965 resultados para Motor vehicle traffic accidents


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Before the Civil War (1936-1939), Spain had seen the emergence offirms of complex organizational forms. However, the conflict andthe postwar years changed this pattern. The argument put forwardin this paper is based on historical experience, the efforts willbe addressed to explain the development of Spanish entrepreneurshipduring the second half of the twentieth century. To illustrate thechange in entrepreneurship and organizational patterns among theSpanish firms during the Francoist regime we will turn to the caseof the motor vehicle industry.

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Objectives and Study: To document the demographics, mechanisms and outcome of traumatic pancreatitis in children at a single large tertiary referral centre in Australia. Methods: We undertook a 10-year retrospective audit of children admitted to the Royal Children's Hospital [RCH], Melbourne, Australia with a hospital coded diagnosis which included pancreatic injury between 1993 and 2002. Data included patient demographics, source of admission, mechanism of injury, pancreatic complications, associated injuries, Intensive Care Unit [ICU] admission, results of any operative findings, results of any acute computed tomography (CT) and/or ultrasound (US) imaging of pancreas, selected laboratory findings and length of stay. Results: We identified two distinct groups of patients in the 91 documented cases of pancreatic trauma (median age 8.0 yr, range 0.6-15.8 yr; M:F 2.5:1.0). Fifty-nine had a history of abdominal trauma and elevated serum lipase but no CT or ultrasound evidence of pancreatic injury (Group A). Thirty-two had a history of abdominal trauma, elevated serum lipase but also had CT scan and/or ultrasound evidence of pancreatic injury[Group B]. Patients with ''less severe'' injury based on normal imaging had a lower initial lipase level [Group A, median 651 U/L (interquartile range 520 - 1324) vs, Group B, 1608 U/L (interquartile range 680-3526); P = 0.005] and shorter admission time [Group A, 9.0 days (interquartile range 5.5-15.5) vs Group B, 13.4 days (interquartile range 6.8 - 23.8), P = 0.04]. There were no differences with respect to mortality [Group A, 13.5 % vs Group B, 12.5 %] but patients with evidence of injury on imaging were more likely to have surgical intervention [P = 0.0001]. The single most important overall cause of pancreatic trauma was involvement in a motor vehicle accident as a passenger or pedestrian. However, in children with high-grade ductal injury, bicycle handlebar injuries were most common. Associated injuries were common in both groups. Conclusion: Significant pancreatic injury can occur in the absence of abnormality on medical imaging. Pancreatic trauma commonly occurs in the context of multiple injuries after motor vehicle accidents in children and bicycle handlebar injuries, especially in boys. Most children can be treated conservatively, with surgical intervention being limited to high-grade ductal injury.

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Iowa’s speed regulations are based on the same basic speed law that is used in all 50 states: “Any person driving a motor vehicle on a highway shall drive the same at a careful and prudent speed not greater than nor less than is reasonable and proper, having due regard to the traffic, surface, and width of the highway and of any other conditions then existing, and no person shall drive any vehicle upon a highway at a speed greater than will permit the person to bring it to a stop within the assured clear distance ahead, such driver having the right to assume, however, that all persons using said highway will observe the law.” Statutory limits are based on the concept that uniform categories of highways can be traveled safely at certain preset maximum speeds under ideal conditions. Whether the speed limit is posted or unposted, drivers should reduce their speed below these values in poor weather, heavy traffic, and under other potentially hazardous conditions.

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Iowa’s speed regulations are based on the same basic speed law that is used in all 50 states: “Any person driving a motor vehicle on a highway shall drive the same at a careful and prudent speed not greater than nor less than is reasonable and proper, having due regard to the traffic, surface, and width of the highway and of any other conditions then existing, and no person shall drive any vehicle upon a highway at a speed greater than will permit the person to bring it to a stop within the assured clear distance ahead, such driver having the right to assume, however, that all persons using said highway will observe the law.” Statutory limits are based on the concept that uniform categories of highways can be traveled safely at certain preset maximum speeds under ideal conditions. Whether the speed limit is posted or unposted, drivers should reduce their speed below these values in poor weather, heavy traffic, and under other potentially hazardous conditions.

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Vehicle Traffic Map produced by the Iowa Department of Transportation.

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Vehicle Traffic Map produced by the Iowa Department of Transportation.

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The State of Iowa [STATE] and the Iowa Department of Transportation [IDOT] hereby is claim any warranty of any kind, express or implied, in reference to the information contained herein. The STATE and the IDOT neither assume nor authorize any person to assume for the STATE or the IDOT any liability in connection with the information contained herein, and there are no oral agreements or warranties regarding the information contained herein. Each and every person is hereby notified that the vertical clearances specified herein are subject to change due to resurfacing, surface buckling, weather conditions, or any other event. It is the responsibility of each and every vehicle operator to ascertain whether sufficient ACTUAL vertical clearance exists to move his vehicle or motor vehicle between the roadway and the underpasses and bridges listed herein. The May 15 date on this map reflects the end of the update schedule for the previous calendar year. Any vertical clearance restrictions which could or may change AFTER this date will not be reflected on this map. For the latest information on vertical clearance restrictions call the Office of Motor Carrier Services in Ankeny, (515) 237-3264 or visit http://www.iowadot.gov/mvd/omcs.

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Les investigations dans le milieu des accidents de la circulation sont très complexes. Elles nécessitent la mise en oeuvre d'un grand nombre de spécialités venant de domaines très différents. Si certains de ces domaines sont déjà bien exploités, d'autres demeurent encore incomplets et il arrive de nos jours d'observer des lacunes dans la pratique, auxquelles il est primordial de remédier.Ce travail de thèse, intitulé « l'exploitation des traces dans les accidents de la circulation », est issu d'une réflexion interdisciplinaire entre de multiples aspects des sciences forensiques. Il s'agit principalement d'une recherche ayant pour objectif de démontrer les avantages découlant d'une synergie entre les microtraces et l'étude de la dynamique d'un accident. Afin de donner une dimension très opérationnelle à ce travail, l'ensemble des démarches entreprises a été axé de manière à optimiser l'activité des premiers intervenants sur les lieux.Après une partie introductive et ayant trait au projet de recherche, traitant des aspects théoriques de la reconstruction d'une scène d'accident, le lecteur est invité à prendre connaissance de cinq chapitres pratiques, abordés selon la doctrine « du général au particulier ». La première étape de cette partie pratique concerne l'étude de la morphologie des traces. Des séquences d'examens sont proposées pour améliorer l'interprétation des contacts entre véhicules et obstacles impliqués dans un accident. Les mécanismes de transfert des traces de peinture sont ensuite étudiés et une série de tests en laboratoire est pratiquée sur des pièces de carrosseries automobiles. Différents paramètres sont ainsi testés afin de comprendre leur impact sur la fragilité d'un système de peinture. Par la suite, une liste de cas traités (crash-tests et cas réels), apportant des informations intéressantes sur le traitement d'une affaire et permettant de confirmer les résultats obtenus est effectuée. Il s'ensuit un recueil de traces, issu de l'expérience pratique acquise et ayant pour but d'aiguiller la recherche et le prélèvement sur les lieux. Finalement, la problématique d'une banque de données « accident », permettant une gestion optimale des traces récoltées est abordée.---The investigations of traffic accidents are very complex. They require the implementation of a large number of specialties coming from very different domains. If some of these domains are already well exploited, others remain still incomplete and it happens nowadays to observe gaps in the practice, which it is essential to remedy. This thesis, entitled "the exploitation of traces in traffic accidents", arises from a multidisciplinary reflection between the different aspects of forensic science. It is primarily a research aimed to demonstrate the benefits of synergy between microtrace evidence and accidents dynamics. To give a very operational dimension to this work, all the undertaken initiatives were centred so as to optimise the activity of the first participants on the crime scene.After an introductory part treating theoretical aspects of the reconstruction of an accident scene the reader is invited to get acquainted with five practical chapters, according to the doctrine "from general to particular". For the first stage of this practical part, the problem of the morphology of traces is approached and sequences of examinations are proposed to improve the interpretation of the contacts between vehicles and obstacles involved in an accident. Afterwards, the mechanisms of transfer of traces of paint are studied and a series of tests in laboratory is practised on pieces of automobile bodies. Various parameters are thus tested to understand their impact on the fragility of a system of paint. It follows that a list of treated cases (crash-tests and real cases) is created, allowing to bring interesting information on the treatment of a case and confirm the obtained results. Then, this work goes on with a collection of traces, stemming from the acquired experience that aims to steer the research and the taking of evidence on scenes. Finally, the practical part of this thesis ends with the problem of a database « accident », allowing an optimal management of the collected traces.

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In 2012, the Iowa legislature passed a bill for an act relating to school bus safety, including providing penalties for failure to obey school bus warning lamps and stop signal arms, providing for a school bus safety study and administrative remedies, and making an appropriation. The bill, referred to as Iowa Senate File (SF) 2218 or “Kadyn’s Law,” became effective March 16, 2012. A multiagency committee addressed three specific safety study elements of Kadyn’s Law as follows: * Use of cameras mounted on school buses to enhance the safety of children riding the buses and aid in enforcement of motor vehicle laws pertaining to stop-arm violations * Feasibility of requiring school children to be picked up and dropped off on the side of the road on which their home is located * Inclusion of school bus safety as a priority in driver training curriculum This report summarizes the findings for each of these topics.

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According to the Centers for Disease Control and Prevention, unintentional injury is the fifth leading cause of death for all age groups and the first leading cause of death for people from 1 to 44 years of age in the United States, while homicide remains the 2nd leading cause of death for 15 to 24 years old (CDC, 2006). In 2004, there were approximately 144,000 deaths due to unintentional injuries in the US; 53% of which represent people over 45 years of age (CDC, 2004). With 20,322 suicidal deaths and 13,170 homicidal deaths, intentional injury deaths affect mostly people under 45 years old. On average, there are 1,150 unintentional deaths per year in Iowa. In 2004, 37% of unintentional deaths were due to motor vehicle accidents (MTVCC) occurring across all age ranges and 30% were due to falls involving persons over 65 years of age 82% of the time (IDPH Health Stat Div., 2004). The most debilitating outcome of injury is traumatic brain injury, which is characterized by the irreversibility of its damages, long-term effects on quality of life, and healthcare costs. The latest data available from the CDC estimated that, nationally, 50,000 traumatic brain injured (TBI) people die each year; three times as many are hospitalized and more than twenty times as many are released from emergency room (ER) departments (CDC, 2006). Besides the TBI registry, brain injury data is also captured through three other data sources: 1) death certificates; 2) hospital inpatient data; and, 3) hospital outpatient data. The inpatient and outpatient hospital data are managed by the Iowa Hospital Association, which provides to Iowa Department of Public Health the hospital data without personal identifiers. (The hospitals send reports to the Agency of Health Care Research and Quality, which developed the Health Care Utilization Project and its product, the National Inpatient Sample).

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OBJECTIVE: Accurate identification of major trauma patients in the prehospital setting positively affects survival and resource utilization. Triage algorithms using predictive criteria of injury severity have been identified in paramedic-based prehospital systems. Our rescue system is based on prehospital paramedics and emergency physicians. The aim of this study was to evaluate the accuracy of the prehospital triage performed by physicians and to identify the predictive factors leading to errors of triage.METHODS: Retrospective study of trauma patients triaged by physicians. Prehospital triage was analyzed using criteria defining major trauma victims (MTVs, Injury Severity Score >15, admission to ICU, need for immediate surgery and death within 48 h). Adequate triage was defined as MTVs oriented to the trauma centre or non-MTV (NMTV) oriented to regional hospitals.RESULTS: One thousand six hundred and eighti-five patients (blunt trauma 96%) were included (558 MTV and 1127 NMTV). Triage was adequate in 1455 patients (86.4%). Overtriage occurred in 171 cases (10.1%) and undertriage in 59 cases (3.5%). Sensitivity and specificity was 90 and 85%, respectively, whereas positive predictive value and negative predictive value were 75 and 94%, respectively. Using logistic regression analysis, significant (P<0.05) predictors of undertriage were head or thorax injuries (odds ratio >2.5). Predictors of overtriage were paediatric age group, pedestrian or 2 wheel-vehicle road traffic accidents (odds ratio >2.0).CONCLUSION: Physicians using clinical judgement provide effective prehospital triage of trauma patients. Only a few factors predicting errors in triage process were identified in this study.

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Vehicle Traffic Map produced by the Iowa Department of Transportation.

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Vehicle Traffic Map produced by the Iowa Department of Transportation.

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Despite a trend of decreasing teen fatalities due to motor vehicle crashes over the past decade, they remain the leading cause of adolescent fatalities in Iowa. The purpose of this study was to create detailed case studies of each fatal motor vehicle crash involving a driver under the age of 20 that occurred in Iowa in 2009, 2010, and 2011. Data for each crash were gathered from media sources, law enforcement agencies, and the Iowa Department of Transportation. The driving records of the teens, which included their licensure history, prior traffic citations, and prior crashes, were also acquired. In addition, data about the charges filed against a teen as a result of being involved in a fatal crash were obtained. A total of 126 crashes involving 131 teen drivers that resulted in 143 fatalities were analyzed. Many findings for fatal crashes involving teen drivers in Iowa are consistent with national trends, including the overrepresentation of male drivers, crash involvement that increases with age, crash involvement per vehicle miles traveled that decreases with age, and prevalence of single-vehicle road departure crashes. Relative to national statistics, teen fatalities from crashes in Iowa are more likely to occur from midnight to 6am and from 9am to noon. Crash type varied by driver age and county population level. Teen drivers contributed to the fatal crashes at a rate of 74%; contribution of the teen driver was unknown for 11% of crashes. Speed was a factor for about 25% of the crashes for which a teen driver was at fault. The same was also true of alcohol/drug impairment. Only 20% of the rear-seat occupants of the teen drivers’ vehicles wore seat belts compared to 60% use for the front-seat occupants. Analysis of the teens’ driving records prior to the fatal crash suggests at-fault crashes and speeding violations are associated with contributing to the fatal crash.

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Traumatic Brain Injury (TBI) impacts the lives of thousands of Iowans each year. The effects of brain injury (often called the "silent epidemic" because resulting injury is often not visible to others) are cognitive, emotional, and social but may also result in physical disability. This state plan, created by the Governor's Advisory Council on Brain Injuries, is intended to provide guidance for brain injury services and prevention activities in Iowa. This is the fourth Iowa State Plan for Brain Injury. In addition to a statewide needs assessment, development of this plan included recommendations made by the Mental Health and Disability Services Redesign Brain Injury Work-group. For the first time in the history of TBI surveillance in Iowa, the numbers and rates of TBI deaths are decreasing, however hospitalizations and emergency department visits resulting from TBI are steadily increasing. This trend is likely due to the decrease in motor vehicle accidents and improved hospitalization protocols. Looking to the future, the Advisory Council on Brain Injuries identified goals in each of four focus areas. These focus areas are: #1 Individual and family access; dedicated to the enhancement of the lives of individuals with brain injuries and their families. #2 Service and support availability; #3 Service system enhancements; continued funding growth and public awareness campaigns that draw attention to the impact of brain injury. #4 Brain injury prevention; working to prevent and reduce three of the most common causes of brain injury are falls, no helmet use, and motor vehicle crashes.