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Powered two-wheelers (PTWs) are considered as one of the risky means of transport as it is vulnerable to road crashes, which may lead to fatal injuries. Crash data revealed that the number of deaths caused by PTWs is significantly higher than any other road users. Literature reports that one of the major causes of high PTW crashes is the riding behavior of the users. Therefore, the present paper reviews existing literature related to factors affecting riding behavior. Several factors with different levels of influence on PTW riding behavior are explored in the paper. Further, safety strategies to improve PTW safety have been reported in the study by categorizing it based on risk factors, i.e., riding behavior, vehicle technology, and road infrastructure. The paper concludes with some of the major findings, i) riding behavior plays an essential role in improving PTW safety, ii) numerous research stated that riding behavior can be improved by enforcement and providing feedback about their riding behavior by profiling them into different categories, and iii) segregation of PTW traffic from other road users is reported to be an effective solution for increasing PTW safety in some developing countries. While a considerable amount of research related to riding behavior and PTW safety has been done, studies related to the impact of riding feedback on PTW riding behavior are scant. Further, it is suggested that future research should focus on the feasibility of advanced traffic management strategies, such as the segregation of PTWs from main traffic to reduce the conflict between vehicles. [ABSTRACT FROM AUTHOR]

While the disproportional application of school discipline has garnered notable attention, the relationship between trauma or adversity and school discipline is under examined. The purpose of the current scoping review was to map the state of the literature, empirical and theoretical, at the intersection of school discipline, and trauma or adversity. The findings identified a gap in our knowledge as only 14 of the 49 included articles detailed empirical studies focused on the relationship between adversity and school discipline, with very few from outside of the United States. However, this burgeoning body of knowledge points to a significant relationship between trauma/adversity and experiencing school discipline that warrants further study and contextualizes expanded adversities, including poverty and racism as adversity. We believe this is necessary to acknowledging the hidden and unaddressed trauma among students being disproportionally disciplined, leading to a greater understanding of student lives, and evidence-based, trauma-informed, and culturally attuned discipline. [ABSTRACT FROM AUTHOR]

Objectives. This study investigated post‐traumatic stress disorder (PTSD) trajectories and their predictors over a 2‐year period, in individuals recovering from physical injuries. Materials and Methods. Between June 2015 and January 2021, 1,142 patients from a South Korean University Hospital Trauma Center underwent baseline evaluations, including PTSD‐related measures and sociodemographic characteristics. They were subsequently followed up for PTSD using the Clinician‐Administered PTSD Scale at 3, 6, 12, and 24 months. The analyzed sample consisted of 1,014 patients who were followed up at least once after the baseline and 3‐month evaluations. Latent class growth analysis and logistic regression models were used. Results. Five distinctive trajectories were identified: resilient, worsening/recovery, worsening, recovery, and chronic groups. The worsening/recovery trajectory was associated with previous traumatic events and traffic‐related injuries, while the worsening trajectory was linked to higher education and elevated depressive symptoms. The recovery trajectory was characterized by female sex, childhood abuse, traffic‐related injuries, dissociative subtype, and higher levels of anxiety and depressive symptoms. The chronic trajectory was predicted by the dissociative subtype and heightened anxiety symptoms. Conclusion. These findings highlighted the heterogeneity of PTSD symptom development and, thus, the importance of considering individual characteristics when assessing and addressing PTSD following physical injuries. [ABSTRACT FROM AUTHOR]

Background: Motorcycle and equestrian accidents can share similar trauma mechanisms and can result in serious injuries., Objective: This study aims to analyze variations in injuries and safety standards through types, severity, and outcomes of traumatic injuries in both motorcycle and equestrian riders., Methods: Using the 2020 ACS TQIP database, we split patients into two groups based on their primary injury. We chose codes V28 and V80.0 to identify non-collision fall or throw injuries for motorcycle and equestrian accidents respectively. A total of 17,730 motorcycle and 5,461 equestrian patients were identified., Results: Motorcyclists were more likely to experience external/superficial injuries (41.34% vs. 29.08%, p < .001) and chest trauma (5.15% vs. 3.18%, p < .001), while equestrian trauma resulted in more injuries to the abdomen and pelvic content (24.07% vs. 15.75%, p < .001), extremities and pelvic girdle (9.85% vs. 4.98%, p < .001), and head/neck (15.57% vs. 12.16%, p < .001) comparatively. Motorcyclists also had a higher average length of inpatient stay (6.06 (8.03) vs. 4.32 (4.23) days, p < .001). Helmet use was more common among motorcyclists than horseback riders (57.79% vs. 24.24%, p < .001). The average injury severity score between the two groups was not significantly different., Conclusion: These data show the different injuries observed between both activities and the need for increased safety equipment, especially in the case of hip and pelvic injuries among equestrians. The low rate of helmet, especially among equestrian riders, is concerning despite broad education regarding their benefits., Competing Interests: The authors declare no conflicts of interest., (Copyright © 2025 Society of Trauma Nurses.)

Background: Emergency medical services (EMS) are often patients’ first point of contact for urgent and emergency care needs. Patients are triaged over the phone and may receive an ambulance response, with potential conveyance to the hospital. A recent scoping review suggested disparities in EMS patient care in the United States. However, it is unknown how health inequalities impact EMS care in other developed countries and how inequalities are being addressed. Objectives: This rapid evidence map of published literature aims to map known health inequalities in EMS patients and describe interventions reducing health inequalities in EMS patient care. Methods: The search strategy consisted of EMS synonyms and health inequality synonyms. The MEDLINE/PubMed database was searched from 1 January 2010 to 26 July 2022. Studies were included if they described empirical research exploring health inequalities within ambulance service patient care. Studies were mapped on to the EMS care interventions framework and Core20PLUS5 framework. Studies evaluating interventions were synthesised using the United Kingdom Allied Health Professions Public Health Strategic Framework. Results: The search strategy yielded 771 articles, excluding duplicates, with two more studies added from hand searches. One hundred studies met the inclusion criteria after full-text review. Inequalities in EMS patient care were predominantly situated in assessment, treatment and conveyance, although triage and response performance were also represented. Studies mostly explored EMS health inequalities within ethnic minority populations, populations with protected characteristics and the core issue of social deprivation. Studies evaluating interventions reducing health inequalities (n = 5) were from outside the United Kingdom and focused on older patients, ethnic minorities and those with limited English proficiency. Interventions included community paramedics, awareness campaigns, dedicated language lines and changes to EMS protocols. Conclusions: Further UK-based research exploring health inequalities of EMS patients would support ambulance service policy and intervention development to reduce health inequality in urgent and emergency care delivery. [ABSTRACT FROM AUTHOR]

Background: Road Traffic injuries (RTI) are among the top ten leading causes of death in the world resulting in 1.35 million deaths every year, about 93% of which occur in low‐ and middle‐income countries (LMICs). Despite several global resolutions to reduce traffic injuries, they have continued to grow in many countries. Many high‐income countries have successfully reduced RTI by using a public health approach and implementing evidence‐based interventions. As many LMICs develop their highway infrastructure, adopting a similar scientific approach towards road safety is crucial. The evidence also needs to be evaluated to assess external validity because measures that have worked in high‐income countries may not translate equally well to other contexts. An evidence gap map for RTI is the first step towards understanding what evidence is available, from where, and the key gaps in knowledge. Objectives: The objective of this evidence gap map (EGM) is to identify existing evidence from all effectiveness studies and systematic reviews related to road safety interventions. In addition, the EGM identifies gaps in evidence where new primary studies and systematic reviews could add value. This will help direct future research and discussions based on systematic evidence towards the approaches and interventions which are most effective in the road safety sector. This could enable the generation of evidence for informing policy at global, regional or national levels. Search Methods: The EGM includes systematic reviews and impact evaluations assessing the effect of interventions for RTI reported in academic databases, organization websites, and grey literature sources. The studies were searched up to December 2019. Selection Criteria: The interventions were divided into five broad categories: (a) human factors (e.g., enforcement or road user education), (b) road design, infrastructure and traffic control, (c) legal and institutional framework, (d) post‐crash pre‐hospital care, and (e) vehicle factors (except car design for occupant protection) and protective devices. Included studies reported two primary outcomes: fatal crashes and non‐fatal injury crashes; and four intermediate outcomes: change in use of seat belts, change in use of helmets, change in speed, and change in alcohol/drug use. Studies were excluded if they did not report injury or fatality as one of the outcomes. Data Collection and Analysis: The EGM is presented in the form of a matrix with two primary dimensions: interventions (rows) and outcomes (columns). Additional dimensions are country income groups, region, quality level for systematic reviews, type of study design used (e.g., case‐control), type of road user studied (e.g., pedestrian, cyclists), age groups, and road type. The EGM is available online where the matrix of interventions and outcomes can be filtered by one or more dimensions. The webpage includes a bibliography of the selected studies and titles and abstracts available for preview. Quality appraisal for systematic reviews was conducted using a critical appraisal tool for systematic reviews, AMSTAR 2. Main Results: The EGM identified 1859 studies of which 322 were systematic reviews, 7 were protocol studies and 1530 were impact evaluations. Some studies included more than one intervention, outcome, study method, or study region. The studies were distributed among intervention categories as: human factors (n = 771), road design, infrastructure and traffic control (n = 661), legal and institutional framework (n = 424), post‐crash pre‐hospital care (n = 118) and vehicle factors and protective devices (n = 111). Fatal crashes as outcomes were reported in 1414 records and non‐fatal injury crashes in 1252 records. Among the four intermediate outcomes, speed was most commonly reported (n = 298) followed by alcohol (n = 206), use of seatbelts (n = 167), and use of helmets (n = 66). Ninety‐six percent of the studies were reported from high‐income countries (HIC), 4.5% from upper‐middle‐income countries, and only 1.4% from lower‐middle and low‐income countries. There were 25 systematic reviews of high quality, 4 of moderate quality, and 293 of low quality. Authors' Conclusions: The EGM shows that the distribution of available road safety evidence is skewed across the world. A vast majority of the literature is from HICs. In contrast, only a small fraction of the literature reports on the many LMICs that are fast expanding their road infrastructure, experiencing rapid changes in traffic patterns, and witnessing growth in road injuries. This bias in literature explains why many interventions that are of high importance in the context of LMICs remain poorly studied. Besides, many interventions that have been tested only in HICs may not work equally effectively in LMICs. Another important finding was that a large majority of systematic reviews are of low quality. The scarcity of evidence on many important interventions and lack of good quality evidence‐synthesis have significant implications for future road safety research and practice in LMICs. The EGM presented here will help identify priority areas for researchers, while directing practitioners and policy makers towards proven interventions. [ABSTRACT FROM AUTHOR]

Background: There is no prior study in Mexico reporting on the 6-h prevalence and risk of drug use among injured patients attending an Emergency Department (ED). Methods: We report here on a sample of 705 adult patients, admitted to the ED of a public hospital in Mexico City (January and February 2002). Patients reported on alcohol and drug use (amphetamines, tranquilizers, marihuana, cocaine, cocaine–crack, hallucinogens, inhalants, heroin, and others) during the last 12 months, within the 6 h prior to the injury and for the day prior to the injury, the same day the week prior and the same day the last month. Results: Drug use was not just infrequently reported immediately before the injury but was less frequently reported in that period than in any other control period. Co-occurrence of drug use and alcohol was not common and did not increase the risk of an injury. Sole use of alcohol was a strong risk factor, while sole use of drugs decreased the risk of injury. Conclusions: It is not apparent why drug use alone reduces the risk of an injury. Studies focusing on a single cause of injuries with larger samples to study the differential effects of specific drugs are needed. [ABSTRACT FROM AUTHOR]

Road traffic injuries are a major public health problem and a leading cause of death and injury around the world. Each year nearly 1.2 million people die as a result of road crashes, and millions more are injured or disabled. According to the National Highway Traffic Safety Administration (NHTSA), motorcycle riders are 26 times more likely to die in a traffic collision than passenger vehicle occupants, and 5 times more likely to be injured. In a study conducted by NHTSA on 104,472 motorcyclists injured in traffic crashes, 15 percent of helmeted and 21 percent of unhelmet riders suffered TBI. A helmet aims to reduce the risk of serious head and brain injuries by reducing the impact of a force or collision to the head. A helmet works by, reducing the deceleration of the skull, spreads the forces of the impact over a greater surface area and by preventing direct contact between the skull and the impacting object. Present study was carried out in Mahadevappa Rampure Medical College, Kalaburagi with the aim to know cause of death in deaths due to bike accidents autopsied at Mahadevappa Rampure Medical College, Kalaburagi between 2011 to 2016(6-year retrospective study). Results of the study shows that out of 100 cases, in 65 cases cause of death was head injury and in 35 cases it was hemorrhagic shock, septicemia, multi organ failure and others. In 48% of cases injuries were seen in thoracic region and in 40% of cases abdominal injuries. Whereas in 34 cases except intracranial hemorrhage no other injuries were seen on the body. The present study shows that maximum deaths can be prevented by wearing a proper protective helmet. [ABSTRACT FROM AUTHOR]

Background. This study investigates the effect of injury mechanism and energy on fracture patterns and distributions. Also, it compares differences in bone fracture patterns based on injury mechanism, gender, and age. Methods. Three thousand and sixty-six admitted patients with bone fractures were reviewed retrospectively, and the fractures were analyzed regarding age, gender, and mechanism of injury. Fractures were located in eleven bones. However, the forearm, hand, leg, and foot were considered one bone, and the fracture was then subclassified according to the anatomic position within each bone. Trauma energy was classified according to the mechanism of injury where simple falls were considered low-energy injury while falling from a height, road traffic accidents, bullet, and industrial injuries were considered high energy. Results. Males represented most of the patients, and most injuries occurred in adults. However, the male patients were more prone to injuries than females across all age groups below fifty years, women above fifty years were more frequent, and a third of females' injuries occurred in the elderly. Simple falls represent two-thirds of the trauma mechanism, and falling from a height and road traffic accidents are the most common high-energy injuries and more prevalent in males. Scapular, clavicular, distal humerus, and shaft of long bones fractures were more prevalent in males. In contrast, females had a higher frequency of proximal humerus, proximal and distal femur, distal leg, and thoracic spine fractures. Industrial injuries are more frequent in males; thus, hand injuries are more frequent. Pathological fractures were higher in females, and spine and pelvic fractures were more associated with high-energy injuries. Conclusions. The trauma's energy determines the bone injury's extent and nature. Knowing the trauma mechanism is essential to expect the extent of injuries and construct preventive measures accordingly. [ABSTRACT FROM AUTHOR]

Vehicle crash tests mitigate an informational market failure and provide substantial benefits to consumers. Consumers cannot accurately assess vehicle safety leading automakers to provide it suboptimally. Crash tests performed by the Insurance Institute for Highway Safety represent an attempt to mitigate this market failure. This paper presents evidence that automakers responded by producing safer vehicles and that consumers increased purchases of highly rated vehicles. A novel identification strategy using the year of vehicle redesign is used to evaluate the tests' safety impact. A lower‐bound estimate of program benefits is $3000 per vehicle resulting in an annual reduction of 1650 fatalities. [ABSTRACT FROM AUTHOR]

Background: A trauma registry review of our trauma center's alcohol misuse screening compliance noted inconsistent screening and data collection methods, putting our American College of Surgeons trauma center reverification at risk for a deficiency., Objective: The objective of this study was to evaluate an alcohol misuse screening improvement initiative on screening compliance in trauma patients., Methods: This before and after analysis of a quality improvement initiative to improve alcohol misuse screening was conducted from 2019 to 2021 at a Southwestern U.S. Level II trauma center on admitted trauma patients aged 13 years and older. The multicomponent initiative included a change in the screening instrument and timing of application, implementing electronic medical record documentation screens, and educating staff. The primary outcome measure was screening adherence., Results: A total of n = 4,734 patients were included in the study period. Alcohol misuse screening improved from 2.9% to 87.4% and remained sustained for over a year after the initiative's implementation., Conclusion: The performance improvement initiative improved the alcohol misuse screening process, resulting in consistent screenings exceeding the American College of Surgeons standards of 80% for verified trauma centers., Competing Interests: The authors declare no conflicts of interest., (Copyright © 2024 Society of Trauma Nurses.)

Introduction: Thousands of youth are sexually trafficked each year worldwide. Increased public attention to the commercial sexual exploitation (CSE) of children has resulted in the rapid deployment of hybrid community public health and social service programs for these vulnerable youth. Research on the effectiveness of these advocacy programs is lacking, particularly whether they decrease psychosocial distress and increase readiness to leave CSE. Methods and analysis: Cisgender girls under age 18 at the time of CSE, and who were identified as at-risk for sex trafficking revictimization, were included in an evaluation of an anti-trafficking advocacy program in the North Texas region of the United States. The program includes crisis response, case management, referral, and mentoring services in collaboration with multi-disciplinary team (MDT) responses to identified youth sex trafficking. Case management notes, needs assessments and individualized treatment plans were collected at intake and every 30 days until study conclusion. Standardized surveys, including the Multidimensional Scale of Perceived Social Support (MSPSS), the Coping Self-Efficacy Scale, and the University of Rhode Island Change Assessment (URICA) were collected at intake and every 180 days until the study concluded. Analyses included descriptive statistics, paired t-tests, chi-square, multivariate linear and logistic regressions, Poisson regressions, and latent profile analysis. Ethics and dissemination: This study was approved by the Texas Christian University's Institutional Review Board (IRB). Results of this study will be presented to the scientific community at conferences and in peer-reviewed journals and non-scholarly outlets such as public health and social service conferences. [ABSTRACT FROM AUTHOR]

Female and male drivers have different size proportions and anthropometry. However, in the United States and throughout the world, male crash dummies are the norm in vehicle testing and female crash dummies with representative anthropometric characteristics has not yet been used in testing to date. Given this discrepancy, female driver safety is not considered at the same level as male driver safety in the vehicle design and testing process. This research investigates the gap in literature of injury locations experienced by female and male drivers in comparable crashes using a newly created linked dataset of crash and emergency medical services (EMS) data in the Commonwealth of Massachusetts. Generalized linear regression and k-fold cross validation of over 26,000 unique crash cases were analyzed using explanatory and predictive methods. These analyses revealed that female drivers are more likely to experience their primary anatomic injury as an abdomen, chest, lower extremity, and upper extremity injury than male drivers. The results of this research can be used by researchers, vehicle designers, and policymakers to act upon these differences in injury outcomes and consider them in the development of a safe environment for all roadway users. [ABSTRACT FROM AUTHOR]

While the majority of individuals make full recovery within a short period following mild traumatic brain injury (mTBI), some continue to experience a more chronic course of symptoms termed persistent post-concussive symptoms (PPCS). Previous models and conceptualizations of PPCS have typically not differentiated the time at which factors present across the injury timeline spectrum or have considered a limited array of contributory factors. In the current review, PPCS are examined within the predisposing, precipitating, and perpetuating (PPP) model, which has been applied to explain other syndromes resulting in a clear framework to explain, disseminate, and further research the specified condition. Previous PPCS models are reviewed and integrated into this comprehensive model, as well. To do so, a literature review was completed which included previous PPP models applied to other conditions, other PPCS models, and more recent findings of factors related to PPCS. This new iteration and application of the PPP model more clearly, completely, and validly identifies contributing factors to PPCS. Future prevention, early identification, clearer questions for future research, and treatment of PPCS is possible with clarity provided by this model. [ABSTRACT FROM AUTHOR]

Background: There is a paucity of literature documenting whether trauma patients with different mechanisms of injury have different rates of hazardous alcohol use and/or risk for depression and posttraumatic stress disorder., Objective: The purpose of this article is to determine whether there are associations between mechanism of injury, hazardous drinking, depression, and posttraumatic stress disorder. Secondary objectives were to examine associations prior to and after the onset of the COVID-19 pandemic., Methods: This is a retrospective cohort study of 5 years of trauma registry data of adult trauma patients (older than 18 years) admitted to a Midwestern Level I trauma center conducted from January 2016 to November 2020. Multivariable logistic regression analyses were performed to explore the association of gender, race, and mechanism of injury on hazardous drinking and posttraumatic stress disorder and depression., Results: A total of 9,392 trauma patients completed the Alcohol Use Disorders Identification Test-Consumption Items to identify hazardous drinking, and 5,012 completed the Injured Trauma Survivor Screen to identify risk for developing posttraumatic stress disorder and/or depression. The proportion of patients screening positive for hazardous drinking was higher for motor vehicle collisions (21.9%) than for gunshot wounds (17.6%) or falls (18.8%; χ2(2) = 14.311, p < .001). Those involved in motor vehicle collisions were also at a higher risk for the development of depression and posttraumatic stress disorder (54.5%) relative to falls (33.5%) but not gunshot wounds (50.7%; χ2(2) = 200.185, p < .001). The impact of COVID-19 revealed increased hazardous drinking, depression, and posttraumatic stress disorder in patients with falls and motor vehicle collisions but not gunshot wounds., Conclusions: Motor vehicle collision patients are at most risk for hazardous drinking concomitant with risk for depression and posttraumatic stress disorder. These results help focus future research efforts toward interventions that can reduce these risks., Competing Interests: The authors declare no conflicts of interest., (Copyright © 2022 Society of Trauma Nurses.)