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OBJECTIVES: Each year, pedestrian injuries constitute over 40% of all road casualty deaths and up to 60% of all urban road casualty deaths in Ghana. This is as a result of the overwhelming dependence on walking as a mode of transport in an environment where there is high vehicular speeds, and inadequate pedestrian facilities. The objectives of this research were to establish (1) the impact of traffic calming measures on vehicle speeds and (2) the association between traffic calming measures and pedestrians’ injury severity in built-up areas in Ghana. METHOD: Vehicle speeds were unobtrusively measured in 38 selected settlements comprising 19 “with” and 19 “without” traffic calming schemes. The study design used in this research was a matched case-control. A regression analysis compared case and control casualties using a conditional logistic regression. RESULTS: Generally, the mean vehicle speeds and the proportion of vehicles exceeding the 50 km/hour speed limit were significantly lower in settlements which have traffic calming measures compared with towns without any traffic calming measures. Additionally, the proportion of motorists who exceeded the speed limit was 30% or less in settlements which have traffic calming devices whilst the proportion who exceeded the speed limit was 60% or more in towns without any traffic calming measures. The odds of pedestrian fatality was significantly higher in settlements which have no traffic calming devices compared to those which have, OR=1.98; (95% CI=1.09 to 4.43). The protective effects of a traffic calming scheme which has a speed table was notably higher than where there were no speed tables. CONCLUSION: It was clearly evident that traffic calming devices reduce vehicular speeds and for that matter, the incidence and severity of pedestrian injuries in built-up areas in Ghana. However, the fact that they are deployed on arterial roads is increasingly becoming a road safety concern. Given the emerging safety challenges associated with speed calming measures, we recommend their use to be restricted to residential streets but not on arterial roads. Long term solutions for improving pedestrian safety proposed herein include by-passing settlements along the highways to reduce pedestrians’ exposure to traffic collisions, adopting a modern way of enforcement such as evidence-based laser monitoring in conjunction with a punishment regime which utilizes the demerit points system.

This study evaluated the safety impacts of pedestrian countdown signals (PCSs) with and without pushbuttons based on pedestrian crashes and pedestrian injuries in Michigan.This study used 10 years of intersection data-5 years before PCSs were installed and 5 years after they were installed-along with a comparison group, to evaluate the crash impacts of PCSs; at 107 intersections the PCS had a pushbutton and at 96 it did not. At these intersections, and at their comparison sites (where no PCS was installed), crash data (from 2004 to 2016) were examined, along with traffic and geometric characteristics, population, education, and poverty level data.Intersections where PCSs with pushbuttons have been installed showed a 29% reduction in total pedestrian crashes and a 30% reduction in fatal/injury pedestrian crashes. Further, when considering only pedestrians age 65 and below, these respective reductions are 33 and 35%. Intersections with PCSs but without pushbuttons did not show any significant change in any type of pedestrian crash.Although the Manual on Uniform Traffic Control Devices (Federal Highway Administration [FHWA] 2009 ) requires the use of PCSs at new traffic signal installations, this study suggests a safety benefit of installing PCSs with pushbutton at signals where a PCS without a pushbutton is present.

The objective of this study was to investigate the injury incidence and patterns in elite youth football at a category 1 Premier League Academy before and after the introduction of a new development strategy, the Elite Player Performance Plan (EPPP). A prospective study was performed over six consecutive seasons encompassing three years before and after the introduction of the EPPP. The findings revealed a most likely moderate increase in total exposure per player per season when the post-EPPP football exposure (640.86 ± 83.25 hours per player per year) was compared with the pre-EPPP football exposure (539.08 ± 71.59). The total injury incidence pre-EPPP was 3.0/1000 hours compared to 2.1/1000 hours post-EPPP (rate ratio 1.43). 6% of all injuries were re-injuries (20.24 ± 33.43 days) but did not result in a substantially longer absence (16.56 ± 15.77 days). The injury burden decreased for the U12-U15 from pre- to post-EPPP, whereas the injury burden increased for the U16-U18 (respectively 125 and 47% higher). These findings suggest that following the introduction of the EPPP there has been a reduction in injuries in the younger age groups U12-U15 but in the older age groups U16-U18 there has been an increase in the severity of the injuries sustained at this club.

To reduce the severity of injuries and the number of cyclist deaths in traffic accidents, active safety devices providing cyclist detection are considered to be effective countermeasures. The features of car-to-bicycle collisions need to be known in detail to develop such safety devices.The study investigated near-miss situations captured by drive recorders installed in passenger cars. Because similarities in the approach patterns between near-miss incidents and real-world fatal cyclist accidents in Japan were confirmed, we analyzed the 229 near-miss incident data via video capturing bicycles crossing the road in front of forward-moving cars. Using a video frame captured by a drive recorder, the time to collision (TTC) was calculated from the car's velocity and the distance between the car and bicycle at the moment when the bicycle initially appeared.The average TTC in the cases where bicycles emerged from behind obstructions was shorter than that in the cases where drivers had unobstructed views of the bicycles. In comparing the TTC of car-to-bicycle near-miss incidents to the previously obtained results of car-to-pedestrian near-miss incidents, it was determined that the average TTC in car-to-bicycle near-miss incidents was significantly longer than that in car-to-pedestrian near-miss incidents.When considering the TTC in the test protocol of evaluation for safety performance of active safety devices, we propose individual TTCs for evaluation of cyclist and pedestrian detections, respectively. In the test protocols, the following 2 scenarios should be employed: bicycle emerging from behind an unobstructed view and bicycle emerging from behind obstructions.

Background. Decisions about the transportation of trauma patients by helicopter are often not well informed by research assessing the risks, benefits, and costs of such transport. Objective. The ob...

This study investigated injury risks in frontal crashes by belt use and crash severity (delta V) with a focus on studying whether there is a pattern to the crashes causing serious head injuries in low-speed frontal collisions.1996-2007 National Automotive Sample System-Crashworthiness Data System (NASS-CDS) was analyzed for frontal crashes involving front-outboard occupants. Light vehicles were included with model year 1997+. Injuries of maximum severity MAIS 0-6 and fatalities were determined by crash severity and belt. Body region injury (AIS 0-6) was also determined. NASS-CDS electronic cases involving15 mph crashes were evaluated to determine the crash circumstances causing serious head injury (AIS 3+) in occupants with overall severe injuries (MAIS 4+F).More than half (51.3%) of belted occupants in 10-15 mph delta V crashes were uninjured compared with 30.2 percent for unbelted occupants. The ratio of the fraction (relative risk) of belted occupants who were uninjured to the fraction of unbelted, uninjured occupants was highest at 3.74 in the 30-35 mph delta V. For 10-15 mph crashes, 0.40 +/- 0.15 percent of unbelted occupants were severely injured (MAIS 4+F) compared to 0.033 +/- 0.009 percent for belted occupants. For 30-35 mph crashes, 8.51 +/- 2.20 percent of unbelted and 5.83 +/- 1.93 percent of belted occupants were severely injured. Overall, seat belt use was 87.4 percent effective in preventing severe injury (MAIS 4+F). The effectiveness decreased with increasing crash severity. The highest relative risk for severe injury of unbelted compared to belted occupants was 12.3 in crashes of 10-15 mph delta V. The relative risk was 8.8 in10 mph crashes. Overall, the relative risk was 8.0 for severe injury (MAIS 4+F) in frontal crashes. 16.5 +/- 0.98 percent of unbelted occupants experienced serious (AIS 3-6) injury. This risk was 6.49 times greater than the 2.53 +/- 0.10 percent risk with belted occupants. The largest relative risk for serious injury (AIS 3-6) was to the neck (367 times), face (15.5 times) and head (10.2 times).The highest relative risk for severe injury of unbelted occupants was in frontal crashes15 mph. Most of the crashes involved multiple impacts and air bag deployment in the accident sequence. The use of long fill-time side curtains, additional curtain deployment logic, limited deflation front air bags and broader curtain coverage of the front interior may address these injuries.

Although there are a number of causes of traumatic brain injury (TBI), the armed conflict in Iraq and Afghanistan has brought this disorder to the attention of the global community. A biomarker that would enable army medics to rapidly diagnose the severity of TBI on the battle-field would be a huge asset. Unfortunately, the study of TBI has not historically attracted the proteomic research community's interest as other disorders have, such as cancer. On the positive side, however, many of the analytical and technological challenges that were overcome in the development of biofluid proteomic methods are now being applied to the study of TBI. In this review, we discuss and highlight select examples of discovery-driven proteomic studies focused on finding effective biomarkers for TBI.

Objectives. This study sought expert consensus about which categories of patients from 248 Medical Priority (MPDS) ambulance dispatch codes might be appropriate for a nonemergency response or for w...

(2003). Long-term injury related disability in Ghana. Disability and Rehabilitation: Vol. 25, No. 13, pp. 732-741.

(2003). International Standards For Neurological Classification Of Spinal Cord Injury. The Journal of Spinal Cord Medicine: Vol. 26, No. sup1, pp. S50-S56.

To investigate the relationship between objective and subjective indicators of handicap or community participation among people with spinal cord injury (SCI) 1 year postinjury.Longitudinal correlational study of quality of life indicators linked to Northern New Jersey SCI System database.A total of 126 (80% male) participants was assessed at 1 year post-SCI. Age ranged from 14-83 years (median age = 34 years); 47% had tetraplegia, and 53% had paraplegia.Objective (or normative) handicap was measured using the Craig Handicap Assessment and Reporting Technique and the Community Integration Questionnaire. Subjective feelings about each area of handicap or community participation were assessed using the Andrews Delighted-Terrible scale.Significant correlations were found between objective and subjective indicators of handicap in work life, social life, mobility, and economic status. Subjective handicap also correlated modestly with severity of impairment and length of hospitalization. These correlations were, however, weak or inconsistent across individuals. Subjective quality of life was not related to preinjury economic or social handicap. Some participants spontaneously reported dissatisfaction with items outside of the standard outcomes scales used (eg, sexuality and personal relationships).The weakness and inconsistency of relationships between objective and subjective appraisals of areas of community participation is a challenge to outcomes measurement and has implications for the targeting of interventions. More research is needed to understand relationships between objective indicators of community participation and subjective appraisals of these areas.