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July 9, 2001
Ladders: accidents waiting to happen.
Tsipouras S, Hendrie JM, Silvapulle MJ. Med J Aust 2001; 174(10):516-519.
Correspondence: Dr. Sipiro Tsipouras, Emergency Department, Austin and Repatriation Medical Centre, Melbourne, Victoria, AUSTRALIA
The authors (using a retrospective survey of medical records) examined the nature, severity and outcomes of injuries sustained from ladder falls. Patients who presented after a fall from a ladder to the emergency department of a tertiary hospital in Melbourne, Victoria, between January 1994 and December 1997. The authors assessed demographic characteristics; height and mechanism of fall; injury site and Injury Severity Score (ISS); rate of hospital admissions. RESULTS: 163 patients presented after ladder falls. They were aged 2.5 to 86 years (mean age, 48 years); 83% were male, and 78% were injured in non-occupational settings. Almost half the incidents (43%) were caused by ladder instability (ladder sliding from position or tilting sideways). Most patients had mild or moderate injuries (usually of the extremities), but 13% had an ISS > or = 16 (indicating severe trauma), usually with head, chest or spinal injuries; 42% were admitted to hospital. Multiple regression analyses showed that ISS increased significantly with height of fall and age (P < 0.05 for both), although a substantial amount of variation was not attributable to these variables. Likelihood of hospital admission increased linearly with increasing ISS to an ISS of 8 and remained high thereafter.
Scooter Injuries: A New Pediatric Morbidity
Abbott MB, Hoffinger SA, Nguyan DM, Weintraub DL. Pediatrics 2001; 108(1): e 2.
Correspondence: Myles B. Abbott, MD, East Bay Pediatrics, 2999 Regent St, Berkeley, California 94705 USA mabbottmd@aol.com
Full text available online HERE.
The authors described types of injuries, mechanisms of injury, and treatment of injuries caused by scooter use in children, and to discuss issues of injury prevention in children who use scooters. Data were collected from 14 children seen by a general pediatrician and an orthopedic surgeon over a 3-month period in the summer of 2000. Detailed histories were obtained from patients and their families, and medical records were reviewed. Eleven of the 14 patients suffered fractures. The injuries in the other 3 patients were a large abrasion, a laceration, and a septic knee. Half (7) of the children were injured within the first day of riding their scooter, and 13 of the 14 injuries occurred within the first month of scooter use. Only 5 patients used protective gear at the time of their injuries, and those patients were injured in unprotected parts of their bodies.
Behavioural factors as predictors of motor vehicle crashes: differentials between young urban and rural drivers
Stevenson MR, Palamara P. Aust N Z J Public Health 2001; 25(3): 245-249
Correspondence: Mark R. Stevenson, Road Accident Prevention Research Unit, Department of Public Health, The University of Western Australia, Nedlands WA 6907 AUSTRALIA
The authors describe the driver and behavioral factors that predispose young drivers to crash in the first 12 months of driving and to compare whether these factors differ between young urban and rural drivers. A cohort comprising 1796 newly licensed urban and rural drivers from Western Australia was recruited and followed over the first 12 months of driving. Using Cox proportional hazard analysis, driver and behavioral factors were assessed to determine whether they predicted the likelihood of a crash. The incidence rate for a motor vehicle crash was marginally higher for urban drivers compared with rural drivers (Urban: IR=4.2/10,000 driving days; Rural: IR=3.7/10,000 driving days). There was no significant difference in the time to crash between urban and rural drivers. Two factors, namely the frequency of driving before obtaining a learner-driver permit and the driver’s level of risk taking, were significantly associated with a motor vehicle crash in the first year of driving. Irrespective of whether the driver is licensed in a rural or urban area, high risk-taking drivers are at an elevated risk of a motor vehicle crash in the first 12 months of driving.
Explanations for 'understating' in self-reported speeding behaviour
Corbett C. Transportation Research Part F: Psychology and Behaviour 2001; 4(2): 133-150.
Correspondence: Claire Corbett, Law Department, Brunel University, Uxbridge UB8 3PH, UK
Self-report is a valuable methodology of social research, especially in regard to offending behavior on and off the road. While assessing the validity of self-report is rarely easy, taking objective measures of drivers' speed choice behavior does provide an opportunity to assess the correlation with subjective measures. Noting studies where this has been possible, research carried out by the author and colleagues in England which allowed similar assessments is discussed. Significant correlations resulted between reported and observed speed in all six surveys comprising the research, but they were of a low order. Analysis of the data showed a consistent and systematic bias towards drivers travelling above the 30 mph speed limit reporting their normal speeds as lower than those observed, with those travelling below the 30 mph speed limit reporting their speeds as higher than those observed. These patterns are discussed in light of other studies which have found tendencies either to overstate or to understate, and the possibilities that drivers either have difficulty reporting accurately or choose not to do so. Psychophysical limitations on accuracy of self-report and the social and cognitive processes that could mediate them are considered. In particular, the notion that drivers may seek to comply with normative speeds, and that these can be perceived as safer than complying with posted limits are discussed in light of normal police practice to tolerate low margins of excess speed.
Efficacy of stimulants for fatigue management: the effects of Provigil and Dexedrine on sleep-deprived aviators
Caldwell JA Transportation Research Part F: Psychology and Behaviour 2001; 4(1): 19-37.
Correspondence: John A. Caldwell, Aeromedical Research Laboratory, P.O. Box 620577, Fort Rucker, AL 36362-0577, USA john.caldwell@se.amedd.army.mil
The author details the results of a quasi-experimental comparison between the alerting effects of modafinil (Provigil) and those of dextroamphetamine (Dexedrine) in sleep-deprived pilots. Data from two separate placebo-controlled studies (one on Dexedrine and one on Provigil) were merged and analyzed to determine whether one compound produced greater effects than the other relative to placebo. The results indicated there were differences between the two stimulants on only two of the 14 dependent measures. In one case (a flight performance measure), modafinil was more effective than dextroamphetamine, and in the other case (subjective fatigue ratings), dextroamphetamine was better than modafinil. The remaining measures indicated no statistically-significant differences between the two stimulants. However, in the majority of cases, it was clear that performance, subjective mood ratings, and physiological indices of alertness were substantially better under both drugs than under placebo. Thus, with the exception that modafinil produced more spontaneous reports of side effects than dextroamphetamine, the overall results indicated equivalent efficacy with the two compounds. Limitations of this study were that the two compounds were tested on different samples at different points in time, and there was no systematic measurement of side effects (instead, spontaneous reports were recorded).
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