Penalty Point System Research Articles

Investigation on Deterrence Effect of Legal Punishment Measures on Driving After Drinking in Chongqing, China

Objective: Driving after drinking is one of the main causes associated with road accidents in China. China has been concerned about this serious problem and updated the regulations of road traffic safety law about driving after drinking 3 times in the last 10 years to deter this offense. The deterrence effect of the current punishment measures implemented since January 2013 was studied in this article.Methods: Data applied in the study were collected by questionnaire surveys carried out in Chongqing, a city in southwest China. A total of 329 drivers participated in 3 rounds of the survey and a 5-point scale rating was applied in the investigation.Results: There was a slight difference between drivers’ familiarity of the law regarding driving after drinking in April 2013 and April 2014. The perceived certainty of being caught for driving after drinking was higher in April 2013 than in April 2014 and it had a time-dependent decreasing tendency. Our investigations also show that license suspension is the most practical and effective measure and penalty points system ranks second. A monetary fine appears to be inefficient to achieve the desired effects.Conclusions: The fourth edition of the Road Traffic Safety Law of the People’s Republic of China, which took effect in January 2013 coinciding with the application of random breath testing and intensification of enforcement activity, is effective in deterring driving after drinking according to our investigation. More measures should be implemented to change the decreasing tendency of perceived certainty of being caught for driving after drinking. An increase in the monetary fine is suggested.

Examiner and simulated patient ratings of empathy in medical student final year clinical examination: are they useful?

BackgroundMany medical schools state that empathy is important and have curricular learning outcomes covering its teaching. It is thought to be useful in team-working, good bedside manner, patient perspective taking, and improved patient care. Given this, one might expect it to be measured in assessment processes. Despite this, there is relatively little literature exploring how measures of empathy in final clinical examinations in medical school map onto other examination scores. Little is known about simulated patient (actors) rating of empathy in examinations in terms of inter-rater reliability compared with clinical assessors or correlation with overall examination results.MethodsExaminers in final year clinical assessments in one UK medical school rated 133 students on five constructs in Objective Structured Long Examination Record (OSLER) with real patients: gathering information, physical examination, problem solving, managing the diagnosis, and relationship with the patient. Scores were based on a standardized well-established penalty point system. In separate Objective Structured Clinical Examination (OSCE) stations, different examiners used the same penalty point system to score performance in both interactional and procedural stations. In the four interaction-based OSCE stations, examiners and simulated patient actors also independently rated empathy of the students.ResultsThe OSLER score, based on penalty points, had a correlation of −0.38 with independent ratings of empathy from the interactional OSCE stations. The intra-class correlation (a measure of inter-rater reliability) between the observing clinical tutor and ratings from simulated patients was 0.645 with very similar means. There was a significant difference between the empathy scores of the 94 students passing the first part of the sequential examination, based on combined OSCE and OSLER scores (which did not include the empathy scores), and 39 students with sufficient penalty points to trigger attendance for the second part (Cohen’s d = 0.81).ConclusionsThese findings suggest that empathy ratings are related to clinical performance as measured by independent examiners. Simulated patient actors are able to give clinically meaningful assessment scores. This gives preliminary evidence that such empathy ratings could be useful for formative learning, and bolsters the call for more research to test whether they are robust enough to be used summatively.

The impact of the penalty point system on the behaviour of young drivers and passengers in Spain

Traffic accidents are one of the main causes of death amongst young people in the European Union and Spain is no exception. In an attempt to reduce road fatalities, the Spanish government introduced a legislative measure which is based upon the loss of points if caught transgressing the traffic laws. After the introduction of the penalty point system (PPS) the Spanish government reported that the number of accidents and fatalities decreased. Therefore, the aim of the present study was to investigate self-reported changes in the behaviour of young drivers and passengers following the implementation of the PPS in Spain. A cross sectional survey was carried out with 1452 undergraduate university students (52.8% female; Mean age=21.5; S.D.=2.5). The results show that young Spanish drivers reduced their risky driving behaviour and increased their use of safety equipment after the PPS was introduced, although there were gender differences. Specifically, more females (than males) reported that they: stopped driving while under the influence of alcohol, exceeded the speed limit less often and began wearing their seat belt at all times after the PPS was introduced. These changes in behaviour may account for the observed reduction in traffic crashes and fatalities reported by the Spanish government. Nevertheless, despite the PPS many young drivers continued to engage in risky driving behaviour.

Impact of road safety interventions on traffic-related occupational injuries in Spain, 2004–2010

ObjectivesTo evaluate the impact of road safety interventions, including the penalty point system (PPS) and the reformed Spanish penal code (RPC), on traffic-related occupational injuries in Spain. MethodsThe study design was an interrupted time-series with a comparison group. The study group had traffic-related, occupational injuries incurred during working and commuting hours; the comparison group had non-traffic-related injuries incurred at the work site. A negative binomial regression model was used to determine the relative risk (RR) of sustaining occupational injuries for the post-intervention periods compared to the non-intervention period. ResultsNon-fatal, traffic-related injuries did not significantly change after the PPS and RPC implementations, except for those occurred in commuting hours, which increased significantly after the PPS. On the other hand, after the RPC, fatal, traffic-related injuries decreased significantly during working hours (0.79; 95%CI 0.65 to 0.97) and commuting hours (RR: 0.63; 95%CI:0.56 to 0.72), although fatal, non-traffic-related injuries also decreased at the work site. ConclusionsRoad safety interventions did not clearly affect traffic-related occupational injuries in Spain. Specific occupational risk factors could influence the occurrence of those injuries.

Impact of the Penalty Points System on Severe Road Traffic Injuries in Kuwait

Objective: This study aimed to examine the effect of a penalty points system (PPS) implemented in early July 2006 on the number of severe road traffic injuries (RTIs) in Kuwait. Methods: Monthly counts of RTIs that occurred between January 2003 and December 2009 were analyzed. We used an interrupted seasonal autoregressive integrated moving average model (SARIMA) to estimate the intervention parameter along with its 95 percent confidence interval (CI) after accounting for seasonal and trend components in the data series. Based on the SARIMA model, we computed the number of RTIs that would have occurred post-PPS for 42 months after July 1, 2006, if it had not been implemented. Results: During the study period, a total of 4696 RTIs occurred. The Poisson rates of injuries (per 10 million of mean mid-year population and per 10 million of annual mean number of registered vehicles) were significantly (P < .001) lower in the post-PPS (λpost-PPS = 7 and 16, respectively) than the pre-PPS (λpre-PPS = 9 and 23, respectively) implementation period. The intervention parameter's estimate was −7.68 (95% CI: −14.77, −0.60), suggesting that 322 (95% CI: 25, 620) individuals would have had RTIs in the 42 months post-PPS enactment, had it not been implemented. This translates to a 14.6 percent (95% CI: 1.1%, 28.0%) reduction. Conclusions: These findings suggest that PPS implementation in Kuwait appears to have resulted in a significant reduction in the number of RTIs in the ensuing period. Therefore, PPS seems a feasible and effective approach in reducing RTIs in Kuwait and other countries in the region, if adequately implemented. Future studies may focus on evaluating the long-term effects of PPS implementation.

Impact of road traffic "penalty points" on high energy pelvic trauma

Background:The penalty points system (PPS) was introduced in 2002 in an attempt to reduce the increasing rate of road traffic accident (RTA) related fatalities and serious injuries. Points are awarded based on the severity of the offence and are cumulative. A total of 12 points results in the disqualification from driving.Objective:A few studies have looked at the immediate or short term impact of PPS on trauma services or specific injuries such as spine trauma in Ireland. Little data is available on the long term effect of the PPS. The aim of this study is to see if the PPS system has had an influence on the number of pelvic injuries referred to our unit for surgical intervention and if this influence is sustained in the longer term.Materials and Methods:A retrospective review of all pelvic and acetabular injuries admitted to our unit from 1999 to 2008 was undertaken. The mechanism of injury, the site and patient demographics were noted.Results:A total of 467 patients were identified over the ten year period. 454 patients were included in the study. There was a significant male preponderance of 76%. Mean age was 36.5 years (range 16 to 83). RTA's were the cause in 74% (n = 335) of the cases. The annual work load remained similar over the years. There has been a reduction in the number of RTA related pelvic injuries. There have been notable drops in the number of these cases corresponding to the introduction of the PPS and its subsequent expansion. The number of pelvic injuries due to falls continues to rise.Conslusion:The introduction of the PPS and its subsequent expansion has had a positive influence on the number of RTA related pelvic trauma. Continued surveillance and enforcement of the PPS is important for a sustained benefit from it in the long term.

The deterrent effects of the penalty points system for driving offences: a regression discontinuity approach

Using data on road accidents, traffic fatalities and driving offences taking place in Italy over the period 2001–2005, we estimate the effects of the introduction on July 2003 of a penalty points system for driving offences. To identify the causal effect of the penalty points system (PPS) on road safety we use a regression discontinuity design. It emerges that, controlling for weather conditions, police patrols, speed cameras, gasoline price, unemployment rate, the introduction of the PPS has led to a reduction of about 9 % of road accidents and of about 30 % of traffic fatalities. These findings are robust to different specifications of the model and different time windows. Moreover, it emerges that the driving offences for which the introduction of the new regime has determined a sharp change in the sanction scheme have reacted more than offences for which the change was less relevant.

Ruling out trouble: Unacceptable behaviour and its control in Hong Kong’s public housing

Resident satisfaction is contingent not only on housing design and construction, but also on neighbourhood quality. However, many neighbourhoods around the world are distressed by neighbourhood nuisances or unacceptable behaviour of the residents. While interventionist approaches and incentives have been adopted in many countries to curb these problems, a punitive measure is used in Hong Kong instead. The Housing Department launched the Marking Scheme for Tenancy Enforcement in Public Housing Estates immediately after the SARS epidemic. The scheme operates as a penalty-point system where sitting tenants will be expelled from public housing if they receive sixteen points for the misdeeds they have committed. Yet, the marking scheme itself was put onto the stage without any prior public consultation. Besides, it has been criticised for its unfair and tenure-biased enforcement. Also, whether the scheme is widely accepted is highly doubtful. Against this background, this study aims to explore the tenants’ views regarding residents’ unacceptable behaviour and the marking scheme in Hong Kong’s public housing. The findings of this research offer valuable insights into the perceived extent and causes of the neighbourhood problems. Moreover, this research lets the public administrators know the acceptability of the marking scheme among public housing tenants.

Social Impacts of the Marking Scheme in Public Housing in Hong Kong

To improve environmental hygiene in public housing estates in Hong Kong, the Housing Department launched the Marking Scheme for Tenancy Enforcement in Public Housing Estates in 2003. The marking scheme operates as a penalty-point system where sitting tenants will be expelled from their public housing units if they receive penalty points up to a certain level for committed misdeeds. By its nature, the marking scheme is a measure to tackle neighbourhood problems or so-called antisocial behaviour (ASB) in public housing. Yet, it was implemented without comprehensive public consultation a priori. Besides, why this control selectively targets public housing tenants but not residents in other housing tenures is not justified. More importantly, no previous attempt has been made to investigate the impacts of the marking scheme. To straddle the existing research gap, this study aims to explore the social impacts brought about by the marking scheme on public housing tenants through a structured questionnaire survey. In the respondents’ eyes, the effectiveness of the scheme to rectify public housing tenants’ bad behaviour is doubtful. Moreover, harmony within families and neighbourliness seems to be undermined by the scheme. Recommendations are then provided to public administrators regarding ASB control in Hong Kong.

The endurance of the effects of the penalty point system in Spain three years after. Main influencing factors

In this work we have used ARIMA time series models to analyse the contribution of the penalty point system, the most important legislative measure for driving licences, in reducing the number of fatalities over 24h on the roads in Spain during the study period (January 1995 to June 2009). In addition, because of this long period of analysis, other control variables were introduced to model the enactment of the Reform of the Penal Code in December 2007, together with other more specific effects needed to fit the model correctly. The ARIMA intervention models methodology combines the basic features of specific times series models: it controls the trend and seasonal variation in data that is present when modelling the structure through autoregressive and moving average parameters and allows for inserting step or impulse input variables for checking and evaluating the effects of deterministic measures, such as legislative changes which are the object of study in this work. This paper analyses the surveillance and control measures introduced in the periods before and after the implementation of the penalty point system and helps to partly explain its apparent endurance over time. The results show that the introduction of the penalty point system in Spain had a very positive effect in reducing the number of fatalities (over 24h) on the road, and that this effect has endured up to the present time. This success may be due to the continuing increase in surveillance measures and fines as well the significantly growing interest shown by the news media in road safety since the measures were introduced. All this has led to positive changes in driver behaviour. It is, therefore, a combination of three factors: the penalty point system, the gradual stepping up of surveillance measures and sanctions, and the publicity given to road safety issues in the mass media would appear to be the key to success. The absence of any of these three factors would have predictably led to a far less positive evolution of the accident rate on Spanish roads.

Impact of the Penalty Points System on Road Traffic Injuries in Spain: A Time–Series Study

We assessed the effectiveness of the penalty points system (PPS) introduced in Spain in July 2006 in reducing traffic injuries. We performed an evaluation study with an interrupted time-series design. We stratified dependent variables-numbers of drivers involved in injury collisions and people injured in traffic collisions in Spain from 2000 to 2007 (police data)--by age, injury severity, type of road user, road type, and time of collision, and analyzed variables separately by gender. The explanatory variable (the PPS) compared the postintervention period (July 2006 to December 2007) with the preintervention period (January 2000 to June 2006). We used quasi-Poisson regression, controlling for time trend and seasonality. Among men, we observed a significant risk reduction in the postintervention period for seriously injured drivers (relative risk [RR] = 0.89) and seriously injured people (RR = 0.89). The RRs among women were 0.91 (P = .095) and 0.88 (P < .05), respectively. Risk reduction was greater among male drivers, moped riders, and on urban roads. The PPS was associated with reduced numbers of drivers involved in injury collisions and people injured by traffic collisions in Spain.

An econometric analysis of the effects of the penalty points system driver's license in Spain

This article seeks to quantify the effects of the penalty points system driver's license during the 18-month period following its coming into force. This is achieved by means of univariate and multivariate unobserved component models set up in a state space framework estimated using maximum likelihood. A detailed intervention analysis is carried out in order to test for the effects and their duration of the introduction of the penalty points system driver's license in Spain. Other variables, mainly indicators of the level of economic activity in Spain, are also considered. Among the main effects, we can mention an average reduction of almost 12.6% in the number of deaths in highway accidents. It would take at least 2 years for that effect to disappear. For the rest of the safety indicator variables (vehicle occupants injured in highway accidents and vehicle occupants injured in accidents built-up areas) the effects disappeared 1 year after the law coming into force.

Ocular injury requiring hospitalisation in the South East of Ireland: 2001–2007

Aim To investigate whether recent socio-demographic changes and recent health and safety measures have impacted on the trends of ocular trauma in the South East of Ireland. Methods We retrospectively reviewed all cases of ocular trauma admitted to our department between October 2001 and September 2007, and the following data were retrieved: demographic details; mechanism of injury and nature of injury. Results During the study period, 517 patients were admitted with ocular trauma. Work-related and home-related activities were the commonest causes of admission, and accounted for 160 (31.8%) and 145 (28.4%) cases, respectively. In 2006/2007, and following the influx of migrant workers from the 10 new EU accession states (EUAS), the incidence of hospitalised ocular injuries per 100,000 was 89 in persons from the EUAS versus 18 in those of Irish origin, P ≤ 0.0001. After adding the offence of not wearing a seat belt to the traffic penalty point system in Ireland, the proportion of road traffic accident (RTA)-related ocular injuries dropped significantly from 6.7% to 2.4%, P = 0.03. Conclusion The inclusion of the offence of not wearing a seat belt in the traffic penalty point system may have contributed to the significantly lower proportion of hospitalised ocular injuries attributable to RTAs. Also, the demographic profile of patients admitted because of ocular trauma has changed over the last 6 years, reflected in an increasing proportion of these injuries in persons from the EUAS. These data will inform healthcare providers, and those involved in developing health and safety guidelines for the workplace.

The effectiveness of the penalty point system on road safety

The penalty point system is an internationally spread strategy aimed to reduce the number of road traffic accidents and its dramatic consequences. This paper summarizes some of the main research projects on the effectiveness of the penalty point system and indicates some issues for further research. The evidence analyzed here suggests that the introduction of the system is an effective way to reduce the number of traffic offences and to improve both road safety and health-related indicators. However, some rigorous studies would still be necessary to clearly separate the effects of the penalty point system from other road safety-relevant factors (such as previous tendencies in accident statistics) and to clarify the issue of the middle-term and long-term duration of its effects.

The immediate impact of the 2003 new law on road safety in Italy: a comparison of mortality and morbility data in the years 2002-2004

Background Road traffic accidents represent an important public health problem in both industrialised and developing countries. In Italy, around 270,000 road traffic accidents occur annually. In 2001 this resulted in 6682 deaths, more than 20% of which were the result of an accident among users of two-wheeled motor vehicles [1].There is evidence that the raise in the speed limit [2] is associated with a sustained increase in traffic related deaths and case fatality rates. On 1st of July 2003 a new law was implemented,introducing new legal sanctions, the driver license points (after the experience in Germany, France, UK and Ireland, New Zealand and Brasil) [3,4], new speed limits and camera controls [5]. The aim of this study is to describe the differences in the epidemiological trend of road accidents in Italy, comparing data before and after the implementation of the new penalty points system law.

Administrative Support Systems In Road Safety:The Case Of The Greek Penalty Point System

In the modern era, road safety is a major problem due to its vast socioeconomic impacts. Enforcement and rehabilitation measures have been applied widely in many countries in order to achieve improved driver behavior. Among administrative support systems of the more competent authorities, at least as far as road safety is concerned, the penalty point system plays an important role in behavioral changes. Greece is among those countries facing severe road safety problems and for this reason a major effort has been made towards the improvement of safety levels in the country. This paper presents and discusses the Greek road safety penalty point system in relation to the country's traffic accident data.

Colored pain drawings: preliminary observations in a neurosurgical practice

Background: Black and white pain drawings were introduced as a proposed means to identify patients, presenting with low back pain, who demonstrated functional overlay upon neurological testing. The use of color may enhance the usefulness of such pain drawings, but has not been described for adult patients. Aims: To retrospectively explore the use of colored pain drawings in patients with neck, low back, or radicular pain. Methods: Patients with neck, low back, or radicular pain referred to a community-based neurosurgical practice for evaluation during 1 year ( n=359) depicted their pain on anatomical drawings using colored pencils representing different pain characteristics. Patients with abnormal ( n=55) and normal ( n=54) pain drawings were selected for this study. Use of medications, findings on physical examination, radiographic findings, activity levels, Waddell signs, and pending litigation were recorded and compared between patients with normal and abnormal pain drawings, as assessed according to the Ransford penalty point system. Results: Patients whose colored pain drawings were abnormal, demonstrated a greater use of medications, more non-focal clinical findings, Waddell signs, impaired activity levels, involvement in pending litigation, and significantly fewer pathological radiographic findings than patients with normal pain drawings. Conclusions: Our findings agree with previous observations using black and white pain drawings, indicating that colored pain drawings are no less useful than the black and white approach. Further research is necessary to examine the psychometric properties and clinical usefulness of colored pain drawings to predict outcomes and/or determine treatment.

Quantified pain drawing in subacute low back pain. Validation in a nonselected outpatient industrial sample.

The criterion and construct validities of pain drawing, quantified by a simple total body area score of pain extent (area raw extent assessment score), were analyzed prospectively on consecutive patients (n = 103), drawn from a predefined blue collar worker population, all sick listed for 6 weeks as a result of low back pain. To evaluate the validity of pain drawing as a screening tool in the secondary prevention of subacute low back pain. Pain drawings have been used clinically for more than 40 years as a complement to a patient's verbal pain descriptions. The main objectives have been to differentiate functional pain from organic pain and to identify meaningful features in spatial-anatomic pain distribution. The ability of the pain drawing to delineate concurrent psychopathology correctly has been questioned. There is no consensus on which scoring method should be used. The area raw extent assessment score was analyzed concurrently against the penalty point system and predictively against return to work and absenteeism over a period of 2 years. Content and construct validity assessed the relative influence of medical, psychologic, and subjective disability as well as psychosocial factors. Criterion validation of the area raw extent assessment score showed significant correlations, both concurrently against the penalty point score (r = 0.86, P < 0.001, with explained variance R2 = 0.75, P < 0.001) and predictively against occupational handicap (r = 0.48, P < 0.001). In construct validation, the highest explained variance was shown for medical (R2 = 0.46, P < 0.001) and psychologic factors (R2 = 0.46, P < 0.001) and psychologic factors (R2 = 0.34, P < 0.001) and for subjective disability (R2 = 0.32, P < 0.001). Variance in the area raw extent assessment score also was explained by psychosocial factors (R2 = 0.19, P < 0.01). Pain drawing quantification of the extent of pain shows high criterion and construct validity for the area raw extent assessment score. Content validity could be shown for significant clinical aspects of the disability experience--assets preferred for a screening tool in secondary prevention.

Driver accident risk in relation to the penalty point system in British Columbia

Driver adjudication systems that assign penalty points to various traffic law infractions, and establish a level of point accumulation at which action to suspend drivers' licenses is taken, are a feature of the activities of virtually all motor vehicle authorities. However, in many cases the number of penalty points assigned to each infraction type is simply a qualitative assessment without any empirical foundation. The ordering of infractions by “severity” is often a very subjective process that tends to result in a linear scale of relatively narrow range. The purpose of the research reported in this paper was to assess the relative impact on future crash-involvement risk of a number of different infractions and also of accident history. A total of 1,998,347 B.C. drivers' records was examined. Logistic regression analysis was employed to identify drivers who were most likely to have one or more at-fault accident involvements in a postperiod on the basis of their preperiod records of at-fault accident involvements and convictions. The results showed a consistent increase in postperiod accidents per driver with increasing preperiod numbers of both crashes and convictions. It was also found that prior at-fault accident involvements were a better predictor of future at-fault accident involvements than were prior convictions, and that up to 23% more high-risk drivers could be identified by making use of prior atfault accident involvements as opposed to convictions alone. Right-of-way infractions such as “failure-to-yield” and disobeying a traffic signal were found, after accidents, to be the type of preperiod incidents most strongly associated with postperiod crashes.

A rating system for use with patient pain drawings

Patients entering treatment for chronic benign pain often are asked to complete drawings indicating the intensity and location of their pain as part of the diagnostic process. While inferences have been made from pain drawings about the relative contributions of physiological and psychological factors to the patient's experience of pain, previous research has provided only equivocal support for this practice. A reliable method for assessing pain drawings is needed both for clinical use and to assess the validity of such interpretations. While a number of systems for using such drawings have been proposed, it is not always clear exactly what aspect of the drawing is being quantified. In this study, 101 patients who presented with chronic pain were asked to complete pain drawings which were than scored for the presence or absence of pain in each of 45 body areas. Scorers achieved a high rate of inter-rater agreement with relatively little training. The body surface scores obtained were shown to correlate highly with the penalty point system developed by Ransford et al., suggesting that extent of pain may account for much of the variance in this system. The results are discussed in relation to the clinical and experimental uses for such a system.