Virginia Martínez-Ruiz

Risk factors for causing road crashes involving cyclists: An application of a quasi-induced exposure method

A quasi-induced exposure approach was applied to the Spanish Register of Traffic Crashes to identify driver- and vehicle-related factors associated with the risk of causing a road crash involving a cyclist in Spain from 1993 to 2009. We analyzed 19,007 collisions between a bicycle and another vehicle in which only one of the drivers committed an infraction, and 13,540 records that included the group of non-infractor cyclists in the above collisions plus cyclists involved in single-bicycle crashes. Adjusted odds ratios were calculated for being responsible for each type of crash for each factor considered. Age from 10 to 19 years, male sex, alcohol or drug consumption and non-helmet use were cyclist-related variables associated with a higher risk of crash, whereas cycling more than 1h increased only the risk of single crashes. Bicycles with brake defects and ridden by two occupants were also at higher risk of involvement in a crash, whereas light defects were associated only with collisions with another vehicle. For drivers of the other vehicle, age more than 60 years, alcohol, not using safety devices and nonprofessional drivers were at higher risk. The risk of colliding with a bicycle was higher for mopeds than for passenger cars.

Contribution of exposure, risk of crash and fatality to explain age- and sex-related differences in traffic-related cyclist mortality rates.

This study was designed to quantify the percent contribution of exposure, risk of collision and fatality rate to the association of age and sex with the mortality rates among cyclists in Spain, and to track the changes in these contributions with time. Data were analyzed for 50,042 cyclists involved in road crashes in Spain from 1993 to 2011, and also for a subset of 13,119 non-infractor cyclists involved in collisions with a vehicle whose driver committed an infraction (used as a proxy sample of all cyclists on the road). We used decomposition and quasi-induced exposure methods to obtain the percent contributions of these three components to the mortality rate ratios for each age and sex group compared to males aged 25-34 years. Death rates increased with age, and the main component of this increase was fatality (around 70%). Among younger cyclists, however, the main component of increased death rates was risk of a collision. Males had higher death rates than females in every age group: this rate increased from 6.4 in the 5-14 year old group to 18.8 in the 65-79 year old group. Exposure, the main component of this increase, ranged between 70% and 90% in all age categories, although the fatality component also contributed to this increase. The contributions of exposure, risk of crash and fatality to cyclist death rates were strongly associated with age and sex. Young male cyclists were a high-risk group because all three components tended to increase their mortality rate.

Pedestrian- and driver-related factors associated with the risk of causing collisions involving pedestrians in Spain

This study aimed to quantify the association between pedestrian- and driver-related factors and the risk of causing road crashes involving pedestrians in urban areas in Spain between 1993 and 2011. From the nationwide police-based registry of road crashes with victims in Spain, we analyzed all 63,205 pairs of pedestrians and drivers involved in crashes in urban areas in which only the pedestrian or only the driver was at fault. Logistic regression models were used to obtain adjusted odds ratios to assess the strength of association between each individual-related variable and the pedestrians odds of being at fault for the crash (and conversely, the drivers odds of not being at fault). The subgroups of road users at high risk of causing a road crash with a pedestrian in urban areas were young and male pedestrians, pedestrians with psychophysical conditions or health problems, the youngest and the oldest drivers, and drivers with markers of high-risk behaviors (alcohol use, nonuse of safety devices, and driving without a valid license). These subgroups should be targeted by preventive strategies intended to decrease the rate of urban road crashes involving pedestrians in Spain.

Consumo de drogas e implicación en estilos de conducción de riesgo en una muestra de estudiantes universitarios. Proyecto uniHcos

OBJECTIVE Drug and alcohol use are known to increase the risk of traffic accidents, especially among youth. However, the association between habitual drug use and the adoption of risky driving behavior is not well known. The aim of this study was to identify and quantify the association between habitual drug use and involvement in risky driving practices overall and by gender among university students. METHODS A cross sectional study was conducted. The study population was composed of 559 car drivers younger than 31 years who completed an online questionnaire during the 2011-2012 academic year. Among other factors, the questionnaire assessed the following items: habitual drug consumption (20 or more days) during the last year and involvement in other risky driving practices during the last month. RESULTS A total of 27.7% of students reported they had used drugs regularly during the last year. Drug use was associated with a higher frequency of involvement in risky driving practices. In men, the factors most strongly associated with drug consumption were speeding, driving under influence of alcohol, and feeling drowsy while driving. In women, drug consumption was mainly associated with smoking while driving, drunk driving, and driving without rest. CONCLUSION The results of our study support the hypothesis that habitual drug use is associated with an increased frequency of risky driving behavior.

Medical students’ satisfaction and academic performance with problem-based learning in practice-based exercises for epidemiology and health demographics

The aim of this study was to evaluate the effect of problem-based learning (PBL) on university students’ satisfaction with and academic performance in a course on epidemiology and social and demographic health. The participants in this interventional study were 529 students (272 in the intervention group and 257 in the control group) enrolled in a medical degree programme during the academic years 2010–2011 and 2011–2012 in Spain. The intervention consisted of the use of a list of problems designed for small-group study in one of the practical sessions (Interpretation of Epidemiological Parameters). We compared students’ satisfaction and performance after either PBL or conventional teaching methods. Students’ satisfaction and academic performance were significantly better in the PBL group than in the traditional-learning group. Satisfaction with teaching was the main predictor of academic performance. After adjustment for level of satisfaction, the difference between groups in academic performance disappeared.

Gender and age differences in components of traffic-related pedestrian death rates: exposure, risk of crash and fatality rate

BackgroundThis ecological study aimed i) to quantify the association of age and gender with the three components of pedestrians’ death rates after a pedestrian-vehicle crash: exposure, risk of crash and fatality, and ii) to determine the contribution of each component to differences in death rates according to age and gender in Spain.MethodsWe analyzed data for 220 665 pedestrians involved in road crashes recorded in the Spanish registry of road crashes with victims from 1993 to 2011, and a subset of 39 743 pedestrians involved in clean collisions (in which the pedestrian did not commit an infraction). Using decomposition and quasi-induced exposure methods, we obtained the proportion of increase in death rates for each age and gender group associated with exposure, risk of collision and fatality.ResultsDeath rates increased with age. The main contributor to this increase was fatality, although exposure also increased with age. In contrast, the risk of collision decreased with age. Males had higher death rates than females, especially in the 24–54 year old group. Higher fatality rates in males were the main determinant of this difference, which was also related with a higher risk of collision in males. However, exposure rates were higher in females.ConclusionsThe magnitude and direction of the associations between age and gender and each of the three components of pedestrians’ death rates differed depending on the specific component explored. These differences need to be taken into account in order to prioritize preventive strategies intended to decrease mortality among pedestrians.

Why has the pedestrian death rate decreased in Spain between 1993 and 2011? An application of the decomposition method

A decomposition procedure was used to estimate the percentage contributions of exposure, risk of collision and fatality to explain the decreases in pedestrian collision death rates observed in Spain from 1993 to 2011. Information was obtained from the Spanish National Institute of Statistics and the Spanish Register of Road Crashes with Victims. A quasi-induced method was used to obtain estimates of annual pedestrian exposure. Poisson regression was used to obtain age-adjusted and sex-adjusted estimates of the mean annual percentage decrease in pedestrian death rates attributable to exposure, collision and fatality; these values were +2.28%, −45.86% and −51.86%, respectively. The results suggest that the decrease in fatality rates and, to a lesser extent, collision rates were the most important determinants of the reduction in pedestrian collision death rates, whereas the contribution of exposure was irrelevant.

Mobility, traffic accidents, and associated factors among Guatemalan university students

The aim of this study was to identify and quantify the association between the amount of driving (km/year), traffic accidents, and other factors among university students in Guatemala. A cross-sectional study was performed during the 2010-2011 school year in a sample of 1,016 drivers who completed a self-administered questionnaire that assessed mobility patterns, use of safety accessories, driving style, and automobile crashes. The results showed a positive association between amount of driving and greater involvement in risky driving (adjusted regression coefficient 3.25, 95%CI: 2.23-4.27, for the highest level of exposure). More frequent involvement in risky driving and older age showed the strongest associations with traffic accidents. Although the amount of driving was positively associated with a higher accident rate, most of this association was found to be mediated by involvement in risky driving practices.The aim of this study was to identify and quantify the association between the amount of driving (km/year), traffic accidents, and other factors among university students in Guatemala. A cross-sectional study was performed during the 2010-2011 school year in a sample of 1,016 drivers who completed a self-administered questionnaire that assessed mobility patterns, use of safety accessories, driving style, and automobile crashes. The results showed a positive association between amount of driving and greater involvement in risky driving (adjusted regression coefficient 3.25, 95%CI: 2.23-4.27, for the highest level of exposure). More frequent involvement in risky driving and older age showed the strongest associations with traffic accidents. Although the amount of driving was positively associated with a higher accident rate, most of this association was found to be mediated by involvement in risky driving practices.

Perinatal outcomes of prematurity and birth weight according to maternal caffeine consumption

UNLABELLED Objetive: identify whether there is an increased risk of adverse perinatal outcomes, like prematurity or decreased weight in newborns, associated with caffeine consumption during the first half of pregnancy in pregnant women of our population. METHODS transversal study carried out in 1 175 patients from Virgen de las Nieves University Hospital of Granada (Spain). Information about caffeine consumption during first half of gestation and perinatal outcomes was obtained by personal interview, medical records and telephone call after delivery. The average caffeine intake was calculated from meals and drinks included in a validated questionnaire. RESULTS there was no difference in caffeine consumption in pregnant women with birth weight ≥2 500 g and.

Satisfacción de los estudiantes de epidemiología de medicina con el proceso docente

Introducción. La implantación del proceso de Bolonia ha supuesto un cambio metodológico en la universidad española en los últimos tiempos. Ello revierte en la calidad de la docencia, específicamente en la titulación de medicina, que se ha ido transformando desde una metodología docente tradicional y unidireccional a otra, más actual, donde el estudiante ocupa un papel principal en el proceso de aprendizaje y donde la evaluación continuada va adquiriendo cada vez más protagonismo.