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This study aimed to explore individuals' experiences of return to work (RTW) following minor to serious road traffic injury (RTI) in Queensland, Australia; seek their recommendations if any, on how to provide support for RTW after RTI; and identify the strategies and resources used to return and remain at work after their RTI. The interpretive description methodological approach was used. Semi-structured interviews were conducted with eligible participants (n = 18) aged 18–65 y who had experienced a minor to serious RTI at least 6 months earlier. Thematic analysis was used to analyse the data. Five themes emerged: (1) physical and mental consequences of RTI negatively impact RTW; (2) money matters; (3) RTW support makes a difference; (4) feeling alone and confused in the RTW process; and (5) several strategies and resources helped with return/stay at work after RTI. Regular contact and cooperation with employers and insurers, job modifications, and using social media to obtain information and social support were helpful RTW strategies. Participants recommended timely and appropriate medical care, financial assistance, and educational support. Policy changes to reduce financial stress, increase employer support, and improve injured individuals' knowledge following a RTI are recommended in jurisdictions operating a fault-based scheme. This study identified several factors that can influence return to work (RTW) following minor to serious road traffic injuries (RTIs) in a jurisdiction operating a fault-based compensation scheme. Legislative changes that provide financial assistance to all injured people regardless of their fault-status could reduce financial stress arising from reduced work ability following a road traffic injury. Increasing employer' awareness of the importance of return to work for those with road traffic injuries and reimbursement for possible expenses of providing RTW support for these individuals could increase employability of injured people following RTI. Improving injured individuals' knowledge about return-to-work processes after a road traffic injury could accelerate recovery and return to work. [ABSTRACT FROM AUTHOR]

Background: Road traffic accidents (RTAs) are the leading cause of death for children and young adults aged 5 to 39 and the third-leading cause of death in Iran. Objectives: The aim of this study was to assess in-hospital costs of patients following RTAs and identify associated factors among the patients admitted to Sina Hospital, a collaborating hospital with the National Trauma Registry of Iran (NTRI). Methods: A hospital-based registry study was conducted between September 17, 2016, and April 30, 2022, involving 3245 patients affected by RTAs. Data collection utilized the NTRI minimum dataset. To assess the factors influencing in-hospital costs of RTAs, various statistical analyses were performed, including independent sample t-tests, one-way ANOVA, and multiple linear regression analysis. Results: The distribution of studied subjects based on sex, age, and road user group revealed that the majority were male (91%), within the working age range of 21-60 years (78.2%), and motorcyclists (55.2%). The mean in-hospital cost per patient following RTAs was 152.3 million Iranian Rial (IRR) ($609.35). In the multiple linear regression analysis, several factors were significantly associated with higher in-hospital costs (ps<0.05). These factors included undergoing surgery, admission to the intensive care unit (ICU), the year of admission, having a moderate injury severity, being a car occupant, being female, and having a longer length of stay (LOS) at the hospital. Patients who required surgery had an additional cost of 102 million IRR, while those admitted to the ICU had an additional charge of 43.4 million IRR (ps<0.001). Conclusions: The study findings revealed that in-hospital costs resulting from RTAs were influenced by factors such as gender, injury severity, road user group, ICU admission, surgery operation, and LOS at the hospital. The mean in-hospital costs per patient were relatively high, amounting to 152.3 million IRR ($609.35). These findings highlight the need for increased efforts to mitigate the burden of RTAs in the country and implement measures to reduce their occurrence. [ABSTRACT FROM AUTHOR]

A patient's current or previous experience of trauma may have an impact on their health and affect their ability to engage in health care. Every year, millions of patients who have experienced physically or emotionally traumatic experiences present to emergency departments (ED) for care. Often, the experience of being in the ED itself can exacerbate patient distress and invoke physiological dysregulation. The physiological reactions that lead to fight, flight, or freeze responses can make providing care to these patients complex and can even lead to harmful encounters for providers. There is a need to improve the care provided to the vast number of patients in the ED and create a safer environment for patients and healthcare workers. One solution to this complex challenge is understanding and integrating trauma-informed care (TIC) into emergency services. The federal Substance Abuse and Mental Health Service Administration's (SAMHSA) six guiding principles of TIC offer a universal precaution framework that ensures quality care for all patients, providers, and staff in EDs. While there is growing evidence that TIC quantitatively and qualitatively improves ED care, there is a lack of practical, emergency medicine-specific guidance on how to best operationalize TIC. In this article, using a case example, we outline how emergency medicine providers can integrate TIC into their practice. [ABSTRACT FROM AUTHOR]

Background: Road traffic accidents are India's sixth leading cause of mortality, with a substantial share of physical, psychosocial and economic losses in the productive age group. Objectives: To explore the victims' and stakeholders' perceptions on quality of life among road traffic accident victims in India. Methods: A qualitative study incorporating in-depth interviews among road traffic accident victims and key informant interviews among stakeholders was conducted from June to August 2019 (3 months) in Puducherry. Participants were selected using purposive sampling. Data was collected till the point of saturation with a semi-structured interview guide through six in-depth interviews among accident victims and six key informant interviews among stakeholders. Content analysis of the data was performed, and a conceptual framework was developed. Written informed consent from each participant was sought. Ethical clearance was obtained from the Institute Ethics Committee. Results: Four themes were identified: reasons for road traffic accidents, problems faced by the victims, problems faced by the caretaker or family member, and preventive measures for road traffic injuries. Conclusion: Physical, psychological, and financial problems were encountered by the victims, caretakers, and family members after a major road traffic accident. Accident victims felt that support from family members was indispensable in returning to normal life. [ABSTRACT FROM AUTHOR]

In this study, we investigate the nature and strength of the social relations of working-age individuals who have survived a severe traumatic brain injury. Fifty-three survivors diagnosed with severe traumatic brain injury completed the social network analysis questionnaire, enabling us to map their social networks using the software program EgoNet.QF. This was combined with interviews with four survivors and their significant members of their network and constructed narrative cases of the resources gained from their network. Half the survivors lost friends because of the brain injury. The most common social network post injury comprised parents followed by spouses. Close relatives experienced a dramatic change in the nature of their relationships with the survivor. They also struggled greatly with the rehabilitation health system, which in many cases affected their own careers. Persons with severe traumatic brain injury and their close relatives predominantly learn to manage the new situation, with functionality driving social interaction. However, as social networks often are limited to the close family, these individuals are placed in a vulnerable position. Existing networks (whether few or many) are of major importance for individuals with traumatic brain injury in the rehabilitation process. Close social relations possess knowledge about the survivor with traumatic brain injury that is important for the rehabilitation process. To support individuals and their families who lack strong resources and social networks, health care professionals should systematically identify these persons from admission to hospital and primary care. When these persons have been identified, individual plans for how to strengthen their network can be developed in collaboration with the individuals and their existing social network. [ABSTRACT FROM AUTHOR]

Accurate predictions of the clearance time of highway accidents can help make more effective decisions and reduce the economic losses caused by the accidents. This paper compares two representations of traffic accidents with mixed vehicle types and establishes two different classification models. The traffic accident data in Shandong Province, China from 2016 to 2019 are used as a case study. The interpretability of the parametric model indicates that the types of vehicles involved in the accident, the type of accident, and the weather can significantly affect the clearance time of the accident. The results of this study can not only provide evidence of whether the types of vehicles involved in the accident will affect the accident clearance time, but also provide advice for the authorities to quickly clear accident scenes and prevent further accidents. [ABSTRACT FROM AUTHOR]

Injury prevention programs for children and adolescents need to be immersive and interactive. This study assessed a bicycle injury prevention program using technology-based education based on the Activated Health Education model and evaluated its effect on environmental factor awareness and attitude toward helmet-wearing. Using virtual reality technology, elementary and middle school students could experience simulated bicycle accidents. It was followed by an awareness phase that included a 30-min lecture where students self-learned and discussed risk-preventive factors. Students then developed user-created content and customized helmets they were given. We assessed students before the program, immediately afterward, and one month after the program. The number of respondents who said they were aware of surrounding bicycle lanes increased from 75.3% (pre-program) to 92.5% (one month after). Those who said they wore helmets often or always rose from 14.3% (pre-program) to 32.5% (one month later). The number needed to treat helmet-wearing behavior was approximately four, meaning that four people were required to participate in the program to have an impact on one person's helmet-wearing. We found that virtual reality and computer-based activities can help children and adolescents experience bicycle accidents, be aware of risk factors, and change their behaviors responsibly. [ABSTRACT FROM AUTHOR]

Background: Claimants with chronically painful injuries sustained in motor vehicle accidents (MVAs) undergo assessment and management influenced by insurance and medico-legal processes defined by a biomedical paradigm which is discordant with best evidence. We aim to demonstrate the impact of biopsychosocial factors on post-MVA sequelae which contribute to non-recovery.Methods: This was a retrospective cohort study of medico-legal documents and reports on 300 consecutive claimants referred to a pain medicine physician over 7 years (2012-2018) for assessment of painful musculoskeletal injuries post-MVA. One hundred data items were extracted from the medico-legal documents and reports for each claimant and entered into an electronic database. Post-MVA sequelae were analysed using chi-square analysis (OR >2) for significant associations with demographic, pre-MVA and post-MVA variables. Factors with significant associations were entered into a logistic regression model to determine significant statistical predictors of post-MVA sequelae contributing to non-recovery.Results: The claimants were aged 17 to 80 years (mean age 42 years), and approximately half (53%, n=159) were female. The time from MVA to interview averaged 2.5 years. Widespread pain was present in 18% (n=54), and widespread somatosensory signs implying central sensitisation (OR=9.85, p<.001) was the most significant multivariate association. Long-term opiate use post-MVA (32%) was predicted by pre-MVA sleep disturbance (OR=5.08, p=.001), post-MVA major depressive disorder (MDD) (OR=3.02, p=.003) and long-term unemployment (OR=2.22. p=.007). Approximately half (47%, n=142) required post-MVA support from a psychologist or psychiatrist. Post-traumatic stress disorder (PTSD) was diagnosed by a psychiatrist or psychologist in 20% (n=59), yet early identification of risk of PTSD was rare. Pre-MVA, 89.4% (n=268) were studying or employed. Permanent unemployability post-MVA occurred in 35% (n=104) and was predicted by MDD (OR=3.59, p=.001) and antidepressant use (OR=2.17, p=.005). Major social change post-MVA (70%) was predicted by older age (OR=.966, p=.003), depressive symptoms (OR=3.71, p<.001) and opiate use (OR=2.00, p=.039).Conclusions: Biomedical factors, including older age, impaired sleep and indicators of widespread central sensitisation, and psychological factors, including stress, anxiety and depression, were the most prominent multivariate associations as statistical predictors of major adverse sequelae contributing to non-recovery for claimants with chronic pain post-MVA. [ABSTRACT FROM AUTHOR]

Roadside memorials are made up of objects, usually flowers, candles and crosses, placed at the roadside to mark the sites of fatal accidents. The paper introduces the potential of Lefebvre's concept of rhythmanalysis and geography of rhythms in exploring roadside memorials. The aim of the paper is to investigate rituals and rhythms at roadside memorials in Poland. Data were collected during two-year field observations of 12 roadside memorials and from 10 semi-structured interviews. Polish roadside memorials are part of widespread rituals which either generate material changes to roadside memorials, like cleaning up works, leaving candles and flowers at memorials or which do not generate such changes, like saying prayers or reminiscing about the deceased. The specifics of roadside memorialisation in Poland are expressed in prayers being said and no personal belongings being left at the sites. We found that the coexistence of individual and social rhythms at roadside memorials was deeply rooted in Catholic liturgy and commonly accepted cemetery rituals in Poland. [ABSTRACT FROM AUTHOR]

We hypothesized that perceived intentionality is one of the factors explaining why terrorism is perceived to be a more important problem than traffic accidents. In Study 1, we conducted an experiment on a large Turkish sample (N = 385) and found that participants suggested allocating significantly more budget to prevent terror-related deaths, as compared to deaths caused by traffic accidents, and this difference was fully mediated by perceived intentionality. In Study 2, which was pre-registered, we hypothesized that American participants (N = 450) would similarly suggest allocating more budget to prevent deaths caused by terrorist incidents, as compared to traffic accidents, but this difference would disappear when traffic accidents are portrayed as involving a perpetrator consciously disregarding the safety of others. Our hypothesis was partially supported. We discuss the potential implications for policy-makers and social psychological research., Author(s): Sinan Alper [sup.1] , Elif Öykü Us [sup.2] Author Affiliations: (1) grid.439251.8, 0000 0001 0690 851X, Department of Psychology, Yasar University, , Izmir, Turkey (2) grid.411548.d, 0000 0001 1457 [...]

The first steam-powered vehicle is attributed to Ferdinand Verbiest in China made in 1672 for the Kangxi Emperor. The first recorded automobile death was Mary Ward in Ireland who was thrown from a steam-powered car and fell under its wheels in 1869. The first person killed in the United States is recorded as Henry Bliss in New York City on Wednesday, September 13, 1899. As the automobile became popular among all groups of humans, motor vehicle crashes became the major cause of death and disability among children and adolescents. Research initially focused on the physical trauma that motor vehicle accidents or crashes induced, but eventually the psychological toll of motor vehicle crashes (MVCs) in the pediatric population became appreciated. This discussion reflects on how this occurred taking the entire 20th century to be acknowledged by researchers, clinicians, parents, and the general society. [ABSTRACT FROM AUTHOR]

Objective: A correlational study examined relationships among driving styles, 4 subfactors of desire for control, illusion of control, accident concern, self-rated likelihood of being involved in an accident, self-rated driving skill, and self-reported accidents, violations, and close calls.Methods: An online sample of participants (N = 601) completed (1) the Multidimensional Driving Style Inventory (MDSI); (2) the Desirability of Control Scale (DCS); (3) an Illusion of Control Scale; (4) an accident concern self-rating, (5) a 3-item speed questionnaire; (6) a 4-item accidents, violations, and close calls questionnaire; (7) a driving skill self-rating; and (8) a demographic questionnaire. Scales were analyzed using exploratory factor analysis where appropriate. Exploratory correlational analyses examined relationships among factor scores for subscales and other variables of interest.Results: The MDSI factored into 6 distinct driving styles, and the DCS factored in 4 subfactors of desire for control. Relationships among driving styles and other variables were used to create profiles of each of 6 driving styles-angry, anxious, cautious, dissociative, risky, and stress reduction-based on relationships among variables examined.Conclusions: Our results may help to identify traits that are related to driving behaviors. In general, our results showed that several maladaptive driving styles (dissociative, risky, and angry) were negatively correlated with 2 subscales of desire for control (desire to proactively seek control and desire to control making decisions) and positively correlated with illusion of control. Cautious driving style, which is adaptive, showed the opposite pattern. We also produced evidence to support the construct validity of the MDSI and added to the growing literature suggesting that the MDSI factors into 6 distinct driving styles. [ABSTRACT FROM AUTHOR]

Objective: Vehicle automation shifts the driver's role from active operator to passive observer at the potential cost of degrading their alertness. This study investigated the role of an in-vehicle voice-based assistant (VA; conversing about traffic/road environment) to counter the disengaging and fatiguing effects of automation.Method: Twenty-four participants undertook two drives- with and without VA in a partially automated vehicle. Participants were subsequently categorized into high and low participation groups (based on their proportion of vocal exchanges with VA). The effectiveness of VA was assessed based on driver alertness measured using Karolinska Sleepiness Scale (KSS), eye-based sleepiness indicators and glance behavior, NASA-TLX workload rating and time to gain motor readiness in response to take-over request and performance rating made by the drivers.Results: Paired samples t-tests comparison of alertness measures across the two drives were conducted. Lower KSS rating, larger pupil diameter, higher glances (rear-mirror, roadside vehicles and signals in the drive with VA) and higher feedback ratings of VA indicated the efficiency of VA in improving driver alertness during automation. However, there was no significant difference in alertness or glance behavior between the driver groups (high and low-PR), although the time to resume steering control was significantly lower in the higher engagement group.Conclusion: The study successfully demonstrated the advantages of using a voice assistant (VA) to counter these effects of passive fatigue, for example, by reducing the time to gain motor-readiness following a TOR. The findings show that despite the low engagement in spoken conversation, active listening also positively influenced driver alertness and awareness during the drive in an automated vehicle. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this study was to identify the relationships between resilience, social support, and body image in patients in an acute stage following traffic accidents and to investigate factors affecting body image. Methods: Data were collected from 86 patients at local hospitals from January 2019 to February 2020. To measure the variables, the body image scale, Conner-Davidson Resilience Scale, and Multidimensional Scale of Perceived Social Support were used. Data were analyzed using descriptive statistics, independent t-tests, analysis of variance, Pearson correlation coefficient, and multiple regression. Results: Mean age of participants was 43.40±14.75 and the proportion of men was 73.3%. The average score for resilience, social support, and body image were 65.16±16.89, 72.93±8.11, and 12.24±6.63, respectively. The highest item on the body image scale was "Are you dissatisfied with the appearance of your scar?". There were differences in scores for body image according to gender, age, and living status. Resilience (r=-.68, p<.001) and social support (r=-.65, p<.001) were negatively correlated with body image. In the regression model, resilience (β=-.41), social support (β=-.30), and gender (β=.22) accounted for 57.6% of the variance in body image. Conclusion: Resilience and social support were identified in this study as significant factors protecting body image of patients during the acute stage following a traffic accident. It is recommended that psychosocial nursing interventions be conducted throughout the course of treatment. [ABSTRACT FROM AUTHOR]

The current study explored subgroups in reported personal growth initiative (PGI) and posttraumatic stress symptoms (PTSS) and examined the changes in class memberships among survivors of a transportation accident. Participants at Time 1 were 602 adults who reported directly experiencing a transportation accident within the past year (Mmonths = 6.36; SDmonths = 3.20). Of these participants, 171 adults completed the follow‐up survey after 3 months (Time 2). Finite mixture modeling was conducted to identify the heterogeneity of PTSS in relation with PGI at each time point. At Time 1, a four‐class model was the best‐fitting model, and at Time 2, a three‐class model was the best‐fitting model. As hypothesized, when examined cross‐sectionally, various subgroups were identified at each time point, finding subgroups with moderate to high levels of PGI but differing in their PTSS. However, when examining the longitudinal changes in class membership from Time 1 to Time 2, members of subgroups with higher PGI skills at Time 1 were more likely to be assigned to subgroups with lower PTSS at Time 2. The current study suggests a potential application of PGI skills in alleviating PTSS after a transportation accident and having a critical role in adjustment after hardship. [ABSTRACT FROM AUTHOR]

Whiplash is the most common injury reported in low-velocity impact road traffic accidents, but claimants report a range of other soft tissue injuries and we looked at the prevalence of these and any patterns. We retrospectively reviewed reports from the medico-legal practice of an orthopaedic surgeon. We collected data on 609 claimants. Sixty-two per cent were women (p < 0.0001). Majority (90.3%) reported an injury to at least one other area than neck, and 48% of claimants reported shoulder pain. Hand/wrist injuries were almost exclusive to drivers (p = 0.0013). Those with knee injuries were older than those without (p = 0.001). There was a significant difference in the age of patients with different spinal injury patterns (p < 0.0001). Occupational status did not appear to influence the pattern of injuries (p = 0.06). Psychological symptoms were associated with a greater number of body parts injured (p < 0.01). Our data confirm a strong association between these soft tissue injuries and psychological symptoms. [ABSTRACT FROM AUTHOR]

Posttraumatic widespread pain (PTWP) and posttraumatic stress symptoms (PTSS) are frequent comorbid sequelae of trauma that occur at different rates in women and men. We sought to identify microRNA (miRNA) that may contribute to sex-dependent differences in vulnerability to these outcomes. Monte Carlo simulations (x10,000) identified miRNA in which predicted targeting of PTWP or PTSS genes was most enriched. Expression of the leading candidate miRNA to target PTWP/PTSS-related genes, miR-19b, has been shown to be influenced by estrogen and stress exposure. We evaluated whether peritraumatic miR-19b blood expression levels predicted PTWP and PTSS development in women and men experiencing trauma of motor vehicle collision (n = 179) and in women experiencing sexual assault trauma (n = 74). A sex-dependent relationship was observed between miR-19b expression levels and both PTWP (β = -2.41, P = 0.034) and PTSS (β = -3.01, P = 0.008) development 6 months after motor vehicle collision. The relationship between miR-19b and PTSS (but not PTWP) was validated in sexual assault survivors (β = -0.91, P = 0.013). Sex-dependent expression of miR-19b was also observed in blood and nervous tissue from 2 relevant animal models. Furthermore, in support of increasing evidence indicating a role for the circadian rhythm (CR) in PTWP and PTSS pathogenesis, miR-19b targets were enriched in CR gene transcripts. Human cohort and in vitro analyses assessing miR-19b regulation of key CR transcripts, CLOCK and RORA, supported the potential importance of miR-19b to regulating the CR pathway. Together, these results highlight the potential role that sex-dependent expression of miR-19b might play in PTWP and PTSS development after trauma/stress exposure. [ABSTRACT FROM AUTHOR]

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Background: Pedestrians are amongst the most vulnerable road users and their unsafe behaviors have a major impact on traffic injuries. The aim of this study was to determine the underlying psychological factors behind red light violation in pedestrians' crossing behavior based on the Theory of Planned Behavior (TPB) and to provide recommendations for preventive interventions. Methods: This qualitative study was conducted in Tabriz, one of the metropolitan cities of Iran. 30 pedestrians were individually interviewed using semi-structured, open-ended questions to elicit salient consequences, social referents, and circumstances regarding pedestrians' red light crossing behavior. The transcribed interviews were analyzed using directed content analysis followed by frequency analysis in order to detect modal salient beliefs. Results: A total number of 115 sub-categories were identified which were then classified in the ten predetermined categories of the Theory of Planned Behavior: advantages, disadvantages, positive feelings, negative feelings, approving referents, disapproving referents, behaving referents, not-behaving referents, facilitators, and barriers. "Saving time" was elicited as the most important both the advantage and the positive feeling. "Getting injured" was identified as the most serious disadvantage. "Lowering the level of culture" was obtained as the main negative feeling. "Friends/Peers" comprise the most prominent group among both the approving and the behaving referents, whereas "Family members" constituted the most significant group both among the disapproving and the not-behaving referents. "Being in a hurry" was introduced as the most substantial facilitator and "The fear of accident" was identified as the most influential deterrent factor. Conclusion: Based on the major findings, reducing pedestrians' red light violations needs to focus: on the perceived negative and positive consequences and feelings of this behavior like getting injured, and saving time respectively; on the approval role of friends/peers, and the disapproval role of family; and on the fear of accident as a barrier, and rushing as a facilitating factor. More precise quantitative research is needed to determine the predictive power of these factors in such risky behavior. [ABSTRACT FROM AUTHOR]

Child safety seat use reduces the risk of fatal injury by 71% for infants and 54% for toddlers, yet more than one-third of child passengers killed in traffic crashes in the US are unrestrained. Nearly half (47%) of crash injuries occur within 5 miles of the injured person's home. Mapping the location of motor vehicle crashes resulting in serious or fatal injury to unrestrained child passengers may pinpoint high-risk neighborhoods. Illinois Department of Transportation data were used to map crashes that resulted in a fatal or incapacitating injury to a child passenger (age 0 to 8) in Cook County, IL from 2011 to 2015. Maptitude® Geographic Information System (GIS) software was used to identify hot spots of unrestrained child passenger injury on the South Side and West Side of Chicago. Of 174 zip codes in Cook County, 3 zip codes on the South Side of Chicago (60620, 60621; 60628) accounted for 11% of the total unrestrained fatalities and incapacitating injuries among children. Results of this study reveal the feasibility of detecting geographic disparities in child passenger safety at the zip code and neighborhood level and indicate the potential for more targeted allocation of resources. [ABSTRACT FROM AUTHOR]

Purpose The purpose of this paper is to identify the effect of people's personality on driving behavior and traffic accidents and violations in the province of South Sulawesi.Design/methodology/approach This research was conducted in order to determine the moderating effects of age on the relationship between personality variables, driving behavior and driving outcomes. The research was conducted over two years. For the first year of this study, research was conducted in the city of Makassar, the capital of the South Sulawesi province, which has the highest volume of accidents compared to other districts/cities in South Sulawesi. The approach used in conducting the data analysis was a quantitative approach; the inferential statistical analysis method of analysis used to test the hypothesis of the research was structural equation modeling.Findings The results of the analysis show that age is a moderating variable in the relationship between personality, driving behavior and driving outcomes. The higher the age, the stronger the influence of personality on driving behavior and driving outcomes, and the stronger the effect of driving behavior on driving outcomes.Originality/value Originality for this paper is shown as follows: using age on personality has a moderating effect on the relationship between driving behavior and driving outcomes; and the research would implicate driving behavior and inclined factors from the eastern part of Indonesia, since most research works were conducted in the western part of Indonesia and they hardly considered the moderating effect of age. [ABSTRACT FROM AUTHOR]

Background: Road traffic injuries are the eighth leading cause of death globally, and the leading cause of death for young people aged 15-29 years. Each year, almost 400,000 young people under 25 years old are killed in a road traffic crash - about 1049 youngsters every day. Aims and objectives: To find out the prevalence of road safety related health risk behaviours and its determinants amongst young males of District Dehradun. Methodology: It was a cross sectional study conducted over 12 months of duration. The study sample comprised of 1800 male youth aged 15-24years studying in various schools and colleges of District Dehradun. A pre-tested and pre-structured questionnaire (YRBSS) was used. The data was entered and analysed using SPSS-version 20.0. Results: Approximately three-fourth of youth reported never using seat-belt while driving and only 4.4% reported always using helmet whereas 24.0% accepted never use of helmet. Approximately one-fourth of the total 1168 at risk subjects in past 30 days, accepted driving a vehicle while drunk and 39.9% reported use of mobile phones while driving. Personality traits (extrovert, neuroticism and lack of direction) turned out to be the major factor in road safety related health risk behaviour. Conclusion: Although, road safety related health risk was found to be more among urban youth as compared to their rural counterparts, yet it was found alarmingly high for both rural and urban study population. [ABSTRACT FROM AUTHOR]

This study evaluated the relationships between driving cognitions (i.e., panic‐related cognitions, accident‐related cognitions, and social‐related cognitions), rumination, and posttraumatic stress disorder (PTSD) symptoms in a sample of road traffic accidents (RTAs) survivors. We also investigated the indirect effect of driving cognitions on PTSD symptoms through rumination. The sample included 633 drivers (62% were men; Mage = 36.09; standard deviation [SD] = 11.42 years). The participants completed scales measuring driving cognitions, rumination, and PTSD symptoms, as well as providing their demographic information. The results showed that all three types of driving cognitions assessed in the present study and rumination were significantly positively associated with PTSD symptoms. Furthermore, rumination mediated the relation between social‐related cognitions and PTSD symptoms. The implications for PTSD treatment and future research are discussed. [ABSTRACT FROM AUTHOR]

Highlights • The coordination of gaze and steering was studied in an on-road study. • Drivers often returned their gaze back to the road ahead before making steering corrections. • The eccentricity of the off-road target influences gaze-steering coordination. Abstract In car driving, gaze typically leads the steering when negotiating curves. The aim of the current study was to investigate whether drivers also use this gaze-leads-steering strategy when time-sharing between driving and a visual secondary task. Fourteen participants drove an instrumented car along a motorway while performing a secondary task: looking at a specified visual target as long and as much as they felt it was safe to do so. They made six trips, and in each trip the target was at a different location relative to the road ahead. They were free to glance back at the road at any time. Gaze behaviour was measured with an eye tracker, and steering corrections were recorded from the vehicle's CAN bus. Both in-car ' Fixation ' targets and outside ' Pursuit ' targets were used. Drivers often used a gaze-leads-steering strategy, glancing at the road ahead 200–600 ms before executing steering corrections. However, when the targets were less eccentric (requiring a smaller change in glance direction relative to the road ahead), the reverse strategy, in which glances to the road ahead followed steering corrections with 0–400 ms latency, was clearly present. The observed use of strategies can be interpreted in terms of predictive processing: The gaze-leads-steering strategy is driven by the need to update the visual information and is therefore modulated by the quality/quantity of peripheral information. Implications for steering models are discussed. [ABSTRACT FROM AUTHOR]

Objective: Children and adolescents are among the most vulnerable road users, and road traffic accidents (RTAs) can lead to not only physical injuries but also adverse psychological outcomes, particularly posttraumatic stress disorder (PTSD). However, estimates of the prevalence of PTSD among children and adolescents following RTAs varied considerably across studies. Therefore, this study aimed to estimate the pooled prevalence of PTSD among this population.Methods: A systematic search for literature was performed in the electronic databases of PubMed, Web of Science, PsycINFO, and Embase. Heterogeneity was assessed using the Cochran's chi-square test and quantified by the I2 value. Meta-regression analyses were carried out to identify the effects of some potential moderators on the overall heterogeneity. Subgroup analyses were performed to estimate the pooled prevalence of PTSD according to some sample characteristics.Results: Eleven eligible studies with a total of 1532 children and adolescents who were involved in RTAs were included. The overall heterogeneity (I2 = 89.7, P < 0.001) was high across the eligible studies, and the pooled prevalence of PTSD was 19.95% (95% confidence interval, 13.63% to 27.09%) by a random-effects model. No significant moderators of the overall heterogeneity were identified using meta-regression analyses. Subgroup analyses showed that the pooled prevalence of PTSD differed significantly according to the study location and gender (P < 0.05).Conclusions: One-fifth of children and adolescents developed PTSD in the aftermath of RTAs, indicating the need for regular assessment of PTSD and timely and effective psychological interventions among this population. Furthermore, more population-based studies with a large sample size are warranted. The protocol was registered in the PROSPERO database (No. CRD42018087941). [ABSTRACT FROM AUTHOR]

Background: Persistent pain and mental health conditions often co-occur after injury, cause enormous disability, reduce social and economic participation, and increase long-term healthcare costs. This study aimed to characterise the incidence, profile and healthcare cost implications for people who have a treated mental health condition, persistent pain, or both conditions, after compensable transport injury.Methods: The study comprised a population cohort of people who sustained a transport injury (n = 74,217) between 2008 to 2013 and had an accepted claim in the no-fault transport compensation system in Victoria, Australia. Data included demographic and injury characteristics, and payments for treatment and income replacement from the Compensation Research Database. Treated conditions were identified from 3 to 24-months postinjury using payment-based criteria developed with clinical and compensation system experts. Criteria included medications for pain, anxiety, depression or psychosis, and services from physiotherapists, psychologists, psychiatrists, and pain specialists. The data were analysed with Cox Proportional Hazards regression to examine rates of treated conditions, and general linear regression to estimate 24 month healthcare costs.Results: Overall, the incidence of treated mental health conditions (n = 2459, 3.3%) and persistent pain (n = 4708, 6.3%) was low, but rates were higher in those who were female, middle aged (35-64 years), living in metropolitan areas or neighbourhoods with high socioeconomic disadvantage, and for people who had a more severe injury. Healthcare costs totalled more than $A707 M, and people with one or both conditions (7.7%) had healthcare costs up to 7-fold higher (adjusting for demographic and injury characteristics) in the first 24 months postinjury than those with neither condition.Conclusions: The incidence of treated mental health and persistent pain conditions was low, but the total healthcare costs for people with treated conditions were markedly higher than for people without either treated condition. While linkage with other public records of treatment was not possible, the true incidence of treated conditions is likely to be even higher than that found in this study. The present findings can be used to prioritise the implementation of timely access to treatment to prevent or attenuate the severity of pain and mental health conditions after transport injury. [ABSTRACT FROM AUTHOR]

Traumatized individuals display overgeneral autobiographical memory (OGM). However, it remains unclear whether autobiographical memory specificity differs among individuals being exposed to different types of trauma and whether emotion affects OGM for varied trauma types. The present study compared three distinct trauma types: sexual assault (SA); motor vehicle accident (MVA); and sudden, unexpected death of a loved one (SUD). The MVA group was found to show a higher level of OGM than the SUD group. Trauma survivors were found to show fewer specific memories in response to the negative cue words than in response to the positive or neutral cue words. [ABSTRACT FROM AUTHOR]

Objective: To examine the prevalence and changing patterns of PTSD, major depressive episode (MDE), and generalized anxiety disorder (GAD) in adult claimants who sustained a non-catastrophic injury in a road traffic crash (RTC) in Queensland, Australia.Method: Participants (N = 284) were assessed at approximately 6, 12, and 24 months post-RTC using the composite international diagnostic interview (CIDI) modules for PTSD, and CIDI-short form for MDE, and GAD.Results: The prevalence of at least one of these disorders was 48.2%, 52.5%, and 49.3%, at 6, 12, and 24 months, respectively. Comorbidity was common (20.8% at 6 months, 27.1% at 12 months, and 21.1% at 24 months) and only 33.1% of participants never met PTSD, GAD, or MDE criteria. A substantial proportion of participants (42.3%) had an unstable diagnostic pattern over time. Participants with multiple diagnoses at 6 months were more likely to continue to meet diagnostic criteria for any disorder at 12 and 24 months than participants with a single diagnosis. Participants with PTSD (with or without MDE/GAD) were more likely to meet criteria for any disorder at 24 months than participants with another diagnosis. Preinjury psychiatric history increased the likelihood of any disorder at 24 months post-injury, but did not significantly increase the likelihood of PTSD.Conclusions: People injured in a RTC are at risk of having complex psychological presentations over time. Interventions to prevent mental disorders, especially PTSD, in the early post-injury period are needed to prevent chronic psychological injury, including consideration of comorbidity and dynamic course. [ABSTRACT FROM AUTHOR]

Background: Electric bike (e-bike) usage is growing worldwide, and so is the e-bike-related injury rate.Objective: This study was undertaken to characterize e-bike-related injuries.Methods: Data of all e-bike-related injuries presenting to our level I trauma center between 2014 and 2016 were collected and analyzed. Adult and pediatric (<18 years of age) e-bike-related injuries were then analyzed separately and compared.Results: Forty-eight patients suffering from e-bike-related injuries presented to our trauma center between January 1, 2014 and December 31, 2016. Seventeen (35%) patients were <18 years of age and 40 (85%) were male. The overall most common mechanism of injury was falling off the e-bike in 24 patients (50%), followed by collision with a static object in 9 patients (18.8%). Head (38%) and facial (33%) injuries were most common in children. In adult patients, orthopedic trauma was predominant, with extremity fractures in 35 (73%) followed by significant lacerations in 14 patients (29%). Severe trauma (Injury Severity Score >15) was found in 17 (35%) patients. The duration of hospital stay was 10.8 ± 6 days, 12 patients (25%) required a stay in the intensive care unit, and 21 patients (43.7%) required surgery. Compared to adults, children (<18 years of age) had significantly more head and face injuries (p = 0.05).Conclusion: Our study suggests that e-bike-related trauma may involve serious injuries and have typical injury patterns that resemble those seen in motorcycle-related injuries. Children are more likely to suffer head and face injuries because of their higher head to body ratio. We suggest that these injuries should therefore be triaged appropriately, preferably to a medical facility with proper trauma capabilities. [ABSTRACT FROM AUTHOR]

Background. Parkinson’s disease (PD) is a common neurodegenerative disorder that impacts a person’s fitness to drive. Practitioners require a sensitive and predictive battery of clinical tests to identify at-risk drivers. Purpose. This study aimed to identify clinical predictors and their optimal cut points, sensitivity, specificity, and predictive values of on-road outcomes in drivers with PD. Method. Participants (N = 101) underwent a comprehensive driving evaluation. We identified predictors of pass/fail outcomes through logistic regression and computed optimal cut points through receiver operating characteristic curves and corresponding Youden indexes. Findings. The Trail Making Test Part B (Trails B; sensitivity = .89, specificity = .74; positive predictive value [PPV] = .71; negative predictive value [NPV] = .91) and contrast sensitivity (sensitivity = .82, specificity = .63; PPV = .61; NPV = .84) emerged as significant predictors. The optimal cut point for the Trails B was 108 s (area under the curve = .86). Implications. Occupational therapists can benefit from implementing Trails B and contrast sensitivity screening as part of in-office screening of potentially at-risk drivers with PD. [ABSTRACT FROM AUTHOR]

Purpose: It is well acknowledged that involvement in injury compensation processes can have a substantial impact on the recovery of the injured person. However, little attention has been given to the social or family consequences of compensable injury. The aims of this study were to better understand both the impact of compensable injury on the family and the role that families play after an injury, throughout the compensation process, and during return to work. Methods: Eighteen injured persons and nine family members recruited through three compensation authorities in Victoria (Australia) were interviewed. A thematic analysis was used to identify the role that family played after injury and how family members were affected during the recovery and compensation process. Results: The results highlight the important role family members play following a compensable injury, in addition to factors that impact family members' daily living, health, and well-being. The study suggests that compensation processes can have an impact on family members, despite compensation systems not formally acknowledging the family in policy or procedure. Conclusions: Compensation authorities should formally consider the role of family in recovery from injury, not only as one means of addressing the overall burden of injury but as a conduit for improving health and function among injured people. [ABSTRACT FROM AUTHOR]

Objective: to characterize the clinical and epidemiological profile of motorcycle accident victims in a General Emergency and Emergency Hospital. Methodology: descriptive, quantitative study of longitudinal and prospective design of the documentary type, carried out in orthopedic and neurological clinics between March and April of 2016 in a public hospital of Piauí. Results: 90.1% were male, 54.5% were single, mean age 34 years, 26.7% had incomplete elementary education, 32.7% were farmers, 51.5% came from the interior of the state. 33.7% did not wear a helmet, 15.8% were drunk, 30.7% had a closed fracture, and 80.2% underwent surgery. The mean length of hospital stay was 6.64 days. Conclusion: important variables for the characterization of the profile of these patients are not registered; More accurate attention is needed in order to raise awareness of the problem in question. [ABSTRACT FROM AUTHOR]

Around 20 to 50 million people are injured as a result of a road traffic accident (RTA) each year throughout the world. In the United Kingdom there have been considerable efforts made to review the assessment of whiplash claimants following RTAs due to the perceived level of fraud. However, very little has been done with regards to assessments for mental disorder; this article seeks to investigate how such assessments are undertaken. Data originating from one clinical forensic psychologist's practice (N D 305) are examined to provide an insight into the assessment of mental disorder in the medico-legal arena in the United Kingdom, building upon previous research. Many important findings emerged from this analysis including a complicated relationship between the diagnosis of mental disorder and the gender of the claimant. In addition, this article provides detailed normative data using the Symptom Checklist 90 Revised, the Impact of Events Scale, and the Beck Depression Inventory. [ABSTRACT FROM AUTHOR]

Resilience is generally understood as the ability to bounce back from setbacks and overcome adversity. Considering children and adolescents, although up to 40% of youth involved in motor accidents develop symptoms of post-traumatic stress disorder (PTSD), the majority do not. What differentiates the young people who remain mostly symptom free from those who develop PTSD? How can medical professionals help to promote resilience among youth involved in motor vehicle accidents? This review provides an overview of resilience by defining key terms, summarizing nearly fifty years of research, explaining current models of resilience, and suggesting interventions intended to enhance and support resiliency among youth involved in motor vehicle accidents. [ABSTRACT FROM AUTHOR]

The motor vehicle crash is the main cause of death and destruction in children and adolescents. One of the major psychological consequences to those who survive a motor vehicle crash (MVC) is post-traumatic stress disorder (PTSD). This discussion considers the future of research in this field that may also involve the use of artificial intelligence in control of motor vehicles that will take human error out of motor vehicle operation. It is important to consider all means in lowering the death and destruction faced by our children and adolescents on the killing fields of the roads in the United States and the world. [ABSTRACT FROM AUTHOR]

Many children and adolescents experience psychological consequences resulting from traumatic events that can impair their development in key areas of functioning. Involvement in a motor vehicle collision (MVC) may compromise children's maturation in social, emotional, behavioral, and academic domains. Approximately one-third of youth survivors of motor vehicle crashes experience post-traumatic stress disorder (PTSD) symptomtology. This review serves educators by providing an overview of trauma-related disorders among school-age children. As teachers are the primary caregivers in classrooms, it is useful to understand how trauma impacts children's abilities to learn, perform, and interact in academic environments. This review aims to describe the signs and symptoms of trauma- and stressor-related disorders in order to assist educators with identifying and responding to at-risk children. The unique needs of youth survivors of motor vehicle crashes are discussed in order to aid educators with conceptualizing classroom behaviors and to help equip them with knowledge that informs their interventions. Following this, the author describes how parental involvement can be managed effectively during the recovery process. Finally, a model for trauma-sensitive classrooms is presented, including the implications for teachers who support and educate youth survivors of trauma. [ABSTRACT FROM AUTHOR]

Motor vehicles accidents (MVA) are one of the leading causes of injuries for children. The consequences of a MVA include physical injuries, such as broken bones or a traumatic brain injury as well as emotional injury, such as post-traumatic stress disorder (PTSD). Between 10% and 35% of children ages 2-18 years meet criteria for PTSD following a MVA, with adolescents being at higher risk for the development of PTSD. This review will focus on assessment, early intervention, and treatment of PTSD following a MVA in children and adolescents. [ABSTRACT FROM AUTHOR]

The psychological impact of motor vehicle crashes on children and adolescents is a phenomenon that often goes under-recognized and as a result often goes untreated. There is an abundance of literature regarding the topic, however, popular culture and even medical and mental health care providers do not always seem to be paying attention. In this review the PTSD narrative section of the DSM 5 will be highlighted as to what is specifically indicated regarding children, reviews general psychological characteristics of trauma and then more specific characteristics of trauma related to motor vehicle crashes. The review highlights some of the most significant aspects of trauma in children including intrusive memories, rumination, thought control strategies, and the concept of social support. The overarching goal of this review is to increase awareness of the prevalence and significance of trauma associated with motor vehicle crashes for children and adolescents. [ABSTRACT FROM AUTHOR]

There are many possible scenarios that would require clinicians to distinguish post-traumatic stress disorder (PTSD) from other mental disorders that share similar signs and symptoms. Further, psychiatric comorbidity is the rule - rather than the exception - with post-traumatic stress disorder. This review provides information on the identification and differential diagnosis of post-traumatic stress disorder with a focus on pediatric patients and psychological sequelae from traffic-related accidents and injuries. Age-specific features of PTSD and a PTSD subtype for preschool children are described. Factors that confound the detection and interpretation of PTSD symptoms are considered with reference to children and their parents. Some common patterns of PTSD comorbidity are discussed, and a summary of some relevant literature is presented, from which recommendations for clinicians and future research are offered in conclusion. [ABSTRACT FROM AUTHOR]

Statistics regarding the prevalence of motor vehicle and traffic related crashes make it very likely that a child or adolescent will encounter one in their lifetime. Although not all crashes result in an injury or are traumatic, the potential is there. Traumatic experiences can affect individuals in different ways. Some may be resilient and not experience any effects while others may develop symptoms that could qualify for a mental health diagnosis like an anxiety, depressive or trauma or stressor related disorder. One of the more significant responses to a traumatic event is a diagnosis of post-traumatic stress disorder (PTSD). However, in order to meet this diagnosis a significant amount of criteria must be met and others ruled out. Because of this a thorough assessment process that is multifaceted is needed to determine if the data elicits a PTSD diagnosis, a differential diagnosis or comorbid diagnosis all of which can be used to develop an appropriate treatment plan. [ABSTRACT FROM AUTHOR]

There has been a significant decrease in traffic injuries and fatalities in the last decade due to major advances in restraint systems in vehicles and by large initiatives that have taken place to educate parents, children and adolescents on the importance of safety in and around cars. However, motor vehicle related crashes continue to be the leading cause of death and injury for children ages 5-19 years. There are a number of different motor vehicle related crashes that a child or adolescent can be involved in; occupant of a vehicle, pedestrian and pedal cyclist. As a result, children and adolescents are exposed to a variety of injuries and psychological stress from these encounters. The following review will provide demographic data related to children and adolescents involvement in these different types of crashes along with the various physical injuries and nonphysical injuries that can occur as a result. This will signify the importance of and demonstrate how often this age group is and can be affected by traffic crashes and the impending trauma that is likely occurring, even in the absence of physical injury. [ABSTRACT FROM AUTHOR]

Objective: A number of training programs that seek to improve driving performance among older drivers are available accompanied by a growing interest in their effectiveness. The purpose of the present investigation was to examine the combined effect of (1) basic in-class training (BT); (2) on-road training with individualized feedback (OR); and (3) training on a driving simulator (S).Methods: Using a randomized controlled trial study design, 78 older drivers were randomly assigned to one of 3 groups (BT, BT + OR, or BT + OR + S). All participants completed a pre- and postintervention on-road driving evaluation on a standardized route. The driving evaluations were recorded using video and Global Positioning System (GPS) equipment and were scored by a blind assessor.Results: The results indicated a significant reduction of approximately 30% in overall number of driving errors/omissions among participants in the BT + OR and the BT + OR + S groups in comparison to participants in the BT group.Conclusions: This study adds to the mounting evidence demonstrating the effectiveness of individualized driver training in improving safe driving among older adults. [ABSTRACT FROM AUTHOR]

Objectives: Pedestrian crashes are a critical problem in Latin American countries. However, little research has been published about pedestrians and even less about their behaviors in a naturalistic context. The objective of the present research was to explore risky pedestrian crossing behaviors in traffic intersections in an argentine city (Ushuaia). It is focused in different stages of the crossing process, traffic code violations, and other potentially risky behaviors such as distractions. A high frequency of risky behaviors among pedestrians was expected. Moreover, according to previous findings, it was hypothesized that men and younger pedestrians would show riskier behaviors.Methods: Participants were 802 pedestrians (53.9% females) observed at several intersections (with and without traffic lights) in the city of Ushuaia. Behaviors were codified following a standardized observation protocol. Observers documented information on behavior previous to, during, and after crossing. Gender and age were also registered. Data were gathered through video recording. Frequency analyses of observed behaviors were conducted for the total sample, as well as by gender and by age group. A general crossing risk index was calculated to facilitate comparisons between the genders and age groups. We conducted an analysis of variance to evaluate gender and age differences for this index.Results: A high proportion of risky behaviors were observed among pedestrians. The majority of pedestrian waited in the street (as opposed to on the sidewalk) before crossing, did not comply with traffic lights, or crossed outside the crosswalk. A large number of pedestrians were distracted while crossing. Men presented higher scores on risky behaviors than women. No differences were observed by age group.Conclusions: The high level of risk behaviors during the different stages of street crossing is worrisome and reinforces the idea that pedestrians are responsible for many of the conflicts with motorists. Many of the risky behaviors seem to be associated with gender, which is in line with the previous literature showing more risk behaviors among men than among women. No differences were found for age group. Findings are interpreted considering some features of the Argentine road culture. [ABSTRACT FROM AUTHOR]

A timely and accurate acquisition of the information provided by variable message signs (VMS) can be crucial while driving. In the current study, we assess the difficulties of adults with dyslexia acquiring the information shown in VMS and provide evidence to discuss the controversial use of pictograms as potential countermeasures. Twenty-two adults with dyslexia and 22 matched controls completed a simulated driving session. The legibility of 12 VMS was assessed, including six text messages (e.g. "ACCIDENT") and six single pictograms (e.g. the icon for "accident ahead"). On average, participants with dyslexia started reading text messages when they were closer to the VMS. In addition, while approaching text VMS, they dedicated more gazes and manifested worse control of speed. Regarding pictogram VMS, we observed no differences in response distance, accuracy, response duration, or number of gazes. To sum up, the evidence provided reveals that adults with dyslexia, despite potential compensation effects, may still find difficulties reading text messages in VMS (shorter legibility distances, longer reading times, and increased cognitive effort), whereas we found no such differences in the recognition of pictograms (only some difficulties keeping a steady speed). Research on inclusive measures to improve reading in low-skilled or dyslexic drivers must be encouraged. [ABSTRACT FROM AUTHOR]

Background: The relationship between driver blood alcohol concentration (BAC) and crash involvement is well understood. However, the role of alcohol use disorders (AUDs) (i.e., dependence or abuse) in crash occurrence, as distinguished from non-clinical heavy alcohol consumption, has not been adequately explored.Methods: Data from the 2010-2011 Crash Risk Study conducted in Virginia Beach, VA, were used in this study. Drivers involved in crashes were compared with control drivers, and four drinker groups were examined: alcohol dependent, alcohol abusers, heavy drinkers, and all other current (i.e., normative) drinkers. Logistic regression analyses were conducted on two outcomes: having a moderate BAC (≥0.05 g/dl), and crash involvement.Results: Overall, 2411 crash-involved and 5514 control drivers provided useable data, 52.4% of which were men and 70.8% Whites. The prevalence of drivers with AUDs was lower for the crash-involved drivers (8.7%) than for the control drivers (12.7%). Only heavy drinkers, but not abusive or dependent drinkers, were over four times more likely to drive with moderate BACs at nighttime. More important, at nighttime, the odds of crash involvement for dependent drinkers were only one third of those for normative drinkers. Daytime crashes, however, were more likely to involve normative drinkers than any of the other three drinker types.Conclusions: Drivers with AUDs are not more likely than normative drinkers to drive with moderate BACs at night. After accounting for the influence of BAC, dependent drinkers have a lower risk of being involved in a crash, at any time of the day. [ABSTRACT FROM AUTHOR]

BACKGROUND: The psychological response of injured people after traffic accidents includes stress and depression. PURPOSE: To assess orthopaedic patients' stress, depression, and satisfaction with life after traffic accidents in Greece. METHODS: Descriptive, longitudinal, correlational study. Patients' background factors, injury severity, scores on the Impact of Events Scale--Revised (IES-R), the Center for Epidemiologic Studies Depression (CES-D) Scale, and the Satisfaction With Life Quality (SWLQ) Scale were recorded. The principles of the Declaration of Helsinki were applied. RESULTS: In total, 60 patients participated in this study during hospitalization following a road traffic accident and 40 patients at 6 months after. Participants were mostly men (75%) with severe injuries (50%). The IES-R score at 6 months was significantly lower than during hospitalization. One out of 3 people had a CES-D score, which is considered of clinical signifi cance. The SWLQ scores were considered high. CONCLUSION: As posttraumatic stress and depression seem to affect a considerable percentage of people involved in road traffic accidents in Greece, these individuals should be assessed for posttraumatic stress and depression while still hospitalized. [ABSTRACT FROM AUTHOR]

Background: Previous studies on the effect of zolpidem or zopiclone use on the risk of road traffic crashes (RTCs) have shown mixed results.Objective: Our objective was to determine the association between zolpidem or zopiclone use (as separate drugs or combined) and the occurrence of injurious RTCs among older adult drivers.Methods: This was a population-based matched case-control and case-crossover study based on secondary data linked together from Swedish national registers. Cases were drivers aged 50-80 years involved in a vehicle crash resulting in injuries between January 2006 and December 2009 for the case-control study (n = 27,096) and from February 2006 to December 2009 for the case-crossover study (n = 26,586). For the first design, four controls were matched to each case by sex, age, and residential area, and exposure was categorized into new, occasional, and frequent use of zolpidem only, zopiclone only, and combined zolpidem and zopiclone. For the case-crossover study, newly dispensed zolpidem or zopiclone users were assessed during the 28 days prior to the crash and compared with an equally long control period using a 12-week washout period. Matched adjusted odds ratios (OR) were computed using conditional logistic regression.Results: Increased ORs for all users were observed. In the case-control study, the highest odds were seen among newly initiated zolpidem-only users involved in single-vehicle crashes (adjusted OR 2.27; 95% confidence interval [CI] 1.21-4.24), followed by frequent combined zolpidem and zopiclone users [adjusted OR 2.20; CI 1.21-4.00]. In the case-crossover, newly initiated treatment with zolpidem or zopiclone showed an increased risk that was highest in the 2 weeks after the start of the treatment (OR 2.66; 95% CI 1.04-6.81).Conclusions: These results provide more compelling evidence for the role of zolpidem or zopiclone in the occurrence of RTCs among older adults, not only in frequent users, but also at the beginning of treatment. [ABSTRACT FROM AUTHOR]

The relationship between type of trauma exposure, cumulative trauma, peritraumatic distress, and subsequent acute stress disorder (ASD) symptoms was examined prospectively in 96 individuals presenting with acute medical injuries to a Level 1 emergency/trauma department. Common precipitating traumas included motor vehicle-related events, stabbings, shootings, and physical assaults. At 2 to 3 weeks follow-up, 22.9% of participants had developed ASD. Univariate analysis revealed no relationship between type of precipitating trauma and ASD symptoms, whereas robust path analysis indicated direct effects of gender, lifetime cumulative trauma exposure, and peritraumatic distress. Peritraumatic distress did not mediate the association between cumulative trauma and symptoms, but did mediate the association between gender and symptomatology. These results, which account for 23.1% of the variance in ASD symptoms, suggest that ASD may be more due to cumulative trauma exposure than the nature of the precipitating trauma, but that cumulative trauma does not exert its primary effect by increasing peritraumatic distress to the most recent trauma. [ABSTRACT FROM AUTHOR]