Road Traffic Injury Prevention Initiatives: A Systematic Review and Metasummary of Effectiveness in Low and Middle Income Countries.

BACKGROUND: Road traffic injuries (RTIs) are a growing but neglected global health crisis, requiring effective prevention to promote sustainable safety. Low- and middle-income countries (LMICs) share a disproportionately high burden with 90% of the world's road traffic deaths, and where RTIs are escalating due to rapid urbanization and motorization. Although several studies have assessed the effectiveness of a specific intervention, no systematic reviews have been conducted summarizing the effectiveness of RTI prevention initiatives specifically performed in LMIC settings; this study will help fill this gap. METHODS: In accordance with PRISMA guidelines we searched the electronic databases MEDLINE, EMBASE, Scopus, Web of Science, TRID, Lilacs, Scielo and Global Health. Articles were eligible if they considered RTI prevention in LMICs by evaluating a prevention-related intervention with outcome measures of crash, RTI, or death. In addition, a reference and citation analysis was conducted as well as a data quality assessment. A qualitative metasummary approach was used for data analysis and effect sizes were calculated to quantify the magnitude of emerging themes. RESULTS: Of the 8560 articles from the literature search, 18 articles from 11 LMICs fit the eligibility and inclusion criteria. Of these studies, four were from Sub-Saharan Africa, ten from Latin America and the Caribbean, one from the Middle East, and three from Asia. Half of the studies focused specifically on legislation, while the others focused on speed control measures, educational interventions, enforcement, road improvement, community programs, or a multifaceted intervention. CONCLUSION: Legislation was the most common intervention evaluated with the best outcomes when combined with strong enforcement initiatives or as part of a multifaceted approach. Because speed control is crucial to crash and injury prevention, road improvement interventions in LMIC settings should carefully consider how the impact of improvements will affect speed and traffic flow. Further road traffic injury prevention interventions should be performed in LMICs with patient-centered outcomes in order to guide injury prevention in these complex settings.

AASK - Aircraft accident statistics and knowledge: A database of human experience in evacuation, derived from aviation accident reports

Computer based mathematical models describing the aircraft evacuation process have a vital role to play in aviation safety. However such models have a heavy dependency on real evacuation data in order to (a) identify the key processes and factors associated with evacuation, (b) quantify variables and parameters associated with the identified factors/processes and finally (c) validate the models. The Fire Safety Engineering Group of the University of Greenwich is undertaking a large data extraction exercise from three major data sources in order to address these issues. This paper describes the extraction and application of data from one of these sources - aviation accident reports. To aid in the storage and analysis of the raw data, a computer database known as AASK (aircraft accident statistics and knowledge) is under development. AASK is being developed to store human observational and anecdotal data contained in accident reports and interview transcripts. AASK comprises four component sub-databases. These consist of the ACCIDENT (crash details), FLIGHT ATTENDANT (observations and actions of the flight attendants), FATALS (details concerning passenger fatalities) and PAX (observations and accounts from individual passengers) databases. AASK currently contains information from 25 survivable aviation accidents covering the period 4 April 1977 to 6 August 1995, involving some 2415 passengers, 2210 survivors, 205 fatalities and accounts from 669 people. In addition to aiding the development of aircraft evacuation models, AASK is also being used to challenge some of the myths which proliferate in the aviation safety industry such as, passenger exit selection during evacuation, nature and frequency of seat jumping, speed of passenger response and group dynamics. AASK can also be used to aid in the development of a more comprehensive approach to conducting post accident interviews, and will eventually be used to store the data directly.

Dynamic multi-partitioning for parallel finite element applications

The central product of the DRAMA (Dynamic Re-Allocation of Meshes for parallel Finite Element Applications) project is a library comprising a variety of tools for dynamic re-partitioning of unstructured Finite Element (FE) applications. The input to the DRAMA library is the computational mesh, and corresponding costs, partitioned into sub-domains. The core library functions then perform a parallel computation of a mesh re-allocation that will re-balance the costs based on the DRAMA cost model. We discuss the basic features of this cost model, which allows a general approach to load identification, modelling and imbalance minimisation. Results from crash simulations are presented which show the necessity for multi-phase/multi-constraint partitioning components

Computational fire engineering - do we have what we need?

This presentation will attempt to address the issue of whether the engineering design community has the knowledge, data and tool sets required to undertake advanced evacuation analysis. In discussing this issue I want to draw on examples not only from the building industry but more widely from where ever people come into contact with an environment fashioned by man. Prescriptive design regulations the world over suggest that if we follow a particular set of essentially configurational regulations concerning travel distances, number of exits, exit widths, etc it should be possible to evacuate a structure within a pre-defined acceptable amount of time. In the U.K. for public buildings this turns out to be 2.5 minutes, internationally in the aviation industry this is 90 seconds, in the UK rail industry this is 90 seconds and the international standard adopted by the maritime industry is 60 minutes. The difficulties and short comings of this approach are well known and so I will not repeat them here, save to say that this approach is usually littered with “magic numbers” that do not stand up to scrutiny. As we are focusing on human behaviour issues, it is also worth noting that more generally, the approach fails to take into account how people actually behave, preferring to adopt an engineer’s view of what people should do in order to make their design work. Examples of the failure of this approach are legion and include the; Manchester Boeing 737 fire, Kings Cross underground station fire, Piper Alpha oil platform explosion, Ladbroke Grove Rail crash and fire, Mont Blanc tunnel fire, Scandinavian Star ferry fire and the Station Nightclub fire.

Simulating the Swissair flight 111 in-flight fire using the CFD fire simulation software SMARTFIRE

At 8.18pm on 2 September 1998, Swissair Flight 111 (SR 111), took off from New York’s JFK airport bound for Geneva, Switzerland. Tragically, the MD-11 aircraft never arrived. According to the crash investigation report, published on 27 March 2003, electrical arcing in the ceiling void cabling was the most likely cause of the fire that brought down the aircraft. No one on board was aware of the disaster unfolding in the ceiling of the aircraft and, when a strange odour entered the cockpit, the pilots thought it was a problem with the air-conditioning system. Twenty minutes later, Swissair Flight 111 plunged into the Atlantic Ocean five nautical miles southwest of Peggy’s Cove, Nova Scotia, with the loss of all 229 lives on board. In this paper, the Computational Fluid Dynamics (CFD) analysis of the in-flight fire that brought down SR 111 is described. Reconstruction of the wreckage disclosed that the fire pattern was extensive and complex in nature. The fire damage created significant challenges to identify the origin of the fire and to appropriately explain the heat damage observed. The SMARTFIRE CFD software was used to predict the “possible” behaviour of airflow as well as the spread of fire and smoke within SR 111. The main aims of the CFD analysis were to develop a better understanding of the possible effects, or lack thereof, of numerous variables relating to the in-flight fire. Possible fire and smoke spread scenarios were studied to see what the associated outcomes would be. This assisted investigators at Transportation Safety Board (TSB) of Canada, Fire & Explosion Group in assessing fire dynamics for cause and origin determination.

Relating plankton assemblages to environmental variables using instruments towed by ships-of-opportunity

Undulating Oceanographic Recorders (UORs) and Continuous Plankton Recorders (CPRs) equipped with a suite of sensors were towed by merchant vessels in the North Sea between 1988 and 1991, recording a range of environmental variables. These were used to interpret the results of analyses of the plankton taken on CPR tows off the northeast coast of the UK in 1989 and in the Skagerrak and Kattegat in July 1988 and through 1989. Correlations were found between the biota and the environmental variables. The tidal front off the northeast coast of the UK and the front between the low salinity water in the Kattegat and the higher salinity water in the Skagerrak were dominant factors correlating with the distribution of the plankton assemblages. Discontinuities, defining the positions of the fronts, in the values of physical variables (temperature and, where measured, salinity and turbidity) were closely identified with geographical divisions between plankton assemblages. Measures of irradiance were found to be important on several occasions, presumably due to diel migrations of the zooplankton.

Pattern and scale of variability among Northwest Atlantic Shelf plankton communities

Continuous plankton recorders (CPRs) have been used in the Northwest Atlantic for almost 50 years. While data collected by these surveys have provided valuable information on long-term variability in plankton populations, all previous analyses have been limited to only a portion of the geographic range of the available data. Here we present an analysis of the CPR data from the Mid Atlantic Bight to the Labrador Sea. Across this wide geographic range, we found many common associations among the taxa. In particular, the changes in most regions were strongly size structured, with small and medium copepods varying together and often positively related to indicators of phytoplankton abundance. The time series from nearby regions were strongly correlated; however, after 1990, the spatial pattern became more complex. During this period, several of the copepod taxa, noticeably Calanus finmarchicus and Centropages typicus, experienced a series of anomalies that appeared to propagate from northeast to southwest. Although the direction of propagation was consistent with the shelf circulation, the anomalies propagated at a rate much slower than typical current speeds. The timing of the copepod anomalies and their phase speed were similar in character to observed changes in salinity and the position of the Shelf Slope Front. The correspondence between the changes in the plankton community and changes in the physical environmental suggests that physical conditions are a strong driver of interannual variability in Northwest Atlantic Shelf ecosystems.

Ecological Investigations with the Continuous Plankton Recorder: The Zooplankton (other than Copepoda and Young Fish) in the Southern North Sea, 1932-37.

I. The report describes the main monthly changes in the distribution and abundance of the zooplankton, other than Copepoda and young fish (dealt with in separate reports), over the southern part of the North Sea from 1932 to 1937. The work is part of the survey carried out by Continuous Plankton Recorders towed at a depth of 10 metres on regular steamship lines between England and the Continent. 2. The limitations to the sampling method are discussed, and it is shown to be unsuitable for recording Mysidacea and Euphausiacea on account of their marked diurnal variation due presumably to vertical migration; they are omitted from the report. 3. The changing distribution of Sagitta, Limacina, Clione, Lamellibranch larvae, Cladocera, Caprellid Amphipoda, Decapod larvae, Echinoderm larvae and Oikopleura are shown in a series of monthly charts while their seasonal fluctuations are compared in time-chart histograms. 4. The Alima larvae of Squilla are recorded on a few occasions in the regions where the Channel opens into the North Sea. 5. The distributional characteristics of the different forms, i.e. their tendencies to even or " patchy " production, are compared.

What is a reasonable time from decision to delivery by Caesarean section? Evidence from 533 deliveries.

Objective To determine how long it takes from the decision to achieve delivery by non-elective caesarean section (DDI), the influence on this interval, and the impact on neonatal condition at birth. Design Twelve months prospective data collection on all non-elective caesarean sections. Methods Prospective collection of data relating to all caesarean sections in 1996 in a major teaching hospital obstetric unit was conducted, without the knowledge of the other clinicians providing clinical care. Details of the indication for section, the day and time of the decision and the interval till delivery were recorded as well as the seniority of the surgeon, and condition of the baby at birth. Results The mean time from decision-to-delivery for 100 emergency intrapartum caesarean sections was 42.9 minutes for fetal distress and 71.1 minutes for 230 without fetal distress (P<0.0001). For 22 'crash' sections the mean time from decision-to-delivery was 27.4 minutes; for 13 urgent antepartum deliveries for fetal reasons it was 124.7 minutes and for 21 with maternal reasons it was 97.4 minutes. The seniority of the surgeon managing the patient did not appear to influence the interval, nor did the time of day or day of the week when the delivery occurred. Intrapartum sections were quicker the more advanced the labour, and general anaesthesia was associated with shorter intervals than regional anaesthesia for emergency caesarean section for fetal distress (P<0.001). Babies born within one hour of the decision tended to be more acidaemic than those born later, irrespective of the indication for delivery. Babies tended to be in better condition when a time from decision-to-delivery was not recorded than those for whom the information had been recorded. Conclusion Fewer than 40% intrapartum deliveries by caesarean section for fetal distress were achieved within 30 minutes of the decision, despite that being the unit standard. There was, however, no evidence to indicate that overall an interval up to 120 minutes was detrimental to the neonate unless the delivery was a 'crash' caesarean section. These data thus do not provide evidence to sustain the recommendation of a standard of 30 minutes for intrapartum delivery by caesarean section.

Diving behaviour of jellyfish equipped with electronic tags

Jellyfish are one of the most abundant and conspicuous members of our coastal marine fauna and are now known to play major trophic roles in marine systems. However, little is known about the movements and behaviour of individuals. We equipped individual compass jellyfish (Chrysaora hysoscella) (n = 15) off the Dingle coast, Ireland, with miniature time-depth recorders to log their depth over periods of a few hours. Vertical movements were extensive, with all jellyfish changing their depth during tracking. A range of vertical movements were seen including initial diving from the surface down to a maximum of 29.6 m after device attachment, some jellyfish remaining near the bottom, some moving up and down in mid-water and some moving back near the surface. These results show that jellyfish actively reposition themselves in the water column over small time-scales and open the way for more extensive studies equipping jellyfish with electronic tags.

Measuring the state of consciousness in a free-living diving sea turtle

We report on results from two types of data-logger attached to hawksbill turtles (Eretmochelys coriacea) in the breeding season at the Seychelles, Indian Ocean. Conventional time-depth recorders (TDRs) showed prolonged bouts of long dives to the seabed, consistent with benthic resting. This behaviour has been widely reported in sea turtles and appears to be a common feature for energy conservation. An Inter-Mandibular Angle Sensor (IMASEN) recorded mouth opening and buccal pumping by one turtle for 2.5 days. Buccal pumping occurred widely while the turtle was submerged, consistent with a function of olfactory sensory perception of the turtle's environment. However, buccal pumping stopped during the middle of long benthic dives consistent with the turtle entering a phase of sleep. It therefore appears that by recording buccal oscillations, it is possible to assess the state of consciousness of turtles allowing the eco-physiology of diving to be more fully explored. (C) 2007 Elsevier B.V. All rights reserved.

Habitat utilization by juvenile hawksbill turtles (Eretmochelys imbricata, Linnaeus, 1766) around a shallow water coral reef

Contemporary studies of sea turtle diving behaviour are generally based upon sophisticated techniques such as the attachment of time depth recorders. However, if the risks of misinterpretation are to be minimized, it is essential that electronic data are analysed in the light of first-hand observations. To this aim, we set out to make observations of juvenile hawksbill turtles (Eretmochelys imbricata , Linnaeus, 1766) foraging and resting in a shallow water coral reef habitat around the granitic Seychelles (4degrees'S, 55degrees'E). Data were collected from six study sites characterized by a shallow reef plateau (

Diving behaviour during the internesting interval for loggerhead turtles Caretta caretta nesting in Cyprus

Time depth recorders were used to assess the patterns of depth utilisation by 2 loggerhead turtles Caretta caretta in Cyprus, eastern Mediterranean. Dives to the seabed accounted for 59 % (171 h) and 75 % (215 h) of the internesting interval, respectively, with most dives being shallow (

How the ship of fools was ship-wrecked - The Irish crisis and response

For a decade and half the Irish economy was the poster-boy of Europe. With substantial growth rates, an open economy, flexible labour markets and low levels of taxation, Ireland was seen as evidence of the success of neoliberal policies. Yet in the matter of a few short years Ireland has turned into a one of the peripheral black-holes (along with Greece and Portugal) that are threatening to bring down the whole Eurozone project. Given this context the paper will address two key questions. Firstly how did the much eulogised Celtic Tiger fall so far and so fast? And, secondly, what has been the government’s response to the fall and crash of the Irish economy? These two questions will be addressed through both a general historical analysis of the developments of Irish society up to the crash in 2008 and then the responses to it. Secondly by an analysis of two specific elements of that development; namely the much discussed low corporation tax rate and the failure of social housing to deliver decent affordable homes for those at the bottom of society. The third element is a review of the banking and sovereign debt crisis that led to the IMF/EU deal in November 2010 and a brief outlining of its implications for public finances, especially the question of default. The paper concludes by placing the Irish crisis in a global context.