[Comparisons of efficacy and safety of levetiracetam versus phenytoin for seizure prophylaxis in patients with brain injury: a meta analysis].

PubMed

Li, J N; Chen, Y M

2016-10-25

Objective: To systematically review the efficacy, side effects and case-fatality rate of levetiracetam (LEV) versus phenytoin (PHT) for seizure prophylaxis of brain injured patients. Methods: Randomized controlled trials of high quality about LEV versus PHT in seizure prophylaxis of brain injured patients from 2000 to 2016 were collected according to the key word PHT, LEV, brain injury in PubMed, Medline, Ovid, Springer, CNKI, Wanfang data and so on. Valid data were extracted to conduct meta-analysis by RevMan 5.3 software according to inclusion and exclusion criteria. Results: A total of 13 English articles were finally included with 2 529 patients in total.Meta-analysis showed that no significant differences were observed in LEV versus PHT at preventing the occurrence of seizures ( RR =0.88, 95% CI : 0.61-1.27). No superiority of either drug at preventing early seizures ( RR =0.74, 95% CI : 0.42-1.27). As to the occurrence of late seizures, the differences of the two drugs were not statistically significant ( RR =0.71, 95% CI : 0.43-1.20). Number of patients with side effect was not statistically significantly different between the two groups ( RR =0.73, 95% CI : 0.48-1.11). But significant difference was found between LEV and PHT in discontinuation because of side effect ( RR =0.11, 95% CI : 0.06-0.23); no significant differences were noted in the case-fatality rate of patients received pretreatment between the two drugs ( RR =1.57, 95% CI : 0.92-2.67). There were no significant differences between the two groups in the length of stay ( WMD =-1.03, 95% CI : -4.97-2.91). Conclusions: LEV and PHT demonstrate equal efficacy in seizure prevention after brain injury. The differences are insignificant in the side effect, the case-fatality rate and the length of stay between LEV and PH treatment, but adverse drug reactions requiring change in therapy occur more in PHT. Phenytoin remains the first choice for seizure prevention after brain injury based on the existing evidence, while levetiracetam seems to be a favorable choice where there is risk of drug-drug interactions and drug toxicity. However, very few randomized controlled trials on this topic were found, and larger prospective trials are warranted.

Cutaneous, gastrointestinal, hepatic, endocrine, and renal side-effects of anti-PD-1 therapy.

PubMed

Hofmann, Lars; Forschner, Andrea; Loquai, Carmen; Goldinger, Simone M; Zimmer, Lisa; Ugurel, Selma; Schmidgen, Maria I; Gutzmer, Ralf; Utikal, Jochen S; Göppner, Daniela; Hassel, Jessica C; Meier, Friedegund; Tietze, Julia K; Thomas, Ioannis; Weishaupt, Carsten; Leverkus, Martin; Wahl, Renate; Dietrich, Ursula; Garbe, Claus; Kirchberger, Michael C; Eigentler, Thomas; Berking, Carola; Gesierich, Anja; Krackhardt, Angela M; Schadendorf, Dirk; Schuler, Gerold; Dummer, Reinhard; Heinzerling, Lucie M

2016-06-01

Anti-programmed cell death receptor-1 (PD-1) antibodies represent an effective treatment option for metastatic melanoma as well as for other cancer entities. They act via blockade of the PD-1 receptor, an inhibitor of the T-cell effector mechanisms that limit immune responses against tumours. As reported for ipilimumab, the anti-PD-1 antibodies pembrolizumab and nivolumab can induce immune-related adverse events (irAEs). These side-effects affect skin, gastrointestinal tract, liver, endocrine system and other organ systems. Since life-threatening and fatal irAEs have been reported, adequate diagnosis and management are essential. In total, 496 patients with metastatic melanoma from 15 skin cancer centers were treated with pembrolizumab or nivolumab; 242 side-effects were described in 138 patients. In 116 of the 138 patients, side-effects affected the skin, gastrointestinal tract, liver, endocrine, and renal system. Rare side-effects included diabetes mellitus, lichen planus, and pancreas insufficiency due to pancreatitis. Anti-PD1 antibodies can induce a plethora of irAEs. The knowledge of them will allow prompt diagnosis and improve the management resulting in decreased morbidity. Copyright © 2016 Elsevier Ltd. All rights reserved.

Driver Mortality in Paired Side Impact Collisions Due to Incompatible Vehicle Types

PubMed Central

Crandall, C.S.

2003-01-01

Using a matched case control design, this study measured the mortality associated with paired passenger car-sport utility vehicle side impact (‘T-bone’) collisions using FARS data. Survival versus fatal outcome within the matched crash pairs was measured with matched pair odds ratios. Conditional logistic regression adjusted for multiple effects. Overall, passenger car drivers experienced greater mortality than did SUV drivers, regardless if they were in the struck or striking vehicle (odds ratio: 10.0; 95% confidence interval: 7.9, 12.5). Differential mortality persisted after adjustment for confounders. Efforts should be sought to improve passenger car side impact crashworthiness and to reduce SUV aggressivity. PMID:12941243

Review about gabapentin misuse, interactions, contraindications and side effects

PubMed Central

Quintero, Gabriel C

2017-01-01

The current work is targeted to review the risks of gabapentin misuse, its potential interactions with other drugs, side effects and use contraindications. This review consists of a total of 99 biographical references (from the year 1983 to 2016). A publication search of PubMed was performed from January 1983 to December 2016. It included animal studies, clinical studies, case studies and reviews related to gabapentin misuse, potential interactions, side effects and use contraindications. The search terms were gabapentin, anticonvulsant and antiepileptic. In general, it seems that gabapentin has risks of being misused based on the increased level of prescriptions, related fatalities, recreational misuse and higher doses of self-administration. The main reasons for gabapentin misuse are as follows: getting high, alleviating opioid withdrawal symptoms and potentiating methadone effects. Some of the main substances that interact with gabapentin are morphine, caffeine, losartan, ethacrynic acid, phenytoin, mefloquine and magnesium oxide. Some of the side effects caused by gabapentin are teratogenicity, hypoventilation, respiratory failure and myopathy. Finally, reports in general contraindicate the use of gabapentin in conditions such as myasthenia gravis and myoclonus. PMID:28223849

Dobutamine stress MRI. Part I. Safety and feasibility of dobutamine cardiovascular magnetic resonance in patients suspected of myocardial ischemia.

PubMed

Kuijpers, Dirkjan; Janssen, Caroline H C; van Dijkman, Paul R M; Oudkerk, Matthijs

2004-10-01

The aim of the study was to evaluate safety and feasibility of dobutamine cardiovascular magnetic resonance (CMR) in patients with proven or suspected coronary artery disease. Dobutamine CMR was evaluated retrospectively in 400 consecutive patients with suspicion of myocardial ischemia. Dobutamine was infused using an incremental protocol up to 40 microg/kg body weight per minute. All anti-anginal medication was stopped 4 days before the CMR study and infusion time of dobutamine was 6 min per stage. Hemodynamic data, CMR findings and side effects were reported. Patients with contraindications to CMR (metallic implants and claustrophobia) were excluded from analysis. Dobutamine CMR was successfully performed in 355 (89%) patients. Forty-five (11%) patients could not be investigated adequately because of non-cardiac side effects in 29 (7%) and cardiac side effects in 16 (4%) patients. Hypotension (1.5%) and arrhythmias (1%) were the most frequent cardiac side effects. One patient developed a severe complication (ventricular fibrillation) at the end of the study. There were no myocardial infarctions or fatal complications of the stress test. The most frequent non-cardiac side effects were nausea, vomiting and claustrophobia. Age >70 years, prior myocardial infarction and rest wall motion abnormalities showed no significant differences with side effects (P>0.05). Dobutamine CMR is safe and feasible in patients with suspicion of myocardial ischemia. Copyright 2004 Springer-Verlag

Potential Side Effect of Inadvertent Intravascular Administration of Liposomal Bupivacaine

DTIC Science & Technology

2017-06-01

treat and is potentially fatal. LAST can impair function of the central nervous system and cause cardiovascular collapse, with potentially...in the reversal of cardiovascular and central nervous system symptoms of local anesthetic and other lipophilic drug overdoses. ILE is gaining...to the sites of toxic action in the central nervous system and the heart. However, liposomal formulations of local anesthetics (EXPAREL in

Fatal falls and PFAS use in the construction industry: Findings from the NIOSH FACE reports.

PubMed

Dong, Xiuwen Sue; Largay, Julie A; Choi, Sang D; Wang, Xuanwen; Cain, Chris Trahan; Romano, Nancy

2017-05-01

This study analyzed the Construction FACE Database (CFD), a quantitative database developed from reports of the Fatality Assessment and Control Evaluation (FACE) program conducted by the National Institute for Occupational Safety and Health (NIOSH). The CFD contains detailed data on 768 fatalities in the construction industry reported by NIOSH and individual states from 1982 through June 30, 2015. The results show that falls accounted for 42% (325) of the 768 fatalities included in the CFD. Personal fall arrest systems (PFAS) were not available to more than half of the fall decedents (54%); nearly one in four fall decedents (23%) had access to PFAS, but were not using it at the time of the fall. Lack of access to PFAS was particularly high among residential building contractors as well as roofing, siding, and sheet metal industry sectors (∼70%). Although the findings may not represent the entire construction industry today, they do provide strong evidence in favor of fall protection requirements by the Occupational Safety and Health Administration (OSHA). In addition to stronger enforcement, educating employers and workers about the importance and effectiveness of fall protection is crucial for compliance and fall prevention. Copyright © 2017 Elsevier Ltd. All rights reserved.

Fatal falls and PFAS use in the construction industry: Findings from the NIOSH FACE reports

PubMed Central

Dong, Xiuwen Sue; Largay, Julie A.; Choi, Sang D.; Wang, Xuanwen; Cain, Chris Trahan; Romano, Nancy

2017-01-01

This study analyzed the Construction FACE Database (CFD), a quantitative database developed from reports of the Fatality Assessment and Control Evaluation (FACE) program conducted by the National Institute for Occupational Safety and Health (NIOSH). The CFD contains detailed data on 768 fatalities in the construction industry reported by NIOSH and individual states from 1982 through June 30, 2015. The results show that falls accounted for 42% (325) of the 768 fatalities included in the CFD. Personal fall arrest systems (PFAS) were not available to more than half of the fall decedents (54%); nearly one in four fall decedents (23%) had access to PFAS, but were not using it at the time of the fall. Lack of access to PFAS was particularly high among residential building contractors as well as roofing, siding, and sheet metal industry sectors (~70%). Although the findings may not represent the entire construction industry today, they do provide strong evidence in favor of fall protection requirements by the Occupational Safety and Health Administration (OSHA). In addition to stronger enforcement, educating employers and workers about the importance and effectiveness of fall protection is crucial for compliance and fall prevention. PMID:28292698

Fatal interstitial lung disease associated with icotinib.

PubMed

Zhang, Jiexia; Zhan, Yangqing; Ouyang, Ming; Qin, Yinyin; Zhou, Chengzhi; Chen, Rongchang

2014-12-01

The most serious, and maybe fatal, yet rare, adverse reaction of gefitinib and erlotinib is drug-associated interstitial lung disease (ILD), which has been often described. However, it has been less well described for icotinib, a similar orally small-molecule tyrosine kinase inhibitor (TKI). The case of a 25-year-old female patient with stage IV lung adenocarcinoma who developed fatal ILD is reported here. She denied chemotherapy, and received palliative treatment with icotinib (125 mg po, three times daily) on March 1, 2013. One month after treatment initiation, the patient complained of continuous dry cough and rapid progressive dyspnea. Forty one days after icotinib treatment, icotinib associated ILD was suspected when the patient became increasingly dyspnoeic despite of treatment of pericardial effusion, left pleural effusion and lower respiratory tract infection, and X-ray computed tomography (CT) of chest revealed multiple effusion shadows and ground-glass opacities in bilateral lungs. Then, icotinib was discontinued and intravenous corticosteroid was started (methylprednisolone 40 mg once daily, about 1 mg per kilogram) respectively. Forty three days after icotinib treatment, the patient died of hypoxic respiratory failure. ILD should be considered as a rare, but often fatal side effect associated with icotinib treatment.

Fatal interstitial lung disease associated with icotinib

PubMed Central

Zhang, Jiexia; Zhan, Yangqing; Ouyang, Ming; Qin, Yinyin; Zhou, Chengzhi

2014-01-01

The most serious, and maybe fatal, yet rare, adverse reaction of gefitinib and erlotinib is drug-associated interstitial lung disease (ILD), which has been often described. However, it has been less well described for icotinib, a similar orally small-molecule tyrosine kinase inhibitor (TKI). The case of a 25-year-old female patient with stage IV lung adenocarcinoma who developed fatal ILD is reported here. She denied chemotherapy, and received palliative treatment with icotinib (125 mg po, three times daily) on March 1, 2013. One month after treatment initiation, the patient complained of continuous dry cough and rapid progressive dyspnea. Forty one days after icotinib treatment, icotinib associated ILD was suspected when the patient became increasingly dyspnoeic despite of treatment of pericardial effusion, left pleural effusion and lower respiratory tract infection, and X-ray computed tomography (CT) of chest revealed multiple effusion shadows and ground-glass opacities in bilateral lungs. Then, icotinib was discontinued and intravenous corticosteroid was started (methylprednisolone 40 mg once daily, about 1 mg per kilogram) respectively. Forty three days after icotinib treatment, the patient died of hypoxic respiratory failure. ILD should be considered as a rare, but often fatal side effect associated with icotinib treatment. PMID:25590006

Occurrence of serious injury in real-world side impacts of vehicles with good side-impact protection ratings.

PubMed

Brumbelow, Matthew L; Mueller, Becky C; Arbelaez, Raul A

2015-01-01

The Insurance Institute for Highway Safety (IIHS) introduced its side impact consumer information test program in 2003. Since that time, side airbags and structural improvements have been implemented across the fleet and the proportion of good ratings has increased to 93% of 2012-2014 model year vehicles. Research has shown that drivers of good-rated vehicles are 70% less likely to die in a left-side crash than drivers of poor-rated vehicles. Despite these improvements, side impact fatalities accounted for about one quarter of passenger vehicle occupant fatalities in 2012. This study is a detailed analysis of real-world cases with serious injury resulting from side crashes of vehicles with good ratings in the IIHS side impact test. NASS-CDS and Crash Injury Research and Engineering Network (CIREN) were queried for occupants of good-rated vehicles who sustained an Abbreviated Injury Scale (AIS) ≥ 3 injury in a side-impact crash. The resulting 110 cases were categorized by impact configuration and other factors that contributed to injury. Patterns of impact configuration, restraint performance, and occupant injury were identified and discussed in the context of potential upgrades to the current IIHS side impact test. Three quarters of the injured occupants were involved in near-side impacts. For these occupants, the most common factors contributing to injury were crash severities greater than the IIHS test, inadequate side-airbag performance, and lack of side-airbag coverage for the injured body region. In the cases where an airbag was present but did not prevent the injury, occupants were often exposed to loading centered farther forward on the vehicle than in the IIHS test. Around 40% of the far-side occupants were injured from contact with the struck-side interior structure, and almost all of these cases were more severe than the IIHS test. The remaining far-side occupants were mostly elderly and sustained injury from the center console, instrument panel, or seat belt. In addition, many far-side occupants were likely out of position due to events preceding the side impact and/or being unbelted. Individual changes to the IIHS side impact test have the potential to reduce the number of serious injuries in real-world crashes. These include impacting the vehicle farther forward (relevant to 28% of all cases studied), greater test severity (17%), the inclusion of far-side occupants (9%), and more restrictive injury criteria (9%). Combinations of these changes could be more effective.

Fatal necrotising enterocolitis due to mydriatic eye drops.

PubMed

Ozgun, Uygur; Demet, Terek; Ozge, Koroglu A; Zafer, Dokumcu; Murat, Sezak; Mehmet, Yalaz; Nilgun, Kultursay

2014-05-01

Retinopathy of prematurity (ROP) is a serious problem of preterm infants which may lead to impairment of vision and even to blindness if untreated. Routine eye examination is necessary for early diagnosis and treatment of ROP in preterm infants. Mydriatic eye drops (cyclopentolate, tropicamide and phenylephrine) are applied before the ophthalmic examination. These agents are rarely absorbed to systemic circulation and in some cases result with serious side effects like skin rash, tachycardia, feeding intolerance, discomfort, apnea, gastric dilatation and ileus, despite different treatment models and dosage reducing strategies. We report here a preterm patient who died because of severe diffuse necrotizing enterocolitis (NEC) after topical application of 0.5% cyclopentolate and 1.25% phenylephrine during ROP screening to emphasise the serious side effects of these agents.

Structure-based discovery of opioid analgesics with reduced side effects.

PubMed

Manglik, Aashish; Lin, Henry; Aryal, Dipendra K; McCorvy, John D; Dengler, Daniela; Corder, Gregory; Levit, Anat; Kling, Ralf C; Bernat, Viachaslau; Hübner, Harald; Huang, Xi-Ping; Sassano, Maria F; Giguère, Patrick M; Löber, Stefan; Da Duan; Scherrer, Grégory; Kobilka, Brian K; Gmeiner, Peter; Roth, Bryan L; Shoichet, Brian K

2016-09-08

Morphine is an alkaloid from the opium poppy used to treat pain. The potentially lethal side effects of morphine and related opioids-which include fatal respiratory depression-are thought to be mediated by μ-opioid-receptor (μOR) signalling through the β-arrestin pathway or by actions at other receptors. Conversely, G-protein μOR signalling is thought to confer analgesia. Here we computationally dock over 3 million molecules against the μOR structure and identify new scaffolds unrelated to known opioids. Structure-based optimization yields PZM21-a potent G i activator with exceptional selectivity for μOR and minimal β-arrestin-2 recruitment. Unlike morphine, PZM21 is more efficacious for the affective component of analgesia versus the reflexive component and is devoid of both respiratory depression and morphine-like reinforcing activity in mice at equi-analgesic doses. PZM21 thus serves as both a probe to disentangle μOR signalling and a therapeutic lead that is devoid of many of the side effects of current opioids.

Structure–based discovery of opioid analgesics with reduced side effects

PubMed Central

Manglik, Aashish; Lin, Henry; Aryal, Dipendra K.; McCorvy, John D.; Dengler, Daniela; Corder, Gregory; Levit, Anat; Kling, Ralf C.; Bernat, Viachaslau; Hübner, Harald; Huang, Xi-Ping; Sassano, Maria F.; Giguère, Patrick M.; Löber, Stefan; Duan, Da; Scherrer, Grégory; Kobilka, Brian K.; Gmeiner, Peter; Roth, Bryan L.; Shoichet, Brian K.

2016-01-01

Morphine is an alkaloid from the opium poppy used to treat pain. The potentially lethal side effects of morphine and related opioids—which include fatal respiratory depression—are thought to be mediated by μ-opioid-receptor (μOR) signalling through the β-arrestin pathway or by actions at other receptors. Conversely, G-protein μOR signalling is thought to confer analgesia. Here we computationally dock over 3 million molecules against the μOR structure and identify new scaffolds unrelated to known opioids. Structure-based optimization yields PZM21—a potent Gi activator with exceptional selectivity for μOR and minimal β-arrestin-2 recruitment. Unlike morphine, PZM21 is more efficacious for the affective component of analgesia versus the reflexive component and is devoid of both respiratory depression and morphine-like reinforcing activity in mice at equi-analgesic doses. PZM21 thus serves as both a probe to disentangle μOR signalling and a therapeutic lead that is devoid of many of the side effects of current opioids. PMID:27533032

Association between side air bags and risk of injury in motor vehicle collisions with near-side impact.

PubMed

McGwin, Gerald; Metzger, Jesse; Porterfield, John R; Moran, Stephan G; Rue, Loring W

2003-09-01

Side air bags (SABs) have been introduced in an attempt to reduce the risk of injury in near-side-impact motor vehicle collisions (MVCs). The impact of SABs on MVC-related mortality and morbidity has yet to be evaluated with a large population-based study. The objective of this study was to assess the effectiveness of SABs in reducing the risk of injury or death in near-side-impact MVCs. A retrospective study investigated outboard front seat occupants involved in police-reported, near-side-impact MVCs using data from the General Estimates System (1997-2000). The risk of MVC-related nonfatal and fatal injury for occupants of vehicles with and without SABs was compared. Front seat occupants of vehicles with SABs had a risk of injury similar to that of occupants of vehicles without SABs (risk ratio [RR], 0.96; 95% CI confidence interval [CI], 0.79-1.15). Adjustment for the potentially confounding effects of age, gender, seat belt use, seating position, damage severity and location, and vehicle body type did not meaningfully affect the association (RR, 0.90; 95% CICI, 0.76-1.08). There is no association between the availability of SABs and overall injury risk in near-side-impact MVCs. Future research is necessary to determine the effectiveness of SABs in preventing the injuries for which they were specifically designed.

Efficacy of side air bags in reducing driver deaths in driver-side collisions.

PubMed

Braver, Elisa R; Kyrychenko, Sergey Y

2004-03-15

Side air bags, a relatively new technology designed to protect the head and/or torso in side-impact collisions, are becoming increasingly common in automobiles. Their efficacy in preventing US driver deaths among cars struck on the near (driver's) side was examined using data from the Fatality Analysis Reporting System and the General Estimates System. Risk ratios for driver death per nearside collision during 1999-2001 were computed for head/torso and torso-only side air bags in cars from model years 1997-2002, relative to cars without side air bags. Confounding was addressed by adjusting nearside risk ratios for front- and rear-impact mortality, which is unaffected by side air bags. Risk ratios were 0.55 (95% confidence interval: 0.43, 0.71) for head/torso air bags and 0.89 (95% confidence interval: 0.79, 1.01) for torso-only air bags. Risk was reduced when cars with head/torso air bags were struck by cars/minivans (significant) or pickup trucks/sport utility vehicles (nonsignificant). Risk was reduced in two-vehicle collisions and among male drivers and drivers aged 16-64 years. Protective effects associated with torso-only air bags were observed in single-vehicle crashes and among male and 16- to 64-year-old drivers. Head/torso side air bags appear to be very effective in reducing nearside driver deaths, whereas torso-only air bags appear less protective.

[MODERN APPROACHES TO THE DIAGNOSIS AND TREATMENT OF CHEMOTHERAPY TOXICITY IN PATIENTS WITH BREAST CANCER].

PubMed

Syvak, L A; Hubareva, H O; Filonenko, K S; Majdanevych, N M; Aleksyk, O M; Lyalkin, S A; Klimanov, M J; Askolskyi, A V; Kasap, N V

2015-01-01

The use of modern chemotherapy (CT) allowed to achieve significant progress in the treatment of many malignant tumors that were previously considered fatal. Improving the efficiency of the treatment was achieved by the intensification of chemotherapy. However, intensification of chemotherapy regimes provoked increase in the number of side effects of anticancer therapy,which often lead to a decrease in the intensity of the selected mode, the additional financial costs of treating the complications and the formation of the negative attitude of the patient to treatment. Thus, the side effects of chemotherapy are the actual problem of modern oncology. The purpose of this literature review was to investigate the frequency, symptoms and ways to prevent and treat various types of toxicity of chemotherapy.

Advances in Pharmacotherapeutics of Space Motion Sickness

NASA Technical Reports Server (NTRS)

Putcha, Lakshmi

2006-01-01

Space Motion Sickness (SMS) is common occurrence in the U.S. manned space flight program and nearly 2/3 of Shuttle crewmembers experience SMS. Several drugs have been prescribed for therapeutic management of SMS. Typically, orally-administered SMS medications (scopolamine, promethazine) have poor bioavailability and often have detrimental neurocognitive side effects at recommended doses. Intramuscularly administered promethazine (PMZ) is perceived to have optimal efficacy with minimal side effects in space. However, intramuscular injections are painful and the sedating neurocognitive side effects of promethazine, significant in controlled ground testing, may be masked in orbit because injections are usually given prior to crew sleep. Currently, EVAs cannot be performed by symptomatic crew or prior to flight day three due to the lack of a consistently efficacious drug, concern about neurocognitive side effects, and because an in-suit vomiting episode is potentially fatal. NASA has long sought a fast acting, consistently effective anti-motion sickness medication which has only minor neurocognitive side effects. Development of intranasal formulations of scopolamine and promethazine, the two commonly used SMS drugs at NASA for both space and reduced gravity environment medical operations, appears to be a logical alternative to current treatment modalities for SMS. The advantages are expected to be fast absorption, reliable and high bioavailability, and probably reduced neurocognitive side effects owing to dose reduction. Results from clinical trials with intranasal scopolamine gel formulation and pre-clinical testing of a prototype microcapsule intranasal gel dosage form of PMZ (INPMZ) will be discussed. These formulations are expected to offer a dependable and effective noninvasive treatment option for SMS.

Pulmonary Hypertension, Hyperthyroidism, and Fenfluramine: A Case Report and Review

PubMed Central

Ying, Leung Ying; Shing, Tang Kam; Chi, Tsang Chiu; Kin, Chan Chi; Keung, Wong Kwan; Wai-yin, Yu Alex

2006-01-01

We report a case of pulmonary hypertension presenting with sudden cardiac arrest, hyperthyroidism and fenfluramine usage. This fatal case of pulmonary hypertension and valvular heart disease is associated with the use of an anorectic drug that had been withdrawn from the market more than eight years ago. Clinicians should alert to the side effects of appetite suppressant and slimming agents. The association between pulmonary hypertension in relation to hyperthyroidism and fenfluramine usage is reviewed. PMID:17415311

Application Side Casing on Open Deck RoRo to Improve Ship Stability

NASA Astrophysics Data System (ADS)

Hasanudin; K. A. P Utama, I.; Chen, Jeng-Horng

2018-03-01

RoRo is a vessel that can transport passengers, cargo, container and cars. Open Car Deck is favourite RoRo Vessel in developing countries due to its small GT, small tax and spacious car deck, but it has poor survival of stability. Many accident involve Open Car Deck RoRo which cause fatalities and victim. In order to ensure the safety of the ship, IMO had applied intact stability criteria IS Code 2008 which adapted from Rahola’s Research, but since 2008 IMO improved criteria become probabilistic damage stability SOLAS 2009. The RoRo type Open Car Deck has wide Breadth (B), small Draft (D) and small freeboard. It has difficulties to satisfy the ship’s stability criteria. Side Casings which has been applied in some RoRo have be known reduce freeboard or improve ship’s safety. In this paper investigated the effect side casings to survival of intact dan damage ship’s stability. Calculation has been conducted for four ships without, existing and full side casings. The investigation results shows that defect stability of Open Deck RoRo can be reduce with fitting side casing.

One side of the story: Examining newspaper coverage of workplace injury and fatality in Ontario, 2007-2012.

PubMed

Gawley, Tim; Dixon, Shane

2015-01-01

News coverage in popular media can shape public perspectives on occupational issues. Few studies exist concerning how occupational injury and fatality are represented in the news. This study examined how injuries, fatalities and worker characteristics were represented in newspapers compared with official government statistics. It also examined what individuals or organizations were most often included by reporters to provide interpretations of injuries and fatalities. Quantitative content analysis was used to examine 304 newspaper articles from between 2007 and 2012 representing the nine most populous cities in the province of Ontario, Canada. Government data came from reports compiled by the Workplace Safety and Insurance Board (WSIB) of Ontario. Compared to workers' compensation board records, physical characteristics of injuries and fatalities were skewed toward the acute traumatic. Women were dramatically underrepresented in newspaper articles. Age distributions were represented. Goods-producing, transportation and resource extraction occupations were overrepresented while services were underrepresented. Worker voices were largely absent in newspaper accounts compared with law enforcement, the State and management. How workplace injury and fatality are framed, and who contributes to these frames, serves to shape public interpretations of occupational injury and fatality and how occupational health and safety issues might be addressed in the future.

The safety potential of lane departure warning systems-A descriptive real-world study of fatal lane departure passenger car crashes in Sweden.

PubMed

Sternlund, Simon

2017-05-29

Lane departure crashes account for a significant proportion of passenger car occupant fatalities and serious injuries. Utilizing real-world data involving fatal passenger car crashes in Sweden, the characteristics of lane departure crashes were identified and the safety potential of lane departure warning (LDW) systems was quantified. The material consisted of 104 in-depth studies of fatal passenger car crashes in 2010. The crashes were classified as single-vehicle (n = 48), head-on (n = 52), and overtaking (n = 4) crashes. These crash types were identified as crashes that could have potentially involved lane departure. A case-by-case analysis was carried out and lane departure crashes were identified and characterized using police reports and information collected by crash investigators at the Swedish Transport Administration; for example, inspections and photographs of the crash sites and of the involved vehicles. Lane departure crashes were separated from crashes where loss of control occurred pre-lane departure. Furthermore, loss of control post-lane departures were identified. When studying the pre-stage of lane departure without prior loss of control, crashes were categorized as unintentional drifting, intentional lane change, or evasive maneuver. Using previously published effectiveness information, the potential for LDW systems to prevent crashes was estimated. Of all crashes with passenger car occupant fatalities in Sweden in 2010, 46% (63/138) were found to relate to lane departure without prior loss of control. These crashes accounted for 61% (63/104) of all single-vehicle, head-on, and overtaking crashes. The remaining 41 crashes were due to loss of control pre-lane departure. Unintentional drifting accounted for 81% (51/63) of all lane departure crashes without prior loss of control, which corresponded to 37% (51/138) of all fatal passenger car occupant crashes. LDW systems were found to potentially prevent 33-38 of the 100 fatal head-on and single vehicle crashes. These crashes involved drifting and occurred on roads with visible lane markings, signed posted speed limits ≥70 km/h, and without rumble strips on the corresponding lane departure side. The range of potentially prevented crashes (33-38) is due to the inclusion or exclusion of crashes involving excessive speeding. In this study, approximately half (51/100) of all head-on and single-vehicle crashes were identified as being a consequence of drifting, where LDW systems had the potential to prevent the majority (33-38) of these crashes. The typical lane departure crash without prior loss of control occurred on undivided roads in rural areas with signed posted speed limits ≥70 km/h, where the center and side road markings were visible.

Hemolysis in a patient with alkaptonuria and chronic kidney failure.

PubMed

Heng, Anne-Elisabeth; Courbebaisse, Marie; Kemeny, Jean Louis; Matesan, Raluca; Bonniol, Claude; Deteix, Patrice; Souweine, Bertrand

2010-07-01

In alkaptonuria, the absence of homogentisic acid oxidase results in the accumulation of homogentisic acid (HGA) in the body. Fatal disease cases are infrequent, and death often results from kidney or cardiac complications. We report a 24-year-old alkaptonuric man with severe decreased kidney function who developed fatal metabolic acidosis and intravascular hemolysis. Hemolysis may have been caused by rapid and extensive accumulation of HGA and subsequent accumulation of plasma soluble melanins. Toxic effects of plasma soluble melanins, their intermediates, and reactive oxygen side products are increased when antioxidant mechanisms are overwhelmed. A decrease in serum antioxidative activity has been reported in patients with chronic decreased kidney function. However, despite administration of large doses of an antioxidant agent and ascorbic acid and intensive kidney support, hemolysis and acidosis could not be brought under control and hemolysis led to the death of the patient.

The strength of graduated drivers license programs and fatalities among teen drivers and passengers.

PubMed

Morrisey, Michael A; Grabowski, David C; Dee, Thomas S; Campbell, Christine

2006-01-01

The purpose of this study is to investigate the effects of differentially stringent graduated drivers license programs on teen driver fatalities, day-time and night-time teen driver fatalities, fatalities of teen drivers with passengers present, and fatalities among teen passengers. The study uses 1992-2002 data on motor vehicle fatalities among 15-17-year-old drivers from the Fatality Analysis Reporting System to identify the effects of "good", "fair", and "marginal" GDL programs based upon designations by the Insurance Institute for Highway Safety. Analysis is conducted using conditional negative binomial regressions with fixed effects. "Good" programs reduce total fatalities among young drivers by 19.4% (c.i. -33.0%, -5.9%). "Fair" programs reduce night-time young driver fatalities by 12.6% (c.i. -23.9%, -1.2%), but have no effect on day-time fatalities. "Marginal" programs had no statistically meaningful effect on driver fatalities. All three types of programs reduced teen passenger fatalities, but the effects of limitations on the number of passengers appear to have had only minimal effects in reducing fatalities among young drivers themselves. Stronger GDL programs are more effective than weaker programs in reducing teenage motor vehicle fatalities.

Severe-to-fatal head injuries in motor vehicle impacts.

PubMed

Yoganandan, Narayan; Baisden, Jamie L; Maiman, Dennis J; Gennarelli, Thomas A; Guan, Yabo; Pintar, Frank A; Laud, Prakash; Ridella, Stephen A

2010-07-01

Severe-to-fatal head injuries in motor vehicle environments were analyzed using the United States Crash Injury Research and Engineering Network database for the years 1997-2006. Medical evaluations included details and photographs of injury, and on-scene, trauma bay, emergency room, intensive care unit, radiological, operating room, in-patient, and rehabilitation records. Data were synthesized on a case-by-case basis. X-rays, computed tomography scans, and magnetic resonance images were reviewed along with field evaluations of scene and photographs for the analyses of brain injuries and skull fractures. Injuries to the parenchyma, arteries, brainstem, cerebellum, cerebrum, and loss of consciousness were included. In addition to the analyses of severe-to-fatal (AIS4+) injuries, cervical spine, face, and scalp trauma were used to determine the potential for head contact. Fatalities and survivors were compared using nonparametric tests and confidence intervals for medians. Results were categorized based on the mode of impact with a focus on head contact. Out of the 3178 medical cases and 169 occupants sustaining head injuries, 132 adults were in frontal (54), side (75), and rear (3) crashes. Head contact locations are presented for each mode. A majority of cases clustered around the mid-size anthropometry and normal body mass index (BMI). Injuries occurred at change in velocities (DeltaV) representative of US regulations. Statistically significant differences in DeltaV between fatalities and survivors were found for side but not for frontal impacts. Independent of the impact mode and survivorship, contact locations were found to be superior to the center of gravity of the head, suggesting a greater role for angular than translational head kinematics. However, contact locations were biased to the impact mode: anterior aspects of the frontal bone and face were involved in frontal impacts while temporal-parietal regions were involved in side impacts. Because head injuries occur at regulatory DeltaV in modern vehicles and angular accelerations are not directly incorporated in crashworthiness standards, these findings from the largest dataset in literature, offer a field-based rationale for including rotational kinematics in injury assessments. In addition, it may be necessary to develop injury criteria and evaluate dummy biofidelity based on contact locations as this parameter depended on the impact mode. The current field-based analysis has identified the importance of both angular acceleration and contact location in head injury assessment and mitigation. Published by Elsevier Ltd.

Crashworthiness evaluation of mass transit buses.

DOT National Transportation Integrated Search

2008-11-01

Mass transit bus systems are an integral part of the national transportation network, serving more than 20.6 billion passenger-miles per year with a relatively low fatality rate. Bus occupant injuries are evenly distributed among crashes on all sides...

Probiotics and Antibiotic-Associated Diarrhea and Clostridium difficile Infection

NASA Astrophysics Data System (ADS)

Surawicz, Christina M.

Diarrhea is a common side effect of antibiotics. Antibiotics can cause diarrhea in 5-25% of individuals who take them but its occurrence is unpredictable. Diarrhea due to antibiotics is called antibiotic-associated diarrhea (AAD). Diarrhea may be mild and resolve when antibiotics are discontinued, or it may be more severe. The most severe form of AAD is caused by overgrowth of Clostridium difficile which can cause severe diarrhea, colitis, pseudomembranous colitis, or even fatal toxic megacolon. Rates of diarrhea vary with the specific antibiotic as well as with the individual susceptibility.

Community-based education and public awareness for all-terrain vehicle (ATV) and side-by-side (SxS) safety to reduce roadway deaths and injuries : preventing roadway deaths and injuries from off-road vehicle crashes : research report summary.

DOT National Transportation Integrated Search

2017-06-30

ATVs and SxSs are designed for off-road use only. Vehicle design, lack of operator training, and other factors, like roadway speeds, all contribute to the risk of a crash. In fact, more than half of all ATV and SxS fatalities occur on public roads. A...

The effect of roof strength on reducing occupant injury in rollovers.

PubMed

Herbst, Brian; Forrest, Steve; Orton, Tia; Meyer, Steven E; Sances, Anthony; Kumaresan, Srirangam

2005-01-01

Roof crush occurs and potentially contributes to serious or fatal occupant injury in 26% of rollovers. It is likely that glazing retention is related to the degree of roof crush experienced in rollover accidents. Occupant ejection (including partial ejection) is the leading cause of death and injury in rollover accidents. In fatal passenger car accidents involving ejection, 34% were ejected through the side windows. Side window glass retention during a rollover is likely to significantly reduce occupant ejections. The inverted drop test methodology is a test procedure to evaluate the structural integrity of roofs under loadings similar to those seen in real world rollovers. Recent testing on many different vehicle types indicates that damage consistent with field rollover accidents can be achieved through inverted drop testing at very small drop heights. Drop test comparisons were performed on 16 pairs of vehicles representing a large spectrum of vehicle types. Each vehicle pair includes a production vehicle and a vehicle with a reinforced roof structure dropped under the same test conditions. This paper offers several examples of post-production reinforcements to roof structures that significantly increase the crush resistance of the roof as measured by inverted drop tests. These modifications were implemented with minimal impact on vehicle styling, interior space and visual clearances. The results of these modifications indicate that roof crush can be mitigated by nearly an order of magnitude, as roof crush was reduced by 44-91% with only a 1-2.3% increase in vehicle weight. Additionally, this paper analyzes the glazing breakage patterns in the moveable tempered side windows on the side adjacent to the vehicle impact point in the inverted drop tests. A comparison is made between the production vehicles and the reinforced vehicles in order to determine if the amount roof crush is related to glazing integrity in the side windows. Lastly, two drop test pairs, performed with Hybrid III test dummies, indicates that the reduction of roof crush resulted in a direct reduction in neck loading and therefore an increase in occupant protection.

Effects of urban sprawl and vehicle miles traveled on traffic fatalities.

PubMed

Yeo, Jiho; Park, Sungjin; Jang, Kitae

2015-01-01

Previous research suggests that urban sprawl increases auto-dependency and that excessive auto use increases the risk of traffic fatalities. This indirect effect of urban sprawl on traffic fatalities is compared to non-vehicle miles traveled (VMT)-related direct effect of sprawl on fatalities. We conducted a path analysis to examine the causal linkages among urban sprawl, VMT, traffic fatalities, income, and fuel cost. The path diagram includes 2 major linkages: the direct relationship between urban sprawl and traffic fatalities and the indirect effect on fatalities through increased VMT in sprawling urban areas. To measure the relative strength of these causal linkages, path coefficients are estimated using data collected nationally from 147 urbanized areas in the United States. Through both direct and indirect paths, urban sprawl is associated with greater numbers of traffic fatalities, but the direct effect of sprawl on fatalities is more influential than the indirect effect. Enhancing traffic safety can be achieved by impeding urban sprawl and encouraging compact development. On the other hand, policy tools reducing VMT may be less effective than anticipated for traffic safety.

A fatal impaling injury in a road traffic accident: a case report.

PubMed

Rautji, R; Girdhar, S; Lalwani, S; Dogra, T D

2004-04-01

A 17-year old, thin-built male was sitting in a bus on the right side of the rear seat. The same side of the bus accidentally hit some iron rods, meant for construction work, projecting from the tail end of a small truck. The incident happened when the bus driver tried to manoeuvre the bus towards the left side of the truck, standing at a red traffic light intersection. One of the iron-rods entered the bus through the glass window next to which the victim had been sitting and penetrated his chest cavity from the side, lacerating both the lungs and exiting through the left shoulder blade. The individual died on his way to hospital.

Fatal attraction: Explaining Russia's sensitive nuclear transfers to Iran

NASA Astrophysics Data System (ADS)

Kuchinsky, Leah R.

This paper explores Russia's sensitive nuclear assistance to Iran in an effort to determine why a supplier state might proliferate against its own apparent security interests. The goal is to help readers understand the supply-side dynamics of nuclear proliferation. Through careful reconstruction of the historical narrative, using open source data, this study tests the plausibility of a "fatalistic calculus" explanation, identified by Stephen Sestanovich as a possible driver for Russia's behavior. According to the hypothesis, Russia has cooperated with Iran as a way both to stay in the good graces of a neighbor that is suspected of developing nuclear weapons and to win short-term influence and profits. The paper also examines the role of other factors advanced in the existing supply-side literature, such as economic motives identified by physicist and nonproliferation scholar David Albright. The findings show that bureaucratic, economic and fatalistic factors have each played a role in motivating Russia's cooperation with Iran, with their relative importance shifting over time. Fatalism begets a strategy of Russian "minimaxing," in the lexicon of Russia scholar Robert Freedman, wherein Russia attempts to minimize damage to its relationship with the U.S. while maximizing influence in Iran via nuclear cooperation. Fatalism, as actualized by minimaxing, best explains Russia's behavior after former Russian president Vladmir Putin came to power, when the bureaucratic and economic arguments become less cogent.

Truck sideguards for Vision Zero : review and technical recommendations for Safe Fleet Transition Plan pilot deployment.

DOT National Transportation Integrated Search

2014-12-01

Large truck crashes are more likely to result in a pedestrian or bicyclist fatality than crashes involving passenger vehicles and are more likely to be side-impact crashes. Sideguards are vehicle-based safety devices that help prevent pedestrians and...

Indefinite antithyroid drug therapy in toxic Graves’ disease: What are the cons

PubMed Central

Rajput, Rajesh; Goel, Vasudha

2013-01-01

Existing treatment modalities for Graves’ disease includes antithyroid drugs (ATDs), radioactive iodine, and surgery. There has been a lack of general agreement as to which therapy is the best as none is ideal since all effectively restore euthyroidism, but with some limitations. Previously, therapies were selected with the goal of achieving euthyroidism. Instead, hypothyroidism is now the goal of treatment, to ensure that hyperthyroidism does not recur. Current evidences suggest that high relapse rate and not so rare fatal side effects seen with ATD therapy compel one to consider other definite modes of treatment like radiotherapy and surgery for toxic Graves’ disease after discussing this with the patient. PMID:24251229

Indefinite antithyroid drug therapy in toxic Graves' disease: What are the cons.

PubMed

Rajput, Rajesh; Goel, Vasudha

2013-10-01

Existing treatment modalities for Graves' disease includes antithyroid drugs (ATDs), radioactive iodine, and surgery. There has been a lack of general agreement as to which therapy is the best as none is ideal since all effectively restore euthyroidism, but with some limitations. Previously, therapies were selected with the goal of achieving euthyroidism. Instead, hypothyroidism is now the goal of treatment, to ensure that hyperthyroidism does not recur. Current evidences suggest that high relapse rate and not so rare fatal side effects seen with ATD therapy compel one to consider other definite modes of treatment like radiotherapy and surgery for toxic Graves' disease after discussing this with the patient.

Large and Small Cars in Real-World Crashes -Patterns of Use, Collision Types and Injury Outcomes

PubMed Central

Thomas, Pete; Frampton, Richard

1999-01-01

Previous work examining the effect of vehicle mass has demonstrated the link with occupant injury severity. The principal factor has been related to Newtonian mechanics. This paper analyses data from the UK Co-operative Crash Injury Study and identifies other factors associated with car size. The mass of the car is found to have a predominant effect on injury outcome in frontal collisions only where the effect is seen most in injuries to the head, face and chest. Most fatal casualties in small cars die when in collision with another car in front or side collisions while the key group for large cars is frontal collisions with road-side objects. There are several characteristics of small car occupants that differ from those in large cars including gender, age and vehicle occupancy. New information in the analysis concerns the priorities in casualty reduction between small and large car occupants and the paper argues that vehicle design should take account of this variation to produce vehicles optimised for the complete range of crashes and car occupants.

Finite element analysis for the evaluation of protective functions of helmets against ballistic impact.

PubMed

Lee, H P; Gong, S W

2010-10-01

The ballistic impact of a human head model protected by a Personnel Armor System Ground Troops Kevlar® helmet is analysed using the finite element method. The emphasis is to examine the effect of the interior cushioning system as a shock absorber in mitigating ballistic impact to the head. The simulations of the frontal and side impacts of the full metal jacket (FMJ) and fragment-simulating projectile (FSP) were carried out using LS-DYNA. It was found that the Kevlar® helmet with its interior nylon and leather strap was able to defeat both the FMJ and FSP without the projectiles penetrating the helmet. However, the head injuries caused by the FMJ impact can be fatal due to the high stiffness of the interior strap. The bulge section at the side of the Kevlar® helmet had more room for deformation that resulted in less serious head injuries.

Mining adverse drug reactions from online healthcare forums using hidden Markov model.

PubMed

Sampathkumar, Hariprasad; Chen, Xue-wen; Luo, Bo

2014-10-23

Adverse Drug Reactions are one of the leading causes of injury or death among patients undergoing medical treatments. Not all Adverse Drug Reactions are identified before a drug is made available in the market. Current post-marketing drug surveillance methods, which are based purely on voluntary spontaneous reports, are unable to provide the early indications necessary to prevent the occurrence of such injuries or fatalities. The objective of this research is to extract reports of adverse drug side-effects from messages in online healthcare forums and use them as early indicators to assist in post-marketing drug surveillance. We treat the task of extracting adverse side-effects of drugs from healthcare forum messages as a sequence labeling problem and present a Hidden Markov Model(HMM) based Text Mining system that can be used to classify a message as containing drug side-effect information and then extract the adverse side-effect mentions from it. A manually annotated dataset from http://www.medications.com is used in the training and validation of the HMM based Text Mining system. A 10-fold cross-validation on the manually annotated dataset yielded on average an F-Score of 0.76 from the HMM Classifier, in comparison to 0.575 from the Baseline classifier. Without the Plain Text Filter component as a part of the Text Processing module, the F-Score of the HMM Classifier was reduced to 0.378 on average, while absence of the HTML Filter component was found to have no impact. Reducing the Drug names dictionary size by half, on average reduced the F-Score of the HMM Classifier to 0.359, while a similar reduction to the side-effects dictionary yielded an F-Score of 0.651 on average. Adverse side-effects mined from http://www.medications.com and http://www.steadyhealth.com were found to match the Adverse Drug Reactions on the Drug Package Labels of several drugs. In addition, some novel adverse side-effects, which can be potential Adverse Drug Reactions, were also identified. The results from the HMM based Text Miner are encouraging to pursue further enhancements to this approach. The mined novel side-effects can act as early indicators for health authorities to help focus their efforts in post-marketing drug surveillance.

Biomechanical analysis of protective countermeasures in underride motor vehicle accidents - biomed 2009.

PubMed

Kumar, Sri; Enz, Bruce; Ponder, Perry L; Anderson, Bob

2009-01-01

Traffic safety has been significantly improved over the past several decades reducing injury and fatality rates. However, there is a paucity of research effort to address the safety issues in underride accidents, specifically the side underride crashes. It is well known that the compromise of occupant space in the vehicle leads to a higher probability of serious or fatal injuries. A better understanding of occupant protection and mechanism of injuries involved in side underride accidents assists in the advancement of safety measures. The present work evaluates the injury potential to occupants during side underride crashes using the car-to-trailer crash methodology. Four crash tests were conducted into the side of a stationary trailer fitted with the side underride guard system (SURG). The SURG used in these tests is 25% lighter than the previous design. A 5th percentile hybrid III female dummy was placed in the driver seat and restrained with the three-point lap and shoulder harness. The anthropometric dummy was instrumented with a head triaxial accelerometer, a chest triaxal accelerometer, a load cell to measure neck force and moment, and a load cell to measure the femur force. The vehicle acceleration was measured using a traxial accelerometer in the rear center tunnel. High speed, standard video and still photos were taken. In all tests, the intrusion was limited to the front structure of the vehicle without any significant compromise to the occupant space. Results indicate that the resultant head and chest accelerations, head injury criterion (HIC), neck force and moment, and femur force were well below the injury tolerance. The present findings support the hypothesis that the SURG not only limits or eliminates the intrusion into the occupant space but also results in biomechanical injury values well below the tolerance limit in motor vehicle crashes.

Difference in dummy responses in matched side impact tests of vehicles with and without side airbags.

PubMed

Viano, David C; Parenteau, Chantal S

2016-07-03

Insurance Institute for Highway Safety (IIHS) high-hooded side impacts were analyzed for matched vehicle tests with and without side airbags. The comparison provides a measure of the effectiveness of side airbags in reducing biomechanical responses for near-side occupants struck by trucks, SUVs, and vans at 50 km/h. The IIHS moving deformable barrier (MDB) uses a high-hooded barrier face. It weighs 1,500 kg and impacts the driver side perpendicular to the vehicle at 50 km/h. SID IIs dummies are placed in the driver and left second-row seats. They represent fifth percentile female occupants. IIHS tests were reviewed for matches with one test with a side airbag and another without it in 2003-2007 model year (MY) vehicles. Four side airbag systems were evaluated: (1) curtain and torso side airbags, (2) head and torso side airbag, (3) curtain side airbag, and (4) torso side airbag. There were 24 matched IIHS vehicle tests: 13 with and without a curtain and torso side airbags, 4 with and without a head and torso side airbag, 5 with and without a side curtain airbag, and 2 with and without a torso airbag. The head, chest, and pelvis responses were compared for each match and the average difference was determined across all matches for a type of side airbag. The average reduction in head injury criterion (HIC) was 68 ± 16% (P < .001) with curtain and torso side airbags compared to the HIC without side airbags. The average HIC was 296 with curtain and torso side airbags and 1,199 without them. The viscous response (VC) was reduced 54 ± 19% (P < .005) with curtain and torso side airbags. The combined acetabulum and ilium force (7 ± 15%) and pelvic acceleration (-2 ± 17%) were essentially similar in the matched tests. The head and torso side airbag reduced HIC by 42 ± 30% (P < .1) and VC by 32 ± 26% compared to vehicles without a side airbag. The average HIC was 397 with the side head and torso airbag compared to 729 without it. The curtain airbag and torso airbag only showed lower head responses but essentially no difference in the chest and pelvis responses. The curtain and torso side airbags effectively reduced biomechanical responses for the head and chest in 50 km/h side impacts with a high-hooded deformable barrier. The reductions in the IIHS tests are directionally the same as estimated fatality reductions in field crashes reported by NHTSA for side airbags.

A novel risk assessment method for landfill slope failure: Case study application for Bhalswa Dumpsite, India.

PubMed

Jahanfar, Ali; Amirmojahedi, Mohsen; Gharabaghi, Bahram; Dubey, Brajesh; McBean, Edward; Kumar, Dinesh

2017-03-01

Rapid population growth of major urban centres in many developing countries has created massive landfills with extraordinary heights and steep side-slopes, which are frequently surrounded by illegal low-income residential settlements developed too close to landfills. These extraordinary landfills are facing high risks of catastrophic failure with potentially large numbers of fatalities. This study presents a novel method for risk assessment of landfill slope failure, using probabilistic analysis of potential failure scenarios and associated fatalities. The conceptual framework of the method includes selecting appropriate statistical distributions for the municipal solid waste (MSW) material shear strength and rheological properties for potential failure scenario analysis. The MSW material properties for a given scenario is then used to analyse the probability of slope failure and the resulting run-out length to calculate the potential risk of fatalities. In comparison with existing methods, which are solely based on the probability of slope failure, this method provides a more accurate estimate of the risk of fatalities associated with a given landfill slope failure. The application of the new risk assessment method is demonstrated with a case study for a landfill located within a heavily populated area of New Delhi, India.

Identifying high-risk small business industries for occupational safety and health interventions.

PubMed

Okun, A; Lentz, T J; Schulte, P; Stayner, L

2001-03-01

Approximately one-third (32%) of U.S. workers are employed in small business industries (those with 80% of workers in establishments with fewer than 100 employees), and approximately 53 million persons in private industry work in small business establishments. This study was performed to identify small business industries at high risk for occupational injuries, illnesses, and fatalities. Small business industries were identified from among all three- and four-digit Standard Industrial Classification (SIC) codes and ranked using Bureau of Labor Statistics (BLS) data by rates and numbers of occupational injuries, illnesses, and fatalities. Both incidence rates and number of injury, illness, and fatality cases were evaluated. The 253 small business industries identified accounted for 1,568 work-related fatalities (34% of all private industry). Transportation incidents and violent acts were the leading causes of these fatalities. Detailed injury and illness data were available for 105 small business industries, that accounted for 1,476,400 work-related injuries, and 55,850 occupational illnesses. Many of the small business industries had morbidity and mortality rates exceeding the average rates for all private industry. The highest risk small business industries, based on a combined morbidity and mortality index, included logging, cut stone and stone products, truck terminals, and roofing, siding, and sheet metal work. Identification of high-risk small business industries indicates priorities for those interested in developing targeted prevention programs.

Estimation of fatality and injury risk by means of in-depth fatal accident investigation data.

PubMed

Yannis, George; Papadimitriou, Eleonora; Dupont, Emmanuelle; Martensen, Heike

2010-10-01

In this article the factors affecting fatality and injury risk of road users involved in fatal accidents are analyzed by means of in-depth accident investigation data, with emphasis on parameters not extensively explored in previous research. A fatal accident investigation (FAI) database is used, which includes intermediate-level in-depth data for a harmonized representative sample of 1300 fatal accidents in 7 European countries. The FAI database offers improved potential for analysis, because it includes information on a number of variables that are seldom available, complete, or accurately recorded in road accident databases. However, the fact that only fatal accidents are examined requires for methodological adjustments, namely, the correction for two types of effects on a road user's baseline risk: "accident size" effects, and "relative vulnerability" effects. Fatality and injury risk can be then modeled through multilevel logistic regression models, which account for the hierarchical dependences of the road accident process. The results show that the baseline fatality risk of road users involved in fatal accidents decreases with accident size and increases with the vulnerability of the road user. On the contrary, accident size increases nonfatal injury risk of road users involved in fatal accidents. Other significant effects on fatality and injury risk in fatal accidents include road user age, vehicle type, speed limit, the chain of accident events, vehicle maneuver, and safety equipment. In particular, the presence and use of safety equipment such as seat belt, antilock braking system (ABS), and electronic stability program (ESP) are protection factors for car occupants, especially for those seated at the front seats. Although ABS and ESP systems are typically associated with positive effects on accident occurrence, the results of this research revealed significant related effects on accident severity as well. Moreover, accident consequences are more severe when the most harmful event of the accident occurs later within the accident chain.

Thoracic Injury Risk as a Function of Crash Severity – Car-to-car Side Impact Tests with WorldSID Compared to Real-life Crashes

PubMed Central

Sunnevång, Cecilia; Rosén, Erik; Boström, Ola; Lechelt, Ulf

2010-01-01

Side airbags reduce the risk of fatal injury by approximately 30%. Due to limited real-life data the risk reducing effect for serious injury has not yet been established. Since side airbags are mainly designed and validated for crash severities used in available test procedures little is known regarding the protective effect when severity increases. The objective of this study was to understand for which crash severities AIS3+ thorax occupant protection in car-to-car nearside collisions need to and can be improved. The aim was fulfilled by means of real life data, for older cars without side airbag, and a series of car-to-car tests performed with the WorldSID 50%-ile in modern and older cars at different impact speeds. The real life data showed that the risk of AIS3+ injury was highest for the thorax followed by the pelvis and head. For both non-senior and senior occupants, most thorax injuries were sustained at lateral delta-v from 20 km/h to 40 km/h. In this severity range, senior occupants were found to have approximately four times higher risk of thoracic injury than non-senior occupants. The crash tests at lateral impact speed 55 km/h (delta-v 32 km/h) confirmed the improved performance at severities represented in current legal and rating tests. The structural integrity of the modern car impacted at 70 km/h showed a potential for improved side impact protection by interior countermeasures. PMID:21050600

Thoracic Injury Risk as a Function of Crash Severity - Car-to-car Side Impact Tests with WorldSID Compared to Real-life Crashes.

PubMed

Sunnevång, Cecilia; Rosén, Erik; Boström, Ola; Lechelt, Ulf

2010-01-01

Side airbags reduce the risk of fatal injury by approximately 30%. Due to limited real-life data the risk reducing effect for serious injury has not yet been established. Since side airbags are mainly designed and validated for crash severities used in available test procedures little is known regarding the protective effect when severity increases.The objective of this study was to understand for which crash severities AIS3+ thorax occupant protection in car-to-car nearside collisions need to and can be improved. The aim was fulfilled by means of real life data, for older cars without side airbag, and a series of car-to-car tests performed with the WorldSID 50%-ile in modern and older cars at different impact speeds.The real life data showed that the risk of AIS3+ injury was highest for the thorax followed by the pelvis and head. For both non-senior and senior occupants, most thorax injuries were sustained at lateral delta-v from 20 km/h to 40 km/h. In this severity range, senior occupants were found to have approximately four times higher risk of thoracic injury than non-senior occupants. The crash tests at lateral impact speed 55 km/h (delta-v 32 km/h) confirmed the improved performance at severities represented in current legal and rating tests. The structural integrity of the modern car impacted at 70 km/h showed a potential for improved side impact protection by interior countermeasures.

Improving Pool Fencing Legislation in Queensland, Australia: Attitudes and Impact on Child Drowning Fatalities

PubMed Central

2017-01-01

Four-sided, non-climbable pool fencing is an effective strategy for preventing children from drowning in home swimming pools. In 2009, the Queensland Government introduced legislation to improve the effectiveness of pool fencing. This study explores community attitudes towards the effectiveness of these legislative changes and examines child (<5 years) drowning deaths in pools. Data from the 2011 Queensland Computer-Assisted Telephone Interviewing (CATI) Social Survey include results from questions related to pool ownership and pool fencing legislation. Fatal child drowning cases between 1 January 2005 and 31 December 2015 were sourced from coronial data. Of the 1263 respondents, 26/100 households had a pool. A total of 58% believed tightening legislation would be effective in reducing child drowning deaths. Pool owners were more likely to doubt the effectiveness of legislation (p < 0.001) when compared to non-pool owners. Perceptions of effectiveness did not differ by presence of children under the age of five. There were 46 children who drowned in Queensland home pools (7.8/100,000 pools with children residing in the residence/annum) between 2005 and 2015. While pool owners were less likely to think that tightening the legislation would be effective, the number of children drowning in home swimming pools declined over the study period. Drowning prevention agencies have more work to do to ensure that the most vulnerable (young children in houses with swimming pools) are protected. PMID:29186787

Assessment of NHTSA’s Report “Relationships Between Fatality Risk, Mass, and Footprint in Model Year 2000-2007 Passenger Cars and LTVs”

DOE Office of Scientific and Technical Information (OSTI.GOV)

Wenzel, Tom

2012-08-01

NHTSA recently completed a logistic regression analysis updating its 2003 and 2010 studies of the relationship between vehicle mass and US fatality risk per vehicle mile traveled (VMT). The new study updates the previous analyses in several ways: updated FARS data from 2002 to 2008 for MY00 to MY07 vehicles are used; induced exposure data from police reported crashes in several additional states are added; a new vehicle category for car-based crossover utility vehicles (CUVs) and minivans is created; crashes with other light-duty vehicles are divided into two groups based on the crash partner vehicle’s weight, and a category formore » all other fatal crashes is added; and new control variables for new safety technologies and designs, such as electronic stability controls (ESC), side airbags, and methods to meet voluntary agreement to improve light truck compatibility with cars, are included.« less

Assessment of NHTSA’s Report “Relationships Between Fatality Risk, Mass, and Footprint in Model Year 2000-2007 Passenger Cars and LTVs”

DOE Office of Scientific and Technical Information (OSTI.GOV)

Wenzel, Tom

2011-09-01

NHTSA recently completed a logistic regression analysis updating its 2003 and 2010 studies of the relationship between vehicle mass and US fatality risk per vehicle mile traveled (VMT). The new study updates the previous analyses in several ways: updated FARS data from 2002 to 2008 for MY00 to MY07 vehicles are used; induced exposure data from police reported crashes in several additional states are added; a new vehicle category for car-based crossover utility vehicles (CUVs) and minivans is created; crashes with other light-duty vehicles are divided into two groups based on the crash partner vehicle’s weight, and a category formore » all other fatal crashes is added; and new control variables for new safety technologies and designs, such as electronic stability controls (ESC), side airbags, and methods to meet voluntary agreement to improve light truck compatibility with cars, are included.« less

Machinery-related deaths: relevance of workplace investigation and antemortem radiological data in reconstructing the fatality.

PubMed

Cecchetto, Giovanni; Viel, Guido; De Lotto, Federica; Manara, Renzo; Montisci, Massimo; Zancaner, Silvano; Ferrara, S Davide

2010-05-01

Machinery-related fatalities are one of the leading causes of traumatic occupational deaths. In our report, we present the case of a 40-year-old male who suffered a severe head trauma while working in a cut-foam industry and died despite an early craniectomy. The radiological reconstruction of the skull based on preoperative computed tomography scans disclosed a large depressed conical fracture of the left parietal bone. The 3D-reconstruction of the work area, combined with a fit-matching analysis between the machinery and the depressed skull fracture allowed us to conclude that the head was crushed between the sliding bar of the cutting device and the metallic protuberance on the opposite side. The case underlines the importance of a detailed workplace investigation and of a thorough evaluation of all circumstantial, clinical, radiological, and autopsy data in the reconstruction of machinery-related fatalities to identify any possible legal responsibilities of the worker and/or the employer.

Nano delivers big: designing molecular missiles for cancer therapeutics.

PubMed

Patel, Sachin; Bhirde, Ashwin A; Rusling, James F; Chen, Xiaoyuan; Gutkind, J Silvio; Patel, Vyomesh

2011-01-01

Current first-line treatments for most cancers feature a short-list of highly potent and often target-blind interventions, including chemotherapy, radiation, and surgical excision. These treatments wreak considerable havoc upon non-cancerous tissue and organs, resulting in deleterious and sometimes fatal side effects for the patient. In response, this past decade has witnessed the robust emergence of nanoparticles and, more relevantly, nanoparticle drug delivery systems (DDS), widely touted as the panacea of cancer therapeutics. While not a cure, nanoparticle DDS can successfully negotiate the clinical payoff between drug dosage and side effects by encompassing target-specific drug delivery strategies. The expanding library of nanoparticles includes lipoproteins, liposomes, dendrimers, polymers, metal and metal oxide nano-spheres and -rods, and carbon nanotubes, so do the modes of delivery. Importantly, however, the pharmaco-dynamics and -kinetics of these nano-complexes remain an urgent issue and a serious bottleneck in the transition from bench to bedside. This review addresses the rise of nanoparticle DDS platforms for cancer and explores concepts of gene/drug delivery and cytotoxicity in pre-clinical and clinical contexts.

The effectiveness of drinking and driving policies for different alcohol-related fatalities: a quantile regression analysis.

PubMed

Ying, Yung-Hsiang; Wu, Chin-Chih; Chang, Koyin

2013-09-27

To understand the impact of drinking and driving laws on drinking and driving fatality rates, this study explored the different effects these laws have on areas with varying severity rates for drinking and driving. Unlike previous studies, this study employed quantile regression analysis. Empirical results showed that policies based on local conditions must be used to effectively reduce drinking and driving fatality rates; that is, different measures should be adopted to target the specific conditions in various regions. For areas with low fatality rates (low quantiles), people's habits and attitudes toward alcohol should be emphasized instead of transportation safety laws because "preemptive regulations" are more effective. For areas with high fatality rates (or high quantiles), "ex-post regulations" are more effective, and impact these areas approximately 0.01% to 0.05% more than they do areas with low fatality rates.

The Effectiveness of Drinking and Driving Policies for Different Alcohol-Related Fatalities: A Quantile Regression Analysis

PubMed Central

Ying, Yung-Hsiang; Wu, Chin-Chih; Chang, Koyin

2013-01-01

To understand the impact of drinking and driving laws on drinking and driving fatality rates, this study explored the different effects these laws have on areas with varying severity rates for drinking and driving. Unlike previous studies, this study employed quantile regression analysis. Empirical results showed that policies based on local conditions must be used to effectively reduce drinking and driving fatality rates; that is, different measures should be adopted to target the specific conditions in various regions. For areas with low fatality rates (low quantiles), people’s habits and attitudes toward alcohol should be emphasized instead of transportation safety laws because “preemptive regulations” are more effective. For areas with high fatality rates (or high quantiles), “ex-post regulations” are more effective, and impact these areas approximately 0.01% to 0.05% more than they do areas with low fatality rates. PMID:24084673

Driver injury in near- and far-side impacts: Update on the effect of front passenger belt use.

PubMed

Parenteau, Chantal S; Viano, David C

2018-04-03

This is a study that updates earlier research on the influence of a front passenger on the risk for severe driver injury in near-side and far-side impacts. It includes the effects of belt use by the driver and passenger, identifies body regions involved in driver injury, and identifies the sources for severe driver head injury. 1997-2015 NASS-CDS data were used to investigate the risk for Maximum Abbreviated Injury Scale (MAIS) 4 + F driver injury in near-side and far-side impacts by front passenger belt use and as a sole occupant in the driver seat. Side impacts were identified with GAD1 = L or R without rollover (rollover ≤ 0). Front-outboard occupants were included without ejection (ejection = 0). Injury severity was defined by MAIS and fatality (F) by TREATMNT = 1 or INJSEV = 4. Weighted data were determined. The risk for MAIS 4 + F was determined using the number of occupants with known injury status MAIS 0 + F. Standard errors were determined. Overall, belted drivers had greater risks for severe injury in near-side than far-side impacts. As a sole driver, the risk was 0.969 ± 0.212% for near-side and 0.313 ± 0.069% for far-side impacts (P < .005). The driver's risk was 0.933 ± 0.430% with an unbelted passenger and 0.596 ± 0.144% with a belted passenger in near-side impacts. The risk was 2.17 times greater with an unbelted passenger (NS). The driver's risk was 0.782 ± 0.431% with an unbelted passenger and 0.361% ± 0.114% with a belted passenger in far-side impacts. The risk was 1.57 times greater with an unbelted passenger (P < .10). Seat belt use was 66 to 95% effective in preventing MAIS 4 + F injury in the driver. For belted drivers, the head and thorax were the leading body regions for Abbreviated Injury Scale (AIS) 4+ injury. For near-side impacts, the leading sources for AIS 4+ head injury were the left B-pillar, roof, and other vehicle. For far-side impacts, the leading sources were the other occupant, right interior, and roof (8.5%). Seat belt use by a passenger lowered the risk of severe driver injury in side impacts. The reduction was 54% in near-side impacts and 36% in far-side impacts. Belted drivers experienced mostly head and thoracic AIS 4+ injuries. Head injuries in the belted drivers were from contact with the side interior and the other occupant, even with a belted passenger.

Mastocytosis and insect venom allergy.

PubMed

Bonadonna, Patrizia; Zanotti, Roberta; Müller, Ulrich

2010-08-01

To analyse the association of systemic allergic hymenoptera sting reactions with mastocytosis and elevated baseline serum tryptase and to discuss diagnosis and treatment in patients with both diseases. In recent large studies on patients with mastocytosis a much higher incidence of severe anaphylaxis following hymenoptera stings than in the normal population was documented. In patients with hymenoptera venom allergy, elevated baseline tryptase is strongly associated with severe anaphylaxis. Fatal sting reactions were reported in patients with mastocytosis, notably after stopping venom immunotherapy. During venom immunotherapy most patients with mastocytosis are protected from further sting reactions. Based on these observations immunotherapy for life is recommended for patients with mastocytosis and venom allergy. The incidence of allergic side-effects is increased in patients with mastocytosis and elevated baseline tryptase, especially in those allergic to Vespula venom. Premedication with antihistamines, or omalizumab in cases with recurrent severe side-effects, can be helpful. In all patients with anaphylaxis following hymenoptera stings, baseline serum tryptase should be determined. A value above 11.4 microg/l is often due to mastocytosis and indicates a high risk of very severe anaphylaxis following re-stings. Venom immunotherapy is safe and effective in this situation.

Cost-effectiveness analysis of applying the Cholesterol and Recurrent Events (CARE) study protocol in Hong Kong.

PubMed

Chau, J; Cheung, B M; McGhee, S M; Lauder, I J; Lau, C P; Kumana, C R

2001-12-01

To determine the cost-effectiveness of secondary prevention with pravastatin in Hong Kong patients with coronary heart disease and average cholesterol levels. Cost-effectiveness analysis based on published results of the CARE study. Men and women post-myocardial infarction with average cholesterol levels. Cost-effectiveness analysis: cost per life saved, cost per fatal or non-fatal coronary event prevented, cost per procedure prevented, and cost per fatal or non-fatal stroke prevented. Cost-utility analysis: gross cost and net cost per quality-adjusted life year gained calculated using two alternative models. Cost per life saved or death prevented was HK$4,442,350 (non-discounted); cost per fatal or non-fatal cardiac event prevented HK$1,146,413; cost per procedure prevented HK$732,759; and cost per fatal or non-fatal stroke prevented HK$2,961,566. Net cost per quality adjusted life year gained was HK$73,218 and HK$65,280 non-discounted, respectively using the two alternative models. The results of this study can assist in prioritising the use of health care resources in Hong Kong but should be considered alongside the benefits and costs of alternative interventions for coronary heart disease.

Recurrent spontaneous massive hemothorax from intrathoracic extramedullary hematopoiesis resulting in respiratory failure.

PubMed

Chu, Kuo-An; Hsu, Chien-Wei; Lin, Min-Hsi; Lin, Shyh-Jer; Huang, Yi-Luan

2015-03-01

Extramedullary hematopoiesis (EMH) is a compensatory response to many chronic anemic disorders. Intrathoracic EMH, usually presenting as paravertebral masses over the posterior mediastinum, is a rare entity and is usually asymptomatic. Hemothorax is a rare but possibly fatal complication. Local radiation for intrathoracic EMH is considered effective in preventing its recurrence. Here we describe a patient who had had α-thalassemia for many years and developed a spontaneous left-sided hemothorax from EMH. A chest film and a chest computed tomography (CT) scan had showed multiple paravertebral masses over the lower thoracic spine with left-sided pleural effusion. A pathological diagnosis of EMH was made by video-assisted thoracoscopic surgery. The patient had not received preventive local chest radiation. Ten years later, he suffered from a life-threatening hemothorax complicated by acute respiratory failure without traumatic history. A CT scan showed posterior mediastinal masses over the lower thoracic spine with right-sided pleural effusion. Thoracoscopy was performed to remove the blood clot in the pleural space for successful weaning from mechanical ventilation. This is the first case of intrathoracic EMH to have recurrent hemothorax associated with acute respiratory failure. Copyright © 2012. Published by Elsevier B.V.

The effect of the 1997 Texas motorcycle helmet law on motorcycle crash fatalities.

PubMed

Bavon, Al; Standerfer, Christina

2010-01-01

This study seeks to determine the effect of the Texas motorcycle helmet law on fatalities since the repeal of the universal helmet law in 1997. Texas monthly motorcycle accident data between 1994 and 2004 were obtained from the National Highway Transportation Safety Administration's Fatality Analysis Reporting System (FARS) and supplemented with motorcycle registration data from the Texas Department of Transportation. An ARIMA model was used to estimate the impact of the law. A sharp increase in fatality rates occurred immediately following the implementation of the law in September 1997. Deaths increased by 30%, fatality rates per motorcycle registrations increased by 15.2%, and fatality rates per vehicle miles traveled increased by 25% after repeal. Helmet use decreased from 77% in 1996 to 63% in 1997 and 36% in 1998 and thereafter. The parameter estimates of the ARIMA model (0,0,0) (0,1,1) show that the change in the law led to statistically significant increases of 2.3 fatalities and 1.18 fatality rate per 100 billion vehicle miles traveled. The repeal of the universal helmet law in Texas in 1997 has had a significant adverse effect on motorcyclist fatalities in Texas.

It is our destiny to die: the effects of mortality salience and culture-priming on fatalism and karma belief.

PubMed

Yen, Chih-Long

2013-01-01

The current study explores whether Asians use culture-specific belief systems to defend against their death anxiety. The effects of mortality salience (MS) and cultural priming on Taiwanese beliefs in fatalism and karma were investigated. Study 1 showed that people believe in fatalism and karma more following MS compared with the control condition. Study 2 found that the effect of MS on fatalism belief was stronger when Taiwanese were exposed to an Eastern cultural context than to a Western cultural context. However, a matched sample of Western participants did not show increased fatalism belief after either a West- or East-prime task. The present research provides evidence that Asians may use some culture-specific beliefs, particularly fatalism belief, to cope with their death awareness.

Obesity is associated with fatal coronary heart disease independently of traditional risk factors and deprivation.

PubMed

Logue, Jennifer; Murray, Heather M; Welsh, Paul; Shepherd, James; Packard, Chris; Macfarlane, Peter; Cobbe, Stuart; Ford, Ian; Sattar, Naveed

2011-04-01

The effect of body mass index (BMI) on coronary heart disease (CHD) risk is attenuated when mediators of this risk (such as diabetes, hypertension and hyperlipidaemia) are accounted for. However, there is now evidence of a differential effect of risk factors on fatal and non-fatal CHD events, with markers of inflammation more strongly associated with fatal than non-fatal events. To describe the association with BMI separately for both fatal and non-fatal CHD risk after accounting for classical risk factors and to assess any independent effects of obesity on CHD risk. In the West of Scotland Coronary Prevention Study BMI in 6082 men (mean age 55 years) with hypercholesterolaemia, but no history of diabetes or CVD, was related to the risk of fatal and non-fatal CHD events. After excluding participants with any event in the first 2 years, 1027 non-fatal and 214 fatal CHD events occurred during 14.7 years of follow-up. A minimally adjusted model (age, sex, statin treatment) and a maximally adjusted model (including known CVD risk factors and deprivation) were compared, with BMI 25-27.4 kg/m² as referent. The risk of non-fatal events was similar across all BMI categories in both models. The risk of fatal CHD events was increased in men with BMI 30.0-39.9 kg/m² in both the minimally adjusted model (HR = 1.75 (95% CI 1.12 to 2.74)) and the maximally adjusted model (HR = 1.60 (95% CI 1.02 to 2.53)). These hypothesis generating data suggest that obesity is associated with fatal, but not non-fatal, CHD after accounting for known cardiovascular risk factors and deprivation. Clinical trial registration WOSCOPS was carried out and completed before the requirement for clinical trial registration.

The effectiveness of automatic belts in reducing fatality rates in Toyota Cressidas.

PubMed

Nash, C E

1989-12-01

Toyota Cressidas have had motor driven automatic belts since 1981. Their observed use rates have been consistently close to 100%. This paper compares fatality rates in Toyota Cressidas with those in the similar Nissan Maximas (which are equipped with three-point manual belts) using the latest data from the Fatal Accident Reporting System. After making adjustments for differences in the average ages of front seat occupants of the two fleets, the Toyotas have a fatality rate that is about three-quarters that of the Nissans. From this, the fatality-reducing effectiveness for the Toyota automatic belts is estimated to be 40% with an uncertainty of +/- 8%. This effectiveness estimate is consistent with earlier estimates of automatic belt effectiveness.

Successfully Treated Calcific Uremic Arteriolopathy: Two Cases of a High Anion Gap Metabolic Acidosis with Intravenous Sodium Thiosulfate

PubMed Central

Rein, Joshua L.; Miyata, Kana N.; Dadzie, Kobena A.; Gruber, Steven J.; Sulica, Roxana; Winchester, James F.

2014-01-01

Calcific uremic arteriolopathy (CUA) is a rare and potentially fatal disorder of calcification involving subcutaneous small vessels and fat in patients with renal insufficiency. We describe the successful use of intravenous sodium thiosulfate (STS) for the treatment of CUA in two patients. The first case was complicated by the development of a severe anion gap metabolic acidosis, which was accompanied by a seizure. Both patients had complete wound healing within five months. Although STS should be considered in the treatment of CUA, little is known about pharmacokinetics and additional studies are required to determine dosing strategies to minimize severe potential side effects. PMID:25506005

[Allergology and clinical immunology].

PubMed

Coattrenec, Yann; Harr, Thomas; Chizzolini, Carlo; Jandus, Peter

2018-01-10

Hereditary angioedema (HA) is a disabling and potentially fatal condition. The management of HA includes treatment of acute attacks, short-term prophylaxis to prevent an attack, and long-term prophylaxis to minimize the frequency and severity of recurrent attacks. In this article, we will present new therapeutic alternatives for long term prophylaxis. Glucocorticoids (GC) usage leads to a number of severe side-effects. In giant cell arteritis, the use of tocilizumab in conjunction with low doses of GC reduces the number of relapses. In ANCA-associated vasculitis the use of an anti-C5R (avacopan) alone or in conjunction with low doses of GC results in similar remission rates to those induced by high dose GC.

Treatment of sinusoidal obstruction syndrome with defibrotide: a single-center experience.

PubMed

Sucak, G T; Aki, Z S; Yagcí, M; Yegin, Z A; Ozkurt, Z N; Haznedar, R

2007-06-01

Sinusoidal obstruction syndrome (SOS) is a frequent, troubling, and potentially fatal complication of hematopoietic stem cell transplantation. Despite promising results with defibrotide (DF), no treatment has been established as standard. DF is a single-stranded polydeoxyribonucleotide, obtained from controlled depolymerization of porcine intestinal mucosal cells. It has antithrombotic, antiischemic, antiinflammatory, and thrombolytic properties without significant side effects. We retrospectively evaluated the charts of 80 consecutive patients, with 89 hematopoietic stem cell transplants for hematologic malignancies. The results of early initiation of DF treatment in 14 patients with SOS are presented in this study. Fourteen patients, 8 males and 6 females % median age 40.5 years (range, 16-46 years) were diagnosed to have SOS. Disease severity was classified as severe in 6 (42.85%), moderate in 4 (28.57%), and mild in 4 (28.57%) patients. We treated 14 patients with DF for a median of 21.5 days (range, 4-39 days). All 14 patients received DF after the diagnosis of SOS. Three patients with severe and all of the patients with mild to moderate SOS responded to treatment with complete resolution of SOS-related signs and symptoms. All patients responding to DF were alive at 100 days posttransplantation. There was no significant drug-related side effect among patients treated with DF. With an overall response rate of 78.56% and a 50% complete response rate in severe SOS cases and minimal side effects, we suggest that DF is the best available agent to treat SOS.

Interventions for preventing injuries in the construction industry.

PubMed

van der Molen, H F; Lehtola, M M; Lappalainen, J; Hoonakker, P L T; Hsiao, H; Haslam, R; Hale, A R; Verbeek, J

2007-10-17

Construction workers are frequently exposed to various types of injury-inducing hazards. A number of injury prevention interventions have been proposed, yet the effectiveness of these is uncertain. To assess the effects of interventions for preventing injuries among workers at construction sites. We searched the Cochrane Injuries Group's specialised register, CENTRAL, MEDLINE, EMBASE, PsycINFO, OSH-ROM (including NIOSHTIC and HSELINE), EI Compendex. The reference lists of relevant papers, reviews and websites were also searched. The searches were not restricted by language or publication status. All databases were searched up to June 2006. Randomized controlled trials, controlled before-after studies and interrupted time series of all types of interventions for preventing fatal and non-fatal injuries among workers at construction sites. Two authors independently extracted data and assessed study quality. For interrupted time series, we reanalysed the studies and used an initial effect, measured as the change in injury-rate in the year after the intervention, as well as a sustained effect, measured as the change in time trend before and after the intervention. Five interrupted time series studies met the inclusion criteria. Three studies evaluated the effect of regulations, one evaluated a safety campaign, and one a drug-free workplace program on fatal or non-fatal injuries compared to no drug-free workplace program. The overall methodological quality was low. The regulatory interventions did not show either an initial or sustained effect on fatal or non-fatal injuries, with effect sizes of 0.69 (95% confidence interval (CI) -1.70 to 3.09) and 0.28 (95% CI 0.05 to 0.51). The safety campaign did have an initial and sustained effect, reducing non-fatal injuries with effect sizes of -1.82 (95% CI -2.90 to -0.75) and -1.30 (95% CI -1.79 to -0.80) respectively. The drug-free workplace program did have an initial and sustained effect, reducing non-fatal injuries compared to no intervention, with effect sizes of -6.74 (95% CI -10.02 to -3.54) and -1.76 (95% CI -3.11 to -0.41) respectively. The vast majority of technical, human factors and organisational interventions which are recommended by standard texts of safety, consultants and safety courses, have not been adequately evaluated. There is no evidence that regulations for reducing fatal and non-fatal injuries are effective. There is limited evidence that a multifaceted safety campaign and a multifaceted drug program can reduce non-fatal injuries in the construction industry.

Fatal accident circumstances and epidemiology (FACE) report: confined-space incident kills two workers - company employee and rescuing fireman

DOE Office of Scientific and Technical Information (OSTI.GOV)

Not Available

1985-01-06

A fatal accident circumstance and epidemiology report on an incident occurring in a confined space and involving two fatalities is presented. Two employees of a petroleum company were determining whether an empty 10,000-gallon toluene tank needed cleaning. Due to limited visibility, one worker decided to enter the tank. As he descended through a 16 inch opening in the top of the tank, he apparently fell into the tank. The other worker called the city fire department. The responding unit decided to use a K 12 saw to cut an opening in the side of the tank. Although water sprays weremore » used to minimize spark generation, an explosion occurred and a fireman was killed by the concussion. Preliminary medical information indicates that the worker inside the tank was dead prior to the explosion. Recommendations include city fire departments establishing a registry of confined spaces and toxic or explosive substances in the area in which they serve and conducting research to determine the best methods to gain entry into enclosed spaces containing inflammable or explosive atmospheres.« less

Fatal lawn mower related projectile injury.

PubMed

Colville-Ebeling, Bonnie; Lynnerup, Niels; Banner, Jytte

2014-06-01

Fatal lawn mower related injuries are a relatively rare occurrence. In a forensic setting, the primary aim is to reconstruct the injury mechanism and establish the cause of death. A relatively rare, but characteristic type of injury is a so-called projectile or missile injury. This occurs when the operator or a bystander is impacted by an object mobilized from the grass by the rotating mower blades. This type of injury often leaves only modest external trauma, which increases the risk of overlooking an entry wound. In this paper we present a case of a fatal lawn mower related projectile injury which was initially overlooked, later interpreted as a possible gunshot homicide, and finally identified as a lawn mower related projectile injury when autopsy revealed a piece of metal thread in the main bronchus to the right middle lobe, hemopericardium, and right-sided hemothorax. To our knowledge, this injury mechanism has not previously been reported as a cause of death. This case illustrates the importance of postmortem radiological imaging and interdisciplinary cooperation when establishing manner and cause of death in unusual cases.

Psyclones: a roller coaster of life? Hidden synthetic cannabinoids and stimulants in apparently harmless products.

PubMed

Santacroce, Rita; Corazza, Ornella; Martinotti, Giovanni; Bersani, Francesco Saverio; Valeriani, Giuseppe; Di Giannantonio, Massimo

2015-07-01

The urge to gain information on a new drug marketed online as 'Psyclone' has emerged after the death of a 38-year-old man in Bolton (UK). The fatality appeared to be a consequence of smoking this psychoactive product. From October to December 2013, qualitative searches of the Web have been carried out in English and Italian, using the keywords 'Psyclone', 'Psyclone legal high', 'Psyclone incense' and 'Psyclone research chemical' on the Google search engine and on the database provided by the Global Public Health Intelligence Network. Our research highlighted the existence of two psychoactive products labelled as Psyclone but with different contents and packaging: a herbal blend containing two synthetic cannabinoids (AKB-48 and 5f-PB-22) and a research chemical containing 50% ethylphenidate, 30% caffeine and 20% lidocaine. Desired and side effects of both compounds are explored in the paper. Being sold as a legal product, Psyclone may appeal to recreational users, who remain unaware of its real content. This is a serious public health threat, which may lead to acute intoxications and fatalities. Further studies in the field, including Internet monitoring, are therefore required. Copyright © 2015 John Wiley & Sons, Ltd.

Field results from Whisper® stethoscope studies.

PubMed

Noffsinger, Tom; Brattain, Kurt; Quakenbush, Greg; Taylor, Garrett

2014-12-01

One area where the feedlot industry has been historically weak is the area of BRD "case definition" or diagnosis. Numerous studies demonstrate a weak correlation between lung lesions at harvest and treatment history. This poor track record is due in part to lack of specific chute side diagnostic tools. To analyze the effectiveness of current diagnostic tools (temperature, manual lung scores, and Whisper® lung scores), two data sets were collected. The first evaluated the correlation between rectal temperature, manual lung scores, and case fatality rate in feedlot cattle pulled for BRD. The second evaluated the relative accuracy of Whisper® scores and rectal temperature. Fever was defined as a rectal temperature of 104.5° F or greater. Manual lung scores better correlated with case fatality rate than fever. When fever and Whisper® scores were compared, a Whisper® score of 1 or less better predicted survival than a temperature of less than 104.5° F. The combination of no fever and Whisper® score of 1 or less best predicted survival. The determination of Whisper® score along with rectal temperature in cattle identified with signs of acute BRD can improve case definition, improve risk assessment, and allow more targeted use of antibiotics.

The ten-year single-center experience with 6-mercaptopurine in the treatment of inflammatory bowel disease.

PubMed

Glazier, Kenneth D; Palance, Adam L; Griffel, Louis H; Das, Kiron M

2005-01-01

To report the 10-year experience of a single center in treating patients with refractory inflammatory bowel disease (IBD) with relatively lower dose of 6-mercaptopurine (6-MP). The charts of 285 patients with IBD (Crohn's disease 160 and ulcerative colitis 125) receiving 6-MP were reviewed. Clinical response, subsequent breakthrough while taking 6-MP, and relapse rates when 6-MP was discontinued and side effects were assessed. Ninety-three percent of the patients were taking 50 to 75 mg/day of 6-MP. Complete remission was achieved in 62%, partial remission in 14.5%, and failure to achieve remission in 23.5% of the patients. Of complete responders, 27.5% had breakthrough while continuing 6-MP. Nine percent of those that achieved a complete remission experienced a relapse after 6-MP was discontinued. Side effects included leukopenia (11.2%), abnormal liver function tests (3.8%), various infections, including pneumonia (3.1%), pancreatitis (2.5%), nausea (2.1%), headache (2.8%), fever (1.4%), hair loss (1%), and rash (0.7%). Two cancers occurred while taking 6-MP: melanoma on the finger and a fatal colonic lymphoma. Four patients continued 6-MP throughout pregnancies and had normal outcomes. In our experience 6-MP is relatively safe and appears to be as effective at a lower dosage (0.84 mg/kg per day) compared with the recommended higher dosage (1-1.5 mg/kg per day), when leukopenia was more frequent. Serious side effects, although rare, need to be monitored.

Effects of the Occupational Safety and Health Administration's control of hazardous energy (lockout/tagout) standard on rates of machinery-related fatal occupational injury.

PubMed

Bulzacchelli, Maria T; Vernick, Jon S; Webster, Daniel W; Lees, Peter S J

2007-10-01

To evaluate the impact of the United States' federal Occupational Safety and Health Administration's control of hazardous energy (lockout/tagout) standard on rates of machinery-related fatal occupational injury. The standard, which took effect in 1990, requires employers in certain industries to establish an energy control program and sets minimum criteria for energy control procedures, training, inspections, and hardware. An interrupted time-series design was used to determine the standard's effect on fatality rates. Machinery-related fatalities, obtained from the National Traumatic Occupational Fatalities surveillance system for 1980 through 2001, were used as a proxy for lockout/tagout-related fatalities. Linear regression was used to control for changes in demographic and economic factors. The average annual crude rate of machinery-related fatalities in manufacturing changed little from 1980 to 1989, but declined by 4.59% per year from 1990 to 2001. However, when controlling for demographic and economic factors, the regression model estimate of the standard's effect is a small, non-significant increase of 0.05 deaths per 100 000 production worker full-time equivalents (95% CI -0.14 to 0.25). When fatality rates in comparison groups that should not have been affected by the standard are incorporated into the analysis, there is still no significant change in the rate of machinery-related fatalities in manufacturing. There is no evidence that the lockout/tagout standard decreased fatality rates relative to other trends in occupational safety over the study period. A possible explanation is voluntary use of lockout/tagout by some employers before introduction of the standard and low compliance by other employers after.

Effects of the Occupational Safety and Health Administration's control of hazardous energy (lockout/tagout) standard on rates of machinery‐related fatal occupational injury

PubMed Central

Bulzacchelli, Maria T; Vernick, Jon S; Webster, Daniel W; Lees, Peter S J

2007-01-01

Objective To evaluate the impact of the United States' federal Occupational Safety and Health Administration's control of hazardous energy (lockout/tagout) standard on rates of machinery‐related fatal occupational injury. The standard, which took effect in 1990, requires employers in certain industries to establish an energy control program and sets minimum criteria for energy control procedures, training, inspections, and hardware. Design An interrupted time‐series design was used to determine the standard's effect on fatality rates. Machinery‐related fatalities, obtained from the National Traumatic Occupational Fatalities surveillance system for 1980 through 2001, were used as a proxy for lockout/tagout‐related fatalities. Linear regression was used to control for changes in demographic and economic factors. Results The average annual crude rate of machinery‐related fatalities in manufacturing changed little from 1980 to 1989, but declined by 4.59% per year from 1990 to 2001. However, when controlling for demographic and economic factors, the regression model estimate of the standard's effect is a small, non‐significant increase of 0.05 deaths per 100 000 production worker full‐time equivalents (95% CI −0.14 to 0.25). When fatality rates in comparison groups that should not have been affected by the standard are incorporated into the analysis, there is still no significant change in the rate of machinery‐related fatalities in manufacturing. Conclusions There is no evidence that the lockout/tagout standard decreased fatality rates relative to other trends in occupational safety over the study period. A possible explanation is voluntary use of lockout/tagout by some employers before introduction of the standard and low compliance by other employers after. PMID:17916891

Mast cells and IgE in defense against venoms: Possible "good side" of allergy?

PubMed

Galli, Stephen J; Starkl, Philipp; Marichal, Thomas; Tsai, Mindy

2016-01-01

Physicians think of mast cells and IgE primarily in the context of allergic disorders, including fatal anaphylaxis. This 'bad side' of mast cells and IgE is so well accepted that it can be difficult to think of them in other contexts, particularly those in which they may have beneficial functions. However, there is evidence that mast cells and IgE, as well as basophils (circulating granulocytes whose functions partially overlap with those of mast cells), can contribute to host defense as components of adaptive type 2 immune responses to helminths, ticks and certain other parasites. Accordingly, allergies often are conceptualized as "misdirected" type 2 immune responses, in which IgE antibodies are produced against any of a diverse group of apparently harmless antigens, as well as against components of animal venoms. Indeed, certain unfortunate patients who have become sensitized to venoms develop severe IgE-associated allergic reactions, including fatal anaphylaxis, upon subsequent venom exposure. In this review, we will describe evidence that mast cells can enhance innate resistance to reptile or arthropod venoms during a first exposure to such venoms. We also will discuss findings indicating that, in mice which survive an initial encounter with venom, acquired type 2 immune responses, IgE antibodies, the high affinity IgE receptor (FcɛRI), and mast cells can contribute to acquired resistance to the lethal effects of both honeybee venom and Russell's viper venom. These findings support the hypothesis that mast cells and IgE can help protect the host against venoms and perhaps other noxious substances. Copyright © 2015 The Authors. Production and hosting by Elsevier B.V. All rights reserved.

The Field Relevance of NHTSA's Oblique Research Moving Deformable Barrier Tests.

PubMed

Prasad, Priya; Dalmotas, Dainius; German, Alan

2014-11-01

A small overlap frontal crash test has been recently introduced by the Insurance Institute for Highway Safety in its frontal rating scheme. Another small overlap frontal crash test is under development by the National Highway Traffic Safety Administration (NHTSA). Whereas the IIHS test is conducted against a fixed rigid barrier, the NHTSA test is conducted with a moving deformable barrier that overlaps 35% of the vehicle being tested and the angle between the longitudinal axis of the barrier and the longitudinal axis of the test vehicle is 15 degrees. The field relevance of the IIHS test has been the subject of a paper by Prasad et al. (2014). The current study is aimed at examining the field relevance of the NHTSA test. The field relevance is indicated by the frequency of occurrence of real world crashes that are simulated by the test conditions, the proportion of serious-to-fatal real world injuries explained by the test condition, and rates of serious injury to the head, chest and other body regions in the real world crashes resembling the test condition. The database examined for real world crashes is NASS. Results of the study indicate that 1.4% of all frontal 11-to-1 o'clock crashes are simulated by the test conditions that account for 2.4% to 4.5% of all frontal serious-to-fatal (MAIS3+F) injuries. Injury rates of the head and the chest are substantially lower in far-side than in near-side frontal impacts. Crash test ATD rotational responses of the head in the tests overpredict the real world risk of serious-to-fatal brain injuries.

Fatal hypersensitivity reaction to an oral spray of flurbiprofen: a case report.

PubMed

Calapai, G; Imbesi, S; Cafeo, V; Ventura Spagnolo, E; Minciullo, P L; Caputi, A P; Gangemi, S; Milone, L

2013-08-01

Safety of the anti-inflammatory drug flurbiprofen is comparable with that of other non-steroidal anti-inflammatory drugs of the propionic acid class, which are commonly associated with gastrointestinal and renal side effects. Here we report a case of a fatal hypersensitivity reaction to an oral spray of flurbiprofen taken for sore throat. A 29-year-old man came to the emergency care unit reporting sore throat with an intense burning sensation associated with fever. Pharyngotonsillitis was diagnosed, and local treatment with oral flurbiprofen spray was prescribed. Immediately after using the spray, the patient experienced a severe reaction characterized by serious dyspnoea, followed by death. The cause of death was heart failure with acute asphyxia from oedema of the glottis. The cause of death was concluded to be hypersensitivity to flurbiprofen spray. Oral propionic acid derivatives have been associated with a relatively high frequency of allergic reactions. However, allergy to flurbiprofen has rarely been documented. Scientific literature reports two relevant cases of hypersensitivity reaction to flurbiprofen: in one case, a patient presented with a maculopapular rash 48 h after having taken oral flurbiprofen followed by angio-oedema and hypotension. In another case, a single oral dose of flurbiprofen caused itching and swelling around the eyes, redness and increased lacrimation. We describe, for the first time, a fatal case of hypersensitivity reaction to flurbiprofen oral spray. Hypersensitivity reactions to flurbiprofen are infrequent; however, health professionals should be aware of potential adverse reactions, even during topical administration as oral spray. © 2013 John Wiley & Sons Ltd.

Are airbags a dangerous safety measure? A meta-analysis of the effects of frontal airbags on driver fatalities.

PubMed

Høye, Alena

2010-11-01

A meta-analysis has been conducted of the effectiveness of frontal airbags in reducing driver fatalities, and some potential moderator variables for airbag effectiveness have been investigated. The results confirm the assumption that airbags reduce accident fatalities among belted drivers, but the results are too heterogeneous for drawing conclusions about the size of the overall effect. No support has been found for the hypothesis that airbags increase overall fatality risk, as has been found in the study by Meyer and Finney (Meyer, M., Finney, T., 2005. Who wants Airbags? Chance, 18 (19) 3-16). The results do not seem to be affected by publication bias, and no indications of confounding effects of vehicle characteristics or impact velocity have been found. In frontal collisions belted driver fatalities were found to be reduced by about 22% when all types of airbags are regarded together. The revision of the test criteria for airbags in the USA in 1997 has improved airbag effectiveness. For unbelted drivers airbags are neither effective nor counterproductive, but may increase fatality risk in single vehicle accidents. The results show that there is a lack of knowledge about the effects of airbags in accidents that are not frontal collisions. 2010 Elsevier Ltd. All rights reserved.

Results of end-to-end cavocavostomy during adult liver transplantation.

PubMed

Glanemann, Matthias; Settmacher, Utz; Langrehr, Jan M; Stange, Barbara; Haase, Roland; Nuessler, Natascha C; Lopez-Hänninen, Enrique; Podrabsky, Petr; Bechstein, Wolf-Otto; Neuhaus, Peter

2002-03-01

The results of end-to-end cavocavostomy during adult liver transplantation were analyzed with special regard to caval complications. In a series of 1000 liver transplants, we observed 17 patients who suffered from postoperative caval obstruction (6 patients) or caval stenosis (11 patients), for an incidence of 1.7%. Surgical therapy was performed in 10 patients (58.8%), and 5 patients required retransplantation (29.4%). Four patients died during the later postoperative course. Two fatalities were related to caval complications, resulting in a mortality rate of 11.8%. Our results indicate that end-to-end cavocavostomy is a safe technique for cavocaval anastomosis. For only a few exceptions, such as pediatric transplantation, reduced size livers, or size mismatch between donor and recipient, should alternative techniques such as end-to-side or side-to-side cavocavostomy be performed.

[Cavernous sinus thrombosis as a rare cause of exophthalmos in childhood : A case report].

PubMed

Kamawal, A; Schmidt, M A; Rompel, O; Gusek-Schneider, G C; Mardin, C Y; Trollmann, R

2017-05-01

Complications of acute bacterial sinusitis mostly occur in children and adolescents. In particular, intracranial spread of the infection can lead to severe even fatal courses of the disease. This article is a case report about a 13-year-old boy suffering from left-sided headache, meningismus and exophthalmos as presenting symptoms. Cranial magnetic resonance imaging (MRI) showed merely right-sided sphenoid sinusitis; however, the diffusion-weighted MRI sequence indicated a left-sided cavernous sinus thrombosis, which could be confirmed by computed tomography (CT) angiography. Cerebrospinal fluid diagnostics showed significant leukocytosis confirming secondary meningitis. Finally, exophthalmos was explained by parainfectious cavernous sinus thrombosis and periorbital edema. This case report highlights the importance of extended and specific diagnostic imaging in cases of clinically suspected complications in children and adolescents with sinusitis and the diagnostic significance of diffusion-weighted MRI.

Surveillance of traumatic firefighter fatalities: an assessment of four systems.

PubMed

Estes, Chris R; Marsh, Suzanne M; Castillo, Dawn N

2011-01-01

Firefighters regularly respond to hazardous situations that put them at risk for fatal occupational injuries. Traumatic occupational fatality surveillance is a foundation for understanding the problem and developing prevention strategies. We assessed four surveillance systems for their utility in characterizing firefighter fatalities and informing prevention measures. We examined three population-based systems (the Bureau of Labor Statistics' Census of Fatal Occupational Injuries and systems maintained by the United States Fire Administration and the National Fire Protection Association) and one case-based system (data collected through the National Institute for Occupational Safety and Health Fire Fighter Fatality Investigation and Prevention Program). From each system, we selected traumatic fatalities among firefighters for 2003-2006. Then we compared case definitions, methods for case ascertainment, variables collected, and rate calculation methods. Overall magnitude of fatalities differed among systems. The population-based systems were effective in characterizing the circumstances of traumatic firefighter fatalities. The case-based surveillance system was effective in formulating detailed prevention recommendations, which could not be made based on the population-based data alone. Methods for estimating risk were disparate and limited fatality rate comparisons between firefighters and other workers. The systems included in this study contribute toward a greater understanding of firefighter fatalities. Areas of improvement for these systems should continue to be identified as they are used to direct research and prevention efforts.

Electrical deaths in the US construction: an analysis of fatality investigations.

PubMed

Zhao, Dong; Thabet, Walid; McCoy, Andrew; Kleiner, Brian

2014-01-01

Electrocution is among the 'fatal four' in US construction according to the Occupational Safety and Health Administration. Learning from failures is believed to be an effective path to success, with deaths being the most serious system failures. This paper examined the failures in electrical safety by analysing all electrical fatality investigations (N = 132) occurring between 1989 and 2010 from the Fatality Assessment and Control Evaluation programme that is completed by the National Institute of Occupational Safety and Health. Results reveal the features of the electrical fatalities in construction and disclose the most common electrical safety challenges on construction sites. This research also suggests the sociotechnical system breakdowns and the less effectiveness of current safety training programmes may significantly contribute to worker's unsafe behaviours and electrical fatality occurrences.

Anticipating Early Fatality: Friends', Schoolmates' and Individual Perceptions of Fatality on Adolescent Risk Behaviors

PubMed Central

Soller, Brian; Williams, Kristi

2015-01-01

Past research indicates that anticipating adverse outcomes, such as early death (fatalism), is associated positively with adolescents' likelihood of engaging in risky behaviors. Health researchers and criminologists have argued that fatalism influences present risk taking in part by informing individuals' motivation for delaying gratification for the promise of future benefits. While past findings highlight the association between the anticipation of early death and a number of developmental outcomes, no known research has assessed the impact of location in a context characterized by high perceptions of fatality. Using data from Add Health and a sample of 9,584 adolescents (51 % female and 71 % white) nested in 113 schools, our study builds upon prior research by examining the association between friends', school mates', and individual perceptions of early fatality and adolescent risk behaviors. We test whether friends' anticipation of being killed prior to age 21 or location in a school where a high proportion of the student body subscribes to attitudes of high fatality, is associated with risky behaviors. Results indicate that friends' fatalism is positively associated with engaging in violent delinquency, non-violent delinquency, and drug use after controlling for individual covariates and prior individual risk-taking. Although friends' delinquency accounts for much of the effect of friends' fatalism on violence, none of the potential intervening variables fully explain the effect of friends' fatalism on youth involvement in nonviolent delinquency and drug use. Our results underscore the importance of friendship contextual effects in shaping adolescent risk-taking behavior and the very serious consequences perceptions of fatality have for adolescents' involvement in delinquency and drug use. PMID:23828725

Ignition Interlock Laws: Effects on Fatal Motor Vehicle Crashes, 1982-2013.

PubMed

McGinty, Emma E; Tung, Gregory; Shulman-Laniel, Juliana; Hardy, Rose; Rutkow, Lainie; Frattaroli, Shannon; Vernick, Jon S

2017-04-01

Alcohol-involved motor vehicle crashes are a major cause of preventable mortality in the U.S., leading to more than 10,000 fatalities in 2013. Ignition interlocks, or alcohol-sensing devices connected to a vehicle's ignition to prevent it from starting if a driver has a predetermined blood alcohol content (BAC) level, are a promising avenue for preventing alcohol-involved driving. This study sought to assess the effects of laws requiring ignition interlocks for some or all drunk driving offenders on alcohol-involved fatal crashes. A multilevel modeling approach assessed the effects of state interlock laws on alcohol-involved fatal crashes in the U.S. from 1982 to 2013. Monthly data on alcohol-involved crashes in each of the 50 states was collected in 2014 from the National Highway Traffic Safety Administration Fatality Analysis Reporting System. Random-intercept models accounted for between-state variation in alcohol-involved fatal crash rates and autocorrelation of within-state crash rates over time. Analysis was conducted in 2015. State laws requiring interlocks for all drunk driving offenders were associated with a 7% decrease in the rate of BAC >0.08 fatal crashes and an 8% decrease in the rate of BAC ≥0.15 fatal crashes, translating into an estimated 1,250 prevented BAC >0.08 fatal crashes. Laws requiring interlocks for segments of high-risk drunk driving offenders, such as repeat offenders, may reduce alcohol-involved fatal crashes after 2 years of implementation. Ignition interlock laws reduce alcohol-involved fatal crashes. Increasing the spread of interlock laws that are mandatory for all offenders would have significant public health benefit. Copyright © 2016 American Journal of Preventive Medicine. All rights reserved.

Rebound effect of modern drugs: serious adverse event unknown by health professionals.

PubMed

Teixeira, Marcus Zulian

2013-01-01

Supported in the Hippocratic aphorism primum non nocere, the bioethical principle of non-maleficence pray that the medical act cause the least damage or injury to the health of the patient, leaving it to the doctor to assess the risks of a particular therapy through knowledge of possible adverse events of drugs. Among these, the rebound effect represents a common side effect to numerous classes of modern drugs, may cause serious and fatal disorders in patients. This review aims to clarify the health professionals on clinical and epidemiological aspects of rebound phenomenon. A qualitative, exploratory and bibliographic review was held in the PubMed database using the keywords 'rebound', 'withdrawal', 'paradoxical', 'acetylsalicylic acid', 'anti-inflammatory', 'bronchodilator', 'antidepressant', 'statin', 'proton pump inhibitor' and 'bisphosphonate'. The rebound effect occurs after discontinuation of numerous classes of drugs that act contrary to the disease disorders, exacerbating them at levels above those prior to treatment. Regardless of the disease, the drug and duration of treatment, the phenomenon manifests itself in a small proportion of susceptible individuals. However, it may cause serious and fatal adverse events should be considered a public health problem in view of the enormous consumption of drugs by population. Bringing together a growing and unquestionable body of evidence, the physician needs to have knowledge of the consequences of the rebound effect and how to minimize it, increasing safety in the management of modern drugs. On the other hand, this rebound can be used in a curative way, broadening the spectrum of the modern therapeutics. Copyright © 2012 Elsevier Editora Ltda. All rights reserved.

Intravenous apoptotic cell infusion as a cell-based therapy toward improving hematopoietic cell transplantation outcome.

PubMed

Saas, Philippe; Gaugler, Béatrice; Perruche, Sylvain

2010-10-01

Allogeneic hematopoietic cell transplantation (AHCT) is an efficient therapy for different malignant and nonmalignant hematological diseases. However, the use of this therapeutic approach is still limited by some severe toxic side effects, mainly graft-versus-host disease (GvHD). Today, the risk of fatal GvHD restrains the wider application of AHCT to many patients in need of an effective therapy for their high-risk hematologic malignancies. Thus, new strategies, including cell-based therapy approaches, are required. We propose to use intravenous donor apoptotic leukocyte infusion to improve AHCT outcome. In experimental AHCT models, we demonstrated that intravenous apoptotic leukocyte infusion, simultaneously with allogeneic bone marrow grafts, favors hematopoietic engraftment, prevents allo-immunization, and delays acute GvHD onset. Here, we review the different mechanisms and the potential beneficial effects associated with the immunomodulatory properties of apoptotic cells in the AHCT setting. © 2010 New York Academy of Sciences.

Clinical courses after administration of oral corticosteroids in patients with severely cholestatic acute hepatitis A; three cases

PubMed Central

Yoon, Eileen L.; Kim, Seung Young; Kim, Jeong Han; Lee, Ju-Han; Lee, Young Sun; Lee, Hyun Jung; Jung, Sung Woo; Lee, Sang Woo; Choi, Jai Hyun

2010-01-01

Acute hepatitis A is currently outbreaking in Korea. Although prognosis of acute hepatitis A is generally favorable, a minority of patients are accompanied by fatal complications. Severe cholestasis is one of the important causes of prolonged hospitalization in patients with acute hepatitis A. In such cases, higher chances of additional complications and increased medical costs are inevitable. We report three cases of severely cholestatic hepatitis A, who showed favorable responses to oral corticosteroids. Thirty milligram of prednisolone was initiated and tapered according to the responses. Rapid improvement was observed in all cases without side effects. We suggest that corticosteroid administration can be useful in hepatitis A patients with severe cholestasis who do not show improvement by conservative managements. Clinical trial will be needed to evaluate effectiveness of corticosteroids in these patients. PMID:20924218

Motorcycle fatalities among out-of-state riders and the role of universal helmet laws.

PubMed

French, Michael T; Gumus, Gulcin; Homer, Jenny F

2012-11-01

Several studies have demonstrated that universal helmet laws (UHLs) and other motor vehicle policies are effective in reducing fatal and non-fatal motorcycle injuries. Although state policies can improve traffic safety overall, very little is known about how they affect different segments of motorcycle riders. In this paper, we investigate the differential effectiveness of such policies by license state of the rider (i.e., in-state versus out-of-state). From a policy perspective, this information gap is noteworthy because variations in state regulations may influence where individuals choose to ride. We use state-level longitudinal (1988-2008) data on motorcycle fatalities in the United States from the fatality analysis reporting system (FARS). Our results reconfirm the effectiveness of UHLs and offer new evidence suggesting that states without such policies may attract more risky riders from out-of-state. In particular, not having a UHL increases out-of-state rider fatalities by 18 percent and this effect is more pronounced for out-of-state riders who reside in a UHL state. These findings have important implications regarding unintended spillover effects of state-specific motor vehicle policies. Copyright © 2012 Elsevier Ltd. All rights reserved.

Macroeconomic fluctuations and motorcycle fatalities in the U.S.

PubMed

French, Michael T; Gumus, Gulcin

2014-03-01

The effects of business cycles on health outcomes in general, and on traffic fatalities in particular, have received much attention recently. In this paper, we focus on motorcycle safety and examine the impact of changing levels of economic activity on fatal crashes by motorcyclists in the United States. We analyze state-level longitudinal data with 1,104 state/year observations from the 1988-2010 Fatality Analysis Reporting System (FARS). Using the extensive motorcycle crash characteristics available in FARS, we examine not only total fatality rates but also rates decomposed by crash type, day, time, and the level of the motorcycle operator's blood alcohol content. Our results are consistent with much of the existing literature showing that traffic fatality rates are pro-cyclical. The estimates suggest that a 10% increase in real income per capita is associated with a 10.4% rise in the total motorcycle fatality rate. Along with potential mechanisms, policymakers and public health officials should consider the effects of business cycles on motorcycle safety. Copyright © 2013 Elsevier Ltd. All rights reserved.

An unusual fatal construction site injury in India: a case report.

PubMed

Rautji, Ravi; Behera, C; Dogra, T D

2009-07-01

A 35-year-old male, employed at a construction site, accidentally injured himself when an iron rod, which he was handing up from the ground floor to a fellow worker standing on the first floor, fell backwards. It pierced his suprascapular fossa on the right side, damaging great vessels and the tricuspid valve, and entered the pericardial cavity after puncturing the posterior wall of the right ventricle. The iron rod was taken out by fellow workers at the site and the injured man was immediately taken to a nearby clinic where he was resuscitated and the wound was stitched. He was later transferred to a tertiary care hospital where he died about an hour after admission. Though many bizarre injuries have been reported at construction sites, a fatal injury of this nature deserves a mention in the forensic literature.

Effectiveness and efficiencies in pedestrian safety.

DOT National Transportation Integrated Search

1982-03-01

Pedestrian fatalities constitute 16 percent of total highway - related fatalities. Excluding motor vehicle occupants, pedestrians comprise the target single category of fatalities on the nation's streets and highways. A total of 85 percent of ! all p...

The effect of the learner license Graduated Driver Licensing components on teen drivers' crashes.

PubMed

Ehsani, Johnathon Pouya; Bingham, C Raymond; Shope, Jean T

2013-10-01

Most studies evaluating the effectiveness of Graduated Driver Licensing (GDL) have focused on the overall system. Studies examining individual components have rarely accounted for the confounding of multiple, simultaneously implemented components. The purpose of this paper is to quantify the effects of a required learner license duration and required hours of supervised driving on teen driver fatal crashes. States that introduced a single GDL component independent of any other during the period 1990-2009 were identified. Monthly and quarterly fatal crash rates per 100,000 population of 16- and 17-year-old drivers were analyzed using single-state time series analysis, adjusting for adult crash rates and gasoline prices. Using the parameter estimates from each state's time series model, the pooled effect of each GDL component on 16- and 17-year-old drivers' fatal crashes was estimated using a random effects meta-analytic model to combine findings across states. In three states, a six-month minimum learner license duration was associated with a significant decline in combined 16- and 17-year-old drivers' fatal crash rates. The pooled effect of the minimum learner license duration across all states in the sample was associated with a significant change in combined 16- and 17-year-old driver fatal crash rates of -.07 (95% Confidence Interval [CI] -.11, -.03). Following the introduction of 30 h of required supervised driving in one state, novice drivers' fatal crash rates increased 35%. The pooled effect across all states in the study sample of having a supervised driving hour requirement was not significantly different from zero (.04, 95% CI -.15, .22). These findings suggest that a learner license duration of at least six-months may be necessary to achieve a significant decline in teen drivers' fatal crash rates. Evidence of the effect of required hours of supervised driving on teen drivers' fatal crash rates was mixed. Copyright © 2013 Elsevier Ltd. All rights reserved.

New evidence concerning fatal crashes of passenger vehicles before and after adding antilock braking systems.

PubMed

Farmer, C M

2001-05-01

Fatal crash rates for passenger cars and vans were compared for the last model year before four-wheel antilock brakes were introduced and the first model year for which antilock brakes were standard equipment. A prior study, based on fatal crash experience through 1995, reported that vehicle models with antilock brakes were more likely than identical but 1-year-earlier models to be involved in crashes fatal to their own occupants, but were less likely to be involved in crashes fatal to occupants of other vehicles. Overall, there was no significant effect of antilocks on the likelihood of fatal crashes. Similar analyses, based on fatal crash experience during 1996-98, yielded very different results. During 1996-98, vehicles with antilock brakes were again less likely than earlier models to be involved in crashes fatal to occupants of other vehicles, but they were no longer overinvolved in crashes fatal to their own occupants.

Disease fatality and bias in survival cohorts.

PubMed

Barry, Vaughn; Klein, Mitchel; Winquist, Andrea; Darrow, Lyndsey A; Steenland, Kyle

2015-07-01

Simulate how the effect of exposure on disease occurrence and fatality influences the presence and magnitude of bias in survivor cohorts, motivated by an actual survivor cohort under study. We simulated a cohort of 50,000 subjects exposed to a disease-causing exposure over time and followed forty years, where disease incidence was the outcome of interest. We simulated this 'inception' cohort under different assumptions about the effect of exposure on disease occurrence and fatality after disease occurrence. We then created a corresponding 'survivor' (or 'cross-sectional') cohort, where cohort enrollment took place at a specific date after exposure began in the inception cohort; subjects dying prior to that enrollment date were excluded. The disease of interest caused all deaths in our simulations, but was not always fatal. In the survivor cohort, person-time at risk began before enrollment for all subjects who did not die prior to enrollment. We compared exposure-disease associations in each inception cohort to those in corresponding survivor cohorts to determine how different assumptions impacted bias in the survivor cohorts. All subjects in both inception and survivor cohorts were considered equally susceptible to the effect of exposure in causing disease. We used Cox proportional hazards regression to calculate effect measures. There was no bias in survivor cohort estimates when case fatality among diseased subjects was independent of exposure. This was true even when the disease was highly fatal and more highly exposed subjects were more likely to develop disease and die. Assuming a positive exposure-response in the inception cohort, survivor cohort rate ratios were biased downwards when case fatality was greater with higher exposure. Survivor cohort effect estimates for fatal outcomes are not always biased, although precision can decrease. Copyright © 2015 Elsevier Inc. All rights reserved.

Fatalism and health promoting behaviors in Chinese and Korean immigrants and Caucasians.

PubMed

Heiniger, Louise E; Sherman, Kerry A; Shaw, Laura-Kate E; Costa, Daniel

2015-02-01

Fatalism has been associated with non-adherence to health behavior in the past. This study compared fatalism of Chinese and Korean immigrants with native-born Caucasians (N = 309) and examined whether the relationship between fatalism and exercise, nutrition and medical screening would be moderated by ethnicity. Chinese reported higher fatalism than Caucasians and Koreans. Higher fatalism was associated with greater exercise among Chinese and Koreans, but less reported exercise among Caucasians. Caucasian participants had higher scores for nutrition and medical screening compared with Chinese and Korean immigrants. These findings indicate that fatalism is more prevalent among Chinese immigrants; however, there is no evidence of a detrimental effect of fatalism on exercise, nutrition or medical screening among the Asian immigrants. Caucasians with higher fatalism may be at greater risk of future illnesses, given the association between fatalism and sedentary behavior in this group. Differences between cultural groups in the adoption of health behavior justify the development and assessment of targeted interventions to optimize health promoting behaviors.

Evaluation of a nationally funded state-based programme to reduce fatal occupational injuries

PubMed Central

Menendez, Cammie Chaumont; Castillo, Dawn; Rosenman, Kenneth; Harrison, Robert; Hendricks, Scott

2015-01-01

Background The Fatality Assessment and Control Evaluation (FACE) programme was established by the National Institute for Occupational Safety and Health to help prevent occupational traumatic fatalities by funding states to conduct targeted fatality investigations within cause-specific focus areas and associated prevention efforts. Purpose To investigate the impact of the state-based FACE programme on two previous focus areas. Methods A longitudinal time-series analysis spanning 22 years compared state fatality rates for occupational falls and electrocutions before and after FACE programme funding with states not receiving FACE programme funding. Lag periods were utilised to allow time for the programme to have an effect, and rates were adjusted for a variety of covariates. Separate analyses were conducted for each injury outcome. Results A reduction in fall fatality rates that was of borderline significance (1-year lag adjRR=0.92 (0.84 to 1.00)) and a non-significant reduction in electrocution fatality rates (3-year lag adjRR=0.92 (0.82 to 1.03)) were observed in states with FACE programme funding, Best-fit models presented two separate lag periods. Conclusions While it is challenging to quantitatively evaluate effectiveness of programmes such as FACE, the data suggest the FACE programme may be effective in preventing occupational injury deaths within its outcome focus areas throughout the state. It is important to look for ways to measure intermediate effects more precisely, as well as ways to maintain effects over time. PMID:22864251

Reducing the legal blood alcohol concentration limit for driving in developing countries: a time for change? Results and implications derived from a time-series analysis (2001-10) conducted in Brazil.

PubMed

Andreuccetti, Gabriel; Carvalho, Heraclito B; Cherpitel, Cheryl J; Ye, Yu; Ponce, Julio C; Kahn, Tulio; Leyton, Vilma

2011-12-01

In Brazil, a new law introduced in 2008 has lowered the blood alcohol concentration limit for drivers from 0.06 to 0.02, but the effectiveness in reducing traffic accidents remains uncertain. This study evaluated the effects of this enactment on road traffic injuries and fatalities. Time-series analysis using autoregressive integrated moving average (ARIMA) modelling. State and capital of São Paulo, Brazil.   A total of 1,471,087 non-fatal and 51,561 fatal road traffic accident cases in both regions. Monthly rates of traffic injuries and fatalities per 100,000 inhabitants from January 2001 to June 2010. The new traffic law was responsible for significant reductions in traffic injury and fatality rates in both localities (P<0.05). A stronger effect was observed for traffic fatality (-7.2 and -16.0% in the average monthly rate in the State and capital, respectively) compared to traffic injury rates (-1.8 and -2.3% in the State and capital, respectively). Lowering the blood alcohol concentration limit in Brazil had a greater impact on traffic fatalities than injuries, with a higher effect in the capital, where presumably the police enforcement was enhanced. © 2011 The Authors, Addiction © 2011 Society for the Study of Addiction.

Coverage and parental perceptions of influenza vaccination among parents of children aged 6 to 23 months in Hong Kong

PubMed Central

2013-01-01

Background The impact of influenza on young children can be severe and even fatal. Influenza vaccination (IV) has been shown to be effective in reducing complications of influenza among children. This study investigated the prevalence and factors of IV among children aged 6-23 months in Hong Kong. Methods A sample of 401 Chinese parents of children aged 6-23 months were interviewed at local Maternal and Child Health Centers. Socio-demographic information, variables related to Health Belief Model, including perceptions about the child’s chance of contracting influenza, perceived harm of influenza on children, perceived benefits and side-effects of IV, having received recommendations from health professionals to uptake IV, and IV behaviors of the children were measured. Multivariate analysis was used to examine factors associated with IV behaviors of children. Results Only 9% of the children had ever been vaccinated. Among those parents who had heard of IV (92.0%), substantial proportions perceived that IV could reduce the risk of influenza-induced complications (70.5%), hospitalization (70.5%) and death (65.9%). Relatively few of the participants believed that IV had no side effects (17.1%) and even less had been recommended by health care professionals to uptake IV (10.6%). Results from multivariate analysis showed that physician recommendations were associated with a higher likelihood for IV among younger children, whilst parental perceptions of the side effects of IV was associated with a lower likelihood for IV. Conclusion The prevalence of IV among children aged 6-23 months in Hong Kong was very low. Promotion of IV with the component of physician recommendations and parents’ knowledge about IV safety for this group is warranted. PMID:24171947

Effectiveness of antilock braking systems in reducing motorcycle fatal crash rates.

PubMed

Teoh, Eric R

2011-04-01

Overbraking and underbraking have been shown to be common factors in motorcycle crashes. Antilock braking systems (ABS) prevent wheels from locking during braking and may make riders less reluctant to apply full braking force. The objective of this study was to evaluate the effect of ABS in fatal motorcycle crashes. Motorcycle drivers involved in fatal crashes per 10,000 registered vehicle years were compared for 13 motorcycle models with optional ABS and those same models without the option during 2003-2008. Motorcycles with optional ABS were included only if the presence of the option could be identified from the vehicle identification number. The rate of fatal motorcycle crashes per 10,000 registered vehicle years was 37 percent lower for ABS models than for their non-ABS versions. ABS appears to be highly effective in preventing fatal motorcycle crashes based on some early adopters of motorcycle ABS technology.

Comparison of cost of immune globulin intravenous therapy to conventional immunosuppressive therapy in treating patients with autoimmune mucocutaneous blistering diseases.

PubMed

Daoud, Yassine J; Amin, Ketan G

2006-04-01

Autoimmune mucocutaneous blistering diseases (AMBD) are a group of potentially fatal diseases that affect the skin and mucous membranes. AMBD have different target antigens as well as variable clinical presentation, course, and prognosis. The mainstay of conventional immunosuppressive therapy (CIST) for AMBD is long-term high-dose systemic corticosteroids and immunosuppressive agents. Such therapy has proven effective in many patients; however, in some patients, the disease continues to progress with significant sequelae such as blindness, loss of voice, anal, and vaginal stenosis which causes poor quality of life. Furthermore, the CIST may have some serious side effects including opportunistic infections which may cause death. Immune globulin intravenous (IGIV) therapy has been reportedly used in the management of patients with AMBD refractory to CIST. IGIV has shown to be more clinically beneficial than CIST by bringing about long-term clinical remission and less recurrence. The high cost of the IGIV is of concern to patients, physicians, and insurance companies. In this report, we compare the cost of IGIV to that of CIST in treating a cohort of 15 mucous membrane pemphigoid (MMP), 10 ocular cicatricial pemphigoid (OCP), 15 bullous pemphigoid (BP), and 32 pemphigus vulgaris (PV) patients. In each cohort of patients, CIST had significant side effects, many of which were hazardous and required prolonged and frequent hospitalizations. Some of these side effects were severe enough to require discontinuation of the treatment. We consider the total cost of CIST to be the actual cost of the drug, plus the cost of management of the side effects produced by CIST. In the same patient cohort, no significant side effects to IGIV were observed. None of the IGIV treated patients required physician visits, laboratory tests, or hospitalizations specifically related to IGIV therapy. Hence, the total cost of the IGIV therapy is the actual cost of the IGIV only. The mean total cost of treatment of IGIV therapy is statistically significantly less than that of CIST during the entire course of the disease and on an annual basis. In conclusion, IGIV therapy is a safe, clinically beneficial, and a cost effective alternative treatment in patients with AMBD, non-responsive to CIST.

Holiday effect on traffic fatalities

DOT National Transportation Integrated Search

1987-04-01

The report identifies those holidays that show an increase in traffic fatalities and estimates the size of the increase for each national holiday. A procedure is presented that can be used to forecast the expected fatality count for each upcoming hol...

Lives saved by child restraints from 1982 through 1987

DOT National Transportation Integrated Search

1988-12-01

Estimates derived from the Fatal Accident Reporting System (FARS) indicate that restraints are very effective in preventing infant (under one year old) and toddler (one through four years old) fatalities. It is estimated that fatality reductions from...

Cost effectiveness analysis of a smoke alarm giveaway program in Oklahoma City, Oklahoma.

PubMed

Haddix, A C; Mallonee, S; Waxweiler, R; Douglas, M R

2001-12-01

To estimate the cost effectiveness of the Lifesavers Residential Fire and Injury Prevention Program (LRFIPP), a smoke alarm giveaway program. In 1990, the LRFIPP distributed over 10,000 smoke alarms in an area of Oklahoma City at high risk for residential fire injuries. The program also included fire prevention education and battery replacement components. A cost effectiveness analysis was conducted from the societal and health care systems perspectives. The study compared program costs with the total costs of medical treatment and productivity losses averted over a five year period. Fatal and non-fatal residential fire related injuries prevented were estimated from surveillance data. Medical costs were obtained from chart reviews of patients with fire related injuries that occurred during the pre-intervention period. During the five years post-intervention, it is estimated that the LRFIPP prevented 20 fatal and 24 non-fatal injuries. From the societal perspective, the total discounted cost of the program was $531,000. Total discounted net savings exceeded $15 million. From the health care system perspective, the total discounted net savings were almost $1 million and would have a net saving even if program effectiveness was reduced by 64%. The program was effective in reducing fatal and non-fatal residential fire related injuries and was cost saving. Similar programs in other high risk areas would be good investments even if program effectiveness was lower than that achieved by the LRFIPP.

Do Blue Laws Save Lives? The Effect of Sunday Alcohol Sales Bans on Fatal Vehicle Accidents

ERIC Educational Resources Information Center

Lovenheim, Michael F.; Steefel, Daniel P.

2011-01-01

This paper analyzes the effect of state-level Sunday alcohol sales restrictions ("blue laws") on fatal vehicle accidents, which is an important parameter in assessing the desirability of these laws. Using a panel data set of all fatal vehicle accidents in the U.S. between 1990 and 2009 combined with 15 state repeals of blue laws, we show that…

Fatally injured pedestrians and bicyclists in the United States with high blood alcohol concentrations.

PubMed

Eichelberger, Angela H; McCartt, Anne T; Cicchino, Jessica B

2018-06-01

Little research has focused on the problem of alcohol impairment among pedestrians and bicyclists in the United States. The aim of the current study was to investigate the prevalence, trends, and characteristics of alcohol-impaired fatally injured pedestrians and bicyclists. Data from the Fatality Analysis Reporting System (FARS) were analyzed for fatally injured passenger vehicle drivers, pedestrians, and bicyclists 16 and older during 1982-2014. Logistic regression models examined whether personal, roadway, and crash characteristics were associated with high blood alcohol concentrations (BACs) among fatally injured pedestrians and bicyclists. From 1982 to 2014, the percentage of fatally injured pedestrians with high BACs (≥0.08g/dL) declined from 45% to 35%, and the percentage of fatally injured bicyclists with high BACs declined from 28% to 21%. By comparison, the percentage of fatally injured passenger vehicle drivers with high BACs declined from 51% in 1982 to 32% in 2014. The largest reductions in alcohol impairment among fatally injured pedestrians and bicyclists were found among ages 16-20. During 2010-2014, fatally injured pedestrians and bicyclists ages 40-49 had the highest odds of having a high BAC, compared with other age groups. A substantial proportion of fatally injured pedestrians and bicyclists have high BACs, and this proportion has declined less dramatically than for fatally injured passenger vehicle drivers during the past three decades. Most countermeasures used to address alcohol-impaired driving may have only limited effectiveness in reducing fatalities among alcohol-impaired pedestrians and bicyclists. Efforts should increase public awareness of the risk of walking or bicycling when impaired. Results suggest the primary target audience for educational campaigns directed at pedestrians and bicyclists is middle-age males. Further research should evaluate the effectiveness of potential countermeasures, such as lowering speeds or improving lighting in urban areas. Copyright © 2018 National Safety Council and Elsevier Ltd. All rights reserved.

[HIV infection in France in 2012: reality, risks and challenges for a chronic multisystem disease].

PubMed

Blot, M; Piroth, L

2012-06-01

Thirty years after the discovery of HIV and 15 years since the advent of Highly Active Antiretroviral Therapy (HAART), the features of HIV infection have evolved and need a new approach, which is both more comprehensive and specialized. Indeed, the burden of a chronic disease with multiple determining features has replaced the rapidly fatal infection of the past, which was almost exclusively related to the effects of immunosuppression. Physicians have to be concerned with "new risks" associated with treatment side effects; the consequences of ongoing inflammation and ageing of the HIV-infected population. These include metabolic, cardiovascular, neurocognitive and renal disease as well as lipodystrophy and malignancy. Antiretroviral treatment has been a major step forward, subject to accessibility, tolerance and adherence, but it has not solved all the problems associated with this infection, as it becomes a chronic illness. Copyright © 2012 SPLF. Published by Elsevier Masson SAS. All rights reserved.

Rare and Severe Maxillofacial Injury Due to Tear Gas Capsules: Report of Three Cases.

PubMed

Çorbacɩoğlu, Şeref Kerem; Güler, Sertaç; Er, Erhan; Seviner, Meltem; Aslan, Şahin; Aksel, Gökhan

2016-03-01

Tear gases are used by police or armed forces for control of riots or social events or by the general population for private self-defense. These agents are used widely throughout the world, but some harmful effects have reported. In addition, despite well-defined chemical side effects documented in the literature, data are insufficient regarding mechanical injury due to tear gas capsules. We report three cases of severe maxillofacial injury in patients who had these capsules fired from tear gas guns directly to their faces. The capsules penetrated the patients' faces, causing potentially fatal injuries. To our knowledge, reports of this kind of injury related to tear gas capsules are very rare in the literature. In conclusion, tear gas guns may be very dangerous in terms of human health and they may cause severe injuries, especially when they are not used according to strict guidelines. © 2015 American Academy of Forensic Sciences.

Effects of mandatory seatbelt use laws on highway fatalities in 1985

DOT National Transportation Integrated Search

1987-04-01

Each year between 40,000 and 50,000 people die in highway accidents. Mandatory : seatbelt use laws (MULs) promise a substantial reduction in both highway fatalities : and the severity of non-fatal accidents. A pooled rross-section time-series model :...

High-altitude cerebral oedema mimicking stroke.

PubMed

Yanamandra, Uday; Gupta, Amul; Patyal, Sagarika; Varma, Prem Prakash

2014-03-26

High-altitude cerebral oedema (HACO) is the most fatal high-altitude illness seen by rural physicians practising in high-altitude areas. HACO presents clinically with cerebellar ataxia, features of raised intracranial pressure (ICP) and coma. Early identification is important as delay in diagnosis can be fatal. We present two cases of HACO presenting with focal deficits mimicking stroke. The first patient presented with left-sided hemiplegia associated with the rapid deterioration in the sensorium. Neuroimaging revealed features suggestive of vasogenic oedema. The second patient presented with monoplegia of the lower limb. Neuroimaging revealed perfusion deficit in anterior cerebral artery territory. Both patients were managed with dexamethasone and they improved dramatically. Clinical picture and neuroimaging closely resembled acute ischaemic stroke in both cases. Thrombolysis in these patients would have been disastrous. Recent travel to high altitude, young age, absence of atherosclerotic risk factors and features of raised ICP concomitantly directed the diagnosis to HACO.

Entrance, exit, and reentrance of one shot with a shotgun.

PubMed

Gulmann, C; Hougen, H P

1999-03-01

The case being reported is one of a homicidal shotgun fatality with an unusual wound pattern. A 34-year-old man was shot at close range with a 12-gauge shotgun armed with No. 5 birdshot ammunition. The shot entered the left axillary region, exited through the left infraclavicular region, and thereafter penetrated the left side of the neck, causing tearing of the left common carotid artery and the right internal carotid artery. The entrance wound in the axilla was larger than the other wounds, and before autopsy it was believed that the shotgun had been fired twice, causing one wound in the neck and one wound perforating the infraclavicular region and exiting through the left axillary region. Thus, this case shows that unusual wound patterns in shotgun fatalities can easily lead to incorrect assumptions with regard to number and direction of shots fired unless thorough investigation is carried out postmortem.

Impact of texting laws on motor vehicular fatalities in the United States.

PubMed

Ferdinand, Alva O; Menachemi, Nir; Sen, Bisakha; Blackburn, Justin L; Morrisey, Michael; Nelson, Leonard

2014-08-01

Using a panel study design, we examined the effects of different types of texting bans on motor vehicular fatalities. We used the Fatality Analysis Reporting System and a difference-in-differences approach to examine the incidence of fatal crashes in 2000 through 2010 in 48 US states with and without texting bans. Age cohorts were constructed to examine the impact of these bans on age-specific traffic fatalities. Primarily enforced laws banning all drivers from texting were significantly associated with a 3% reduction in traffic fatalities in all age groups, and those banning only young drivers from texting had the greatest impact on reducing deaths among those aged 15 to 21 years. Secondarily enforced restrictions were not associated with traffic fatality reductions in any of our analyses.

Impact of Texting Laws on Motor Vehicular Fatalities in the United States

PubMed Central

Ferdinand, Alva O.; Blackburn, Justin L.; Morrisey, Michael; Nelson, Leonard

2014-01-01

Using a panel study design, we examined the effects of different types of texting bans on motor vehicular fatalities. We used the Fatality Analysis Reporting System and a difference-in-differences approach to examine the incidence of fatal crashes in 2000 through 2010 in 48 US states with and without texting bans. Age cohorts were constructed to examine the impact of these bans on age-specific traffic fatalities. Primarily enforced laws banning all drivers from texting were significantly associated with a 3% reduction in traffic fatalities in all age groups, and those banning only young drivers from texting had the greatest impact on reducing deaths among those aged 15 to 21 years. Secondarily enforced restrictions were not associated with traffic fatality reductions in any of our analyses. PMID:24922151

An experimental conflict of interest between parasites reveals the mechanism of host manipulation

PubMed Central

Milinski, Manfred

2016-01-01

Parasites can increase their host’s predation susceptibility. It is a long-standing puzzle, whether this is caused by host manipulation, an evolved strategy of the parasite, or by side effects due to, for example, the parasite consuming energy from its host thereby changing the host’s trade-off between avoiding predation and foraging toward foraging. Here, we use sequential infection of three-spined sticklebacks with the cestode Schistocephalus solidus so that parasites have a conflict of interest over the direction of host manipulation. With true manipulation, the not yet infective parasite should reduce rather than enhance risk taking because predation would be fatal for its fitness; if host behavior is changed by a side effect, the 2 parasites would add their increase of predation risk because both drain energy. Our results support the latter hypothesis. In an additional experiment, we tested both infected and uninfected fish either starved or satiated. True host manipulation should act independently of the fish’s hunger status and continue when energy drain is balanced through satiation. Starvation and satiation affect the risk averseness of infected sticklebacks similarly to that of uninfected starved and satiated ones. Increased energy drain rather than active host manipulation dominates behavioral changes of S. solidus-infected sticklebacks. PMID:27004014

An experimental conflict of interest between parasites reveals the mechanism of host manipulation.

PubMed

Hafer, Nina; Milinski, Manfred

2016-01-01

Parasites can increase their host's predation susceptibility. It is a long-standing puzzle, whether this is caused by host manipulation, an evolved strategy of the parasite, or by side effects due to, for example, the parasite consuming energy from its host thereby changing the host's trade-off between avoiding predation and foraging toward foraging. Here, we use sequential infection of three-spined sticklebacks with the cestode Schistocephalus solidus so that parasites have a conflict of interest over the direction of host manipulation. With true manipulation, the not yet infective parasite should reduce rather than enhance risk taking because predation would be fatal for its fitness; if host behavior is changed by a side effect, the 2 parasites would add their increase of predation risk because both drain energy. Our results support the latter hypothesis. In an additional experiment, we tested both infected and uninfected fish either starved or satiated. True host manipulation should act independently of the fish's hunger status and continue when energy drain is balanced through satiation. Starvation and satiation affect the risk averseness of infected sticklebacks similarly to that of uninfected starved and satiated ones. Increased energy drain rather than active host manipulation dominates behavioral changes of S. solidus -infected sticklebacks.

Mathematical modelling of prostate cancer growth and its application to hormone therapy.

PubMed

Tanaka, Gouhei; Hirata, Yoshito; Goldenberg, S Larry; Bruchovsky, Nicholas; Aihara, Kazuyuki

2010-11-13

Hormone therapy in the form of androgen deprivation is a major treatment for advanced prostate cancer. However, if such therapy is overly prolonged, tumour cells may become resistant to this treatment and result in recurrent fatal disease. Long-term hormone deprivation also is associated with side effects poorly tolerated by patients. In contrast, intermittent hormone therapy with alternating on- and off-treatment periods is a possible clinical strategy to delay progression to hormone-refractory disease with the advantage of reduced side effects during the off-treatment periods. In this paper, we first overview previous studies on mathematical modelling of prostate tumour growth under intermittent hormone therapy. The model is categorized into a hybrid dynamical system because switching between on-treatment and off-treatment intervals is treated in addition to continuous dynamics of tumour growth. Next, we present an extended model of stochastic differential equations and examine how well the model is able to capture the characteristics of authentic serum prostate-specific antigen (PSA) data. We also highlight recent advances in time-series analysis and prediction of changes in serum PSA concentrations. Finally, we discuss practical issues to be considered towards establishment of mathematical model-based tailor-made medicine, which defines how to realize personalized hormone therapy for individual patients based on monitored serum PSA levels.

Psoriasis patients' willingness to accept side-effect risks for improved treatment efficacy.

PubMed

Kauf, Teresa L; Yang, Jui-Chen; Kimball, Alexa B; Sundaram, Murali; Bao, Yanjun; Okun, Martin; Mulani, Parvez; Hauber, A Brett; Johnson, F Reed

2015-01-01

Previous studies suggest that efficacy is more important than side-effect risks to psoriasis patients. However, those studies did not consider potentially fatal risks of biologic treatments. To quantify the risks patients are willing to accept for improvements in psoriasis symptoms. Adults with a self-reported physician diagnosis of psoriasis were recruited through the National Psoriasis Foundation. Using a discrete-choice experiment, patients completed a series of nine choice questions, each including a pair of hypothetical treatments. Treatments were defined by severity of plaques, body surface area (BSA), and 10-year risks of tuberculosis, serious infection and lymphoma. For complete clearance of 25% BSA with mild plaques, respondents (n = 1608) were willing to accept a 20% (95% confidence interval: 9-26%) risk of serious infection, 10% (5-15%) risk of tuberculosis and 2% (1-3%) risk of lymphoma. For complete clearance of 25% BSA with severe plaques, respondents were willing to accept a 54% (48-62%) risk of serious infection, 36% (28-49%) risk of tuberculosis and 8% (7-9%) risk of lymphoma. Respondents were asked to evaluate hypothetical scenarios. Actual treatment choices may differ. Respondents were willing to accept risks above likely clinical exposures for improvements in psoriasis symptoms. Individual risk tolerances may vary.

A rare side effect of transesophageal echocardiography: methemoglobinemia from topical benzocaine anesthesia.

PubMed

Jaffery, Zehra; Ananthasubramaniam, Karthik

2008-03-01

Benzocaine induced methemoglobinemia is an uncommon, potentially fatal condition. A 44-year-old woman with a history of hepatitis C and intravenous drug use was referred for transesophageal echocardiography for bacteremia evaluation. During induction of topical anesthesia with benzocaine spray she became cyanotic. Pulse oximetry revealed marked desaturation (75%) but was discordant from arterial blood O(2) saturation (99%). Due to clinical suspicion, methemoglobin level was measured and noted to be 69%. The patient was treated with 2 mg/kg of methylene blue intravenously with resolution of her symptoms. Physicians using topical anesthesia in endoscopic suites should be aware of this rare, potentially life-threatening treatable condition. High clinical suspicion and availability of methylene blue in endoscopy suites will facilitate prompt diagnosis and treatment.

Future therapeutic options in food allergy.

PubMed

Eigenmann, P A

2003-12-01

Up to 5% of young children and 2% of adults suffer from food allergy. Among them many have immunoglobulin E (IgE)-mediated food allergy, a condition with potentially fatal allergic reactions. Several studies have addressed possible definite treatment options for food allergy. Immunotherapy, by the oral route or by systemic injections shows promising preliminary results, but current interpretation of these therapeutic options are mostly handicapped by studies with insufficient scientific support, or by severe side-effects. Currently, no studies can support pharmacotherapy. Finally, most promising results were recently published with anti-IgE antibodies in a human trial, or various approaches in a mouse model of food allergy (chinese herbal medicine, specific modulation of the T cell response). Rapidly evolving findings might provide hope for a cure of food allergy in the near future.

Interventions to prevent injuries in construction workers.

PubMed

van der Molen, Henk F; Lehtola, Marika M; Lappalainen, Jorma; Hoonakker, Peter L T; Hsiao, Hongwei; Haslam, Roger; Hale, Andrew R; Frings-Dresen, Monique H W; Verbeek, Jos H

2012-12-12

Construction workers are frequently exposed to various types of injury-inducing hazards. A number of injury prevention interventions have been proposed, yet their effectiveness is uncertain. To assess the effects of interventions to prevent injuries in construction workers. We searched the Cochrane Injuries Group's specialised register, CENTRAL, MEDLINE, EMBASE, PsycINFO, OSH-ROM (including NIOSHTIC and HSELINE), Scopus, Web of Science and EI Compendex to September 2011. The searches were not restricted by language or publication status. The reference lists of relevant papers and reviews were also searched. Randomised controlled trials, controlled before-after (CBA) studies and interrupted time series (ITS) of all types of interventions for preventing fatal and non-fatal injuries among workers at construction sites. Two review authors independently selected studies, extracted data and assessed study quality. For ITS, we re-analysed the studies and used an initial effect, measured as the change in injury-rate in the year after the intervention, as well as a sustained effect, measured as the change in time trend before and after the intervention. Thirteen studies, 12 ITS and one CBA study met the inclusion criteria. The ITS evaluated the effects of the introduction or change of regulations (N = 7), a safety campaign (N = 2), a drug-free workplace programme (N = 1), a training programme (N = 1), and safety inspections (N = 1) on fatal and non-fatal occupational injuries. One CBA study evaluated the introduction of occupational health services such as risk assessment and health surveillance.The overall risk of bias among the included studies was high as it was uncertain for the ITS studies whether the intervention was independent from other changes and thus could be regarded as the main reason of change in the outcome.The regulatory interventions at national or branch level showed a small but significant initial and sustained increase in fatal (effect sizes of 0.79; 95% confidence interval (CI) 0.00 to 1.58) and non-fatal injuries (effect size 0.23; 95% CI 0.03 to 0.43).The safety campaign intervention resulted in a decrease in injuries at the company level but an increase at the regional level. Training interventions, inspections or the introduction of occupational health services did not result in a significant reduction of non-fatal injuries in single studies.A multifaceted drug-free workplace programme at the company level reduced non-fatal injuries in the year following implementation by -7.6 per 100 person-years (95% CI -11.2 to -4.0) and in the years thereafter by -2.0 per 100 person-years per year (95% CI -3.5 to -0.5). The vast majority of technical, human and organisational interventions that are recommended by standard texts of safety, consultants and safety courses have not been adequately evaluated. There is no evidence that introducing regulations for reducing fatal and non-fatal injuries are effective as such. There is neither evidence that regionally oriented safety campaigns, training, inspections nor the introduction of occupational health services are effective at reducing non-fatal injuries in construction companies. There is low-quality evidence that company-oriented safety interventions such as a multifaceted safety campaign and a multifaceted drug workplace programme can reduce non-fatal injuries among construction workers. Additional strategies are needed to increase the compliance of employers and workers to the safety measures that are prescribed by regulation. Continuing company-oriented interventions among management and construction workers, such as a targeted safety campaign or a drug-free workplace programme, seem to have an effect in reducing injuries in the longer term.

Combined use of ursodeoxycholic acid and bosentan prevents liver toxicity caused by endothelin receptor antagonist bosentan monotherapy: two case reports.

PubMed

Ito, Tomoki; Ozaki, Yoshio; Son, Yonsu; Nishizawa, Tohru; Amuro, Hideki; Tanaka, Akihiro; Tamaki, Takeshi; Nomura, Shosaku

2014-07-11

Pulmonary arterial hypertension is a fatal disease characterized by progressive remodeling of the pulmonary arteries and an increase in pulmonary vascular resistance. Up to 50% of patients with systemic sclerosis have pulmonary arterial hypertension, which significantly affects the prognosis. The endothelin receptor antagonist bosentan is used for the treatment of pulmonary arterial hypertension and shows a great beneficial effect. However, the most frequent side effect of bosentan is liver toxicity, which often requires dose reduction and discontinuation. We report two cases (a 64-year-old Japanese woman and a 69-year old Japanese woman) of systemic sclerosis, both with severe Raynaud's phenomenon and pulmonary arterial hypertension. Both patients had initially received bosentan monotherapy, which caused liver toxicity as indicated by increased levels of alanine aminotransferase, alkaline phosphatase, and gamma-glutamyltransferase. After dose reduction or discontinuation of bosentan, these liver function abnormalities were normalized and the patients subsequently received retreatment with a combination of bosentan and ursodeoxycholic acid. The results of liver function tests did not show any abnormalities after this combination therapy. These reports suggest the usefulness of ursodeoxycholic acid for preventing liver toxicity caused by bosentan. Thus, the addition of ursodeoxycholic acid to the treatment protocol is expected to be useful when liver toxicity emerges as a side effect of bosentan.

The local and systemic side-effects of venom and inhaled-allergen subcutaneous immunotherapy.

PubMed

Adamic, Katja; Zidarn, Mihaela; Bajrovic, Nissera; Erzen, Renato; Kopac, Peter; Music, Ema

2009-01-01

Although immunotherapy is effective in allergic rhinitis, conjunctivitis, asthma and stinging insect hypersensitivity, it carries a risk of anaphylactic reactions. In a 4-year retrospective survey, we investigated 1257 adult patients who had received venom or inhaled-allergen subcutaneous immunotherapy. The dose-increase phase was performed as the 2-day rush protocol for venom immunotherapy and the 6-week protocol for inhaled-allergen immunotherapy. A total of 904 patients received venom immunotherapy and 353 patients inhaled-allergen immunotherapy. The prevalence of systemic reactions was 13.6%. The frequency of systemic reactions was higher during the maintenance phase than in the dose-increase phase (9.6% vs. 5.9%) and was highest in both phases of treatment with honeybee venom (P < 0.001). The majority of systemic reactions were mild. Five (0.4%) patients had reaction with a fall of blood pressure and were treated with adrenaline. There was no fatal outcome. The systemic side-effects during the dose-increase phase of venom immunotherapy occurred at a median dose of 46 microg (range 2-100 microg). Large local reactions occurred in 13.9% of patients without any significant difference between the allergens. We have shown that systemic reactions are not rare even during maintenance phase in patients with a well tolerated dose-increase phase of treatment. The most prominent risk factor for systemic reactions was immunotherapy with honeybee extract.

Spectral Analysis of the Effects of Daylight Saving Time on Motor Vehicle Fatal Traffic Accidents

DOT National Transportation Integrated Search

1977-04-01

This report shows that Daylight Saving Time (DST) reduces the number of persons killed in motor vehicle fatal traffic accidents by about one percent. This estimate is based on a spectral (Fourier) analysis of these fatalities which utilizes a filteri...

Distance matters: Effect of geographic trauma system resource organization on fatal motor vehicle collisions.

PubMed

Brown, Joshua B; Rosengart, Matthew R; Billiar, Timothy R; Peitzman, Andrew B; Sperry, Jason L

2017-07-01

Trauma systems improve outcome; however, it is unclear how geographic organization of trauma system resources (TSR) affects outcome. Our objective was to evaluate the relationship of fatal motor vehicle collision (MVC) rates and the distance from individual MVC locations to the nearest TSR as a measure of the geographical organization of trauma systems, as well as how theoretical changes in the distribution of TSR may affect fatal MVC rates. All fatal MVC in Pennsylvania 2013-2014 were mapped from the Fatality Analysis Reporting System database. Deaths on scene were excluded. TSR including trauma centers and helicopter bases were mapped. Distance between each fatal MVC and nearest TSR was calculated. The primary outcome was fatal MVC rate per 100 million vehicle miles traveled (VMT). Empiric Bayes kriging and hot spot analysis were performed to evaluate geographic patterns in fatal MVC rates. Association between fatal MVC rate and distance to the nearest TSR was evaluated with linear regression. Spatial lag regression evaluated this association while controlling for MVC and county-level characteristics. We identified 886 fatalities from 863 fatal MVC. Median fatal MVC rate was 0.187 per 100 million VMT. Higher fatal MVC rates and fatality hot spots occur in locations farther from TSR. The fatal MVC rate increased 0.141 per 100 million VMT for every 10 miles farther from the nearest TSR (p < 0.01). When controlling for confounders, the fatal MVC rate increased by 0.089 per 100 million VMT for every 10 miles farther from the nearest TSR (p < 0.01). If two helicopters stationed at trauma centers were relocated into the highest fatality regions, our model predicts a 12.3% relative reduction in the overall MVC fatality rate. Increasing distance to the nearest TSR is associated with increasing fatal MVC rate. The geographic organization of trauma systems may impact outcome, and geospatial analysis can allow data-driven changes to potentially improve outcome. Prognostic/Epidemiologic, level III; Case management, level III.

Cirrus Airframe Parachute System and Odds of a Fatal Accident in Cirrus Aircraft Crashes.

PubMed

Alaziz, Mustafa; Stolfi, Adrienne; Olson, Dean M

2017-06-01

General aviation (GA) accidents have continued to demonstrate high fatality rates. Recently, ballistic parachute recovery systems (BPRS) have been introduced as a safety feature in some GA aircraft. This study evaluates the effectiveness and associated factors of the Cirrus Airframe Parachute System (CAPS) at reducing the odds of a fatal accident in Cirrus aircraft crashes. Publicly available Cirrus aircraft crash reports were obtained from the National Transportation Safety Board (NTSB) database for the period of January 1, 2001-December 31, 2016. Accident metrics were evaluated through univariate and multivariate analyses regarding odds of a fatal accident and use of the parachute system. Included in the study were 268 accidents. For CAPS nondeployed accidents, 82 of 211 (38.9%) were fatal as compared to 8 of 57 (14.0%) for CAPS deployed accidents. After controlling for all other factors, the adjusted odds ratio for a fatal accident when CAPS was not deployed was 13.1. The substantial increased odds of a fatal accident when CAPS was not deployed demonstrated the effectiveness of CAPS at providing protection of occupants during an accident. Injuries were shifted from fatal to serious or minor with the use of CAPS and postcrash fires were significantly reduced. These results suggest that BPRS could play a significant role in the next major advance in improving GA accident survival.Alaziz M, Stolfi A, Olson DM. Cirrus Airframe Parachute System and odds of a fatal accident in Cirrus aircraft crashes. Aerosp Med Hum Perform. 2017; 88(6):556-564.

The changing face of antihistamines and cardiac adverse drug reactions: a clinical perspective.

PubMed

Shaikh, W A

2000-07-01

Recent times have witnessed a qualitative shift in the recognition and management of adverse drug effects. Many of them occur in organs that are unconnected to the primary target of pharmacological action. Out of these, cardiac side-effects have drawn particular attention because of their potential to cause death. Starting with the early observations on antibiotics such as macrolides, followed by fluoroquinolones and others, the focus has now shifted to the antihistamine class of drugs which are used extensively by patients all over the world, thanks to the ever increasing levels of environmental pollution. The occurrence of prolonged QTc interval following treatment with terfenadine leading to ventricular tachycardia of torsades de points variety with a potentially fatal outcome has forced many regulatory authorities of the world to clamp a ban the use of this drug. Alerted by these developments, studies on a new member, followed by fluoroquinolones and others, the focus has now shifted to the antihistamine class of drugs which are used extensively by patients all over the world, thanks to the ever incresing levels of envrionmental pollution. The occurrence of prolonged QTc interval following treatment with terfenadine leading to ventricular tachycardia of torsades de points variety with a potentially fatal outcome has forced many regulatory authorities of the world to clamp a ban use of this drug. Alerted by these developments, studies on a new member of non-sedating antihistamine class viz, fexofenadine, have been reviewed especially because of the structural similarity between terfenadine and fexofenadine. It is now clear that despite the closeness of its chemical structure to terfenadine fexofenadine behaves in a different manner and does not affect the electrophysiology of the heart muscle tissue, as proved by data from extensive clinical trials as well as membrane models in vitro. Interestingly, the solitary false alarm that was sounded on the drug by a group of workers in the Netherlands was later rectified by the same group. Clinically speaking, the cardiovascular safety of fexofenadine has been convincingly demonstrated at various dose levels and various time intervals, alone and together with other drugs of potential toxigenicity. All things put together, it appears reasonable to conclude that fexofenadine is free from cardiovascular ADRs of clinical significance. It could also be concluded that cardiac side-effects of antihistamines is not a class effect.

Methods of a large prospective, randomised, open-label, blinded end-point study comparing morning versus evening dosing in hypertensive patients: the Treatment In Morning versus Evening (TIME) study.

PubMed

Rorie, David A; Rogers, Amy; Mackenzie, Isla S; Ford, Ian; Webb, David J; Willams, Bryan; Brown, Morris; Poulter, Neil; Findlay, Evelyn; Saywood, Wendy; MacDonald, Thomas M

2016-02-09

Nocturnal blood pressure (BP) appears to be a better predictor of cardiovascular outcome than daytime BP. The BP lowering effects of most antihypertensive therapies are often greater in the first 12 h compared to the next 12 h. The Treatment In Morning versus Evening (TIME) study aims to establish whether evening dosing is more cardioprotective than morning dosing. The TIME study uses the prospective, randomised, open-label, blinded end-point (PROBE) design. TIME recruits participants by advertising in the community, from primary and secondary care, and from databases of consented patients in the UK. Participants must be aged over 18 years, prescribed at least one antihypertensive drug taken once a day, and have a valid email address. After the participants have self-enrolled and consented on the secure TIME website (http://www.timestudy.co.uk) they are randomised to take their antihypertensive medication in the morning or the evening. Participant follow-ups are conducted after 1 month and then every 3 months by automated email. The trial is expected to run for 5 years, randomising 10,269 participants, with average participant follow-up being 4 years. The primary end point is hospitalisation for the composite end point of non-fatal myocardial infarction (MI), non-fatal stroke (cerebrovascular accident; CVA) or any vascular death determined by record-linkage. Secondary end points are: each component of the primary end point, hospitalisation for non-fatal stroke, hospitalisation for non-fatal MI, cardiovascular death, all-cause mortality, hospitalisation or death from congestive heart failure. The primary outcome will be a comparison of time to first event comparing morning versus evening dosing using an intention-to-treat analysis. The sample size is calculated for a two-sided test to detect 20% superiority at 80% power. TIME has ethical approval in the UK, and results will be published in a peer-reviewed journal. UKCRN17071; Pre-results. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

Overall Fatality Risk to the Public at Large Related to National Weight Mix of Passenger Cars

DOT National Transportation Integrated Search

1989-10-01

This report addresses the question of the effect on the fatality risk to the public at : large due to shifts in the weight distributions of passenger cars. For example, if the : weight o f the average passenger car were decreased would fatalities inc...

An Evaluation of Graduated Driver Licensing Effects on Fatal Crash Involvements of Young Drivers in the United States

PubMed Central

Fell, James C.; Jones, Kristina; Romano, Eduardo; Voas, Robert

2013-01-01

Objective Graduated driver licensing (GDL) systems are designed to reduce the high crash risk of young novice drivers. Almost all states in the United States have some form of a three-phased GDL system with various restrictions in the intermediate phase. Studies of the effects of GDL in various states show significant reductions in fatal crash involvements of 16- and 17-year-old drivers; however, only a few national studies of GDL effects have been published. The objective of this national panel study was to evaluate the effect of GDL laws on the fatal crash involvements of novice drivers while controlling for possible confounding factors not accounted for in prior studies. Methods The Fatality Analysis Reporting System (FARS) was used to examine 16- and 17-year-old driver involvement in fatal crashes (where GDL laws are applied) relative to two young driver age groups (19-20, 21-25) where GDL would not be expected to have an effect. Dates when various GDL laws were adopted in the states between 1990 and 2007 were coded from a variety of sources. Covariates in the longitudinal panel regression analyses conducted included four laws that could have an effect on 16- and 17-year-old drivers: primary enforcement seat belt laws, zero-tolerance (ZT) alcohol laws for drivers younger than age 21, lowering the blood alcohol concentration limit for driving to .08, and so-called “use and lose” laws where drivers aged 20 and younger lose their licenses for underage drinking violations. Results The adoption of a GDL law of average strength was associated with a significant decrease in fatal crash involvements of 16- and 17-year-old drivers relative to fatal crash involvements of one of the two comparison groups. GDL laws rated as “good” showed stronger relationships to fatal crash reductions, and laws rated as “less than good” showed no reductions in crash involvements relative to the older driver comparison groups. Conclusions States that adopt a basic GDL law can expect a decrease of 8 to 14% in the proportion of 16- and 17-year-old drivers involved in fatal crashes (relative to 21- to 25-year-old drivers), depending upon their other existing laws that affect novice drivers, such as those used in these analyses. This finding is consistent with recent national studies that used different outcome measures and covariates. The results of this study provide additional support for states to adopt, maintain, and upgrade GDL systems to reduce youthful traffic crash fatalities. PMID:21972851

Disseminated intravascular coagulation induced by progesterone in the pregnant rat. Prevention by estogens.

PubMed

Stamler, F W

1977-03-01

Fatal disseminated intravascular coagulation (DIC) was induced in female rats by administration of progesterone in late pregnacy. This prevented parturition, with intrauterine fetal death 2 to 4 days past term and subsequent retention of dead fetuses. Concomitantly with or closely following the intrauterine death of their litters, a large proportion of pregnant rats died with histologically evident DIC. Administration of cortisone, heparin, or disoumarin did not prevent DIC, and xi-aminocaproic acid, acetylsalicylic acid, or an onion-rich diet tended to increase its incidence. Antibiotic regimens gave variable results, with significant decrease in DIC only with a combination of two wide-spectrum penicillins. Neomycin and polymyxin had little effect on susceptible Sprague-dawley derived rats, but polymxin caused a significant increase in DIC in a resistant strain of hooded rats. Fatal maternal DIC was completely prevented only by use of natural or synthetic estrogens concurrently with progesterone, although this did not alter the sequence of abnormally prolonged pregnacy with intrauterine fetal death and retention of dead fetuses. Potencies of estrogens varied greatly, but all compounds tested prevented DIC at adequate dosage levels. Diethylstilbestrol, the most potent drug tested, was completely protective at 1 mug daily given subcutaneously. beta-Estradiol was the most effective natural estrogen, giving complete protection with a 10-mug daily subcutaneous injection. Estrogens were much more potent by subcutaneous injection than by oral ingestion, and toxic side effects were sometimes noted with higher levels of the latter. For estrogen therapy to be effective, it was necessary to begin its use before the expected onset of DIC, and in no instance was there evidence of reversal of this process after signs of illness were observed.

Disseminated intravascular coagulation induced by progesterone in the pregnant rat. Prevention by estogens.

PubMed Central

Stamler, F. W.

1977-01-01

Fatal disseminated intravascular coagulation (DIC) was induced in female rats by administration of progesterone in late pregnacy. This prevented parturition, with intrauterine fetal death 2 to 4 days past term and subsequent retention of dead fetuses. Concomitantly with or closely following the intrauterine death of their litters, a large proportion of pregnant rats died with histologically evident DIC. Administration of cortisone, heparin, or disoumarin did not prevent DIC, and xi-aminocaproic acid, acetylsalicylic acid, or an onion-rich diet tended to increase its incidence. Antibiotic regimens gave variable results, with significant decrease in DIC only with a combination of two wide-spectrum penicillins. Neomycin and polymyxin had little effect on susceptible Sprague-dawley derived rats, but polymxin caused a significant increase in DIC in a resistant strain of hooded rats. Fatal maternal DIC was completely prevented only by use of natural or synthetic estrogens concurrently with progesterone, although this did not alter the sequence of abnormally prolonged pregnacy with intrauterine fetal death and retention of dead fetuses. Potencies of estrogens varied greatly, but all compounds tested prevented DIC at adequate dosage levels. Diethylstilbestrol, the most potent drug tested, was completely protective at 1 mug daily given subcutaneously. beta-Estradiol was the most effective natural estrogen, giving complete protection with a 10-mug daily subcutaneous injection. Estrogens were much more potent by subcutaneous injection than by oral ingestion, and toxic side effects were sometimes noted with higher levels of the latter. For estrogen therapy to be effective, it was necessary to begin its use before the expected onset of DIC, and in no instance was there evidence of reversal of this process after signs of illness were observed. Images Figure 3 Figure 4 Figure 1 Figure 2 PMID:65916

Automobile driver fatalities in frontal impacts: air bags compared with manual belts.

PubMed Central

Zador, P L; Ciccone, M A

1993-01-01

OBJECTIVES. The effectiveness of air bags was estimated in this study by comparing driver fatalities in frontal crashes with driver fatalities in nonfrontal crashes, for cars with air bags and manual belts and cars with manual belts only. METHODS. Fatal Accident Reporting System data for drivers fatally injured during 1985 to 1991 in 1985 to 1991 model year cars that were equipped with air bags in or before model year 1991 were analyzed. RESULTS. Driver fatalities in frontal crashes in air bag cars were 28% lower than those in comparable cars with manual belts only. This percentage was used for estimating the overall fatality reduction in air bag cars. The reduction was greater in large cars (50%) than in midsize cars (19%) or in small cars (14%). Air bags reduced driver fatalities in frontal crashes involving ejection by about 9%. Fatalities in frontal crashes among drivers who were reportedly using manual belts at the time of the crash were reduced by about 15%. The comparable reduction among drivers who were reportedly not using manual belts was 31%. CONCLUSION. It was estimated that air bags reduced the total number of all driver fatalities by about 19%. PMID:8484445

Trends in Fatalities From Distracted Driving in the United States, 1999 to 2008

PubMed Central

Stimpson, Jim P.

2010-01-01

Objectives. We examined trends in distracted driving fatalities and their relation to cell phone use and texting volume. Methods. The Fatality Analysis Reporting System (FARS) records data on all road fatalities that occurred on public roads in the United States from 1999 to 2008. We studied trends in distracted driving fatalities, driver and crash characteristics, and trends in cell phone use and texting volume. We used multivariate regression analysis to estimate the relation between state-level distracted driving fatalities and texting volumes. Results. After declining from 1999 to 2005, fatalities from distracted driving increased 28% after 2005, rising from 4572 fatalities to 5870 in 2008. Crashes increasingly involved male drivers driving alone in collisions with roadside obstructions in urban areas. By use of multivariate analyses, we predicted that increasing texting volumes resulted in more than 16 000 additional road fatalities from 2001 to 2007. Conclusions. Distracted driving is a growing public safety hazard. Specifically, the dramatic rise in texting volume since 2005 appeared to be contributing to an alarming rise in distracted driving fatalities. Legislation enacting texting bans should be paired with effective enforcement to deter drivers from using cell phones while driving. PMID:20864709

Trends in fatalities from distracted driving in the United States, 1999 to 2008.

PubMed

Wilson, Fernando A; Stimpson, Jim P

2010-11-01

We examined trends in distracted driving fatalities and their relation to cell phone use and texting volume. The Fatality Analysis Reporting System (FARS) records data on all road fatalities that occurred on public roads in the United States from 1999 to 2008. We studied trends in distracted driving fatalities, driver and crash characteristics, and trends in cell phone use and texting volume. We used multivariate regression analysis to estimate the relation between state-level distracted driving fatalities and texting volumes. After declining from 1999 to 2005, fatalities from distracted driving increased 28% after 2005, rising from 4572 fatalities to 5870 in 2008. Crashes increasingly involved male drivers driving alone in collisions with roadside obstructions in urban areas. By use of multivariate analyses, we predicted that increasing texting volumes resulted in more than 16,000 additional road fatalities from 2001 to 2007. Distracted driving is a growing public safety hazard. Specifically, the dramatic rise in texting volume since 2005 appeared to be contributing to an alarming rise in distracted driving fatalities. Legislation enacting texting bans should be paired with effective enforcement to deter drivers from using cell phones while driving.

Complete Streets and Adult Bicyclist Fatalities: Applying G-Computation to Evaluate an Intervention That Affects the Size of a Population at Risk.

PubMed

Mooney, Stephen J; Magee, Caroline; Dang, Kolena; Leonard, Julie C; Yang, Jingzhen; Rivara, Frederick P; Ebel, Beth E; Rowhani-Rahbar, Ali; Quistberg, D Alex

2018-05-14

"Complete Streets" policies require transportation engineers to make provisions for pedestrians, cyclists and transit users. These policies may make bicycling safer for individual cyclists while increasing overall bicycle fatalities if more individuals cycle due to improved infrastructure. We merged county-level records of Complete Streets policies with Fatality Analysis Reporting System counts of cyclist fatalities occurring between January 2000 and December 2015. Because comprehensive county cycling estimates were not available, we used bicycle commute estimates from the American Community Survey and US Census as a proxy for the cycling population, and limited analysis to 183 counties (accounting for over half the US population) for which cycle commute estimates were consistently non-zero. We used G-computation to estimate the effect of policies on overall cyclist fatalities while also accounting for potential policy effects on the size of the cycling population. Over 16 years, 5,254 cyclists died in these counties, representing 34 fatalities per 100,000 cyclist-years. We estimated that Complete Streets policies made cycling safer, averting 0.6 fatalities per 100,000 cyclist-years (95% CI: 0.3, 1.0) by encouraging a 2.4% increase in cycling and a 0.7% increase in cyclist fatalities. G-computation is a useful tool for understanding policy impact on risk and exposure.

Bleomycin-Induced Pulmonary Changes on Restaging Computed Tomography Scans in Two Thirds of Testicular Cancer Patients Show No Correlation With Fibrosis Markers.

PubMed

den Hollander, Martha W; Westerink, Nico-Derk L; Lubberts, Sjoukje; Bongaerts, Alfons H H; Wolf, Rienhart F E; Altena, Renska; Nuver, Janine; Oosting, Sjoukje F; de Vries, Elisabeth G E; Walenkamp, Anna M E; Meijer, Coby; Gietema, Jourik A

2016-08-01

In metastatic testicular cancer patients treated with bleomycin, etoposide, and cisplatin (BEP) chemotherapy, bleomycin-induced pneumonitis is a well-known and potentially fatal side effect. We sought to determine the prevalence of lesions as signs of bleomycin-induced pulmonary changes on restaging computed tomography (CT) scans after treatment and to ascertain whether fibrosis markers were predictive of these changes. This prospective nonrandomized cohort study included metastatic testicular cancer patients, 18-50 years of age, treated with BEP chemotherapy. Restaging CT scans were examined for lesions as signs of bleomycin-induced pulmonary changes by two independent radiologists and graded as minor, moderate, or severe. Plasma samples were collected before, during, and after treatment and were quantified for transforming growth factor-β1 (TGF-β1), growth differentiation factor-15 (GDF-15), and high-sensitivity C-reactive protein (hs-CRP). In total, 66 patients were included: forty-five (68%) showed signs of bleomycin-induced pulmonary changes on the restaging CT scan, 37 of which were classified as minor and 8 as moderate. No differences in TGF-β1, GDF-15, or hs-CRP plasma levels were found between these groups. Bleomycin-induced pulmonary changes are common on restaging CT scans after BEP chemotherapy for metastatic testicular cancer. Changes in TGF-β1, GDF-15, and hs-CRP plasma levels do not differ between patients with and without radiological lesions as signs of bleomycin-induced pulmonary changes and are therefore not helpful as predictive biomarkers. Bleomycin-induced pneumonitis (BIP) is a well-known and potentially fatal side effect in metastatic testicular cancer patients treated with bleomycin, etoposide, and cisplatin chemotherapy. Currently, the decision to discontinue bleomycin administration is made during treatment and is based on clinical signs. An upfront or early marker or biomarker that identifies patients likely to develop BIP would be preferable. This study found that bleomycin-induced pulmonary changes are common on restaging computed tomography scans and mostly resolve. No correlation was seen between these changes and fibrosis or inflammation markers (transforming growth factor-β1, growth differentiation factor-15, and high-sensitivity C-reactive protein). ©AlphaMed Press.

States with low non-fatal injury rates have high fatality rates and vice-versa.

PubMed

Mendeloff, John; Burns, Rachel

2013-05-01

State-level injury rates or fatality rates are sometimes used in studies of the impact of various safety programs or other state policies. How much does the metric used affect the view of relative occupational risks among U.S. states? This paper uses a measure of severe injuries (fatalities) and of less severe injuries (non-fatal injuries with days away from work, restricted work, or job transfer-DART) to examine that issue. We looked at the correlation between the average DART injury rate (from the BLS Survey of Occupational Injuries and Illnesses) and an adjusted average fatality rate (from the BLS Census of Fatal Occupational Injuries) in the construction sector for states for 2003-2005 and for 2006-2008. The RAND Human Subjects Protection Committee determined that this study was exempt from review. The correlations between the fatal and non-fatal injury rates were between -0.30 and -0.70 for all construction and for the subsector of special trade contractors. The negative correlation was much smaller between the rate of fatal falls from heights and the rate of non-fatal falls from heights. Adjusting for differences in the industry composition of the construction sector across states had minor effects on these results. Although some have suggested that fatal and non-fatal injury rates should not necessarily be positively correlated, no one has suggested that the correlation is negative, which is what we find. We know that reported non-fatal rates are influenced by workers' compensation benefits and other factors. Fatality rates appear to be a more valid measure of risk. Efforts to explain the variations that we find should be undertaken. Copyright © 2012 Wiley Periodicals, Inc.

Fatal falls in the US construction industry, 1990 to 1999.

PubMed

Derr, J; Forst, L; Chen, H Y; Conroy, L

2001-10-01

The Occupational Safety and Health Administration's (OSHA's) Integrated Management Information System (IMIS) database allows for the detailed analysis of risk factors surrounding fatal occupational events. This study used IMIS data to (1) perform a risk factor analysis of fatal construction falls, and (2) assess the impact of the February 1995 29 CFR Part 1926 Subpart M OSHA fall protection regulations for construction by calculating trends in fatal fall rates. In addition, IMIS data on fatal construction falls were compared with data from other occupational fatality surveillance systems. For falls in construction, the study identified several demographic factors that may indicate increased risk. A statistically significant downward trend in fatal falls was evident in all construction and within several construction categories during the decade. Although the study failed to show a statistically significant intervention effect from the new OSHA regulations, it may have lacked the power to do so.

Fatal crashes of passenger vehicles before and after adding antilock braking systems.

PubMed

Farmer, C M; Lund, A K; Trempel, R E; Braver, E R

1997-11-01

Fatal crash rates of passenger cars and vans were compared for the last model year before four-wheel antilock brakes were introduced and the first model year for which antilock brakes were standard equipment. Vehicles selected for analysis had no other significant design changes between the model years being compared, and the model years with and without antilocks were no more than two years apart. The overall fatal crash rates were similar for the two model years. However, the vehicles with antilocks were significantly more likely to be involved in crashes fatal to their own occupants, particularly single-vehicle crashes. Conversely, antilock vehicles were less likely to be involved in crashes fatal to occupants of other vehicles or nonoccupants (pedestrians, bicyclists). Overall, antilock brakes appear to have had little effect on fatal crash involvement. Further study is needed to better understand why fatality risk has increased for occupants of antilock vehicles.

Do coping strategies mediate the effects of emotional support on emotional well-being among Spanish-speaking Latina breast cancer survivors?

PubMed

Gonzales, Felisa A; Hurtado-de-Mendoza, Alejandra; Santoyo-Olsson, Jasmine; Nápoles, Anna María

2016-11-01

This study aimed to assess the relationship between emotional social support and emotional well-being among Latina immigrants with breast cancer and test whether two culturally relevant coping strategies, fatalism and acceptance, mediate this relationship. One hundred fifty Spanish-speaking Latinas within 1 year of breast cancer diagnosis participating in a randomized trial of a stress management intervention were assessed in person at baseline and via telephone 6 months later. Survey measures included baseline emotional support, fatalism, and acceptance and emotional well-being 6 months later. Generalized linear models estimated direct effects of emotional support on emotional well-being and indirect effects through fatalism and acceptance. Mean age was 50.1 (SD = 10.9) years; most women had low education and acculturation levels. Emotional support was negatively associated with fatalism (r = -0.24, p < 0.01) and positively associated with acceptance (r = 0.30, p < 0.001). Emotional support (r = 0.23, p = 0.005) and acceptance (r = 0.28, p = 0.001) were positively associated with emotional well-being, whereas fatalism (r = -0.36, p < 0.0001) was negatively associated with emotional well-being. In multivariable models, emotional support was associated with emotional well-being (b = 0.88, 95% CI: 0.24, 1.52). This direct effect remained significant when additionally controlling for fatalism (b = 0.66, 95% CI: 0.03, 1.30) and acceptance (b = 0.73, 95% CI: 0.09, 1.37) in separate models. There was a significant indirect effect of emotional support on emotional well-being through fatalism (b = 0.21, 95% CI: 0.04, 0.51) as well as a marginally significant effect through acceptance (b = 0.15, 95% CI: 0.001, 0.43). Emotional support may increase well-being among Spanish-speaking Latina cancer survivors by reducing cancer fatalism.Copyright © 2015 John Wiley & Sons, Ltd. Copyright © 2015 John Wiley & Sons, Ltd.

Predictors of road traffic accident, road traffic injury and death among commercial motorcyclists in an urban area of Nigeria.

PubMed

Adogu, P O U; Ilika, A L; Asuzu, A L

2009-01-01

Road traffic accidents, injuries and deaths remain important public health problems in both developed and developing countries. These problems have since escalated with the introduction of the new phenomenon of commercial motorcycle transportation such as is found in the urbanizing slum of Nnewi, Anambra state of Nigeria. Using a semi-structured, interviewer-administered questionnaire, relevant data on socio-demographic and motorcycle characteristics were collected from a sample of 291 commercial motorcyclists selected by systematic sampling technique. Data on RTA, RTI and death were also collected from them overa period of three months. The result showed that young commercial motorcyclists {<30 years of age}, experienced higher fatal injury rate than older ones {> or =30 years of age}, {p < 0.01}. Motorcyclists with some formal education experienced RTA and RTI incidence rates that were significantly lower than those of motorcyclists with no formal education, {p < 0.01}. In the same vein, medical condition and social vices such as alcohol intake among the motorcyclists were found to be obvious predictors of RTA, RTI and death. Furthermore, motorcyclists who used >100 cc engine capacity motorcycles had significantly higher RTA incidence rate {478.8/100 MCY}, RTI rate {223.2/100 MCY} and FIR {410/100 MCY} than users of <100 cc engine motorcycles who recorded RTA incidence of 258.9/100 MCY, RTI rate of 49/100 MCY and zero fatal injury respectively {p < 0.01, p < 0.001, p < 0.001 respectively}. A careful consideration of all these predictors individually and collectively, will enable stakeholders in transport industry plan effective RTA, RTI and death control measures. Rather than an outright ban of motorcycle transportation, evening classes can be organized for the motorcyclists at subsidized rates to improve their literacy levels to run side by side with road safety informational lessons delivered at their places of work.

Evaluation of motorcycle safety strategies using the severity of injuries.

PubMed

Jung, Soyoung; Xiao, Qin; Yoon, Yoonjin

2013-10-01

The growth of motorcycle fatalities in California has been especially prominent, specifically with regard to the 24 and under age group and those aged 45-54. This research quantitatively examined factors associated with motorcyclist fatalities and assessed strategies that could improve motorcyclist safety, specifically focusing on the two age groups mentioned above. Severity of injury was estimated separately for both age groups with multinomial logit models and pseudo-elasticity using motorcycle-related collision data that was collected between 2005 and 2009. The results were compared with motorcyclists aged 35-44, a group that shows a consistent trend of fatalities. This research found that lack or improper use of helmets, victim ejection, alcohol/drug effects, collisions (head-on, broadside, hit-object), and truck involvement were more likely to result in fatal injuries regardless of age group. Weekend and non-peak hour activity was found to have a strong effect in both the younger and older age groups. Two factors, movement of running off the road preceding a collision and multi-vehicle involvement, were found to be statistically significant factors in increasing older motorcyclist fatalities. Use of street lights in the dark was found to decrease the probability of severe injury for older motorcyclists. Driver type of victim, at-fault driver, local road, and speed violation were significant factors in increasing the fatalities of younger motorcyclists. Road conditions and collision location factors were not found to be statistically significant to motorcyclist fatalities. Based on the statistically significant factors identified in this research, the following safety strategies appear to be effective methods of reducing motorcyclist fatalities: public education of alcohol use, promoting helmet use, enforcing heavy vehicle and speed violations, improving roadway facilities, clearer roadway guidance and street lighting systems, and motorcyclist training. Copyright © 2013 Elsevier Ltd. All rights reserved.

Modelling the effect on injuries and fatalities when changing mode of transport from car to bicycle.

PubMed

Nilsson, Philip; Stigson, Helena; Ohlin, Maria; Strandroth, Johan

2017-03-01

Several studies have estimated the health effects of active commuting, where a transport mode shift from car to bicycle reduces risk of mortality and morbidity. Previous studies mainly assess the negative aspects of bicycling by referring to fatalities or police reported injuries. However, most bicycle crashes are not reported by the police and therefore hospital reported data would cover a much higher rate of injuries from bicycle crashes. The aim of the present study was to estimate the effect on injuries and fatalities from traffic crashes when shifting mode of transport from car to bicycle by using hospital reported data. This present study models the change in number of injuries and fatalities due to a transport mode change using a given flow change from car to bicycle and current injury and fatality risk per distance for bicyclists and car occupants. show that bicyclists have a much higher injury risk (29 times) and fatality risk (10 times) than car occupants. In a scenario where car occupants in Stockholm living close to their work place shifts transport mode to bicycling, injuries, fatalities and health loss expressed in Disability-Adjusted Life Years (DALY) were estimated to increase. The vast majority of the estimated DALY increase was caused by severe injuries and fatalities and it tends to fluctuate so that the number of severe crashes may exceed the estimation with a large margin. Although the estimated increase of traffic crashes and DALY, a transport mode shift is seen as a way towards a more sustainable society. Thus, this present study highlights the need of strategic preventive measures in order to minimize the negative impacts from increased bicycling. Copyright © 2016 Elsevier Ltd. All rights reserved.

A statistical analysis of the global historical volcanic fatalities record

USGS Publications Warehouse

Auker, Melanie Rose; Sparks, Robert Stephen John; Siebert, Lee; Crosweller, H. S.; Ewert, John W.

2013-01-01

A new database of volcanic fatalities is presented and analysed, covering the period 1600 to 2010 AD. Data are from four sources: the Smithsonian Institution, Witham (2005), CRED EM-DAT and Munich RE. The data were combined and formatted, with a weighted average fatality figure used where more than one source reports an event; the former two databases were weighted twice as strongly as the latter two. More fatal incidents are contained within our database than similar previous works; approximately 46% of the fatal incidents are listed in only one of the four sources, and fewer than 10% are in all four. 278,880 fatalities are recorded in the database, resultant from 533 fatal incidents. The fatality count is dominated by a handful of disasters, though the majority of fatal incidents have caused fewer than ten fatalities. Number and empirical probability of fatalities are broadly correlated with VEI, but are more strongly influenced by population density around volcanoes and the occurrence and extent of lahars (mudflows) and pyroclastic density currents, which have caused 50% of fatalities. Indonesia, the Philippines, and the West Indies dominate the spatial distribution of fatalities, and there is some negative correlation between regional development and number of fatalities. With the largest disasters removed, over 90% of fatalities occurred between 5 km and 30 km from volcanoes, though the most devastating eruptions impacted far beyond these distances. A new measure, the Volcano Fatality Index, is defined to explore temporal changes in societal vulnerability to volcanic hazards. The measure incorporates population growth and recording improvements with the fatality data, and shows prima facie evidence that vulnerability to volcanic hazards has fallen during the last two centuries. Results and interpretations are limited in scope by the underlying fatalities data, which are affected by under-recording, uncertainty, and bias. Attempts have been made to estimate the extent of these issues, and to remove their effects where possible.The data analysed here are provided as supplementary material. An updated version of the Smithsonian fatality database fully integrated with this database will be publicly available in the near future and subsequently incorporate new data.

Fatal Airway Obstruction in a Man With a Cystic Hygroma.

PubMed

Wygant, Cassandra Maria; Cohle, Stephen D

2018-05-03

We describe a 24-year-old man with a cystic hygroma of the left side of the lower neck that led to sudden death. Cystic hygroma (cystic lymphangioma) is a congenital malformation of the lymphatic system. The patient, who had a tracheostomy because of airway obstruction from the cystic hygroma, was found dead with his tracheostomy tube on the floor next to him. Complications of cystic hygroma include infiltration of the neck causing airway obstruction, dysphagia, pain, and obstructive sleep apnea.

Aircraft Research and Technology for Antimisting Kerosene Conference, February 18-19, 1981.

DTIC Science & Technology

1981-06-01

carrier turbine aircraft fatal accidents from 1964 through 1976. Since antimisting fuel is intended to inhibit ignition and flame propagation when fuel is...been shown to be possible and rapid, although costly and complex. One item that should be added at this point is in the event turbine engine power...port side with 0.28 percent FM-9 fuel was ignited by the rocket motors. When the turbine engine separated from the wing, localized fire remained with

Dollars for lives: the effect of highway capital investments on traffic fatalities.

PubMed

Nguyen-Hoang, Phuong; Yeung, Ryan

2014-12-01

This study examines the effect of highway capital investments on highway fatalities. We used state-level data from the 48 contiguous states in the United States from 1968 through 2010 to estimate the effects on highway fatalities of capital expenditures and highway capital stock. We estimated these effects by controlling for a set of control variables together with state and year dummy variables and state-specific linear time trends. We found that capital expenditures and capital stock had significant and negative effects on highway fatalities. States faced with declines in gas tax revenues have already cut back drastically on spending on roads including on maintenance and capital outlay. If this trend continues, it may undermine traffic safety. While states and local governments are currently fiscally strained, it is important for them to continue investments in roadways to enhance traffic safety and, more significantly, to save lives. Copyright © 2014 National Safety Council and Elsevier Ltd. All rights reserved.

Global dengue death before and after the new World Health Organization 2009 case classification: A systematic review and meta-regression analysis.

PubMed

Low, Gary Kim-Kuan; Ogston, Simon A; Yong, Mun-Hin; Gan, Seng-Chiew; Chee, Hui-Yee

2018-06-01

Since the introduction of 2009 WHO dengue case classification, no literature was found regarding its effect on dengue death. This study was to evaluate the effect of 2009 WHO dengue case classification towards dengue case fatality rate. Various databases were used to search relevant articles since 1995. Studies included were cohort and cross-sectional studies, all patients with dengue infection and must report the number of death or case fatality rate. The Joanna Briggs Institute appraisal checklist was used to evaluate the risk of bias of the full-texts. The studies were grouped according to the classification adopted: WHO 1997 and WHO 2009. Meta-regression was employed using a logistic transformation (log-odds) of the case fatality rate. The result of the meta-regression was the adjusted case fatality rate and odds ratio on the explanatory variables. A total of 77 studies were included in the meta-regression analysis. The case fatality rate for all studies combined was 1.14% with 95% confidence interval (CI) of 0.82-1.58%. The combined (unadjusted) case fatality rate for 69 studies which adopted WHO 1997 dengue case classification was 1.09% with 95% CI of 0.77-1.55%; and for eight studies with WHO 2009 was 1.62% with 95% CI of 0.64-4.02%. The unadjusted and adjusted odds ratio of case fatality using WHO 2009 dengue case classification was 1.49 (95% CI: 0.52, 4.24) and 0.83 (95% CI: 0.26, 2.63) respectively, compared to WHO 1997 dengue case classification. There was an apparent increase in trend of case fatality rate from the year 1992-2016. Neither was statistically significant. The WHO 2009 dengue case classification might have no effect towards the case fatality rate although the adjusted results indicated a lower case fatality rate. Future studies are required for an update in the meta-regression analysis to confirm the findings. Copyright © 2018 Elsevier B.V. All rights reserved.

Effects of state-level policy changes on homicide and nonfatal shootings of law enforcement officers.

PubMed

Crifasi, Cassandra K; Pollack, Keshia M; Webster, Daniel W

2016-08-01

To evaluate the impact of state-level policy changes on assaults on law enforcement officers (LEOs) in the USA. Pooled time series and cross-sections with negative binomial regression were used to estimate the impact of state-level changes of right-to-carry (RTC), three-strikes and permit-to-purchase (PTP) handgun laws on fatal and non-fatal assaults of LEOs. LEO assaults were stratified by weapon type (all methods, handgun and non-handgun) and whether or not the assault was fatal. Data were collected from the Federal Bureau of Investigation's Law Enforcement Officers Killed and Assaulted database and analysed for the period 1984-2013 for fatal assaults and 1998-2013 for non-fatal assaults. RTC laws showed no association with fatal (p>0.4) or non-fatal (p>0.15) assaults on LEOs. Three-strikes laws were associated with a 33% increase in the risk of fatal assaults on LEOs. Connecticut's PTP law was not associated with fatal (p>0.16) or non-fatal (p>0.13) assaults. Missouri's repeal of its PTP legislation was marginally associated with a twofold increased risk of non-fatal handgun assaults (p=0.089). This research indicates that three-strikes laws increase the risk of fatal assaults. RTC laws are not associated with increased risk of assault. Missouri's PTP repeal may increase the risk of non-fatal handgun assaults. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

Neurological injuries from car surfing.

PubMed

Wang, Arthur; Cohen, Alan R; Robinson, Shenandoah

2009-11-01

Trauma secondary to car surfing is a unique mechanism of head and spinal injury in children and adolescents. In this study, the authors present their experience with neurological injuries resulting from car surfing and describe the growing national trend of car-surfing injuries and the increasing portrayal of this activity in the media. A retrospective study of the Rainbow Babies and Children's Hospital trauma database was conducted to identify all cases of neurological injuries secondary to car surfing. Between January 1995 and December 2008, 7 patients

Estimating effects of alcohol tax increases on highway fatalities

DOT National Transportation Integrated Search

1989-12-01

There can be no doubt that tax increases which raise the price of all alcoholic beverages : will reduce the overall consumption of alcohol which in turn will reduce highway : accidents and fatalities. Both theoretical reasoning about the effects of t...

Social class, Mexican culture, and fatalism: their effects on psychological distress.

PubMed

Ross, C E; Mirowsky, J; Cockerham, W C

1983-08-01

We examine the causes and consequences of fatalism in a cross-cultural setting, focusing on the ways in which a fatalistic world view may mediate the effects of social class and Mexican ethnic identity on psychological distress. We find that persons in the lower social classes and Mexicans tend to be more fatalistic than persons in the upper classes and Anglos, and that fatalism, in turn, increases psychological distress. We attempt to integrate research on the social and cultural determinants of cognitive orientations with studies of the effects of social class and Mexican culture on distress.

Cost effectiveness of a dealer's intervention in retrofitting rollover protective structures

PubMed Central

Myers, M; Cole, H; Westneat, S

2005-01-01

Objective: To evaluate the cost effectiveness of a 4.5 year education campaign that promoted farmers' adoption of rollover protective structures (ROPS) to prevent tractor overturn injuries. Design: Randomized controlled trial, decision analysis, and cost effectiveness analysis. Setting: One treatment county and one control county in the State of Kentucky. Intervention: A campaign by a local tractor and equipment dealership to encourage farmers to purchase and install ROPS and seatbelt retrofit kits for older tractors. Main outcome measures: Number of injuries averted and cost per injury averted. Results: The dealership's 4.5 year intervention was shown to potentially reduce both fatal (0.26) and non-fatal (1.50) injuries by 2.6% in its county over the intervention period using a 20 year analytic horizon. When extrapolated statewide, 6.7 lives would be saved and 39 non-fatal injuries would be averted over the combined 24.5 year combined intervention period and analytic horizon. The intervention for this period was cost effective with a "savings" of $35 713 per injury (fatal plus non-fatal) averted at a 4% discount rate. Conclusions: Tractor manufacturer promotions can influence their dealerships to promote ROPS retrofits by their customers. A manufacturer backed dealer ROPS retrofit campaign was cost effective in reducing overturn related injuries. PMID:15933410

Random parameter models of interstate crash frequencies by severity, number of vehicles involved, collision and location type.

PubMed

Venkataraman, Narayan; Ulfarsson, Gudmundur F; Shankar, Venky N

2013-10-01

A nine-year (1999-2007) continuous panel of crash histories on interstates in Washington State, USA, was used to estimate random parameter negative binomial (RPNB) models for various aggregations of crashes. A total of 21 different models were assessed in terms of four ways to aggregate crashes, by: (a) severity, (b) number of vehicles involved, (c) crash type, and by (d) location characteristics. The models within these aggregations include specifications for all severities (property damage only, possible injury, evident injury, disabling injury, and fatality), number of vehicles involved (one-vehicle to five-or-more-vehicle), crash type (sideswipe, same direction, overturn, head-on, fixed object, rear-end, and other), and location types (urban interchange, rural interchange, urban non-interchange, rural non-interchange). A total of 1153 directional road segments comprising of the seven Washington State interstates were analyzed, yielding statistical models of crash frequency based on 10,377 observations. These results suggest that in general there was a significant improvement in log-likelihood when using RPNB compared to a fixed parameter negative binomial baseline model. Heterogeneity effects are most noticeable for lighting type, road curvature, and traffic volume (ADT). Median lighting or right-side lighting are linked to increased crash frequencies in many models for more than half of the road segments compared to both-sides lighting. Both-sides lighting thereby appears to generally lead to a safety improvement. Traffic volume has a random parameter but the effect is always toward increasing crash frequencies as expected. However that the effect is random shows that the effect of traffic volume on crash frequency is complex and varies by road segment. The number of lanes has a random parameter effect only in the interchange type models. The results show that road segment-specific insights into crash frequency occurrence can lead to improved design policy and project prioritization. Copyright © 2013 Elsevier Ltd. All rights reserved.

Trends in rates of occupational fatal injuries in the United States (1983-92).

PubMed

Bailer, A J; Stayner, L T; Stout, N A; Reed, L D; Gilbert, S J

1998-07-01

An updated version of a national surveillance system of traumatic occupational fatalities was used to explore adjusted and unadjusted trends in rates of fatal injury. Data from the national traumatic occupational fatalities surveillance system were combined with data on employment from the United States Bureau of Labor Statistics. Poisson regression was then used to examine trends in rates of occupational fatality injuries while controlling for demographic and workplace characteristics. Adjusted annual changes in rates of fatal injuries ranged from a decline of 6.2% for workers in technical and administrative support occupations--for example, health, science, and engineering technicians, pilots, computer programmers--to an increase of 1.6% in machine operators, assemblers, and inspectors. For industries, annual changes ranged from a decline of 5.3% for workers in public administration--for example, justice, public order, and safety workers--to an increase of 2.6% for workers in the wholesale trade. By comparison, the annual decline over all industries and occupations was 3.1%. In many industries and occupations, an effect modification of annual trends by the age of the worker was also found with the oldest workers experiencing either no decline or a significant increase in rates of fatal injuries. This general pattern of decline, adjusted for the effects of demographic characteristics of the worker population, is encouraging; however, increases in rates of fatal injuries found in particular industries and occupations, suggest appropriate targets for increased injury prevention efforts.

Trends in rates of occupational fatal injuries in the United States (1983-92)

PubMed Central

Bailer, A. J.; Stayner, L. T.; Stout, N. A.; Reed, L. D.; Gilbert, S. J.

1998-01-01

OBJECTIVES: An updated version of a national surveillance system of traumatic occupational fatalities was used to explore adjusted and unadjusted trends in rates of fatal injury. METHODS: Data from the national traumatic occupational fatalities surveillance system were combined with data on employment from the United States Bureau of Labor Statistics. Poisson regression was then used to examine trends in rates of occupational fatality injuries while controlling for demographic and workplace characteristics. RESULTS: Adjusted annual changes in rates of fatal injuries ranged from a decline of 6.2% for workers in technical and administrative support occupations--for example, health, science, and engineering technicians, pilots, computer programmers--to an increase of 1.6% in machine operators, assemblers, and inspectors. For industries, annual changes ranged from a decline of 5.3% for workers in public administration--for example, justice, public order, and safety workers--to an increase of 2.6% for workers in the wholesale trade. By comparison, the annual decline over all industries and occupations was 3.1%. In many industries and occupations, an effect modification of annual trends by the age of the worker was also found with the oldest workers experiencing either no decline or a significant increase in rates of fatal injuries. CONCLUSIONS: This general pattern of decline, adjusted for the effects of demographic characteristics of the worker population, is encouraging; however, increases in rates of fatal injuries found in particular industries and occupations, suggest appropriate targets for increased injury prevention efforts.   PMID:9816383

The impact of bleeding complications in patients receiving target-specific oral anticoagulants: a systematic review and meta-analysis.

PubMed

Chai-Adisaksopha, Chatree; Crowther, Mark; Isayama, Tetsuya; Lim, Wendy

2014-10-09

Vitamin K antagonists (VKAs) have been the standard of care for treatment of thromboembolic diseases. Target-specific oral anticoagulants (TSOACs) have been developed and found to be at least noninferior to VKAs with regard to efficacy, but the risk of bleeding with TSOACs remains controversial. We performed a systematic review and meta-analysis of phase-3 randomized controlled trials (RCTs) to assess the bleeding side effects of TSOACs compared with VKAs in patients with venous thromboembolism or atrial fibrillation. We searched MEDLINE, EMBASE, and Cochrane Central Register of Controlled Trials; conference abstracts; and www.clinicaltrials.gov with no language restriction. Two reviewers independently performed study selection, data extraction, and study quality assessment. Twelve RCTs involving 102 607 patients were retrieved. TSOACs significantly reduced the risk of overall major bleeding (relative risk [RR] 0.72, P < .01), fatal bleeding (RR 0.53, P < .01), intracranial bleeding (RR 0.43, P < .01), clinically relevant nonmajor bleeding (RR 0.78, P < .01), and total bleeding (RR 0.76, P < .01). There was no significant difference in major gastrointestinal bleeding between TSOACs and VKAs (RR 0.94, P = .62). When compared with VKAs, TSOACs are associated with less major bleeding, fatal bleeding, intracranial bleeding, clinically relevant nonmajor bleeding, and total bleeding. Additionally, TSOACs do not increase the risk of gastrointestinal bleeding. © 2014 by The American Society of Hematology.

The hazards of eruptions through lakes and seawater

USGS Publications Warehouse

Mastin, L.G.; Witter, J.B.

2000-01-01

Eruptions through crater lakes or shallow seawater, referred to here as subaqueous eruptions, present hazards from hydromagmatic explosions, such as base surges, lahars, and tsunamis, which may not exist at volcanoes on dry land. We have systematically compiled information from eruptions through surface water in order to understand the circumstances under which these hazards occur and what disastrous effects they have caused in the past. Subaqueous eruptions represent only 8% of all recorded eruptions but have produced about 20% of all fatalities associated with volcanic activity in historical time. Excluding eruptions that have resulted in about a hundred deaths or less, lahars have killed people in the largest number of historical subaqueous eruptions (8), followed by pyroclastic flows (excluding base surges; 5) tsunamis (4), and base surges (2). Subaqueous eruptions have produced lahars primarily on high (>1000 m), steep-sided volcanoes containing small (<1 km diameter) crater lakes. Tsunamis and other water waves have caused death or destroyed man-made structures only at submarine volcanoes and at Lake Taal in the Philippines. In spite of evidence that magma-water mixing makes eruptions more explosive, such explosions and their associated base surges have caused fewer deaths, and have been implicated in fewer eruptions involving large numbers of fatalities than lahars and tsunamis. The latter hazards are more deadly because they travel much farther from a volcano and inundate coastal areas and stream valleys that tend to be densely settled.

Socioeconomic Disparities in Fatalistic Beliefs About Cancer Prevention and the Internet

PubMed Central

Lee, Chul-joo; Niederdeppe, Jeff; Freres, Derek

2014-01-01

Given the importance of public information environment in cancer control, it is theoretically and practically important to explore how people's media use to acquire health information influences their beliefs about cancer prevention. In the current research, we focus on the role of the Internet in shaping fatalistic beliefs about cancer prevention (cancer fatalism). To be more specific, we examine the effect of Internet use for health information on changes in cancer fatalism using a 2-wave nationally representative survey. We then investigate whether the effect of Internet use on cancer fatalism is moderated by education and health knowledge. Health-related Internet use reduced cancer fatalism only among those with average and lower than the average levels of education and health knowledge. PMID:25530627

Hemodialysis-refractory metformin-associated lactate acidosis with hypoglycemia, hypothermia, and bradycardia in a diabetic patient with belated diagnosis and chronic kidney disease
.

PubMed

Zibar, Lada; Zibar, Karin

2017-04-01

Metformin is a first-line oral antidiabetic therapy for patients with type 2 diabetes mellitus. Metformin-associated lactate acidosis (MALA) is a well-known, life-threatening, but rare side effect of metformin therapy. Chronic kidney disease (CKD) patients have a much greater risk of MALA. We report the case of a severe refractory MALA despite hemodialysis (HD) treatment, associated with hypoglycemia, hypothermia, and bradycardia in a neglected and thus untimely-recognized CKD patient with type 2 diabetes mellitus. Despite the recent rehabilitation of metformin as a treatment of choice for type 2 diabetes mellitus, the drug should be prescribed with caution as it can be associated with life-threatening refractory acidosis, particularly in CKD patients. Moreover, HD treatment could occasionally be ineffective, resulting in a fatal outcome.
.

Vasoactive Intestinal Peptide Inhibits Human Small-Cell Lung Cancer Proliferation in vitro and in vivo

NASA Astrophysics Data System (ADS)

Maruno, Kaname; Absood, Afaf; Said, Sami I.

1998-11-01

Small-cell lung carcinoma (SCLC) is an aggressive, rapidly growing and metastasizing, and highly fatal neoplasm. We report that vasoactive intestinal peptide inhibits the proliferation of SCLC cells in culture and dramatically suppresses the growth of SCLC tumor-cell implants in athymic nude mice. In both cases, the inhibition was mediated apparently by a cAMP-dependent mechanism, because the inhibition was enhanced by the adenylate cyclase activator forskolin and the phosphodiesterase inhibitor 3-isobutyl-1-methylxanthine in proportion to increases in intracellular cAMP levels, and the inhibition was abolished by selective inhibition of cAMP-dependent protein kinase. If confirmed in clinical trials, this antiproliferative action of vasoactive intestinal peptide may offer a new and promising means of suppressing SCLC in human subjects, without the toxic side effects of chemotherapeutic agents.

On the potential of acarbose to reduce cardiovascular disease

PubMed Central

2014-01-01

In the emerging landscape of cardiovascular (CV) outcome trials evaluating the effects of blood glucose lowering drugs in individuals with type 2 diabetes, it is becoming increasingly apparent that since the promising signals coming from the United Kingdom Prospective Diabetes Study (UKPDS) no unequivocal benefits have been established for any single therapy thus far. There is an unmet need for introducing an effective pharmacological agent which could target both correlates of glycaemic regulation and CV risk factors, to ameliorate the enormous burden of fatal and non-fatal CV events in diabetic patients. Acarbose, like other alpha-glucosidase inhibitors (AGIs), has been proven to be an effective antidiabetic treatment for decades, but the overall significant impact of this class of drugs on modulating CV risk has only recently been appreciated. Accumulating evidence has shown that apart from its multiple effects on primarily postprandial glucose dysmetabolism, a key component of mechanisms linked to increased incidence of CV events, acarbose therapy also associates with a favorable impact on an array of surrogate markers of CV disease. Data stemming from in vitro testing of human cell lines as well as from preliminary trials in diabetic populations, like the Study to Prevent Non-Insulin-Dependent Diabetes Mellitus (STOP-NIDDM) trial, have highlighted – though not undisputed – the potential beneficial effects of the drug on CV morbidity. Large scale trials, like the ongoing Acarbose Cardiovascular Evaluation (ACE) trial, aim at conclusively establishing such a positive effect in patients with coronary heart disease and impaired glucose tolerance. In view of its usually acceptable level of side effects that are, if they occur, mostly limited to transient gastrointestinal symptoms, acarbose could well be a strong future player in CV disease secondary prevention. Current discouraging results from many trials of antidiabetic medications to significantly lower CV event rates in diabetic patients, should only draw further attention on alternative glucose lowering agents, among which acarbose is indeed promising. PMID:24742256

On the potential of acarbose to reduce cardiovascular disease.

PubMed

Standl, Eberhard; Theodorakis, Michael J; Erbach, Michael; Schnell, Oliver; Tuomilehto, Jaakko

2014-04-16

In the emerging landscape of cardiovascular (CV) outcome trials evaluating the effects of blood glucose lowering drugs in individuals with type 2 diabetes, it is becoming increasingly apparent that since the promising signals coming from the United Kingdom Prospective Diabetes Study (UKPDS) no unequivocal benefits have been established for any single therapy thus far. There is an unmet need for introducing an effective pharmacological agent which could target both correlates of glycaemic regulation and CV risk factors, to ameliorate the enormous burden of fatal and non-fatal CV events in diabetic patients. Acarbose, like other alpha-glucosidase inhibitors (AGIs), has been proven to be an effective antidiabetic treatment for decades, but the overall significant impact of this class of drugs on modulating CV risk has only recently been appreciated. Accumulating evidence has shown that apart from its multiple effects on primarily postprandial glucose dysmetabolism, a key component of mechanisms linked to increased incidence of CV events, acarbose therapy also associates with a favorable impact on an array of surrogate markers of CV disease. Data stemming from in vitro testing of human cell lines as well as from preliminary trials in diabetic populations, like the Study to Prevent Non-Insulin-Dependent Diabetes Mellitus (STOP-NIDDM) trial, have highlighted - though not undisputed - the potential beneficial effects of the drug on CV morbidity. Large scale trials, like the ongoing Acarbose Cardiovascular Evaluation (ACE) trial, aim at conclusively establishing such a positive effect in patients with coronary heart disease and impaired glucose tolerance. In view of its usually acceptable level of side effects that are, if they occur, mostly limited to transient gastrointestinal symptoms, acarbose could well be a strong future player in CV disease secondary prevention. Current discouraging results from many trials of antidiabetic medications to significantly lower CV event rates in diabetic patients, should only draw further attention on alternative glucose lowering agents, among which acarbose is indeed promising.

Female compared with male fatality risk from similar physical impacts.

PubMed

Evans, L

2001-02-01

If a female and a male suffer similar potentially lethal physical impacts, which of them (other factors being equal) is more likely to die? This question is addressed using 245,836 traffic fatalities. Fatality risk ratios were estimated using crash data for cars, light trucks, and motorcycles with two occupants, at least one being killed. Combinations of seat belt use, helmet use, and seating location led to 14 occupant categories. Relationships between fatality risk and gender are similar for all 14 occupant categories. Female fatality risk exceeds male risk from preteens to late 50s. For ages from about 20 to about 35, female risk exceeds male risk by (28 +/- 3)%. Whereas specific injury mechanisms differ greatly between the 14 occupant categories, the effect of gender on fatality risk does not, thus implying that the relationships reflect fundamental gender-dependent differences.

Effects of Dram Shop, Responsible Beverage Service Training, and State Alcohol Control Laws on Underage Drinking Driver Fatal Crash Ratios.

PubMed

Scherer, Michael; Fell, James C; Thomas, Sue; Voas, Robert B

2015-01-01

In this study, we aimed to determine whether three minimum legal drinking age 21 (MLDA-21) laws-dram shop liability, responsible beverage service (RBS) training, and state control of alcohol sales-have had an impact on underage drinking and driving fatal crashes using annual state-level data, and compared states with strong laws to those with weak laws to examine their effect on beer consumption and fatal crash ratios. Using the Fatality Analysis Reporting System, we calculated the ratio of drinking to nondrinking drivers under age 21 involved in fatal crashes as our key outcome measure. We used structural equation modeling to evaluate the three MLDA-21 laws. We controlled for covariates known to impact fatal crashes including: 17 additional MLDA-21 laws; administrative license revocation; blood alcohol concentration limits of.08 and.10 for driving; seat belt laws; sobriety checkpoint frequency; unemployment rates; and vehicle miles traveled. Outcome variables, in addition to the fatal crash ratios of drinking to nondrinking drivers under age 21 included state per capita beer consumption. Dram shop liability laws were associated with a 2.4% total effect decrease (direct effects: β =.019, p =.018). Similarly, RBS training laws were associated with a 3.6% total effect decrease (direct effect: β =.048, p =.001) in the ratio of drinking to nondrinking drivers under age 21 involved in fatal crashes. There was a significant relationship between dram shop liability law strength and per capita beer consumption, F (4, 1528) = 24.32, p <.001, partial η(2) =.016, showing states with strong dram shop liability laws (Mean (M) = 1.276) averaging significantly lower per capita beer consumption than states with weak laws (M = 1.340). Dram shop liability laws and RBS laws were both associated with significantly reduced per capita beer consumption and fatal crash ratios. In practical terms, this means that dram shop liability laws are currently associated with saving an estimated 64 lives in the 45 jurisdictions that currently have the law. If the remaining 6 states adopted the dram shop law, an additional 9 lives could potentially be saved annually. Similarly, RBS training laws are associated with saving an estimated 83 lives in the 37 jurisdictions that currently have the laws. If the remaining 14 states adopted these RBS training laws, we estimate that an additional 28 lives could potentially be saved.

Effects of Dram Shop, Responsible Beverage Service Training, and State Alcohol Control Laws on Underage Drinking Driver Fatal Crash Ratios

PubMed Central

Scherer, Michael; Fell, James C.; Thomas, Sue; Voas, Robert B.

2015-01-01

Objectives In this study, we aimed to determine whether three minimum legal drinking age 21 (MLDA-21) laws—dram shop liability, responsible beverage service (RBS) training, and state control of alcohol sales—have had an impact on underage drinking-and-driving fatal crashes using annual state-level data, and compared states with strong laws to those with weak laws to examine their effect on beer consumption and fatal crash ratios. Methods Using the Fatality Analysis Reporting System, we calculated the ratio of drinking to nondrinking drivers under age 21 involved in fatal crashes as our key outcome measure. We used structural equation modeling to evaluate the three MLDA-21 laws. We controlled for covariates known to impact fatal crashes including: 17 additional MLDA-21 laws; administrative license revocation; blood alcohol concentration limits of .08 and .10 for driving; seat belt laws; sobriety checkpoint frequency; unemployment rates; and vehicle miles traveled. Outcome variables, in addition to the fatal crash ratios of drinking to nondrinking drivers under age 21 included state per capita beer consumption. Results Dram shop liability laws were associated with a 2.4% total effect decrease (direct effects: β = .019, p = .018). Similarly, RBS training laws were associated with a 3.6% total effect decrease (direct effects: β = .048, p = .001) in the ratio of drinking to nondrinking drivers under age 21 involved in fatal crashes. There was a significant relationship between dram shop liability law strength and per capita beer consumption, F (4, 1528) = 24.32, p < .001, partial η2 = .016, showing states with strong dram shop liability laws (Mean (M) = 1.276) averaging significantly lower per capita beer consumption than states with weak laws (M = 1.340). Conclusions Dram shop liability laws and RBS laws were both associated with significantly reduced per capita beer consumption and fatal crash ratios. In practical terms, this means that dram shop liability laws are currently associated with saving an estimated 64 lives in the 45 jurisdictions that currently have the law. If the remaining 6 states adopted the dram shop law, an additional 9 lives could potentially be saved annually. Similarly, RBS training laws are associated with saving an estimated 83 lives in the 37 jurisdictions that currently have the law. If the remaining 14 states adopted these RBS training laws, we estimate that an additional 28 lives could potentially be saved. PMID:26436244

Reported fatal and non-fatal incidents involving tourists in Hawaii Volcanoes National Park, 1992-2002.

PubMed

Heggie, Travis W

2005-08-01

Objectives. To examine fatal and non-fatal incidents involving tourists in Hawaii Volcanoes National Park. Methods. Official press releases from the public relations office at Hawaii Volcanoes National Park were examined for reports of fatal and non-fatal incidents involving tourists. Results. Between 1992 and 2002 there were 65 press releases reporting 40 fatalities, 45 serious injuries, 53 minor injuries, and 25 no injury events. Severity information was unavailable for four additional tourists. Aircraft and backcountry incidents each accounted for 30% of all incidents followed by road incidents (22%) and frontcountry incidents (17%). Aircraft incidents reported 17 fatalities, backcountry incidents accounted for 10 fatalities, frontcountry incidents reported seven fatalities, and road incidents totaled six fatalities. One fatality was classified as a suicide. Backcountry (23) and road (10) incidents had the highest number of serious incidents. Male tourists (62) were more frequently involved in incidents than female tourists (41) and tourists aged 20-29 years and 40-49 years accounted for the highest number of fatalities and total incidents. Conclusions. Helicopter tours, hiking in areas with active lava flows, falls into steam vents and earthcracks, and driving unfamiliar rental cars in unfamiliar locations are the major activities resulting in death and serious injury. Additional factors such as tourists ignoring warning signs, wandering off-trail or hiking at night, tourists misinformed by guidebooks and other tourists, and tourists with pre-existing heart and asthma conditions are contributing causes in many incidents. The findings of this study provide information that allows prospective tourists, tourism managers, and travel health providers make informed decisions that promote safe tourism and can aid future efforts in developing preventative strategies at tourist destinations with similar environments and activities. However, in order for preventative strategies to be most effective, future research using medical or emergency response records and employing an injury epidemiology framework that identifies the cause of fatal and non-fatal injuries is recommended.

[Tranexamic acid as first-line emergency treatment for episodes of bradykinin-mediated angioedema induced by ACE inhibitors].

PubMed

Beauchêne, C; Martins-Héricher, J; Denis, D; Martin, L; Maillard, H

2018-05-04

Episodes of acquired bradykinin-mediated angioedema due to angiotensin-converting enzyme (ACE) inhibitors may result in fatal outcomes. There is no consensus regarding emergency pharmacological management of these episodes. Treatment options include icatibant and C1INH concentrate. Tranexamic acid is administered for moderate episodes. Its efficacy in the treatment of ACE inhibitor-induced episodes of angioedema is not established. The aim of this retrospective study is to assess the benefits of emergency tranexamic acid administration in the management of ACE inhibitor-induced episodes of angioedema. Retrospective analysis of the medical files of patients who consulted between 2010 and 2016 in two French tertiary care hospitals for a bradykinic angioedema attributed to an ACE treatment. All of them had received tranexamic acid as a first line treatment. Thirty three patients who had experienced severe episode of angioedema were included. Twenty seven patients showed significant improvement when treated with tranexamic acid alone. The six remaining patients were treated with icatibant (5/33) or C1INH concentrate (1/33), due to partial improvement after tranexamic acid therapy. None of the patients were intubated, no fatalities were recorded and no side effects were reported. Tranexamic acid is an easily accessible and affordable therapy that may provide effective treatment for ACE inhibitor-induced episodes of angioedema. It may help while waiting for a more specific treatment (icatibant and C1INH concentrate) that is at times unavailable in emergency departments. Copyright © 2018 Société Nationale Française de Médecine Interne (SNFMI). Published by Elsevier SAS. All rights reserved.

Rush immunotherapy for wasp venom allergy seems safe and effective in patients with mastocytosis.

PubMed

Verburg, M; Oldhoff, J M; Klemans, R J B; Lahey-de Boer, A; de Bruin-Weller, M S; Röckmann, H; Sanders, C; Bruijnzeel-Koomen, C A F M; Pasmans, S G M A; Knulst, A C

2015-11-01

Patients with mastocytosis and wasp venom allergy (WA) may benefit from venom immunotherapy (VIT). However, fatal insect sting reactions have been described in mastocytosis patients despite previous immunotherapy. We investigated the safety and efficacy of (rush) VIT in patients with mastocytosis and WA. To investigate the safety and efficacy of (rush) VIT in patients with mastocytosis and WA. We describe nine patients with cutaneous mastocytosis and WA who received VIT. Cutaneous mastocytosis was confirmed by histopathology and systemic mastocytosis was diagnosed according to World Health Organization criteria. VIT was given according to a rush protocol. Given the difference in safety and efficacy of VIT in patients with WA and honeybee venom allergy, we reviewed the literature for VIT with the focus on WA patients with mastocytosis and addressed the difference between patients with cutaneous versus systemic mastocytosis. Nine patients had WA and mastocytosis, of whom six had cutaneous mastocytosis, two combined cutaneous and systemic mastocytosis and one systemic mastocytosis. All patients received rush IT with wasp venom. Most patients had only mild local side effects, with no systemic side effects during the course of VIT. One patient had a systemic reaction upon injection on one occasion, during the updosing phase, with dyspnoea and hypotension, but responded well to treatment. Immunotherapy was continued after temporary dose adjustment without problems. Two patients with a previous anaphylactic reaction were re-stung, without any systemic effects. VIT is safe in cutaneous mastocytosis patients with WA, while caution has to be made in case of systemic mastocytosis. VIT was effective in the patients who were re-stung.

An Analysis of the Relationship between Casualty Risk Per Crash and Vehicle Mass and Footprint for Model Year 2000-2007 Light-Duty Vehicles

DOE Office of Scientific and Technical Information (OSTI.GOV)

Wenzel, Tom

2012-08-01

NHTSA recently completed a logistic regression analysis (Kahane 2012) updating its 2003 and 2010 studies of the relationship between vehicle mass and US fatality risk per vehicle mile traveled (VMT). The new study updates the previous analyses in several ways: updated FARS data for 2002 to 2008 involving MY00 to MY07 vehicles are used; induced exposure data from police reported crashes in several additional states are added; a new vehicle category for car-based crossover utility vehicles (CUVs) and minivans is created; crashes with other light-duty vehicles are divided into two groups based on the crash partner vehicle’s weight, and amore » category for all other fatal crashes is added; and new control variables for new safety technologies and designs, such as electronic stability controls (ESC), side airbags, and methods to meet voluntary agreement to improve light truck compatibility with cars, are included.« less

Graduated licensing laws and fatal crashes of teenage drivers: a national study.

PubMed

McCartt, Anne T; Teoh, Eric R; Fields, Michele; Braitman, Keli A; Hellinga, Laurie A

2010-06-01

The objective of the current study was to quantify the effects of the strength of US state graduated driver licensing laws and specific licensing components on the rate of teenage driver fatal crash involvements per 100,000 teenagers during 1996-2007. The strengths of state laws were rated good, fair, marginal, or poor based on a system developed previously by the Insurance Institute for Highway Safety. Analysis was based on quarterly counts of drivers involved in fatal crashes. Associations of overall ratings and individual licensing components with teenage crash rates were evaluated using Poisson regression, with the corresponding fatal crash rate for drivers ages 30-59 controlling for state- or time-dependent influences on crash rates unrelated to graduated licensing laws. Compared with licensing laws rated poor, laws rated good were associated with 30 percent lower fatal crash rates among 15- to 17-year-olds. Laws rated fair yielded fatal crash rates 11 percent lower. The longer the permit age was delayed, or the longer the licensing age was delayed, the lower the estimated fatal crash rates among 15- to 17-year-olds. Stronger nighttime restrictions were associated with larger reductions, and reductions were larger for laws limiting teenage passengers to zero or one than laws allowing two or more teenage passengers or laws without passenger restrictions. After the effects of any related delay in licensure were accounted for, an increase in the minimum learner's permit holding period showed no association with fatal crash rates. An increase in required practice driving hours did not appear to have an independent association with fatal crash rates. Graduated licensing laws that include strong nighttime and passenger restrictions and laws that delay the learner's permit age and licensing age are associated with lower teenage fatal crash rates. States that adopt such laws can expect to achieve substantial reductions in crash deaths.

Fire fighter fatalities 1998–2001: overview with an emphasis on structure related traumatic fatalities

PubMed Central

Hodous, T; Pizatella, T; Braddee, R; Castillo, D

2004-01-01

Objective: To review the causes of all fire fighter line-of-duty-deaths from 1998 through 2001, and present recommendations for preventing fatalities within the specific subgroup of structure related events. Methods: Fire fighter fatality data from the United States Fire Administration were reviewed and classified into three main categories of injury. Investigations conducted through the National Institute for Occupational Safety and Health (NIOSH) Fire Fighter Fatality Investigation and Prevention Program provided the basis for the recommendations presented in this paper. Results: During the time period from 1998–2001, there were 410 line-of-duty deaths among fire fighters in the United States, excluding the 343 fire fighters who died at the World Trade Center on 11 September 2001. The 410 fatalities included 191 medical (non-traumatic) deaths (47%), 75 motor vehicle related fatalities (18%), and 144 other traumatic fatalities (35%). The latter group included 68 fatalities that were associated with structures which commonly involved structural collapse, rapid fire progression, and trapped fire fighters. Conclusions: Structural fires pose particular hazards to fire fighters. Additional efforts must be directed to more effectively use what we have learned through the NIOSH investigations and recommendations from published experts in the safety community, consensus standards, and national fire safety organizations to reduce fire fighter fatalities during structural fire fighting. PMID:15314049

The turning point in the number of traffic fatalities: two hypotheses about changes in underlying trends.

PubMed

Brüde, Ulf; Elvik, Rune

2015-01-01

The number of traffic fatalities reached a peak in many highly motorised countries around 1970. Some previous studies have suggested that the turning point in the number of traffic fatalities was inevitable and did not reflect a change in the underlying trends influencing the number of traffic fatalities. Other studies suggest that trends in traffic growth and fatality rate changed from before to after the turning point. This paper proposes two hypotheses about the turning point in the number of traffic fatalities. One hypothesis is that the long-term trends in traffic growth and fatality rate were the same before and after the turning point. The other hypothesis is that the long-term trends in traffic growth and fatality rate were different before and after the turning point was reached, in particular that the annual percentage decline in fatality rate became greater after the turning point than before. Such a change would suggest that road safety policy became more effective. Analysis of data for six countries (Denmark, Great Britain, Netherlands, Norway, Sweden, United States) lends stronger support to the latter hypothesis than to the former. The lesson for policy makers, in particular in countries where the number of traffic fatalities is still growing, is that they should not expect a turning point to be reached without policy interventions. Copyright © 2014 Elsevier Ltd. All rights reserved.

Substance use and its implications for the critical care nurses: a literature review.

PubMed

Brotto, Vanessa; Lee, Geraldine

2007-04-01

Illicit drug use in Australia has been increasing and studies indicate that illicit drug users have a higher risk of accidents which may result in the user needing critical care. However, there is a significant gap in the literature specifically pertaining to the implications of drug use in critical care. The primary objective was to examine the literature for the physiological effects of methylenedioxymethamphetamine (MDMA), cocaine and amphetamines in critically ill patients. A comprehensive literature review was undertaken and a body systems framework was used to categorise the effects of these illicit drugs. The illicit substances addressed have potentially fatal and long-term side effects. For those users involved in accidents or trauma requiring intensive or critical care nursing, the mortality and co-morbidity risks are increased significantly. It is, therefore, important that nurses are able to recognise the specific physiological effects and possible complications that can occur with the use of each illicit drug. Both nursing and medical staff need to have a thorough understanding of how illicit substances work and how they can affect the critical care patient and the care they are given.

Fatal crash involvement and laws against alcohol-impaired driving.

PubMed

Zador, P L; Lund, A K; Fields, M; Weinberg, K

1989-01-01

It is estimated that in 1985 about 1,560 fewer drivers were involved in fatal crashes because of three types of drinking-driving laws. The laws studied were per se laws that define driving under the influence using blood alcohol concentration (BAC) thresholds; laws that provide for administrative license suspension or revocation prior to conviction for driving under the influence (often referred to as "administrative per se" laws); and laws that mandate jail or community service for first convictions of driving under the influence. It is estimated that if all 48 of the contiguous states adopted laws similar to those studied here, and if these new laws had effects comparable to those reported here, another 2,600 fatal driver involvements could be prevented each year. During hours when typically at least half of all fatally injured drivers have a BAC over 0.10 percent, administrative suspension/revocation is estimated to reduce the involvement of drivers in fatal crashes by about 9 percent; during the same hours, first offense mandatory jail/community service laws are estimated to have reduced driver involvement by about 6 percent. The effect of per se laws was estimated to be a 6 percent reduction during hours when fatal crashes typically are less likely to involve alcohol. These results are based on analyses of drivers involved in fatal crashes in the 48 contiguous states of the United States during the years 1978 to 1985.

Doping and thrombosis in sports.

PubMed

Lippi, Giuseppe; Banfi, Giuseppe

2011-11-01

Historically, humans have long sought to enhance their "athletic" performance to increase body weight, aggressiveness, mental concentration and physical strength, contextually reducing fatigue, pain, and improving recovery. Although regular training is the mainstay for achieving these targets, the ancillary use of ergogenic aids has become commonplace in all sports. The demarcation between ergogenic aids and doping substances or practices is continuously challenging and mostly based on perceptions regarding the corruption of the fairness of competition and the potential side effects or adverse events arising from the use of otherwise unnecessary ergogenic substances. A kaleidoscope of side effects has been associated with the use of doping agents, including behavioral, skeletal, endocrinologic, metabolic, hemodynamic, and cardiovascular imbalances. Among the various doping substances, the most striking association with thrombotic complications has been reported for androgenic anabolic steroids (i.e., cardiomyopathy, fatal and nonfatal arrhythmias, myocardial infarction [MI], intracardiac thrombosis, stroke, venous thromboembolism [VTE], limb arterial thrombosis, branch retinal vein occlusion, cerebral venous sinus thrombosis) and blood boosting (i.e., VTE and MI, especially for epoetin and analogs). The potential thrombotic complication arising from misuse of other doping agents such as the administration of cortisol, growth hormone, prolactin, cocaine, and platelet-derived preparations is instead speculative or anecdotal at best. The present article provides an overview on the epidemiological association as well as the underlying biochemical and biological mechanisms linking the practice of doping in sports with the development of thrombosis. © Thieme Medical Publishers.

Topical Medical Cannabis: A New Treatment for Wound Pain-Three Cases of Pyoderma Gangrenosum.

PubMed

Maida, Vincent; Corban, Jason

2017-11-01

Pain associated with integumentary wounds is highly prevalent, yet it remains an area of significant unmet need within health care. Currently, systemically administered opioids are the mainstay of treatment. However, recent publications are casting opioids in a negative light given their high side effect profile, inhibition of wound healing, and association with accidental overdose, incidents that are frequently fatal. Thus, novel analgesic strategies for wound-related pain need to be investigated. The ideal methods of pain relief for wound patients are modalities that are topical, lack systemic side effects, noninvasive, self-administered, and display rapid onset of analgesia. Extracts derived from the cannabis plant have been applied to wounds for thousands of years. The discovery of the human endocannabinoid system and its dominant presence throughout the integumentary system provides a valid and logical scientific platform to consider the use of topical cannabinoids for wounds. We are reporting a prospective case series of three patients with pyoderma gangrenosum that were treated with topical medical cannabis compounded in nongenetically modified organic sunflower oil. Clinically significant analgesia that was associated with reduced opioid utilization was noted in all three cases. Topical medical cannabis has the potential to improve pain management in patients suffering from wounds of all classes. Copyright © 2017 American Academy of Hospice and Palliative Medicine. Published by Elsevier Inc. All rights reserved.

Non-nosocomial healthcare-associated left-sided Pseudomonas aeruginosa endocarditis: a case report and literature review.

PubMed

Hagiya, Hideharu; Tanaka, Takeshi; Takimoto, Kohei; Yoshida, Hisao; Yamamoto, Norihisa; Akeda, Yukihiro; Tomono, Kazunori

2016-08-20

With the development of invasive medical procedures, an increasing number of healthcare-associated infective endocarditis cases have been reported. In particular, non-nosocomial healthcare-associated infective endocarditis in outpatients with recent medical intervention has been increasingly identified. A 66-year-old man with diabetes mellitus and a recent history of intermittent urethral self-catheterization was admitted due to a high fever. Repeated blood cultures identified Pseudomonas aeruginosa, and transesophageal echocardiography uncovered a new-onset severe aortic regurgitation along with a vegetative valvular structure. The patient underwent emergency aortic valve replacement surgery and was successfully treated with 6 weeks of high-dose meropenem and tobramycin. Historically, most cases of P. aeruginosa endocarditis have occurred in the right side of the heart and in outpatients with a history of intravenous drug abuse. In the case presented, the repeated manipulations of the urethra may have triggered the infection. Our literature review for left-sided P. aeruginosa endocarditis showed that non-nosocomial infection accounted for nearly half of the cases and resulted in fatal outcomes as often as nosocomial cases. A combination therapy with anti-pseudomonal beta-lactams or carbapenems and aminoglycosides may be the preferable treatment. Medical treatment alone may be effective, and surgical treatment should be carefully considered. We presented a rare case of native aortic valve endocarditis caused by P. aeruginosa. This case illustrates the importance of identifying the causative pathogen(s), especially for outpatients with a recent history of medical procedures.

Is there a pattern in European bus and coach incidents? A literature analysis with special focus on injury causation and injury mechanisms.

PubMed

Albertsson, Pontus; Falkmer, Torbjörn

2005-03-01

In order to identify and describe a pattern in bus and coach incident related injuries and fatalities, and to suggest possible future measures for improvement of bus and coach safety, a literature analysis was performed. The results formed a multi-faceted pattern, which briefly can be described as follows; women travelled more frequently by bus as compared to men. Injuries sustained predominantly affected women 60 years of age and older. Of all traffic fatalities in Europe, bus and coach fatalities represented 0.3-0.5%. In the OECD countries, the risk of being killed or seriously injured was found to be seven to nine times lower for bus and coach occupants as compared to those of car occupants. Despite the fact that fatalities were more frequent on rural roads, a vast majority of all bus and coach casualties occurred on urban roads and in dry weather conditions. Boarding and alighting caused about one-third of all injury cases. Collisions were a major injury-contributing factor. Buses and coaches most frequently collided with cars, but unprotected road users were hit in about one-third of all cases of a collision, the point of impact on the bus or the coach being typically frontal or side. Rollovers occurred in almost all cases of severe coach crashes. In this type of crash projection, total ejection, partial ejection, intrusion and smoke inhalation were the main injury mechanisms and among those, ejection being the most dangerous. A 2-point belt may prevent passenger ejection, but in frontal crashes when the upper abdominal parts and the head hit the seatback in front, it could, however, contribute to head and thoracic injuries. Hence, a 3-point belt provides the best restraint in rollovers and frontal crashes.

Smeed's law and expected road fatality reduction: An assessment of the Italian case.

PubMed

Persia, Luca; Gigli, Roberto; Usami, Davide Shingo

2015-12-01

Smeed's law defines the functional relationship existing between the fatality rate and the motorization rate.While focusing on the Italian case and based on the Smeed's law, the study assesses the possibility for Italy of reaching the target of halving the number of road fatalities by 2020, in light of the evolving socioeconomic situation. A Smeed's model has been calibrated based on the recorded Italian data. The evolution of the two indicators, fatality and motorization rates, has been estimated using the predictions of the main parameters (population, fleet size and fatalities). Those trends have been compared with the natural decreasing trend derived from the Smeed's law. Nine scenarios have been developed showing the relationship between the fatality rate and the motorization rate. In case of a limited increase (logistic regression) of the vehicle fleet and according to the estimated evolution of the population, the path defined by motorization and fatality rate is very steep, diverging from the estimated confidence interval of the Smeed's model. In these scenarios the motorization rate is almost constant during the decade. In the actual economic context, a limited development of the vehicle fleet is more plausible. In these conditions the target achievement of halving the number of fatalities in Italy may occur only in case of a structural break (i.e., the introduction of highly effective road safety policies). Practical application: The proposed tools can be used both to evaluate retrospectively the effectiveness of road safety improvements and to assess if a relevant effort is needed to reach the established road safety targets.

[Exercise guidelines for health-oriented recreational sports].

PubMed

Faude, Oliver; Zahner, Lukas; Donath, Lars

2015-05-01

Physical inactivity is one the biggest Public Health problems of the 21th century. Regular physical activity and sports can contribute to a reduction of overall mortality and morbidity and, thus, can have a considerable health impact for individuals as well as for the society as a whole. The beneficial health effects of exercise are convincingly evaluated yet and there is further evidence that physical activity can result in improvements in specific cardiorespiratory and metabolic diseases similar to pharmacological treatments. It is the aim of this review article to outline evidence-based guidelines for exercise to improve physical fitness and health in primary prevention in healthy adults. Based on the current scientific evidence a dose-response-relationship between physical activity and health markers as well as physical fitness is likely. Health-oriented exercise training should allow for an exercise-induced energy expenditure of at least 1000 kcal per week. This should be approached by an appropriate combination of exercises targeting on an improvement in cardiorespiratory and metabolic functioning as well as muscular fitness. It is recommended to supplement such a training regimen by appropriate amounts of functional and flexibility exercises. Usually, sports targeting on these particular fitness areas are recommended, for instance, typical endurance sports like cycling, jogging, (Nordic) walking or swimming for the cardiorespiratory and metabolic domains and strength training for muscular fitness. In recent years, scientific studies have evaluated potentially more attractive sports like football, dancing and Tai Chi and reported promising results. Such sports may contribute to an increased long-term compliance to health-oriented exercise programmes. Although regular physical activity is associated with considerable health benefits, risks and side effects should be taken into account. The most frequent side effects are injuries, and the most severe are fatal cardiac events. Preventive measures should be applied to reduce the risk of these side effects. Health-oriented exercise guidelines should incorporate individual preferences and training responses to support a permanent adaptation towards a sportive life style.

Reducing death on the road: the effects of minimum safety standards, publicized crash tests, seat belts, and alcohol.

PubMed Central

Robertson, L S

1996-01-01

OBJECTIVES. Two phases of attempts to improve passenger car crash worthiness have occurred: minimum safety standards and publicized crash tests. This study evaluated these attempts, as well as changes in seat belt and alcohol use, in terms of their effect on occupant death and fatal crash rates. METHODS. Data on passenger car occupant fatalities and total involvement in fatal crashes, for 1975 through 1991, were obtained from the Fatal Accident Reporting System. Rates per mile were calculated through published sources on vehicle use by vehicle age. Regression estimates of effects of regulation, publicized crash tests, seat belt use and alcohol involvement were obtained. RESULTS. Substantial reductions in fatalities occurred in the vehicle model years from the late 1960s through most of the 1970s, when federal standards were applied. Some additional increments in reduced death rates, attributable to additional improved vehicle crashworthiness, occurred during the period of publicized crash tests. Increased seat belt use and reduced alcohol use also contributed significantly to reduced deaths. CONCLUSIONS. Minimum safety standards, crashworthiness improvements, seat belt use laws, and reduced alcohol use each contributed to a large reduction in passenger car occupant deaths. PMID:8561238

Bacillus atrophaeus inactivated spores as a potential adjuvant for veterinary rabies vaccine.

PubMed

Oliveira-Nascimento, L; Caricati, A T P; Abdulack-Lopes, F; Neves, L C M; Caricati, C P; Penna, T C V; Stephano, M A

2012-05-14

Rabies is a viral encephalitis, nearly always fatal, but preventable through vaccines. Rabid animal bite is the prime transmission act, while veterinary vaccination is one of the best strategies for rabies general prevention. Aluminum compounds and saponin are the commercial adjuvants used for this vaccine nowadays. Nevertheless, aluminum compounds can provoke undesired side effects and saponin has a narrow activity range without toxicity. B. atrophaeus inactivated spores (BAIS), with or without saponin, were then used as an alternative to boost the inactivated rabies virus response. BAIS was as effective as saponin in augmenting antibody titers, but combination of both adjuvants doubled the titers raised by them individually. The combined adjuvant formulation maintained viability for 21 months when stored at 4-8°C. Overall, BAIS was demonstrated as a viable alternative to commercial adjuvants, while its combination with saponin resulted in even higher vaccine potency with good stability. Copyright © 2012 Elsevier Ltd. All rights reserved.

Interventions to prevent injuries in construction workers.

PubMed

van der Molen, Henk F; Basnet, Prativa; Hoonakker, Peter Lt; Lehtola, Marika M; Lappalainen, Jorma; Frings-Dresen, Monique Hw; Haslam, Roger; Verbeek, Jos H

2018-02-05

Construction workers are frequently exposed to various types of injury-inducing hazards. There are a number of injury prevention interventions, yet their effectiveness is uncertain. To assess the effects of interventions for preventing injuries in construction workers. We searched the Cochrane Injuries Group's specialised register, CENTRAL (issue 3), MEDLINE, Embase and PsycINFO up to April 2017. The searches were not restricted by language or publication status. We also handsearched the reference lists of relevant papers and reviews. Randomised controlled trials, controlled before-after (CBA) studies and interrupted time-series (ITS) of all types of interventions for preventing fatal and non-fatal injuries among workers at construction sites. Two review authors independently selected studies, extracted data and assessed their risk of bias. For ITS studies, we re-analysed the studies and used an initial effect, measured as the change in injury rate in the year after the intervention, as well as a sustained effect, measured as the change in time trend before and after the intervention. Seventeen studies (14 ITS and 3 CBA studies) met the inclusion criteria in this updated version of the review. The ITS studies evaluated the effects of: introducing or changing regulations that laid down safety and health requirements for the construction sites (nine studies), a safety campaign (two studies), a drug-free workplace programme (one study), a training programme (one study), and safety inspections (one study) on fatal and non-fatal occupational injuries. One CBA study evaluated the introduction of occupational health services such as risk assessment and health surveillance, one evaluated a training programme and one evaluated the effect of a subsidy for upgrading to safer scaffoldings. The overall risk of bias of most of the included studies was high, as it was uncertain for the ITS studies whether the intervention was independent from other changes and thus could be regarded as the main reason of change in the outcome. Therefore, we rated the quality of the evidence as very low for all comparisons.Compulsory interventionsRegulatory interventions at national or branch level may or may not have an initial effect (effect size (ES) of -0.33; 95% confidence interval (CI) -2.08 to 1.41) and may or may not have a sustained effect (ES -0.03; 95% CI -0.30 to 0.24) on fatal and non-fatal injuries (9 ITS studies) due to highly inconsistent results (I² = 98%). Inspections may or may not have an effect on non-fatal injuries (ES 0.07; 95% CI -2.83 to 2.97; 1 ITS study).Educational interventionsSafety training interventions may result in no significant reduction of non-fatal injuries (1 ITS study and 1 CBA study).Informational interventionsWe found no studies that had evaluated informational interventions alone such as campaigns for risk communication.Persuasive interventionsWe found no studies that had evaluated persuasive interventions alone such as peer feedback on workplace actions to increase acceptance of safe working methods.Facilitative interventionsMonetary subsidies to companies may lead to a greater decrease in non-fatal injuries from falls to a lower level than no subsidies (risk ratio (RR) at follow-up: 0.93; 95% CI 0.30 to 2.91 from RR 3.89 at baseline; 1 CBA study).Multifaceted interventionsA safety campaign intervention may result in an initial (ES -1.82; 95% CI -2.90 to -0.74) and sustained (ES -1.30; 95% CI -1.79 to -0.81) decrease in injuries at the company level (1 ITS study), but not at the regional level (1 ITS study). A multifaceted drug-free workplace programme at the company level may reduce non-fatal injuries in the year following implementation by -7.6 per 100 person-years (95% CI -11.2 to -4.0) and in the years thereafter by -2.0 per 100 person-years (95% CI -3.5 to -0.5) (1 ITS study). Introducing occupational health services may result in no decrease in fatal or non-fatal injuries (one CBA study). The vast majority of interventions to adopt safety measures recommended by standard texts on safety, consultants and safety courses have not been adequately evaluated. There is very low-quality evidence that introducing regulations as such may or may not result in a decrease in fatal and non-fatal injuries. There is also very low-quality evidence that regionally oriented safety campaigns, training, inspections or the introduction of occupational health services may not reduce non-fatal injuries in construction companies. There is very low-quality evidence that company-oriented safety interventions such as a multifaceted safety campaign, a multifaceted drug workplace programme and subsidies for replacement of scaffoldings may reduce non-fatal injuries among construction workers. More studies, preferably cluster-randomised controlled trials, are needed to evaluate different strategies to increase the employers' and workers' adherence to the safety measures prescribed by regulation.

Did Chile's traffic law reform push police enforcement? Understanding Chile's traffic fatalities and injuries reduction.

PubMed

Nazif-Munoz, José Ignacio; Quesnel-Vallée, Amélie; van den Berg, Axel

2015-06-01

The objective of the current study is to determine to what extent the reduction of Chile's traffic fatalities and injuries during 2000-2012 was related to the police traffic enforcement increment registered after the introduction of its 2005 traffic law reform. A unique dataset with assembled information from public institutions and analyses based on ordinary least square and robust random effects models was carried out. Dependent variables were traffic fatality and severe injury rates per population and vehicle fleet. Independent variables were: (1) presence of new national traffic law; (2) police officers per population; (3) number of traffic tickets per police officer; and (4) interaction effect of number of traffic tickets per police officer with traffic law reform. Oil prices, alcohol consumption, proportion of male population 15-24 years old, unemployment, road infrastructure investment, years' effects and regions' effects represented control variables. Empirical estimates from instrumental variables suggest that the enactment of the traffic law reform in interaction with number of traffic tickets per police officer is significantly associated with a decrease of 8% in traffic fatalities and 7% in severe injuries. Piecewise regression model results for the 2007-2012 period suggest that police traffic enforcement reduced traffic fatalities by 59% and severe injuries by 37%. Findings suggest that traffic law reforms in order to have an effect on both traffic fatality and injury rates reduction require changes in police enforcement practices. Last, this case also illustrates how the diffusion of successful road safety practices globally promoted by WHO and World Bank can be an important influence for enhancing national road safety practices. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Lavia – an Evaluation of the Potential Safety Benefits of the French Intelligent Speed Adaptation Project

PubMed Central

Driscoll, R.; Page, Y.; Lassarre, S.; Ehrlich, J.

2007-01-01

This paper presents the potential safety benefits of the experimental French LAVIA Intelligent Speed Adaptation system, according to road network and system mode, based on observed driving speeds, distributions of crash severity and crash injury risk. Results are given for car frontal and side impacts that together, represent 80% of all serious and fatal injuries in France. Of the three system modes tested (advisory, driver select, mandatory), our results suggest that driver select would most significantly reduce serious injuries and death. We estimate this 100% utilization of cars equipped with this type of speed adaptation system would decrease injury rates by 6% to 16% over existing conditions depending on the type of crash (frontal or side) and road environment considered. Some limitations associated with the analysis are also identified. PMID:18184509

Firearm Legislation and Fatal Police Shootings in the United States.

PubMed

Kivisto, Aaron J; Ray, Bradley; Phalen, Peter L

2017-07-01

To examine whether stricter firearm legislation is associated with rates of fatal police shootings. We used a cross-sectional, state-level design to evaluate the effect of state-level firearm legislation on rates of fatal police shootings from January 1, 2015, through October 31, 2016. We measured state-level variation in firearm laws with legislative scorecards from the Brady Center, and for fatal police shootings we used The Counted, an online database maintained by The Guardian. State-level firearm legislation was significantly associated with lower rates of fatal police shootings (incidence rate ratio = 0.961; 95% confidence interval = 0.939, 0.984). When we controlled for sociodemographic factors, states in the top quartile of legislative strength had a 51% lower incidence rate than did states in the lowest quartile. Laws aimed at strengthening background checks, promoting safe storage, and reducing gun trafficking were associated with fewer fatal police shootings. Legislative restrictions on firearms are associated with reductions in fatal police shootings. Public Health Implications. Although further research is necessary to determine causality and potential mechanisms, firearm legislation is a potential policy solution for reducing fatal police shootings in the United States.

Nonconformities in real-world fatal crashes--electronic stability control and seat belt reminders.

PubMed

Lie, Anders

2012-01-01

Many new safety systems are entering the market. Vision Zero is a safety strategy aiming at the elimination of fatalities and impairing injuries by the use of a holistic model for safe traffic to develop a safe system. The aim of this article is to analyze fatalities in modern cars with respect to the Vision Zero model with special respect to electronic stability control (ESC) systems and modern seat belt reminders (SBRs). The model is used to identify and understand cases where cars with ESC systems lost control and where occupants were unbelted in a seat with seat belt reminders under normal driving conditions. The model for safe traffic was used to analyze in-depth studies of fatal crashes with respect to seat belt use and loss of control. Vehicles from 2003 and later in crashes from January 2004 to mid-2010 were analyzed. The data were analyzed case by case. Cars that were equipped with ESC systems and lost control and occupants not using the seat belt in a seat with a seat belt reminder were considered as nonconformities. A total of 138 fatal crashes involving 152 fatally injured occupants were analyzed. Cars with ESC systems had fewer loss-of-control-relevant cases than cars without ESC systems. Thirteen percent of the ESC-equipped vehicles had loss-of-control-relevant crashes and 36 percent of the cars without ESC systems had loss-of-control-relevant crashes. The analysis indicates that only one car of the 9 equipped with ESC that lost control did it on a road surface with relevant friction when driving within the speed restriction of the road. In seats with seat belt reminders that are in accordance with the European New Car Assessment Programme's (Euro NCAP) protocol, 93 percent of the occupants were using a seat belt. In seats without reminders this number was 74 percent. This study shows that ESC systems result in a very significant reduction in fatal crashes, especially under normal driving conditions. Under extreme driving conditions such as speeding or extremely low friction (snow or on the side of the road), ESC systems can fail in keeping the car under control. Seat belt reminders result in higher seat belt use rates but the level of unbelted occupants is higher than roadside studies have indicated. The holistic Vision Zero approach helped in the analysis by identifying nonconformities and putting these into the safe systems perspective.

Effects of legislative reform to reduce drunken driving and alcohol-related traffic fatalities.

PubMed Central

Hingson, R W; Howland, J; Levenson, S

1988-01-01

From 1980 through 1985, considerable progress was made across the Nation in reducing drunken driving and fatal automobile crashes. More than 400 chapters of local citizen groups concerned with reducing drunken driving were formed. New media coverage, measured in number of stories, increased fiftyfold from 1980 to 1984. More than 500 legislative reforms were passed. All States now have adopted a legal drinking age of 21. Many also adopted criminal and administrative per se laws and instituted penalty increases for drunken driving. By 1985, the total number of fatal crashes declined to 39,168, a decrease of 6,116, or 16 percent, from the 1980 level of 45,284. Single-vehicle fatal crashes occurring at night, those most likely to involve alcohol, declined by 20 percent, with 3,674 fewer crashes in 1985 than in 1980. Among teenage drivers, declines in fatal crashes were steeper: Fatal crashes decreased 26 percent, and single-vehicle night fatal crashes were down 34 percent. After 1984, however, the number of new citizen groups established and the number of stories appearing in the media began to decline. In 1986, after decreasing for several years, the number of fatal crashes rose 5 percent, and single-vehicle night fatal crashes rose 7 percent, up 1,060 from 1985. Among teenage drivers, the increase in single-vehicle night fatal crashes was even higher, up 17 percent. In 1987, single-vehicle night fatal crashes declined slightly but still remained higher than in 1983, 1984, or 1985.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:3141962

Ambient air pollutants and acute case-fatality of cerebro-cardiovascular events: Takashima Stroke and AMI Registry, Japan (1988-2004).

PubMed

Turin, Tanvir Chowdhury; Kita, Yoshikuni; Rumana, Nahid; Nakamura, Yasuyuki; Ueda, Kayo; Takashima, Naoyuki; Sugihara, Hideki; Morita, Yutaka; Ichikawa, Masaharu; Hirose, Kunihiko; Nitta, Hiroshi; Okayama, Akira; Miura, Katsuyuki; Ueshima, Hirotsugu

2012-01-01

Apart from the conventional risk factors, cerebro-cardiovascular disease (CVD) are also reported to be associated with air pollution, thus lowering the level of exposure might contribute in prevention activities to reduce the associated adverse outcomes. Though few studies conducted in Japan have reported on the CVD mortality but none have explored the effect of air pollutant exposure on the acute case-fatality of CVD. We investigated the effects of air pollution exposure on acute case-fatality of stroke and acute myocardial infarction (AMI) in a setting where pollutant levels are rather low. We leveraged the data from the Takashima Stroke and AMI Registry, which covers a population of approximately 55,000 in Takashima County located in central Japan. The study period of 6,210 days (16 years, leap years also taken into account) were divided into quartiles of daily average pollutant concentration; suspended particulate matter (SPM), sulfur dioxide (SO(2)), nitrogen dioxide (NO(2)), and photochemical oxidants (Ox). The stroke and AMI events were categorized to corresponding quartiles based on the pollution levels of the onset day. To study the effects of air pollutants, we estimated the fatality rate ratio across quartiles of the pollutants where the lowest quartile served as the reference. There were 307 (men: 153 and women: 154) fatal stroke cases within 28 days of onset among the 2,038 first ever stroke during 1988-2004. In the same period, there were 142 (men: 94 and women: 54) fatal AMI cases within 28 days of onset among the 429 first ever AMI events. The mean of the measured pollutant levels were as follows: SPM 26.9 µg/m(3), SO(2) 3.9 ppb, NO(2) 16.0 ppb, and Ox 28.4 ppb. Among the pollutants, higher levels of NO(2) showed increased fatality risk. In multi-pollutant model, the highest quartile of NO(2) was associated with 60% higher stroke case-fatality risk in comparison to lowest quartile of NO(2). In the fully adjusted model the fatality-rate ratio was 1.65 (95% CI 1.06-2.57). This association was more prominent among stroke subtype of cerebral infarction. Other pollutant levels did not show any association with stroke or AMI case-fatality. We observed association between NO(2) levels, an index of traffic related air pollution, with the acute case-fatality of stroke, especially cerebral infarction in our study population. Further studies are needed in different regions to determine the association between ambient air pollutants and acute cardiovascular fatalities. Copyright © 2012 S. Karger AG, Basel.

IIHS side crash test ratings and occupant death risk in real-world crashes.

PubMed

Teoh, Eric R; Lund, Adrian K

2011-10-01

To evaluate how well the Insurance Institute for Highway Safety (IIHS) side crash test ratings predict real-world occupant death risk in side-impact crashes. The IIHS has been evaluating passenger vehicle side crashworthiness since 2003. In the IIHS side crash test, a vehicle is impacted perpendicularly on the driver's side by a moving deformable barrier simulating a typical sport utility vehicle (SUV) or pickup. Injury ratings are computed for the head/neck, torso, and pelvis/leg, and vehicles are rated based on their ability to protect occupants' heads and resist occupant compartment intrusion. Component ratings are combined into an overall rating of good, acceptable, marginal, or poor. A driver-only rating was recalculated by omitting rear passenger dummy data. Data were extracted from the Fatality Analysis Reporting System (FARS) and National Automotive Sampling System/General Estimates System (NASS/GES) for the years 2000-2009. Analyses were restricted to vehicles with driver side air bags with head and torso protection as standard features. The risk of driver death was computed as the number of drivers killed (FARS) divided by the number involved (NASS/GES) in left-side impacts and was modeled using logistic regression to control for the effects of driver age and gender and vehicle type and curb weight. Death rates per million registered vehicle years were computed for all outboard occupants and compared by overall rating. Based on the driver-only rating, drivers of vehicles rated good were 70 percent less likely to die when involved in left-side crashes than drivers of vehicles rated poor, after controlling for driver and vehicle factors. Compared with vehicles rated poor, driver death risk was 64 percent lower for vehicles rated acceptable and 49 percent lower for vehicles rated marginal. All 3 results were statistically significant. Among components, vehicle structure rating exhibited the strongest relationship with driver death risk. The vehicle registration-based results for drivers were similar, suggesting that the benefit was not due to differences in crash risk. The same pattern of results held for outboard occupants in nearside crashes per million registered vehicle years and, with the exception of marginally rated vehicles, also held for other crash types. Results show that IIHS side crash test ratings encourage designs that improve crash protection in meaningful ways beyond encouraging head protection side air bags, particularly by promoting vehicle structures that limit occupant compartment intrusion. Results further highlight the need for a strong occupant compartment and its influence in all types of crashes.

The effects of driving age, driver education, and curfew laws on traffic fatalities of 15-17 year olds.

PubMed

Levy, D T

1988-12-01

This study examines the effect of state driving age, learning permit, driver's education, and curfew laws on 15-17-year-old driver fatality rates. A multivariate regression model is estimated for 47 states and nine years. The minimum legal driving age and curfew laws are found to be important determinants of fatalities. Driver's education and learning permits have smaller effects. The relationship between rates of licensure and driving age, education, and curfew laws is also examined. In each case, a more restrictive policy is found to reduce licensure of 15-17 year olds. The results suggest that the imposition of curfew laws and higher minimum driving ages are particularly effective traffic safety policies.

Resistant hypertension: Renal denervation or intensified medical treatment?

PubMed

Morganti, Alberto; Mancia, Giuseppe

2018-04-01

Resistant hypertension (RH) can be diagnosed if blood pressure (BP) is not controlled with the combination of three antihypertensive drugs, including a diuretic, all at effective doses. Patients affected by this condition exhibit a marked increase in the risk of cardiovascular and renal morbid and fatal events. They also exhibit an increased activity of the sympathetic nervous system which is likely to importantly contribute at the renal and other vascular levels to the hypertensive state. Almost 10years ago renal denervation (RDN) by radiofrequency thermal energy delivery to the walls of the renal arteries was proposed for the treatment of RH. Several uncontrolled studies initially reported that this procedure substantially reduced the elevated BP values but this conclusion has not been supported by a recent randomized control trial, which has almost marginalized this therapeutic approach. A revival, however, is under way because of recent positive findings and technical improvement that hold promise to make renal denervation more complete. The antihypertensive efficacy and overall validity of RDN will have to be tested against drug treatment of RH. Several studies indicate that an excess of aldosterone production contributes to RH and recent evidence documents indisputably that anti-aldosterone agents such as spironolactone can effectively control BP in many RH patients, although with some side effects that require close patients' monitoring. At present, it is advisable to treat RH with the addition of an anti-aldosterone agent. If BP control is not achieved or serious side effects become manifest RDN may then be considered. Copyright © 2017 European Federation of Internal Medicine. Published by Elsevier B.V. All rights reserved.

Evaluating the Effectiveness of an Ultrasonic Acoustic Deterrent for Reducing Bat Fatalities at Wind Turbines.

PubMed

Arnett, Edward B; Hein, Cris D; Schirmacher, Michael R; Huso, Manuela M P; Szewczak, Joseph M

2013-01-01

Large numbers of bats are killed by wind turbines worldwide and minimizing fatalities is critically important to bat conservation and acceptance of wind energy development. We implemented a 2-year study testing the effectiveness of an ultrasonic acoustic deterrent for reducing bat fatalities at a wind energy facility in Pennsylvania. We randomly selected control and treatment turbines that were searched daily in summer and fall 2009 and 2010. Estimates of fatality, corrected for field biases, were compared between treatment and control turbines. In 2009, we estimated 21-51% fewer bats were killed per treatment turbine than per control turbine. In 2010, we determined an approximate 9% inherent difference between treatment and control turbines and when factored into our analysis, variation increased and between 2% more and 64% fewer bats were killed per treatment turbine relative to control turbines. We estimated twice as many hoary bats were killed per control turbine than treatment turbine, and nearly twice as many silver-haired bats in 2009. In 2010, although we estimated nearly twice as many hoary bats and nearly 4 times as many silver-haired bats killed per control turbine than at treatment turbines during the treatment period, these only represented an approximate 20% increase in fatality relative to the pre-treatment period for these species when accounting for inherent differences between turbine sets. Our findings suggest broadband ultrasound broadcasts may reduce bat fatalities by discouraging bats from approaching sound sources. However, effectiveness of ultrasonic deterrents is limited by distance and area ultrasound can be broadcast, in part due to rapid attenuation in humid conditions. We caution that an operational deterrent device is not yet available and further modifications and experimentation are needed. Future efforts must also evaluate cost-effectiveness of deterrents in relation to curtailment strategies to allow a cost-benefit analysis for mitigating bat fatalities.

Evaluating the Effectiveness of an Ultrasonic Acoustic Deterrent for Reducing Bat Fatalities at Wind Turbines

PubMed Central

Arnett, Edward B.; Hein, Cris D.; Schirmacher, Michael R.; Huso, Manuela M. P.; Szewczak, Joseph M.

2013-01-01

Large numbers of bats are killed by wind turbines worldwide and minimizing fatalities is critically important to bat conservation and acceptance of wind energy development. We implemented a 2-year study testing the effectiveness of an ultrasonic acoustic deterrent for reducing bat fatalities at a wind energy facility in Pennsylvania. We randomly selected control and treatment turbines that were searched daily in summer and fall 2009 and 2010. Estimates of fatality, corrected for field biases, were compared between treatment and control turbines. In 2009, we estimated 21–51% fewer bats were killed per treatment turbine than per control turbine. In 2010, we determined an approximate 9% inherent difference between treatment and control turbines and when factored into our analysis, variation increased and between 2% more and 64% fewer bats were killed per treatment turbine relative to control turbines. We estimated twice as many hoary bats were killed per control turbine than treatment turbine, and nearly twice as many silver-haired bats in 2009. In 2010, although we estimated nearly twice as many hoary bats and nearly 4 times as many silver-haired bats killed per control turbine than at treatment turbines during the treatment period, these only represented an approximate 20% increase in fatality relative to the pre-treatment period for these species when accounting for inherent differences between turbine sets. Our findings suggest broadband ultrasound broadcasts may reduce bat fatalities by discouraging bats from approaching sound sources. However, effectiveness of ultrasonic deterrents is limited by distance and area ultrasound can be broadcast, in part due to rapid attenuation in humid conditions. We caution that an operational deterrent device is not yet available and further modifications and experimentation are needed. Future efforts must also evaluate cost-effectiveness of deterrents in relation to curtailment strategies to allow a cost-benefit analysis for mitigating bat fatalities. PMID:23840369

Evaluating the effectiveness of an ultrasonic acoustic deterrent for reducing bat fatalities at wind turbines

USGS Publications Warehouse

Arnett, Edward B.; Hein, Cris D.; Schirmacher, Michael R.; Huso, Manuela M.P.; Szewczak, Joseph M.

2013-01-01

Large numbers of bats are killed by wind turbines worldwide and minimizing fatalities is critically important to bat conservation and acceptance of wind energy development. We implemented a 2-year study testing the effectiveness of an ultrasonic acoustic deterrent for reducing bat fatalities at a wind energy facility in Pennsylvania. We randomly selected control and treatment turbines that were searched daily in summer and fall 2009 and 2010. Estimates of fatality, corrected for field biases, were compared between treatment and control turbines. In 2009, we estimated 21–51% fewer bats were killed per treatment turbine than per control turbine. In 2010, we determined an approximate 9% inherent difference between treatment and control turbines and when factored into our analysis, variation increased and between 2% more and 64% fewer bats were killed per treatment turbine relative to control turbines. We estimated twice as many hoary bats were killed per control turbine than treatment turbine, and nearly twice as many silver-haired bats in 2009. In 2010, although we estimated nearly twice as many hoary bats and nearly 4 times as many silver-haired bats killed per control turbine than at treatment turbines during the treatment period, these only represented an approximate 20% increase in fatality relative to the pre-treatment period for these species when accounting for inherent differences between turbine sets. Our findings suggest broadband ultrasound broadcasts may reduce bat fatalities by discouraging bats from approaching sound sources. However, effectiveness of ultrasonic deterrents is limited by distance and area ultrasound can be broadcast, in part due to rapid attenuation in humid conditions. We caution that an operational deterrent device is not yet available and further modifications and experimentation are needed. Future efforts must also evaluate cost-effectiveness of deterrents in relation to curtailment strategies to allow a cost-benefit analysis for mitigating bat fatalities.

Traffic-law enforcement and risk of death from motor-vehicle crashes: case-crossover study.

PubMed

Redelmeier, Donald A; Tibshirani, Robert J; Evans, Leonard

2003-06-28

Driving offences and traffic deaths are common in countries with high rates of motor-vehicle use. We tested whether traffic convictions, because of their direct effect on the recipient, might be associated with a reduced risk of fatal motor-vehicle crashes. We identified licensed drivers in Ontario, Canada, who had been involved in fatal crashes in the past 11 years. We used the case-crossover design to analyse the protective effect of recent convictions on individual drivers. 8975 licensed drivers had fatal crashes during the study period. 21501 driving convictions were recorded for all drivers from the date of obtaining a full licence to the date of fatal crash, equivalent to about one conviction per driver every 5 years. The risk of a fatal crash in the month after a conviction was about 35% lower than in a comparable month with no conviction for the same driver (95% CI 20-45, p=0.0002). The benefit lessened substantially by 2 months and was not significant by 3-4 months. The benefit was not altered by age, previous convictions, and other personal characteristics; was greater for speeding violations with penalty points than speeding violations without points; was no different for crashes of differing severity; and was not seen in drivers whose licences were suspended. Traffic-law enforcement effectively reduces the frequency of fatal motor-vehicle crashes in countries with high rates of motor-vehicle use. Inconsistent enforcement, therefore, may contribute to thousands of deaths each year worldwide.

Xylazine intoxication in humans and its importance as an emerging adulterant in abused drugs: A comprehensive review of the literature.

PubMed

Ruiz-Colón, Kazandra; Chavez-Arias, Carlos; Díaz-Alcalá, José Eric; Martínez, María A

2014-07-01

Xylazine is not a controlled substance; it is marketed as a veterinary drug and used as a sedative, analgesic and muscle relaxant. In humans, it could cause central nervous system depression, respiratory depression, bradycardia, hypotension, and even death. There have been publications of 43 cases of xylazine intoxication in humans, in which 21 (49%) were non-fatal scenarios and 22 (51%) resulted in fatalities. Most of the non-fatal cases required medical intervention. Over recent years xylazine has emerged as an adulterant in recreational drugs, such as heroin or speedball (a cocaine and heroin mixture). From the 43 reported cases, 17 (40%) were associated with the use of xylazine as an adulterant of drugs of abuse. Its chronic use is reported to be associated with physical deterioration and skin ulceration. Literature shows some similar pharmacologic effects between xylazine and heroin in humans. These similar pharmacologic effects may create synergistic toxic effects in humans. Therefore, fatalities among drug users may increase due to the use of xylazine as an adulterant. Xylazine alone has proven harmful to humans and even more when it is combined with drugs of abuse. A comprehensive review of the literature of non-fatal and fatal xylazine intoxication cases including those in which the substance was used as adulterant is presented, in order to increase the awareness in the forensic community, law enforcement, and public health agencies. Published by Elsevier Ireland Ltd.

Assessment of NHTSA’s Report “Relationships Between Fatality Risk, Mass, and Footprint in Model Year 2004-2011 Passenger Cars and LTVs” (LBNL Phase 1)

DOE Office of Scientific and Technical Information (OSTI.GOV)

Wenzel, Tom P.

In its 2012 report NHTSA simulated the effect four fleetwide mass reduction scenarios would have on the change in annual fatalities. NHTSA estimated that the most aggressive of these scenarios (reducing mass 5.2% in heavier light trucks and 2.6% in all other vehicles types except lighter cars) would result in a small reduction in societal fatalities. LBNL replicated the methodology NHTSA used to simulate six mass reduction scenarios, including the mass reductions recommended in the 2015 NRC committee report, and estimated in 2021 and 2025 by EPA in the TAR, using the updated data through 2012. The analysis indicates thatmore » the estimated x change in fatalities under each scenario based on the updated analysis is comparable to that in the 2012 analysis, but less beneficial or more detrimental than that in the 2016 analysis. For example, an across the board 100-lb reduction in mass would result in an estimated 157 additional annual fatalities based on the 2012 analysis, but would result in only an estimated 91 additional annual fatalities based on the 2016 analysis, and an additional 87 fatalities based on the current analysis. The mass reductions recommended by the 2015 NRC committee report6 would result in a 224 increase in annual fatalities in the 2012 analysis, a 344 decrease in annual fatalities in the 2016 analysis, and a 141 increase in fatalities in the current analysis. The mass reductions EPA estimated for 2025 in the TAR7 would result in a 203 decrease in fatalities based on the 2016 analysis, but an increase of 39 fatalities based on the current analysis. These results support NHTSA’s conclusion from its 2012 study that, when footprint is held fixed, “no judicious combination of mass reductions in the various classes of vehicles results in a statistically significant fatality increase and many potential combinations are safety-neutral as point estimates.”Like the previous NHTSA studies, this updated report concludes that the estimated effect of mass reduction while maintaining footprint on societal U.S. fatality risk is small, and not statistically significant at the 95% or 90% confidence level for all vehicle types based on the jack-knife method NHTSA used. This report also finds that the estimated effects of other control variables, such as vehicle type, specific safety technologies, and crash conditions such as whether the crash occurred at night, in a rural county, or on a high-speed road, on risk are much larger, in some cases two orders of magnitude larger, than the estimated effect of mass or footprint reduction on risk. Finally, this report shows that after accounting for the many vehicle, driver, and crash variables NHTSA used in its regression analyses, there remains a wide variation in risk by vehicle make and model, and this variation is unrelated to vehicle mass. Although the purpose of the NHTSA and LBNL reports is to estimate the effect of vehicle mass reduction on societal risk, this is not exactly what the regression models are estimating. Rather, they are estimating the recent historical relationship between mass and risk, after accounting for most measurable differences between vehicles, drivers, and crash times and locations. In essence, the regression models are comparing the risk of a 2600-lb Dodge Neon with that of a 2500-lb Honda Civic, after attempting to account for all other differences between the two vehicles. The models are not estimating the effect of literally removing 100 pounds from the Neon, leaving everything else unchanged. In addition, the analyses are based on the relationship of vehicle mass and footprint on risk for recent vehicle designs (model year 2004 to 2011). These relationships may or may not continue into the future as manufacturers utilize new vehicle designs and incorporate new technologies, such as more extensive use of strong lightweight materials and specific safety technologies. Therefore, throughout this report we use the phrase “the estimated effect of mass (or footprint) reduction on risk” as shorthand for “the estimated change in risk as a function of its relationship to mass (or footprint) for vehicle models of recent design.”« less

Effect of Using Different Vehicle Weight Groups on the Estimated Relationship Between Mass Reduction and U.S. Societal Fatality Risk per Vehicle Miles of Travel

DOE Office of Scientific and Technical Information (OSTI.GOV)

Wenzel, Tom P.

This report recalculates the estimated relationship between vehicle mass and societal fatality risk, using alternative groupings by vehicle weight, to test whether the trend of decreasing fatality risk from mass reduction as case vehicle mass increases, holds over smaller increments of the range in case vehicle masses. The NHTSA baseline regression model estimates the relationship using for two weight groups for cars and light trucks; we re-estimated the mass reduction coefficients using four, six, and eight bins of vehicle mass. The estimated effect of mass reduction on societal fatality risk was not consistent over the range in vehicle masses inmore » these weight bins. These results suggest that the relationship indicated by the NHTSA baseline model is a result of other, unmeasured attributes of the mix of vehicles in the lighter vs. heavier weight bins, and not necessarily the result of a correlation between mass reduction and societal fatality risk. An analysis of the average vehicle, driver, and crash characteristics across the various weight groupings did not reveal any strong trends that might explain the lack of a consistent trend of decreasing fatality risk from mass reduction in heavier vehicles.« less

The Effect of Breast Cancer Fatalism on Breast Cancer Awareness Among Turkish Women.

PubMed

Altintas, Hulya Kulakci; Ayyildiz, Tulay Kuzlu; Veren, Funda; Topan, Aysel Kose

2017-10-01

The aim of this study was to evaluate the effect of breast cancer fatalism and other factors on breast cancer awareness among Turkish women. This cross-sectional and comparative descriptive study was conducted with 894 women. Data were collected by Personal Information Form, Powe Fatalism Inventory and Champion's Health Belief Model Scale. Seriousness, health motivation, BSE benefits and BSE self-efficacy perceptions of the women were moderate, and susceptibility and BSE barriers perceptions were low. It was determined that awareness of breast cancer of the women was affected by breast cancer fatalism, age, education level, employment status, marital status, family type, economic status, social assurance, menopause status, family history of cancer, family history of breast cancer, knowledge on BSE, source of information on BSE, performing of BSE, frequency of BSE performing, having a problem with breast, having a breast examination in hospital, feeling during breast examination by healthcare professional, sex of healthcare professional for breast examination and their health beliefs (p < .05). The results suggested that awareness of breast cancer of the women was affected by breast cancer fatalism. In providing breast cancer early diagnosis behaviors, it is recommended to evaluate fatalism perceptions and health beliefs of the women and to arrange educational programs for this purpose.

Influence of Referral Pathway on Ebola Virus Disease Case-Fatality Rate and Effect of Survival Selection Bias.

PubMed

Rudolf, Frauke; Damkjær, Mads; Lunding, Suzanne; Dornonville de la Cour, Kenn; Young, Alyssa; Brooks, Tim; Sesay, Tom; Salam, Alex P; Mishra, Sharmistha; Storgaard, Merete

2017-04-01

Case-fatality rates in Ebola treatment centers (ETCs) varied widely during the Ebola virus disease (EVD) outbreak in West Africa. We assessed the influence of referral pathway on ETC case-fatality rates with a retrospective cohort of 126 patients treated at the Mathaska ETC in Port Loko, Sierra Leone. The patients consisted of persons who had confirmed EVD when transferred to the ETC or who had been diagnosed onsite. The case-fatality rate for transferred patients was 46% versus 67% for patients diagnosed onsite (p = 0.02). The difference was mediated by Ebola viral load at diagnosis, suggesting a survival selection bias. Comparisons of case-fatality rates across ETCs and clinical management strategies should account for potential survival selection bias.

Influence of Referral Pathway on Ebola Virus Disease Case-Fatality Rate and Effect of Survival Selection Bias

PubMed Central

Damkjær, Mads; Lunding, Suzanne; Dornonville de la Cour, Kenn; Young, Alyssa; Brooks, Tim; Sesay, Tom; Salam, Alex P.; Mishra, Sharmistha; Storgaard, Merete

2017-01-01

Case-fatality rates in Ebola treatment centers (ETCs) varied widely during the Ebola virus disease (EVD) outbreak in West Africa. We assessed the influence of referral pathway on ETC case-fatality rates with a retrospective cohort of 126 patients treated at the Mathaska ETC in Port Loko, Sierra Leone. The patients consisted of persons who had confirmed EVD when transferred to the ETC or who had been diagnosed onsite. The case-fatality rate for transferred patients was 46% versus 67% for patients diagnosed onsite (p = 0.02). The difference was mediated by Ebola viral load at diagnosis, suggesting a survival selection bias. Comparisons of case-fatality rates across ETCs and clinical management strategies should account for potential survival selection bias. PMID:28322693

Promising treatments in development for food allergies.

PubMed

Rancé, Fabienne

2004-11-01

Up to 6% of young children and 2% of adults suffer from food allergy. Among them many have IgE-mediated food allergy, a condition with potentially fatal allergic reactions. The only proven treatment is avoidance of the offending food, which can be identified using standardised allergic tests. However, several studies have addressed possible definite treatment options for food allergy. Immunotherapy, administered orally or by systemic injections, shows promising preliminary results, but these therapeutics are based on studies with insufficient scientific support, or are associated with a high risk of severe side effects. At present, no studies can support pharmacotherapy. However, promising results were recently published with anti-IgE antibodies in a human trial, and various approaches in a mouse model of food allergy (chinese herbal medicine, specific modulation of the T-cell response). Rapidly evolving findings might provide hope for a cure for food allergy in the near future.

Application of botulinum toxin to treat sialorrhea in amyotrophic lateral sclerosis patients: a literature review

PubMed Central

de Oliveira, Ademar Francisco; Silva, Gêssyca Adryene de Menezes; Almeida, Débora Milenna Xavier

2016-01-01

ABSTRACT Amyotrophic lateral sclerosis is a progressive and fatal neurodegenerative disease characterized by the degeneration of motor neurons, which are the central nervous system cells that control voluntary muscle movements. The excessive salivation (sialorrhea) is present in approximately 50% of amyotrophic lateral sclerosis cases. Thus, some alternative therapeutic methods are sought, such as anticholinergic drugs and surgery. Recently the use of botulinum toxin applied at a midpoint of the salivary glands, often guided by ultrasound, have demonstrated positive results. The objective was to review the literature to demonstrate an alternative method to treatments of sialorrhea in patients with amyotrophic lateral sclerosis. In recent studies, the efficacy of botulinum toxin is confirmed, although new applications are required. Since the side effects are negligible, this is an alternative to treat amyotrophic lateral sclerosis, and other patients with diseases that present sialorrhea. PMID:27759834

The effectiveness of air bags.

PubMed

Barry, S; Ginpil, S; O'Neill, T J

1999-11-01

Previous research has shown that the installation of air bags in vehicles significantly reduces crash related deaths, but these analyses have used statistical techniques which have not been capable of controlling for other major determinants of crash survival. This study analysed data from the US FARS database of fatal crashes using conditional logistic regression which is simultaneously able to estimate occupant protection effects for a range of variables. Results of the analysis provided a comparative quantification of both the effect of the air bag as well as other well known determinants of occupant crash survival (age, seat belt use, and gender). When potentially confounding variables were controlled, both the driver and passenger side air bag devices were shown to significantly reduce the probability of death in direct frontal collisions, but the effect size calculated was small compared to the effect of the seat belt. The effect size may also be very small in absolute terms depending on the severity of the crash involved. Given the limited benefit of the air bag, efforts to promote air bags seem particularly difficult to justify in countries such as the United States where the vastly superior occupant protection of the seat belt is under-utilised.

Impact of the effect of economic crisis and the targeted motorcycle safety programme on motorcycle-related accidents, injuries and fatalities in Malaysia.

PubMed

Law, T H; Umar, R S Radin; Zulkaurnain, S; Kulanthayan, S

2005-03-01

In 1997, a Motorcycle Safety Programme (MSP) was introduced to address the motorcycle-related accident problem. The MSP was specifically targeted at motorcyclists. In addition to the MSP, the recent economic recession has significantly contributed to a reduction of traffic-related incidents. This paper examines the effects of the recent economic crisis and the MSP on motorcycle-related accidents, casualties and fatalities in Malaysia. The autocorrelation integrated moving average model with transfer function was used to evaluate the overall effects of the interventions. The variables used in developing the model were gross domestic product and MSPs. The analysis found a 25% reduction in the number of motorcycle-related accidents, a 27% reduction in motorcycle casualties and a 38% reduction in motorcycle fatalities after the implementation of MSP. Findings indicate that the MSP has been one of the effective measures in reducing motorcycle safety problems in Malaysia. Apart from that, the performance of the country's economy was also found to be significant in explaining the number of motorcycle-related accidents, casualties and fatalities in Malaysia.

Heart rate is a prognostic risk factor for myocardial infarction: a post hoc analysis in the PERFORM (Prevention of cerebrovascular and cardiovascular Events of ischemic origin with teRutroban in patients with a history oF ischemic strOke or tRansient ischeMic attack) study population.

PubMed

Fox, Kim; Bousser, Marie-Germaine; Amarenco, Pierre; Chamorro, Angel; Fisher, Marc; Ford, Ian; Hennerici, Michael G; Mattle, Heinrich P; Rothwell, Peter M

2013-10-09

Elevated resting heart rate is known to be detrimental to morbidity and mortality in cardiovascular disease, though its effect in patients with ischemic stroke is unclear. We analyzed the effect of baseline resting heart rate on myocardial infarction (MI) in patients with a recent noncardioembolic cerebral ischemic event participating in PERFORM. We compared fatal or nonfatal MI using adjusted Cox proportional hazards models for PERFORM patients with baseline heart rate <70 bpm (n=8178) or ≥70 bpm (n=10,802). In addition, heart rate was analyzed as a continuous variable. Other cerebrovascular and cardiovascular outcomes were also explored. Heart rate ≥70 bpm was associated with increased relative risk for fatal or nonfatal MI (HR 1.32, 95% CI 1.03-1.69, P=0.029). For every 5-bpm increase in heart rate, there was an increase in relative risk for fatal and nonfatal MI (11.3%, P=0.0002). Heart rate ≥70 bpm was also associated with increased relative risk for a composite of fatal or nonfatal ischemic stroke, fatal or nonfatal MI, or other vascular death (excluding hemorrhagic death) (P<0001); vascular death (P<0001); all-cause mortality (P<0001); and fatal or nonfatal stroke (P=0.04). For every 5-bpm increase in heart rate, there were increases in relative risk for fatal or nonfatal ischemic stroke, fatal or nonfatal MI, or other vascular death (4.7%, P<0.0001), vascular death (11.0%, P<0.0001), all-cause mortality (8.0%, P<0.0001), and fatal and nonfatal stroke (2.4%, P=0.057). Elevated heart rate ≥70 bpm places patients with a noncardioembolic cerebral ischemic event at increased risk for MI. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

[«All of a sudden…» preventability and priorities of construction fatalities: an experience in Piedmont].

PubMed

Pasqualini, Osvaldo; Libener, Marcello; Farina, Elena; Bena, Antonella

2011-01-01

To examine the usefulness for prevention of the National Surveillance System on occupational fatalities, which is based on the narrative description of the work accident collected by OSH inspectors and on the subsequent classification of the injury dynamics by means of a standardized model of analysis. The system ability of providing useful recommendations for prevention was evaluated on one hand by analyzing the effectiveness of inspections in preventing fatalities, on the other hand by identifying the most frequent accident mechanisms. Data analyzed consisted of investigation reports of construction fatalities occurred during 2002-2008 in the Piedmont Region, collected by surveillance system. The injury narrative description was used to assess whether the fatality would have been preventable by an inspection hypothetically conducted the day before the event; injuries were classified as probably preventable, probably not preventable, and uncertain. A standardized model of classification of injury dynamics was employed to identify mechanisms and circumstances related to the construction fatalities, and particularly those caused by falls from height. Among 122 construction fatalities occurred, 25%were considered probably preventable and 60%probably not preventable. Half of the construction fatalities was caused by fall from height, most of which were caused by sudden breaking of a surface walkway, and almost 20% by fall of objects, including burial. The analysis of the preventability of construction fatalities in Piedmont seems partly to rebut the assumption that more inspections are necessarily associated with a reduction in fatalities. The interpretation of the injury narrative descriptions, which are implemented by OHS inspectors as part of their usual activity, through a standardized model of analysis allows to identify the breaking of surface walkways as the most important mechanism of fatality among falls from height.

Fatal injuries among grounds maintenance workers: United States, 2003--2008.

PubMed

2011-05-06

A total of 1,142 grounds maintenance workers (GMWs) were fatally injured at work during 2003--2008, an average of 190 each year. GMWs accounted for 3.4% of all occupational fatalities, and 31% of those GMWs were Hispanic or Latino. Approximately 83% of the Hispanic or Latino GMWs who died were born outside the United States. In 2008, approximately 1.52 million persons were employed as GMWs, constituting 1.0% of the U.S. workforce. During 2003--2007, an average of 13.3 per 100,000 employed GMWs died each year, compared with an overall rate of 4.0 fatalities per 100,000 U.S. workers. The rate of on-the-job fatal injuries among GMWs has remained elevated relative to other workers for >20 years. This report characterizes events leading to GMW fatalities and differences in fatality characteristics across demographic groups among GMWs, based on an evaluation of 2003--2008 data from the U.S. Department of Labor's Bureau of Labor Statistics (BLS) Census of Fatal Occupational Injuries (CFOI) program. The report also identifies workplace interventions that might reduce the incidence of fatal injuries. Major events leading to GMW occupational fatalities included transportation incidents (31%), contact with objects and equipment (25%), falls (23%), and traumatic acute exposures to harmful substances or environments (e.g., electrocution and drowning) (16%). To reduce the incidence of such fatalities, employers, trade and worker associations, and policy makers should focus on effective, targeted workplace safety interventions such as frequent hazard identification and training for specific hazards. Diversity among the populations of workers requires use of culture- and language-appropriate training techniques as part of comprehensive injury and illness prevention programs.

Effects of red light camera enforcement on fatal crashes in large U.S. cities.

PubMed

Hu, Wen; McCartt, Anne T; Teoh, Eric R

2011-08-01

To estimate the effects of red light camera enforcement on per capita fatal crash rates at intersections with signal lights. From the 99 large U.S. cities with more than 200,000 residents in 2008, 14 cities were identified with red light camera enforcement programs for all of 2004-2008 but not at any time during 1992-1996, and 48 cities were identified without camera programs during either period. Analyses compared the citywide per capita rate of fatal red light running crashes and the citywide per capita rate of all fatal crashes at signalized intersections during the two study periods, and rate changes then were compared for cities with and without cameras programs. Poisson regression was used to model crash rates as a function of red light camera enforcement, land area, and population density. The average annual rate of fatal red light running crashes declined for both study groups, but the decline was larger for cities with red light camera enforcement programs than for cities without camera programs (35% vs. 14%). The average annual rate of all fatal crashes at signalized intersections decreased by 14% for cities with camera programs and increased slightly (2%) for cities without cameras. After controlling for population density and land area, the rate of fatal red light running crashes during 2004-2008 for cities with camera programs was an estimated 24% lower than what would have been expected without cameras. The rate of all fatal crashes at signalized intersections during 2004-2008 for cities with camera programs was an estimated 17% lower than what would have been expected without cameras. Red light camera enforcement programs were associated with a statistically significant reduction in the citywide rate of fatal red light running crashes and a smaller but still significant reduction in the rate of all fatal crashes at signalized intersections. The study adds to the large body of evidence that red light camera enforcement can prevent the most serious crashes. Communities seeking to reduce crashes at intersections should consider this evidence. Copyright © 2011 Elsevier Ltd. All rights reserved.

Risky driving behaviors in Tehran, Iran.

PubMed

Shams, Mohsen; Rahimi-Movaghar, Vafa

2009-03-01

Iran has one of the highest fatality rates due to road traffic crashes (RTC) in the world. The disability adjusted life years (DALYs) for RTC in Iran is more than 1,300,000 years, which is more than that for any other disease such as cardiovascular or cancer. We evaluated risky driving behaviors in Tehran, the capital of Iran. A retrospective analysis was conducted based on the data obtained from the Tehran Police Safety Driving Department. Offenses and crashes were studied in different municipal districts in Tehran from March 2006 to March 2007. The inclusion criteria were risky driving behaviors fined by the police. Nonbehavioral offences were excluded. There were 3,821,798 offenses in Tehran. Not wearing a seat belt was the most common (59%) example of risky driving behavior, followed by tailgating, not wearing motorcycle helmets, talking on the cell phone while driving, overtaking from the wrong side, speeding, not driving between the lanes, weaving in and out of traffic, left deviation, and changing lanes without signals. The most common causes of RTC in Tehran are speeding, overtaking from the wrong side, and the rapid changing of driving lanes. The study factors effective in preventing risky driving behaviors in Tehran is recommended. The consideration of specific characteristics of the municipal districts is necessary to reduce risky driving behaviors.

Macroeconomic conditions and alcohol-impaired driving.

PubMed

Wagenaar, A C; Streff, F M

1989-05-01

Several distinct bodies of literature indicate that economic factors influence alcohol consumption and driving behavior, including: econometric studies of effects of income and price on drinking, studies of booming and depressed communities, studies of the effects of recession on mental health and studies of the effects of the business cycle on driving patterns. The core research questions of this study were: (1) Does the state of the economy affect the rate of fatal motor vehicle crashes involving drinking drivers? and (2) Is the relationship between the state of the economy and motor vehicle fatalities mediated by effects of economic conditions on amount of alcohol consumed and amount of driving? Data were collected on multiple indicators of economic conditions, alcohol consumption, vehicle miles traveled and rates per population of fatal crashes in the United States on a monthly basis from 1976 through 1985. Nonlinear time-series modeling methods were used to estimate both direct and indirect effects and both coincident and lagged relationships. Results showed that economic conditions significantly influence fatal crash rates both directly and via changes in aggregate amount of alcohol consumed and aggregate amount of driving. However, these interrelationships at multiple lags are complex and not yet fully understood.

Fatal disease and demographic Allee effect: population persistence and extinction.

PubMed

Friedman, Avner; Yakubu, Abdul-Aziz

2012-01-01

If a healthy stable host population at the disease-free equilibrium is subject to the Allee effect, can a small number of infected individuals with a fatal disease cause the host population to go extinct? That is, does the Allee effect matter at high densities? To answer this question, we use a susceptible-infected epidemic model to obtain model parameters that lead to host population persistence (with or without infected individuals) and to host extinction. We prove that the presence of an Allee effect in host demographics matters even at large population densities. We show that a small perturbation to the disease-free equilibrium can eventually lead to host population extinction. In addition, we prove that additional deaths due to a fatal infectious disease effectively increase the Allee threshold of the host population demographics.

Sex differences in case fatality before and after admission to hospital after acute cardiac events: analysis of community based coronary heart disease register.

PubMed Central

Sonke, G. S.; Beaglehole, R.; Stewart, A. W.; Jackson, R.; Stewart, F. M.

1996-01-01

OBJECTIVE: To determine whether the reported higher case fatality in hospital after an acute cardiac event in women can be explained by sex differences in mortality before admission and in baseline risk factors. DESIGN: Analyses of data from a community based coronary heart disease register. SETTING: Auckland region, New Zealand. SUBJECTS: 5106 patients aged 25-64 years with an acute cardiac event leading to coronary death or definite myocardial infarction within 28 days of onset, occurring between 1986 and 1992. MAIN OUTCOME MEASURES: Case fatality before admission, 28 day case fatality for patients in hospital, and total case fatality after an acute cardiac event. RESULTS: Despite a more unfavourable risk profile women tended to have lower case fatality before admission than men (crude odds ratio 0.88; 95% confidence interval 0.77 to 1.02). Adjustment for age, living arrangements, smoking, medical history, and treatment increased the effect of sex (0.72; 0.60 to 0.86). After admission to hospital, women had a higher case fatality than men (1.76; 1.43 to 2.17), but after adjustment for confounders this was reduced to 1.18 (0.89 to 1.58). Total case fatality 28 days after an acute cardiac event showed no significant difference between men and women (0.85; 0.70 to 1.02) CONCLUSIONS: The higher case fatality after an acute cardiac event in women admitted to hospital is largely explained by differences in living status, history, and medical treatment and is balanced by a lower case fatality before admission. PMID:8870571

Influences of Vehicle Size and Mass and Selected Driver Factors on Odds of Driver Fatality

PubMed Central

Padmanaban, Jeya

2003-01-01

Research was undertaken to determine vehicle size parameters influencing driver fatality odds, independent of mass, in two-vehicle collisions. Forty vehicle parameters were evaluated for 1,500 vehicle groupings. Logistic regression analyses show driver factors (belt use, age, drinking) collectively contribute more to fatality odds than vehicle factors, and that mass is the most important vehicular parameter influencing fatality odds for all crash configurations. In car crashes, other vehicle parameters with statistical significance had a second order effect compared to mass. In light truck-to-car crashes, “vehicle type-striking vehicle is light truck” was the most important parameter after mass, followed by vehicle height and bumper height, with second order effect. To understand the importance of “vehicle type” variable, further investigation of vehicle “stiffness” and other passenger car/light truck differentiating parameters is warranted. PMID:12941244

[Instability of the distal radioulnar joint: Treatment options for ulnar lesions of the triangular fibrocartilage complex].

PubMed

Spies, C K; Prommersberger, K J; Langer, M; Müller, L P; Hahn, P; Unglaub, F

2015-08-01

Injuries of the triangular fibrocartilage complex (TFCC) may be fatal to the distal radioulnar joint (DRUJ). This structure is one of the crucial stabilizers and guarantees unrestricted pronosupination of the forearm. A systematic examination is mandatory to diagnose DRUJ instability reliably. A clinical examination in comparison to the contralateral side is obligatory. Plain radiographs are required to exclude osseous lesions or deformities. Computed tomography of both wrists in neutral, pronation and supination is necessary to verify DRUJ instability in ambiguous situations. Based on a systematic examination wrist and DRUJ arthroscopy identify lesions clearly. Injuries of the radioulnar ligaments which entail DRUJ instability, should be reconstructed preferably anatomically. Ulnar-sided TFCC lesions may often cause DRUJ instability. Osseous ligament avulsions are mostly treated osteosynthetically. Ligament tears may be refixated using anchor or transosseous sutures. Tendon transplants are necessary for an anatomical reconstruction in cases of irreparable ruptures.

The history of the diagnosis and treatment of ectopic pregnancy: a medical adventure.

PubMed

Lurie, S

1992-01-09

From its indirect reference by Abulcasis (936-1013) and until the 19th century the ectopic pregnancy was known as a universally fatal accident. By reporting successful treatment of tubal pregnancy with salpingectomy in 1884 Robert Lawson Tait (1845-1899) started an era of almost 70 years of exclusively extirpative treatment of ectopic pregnancy. The technologic revolution of the 20th century improved diagnostic capabilities so that diagnosis of unruptured ectopic pregnancy becomes feasible and even mandatory. Side by side our understanding of the natural history of ectopic pregnancy improved. Many patients with early-resolving ectopic pregnancies escape surgical treatment. Preservation of future fertility became possible with the introduction of conservative surgical procedures and with the use of methotrexate. The main achievement in the treatment of ectopic pregnancy over the past 110 years is the dramatic decrease in mortality rate: from 72-90% in 1880 to 0.14% in 1990.

The Effectiveness of Fatal Vision Goggles: Disentangling Experiential versus Onlooker Effects

ERIC Educational Resources Information Center

Jewell, Jeremy; Hupp, Stephen; Luttrell, Greg

2004-01-01

This study provides the first empirical investigation of Fatal Vision Goggles as a prevention tool aimed at changing attitudes toward drinking and driving. College students (N = 163) were randomly assigned to three groups: A control group, a group wearing the goggles, and a group of onlookers who were observing those wearing the goggles. Attitudes…

Urban street structure and traffic safety.

PubMed

Mohan, Dinesh; Bangdiwala, Shrikant I; Villaveces, Andres

2017-09-01

This paper reports the influence of road type and junction density on road traffic fatality rates in U.S. cities. The Fatality Analysis Reporting System (FARS) files were used to obtain fatality rates for all cities for the years 2005-2010. A stratified random sample of 16 U.S. cities was taken, and cities with high and low road traffic fatality rates were compared on their road layout details (TIGER maps were used). Statistical analysis was done to determine the effect of junction density and road type on road traffic fatality rates. The analysis of road network and road traffic crash fatality rates in these randomly selected U.S. cities shows that, (a) higher number of junctions per road length was significantly associated with a lower motor- vehicle crash and pedestrian mortality rates, and, (b) increased number of kilometers of roads of any kind was associated with higher fatality rates, but an additional kilometer of main arterial road was associated with a significantly higher increase in total fatalities. When compared to non-arterial roads, the higher the ratio of highways and main arterial roads, there was an association with higher fatality rates. These results have important implications for road safety professionals. They suggest that once the road and street structure is put in place, that will influence whether a city has low or high traffic fatality rates. A city with higher proportion of wider roads and large city blocks will tend to have higher traffic fatality rates, and therefore in turn require much more efforts in police enforcement and other road safety measures. Urban planners need to know that smaller block size with relatively less wide roads will result in lower traffic fatality rates and this needs to be incorporated at the planning stage. Copyright © 2017 National Safety Council and Elsevier Ltd. All rights reserved.

Fatalities after taking ibogaine in addiction treatment could be related to sudden cardiac death caused by autonomic dysfunction.

PubMed

Maas, U; Strubelt, S

2006-01-01

Ibogaine is the most important alkaloid of the Central African Iboga-shrub. It is the central drug in Gabonian initiation ceremonies in which it is used to cause a near-death experience. In Western countries it is used in private clinics to treat addiction. However, in the United States and most European countries it is classified as an illegal drug because at least eight persons have died after having taken Ibogaine. These fatalities occurred in most cases several days after ingestion or following the intake of very small doses. There is no conclusive explanation at the present time for these deaths. We hypothesize, that these deaths may be a result of cardiac arrhythmias, caused by a dysregulation of the autonomic nervous system. Ibogaine affects the autonomic nervous system by influencing several neurotransmitter-systems and the fastigial nucleus. The cerebellar nucleus responds to small doses with a stimulation of the sympathetic system, leading to a fight or flight reaction. High doses, however, lead to a vagal dominance: a "feigned death". The risk of cardiac arrhythmias is increased in situations of sympathetic stimulation or coincidence of a high parasympathetic tonus and a left-sided sympathetic stimulation. This could occur under influence of small doses of ibogaine and also at times of exhaustion with a high vagal tonus, when sudden fear reactions could cause a critical left-sided sympathetic stimulation. Gabonian healers prevent these risks by isolating their patients from normal life and by inducing a trance-state with right-hemispheric and vagal dominance for several days.

Acute Myocardial Infarction Population Incidence and Mortality Rates, and 28-day Case-fatality in Older Adults. The REGICOR Study.

PubMed

Vázquez-Oliva, Gabriel; Zamora, Alberto; Ramos, Rafel; Marti, Ruth; Subirana, Isaac; Grau, María; Dégano, Irene R; Marrugat, Jaume; Elosua, Roberto

2017-11-22

Our aims were to determine acute myocardial infarction (AMI) incidence and mortality rates, and population and in-hospital case-fatality in the population older than 74 years; variability in clinical characteristics and AMI management of hospitalized patients, and changes in the incidence and mortality rates, case-fatality, and management by age groups from 1996 to 1997 and 2007 to 2008. A population-based AMI registry in Girona (Catalonia, Spain) including individuals with suspected AMI older than 34 years. The incidence rate increased with age from 169 and 28 cases/100 000 per year in the group aged 35 to 64 years to 2306 and 1384 cases/100 000 per year in the group aged 85 to 94 years, in men and women, respectively. Population case-fatality also increased with age, from 19% in the group aged 35 to 64 years to 84% in the group aged 85 to 94 years. A lower population case-fatality was observed in the second period, mainly explained by a lower in-hospital case-fatality. The use of invasive procedures and effective drugs decreased with age but increased in the second period in all ages up to 84 years. Acute myocardial infarction incidence, mortality, and case-fatality increased exponentially with age. There is still a gap in the use of invasive procedures and effective drugs between younger and older patients. Copyright © 2017 Sociedad Española de Cardiología. Published by Elsevier España, S.L.U. All rights reserved.

Fatal passenger vehicle crashes 1999 to 2004 with drivers under age 15: the impact in Texas and other southern and southwestern states.

PubMed

Frisch, Larry

2007-03-01

Texas has more fatal crashes involving unlicensed drivers under age 15 than does any other US state. Numbers and rates of such crashes are also above the national mean in many southern and Southwest states. Data on fatal passenger vehicle crashes from 1999 through 2004 were obtained from the online Fatality Analysis Reporting System (FARS). During the study period, there were 51 fatal passenger vehicle crashes in Texas in which drivers were under age 15. These crashes accounted for 12.3% of the US total. Nine southern states, including Texas, together accounted for 44% of all fatal crashes involving drivers under 15. Unlicensed crash rates per million inhabitants were higher in Texas than in other states with comparable populations but were much lower than those in other southern, southwest, and north central states. While Texas has recently improved its compliance with proposed graduated licensing models, state law explicitly prohibits police from stopping drivers based solely on age-related probable cause. This restriction may be a major barrier to effective detection and interdiction of under-age unlicensed driving. Because of the relatively high number of fatal crashes involving drivers under age 15 occurring in Texas, preventive efforts targeted to this state could modestly reduce the national burden of deaths due to very young unlicensed drivers. Expanding these efforts to other southern and southwest states could further reduce numbers and rates of such crashes. Expanded use of graduated licensing and increased public awareness are likely to prove effective tools in this public health effort.

A Review of Disaster-Related Carbon Monoxide Poisoning: Surveillance, Epidemiology, and Opportunities for Prevention

PubMed Central

Clower, Jacquelyn H.; Hernandez, Sandra A.; Damon, Scott A.; Yip, Fuyuen Y.

2012-01-01

Objectives. We conducted a systematic literature review to better understand aspects of disaster-related carbon monoxide (CO) poisoning surveillance and determine potentially effective prevention strategies. Methods. This review included information from 28 journal articles on disaster-related CO poisoning cases occurring between 1991 and 2009 in the United States. Results. We identified 362 incidents and 1888 disaster-related CO poisoning cases, including 75 fatalities. Fatalities occurred primarily among persons who were aged 18 years or older (88%) and male (79%). Hispanics and Asians accounted for 20% and 14% of fatal cases and 21% and 7% of nonfatal cases, respectively. Generators were the primary exposure source for 83% of fatal and 54% of nonfatal cases; 67% of these fatal cases were caused by indoor generator placement. Charcoal grills were a major source of exposure during winter storms. Most fatalities (94%) occurred at home. Nearly 89% of fatal and 53% of nonfatal cases occurred within 3 days of disaster onset. Conclusions. Public health prevention efforts could benefit from emphasizing predisaster risk communication and tailoring interventions for racial, ethnic, and linguistic minorities. These findings highlight the need for surveillance and CO-related information as components of disaster preparedness, response, and prevention. PMID:22897556

Protection of children restrained in child safety seats in side impact crashes.

PubMed

Arbogast, Kristy B; Locey, Caitlin M; Zonfrillo, Mark R; Maltese, Matthew R

2010-10-01

The performance of child restraint systems (CRS) in side impact motor vehicle crashes has been under study due to the injury and fatality burden of these events. Although previous research has quantified injury risk or described injured body regions, safety advances require an understanding of injury causation. Therefore, the objective was to delineate injury causation scenarios for CRS-restrained children in side impacts and document probable contact points in the vehicle interior. Two in-depth crash investigation databases, the Crash Injury Research and Engineering Network and the Partners for Child Passenger Safety Study, were queried for rear-seated, CRS-restrained children in side impact crashes who sustained Abbreviated Injury Scale 2+ injury. These cases were reviewed by a multidisciplinary team of physicians and engineers to describe injury patterns, injury causation, and vehicle components that contributed to the injuries. Forty-one occupants (average age, 2.6 years) met the inclusion criteria. Twenty-four were near side to the crash, 7 were far side, and 10 were center seated. The most common injuries were to the skull and brain with an increasing proportion of skull fracture as age increased. Head and spine injuries without evidence of head contact were rare but present. All thoracic injuries were lung contusions and no rib fractures occurred. Near-side head and face contacts points were along the rear vertical plane of the window and the horizontal plane of the window sill. Head and face contact points for center- and far-side occupants were along the edges of the front seat back and front seat head restraint. Head injuries are the target for injury prevention for children in CRS in side impact crashes. Most of these injuries are due to the contact; for near-side occupants, contact with the CRS structure and the door interior, for far- or center-seated occupants, contact with the front seat back. These data are useful in developing both educational and technological interventions to reduce the burden of injury to these children.

Zinc as an adjunct treatment for reducing case fatality due to clinical severe infection in young infants: study protocol for a randomized controlled trial.

PubMed

Wadhwa, Nitya; Basnet, Sudha; Natchu, Uma Chandra Mouli; Shrestha, Laxman P; Bhatnagar, Shinjini; Sommerfelt, Halvor; Strand, Tor A; Ramji, Siddarth; Aggarwal, K C; Chellani, Harish; Govil, Anuradha; Jajoo, Mamta; Mathur, N B; Bhatt, Meenakshi; Mohta, Anup; Ansari, Imran; Basnet, Srijana; Chapagain, Ram H; Shah, Ganesh P; Shrestha, Binod M

2017-07-10

An estimated 2.7 of the 5.9 million deaths in children under 5 years of age occur in the neonatal period. Severe infections contribute to almost a quarter of these deaths. Mortality due to severe infections in developing country settings is substantial despite antibiotic therapy. Effective interventions that can be added to standard therapy for severe infections are required to reduce case fatality. This is a double-blind randomized placebo-controlled parallel group superiority trial to investigate the effect of zinc administered orally as an adjunct to standard therapy to infants aged 3 days up to 2 months (59 days) hospitalized with clinical severe infection, that will be undertaken in seven hospitals in Delhi, India and Kathmandu, Nepal. In a 1:1 ratio, we will randomly assign young infants to receive 10 mg of elemental zinc or placebo orally in addition to the standard therapy for a total of 14 days. The primary outcomes hospital case fatality, which is death due to any cause and at any time after enrolment while hospitalized for the illness episode, and extended case fatality, which encompasses the period until 12 weeks after enrolment. A previous study showed a beneficial effect of zinc in reducing the risk of treatment failure, as well as a non-significant effect on case fatality. This study was not powered to detect an effect on case fatality, which this current study is. If the results are consistent with this earlier trial, we would have provided strong evidence for recommending zinc as an adjunct to standard therapy for clinical severe infection in young infants. Universal Trial Number: U1111-1187-6479, Clinical Trials Registry - India: CTRI/2017/02/007966 : Registered on February 27, 2017.

Is passenger vehicle incompatibility still a problem?

PubMed

Teoh, Eric R; Nolan, Joseph M

2012-01-01

Passenger cars often are at a disadvantage when colliding with light trucks (sport utility vehicles [SUVs] and pickups) due to differences in mass, vehicle structural alignment, and stiffness. In 2003, vehicle manufacturers agreed to voluntary measures to improve compatibility, especially in front-to-front and front-to-side crashes, with full adherence to be achieved by September 2009. This study examined whether fatality rates are consistent with the expected benefit of this agreement. Analyses examined 2 death rates for 1- to 4-year-old passenger vehicles during 2000-2001 and 2008-2009 in the United States: occupant deaths per million registered vehicle years in these vehicles and deaths in other cars that collided with these vehicles in 2-vehicle crashes per million registered vehicle years. These rates were computed for each study period and for cars/minivans (referred to as cars), SUVs, and pickups by curb weight (in 500-pound increments). The latter death rate, referred to as the car crash partner death rate, also was computed for front-to-front crashes and front-to-side crashes where the front of the 1- to 4-year-old vehicle struck the side of the partner car. In both study periods, occupant death rates generally decreased for each vehicle type both with increasing curb weight and over time. SUVs experienced the greatest declines compared with cars and pickups. This is due in part to the early fitment of electronic stability control in SUVs, which drastically reduced the incidence of single-vehicle rollover crashes. Pickups had the highest death rates in both study periods. Car crash partner death rates generally declined over time for all vehicle categories but more steeply for SUVs and pickups colliding with cars than for cars colliding with cars. In fact, the car crash partner death rates for SUVs and cars were nearly identical during 2008-2009, suggesting that the voluntary design changes for compatibility have been effective. Car crash partner death rates also declined for pickups, but their rates were consistently the highest in both study periods. It is impossible to disentangle the individual contributions of the compatibility agreement, improved crashworthiness of cars, and other factors in reducing car crash partner fatality rates. However, the generally larger reductions in car crash partner death rates for SUVs and pickups indicate the likely benefits of the agreement. Overall, this study finds that the system of regulatory testing, voluntary industry initiatives, and consumer information testing has led to a passenger vehicle fleet that is much more compatible in crashes.

Effects of smoke-free laws on alcohol-related car crashes in California and New York: time series analyses from 1982 to 2008.

PubMed

Bernat, Debra H; Maldonado-Molina, Mildred; Hyland, Andrew; Wagenaar, Alexander C

2013-02-01

We examined effects of New York and California's statewide smoke-free restaurant and bar policies on alcohol-related car crash fatalities. We used an interrupted time-series design from 1982 to 2008, with 312 monthly observations, to examine the effect of each state's law on single-vehicle-nighttime crashes and crashes involving a driver with a blood alcohol concentration of 0.08 grams per deciliter or greater. Implementation of New York and California's statewide smoke-free policies was not associated with alcohol-related car crash fatalities. Additionally, analyses showed no effect of New York's smoke-free policy on alcohol-related car crash fatalities in communities along the Pennsylvania-New York border. Statewide smoke-free restaurant and bar laws do not appear to affect rates of alcohol-related car crashes.

An estimate of the effectiveness of an in-vehicle automatic collision notification system in reducing road crash fatalities in South Australia.

PubMed

Ponte, G; Ryan, G A; Anderson, R W G

2016-01-01

The aim of this study was to estimate the potential effectiveness of an in-vehicle automatic collision notification (ACN) system in reducing all road crash fatalities in South Australia (SA). For the years 2008 to 2009, traffic accident reporting system (TARS) data, emergency medical services (EMS) road crash dispatch data, and coroner's reports were matched and examined. This was done to initially determine the extent to which there were differences between the reported time of a fatal road crash in the mass crash data and the time EMS were notified and dispatched. In the subset of fatal crashes where there was a delay, injuries detailed by a forensic pathologist in individual coroner's reports were examined to determine the likelihood of survival had there not been a delay in emergency medical assistance. In 25% (N = 53) of fatalities in SA in the period 2008 to 2009, there was a delay in the notification of the crash event, and hence dispatch of EMS, that exceeded 10 min. In the 2-year crash period, 5 people were likely to have survived through more prompt crash notification enabling quicker emergency medical assistance. Additionally, 3 people potentially would have survived if surgical intervention (or emergency medical assistance to sustain life until surgery) occurred more promptly. The minimum effectiveness rate of an ACN system in SA with full deployment is likely to be in the range of 2.4 to 3.8% of all road crash fatalities involving all vehicle types and all vulnerable road users (pedestrians, cyclists, and motorcyclists) from 2008 to 2009. Considering only passenger vehicle occupants, the benefit is likely to be 2.6 to 4.6%. These fatality reductions could only have been achieved through earlier notification of each crash and their location to enable a quicker medical response. This might be achievable through a fully deployed in-vehicle ACN system.

Effects of seatbelt laws on highway fatalities

DOT National Transportation Integrated Search

1989-11-01

The statistical models used in this update indicate that states : which have a seatbelt law have experienced on average a 7.7 : percent reduction in frontseat occupant fatalities in vehicles : generally covered by laws. That is, on average in any law...

Australian quad bike fatalities: what is the economic cost?

PubMed

Lower, Tony; Pollock, Kirrily; Herde, Emily

2013-04-01

To determine the economic costs associated with all quad bike-related fatalities in Australia, 2001 to 2010. A human capital approach to establish the economic costs of quad bike related fatalities to the Australian economy. The model included estimates on loss of earnings due to premature death and direct costs based on coronial records for ambulance, police, hospital, premature funeral, coronial and work safety authority investigation, and death compensation costs. All costs were calculated to 2010 dollars. The estimated total economic cost associated with quad bike fatalities over this period was $288.1 million, with an average cost for each fatality of $2.3 million. When assessing the average cost of incidents between age cohorts, those aged 25-34 years had the lowest number of fatalities but had the highest average cost ($4.2 million). Quad bike fatalities have a significant economic impact on Australian society that is increasing. Implications : Given the high cost to society, interventions to address quad bike fatalities have the potential to be highly cost-effective. Such interventions should focus on design approaches to improve the safety of quad bikes in terms of stability and protection in the event of a rollover. Additionally, relevant policy (e.g. no children under 16 years riding quads, no passengers) and intervention approaches (e.g. training and use of helmets) must also support the design modifications. © 2013 The Authors. ANZJPH © 2013 Public Health Association of Australia.

Fatal occupational accidents in Danish fishing vessels 1989-2005.

PubMed

Laursen, Lise H; Hansen, Henrik L; Jensen, Olaf C

2008-06-01

The purpose of the study was to study the circumstances and incidence rates of fatal accidents in inspection obligated and non-inspection obligated Danish fishing vessels to identify areas for prevention. Information about the fatalities came from maritime authority reports, including vessel disaster reports, post mortem reports, maritime inquiries and police reports. The person- and vessel years at risk came from the Danish Directorate of Fisheries. During the period 1989-2005, 114 fatalities occurred. Sixty-one of the fatalities occurred in 36 vessel disasters mainly caused by foundering/capsizing due to stability changes in rough weather and collisions; 39 fatal occupational accidents mainly occurred on the larger inspection obligated trawlers during fishing. In the remaining 14 other fatal accidents, the main causal factors were difficult embarking/disembarking conditions by darkness in foreign ports and alcohol intoxication. In the period 1995-2005, the overall incidence rate was 10 per 10,000 fishermen per year with no down-going trend during that period. The fatal accident rates are still too high, despite the efforts to reduce the risk. Increased focus on regular and repeated safety training for all fishermen and improved safety measures are needed, especially in the underscored areas of sea disasters concerning small vessels and occupational accidents on big vessels. Better registration of time at risk for fishermen is needed to validate the effect of the safety measures.

Modeling the effect of operator and passenger characteristics on the fatality risk of motorcycle crashes

PubMed Central

Tavakoli Kashani, Ali; Rabieyan, Rahim; Besharati, Mohammad Mehdi

2016-01-01

Abstract: Background: In Iran more than 25% of crash fatalities belong to motorcycle operators and passengers in the recent years, from which about 20% are related to passenger fatalities. Methods: The aim of this study was to investigate the motorcycle operator and passenger characteristics as well as other contributory factors that may affect the fatality risk of motorcyclists involved in traffic crashes. To this end, motorcycle crash data between 2009 and 2012 was extracted from Iran traffic crash database and a logistic regression analysis was performed to obtain odds ratio estimates for each of the study variables. Results: The fatality risk of motorcyclists has a direct relationship with the number of pillion passengers carried. Results also indicate that the amount of increase in the likelihood of having a fatality in a motorcycles crash is considerably higher when the operator is accompanied by a male passenger of the same age. Furthermore, results showed that if the crash is occurred in the darkness, on curves, in rural areas and on highways, then the crash would be more likely to be fatal. Moreover, the head-on collisions, older operators, unlicensed operators and not using a safety helmet were found to increase the likelihood of a fatality in a motorcycle crash. Conclusions: Preventative measures such as, imposing stricter rules regarding safety helmet usage and confining the number of pillion passengers to one, might be implemented to reduce the fatality risk in motorcycle crashes. In addition, more appropriate infrastructures for penalizing offending motorcyclists could also reduce the frequency of law violations such as not wearing helmet or riding without motorcycle license, which in turn, would result into a reduction in the fatality risk of motorcycle crashes. PMID:26420217

The effect of rate denominator source on US fatal occupational injury rate estimates.

PubMed

Richardson, David; Loomis, Dana; Bailer, A John; Bena, James

2004-09-01

The Current Population Survey (CPS) is often used as a source of denominator information for analyses of US fatal occupational injury rates. However, given the relatively small sample size of the CPS, analyses that examine the cross-classification of occupation or industry with demographic or geographic characteristics will often produce highly imprecise rate estimates. The Decennial Census of Population provides an alternative source for rate denominator information. We investigate the comparability of fatal injury rates derived using these two sources of rate denominator information. Information on fatal occupational injuries that occurred between January 1, 1983 and December 31, 1994 was obtained from the National Traumatic Occupational Fatality surveillance system. Annual estimates of employment by occupation, industry, age, and sex were derived from the CPS, and by linear interpolation and extrapolation from the 1980 and 1990 Census of Population. Fatal injury rates derived using these denominator data were compared. Fatal injury rates calculated using Census-based denominator data were within 10% of rates calculated using CPS data for all major occupation groups except farming/forestry/fishing, for which the fatal injury rate calculated using Census-based denominator data was 24.69/100,000 worker-years and the rate calculated using CPS data was 19.97/100,000 worker-years. The choice of denominator data source had minimal influence on estimates of trends over calendar time in the fatal injury rates for most major occupation and industry groups. The Census offers a reasonable source for deriving fatal injury rate denominator data in situations where the CPS does not provide sufficiently precise data, although the Census may underestimate the population-at-risk in some industries as a consequence of seasonal variation in employment.

Type, size and age of vehicles driven by teenage drivers killed in crashes during 2008-2012.

PubMed

McCartt, Anne T; Teoh, Eric R

2015-04-01

Given teenagers' elevated crash rates, it is especially important that their vehicles have key safety features and good crash protection. A profile of vehicles driven by teenagers killed in crashes was developed. Data on vehicles of drivers ages 15-17 and ages 35-50 who died in crashes during 2008-2012 were obtained from the Fatality Analysis Reporting System. Using vehicle identification numbers, the vehicle make, model and model year were identified. 29% of fatally injured teenagers were driving mini or small cars, 82% were driving vehicles at least 6 years old, and 48% were driving vehicles at least 11 years old. Compared with middle-aged drivers, teenagers' vehicles more often were small or mini cars or older vehicles. Few teenagers' vehicles had electronic stability control or side airbags as standard features. Parents should consider safety when choosing vehicles for their teenagers. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Spatiotemporal and random parameter panel data models of traffic crash fatalities in Vietnam.

PubMed

Truong, Long T; Kieu, Le-Minh; Vu, Tuan A

2016-09-01

This paper investigates factors associated with traffic crash fatalities in 63 provinces of Vietnam during the period from 2012 to 2014. Random effect negative binomial (RENB) and random parameter negative binomial (RPNB) panel data models are adopted to consider spatial heterogeneity across provinces. In addition, a spatiotemporal model with conditional autoregressive priors (ST-CAR) is utilised to account for spatiotemporal autocorrelation in the data. The statistical comparison indicates the ST-CAR model outperforms the RENB and RPNB models. Estimation results provide several significant findings. For example, traffic crash fatalities tend to be higher in provinces with greater numbers of level crossings. Passenger distance travelled and road lengths are also positively associated with fatalities. However, hospital densities are negatively associated with fatalities. The safety impact of the national highway 1A, the main transport corridor of the country, is also highlighted. Copyright © 2016 Elsevier Ltd. All rights reserved.

The Effects of Fatal Vision Goggles on Drinking and Driving Intentions in College Students

ERIC Educational Resources Information Center

Hennessy, Dwight A.; Lanni-Manley, Elizabeth; Maiorana, Nicole

2006-01-01

The present study was designed to examine the effectiveness of Fatal Vision Goggles in reducing intentions to drink and drive. Participants performed a field sobriety task and drove in a traffic simulator while wearing the goggles. A regression analysis was performed in order to predict changes in intentions to drink and drive, using typical…

Determinant of Road Traffic Crash Fatalities in Iran: A Longitudinal Econometric Analysis.

PubMed

Rezaei, Satar; Bagheri Lankarani, Kamran; Karami Matin, Behzad; Bazyar, Mohammad; Hamzeh, Behrooz; Najafi, Farid

2015-01-01

Injuries and deaths from road traffic crashes are one of the main public health problems throughout the world. This study aimed to identify determinants of fatality traffic accident in Iran for the twenty-span year from 1991 to 2011. A time series analysis (1991-2011) was used to examine the effects of some of the key explanatory factors (GDP per capita, number of doctors per 10,000 populations, degree of urbanization, unemployment rate and motorization rate) on deaths from road traffic in Iran. In order to examine long- and short-run effects of variables, we employed autoregressive distributed lag (ARDL) approach and error correction method (ECM). The data for the study was obtained from the Central Bank of Iran (CBI), Iranian Statistical Center (ISC) and Legal medical organizations (LMO). GDP per capita, doctor per 10,000 populations, degree of urbanization and motorization rate had a significant impact on fatality from road traffic in Iran. We did not observe any short- and long-term effects of the unemployment rate on fatality from road traffic. GDP per capita, doctor per 10,000 populations, degree of urbanization and motorization rate were identified as main determinant of fatality from road traffic accidents in Iran. We hope the results of the current study enable health policy-makers to understand better the factors affecting deaths from road traffic accidents in the country.

Effectiveness of source documents for identifying fatal occupational injuries: a synthesis of studies.

PubMed

Stout, N; Bell, C

1991-06-01

The complete and accurate identification of fatal occupational injuries among the US work force is an important first step in developing work injury prevention efforts. Numerous sources of information, such as death certificates, Workers' Compensation files, Occupational Safety and Health Administration (OSHA) files, medical examiner records, state health and labor department reports, and various combinations of these, have been used to identify cases of work-related fatal injuries. Recent studies have questioned the effectiveness of these sources for identifying such cases. At least 10 studies have used multiple sources to define the universe of fatal work injuries within a state and to determine the capture rates, or proportion of the universe identified, by each source. Results of these studies, which are not all available in published literature, are summarized here in a format that allows researchers to readily compare the ascertainment capabilities of the sources. The overall average capture rates of sources were as follows: death certificates, 81%; medical examiner records, 61%; Workers' Compensation reports, 57%; and OSHA reports 32%. Variations by state and value added through the use of multiple sources are presented and discussed. This meta-analysis of 10 state-based studies summarizes the effectiveness of various source documents for capturing cases of fatal occupational injuries to help researchers make informed decisions when designing occupational injury surveillance systems.

Effectiveness of source documents for identifying fatal occupational injuries: a synthesis of studies.

PubMed Central

Stout, N; Bell, C

1991-01-01

BACKGROUND: The complete and accurate identification of fatal occupational injuries among the US work force is an important first step in developing work injury prevention efforts. Numerous sources of information, such as death certificates, Workers' Compensation files, Occupational Safety and Health Administration (OSHA) files, medical examiner records, state health and labor department reports, and various combinations of these, have been used to identify cases of work-related fatal injuries. Recent studies have questioned the effectiveness of these sources for identifying such cases. METHODS: At least 10 studies have used multiple sources to define the universe of fatal work injuries within a state and to determine the capture rates, or proportion of the universe identified, by each source. Results of these studies, which are not all available in published literature, are summarized here in a format that allows researchers to readily compare the ascertainment capabilities of the sources. RESULTS: The overall average capture rates of sources were as follows: death certificates, 81%; medical examiner records, 61%; Workers' Compensation reports, 57%; and OSHA reports 32%. Variations by state and value added through the use of multiple sources are presented and discussed. CONCLUSIONS: This meta-analysis of 10 state-based studies summarizes the effectiveness of various source documents for capturing cases of fatal occupational injuries to help researchers make informed decisions when designing occupational injury surveillance systems. PMID:1827569

Driver air bag effectiveness by severity of the crash.

PubMed Central

Segui-Gomez, M

2000-01-01

OBJECTIVES: This analysis provided effectiveness estimates of the driver-side air bag while controlling for severity of the crash and other potential confounders. METHODS: Data were from the National Automotive Sampling System (1993-1996). Injury severity was described on the basis of the Abbreviated Injury Scale, Injury Severity Score, Functional Capacity Index, and survival. Ordinal, linear, and logistic multivariate regression methods were used. RESULTS: Air bag deployment in frontal or near-frontal crashes decreases the probability of having severe and fatal injuries (e.g., Abbreviated Injury Scale score of 4-6), including those causing a long-lasting high degree of functional limitation. However, air bag deployment in low-severity crashes increases the probability that a driver (particularly a woman) will sustain injuries of Abbreviated Injury Scale level 1 to 3. Air bag deployment exerts a net injurious effect in low-severity crashes and a net protective effect in high-severity crashes. The level of crash severity at which air bags are protective is higher for female than for male drivers. CONCLUSIONS: Air bag improvement should minimize the injuries induced by their deployment. One possibility is to raise their deployment level so that they deploy only in more severe crashes. PMID:11029991

Effectiveness of rumble stripes on roadway safety in Mississippi.

DOT National Transportation Integrated Search

2009-12-01

Although traffic deaths are caused by an array of factors, in the United States more than half of all roadway : fatalities are caused by roadway departures [FHWA 2006]. In 2003, there were 25,562 roadway departure : fatalities, accounting for 55 perc...

A statistical analysis of the effects of a uniform minimum drinking age

DOT National Transportation Integrated Search

1987-04-01

This report examines the relationship between minimum drinking age (MDA) and : highway fatalities during the 1975-1985 period, when 35 states changed their : MDAs. An econometric model of fatalities involving the 18-20 year-old driver : normalized by...

No association between HIV status and risk of non-fatal overdose among people who inject drugs in Vancouver, Canada

PubMed Central

Escudero, Daniel J; Marshall, Brandon DL; Kerr, Thomas; Hayashi, Kanna; Feng, Cindy; Guillemi, Silvia A; Hogg, Robert S; Montaner, Julio; Wood, Evan; Milloy, M-J

2016-01-01

Background The evidence to date on whether HIV infection increases the risk of accidental drug overdose among people who inject drugs (PWID) is equivocal. Thus, we sought to estimate the effect of HIV infection on risk of non-fatal overdose among two parallel cohorts of HIV-positive and –negative PWID. Methods Data were collected from a prospective cohort of PWID in Vancouver, Canada between 2006 and 2013. During biannual follow-up assessments, non-fatal overdose within the previous 6 months was assessed. Bivariable and multivariable generalized mixed-effects regression models were used to determine the unadjusted and adjusted associations between HIV status, plasma HIV-1 RNA viral load, and likelihood of non-fatal overdose. Results A total of 1,760 eligible participants (67% male, median age = 42, and 42% HIV-positive at baseline) were included. Among 15,070 unique observations, 649 (4.3%) included a report of a non-fatal overdose within the previous 6 months (4.4% among seropositive and 4.3% among seronegative individuals). We did not observe a difference in the likelihood of overdose by HIV serostatus in crude (odds ratio [OR]: 1.05, p=0.853) analyses or analyses adjusted for known overdose risk factors (adjusted OR [AOR]: 1.19, p=0.474). In a secondary analysis, among HIV-positive PWID, we did not observe an association between having a detectable viral load and overdose (AOR: 1.03, p=0.862). Conclusions Despite the evidence that HIV infection is a risk factor for fatal overdose, we found no evidence for a relationship between HIV disease and non-fatal overdose. However, overdose remains high among PWID, indicating the need for ongoing policy addressing this problem, and research into understanding modifiable risk factors that predict non-fatal overdose. PMID:27082262

Effect of mobile phone proliferation on crash notification times and fatality rates.

PubMed

Stickles, Jimmy L; Kempema, James M; Brown, Lawrence H

2018-01-01

The purpose of this study was to evaluate whether increased proliferation of mobile telephones has been associated with decreased MVC notification times and/or decreased MVC fatality rates in the United States (US). We used World Bank annual mobile phone market penetration data and US Fatality Analysis Reporting System (FARS) fatal MVC data for 1994-2014. For each year, phone proliferation was measured as mobile phones per 100 population. FARS data were used to calculate MVC notification time (time EMS notified - time MVC occurred) in minutes, and to determine the MVC fatality rate per billion vehicle miles traveled (BVMT). We used basic vector auto-regression modeling to explore relationships between changes in phone proliferation and subsequent changes in median and 90th percentile MVC notification times, as well as MVC fatality rates. From 1994 to 2014, larger year-over-year increases in phone proliferation were associated with larger decreases in 90th percentile notification times for MVCs occurring during daylight hours (p=0.004) and on the national highway system (p=0.046) two years subsequent, and crashes off the national highway system three years subsequent (p=0.023). There were no significant associations between changes in phone proliferation and subsequent changes in median crash notification times, nor with subsequent changes in MVC fatality rates. Between 1994 and 2014 increased mobile phone proliferation in the U.S. was associated with shorter 90th percentile EMS notification times for some subgroups of fatal MVCs, but not with decreases in median notification times or overall MVC fatality rates. Copyright © 2017 Elsevier Inc. All rights reserved.

The effect of airline deregulation on automobile fatalities.

PubMed

Bylow, L F; Savage, I

1991-10-01

This paper attempts to quantify the effects of airline deregulation in the United States on intercity automobile travel and consequently on the number of highway fatalities. A demand model is constructed for auto travel, which includes variables representing the price and availability of air service. A reduced form model of the airline market is then estimated. Finding that deregulation has decreased airfares and increased flights, it is estimated that auto travel has been reduced by 2.2% per year on average. Given assumptions on the characteristics of drivers switching modes and the types of roads they drove on, the number of automobile fatalities averted since 1978 is estimated to be in the range 200-300 per year.

Bumper and grille airbags concept for enhanced vehicle compatibility in side impact: phase II.

PubMed

Barbat, Saeed; Li, Xiaowei; Prasad, Priya

2013-01-01

Fundamental physics and numerous field studies have shown a higher injury and fatality risk for occupants in smaller and lighter vehicles when struck by heavier, taller and higher vehicles. The consensus is that the significant parameters influencing compatibility in front-to-side crashes are geometric interaction, vehicle stiffness, and vehicle mass. The objective of this research is to develop a concept of deployable bumper and grille airbags for improved vehicle compatibility in side impact. The external airbags, deployed upon signals from sensors, may help mitigate the effect of weight, geometry and stiffness differences and reduce side intrusions. However, a highly reliable pre-crash sensing system is required to enable the reliable deployment, which is currently not technologically feasible. Analytical and numerical methods and hardware testing were used to help develop the deployable external airbags concept. Various Finite Element (FE) models at different stages were developed and an extensive number of iterations were conducted to help optimize airbag and inflator parameters to achieve desired targets. The concept development was executed and validated in two phases. This paper covers Phase II ONLY, which includes: (1) Re-design of the airbag geometry, pressure, and deployment strategies; (2) Further validation using a Via sled test of a 48 kph perpendicular side impact of an SUV-type impactor against a stationary car with US-SID-H3 crash dummy in the struck side; (3) Design of the reaction surface necessary for the bumper airbag functionality. The concept was demonstrated through live deployment of external airbags with a reaction surface in a full-scale perpendicular side impact of an SUV against a stationary passenger car at 48 kph. This research investigated only the concept of the inflatable devices since pre-crash sensing development was beyond the scope of this research. The concept design parameters of the bumper and grille airbags are presented in this paper. Full vehicle-to-vehicle crash test results, Via sled test, and simulation results are also presented. Head peak acceleration, Head Injury Criteria (HIC), Thoracic Trauma Index (TTI), and Pelvic acceleration for the SID-H3 dummy and structural intrusion profiles were used as performance metrics for the bumper and grille airbags. Results obtained from the Via sled tests and the full vehicle-to-vehicle tests with bumper and grille airbags were compared to those of baseline test results with no external airbags.

Relationships of Fear of Breast Cancer and Fatalism with Screening Behavior in Women Referred to Health Centers of Tabriz in Iran.

PubMed

Ghahramanian, Akram; Rahmani, Azad; Aghazadeh, Ahmad Mirza; Mehr, Lida Emami

2016-01-01

Fear and fatalism have been proposed as factors affecting breast cancer screening, but the evidence is not strong. This study aimed to determine relationships of fear and fatalism with breast cancer screening behavior among Tabriz women in Iran. In a cross- sectional study, 370 women referred to 12 health centers in Tabriz were selected with two-stage cluster sampling and data regarding breast cancer screening, fatalism and fear of breast cancer were collected respectively with a checklist for screening performance, Champions Fear and Pow Fatalism Questionnaires. Data were analyzed by logistic regression with SPSS software version 16. Only 43% and 23% of participants had undergone breast self- examination and clinical breast examination. Among women older than 40 years, 38.2% had mammography history and only 2.7% of them had done it annually. Although fatalism and fear had a stimulating effects on breast cancer screening performance th relationships were not signi cant (P>0.05). There was a negative significant correlation between fear and fatalism (r= -0.24, p=0.000). On logistic regression analysis, age (OR=1.037, p<0.01) and income status (OR= 0.411, p<0.05) significantly explained BSE and age (OR=1.051, p<0.01) and body mass index (OR= 0.879, p<0.01) explained CBE. Also BMI (OR= 0.074, p<0.05) and income status (OR=0.155, p<0.01) was significantly effective for mammography following. Breast cancer screening behavior is inappropriate and affected by family livelihood status and lifestyle leads to weight gain, so that for promoting of screening behavior, economic support to families, lifestyle modification and public education are suggested.

Performance of Dental Hygiene Students in Mass Fatality Training and Radiographic Imaging of Dental Remains.

PubMed

Newcomb, Tara L; Bruhn, Ann M; Ulmer, Loreta H; Diawara, Norou

2015-10-01

Mass fatality incidents can overwhelm local, state and national resources quickly. Dental hygienists are widely distributed and have the potential to increase response teams' capacity. However, appropriate training is required. The literature is void of addressing this type of training for dental hygienists and scant in dentistry. Hence, the purpose of this study was to assess one facet of such training: Whether the use of multimedia is likely to enhance educational outcomes related to mass fatality training. A randomized, double-blind, pre- and post-test design was used to evaluate the effectiveness of comparable educational modules for 2 groups: a control group (n=19) that received low media training and a treatment group (n=20) that received multimedia training. Participants were second-year, baccalaureate dental hygiene students. Study instruments included a multiple-choice examination, a clinical competency-based radiology lab scored via a standardized rubric, and an assessment of interest in mass fatality education as a specialty. ANOVA was used to analyze results. Participants' pre- and post-test scores and clinical competency-based radiology lab scores increased following both educational approaches. Interest in mass fatality training also increased significantly for all participants (p=0.45). There was no significant difference in pre- and post-test multiple choice scores (p=0.6455), interest (p=0.9133) or overall competency-based radiology lab scores (p=0.997) between groups. Various educational technique may be effective for mass fatality training. However, mass fatality training that incorporates multimedia is an appropriate avenue for training instruction. Continued research about multimedia's role in this specialty area is encouraged. Copyright © 2015 The American Dental Hygienists’ Association.

Effects of damaging hydrogeological events on people throughout 15 years in a Mediterranean region

NASA Astrophysics Data System (ADS)

Aceto, Luigi; Aurora Pasqua, A.; Petrucci, Olga

2017-07-01

Damaging Hydrogeological Events (DHE) are defined as rainy periods during which landslides and floods can damage people. The paper investigated the effects of DHE on people living in Calabria (southern Italy) in the period 2000-2014, using data coming from the systematic survey of regional newspapers. Data about fatalities, people injured and people involved (not killed neither hurt) were stored in the database named PEOPLE, made of three sections: (1) event identification, (2) victim-event interaction, (3) effects on people. The outcomes highlighted vulnerability factors related to gender and age: males were killed more frequently (75 %) than females (25 %), and fatalities were older (average age 49 years) than injured (40.1 years) and involved people (40.5 years). The average ages of females killed (67.5 years), injured (43.4 years) and involved (44.6 years) were higher than the same values assessed for males, maybe indicating that younger females tended to be more cautious than same-age males, while older females showed an intrinsic greater vulnerability. Involved people were younger than injured people and fatalities, perhaps because younger people show greater promptness to react in dangerous situations. In the study region, floods caused more fatalities (67.9 %), injured (55 %) and involved people (55.3 %) than landslides. Fatalities and injuries mainly occurred outdoor, especially along roads, and the most dangerous dynamic was to be dragged by flood, causing the majority of fatalities (71.4 %). These outcomes can be used to strengthen the strategies aimed at saving people, and to customise warning campaigns according to the local risk features and people's behaviour. The results can improve the understanding of the potential impacts of geo-hydrological hazards on the population and can increase risk awareness among both administrators and citizens.

Statistical Analysis to Assess Effectiveness of Rumble Stripes on Highway Safety

DOT National Transportation Integrated Search

2011-01-01

Although traffic deaths are caused by an array of factors, in the United States more than half of all roadway fatalities are caused by roadway departures [FHWA 2006]. In 2003, there were 25,562 roadway departure fatalities, accounting for 55 percent ...

The use of technology to address patterns of risk among teenage drivers.

PubMed

Brovold, Shawn; Ward, Nic; Donath, Max; Simon, Stephen; Shankwitz, Craig; Creaser, Janet

2007-01-01

The crash risk of teens is high, with fatal crash rates of teen drivers higher than any other age group. New approaches to reduce teen traffic fatalities are clearly needed. A possible approach to reduce the incidence of teen driver crashes and fatalities is through the use of vehicle-based intelligent driver support systems. To be most effective, the system should address the behaviors associated with an overwhelming number of teen fatal crashes: speed, low seatbelt use, and alcohol impairment. In-vehicle technology also offers an opportunity to address the issue of inexperience through enforcement of certain Graduated Driver's License provisions. To fully understand the capability of such technologies, there should be a concerted effort to further their development, and human factors testing should take place to understand their effects on the driver. If successfully implemented, a Teen Driver Support System (TDSS), such as the one described here, could significantly decrease the number of teens killed in traffic crashes.

Effects of Smoke-Free Laws on Alcohol-Related Car Crashes in California and New York: Time Series Analyses From 1982 to 2008

PubMed Central

Maldonado-Molina, Mildred; Hyland, Andrew; Wagenaar, Alexander C.

2013-01-01

We examined effects of New York and California’s statewide smoke-free restaurant and bar polices on alcohol-related car crash fatalities. We used an interrupted time-series design from 1982 to 2008, with 312 monthly observations, to examine the effect of each state’s law on single-vehicle-nighttime crashes and crashes involving a driver with a blood alcohol concentration of 0.08 grams per deciliter or greater. Implementation of New York and California’s statewide smoke-free policies was not associated with alcohol-related car crash fatalities. Additionally, analyses showed no effect of New York’s smoke-free policy on alcohol-related car crash fatalities in communities along the Pennsylvania-New York border. Statewide smoke-free restaurant and bar laws do not appear to affect rates of alcohol-related car crashes. PMID:23237160

The effect of statin therapy on heart failure events: a collaborative meta-analysis of unpublished data from major randomized trials

PubMed Central

Preiss, David; Campbell, Ross T.; Murray, Heather M.; Ford, Ian; Packard, Chris J.; Sattar, Naveed; Rahimi, Kazem; Colhoun, Helen M.; Waters, David D.; LaRosa, John C.; Amarenco, Pierre; Pedersen, Terje R.; Tikkanen, Matti J.; Koren, Michael J.; Poulter, Neil R.; Sever, Peter S.; Ridker, Paul M.; MacFadyen, Jean G.; Solomon, Scott D.; Davis, Barry R.; Simpson, Lara M.; Nakamura, Haruo; Mizuno, Kyoichi; Marfisi, Rosa M.; Marchioli, Roberto; Tognoni, Gianni; Athyros, Vasilios G.; Ray, Kausik K.; Gotto, Antonio M.; Clearfield, Michael B.; Downs, John R.; McMurray, John J.

2015-01-01

Aims The effect of statins on risk of heart failure (HF) hospitalization and HF death remains uncertain. We aimed to establish whether statins reduce major HF events. Methods and results We searched Medline, EMBASE, and the Cochrane Central Register of Controlled Trials for randomized controlled endpoint statin trials from 1994 to 2014. Collaborating trialists provided unpublished data from adverse event reports. We included primary- and secondary-prevention statin trials with >1000 participants followed for >1 year. Outcomes consisted of first non-fatal HF hospitalization, HF death and a composite of first non-fatal HF hospitalization or HF death. HF events occurring <30 days after within-trial myocardial infarction (MI) were excluded. We calculated risk ratios (RR) with fixed-effects meta-analyses. In up to 17 trials with 132 538 participants conducted over 4.3 [weighted standard deviation (SD) 1.4] years, statin therapy reduced LDL-cholesterol by 0.97 mmol/L (weighted SD 0.38 mmol/L). Statins reduced the numbers of patients experiencing non-fatal HF hospitalization (1344/66 238 vs. 1498/66 330; RR 0.90, 95% confidence interval, CI 0.84–0.97) and the composite HF outcome (1234/57 734 vs. 1344/57 836; RR 0.92, 95% CI 0.85–0.99) but not HF death (213/57 734 vs. 220/57 836; RR 0.97, 95% CI 0.80–1.17). The effect of statins on first non-fatal HF hospitalization was similar whether this was preceded by MI (RR 0.87, 95% CI 0.68–1.11) or not (RR 0.91, 95% CI 0.84–0.98). Conclusion In primary- and secondary-prevention trials, statins modestly reduced the risks of non-fatal HF hospitalization and a composite of non-fatal HF hospitalization and HF death with no demonstrable difference in risk reduction between those who suffered an MI or not. PMID:25802390

Improving the therapeutic ratio of craniospinal irradiation in medulloblastoma

DOE Office of Scientific and Technical Information (OSTI.GOV)

Maor, M.H.; Fields, R.S.; Hogstrom, K.R.

1985-04-01

Radiation therapy delivered to the entire cerebrospinal axis is indicated for a number of pediatric brain tumors, especially medulloblastoma. Improved radiotherapy techniques have changed the near fatal prognosis for children with medulloblastoma to a 50%, 5-year survival. Nevertheless, the treatment results in substantial acute toxicity, and many survivors have serious sequelae. Refinements in radiotherapy technique, however, can improve the therapeutic ratio of the treatment by lowering its side effects. In the last year children who required craniospinal irradiation at M.D. Anderson Hospital were treated with 6 MV photons to the brain and primary tumor and with 15-17 MeV electrons tomore » the spinal canal. The elective dose to the whole brain was 30 Gy in 17 fractions and 30 Gy in 20 fractions to the spine. The primary tumor received an additional 20-25 Gy. An electron-beam dose distribution was drawn on a computerized tomography (CT) reconstructed sagittal plane. The treatment was well tolerated in the first five patients. It is projected that the current technique will cause fewer late effects and improve the tolerance to chemotherapy.« less

Nanotheranostics ˗ Application and Further Development of Nanomedicine Strategies for Advanced Theranostics

PubMed Central

Muthu, Madaswamy S.; Leong, David Tai; Mei, Lin; Feng, Si-Shen

2014-01-01

Nanotheranostics is to apply and further develop nanomedicine strategies for advanced theranostics. This review summarizes the various nanocarriers developed so far in the literature for nanotheranostics, which include polymer conjugations, dendrimers, micelles, liposomes, metal and inorganic nanoparticles, carbon nanotubes, and nanoparticles of biodegradable polymers for sustained, controlled and targeted co-delivery of diagnostic and therapeutic agents for better theranostic effects with fewer side effects. The theranostic nanomedicine can achieve systemic circulation, evade host defenses and deliver the drug and diagnostic agents at the targeted site to diagnose and treat the disease at cellular and molecular level. The therapeutic and diagnostic agents are formulated in nanomedicine as a single theranostic platform, which can then be further conjugated to biological ligand for targeting. Nanotheranostics can also promote stimuli-responsive release, synergetic and combinatory therapy, siRNA co-delivery, multimodality therapies, oral delivery, delivery across the blood-brain barrier as well as escape from intracellular autophagy. The fruition of nanotheranostics will be able to provide personalized therapy with bright prognosis, which makes even the fatal diseases curable or at least treatable at the earliest stage. PMID:24723986

Investigating the effect of banning non-reduced ignition propensity cigarettes on fatal residential fires in Sweden.

PubMed

Bonander, Carl M; Jonsson, Anders P; Nilson, Finn T

2016-04-01

Annually, 100 people die as a result of residential fires in Sweden and almost a third of the fatal fires are known to be caused by smoking. In an attempt to reduce the occurrence of these events, reduced ignition propensity (RIP) cigarettes have been developed. They are designed to reduce the risk of fire by preventing the cigarette from burning through the full length when left unattended. In November 2011, a ban was introduced, forbidding the production and sale of all non-RIP cigarettes in all member states of the European Union, including Sweden. Monthly data on all recorded residential fires and associated fatalities in Sweden from January 2000 to December 2013 were analyzed using an interrupted time series design. The effect of the intervention [in relative risk (RR)] was quantified using generalised additive models for location, shape and scale. There were no statistically significant intervention effects on residential fires (RR 0.95 [95% CI: 0.89-1.01]), fatal residential fires (RR 0.99 [95% CI: 0.80-1.23]), residential fires where smoking was a known cause (RR 1.10 [95% CI: 0.95-1.28]) or fatal residential fires where smoking was a known cause (RR 0.92 [95% CI: 0.63-1.35]). No evidence of an effect of the ban on all non-RIP cigarettes on the risk of residential fires in Sweden was found. The results may not be generalisable to other countries. © The Author 2015. Published by Oxford University Press on behalf of the European Public Health Association. All rights reserved.

Dollars for lives : the effect of highway capital investments on traffic fatalities.

DOT National Transportation Integrated Search

2014-10-01

There is no research that links capital investments on highways with highway fatalities. Our research project aimed to fill : t : hat gap. We used state : - : level data from the 48 contiguous states of the U.S. from 1968 through 2010 to estimate the...

A method for estimating the effect of vehicle crashworthiness design changes on injuries and fatalities

DOT National Transportation Integrated Search

1998-02-01

A general methodology is developed for estimating the change in the number of injuries and fatalities expected as a result of a change in vehicle crashworthiness design. It is assumed that crash tests have provided information on dummy response measu...

Left and right in the Bible from a neuropsychological perspective.

PubMed

Fabbro, F

1994-03-01

Although in several neuropsychological works dealing with hemispheric specializations a few passages of the Bible referring to the left and the right have been mentioned now and then, a systematical study with a neuropsychological approach to this topic was still a missing link. By using concordance texts from the Bible books of the Hebrew Canon (Old Testament, OT) and from the New Testament (NT), all the verses containing any reference to the left and the right (OT = 151, NT = 49 verses) have been identified and classified into 10 groups: (1) references to space, (2) symmetric sayings, (3) the right hand is the favorite hand, (4) right eye preference, (5) God's right hand, (6) the right side is more prestigious, (7) the right side in liturgy, (8) left hand preference, (9) fatal left-hand shots, and (10) on the left side. Some statistical considerations have been put forward and a neuropsychological, anthropological approach has been suggested for the purpose of interpreting the most interesting verses. According to the author of the present paper, it would be worthwhile commenting on some texts of ancient and modern literature not only from a linguistic, historical, religious and theological point of view, but also by means of a neuropsychological approach.

Internet & branding: a perfect match or a fatal attraction? Analysis of fifty states of the U.S. official tourism websites

Treesearch

Gyehee Lee; Liping A. Cai; Everette Mills; Joseph T. O' Leary

2002-01-01

Internet plays a significant role in generating new business and facilitating customers' need for a better way to plan and book their trips. From a marketers' perspective, one of the seemingly "fatal attractions" of the Internet for DMOs is that it can be an extremely effective tool in terms of both cost effectiveness and market penetration compared...

Side Impact Regulatory Trends, Crash Environment and Injury Risk in the USA.

PubMed

Prasad, Priya; Dalmotas, Dainius; Chouinard, Aline

2015-11-01

Light duty vehicles in the US are designed to meet and exceed regulatory standards, self-imposed industry agreements and safety rating tests conducted by NHTSA and IIHS. The evolution of side impact regulation in the US from 1973 to 2015 is discussed in the paper along with two key industry agreements in 2003 affecting design of restraint systems and structures for side impact protection. A combination of all the above influences shows that vehicles in the US are being designed to more demanding and comprehensive requirements than in any other region of the world. The crash environment in the US related to side impacts was defined based on data in the nationally representative crash database NASS. Crash environment factors, including the distribution of cars, light trucks and vans (LTV's), and medium-to-heavy vehicles (MHV's) in the fleet, and the frequency of their interactions with one another in side impacts, were considered. Other factors like, crash severity in terms of closing velocity between two vehicles involved in crash, gender and age of involved drivers in two-vehicle and single vehicle crashes, were also examined. Injury risks in side impacts to drivers and passengers were determined in various circumstances such as near-side, far-side, and single vehicle crashes as a function of crash severity, in terms of estimated closing speed or lateral delta-V. Also injury risks in different pairs of striking and struck cars and LTV's, were estimated. A logistic regression model for studying injury risks in two vehicle crashes was developed. The risk factors included in the model include case and striking vehicles, consisting of cars, SUV's, vans, and pickup trucks, delta-V, damage extent, occupant proximity to the impact side, age and gender of the occupant, and belt use. Results show that car occupants make up the vast majority of serious-to-fatally injured occupants. Injury rates of car occupants in two-vehicle collision are highest when the car is struck by a pickup and lowest when struck by a car. This was the case across all lateral delta-V ranges. Additionally, near-side injury rates are substantially higher than those in far-side impacts.

Effect of Pokémon GO on incidence of fatal traffic injuries: a population-based quasi-experimental study using the national traffic collisions database in Japan.

PubMed

Ono, Sachiko; Ono, Yosuke; Michihata, Nobuaki; Sasabuchi, Yusuke; Yasunaga, Hideo

2017-10-12

Pokémon GO (Niantic Labs, released on 22 July 2016 in Japan) is an augmented reality game that gained huge popularity worldwide. Despite concern about Pokémon GO-related traffic collisions, the effect of playing Pokémon GO on the incidence of traffic injuries remains unknown. We performed a population-based quasi-experimental study using national data from the Institute for Traffic Accident Research and Data Analysis, Japan. The outcome was incidence of traffic injuries. Of 127 082 000 people in Japan, 886 fatal traffic injuries were observed between 1 June and 31 August in 2016. Regression discontinuity analysis showed a non-significant change in incidence of fatal traffic injuries after the Pokémon GO release (0.017 deaths per million, 95%CI -0.036 to 0.071). This finding was similar to that obtained from a difference-in-differences analysis. Effect of Pokémon GO on fatal traffic injuries may be negligible. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

A National Evaluation of the Nighttime and Passenger Restriction Components of Graduated Driver Licensing

PubMed Central

Fell, James C.; Todd, Michael; Voas, Robert B.

2011-01-01

Introduction The high crash rate of youthful novice drivers has been recognized for half a century. Over the last decade, graduated driver licensing (GDL) systems, which extend the period of supervised driving and limit the novice’s exposure to higher-risk conditions (such as nighttime driving) has effectively reduced crash involvements of novice drivers. Method This study used data from the Fatality Analysis Reporting System (FARS) and the implementation dates of GDL laws in a state-by-year panel study to evaluate the effectiveness of two key elements of GDL laws: nighttime restrictions and passenger limitations. Results Nighttime restrictions were found to reduce 16- and 17-year-old driver involvements in nighttime fatal crashes by an estimated 10% and 16- and 17-year-old drinking drivers in nighttime fatal crashes by 13%. Passenger restrictions were found to reduce 16- and 17-year-old driver involvements in fatal crashes with teen passengers by an estimated 9%. Conclusions These results confirm the effectiveness of these provisions in GDL systems. Impact on Public Health The results of this study indicate that nighttime restrictions and passenger limitations are very important components of any GDL law. PMID:22017831

Legislation raising the legal drinking age in Massachusetts from 18 to 20: effect on 16 and 17 year-olds.

PubMed

Smith, R A; Hingson, R W; Morelock, S; Heeren, T; Mucatel, M; Mangione, T; Scotch, N

1984-11-01

The 1979 Massachusetts law raising the legal drinking age from 18 to 20 is examined--the effects on the drinking, drinking and driving, and nonfatal and fatal crash involvement of 16-17 yr-olds, teenagers immediately younger than those targeted by the law. Data from Massachusetts are compared with those from New York State, where the drinking age remained at 18. A total of 3 yr of survey data from the two states and 6 yr of data from the Department of Transportation's Fatal Accident Reporting System provide for pre- and postlaw comparisons. The findings suggest that raising the drinking age had minimal effects on the drinking behavior of Massachusetts teenagers. Although there was a significant reduction in nonfatal crashes in Massachusetts compared with New York, no decline in single-vehicle nighttime fatal crashes or in overall fatal crashes was observed. It is suggested that changes in the drinking age may offer some reduction in teenage driving after drinking and traffic crash involvement, but that teenage drinking and driving after drinking remain serious problems even in states that raise their drinking ages.

Integrated efforts in North Carolina prove effective in reducing fatal, truck-involved crashes

DOT National Transportation Integrated Search

2000-02-01

In recent years, North Carolina has ranked as one of the worst states in the nation in terms of the number of fatal, truck-involved crashes. In 1998, North Carolina was ranked 4th on the National Highway Traffic Safety Administration's (NHTSA's) 'Top...

Evaluation of New York state's mandatory occupant restraint law : fatalities and injuries among motor vehicle occupants covered by the law

DOT National Transportation Integrated Search

1987-02-01

The report focuses on the ultimate measure of the effectiveness of New York State's Mandatory Occupant Restraint Law: reductions in fatalities and serious injuries among vehicle occupants. All front seat occupants and children under the age of ten, r...

Investigation of shipping accident injury severity and mortality.

PubMed

Weng, Jinxian; Yang, Dong

2015-03-01

Shipping movements are operated in a complex and high-risk environment. Fatal shipping accidents are the nightmares of seafarers. With ten years' worldwide ship accident data, this study develops a binary logistic regression model and a zero-truncated binomial regression model to predict the probability of fatal shipping accidents and corresponding mortalities. The model results show that both the probability of fatal accidents and mortalities are greater for collision, fire/explosion, contact, grounding, sinking accidents occurred in adverse weather conditions and darkness conditions. Sinking has the largest effects on the increment of fatal accident probability and mortalities. The results also show that the bigger number of mortalities is associated with shipping accidents occurred far away from the coastal area/harbor/port. In addition, cruise ships are found to have more mortalities than non-cruise ships. The results of this study are beneficial for policy-makers in proposing efficient strategies to prevent fatal shipping accidents. Copyright © 2015 Elsevier Ltd. All rights reserved.

Quantifying the effect of autonomous adaptation to global river flood projections: application to future flood risk assessments

NASA Astrophysics Data System (ADS)

Kinoshita, Youhei; Tanoue, Masahiro; Watanabe, Satoshi; Hirabayashi, Yukiko

2018-01-01

This study represents the first attempt to quantify the effects of autonomous adaptation on the projection of global flood hazards and to assess future flood risk by including this effect. A vulnerability scenario, which varies according to the autonomous adaptation effect for conventional disaster mitigation efforts, was developed based on historical vulnerability values derived from flood damage records and a river inundation simulation. Coupled with general circulation model outputs and future socioeconomic scenarios, potential future flood fatalities and economic loss were estimated. By including the effect of autonomous adaptation, our multimodel ensemble estimates projected a 2.0% decrease in potential flood fatalities and an 821% increase in potential economic losses by 2100 under the highest emission scenario together with a large population increase. Vulnerability changes reduced potential flood consequences by 64%-72% in terms of potential fatalities and 28%-42% in terms of potential economic losses by 2100. Although socioeconomic changes made the greatest contribution to the potential increased consequences of future floods, about a half of the increase of potential economic losses was mitigated by autonomous adaptation. There is a clear and positive relationship between the global temperature increase from the pre-industrial level and the estimated mean potential flood economic loss, while there is a negative relationship with potential fatalities due to the autonomous adaptation effect. A bootstrapping analysis suggests a significant increase in potential flood fatalities (+5.7%) without any adaptation if the temperature increases by 1.5 °C-2.0 °C, whereas the increase in potential economic loss (+0.9%) was not significant. Our method enables the effects of autonomous adaptation and additional adaptation efforts on climate-induced hazards to be distinguished, which would be essential for the accurate estimation of the cost of adaptation to climate change.

The role of the chemical burns caused by hydroxide ion in the toxicity of dermal exposure to tetramethylammonium ion in a rat model.

PubMed

Wu, Chen-Long; Su, Shih-Bin; Lien, Hsiao-Yin; Guo, How-Ran

2012-11-01

To evaluate the role of the chemical burns caused by hydroxide ion in the fatal effects of tetramethylammonium ion (TMA) in dermal exposure to tetramethylammonium hydroxide (TMAH), we conducted a rat study consisting of two-step treatments with dermal exposure to NaOH and tetramethylammonium chloride (TMACl). In the first step, NaOH or saline was administered in the gauze on the shaved skin for 5 min, and in the second step, TMAH, TMACl, or saline was administered in the same way. The mean blood pressure (MBP), heart rate (HR), and survival in rats were compared among seven groups. Dermal exposure to saline and then 2.75 M TMACl introduced limited and temporary non-fatal effects. Exposure to 2.75 M NaOH and then saline had almost no effects and caused no deaths. Treatments with more concentrated NaOH or TMACl resulted in suppressions of MBP and HR, and deaths were observed after the dosing of TMACl. The toxicity of dermal exposure to TMA alone is limited, but fatal effects can be introduced by pre-treatment with hydroxide ion. Therefore, the chemical burn caused by hydroxide ion plays an essential role in the toxicity, implicating that effective neutralizing may help decreasing the fatality rate. Copyright © 2012 Elsevier Ltd and ISBI. All rights reserved.

Occupational fatalities due to electrocutions in the construction industry.

PubMed

Janicak, Christopher A

2008-01-01

Occupational fatalities due to contact with electricity account for approximately 9% of all deaths in the construction industry and is the fourth leading cause of death in this industry. Differences in the proportions of electrocutions in the construction industry are significantly different from other industries based upon the age of the worker and the source of the electricity. This study found that, in the construction industry, the proportion of occupational fatalities due to contact with electric current is significantly higher for workers in the 16 to 19 years old age group. Contact with overhead power lines occurred more frequently with younger workers, while contact with electric wiring, transformers, and related equipment was found to occur more frequently with older workers. The proportion of fatalities due to this event was also found to account for a significantly greater proportion of fatalities in the construction industry overall. The proportions of electrocution fatalities in the construction industry were found to be significantly higher for younger workers when compared to all other industries. Focusing prevention measures toward younger workers who work near overhead power lines could have a significant impact upon death rates. For older workers, the focus should be on those who work on or near transformers, electrical wiring, and components. Across the construction industry, implementation of effective lockout-tagout programs, and verification of energy isolation, can prevent approximately 125 fatalities per year in the construction industry.

Occupational Fatalities Resulting from Falls in the Oil and Gas Extraction Industry, United States, 2005-2014.

PubMed

Mason, Krystal L; Retzer, Kyla D; Hill, Ryan; Lincoln, Jennifer M

2017-04-28

During 2003-2013, fatality rates for oil and gas extraction workers decreased for all causes of death except those associated with fall events, which increased 2% annually during 2003-2013 (1). To better understand risk factors for these events, CDC examined fatal fall events in the oil and gas extraction industry during 2005-2014 using data from case investigations conducted by the Occupational Safety and Health Administration (OSHA). Sixty-three fatal falls were identified, accounting for 15% of all fatal events. Among fatal falls, 33 (52%) workers fell from a height of >30 feet (9 meters), and 22 (35%) fell from the derrick board, the elevated work platform located in the derrick (structure used to support machinery on a drilling rig). Fall fatalities occurred most frequently when drilling rigs were being assembled or disassembled at the well site (rigging up or rigging down) (14; 22%) or when workers were removing or inserting drill pipe into the wellbore (14; 22%). Measures that target derrickmen and workers engaged in assembling and disassembling drilling rigs (rigging up and down) could reduce falls in this industry. Companies should annually update their fall protection plans and ensure effective fall prevention programs are in place for workers at highest risk for falls, including providing trainings on proper use, fit, and inspection of personal protective equipment.

Effects of Maine's 0.05% legal blood alcohol level for drivers with DWI convictions.

PubMed Central

Hingson, R; Heeren, T; Winter, M

1998-01-01

OBJECTIVE: To determine whether a Maine law lowering the legal blood alcohol limit (BAL) from 0.10% to 0.05% for people convicted of driving while intoxicated (DWI) reduced the involvement of this group in fatal crashes. METHODS: The authors calculated changes in the proportions of fatal crashes involving drivers with prior DWI convictions from the six-year period before enactment of the law to the six-year period following enactment of the law, comparing Maine with the other New England states. RESULTS: In Maine, the proportion of fetal crashes involving drivers with recorded prior DWI convictions declined 25% following passage of the 0.05% DWI law, while the proportion rose in the rest of New England during the same years. The proportion of fatal crashes involving drivers with recorded prior DWI convictions and illegal alcohol levels also declined significantly in Maine, as did the proportion of fatal crashes involving fatally injured drivers with recorded prior DWI convictions and illegal alcohol levels. Most of the latter decline was due to a decline in alcohol-related fatalities of previously convicted drivers with very high BALs, of 0.15% or higher, at the time of the fatal crash. Each of these declines in Maine was significant relative to the rest of New England. CONCLUSION: Other states should consider instituting 0.05% BAL limits for convicted DWI offenders. PMID:9769769

The High-risk Groups According to the Trends and Characteristics of Fatal Occupational Injuries in Korean Workers Aged 50 Years and Above.

PubMed

Yi, Kwan Hyung

2018-06-01

Due to an increasing number of workers aged 50 years and above, the number of those employed is also on the rise, and those workers aged 50 and over has exceeded 50% of the total fatal occupational injuries. Therefore, it is necessary to implement the selection and concentration by identifying the characteristics of high-risk groups necessary for an effective prevention against and reduction of fatal occupational injuries. This study analyzed the characteristics of high-risk groups and the occupational injury fatality rate per 10,000 workers among the workers aged 50 and over through a multi-dimensional analysis by sex, employment status of workers, industry and occupation by targeting 4,079 persons who died in fatal occupational injuries from January 2007 to December 12. The share of the workers aged 50 years and above is increasing every year in the total fatal occupational injuries occurrence, and the high-risk groups include 'male workers' by sex, 'daily workers' by worker's status, 'craft and related-trades workers' by occupation, and 'mining' by industry. The most frequent causal objects of fatal occupational injuries of the workers aged 50 years and above are found out to be 'installment and dismantlement of temporary equipment and material on work platforms including scaffold' in the construction industry and 'mobile crane, conveyor belt and fork lifts' in the manufacturing industry.

Investigating the Effect of Compaction Characteristics on the Erodibility of Cohesive Soils Using the JET Method

NASA Astrophysics Data System (ADS)

Asghari Tabrizi, A.; LaRocque, L. A.; Chaudhry, M.; Imran, J.

2013-12-01

Several flood disasters occur every year all over the world, mostly due to levee and dam failure which result in human fatalities as well as devastating economic damages. To model and predict earthen embankment failures for the preparation of emergency action plans and risk assessments, the soil erodibility by flowing water is an essential parameter. The determination of erodibility becomes even more complicated for cohesive soils because of the large number of parameters controlling their erosion behavior (e.g. clay content, plasticity, compaction effort, compaction water content) and the difficulty of estimating these parameters. In this study the effect of the compaction energy and compaction water content on the erodibility of a sandy loam soil was assessed. Soil samples were prepared in a standard diameter compaction mold, 101.6 mm, for three levels of compaction effort and water content (i.e. low, medium, and high) with two replications for each case (18 tests total) and examined using the jet erosion test (JET). Observations from qualitative and statistical analyses of the data are: 1) a wide range of erodibility, from very erodible to very resistant, was produced by changes in the compaction characteristics; 2) for a given compaction energy, the erosion resistance based on the detachment rate coefficient kd tends to become minimum near the optimum compaction water content. On the dry side of optimum compaction water content, kd decreases with steep gradients by increasing the water content, while it increases with a flatter gradient on the wet side; 3) At a given water content, the soil erosion resistance increases with compaction efforts; 4) compaction water content influences soil erosibility more than compaction energy, especially on the dry side of the optimum compaction water content; and 5) for a given compaction effort, the critical shear stress increases with water content up to an optimum water content and then it decreases which is in consistent with the kd trends.

Fatal crash involvement of unlicensed young drivers: county level differences according to material deprivation and urbanicity in the United States.

PubMed

Hanna, Christian L; Laflamme, Lucie; Bingham, C Raymond

2012-03-01

This study assessed the association between county level material deprivation and urbanization with fatal road traffic crashes involving young unlicensed drivers in the United States (US). Road traffic crashes have been positively associated with area deprivation and low population density but thus far few studies have been concerned specifically with young drivers, especially those that are unlicensed. A county material deprivation index was derived from the Townsend Material Deprivation Index, with variables extracted from the US Census (2000). An urbanicity scale was adapted from the US Department of Agriculture's Rural-Urban Continuum Codes (2003). Data on fatal crashes involving a young unlicensed driver during a seven-year period (2000-2006; n=3059) were extracted from the Fatality Analysis Reporting System. The effect of deprivation and urbanicity on the odds of the occurrence of at least one fatal crash at the county level was modeled by conditional and unconditional logistic regression. The conditional model found a positive association between material deprivation and a fatal crash involving a young unlicensed driver (OR=1.19, 95% CI 1.17, 1.21). The interaction between urbanicity and material deprivation was negatively associated in suburban counties for fatal crashes (OR=0.92, 95% CI 0.90, 0.95). An association with material deprivation and the likelihood of a fatal crash involving a young unlicensed driver is a new finding. It can be used to inform specific county-level interventions and promote state licensing policies to provide equity in young people's mobility regardless of where they live. Copyright © 2011. Published by Elsevier Ltd.

Behavior of bats at wind turbines

PubMed Central

Cryan, Paul. M.; Gorresen, P. Marcos; Hein, Cris D.; Schirmacher, Michael R.; Diehl, Robert H.; Huso, Manuela M.; Hayman, David T. S.; Fricker, Paul D.; Bonaccorso, Frank J.; Johnson, Douglas H.; Heist, Kevin; Dalton, David C.

2014-01-01

Wind turbines are causing unprecedented numbers of bat fatalities. Many fatalities involve tree-roosting bats, but reasons for this higher susceptibility remain unknown. To better understand behaviors associated with risk, we monitored bats at three experimentally manipulated wind turbines in Indiana, United States, from July 29 to October 1, 2012, using thermal cameras and other methods. We observed bats on 993 occasions and saw many behaviors, including close approaches, flight loops and dives, hovering, and chases. Most bats altered course toward turbines during observation. Based on these new observations, we tested the hypotheses that wind speed and blade rotation speed influenced the way that bats interacted with turbines. We found that bats were detected more frequently at lower wind speeds and typically approached turbines on the leeward (downwind) side. The proportion of leeward approaches increased with wind speed when blades were prevented from turning, yet decreased when blades could turn. Bats were observed more frequently at turbines on moonlit nights. Taken together, these observations suggest that bats may orient toward turbines by sensing air currents and using vision, and that air turbulence caused by fast-moving blades creates conditions that are less attractive to bats passing in close proximity. Tree bats may respond to streams of air flowing downwind from trees at night while searching for roosts, conspecifics, and nocturnal insect prey that could accumulate in such flows. Fatalities of tree bats at turbines may be the consequence of behaviors that evolved to provide selective advantages when elicited by tall trees, but are now maladaptive when elicited by wind turbines. PMID:25267628

Behavior of bats at wind turbines.

PubMed

Cryan, Paul M; Gorresen, P Marcos; Hein, Cris D; Schirmacher, Michael R; Diehl, Robert H; Huso, Manuela M; Hayman, David T S; Fricker, Paul D; Bonaccorso, Frank J; Johnson, Douglas H; Heist, Kevin; Dalton, David C

2014-10-21

Wind turbines are causing unprecedented numbers of bat fatalities. Many fatalities involve tree-roosting bats, but reasons for this higher susceptibility remain unknown. To better understand behaviors associated with risk, we monitored bats at three experimentally manipulated wind turbines in Indiana, United States, from July 29 to October 1, 2012, using thermal cameras and other methods. We observed bats on 993 occasions and saw many behaviors, including close approaches, flight loops and dives, hovering, and chases. Most bats altered course toward turbines during observation. Based on these new observations, we tested the hypotheses that wind speed and blade rotation speed influenced the way that bats interacted with turbines. We found that bats were detected more frequently at lower wind speeds and typically approached turbines on the leeward (downwind) side. The proportion of leeward approaches increased with wind speed when blades were prevented from turning, yet decreased when blades could turn. Bats were observed more frequently at turbines on moonlit nights. Taken together, these observations suggest that bats may orient toward turbines by sensing air currents and using vision, and that air turbulence caused by fast-moving blades creates conditions that are less attractive to bats passing in close proximity. Tree bats may respond to streams of air flowing downwind from trees at night while searching for roosts, conspecifics, and nocturnal insect prey that could accumulate in such flows. Fatalities of tree bats at turbines may be the consequence of behaviors that evolved to provide selective advantages when elicited by tall trees, but are now maladaptive when elicited by wind turbines.

Behavior of bats at wind turbines

USGS Publications Warehouse

Cryan, Paul M.; Gorresen, P. Marcos; Hine, Cris D.; Schirmacher, Michael; Diehl, Robert H.; Huso, Manuela M.; Hayman, David T.S.; Fricker, Paul D.; Bonaccorso, Frank J.; Johnson, Douglas H.; Heist, Kevin W.; Dalton, David C.

2014-01-01

Wind turbines are causing unprecedented numbers of bat fatalities. Many fatalities involve tree-roosting bats, but reasons for this higher susceptibility remain unknown. To better understand behaviors associated with risk, we monitored bats at three experimentally manipulated wind turbines in Indiana, United States, from July 29 to October 1, 2012, using thermal cameras and other methods. We observed bats on 993 occasions and saw many behaviors, including close approaches, flight loops and dives, hovering, and chases. Most bats altered course toward turbines during observation. Based on these new observations, we tested the hypotheses that wind speed and blade rotation speed influenced the way that bats interacted with turbines. We found that bats were detected more frequently at lower wind speeds and typically approached turbines on the leeward (downwind) side. The proportion of leeward approaches increased with wind speed when blades were prevented from turning, yet decreased when blades could turn. Bats were observed more frequently at turbines on moonlit nights. Taken together, these observations suggest that bats may orient toward turbines by sensing air currents and using vision, and that air turbulence caused by fast-moving blades creates conditions that are less attractive to bats passing in close proximity. Tree bats may respond to streams of air flowing downwind from trees at night while searching for roosts, conspecifics, and nocturnal insect prey that could accumulate in such flows. Fatalities of tree bats at turbines may be the consequence of behaviors that evolved to provide selective advantages when elicited by tall trees, but are now maladaptive when elicited by wind turbines.

Antibody response of sandhill and whooping cranes to an eastern equine encephalitis virus vaccine

USGS Publications Warehouse

Clark, G.G.; Dein, F.J.; Crabbs, C.L.; Carpenter, J.W.; Watts, D.M.

1987-01-01

As a possible strategy to protect whooping cranes (Grus americana) from fatal eastern equine encephalitis (EEE) viral infection, studies were conducted to determine the immune response of this species and sandhill cranes (Grus canadensis) to a formalin-inactivated EEE viral vaccine. Viral-specific neutralizing antibody was elicited in both species after intramuscular (IM) vaccination. Subcutaneous and intravenous routes of vaccination failed to elicit detectable antibody in sandhill cranes. Among the IM vaccinated cranes, the immune response was characterized by nondetectable or low antibody titers that waned rapidly following primary exposure to the vaccine. However, one or more booster doses consistently elicited detectable antibody and/or increased antibody titers in the whooping cranes. In contrast, cranes with pre-existing EEE viral antibody, apparently induced by natural infection, exhibited a rapid increase and sustained high-antibody titers. Even though EEE virus vaccine induced neutralizing antibody and produced no adverse side effects, further studies will be required to determine the protective efficacy of the antibody.

Current approaches to the management of idiopathic pulmonary fibrosis.

PubMed

Raghu, Ganesh; Richeldi, Luca

2017-08-01

Idiopathic pulmonary fibrosis (IPF) is a progressive and ultimately fatal lung disease associated with dyspnoea, cough and impaired quality of life. Currently, the aims of patient care are to improve outcomes for patients by slowing the progression of the disease, extending life, and improving quality of life. A prompt, accurate diagnosis is important to enable patients to receive treatment early in the course of the disease and to be considered for lung transplantation. Two anti-fibrotic drugs, nintedanib and pirfenidone, have been shown to reduce decline in lung function in patients with IPF. In addition to pharmacological therapy, optimal management of IPF includes treatment of comorbidities, symptom relief, pulmonary rehabilitation, and palliative care. Patient education is important to enable patients to make decisions about their care and to help them manage their disease and the side-effects of anti-fibrotic drugs. Research continues into new treatments and combinations of treatments that may improve outcomes for patients with this devastating disease. Copyright © 2017. Published by Elsevier Ltd.

Cantharides poisoning: A retrospective analysis from 1996 to 2016 in China.

PubMed

Zhang, Youyou; Zhou, Xiaowei; Zhang, Jie; Guan, Chuhuai; Liu, Liang

2018-05-10

Cantharides poisoning may cause serious adverse reactions or even death.We attempt to retrieval articles automatically and manually with the key words of "cantharides" and " poisoning " or " side effects ", then summarized and analyzed the cases of cantharides poisoning from 1996 to 2016 in China, to provide some reference for clinical drug use and forensic identification. Finally, 91 cases were conformance to require; general data, clinical data, prognosis, autopsy results were analyzed.We found that the health education of cantharides in primary doctors and people is lackable, the case fatality rate was 18.68% . The death patients of cantharides poisoning had cardiomyocyte necrosis and neuronal apoptosis in the histopathological examination of autopsy , but the toxicological mechanism was unclear. There may be redistribution of cantharidin in vivo after death. Collectively, we hope that an anthropological database for cantharides poisoning established by multicenter cooperation, include medical institutions and forensic identified centers, and conduct more further studies on its cardiotoxicity and neurotoxicity. Copyright © 2018. Published by Elsevier Inc.

The Discovery and Development of Drug Combinations for the Treatment of Various Diseases from Patent Literature (1980-Present).

PubMed

Kleczkowska, Patrycja; Kowalczyk, Agnieszka; Lesniak, Anna; Bujalska-Zadrozny, Magdalena

2017-01-01

The search for a miracle drug that would help to alleviate multiple ailments, dates back many thousands of years before our era and continues until today. Various techniques have been used to obtain a formulation, that would give the desired therapeutic effect. The most popular approach includes drug coctails and multicomponent drugs. Polytherapy is widely accapted as an effective tool for the treatment of several diseases, however it is often faced with important drawbacks that may sometimes result in fatal adverse effects associated with unpredictable drug interactions. Conversly, hybrid compounds were found to be an attractive way to counterbalance the unwanted side effects derived from the administration of individual drug components. Futhermore, they can serve as effective and improved remedies for patients suffering from several diseases simultaneously, as different receptorrelated pharmacophores are used as structural components. This review covers patent literature from 1980 till now that highlights the progress that has been made in the discovery of hybrid compounds potentially useful in the treatment on various disorders, including pain states, neurodegenerative or infectious diseases. Additionally, this review was further enriched with findings from original research papers. Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.org.

Efficacy of traditional Chinese medicine in treating cancer

PubMed Central

NIE, JIAO; ZHAO, CHANGLIN; DENG, LI; CHEN, JIA; YU, BIN; WU, XIANLIN; PANG, PENG; CHEN, XIAOYIN

2016-01-01

The morbidity associated with cancer has rapidly increased in recent years, and in the previous 5 years has had a tendency to be the leading cause of fatality compared with cardiovascular disease. Therefore, effective measures are required with an aim to reduce the incidence. Based on the results of clinical investigation, a multidisciplinary treatment strategy for cancer, which includes radiotherapy, chemotherapy, surgery, targeted therapy and immunotherapy, are prominently used in clinical practice. However, the therapies are insufficient due to multidrug resistance, adverse effects and the presence of the root of the cancer. Therefore, there is a necessity to develop more effective or adjunctive therapies for cancer prevention and treatment. Cancer is now widely recognized as a systemic humoral disease. Similarly, the function of herbal drugs is to modulate the whole body system in a more holistic way. Recently, herbal drugs have been applied to one of the efficient approaches for cancer therapy. Furthermore, there is evidence that various herbal medicines have been proven to be useful and effective in sensitizing the conventional agents against the various factors at the cellular and molecular levels that are associated with the occurrence of cancer and in prolonging survival time, alleviating side effects of chemotherapy and radiotherapy and improving the quality of life in cancer patients. PMID:26870326

Disentangling age–gender interactions associated with risks of fatal and non-fatal road traffic injuries in the Sultanate of Oman

PubMed Central

Al-Aamri, Amira K; Padmadas, Sabu S; Zhang, Li-Chun; Al-Maniri, Abdullah A

2017-01-01

Objective Road traffic injuries (RTIs) are the leading cause of disability-adjusted life years lost in Oman, Saudi Arabia and United Arab Emirates. Injury prevention strategies often overlook the interaction of individual and behavioural risk factors in assessing the severity of RTI outcomes. We conducted a systematic investigation of the underlying interactive effects of age and gender on the severity of fatal and non-fatal RTI outcomes in the Sultanate of Oman. Methods We used the Royal Oman Police national database of road traffic crashes for the period 2010–2014. Our study was based on 35 785 registered incidents: of these, 10.2% fatal injuries, 6.2% serious, 27.3% moderate, 37.3% mild injuries and 19% only vehicle damage but no human injuries. We applied a generalised ordered logit regression to estimate the effect of age and gender on RTI severity, controlling for risk behaviours, personal characteristics, vehicle, road, traffic, environment conditions and geographical location. Results The most dominant group at risk of all types of RTIs was young male drivers. The probability of severe incapacitating injuries was the highest for drivers aged 25–29 (26.6%) years, whereas the probability of fatal injuries was the highest for those aged 20–24 (26.9%) years. Analysis of three-way interactions of age, gender and causes of crash show that overspeeding was the primary cause of different types of RTIs. In particular, the probability of fatal injuries among male drivers attributed to overspeeding ranged from 3%–6% for those aged 35 years and above to 13.4% and 17.7% for those aged 25–29 years and 20–24 years, respectively. Conclusions The high burden of severe and fatal RTIs in Oman was primarily attributed to overspeed driving behaviour of young male drivers in the 20–29 years age range. Our findings highlight the critical need for designing early gender-sensitive road safety interventions targeting young male and female drivers. PMID:29018585

Administrative license suspension: Does length of suspension matter?

PubMed

Fell, James C; Scherer, Michael

2017-08-18

Administrative license revocation (ALR) laws, which provide that the license of a driver with a blood alcohol concentration at or over the illegal limit is subject to an immediate suspension by the state department of motor vehicles, are an example of a traffic law in which the sanction rapidly follows the offense. The power of ALR laws has been attributed to how swiftly the sanction is applied, but does the length of suspension matter? Our objectives were to (a) determine the relationship of the ALR suspension length to the prevalence of drinking drivers relative to sober drivers in fatal crashes and (b) estimate the extent to which the relationship is associated to the general deterrent effect compared to the specific deterrent effect of the law. Data comparing the impact of ALR law implementation and ALR law suspension periods were analyzed using structural equation modeling techniques on the ratio of drinking drivers to nondrinking drivers in fatal crashes from the Fatality Analysis Reporting System (FARS). States with an ALR law with a short suspension period (1-30 days) had a significantly lower drinking driver ratio than states with no ALR law. States with a suspension period of 91-180 days had significantly lower ratios than states with shorter suspension periods, while the three states with suspension lengths of 181 days or longer had significantly lower ratios than states with shorter suspension periods. The implementation of any ALR law was associated with a 13.1% decrease in the drinking/nondrinking driver fatal crash ratio but only a 1.8% decrease in the intoxicated/nonintoxicated fatal crash ratio. The ALR laws and suspension lengths had a significant general deterrent effect, but no specific deterrent effect. States might want to keep (or adopt) ALR laws for their general deterrent effects and pursue alternatives for specific deterrent effects. States with short ALR suspension periods should consider lengthening them to 91 days or longer.

Measles in Pakistan: Time to make steps towards eradication.

PubMed

Rehman, Inayat Ur; Bukhsh, Allah; Khan, Tahir Mehmood

World Health Organization (WHO) measles surveillance data report a reduction in cases of measles globally from 67,524 cases in 2015 to 16,846 in 2016, and a reduction in deaths from 546,800 to 114,900 during period of 2000-14. Pakistan is among the five nations where almost a million children did not receive their first dose of measles vaccination, and outbreaks of the disease resulted in 4386 cases in 2011, 14,687 cases in 2012 with 310 deaths. In 2013, about 25,401 cases of measles were reported and 321 affected children died. The measles vaccination coverage is very low in Pakistan for both 1st dose and booster dose. To prevent outbreaks of measles in Pakistan a national vaccination program should be launched side by side with a polio eradication program in each district and township and a campaign should be launched to educate parents on measles vaccination for childrens to reduce the measles case fatality rate. Copyright © 2017 Elsevier Ltd. All rights reserved.

Effects of a Citizens Review Panel in Preventing Child Maltreatment Fatalities

ERIC Educational Resources Information Center

Palusci, Vincent J.; Yager, Steve; Covington, Theresa M.

2010-01-01

Objective: Child maltreatment (CM) fatalities are often preventable, and reviewing these deaths often highlights problems in law, policy or practice that can be addressed to prevent future deaths. Citizen Review Panels (CRPs) comprised of medical and child welfare professionals were established in 1996 to review Child Protective Services (CPS)…

The effect of high-visibility enforcement on driver compliance with pedestrian right-of-way laws: 4-year follow-up : traffic tech.

DOT National Transportation Integrated Search

2017-01-01

In large cities, pedestrians can account for 40% to 50% of traffic : fatalities. In 2014 there were 4,884 pedestrian fatalities and : about 65,000 injuries in the United States (NHTSA, 2015). Many : of these incidents occur at crosswalks where driver...

A case of fatal necrotizing fasciitis arising from chronic lymphedema.

PubMed

Jun, Young Joon; Kang, In Sook; Lee, Jung Ho; Kim, Sue Min; Kim, Young Jin

2013-12-01

Chronic lymphedema and lymphangitis are common adverse effects following treatment for gynecological cancer. Because the early symptoms of necrotizing fasciitis are similar to those of lymphangitis, fatal outcome can occur if patients or physicians underestimate this condition. Here, we present a case of necrotizing fasciitis in a patient with chronic lymphedema.

A Case of near Fatal Ammonia Gas Poisoning

NASA Technical Reports Server (NTRS)

White, E.

1971-01-01

A report is given of the near fatal effects of anhydrous ammonia poisoning to a repairman working on a compression room cooling system. The repairman was exposed for approximately 5 minutes to an environment of nearly 100% ammonia gas. Descriptions are given of body burns, breathing problems, and eye burns suffered by the worker.

Does facing traffic improve pedestrian safety?

PubMed

Luoma, Juha; Peltola, Harri

2013-01-01

This study was designed to evaluate the potential safety importance of the walking direction along a road by examining pedestrian accidents as a function of exposure to risk. The study was limited to rural two-lane roads with no pavement or pedestrian lane. The accident data included police-reported road accidents from Finland between 2006 and 2010 in which a motorized vehicle had struck a pedestrian walking along the road. There were 18 accidents involving a fatally injured pedestrian and 87 accidents involving a non-fatally injured pedestrian. The exposure data collected from the roughly 3400km included 258 pedestrians. The main finding was that the mean effect of facing traffic compared to walking with traffic was a 77% decrease in fatal and in non-fatal injury pedestrian accidents. The results further showed that the effects were greater for main roads than for secondary roads. The main implication of this study is that information about the importance of facing traffic should be reinforced with specific information about its substantial safety benefits. Copyright © 2012 Elsevier Ltd. All rights reserved.

[Effects of controlling specific dangerous pesticides on prevention of acute pesticide poisoning in rural area].

PubMed

Zhang, Ping; Zhao, Jiang-xia; Chang, Xiu-li; Zhou, Zhi-jun

2010-09-01

To investigate the effects of controlling the specific dangerous pesticides on prevention of acute pesticide poisoning in rural area. The data of reported cases of pesticide poisoning were analyzed to find out the specific dangerous pesticide in acute pesticide poisoning. Then the occurrence of occupational pesticide poisoning and fatality of non-occupational pesticide poisoning were estimated under the hypothesis of removing the specific dangerous pesticides. The data indicated that parathion (including methyl parathion) was the specific dangerous pesticide inducing occupational pesticide poisoning. After removing the use of parathion, the hazard of pesticides which caused occupational pesticide poisoning would be significantly decreased (P < 0.01). Parathion was also the most dangerous pesticide which caused non-occupational pesticide poisoning, with its fatality up to 15.8%. If parathion was well controlled, the fatality of non-occupational pesticide poisoning would be declined from 9.4% to 7.4%. The analyses of related literatures also revealed the similar results. The occurrence of occupational pesticide poisoning and fatality of non-occupational pesticide poisoning may decrease if the most dangerous pesticides are well supervised.

Evidence of Absence software

USGS Publications Warehouse

Dalthorp, Daniel; Huso, Manuela M. P.; Dail, David; Kenyon, Jessica

2014-01-01

Evidence of Absence software (EoA) is a user-friendly application used for estimating bird and bat fatalities at wind farms and designing search protocols. The software is particularly useful in addressing whether the number of fatalities has exceeded a given threshold and what search parameters are needed to give assurance that thresholds were not exceeded. The software is applicable even when zero carcasses have been found in searches. Depending on the effectiveness of the searches, such an absence of evidence of mortality may or may not be strong evidence that few fatalities occurred. Under a search protocol in which carcasses are detected with nearly 100 percent certainty, finding zero carcasses would be convincing evidence that overall mortality rate was near zero. By contrast, with a less effective search protocol with low probability of detecting a carcass, finding zero carcasses does not rule out the possibility that large numbers of animals were killed but not detected in the searches. EoA uses information about the search process and scavenging rates to estimate detection probabilities to determine a maximum credible number of fatalities, even when zero or few carcasses are observed.

Successful treatment of MRSA native valve endocarditis with oral linezolid therapy: a case report.

PubMed

Nathani, N; Iles, P; Elliott, T S J

2005-11-01

Staphylococcal endocarditis is potentially fatal and is now the most common cause of infective endocarditis with a mortality rate of 25-47% [Hecht SR, Berger M. Right-sided endocarditis in intravenous drug users: prognostic features in 102 episodes. Ann Intern Med 1992;117:560-6]. Its treatment requires maintenance of bactericidal level of antibiotics for prolonged periods to attain a culture-negative state. Although intravenous vancomycin is currently the drug of choice for methicillin resistant Staphylococcus aureus (MRSA) endocarditis, we present a case treated successfully with oral linezolid for 4 weeks due to a lack of venous access.

Cross channel infections: nostalgia, spleen and the construction of national character.

PubMed

O'Sullivan, Lisa

2009-06-01

In the nineteenth century, both spleen and nostalgia were considered clinical categories, and each associated with the character of a nation. English medical commentators boasted of their compatriots' resistance to nostalgia, an often fatal form of homesickness, while the French in turn argued that the splenetic English were flocking to France to escape their own insalubrious climate. Behind such jingoistic claims were broader concerns, on both sides of the channel but particularly acute for the French, about the impact of modernity on subjectivity, the relation between home, homeland and empire, and the fitness of both nations to succeed in the modern age.

Impact of long-hours family caregiving on non-fatal coronary heart disease risk in middle-aged people: Results from a longitudinal nationwide survey in Japan.

PubMed

Miyawaki, Atsushi; Tomio, Jun; Kobayashi, Yasuki; Takahashi, Hideto; Noguchi, Haruko; Tamiya, Nanako

2017-11-01

The effects of family caregiving, especially long-hours caregiving, on coronary heart disease (CHD) are debatable. We examined the impact of family caregiving on incident non-fatal CHD. We used data from the Longitudinal Survey of Middle-Aged and Elderly Persons from 2005 to 2010, a nationwide panel survey for Japanese people aged 50-59 years in 2005 (baseline). After we excluded non-respondents and people with missing key variables at baseline, 25 121 individuals without CHD, stroke or cancer were followed up for a mean of 4.6 years. The exposure was assessed at baseline by three indicators: (i) family caregiving; (ii) hours spent caregiving; and (iii) kinship type of care recipient. The non-fatal CHD incidence was identified according to questionnaire responses from 2006 to 2010. Cox's proportional hazards analysis did not show a statistically significant association between family caregiving and incident non-fatal CHD (hazard ratio [HR] 1.13, 95% confidence interval [CI] 0.92-1.40). Caregivers who spent 20-69 h per week on care showed a statistically significant increased risk for non-fatal CHD (HR 1.78, 95% CI 1.23-2.58) compared with non-caregivers; whereas this increased risk was statistically significant only among women (HR 1.98, 95% CI 1.27-3.08), but not among men (HR 1.35, 95% CI 0.67-2.71). Kinship type of care recipient did not make a significant difference to the effects of family caregiving on incident non-fatal CHD. Long-hours family caregiving could be an independent risk factor for incident non-fatal CHD among middle-aged women in Japan. Geriatr Gerontol Int 2017; 17: 2109-2115. © 2017 The Authors. Geriatrics & Gerontology International published by John Wiley & Sons Australia, Ltd on behalf of Japan Geriatrics Society.

Alcohol consumption and fatal injuries in Australia before and after major traffic safety initiatives: a time series analysis.

PubMed

Jiang, Heng; Livingston, Michael; Room, Robin

2015-01-01

The associations between population-level alcohol consumption and fatal injuries have been examined in a number of previous studies, but few have considered the external impacts of major policy interventions. This study aims to quantify the associations between per capita alcohol consumption and traffic and nontraffic injury mortality rates in Australia before and after major traffic safety initiatives (the introduction of compulsory seat belt legislation [CSBL] and random breath testing [RBT] in 1970s). Using data from 1924 to 2006, gender- and age-specific traffic and nontraffic mortality rates (15 years and above) were analyzed in relation to per capita alcohol consumption using time series analysis. The external effects of policy interventions were measured by inserting a dummy variable in the time series models. Statistically significant associations between per capita alcohol consumption and both types of fatal injuries were found for both males and females. The results suggest that an increase in per capita alcohol consumption of 1 l was accompanied by an increase in traffic mortality of 3.4 among males and 0.5 among females per 100,000 inhabitants and an increase in nontraffic mortality of 3.0 among males and 0.9 among females. The associations between alcohol consumption and fatal injury rates varied across age groups. The introduction of CSBL and RBT was associated with significant reductions in traffic crash mortality in Australia, particularly for males and young people. The magnitude and distribution of the preventive effects from the reduction in population drinking on fatal injuries vary across different gender and age groups, with the strongest preventive impacts on fatal injuries among people aged 15 to 29 and 70 years and above. The mechanisms behind these effects are unclear from this study, but are likely to be due to the strong association between per capita consumption and heavy drinking. Copyright © 2015 by the Research Society on Alcoholism.

Air pollution and case fatality of SARS in the People's Republic of China: an ecologic study

PubMed Central

Cui, Yan; Zhang, Zuo-Feng; Froines, John; Zhao, Jinkou; Wang, Hua; Yu, Shun-Zhang; Detels, Roger

2003-01-01

Background Severe acute respiratory syndrome (SARS) has claimed 349 lives with 5,327 probable cases reported in mainland China since November 2002. SARS case fatality has varied across geographical areas, which might be partially explained by air pollution level. Methods Publicly accessible data on SARS morbidity and mortality were utilized in the data analysis. Air pollution was evaluated by air pollution index (API) derived from the concentrations of particulate matter, sulfur dioxide, nitrogen dioxide, carbon monoxide and ground-level ozone. Ecologic analysis was conducted to explore the association and correlation between air pollution and SARS case fatality via model fitting. Partially ecologic studies were performed to assess the effects of long-term and short-term exposures on the risk of dying from SARS. Results Ecologic analysis conducted among 5 regions with 100 or more SARS cases showed that case fatality rate increased with the increment of API (case fatality = - 0.063 + 0.001 * API). Partially ecologic study based on short-term exposure demonstrated that SARS patients from regions with moderate APIs had an 84% increased risk of dying from SARS compared to those from regions with low APIs (RR = 1.84, 95% CI: 1.41–2.40). Similarly, SARS patients from regions with high APIs were twice as likely to die from SARS compared to those from regions with low APIs. (RR = 2.18, 95% CI: 1.31–3.65). Partially ecologic analysis based on long-term exposure to ambient air pollution showed the similar association. Conclusion Our studies demonstrated a positive association between air pollution and SARS case fatality in Chinese population by utilizing publicly accessible data on SARS statistics and air pollution indices. Although ecologic fallacy and uncontrolled confounding effect might have biased the results, the possibility of a detrimental effect of air pollution on the prognosis of SARS patients deserves further investigation. PMID:14629774

Risks of Serious Injuries and Fatalities of Cyclists Associated with Impact Velocities of Cars in Car-Cyclist Accidents in Japan.

PubMed

Matsui, Yasuhiro; Oikawa, Shoko

2015-11-01

The main purpose of this study is to define the relationship between the car impact velocity and serious injury risk or fatality risk of cyclists. The authors investigated the risks of serious injuries and fatalities of cyclists using vehicle-cyclist accident data from the database of the Institute for Traffic Accident Research and Data Analysis (ITARDA) in Japan. The vehicle types considered are sedans, mini vans, box vans, light passenger cars and light cargo vans. The results revealed that a 10-km/h decrease in the impact velocity could reduce the severe injury risk and fatality risk for impact velocities of 40 km/h or higher. Specifically, when the impact velocity was less than or equal to 30 km/h, the serious injury risks were less than 21% and the fatality risks were less than or equal to 1% for the above listed vehicle types. Therefore, if the Collision Damage Mitigation Braking System (CDMBS) equipped vehicles can perform its functions effectively so as to reduce the impact velocities, then cyclist injuries will likely be significantly reduced. Another purpose of this study is to assess the effect of wearing a helmet for protection of the cyclist's head. Impact experiment results showed that the measured head injury criterion (HIC) with helmets are lower than that of head-form impactor without a helmet, reducing the HIC by 57%.

Effectiveness of an improved road safety policy in Ethiopia: an interrupted time series study.

PubMed

Abegaz, Teferi; Berhane, Yemane; Worku, Alemayehu; Assrat, Abebe

2014-05-31

In recent years, there has been an increasing interest in implementing road safety policy by different low income countries. However; the evidence is scarce on its success in the reduction of crashes, injuries and deaths. This study was conducted to assess whether road crashes, injuries and fatalities was reduced following the road safety regulation introduced as of September 2007 by Oromia Regional State Transport Bureau. Routine road traffic accident data for the year 2002-2011were collected from sixteen traffic police offices. Data on average daily vehicle flow was obtained from the Ethiopian Road Authority. Interrupted time series design using segmented linear regression model was applied to estimate the effect of an improved road safety policy. A total of 4,053 crashes occurred on Addis Ababa - Adama/Hawassa main road. Of these crashes, almost half 46.4% (1,880) were property damage, 29.4% (1,193) were fatal and 24.2% (980) injury crashes, resulting 1,392 fatalities and 1,749 injuries. There were statistically significant reductions in non-injury crashes and deaths. Non-injury crash was reduced by 19% and fatality by 12.4% in the first year of implementing the revised transport safety regulation. Although revised road safety policy helped in reducing motor vehicle crashes and associated fatalities, the overall incidence rate is still very high. Further action is required to avoid unnecessary loss of lives.

Correlates of fatality risk of vulnerable road users in Delhi.

PubMed

Goel, Rahul; Jain, Parth; Tiwari, Geetam

2018-02-01

Pedestrians, cyclists, and users of motorised two-wheelers account for more than 85% of all the road fatality victims in Delhi. The three categories are often referred to as vulnerable road users (VRUs). Using Bayesian hierarchical approach with a Poisson-lognormal regression model, we present spatial analysis of road fatalities of VRUs with wards as areal units. The model accounts for spatially uncorrelated as well as correlated error. The explanatory variables include demographic factors, traffic characteristics, as well as built environment features. We found that fatality risk has a negative association with socio-economic status (literacy rate), population density, and number of roundabouts, and has a positive association with percentage of population as workers, number of bus stops, number of flyovers (grade separators), and vehicle kilometers travelled. The negative effect of roundabouts, though statistically insignificant, is in accordance with their speed calming effects for which they have been used to replace signalised junctions in various parts of the world. Fatality risk is 80% higher at the density of 50 persons per hectare (pph) than at overall city-wide density of 250 pph. The presence of a flyover increases the relative risk by 15% compared to no flyover. Future studies should investigate the causal mechanism through which denser neighborhoods become safer. Given the risk posed by flyovers, their use as congestion mitigation measure should be discontinued within urban areas. Copyright © 2017 Elsevier Ltd. All rights reserved.

The effects of studded tires on fatal crashes with passenger cars and the benefits of electronic stability control (ESC) in Swedish winter driving.

PubMed

Strandroth, Johan; Rizzi, Matteo; Olai, Maria; Lie, Anders; Tingvall, Claes

2012-03-01

This study set out to examine the effects of studded tires on fatal crashes on roads covered with ice or snow in Sweden and also to investigate the extra benefits of electronic stability control (ESC) during the winter months. Two different studies are presented in this paper. Both studies used an induced exposure approach. In the main study, 369 in-depth studies of fatal crashes with passenger cars were analyzed to determine whether loss-of-control (LOC) had been a major component or not. Only crashes involving cars without ESC and equipped with approved studded or non-studded winter tires were analyzed. The additional study used police-reported crashes that occurred during the winter seasons 2003-2010, involving passenger cars with and without ESC. While police records in Sweden do not include any tire information, it was assumed that most cars involved in crashes during the winter period would be equipped with studded tires. Findings in the main study showed that in 64% of the fatal crashes on roads covered with ice or snow LOC had been a major component. Furthermore, in 82% of LOC crashes, the passenger car over-steered prior to collision. Studded tires were found to have a statistically significant effect of 42% in terms of fatal crash reduction on roads covered with ice or snow, compared to non-studded winter tires. The effect on dry or wet roads in the winter was negative, although statistically non-significant. In the additional study, it was found that ESC further reduced crashes with injuries by 29%. The benefits on severe and fatal crashes were slightly greater (32%), although the lower 95% confidence limit was lower. Although studded tires were shown to reduce the risk of fatal crash involvement, compared to non-studded winter tires, the proportion of LOC and over-steering among cars with studded tires was large (59% and 49%, respectively). It was therefore concluded that studded tires do not prevent all LOC crashes, while ESC has benefits in those crashes since this technology mostly addresses over-steering. This is also supported by the fact that the share of LOC fatal crashes is considerably lower for ESC-equipped cars. This study recommends that non-ESC cars should be fitted with studded tires if they are to be driven on roads covered by ice or snow. If the proportion of studded tires is to be decreased on Swedish roads to reduce the about of hazardous particulates especially in built up areas, from a road safety point of view it is recommended that this should be done in phase with the implementation of ESC on all passenger cars. Copyright © 2011 Elsevier Ltd. All rights reserved.

Modeling the injury prevention impact of mandatory alcohol ignition interlock installation in all new US vehicles.

PubMed

Carter, Patrick M; Flannagan, Carol A C; Bingham, C Raymond; Cunningham, Rebecca M; Rupp, Jonathan D

2015-05-01

We estimated the injury prevention impact and cost savings associated with alcohol interlock installation in all new US vehicles. We identified fatal and nonfatal injuries associated with drinking driver vehicle crashes from the Fatality Analysis Reporting System and National Automotive Sampling System's General Estimates System data sets (2006-2010). We derived the estimated impact of universal interlock installation using an estimate of the proportion of alcohol-related crashes that were preventable in vehicles < 1 year-old. We repeated this analysis for each subsequent year, assuming a 15-year implementation. We applied existing crash-induced injury cost metrics to approximate economic savings, and we used a sensitivity analysis to examine results with varying device effectiveness. Over 15 years, 85% of crash fatalities (> 59 000) and 84% to 88% of nonfatal injuries (> 1.25 million) attributed to drinking drivers would be prevented, saving an estimated $342 billion in injury-related costs, with the greatest injury and cost benefit realized among recently legal drinking drivers. Cost savings outweighed installation costs after 3 years, with the policy remaining cost effective provided device effectiveness remained above approximately 25%. Alcohol interlock installation in all new vehicles is likely a cost-effective primary prevention policy that will substantially reduce alcohol-involved crash fatalities and injuries, especially among young vulnerable drivers.

Modeling the Injury Prevention Impact of Mandatory Alcohol Ignition Interlock Installation in All New US Vehicles

PubMed Central

Flannagan, Carol A. C.; Bingham, C. Raymond; Cunningham, Rebecca M.; Rupp, Jonathan D.

2015-01-01

Objectives. We estimated the injury prevention impact and cost savings associated with alcohol interlock installation in all new US vehicles. Methods. We identified fatal and nonfatal injuries associated with drinking driver vehicle crashes from the Fatality Analysis Reporting System and National Automotive Sampling System’s General Estimates System data sets (2006–2010). We derived the estimated impact of universal interlock installation using an estimate of the proportion of alcohol-related crashes that were preventable in vehicles < 1 year-old. We repeated this analysis for each subsequent year, assuming a 15-year implementation. We applied existing crash-induced injury cost metrics to approximate economic savings, and we used a sensitivity analysis to examine results with varying device effectiveness. Results. Over 15 years, 85% of crash fatalities (> 59 000) and 84% to 88% of nonfatal injuries (> 1.25 million) attributed to drinking drivers would be prevented, saving an estimated $342 billion in injury-related costs, with the greatest injury and cost benefit realized among recently legal drinking drivers. Cost savings outweighed installation costs after 3 years, with the policy remaining cost effective provided device effectiveness remained above approximately 25%. Conclusions. Alcohol interlock installation in all new vehicles is likely a cost-effective primary prevention policy that will substantially reduce alcohol-involved crash fatalities and injuries, especially among young vulnerable drivers. PMID:25790385

Age and pedestrian injury severity in motor-vehicle crashes: a heteroskedastic logit analysis.

PubMed

Kim, Joon-Ki; Ulfarsson, Gudmundur F; Shankar, Venkataraman N; Kim, Sungyop

2008-09-01

This research explores the injury severity of pedestrians in motor-vehicle crashes. It is hypothesized that the variance of unobserved pedestrian characteristics increases with age. In response, a heteroskedastic generalized extreme value model is used. The analysis links explanatory factors with four injury outcomes: fatal, incapacitating, non-incapacitating, and possible or no injury. Police-reported crash data between 1997 and 2000 from North Carolina, USA, are used. The results show that pedestrian age induces heteroskedasticity which affects the probability of fatal injury. The effect grows more pronounced with increasing age past 65. The heteroskedastic model provides a better fit than the multinomial logit model. Notable factors increasing the probability of fatal pedestrian injury: increasing pedestrian age, male driver, intoxicated driver (2.7 times greater probability of fatality), traffic sign, commercial area, darkness with or without streetlights (2-4 times greater probability of fatality), sport-utility vehicle, truck, freeway, two-way divided roadway, speeding-involved, off roadway, motorist turning or backing, both driver and pedestrian at fault, and pedestrian only at fault. Conversely, the probability of a fatal injury decreased: with increasing driver age, during the PM traffic peak, with traffic signal control, in inclement weather, on a curved roadway, at a crosswalk, and when walking along roadway.

Chlorine truck attack consequences and mitigation.

PubMed

Barrett, Anthony Michael; Adams, Peter J

2011-08-01

We develop and apply an integrated modeling system to estimate fatalities from intentional release of 17 tons of chlorine from a tank truck in a generic urban area. A public response model specifies locations and actions of the populace. A chemical source term model predicts initial characteristics of the chlorine vapor and aerosol cloud. An atmospheric dispersion model predicts cloud spreading and movement. A building air exchange model simulates movement of chlorine from outdoors into buildings at each location. A dose-response model translates chlorine exposures into predicted fatalities. Important parameters outside defender control include wind speed, atmospheric stability class, amount of chlorine released, and dose-response model parameters. Without fast and effective defense response, with 2.5 m/sec wind and stability class F, we estimate approximately 4,000 (half within ∼10 minutes) to 30,000 fatalities (half within ∼20 minutes), depending on dose-response model. Although we assume 7% of the population was outdoors, they represent 60-90% of fatalities. Changing weather conditions result in approximately 50-90% lower total fatalities. Measures such as sheltering in place, evacuation, and use of security barriers and cryogenic storage can reduce fatalities, sometimes by 50% or more, depending on response speed and other factors. © 2011 Society for Risk Analysis.

The effect of statin therapy on heart failure events: a collaborative meta-analysis of unpublished data from major randomized trials.

PubMed

Preiss, David; Campbell, Ross T; Murray, Heather M; Ford, Ian; Packard, Chris J; Sattar, Naveed; Rahimi, Kazem; Colhoun, Helen M; Waters, David D; LaRosa, John C; Amarenco, Pierre; Pedersen, Terje R; Tikkanen, Matti J; Koren, Michael J; Poulter, Neil R; Sever, Peter S; Ridker, Paul M; MacFadyen, Jean G; Solomon, Scott D; Davis, Barry R; Simpson, Lara M; Nakamura, Haruo; Mizuno, Kyoichi; Marfisi, Rosa M; Marchioli, Roberto; Tognoni, Gianni; Athyros, Vasilios G; Ray, Kausik K; Gotto, Antonio M; Clearfield, Michael B; Downs, John R; McMurray, John J

2015-06-21

The effect of statins on risk of heart failure (HF) hospitalization and HF death remains uncertain. We aimed to establish whether statins reduce major HF events. We searched Medline, EMBASE, and the Cochrane Central Register of Controlled Trials for randomized controlled endpoint statin trials from 1994 to 2014. Collaborating trialists provided unpublished data from adverse event reports. We included primary- and secondary-prevention statin trials with >1000 participants followed for >1 year. Outcomes consisted of first non-fatal HF hospitalization, HF death and a composite of first non-fatal HF hospitalization or HF death. HF events occurring <30 days after within-trial myocardial infarction (MI) were excluded. We calculated risk ratios (RR) with fixed-effects meta-analyses. In up to 17 trials with 132 538 participants conducted over 4.3 [weighted standard deviation (SD) 1.4] years, statin therapy reduced LDL-cholesterol by 0.97 mmol/L (weighted SD 0.38 mmol/L). Statins reduced the numbers of patients experiencing non-fatal HF hospitalization (1344/66 238 vs. 1498/66 330; RR 0.90, 95% confidence interval, CI 0.84-0.97) and the composite HF outcome (1234/57 734 vs. 1344/57 836; RR 0.92, 95% CI 0.85-0.99) but not HF death (213/57 734 vs. 220/57 836; RR 0.97, 95% CI 0.80-1.17). The effect of statins on first non-fatal HF hospitalization was similar whether this was preceded by MI (RR 0.87, 95% CI 0.68-1.11) or not (RR 0.91, 95% CI 0.84-0.98). In primary- and secondary-prevention trials, statins modestly reduced the risks of non-fatal HF hospitalization and a composite of non-fatal HF hospitalization and HF death with no demonstrable difference in risk reduction between those who suffered an MI or not. Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2015. For permissions please email: journals.permissions@oup.com.

Trends in Arkansas motorcycle trauma after helmet law repeal.

PubMed

Bledsoe, Gregory H; Li, Guohua

2005-04-01

This study aimed to assess the impact of the 1997 Arkansas helmet law repeal on motorcycle registrations, crash and fatality risks, and alcohol involvement in motorcycle crashes. Annual motorcycle registration data for the years 1990 through 2001 were obtained from the Arkansas Department of Finance and Administration. These motorcycle registration data were complemented by the motorcycle crash data from the Arkansas State Police Highway Safety Office and motorcycle fatality data for the state of Arkansas from the Fatality Analysis Reporting System. The impact of the repeal on crash rates, helmet usage, and alcohol involvement was assessed through comparisons of data from before (1993 to 1996) and after (1998 to 2001) the repeal. After the repeal, an increase in motorcycle registrations correlated with a marked rise in the total number of crashes and fatalities; however, fatalities per crash remained virtually the same. The proportion of motorcycle fatalities that were not wearing a helmet increased from 47.0% (47/100) before the repeal to 78.2% (104/133) after the repeal (P = 0.001). The overall percentage of fatal motorcycle crashes involving alcohol use remained unchanged after the repeal (37.6% [29/77] to 38.5% [40/104], P = 0.91), but the percentage of fatal crashes involving drinking nonhelmeted drivers increased from 14.2% (11/77) to 33.6% (35/104) (P = 0.003). Inebriated motorcyclists killed in crashes were overwhelmingly non-helmeted (87.5%, 35/40) after the repeal, up from 37.9% (11/29) before the repeal (P < 0.001). These findings suggest that the repeal of the mandatory helmet law in Arkansas has had a significant adverse effect on road safety.

Obesity and Non-fatal Motor Vehicle Crash Injuries: Sex Difference Effects

PubMed Central

Ma, Xiaoguang; Laud, Purushottam W.; Pintar, Frank; Kim, Jong-Eun; Shih, Alan; Shen, Wei; Heymsfield, Steven B.; Allison, David B.; Zhu, Shankuan

2010-01-01

Background Obesity and motor vehicle crash (MVC) injuries are two parallel epidemics in the United States. An important unanswered question is if there are sex differences in the associations between the presence of obesity and non-fatal MVC injuries. Objectives To further understand the association between obesity and non-fatal motor vehicle crash injuries, particularly the sex differences in these relations. Methods We examined this question by analyzing data from the 2003 to 2007 National Automotive Sampling System Crashworthiness Data System (NASS CDS). A total of 10, 962 drivers who were aged 18 years or older and who survived frontal collision crashes were eligible for study. Results Male drivers experienced a lower rate of overall non-fatal MVC injuries than did female drivers (38.1% vs. 52.2%) but a higher rate of severe injuries (0.7% vs. 0.2%). After adjusting for change in velocity (ΔV) during the crashes, obese male drivers showed a much higher risk [logistic coefficients of BMI for moderate, serious, and severe injury are 0.0766, 0.1470, and 0.1792, respectively; all p<0.05] of non-fatal injuries than did non-obese male drivers and these risks increased with injury severity. Non-fatal injury risks were not found to be increased in obese female drivers. The association between obesity and risk of non-fatal injury was much stronger for male drivers than for female drivers. Conclusion The higher risk of non-fatal MVC injuries in obese male drivers might result from their different body shape and fat distribution compared with obese female drivers. Our findings should be considered for obesity reduction, traffic safety evaluation and vehicle design for obese male drivers and provide testable hypotheses for future studies. PMID:21224830

Obesity and non-fatal motor vehicle crash injuries: sex difference effects.

PubMed

Ma, X; Laud, P W; Pintar, F; Kim, J-E; Shih, A; Shen, W; Heymsfield, S B; Allison, D B; Zhu, S

2011-09-01

Obesity and motor vehicle crash (MVC) injuries are two parallel epidemics in the United States. An important unanswered question is whether there are sex differences in the associations between the presence of obesity and non-fatal MVC injuries. To further understand the association between obesity and non-fatal MVC injuries, particularly the sex differences in these relations. We examined this question by analyzing data from the 2003 to 2007 National Automotive Sampling System Crashworthiness Data System (NASS CDS). A total of 10,962 drivers who were aged 18 years or older and who survived frontal collision crashes were eligible for the study. Male drivers experienced a lower rate of overall non-fatal MVC injuries than did female drivers (38.1 versus 52.2%), but experienced a higher rate of severe injuries (0.7 versus 0.2%). After adjusting for change in velocity (ΔV) during the crashes, obese male drivers showed a much higher risk (logistic coefficients of body mass index (BMI) for moderate, serious and severe injury are 0.0766, 0.1470 and 0.1792, respectively; all P<0.05) of non-fatal injuries than did non-obese male drivers and these risks increased with injury severity. Non-fatal injury risks were not found to be increased in obese female drivers. The association between obesity and risk of non-fatal injury was much stronger for male drivers than for female drivers. The higher risk of non-fatal MVC injuries in obese male drivers might result from their different body shape and fat distribution compared with obese female drivers. Our findings should be considered for obesity reduction, traffic safety evaluation and vehicle design for obese male drivers and provide testable hypotheses for future studies.

Early morning awakening and nonrestorative sleep are associated with increased minor non-fatal accidents during work and leisure time.

PubMed

Chiu, Hsiao-Yean; Wang, Mei-Yeh; Chang, Cheng-Kuei; Chen, Ching-Min; Chou, Kuei-Ru; Tsai, Jen-Chen; Tsai, Pei-Shan

2014-10-01

The relationship between a composite measure of insomnia and occupational or fatal accidents has been investigated previously; however, little is known regarding the effect of various insomnia symptoms on minor non-fatal accidents during work and leisure time. We investigated the predicting role of insomnia symptoms on minor non-fatal accidents during work and leisure time. Data from the 2005 Taiwan Social Development Trend Survey of 36,473 Taiwanese aged ≥18 years were analyzed in 2013. Insomnia symptoms, including difficulty in initiating sleep (DIS), difficulty in maintaining sleep (DMS), early morning awakening (EMA), and nonrestorative sleep (NRS) were investigated. A minor non-fatal accident was defined as any mishap such as forgetting to turn off the gas or faucets, accidental falls, and abrasions or cuts occurring during work and leisure time in the past month that do not require immediate medical attention. Multivariable logistic regression was performed to assess the odds ratios (ORs) and associated 95% confidence interval (CI) of minor non-fatal accidents (as a binary variable) for each insomnia symptom compared with those of people presenting no symptoms, while controlling for possible confounders. EMA and NRS increased the odds of minor non-fatal accidents occurring during work and leisure time (adjusted OR=1.19, 95% CI=1.08-1.32 and adjusted OR=1.27, 95% CI=1.17-1.37, respectively). EMA and NRS are two symptoms that are significantly associated with an increased likelihood of minor non-fatal accidents during work and leisure time after adjusting for of a range of covariates. Copyright © 2014 Elsevier Ltd. All rights reserved.

Studded and unstudded winter tires in fatal road accidents in Finland.

PubMed

Malmivuo, Mikko; Luoma, Juha; Porthin, Markus

2017-07-04

The aim of the study was to compare the safety effects of studded and unstudded winter tires based on fatal road accidents. The data included 958 road accidents involving a passenger car or van that occurred in Finland from November to March between 1997 and 2012. Comparing the proportions of winter tire type in accidents and in general traffic showed that the overall effect of tire type on the number of accidents was not significant, although studded tires reduced fatal accidents by 10-15%. Compared to unstudded tires, studded tires reduced accidents significantly only on bald ice in 2005-2012. Drivers using unstudded tires were more experienced and their profession was more frequently related to driving. In addition, the vehicle age was lower for vehicles with unstudded tires. On the other hand, the state of repair was less pertinent for unstudded than for studded tires. These confounding factors offset their effects to some degree. The risk of fatal road accidents in winter between studded and unstudded tires does not differ significantly. However, the accident risk has recently been substantially higher on bald ice for unstudded than for studded tires. The magnitude of this risk difference is difficult to determine without specific information on exposure by road surface.

Fatal and non-fatal opioid overdose in opioid dependent patients treated with methadone, buprenorphine or implant naltrexone.

PubMed

Kelty, Erin; Hulse, Gary

2017-08-01

Illicit opioid use is associated with high rates of fatal and non-fatal opioid overdose. This study aims to compare rates of fatal and serious but non-fatal opioid overdose in opioid dependent patients treated with methadone, buprenorphine or implant naltrexone, and to identify risk factors for fatal opioid overdose. Opioid dependent patients treated with methadone (n=3515), buprenorphine (n=3250) or implant naltrexone (n=1461) in Western Australia for the first time between 2001 and 2010, were matched against state mortality and hospital data. Rates of fatal and non-fatal serious opioid overdoses were calculated and compared for the three treatments. Risk factors associated with fatal opioid overdose were examined using multivariate cox proportional hazard models. No significant difference was observed between the three groups in terms of crude rates of fatal or non-fatal opioid overdoses. During the first 28days of treatment, rates of non-fatal opioid overdose were high in all three groups, as were fatal opioid overdoses in patients treated with methadone. However, no fatal opioid overdoses were observed in buprenorphine or naltrexone patients during this period. Following the first 28 days, buprenorphine was shown to be protective, particularly in terms of non-fatal opioid overdoses. After the cessation of treatment, rates of fatal and non-fatal opioid overdoses were similar between the groups, with the exception of lower rates of non-fatal opioid overdose in the naltrexone treated patients compared with the methadone treated patients. After the commencement of treatment, gender, and hospitalisations with a diagnosis of opioid poisoning, cardiovascular or mental health problems were significant predictors of subsequent fatal opioid overdose. Rates of fatal and non-fatal opioid overdose were not significantly different in patients treated with methadone, buprenorphine or implant naltrexone. Gender and prior cause-specific hospitalisations can be used to identify patients at a high risk of fatal opioid overdose. Copyright © 2017 Elsevier B.V. All rights reserved.

Estimated rate of fatal automobile accidents attributable to acute solvent exposure at low inhaled concentrations.

PubMed

Benignus, Vernon A; Bushnell, Philip J; Boyes, William K

2011-12-01

Acute solvent exposures may contribute to automobile accidents because they increase reaction time and decrease attention, in addition to impairing other behaviors. These effects resemble those of ethanol consumption, both with respect to behavioral effects and neurological mechanisms. These observations, along with the extensive data on the relationship between ethanol consumption and fatal automobile accidents, suggested a way to estimate the probability of fatal automobile accidents from solvent inhalation. The problem can be approached using the logic of the algebraic transitive postulate of equality: if A=B and B=C, then A=C. We first calculated a function describing the internal doses of solvent vapors that cause the same magnitude of behavioral impairment as ingestion of ethanol (A=B). Next, we fit a function to data from the literature describing the probability of fatal car crashes for a given internal dose of ethanol (B=C). Finally, we used these two functions to generate a third function to estimate the probability of a fatal car crash for any internal dose of organic solvent vapor (A=C). This latter function showed quantitatively (1) that the likelihood of a fatal car crash is increased by acute exposure to organic solvent vapors at concentrations less than 1.0 ppm, and (2) that this likelihood is similar in magnitude to the probability of developing leukemia from exposure to benzene. This approach could also be applied to other potentially adverse consequences of acute exposure to solvents (e.g., nonfatal car crashes, property damage, and workplace accidents), if appropriate data were available. © 2011 Society for Risk Analysis Published 2011. This article is a U.S. Government work and is in the public domain for the U.S.A.

"If I know I am on the pill and I get pregnant, it's an act of God": women's views on fatalism, agency and pregnancy.

PubMed

Jones, Rachel K; Frohwirth, Lori F; Blades, Nakeisha M

2016-06-01

Fatalism is the idea that outside forces have control over events. Pregnancy and pregnancy prevention play a prominent role in many women's lives, and we sought to understand if and how fatalism informed their thinking about these issues. We conducted in-depth interviews with 52 unmarried women between the ages of 18 and 30. We used NVivo to analyze the transcripts. The current analysis focuses on the ways that women discussed fatalism and pregnancy both in response to a direct question and as it came up spontaneously. The majority of respondents expressed a mix of fatalistic and non-fatalistic views about pregnancy. Many related that "fate," "destiny" and/or God play a role in pregnancy, but most also asserted that pregnancy risk could be substantially reduced, most commonly by using contraception. Fatalism sometimes served a positive function, for example as a mechanism to deal with an unintended pregnancy. Having a fatalistic outlook did not preclude contraceptive use. Rather, some women using highly effective methods related that if they were to become pregnant, they would interpret it as a sign that the pregnancy was "meant to happen." Finally some women related that there was no guarantee a woman could get pregnant when she wanted to, suggesting that some degree of fatalism may be inevitable when it comes to pregnancy. Fatalism and agency should not be viewed as opposing outlooks when it comes to pregnancy and pregnancy prevention; having fatalistic views about pregnancy does not preclude contraceptive use. Given that women do not have total control over attainment of a wanted pregnancy or even prevention of pregnancy, some amount of fatalism about fertility is a logical and pragmatic response. Both research and clinical practice need to recognize that fatalism and contraceptive use are often not in conflict. Copyright © 2016 The Authors. Published by Elsevier Inc. All rights reserved.

“If I know I am on the pill and I get pregnant, it’s an act of God”: women’s views on fatalism, agency and pregnancy

PubMed Central

Jones, Rachel K.; Frohwirth, Lori F.; Blades, Nakeisha M.

2016-01-01

Objectives Fatalism is the idea that outside forces have control over events. Pregnancy and pregnancy prevention play a prominent role in many women’s lives, and we sought to understand if and how fatalism informed their thinking about these issues. Study design We conducted in-depth interviews with 52 unmarried women between the ages of 18 and 30. We used NVivo to analyze the transcripts. The current analysis focuses on the ways that women discussed fatalism and pregnancy both in response to a direct question and as it came up spontaneously. Results The majority of respondents expressed a mix of fatalistic and non-fatalistic views about pregnancy. Many related that “fate,” “destiny” and/or God play a role in pregnancy, but most also asserted that pregnancy risk could be substantially reduced, most commonly by using contraception. Fatalism sometimes served a positive function, for example as a mechanism to deal with an unintended pregnancy. Having a fatalistic outlook did not preclude contraceptive use. Rather, some women using highly effective methods related that if they were to become pregnant, they would interpret it as a sign that the pregnancy was “meant to happen.” Finally some women related that there was no guarantee a woman could get pregnant when she wanted to, suggesting that some degree of fatalism may be inevitable when it comes to pregnancy. Conclusions Fatalism and agency should not be viewed as opposing outlooks when it comes to pregnancy and pregnancy prevention; having fatalistic views about pregnancy does not preclude contraceptive use. Implications Given that women do not have total control over attainment of a wanted pregnancy or even prevention of pregnancy, some amount of fatalism about fertility is a logical and pragmatic response. Both research and clinical practice need to recognize that fatalism and contraceptive use are often not in conflict. PMID:26872719

Trends in local newspaper reporting of London cyclist fatalities 1992-2012: the role of the media in shaping the systems dynamics of cycling

PubMed Central

Macmillan, Alex; Roberts, Alex; Woodcock, James; Aldred, Rachel; Goodman, Anna

2016-01-01

Background Successfully increasing cycling across a broad range of the population would confer important health benefits, but many potential cyclists are deterred by fears about traffic danger. Media coverage of road traffic crashes may reinforce this perception. As part of a wider effort to model the system dynamics of urban cycling, in this paper we examined how media coverage of cyclist fatalities in London changed across a period when the prevalence of cycling doubled. We compared this with changes in the coverage of motorcyclist fatalities as a control group. Methods Police records of traffic crashes (STATS19) were used to identify all cyclist and motorcyclist fatalities in London between 1992 and 2012. We searched electronic archives of London's largest local newspaper to identify relevant articles (January 1992–April 2014), and sought to identify which police-reported fatalities received any media coverage. We repeated this in three smaller English cities. Results Across the period when cycling trips doubled in London, the proportion of fatalities covered in the local media increased from 6% in 1992–1994 to 75% in 2010–2012. By contrast, the coverage of motorcyclist fatalities remained low (4% in 1992–1994 versus 5% in 2010–2012; p = 0.007 for interaction between mode and time period). Comparisons with other English cities suggested that the changes observed in London might not occur in smaller cities with lower absolute numbers of crashes, as in these settings fatalities are almost always covered regardless of mode share (79–100% coverage for both cyclist and motorcyclist fatalities). Conclusion In large cities, an increase in the popularity (and therefore ‘newsworthiness’) of cycling may increase the propensity of the media to cover cyclist fatalities. This has the potential to give the public the impression that cycling has become more dangerous, and thereby initiate a negative feedback loop that dampens down further increases in cycling. Understanding these complex roles of the media in shaping cycling trends may help identify effective policy levers to achieve sustained growth in cycling. PMID:26551734

Trends in local newspaper reporting of London cyclist fatalities 1992-2012: the role of the media in shaping the systems dynamics of cycling.

PubMed

Macmillan, Alex; Roberts, Alex; Woodcock, James; Aldred, Rachel; Goodman, Anna

2016-01-01

Successfully increasing cycling across a broad range of the population would confer important health benefits, but many potential cyclists are deterred by fears about traffic danger. Media coverage of road traffic crashes may reinforce this perception. As part of a wider effort to model the system dynamics of urban cycling, in this paper we examined how media coverage of cyclist fatalities in London changed across a period when the prevalence of cycling doubled. We compared this with changes in the coverage of motorcyclist fatalities as a control group. Police records of traffic crashes (STATS19) were used to identify all cyclist and motorcyclist fatalities in London between 1992 and 2012. We searched electronic archives of London's largest local newspaper to identify relevant articles (January 1992-April 2014), and sought to identify which police-reported fatalities received any media coverage. We repeated this in three smaller English cities. Across the period when cycling trips doubled in London, the proportion of fatalities covered in the local media increased from 6% in 1992-1994 to 75% in 2010-2012. By contrast, the coverage of motorcyclist fatalities remained low (4% in 1992-1994 versus 5% in 2010-2012; p=0.007 for interaction between mode and time period). Comparisons with other English cities suggested that the changes observed in London might not occur in smaller cities with lower absolute numbers of crashes, as in these settings fatalities are almost always covered regardless of mode share (79-100% coverage for both cyclist and motorcyclist fatalities). In large cities, an increase in the popularity (and therefore 'newsworthiness') of cycling may increase the propensity of the media to cover cyclist fatalities. This has the potential to give the public the impression that cycling has become more dangerous, and thereby initiate a negative feedback loop that dampens down further increases in cycling. Understanding these complex roles of the media in shaping cycling trends may help identify effective policy levers to achieve sustained growth in cycling. Copyright © 2015 The Authors. Published by Elsevier Ltd.. All rights reserved.

Trends and characteristics of animal-vehicle collisions in the United States.

PubMed

Sullivan, John M

2011-02-01

Since 1990, fatal animal-vehicle collisions (AVCs) in the United States have more than doubled. This paper examines annual AVC trends in the United States over a 19-year period, seasonal and diurnal patterns of AVC risk, the geographic distribution of crash risk by state, and the association between posted speed limit and AVC crash risk in darkness. AVCs were compiled from the Fatality Analysis Reporting System (FARS) and the General Estimates System (GES) for the years 1990-2008 to examine annual crash trends for fatal and nonfatal crashes. Seasonal trends for fatal AVCs were examined with the aggregated FARS dataset; seasonal trends for fatal and nonfatal AVCs were also examined by aggregating four years of Michigan crash data. State-by-state distributions of fatal AVCs were also described with the aggregated FARS dataset. Finally, the relationship between posted speed limit and the odds that a fatal or nonfatal AVC occurred in darkness were examined with logistic regressions using the aggregated FARS and Michigan datasets. Between 1990 and 2008, fatal AVCs increased by 104% and by 1.3 crashes per trillion vehicle miles travelled per year. Although not all AVCs involve deer, daily and seasonal AVC crash trends follow the general activity pattern of deer populations, consistent with prior reports. The odds that a fatal AVC occurred in darkness were also found to increase by 2.3% for each mile-per-hour increase in speed; a similar, albeit smaller, effect was also observed in the aggregated Michigan dataset, among nonfatal crashes. AVCs represent a small but increasing share of crashes in the United States. Seasonal and daily variation in the pattern of AVCs seem to follow variation in deer exposure and ambient light level. Finally, the relative risk that a fatal and nonfatal AVC occurred in darkness is influenced by posted speed limit, suggesting that a driver's limited forward vision at night plays a role in AVCs, as it does in pedestrian collisions. The association between speed limit and crash risk in darkness suggests that AVC risk might be reduced with countermeasures that improve a driver's forward view of the road. Copyright © 2010 Elsevier Ltd. All rights reserved.

Causes of fatal accidents for instrument-certified and non-certified private pilots.

PubMed

Shao, Bob Siyuan; Guindani, Michele; Boyd, Douglas D

2014-11-01

Instrument certification (IFR) enhances a pilot's skills in precisely controlling the aircraft and requires a higher level of standards in maintaining heading and altitude compared with the less stringent private pilot certificate. However, there have been no prior studies to compare fatal accident causes for airmen with, and without, this rating, The NTSB accident database was queried for general aviation fatal accidents for private pilots with, and without IFR certification. Exact Poisson tests were used to calculate whether two rate parameters were equal (ratio of 1), normalized to the number of IFR-rated pilots and flight hours in the given time period. Proportion tests were used to determine whether there were significant differences in fatal accident causes between IFR-certified and non-certified pilots. A logistic regression for log-odds success was used in determining the trend and effect of age on fatal accident rates. IFR certification was associated with a reduced risk of accidents due to failure to maintain obstacle/terrain clearance and spatial disorientation for day and night operations respectively. In contrast, the likelihood of fatal accident due to equipment malfunction during day operations was higher for IFR-certified pilots. The fatal accident rate decreased over the last decade for IFR-certified but not for non-IFR-certified private pilots. However, the overall accident rate for IFR-certified private pilots was more than double that of the cohort lacking this certification. Finally, we found a trend for an increased fatality rate with advancing age for both group of pilots. Our findings informs on where training and/or technology should be focused. Both training for aerodynamic stalls, which causes over a quarter of all fatal accidents, should be intensified for both IFR-certified and non-certified private pilots. Similarly, adherence to minimum safe altitudes for both groups of pilots should be encouraged toward reducing the fatal accidents rate due to failure to maintain obstacle/terrain clearance. For night operations, the high percentage of accidents due to spatial disorientation for non-IFR certified airmen suggests that additional training be required for such operations or such flights carry restrictions for this subset of pilots. Copyright © 2014 Elsevier Ltd. All rights reserved.

A radical change in traffic law: effects on fatalities in the Czech Republic.

PubMed

Montag, J

2014-12-01

This study examines short- and long-run effects of a new-stricter-road traffic law on traffic accident-related fatalities in the Czech Republic. The law introduced tougher punishments through the introduction of a demerit point system and a manifold increase in fines, together with augmented authority of traffic police. Identification is based on difference-in-differences methodology, with neighbouring countries serving as a control group. There was a sharp, 33.3%, decrease in accident-related fatalities during the first three post-reform months. This translates into 127 saved lives (95% confidence interval: 51, 204). The decline was, however, temporary; the estimates of the effects going beyond the first year are around zero. Unique data on traffic police activity reveal that police resources devoted to traffic law enforcement gradually declined. Tougher penalties have significant, but often short-lived effects. Weaker enforcement in the aftermath of such reforms may explain the absence of long-run effects. © The Author 2014. Published by Oxford University Press on behalf of Faculty of Public Health. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

A fatal bite from the burrowing asp Atractaspis corpulenta (Hallowell 1854).

PubMed

Tilbury, Colin R; Verster, Janette

2016-08-01

Bites from the various species of Atractaspis are a common occurrence in Africa but deaths are very unusual. Of the 19 described species, the clinical effects of the bite of only seven have been described, and in only three (Atractaspis irregularis, Atractaspis microlepidota and Atractaspis engaddensis) have fatalities been documented. A case of envenomation is described following a bite to a finger by Atractaspis corpulenta, which resulted in sudden death approximately two and a half hours later. The victim received antivenom and although anaphylaxis to this cannot be ruled out, we consider it to be unlikely to be the cause of death. A late autopsy was performed and the findings and their interpretation are discussed. The previous case fatalities, toxic fractions and clinical effects of Atractaspis venom are briefly reviewed. Copyright © 2016 Elsevier Ltd. All rights reserved.

The Effect of State Regulations on Motor Vehicle Fatalities for Younger and Older Drivers: A Review and Analysis

PubMed Central

Grabowski, David C.; Morrisey, Michael A.

2001-01-01

Policymakers have had a long-standing interest in improving the motor vehicle safety of both younger and older drivers. Although younger and older drivers share the distinction of having more crashes and fatalities per mile driven than other age groups, the problems posed by these two groups stem from different origins and manifest in different ways. A number of state-level policies and regulations may affect the number of motor vehicle crashes and fatalities in these two high-risk groups. A critical review of the existing literature in regard to the risk factors and the effects of various policy measures on motor vehicle crashes in these two high-risk populations provides direction for policymakers and high-priority areas of interest for the research community. PMID:11789116

Evaluation of poly-drug use in methadone-related fatalities using segmental hair analysis.

PubMed

Nielsen, Marie Katrine Klose; Johansen, Sys Stybe; Linnet, Kristian

2015-03-01

In Denmark, fatal poisoning among drug addicts is often related to methadone. The primary mechanism contributing to fatal methadone overdose is respiratory depression. Concurrent use of other central nervous system (CNS) depressants is suggested to heighten the potential for fatal methadone toxicity. Reduced tolerance due to a short-time abstinence period is also proposed to determine a risk for fatal overdose. The primary aims of this study were to investigate if concurrent use of CNS depressants or reduced tolerance were significant risk factors in methadone-related fatalities using segmental hair analysis. The study included 99 methadone-related fatalities collected in Denmark from 2008 to 2011, where both blood and hair were available. The cases were divided into three subgroups based on the cause of death; methadone poisoning (N=64), poly-drug poisoning (N=28) or methadone poisoning combined with fatal diseases (N=7). No significant differences between methadone concentrations in the subgroups were obtained in both blood and hair. The methadone blood concentrations were highly variable (0.015-5.3, median: 0.52mg/kg) and mainly within the concentration range detected in living methadone users. In hair, methadone was detected in 97 fatalities with concentrations ranging from 0.061 to 211ng/mg (median: 11ng/mg). In the remaining two cases, methadone was detected in blood but absent in hair specimens, suggesting that these two subjects were methadone-naive users. Extensive poly-drug use was observed in all three subgroups, both recently and within the last months prior to death. Especially, concurrent use of multiple benzodiazepines was prevalent among the deceased followed by the abuse of morphine, codeine, amphetamine, cannabis, cocaine and ethanol. By including quantitative segmental hair analysis, additional information on poly-drug use was obtained. Especially, 6-acetylmorphine was detected more frequently in hair specimens, indicating that regular abuse of heroin was common among the deceased. In conclusion, continuous exposure of methadone provide by segmental hair analysis suggested that reduced tolerance of methadone was not a critical factor among methadone-related fatalities. In contrast, a high abundance of co-ingested CNS depressants suggested that adverse effects from drug-drug interactions were more important risk factors for fatal outcome in these deaths. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

The effects of electronic stability control (ESC) on crashes--an update.

PubMed

Høye, Alena

2011-05-01

The present study is an update of the meta-analysis by Erke (Erke, A., 2008. Effects of Electronic Stability Control (ESC) on accidents: a review of empirical evidence. Accident Analysis & Prevention, 40 (1), 167-173). Results from 12 studies of the effects of Electronic Stability Control (ESC) on the number of different types of crashes were summarized by means of meta-analysis. The results indicate that ESC prevents about 40% of all crashes involving loss of control. The greatest reductions were found for rollover crashes (-50%), followed by run-off-road (-40%) and single vehicle crashes (-25%). These results are however likely to be somewhat overestimated, especially for non-fatal crashes. Multiple vehicle crashes were found to be largely unchanged. Reductions were found for some types of multiple vehicle crashes. Rear-end collisions are unchanged or may increase. Fatal crashes involving pedestrians, bicycles or animals were found to increase as well. ESC was found to be more effective in preventing fatal crashes than non-fatal crashes. ESC is often found to be more effective in Sports Utility Vehicles (SUVs) than in passenger cars. This may be due to differences between drivers of SUVs and passenger cars. The results from meta-analysis indicate that drivers of ESC-equipped vehicles are likely to be safer drivers than other drivers. All the same, ESC may lead to behavioural adaptation in some cases, but it is not likely that behavioural adaptation offsets the positive safety effects. This may be due to a lack of knowledge about ESC. Copyright © 2010 Elsevier Ltd. All rights reserved.

Fatal occupational injuries of women, Texas 1975-84.

PubMed Central

Davis, H; Honchar, P A; Suarez, L

1987-01-01

A review of Texas death certificates for 1975-84 identified 348 cases of fatal occupational injuries of civilian females. Homicides accounted for 53 per cent and motor vehicle-related injuries accounted for 26 per cent of the deaths. Injuries from firearms caused 70 per cent of the homicides. One hundred thirty-three deaths occurred to women employed in the retail trade industry; of these, 77 per cent resulted from homicide. Women workers in gasoline service stations, food-bakery-and-dairy stores, and eating-and-drinking places had especially high risks of homicide. Texas female heavy-truck drivers had the highest fatal-injury rate, with motor-vehicle-related injuries causing 89 per cent of their deaths. These results indicate that effective strategies to prevent fatal occupational injuries of Texas women will need to address the problems of workplace violence and the hazards posed by motor vehicles. PMID:3674251

Effect of electronic stability control on automobile crash risk.

PubMed

Farmer, Charles

2004-12-01

Per vehicle crash involvement rates were compared for otherwise identical vehicle models with and without electronic stability control (ESC) systems. ESC was found to affect single-vehicle crashes to a greater extent than multiple-vehicle crashes, and crashes with fatal injuries to a greater extent than less severe crashes. Based on all police-reported crashes in 7 states over 2 years, ESC reduced single-vehicle crash involvement risk by approximately 41 percent (95 percent confidence limits 3348) and single-vehicle injury crash involvement risk by 41 percent (2752). This translates to an estimated 7 percent reduction in overall crash involvement risk (310) and a 9 percent reduction in overall injury crash involvement risk (314). Based on all fatal crashes in the United States over 3 years, ESC was found to have reduced single-vehicle fatal crash involvement risk by 56 percent (3968). This translates to an estimated 34 percent reduction in overall fatal crash involvement risk (2145).

The role of mobile computed tomography in mass fatality incidents.

PubMed

Rutty, Guy N; Robinson, Claire E; BouHaidar, Ralph; Jeffery, Amanda J; Morgan, Bruno

2007-11-01

Mobile multi-detector computed tomography (MDCT) scanners are potentially available to temporary mortuaries and can be operational within 20 min of arrival. We describe, to our knowledge, the first use of mobile MDCT for a mass fatality incident. A mobile MDCT scanner attended the disaster mortuary after a five vehicle road traffic incident. Five out of six bodies were successfully imaged by MDCT in c. 15 min per body. Subsequent full radiological analysis took c. 1 h per case. The results were compared to the autopsy examinations. We discuss the advantages and disadvantages of imaging with mobile MDCT in relation to mass fatality work, illustrating the body pathway process, and its role in the identification of the pathology, personal effects, and health and safety hazards. We propose that the adoption of a single modality of mobile MDCT could replace the current use of multiple radiological sources within a mass fatality mortuary.

[Reduced number of fatal and life-threatening reactions to food. Reporting by the medical profession has resulted in effective measures].

PubMed

Foucard, Tony; Yman, Ingrid Malmheden; Nordvall, Lennart

The results from the Swedish system for reporting severe and fatal reactions caused by food for the period 1993-96 were published in Lakartidningen in 1997. We now report the results for the period 1997-2003. The number of fatal cases has decreased from 1.75 to 0.86 per year and the number of life-threatening cases from 3 to I per year. The most gratifying result was the large decrease in severe reactions caused by soy, from 3 deaths and 6 life-threatening cases during the first 4-year period to just one life-threatening case during the following 7-year period. This reduction is probably largely due to an increased awareness of identified risk persons, but also to a reduced use of soy protein. The ongoing study illustrates the usefulness of a national system for reporting severe and fatal reactions caused by food.

Fleet Safety: Developing & Sustaining an Effective Program With ANSI/ASSE Z15.1.

PubMed

Hammer, Brian S; Pratt, Stephanie G; Ross, Peggy

2014-03-01

Millions of U.S. workers are at risk for a work-related motor vehicle crash. Fatality data show that across all industries, motor vehicle crashes are consistently the leading cause of work-related fatalities. Of 43,025 work-related fatalities reported by BLS between 2003 and 2010, 10,202 were the result of single- or multiple-vehicle crashes of workers driving or riding in a vehicle on a public roadway, and 2,707 were pedestrian workers struck by a motor vehicle. During the same period, an additional 2,487 workers died in crashes that occurred off a public roadway or on industrial premises (BLS, 2013).

Associations between unprocessed red and processed meat, poultry, seafood and egg intake and the risk of prostate cancer: A pooled analysis of 15 prospective cohort studies.

PubMed

Wu, Kana; Spiegelman, Donna; Hou, Tao; Albanes, Demetrius; Allen, Naomi E; Berndt, Sonja I; van den Brandt, Piet A; Giles, Graham G; Giovannucci, Edward; Alexandra Goldbohm, R; Goodman, Gary G; Goodman, Phyllis J; Håkansson, Niclas; Inoue, Manami; Key, Timothy J; Kolonel, Laurence N; Männistö, Satu; McCullough, Marjorie L; Neuhouser, Marian L; Park, Yikyung; Platz, Elizabeth A; Schenk, Jeannette M; Sinha, Rashmi; Stampfer, Meir J; Stevens, Victoria L; Tsugane, Shoichiro; Visvanathan, Kala; Wilkens, Lynne R; Wolk, Alicja; Ziegler, Regina G; Smith-Warner, Stephanie A

2016-05-15

Reports relating meat intake to prostate cancer risk are inconsistent. Associations between these dietary factors and prostate cancer were examined in a consortium of 15 cohort studies. During follow-up, 52,683 incident prostate cancer cases, including 4,924 advanced cases, were identified among 842,149 men. Cox proportional hazard models were used to calculate study-specific relative risks (RR) and then pooled using random effects models. Results do not support a substantial effect of total red, unprocessed red and processed meat for all prostate cancer outcomes, except for a modest positive association for tumors identified as advanced stage at diagnosis (advanced(r)). For seafood, no substantial effect was observed for prostate cancer regardless of stage or grade. Poultry intake was inversely associated with risk of advanced and fatal cancers (pooled multivariable RR [MVRR], 95% confidence interval, comparing ≥ 45 vs. <5 g/day: advanced 0.83, 0.70-0.99; trend test p value 0.29), fatal, 0.69, 0.59-0.82, trend test p value 0.16). Participants who ate ≥ 25 versus <5 g/day of eggs (1 egg ∼ 50 g) had a significant 14% increased risk of advanced and fatal cancers (advanced 1.14, 1.01-1.28, trend test p value 0.01; fatal 1.14, 1.00-1.30, trend test p value 0.01). When associations were analyzed separately by geographical region (North America vs. other continents), positive associations between unprocessed red meat and egg intake, and inverse associations between poultry intake and advanced, advanced(r) and fatal cancers were limited to North American studies. However, differences were only statistically significant for eggs. Observed differences in associations by geographical region warrant further investigation. © 2015 UICC.

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

PubMed Central

2015-01-01

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. PMID:26713066

Epidemiology & preventive aspects of railway suicides and fatalities related to trespassing accidents.

PubMed

Kumar, Sachil; Verma, Anoop K; Bhattacharya, Sandeep; Singh, Uma Shankar

2013-11-01

Suicide and trespass are major contributors to risk on the railway, resulting in around 170-180 fatalities per year in Lucknow region, as well as associated major disruption to the rail network. Lucknow is the capital city of the state of Uttar Pradesh in India. The analysis included train-pedestrian fatalities during 2007-2012. The data for 2007-2012 were collected from the autopsy reports of the university, case sheets from the hospital, the general prosecutor's investigations report and the inquest reports from police. The results show that the majority of victims were males. Half of the suicide victims were 20-39 years old. Accidents happened most frequently in situations when a person was walking on the tracks/in front of train (22.7%) or were crossing the tracks illegally (20.9%). Among all train-pedestrian fatalities, about half of the victims (42.8%) were intoxicated by alcohol. Female suicide victims suffered from mental health problems more frequently (55.8%) than male suicide victims. Overall, there is no reason to believe that train-pedestrian fatalities are unavoidable. By contrast, the effective prevention of railway suicides and accidents should be based on a systems approach involving effective measures introduces by several organisations such as government, railway organisations, various authorities (such as public health, education, enforcement, urban planning) and communities. Same measures can often be used to prevent both trespassing and suicides, even though their effectiveness may depend on the target group. In addition, there are measures specifically targeted to prevent either trespassing or suicides. Copyright © 2013 Elsevier Ltd and Faculty of Forensic and Legal Medicine. All rights reserved.

Substantial improvement of primary cardiovascular prevention by a systematic score-based multimodal approach: A randomized trial: The PreFord-Study.

PubMed

Gysan, Detlef Bernd; Millentrup, Stefanie; Albus, Christian; Bjarnason-Wehrens, Birna; Latsch, Joachim; Gohlke, Helmut; Herold, Gerd; Wegscheider, Karl; Heming, Christian; Seyfarth, Melchior; Predel, Hans-Georg

2017-09-01

Trial design Prospective randomized multicentre interventional study. Methods Individual cardiovascular risk assessment in Ford Company, Germany employees ( n = 4.196), using the European Society of Cardiology-Systematic Coronary Risk Evaluation (ESC-SCORE) for classification into three risk groups. Subjects assigned to ESC high-risk group (ESC-SCORE ≥ 5%), without a history of cardiovascular disease were eligible for randomization to a multimodal 15-week intervention programme (INT) or to usual care and followed up for 36 months. Objectives Evaluation of the long-term effects of a risk-adjusted multimodal intervention in high-risk subjects. Primary endpoint: reduction of ESC-SCORE in INT versus usual care. Secondary endpoints: composite of fatal and non-fatal cardiovascular events and time to first cardiovascular event. intention-to-treat and per-protocol analysis. Results Four hundred and forty-seven subjects were randomized to INT ( n = 224) or to usual care ( n = 223). After 36 months ESC-SCORE development favouring INT was observed (INT: 8.70% to 10.03% vs. usual care: 8.49% to 12.09%; p = 0.005; net difference: 18.50%). Moreover, a significant reduction in the composite cardiovascular events was observed: (INT: n = 11 vs. usual care: n = 27). Hazard ratio of intervention versus control was 0.51 (95% confidence interval 0.25-1.03; p = 0.062) in the intention-to-treat analysis and 0.41 (95% confidence interval 0.18-0.90; p = 0.026) in the per-protocol analysis, respectively. No intervention-related adverse events or side-effects were observed. Conclusions Our results demonstrate the efficiency of identifying cardiovascular high-risk subjects by the ESC-SCORE in order to enrol them to a risk adjusted primary prevention programme. This strategy resulted in a significant improvement of ESC-SCORE, as well as a reduction in predefined cardiovascular endpoints in the INT within 36 months. (ISRCTN 23536103.).

The Effect of Cancer Information Seeking on Perceptions of Cancer Risks, Fatalism, and Worry among a U.S. National Sample

ERIC Educational Resources Information Center

Amuta, Ann Oyare; Chen, Xuewei; Mkuu, Rahma

2017-01-01

Background: Information seeking is crucial in the health behavior context. Cancer information seeking may play a key role in individuals' perceptions and subsequent health behaviors. Purpose: The purpose of this study is to investigate the influence of cancer information seeking on perceptions of cancer worry, fatalism and risk. Methods: Data from…

Adverse weather conditions and fatal motor vehicle crashes in the United States, 1994-2012.

PubMed

Saha, Shubhayu; Schramm, Paul; Nolan, Amanda; Hess, Jeremy

2016-11-08

Motor vehicle crashes are a leading cause of injury mortality. Adverse weather and road conditions have the potential to affect the likelihood of motor vehicle fatalities through several pathways. However, there remains a dearth of assessments associating adverse weather conditions to fatal crashes in the United States. We assessed trends in motor vehicle fatalities associated with adverse weather and present spatial variation in fatality rates by state. We analyzed the Fatality Analysis Reporting System (FARS) datasets from 1994 to 2012 produced by the National Highway Traffic Safety Administration (NHTSA) that contains reported weather information for each fatal crash. For each year, we estimated the fatal crashes that were associated with adverse weather conditions. We stratified these fatalities by months to examine seasonal patterns. We calculated state-specific rates using annual vehicle miles traveled data for all fatalities and for those related to adverse weather to examine spatial variations in fatality rates. To investigate the role of adverse weather as an independent risk factor for fatal crashes, we calculated odds ratios for known risk factors (e.g., alcohol and drug use, no restraint use, poor driving records, poor light conditions, highway driving) to be reported along with adverse weather. Total and adverse weather-related fatalities decreased over 1994-2012. Adverse weather-related fatalities constituted about 16 % of total fatalities on average over the study period. On average, 65 % of adverse weather-related fatalities happened between November and April, with rain/wet conditions more frequently reported than snow/icy conditions. The spatial distribution of fatalities associated with adverse weather by state was different than the distribution of total fatalities. Involvement of alcohol or drugs, no restraint use, and speeding were less likely to co-occur with fatalities during adverse weather conditions. While adverse weather is reported for a large number of motor vehicle fatalities for the US, the type of adverse weather and the rate of associated fatality vary geographically. These fatalities may be addressed and potentially prevented by modifying speed limits during inclement weather, improving road surfacing, ice and snow removal, and providing transit alternatives, but the impact of potential interventions requires further research.

Effects of introducing an administrative .05% blood alcohol concentration limit on law enforcement patterns and alcohol-related collisions in Canada.

PubMed

Blais, Étienne; Bellavance, François; Marcil, Alexandra; Carnis, Laurent

2015-09-01

Except for Quebec, all Canadian provinces have introduced administrative laws to lower the permitted blood alcohol concentration (BAC) to .05% or .04% for driving-or having the care of-a motor vehicle. Using linear mixed effects models for longitudinal data, this study evaluates the effect of administrative BAC laws on fatal alcohol related crashes and law enforcement patterns in Canada from 1987 to 2010. Results reveal a significant decrease of 3.7% (95% C.I.: 0.9-6.5%) in fatally injured drivers with a BAC level equal or greater than .05% following the introduction of these laws. Reductions were also observed for fatally injured drivers with BAC levels greater that .08% and .15%. The introduction of administrative BAC laws led neither to significant changes in the rate of driving while impaired (DWI) incidents reported by police officers nor in the probability of being charged for DWI under the Criminal Code. Copyright © 2015 Elsevier Ltd. All rights reserved.

Plague Gives Surprises in the First Decade of the 21st Century in the United States and Worldwide

PubMed Central

Butler, Thomas

2013-01-01

Plague is an ancient disease caused by the bacterium Yersinia pestis and transmitted by rodent flea bites that continues to surprise us with first-ever events. This review documents plague in human cases in the 1st decade of the 21st century and updates our knowledge of clinical manifestations, transmission during outbreaks, diagnostic testing, antimicrobial treatment, and vaccine development. In the United States, 57 persons were reported to have the disease, of which seven died. Worldwide, 21,725 persons were affected with 1,612 deaths, for a case-fatality rate of 7.4%. The Congo reported more cases than any other country, including two large outbreaks of pneumonic plague, surpassing Madagascar, which had the most cases in the previous decade. Two United States scientists suffered fatal accidental exposures: a wildlife biologist, who carried out an autopsy on a mountain lion in Arizona in 2007, and a geneticist with subclinical hemochromatosis in Chicago, who was handling an avirulent strain of Y. pestis in 2009. Antimicrobial drugs given early after the onset of symptoms prevented many deaths; those recommended for treatment and prophylaxis included gentamicin, doxycycline, and fluoroquinolones, although fluoroquinolones have not been adequately tested in humans. Fleas that do not have their guts blocked by clotted blood meals were shown to be better transmitters of plague than blocked fleas. Under development for protection against bioterrorist use, a subunit vaccine containing F1 and V antigens of Y. pestis was administered to human volunteers eliciting antibodies without any serious side effects. These events, although showing progress, suggest that plague will persist in rodent reservoirs mostly in African countries burdened by poverty and civil unrest, causing death when patients fail to receive prompt antimicrobial treatment. PMID:24043686

Air bags and ocular injuries.

PubMed

Stein, J D; Jaeger, E A; Jeffers, J B

1999-01-01

This investigation retrospectively examined ocular injuries associated with air bag deployment to gain a better appreciation of potential risk factors in motor vehicle accidents. National statistics regarding the efficacy of air bags were reviewed. Review of the literature from 1991 to 1998 identified 44 articles describing 97 patients with air-bag-induced ocular injuries. Variables extracted from each case were age, sex, height, position in the car, eye wear, vehicle impact speed, visual acuity, and specific ocular injuries. Corneal abrasions occurred in 49% of occupants, hyphemas in 43%, vitreous or retinal hemorrhages in 25%, and retinal tears or detachments in 15%. The globe was ruptured in 10 patients. Patients involved in higher-speed accidents (over 30 mph) sustained a greater percentage of vitreous or retinal hemorrhages and traumatic cataracts, while those at slower speeds were more prone to retinal tears or detachments. In a subset of 14 patients with serious ocular injuries, the impact speed of 11 patients was recorded at 30 mph or less. Slower speed may be a risk factor for some ocular injuries. Occupant height was not a significant factor. National statistics confirm that air bags reduce fatalities in motor vehicle accidents. However, children sitting in the front seat without a seat belt and infants in passenger-side rear-facing car seats are at risk for fatal injury. Air bags combined with seat belts are an effective means of reducing injury and death in adults during motor vehicle accidents. However, this study has documented a wide variety of ocular injuries associated with air bag deployment. It is hoped that researchers can develop modifications that continue to save lives while minimizing additional harm.

How Safe is Vehicle Safety? The Contribution of Vehicle Technologies to the Reduction in Road Casualties in France from 2000 to 2010

PubMed Central

Page, Yves; Hermitte, Thierry; Cuny, Sophie

2011-01-01

In France, over the last 10 years, road fatalities have decreased dramatically by 48%. This reduction is somewhat close to the target fixed by the European Commision in 2001 for the whole of Europe (−50 %). According to the French govnerment, 75% of this reduction was due to the implementation of automatic speed cameras on the roadsides from 2003 onwards. Yet, during this period, there was also a significantly increase in safety technology, new regulations in front and side impacts, and developments in Euro NCAP to improve passive safety in the vehicles. This paper set out to estimate the extent that vehicle safety technologies contributed to the road safety benefits over this decade. Using a combination of databases and fitment rates, the number of fatalities and hospitalized injuries saved in passenger car crashes was estimated for a number of safety technologies, individually and as a package including a 5 star EuroNCAP rating. The additional benefits from other public safety measures were also similarly estimated. The results showed that overall safety measures during this decade saved 240,676 fatalities + serious injuries, of which 173,663 were car occupants. Of these, 27,365 car occupants and 1,083 pedestrian savings could be attributed directly to vehicle safety improvements (11% overall). It was concluded that while public safety measures were responsible for the majority of the savings, enhanced vehicle safety technologies also made a significant improvement in the road toll in France during the last decade. As the take-up rate for these technologies improves, is expected to continue to provide even more benefits in the next 10-year period. PMID:22105388

Rising gasoline prices increase new motorcycle sales and fatalities.

PubMed

Zhu, He; Wilson, Fernando A; Stimpson, Jim P; Hilsenrath, Peter E

2015-12-01

We examined whether sales of new motorcycles was a mechanism to explain the relationship between motorcycle fatalities and gasoline prices. The data came from the Motorcycle Industry Council, Energy Information Administration and Fatality Analysis Reporting System for 1984-2009. Autoregressive integrated moving average (ARIMA) regressions estimated the effect of inflation-adjusted gasoline price on motorcycle sales and logistic regressions estimated odds ratios (ORs) between new and old motorcycle fatalities when gasoline prices increase. New motorcycle sales were positively correlated with gasoline prices (r = 0.78) and new motorcycle fatalities (r = 0.92). ARIMA analysis estimated that a US$1 increase in gasoline prices would result in 295,000 new motorcycle sales and, consequently, 233 new motorcycle fatalities. Compared to crashes on older motorcycle models, those on new motorcycles were more likely to be young riders, occur in the afternoon, in clear weather, with a large engine displacement, and without alcohol involvement. Riders on new motorcycles were more likely to be in fatal crashes relative to older motorcycles (OR 1.14, 95 % confidence interval (CI) 1.02-1.28) when gasoline prices increase. Our findings suggest that, in response to increasing gasoline prices, people tend to purchase new motorcycles, and this is accompanied with significantly increased crash risk. There are several policy mechanisms that can be used to lower the risk of motorcycle crash injuries through the mechanism of gas prices and motorcycle sales such as raising awareness of motorcycling risks, enhancing licensing and testing requirements, limiting motorcycle power-to-weight ratios for inexperienced riders, and developing mandatory training programs for new riders.

Measles incidence, case fatality, and delayed mortality in children with or without vitamin A supplementation in rural Ghana.

PubMed

Dollimore, N; Cutts, F; Binka, F N; Ross, D A; Morris, S S; Smith, P G

1997-10-15

Data on measles incidence, acute case fatality, and delayed mortality were collected on 25,443 children aged 0-95 months during the course of a community-based, double-blind, placebo-controlled, randomized trial of vitamin A supplementation in rural, northern Ghana between 1989 and 1991. Measles vaccine coverage in these children was 48%. The overall estimated measles incidence rate was 24.3 per 1,000 child-years, and acute case fatality was 15.7%. There was not significantly increased mortality in survivors of the acute phase of measles compared with controls (rate ratio = 1.22, 95% confidence interval (CI) 0.65-2.30). Reported incidence rates and case fatality were higher in families with low paternal education, in the dry season, and in unvaccinated children, and case fatality was higher in malnourished children. There was no sex difference in incidence, but acute case fatality was somewhat higher in girls than boys (adjusted odds ratio = 1.3, 95% CI 0.9-2.1). Measles incidence was lower in vitamin A-supplemented groups (23.6 per 1,000 child-years) than in placebo groups (28.9 per 1,000 child-years), but this difference was not statistically significant (p = 0.33). Among 946 measles cases in clusters randomized to receive vitamin A or placebo, there was no marked difference in acute measles case fatality between vitamin A-supplemented and placebo groups (15.4% vs. 14.5%, respectively). The biologic effects of vitamin A supplemented on the subsequent clinical manifestations and severity of measles need further elucidation.

Injury Deaths Among U.S. Females: CDC Resources and Programs

PubMed Central

Mack, Karin A.; Peterson, Cora; Zhou, Chao; MacConvery, Elliane; Wilkins, Natalie

2017-01-01

Injury death rates are lower for women than for men at all ages, but we have a long way to go in understanding the circumstances of injury fatalities among females. This article presents resources that can be used to examine the most recent data on injury fatalities among females and highlights activities of CDC’s Injury Center. The National Center for Injury Prevention and Control’s (NCIPC’s) Web-based Injury Statistics Query and Reporting System, an online surveillance database, can be used to examine injury deaths. We present examples that show the 2015 number of female fatal injuries by age group and injury cause and method, as well as a 2008–2014 county-level map of female fatal injury rates. In 2015, there were 68,572 injury fatalities of females of age ≥1 year, equivalent to 1 death every 7 minutes. Injuries were the leading cause of death for females of ages 1–41 years and the sixth-ranked cause of female death overall. Falls were the leading cause of injury death overall (and for women ≥70 years), unintentional poisonings were second, and motor vehicle traffic injuries were third. NCIPC funds national organizations, state health agencies, and other groups to develop, implement, and promote effective injury and violence prevention and control practices. Five key programs are discussed. Presenting data on injury fatalities is an essential element in identifying meaningful prevention efforts. Further investigation of the causes and impact of female injury fatalities can refine the public health approach to reduce this injury burden. PMID:28294691

Does 'right to work' imperil the right to health? The effect of labour unions on workplace fatalities.

PubMed

Zoorob, Michael

2018-06-13

Economic policies can have unintended consequences on population health. In recent years, many states in the USA have passed 'right to work' (RTW) laws which weaken labour unions. The effect of these laws on occupational health remains unexplored. This study fills this gap by analysing the effect of RTW on occupational fatalities through its effect on unionisation. Two-way fixed effects regression models are used to estimate the effect of unionisation on occupational mortality per 100 000 workers, controlling for state policy liberalism and workforce composition over the period 1992-2016. In the final specification, RTW laws are used as an instrument for unionisation to recover causal effects. The Local Average Treatment Effect of a 1% decline in unionisation attributable to RTW is about a 5% increase in the rate of occupational fatalities. In total, RTW laws have led to a 14.2% increase in occupational mortality through decreased unionisation. These findings illustrate and quantify the protective effect of unions on workers' safety. Policymakers should consider the potentially deleterious effects of anti-union legislation on occupational health. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Motor vehicle fatalities in the United States construction industry.

PubMed

Ore, T; Fosbroke, D E

1997-09-01

A death certificate-based surveillance system was used to identify 2144 work-related motor vehicle fatalities among civilian workers in the United States construction industry over the years 1980-92. Construction workers were twice as likely to be killed by a motor vehicle as the average worker, with an annual crude mortality rate of 2.3/100,000 workers. Injury prevention efforts in construction have had limited effect on motor vehicle-related deaths, with death rates falling by only 11% during the 13-year period, compared with 43% for falls, 54% for electrocutions and 48% for machinery. In all industries combined, motor vehicle fatality rates dropped by 47%. The largest proportion of motor vehicle deaths (40%) occurred among pedestrians, with construction accounting for more than one-fourth of all pedestrian deaths. A minimum of 54 (6%) of these pedestrian fatalities were flaggers or surveyors. Flaggers accounted for half the 34 pedestrian fatalities among women, compared with only 3% among men. Along with previous studies and recent trends in the amount and type of road construction, these results underscore the need for better traffic control management in construction work areas to reduce pedestrian fatalities. As the second leading cause of traumatic death in construction, with an annual average share of 15% of the total deaths, exceeded only by falls, prevention of work-related motor vehicle research should become a greater priority in the construction industry.

The Impact of Michigan’s Partial Repeal of the Universal Motorcycle Helmet Law on Helmet Use, Fatalities, and Head Injuries

PubMed Central

Carter, Patrick M.; Buckley, Lisa; Flannagan, Carol A. C.; Cicchino, Jessica B.; Hemmila, Mark; Bowman, Patrick J.; Almani, Farideh; Bingham, C. Raymond

2017-01-01

Objectives To evaluate the impact of the partial repeal of Michigan’s universal motorcycle helmet law on helmet use, fatalities, and head injuries. Methods We compared helmet use rates and motorcycle crash fatality risk for the 12 months before and after the April 13, 2012, repeal with a statewide police-reported crash data set. We linked police-reported crashes to injured riders in a statewide trauma registry. We compared head injury before and after the repeal. Regression examined the effect of helmet use on fatality and head injury risk. Results Helmet use decreased in crash (93.2% vs 70.8%; P < .001) and trauma data (91.1% vs 66.2%; P < .001) after the repeal. Although fatalities did not change overall (3.3% vs 3.2%; P = .87), head injuries (43.4% vs 49.6%; P < .05) and neurosurgical intervention increased (3.7% vs 6.5%; P < .05). Male gender (adjusted odds ratio [AOR] = 1.65), helmet nonuse (AOR = 1.84), alcohol intoxication (AOR = 11.31), intersection crashes (AOR = 1.62), and crashes at higher speed limits (AOR = 1.04) increased fatality risk. Helmet nonuse (AOR = 2.31) and alcohol intoxication (AOR = 2.81) increased odds of head injury. Conclusions Michigan’s helmet law repeal resulted in a 24% to 27% helmet use decline among riders in crashes and a 14% increase in head injury. PMID:27854530

Infringement of the barriers of cancer via dietary phytoconstituents capsaicin through novel drug delivery system.

PubMed

Giri, Tapan Kumar; Alexander, Amit; Ajazuddin; Barman, Tapan Kumar; Maity, Subhasis

2016-01-01

Cancer is the major cause of fatality and the number of new cases is increasing incessantly. Conventional therapies and existing anticancer agents cause serious side effects and expand the patient's lifespan by a few years. There is the need to exploit alternative anticancer agents and novel drug delivery system to deliver these agents to the tumor site for the prevention of cancer. Recently, biologically active compounds isolated from plants used for the management of cancer have been the heart of interest. Capsaicin is a major pungent agent present in the chili peppers that is heavily consumed in the world. Capsaicin has demonstrated effectiveness as an anticancer agent, but a restraining factor is its pungency, extremely low aqueous solubility, and poor oral bioavailability which impede its use as an anticancer agent. Many technologies have been developed and applied to conquer this drawback. We bring to light the benefits of this phytoconstituent for treating different types of cancer. We also discussed some of the delivery approaches that have already made an impact by either delivering a drug to target tissue or increasing its bioavailability by many folds.

The efficacy and safety of epsilon-aminocaproic acid treatment in patients with cirrhosis and hyperfibrinolysis.

PubMed

Gunawan, B; Runyon, B

2006-01-01

Patients with decompensated cirrhosis are at risk for hyperfibrinolysis; this is potentially fatal. epsilon-aminocaproic acid has been used to treat patients with hyperfibrinolysis; however, the data about its benefit in the setting of cirrhosis are minimal. To analyse the efficacy of epsilon-aminocaproic acid and its safety in cirrhotic patients with hyperfibrinolysis. All patients with an abnormal euglobin lysis time who were admitted to Rancho Los Amigos Medical Center from 1 January 2001 to 31 December 2002 were included in the study. Their medical records were reviewed and analysed. There were 60 cirrhotic patients with shortened euglobin lysis time. Fifty-two patients received epsilon-aminocaproic acid. Of the 52 patients, seven had one or more bleeding episodes with the subcutaneous or soft tissue bleeding as the most common indication for epsilon-aminocaproic acid use. Of the 37 patients, 34 (92%) had improvement or resolution of their bleeding. Only two (3%) patients had epsilon-aminocaproic acid treatment discontinued because of minor side effects, rash and lightheadedness. There were no thromboembolic complications of treatment. epsilon-aminocaproic acid was found to be effective and safe for treatment of hyperfibrinolysis in patients with cirrhosis.

Pegademase bovine (PEG-ADA) for the treatment of infants and children with severe combined immunodeficiency (SCID).

PubMed

Booth, Claire; Gaspar, H Bobby

2009-01-01

Adenosine deaminase deficiency (ADA) is a rare, inherited disorder of purine metabolism characterized by immunodeficiency, failure to thrive and metabolic abnormalities. A lack of the enzyme ADA allows accumulation of toxic metabolites causing defects of both cell mediated and humoral immunity leading to ADA severe combined immune deficiency (SCID), a condition that can be fatal in early infancy if left untreated. Hematopoietic stem cell transplant is curative but is dependent on a good donor match. Other therapeutic options include enzyme replacement therapy (ERT) with pegademase bovine (PEG-ADA) and more recently gene therapy. PEG-ADA has been used in over 150 patients worldwide and has allowed stabilization of patients awaiting more definitive treatment with hematopoietic stem cell transplant. It affords both metabolic detoxification and protective immune function with patients remaining clinically well, but immune reconstitution is often suboptimal and may not be long lived. We discuss the pharmacokinetics, immune reconstitution, effects on systemic disease and side effects of treatment with PEG-ADA. We also review the long-term outcome of patients receiving ERT and discuss the role of PEG-ADA in the management of infants and children with ADA-SCID, alongside other therapeutic options.

Augmenting the Efficacy of Immunotoxins and Other Targeted Protein Toxins by Endosomal Escape Enhancers.

PubMed

Fuchs, Hendrik; Weng, Alexander; Gilabert-Oriol, Roger

2016-07-01

The toxic moiety of almost all protein-based targeted toxins must enter the cytosol of the target cell to mediate its fatal effect. Although more than 500 targeted toxins have been investigated in the past decades, no antibody-targeted protein toxin has been approved for tumor therapeutic applications by the authorities to date. Missing efficacy can be attributed in many cases to insufficient endosomal escape and therefore subsequent lysosomal degradation of the endocytosed toxins. To overcome this drawback, many strategies have been described to weaken the membrane integrity of endosomes. This comprises the use of lysosomotropic amines, carboxylic ionophores, calcium channel antagonists, various cell-penetrating peptides of viral, bacterial, plant, animal, human and synthetic origin, other organic molecules and light-induced techniques. Although the efficacy of the targeted toxins was typically augmented in cell culture hundred or thousand fold, in exceptional cases more than million fold, the combination of several substances harbors new problems including additional side effects, loss of target specificity, difficulties to determine the therapeutic window and cell type-dependent variations. This review critically scrutinizes the chances and challenges of endosomal escape enhancers and their potential role in future developments.

Augmenting the Efficacy of Immunotoxins and Other Targeted Protein Toxins by Endosomal Escape Enhancers

PubMed Central

Fuchs, Hendrik; Weng, Alexander; Gilabert-Oriol, Roger

2016-01-01

The toxic moiety of almost all protein-based targeted toxins must enter the cytosol of the target cell to mediate its fatal effect. Although more than 500 targeted toxins have been investigated in the past decades, no antibody-targeted protein toxin has been approved for tumor therapeutic applications by the authorities to date. Missing efficacy can be attributed in many cases to insufficient endosomal escape and therefore subsequent lysosomal degradation of the endocytosed toxins. To overcome this drawback, many strategies have been described to weaken the membrane integrity of endosomes. This comprises the use of lysosomotropic amines, carboxylic ionophores, calcium channel antagonists, various cell-penetrating peptides of viral, bacterial, plant, animal, human and synthetic origin, other organic molecules and light-induced techniques. Although the efficacy of the targeted toxins was typically augmented in cell culture hundred or thousand fold, in exceptional cases more than million fold, the combination of several substances harbors new problems including additional side effects, loss of target specificity, difficulties to determine the therapeutic window and cell type-dependent variations. This review critically scrutinizes the chances and challenges of endosomal escape enhancers and their potential role in future developments. PMID:27376327

Drugs in development for toxoplasmosis: advances, challenges, and current status.

PubMed

Alday, P Holland; Doggett, Joseph Stone

2017-01-01

Toxoplasma gondii causes fatal and debilitating brain and eye diseases. Medicines that are currently used to treat toxoplasmosis commonly have toxic side effects and require prolonged courses that range from weeks to more than a year. The need for long treatment durations and the risk of relapsing disease are in part due to the lack of efficacy against T. gondii tissue cysts. The challenges for developing a more effective treatment for toxoplasmosis include decreasing toxicity, achieving therapeutic concentrations in the brain and eye, shortening duration, eliminating tissue cysts from the host, safety in pregnancy, and creating a formulation that is inexpensive and practical for use in resource-poor areas of the world. Over the last decade, significant progress has been made in identifying and developing new compounds for the treatment of toxoplasmosis. Unlike clinically used medicines that were repurposed for toxoplasmosis, these compounds have been optimized for efficacy against toxoplasmosis during preclinical development. Medicines with enhanced efficacy as well as features that address the unique aspects of toxoplasmosis have the potential to greatly improve toxoplasmosis therapy. This review discusses the facets of toxoplasmosis that are pertinent to drug design and the advances, challenges, and current status of preclinical drug research for toxoplasmosis.

A current review of cytochrome P450 interactions of psychotropic drugs.

PubMed

Madhusoodanan, Subramoniam; Velama, Umamaheswararao; Parmar, Jeniel; Goia, Diana; Brenner, Ronald

2014-05-01

The number of psychotropic drugs has expanded tremendously over the past few decades with a proportional increase in drug-drug interactions. The majority of psychotropic agents are biotransformed by hepatic enzymes, which can lead to significant drug-drug interactions. Most drug-drug interactions of psychotropics occur at metabolic level involving the hepatic cytochrome P450 enzyme system. We searched the National Library of Medicine, PsycINFO, and Cochrane reviews from 1981 to 2012 for original studies including clinical trials, double-blind, placebo-controlled studies, and randomized controlled trials. In addition, case reports, books, review articles, and hand-selected journals were utilized to supplement this review. Based on the clinical intensity of outcome, cytochrome interactions can be classified as severe, moderate, and mild. Severe interactions include effects that might be acutely life threatening. They are mainly inhibitory interactions with cardiovascular drugs. Moderate interactions include efficacy issues. Mild interactions include nonserious side effects, such as somnolence. Psychotropic drugs may interact with other prescribed medications used to treat concomitant medical illnesses. A thorough understanding of the most prescribed medications and patient education will help reduce the likelihood of potentially fatal drug-drug interactions.

Drugs in development for toxoplasmosis: advances, challenges, and current status

PubMed Central

Alday, P Holland; Doggett, Joseph Stone

2017-01-01

Toxoplasma gondii causes fatal and debilitating brain and eye diseases. Medicines that are currently used to treat toxoplasmosis commonly have toxic side effects and require prolonged courses that range from weeks to more than a year. The need for long treatment durations and the risk of relapsing disease are in part due to the lack of efficacy against T. gondii tissue cysts. The challenges for developing a more effective treatment for toxoplasmosis include decreasing toxicity, achieving therapeutic concentrations in the brain and eye, shortening duration, eliminating tissue cysts from the host, safety in pregnancy, and creating a formulation that is inexpensive and practical for use in resource-poor areas of the world. Over the last decade, significant progress has been made in identifying and developing new compounds for the treatment of toxoplasmosis. Unlike clinically used medicines that were repurposed for toxoplasmosis, these compounds have been optimized for efficacy against toxoplasmosis during preclinical development. Medicines with enhanced efficacy as well as features that address the unique aspects of toxoplasmosis have the potential to greatly improve toxoplasmosis therapy. This review discusses the facets of toxoplasmosis that are pertinent to drug design and the advances, challenges, and current status of preclinical drug research for toxoplasmosis. PMID:28182168

A stable dynamic cohort analysis of installing cost-effective rollover protective structures (CROPS).

PubMed

Owusu-Edusei, K; Biddle, E A

2007-04-01

Cost-effective rollover protective structures (CROPS) are less costly model-specific rollover protective structure (ROPS) retrofits that are being developed and evaluated with the hope of increasing adoption and eventually preventing or mitigating injuries due to tractor overturns. A dynamic cohort of the estimated retrofittable non-ROPS tractors (accounting for attrition due to aging) was tracked over a 20-year period to determine the expected costs, as well as the expected number of fatal and non-fatal injuries resulting from tractor overturns. Two alternatives were tracked: No-ROPS and Install-CROPS. For a starting cohort size of 1,065,164 (an estimate for the year 2004), the Install-CROPS option prevented an estimated total of 878 (192 fatal and 686 non-fatal) injuries over the 20-year period. Expected costs were $513 million (cost of installing CROPS on all the non-ROPS tractors plus cost of the associated injuries) and $284 million (cost of injuries resulting from the No-ROPS option) over the same time period. Thus, the net cost per injury prevented was $260,820. When the cost of intervention ($1000 for purchasing, shipping, and installation of existing ROPS retrofit) was used in the analysis, the cost-effectiveness ratio was $927,000 per injury prevented over the 20-year period. Thus, installing CROPS instead of existing ROPS retrofits improved the cost-effectiveness ratio substantially, with a 72% reduction in the net cost per injury prevented.

Effects of a 2009 Illinois Alcohol Tax Increase on Fatal Motor Vehicle Crashes.

PubMed

Wagenaar, Alexander C; Livingston, Melvin D; Staras, Stephanie S

2015-09-01

We examined the effects of a 2009 increase in alcohol taxes in Illinois on alcohol-related fatal motor vehicle crashes. We used an interrupted time-series design, with intrastate and cross-state comparisons and measurement derived from driver alcohol test results, for 104 months before and 28 months after enactment. Our analyses used autoregressive moving average and generalized linear mixed Poisson models. We examined both population-wide effects and stratifications by alcohol level, age, gender, and race. Fatal alcohol-related motor vehicle crashes declined 9.9 per month after the tax increase, a 26% reduction. The effect was similar for alcohol-impaired drivers with positive alcohol levels lower than 0.15 grams per deciliter (-22%) and drivers with very high alcohol levels of 0.15 or more (-25%). Drivers younger than 30 years showed larger declines (-37%) than those aged 30 years and older (-23%), but gender and race stratifications did not significantly differ. Increases in alcohol excise taxes, such as the 2009 Illinois act, could save thousands of lives yearly across the United States as part of a comprehensive strategy to reduce alcohol-impaired driving.

[The morphofunctional changes in the rat lung tissue during simulation of acute fatal poisoning with household gas].

PubMed

Kalinina, E Iu; Iagmurov, O D

2014-01-01

The methods of light microscopy, immunohistochemistry, and electron microscopy were employed to study the morphofunctional changes in epithelium of bronchial and respiratory segments of the rat lungs used as models of acute fatal poisoning with household gas. It was shown that this toxic effect induces the pathological process involving all the elements of the epithelial layer in the bronchial and respiratory segments of the lungs of experimental animals. At the ultrastructural level, mitochondria and endoplasmic reticulum structures are affected, with the death of epithelial cells leading to the damage of the aerohematic barrier. The toxic effect of the gaseous mixture on the membranes causes the destruction of various elements of the epithelial layer. The results of this study help to understand the mechanisms of death in the case of acute fatal poisoning with household gas.

Fatal accidents in nighttime vs. daytime highway construction work zones.

PubMed

Arditi, David; Lee, Dong-Eun; Polat, Gul

2007-01-01

Awareness about worker safety in nighttime construction has been a major concern because it is believed that nighttime construction creates hazardous work conditions. However, only a few studies provide valuable comparative information about accident characteristics of nighttime and daytime highway construction activities. This study investigates fatal accidents that occurred in Illinois highway work zones in the period 1996-2001 in order to determine the safety differences between nighttime and daytime highway construction. The lighting and weather conditions were included into the study as control parameters to see their effects on the frequency of fatal accidents occurring in work zones. According to this study, there is evidence that nighttime construction is more hazardous than daytime construction. The inclusion of a weather parameter into the analysis has limited effect on this finding. The study justifies establishing an efficient work zone accident reporting system and taking all necessary measures to enhance safety in nighttime work zones.

Diary of an astronaut: examination of the remains of the late Israeli astronaut Colonel Ilan Ramon's Crew Notebook recovered after the loss of NASA's space shuttle Columbia.

PubMed

Brown, Sharon; Sin-David, Laser

2007-05-01

Two months after the fatal re-entering into the Earth's atmosphere of Columbia flight STS-107, the remains of Israeli astronaut Colonel Ilan Ramon's Crew Notebook were found strewn in a field in San Augustine County, TX. The random pile of papers was found to have survived the calamity of the Shuttle's disintegration remarkably well. Most of the papers recovered were torn and/or washed out to varying degrees but only mildly charred around the edges. The sheets of paper could be categorized into four groups: Group I: eight sides of paper written while in space in black ink and in pencil--Ramon's personal diary; the writing on these eight sides of paper survived well and is only missing where the pages were torn. Small fragments found in the field were physically matched to holes in the pages thus locating their original positions in the text. Group II: six sides of technical preparation notes written by Ramon before the mission. The writing on these pages was washed out entirely, but much of it was visualized using infrared luminescence. Group III: eight sides of personal notes prepared by Ramon before the mission written in blue ink. The writing on these pages was barely visible to the naked eye and not visualized by infrared luminescence, but was made largely legible by digital enhancement imaging. Group IV: a few sides of printed technical information. These pages were mostly intact and were not examined at length as they contained standard printed material. After completion of examinations at the Questioned Document Laboratory of the Israel Police, the diary was transferred to the Paper Conservation Department of the Israel Museum for preservation and strengthening treatments.

Direct cardiac effects of intracoronary bupivacaine, levobupivacaine and ropivacaine in the sheep

PubMed Central

Chang, Dennis H-T; Ladd, Leigh A; Copeland, Susan; Iglesias, Miguel A; Plummer, John L; Mather, Laurence E

2001-01-01

The racemic local anaesthetic agent bupivacaine is widely used clinically for its long duration of action. Levobupivacaine and ropivacaine are bupivacaine enantiopure congeners, developed to improve upon the clinical safety of bupivacaine, especially the risk of fatal arrhythmogenesis. In previous preclinical studies of the safety of these drugs with intravenous administration in conscious ewes over a wide dose range, we found that central nervous system (CNS) excito-toxicity reversed the cardiac depressant effects when doses approached the convulsant threshold and thus precluded accurate comparison of their cardiovascular system (CVS) effects. To study CVS effects over a wide range of doses with minimal CNS and other influences, brief (3 min) infusions of bupivacaine, levobupivacaine or ropivacaine were administered into the left main coronary arteries of previously instrumented conscious ewes (∼50 Kg body weight). After dose-ranging studies, the drugs were compared in a randomized, blinded, parallel group design. Equimolar doses were increased from 8 μmol (≈amp;2.5 mg) in 8 μmol increments, to either a fatal outcome or a 40 μmol (≈amp;12.5 mg) maximum. All three drugs produced tachycardia, decreased myocardial contractility and stroke volume and widening of electrocardiographic QRS complexes. Thirteen of 19 animals died of ventricular fibrillation: four of six with bupivacaine (mean±s.e.mean actual fatal dose: 21.8±6.4 μmol), five of seven with levobupivacaine (22.9±3.5 μmol), four of six with ropivacaine (22.9±5.9 μmol). No significant differences in survival or in fatal doses between these drugs were found. The findings suggest that ropivacaine, levobupivacaine and bupivacaine have similar intrinsic ability to cause direct fatal cardiac toxicity when administered by left intracoronary arterial infusion in conscious sheep and do not explain the differences between the drugs found with intravenous dosage. PMID:11159717

Seasonality and Coronary Heart Disease Deaths in United States Firefighters

PubMed Central

Mbanu, Ibeawuchi; Wellenius, Gregory A.; Mittleman, Murray A.; Peeples, Lynne; Stallings, Leonard A.; Kales, Stefanos N.

2013-01-01

United States firefighters have a high on-duty fatality rate and coronary heart disease is the leading cause. Seasonality affects the incidence of cardiovascular events in the general population, but its effects on firefighters are unknown. We statistically examined the seasonal and annual variation of all on-duty coronary heart disease deaths among US firefighters between 1994 and 2004 using the chi-square distribution and Poisson regression model of the monthly fatality counts. We also examined the effect of ambient temperature (apparent as well as wind chill temperature) on coronary heart disease fatalities during the study span using a time-stratified, case-crossover study design. When grouped by season, we observed the distribution of the 449 coronary heart disease fatalities to show a relative peak in winter (32%) and relative nadir in spring (21%). This pattern was significantly different (p=0.005) from the expected distribution under the null hypothesis where season has no effect. The pattern persisted in additional analyses, stratifying the deaths by the type of duty in which the firefighters were engaged at the time of their deaths. In the Poisson regression model of the monthly fatality counts, the overall goodness-of-fit between the actual and predicted case counts was excellent ( χ42 = 16.63; p = 0.002). Two distinct peaks were detected, one in January-February and the other in August-September. Overall, temperature was not associated with increased risk of on-duty death. After allowing for different effects of temperature in mild/hot versus cold periods, a 1°C increase was not protective in cold weather, nor did it increase the risk of death in warmer weather. The findings of this study reveal statistical evidence for excess coronary heart disease deaths among firefighters during winter; however, the temporal pattern coronary heart disease deaths was not linked to temperature variation. We also found the seasonal pattern to be independent of duty-related risks. PMID:17701682

Utility competition, DSM, and piano bars: The fatal flaw

DOE Office of Scientific and Technical Information (OSTI.GOV)

Studness, C.M.

1993-08-01

This article is an economic analysis of demand side management (DSM). The author contends that utilities and regulators have lost sight of their primary mission of providing electric power as efficiently as possible; DSM conflicts with this mission. DSM measures have not be submitted to a market test, so utilities are not necessarily providing the customers with what they want. This situation is compared to the airline industry before deregulation, when airlines provided expensive services that customers did not want. Also, with present technology, DSM measures consume more in total resources than it what it costs to produce electricity, therebymore » depleting the nation's resources at a greater rate.« less

Aspects of the passenger airbag E.C.U. location

NASA Astrophysics Data System (ADS)

Soica, A.

2016-08-01

Road accidents represent the dark side of road traffic, their consequences leading to material damage and often to vehicle occupant fatalities. Passive safety systems offer a high level of protection to vehicle occupants; yet, depending on a number of constructive factors and not only, these systems can not always ensure a high survival rate. The costs of road traffic accidents are to be borne by the whole society, with high amounts of money required. In this paper we analyze how the collision is felt in various points on the vehicle, at a given time and how this may affect the proper functioning of the passive safety systems, especially the airbag system.

Fatalities and fatality rates in alcohol-impaired crashes by state, 2005-2006

DOT National Transportation Integrated Search

2008-02-01

In 2006, as compared to 2005, while the overall fatality rate declined from 1.46 to 1.41 fatalities per 100 million vehicle miles of travel (VMT), the alcohol-impaired fatality rate remained flat at 0.45 fatalities per 100 million VMT. In 2006, the a...

Evaluating the effectiveness of red light running camera enforcement in Cedar Rapids and developing guidelines for selection and use of red light running countermeasures.

DOT National Transportation Integrated Search

2011-11-01

Red light running (RLR) is a problem in the US that has resulted in 165,000 injuries and 907 fatalities annually. In Iowa, RLR-related crashes make up 24.5 percent of all crashes and account for 31.7 percent of fatal and major injury crashes at signa...

AAV9 intracerebroventricular gene therapy improves lifespan, locomotor function and pathology in a mouse model of Niemann-Pick type C1 disease.

PubMed

Hughes, Michael P; Smith, Dave A; Morris, Lauren; Fletcher, Claire; Colaco, Alexandria; Huebecker, Mylene; Tordo, Julie; Palomar, Nuria; Massaro, Giulia; Henckaerts, Els; Waddington, Simon N; Platt, Frances M; Rahim, Ahad A

2018-06-05

Niemann-Pick type C disease (NP-C) is a fatal neurodegenerative lysosomal storage disorder. It is caused in 95% of cases by a mutation in the NPC1 gene that encodes NPC1, an integral transmembrane protein localised to the limiting membrane of the lysosome. There is no cure for NP-C but there is a disease-modifying drug (miglustat) that slows disease progression but with associated side effects. Here, we demonstrate in a well-characterised mouse model of NP-C that a single administration of AAV-mediated gene therapy to the brain can significantly extend lifespan, improve quality of life, prevent or ameliorate neurodegeneration, reduce biochemical pathology and normalize or improve various indices of motor function. Over-expression of human NPC1 does not cause adverse effects in the brain and correctly localises to late endosomal/lysosomal compartments. Furthermore, we directly compare gene therapy to licensed miglustat. Even at a low dose, gene therapy has all the benefits of miglustat but without adverse effects. On the basis of these findings and on-going ascendency of the field, we propose intracerebroventricular gene therapy as a potential therapeutic option for clinical use in NP-C.

Pirfenidone for the treatment of Hermansky-Pudlak Syndrome pulmonary fibrosis

PubMed Central

O’Brien, Kevin; Troendle, James; Gochuico, Bernadette R.; Markello, Thomas C.; Salas, Jose; Cardona, Hilda; Yao, Jianhua; Bernardini, Isa; Hess, Richard; Gahl, William A.

2013-01-01

Hermansky-Pudlak syndrome (HPS) type is a rare disorder of oculocutaneous albinism, platelet dysfunction, and in some subtypes, fatal pulmonary fibrosis. There is no effective treatment for the pulmonary fibrosis except lung transplantation, but an initial trial using pirfenidone, an anti-fibrotic agent, showed promising results. The current, randomized, placebo-controlled, prospective, double-blind trial investigated the safety and efficacy of pirfenidone for mild to moderate HPS-1 and 4 pulmonary fibrosis. Subjects were evaluated every 4 months at the National Institutes of Health Clinical Center, and the primary outcome parameter was change in forced vital capacity using repeated measures analysis with random coefficients. Thirty-five subjects with HPS-1 pulmonary fibrosis were enrolled during a 4-year interval; 23 subjects received pirfenidone and 12 received placebo. Four subjects withdrew from the trial, 3 subjects died, and 10 serious adverse events were reported. Both groups experienced similar side effects, especially gastroesophageal reflux. Interim analysis of the primary outcome parameter, performed 12 months after 30 patients were enrolled, showed no statistical difference between the placebo and pirfenidone groups, and the study was stopped due to futility. There were no significant safety concerns. Other clinical trials are indicated to identify single or multiple drug regimens that may be effective in treatment for progressive HPS-1 pulmonary fibrosis. PMID:21420888

Prevention of motor‐vehicle deaths by changing vehicle factors

PubMed Central

Robertson, Leon S

2007-01-01

Objective To estimate the effect of changing vehicle factors to reduce mortality in a comprehensive study. Design/methods Odds of death in the United States during 2000–2005 were analyzed, involving specific makes and models of 1999–2005 model year cars, minivans, and sport utility vehicles using logistic regression after selection of factors to be included by examination of least‐squares correlations of vehicle factors to maximize independence of predictors. Based on the regression coefficients, percentages of deaths preventable by changes in selected factors were calculated. Correlations of vehicle characteristics to environmental and behavioral risk factors were also examined to assess any potential confounding. Results Deaths in the studied vehicles would have been 42% lower had all had electronic stability control (ESC) systems. Improved crashworthiness as measured by offset frontal and side crash tests would have produced an additional 28% reduction, and static stability improvement would have reduced the deaths 11%. Although weight–power that reduces fuel economy is associated with lower risk to drivers, it increases risk of deaths to pedestrians and bicyclists but has an overall minor effect compared to the other factors. Conclusion A large majority of motor‐vehicle‐related fatalities could be avoided by universal adoption of the most effective technologies. PMID:17916886

"Until people start dying in droves, no actions will be taken": perception and experience of HIV-preventive measures among people who inject drugs in northwestern Russia.

PubMed

Meylakhs, Peter; Aasland, Aadne; Grønningsæter, Arne

2017-06-05

The HIV epidemic among people who inject drugs (PWID) in Russia continues to spread. This exploratory study examines how HIV-prevention measures are perceived and experienced by PWID in the northwestern region of Russia. Purposive sampling was used to obtain a variety of cases that could reflect possible differences in perception and experience of HIV-prevention efforts. We conducted 22 semi-structured interviews with PWID residing in the Arkhangelsk and St. Petersburg regions. The main sources of prevention information on HIV for PWID were media campaigns directed to the general population. These campaigns were effective with regard to communicating general knowledge on HIV but were ineffective in terms of risk behavior change. The subjects generally had trust in medical professionals and their advice but did not follow prevention recommendations. Most informants had no or very little prior contact with harm reduction services. On the level of attitudes towards HIV prevention efforts, we discovered three types of fatalism among PWID: "personal fatalism" - uselessness of HIV prevention efforts, if one uses drugs; "prevention-related fatalism" - prevention programs are low effective, because people do not pay attention to them before they get infected; "state-related fatalism" - the lack of belief that the state is concerned with HIV prevention issues. Despite this fatalism the participants opined that NGOs would do a better job than the state as they are "really working" with risk groups. As HIV prevention campaigns targeted at the general population and prevention advice received from medical professionals are not sufficiently effective for PWID in terms of risk behavior change, prevention programs, such as community-based and peer-based interventions specifically tailored to the needs of PWID are needed, which can be achieved by a large expansion of harm reduction services in the region. Personal communication should be a crucial element in such interventions in addition to harm reduction materials provision. Training programs, peer outreach, and culture-change interventions which try to alter widespread fatalistic norms or attitudes towards their health are especially needed, since this study indicates that fatalism is a major barrier for behavior change.

Surgical decompression for space-occupying cerebral infarction (the Hemicraniectomy After Middle Cerebral Artery infarction with Life-threatening Edema Trial [HAMLET]): a multicentre, open, randomised trial.

PubMed

Hofmeijer, Jeannette; Kappelle, L Jaap; Algra, Ale; Amelink, G Johan; van Gijn, Jan; van der Worp, H Bart

2009-04-01

Patients with space-occupying hemispheric infarctions have a poor prognosis, with case fatality rates of up to 80%. In a pooled analysis of randomised trials, surgical decompression within 48 h of stroke onset reduced case fatality and improved functional outcome; however, the effect of surgery after longer intervals is unknown. The aim of HAMLET was to assess the effect of decompressive surgery within 4 days of the onset of symptoms in patients with space-occupying hemispheric infarction. Patients with space-occupying hemispheric infarction were randomly assigned within 4 days of stroke onset to surgical decompression or best medical treatment. The primary outcome measure was the modified Rankin scale (mRS) score at 1 year, which was dichotomised between good (0-3) and poor (4-6) outcome. Other outcome measures were the dichotomy of mRS score between 4 and 5, case fatality, quality of life, and symptoms of depression. Analysis was by intention to treat. This trial is registered, ISRCTN94237756. Between November, 2002, and October, 2007, 64 patients were included; 32 were randomly assigned to surgical decompression and 32 to best medical treatment. Surgical decompression had no effect on the primary outcome measure (absolute risk reduction [ARR] 0%, 95% CI -21 to 21) but did reduce case fatality (ARR 38%, 15 to 60). In a meta-analysis of patients in DECIMAL (DEcompressive Craniectomy In MALignant middle cerebral artery infarction), DESTINY (DEcompressive Surgery for the Treatment of malignant INfarction of the middle cerebral arterY), and HAMLET who were randomised within 48 h of stroke onset, surgical decompression reduced poor outcome (ARR 16%, -0.1 to 33) and case fatality (ARR 50%, 34 to 66). Surgical decompression reduces case fatality and poor outcome in patients with space-occupying infarctions who are treated within 48 h of stroke onset. There is no evidence that this operation improves functional outcome when it is delayed for up to 96 h after stroke onset. The decision to perform the operation should depend on the emphasis patients and relatives attribute to survival and dependency.

Are women getting relevant information about mammography screening for an informed consent: a critical appraisal of information brochures used for screening invitation in Germany, Italy, Spain and France.

PubMed

Gummersbach, Elisabeth; Piccoliori, Giuliano; Zerbe, Cristina Oriol; Altiner, Attila; Othman, Cecile; Rose, Christine; Abholz, Heinz-Harald

2010-08-01

The aim was to find out if information brochures on mammography screening in Germany, Italy, Spain and France contain more information to facilitate informed consent than in similar studies carried out over the last few years in Sweden, Canada, USA and the UK, countries with different medical cultures. We generated a list of essential information items on mammography screening for the purpose of informed consent. We mostly used the same items of information as had been used in previous studies and analysed the information brochures of major national initiatives in Germany and France, and three brochures each from regionalized programmes in Italy and Spain. We cross-checked which of our items were covered in the brochures and if correct numbers were given. We found that the information brochures contained only about half of the information items we defined. Six of the eight brochures mentioned the reduction in breast-cancer fatalities. Four of the eight provided information on false positives, and four of the brochures highlighted the side-effects of radiation. The information on side-effects and risks provided by the brochures was generally of poor quality, and none of them referred to over diagnosis. When numbers were given, they were only indicated in terms of relative numbers. The information brochures currently being used in Germany, Italy, Spain and France are no better than the brochures analysed some years ago. Our results suggest that the providers of mammography screening programmes continue to conceal information from women that is essential when making an informed decision.

Fatal fulminant hepatitis associated with Ganoderma lucidum (Lingzhi) mushroom powder.

PubMed

Wanmuang, Harirak; Leopairut, Juvady; Kositchaiwat, Chomsri; Wananukul, Winai; Bunyaratvej, Sukhum

2007-01-01

Hepatotoxic effect related to Ganoderma lucidum (Lingzhi) mushroom powder was first described in a patient from Hong Kong in 2004. In 2005, the authors experienced a case of fatal fulminant hepatitis associated with such a preparation. Both patients had taken other therapeutic agents and traditionally boiled Lingzhi without any toxic effect. After switching to taking Lingzhi in powder form for 1-2 months, the hepatotoxic episode occurred in both patients. The toxic role of Lingzhi powder needs close monitoring in the future, especially in combination with other drugs.

Worker safety and injury severity analysis of earthmoving equipment accidents.

PubMed

Kazan, Emrah; Usmen, Mumtaz A

2018-06-01

Research on construction worker safety associated with construction equipment has mostly focused on accident type rather than injury severity and the embedded factor relationships. Significant variables and their effects on the degree of injury are examined for earthmoving equipment using data from OSHA. Four types of equipment, backhoe, bulldozer, excavator, and scraper are included in the study. Accidents involving on-foot workers and equipment operators are investigated collectively, as well as separately. Cross tabulation analysis was conducted to establish the associations between selected categorical variables, using degree of injury as a dichotomous dependent variable (fatal vs. nonfatal) and a number of independent variables having different values. Odds ratios were calculated to determine how much a certain variable/factor increases the odds of fatality in an accident, and the odds ratios were ranked to determine the relative impact of a given factor. It was found that twelve variables were significantly associated with injury severity. Rankings based on odds ratios showed that inadequate safety training (2.54), missing equipment protective system (2.38), being a non-union worker (2.26), being an equipment operator (1.93), and being on or around inadequately maintained equipment (1.58) produced higher odds for fatality. A majority of the earthmoving equipment accidents resulted in fatality. Backhoes were the most common equipment involved in accidents and fatalities. Struck-by accidents were the most prevalent and most fatal. Non-OSHA compliant safety training, missing seatbelt, operator not using seatbelt, malfunctioning back-up alarms, and poorly maintained equipment were factors contributing to accidents and fatalities. On-foot workers experienced a higher number of accidents than operators, while fatality odds were higher for the operators. Practical applications: Safety professionals should benefit from our findings in planning and delivering training and providing oversight to workers in earthmoving equipment operations. Copyright © 2018 National Safety Council and Elsevier Ltd. All rights reserved.

Spatial Analysis of Earthquake Fatalities in the Middle East, 1970-2008: First Results

NASA Astrophysics Data System (ADS)

Khaleghy Rad, M.; Evans, S. G.; Brenning, A.

2010-12-01

Earthquakes claim the lives of thousands of people each year and the annual number of earthquake fatalities in the Middle East (21 countries) is 20 % of the total yearly fatalities of the World. There have been several attempts to estimate the number of fatalities in a given earthquake. We review the results of previous attempts and present an estimation of fatalities using a new conceptual model for life loss that includes hazard (earthquake magnitude and focal depth), vulnerability (GDP value of countries and elapsed time since 1970 as proxy variables) and exposed population in the affected area of a given earthquake. PAGER_CAT is a global catalog (http://earthquake.usgs.gov/research/data/pager/) that presents information on casualties of earthquakes since 1900. Although, the catalog itself is almost a complete record of fatal earthquakes, the data on number of deaths is not complete. We use PAGER_CAT to assemble a Middle East (the latitude and longitude of 10°-42° N and 24°-64° E respectively) catalog for the period 1970-2008 that includes 202 events with published number of fatalities, including events with zero casualties. We investigated the effect of components of each event, e.g. exposed population, instrumental earthquake magnitude, focal depth, date (year of event) and GDP on earthquake fatalities in Middle East in the 202 events with detailed fatality estimates. To estimate the number of people exposed to each event, we used a fatality threshold for peak ground acceleration of 0.1g to calculate the radius of affected area. The exposed population of each event is the enclosed population of each circle calculated from gridded population data available on SEDAC (http://sedac.ciesin.columbia.edu/gpw/global.jsp) using ArcGIS. Results of our statistical model, using Poisson regression in R statistical software, show that the number of fatalities due to earthquakes is in direct (positive) relation to the exposed population and the magnitude of the earthquake at the epicenter. On the other hand, it is in inverse (negative) relation to elapsed time since 1970, focal depth and GDP of the country affected. These spatial and temporal patterns of life loss are consistent with the patterns expected within our conceptual framework in relationship with hazard, exposed population and proxies of vulnerability. Our findings suggest that for earthquakes with comparable physical characteristics, the number of fatalities has been falling since 1970 in the Middle East region. We interpret this as an overall reduction of vulnerability of the Middle East during 1970-2008. Ongoing research is focusing on more detailed analysis of particular indicators of vulnerability reduction such as the development of earthquake building codes and preparedness, and on the spatial disaggregation of exposed population and the attenuation of earthquake magnitude.

Active transportation: do current traffic safety policies protect non-motorists?

PubMed

Mader, Emily M; Zick, Cathleen D

2014-06-01

This study investigated the impact that state traffic safety regulations have on non-motorist fatality rates. Data obtained from the National Highway Traffic Safety Administration (NHTSA), the Federal Highway Administration (FHWA), and the National Institute on Alcohol Abuse and Alcoholism (NIAAA) were analyzed through a pooled time series cross-sectional model using fixed effects regression for all 50 states from 1999 to 2009. Two dependent variables were used in separate models measuring annual state non-motorist fatalities per million population, and the natural log of state non-motorist fatalities. Independent variables measuring traffic policies included state expenditures for highway law enforcement and safety per capita; driver cell phone use regulations; graduated driver license regulations; driver blood alcohol concentration regulations; bike helmet regulations; and seat belt regulations. Other control variables included percent of all vehicle miles driven that are urban and mean per capita alcohol consumption per year. Non-motorist traffic safety was positively impacted by state highway law enforcement and safety expenditures per capita, with a decrease in non-motorist fatalities occurring with increased spending. Per capita consumption of alcohol also influenced non-motorist fatalities, with higher non-motorist fatalities occurring with higher per capita consumption of alcohol. Other traffic safety covariates did not appear to have a significant impact on non-motorist fatality rates in the models. Our research suggests that increased expenditures on state highway and traffic safety and the initiation/expansion of programs targeted at curbing both driver and non-motorist intoxication are a starting point for the implementation of traffic safety policies that reduce risks for non-motorists. Copyright © 2014 Elsevier Ltd. All rights reserved.

Prescription of Zolpidem and the Risk of Fatal Motor Vehicle Collisions: A Population-Based, Case-Crossover Study from South Korea.

PubMed

Yang, Bo Ram; Kim, Ye-Jee; Kim, Mi-Sook; Jung, Sun-Young; Choi, Nam-Kyong; Hwang, Byungkwan; Park, Byung-Joo; Lee, Joongyub

2018-05-23

Zolpidem is one of the most frequently used hypnotics worldwide, but associations with serious adverse effects such as motor vehicle collisions have been reported. The objective of this study was to evaluate the association of fatal motor vehicle collisions with a prescription for zolpidem, considering the context of the motor vehicle collisions. We conducted a case-crossover study, where each case served as its own control, by linking data about fatal motor vehicle collisions from the Korean Road Traffic Authority between 2010 and 2014 with national health insurance data. The case period was defined as 1 day before the fatal motor vehicle collisions, and was matched to four control periods at 90-day intervals. Conditional logistic regression was performed to calculate the odds ratio for fatal motor vehicle collisions associated with zolpidem exposure, and odds ratios were adjusted for time-varying exposure to confounding medications. A stratified analysis was performed by age group (younger than 65 years or not), the Charlson Comorbidity Index, and whether patients were new zolpidem users. Among the 714 subjects, the adjusted odds ratio for a fatal motor vehicle collision associated with a prescription for zolpidem the previous day was 1.48 (95% confidence interval 1.06-2.07). After stratification, a significantly increased risk was observed in subjects with a high Charlson Comorbidity Index (odds ratio 1.81; 95% confidence interval 1.16-2.84), the younger age group (odds ratio: 1.62; 95% confidence interval 1.03-2.56), and new zolpidem users (odds ratio 2.37; 95% confidence interval 1.40-4.00). A prescription for zolpidem on the previous day was significantly related to an increased risk of fatal motor vehicle collisions in this population-based case-crossover study.

Occupational injuries in Italy: risk factors and long term trend (1951-98)

PubMed Central

Fabiano, B; Curro, F; Pastorino, R

2001-01-01

OBJECTIVES—Trends in the rates of total injuries and fatal accidents in the different sectors of Italian industries were explored during the period 1951-98. Causes and dynamics of injury were also studied for setting priorities for improving safety standards.
METHODS—Data on occupational injuries from the National Organisation for Labour Injury Insurance were combined with data from the State Statistics Institute to highlight the interaction between the injury frequency index trend and the production cycle—that is, the evolution of industrial production throughout the years. Multiple regression with log transformed rates was adopted to model the trends of occupational fatalities for each industrial group.
RESULTS—The ratios between the linked indices of injury frequency and industrial production showed a good correlation over the whole period. A general decline in injuries was found across all sectors, with values ranging from 79.86% in the energy group to 23.32% in the textile group. In analysing fatalities, the trend seemed to be more clearly decreasing than the trend of total injuries, including temporary and permanent disabilities; the fatalities showed an exponential decrease according to multiple regression, with an annual decline equal to 4.42%.
CONCLUSIONS—The overall probability of industrial fatal accidents in Italy tended to decrease exponentially by year. The most effective actions in preventing injuries were directed towards fatal accidents. By analysing the rates of fatal accident in the different sectors, appropriate targets and priorities for increased strategies to prevent injuries can be suggested. The analysis of the dynamics and the material causes of injuries showed that still more consideration should be given to human and organisational factors.


Keywords: labour injuries; severity; regression model PMID:11303083

Fatalism, optimism, spirituality, depressive symptoms and stroke outcome: A population-based analysis

PubMed Central

Morgenstern, Lewis B.; Sánchez, Brisa N.; Skolarus, Lesli E.; Garcia, Nelda; Risser, Jan M.H.; Wing, Jeffrey J.; Smith, Melinda A.; Zahuranec, Darin B.; Lisabeth, Lynda D.

2011-01-01

Background and Purpose We sought to describe the association of spirituality, optimism, fatalism and depressive symptoms with initial stroke severity, stroke recurrence and post-stroke mortality. Methods Stroke cases June 2004–December 2008 were ascertained in Nueces County, Texas. Patients without aphasia were queried on their recall of depressive symptoms, fatalism, optimism, and non-organizational spirituality before stroke using validated scales. The association between scales and stroke outcomes was studied using multiple linear regression with log-transformed NIHSS and Cox proportional hazards regression for recurrence and mortality. Results 669 patients participated, 48.7% were women. In fully adjusted models, an increase in fatalism from the first to third quartile was associated with all-cause mortality (HR=1.41, 95%CI: 1.06, 1.88), marginally associated with risk of recurrence (HR=1.35, 95%CI: 0.97, 1.88), but not stroke severity. Similarly, an increase in depressive symptoms was associated with increased mortality (HR=1.32, 95%CI: 1.02, 1.72), marginally associated with stroke recurrence (HR=1.22, CI: 0.93, 1.62), and with a 9.0% increase in stroke severity (95%CI: 0.01, 18.0). Depressive symptoms altered the fatalism-mortality association such that the association of fatalism and mortality was more pronounced for patients reporting no depressive symptoms. Neither spirituality nor optimism conferred a significant effect on stroke severity, recurrence or mortality. Conclusions Among patients who have already had a stroke, self-described pre-stroke depressive symptoms and fatalism, but not optimism or spirituality, are associated with increased risk of stroke recurrence and mortality. Unconventional risk factors may explain some of the variability in stroke outcomes observed in populations, and may be novel targets for intervention. PMID:21940963

Revisiting the Role of the Urban Environment in Substance Use: The Case of Analgesic Overdose Fatalities

PubMed Central

Ransome, Yusuf; Keyes, Katherine M.; Koenen, Karestan C.; Tardiff, Kenneth; Vlahov, David; Galea, Sandro

2013-01-01

Objectives. We examined whether neighborhood social characteristics (income distribution and family fragmentation) and physical characteristics (clean sidewalks and dilapidated housing) were associated with the risk of fatalities caused by analgesic overdose. Methods. In a case-control study, we compared 447 unintentional analgesic opioid overdose fatalities (cases) with 3436 unintentional nonoverdose fatalities and 2530 heroin overdose fatalities (controls) occurring in 59 New York City neighborhoods between 2000 and 2006. Results. Analgesic overdose fatalities were less likely than nonoverdose unintentional fatalities to have occurred in higher-income neighborhoods (odds ratio [OR] = 0.82; 95% confidence interval [CI] = 0.70, 0.96) and more likely to have occurred in fragmented neighborhoods (OR = 1.35; 95% CI = 1.05, 1.72). They were more likely than heroin overdose fatalities to have occurred in higher-income (OR = 1.31; 95% CI = 1.12, 1.54) and less fragmented (OR = 0.71; 95% CI = 0.55, 0.92) neighborhoods. Conclusions. Analgesic overdose fatalities exhibit spatial patterns that are distinct from those of heroin and nonoverdose unintentional fatalities. Whereas analgesic fatalities typically occur in lower-income, more fragmented neighborhoods than nonoverdose fatalities, they tend to occur in higher-income, less unequal, and less fragmented neighborhoods than heroin fatalities. PMID:24134362

Microstructural tissue-engineering in the rachis and barbs of bird feathers

PubMed Central

Lingham-Soliar, Theagarten

2017-01-01

Feathers do not have to be especially strong but they do need to be stiff and at the same time resilient and to have a high work of fracture. Syncitial barbule fibres are the highest size-class of continuous filaments in the cortex of the rachis of the feather. However, the rachis can be treated as a generalized cone of rapidly diminishing volume. This means that hundreds of syncitial barbule fibres of the rachis may have to be terminated before reaching the tip – creating potentially thousands of inherently fatal crack-like defects. Here I report a new microstructural architecture of the feather cortex in which most syncitial barbule fibres deviate to the right and left edges of the feather rachis from far within its borders and extend into the barbs, side branches of the rachis, as continuous filaments. This novel morphology adds significantly to knowledge of β-keratin self-assembly in the feather and helps solve the potential problem of fatal crack-like defects in the rachidial cortex. Furthermore, this new complexity, consistent with biology’s robust multi-functionality, solves two biomechanical problems at a stroke. Feather barbs deeply ‘rooted’ within the rachis are also able to better withstand the aerodynamic forces to which they are subjected. PMID:28345593

Reasons underlying behaviour of motorcyclists disregarding traffic regulations in urban areas of Indonesia.

PubMed

Susilo, Yusak O; Joewono, Tri Basuki; Vandebona, Upali

2015-02-01

Over the last decade, motorcycle use has been rapidly increasing in Indonesia as have violations of traffic rules committed by motorcyclists. This study aims to explore the impacts of motorcyclists' attitudes, habits, preferences, and travel patterns on their behaviour in disregarding traffic regulations in three cities in Indonesia. The theory of planned behaviour and structural equation modelling are employed to explore these relationships. Consistent with results from previous studies in developed countries, an individual's beliefs and attitudes, social norms and perceived behaviour control significantly influence behaviour in disregarding traffic rules. Young adults and students are found to be more likely to frequently violate traffic regulations. However, unlike previous findings from developed countries, in Indonesia, males are less likely to disregard traffic rules than females. Overall, pushing the motorcycle through a (very) narrow gap, speeding, driving recklessly, and overtaking on the wrong side are the most frequent traffic violations that make up repetitive violation behaviour among urban motorcyclists in Indonesia. The results highlight the need to revisit Indonesian National Traffic Law traffic violation classification and penalties and separate violations that are likely to cause fatal results, thus requiring tougher law enforcement, from violations that are unlikely to have fatal consequences. Copyright © 2014 Elsevier Ltd. All rights reserved.

Review of Regulatory Emphasis on Transportation Safety in the United States, 2002-2009: Public versus Private Modes.

PubMed

Waycaster, Garrett C; Matsumura, Taiki; Bilotkach, Volodymyr; Haftka, Raphael T; Kim, Nam H

2018-05-01

The U.S. Department of Transportation is responsible for implementing new safety improvements and regulations with the goal of ensuring limited funds are distributed to where they can have the greatest impact on safety. In this work, we conduct a study of new regulations and other reactions (such as recalls) to fatal accidents in several different modes of transportation implemented from 2002 to 2009. We find that in the safest modes of commercial aviation and bus transport, the amount of spending on new regulations is high in relation to the number of fatalities compared to the regulatory attention received by less safe modes of general aviation and private automobiles. Additionally, we study two major fatal accident investigations from commercial aviation and two major automotive recalls associated with fatal accidents. We find differences in the cost per expected fatality prevented for these reactions, with the airline accident investigations being more cost effective. Overall, we observe trends in both the automotive and aviation sectors that suggest that public transportation receives more regulatory attention than private transport. We also observe that the types of safety remedies utilized, regulation versus investigation, have varying levels of effectiveness in different transport modes. We suggest that these differences are indicative of increased public demand for safety in modes where a third party may be held responsible, even for those not participating in the transportation. These findings have important implications for the transportation industry, policymakers, and for estimating the public demand for safety in new transport modes. © 2017 Society for Risk Analysis.

The effect of intensive glucose control on all-cause and cardiovascular mortality, myocardial infarction and stroke in persons with type 2 diabetes mellitus: a systematic review and meta-analysis.

PubMed

Marso, Steven P; Kennedy, Kevin F; House, John A; McGuire, Darren K

2010-04-01

We performed a meta-analysis of studies evaluating the effect of intensive glucose control on major adverse cardiovascular events in patients with type 2 diabetes from 1990 to 2009. A search of the published literature and the Cochran Central Register for Controlled Trials was performed using pre-specified inclusion criteria consisting of randomised controlled trials evaluating intensive glycaemic control and reporting the individual endpoints of all-cause mortality, non-fatal myocardial infarction, and non-fatal stroke. Incident rate ratios for these endpoints were calculated using standard meta-analytic techniques of pooled data from eligible trials. Six reports from four randomised trials including 27,544 patients met the pre-specified inclusion criteria. Mean follow-up was 5.4 years; haemoglobin A(1C) at study end was 6.6% vs. 7.4% in patients randomised to intensive compared with conventional glucose control. Intensive glucose control did not affect the incident rate ratio for all-cause mortality (1.01, 95% confidence interval 0.86-1.18, p=0.54) or stroke (1.02, 95% confidence interval 0.88-1.20, p=0.62). However, there was a statistically significant 14% reduction in non-fatal myocardial infarction in patients randomised to intensive glucose control (0.86, 95% confidence interval 0.77-0.97, p=0.015). Although intensification of glucose control did not affect mortality or non-fatal stroke, the risk for non-fatal myocardial infarction was significantly reduced in patients with type 2 diabetes.

Prominent barriers and motivators to installing ROPS: an analysis of survey responses from Pennsylvania and Vermont.

PubMed

Jenkins, P L; Sorensen, J A; Yoder, A; Myers, M; Murphy, D; Cook, G; Wright, F; Bayes, B; May, J J

2012-04-01

Tractor overturns contribute significantly to the number of work-related deaths that occur every year on U.S. farms. Although the agriculture, forestry, and fishing industries have the highest fatality rates of any industries, researchers predict that the elimination of tractor overturn fatalities could result in a noticeable reduction in the farm fatality rate. Rollover protection structures (ROPS) are 99% effective in preventing overturn fatalities. However, roughly 50% of U.S. tractors do not have a ROPS. In order to identify prominent barriers and motivators to installing ROPS, a phone survey was conducted with a random sample of farmers (n = 327) in Vermont and Pennsylvania, two states interested in developing ROPS installation programs. Results indicated that cost and perceived need were the most frequently highly rated barriers to ROPS installation in both states, while working near hills or ditches and concerns regarding liability were the most frequently highly rated motivators for installing ROPS. Additionally, older farmers identified limited use of a tractor as a highly rated barrier.

Traffic related deaths in Nuevo Leon, Mexico: causes and associated factors.

PubMed

Arreola-Rissa, Carlos; Santos-Guzmán, Jesús; Esquivel-Guzmán, Adol; Mock, Charles N

2008-01-01

The effects of alcohol on mortality due to motor vehicle accidents was studied. During the first semester of 2003, a sample of 243 fatality victims of traffic-related accidents and their blood alcohol levels were analyzed in the state of Nuevo Leon, Mexico. The age-adjusted mortality rate for traffic accidents was 8.9/100000 pop. (13.2 for males and 3.21 for females, per 100000). Fatal accidents were more common in the Metropolitan Area (MA). Fatalities were four times greater in males and the mean age was 34.7+/-18.2 years. Blood alcohol was detected in almost half of the victims who were drivers of the vehicles; the other cases of fatalities may be associated with road/car condition, weather and other factors. Alcohol intoxication levels were primarily associated with male drivers ages 16 to 45 (p=0.029); levels increased with age. In females, alcohol played a lesser role, affecting mostly ages 31 to 45 y (p=0.055).

Analysis of the Cochrane Review: Fibrates for secondary prevention of cardiovascular disease and stroke.

PubMed

Pires da Rosa, Gilberto; Libânio, Diogo; Filipe Azevedo, Luís

2017-01-01

The influence of fibrates on cardiovascular risk has been the focus of several clinical trials. This Cochrane Collaboration Systematic Review evaluated the efficacy of fibrates for secondary prevention of cardiovascular events and stroke, analyzing 13 randomized controlled trials, in a total of 16 112 participants with a history of cardiovascular disease. Fibrates showed a protective effect for the composite outcome of non-fatal stroke, non-fatal myocardial infarction (MI) and vascular death, mainly due to reduction in the risk of non-fatal or fatal MI. Nonetheless, these results largely relied on studies including clofibrate, a drug withdrawn from the market in 2002. No statistically significant differences regarding adverse events were found between fibrates and placebo. Although insufficient to support the routine prescription of fibrates in this setting, this evidence should be taken into account when deciding on lipid-modifying therapy in dyslipidemic patients with a history of cardiovascular disease. Copyright © 2016 Sociedade Portuguesa de Cardiologia. Publicado por Elsevier España, S.L.U. All rights reserved.

Serious Injury and Fatality Investigations Involving Pneumatic Nail Guns, 1985-2012

PubMed Central

Lowe, Brian D.; Albers, James T.; Hudock, Stephen D.; Krieg, Edward F.

2016-01-01

Background This paper examines serious and fatal pneumatic nail gun (PNG) injury investigations for workplace, tool design, and human factors relevant to causation and resulting OS&H authorities’ responses in terms of citations and penalties. Methods The U.S. OSHA database of Fatality and Catastrophe Investigation Summaries (F&CIS) were reviewed (1985 - 2012) to identify n=258 PNG accidents. Results 79.8% of investigations, and 100% of fatalities, occurred in the Construction industry. Between 53-71% of injuries appear preventable had a safer sequential trigger tool been used. Citations and monetary penalties were related to injury severity, body part injured, disabling of safety devices, and insufficient personal protective equipment (PPE). Conclusions Differences may exist between Construction and other industries in investigators interpretations of PNG injury causation and resulting citations/penalties. Violations of PPE standards were penalized most severely, yet the preventive effect of PPE would likely have been less than that of a safer sequential trigger. PMID:26725335

Homocysteine levels and treatment effect in the PROspective Study of Pravastatin in the Elderly at Risk.

PubMed

Drewes, Yvonne M; Poortvliet, Rosalinde K E; Blom, Jeanet W; de Ruijter, Wouter; Westendorp, Rudi G J; Stott, David J; Blom, Henk J; Ford, Ian; Sattar, Naveed; Wouter Jukema, J; Assendelft, Willem J J; de Craen, Anton J M; Gussekloo, Jacobijn

2014-02-01

To assess the effect of preventive pravastatin treatment on coronary heart disease (CHD) morbidity and mortality in older persons at risk for cardiovascular disease (CVD), stratified according to plasma levels of homocysteine. A post hoc subanalysis in the PROspective Study of Pravastatin in the Elderly at Risk (PROSPER), started in 1997, which is a double-blind, randomized, placebo-controlled trial with a mean follow-up of 3.2 years. Primary care setting in two of the three PROSPER study sites (Netherlands and Scotland). Individuals (n = 3,522, aged 70-82, 1,765 male) with a history of or risk factors for CVD were ranked in three groups depending on baseline homocysteine level, sex, and study site. Pravastatin (40 mg) versus placebo. Fatal and nonfatal CHD and mortality. In the placebo group, participants with a high homocysteine level (n = 588) had a 1.8 higher risk (95% confidence interval (CI) = 1.2-2.5, P = .001) of fatal and nonfatal CHD than those with a low homocysteine level (n = 597). The absolute risk reduction in fatal and nonfatal CHD with pravastatin treatment was 1.6% (95% CI = -1.6 to 4.7%) in the low homocysteine group and 6.7% (95% CI = 2.7-10.7%) in the high homocysteine group (difference 5.2%, 95% CI = 0.11-10.3, P = .046). Therefore, the number needed to treat (NNT) with pravastatin for 3.2 years for benefit related to fatal and nonfatal CHD events was 14.8 (95% CI = 9.3-36.6) for high homocysteine and 64.5 (95% CI = 21.4-∞) for low homocysteine. In older persons at risk of CVD, those with high homocysteine are at highest risk for fatal and nonfatal CHD. With pravastatin treatment, this group has the highest absolute risk reduction and the lowest NNT to prevent fatal and nonfatal CHD. © 2014, Copyright the Authors. Journal compilation © 2014, The American Geriatrics Society.

Causes and circumstances of damage to people in Calabria (Italy) due to hydrogeological events in the period 1980-2014

NASA Astrophysics Data System (ADS)

Aceto, Luigi; Pasqua, A. Aurora; Petrucci, Olga

2017-04-01

Damaging Hydrogeological Events (DHE) can be defined as rainy periods during which landslides and floods can damage people. We investigates the effects of DHE on people in Calabria (southern Italy) ,in the period 1980-2014, using data coming from the systematic survey of regional daily newspapers. Data about "fatalities", people "injured" and people "involved" (not killed neither hurt) are stored in the database named PEOPLE, made of five sections: 1) event identification, 2) victim identification, 3) type of victim's involvement, 4) victim-event interaction, and 5) effects on victim. The outcomes highlight vulnerability factors related to gender and age: males were killed more frequently (75%) than females (25%), and fatalities were older (average age 49 years) than injured (40.1 years) and involved people (40.5 years). The average age of females killed (67.5 years), injured (43.4 years) and involved (44.6 years) were higher than the same values assessed for males, maybe indicating that younger females tend to be more cautious than coetaneous males, while older females show an intrinsic greater vulnerability. Involved people were younger than injured and fatalities, perhaps because younger people showed greater promptness to react in dangerous situations. In the study region, floods caused more fatalities (67.9%), injured (55%) and involved people (55.3%) than landslides. Fatalities and injured mainly occurred outdoor, especially along roads, and the most dangerous dynamic seems to be dragged by flood, causing the majority of fatalities. The present work is the progression of the described research, and it has been carried out by enlarging the database to a 34-year period, from 1980 to 2014. The aim is to validate the conclusions drawn for the 2000-2014 period and to investigate if and how the gender and age vulnerability factors of Calabrian people have been changing throughout the study period.

MOTOR VEHICLE CRASH FATALATIES AND UNDERCOMPENSATED CARE ASSOCIATED WITH LEGALIZATION OF MARIJUANA.

PubMed

Steinemann, Susan; Galanis, Daniel; Nguyen, Tiffany; Biffl, Walter

2018-05-21

Half of U.S. states have legalized medical cannabis (marijuana), some allow recreational use. The economic and public health effects of these policies are still being evaluated. We hypothesized that cannabis legalization was associated with an increase in the proportion of motor vehicle crash fatalities involving cannabis-positive drivers, and that cannabis use is associated with high-risk behavior and poor insurance status. Hawaii legalized cannabis in 2000. Fatality Analysis Reporting System (FARS) data were analyzed before (1993-2000) and after (2001-2015) legalization. Presence of cannabis (THC), methamphetamine, and alcohol in fatally injured drivers were compared. Data from the state's highest level trauma center were reviewed for THC status from 1997-2013. State Trauma Registry data from 2011-2015 were reviewed to evaluate association between cannabis, helmet/seatbelt use, and payor mix. THC-positivity among driver fatalities increased since legalization, with a three-fold increase from 1993-2000 to 2001-2015. Methamphetamine, which has remained illegal, and alcohol positivity were not significantly different before versus after 2000. THC-positive fatalities were younger, and more likely single-vehicle accidents, nighttime crashes, and speeding. They were less likely to have used a seatbelt or helmet. THC-positivity among all injured patients tested at our highest level trauma center increased from 11% before to 20% after legalization. From 2011-2015, THC-positive patients were significantly less likely to wear a seatbelt or helmet (33% vs 56%). They were twice as likely to have Medicaid insurance (28% vs 14%). Since legalization of cannabis, THC-positivity among MVC fatalities has tripled statewide, and THC-positivity among patients presenting to the highest level trauma center has doubled. THC-positive patients are less likely to use protective devices and more likely to rely on publically funded medical insurance. These findings have implications nationally and underscore the need for further research and policy development to address the public health effects and the costs of cannabis-related trauma. 3, original research, prognostic.

Dead or Alive? Factors Affecting the Survival of Victims during Attacks by Saltwater Crocodiles (Crocodylus porosus) in Australia.

PubMed

Fukuda, Yusuke; Manolis, Charlie; Saalfeld, Keith; Zuur, Alain

2015-01-01

Conflicts between humans and crocodilians are a widespread conservation challenge and the number of crocodile attacks is increasing worldwide. We identified the factors that most effectively decide whether a victim is injured or killed in a crocodile attack by fitting generalized linear models to a 42-year dataset of 87 attacks (27 fatal and 60 non-fatal) by saltwater crocodiles (Crocodylus porosus) in Australia. The models showed that the most influential factors were the difference in body mass between crocodile and victim, and the position of victim in relation to the water at the time of an attack. In-water position (for diving, swimming, and wading) had a higher risk than on-water (boating) or on-land (fishing, and hunting near the water's edge) positions. In the in-water position a 75 kg person would have a relatively high probability of survival (0.81) if attacked by a 300 cm crocodile, but the probability becomes much lower (0.17) with a 400 cm crocodile. If attacked by a crocodile larger than 450 cm, the survival probability would be extremely low (<0.05) regardless of the victim's size. These results indicate that the main cause of death during a crocodile attack is drowning and larger crocodiles can drag a victim more easily into deeper water. A higher risk associated with a larger crocodile in relation to victim's size is highlighted by children's vulnerability to fatal attacks. Since the first recently recorded fatal attack involving a child in 2006, six out of nine fatal attacks (66.7%) involved children, and the average body size of crocodiles responsible for these fatal attacks was considerably smaller (384 cm, 223 kg) than that of crocodiles that killed adults (450 cm, 324 kg) during the same period (2006-2014). These results suggest that culling programs targeting larger crocodiles may not be an effective management option to improve safety for children.

Dead or Alive? Factors Affecting the Survival of Victims during Attacks by Saltwater Crocodiles (Crocodylus porosus) in Australia

PubMed Central

Fukuda, Yusuke

2015-01-01

Conflicts between humans and crocodilians are a widespread conservation challenge and the number of crocodile attacks is increasing worldwide. We identified the factors that most effectively decide whether a victim is injured or killed in a crocodile attack by fitting generalized linear models to a 42-year dataset of 87 attacks (27 fatal and 60 non-fatal) by saltwater crocodiles (Crocodylus porosus) in Australia. The models showed that the most influential factors were the difference in body mass between crocodile and victim, and the position of victim in relation to the water at the time of an attack. In-water position (for diving, swimming, and wading) had a higher risk than on-water (boating) or on-land (fishing, and hunting near the water's edge) positions. In the in-water position a 75 kg person would have a relatively high probability of survival (0.81) if attacked by a 300 cm crocodile, but the probability becomes much lower (0.17) with a 400 cm crocodile. If attacked by a crocodile larger than 450 cm, the survival probability would be extremely low (<0.05) regardless of the victim’s size. These results indicate that the main cause of death during a crocodile attack is drowning and larger crocodiles can drag a victim more easily into deeper water. A higher risk associated with a larger crocodile in relation to victim’s size is highlighted by children’s vulnerability to fatal attacks. Since the first recently recorded fatal attack involving a child in 2006, six out of nine fatal attacks (66.7%) involved children, and the average body size of crocodiles responsible for these fatal attacks was considerably smaller (384 cm, 223 kg) than that of crocodiles that killed adults (450 cm, 324 kg) during the same period (2006–2014). These results suggest that culling programs targeting larger crocodiles may not be an effective management option to improve safety for children. PMID:25961294

Jump Horse Safety: Reconciling Public Debate and Australian Thoroughbred Jump Racing Data, 2012-2014.

PubMed

Ruse, Karen; Davison, Aidan; Bridle, Kerry

2015-10-22

Thoroughbred jump racing sits in the spotlight of contemporary welfare and ethical debates about horse racing. In Australia, jump racing comprises hurdle and steeplechase races and has ceased in all but two states, Victoria and South Australia. This paper documents the size, geography, composition, and dynamics of Australian jump racing for the 2012, 2013, and 2014 seasons with a focus on debate about risks to horses. We found that the majority of Australian jump racing is regional, based in Victoria, and involves a small group of experienced trainers and jockeys. Australian jump horses are on average 6.4 years of age. The jump career of the majority of horses involves participating in three or less hurdle races and over one season. Almost one quarter of Australian jump horses race only once. There were ten horse fatalities in races over the study period, with an overall fatality rate of 5.1 fatalities per 1000 horses starting in a jump race (0.51%). There was significant disparity between the fatality rate for hurdles, 0.75 fatalities per 1000 starts (0.075%) and steeplechases, 14 fatalities per 1000 starts (1.4%). Safety initiatives introduced by regulators in 2010 appear to have significantly decreased risks to horses in hurdles but have had little or no effect in steeplechases. Our discussion considers these Animals 2015, 5 1073 data in light of public controversy, political debate, and industry regulation related to jump horse safety.

Indiana crash facts 1999

DOT National Transportation Integrated Search

1997-01-01

The 892 fatal crashes in 1999 resulted in 1,021 fatalities. : This equates to a fatality each and every 8 hours : during 1999. The number of fatalities and fatal crashes : represented one of the worst years in the past decade for : Indiana. The 72,...

Why are doctors still prescribing neuroleptics?

PubMed

Charlton, B G

2006-06-01

There are two main pharmacological methods of suppressing undesired behaviour: sedation or neuroleptics. Traditionally, the invention of neuroleptics has been hailed as one of the major clinical breakthroughs of the twentieth century, since they calmed agitation without (necessarily) causing sedation. The specifically neuroleptic form of behavioural control is achieved by making patients psychologically Parkinsonian, which entails emotional blunting and consequent demotivation. Furthermore, chronic neuroleptic usage creates dependence, so that in the long term, neuroleptics are doing most patients more harm than good. The introduction of 'atypical' neuroleptics (neuroleptically-weak but strongly sedative neuroleptics) has made only a difference in degree, and at the cost of a wide range of potentially fatal metabolic and other side-effects. For half a century, the creation of millions of Parkinsonian patients may have been misinterpreted as a 'cure' for schizophrenia. Such a wholesale re-interpretation of neuroleptic therapy represents an unprecedented disaster for the self-image and public reputation of both psychiatry and the whole medical profession. Nonetheless, except as a last resort, neuroleptics should swiftly be replaced by gentler and safer sedatives.

[Practical Use of Doppler Ultrasonography of the Cardiovascular System and Clinical Laboratory Tests for the Management of Pulmonary Embolism].

PubMed

Mizukami, Naoko

2015-08-01

Acute or chronic pulmonary embolism (PE) is a serious disease, and the risk of mortality is increased if untreated. In 90% of cases the embolus source is deep vein thrombosis (DVT) of the lower limbs or pelvic cavity. Therefore, it is necessary to recognize these as venous thromboembolism (VTE) which includes both DVT and PE. I suggest that Doppler ultrasonography of cardiovascular and clinical laboratory tests provide very valuable medical support for the management of VTE. Specifically, in the early diagnosis of VTE and the prevention of fatal PE, Doppler ultrasonography (cardiac and vascular) can provide very useful information. On the other hand, blood coagulation and thrombophilia tests are important to determine the risk of VTE and evaluate the effect of anticoagulant therapy on VTE. In this paper, I explain the main points of each examination of VTE by describing representative cases. I also show the results on investigating cases in our hospital involving diseases related to VTE and the onset site of DVT. In addition, I introduce how we convey the results of analysis to the clinical side.

Fatal serotonin toxicity caused by moclobemide and fluoxetine overdose.

PubMed

Wu, Ming-Ling; Deng, Jou-Fang

2011-01-01

Both moclobemide and fluoxetine are used in the treatment of depression, and have been shown to produce fewer side effects than conventional tricyclic antidepressants. A combination of moclobemide and fluoxetine has been used in refractory depression, however there is potential for severe serotonin toxicity. We describe a lethal case of serotonin toxicity in a 36 year-old woman after she ingested multiple drugs, including moclobemide 4500 mg, fluoxetine 200 mg, propranolol 300 mg and several benzodiazepines. The clinical features included coma, mydriasis, hyperthermia, tremor, hyperreflexia, rhabdomyolysis, renal failure and respiratory insufficiency. Eventually, the patient died of disseminated intravascular coagulation and circulatory collapse at 22.5 h postingestion. Toxicological analysis of the patient's blood confirmed high levels of moclobemide 150 μg/mL (therapeutic 1-3 μg/mL), fluoxetine 3750 ng/mL (therapeutic 47-469 ng/mL) and several benzodiazepines. In conclusion, a combination of moclobemide and fluoxetine should be avoided in depressed patients with high suicidal tendencies. Moreover, early recognition and aggressive intervention are the mainstays in the management of potentially life-threatening serotonin toxicity.

Repeated daclizumab administration to delay the introduction of calcineurin inhibitors in heart transplant patients with postoperative renal dysfunction.

PubMed

Sánchez Lázaro, Ignacio J; Almenar Bonet, Luis; Martínez Dolz, Luis; Buendía Fuentes, Francisco; Navarro Manchón, Josep; Agüero Ramón-Llin, Jaime; Vicente Sánchez, José Luis; Salvador Sanz, Antonio

2011-03-01

Daclizumab is an interleukin-2 receptor antagonist which is used for induction therapy in heart transplant patients. It has few side effects and is associated with a low infection rate. Postoperative renal failure after heart transplantation is common and potentially fatal. The administration of calcineurin inhibitors in the postoperative period can aggravate the situation. We report the cases of six patients who underwent heart transplantation and developed acute renal failure in the immediate postoperative period. All were administered daclizumab weekly to avoid the introduction of calcineurin inhibitors and to facilitate recovery of renal function. Calcineurin inhibitors were introduced only once renal function had improved. Renal function recovered in all cases and there was a low complication rate. The administration of repeated doses of daclizumab to patients who experience acute postoperative renal failure after heart transplantation may provide an alternative therapeutic approach that enables calcineurin inhibitors to be avoided and, consequently, renal function to recover. Copyright © 2010 Sociedad Española de Cardiología. Published by Elsevier Espana. All rights reserved.

Solar-blind-ultraviolet extraordinary transmission for ultrasensitive photoconductive detector based on plasmonic subwavelength interdigital electrodes

NASA Astrophysics Data System (ADS)

Peng, Nan; Huang, Feng; Chu, Sheng; Chen, Hao

2016-12-01

The solar-blind-ultraviolet (SBUV) detection industry demands high sensitivity as well as easy processability for its semiconductor devices. Photoconductive detectors have the simplest structure. However, the electrodes covering the illuminated side cause optical shielding losses, resulting in a relatively low sensitivity of such devices. Through finite-difference time-domain (FDTD) simulation, we demonstrated that surface-plasmon-based enhanced SBUV transmission is achievable for Al interdigital electrodes (IDEs) with a period  ⩽200 nm and an interval  ⩾140 nm. Under this parameter setting, a larger interval and smaller period leads to further enhancement of SBUV transmission. Particularly, we have found that different possible dielectric environments, such as Ni insertion, Al oxidization, and MgF2 anti-oxidation, would not exert fatal effects on this enhancement. Besides, such an enhancement is maintained under the angle of incidence within 10°, which is large enough for practical SBUV detection. Our research reveals the feasibility of high sensitivity by a simple photoconductive device, showing profound significance for an applicable SBUV detector.

Effects of a provincial ban of two toxic organophosphorus insecticides on pesticide poisoning hospital admissions.

PubMed

Eddleston, Michael; Adhikari, Sriyantha; Egodage, Samitha; Ranganath, Hasantha; Mohamed, Fahim; Manuweera, Gamini; Azher, Shifa; Jayamanne, Shaluka; Juzczak, Edmund; Sheriff, Mh Rezvi; Dawson, Andrew H; Buckley, Nick A

2012-03-01

Pesticide self-poisoning causes one third of global suicides. Sri Lanka halved its suicide rate by banning WHO Class I organophosphorus (OP) insecticides and then endosulfan. However, poisoning with Class II toxicity OPs, particularly dimethoate and fenthion, remains a problem. We aimed to determine the effect and feasibility of a ban of the two insecticides in one Sri Lankan district. Sale was banned in June 2003 in most of Polonnaruwa District, but not Anuradhapura District. Admissions with pesticide poisoning to the district general hospitals was prospectively recorded from 2002. Hospital admissions for dimethoate and fenthion poisoning fell by 43% after the ban in Polonnaruwa, while increasing by 23% in Anuradhapura. The pesticide case fatality fell from 14.4% to 9.0% in Polonnaruwa (odds ratio [OR] 0.59, 95% confidence interval [CI] 0.41-0.84) and 11.3% to 10.6% in Anuradhapura (OR 0.93, 95%CI 0.70-1.25; p = 0.051). This reduction was not sustained, with case fatality in Polonnaruwa rising to 12.1% in 2006-2007. Further data analysis indicated that the fall in case fatality had actually been due to a coincidental reduction in case fatality for pesticide poisoning overall, in particular for paraquat poisoning. We found that the insecticides could be effectively banned from agricultural practice, as shown by the fall in hospital admissions, with few negative consequences. However, the ban had only a minor effect on pesticide poisoning deaths because it was too narrow. A study assessing the agricultural and health effects of a more comprehensive ban of highly toxic pesticides is necessary to determine the balance between increased costs of agriculture and reduced health care costs and fewer deaths.

Responsibility Study: Main Illicit Psychoactive Substances Among Car Drivers Involved in Fatal Road Crashes

PubMed Central

Gadegbeku, Blandine; Amoros, Emmanuelle; Laumon, Bernard

2011-01-01

In 1999, in France, before considering modifications in drug legislation, the government requested a study of the effect of illicit drugs on the risk of road crashes. It implemented a systematic screening of illicit drugs for all drivers involved in fatal crashes between October 2001 and September 2003. Within the European DRUID project, the study was restricted to car drivers. The project reported here is a responsibility analysis and, as such, it belongs to the framework of case-control studies; the outcome of interest is “being responsible for a fatal crash”. It was assessed with a method adapted from Robertson and Drummer. Cases are the 4,946 car drivers who are responsible for the crash; controls are the 1,986 car drivers selected from the non-responsible car drivers, in a way that makes the control group similar to the general driving population. The effect of cannabis on fatal crash responsibility is significant after adjustment for age, sex and alcohol: adjusted odds ratio is 1.89 [1.43–2.51]. The dose-response effect is significant (p=0.0001). For alcohol (≥0.1 g/l), the adjusted odds ratio for responsibility is 8.39 [6.95–10.11]. No interaction was found between alcohol and cannabis. For amphetamine, cocaine and opiates, adjusted odds ratios were not significantly different from 1. However the statistical power is low. The study finds similar odds ratios for alcohol as previously published. For cannabis, the significant odds ratio together with the significant dose-response effect indicates a causal relationship between cannabis and road crashes. A multiplicative effect between cannabis and alcohol was noted. PMID:22105404

Effects of a provincial ban of two toxic organophosphorus insecticides on pesticide poisoning hospital admissions

PubMed Central

2012-01-01

Background. Pesticide self-poisoning causes one third of global suicides. Sri Lanka halved its suicide rate by banning WHO Class I organophosphorus (OP) insecticides and then endosulfan. However, poisoning with Class II toxicity OPs, particularly dimethoate and fenthion, remains a problem. We aimed to determine the effect and feasibility of a ban of the two insecticides in one Sri Lankan district. Methods. Sale was banned in June 2003 in most of Polonnaruwa District, but not Anuradhapura District. Admissions with pesticide poisoning to the district general hospitals was prospectively recorded from 2002. Results. Hospital admissions for dimethoate and fenthion poisoning fell by 43% after the ban in Polonnaruwa, while increasing by 23% in Anuradhapura. The pesticide case fatality fell from 14.4% to 9.0% in Polonnaruwa (odds ratio [OR] 0.59, 95% confidence interval [CI] 0.41–0.84) and 11.3% to 10.6% in Anuradhapura (OR 0.93, 95%CI 0.70–1.25; p = 0.051). This reduction was not sustained, with case fatality in Polonnaruwa rising to 12.1% in 2006–2007. Further data analysis indicated that the fall in case fatality had actually been due to a coincidental reduction in case fatality for pesticide poisoning overall, in particular for paraquat poisoning. Conclusions. We found that the insecticides could be effectively banned from agricultural practice, as shown by the fall in hospital admissions, with few negative consequences. However, the ban had only a minor effect on pesticide poisoning deaths because it was too narrow. A study assessing the agricultural and health effects of a more comprehensive ban of highly toxic pesticides is necessary to determine the balance between increased costs of agriculture and reduced health care costs and fewer deaths. PMID:22372788

Preliminary analysis of the National Crash Severity Study : factors in fatal accidents

DOT National Transportation Integrated Search

1979-06-01

This study investigates the fatalities on the National Crash Severity Study (NCSS) of towaway, passenger car accidents. The analysis is in three stages. First, NCSS fatalities are compared to the fatally-injured occupants reported on the Fatal Accide...

Superficial Temporal Artery-Superior Cerebellar Artery Bypass with Anterior Petrosectomy.

PubMed

Hokari, Masaaki; Asaoka, Katsuyuki; Shimbo, Daisuke; Uchida, Kazuki; Itamoto, Koji

2018-06-01

Superficial temporal artery (STA) to superior cerebellar artery (SCA) bypass is associated with a relatively high risk of surgical complications, such as hematoma and/or edema caused by temporal lobe retraction. Therefore, the right side is typically used to avoid retraction of the left temporal lobe. In this report, we present a case of left STA-SCA bypass with anterior petrosectomy to avoid retraction of dominant-side temporal lobe and describe the surgical technique in detail. A 69-year-old man presented with gradual worsening of dysarthria and gait disturbance. Magnetic resonance imaging showed no signs of acute infarction, but digital subtraction angiography showed severe stenosis of basilar artery and faint flow in the distal basilar artery. On 3-dimensional computed tomography angiography, posterior communicating arteries were not visualized; we could identify the left SCA, but not the right SCA. Despite dual antiplatelet therapy, a small fresh brainstem infarct was detected 10 days after admission. To avert fatal brainstem infarction and further enlargement of the infarct, we performed left STA-SCA bypass with anterior petrosectomy to avoid retraction of the dominant-side temporal lobe. Postoperative imaging revealed no new lesions, such as infarction or temporal lobe contusional hematoma, and confirmed the patency of the bypass. Postoperative single-photon emission computed tomography demonstrated improved cerebral blood flow in the posterior circulation. The patient was transferred to another hospital for rehabilitation. This method helps minimize the risk of injury to the temporal lobe, especially that of the dominant side. Copyright © 2018. Published by Elsevier Inc.

Highway deaths: false PR on the effects of PR.

PubMed

Robertson, L S

1994-01-01

In June, 1988, the Department of Public Safety (DPS) in South Carolina launched a media campaign, called "Highways or Dieways?", in an attempt to reduce motor vehicle fatalities. Deaths per vehicle mile declined during the succeeding years and the DPS attributed all of the reduction to the campaign, gleaning some 62 awards in the process. This research indicates that the DPS took credit for a decline in fatalities that resulted from other factors. Fatality rates in South Carolina were actually higher during the campaign than would have been expected from the historic association of South Carolina's rates with the national rate or those of other states in the region. The campaign actually illustrates the principle that ad campaigns alone are often ineffective in changing public health.

Occupational Carbon Monoxide Fatalities in the US From Unintentional Non-Fire Related Exposures, 1992–2008

PubMed Central

Henn, Scott A.; Bell, Jennifer L.; Sussell, Aaron L.; Konda, Srinivas

2015-01-01

Objective To analyze characteristics of, and trends in, work-related carbon monoxide (CO) fatalities in the US. Methods Records of unintentional, non-fire related fatalities from CO exposure were extracted from the Bureau of Labor Statistics’ Census of Fatal Occupational Injuries and the Occupational Safety and Health Administration’s Integrated Management Information System for years 1992–2008 and analyzed separately. Results The average number of annual CO fatalities was 22 (standard deviation = 8). Fatality rates were highest among workers aged ≥65, males, Hispanics, winter months, the Midwest, and the Fishing, Hunting, and Trapping industry subsector. Self-employed workers accounted for 28% of all fatalities. Motor vehicles were the most frequent source of fatal CO exposure, followed by heating systems and generators. Conclusions CO has been the most frequent cause of occupational fatality due to acute inhalation, and has shown no significant decreasing trend since 1992. The high number of fatalities from motor vehicles warrants further investigation. PMID:23868822

Cannabis as a Substitute for Opioid-Based Pain Medication: Patient Self-Report.

PubMed

Reiman, Amanda; Welty, Mark; Solomon, Perry

2017-01-01

Introduction: Prescription drug overdoses are the leading cause of accidental death in the United States. Alternatives to opioids for the treatment of pain are necessary to address this issue. Cannabis can be an effective treatment for pain, greatly reduces the chance of dependence, and eliminates the risk of fatal overdose compared to opioid-based medications. Medical cannabis patients report that cannabis is just as effective, if not more, than opioid-based medications for pain. Materials and Methods: The current study examined the use of cannabis as a substitute for opioid-based pain medication by collecting survey data from 2897 medical cannabis patients. Discussion : Thirty-four percent of the sample reported using opioid-based pain medication in the past 6 months. Respondents overwhelmingly reported that cannabis provided relief on par with their other medications, but without the unwanted side effects. Ninety-seven percent of the sample "strongly agreed/agreed" that they are able to decrease the amount of opiates they consume when they also use cannabis, and 81% "strongly agreed/agreed" that taking cannabis by itself was more effective at treating their condition than taking cannabis with opioids. Results were similar for those using cannabis with nonopioid-based pain medications. Conclusion: Future research should track clinical outcomes where cannabis is offered as a viable substitute for pain treatment and examine the outcomes of using cannabis as a medication assisted treatment for opioid dependence.

A comment on "Novel scavenger removal trials increase wind turbine-caused avian fatality estimates"

USGS Publications Warehouse

Huso, Manuela M.P.; Erickson, Wallace P.

2013-01-01

In a recent paper, Smallwood et al. (2010) conducted a study to compare their “novel” approach to conducting carcass removal trials with what they term the “conventional” approach and to evaluate the effects of the different methods on estimated avian fatality at a wind power facility in California. A quick glance at Table 3 that succinctly summarizes their results and provides estimated fatality rates and 80% confidence intervals calculated using the 2 methods reveals a surprising result. The confidence intervals of all of their estimates and most of the conventional estimates extend below 0. These results imply that wind turbines may have the capacity to create live birds. But a more likely interpretation is that a serious error occurred in the calculation of either the average fatality rate or its standard error or both. Further evaluation of their methods reveals that the scientific basis for concluding that “many estimates of scavenger removal rates prior to [their] study were likely biased low due to scavenger swamping” and “previously reported estimates of avian fatality rates … should be adjusted upwards” was not evident in their analysis and results. Their comparison to conventional approaches was not applicable, their statistical models were questionable, and the conclusions they drew were unsupported.

Classification scheme and prevention measures for caught-in-between occupational fatalities.

PubMed

Chi, Chia-Fen; Lin, Syuan-Zih

2018-04-01

The current study analyzed 312 caught-in-between fatalities caused by machinery and vehicles. A comprehensive and mutually exclusive coding scheme was developed to analyze and code each caught-in-between fatality in terms of age, gender, experience of the victim, type of industry, source of injury, and causes for these accidents. Boolean algebra analysis was applied on these 312 caught-in-between fatalities to derive minimal cut set (MCS) causes associated with each source of injury. Eventually, contributing factors and common accident patterns associated with (1) special process machinery including textile, printing, packaging machinery, (2) metal, woodworking, and special material machinery, (3) conveyor, (4) vehicle, (5) crane, (6) construction machinery, and (7) elevator can be divided into three major groups through Boolean algebra and MCS analysis. The MCS causes associated with conveyor share the same primary causes as those of the special process machinery including textile, printing, packaging and metal, woodworking, and special material machinery. These fatalities can be eliminated by focusing on the prevention measures associated with lack of safeguards, working on a running machine or process, unintentional activation, unsafe posture or position, unsafe clothing, and defective safeguards. Other precise and effective intervention can be developed based on the identified groups of accident causes associated with each source of injury. Copyright © 2017 Elsevier Ltd. All rights reserved.

Effects of a 2009 Illinois Alcohol Tax Increase on Fatal Motor Vehicle Crashes

PubMed Central

Livingston, Melvin D.; Staras, Stephanie S.

2015-01-01

Objectives. We examined the effects of a 2009 increase in alcohol taxes in Illinois on alcohol-related fatal motor vehicle crashes. Methods. We used an interrupted time-series design, with intrastate and cross-state comparisons and measurement derived from driver alcohol test results, for 104 months before and 28 months after enactment. Our analyses used autoregressive moving average and generalized linear mixed Poisson models. We examined both population-wide effects and stratifications by alcohol level, age, gender, and race. Results. Fatal alcohol-related motor vehicle crashes declined 9.9 per month after the tax increase, a 26% reduction. The effect was similar for alcohol-impaired drivers with positive alcohol levels lower than 0.15 grams per deciliter (−22%) and drivers with very high alcohol levels of 0.15 or more (−25%). Drivers younger than 30 years showed larger declines (−37%) than those aged 30 years and older (−23%), but gender and race stratifications did not significantly differ. Conclusions. Increases in alcohol excise taxes, such as the 2009 Illinois act, could save thousands of lives yearly across the United States as part of a comprehensive strategy to reduce alcohol-impaired driving. PMID:25790414

Pedestrian and bicyclist fatalities in large truck crashes, 2013 : [analysis brief].

DOT National Transportation Integrated Search

2015-11-01

From 2006 to 2013, pedestrian fatalities as a : percentage of total fatalities in all motor vehicle : crashes rose from 11.2 percent to 14.5 percent, and : bicyclist fatalities as a percentage of total fatalities : rose from 1.8 percent to 2.3 percen...

Analysis of spatial variations in the effectiveness of graduated driver's licensing (GDL) program in the state of Michigan.

PubMed

Chen, Yu; Berrocal, Veronica J; Bingham, C Raymond; Song, Peter X K

2014-04-01

Injury resulting from motor vehicle crashes is the leading cause of death among teenagers in the US. Few programs or policies have been found to be effective in reducing the risk of fatal car crashes for young novice drivers. One effective policy that has been widely implemented is Graduated Driver Licensing (GDL). Published articles have mostly reported on the temporal effectiveness of GDL in the US. This article reports on the development of spatial statistical modeling approaches to evaluate and compare the effectiveness of GDL policy across eighty-three counties in the state of Michigan. Data were gathered from several publicly available databases, including the US Fatality Analysis Reporting System (FARS), US Census Bureau, US Bureau of Labor Statistics, and US Department of Agriculture. To account for spatial dependence among crash counts from adjacent counties we invoke spatial random effects, which we provide with a Conditionally AutoRegressive (CAR) prior. Our analysis confirms previous findings that GDL in Michigan is an effective policy that significantly reduces the risk of fatal car crashes among novice teenage drivers. In addition, it indicates that rurality is an important contextual variable associated with spatial differences in GDL effectiveness across the state of Michigan. Finally, our findings provide information that can be used to strengthen GDL policy and its implementation to further enhance teenage-driver safety. Copyright © 2013 Elsevier Ltd. All rights reserved.

Extended investigation on road fatality in Brunei.

PubMed

Yusof, N B; Hoque, M A; Steele, M C; Yong, S Y

2018-06-08

Road fatality is one of the leading causes of death in Brunei with 79 deaths in 1993, the highest ever recorded. The Brunei government has been trying to reduce this by implementing new traffic measures and successfully reduced fatalities to 24 fatalities in 2014. Yearly road fatality has been fluctuating, but there has been a declining tendency overall. The aim of this study is to investigate road fatality in Brunei by extending the research. We developed a multiple regression model and carried out an analysis on road fatality in Brunei. Our analysis indicates that the road fatality appears to rise depending on the increase in the number of young drivers between 15 to 24 years and the number of unemployed people. Comparisons of Brunei road fatality rate per 10,000 vehicles are made with some other countries and we conclude that Brunei has approximately the same rate as Australia in 2014.

Machinery-related occupational fatalities in the United States, 1980 to 1989.

PubMed

Pratt, S G; Kisner, S M; Helmkamp, J C

1996-01-01

The National Traumatic Occupational Fatalities surveillance system identified machinery-related incidents as the second leading cause of traumatic occupational fatalities in the United States between 1980 and 1989. These incidents resulted in 8,505 civilian worker deaths and an average annual fatality rate of .80 per 100,000 workers. Workers aged 65 years and older had 5.8 times the fatality rate of workers aged 16 to 64 years (4.06 vs. 70). The highest industry-specific rate was noted in agriculture, forestry, and fishing (7.47). Tractors and other agricultural machinery were associated with nearly 9 of every 10 fatal machinery-related incidents involving workers aged 65 or older. Although numerous studies of agricultural machinery-related fatalities are found in the literature, detailed analyses of machinery-related fatalities in the construction industry as well as analyses of work situations and risk factors associated with fatal injuries are needed.

Construction fatality due to electrical contact in Ontario, Canada, 1997-2007.

PubMed

Kim, Hwan; Lewko, John; Garritano, Enzo; Sharma, Bhanu; Moody, Joel; Colantonio, Angela

2016-06-27

Electrical contact is a leading cause of occupational fatality in the construction industry. However, research on the factors that contribute to electricity-related fatality in construction is limited. To characterize, using an adapted Haddon's Matrix, the factors that contribute to electricity-related occupational fatalities in the construction industry in Ontario, Canada. Coroner's data on occupational electricity-related fatalities between 1997-2007 in the construction industry were acquired from the Ontario Ministry of Labour. Using an adapted Haddon's Matrix, we characterized worker, agent, and environmental characteristics of electricity-related occupational fatalities in the province through a narrative text analysis. Electrical contact was responsible for 15% of all occupational fatalities among construction workers in Ontario. Factors associated with said occupational fatalities included direct contact with electrical sources, lower voltage sources, and working outdoors. This study provides a profile of electricity-related occupational fatalities among construction workers in Ontario, and can be used to inform safety regulations.

Fatal accidents at railway level crossings in Great Britain 1946-2009.

PubMed

Evans, Andrew W

2011-09-01

This paper investigates fatal accidents and fatalities at level crossings in Great Britain over the 64-year period 1946-2009. The numbers of fatal accidents and fatalities per year fell by about 65% in the first half of that period, but since then have remained more or less constant at about 11 fatal accidents and 12 fatalities per year. At the same time other types of railway fatalities have fallen, so level crossings represent a growing proportion of the total. Nevertheless, Britain's level crossing safety performance remains good by international standards. The paper classifies level crossings into three types: railway-controlled, automatic, and passive. The safety performance of the three types of crossings has been very different. Railway-controlled crossings are the best-performing crossing type, with falling fatal accident rates. Automatic crossings have higher accident rates per crossing than railway controlled or passive crossings, and the accident rates have not decreased. Passive crossings are by far the most numerous, but many have low usage by road users. Their fatal accident rate has remained remarkably constant over the whole period at about 0.9 fatal accidents per 1000 crossings per year. A principal reason why fatal accidents and fatalities have not fallen in the second half of the period as they did in the first half is the increase in the number of automatic crossings, replacing the safer railway controlled crossings on some public roads. However, it does not follow that this replacement was a mistake, because automatic crossings have advantages over controlled crossings in reducing delays to road users and in not needing staff. Based on the trends for each type of crossing and for pedestrian and non-pedestrian accidents separately, in 2009 a mean of about 5% of fatal accidents were at railway controlled crossings, 52% were at automatic crossings, and 43% were at passive crossings. Fatalities had similar proportions. About 60% of fatalities were to pedestrians. A simple comparison of automatic railway level crossings and signalised road intersections found that in 2005 the numbers of fatalities per 1000 crossings or intersections were similar. Copyright © 2011 Elsevier Ltd. All rights reserved.

Ebola virus disease: a highly fatal infectious disease reemerging in West Africa.

PubMed

To, Kelvin K W; Chan, Jasper F W; Tsang, Alan K L; Cheng, Vincent C C; Yuen, Kwok-Yung

2015-02-01

Ebolavirus can cause a highly fatal and panic-generating human disease which may jump from bats to other mammals and human. High viral loads in body fluids allow efficient transmission by contact. Lack of effective antivirals, vaccines and public health infrastructures in parts of Africa make it difficult to health workers to contain the outbreak. Copyright © 2014 Institut Pasteur. Published by Elsevier Masson SAS. All rights reserved.

Motor vehicle safety, health care, and taxes. National Highway Traffic Safety Administration, U.S. Department of Transportation.

PubMed

1994-01-01

Motor vehicle injuries are a major public health problem. They are a primary cause of: 1) death and injury in the United States; and 2) result in a substantial loss of productive life. These injuries and fatalities have serious social and economic consequences for the injured individual, their families, and society. This report focuses on the portion of health care expense borne by the public and the tax revenue implications of these injuries and fatalities. The relationship between motor vehicle injuries and fatalities, health care costs, and income taxes was analyzed for four situations: 1) 1990 baseline; 2) achievement of modest goals for safety improvements; 3) population growth with constant injury and fatality rates; and 4) the effect of higher injury and fatality rates. Total health care costs, publicly funded health care costs, lost income tax revenue, and increased public assistance were estimated at the [U.S.] federal level, and at the state and local level. Study of these relationships indicate that: 1) the lifetime economic cost of motor vehicle injuries, fatalities, and property damage that occurred in 1990 is $137.5 billion. American taxpayers will pay $11.4 billion of that total to cover publicly funded health care ($3.7 billion), reduced income tax revenue ($6.1 billion), and increased public assistance expenses ($1.6 billion); 2) the lifetime economic cost of alcohol-related, motor vehicle injuries, fatalities, and property damage that occurred in 1990 was $46.1 billion. Of this, the American taxpayer will pay $1.4 billion to cover publicly funded health care and $3.8 billion to cover reduced income tax revenue and increased public assistance; 3) reducing the percentage of the alcohol-related portion of these fatalities from 45% to 43% (1,200 lives saved), and alcohol-related injuries by a proportionate amount, would save American taxpayers $73 million in publicly funded health care and $208 million in income taxes and public assistance; 4) by increasing observed safety-belt usage in passenger cars from 62% to 75%, (1,700 lives saved plus a proportionate reduction in injuries), publicly funded health care costs would be reduced by $180 million, and $328 million would be saved in the combination of increased income tax revenues and reduced public assistance; 5) Further reductions in publicly funded health care, increases in income tax revenues, and reductions in public assistance are possible as a result of reasonable gains in other areas, such as increased safety-belt usage in light trucks, increased usage of motorcycle helmets, increased correct usage of child safety seats, and reducing the number of speeding drivers; 6) if injury and fatality rates remain at the 1992 level, population increases alone would result in 3,300 more fatalities in the year 2000. Economic costs from these fatalities and a proportionate increase in injuries would increase by an estimated $7.4 billion, including a $277 million increase in publicly funded health care costs, and $573 million in reduced income tax revenue and increased public assistance; and 7) if injury and fatality rates increase from the 1992 level, injuries, fatalities, and costs will increase. In one scenario, with 5,800 more fatalities than the population growth scenario, economic costs would increase by $13 billion, including a $350 million increase in publicly funded health care, and an additional $1 billion in taxes to cover lost income tax revenue and increased public assistance. It is obvious that inaction is a costly alternative and that anticipated population gains will require further reductions in injury and fatality rates just to maintain current injury and fatality rates. Fortunately, countermeasures are to be available that can accomplish this. Lack of vigilance that would result in deterioration of safety levels would be even more costly.

Enhancing Effect of Continuous Cobalt-60 Gamma-Radiation on Susceptibility to Anaphylactic Shock in Mice

DOE Office of Scientific and Technical Information (OSTI.GOV)

Hale, William M.; Stoner, Richard D.

1958-05-01

Continuous exposure to gamma -radiation at a dose rate of 4 rep/hr enhanced the severity of anaphylactnic shock ln mice sensitized with tetanus toxoid and challenged 1 hour or 7 days postradiation with fluid tetanus toxoid. A sharp increase in susceptibility to fatal anaphylaxis was observed as the accumulated dose was increased from 192 to 288 rep. Recovery from the enhancing effect of continuous gamma -radiation began during the second week postradiation; complete recovery occurred during the third week after an accumulated dose of 672 rep. Anaphylactic shock was demonstrable in mice sensitized 6 months before challenge with the specificmore » antigen. An enhanced susceptibility to fatal anaphylaxis was obtained when these animals were given an accumulated dose of 288 rep and challenged 1 hour postradiation. Passive anaphylaxis was more severe in irradiated mice sensitized with homopogous antitoxin 1 hour postradiation and challenged the following day with tetanus toxoid. The antihistaminic agent Thephorin afforded complete protection from fatal anaphypaxis in irradiated mice. (auth)« less

An Examination of the Effectiveness of Child Endangerment Laws in Preventing Child Fatalities in Alcohol-Involved Motor Vehicle Crashes.

PubMed

Kelley-Baker, Tara; Romano, Eduardo

2016-09-01

The aim of this study was to assess the impact of U.S. child-endangerment laws on the prevalence of child passengers fatally injured in motor vehicle crashes in which the adult driver was drinking. We used data from the 2002-2012 Fatality Analysis Reporting System. We conducted both bivariate and multivariate analyses using Heckman selection models. After adjusting for several cofactors, including driver demographics and blood alcohol concentration, child seat positioning, and seat belt laws, we found that passing a DUI child-endangerment law may have no impact at all on the likelihood of finding impaired drivers among those driving with children. There are a number of reasons why DUI child-endangerment laws have not been effective in saving the lives of young passengers who are driven by adult drinking drivers. These reasons include lack of publicity and education, as well as issues related to enforcement. Potential solutions are suggested that include examining sanctions and strengthening of DUI child endangerment laws.

Traumatic thrombosis of internal carotid artery sustained by transfer of kinetic energy.

PubMed

Kalcioglu, Mahmut Tayyar; Celbis, Osman; Mizrak, Bulent; Firat, Yezdan; Selimoglu, Erol

2012-06-01

A 31-year-old male patient with a fatal thrombosis of the internal carotid artery caused by gun shot injury was presented in this case report. The patient was referred to the hospital with a diffuse edema on his left cheek. On otolaryngologic examination, there was a bullet entrance hole at the left mandibular corpus. No exit hole could be found. The finding from his axial computed tomography of neck and paranasal sinuses was normal. On neurological examination, a dense right hemiparesis was observed. In his cerebral angiogram, left common carotid artery was totally obliterated. Diffuse ischemia was observed in the left cerebral hemisphere. Despite intensive interventions, the patient died 4 days after the accident. In the autopsy, a large thrombosis was obtained in the left common carotid artery. This case emphasizes a fatal kinetic energy effect in vascular structures. It is stressed that a gun shot injury could be fatal with its indirect kinetic energy effects at subacute phase.

Jurisdictional spillover effects of sprawl on injuries and fatalities.

PubMed

Mohamed, Rayman; Vom Hofe, Rainer; Mazumder, Sangida

2014-11-01

There is a considerable literature on the relationship between sprawl and accidents. However, these studies do not account for the spatially correlated effects of sprawl on accidents. In our analysis of 122 jurisdictions in Southeast Michigan, we use a Bayesian spatial autoregressive model to estimate how injuries and fatalities in one jurisdiction are associated with sprawl in that jurisdiction and sprawl in neighboring jurisdictions; we also correct for heteroskedasticity in the data. Using principal component analysis, we create a sprawl index from five underlying land use characteristics. Our results show that the number of injuries and fatalities in a jurisdiction increases with the magnitude of sprawl in neighboring jurisdictions. We believe that this is because more drivers per capita in sprawled jurisdictions traverse similarly sprawled neighboring jurisdictions for daily activities. Furthermore, driving habits attuned to less defensive driving in sprawled jurisdiction are transferred to similarly designed neighboring jurisdictions, contributing to accidents in the latter. Copyright © 2014 Elsevier Ltd. All rights reserved.

The effect of verified pediatric trauma centers, state laws and crash characteristics on time trends in adolescent motor vehicle fatalities, 1999-2015.

PubMed

Notrica, David M; Sayrs, Lois W; Krishna, Nidhi

2018-05-15

Motor vehicle crashes (MVCs) are a leading cause of adolescent death from trauma. A recent study found ACS verified pediatric trauma centers (vPTC) were inversely correlated with pediatric mortality, but the analysis was limited to a single year. This study assesses the contribution of vPTCs, crash characteristics, and state driver laws on 15 to 17 years old MVC mortality for all 50 states from 1999-2015. Prospective data on motor vehicle fatalities, crash characteristics, state driving laws, and ACS verified trauma centers were collected from publically available sources for 50 U.S. states from 1999-2015. A mixed fixed/random effects multivariate regression model was fitted to assess the relative contribution of crash characteristics, state laws and vPTCs while controlling for state variation and time trends. The final regression model included driver and crash characteristics, verified trauma centers, and state laws. Camera laws ([B=-0.57[P<0.001]) were associated with a 57% decrease in the rate of change in adolescent crude fatalities. The lagged Level 1 vPTC crude rate (B=-0.12[P<.001]) was protective and contributed independently to a 12% decline in the rate of change in teen fatalities over the time period. Seat belt laws (B=-0.15[P<0.001]), GDL passenger restrictions (B=-0.07[P<0.001]), GDL learner permit period (B=-0.04[P<0.002]), non-deployed airbag (B=-0.003[P<0.001]), Hispanic heritage (B=-0.003[P<0.05]), were protective. Increased risk of fatality was associated with mini-van (B=0.01[P<0.001]), speed>90mph (B=0.004[P<0.001]), rural roads (B=0.002[P<0.002], unknown seat belt compliance (B=0.004[P<0.001]) and dry road surface (B=0.005[P<0.001]). State camera laws during the study time frame are associated with a 57% decrease in the rate of change in adolescent crude fatalities; vPTCs during the study time period reduced overall rate of change in the crude fatality rate by 12%. State laws, restrictions on teenage passengers and longer learner's permit periods, and seat belt laws are associated with significant decreases the crude teen mortality rate. Level III, Prospective.

Variations in otological presentation of lightning strike victims: Clinical report of 3 patients.

PubMed

Kılıç, Erbil; Genç, Hakan; Aydın, Ümit; Aşık, Burak; Satar, Bülent

2017-03-01

Lightning strike can cause fatal or nonfatal injuries. Some nonfatal injuries are associated with otological symptoms and findings. Conductive hearing loss due to rupture of the tympanic membrane is the most common audiovestibular lesion of lightning strike. Various forms of sensorineural hearing loss and dizziness have also been reported. Presently described are 3 cases of lightning strike injury. First patient had mid-frequency hearing loss in right ear and high frequency sensorineural hearing loss in left ear. Second patient had high frequency sensorineural hearing loss in left ear, and the third had peripheral facial palsy with perilymphatic fistula on same side. This is the first documented case of mid-frequency hearing loss occurring after lightning strike.

Automobile-dependency as a barrier to vision zero, evidence from the states in the USA.

PubMed

Ahangari, Hamed; Atkinson-Palombo, Carol; Garrick, Norman W

2017-10-01

With a traffic fatality rate of 10.6 per 100,000 as of 2013-more than triple that in the UK, the Netherlands, and Sweden-the United States has the worst traffic safety performance of all developed countries. Statewide variations are even more pronounced. North Dakota registers more than twice the national average and five times the rate of Massachusetts. We used panel models and annual data from 1997 to 2013 to capture the effect of seven separate sets of factors that influence traffic safety: exposure, travel behavior, socioeconomics, macroeconomics, safety policies, and mitigating factors such as health care. The results of our panel models and supplementary analysis of state effects show that two variables - Vehicle Miles Traveled and Vehicles per Capita-have the strongest impact on traffic fatality rates. This is closely followed by Infant Mortality Rates, the proxy that we used to represent the quality of health care. Policy levers such as Graduated Driver's Licenses (GDL) have improved safety, but to a limited extent. We also found that states with higher urban density and more walking are associated with lower traffic fatality rates. Taken as a whole, our findings suggest that if additional progress is to be made in reducing traffic fatalities, emphasis needs to move beyond simply focusing on policies such as GDL and seat belt laws, which have already been adopted by almost all jurisdictions across the United States. We need to also consider factors that focus on the type of urban form that we are creating to ensure that we are fostering environments that encourage multi-modal transportation such as walking to reduce the VMT and Vehicles per Capita, the two strongest predictors of traffic fatalities. Copyright © 2017 Elsevier Ltd. All rights reserved.

Alcohol-control public service announcements (PSAs) and drunk-driving fatal accidents in the United States, 1996-2010.

PubMed

Niederdeppe, Jeff; Avery, Rosemary; Miller, Emily N

2017-06-01

Widespread concern regarding the detrimental effects of excessive alcohol consumption (especially by minors) and associated social problems (particularly drunk driving) continues to exist among policymakers, law enforcement officers, and the general public. Alcohol consumption is a leading contributor to death from injuries, which itself is one of the main causes of death for people under 21years of age in the United States. This study examines the relationship between the volume and timing of alcohol-control public service announcements (PSAs) and rates of drunk-driving fatal accidents in the U.S. We estimate ordinary least squares (OLS) regression models to predict rates of drunk-driving fatal accidents by state and month as a function of the volume of alcohol-control PSAs aired during the previous 8months. Models include controls for state anti-drunk-driving laws and regulations, state demographic characteristics, state taxes on alcohol, calendar year, and seasonality. Results indicate that higher volumes of anti-drunk driving PSAs airing in the preceding 2 to 3months are associated, albeit modest in magnitude, with reduced rates of drunk-driving fatal accidents. The regression coefficients are largest for adults (relative to underage drunk drivers) and when the PSAs air during prime time (relative to daytime or nighttime). We conclude that PSAs could play an important contributing role in reducing drunk-driving fatal accidents, although levels of exposure and potential effects likely remain modest due to reliance on donated air time. Well-funded anti-drunk driving campaigns could achieve higher levels of exposure and have a larger impact. Copyright © 2017 Elsevier Inc. All rights reserved.

Landslide fatalities in the Western Ghats of Kerala, India

NASA Astrophysics Data System (ADS)

Lukose Kuriakose, Sekhar; Sankar, G.; Muraleedharan, C.

2010-05-01

The Western Ghats of Kerala, India is prone to shallow landslides and consequent debris flows. An earlier study (Kuriakose et al., EG, 2009) has compiled and presented the history and chorology of landslide prone areas of the region. An attempt to collect and compile a reliable fatal landslide inventory of the region resulted in a database of 63 landslides from 1961 to 2009. The data base was compiled from the news paper reports and research reports of the CESS and GSI. Most landslides were visited in and the locations were mapped using a handheld GPS. Date and fatality information was also collected. For twelve of the landslides accurate location information was not available and hence was plotted at the nearest known village centre. Three landslides did not have any location information but was recorded in the district gazetteer and hence included in the data base. A total of 257 valuable lives were lost in landslides. The landslide that caused the highest number of deaths was the Amboori landslide (Thiruvananthapuram) which occurred on 11 September 2001 that caused 39 fatalities. Idukki district experienced the largest number of fatal landslides during this period, 20 events resulting in 67 fatalities. Thiruvananthapuram district experienced the highest average number of fatalities per landslide (47 deaths from 5 events). The district wise statistics from north to south are, Kannur (6 from 5), Kasargodu (24 from 6), Wayanad (36 from 6), Kozhikode (44 from 10), Malappuram (9 from 3), Palakkad (3 from 3), Thrissur (2 from 1), Kottayam (5 from 3), and Pathanamthitta (14 from 3). It was noted that there exists a spatial trend in the occurrence of fatal landslides which follows the general monsoon rainfall trends and the population density. About 55% of the events occurred during the south west monsoon (June to September) season. It was also observed that there exists a strong upward trend in the number of fatal landslides. This upward trend can be directly attributed to the increased migration of people from the plains to the high lands in the mid 1970's and the resultant clearing of natural forests for agriculture and infrastructural development. This upward trend may continue given the population pressure and the expected increase in the frequency of prolonged high intensity rainfall events owing to the effects of climate change on the Indian Monsoon System.

Systematic Review and Meta-Analysis of Randomised Trials to Ascertain Fatal Gastrointestinal Bleeding Events Attributable to Preventive Low-Dose Aspirin: No Evidence of Increased Risk

PubMed Central

Dolwani, Sunil; Graziano, J. Michael; Lanas, Angel; Longley, Marcus; Phillips, Ceri J.; Roberts, Stephen E.; Soon, Swee S.; Steward, Will

2016-01-01

Background Aspirin has been shown to lower the incidence and the mortality of vascular disease and cancer but its wider adoption appears to be seriously impeded by concerns about gastrointestinal (GI) bleeding. Unlike heart attacks, stroke and cancer, GI bleeding is an acute event, usually followed by complete recovery. We propose therefore that a more appropriate evaluation of the risk-benefit balance would be based on fatal adverse events, rather than on the incidence of bleeding. We therefore present a literature search and meta-analysis to ascertain fatal events attributable to low-dose aspirin. Methods In a systematic literature review we identified reports of randomised controlled trials of aspirin in which both total GI bleeding events and bleeds that led to death had been reported. Principal investigators of studies in which fatal events had not been adequately described were contacted via email and asked for further details. A meta-analyses was then performed to estimate the risk of fatal gastrointestinal bleeding attributable to low-dose aspirin. Results Eleven randomised trials were identified in the literature search. In these the relative risk (RR) of ‘major’ incident GI bleeding in subjects who had been randomised to low-dose aspirin was 1.55 (95% CI 1.33, 1.83), and the risk of a bleed attributable to aspirin being fatal was 0.45 (95% CI 0.25, 0.80). In all the subjects randomised to aspirin, compared with those randomised not to receive aspirin, there was no significant increase in the risk of a fatal bleed (RR 0.77; 95% CI 0.41, 1.43). Conclusions The majority of the adverse events caused by aspirin are GI bleeds, and there appears to be no valid evidence that the overall frequency of fatal GI bleeds is increased by aspirin. The substantive risk for prophylactic aspirin is therefore cerebral haemorrhage which can be fatal or severely disabling, with an estimated risk of one death and one disabling stroke for every 1,000 people taking aspirin for ten years. These adverse effects of aspirin should be weighed against the reductions in vascular disease and cancer. PMID:27846246

State Traffic Data: Traffic Safety Facts, 2001.

ERIC Educational Resources Information Center

National Center for Statistics and Analysis (NHTSA), Washington, DC.

This brief provides statistical information on U.S. traffic accidents delineated by state. A map details the 2001 traffic fatalities by state and the percent change from 2000. Data tables include: (1) traffic fatalities and fatality rates, 2001; (2) traffic fatalities and percent change, 1975-2001; (3) alcohol involvement in fatal traffic crashes,…

Highway Safety: Trends in Highway Fatalities 1975-1987

DTIC Science & Technology

1990-03-01

pattern of fatalities as the overall trend. This pattern applies to many of the general fatality statis- tics we present, and, in all cases, it serves as a...Fatalities 1975-87 Appemfx IV Vehicle-Related Statistics Figure IV.17: Vehicle Fatalities by Direction of Principal Impacto NNNumber of PddUlsils lwam 0 1975

Fatalism and HIV/AIDS beliefs in rural Mali, West Africa.

PubMed

Hess, Rosanna F; McKinney, Dawn

2007-01-01

To examine beliefs about HIV/AIDS of rural Malians and to measure their level of fatalism in context of HIV/AIDS and prevention behaviors. Descriptive, correlational. An AIDS Knowledge and Beliefs survey and the Powe Fatalism Inventory (PFI)-HIV/AIDS version were administered to a convenience sample of 84 people at three health center maternity clinics in southeastern Mali, West Africa. The sample's HIV/AIDS fatalism mean was 9.2 on a 15-point scale, with an internal consistency of .89. Health workers and more educated participants had significantly lower fatalism scores. Fatalism also varied by the combination of gender and ethnicity. People who believed that AIDS was not real, was a punishment from God, was fabricated by the West, was a curse, and that it was taboo to talk about AIDS had higher fatalism means. None of the prevention indicators were significantly related to fatalism scores. These rural Malians had a high overall fatalism mean and their beliefs about AIDS based on traditional culture may affect prevention behaviors. More research is needed to understand the influence of fatalism on prevention behaviors.

[Occupational injury in foreign workers by economic activity and autonomous community (Spain 2005)].

PubMed

López-Jacob, Ma José; Ahonen, Emily; García, Ana M; Gil, Angel; Benavides, Fernando G

2008-01-01

While the immigrant collective in Spain has grown considerably in recent years, little is known about working conditions and their corresponding effects on occupational injury in this group. The objective of this study was to compare the incidences for both fatal and non-fatal injuries in foreign workers to that of Spanish workers in 2005, by autonomous community and economic activity. injury data came from the accident registry of the ministry of labor and social issues, and denominators were taken from available social security affiliation statistics from general and coal mining social security system. Incidence indices for fatal and non-fatal occupational injuries for foreign and spanish workers were calculated. In addition, relative risks and their 95% confidence intervals (95% CI) were calculated by autonomous community and economic activity, using spanish workers as the reference group. Overall, relative risk for occupational injury in foreign workers in 2005 was superior to base risk for both fatal (1.34; 95% CI: 1.11-1.62) and non-fatal injury (1.13; 95% CI: 1.13-1.14), though there were important differences by autonomous community and activity sectors. Compared with Spanish workers, risk for occupational injury was higher for foreign workers in industrial activities, while it was lower in construction, commerce and restaurants and hotels. By autonomous community, Aragón and Catalonia showed the highest risks for foreign workers. A higher risk for occupational injury among foreign workers is confirmed, and may be higher than that observed. The differences in risk among economic activities and autonomous communities require more detailed analysis.

Modeling the impact of rescinding Michigan's primary and secondary seat belt laws on death and injury from passenger vehicle crashes.

PubMed

Carter, Patrick M; Flannagan, Carol A C; Bingham, C Raymond; Cunningham, Rebecca M; Rupp, Jonathan D

2014-01-01

Seat belts are the most effective method of decreasing fatal and nonfatal motor vehicle crash injury. Advocacy groups have recently been successful in enacting repeals of mandatory motorcycle helmet laws in several states. In some states, this has prompted renewed efforts aimed at repealing mandatory seat belt laws. To evaluate and quantify the potential impact of rescinding seat belt laws on annual crash-related fatalities, nonfatal injuries, and associated economic costs, using Michigan as a model, to inform the national debate. Proportional injury rates were calculated utilizing police-reported statewide passenger vehicle crash data from 1999 and 2002, where belt use rates approximate estimates associated with repeal of primary and secondary seat belt laws. Proportional rates were applied to the most recent year of crash data (2011) to estimate changes in statewide fatalities and nonfatal injuries. National cost estimates were applied to injury data to calculate associated economic costs. Full repeal of the seat belt law is estimated to result in an additional 163 fatalities, 13,722 nonfatal injuries, and an associated societal cost of $1.6 billion annually. Repeal of the primary seat belt law only is estimated to result in an additional 95 fatalities, 9156 nonfatal injuries, and an associated societal cost of $1.0 billion annually. This analysis suggests that repealing the either the primary or full seat belt law would have a substantial and negative impact on public health, increasing motor vehicle crash related fatality, nonfatal injury, and associated economic costs.

Urban sprawl as a risk factor in motor vehicle occupant and pedestrian fatalities.

PubMed

Ewing, Reid; Schieber, Richard A; Zegeer, Charles V

2003-09-01

We sought to determine the association between urban sprawl and traffic fatalities. We created a sprawl index by applying principal components analysis to data for 448 US counties in the largest 101 metropolitan areas. Regression analysis was used to determine associations between the index and traffic fatalities. For every 1% increase in the index (i.e., more compact, less sprawl), all-mode traffic fatality rates fell by 1.49% (P <.001) and pedestrian fatality rates fell by 1.47% to 3.56%, after adjustment for pedestrian exposure (P <.001). Urban sprawl was directly related to traffic fatalities and pedestrian fatalities. Subsequent studies should investigate relationships at a finer geographic scale and should strive to improve on the measure of exposure used to adjust pedestrian fatality rates.

Road traffic fatalities in selected governorates of Iraq from 2010 to 2013: prospective surveillance.

PubMed

Leidman, Eva; Maliniak, Maret; Sultan, Abdul-Salam Saleh; Hassan, Ahmed; Hussain, Syed Jaffar; Bilukha, Oleg O

2016-01-01

The insurgency tactics that characterize modern warfare, such as suicide car bombs and roadside bombs, have the potential to significantly impact road traffic injuries in conflict affected-countries. As road traffic incidents are one of the top ten causes of death in Iraq, changes in incidence have important implications for the health system. We aimed to describe patterns of road traffic fatalities for all demographic groups and types of road users in Iraq during a period characterized by a resurgence in insurgency activity. Iraqi Ministry of Health routine prospective injury surveillance collects information on all fatal injuries in eight governorates of Iraq: Baghdad, Al-Anbar, Basrah, Erbil, Kerbala, Maysan, Ninevah, and Al-Sulaimaniya. From all injury fatalities documented at the coroner office, we analyzed only those attributed to road traffic that occurred between 1 January 2010 and 31 December 2013. Coroners ascertain information from physical examinations, police reports and family members. Analysis included 7,976 road traffic fatalities. Overall, 6,238 (78.2 %) fatalities were male and 2,272 (28.5 %) were children under 18 years of age. The highest numbers of road traffic fatalities were among males 15 to 34 years of age and children of both sexes under 5 years of age. 49.2 % of fatalities occurred among pedestrians. Among children and females, the majority of road traffic fatalities were pedestrians, 69.0 % and 56.6 %, respectively. Fatalities among motorcyclists (3.7 %) and bicyclists (0.4 %) were least common. Rates of road traffic fatalities ranged from 8.6 to 10.7 per 100,000 population. The injury surveillance system provides the first data from a conflict-affected country on road traffic fatalities disaggregated by type of road user. The highest numbers of fatalities were among children and young men. Nearly half of fatalities were pedestrians, a proportion nearly double that of any neighboring country. As insurgency activity increased in 2013, the number of road traffic fatalities declined.

Comparison of the injury severity and medical history of disease-related versus trauma-related bicyclist fatalities.

PubMed

Hitosugi, Masahito; Koseki, Takeshi; Miyama, Genta; Furukawa, Satoshi; Morita, Satomu

2016-01-01

The objective of this study was to clarify the relationship between injury severity and mechanism of death in bicycle fatalities resulting from trauma compared with those resulting from disease, to propose effective measures to prevent fatal bicyclist accidents. Autopsy and accident records were reviewed for bicyclist fatalities who had undergone forensic autopsy at the Dokkyo Medical University School of Medicine between September 1999 and March 2014. Victims' health histories, blood alcohol levels, causes of death, mechanisms of injury, Abbreviated Injury Scale (AIS) scores and Injury Severity Scores (ISSs) were determined. Fifty-five bicyclists (43 male and 12 female) with a mean age of 62.5±17.3 years were included in this study. Sixteen victims had driven under the influence of alcohol (mean blood concentration of 1.8±0.7 mg/ml). Mean ISS was 32.4 and the chest had the highest mean AIS score (2.6), followed by the head (2.1) and the neck (1.8). Thirty-nine victims (70.9%) had died of trauma and 16 had died of disease. The disease-death victims had significantly higher prevalence of having diabetes mellitus, hyperlipidemia, hypertension, heart disease or cerebrovascular diseases (50.0% vs. 22.2%, p=0.03) and a lower rate of drunk driving (6.3% vs. 41.0%, p=0.01) than the trauma-death group. All victims who were affected by disease, and 33.3% of trauma-death victims, had fallen on the road without a vehicle collision (p<0.001). The mean ISS of the trauma-death group was significantly higher than that of the disease-death group (44.0 vs. 4.2, p<0.001). Except for facial injuries, the AIS scores were significantly higher in trauma-death victims than in the disease-death group (p<0.005). To effectively reduce bicyclist fatalities, the authors strongly advocate efforts that will increase compliance with drunk driving prohibitions. For victims of fatal bicycle accidents with a medical history of diseases, a forensic autopsy should be performed to establish a disease-related death while bicycle riding. We must also put into effect preventative safety measures, which take into consideration the physical condition of bicyclists, to reduce the incidence of these types of accidents. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

Hazards of Extreme Weather: Flood Fatalities in Texas

NASA Astrophysics Data System (ADS)

Sharif, H. O.; Jackson, T.; Bin-Shafique, S.

2009-12-01

The Federal Emergency Management Agency (FEMA) considers flooding “America’s Number One Natural Hazard”. Despite flood management efforts in many communities, U.S. flood damages remain high, due, in large part, to increasing population and property development in flood-prone areas. Floods are the leading cause of fatalities related to natural disasters in Texas. Texas leads the nation in flash flood fatalities. There are three times more fatalities in Texas (840) than the following state Pennsylvania (265). This study examined flood fatalities that occurred in Texas between 1960 and 2008. Flood fatality statistics were extracted from three sources: flood fatality databases from the National Climatic Data Center, the Spatial Hazard Event and Loss Database for the United States, and the Texas Department of State Health Services. The data collected for flood fatalities include the date, time, gender, age, location, and weather conditions. Inconsistencies among the three databases were identified and discussed. Analysis reveals that most fatalities result from driving into flood water (about 65%). Spatial analysis indicates that more fatalities occurred in counties containing major urban centers. Hydrologic analysis of a flood event that resulted in five fatalities was performed. A hydrologic model was able to simulate the water level at a location where a vehicle was swept away by flood water resulting in the death of the driver.

Assessing the Impact of Twenty Underage Drinking Laws.

PubMed

Fell, James C; Scherer, Michael; Thomas, Sue; Voas, Robert B

2016-03-01

Over the last two decades, many states have adopted several of the 20 laws that aim to control youth access to and possession of alcohol and prevent underage drinking in the United States. However, many of these laws have not been evaluated since their adoption. The objective of this study was to determine which minimum legal drinking age 21 (MLDA-21) laws currently have an effect on underage drinking-and-driving fatal crashes. We updated the effective dates of the 20 MLDA-21 laws examined in this study and used scores of each law's strengths and weaknesses. Our structural equation model included the 20 MLDA-21 laws, impaired driving laws, seat belt safety laws, economic strength, driving exposure, beer consumption, and fatal crash ratios of drinking-to-nondrinking drivers under age 21. Nine MLDA-21 laws were associated with significant decreases in fatal crash ratios of underage drinking drivers: possession of alcohol (-7.7%), purchase of alcohol (-4.2%), use alcohol and lose your license (-7.9%), zero tolerance .02 blood alcohol concentration limit for underage drivers (-2.9%), age of bartender ≥21 (-4.1%), state responsible beverage service program (-3.8%), fake identification support provisions for retailers (-11.9%), dram shop liability (-2.5%), and social host civil liability (-1.7%). Two laws were associated with significant increases in the fatal crash ratios of underage drinking drivers: prohibition of furnishing alcohol to minors (+7.2%) and registration of beer kegs (+9.6%). The nine effective MLDA-21 laws are estimated to be currently saving approximately 1,135 lives annually, yet only five states have enacted all nine laws. If all states adopted these nine effective MLDA-21 laws, it is estimated that an additional 210 lives could be saved every year.

Assessing the Impact of Twenty Underage Drinking Laws

PubMed Central

Fell, James C.; Scherer, Michael; Thomas, Sue; Voas, Robert B.

2016-01-01

Objective: Over the last two decades, many states have adopted several of the 20 laws that aim to control youth access to and possession of alcohol and prevent underage drinking in the United States. However, many of these laws have not been evaluated since their adoption. The objective of this study was to determine which minimum legal drinking age 21 (MLDA-21) laws currently have an effect on underage drinking-and-driving fatal crashes. Method: We updated the effective dates of the 20 MLDA-21 laws examined in this study and used scores of each law’s strengths and weaknesses. Our structural equation model included the 20 MLDA-21 laws, impaired driving laws, seat belt safety laws, economic strength, driving exposure, beer consumption, and fatal crash ratios of drinking-to-nondrinking drivers under age 21. Results: Nine MLDA-21 laws were associated with significant decreases in fatal crash ratios of underage drinking drivers: possession of alcohol (-7.7%), purchase of alcohol (-4.2%), use alcohol and lose your license (-7.9%), zero tolerance .02 blood alcohol concentration limit for under-age drivers (-2.9%), age of bartender ≥21 (-4.1%), state responsible beverage service program (-3.8%), fake identification support provisions for retailers (-11.9%), dram shop liability (-2.5%), and social host civil liability (-1.7%). Two laws were associated with significant increases in the fatal crash ratios of underage drinking drivers: prohibition of furnishing alcohol to minors (+7.2%) and registration of beer kegs (+9.6%). Conclusions: The nine effective MLDA-21 laws are estimated to be currently saving approximately 1,135 lives annually, yet only five states have enacted all nine laws. If all states adopted these nine effective MLDA-21 laws, it is estimated that an additional 210 lives could be saved every year. PMID:26997183

Exploring the effects of state highway safety laws and sociocultural characteristics on fatal crashes.

PubMed

Dong, Chunjiao; Nambisan, Shashi S; Clarke, David B; Sun, Jian

2017-04-03

Distinguished from the traditional perspectives in crash analyses, which examined the effects of geometric design features, traffic factors, and other relevant attributes on the crash frequencies of roadway entities, our study focuses on exploring the effects of highway safety laws, as well as sociocultural characteristics, on fatal crashes across states. Law and regulation related data were collected from the Insurance Institute for Highway Safety, State Highway Safety Offices, and Governors Highway Safety Association. A variety of sociodemographic characteristics were obtained from the U.S. Census Bureau. In addition, cultural factors and other attributes from a variety of resources are considered and incorporated in the modeling process. These data and fatal crash counts were collected for the 50 U.S. states and the District of Columbia and were analyzed using zero-truncated negative binomial (ZTNB) regression models. The results show that, in law and regulation-related factors, the use of speed cameras, no handheld cell phone ban, limited handheld cell phone ban, and no text messaging ban are found to have significant effects on fatal crashes. Regarding sociocultural characteristics, married couples with both husband and wife in the labor force are found to be associated with lower crash frequencies, the ratios of workers traveling to work by carpool, those driving alone, workers working outside the county of residence, language other than English and limited English fluency, and the number of licensed drivers are found to be associated with higher crash frequencies. Through reviewing and modeling existing state highway safety laws and sociocultural characteristics, the results reveal new insights that could influence policy making. In addition, the results would benefit amending existing laws and regulations and provide testimony about highway safety issues before lawmakers consider new legislation.

Effect of Statin Use on Outcomes of Adults with Candidemia

PubMed Central

Cuervo, Guillermo; Garcia-Vidal, Carolina; Nucci, Marcio; Puchades, Francesc; Fernández-Ruiz, Mario; Mykietiuk, Analía; Manzur, Adriana; Gudiol, Carlota; Pemán, Javier; Viasus, Diego; Ayats, Josefina; Carratalà, Jordi

2013-01-01

Background Statins have immunomodulatory properties and hinder Candida growth. However, it is unknown whether they may improve prognosis in patients with candidemia. We sought to determine the effect of prior statin use on the clinical outcomes of patients suffering candidemia. Methods and Findings Multicenter cohort study of hospitalized adults with candidemia between 2005 and 2011 in six hospitals in Spain, Brazil and Argentina. Of 326 candidemias, 44 (13.5%) occurred in statin users and 282 (86.5%) in statin non-users. The median value of APACHE II at candidemia diagnosis was similar between groups (18 vs. 16; p=.36). Candida albicans was the most commonly isolated species, followed by C. parapsilosis, C. tropicalis, C. glabrata, and C. krusei. There were no differences regarding appropriate empirical antifungal treatment. Statin users had a lower early (5 d) case-fatality rate than non-users (4.5 vs. 17%; p=.031). This effect was not observed with other cardiovascular drugs (aspirin, beta blockers and ACE inhibitors). Independent factor related to early case-fatality rate was APACHE II score (AOR, 1.08; 95% CI, 1.03–1.14; p=.002). An appropriate empirical antifungal therapy (AOR, 0.11; 95% CI, 0.04–0.26; p=<.001) and prior statin use were independently associated with lower early case-fatality (AOR, 0.17; 95% CI, 0.03–0.93; p=.041). Fourteen days (14d) and overall (30d) case-fatality rates were similar between groups (27% vs. 29%; p=0.77 and 40% vs. 44%; p=.66). Conclusions The use of statins might have a beneficial effect on outcomes of patients with candidemia. This hypothesis deserves further evaluation in randomized trials. PMID:24155941

Effects of acarbose on cardiovascular and diabetes outcomes in patients with coronary heart disease and impaired glucose tolerance (ACE): a randomised, double-blind, placebo-controlled trial.

PubMed

Holman, Rury R; Coleman, Ruth L; Chan, Juliana C N; Chiasson, Jean-Louis; Feng, Huimei; Ge, Junbo; Gerstein, Hertzel C; Gray, Richard; Huo, Yong; Lang, Zhihui; McMurray, John J; Rydén, Lars; Schröder, Stefan; Sun, Yihong; Theodorakis, Michael J; Tendera, Michal; Tucker, Lynne; Tuomilehto, Jaakko; Wei, Yidong; Yang, Wenying; Wang, Duolao; Hu, Dayi; Pan, Changyu

2017-11-01

The effect of the α-glucosidase inhibitor acarbose on cardiovascular outcomes in patients with coronary heart disease and impaired glucose tolerance is unknown. We aimed to assess whether acarbose could reduce the frequency of cardiovascular events in Chinese patients with established coronary heart disease and impaired glucose tolerance, and whether the incidence of type 2 diabetes could be reduced. The Acarbose Cardiovascular Evaluation (ACE) trial was a randomised, double-blind, placebo-controlled, phase 4 trial, with patients recruited from 176 hospital outpatient clinics in China. Chinese patients with coronary heart disease and impaired glucose tolerance were randomly assigned (1:1), in blocks by site, by a centralised computer system to receive oral acarbose (50 mg three times a day) or matched placebo, which was added to standardised cardiovascular secondary prevention therapy. All study staff and patients were masked to treatment group allocation. The primary outcome was a five-point composite of cardiovascular death, non-fatal myocardial infarction, non-fatal stroke, hospital admission for unstable angina, and hospital admission for heart failure, analysed in the intention-to-treat population (all participants randomly assigned to treatment who provided written informed consent). The secondary outcomes were a three-point composite outcome (cardiovascular death, non-fatal myocardial infarction, and non-fatal stroke), death from any cause, cardiovascular death, fatal or non-fatal myocardial infarction, fatal or non-fatal stroke, hospital admission for unstable angina, hospital admission for heart failure, development of diabetes, and development of impaired renal function. The safety population comprised all patients who received at least one dose of study medication. This trial is registered with ClinicalTrials.gov, number NCT00829660, and the International Standard Randomised Controlled Trial Number registry, number ISRCTN91899513. Between March 20, 2009, and Oct 23, 2015, 6522 patients were randomly assigned and included in the intention-to-treat population, 3272 assigned to acarbose and 3250 to placebo. Patients were followed up for a median of 5·0 years (IQR 3·4-6·0) in both groups. The primary five-point composite outcome occurred in 470 (14%; 3·33 per 100 person-years) of 3272 acarbose group participants and in 479 (15%; 3·41 per 100 person-years) of 3250 placebo group participants (hazard ratio 0·98; 95% CI 0·86-1·11, p=0·73). No significant differences were seen between treatment groups for the secondary three-point composite outcome, death from any cause, cardiovascular death, fatal or non-fatal myocardial infarction, fatal or non-fatal stroke, hospital admission for unstable angina, hospital admission for heart failure, or impaired renal function. Diabetes developed less frequently in the acarbose group (436 [13%] of 3272; 3·17 per 100 person-years) compared with the placebo group (513 [16%] of 3250; 3·84 per 100 person-years; rate ratio 0·82, 95% CI 0·71-0·94, p=0·005). Gastrointestinal disorders were the most common adverse event associated with drug discontinuation or dose changes (215 [7%] of 3263 patients in the acarbose group vs 150 [5%] of 3241 in the placebo group [p=0·0007]; safety population). Numbers of non-cardiovascular deaths (71 [2%] of 3272 vs 56 [2%] of 3250, p=0·19) and cancer deaths (ten [<1%] of 3272 vs 12 [<1%] of 3250, p=0·08) did not differ between groups. In Chinese patients with coronary heart disease and impaired glucose tolerance, acarbose did not reduce the risk of major adverse cardiovascular events, but did reduce the incidence of diabetes. Bayer AG. Copyright © 2017 Elsevier Ltd. All rights reserved.

The effect of city curfew ordinances on teenage motor vehicle fatalities.

PubMed

Preusser, D F; Zador, P L; Williams, A F

1993-10-01

Of 149 large cities surveyed, 72 were found to have nighttime curfew ordinances applying to teenagers of various ages. The typical city curfew identified starts at midnight, ends at 5 A.M., and affects all activity of teenagers ages 13-17 in a public place and unaccompanied by a parent. In comparisons of 47 cities with curfews covering 13- to 17-year-olds and 77 cities without curfews, curfews were associated with a 23% reduction in fatal injury for 13- to 17-year-olds for the 9 P.M.-5:59 A.M. time period. This is identical to the 23% reduction estimated for both fatal and nonfatal motor vehicle injuries for 13- to 17-year-olds in an earlier, more limited study of curfews in Detroit, Cleveland, and Columbus, Ohio.

Validation of the CALSPAN gross-motion-simulation code with actually occurring injury patterns in aircraft accidents.

PubMed

Ballo, J M; Dunne, M J; McMeekin, R R

1978-01-01

Digital simulation of aircraft-accident kinematics has heretofore been used almost exclusively as a design tool to explore structural load limits, precalculate decelerative forces at various cabin stations, and describe the effect of protective devices in the crash environment. In an effort to determine the value of digital computer simulation of fatal aircraft accidents, a fatality involving an ejection-system failure (out-of-envelope ejection) was modeled, and the injuries actually incurred were compared to those predicted; good agreement was found. The simulation of fatal aircraft accidents is advantageous because of a well-defined endpoint (death), lack of therapeutic intervention, and a static anatomic situation that can be minutely investigated. Such simulation techniques are a useful tool in the study of experimental trauma.

Built environment effects on cyclist injury severity in automobile-involved bicycle crashes.

PubMed

Chen, Peng; Shen, Qing

2016-01-01

This analysis uses a generalized ordered logit model and a generalized additive model to estimate the effects of built environment factors on cyclist injury severity in automobile-involved bicycle crashes, as well as to accommodate possible spatial dependence among crash locations. The sample is drawn from the Seattle Department of Transportation bicycle collision profiles. This study classifies the cyclist injury types as property damage only, possible injury, evident injury, and severe injury or fatality. Our modeling outcomes show that: (1) injury severity is negatively associated with employment density; (2) severe injury or fatality is negatively associated with land use mixture; (3) lower likelihood of injuries is observed for bicyclists wearing reflective clothing; (4) improving street lighting can decrease the likelihood of cyclist injuries; (5) posted speed limit is positively associated with the probability of evident injury and severe injury or fatality; (6) older cyclists appear to be more vulnerable to severe injury or fatality; and (7) cyclists are more likely to be severely injured when large vehicles are involved in crashes. One implication drawn from this study is that cities should increase land use mixture and development density, optimally lower posted speed limits on streets with both bikes and motor vehicles, and improve street lighting to promote bicycle safety. In addition, cyclists should be encouraged to wear reflective clothing. Copyright © 2015 Elsevier Ltd. All rights reserved.

Comparison of enrofloxacin and ceftiofur sodium for the treatment of relapse of undifferentiated fever/bovine respiratory disease in feedlot cattle.

PubMed

Abutarbush, Sameeh M; Schunicht, Oliver C; Wildman, Brian K; Hannon, Sherry J; Jim, G Kee; Ward, Tracy I; Booker, Calvin W

2012-01-01

This commercial field trial compared the efficacy of enrofloxacin and ceftiofur sodium in beef cattle at high risk of developing undifferentiated fever (UF), also known as bovine respiratory disease (BRD) that received tilmicosin at feedlot arrival, were diagnosed and initially treated for UF with tilmicosin, and subsequently required a second UF treatment (first relapse). Feedlot cattle (n = 463) were randomly assigned to 2 experimental groups: ENRO or CEF. Second UF relapse, 3rd UF relapse, overall case fatality and BRD case fatality rates were lower in the ENRO group than in the CEF group (P < 0.05). There were no differences in average daily gain (allocation to re-implant date), chronicity, histophilosis case fatality or miscellaneous case fatality rates between the groups (P ≥ 0.05). A per-animal economic advantage of Can$57.08 was calculated for the ENRO group versus the CEF group. In feedlot cattle in western Canada at high risk of developing UF, it was more cost effective to administer enrofloxacin than ceftiofur sodium for treatment of UF relapse.

Serious injury and fatality investigations involving pneumatic nail guns, 1985-2012.

PubMed

Lowe, Brian D; Albers, James T; Hudock, Stephen D; Krieg, Edward F

2016-02-01

This article examines serious and fatal pneumatic nail gun (PNG) injury investigations for workplace, tool design, and human factors relevant to causation and resulting OS&H authorities' responses in terms of citations and penalties. The U.S. Occupational Safety and Health Administration (OSHA) database of Fatality and Catastrophe Investigation Summaries (F&CIS) were reviewed (1985-2012) to identify n = 258 PNG accidents. 79.8% of investigations, and 100% of fatalities, occurred in the construction industry. Between 53-71% of injuries appear to have been preventable had a safer sequential trigger tool been used. Citations and monetary penalties were related to injury severity, body part injured, disabling of safety devices, and insufficient personal protective equipment (PPE). Differences may exist between construction and other industries in investigators interpretations of PNG injury causation and resulting citations/penalties. Violations of PPE standards were penalized most severely, yet the preventive effect of PPE would likely have been less than that of a safer sequential trigger. Published 2016. This article is a U.S. Government work and is in the public domain in the USA.

Comparison of enrofloxacin and ceftiofur sodium for the treatment of relapse of undifferentiated fever/bovine respiratory disease in feedlot cattle

PubMed Central

Abutarbush, Sameeh M.; Schunicht, Oliver C.; Wildman, Brian K.; Hannon, Sherry J.; Jim, G. Kee; Ward, Tracy I.; Booker, Calvin W.

2012-01-01

This commercial field trial compared the efficacy of enrofloxacin and ceftiofur sodium in beef cattle at high risk of developing undifferentiated fever (UF), also known as bovine respiratory disease (BRD) that received tilmicosin at feedlot arrival, were diagnosed and initially treated for UF with tilmicosin, and subsequently required a second UF treatment (first relapse). Feedlot cattle (n = 463) were randomly assigned to 2 experimental groups: ENRO or CEF. Second UF relapse, 3rd UF relapse, overall case fatality and BRD case fatality rates were lower in the ENRO group than in the CEF group (P < 0.05). There were no differences in average daily gain (allocation to re-implant date), chronicity, histophilosis case fatality or miscellaneous case fatality rates between the groups (P ≥ 0.05). A per-animal economic advantage of Can$57.08 was calculated for the ENRO group versus the CEF group. In feedlot cattle in western Canada at high risk of developing UF, it was more cost effective to administer enrofloxacin than ceftiofur sodium for treatment of UF relapse. PMID:22753964

Estimation of number of fatalities caused by toxic gases due to fire in road tunnels.

PubMed

Qu, Xiaobo; Meng, Qiang; Liu, Zhiyuan

2013-01-01

The quantitative risk assessment (QRA) is one of the explicit requirements under the European Union (EU) Directive (2004/54/EC). As part of this, it is essential to be able to estimate the number of fatalities in different accident scenarios. In this paper, a tangible methodology is developed to estimate the number of fatalities caused by toxic gases due to fire in road tunnels by incorporating traffic flow and the spread of fire in tunnels. First, a deterministic queuing model is proposed to calculate the number of people at risk, by taking into account tunnel geometry, traffic flow patterns, and incident response plans for road tunnels. Second, the Fire Dynamics Simulator (FDS) is used to obtain the temperature and concentrations of CO, CO(2), and O(2). By taking advantage of the additivity of the fractional effective dose (FED) method, fatality rates for different locations in given time periods can be estimated. An illustrative case study is carried out to demonstrate the applicability of the proposed methodology. Copyright © 2012 Elsevier Ltd. All rights reserved.

Road accidents and business cycles in Spain.

PubMed

Rodríguez-López, Jesús; Marrero, Gustavo A; González, Rosa Marina; Leal-Linares, Teresa

2016-11-01

This paper explores the causes behind the downturn in road accidents in Spain across the last decade. Possible causes are grouped into three categories: Institutional factors (a Penalty Point System, PPS, dating from 2006), technological factors (active safety and passive safety of vehicles), and macroeconomic factors (the Great recession starting in 2008, and an increase in fuel prices during the spring of 2008). The PPS has been blessed by incumbent authorities as responsible for the decline of road fatalities in Spain. Using cointegration techniques, the GDP growth rate, the fuel price, the PPS, and technological items embedded in motor vehicles appear to be statistically significantly related with accidents. Importantly, PPS is found to be significant in reducing fatal accidents. However, PPS is not significant for non-fatal accidents. In view of these results, we conclude that road accidents in Spain are very sensitive to the business cycle, and that the PPS influenced the severity (fatality) rather than the quantity of accidents in Spain. Importantly, technological items help explain a sizable fraction in accidents downturn, their effects dating back from the end of the nineties. Copyright © 2016 Elsevier Ltd. All rights reserved.

Urban Sprawl as a Risk Factor in Motor Vehicle Occupant and Pedestrian Fatalities

PubMed Central

Ewing, Reid; Schieber, Richard A.; Zegeer, Charles V.

2003-01-01

Objectives. We sought to determine the association between urban sprawl and traffic fatalities. Methods. We created a sprawl index by applying principal components analysis to data for 448 US counties in the largest 101 metropolitan areas. Regression analysis was used to determine associations between the index and traffic fatalities. Results. For every 1% increase in the index (i.e., more compact, less sprawl), all-mode traffic fatality rates fell by 1.49% (P < .001) and pedestrian fatality rates fell by 1.47% to 3.56%, after adjustment for pedestrian exposure (P < .001). Conclusions. Urban sprawl was directly related to traffic fatalities and pedestrian fatalities. Subsequent studies should investigate relationships at a finer geographic scale and should strive to improve on the measure of exposure used to adjust pedestrian fatality rates. PMID:12948977

Seat Integrated and Conventional Restraints: A Study of Crash Injury/Fatality Rates in Rollovers

PubMed Central

Padmanaban, Jeya; Burnett, Roger A.

2008-01-01

This study used police-reported motor vehicle crash data from eleven states to determine ejection, fatality, and fatal/serious injury risks for belted drivers in vehicles with conventional seatbelts compared to belted drivers in vehicles with seat integrated restraint systems (SIRS). Risks were compared for 11,159 belted drivers involved in single- or multiple-vehicle rollover crashes. Simple driver ejection (partial and complete), fatality, and injury rates were derived, and logistic regression analyses were used to determine relative contribution of factors (including event calendar year, vehicle age, driver age/gender/alcohol use) that significantly influence the likelihood of fatality and fatal/serious injury to belted drivers in rollovers. Results show no statistically significant difference in driver ejection, fatality, or fatal/serious injury rates between vehicles with conventional belts and vehicles with SIRS. PMID:19026243

Relating traffic fatalities to GDP in Europe on the long term.

PubMed

Antoniou, Constantinos; Yannis, George; Papadimitriou, Eleonora; Lassarre, Sylvain

2016-07-01

Modeling road safety development can provide important insight into policies for the reduction of traffic fatalities. In order to achieve this goal, both the quantifiable impact of specific parameters, as well as the underlying trends that cannot always be measured or observed, need to be considered. One of the key relationships in road safety links fatalities with risk and exposure, where exposure reflects the amount of travel, which in turn translates to how much travelers are exposed to risk. In general two economic variables: GDP and unemployment rate are selected to analyse the statistical relationships with some indicators of road accident fatality risk. The objective of this research is to provide an overview of relevant literature on the topic and outline some recent developments in macro-panel data analysis that have resulted in ongoing research that has the potential to improve our ability to forecast traffic fatality trends, especially under turbulent financial situations. For this analysis, time series of the number of fatalities and GDP in 30 European countries for a period of 38 years (1975-2012) are used. This process relies on estimating long-term models (as captured by long term time-series models, which model each country separately). Based on these developments, utilizing state-of-the-art modelling and analysis techniques such as the Common Correlated Effects Mean Group estimator (Pesaran), the long-term elasticity mean value equals 0.63, and is significantly different from zero for 10 countries only. When we take away the countries, where the number of fatalities is stationary, the average elasticity takes a higher value of nearly 1. This shows the strong sensitivity of the estimate of the average elasticity over a panel of European countries and underlines the necessity to be aware of the underlying nature of the time series, to get a suitable regression model. Copyright © 2016 Elsevier Ltd. All rights reserved.

Breast cancer incidence and case fatality among 4.7 million women in relation to social and ethnic background: a population-based cohort study

PubMed Central

2012-01-01

Introduction Incidence of breast cancer is increasing around the world and it is still the leading cause of cancer mortality in low- and middle-income countries. We utilized Swedish nationwide registers to study breast cancer incidence and case fatality to disentangle the effect of socioeconomic position (SEP) and immigration from the trends in native Swedes. Methods A nation-wide cohort of women in Sweden was followed between 1961 and 2007 and incidence rate ratio (IRR) and hazard ratio (HR) with 95% confidence intervals (CIs) were estimated using Poisson and Cox proportional regression models, respectively. Results Incidence continued to increase; however, it remained lower among immigrants (IRR = 0.88, 95% CI = 0.86 to 0.90) but not among immigrants' daughters (IRR = 0.97, 95% CI = 0.94 to 1.01) compared to native Swedes. Case fatality decreased over the last decades and was similar in native Swedes and immigrants. However, case fatality was significantly 14% higher if cancer was diagnosed after age 50 and 20% higher if cancer was diagnosed in the most recent years among immigrants compared with native Swedes. Women with the highest SEP had significantly 20% to 30% higher incidence but had 30% to 40% lower case fatality compared with women with the lowest SEP irrespective of country of birth. Age at immigration and duration of residence significantly modified the incidence and case fatality. Conclusions Disparities found in case fatality among immigrants by age, duration of residence, age at immigration and country of birth emphasize the importance of targeting interventions on women that are not likely to attend screenings or are not likely to adhere to the therapy suggested by physicians. The lower risk of breast cancer among immigrant women calls for more knowledge about how the lifestyle factors in these women differ from those with high risk, so that preventative measures may be implemented. PMID:22225950

Incidence and case-fatality of varicella-zoster virus infection among pediatric cancer patients in developing countries.

PubMed

Ojha, Rohit P; Stallings-Smith, Sericea; Aviles-Robles, Martha J; Gomez, Sergio; Somarriba, María Mercedes; Caniza, Miguela A

2016-04-01

Limited evidence is available about varicella-zoster virus (VZV) infection among pediatric cancer patients in developing countries, which raises questions about the generalizability of VZV vaccine recommendations for pediatric cancer patients (derived from developed countries) to these settings. We assessed the incidence and case-fatality of VZV infection at three institutions in developing countries (Argentina, Mexico, and Nicaragua). Individuals eligible for our study were aged <20 years and actively receiving cancer-directed therapy. We estimated a summary incidence rate (IR) and case-fatality risk with corresponding 95 % confidence limits (CL) of VZV infection across sites using random-effects models. Our study population comprised 511 pediatric cancer patients, of whom 64 % were aged <10 years, 58 % were male, and 58 % were diagnosed with leukemia. We observed a total of 10 infections during 44,401 person-days of follow-up across the 3 sites (IR = 2.3, 95 % CL 1.2, 4.2). The summary case-fatality risk was 10 % (95 % CL 1.4, 47 %) based on one death. Our results suggest low incidence and case-fatality of VZV infections among pediatric cancer patients in three developing countries. VZV vaccine recommendations for pediatric cancer patients in developed countries may be generalizable to developing countries. • Current recommendations, based on evidence from pediatric cancer patients in developed countries, contraindicate varicella-zoster virus (VZV) vaccination until completion of cancer-directed therapy and recovery of immune function. • The generalizability of these VZV vaccine recommendations to pediatric cancer patients in developing countries is unknown because of limited information about the incidence and case-fatality of VZV in these settings. What is New: • Our results suggest low incidence and case-fatality of VZV infections among pediatric cancer patients in three developing countries. • VZV vaccine recommendations based on evidence from pediatric cancer patients in developed countries may be generalizable to pediatric cancer patients in developing countries.

Case-Based Teaching of Fatal Incidents in Outdoor Education Teacher Preparation Courses

ERIC Educational Resources Information Center

North, Chris; Brookes, Andrew

2017-01-01

This article examines the use of case-based approaches to fatal incidents in outdoor education (OE) with a view to fatality prevention. Fatalities are rare in OE and therefore it is nearly impossible for teachers to learn how to avoid fatalities from their own past experiences. It is, however, possible to learn from the mistakes of others through…

US Traffic Fatalities, 1985–2014, and Their Relationship to Medical Marijuana Laws

PubMed Central

Mauro, Christine M.; Wall, Melanie M.; Kim, June H.; Cerdá, Magdalena; Keyes, Katherine M.; Hasin, Deborah S.; Galea, Sandro; Martins, Silvia S.

2017-01-01

Objectives. To determine the association of medical marijuana laws (MMLs) with traffic fatality rates. Methods. Using data from the 1985–2014 Fatality Analysis Reporting System, we examined the association between MMLs and traffic fatalities in multilevel regression models while controlling for contemporaneous secular trends. We examined this association separately for each state enacting MMLs. We also evaluated the association between marijuana dispensaries and traffic fatalities. Results. On average, MML states had lower traffic fatality rates than non-MML states. Medical marijuana laws were associated with immediate reductions in traffic fatalities in those aged 15 to 24 and 25 to 44 years, and with additional yearly gradual reductions in those aged 25 to 44 years. However, state-specific results showed that only 7 states experienced post-MML reductions. Dispensaries were also associated with traffic fatality reductions in those aged 25 to 44 years. Conclusions. Both MMLs and dispensaries were associated with reductions in traffic fatalities, especially among those aged 25 to 44 years. State-specific analysis showed heterogeneity of the MML–traffic fatalities association, suggesting moderation by other local factors. These findings could influence policy decisions on the enactment or repealing of MMLs and how they are implemented. PMID:27997245

Unique fatality due to claw injuries in a tiger attack: a case report.

PubMed

Pathak, Hrishikesh; Dixit, Pradeep; Dhawane, Shailendra; Meshram, Satin; Shrigiriwar, Manish; Dingre, Niraj

2014-11-01

This paper describes a unique case of a fatal tiger attack in the wild. In the present case, a tiger fatally mauled a 34-year-old female with its claws, instead of the usual mechanism of killing by the bite injury to the neck. The autopsy revealed multiple fatal and non-fatal injuries caused by the tiger claws. The characteristic injuries due to the tooth impacts were absent as the teeth of the offending tiger were either fallen or non-functional. To the best of our knowledge, probably this rare case would be the first reported human fatality due to the tiger claw injuries in the world. The purpose of the present article is to highlight the fatal injuries due to the tiger claws, as the claw-induced fatal injuries in a tiger attack are not reported in the medico-legal literature. Moreover, this report would be an illustrative one for differentiation between the fatal injuries due to the claws and tooth impacts in a tiger attack. Furthermore, the present report establishes the importance of the tiger claws as a source of fatal injuries in a tiger attack. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

Fatal and Non-Fatal Overdose After Narcology Hospital Discharge Among Russians Living with HIV/Aids who Inject Drugs‡

PubMed Central

Walley, Alexander Y; Cheng, Debbie M; Quinn, Emily K.; Blokhina, Elena; Gnatienko, Natalia; Chaisson, Christine E.; Krupitsky, Evgeny; Coffin, Philip O; Samet, Jeffrey H

2016-01-01

Objectives Among Russians living with HIV/AIDS who inject drugs, we examined the incidence of fatal and non-fatal overdoses following discharge from a narcology hospital and the associations with more advanced HIV infection. Design Prospective cohort study of data collected at baseline, 3 and 6 months from HIV-infected patients with a history of injection drug use who were not treated with anti-retroviral therapy. Participants were recruited between 2012-14 from a narcology (addiction) hospital in St. Petersburg, Russia. Methods Fatal overdose was determined based on contact reports to study staff in the year after discharge. Non-fatal overdose was self-reported at the 3- and 6-month assessments. The main independent variable for HIV severity was CD4 cell count at the baseline interview (<200 cells/mm3 ≥ 200 cells/mm3). Secondary analyses assessed time since HIV diagnosis and treated with anti-retroviral treatment (ART) prior to enrollment as independent variables. We fit Cox proportional hazards models to assess whether HIV severity is associated with either fatal or non-fatal overdose. Results Among 349 narcology patients, 18 participants died from overdose within one year after discharge (8.7%, 95%CI 3.4-14.2 by Kaplan-Meier); an estimated 51% [95% CI 34-68%] reported at least one non-fatal overdose within 6 months of discharge. HIV severity, time since HIV diagnosis and ever ART were not significantly associated with either fatal or non-fatal overdose events. Conclusion Fatal and non-fatal overdose are common among Russians living with HIV/AIDS who inject drugs after narcology hospital discharge. Overdose prevention interventions are urgently warranted among Russian narcology patients with HIV infection. PMID:27907848

A fatal outcome after unintentional overdosing of rivastigmine patches.

PubMed

Lövborg, Henrik; Jönsson, Anna K; Hägg, Staffan

2012-02-01

Rivastigmine is an acetylcholine esterase inhibitor used in the treatment of dementia. Patches with rivastigmine for transdermal delivery have been used to increase compliance and to reduce side effects. We describe an 87-year old male with dementia treated with multiple rivastigmine patches (Exelon 9,5 mg/24 h) who developed nausea, vomiting and renal failure with disturbed electrolytes resulting in death. The symptoms occurred after six rivastigmine patches had concomitantly been erroneously applied by health care personnel on two consecutive days. The terminal cause of death was considered to be uremia from an acute tubular necrosis that was assessed as a result of dehydration through vomiting. The rivastigmine intoxication was assessed as having caused or contributed to the dehydrated condition. The medication error occurred at least partly due to ambiguous labeling. The clinical signs were not initially recognized as adverse effects of rivastigmine. The presented case is a description of a rivastigmine overdose due to a medication error involving patches. This case indicates the importance of clear and unambiguous instructions to avoid administration errors with patches and to be vigilant to adverse drug reactions for early detection and correction of drug administration errors. In particular, instructions clearly indicating that only one patch should be applied at a time are important.

Molecular Biology, Epidemiology, and Pathogenesis of Progressive Multifocal Leukoencephalopathy, the JC Virus-Induced Demyelinating Disease of the Human Brain

PubMed Central

Ferenczy, Michael W.; Marshall, Leslie J.; Nelson, Christian D. S.; Atwood, Walter J.; Nath, Avindra; Khalili, Kamel

2012-01-01

Summary: Progressive multifocal leukoencephalopathy (PML) is a debilitating and frequently fatal central nervous system (CNS) demyelinating disease caused by JC virus (JCV), for which there is currently no effective treatment. Lytic infection of oligodendrocytes in the brain leads to their eventual destruction and progressive demyelination, resulting in multiple foci of lesions in the white matter of the brain. Before the mid-1980s, PML was a relatively rare disease, reported to occur primarily in those with underlying neoplastic conditions affecting immune function and, more rarely, in allograft recipients receiving immunosuppressive drugs. However, with the onset of the AIDS pandemic, the incidence of PML has increased dramatically. Approximately 3 to 5% of HIV-infected individuals will develop PML, which is classified as an AIDS-defining illness. In addition, the recent advent of humanized monoclonal antibody therapy for the treatment of autoimmune inflammatory diseases such as multiple sclerosis (MS) and Crohn's disease has also led to an increased risk of PML as a side effect of immunotherapy. Thus, the study of JCV and the elucidation of the underlying causes of PML are important and active areas of research that may lead to new insights into immune function and host antiviral defense, as well as to potential new therapies. PMID:22763635

Punica granatum (Pomegranate) activity in health promotion and cancer prevention

PubMed Central

2018-01-01

Cancer has become one of the most fatal diseases in most countries. In spite of the medical care developing, cancer still remains a significant problem. The majority of the cancers are resistant to treatment. Thus, the research for novel, more efficient and less side effect treatment methods continues. Pomegranate contains strong antioxidant activity, with potential health interests. Research concern in pomegranate is increasing because of their anticancer potential due to possess rich in polyphenols. We highlight the pomegranate potential health benefits and mechanism of cancer progression inhibition. Pomegranate has indicated antiproliferative, anti-metastatic and anti-invasive effects on different cancer cell line in vitro, in vivo and clinical trial. The aim of this review is to evaluate functional properties and the medical benifits of pomegranate against various cancer diseases. In addition, pomegranate properties in in vitro and in vivo experimental human and animal clinical trials and its future use are explored. The available data suggest that Punica granatum (pomegranate) might be used in the control and potential therapeutic for some disease conditions and benefits human health status. This review summarizes in vitro, in vivo and clinical trial studies highlighting the pomegranate role in prevent and treatment of breast, prostate, lung, colon, skin and hepatocellular cell cancers. PMID:29441150

Statins for the primary prevention of cardiovascular disease

PubMed Central

Taylor, Fiona; Ward, Kirsten; Moore, Theresa HM; Burke, Margaret; Smith, George Davey; Casas, Juan P; Ebrahim, Shah

2014-01-01

Background Reducing high blood cholesterol, a risk factor for cardiovascular disease (CVD) events in people with and without a past history of coronary heart disease (CHD) is an important goal of pharmacotherapy. Statins are the first-choice agents. Previous reviews of the effects of statins have highlighted their benefits in people with coronary artery disease. The case for primary prevention, however, is less clear. Objectives To assess the effects, both harms and benefits, of statins in people with no history of CVD. Search methods To avoid duplication of effort, we checked reference lists of previous systematic reviews. We searched the Cochrane Central Register of Controlled Trials (Issue 1, 2007), MEDLINE (2001 to March 2007) and EMBASE (2003 to March 2007). There were no language restrictions. Selection criteria Randomised controlled trials of statins with minimum duration of one year and follow-up of six months, in adults with no restrictions on their total low density lipoprotein (LDL) or high density lipoprotein (HDL) cholesterol levels, and where 10% or less had a history of CVD, were included. Data collection and analysis Two authors independently selected studies for inclusion and extracted data. Outcomes included all cause mortality, fatal and non-fatal CHD, CVD and stroke events, combined endpoints (fatal and non-fatal CHD, CVD and stroke events), change in blood total cholesterol concentration, revascularisation, adverse events, quality of life and costs. Relative risk (RR) was calculated for dichotomous data, and for continuous data pooled weighted mean differences (with 95% confidence intervals) were calculated. Main results Fourteen randomised control trials (16 trial arms; 34,272 participants) were included. Eleven trials recruited patients with specific conditions (raised lipids, diabetes, hypertension, microalbuminuria). All-cause mortality was reduced by statins (RR 0.84, 95% CI 0.73 to 0.96) as was combined fatal and non-fatal CVD endpoints (RR 0.70, 95% CI 0.61 to 0.79). Benefits were also seen in the reduction of revascularisation rates (RR 0.66, 95% CI 0.53 to 0.83). Total cholesterol and LDL cholesterol were reduced in all trials but there was evidence of heterogeneity of effects. There was no clear evidence of any significant harm caused by statin prescription or of effects on patient quality of life. Authors’ conclusions Reductions in all-cause mortality, major vascular events and revascularisations were found with no excess of cancers or muscle pain among people without evidence of cardiovascular disease treated with statins. Other potential adverse events were not reported and some trials included people with cardiovascular disease. Only limited evidence showed that primary prevention with statins may be cost effective and improve patient quality of life. Caution should be taken in prescribing statins for primary prevention among people at low cardiovascular risk. PMID:21249663

Characteristics of fatal road crashes involving unlicensed drivers or riders: Implications for countermeasures.

PubMed

Sagberg, Fridulv

2018-08-01

Drivers or riders without a valid license are involved in 10% of fatal road crashes in Norway. This was shown by an analysis of data from all fatal crashes in the period 2005-2014. A literature review shows that unlicensed drivers have a considerably increased crash risk. Such crashes could be prevented by electronic driver authentication, i.e., a technical system for checking that a driver or rider has legal access to a vehicle before driving is permitted. This can be done by requiring the driver/rider to identify themselves with a national identity number and a unique code or biometric information before driving may commence. The vehicle thereafter verifies license availability and vehicle access by communication with a central register. In more than 80% of fatal crashes with unlicensed drivers/riders, speeding and/or drug influence contributed to the crash. This means that a majority of crashes with unlicensed drivers alternatively could be prevented by already available systems, such as alcolock and speed limit dependent speed adapters. These systems will have a wider influence, by preventing crashes also among licensed drivers. Mandatory implementation of alcolock, speed limiter, and electronic driver authentication in all motorized vehicles is estimated to prevent up to 28% of fatal road crashes, depending on effectiveness of the systems. Copyright © 2018 Elsevier Ltd. All rights reserved.

Epidemiology of Drowning in Bangladesh: An Update.

PubMed

Rahman, Aminur; Alonge, Olakunle; Bhuiyan, Al-Amin; Agrawal, Priyanka; Salam, Shumona Sharmin; Talab, Abu; Rahman, Qazi Sadeq-Ur; Hyder, Adnan A

2017-05-05

Over one-quarter of deaths among 1-4 year-olds in Bangladesh were due to drowning in 2003, and the proportion increased to 42% in 2011. This study describes the current burden and risk factors for drowning across all demographics in rural Bangladesh. A household survey was carried out in 51 union parishads of rural Bangladesh between June and November 2013, covering 1.17 million individuals. Information on fatal and nonfatal drowning events was collected by face-to-face interviews using a structured questionnaire. Fatal and non-fatal drowning rates were 15.8/100,000/year and 318.4/100,000/6 months, respectively, for all age groups. The highest rates of fatal (121.5/100,000/year) and non-fatal (3057.7/100,000/6 months) drowning were observed among children 1 to 4 years of age. These children had higher rates of fatal (13 times) and non-fatal drowning (16 times) compared with infants. Males had slightly higher rates of both fatal and non-fatal drowning. Individuals with no education had 3 times higher rates of non-fatal drowning compared with those with high school or higher education. Non-fatal drowning rates increased significantly with decrease in socio-economic status (SES) quintiles, from the highest to the lowest. Drowning is a major public health issue in Bangladesh, and is now a major threat to child survival.

Assessing the impact of Syrian refugees on earthquake fatality estimations in southeast Turkey

NASA Astrophysics Data System (ADS)

Wilson, Bradley; Paradise, Thomas

2018-01-01

The influx of millions of Syrian refugees into Turkey has rapidly changed the population distribution along the Dead Sea Rift and East Anatolian fault zones. In contrast to other countries in the Middle East where refugees are accommodated in camp environments, the majority of displaced individuals in Turkey are integrated into local cities, towns, and villages - placing stress on urban settings and increasing potential exposure to strong earthquake shaking. Yet displaced populations are often unaccounted for in the census-based population models used in earthquake fatality estimations. This study creates a minimally modeled refugee gridded population model and analyzes its impact on semi-empirical fatality estimations across southeast Turkey. Daytime and nighttime fatality estimates were produced for five fault segments at earthquake magnitudes 5.8, 6.4, and 7.0. Baseline fatality estimates calculated from census-based population estimates for the study area varied in scale from tens to thousands of fatalities, with higher death totals in nighttime scenarios. Refugee fatality estimations were analyzed across 500 semi-random building occupancy distributions. Median fatality estimates for refugee populations added non-negligible contributions to earthquake fatalities at four of five fault locations, increasing total fatality estimates by 7-27 %. These findings communicate the necessity of incorporating refugee statistics into earthquake fatality estimations in southeast Turkey and the ongoing importance of placing environmental hazards in their appropriate regional and temporal context.

1990 traffic fatalities : semiannual report

DOT National Transportation Integrated Search

1990-11-01

Author's abstract: This report contains preliminary estimates of traffic fatalities and fatal accidents for the first six months of 1990. Trend data are presented for both the long and short term. The national estimates of fatalities are quite extens...

The effect of passenger load on unstable vehicles in fatal, untripped rollover crashes.

PubMed Central

Whitfield, R A; Jones, I S

1995-01-01

Consumers may be unaware of the risk of rollover crashes posed by passenger loads in vehicles with poor roll stability. This analysis demonstrates that certain sports utility vehicles and small pickup trucks have designs that are so unstable that the weight of the passengers in the vehicle affects its propensity to roll over. This effect occurs even though the weight of the loaded vehicle is less than the manufacturer's gross vehicle weight rating. The risk of a fatal, "untripped" rollover crash in vehicles with low roll stability is increased as each passenger is added to the vehicle load. PMID:7661237

Assessing the effectiveness of minimum legal drinking age and zero tolerance laws in the United States.

PubMed

Voas, Robert B; Tippetts, A Scott; Fell, James C

2003-07-01

The objective of this research was to determine the extent to which the decline in alcohol-related highway deaths among drivers younger than age 21 years can be attributed to raising the minimum legal drinking age (MLDA) and establishing zero tolerance (0.02% blood alcohol concentration (BAC) limit for drivers younger than age 21 years) laws. Data on all drivers younger than age 21 years involved in fatalities in the United States from 1982 to 1997 were used in the study. Quarterly ratios of BAC-positive to BAC-negative drivers in each of the 50 states where analyzed in a pooled cross-sectional time-series analysis. After accounting for differences among the 50 states in various background factors, changes in economic and demographic factors within states over time, and the effects of other related laws, results indicated substantial reductions in alcohol-positive involvement in fatal crashes were associated with the two youth-specific laws. The policy of limiting youth access to alcohol through MLDA laws and reinforcing this action by making it illegal for underage drivers to have any alcohol in their system appears to have been effective in reducing the proportion of fatal crashes involving drinking drivers.

Do industrial incidents in the chemical sector create equity market contagion?

PubMed

Brown, Gavin D; Corbet, Shaen; McMullan, Caroline; Sharma, Ruchira

2015-12-01

This paper examines a number of US chemical industry incidents and their effect on equity prices of the incident company. Furthermore, this paper then examines the contagion effect of this incident on direct competitors. Event study methodology is used to assess the impact of chemical incidents on both incident and competitor companies. This paper finds that the incident company experiences deeper negative abnormal returns as the number of injuries and fatalities as a result of the incident increases. The equity value of the competitor companies suffer substantial losses stemming from contagion effects when disasters that occur cause ten or more injuries and fatalities, but benefit from the incident through increasing equity value when the level of injury and fatality is minor. Presence of contagion suggests collective action may reduce value destruction brought about by safety incidents that result in significant injury or loss of life. This research can be used as a resource to promote and justify the cost of safety mechanisms within the chemical industry, as incidents have been shown to negatively affect the equity value of the not just the incident company, but also their direct competitors. Copyright © 2015 Elsevier Ltd and National Safety Council. All rights reserved.

The PMMA epidemic in Norway: comparison of fatal and non-fatal intoxications.

PubMed

Vevelstad, Merete; Øiestad, Elisabeth Leere; Middelkoop, Gerrit; Hasvold, Inger; Lilleng, Peer; Delaveris, Gerd Jorunn M; Eggen, Tormod; Mørland, Jørg; Arnestad, Marianne

2012-06-10

During a 6 month period (July 2010-January 2011) we observed 12 fatal intoxications and 22 non-fatal cases related to the drug paramethoxymethamphetamine (PMMA) in Norway (4.8 mill inhabitants). This toxic designer drug, also known as "Death", is occasionally found in street drugs offered as "ecstasy" or "amphetamine". The present study aimed to evaluate the cause of death, and to compare the PMMA blood concentrations in fatal and non-fatal cases. Methods for identification and quantification of PMMA are presented. The median age of fatalities was 30 years (range 15-50) with 67% males; in non-fatal cases 27 years (20-47) with 86% males. In the 12 fatalities, the median PMMA blood concentration was 1.92 mg/L (range 0.17-3.30), which is in the reported lethal range of 0.6-3.1 mg/L in peripheral blood and 1.2-15.8 mg/L in heart blood. In the 22 non-fatal cases, the median PMMA concentration was 0.07 mg/L (range 0.01-0.65). Poly-drug use was frequent both in fatal and non-fatal cases. The PMA concentrations ranging from 0.00 to 0.26 mg/L in both groups likely represented a PMMA metabolite. Three fatalities were attributed to PMMA only, six to PMMA and other psychostimulant drugs, and three to PMMA and CNS depressant drugs, with median PMMA concentrations of 3.05 mg/L (range 1.58-3.30), 2.56 (1.52-3.23) and 0.52 mg/L (0.17-1.24), respectively. Eight victims were found dead, while death was witnessed in four cases, with symptoms of acute respiratory distress, hyperthermia, cardiac arrest, convulsions, sudden collapse and/or multiple organ failure. In summary, all fatalities attributed to PMMA had high PMMA blood concentrations compared to non-fatal cases. Our sample size was too small to evaluate a possible impact of poly-drug use. A public warning is warranted against use and overdose with illegal "ecstasy" or "speed" drugs. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

Blockade of phosphodiesterase 4 reverses morphine-induced ventilatory disturbance without loss of analgesia.

PubMed

Kimura, Satoko; Ohi, Yoshiaki; Haji, Akira

2015-04-15

Ventilatory disturbance is a fatal side-effect of opioid analgesics. Separation of analgesia from ventilatory depression is important for therapeutic use of opioids. It has been suggested that opioid-induced ventilatory depression results from a decrease in adenosine 3',5'-cyclic monophosphate content in the respiratory-related neurons. Therefore, we examined the effects of caffeine, a methylxanthine non-selective phosphodiesterase (PDE) inhibitor with adenosine antagonistic activity, and rolipram, a racetam selective PDE4 inhibitor, on ventilatory depression induced by morphine. Spontaneous ventilation and paw withdrawal responses to nociceptive thermal stimulation were measured in anesthetized rats simultaneously. The efferent discharge of the phrenic nerve was recorded in anesthetized, vagotomized, paralyzed and artificially ventilated rats. Rolipram (0.1 and 0.3 mg/kg, i.v.) and caffeine (3.0 and 10.0 mg/kg, i.v.) relieved morphine (1.0 mg/kg, i.v.)-induced ventilatory depression but had no discernible effect on its analgesic action. Rolipram (0.3 and 1.0 mg/kg, i.v.) and caffeine (10.0 and 20.0 mg/kg, i.v.) recovered morphine (3.0 mg/kg, i.v.)-induced prolongation and flattening of inspiratory discharge in the phrenic nerve. Inhibition of PDE4 may be a possible approach for overcoming morphine-induced ventilatory depression without loss of analgesia. Copyright © 2015 Elsevier Inc. All rights reserved.

Association of Graduated Driver Licensing With Driver, Non-Driver, and Total Fatalities Among Adolescents.

PubMed

Zhu, Motao; Zhao, Songzhu; Long, D Leann; Curry, Allison E

2016-07-01

Graduated driver licensing systems typically require an extended learner permit phase, and create night-time driving or passenger restrictions for adolescent drivers. Restricted driving might increase the use of alternative transportation to replace driving and consequently increase crashes and injuries for passengers, bus riders, pedestrians, and bicyclists. This study examined whether graduated driver licensing increases non-driver fatalities among adolescents, and whether it reduces total traffic fatalities combining drivers and non-drivers. Longitudinal analyses were conducted using data from the 1995-2012 U.S. Fatality Analysis Reporting System. Adjusted rate ratios were estimated for being fatally injured in a crash according to: (1) presence/absence of a graduated driver licensing system; and (2) four levels of graduated driver licensing systems (absent, weak, medium, strong). Analyses were conducted in 2015. Among adolescents aged 16 years, graduated driver licensing was not associated with increased passenger fatalities (adjusted rate ratio, 0.96; 95% CI=0.90, 1.03) or pedestrian and bicyclist fatalities (adjusted rate ratio, 1.09; 95% CI=0.85, 1.39), but was associated with an 11% reduction in total traffic fatalities. Among those aged 17 years, graduated driver licensing was not associated with increased fatalities as passengers, pedestrians, or bicyclists, and was not associated with reduced total traffic fatalities. In general, graduated driver licensing systems were not associated with increased fatalities as passengers, pedestrians, bicyclists, and bus riders. Graduated driver licensing systems were associated with reduced total fatalities of adolescents aged 16 years. Copyright © 2016 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.

Neglecting safety precautions may lead to trenching fatalities.

PubMed

Deatherage, J Harold; Furches, Lisa K; Radcliffe, Mike; Schriver, William R; Wagner, John P

2004-06-01

Trench collapses ranked as the seventh leading cause of the possible twenty-nine causes of OSHA-inspected fatal construction events during the period 1991-2001. This study aims to examine why these fatalities occurred. Forty-four case files from OSHA inspections of fatal trench collapses were reviewed. Improper protection of the excavation site where work was taking place was the leading fatality cause. Several organizational or physical conditions were present at many fatal sites; the most frequent was that no training had been provided for trenching. Presence of a competent, diligent person at the site would have prohibited most fatalities. The top cited violation was lack of protection, that is, benching, shoring, sloping, trench boxes, etc. (29 CFR 1926.652 (a) (1)). Copyright 2004 Wiley-Liss, Inc.

Analysis of Ejection in Fatal Crashes

DOT National Transportation Integrated Search

1997-11-01

Data from NHTSA's Fatality Analysis Reporting System (FARS) show that the : ejection rate among fatally injured passenger vehicle occupants has remained at : over 20 percent since the early 1980's. Because the risk of fatality in a crash : is over th...

Traffic safety facts 1999 : state traffic data

DOT National Transportation Integrated Search

2000-01-01

This traffic safety fact sheet presents state traffic data in a figure showing 1999 Traffic Fatalities by State and Percent Change from 1998 and in 11 tables showing: (1) Traffic Fatalities and Fatality Rates, 1999; (2) Traffic Fatalities and Percent...

Traffic safety facts 1998 : state traffic data

DOT National Transportation Integrated Search

1999-01-01

This publication contains a map of the United States showing 1998 traffic fatalities by state and percent change from 1997 and eleven tables containing data on the following: (1) Traffic fatalities and fatality rates, 1998; (2) Traffic fatalities and...

Fatal car fires from rear-end crashes: the effects of fuel tank placement before and after regulation.

PubMed Central

Robertson, L S

1993-01-01

A federal standard for fuel tank integrity in cars was applied to 1977 and subsequent models. National data indicate that fatalities per 10,000 occupants in rear-end crashes of small cars, where fire was the most harmful event, were reduced by approximately 57% if the fuel tank was located behind the rear axle and 77% if the tank was situated directly above or in front of the rear axle. PMID:8342730

Year-round monitoring reveals prevalence of fatal bird-window collisions at the Virginia Tech Corporate Research Center

PubMed Central

Barton, Christine M.; Zirkle, Keith W.; Greene, Caitlin F.; Newman, Kara B.

2018-01-01

Collisions with glass are a serious threat to avian life and are estimated to kill hundreds of millions of birds per year in the United States. We monitored 22 buildings at the Virginia Tech Corporate Research Center (VTCRC) in Blacksburg, Virginia, for collision fatalities from October 2013 through May 2015 and explored possible effects exerted by glass area and surrounding land cover on avian mortality. We documented 240 individuals representing 55 identifiable species that died due to collisions with windows at the VTCRC. The relative risk of fatal collisions at all buildings over the study period were estimated using a Bayesian hierarchical zero-inflated Poisson model adjusting for percentage of tree and lawn cover within 50 m of buildings, as well as for glass area. We found significant relationships between fatalities and surrounding lawn area (relative risk: 0.96, 95% credible interval: 0.93, 0.98) as well as glass area on buildings (RR: 1.30, 95% CI [1.05–1.65]). The model also found a moderately significant relationship between fatal collisions and the percent land cover of ornamental trees surrounding buildings (RR = 1.02, 95% CI [1.00–1.05]). Every building surveyed had at least one recorded collision death. Our findings indicate that birds collide with VTCRC windows during the summer breeding season in addition to spring and fall migration. The Ruby-throated Hummingbird (Archilochus colubris) was the most common window collision species and accounted for 10% of deaths. Though research has identified various correlates with fatal bird-window collisions, such studies rarely culminate in mitigation. We hope our study brings attention, and ultimately action, to address this significant threat to birds at the VTCRC and elsewhere. PMID:29637021

Impact of earthquake source complexity and land elevation data resolution on tsunami hazard assessment and fatality estimation

NASA Astrophysics Data System (ADS)

Muhammad, Ario; Goda, Katsuichiro

2018-03-01

This study investigates the impact of model complexity in source characterization and digital elevation model (DEM) resolution on the accuracy of tsunami hazard assessment and fatality estimation through a case study in Padang, Indonesia. Two types of earthquake source models, i.e. complex and uniform slip models, are adopted by considering three resolutions of DEMs, i.e. 150 m, 50 m, and 10 m. For each of the three grid resolutions, 300 complex source models are generated using new statistical prediction models of earthquake source parameters developed from extensive finite-fault models of past subduction earthquakes, whilst 100 uniform slip models are constructed with variable fault geometry without slip heterogeneity. The results highlight that significant changes to tsunami hazard and fatality estimates are observed with regard to earthquake source complexity and grid resolution. Coarse resolution (i.e. 150 m) leads to inaccurate tsunami hazard prediction and fatality estimation, whilst 50-m and 10-m resolutions produce similar results. However, velocity and momentum flux are sensitive to the grid resolution and hence, at least 10-m grid resolution needs to be implemented when considering flow-based parameters for tsunami hazard and risk assessments. In addition, the results indicate that the tsunami hazard parameters and fatality number are more sensitive to the complexity of earthquake source characterization than the grid resolution. Thus, the uniform models are not recommended for probabilistic tsunami hazard and risk assessments. Finally, the findings confirm that uncertainties of tsunami hazard level and fatality in terms of depth, velocity and momentum flux can be captured and visualized through the complex source modeling approach. From tsunami risk management perspectives, this indeed creates big data, which are useful for making effective and robust decisions.

Global trend according to estimated number of occupational accidents and fatal work-related diseases at region and country level.

PubMed

Hämäläinen, Päivi; Leena Saarela, Kaija; Takala, Jukka

2009-01-01

Although occupational accidents and work-related diseases have been of interest for a long time, due to lack of proper recording and notification systems the official numbers of occupational accidents and work-related diseases are missing for many countries. Presently, the demand for effectiveness and an interest in the economic aspects of accidents have increased prevention activities at company and country levels. Occupational accident data of selected countries and of World Health Organization regional divisions together with the global burden of disease were used in estimating global occupational accidents and fatal work-related diseases. The trend of global occupational accidents and work-related diseases is presented at region and country levels. The years 1998, 2001, and 2003 are compared in the case of occupational accidents and the years 2000 and 2002 in the case of work-related diseases. The total number of occupational accidents and fatal work-related diseases has increased, but the fatality rates per 100,000 workers have decreased. There were almost 360,000 fatal occupational accidents in 2003 and almost 2 million fatal work-related diseases in 2002. Every day more than 960,000 workers get hurt because of accidents. Each day 5,330 people die because of work-related diseases. Information on occupational accidents and work-related diseases is needed so that countries may understand better the importance of occupational health and safety at country and company level. Especially companies in developing countries are not familiar with occupational safety and health. Statistical data is essential for accident prevention; it is a starting point for the safety work.

Diminished Disease-Free Survival After Lobectomy: Screening Implications.

PubMed

Reich, Jerome M; Kim, Jong S; Asaph, James W

2015-09-01

The aim of this study was to estimate the effect of lobectomy on life expectancy in healthy smokers and consider the implications for lung cancer screening. In a retrospective cohort study that provided a minimum of 15 years of follow-up, we analyzed lung cancer survival, all-cause survival, and fatality (1-survival) of 261 persons with stage I non-small-cell lung cancer who underwent lobectomy at Portland Providence Medical Center between 1978 and 1994. We: (1) compared 5-year disease-free fatality (non-lung-cancer fatality) with lung cancer fatality; and (2) based on actuarial data that demonstrated life expectancy equivalence of the healthiest smokers (whom we assumed would be comparable with subjects judged eligible for lobectomy) in the US population, we compared their long-term, disease-free survival (our primary end point) with actuarial expectations by computing the Kaplan-Meier survival function of the differences between lifetimes since surgery in disease-free persons versus matched, expected remaining lifetimes in the US population. (1) Five-year disease-free fatality (16.1%) was 58% as high as 5-year lung cancer fatality (27.6%); (2) disease-free survival was reduced by 6.9-years (95% confidence interval, 5.5-8.3), 41% of actuarial life expectancy (17 years). The divergence from expected survival took place largely after 6 years of follow-up. Lobectomy materially diminishes long-term disease-free survival in the healthiest smokers--persons judged healthy enough to tolerate major surgery and to have sufficient pulmonary reserve to sustain loss of one-fifth of their lung tissue. In screened populations, diminished survival in overdiagnosed persons will offset, to an undetermined extent, the mortality benefit imparted by preemption of advanced lung cancer. Copyright © 2015 Elsevier Inc. All rights reserved.

Occupational fatalities in Jordan.

PubMed

Al-Abdallat, Emad M; Oqailan, Ahmad Mohammad A; Al Ali, Rayyan; Hudaib, Arwa A; Salameh, Ghada A M

2015-01-01

Occupational fatalities are a worldwide problem. Certain occupations pose a greater risk than others. Recent statistics on global occupational injuries and diseases that might lead to temporary or permanent disability and even worse might lead to death, are staggering. The purpose of this study was to estimate the death rates from occupational injuries in Jordan over a period of four years; to estimate occupational fatality rate that results from accidental injuries and identify the most risky concurrent occupations with the type of injuries, the age and nationality of the victims. A total of 88 work related fatalities were admitted to three hospitals in Amman through 2008-2012 and were examined by a forensic (occupational) physician at the time. They were categorized according to, age, nationality, occupation, type of injury and were all tested for toxic substances. The occupation with the most fatalities was construction (44%); falling from a height was the commonest type of accident (44%) and head injuries were the leading injury type (21.6%); 9.1% of the deaths were positive for alcohol. Moreover, 22.7% of deaths were between ages of 25-29. Consequently, the mean occupational fatality rate was 2 per 100.000 workers during 2008-2012. Constructions and other types of occupations are more extensive problems than what is usually anticipated, especially when safety precautions are not effective or implemented. They may cause injuries and death, which will have a socioeconomic burden on families, society, governments and industries. Not to mention the grief that is associated with the death of a worker at his work site to all concerned parties. Copyright © 2014 Elsevier Ltd and Faculty of Forensic and Legal Medicine. All rights reserved.