Consumo de bebida alcoólica por estudantes de medicina: um panorama global / Alcohol consumption by medical students: a global overview / Consumo de alcohol por estudiantes de medicina: una visión global

O consumo de bebidas alcoólicas representa um dos principais fatores de risco de envolvimento em acidentes de trânsito. Objetivou-se analisar o panorama geral de consumo de bebida alcoólica por estudantes de medicina e as implicações nos acidentes de trânsito. Foram consultadas as bases de dados SciELO, PubMed e Biblioteca Virtual em Saúde e incluídos dez artigos completos disponíveis entre 2010 e 2022, em língua portuguesa e inglesa. Resultou que o consumo de bebidas alcoólicas pelos estudantes variou de 76,6% a 81,2%, e que ingerir bebidas alcoólicas expõe os motoristas ao envolvimento em acidentes de trânsito 68% maior do que os que não estão expostos a tal fator. Concluiu-se que os estudantes de medicina, população jovem, apresentam um alto índice de consumo de bebidas alcoólicas, e os motivos envolvidos apontam para o nível de pressão do curso, alta carga horária, períodos do curso mais avançados, festas acadêmicas e morar sem os pais.

The consumption of alcoholic drinks represents one of the main risk factors for the involvement in traffic accidents. The objective of this study was to analyze the general panorama of alcohol consumption by medical students and the implications for traffic accidents. SciELO, PubMed and Virtual Health Library databases were consulted, and ten full articles available between 2010 and 2022, in Portuguese and English, were included. The results obtained were that the consumption of alcoholic drinks by students ranged from 76.6% to 81.2%, and that alcohol drinking exposes drivers to involvement in 68% more traffic accidents than those who are not exposed to such factor. It was concluded that medical students, a young population, have a high rate of consumption of alcoholic beverages, and the reasons involved point to the level of pressure of the medical school, high workload, seniority in the program, academic parties, and living without the parents

El consumo de bebidas alcohólicas representa uno de los principales factores de riesgo de implicación en accidentes de tráfico. El objetivo de este estudio fue analizar el panorama del consumo de alcohol por los estudiantes de medicina y las implicaciones en los accidentes de tránsito. Se consultaron las bases de datos SciELO, PubMed y Biblioteca Virtual en Salud y se incluyeron diez artículos completos disponibles entre 2010 y 2022, en portugués e inglés. Los resultados obtenidos fueran que el consumo de bebidas alcohólicas osciló entre 76,6% y 81,2%, y que el expone a los conductores a involucrarse en accidentes de tráfico un 68% más que aquellos que non están expuestos a tal factor. Se concluyó que los estudiantes de medicina, una población joven, tienen un alto índice de consumo de bebidas alcohólicas, y los motivos involucrados apuntan para el nivel de presión del curso, alta carga horaria, períodos más avanzados del curso, fiestas académicas y morar sin los padres

Desigualdades sociales urbano-rurales en la mortalidad por siniestros viales en Colombia, 1998-2019

Introducción: Anualmente se pierden 1,35 millones de vidas por causa de siniestros viales; su ocurrencia se ha relacionado, además de factores comportamentales, con desigualdades sociales. Objetivo: Analizar las desigualdades sociales urbano-rurales en la mortalidad por siniestros viales en Colombia para el periodo 1998-2019. Materiales y métodos: Estudio ecológico a partir del análisis de las tasas de mortalidad ajustadas de los grupos poblacionales urbanos y rurales estratificados por sexo. Se hicieron análisis con regresión de Joinpoint y se calcularon medidas de desigualdad simple absoluta y relativa. Resultados: Se registraron 139 323 muertes por siniestros viales, en Colombia la tasa de mortalidad por esta causa se ha venido reduciendo. En contraste con las áreas rurales, en las áreas urbanas esta reducción es más significativa. Existen desigualdades en la mortalidad entre las áreas urbanas y rurales que han venido estrechándose. No obstante, en el caso de hombres y mujeres ha venido incrementándose. Discusión: La reducción de la tasa de mortalidad por siniestros viales sugiere que las intervenciones en seguridad vial han sido efectivas. La mayor mortalidad en hombres puede explicarse a partir de factores comportamentales. Las desigualdades urbano-rurales pueden estar relacionadas con las dinámicas de desarrollo. Conclusiones: Se registra una reducción en la tasa de mortalidad por siniestros viales, la cual es más significativa en áreas urbanas. Existen desigualdades urbano-rurales en la mortalidad por esta causa. Las políticas de seguridad vial deben partir de un enfoque integrador vinculado con otras agendas políticas.

Introduction: Annually, 1,35 million lives are lost due to road accidents; their occurrence has been related, in addition to behavioral factors, to social inequalities. Objective: To analyze urban-rural social inequalities in mortality from traffic accidents in Colombia from 1998-2019. Methods and materials: Ecological study based on the analysis of standardized mortality rates adjusted for age and sex of urban and rural population groups stratified by sex. Joinpoint regression analyses were performed, and absolute and relative simple inequality measures were calculated. Results: There were 139.323 deaths from road accidents; in Colombia mortality rates from this cause has been decreasing. In urban areas, the reduction is more significant than in rural areas. Disparities in mortality between urban and rural areas have been narrowing, however, in the case of men and women, they have been increasing. Discussion: Reducing the mortality rate from road accidents suggests that road safety interventions have been effective. Behavioral factors can explain the higher mortality in men. Urban-rural inequalities can be related to development dynamics. Conclusions: There is a significant reduction in the mortality rate due to road accidents in urban areas. There are urban-rural inequalities in mortality from this cause. Road safety policies must be based on an integrative approach linked to other political agendas.

Mortalidad en accidentes por moto en Venezuela, y su relación con Políticas Públicas de seguridad vial y preventiva,1996-2018 / Mortality in motorcycle accidents in Venezuela and relationship with public road safety and preventive policies, 1996 - 2018

Los accidentes de tránsito son un problema de salud pública de gran magnitud y gravedad, en las Américas; Venezuela ocupa un lugar destacado por su alta incidencia. El objetivo de la investigación es establecer la relación entre las políticas públicas para la prevención de los accidentes de motocicletas, y las tasas de mortalidad. Metodología: Estudio documental retrospectivo de las políticas viales y las tasas de mortalidad específicas de lesionados por accidentes de motocicletas en Venezuela durante el período 1996-2018. Resultados: como causa de muerte en Venezuela (2000-2018), representa casi 7% del total, entre 6 a 50% del total de las muertes por accidentes de tránsito terrestre y se mantiene muy alta al final del período, con fallecidos por motocicletas sobre 25%. La elevación de la curva endémica de mortalidad ocurrió simultáneamente al aumento en la producción e importación de motocicletas, y cayó durante la crisis económica, en el año 2014. La legislación actualizada mas no acatada en esta materia, es notoria Conclusiones: Los accidentes de motocicleta son un problema de salud pública de primer orden en Venezuela asociadas al clima económico y social, las tasas de mortalidad tuvieron su máxima meseta de elevación durante la bonanza petrolera 2005-2013. Las políticas asociadas a la prevención de accidentes viales en moto están fragmentadas, son ineficientes y reactivas a situaciones complejas, deficientemente aplicadas por los organismos de tránsito responsables a escala nacional, regional y municipal.

Introduction. Traffic accidents are a public health problem of great magnitude and gravity in the Americas; Venezuela occupies a prominent place for its high incidence. The objective of the research is to establish the relationship between public policies for the prevention of motorcycle accidents, and mortality rates. Methodology: Retrospective documentary study of road policies and specific mortality rates of those injured by motorcycle accidents in Venezuela during the period 1996-2018. Descriptive statistical analysis with trend lines, frequency distributions and annual average rates. Results: cause of death in Venezuela (2000-2018), represents almost 7% of the total. The burden of motorcycle injury deaths represents between 6 to 50% of total road traffic fatalities and remains very high at the end of the period, with motorcycle fatalities over 25%. The elevation of the endemic mortality curve occurred simultaneously with the increase in the production and import of motorcycles, and fell concomitantly with the economic crisis in 2014. Conclusions: Motorcycle accidents are a public health problem of the first order in Venezuela associated with the economic and social climate, mortality rates had their maximum plateau of elevation during the oil economic boom 2005-2013. The policies associated with the prevention of road accidents by motorcycle are fragmented, inefficient and reactive to complex situations and poorly applied by the responsible traffic agencies at national, regional and municipal level.

Discapacidad y calidad de vida después de un accidente de tránsito en Medellín y su área metropolitana. Estudio de cohorte

Objetivo: Comparar al año, el funcionamiento, calidad de vida (cv), dolor y depresión entre adultos menores y mayores de 60 años que tuvieron lesiones moderadas y graves en accidentes de tránsito ocurridos en Medellín y su área metropolitana. Metodología: Análisis secundario de dos cohortes de pacientes con lesiones moderadas y graves ocurridas en Medellín y su área metropolitana en 2009-2010 y 2015-2016. Se hizo evaluación para el funcionamiento, la cv, depresión y el dolor, con instrumentos validados para ello. Las diferencias entre las cohortes 12 meses después del accidente se compararon con t-Student. Se hizo un análisis de regresión lineal múltiple para determinar los factores explicativos de discapacidad y cv. Resultados: Se incluyeron 837 pacientes, de los cuales el 84,8 % completó el seguimiento. La motocicleta fue el principal vehículo involucrado (86,1 y 60,7 %). Se observó mejor funcionamiento en mayores de 60 años en cuidado personal, y mayor compromiso en las actividades de la vida diaria, laborales y funcionamiento global. La cv fue significativamente mejor en menores, en desempeño emocional, desempeño físico y función física. En el análisis multivariado, el mayor compromiso en el funcionamiento fue explicado por ser mujer, tener más edad, lesión más grave, mayor dolor y depresión. La mejor cv fue explicada por ser hombre, menos edad, menor gravedad de la lesión, dolor y síntomas depresivos. Conclusiones: La edad, el sexo, la gravedad de la lesión, el dolor y la depresión explican la discapacidad y las dimensiones de la cv 12 meses después del accidente de tránsito.

Objective: To compare functioning, quality of life (QoL), pain, and depression at one year between adults under and over 60 years of age who had moderate and severe injuries in traffic accidents in Medellin and its metropolitan area. Methodology: Secondary analysis of two cohorts of patients with moderate and severe injuries that occurred in Medellín and its metropolitan area in 2009-2010 and 2015-2016. They were evaluated at baseline and 12 months with functioning (who-das ii), QoL (sf-36), pain (vas), and depression (phq-9). The differences between cohorts 12 months after the accident were compared with t-Student test. A multiple linear regression analysis was done to determine factors related to disability and QoL. Results: 837 patients were included, 84,8% completed the follow-up. The motorcycle was the main vehicle involved (86,1% vs. 60,7). Better functioning was observed in people over 60 years of age in personal care, and greater commitment in activities of daily living, work and global functioning. QoL was significantly better in minors, in emotional performance, physical performance and physical function. In the multivariate analysis, the greater compromise in functioning was explained by being female, older, more severe injury, greater pain, and depression. The best QoL was explained by being male, younger, less severe injury, pain, and depressive symptoms. Conclusions: Age, sex, injury severity, pain, and depression explain disability and QoL dimensions 12 months after the traffic accident.

Objetivo: Comparar a funcionalidade, qualidade de vida (QV), dor e depressão entre adultos com menos e mais de 60 anos de idade que sofreram lesões moderadas e graves em acidentes de trânsito ocorridos em Medellín e sua região metropolitana. Metodologia: Análise secundária de duas coortes de pacientes com lesões moderadas e graves que ocorreram em Medellín e sua área metropolitana em 2009-2010 e 2015-2016. Foi feita avaliação funcional, cv, depressão e dor, com instrumentos validados para isso. As diferenças entre as coortes 12 meses após o acidente foram comparadas com o teste t de Student. Uma análise de regressão linear múltipla foi realizada para determinar os fatores explicativos para deficiência e cv. Resultados: foram incluídos 837 pacientes, dos quais 84,8% completaram o seguimento. A motocicleta foi o principal veículo envolvido (86,1 e 60,7%). Melhor funcionamento foi observado em pessoas com mais de 60 anos nos cuidados pessoais e maior comprometimento nas atividades de vida diária, trabalho e funcionamento global. A QV foi significativamente melhor nos menores, no desempenho emocional, no desempenho físico e na função física. Na análise multivariada, o maior comprometimento funcional foi explicado por ser mulher, ser mais velho, lesão mais grave, maior dor e depressão. A melhor QV foi explicada por ser homem, menor idade, menor gravidade da lesão, dor e sintomas depressivos. Conclusões: Idade, sexo, gravidade da lesão, dor e depressão explicam as dimensões de incapacidade e QV 12 meses após o acidente de trânsito.

Años de vida perdidos y distribución espacial de la mortalidad por incidente vial en Medellín, 2010-2020

Objetivo: Estimar los años potenciales de vida perdidos y la distribución espacial de la mortalidad por incidente vial según modo de transporte en Medellín 2010-2020, como línea base para la implementación de la estrategia Visión Cero, de la Organización Mundial de la Salud, en la movilidad de la ciudad. Metodología: Estudio retrospectivo y descriptivo de corte transversal, con fuente secundaria. El cálculo de los años potenciales de vida perdidos se hizo tomando como edad límite la esperanza de vida al nacer de Colombia, según año y género. El análisis espacial se realizó a partir de la dirección del incidente; la representación de la densidad de Kernel fue por el método de clasificación estándar-cuantil, y las zonas de influencia se crearon por el método búfer de anillos múltiples, con distancias de 500 y 1000 metros. Resultados: Medellín, entre 2010 y 2020, registró 2988 muertes por incidente vial. Quienes más murieron fueron los peatones, con 1423 (47,6 %) muertes, seguidos por los motociclistas, con 1295 (43,3 %). Los años potenciales de vida perdidos fueron 98 787. Las comunas de mayor concentración en muerte de peatones fueron: Candelaria, Buenos Aires y Manrique; en motociclistas, la mayor concentración se evidenció en el sistema vial del río. Por zonas de influencia, los peatones fallecidos en un radio de 1000 metros del sistema vial del río fueron 688 (49,8 %), y los motociclistas, 636 (52,2 %). Conclusión: Los motociclistas fueron quienes murieron más jóvenes y más años dejaron de vivir. Politraumatismos son diagnósticos constantes de muerte, pero lesiones en cabeza, cráneo y tórax son más letales en peatones y motociclistas.

Objective: To estimate the potential years of life lost and the spatial distribution of mortality from road incidents by mode of transport in Medellín 2010-2020, as a baseline for the implementation of the Vision Zero strategy of the World Health Organization in the city's mobility. Methodology: This is a retrospective and descriptive cross-sectional study, with a secondary source. The calculation of the potential years of life lost was made using the life expectancy at birth in Colombia as the age limit, according to year and gender. The spatial analysis was carried out from the direction of the incident; Kernel density was represented by the standard-quantile classification method, and the zones of influence were created by the multiple ring buffer method, with distances of 500 and 1000 meters. Results: Between 2010 and 2020, Medellín registered 2,988 deaths due to road incidents. Those who died the most were pedestrians, with 1,423 (47.6%) deaths, followed by motorcyclists, with 1,295 (43.3%). Potential years of life lost were 98,787. The zones (comunas) with the highest concentration of pedestrian deaths were: Candelaria, Buenos Aires and Manrique; in motorcyclists, the highest concentration was evidenced in the river road system. By areas of influence, pedestrians killed within a radius of 1,000 meters from the river road system were 688 (49.8%), and motorcyclists, 636 (52.2%). Conclusion: Motorcyclists were the ones who died the youngest and the most years they stopped living. Polytrauma is a constant diagnosis of death, but injuries to the head, skull and thorax are more lethal in pedestrians and motorcyclists.

Objetivo: Estimar os anos potenciais de vida perdidos e a distribuição espacial da mortalidade por incidente de trânsito segundo o modo de transporte em Medellín 2010-2020, como linha base para a implementação da estratégia Visão Zero, da Organização Mundial da Saúde, na mobilidade da cidade. Metodologia: Estudo retrospectivo e descritivo de corte transversal, com fonte secundária. O cálculo dos anos potenciais de vida perdidos foi feito considerando como idade limite a esperança de vida ao nascer da Colômbia, segundo ano e gênero. A análise espacial realizou-se a partir do local do incidente; a representação da densidade de Kernel foi pelo método de classificação padrão-quantil, e as zonas de influência criaram-se pelo método buffer de anéis múltiplos, com distâncias de 500 e 1000 metros. Resultados: Medellín, entre 2010 e 2020, registrou 2988 mortes por incidente de trânsito. O maior número de mortes foi de pedestres, sendo 1423 (47,6%), seguido pelo de motoqueiros, sendo 1295 (43,3%). Os anos potenciais de vida perdidos foram 98.787. As localidades com maior concentração de mortes de pedestres foram: Candelaria, Buenos Aires e Manrique; no caso dos motoqueiros, a maior concentração evidenciou-se no sistema viário do rio. Por zonas de influência, os pedestres falecidos em um raio de 1000 metros do sistema viário do rio foram 688 (49,8%), e os motoqueiros 636 (52,2%). Conclusão: Os motoqueiros foram quem morreram mais novos e mais anos deixaram de viver. Politraumatismos são diagnósticos constantes de morte, mas lesões na cabeça, no crâneo e no tórax são mais letais em pedestres e motoqueiros.

Trauma abdominal en pacientes del Hospital Universitario General Calixto García

Introducción: El trauma abdominal se considera un problema de salud significativo, debido a que su cinemática ocasiona lesiones tanto anatómicas como funcionales de los órganos del abdomen. Objetivo: Caracterizar el trauma abdominal en un grupo de pacientes lesionados del Hospital Universitario General Calixto García. Métodos: Se realizó un estudio observacional, descriptivo, prospectivo, de corte transversal en los pacientes con trauma abdominal atendidos en el Servicio de Cirugía General desde enero de 2017 hasta diciembre de 2019. La muestra fue de 879 pacientes. Resultados: Existió un mayor número de pacientes con trauma abdominal en el grupo etario de 19-29 años, con una prevalencia del sexo masculino. Predominaron los accidentes de tránsito como la principal causa de trauma abdominal con el 52 %. Prevalecieron las lesiones sobre órganos macizos, con mayor frecuencia en el hígado con un 33 %. El tratamiento que con mayor asiduidad se empleó fue el quirúrgico, lo que representa el 83 % con respecto al manejo conservador. Conclusiones: Por su ubicación y funcionalidad, las lesiones asociadas a trauma abdominal se convierten en un factor que representa gran riesgo para la vida del paciente. Los accidentes de tránsito continúan estando dentro de las primeras causas de trauma abdominal. Aunque la conducta conservadora ha ganado adeptos, existe un predominio en el tratamiento quirúrgico apoyado fundamentalmente en la sintomatología de los pacientes y en los medios diagnósticos.

Introduction: Abdominal trauma is considered a significant health problem due to the fact that its kinematics causes both anatomical and functional injuries to the abdominal organs. Objective: To characterize abdominal trauma in a group of injured patients from Hospital Universitario General Calixto García. Methods: An observational, descriptive, prospective and cross-sectional study was conducted in patients with abdominal trauma attended at the general surgery service from January 2017 to December 2019. The sample was 879 patients. Results: There was a higher number of patients with abdominal trauma within the age group 19-29 years, with a prevalence of the male sex. Road traffic accidents predominated as the main cause of abdominal trauma, accounting for 52 %. Injuries to solid organs prevailed, most frequently to the liver, accounting for 33 %. The most frequently used treatment was surgical, which represents 83 % with reference to conservative management. Conclusions: Due to their location and functionality, injuries associated with abdominal trauma become a factor that represents a great risk for the patient's life. Road traffic accidents continue to be among the first causes of abdominal trauma. Although the conservative approach has gained followers, there is a predominance of surgical treatment supported mainly by the patients' symptomatology and diagnostic means.

Screening for Obstructive Sleep Apnea in truck drivers / Rastreio de Síndrome de Apneia Obstrutiva do Sono em motoristas

Abstract Professional drivers show a higher prevalence of obstructive sleep apnea (OSA) compared with the general population. OSA has been widely associated with an increased risk of traffic accidents. This article aims to investigate the presence of risk factors for OSA, its prevalence and the value of screening tools in a truck drivers' cohort. Descriptive and analytical prospective study. Demographic, anthropometric, Epworth Sleepiness Scale, STOP-Bang and Berlin Questionnaire were used to select subjects with suspicion of OSA. Polysomnography (PSG) was performed in individuals with positive screening. Mean age was 44.6±7 years, mean body mass index was 28.7±4 kg/m². Of the 281 truck drivers screened, 88 were positive for potential OSA. Of these, 63 completed PSG study and the diagnosis was confirmed in 85.7% (prevalence of 19.2%). The following variables showed a positive correlation with the apnea-hypopnea index: neck circumference and STOP-Bang. The combination of a predominantly male population, obesity, age distribution and lifestyle could account for the high prevalence of OSA in this specific population. Questionnaires proved to be a valuable screening tool. Screening, treatment, and management of OSA should be a priority as a public safety policy.

Resumo A prevalência de Síndrome de Apneia Obstrutiva do Sono (SAOS) em motoristas profissionais é superior à da população geral e esta tem sido amplamente associada ao risco aumentado de acidentes rodoviários. Este artigo tem por objetivos investigar fatores de risco de SAOS, estimar a sua prevalência e o valor de instrumentos de rastreio numa amostra de motoristas de pesados. Estudo prospetivo descritivo e analítico. Rastreio realizado com recurso a dados demográficos, antropométricos, Escala de Sonolência de Epworth, STOP-Bang e Questionário de Berlim. Nos indivíduos com rastreio positivo foi realizada polissonografia (PSG). A idade média era de 44,6±7 anos, índice de massa corporal 28,7±4 kg/m². Dos 281 motoristas incluídos, 88 apresentavam risco elevado de SAOS. Destes, 63 realizaram PSG, com confirmação diagnóstica em 85,7% (prevalência de 19,2%). O perímetro cervical e STOP-Bang apresentaram correlação positiva com o índice de apneia-hipopneia. A combinação de género predominantemente masculino, obesidade, distribuição de idade e estilo de vida pode justificar a elevada prevalência de SAOS nesta população. O uso de questionários é uma medida eficaz de rastreio. Nos motoristas, o rastreio e tratamento de SAOS deveria ser uma medida de saúde pública prioritária.

Perfil epidemiológico de los accidentes de tránsito en México, 2010-2019 / Epidemiological profile of road traffic accidents in México, 2010-2019

Resumen: Objetivo: Describir las características del perfil epidemiológico de los accidentes de tránsito (AT) en México, en el periodo 2010 - 2019. Materiales y métodos: Estudio descriptivo, retrospectivo, se analizaron como fuentes secundarias las bases de datos Accidentes del tránsito, parque vehicular y Mortalidad del Instituto Nacional de Estadística y Geografía (INEGI). Además, se agregó un análisis descriptivo utilizando chi-cuadrada. Resultados: En el periodo estudiado se produjeron 3,808,981 AT, el 19.8% de éstos sucedieron en Nuevo León. Los automóviles y las camionetas representan los tipos de vehículo más veces involucrados en estos accidentes. La imprudencia del conductor es la principal causa de siniestralidad. El tipo de accidente más común es la colisión con vehículo automotor (67.6%). Los AT han provocado 52,387 muertos en el lugar del accidente y 1,126,709 lesionados en México en la década estudiada. Conclusiones: Los AT son un problema de salud pública en México. Se registra una tendencia a la baja en las cifras de fallecimientos y heridos, así como en la tasa de mortalidad y morbilidad por AT, pero no así en la tasa de letalidad por AT en el periodo estudiado. Aunque los ocupantes de vehículos son las principales víctimas de accidentes fatales y no fatales, los peatones figuran como el grupo más vulnerable en mortalidad. El estudio abona a la literatura mexicana en materia de seguridad vial buscando servir en la toma de decisiones de las instituciones involucradas.

Abstract Objective: To describe the characteristics and epidemiological profile of road traffic accidents (RTAs) in Mexico during the period 2010-2019. Materials and methods: The study is descriptive and retrospective. As secondary sources were analyzed the database "Road Accidents", "Vehicle fleet" and "Mortality" of the National Institute of Statistics and Geography (INEGI). In addition, a descriptive analysis was added using chi square. Results: In the period studied, there were 3,808,981 RTAs, 19.8% of these occurred in Nuevo León. Cars and trucks are the types of vehicle most often involved in these accidents. The recklessness of the driver is the main cause of traffic accidents. The most common type of accident is a collision with a motor vehicle (67.7%). RTAs have caused 52,387 deaths at the accident site and 1,126,709 injured in Mexico in the period. Conclusions: RAs are a public health problem in Mexico. There is a downward trend in the mortality and morbidity figures from RA in the period studied. Although vehicle occupants are the main victims of fatal and non-fatal accidents, pedestrians are the most vulnerable group in terms of mortality. The study adds to the Mexican literature on road safety, seeking to serve in the decision-making of the institutions involved.

Mortalidade de ciclistas no município de São Paulo, Brasil: características demográficas e tendências recentes / Cyclist mortality in the municipality of São Paulo, Brazil: recent demographic characteristics and trends

Resumo A bicicleta é um transporte barato e saudável, porém os acidentes constituem sua externalidade negativa. Objetivou-se descrever as características dos óbitos de ciclistas, sua evolução recente e o papel da estrutura cicloviária no município de São Paulo. Estudo descritivo utilizando informações do Sistema de Informações de Mortalidade (SIM-DATASUS) entre 2000-2017. A relação entre taxa de mortalidade de ciclistas e malha cicloviária foi avaliada por meio de teste de correlação de Pearson. Foi realizada uma comparação com as viagens de bicicleta no mesmo período. O perfil sociodemográfico dos óbitos foi comparado com o da população geral. A taxa de mortalidade atingiu pico de 7,91/milhão de habitantes em 2006 e diminuiu até 1,8/milhão em 2017; neste período houve aumento das viagens de bicicleta e da estrutura cicloviária. Observou-se correlação negativa entre a taxa de mortalidade e a estrutura cicloviária. A análise dos óbitos indica perfil predominantemente masculino, branco, jovem, com ≤7 anos de estudo; 65% morreram em colisão com veículos. Observou-se diminuição dos óbitos de ciclistas no município de São Paulo correlacionada ao incremento de ciclovias a partir de 2008, em um cenário de aumento da demanda por transporte em bicicleta.

Abstract Bicycles are a low cost and healthy means of transport, however accidents represent the negative downside. This study sought to describe the characteristics of cyclist deaths, their recent evolution, and the status of the cycle path structure in the city of São Paulo. It involved a descriptive study using information from the Mortality Information System (SIM-DATASUS) between 2000 and 2017. The relationship between the cyclist mortality rate and the cycling path network was evaluated using Pearson's correlation test. A comparison was made with bicycle journeys in the same period. The sociodemographic profile of deaths was compared with that of the general population. The mortality rate peaked at 7.91/million inhabitants in 2006 and decreased to 1.8/million in 2017; in this period, there was an increase in cycling journeys and in the cycle path structure. A negative correlation was observed between the mortality rate and the cycle path structure. The analysis of deaths indicates a predominantly male, white, young profile, with ≤7 years of schooling; 65% died in collisions with vehicles. There was a decrease in cyclist deaths in the city of São Paulo correlated with the increase in the bicycle path grid from 2008 onwards, in a scenario of increased demand for bicycle transport.

Jovens diante da morte: experiências de sobreviventes de acidentes de trânsito e tentativas de homicídios / Young people facing death: experiences of survivors of traffic accidents and attempted homicides / Jóvenes frente a la muerte: experiencias de sobrevivientes de accidentes de tránsito y tentativas de homicidio

INTRODUÇÃO: Ainda hoje, a morte é um tema tabu, fortemente associado ao envelhecimento. Contudo, é preocupante o número de jovens que se envolvem em situações inesperadas, como os acidentes de trânsito e as tentativas de homicídio, levando-os a se depararem com sua finitude. OBJETIVO: compreender e analisar a experiência de jovens sobreviventes de acidentes de trânsito e tentativas de homicídios. MÉTODO: Foram realizadas entrevistas narrativas com oito jovens, com idade entre 19 e 29 anos, que residem no estado de Mato Grosso do Sul e que se sobreviveram a acidentes de trânsito ou tentativas de homicídio. As entrevistas foram orientadas por um roteiro semiestruturado e foram analisadas na perspectiva da Análise de Conteúdo. RESULTADOS: O discurso dos jovens entrevistados aponta para as implicações existenciais das mudanças impostas pelas intercorrências, sobretudo a partir dos impactos que elas causaram, alterando tanto suas rotinas como também a forma como pensavam e viviam. Além disso, essa experiência também trouxe implicações na percepção da imagem corporal, além de mudanças em outros âmbitos da vida dos entrevistados, como o trabalho, os estudos, bem como as relações familiares e de amizade, que também foram afetadas. CONCLUSÃO: Faz-se necessária uma maior compreensão dessas experiências, com o intuito de contribuir com elaboração de estratégias em saúde para ajudar esses jovens a lidarem com as consequências das ocorrências que, muitas vezes, são graves e permanentes.

INTRODUCTION: Even today, death is a taboo topic, strongly associated with aging. However, the number of young people who become involved in unexpected situations, such as traffic accidents and attempted murders, is worrying, leading them to face their finitude. OBJECTIVE: To understand and analyze the experience of young survivors of traffic accidents and attempted homicides. METHOD: Open interviews were carried out with eight young people, aged between 19 and 29 years old, who live in the state of Mato Grosso do Sul and who survived traffic accidents or attempted homicides. The interviews were guided by a semi-structured script and were analyzed from the perspective of Content Analysis. RESULTS: The speech of the young people interviewed points to the existential implications of the changes imposed by the intercurrences, especially from the impacts they caused, changing both their routines and the way they thought and lived. In addition, this experience also had implications for the perception of body image, in addition to changes in other areas of the interviewees' lives, such as work, studies, as well as family and friendship relationships that were also affected. CONCLUSION: A better understanding of these experiences is needed, in order to contribute to the development of health strategies that help these young people to deal with the consequences of events that are often serious and permanent.

INTRODUCCIÓN: Hoy en día, la muerte es un tema tabú, fuertemente asociado al envejecimiento. Sin embargo, es preocupante la cantidad de jóvenes que se ven involucrados en situaciones inesperadas, como accidentes de tránsito e intentos de homicidio, que los llevan a enfrentar su finitud. OBJETIVO: Comprender y analizar la experiencia de jóvenes sobrevivientes de accidentes de tránsito y tentativas de homicidio. MÉTODO: Se realizaron entrevistas abiertas con ocho jóvenes, con edades entre 19 y 29 años, que viven en el estado de Mato Grosso do Sul y que han sobrevivido a accidentes de tráfico o intentos de homicidio. Las entrevistas fueron guiadas por un guión semiestructurado y fueron analizadas desde la perspectiva del Análisis de Contenido. RESULTADOS: El discurso de los jóvenes entrevistados apunta a las implicaciones existenciales de los cambios impuestos por las intercurrencias, especialmente a partir de los impactos que provocaron, modificando tanto sus rutinas como su forma de pensar y vivir. Además, esta experiencia también tuvo implicaciones en la percepción de la imagen corporal, además de cambios en otras áreas de la vida de los entrevistados, como el trabajo, los estudios, así como las relaciones familiares y de amistad que también se vieron afectadas. CONCLUSION: Se necesita una mejor comprensión de estas experiencias, para contribuir al desarrollo de estrategias de salud que ayuden a estos jóvenes a enfrentar las consecuencias de eventos que muchas veces son graves y permanentes.

Association Of Socio-Demographic Determinants with Economic Burden Among Road Traffic Accident Victims: A Longitudinal Study

Background: RTA are the sixth leading cause of death in India with a greater share of hospitalization, disabili-ties, deaths and socio-economic losses. The study was conducted to assess the socio-demographic determi-nants associated with households’ economic burden among RTA victims. Methods: A longitudinal study was conducted for 2 years in Puducherry employing simple random sampling to include 169 accident victims. Baseline data was collected with a semi-structured questionnaire on socio-demographic details, direct and indirect costs towards road traffic injuries. Follow up was at 6th and 12thmonth from the day of accident. Data entry and analysis were performed using Epi-data. Written informed consent from each participant was sought. Ethical clearance received. Results: Mean age of the accident victims was 36.2 (11.4) years. The median (IQR) for direct, indirect and to-tal expenses were INR 1500 (1000-22100), 18000 (2400-46500) and 3000 (1037-47125) respectively. Asso-ciation between the median (IQR) indirect expenses and marital status as well as socio-economic status of vic-tims were found to be statistically significant. Conclusion: Accident victims and their family faced financial burden, as a large proportion of victims were from productive age group belonging to lower- and middle-class income group

Analysis of traffic accidents caused by epileptic seizures in 7 patients without definite diagnosis / 中华神经科杂志

Objective:To elucidate the phenomenon that epileptic seizure occurs in patients with epilepsy without definite diagnosis when driving a motor vehicle and its hazards.Methods:From January 2020 to June 2022, 7 epileptic patients who experienced traffic accidents caused by seizures were selected from the First Affiliated Hospital of Soochow University, and their demographic data, traffic accident related data and epilepsy diagnosis and treatment data were summarized and analyzed.Results:A total of 7 adult patients with epilepsy were collected, including 6 males, 4 of whom had been driving for more than 10 years. Among them, 1 patient drove a bus, and the other 6 patients drove private cars. Totally 5/7 of the accidents resulted in personal injury, and 3/7 of the accidents resulted in personal death. In 5 patients, video electroencephalogram showed interictal epileptiform discharges. In 2 patients, the imaging findings suggested the presence of cerebral cortical lesions that may lead to seizures. In terms of the form of seizure, 3 patients′ seizure type was focal to bilateral tonic-clonic, and the other 4 patients were very probable to be focal impaired awareness seizure.Conclusions:Undiagnosed epileptic seizures lead to traffic accidents, endanger patients and public safety, which need to attract attention from both doctors and patients, as well as the whole society.

Mortalidad en estudiantes universitarios según causas de muerte (2004-2018) / College student mortality by causes of death (2004-2018)

Introduction: College students represent an important subpopulation of the United States, with over 19 million college students in the U.S. enrolled yearly. Methods: Descriptive analysis of the causes of death for all deceased students reported by the UW Dean of Students Office (DSO) between 2004 and 2018. We analyzed frequencies and yearly rates. Results: Our analysis shows that contrary to published data and national statistics for the relevant age groups, intentional by self-harm deaths lead causes of death in enrolled students from 2004 to 2018. Intentional by self-harm is the main cause of death in male students, younger students, and white students. "Other" causes of death is the main cause in female students, older students, and students of color. Conclusions: These results must be shared with different stakeholders across campus as well as with other universities in order to support and evaluate campus-wide prevention strategies for means restriction and environmental safety.

Introducción: Los estudiantes universitarios representan una subpoblación importante de los Estados Unidos, con más de 19 millones de matriculados anualmente. Sin embargo, hay pocos datos publicados sobre la mortalidad y causas de muerte en la población universitaria. El propósito de este estudio fue analizar las causas de muerte, basadas en datos de certificados de defunción, de estudiantes matriculados en University of Winconsin- Madison desde 2004 hasta 2018. Métodos: Análisis descriptivo de las causas oficiales de muerte de todos los estudiantes fallecidos reportados por la Oficina del Decano de Estudiantes entre 2004 y 2018. Se analizaron frecuencias y tasas anuales. Resultados: El análisis muestra que, contrariamente a los datos publicados y las estadísticas nacionales para los grupos de edad relevantes, las muertes intencionales por autolesión lideran las causas de muerte en los estudiantes matriculados entre esos años. Las autolesiones intencionales son la principal causa de muerte en los estudiantes varones, en los estudiantes más jóvenes y en los estudiantes blancos. Las causas incluidas en la categoría indicada como Otras son las principales en las estudiantes mujeres, en estudiantes mayores y en estudiantes de color. Conclusiones: Los resultados de este estudio deben compartirse con las diferentes áreas interesadas en todo el campus universitario y con otras instituciones universitarias, para apoyar y evaluar las estrategias de prevención, la aplicación de los medios de restricción y la seguridad ambiental.

Immunochromatography screening devices for cannabinoids in oral fluid sample

Abstract Cannabis sativa L. is one of the most consumed drugs in the world and recent studies have associated its use with an increase in the number of traffic accidents in different countries. In many countries, like Brazil, simple and reliable methodologies are still needed for the detection of drugs on site, mainly cannabinoids, considering its prevalence of use and oral fluid (OF) has been proved as an appropriate biological matrix for this purpose. Considering that, this work aims to review previous studies on immunochromatographic devices for on-site detection of cannabinoids in OF, discussing their sensitivity, specificity, cut-offs values and confirmatory methods. This data shows the importance of choosing a screening device and it reinforces the need for its implementation in Brazil. The research was conducted on 5 databases and all original articles, published in the last 10 years, were selected. A total of 32 articles were found, providing data for 17 screening devices of distinct brands. Only 2 screening devices showed satisfactory sensitivity and specificity in the evaluated studies (≥80% and ≥90% respectively). However, it should be considered that the screening devices still have some limitations, such as a higher cut-off than those recommended by international guidelines (cut-off > 2 ng/mL), therefore demonstrating the need for more studies in the area and the importance of confirmatory analysis usually fulfilled by LC-MS/MS, GC-MS/MS or GC-MS. Thus, the screening analyzes should not be evaluated by itself, but in association with confirmatory results and observational traits (behavioral changes), for a better understanding of the traffic scenario

Infección por Toxoplasma gondii y accidentes de tránsito. Evidencias epidemiológicas de una asociación poco conocida

Recientes pesquisas en las que se utilizó la detección de anticuerpos anti-Toxoplasma gondii como herramienta diagnóstica de toxoplasmosis latente, demostraron asociación entre la infección crónica por el parásito y la disminución de funciones cognitivas, las enfermedades psiquiátricas (esquizofrenia, bipolar, trastornos obsesivo-compulsivos), las enfermedades degenerativas (enfermedad de Alzheimer, múltiples esclerosis, enfermedad de Huntington), y cambios de comportamiento (mayor frecuencia de conductas suicidas y, sobre todo, de accidentes de tránsito). En la literatura revisada, varios estudios demostraron seroprevalencias de anticuerpos anti-T. gondii significativamente mayores en grupos de personas involucradas en accidentes de tránsito que las de sus correspondientes grupos control. La no disponibilidad de fármacos adecuados contra los bradizoítos de T. gondii y de vacunas efectivas contra el parásito, además de no posibilitarse la demostración de una posible relación causal, se obstaculizaba la que podría resultar una vía complementaria para el control de los accidentes de tránsito, un problema de la cotidianidad universal de muy adversas consecuencias humanas y sociales. En perspectivas, la superación de estas limitaciones debe recibir una adecuada atención, tanto de las autoridades sanitarias como de la Academia. En esa dirección, el propósito de este documento es contribuir a ganar conciencia sobre la existencia de esa asociación.

Recent investigations, in which the detection of anti-Toxoplasma gondii antibodies has been used as a diagnostic tool for latent toxoplasmosis, have shown an association between chronic infection by the parasite and decreased cognitive functions, psychiatric illnesses (schizophrenia, bipolar disorder, obsessive - compulsive disorders), degenerative diseases (Alzheimer's disease, multiple sclerosis, Huntington's disease) and behavioral changes (greater frequency of suicidal behaviors and, above all, traffic accidents). In the reviewed literature, several studies demonstrated significantly higher seroprevalence of anti-T. gondii in groups of people involved in traffic accidents than in their corresponding control groups. The unavailability of adequate drugs against T. gondii bradyzoites and effective vaccines against the parasite, in addition to not allowing the demonstration of a possible causal relationship, hinders what could be a complementary way to control traffic accidents, a problem of universal daily life with very adverse human and social consequences. In perspective, overcoming these limitations should receive adequate attention, both from the health authorities and from academia. In this direction, the purpose of this document is to contribute to raising awareness of the existence of this association.

La salud de los conductores de las rutas en Uruguay. Estudio acerca del estado de salud-enfermedad de los conductores profesionales de las rutas departamentales y nacionales. Uruguay 2021 / A study on the health status of professional drivers in national routes and regional roads. Uruguay 2021 / Estudo sobre o estado de saúde-doença de motoristas profissionais de rotas departamentais e nacionais. Uruguai 2021

Introducción: la siniestralidad vial es un problema de salud pública(1). La Unidad Nacional de Seguridad Vial (UNASEV) informa que en 2019 fallecieron 422 personas por esta causa, el 52% falleció en rutas nacionales(2). El factor humano es clave en este fenómeno multifactorial, y es muy importante el estado de salud de los conductores profesionales. No existen estudios dirigidos específicamente a evaluar este aspecto en nuestro país. Objetivo: conocer el estado de salud-enfermedad de los conductores profesionales del transporte terrestre de pasajeros y de carga que trabajaron en rutas nacionales y departamentales durante mayo-agosto de 2021. Método: estudio descriptivo, transversal, dirigido a conductores mayores de 18 años con libreta profesional, que recorren más de 100 km en una jornada laboral en rutas del corredor internacional y la red primaria de la Red Vial Nacional(3). Se utilizó un cuestionario autoadministrado y anónimo. Resultados: 112 conductores respondieron el cuestionario, 97,3% hombres, con una media de 43,5 años, predominantemente de Canelones (24,1%), Montevideo y San José (16,1% respectivamente). 67,8% conducía transporte de cargas. 59,8% percibía tener un buen estado de salud. Respecto a la prevalencia de enfermedades predominaron las osteoarticulares (55,3% lumbalgia). En lo referente a los estilos de vida, declararon dormir una media de 6,75 h por día, y un 39,3% tuvo que detener la marcha para dormir. El 77,8% eran sedentarios. 65,2% no consumía fármacos, y en el último mes, 92,8% consumió mate, 19,64% alcohol y dos conductores, cocaína. El 54,5% negó tener médico de referencia. Discusión: se realizó con la Coordinadora de Sindicatos del Transporte, la Asociación Nacional de Empresas de Transporte Carretero (ANETRA) y UNASEV. Preocupa la subdeclaración de patologías, de consumo de medicación y sustancias, y proponen mejoras en la atención a la salud de los trabajadores y en la accesibilidad al médico de referencia.

Summary: Introduction: road accidents are a Public Health issue. The UNASEV (National Unit of Road Safety) reported that 422 people died in road accidents in 2019, and 52% of them died in national routes. The human factor is a key element in this multi-factor phenomenon, and therefore, the health status of route professional drivers is extremely important. There are no specific studies addressing this aspect in our country. Objective: to learn about the health-disease status of professional drivers in the land freight or passenger transport sector, who work in national and regional routes between May and August 2021. Method: descriptive, transversal study focusing on drivers over 18 years old, holder of professional drivers' licenses, who cover distances greater than 100 km during a working day in national routes and the primary network of the National Road Network. A self-administered anonymous questionnaire was used. Results: 112 drivers answered the questionnaire, 97.3% of which were male. Average age was 43.5 years old, and most of them came from Canelones (24.1%), Montevideo and San José (16.1%) respectively. 67.8% were transporting loads and 59.8% thought their health status was good. As to diseases, osteoarticular conditions prevailed (55.3% had back pain). In terms of lifestyle, drivers declared they slept 6.74 hours per day on average, and 39.3% stated they needed to stop driving in order to sleep. 77.8% led a sedentary life, 65.2% used some kind of medication, and in the last month, 98.8% consumed mate (national infusion), 19.64% alcohol and 2 drivers used cocaine. 54.5% stated they had no primary physician. Discussion: a discussion was held with the Coordinating Entity of Transport Unions, the National Association of Route Transport Companies (ANETRA) and UNASEV. The under-declaration of diseases and consumption of medication and substances are reasons of concern, and proposals were made to improve the health care services of workers and their access to a primary physician.

Introdução: os acidentes rodoviários são um problema de Saúde Pública. A Unidade Nacional de Segurança Rodoviária (UNASEV) informa que em 2019, 422 pessoas morreram por essa causa, e 52% morreram nas rotas nacionais. O Fator Humano é fundamental neste fenômeno multifatorial, sendo muito importante o estado de saúde dos motoristas profissionais nas vias. Não existem estudos especificamente voltados para avaliar esse aspecto no Uruguai. Objetivo: conhecer a relação saúde-doença dos motoristas profissionais do transporte terrestre de passageiros e de carga, que trabalham nas rotas nacionais e departamentais no período maio-agosto de 2021. Método: estudo descritivo, transversal, de condutores maiores de 18 anos com habilitação profissional, que trafegam mais de 100 km em uma jornada de trabalho em trechos do corredor internacional e da rede primária da Rede Rodoviária Nacional. Foi utilizado um questionário anônimo autoaplicável. Resultados: 112 motoristas responderam ao questionário, 97,3% homens, com média de idade de 43,5 anos, predominantemente de Canelones (24,1%), Montevidéu e San José (16,1% respectivamente). 67,8% conduziram o transporte de cargas. 59,8% perceberam ter um bom estado de saúde. Em relação à prevalência de doenças, predominaram as doenças osteoarticulares (55,3% lombalgia). Quanto ao estilo de vida, declararam dormir em média 6,75 horas por dia, e 39,3% tiveram que parar de conduzir para dormir. 77,8% eram sedentários. 65,2% não consumiram drogas e, no último mês, 92,8% consumiram mate, 19,64% álcool e 2 motoristas, cocaína. 54,5% negaram ter médico de referência. Discussão: este estudo foi realizado com a Coordenadoria dos Sindicatos dos Transportes, a Associação Nacional das Empresas de Transporte Rodoviário (ANETRA) e a UNASEV. A subnotificação de patologias, consumo de medicamentos e uso de substâncias psicoativas é preocupante; os participantes propõem melhorias na atenção à saúde dos trabalhadores e no acesso a um médico de referência.

Rendimiento de escalas de trauma ISS, NISS y RTSen accidentes de tránsito para predecir mortalidad en un hospital de alta complejidad / Performance of ISS, NISS, and RTS trauma scales in traffic accidents to predict mortality in a high-complexity hospital

Introducción. La población mundial crece y con ello los accidentes de tránsito, incrementando la morbimortalidad. La combinación de factores clínicos y paraclínicos mediante las escalas de trauma impacta en los desenlaces al permitir tomar acciones oportunas. Métodos. Estudio de corte transversal en el que se incluyeron pacientes con lesiones por colisión en accidentes de tránsito, atendidos entre 2017 y 2018, en urgencias del Hospital Universitario San José de Popayán, Colombia, un hospital de alta complejidad. Se recolectaron variables sociodemográficas y biológicas y se aplicaron tres escalas de trauma, Revised Trauma Score, Injury SeverityScore y New Injury Severity Score. Posteriormente, se evaluó su rendimiento para predecir mortalidad. Resultados. Se atendieron en el servicio de urgencias 650 pacientes con lesiones en accidentes de tránsito y se presentaron 16 muertes. Al evaluar el rendimiento de las escalas de trauma se encontró que la sensibilidad para mortalidad varía entre el 75 % para Revised Trauma Score y el 93,8 % para Injury Severity Score y New Injury Severity Score, con una especificidad que varía entre 89,1 % y 96,8 %. Se identificó que la mejor razón de verosimilitud positiva fue para Revised Trauma Score, mientras que la mejor razón de verosimilitud negativa fue para Injury Severity Scorey New Injury Severity Score. Conclusiones. Los resultados evidencian un adecuado rendimiento de las escalas de trauma evaluadas para predecir mortalidad. La escala que presentó mejor rendimiento fue Injury Severity Score por su sensibilidad, especificidad y razón de verosimilitud positiva.

Background. The global population is on the rise and with such motor vehicle collisions, increasing the morbidity and mortality of individuals implicated in traffic accidents. The combination of clinical and paraclinical factors, as done by the different trauma scales, have an impact upon morbidity and mortality by allowing timely actions.Methods. Cross-sectional study that included patients with collision injuries in traffic accidents, treated at an emergency department from 2017 to 2018 at Hospital Universitario San José in Popayán, Colombia, a high-complexity hospital. The study defined the universe, collected sociodemographic and biological variables, and applied three trauma scales: Revised Trauma Score, Injury Severity Score, and New Injury Severity Score. Subsequently, its performance in predicting mortality was evaluated. Results. Six-hundred-fifty patients with collision injuries were treated in the emergency department with lesions due to collisions in traffic accidents; 16 deaths were reported. We found that the sensitivity varies between 75% for the Revised Trauma Score to 93.8% for the Injury Severity Score and the New Injury Severity Score. Likewise, an adequate specificity varying from 89,1% for the Injury Severity Score to 96,8% for the Revised Trauma Score. The best positive likelihood ratio was for the Revised Trauma Score. The negative likelihood ratios for the Injury Severity Score and the New Injury Severity Score were adequate.Conclusion. The results show an adequate performance of the trauma scales evaluated to predict mortality. The scale that presented the best performance was Injury Severity Score due to its sensitivity, specificity and positive likelihood ratio.

Refractive errors, road traffic accidents and long-term spectacle compliance amongst commercial taxi drivers in a major North-East Indian city

Purpose: To assess the prevalence of refractive error (RE) and its association with road traffic accidents (RTAs) and the subsequent long?term spectacle compliance and adherence to suggested appropriate strategies In Shillong, India. Methods: This prospective study was conducted between July and October 2019 among commercial taxi drivers (CTDs), with follow?up interviews conducted with a subset of respondents to assess long?term spectacle compliance after a year. Gross ophthalmologic examination was performed, including visual acuity and refraction. Descriptive statistics and Chi?square tests were conducted to assess the association between the type of REs, spectacle compliance, and selected sociodemographic and clinical variables. Multiple logistic regression was performed for analysis of the association between RTAs and sociodemographic, clinical, and work characteristics variables. Results: A total of 382 (95.5%) CTDs completed interviews and gross eye examination. The prevalence of any RE in the worst eye was 28.8% (95% CI: 24.3–33.6). Presbyopia with or without distance vision was the commonest type of RE with 21.7% (95% CI: 17.7%–26.2). Among those who were prescribed spectacles, 70.5% needed near correction. Drivers with RE were nearly two times (OR: 2.6; 95% CI: 1.4–5.1) more likely to be involved in RTAs compared to those without any RE. Long?term spectacle compliance was at 40.9%. The predominant barrier reported for spectacle compliance was “can manage well without spectacles.” Conclusion: This survey has demonstrated a significant relationship between poor vision and occurrence of RTAs. There is an urgent need for tailor?made targeted interventions to address the eye health needs of CTDs in India

Trends in mortality due to traffic accidents in Brazil during the period from 1997 to 2015 for the male population / Tendências da mortalidade em decorrência de traumas de trânsito no Brasil e nas unidades federativas entre os anos de 1997 e 2015 na população masculina

Abstract Background Traffic accidents are one of the main causes of death in Brazil and the increase in the mortality rate is concerning. Objective The study aims to perform a temporal analysis of mortality trends related to traffic accidents in Brazil and its states. Method This is an ecological study of time series of mortality from traffic accidents in Brazil and its Federative Units. Data was obtained from the Information System for Mortality (SIM), processed by Datasus and classified under the headings V01 to V89 (CID-10). Specific mortality rates were calculated and adjusted by age. The temporal tendency analysis was run on the Joinpoint Regression Program. Results The Brazilian male population showed no change in the average annual percentage for the mortality rate (-0.8%; CI 95% -1.7;0.1). Ten states showed increased mortality rates; nine presented a decline, and eight remained constant throughout the period. Conclusion The male population showed no change in the rates, but the mortality rate for the general Brazilian population decreased by 1% per year from 1997 to 2015. Both general and male populations had a decrease of 4.6% and 4.9% per year during the last years, respectively (2012-2015).

Resumo Introdução Acidentes de trânsito são uma das principais causas de morte no Brasil e no mundo. Objetivo O estudo teve por objetivo realizar uma análise temporal da tendência de mortalidade por acidentes de transportes terrestres no Brasil. Método Estudo ecológico de séries temporais da mortalidade por acidentes de transporte terrestre no Brasil no período de 1997 a 2015 para a população masculina. Os dados são provenientes do Sistema de Informação sobre Mortalidade (SIM), processados pelo Datasus e classificados nas rubricas V01 a V89 (CID-10). Foram calculadas as taxas específicas de mortalidade, ajustadas por idade, e realizada análise da tendência temporal através do software Joinpoint Regression Program. Resultados A população brasileira masculina não apresentou mudanças na taxa de mortalidade ao longo dos anos (-0.8%; CI 95% - 1.7;0.1). Dez estados tiveram aumento nas taxas de mortalidade, nove reduziram e oito mantiveram as taxas. Conclusão A população masculina não apresentou diferença nas taxas, entretanto, a população geral apresentou redução de 1% ao ano na taxa mortalidade. Além disso, ambas populações geral e masculina mostraram uma redução de 4,6% e 4,9% ao ano durante os últimos anos (2012- 2015).

Avaliação do grau da implementação do Programa Vida no Trânsito em municípios brasileiros e verificação do desempenho do Record Linkage da "Plataforma Digital do PVT" / Avaliação do grau da implementação do Programa Vida no Trânsito em municípios brasileiros e verificação do desempenho do Record Linkage da "Plataforma Digital do PVT"

Introdução: Em 2020, conclui-se o ciclo da Década de Ações para a Segurança no Trânsito proposto pela Organização das Nações Unidas. Para atingir a meta de redução das mortes estabelecida pela ONU, em 2010, teve início o Programa Vida no Trânsito (PVT), cuja implementação está organizada em quatro etapas: articulação intersetorial; qualificação e integração dos dados; ações integradas de segurança no trânsito; e monitoramento das ações. Considera-se importante identificar quais etapas não estão implementadas e apontar possíveis estratégias para o ajuste do programa, de modo a atingir suas metas. A possibilidade de se obter uma plataforma web capaz de vincular bases epidemiológicas de dados consolidados, permitindo o amplo uso desses na vigilância para a produção de informação sobre os acidentes de trânsito, faz-se oportuna à avaliação do desempenho dessa ferramenta digital. Objetivo: Avaliar o grau da implementação do PVT em 31 municípios, a confiabilidade e a validade no pareamento probabilístico de bases de dados (record linkage) realizado na plataforma digital especialmente desenvolvida para a o PVT. Método: foi realizada uma avaliação formal e normativa, composta de duas fases: a) validação de conteúdo de 28 indicadores da implementação do PVT e b) a avaliação do grau da implementação, a partir de dois inquéritos (2015 e 2017) numa amostra de 30 municípios. Em seguida, Record Linkage (RL) probabilístico foi realizado com uso do software Reclink e da plataforma digital PD-PVT. Estes estudos utilizaram registros disponíveis na base de dados de vítimas do trânsito (VIT), no Sistema de Internação Hospitalar (SIH) e no Sistema de Informação de Mortalidade (SIM), referentes ao segundo trimestre de 2016 de um município participante do PVT. Foi então verificado o desempenho do RL na PD-PVT, por meio da análise das medidas de concordância e validade comparadas à rotina do RL realizado no Reclink. Resultados: O PVT encontra-se parcial ou totalmente implementado em 84,61% dos municípios. Observou-se um aumento no número de municípios implementados, passando de oito para dez, nos anos de 2015 a 2017. Entre as quatro etapas da metodologia do PVT, apenas a primeira, encontra-se implementada. Acerca do desempenho do RL na PD-PVT, a integração entre as bases SIH-VIT e SIM-VIT mostraram uma excelente confiabilidade entre os avaliadores (Kappa 0,95-0,98). Para validade, os resultados do PD-PVT foram: Precision 1,00 (IC 1,00-1,00) para o SIM-VIT; Recall 1,00 (CI 1,00-1,00) para SIH-VIT; e AUCPR 0,99 (CI 0,99-1,00) para SIH-VIT. Conclusão: Este estudo encontrou avanços no processo de implementação do programa nos anos avaliados, no entanto, apenas a primeira etapa apresenta-se implementada nos municípios avaliados. A técnica de RL realizada na PD-PVT mostrou excelente desempenho. É relevante destacar que uma das grandes vantagens desse sistema web está no processo automatizado de pareamento probabilístico. Diante disso, acredita-se que a redução dos passos torne o processo de RL mais ágil e mais simples, possibilitando, dessa forma a incorporação da técnica de RL, na rotina do serviço dos profissionais envolvidos, o que deverá contribuir para o andamento das atividades seguintes à etapa de qualificação da informação.

Introduction: In 2020, the cycle of the Decade of Actions for Traffic Safety proposed by the United Nations Organization ends. In order to reach the goal of reducing deaths caused by the UN, in 2010, the Program Vida no Trânsito (PVT) was started, whose implementation is organized in four stages: intersectoral articulation; qualification and integration of data; integrated traffic safety actions; and monitoring of actions. It is considered important to identify which steps are not implemented and point out possible adjustments to the program in order to achieve its goals. The possibility of obtaining a web platform capable of linking epidemiological databases of consolidated data, allowing wide use in surveillance for the production of information on traffic accidents, makes the performance evaluation of this digital tool opportune. Objective: To evaluate the degree of implementation of the PVT in 31 municipalities, the reliability and validation of the probabilistic pairing of databases (record linkage) carried out on the digital platform specially developed for the PVT. Method: a formal and normative one was carried out, consisting of two phases: a) content validation of 28 indicators of the PVT implementation and b) the evaluation of the degree of implementation, based on two surveys (2015 and 2017) in a sample of 30 municipalities. Then, probabilistic Record Linkage (RL) was performed using the Reclink software and the PD-PVT digital platform. These studies use records available in the traffic death database (VIT), in the Hospital Admission System (SIH) and in the Mortality Information System (SIM), referring to the second quarter of 2016 of a municipality participating in the PVT. The performance of the RL in the PD-PVT was then verified, through the analysis of the measures of agreement and validated to the routine of the RL performed in the Reclink. Results: The PVT is partially or fully implemented in 84.61% of the municipalities. There was an increase in the number of implemented municipalities, from eight to ten, in the years 2015 to 2017. Among the four stages of the PVT methodology, only the first is implemented. Regarding the performance of the RL in the PD-PVT, an integration between the SIH-VIT and permanent SIM-VIT bases and an excellent reliability among the evaluators (Kappa 0.95-0.98). For validation, the PD-PVT results were: Precision 1.00 (CI 1.00-1.00) for SIM-VIT; Remember 1.00 (CI 1.00-1.00) for SIH-VIT; and AUCPR 0.99 (CI 0.99-1.00) for SIH-VIT. Conclusion: This study found advances in the process of implementing the program in the years obtained, however, only the first stage is implemented in the recovered municipalities. The RL technique performed on the PD-PVT revealed excellent performance. It is worth noting that one of the great advantages of this web system is not the automated process of probabilistic matching. Therefore, it is believed that the reduction of steps makes the RL process more agile and simpler, thus enabling an incorporation of the RL technique in the service routine of the professionals involved, which should contribute to the progress of activities following the information qualification stage.