Factors affecting the likelihood of reporting road crashes resulting in medical treatment to the police

Objective: This paper aims to determine the percentage of road crashes resulting in injuries requiring hospital care that are reported to the police and to identify factors associated with reporting such crashes to the police. Design: The data of one of two hospitals in the Road Casualty Information System were matched with the police's Traffic Accident Database System. Factors affecting the police-reporting rate were examined at two levels: the different reporting rates among subgroups examined and tested with χ2 tests; and multiple explanatory factors were scrutinised with a logistic regression model to arrive at the odds ratios to reflect the probability of police-reporting among subgroups. Results: The police-reporting rate was estimated to be 57.5-59.9%. In particular, under-reporting among children (reporting rate = 33.6%) and cyclists (reporting rate = 33.0%) was notable. Discussion: Accurate and reliable road crash data are essential for unveiling the full-scale and nature of the road safety problem. The police crash database needs to be supplemented by other data. In particular, any estimation about the social costs of road crashes must recognise the under-reporting problem. The large number of injuries not reflected in the police crash database represents a major public health issue that should be carefully examined.published_or_final_versio

Age as a Risk Factor in Pedestrian Traffic Casualties

This paper makes use of a linked hospital database, the Road Casualty Information System (RoCIS), to examine age as a risk factor in pedestrian traffic casualties. The database consisted of 4,290 traffic casualty records admitted to two major hospitals in Hong Kong in 2004. Among these records, there were 897 pedestrian traffic casualties (PTC) and 3,367 non-pedestrian traffic casualties (NPTC). Statistically, there was no significant age difference among the two groups. However, the severity of injury differed significantly at the 0.05 level. In order to conduct a more in-depth analysis of the age factor in affecting the severity of injuries, the pedestrian traffic casualties were divided into four age groups. A set of five injury severity variables were calculated for different age groups. For PTC, all injury severity indicators increased by age. The picture was less clear for NPTC. Theoretically, there are many confounding factors, such as gender, vehicle class and injury patterns, to injury severity. The relationships of these risk factors with the five injury severity variables are analyzed by logistic regression. Overall, the results clearly point to the importance of age as a risk factor. In all models, the elderly (≥65 years) were having higher chances of serious injury and fatality. The odd ratios imply that elderly PTC were about twice more likely to die and to suffer from serious injury than younger ones. In addition, multiple injuries and heavy vehicles also increased the chance of severe injury among PTC.published_or_final_versio

Image registration in intra-oral radiography

Image registration is one of the image processing methods which is widely used in computer vision, pattern recognition, and medical imaging. In digital subtraction radiography, image registration is one of the important prerequisites to match the reference and subsequent images. In this paper, we propose an automatic non-rigid registration method namely curvature-based registration that relies on a curvature based penalizing term and its application on dental radiography. The regularizing term of this intensity-based registration approach provides affine linear transformation so that pre-registration step is no longer necessary. This leads to faster and more reliable solutions. The implementation of this approach is based on the numerical solution of the underlying Euler-Lagrange equations. In addition, a comparison between this algorithm and Linear Alignment Method (LAM) with 20 image pairs is presented. © 2005 IEEE.published_or_final_versio

Rapid and efficient generation of neural progenitors from adult bone marrow stromal cells by hypoxic preconditioning

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Prevalence of drugged drivers among non-fatal driver casualties presenting to a trauma centre in Hong Kong

OBJECTIVE: To investigate the prevalence and characteristics of abusive drug exposure among non-fatal motor vehicle driver casualties presenting to a designated trauma centre in Hong Kong. DESIGN: Cross-sectional study. SETTING: Designated trauma centre/regional accident and emergency department in Hong Kong. SUBJECTS: Non-fatal motor vehicle driver casualties who presented to the trauma centre from 1 January 2007 to 31 December 2007. MAIN OUTCOME MEASURES: Screening of abusive drug exposure using commercial bedside urine immunoassay kits. RESULTS: Drug screening was performed in 395 injured drivers, 10% of whom tested positive for the drugs of interest. Ketamine was the most commonly detected abusive substance (found in 45% of the subjects). A significantly higher proportion of young drivers (aged <25 years) screened positive (odds ratio=2.3; 95% confidence interval, 1.0-5.2; P=0.04), with the rate being 21%. The presence of these drugs in urine was related to the time of occurrence of the crash; those occurring between midnight and dawn revealed a trend towards a higher proportion of casualties testing drug-positive (odds ratio=2.2; 95% confidence interval, 0.9-5.3; P=0.07). There were no significant differences in the frequency of persons testing positive for the screened drugs with respect to gender, class of motor vehicle driven, or the day of the week on which the crash occurred. CONCLUSIONS: The prevalence of drugged driving among non-fatal casualties in our series of Hong Kong drivers was 10%. The frequency of such drivers testing positive for drugs was significantly higher in persons aged less than 25 years. These findings indicate a need to amend existing laws and implement on-site drug screening for suspected drugged drivers.published_or_final_versio

Effects of Patient Empowerment Programme (PEP) on Clinical Outcomes and Health Service Utilization in Type 2 Diabetes Mellitus in Primary Care: An Observational Matched Cohort Study

Background: To evaluate the effects of a large population-based patient empowerment programme (PEP) on clinical outcomes and health service utilization rates in type 2 diabetes mellitus (T2DM) patients in the primary care setting. Research Design and Subjects: A stratified random sample of 1,141 patients with T2DM enrolled to PEP between March and September 2010 were selected from general outpatient clinics (GOPC) across Hong Kong and compared with an equal number of T2DM patients who had not participated in the PEP (non-PEP group) matched by age, sex and HbA1C level group. Measures: Clinical outcomes of HbA1c, SBP, DBP and LDL-C levels, and health service utilization rates including numbers of visits to GOPC, specialist outpatient clinics (SOPC), emergency department (ED) and inpatient admissions, were measured at baseline and at 12-month post-recruitment. The effects of PEP on clinical outcomes and health service utilization rates were assessed by the difference-in-difference estimation, using the generalized estimating equation models. Results: Compared with non-PEP group, PEP group achieved additional improvements in clinical outcomes over the 12-month period. A significantly greater percentage of patients in the PEP group attained HbA1C≤7% or LDL-C≤2.6 mmol/L at 12-month follow-up compared with the non-PEP group. PEP group had a mean 0.813 fewer GOPC visits in comparison with the non-PEP group. Conclusions: PEP was effective in improving the clinical outcomes and reduced the general outpatient clinic utilization rate over a 12-month period. Empowering T2DM patients on self-management of their disease can enhance the quality of diabetes care in primary care.published_or_final_versio

A simulation study of the effects of alcohol on driving performance in a Chinese population

Driving under the influence of alcohol (DUIA) is a significant factor contributing to road traffic crashes, injuries, and fatalities. Although the effects of alcohol on driving performance are widely acknowledged, studies of the effects of alcohol impairment on driving performance and particularly on the control system of Chinese adults are rare. This study attempts to evaluate the effects of alcohol on the driving performance of Chinese adults using a driving simulator.Method: A double-blind experimental study was conducted to evaluate the effects of alcohol impairment on the driving performance of 52 Chinese participants using a driving simulator. A series of simulated driving tests covering two driving modules, including emergency braking (EB) and following braking (FB), at 50. km/h and 80. km/h were performed. Linear mixed models were established to evaluate driving performance in terms of braking reaction time (BRT), the standard deviation of lateral position (SD-LANE), and the standard deviation of speed (SD-SPEED).Results: Driving performance in terms of BRT and SD-LANE was highly correlated with the level of alcohol consumption, with a one-unit increase in breath alcohol concentration (BrAC) degrading BRT and SD-LANE by 0.3% and 0.2%, respectively. Frequent drinkers generally reacted faster in their BRT than less-frequent drinkers and non-drinkers by 10.2% and 30.6%, respectively. Moreover, alcohol impairment had varying effects on certain aspects of the human control system, and automatic action was less likely to be affected than voluntary action from a psychological viewpoint.Conclusion: The findings should be useful for planning and developing effective measures to combat drink driving in Chinese communities.Department of Civil and Environmental Engineerin

Transmission of methicillin-resistant staphylococcus aureus in the long term care facilities in Hong Kong

Background The relative contribution of long term care facilities (LTCFs) and hospitals in the transmission of methicillin-resistant Staphylococcus aureus (MRSA) is unknown. Methods Concurrent MRSA screening and spa type analysis was performed in LTCFs and their network hospitals to estimate the rate of MRSA acquisition among residents during their stay in LTCFs and hospitals, by colonization pressure and MRSA transmission calculations. Results In 40 LTCFs, 436 (21.6%) of 2020 residents were identified as ‘MRSA-positive’. The incidence of MRSA transmission per 1000-colonization-days among the residents during their stay in LTCFs and hospitals were 309 and 113 respectively, while the colonization pressure in LTCFs and hospitals were 210 and 185 per 1000-patient-days respectively. MRSA spa type t1081 was the most commonly isolated linage in both LTCF residents (76/121, 62.8%) and hospitalized patients (51/87, 58.6%), while type t4677 was significantly associated with LTCF residents (24/121, 19.8%) compared with hospitalized patients (3/87, 3.4%) (p < 0.001). This suggested continuous transmission of MRSA t4677 among LTCF residents. Also, an inverse linear relationship between MRSA prevalence in LTCFs and the average living area per LTCF resident was observed (Pearson correlation −0.443, p = 0.004), with the odds of patients acquiring MRSA reduced by a factor of 0.90 for each 10 square feet increase in living area. Conclusions Our data suggest that MRSA transmission was more serious in LTCFs than in hospitals. Infection control should be focused on LTCFs in order to reduce the burden of MRSA carriers in healthcare settings.published_or_final_versio