ABSTRACT
Background: Motorcycle accidents pose a significant threat to traffic safety in Thailand, particularly in rural areas where the severity of these accidents often results in prolonged medical treatment and a reduction in the quality of life of the affected individual. Objectives: To investigate the prevalence and the factors associated with motorcycle accidents among motorcycle riders in rural areas in Chiang Mai, Thailand. Method: A cross-sectional study was conducted from December 2022 to March 2023 via an anonymous survey in Chiang Mai, Thailand. A total of 308 participants engaged with the survey. The data about background information, motorcycle details, personal protective equipment, risky behaviors, attitude toward riding, and history of motorcycle accidents in the prior six months were collected and analyzed by binary logistic regression. Results: Of 308 participants, the mean age was 56 years old (SD = 14.2), females were 56.8 % (N = 175), 51 % had co-morbidity, and 40.6 % were active alcohol drinkers. The prevalence of individuals who experienced a motorcycle accident within the previous six months was 57.1 %. Notably, the most unsafe riding behavior was not wearing a helmet while riding, which had a prevalence of more than 80 % in both the accident and non-accident groups. The study found significant associated factors for motorcycle accidents in rural communities, including the history of alcohol consumption (aOR 1.71, 95 % CI: 1.05,2.79), changing lanes without using turn signals (aOR 1.93, 95 % CI: 1.07,3.48) and those who strongly disagree with the notion that listening to music while riding is dangerous (aOR 2.80, 95 % CI: 1.06, 7.43). Conclusion: Over half of motorcycle riders have been in accidents. These findings emphasize the need to enforce drunk-driving and traffic laws. Comprehensive motorcycle rider education and safety training are needed to encourage responsible riding.
ABSTRACT
OBJECTIVE: Behavioral symptoms are common after traumatic brain injury (TBI), but their treatments remain unsatisfactory. This systematic review and meta-analysis compared the efficacy and acceptability between blue-wavelength light therapy (BWLT) and long-wavelength/no light therapy (LW/NLT) for post-TBI sleepiness, sleep disturbance, depressive symptoms, and fatigue. METHODS: This study included randomized controlled trials comparing the effects of BWLT and LW/NLT on post-TBI sleepiness, sleep disturbance, depression, or fatigue. We searched Pubmed, Embase, CINAHL, and Cochrane Central Register of Controlled of Trials on April 13, 2022. The revised tool for assessing the risk of bias in randomized trials was applied. We performed a frequentist pairwise meta-analysis using a random-effects model. RESULTS: Of 233 retrieved records, six trials (N = 278) were included in this meta-analysis. TBIs ranged from mild to severe, and the interventions were administered for a median of 35 days. Most trials delivered light therapy via lightboxes. Three trials had a high risk of bias. BWLT was significantly superior to LW/NLT in reducing sleep disturbance (5 trials; SMD = -0.63; 95% CI = -1.21 to -0.05; p = 0.03; I2 = 61%) and depressive symptoms (4 trials; SMD = -1.00; 95% CI = -1.62 to -0.38; p < 0.01; I2 = 56%). There were trends that BWLT was superior to LW/NLT in reducing sleepiness (6 trials; SMD = -0.92; 95% CI = -1.84 to 0.00; p = 0.05; I2 = 88%) and fatigue (4 trials; SMD = -1.44; 95% CI = -2.95 to 0.08; p = 0.06; I2 = 91%). All-cause dropout rates were not significantly different between groups. CONCLUSION: Limited and heterogenous evidence suggests that short-term BWLT is well accepted, has a large treatment effect on post-TBI depressive symptoms, and may have a moderate treatment effect on post-TBI sleep disturbance.
Subject(s)
Sleep Wake Disorders , Sleepiness , Depression/therapy , Fatigue/therapy , Humans , Randomized Controlled Trials as Topic , Sleep Wake Disorders/therapyABSTRACT
OBJECTIVE: This review aimed to determine the efficacy of blue-wavelength light therapy (BWLT) for post-traumatic brain injury (TBI) sleepiness, sleep disturbance, depression, and fatigue. METHODS: Pubmed, Scopus, Web of Science, Cochrane Library, Academic Search Complete, and CINAHL. Included trials were randomized controlled trials (RCTs) of BWLT in adults with a history of TBI. Outcomes of interest included sleepiness, sleep disturbance, depression, or fatigue. Two reviewers independently screened the searched items, selected the trials, extracted the data, and rating the quality of trials. We aggregated the data using a random-effect, frequentist network meta-analysis (NMA). RESULTS: We searched the databases on July 4, 2020. This review included four RCTs of 117 patients with a history of TBI who were randomized to received BWLT, amber light therapy (ALT), or no light therapy (NLT). Moderate-quality evidence revealed that: i) BWLT was significantly superior to NLT in reducing depression (SMD = 0.81, 95% CI = 0.20 to 1.43) ii) BWLT reduced fatigue at a significantly greater extent than NLT (SMD = 1.09, 95% CI = 0.41 to 1.76) and ALT (SMD = 1.00, 95% CI = 0.14 to 1.86). Low-quality evidence suggested that BWLT reduced depression at a greater extent than ALT (SMD = 0.57, 95% CI = 0.04 to 1.10). Low-quality evidence found that the dropout rates of those receiving BWLT and ALT were not significantly different (RR = 3.72, 95% CI = 0.65 to 21.34). CONCLUSION: Moderate-quality evidence suggests that BWLT may be useful for post-TBI depression and fatigue.
