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.

Maintenance of a case-base for the retrieval of rotationally symmetric shapes for the design of metal castings

In this paper, we discuss the problem of maintenance of a CBR system for retrieval of rotationally symmetric shapes. The special feature of this system is that similarity is derived primarily from graph matching algorithms. The special problem of such a system is that it does not operate on search indices that may be derived from single cases and then used for visualisation and principle component analyses. Rather, the system is built on a similarity metric defined directly over pairs of cases. The problems of efficiency, consistency, redundancy, completeness and correctness are discussed for such a system. Performance measures for the CBR system are given, and the results for trials of the system are presented. The competence of the current case-base is discussed, with reference to a representation of cases as points in an n-dimensional feature space, and a Gramian visualisation. A refinement of the case base is performed as a result of the competence analysis and the performance of the case-base before and after refinement is compared.

Policy packages as potential routes to urban road pricing in the UK

This paper focuses on urban road pricing as a demand management policy that is often regarded as radical and generally unacceptable. Road pricing often gets delayed or abandoned due to low acceptability. This may be due to the fact that complex interactions and drivers of change affect road transport management and require cooperation within implementation networks. The implementation network is a group of people (referred to as partners and actors) who co-ordinate the introduction of policy tools. The drivers of change include any internal or external influences that have an effect on the time, place, or ‘shape’ of the policy measures being introduced. Demand management measures that focus on 'sustainable transport' usually address a limited set of objectives and are often implemented alone i.e. are not necessarily combined with other policy measures. When combined with other measures, it is not always clear whether the multiple interactions between policy tools and implementation networks have been sufficiently considered. Examples of ongoing implementation of policy package in the UK are the support of road pricing initiatives combined with public transport improvements by the Transport Innovation Fund. The objectives of the paper are twofold. First, we present a review of the UK urban road pricing situation. Second, we contrast the emerging issues against six key implementation factors. The analysis of three existing UK road pricing examples - London, Edinburgh and Durham – shows the importance of combining policy tools. Furthermore, through the above examples and theoretical arguments, we emphasise the additional need of creating and maintaining strong networks when implementing policy packages.

Routine maintenance and sustainability of existing social housing

Improving the sustainability of the housing stock is a major challenge facing the UK social housing sector. UK social housing accounts for approximately 18% of total UK housing and generates maintenance costs in the region of 1.25 billion pounds per annum. The extent to which routine maintenance can be used as a vehicle to improve the overall sustainability (social, environmental and economic) of existing social housing is one focus of a 5 year EPSRC funded research programme. This paper reports the findings of a questionnaire survey examining current social housing maintenance practices and attitudes towards sustainability. The research found that, whilst the stock condition survey is the favoured format for determining maintenance need and economics the basis for priority setting; neither systematically addresses wider sustainability issues; and, whilst cost is a major barrier to more sustainable solutions being adopted, landlords are able and have the desire to improve their practices.

Routine maintenance and sustainability of existing social housing

Presently the UK social housing stock accounts for approximately 18% of the total UK housing with maintenance costs in the region of £1.25 billion per annum. In terms of its impact on the environment, housing is generally responsible for approximately 27% of the UK’s CO2 emissions. The extent to which routine maintenance (planned preventative and responsive) can be used as a vehicle to improve the overall sustainability (social, environmental and economic) of existing social housing is one focus of a 5 year EPSRC funded research programme. This paper reports on the findings of a series of in-depth interviews with social housing providers examining current social housing maintenance practices and attitudes towards sustainability. This paper will report the initial findings of interviews and outline a new performance based multi-criteria maintenance model from which an AHP hierarchy will be presented, integrating the principles of sustainability into maintenance strategies