Crash harm before and during the COVID-19 pandemic: Evidence for spatial heterogeneity in Tennessee.

Major concerns have been raised about road safety during the COVID-19 pandemic in the US, as the crash fatalities have increased, despite the substantial reduction in traffic. However, a comprehensive analysis of safety-critical events on roadways based on a broader set of traffic safety metrics and their correlates is needed. In addition to fatalities, this study uses changes in total crashes and total monetary harm as additional measures of safety. A comprehensive and unique time-series database of crashes and socio-economic variables is created at the county level in Tennessee. Statistics show that while fatal crashes increase by 8.2%, total crashes decrease by 15.3%, and the total harm cost is lower by about $1.76 billion during COVID-19 (2020) compared with pre-COVID-19 conditions (2019). Several models, including generalized least squares linear, Poisson, and geographically weighted regression models using the differences between 2020 and 2019 values, are estimated to rigorously quantify the correlates of fatalities, crashes, and crash harm. The results indicate that compared to the pre-pandemic periods, fatal crashes that occurred during the pandemic are associated with more speeding & reckless behaviors and varied across jurisdictions. Fatal crashes are more likely to happen on interstates and dark-not-lighted roads and involve commercial trucks. These same factors largely contribute to crash harm. In addition, a greater number of long trips per person not staying home during COVID-19 is found to be associated with more crashes and crash harm. These results can inform policymaking to strengthen traffic law enforcement through appropriate countermeasures, such as the placement of warning signs and the reduction of the speed limit in hotspots.

Incorporating driving volatility measures in safety performance functions: Improving safety at signalized intersections.

About 40 percent of motor vehicle crashes in the US are related to intersections. To deal with such crashes, Safety Performance Functions (SPFs) are vital elements of the predictive methods used in the Highway Safety Manual. The predictions of crash frequencies and potential reductions due to countermeasures are based on exposure and geometric variables. However, the role of driving behavior factors, e.g., hard accelerations and declarations at intersections, which can lead to crashes, are not explicitly treated in SPFs. One way to capture driving behavior is to harness connected vehicle data and quantify performance at intersections in terms of driving volatility measures, i.e., rapid changes in speed and acceleration. According to recent studies, driving volatility is typically associated with higher risk and safety-critical events and can serve as a surrogate for driving behavior. This study incorporates driving volatility measures in the development of SPFs for four-leg signalized intersections. The Safety Pilot Model Deployment (SPMD) data containing over 125 million Basic Safety Messages generated by over 2,800 connected vehicles are harnessed and linked with the crash, traffic, and geometric data belonging to 102 signalized intersections in Ann Arbor, Michigan. The results show that including driving volatility measures in SPFs can reduce model bias and significantly enhances the models' goodness-of-fit and predictive performance. Technically, the best results were obtained by applying Bayesian hierarchical Negative Binomial Models, which account for spatial correlation between signalized intersections. The results of this study have implications for practitioners and transportation agencies about incorporating driving behavior factors in the development of SPFs for greater accuracy and measures that can potentially reduce volatile driving.

Indian experience of home based mothers card: ICMR task force study.

To improve the quality of MCH services, a Home Based Mothers Card (HBMC) prepared and recommended by World Health Organization was adapted to Indian situation, and introduced in 1.5 lakh population of rural area covered by 6 participating centres under the aegis of Indian Council of Medical Research. Two thousand four hundred and forty six mothers were given this card and were followed up for a period of 2 years. Only 89.2 percent retrieval of the cards was possible after a period of 18 months. Screening of the population for "at risk" women monitoring and referral could be undertaken with the help of this card. Improved antenatal, and referral services were observed during the study period. The card (HBMC) was acceptable to the mothers as well as to the health workers, as a tool for improving the quality and coverage of MCH services being rendered at the Primary Health Centre.

PIP: Health workers at 6 primary health centers in different areas of India introduced the home-based mothers card (HBMC) to 2446 pregnant and mostly illiterate women in November 1984-October 1985 and followed them for 2 years to evaluate the acceptability and feasibility of the HBMC among rural women. Overall retrieval of the HBMCs after 18 months was 89.2%. 66.9% had at least 1 maternal risk factor. The most common risk factors were previous abortions (7.8%), neonatal deaths (5.9%), and fetal deaths (5%). The risk factors associated with the highest perinatal mortality rates were eclampsia (133.3) and fetal deaths (118.2). The researchers learned that they needed to revise the criteria for identifying at-risk mothers by using risk factors associated with the higher risk of perinatal mortality. Women with 3-4 risk factors were more likely to experience perinatal mortality than those with 1-2 risk factors (39.7 and 56.5 vs. 122.5 and 105). Health workers should refer women at highest risk (3-4 risk factors) to a health care facility for delivery. Of the 66.9% at-risk mothers, only 10% experienced risk factors during delivery. The risk factors during delivery were associated with a high relative risk (RR) of perinatal death, e.g., RRs ranged from 1.8 to 4.6. Prenatal care can detect the 2 delivery risk factors with the highest perinatal mortality (multiple pregnancy and abnormal presentation). Health workers should also refer mothers with these risk factors to a health care facility. 78% of at-risk mothers who had been referred to a health facility did indeed go for referral care. Health workers at the centers found the HBMC to be helpful, but it would be more so if it were to include infant health. Anganwadi workers would be more accepting of the card if it had pictorial illustrations.