Variabilidad interobservador del baremo de tráfico (Ley 35/2015) y utilidad de las pruebas biomecánicas en la valoración de las secuelas / Inter-observer variability of the traffic rate system (law 35/2015) and utility of biomechanical tests in the assessment of sequels

Introducción: la Ley 35/2015 valora daños y perjuicios en los accidentes de circulación y trata de garantizar una respuesta igualitaria ante situaciones idénticas. La valoración funcional biomecánica (VFB) es una prueba médica complementaria que aporta objetividad en la evaluación de la cervicalgia postraumática. Este estudio analiza la variabilidad interobservador del sistema de valoración de la Ley 35/2015 y estudia el efecto de la VFB y del perfil del evaluador en la determinación de secuelas.Material y métodospara ello, 49 profesionales de la valoración del daño corporal evaluaron 5 casos clínicos de accidentados con cervicalgia postraumática; un mes más tarde, 35 de los anteriores valoraron los mismos casos incluyendo informe de VFB.Resultadoshay una elevada variabilidad en la determinación de los días de perjuicio personal (coeficientes kappa entre 0,04 y 0,073) con o sin VFB; una elevada variabilidad interobservador en la valoración de las secuelas en los casos sin VFB (coeficientes kappa entre 0,022 y 0,044), que mejora discretamente con VFB (coeficientes kappa entre 0,128 y 0,26), aún mostrando concordancia débil. El resultado de la VFB tiene influencia en la determinación de las secuelas (p < 0,01), no así el perfil del evaluador. Más del 79,4% de los evaluadores encontraron útiles las pruebas para poner de manifiesto o confirmar sintomatología, recuperación o simulación.Conclusionesexiste variabilidad en la aplicación de la Ley 35/2015 para la valoración de los accidentados de tráfico con cervicalgia postraumática entre los profesionales del daño corporal. La VFB resulta de utilidad para los evaluadores y tiene influencia en la determinación de las secuelas. (AU)

Introduction: Law 35/2015 assesses damages in traffic accidents and tries to guarantee an equal response to identical situations. Biomechanical functional assessment (BFA) is a complementary medical test that provides objectivity in the evaluation of post-traumatic neck pain. This study analyzes the interobserver variability of the assessment system defined by Law 35/2015 and studies the effect of having BFA tests and the profile of the evaluator in determining sequelae.Materials and methodsTo do this, 49 professionals in the assessment of bodily injury evaluated 5 clinical cases of accident victims with post-traumatic neck pain; a month later, 35 of them assessed the same cases including a BFA report.ResultsThe results show high variability in determining the days of personal injury (Kappa coefficients between 0.04 and 0.073) with or without BFA; high interobserver variability in the assessment of sequelae in cases without BFA (Kappa coefficients between 0.022 and 0.044), which slightly improves with BFA (Kappa coefficients between 0.128 and 0.26), even showing weak concordance. The BFA has an influence on the determination of sequelae (p < 0.01), but the profile of the evaluator does not. More than 79.4% of the evaluators found the BFA tests useful to reveal or to confirm symptoms, recovery, or simulation.ConclusionsThere is variability in the application of Law 35/2015 for the assessment of traffic accidents among professionals of bodily injury. The BFA is useful for evaluators and influences the determination of sequelae. (AU)

How many collateral casualties are associated with road users responsible for road crashes? / ¿Cuántas víctimas colaterales se asocian con los usuarios de la carretera responsables de los accidentes de tráfico?

Objective: To estimate the number of collateral casualties associated with road users considered responsible for a road crash. Method: We analyzed the case series comprising all 790,435 road users involved in road crashes with victims in Spain from 2009 to 2013, recorded in a nationwide police-based registry. For each road user assumed to be responsible for a crash, we collected information relative to health outcomes in other people involved in it, and obtained the total number of collateral casualties per 100 road users considered responsible for the crash. We then estimated the strength of associations between sex, age and the number of collateral casualties generated by car drivers considered responsible for the crash, and calculated rate ratios and corresponding 95% confidence intervals. Results: Pedestrians responsible for crashes were associated with the lowest number of collateral casualties (13.1/100), whereas the highest number (153/100) was observed for bus drivers responsible for crashes. Car drivers were associated with 104.4/100 collateral casualties. The youngest and the oldest car drivers responsible for crashes were associated with 33% and 41% more deaths, respectively, than the 25-34 year old group. Male drivers were associated with 22% more collateral casualties than female drivers. Conclusions: Regardless of the type of road user who was responsible for a road crash, their active contribution to the crash led to an additional number of collateral casualties in other, non-responsible users. The number and severity of collateral casualties were related to the type of vehicle and the number of people involved. These results are potentially useful to support the need to promote safer driver practices among subgroups of high-risk drivers. (AU)

Objetivo: Estimar el número de víctimas colaterales asociadas a los usuarios de las vías de tráfico responsables de una colisión. Método: Se estudió la serie de casos formada por los 790.435 usuarios de la vía implicados en accidentes de tráfico con víctimas en España, entre 2009 y 2013, recogidos en el Registro de Accidentes de Tráfico con Víctimas de la Dirección General de Tráfico. Para cada uno de los usuarios considerado responsable se recogió información sobre las consecuencias sanitarias para las otras personas implicadas en el mismo accidente, y se calculó el número total de víctimas colaterales por cada 100 usuarios responsables. A continuación se estimó la fuerza de asociación de la edad y el sexo de los conductores de turismo con el número de víctimas colaterales generadas por ellos, y se obtuvieron las correspondientes razones de tasas y sus intervalos de confianza del 95%. Resultados: Los peatones responsables de atropellos se asociaron al menor número de víctimas colaterales (13,1/100), mientras que la cifra más alta de estas (153/100) se asoció a los conductores de autobús responsables del accidente. Los de turismo implicaron a 104,4/100. Los conductores de turismo más jóvenes (<25 años) y los de mayor edad (>64 años) implicaron respectivamente un 33% y un 41% más de víctimas colaterales que el grupo de 25-34 años. Los varones se asociaron a un 22% más de víctimas colaterales que las mujeres. Conclusiones: Independientemente del tipo de usuario responsable del accidente, su contribución activa se asoció a un número adicional de víctimas colaterales, cuyas magnitud y gravedad dependieron sobre todo del tipo de vehículo conducido. Este trabajo puede ser útil para reforzar las actuaciones destinadas a prevenir la accidentalidad en los usuarios de alto riesgo. (AU)

How many collateral casualties are associated with road users responsible for road crashes?

OBJECTIVE: To estimate the number of collateral casualties associated with road users considered responsible for a road crash. METHOD: We analyzed the case series comprising all 790,435 road users involved in road crashes with victims in Spain from 2009 to 2013, recorded in a nationwide police-based registry. For each road user assumed to be responsible for a crash, we collected information relative to health outcomes in other people involved in it, and obtained the total number of collateral casualties per 100 road users considered responsible for the crash. We then estimated the strength of associations between sex, age and the number of collateral casualties generated by car drivers considered responsible for the crash, and calculated rate ratios and corresponding 95% confidence intervals. RESULTS: Pedestrians responsible for crashes were associated with the lowest number of collateral casualties (13.1/100), whereas the highest number (153/100) was observed for bus drivers responsible for crashes. Car drivers were associated with 104.4/100 collateral casualties. The youngest and the oldest car drivers responsible for crashes were associated with 33% and 41% more deaths, respectively, than the 25-34 year old group. Male drivers were associated with 22% more collateral casualties than female drivers. CONCLUSIONS: Regardless of the type of road user who was responsible for a road crash, their active contribution to the crash led to an additional number of collateral casualties in other, non-responsible users. The number and severity of collateral casualties were related to the type of vehicle and the number of people involved. These results are potentially useful to support the need to promote safer driver practices among subgroups of high-risk drivers.

[Association between type of vehicle and the risk of provoking a collision between vehicles]. / Asociación del tipo de vehículo con el riesgo de provocar una colisión entre vehículos.

OBJECTIVE: To quantify the magnitude of the association between the type of vehicle and the probability of being responsible for a collision between two or more vehicles. METHOD: From the registry of road crashes with victims maintained by the Spanish Traffic General Directorate (2014 and 2015), a matched case-control study was designed. Cases were offending drivers involved in the 27,630 collisions between two or more vehicles in which only one of the drivers had committed a driving mistake or offence. Each case was matched with the non-offending drivers of the vehicles involved in the same crash: in all, 31,219 controls were included. Apart from the commission of offences and the type of vehicle involved, we got information about other characteristics of the driver (age, sex, etc.) and about the vehicle (age). Odds ratios (OR) were calculated in order to quantify the association between each type of vehicle and the odds of being responsible for the collision, crude and adjusted (by conditioned logistic regression) by the rest of collected variables. RESULTS: In comparison with private cars, bicycles had a lower risk of causing a collision (adjusted OR: .30), and also mopeds (aOR: .52) and buses (aOR: .63). Vans (aOR: 1.19) and four-wheel vehicles (aOR: 1.33) increased the risk. CONCLUSION: Two-wheeled vehicles and buses had a lower risk of causing collisions than private cars. This association is independent of some of the characteristics of the driver, as well as the age of the vehicle.

Sistema de indicadores de morbilidad y mortalidad por accidentes de tráfico: una revisión sistemática / System of morbidity and mortality indicators for traffic accidents: a systematic review

RESUMEN Objetivo Elaborar un sistema de indicadores de morbilidad y mortalidad por accidentes de tráfico, con el fin de mejorar los procesos de recopilación y registro de la información de seguridad vial en el país. Materiales y Métodos Revisión sistemática cualitativa de artículos científicos publicados en revistas indexadas en las principales bases de datos (Scopus, PubMed, Lilacs, SciELO, Google Scholar), sobre accidentes de tráfico desde el año 1995 hasta el año 2015. La información recolectada pasó por 4 fases de revisión. Resultados Se seleccionaron 84 indicadores, agrupados en nueve dimensiones: accidentalidad, morbilidad, mortalidad, temporalidad, geoespacial, sociodemográfica, parque vehicular, impacto en salud pública, tipos y causas. Conclusiones Una gestión eficaz sobre seguridad vial exige que cada país cuente con un sistema de indicadores efectivo e institucionalizado que permita recolectar, analizar y gestionar la información de forma rápida y oportuna, enmarcada en el campo de la investigación científica, para difundir a la comunidad y organismos responsables de la seguridad vial, con miras a la adopción de medidas preventivas y correctivas. Por lo que, se recomienda a los organismos competentes de seguridad vial del país incorporar el sistema de indicadores elaborado en la presente investigación, lo cual permitirá contar con un sistema de registro de datos confiables.

ABSTRACT Objective Prepare a system of morbidity and mortality indicators for traffic accidents, to propose its implementation in Ecuador, in order to improve the processes for collecting and recording road safety information in the country. Materials and Methods Qualitative systematic review of scientific articles published in journals indexed in the main databases (Scopus, PubMed, Lilacs, SciELO, Google Scholer), on traffic accidents from 1995 to 2015. The information collected went through 4 phases review. Results 84 indicators were selected, grouped into nine dimensions: accident rate, morbidity, mortality, temporality, geospatial, socio-demographic, vehicle fleet, impact on public health, types and causes. Conclusions An effective management of road safety requires that each country have an effective and institutionalized system of indicators that allows the collection, analysis and management of information in a fast and timely manner, framed in the field of scientific research, to disseminate to the community and organizations. responsible for road safety, with a view to adopting preventive and corrective measures. Therefore, it is recommended that the competent road safety agencies of the country incorporate the system of indicators developed in this research, which will allow them to have a reliable data registration system.

Causas associadas aos acidentes de trânsito envolvendo motociclistas: revisão integrativa / Causas asociadas a los accidentes de tránsito que involucran a motociclistas: una revisión integradora / Causes associated with traffic accidents involving motorcyclists: integrative review

Objetivo: o presente estudo objetivou identificar na produção científica existente as causas associadas aos acidentes de trânsito envolvendo motociclistas. Metodologia Trata-se de uma revisão integrativa de literatura, a busca pelos artigos foi realizada em maio de2015 na Biblioteca Virtual de Saúde (BVS-Bireme), pelas bases de dados: Literatura Latino-Americana e do Caribe em Ciências da Saúde(LILACS) e portal da Scientific Eletronic Library Online (SCIELO), considerando as publicações disponíveis no período de 2009 a 2014. A busca pelas produções resultou inicialmente 114 produções e a partir do estabelecimento dos critérios de inclusão e exclusão, a revisão constitui-se em 8 artigos. Resultados: Foram identificadas as seguintes categorias de análise temática: ‘O pedestre e o crescimento da frota de motocicleta no Brasil’, Perfil epidemiológico da vítima de acidente de trânsito envolvendo motocicleta’ e ‘Principais causas associadas aos acidentes de trânsito envolvendo motociclistas’. Conclusão: O estudo permite concluir que as principais causas associadas aos acidentes envolvendo motociclistas e motocicletas, foram o aumento da frota de motocicletas, as características individuais dos condutores, as condições locais do tráfego, a fadiga ao fim do dia e elevação do fluxo de veículos, a estrutura das vias, sinalização e iluminação, dia da semana e o horário da ocorrência, a falta de educação preventiva para o trânsito e o aumento do uso deste tipo de veículo para trabalho e lazer. Ressalta-se a necessidade de intervenções amplas, intersetoriais e multiprofissionais, que promovam um ambiente mais favorável para circulação de pessoas.

Objective: the objective of this study was to identify the causes of traffic accidents which involve motorcyclists in scientific production. Methodology:This is an integrative review of literature, the search for articles was carried out in May 2015, in the Virtual Health Library (BVS-Bireme), by thedatabases: Latin American and Caribbean Literature in Health Sciences (LILACS) and portal of the Scientific Electronic Library Online (SCIELO), consideringthe publications available in the period from 2009 to 2014. The search for the productions initially resulted in 114 productions and from theestablishment of inclusion and exclusion criteria, the revision constitutes in 8 articles. Result: The following categories of thematic analysis wereidentified: 'The pedestrian and motorcycle fleet growth in Brazil', Epidemiological profile of the victim of traffic accident which involves motorcycle' and'Main causes associated with traffic accidents involving motorcyclists'. Conclusion: The study concludes that the main causes associated with accidents involving motorcyclists and motorcycles were the increase of the motorcycle fleet, the motorcyclists’ individual characteristics, the local trafficconditions, the fatigue at the end of the day and the increase of the flow of vehicles, the structure of roads, signaling and lighting, day of the week andthe time of occurrence, lack of preventive education for traffic and increased use of this type of vehicle for work and leisure. It is important to emphasizethe need for broad, inter-sectoral and multi-professional interventions that promote a more favorable environment for the movement of people.

Objetivo: el presente estudio objetivó identificar en la producción científica existente las causas asociadas a los accidentes de tránsito involucrandoa los motociclistas. Metodología: Se trata de una revisión integrativa de literatura, la búsqueda por los artículos fue realizada en mayo de 2015 en la Biblioteca Virtual de Salud (BVS-Bireme), por las bases de datos: Literatura Latinoamericana y del Caribe en Ciencias de la Salud (LILACS Y el portalde Scientific Eletronic Library Online (SCIELO), considerando las publicaciones disponibles en el período de 2009 a 2014. La búsqueda por lasproducciones resultó inicialmente en 114 producciones y a partir del establecimiento de los criterios de inclusión y exclusión, la revisión seconstituye en el 08 Artículos. Resultados: Se identificaron las siguientes categorías de análisis temático: 'El peatón y crecimiento de la flota demotocicleta en Brasil', Perfil epidemiológico de la víctima de accidente de tránsito involucrando motocicleta 'e' Principales causas asociadas a los accidentes de tránsito involucrando a los motociclistas'. Conclusión: El estudio permite concluir que las principales causas asociadas a los accidentes involucrados en motociclistas y motocicletas, fueron el aumento de la flota de motocicletas, las características individuales de los conductores, las condiciones locales del tráfico, la fatiga al final del día y la elevación del flujo de vehículos , La estructura de las vías, señalización e iluminación, díade la semana y el horario de la ocurrencia, la falta de educación preventiva para el tránsito y el aumento del uso de este tipo de vehículo paratrabajo y ocio. Se resalta la necesidad de intervenciones amplias, intersectoriales y multiprofesionales, que promuevan un ambiente más favorable para la circulación de personas.

Improving Accident Statistics and Expanding the Role of Traffic Psychologists in Brazil / Melhorando as Estatísticas de Acidentes e Ampliando o Papel dos Psicólogos do Trânsito no Brasil / Mejorando las Estadísticas de Accidentalidad y Ampliando el Papel de los Psicólogos del Tráfico en Brasil

Abstract Due to the mandatory assessment of psychological fitness to drive of prospective drivers, Brazil has a relatively large amount of traffic psychologists. Since, in general, assessment only happens upon first licensing, the task of these psychologists is fairly limited (as is the scope of the assessment itself). Intention and method: this study aims to perform a critical analysis of possibilities to expand the role of psychologists working in the traffic system in Brazil. A systematic review study of databases and international documents was conducted and a scope of activity of psychologists in this area was built. First result statistical data is scattered over many agencies. First conclusion in order to better identify specific tendencies and risk groups in Brazil, statistical data related to accident involvement needs to be better, perhaps centrally, coordinated and consolidated. Second result international research related to three subgroups of drivers that constitute a significantly increased safety risk can inform future directions for traffic psychology in Brazil. Psychological processes that may underlie these risk increases are discussed. Second conclusion two subgroups (young drivers and aggressive drivers) could benefit from more than assessment, they could benefit from specific psychological interventions. The third subgroup (elderly drivers) is expected to increase significantly in the future, which asks for clearer policies, with a significant input form psychologists and psychological research....(AU)

Resumo A avaliação psicológica no Brasil é obrigatória no processo de obtenção da Carteira Nacional de Habilitação (CNH), o que faz com que o país tenha uma quantidade relativamente grande de psicólogos atuando neste segmento. Uma vez que, em geral, a avaliação ocorre somente no momento da obtenção da CNH, a atuação desses psicólogos é limitada (assim como o escopo da avaliação em si). Justificativa e método: este estudo tem por objetivo realizar uma análise crítica das possibilidades de expansão do trabalho dos psicólogos que atuam no sistema trânsito no Brasil. Foi realizado um estudo de revisão sistemática em bases de dados e documentos internacionais, e levantado o escopo de atividades dos psicólogos que atuam nessa área. Primeiro resultado dados estatísticos estão dispersos em diferentes agências. Primeira conclusão a fim de entender melhor tendências específicas e grupos de risco, os dados estatísticos relacionados ao envolvimento em acidentes precisam ser melhor coordenados e consolidados. Segundo resultado pesquisas internacionais relacionadas a três subgrupos de motoristas, que constituem um aumento significativo de risco, podem indicar direções futuras para a psicologia do trânsito no Brasil. Processos psicológicos que possivelmente constituem a base desse aumento de risco são discutidos. Segunda conclusão dois subgrupos (motoristas jovens e motoristas agressivos) poderiam se beneficiar com algo além de uma avaliação, com intervenções psicológicas específicas. É esperado que o terceiro subgrupo (motoristas idosos) aumente significativamente no futuro, o que demanda políticas mais claras, com contribuições significativas de psicólogos e de pesquisas em psicologia do trânsito....(AU)

Resumen La evaluación psicológica en Brasil es obligatoria en el proceso de obtención de la licencia de conducir; así, el país tiene una gran cantidad de psicólogos del tráfico. Una vez que generalmente la evaluación ocurre solamente en la obtención de la licencia, la tarea de estos psicólogos (y también el alcance de la evaluación) es muy limitada. Justificación y método: este estudio tiene como objetivo presentar un análisis crítico de las posibilidades de expansión del trabajo de psicólogos que actúan en el sistema de tráfico en Brasil. Se llevó a cabo un estudio en base de datos y documentos internacionales y se levantó el ámbito de actividad de los psicólogos. Primer resultado : datos estadísticos están dispersos en diferentes agencias. Primera conclusión : para comprender mejor las tendencias específicas y subgrupos de riesgo, los datos estadísticos de accidentes de tránsito necesitan ser mejor coordenados y consolidados. Segundo resultado : investigaciones internacionales relacionadas a tres subgrupos de conductores, los cuales constituyen un aumento significativo de riesgo, pueden indicar direcciones futuras para la psicología del tránsito en Brasil. Se discuten procesos psicológicos que posiblemente forman la base de este riesgo. Segunda conclusión : dos subgrupos (conductores jóvenes y conductores agresivos) podrían tener beneficios con algo más que una evaluación, incluyendo intervenciones psicológicas específicas. Es esperado que el tercer subgrupo (conductores ancianos) aumente significativamente en el futuro, lo que demanda políticas más claras, con contribuciones significativas de psicólogos e investigaciones psicológicas....(AU)

Atropelamentos: análise epidemiológica dos últimos quatro anos / Atropellos: análisis epidemiológico de los últimos cuatro años / Run over: epidemiological analysis of the last four years

RESUMO O objetivo do estudo foi caracterizar os atropelamentos atendidos por serviços de urgência pré-hospitalar móvel em um município do norte do Paraná. Pesquisa retrospectiva, transversal, com abordagem quantitativa, obtida por meio dos dados do prontuário das vítimas atendidas pelo serviço pré-hospitalar móvel nos últimos quatro anos. A análise dos dados foi por meio da estatística descritiva e exploratória. Foram analisadas 1.663 ocorrências: 469 no ano de 2011, 431 em 2012, 408 em 2013 e 355 em 2014. Das ocorrências atendidas, a idade mediana foi de 39 anos, entretanto, as crianças e adolescentes foram mais acometidos. Também o episódio foi mais freqüente em ruas, na região central do município, às sextas e quartas-feiras, nos meses de março e maio, sendo mulheres no período da manhã e tarde, e homens principalmente no período noturno, provocado por automóvel, seguido por motocicleta. Destes acidentes, 3% dos condutores se evadiram do local sem prestar assistência à vítima. Identificou-se uma diminuição do evento atropelamento nos últimos quatro anos. Sugere-se intensificar a fiscalização nos pontos descritos e a elaboração de medidas preventivas, utilizando-se outros métodos e outras fontes de informação.

RESUMEN El objetivo del estudio fue caracterizar los atropellos atendidos por servicio de urgencia prehospitalario móvil en un municipio del norte de Paraná, Brasil. Investigación retrospectiva, transversal, con abordaje cuantitativo, obtenida por medio de los datos de los registros médicos de las víctimas atendidas por el servicio prehospitalario móvil en los últimos cuatro años. El análisis de los datos fue por medio de la estadística descriptiva y exploratoria. Fueron analizadas 1.663 ocurrencias: 469 en el año de 2011, 431 el 2012, 408 el 2013 y 355 el 2014. De las ocurrencias atendidas, el promedio de edad fue de 39 años, aunque los niños hayan sido los más acometidos. El hecho fue más frecuente en calles, en la región central del municipio, los viernes y miércoles, los meses de marzo y mayo, siendo las mujeres en el período de la mañana y tarde, y los hombres principalmente en el período nocturno, provocado por automóvil, seguido por motocicleta. De estos accidentes, el 3% de los conductores se evadieron del local sin prestar atención a la víctima. Se identificó una disminución del evento atropello en los últimos cuatro años. Se sugiere intensificar la fiscalización en los puntos descriptos además de la elaboración de medidas preventivas, utilizándose otros métodos y otras fuentes de información.

ABSTRACT The objective of the study was to characterize the motor vehicle accidents attended by pre-hospital emergency mobile services in a municipality in the North of Paraná. Retrospective, cross-sectional study with a quantitative approach, obtained through the medical record data of the victims attended by the pre-hospital mobile service in the last four years. The analysis of the data was through descriptive and exploratory statistics. A total of 1,663 occurrences were analyzed: 469 in 2011, 431 in 2012, 408 in 2013 and 355 in 2014. Of the occurrences attended, the median age was 39 years, however, children and adolescents were more affected. Also the most frequent episode in streets in the central region of the city, on Fridays and Wednesdays, in the months of March and may, being women in the morning and afternoon, and men mainly in the night period, caused by automobile, followed by motorcycle. Of these accidents, 3% of the drivers left without providing assistance to the victim. It was identified a decrease in motor vehicle accidents in the last four years. It is suggested to intensify the monitoring in the described points and to elaborate preventive measures, using other methods and other sources of information.

Visual function among commercial vehicle drivers in the central region of Ghana.

AIM: To determine the relationship between some visual functions: colour vision defects, abnormal stereopsis, visual acuity and the occurrence of road traffic accident (RTAs) among commercial vehicle drivers in the central region of Ghana, and to assess their knowledge of these anomalies. METHOD: A descriptive cross-sectional study employing a multi-stage random sampling approach was conducted in the major commercial towns within the central region of Ghana. Participants were taken through a comprehensive eye examination after the administration of a structured questionnaire. RESULTS: 520 male commercial vehicle drivers were enrolled for this study with a mean age of 39.23 years ±10.96 years and mean visual acuity of 0.02±0.08 logMAR. Protans were more likely to be involved in RTAs (χ(2)=6.194, p=0.034). However, there was no statistically significant association between abnormal stereopsis (OR=0.89 95% CI: 0.44-1.80, p=0.56), poor vision due to refractive error (χ(2)=3.090, p=0.388) and the occurrence of RTAs. While 86.9% were aware of abnormal stereopsis, only 45% were aware of colour vision defects. There was a statistically significant association between stereopsis anomaly and colour vision defect (r=0.371, p<0.005). CONCLUSION: The study found an association between protanopia and RTAs but none between stereopsis anomalies, refractive errors and the occurrence of RTAs. Drivers were less knowledgeable on colour vision defects as compared to stereopsis anomalies.

Head-on crashes on two-way interurban roads: a public health concern in road safety.

OBJECTIVE: To describe the magnitude and characteristics of crashes and drivers involved in head-on crashes on two-way interurban roads in Spain between 2007 and 2012, and to identify the factors associated with the likelihood of head-on crashes on these roads compared with other types of crash. METHODS: A cross-sectional study was conducted using the National Crash Register. The dependent variables were head-on crashes with injury (yes/no) and drivers involved in head-on crashes (yes/no). Factors associated with head-on crashes and with being a driver involved in a head-on crash versus other types of crash were studied using a multivariate robust Poisson regression model to estimate proportion ratios (PR) and confidence intervals (95% CI). RESULTS: There were 9,192 head-on crashes on two-way Spanish interurban roads. A total of 15,412 men and 3,862 women drivers were involved. Compared with other types of crash, head-on collisions were more likely on roads 7 m or more wide, on road sections with curves, narrowings or drop changes, on wet or snowy surfaces, and in twilight conditions. Transgressions committed by drivers involved in head-on crashes were driving in the opposite direction and incorrectly overtaking another vehicle. Factors associated with a lower probability of head-on crashes were the existence of medians (PR=0.57; 95%CI: 0.48-0.68) and a paved shoulder of less than 1.5 meters (PR=0.81; 95%CI: 0.77-0.86) or from 1.5 to 2.45 meters (PR=0.90; 95%CI: 0.84-0.96). CONCLUSIONS: This study allowed the characterization of crashes and drivers involved in head-on crashes on two-way interurban roads. The lower probability observed on roads with median strips point to these measures as an effective way to reduce these collisions.

[Differences between immediate and 30-day deaths due to traffic injuries according to forensic sources]. / Diferencias entre fallecimientos inmediatos y a 30 días por lesiones por tráfico según fuentes forenses.

OBJECTIVE: To study immediate (same day of the collision) and delayed (within 30 days of the collision) deaths due to traffic injuries in Catalonia (Spain) according to forensic sources and to assess the differences between the two kinds of deaths. MATERIAL AND METHODS: An observational study was conducted of all the traffic accident deaths registered in the Institute of Legal Medicine of Catalonia between January 1(st) 2005 and December 31(st) 2014. Data analysis was performed using the SPSS v.18.0 statistical package. Comparisons of proportions were based on the χ(2) test. RESULTS: During the study period, 4044 deaths due to traffic injuries were recorded. Deaths within 30 days included more women, minors, elderly people, and pedestrians than immediate deaths. CONCLUSIONS: Traffic injury deaths in the 30 days following a crash differ from immediate deaths.

[Factors associated with empowerment in people with a spinal cord injury due to traffic accidents]. / Factores asociados al empoderamiento en personas con lesión medular tras un accidente de tráfico.

OBJETIVO: Analizar la capacidad de empoderamiento de un grupo de personas con lesión medular en función de la edad, el sexo, la condición funcional y la edaden la cual adquirieron la lesión. METHODS: Ninety-four participants with a spinal cord injury (42 tetraplegics and 52 paraplegics) completed the Spanish version of the Rogers, Chamberlin, Ellison and Crean Scale (1997), designed to measure empowerment. RESULTS: The analyses indicated higher levels of empowerment among women. Persons with tetraplegia whose injury was more longstanding also showed greater empowerment. CONCLUSION: This study suggests that the capacity to become empowered can vary and evolve and should therefore be promoted in intervention programs.

[Factors associated with empowerment in people with a spinal cord injury due to traffic accidents]. / Factores asociados al empoderamiento en personas con lesión medular tras un accidente de tráfico.

OBJETIVO: Analizar la capacidad de empoderamiento de un grupo de personas con lesión medular en función de la edad, el sexo, la condición funcional y la edaden la cual adquirieron la lesión. METHODS: Ninety-four participants with a spinal cord injury (42 tetraplegics and 52 paraplegics) completed the Spanish version of the Rogers, Chamberlin, Ellison and Crean Scale (1997), designed to measure empowerment. RESULTS: The analyses indicated higher levels of empowerment among women. Persons with tetraplegia whose injury was more longstanding also showed greater empowerment. CONCLUSION: This study suggests that the capacity to become empowered can vary and evolve and should therefore be promoted in intervention programs.

[Profiles of resilience and quality of life in people with acquired disability due to traffic accidents]. / Perfiles resilientes y calidad de vida en personas con discapacidad sobrevenida por accidentes de tráfico.

OBJECTIVES: To identify distinct profiles of resilience in people with spinal cord injuries due to traffic accidents and to determine whether the profiles identified are related to differences in subjective well-being. METHODS: The Resilience Scale (Wagnild and Young, 1993) and an adapted quality of life scale (GENCAT) were administered to 98 people with physical disabilities due to traffic accidents. RESULTS: Cluster analyses identified three different resilience profiles: a high-resilience group, a low-resilience group, and a group showing a predominance of high scores in self and life acceptance and social competence. The results also revealed statistically significant differences among profiles in most domains of subjective well-being. CONCLUSION: The results suggest the need to study resilience in greater depth and to design programs to enhance quality of life among people with disabilities due to traffic accidents.

[Definition of hospital discharge, serious injury and death from traffic injuries]. / Definición de alta hospitalaria, lesión grave y muerte por lesiones por tráfico.

Road traffic injury surveillance involves methodological difficulties due, among other reasons, to the lack of consensus criteria for case definition. Police records have usually been the main source of information for monitoring traffic injuries, while health system data has hardly been used. Police records usually include comprehensive information on the characteristics of the crash, but often underreport injury cases and do not collect reliable information on the severity of injuries. However, statistics on severe traffic injuries have been based almost exclusively on police data. The aim of this paper is to propose criteria based on medical records to define: a) "Hospital discharge for traffic injuries", b) "Person with severe traffic injury", and c) "Death from traffic injuries" in order to homogenize the use of these sources.

[Bicycle accidents treated in emergency departments. A multicentre study]. / Accidentes de bicicleta atendidos en los Servicios de Urgencias. Estudio multicéntrico.

OBJECTIVES: To describe epidemiological characteristics, types of injury, prognosis and medical management of bicycle-related Paediatric Emergency Department (ED) visits and to identify potential preventive measures. PATIENTS AND METHODS: This multicentred, observational prospective study included all children between 3 and 16 years of age treated for bicycle-related injuries in the Emergency Departments of 15 Spanish Hospitals belonging to the «Unintentional Paediatric Injury Workshop¼ of the Spanish Paediatric Emergency Society between the 1(st) of June 2011 and the 31(st) of May 2012. Characteristics of all ED visits, as well as epidemiological data and accident-related information, were collected. RESULTS: A total of 846 patients were included in the study, with a male predominance (72.9%) and a median age of 9.6 ± 3.6 years. Head injury was the third most common injury (22.3%) and the main cause of admission to the Pediatric Intensive Care Unit (PICU) (68.4%). More than three-quarters (77.9%) of the patients did not wear a helmet, which was significantly associated to a higher incidence of head injury and admission to PICU. Older children (OR 1.063) and bicycle injuries involving motor vehicles (OR 2.431) were identified as independent risk factors for worse outcomes. CONCLUSIONS: Since helmet use reduces up to 88% of central nervous system lesions secondary to head injury, promotion of its use should be the main preventive measure, followed by restriction of bike-riding to cycling areas.

Caracterização das ocorrências traumáticas atendidas pelo corpo de bombeiros do município de Itapiranga – SC / Caracterización de los eventos traumáticos asistidos por los bomberos de la ciudad de Itapiranga - SC / Characterization of traumatic events attended by the fire department of the city of Itapiranga -SC

Objetivo: Caracterizar as ocorrências traumáticas atendidas pela corporação dos bombeiros do município de Itapiranga - SC. Método: Pesquisa quantitativa, documental, retrospectiva onde se analisou 202 fichas de atendimento pré-hospitalar descritas neste estudo como atropelamentos, colisões, quedas de moto durante o ano de 2010. Para a coleta de dados utilizou-se um formulário contendo dados pessoais, características dos ferimentos e tipo de acidente. Resultados: 61% dos acidentes foram causados por motocicleta; 25% dos atendimentos ocorreram entre as 15h às 19h59min; 70% das vítimas eram do sexo masculino; 48% das vítimas tinham idade entre 18 a 26 anos; 12% dos atendimentos às vítimas apresentavam odor etílico. Conclusão: Os adultos jovens do sexo masculino são as principais vítimas envolvidas nos acidentes de transito. Este trabalho contribuirá na construção de estratégias nas políticas públicas e nos serviços de saúde corroborando na diminuição de ocorrências traumáticas.

Objetivo: caracterizar los eventos traumáticos atendidos por la corporación de bomberos de la ciudad de Itapiranga -SC. Método: fue escogida la investigación cuantitativa, documental, donde retrospectivo analizó 202 registros de atención prehospitalaria se describe en este estudio como pisoteo, colisõe, por debajo de motocicleta en 2010. Para recopilar los datos, se utilizó un formulario que contiene los datos personales, las características de la lesión y el tipo de accidente. Resultados: 61% de los accidentes fueron causados por motocicletas; 25% de las visitas se produjeron entre 15h a 19:59; 70% de las víctimas de sexo masculino; 48% de las víctimas de entre 18 y 26 años de edad; 12% de los casos hay olor a éter. Conclusión: los varones adultos jóvenes son las principales víctimas involucradas en accidentes de tráfico. Este trabajo contribuirá en la construcción de políticas públicas de salud.

Objective: To characterize the traumatic events attended by firefighters corporation of the city of Itapiranga - SC. Method: Quantitative research, documentary, where retrospective analyzed 202 records of prehospital care described in this study as roadkill, collisions, falls from bike during the year 2010. To collect data, we used a form containing personal data, characteristics of injury and accident type. Results: 61% of accidents were caused by motorcycle, 25% of visits occurred between 19:59 to 15h, 70% of victims were male, 48% of victims were aged between 18 and 26 years, 12% of visits to the victims had ethyl odor. Conclusion: The young adult males are the primary victims involved in car accidents. This work will contribute in building strategies in public policy and health services corroborating the reduction of traumatic events.