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"Accidents, Traffic - psychology"
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The Protective Effect of MEWS-based Graded Nursing on the Life Safety of Car Accident Patients
To demonstrate the improvement effect of modified early warning score (MEWS)-based on graded nursing (different levels of care are given according to the assessment of the severity, seriousness, urgency and self-care ability of the patient) on the outcome and quality of life (QoL) of emergency car accident patients.
A prospective non-randomized controlled trial was conducted on 103 emergency car accident patients admitted between May 2020 and May 2021. Among them, 57 patients received MEWS-based graded nursing and were regarded as the research group (RG), while the other 46 patients received routine nursing and were regarded as the control group (CG). The Symptom Check List-90 (SCL-90), the Visual Analogue Scale (VAS), and the Post-traumatic Stress Disorder (PTSD) Checklist-Civilian version (PCL-C) scoring surveys were administered before and after care, respectively. Nursing satisfaction was investigated when patients were discharged from the hospital. Then, patient outcomes were followed up for one year to evaluate patients' QoL by the Generic Quality of Life Inventory-74 (GQOL-74).
SCL-90, VAS, and PCL-C were lower, and satisfaction with care was higher after RG treatment compared to CG (P < .05). The incidence of adverse events during treatment was lower in RG than in CG (P < .05). In addition, PCL-C scores were also lower in RG than in CG (P < .05).
MEWS-based graded nursing can effectively mitigate the NEs and PTSD of emergency car accident patients and improve their outcomes and QoL.
Journal Article
The effects of feedback and incentive-based insurance on driving behaviours: study approach and protocols
BackgroundRoad injury is the leading cause of death for young people, with human error a contributing factor in many crash events. This research is the first experimental study to examine the extent to which direct feedback and incentive-based insurance modifies a driver's behaviour. The study applies in-vehicle telematics and will link the information obtained from the technology directly to personalised safety messaging and personal injury and property damage insurance premiums.MethodsThe study has two stages. The first stage involves laboratory experiments using a state-of-the-art driving simulator. These experiments will test the effects of various monetary incentives on unsafe driving behaviours. The second stage builds on these experiments and involves a randomised control trial to test the effects of both direct feedback (safety messaging) and monetary incentives on driving behaviour.DiscussionAssuming a positive finding associated with the monetary incentive-based approach, the study will dramatically influence the personal injury and property damage insurance industry. In addition, the findings will also illustrate the role that in-vehicle telematics can play in providing direct feedback to young/novice drivers in relation to their driving behaviours which has the potential to transform road safety.
Journal Article
Lost boy
After a near-fatal car accident, twelve-year-old Ryder's mother needs an operation they cannot afford and while a new friend tries to raise funds, Ryder travels with a grouchy, disabled neighbor, from Yankee Stadium to Turner Field seeking the major league baseball player who might be Ryder's father.
Book
Virtual reality by mobile smartphone: improving child pedestrian safety
BackgroundPedestrian injuries are a leading cause of paediatric injury. Effective, practical and cost-efficient behavioural interventions to teach young children street crossing skills are needed. They must be empirically supported and theoretically based. Virtual reality (VR) offers promise to fill this need and teach child pedestrian safety skills for several reasons, including: (A) repeated unsupervised practice without risk of injury, (B) automated feedback on crossing success or failure, (C) tailoring to child skill levels: (D) appealing and fun training environment, and (E) most recently given technological advances, potential for broad dissemination using mobile smartphone technology.Objectives and methodsExtending previous work, we will evaluate delivery of an immersive pedestrian VR using mobile smartphones and the Google Cardboard platform, technology enabling standard smartphones to function as immersive VR delivery systems. We will overcome limitations of previous research suggesting children learnt some pedestrian skills after six VR training sessions but did not master adult-level pedestrian skills by implementing a randomised non-inferiority trial with two equal-sized groups of children ages 7–8 years (total N=498). All children will complete baseline, postintervention and 6-month follow-up assessments of pedestrian safety and up to 25 30-min pedestrian safety training trials until they reach adult levels of functioning. Half the children will be randomly assigned to train in Google Cardboard and the other half in a semi-immersive kiosk VR. Analysis of Covariance (ANCOVA) models will assess primary outcomes.DiscussionIf results are as hypothesised, mobile smartphones offer substantial potential to overcome barriers of dissemination and implementation and deliver pedestrian safety training to children worldwide.
Journal Article
Distraction produces over-additive increases in the degree to which alcohol impairs driving performance
Rationale
Research indicates that alcohol intoxication and increased demands on drivers’ attention from distractions (e.g., passengers and cell phones) contribute to poor driving performance and increased rates of traffic accidents and fatalities.
Objectives
The present study examined the separate and combined effects of alcohol and distraction on simulated driving performance at blood alcohol concentrations (BrACs) below the legal driving limit in the USA (i.e., 0.08 %).
Methods
Fifty healthy adult drivers (36 men and 14 women) were tested in a driving simulator following a 0.65-g/kg dose of alcohol and a placebo. Drivers completed two drive tests: a distracted drive, which included a two-choice detection task, and an undistracted control drive. Multiple indicators of driving performance, such as drive speed, within-lane deviation, steering rate, and lane exceedances were measured.
Results
Alcohol and distraction each impaired measures of driving performance. Moreover, the magnitude of alcohol impairment was increased by at least twofold when tested under the distracting versus the undistracted condition.
Conclusions
The findings highlight the need for a clearer understanding of how common distractions impact intoxicated drivers, especially at BrACs that are currently legal for driving in the USA.
Journal Article
Investigating Helmet Promotion for Cyclists: Results from a Randomised Study with Observation of Behaviour, Using a Semi-Automatic Video System
Half of fatal injuries among bicyclists are head injuries. While helmet use is likely to provide protection, their use often remains rare. We assessed the influence of strategies for promotion of helmet use with direct observation of behaviour by a semi-automatic video system.
We performed a single-centre randomised controlled study, with 4 balanced randomisation groups. Participants were non-helmet users, aged 18-75 years, recruited at a loan facility in the city of Bordeaux, France. After completing a questionnaire investigating their attitudes towards road safety and helmet use, participants were randomly assigned to three groups with the provision of \"helmet only\", \"helmet and information\" or \"information only\", and to a fourth control group. Bikes were labelled with a colour code designed to enable observation of helmet use by participants while cycling, using a 7-spot semi-automatic video system located in the city. A total of 1557 participants were included in the study.
Between October 15th 2009 and September 28th 2010, 2621 cyclists' movements, made by 587 participants, were captured by the video system. Participants seen at least once with a helmet amounted to 6.6% of all observed participants, with higher rates in the two groups that received a helmet at baseline. The likelihood of observed helmet use was significantly increased among participants of the \"helmet only\" group (OR = 7.73 [2.09-28.5]) and this impact faded within six months following the intervention. No effect of information delivery was found.
Providing a helmet may be of value, but will not be sufficient to achieve high rates of helmet wearing among adult cyclists. Integrated and repeated prevention programmes will be needed, including free provision of helmets, but also information on the protective effect of helmets and strategies to increase peer and parental pressure.
Journal Article
Psychological debriefing for road traffic accident victims: Three-year follow-up of a randomised controlled trial
Psychological debriefing is widely used for trauma victims but there is uncertainty about its efficacy. We have previously reported a randomised controlled trial which concluded that at 4 months it was ineffective.
To evaluate the 3-year outcome in a randomised controlled trial of debriefing for consecutive subjects admitted to hospital following a road traffic accident.
Patients were assessed in hospital by the Impact of Event Scale (IES), Brief Symptom Inventory (BSI) and questionnaire and re-assessed at 3 months and 3 years. The intervention was psychological debriefing as recommended and described in the literature.
The intervention group had a significantly worse outcome at 3 years in terms of general psychiatric symptoms (BSI), travel anxiety when being a passenger, pain, physical problems, overall level of functioning, and financial problems. Patients who initially had high intrusion and avoidance symptoms (IES) remained symptomatic if they had received the intervention, but recovered if they did not receive the intervention.
Psychological debriefing is ineffective and has adverse long-term effects. It is not an appropriate treatment for trauma victims.
Journal Article
The ROARI project – Road Accident Acute Rehabilitation Initiative: a randomised clinical trial of two targeted early interventions for road-related trauma
Objectives:
To determine the effectiveness of an Early Rehabilitation Intervention (ERI ) versus a Brief Education Intervention (BEI) following road trauma. Primary objective: return to work or usual activities at 12 weeks (for minor/moderate injury) and 24 weeks for major injury. Secondary objectives: Reduction in pain, anxiety, depression, disability and incidence of Post Traumatic Stress Disorder and improved quality of life.
Design:
A multi-site single-blinded stratified randomized clinical trial (RCT).
Methods:
184 patients (92 in each arm) were recruited over 18 months and followed for 12 weeks (minor/moderate injury) and 24 weeks (major injury). Screening questionnaires at 2-4 weeks and follow-up interviews by phone for all outcome measures were undertaken. For those in the ERI group with a positive screen for high risk of persistent symptoms, an early assessment and intervention by a Rehabilitation Physician was offered. Those in the BEI group were sent written information and advised to see their GP.
Results:
89.4% of injuries were mild in this cohort. At 12 weeks 73.8% and 69.1% of patients in the ERI and the BEI groups respectively had returned to work or usual activities. There were no significant differences between the two intervention groups with respect to the primary or any secondary outcome measures.
Conclusion:
This is the first RCT of an ERI following road trauma in Australia. A targeted ERI is as effective as a BEI in assisting those with mild/moderate trauma to return to work or usual activities.
Journal Article