Accident; analysis and prevention
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American Indians (AI's) have the lowest rate of seatbelt use in the nation, putting them at significant risk for motor vehicle crash (MVC) morbidity and mortality. This study compares seatbelt use in victims of level one trauma crashes presenting from on and off AI reservations. Predictors of seatbelt use were evaluated as well. We hypothesized that AI's in crashes on a reservation would have lower rates of seatbelt use, even compared to AI's in crashes from off the reservation. ⋯ In this analysis, alcohol, rather than race or location, is the overriding predictor of seatbelt use. This study compared patients that were in crashes, and only those triaged to a level one trauma facility. If we assume unbelted passengers are more severely injured, this would bias our results. The application of these data may help direct future public service efforts to increase seatbelt use in target populations.
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Older drivers have one of the highest motor vehicle crash (MVC) rates per kilometer driven, largely due to the functional effects of the accumulation, and progression of age-associated medical conditions that eventually impact on fitness-to-drive. Consequently, physicians in many jurisdictions are legally mandated to report to licensing authorities patients who are judged to be medically at risk for MVCs. Unfortunately, physicians lack evidence-based tools to assess the fitness-to-drive of their older patients. This paper reports on a pilot study that examines the acceptability and association with MVC of components of a comprehensive clinical assessment battery. ⋯ Based on their degree of acceptability to patients and their positive associations with MVC, the MMSE, the Driving Habits Questionnaire, the Ottawa Driving and Dementia Toolkit patient questions merit further study regarding their ability to identify older drivers at high risk of future motor vehicle crashes. Given the paucity of physical examination measures that are theoretically linked to fitness-to-drive, the new physical examination tests introduced in this paper (e.g. the Timed Toe Tap Test, the Peripheral Vision Finger Test, the Neck Rotation Finger Test, and the Coin-catch Reaction Time Test) represent additions to this field of research and also merit consideration for further study.
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Comparative Study
The risk of traffic accidents after prescriptions of carisoprodol.
Carisoprodol, a drug used for acute lower back pain, may cause psychomotor impairment. We wanted to investigate if patients using carisoprodol had increased risk of being involved in a traffic accident. ⋯ Patients receiving carisoprodol seem to have an increased risk of being involved in traffic accidents involving person injury. The study gives support to earlier work published on the impairing effects of carisoprodol.