Gertsenclausen8053

Linear regression analyses suggest a small positive effect on the students' knowledge of the three most important risk factors in traffic but not on the age group most at risk. Concerning seatbelt use or overall cycling behavior no effect was found, although a small positive effect was found on helmet use. Neither was the effectiveness modified by gender, parental educational background, or risky cycling behavior at baseline. Although classroom-based interventions using testimonials may have the potential to increase knowledge of risk factors in traffic among adolescents, translating knowledge into safe traffic behavior is challenging. More studies are needed on how to further adapt the intervention to an age group who are not yet drivers. Such research may focus on mechanisms of change including the age-specific relevance of the ambassador's testimonial and on employing strong elements of action guidance.This paper proposes a reliability-based framework to address the risk associated with limitations in the Available Sight Distance (ASD) on curved highway segments considering a three-dimensional (3D) sight distance computation approach. To facilitate this assessment, the ASD on horizontal curves was evaluated and an accurate inventory of curve attribute information was generated using LiDAR (Light Detection and Ranging) data in an automated and efficient manner. These datasets were then used to estimate the risk (probability of noncompliance, Pnc) associated with sight distance insufficiencies. Full Bayes multivariate Poisson log-normal safety performance functions were developed to relate the Pnc to the expected number of collisions. The results show that there was a statistically significant relationship between Pnc and collision frequency. There was also a significant correlation of 0.444 to 0.452 across collision severity levels indicating that curves with high Property-Damage-Only (PDO) collisions could be associated with higher injury and fatal (I + F) collisions. It was also found that Pnc had a greater impact on increasing PDO collisions than I + F collisions, suggesting that collisions associated with insufficient sight distance are likely to be less severe. The results of this analysis are expected to improve our understanding of the risks associated with deviations from design guidelines and quantitatively assess the safety margins due to these variations. The framework presented in this paper can be used to compare different design alternatives and investigate the influence of design deficiencies on collision occurrence across various severity levels.

In rural northern New England, located in the northeastern United States, the overdose epidemic has accelerated with the introduction of fentanyl. Opioid initiation and transition to opioid injection have been studied in urban settings. Little is known about opioid initiation and transition to injection drug use in rural northern New England.

This mixed-methods study characterized opioid use and drug injection in 11 rural counties in Massachusetts, Vermont, and New Hampshire between 2018 and 2019. People who use drugs completed audio computer-assisted self-interview surveys on substance use and risk behaviors (n = 589) and shared personal narratives through in-depth interviews (n = 22). The objective of the current study is to describe initiation of opioid use and drug injection in rural northern New England.

Median age of first injection was 22 years (interquartile range 18-28 years). Key themes from in-depth interviews that led to initiating drug injection included normalization of drug use in familiermed care in rural areas.

Rates of fatal overdose (OD) from synthetic opioids rose nearly 60 % from 2016 to 2018. 911 Good Samaritan Laws (GSLs) are an evidenced-based strategy for preventing OD fatality. This study describes patrol officers' knowledge of their state's GSL, experience with OD response, and their perspectives on strategies to prevent and respond to opioid OD.

An electronic survey assessed officers' knowledge of state GSLs and experiences responding to OD. Descriptive statistics and hierarchical linear modeling were generated to examine differences in knowledge, preparedness, and endorsement of OD response efforts by experience with OD response.

2,829 officers responded to the survey. Among those who had responded to an OD call in the past six months (n = 1,946), 37 % reported administering naloxone on scene and 36 % reported making an arrest. Most (91 %) correctly reported whether their state had a GSL in effect. Daurisoline concentration Only 26 % correctly reported whether that law provides limited immunity from arrest. Fifteen percent of officers who had responded to an OD work in departments that do not carry naloxone. Compared with officers who had not responded to any OD calls, those who reported responding OD calls at least monthly and at least weekly, were significantly less likely to endorse OD response efforts.

Officers who respond to OD calls are generally receiving training and naloxone supplies to respond, but knowledge gaps and additional training needs persist. Additional training and strategies to relieve compassion fatigue among those who have more experience with OD response efforts may be indicated.

Officers who respond to OD calls are generally receiving training and naloxone supplies to respond, but knowledge gaps and additional training needs persist. Additional training and strategies to relieve compassion fatigue among those who have more experience with OD response efforts may be indicated.Short sleep or insufficient sleep are significant health concerns among patients with inflammatory bowel disease (IBD). Although an association between sleep quality and disease activity has been reported, findings have been inconsistent. The aim of this systematic review and meta-analysis was to assess the association between sleep quality and disease activity in IBD patients by reviewing findings from cross-sectional and prospective cohort studies. Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, a systematic search was conducted in five electronic databases from inception to May 2020. Studies that examined the relationship between sleep quality and disease activity in IBD patients were screened for eligibility. Six studies were included for the analysis. Sleep quality was measured using subjective questionnaires in six studies and objective methods in three studies. Disease activity was diagnosed following standard guidelines. A significant association between subjective sleep quality and disease activity was observed (pooled OR = 3.