Comparing motor-­vehicle crash risk of EU and US vehicles

This study examined the hypotheses that vehicles meeting EU safety standards perform similarly to US-­‐regulated vehicles in the US driving environment, and vice versa. The analyses used three statistical approaches to “triangulate” evidence regarding differences in crash and injury risk. Separate analyses assessed crash avoidance technologies, including headlamps and mirrors. The results suggest that when controlling for differences in environment and exposure, vehicles meeting EU standards offer reduced risk of serious injury in frontal/side crashes and have driver-­‐side mirrors that reduce risk in lane-­‐change crashes better, while vehicles meeting US standards provide a lower risk of injury in rollovers and have headlamps that make pedestrians more conspicuous.Alliance of Automobile Manufacturershttp://deepblue.lib.umich.edu/bitstream/2027.42/112977/1/103199.pd

Injury crashes and the relationship with disease causing excessive daytime sleepiness

Objective The objective of this study was to understand the relationship between some of the most common diseases that are known to contribute to excessive daytime sleepiness (EDS) and traffic injury crashes. Specific focus was on the relationship between disease and crash type (single-vehicle or multiple-vehicle crash) and between disease and injury severity. Methods This registry-based study considered all passenger car drivers involved in a crash in Sweden between 2011 and 2016 who were 40 years or older at the time of the crash (n = 54,090). For each crash-involved driver, selected medical diagnoses registered from 1997 until the day before the crash were extracted from the National Patient Register. The drivers were assigned to 1 of 4 groups, depending on prior diseases: sleep apnea (SA; group 1, n = 2,165), sleep disorders (group 2, n = 724), Parkinsons or epilepsy (group 3, n = 645) and a reference group (group 4, n = 50,556). Logistic regression analysis compared single-vehicle crashes with multiple-vehicle crashes and moderately/severely injured drivers with slightly/uninjured drivers. Results Drivers with EDS-related diseases (groups 1-3) had higher probability of a single-vehicle crash than a multiple-vehicle crash compared to the reference group. The most sizeable effect was found for Parkinsons/epilepsy with an odds ratio (OR) of 2.5 (confidence interval [CI], 2.1-3.0). For multiple-vehicle crashes, the probability of a moderate/severe injury was higher for drivers with other sleep disorders (OR = 1.5; CI, 1.0-2.2) and Parkinsons/epilepsy (OR = 1.6; CI, 1.1-2.3) compared to the reference group. Conclusions This study has made first steps toward understanding the relationship between some of the most common diseases that are known to contribute to EDS and crashes. Having Parkinsons/epilepsy, in particular, elevated the probability of a single-vehicle crash compared to a multiple-vehicle crash. A single-vehicle crash was seen as indicative of causing a crash; thus, having Parkinsons/epilepsy could be interpreted as a risk factor for crash involvement. Having Parkinsons/epilepsy, as well as other sleep disorders, was also related to more severe outcomes in multiple-vehicle crashes, given that a crash occurred. This was not identified in single-vehicle crashes.Funding Agencies|project ADAS&amp;ME - European Unions Horizon 2020 research and innovation program [688900]; Swedish Transport Agency</p

Nursing management matters for registered nurses with a PhD working in clinical practice

AimTo investigate what registered nurses (RNs) with a PhD working in clinical practice experience in terms of their role, function and work context. BackgroundPrevious studies have shown that RNs with a graduate degree contribute to better and safer care for patients. However, little is known about what further academic schooling of RNs, at PhD level, means for clinical practice. MethodQualitative design, with semi-structured interviews and inductive content analysis. ResultsThe main areas of responsibilities for RNs with a PhD working in clinical practice were related to practice development and implementation of research results. In their work, they experienced barriers to the full use of their competence; the expectations and prerequisites of the organisation were not clearly defined, and they often lacked a mandate to create conditions for quality improvement of nursing care. ConclusionsRNs with a PhD can contribute to evidence-based practice (EBP), clinical training, as well as the development of clinical research. Their roles and responsibilities need to be clarified, and for this, they need support from managers. Implications for Nursing ManagementNurse managers have the opportunity to partner with RNs with a PhD to support the EBP process and help structure nursing practice in more efficient ways.Funding Agencies|Karolinska University Hospital</p