Differences In Subjective Well-being Research Articles

Associations between subjective well-being and subcortical brain volumes

To study the underpinnings of individual differences in subjective well-being (SWB), we tested for associations of SWB with subcortical brain volumes in a dataset of 724 twins and siblings. For significant SWB-brain associations we probed for causal pathways using Mendelian Randomization (MR) and estimated genetic and environmental contributions from twin modeling. Another independent measure of genetic correlation was obtained from linkage disequilibrium (LD) score regression on published genome-wide association summary statistics. Our results indicated associations of SWB with hippocampal volumes but not with volumes of the basal ganglia, thalamus, amygdala, or nucleus accumbens. The SWB-hippocampus relations were nonlinear and characterized by lower SWB in subjects with relatively smaller hippocampal volumes compared to subjects with medium and higher hippocampal volumes. MR provided no evidence for an SWB to hippocampal volume or hippocampal volume to SWB pathway. This was in line with twin modeling and LD-score regression results which indicated non-significant genetic correlations. We conclude that low SWB is associated with smaller hippocampal volume, but that genes are not very important in this relationship. Instead other etiological factors, such as exposure to stress and stress hormones, may exert detrimental effects on SWB and the hippocampus to bring about the observed association.

National baselines for the Sustainable Development Goals assessed in the SDG Index and Dashboards

The Sustainable Development Goals map out a broad spectrum of objectives. Analytical tools in form of the Index and Dashboards provide a starting point to set national baselines, and allow comparison of the SDGs with other indices of well-being. The Sustainable Development Goals (SDGs) — agreed in 2015 by all 193 member states of the United Nations and complemented by commitments made in the Paris Agreement — map out a broad spectrum of economic, social and environmental objectives to be achieved by 2030. Reaching these goals will require deep transformations in every country, as well as major efforts in monitoring and measuring progress. Here we introduce the SDG Index and Dashboards as analytical tools for assessing countries' baselines for the SDGs that can be applied by researchers in the cross-disciplinary analyses required for implementation. The Index and Dashboards synthesize available country-level data for all 17 goals, and for each country estimate the size of the gap towards achieving the SDGs. They will be updated annually. All 149 countries for which sufficient data is available face significant challenges in achieving the goals, and many countries' development strategies are imbalanced across the economic, social and environmental priorities. We illustrate the analytical value of the index by examining its relationship with other widely used development indices and by showing how it accounts for cross-national differences in subjective well-being. Given significant data gaps, scope and coverage of the Index and Dashboards are limited, but we suggest that these analyses represent a starting point for a comprehensive assessment of national SDG baselines and can help policymakers determine priorities for early action and monitor progress. The tools also identify data gaps that must be closed for SDG monitoring.

Children's subjective well-being in relation to gender — What can we learn from dissatisfied children?

Gender differences in subjective well-being (SWB) are a common finding in studies of children, but the nature, causes and effects of these differences remain unclear. This article draws on data from the Children's Worlds study, an international survey of child well-being across countries, to examine the structure of SWB drawing on different life domains, and comparing the effects of these domains on SWB for boys and girls. Structural equation modelling is used to examine differences between 12year old boys and girls who reported low subjective well-being (bottom 25% of the sample). Findings reveal that the structure of SWB is comparable across the genders; girls' SWB was lower than boys'; and different domains of SWB vary in their importance for boys and girls. Specifically, girls' SWB appears to be more driven by relational factors, whilst boys' SWB is more driven by perceived academic achievement.

Randomized Trial on Fast Track Care in Colorectal Surgery for Deep Infiltrating Endometriosis

Study ObjectiveTo study the application of a fast-track care protocol in colorectal surgery for deep infiltrating endometriosis. Bowel endometriosis is an infrequent but not rare condition that often needs intestinal surgery and imposes a high economic burden on society. DesignProspective randomized trial (Canadian Task Force classification I). SettingTertiary referral center. PatientsTwo hundred twenty-seven patients with preoperative evidence of bowel endometriosis. InterventionsWe randomly assigned 227 patients with preoperative evidence of bowel endometriosis to a fast-track protocol (no preoperative bowel preparation, early restoration of diet, no postoperative antibiotics, and early postoperative mobilization) or conventional care for laparoscopic intestinal surgery. Randomization was obtained on a double-blind, date-based schedule, and all procedures were performed by a homogenous group of expert surgeons. Surgical outcomes and a health economic evaluation were assessed. Measurements and Main ResultsThe primary outcome was hospital stay. Patient's well-being and intraoperative and postoperative complications up to 30 days after surgery were also assessed. Subsequently, direct medical costs were analyzed. Patients assigned to the fast-track protocol were discharged earlier (median 3 vs 7 days, p < .001) with no significant differences in subjective well-being (p = .55). Operative details, postoperative complications, and need of temporary ileostomy were similar (p = .89) between groups as well as readmission rates within 30 days (p = .69). The application of a fast-track protocol resulted in an overall significant reduction of costs (USD 6699 vs 8674, p < .01), and differences were more evident in cases of protective stoma (7652 vs 8793, p < .05) and surgery with postoperative complications (10 835 vs 14 005, p < .01). ConclusionThe application of a fast-track care protocol for laparoscopy in cases of pelvic and intestinal endometriosis does not increase the risk of complications and ensures a reduction of medical costs.

Italian and Swedish adolescents: differences and associations in subjective well-being and psychological well-being.

BackgroundOne important aspect of subjective judgments about one’s well-being (i.e., subjective well-being: life satisfaction, positive affect, and negative affect) is that cultural features, such as, nationality seem to shape cognitive judgments about the “the ideal life.” In this comparative study we examined differences in subjective well-being and psychological well-being between Italian and Swedish adolescents and tested if the relationship between the three constructs of subjective well-being (i.e., satisfaction with life, positive affect, and negative affect) and psychological well-being was moderated by the adolescents’ nationality.MethodItalian (n = 255) and Swedish (n = 277) adolescents answered to the Satisfaction with Life Scale, the Positive Affect Negative Affect Schedule, and Ryff’s Scales of Psychological Well-Being. Differences between samples were tested using a Multiple Analysis of Variance. We also conducted a multiple group analysis (Italy and Sweden) using Structural Equation Modelling to investigate the relationship between all three subjective well-being constructs and psychological well-being.ResultsItalian adolescents scored significantly higher in satisfaction with life than Swedish adolescents. Additionally, across countries, girls scored significantly higher in negative affect than boys. In both countries, all three constructs of subjective well-being were significantly associated to adolescents’ psychological well-being. Nevertheless, while the effect of the relationship between affect and psychological well-being was almost the same across countries, life satisfaction was more strongly related to psychological well-being among Swedish adolescents.ConclusionsThe present study shows that there are larger variations between these two cultures in the cognitive construct of subjective well-being than in the affective construct. Accordingly, associations between the cognitive component, not the affective component, of subjective well-being and psychological well-being differ between countries as well.

Differences in Subjective Well-being Between Older Migrants and Natives in Europe

This study examines disparities in subjective well-being (SWB) among older migrants and natives across several European countries using data from the Survey of Health, Aging and Retirement in Europe (SHARE). Our results show a significant SWB gap between migrants and non-migrants that diminishes with increasing age. While migrants from Northern and Central Europe have similar SWB levels as natives, Southern European, Eastern European, and Non-European migrants have significantly lower levels of SWB than the native population. The immigrant-native gap becomes smaller but remains significant after controlling for sociodemographic characteristics and health, the financial situation, citizenship, age at migration, and length of residence. Additionally, we find that the size of the SWB gap varies largely across countries. Current family reunion policies as measured by the Migrant Integration Policy Index (MIPEX) correlate with these country differences. The immigrant-native gap is bigger in countries with restrictive and smaller in countries with open policies.

How animals contribute to subjective well-being: A comprehensive model of protective and risk factors

In this paper, we elaborate and test a comprehensive theoretical model of SWB of animal caregivers. This model includes risk factors such as restrictions in daily life, negative emotions, and financial strain, and protective factors such as a sense of purpose in life, positive emotions, and physical activities. The model was tested in a sample of caregivers of dogs, cats, and horses (N = 631). Higher levels of satisfaction of the need for autonomy, experiencing more positive emotions, and greater fulfillment of social roles through the animal were positively associated with SWB, whereas experiencing more negative emotions, greater financial strain due to the animal, and degree of attachment to the animal were negatively associated with SWB. The proposed model is suitable to explain differences in subjective well-being among animal caregivers and may be valid across different types of animal caregivers.

Why Do Easterners Have Lower Well-Being Than Westerners? The Role of Others’ Approval Contingencies of Self-Worth in the Cross-Cultural Differences in Subjective Well-Being

Previous studies have shown that Easterners generally perceive themselves as having lower subjective well-being compared with Westerners, and several mechanisms causing such differences have been identified. However, few studies have analyzed the causes of such differences from the perspective of the cross-cultural differences in the meanings of important life events such as whether people receive approval from others. Specifically, events regarding others’ approval might have different meanings to and influences on Easterners and Westerners. Thus, the degree of fluctuation of people’s views of self-worth in response to these events (i.e., others’ approval contingencies of self-worth [CSW]) probably differs between Easterners and Westerners. This may be a reason for cross-cultural differences in subjective well-being. We investigated two samples of undergraduate students from Taiwan and the United States to examine the mediating role of others’ approval CSW in forming cross-cultural differences in subjective well-being. The results revealed that Taiwanese participants exhibited lower subjective well-being and higher others’ approval CSW than American participants. In addition, others’ approval CSW partially mediated the cross-cultural differences in subjective well-being. Thus, one reason for lower subjective well-being among Easterners was likely that their self-esteem was more prone to larger fluctuations depending on whether they receive approval from others in everyday life.

Subjective well-being in a remote culture: The Himba

Existing studies of cultural differences in subjective well-being (SWB) have tended to focus on more Westernised and industrialised cultural groups, and have paid less attention to heterogeneity within cultural groups that share the same national boundary, but differ in level of urbanisation. This study considers differences in life satisfaction within the Himba of Namibia. The research looks across three groups; semi-nomadic and non-literate Himba, living their traditional lives in remote Namibian villages; Himba that have chosen to move to the local town; and, a sample of UK adults. Participants were administered the Satisfaction with Life Scale (Diener, Emmons, Larson, & Griffin, 1985). Results showed that the Rural Himba group had significantly higher levels of life satisfaction compared to the Urban Himba, and both Himba groups had significantly higher life satisfaction scores than a sample of UK adults matched for age and gender with the Himba. The results run contrary to the findings of other studies where more wealthy cultures tended to have higher SWB than less wealthy cultures.

Housing and subjective well-being of older adults in Europe

Housing quality is known to be related to subjective well-being (SWB), but much less is known how this relationship varies with national contexts. This study addresses the association between housing tenure and housing quality on the one hand and the SWB of older Europeans on the other, given the differences in housing markets across Europe. Data from the Survey of Health, Ageing and Retirement in Europe were used, and linear regression models of SWB were estimated for 16 European countries. The findings indicate that being a renter is negatively related to SWB, while having a large house is positively associated with it. The negative effect of being a renter on SWB is small in several countries with accessible and well-regulated rental markets. Moreover, the difference in SWB between older people with a small and a large dwelling is somewhat smaller in countries with a high level of housing quality than in countries with lower housing quality. For each of our housing indicators, however, we also found countries for which the findings deviated from the general pattern. The findings imply that housing-market characteristics matter to how housing relates to SWB and, therefore, that housing-market interventions might affect this relationship.

What Matters in for the Subjective Well-Being of Children in Care?

Children’s subjective well-being (SWB) constitutes an important component in understanding their quality of life. However, little is known about children in public care regarding their perceptions and satisfaction with life. The purpose of this study is to explore differences in SWB between adolescents in residential care, kinship care and family foster care with no relatives. The study used data from care population in Catalonia (Spain) aged 12–14 years (N = 669): 397 adolescents in residential care, 251 adolescents in kinship care and 41 adolescents in non-kinship foster care. The questionnaire of the International Survey of Children’s Well-Being (ISCWeB) was adapted for children in care. It includes a psychometric scale on SWB, the Personal Well-Being Index-School Children (PWI-SC6). Multiple regressions have been used to explore which factors are related to children’s subjective well-being according to type of placement. Findings showed that adolescents living in kinship and non-kinship foster care reported better SWB in all life domains than those in residential care. On one hand, variables as gender and age and on the other hand, the agreement with their placement, satisfaction with the school, with their relationships with friends, and with their use of time and computer, may have an influence on their SWB. These findings highlight the need to address the participation of children any decision that affects their lives, the importance of supporting the education of children in care, and the importance of having friends and of their leisure time. Results are discussed in view of the value of practice and political implications.

Spousal similarity in life satisfaction before and after divorce.

Previous research has explored possible origins of individual differences in subjective well-being, focusing largely on stable, internal characteristics of traits as predictors of life satisfaction (Diener & Lucas, 1999). Although past work has demonstrated that life satisfaction is largely stable over the life span, other evidence has also demonstrated the lasting impact of life events. In this study, we use married couples as a test of the impact of life circumstances on life satisfaction, focusing on similarity in life satisfaction before and after divorce. If life satisfaction is impacted by shared life circumstances, married couples (who share life circumstances) should show greater similarity in life satisfaction before divorce than after. We tested this possibility using a dyadic latent-state-trait model that examined cross-spouse similarity in the stable and changing components of life satisfaction. Using a nationally representative panel study from Germany (Wagner, Frick & Schupp, 2007), we showed that similarity declined substantially following divorce. This suggests that life satisfaction is related to shared life circumstances.

Does Variation in the Extent of Generalized Trust, Individual Education and Extensiveness of Social Security Policies Matter for Maximization of Subjective Well-Being?

In this paper, I examine whether generalized trust and education, as well as social security policies of welfare state institutions matter for cross-national differences in subjective well-being (SWB), because knowledge on this issue is still lacking. For this purpose I integrated the insights of two sociological theories: Social Function Production theory and Actor-Centred Institutionalism. Based on these theoretical notions we derived several hypotheses, which I tested using multilevel analysis of the data from the European Social Survey (2006), in a sample of 37,237 respondents from 22 European countries. My findings indicate that various extensiveness of social security policies matter for the level of SWB, and for the impact of education on SWB. I found negative impact of low education on SWB in all countries, except in Northern and Western European countries. This might suggest that social security policies of the latter countries have diminished the negative impact of low education on SWB. Moreover, my findings indicate positive relationship between individual education and generalized trust; as well as between generalized trust and SWB in countries with all five types of social security polices.

A Genetic Component to National Differences in Happiness

National differences in subjective well-being (SWB) have been attributed to socioeconomic, climatic, and genetic factors. We focus on one particular facet of SWB—happiness or positive affect—measured by the nationally representative World Values Survey (WVS). We find that national percentages of very happy people across the three latest WVS waves (2000–2004, 2005–2009, 2010–2014) are consistently and highly correlated with national prevalence of the rs324420 A allele in the FAAH gene, involved in the hydrolysis of anandamide, a substance that reportedly enhances sensory pleasure and helps reduce pain. Climatic differences are also significantly associated with national differences in happiness, whereas economic wealth, recent economic growth, rule of law, pathogen prevalence, and the distribution of short versus long alleles in the serotonin transporter gene SLC6A4 are not significant predictors of national happiness.

The role of taekwondo training on the subjective wellbeing of adolescents in Addis Ababa, Ethiopia

&lt;p&gt;The purpose of this study was to investigate the role of taekwondo (TKD) training on the subjective well-being (SWB) of adolescents (12-18 years old) in Addis Ababa city. A cross-sectional survey method was used; self-administered questionnaire was the main data collection tool. A total number of 162 adolescents (108 TKD adolescents from four randomly selected TKD clubs and 54 non-TKD adolescents from a randomly selected public high school), participated in the study. The study sought to determine TKD adolescents’ level of SWB as measured by the Personal Wellbeing Index – School Children (PWI-SC). Besides, adolescents in different groups (TKD adolescents in three groups according to rank/belt level and TKD adolescents and non-TKD adolescents) were compared based on their score of PWI-SC. Results of the study showed that: (1) TKD adolescents had high level (mean points) of SWB as measured by the PWI-SC, i.e., 81.95 (95%CI: 79.70 to 84.20); (2) there was no significant difference in SWB among the three groups of TKD adolescents (lower, middle and high level belts) (F&lt;sub&gt;(2, 81)&lt;/sub&gt; = 1.58, &lt;em&gt;p&lt;/em&gt; &amp;gt; .05.); and (3) when compared with non-TKD adolescents, TKD adolescents were found to have a significantly higher mean points of SWB, (&lt;em&gt;t&lt;/em&gt; = 4.25&lt;sub&gt;(77.97)&lt;/sub&gt;, &lt;em&gt;p&lt;/em&gt; &amp;lt; 0.001; &lt;em&gt;d &lt;/em&gt;= 0.79). Overall, the results of this study indicated the training of TKD can have a positive contribution to adolescents’ well-being.&lt;/p&gt;

How Welfare-State Regimes Shape Subjective Well-Being Across Europe

Welfare-state regimes achieve different outcomes in dealing with social inequalities. For example, the social democratic or Scandinavian welfare-state regime is often considered as the most egalitarian with a high social transfer rate and a comparably low level of income inequality. While most research on welfare-state regimes focuses on objective indicators of quality of life and inequalities, we are interested in how citizens actually evaluate their lives, using subjective well-being (SWB) as an indicator. The paper deals with two research questions: (1) How does the welfare-state regime affect subjective well-being, and (2) does the welfare-state regime influence the effect of status on SWB? Status is an essential first-order goal to produce subjective well-being according to the social production theory of Lindenberg and colleagues (Ormel et al. 1999), but is also linked to many other instrumental goals such as comfort and stimulation. The study carries out a multilevel analysis using pooled European Social Survey data from the years 2002–2012, covering more than 30 European countries. While we first look at how status drives SWB levels in different welfare-state regimes as classified by Esping-Andersen 1990, 1999), our focus is mainly on cross-level interactions between welfare-state regime type and the relationship between status and SWB. Our results provide evidence that social-democratic welfare-state regimes not only provide for living standards that are associated with the highest SWB levels, but also compensate best for status differences in SWB compared to other welfare-state regimes.

Role of Optimism and Sense of Humor towards Subjective Well Being among College Students

This study is conducted for predicting, the role of optimism & sense of humor towards subjective wellbeing among college students. The main obj ectives of this study are to identify the role of humor towards subjective well-being, to understand the role of optimism towards subjective well-being and to examine the gender difference in level of subjective well-being, humor and optimism.The last two decades show an increasing interest of scientists to subjective wellbeing (SWB) studies. Subjective well-being (SWB) refers to one's perception of quality of life (McNeil, Stones, & Kozma, 1986). It is a measure of how someone feels about his life at a given moment (Ehrlich & Isaacowitz, 2002). It includes emotional reactions to events, feelings, pleasures, satisfaction with life and satisfaction with specific areas such as marriage and work (Diener, Oishi, & Lucas, 2003). A little humor can brighten one's outlook, and optimism can fuel humor. In similar vein, Fry (1995) also found that humor and optimism moderate the effects of daily hassles on self-esteem and physical health. Britt (2005) found that perfectionism, humor, and optimism moderate the deleterious effects of daily hassles on self-esteem, burnout and physical health. He further found that humor is directly linked to optimism. Humor and optimism play a beneficial role in relieving stress in students and maintaining one's life satisfaction.Most studies on subjective well-being are conducted among college students (Emmons & Diener, 1986 Steger & Kashan, 2007 cited in Galang, Magno, Paterno, & Roldan, 2011) because of age-related changes and high activation of emotions as individuals develop in this age period. College students (graduate students) face a barrage of challenges in their daily life. Aside from doing their home works, projects and extra-curricular activities, they also have responsibilities at home as a son or daughter, brother or sister and as a friend. Thus, it is vital to understand the importance of their life purpose and their well-being. Emmons and Diener (1986) worked on the assumption that the successful pursuit of meaning in life plays an important role in the development of individuals' psychological well-being. That is why there is an increasing attention to subjective well-being (Inglehart, 1993).Current study also assessed, if there is any gender difference between SWB, humor & optimism.Subjective well-beingSubjective well-being (SWB) is defined as 'a person's cognitive and affective evaluations of his or her life (Diener, Lucas, & Oshi, 2002, p. 63). Robbins and Kliewer (2000) refers to subjective well-being to the self-evaluation of life satisfaction. In line with this, life satisfaction refers to the satisfaction experienced by an individual in his or her life as a whole; it is the cognitive element referred to what one thinks about his or her life satisfaction in global terms (life as a whole) and in domain terms (in specific areas of life such as work, relationships, etc.) On the other hand, subjective happiness is inherently defined from the perspective of a person (Emmons & Diener, 1986; Omodci & Wearing, 1990; Plays & Little, 1983; Ruehlman & Wolchik, 1988). The affective element refers to emotions, moods and feelings. Subjective well-being can be expressed in simple terms like saying oftently, I feel good and I feel (Schwartz & Strack, 1999).The study of subjective well-being is a central concern of positive psychology. Researchers in positive psychology have pointed out that in almost every culture studied the pursuit of happiness is regarded as one of the most valued goals in life. Understanding individual differences in subjective well-being is of key interest in positive psychology, particularly the issue of why some people are happier than others. Some people continue to be happy in the face of adversity whereas others are chronically unhappy at the best of times. …

Subjective well-being and hookah use among adults in the United States: A nationally-representative sample

BackgroundUsing a nationally-representative dataset of adults 18–30 years old in the United States, this study examined the relationship between hookah use and subjective well-being. Levels of sadness, happiness, tiredness, pain, and stress were compared between persons who have used hookah and those who have not. MethodsData were merged from the Tobacco Use Supplement of the Current Population Survey, the American Time Use Survey, and the Subjective Well-being Supplement to the American Time Use Survey for the years 2010–2012 for persons 18–30 years old (n=1147). Wald tests were used to compare mean differences in subjective well-being between hookah users and non-users. Lastly, multivariable regression was used to determine whether there were significant differences in subjective well-being between hookah users and non-users, controlling for demographic factors, self-perceived health, and cigarette smoking. ResultsThe lifetime prevalence rate of hookah use was 5.2% among 18–30 year olds. Hookah users reported higher levels of stress and sadness than non-users. These relationships remained significant after controlling for demographic characteristics, self-perceived health, and cigarette use. The results were robust to the use of different statistical models, different age cut-offs, the inclusion of additional covariates (such as income and population density), and separate analyses by sex. ConclusionsHookah use is an emerging public health issue associated with increased levels of stress and sadness. Similar to cigarette use, healthcare providers may consider expanding their screening tests to include hookah use. Public policy geared toward greater prevention and control of hookah use is also recommended.

Linking health states to subjective well-being: an empirical study of 5854 rural residents in China

ObjectivesDespite a maturing literature on the association between subjective well-being (SWB) and health status of the general population in Western countries, little is known regarding the happiness–health relation in China, and rural populations in particular. This study was aimed to explore the correlation between SWB and health states of China's rural residents. Study designCross-sectional survey. MethodsData derived from a household survey conducted in 2010 with 5854 rural residents included. The single-item self-reported happiness measure used in the World Values Survey was employed to measure SWB. EQ-5D dimensions and visual analogue scale (VAS) were applied to measure subjective health status. The number of chronic diseases was used as proxy of objective health status. OLS regressions were performed to estimate the variation in SWB by health status and β coefficients were employed as effect size measures. ResultsAmong EQ-5D dimensions, anxiety/depression had the strongest negative effect on SWB. Having severe anxiety/depression problems could reduce SWB by 1.65 on a scale 1–4. Reporting severe problems in pain/discomfort could also reduce SWB by 0.41, while the impact of other dimensions was insignificant. The coefficient on VAS implied a difference in SWB of 1.60 between the worst health state and the best health state. And suffering from three chronic diseases could reduce SWB by 0.62, but the effect turned insignificant when all measures of subjective health status were entered in the regression. ConclusionsThe results from this study verify the strongly negative effect of the mental health dimension on SWB in the context of rural China. And suffering from chronic diseases has substantial negative effect on SWB even after subjective health status is controlled for. But the impact of chronic diseases on SWB could be fully captured when all measures of subjective health status are taken into account.

Perfiles resilientes y calidad de vida en personas con discapacidad sobrevenida por accidentes de tráfico

ObjectivesTo identify distinct profiles of resilience in people with spinal cord injuries due to traffic accidents and to determine whether the profiles identified are related to differences in subjective well-being. MethodsThe Resilience Scale (Wagnild and Young, 1993) and an adapted quality of life scale (GENCAT) were administered to 98 people with physical disabilities due to traffic accidents. ResultsCluster analyses identified three different resilience profiles: a high-resilience group, a low-resilience group, and a group showing a predominance of high scores in self and life acceptance and social competence. The results also revealed statistically significant differences among profiles in most domains of subjective well-being. ConclusionThe results suggest the need to study resilience in greater depth and to design programs to enhance quality of life among people with disabilities due to traffic accidents.