The crash and offence experience of drivers eligible for the South Australian driver intervention program

This report compares the crash and driving offence experience of two groups of offending drivers: those attending the Driver Intervention Program (DIP, a small-group workshop for disqualified L- or P-plate drivers), and those who could have attended the DIP but chose not to and paid an expiation fee instead; both before and after they became eligible for the DIP. Concerning crashes, the DIP group did not have a statistically significantly different rate from the Expiation group. Concerning moving offences (such as speeding), the DIP group had a statistically significantly lower rate than the Expiation group. Concerning administrative offences (such as driving without a licence), the DIP group had a statistically significant and much lower rate than the Expiation group. The fact that drivers themselves chose whether to attend the DIP or pay an expiation fee means that any differences found could not be ascribed solely to the DIP: pre-existing differences in the sex, age and offending rates were found. No comment could be made on the effect of the DIP on offences. It does seem unlikely that the DIP results in a large reduction in crash rate among its attendees. However, given that the DIP is a cheap measure and that the current study could not show that it is not having an effect large enough to justify this small cost, there is no reason in this study for its discontinuation. In the Discussion a true randomised experiment is described that would, if conducted, be expected to detect if the DIP program has a substantial impact.C.N. Kloeden and T.P. Hutchinso

Reduction of speed limit from 110 km/h to 100 km/h on certain roads in South Australia: a preliminary evaluation

In July 2003, the speed limit on approximately 1,100 km of rural arterial roads in South Australia was reduced from 110 km/h to 100 km/h. The crash experience on these roads in the two years before and the two years following the change has been compared with that on other roads where the 100 km/h limit was not changed. It appears that the speed limit reduction has had the effect of reducing casualty crashes by 20 per cent. However, the number of crashes on these roads is small and the time since the change is so short that this estimate is uncertain. It is reasonable to think that in the longer term the change might be anywhere between an increase of 4 per cent and a decrease of 44 per cent. There was a decrease in crashes and casualties on the 100 km/h roads where the speed limit did not change and that has been allowed for in the calculations. At six sites, speed measurements before and after the speed limit reduction were available: an average speed reduction of 2 km/h was foundA.D. Long, C.N. Kloeden, T.P. Hutchinson and A.J. McLea

Trends in traffic casualties in South Australia, 1981-2003

There has been a reduction in traffic fatalities in South Australia between 1981 and 2003, but this has not been accompanied by a fall in the total number of traffic casualties, and even the number of fatalities has declined very little since about 1992. This report throws light on these and related observations. The main data source is TARS, the database of crashes reported to the police; in addition, some use is made of statistics of death registration and of casualties hospitalised. Among the findings are the following. (a) Although the number of fatalities has not fallen much since about 1992, this has been a result of a continued decline in fatality rate and an increase in vehicle kilometres. (b) The increase in total casualties over the period 1992-2000 was largely confined to the minor categories of injury. (c) An increase in minor rear-end crashes was part of this, but not all of it. (d) In the metropolitan area of Adelaide, hospital-admitted casualties have been falling faster than fatalities over the period 1981-2003. (The evidence is less clear for country areas.) (e) There are numerous other features of the data that are not fully understood. In some cases, a more elaborate tabulation of subcategory numbers might resolve the issue, but in other cases, it is difficult to imagine doing so with mass accident data.T.P. Hutchinson, R.W.G Anderson, A.J. McLean and C.N. Kloede

A Mathematical Model of Black Rhino Translocation Strategy

A deterministic mathematical model of the black rhino population in South Africa will be discussed. The model is constructed by dividing the black rhino population into multiple patches. The impact of human intervention on different translocation strategies is incorporated into the model. It is shown that, when implemented correctly, translocation can accelerate the growth rate of the total black rhino population. Equilibrium points are shown with their local stability criteria

Cortical bony thickening of the lateral intercondylar wall : the functional attachment of the anterior cruciate ligament

Background: The anatomy of the anterior cruciate ligament (ACL) has become the subject of much debate. There has been extensive study into attachment points of the native ligament, especially regarding the femoral attachment. Some of these studies have suggested that fibers in the ACL are of differing functional importance. Fibers with higher functional importance would be expected to exert larger mechanical stress on the bone. According to Wolff’s law, cortical thickening would be expected in these areas. Purpose: To examine cortical thickening in the region of the ACL footprint (ie, the functional footprint of the ACL). Study Design: Descriptive laboratory study. Methods: Using micro–computed tomography with resolutions ranging from 71 to 91 μm, the cortical thickness of the lateral wall of the intercondylar notch in 17 cadaveric knees was examined, along with surface topography. After image processing, the relationship between the cortical thickening and surface topology was visually compared. Results: A pattern of cortical thickening consistent with the functional footprint of the ACL was found. On average, this area was 3 times thicker than the surrounding bone and significantly thicker than the remaining lateral wall (P < .0001). This thickening was roughly elliptical in shape (with a mean centroid at 23.5 h:31 t on a Bernard and Hertel grid) and had areas higher on the wall where greater thickness was present. The relationship to previously reported osseous landmarks was variable, although the patterns were broadly consistent with those reported in previous studies describing direct and indirect fibers of the ACL. Conclusion: The findings of this study are consistent with those of recent studies describing fibers in the ACL of differing functional importance. The area in which the thickening was found has been defined and is likely to represent the functional footprint of the ACL

Crosstalk between monocytes and myometrial smooth muscle in culture generates synergistic pro-inflammatory cytokine production and enhances myocyte contraction, with effects opposed by progesterone

Both term and preterm parturition are characterized by an influx of macrophages and neutrophils into the myometrium and cervix, with co-incident increased peripheral blood monocyte activation. Infection and inflammation are strongly implicated in the pathology of preterm labour (PTL), with progesterone considered a promising candidate for its prevention or treatment. In this study, we investigated the effect of monocytes on myometrial smooth muscle cell inflammatory cytokine production both alone and in response to LPS, a TLR4 agonist used to trigger PTL in vivo. We also investigated the effect of monocytes on myocyte contraction. Monocytes, isolated from peripheral blood samples from term pregnant women, were cultured alone, or co-cultured with PHM1-41 myometrial smooth muscle cells, for 24 h. In a third set of experiments, PHM1-41 myocytes were cultured for 24 h in isolation. Cytokine secretion was determined by ELISA or multiplex assays. Co-culture of monocytes and myocytes led to synergistic secretion of pro-inflammatory cytokines and chemokines including IL-6, IL-8 and MCP-1, with the secretion being further enhanced by LPS (100 ng/ml). The synergistic secretion of IL-6 and IL-8 from co-cultures was mediated in part by direct cell–cell contact, and by TNF. Conditioned media from co-cultures stimulated contraction of PHM1-41 myocytes, and the effect was inhibited by progesterone. Both progesterone and IL-10 inhibited LPS-stimulated IL-6 and IL-8 secretion from co-cultures, while progesterone also inhibited chemokine secretion. These data suggest that monocytes infiltrating the myometrium at labour participate in crosstalk that potentiates pro-inflammatory cytokine secretion, an effect that is enhanced by LPS, and can augment myocyte contraction. These effects are all partially inhibited by progesterone

Vitamin D and subsequent all-age and premature mortality: a systematic review

&lt;br&gt;Background: All-cause mortality in the population &#60; 65 years is 30% higher in Glasgow than in equally deprived Liverpool and Manchester. We investigated a hypothesis that low vitamin D in this population may be associated with premature mortality via a systematic review and meta-analysis.&lt;/br&gt; &lt;br&gt;Methods: Medline, EMBASE, Web of Science, the Cochrane Library and grey literature sources were searched until February 2012 for relevant studies. Summary statistics were combined in an age-stratified meta-analysis.&lt;/br&gt; &lt;br&gt;Results: Nine studies were included in the meta-analysis, representing 24,297 participants, 5,324 of whom died during follow-up. The pooled hazard ratio for low compared to high vitamin D demonstrated a significant inverse association (HR 1.19, 95% CI 1.12-1.27) between vitamin D levels and all-cause mortality after adjustment for available confounders. In an age-stratified meta-analysis, the hazard ratio for older participants was 1.25 (95% CI 1.14-1.36) and for younger participants 1.12 (95% CI 1.01-1.24).&lt;/br&gt; &lt;br&gt;Conclusions: Low vitamin D status is inversely associated with all-cause mortality but the risk is higher amongst older individuals and the relationship is prone to residual confounding. Further studies investigating the association between vitamin D deficiency and all-cause mortality in younger adults with adjustment for all important confounders (or using randomised trials of supplementation) are required to clarify this relationship.&lt;/br&gt

Establishing an Emergency Medicine Education Research Network

This project was developed from the research network track at the 2012 Academic Emergency Medicine consensus conference on education research in emergency medicine ( EM ). Using a combination of consensus techniques, the modified Delphi method, and qualitative research methods, the authors describe multiple aspects of developing, implementing, managing, and growing an EM education research network. A total of 175 conference attendees and 24 small‐group participants contributed to discussions regarding an education research network; participants were experts in research networks, education, and education research. This article summarizes relevant conference discussions and expert opinion for recommendations on the structure of an education research network, basic operational framework, site selection, leadership, subcommittees, guidelines for authorship, logistics, and measuring success while growing and maintaining the network.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/95595/1/acem12028.pd

Age-related changes in global motion coherence: conflicting haemodynamic and perceptual responses

Our aim was to use both behavioural and neuroimaging data to identify indicators of perceptual decline in motion processing. We employed a global motion coherence task and functional Near Infrared Spectroscopy (fNIRS). Healthy adults (n = 72, 18-85) were recruited into the following groups: young (n = 28, mean age = 28), middle-aged (n = 22, mean age = 50), and older adults (n = 23, mean age = 70). Participants were assessed on their motion coherence thresholds at 3 different speeds using a psychophysical design. As expected, we report age group differences in motion processing as demonstrated by higher motion coherence thresholds in older adults. Crucially, we add correlational data showing that global motion perception declines linearly as a function of age. The associated fNIRS recordings provide a clear physiological correlate of global motion perception. The crux of this study lies in the robust linear correlation between age and haemodynamic response for both measures of oxygenation. We hypothesise that there is an increase in neural recruitment, necessitating an increase in metabolic need and blood flow, which presents as a higher oxygenated haemoglobin response. We report age-related changes in motion perception with poorer behavioural performance (high motion coherence thresholds) associated with an increased haemodynamic response