Correlating Geographic Location with Incidence of Motor Vehicle–Induced Pedestrian Injury

2018 ◽  
Vol 84 (6) ◽  
pp. 1049-1053 ◽  
Author(s):  
Neal Bhutiani ◽  
Keith R. Miller ◽  
Matthew V. Benns ◽  
Nicholas A. Nash ◽  
Glen A. Franklin ◽  
...  
Keyword(s):  
Household Income ◽  
Motor Vehicle ◽  
Motor Vehicle Accident ◽  
Multivariable Analysis ◽  
Geographic Location ◽  
Motor Vehicles ◽  
Median Household Income ◽  
Risk Of Death ◽  
Pedestrian Injury ◽  
The Impact

To date, no studies have examined the relationship between geographic and socioeconomic factors and the frequency of pedestrians sustaining traumatic injuries from a motor vehicle. The objective of this study was to analyze the impact of location on the frequency of pedestrian injury by motor vehicle. The University of Louisville Trauma Registry was queried for patients who had been struck by a motor vehicle from 2010 to 2015. Demographic and injury information as well as outcome measures were evaluated to identify those impacting risk of pedestrian versus motor vehicle accidents. Number of incidents was correlated with lower median household income. There was also a moderate correlation between the number of incidents and population density. Multivariable analysis demonstrated a significant association between increased median household income and distance from downtown Louisville and decreased risk of death following pedestrian versus motor vehicle accident. Incidence of pedestrian injury by motor vehicles is influenced by regional socioeconomic status. Efforts to decrease the frequency of these events should include further investigation into the mechanisms underpinning this relationship.

Correlating Geographic Location with Incidence of Motor Vehicle–Induced Pedestrian Injury

2018 ◽  
Vol 84 (8) ◽  
pp. 1376-1379
Author(s):  
Neal Bhutiani ◽  
Keith R. Miller ◽  
Matthew V. Benns ◽  
Nicholas A. Nash ◽  
Glen A. Franklin ◽  
...  
Keyword(s):  
Household Income ◽  
Motor Vehicle ◽  
Motor Vehicle Accident ◽  
Multivariable Analysis ◽  
Geographic Location ◽  
Motor Vehicles ◽  
Median Household Income ◽  
Risk Of Death ◽  
Pedestrian Injury ◽  
The Impact

To date, no studies have examined the relationship between geographic and socioeconomic factors and the frequency of pedestrians sustaining traumatic injuries from a motor vehicle. The objective of this study was to analyze the impact of location on the frequency of pedestrian injury by motor vehicle. The University of Louisville Trauma Registry was queried for patients who had been struck by a motor vehicle from 2010 to 2015. Demographic and injury information as well as outcome measures were evaluated to identify those impacting risk of pedestrian versus motor vehicle accidents. Number of incidents was correlated with lower median household income. There was also a moderate correlation between number of incidents and population density. Multivariable analysis demonstrated a significant association between increased median household income and distance from downtown Louisville and decreased risk of death after pedestrian versus motor vehicle accident. Incidence of pedestrian injury by motor vehicles is influenced by regional socioeconomic status. Efforts to decrease the frequency of these events should include further investigation into the mechanisms underpinning this relationship.

Risk Factors and Outcomes From All-Terrain Vehicle Injuries Compared With Motor Vehicle Collisions in Children

2019 ◽  
Vol 58 (11-12) ◽  
pp. 1255-1261
Author(s):  
Sriram Ramgopal ◽  
Natan Cramer ◽  
Barbara A. Gaines ◽  
Kavitha A. Conti
Keyword(s):  
Risk Factors ◽  
Household Income ◽  
Motor Vehicle ◽  
Multivariable Analysis ◽  
Risk Groups ◽  
Median Household Income ◽  
Motor Vehicle Collisions ◽  
Vehicle Collisions ◽  
Targeted Interventions ◽  
Extremity Injuries

We compared risk factors and outcomes of children injured from all-terrain vehicle (ATV) injuries to those injured from motor vehicle collisions (MVC). We reviewed records of patients ≤18 years of age admitted to a trauma center with ATV- or MVC-related injuries between January 1, 2000, and December 31, 2015. Demographics were compared using logistic regression. Rates of injuries were compared using χ2 tests. Of 6293 patients, 1140 (18%) ATV and 5153 (82%) MVC events were identified. In multivariable analysis (adjusted odds ratio [aOR], 95% confidence interval [CI]), patients with ATV-related injuries occurred more at older age (≥12 years; aOR = 4.29, 95% CI = 3.20-5.77), in rural counties (aOR = 3.72, 95% CI = 2.62-5.28), in regions with lower median household income (aOR = 1.37, 95% CI = 1.03-1.83), and in the spring (aOR = 2.44, 95% CI = 1.87-3.18), and summer (aOR = 2.50, 95% CI = 1.93-3.25) compared with winter. ATV-related injuries occurred less frequently among females (aOR = 0.76, 95% CI = 0.65-0.89). Upper extremity injuries were associated with ATV-related injuries ( P ≤ .001). Findings may facilitate identification of at-risk groups for targeted interventions.

scholarly journals 910. A Comprehensive, One Year, Hospital-Wide Snapshot of All Serious Infectious Complications in People Who Inject Drugs

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S489-S490
Author(s):  
John T Henderson ◽  
Evelyn Villacorta Cari ◽  
Nicole Leedy ◽  
Alice Thornton ◽  
Donna R Burgess ◽  
...  
Keyword(s):  
Multivariable Analysis ◽  
Vertebral Osteomyelitis ◽  
The United States ◽  
Infectious Complications ◽  
Data Set ◽  
Cumulative Impact ◽  
Mortality And Morbidity ◽  
Icu Admission ◽  
Risk Of Death ◽  
The Impact

Abstract Background There has been a dramatic rise in IV drug use (IVDU) and its associated mortality and morbidity, however, the scope of this effect has not been described. Kentucky is at the epicenter of this epidemic and is an ideal place to better understand the health complications of IVDU in order to improve outcomes. Methods All adult in-patient admissions to University of Kentucky hospitals in 2018 with an Infectious Diseases (ID) consult and an ICD 9/10 code associated with IVDU underwent thorough retrospective chart review. Demographic, descriptive, and outcome data were collected and analyzed by standard statistical analysis. Results 390 patients (467 visits) met study criteria. The top illicit substances used were methamphetamine (37.2%), heroin (38.2%), and cocaine (10.3%). While only 4.1% of tested patients were HIV+, 74.2% were HCV antibody positive. Endocarditis (41.1%), vertebral osteomyelitis (20.8%), bacteremia without endocarditis (14.1%), abscess (12.4%), and septic arthritis (10.4%) were the most common infectious complications. The in-patient death rate was 3.0%, and 32.2% of patients were readmitted within the study period. The average length of stay was 26 days. In multivariable analysis, infectious endocarditis was associated with a statistically significant increase in risk of death, ICU admission, and hospital readmission. Although not statistically significant, trends toward mortality and ICU admission were identified for patients with prior endocarditis and methadone was correlated with decreased risk of readmission and ICU stay. FIGURE 1: Reported Substances Used FIGURE 2: Comorbidities FIGURE 3: Types of Severe Infectious Complications Conclusion We report on a novel, comprehensive perspective on the serious infectious complications of IVDU in an attempt to measure its cumulative impact in an unbiased way. This preliminary analysis of a much larger dataset (2008-2019) reveals some sobering statistics about the impact of IVDU in the United States. While it confirms the well accepted mortality and morbidity associated with infective endocarditis and bacteremia, there is a significant unrecognized impact of other infectious etiologies. Additional analysis of this data set will be aimed at identifying key predictive factors in poor outcomes in hopes of mitigating them. Disclosures All Authors: No reported disclosures

scholarly journals CINP 2005 Regional Meeting, 20-22 April 2005

2005 ◽  
Vol 11 (1) ◽  
pp. 10
Author(s):  
Anissa Abi-Dargham ◽  
Christer Allgulander ◽  
O Gureje ◽  
Rachel Jenkins ◽  
R N Kalaria ◽  
...  
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Mental Health Care ◽  
Motor Vehicle ◽  
Motor Vehicle Accident ◽  
Mental Health Policy ◽  
Traumatic Experiences ◽  
Focus Group Study ◽  
African Context ◽  
The Impact

List of abstract titles and authors:1. Antipsychotics across the spectrum: An overview of their mechanisms of actionAnissa Abi-Dargham2. Recent advances in the treatment of common anxiety disordersChrister Allgulander3. Psychiatry in Africa: The myths, the realities and the exoticO Gureje4. Mental Health policy developmet in Kenya and Tanznia - A DFID funded projectRachel Jenkins, David Kima, Joseph Mbatia, Frank Njenga5. Vascular factors in Alzheimer's diseaseR N Kalaria6. Depression as an immunologically based Neurodegenerative disorderBrian Leonard7. Eight years of progress in Arican PsychiatryF Njenga8. Treatment of Depression: Present and futureDr R.M. Pinder9. Imaging the Serotinergic system in impulsive aggressive personality disorder patientsLarry J Siever, Antonia S. New, Mari Goodman, Monte Buchsbaum, Erin Hazlett, Karen O'Flynn, Anissa Abi-argham, Marc Lauelle10. Mode of action of Atypical antipsychotic rugs: Focus on A2 AdrnoceptorsT.H. SvenssonNeuroscience: Selected Abstracts11. Chemical odulato of Fronto-execuitive functions: Neropsychiatric implicationsTrevor W Robbins12. Neural mechanisms of recognition memory and of social atacntProf. G Horn13. Estrogen signling after estrogen receptor ß (ERß)Jan-Ake Gustafsson14. Getting Lost: Hippocampal contributions to agerelated memory dysfunctionCarol BarnesMetals and the brain: Selected abstracts15. Modeling the contributin of iron mismanagement to Neurological disordersProf. J R C Connor16. Aluminium-triggered fibrillogenesis of B-AmyloidsProf. PZ Zatta, Dr D Drago, Mr G Tognon, Dr F RicchelliPsychiatry in Africa:17. Psychosocal aspects of Khat use among the youth of NairobiMs T M Khamis18. PTSD among motor vehicle accident survivors, KenyaDr F A Ongecha19. Psychiatric relities within African context - The Kenyan case StudyProf. D M  N Ndetei20. Adolescent-parenta interactions from infancy, Nairobi KenyaDr L K Ksakhala, Prof. D M N Ndetei21. Alcohol use ong young persons: A focus group study in Southwest NigeriaO A Obeijide22. Personality disorders and personality traits among tyoe 2 Diabetic patientsProf. O El Rufaie, Dr M Sabosy, Dr M S Abuzeid23. Association of traumatic experiences with depression among Nigerian adolescentsDr O Omigbodun, Dr K BakareMs O B Yusuf, Dr O Esan24. Prevalence of depression among women attending outpatient clinics in MalawiDr  M Tugumisirize, Prof. Agn, Dr Musisi25. Non-fatal suicidalbehaviour at the Johannesburg General HospitalDr  M Y H Moosa, Prof. F Y Jeenah, Dr A Pillay, Pof. M Vorstere, Dr R Liebenberg26. Integrating mental health into general primary health care - Uganda's experienceDr N Kigozi27. Depression among Nigerian survivors of stroke:Prevalance and associated factorsDr F.O Fatoye Dr M A Komolafe, Dr A. O Adewuya, Dr B.A. Eegunranti Prof. M.A. Lawal28. NGO Involvement mental health care -The way forwardDr  Basangwa29. Prevalen of Attenton Deficit Hyperactivity sorder among African school childrenDr E KashalaProf. T Tylleskar, Dr I Elgen, Dr K Sommerfelt30. Barriers to effective mental health care in NigeriaMs L. Kola31. Quay of life evaluation in patients with HIV-I infection with respect to the impact of Phyttherapy (Traditional Herb in Zimbabwe)M B Sebit, S K Chandiwaa, A S Latif, E Gomo, S W Acuda, F Makoni, J Vushe

Part IV Motor Vehicle Distribution, 11 Motor Vehicle Distribution

2018 ◽  
Author(s):  
Wijckmans Frank ◽  
Tuytschaever Filip
Keyword(s):  
Automotive Industry ◽  
Motor Vehicle ◽  
Spare Parts ◽  
Motor Vehicles ◽  
Secondary Markets ◽  
The Impact ◽  
Practice Regulation ◽  
Block Exemption

This chapter addresses the specific block exemption regime that applies to the automotive industry. The relevant regime is contained in Regulation 461/2010. Different from past practice, Regulation 461/2010 closely resembles the general block exemption (Regulation 330/2010) and limits itself to adding certain hardcore restrictions applicable in the secondary markets. The chapter provides an overview of the impact of the block exemption from the perspective of the various stakeholders active in the sector. It then goes on to describe separately the block exemption principles governing the distribution of motor vehicles, the provision of after-sales services, and the distribution of spare parts.

scholarly journals The Impact of Pedestrian Crossing Flags on Driver Yielding Behavior in Las Vegas, NV

2019 ◽  
Vol 11 (17) ◽  
pp. 4741 ◽  
Author(s):  
Sheila Clark ◽  
Courtney Coughenour ◽  
Kelly Bumgarner ◽  
Hanns de la Fuente-Mella ◽  
Chantel Reynolds ◽  
...  
Keyword(s):  
Motor Vehicle ◽  
Las Vegas ◽  
Low Cost ◽  
Pedestrian Safety ◽  
Future Research ◽  
Pedestrian Injury ◽  
Pass Through ◽  
Trained Observers ◽  
Pedestrian Crossing ◽  
The Impact

Walking is the most affordable, accessible, and environmentally friendly method of transportation. However, the risk of pedestrian injury or death from motor vehicle crashes is significant, particularly in sprawling metropolitan areas. The purpose of this study was to examine the effect of pedestrian crossing flags (PCFs) on driver yielding behaviors. Participants crossed a marked, midblock crosswalk on a multilane road in Las Vegas, Nevada, with and without PCFs, to determine if there were differences in driver yielding behaviors (n = 160 crossings). Trained observers recorded (1) the number of vehicles that passed in the nearest lane without yielding while the pedestrian waited at the curb and (2) the number of vehicles that passed through the crosswalk while the pedestrian was in the same half of the roadway. ANOVA revealed that drivers were significantly less likely to pass through the crosswalk with the pedestrian in the roadway when they were carrying a PCF (M = 0.20; M = 0.06); drivers were more likely to yield to the pedestrian waiting to enter the roadway when they were carrying a PCF (M = 1.38; M = 0.95). Pedestrian crossing flags are a low-tech, low-cost intervention that may improve pedestrian safety at marked mid-block crosswalks. Future research should examine driver fade-out effects and more advanced pedestrian safety alternatives.

No Turns Allowed: Controlling Vehicles Turning in Front of Light Rail Vehicles

2000 ◽  
Vol 1704 (1) ◽  
pp. 85-89 ◽  
Author(s):  
José I. Farrán
Keyword(s):  
Traffic Control ◽  
Motor Vehicle ◽  
Motor Vehicle Accident ◽  
High Capacity ◽  
Urban Environments ◽  
Motor Vehicles ◽  
Light Rail ◽  
Right Of Way ◽  
Accident Data ◽  
Mode Of Transportation

A key attribute of light rail transit (LRT) is its ability to integrate well into urban environments, sharing the public right-of-way with motor vehicles, bicycles, and pedestrians. This characteristic has made LRT very successful in urban corridors that require a high-capacity mode of transportation operating in a shared (on-street or mall) right-of-way environment. Although LRT is an inherently safe mode of transportation, accidents do occur. Such accidents negatively affect not only the parties involved, but also the operation of the entire LRT system and the reputation of the transit property. LRT accident data indicate that the most prevalent type of light rail vehicle (LRV)-motor vehicle accident occurs when motor vehicles turn left or right across LRT tracks and collide with an LRV rapidly approaching the intersection. Five of the most-common types of such accidents are identified, and traffic control devices and techniques are recommended to improve safety by conveying to the motorist the higher level of risk in violating a left or right turn signal prohibition.

Surgical density and its effect on esophageal cancer (EC) and gastric (GC) mortality.

2011 ◽  
Vol 29 (4_suppl) ◽  
pp. 16-16
Author(s):  
M. Y. Ho ◽  
J. S. Albarrak ◽  
W. Y. Cheung
Keyword(s):  
Household Income ◽  
Population Level ◽  
Multimodality Treatment ◽  
General Surgeon ◽  
County Level ◽  
Median Household Income ◽  
Hospital Beds ◽  
Beta Coefficient ◽  
General Surgeons ◽  
The Impact

16 Background: Surgical resection plays an integral role in the multimodality treatment of patients with EC or GC. The distribution of thoracic and general surgeons at the county level varies widely across the US. The impact of the allocation of these surgeons on cancer outcomes is unclear. Our aims were to 1) examine the effect of surgeon density on EC or GC mortality, 2) compare the relative roles of thoracic and general surgeons on EC and GC outcomes and 3) determine other county characteristics associated with cancer mortality. Methods: Using county-level data from the Area Resources File, U.S. Census and National Cancer Institute, we constructed regression models to explore the effect of thoracic and general surgeon density on EC and GC mortality, respectively. Multivariate analyses controlled for incidence rate, county demographics (population aged 65+, proportion eligible for Medicare, education attainment, metropolitan vs. rural), socioeconomic factors (median household income) and healthcare resources (number of general practitioners, number of hospital beds). Results: In total, 332 and 402 counties were identified for EC and GC, respectively: mean EC/GC incidence = 5.29/6.83; mean EC/GC mortality=4.70/3.92; 91% were metropolitan and 9% were rural; mean thoracic and general surgeon densities were 10 and 63 per 100,000 people, respectively. When compared to counties with no thoracic surgeons, those with at least 1 thoracic surgeon had reduced EC mortality (beta coefficient -0.031). For GC, counties with 1 or more general surgeons also had decreased number of deaths (beta coefficient -0.095) when compared with those without any surgeons. While increasing the density of surgeons beyond 10 only yielded minimal improvements in EC mortality, it resulted in significant further reductions in GC mortality. Other county characteristics, such as increased number of hospital beds and higher median household income, were correlated with improved outcomes. Conclusions: Mortality from GC appears to be more susceptible to the benefits of increased surgeon density. For EC, a strategic policy of allocating health resources and distributing the workforce across counties will be best able to optimize outcomes at the population-level. No significant financial relationships to disclose.

CD3+ tumor-infiltrating lymphocytes (TILs) as prognostic in patients (pts) with stage II colon cancer (CC) not treated with adjuvant chemotherapy (ADJ).

2020 ◽  
Vol 38 (4_suppl) ◽  
pp. 167-167
Author(s):  
Edoardo Francini ◽  
Fang-Shu Ou ◽  
Stefano Lazzi ◽  
Roberto Petrioli ◽  
Andrea Giovanni Multari ◽  
...  
Keyword(s):  
Clinical Decision Making ◽  
Multivariable Analysis ◽  
Tumor Infiltrating Lymphocytes ◽  
Clinical Decision ◽  
Stage Ii ◽  
Prognostic Impact ◽  
Curative Surgery ◽  
Cox Models ◽  
Risk Of Death ◽  
The Impact

167 Background: Previous studies have reported high TILs are a favorable prognostic factor in stage II CC. However, whether the impact of TILs on overall survival (OS) differs among pts who did or did not receive ADJ is still to be determined. We assessed the prognostic value of CD3+ TILs in pts with stage II CC according to whether they received ADJ or not (no-ADJ). Methods: Pts treated with curative surgery for stage II CC (2002-2013) were identified through the Santa Maria alle Scotte Hospital database. CD3+ TILs at the invasive front, center of tumor, and stroma, were determined by immunohistochemistry and manually quantified as the rate of TILs/total tissue areas. High TILs (H-TILs) was defined as > 20%. Pts were classified as high or low TILs (L-TILs) and ADJ or no-ADJ. Cox models were used to assess OS with hazard ratio estimates (95% CI). Results: Of the 678 pts included (356 deaths), 137 (20%) received ADJ while 541 (80%) did not. ADJ comprised fluoropyrimidine +/- oxaliplatin. Median follow-up was 8.5 years. The distributions of the 4 groups were: 16% (L-TIL/ADJ), 64% (L-TIL/no-ADJ), 5% (H-TIL/ADJ), 15% (H-TIL/no-ADJ). Compared to H-TILs/no-ADJ, ADJ pts had a significantly longer OS (P < .0001) regardless of the TILS rate while L-TILs/no ADJ had significantly shorter OS and higher risk of death (HR = 1.41; 95% CI, 1.06-1.88; P < .0001) [See table]. On multivariable analysis, adjusting for perforation, obstruction, T-stage, grade, < 12 lymph nodes resected, lymphovascular and perineural invasion, the adverse prognostic impact of L-TILs (vs H-TILs) in no-ADJ pts was confirmed (HR = 1.36; 95% CI 1.02, 1.82; P = .0373). Conclusions: Low CD3+ TILs rate was independently associated with shorter OS in stage II CC pts who did not receive ADJ, but was not prognostic among pts who had ADJ. These data suggest a potentially different impact of TILs in chemo-treated vs -untreated stage II CC which could affect clinical decision making. [Table: see text]

Relationship of Field Dependence and Motor-Vehicle-Accident Involvement

1970 ◽  
Vol 31 (1) ◽  
pp. 272-274 ◽  
Author(s):  
Richard M. Harano
Keyword(s):  
Field Dependence ◽  
Traffic Safety ◽  
Motor Vehicle ◽  
Motor Vehicle Accident ◽  
Motor Vehicles ◽  
Future Research ◽  
California Department ◽  
Research Survey ◽  
Vehicle Accident ◽  
Relationship Of

A group of 28 accident and 27 accident-free drivers were requested by the California Department of Motor Vehicles to participate in a Driver Research Survey, the purpose being to evaluate the relationship between field dependence and motor-vehicle-accident involvement. The multiple regression results indicated that field dependence was significantly related to accident involvement. The results suggest that measures of perceptual style such as field dependence may hold promise for future research in traffic safety.

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