Accident; analysis and prevention
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To determine prevalence and correlates of handgun access among adolescents seeking care in an urban Emergency Department (ED) in order to inform future injury prevention strategies. ⋯ High rates of handgun access were evident among adolescents presenting in an inner city ED, including those seeking care for non-injury related reasons. Adolescents with access to handguns were more likely to report risk behaviors and past injury, providing clinicians with an opportunity for injury prevention initiatives.
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The Crash Injury Research Engineering Network (CIREN) database contains detailed medical and crash information on a large number of severely injured occupants in motor vehicle crashes. CIREN's major limitation for stand-alone analyses to explore injury risk factors is that control subjects without a given injury type must have another severe injury to be included in the database. This leads to bias toward the null in the estimation of risk associations. ⋯ These pseudo-weights not only allow for reduced bias in the estimation of risk associations, they allow direct prevalence estimates to be made using medical outcome data available only in CIREN. We illustrate the use of these methods with both simulation studies and application to estimation of prevalence and predictors of AIS 3+ injury risk to head, thorax, and lower extremity regions, as well as prevalence and predictors of acetabular pelvic fractures. Results of these analyses demonstrate combining NASS and CIREN data can yield improvements in mean square error and nominal confidence interval coverage over analyses that use either the NASS-CDS or the CIREN sample alone.
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The Committee on Trauma recommends that older motor vehicle crash (MVC) victims or victims of crashes with significant vehicle intrusion of more than 12 in. be transferred to a trauma center since those older than 55 have an increased risk of death after injury. Yet, the precise injury thresholds as they relate to age, gender and velocity remain ill-defined. To maintain a low rate of under triage, reliable methods to identify patients at moderate injury risk are needed. We therefore characterized the likelihood of moderate to severe injury in MVC victims to determine the influence of age, gender and velocity. ⋯ Our data indicate that age and gender must be considered in addition to crash velocity when making triage decisions. Furthermore, Federal Motor Vehicle Safety Standards may need to be modified to address the increased risk of injury among older adults at lower velocities given the increasing number of elderly drivers in the US.
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Hazard perception is a critical skill for road users. In this study, an open-loop motorcycle simulator was used to examine the effects of motorcycle riding and car driving experience on hazard perception and visual scanning patterns. Three groups of participants were tested: experienced motorcycle riders who were experienced drivers (EM-ED), inexperienced riders/experienced drivers (IM-ED), and inexperienced riders/inexperienced drivers (IM-ID). ⋯ The results revealed a significant monotonic decrease in hazard response times as experience increased from IM-ID to IM-ED to EM-ED. Compared to the IM-ID group, both the EM-ED and IM-ED groups exhibited more flexible visual scanning patterns that were sensitive to the presence of hazards. These results point to the potential benefit of training hazard perception and visual scanning in motorcycle riders, as has been successfully demonstrated in previous studies with car drivers.
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With the expansion of bicycle usage and limited funding and/or space for segregated pedestrian and bicycle paths, there is a need for traffic, road design and local government engineers to decide if it is more appropriate for space to be shared between either cyclists and pedestrians, or between cars and cyclists, and what restrictions need to be applied in such circumstances. To provide knowledge to aid engineers and policy makers in making these decisions, this study explored death and morbidity data for the state of New South Wales, Australia to examine rates and severity of injury arising from collisions between pedestrians and cyclists, and between cyclists and motor vehicles (MVs). An analysis of the severity of hospitalised injuries was conducted using International Classification of Diseases, Version 10, Australian Modification (ICD-10-AM) diagnosis-based Injury Severity Score (ICISS) and the Disability Adjusted Life Year (DALY) was used to measure burden of injury arising from collisions resulting in death or hospitalisation. ⋯ For all collision mechanisms, the odds of serious injury on admission are greater for the elderly than for those in other age groups. The significant burden of injury arising from collisions of cyclists and MVs needs to be addressed. However in the absence of appropriate controls, increasing the opportunity for conflict between cyclists and pedestrians (through an increase in shared spaces for these users) may shift the burden of injury from cyclists to pedestrians, in particular, older pedestrians.