Identification of mechanism, PECARN risk factors and injury patterns in severe paediatric cervical spine injuries in Queensland

Introduction Canadian C spine rule and NEXUS criteria have identified risk factors for cervical spine injury in adults but not for children. PECARN has developed an 8 variable model for cervical spine injury in children. We sought to identify the mechanism, prevalence of PECARN risk factors, injury patterns, and management of severe Paediatric cervical spine injuries presenting to the major children’s hospitals in Brisbane, Australia. Methods This a retrospective study of the children with cervical spine injuries who presented directly or were referred to the major children’s hospitals in Brisbane over 5 years. Results There were 38 patients with 18 male and 20 female.The mean age was 8.6 years. They were divided into two groups according to their age, (Group 1 < =8 years had 18 (47%) patients, while group 2 (9-15 years) had 20 (53%) patients. Motor vehicle related injuries were the most common (61%) in Group 1 while it was sporting injuries (50%) in group 2. All patients in group 1 had upper cervical injury (C0-C2) while subaxial injuries were most common in group 2 (66.6%). 82% of the patients had 2 or more PECARN risk factors. 18 children (47%) had normal neurological assessment at presentation, 6 (16%) had radicular symptoms, 11 (29%) could not be assessed as they had already been intubated due to the severity of the injury, 3 (8%) had incomplete cord injury. 29 (69%) patients had normal neurological assessment at final follow up and 2 children died from their injuries. Conclusion Our study confirms that younger children sustain upper cervical injuries most commonly secondary to motor vehicle accidents, while the older sustain subaxial injuries from sporting activities. The significant prevalence of the PECARN risk factors among this cohort of patients have led to them being incorporated into a protocol at these hospitals used to assess patients with suspected cervical spinal injury.

New England Youth Speeding Project: A pilot study of young drivers and risky driving: Effective strategies for preventing speeding amongst young Australians aged 16-25 years in the New England Region

Young Australian drivers aged 17 – 25 years are overwhelmingly represented in road fatalities where speed is a factor. In the combined LGAs of Armidale Dumaresq, Guyra, Uralla and Walcha in the 5 years 1999-2003 inclusive, 43% of speeding related casualty crashes involved a young driver aged less than 25 years. This is despite the fact that the 17-25 age group account for only 25% of the driving population in this area. Young male drivers account for the majority of these crashes and also tend to have a higher number of driving offences and accrue more penalties for road traffic offences, especially speeding. By analysing data from questionnaires by male and female participants this research project has been able to evaluate road safety advertisements to determine which ones are most effective to young drivers, what features of these advertisements are effective, how males differ from females in their receptiveness and preferences for road safety advertisements and specifically how to target young people especially young men in conveying road safety messages. Finally this research project has identified factors that are important in the production of media road safety advertisements and has made recommendations for how best to convey effective road safety messages to young Australian drivers in rural areas.

Predicting the performance of LSF walls made of hollow flange channel sections in fire

Fire resistance of load bearing Light Gauge Steel Frame (LSF) wall systems is important to protect lives and properties in fire accidents. Recent fire tests of LSF walls made of the new cold-formed and welded hollow flange channel (HFC) section studs and the commonly used lipped channel section (LCS) studs have shown the influence of stud sections on the fire resistance rating (FRR) of LSF walls. To advance the use of HFC section studs and to verify the outcomes from the fire tests, finite element models were developed to predict the structural fire performance of LSF walls made of welded HFC section studs. The developed models incorporated the measured non-uniform temperature distributions in LSF wall studs due to the exposure of standard fire on one side, and accurate elevated temperature mechanical properties of steel used in the stud sections. These models simulated the various complexities involved such as thermal bowing and neutral axis shift caused by the non-uniform temperature distribution in the studs. The finite element analysis (FEA) results agreed well with the full scale fire test results including the FRR, outer hot and cold flange temperatures at failure and axial deformation and lateral displacement profiles. They also confirmed the superior fire performance of LSF walls made of HFC section studs. The applicability of both transient and steady state FEA of LSF walls under fire conditions was verified in this study, which also investigated the effects of using various temperature distribution patterns across the cross-section of HFC section studs on the FRR of LSF walls. This paper presents the details of this numerical study and the results.

When should ballooning incidents be reported?

This article follows on from our previous article in Aeronotes Volume 37 No.2 "Prepare and prevent, don't repair and repent: Causal factors of hot air ballooning incidents". While nearly every balloon flight ends safely, with every flight comes the opportunity for an accident. The ABF maintains an incident reporting database containing information on all the accidents and near misses that are reported to them. The goal of the database is to provide a formal way for ABF members to share accident or near miss experiences and prevent future occurrences. We recently analysed the causal factors involved in the incident reports collected by the ABF. Twenty-two incident reports were analysed and 54 causal factors were identified that were reported to play a role in hot air ballooning accidents. While many factors were identified, the findings of this study were limited by the small number of incident reports available from the ABF reporting system...

Improving health and safety communication of migrant construction workers

Although statistical data in some developed countries indicate that migrant workers are nearly 30% more likely to have work-related injuries than local workers, no equivalent official injury/ incident statistics on the health and safety (H&S) of migrant workers are currently tracked in Australia. With increasing numbers of migrant workers having joined Australia’s extractive industries infrastructure and commercial construction industry, this suggests the need for some investigation. A particular issue is that lack of H&S communication is one of the key factors leading to construction industry accidents/ incidents as it prevents workers from effectively receiving H&S safety training and acquiring H&S information. Migrant workers whose first languages are not English are particularly affected by this problem and ways are needed to improve their situation. The research aims to do this by evaluating the H&S communication problems of migrant workers and identify an effective H&S communication structure. An overview of the challenge being addressed by the research is firstly provided, followed by a description of the research framework, and a report of the initial findings, from which recommendations are provided for improving H&S performance in the construction industry.

En förutbestämd sanning : Barnamord och delaktighet i 1700-talets Finland belysta genom kön, kropp och social kontroll

The study analyses the prevention or endorsing of the crime of infanticide in Finland 1702 1807, rather than the result. Also the impacts of the female body, biology of childbirth and experiences of pregnancy are examined, together with insights from modern medical research. Circumstances are reconstructed by a critical reading of judicial records on all levels of the judicial system. In all 269 cases of infanticide and 142 accessory crimes within the jurisdiction of the Turku court of appeal are studied, with particular focus on exceptionally well recorded cases of 83 accused women and 41 women and men accused of being party to the crime. Secondary sources are medical and jurisprudential writings, the public debate on infanticide, broadsheets and letters asking the King for pardon. Infanticide was considered murder by law. Unmarried women were predetermined as the main culprits. Nevertheless, deliberate infanticides were rare and committed mostly in accomplice. The majority of the infanticides studied were cases where inexperienced and unmarried women accidentally had given birth alone and usually to a dead child. Unaware that the pain they were experiencing was in fact a labour, the accused women instinctively sought solitude to push out the child. Some misunderstood the birth as an urgent need to defecate. The unexpected delivery ended in hiding the baby without remorse. This crime was promoted by several factors in Finnish rural culture, amongst others that also married women hid their pregnancy. The immediate household members did not necessarily know about the childbirth and failed to help the woman. This typical pattern in most cases of infanticide in 18th century Finland is also recorded in modern cases of unknown pregnancies. Fear of accountability prevented witnesses testifying to the actual course of events. The truth remained elusive. With only a few exceptions, the women were sentenced to death or imprisonment. The majority of those accused of accomplice were acquitted. However, too harsh sentences for accidents affected the reporting of the crime. Criminal politics failed to curtail infanticide as the crime was unsatisfactorily addressed by law, society and the judicial system.

Kirjan tie lukijalle : Kirjakauppojen vakiintuminen Suomessa 1740 - 1860

Books Paths to Readers describes the history of the origins and consolidation of modern and open book stores in Finland 1740 1860. The thesis approaches the book trade as a part of a print culture. Instead of literary studies choice to concentrate on texts and writers, book history seeks to describe the print culture of a society and how the literary activities and societies interconnect. For book historians, printed works are creations of various individuals and groups: writers, printers, editors, book sellers, censors, critics and finally, readers. They all take part in the creation, delivery and interpretation of printed works. The study reveals the ways selling and distributing books have influenced the printed works and the literary and print culture. The research period 1740 1860 covers the so-called second revolution of the book, or the modernisation of the print culture. The thesis describes the history of 60 book stores and their 96 owners. The study concentrates on three themes: firstly, how the particular book trade network became a central institution for printed works distribution, secondly what were the relations between cosmopolitan European book markets and the national cultural sphere, and thirdly how book stores functioned as cultural institutions and business enterprises. Book stores that have a varied assortment and are targeted to all readers became the main institution for book trade in Finland during 1740 1860. It happened because of three features. First, the book binders monopoly on selling bound copies in Sweden was abolished in 1740s. As a consequence entrepreneurs could concentrate solely to trade activities and offer copies from various publishers at their stores. Secondly the common business model of bartering was replaced by selling copies for cash, first in the German book trade centre Leipzig in 1770s. The change intensified book markets activities and Finnish book stores foreign connections. Thirdly, after Finland was annexed to the Russian empire in 1809, the Grand duchy s administration steered foreign book trade to book stores (because of censorship demands). Up to 1830 s book stores were available only in Helsinki and Turku. During next ten years book stores opened in six regional centres. The early entrepreneurs ran usually vertical businesses consisting of printing, publishing and distribution activities. This strategy lowered costs, eased the delivery of printed works and helped to create elaborated centres for all book activities. These book stores main clientele consisted of the Swedish speaking gentry. During late 1840s various opinion leaders called for the development of a national Finnish print culture, and also book stores. As a result, during the five years before the beginning of the Crimean war (1853 1856) book stores were opened in almost all Finnish towns: at the beginning of the war 36 book stores operated in 21 towns. The later book sellers, mainly functioning in small towns among Finnish speaking people, settled usually strictly for selling activities. Book stores received most of their revenues from selling foreign titles. Swedish, German, French and Belgian (pirate editions of popular French novels) books were widely available for the multilingual gentry. Foreign titles and copies brought in most of the revenues. Censorship inspections or unfavourable custom fees would not limit the imports. Even if the local Finnish print production steadily rose, many copies, even titles, were never delivered via book stores. Only during the 1840 s and 1850 s the most advanced publishers would concentrate on creating publishing programmes and delivering their titles via book stores. Book sellers regulated commissions were small. They got even smaller because of large amounts of unsold copies, various and usual misunderstandings of consignments and accounts or plain accidents that destroyed shipments and warehouses. Also, the cultural aim of a creating large and assortments and the tendency of short selling periods demanded professional entrepreneurship, which many small town book sellers however lacked. In the midst of troublesome business efforts, co-operation and mutual concern of the book market s entrepreneurs were the key elements of the trade, although on local level book sellers would compete, sometimes even ferociously. The difficult circumstances (new censorship decree of 1850, Crimean war) and lack of entrepreneurship, experience and customers meant that half of the book stores opened in 1845 1860 was shut in less than five years. In 1858 the few leading publishers established The Finnish Book Publishers Association. Its first task was to create new business rules and manners for the book trade. The association s activities began to professionalise the whole network, but at the same time the earlier independence of regional publishing and selling enterprises diminished greatly. The consolidation of modern and open book store network in Finland is a history of a slow and complex development without clear signs of a beginning or an end. The ideal book store model was rarely accomplished in its all features. Nevertheless, book stores became the norm of the book trade. They managed to offer larger selections, reached larger clienteles and maintained constant activity better than any other book distribution model. In essential, the book stores methods have not changed up to present times.

Cyclic plastic deformation characteristics of subgrade under moving train wheel load

Cyclic plastic deformation of subgrade and other engineered layers is generally not taken into account in the design of railway bridge transition zones, although the plastic deformation is the governing factor of frequent track deterioration. Actual stress behavior of fine grained subgrade/embankment layers under train traffic is, however, difficult to replicate using the conventional laboratory test apparatus and techniques. A new type of torsional simple shear apparatus, known as multi-ring shear apparatus, was therefore developed to evaluate the actual stress state and the corresponding cyclic plastic deformation characteristics of subgrade materials under moving wheel load conditions. Multi-ring shear test results has been validated using a theoretical model test results; the capability of the multi-ring shear apparatus for replicating the cyclic plastic deformation characteristics of subgrade under moving train wheel load conditions is thus established. This paper describes the effects of principal stress rotation (PSR) of the subgrade materials to the cyclic plastic deformation in a railroad and impacts of testing methods in evaluating the influence of principal stress rotation to the track deterioration of rail track.

Introducing a new limit states design concept to railway concrete sleepers: An Australian experience

Over 50 years, a large number of research and development projects with respect to the use of cementitious and concrete materials for manufacturing railway sleepers have been significantly progressed in Australia, Europe, and Japan (Wang, 1996; Murray and Cai, 1998; Wakui and Okuda, 1999; Esveld, 2001; Freudenstein and Haban, 2006; Remennikov and Kaewunruen, 2008). Traditional sleeper materials are timber, steel, and concrete. Cost-efficiency, superior durability, and improved track stability are the main factors toward significant adoption of concrete materials for railway sleepers. The sleepers in a track system, as shown in Figure 1, are subjected to harsh and aggressive external forces and natural environments across a distance. Many systemic problems and technical issues associated with concrete sleepers have been tackled over decades. These include pre-mature failures of sleepers, concrete cancer or ettringite, abrasion of railseats and soffits, impact damages by rail machinery, bond-slip damage, longitudinal and lateral instability of track system, dimensional instability of sleepers, nuisance noise and vibration, and so on (Pfeil, 1997; Gustavson, 2002; Kaewunruen and Remennikov, 2008a,b, 2013). These issues are, however, becoming an emerging risk for many countries (in North and South Americas, Asia, and the Middle East) that have recently installed large volumes of concrete sleepers in their railway networks (Federal Railroad Administration, 2013). As a result, it is vital to researchers and practitioners to critically review and learn from previous experience and lessons around the world.

Factors related to seat belt use : A Turkish case

Seat belts are effective safety devices used to protect car occupants from severe injuries and fatalities during road vehicle accidents. Despite the proven effectiveness of seat belts, seat belt use rates are quite low, especially in developing countries, such as Turkey. The general aim of the present study was to investigate a large variety of factors related to seat belt use among Turkish car occupants using different perspectives and methods and therefore, to contribute to the design of effective seat belt use interventions for increasing seat belt use rates in Turkey. Five sub-studies were conducted within the present study. In the first sub-study, environmental (e.g., road type) and psycho-social factors (e.g., belt use by other car occupants) related to the seat belt use of front-seat occupants were investigated using observation techniques. Being male, of a young age, and traveling on city roads were the main factors negatively related to seat belt use. Furthermore, seat belt use by the drivers and front-seat passengers was highly correlated and a significant predictors of each other. In the second sub-study, the motivations of the car occupants for seat belt use and non-use were investigated using interview techniques. Situational conditions, such as traveling on city roads and for short distances, and not believing in the effectiveness and relevance of seat belt use for safety, were the most frequently reported reasons for not using a seat belt. Safety, habit and avoiding punishment were among the most frequently reported reasons for using a seat belt. In the third sub-study, the Theory of Planned Behavior (TPB) and the Health Belief Model (HBM) were applied to seat belt use using Structural Equation Modeling techniques. The TPB model showed a good fit to the data, whereas the HBM showed a poor fit to the data. Within the TPB model, attitude and subjective norm were significant predictors of intentions to use a seat belt on both urban and rural roads. In the fourth sub-study, seat belt use frequency and motivations for seat belt use among taxi drivers were investigated and compared between free-time and work-time driving using a survey. The results showed that taxi drivers used seat belts more when driving a private car in their free-times compared to when driving a taxi during their work-times. The lack of a legal obligation to use a seat belt in city traffic and fear of being attacked or robbed by the passengers were found as two specific reasons for not using a seat belt when driving a taxi. Lastly, in the fifth sub-study, the relationship of seat belt use to driver and health behaviors was investigated using a survey. Although seat belt use was related both to health and driver behaviors, factor analysis results showed that it grouped with driver behaviors. Based on the results of the sub-studies, a tentative empirical model showing different predictors of seat belt use was proposed. According to the model, safety and normative motivations and perceived physical barriers related to seat belt use are the three important predictors of seat belt use. Keywords: Seat belt use; environmental factors; psycho-social factors; safety and normative motivations; the Theory of Planned Behavior; the Health Belief Model; health behaviors; driver behaviors; front-seat occupants; taxi drivers; Turkey.

Fatigued driving : prevalence, risk factors and groups, and the law

Fatigue and sleepiness are major causes of road traffic accidents. However, precise data is often lacking because a validated and reliable device for detecting the level of sleepiness (cf. the breathalyzer for alcohol levels) does not exist, nor does criteria for the unambiguous detection of fatigue/sleepiness as a contributing factor in accident causation. Therefore, identification of risk factors and groups might not always be easy. Furthermore, it is extremely difficult to incorporate fatigue in operationalized terms into either traffic or criminal law. The main aims of this thesis were to estimate the prevalence of fatigue problems while driving among the Finnish driving population, to explore how VALT multidisciplinary investigation teams, Finnish police, and courts recognize (and prosecute) fatigue in traffic, to identify risk factors and groups, and finally to explore the application of the Finnish Road Traffic Act (RTA), which explicitly forbids driving while tired in Article 63. Several different sources of data were used: a computerized database and the original folders of multidisciplinary teams investigating fatal accidents (VALT), the driver records database (AKE), prosecutor and court decisions, a survey of young male military conscripts, and a survey of a representative sample of the Finnish active driving population. The results show that 8-15% of fatal accidents during 1991-2001 were fatigue related, that every fifth Finnish driver has fallen asleep while driving at some point during his/her driving career, and that the Finnish police and courts punish on average one driver per day on the basis of fatigued driving (based on the data from the years 2004-2005). The main finding regarding risk factors and risk groups is that during the summer months, especially in the afternoon, the risk of falling asleep while driving is increased. Furthermore, the results indicate that those with a higher risk of falling asleep while driving are men in general, but especially young male drivers including military conscripts and the elderly during the afternoon hours and the summer in particular; professional drivers breaking the rules about duty and rest hours; and drivers with a tendency to fall asleep easily. A time-of-day pattern of sleep-related incidents was repeatedly found. It was found that VALT teams can be considered relatively reliable when assessing the role of fatigue and sleepiness in accident causation; thus, similar experts might be valuable in the court process as expert witnesses when fatigue or sleepiness are suspected to have a role in an accident’s origins. However, the application of Article 63 of the RTA that forbids, among other things, fatigued driving will continue to be an issue that deserves further attention. This should be done in the context of a needed attitude change towards driving while in a state of extreme tiredness (e.g., after being awake for more than 24 hours), which produces performance deterioration comparable to illegal intoxication (BAC around 0.1%). Regarding the well-known interactive effect of increased sleepiness and even small alcohol levels, the relatively high proportion (up to 14.5%) of Finnish drivers owning and using a breathalyzer raises some concern. This concern exists because these drivers are obviously more focused on not breaking the “magic” line of 0.05% BAC than being concerned about driving impairment, which might be much worse than they realize because of the interactive effects of increased sleepiness and even low alcohol consumption. In conclusion, there is no doubt that fatigue and sleepiness problems while driving are common among the Finnish driving population. While we wait for the invention of reliable devices for fatigue/sleepiness detection, we should invest more effort in raising public awareness about the dangerousness of fatigued driving and educate drivers about how to recognize and deal with fatigue and sleepiness when they ultimately occur.

The regional differences between countries in traffic safety: A cross-cultural study and Turkish Case

Road traffic accidents are a large problem everywhere in the world. However, regional differences in traffic safety between countries are considerable. For example, traffic safety records are much worse in Southern Europe and the Middle East than in Northern and Western Europe. Despite the large regional differences in traffic safety, factors contributing to different accident risk figures in different countries and regions have remained largely unstudied. The general aim of this study was to investigate regional differences in traffic safety between Southern European/Middle Eastern (i.e., Greece, Iran, Turkey) and Northern/Western European (i.e., Finland, Great Britain, The Netherlands) countries and to identify factors related to these differences. We conducted seven sub-studies in which I applied a traffic culture framework, including a multi-level approach, to traffic safety. We used aggregated level data (national statistics), surveys among drivers, and data on traffic accidents and fatalities in the analyses. In the first study, we investigated the influence of macro level factors (i.e., economic, societal, and cultural) on traffic safety across countries. The results showed that a high GNP per capita and conservatism correlated with a low number of traffic fatalities, whereas a high degree of uncertainty avoidance, neuroticism, and egalitarianism correlated with a high number of traffic fatalities. In the second, third, and fourth studies, we examined whether the conceptualisation of road user characteristics (i.e., driver behaviour and performance) varied across traffic cultures and how these factors determined overall safety, and the differences between countries in traffic safety. The results showed that the factorial agreement for driver behaviour (i.e., aggressive driving) and performance (i.e., safety skills) was unsatisfactory in Greece, Iran, and Turkey, where the lack of social tolerance and interpersonal aggressive violations seem to be important characteristics of driving. In addition, we found that driver behaviour (i.e., aggressive violations and errors) mediated the relationship between culture/country and accidents. Besides, drivers from "dangerous" Southern European countries and Iran scored higher on aggressive violations and errors than did drivers from "safe" Northern European countries. However, "speeding" appeared to be a "pan-cultural" problem in traffic. Similarly, aggressive driving seems largely depend on road users' interactions and drivers' interpretation (i.e., cognitive biases) of the behaviour of others in every country involved in the study. Moreover, in all countries, a risky general driving style was mostly related to being young and male. The results of the fifth and sixth studies showed that among young Turkish drivers, gender stereotypes (i.e., masculinity and femininity) greatly influence driver behaviour and performance. Feminine drivers were safety-oriented whereas masculine drivers were skill-oriented and risky drivers. Since everyday driving tasks involve not only erroneous (i.e., risky or dangerous driving) or correct performance (i.e., normal habitual driving), but also "positive" driver behaviours, we developed a reliable scale for measuring "positive" driver behaviours among Turkish drivers in the seventh study. Consequently, I revised Reason's model [Reason, J. T., 1990. Human error. Cambridge University Press: New York] of aberrant driver behaviour to represent a general driving style, including all possible intentional behaviours in traffic while evaluating the differences between countries in traffic safety. The results emphasise the importance of economic, societal and cultural factors, general driving style and skills, which are related to exposure, cognitive biases as well as age, sex, and gender, in differences between countries in traffic safety.

Evaluation of the Red Light Camera Program and the Owner Onus Legislation

Red light cameras were introduced in Victoria in August 1983, with the intention of reducing the number of accidents that result from motorists disobeying red traffic signals at signalised intersections. Accident data from 46 treated and 46 control sites from 1981 to 1986 were analysed. The analysis indicated that red light camera use resulted in a reduction in the incidence of right angle accidents, and in the number of accident casualties. Legislation was introduced in March 1986 to place the onus for red light camera offences onto the vehicle owner. This legislation was intended to improve Police efficiency and therefore increase the number of red light cameras in operation. Data supplied by the Police indicated that these aims have beneficial road safety effects.

The Red Light Camera Evaluation - Interim Report - July 1985

Red light cameras were introduced in August 1983 to deter run-the-red offences and therefore to reduce the incidence of right-angle accidents at signalised intersections in Melbourne. This report was prepared after two years of operation of the program. It provides a detailed account of the technical aspects of the program, but does not provide any detailed, evaluative analyses of accident data.

The Victorian 260 cc Legislation. Evaluation Report Using Accident Data to December, 1982.

Learner and first year probationary motorcyclists are over-represented in traffic accidents, being involved about four times as often as full motorcycle licence holders in relation to their numbers. In an attempt to reduce this over-involvement, the Victorian Government amended the law in 1979 to restrict learner and first year probationary motorcyclists to motorcycles with engine capacities of less than 260 cc. This paper reports an evaluation which showed that casualty rates for learner and first year probationers began to decrease from mid 1979 and continued to do so until the end of 1980. A further analysis indicated that compared to full licence holder casualties, learner permit casualties were about 40% less than expected while first year probationary casualties were about 39% lower.