Are Pedelec crashes different to bicycle crashes?: A comparison of national accident data in Germany

Since 2014, a distinction between Pedelec (electrical support up to 25 km/h) and bicycle crashes is made in official police reported accidents with personal injuries in Germany. Yet, no comparative analysis using national data is available, moreover some estimation was done how Pedelec crashes may look like based on bicycle crashes. Hence, the present study aims to compare real-world crashes with personal injuries with both vehicle types - Pedelec and bicycle and show similarities and differences of the vehicle classes. Nearly a decade of reporting allows furthermore to have a closer look at the accident figures in a time series and to estimate possible trends

Organizational network strengthening effects on antiretroviral therapy initiation and adherence

The WHO recommends antiretroviral therapy (ART) initiation immediately after HIV diagnosis. When HIV services are fragmented and poorly coordinated, initiation of ART can be delayed. MEASURE Evaluation conducted an organizational network intervention in Addis Ababa, Ethiopia, which increased referral network density and client satisfaction in the intervention versus control networks. The objective of our study was to extend the parent study by assessing effects of network density on the speed of ART initiation and adherence to ART. Measures of client-time since HIV diagnosis, use of ART, satisfaction with HIV-related services, and adherence were obtained from cross-sectional interviews with female service recipients with HIV/AIDS at baseline (T1, 402) and at 18-month follow-up (T2, 524) and compared between network sites. We used weighted least squares estimation with probit regression techniques in a structural equation modeling framework for analyses. On average at follow-up, clients in the intervention network were more likely to have quicker ART initiation, and were initiated on ART 15 days faster than clients in the control network. Moreover, quicker ART initiation was associated with higher adherence. A unit increase in speed of ART initiation was associated with 0.5 points increase in latent adherence score in the intervention group (ρ < .05). Satisfaction with care positively predicted adherence to ART. Network density had no direct effect on ART adherence. This quasi-experiment demonstrated that increased referral network density, through improved HIV client referrals, can enhance speed of ART initiation, resulting in improved adherence. © Society of Behavioral Medicine 2018

Interactions among poverty, gender, and health systems affect women's participation in services to prevent HIV transmission from mother to child: A causal loop analysis

Retention in care remains an important issue for prevention of mother-to-child transmission (PMTCT) programs according to WHO guidelines, formerly called the ªOption B+º approach. The objective of this study was to examine how poverty, gender, and health system factors interact to influence women's participation in PMTCT services. We used qualitative research, literature, and hypothesized variable connections to diagram causes and effects in causal loop models. We found that many factors, including antiretroviral therapy (ART) use, service design and quality, stigma, disclosure, spouse/partner influence, decision- making autonomy, and knowledge about PMTCT, influence psychosocial health, which in turn affects women's participation in PMTCT services. Thus, interventions to improve psychosocial health need to address many factors to be successful. We also found that the design of PMTCT services, a modifiable factor, is important because it affects several other factors. We identified 66 feedback loops that may contribute to policy resistanceÐthat is, a policy's failure to have its intended effect. Our findings point to the need for a multipronged intervention to encourage women's continued participation in PMTCT services and for longitudinal research to quantify and test our causal loop model

Toward Rigorous Idiographic Research in Prevention Science: Comparison Between Three Analytic Strategies for Testing Preventive Intervention in Very Small Samples

Psychosocial prevention research lacks evidence from intensive within-person lines of research to understand idiographic processes related to development and response to intervention. Such data could be used to fill gaps in the literature and expand the study design options for prevention researchers, including lower-cost yet rigorous studies (e.g., for program evaluations), pilot studies, designs to test programs for low prevalence outcomes, selective/indicated/ adaptive intervention research, and understanding of differential response to programs. This study compared three competing analytic strategies designed for this type of research: autoregressive moving average, mixed model trajectory analysis, and P-technique. Illustrative time series data were from a pilot study of an intervention for nursing home residents with diabetes (N=4) designed to improve control of blood glucose. A within-person, intermittent baseline design was used. Intervention effects were detected using each strategy for the aggregated sample and for individual patients. The P-technique model most closely replicated observed glucose levels. ARIMA and P-technique models were most similar in terms of estimated intervention effects and modeled glucose levels. However, ARIMA and P-technique also were more sensitive to missing data, outliers and number of observations. Statistical testing suggested that results generalize both to other persons as well as to idiographic, longitudinal processes. This study demonstrated the potential contributions of idiographic research in prevention science as well as the need for simulation studies to delineate the research circumstances when each analytic approach is optimal for deriving the correct parameter estimates

Are Pedelec crashes different to bicycle crashes?: A comparison of national accident data in Germany

Since 2014, a distinction between Pedelec (electrical support up to 25 km/h) and bicycle crashes is made in official police reported accidents with personal injuries in Germany. Yet, no comparative analysis using national data is available, moreover some estimation was done how Pedelec crashes may look like based on bicycle crashes. Hence, the present study aims to compare real-world crashes with personal injuries with both vehicle types - Pedelec and bicycle and show similarities and differences of the vehicle classes. Nearly a decade of reporting allows furthermore to have a closer look at the accident figures in a time series and to estimate possible trends

Are Pedelec crashes different to bicycle crashes?: A comparison of national accident data in Germany

Since 2014, a distinction between Pedelec (electrical support up to 25 km/h) and bicycle crashes is made in official police reported accidents with personal injuries in Germany. Yet, no comparative analysis using national data is available, moreover some estimation was done how Pedelec crashes may look like based on bicycle crashes. Hence, the present study aims to compare real-world crashes with personal injuries with both vehicle types - Pedelec and bicycle and show similarities and differences of the vehicle classes. Nearly a decade of reporting allows furthermore to have a closer look at the accident figures in a time series and to estimate possible trends

How to Link Accident Data and Road Traffic Measurements to Enable ADAS/AS Simulation?

The progress of safety technologies, based on the continuous advances in vehicle crash worthiness, restraint systems and active safety functions made traffic safer than ever before. Latest developments heading from assisted Advanced Driver Assistance System (ADAS) to Automated Driving (AD), lead to more and more complex real-world situations to be handled, going from standard driving tasks up to critical situations, which may cause a collision. Therefore, throughout the development process of such systems, it becomes common to use simulation technologies in order to assess these systems in advance. To gain results out of the simulation, input data are required; typically, from various sources, so the requirements can be covered. Thus, the challenge of scoping with different input sources arises. To come along with that problem, two main kinds of input data will be needed in general: (1) the descriptive parameter covering all border conditions, so called parameter room; (2) the system specifications for estimation. The quality of the results correlates strongly with the quality of inputs given. In case of ADAS systems and AD functions, the second kind of input data is very well known. Major challenges relate to the first kind of input data. Thus, the paper will describe a way to create input data that cover all descriptive parameters needed from normal driving up to the collision by the combination of accident analysis and real-world road traffic observations. The method aims at being applicable to different data sources and to different countries

Is there a broken trend in traffic safety in Germany? Model based approach describing the relation between traffic fatalities in Germany and environmental conditions

The declining trend since 1991 in the number of killed people was broken in 2011 when overall 4 009 people died in traffic accidents in Germany. The question arises if there is a stagnating trend of fatalities in Germany in future? By breaking down the accidents with casualties towards a monthly view one can see a decreasing trend of fatalities in the warmer months especially since 2009. When comparing against winter months higher deviations are observed. In December 2011 an increase of 191 traffic deaths were registered (181 in 2010 compared to 372 in 2011). Further analyses of different accident influences were evaluated and their possibility of drastic change from one year to the other was determined. As seen weather- and environmental conditions are one of the major contributing factors and are one of the causes for the increased number of fatalities. To support the underlying assumption a model had been created to calculate the number of traffic deaths on a daily basis approach. As an input, road conditions projected through weather parameters and also different driving behaviors on weekdays or holidays were used. As a result, estimates of daily fatality with up to 75% precision can be achieved out of the 2009, 2010 and 2011 data. Further on it shows that weather and street conditions have a high influence on the overall resulting number of traffic accidents with casualties, and especially to the number of fatalities. Hence it is estimated that approximately 3 300 people were killed in traffic accidents in Germany in 2013 which would be again a reduction of another 13% compared to 2012. Therefore an answer to the question will be that the decreasing trend in traffic fatalities in Germany somehow is not broken when environmental conditions are included in national statistics. Their effects will become more visible in future accident statistics and it is estimated variances of 5% to 8% of the annual number of traffic fatalities in Germany will be seen