Cyclist deaths in London: implications from a safe systems perspective

Cyclist deaths in London: implications from a safe systems perspectiv

Pedal cyclist fatalities in London: analysis of police collision files (2007-2011)

The objective of this research report is to support the development of the forthcoming Cycle Safety Action Plan being prepared by Transport for London to be published in 2014. TfL wished to improve the understanding of the factors which lead to collisions involving fatally injured cyclists and those with life-changing injuries. The research focussed on an in-depth analysis of collisions that occurred between 2007 – 2011 when there were 79 fatal and life threatening collisions involving cyclists of which 53 were available for analysis

Seeking support after hospitalisation for injury: a nested qualitative study of the role of primary care

Background In the UK, studies suggest that the transition from hospital to home after an injury can be a difficult time and many patients report feeling inadequately prepared. Patients often use primary care services after hospital discharge. These consultations provide opportunities to consider problems that patients experience and to facilitate recovery. Little is known, however, about how patients and service providers view care after hospital discharge and the role played by primary care services, specifically GPs. Aim To identify good practice and unmet needs in respect of post-discharge support for injured patients. Design and setting Qualitative study using semi-structured interviews at four sites (Bristol, Leicester/ Loughborough, Nottingham, and Surrey). Method Qualitative interviews with 40 service providers and 45 hospitalised injured patients. Results Although there were examples of wellmanaged hospital discharges, many patients felt they were not provided with the information they needed about their injury, what to expect in terms of recovery, pain control, return to work, psychological problems, and services to help meet their needs. They also described difficulty accessing services such as physiotherapy or counselling. Service providers identified problems with communication between secondary and primary care, lack of access to physiotherapy, poor communication about other services that may help patients, GP service and resource constraints, and difficulties in providing information to patients concerning likely prognosis. Conclusion Discharge from hospital after an injury can be problematic for patients. Changes in both secondary and primary care are required to resolve this problem

Psychological morbidity and health related quality of life after injury: multicentre cohort study

Purpose To demonstrate the impact of psychological morbidity 1 month post-injury on subsequent post-injury quality of life (HRQoL) in a general injury population in the UK to inform development of trauma care and rehabilitation services. Methods Multicentre cohort study of 16–70-year-olds admitted to 4 UK hospitals following injury. Psychological morbidity and HRQoL (EQ-5D-3L) were measured at recruitment and 1, 2, 4 and 12 months post-injury. A reduction in EQ-5D compared to retrospectively assessed pre-injury levels of at least 0.074 was taken as the minimal important difference (MID). Multilevel logistic regression explored relationships between psychological morbidity 1 month post-injury and MID in HRQoL over the 12 months after injury. Results A total of 668 adults participated. Follow-up rates were 77% (1 month) and 63% (12 months). Substantial reductions in HRQoL were seen; 93% reported a MID at 1 month and 58% at 12 months. Problems with pain, mobility and usual activities were commonly reported at each time point. Depression and anxiety scores 1 month post-injury were independently associated with subsequent MID in HRQoL. The relationship between depression and HRQoL was partly explained by anxiety and to a lesser extent by pain and social functioning. The relationship between anxiety and HRQoL was not explained by factors measured in our study. Conclusions Hospitalised injuries result in substantial reductions in HRQoL up to 12 months later. Depression and anxiety early in the recovery period are independently associated with lower HRQoL. Identifying and managing these problems, ensuring adequate pain control and facilitating social functioning are key elements in improving HRQoL post-injury

RSRR 123 Road user safety and disadvantage – appendix 2: literature review

RSRR 123 Road user safety and disadvantage – appendix 2: literature revie

Fatal and serious collisions involving pedal cyclists and trucks in London between 2007 and 2011

<p><b>Objective</b>: Increased numbers of people riding pedal cycles have led to a greater focus on pedal cycle safety. The aim of this article is to explore factors that are associated with fatal and a small number of serious-injury pedal cyclist crashes involving trucks that occurred in London between 2007 and 2011.</p> <p><b>Methods</b>: Data were collected from police collision files for 53 crashes, 27 of which involved a truck (≥3.5 tonnes) and a pedal cycle. A systematic case review approach was used to identify the infrastructure, vehicle road user, and management factors that contributed to these crashes and injuries and how these factors interacted.</p> <p><b>Results</b>: Trucks turning left conflicting with pedal cyclists traveling straight ahead was a common crash scenario. Key contributory factors identified included the pedal cyclists not being visible to the truck drivers, road narrowing, and inappropriate positioning of pedal cyclists.</p> <p><b>Conclusions</b>: Crashes involving trucks and pedal cyclists are complex events that are caused by multiple interacting factors; therefore, multiple measures are required to prevent them from occurring.</p

sj-docx-1-tra-10.1177_14604086231216180 - Supplemental material for The association between post-injury chronic physical health conditions, health status, and survival time in people with serious orthopaedic injuries

Supplemental material, sj-docx-1-tra-10.1177_14604086231216180 for The association between post-injury chronic physical health conditions, health status, and survival time in people with serious orthopaedic injuries by Asmare Yitayeh Gelaw, Belinda J Gabbe, Sarah J Arnup, Sandra Reeder, Mark Fitzgerald, Ronan Anthony Lyons, Jennie Louise Ponsford, Alex Collie, Nicola Christie, Andrew Nunn, James E Harrison, Peter Cameron and Christina L Ekegren in Trauma</p

sj-docx-3-tra-10.1177_14604086231216180 - Supplemental material for The association between post-injury chronic physical health conditions, health status, and survival time in people with serious orthopaedic injuries

Supplemental material, sj-docx-3-tra-10.1177_14604086231216180 for The association between post-injury chronic physical health conditions, health status, and survival time in people with serious orthopaedic injuries by Asmare Yitayeh Gelaw, Belinda J Gabbe, Sarah J Arnup, Sandra Reeder, Mark Fitzgerald, Ronan Anthony Lyons, Jennie Louise Ponsford, Alex Collie, Nicola Christie, Andrew Nunn, James E Harrison, Peter Cameron and Christina L Ekegren in Trauma</p

sj-docx-2-tra-10.1177_14604086231216180 - Supplemental material for The association between post-injury chronic physical health conditions, health status, and survival time in people with serious orthopaedic injuries

Supplemental material, sj-docx-2-tra-10.1177_14604086231216180 for The association between post-injury chronic physical health conditions, health status, and survival time in people with serious orthopaedic injuries by Asmare Yitayeh Gelaw, Belinda J Gabbe, Sarah J Arnup, Sandra Reeder, Mark Fitzgerald, Ronan Anthony Lyons, Jennie Louise Ponsford, Alex Collie, Nicola Christie, Andrew Nunn, James E Harrison, Peter Cameron and Christina L Ekegren in Trauma</p

Baseline characteristics of treatment groups. Values are numbers and % unless stated otherwise.

<p>[] denotes missing values for responders to questionnaire.</p