Impact of 4-to-3 Lane Conversions on Emergency Response.

4-to-3 lane conversions, often called road diets, have been implemented throughout the U.S. as a means to reduce crashes.

Traumatic head injuries in Moldova: a cross-sectional analysis of medical registry data.

The aims of this study were to evaluate the demographics and crash profiles of road traffic-related traumatic brain injury (TBI) patients treated at two emergency departments in the Republic of Moldova, and to identify areas for prevention.

Informing traffic enforcement leniency and discretion: Crash culpability and the effectiveness of written warnings versus citations.

Objectives: Deterrence of risky driving behavior is important for the prevention of crashes and injuries. Traffic law enforcement is a key strategy used to decrease risky driving, but there is little evidence on the deterrent effect of issuing warnings versus citations to drivers regarding the prevention of future crashes. The purpose of this study was to 1) investigate the difference between citations and written warnings in their association with future crash culpability and 2) investigate whether drivers who were issued written warnings or citations have different associations with future crash culpability likelihood than those without prior citations or written warnings.

Direct medical charges of all parties in teen-involved vehicle crashes by culpability.

Background: Motor vehicle crashes among teen drivers often involve passengers in the teen's vehicle and occupants of other vehicles, and the full cost burden for all individuals is largely unknown. This analysis estimated direct hospitalisation and emergency department charges for teen-involved crashes by teen culpability, comparing charges for the teen driver, passengers and occupants of other vehicles.

Methods: Probabilistic linkage was performed to link the Iowa police crash reports with Iowa emergency department and Iowa hospital inpatient data.

Should we throw the book at 'em? Charge combinations and conviction rates among alcohol-influenced drivers involved in motorcycle crashes.

Introduction: Motorcycle fatality rates are increasing, and impaired driving is a major contributing factor. Impaired driving laws are a main component of state efforts to reduce drunk driving, but motorcycle crash charge and conviction outcomes have yet to be studied. The purpose of this study was to evaluate driver charge and conviction outcomes following alcohol-related motorcycle crashes.

Community engagement in the development and implementation of a rural road safety campaign: Steps and lessons learned.

Introduction: Rural crashes result in fatality rates twice as high as urban, after accounting for vehicle miles traveled, and those involving farm vehicles tend to be the most severe. Farm vehicle crash interventions have focused on the farm equipment (e.g.

Association between driver and child passenger restraint: Analysis of community-based observational survey data from 2005 to 2019.

Introduction: Crash data suggest an association between driver seatbelt use and child passenger restraint. However, community-based restraint use is largely unknown. We examined the association between driver seatbelt use and child restraint using data from a state-wide observational study.

Trends in pediatric passenger restraint use by rurality and age in Iowa, 2006-2019.

Objective: Pediatric restraint use has increased over time in the United States, but motor vehicle crashes remain a leading cause of death for children under age 18. Age-appropriate use of safety restraints (safety seats, booster seats, seat belt) and statewide child restraint laws can greatly reduce injury or death in the event of a crash. Surveillance of pediatric restraint use and compliance with policy can inform prevention efforts.

Association of traumatic brain injury severity and time to definitive care in three low-middle-income European countries.

Background: Low-middle-income countries experience among the highest rates of traumatic brain injury in the world. Much of this burden may be preventable with faster intervention, including reducing the time to definitive care. This study examines the relationship between traumatic brain injury severity and time to definitive care in major trauma hospitals in three low-middle-income countries.

The Associations Between Older Driver Licensure Laws with Travel and Passenger Behaviors Among Adults Aged 65 Years or Older (United States, 2003-2017).

Introduction: The aging population has been rapidly growing in the United States (U.S.).

Inventory of child bicycle education programs reveals need for age, development, and skill-level considerations.

There are a plethora of child bicycle safety education programs worldwide. However, the content and durations vary widely from program to program and no gold standard has been established. The main objective of this project was to create an inventory of youth bicycle safety education programs and their content, approaches, and age and developmental considerations.

Parent-adolescent bicycling safety communication and bicycling behavior.

Introduction: Efforts to encourage bicycling to school have increased in the United States. However, little is known about how parent-child communication affects bicycle safety. The purpose of this study was to examine parent-child agreement on biking instructions and their correlation with the early adolescents' real-world riding behavior.

A randomized trial to test the impact of parent communication on improving in-vehicle feedback systems.

This randomized controlled trial evaluated the impact of integrating Steering Teens Safe, a parent communication intervention, with feedback from an in-vehicle video recording system. In-vehicle video systems that trigger a recording when the vehicle exceeds a g-force threshold have been used to provide feedback to young drivers. Few of these programs have involved parental engagement.

Examination of adult and child bicyclist safety-relevant events using naturalistic bicycling methodology.

Among roadway users, bicyclists are considered vulnerable due to their high risk for injury when involved in a crash. Little is known about the circumstances leading to near crashes, crashes, and related injuries or how these vary by age and gender. The purpose of this study was to examine the rates and characteristics of safety-relevant events (crashes, near crashes, errors, and traffic violations) among adult and child bicyclists.

Beyond GPS: Improved study of bicycling exposure through added use of video data.

Bicycling has become increasingly popular in the United States in recent years for both recreation and utilitarian purposes. Yet, attributes of the bicycle riding experience and riding differences between adults and children and males and females are not well documented. Most existing data on bicycling trip characteristics are based on self-reported interviews or surveys, which are prone to recall bias.

Disaster Preparedness in Rural Families of Children With Special Health Care Needs.

Objective: The purpose of this study was to describe disaster preparedness strategies and behaviors among rural families who have children with special health care needs and to examine the effect of self-efficacy and response-efficacy on disaster preparedness.

Methods: Data for this study were drawn from the baseline surveys of 287 rural families with children with special health care needs who were part of a randomized controlled trial examining the impact of an intervention on disaster preparedness. Distributions of child, parent, and family characteristics were examined by preparedness.

Effectiveness of Parent-Focused Interventions to Increase Teen Driver Safety: A Critical Review.

Purpose: We critically reviewed recent parent-directed teen driving interventions to summarize their success in meeting stated goals; identify promising intervention components and knowledge gaps; aid in the selection, adaptation, and dissemination of effective interventions; and guide future research efforts.

Methods: We focused on interventions that included a direct parent component, explicitly stated outcomes related to the teen and/or their parents, were evaluated for parent or teen outcomes, targeted drivers younger than the age of 21 years, and had at least one evaluation study published since 1990 and in English. We conducted a comprehensive systematic search of 26 online databases between November 2013 and January 2014 and identified 34 articles representing 18 interventions.

Parent and teen agreement on driving expectations prior to teen licensure.

Objectives: To examine pre-licensure agreement on driving expectations and predictors of teen driving expectations among parent-teen dyads.

Methods: Cross-sectional survey of 163 parent-teen dyads. Descriptive statistics, weighted Kappa coefficients, and linear regression were used to examine expectations about post-licensure teen driving.

Simulation training in central venous catheter insertion: improved performance in clinical practice.

Purpose: To determine whether simulation training of ultrasound (US)-guided central venous catheter (CVC) insertion skills on a partial task trainer improves cannulation and insertion success rates in clinical practice.

Method: This prospective, randomized, controlled, single-blind study of first- and second-year residents occurred at a tertiary care teaching hospital from January 2007 to September 2008. The intervention group (n = 90) received a didactic and hands-on, competency-based simulation training course in US-guided CVC insertion, whereas the control group (n = 95) received training through a traditional, bedside apprenticeship model.

The development of an independent rater system to assess residents' competence in invasive procedures.

Purpose: To design an independent rater (IR) direct observation system to monitor invasive procedures performed by residents in the hospital setting.

Method: The authors recruited, trained, and tested nonphysicians to become IRs for an Agency for Healthcare Research and Quality-funded study evaluating the impact of partial task simulation training of ultrasound-guided central venous catheter (CVC) insertion on skills transfer at a major academic medical center. IR applicants completed four hours of training: a two-hour didactic session and a two-hour testing session, including observation of 5 of 10 choreographed CVC insertion videotapes and completion of a 50-data-point procedural checklist.

Teaching and assessing procedural skills using simulation: metrics and methodology.

Simulation allows educators to develop learner-focused training and outcomes-based assessments. However, the effectiveness and validity of simulation-based training in emergency medicine (EM) requires further investigation. Teaching and testing technical skills require methods and assessment instruments that are somewhat different than those used for cognitive or team skills.

Knowledge translation at the macro level: legal and ethical considerations.

Macro-level legal and ethical issues play a significant role in the successful translation of knowledge into practice. The medicolegal milieu, in particular, can promote clinical inertia and stifle innovation. Embracing new clinical practice guidelines and best practice models has not protected physicians from superfluous torts; in some cases, emerging evidence has been used as the dagger of trial lawyers rather than the scalpel of physicians.