The Reluctance of Taxi Drivers to Use Seat Belts. Observed and Self-Reported Behavior in Argentina / La reticencia al uso del cinturón de seguridad de los conductores de taxi. Conductas observadas y auto-informadas en Argentina / Relutância em usar cinto de segurança em taxistas. Comportamentos observados e autorrelatados na Argentina

Although taxi drivers are more exposed to traffic crashes, they usually exhibit riskier behaviors and more negative attitudes toward road safety. For example, previous research suggests that they are particularly reluctant to wear seat belts. The research aimed (a) to estimate the prevalence of seat belt use among taxi drivers com-pared to other professional and non-professional drivers (Study 1, n = 3.810) and (b) to explore attitudes toward seat belt use in taxi drivers using the Theory of Planned Behavior (tpb) (Study 2, n = 100). Study 1 showed lower seat belt use among taxi drivers (vs. other professional and non-professional drivers). Study 2 showed that self-reported use tends to be higher than the estimated observed use and that negative experiential attitudes appear to be essential for understanding the reluctance of taxi drivers to use seat belts. Practical implications and future lines of research are discussed.

Aunque los taxistas están más expuestos a los siniestros viales, suelen mostrar comportamientos más arriesgados y actitudes más negativas hacia la seguridad vial. Por ejemplo, investigaciones previas sugieren que son especialmente reacios a usar el cinturón de seguridad. En tal sentido, los objetivos de la presente investigación fueron (a) estimar la prevalencia del uso del cinturón de seguridad entre los taxistas en comparación con otros conductores profesionales y no profesionales (Estudio 1, n = 3.810) y (b) explorar las actitudes hacia el uso del cinturón de seguridad en los taxistas utilizando la Teoría del Comportamiento Planificado (tpb) (Estudio 2, n = 100). El estudio 1 mostró un menor uso del cinturón de seguridad entre los taxistas (frente a otros conductores profesionales y no profesionales). El estudio 2 demostró que el uso auto informado tiende a ser mayor que el uso observado estimado, y que las actitudes negativas por la experiencia parecen ser esenciales para entender la reticencia de los taxistas a utilizar el cinturón de seguridad. Se discuten las implicaciones prácticas y las futuras líneas de investigación.

Embora os taxistas estejam mais expostos a acidentes rodoviários, tendem a exibir comportamentos mais arriscados e atitudes mais negativas em relação à segu-rança rodoviária. Por exemplo, investigações anteriores sugerem que estão particularmente relutantes em usar o cinto de segurança. Os objectivos do presente estu-do foram: (a) estimar a prevalência do uso do cinto de segurança entre taxistas em comparação com outros taxistas profissionais e não profissionais (Estudo 1, n = 3.810), e (b) explorar atitudes em relação ao uso do cinto de segurança entre taxistas utilizando a Teoria do Comportamento Planeado (tpb) (Estudo 2, n = 100). O estudo 1 mostrou um menor uso do cinto de segurança entre os taxistas (em comparação com outros motoristas profissionais e não profissionais). O estudo 2 mostrou que o uso auto-relatado tende a ser superior ao uso observado estimado, e que as atitudesexperimentais negativas parecem ser centrais para compreender a relutância dos taxistas em usar cintos de segurança. São discutidas implicações práticas e linhas futuras de investigação.

Promoção de comportamento seguro no trânsito: relato de uma intervenção / Promoting safe behavior in traffic: an intervention report / Promoción de comportamiento seguro en el tránsito: relato de una intervención

Este artigo objetiva relatar uma intervenção em Psicologia do Trânsito, visando conscientizar jovens estudantes sobre aspectos importantes do trânsito que estão envolvidos no cotidiano. O projeto "Meu Primeiro Certificado UFPR" foi elaborado como projeto piloto para implementação durante a Feira de Profissões da Universidade Federal do Paraná, desenvolvendo quatro temáticas: o pedestre e uso do celular; cinto de segurança; mobilidade com a bicicleta; e entrar no carro com motorista alcoolizado. Estandes com os temas foram montados em pontos estrategicamente distribuídos na feira. Ao entrar na feira, os estudantes recebiam um material já no primeiro estande; ao visitarem os outros quatro estandes, recebiam carimbos de presença em cada um; e, ao final da feira, o estudante recebia um certificado mediante a apresentação do cartão carimbado. Ao todo, o projeto alcançou diretamente 2674 estudantes de Ensino Médio, 68,7% adolescentes mulheres. Os participantes tinham entre 14 e 19 anos (M = 16,59). Do total de jovens, 72,3% estudam em escola pública. Concluiu-se que a aplicação do piloto foi relevante, uma vez que houve grande alcance do público-alvo, que demonstrou interesse em visitar os estandes e dialogar sobre as temáticas apresentadas. O projeto foi bem avaliado pelos participantes, a maioria (75%) classificando-o como excelente.(AU)

This article aims to report a Traffic Psychology intervention that sought to raise awareness about important traffic features involved in everyday life among young students. Developed to be implemented in the Career Expo at the Universidade Federal do Paraná, the pilot project Meu Primeiro Certificado UFPR (My first UFPR Certificate) consisted of four stands strategically positioned along the expo, each approaching one of the following themes: pedestrian's use of mobile phone, seat belt, bicycle use, and travelling with a drunk driver. The students received the material to participate in the activity upon entering the expo; for each visited stand, they received a stamp and, after completing the four stands, they received a certificate. The project was offered to 2674 high school students (68.7% female; 72.3% of whom studied in public schools) aged between 14 and 19 years (M = 16.59); among these, 924 visited all stands and received the certificate. The intervention program was relevant due to its wide reach, as a considerable amount of students showed interest in visiting the stands and talking about the presented topics, with 75% of them rating the project as excellent.(AU)

Este artículo tiene como objetivo relatar una intervención en Psicología del Tránsito con el fin de concientizar a jóvenes estudiantes sobre los aspectos importantes de esta involucrados en el día a día. El proyecto Meu Primeiro Certificado UFPR ("Mi Primer Certificado UFPR") se elaboró como un proyecto piloto y fue desarrollado durante la Feria de Profesiones de la Universidade Federal do Paraná, teniendo en cuenta cuatro temáticas: el peatón y uso del celular; el cinturón de seguridad; la movilidad con la bicicleta y el manejo del coche con conductor alcohólico. Los estudiantes recibían el material en el primero de los stands, junto con un sello de presencia por cada visita a los cuatro stands, y obtenían el certificado al final de la feria mediante la presentación de la tarjeta sellada. En total, el proyecto llegó directamente a 2.674 estudiantes de la secundaria, siendo el 68,7% mujeres. Los participantes tenían edades entre los 14 y los 19 años (media = 16,59). Del total de jóvenes, el 72,3% estudiaban en escuelas públicas. Se concluye que la aplicación piloto se mostró relevante debido al gran alcance dentro del público objetivo, que durante la aplicación se mostró interesado por la visita a los stands y el diálogo con respecto a las temáticas presentadas. En cuanto al nivel de satisfacción, el 75% de los participantes clasificaron el proyecto como excelente.(AU)

Factors Affecting Self-efficacy of Cardiopulmonary Resuscitation(CPR) in Adults / 農村醫學 地域保健

OBJECTIVES: The purpose of this study was factors affecting self-efficacy of cardiopulmonary resuscitation (CPR) in adults. Therefore, the provide basic data for strategy development to improve the performance rate of bystander CPR. METHODS: The data were collected from 164,165 adults of the 2016 Korean Community Health Survey. The survey method was 1:1 interview with households, and the survey period was from August 16, 2016 to October 31, 2016. The survey variables were as follows: self-efficacy of CPR, awareness of CPR, training experience of CPR, demographic characteristics, medical characteristics, health promoting behaviors, and safety practices. RESULTS: The rate of self-efficacy of CPR in adults was 60.6%. Factors affecting self-efficacy of CPR were age, sex, residence, education level, occupation, marital status, any CPR training, CPR training within the last 2 years, CPR training with manikin within the last 2 years, emergency room visit within the last 1 year, physical activity status, drive a bicycle, seat belts on rear seat, seat belts when riding a bus were statistically significant. CONCLUSIONS: In conclusion, in order to improve the self-efficacy of CPR in adults, the recent experience rate of CPR education, the practice rate of health promotion behavior, and the practice rate of safety behavior should be improved. The government should expand the provision of education programs to improve the self-efficacy of CPR and actively prepare national-level public advertisements strategies.

Vaccination = Seat Belt

No abstract available.

Perfil e tendência dos fatores de risco para acidentes de trânsito em escolares nas capitais brasileiras: PeNSE 2009, 2012 e 2015 / Profile and trend of risk factors for traffic accidents in schoolchildren in Brazilian capitals: PeNSE 2009, 2012 and 2015

RESUMO: Introdução: Os acidentes de transporte terrestre (ATT) são a segunda causa de morte em escolares de 13 a 17 anos. O presente estudo visou descrever os fatores de risco para ATT em escolares da Pesquisa Nacional de Saúde do Escolar (PeNSE) de 2015 e avaliar a tendência de indicadores selecionados nas três últimas edições da PeNSE. Metodologia: Estudo descritivo sobre fatores de risco para ATT no ano de 2015, com dados da PeNSE e análise de tendência das séries temporais, com testes de regressão ajustados por idade, das edições de 2009, 2012 e 2015, nas capitais brasileiras. Resultados: Em 2015, 26,3% dos escolares do nono ano, na maioria entre 13 e 15 anos, relataram terem sido conduzidos em veículo motorizado dirigido por alguém que consumiu bebida alcoólica e 32,4% relataram terem dirigido veículo motorizado; 30,7% dos adolescentes não usaram cinto de segurança no banco de trás; e 16,8% dos escolares usuários de motocicleta não usaram capacetes. Observou-se ainda tendência de piora dos indicadores entre 2009 e 2015, referentes a dirigir veículo motorizado (1,0 pontos percentuais) e ter sido conduzido em veículo por alguém que consumiu bebida alcoólica (1,1 pontos percentuais). Discussão: A ocorrência de ATT resulta da interação entre vias, veículos e usuários, tendo forte correlação com o comportamento. Conclusões: Os resultados apontam a necessidade de investir em medidas educativas, associadas a fiscalização, a melhoria das vias, pesquisas e aprimoramento da legislação. O monitoramento dos fatores de risco em escolares contribui substancialmente para apoiar intervenções das políticas públicas intersetoriais para a redução de morbimortalidade por trânsito.

ABSTRACT: Introduction: Land transport accidents (LTA) are the second cause of death in schoolchildren aged 13 to 17 years. The study aims to describe the risk factors for LTA in schoolchildren from the National School Health Survey (PeNSE) of 2015 and to evaluate the trend of selected indicators in the last three editions of PeNSE. Methodology: A descriptive study on risk factors for LTA in 2015, with PeNSE data and time series trends analysis, with age-adjusted regression tests of the 2009, 2012 and 2015 editions, in Brazilian capitals. Results: In 2015, 26.3% of ninth grade schoolchildren, mostly between 13 and 15 years of age, reported having been in a motor vehicle driven by someone who consumed alcohol and 32.4% had driven a motor vehicle; 30.7% of adolescents did not use seat belts in the back seat; and 16.8% of schoolchildren who ride motorcycles did not wear helmets. There was also a worsening of the indicators between 2009 and 2015, regarding driving a motor vehicle (1.0 percentage points) and having been driven by vehicle for consumption of alcoholic beverages (1.1 percentage points). Discussion: The LTA occurrence results from the interaction between roads, vehicles and users, and has a strong correlation with behavior. Conclusions: The results show the need to invest in educational measures, associated with supervision, the improvement of road infrastructure, research and improvement of legislation. The monitoring of risk factors in schoolchildren substantially contributes to support intersectoral public policies interventions to reduce morbidity and mortality in traffic.

Current use of safety restraint systems and front seats in Korean children based on the 2008–2015 Korea National Health and Nutrition Examination Survey / 소아과

PURPOSE: The use of proper safety restraint systems by children is vital for the reduction of traffic accident-related injury and death. This study evaluated the rates of use of safety restraint systems and front seats by Korean children. METHODS: Based on data from the National Health and Nutrition Examination Survey from 2008 to 2015, I investigated the frequencies of safety restraint systems and front seat use by children under six and 12 years of age, respectively. RESULTS: The percentage of respondents who said they always use safety restraint systems increased from 17.7% in 2008 to 45.0% in 2015. The rate of children who did not use the front seats at all was 47.3 % in 2008 compared to 33.4% in 2015. Multivariate logistic regression analysis showed a decrease in safety-restraint-system use as age increased (odds ratio, 0.63; 95% confidence interval [CI], 0.51–0.77). The use rate of front-passenger seat belts by the mother is significantly correlated with the safety-restraint- system use rate by children (odds ratio, 2.14; 95% CI, 1.12–4.06). CONCLUSION: Although the rate of safety-restraint-system use for children is increasing annually, it remains low. Additionally, the use rate of front passenger seats for children is high. To reduce the rates of injury and death of children from traffic accidents, it is necessary to educate on the appropriate use of safety restraint systems according to age and body size and to develop stronger regulations.

Use of child safety seats during transportation of newborns / 소아과

PURPOSE: Child safety seats (CSS) are critical for the protection of children, in case of motor vehicle accidents. Although the national legislation mandates that all newborns must be placed in an appropriately installed CSS during transportation, people often do not perceive the importance of CSS and do not use it as recommended. The purpose of this survey was to understand the use of CSS for the safe transport of newborns from hospital to home. METHODS: We interviewed parents of newborn infants, using a structured questionnaire, at the time of their discharge from Cheil General Hospital & Women’s Health Care Center, between May 2014 and July 2014. RESULTS: A total of 403 participants were interviewed. The rate of CSS use was only 14.9%. Overall, 76.4% of the families interviewed were not aware about the recommendations on CSS use for newborns when travelling in a car. The provision of education on using CSS significantly influenced their rate of use. Parents who were educated about mounting the CSS in a car used it more as compared with others (25.7% vs. 12.2%) (P=0.002). Furthermore, if parents had heard about the importance or necessity of CSS, they used it more than others did (19.5% vs. 10.6%, P=0.032). CONCLUSION: Despite the legal regulation, most parents transport their newborn infants without a CSS while traveling from hospital to their home. The rate of CSS use was influenced by parental education and their knowledge about its necessity. Education programs for parents must be reinforced to increase the CSS use.

Traumatic Lumbar Plexopathy by Seat Belt Injury

STUDY DESIGN: A case report. OBJECTIVES: To report and discuss an extremely uncommon cause of lumbar plexopathy seat belt injury. SUMMARY OF LITERATURE REVIEW: For patients who undergo traffic accidents, most cases of seat belt injury cause trauma to the lower torso. Seat belt injury is associated with variable clinical problems such as vascular injury, intestinal injury (perforation), vertebral injury (flexion-distraction injury), chest wall injury, diaphragmatic rupture/hernia, bladder rupture, lumbosacral plexopathy, and other related conditions. MATERIALS AND METHODS: A 38-year-old male truck driver (traffic accident victim) who suffered monoplegia of his right leg due to lumbar plexus injury without spinal column involvement. Injury to a lumbar plexus and the internal vasculatures originated from direct compression to internal abdominal organs (the iliopsoas muscle and internal vasculatures anterior to the lumbar vertebrae) caused by the seat belt. We have illustrated an extremely uncommon cause of a neurologic deficit from a traffic accident through this case. RESULTS: Under the impression of traumatic lumbar plexopathy, we managed it conservatively, and the patient showed signs of recovery from neurologic deficit. CONCLUSIONS: We need to review the lumbar plexus pathway, in patients with atypical motor weakness and sensory loss of the lower extremities which are not unaccompanied by demonstrable spinal lesions. Therefore, close history taking, physical examination and comprehension of injury mechanism are important in the diagnosis.

Appendiceal transection associated with seat belt restraint

The seat belt is designed for safety in a motor vehicle and should be worn to prevent severe injuries. But, the seat belt itself can be an injury factor in combination with deceleration forces applied to fixation points of mobile viscera. Here, we present a 23-year-man with traumatic transection of the appendix, highly mobile viscera, following seat belt injury.

Preventive Effects of Seat Belt on Clinical Outcomes for Road Traffic Injuries

Proper seat belt use saves lives; however, the use rate decreased in Korea. This study aimed to measure the magnitude of the preventive effect of seat belt on case-fatality across drivers and passengers. We used the Emergency Department based Injury In-depth Surveillance (EDIIS) database from 17 EDs between 2011 and 2012. All of adult injured patients from road traffic injuries (RTI) in-vehicle of less than 10-seat van were eligible, excluding cases with unknown seat belt use and outcomes. Primary and secondary endpoints were in-hospital mortality and intracranial injury. We calculated adjusted odds ratios (AORs) of seat belt use and driving status for study outcomes adjusting for potential confounders. Among 23,698 eligible patients, 15,304 (64.6%) wore seat belts. Driver, middle aged (30-44 yr), male, daytime injured patients were more likely to use seat belts (all P < 0.001). In terms of clinical outcome, no seat belt group had higher proportions of case-fatality and intracranial injury compared to seat belt group (both P < 0.001). Compared to seat belt group, AORs (95% CIs) of no seat belt group were 10.43 (7.75-14.04) for case-fatality and 2.68 (2.25-3.19) for intracranial injury respectively. In the interaction model, AORs (95% CIs) of no seat belt use for case-fatality were 11.71 (8.45-16.22) in drivers and 5.52 (2.83-14.76) in non-driving passengers, respectively. Wearing seat belt has significantly preventive effects on case-fatality and intracranial injury. Public health efforts to increase seat belt use are needed to reduce health burden from RTIs.

Correct use of safety belts and child restraint devices in cars among children in Goiânia / Uso correto do cinto de segurança e dos dispositivos de restrição infantil em automóveis de Goiânia

Objective: to conduct an observational study, by means of campaigns, regarding the use of child restraint devices in cars in Goiânia. Methods: this was a cross-sectional study using a convenience sample built up as cases arose. The data were gathered into an Excel spreadsheet and were analyzed descriptively and statistically (SPSS 16.0), using chi-square and taking p < 0.05 as significant. Results: in 2006, 410 cars were evaluated, and in 2010, 544 cars were evaluated. Around 85% of the occupants were using seat belts correctly at both times (p = 0.650). In 2006, it was observed that a total of 273 passengers were occupying the rear seats, while in 2010 there were 226. Among these, 178 and 170 were using seat belts, respectively, i.e. 65.2% and 75.22% (p = 0.001). In 2006, five children were occupying the front seat without using the seat belt, while in 2010, this number was 42 (p < 0.001). In 2010, it was observed that 458 vehicles were transporting children on the rear seats, and this was being done correctly in 214 vehicles, i.e. 46.72%. In 2006, of the 410 vehicles analyzed, only 90 of them (21.95%) were transporting children correctly (p < 0.001). In addition, there was a difference in the variables within the year evaluated, in which transportation done correctly in the front seat was much more frequent than transportation done correctly in the rear seats, in both years (p < 0.001). Cars transported one to four children, while vans transported one to nine children. In 2006, one van transporting children irregularly was observed, while in 2010 it was done correctly in all cases. Conclusion: comparing these two years (2006 and 2010) in which data were gathered, we can conclude that changes in behavior among drivers in Goiânia have begun, with regard to safety when transporting children in vehicles, with an improvement of 25% (p < 0.001). A large part of this has come through changes in knowledge among ...

Objetivo: Fazer um estudo observacional, por meio de campanhas, sobre o uso dos dispositivos de restrição infantil em automóveis de Goiânia. Métodos: Estudo transversal por amostra de conveniência conforme surgimento dos casos. Os dados foram coletados em uma tabela Excel, analisados de forma descritiva e estatística (SPSS 16.0), com o uso do qui-quadrado, com p < 0,05 como significativo. Resultados: Em 2006, foram avaliados 410 automóveis, enquanto que em 2010 foram avaliados 544, nos quais cerca de 85% das pessoas usavam o cinto de forma correta nos dois períodos (p = 0,650). Em 2006, foram observados 273 passageiros no banco dianteiro e em 2010, 226. Usavam cinto de segurança 178 e 170, respectivamente, ou 65,2 e 75,22% (p = 0,001). Em 2006, cinco crianças ocupavam o banco da frente sem o uso do cinto de segurança. Em 2010, esse número foi de 42 (p < 0,001). Em 2010, foram observados 458 veículos que transportavam crianças no banco traseiro, 214 de maneira correta, ou 46,72%. Em 2006, dos 410 veículos analisados, apenas 90 (21,95%) transportavam crianças de maneira correta (p < 0,001). Além disso, houve diferença entre as variáveis dentro do ano avaliado, no qual o transporte correto no banco da frente foi bem mais frequente do que o no banco de trás, nos dois anos (p < 0,001). Carros transportavam de uma a quatro crianças e as vans, de uma a nove crianças. Em 2006 foi observada uma van que transportava crianças de maneira irregular, enquanto que em 2010 todas estavam corretas. Conclusão: Na comparação desses dois períodos, podemos avaliar que houve um início de mudança no comportamento do motorista goianiense no que tange à segurança no transporte de crianças em automóveis, com melhoria de 25% (p < 0,001). Grande parte disso decorreu da mudança ...

The Impact of Seat-belts in Limiting the Severity of Injuries in Patients Presenting to a University Hospital in the Developing World

Road traffic injuries are major public health problems and a leading cause of death and injury around the world. Approximately 1.2 million people are killed each year in road crashes worldwide; with up to 50 million more injured. Over 95 of these deaths and injuries occur in the low- and middle-income countries of the world. The aim of this study is to evaluate the impact of the use of seat-belts in reducing the severity of injuries from road traffic crashes and to determine the compliance and awareness of the importance of the use of seat-belts among Nigerian motorists. Patients and Methods: The injury patterns and outcome of care in 140 patients who were seen at the emergency department of our tertiary hospital were evaluated. Initial care and resuscitation was carried out on all patients using the advanced trauma life support protocol. Results: A total of 81 (57) patients used seat-belts; while 59 (42.1) did not. Nineteen (13.6) patients died as a result of their injuries; 4 (21.1) of these had used seat-belts; while 15 (79) had not ( P = 0.001). The mortality rate of 79 for patients who did not use seat-belt was statistically significant. Conclusions: The seat-belt is an effective safety tool that not only saves lives; but also significantly reduces the severity of the injury that a vehicle occupant may have sustained if they were not wearing the device. More public enlightenment is needed to increase the awareness and compliance of use of seat-belts among Nigerian motorists. for patients who did not use seat-belt was statistically significant. Conclusions: The seat-belt is an effective safety tool that not only saves lives; but also significantly reduces the severity of the injury that a vehicle occupant may have sustained if they were not wearing the device. More public enlightenment is needed to increase the awareness and compliance of use of seat-belts among Nigerian motorists

The Effect of Rear Seatbelt Advocacy and Law Enforcement in Reducing Injuries among Passenger Vehicle Occupants in Malaysia

The increase in car usage due to economic prosperity has led to increase in occupant injuries. One way to reduce the injuries encountered by road accident victims is by implementing the rear seatbelt (RSB) law. Rear seatbelt wearing has been proven to save lives. In Malaysia, the implementation of the restraint system for front occupant has started in the 70’s. However, the rear seatbelt enforcement law only came in 2009, after six months of an advocacy program. Prior to the introduction of the rear seatbelt law, rear seatbelt wearing rate was rather low, started to increase gradually during the advocacy period and jumped to the highest level after two month of the enforcement. This paper attempts to assess the effectiveness of the rear seatbelt intervention in reducing injuries among passenger car occupants in Malaysia using the generalized linear model (GLM). In GLM procedure, the dependent variable is the number of people from passenger vehicles that sustained severe and slight injuries, for the study period. The study period selected covers six months before implementation, six months during advocacy program, and six months after the law is implemented. The independent variables considered are enforcement and balik kampung activities (both are dummy variables) and time effect. Our results suggest that RSB intervention (p-value= 0.0001) had significantly reduced the number of people sustained serious and slight injuries by about 20%. The implementation of change in the RSB law has benefited not only in reducing the number of injuries but also result to great impact to the health outcomes.

Splenic artery pseudoaneurysm due to seatbelt injury in a glucose-6-phosphate dehydrogenase-deficient adult

A 23-year-old man presented with abdominal pain after suffering blunt trauma caused by a seatbelt injury. His low platelet count of 137 × 10(9)/L was initially attributed to trauma and his underlying hypersplenism due to glucose-6-phosphate dehydrogenase (G6PD) deficiency. Despite conservative management, his platelet count remained persistently reduced even after his haemoglobin and clotting abnormalities were stabilised. After a week, follow-up imaging revealed an incidental finding of a pseudoaneurysm (measuring 9 mm × 8 mm × 10 mm) adjacent to a splenic laceration. The pseudoaneurysm was successfully closed via transcatheter glue embolisation; 20% of the spleen was also embolised. A week later, the platelet count normalised, and the patient was subsequently discharged. This case highlights the pitfalls in the detection of a delayed occurrence of splenic artery pseudoaneurysm after blunt injury via routine delayed phase computed tomography. While splenomegaly in G6PD may be a predisposing factor for injury, a low platelet count should arouse suspicion of internal haemorrhage rather than hypersplenism.

Injury to the Abdominal Aorta from a Seat Belt in a Frontal Motor Vehicle Collision

In traffic accidents, wearing a seatbelt can cause abdominal aortic injury due to an abrupt deceleration. We report a case of abdominal aorta dissection caused by a seat belt in a frontal motor vehicle collision. The initial symptoms and signs were vague or uncertain. However, he complained severe abdominal pain with seat belt sign below the umbilicus. Abdominal computed tomography scans showed an initial flap of the abdominal aorta with hematoma and hazy stranding of the mesentery.

Road safety legislation in the Americas / Legislación sobre seguridad vial en las Américas

Legislating five of the main risk factors for road traffic injuries (RTIs), as much as enforcing the law, is essential in forging an integral culture of road safety. Analysis of the level of progression in law enforcement allows for an evaluation of the state of world regions. A secondary analysis of the 2009 Global status report on road safety: time for action survey was undertaken to evaluate legislation on five risk factors (speed management, drinking and driving, motorcycle helmet use, seatbelt use, and use of child restraints) in the Americas. Laws were classified depending on their level of progression: the existence of legislation, whether the legislation is adequate, a level of law enforcement > 6 (on a scale of 0-10), and whether the law is considered comprehensive. A descriptive analysis was performed. The totality of the countries has national or subnational legislation for at least one of the five risk factors. However, 63% have laws on the five risk factors studied, and none of them has comprehensive laws for all five. Seatbelt use appears to be the most extended enforced legislation, while speeding laws appear to be the least enforced. There are positive efforts that should be recognized in the region. However, the region stands in different stages of progression. Law enforcement remains the main issue to be tackled. Laws should be based on evidence about what is already known to be effective.

La legislación sobre cinco de los principales factores de riesgo de sufrir lesiones causadas por el tránsito, así como el cumplimiento de la ley, son esenciales para forjar una cultura integral de seguridad vial. El análisis del nivel de progresión en el cumplimiento de la ley permite evaluar el estado de las regiones del mundo. Se llevó a cabo un análisis secundario de la encuesta Informe sobre la situación mundial de la seguridad vial: es hora de pasar a la acción, de 2009, para evaluar la legislación sobre cinco factores de riesgo (control de la velocidad, conducir bajo la influencia del alcohol, uso del casco al conducir motocicletas, uso de cinturones de seguridad y uso de sistemas de retención para niños) en las Américas. Las leyes se clasificaron según su nivel de progresión: la existencia de legislación, si la legislación es adecuada, un nivel de cumplimiento de la ley > 6 (en una escala de 0-10) y si la ley se considera integral. Se realizó un análisis descriptivo. Todos los países tienen legislación nacional o subnacional al menos con respecto a uno de los cinco factores de riesgo; sin embargo, 63% tienen leyes sobre los cinco factores de riesgo estudiados, y ninguno de ellos tiene leyes integrales para los cinco. La legislación sobre uso de cinturones de seguridad parece ser la de mayor cumplimiento, mientras que las leyes de exceso de velocidad parecen ser las que menos se cumplen. En la región hay esfuerzos positivos que deben reconocerse; sin embargo, existen diferentes etapas de progresión. El cumplimiento de la ley sigue siendo el principal tema por abordar. Las leyes deben basarse en datos de eficacia reconocida.

Pediatric trauma due to motor vehicle accidents on high traffic roadway / Trauma pediátrico devido a acidente veicular em via de grande tráfego

Objective: To outline a profile of pediatric trauma victims and verify the likelihood of trauma in children on a high traffic roadway. Methods: A descriptive cohort study of the records of emergency medical service activations on the Rio-Niterói Bridge, a high traffic roadway in Rio de Janeiro, Brazil. Descriptive statistics were expressed as absolute and relative frequencies. The estimated risk of trauma in children aged < 12 years was calculated by means of odds ratios, with a 95% confidence interval. Results: Trauma accounted for 514 of 1,244 activations (41.31%) of the Rio-Niterói Bridge emergency medical service between March 2002 and March 2003. Response to incidents involving children aged < 12 years accounted for 52 of these (4.18%). Half of victims were between the ages of 6 and 12 years (n = 26), and 55.76% were male (n = 29). Of the 52 victims, 37 (71.15%) were involved in motor vehicle accidents (OR: 3.70; 95%CI: 1.94-7.13; p < 0.0001). Of these, 28 were vehicle?vehicle collisions (75.67%). The most common sites of injury were the extremities (n = 12; 32.43%), face (n = 10; 27.02%), and head (n = 9; 24.32%). Pre-hospital procedures were performed on 23 of the 37 patients (62.16%), and 44.23% (n = 23/52) required hospital transportation. There were no deaths during the study period. Conclusions: In this study, children were at significantly higher odds of being treated for trauma while on a highway with heavy traffic flow. The most common sites of injury in this sample were the lower extremities and the head, face, and neck complex.

Objetivo: Caracterizar o perfil dos atendimentos pediátricos por trauma e verificar a chance de ocorrência de trauma em uma rodovia de alto fluxo de veículos. Métodos: Estudo de coorte descritivo dos dados armazenados nos boletins de atendimentos realizados por grupo de resgate pré-hospitalar da Ponte Rio-Niterói, uma via de grande tráfego, no Rio de Janeiro. Estatística descritiva foi aplicada utilizando-se a frequência simples e percentual, verificando-se o risco estimado de "trauma" em crianças < 12 anos, por meio de odds ratio, com intervalo de confiança de 95%. Resultados: Em 1.244 atendimentos, entre março de 2002 e março de 2003, trauma representou 41,31% (n = 514), 76% do sexo masculino dos casos. O atendimento a crianças de até 12 anos correspondeu a 4,18% (n = 52) e metade das vítimas tinha entre 6 e 12 anos (n = 26), sendo 29 (55,76%) do sexo masculino. Entre as 52 vítimas, 71,15% (n = 37) estavam envolvidas em acidente de trânsito (OR: 3,70; IC95%: 1,94-7,13; p < 0,0001), sendo 28 (75,67%) colisões. Os locais mais frequentes de lesões foram extremidades (n = 12; 32,43%), face (n = 10; 27,02%) e cabeça (n = 9; 24,32%). Os procedimentos pré-hospitalares foram realizados em 23 dos 37 pacientes (62,16%) e 44,23% (n = 23/52) necessitaram de remoção hospitalar. Não houve óbito pediátrico durante o período analisado. Conclusões: Neste estudo as crianças apresentaram maior probabilidade de serem tratadas para traumatismo nessa rodovia de intenso fluxo de veículos. Os locais mais frequentes de lesões foram membros inferiores e o complexo cabeça, face e pescoço.

Uso de sistemas de seguridad vial en vehículos en los que viajan niños y adolescentes uruguayos. Estudio observacional en tres ciudades uruguayas / Using road safety systems in vehicles traveling Uruguayan children and adolescents. Observational study in three cities in Uruguay

Introducción: los traumatismos o injurias causadaspor siniestros de tránsito constituyen un serio problema de salud en Uruguay y en el mundo. El uso de cinturón de seguridad y sistemas de retención infantil constituyen medidas fundamentales para prevenir estos traumatismos o disminuir sus consecuencias. En Uruguay la Ley de Tránsito y Seguridad Vial Nº 18.191, decreta obligatoriedad en el uso de cinturón por el conductor y los pasajeros. No hace referencia a sistemas de seguridad específicos para niños. Objetivo: describir características vinculadas a la seguridad intravehicular de niños uruguayos que viajan en vehículos particulares motorizados de cuatro ruedas y la prevalencia del uso de cinturón de seguridad de los mayoresde14 añosqueviajanconellos. Método: estudio descriptivo, observacional, transversal realizado en Montevideo, Salto y Paysandú, en mayo y junio de 2008. Resultados: vehículos observados 909. Total de ocupantes 2.523. 47 % eran menores de 14 años.Viajaban en filas delanteras: 25% de los menores de 5 años y 32% de los menores de un año. No utilizabansistema de seguridad intravehicular 83 % de los menores de 14 años. No utilizaban cinturón de seguridad 45 % de los mayores de 14 años. Conclusiones: es imperativa la elaboración y aprobación de leyes sobre el uso de sistemas de retención infantil adecuados así como el desarrollo de acciones de fiscalización del cumplimiento de éstas. Es tarea de todos promover la responsabilidad social apelando a modificar la conducta en la vía pública con el fin de disminuir los factores de riesgo que inciden en la enfermedad traumática.

A Comparison of Community Health Status by Region and an Investigation of related Factors using Community Health Indicators

PURPOSE: The purpose of this paper was to compare community health status by region and to investigate related factors using community health and social indicators. METHODS: Data were collected from statistics of local districts that were provided by KNSO and KCDC. ANOVA and correlation were analyzed using PASW 18.0. RESULTS: The standardized cancer mortality rate was higher in metropolitan areas than in other areas. On the contrary, the mortality of respiratory disease, traffic accident, and suicide were higher in rural areas. Small cities and county districts showed higher prevalence in obesity prevalence than metropolitan areas. Metropolitan areas presented higher prevalence in alcohol drinking during the previous month, perceived stress, and seat belt use. The age-adjusted standardized mortality rate was correlated with higher prevalence of smoking, obesity, percentage of the elderly, number of beds, number of social welfare facilities, number of registered cars, lower percentage of financial independence, number of doctors, and percentage of water supply service & sewage. CONCLUSION: Since significant differences in mortality rate and prevalence of health risk behaviors exist between regional areas and the mortality rate was correlated with other social indicators and health indicators, health policies and social policies considering these differences should be develop and implemented to the communities.