Accident; analysis and prevention
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The objectives of this autopsy-based audit of firearm-related fatalities were to acquire data to inform policy decisions and to assess the probability of the injured arriving alive at a hospital and receiving definitive care. ⋯ Of a total of 370 fatalities, 85.7% were male. The median age was 38 (9-95) years. Suicides (47%) and assaults (45.1%) were the most common underlying intentions. The most seriously injured regions were the head (44.5%), thorax (25.7%), abdomen (10.7%), and spine (5.7%). Of the 370 total subjects, 4.9% had an ISS<16 and 59.5% had an ISS≤74; both groups were classified as potentially preventable deaths. The majority (84%) died at the scene, and only 9.8% left the emergency department alive for further treatment. Multivariate analyses documented that postmortem ISS is an independent factor that predicts the probability of the injured reaching a hospital alive and receiving definitive care. Individuals injured in greater Athens and those most seriously injured in the face, abdomen or spine had significantly greater chances of reaching a hospital alive and receiving definitive care, whereas those injured by a shotgun and the positive toxicology group were significantly less likely to. In conclusion, this study provides data to inform policy decisions, calls for a surveillance network and establishes a baseline for estimating the probability regarding the location of firearm-related deaths.
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Governments aim to promote a shift from car to bicycle, but concerns about road safety seem to represent an important argument against this encouragement. This study examines the road safety impact of a modal shift from short car trips to cycling in Dutch municipalities. The road safety effect is estimated using Accident Prediction Models (APMs) that account for the non-linearity of risk. ⋯ The neutral effect on fatalities, despite the high fatality risk for cyclists, can be explained by there being fewer cars on the road to pose a risk to others, the shorter length of bicycle trips compared to the car trips they replace, and the "safety in numbers" phenomenon. The rise in the number of serious road injuries is due wholly to the high number of cycling crashes with no other vehicle involved. The effect of a modal shift is dependent on the age of the population in which the shift is concentrated, and can be influenced by measures affecting cyclists' injury risk.
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The objective of this paper is to develop crash estimation models at traffic analysis zone (TAZ) level as a function of land use characteristics. Crash data and land use data for the City of Charlotte, Mecklenburg County, North Carolina were used to illustrate the development of TAZ level crash estimation models. Negative binomial count models (with log-link) were developed as data was observed to be over-dispersed. ⋯ The coefficient for single-family residential area was observed to be negative, indicating a decrease in the number of crashes with an increase in single-family residential area. Models were also developed to estimate these crashes by severity (injury and property damage only crashes). The outcomes can be used in safety conscious planning, land use decisions, long range transportation plans, and, to proactively apply safety treatments in high risk TAZs.
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Randomized Controlled Trial Comparative Study
The effect of a low and high resource intervention on older drivers' knowledge, behaviors and risky driving.
This study aimed to compare an in-class Seniors on the MOVE (Mature Operators Vehicular Education) interactive multi-session driving curriculum with a self-guided MOVE curriculum for older adults. Using a two group randomized design, we sought to determine if there are between-group differences in older drivers' knowledge and safety behaviors among participants. Forty-four participants with an average age of 79 years (SD=7.1) were randomly assigned to the original MOVE program (SOM-A) or a lower resource (SOM-B) self-guided intervention. ⋯ Mean behavior change scores for participants sitting 10-12 inches from the steering wheel were significantly more likely among SOM-A (mean=.65, SD=.5) participants than those in SOM-B (mean=.29, SD=.5, p=.01) at first follow-up. Taken together, these findings suggest that the more intensive program is more effective and that driving safety programs focused on behaviors to self evaluate driving abilities continue to be needed to help older drivers remain safer on the road as they age. The involvement of health care providers in such efforts may be an untapped potential.
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To study the anatomical distribution, severity, outcome, and age by nationality of hospitalized motorcycle-related injured patients in Al-Ain, United Arab Emirates so as to improve preventive measures. ⋯ The most common mechanism of motorcycle crashes was hitting a moving vehicle. Young UAE national motorcyclists are at a higher risk of being injured compared with non UAE nationals. This may be due to risk-taking behavior of young motorcyclists who are mainly riding for leisure. Extremities were the most common injured body region. Severe head injury was the main cause of death. This signifies the need for effective application of motorcycle helmet law in the UAE along with other preventive measures that might include increasing the licensing age.