due to daily wages etc. Conclusion: The present study hereby concludes that there is an urgent need for creating awareness about Road Traffic Accident. The study also concludes that majority of the out of pocket expenditure in the first week of admission is on the medication.
The effective treatment of road accidents and thus the enhancement of road safety is a major concern to societies due to the losses in human lives and the economic and social costs. The investigation of road accident likelihood and severity by utilizing real-time traffic and weather data has recently received significant attention by researchers. However, collected data mainly stem from freeways and expressways. Consequently, the aim of the present paper is to add to the current knowledge by investigating accident likelihood and severity by exploiting real-time traffic and weather data collected from urban arterials in Athens, Greece. Random Forests (RF) are firstly applied for preliminary analysis purposes. More specifically, it is aimed to rank candidate variables according to their relevant importance and provide a first insight on the potential significant variables. Then, Bayesian logistic regression as well finite mixture and mixed effects logit models are applied to further explore factors associated with accident likelihood and severity respectively. Regarding accident likelihood, the Bayesian logistic regression showed that variations in traffic significantly influence accident occurrence. On the other hand, accident severity analysis revealed a generally mixed influence of traffic variations on accident severity, although international literature states that traffic variations increase severity. Lastly, weather parameters did not find to have a direct influence on accident likelihood or severity. The study added to the current knowledge by incorporating real-time traffic and weather data from urban arterials to investigate accident occurrence and accident severity mechanisms. The identification of risk factors can lead to the development of effective traffic management strategies to reduce accident occurrence and severity of injuries in urban arterials. Copyright © 2017 Elsevier Ltd and National Safety Council. All rights reserved.
Krogh, Benjamin Bjerre; Andersen, Ove; Lewis-Kelham, Edwin
We present the INTRA system for interactive path-based traffic analysis. The analyses are developed in collaboration with traffic researchers and provide novel insights into conditions such as congestion, travel-time, choice of route, and traffic-flow. INTRA supports interactive point-and-click a......We present the INTRA system for interactive path-based traffic analysis. The analyses are developed in collaboration with traffic researchers and provide novel insights into conditions such as congestion, travel-time, choice of route, and traffic-flow. INTRA supports interactive point......-and-click analysis, due to a novel and efficient indexing structure. With the web-site daisy.aau.dk/its/spqdemo/we will demonstrate several analyses, using a very large real-world data set consisting of 1.9 billion GPS records (1.5 million trajectories) recorded from more than 13000 vehicles, and touching most...
Congdon, C C; Fliedner, T M
The injury to haemopoietic and lymphatic tissues produced by ionizing irradiation in various species of mammals including man is one of the major features of the biological effects of radiation (Bond et al. 1965,' Cottier, 1961). At the moment of injury and for a short time thereafter relatively little morphological evidence of cell damage in bone marrow other than cessation of cell division and DNA synthesis is seen. Within a few hours, however, depending on the level of exposure, major destruction of red bone marrow tissue can occur. In this chapter the histologic changes in bone marrow are summarized for correlation with the functional aspects of the change in the target tissue, particularly its cell renewal features and where possible the remarkable flux or migration of cells through bone marrow and lymphatic tissues. This latter topic of cellular traffic represents the outcome of extensive physiological studies on haemopoiesis and lymphopoiesis by mammalian radiobiologists. The initial injury, the structural changes and the physiological consequences are the first half of the radiation injury sequence. Regeneration also has morphological features of major importance to the understanding of radiation haematology. It is common to discuss radiation effects on biological materials from the point of view of external or internal sources of exposure. In addition exposure rate, whole body or partial body, type and quality of the ionizing source are features that must be taken into account. While these features are extremely important, the simplest approach to understanding histologic effects on the bone marrow is to assume acute penetrating whole-body exposure in the lethal range. With this background the differences related to variations in the conditions of exposure can usually be understood. The individual human or animal organism receiving the exposure must also be considered in the final outcome of the experience because age, sex, nutritional status and presence
Renee Yuen-Jan Hsia
Full Text Available Globally, 90% of road crash deaths occur in the developing world. Children in Africa bear the major part of this burden, with the highest unintentional injury rates in the world. Our study aims to better understand injury patterns among children living in Kampala, Uganda and provide evidence that injuries are significant in child health. Trauma registry records of injured children seen at Mulago Hospital in Kampala were analysed. This data was collected when patients were seen initially and included patient condition, demographics, clinical variables, cause, severity, as measured by the Kampala trauma score, and location of injury. Outcomes were captured on discharge from the casualty department and at two weeks for admitted patients. From August 2004 to August 2005, 872 injury visits for children <18 years old were recorded. The mean age was 11 years (95% CI 10.9–11.6; 68% (95% CI 65–72% were males; 64% were treated in casualty and discharged; 35% were admitted. The most common causes were traffic crashes (34%, falls (18% and violence (15%. Most children (87% were mildly injured; 1% severely injured. By two weeks, 6% of the patients admitted for injuries had died and, of these morbidities, 16% had severe injuries, 63% had moderate injuries and 21% had mild injuries. We concluded that, in Kampala, children bear a large burden of injury from preventable causes. Deaths in low severity patients highlight the need for improvements in facility-based care. Further studies are necessary to capture overall child injury mortality and to measure chronic morbidity owing to sequelae of injuries.
Ezeibe, Christian; Ilo, Chukwudi; Oguonu, Chika; Ali, Alphonsus; Abada, Ifeanyi; Ezeibe, Ezinwanne; Oguonu, Chukwunonso; Abada, Felicia; Izueke, Edwin; Agbo, Humphrey
This study assesses the impact of traffic sign deficit on road traffic accidents in Nigeria. The participants were 720 commercial vehicle drivers. While simple random sampling was used to select 6 out of 137 federal highways, stratified random sampling was used to select six categories of commercial vehicle drivers. The study used qual-dominant mixed methods approach comprising key informant interviews; group interviews; field observation; policy appraisal and secondary literature on traffic signs. Result shows that the failure of government to provide and maintain traffic signs in order to guide road users through the numerous accident black spots on the highways is the major cause of road accidents in Nigeria. The study argues that provision and maintenance of traffic signs present opportunity to promoting safety on the highways and achieving the sustainable development goals.
Eltahir, E M; Hamilton, D
Colonic seat belt injuries are rare but carry higher mortality rates than small bowel injuries. The case of a 44 year old man is described who had severe sigmoid colon compression injury from his seat belt a few days after a road traffic accident.
Mulder, S. Bloemhoff, A. Harris, S. Kampen, L.T.B. van & Schoots, W.
As a repeat of a survey carried out in 1986-1987, a telephone survey was conducted. More than 25,000 households, comprising over 67,000 persons, were questioned about any recent traffic, home and leisure, sports and occupational injuries. Expressed as a national number, a total of approximately
Full Text Available Background. Hand injuries are common worldwide and lead to heavy financial losses in terms of treatment, job loss, and time off duty. There is paucity of data on hand injuries in sub-Saharan Africa. The aim of this study was to determine the burden and early outcomes of hand injuries at a tertiary hospital. Method. A descriptive prospective study. Eligible patients were recruited over 5 months and followed up for four weeks. Pain, nerve function, and gross functions of the hand were assessed. Results. In total 138 patients were enrolled out of 2940 trauma patients. Of these, 122 patients returned for follow-up. The majority of the patients were males (83%. Mean age was 26.7 years (SD 12.8. The commonest places of injury occurrence were the workplace (36%, home (28%, and on the road (traffic crushes (23%. Machines (21.3% were the commonest agent of injuries; others were knives (10% and broken glass (10%. Sixty-three (51% patients still had pain at one month. Conclusions. Hand injuries accounted for 4.7% of all trauma patients. Road traffic crushes and machines were the commonest causes of hand injuries. Men in their 20s were mostly involved. Sensitization for prevention strategies at the workplace may be helpful.
Protocol for an economic evaluation alongside University Health Network Whiplash Intervention Trial: Cost-effectiveness of education and activation, a rehabilitation program, and the legislated standard of care for acute whiplash injury in Ontario
van de Velde, G.; Cote, P.; Bayoumi, A.M.; Cassidy, J.D.; Boyle, E.; Shearer, H.M.; Stupar, M.; Jacobs, C.; Ammendolia, C.; Carette, S.; van Tulder, M.W.
Background: Whiplash injury affects 83% of persons in a traffic collision and leads to whiplash-associated disorders (WAD). A major challenge facing health care decision makers is identifying cost-effective interventions due to lack of economic evidence. Our objective is to compare the
Epps, J. W.
Current references were surveyed for the application of remote sensing to traffic and transportation studies. The major problems are presented that concern traffic engineers and transportation managers, and the literature references that discuss remote sensing applications are summarized.
Traffic congestion is a daily and growing problem of the modern era in mostly all major cities in the world. : Increasing traffic demand strains the existing transportation system, leading to oversaturated network : conditions, especially at peak hou...
States use a variety of countermeasures to reduce traffic crashes, injuries, and fatalities within their jurisdictions. These countermeasures focus primarily on engineering, law enforcement, and public education (NHTSA, 2006). NHTSA's bi-annual publi...
Full Text Available To The Editor: In his outstanding article regarding Road Traffic Accidents (RTAs in Libya , Dr Abdulmajid Ali has raised awareness and started a debate about this extremely important issue. Before responding to some points in Dr Ali’s article, I would like to tell a real story of a tragic accident that happened last week, which highlights several issues related to RTAs in Libya. A 55 year old driver left after Fajr prayer to the vegetable market to buy a few things for his daughter’s wedding lunch. While trying to avoid a big pothole in the middle of the road, he was hit by a truck without headlights coming from the opposite direction. The truck driver continued driving as if nothing had happened. None of the road users cared to help the victim but he was able to contact his son by mobile phone to come and help him out of the wreckage. His son took him to the main Trauma Hospital in Tripoli. The patient had no external injuries. He was admitted for observation only. A few hours later the patient died as a result of major internal haemorrhage. Further information revealed that the truck driver had no driving licence and the truck was not road worthy.This story is not unique However, it highlights the complex and intermingled issues that need to be addressed to have any real impact on this disastrous problem in Libya. The specific points I would like to add to Dr Ali’s article are:There is no doubt that RTAs are a major killer in Libya especially in the young age group. The annual reporting of road causalities is considered to be the yard stick to measure the effectiveness of any national traffic policy,; in the UK for example the target is to reduce fatalities from RTAs by 50% by 2010 . It is a disgrace not to have accurate official statistics published at least annually of fatalities, injuries, disabilities and the economic consequences of this undeclared war in Libya. There is evidence to support that there could be a positive
Karacasu, Murat; Ergül, Barış; Altin Yavuz, Arzu
Factors that affect traffic accidents have been analysed in various ways. In this study, we use the methods of logistic regression and discriminant analysis to determine the damages due to injury and non-injury accidents in the Eskisehir Province. Data were obtained from the accident reports of the General Directorate of Security in Eskisehir; 2552 traffic accidents between January and December 2009 were investigated regarding whether they resulted in injury. According to the results, the effects of traffic accidents were reflected in the variables. These results provide a wealth of information that may aid future measures toward the prevention of undesired results.
Due to urbanization and accelerated growth in vehicular traffic, most big cities in India face problems related to traffic management resulting in severe congestion, pollution, and a high rate of accidents during peak hours. Lane blocking incidents on arterials or urban traffic corridors cause major disruption to traffic flow. Peak hour congestion with low average speeds and high accident rates are commonly associated with traffic in major cities in India. The situation is deteriorating further as creation of new facilities are almost impossible, with resource and space constraints. In such scenarios, application of advanced technologies seems to offer hope. One such application area is Advanced Traffic Management Systems (ATMS), a component of intelligent transportation system (ITS). Due to the unique traffic characteristics prevailing in India, the application of such systems needs to first be evaluated before implementation. This paper proposed a research methodology for the evaluation of diversion strategies in the context of ATMS for an urban corridor in India. The evaluation framework combined several relevant modules related to various aspects of traffic control, surveillance and advisory. As part of this study, a simulation model and a simulation optimization model were developed. The simulation model was microscopic in nature and captured the driver behaviour and traffic characteristics realistically by modeling the complex interactions among vehicles traversing a corridor. It was concluded that the results and observations were useful indicators to gauge the potential success of diversion plans. 10 refs., 1 tab., 2 figs.
.... Air Force Research Laboratory. It is a video-camera-based, wide-area, traffic surveillance and detection system that provides real-time traffic information to traffic management center operators...
This project continues research aimed at real-time detection and use of pedestrian : traffic flow information to enhance adaptive traffic signal control in urban areas : where pedestrian traffic is substantial and must be given appropriate attention ...
Alkheder,Sharaf A.; Sabouni,Reem; El Naggar,Hany; Sabouni,Abdul Rahim
Former traffic safety studies showed clearly that driver or human factor is a major contributor to road accidents. Hence, to better understand the traffic accident nature it's so vital to analyze all characteristics related to drivers involved in these accidents. This article focuses on this aspect through using a dataset representing UAE traffic accidents in the time interval between 2007 and 2010. A major focus was given in this article to analyzing the relation between traffic accidents an...
David A. Sleet
Full Text Available Injuries are one of the most under-recognized public health problems facing the world today. With more than 5 million deaths every year, violence and injuries account for 9% of global mortality, as many deaths as from HIV, Malaria and Tuberculosis combined. Eight of the 15 leading causes of death for people ages 15 to 29 years are injury-related: road traffic injuries, suicides, homicides, drowning, burns, war injuries, poisonings and falls. For every death due to war, there are three deaths due to homicide and five deaths due to suicide. However, most violence happens to people behind closed doors and results not in death, but often in years of physical and emotional suffering . Injuries can be classified by intent: unintentional or intentional. Traffic injuries, fire-related injuries, falls, drowning, and poisonings are most often classified as unintentional injuries; injuries due to assault, selfinflicted violence such as suicide, and war are classified as intentional injuries, or violence. Worldwide, governments and public and private partners are increasingly aware of the strains that unintentional injuries and violence place on societies. In response they are strengthening data collection systems, improving services for victims and survivors, and increasing prevention efforts .
Controlled Traffic Farming Europe
Metadata only record Controlled Traffic Farming (CTF) is a farming method used to reduce soil compaction, decrease inputs, and improve soil structure when coupled with reduced-till or no-till practices. This practices utilizes permanent traffic/wheel zones to limit soil compaction to a specific area. This website provides practical information on CTF, case studies, workshops, and links to additional resources.
Jie, L.; Van Zuylen, H.J.
Traffic is tightly related to the social and economic development in a country. In China the development of the economy has been very fast in the past 30 years and this is still continuing. The transport infrastructure shows a similar pattern, while traffic is also rapidly growing. In urban areas
Tang, Tie-Qiao; Huang, Hai-Jun; Shang, Hua-Yan; Xue, Yu
We use the model with the consideration of the traffic interruption probability (Physica A 387(2008)6845) to study the relationship between the traffic risk coefficient and the traffic interruption probability. The analytical and numerical results show that the traffic interruption probability will reduce the traffic risk coefficient and that the reduction is related to the density, which shows that this model can improve traffic security.
Full Text Available Fast development of the number of vehicles is closely related not only to large benefit for the public but also to certain undesirable social and economic consequences. Firstly - large numbers of injured and killed people are involved into the accidents. The target to improve traffic safety situation in Lithuania can be reached only after the detailed evaluation of transport system, environment, traffic participants, road and vehicle. Taking into consideration the accident situation in Lithuania and its causes the followings priority trends are suggested: The improvement of the coordination of road traffic safety system, the training and education of road users, the explanation of the importance of traffic safety and its propagation, the improvement of traffic conditions. Recommendations and proposals for differentiated criterion of maximum speed limit selection taking into account different factors are provided in the work.
Ibrahim, Khalid Bakri [Faculty of medicine, University of Khartoum, Khartoum (Sudan)
This hospital based study was undertaken to report on the role of radiology and its pattern in road traffic accident. It is a prospective study of 400 patients with R.T. injuries presenting to Khartoum teaching hospital during the first six months of 1998 during the first shift. The affected age group was between (20-50) years and the great majority of them were males (305) (76%). The pedestrians were (109) represent (27.25%) of cases. The commonest causative factor of injury with lower extremities (281) (70.4%), and the commonest causative factor of injury was vehicle pick up (24) represent (37.5%). Multiple injuries (147) (36%) were mostly seen in pedestrians. The injuries of the skull were (69) (17.3%), upper extremities (140) (35%), chest (42) (10.5%), abdomen and spine (20) (5%each) and pelvis (5 patients) represent (1.25%). Plain radiography done to all of the patients (100%). U/S was required in 20 patients (5%) and C.T. was also required in 13 patients (3.3%). I.V.U. urethrogram and Ba examinations were carried out in selective cases. MRI and others radiological modalities were not done in this study. Chronic osteomyelitis was developed in (3 patients) (0.75%), amputation was carried out in (5 patients) (1.25%)
Ibrahim, Khalid Bakri
This hospital based study was undertaken to report on the role of radiology and its pattern in road traffic accident. It is a prospective study of 400 patients with R.T. injuries presenting to Khartoum teaching hospital during the first six months of 1998 during the first shift. The affected age group was between (20-50) years and the great majority of them were males (305) (76%). The pedestrians were (109) represent (27.25%) of cases. The commonest causative factor of injury with lower extremities (281) (70.4%), and the commonest causative factor of injury was vehicle pick up (24) represent (37.5%). Multiple injuries (147) (36%) were mostly seen in pedestrians. The injuries of the skull were (69) (17.3%), upper extremities (140) (35%), chest (42) (10.5%), abdomen and spine (20) (5% each) and pelvis (5 patients) represent (1.25%). Plain radiography done to all of the patients (100%). U/S was required in 20 patients (5%) and C.T. was also required in 13 patients (3.3%). I.V.U. urethrogram and Ba examinations were carried out in selective cases. MRI and others radiological modalities were not done in this study. Chronic osteomyelitis was developed in (3 patients) (0.75%), amputation was carried out in (5 patients) (1.25%)
Conclusions: The prevalence of disability due to road traffic accidents in Spain is lower than in other developed countries, with middle-aged and socio-economically underprivileged persons being the most affected. Disability due to road traffic accidents is related to a greater demand for social/health care support, problems of accessibility/commuting, and major changes in economic activity.
The major objective of this research is to examine the variation patterns of road traffic .... situation in Lagos state is bad because of the absence of effective transport ... environment as judged by the investigating officers. Also .... pattern of road traffic accident occurrence over that part of Lagos State. For ... Ph.D Thesis.
...The FAA is issuing this notice to advise the public that a meeting of the Federal Aviation Administration Air Traffic Procedures Advisory Committee (ATPAC) will be held to review present air traffic control procedures and practices for standardization, revision, clarification, and upgrading of terminology and procedures. Class B airspace will be a major topic of discussion on the ATPAC Agenda.
Full Text Available significantly from the developed world. We observe dominance of web-based traffic, as opposed to peer-to-peer traffic common in urban areas. Application-wise, online social networks are the most popular, while the majority of bandwidth is consumed by large...
Cui, Li-Juan; Yi, Xu-Fu; Chen, Xiao-Gang
In recent years, the traffic accidents increased gradually, especially those caused by the drivers daily emotional abnormality and in which the drivers were liable. This article reviewed the traffic accidents caused by divorced driver's emotional abnormality, illustrated the features of those accidents from the gender, age, occupation and mileage of drivers. It was considered that the major cause of those accidents was excessive drinking due to drivers' emotional stress. Suggestions about preventing the traffic accidents caused by emotional abnormality were put forward so as to make the corresponding rules and finally decrease the emotional abnormality traffic accidents.
Full Text Available Background and Objectives: Pedestrian injuries are a public health problem and one of the major victims of road traffic injuries are children. Education is one of the most important strategies to solve traffic problems. To achieve effective results, education should be defined on the basis of theories and models. The aim of this study was to evaluate the effect of PRECEDE-PROCEED based intervention for promoting traffic safety behaviors in elementary schools students of Tabriz. Materials and Methods: This study was a randomized controlled trial. The sample included 75 elementary students who were randomly selected from two different schools. Data was collected using a questionnaire including the PRECEDE-PROCEED model constructs and demographic variables. Participants completed questionnaires before and one month after intervention. The intervention consisted of six sessions and was conducted in experimental group schools. The data were analyzed with fisher’s exact test, chi square, t-test and paired t-test, using SPSS-18 software. Results: The average age of participants was 10.11 ± 0.68 years. There was no significant differences in demographic variables between the two groups before the intervention (P>0.05. The findings showed that after the educational intervention, significant differences were observed in knowledge, attitude, enabling factors, reinforcing factors and behavior scores in the experimental group compared to the control group. Conclusions: An educational intervention based on the PRECEDE-PROCEED model could promote students’ traffic safety behaviors.
Lankarani, Kamran B; Heydari, Seyed Taghi; Aghabeigi, Mohammad Reza; Moafian, Ghasem; Hoseinzadeh, Amin; Vossoughi, Mehrdad
Road traffic crashes are the third highest cause of mortality in Iran. The aim of this study was to determine the impact of roadway environmental factors on traffic crash. This cross-sectional study was conducted in Iran between March 21, 2010 and December 30, 2010. The data on road traffic crashes were obtained from the Traffic Police Department records. These records were classified to control for the main confounders related to the type of crash and roadway environmental factors. Roadway environmental factors included crash scene light, weather, place of accident, the defects and geometrics of roadway and road surface. The study included 542,863 traffic crashes. The proportions of road traffic crash which led to injury were 24.44% at sunrise and 27.16% at sunset compared with 5.43% and 1.43% deaths at sunrise and sunset respectively. In regard to day time accidents, the proportions were 20.50% injuries and 0.55% deaths. The statistical analysis of the results showed that the ratio of injuries and deaths were significantly higher at sunrise and sunset than those occurring during daytime (P less than 0.001). The highest rate of death (5.07%) was due to dusty weather compared to 5.07% for other weather conditions (P less than 0.001). The highest mortality rate (3.45%) occurred on oily surfaces (P less than 0.001). The defective traffic signs were responsible for 30,046 injuries and 5.58% deaths, and road narrowing accounted for 22,775 injuries and, 4.23% deaths which indicated that the roadway defects inflict most frequent injuries and deaths. The lowest (0.74 %) and highest (3.09%) proportion of traffic crash- related deaths were due to flat straight and winding uphill/downhill roads respectively (P less than 0.001). Sunrise, sunset, dusty weather, oily road surfaces and winding uphill/downhill road were hazardous environmental factors. This study provides an insight into the potential impacts of environmental factors on road traffic accidents and underlines the
Full Text Available Traffic accidents have long been known as an iceberg for comprehending the discrepancies of traffic management and entire transportation systems. Figures detailing traffic accidents in Indonesia, as is the case in many other countries, show significantly high numbers and severity levels; these types of totals are also evident in Jakarta, the highest-populated city in the country. While the common consensus recognizes that traffic accidents are the results of three different factor types, namely, human factors, vehicle factors, and external factors (including road conditions, human factors have the strongest influence—and figures on a worldwide scale corroborate that assertion. We, however, try to pinpoint the issues of non-human factors in light of increasing traffic accidents in Indonesia, where motorbike accidents account for the majority of incidents. We then consider three important pillars of action: the development of public transportation, improvement of the road ratio, and traffic management measures.
There has been a phenomenal growth in video applications over the past few years. An accurate traffic model of Variable Bit Rate (VBR) video is necessary for performance evaluation of a network design and for generating synthetic traffic that can be used for benchmarking a network. A large number of models for VBR video traffic have been proposed in the literature for different types of video in the past 20 years. Here, the authors have classified and surveyed these models and have also evaluated the models for H.264 AVC and MVC encoded video and discussed their findings.
Smirenin, S A; Fetisov, V A; Grigoryan, V G; Gusarov, A A; Kucheryavets, Yu O
The disabling injuries inflicted during road traffic accidents (RTA) create a serious challenge for the public health services and are at the same time a major socio-economic problem in the majority of the countries throughout the world. The injuries to the lower extremities of the pedestrians make up the largest fraction of the total number of the non-lethal RTA injuries. Most of them are responsible for the considerable deterioration of the quality of life for the participants in the accidents during the subsequent period. The objective of the present study was to summarize the currently available results of experimental testing of the biomechanical models of the pedestrians' lower extremities in the framework of the program for the prevention of the road traffic accidents as proposed by the World Health Organization (WHO, 2004). The European Enhanced Safety Vehicle Committee (EEVC) has developed a series of crash-tests with the use of the models of the pedestrians' lower extremities simulating the vehicle bumper-pedestrian impact. The models are intended for the assessment of the risk of the tibia fractures and the injuries to the knee joint ligaments. The experts of EEVC proposed the biomechanical criteria for the acceleration of the knee and talocrural parts of the lower limbs as well as for the shear displacement of the knee and knee-bending angle. The engineering solution of this problem is based on numerous innovation proposals being implemented in the machine-building industry with the purpose of reducing the stiffness of structural elements of the bumper and other front components of a modern vehicle designed to protect the pedestrians from severe injuries that can be inflicted in the road traffic accidents. The activities of the public health authorities (in the first place, bureaus of forensic medical expertise and analogous facilities) have a direct bearing on the solution of the problem of control of road traffic injuries because they are possessed of
A number of injuries and fatal collisions have occurred at certain highway-rail grade crossings that are located immediately adjacent to highway intersections, driveways or interstate ramps. Some guide signage, pavement markings, and other traffic co...
Full Text Available 【Abstract】 Objective: To study the patterns and morphologic characteristics of blunt head injury and analyse its formative mechanism in attempt to provide references for medicolegal expertise. Methods: The statistical analysis was done in terms of gender, age, as well as the nature, pattern, location, and feature of the injuries. Results: Among the 202 cases of head injury-induced death, 124 were male and 78 female with the age ranging from 1-81 years. Death caused by homicide was dominant (106, 52.5%, followed by suicide (49, 24.3% and accident (44, 21.8%. The majority of suicide-induced death were by falling from height, and traffic crash was responsible for majority of unexpected death cases. The morphology and pathogenesis of the injuries varied according to differences on the mode, magnitude, and orientation of the outside force giving rise to blunt injury as well as the character of vulnerants. Conclusion: Studies on the morphology and its forma-tive rationale of blunt head injury will offer easy access to medicolegal expertise on the mode and character of the injury. Key words: Brain; Head injuries, closed; Cranioce-rebral trauma; Forensic medicine
Fallah Shorshani, Masoud; Bonhomme, Céline; Petrucci, Guido; André, Michel; Seigneur, Christian
Methods for simulating air pollution due to road traffic and the associated effects on stormwater runoff quality in an urban environment are examined with particular emphasis on the integration of the various simulation models into a consistent modelling chain. To that end, the models for traffic, pollutant emissions, atmospheric dispersion and deposition, and stormwater contamination are reviewed. The present study focuses on the implementation of a modelling chain for an actual urban case study, which is the contamination of water runoff by cadmium (Cd), lead (Pb), and zinc (Zn) in the Grigny urban catchment near Paris, France. First, traffic emissions are calculated with traffic inputs using the COPERT4 methodology. Next, the atmospheric dispersion of pollutants is simulated with the Polyphemus line source model and pollutant deposition fluxes in different subcatchment areas are calculated. Finally, the SWMM water quantity and quality model is used to estimate the concentrations of pollutants in stormwater runoff. The simulation results are compared to mass flow rates and concentrations of Cd, Pb and Zn measured at the catchment outlet. The contribution of local traffic to stormwater contamination is estimated to be significant for Pb and, to a lesser extent, for Zn and Cd; however, Pb is most likely overestimated due to outdated emissions factors. The results demonstrate the importance of treating distributed traffic emissions from major roadways explicitly since the impact of these sources on concentrations in the catchment outlet is underestimated when those traffic emissions are spatially averaged over the catchment area.
van Beeck, E. F.; Mackenbach, J. P.; Looman, C. W.; Kunst, A. E.
In the Netherlands, a country with one of the lowest levels of traffic accident mortality in the world, large regional mortality differences can be observed. An analysis was performed of the contribution of regional differences in traffic mobility (kilometers travelled/person-years), injury rate
Landri, G.; Prati, M.V.
Only recently the attention for the injuries to human and environmental health due to vehicular pollutant emission has been enlarged to the sea traffic. Consequently, technologies and local and international actions has been developed to control the phenomenon. In this paper the activities undertaken in the marine field, comparing the two types of traffic with references to the relevant legislations, are shown [it
Acute subdural hematoma and diffuse axonal injury in fatal road traffic accident victims: a clinico-pathological study of 15 patients Hematoma subdural agudo e lesão axonal difusa em vítimas fatais de acidente de trânsito: estudo clínico-patológico de 15 pacientes
Sebastião Nataniel Silva Gusmão
Full Text Available OBJECTIVE: Although acute subdural hematoma (ASDH and diffuse axonal injury (DAI are commonly associated in victims of head injury due to road traffic accidents, there are only two clinico-pathological studies of this association. We report a clinical and pathological study of 15 patients with ASDH associated with DAI. METHOD: The patients were victims of road traffic accidents and were randomly chosen. The state of consciousness on hospital admission was evaluated by the Glasgow coma scale. For the identification of axons the histological sections of the brain were stained with anti-neurofilament proteins. RESULTS: Twelve of the 15 patients were admitted to hospital in a state of coma; in three patients, the level of consciousness was not evaluated, as they died before hospital admission. CONCLUSION: The poorer prognosis in patients with ASDH who lapse into coma immediately after sustaining a head injury, as described by several authors, can be explained by the almost constant association between ASDH and DAI in victims of fatal road traffic accidents.OBJETIVO: Embora o hematoma subdural agudo (HSDA e a lesão axonal difusa (LAD estejam frequentemente associados em vítimas de trauma crânio-encefálico causado por acidentes de trânsito, há somente dois estudos clínico-patológicos sobre esta associação. Relatamos o estudo clínico-patológico de 15 pacientes com HSDA associado com LAD. MÉTODO: Os pacientes, vítimas de acidentes de trânsito, foram selecionados aleatoriamente. O estado de consciência à admissão hospitalar foi avaliado pela escala de coma de Glasgow. Para a identificação dos axônios, os cortes histológicos do cérebro foram corados com antisoro anti-proteínas do neurofilamento. RESULTADOS: Doze dos 15 pacientes foram admitidos no hospital em estado de coma; em três pacientes, o nível de consciência não foi avaliado, pois eles faleceram antes da admissão hospitalar. CONCLUSÃO: O pior prognóstico em pacientes
Existing traffic analysis and management tools do not model the ability of drivers to recognize their environment and respond to it with behaviors that vary according to the encountered driving situation. The small body of literature on characterizin...
Traffic offenders are penalized in various ways: fines, (temporary) driving licence suspensions, confiscation of their vehicles, penalty points, mandatory participation in rehabilitation programmes, prison sentences or community service. The aim of penalties is to punish offenders, to protect
Allegheny County / City of Pittsburgh / Western PA Regional Data Center — Non-traffic citations (NTCs, also known as "summary offenses") document low-level criminal offenses where a law enforcement officer or other authorized official...
Allegheny County / City of Pittsburgh / Western PA Regional Data Center — Traffic sensors at over 1,200 locations in Allegheny County collect vehicle counts for the Pennsylvania Department of Transportation. Data included in the Health...
Town of Chapel Hill, North Carolina — Traffic signal location list for the town of Chapel Hill. This data set includes light cycle information as well as as intersection information.The Town of Chapel...
Neutrophil gelatinase-associated lipocalin (NGAL) is emerging as a new biomarker for the early identification of acute kidney injury (AKI). There is also increasing evidence of an association between urinary albumin\\/creatinine ratio (ACR) and AKI. The primary aim of this study was to evaluate the clinical utility of these biomarkers to predict AKI in a population of perioperative patients treated with goal-directed haemodynamic therapy (GDHT). Secondary aims were to examine NGAL and ACR as sensitive biomarkers to detect the effects of GDHT and to investigate the association of these biomarkers with secondary outcomes.
Kim, Dae-Hwan; Ramjan, Lucie M; Mak, Kwok-Kei
Traffic safety is a significant public health challenge, and vehicle crashes account for the majority of injuries. This study aims to identify whether drivers' characteristics and past traffic violations may predict vehicle crashes in Korea. A total of 500,000 drivers were randomly selected from the 11.6 million driver records of the Ministry of Land, Transport and Maritime Affairs in Korea. Records of traffic crashes were obtained from the archives of the Korea Insurance Development Institute. After matching the past violation history for the period 2004-2005 with the number of crashes in year 2006, a total of 488,139 observations were used for the analysis. Zero-inflated negative binomial model was used to determine the incident risk ratio (IRR) of vehicle crashes by past violations of individual drivers. The included covariates were driver's age, gender, district of residence, vehicle choice, and driving experience. Drivers violating (1) a hit-and-run or drunk driving regulation at least once and (2) a signal, central line, or speed regulation more than once had a higher risk of a vehicle crash with respective IRRs of 1.06 and 1.15. Furthermore, female gender, a younger age, fewer years of driving experience, and middle-sized vehicles were all significantly associated with a higher likelihood of vehicle crashes. Drivers' demographic characteristics and past traffic violations could predict vehicle crashes in Korea. Greater resources should be assigned to the provision of traffic safety education programs for the high-risk driver groups.
Mytton, Julie A; Towner, Elizabeth M L; Powell, Jane; Pilkington, Paul A; Gray, Selena
The relative significance of child injury as a cause of preventable death has increased as mortality from infectious diseases has declined. Unintentional child injuries are now a major cause of death and disability across the world with the greatest burden falling on those who are most disadvantaged. A review of long-term data on child injury mortality was conducted to explore trends and inequalities and consider how data were used to inform policy, practice and research. The authors systematically collated and quality appraised data from publications and documents reporting unintentional child injury mortality over periods of 20 years or more. A critical narrative synthesis explored trends by country income group, injury type, age, gender, ethnicity and socioeconomic group. 31 studies meeting the inclusion criteria were identified of which 30 were included in the synthesis. Only six were from middle income countries and none were from low income countries. An overall trend in falling child injury mortality masked rising road traffic injury deaths, evidence of increasing vulnerability of adolescents and widening disparities within countries when analysed by ethnic group and socioeconomic status. Child injury mortality trend data from high and middle income countries has illustrated inequalities within generally falling trends. There is scope for greater use of existing trend data to inform policy and practice. Similar evidence from low income countries where the burden of injury is greatest is needed.
Swain, Rajanikanta; Dhaka, Shivani; Sharma, Munish; Bakshi, Mantaran Singh; Murty, O P; Sikary, Asit Kumar
Accidental cut-throat injuries are extremely rare and usually involve a sharp-edged weapon. In this paper, two cases of a cut-throat wound to two auto-rickshaw drivers are presented where the broken windshield of the auto-rickshaws was responsible for the wounds. In both the cases, fatal incised wounds were present over the neck, cutting the soft tissue along with the major vessels. The death occurred due to exsanguination caused by neck-vessel injury in one case and trachea along with neck-vessel injury in the second case. Although the wounds on the neck initially suggested homicide, they were found to have occurred accidentally as a result of a road traffic accident involving a head-on collision of auto rickshaws. The injuries were inflicted by the shattered glass of the windshield.
Full Text Available Traffic safety is a major concern in the transportation industry due to immense monetary and emotional burden caused by crashes of various severity levels, especially the injury and fatality ones. To reduce such crashes on all public roads, the safety management processes are commonly implemented which include network screening, problem diagnosis, countermeasure identification, and project prioritization. The selection of countermeasures for potential mitigation of crashes is governed by the influential factors which impact roadway crashes. Crash prediction model is the tool widely adopted by safety practitioners or researchers to link various influential factors to crash occurrences. Many different approaches have been used in the past studies to develop better fitting models which also exhibit prediction accuracy. In this study, a crash prediction model is developed to investigate the vehicular crashes occurring at roadway segments. The spatial and temporal nature of crash data is exploited to form a spatiotemporal model which accounts for the different types of heterogeneities among crash data and geometric or traffic flow variables. This study utilizes the Poisson lognormal model with random effects, which can accommodate the yearly variations in explanatory variables and the spatial correlations among segments. The dependency of different factors linked with roadway geometric, traffic flow, and road surface type on vehicular crashes occurring at segments was established as the width of lanes, posted speed limit, nature of pavement, and AADT were found to be correlated with vehicle crashes.
Gill, G.; Sakrani, T.; Cheng, W.; Zhou, J.
Traffic safety is a major concern in the transportation industry due to immense monetary and emotional burden caused by crashes of various severity levels, especially the injury and fatality ones. To reduce such crashes on all public roads, the safety management processes are commonly implemented which include network screening, problem diagnosis, countermeasure identification, and project prioritization. The selection of countermeasures for potential mitigation of crashes is governed by the influential factors which impact roadway crashes. Crash prediction model is the tool widely adopted by safety practitioners or researchers to link various influential factors to crash occurrences. Many different approaches have been used in the past studies to develop better fitting models which also exhibit prediction accuracy. In this study, a crash prediction model is developed to investigate the vehicular crashes occurring at roadway segments. The spatial and temporal nature of crash data is exploited to form a spatiotemporal model which accounts for the different types of heterogeneities among crash data and geometric or traffic flow variables. This study utilizes the Poisson lognormal model with random effects, which can accommodate the yearly variations in explanatory variables and the spatial correlations among segments. The dependency of different factors linked with roadway geometric, traffic flow, and road surface type on vehicular crashes occurring at segments was established as the width of lanes, posted speed limit, nature of pavement, and AADT were found to be correlated with vehicle crashes.
Di Stasi, Leandro L; Megías, Alberto; Cándido, Antonio; Maldonado, Antonio; Catena, Andrés
Injury to pedestrians is a major safety hazard in many countries. Since the beginning of the last century, modern cities have been designed around the use of motor vehicles despite the unfavourable interactions between the vehicles and pedestrians. This push towards urbanization resulted in a substantial number of crashes and fatalities involving pedestrians every day, all over the world. Thus, improving the design of urban cities and townships is a pressing issue for modern society. The study presented here provides a characterization of pedestrian safety problems, with the emphasis on signalized crosswalks (i.e. traffic signal) design solutions. We tested the impact of seven different traffic light configurations (steady [green, yellow, and red], flashing [green, yellow, and red], and light off) on pedestrian self-reported road-crossing behavior, using a 11-point scale -ranging from 0 ("I never cross in this situation") to 10 ("I always cross in this situation"). Results showed that mandatory solutions (steady green vs. steady red) are the best solutions to avoid unsafe pedestrian behaviors while crossing controlled intersections (frequency of crossing: Mgreen = 9.4 ± 1 vs. Mred = 2.6 ± 2). These findings offer important guidelines for the design of future traffic signals for encouraging a pedestrian/transit-friendly environment.
Mbakwe, Anthony C; Saka, Anthony A; Choi, Keechoo; Lee, Young-Jae
Highway traffic accidents all over the world result in more than 1.3 million fatalities annually. An alarming number of these fatalities occurs in developing countries. There are many risk factors that are associated with frequent accidents, heavy loss of lives, and property damage in developing countries. Unfortunately, poor record keeping practices are very difficult obstacle to overcome in striving to obtain a near accurate casualty and safety data. In light of the fact that there are numerous accident causes, any attempts to curb the escalating death and injury rates in developing countries must include the identification of the primary accident causes. This paper, therefore, seeks to show that the Delphi Technique is a suitable alternative method that can be exploited in generating highway traffic accident data through which the major accident causes can be identified. In order to authenticate the technique used, Korea, a country that underwent similar problems when it was in its early stages of development in addition to the availability of excellent highway safety records in its database, is chosen and utilized for this purpose. Validation of the methodology confirms the technique is suitable for application in developing countries. Furthermore, the Delphi Technique, in combination with the Bayesian Network Model, is utilized in modeling highway traffic accidents and forecasting accident rates in the countries of research. Copyright © 2016 Elsevier Ltd. All rights reserved.
Wind farms' influences for traffic safety. Study of distance requirements for road traffic, railway traffic, sea traffic and air travel; Tuulivoimaloiden vaikutukset liikenneturvallisuuteen. Selvitys etaeisyysvaatimuksista tie-, rautatie-, meri- ja lentoliikenteen osalta
Hytoenen, K.; Harju, M.; Piispanen, J.; Haulos, S.
As wind power projects, both design and implementation, have increased rapidly, wind power manufacturers have stated that infrastructure of traffic restricts and complicates implementation of wind power projects. Failure of wind farm and both snow and ice thrown from blades and tower are commonly thought to be dangerous for settlement and for road, railway and sea traffic. Based on the accessible information accidents, which are connected to wind farms, won't cause notable harm for outsiders. Majority of the human injury and fatal accidents concerns the personnel of the wind farm in implementation and operational phases, not outsiders. Purpose of this study has been to clarify how distances requirements in different forms of traffic in Finland differ from other countries that are included in this comparison, and to find grounds for possibly revising these guidelines. In Finland there are still longest distance requirements when placing wind farm nearby the main roads, even after Finnish Traffic Agency revised guidelines in 2012. Regarding roads, differences between all the countries were minor. Also distance requirements regarding railways differ relatively little. Sweden has shortest distance requirement. Distance requirements in Finland and Denmark have been reduced in past few years. Any of these countries have not stated actual defined distance requirements related for example to shipping channels or lanes. International Civil Aviation Organization ICAO has settled internationally rules for obstacle limitation surface nearby airports and marking flight obstacles. Countries have stated national aviation regulations according to these rules and for this reason these regulations are quite consistent. In this study distance requirements are recommended to be calculated for certain basis. In case of roads and railways a general minimum distance requirement is suggested to be 1 x wind farm overall height. Road owner is allowed to require higher distance for
Kuoppamäki, Kirsi; Setälä, Heikki; Rantalainen, Anna-Lea; Kotze, D Johan
Traffic is a major source of pollutants in cities. In this well-replicated study we analysed a broad array of contaminants in snowpacks along roads of different traffic intensities. The majority of pollutants showed a similar pattern with respect to traffic intensity: pH and conductivity as well as concentrations of PAHs, total suspended solids, phosphorus and most heavy metals were higher next to high intensity roads compared to low intensity roads. These pollutant levels also decreased considerably up to 5 m distance from the roads. Furthermore, apart from nitrogen, these variables increased in concentration from control sites in urban forest patches to road bank sites next to roads of low, intermediate and high traffic intensities. The deposition pattern of various traffic-derived pollutants--whether gaseous or particle-bound--was the same. Such information can be useful for the purposes of managing pollutants in urban areas. Copyright © 2014 Elsevier Ltd. All rights reserved.
The most common mode of injury was road traffic accident. All the patients admitted to ICU had either moderate or severe head injury, with 73.7% having severe head injury. About 26.3% of the patients had associated cervical spine injuries and 50% had various musculoskeletal and soft tissue injuries. Cranial computed ...
other sports,[1,2] and youth football players are no exception to this. ... at risk of sports injury because of high levels of exposure at a time of major physiological change. The ..... As part of injury prevention, adequate injury management and.
Weijermars, Wendy; Bos, Niels; Filtness, Ashleigh; Brown, Laurie; Bauer, Robert; Dupont, Emmanuelle; Martin, Jean Louis; Perez, Katherine; Thomas, Pete
Information about the burden of (non-fatal) road traffic injury is very useful to further improve road safety policy. Previous studies calculated the burden of injury in individual countries. This paper estimates and compares the burden of non-fatal serious road traffic injuries in six EU countries/regions: Austria, Belgium, England, The Netherlands, the Rhône region in France and Spain. It is a cross-sectional study based on hospital discharge databases. of study are patients hospitalized with MAIS3+ due to road traffic injuries. The burden of injury (expressed in years lived with disability (YLD)) is calculated applying a method that is developed within the INTEGRIS study. The method assigns estimated disability information to the casualties using the EUROCOST injury classification. The average burden per MAIS3+ casualty varies between 2.4 YLD and 3.2 YLD per casualty. About 90% of the total burden of injury of MAIS3+ casualties is due to lifelong consequences that are experienced by 19% to 33% of the MAIS3+ casualties. Head injuries, spinal cord injuries and injuries to the lower extremities are responsible for more than 90% of the total burden of MAIS3+ road traffic injuries. Results per transport mode differ between the countries. Differences between countries are mainly due to differences in age distribution and in the distribution over EUROCOST injury groups of the casualties. The analyses presented in this paper can support further improvement of road safety policy. Countermeasures could for example be focused at reducing skull and brain injuries, spinal cord injuries and injuries to the lower extremities, as these injuries are responsible for more than 90% of the total burden of injury of MAIS3+ casualties. Copyright © 2017 Elsevier Ltd. All rights reserved.
Zuraik, Christopher; Sampalis, John; Brierre, Alexa
The cost of traumatic injury is unknown in Haiti. This study aims to examine the burden of traumatic injury of patients treated and evaluated at a trauma hospital in the capital city of Port-au-Prince. A retrospective cross-sectional chart review study was conducted at the Hospital Bernard Mevs Project Medishare for all patients evaluated for traumatic injury from December 2015 to January 2016, as described elsewhere (Zuraik and Sampalis in World J Surg, https://doi.org/10.1007/s00268-017-4088-2 , 2017). Direct medical costs were obtained from patient hospital bills. Indirect and intangible costs were calculated using the human capital approach. A total of 410 patients were evaluated for traumatic injury during the study period. Total costs for all patients were $501,706 with a mean cost of $1224. Indirect costs represented 63% of all costs, direct medical costs 19%, and intangible costs 18%. Surgical costs accounted for the majority of direct medical costs (29%). Patients involved in road traffic accidents accounted for the largest number of injuries (41%) and the largest percentage of total costs (51%). Patients with gunshot wounds had the highest total mean costs ($1566). Mean costs by injury severity ranged from $62 for minor injuries, $1269 for serious injuries, to $13,675 for critical injuries. Injuries lead to a significant economic burden for individuals treated at a semi-private trauma hospital in the capital city of Port-au-Prince, Haiti. Programs aimed at reducing injuries, particularly road traffic accidents, would likely reduce the economic burden to the nation.
Background Splenic injuries constitute a continuing diagnostic and therapeutic challenge to the trauma or general surgeons practicing in developing countries where sophisticated imaging facilities are either not available or exorbitantly expensive. The purpose of this review was to describe our own experience in the management of the splenic injuries outlining the aetiological spectrum, injury characteristics and treatment outcome of splenic injuries in our local environment and to identify predictors of outcome among these patients. Methods A prospective descriptive study of splenic injury patients was carried out at Bugando Medical Centre in Northwestern Tanzania between March 2009 and February 2011. Statistical data analysis was done using SPSS software version 17.0. Results A total of 118 patients were studied. The male to female ratio was 6.4:1. Their ages ranged from 8 to 74 years with a median age of 22 years. The modal age group was 21-30 years. The majority of patients (89.8%) had blunt trauma and road traffic accidents (63.6%) were the most frequent cause of injuries. Most patients sustained grade III (39.0%) and IV (38.1%) splenic injuries. Majority of patients (86.4%) were treated operatively with splenectomy (97.1%) being the most frequently performed procedure. Postoperative complications were recorded in 30.5% of cases. The overall length of hospital stay (LOS) ranged from 1 day to 120 days with a median of 18 days. Mortality rate was 19.5%. Patients who had severe trauma (Kampala Trauma Score II ≤ 6) and those with associated injuries stayed longer in the hospital (P trauma scores (KTS II), grade of splenic injuries, admission systolic blood pressure ≤ 90 mmHg, estimated blood loss > 2000 mls, HIV infection with CD4 ≤ 200 cells/μl and presence of postoperative complications were significantly associated with mortality (P Trauma resulting from road traffic accidents (RTAs) remains the most common cause of splenic injuries in our setting. Most
splenic injuries were 20. In this study of the 20 patients, 15 cases were males and 5 cases were females. After improving the general condition of the patient, laparotomy proceeded in 12 cases, in which splenectomy done in 8 cases and splenoraphy in 5 cases. CONCLUSION Road traffic accident is the commonest cause for splenic injury abdomen. Predominance of male over female in splenic injury abdomen with the ratio of 3:1.People in the age group of 3 rd and 4 th decade were commonly involved in splenic injury abdomen constituting about 55%. Based upon the grading of injuries and haemodynamic stability of the patient and other associated injuries, decision of laparotomy versus conservative management was taken. 12 patients were managed surgically, 8 underwent splenectomy and 4 underwent splenoraphy by topical haemostatic agents and sutural repair. Overall mortality due to splenic injury abdomen was 15%. Sepsis and associated injury were the major causes of death.
Backgrounds: Sixty percent of the global deaths and injuries occur in the developing world and mostly are due to Road traffic accidents (RTAs. looking at the etiological related factors which include, carelessness of the driver, condition of the vehicle or motorcycle, poor condition of roads, risky behavior of the driver, most of ...
Adminaite, D. Jost, G. Stipdonk, H. & Ward, H.
Exceeding speed limits, drink or distracted driving and failure to wear a seat belt are still the leading causes of death and serious injury on European roads. Despite legislation designed to prevent all four, many drivers involved in fatal traffic collisions clearly failed to comply with one or
Many freeways and arterials in major cities in Texas are presently equipped with video detection cameras to : collect data and help in traffic/incident management. In this study, carefully controlled experiments determined : the throughput and output...
La, Quang Ngoc; Lee, Andy H; Meuleners, Lynn B; Van Duong, Dat
Injury due to road traffic crash is a major cause of ill health and premature deaths in developing countries. Taxis provide a main mode of public transport in Vietnam but there has been little research on the risk of crash for taxi drivers. This retrospective study collected information on taxi crashes for the period 2006-2009 by interviewing drivers from five taxi companies in Hanoi, Vietnam, using a structured questionnaire. Of the total 1214 participants recruited, 276 drivers reported at least one crash, giving an overall crash prevalence of 22.7%. Among the crashed group, 50 drivers (18.1%) were involved in two to four crashes. Logistic regression analysis further identified age of driver, type of driving licence, employment status, perceived sufficiency of income, seat-belt usage, and traffic infringement history to be significantly associated with the crash risk. Further prospective and qualitative studies are recommended to provide detailed crash characteristics as well as behaviour and perception of taxi drivers, so that an effective intervention can be developed to improve road safety and to prevent injury of these commercial drivers. Copyright © 2012 Elsevier Ltd. All rights reserved.
Bent, C.; Iyngkaran, T.; Power, N.; Matson, M.; Hajdinjak, T.; Buchholz, N.; Fotheringham, T.
Blunt renal trauma is the third most common injury in abdominal trauma following splenic and hepatic injuries, respectively. In the majority, such injuries are associated with other abdominal organ injuries. As urological injuries are not usually life-threatening, and clinical signs and symptoms are non-specific, diagnosis is often delayed. We present a practical approach to the diagnosis and management of these injuries based on our experience in a busy inner city trauma hospital with a review of the current evidence-based practice. Diagnostic imaging signs are illustrated
Bent, C. [Department of Diagnostic Imaging, Barts and The London NHS Trust, London (United Kingdom)], E-mail: email@example.com; Iyngkaran, T.; Power, N.; Matson, M. [Department of Diagnostic Imaging, Barts and The London NHS Trust, London (United Kingdom); Hajdinjak, T.; Buchholz, N. [Department of Urology, Barts and The London NHS Trust, London (United Kingdom); Fotheringham, T. [Department of Diagnostic Imaging, Barts and The London NHS Trust, London (United Kingdom)
Blunt renal trauma is the third most common injury in abdominal trauma following splenic and hepatic injuries, respectively. In the majority, such injuries are associated with other abdominal organ injuries. As urological injuries are not usually life-threatening, and clinical signs and symptoms are non-specific, diagnosis is often delayed. We present a practical approach to the diagnosis and management of these injuries based on our experience in a busy inner city trauma hospital with a review of the current evidence-based practice. Diagnostic imaging signs are illustrated.
Cohn, Michael A; Lee, Steven K; Strauss, Eric J
Golf is a global sport enjoyed by an estimated 60 million people around the world. Despite the common misconception that the risk of injury during the play of golf is minimal, golfers are subject to a myriad of potential pathologies. While the majority of injuries in golf are attributable to overuse, acute traumatic injuries can also occur. As the body's direct link to the golf club, the upper extremities are especially prone to injury. A thorough appreciation of the risk factors and patterns of injury will afford accurate diagnosis, treatment, and prevention of further injury.
Bent, C; Iyngkaran, T; Power, N; Matson, M; Hajdinjak, T; Buchholz, N; Fotheringham, T
Blunt renal trauma is the third most common injury in abdominal trauma following splenic and hepatic injuries, respectively. In the majority, such injuries are associated with other abdominal organ injuries. As urological injuries are not usually life-threatening, and clinical signs and symptoms are non-specific, diagnosis is often delayed. We present a practical approach to the diagnosis and management of these injuries based on our experience in a busy inner city trauma hospital with a review of the current evidence-based practice. Diagnostic imaging signs are illustrated.
Drew, Michael; Sheth, Kapil
In this paper two frequency domain techniques are applied to air traffic analysis. The Continuous Wavelet Transform (CWT), like the Fourier Transform, is shown to identify changes in historical traffic patterns caused by Traffic Management Initiatives (TMIs) and weather with the added benefit of detecting when in time those changes take place. Next, with the expectation that it could detect anomalies in the network and indicate the extent to which they affect traffic flows, the Spectral Graph Wavelet Transform (SGWT) is applied to a center based graph model of air traffic. When applied to simulations based on historical flight plans, it identified the traffic flows between centers that have the greatest impact on either neighboring flows, or flows between centers many centers away. Like the CWT, however, it can be difficult to interpret SGWT results and relate them to simulations where major TMIs are implemented, and more research may be warranted in this area. These frequency analysis techniques can detect off-nominal air traffic behavior, but due to the nature of air traffic time series data, so far they prove difficult to apply in a way that provides significant insight or specific identification of traffic patterns.
Birk, Matthias; Ivina, Olga; von Klot, Stephanie; Babisch, Wolfgang; Heinrich, Joachim
self-reported road traffic noise annoyance is commonly used in epidemiological studies for assessment of potential health effects. Alternatively, some studies have used geographic information system (GIS) modelled exposure to road traffic noise as an objective parameter. The aim of this study was to analyse the association between noise exposure due to neighbouring road traffic and the noise annoyance of adults, taking other determinants into consideration. parents of 951 Munich children from the two German birth cohorts GINIplus and LISAplus reported their annoyance due to road traffic noise at home. GIS modelled road traffic noise exposure (L(den), maximum within a 50 m buffer) from the noise map of the city of Munich was available for all families. GIS-based calculated distance to the closest major road (≥10,000 vehicles per day) and questionnaire based-information about family income, parental education and the type of the street of residence were explored for their potential influence. An ordered logit regression model was applied. The noise levels (L(den)) and the reported noise annoyance were compared with an established exposure-response function. the correlation between noise annoyance and noise exposure (L(den)) was fair (Spearman correlation r(s) = 0.37). The distance to a major road and the type of street were strong predictors for the noise annoyance. The annoyance modelled by the established exposure-response function and that estimated by the ordered logit model were moderately associated (Pearson's correlation r(p) = 0.50). road traffic noise annoyance was associated with GIS modelled neighbouring road traffic noise exposure (L(den)). The distance to a major road and the type of street were additional explanatory factors of the noise annoyance appraisal.
Reichenheim, Michael Eduardo; de Souza, Edinilsa Ramos; Moraes, Claudia Leite; de Mello Jorge, Maria Helena Prado; da Silva, Cosme Marcelo Furtado Passos; de Souza Minayo, Maria Cecília
Although there are signs of decline, homicides and traffic-related injuries and deaths in Brazil account for almost two-thirds of all deaths from external causes. In 2007, the homicide rate was 26·8 per 100,000 people and traffic-related mortality was 23·5 per 100,000. Domestic violence might not lead to as many deaths, but its share of violence-related morbidity is large. These are important public health problems that lead to enormous individual and collective costs. Young, black, and poor men are the main victims and perpetrators of community violence, whereas poor black women and children are the main victims of domestic violence. Regional differentials are also substantial. Besides the sociocultural determinants, much of the violence in Brazil has been associated with the misuse of alcohol and illicit drugs, and the wide availability of firearms. The high traffic-related morbidity and mortality in Brazil have been linked to the chosen model for the transport system that has given priority to roads and private-car use without offering adequate infrastructure. The system is often poorly equipped to deal with violations of traffic rules. In response to the major problems of violence and injuries, Brazil has greatly advanced in terms of legislation and action plans. The main challenge is to assess these advances to identify, extend, integrate, and continue the successful ones. Copyright © 2011 Elsevier Ltd. All rights reserved.
Full Text Available Background: Facial fractures and concomitant cranial injuries carry the significant potential for mortality and neurological morbidity mainly in young adults. Aims and Objectives: To analyze the characteristics of head injuries and associated facial injuries, the management options and outcome following cranio-facial trauma. Methods: This retrospective review was performed at Justice K. S. Hegde Charitable Hospital, and associated A. B. Shetty Memorial Institute of Dental sciences, Deralakatte, Mangalore. Following Ethical Committee approval, hospital charts and radiographs of 100 consecutive patients of cranio-facial trauma managed at the Department of Oral and Maxillofacial Surgery and Neurosurgery between January 2004 and December 2004 were reviewed. Results: Majority of the patients were in the 2nd to 4th decade (79% with a male to female ratio of -8.09:1. Road traffic accidents were the common cause of craniofacial trauma in present study (54% followed by fall from height (30%. Loss of consciousness was the most common clinical symptom (62% followed by headache (33%. Zygoma was the most commonly fractured facial bone 48.2% (alone 21.2%, in combination 27.2%. Majority of patients had mild head injury and managed conservatively in present series. Causes of surgical intervention for intracranial lesions were compound depressed fracture, contusion and intracranial hematoma. Operative indications for facial fractures were displaced facial bone fractures. Major causes of mortality were associated systemic injuries. Conclusion: Adult males are the most common victims in craniofacial trauma, and road traffic accidents were responsible for the majority. Most of the patients sustained mild head injuries and were managed conservatively. Open reduction and internal fixation with miniplates was used for displaced facial bone fractures.
Moradi, Ali; Soori, Hamid; Kavousi, Amir; Eshghabadi, Farshid; Nematollahi, Shahrzad; Zeini, Salahdien
In most countries, occurrence of traffic causalities is high in pedestrians. The aim of this study is to geographically analyze the traffic casualties in pedestrians in downtown Tehran city. The study population consisted of traffic injury accidents in pedestrians occurred during 2015 in Tehran city. Data were extracted from offices of traffic police and municipality. For analysis of environmental factors and site of accidents, ordinary least square regression models and geographically weighted regression were used. Fitness and performance of models were checked using the Akaike information criteria, Bayesian information criteria, deviance, and adjusted R 2 . Totally, 514 accidents were included in this study. Of them, site of accidents was arterial streets in 370 (71.9%) cases, collector streets in 133 cases (25.2%), and highways in 11 cases (2.1%). Geographical units of traffic accidents in pedestrians had statistically significant relationship with a number of bus stations, number of crossroads, and recreational areas. Distribution of injury traffic accidents in pedestrians is different in downtown Tehran city. Neighborhoods close to markets are considered as most dangerous neighborhoods for injury traffic accidents. Different environmental factors are involved in determining the distribution of these accidents. The health of pedestrians in Tehran city can be improved by proper traffic management, control of environmental factors, and educational programs.
Jou, Rong-Chang; Chen, Tzu-Ying
In this study, willingness to pay (WTP) for loss of productivity and consolation compensation by parties to traffic accidents is investigated using the Tobit model. In addition, WTP is compared to compensation determined by Taiwanese courts. The modelling results showed that variables such as education, average individual monthly income, traffic accident history, past experience of severe traffic accident injuries, the number of working days lost due to a traffic accident, past experience of accepting compensation for traffic accident-caused productivity loss and past experience of accepting consolation compensation caused by traffic accidents have a positive impact on WTP. In addition, average WTP for these two accident costs were obtained. We found that parties to traffic accidents were willing to pay more than 90% of the compensation determined by the court in the scenario of minor and moderate injuries. Parties were willing to pay approximately 80% of the compensation determined by the court for severe injuries, disability and fatality. Therefore, related agencies can use our study findings as the basis for determining the compensation that parties should pay for productivity losses caused by traffic accidents of different types. Copyright © 2015 Elsevier Ltd. All rights reserved.
Medidas y estrategias para la prevención y control de los accidentes de tránsito: experiencia peruana por niveles de prevención Actions and strategies for the prevention and control of road traffic injuries: peruvian experience by levels of prevention
Full Text Available El presente artículo busca describir las principales medidas de prevención primaria y secundaria sobre accidentes de tránsito que vienen desarrollándose en Perú, considerando aspectos epidemiológicos propios de la experiencia peruana, como lo reportado en otros países. Se aborda lo a nivel de prevención primaria lo relacionado a la restricción horaria de expendio de bebidas alcohólicas, detección de conductores con alcoholemia positiva y el conductor elegido. En cuanto a prevención secundaria, se presenta los estudios de puntos negros y los barriles de contención de impacto, asimismo, una breve visión de los sistemas de atención pre hospitalaria en el caso de los traumatismos por accidentes de tránsito. Existe la necesidad de una mejor caracterización del problema, para establecer las políticas públicas saludables en lo concerniente a accidentes de tránsito, existe la necesidad de valoraciones basadas en evidencia científica y en estudios de evaluaciones económicas.This article aims to describe the main actions that are being developed in Peru for primary and secondary prevention of road traffic injuries, considering the epidemiological aspects that characterize the Peruvian experience, as reported in other countries. At the primary prevention level, it addresses issues related to the timing restriction of the sales of alcoholic beverages, detection of drivers with positive testing for alcohol in blood and the chosen driver. Regarding secondary prevention, the studies on black spots and the impact containment barrels are presented, also a brief overview of the pre-hospital care systems in the case of road traffic injuries. There is a need for better characterization of the problem, in order to establish healthy public policies regarding traffic accidents, there is a need for evidence-based reviews and studies of economic evaluations.
Moradi, Ali; Rahmani, Khaled; Kavousi, Amir; Eshghabadi, Farshid; Nematollahi, Shahrzad; Zainni, Slahedyn; Soori, Hamid
The aim of this study was to geographically analyse the traffic casualties in pedestrians in downtown of Tehran City. Study population consisted of pedestrians who had traffic injury accidents from April 2014 to March 2015 in Tehran City. Data were extracted from the offices of traffic police and municipality. For analysis of environmental factors and site of accidents, Ordinary Least Square (OLS) regression models and Geographically Weighted Regression (GWR) were used. All pedestrian accidents including 514 accidents were assessed in this study in which the site of accidents included arterial streets in 370 (71.9%) cases, collector streets in 133 cases (25.2%) and highways in 11 cases (2.1%). Geographical units of traffic accidents in pedestrians had statistically significant relationship with the number of bus stations, number of crossroads and recreational areas. Neighbourhoods close to markets are considered as the most dangerous places for injury in traffic accidents.
Nagel, K.; Paczuski, M.
We study a single-lane traffic model that is based on human driving behavior. The outflow from a traffic jam self-organizes to a critical state of maximum throughput. Small perturbations of the outflow far downstream create emergent traffic jams with a power law distribution P(t)∼t -3/2 of lifetimes t. On varying the vehicle density in a closed system, this critical state separates lamellar and jammed regimes and exhibits 1/f noise in the power spectrum. Using random walk arguments, in conjunction with a cascade equation, we develop a phenomenological theory that predicts the critical exponents for this transition and explains the self-organizing behavior. These predictions are consistent with all of our numerical results
Nagel, Kai; Paczuski, Maya
We study a single-lane traffic model that is based on human driving behavior. The outflow from a traffic jam self-organizes to a critical state of maximum throughput. Small perturbations of the outflow far downstream create emergent traffic jams with a power law distribution P(t)~t-3/2 of lifetimes t. On varying the vehicle density in a closed system, this critical state separates lamellar and jammed regimes and exhibits 1/f noise in the power spectrum. Using random walk arguments, in conjunction with a cascade equation, we develop a phenomenological theory that predicts the critical exponents for this transition and explains the self-organizing behavior. These predictions are consistent with all of our numerical results.
Joosse, P.; Soedarmo, S.; Luitse, J. S.; Ponsen, K. J.
In this prospective study, the TRISS methodology is used to compare trauma care at a University Hospital in Jakarta, Indonesia, with the standards reported in the Major Trauma Outcome Study (MTOS). Between February 24, 1999, and July 1, 1999, all consecutive patients with multiple and severe trauma
Mutto, Milton; Lawoko, Stephen; Nansamba, Catherine; Ovuga, Emilio; Svanstrom, Leif
Unintentional Childhood Injuries pose a major public health challenge in Africa and Uganda. Previous estimates of the problem may have underestimated the childhood problem. We set to determine unintentional childhood injury pattern, odds, and outcomes at the National Paediatric Emergency unit in Kampala city using surveillance data. Incident proportions, odds and proportional rates were calculated and used to determine unintentional injury patterns across childhood (1-12 years). A total of 556 cases recorded between January and May 2008 were analyzed: majority had been transported to hospital by mothers using mini-buses, private cars, and motorcycles. Median distance from injury location to hospital was 5 km. Homes, roads, and schools were leading injury locations. Males constituted 60% of the cases. Play and daily living activities were commonest injury time activities. Falls, burns and traffic accounted for 70.5% of unintentional childhood injuries. Burns, open wounds, fractures were commonest injury types. Motorcycles, buses and passenger-cars caused most crashes. Play grounds, furniture, stairs and trees were commonest source of falls. Most burn injuries were caused by liquids, fires and hot objects. 43.8% of cases were admitted. 30% were discharged without disability; 10%, were disabled; 1%, died. Injury odds and proportional incidence rates varied with age, place and cause. Poisoning and drowning were rare. Local pediatric injury priorities should include home, road and school safety. Unintentional injuries are common causes of hospital visit by children under 13 years especially boys. Homes, roads and educational facilities are commonest unintentional injury sites. Significant age and gender differences exist in intentional injury causation, characteristics and outcomes. In its current form, our surveillance system seems inefficient in capturing poisoning and drowning. The local prevention priorities could include home, road and school safety; especially
Full Text Available BACKGROUND: Unintentional Childhood Injuries pose a major public health challenge in Africa and Uganda. Previous estimates of the problem may have underestimated the childhood problem. We set to determine unintentional childhood injury pattern, odds, and outcomes at the National Paediatric Emergency unit in Kampala city using surveillance data. METHODS: Incident proportions, odds and proportional rates were calculated and used to determine unintentional injury patterns across childhood (1-12 years. RESULTS: A total of 556 cases recorded between January and May 2008 were analyzed: majority had been transported to hospital by mothers using mini-buses, private cars, and motorcycles. Median distance from injury location to hospital was 5 km. Homes, roads, and schools were leading injury locations. Males constituted 60% of the cases. Play and daily living activities were commonest injury time activities. Falls, burns and traffic accounted for 70.5% of unintentional childhood injuries. Burns, open wounds, fractures were commonest injury types. Motorcycles, buses and passenger-cars caused most crashes. Play grounds, furniture, stairs and trees were commonest source of falls. Most burn injuries were caused by liquids, fires and hot objects. 43.8% of cases were admitted. 30% were discharged without disability; 10%, were disabled; 1%, died. Injury odds and proportional incidence rates varied with age, place and cause. Poisoning and drowning were rare. Local pediatric injury priorities should include home, road and school safety. CONCLUSIONS: Unintentional injuries are common causes of hospital visit by children under 13 years especially boys. Homes, roads and educational facilities are commonest unintentional injury sites. Significant age and gender differences exist in intentional injury causation, characteristics and outcomes. In its current form, our surveillance system seems inefficient in capturing poisoning and drowning. The local prevention
Chalya Phillipo L
Full Text Available Abstract Background Splenic injuries constitute a continuing diagnostic and therapeutic challenge to the trauma or general surgeons practicing in developing countries where sophisticated imaging facilities are either not available or exorbitantly expensive. The purpose of this review was to describe our own experience in the management of the splenic injuries outlining the aetiological spectrum, injury characteristics and treatment outcome of splenic injuries in our local environment and to identify predictors of outcome among these patients. Methods A prospective descriptive study of splenic injury patients was carried out at Bugando Medical Centre in Northwestern Tanzania between March 2009 and February 2011. Statistical data analysis was done using SPSS software version 17.0. Results A total of 118 patients were studied. The male to female ratio was 6.4:1. Their ages ranged from 8 to 74 years with a median age of 22 years. The modal age group was 21-30 years. The majority of patients (89.8% had blunt trauma and road traffic accidents (63.6% were the most frequent cause of injuries. Most patients sustained grade III (39.0% and IV (38.1% splenic injuries. Majority of patients (86.4% were treated operatively with splenectomy (97.1% being the most frequently performed procedure. Postoperative complications were recorded in 30.5% of cases. The overall length of hospital stay (LOS ranged from 1 day to 120 days with a median of 18 days. Mortality rate was 19.5%. Patients who had severe trauma (Kampala Trauma Score II ≤ 6 and those with associated injuries stayed longer in the hospital (P 2000 mls, HIV infection with CD4 ≤ 200 cells/μl and presence of postoperative complications were significantly associated with mortality (P Conclusion Trauma resulting from road traffic accidents (RTAs remains the most common cause of splenic injuries in our setting. Most of the splenic injuries were Grade III & IV and splenectomy was performed in majority of
Full Text Available BACKGROUND In the present scenario, road traffic accidents have become a major cause of human mortality and morbidity. Accidents are increasing at alarming rates in India. The objective of our study was to assess the socio-demographic profile of road traffic accident victims admitted in a tertiary care setting, and to assess the pattern of injuries. METHODOLOGY The present study is prospective and analytical hospital based study. RESULTS The present studies show that more than 70% of the victims are in the age group of below 45 years (n=3196 and with male preponderance. Out of 14364 accident patients visiting the emergency department of Gauhati Medical College and Hospital, 4953 patients were admitted. The majorities of the patients (n=2995 were admitted in surgery department and 1586 in orthopaedic department. CONCLUSIONS Several factors are responsible for causing road accidents such as drunk driving, lack of awareness of traffic rules, nonadherence to safety measures. To reduce morbidity and mortality following road accidents, comprehensive policy has to be adopted by the government
Análise das ocorrências das lesões no trânsito e fatores relacionados segundo resultados da Pesquisa Nacional por Amostra de Domicílios (PNAD Brasil, 2008 Analysis of the occurrence of traffic injuries and related factors according to the National Household Sample Survey (PNAD Brazil, 2008
Deborah Carvalho Malta
Full Text Available O objetivo foi descrever as estimativas de ocorrência de lesões decorrentes do trânsito e os fatores relacionados à população brasileira a partir dos dados obtidos na Pesquisa Nacional por Amostra de Domicílios (PNAD. Trata-se de amostra probabilística em três estágios: municípios, setores censitários e domicílios. Foram entrevistadas 391.868 pessoas. As variáveis acidente de trânsito (AT e uso de cinto de segurança foram descritas segundo dados sociodemográficos e de região de residência. Calcularam-se as proporções, intervalos de confiança de 95%, teste c2 e valor de p. 2,5% (IC95% 2,4-2,6 da população relataram a ocorrência de AT, com maior acometimento da população masculina (3,5%; IC95%: 3,4-3,6, jovens (4,4%; IC95%: 4,2-4,6 e residentes da região Centro-Oeste (3,3%; IC95%: 3,0-3,6. Os AT predominaram entre condutores ou ocupantes de automóveis/vans (53,9% e de motocicletas (30,1%, seguidos de ciclistas (7,6% e pedestres (5,2%. O uso de cinto de segurança dianteiro foi relatado por 73,2% (IC95%: 72,2-74,2 e o cinto traseiro por 37,4% (IC95% 36.6-38,2. O AT determinou o afastamento das atividades habituais em 30,7% dos acometidos. A magnitude das lesões no trânsito justifica avançar em medidas preventivas e legislativas para a redução dos eventos.The study describes the estimates of occurrence of injury due to traffic accidents among the Brazilian population based on data obtained from the National Household Sample Survey (PNAD. It is a probabilistic sample, in which 391,868 people were interviewed. in three stages, namely municipalities, census sectors and households. The traffic accident (TA and the safety belt usage variables were described according to socio-demographic variables and region of residence. Proportions, 95% confidence intervals, c² tests and p values were calculated. 2.5% (CI95% 2.4-2.6% of the population reported higher traffic accident (TA incidence among males (3.5%; CI95%: 3
Subotić Jovana Lj.
Full Text Available Speed, and vehicles themselves, affect the level of service and road safety, quality of life, noise from traffic, the environment, health, air pollution, emission of carbon dioxide, global warming, the economy and consumption of non-renewable energy such as oil. Therefore, the speed management of the traffic of multiple significance and that should be primarily to provide effective and economical conditions of the modern and preventive protection of human life as the greatest treasure and then the material resources. The way to accomplish this is by using various (different measures such as: appropriate planning and projecting roads and streets, speed control, the legislation, enforcement, campaigns, education, advanced technologies (ITS.
Philipsen, Mark Philip; Jensen, Morten Bornø; Møgelmose, Andreas
Traffic light recognition (TLR) is an integral part of any intelligent vehicle, which must function in the existing infrastructure. Pedestrian and sign detection have recently seen great improvements due to the introduction of learning based detectors using integral channel features. A similar push...... database is collected based on footage from US roads. The database consists of both test and training data, totaling 46,418 frames and 112,971 annotated traffic lights, captured in continuous sequences under a varying light and weather conditions. The learning based detector achieves an AUC of 0.4 and 0...
Mohanty, Anita; Bhanja, Urmila; Mahapatra, Sudipta
Currently, city traffic monitoring and controlling is a big issue in almost all cities worldwide. Vehicular ad-hoc Network (VANET) technique is an efficient tool to minimize this problem. Usually, different types of on board sensors are installed in vehicles to generate messages characterized by different vehicle parameters. In this work, an intelligent system based on fuzzy clustering technique is developed to reduce the number of individual messages by extracting important features from the messages of a vehicle. Therefore, the proposed fuzzy clustering technique reduces the traffic load of the network. The technique also reduces congestion and quantifies congestion.
Johansson, M S; Boyle, E; Hartvigsen, Jan
BACKGROUND: Traffic collisions often result in a wide range of symptoms included in the umbrella term whiplash-associated disorders. Mid-back pain (MBP) is one of these symptoms. The incidence and prognosis of different traffic injuries and their related conditions (e.g. neck pain, low back pain...... data from a population-based inception cohort of all traffic injuries occurring in Saskatchewan, Canada, during a 2-year period were used. Annual overall and age-sex-specific incidence rates were calculated, the course of recovery was described using the Kaplan-Meier technique, and associations between...... recovery was 101 days (95% CI: 99-104) and about 23% were still not recovered after 1 year. Participant's expectation for recovery, general health, extent of severely affecting comorbidities and having experienced a previous traffic injury were some of the prognostic factors identified. CONCLUSIONS...
Heydari Seyed Taghi
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