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1.
Codas ; 32(1): e20170097, 2020.
Artigo em Português, Inglês | MEDLINE | ID: mdl-31851208

RESUMO

PURPOSE: To verify the access to speech-language pathology (SLP) therapy and continuity of assistance in Primary Health Care (PHC) for victims of motorcycle accidents. METHODS: A quantitative and qualitative study was conducted at a large hospital in the city of Recife, Pernanbuco state, Brazil. Among the 99 victims recruited between June and July 2014, 30 had SLP complaints as a result of the accidents. After hospital discharge, all victims were contacted for investigation of the SLP rehabilitation process. Absolute and relative frequencies were used for the analysis in PHC, and data were displayed in tables for the therapy cases. RESULTS: Among the 30 individuals who reported having alterations of the stomatognathic system, eight were undergoing rehabilitation and 18 reported residing in an area covered by the Family Health Strategy (primary care modality). Seeking and obtaining continuity of treatment (medication and bandaging) in primary care were frequent; in contrast, home visits were less frequent. The main obstacles to access SLP therapy were distance to the service and waiting time to begin treatment. CONCLUSION: This study identified obstacles that hamper access to SLP therapy in PHC, such as the low frequency of home visits, contributing to the fragmentation of continuous and complete care for victims.


Assuntos
Acidentes de Trânsito , Transtornos de Deglutição/reabilitação , Acesso aos Serviços de Saúde/estatística & dados numéricos , Transtornos da Linguagem/reabilitação , Motocicletas , Atenção Primária à Saúde , Adulto , Brasil , Estudos Transversais , Transtornos de Deglutição/epidemiologia , Transtornos de Deglutição/etiologia , Feminino , Humanos , Transtornos da Linguagem/epidemiologia , Transtornos da Linguagem/etiologia , Masculino , Pessoa de Meia-Idade , Adulto Jovem
2.
Accid Anal Prev ; 134: 105251, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31402051

RESUMO

Powered two-wheelers (PTWs) are growing globally each year as they are considered an attractive alternative to cars (flexible, small, affordable, fast and easy to park), especially on congested traffic situations. However, PTWs represent an important challenge for road safety. In fact, in 2016, Spain ranked fifth in terms of PTW fatalities among EU 28. For this reason, this paper aims to investigate which are the patterns among crash characteristics contributing to PTW crashes in Spain. Data from 78,611 crashes involving PTWs occurred in Spain in the period 2011-2013 were analyzed. The analysis was performed by using classification trees and rules discovery which are suitable models aimed at extracting knowledge and identifying valid and understandable patterns from large amounts of data previously unknown and indistinguishable. The response variables assessed in this study were severity and crash type. As a result, several combinations of road, environmental and drivers' characteristics associated with severity and typology of PTW crashes in Spain were identified. Based on the analysis results, several countermeasures to solve or mitigate the safety issues identified in the study were proposed. From the methodological point of view, study results show that both the classification trees and the a priori algorithm were effective in providing non-trivial and unsuspected relations in the data. Classification trees structure allowed a simpler understanding of the phenomenon under study while association discovery provided new information which was previously hidden in the data. Given that the results of the two different techniques were never contradictory, we recommend using classification trees and association discovery as complementary approaches since their combination is effective in exploring data providing meaningful insights about PTW crash characteristics and their interdependencies.


Assuntos
Acidentes de Trânsito/mortalidade , Mineração de Dados/métodos , Motocicletas/estatística & dados numéricos , Algoritmos , Humanos , Curva ROC , Espanha/epidemiologia
3.
Accid Anal Prev ; 134: 105330, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31678785

RESUMO

BACKGROUND: Driving/riding under the influence (DUI) of alcohol is a major public concern worldwide. Only a few studies have distinguished DUI-related variables between motorcyclists and car drivers. This study examined the differences in demographic characteristics and drinking behaviors among first-time DUI offenders operating different transportation vehicles, and risk factors for frequent DUI (fDUI) among them. METHODS: We conducted an anonymous survey for 561 first-time DUI offenders who attended a mandatory educational program. Participants self-administered questionnaires concerning alcohol drinking behaviors and DUI. We defined fDUI as at least two DUI behaviors per month based on self-reported information. Demographic and drinking characteristics were compared between DUI offenders, car drivers and motorcyclists. Logistic regression analysis was used to examine risk factors for fDUI. RESULTS: Two-thirds of first-time DUI offenders were motorcyclists. Compared with car drivers, motorcyclists were younger and less educated, with a higher percentage of them being women and unmarried. Car drivers reported a higher rate of fDUI than motorcyclists (16.5% vs. 9.7%). Regression analysis revealed that binge drinkers had a higher fDUI risk in both groups. Regarding the drinking place prior to DUI behavior, workplace was significantly associated with fDUI in car drivers. CONCLUSIONS: Distinct strategies may be required for motorcyclists and car drivers for DUI recidivism prevention, and drinking place interventions should also be considered.


Assuntos
Consumo de Bebidas Alcoólicas/epidemiologia , Dirigir sob a Influência/estatística & dados numéricos , Adulto , Automóveis/estatística & dados numéricos , Dirigir sob a Influência/legislação & jurisprudência , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Motocicletas/estatística & dados numéricos , Autorrelato , Taiwan/epidemiologia
4.
Accid Anal Prev ; 134: 105297, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31683233

RESUMO

The motorcyclist is exposed to the risk of falling and impacting ground head-first at a wide range of travelling speeds - from a speed limit of less than 50 km/h on the urban road to the race circuit where speed can reach well above 200 km/h. However, motorcycle helmets today are tested at a single and much lower impact speed, i.e. 30 km/h. There is a knowledge gap in understanding the dynamics and head impact responses at high travelling speeds due to the limitation of existing laboratory rigs. This study used a finite element head model coupled with a motorcycle helmet model to simulate head-first falls at travelling speed (or tangential velocity at impact) from 0 to 216 km/h. The effect of different falling heights (1.6 m and 0.25 m) and coefficient of frictions (0.20 and 0.45) between the helmet outer shell and ground were also examined. The simulation results were analysed together with the analytical model to better comprehend rolling and/or sliding phenomena that are often observed in helmet oblique impacts. Three types of helmet-to-ground interactions are found when the helmet impacts ground from low to high tangential velocities: (1) helmet rolling without slipping; (2) a combination of sliding and rolling; and (3) continuous sliding. The tangential impulse transmitted to the head-helmet system, peak angular head kinematics and brain strain increase almost linearly with the tangential velocity when the helmet rolls but plateaus when the helmet slides. The critical tangential velocity at which the motion transit from the rolling regime to the sliding regime depends on both the falling height and friction coefficient. Typically, for a fall height of 1.63 m and a friction coefficient of 0.45, the rolling/sliding transition occurs at a tangential velocity of 10.8 m/s (38.9 km/h). Low sliding resistance in helmet design, i.e. by the means of a lower friction coefficient between the helmet outer shell and ground, has shown a higher reduction of brain tissue strain in the sliding regime than in the rolling regime. This study uncovers the underlying dynamics of rolling and sliding phenomena in high-speed oblique impacts, which largely affect head impact biomechanics. Besides, the study highlights the importance of testing helmets at speeds covering both the rolling and sliding regime since potential designs for improved head protection at high-speed impacts can be more distinguishable in the sliding regime than in the rolling regime.


Assuntos
Fricção , Dispositivos de Proteção da Cabeça , Motocicletas/estatística & dados numéricos , Aceleração , Acidentes de Trânsito/classificação , Fenômenos Biomecânicos/fisiologia , Traumatismos Craniocerebrais/etiologia , Traumatismos Craniocerebrais/prevenção & controle , Humanos , Fatores de Risco
5.
Accid Anal Prev ; 134: 105336, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31704640

RESUMO

Electric two-wheelers (E2Ws) have become newly popular transportation tools with the associated growing traffic safety concerns. E2W riders and bicyclists behave similarly as vulnerable road users (VRUs), while exhibited dissimilarities in riding postures and interactions with the two-wheelers. Existing epidemiology reveals prominent differences in injury risks between E2W riders and other vulnerable road users in collisions with motor vehicles. The objective of this study is to investigate the factors influencing kinematics and head injury risks of two-wheeler rides in two-wheeler-vehicle collisions and compare between E2W-vehicle and bicycle-vehicle collisions. Via multi-body modeling of two two-wheeler types, two vehicle types, and three rider statures in MADYMO, twelve collision scenarios were developed. A simulation matrix considering a range of impact velocities and relative positions was performed for each scenario. A subsequent parametric analysis was conducted with focus on the kinematics and head injury risks of two-wheeler riders. Results show that the head injury risk increased with vehicle moving velocity, while the two-wheeler velocity and relative location between rider and vehicle prior to the collision exhibited highly non-linear influence on the kinematical response. The rider with larger stature had higher possibilities to miss head impact on the vehicle. In collisions with the sedan, E2W riders would sustain lower head injury risks with lower contacting velocity on the windshield than bicyclists. While in collisions with the SUV, E2W riders would sustain increasing head injury risks due to the higher structural stiffness at contact, and the risk level was about the same as bicyclists. The findings revealed the loading mechanisms behind the different head injury risks between E2W riders and bicyclists.


Assuntos
Acidentes de Trânsito , Ciclismo/lesões , Motocicletas , Ferimentos e Lesões/etiologia , Fenômenos Biomecânicos , Simulação por Computador , Feminino , Humanos , Masculino , Medição de Risco , Segurança , Ferimentos e Lesões/prevenção & controle
6.
Accid Anal Prev ; 134: 105319, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31706186

RESUMO

The continuous motorization of traffic has led to a sustained increase in the global number of road related fatalities and injuries. To counter this, governments are focusing on enforcing safe and law-abiding behavior in traffic. However, especially in developing countries where the motorcycle is the main form of transportation, there is a lack of comprehensive data on the safety-critical behavioral metric of motorcycle helmet use. This lack of data prohibits targeted enforcement and education campaigns which are crucial for injury prevention. Hence, we have developed an algorithm for the automated registration of motorcycle helmet usage from video data, using a deep learning approach. Based on 91,000 annotated frames of video data, collected at multiple observation sites in 7 cities across the country of Myanmar, we trained our algorithm to detect active motorcycles, the number and position of riders on the motorcycle, as well as their helmet use. An analysis of the algorithm's accuracy on an annotated test data set, and a comparison to available human-registered helmet use data reveals a high accuracy of our approach. Our algorithm registers motorcycle helmet use rates with an accuracy of -4.4% and +2.1% in comparison to a human observer, with minimal training for individual observation sites. Without observation site specific training, the accuracy of helmet use detection decreases slightly, depending on a number of factors. Our approach can be implemented in existing roadside traffic surveillance infrastructure and can facilitate targeted data-driven injury prevention campaigns with real-time speed. Implications of the proposed method, as well as measures that can further improve detection accuracy are discussed.


Assuntos
Aprendizado Profundo , Dispositivos de Proteção da Cabeça/estatística & dados numéricos , Motocicletas/estatística & dados numéricos , Acidentes de Trânsito/estatística & dados numéricos , Adulto , Cidades , Coleta de Dados/métodos , Humanos , Masculino , Mianmar
7.
Artigo em Inglês, Português | LILACS, BDENF - Enfermagem | ID: biblio-1052973

RESUMO

Objetivo: conhecer a percepção dos enfermeiros sobre os acidentes motociclísticos atendidos pelo Serviço de Atendimento Móvel de Urgência (SAMU) de Sobral. Método: trata-se de um estudo exploratório descritivo, com abordagem qualitativa realizado com enfermeiros do SAMU do município de Sobral-Ceará, atualmente composto por oito enfermeiros. Resultados: os resultados da pesquisa evidenciaram que os enfermeiros do SAMU, tem conhecimento sobre a práxis das intercorrências dos motociclistas. Neste sentido, a associação entre os condutores com a não utilização de capacete e a imprudência no trânsito prevaleceram entre as principais morbidades; e dentre as principais lesões, as abrasões e as fraturas destacam-se como mais comuns. Conclusão: evidenciou-se que a atuação da enfermagem é imprescindível em todo processo de assistência à população-alvo do atendimento pré-hospitalar (APH), desde a prevenção de eventos à orientação e educação em saúde


Objective: to find out nurses' perception of the motorcycle accidents attended by the Sobral Emergency Mobile Service (SAMU). Method: this is a descriptive exploratory study, with a qualitative approach performed with nurses from the SAMU in the city of Sobral-Ceará, currently composed of eight nurses. Results: the results of the research show that the nurses of the SAMU, have knowledge about the praxis of the intercurrences of the motorcyclists. In this sense, the links between the drivers without helmet and the imprudence in the traffic prevailed between the main morbidities; and among the main lesions, abrasions and fractures stand out as the most common injuries. Conclusion: it appeared that nursing performance is essential in any assistance process to the target population in prehospital care (APH), from the prevention of events to orientation and health education


Objetivo: conocer la percepción de los enfermeros sobre los accidentes motociclísticos atendidos por el Servicio de Atención Móvil de Urgencia (SAMU) de Sobral. Método: se trata de un estudio exploratorio descriptivo, con abordaje cualitativo realizado con enfermeros del SAMU del municipio de Sobral-Ceará, actualmente compuesto por ocho enfermeros. Resultados: los resultados de la investigación evidenciaron que los enfermeros del SAMU, tienen conocimiento sobre la praxis de las intercurrencias de los motociclistas. En este sentido, la asociación entre los conductores con la no utilización de casco y la imprudencia en el tránsito prevalecieron entre las principales morbilidades; y entre las principales lesiones, las abrasiones y las fracturas se destacan como más comunes. Conclusión: se evidenció que la actuación de la enfermería es imprescindible en todo proceso de asistencia a la población objetivo de la atención prehospitalaria (APH), desde la prevención de eventos a la orientación y educación en salud


Assuntos
Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Motocicletas , Acidentes de Trânsito , Serviços Médicos de Emergência/métodos , Ambulâncias , Enfermagem em Emergência , Enfermagem de Cuidados Críticos
8.
Artigo em Inglês, Português | LILACS, BDENF - Enfermagem | ID: biblio-1048105

RESUMO

Objetivo: descrever as repercussões do acidente motociclístico na vida do trabalhador e dos seus familiares. Método: estudo descritivo, de abordagem qualitativa, do tipo estudo de caso. Para a coletada de dados foram aplicados formulário, entrevista semiestruturada e a observação sistemática no domicílio do trabalhador. Os dados foram submetidos à técnica de análise de conteúdo, modalidade temática. Resultados: identificou-se que devido o acidente de trânsito o trabalhador teve repercussões definitivas, levando-o a viver em estado vegetativo e a aposentadoria por invalidez. A partir da entrevista emergiram as categorias: Abdicação da vida: mudança na rotina familiar; Apoio (ou não) encontrado; Dificuldade financeira e Esperança e a fé que se renovam. Conclusão: os resultados evidenciaram que houve diversas repercussões na vida do trabalhador vítima de acidente motociclístico e da sua família, o que demonstra a necessidade do desenvolvimento de políticas públicas que observem para além dos custos originados dos acidentes de trânsito


Objective: to describe the repercussions of the motorcycle accident on the life of the worker and his relatives. Method: descriptive, qualitative study, case study type. For the collected data were applied form, semi-structured interview and the systematic observation in the domicile of the worker. The data were submitted to the technique of content analysis, thematic modality. Results: it was identified that due to the traffic accident the worker had definite repercussions, leading him to live in a vegetative state and retirement due to disability. From the interview emerged the categories: Abdication of life: change in the family routine; Support (or not) found; Financial difficulty and hope and renewing faith. Conclusion: the results showed that there were several repercussions in the life of motorcycle accident victims and their families, which demonstrates the need to develop public policies that observe the costs of traffic accidents


Objetivo: describir las repercusiones del accidente motociclístico en la vida del trabajador y de sus familiares. Método: estudio descriptivo, de abordaje cualitativo, del tipo estudio de caso. Para la recolección de datos fueron aplicados formulario, entrevista semiestructurada y la observación sistemática en el domicilio del trabajador. Los datos fueron sometidos a la técnica de análisis de contenido, modalidad temática. Resultados: se identificó que debido al accidente de tránsito el trabajador tuvo repercusiones definitivas, llevándolo a vivir en estado vegetativo y la jubilación por invalidez. A partir de la entrevista emergieron las categorías: Abdía de la vida: cambio en la rutina familiar; Apoyo (o no) encontrado; Dificultad financiera y Esperanza y la fe que se renuevan. Conclusión: los resultados evidenciaron que hubo varias repercusiones en la vida del trabajador víctima de accidente motociclístico y de su familia, lo que demuestra la necesidad del desarrollo de políticas públicas que observen más allá de los costos originados por los accidentes de tránsito


Assuntos
Humanos , Motocicletas , Acidentes de Trânsito , Consequências de Acidentes , Brasil
9.
J Surg Res ; 245: 373-376, 2020 01.
Artigo em Inglês | MEDLINE | ID: mdl-31425878

RESUMO

BACKGROUND: Recently, there has been an increase in the usage of dirt bikes and all-terrain vehicles in urban environments. Previously, it has been shown that crashes involving these urban off-road vehicles (UORVs) resulted in different injury patterns from crashes that occurred in rural environments. The aim of this study was to compare injury patterns of patients involved in crashes while riding UORVs versus motorcycles (MCs). METHODS: A retrospective review (2005-2016) of patients who presented to our urban level I trauma center as a result of any MC or UORV crash was performed. Patients who presented after 48 h from the time of accident were excluded. A P < 0.05 was considered significant. RESULTS: We identified 1556 patients who were involved in an MC or UORV crash resulting in injury (MC: n = 1324 [85%]; UORVs: n = 232 [15%]). Patients in UORV crashes were younger (26.2 y versus 39.6 y), less likely to be helmeted (39.6% versus 90.2%), required fewer emergent trauma bay procedures (28.4% versus 36.7%), and needed fewer operative interventions (45.9% versus 54.2%) (all P < 0.05). Both groups had a similar Injury Severity Score (12.2 versus 12.6; P = 0.54) and Glasgow Coma Score (13.8 versus 13.5; P = 0.46). UORV patients had a lower mortality (0.9% versus 4.7%; P < 0.05) compared to MC crash patients despite similar injury patterns. CONCLUSIONS: Our data demonstrate that patients sustaining UORV injuries were younger and less likely to be helmeted but have a lower mortality rate after a crash, despite sustaining similar injuries as motorcyclists. This study provides an overview of how crashes involving UORV usage is a unique phenomenon and not entirely comparable to MC crashes.


Assuntos
Acidentes de Trânsito/estatística & dados numéricos , Motocicletas/estatística & dados numéricos , Veículos Off-Road/estatística & dados numéricos , Ferimentos e Lesões/epidemiologia , Adulto , Feminino , Humanos , Masculino , New Jersey/epidemiologia , Estudos Retrospectivos
10.
Rev Bras Epidemiol ; 22: e190054, 2019.
Artigo em Português, Inglês | MEDLINE | ID: mdl-31826110

RESUMO

OBJECTIVES: To estimate the incidence of traffic accidents among land vehicle drivers and to verify differences between motorcyclist and car driver accident victims. METHODS: A household survey was conducted in Jequié city, Bahia, Brazil, in 2013, with 1,406 drivers who were selected by cluster sampling strategy. Estimates of the cumulative incidence of traffic accidents were weighted by the sample design and, to compare groups of drivers, incidence rates (IR) and 95% confidence intervals were calculated with Poisson Regression. The Chi-Square test were used with Rao-Scott correction (p ≤ 0.05) to evaluate differentials of the event between motorcyclists and car driver victims. RESULTS: Involvement in traffic accidents in the last 12 months before the interview was reported by 10.6% of the drivers. The cumulative incidence was 4.3% for accidents that caused injuries. Motorcyclists had double the risk of being involved in accidents (IR = 2.03; 95%CI 1.40 - 2.94) and higher proportions of injuries (p < 0.001), interruption in daily life activities (p = 0.003) and use of emergency services (p = 0.008). Factors related to time and place of accident were not different between groups. CONCLUSION: Higher incidence of traffic accidents and higher proportions of injuries and others repercussions of these events were seen in motorcyclists. These findings reaffirm the vulnerability of this group and explains the different impact that a preventable cause of morbidity and mortality has on each driver group.


Assuntos
Acidentes de Trânsito/estatística & dados numéricos , Condução de Veículo/estatística & dados numéricos , Automóveis/estatística & dados numéricos , Motocicletas/estatística & dados numéricos , Adulto , Fatores Etários , Brasil/epidemiologia , Escolaridade , Feminino , Humanos , Incidência , Masculino , Pessoa de Meia-Idade , Pesquisa Qualitativa , Fatores Sexuais , Adulto Jovem
14.
Cien Saude Colet ; 24(10): 3957-3967, 2019.
Artigo em Português, Inglês | MEDLINE | ID: mdl-31577025

RESUMO

This study evaluated the work capacity of motorcycle taxi drivers and its association with sociodemographic and work and quality of life factors. This is a cross-sectional study realized with 392 motorcycle taxi drivers that used a form containing demographic and labor data, Work Capacity Index, the WHOQOL-bref. We employed a descriptive and inferential analysis. The moderate/good prevalence work capacity was 51%. Motorcycle taxi drivers aged 40 years and over recorded a 31% increase in low work capacity (PR: 1.31; 95% CI: 1.07; 1.61) compared to younger workers. Motorcycle taxi drivers aged 21-29 and 30-39 years evidenced a higher median for absenteeism (p = 0.023) and self-prognosis regarding future work capacity (p < 0.001). A greater proportion of diseases diagnosed among those with five or more years of service (p = 0.003) and of self-prognosis in those with five years or less of service (p < 0.001) was observed. Motorcycle taxi drivers with moderate/good capacity showed better perception of quality of life in the physical realm (p < 0.001). Work capacity of motorcycle taxi drivers was associated with higher exposure to noxious factors that affect their quality of life and work force. Priority public policies and educational actions are required to minimize this exposure.


Assuntos
Absenteísmo , Motocicletas/estatística & dados numéricos , Doenças Profissionais/epidemiologia , Avaliação da Capacidade de Trabalho , Adulto , Fatores Etários , Idoso , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Prevalência , Prognóstico , Política Pública , Qualidade de Vida , Inquéritos e Questionários , Adulto Jovem
16.
Ulus Travma Acil Cerrahi Derg ; 25(5): 474-478, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31475318

RESUMO

BACKGROUND: The incidence of motorcycle-induced spoke wheel injury is on the rise in our set up. These injuries range from minor soft tissue laceration to extensive crush injuries. This study aimed to evaluate the mechanism, characteristics, incidence and management of wheel spoke injuries. METHODS: Data of all children admitted to Pediatric Surgery Emergency from January 2014 to December 2017, presenting with wheel spoke injuries were analyzed. Incidence, mechanism and characteristics of injury, along with management plan, were noted. The outcomes were assessed by evaluating patients in follow up. RESULTS: Total study patients were 120, with an incidence of 21.7%. Mean age was 8.03±2.28 years. There were 101male patients and nine female patients. All patients were passengers and were sitting astride. Most of the patients were wearing shoes, and hindfoot area of the right foot was mainly involved. Grade 2 injury was seen in 55 (45.8%) and Grade 3 in 55 (45.8%) patients. Flap was needed in 27(22.5%) patients. All patients were mobile at the time of the follow-up. CONCLUSION: We noted the rising incidence of entrapment injuries; however, we had a satisfactory outcome in our patients using different management techniques. We recommend the implementation of safety protocols to avoid such catastrophic injuries.


Assuntos
Acidentes de Trânsito , Traumatismos do Pé , Motocicletas , Acidentes de Trânsito/prevenção & controle , Acidentes de Trânsito/estatística & dados numéricos , Criança , Pré-Escolar , Feminino , Seguimentos , Traumatismos do Pé/epidemiologia , Traumatismos do Pé/prevenção & controle , Traumatismos do Pé/cirurgia , Humanos , Masculino
17.
Accid Anal Prev ; 132: 105279, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31491683

RESUMO

BACKGROUND: Pedestrians, cyclists and motorcyclists are vulnerable to serious injury due to limited external protective devices. Understanding the level of recovery, and differences between these road user groups, is an important step towards improved understanding of the burden of road trauma, and prioritisation of prevention efforts. This study aimed to characterise and describe patient-reported outcomes of vulnerable road users at 6 and 12 months following orthopaedic trauma. METHODS: A registry-based cohort study was conducted using data from the Victorian Orthopaedic Trauma Outcomes Registry (VOTOR) and included pedestrians, cyclists and motorcyclists who were hospitalised for an orthopaedic injury following an on-road collision that occurred between January 2009 and December 2016. Outcomes were measured using the 3-level EuroQol 5 dimensions questionnaire (EQ-5D-3 L), Glasgow Outcome Scale - Extended (GOS-E) and return to work questions. Outcomes were collected at 6 and 12 months post-injury. Multivariable generalized estimating equations (GEE), adjusted for confounders, were used to compare outcomes between the road user groups over time. RESULTS: 6186 orthopaedic trauma patients met the inclusion criteria during the 8-year period. Most patients were motorcyclists (42.8%) followed by cyclists (32.6%) and pedestrians (24.6%). Problems were most prevalent on the usual activities item of the EQ-5D-3 L at 6-months post-injury, and the pain/discomfort item of the EQ-5D-3 L at 12 months. The adjusted odds of reporting problems on all EQ-5D-3 L items were lower for cyclists when compared to pedestrians. Moreover, an average cyclist had a greater odds of a good recovery on the GOS-E, (AOR 2.75, 95% CI 2.33, 3.25) and a greater odds of returning to work (AOR = 3.13, 95% CI 2.46, 3.99) compared to an average pedestrian. CONCLUSION: Pedestrians and motorcyclists involved in on-road collisions experienced poorer patient-reported outcomes at 6 and 12 months post-injury when compared to cyclists. A focus on both primary injury prevention strategies, and investment in ongoing support and treatment to maximise recovery, is necessary to reduce the burden of road trauma for vulnerable road users.


Assuntos
Acidentes de Trânsito/estatística & dados numéricos , Hospitalização/estatística & dados numéricos , Qualidade de Vida , Ferimentos e Lesões/epidemiologia , Ferimentos e Lesões/reabilitação , Adolescente , Adulto , Idoso , Ciclismo/estatística & dados numéricos , Feminino , Humanos , Escala de Gravidade do Ferimento , Estudos Longitudinais , Masculino , Motocicletas/estatística & dados numéricos , Medidas de Resultados Relatados pelo Paciente , Pedestres/estatística & dados numéricos , Sistema de Registros , Adulto Jovem
18.
World Neurosurg ; 132: 202-207, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31505288

RESUMO

BACKGROUND: To decrease vehicular traffic in major metropolitan cities throughout the United States, multiple ridesharing companies have launched dockless electric scooters and bicycles throughout cities. From September 2017 through November 2018, Washington, DC, launched a 15-month dockless vehicle pilot program to allow for the rapid entry and growth of electric scooters within the metropolitan area. This rapid growth resulted in a number of minor and significant injuries. CASE DESCRIPTION: We reviewed the electronic medical record of The George Washington University Hospital to investigate and characterize the types of electric scooter-related injuries resulting in neurosurgical consultation in the 15-month period of the Washington, DC, scooter pilot program. Thirteen patients sustained injuries serious enough to merit neurosurgical consultation, including 1 patient whose symptoms required procedural intervention by a neurointerventional radiologist and another patient who was pronounced dead soon after arrival to the hospital. CONCLUSIONS: In this case series, we highlight more severe injuries that resulted in hospitalization or intervention, including skull fracture, central cord syndrome, and vertebral compression fracture. This case series aims to illustrate the potential severity of injuries related to electric scooters, raise awareness on the issues of safety and public health, and call for further investigation into injuries relating to electric scooters.


Assuntos
Acidentes de Trânsito/estatística & dados numéricos , Motocicletas , Procedimentos Neurocirúrgicos/estatística & dados numéricos , Adulto , Síndrome Medular Central/epidemiologia , District of Columbia/epidemiologia , Registros Eletrônicos de Saúde , Feminino , Fraturas por Compressão/epidemiologia , Hospitalização/estatística & dados numéricos , Humanos , Masculino , Pessoa de Meia-Idade , Encaminhamento e Consulta , Fraturas Cranianas/epidemiologia , Fraturas da Coluna Vertebral/epidemiologia , Resultado do Tratamento , Adulto Jovem
19.
Accid Anal Prev ; 132: 105288, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31505306

RESUMO

In many countries, motorcycle taxis remain an important mode of travel due to their fast, flexible, and inexpensive service. The recent advent of ride-hailing services has led to dramatic growth in the fleet of motorcycle taxis and additional types of motorcycle taxi drivers. Furthermore, mobile phone use while riding a motorcycle is an emerging safety issue, particularly among ride-hailing motorcycle taxi drivers. This paper investigates mobile phone use while riding, crashes and mobile phone related crashes among ride-hailing, traditional, and hybrid motorcycle taxi drivers, using data from a survey in Hanoi, Vietnam. Results show that ride-hailing motorcycle taxi drivers had the highest prevalence of mobile phone use while riding a motorcycle taxi (95.3%), followed by hybrid (88.6%) and traditional taxi drivers (64%). Approximately 32.6%, 19.3%, and 9.7% of motorcycle taxi drivers reported being involved in a crash, injury crash, and mobile phone related crash respectively. Mobile phone related crashes represent 20.5% of all reported crashes. Logistic and negative binomial regression were used to explore factors influencing mobile phone use while riding and crash frequencies. Regression results indicate that ride-hailing taxi drivers were more likely to be involved in a mobile phone related crash. Delivery trips were found to be associated with increases in crashes whereas passenger trips were found to be associated with decreases in crashes. Policy implications are also discussed.


Assuntos
Acidentes de Trânsito/estatística & dados numéricos , Uso do Telefone Celular/estatística & dados numéricos , Motocicletas/estatística & dados numéricos , Feminino , Humanos , Medição de Risco , Inquéritos e Questionários , Vietnã/epidemiologia
20.
BMC Public Health ; 19(1): 1070, 2019 Aug 08.
Artigo em Inglês | MEDLINE | ID: mdl-31395038

RESUMO

BACKGROUND: A prospective study was conducted to investigate the effects of helmet nonuse and seating position on patterns and severity of motorcycle injuries among child passengers in Taiwan. METHODS: In total, 305 child passengers aged ≤14 years who visited the emergency departments of three teaching hospitals following a motorcycle crash were recruited. Children's injury data were collected from medical records, and their riding behaviors along with operators' demographics were sourced from telephone interviews. Parental responses over the telephone about children's riding behaviors were checked by roadside observations. RESULTS: Results of the multivariable logistic regression analysis revealed that compared to child passengers aged ≥7 years, those aged ≤3 (odds ratio (OR), 2.88; 95% confidence interval (CI), 1.37~6.06) and 4~6 years (OR, 2.93; 95% CI, 1.50~5.70) were significantly more likely to have sustained a head/face injury, while those aged 4~6 years (OR, 2.76; 95% CI, 1.01~7.55) were significantly more likely to have sustained a severe injury. Compared to child passengers who were wearing a full-coverage helmet, those who were not wearing a helmet were significantly more likely to have sustained a head/face injury (OR, 3.12; 95% CI, 1.02~9.52) and a severe injury (OR, 3.02; 95% CI, 1.19~7.62). Children seated in front of the operator were significantly more likely to have experienced a head/face injury (OR, 2.22; 95% CI, 1.25~3.94) than those seated behind the operator. For each increment in the riding speed of 1 km/h, the odds of a severe injury to child passengers increased by 5% (OR, 1.05; 95% CI, 1.01~1.09). CONCLUSIONS: For the safety of child motorcycle passengers, laws on a minimum age restriction, helmet use, an adequate seating position, and riding speed need to be enacted and comprehensively enforced.


Assuntos
Acidentes de Trânsito/estatística & dados numéricos , Dispositivos de Proteção da Cabeça/estatística & dados numéricos , Motocicletas , Postura Sentada , Ferimentos e Lesões/epidemiologia , Adolescente , Criança , Pré-Escolar , Serviço Hospitalar de Emergência , Feminino , Hospitais de Ensino , Humanos , Masculino , Registros Médicos , Estudos Prospectivos , Taiwan/epidemiologia , Índices de Gravidade do Trauma
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