Traffic injury prevention
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Traffic injury prevention · Jan 2013
Importance of muscle activations for biofidelic pediatric neck response in computational models.
During dynamic injury scenarios, such as motor vehicle crashes, neck biomechanics contribute to head excursion and acceleration, influencing head injuries. One important tool in understanding head and neck dynamics is computational modeling. However, realistic and stable muscle activations for major muscles are required to realize meaningful kinematic responses. The objective was to determine cervical muscle activation states for 6-year-old, 10-year-old, and adult 50th percentile male computational head and neck models. Currently, pediatric models including muscle activations are unable to maintain the head in an equilibrium position, forcing models to begin from nonphysiologic conditions. Recent work has realized a stationary initial geometry and cervical muscle activations by first optimizing responses against gravity. Accordingly, our goal was to apply these methods to Duke University's head-neck model validated using living muscle response and pediatric cadaveric data. ⋯ Though muscular loads were not large enough to cause vertebral compressive failure, they would provide a prestressed state that could protect the vertebrae during tensile loading but might exacerbate risk during compressive loading. For example, in the 10-year-old, a load of 602 N was produced, though estimated compressive failure tolerance is only 2.8 kN. Including muscles and time-variant activation schemes is vital for producing biofidelic models because both vary by age. The pediatric activations developed represent physiologically appropriate sets of initial conditions and are based on validated adult cadaveric data.
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Traffic injury prevention · Jan 2013
Feasibility of a computer-delivered driver safety behavior screening and intervention program initiated during an emergency department visit.
Injuries from motor vehicle crashes are a significant public health problem. The emergency department (ED) provides a setting that may be used to screen for behaviors that increase risk for motor vehicle crashes and provide brief interventions to people who might otherwise not have access to screening and intervention. The purpose of the present study was to (1) assess the feasibility of using a computer-assisted screening program to educate ED patients about risky driving behaviors, (2) evaluate patient acceptance of the computer-based traffic safety educational intervention during an ED visit, and (3) assess postintervention changes in risky driving behaviors. ⋯ Overall, patients were very satisfied receiving educational information about these behaviors via computer during their ED visits and found the program easy to use. We found a high prevalence of self-reported risky driving behaviors in our ED population. At 1-month follow-up, patients reported a significant decrease in these behaviors. This study indicates that a low-intensity, computer-based educational intervention during an ED visit may be a useful approach to educate patients about safe driving behaviors and safe drinking limits and help promote behavior change.
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Traffic injury prevention · Jan 2013
Crash involvement of motor vehicles in relationship to the number and severity of traffic offenses. An exploratory analysis of Dutch traffic offenses and crash data.
To establish the statistical relationship between offenses and crashes when the unit of analysis is the vehicle instead of the driver, to show the influence of the severity (e.g., minor speed offenses) on this relationship, and to research whether the form of this relationship is similar in different enforcement contexts. ⋯ The crash involvement of vehicles increased more than linearly with the number of minor traffic violations. Thus, automatic detection of minor offenses bears relevance to safety. The substantial increase in crash rates with speed offense frequency for vehicles with at least one major speed violation suggests that these vehicles represent a specific group with a significantly increased crash risk, especially in the case of many minor offenses. The more progressive relationship between offenses and crashes in The Netherlands when compared to Canada was hypothesized to result from the higher intensity camera enforcement levels and less severe consequences in the Dutch enforcement and adjudication system.
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Traffic injury prevention · Jan 2013
The effect of earlier or automatic collision notification on traffic mortality by survival analysis.
This article explores the effects of earlier emergency medical services (EMS) or automatic collision notification (ACN) and EMS arrival on passenger/driver survivability within the short time frame following traffic crashes. ⋯ This article obtains the driver/passenger survival probability differences over time under different conditions of collision notifications, EMS arrivals, and crash locations; furthermore, this analysis provides an estimation of the lives that could potentially be saved (approximately 154 to 290 per year) due to earlier ACN.
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Traffic injury prevention · Jan 2013
Police documentation of alcohol involvement in hospitalized injured drivers.
Injured drivers with blood alcohol concentration (BAC) above the legal limit are rarely convicted of impaired driving. One explanation is that police may have difficulty recognizing alcohol intoxication in injured drivers. In this study, we compare police documentation of alcohol involvement with BAC measured on arrival at a hospital. Our objectives were to determine how often police document alcohol involvement in injured drivers with BAC ≥ 0.05 percent and identify factors that influence police documentation of alcohol involvement. ⋯ Police recognized and documented alcohol involvement in 72 percent of injured drivers with BAC ≥ 0.05 percent. Police documentation of alcohol involvement was more common at higher BAC levels, in nighttime or single-vehicle crashes, for drivers who committed traffic violations or drove unsafely, and for drivers with a prior record of impaired driving. The low conviction rate of injured impaired drivers does not appear to be due to police inability to recognize alcohol involvement.