Effective interventions in road traffic accidents among the young and novice drivers of low and middle-income countries: A scoping review

Problem considered
Road traffic accident (RTA) is the ninth leading cause of global mortality and are also contributes mortality rates among young adults aged 15–29 years. This paper aims to conduct a comprehensive review to provide evidence of effective interventions of RTA prevention among young adults.

Methods
Three databases, MEDLINE, Embase, and PsychINFO, were searched. Eligible articles were practical behavioural and technological interventions directly affecting young drivers. The quality assessment used critical appraisal tools from the Joanna Briggs Institute (JBI). A narrative approach was used to analyze data of the 1107 articles identified, 17 articles met the inclusion criteria. Six studies used a driving simulator; five studies were educational training interventions; one used an incentive and in-car GPS, and one video-based training. One intervention used a vehicle warning system. A motorcycle simulator intervention and two-hybrid interventions, a pc-training and field training, and a driving simulator and vehicle training were also identified.

Result
The Green Light for Life, a training program, was emphasized as it was a simple intervention, using parent influences to improve injury crash rates by 12.7% p < 0.001. Furthermore, RAPT, a driving simulator, improved gaze in the range of 52.1–70% p < 0.001, and HRT, a motorcycle simulator, showed 0.92, p < 0.001 proportion of hazard avoidance. Conclusion These interventions can provide important leads to be adapted and replicated in various settings globally, to improve RTA outcomes among young adults. Future research can adopt a qualitative approach to determine the willingness of use for these interventions and adherence to current interventions.

Trauma system developments reduce mortality in hospitalized trauma patients in Al-Ain City, United Arab Emirates, despite increased severity of injury

Background: Trauma is a leading cause of death in the United Arab Emirates (UAE). There have been major developments in the trauma system in Al-Ain City during the last two decades. We aimed to study the effects of these developments on the trauma pattern, severity, and clinical outcome of hospitalized trauma patients in Al-Ain City, United Arab Emirates.

Methods: This is a retrospective analysis of two separate sets of prospectively collected trauma registry data of Al-Ain Hospital. Data were collected over two periods: from March 2003 to March 2006 and from January 2014 to December 2017. Demography, injury mechanism, injury location, and clinical outcomes of 2573 trauma patients in the first period were compared with 3519 patients in the second period.

Results: Trauma incidence decreased by 38.2% in Al-Ain City over the last 10 years. Trauma to females, UAE nationals, and the geriatric population significantly increased over time (p < 0.0001, Fisher's exact test for each). Falls on the same level significantly increased over time, while road traffic collisions and falls from height significantly decreased over time (p < 0.0001, Fisher's exact test for each). Mortality significantly decreased over time (2.3% compared with 1%, p < 0.0001, Fisher's exact test). Conclusions: Developments in the trauma system of our city have reduced mortality in hospitalized trauma patients by 56% despite an increased severity of injury. Furthermore, the injury incidence in our city decreased by 38.2% over the last decade. This was mainly in road traffic collisions and work-related injuries. Nevertheless, falls on the same level in the geriatric population continue to be a significant problem that needs to be addressed.

Chronic osteomyelitis: a continuing orthopaedic challenge in developing countries.

Nine patients with chronic osteomyelitis, three with problems due to diagnosis, three with dilemmas regarding treatment and three with other complications are presented. It is suggested that although the diagnosis of osteomyelitis in most cases is straightforward, presentation might sometimes be similar to other conditions, which can lead to a dilemma in the diagnosis. Because of the formidable complications, which may be difficult to manage and the difficulty in guaranteeing permanent cure, the best approach is prevention by judicious treatment of acute haematogenous osteomyelitis and of open fractures.