Orientador: Tirza Aidar / Tese (doutorado) - Universidade Estadual de Campinas, Instituto de Filosofia e Ciencias Humanas / Made available in DSpace on 2018-08-12T21:57:32Z (GMT). No. of bitstreams: 1 Maia_PauloBorlina_D.pdf: 17064044 bytes, checksum: c5a7f76cc959d1abdcec9a6bfb9aa950 (MD5) Previous issue date: 2009 / Resumo: Este trabalho teve como objetivo analisar a mortalidade dos acidentes de trânsito no Município de São Paulo para o período de 2003 a 2005, avaliando a distribuição espacial a partir do local de ocorrência dos eventos e as possíveis relações destes acidentes com o local de residência das vítimas. Análises espaciais foram conduzidas por meio da vinculação de dois bancos de dados oficiais, referentes aos registros das Declarações de Óbito da Fundação Seade e Boletins de Ocorrência, da Secretaria de Segurança Pública do Estado de São Paulo. Os resultados indicam padrões espaciais específicos e diferenciados segundo o tipo do acidente e as características das vítimas, apontando para a enorme potencialidade das informações georreferenciadas geradas e das técnicas de análise utilizadas para a construção do conhecimento, orientação de políticas e planejamento urbano. / Abstract: This study aimed to examine the mortality of transport accidents in the city of Sao Paulo for the period from 2003 to 2005, evaluating the spatial distribution from the site of occurrence of the events and the possible relationship of these accidents with the place of residence of the victims. Spatial analyses were conducted through the linking of two data banks related to the records of official statements of deaths the Seade Foundation and the Bulletins of Occurrence of the Secretary of Public Security of the State of Sao Paulo. The results indicate specific and spatial patterns which vary with the type and characteristics of the accident victims, pointing to the enormous potential of the georeferenciate information and techniques of analysis used to build the knowledge, directions for public policies and urban planning. / Doutorado / Doutor em Demografia

No Brasil, em 2014, os acidentes de trânsito contabilizaram mais de 44 mil óbitos. Já foi relatado na literatura científica a relação entre o uso de drogas por motoristas de caminhão a fim de manterem a exaustiva jornada de trabalho a que são submetidos. O presente estudo teve como objetivo avaliar a frequência do uso de drogas ilícitas por motoristas de caminhão através de análises toxicológicas em amostras de fluido oral. Motoristas de caminhão foram abordados de forma aleatória por policiais rodoviários federais e convidados a participar dos Comandos de Saúde nas Rodovias, evento de promoção à saúde dos caminhoneiros. Os motoristas que aceitaram participar do estudo doaram uma amostra de fluido oral, coletado com o dispositivo Quantisal(TM), e responderam a um questionário estruturado para coleta de dados sociodemográficos. As amostras de fluido oral foram submetidas à análise de triagem para cocaína, anfetamina e delta9-tetrahidrocanabinol (delta9-THC) por ELISA, sendo esse estudo pioneiro na utilização dessa técnica para triagem de amostras de fluido oral no trânsito. As amostras que apresentaram resultados positivos foram confirmadas por cromatografia gasosa acoplada à espectrometria de massas (GC-MS). No período de desenvolvimento desse estudo foi possível o envio das amostras positivas na etapa de triagem para o Instituto Norueguês de Saúde Pública para confirmação por cromatografia líquida de ultra eficiência acoplada à espectrometria de massas em tandem (UPLC-MS/MS). Além das três substâncias já pesquisadas no estudo foram analisadas a presença de outras 29, dentre drogas ilícitas e medicamentos psicoativos. Foram incluídos 762 motoristas. Das amostras analisadas, 5,2% (n=40) apresentaram resultado positivo para algum tipo das drogas estudadas. A cocaína foi a droga mais encontrada (n=16), seguida pela anfetamina (n=11) e delta9-THC (n=4). Ainda, três amostras apresentaram resultados positivos para cocaína e ?9-THC e uma amostra para cocaína e anfetamina. Além da cocaína, anfetamina e ?9-THC, com a confirmação por UPLC-MS/MS foram detectados outros fármacos psicoativos, o meprobamato e o alprazolam, (duas amostras testaram positivo para anfetamina e meprobamato uma para anfetamina e alprazolam e outra amostra para cocaína e meprobamato). Os motoristas com amostras positivas eram mais jovens, com menos escolaridade, mais inexperientes, possuíam uma jornada de trabalho mais extensa e percorriam percursos mais longos. Esse fato alerta, sem dúvida, a necessidade da ampliação de estudos nacionais sobre o uso de substâncias psicoativas, incluindo as ilícitas e medicamentos, para melhor entendimento na comunidade científica e permitindo a implementação de políticas públicas voltadas à prevenção e fiscalização do uso dessas substâncias, com o objetivo de reduzir a morbimortalidade resultante dos acidentes de trânsito nacionais / In Brazil, in 2014 it caused more than 44 thousand deaths. In Brazil is already described in the literature the use of psychoactive substances by truck drivers to maintain their extensive work schedule and stay awake for several hours. Important highways cross through Sao Paulo to other regions from Brazil and to countries from Latin America. This study aims to demonstrate the prevalence of illicit drug use by truck drivers on the State of Sao Paulo through toxicological analyses on oral fluid. Truck drivers were randomly stopped by police officers on federal roads during morning hours. Oral fluid samples were collected using the Quantisal(TM) device. In addition, a questionnaire concerning sociodemographic characteristics and health information was administered. Oral fluid samples were screened for amphetamine, cocaine, and tetrahydrocannabinol (?9-THC) by ELISA. The samples were confirmed by GC-MS, using validated methods for the substances of interest. During the development of this study we had the opportunity to send the positive samples to the Norwegian Institute of Public Health for confirmation using UPLC-MS/MS. Besides cocaine, amphetamine and delta9-THC the samples were tested for others 29 samples, including illicit drugs and psychoactive medicines. 762 drivers agreed to participate. Of the total samples 5.2% (n = 40) tested positive for drugs. Cocaine was the most found drug (n = 16), followed by amphetamine (n = 11) and delta9-THC (n = 4). Furthermore, three samples tested positive for cocaine and delta9-THC and one sample for cocaine and amphetamine. The confirmation using UPLC-MS/MS pointed another two substances that were not tested previously, meprobamate and alprazolam (two samples tested positive for amphetamine and meprobamate, one for amphetamine and alprazolam and another one for cocaine and meprobamate). Drivers presenting positive samples were younger, with less education, less experienced, had a longer work schedule and drove longer distances. This fact shows that, undoubtedly, there is need for more national studies regarding the use of psychoactive substances, illicit and medicines, for a better understand by the scientific community and those responsible for implementation of public policies aiming the control of the use of these substances, in order to, one day, we were able to indeed reduce traffic accidents mortality in our country

The growing population and motorization generate more movements. In many cities, the increase of population and motorization is much greater than the development of the capacity of the transportation network. For unprotected road users, the risk of getting in a traffic accident increases and the risk of being more severely injured in an accident. In March 2020, a pandemic was declared because of a Coronavirus. More people started to work/study from home to prevent the virus from spreading by avoiding unnecessary trips, gatherings, and crowded areas. Therefore, travel behaviours have shifted during the pandemic compared to previous years. This project aims to get knowledge of how mobility and traffic accidents are affected by significant shifts of travel flow, predict the effect of traffic accidents based on mobility, and evaluate the risk of travelling on a particular road segment. / <p>Examensarbetet är utfört vid Institutionen för teknik och naturvetenskap (ITN) vid Tekniska fakulteten, Linköpings universitet</p>

Objetivos: Avaliar a capacidade funcional de pacientes vítimas de trauma um ano após alta hospitalar e verificar associação da capacidade funcional com fatores relacionados ao trauma e à internação hospitalar. Metodologia: Estudo de coorte prospectivo, com pacientes vítimas de trauma grave (Injury Severity Score - ISS >=16), internados entre Junho e Setembro de 2010 em unidade de terapia intensiva (UTI) cirúrgica especializada em paciente politraumatizado de um hospital público de grande porte na cidade de São Paulo, Brasil. Variáveis de interesse como idade, sexo, escore de Glasgow, Acute Physiology and Chronic Health Disease Classification System II (APACHE II), mecanismos de trauma, número de lesões, região corpórea afetada, número de cirurgias, duração da ventilação mecânica (VM) e tempo de internação hospitalar foram coletadas dos prontuários médicos. A capacidade funcional foi avaliada um ano após alta hospitalar utilizando as escalas Glasgow Outcome Scale (GOS) e Escala de Atividades Instrumentais de Vida Diária de Lawton (AIVDL). Os pacientes também foram questionados se haviam retornado ao trabalho ou estudo. Resultados: O seguimento um ano após trauma foi completo em 49 indivíduos, a maioria composta por jovens (36±11 anos), do sexo masculino (81,6%) e vítimas de acidentes de trânsito (71,5%). Cada indivíduo sofreu aproximadamente 4 lesões corporais, acarretando uma média no ISS de 31 ± 14,4. O traumatismo cranioencefálico foi o tipo de lesão mais comum (65,3%). De acordo com a GOS, a maioria dos pacientes apresentou disfunção moderada (43%) ou disfunção leve ou ausente (37%) um ano após o trauma. A escala AIVDL apresentou pontuação média de 12±4 com aproximadamente 60- 70% dos indivíduos capazes de realizar de forma independente a maioria das atividades avaliadas. Escore de Glasgow, APACHE II, duração da VM e tempo de internação hospitalar foram associadas com a capacidade funcional um ano após lesão. A regressão linear múltipla considerando todas as variáveis significativas revelou associação entre a pontuação da escala AIVDL e o tempo de internação hospitalar. Apenas 32,6% dos indivíduos retornaram ao trabalho ou estudo. Conclusões: A maioria dos pacientes vítimas de trauma grave foi capaz de realizar as atividades avaliadas com independência; apenas um terço deles retornou ao trabalho e/ou estudo um ano após alta hospitalar. O tempo de internação hospitalar foi revelado como preditor significativo para a recuperação da capacidade funcional um ano após lesão grave / Objectives: To investigate the functional capacity of trauma survivors at one year after hospital discharge and to verify the association between functional capacity and trauma-related aspects and hospital stay. Methods: This prospective cohort study included severe trauma patients (Injury Severity Score - ISS >= 16) admitted between June and September 2010 to a surgical intensive care unit (ICU) of a large public hospital in São Paulo, Brazil. Variables of interest such as age, gender, Acute Physiology and Chronic Health Disease Classification System II (APACHE II), trauma mechanisms, number of injuries, body region injured, number of surgeries, mechanical ventilation (MV) duration and hospital length of stay (LOS) were collected from patient records. Functional capacity was assessed one year after hospital discharge using the Glasgow Outcome Scale (GOS) and the Lawton Instrumental Activities of Daily Living Scale (LIADL). Patients were also asked if they had returned to work or school. Results: A total of 49 trauma survivors completed 1 year of follow-up. Most subjects were young (36±11 years), male (81.6%) and victims of traffic accidents (71.5%). Each patient suffered approximately 4 injuries, with a mean ISS of 31 ± 14.4. Traumatic brain injury was the most common type of injury (65.3%). According to the GOS, most patients were classified into two categories, indicating moderate dysfunction (43%) or mild or no dysfunction (37%) at one year after trauma. Additionally, the LIADL also showed favorable functional outcomes (average score 12 ± 4); approximately 60-70% of the subjects were able to perform most activities independently. Glasgow score, APACHE II score, MV duration and hospital LOS were factors related to the recovery of functional capacity one year after injury. Multiple linear regression analysis including all variables with statistical power revealed a significant association between the LIADL score and hospital LOS. Only 32.6% of the subjects had returned to work or school. Conclusions: Most severe trauma patients were able to perform the assessed activities independently, although only a third had returned to work or school one year after hospital discharge. Hospital LOS was identified as a significant predictor of functional capacity recovery one year after severe injury

INTRODUÇÃO O consumo de álcool combinado com bebidas energéticas (AmED) tem se mostrado associado tanto a um padrão pesado de ingestão de bebidas alcoólicas, quanto a comportamentos de risco no trânsito (CRTs) entre jovens adultos. Devido ao grave impacto causado pelas incapacidades e mortes no trânsito serem decorrentes de comportamentos previsíveis e em grande parte evitáveis, o presente estudo procura investigar a influência do consumo de AmED sobre os comportamentos de risco no trânsito entre os motoristas de caminhão. MÉTODOS Dados de uma amostra de profissionais que trafegavam pelas rodovias do Estado de São Paulo entre junho de 2012 e setembro de 2013 (N=535) foram separados em três grupos: (a) os que afirmaram ingerir AmED (n=90), (b) que relataram consumir apenas bebidas alcoólicas (n=326) e (c) o restante da amostra (n=445). Análises bivariadas foram realizadas com os relatos positivos nos últimos 12 meses que antecederam a pesquisa. O nível de significância foi estipulado para um alfa de 5% e, posteriormente, a analise múltipla utilizou a regressão logística. RESULTADOS Comparando os condutores que ingeriram AmED com os que consumiram apenas bebidas alcoólicas, os primeiros tiveram mais chances de possuir idades entre 20 e 24 anos (OR=3,3), de trabalhar como profissional a menos de 5 anos (OR=2,5), apresentaram maiores riscos de dirigir sem cinto de segurança (OR=2,2), em alta velocidade (OR=1,9), ter brigado ou discutido no trânsito (OR=2,1), ter consumido bebidas alcoólicas em um padrão pesado (OR=3,4), bebendo mais doses alcoólicas por ocasião (mediana 5 vs 2 doses, p < 0,008); em maior frequência (OR=1,9), bebendo mais frequentemente no padrão binge drinking (OR=2,3) e consumindo drogas ilícitas em maior frequência (OR=2,3), além de maiores chances de apresentar uma qualidade de sono ruim (OR=1,7). Comparados ao restante da amostra, observou-se que os motoristas de caminhão que ingeriram AmED apresentaram maior risco de dirigir sem cinto de segurança (OR=2,2), em alta velocidade (OR=1,9), alcoolizado (OR=2,6), de brigar ou discutir no trânsito (OR=2,0), apresentaram maiores chances de ingerir mais doses alcoólicas por ocasião (medianas 5 vs 2 doses, p < 0,001), beber mais frequentemente (OR=2,6), inclusive no padrão binge drinking (OR=2,1), também em maior frequência em binge drinking (OR=3,2), consumir álcool em um padrão pesado (OR=3,4) e usar drogas ilícitas (OR=2,6). A regressão logística ajustada por idade indicou que os motoristas que brigaram ou discutiram no trânsito (OR=2,2), que dirigiram sem cinto de segurança (OR=1,9) e que relataram o uso de drogas ilícitas nos últimos 12 meses (OR=2,0) tiveram maiores chances de ter ingerido AmED. CONCLUSÃO O estudo indica uma associação entre a ingestão conjunta de álcool com bebidas energéticas e maiores chances de apresentar CRTs. São necessários investimentos em pesquisas e ações preventivas voltadas para essa população / INTRODUCTION: Consumption of alcohol mixed with energy drinks (AmED) has been shown associated with both a heavy pattern of alcohol intake as well as the traffic risk behaviors (TRB) among young adults. Due to the serious impact caused by disabilities and traffic deaths arising from predictable and largely preventable behaviors, the present study investigates the influence of AmED consumption on traffic risk behaviors among truck drivers. METHODS: Data from a sample of professional driving along the highways of the State of São Paulo (Brazil) between June 2012 and September 2013 (N=535) were divided into three groups: (a) those who reported drinking AmED (n=90), (b) who reported consuming alcohol only (n=326) and (c) the rest of the sample (n=445). Bivariate analyzes were performed with positive reports in the last 12 months preceding the survey. The level of significance was set for an alpha of 5% and, subsequently, it was made a multiple logistic regression analysis. RESULTS: Comparing the drivers who drink AmED with those who consumed only alcohol, the first were more likely to have between 20 and 24 years (OR=3.3), to work as a professional less than five years (OR=2.5), had higher risks of driving without a seat belt (OR=2.2), in high speed (OR=1.9), have a fight or discussion in traffic (OR=2.1), having consumed alcohol in a heavy pattern (OR=3.4), drinking more alcoholic drinks per occasion (median 5 vs 2 doses, p < 0.008); at higher frequency (OR=1.9), more often in binge drinking (OR=2.3), consuming illicit drugs more frequently (OR=2.3), as well as more likely to have a bad quality sleep (OR=1.7). Compared to the rest of the sample, it was found that truck drivers who drink AmED had higher risk of driving without a seat belt (OR=2.2), in high speed (OR=1.9), drunk (OR=2 , 6), to fight or discuss in traffic (OR=2.0), were more likely to consume more alcoholic drinks per occasion (median 5 vs 2 doses, p < 0.001), drinking more often (OR=2.6), including in binge drinking (OR=2.1), also in higher frequency in binge drinking (OR=3.2), consuming alcohol in a heavy pattern (OR=3.4) and use illicit drugs (OR=2 6). Logistic regression adjusted for age indicated that drivers who fought or discussed in traffic (OR = 2.2), which drove without a seat belt (OR = 1.9) and that reported using illicit drugs in the last 12 months (OR = 2.0) had higher chances of having ingested AmED. CONCLUSION: This study indicates an association between the combined intake of alcohol with energy drinks and more likely to have TRBs. Investment is needed in research and preventive actions for this population

Made available in DSpace on 2014-07-29T15:04:45Z (GMT). No. of bitstreams: 1 Dissertacao Carlos Roberto Caixeta.pdf: 262265 bytes, checksum: a9808efbfa64d535642727610bfa9bca (MD5) Previous issue date: 2006-03-27 / Transport accidents are currently one of the world s main public health problems. The aim of this investigation is to describe the profile of transport injury victims attended at Hospital de Urgências de Goiânia (HUGO) and of victims who deceased in these accidents, with age 15 to 24 years, residents in Goiânia, Goiás - Brazil. It also describes the circumstances involved in these accidents. This descriptive transversal study was carried out in the city of Goiânia from August 2005 to August 2006 with systematic sampling, considering the day of the week and the time of the day. At that period were interviewed 301 victims attended at HUGO, the main Emergency Service Center of the city, and the family of 62 cases of death occurred in the municipality. The data were treated by descriptive statistics. Most victims attended at HUGO and most of those who died were male, mean age 19.94 ± 2.73 years. The main transport used by the victims attended at HUGO was the motorcycle (67.33%), followed by the bicycle (16.67%). The motorcycle was the most used by fatal victims (66.67%) as well. The accidents usually occurred at night, especially around 6 pm to 9 pm and at weekends (fridays and sundays). The victims were generally on the way to do physical, sportive, school, leisure or entertaining activities at that time. Those who were doing paid work had the accident between 6 am and 9 am. Suspicion of alcohol use was confirmed in 15.16% of the cases attended at HUGO and by 26.31% of the family of fatal victims. The victims attended at HUGO were the drivers in 77.11% of the motorcycle accidents and 92.00% of bicycle accidents, as well as in 76.92% of the fatal victims. There were victims under 18 years of age identified as drivers of automobiles and motorcycles. In proportion (p<0.05), more motorcyclists (66.48%) believed that there was imprudence/ negligence than the cyclists (47.72%) attended at HUGO. Security equipment was not used by 8.58% of motorcyclists, by 95.45% of cyclists attended at HUGO and by 12.5% of the motorcyclists who died. The safety belt was not used by 50.00% of the attended at HUGO and by 60.00% of who died. The results indicate a need for a differentiated look at motorcyclists, which justifies a specific approach to this group, as well as measures of inspection, giving priority to the periods of night and weekends. The service of attending victims must be planned, adjusting the amount of human, material and equipment resources, and the seasonality of accidents. The epidemiologic profile of the victims provides important information for administrators to implement politics of promoting health and preventing injury transport, which takes intersectional and multiprofessional actions to confront the problem. Keywords: Transport accidents are currently one of the world s main public health problems. The aim of this investigation is to describe the profile of transport injury victims attended at Hospital de Urgências de Goiânia (HUGO) and of victims who deceased in these accidents, with age 15 to 24 years, residents in Goiânia, Goiás - Brazil. It also describes the circumstances involved in these accidents. This descriptive transversal study was carried out in the city of Goiânia from August 2005 to August 2006 with systematic sampling, considering the day of the week and the time of the day. At that period were interviewed 301 victims attended at HUGO, the main Emergency Service Center of the city, and the family of 62 cases of death occurred in the municipality. The data were treated by descriptive statistics. Most victims attended at HUGO and most of those who died were male, mean age 19.94 ± 2.73 years. The main transport used by the victims attended at HUGO was the motorcycle (67.33%), followed by the bicycle (16.67%). The motorcycle was the most used by fatal victims (66.67%) as well. The accidents usually occurred at night, especially around 6 pm to 9 pm and at weekends (fridays and sundays). The victims were generally on the way to do physical, sportive, school, leisure or entertaining activities at that time. Those who were doing paid work had the accident between 6 am and 9 am. Suspicion of alcohol use was confirmed in 15.16% of the cases attended at HUGO and by 26.31% of the family of fatal victims. The victims attended at HUGO were the drivers in 77.11% of the motorcycle accidents and 92.00% of bicycle accidents, as well as in 76.92% of the fatal victims. There were victims under 18 years of age identified as drivers of automobiles and motorcycles. In proportion (p<0.05), more motorcyclists (66.48%) believed that there was imprudence/ negligence than the cyclists (47.72%) attended at HUGO. Security equipment was not used by 8.58% of motorcyclists, by 95.45% of cyclists attended at HUGO and by 12.5% of the motorcyclists who died. The safety belt was not used by 50.00% of the attended at HUGO and by 60.00% of who died. The results indicate a need for a differentiated look at motorcyclists, which justifies a specific approach to this group, as well as measures of inspection, giving priority to the periods of night and weekends. The service of attending victims must be planned, adjusting the amount of human, material and equipment resources, and the seasonality of accidents. The epidemiologic profile of the victims provides important information for administrators to implement politics of promoting health and preventing injury transport, which takes intersectional and multiprofessional actions to confront the problem. / Os acidentes de transporte constituem na atualidade um dos principais problemas de saúde pública em todo mundo, especialmente nos países em desenvolvimento. Este estudo teve como objetivo descrever o perfil das vítimas dos acidentes de transportes atendidos no Hospital de Urgências de Goiânia (HUGO) e das vítimas que foram a óbito, na faixa etária de 15 a 24 anos e residentes em Goiânia - Goiás, bem como descrever as circunstâncias envolvendo esses acidentes. Trata-se de estudo descritivo, transversal, conduzido em Goiânia de agosto/2005 a agosto/2006, com amostragem sistemática considerando dia da semana e horários do dia. Foram entrevistadas 301 vítimas atendidas no HUGO, principal Serviço de Emergência da cidade, e familiares de 62 casos de óbitos ocorridos no município naquele período. Os dados foram tratados por meio de estatística descritiva. Dentre as vítimas atendidas no HUGO e das que foram a óbito a maioria era do sexo masculino, com idade média de 19,94 ± 2,73 anos. O meio de transporte mais utilizado pelas vítimas atendidas no HUGO foi a motocicleta (67,33%), seguido da bicicleta (16,67%). A motocicleta também foi a mais usada entre as vítimas fatais (76,36%). Os acidentes ocorreram mais no período noturno, especialmente entre as 18h e 21h e aos finais de semana (6ª feira e domingo). As vítimas estavam principalmente no trajeto para atividades físicas, esportivas, escolares, lazer e entretenimento nesses horários. Aquelas que realizavam trabalho pago acidentaram-se principalmente entre 06 e 09 h. A suspeita do uso de álcool foi confirmada por 15,14% dos atendidos no HUGO e por 26,31% dos familiares das vítimas fatais. Eram condutores 77,11% dos motociclistas e 92% ciclistas atendidos no HUGO, bem como 76,92% das vítimas fatais. Foram identificadas vítimas menores de 18 anos condutores dos automóveis e motocicletas. Proporcionalmente mais motociclistas (66,48%) julgaram que houve imprudência / negligência que os ciclistas (47,72%) atendidos no HUGO (p<0,05). Os equipamentos de segurança não eram usados por 8,58% dos motociclistas e 95,45% dos ciclistas atendidos no HUGO e por 12,50% motociclistas que morreram. O cinto de segurança era não era usado por 50,00% dos atendidos no HUGO e por 60,00% das vítimas fatais. Os resultados indicam que um olhar diferenciado deve ser dirigido aos motociclistas, justificando uma abordagem específica para este grupo, bem como são necessárias medidas de fiscalização que priorizem o período noturno e os finais de semana. Os serviços de atendimento às vítimas devem planejar o atendimento adequando a quantidade de recursos humanos, materiais e equipamentos, considerando a sazonalidade dos acidentes. O perfil epidemiológico das vítimas fornece informações importantes aos gestores para implementar políticas de promoção da saúde e de prevenção dos acidentes de transporte.

INTRODUÇÃO O consumo de álcool combinado com bebidas energéticas (AmED) tem se mostrado associado tanto a um padrão pesado de ingestão de bebidas alcoólicas, quanto a comportamentos de risco no trânsito (CRTs) entre jovens adultos. Devido ao grave impacto causado pelas incapacidades e mortes no trânsito serem decorrentes de comportamentos previsíveis e em grande parte evitáveis, o presente estudo procura investigar a influência do consumo de AmED sobre os comportamentos de risco no trânsito entre os motoristas de caminhão. MÉTODOS Dados de uma amostra de profissionais que trafegavam pelas rodovias do Estado de São Paulo entre junho de 2012 e setembro de 2013 (N=535) foram separados em três grupos: (a) os que afirmaram ingerir AmED (n=90), (b) que relataram consumir apenas bebidas alcoólicas (n=326) e (c) o restante da amostra (n=445). Análises bivariadas foram realizadas com os relatos positivos nos últimos 12 meses que antecederam a pesquisa. O nível de significância foi estipulado para um alfa de 5% e, posteriormente, a analise múltipla utilizou a regressão logística. RESULTADOS Comparando os condutores que ingeriram AmED com os que consumiram apenas bebidas alcoólicas, os primeiros tiveram mais chances de possuir idades entre 20 e 24 anos (OR=3,3), de trabalhar como profissional a menos de 5 anos (OR=2,5), apresentaram maiores riscos de dirigir sem cinto de segurança (OR=2,2), em alta velocidade (OR=1,9), ter brigado ou discutido no trânsito (OR=2,1), ter consumido bebidas alcoólicas em um padrão pesado (OR=3,4), bebendo mais doses alcoólicas por ocasião (mediana 5 vs 2 doses, p < 0,008); em maior frequência (OR=1,9), bebendo mais frequentemente no padrão binge drinking (OR=2,3) e consumindo drogas ilícitas em maior frequência (OR=2,3), além de maiores chances de apresentar uma qualidade de sono ruim (OR=1,7). Comparados ao restante da amostra, observou-se que os motoristas de caminhão que ingeriram AmED apresentaram maior risco de dirigir sem cinto de segurança (OR=2,2), em alta velocidade (OR=1,9), alcoolizado (OR=2,6), de brigar ou discutir no trânsito (OR=2,0), apresentaram maiores chances de ingerir mais doses alcoólicas por ocasião (medianas 5 vs 2 doses, p < 0,001), beber mais frequentemente (OR=2,6), inclusive no padrão binge drinking (OR=2,1), também em maior frequência em binge drinking (OR=3,2), consumir álcool em um padrão pesado (OR=3,4) e usar drogas ilícitas (OR=2,6). A regressão logística ajustada por idade indicou que os motoristas que brigaram ou discutiram no trânsito (OR=2,2), que dirigiram sem cinto de segurança (OR=1,9) e que relataram o uso de drogas ilícitas nos últimos 12 meses (OR=2,0) tiveram maiores chances de ter ingerido AmED. CONCLUSÃO O estudo indica uma associação entre a ingestão conjunta de álcool com bebidas energéticas e maiores chances de apresentar CRTs. São necessários investimentos em pesquisas e ações preventivas voltadas para essa população / INTRODUCTION: Consumption of alcohol mixed with energy drinks (AmED) has been shown associated with both a heavy pattern of alcohol intake as well as the traffic risk behaviors (TRB) among young adults. Due to the serious impact caused by disabilities and traffic deaths arising from predictable and largely preventable behaviors, the present study investigates the influence of AmED consumption on traffic risk behaviors among truck drivers. METHODS: Data from a sample of professional driving along the highways of the State of São Paulo (Brazil) between June 2012 and September 2013 (N=535) were divided into three groups: (a) those who reported drinking AmED (n=90), (b) who reported consuming alcohol only (n=326) and (c) the rest of the sample (n=445). Bivariate analyzes were performed with positive reports in the last 12 months preceding the survey. The level of significance was set for an alpha of 5% and, subsequently, it was made a multiple logistic regression analysis. RESULTS: Comparing the drivers who drink AmED with those who consumed only alcohol, the first were more likely to have between 20 and 24 years (OR=3.3), to work as a professional less than five years (OR=2.5), had higher risks of driving without a seat belt (OR=2.2), in high speed (OR=1.9), have a fight or discussion in traffic (OR=2.1), having consumed alcohol in a heavy pattern (OR=3.4), drinking more alcoholic drinks per occasion (median 5 vs 2 doses, p < 0.008); at higher frequency (OR=1.9), more often in binge drinking (OR=2.3), consuming illicit drugs more frequently (OR=2.3), as well as more likely to have a bad quality sleep (OR=1.7). Compared to the rest of the sample, it was found that truck drivers who drink AmED had higher risk of driving without a seat belt (OR=2.2), in high speed (OR=1.9), drunk (OR=2 , 6), to fight or discuss in traffic (OR=2.0), were more likely to consume more alcoholic drinks per occasion (median 5 vs 2 doses, p < 0.001), drinking more often (OR=2.6), including in binge drinking (OR=2.1), also in higher frequency in binge drinking (OR=3.2), consuming alcohol in a heavy pattern (OR=3.4) and use illicit drugs (OR=2 6). Logistic regression adjusted for age indicated that drivers who fought or discussed in traffic (OR = 2.2), which drove without a seat belt (OR = 1.9) and that reported using illicit drugs in the last 12 months (OR = 2.0) had higher chances of having ingested AmED. CONCLUSION: This study indicates an association between the combined intake of alcohol with energy drinks and more likely to have TRBs. Investment is needed in research and preventive actions for this population

Objetivos: Avaliar a capacidade funcional de pacientes vítimas de trauma um ano após alta hospitalar e verificar associação da capacidade funcional com fatores relacionados ao trauma e à internação hospitalar. Metodologia: Estudo de coorte prospectivo, com pacientes vítimas de trauma grave (Injury Severity Score - ISS >=16), internados entre Junho e Setembro de 2010 em unidade de terapia intensiva (UTI) cirúrgica especializada em paciente politraumatizado de um hospital público de grande porte na cidade de São Paulo, Brasil. Variáveis de interesse como idade, sexo, escore de Glasgow, Acute Physiology and Chronic Health Disease Classification System II (APACHE II), mecanismos de trauma, número de lesões, região corpórea afetada, número de cirurgias, duração da ventilação mecânica (VM) e tempo de internação hospitalar foram coletadas dos prontuários médicos. A capacidade funcional foi avaliada um ano após alta hospitalar utilizando as escalas Glasgow Outcome Scale (GOS) e Escala de Atividades Instrumentais de Vida Diária de Lawton (AIVDL). Os pacientes também foram questionados se haviam retornado ao trabalho ou estudo. Resultados: O seguimento um ano após trauma foi completo em 49 indivíduos, a maioria composta por jovens (36±11 anos), do sexo masculino (81,6%) e vítimas de acidentes de trânsito (71,5%). Cada indivíduo sofreu aproximadamente 4 lesões corporais, acarretando uma média no ISS de 31 ± 14,4. O traumatismo cranioencefálico foi o tipo de lesão mais comum (65,3%). De acordo com a GOS, a maioria dos pacientes apresentou disfunção moderada (43%) ou disfunção leve ou ausente (37%) um ano após o trauma. A escala AIVDL apresentou pontuação média de 12±4 com aproximadamente 60- 70% dos indivíduos capazes de realizar de forma independente a maioria das atividades avaliadas. Escore de Glasgow, APACHE II, duração da VM e tempo de internação hospitalar foram associadas com a capacidade funcional um ano após lesão. A regressão linear múltipla considerando todas as variáveis significativas revelou associação entre a pontuação da escala AIVDL e o tempo de internação hospitalar. Apenas 32,6% dos indivíduos retornaram ao trabalho ou estudo. Conclusões: A maioria dos pacientes vítimas de trauma grave foi capaz de realizar as atividades avaliadas com independência; apenas um terço deles retornou ao trabalho e/ou estudo um ano após alta hospitalar. O tempo de internação hospitalar foi revelado como preditor significativo para a recuperação da capacidade funcional um ano após lesão grave / Objectives: To investigate the functional capacity of trauma survivors at one year after hospital discharge and to verify the association between functional capacity and trauma-related aspects and hospital stay. Methods: This prospective cohort study included severe trauma patients (Injury Severity Score - ISS >= 16) admitted between June and September 2010 to a surgical intensive care unit (ICU) of a large public hospital in São Paulo, Brazil. Variables of interest such as age, gender, Acute Physiology and Chronic Health Disease Classification System II (APACHE II), trauma mechanisms, number of injuries, body region injured, number of surgeries, mechanical ventilation (MV) duration and hospital length of stay (LOS) were collected from patient records. Functional capacity was assessed one year after hospital discharge using the Glasgow Outcome Scale (GOS) and the Lawton Instrumental Activities of Daily Living Scale (LIADL). Patients were also asked if they had returned to work or school. Results: A total of 49 trauma survivors completed 1 year of follow-up. Most subjects were young (36±11 years), male (81.6%) and victims of traffic accidents (71.5%). Each patient suffered approximately 4 injuries, with a mean ISS of 31 ± 14.4. Traumatic brain injury was the most common type of injury (65.3%). According to the GOS, most patients were classified into two categories, indicating moderate dysfunction (43%) or mild or no dysfunction (37%) at one year after trauma. Additionally, the LIADL also showed favorable functional outcomes (average score 12 ± 4); approximately 60-70% of the subjects were able to perform most activities independently. Glasgow score, APACHE II score, MV duration and hospital LOS were factors related to the recovery of functional capacity one year after injury. Multiple linear regression analysis including all variables with statistical power revealed a significant association between the LIADL score and hospital LOS. Only 32.6% of the subjects had returned to work or school. Conclusions: Most severe trauma patients were able to perform the assessed activities independently, although only a third had returned to work or school one year after hospital discharge. Hospital LOS was identified as a significant predictor of functional capacity recovery one year after severe injury

The tendency is to create comprehensive documentation, based on the methodology for carrying out safety inspections, to serve the communications manager territory (mainly municipalities and cities) as a basis for usable implementation of proposed measures to increase safety, as well as Study for implementation of proposals contained in the projected future and implemented traffic-engineering measures on roads solved territorial unit.

This student thesis deals with problems of the causes of road accidents and injury in the Czech Republic, and with the possibilities of their elimination. The human is the most dangerous factor of the transportation system. This resulted in the analysis of the causes of road accidents. The safety of the human factor depends on the experience of the driver, appreciating of danger, attention paid to the driving of vehicle, and on the stress of the road-traffic. The basis of the effective accident prevention are traffic safety precautions.