Transport Accident Commission

BackgroundWhile diverse studies highlight the benefits of women in road safety, their experiences and challenges in advocacy remain under-researched. Landmark road safety legislation, like Law Julian Esteban in Colombia (2022) or the General Law of Mobility and Road Safety in Mexico (2022) were led by women advocates. This study explored the role, challenges, and solutions related to women advocating for road safety through a comprehensive survey.ObjectivesUnderstand the unique role of women leaders in road safety advocacy.Identify the barriers faced by women leaders in road safety advocacy.Analyze potential solutions implemented and proposed by women leaders in road safety advocacy.MethodsA global online survey with 29 closed and open-ended questions was conducted, reaching health advocates across 38 countries. We received 110 responses (51% female, 48% male, 1% non-binary; ages 18–60). Respondents represented academia, nonprofits, for-profits and the public sector/government, including junior to senior roles, with experience in road safety, tobacco control, drowning prevention and nutritional health. We then conducted qualitative and quantitative analyses.ResultsDiffering approaches: 70% of respondents perceive women advocates adopting different approaches from male advocates and are particularly effective in communication and partnership building. Further, female respondents perceived as more important to be presentable and empathetic, and observed as less important to follow political rules of etiquette, than their male counterparts. There is a higher correlation of women using advocacy techniques that incorporate teamwork, whereas the observed correlation with men emphasizes individual advocacy techniques.Unique barriers: Women face challenges like work-family balance, lack of mentorship, pay gaps, gender bias, and safety concerns.Potential solutions: Spotlight the barriers women in advocacy face, policy changes for equality, formal training programs, leadership placements, creating safe spaces, and network building.Conclusions:Law Julian Esteban and the General Law of Mobility and Road Safety showcase how women advocates exemplified the potential solutions portrayed in this study. Indeed, empowering more women advocates will strengthen teamwork and coalitions, maximizing the possibility for stronger laws and policies not just in road safety but other fields.

The increasing demand for pain management and limited resources available highlight the need to measure treatment effectiveness. We analysed data collected at 75 specialist persistent pain services located in Australia and New Zealand to calculate the overall treatment outcome for patients receiving care during 2014 to 2020. Sociodemographic and clinical information was provided for 23,915 patients, along with patient-reported measures assessing pain, pain interference, depression, anxiety, stress, pain catastrophizing, and pain self-efficacy. Latent class analysis identified 4 distinct outcomes based on patients' pattern of responses across the assessment tools at treatment end. Group 1 (n = 8369, 35%) reported low/mild severity across all clinical domains at the end of care, while group 4 (n= 7081, 30%) were more likely to report moderate/high severity on all domains. Group 2 (n = 1991, 8%) reported low/mild pain with moderate/high psychological distress at treatment end, and group 3 (n = 6474, 27%) reported moderate/high pain with low/mild psychological distress. Multivariable logistic regression identified those factors associated with the different groups. In particular, factors most predictive of a poor (group 4) vs good outcome (group 1) were unemployment (due to pain or other reasons), requiring an interpreter, widespread pain, pain of longer duration, and attributing the pain to an injury at work. The results may allow identification of those most likely to benefit from the services currently provided and inform development of alternative or enhanced services for those at risk of a poor outcome.

Abstract For many decades, road safety measures in Australia focused almost exclusively on behavioral approaches. When Claes Tingvall was appointed Director of MUARC, he introduced the concept of “Vision Zero” to Australia and, with it, the “Safe System” approach. While political leaders initially regarded a vision for zero deaths as unachievable, they supported the inherent logic of the Safe System.Initially the Safe System was applied as four independent pillars. While this lack of integration had limitations, it did enable road safety measures to move beyond road user behavior to focus more on safer road infrastructure and vehicle safety.The initial Safe System approach became “Towards Zero” an approach that accepts humans are fragile, and the road system designed to protect from death or serious injury was adopted across all Australia jurisdictions between 2004 and 2018.Public education has been used to introduce and explain Towards Zero and bring greater attention to the importance of purchasing a safe vehicle. Infrastructure investment has moved from a “blackspot” approach to the Safe System approach. However, shifting community and decision-makers’ understanding of the importance of speed limits being set to match the safety standard and design of a road remains a challenge. Future opportunities involve better integration of the components of the Safe System, focusing on serious injuries and improving strategy delivery, performance reporting, management, and accountability.

In document clustering, individual documents are typically represented by feature vectors based on term-frequency or bag-of-word models. However, such feature vectors intrinsically dismiss the order of the words in the document and suffer from very high dimensionality. For these reasons, in this paper we present novel taxonomy-augmented features that enjoy two promising characteristics: (1) they leverage semantic word embeddings to take the word order into account, and (2) they reduce the feature dimensionality to a very manageable size. Our feature extraction approach consists of three main steps: first, we apply a word embedding technique to represent the words in a word embedding space. Second, we partition the word vocabulary into a hierarchy of clusters by using k-means hierarchically. Lastly, the individual documents are projected to the hierarchy and a compact feature vector is extracted. We propose two methods for generating the features: the first uses all the clusters in the hierarchy and results in a feature vector whose dimensionality is equal to the number of the clusters. The second uses a small set of user-defined words and results in an even smaller feature vector whose dimensionality is equal to the size of the set. Numerical experiments on document clustering show that the proposed approach is capable of achieving comparable or even higher accuracy than conventional feature vectors with a much more compact representation.

BackgroundThe path to recovery following major trauma can involve a long trajectory of complex health care needs and multiple interactions with health professions. We explored the perspectives of seriously injured patients regarding issues that arise during their interactions with health providers.MethodsThis qualitative study, nested within a population-based longitudinal cohort study, involved semi-structured telephone interviews conducted three years following injury with 64 adult major trauma patients purposively sampled from the Victorian State Trauma Registry. We report one aspect here. Thematic analysis was undertaken of interview transcripts.ResultsThe importance of effective communication was a theme that had implications in the in-hospital, rehabilitation and community care settings. Effective communication occurred when service providers conveyed detailed information in a sensitive and clear manner, frequently and actively involved patients in discussion, and were responsive to patients’ questions. Such interactions encouraged information exchange and shared decision-making. Ineffective communication arose predominately during in-hospital care and at discharge from inpatient facilities. Themes related to hospital care included limited contact with health professionals, inability to process information, indirect communication, and struggling to deal with multiple health professionals. At hospital and rehabilitation discharge, themes included insufficient patient engagement, inadequate information flow and feeling disregarded. Ineffective communication resulted in discontinuity of care and preventable health problems.ConclusionsThe communication and information needs of seriously injured patients were inconsistently met over the course of their recovery. The findings reveal the need for trauma care systems to support relevant training of service providers, engage patients in planning decisions, and provide information in appropriate forms.

The second year of life is a time of rapid developmental changes. This paper aims to describe the pattern of unintentional injuries to one-year old children in three-month age bands to better understand the risks associated with developmental stages and, therefore, identify opportunities for proactive prevention. Injury surveillance data were used to identify children admitted to hospital in Queensland, Australia for an unintentional injury from 2002–2012. Falls were the most common injury, followed by burns and scalds, contact injuries and poisonings. Falls and contact injuries remained roughly constant by age, burns and scalds decreased and poisonings (by medications) increased. Animal- and transport-related injuries also became more common, immersions and other threats to breathing less common. Within the falls and contact categories falls from play equipment and injuries due to contact with persons increased, while falls down stairs and catching fingers in doors decreased. The pattern of injuries varies over the second year of life and is clearly linked to the child’s increasing mobility and boldness. Preventive measures for young children need to be designed—and evaluated—with their developmental stage in mind, using a variety of strategies, including opportunistic, developmentally specific education of parents; and practitioners should also consider potential for lapses in supervision and possible intentional injury in all injury assessments.

ObjectiveThe ability to predict costs following a traumatic brain injury (TBI) would assist in planning treatment and support services by healthcare providers, insurers and other agencies. The objective of the current study was to develop predictive models of hospital, medical, paramedical, and long-term care (LTC) costs for the first 10 years following a TBI.MethodsThe sample comprised 798 participants with TBI, the majority of whom were male and aged between 15 and 34 at time of injury. Costing information was obtained for hospital, medical, paramedical, and LTC costs up to 10 years postinjury. Demographic and injury-severity variables were collected at the time of admission to the rehabilitation hospital.ResultsDuration of PTA was the most important single predictor for each cost type. The final models predicted 44% of hospital costs, 26% of medical costs, 23% of paramedical costs, and 34% of LTC costs. Greater costs were incurred, depending on cost type, for individuals with longer PTA duration, obtaining a limb or chest injury, a lower GCS score, older age at injury, not being married or defacto prior to injury, living in metropolitan areas, and those reporting premorbid excessive or problem alcohol use.ConclusionsThis study has provided a comprehensive analysis of factors predicting various types of costs following TBI, with the combination of injury-related and demographic variables predicting 23-44% of costs. PTA duration was the strongest predictor across all cost categories. These factors may be used for the planning and case management of individuals following TBI.

Background: In 2007, the Health and Disability Strategy Group (HDSG) of the TAC and Victorian WorkCover Authority recognised an opportunity to improve scheme outcomes by working more closely with health disciplines. To investigate whether this was feasible, a pilot program was proposed with a select group of physiotherapists. Objectives: To determine whether a network of physiotherapists who were provided with training, monitoring and support could achieve improved outcome in return to work and health outcomes.Method: In 2008, 92 physiotherapists undertook a select tender process and then completed training in return to work, the HDSG's Clinical Framework and familiarisation of the compensation system for work related and motor accident injuries. The outcomes of this network physiotherapist program were evaluated internally and by three independent research organisations to determine 1) impact on return to work, 2) impact on health outcomes, 3) patient satisfaction and 4) satisfaction of the physiotherapist providing the service. Results: When compared to non-network physiotherapist, the network physiotherapists demonstrated improved return to work for clients, better health outcomes, and greater patient satisfaction. Therapist satisfaction was also higher within the network physiotherapists.Discussion: This body of work conducted on a pilot group of physiotherapists demonstrates improved outcomes in a number of important domains for the management of worker's and motor accident injuries. It indicates that there is a benefit for schemes in supporting clinical programs. Current evidence suggests that compensable patients have worse health outcomes than their non-compensable counterparts. There is a need to promote programs that are beneficial to patients, compensable schemes and providers. Further investigation is required to demonstrate this benefit on a larger scale.Conclusions: This study indicates that there may be opportunities to improve health outcomes by investment from compensable bodies in training, support and monitoring of specific health disciplines.