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1.
Healthc Policy ; 17(4): 26-36, 2022 May.
Artigo em Inglês | MEDLINE | ID: mdl-35686822

RESUMO

This paper reviews the response by public sector research organizations and their technology transfer offices to the COVID-19 pandemic. It shows that leading universities and technology transfer associations quickly enacted licensing principles for the duration of the pandemic to maximize availability and minimize delays in translating public sector research institutes' (PSRIs') COVID-19 inventions to the public - in both the developed and the developing world - while waiving payment of royalties. It discusses examples of vaccines, drugs, diagnostics and personal protective equipment that were developed in PSRIs and swiftly deployed throughout the world on socially responsible terms. It reviews the case cited by Herder et al. (2022) and concludes that their proposed mandates are unnecessary and may inhibit the free flow of healthcare innovation from bench to bedside.


Assuntos
COVID-19 , Transferência de Tecnologia , COVID-19/epidemiologia , COVID-19/prevenção & controle , Humanos , Licenciamento , Pandemias/prevenção & controle , Universidades
2.
Healthc Policy ; 17(4): 37-44, 2022 May.
Artigo em Inglês | MEDLINE | ID: mdl-35686823

RESUMO

In their piece, Herder and colleagues (2022) reveal the university origins of a key technology used in COVID-19 mRNA vaccines. They note that despite federal funding support and the university adopting "Global Access Principles," equitable, global access remains a challenge - in part due to the university's technology transfer practices. While for the past two decades university students have been successful in engaging institutional technology transfer offices in adopting similar access principles, implementation of these principles has been limited. This rejoinder points to the need for greater federal oversight and regulation to incentivize university action that enables equitable, global access.


Assuntos
COVID-19 , COVID-19/prevenção & controle , Humanos , Licenciamento , Universidades
5.
J Safety Res ; 81: 110-115, 2022 06.
Artigo em Inglês | MEDLINE | ID: mdl-35589281

RESUMO

INTRODUCTION: Allowing young drivers to gain experience while being supervised by an experienced driver is a widely used measure to try to reduce crash risk. On 1 January 2017, the Danish licensing system was updated to allow licensing at age 17 with post-license supervised driving until solo driving at age 18. METHOD: Based on data from the Danish Driving License register and Statistics Denmark, including the entire population, the purpose of this study is to determine if sociodemographic characteristics and a history of violations and crash involvement among youth predict licensing at age 17. A second purpose is to estimate the time period from licensing until the driver turns 18 and to explore changes in license demand in the context of Denmark's updated licensing system. RESULTS: An increasing proportion choose to license at the age of 17, but the proportion below 19 with a driver's license is unchanged. On average, the license is obtained 5.3 months before turning 18. Living in rural areas, with both parents, and in a family with several cars and higher income increases the likelihood of licensing at age 17. Young people with a history of involvement in non-traffic-related accidents or violations are more likely to license at age 17. CONCLUSION: Lowering the license age to allow supervised driving increases early licensing. The average time period from licensing until the driver turns 18 is less than six months. Sociodemographic characteristics predict early licensing. PRACTICAL IMPLICATIONS: Minimum requirements for the time period from licensing until the driver turns 18 are needed to support a safety benefit. Follow-up studies mapping supervised driving, crash involvement, and possible changes in crash risk associated with the change in the Danish licensing system are needed to specify the requirements.


Assuntos
Acidentes de Trânsito , Condução de Veículo , Acidentes de Trânsito/prevenção & controle , Adolescente , Automóveis , Dinamarca , Humanos , Licenciamento
6.
Nat Immunol ; 23(6): 892-903, 2022 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-35624206

RESUMO

Intracellular sensing of stress and danger signals initiates inflammatory innate immune responses by triggering inflammasome assembly, caspase-1 activation and pyroptotic cell death as well as the release of interleukin 1ß (IL-1ß), IL-18 and danger signals. NLRP3 broadly senses infectious patterns and sterile danger signals, resulting in the tightly coordinated and regulated assembly of the NLRP3 inflammasome, but the precise mechanisms are incompletely understood. Here, we identified NLRP11 as an essential component of the NLRP3 inflammasome in human macrophages. NLRP11 interacted with NLRP3 and ASC, and deletion of NLRP11 specifically prevented NLRP3 inflammasome activation by preventing inflammasome assembly, NLRP3 and ASC polymerization, caspase-1 activation, pyroptosis and cytokine release but did not affect other inflammasomes. Restored expression of NLRP11, but not NLRP11 lacking the PYRIN domain (PYD), restored inflammasome activation. NLRP11 was also necessary for inflammasome responses driven by NLRP3 mutations that cause cryopyrin-associated periodic syndrome (CAPS). Because NLRP11 is not expressed in mice, our observations emphasize the specific complexity of inflammasome regulation in humans.


Assuntos
Inflamassomos , Proteína 3 que Contém Domínio de Pirina da Família NLR , Animais , Caspase 1/genética , Caspases/metabolismo , Humanos , Inflamassomos/metabolismo , Interleucina-1beta/metabolismo , Licenciamento , Macrófagos , Camundongos , Proteína 3 que Contém Domínio de Pirina da Família NLR/genética , Proteína 3 que Contém Domínio de Pirina da Família NLR/metabolismo
7.
Artigo em Inglês | MEDLINE | ID: mdl-35535467

RESUMO

PURPOSE: This study aimed to gather opinions from medical educators on the possibility of introducing an interview to the Korean Medical Licensing Examination (KMLE) to assess professional attributes. Specifically following topics were dealt with: the appropriate timing and tool to assess unprofessional conduct; the possiblity of prevention of unprofessional conduct by introducing an interview to the KMLE; and the possibility of implementation of an interview to the KMLE. METHODS: A cross-sectional study approach based on a survey questionnaire was adopted. We analyzed 104 pieces of news about doctors' unprofessional conduct to determine the deficient professional attributes. We derived 24 items of unprofessional conduct and developed the questionnaire and surveyed 250 members of the Korean Society of Medical Education 2 times. Descriptive statistics, cross-tabulation analysis, and Fisher's exact test were applied to the responses. The answers to the open-ended questions were analyzed using conventional content analysis. RESULTS: In the survey, 49 members (19.6%) responded. Out of 49, 24 (49.5%) responded in the 2nd survey. To assess unprofessional conduct, there was no dominant timing among basic medical education (BME), KMLE, and continuing professional development (CPD). There was no overwhelming assessment tool among written examination, objective structured clinical examination, practice observation, and interview. Response rates of "impossible" (49.0%) and "possible" (42.9%) suggested an interview of the KMLE prevented unprofessional conduct. In terms of implementation, "impossible" (50.0%) was selected more often than "possible" (33.3%). CONCLUSION: Professional attributes should be assessed by various tools over the period from BME to CPD. Hence, it may be impossible to introduce an interview to assess professional attributes to the KMLE, and a system is needed such as self-regulation by the professional body rather than licensing examination.


Assuntos
Educação Médica , Licenciamento , Estudos Transversais , Humanos , República da Coreia , Inquéritos e Questionários
8.
Bioinformatics ; 38(10): 2970-2972, 2022 05 13.
Artigo em Inglês | MEDLINE | ID: mdl-35561161

RESUMO

MOTIVATION: Live-cell microscopy has become an essential tool for analyzing dynamic processes in various biological applications. Thereby, high-throughput and automated tracking analyses allow the simultaneous evaluation of large numbers of objects. However, to critically assess the influence of individual objects on calculated summary statistics, and to detect heterogeneous dynamics or possible artifacts, such as misclassified or -tracked objects, a direct mapping of gained statistical information onto the actual image data would be necessary. RESULTS: We present VisuStatR as a platform independent software package that allows the direct visualization of time-resolved summary statistics of morphological characteristics or motility dynamics onto raw images. The software contains several display modes to compare user-defined summary statistics and the underlying image data in various levels of detail. AVAILABILITY AND IMPLEMENTATION: VisuStatR is a free and open-source R-package, containing a user-friendly graphical-user interface and is available via GitHub at https://github.com/grrchrr/VisuStatR/ under the MIT+ license. SUPPLEMENTARY INFORMATION: Supplementary data are available at Bioinformatics online.


Assuntos
Microscopia , Software , Artefatos , Licenciamento
9.
Bioinformatics ; 38(10): 2943-2945, 2022 05 13.
Artigo em Inglês | MEDLINE | ID: mdl-35561197

RESUMO

SUMMARY: HTSeq 2.0 provides a more extensive application programming interface including a new representation for sparse genomic data, enhancements for htseq-count to suit single-cell omics, a new script for data using cell and molecular barcodes, improved documentation, testing and deployment, bug fixes and Python 3 support. AVAILABILITY AND IMPLEMENTATION: HTSeq 2.0 is released as an open-source software under the GNU General Public License and is available from the Python Package Index at https://pypi.python.org/pypi/HTSeq. The source code is available on Github at https://github.com/htseq/htseq. SUPPLEMENTARY INFORMATION: Supplementary data are available at Bioinformatics online.


Assuntos
Sequenciamento de Nucleotídeos em Larga Escala , Software , Documentação , Genômica , Licenciamento
10.
BMC Public Health ; 22(1): 1020, 2022 May 21.
Artigo em Inglês | MEDLINE | ID: mdl-35596168

RESUMO

BACKGROUND: This study examined warning messages as a strategy for preventing automobile crashes by drivers on medications. We investigated the degree of awareness regarding the effects of medication on automobile driving and changes in medication-taking and driving behavior. We also assessed associations between socio-environmental factors and the driving and medication-taking behavior adopted by individuals after being warned about driving-related risks. METHODS: Responses to an online questionnaire from 1200 people with a driving license who were taking prescription medications at the time of inquiry (March 2019) were collected and analyzed. The items surveyed were sex, age, educational history, health literacy, current medications, and medication-taking and driving behavior after being warned. RESULTS: Of the total respondents, 30% were taking medicine that prohibited driving. Of those taking prohibited medications, 25.7% did not receive a warning about driving from healthcare professionals. Most respondents taking prohibited medications received euphemistic warnings, such as "practice caution" (30%), "refrain from calling attention" (29.4%), and "avoid driving" (19.8%); 16% of the direct warnings were about not driving. Medication's effects on driving were recognized by 80% of the total respondents. The degree of awareness was significantly higher among respondents taking medications that prohibit driving than among those taking medications that did not prohibit driving or those taking unknown medications. Awareness of medicine's influence on driving was associated with health literacy. No association was found between age, gender, health literacy, history of side effects, and driving and medication-taking behavior. Approximately 22% of respondents adjusted their medication use at their discretion and 39% maintained treatment compliance but continued driving. Among respondents taking medications that prohibit driving, whether driving was required for work was a significant factor in their driving and medication-taking behavior after being warned. CONCLUSIONS: Healthcare professionals do not always fully inform patients about the driving-related risks of medications. To encourage patients who are taking medications that have a significant impact on their driving to either stop driving or consult a healthcare professional, healthcare professionals must first understand the patient's social environment, such as whether driving is required for work, and then create an environment conducive to advice-seeking.


Assuntos
Condução de Veículo , Medicamentos sob Prescrição , Humanos , Licenciamento , Medicamentos sob Prescrição/efeitos adversos , Prescrições , Inquéritos e Questionários
11.
Artigo em Inglês | MEDLINE | ID: mdl-35457440

RESUMO

Previous studies have frequently reported that those with a driver's license have better physical and cognitive functions than those without. However, there are many people in the world who do not need or who cannot have a driver's license. We hypothesized that if the non-driver's license group had the same or better physical and cognitive functioning as the driver's license group, they could lead healthy lives without the risk of functional decline or loss of functioning due to surrendering their licenses or giving up driving. The subjects were 47 community-dwelling older adults. We measured their physical function and cognitive function and performed psychological assessment via the following tests: grip strength, Timed Up and Go test, walking speed, Five Times Sit to Stand test, Functional Reach test, Two-Step Test, Mini-Mental State Examination, Trail Making Test, Modified Falls Efficacy Scale, Geriatric Depression Scale, and University of California Los Angeles Loneliness Scale. In previous studies, it has been said that having a driver's license provides good physical, cognitive, and psychological functions. However, in this study, loneliness and executive function were strongly influenced by age and sex, and no direct relationship to a driver's license was suggested. Rather, non-driver license holders may be relieved because there is no risk of accidents due to driving, and there is no possibility of a suddenly decline in physical or cognitive function due to revocation of a driver's license.


Assuntos
Condução de Veículo , Equilíbrio Postural , Idoso , Condução de Veículo/psicologia , Cognição , Humanos , Licenciamento , Projetos Piloto , Estudos de Tempo e Movimento
12.
JAMA Netw Open ; 5(4): e228780, 2022 04 01.
Artigo em Inglês | MEDLINE | ID: mdl-35467733

RESUMO

Importance: Despite US graduated driver licensing laws, young novice driver crash rates remain high. Study findings suggest comprehensive license policy that mandates driver education including behind-the-wheel (BTW) training may reduce crashes postlicensure. However, only 15 states mandate BTW training. Objective: To identify differences in licensing and crash outcomes for drivers younger than 18 years who are subject to comprehensive licensing requirements (graduated driver licensing, driver education, and BTW training) vs those aged 18 to 24 years who are exempt from these requirements. Design, Setting, and Participants: This prospective, population-based cohort study used Ohio licensing data to define a cohort of 2018 license applicants (age 16-24 years, n = 136 643) and tracked licensed driver (n = 129 897) crash outcomes up to 12 months postlicensure. The study was conducted from January 1, 2018, to December 31, 2019, and data analysis was performed from October 7, 2019, to February 11, 2022. Main Outcomes and Measures: Licensing examination performance and population-based, police-reported crash rates in the first 2 months and 12 months postlicensure across age groups, sex, and census tract-level sociodemographic variables were measured. Poisson regression models compared newly licensed driver crash rates, with reference to individuals licensed at 18 years, while controlling for census tract-level sociodemographic factors, time spent in the learner permit period, and licensing examination performance measures. Results: Of 136 643 novice drivers, 69 488 (50.9%) were male and 67 152 (49.1%) were female. Mean (SD) age at enrollment (age at first on-road examination) was 17.7 (2.1) years. License applicants aged 16 and 17 years performed best on license examinations (15 466 [21.6%] and 5112 [30.9%] failing vs 7981 [37.5%] of applicants aged 18 years). Drivers licensed at 18 years had the highest crash rates of all those younger than 25 years. Compared with drivers licensed at 18 years, crash rates were 27% lower in individuals aged 16 years and 14% lower in those aged 17 years during the first 2 months postlicensure when controlling for socioeconomic status, time spent in learner permit status, and license examination performance measures (adjusted relative risk [aRR] at age 16 years: 0.73; 95% CI, 0.67-0.80; age 17 years: aRR, 0.86; 95% CI, 0.77-0.96). At 12 months postlicensure, crash rates were 19% lower for individuals licensed at age 16 years (aRR, 0.81; 95%, CI, 0.77-0.85) and 6% lower at age 17 years (aRR, 0.94; 95% CI, 0.89-0.99) compared with individuals aged 18 years. Conclusions and Relevance: In Ohio, drivers younger than 18 years who are subject to graduated driver licensing and driver education, including BTW training requirements, had lower crash rates in the first year postlicensure compared with those aged 18 years, with controls applied. These findings suggest that it may be fruitful for future work to reconsider the value of mandated driver license policies, including BTW training, and to examine reasons for delayed licensure and barriers to accessing training.


Assuntos
Condução de Veículo , Licenciamento , Acidentes de Trânsito/prevenção & controle , Adolescente , Estudos de Coortes , Feminino , Humanos , Masculino , Estudos Prospectivos
13.
Immunobiology ; 227(3): 152215, 2022 05.
Artigo em Inglês | MEDLINE | ID: mdl-35468553

RESUMO

BACKGROUND: Corticosteroid resistance (CR) is a serious disadvantage in treating many chronic inflammatory conditions. Eosinophils are the main inflammation cells in allergic reactions. Environmental pollution, such as PM2.5, is associated with the pathogenesis of allergic disorders. The objective of this study is to elucidate the mechanism by which the exposure to PM2.5 confers eosinophil CR status. METHODS: Patients with allergic rhinitis were recruited and assigned to corticosteroid sensitive (CS) and CR groups. Eosinophils were purified from nasal lavage fluids collected from patients with allergic rhinitis. A murine AR mouse model was developed with dust mite allergens and PM2.5 as the sensitization reagents. RESULTS: CR status was detected in about 60% eosinophil collected in patients with AR. Upon exposure to eosinophil activators, CS eosinophils released a large quantity of mediators, which was suppressed by the presence of steroids in the culture. CR eosinophils demonstrated resistance to steroidal therapy. RAS activation levels in eosinophils were higher in CR eosinophils than in CS eosinophils. Higher expression of the Son of sevenless-1 (Sos1) was detected in CR eosinophils, which formed a complex with RAS and glucocorticoidreceptor-α in CR eosinophils to prevent the binding between steroids and glucocorticoidreceptor-α. The presence of an Sos1 inhibitor dissociated glucocorticoid receptor-α from RAS/Sos1 complex, that restored the sensitivity to steroids in eosinophils. Administering the Sos1 inhibitor effectively attenuated the experimental allergic rhinitis. CONCLUSIONS: CR status was detected in approximately 1/3 eosinophils sampled from patients with allergic rhinitis. Sos1 was instrumental in the development and perseverance of CR in eosinophils. Sos1 inhibition restored sensitivity to steroids in CR eosinophils, which effectively reduced experimental allergic rhinitis.


Assuntos
Eosinófilos , Rinite Alérgica , Corticosteroides/farmacologia , Corticosteroides/uso terapêutico , Animais , Eosinófilos/metabolismo , Humanos , Licenciamento , Camundongos , Mucosa Nasal/patologia , Núcleo Familiar , Material Particulado , Rinite Alérgica/tratamento farmacológico
15.
BMC Public Health ; 22(1): 649, 2022 04 05.
Artigo em Inglês | MEDLINE | ID: mdl-35382791

RESUMO

BACKGROUND: The toll associated with road traffic crashes (RTC) is high, and the burden of injury is disproportionately borne by pedestrians and motor riders, particularly in developing countries. This study synthesized the factors associated with motorcycle-related RTC in Africa. METHODS: The PICO framework and the PRISMA guidelines for conducting reviews were incorporated in searching, screening, and reporting the findings. Advanced search in five electronic databases (Google Scholar, PubMed Central, Scopus, CINAHL, and Embase) yielded 2552 titles and 22 from manual search, filtered for 2016 to 2022 (to generate 1699) and then further for primary studies (854). Through the title, abstract and full-text screening, 22 were appropriate for this review. Data extraction was done by the two researchers independently, and the results were compared. Convergent synthesis was adopted to integrate results, transformed into a narrative, and analyzed using thematic synthesis. RESULTS: The four main themes identified were the rider-related, non-rider-related factors, prevalence and severity of injuries from RTC, and the measures to reduce RTC. The behavioral factors associated with RTC were alcohol use, smoking, use of illicit drugs, tiredness of rider, poor knowledge on traffic regulations, more than one pillow rider, lack of rider license, non-observance of traffic regulations, and non-use of personal protective equipment. Road traffic crashes were common among younger age and male gender. Other factors identified included poor road network, unplanned stoppage by police, unlawful vehicular packing, increased urbanization, and slippery floors. CONCLUSION: There is the need to institute multi-sectoral measures that target riders' behavior change. Coordinated efforts should target governments, enforcement authorities, and regulatory bodies to enforce enactment that ensures safe use of roads.


Assuntos
Motocicletas , Ferimentos e Lesões , Acidentes de Trânsito/prevenção & controle , África/epidemiologia , Humanos , Licenciamento , Masculino , Polícia , Ferimentos e Lesões/epidemiologia
16.
Tidsskr Nor Laegeforen ; 142(6)2022 Apr 05.
Artigo em Inglês, Norueguês | MEDLINE | ID: mdl-35383458

RESUMO

BACKGROUND: In February 2021, the Storting decided to abolish the mandatory medical certificate required for driving licence renewals for drivers over the age of 80. The decision will affect older drivers, traffic safety in general, and the everyday work of GPs in particular. MATERIALS AND METHODS: A content analysis was performed of the parliamentary debates and supporting documentation on the issue of medical certificates for older drivers, from the time of the motion in December 2020 up to the debate on when to implement the decision in May 2021. RESULTS: The majority decision was founded on an anti-discrimination argument with undertones of district politics, in which the traffic safety element was relativised. A minority argued for a traffic safety policy based on a health authority decision and with an emphasis on the added overall health value. Cognitive screening tests were unanimously rejected. INTERPRETATION: The parties that represent the majority decision framed cognitive testing in a way that suggests the decision is a reaction to these tests rather than to the medical certificate requirement as such. There was little discussion on how the decision will affect GPs' ability to identify impaired fitness to drive among the older population.


Assuntos
Acidentes de Trânsito , Condução de Veículo , Acidentes de Trânsito/prevenção & controle , Humanos , Licenciamento , Programas de Rastreamento , Testes Neuropsicológicos
17.
Nat Biotechnol ; 40(4): 439, 2022 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-35379964

Assuntos
Licenciamento
18.
BMJ Open ; 12(4): e059312, 2022 04 13.
Artigo em Inglês | MEDLINE | ID: mdl-35418439

RESUMO

OBJECTIVE: To identify and prioritise the research needed to help Nepali agencies develop an improved road safety system. DESIGN: Delphi study. SETTING: Nepal. PARTICIPANTS: Stakeholders from government institutions, academia, engineering, healthcare and civil society were interviewed to identify knowledge gaps and research questions. Participants then completed two rounds of ranking and a workshop. RESULTS: A total of 93 participants took part in interviews and two rounds of ranking. Participants were grouped with others sharing expertise relating to each of the five WHO 'pillars' of road safety: (1) road safety management; (2) safer roads; (3) safer vehicles; (4) safer road users and (5) effective postcrash response. Interviews yielded 1019 research suggestions across the five pillars. Two rounds of ranking within expert groups yielded consensus on the important questions for each pillar. A workshop involving all participants then led to the selection of 6 questions considered the most urgent: (1) How can implementing agencies be made more accountable? (2) How should different types of roads, and roads in different geographical locations, be designed to make them safer for all road users? (3) What vehicle fitness factors lead to road traffic crashes? (4) How can the driver licensing system be improved to ensure safer drivers? (5) What factors lead to public vehicle crashes and how can they be addressed? and (6) What factors affect emergency response services getting to the patient and then getting them to the right hospital in the best possible time? CONCLUSIONS: The application of the Delphi approach is useful to enable participants representing a range of institutions and expertise to contribute to the identification of road safety research priorities. Outcomes from this study provide Nepali researchers with a greater understanding of the necessary focus for future road safety research.


Assuntos
Condução de Veículo , Acidentes de Trânsito/prevenção & controle , Técnica Delfos , Humanos , Licenciamento , Nepal , Pesquisa , Segurança
19.
Artigo em Inglês | MEDLINE | ID: mdl-35409647

RESUMO

The Environmental Impact Assessment (EIA) is a legal and administrative tool aimed to identify, predict, and interpret the impact of a project or activity on the environment and human health. The EIA also evaluates the accuracy of the predictions and audits the effectiveness of the established preventive measures. Regarding the sanitation sector, efficiency of wastewater treatments and sanitation networks determine the pollutant level of the discharged liquid effluents and the subsequent impact on the environment and human health. This problematic makes necessary to assess how proper the regulatory follow-ups of sanitation projects is. This paper evaluates the performance of the Chilean EIA System concerning to sanitation projects. Taking into account that the more restrictive Environmental Impact Study (EIS) and more permissive Environmental Impact Declaration (EID) are the ways for projects' entry to the EIA System in Chile, 5336 sanitation projects submitted to EIA between 1994 and 2019 were complied. A representative sample of 76 projects (15 entered as EIS and 61 as EID) was analyzed by using a principal coordinate analysis (PCoA) through 14 selected performance indicators. Observed weaknesses have led to propose improvement opportunities of the EIA focused on the follow-ups after the environmental license is obtained, such as creation of a simplified sanctioning procedure, decentralization of decision-making, deadline establishment in each stage, and unified direct link for each project. These proposals seek to improve the effectiveness of monitoring and possible sanctions to early identify impacts of sanitation projects on the environment and human health. This paper introduces a robust methodology for evaluation criteria focused on the follow-ups analysis, which can be used in other countries that consider respectful sanitation projects have direct social and environmental benefits leading to long-term indirect cultural and economic values.


Assuntos
Meio Ambiente , Saneamento , Chile , Seguimentos , Humanos , Licenciamento
20.
BMC Med Educ ; 22(1): 216, 2022 Mar 30.
Artigo em Inglês | MEDLINE | ID: mdl-35354466

RESUMO

BACKGROUND: Compared to other road users, ambulance drivers are at a higher accident risk while driving with warning lights and sirens. No standard exists for training or education for emergency medical service employees driving ambulances. Training programs should positively influence knowledge. However, knowledge gain can be influenced by several different factors. This study developed a knowledge test for ambulance drivers to determine influencing factors on knowledge and its gain by simulator-based training. METHODS: Two parallel knowledge test forms with 20 questions each were designed in several steps and tested on up to 174 participants. Questionnaires were used to study associated and influencing factors, such as objective experience, subjective attitudes, personality, motivation and demographic data. RESULTS: Test construction showed good overall parallelism of the two tests as well as reliability and sensitivity. There was no correlation between subjective and objective knowledge gain, but participants with higher subjective knowledge gain showed a higher variation in objective knowledge. Younger age, higher qualification, higher number of license classes, fewer traffic violations, and more traffic safety trainings were positively associated with knowledge, whereas less yearly driving mileage, more traffic safety trainings, and higher risk sensitivity positively influenced knowledge gain through the training. CONCLUSION: Knowledge and its gain through training are very low. Reasons for the lack of predictive power of some variables, such as motivation, personality and attitudes, are discussed. This study presents a new tool for testing knowledge on driving with warning lights and sirens. It shows the need for objective testing and for further research in this special area.


Assuntos
Ambulâncias , Condução de Veículo , Acidentes de Trânsito/prevenção & controle , Humanos , Licenciamento , Reprodutibilidade dos Testes
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