Effectiveness of two interventions in preventing traffic accidents: a systematic review.

BACKGROUND: The prevention of road traffic accidents should be considered a serious public health concern, since they are the eighth leading cause of death globally and the main cause of death for young people aged 15-29. Evidences from many countries show that successes in preventing road traffic injuries can be achieved through concerted efforts at national level. The aim of our study was to assess the effectiveness of two interventions to prevent road traffic accidents: the introduction of graduated driver licensing (GDL) and the interventions to improve pedestrian and cyclist visibility. METHODS: Our search started with a scoping review on the interventions to prevent road traffic accidents to allow the development of a logical framework of traffic accidents. Specific and answerable questions formulated according to PICO scheme and combinations of keywords were used to perform a systematic search in the following databases: Pubmed, Cochrane Database of Systematic Reviews, Database of Abstracts of Reviews of Effects (DARE), Health Evidence, Transport Research International Documentation (TRID) and Google. References of selected papers were searched. Only systematic reviews and meta-analyses were eligible. No temporal limits or linguistic filters were applied. RESULTS: 160 systematic reviews and meta-analyses were found for the question of the introduction of GDL program and 188 on the improvement of visibility in cyclists and pedestrians. After selection, four papers were included in qualitative synthesis for each question. All included studies underwent quality evaluation. GDL programs seem to be effective in reducing crash rates among young drivers, in particular in 16 year-old. Programs with more restrictions seem also to reduce fatal events. To improve visibility of pedestrians and cyclists, street lighting has been suggested as an intervention able to improve driver's visual capabilities and ability to detect roadway hazards and to prevent car crashes. Visibility aids (fluorescent materials, lamps, flashing lights and retroreflective materials) have the potential to increase visibility and enable drivers to detect pedestrians and cyclists earlier. CONCLUSIONS: The two interventions seem to be effective, but further examinations are needed to measure long-term effects. It is necessary to provide feasible studies in local context to estimate the impact of introduction of GDL programs or of some of their components and to improve interventions to increase visibility of pedestrians and cyclists.

[Influenza vaccination: coverage and risk perception among students of the health professions at Florence University, Italy]. / Vaccinazione antinfluenzale: copertura e percezione del rischio tra gli stusenti dell' area sanitaria dell' Univesità di Firenze.

BACKGROUND: It is well demonstrated that influenza vaccination coverage among health care workers and health professions students continues to be low, despite WHO and CDCs strongly recommend flu shot for these categories. Aim of this work is to investigate among students the flu risk perception (both seasonal and 2009 H1N1), knowledge and attitudes towards vaccination and the main factors of acceptance or refusal of the vaccination. METHODS: The study population includes 662 health professions students from the University of Florence. Survey was conducted from October 2010 to March 2011 by an anonymous questionnaire consisting of multiple-choice questions. Statistical analysis was performed in SPSS 19 and the dichotomous variables were analysed using chi2 test and Fisher's exact test. RESULTS: The proportion of students vaccinated against seasonal flu was 10.3% in 2007, 12.1% in 2008, 12.6% in 2009. A lower percentage (9.6%) has received the H1N1v vaccine. In 2009, the majority of the vaccinated students chose to get immunized in order to protect themselves (84.8% for seasonal flu and 71% for H1N1) and other people (over 77% both for seasonal and H1N1). The most common reason to refuse vaccination was to perceive a low disease risk (62.5% for seasonal and 61.9% for H1N1). CONCLUSIONS: Our findings suggest the need to promote a better and accessible offer and to extend flu shot to students during vaccination campaign, in order to increase the primary prevention through vaccination among future's health care workers.