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Lim A. Post-lockdown burden of road injury involving hospitalisation in Victoria, Australia: A statewide, population-based time series analysis. Emerg Med Australas 2024. [PMID: 38684938 DOI: 10.1111/1742-6723.14422] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2023] [Revised: 03/21/2024] [Accepted: 04/14/2024] [Indexed: 05/02/2024]
Abstract
OBJECTIVES Ever since COVID-19, short-term changes in transport injury patterns have been observed. The aim is to examine both the initial and the enduring impact of government lockdown and the pandemic on road injuries requiring hospitalisation and road fatalities. METHODS Time series analysis of Transport Accident Commission (TAC) claims involving hospitalisation and fatalities in Victoria, Australia, from July 2016 to May 2023, including lockdown (March 2020 to October 2020) and post-lockdown (November 2020 onwards). RESULTS A total of 46 450 TAC claims were included. Average claims during the pre-pandemic period were 652/month. Lockdown restrictions were associated with a statistically significant fall in monthly claims (-255, 95% confidence interval [CI] = -315 to -194, P < 0.01). This was consistent across road users, days of the week, hours of the day, injury severity, sex and central versus rural locations. The post-lockdown period had a statistically significant reduction in monthly claims to 76% (95% CI = 67-84) of pre-pandemic levels (-158, 95% CI = -213 to -102, P <0.01). This was consistent across all subgroups except bicyclist injuries, which remained constant (-8, 95% CI = -16 to 0, P = 0.05). There was a significant upward trend in the fatality-to-claim ratio post-lockdown (0.001, 95% CI = 0-0.001, P <0.01). CONCLUSION Road injury requiring hospitalisation decreased significantly during governmental lockdown and has returned to three-quarters of pre-pandemic levels (except bicyclist injuries that have remained constant), but there is an increasingly disproportionate number of fatalities. This represents a new baseline of injury burden for EDs and hospitals that manage trauma patients.
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Affiliation(s)
- Andy Lim
- Department of Emergency Medicine, Holmesglen Private Hospital, Melbourne, Victoria, Australia
- School of Clinical Sciences at Monash Health, Monash University, Melbourne, Victoria, Australia
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Lourens A, Sinclair M, Willems B, Young T. Education, incentive, and engineering-based interventions to promote the use of seat belts. Cochrane Database Syst Rev 2024; 1:CD011218. [PMID: 38197528 PMCID: PMC10777455 DOI: 10.1002/14651858.cd011218.pub2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/11/2024]
Abstract
BACKGROUND Over 1.3 million people die each year as a result of traffic collisions and hundreds of thousands of others are permanently and seriously injured. Most of these deaths occur in low- and middle-income countries, where mortality rates can be up to 10 times higher than those of some high-income countries. Seat belts are designed to accomplish two key functions - to prevent the occupant from being ejected from the vehicle by the force of impact, and to extend the time that the decelerating force is applied to a person. Seat belts also spread the area of impact both to larger and less vulnerable parts of the body. Since the 1950s, seat belts have been factory-fitted to most vehicles, and today around 90% of high-income countries have adopted seat belt legislation that makes it mandatory for some, if not all, vehicle occupants to wear seat belts. However, the simple passing of laws is not sufficient to ensure seat belt use, and, while the enforcement of seat belt laws does increase seat belt use, other interventions have been developed to encourage voluntary - and hence sustainable - behaviour change. OBJECTIVES To evaluate the benefits of behavioural-change interventions (educational-based, incentive-based, engineering-based, or a combination, but not enforcement-based) that promote the use of seat belts, and to determine which types of interventions are most effective. SEARCH METHODS On 9 August 2022, we searched the Cochrane Central Register of Controlled Trials (CENTRAL), OvidSP Embase, OvidSP MEDLINE, 14 other databases, and clinical trials registers. We also screened reference lists and conference proceedings, searched websites of relevant organisations, and contacted road safety experts. The search was performed with no restrictions in terms of language and date of publication. SELECTION CRITERIA We included randomised controlled trials (RCTs), both individually randomised and cluster-randomised, that evaluated education, engineering, incentive-based interventions (or combinations) that promoted seat belt use. DATA COLLECTION AND ANALYSIS Two review authors independently assessed the eligibility of RCTs, evaluated the risk of bias, and extracted data. We performed a narrative synthesis based on effect direction due to the heterogeneity observed between RCTs and reported the synthesis in accordance with reporting guidelines for systematic reviews without meta-analysis, as appropriate. We assessed the certainty of the evidence using the GRADE approach. We analysed data on the primary outcome, frequency of wearing a seat belt. None of the included RCTs reported the other primary outcome, crash-related injury rate or the secondary outcome, crash-related mortality rates of interest in this review. MAIN RESULTS We included 15 completed RCTs (12 individual, parallel-group, and three cluster) that enroled 12,081 participants, published between 1990 and 2022. Four trials were published between 2019 and 2022, and the remaining trials were published 10 or more years ago. We also identified four ongoing RCTs. Thirteen RCTs were conducted in the USA. Trials recruited participants from various sites (worksites, schools, emergency departments, a residential retirement community, and primary care settings) and different age groups (adults, late adolescents, early adolescents, and dyads). Thirteen trials investigated educational interventions, one of which used education in addition to incentives (one of the intervention arms) measured through participant self-reports (12) and observation (one), and two trials investigated engineering-based interventions measured through in-vehicle data monitor systems at various follow-up periods (six weeks to 36 months). We grouped RCTs according to types of education-based interventions: behavioural education-based, health risk appraisal (HRA), and other education-based interventions. The evidence suggests that behavioural education-based (four trials) interventions may promote seat belt use and HRA interventions (one trial) likely promote seat belt use in the short term (six weeks to nine months). Four of the six trials that investigated behavioural education-based interventions found that the intervention compared to no or another intervention may promote seat belt use. These effects were measured through participant self-report and at various time points (six-week to 12-month follow-up) (low-certainty evidence). One of the three trials investigating HRA only or with additional intervention versus no or another intervention showed observed effects likely to promote seat belt use (moderate-certainty evidence). The evidence suggests that engineering-based interventions using vehicle monitoring systems (with in-vehicle alerts and with or without notifications/feedback) may promote the use of seat belts. One trial showed that engineering interventions (in-vehicle alerts and feedback) may promote seat belt use while the other showed unclear effects in two of the three intervention groups (low-certainty evidence). Both trials had small sample sizes and high baseline seat belt use. AUTHORS' CONCLUSIONS The evidence suggests that behavioural education-based interventions may promote seat belt use and HRA (including incentives) with or without additional interventions likely promote seat belt use. Likewise, for engineering-based interventions using in-vehicle data monitor systems with in-vehicle alerts, with or without notifications/feedback the evidence suggests the interventions may promote the use of seat belts. Well-designed RCTs are needed to further investigate the effectiveness of education and engineering-based interventions. High-quality trials that examine the potential benefits of incentives to promote seat belt use, either alone or in combination with other interventions, as well as trials to investigate other types of interventions (such as technology, media/publicity, enforcement, insurance schemes, employer programmes, etc.) to promote the use of seat belts, are needed. Evidence from low- and middle-income economies is required to improve the generalisability of the data. In addition, research focused on determining which interventions or types of interventions are most effective in different population groups is needed.
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Affiliation(s)
- Andrit Lourens
- Division of Emergency Medicine, Department of Family, Community and Emergency Care, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
- Department of Clinical Health Sciences, School of Health Sciences, Faculty of Health, Natural Resources and Applied Sciences, Namibia University of Science and Technology, Windhoek, Namibia
| | - Marion Sinclair
- Department of Civil Engineering, University of Stellenbosch, Matieland, South Africa
| | - Bart Willems
- Division of Health Systems and Public Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - Taryn Young
- Centre for Evidence-based Health Care, Division of Epidemiology and Biostatistics, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
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Murillo-Hoyos J, García-Moreno LM, Tinjacá N, Jaramillo C. [Deaths from traffic injuries and social inequality in Colombia, 2019Mortalidade por acidentes de trânsito e desigualdades sociais na Colômbia, 2019]. Rev Panam Salud Publica 2023; 47:e121. [PMID: 37654795 PMCID: PMC10464641 DOI: 10.26633/rpsp.2023.121] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2022] [Accepted: 06/05/2023] [Indexed: 09/02/2023] Open
Abstract
Objective To evaluate the association between social inequalities and deaths from traffic injuries in Colombia in 2019. Methods This ecological study evaluated the association between social inequalities and deaths from traffic injuries among users of the road transport system in Colombia in 2019, based on secondary information sources, using the department level as the administrative and geographic unit of study. A descriptive statistical analysis of health indicators and equity stratifiers was performed. Absolute and relative measures were used to determine social inequality gaps. Results In 2019, 6 580 people died from road traffic injuries in Colombia. The majority of them (82%) were men. The most critical user condition was being a motorcyclist. The age group with the most victims was approximately 30 years old. Departments with populations between 500 000 and 2 000 000 were the most represented. The most critical equity stratifier was the number of registered motorcycles per 100 000 population. Significant inequality gaps between departments were observed. Conclusions Inequalities in deaths from road traffic injuries in Colombia were observed. Policies and actions should focus on helping to reduce identified inequities, resulting in better quality of life, well-being, and health for the population.
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Affiliation(s)
- Jackeline Murillo-Hoyos
- Escuela de Ingeniería Civil y GeomáticaUniversidad del ValleCaliColombiaEscuela de Ingeniería Civil y Geomática. Universidad del Valle, Cali, Colombia.
| | - Lina M. García-Moreno
- Escuela de Ingeniería Civil y GeomáticaUniversidad del ValleCaliColombiaEscuela de Ingeniería Civil y Geomática. Universidad del Valle, Cali, Colombia.
| | - Natalia Tinjacá
- Organización Panamericana de la SaludBogotáColombiaOrganización Panamericana de la Salud. Bogotá, Colombia.
| | - Ciro Jaramillo
- Escuela de Ingeniería Civil y GeomáticaUniversidad del ValleCaliColombiaEscuela de Ingeniería Civil y Geomática. Universidad del Valle, Cali, Colombia.
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Aires CCG, Araújo HTDE, Souza RRLDE, Santos AJFD, Vasconcellos RJDEH, Vasconcelos BCDOE. Relationship between the use and types of helmets with facial injuries - a prospective study. Rev Col Bras Cir 2023; 49:e20223387. [PMID: 36629720 PMCID: PMC10578819 DOI: 10.1590/0100-6991e-20223387-en] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2022] [Accepted: 08/14/2022] [Indexed: 01/11/2023] Open
Abstract
INTRODUCTION many studies have demonstrated the benefits of helmet to prevent and reduce severity of injuries in motorcyclists. OBJECTIVE the aim of the present study was to evaluate a possible relationship between the use of different types of helmets and the occurrence of facial injuries among victims of motorcycle accidents, seen at Hospital da Restauração, Recife/PE, Brazil. MATERIALS AND METHODS demographic and trauma data were collected from hospitalized motorcycle accident victims with facial injuries from December 2020 to July 2021. Pearsons chi-square test was used to assess association between two categorical variables using a margin of error of 5%. RESULTS among the participants, the average age was 33.46 years. The age group between 18 and 29 years was the most prevalent. Most participants were male. 60.0% of motorcyclists used helmets at the time of the accident and of this percentage 37.6% used fixed full-face helmet, 16.5% open-face helmet and the other 5.9% articulated full-face helmet. 62.7% of participants had facial fractures. Among the fractures, those of the zygomatic-orbital complex were the most common fracture and were significantly associated with the use of helmets, especially with open-face helmet. CONCLUSIONS the use of helmets was associated with a lower number of facial fractures among patients who were victims of motorcycle accidents. Fracture of the zygomatic-orbital complex was related to the absence of a helmet at the time of the accident, as well as the use of open-face helmets.
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Affiliation(s)
- Carolina Chaves Gama Aires
- - Universidade de Pernambuco, Departamento de Cirurgia e Traumatologia Buco-Maxilo-Facial - Recife - PE - Brasil
| | - Heitor Tavares DE Araújo
- - Universidade de Pernambuco, Departamento de Cirurgia e Traumatologia Buco-Maxilo-Facial - Recife - PE - Brasil
| | - Rosa Rayanne Lins DE Souza
- - Universidade de Pernambuco, Departamento de Cirurgia e Traumatologia Buco-Maxilo-Facial - Recife - PE - Brasil
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Silva AADA, Ströher GR, Teixeira HM, Cordeiro MVG, Olandoski M, VON-Bahten LC. Impact of the COVID-19 pandemic on the epidemiology of traffic accidents: a cross-sectional study. Rev Col Bras Cir 2022; 49:e20223364. [PMID: 36515331 PMCID: PMC10578847 DOI: 10.1590/0100-6991e-20223364-en] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2022] [Accepted: 07/20/2022] [Indexed: 12/14/2022] Open
Abstract
OBJECTIVE to assess the epidemiological profile of traffic accident victims in the setting of the Coronavirus Disease 2019 (COVID-19) pandemic and analyze the admissions throughout the different levels of restriction (flags), as well as compare the results with the pre-pandemic period. METHODS a cross-sectional study was performed, with probability sampling, in a trauma center in Brazil. Medical records of patients involved in traffic accidents from June 2020 to May 2021 were evaluated. Aside from epidemiological characteristics, variables such as the current flag, the trauma mechanism, the resulting injuries, and the Revised Trauma Score (RTS) were also considered. Data were compared between three different flag periods and the proportion of consultations during the pandemic was compared with that from pre-pandemic time (December 2016 to February 2018). RESULTS it was observed that 62.2% of the patients were victims of motorcycle accidents, 77.5% were male, and the mean age was 33 ± 12.4 years. The mean and median RTS were 7.5 and 7.8, respectively. Statistical difference was stated when comparing the number of visits per day between the yellow and red flags (p=0.001) and orange and red flags (p=0.016). A significantly lower number of consultations for traffic accidents was observed in the pandemic when compared to the pre-pandemic period. CONCLUSIONS the epidemiological profile of the study consisted mostly of young men who were victims of motorcycle accidents. There was a lower incidence of admissions during red flag periods and a lower proportion of consultations throughout the survey when compared to the pre-pandemic period.
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Affiliation(s)
- Angel Adriany DA Silva
- - Hospital Universitário Cajuru, Liga Acadêmica do Trauma (LATHUC) - Curitiba - PR - Brasil
| | | | - Heloísa Moro Teixeira
- - Hospital Universitário Cajuru, Liga Acadêmica do Trauma (LATHUC) - Curitiba - PR - Brasil
| | | | - Marcia Olandoski
- - Pontifícia Universidade Católica do Paraná, Escola de Medicina e Ciências da Vida, Departamento de Bioestatística - Curitiba - PR - Brasil
| | - Luiz Carlos VON-Bahten
- - Hospital Universitário Cajuru, Liga Acadêmica do Trauma (LATHUC) - Curitiba - PR - Brasil
- - Universidade Federal do Paraná, Departamento de Clínica Cirúrgica - Curitiba - PR - Brasil
- - Pontifícia Universidade Católica do Paraná, Escola de Medicina e Ciências da Vida, Departamento de Clínica Cirúrgica - Curitiba - PR - Brasil
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Conde K, Peltzer RI, Gimenez PV, Salomón T, Suarez G, Monteiro M, Cherpitel CJ, Cremonte M. Road traffic injury risk from alcohol and cannabis use among emergency department patients in Argentina. Rev Panam Salud Publica 2022; 46:e116. [PMID: 36060199 PMCID: PMC9426949 DOI: 10.26633/rpsp.2022.116] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2022] [Accepted: 06/07/2022] [Indexed: 11/24/2022] Open
Abstract
Objective To report the risk from alcohol, cannabis, and their combined use for non-fatal road traffic injuries for drivers, passengers, and pedestrians. Methods Risk was estimated using the case-crossover method. Participants (N= 306) were injured patients from an emergency department in Mar del Plata, Argentina. Results Alcohol use (OR= 6.78, CI 95% 3.75-12.25) as well as combined alcohol and cannabis use (OR= 7.05, CI 95% 1.16-42.73) significantly increased the risk of a road traffic injuries. Alcohol use increased the risk in both, women (OR= 8.87, CI 95% 2.69-29.21) and men (OR= 6.16, CI 95% 3.10-12.23); in those >30 years old (OR= 6.01, CI 95% 2.09-17.24) and those <30 years old (OR= 7.15, CI 95% 3.49-14.65). This last group also had an increased risk after combined alcohol and cannabis use (OR= 7.05, CI 95% 1.16-42.75). Both drivers (OR= 6.40, CI 95% 3.23-12.69) and passengers (OR= 13.83, CI 95% 2.87-66.42) had an increased risk after alcohol consumption. Conclusions To our knowledge, these are the first estimates of the risk of having a road traffic injury after alcohol and cannabis consumption in one of the countries of the Southern Cone (Argentina, Chile, and Uruguay). These results highlight the urgent need to implement and enforce comprehensive alcohol control measures. Furthermore, given the global trend towards legalizing cannabis for recreational use, our results could also inform policymakers to enact or amend impaired driving laws.
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Affiliation(s)
- Karina Conde
- Universidad Nacional de Mar del PlataMar del PlataArgentinaUniversidad Nacional de Mar del Plata, Mar del Plata, Argentina.
| | - Raquel Inés Peltzer
- Universidad Nacional de Mar del PlataMar del PlataArgentinaUniversidad Nacional de Mar del Plata, Mar del Plata, Argentina.
| | - Paula Victoria Gimenez
- Universidad Nacional de Mar del PlataMar del PlataArgentinaUniversidad Nacional de Mar del Plata, Mar del Plata, Argentina.
| | - Tomás Salomón
- Universidad Nacional de Mar del PlataMar del PlataArgentinaUniversidad Nacional de Mar del Plata, Mar del Plata, Argentina.
| | - Gabriel Suarez
- Hospital Interzonal General de Agudos “Dr. Oscar Alende”Mar del PlataArgentinaHospital Interzonal General de Agudos “Dr. Oscar Alende”, Mar del Plata, Argentina
| | - Maristela Monteiro
- Pan American Health OrganizationWashington, D.C.United States of AmericaPan American Health Organization, Washington, D.C., United States of America
| | - Cheryl J Cherpitel
- Public Health InstituteEmeryvilleUnited States of AmericaPublic Health Institute, Emeryville, United States of America
| | - Mariana Cremonte
- Universidad Nacional de Mar del PlataMar del PlataArgentinaUniversidad Nacional de Mar del Plata, Mar del Plata, Argentina.
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Below C, Brianti IC, Parreira JG, Lucarelli-Antunes PDES, Saade N, Golin M, Pivetta LGA, Veiga JCE, Assef JC. Clinical assessment of head injuries in motorcyclists involved in traffic accidents: A prospective, observational study. Rev Col Bras Cir 2022; 49:e20223340. [PMID: 35894390 PMCID: PMC10578845 DOI: 10.1590/0100-6991e-20223340-en] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2022] [Accepted: 05/09/2022] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE to review the clinical assessment of head injuries in motorcyclists involved in traffic accidents. METHOD prospective observational study, including adult motorcyclists involved in traffic accidents in a period of 12 months. Patients sustaining signs of intoxication were excluded. A modification of the Canadian Head CT Rules was used to indicate computed tomography (CT). Patients not undergoing CT were followed by phone calls for three months. Collected variables were compared between the group sustaining head injuries and the others. We used chi-square, Fisher, and Student's t for statistical analysis, considering p<0.05 as significant. RESULTS we included 208 patients, 99.0% were wearing helmets. Seventeen sustained signs of intoxication and were excluded. Ninety (47.1%) underwent CT and 12 (6.3%) sustained head injuries. Head injuries were significantly associated with Glasgow Coma Scale<15 (52.3% vs. 2.8% - p<0,001) and a positive physical exam (17.1% vs. zero - p<0,05). Four (2.1%) patients with intracranial mass lesions needed surgical interventions. None helmet-wearing patients admitted with GCS=15 and normal physical examination sustained head injuries. CONCLUSION Head CT is not necessary for helmet-wearing motorcyclists admitted with GCS=15 and normal physical examination.
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Affiliation(s)
- Cristiano Below
- - Irmandade da Santa Casa de Misericórdia de São Paulo, Cirurgia - São Paulo - SP - Brasil
- - Faculdade de Ciências Médicas da Santa Casa de São Paulo, Cirurgia - São Paulo - SP - Brasil
| | - Isabela Campos Brianti
- - Faculdade de Ciências Médicas da Santa Casa de São Paulo, Cirurgia - São Paulo - SP - Brasil
| | - José Gustavo Parreira
- - Irmandade da Santa Casa de Misericórdia de São Paulo, Cirurgia - São Paulo - SP - Brasil
- - Faculdade de Ciências Médicas da Santa Casa de São Paulo, Cirurgia - São Paulo - SP - Brasil
| | - Pedro DE Souza Lucarelli-Antunes
- - Irmandade da Santa Casa de Misericórdia de São Paulo, Cirurgia - São Paulo - SP - Brasil
- - Faculdade de Ciências Médicas da Santa Casa de São Paulo, Cirurgia - São Paulo - SP - Brasil
| | - Nelson Saade
- - Irmandade da Santa Casa de Misericórdia de São Paulo, Cirurgia - São Paulo - SP - Brasil
- - Faculdade de Ciências Médicas da Santa Casa de São Paulo, Cirurgia - São Paulo - SP - Brasil
| | - Murilo Golin
- - Irmandade da Santa Casa de Misericórdia de São Paulo, Cirurgia - São Paulo - SP - Brasil
- - Faculdade de Ciências Médicas da Santa Casa de São Paulo, Cirurgia - São Paulo - SP - Brasil
| | | | - José Carlos Esteves Veiga
- - Irmandade da Santa Casa de Misericórdia de São Paulo, Cirurgia - São Paulo - SP - Brasil
- - Faculdade de Ciências Médicas da Santa Casa de São Paulo, Cirurgia - São Paulo - SP - Brasil
| | - Jose Cesar Assef
- - Irmandade da Santa Casa de Misericórdia de São Paulo, Cirurgia - São Paulo - SP - Brasil
- - Faculdade de Ciências Médicas da Santa Casa de São Paulo, Cirurgia - São Paulo - SP - Brasil
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Morrison CN, Kirk DS, Brazil NB, Humphreys DK. Ride-Hailing and Road Traffic Crashes: A Critical Review. Am J Epidemiol 2022; 191:751-758. [PMID: 35179205 PMCID: PMC9431654 DOI: 10.1093/aje/kwac033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2021] [Revised: 01/28/2022] [Accepted: 02/11/2022] [Indexed: 02/02/2023] Open
Abstract
Ride-hailing businesses, including Uber and Lyft, have reshaped road traffic since they first began operating in the United States approximately a decade ago. It follows that ride-hailing may also alter the incidence and distribution of road traffic crash injuries and deaths. The available evidence relating ride-hailing to crashes is critically reviewed in this article. We present a theoretical model that synthesizes the hypothesized mechanisms, and we identify common methodological challenges and suggest priorities for future research. Mixed results have been reported for the overall incidence of road traffic crash injuries and deaths, likely due to heterogeneous impacts on vehicular traffic flow (e.g., increasing the volume of vehicles); on vehicle-, person-, and event-level characteristics (e.g., reducing alcohol-impaired driver crashes); on road-user types (e.g., increasing pedestrian crashes); and on environmental conditions (e.g., reducing crashes most substantially where public transit access is poorest). The lack of a well-developed theory of human mobility and methodological challenges that are common to many ecological studies impede exploration of these sources of moderation. Innovative solutions are required to explicate ride-hailing's heterogeneous impacts, to guide policy that can take advantage of the public health benefits of ride-hailing, and to ensure that research keeps pace with technological advances that continue to reshape road traffic use.
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Affiliation(s)
- Christopher N Morrison
- Correspondence to Dr. Christopher N. Morrison, Department of Epidemiology, Mailman School of Public Health, Columbia University, 722 W. 168th Street, New York, NY 10032 (e-mail: )
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Brown K, Cameron ID, Keay L, Rogers K, Nguyen H, Vines P, Ivers R. Factors influencing duration of compensation following road traffic crash injury in older vs younger adults. Australas J Ageing 2020; 40:e13-e21. [PMID: 33025702 DOI: 10.1111/ajag.12830] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2019] [Revised: 05/10/2020] [Accepted: 06/03/2020] [Indexed: 11/28/2022]
Abstract
OBJECTIVE To identify factors independently associated with late claim closure, a proxy for recovery, in older (65+ years) compared to younger (17-64 years) adults following road traffic crash injury (RTI). METHODS Multivariable analysis of statewide compensation data from New South Wales (NSW), Australia, for NSW residents aged ≥17 years injured in a non-catastrophic RTI between July 2010 and June 2013 with finalised claims (n = 16 687). RESULTS Legal representation was the dominant factor independently associated with late claim closure in both age groups. However, the odds were doubly high for the younger group (younger: AOR 8.46, 95% CI 7.7-9.4; older: AOR 3.95, 95% CI 3.1-5.0). Median time to claim closure was shorter for older people. CONCLUSION Older (and younger) claimants with legal representation are at increased risk of late claim closure and can be readily identified within routinely collected compensation data, enabling delivery of targeted strategies or supports early in the claims process.
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Affiliation(s)
- Katherine Brown
- The George Institute for Global Health, UNSW Sydney, Sydney, New South Wales, Australia.,Faculty of Medicine and Health, the University of Sydney, Sydney, New South Wales, Australia
| | - Ian D Cameron
- Faculty of Medicine and Health, the University of Sydney, Sydney, New South Wales, Australia.,John Walsh Centre for Rehabilitation Research, Sydney Medical School Northern, Kolling Institute, Royal North Shore Hospital, the University of Sydney, Sydney, New South Wales, Australia
| | - Lisa Keay
- The George Institute for Global Health, UNSW Sydney, Sydney, New South Wales, Australia.,School of Optometry and Vision Science, UNSW Sydney, Sydney, New South Wales, Australia
| | - Kris Rogers
- The George Institute for Global Health, UNSW Sydney, Sydney, New South Wales, Australia.,Graduate School of Health, University of Technology Sydney, Sydney, New South Wales, Australia
| | - Ha Nguyen
- The George Institute for Global Health, UNSW Sydney, Sydney, New South Wales, Australia.,Faculty of Medicine and Health, the University of Sydney, Sydney, New South Wales, Australia.,John Walsh Centre for Rehabilitation Research, Sydney Medical School Northern, Kolling Institute, Royal North Shore Hospital, the University of Sydney, Sydney, New South Wales, Australia
| | - Prue Vines
- Faculty of Law, UNSW Sydney, Sydney, New South Wales, Australia
| | - Rebecca Ivers
- The George Institute for Global Health, UNSW Sydney, Sydney, New South Wales, Australia.,School of Population Health, UNSW Sydney, Sydney, New South Wales, Australia
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Ganem G, Fernandes RDCP. Motorcycle accidents: characteristics of victims admitted to public hospitals and circumstances. Rev Bras Med Trab 2020; 18:51-58. [PMID: 32783004 DOI: 10.5327/z1679443520200447] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2019] [Accepted: 12/18/2019] [Indexed: 11/05/2022] Open
Abstract
Background Motorcycle accidents are a considerable cause of morbidity and mortality in Brazil, with high social and economic costs. Victims are mostly men, young and vulnerable. Objective To characterize motorcycle accident victims and circumstances among patients admitted to a public hospital. Methods We administered a questionnaire to 74 victims of motorcycle accidents in the period from January through July 2018 among patients admitted to a referral hospital for elective orthopedic surgery in Salvador, Bahia, Brazil. Results Most victims were male (98.4%), up to 31 years old (49%), black or brown (84%) and had low educational level (54%). Motorcycling was the occupation of 50.8%. Drinking was less frequent among motorcyclists in the capital compared to the interior of the state (16 vs. 26%) and a larger proportion had a driving license (72 vs. 39%). Conclusion Main victims of motorcycling accident victims were male, with low educational level, and without a driving license. Actions are needed to promote road safety, including educational programs to protect life and reduce the social and economic costs of accidents.
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Affiliation(s)
- Gustavo Ganem
- School of Medicine of Bahia, Universidade Federal da Bahia - Salvador (BA), Brazil. Universidade Federal da Bahia School of Medicine of Bahia Universidade Federal da Bahia Brazil
| | - Rita de Cássia Pereira Fernandes
- Department of Preventive and Social Medicine, School of Medicine of Bahia, Universidade Federal da Bahia - Salvador (BA), Brazil. Universidade Federal da Bahia Department of Preventive and Social Medicine School of Medicine of Bahia Universidade Federal da Bahia Brazil
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11
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Grethlein D, Winston FK, Walshe E, Tanner S, Kandadai V, Ontañón S. Simulator Pre-Screening of Underprepared Drivers Prior to Licensing On-Road Examination: Clustering of Virtual Driving Test Time Series Data. J Med Internet Res 2020; 22:e13995. [PMID: 32554384 PMCID: PMC7333075 DOI: 10.2196/13995] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2019] [Revised: 11/11/2019] [Accepted: 12/16/2019] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND A large Midwestern state commissioned a virtual driving test (VDT) to assess driving skills preparedness before the on-road examination (ORE). Since July 2017, a pilot deployment of the VDT in state licensing centers (VDT pilot) has collected both VDT and ORE data from new license applicants with the aim of creating a scoring algorithm that could predict those who were underprepared. OBJECTIVE Leveraging data collected from the VDT pilot, this study aimed to develop and conduct an initial evaluation of a novel machine learning (ML)-based classifier using limited domain knowledge and minimal feature engineering to reliably predict applicant pass/fail on the ORE. Such methods, if proven useful, could be applicable to the classification of other time series data collected within medical and other settings. METHODS We analyzed an initial dataset that comprised 4308 drivers who completed both the VDT and the ORE, in which 1096 (25.4%) drivers went on to fail the ORE. We studied 2 different approaches to constructing feature sets to use as input to ML algorithms: the standard method of reducing the time series data to a set of manually defined variables that summarize driving behavior and a novel approach using time series clustering. We then fed these representations into different ML algorithms to compare their ability to predict a driver's ORE outcome (pass/fail). RESULTS The new method using time series clustering performed similarly compared with the standard method in terms of overall accuracy for predicting pass or fail outcome (76.1% vs 76.2%) and area under the curve (0.656 vs 0.682). However, the time series clustering slightly outperformed the standard method in differentially predicting failure on the ORE. The novel clustering method yielded a risk ratio for failure of 3.07 (95% CI 2.75-3.43), whereas the standard variables method yielded a risk ratio for failure of 2.68 (95% CI 2.41-2.99). In addition, the time series clustering method with logistic regression produced the lowest ratio of false alarms (those who were predicted to fail but went on to pass the ORE; 27.2%). CONCLUSIONS Our results provide initial evidence that the clustering method is useful for feature construction in classification tasks involving time series data when resources are limited to create multiple, domain-relevant variables.
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Affiliation(s)
- David Grethlein
- Diagnostic Driving, Inc, Philadelphia, PA, United States.,Computer Science Department, Drexel University, Philadelphia, PA, United States
| | - Flaura Koplin Winston
- Diagnostic Driving, Inc, Philadelphia, PA, United States.,Center for Injury Research and Prevention, Children's Hospital of Philadelphia, Philadelphia, PA, United States.,Perelmen School of Medicine, University of Pennsylvania, Philadelphia, PA, United States
| | - Elizabeth Walshe
- Center for Injury Research and Prevention, Children's Hospital of Philadelphia, Philadelphia, PA, United States.,Annenberg Public Policy Center, University of Pennsylvania, Philadelphia, PA, United States
| | - Sean Tanner
- Diagnostic Driving, Inc, Philadelphia, PA, United States.,Geography Department, Rutgers University, New Brunswick, NJ, United States
| | - Venk Kandadai
- Diagnostic Driving, Inc, Philadelphia, PA, United States
| | - Santiago Ontañón
- Computer Science Department, Drexel University, Philadelphia, PA, United States
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12
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Jamshidi H, Jazani RK, Alibabaei A, Alamdari S, Kalyani MN. Challenges of Cooperation between the Pre-hospital and In-hospital Emergency services in the handover of victims of road traffic accidents: A Qualitative Study. Invest Educ Enferm 2019; 37:e08. [PMID: 31083845 PMCID: PMC7871464 DOI: 10.17533/udea.iee.v37n1e08] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/08/2018] [Accepted: 02/11/2019] [Indexed: 06/01/2023]
Abstract
OBJECTIVES To take a deep look at the challenges of cooperation between the pre-hospital and in-hospital emergency services in the handover of victims of road traffic accidents. METHODS This is a qualitative study and the method used is of content analysis type. Semi-structured interviews were used to collect the data. Through purposive sampling, fifteen employees from ambulance personnel and hospital emergency staff were selected and interviewed. They expressed their experiences of cooperation between these two teams in the handover of traffic accident casualties. The interviews were transcribed verbatim and content analysis method was used to explain and interpret the content of the interviews. RESULTS Three major categories were derived from the analysis of interviews: Shortage of infrastructure resources (Shortage of equipment, Shortage of physical space, and Shortage of manpower); Inefficient and unscientific management (Shaky accountability, Out-of-date information based activities, Poor motivation, and Manpower low productivity); and Non-common language (Difference in understanding and empathy, and Difference in training and experience). CONCLUSIONS The obtained results of this study suggest that the careful planning of resources, the promotion of managerial practices as well as empowerment program of the staff, healthcare managers and policymakers can take a pace forward in order to enter into a hearty coordination between these two services for the attention of victims of road traffic accidents.
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13
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Costa RF, Yoshida RDA, Gibin RJ, Sobreira ML, Pimenta REF, Bertanha M, de Camargo PAB, Yoshida WB. Inferior gluteal artery pseudoaneurysm after fall from a bicycle: case report. J Vasc Bras 2018; 17:353-357. [PMID: 30787957 PMCID: PMC6375272 DOI: 10.1590/1677-5449.003018] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Pseudoaneurysms of gluteal arteries are rare, especially involving the inferior gluteal artery. They are mainly associated with penetrating trauma, infections, or pelvic fractures. A minority of cases are caused by blunt traumas, with only six cases reported in English. We present a case of pseudoaneurysm of the right inferior gluteal artery after a bicycle fall, presenting with a large hematoma in the gluteal region, observed during clinical examination, and significantly reduced hemoglobin. CT angiography revealed a large hematoma, with contrast extravasation and pseudoaneurysm formation. Angiography revealed that the origin of the lesion was in the right inferior gluteal artery. This artery was embolized with coils. After the procedure, the patient was referred to an intensive care unit, from where he was later transferred to a different hospital, with bleeding controlled. Endovascular treatment of these cases is a safe, fast and an effective option.
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Affiliation(s)
| | - Ricardo de Alvarenga Yoshida
- Universidade Estadual Paulista - UNESP, Faculdade de Medicina de Botucatu, Departamento de Cirurgia e Ortopedia, Botucatu, SP, Brasil
| | - Rodrigo Jaldin Gibin
- Universidade Estadual Paulista - UNESP, Faculdade de Medicina de Botucatu, Departamento de Cirurgia e Ortopedia, Botucatu, SP, Brasil
| | - Marcone Lima Sobreira
- Universidade Estadual Paulista - UNESP, Faculdade de Medicina de Botucatu, Departamento de Cirurgia e Ortopedia, Botucatu, SP, Brasil
| | - Rafael Elias Fares Pimenta
- Universidade Estadual Paulista - UNESP, Faculdade de Medicina de Botucatu, Departamento de Cirurgia e Ortopedia, Botucatu, SP, Brasil
| | - Matheus Bertanha
- Universidade Estadual Paulista - UNESP, Faculdade de Medicina de Botucatu, Departamento de Cirurgia e Ortopedia, Botucatu, SP, Brasil
| | - Paula Angeleli Bueno de Camargo
- Universidade Estadual Paulista - UNESP, Faculdade de Medicina de Botucatu, Departamento de Cirurgia e Ortopedia, Botucatu, SP, Brasil
| | - Winston Bonetti Yoshida
- Universidade Estadual Paulista - UNESP, Faculdade de Medicina de Botucatu, Departamento de Cirurgia e Ortopedia, Botucatu, SP, Brasil
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14
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He YW, Zeng XF, Yan W, Li Y, Song TZ, Huang J, Duan TL, Li L, Li Z. [Research Progress of Traffic Accident Reconstruction Technology Based on PC-Crash Software]. Fa Yi Xue Za Zhi 2018; 34:276-279. [PMID: 30051667 DOI: 10.12116/j.issn.1004-5619.2018.03.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 10/24/2016] [Indexed: 11/30/2022]
Abstract
With the development of the computer simulation technology and the digital simulation technology, the traditional calculation method has been gradually replaced by the digital method to deal the road traffic accident scene and analyse the process. The PC-Crash software simulation system can reconstruct the traffic accidents within 32 vehicles, and the accuracy of reconstruction has been fully verified, which is widely used by the transport police department and the accreditation agency. In this paper, the research of road traffic accident reconstruction using PC-Crash software is reviewed, and the application of road traffic accident reconstruction technology based on PC-Crash software and some existing problems in forensic practice are discussed, which provides reference for the research and identification of road traffic accident simulation and reconstruction and theoretical basis for accident treatment.
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Affiliation(s)
- Y W He
- School of Forensic Medicine, Kunming Medical University, Kunming 650500, China
| | - X F Zeng
- School of Forensic Medicine, Kunming Medical University, Kunming 650500, China
| | - W Yan
- Accident Section of Traffic Police Detachment, Kunming Public Security Bureau, Kunming 650500, China
| | - Y Li
- Accident Section of Traffic Police Detachment, Kunming Public Security Bureau, Kunming 650500, China
| | - T Z Song
- Accident Section of Traffic Police Detachment, Kunming Public Security Bureau, Kunming 650500, China
| | - J Huang
- School of Forensic Medicine, Kunming Medical University, Kunming 650500, China
| | - T L Duan
- School of Forensic Medicine, Kunming Medical University, Kunming 650500, China
| | - L Li
- School of Forensic Medicine, Kunming Medical University, Kunming 650500, China
| | - Z Li
- School of Forensic Medicine, Kunming Medical University, Kunming 650500, China
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15
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Bai R, Chen M. [Forensic Analysis of 498 Road Traffic Accident Deaths in Haikou City]. Fa Yi Xue Za Zhi 2018; 33:604-606. [PMID: 29441767 DOI: 10.3969/j.issn.1004-5619.2017.06.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 03/14/2017] [Indexed: 11/18/2022]
Abstract
OBJECTIVES 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. METHODS 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. RESULTS 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. CONCLUSIONS The autopsy of road traffic accident deaths plays an important role in identification of death manner and responsibility confirmation.
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Affiliation(s)
- R Bai
- Traffic Police Branch, Haikou City Public Security Bureau, Haikou 570102, China
| | - M Chen
- Traffic Police Corps, Hainan Provincial Public Security Department, Haikou 570102, China
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16
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Sun J, Wang T, Li ZD, Shao Y, Zhang ZY, Feng H, Zou DH, Chen YJ. [Reconstruction of Vehicle-human Crash Accident and Injury Analysis Based on 3D Laser Scanning, Multi-rigid-body Reconstruction and Optimized Genetic Algorithm]. Fa Yi Xue Za Zhi 2018; 33:575-580. [PMID: 29441761 DOI: 10.3969/j.issn.1004-5619.2017.06.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 08/23/2017] [Indexed: 11/18/2022]
Abstract
OBJECTIVES To reconstruct a vehicle-bicycle-cyclist crash accident and analyse the injuries using 3D laser scanning technology, multi-rigid-body dynamics and optimized genetic algorithm, and to provide biomechanical basis for the forensic identification of death cause. METHODS The vehicle was measured by 3D laser scanning technology. The multi-rigid-body models of cyclist, bicycle and vehicle were developed based on the measurements. The value range of optimal variables was set. A multi-objective genetic algorithm and the nondominated sorting genetic algorithm were used to find the optimal solutions, which were compared to the record of the surveillance video around the accident scene. RESULTS The reconstruction result of laser scanning on vehicle was satisfactory. In the optimal solutions found by optimization method of genetic algorithm, the dynamical behaviours of dummy, bicycle and vehicle corresponded to that recorded by the surveillance video. The injury parameters of dummy were consistent with the situation and position of the real injuries on the cyclist in accident. CONCLUSIONS The motion status before accident, damage process by crash and mechanical analysis on the injury of the victim can be reconstructed using 3D laser scanning technology, multi-rigid-body dynamics and optimized genetic algorithm, which have application value in the identification of injury manner and analysis of death cause in traffic accidents.
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Affiliation(s)
- J Sun
- Department of Forensic Medicine, Shanghai Medical College, Fudan University, Shanghai 200032, China.,Shanghai Key Laboratory of Forensic Medicine, Shanghai Forensic Service Platform, Academy of Forensic Science, Shanghai 200063, China
| | - T Wang
- Institute of Criminal Science and Technology, Songjiang Branch of Shanghai Public Security Bureau, Shanghai 201600, China
| | - Z D Li
- Shanghai Key Laboratory of Forensic Medicine, Shanghai Forensic Service Platform, Academy of Forensic Science, Shanghai 200063, China
| | - Y Shao
- Shanghai Key Laboratory of Forensic Medicine, Shanghai Forensic Service Platform, Academy of Forensic Science, Shanghai 200063, China
| | - Z Y Zhang
- Shanghai Key Laboratory of Forensic Medicine, Shanghai Forensic Service Platform, Academy of Forensic Science, Shanghai 200063, China
| | - H Feng
- Shanghai Key Laboratory of Forensic Medicine, Shanghai Forensic Service Platform, Academy of Forensic Science, Shanghai 200063, China
| | - D H Zou
- Shanghai Key Laboratory of Forensic Medicine, Shanghai Forensic Service Platform, Academy of Forensic Science, Shanghai 200063, China
| | - Y J Chen
- Shanghai Key Laboratory of Forensic Medicine, Shanghai Forensic Service Platform, Academy of Forensic Science, Shanghai 200063, China
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17
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Pavanitto DR, Menezes RADM, Nascimento LFC. Accidents involving motorcycles and potential years of life lost. An ecological and exploratory study. SAO PAULO MED J 2018; 136:4-9. [PMID: 29340501 PMCID: PMC9924167 DOI: 10.1590/1516-3180.2017.0098070817] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/02/2017] [Accepted: 08/07/2017] [Indexed: 11/22/2022] Open
Abstract
CONTEXT AND OBJECTIVE Traffic accidents have gained prominence as one of the modern epidemics that plague the world. The objective of this study was to identify the spatial distribution of potential years of life lost (PYLL) due to accidents involving motorcycles in the state of São Paulo, Brazil. DESIGN AND SETTING Ecological and exploratory study conducted in São Paulo. METHODS Data on deaths among individuals aged 20-39 years due to motorcycle accidents (V20-V29 in the International Classification of Diseases, 10th revision) in the state of São Paulo in the years 2007-2011 were obtained from DATASUS. These data were stratified into a database for the 63 microregions of this state, according to where the motorcyclist lived. PYLL rates per 100,000 inhabitants were calculated. Spatial autocorrelations were estimated using the Global Moran index (IM). Thematic, Moran and Kernel maps were constructed using PYLL rates for the age groups of 20-29 and 30-39 years. The Terraview 4.2.2 software was used for the analysis. RESULTS The PYLL rates were 486.9 for the ages of 20-29 years and 199.5 for 30-39 years. Seventeen microregions with high PYLL rates for the age group of 20-29 years were identified. There was higher density of these rates on the Kernel map of the southeastern region (covering the metropolitan region of São Paulo). There were no spatial autocorrelations between rates. CONCLUSIONS The data presented in this study identified microregions with high accident rates involving motorcycles and microregions that deserve special attention from regional managers and traffic experts.
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Affiliation(s)
| | | | - Luiz Fernando Costa Nascimento
- PhD. Researcher, Department of Energy, Universidade Estadual Paulista (UNESP), Guaratinguetá (SP), and Assistant Professor, Department of Medicine, Universidade de Taubaté (UNITAU), Taubaté (SP), Brazil.
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18
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Du YL, Zhang WL. [Automobile Traffic Accident Death Case Analysis of Characteristics of Driver Injury]. Fa Yi Xue Za Zhi 2017; 33:36-37. [PMID: 29231007 DOI: 10.3969/j.issn.1004-5619.2017.01.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 11/27/2015] [Indexed: 11/18/2022]
Abstract
OBJECTIVES To distinguish the injury characteristic changes on the drivers between the injuries of drivers and passengers in traffic accidents, and to provide scientific evidence for confirming the identity of driver in traffic accidents. METHODS Data of 126 automobile traffic accident death cases in the reclamation areas of Heilongjiang province from 2006-2014 were retrospectively studied. The injury characteristics on the drivers of automobile traffic accident death cases were analyzed and the forensic identification problem in the injuries of drivers and passengers were discussed. RESULTS Injuries were frequently observed on driver's neck, chest and abdomen. The characteristic injuries caused by auto parts were also found, which appeared at the places of passenger's head, face and limbs contacted with automobile. Such characteristic injuries were not found at other places. CONCLUSIONS The location and type of injury are associated with the identity of the deceased.
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Affiliation(s)
- Y L Du
- Nine-three Reclamation Public Security Bureau, Nenjiang 161441, China
| | - W L Zhang
- Agricultural Areas in Public Security Bureau Criminal Technical Team, Harbin 150038, China
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Quistberg DA, Howard EJ, Hurvitz PM, Moudon AV, Ebel BE, Rivara FP, Saelens BE. The Relationship Between Objectively Measured Walking and Risk of Pedestrian-Motor Vehicle Collision. Am J Epidemiol 2017; 185:810-821. [PMID: 28338921 DOI: 10.1093/aje/kwx020] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2015] [Accepted: 07/26/2016] [Indexed: 12/21/2022] Open
Abstract
Safe urban walking environments may improve health by encouraging physical activity, but the relationship between an individual's location and walking pattern and the risk of pedestrian-motor vehicle collision is unknown. We examined associations between individuals' walking bouts and walking risk, measured as mean exposure to the risk of pedestrian-vehicle collision. Walking bouts were ascertained through integrated accelerometry and global positioning system data and from individual travel-diary data obtained from adults in the Travel Assessment and Community Study (King County, Washington) in 2008-2009. Walking patterns were superimposed onto maps of the historical probabilities of pedestrian-vehicle collisions for intersections and midblock segments within Seattle, Washington. Mean risk of pedestrian-vehicle collision in specific walking locations was assessed according to walking exposure (duration, distance, and intensity) and participant demographic characteristics in linear mixed models. Participants typically walked in areas with low pedestrian collision risk when walking for recreation, walking at a faster pace, or taking longer-duration walks. Mean daily walking duration and distance were not associated with collision risk. Males walked in areas with higher collision risk compared with females, while vehicle owners, residents of single-family homes, and parents of young children walked in areas with lower collision risk. These findings may suggest that pedestrians moderate collision risk by using lower-risk routes.
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Noll-Hussong M. Whiplash Syndrome Reloaded: Digital Echoes of Whiplash Syndrome in the European Internet Search Engine Context. JMIR Public Health Surveill 2017; 3:e15. [PMID: 28347974 PMCID: PMC5387115 DOI: 10.2196/publichealth.7054] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2016] [Revised: 01/22/2017] [Accepted: 02/20/2017] [Indexed: 11/13/2022] Open
Abstract
Background In many Western countries, after a motor vehicle collision, those involved seek health care for the assessment of injuries and for insurance documentation purposes. In contrast, in many less wealthy countries, there may be limited access to care and no insurance or compensation system. Objective The purpose of this infodemiology study was to investigate the global pattern of evolving Internet usage in countries with and without insurance and the corresponding compensation systems for whiplash injury. Methods We used the Internet search engine analytics via Google Trends to study the health information-seeking behavior concerning whiplash injury at national population levels in Europe. Results We found that the search for “whiplash” is strikingly and consistently often associated with the search for “compensation” in countries or cultures with a tort system. Frequent or traumatic painful injuries; diseases or disorders such as arthritis, headache, radius, and hip fracture; depressive disorders; and fibromyalgia were not associated similarly with searches on “compensation.” Conclusions In this study, we present evidence from the evolving viewpoint of naturalistic Internet search engine analytics that the expectations for receiving compensation may influence Internet search behavior in relation to whiplash injury.
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Affiliation(s)
- Michael Noll-Hussong
- Department of Psychosomatic Medicine and Psychotherapy, University of Ulm, Ulm, Germany
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21
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Liu CG, Lu YJ, Gao J, Liu Q. Application of Finite Element Method in Traffic Injury and Its Prospect in Forensic Science. Fa Yi Xue Za Zhi 2016; 32:196-199. [PMID: 29171739 DOI: 10.3969/j.issn.1004-5619.2016.03.009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 04/10/2015] [Indexed: 11/18/2022]
Abstract
The finite element method (FEM) is a numerical computation method based on computer technology, and has been gradually applied in the fields of medicine and biomechanics. The finite element analysis can be used to explore the loading process and injury mechanism of human body in traffic injury. FEM is also helpful for the forensic investigation in traffic injury. This paper reviews the development of the finite element models and analysis of brain, cervical spine, chest and abdomen, pelvis, limbs at home and aboard in traffic injury in recent years.
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Affiliation(s)
- C G Liu
- Jinchang Public Security Bureau, Jinchang 737100, China
| | - Y J Lu
- Jinchang Public Security Bureau, Jinchang 737100, China
| | - J Gao
- Jinchang Public Security Bureau, Jinchang 737100, China
| | - Q Liu
- Kunming Medical University, Kunming 650500, China
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Abstract
PURPOSE In Iran, the most common cause of injuries and the second leading cause of deaths are traffic accidents, and those problems impose a substantial financial burden on the society. This study aims to determine traffic accident mortality trends and their epidemiologic characteristics in the Kermanshah province, west of Iran. METHODS In a cross sectional study, road traffic fatality data from 2004 to 2013 were analyzed to determine the epidemiological pattern of traffic accident mortality. Trend assessment was performed to ascertain the decreasing or increasing status. Chi-square and one-way analysis of variance (ANOVA) tests, as well as Poisson regression were used to determine the significance of the data in time. Data were analyzed using Excel and statistical package of SPSS version 19. RESULTS Out of 5110 people that died in traffic accidents, 4024 (78.7%) were males. The state of accidents indicated that 404 (43.8%) female pedestrians died as a result of car crashes, and 1330 (41.4%) males died because of car collisions. 1554 (31.9%) deaths happened to pedestrians and 1556 (32.1%) to vehicle drivers, and the rest belonged to vehicle passengers. Head trauma was the cause of death for as much as 3400 (69.9%) cases. Fatal crashes in which pedestrians were involved mostly occurred between the hours 13:00 to 15:00, while the time for vehicle drivers was between 16:00 to 18:00. 2882 people (59.1%) died before reaching to health care facilities. Traffic crash mortality trend for pedestrians follows a linear pattern with a gentle downward slope, but the trend shows various swings when it comes to vehicle drivers. CONCLUSION The number of traffic crash deaths from 2004 to 2013 indicates a decreasing trend in two groups of road users: vehicle drivers and car occupants. This can be due to some interventions such as modification of traffic rules and enhancement of police control which has been implemented in recent years. Moreover, more attention should be paid to promote the optimal health care services to save the lives of the injured from traffic accidents.
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Babu A, Rattan A, Ranjan P, Singhal M, Gupta A, Kumar S, Mishra B, Sagar S. Are falls more common than road traffic accidents in pediatric trauma? Experience from a Level 1 trauma centre in New Delhi, India. Chin J Traumatol 2016; 19:75-8. [PMID: 27140213 PMCID: PMC4897843 DOI: 10.1016/j.cjtee.2015.10.004] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023] Open
Abstract
PURPOSE The epidemiology of pediatric trauma is different in different parts of the world. Some re- searchers suggest falls as the most common mechanism, whereas others report road traffic accidents (RTAs) as the most common cause. The aim of this study is to find out the leading cause of pediatric admissions in Trauma Surgery in New Delhi, India. METHODS Inpatient data from January 2012 to September 2014 was searched retrospectively in Jai Prakash Narayan Apex Trauma Centre Trauma Registry. All patients aged 18 years or less on index presentation admitted to surgical ward/ICU or later taken transfer by the Department of Trauma Surgery were included. Data were retrieved in predesigned proformas. Information thus compiled was coded in unique alphanumeric codes for each variable and subjected to statistical analysis using SPSS version 21. RESULTS We had 300 patients over a 33 month period. Among them, 236 (78.6%) were males and 64 (21.3%) females. Overall the predominant cause was RTAs in 132 (43%) patients. On subgroup analysis of up to 12 years age group (n = 147), the most common cause was found to be RTAs again. However, falls showed an incremental upward trend (36.05% in up to 12 age group versus 27% overall), catching up with RTAs (44.89%). Pediatric Trauma Score (PTS) ranged from 0 to 12 with a mean of 8.12 ± 2.022. 223 (74.33%) patients experienced trauma limited to one anatomic region only, whereas 77 (25.66%) patients suffered polytrauma. 288 patients were discharged to home care. Overall, 12 patients expired in the cohort. Median hospital stay was 6 days (range 1-182). CONCLUSION Pediatric trauma is becoming a cause of increasing concern, especially in the developing countries. The leading cause of admissions in Trauma Surgery is RTAs (43%) as compared to falls from height (27%); however, falls from height are showing an increasing trend as we move to younger age groups. Enhancing road safety alone may not be a lasting solution for prevention of pediatric trauma and local injury patterns must be taken into account when formulating policies to address this unique challenge.
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Brubacher JR, Chan H, Martz W, Schreiber W, Asbridge M, Eppler J, Lund A, Macdonald S, Drummer O, Purssell R, Andolfatto G, Mann R, Brant R. Prevalence of alcohol and drug use in injured British Columbia drivers. BMJ Open 2016; 6:e009278. [PMID: 26966054 PMCID: PMC4800149 DOI: 10.1136/bmjopen-2015-009278] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVES Determine the prevalence of drug use in injured drivers and identify associated demographic factors and crash characteristics. DESIGN Prospective cross-sectional study. SETTING Seven trauma centres in British Columbia, Canada (2010-2012). PARTICIPANTS Automobile drivers who had blood obtained within 6 h of a crash. MAIN OUTCOME MEASURES We analysed blood for cannabis, alcohol and other impairing drugs using liquid chromatography/mass spectrometry (LCMS). RESULTS 1097 drivers met inclusion criteria. 60% were aged 20-50 years, 63.2% were male and 29.0% were admitted to hospital. We found alcohol in 17.8% (15.6% to 20.1%) of drivers. Cannabis was the second most common recreational drug: cannabis metabolites were present in 12.6% (10.7% to 14.7%) of drivers and we detected Δ-9-tetrahydrocannabinol (Δ-9-THC) in 7.3% (5.9% to 9.0%), indicating recent use. Males and drivers aged under 30 years were most likely to use cannabis. We detected cocaine in 2.8% (2.0% to 4.0%) of drivers and amphetamines in 1.2% (0.7% to 2.0%). We also found medications including benzodiazepines (4.0% (2.9% to 5.3%)), antidepressants (6.5% (5.2% to 8.1%)) and diphenhydramine (4.7% (3.5% to 6.2%)). Drivers aged over 50 years and those requiring hospital admission were most likely to have used medications. Overall, 40.1% (37.2% to 43.0%) of drivers tested positive for alcohol or at least one impairing drug and 12.7% (10.7% to 14.7%) tested positive for more than one substance. CONCLUSIONS Alcohol, cannabis and a broad range of other impairing drugs are commonly detected in injured drivers. Alcohol is well known to cause crashes, but further research is needed to determine the impact of other drug use, including drug-alcohol and drug-drug combinations, on crash risk. In particular, more work is needed to understand the role of medications in causing crashes to guide driver education programmes and improve public safety.
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Affiliation(s)
- Jeffrey R Brubacher
- Department of Emergency Medicine, University of British Columbia, Vancouver, British Columbia, Canada
| | - Herbert Chan
- Department of Emergency Medicine, University of British Columbia, Vancouver, British Columbia, Canada
| | - Walter Martz
- Provincial Toxicology Centre, Vancouver, British Columbia, Canada
| | - William Schreiber
- Provincial Toxicology Centre, Vancouver, British Columbia, Canada
- Department of Pathology and Laboratory Medicine, The University of British Columbia, Vancouver, British Columbia, Canada
| | - Mark Asbridge
- Department of Community Health and Epidemiology, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Jeffrey Eppler
- Department of Emergency Medicine, University of British Columbia, Vancouver, British Columbia, Canada
| | - Adam Lund
- Department of Emergency Medicine, University of British Columbia, Vancouver, British Columbia, Canada
| | - Scott Macdonald
- University of Victoria, Centre for Addiction Research of British Columbia, Vancouver, British Columbia, Canada
| | - Olaf Drummer
- Department of Forensic Medicine, Monash University, Melbourne, Victoria, Australia
| | - Roy Purssell
- Department of Emergency Medicine, University of British Columbia, Vancouver, British Columbia, Canada
- Provincial Health Services Authority, British Columbia Centre for Disease Control, Vancouver, British Columbia, Canada
| | - Gary Andolfatto
- Department of Emergency Medicine, University of British Columbia, Vancouver, British Columbia, Canada
| | - Robert Mann
- Provincial Health Services Authority, British Columbia Centre for Disease Control, Vancouver, British Columbia, Canada
| | - Rollin Brant
- Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
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Leite Cavalcanti A, Barros De Alencar CY, Sant'Anna Araujo Rodrigues I, Suenya de Almeida Pinto M, Fabia Cabral Xavier A, Leite Cavalcanti C, Gondim Valenciq AM. Injuries to the head and face in Brazilian adolescents and teenagers victims of non-natural deaths. J Forensic Odontostomatol 2012; 30:13-21. [PMID: 23000807 PMCID: PMC5734846] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
This study aimed to evaluate the occurrence of injuries to the head and face in adolescent and teenager victims of non-natural deaths. A retrospective study was undertaken by the analysis of medical forensic reports obtained from medical forensic examinations performed at the Department of Forensic Medicine of the city of Campina Grande, PB, Brazil, between January 2003 and December 2007. From a total of 607 reports issued during this time span, the study sample consisted of 423 reports (69.6%) referring to adolescents and teenagers of both genders, aged 12 to 18 years, who were confirmed to have died from external causes. The causes of death were encoded according to the Chapter XX of the International Statistical Classification of Diseases and Related Health Problems (ICD-10). The majority of victims were 17 year old males (25.8%). Firearms (33.3%) and transport accidents (32.2%) were the most common causes of death, with boys showing a 3.7 times greater likelihood of getting killed by firearms than girls. There was statistically significant relationship between the occurrence of transport accidents and gender. The majority of victims (71.6%) presented with multiple injuries throughout the body. There was statistically significant relationship between the occurrence of transport accidents and the presence of multiple injuries. A high percentage of the victims presented with injuries to the head and face. There was statistically significant relationship between the occurrence of transport accidents and the presence of injury to the head. Fatal gunshot wounds and transport accidents were the main causes of death of male adolescents and teenagers. The victims presented with multiple injuries, especially to the head and face, and the mandible was the most frequently injured facial bone. .
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Affiliation(s)
- A Leite Cavalcanti
- Graduate Program in Community Health, State University of Paraíba, Campina Grande, PB, Brazil.
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Abstract
Since 1996, 16 states and the District of Columbia in the United States have enacted legislation to decriminalize marijuana for medical use. Although marijuana is the most commonly detected nonalcohol drug in drivers, its role in crash causation remains unsettled. To assess the association between marijuana use and crash risk, the authors performed a meta-analysis of 9 epidemiologic studies published in English in the past 2 decades identified through a systematic search of bibliographic databases. Estimated odds ratios relating marijuana use to crash risk reported in these studies ranged from 0.85 to 7.16. Pooled analysis based on the random-effects model yielded a summary odds ratio of 2.66 (95% confidence interval: 2.07, 3.41). Analysis of individual studies indicated that the heightened risk of crash involvement associated with marijuana use persisted after adjustment for confounding variables and that the risk of crash involvement increased in a dose-response fashion with the concentration of 11-nor-9-carboxy-delta-9-tetrahydrocannabinol detected in the urine and the frequency of self-reported marijuana use. The results of this meta-analysis suggest that marijuana use by drivers is associated with a significantly increased risk of being involved in motor vehicle crashes.
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Affiliation(s)
| | | | | | | | | | - Guohua Li
- Correspondence to Dr. Guohua Li, Department of Anesthesiology, Columbia University College of Physicians and Surgeons, 622 West 168th Street, New York, NY 10032 (e-mail: )
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Nabi H, Consoli SM, Chiron M, Lafont S, Chastang JF, Zins M, Lagarde E. Aggressive/hostile personality traits and injury accidents: an eight-year prospective study of a large cohort of French employees -- the GAZEL cohort. Psychol Med 2006; 36:365-373. [PMID: 16332284 PMCID: PMC2253658 DOI: 10.1017/s0033291705006562] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND Aggressiveness on the roads and/or anger behind the wheel are considered to be a major traffic safety problem in several countries. However, the psychological mechanisms of anger and/or aggression on the roads remain largely unclear. This study examines a large cohort of French employees followed over the period 1994-2001 to establish whether psychometric measures of aggression/hostility were significantly associated with an increased risk of an injury accident (I-A). An I-A was defined as a traffic accident in which someone was injured, that is required medical care. METHOD A total of 11,754 participants aged from 39 to 54 years in 1993 were included in this study. Aggression/hostility was measured in 1993 using the French version of the Buss-Durkee Hostility Inventory (BDHI). Driving behaviors and I-A were recorded in 2001. Sociodemographic and alcohol consumption data were available from annual follow-up of the cohort. The relationship between aggression/hostility scores and I-A was assessed using negative binomial regression models with time-dependent covariates. RESULTS The overall BDHI scoring was not statistically predictive of subsequent I-A: adjusted rate ratio (aRR) 1.02, 95% confidence interval (CI) 0.81-1.28, for participants with intermediate scores and aRR 1.25, 95% CI 0.98-1.61 for those with high scores, both compared to those with low scores. The only BDHI subscales found to be associated with I-A were 'irritability' (aRR 1.33, 95% CI 1.02-1.75 for participants with high scores) and 'negativism' (aRR 1.32, 95% CI 1.01-1.71 for participants with high scores). CONCLUSION Overall aggression/hostility personality traits did not predict I-A in this large cohort of French employees, suggesting that aggressiveness on the roads and/or anger behind the wheel extend beyond the individual's general propensity for aggression.
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Affiliation(s)
- Hermann Nabi
- Institut National de la Santé et de la Recherche Médicale, INSERM, U687, Saint-Maurice, F-94415 France.
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Rangasetty UC, Raza S, Lick S, Uretsky BF, Birnbaum Y. Chronic pseudoaneurysm and coarctation of the aorta: a rare delayed complication of trauma. Tex Heart Inst J 2006; 33:368-70. [PMID: 17041699 PMCID: PMC1592259] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/12/2023]
Abstract
We report an unusual case of pseudoaneurysm and coarctation of the descending thoracic aorta after trauma. The coarctation of aorta resulted in hypertension, severe left ventricular dysfunction, and symptoms of congestive heart failure. Surgical bypass resulted in control of blood pressure and improvement of heart failure symptoms. The mechanism of aortic injury leading to the development of this rare combination is discussed.
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Affiliation(s)
- Umamahesh C Rangasetty
- Department of Internal Medicine, University of Texas Medical Branch, Galveston, Texas 77555-0553, USA
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Takach TJ, Anstadt MP, Moore HV. Pediatric aortic disruption. Tex Heart Inst J 2005; 32:16-20. [PMID: 15902816 PMCID: PMC555816] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/02/2023]
Abstract
Although trauma is the primary cause of death in children, few reports or series exist regarding the management of traumatic aortic disruption in the pediatric age group. The clinical outcome in children diagnosed with acute aortic disruption may be directly influenced by diagnostic and therapeutic management decisions. We reviewed the clinical course of 3 consecutive pediatric patients (mean age, 10.0 years; range, 4-16 years) admitted to our institution from January 2002 through May 2003 with the diagnosis of acute aortic disruption due to blunt trauma. In each case, the cause was a motor vehicle accident. Major, concomitant injuries involving other organ systems were present in each patient. Our operative goals were to use primary repair techniques, avoid the use of endovascular stent grafts, and use partial left heart bypass during aortic cross-clamping whenever possible. Each patient underwent successful operative repair. Aortic reconstruction techniques included primary suture repair in the 4-year-old patient, patch angioplasty in the 16-year-old, and placement of an interposition conduit in the 10-year-old for a blow-out type aortic injury. All patients received partial left heart bypass during aortic cross-clamping (mean, 36.6 min; range, 27-50 min), via a centrifugal pump, and anticoagulation. All patients recovered without evidence of adverse neurologic sequelae. Operative repair of acute aortic disruption in pediatric patients using circulatory support can provide good outcomes. Although not always feasible, the preferential use of primary aortic repair techniques in lieu of interposition conduits and endovascular aortic stents may decrease the potential for late pseudocoarctation.
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Affiliation(s)
- Thomas J Takach
- Department of Cardiovascular Surgery, Medical College of Georgia, Augusta, GA 30912, USA.
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Dimas VV, Grifka RG, Fraser CD. Combined tricuspid valvuloplasty and superior cavopulmonary anastomosis for repair of traumatictricuspid valve injury. Tex Heart Inst J 2004; 31:418-20. [PMID: 15745295 PMCID: PMC548245] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/02/2023]
Abstract
Chronic tricuspid valve insufficiency secondary to blunt chest trauma is rare in the pediatric population, with fewer than 10 cases reported. Surgical repair has focused on the tricuspid valve. We present 2 cases of traumatic tricuspid valve insufficiency in pediatric patients after blunt chest trauma in whom tricuspid valve repair was performed along with superior cavopulmonary anastomosis. To our knowledge, this is the 1st report of the use of this combination of surgical procedures for repair of traumatic tricuspid regurgitation in either adults or children.
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Affiliation(s)
- V Vivian Dimas
- Department of Pediatrics, Texas Children's Hospital, 6621 Fannin Street, MC 1935-C, Houston, TX 77030, USA.
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De Amicis V, Rossi M, Monaco M, Di Lello F. Right luxation of the heart after pericardial rupture caused by blunt trauma. Tex Heart Inst J 2003; 30:140-2. [PMID: 12809258 PMCID: PMC161902] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/03/2023]
Abstract
Rupture of the pericardium with luxation of the heart after blunt trauma is a fairly rare condition but carries a high mortality rate. In this report, we describe our experience with a case of right luxation of the heart in a young patient with multiple injuries due to an automobile accident. The patient, who was in hemodynamic failure, underwent successful emergency surgical treatment to replace the heart in its anatomic site. We discuss the diagnosis and management of this dangerous event.
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Affiliation(s)
- Vincenzo De Amicis
- Department of Cardiac Surgery, University of Naples Federico II, Naples 80131, Italy
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Unal M, Demirsoy E, Gogus A, Arbatli H, Hamzaoglu A, Sonmez B. Acute aortic valve regurgitation secondary to blunt chest trauma. Tex Heart Inst J 2001; 28:312-4. [PMID: 11777159 PMCID: PMC101210] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/23/2023]
Abstract
Blunt injury to the cardiac valves leads to progressive acute ventricular failure, which often requires urgent surgical management. In this case report, we describe an acute aortic valve rupture caused by air-bag inflation during an automobile accident. Laceration of an aortic valve cusp was treated successfully with urgent aortic valve replacement. A concomitant orthopedic injury was treated electively 15 days after cardiac surgery Acute aortic valve rupture is a very rare complication of blunt chest trauma. We discuss how to diagnose and manage this potentially catastrophic event.
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Affiliation(s)
- M Unal
- The Department of Cardiovascular Surgery, Kadir Has University, Florence Nightingale Hospital, Istanbul, Turkey
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