Exploring responsible innovation: Dutch public perceptions of the future of medical neuroimaging technology

Insight into public perceptions provides opportunities to take public desires and concerns into account in an early phase of innovation development in order to maximise the potential benefits for users of the future. Public perceptions of neuroimaging in health care are presented in this article, based on research undertaken in the Netherlands. In six focus groups, 46 citizens articulated benefits, disadvantages and specific concerns regarding future medical neuroimaging applications. Six technological frames of neuroimaging and three frames of the socio-technical system surrounding neuroimaging were found to underlie the arguments used to articulate the degree of desirability of future applications. Depending on the context, individuals use different frames and related lines of arguments. New and improved options for the prevention, diagnosis and treatment of brain disorders are considered conditionally desirable by almost all citizens consulted. The desirability of neuroimaging applications becomes controversial when specific applications embody conflicting values and desires. Depending on the weight given to these different values and desires, the application is perceived as desirable or undesirable. It appears that concerns regarding the endorsed values of certainty and naturalness are preferred to desired states as control over life and risk avoidance. As a consequence, enhancement options and options to determine a predisposition and to diagnose mental disorders might be considered controversial. The identified different perspectives and concerns are a suitable starting point for processes aiming at the identification of more responsible future directions and related applications of medical neuroimaging.     

Speed enforcement in China: National,provincial and city initiatives and their success

China is motorizing rapidly, with associated urban road development and extensive construction of motorways. Speeding accounts for about 10% of fatalities, which represents a large decrease from a peak of 17.2% in 2004. Speeding has been addressed at a national level through the introduction of laws and procedural requirements in 2004, in provinces either across all road types or on motorways, and at city level. Typically, documentation of speed enforcement programmes has taken place when new technology (i.e. speed cameras) is introduced, and it is likely that many programmes have not been documented or widely reported. In particular, the national legislation of 2004 and its implementation was associated with a large reduction in fatalities attributed to speeding. In Guangdong Province, after using speed detection equipment, motorway fatalities due to speeding in 2005 decreased by 32.5% comparing with 2004. In Beijing, the number of traffic monitoring units which were used to photograph illegal traffic activities such as traffic light violations, speeding and using bus lanes illegally increased to 1958 by April 1, 2009, and in the future such automated enforcement will become the main means of enforcement, expected to account for 60% of all traffic enforcement in Beijing. This paper provides a brief overview of the speeding enforcement programmes in China which have been documented and their successes.     

Equine road user safety: public attitudes, understandings and beliefs from a qualitative study in the United Kingdom

Horse riders represent a significant group of vulnerable road user and are involved in a number of accidents and near misses on the road. Despite this horse riders have received little attention both in terms of academic research and transport policy. Based on literature on vulnerable road user safety, including attitudes to road user safety and behaviour of drivers and their relationship with cyclists and motorcyclists, this paper examines the attitudes and reported behaviour of drivers and horse riders. A total of 46 participants took part in six focus groups divided into four groups of drivers with little or no horse riding experience and two groups of frequent horse riders. Each group investigated five key topic areas stemming from the literature review on vulnerable road users including hazard perception, risk perception, emotion, attitudes to sharing the road and empathy. It was found that drivers and horse riders are not always aware of the same hazards in the road and that this may lead drivers to under-estimate the risk when encountering horses. Drivers often had good intentions to overtake horses safely, but were unaware of how vulnerable passing very wide and slow made them feel until they had begun the manoeuvre and hence quickly reduced such feelings either by speeding up or cutting in too soon. However, other than this, drivers had good skills when encountering horses. But these skills could be impeded by frustration when encountering a slow moving horse which was further compounded by a feeling, mainly by younger drivers, that horse riding was for leisure and as such should not get in the way of necessary work journeys. There is a need for drivers to be more aware of the potential hazards a horse rider faces on the road and these could be achieved through inducing empathy amongst drivers for horse riders, creating nudges for drivers in the environment and better education for drivers.     

A simulator study on the impact of traffic calming measures in urban areas on driving behavior and workload

This study examined the impact of traffic calming measures (TCM) on major roads in rural and urban areas. More specifically we investigated the effect of gate constructions located at the entrance of the urban area and horizontal curves within the urban area on driving behavior and workload. Forty-six participants completed a 34 km test-drive on a driving simulator with eight thoroughfare configurations, i.e., 2 (curves: present, absent) × 2 (gates: present, absent) × 2 (peripheral detection task (PDT): present, absent) in a within-subject design.     

Older drivers and road safety: the acceptability of a range of intervention measures

A survey questionnaire was used to ascertain the views of 1932 UK drivers aged between 50 and 90 on a range of measures designed to promote safer driving among the elderly. Factor analysis of the items produced six factors, relating to statistically distinct types of measure. Differences in acceptability on the basis of age and sex were explored. Ratings of the effectiveness of each measure revealed little consensus about which measures would be most effective. Compulsory re-testing after a driving ban, a police power to require an assessment of the driving of anyone observed driving in a risky manner, and a requirement for opticians to report to the licensing authority any driver with sight problems likely to affect driving emerged as the individual measures offering the best combination of acceptability and perceived effectiveness.     

Addressing the road trauma burden in China: Exploring attitudes,behaviours, risk perceptions and cultural uniqueness

As China continues to motorise rapidly, solutions are needed to reduce the burden of road trauma that is spread inequitably across the community. Little is currently known about how new drivers are trained to deal with on-road challenges, and little is also known about the perceptions, behaviours and attitudes of road users in China. This paper reports on a pilot study conducted in a driver retraining facility in one Chinese city where people who have had their licence suspended for accrual of 12 demerit points in a one year period must attend compulsory retraining in order to regain their licence. A sample of 239 suspended drivers responded to an anonymous questionnaire that sought information about preferred driving speeds and perceptions of safe driving speeds across two speed zones. Responses indicated that speeds higher than the posted limits were commonly reported, and that there was incongruence between preferred and safe speeds, such that a greater proportion of drivers reported preferred speeds that were substantially faster than what were reported as safe speeds. Participants with more driving experience reported significantly fewer crashes than newly licensed drivers (less than 2 years licensed) but no differences were found in offences when compared across groups with different levels of driving experience. Perceptions of risky behaviours were assessed by asking participants to describe what they considered to be the most dangerous on-road behaviours. Speeding and drink driving were the most commonly reported by far, followed by issues such as fatigue, ignoring traffic rules, not obeying traffic rules, phone use while driving, and non-use of seatbelts, which attracted an extremely low response which seems consistent with previously reported low belt wearing rates, unfavourable attitudes towards seatbelt use, and low levels of enforcement. Finally, observations about culturally specific considerations are made from previous research conducted by the authors and others. Specifically, issues of saving face and the importance and pervasiveness of social networks and social influence are discussed with particular regard to how any future countermeasures need to be informed by a thorough understanding of Chinese customs and culture.     

Road traffic injury incidence and crash characteristics in Dar es Salaam: A population based study

Road traffic injuries (RTI) are a public health threat and a major source of disability in developing countries. A population-based analysis of RTIs in a testimonially high-risk area of Dar es Salaam, the largest city in the East African country of Tanzania, was carried out with the goal of establishing an RTI incidence and to identify RTI characteristics that may be used for a targeted injury prevention program in these communities.     

Off-highway vehicle parks: Combining environment,knowledge, and enforcement for all-terrain vehicle injury prevention

The number of off-highway vehicle (OHV) parks continues to grow to meet the recreational needs of ATV enthusiasts and the increasing popularity of the vehicle. Little is known about how OHV park regulations and enforcement affect ATV safety among their users. This study was designed to determine whether there were differences in crash mechanisms and/or compliance with ATV safety laws and regulations when comparing off-road ATV crashes inside and outside state OHV parks. Relative to outside the parks, a smaller percentage of park victims were under the age of sixteen, a lower percentage were passengers, and a dramatically higher percentage were helmeted. Mean injury severity scores were not different inside and outside the parks, but 5% of outside victims had severe brain injuries, as compared to no park victims. Overall, park victims exhibited better compliance with ATV safety laws and regulations and suffered less severe brain injury outcomes. However, park crashes involved more jump-related injuries, suggesting that additional approaches are needed to improve park safety. These findings support the hypothesis that riding environments with safety regulations and effective enforcement can promote safe behaviors and may prevent injuries.     

Dominant role of drivers’ attitude in prevention of road traffic crashes: A study on knowledge,attitude, and practice of drivers in Iran

Objective

Evaluating the relation between Iranian drivers’ knowledge, attitude, and practice (KAP) regarding traffic regulations, and their deterministic effect on road traffic crashes (RTCs).

Setting

Two cities of Tehran and Zahedan, Iran.

Methods

A cross-sectional study was designed. Using a simplified cluster sampling design, 2200 motor vehicle drivers including 1200 in Tehran and 1000 in Zahedan were selected. Sixty locations in Tehran and 50 in Zahedan were chosen. In each pre-identified location, 20 adult drivers were approached consecutively. A questionnaire developed by researchers was filled by each participant. The questionnaire had four sections including items assessing the demographics, knowledge, attitude and practice of drivers toward traffic regulations. Logistic regression analysis was used to evaluate the relationship between the RTCs and KAP variables.

Results

The study sample consisted of 619 (28.1%) occupational and 1580 (71.8%) private drivers. Among them, 86.4% were male. The median age was 33.6 ± 10.83. Drivers in Tehran and Zahedan had no significant differences between their mean scores of KAP items of the questionnaire. Higher knowledge, safer attitude, and safer practice were associated with a decreased number of RTC. After adjusting for possible confounders, increase of one standard deviation in attitude and practice scores (but not knowledge) resulted in 26.4% and 18.5% decrease in RTC, respectively. Finally, considering knowledge, attitude and practice of drivers in one model to assess their mutual effect, it was shown that only attitude is significantly associated with a decrease of RTC (OR = 0.76, P = 0.007).

Conclusion

Increase in attitude and practice accompanied with decreased number of RTCs in Iranian drivers. Specifically, drivers’ attitude had the crucial effect. It is not knowledge and standard traffic education; rather it is how such education is registered as an attitude that translates what is being learned into actions. Without safer attitude, even safer self-reported practice will not result in lower RTCs.     

Young worker safety behaviors: development and validation of measures

We conducted four studies to develop and validate measures of workplace safety-related behaviors relevant to young workers. The conceptual basis for this set of measures is a range of behavioral responses to deteriorating conditions (e.g., exit, voice, and loyalty, Hirschman, 1970; exit, voice, loyalty/patience, and neglect, Rusbult et al., 1982). In Study 1, items were generated by young workers (n = 39) who participated in focus groups. The representativeness of these items was judged in Study 2 by a separate sample of young workers (n = 79). In Study 3, we found support for five factors using exploratory factor analysis with a sample of young workers (n = 266). Confirmatory factor analysis was conducted in Study 4 using a separate sample (n = 282) and this supported the five-factor model. Self-report data on these participants and other-report (co-worker) data on a sub-sample (n = 26) of the same participants provided additional support for the validity of the scales. Overall, these studies support the validity and reliability of this set of safety-related behaviors: intentions to quit an unsafe job (exit), speaking out about safety concerns (voice), adapting to a dangerous job hoping that safety conditions improve (patience), deliberately letting safety conditions worsen (neglect), and following safety policies (compliance). This set is useful for evaluating safety interventions aimed at young workers and studying safety-related behavior in a vulnerable work population.     

Safety effects of low-cost engineering measures. An observational study in a Portuguese multilane road

Single carriageway multilane roads are not, in general, a very safe type of road, mainly because of the high number of seriously injured victims in head-on collisions, when compared with dual carriageway multilane roads, with a median barrier.     

The effects of speed enforcement with mobile radar on speed and accidents. An evaluation study on rural roads in the Dutch province Friesland

In an evaluation study, the effects of targeted speed enforcement on speed and road accidents were assessed. Enforcement was predominantly carried out by means of mobile radar and focused on rural non-motorway roads. Information and publicity supported the enforcement activities. The evaluation covered a period of 5 years of enforcement. The speed data of these 5 years and the year preceding the enforcement project showed a significant decrease in mean speed and the percentage speed limit violators over time. The largest decrease was found in the first year of the enforcement project and in the fourth year of the project, when the enforcement effort was further intensified. There were similar decreases in speeding at both the enforced roads and at the nearby comparison roads that were not subjected to the targeted speed enforcement project, which may be explained by spillover effects. The best estimate for the safety effect of the enforcement project is a reduction of 21% in both the number of injury accidents and the number of serious casualties. This was based on comparison between the number of accidents/casualties during the enforcement project (5 years) and and the 8 preceding years on the enforced roads and at all other roads outside urban areas in the same region.     

Impact of real-time traffic characteristics on freeway crash occurrence: Systematic review and meta-analysis

The development of methods for real-time crash prediction as a function of current or recent traffic and roadway conditions is gaining increasing attention in the literature. Numerous studies have modeled the relationships between traffic characteristics and crash occurrence, and significant progress has been made. Given the accumulated evidence on this topic and the lack of an articulate summary of research status, challenges, and opportunities, there is an urgent need to scientifically review these studies and to synthesize the existing state-of-the-art knowledge.     

Post-licence driver education for the prevention of road traffic crashes: a systematic review of randomised controlled trials

The effectiveness of post-licence driver education for preventing road traffic crashes was quantified using a systematic review and meta-analyses of randomised controlled trials. Searches of appropriate electronic databases, the Internet and reference lists of relevant papers were conducted. The searches were not restricted by language or publication status. Data were pooled from 21 randomised controlled trials, including over 300,000 full licence-holding drivers of all ages. Nineteen trials reported subsequent traffic offences, with a pooled relative risk of 0.96 (95% confidence interval 0.94, 0.98). Fifteen trials reported traffic crashes with a pooled relative risk of 0.98 (0.96, 1.01). Four trials reported injury crashes with a pooled relative risk of 1.12 (0.88, 1.41). The results provide no evidence that post-licence driver education is effective in preventing road injuries or crashes. Although the results are compatible with a small reduction in the occurrence of traffic crashes, this may be due to selection biases or bias in the included trials.     

The frequency and predictors of helmet use among Iranian motorcyclists: A quantitative and qualitative study

Objective

This study examines the rate of helmet use and identifies barriers and facilitators of wearing helmets among Iranian motorcyclists. A mixed-method approach was used, including a structured seasonal survey with specific observations of a random sample of 6010 riders and qualitative methods that included 29 in-depth interviews and seven focus groups (n = 31).

Results

Only 10% of motorcyclists wear a standard helmet while riding. However, another 23% of motorcyclists used non-standard or partial helmets that covered only part of the head and do not prevent head trauma injuries effectively. We observed only 2 of 264 child passengers and 22 of 1951 adult passengers wearing helmets. Almost no one used protective pants or clothing made to be more visible in traffic. Themes emerged from qualitative interviews and were grouped into three main categories: (1) helmet characteristics; (2) social and cultural factors; and (3) personal and psychological factors.

Conclusion

Overall, the motorcyclists in our study believed that wearing a safety helmet protects them against serious injuries or death during a crash; however, only a small percentage of the motorcyclists used safety helmets. National intervention programs addressing motorcycle safety should aim to overcome barriers to and promote facilitators of helmet use, including providing inexpensive standard helmets, banning manufacturing/using unsafe partial or dummy helmets, as well as enforcing helmet use on a consistent basis.     

Misunderstanding of right-of-way rules at various pedestrian crossing types: observational study and survey

Misunderstanding of right-of-way rules may contribute to pedestrian trauma, especially at crossings where pedestrian and traffic signals appear to give contradictory messages. Two thousand eight hundred and fifty-four pedestrians were observed crossing at signal-controlled intersections to compare attention to traffic for different combinations of pedestrian and traffic signals. In addition, a survey was conducted at signal-controlled intersections and nearby car parks in metropolitan and rural areas. Five hundred and seventy-four participants took the role of pedestrian or driver when responding to questions regarding beliefs about pedestrian right-of-way for a range of situations at signal-controlled crossings, zebra crossings, and unmarked sections of road (specifically: alone, with pedestrian refuge, or paved). Results suggest that at signal-controlled crossings pedestrian right-of-way is erroneously thought to be influenced by the pedestrian signal. Many respondents thought that a pedestrian refuge or paving gave a pedestrian right-of-way at an otherwise unmarked section of road. In many situations more than 20% of both drivers and pedestrians reported that they would take right-of-way. Pedestrian crossing types should be rationalised, and education should be provided regarding rules and responsibilities at available crossings.     

Evaluating traffic informers: Testing the behavioral and social-cognitive effects of an adolescent bicycle safety education program

In The Netherlands, 12–24 years old are over-represented in the total number of traffic fatalities and injuries. In this study, the traffic informer program – designed to promote safe traffic behavior in the pre-driver population – was experimentally evaluated, with a specific focus on bicycle use. Students were subjected to graphic videos of traffic accidents and listened to a first-person narrative provided by a traffic accident victim. The influence of the program on concepts derived from the theory of planned behavior and protection motivation theory (attitudes, norms, self-efficacy, risk-perception, intention and behavior) was assessed. Students from various schools (N = 1593; M age = 15 years, SD = .84) participated in a quasi-experimental study, either in an experimental or a control group, completing self-report questionnaires one week prior to the program implementation and approximately one month after the program implementation. Mixed regression analyses showed significant positive and negative time × intervention interaction effects on attitude toward traffic violations, relative attitude toward traffic safety, and risk comparison, but not on intention and behavior. More research is needed to find effective behavioral change techniques (other than increasing risk awareness) for promoting safe traffic behavior in adolescents. Research is also needed to address how these can be translated into effective interventions and educational programs.     

Safety effects of blue cycle crossings: a before-after study

This paper presents a before-after accident study of marking blue cycle crossings in 65 signalised junctions. Corrections factors for changes in traffic volumes and accident/injury trends are included using a general comparison group in this non-experimental observational study. Analysis of long-term accident trends point towards no overall abnormal accident counts in the before period. The safety effect depends on the number of blue cycle crossings at the junction. One blue cycle crossing reduces the number of junction accidents by 10%, whereas marking of two and four blue cycle crossings increases the number of accidents by 23% and 60%, respectively. Larger reduction and increases are found for injuries. Safety gains at junctions with one blue cycle crossing arise because the number of accidents with cyclists and moped riders that may have used the blue cycle crossing in the after period and pedestrians in the pedestrian crossing parallel and just next to the blue marking was statistically significant reduced. Two or four blue cycle crossings especially increase the number of rear-end collisions only with motor vehicles involved and right-angle collisions with passenger cars driving on red traffic lights.     

The economic costs of road traffic crashes: Australia, states and territories

In this paper, we obtain detailed data on road traffic crash (RTC) casualties, by severity, for each of the eight state and territory jurisdictions for Australia and use these to estimate and compare the economic impact of RTCs across these regions. We show that the annual cost of RTCs in Australia, in 2003, was approximately $17b, which is approximately 2.3% of the Gross Domestic Product (GDP). Importantly, though, there is remarkable intra-national variation in the incident rates of RTCs in Australia and costs range from approximately 0.62 to 3.63% of Gross State Product (GSP). The paper makes two fundamental contributions: (i) it provides a detailed breakdown of estimated RTC casualties, by state and territory regions in Australia, and (ii) it presents the first sub-national breakdown of RTC costs for Australia. We trust that these contributions will assist policy-makers to understand sub-national variations in the road toll better and will encourage further research on the causes of the marked differences between RTC outcomes across the states and territories of Australia.     

Validation of a method to evaluate future impact of road safety interventions,a comparison between fatal passenger car crashes in Sweden 2000 and 2010

When targeting a society free from serious and fatal road-traffic injuries, it has been a common practice in many countries and organizations to set up time-limited and quantified targets for the reduction of fatalities and injuries. In setting these targets EU and other organizations have recognized the importance to monitor and predict the development toward the target as well as the efficiency of road safety policies and interventions.