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1.
MMWR Morb Mortal Wkly Rep ; 69(47): 1771-1776, 2020 Nov 27.
Artigo em Inglês | MEDLINE | ID: mdl-33237891

RESUMO

During August 7-16, 2020, a motorcycle rally was held in western South Dakota that attracted approximately 460,000 persons from across the United States to numerous indoor and outdoor events over a 10-day period. During August-September 2020, the Minnesota Department of Health (MDH) investigated a coronavirus disease 2019 (COVID-19) outbreak associated with the rally in Minnesota residents. Fifty-one primary event-associated cases were identified, and 35 secondary or tertiary cases occurred among household, social, and workplace contacts, for a total of 86 cases; four patients were hospitalized, and one died. Approximately one third (34%) of 87 counties in Minnesota had at least one primary, secondary, or tertiary case associated with this rally. Genomic sequencing supported the associations with the motorcycle rally. These findings support current recommendations for mask use, physical distancing, reducing the number of attendees at gatherings, isolation for patients with COVID-19, and quarantine for close contacts to slow the spread of SARS-CoV-2 (1). Furthermore, although these findings did not capture the impact of the motorcycle rally on residents of other states, they demonstrate the rationale for consistent mitigation measures across states.


Assuntos
Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/transmissão , Surtos de Doenças , Motocicletas , Pneumonia Viral/epidemiologia , Pneumonia Viral/transmissão , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Betacoronavirus/genética , Betacoronavirus/isolamento & purificação , Criança , Pré-Escolar , Técnicas de Laboratório Clínico , Busca de Comunicante , Infecções por Coronavirus/diagnóstico , Infecções por Coronavirus/prevenção & controle , Feminino , Humanos , Lactente , Masculino , Pessoa de Meia-Idade , Minnesota/epidemiologia , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controle , Quarentena , South Dakota , Sequenciamento Completo do Genoma , Adulto Jovem
2.
Artigo em Inglês | MEDLINE | ID: mdl-33143161

RESUMO

BACKGROUND: During the first Austrian MotoGP Grand Prix of 2020, following a serious accident involving the riders J. Zarco and F. Morbidelli, Morbidelli's riderless bike cartwheeled across turn 3, narrowly missing V. Rossi and M. Viñales by just a few centimeters. As is the case with ordinary traffic accidents, analyzing the dynamics of motorcycle racing accidents can help improve safety; however, to date, the literature lacks studies that analyze the causes and severity of such accidents. Hence, the purpose of this study was to analyze the main causes that led to the accident at the 2020 Austrian MotoGp Grand Prix, to quantify the speeds and distances of the bikes and riders involved, and to hypothesize several alternative scenarios using a low-cost method. METHOD: Kinovea and Google Earth Pro software were used to identify markers along the racetrack and to measure the distances and calculate the time it took the motorcycles to cover those distances. The analyses were carried out on three 30-fps (frames per second) videos. RESULTS: Zarco's average speed as he was overtaking Morbidelli on the straightaway before turn 2 was 302 ± 1.8 km/h, higher than that of Rins and Rossi (299.7 ± 1.7 and 296 ± 1.7 km/h, respectively). The speed of Zarco and Rossi's bikes 44.5 m before the crash was the same (267 ± 7.9 km/h). Immediately after overtaking Morbidelli, Zarco moved 2.92 m towards the center of the racetrack from point A to B, crossing Morbidelli's trajectory and triggering the accident. Morbidelli's riderless bike flew across turn 3 at a speed of about 76 km/h, missing V. Rossi by just 20 cm. The consequences could have been catastrophic if Rossi had not braked just 0.42 s before encountering Morbidelli's bike in turn 3. CONCLUSION: Through a low-cost quali-quantitative analysis, the present study helps us to gain a deeper understanding of the dynamics of the accident and its main causes. Furthermore, in light of our findings regarding the dynamics and severity of the accident and the particular layout of the Red Bull Ring circuit, racers should be aware that overtaking at the end of turn 2, following the same trajectory as the riders involved in the crash, could be very risky.


Assuntos
Acidentes de Trânsito/estatística & dados numéricos , Motocicletas , Segurança , Acidentes de Trânsito/prevenção & controle , Áustria , Ciclismo , Fenômenos Biomecânicos , Humanos , Gravação de Videoteipe
3.
Medicine (Baltimore) ; 99(48): e23451, 2020 Nov 25.
Artigo em Inglês | MEDLINE | ID: mdl-33235132

RESUMO

RATIONALE: Radiocarpal fracture-dislocations are extremely infrequent injuries caused by high-energy trauma and involve significant osseous and ligamentous injuries. If not treated properly, it can lead to serious complications such as ulnar translation of the carpus, multidirectional instability, loss of motion, and post-traumatic arthritis. Purely ligamentous injuries are rarer than fracture-dislocation injuries. Because previous studies have reported small patient cohorts, there has been no standardized treatment strategy for purely ligamentous radiocarpal dislocation. PATIENT CONCERNS: A 24-year-old man suffered a left wrist injury in a motorcycle accident. Plain radiographs revealed dorso-ulnar radiocarpal dislocation without radial fracture and Carpal-ulnar distance ratio (CUDR) was 0.16. MRI scans showed the disruption of the dorsal ligaments and capsules and avulsed from the proximal insertion of the volar radiocarpal ligaments. DIAGNOSIS: Dorsoulnar radiocarpal dislocation with purely ligamentous injury. INTERVENTION: We removed the interposing chondral fragment from the radiocarpal joint and repaired the radioscaphocapitate (RSC) and radiolunate (RL) ligaments with the Jugger Knot Soft Anchor Suture (Biomet, Inc, Warsaw, IN) and applied additional radiocarpal K-wires and an external fixator to maintain reduction and optimal ligament tension. OUTCOMES: The patient showed good clinical results although ulnar translation of the carpus recurred in radiological follow-up. LESSONS: Aggressive surgical management is needed earlier in the treatment of purely ligamentous radiocarpal dislocation, especially if the ulnar translation of the carpus was observed in the initial radiographs.


Assuntos
Luxações Articulares/cirurgia , Ligamentos Articulares/cirurgia , Traumatismos do Punho/cirurgia , Acidentes de Trânsito , Fios Ortopédicos , Fixadores Externos , Humanos , Luxações Articulares/diagnóstico por imagem , Ligamentos Articulares/diagnóstico por imagem , Ligamentos Articulares/lesões , Imagem por Ressonância Magnética , Masculino , Motocicletas , Radiografia , Âncoras de Sutura , Traumatismos do Punho/diagnóstico por imagem , Adulto Jovem
4.
Afr Health Sci ; 20(2): 789-797, 2020 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-33163045

RESUMO

Background: The maxillofacial structures are commonly affected in motorcycle crashes, with the mandible being one of the most frequently fractured bones. Helmets have been shown to have a protective effect in preventing maxillofacial injuries, however, its effect on the occurrence of mandibular fractures is not very well established. Objectives: To evaluate the pattern of mandibular fractures among motorcycle crash victims in Tanzania, and determine the role of helmets in occurrence of mandibular fractures among the motorcyclists. Methodology: This was a 6-months prospective, cross-sectional study that recruited motorcycle crash victims who reported with mandibular fractures following motorcycle crash at Muhimbili National Hospital. A specially designed questionnaire was used for data collection. For purpose of analysis, the Statistical Package for Social Sciences software version 20 was used. Results: The study included a total of 132 participants of whom majority were male (120, 90.9%). The peak age incidence was 21-40 years in 76.5% of the victims. More than half (89, 67.4%) of the victims were riders during the crash. Helmet use was reported in 42.3% of the victims, and majority (67.3%) were usinghalf-face helmets. The symphysis region was the frequently fractured anatomical location (50, 37.9%). More than half of the victims had multiple site involvement, with higher odds observed in individuals wearing half-face helmets. Conclusion: Young males were affected ten times more than females. Most of the victims were riders during the crash. The symphysis region was the frequently fractured anatomical site. There was no difference in occurrence of mandibular fractures between those who wore and those who did not wear helmets during the crashes. However, the severity of mandibular fractures was dependent on the type of helmet used.


Assuntos
Acidentes de Trânsito/estatística & dados numéricos , Dispositivos de Proteção da Cabeça/estatística & dados numéricos , Fraturas Mandibulares/epidemiologia , Motocicletas/estatística & dados numéricos , Adolescente , Adulto , Criança , Pré-Escolar , Estudos Transversais , Feminino , Humanos , Lactente , Recém-Nascido , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Tanzânia/epidemiologia , Adulto Jovem
6.
Environ Health Prev Med ; 25(1): 47, 2020 Sep 04.
Artigo em Inglês | MEDLINE | ID: mdl-32887547

RESUMO

BACKGROUND: Helmet use reduces the risk and severity of head injury and death due to road traffic crash among motorcyclists. The protective efficacy of different types of helmets varies. Wearing firmly fastened full-face helmet termed as effective helmet use provides greatest protection. This study estimates the prevalence and factors associated with effective helmet use among motorcyclists in Mysuru, a tier II city in Southern India. METHODS: Cross-sectional road side observational study of 3499 motorcyclists (2134 motorcycle riders and 1365 pillion riders) at four traffic intersections was done followed by interview of random sample of 129 of the above riders. Effective helmet use proportion and effective helmet use per 100 person-minute of observation was calculated. Multivariate logistic regression analysis was done to identify factors associated with effective helmet use. RESULTS: Prevalence of effective helmet use was 28 per 100 riders and 19.5 per 100 person-minute of observation in traffic intersections. Prevalence rates of effective helmet use was higher among riders (34.5% vs pillion riders 18.1%), female riders (51.3% vs male riders 26.8%), and male pillion riders (30.5% vs female pillion riders 13.7%). Riders commuting for work and school and those ever stopped by the police in the past 3 months had significantly higher odds of effective helmet use. CONCLUSION: Despite helmet use being compulsory by law for motorcyclists, the effective helmet use was low in Mysore. Strict enforcement and frequent checks by the police are necessary to increase the effective helmet use.


Assuntos
Dispositivos de Proteção da Cabeça/estatística & dados numéricos , Motocicletas/estatística & dados numéricos , Transportes , Adulto , Cidades , Traumatismos Craniocerebrais/prevenção & controle , Estudos Transversais , Feminino , Humanos , Índia , Masculino , Pessoa de Meia-Idade , Adulto Jovem
7.
Accid Anal Prev ; 145: 105697, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-32750527

RESUMO

Motorcycle to vehicle collision is one of the most common accidents in the world and usually leads to serious or fatal head injuries to motorcyclists. This study aims to investigate the influences of impact scenarios and vehicle front-end design parameters on head injury risk of the motorcyclist. Five general vehicle types and different impact scenarios were selected for a parametric analysis. Impact scenarios were set according to ISO, 13232 regulation considering impact angles and impact speeds. Five vehicle types of Sedan, MPV (Multi-Purpose Vehicle), SUV (Sport Utility Vehicle), EV (Electric Vehicle) and 1-Box vehicle were included. HIC15 (Head Injury Criterion), head angular acceleration and CSDM (Cumulative Strain Damage Measure) were calculated to evaluate head injury risk of the motorcyclist. The results show that the critical impact speed for HIC15 and head angular acceleration was around 15 m/s, while the critical speed for CSDM was approximately 10 m/s. Impact angle of 45° show extremely high injury risk to the motorcyclist head. Bonnet leading edge height and its combination with other parameter present high influences on motorcyclist head injuries, and the increasing the bonnet leading edge height can potentially reduce head injury risk of motorcyclists. In summary, the present research results provide some theoretic bases for determining the test speed in motorcycle-vehicle crash regulation and design consideration for typical vehicle front end shape.


Assuntos
Acidentes de Trânsito/classificação , Traumatismos Craniocerebrais/etiologia , Veículos Automotores/classificação , Motocicletas , Aceleração/efeitos adversos , Humanos , Medição de Risco
8.
Accid Anal Prev ; 146: 105731, 2020 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-32827843

RESUMO

The effect of ambient light level on road traffic collisions (RTCs) involving a motorcycle was investigated. Data were drawn from the STATS19 database of UK reported RTCs for the period 2005-2015. To isolate the effect of ambient light (daylight vs darkness) an odds ratio was used to compare RTCs at specific times of day in the weeks either side of the Spring and Autumn clock changes. This work extended previous studies by using a more precise method for distinguishing between RTCs in daylight and after dark, thus avoiding the ambiguity of twilight. Data for four-wheel motor vehicle (FWMV) RTCs were also investigated to provide a datum. As expected, the risk of an RTC occurring was significantly higher after dark compared to daylight for both motorcycles and FWMVs. Investigation of contextual factors suggests that risk after dark is significantly higher for motorcycles compared to FWMVs for RTCs with two-vehicles, on roads with low speed limits (≤30 mph), at T-junctions, and junctions controlled by a give way sign. These are the situations where visual aids for increasing conspicuity after dark have the greater potential for reducing motorcycle RTCs.


Assuntos
Acidentes de Trânsito/estatística & dados numéricos , Motocicletas , Adulto , Estudos de Casos e Controles , Escuridão , Bases de Dados Factuais , Feminino , Humanos , Masculino , Razão de Chances , Medição de Risco
9.
Pan Afr Med J ; 36: 47, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32774623

RESUMO

Introduction: Understanding motorcyclists' on-the-road behaviour is critical for developing and evaluating interventions specifically targeting them. Risky on-the-road behaviours have historically been subdivided into errors and violations of the rules of road use. Police records could be used to record cyclists' behaviours, however these documents do not necessarily capture all errors and violations. None use of protective wears have been documented in many studies conducted on Boda-boda drivers in Uganda. The relationship between drivers' economic stress and road safety have been studied for many years but the effects of global and economic stress, its joint effects on behaviours of drivers in relations to accidents have received very little attention. This study aimed at assessing the relationship between injuries and the Boda-boda drivers' behaviours in Northern Uganda. Methods: Two hundred Boda-boda drivers from Gulu Municipality had face-to-face interviews to assess views and underlying factors on the issue of high prevalence of motorcycle road traffic accidents and injuries. Descriptive statistics were used to describe factors on road accidents including personal information, knowledge, skills and attitudes towards road use and safety. The study was approved by a local Institutional Review Board (IRB). Results: Collectively, the results showed that economic stress is an important factor that affects drivers' behaviour and increases their risks to motorcycle accidents. Conclusion: These authors suggest that more studies should be conducted to determine the relationship between economic stress, anger and dangerous behaviours among Boda-boda drivers and accidents in Gulu Municipality using a Motorcycle Rider Behaviour Questionnaire (MRBQ).


Assuntos
Acidentes de Trânsito/estatística & dados numéricos , Condução de Veículo/estatística & dados numéricos , Motocicletas/estatística & dados numéricos , Urbanização , Acidentes de Trânsito/psicologia , Adolescente , Adulto , Condução de Veículo/psicologia , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Prevalência , Assunção de Riscos , Fatores Socioeconômicos , Inquéritos e Questionários , Uganda/epidemiologia , Adulto Jovem
10.
Rev Bras Epidemiol ; 23 Suppl 1: e200011.SUPL.1, 2020.
Artigo em Inglês, Português | MEDLINE | ID: mdl-32638982

RESUMO

OBJECTIVE: To analyze the effect of helmet use on injury severity among motorcyclists and passengers involved in traffic accidents. METHODS: Cross-sectional study of traffic accidents involving motorcyclists attended at the emergency healthcare units participating in the Violence and Accidents Survey Conducted in Sentinel Emergency Departments (Viva Survey) 2017. RESULTS: There was a predominance of individuals aged 18 to 29 years old (46.6%), black (75.2%), with high school education (50.6%). Alcohol use was observed in 14.1% of cases. Helmet use was associated with a 76% reduction in the occurrence of head trauma and a 28% reduction in the referral, hospitalization or death. CONCLUSION: Young, male, black individuals and those with low education were the most frequent victims of accidents. Helmet use was protective for severe injuries.


Assuntos
Acidentes de Trânsito/estatística & dados numéricos , Dispositivos de Proteção da Cabeça/estatística & dados numéricos , Motocicletas , Ferimentos e Lesões/epidemiologia , Adolescente , Adulto , Brasil/epidemiologia , Estudos Transversais , Feminino , Humanos , Masculino , Fatores Socioeconômicos , Inquéritos e Questionários , Índices de Gravidade do Trauma , Ferimentos e Lesões/prevenção & controle , Adulto Jovem
11.
Rev Bras Epidemiol ; 23 Suppl 1: e200010.SUPL.1, 2020.
Artigo em Inglês, Português | MEDLINE | ID: mdl-32638989

RESUMO

OBJECTIVE: To analyze the spatial distribution of female mortality due to motorcycle accidents in Brazilian municipalities between 2005 and 2015, as well as the variation in rates in the same period. METHODS: Female mortality rates for the years 2005, 2010 and 2015 were estimated considering a three-year moving average around the base year, standardized by the direct method. Rates were standardized using the same pattern (Brazilian females in 2010) for each year. Then, the empirical Bayes estimator was used to reduce the effect of the random fluctuation. The percentage variation of the standardized rates was also analyzed for different population sizes (less than ten thousand, less than 50 thousand, more than 100 thousand and more than one million inhabitants). RESULTS: Bayesian rates showed a clear increase in female mortality due to motorcycle accidents, especially in the North, Northeast and Midwest regions. In the municipalities of the South and Southeast regions, mainly in the period between 2010 and 2015, there was an apparent decrease in mortality. The percentage variation showed a reduction in the indicator analyzed in the period between 2010 and 2015 for the largest municipalities in the South and Southeast regions. For almost all regions and population sizes, the period between 2010 and 2015 showed a deceleration in the growth of rates. CONCLUSION: The analysis clearly shows concentrations of municipalities with higher mortality, while also showing that the phenomenon has spread to a greater number of municipalities. The studied period allows the identification of different dynamics in female mortality, in a period of significant variation in mortality due to motorcycle accidents.


Assuntos
Acidentes de Trânsito/mortalidade , Motocicletas , Teorema de Bayes , Brasil/epidemiologia , Cidades/epidemiologia , Feminino , Humanos , Densidade Demográfica
12.
Artigo em Inglês | MEDLINE | ID: mdl-32630709

RESUMO

To identify and quantify the factors that influence the risky riding behaviors of electric bike riders, we designed an e-bike rider behavior questionnaire (ERBQ) and obtained 573 valid samples through tracking surveys and random surveys. An exploratory factor analysis was then conducted to extract four scales: riding confidence, safety attitude, risk perception, and risky riding behavior. Based on the exploratory factor analysis, a structural equation model (SEM) of electric bike riding behaviors was constructed to explore the intrinsic causal relationships among the variables that affect the risky e-bike riding behavior. The results show that the relationship between riding confidence and risky riding behavior is mediated by risk perception and safety attitudes. Safety attitude was found to be significantly associated with risky riding behaviors. Specifically, herd mentality is most closely related to safety attitudes, which means that those engaged in e-bike traffic management and safety education should pay special attention to riders' psychological management and education. Risk perception has a direct path to risky riding behaviors. Specifically, stochastic evaluation and concern degree are significantly related to e-bike riders' risk perception. The findings of this study provide an empirical basis for the creation of safety interventions for e-bike riders in China.


Assuntos
Ciclismo , Conhecimentos, Atitudes e Prática em Saúde , Assunção de Riscos , Acidentes de Trânsito , Adolescente , Adulto , Atitude , China , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Motocicletas , Segurança
13.
Chin J Traumatol ; 23(4): 219-223, 2020 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-32669222

RESUMO

PURPOSE: Motorcycle accident is a major cause of road traffic injuries and the motorcyclists are considered as vulnerable road users. The present study aimed to determine the epidemiological characteristics of fatal motorcycle crashes in Iran. METHODS: In this cross-sectional study, a total of 28,356 motorcycle traffic fatalities registered in the Legal Medicine Organization of Iran were analyzed during the period between March 2011 and March 2017. The examined variables included demographic characteristics, helmet use, crash mechanisms, crash location, position state, type of counterpart vehicle, cause of death and place of death. In the study, road traffic mortalities involving drivers and/or passenger of motorcycles were included. Cases or events registered without these conditions were excluded from the study. To analyse the data, SPSS statistics 25 and GraphPad Prism 8 softwares were used. RESULTS: Of the 122,682 fatal traffic injury cases, 28,356 (23.1%) were motorcycle users, of whom 95.3% were male and 4.7% were female. Most of the motorcycle fatalities belonged to the age group of 18-24 years (29.1%). Head trauma was the major cause of death (59.0%). Also, the overall proportion of safety helmet use among motorcycle crash victims was estimated at 37.4%. Most of the road traffic crash cases (46.8%) happened out of city and half of people (49.9%) died in hospital. About 77.4% of the victims were motorcycle riders and 21.1% were pillion passengers. The highest rate of mortality belonged to the self-employed (38.4%) and then workers (21.8%) and students (10.2%). In addition, most fatalities occurred in people with low education (77.5%) and the least occurred in university graduates (5.5%). Among 31 provinces of Iran, Fars had the highest (9.3%) occurrence rate and Kohgiluyeh and Buyer-Ahmad had the lowest (0.5%). Most of the crash mechanisms were due to motorcycle-vehicle crashes (80.2%), followed by rollover (9.8%). CONCLUSION: Comprehensive public education and special rules are needed to reduce the rate of deaths in motorcycle crashes.


Assuntos
Lesões Acidentais/epidemiologia , Lesões Acidentais/mortalidade , Acidentes de Trânsito/mortalidade , Acidentes de Trânsito/estatística & dados numéricos , Motocicletas , Lesões Acidentais/prevenção & controle , Acidentes de Trânsito/prevenção & controle , Adolescente , Adulto , Criança , Estudos Transversais , Escolaridade , Feminino , Dispositivos de Proteção da Cabeça/estatística & dados numéricos , Educação em Saúde , Humanos , Irã (Geográfico)/epidemiologia , Masculino , Pessoa de Meia-Idade , Sistema de Registros , Adulto Jovem
14.
Accid Anal Prev ; 144: 105627, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-32559660

RESUMO

Since motorcycle taxi drivers often work long hours, fatigue would affect their riding abilities, impacting crash risks. However, there is limited understanding about motorcycle taxi drivers' fatigue-related crashes. This study investigates self-reported fatigue-related crashes among motorcycle taxi drivers in Hanoi, Vietnam. Results from a survey showed that approximately 16% of the motorcycle taxi drivers reported fatigue-related crash involvement. It was also found that nearly 37% of all crashes reported by motorcycle taxi drivers were related to fatigue while riding a motorcycle taxi. Results of the heterogeneity-in-means random parameter logistic model suggested that working fulltime, more delivery trips, and overweight conditions were associated with increased likelihoods of fatigue-related crash involvement. Hybrid taxi drivers, who operate as either traditional or ride-hailing taxi drivers at different times, and most ride-hailing taxi drivers had a reduced likelihood of fatigue-related crash involvement when compared to traditional taxi drivers. Overall, this study has revealed a significant issue of fatigue-related crashes among motorcycle taxi drivers. Immediate interventions via publicity or educational campaigns should be considered by authorities to address this important issue. Ride-hailing companies should contribute by sending warnings of excessive riding hours to ride-hailing taxi drivers.


Assuntos
Acidentes de Trânsito/estatística & dados numéricos , Fadiga/epidemiologia , Motocicletas/estatística & dados numéricos , Adulto , Feminino , Humanos , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , Autorrelato , Vietnã/epidemiologia , Carga de Trabalho
15.
Accid Anal Prev ; 144: 105642, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-32580063

RESUMO

OBJECTIVE: In Vietnam, motorcycle riders comprise about three-quarters of road traffic fatalities, the most common cause of which is head injuries that can be prevented by wearing a helmet. This study aims to assess helmet-wearing behaviors in Ho Chi Minh City, the largest city in Vietnam. METHODS: Eight rounds of observational studies were conducted in six randomly selected locations between July 2015 and April 2019. Given the multinomial nature of the outcome measure (not wearing a helmet; wearing a substandard helmet; wearing an unstrapped standard helmet; wearing a strapped standard helmet), a multinomial model was developed to estimate the level and trend of helmet use and identify the related individual and environmental factors. FINDINGS: A total of 479,892 motorcycle riders were observed, over 90 % of whom were wearing helmets (range over the eight rounds: 92.5 %-96.0 %). However, the prevalence of correct helmet use (defined as wearing a strapped standard helmet) gradually declined from 80.8 % in round 1-55.6 % in round 8. Results from a multinomial model showed the probability of wearing a strapped standard helmet had declined by 22.4 percentage points from round 3 to round 8 while holding other factors constant (95 % CI: 21.8-23.0). The prevalence of correct use is 11.3 percentage points higher for adults than for children (95 % CI: 10.5-12.1). During the same period, unstrapped standard helmet use increased by 24.5 percentage points (95 % CI: 24.1-24.9); substandard helmet use declined but remained high. CONCLUSION: The upward trend of incorrect helmet wearing behaviors and wearing substandard helmets sends a rallying call for multisectoral interventions.


Assuntos
Dispositivos de Proteção da Cabeça/estatística & dados numéricos , Motocicletas/estatística & dados numéricos , Adolescente , Adulto , Criança , Traumatismos Craniocerebrais/prevenção & controle , Estudos Transversais , Feminino , Dispositivos de Proteção da Cabeça/normas , Humanos , Masculino , Prevalência , Vietnã/epidemiologia
16.
Am J Med ; 133(11): 1274-1279, 2020 11.
Artigo em Inglês | MEDLINE | ID: mdl-32592663

RESUMO

With the advent of commercial human spaceflight, it is important to analyze the historical safety of humans traveling to, in, and from space. We break down the fatality rates of human spaceflight and compare them to those of several terrestrial transportation modes. We created a database of human space travel, containing the vehicles, launches, and the total time and distance traveled. For the 4 fatal space missions and 18 fatalities, we determined the fatality rates, calculated by several methods, including rates per trip, person, and distance traveled, stratified by the mission segment affected. Two of the 326 launches did not reach space, and 8 others were suborbital. There have been 1285 person-launches to space; the total time in space is estimated to be 55,939 person-days; and the total distance traveled is approximately 23.5 billion person-miles. One fatal trip occurred on the way to orbit and the other 3 during the return. There has yet to be a fatality in orbit, and there have been none on any space flight since 2003. The per-trip and per-person fatality rates are 1.2% and 1.4%, respectively, but the per mile rate is much lower, depending on the flight segment.


Assuntos
Acidentes Aeronáuticos/mortalidade , Acidentes de Trânsito/mortalidade , Aviação , Veículos Automotores , Ferrovias , Voo Espacial , Automóveis , Humanos , Motocicletas , Transportes , Viagem
17.
Accid Anal Prev ; 144: 105611, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-32534290

RESUMO

Turn signal neglect is considered to be a key contributor to crashes at intersections, yet relatively little research has been undertaken on this topic, particularly in developing countries. Using a case study of Vietnam, this research aimed to explore the role of environmental characteristics, perceived risk, beliefs and lifestyle behaviours on the frequency of turn signal use at intersections. A self-administered questionnaire was distributed to motorcyclists (n = 527) and car drivers (n = 326) using online and offline methods. Using partial least squares structural equation modelling (PLS-SEM), key findings indicate that perceived risk, beliefs and environmental characteristics play a significant role in affecting the frequency of turn signal use among motorcycle riders and car drivers at intersections. While lifestyle behaviours were not found to be a good predictor of turn signal use among car drivers, they were found to indirectly affect turn signal use among motorcycle riders through the mediation of beliefs and perceived risk. The findings can help inform the development of more targeted measures to increase turn signal use.


Assuntos
Condução de Veículo/estatística & dados numéricos , Motocicletas/estatística & dados numéricos , Acidentes de Trânsito/estatística & dados numéricos , Adulto , Condução de Veículo/psicologia , Feminino , Humanos , Estilo de Vida , Masculino , Medição de Risco , Inquéritos e Questionários , Vietnã
18.
Rev. bras. ortop ; 55(3): 284-292, May-June 2020. tab, graf
Artigo em Inglês | LILACS | ID: biblio-1138038

RESUMO

Abstract Objective To evaluate whether the conducts involving antimicrobial treatment and prophylaxis against tetanus have been performed according to the Clinical Protocol of the Institution. Methods Descriptive and retrospective study conducted in patients of both genders, > 18 years old admitted to a public hospital specialized in emergency and trauma, to treat primary open fracture. The data of interest were surveyed in medical records, drug prescriptions, report of patients admitted in the Surgical Block and tetanus prophylaxis requests. Results A total of 241 patients were selected, mostly male (81.7%), young adults (64.3%), victims of motorcycle accidents (53.5%). Infectious complications were present in 18.7% of the fractures, the mean time for the surgical approach was 4 hours and 12 minutes, and 91.7% of the patients had preoperative antimicrobial prescription. The main inadequacies identified were: period of prescription of antimicrobial treatment (63.5%); choice of the antimicrobial scheme (59.3%) and antimicrobial dose (58.0%). Only 14.1% of the patients were immunized against tetanus. Conclusion The greatest divergences with the Clinical Protocol were observed in the issues involving the antimicrobial regimen used, doses and time of prescription, as well as in tetanus prophylaxis.


Resumo Objetivo Avaliar se as condutas envolvendo o tratamento antimicrobiano e a profilaxia contra o tétano têm sido realizadas conforme o Protocolo Clínico da Instituição. Métodos Estudo descritivo e retrospectivo, realizado em pacientes de ambos os gêneros, > 18 anos, admitidos em um hospital público estadual especializado em urgência e trauma, para tratamento primário de fratura exposta. Os dados de interesse foram pesquisados em prontuários médicos, prescrições de medicamentos, relatórios de pacientes admitidos no Bloco Cirúrgico e solicitações de profilaxia antitetânica. Resultados Foram selecionados 241 pacientes, a maioria homens (81,7%), adultos jovens (64,3%), vítimas de acidentes motociclísticos (53,5%). As complicações infecciosas estiveram presentes em 18,7% das fraturas, o tempo médio para a abordagem cirúrgica foi de 4 horas e 12 minutos, e 91,7% dos pacientes tiveram prescrição do tratamento antimicrobiano no pré-operatório. As principais inadequações identificadas foram: período de prescrição do tratamento antimicrobiano (63,5%); escolha do esquema de antimicrobianos (59,3%) e dose dos antimicrobianos (58,0%). Apenas 14,1% dos pacientes foram imunizados contra o tétano. Conclusão As maiores divergências com o Protocolo Clínico foram observadas nas questões envolvendo o esquema de antimicrobianos utilizados, doses e tempo de prescrição, bem como na profilaxia antitetânica.


Assuntos
Humanos , Masculino , Feminino , Adolescente , Adulto , Pessoa de Meia-Idade , Tétano , Ferimentos e Lesões , Motocicletas , Acidentes , Tratamento Primário , Antibioticoprofilaxia , Emergências , Prevenção de Doenças , Fraturas Ósseas , Auditoria Clínica , Fraturas Expostas , Hospitais Públicos , Infecções , Anti-Infecciosos , Antibacterianos
19.
Soud Lek ; 65(2): 22-26, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32493019

RESUMO

From the National Registry of autopsies and toxicology examinations, we selected the deceased for 2015, 2016, 2017 and January 2018 active road accident participants, i.e. pedestrians, cyclists and motor vehicle drivers. From these, we further selected those who were tested for THC presence. Of the 836 deceased active road accident participants, only 251 (i.e. 30%) were tested for cannabinoids, most often passenger car drivers, 46 percent. Of the 251 people tested, THC was demonstrated in 12 (4.8%), most commonly motorcycle drivers (7.8%) and passenger car drivers (3.4%). Of the 12 positive people, 7 were found to have a possible effect of THC ingestion on the road accident, but only one participant was found to have overdosed on THC, and 2 were reported by the dissecting physician to have had no effect on the accident. In the Czech Republic, when driving under the influence of addictive substances, there is no uniform procedure for qualification, whether it is an offence or an offence, and thus in the award of punishment. While somewhere there is an effort to divide this wrongdoing into offences and crimes, elsewhere it practically always only constitutes an offense. This situation seeks to resolve the instruction of the Attorney-at-chief 1 SL 732/2018 of 29 December 4.2019, which, however, arose without any discussion with the professional public, which is heavily criticized especially for the absurly high limits, which in particular in morphine and cocaine are practically unachievable. At the time of this writing, the impact of this guideline on practice is not clear.


Assuntos
Acidentes de Trânsito , Condução de Veículo , Acidentes de Trânsito/mortalidade , República Tcheca/epidemiologia , Dronabinol , Humanos , Motocicletas
20.
Accid Anal Prev ; 143: 105594, 2020 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-32474168

RESUMO

BACKGROUND: Alcohol-involved riders tend to engage in other risk-taking behaviours such as un-helmeted riding which could further increases injury severity. The combined effect of alcohol-involved and un-helmeted riding on fatal injuries is rarely investigated. This study investigated the interaction effect between blood alcohol concentration and helmet use on fatal injuries. METHODS: This study used the National Taiwan Traffic Crash Dataset for the period from 2011 to 2015. Data on road crashes involving a motorcycle and an automobile were extracted and analysed. Multiple logistic regression models were used to calculate the adjusted odds ratio (AOR). We calculated an interaction effect for blood alcohol concentration and helmet use based on STROBE guidelines. RESULTS: There were a total of 669,292 motorcyclist casualties; among these casualties, 3459 (0.5 %) motorcyclists sustained fatal injuries. Alcohol-involved riders were 9.47 times (AOR = 9.47; 95 % CI = 8.75-10.25) more likely than sober ones to sustain fatal injuries. Alcohol-involved and un-helmeted riders were approximately 18 times (AOR = 18.1; CI: 15.9-20.4) more likely to sustain fatal injuries than sober and helmeted riders. Riders involved in head-on crashes and approach-turn motorcycle crashes had an increased probability of sustaining fatal injuries by 240 % (AOR = 3.4; 95 % CI = 2.91-4.09) and 132 % (AOR = 2.3; 95 % CI = 2.016-2.67), respectively. CONCLUSIONS: This study found that alcohol-involved riding acts synergistically with un-helmeted riding to increase motorcyclist injury severity.


Assuntos
Acidentes de Trânsito/mortalidade , Dirigir sob a Influência/estatística & dados numéricos , Dispositivos de Proteção da Cabeça/estatística & dados numéricos , Motocicletas/estatística & dados numéricos , Adulto , Feminino , Humanos , Masculino , Fatores de Risco , Assunção de Riscos , Taiwan/epidemiologia
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