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Background Being injured in a road traffic accident may affect individuals’ functional ability and in turn lead to sickness absence (SA) and disability pension (DP). Knowledge regarding long-term consequences in terms of SA and DP following a road traffic accident is lacking, especially comparing different groups of road users and compared to the general population. The aim was to estimate excess diagnosis-specific SA and DP among individuals of different road user groups injured in a road traffic accident compared to matched references without such injury. Methods A nationwide register-based study, including all working individuals aged 20–59 years and living in Sweden who in 2015 had in- or specialized outpatient healthcare after a new traffic-related injury (n = 20 177) and population-based matched references (matched on: sex, age, level of education, country of birth, living in cities) without any traffic-related injury during 2014–2015 (n = 100 885). Diagnosis-specific (injury and other diagnoses) SA and DP were assessed during 5 years: 1 year before and 4 years following the accident. Mean SA and DP net days/year for each road user group and mean differences of (excess) SA and DP net days/year compared with their matched references were calculated with independent t-tests with bootstrapped 95% confidence intervals (CIs).

Background Being injured in a road traffic accident may affect individuals’ functional ability and in turn lead to sickness absence (SA) and disability pension (DP). Knowledge regarding long-term consequences in terms of SA and DP following a road traffic accident is lacking, especially comparing different groups of road users and compared to the general population. The aim was to estimate excess diagnosis-specific SA and DP among individuals of different road user groups injured in a road traffic accident compared to matched references without such injury. Methods A nationwide register-based study, including all working individuals aged 20–59 years and living in Sweden who in 2015 had in- or specialized outpatient healthcare after a new traffic-related injury (n = 20 177) and population-based matched references (matched on: sex, age, level of education, country of birth, living in cities) without any traffic-related injury during 2014–2015 (n = 100 885). Diagnosis-specific (injury and other diagnoses) SA and DP were assessed during 5 years: 1 year before and 4 years following the accident. Mean SA and DP net days/year for each road user group and mean differences of (excess) SA and DP net days/year compared with their matched references were calculated with independent t-tests with bootstrapped 95% confidence intervals (CIs).

Introduction: This study aims to analyze the clinical characteristics, demographic features, and injury circumstances of patients admitted to the Emergency Department (ED) at Fondazione Policlinico Universitario A. Gemelli (IRCCS) in Rome, Italy, due to bicycle accidents. Methods: Data on clinical characteristics, accident timing, injury circumstances, and helmet use were collected for ED patients involved in bicycle accidents from January 2019 to December 2022. Subsequently, Abbreviated Injury Scale codes of all diagnoses were recorded and the Injury Severity Score was calculated. Results: Over the study period, 763 patients were admitted to the ED following bicycle accidents, with a 0.3 % fatality rate and a 30.4 % frequency of multitrauma. Multivariate analysis revealed that collisions with other vehicles increased trauma severity and the risk of ICU admission. Conversely, helmet use was associated with reduced severity of head trauma and a lower likelihood of ICU admission. Notably, toxicological investigations were not conducted for any ED-admitted patients. Conclusions: Although a low mortality rate and a low incidence of multi-trauma have been shown in comparison to other nations, it is necessary to adopt prevention strategies like safety devices, more cycle paths, and better infrastructures on the one hand, and stricter laws on the other. It is essential to require toxicological testing in Italy for all accidents involving this means of transport, and to make helmet use compulsory for all ages.

The purpose of the study – to determine and verify the extent of damage in victims oftraffic accidents (TA) under conditions of a regional city.Materials and methods. A retrospective analysis of 242 cases of injured persons, whoreceived damages as a result of a car accident and were treated in the emergency medicalcare hospital of Chernivtsi from 2019 to 2020, was conducted.The results. In the total file of the study, 28.51 % of victims have the range of damage oftwo anatomical and functional areas (AFA), 27.51 % – one, 24.38 % – three AFA. Amongthe survived victims, the same trend is observed – 30.32 % of the victims have damage oftwo AFAs, 26.56 % – one, and only 0.89 % have damage of six AFAs. Among the victimswho died, the highest specific weight falls on persons who have one and two damagedAFAs – 23.53 % each, and four and five AFAs – 17.65 % each. The highest mortality isobserved in victims with damage of five and six AFA – 33.33 % and 50.50 %, respectively.Damage of one and two AFAs is more typical for passengers (40.91 % and 40.58 %,respectively), and damage of four, five and six AFAs is more typical for pedestrians(37.14 %, 66.67 % and 50.0 % respectively).Conclusions. 1. Combined trauma (polytrauma) prevails in road accident victims in theconditions of a regional city – 72.72 %. 2. The largest specific weight in the array ofthose who died is the combination of three AFA (23.53 %), and in the array of those whosurvived – two AFA 30.22 %. 3. The sign of participation in traffic has a significant impacton the amount of damage in road accident victims, especially for pedestrians.

Traffic injuries are one of the main causes of death of children and youngpeople. About 3,700 people die in traffic accidents worldwide in one day.The aim of the research – to verify the clinical and anatomical characteristics of injuriesresulting from traffic accidents in the conditions of a regional city. Materials and methods. A retrospective analysis of 242 cases of victims who were injuredas a result of a traffic accident and were treated in the emergency medical hospital ofChernivtsi from 2019 to 2020 was conducted. The research array was formed by themethod of irreversible randomization using the methodology of random numbers.Results. As a result of the study, it was established that the head – 75.62 %, the limbs –55.79 %, and the chest – 42.56 % are most often injured in road accidents. In the array ofvictims who survived, a similar rank distribution of victims is observed, and the specificgravity indicators are close in value. In the array of victims, there is a difference in ranking:the head and neck are most often injured – 88.23 %, the pelvis – 70.59 %, and the chest –64.71 %. In drivers, the cranial component is observed in 65.91 %, in passengers – in76.14 %, in pedestrians – in 87.88 % (the first ranking place). Abdomen and pelvis arethe least frequently injured in drivers – 15.91 % each, in passengers – pelvis, 12.50 %,and in pedestrians – abdomen, 18.18 %. In all groups of traffic participants who died, thecoefficient of combination of damages is higher than in the victims who survived, but thisindicator is different in each group. The highest mortality in cranial injuries is observed inpassengers – 10.45 %, vertebral injuries – in pedestrians, 16.67 %, thoracic injuries – ina group of pedestrians, 12.12 %, abdominal injuries – in pedestrians, 33.33 %, in the case ofpelvis injuries – in pedestrians, 42.86 %, in the case of limb injuries – in passengers, 5.56 %.Conclusions. 1. Clinical and anatomical characteristics: victims of traffic accid

Seat belts with shoulder restraints have decreased the frequency of life-threatening severe chest trauma caused by car accidents. However, the introduction of seat belt legislation has led to an increase in a specific pattern of blunt trauma known as seat belt syndrome, which includes rib, clavicle, spine, and sternum fractures, as well as rupture of hollow pelvic and abdominal viscera, mesenteric tears, and major vessel injuries. The shoulder restraint part of the three-point seat belt commonly rests near or over the female and male breast. A 54-year-old female presented to our emergency department complaining of swelling and pain in her left breast immediately after a traffic accident. The patient had used a seat belt with a shoulder restraint. Bruising was noted along her chest where there had been seat belt contact. Her breast hematoma was most likely caused by breast tissue compression between her rib and the seat belt. Contrast-enhanced computed tomography demonstrated a sizable breast hematoma with active arterial contrast material extravasation, as well as multiple left rib fractures. The patient was conservatively treated with analgesic and anti-inflammatory drugs. Complete resolution was achieved, and her breast returned to its normal appearance. Although endovascular treatment and surgical hemostasis have been proposed for the treatment of breast injuries with active bleeding, conservative treatment such as compression hemostasis may be feasible.

Seat belts with shoulder restraints have decreased the frequency of life-threatening severe chest trauma caused by car accidents. However, the introduction of seat belt legislation has led to an increase in a specific pattern of blunt trauma known as seat belt syndrome, which includes rib, clavicle, spine, and sternum fractures, as well as rupture of hollow pelvic and abdominal viscera, mesenteric tears, and major vessel injuries. The shoulder restraint part of the three-point seat belt commonly rests near or over the female and male breast. A 54-year-old female presented to our emergency department complaining of swelling and pain in her left breast immediately after a traffic accident. The patient had used a seat belt with a shoulder restraint. Bruising was noted along her chest where there had been seat belt contact. Her breast hematoma was most likely caused by breast tissue compression between her rib and the seat belt. Contrast-enhanced computed tomography demonstrated a sizable breast hematoma with active arterial contrast material extravasation, as well as multiple left rib fractures. The patient was conservatively treated with analgesic and anti-inflammatory drugs. Complete resolution was achieved, and her breast returned to its normal appearance. Although endovascular treatment and surgical hemostasis have been proposed for the treatment of breast injuries with active bleeding, conservative treatment such as compression hemostasis may be feasible.

Background The knowledge is scarce about sickness absence (SA) and disability pension (DP) among pedestrians injured in a traffic-related accident, including falls. Thus, the aim was to explore the frequencies of types of accidents and injuries and their association with SA and DP among working-aged individuals. Methods A nationwide register-based study, including all individuals aged 16-64 and living in Sweden, who in 2010 had in- or specialized outpatient healthcare after a new traffic-related accident as a pedestrian. Information on age, sex, sociodemographics, SA, DP, type of accident, injury type, and injured body region was used. Frequencies of pedestrians with no SA or DP, with ongoing SA or full-time DP already at the time of the accident, and with a new SA spell >14 days in connection to the accident were analyzed. Crude and adjusted odds ratios (ORs) with 95% confidence intervals (CIs) for new SA were estimated by logistic regression. Results In total, 5576 pedestrians received healthcare due to a traffic-related accident (of which 75% were falls, with half of the falls related to snow and ice). At the time of the accident, 7.5% were already on SA and 10.8% on full-time DP, while 20% started a new SA spell. The most common types of injuries were fractures (45%) and external injuries (30%). The body region most frequently injured was the lower leg, ankle, foot, and other (in total 26%). Older individuals had a higher OR for new SA compared with younger (OR 1.91; 95% CI 1.44-2.53, for ages: 45-54 vs. 25-34). The injury type with the highest OR for new SA, compared with the reference group external injuries, was fractures (9.58; 7.39-12.43). The injured body region with the highest OR for new SA, compared with the reference group head, face, and neck, was lower leg, ankle, foot, and other (4.52; 2.78-7.36).

Background The knowledge is scarce about sickness absence (SA) and disability pension (DP) among pedestrians injured in a traffic-related accident, including falls. Thus, the aim was to explore the frequencies of types of accidents and injuries and their association with SA and DP among working-aged individuals. Methods A nationwide register-based study, including all individuals aged 16-64 and living in Sweden, who in 2010 had in- or specialized outpatient healthcare after a new traffic-related accident as a pedestrian. Information on age, sex, sociodemographics, SA, DP, type of accident, injury type, and injured body region was used. Frequencies of pedestrians with no SA or DP, with ongoing SA or full-time DP already at the time of the accident, and with a new SA spell >14 days in connection to the accident were analyzed. Crude and adjusted odds ratios (ORs) with 95% confidence intervals (CIs) for new SA were estimated by logistic regression. Results In total, 5576 pedestrians received healthcare due to a traffic-related accident (of which 75% were falls, with half of the falls related to snow and ice). At the time of the accident, 7.5% were already on SA and 10.8% on full-time DP, while 20% started a new SA spell. The most common types of injuries were fractures (45%) and external injuries (30%). The body region most frequently injured was the lower leg, ankle, foot, and other (in total 26%). Older individuals had a higher OR for new SA compared with younger (OR 1.91; 95% CI 1.44-2.53, for ages: 45-54 vs. 25-34). The injury type with the highest OR for new SA, compared with the reference group external injuries, was fractures (9.58; 7.39-12.43). The injured body region with the highest OR for new SA, compared with the reference group head, face, and neck, was lower leg, ankle, foot, and other (4.52; 2.78-7.36).

[EN] Objective The present review is intended to provide an up-to-date overview of the strategies available to detect malingered symptoms following whiplash. Whiplash-associated disorders (WADs) represent the most common traffic injuries, having a major impact on economic and healthcare systems worldwide. Heterogeneous symptoms that may arise following whiplash injuries are difficult to objectify and are normally determined based on self-reported complaints. These elements, together with the litigation context, make fraudulent claims particularly likely. Crucially, at present, there is no clear evidence of the instruments available to detect malingered WADs. Methods We conducted a targeted literature review of the methodologies adopted to detect malingered WADs. Relevant studies were identified via Medline (PubMed) and Scopus databases published up to September 2020. Results Twenty-two methodologies are included in the review, grouped into biomechanical techniques, clinical tools applied to forensic settings, and cognitive-based lie detection techniques. Strengths and weaknesses of each methodology are presented, and future directions are discussed. Conclusions Despite the variety of techniques that have been developed to identify malingering in forensic contexts, the present work highlights the current lack of rigorous methodologies for the assessment of WADs that take into account both the heterogeneous nature of the syndrome and the possibility of malingering. We conclude that it is pivotal to promote awareness about the presence of malingering in whiplash cases and highlight the need for novel, high-quality research in this field, with the potential to contribute to the development of standardised procedures for the evaluation of WADs and the detection of malingering.

[EN] Objective The present review is intended to provide an up-to-date overview of the strategies available to detect malingered symptoms following whiplash. Whiplash-associated disorders (WADs) represent the most common traffic injuries, having a major impact on economic and healthcare systems worldwide. Heterogeneous symptoms that may arise following whiplash injuries are difficult to objectify and are normally determined based on self-reported complaints. These elements, together with the litigation context, make fraudulent claims particularly likely. Crucially, at present, there is no clear evidence of the instruments available to detect malingered WADs. Methods We conducted a targeted literature review of the methodologies adopted to detect malingered WADs. Relevant studies were identified via Medline (PubMed) and Scopus databases published up to September 2020. Results Twenty-two methodologies are included in the review, grouped into biomechanical techniques, clinical tools applied to forensic settings, and cognitive-based lie detection techniques. Strengths and weaknesses of each methodology are presented, and future directions are discussed. Conclusions Despite the variety of techniques that have been developed to identify malingering in forensic contexts, the present work highlights the current lack of rigorous methodologies for the assessment of WADs that take into account both the heterogeneous nature of the syndrome and the possibility of malingering. We conclude that it is pivotal to promote awareness about the presence of malingering in whiplash cases and highlight the need for novel, high-quality research in this field, with the potential to contribute to the development of standardised procedures for the evaluation of WADs and the detection of malingering.

Background Bicyclists are the road user group with the highest number of severe injuries in the EU, yet little is known about sickness absence (SA) and disability pension (DP) following such injuries. Aims To explore long-term patterns of SA and DP among injured bicyclists, and to identify characteristics associated with the specific patterns. Methods A longitudinal register-based study was conducted, including all 6353 individuals aged 18–59 years and living in Sweden in 2009, who in 2010 had incident in-patient or specialized out-patient healthcare after a bicycle crash. Information about sociodemographic factors, the injury, SA (SA spells > 14 days), and DP was obtained from nationwide registers. Weekly SA/DP states over 1 year before through 3 years after the crash date were used in sequence and cluster analyses. Multinomial logistic regression was used to estimate odds ratios (OR) and 95% confidence intervals (CI) for factors associated with each identified sequence cluster. Results Seven clusters were identified: “No SA or DP” (58.2% of the cohort), “Low SA or DP” (7.4%), “Immediate SA” (20.3%), “Episodic SA” (5.9%), “Long-term SA” (1.7%), “Ongoing part-time DP” (1.7%), and “Ongoing full-time DP” (4.8%). Compared to the cluster “No SA or DP”, all other clusters had higher ORs for women, and higher age. All clusters but “Low SA and DP” had higher ORs for inpatient healthcare. The cluster “Immediate SA” had a higher OR for: fractures (OR 4.3; CI 3.5–5.2), dislocation (2.8; 2.0–3.9), sprains and strains (2.0; 1.5–2.7), and internal injuries (3.0; 1.3–6.7) compared with external injuries. The cluster “Episodic SA” had higher ORs for: traumatic brain injury, not concussion (4.2; 1.1–16.1), spine and back (4.5; 2.2–9.5), torso (2.5; 1.4–4.3), upper extremities (2.9; 1.9–4.5), and lower extremities (3.5; 2.2–5.5) compared with injuries to the head, face, and neck (not traumatic brain injuries). The cluster “Long-term SA” had higher ORs for collisions with motor ve

Background Bicyclists are the road user group with the highest number of severe injuries in the EU, yet little is known about sickness absence (SA) and disability pension (DP) following such injuries. Aims To explore long-term patterns of SA and DP among injured bicyclists, and to identify characteristics associated with the specific patterns. Methods A longitudinal register-based study was conducted, including all 6353 individuals aged 18–59 years and living in Sweden in 2009, who in 2010 had incident in-patient or specialized out-patient healthcare after a bicycle crash. Information about sociodemographic factors, the injury, SA (SA spells > 14 days), and DP was obtained from nationwide registers. Weekly SA/DP states over 1 year before through 3 years after the crash date were used in sequence and cluster analyses. Multinomial logistic regression was used to estimate odds ratios (OR) and 95% confidence intervals (CI) for factors associated with each identified sequence cluster. Results Seven clusters were identified: “No SA or DP” (58.2% of the cohort), “Low SA or DP” (7.4%), “Immediate SA” (20.3%), “Episodic SA” (5.9%), “Long-term SA” (1.7%), “Ongoing part-time DP” (1.7%), and “Ongoing full-time DP” (4.8%). Compared to the cluster “No SA or DP”, all other clusters had higher ORs for women, and higher age. All clusters but “Low SA and DP” had higher ORs for inpatient healthcare. The cluster “Immediate SA” had a higher OR for: fractures (OR 4.3; CI 3.5–5.2), dislocation (2.8; 2.0–3.9), sprains and strains (2.0; 1.5–2.7), and internal injuries (3.0; 1.3–6.7) compared with external injuries. The cluster “Episodic SA” had higher ORs for: traumatic brain injury, not concussion (4.2; 1.1–16.1), spine and back (4.5; 2.2–9.5), torso (2.5; 1.4–4.3), upper extremities (2.9; 1.9–4.5), and lower extremities (3.5; 2.2–5.5) compared with injuries to the head, face, and neck (not traumatic brain injuries). The cluster “Long-term SA” had higher ORs for collisions with motor ve

Injuries are one of the most important medical and social problems of modern time for the majority of countries in the world. Injury rate around the world has been steadily increasing, causing a huge public social and economic damage. Traffic injuries (RTIs) are a significant proportion in its structure, being the most severe injuries. Traffic accidents are the only external cause of death, and one of the seven leading causes by the Global Burden of Disease (The Global Burden of Disease: 2004 update Geneva, World Health Organization, 2008). According to WHO, all over the world daily 3,000 people die from accident-associated injuries and injured or nearly 40 million become disabled per year (World Report on Road Traffic Injury Prevention, Geneva, 2014). Injuries, being preventable, are an important and very real reserve for reducing population mortality. For over 40 years the Department of Traumatology, Orthopedics and Military Surgery in Zaporozhye State Medical University has been studying the issues of road traffic injuries. The research results offer a number of proposals for the prevention and timely organization of qualified and specialized medical care. In recent years, we have set the goal to study the role of a woman-driver in the structure of road accidents and road traffic injuries. According to our data of the analysis of accident cases (12,706) in Zaporizhzhia and sections of the route Kharkiv — Simferopol in the range of 240 km from Zaporizhzhia region there were determined the most typical accidents provoked by male and female drivers. Japan is considered to have the lowest rate of traffic accidents. This is related to the fact, in particular, that female drivers are about 35 %, and the Japanese believe that this also reduces the rate of accidents on the roads. The analysis of 12 schools and courses for driving training in Zaporizhzhia region demonstrated a regular increase in the number of women who wish to acquire a driver’s license among the student, Травматизм является одной из важнейших медико-социальных проблем современности для большинства стран мира. Травматизм во всем мире неуклонно растет, нанося обществу огромный социальный и экономический ущерб. Значительную долю в его структуре составляют дорожно-транспортные травмы, относящиеся к наиболее тяжелым видам травматизма. Транспортные происшествия являются единственной внешней причиной смерти, входящей в семь ведущих причин по критерию «Глобального бремени болезней» (The Global Burden of Disease: 2004 update. — Geneva: World Health Oгganization, 2008). По данным Всемирной организации здравоохранения, в мире от травм, полученных в дорожно-транспортных происшествиях (ДТП), каждый день погибает в среднем 3 тыс. человек, а получают травмы или становятся инвалидами около 40 млн человек в год (Всемирный доклад предупреждения дорожно-транспортного травматизма. — Женева, 2014). Травматизм в связи с его предотвратимостью является важным и вполне реальным резервом снижения смертности населения страны. На протяжении более 40 лет кафедра травматологии, ортопедии и военно-полевой хирургии Запорожского государственного медицинского университета занималась изучением вопросов дорожно-транспортного травматизма. По результатам исследований сделан ряд предложений по профилактике и организации своевременной квалифицированной и специальной медпомощи пострадавшим при ДТП. В последние годы мы поставили себе цель изучить роль женщины за рулем в структуре дорожных происшествий и дорожно-транспортного травматизма. По данным нашего анализа случаев ДТП (12 706) по г. Запорожью и участку трассы Харьков — Симферополь в пределах 240 км по Запорожской области отмечены наиболее характерные ДТП, совершаемые водителями-мужчинами и водителями-женщинами. Считается, что самое низкое число аварий — в Японии, потому что женщин-автомобилистов в этой стране около 35 %. Японцы уверены, что это и снижает показатель аварийности на дорогах. При анализе 12 школ и курсов по подготовке водителей-автомобили, Травматизм є однією з найважливіших медико-соціальних проблем сучасності для більшості країн світу. Травматизм у всьому світі неухильно зростає, наносячи суспільству величезний соціальний і економічний збиток. Значну частку в його структурі становлять дорожньо-транспортні травми, що належать до найбільш тяжких видів травматизму. Транспортні пригоди є єдиною зовнішньою причиною смерті, що входить у сім провідних причин за критерієм «Глобального тягаря хвороб» (The Global Burden of Disease: 2004 update. — Geneva: World Health Oгganization, 2008). За даними Всесвітньої організації охорони здоров’я, у світі від травм, отриманих у дорожньо-транспортних пригодах (ДТП), кожен день гине в середньому 3 тис. людей, а отримують травми або стають інвалідами близько 40 млн осіб на рік (Всесвітня доповідь запобігання дорожньо-транспортному травматизму. — Женева, 2014). Травматизм у зв’язку з його передбачуваністю є важливим і цілком реальним резервом зниження смертності населення країни. Протягом більше 40 років кафедра травматології, ортопедії та військово-польової хірургії Запорізького державного медичного університету займалася вивченням питань дорожньо-транспортного травматизму. За результатами досліджень зроблено ряд пропозицій щодо профілактики та організації своєчасної кваліфікованої та спеціальної меддопомоги постраждалим при ДТП. Останнім часом ми поставили собі за мету вивчити роль жінки за кермом у структурі дорожніх пригод і дорожньо-транспортного травматизму. За даними нашого аналізу випадків ДТП (12 706) по м. Запоріжжю та ділянкам траси Харків — Сімферополь у межах 240 км по Запорізькій області відзначені найбільш характерні ДТП, що здійснюються водіями-чоловіками і водіями-жінками. Вважається, що найнижча кількість аварій — в Японії, тому що жінок-автомобілістів в цій країні близько 35 %. Японці впевнені, що це і знижує показник аварійності на дорогах. Аналізуючи 12 шкіл і курсів із підготовки водіїв-автомобілістів Запорізької області, ми відзначили, що серед курс

BackgroundThe associations between population-level alcohol consumption and fatal injuries have been examined in a number of previous studies, but few have considered the external impacts of major policy interventions. This study aims to quantify the associations between per capita alcohol consumption and traffic and nontraffic injury mortality rates in Australia before and after major traffic safety initiatives (the introduction of compulsory seat belt legislation [CSBL] and random breath testing [RBT] in 1970s). MethodsUsing data from 1924 to 2006, gender- and age-specific traffic and nontraffic mortality rates (15years and above) were analyzed in relation to per capita alcohol consumption using time series analysis. The external effects of policy interventions were measured by inserting a dummy variable in the time series models. ResultsStatistically significant associations between per capita alcohol consumption and both types of fatal injuries were found for both males and females. The results suggest that an increase in per capita alcohol consumption of 1l was accompanied by an increase in traffic mortality of 3.4 among males and 0.5 among females per 100,000 inhabitants and an increase in nontraffic mortality of 3.0 among males and 0.9 among females. The associations between alcohol consumption and fatal injury rates varied across age groups. The introduction of CSBL and RBT was associated with significant reductions in traffic crash mortality in Australia, particularly for males and young people. ConclusionsThe magnitude and distribution of the preventive effects from the reduction in population drinking on fatal injuries vary across different gender and age groups, with the strongest preventive impacts on fatal injuries among people aged 15 to 29 and 70years and above. The mechanisms behind these effects are unclear from this study, but are likely to be due to the strong association between per capita consumption and heavy drinking., AuthorCount:3

There is a disproportional risk of motor vehicle death and injury among American Indian/Alaska Native (AI/AN) populations in the United States. As home to the nation’s largest population of AI individuals, it is vital that California develop a better understanding of the factors contributing to this risk to guide the development and implementation of interventions to improve traffic safety for this population on the nearly 100 Rancherias and reservations in the state. However, there is very little data about the numbers and types of collisions, and driver and environmental factors contributing to the collisions that occur on tribal lands. As a first step toward better understanding the scope of the risk disparity, and the shortcomings in data collection, SafeTREC conducted a literature review and crash analysis using data from the Statewide Integrated Traffic Record System (SWITRS) and tribal area base maps targeting these communities. As a result of presentations and discussions at a California Tribal Safety conference where these analyses were presented, a number of procedural and institutional challenges were identified. Addressing these issues will not only help policymakers identify interventions to improve traffic safety on tribal lands, but it will give tribal jurisdictions tools to compete for scarce safety funding through the use of data documenting the need for safety improvements. Future research efforts should be aimed at refining these and other initiatives to address both the dire conditions of traffic safety on California’s tribal lands, and the limitations of the data.

There is a disproportional risk of motor vehicle death and injury among American Indian/Alaska Native (AI/AN) populations in the United States. As home to the nation’s largest population of AI individuals, it is vital that California develop a better understanding of the factors contributing to this risk to guide the development and implementation of interventions to improve traffic safety for this population on the nearly 100 Rancherias and reservations in the state. However, there is very little data about the numbers and types of collisions, and driver and environmental factors contributing to the collisions that occur on tribal lands. As a first step toward better understanding the scope of the risk disparity, and the shortcomings in data collection, SafeTREC conducted a literature review and crash analysis using data from the Statewide Integrated Traffic Record System (SWITRS) and tribal area base maps targeting these communities. As a result of presentations and discussions at a California Tribal Safety conference where these analyses were presented, a number of procedural and institutional challenges were identified. Addressing these issues will not only help policymakers identify interventions to improve traffic safety on tribal lands, but it will give tribal jurisdictions tools to compete for scarce safety funding through the use of data documenting the need for safety improvements. Future research efforts should be aimed at refining these and other initiatives to address both the dire conditions of traffic safety on California’s tribal lands, and the limitations of the data.

The objective of the current study was to evalu- ate outcomes of a program to prevent traffic injuries among the different social strata under WHO Safe Community Program. A quasi-experi- mental design was used, with pre- and post- implementation registrations in the program im- plementation area (population 41,000) and in a neighbouring control municipality (population 26,000) in Östergötland County, Sweden. The traffic injury rate in the not vocationally active households was twice than employed or self- employed households in the intervention area. In the employed and not vocationally active households, males showed higher injury rates than females in both areas. In the self-employed households females exhibited higher injury rates than males in the intervention area. Males from not vocationally active households displayed the highest post-intervention injury rate in both the intervention and control areas. After 6 years of Safe Community program activity, the injury rates for males in employed category, injury rates for females in self-employed category, and males/females in non- vocationally active cate- gory displayed a decreasing trend in the inter- vention area. However, in the control area injury rate decreased only for males of employed households. The study indicated that there was almost no change in injury rates in the control area. Reduction of traffic injuries in the inter- vention area between 1983 and 1989 was likely to be attributable to the success of safety pro- motion program. Therefore, the current study concludes that Safe Community program seems to be successful for reducing traffic injuries in different social strata.

The objective of the current study was to evalu- ate outcomes of a program to prevent traffic injuries among the different social strata under WHO Safe Community Program. A quasi-experi- mental design was used, with pre- and post- implementation registrations in the program im- plementation area (population 41,000) and in a neighbouring control municipality (population 26,000) in Östergötland County, Sweden. The traffic injury rate in the not vocationally active households was twice than employed or self- employed households in the intervention area. In the employed and not vocationally active households, males showed higher injury rates than females in both areas. In the self-employed households females exhibited higher injury rates than males in the intervention area. Males from not vocationally active households displayed the highest post-intervention injury rate in both the intervention and control areas. After 6 years of Safe Community program activity, the injury rates for males in employed category, injury rates for females in self-employed category, and males/females in non- vocationally active cate- gory displayed a decreasing trend in the inter- vention area. However, in the control area injury rate decreased only for males of employed households. The study indicated that there was almost no change in injury rates in the control area. Reduction of traffic injuries in the inter- vention area between 1983 and 1989 was likely to be attributable to the success of safety pro- motion program. Therefore, the current study concludes that Safe Community program seems to be successful for reducing traffic injuries in different social strata.

The objective of the current study was to evalu- ate outcomes of a program to prevent traffic injuries among the different social strata under WHO Safe Community Program. A quasi-experi- mental design was used, with pre- and post- implementation registrations in the program im- plementation area (population 41,000) and in a neighbouring control municipality (population 26,000) in Östergötland County, Sweden. The traffic injury rate in the not vocationally active households was twice than employed or self- employed households in the intervention area. In the employed and not vocationally active households, males showed higher injury rates than females in both areas. In the self-employed households females exhibited higher injury rates than males in the intervention area. Males from not vocationally active households displayed the highest post-intervention injury rate in both the intervention and control areas. After 6 years of Safe Community program activity, the injury rates for males in employed category, injury rates for females in self-employed category, and males/females in non- vocationally active cate- gory displayed a decreasing trend in the inter- vention area. However, in the control area injury rate decreased only for males of employed households. The study indicated that there was almost no change in injury rates in the control area. Reduction of traffic injuries in the inter- vention area between 1983 and 1989 was likely to be attributable to the success of safety pro- motion program. Therefore, the current study concludes that Safe Community program seems to be successful for reducing traffic injuries in different social strata.

The objective of the current study was to evalu- ate outcomes of a program to prevent traffic injuries among the different social strata under WHO Safe Community Program. A quasi-experi- mental design was used, with pre- and post- implementation registrations in the program im- plementation area (population 41,000) and in a neighbouring control municipality (population 26,000) in Östergötland County, Sweden. The traffic injury rate in the not vocationally active households was twice than employed or self- employed households in the intervention area. In the employed and not vocationally active households, males showed higher injury rates than females in both areas. In the self-employed households females exhibited higher injury rates than males in the intervention area. Males from not vocationally active households displayed the highest post-intervention injury rate in both the intervention and control areas. After 6 years of Safe Community program activity, the injury rates for males in employed category, injury rates for females in self-employed category, and males/females in non- vocationally active cate- gory displayed a decreasing trend in the inter- vention area. However, in the control area injury rate decreased only for males of employed households. The study indicated that there was almost no change in injury rates in the control area. Reduction of traffic injuries in the inter- vention area between 1983 and 1989 was likely to be attributable to the success of safety pro- motion program. Therefore, the current study concludes that Safe Community program seems to be successful for reducing traffic injuries in different social strata.

The objective of the current study was to evalu- ate outcomes of a program to prevent traffic injuries among the different social strata under WHO Safe Community Program. A quasi-experi- mental design was used, with pre- and post- implementation registrations in the program im- plementation area (population 41,000) and in a neighbouring control municipality (population 26,000) in Östergötland County, Sweden. The traffic injury rate in the not vocationally active households was twice than employed or self- employed households in the intervention area. In the employed and not vocationally active households, males showed higher injury rates than females in both areas. In the self-employed households females exhibited higher injury rates than males in the intervention area. Males from not vocationally active households displayed the highest post-intervention injury rate in both the intervention and control areas. After 6 years of Safe Community program activity, the injury rates for males in employed category, injury rates for females in self-employed category, and males/females in non-vocationally active cate- gory displayed a decreasing trend in the inter- vention area. However, in the control area injury rate decreased only for males of employed households. The study indicated that there was almost no change in injury rates in the control area. Reduction of traffic injuries in the inter- vention area between 1983 and 1989 was likely to be attributable to the success of safety pro- motion program. Therefore, the current study concludes that Safe Community program seems to be successful for reducing traffic injuries in different social strata., This study was supported by grants from the Swedish Civil Contingen-cies Agency (MSB).

The objective of the current study was to evalu- ate outcomes of a program to prevent traffic injuries among the different social strata under WHO Safe Community Program. A quasi-experi- mental design was used, with pre- and post- implementation registrations in the program im- plementation area (population 41,000) and in a neighbouring control municipality (population 26,000) in Östergötland County, Sweden. The traffic injury rate in the not vocationally active households was twice than employed or self- employed households in the intervention area. In the employed and not vocationally active households, males showed higher injury rates than females in both areas. In the self-employed households females exhibited higher injury rates than males in the intervention area. Males from not vocationally active households displayed the highest post-intervention injury rate in both the intervention and control areas. After 6 years of Safe Community program activity, the injury rates for males in employed category, injury rates for females in self-employed category, and males/females in non- vocationally active cate- gory displayed a decreasing trend in the inter- vention area. However, in the control area injury rate decreased only for males of employed households. The study indicated that there was almost no change in injury rates in the control area. Reduction of traffic injuries in the inter- vention area between 1983 and 1989 was likely to be attributable to the success of safety pro- motion program. Therefore, the current study concludes that Safe Community program seems to be successful for reducing traffic injuries in different social strata.

The objective of the current study was to evalu- ate outcomes of a program to prevent traffic injuries among the different social strata under WHO Safe Community Program. A quasi-experi- mental design was used, with pre- and post- implementation registrations in the program im- plementation area (population 41,000) and in a neighbouring control municipality (population 26,000) in Östergötland County, Sweden. The traffic injury rate in the not vocationally active households was twice than employed or self- employed households in the intervention area. In the employed and not vocationally active households, males showed higher injury rates than females in both areas. In the self-employed households females exhibited higher injury rates than males in the intervention area. Males from not vocationally active households displayed the highest post-intervention injury rate in both the intervention and control areas. After 6 years of Safe Community program activity, the injury rates for males in employed category, injury rates for females in self-employed category, and males/females in non- vocationally active cate- gory displayed a decreasing trend in the inter- vention area. However, in the control area injury rate decreased only for males of employed households. The study indicated that there was almost no change in injury rates in the control area. Reduction of traffic injuries in the inter- vention area between 1983 and 1989 was likely to be attributable to the success of safety pro- motion program. Therefore, the current study concludes that Safe Community program seems to be successful for reducing traffic injuries in different social strata.

Objective: To investigate whether nursing intervention via telephone follow-up can affect health-related quality of life among road users in the postinjury phase. Background: Injuries in the traffic environment often cause both physical impairment and psychological trauma. Therefore, it is important to investigate whether nursing via telephone follow-up after discharge could affect health-related quality of life among injured road users. Design: A randomised controlled study. Method: Between April 2003–April 2005, car occupants, cyclists and pedestrians, aged 18–70 years, all injured in the traffic environment, were randomly assigned to an intervention (n = 288) or control group (n = 280). All patients were initially managed by one emergency department with the intervention group being followed up by nurse led telephone follow-up three weeks after discharge, while the control group did not receive any telephone follow-up. Data were collected from a mail survey using the non-disease-specific health-related quality of life instrument EQ5D, at baseline and after six months. Results: In general, the intervention group rated significantly higher health-related quality of life than the control group. This difference was most pronounced in the group of those provided with advice as part of telephone follow-up and significantly for the general health status. Car occupants gained most advantage from the nursing telephone follow-up, with significantly lower problems in the dimensions of pain/discomfort and usual activities. Conclusion: Nursing intervention via telephone follow-up was effective at increasing the health-related quality of life of injured road users. Early identification of the concerns of the injured and specific advice provided by the intervening nurse seems to be of greatest weight. Thus, more research is needed regarding the usefulness of early support and the advantage of this from a health economic perspective. Relevance to clinical practice: There is a ne

AIM: To describe the patients' perceptions of quality of care (QoC) in an emergency department (ED) and to analyse associations between patients' background characteristics and estimated QoC. BACKGROUND: Each year 1.4 out of every 100 inhabitants are injured in the traffic environment and receive care at the ED. No study has yet analysed different injured road users' perceived QoC, or how important they rate different caring dimensions. DESIGN: Cross-sectional study at the ED, in the University Hospital in Umeå, Sweden. METHOD: A stratified consecutive sample of 166 car occupants, 200 cyclists and 199 pedestrians, aged 18-70 years, all injured in the traffic environment. Data were collected from medical records and from a mail survey using a short form of the Quality from the Patient's Perspective questionnaire, modified for ED use. The statistical methods used included Mann-Whitney's U-test, the Kruskal-Wallis test and multiple logistic regression. RESULTS: The perceived QoC and the subjective importance of the corresponding QoC dimensions were rated at the 'better' half of the rating scale, with no differences between the different road user categories. The most prominent factors associated with a positive perceived QoC rating were a short waiting time, moderate or serious injuries and high age as well as high educational level of the injury victim. For the subjective importance, a short waiting time was rated as the most important but slight differences were seen, related to education and sex. CONCLUSION: The association patterns between the areas of perceived reality and subjective importance indicated that expectations were higher than perceived QoC, suggesting that patients expected somewhat higher QoC than they received. RELEVANCE TO CLINICAL PRACTICE: Information on factors causing long waiting times, adapted to patients' age, sex and educational level, may reduce dissatisfaction among long waiting patients, especially among those with minor injuries., Published Online: 5 Apr 2007