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This project aimed to understand the impact that the COVID-19 pandemic has had on travel exposure and risk-taking behaviour and the subsequent impact of these factors on observed changes in serious road trauma in Victoria. This has been particularly important during 2020 and 2021 but is also relevant for understanding the impact of any future major events. Through the interrogation of available data, the project aimed to develop quantitative measures of the impact of both exposure and crash risk per unit exposure. A consideration of these two aspects in tandem allowed interpretation of the observed deviation in road trauma from projected long-term trends. Notably, it was found that reductions in exposure did not directly translate into reductions in road trauma. Rather it was important to take into account increases in risk whilst also accounting for the effect of changes to countermeasure delivery. One way to assess and monitor the effect of risk-taking behaviours on road trauma is through the definition and calculation of intermediate outcome measures. An intermediate outcome measure is one that is used in addition to crashes or injuries to measure changes in road safety outcomes. There should be a causal relationship between an intermediate outcome measure and final outcomes (crashes or injuries). The current project risk-weighted excessive speed data from the Fixed Digital Road Safety Camera (FDRSC) network to create an indicator of risk (intermediate outcome measure) linked to road trauma. Such a measure is useful for road safety strategy monitoring generally. It is also particularly useful when shocks such as the COVID-19 pandemic occur that can lead to unexpected changes in road trauma with very little lead time to consider their effect on road safety strategy targets. The calculation of an intermediate outcome measure based on FDRSC data provided a quantitative measure of the increase in risk on the road network at the same time as there was a drop in travel exposure. Consideration of both risk and exposure was necessary to allow proper interpretation of the observed deviation in road trauma rather than simply expecting a reduction in road trauma proportionate with a drop in travel. The same approach was taken to define intermediate outcome measures based on mobile speed camera data. Other areas that involve risk-taking behaviours, namely drink- and drug-driving, could also be used as the basis for defining and calculating intermediate outcome measures to measure risk for road safety strategy monitoring. Overall, it was found that increases in excessive speeding, and drink- and drug-driving added to the evidence that suggests such risk-taking behaviours have contributed to higher levels of road trauma than might have been expected based on changes to exposure alone. In terms of the impact of countermeasure delivery, it was found that reduced roadside alcohol testing during the pandemic resulted in negative fatality savings, i.e. an increase in forecast fatalities. No differences were predicted in fatalities as a result of changes to roadside drug testing. At the same time, increases in the mobile speed camera program through increased enforcement hours has translated into crash savings or a decrease in forecast fatalities. Together with increased infrastructure investment, which also resulted in decreased forecast fatalities, net road trauma savings were predicted for 2020 and 2021 due to changes in countermeasure delivery. These findings emphasise the importance of maintaining enforcement activities and countermeasure delivery, especially during major shocks such as the COVID-19 pandemic, if road safety targets are to be met. The project also identified how enhancements to future Victorian road safety strategy baseline models through the incorporation of learnings from this project around both exposure and risk would allow future road trauma outcomes, both fatalities and serious injuries, to be better predicted.

In October 2018 the Monash University Accident Research Centre (MUARC) reported that Quiet Road Transport Vehicles (QRTVs) have significant negative impacts for pedestrian safety, particularly those who are blind or have low vision (Liu at al., 2018). These negative impacts relate to crash and near-crash experiences, as well as the impact on perceived safety and the associated harms to mental health and impacts on community participation. This was related to the inability of pedestrians to detect the presence of QRTVs. A principal recommendation of the MUARC report was that Australia adopt UN Regulation No. 138-01 as an Australian Design Rule. This would require fitment of an Acoustic Vehicle Alerting System (AVAS) on all hybrid and electric vehicles, activated when travelling at low speed, in order to be sold in the Australian market. The present research study titled, Quiet Road Transport Vehicles: Crash reduction benefits of the fitment of Acoustic Vehicle Alerting Systems in Australia was commissioned by the Department of Infrastructure, Transport, Cities and Regional Development. The objective of the research was to estimate the potential pedestrian-involved crash reduction benefits of fitting AVAS to hybrid and electric vehicles in Australia. A focus of the assessment was defining the crash applicability of AVAS to the pedestrian-involved crash population. In doing so, the assessment considers the acoustic characteristics of AVAS, the current and projected number of QRTVs in the Australian vehicle fleet, the differential crash risk of a pedestrian crash given QRTV involvement, and the effectiveness of AVAS in enhancing aural detection of QRTVs. The analysis incorporated a crash reduction benefit associated with Auto Emergency Braking Systems (AEBS), as per UN Regulation 152 that was adopted in early 2020. The outcomes of this Report provide inputs for use in the conduct of a future cost-benefit calculation of AVAS in the Australian context.

Supplemental material, sj-docx-1-sph-10.1177_19417381221087245 for Elite Junior Australian Football Players With Impaired Wellness Are at Increased Injury Risk at High Loads by Timothy J.H. Lathlean, Stuart V. Newstead and Paul B. Gastin in Sports Health: A Multidisciplinary Approach

This thesis was scanned from the print manuscript for digital preservation and is copyright the author. Researchers can access this thesis by asking their local university, institution or public library to make a request on their behalf. Monash staff and postgraduate students can use the link in the References field.

Additional file 10: Appendix A5. Using the Australian Injury Comorbidity Indices.

Additional file 7: Appendix A2. Interaction plots.

Additional file 5: Appendix A1.4. ROC curves for all-cause 30-day readmissions (age > = 15 years).

Additional file 9: Appendix A4. Internal and external validation details.

Rollover crashes, which occur when the vehicle’s side or roof makes impact with the ground, present particularly serious injury risk. Higher rollover risk has been found for high riding vehicles – those with a relatively high center of gravity compared to the width of the wheel track. Electronic Stability Control (ESC), which automatically applies brakes to individual wheels and reduces engine power to help drivers regain control when traction is lost, has been shown to be effective in preventing a proportion of rollovers. A newer safety technology, Roll Stability Control (RSC), uses similar technology aimed specifically to reduce rollover risk. This study sought to estimate rollover crash rates associated with the fitment of RSC compared to non-fitment for high center of gravity (CG) light passenger vehicles using an induced exposure analysis. Police-recorded Australasian crash data were studied for the years 2008-2017. A quasi-induced exposure analysis was restricted to vehicles already equipped with ESC as vehicles fitted with RSC always have ESC fitted. Rollover risk associated with RSC fitment was assessed, controlling for year of crash, speed limit at crash location, year of vehicle manufacture, vehicle market group, driver age, driver gender and jurisdiction identifier. The analysis found a statistically significant rollover risk ratio of 0.76 (95% CI 0.62-0.93), representing a 24% reduction in rollover risk, associated with RSC fitment for vehicles manufactured between 2008 and 2017. Analysis by particular market groups found significant risk ratio reductions for commercial utilities and large SUVs, but not for the other high CG market groups individually. These results suggest that RSC is a highly effective safety feature for high CG vehicles. Fleet data from Australia and New Zealand showed declining rates of RSC fitment over recent years for SUVs, meaning the potential road safety benefits of the technology are not being fully realized.

Additional file 8: Appendix A3. Model performance details.

Additional file 3: Appendix A1.2. Plots of predicted length of stay (days) vs observed (at least 1 overnight and LOS

Additional file 1: Table S1. Socio Economic Index for Areas (SEIFA) and country of birth details for the Victorian, NSW and WA study populations. Table S2. Performance of selected model fitting strategies in assessing the effect of comorbidity on selected outcome measures (Victoria). Table S3. Performance of new vs existing comorbidity indices using classification tables (Victoria). Table S4. Conditions included in the injury comorbidity indices for burden, readmissions, CCI and ECM. Table S5. Performance of new comorbidity indices vs existing comorbidity indices in injury sub-groups (Victoria). Table S6. Presence of comorbidity with mean LOS and proportion of patients with readmission outcomes in the NSW and WA study populations (> = 15 years). Table S7. Performance of selected model fitting strategies in assessing the effect of comorbidity on selected outcome measures (NSW and WA).

Additional file 4: Appendix A1.3. Residual plots for costs.

Additional file 2: Appendix A1.1. ROC curves for overnight stay (age > = 15 years).

Associations between outcomes. Table S1. Associations between outcomes: results of univariate modelling. Table S2. Univariate model types used to output Table S1. (DOCX 16 kb)

Background Preventing disability and offering effective interventions to older people during early decline in function is most likely to be effective if those most at risk of progressive disablement are able to be identified. Similarly the ability to easily identify a group with similar functional profile from disparate sectors of the community is of significant benefit to researchers. This study aimed to (1) describe the use of a pre-clinical disability screening tool to select a functionally comparable group of older men and women with early functional limitation from different settings, and (2) explore factors associated with function and disability. Methods Self-reported function and disability measured with the Late-Life Function and Disability Instrument along with a range of physical performance measurements were compared across residential settings and gender in a sample of 471 trial participants identified as pre-clinically disabled after being screened with the Fried pre-clinical disability tool. Factors that might lie on the pathway to progressive disablement were identified using multiple linear regression analysis. Results We found that a sample population, screened for pre-clinical disability, had a functional status and disability profile reflecting early functional limitation, regardless of residential setting or gender. Statistical models identified a range of factors associated with function and disability which explained a greater degree of the variation in function, than disability. Conclusions We selected a group of people with a comparable function and disability profile, consistent with the pre-clinical stage of disability, from a sample of older Australian men and women from different residential settings using the Fried pre-clinical disability screening tool. The results suggest that the screening tool can be used with greater confidence for research, clinical and population health purposes. Further research is required to examine the validity of the tool. These findings offer insight into the type of impairment factors characterising early functional loss that could be addressed through disability prevention initiatives. Trial Registration ACTRN01206000431527