Risk Of Serious Injury Research Articles

How do drivers overtake cyclists?

In Europe, the number of road crashes is steadily decreasing every year. However, the incidence of bicycle crashes is not declining as fast as that of car crashes. In Sweden, cyclists are the most frequently injured road users. Collisions between bicycles and motorized vehicles are of particular concern because the high speed and large mass of motorized vehicles create a high risk of serious injury to cyclists. In Sweden's urban areas, bicycle lanes keep bicycles separated from motorized vehicles, but on rural roads bicycle lanes are often absent, requiring drivers to interact with cyclists—usually by overtaking them. During this maneuver, drivers regulate speed and lateral position, negotiating with potential oncoming traffic to stay within their comfort zones while approaching and passing cyclists.In this study an instrumented bicycle recorded 145 overtaking maneuvers performed by car and truck drivers on public rural roads in Sweden. The bicycle was equipped with a LIDAR and two cameras to assess how drivers approached and circumvented the bicycle. The collected data allowed us to identify four overtaking phases and quantify the corresponding driver comfort zones. The presence of an oncoming vehicle was the factor that most influenced the maneuver, whereas neither vehicle speed, lane width, shoulder width nor posted speed limit significantly affected the driver comfort zone or the overtaking dynamics.

Dabigatran: ‘One-dose-fits-all’ approach raises risks

Dabigatran: ‘One-dose-fits-all’ approach raises risks

Setting, Structure, and Timing of the Preparticipation Examination: The Wilderness Adventure Consultation

Patients pursue wilderness experiences throughout the entire life cycle, and while outdoor pursuits are relatively safe, injuries do occur. Many of these adverse events can be anticipated, identified, and prevented through a wilderness preparticipation examination (PPE). To accomplish this, it is incumbent on the physician to assess the extrinsic and intrinsic factors faced by the patient and attempt to correct them to ensure an enjoyable experience in the outdoors. This article outlines the goals of the PPE along with identification of various risk factors that can influence a trip. Most injuries and rescues occur from underestimating the risks from extrinsic, environmental factors, and/or overestimating one's intrinsic skills. By matching the patient's fitness and skill level to the environment, the physician can help reduce the risk of serious injury.

Firearm Availability and Violent Death: The Need for a Culture Change in Attitudes toward Guns

There are two conflicting positions toward gun ownership in the United States. Proponents of stricter gun control argue that guns are responsible for 32,000 gun-related deaths each year and that the introduction of stricter gun control laws would reduce this death toll. Gun rights advocates argue that the general availability of guns reduces homicide rates, due to deterrence and because guns are effective means of self-defense. Based on a review of the evidence, I draw the following conclusions: Gun prevalence is positively related to homicide rates. There is no evidence for a protective effect of gun ownership. In fact, gun owners have a greater likelihood of being murdered. Furthermore, gun ownership is associated with an increased risk of serious injuries, accidental death, and death from suicide. The evidence on the effectiveness of gun control measures has not been encouraging, partly because the influential gun lobby has successfully prevented the introduction of more effective measures. A federal registration system for all firearms would address many limitations of present gun control measures. To mobilize public opinion, a culture change in attitudes toward firearms is needed.

Risks of Serious Injuries and Fatalities of Cyclists Associated with Impact Velocities of Cars in Car-Cyclist Accidents in Japan.

The main purpose of this study is to define the relationship between the car impact velocity and serious injury risk or fatality risk of cyclists. The authors investigated the risks of serious injuries and fatalities of cyclists using vehicle-cyclist accident data from the database of the Institute for Traffic Accident Research and Data Analysis (ITARDA) in Japan. The vehicle types considered are sedans, mini vans, box vans, light passenger cars and light cargo vans. The results revealed that a 10-km/h decrease in the impact velocity could reduce the severe injury risk and fatality risk for impact velocities of 40 km/h or higher. Specifically, when the impact velocity was less than or equal to 30 km/h, the serious injury risks were less than 21% and the fatality risks were less than or equal to 1% for the above listed vehicle types. Therefore, if the Collision Damage Mitigation Braking System (CDMBS) equipped vehicles can perform its functions effectively so as to reduce the impact velocities, then cyclist injuries will likely be significantly reduced. Another purpose of this study is to assess the effect of wearing a helmet for protection of the cyclist's head. Impact experiment results showed that the measured head injury criterion (HIC) with helmets are lower than that of head-form impactor without a helmet, reducing the HIC by 57%.

Practical Applications of Dynamic Choice and Optimal Annuitization

<h3>Abstract</h3> Loss of consciousness (LOC) is a hallmark of many epileptic seizures and carries risks of serious injury and sudden death. While cortical sleep-like activities accompany LOC during focal impaired awareness (FIA) seizures, the mechanisms of LOC during focal to bilateral tonic-clonic (FBTC) seizures remain unclear. Quantifying differences in markers of cortical activation and ictal recruitment between FIA and FBTC seizures may also help to understand their different consequences for clinical outcomes and to optimize neuromodulation therapies. We quantified clinical signs of LOC and intracranial EEG (iEEG) activity during 129 FIA and 50 FBTC from 41 patients. We characterized iEEG changes both in the seizure onset zone (SOZ) and in areas remote from SOZ with a total of 3386 electrodes distributed across brain areas. First, we compared the dynamics of iEEG sleep-like activities: slow-wave activity (SWA; 1-4 Hz) and beta/delta ratio (B/D; a validated marker of cortical activation) during FIA vs. FBTC. Second, we quantified differences between FBTC and FIA for a marker validated to detect ictal cross-frequency coupling: phase-locked high-gamma (PLHG; high gamma phased locked to low frequencies) and a marker of ictal recruitment: the epileptogenicity index (i.e. the number of channels crossing an energy ratio threshold for high vs. low frequency power). Third, we assessed changes in iEEG activity preceding and accompanying behavioral generalization onset and their correlation with electromyogram (EMG) channels. In addition, we analyzed human cortical multi-unit activity recorded with Utah arrays during three FBTC. Compared to FIA, FBTC seizures were characterized by deeper LOC and by stronger increases in SWA in parieto-occipital cortex. FBTC also displayed more widespread increases in cortical activation (B/D), ictal cross-frequency coupling (PLHG) and ictal recruitment (epileptogenicity index). Even before generalization, FBTC displayed deeper LOC; this early LOC was accompanied by a paradoxical increase in B/D in fronto-parietal cortex. Behavioral generalization coincided with complete loss of responsiveness and a subsequent increase in high-gamma in the whole brain, which was especially synchronous in deep sources and could not be explained by EMG. Similarly, multi-unit activity analysis of FBTC revealed sustained increases in cortical firing rates during and after generalization onset in areas remote from the SOZ. Unlike during FIA, LOC during FBTC is characterized by a paradoxical increase in cortical activation and neuronal firing. These findings suggest differences in the mechanisms of ictal LOC between FIA and FBTC and may account for the more negative prognostic consequences of FBTC.

Cocaine use in trauma patients admitted to intensive care medicine. clinical and epidemiological characterization

Traumatic disease is a leading cause of death in younger patients. Substance abuse is a factor of risk for serious injuries and also influences the recurrence thereof. Detecting consumption is paramount to optimize the management of these patients in the care unit intensive as well as high once for prevention strategies secondary. Within these substances, the incidence of cocaine use in the South American cone is a growing health problem.

Setting, Structure, and Timing of the Preparticipation Examination: The Wilderness Adventure Consultation.

Patients pursue wilderness experiences throughout the entire life cycle, and while outdoor pursuits are relatively safe, injuries do occur. Many of these adverse events can be anticipated, identified, and prevented through a wilderness preparticipation examination (PPE). To accomplish this, it is incumbent on the physician to assess the extrinsic and intrinsic factors faced by the patient and attempt to correct them to ensure an enjoyable experience in the outdoors. This article outlines the goals of the PPE along with identification of various risk factors that can influence a trip. Most injuries and rescues occur from underestimating the risks from extrinsic, environmental factors, and/or overestimating one's intrinsic skills. By matching the patient's fitness and skill level to the environment, the physician can help reduce the risk of serious injury.

Commentary: Robotic vs. Standard Laparoscopic Technique - What is Better?

We read with great interest the recently published article by Ferdinand Kockerling in Frontiers in Surgery (1). The author has provided expert insight into the role of robotic surgery in common abdominal, bariatric, colorectal, and oncologic procedures. The robotic approach allows superiority over the traditional laparoscopic abdominal surgery in terms of a three-dimensional high definition view, seven degrees of freedom of motion, intuitive movements, tremor filtering, and other advantages due to its inherent design (2). Experienced surgeons claim comparable or better outcomes for patients undergoing robotic surgery. We had recently compared the surgical value, which is defined as the outcome of the procedure divided by the cost to achieve that outcome, of traditional laparoscopic cholecystectomy to the robotic approach. Our outcomes were comparable to national standards in terms of complications, length of stay and readmissions but we became granular with the procedure cost wherein we accounted for supplies, equipment, per use or annual contract costs, and for the operating room (OR) time. Our calculations clearly showed a lower surgical value for the robotic approach. Similarly, concerns for a higher cost have been described for pancreatic surgery (3), colorectal surgery (4), and bariatric surgery (5). Some studies claim a lesser cumulative cost due to a reduction in the hospital length of stay, but at the same time the question arises that how is this reduction in length of stay being achieved if both the laparoscopic and robotic procedures are near similar. Waters et al. (3) reported a shorter average length of stay in their robotic distal pancreatic cohort but that was because of outliers in the laparoscopic group which stayed in excess of 3 weeks. Similarly, the literature is abundant with studies vouching for comparable outcomes but they are plagued with a selection bias for patients with favorable anatomy or a lesser acuity of the disease. This just highlights the dire need to shift from observational data and move toward prospective randomized trials. Robotic surgery is going through a phase of exponential growth (6). Salisbury et al. (7) commented that structured cross pollination between surgeons and engineers will bridge current deficiencies in robotics. Critical access hospitals may continue to stall on investing due to technology costs, but if this evolution in robotics leads to improved outcomes that argument will be very hard to hold onto. Future improvements expected in robotics aim to miniaturize the console and reduce OR set-up times. These improvements will also include tactile and force sensors to address the lack of haptic feedback. Other advancements are likely to include motion and force scaling for greater precision, and the ability to establish virtual operative boundaries to avoid damaging vital structures. With an industry geared and motivated to redefining surgical norms, my biggest concern is that general surgeons will fall behind the curve and be forced to play catch up. It is critical that adequate education and training keep pace with technology, so the next generation is prepared to recognize and take advantage of the opportunities robotics may provide. The robotics era is currently catering to the demand for increased patient autonomy but the question remains whether there is sufficient value for critical access hospitals to invest resources in a technology still in its infancy. Training and credentialing remains a big concern and so is the steep learning curve which can potentially introduce a risk for serious injury to patients. This may be part of the reason why penetrance of the robotic approach in visceral surgery has been slow and there has been negligible integration in residency curriculums to introduce the skill early in the surgical career of trainees. Having done this meticulous review, we would like to know the authors view on the future of robotic surgery. We do not think there is evidence in these observational studies that robotic surgery provides enough surgical value. That, however, may change with new innovations in the field. Is it possible that traditional laparoscopic surgeons are resisting the tide of change the same way general surgeons were when laparoscopy was first introduced?

Childhood Sleepwalking and Sleep Terrors: A Longitudinal Study of Prevalence and Familial Aggregation.

Childhood sleepwalking and sleep terrors are 2 parasomnias with a risk of serious injury for which familial aggregation has been shown. To assess the prevalence of sleepwalking and sleep terrors during childhood; to investigate the link between early sleep terrors and sleepwalking later in childhood; and to evaluate the degree of association between parental history of sleepwalking and presence of somnambulism and sleep terrors in children. Sleep data from a large prospective longitudinal cohort (the Quebec Longitudinal Study of Child Development) of 1940 children born in 1997 and 1998 in the province were studied from March 1999 to March 2011. Prevalence of sleep terrors and sleepwalking was assessed yearly from ages 1 1/2 and 2 1/2 years, respectively, to age 13 years through a questionnaire completed by the mother. Parental history of sleepwalking was also queried. The peak of prevalence was observed at 1 1/2 years for sleep terrors (34.4% of children; 95% CI, 32.3%-36.5%) and at age 10 years for sleepwalking (13.4%; 95% CI, 11.3%-15.5%). As many as one-third of the children who had early childhood sleep terrors developed sleepwalking later in childhood. The prevalence of childhood sleepwalking increases with the degree of parental history of sleepwalking: 22.5% (95% CI, 19.2%-25.8%) for children without a parental history of sleepwalking, 47.4% (95% CI, 38.9%-55.9%) for children who had 1 parent with a history of sleepwalking, and 61.5% (95% CI, 42.8%-80.2%) for children whose mother and father had a history of sleepwalking. Moreover, parental history of sleepwalking predicted the incidence of sleep terrors in children as well as the persistent nature of sleep terrors. These findings substantiate the strong familial aggregation for the 2 parasomnias and lend support to the notion that sleepwalking and sleep terrors represent 2 manifestations of the same underlying pathophysiological entity.

Injury risk for matched front and rear seat car passengers by injury severity and crash type: An exploratory study

BackgroundThe risk of serious injury or death has been found to be reduced for some front compared to rear seat car passengers in newer vehicles. However, differences in injury severity between car occupants by seating position has not been examined. This study examines the injury severity risk for rear compared to front seat car passengers. MethodA retrospective matched-cohort analysis was conducted of vehicle crashes involving injured rear vs front seat car passengers identified in linked police-reported, hospitalisation and emergency department (ED) presentation records during 2001–2011 in New South Wales (NSW), Australia. Odds ratios were estimated using an ordinal logistic mixed model and logistic mixed models. ResultsThere were 5419 front and 4588 rear seat passengers in 3681 vehicles. There was a higher odds of sustaining a higher injury severity as a rear-compared to a front seat car passenger, with a higher odds of rear seat passengers sustaining serious injuries compared to minimal injuries. Where the vehicle occupant was older, travelling in a vehicle manufactured between 1990 and 1996 or after 1997, where the airbag deployed, and where the vehicle was driven where the speed limit was ≥70km/h there was a higher odds of the rear passenger sustaining a higher injury severity then a front seated occupant. ConclusionRear seat car passengers are sustaining injuries of a higher severity compared to front seat passengers travelling in the same vehicle, as well as when travelling in newer vehicles and where the front seat occupant is shielded by an airbag deployed in the crash. Rear seat occupant protective mechanisms should be examined. Pre-hospital trauma management policies could influence whether an individual is transported to a hospital ED, thus it would be beneficial to have an objective measure of injury severity routinely available in ED records. Further examination of injury severity between rear and front seat passengers is warranted to examine less severe non-fatal injuries by car seating position and vehicle intrusion.

A52 Trends in inpatient admissions for pedal cycle injuries for the state of California: 2005-2011

Abstract Background In the United States, cycling has grown substantially in popularity in recent years. It is unclear, however, whether pedal cycling safety, such as use of helmets, have kept pace with this rapid growth. We use administrative records of pedal cyclist crashes and hospitalizations to explore trends in injuries and fatalities among pedal cyclists in the state of California. Methods We perform a retrospective analysis of the Statewide Integrated Traffic Records System (SWITRS), the State Emergency Department Database (SEDD), and the State Inpatient Database (SID) for the state of California in 2005 to 2011. SWITRS contains all motor vehicle crash records reported to law enforcement in California and is maintained by the California Highway Patrol. SEDD/SID provide records on all emergency department (ED) and inpatient admissions in community hospitals for California. Pedal cyclist injury records were selected using Clinical Classification Software codes (External Causes of Injury code 2608 “Pedal Cyclist, not MVT”). We examine patient characteristics related to pedal cyclist injuries including age, gender, insurance status, race, disposition status and all related bodily injuries. Trends in number of bicycle-related injuries on public roads, and ED visits and inpatient admissions (number and per capita) are presented. Cost-to-charge ratios provided by HCUP are used to calculate costs of treatment for injured bicyclists. Results During the 7-year period from 2005 to 2011, there were 275,845 ED visits and 24,281 pedal cyclist-related inpatient admissions in the state of California. Number of ED visits per 100,000 population increased from 95.1 to 122.6 in 2005-11—a 29% increase. Much of this increase was driven by older pedal cyclists. The average age of a cyclist increased by 3.4 years in the study period, and the proportion aged 45 and older increased from 15.9% to 22.1%. For inpatient admissions, this proportion increased from 39.1% to 50.4%. Upper limb fractures and intracranial injuries were the most common types of injuries sustained by hospitalized pedal cyclists. Median inpatient costs of treatment were $11,264 per case, and totaled $59.7 million in 2011. Conclusions In an average week in California, there are about 26.5 million pedal cycling trips. Although pedal cycling is associated with a number of important cardiovascular and other health benefits, our study suggests that injuries have increased substantially as pedal cycling has become more popular. These results call for the need to examine pedal cycling safety efforts, especially among older riders who are at risk for serious injury.

Pedestrian Injury Outcome as a Function of Vehicle Market Group in Victoria, Australia

Objective: Pedestrians are among the most vulnerable road users in terms of their risk of serious injury when involved in a collision with a vehicle. In Australia, around 200 pedestrians are killed in road crashes annually and over 2,000 are seriously injured. The objective of the current study was to analyze pedestrian death and injury risk by body region across 10 light passenger and commercial vehicle market groups in Victoria, Australia.Methods: This study utilized police-reported crash data linked to insurance injury compensation claims data during the period 2001–2010 to determine whether pedestrian injury outcome is a function of colliding vehicle type. Logistic regression models were developed to measure the risk of pedestrian death or injury as a function of vehicle market group for 4 body region groupings, namely, all body regions; the head, face, or neck; the thorax; and the lower extremities (including pelvis).Results: Analysis focused on head, face, or neck injury found that pedestrians struck by small cars, people movers, large sport utility vehicles (SUVs), vans, or utility vehicles had statistically significantly higher odds of death or injury compared to large cars. When the analysis focused on thoracic injury, it was again found that pedestrians struck by large SUVs and vans had statistically significantly higher odds of death injury compared to large cars. In particular, the odds of death or thoracic injury is 74.4% higher for large SUVs compared to large cars. Analysis focused on lower extremity injury found no market group with statistically significant different odds of death or injury compared to large cars at the 5% level; however, medium cars and vans were found to have statistically significantly lower odds of death or lower extremity injury at the 10% level.Conclusions: The results suggest that the increasing popularity of vehicles such as SUVs has the potential to lead to an increase in the level of pedestrian road trauma. With the general trend toward the use of larger vehicles, the results provide validation of the importance of improved vehicle design and the incorporation of new pedestrian safety features.

Rear seat safety: Variation in protection by occupant, crash and vehicle characteristics

ObjectivesCurrent information on the safety of rear row occupants of all ages is needed to inform further advances in rear seat restraint system design and testing. The objectives of this study were to describe characteristics of occupants in the front and rear rows of model year 2000 and newer vehicles involved in crashes and determine the risk of serious injury for restrained crash-involved rear row occupants and the relative risk of fatal injury for restrained rear row vs. front passenger seat occupants by age group, impact direction, and vehicle model year. MethodData from the National Automotive Sampling System Crashworthiness Data System (NASS-CDS) and Fatality Analysis Reporting System (FARS) were queried for all crashes during 2007–2012 involving model year 2000 and newer passenger vehicles. Data from NASS-CDS were used to describe characteristics of occupants in the front and rear rows and to determine the risk of serious injury (AIS 3+) for restrained rear row occupants by occupant age, vehicle model year, and impact direction. Using a combined data set containing data on fatalities from FARS and estimates of the total population of occupants in crashes from NASS-CDS, logistic regression modeling was used to compute the relative risk (RR) of death for restrained occupants in the rear vs. front passenger seat by occupant age, impact direction, and vehicle model year. ResultsAmong all vehicle occupants in tow-away crashes during 2007–2012, 12.3% were in the rear row where the overall risk of serious injury was 1.3%. Among restrained rear row occupants, the risk of serious injury varied by occupant age, with older adults at the highest risk of serious injury (2.9%); by impact direction, with rollover crashes associated with the highest risk (1.5%); and by vehicle model year, with model year 2007 and newer vehicles having the lowest risk of serious injury (0.3%). Relative risk of death was lower for restrained children up to age 8 in the rear compared with passengers in the right front seat (RR=0.27, 95% CI 0.12–0.58 for 0–3 years, RR=0.55, 95% CI 0.30–0.98 for 4–8 years) but was higher for restrained 9–12-year-old children (RR=1.83, 95% CI 1.18–2.84). There was no evidence for a difference in risk of death in the rear vs. front seat for occupants ages 13-54, but there was some evidence for an increased relative risk of death for adults age 55 and older in the rear vs. passengers in the right front seat (RR=1.41, 95% CI 0.94–2.13), though we could not exclude the possibility of no difference. After controlling for occupant age and gender, the relative risk of death for restrained rear row occupants was significantly higher than that of front seat occupants in model year 2007 and newer vehicles and significantly higher in rear and right side impact crashes. ConclusionsResults of this study extend prior research on the relative safety of the rear seat compared with the front by examining a more contemporary fleet of vehicles. The rear row is primarily occupied by children and adolescents, but the variable relative risk of death in the rear compared with the front seat for occupants of different age groups highlights the challenges in providing optimal protection to a wide range of rear seat occupants. Findings of an elevated risk of death for rear row occupants, as compared with front row passengers, in the newest model year vehicles provides further evidence that rear seat safety is not keeping pace with advances in the front seat.

Bicycle Safety

Bicycle Safety

Driving down injuries and deaths on country roads

The National Road Safety Strategy 2011–2020 stipulates that by 2020, Australia should aim to achieve a 30% reduction in the number of serious injuries and deaths on our roads each year.1 People in rural and remote areas are significantly overrepresented in these numbers, meaning that road safety in the bush should be a particular focus for policymakers and researchers. The rate of serious road-related injury among those living outside major cities is nearly twice that of those living within them.2 Country people are also more than three times more likely to die as a result of a transport accident than their city cousins.3 The difference in outcomes for city and country people is particularly marked among young men; the death rate in transport-related accidents for young men aged 20–24 years living in the country is nearly four times higher than it is for those in the city.4 These startling statistics can be attributed to a combination of factors, such as vehicle and road characteristics, transport habits, perceptions of risk and law enforcement rates. In country areas, for example, road conditions are more varied. Compared with urban areas, there are more dirt roads, more hazardous roadsides and generally poorer road geometry. There is a greater likelihood of colliding with livestock and wildlife, and more heavy agriculture and mining vehicles on the road. People in rural and remote areas also tend to travel longer distances than city people, and this places them at higher risk of fatigue and accidents. They generally travel at higher speeds and, as a consequence, have a greater risk of serious injury or fatality in the event of a crash.5, 6 They also tend to travel in vehicles that are not as safe as those used by city people. The lower socio-economic status of people in rural and remote areas may mean that they own older vehicles (meaning fewer safety features), and may give vehicle maintenance a lower priority. The poorer condition of country roads also contributes to faster rates of deterioration of vehicles. Crashes in remote areas are also more likely to involve an unlicensed driver/rider. This in part reflects the lower levels of licence ownership.7 Research also shows that there is much that can be done to improve road safety in rural and remote areas. Improvements to the physical features of rural roads, such as removing roadside hazards and having clearer road markings, have been shown to reduce the frequency and severity of rural road crashes. Expanding public and community transport options can provide a safe alternative to drink driving, driving without a license and driving while fatigued, and prevent vehicle overcrowding – all factors that contribute to road accidents. Ensuring that education programs are tailored to the specific needs of rural and remote people, and delivered through channels by which they normally receive their messages, is another important way of reducing risk behaviours, particularly among young men. Investment in better roads also has the potential to have a direct impact on rural people's access to the health system, and therefore their health and well-being. With better roads, country people will be able to get to primary care and rehabilitation services more easily, and this may lead to better chronic disease prevention and management for people in the bush. With better roads, patient retrievals and patient transfers between facilities and the supply of essential medicines and equipment will all be quicker, and this may contribute to better health outcomes for acutely unwell people. Improving road infrastructure also has the potential to make it easier for health professionals to get to country areas – for example, locums and drive-in, drive-out workers – and therefore may help address the chronic workforce shortages in rural and remote Australia. The Senate Standing Committee on Rural and Regional Affairs and Transport is currently holding an inquiry into aspects of road safety in Australia. The National Rural Health Alliance will make a submission to the inquiry and closely monitor its implications for the people of rural and remote Australia.

The relation between speed environment, age and injury outcome for bicyclists struck by a motorized vehicle – a comparison with pedestrians

This study analyzes (a) the relation between injury severities, the age of the bicyclist and the speed environment at accident locations (mean travel speed of the traffic flow involved in the accident) where a bicyclist was struck by a motorized vehicle and (b) how these relations differ from those for struck pedestrians. Accident data from Sweden for the years 2004–2008 was used to identify accident locations to analyze the relations between speed environment, age and injury outcome. Seventy-seven accident sites were used for field measurements and further analysis. The results show that both speed environment and age have considerable correlation with injury severity. There was a statistically significant relation between injury severity and the speed environment, and large proportion of the serious bicycle accidents occur at locations with speeds below 30km/h. Also, the risk of serious injuries or fatalities seems to increase after the age of 45. To our knowledge this is the first study that uses the mean travel speed in this manner for analyzing injury severity of struck bicyclists.

ANALYSIS OF DYNAMIC LOADS OF THE ARMOURED PERSONNEL CARRIER CREW DURING FRONTAL CRASH

The work describes chosen problem connected with using of armoured personnel carriers (APC) in the frame of stabilisation and peacekeeping mission. The new type of tasks appears: ramming obstacles such as fences, entry gates, light engineering obstacles and also pushing other vehicles aside the road in order to obtain trafficability. The main threat in such situation is a risk of serious injury of soldiers inside vehicle. The lack of a crumple zone increases a value of acceleration acting on the crew. In the work models of driver and crew member seats used in the APC were showed. To the tests a Hybrid III 50th male dummy model in a seated position were used, which is a good representation of the average population of men. To the modelling LS-DYNA software was applied. The work shows the numeric test results. Behaviour of the dummies during the impact on both the driver and crew member were presented. To assess a risk of injury standard indicators of crash test were used, including: maximum value of the head acceleration, the criterion HIC and the maximum values of the forces and moments in the neck. The distributions of these parameters were presented. Results of simulation indicated that velocity and location of dummies has large influence on levels of dynamic loads. To further research is proposed to take into consideration models of dummy with additional equipment of soldiers (e.g. a helmet, a weapon, a bullet-proof jacket).

Značaj redovne fizičke aktivnosti i fizikalne terapije u prevenciji padova starijih osoba

Every year between 28 and 35% of people older than 65 years, and 32-42% of people older than 70 years, experience fall injuries. Even though there are usually no serious consequences, the elderly carry an increased risk of serious injury from a fall, and the injuries can even be fatal. 'Successful aging' is often mentioned as a desirable goal, but the most important thing is preservation of the elderly person's functional capacity. Aging is characterized by involuntary processes, reduced vitality, and increased vulnerability to various diseases. Medicine can be useful in maintaining the functional abilities and preventing falls. Regular physical activity maintains and improves locomotive function and other systems through an analgetic function in particular they improve tissue circulation and metabolism. Introducing physical care services to the existing menu of social services is essential to the care of the elderly. The elderly could practice and implement physical therapy in order to reduce the risk and injury of falls. Although this implies an upfront financial investment, the likely ensuing reduction in fall injuries will result in a lower overall financial burden.

Protection of Vulnerable Occupant Population in Traffic Incidents

Motor vehicle crash (MVC) related injuries have been effectively reduced over the past decades. However, field data analysis indicates not all occupants were equally protected under the current safety design. Comparing to mid-age and mid-size occupants, children, elderly, and obese occupants are at greater risk of severe injuries and death [1-3]. For example, with similar incidents, a 75-year-old occupant is, on the average, 3.87 to 6.7 times as likely to die as a 21year-old male occupant. Moreover, older occupants are at greater risk of serious injury to all body regions [1]. As a result, vehicle safety designs should be specifically tailored toward these vulnerable populations for full-scale injury prevention.