Social comparison orientation mediates the association between HEXACO and self-presentation.

Various researchers have investigated the personality correlates of defensive and assertive self-presentation. Yet, only a few studies go beyond the direct relationships and examine the underlying mechanism. The current study examines whether the social comparison orientation (SCO) mediates the relationship between personality and self-presentation. We also tested whether our proposed model is invariant across genders. We collected data from 496 individuals using the HEXACO personality inventory, the self-presentation tactic scale, and Iowa-Netherlands SCO scale to test these hypotheses. The path analysis indicated that the partial mediation model provides the best fit to the data (root-mean-square error of approximation [RMSEA] = 0.08, comparative fit index [CFI] = 0.97, standardized root mean squared residual [SRMR] = 0.026). While honesty-humility (ß = -0.43) had the strongest total effect on assertive self-presentation, emotionality (ß = 0.34) had the strongest total effect on defensive self-presentation among other HEXACO dimensions. Additionally, we conducted a multigroup path analysis to test the structural invariance, and the findings indicate that the relationships are invariant across women and men (Δχ2 [14] = 11.83, p = 0.61). These findings suggest that the association between personality and self-presentation might not be straightforward. The findings are discussed in relation to facet and factor level associations among the variables, self-presentation strategies, and gender roles.

Distally based subcutaneous veins for venous insufficiency of the reverse posterior interosseous artery flap.

BACKGROUND: The reverse posterior interosseous artery flap (PIAF) provides soft, thin, and pliable tissue for upper extremity reconstruction without sacrificing any major arteries of the hand. The authors performed a new technique that included one extra distally based subcutaneous vein within the pedicle to diminish venous insufficiency and they aimed to present the results of reconstruction with this technique. PATIENTS AND METHODS: Twelve patients with a mean age of 30 years (range 5-52 years) underwent reverse PIAF surgery. The defects were located on the hand and wrist, with a mean area of 57.8 cm2 (range 20-99 cm2) . After the skin between the distal edge and the pivot point of the flap was elevated, the most reliable subcutaneous vein was chosen, chased, and included within the flap. RESULTS: The average size of the PIAF was 6 × 5 cm to 12 × 9 cm (mean area: 64.4 cm2 ) and the median follow-up time was 13 months (range 4-16 months). The mean quick Disabilities of the Arm, Shoulder and Hand (DASH) score was 21.4, indicating a low degree of disability. Of the 12 patients, ten were very satisfied and two were satisfied with the result of the reconstruction. All but one flap survived completely. One flap was nearly totally lost due to arterial insufficiency after hemodialysis. We observed no venous congestion or insufficiency in the patients. CONCLUSIONS: Subcutaneous veins may be reliable and useful for overcoming major drawbacks associated with reverse flow posterior interosseous artery flap and for diminishing flap loss due to venous insufficiency. © 2016 Wiley Periodicals, Inc. Microsurgery 36:384-390, 2016.

A distinctive presentation of diplopodia: a Y-metatarsal combining the extra foot and the extra digit of the main foot.

Diplopodia is a rare congenital anomaly and has been described as extra digits, metatarsals, and tarsal bones that form an extra foot or foot-like structure. Various skeletal deformities and anomalies involving other organ systems can accompany diplopodia. Treatment consists of surgery, splinting, and physical therapy, planned according to each patient's specific condition. We present a patient who had diplopodia with distinctive anatomic features (with postaxial polydactyly and without any anomaly of the tibia or fibula) compared with the previously reported cases, and concomitant anomalies, including left renal agenesis and anal atresia.

Fractures of the fingers missed or misdiagnosed on poorly positioned or poorly taken radiographs: a retrospective study.

BACKGROUND: Missed fractures, the most common diagnostic error in emergency departments, are usually the result of a misread radiograph or the failure to obtain a radiograph. However, a poorly positioned or poorly taken radiograph may also result in diagnostic errors. We sought to analyze the frequency of missed or misdiagnosed finger fractures that could be attributed to inadequate radiographs. METHODS: We reviewed the medical records of the hand surgery divisions of Istanbul Bilim University Medical Faculty Hospital and the Orthopedics Department of Private Florence Nightingale Hospital between January 2008 and March 2010 for patients with fractures of the fingers that had been missed or misdiagnosed on the basis of inadequate radiographs. RESULTS: In 182 patients, we identified 7 missed and 7 misdiagnosed fractures of the fingers because of inadequate radiographs. Lack of a true lateral radiographic view of the fingers or a true anteroposterior radiographic view of the thumb was the most frequent reason for diagnostic errors (71%; 10 of 14), leading to missed fractures in six patients and to misdiagnosed fractures in four patients. Superimposition of the fingers on lateral radiographs led to misjudging of displaced proximal phalangeal fractures of the fifth finger in three patients. CONCLUSION: Diagnostic errors attributed to inadequate radiographs are rare. Proper radiographic evaluation of finger trauma requires at least true anteroposterior and lateral views. An oblique view can complement the lateral view but not replace it. Poor quality radiographs or inadequate views should never be accepted or used as a basis for treatment.

Does primary brachial plexus surgery alter palliative tendon transfer surgery outcomes in children with obstetric paralysis?

BACKGROUND: The surgical management of obstetrical brachial plexus palsy can generally be divided into two groups; early reconstructions in which the plexus or affected nerves are addressed and late or palliative reconstructions in which the residual deformities are addressed. Tendon transfers are the mainstay of palliative surgery. Occasionally, surgeons are required to utilise already denervated and subsequently reinnervated muscles as motors. This study aimed to compare the outcomes of tendon transfers for residual shoulder dysfunction in patients who had undergone early nerve surgery to the outcomes in patients who had not. METHODS: A total of 91 patients with obstetric paralysis-related shoulder abduction and external rotation deficits who underwent a modified Hoffer transfer of the latissimus dorsi/teres major to the greater tubercle of the humerus tendon between 2002 and 2009 were retrospectively analysed. The patients who had undergone neural surgery during infancy were compared to those who had not in terms of their preoperative and postoperative shoulder abduction and external rotation active ranges of motion. RESULTS: In the early surgery groups, only the postoperative external rotation angles showed statistically significant differences (25 degrees and 75 degrees for total and upper type palsies, respectively). Within the palliative surgery-only groups, there were no significant differences between the preoperative and postoperative abduction and external rotation angles. The significant differences between the early surgery groups and the palliative surgery groups with total palsy during the preoperative period diminished postoperatively (p < 0.05 and p > 0.05, respectively) for abduction but not for external rotation. Within the upper type palsy groups, there were no significant differences between the preoperative and postoperative abduction and external rotation angles. CONCLUSIONS: In this study, it was found that in patients with total paralysis, satisfactory shoulder abduction values can be achieved with tendon transfers regardless of a previous history of neural surgery even if the preoperative values differ.

Evaluation of patients undergoing removal of glass fragments from injured hands: a retrospective study.

The hand is the body part most frequently injured by broken glass. Glass fragments lodged in soft tissues may result in numerous complications, such as infection, delayed healing, persistent pain, and late injury as a result of migration. Between 2005 and 2010, we removed 46 glass particles from the hands of 26 patients. The injuries were caused by the following: car windows broken during motor vehicle accidents in 11 patients (42%); fragments from broken glasses, dishes, or bottles in 9 (35%); the hand passing through glass in 5 (19%); and a fragment from a broken fluorescent lamp in 1 (4%) patient. Despite the efficacy of plain radiographs in detecting glass fragments, these are sometimes not obtained. Given the relatively low cost, accessibility, and efficacy of radiographs, and the adverse consequences of retained foreign bodies, the objections to obtaining radiographs should be few in diagnosing glass-related injuries of the hand.

Masculinity, femininity, and angry drivers: Masculinity and femininity as moderators between driver anger and anger expression style among young drivers.

Driver anger and its expression are among the most studied topics in traffic safety literature. However, the function of gender roles, i.e., masculinity and femininity, in driving anger experience and expression has remained mainly unexplored. The present study investigates the association between driving anger and gender roles on the expression of anger among young drivers. Three hundred seventy-nine young drivers filled a questionnaire including the Driving Anger Scale, Bem Sex Roles Inventory, Driving Anger Expression Inventory, and demographic information. Moderated regression analyses showed that masculine gender role and anger provoked by other road users' discourtesy were positively and femininity negatively related to verbal aggression while driving. Anger related to police presence, slow driving, and masculine gender role were positively related to gesture-based and vehicle-based expression of driver aggression. Hostility and feminine gender role were negatively related to the gesture-based expression of driver aggression, while anger related to witnessing illegal driving and feminine gender role were negatively related to the vehicle-based expression of aggression. The interaction effects between masculinity and hostility, masculinity and slow driving, and femininity and illegal driving were also found on the gesture-based expression of driver aggression. The effects of interaction between masculinity and slow driving and femininity and illegal driving were also found on the vehicle-based expression of driver aggression. Slow driving and femininity had a positive relationship to the adaptive expression of anger in driving. The results suggest that masculinity and femininity moderate the relationship between driving anger and the expression of driving anger among young drivers.

Traffic climate and driver behaviors: The moderating role of driving skills in Turkey and China.

INTRODUCTION: While road traffic accidents and fatalities are a worldwide problem, the rates of road traffic accidents and fatalities show differences among countries. Similarly, driver behaviors, traffic climate, and their relationships also show differences among countries. The aim of the current study is to investigate the moderating effect of driving skills on the relationship between traffic climate and driver behaviors by country. (Turkey and China). METHOD: There were 294 Turkish drivers and 292 Chinese drivers, and they completed the Traffic Climate Scale, the Driving Skills Inventory, and the Driver Behavior Questionnaire. The moderated moderation analyses were conducted with Hayes PROCESS tool on SPSS. RESULTS: The results showed that safety skills moderated the relationship between internal requirements and violations both in Turkey and China. Safety skills also moderated the relationship between internal requirements and errors only in China and the relationship between functionality and violations in Turkey. Perceptual-motor skills moderated the relationships between external affective demands and errors, and also the relationship between internal requirements and positive driver behaviors in Turkey. It can be inferred that driving skills has different influences on traffic climate-driver behaviors relationship in different cultures and there might be cultural differences in the evaluation of drivers' own driving skills. Practical Applications: Among driving skills, safety skills have a more critical role to increase road safety by decreasing number of violations. Interventions to increase safety skills of drivers might be promising for road safety.

Cross-cultural differences in pedestrian behaviors in relation to values: A comparison of five countries.

This study compared pedestrian behaviors in five countries (Estonia, Greece, Kosovo, Russia, and Turkey) and investigated the relationships between these behaviors and values in each country. The study participants were 131 pedestrians for Estonia, 249 for Greece, 112 for Kosovo, 176 for Russia, and 145 for Turkey. The principal component analyses revealed that the four-factor structure of the Pedestrian Behavior Scale (PBS) was highly consistent across the five countries. ANCOVA results revealed significant differences between countries on the PBS items and scale scores. Specifically, Greek and Turkish participants reported transgressive pedestrian behaviors more frequently than Estonian, Kosovar, and Russian pedestrians while Kosovar participants reported transgressive pedestrian behaviors less frequently than Estonian pedestrians. In addition, Turkish and Russian pedestrians reported lapses and aggressive behaviors more frequently than Estonian, Greek, and Kosovar pedestrians. Finally, Turkish and Estonian pedestrians reported positive behaviors more frequently than Kosovar pedestrians. Unexpectedly, the regression analyses showed that values have varying effects on pedestrian behavior in the five countries. That is, context or country may determine the effect of values on pedestrian behaviors. The results are discussed in relation to the previous literature.

[Tendon transfers for the upper extremity in cerebral palsy]. / Spastik üst ekstremitede cerrahi tedavi: Tendon transferi uygulamalari.

Upper extremity deformities in cerebral palsy are caused by the imbalance between spastic and weak muscles acting on unstable joints. The basic goals of surgical treatment of spastic hands and upper extremities of patients with cerebral palsy can be summarized as reducing the strength of spastic muscles, strengthening the antagonist muscles, and permanent stabilization of unstable joints. Surgical techniques to achieve these goals include lengthening of spastic muscles, tendon transfers, release or plication of the joint capsule, joint arthrodesis, neurectomies, and skin procedures. Amongst these surgical treatment options, this article will present, in more detail, tendon transfers which are performed especially to achieve balance and restore motor functions.

Traffic climate, driver behaviour, and accidents involvement in China.

Traffic Climate Scale (TCS) and Positive Driver Behaviours Scale (PDBS) are new measurement tools. The study aims to translate the TCS and PDBS into Chinese and to assess their factor structures in a large sample of licensed motor vehicle drivers in China. A further aim is to investigate the effects of TCS factors on drivers' behaviours and traffic accidents involvement. Data were collected using an online survey. Participants were 887 fully licensed motor vehicle drivers, including 531 males and 356 females who completed a Chinese translated questionnaire including the TCS, PDBS, Driver Behaviour Questionnaire (DBQ), items related to drivers' driving records and demographic characteristics. The result of the exploratory factor analysis revealed clear three-factor solution ('Functionality', 'External affective demand' and 'Internal requirement') of TCS with high item loadings and acceptable internal consistency coefficients. The convergent validity of the Chinese TCS was supported by its relationship with driver behaviour factors (violations, errors, lapses and positive behaviours), the traffic accidents involvement and demographic characteristics. The results further show that the external affective demand consistently and positively relate to aberrant behaviours and negatively relate to positive behaviours with indirect positive significant effects on accidents involvement. Functionality is concurrently and negatively related to aberrant behaviours and positively related to positive behaviours with no effects on accidents involvement. The internal requirement is negatively related to aberrant behaviours but, positively related to positive behaviours with positive significant direct effects on accidents involvement.

The Relationship Between Hofstede's Cultural Dimensions, Schwartz's Cultural Values, and Obesity.

According to the World Health Organization, obesity is a major public health issue. In 2014, there were more than 600 million obese people around the world. According to the data of the World Health Organization, obesity rates differ among countries. One possible underlying reason of the difference can be culture, more specifically shared cultural values. The strategies and policies regarding obesity were developed; however, the effect of culture is not adequately considered. The aim of the study is to investigate the relationship between obesity rates of countries, Hofstede's cultural dimensions, Schwartz's values, and Gross National Income per capita per country. The data consist of obesity ranking (i.e., the percentage of the population with a body mass index of 30 kg/m2 or higher), Gross National Income per capita for each country, and cultural variables (i.e., Hofstede's cultural dimensions for 54 nations and Schwartz's cultural values for 57 nations). Hierarchical regression analysis results revealed that Gross National Income per capita was not a significantly related obesity at the aggregated level. Among Hofstede's dimensions, individualism and uncertainty avoidance were positively associated with obesity, and long-term orientation was negatively associated with obesity. The relationship between Schwartz's cultural values and obesity was not found to be significant. Findings suggest that Hofstede's cultural dimensions should be considered when developing national level strategies and campaigns to decrease obesity.

'Switch' technique to restore pronation and radial deviation in 17 patients with brachial plexus birth palsy.

We report outcomes of 17 children with brachial plexus birth palsy that underwent extensor carpi ulnaris to brachioradialis and brachioradialis to abductor pollicis longus transfers to correct supination and ulnar deviation deformity. Mean age at the time of surgery was 8.7 years and mean follow-up time was 21 months (8-44). These patients had marked increases in active forearm rotation and Canadian Occupational Performance Measure scores. Activity performance score on the measure increased from 1.1 to 6.7 and satisfaction score increased from 0.8 to 8.7 at final follow-up. We conclude from our patient series that these tendon transfers are effective in correction of the supination and ulnar deviation deformities in brachial plexus birth palsy. Level of evidence: IV.

The Driver Behaviour Questionnaire in Arab Gulf countries: Qatar and United Arab Emirates.

Manchester Driver Behaviour Questionnaire (DBQ) is one of the most widely used instruments for measuring self-reported driving style and investigating the relationship between driving behaviour and accident involvement. In spite of the fact that Arab Gulf countries have a higher road accident fatality rate compared to European countries and USA, the DBQ has not been used in Arab countries so far. The aim of the present study was to investigate the factor structure of the DBQ, then to examine the relationships between the factors of the DBQ and accident involvement, and finally to compare DBQ scores between the two gulf countries: Qatar and United Arab Emirates (UAE). In this study, 1110 Qatari (263 females and 847 males) and 1286 UAE drivers (294 females and 992 males) filled a survey questionnaire including the DBQ and background information. The results showed that UAE drivers scored higher on almost all DBQ items than Qatari drivers. Surprisingly, only very small differences between men and women on the DBQ item scores were found in UAE. Factor analysis resulted in four factors, which were named as errors, pushing-speeding violations, lapses, and aggression-speeding violations. However, there were a number of differences in the factor structure of the DBQ in UAE and Qatar when compared to the theoretical four-factor structure of the DBQ. Reliabilities of some subscales were also questionably lower than in the original British data. Logistic regression analyses showed that errors, lapses, and aggression-speeding violations predicted accident involvement in Qatar but not in UAE after controlling the effect of the demographic variables (age, sex, and annual mileage).

[The results of tendon transfer in irreparable radial nerve palsy]. / Onarilmasi mümkün olmayan radial sinir felcinde tendon transferi sonuçlari.

OBJECTIVES: The purpose of this study was to evaluate the results of tendon transfers in patients with irreparable radial nerve palsy. METHODS: The study included 29 patients (5 females, 24 males; mean age 29 years; range 9 to 51 years) who underwent tendon transfers for radial nerve palsy. Four patients had low- and 25 patients had high-level radial nerve palsy. The mean duration of tendon transfer after injury (paralysis time) was 19.7 months (range 1 day to 180 months). Clinical evaluations included joint range of motion and muscle strengths. Functional evaluation was made using the Tajima criteria. The mean follow-up was 56.9 months (range 5 to 90 months). RESULTS: Muscle strengths were measured as follows: 3 (n=3), 4 (n=10), and 5 (n=12) for the wrist extensor muscle; 3 (n=7), 4 (n=10), and 5 (n=12) for the finger extensor muscle; and 3 (n=6), 4 (n=13), and 5 (n=10) for the thumb extensor muscle. The mean wrist range of motion was 67.4 degrees , extension was 48.3 degrees (10 degrees to 70 degrees ), and flexion was 21.5 degrees (10 degrees to 55 degrees ). The mean metacarpophalangeal joint extension was 1.7 degrees (0 degrees to 12 degrees ), thumb abduction was 45.6 degrees (34 degrees to 56 degrees ), and thumb interphalangeal joint extension was 18 degrees (0 degrees to 30 degrees ). According to the Tajima criteria, the results were excellent in 15 patients (51.7%), good in nine patients (31%), and moderate in five patients (17.2%). Eight patients (27.6%) had radial deviation deformity and four patients (13.8%) had 1-level weaker finger extensor muscle strength compared to the other fingers. The flexor carpi ulnaris (FCU) was used in the transfer of patients who developed radial deviation deformity. CONCLUSION: Treatment of irreparable radial nerve palsy with tendon transfers yields successful results. Radial deviation deformity mostly occurs in patients receiving FCU transfer for finger extension.

Physical, psychological and economic burden of two-wheel users after a road traffic injury: Evidence from intensive care units of three EU countries.

INTRODUCTION: This study aimed to assess the physical, psychological, and economic burden shouldered by severely injured two-wheel users in three European countries as well as the cost resulting from their hospitalization. METHODS: A total of seven public hospitals were involved in three countries: Greece, Italy, and Germany. Participants enrolled during a 12-month period starting in April 2013. Eligibility criteria included an injury sustained at Road Traffic Crashes (RTC) irrespective of the type of vehicle, hospitalization 1 day in the Intensive Care Unit (ICU) or sub-ICU, and age 18 years or over. Patients were interviewed at 1, 6, and 12 months upon admission. The study used widely recommended classifications for injury severity (Abbreviated Injury Severity [AIS]; Maximum Abbreviated Injury Severity [MAIS]) and standardized measures such as the Disability Assessment Schedule II (WHODAS 2.0), "Impact of Event Scale" (IES-R), Center for Epidemiological Studies Depression Scale (CES-D Scale). Health Care Expenditure was assessed through the Monash University Accident Research Centre (MUARC's) framework, which included measures of 'Direct' and 'Indirect' costs. Diagnosis-related groups (DRGs) were used to estimate hospitalization costs. RESULTS: A total of 54 two-wheel users enrolled in the study in all the countries and 32 completed all follow-up questionnaires. Physical disability increased over 12 months following the injury. Post Traumatic Stress Disorder (PTSD) symptoms of avoidance remained at high levels over the study period. PTSD symptoms of intrusion improved significantly during the second half of the year under investigation. The total annual cost of injury for the two-wheel users who were hospitalized in the selected ICU of all the partner countries for severe injury in 2013/2014, was estimated at €714,491 made up of €123,457 direct and €591,034 indirect costs. Men, aged 50-64 years and those who sustained slight injuries primarily at the lower extremities presented higher indirect costs per person. A total of €1032.092 was spent on hospitalization payments. Women, aged 65+ and those who sustained severe injuries at the central body region presented higher direct costs per person. Women, aged 50-64 years, those with severe injuries and a major injury at the central body and the upper body region presented the highest hospitalization costs per person. CONCLUSIONS: There is a need for effective strategies to early detect and treat groups at risk of being confronted with prolonged psychosocial and economic consequences. PRACTICAL IMPLICATIONS: A holistic understanding of the impact of injury on individuals is important in order to achieve effective treatment of psychological co-morbidities in a timely manner.

[Nonvascular phalangeal transfer from toes to hand in congenital aphalangia]. / Dogustan afalangiali olgularda ayaktan ele nonvasküler falanks transferi.

OBJECTIVES: Free transfer of the toe phalanges to the hand without vascular anastomosis is a proposed option for reconstruction of congenital aphalangia. We evaluated the growth behavior of the phalanges in patients after transfer. METHODS: Six patients with congenital aphalangia underwent 18 nonvascular phalangeal transfers from toes to the hand. The anomaly was bilateral in one patient. Except for one patient who was 11.5 years old, the mean age at the time of surgery was 27 months (range 14 to 48 months). The patients were followed-up for a mean of 2.5 years (range 2 to 4 years) with respect to functional results, yearly longitudinal growth, epiphysial closure, bone resorption or necrosis, digital tip necrosis, fracture, angulation, subluxation, infections, and donor site morbidity. RESULTS: The mean yearly longitudinal growth rate of transferred phalanges was 2.4 mm. On final radiographic examinations, epiphysial closure was not completed in 14 phalanges (78%). Functional improvements included stabilization using the affected digit in three patients, and performing further movements in three patients. One patient underwent reoperation for postoperative subluxation. No fractures or angulation above 15 degrees were seen. Bone resorptions were partial in three patients (16%), and total in one patient (5%). Concerning soft tissue complications, digital tip necrosis developed in one patient (5%). No infections were encountered during the follow-up. All the patients exhibited minimal donor digit shortening. CONCLUSION: Nonvascular phalangeal transfer is an alternative rehabilitation method by which use of prosthetics may be facilitated and functional capacity may be increased in congenital hand anomalies such as congenital aphalangia, in which vascular phalanx transfer is not suitable.

[Surgical restoration of drop foot deformity with tibialis posterior tendon transfer]. / Düsük ayak deformitesinin posterior tibial tendon transferi ile düzeltilmesi.

OBJECTIVES: The transfer of the tibialis posterior tendon to the paralysed tendons on the anterior aspect of the ankle not only restores the function of the paralyzed muscles, but also removes the deforming force on the medial aspect of the foot. In this study, we evaluated patients who underwent tibialis posterior tendon transfer for the treatment of drop foot. METHODS: The study included 41 patients (24 males, 17 females; mean age 32 years; range 11 to 73 years) who underwent tibialis posterior tendon transfer for drop foot. The mean duration of paralysis was 51.5 months (range 4 to 240 months). The mean preoperative drop foot angle was 30.9 degrees (range 15 to 55 degrees). The tibialis posterior tendon was first detached from its insertion and carried proximally on the crural midline, then transferred to the dorsum of the foot through the circumtibial route, where it was split into two parts. One strip was attached to the tibialis anterior tendon, and the other to the extensor hallucis longus, extensor digitorum longus, and peroneus tertius tendons. The results were evaluated according to the criteria of Carayon et al. The mean follow-up was 107.9 months (range 12 to 254 months). RESULTS: The mean postoperative active dorsiflexion was 7.6 degrees , plantar flexion was 21.8 degrees , and their sum was 30.4 degrees . The results were excellent in six feet (14.6%), good in 23 feet (56.1%), moderate in seven feet (17.1%), and poor in five feet (12.2%). CONCLUSION: Tibialis posterior tendon transfer in drop foot yields highly successful results in the restoration of active dorsiflexion and prevention of flexion deformity in the toes.

Psychological distress and physical disability in patients sustaining severe injuries in road traffic crashes: Results from a one-year cohort study from three European countries.

The current study aimed to follow-up a group of road crash survivors for one year and assesses the impact of injury on their psychological and physical condition. All crash survivors that were admitted to the intensive or sub-intensive care units of selected hospitals in Greece, Germany and Italy over one year period (2013-2014), were invited to participate in the study and were interviewed at three different time-points as follows: (a) at one month (baseline data), (b) at six months, and (c) at twelve months. The study used widely recommended classifications for injury severity (AIS, MAIS) and standardized health outcome measures such as the Disability Assessment Schedule II (WHODAS 2.0) to measure disability, "Impact of Event Scale" (IES-R) to measure Post-Traumatic Stress Disorder (PTSD), Center for Epidemiological Studies Depression Scale (CES-D Scale) to measure depression. A total of 120 patients were enrolled in the study in all the partner countries and 93 completed all follow up questionnaires. The risk of physical disability was 4.57 times higher [CI 1.98-2.27] at the first follow up and 3.43 times higher [CI 1.43-9.42] at the second follow up as compared with the time before the injury. There was a 79% and an 88% lower risk of depression at the first and the second follow up respectively, as compared with the baseline time. There was also a 72% lower risk of Post-Traumatic Stress at the second follow up as compared with the baseline time. A number of factors relevant to the individuals, the road crash and the injury, were shown to distinguish those at higher risk of long-lasting disability and psychological distress including age, marital status, type of road user, severity and type of the injury, past emotional reaction to distress. The study highlights the importance of a comprehensive and holistic understanding of the impact of injury on an individual and further underlines the importance of screening and treating psychological comorbidities in injury in a timely manner.

Driver Behaviour Questionnaire: a follow-up study.

The aim of the present study was to investigate time-across stability of different factor solutions (two to six factors) of the Driver Behaviour Questionnaire (DBQ) and to examine the changes on self-reported driving pattern in a follow-up sample (n=622) after three years of the first responses. Repeated measures ANOVA indicated that there was a significant change between Time 1 and Time 2 scores in six items of the DBQ. Drivers reported less competitiveness while driving at Time 2 but more speeding, drinking and driving, driving to wrong destinations and having no recollection of the road just travelled. Significant Time x Sex x Age interactions were found in change scores of four items. Young males and middle-aged female drivers emerged as a group of drivers who changed their self-reported driving pattern over three years. Additionally, sex, age or both had main effects on scores of 21 items. Males and young drivers reported more violations than females and older drivers, whereas female drivers reported more errors and lapses. After running possible factor solutions with Tucker's Phi agreement coefficients, the results indicated that the four- and two-factor solutions were the most stable and interpretable ones. The two-factor solution showed better time-across stability than the four-factor structure did, although the factor solutions found at Time 1 and Time 2 were not as identical as expected. Separate analysis revealed that drivers who had high annual mileage at Time 1 and Time 2 showed the strongest two-factor time-across stability. The test-retest reliability was 0.50 for errors, 0.76 for violations and 0.61 for the whole scale.