Este trabalho apresenta um modelo de previsão de acidentes com a participação de motocicletas que foi desenvolvido a partir do método da análise de regressão estatística adaptado às particularidades técnicas das rodovias do Estado do Rio Grande do Sul. O objetivo do trabalho é gerar uma ferramenta que possibilite prever o número de acidentes a partir da combinação do nível de exposição veicular associada com os prováveis fatores de risco deste peculiar ambiente. Com esta finalidade, é confrontado o número de acidentes observados com relação às características técnicas das rodovias investigadas com o intuito de avaliar os fatores de risco. Nove variáveis de controle representando atributos físicos, funcionais, econômicos e legais das rodovias foram analisadas sob diversos parâmetros tais como: largura da plataforma, sinuosidade; inclinação, intersecções, condição do pavimento, tráfego de veículos, tráfego de caminhões, urbanização e dispositivos de controle de tráfego. A aplicação do método estatístico permite classificar as rodovias mais importantes quanto ao nível de acidentes; identificar, mensurar e avaliar os fatores de risco; estimar a probabilidade média para a realização do evento sinistro e simular, em nível de projeto, a ocorrência futura de acidentes. Uma vez processado, o modelo obteve um fator de explicação (R2) para os dados em torno de 96%. As variáveis de controle que apresentaram maior efeito na variável de resposta foram obtidas através do tráfego de veículos seguido da largura da plataforma da rodovia. Após a análise do modelo, as rodovias com maior fator de propensão para acidentes foram a ERS734 sendo seguida pela ERS118 e ERS130. Os resultados que foram obtidos indicaram que a frota de motocicletas do Estado do Rio Grande do Sul - Brasil apresenta um risco de envolvimento em acidentes duas vezes maior que aquela incorrida pela frota dos Estados Unido e três vezes maior que aquela apresentada pela frota do Reino Unido. / This article presents an accident prediction model with the participation of motorcycles, developed by statistical regression analysis adapted to the technical peculiarities of the roads of the state of Rio Grande do Sul, Brazil. The aim of the model is to generate a tool to allow predicting the number of accidents based on the combination of vehicle exposure level with possible risk factors. The number of accidents observed is compared with road technical characteristics, aiming at evaluating risk factors. Nine control variables, representing physical, functional, economical and legal road attributes, were analyzed as to different parameters, such as platform width; sinuosity; inclination; junctions ; pavement condition; vehicle traffic; truck traffic; urbanization; and traffic control devices. The application of the statistical method allows the classification of the most important roads in terms of accident level; to identify, measure, and evaluate risk factors; to estimate mean accident probability; and to simulate, at project level, the future occurrence of accidents. Once processed, the model obtained an explanation factor (R2) for the data around 96%. Vehicle traffic, followed by highway platform width had the highest effect on the response variable. After being analyzed by the model, ERS734, followed by ERS118, and ERS130 presented the highest accident probability factor. The results obtained indicated that the risk of motorcycles being involved in accidents in the state of Rio Grande do Sul is twice as high as in the USA, and three times higher than in the United Kingdom.

This thesis examines the application of Systems-Theoretic Accident Model and Processes (STAMP) in healthcare and the analysis of patient safety incidents. Healthcare organisations have a responsibility for the safety of the patients they are treating. This includes the avoidance of unintended or unexpected harm to people during the provision of care. Patient safety incidents, that is adverse events where patients are harmed, are investigated and analysed as accidents are in other safety-critical industries, to gain an understanding of failure and to generate recommendations to prevent similar incidents occurring in the future. However, there is some dissatisfaction with the current quality of incident analysis in healthcare. There is dissatisfaction with the recommendations that are generated from healthcare incident analysis which are felt to produce weak and ineffective remedial actions, often including retraining of individuals and small policy change. Issues with current practice have been linked to the use of Root Cause Analysis (RCA), an analysis method that often results in the understanding of an accident as being the result of a linear chain of events. This type of simple linear approach has been the target of criticism in safety science research and is not felt to be effective in the analysis of incidents in complex systems, such as healthcare. Research in accident analysis methods has developed from a focus on technical failure and individual human actions to consideration of the interactions between people, technology and the organisation. Accident analysis methods have been developed that guide investigations to consideration of the whole system and interactions between system components. These system approaches are judged to be superior to simple linear approaches by the research community, however, they are not currently used in healthcare incident investigation practice. The systems approach of STAMP is felt to be a promising method for the improvement of healthcare incident analysis. STAMP strongly embodies the concepts of systems theory and analyses human decision-making. The application of STAMP in healthcare was investigated through three case studies, which applied STAMP in: 1. The analysis of the large-scale organisational failure at Mid-Staffordshire NHS Trust between 2005-2009. 2. The analysis of a common small-scale hospital-based medication prescription error. 3. The analysis of patient suicide in the community-based services of a Mental Health Trust. The effectiveness of the STAMP applications was evaluated with feedback from healthcare stakeholders on the usability and utility of STAMP and discussion of the STAMP applications against criteria for accident analysis models and methods. Healthcare stakeholders were generally positive about the utility of STAMP, finding it to provide a system view and guide consideration of interactions between system components. They also felt it would help them generate recommendations and were positive about the future application of STAMP in healthcare. However, many felt it to be a complicated method that would need specialist expertise to apply. The STAMP applications demonstrated the ability of STAMP to consider the whole system and guide an analysis to the generation of recommendations for system measures to prevent future incidents. From the findings of the research, recommendations are made to improve STAMP and to assist future applications of STAMP in healthcare. The research also discusses the other factors that influence incident analysis beyond that of the analytical approach used and how these need to be considered to maximise the effectiveness of STAMP.

Nesta dissertação é feita uma avaliação dos resultados da aplicação do modelo de previsão de acidentes apresentado no Highway Safety Manual - HSM, publicado pela American Association of State Highway and Transportation Officials (AASHTO) no ano de 2010, para o caso de trechos de rodovia de pista simples localizados no interior do estado de São Paulo. São analisados o método original do HSM, o método do HSM calibrado para os trechos de rodovias estudados e o método empírico de Bayes. Os resultados apresentados pelo método original do HSM são bastante distintos dos valores reais observados, o que exclui a possibilidade do seu emprego direto no universo analisado. No entanto, os valores resultantes da aplicação do método do HSM calibrado e do método de Bayes, em todas as análises realizadas, aproximam-se de maneira satisfatória dos valores observados (com resultados melhores no método de Bayes) - o que mostra que esses métodos podem ser utilizados para a previsão de acidentes no universo analisado, bem como em outras situações com condições similares. Ainda que seja recomendada a realização de estudos específicos para a aplicação do modelo em outras regiões do país, na ausência desses estudos, os valores obtidos neste trabalho podem ser empregados como primeira aproximação. / This research conducts an evaluation of the results achieved by means of the application of crash prediction method presented by the Highway Safety Manual - HSM, published by the American Association of State Highway and Transportation Officials (AASHTO) in 2010, for the case of two lane highway segments situated in the state of Sao Paulo. The analyses were aimed at the original method of the HSM, the method calibrated to the studied highways segments and with the use of the empirical Bayes method. The results obtained by application of the HSM original method are quite distinct from the actual crash values observed, which excludes the possibility of its direct employment in the universe analyzed. However, the values resulting from application of the calibrated HSM method and the method of Bayes, in all data analysis, approach satisfactorily the observed values (with better results with the use of Bayes method) - which shows that these methods can be used for the prediction of accidents in the universe analyzed, as well as in other situations with similar conditions. Although it is recommended to perform specific studies for the application of the method in other regions of the country, in the absence of these studies, the values provided by this research study can be used as a first approximation.

Diversos tipos de acidentes envolvendo crianças e adolescentes acontecem no ambiente domiciliar e, dentre os principais, encontram-se as queimaduras. O objetivo desta pesquisa foi interpretar os significados atribuídos à prevenção de queimaduras pediátricas no ambiente doméstico, na perspectiva de crianças vítimas de queimaduras e suas famílias. Para tal, realizou-se estudo com abordagem metodológica qualitativa, fundamentado no referencial teórico da Antropologia Interpretativa e no método etnográfico. Após a aprovação pelo comitê de ética, tanto da instituição proponente quanto da coparticipante, foram convidadas a participar da pesquisa seis crianças vítimas de queimadura em ambiente doméstico, atendidas no Centro de Tratamento de Queimaduras do Hospital das Clínicas da Faculdade de Medicina de Ribeirão Preto da Universidade de São Paulo e seus familiares, totalizando 20 participantes. Para a coleta de dados, realizaram-se observações participantes, diário de campo, entrevistas em profundidade e a baseada na eliciação da fotografia, prioritariamente nos domicílios dos informantes e contexto hospitalar, no período de janeiro de 2012 a junho de 2013. Privilegiamos um engajamento prolongado no campo, com a coleta e a análise dos dados desenvolvidas concomitantemente. Procedeu-se à análise temática indutiva dos dados. Identificaram-se os códigos e quatro unidades de sentidos: Explicação para a ocorrência da queimadura, Identificação do perigo, Prevenção de queimaduras, Repercussões da queimadura, as quais serviram de base para a construção de três núcleos temáticos, que fornecem os significados: \"Abrir o olho de verdade\": enxergando a possibilidade da queimadura, \"Aqui dentro, não!\": o exercício do controle dentro de casa, e \"Uma questão de cultura do jeitinho brasileiro\": partindo do \"acidente que aconteceu\" para a \"mudança de hábito\". Os significados foram explicados pelo conceito antropológico da vulnerabilidade. O processo de prevenção de queimaduras no ambiente doméstico é muito amplo e necessita do envolvimento de diversos setores públicos, bem como da conscientização da comunidade para esta temática. Somente com a interligação de todos é que será possível, aos poucos, produzir uma mudança cultural de hábitos com vistas à redução das vulnerabilidades pessoal, social e programática de crianças e suas famílias para as queimaduras, fortalecendo, individual e coletivamente, as crianças e seus familiares / Different types of accidents involving children and adolescents happen at home, and the main ones include burns. The objective in this research was to interpret the meanings attributed to pediatric burn prevention in the home context, according to children who were victims of burns and their families. Therefore, a qualitative study was undertaken, based on the theoretical framework of Interpretive Anthropology and the ethnographic method. After receiving ethical clearance from the proponent and the co-participant institution, six children who were victims of domestic burns and their families were invited to participate in the research, totaling 20 participants. The children were attended at the Burns Treatment Center of the University of São Paulo at Ribeirão Preto Medical School Hospital das Clínicas. To collect the data, participant observation, a field diary, in-depth interviews and photography exclusion interview, mainly at the informants\' homes and in the hospital context, between January 2012 and June 2013. We privileged a prolonged engagement in the field, with concomitant data collection and analysis. The data were processed through inductive thematic analysis. The codes were identified, as well as four units of meaning: Explanation for the burn event, Identification of the danger, Burn prevention and Burn repercussions, which supported the construction of three thematic cores that provided the meanings: \"Truly opening your eyes\": seeing the possibility of the burn, \"Not in here!\": the exercise of control at home, and \"A Brazilian cultural thing\": from the \"accident that happened\" to the \"change of habit\". The meanings were explained by the anthropological concept of vulnerability. The burn prevention process in the domestic environment is very broad and needs involvement from different public sectors, as well as the community\'s enhanced awareness about this theme. It is only by interconnecting all stakeholders that, little by little, a cultural change of habits can be produced with a view to the reduction of the personal, social and programmatic vulnerabilities of children and their families to burns, strengthening the children and their family members individually and collectively

O estudo termo-hidráulico, utilizado para análise de acidentes e transientes em reatores nucleares, é feito com o uso de algumas ferramentas computacionais sofisticadas. Esses programas utilizam uma filosofia realista (best estimate) para análise de acidentes e transientes em reatores refrigerados à água leve do tipo PWR (Pressurized Water Reactor) e sistemas associados. O código RELAP5, objeto de nosso estudo, tem sido usado como uma ferramenta para o licenciamento de instalações nucleares no nosso país. Uma das maiores dificuldades na simulação de acidentes e transientes em uma instalação nuclear com o código RELAP5 é a quantidade de informações necessárias, que na maioria dos casos é muito grande. Além disso, existe a necessidade de uma quantidade razoável de operações matemáticas para os cálculos da geometria dos componentes. Portanto, a fim de facilitar a manipulação destas informações, percebeu-se a necessidade do desenvolvimento de um pré-processador amigável com o usuário, para realização desses cálculos e para elaboração dos dados de entrada do RELAP5. A ferramenta escolhida foi o MS-EXCEL, que apresentou grande potencialidade no desenvolvimento do pré-processador desejado. / Computational program are used for thermal hydraulic analysis of accidents and transients conditions in nuclear power plants. The RELAP5 code has been developed to simulate accidents and transients conditions, performing a best estimate analysis, in Pressurized Water Reactors (PWR) and auxiliary systems. The RELAP5 code, which has been used as a tool for licensing nuclear facilities in Brazil, is the objective of the study performed in this work. The main problem in using the RELAP5 code is the huge amount of information necessary to model the nuclear reactor and thus to simulate thermal-hydraulic accidents. Moreover, the RELAP5 code input data requires a large amount of mathematical operations to calculate the geometry of the plant components. Therefore, in order to make easier the data input for the RELAP5 code a friendly preprocessor has been developed. The preprocessor accepts basic information about the geometry of the plant components and performs all the calculations needed for the RELAP5 input. This preprocessor has been developed based on the MS-EXCEL software.

Introdução - O cruzamento do modal ferroviário com rodoviário em um mesmo nível é chamado de passagem de nível (PN), os quais apresentam baixa freqüência de acidentes, porém elevados índices de gravidade. No dia 08 de setembro de 2010, em Americana-SP, ocorreu acidente envolvendo dois trens e um ônibus em uma PN, com dez vítimas fatais e dezessete feridos, dos quais quatro foram registrados como acidentes de trabalho. Objetivo - Analisar origens imediatas e latentes desse acidente visando evitar ou minimizar as chances de ocorrência de eventos semelhante no futuro. Método - Estudo de caso que foi realizado através da pesquisa de artigos, livros, jornais e reportagens televisivas sobre o assunto. Após essa etapa, foram realizadas entrevistas com pessoas envolvidas no acidente, como canceleiros, motoristas de ônibus e maquinistas. O Modelo de Análise e Prevenção de Acidentes de Trabalho (MAPA), que propõe uma abordagem sistêmica do caso, foi usado na análise do evento. Resultados - O local é mal iluminado e com presença de construções que dificultam a visualização dos trens. Essa PN apresenta intenso tráfego de pedestres e de carros mesmo com o sinal fechado. O motorista informou que o sinal vermelho só foi acionado quando o ônibus já estava no meio da PN, instantes antes do choque. As condições de trabalho dos motoristas de ônibus e maquinistas são inadequadas com uma prática freqüente de horas extras e às vezes não é respeitado o intervalo legal de 11 horas entre uma jornada e outra. As barreiras presentes na PN eram apenas simbólicas. O sistema de comunicação entre canceleiros, motoristas e maquinistas é dependente da ação humana sendo considerado frágil. Os entrevistados afirmaram já ter presenciado acidentes em PN, confirmando a fragilidade do sistema. O acidente foi investigado pelo Instituto de Criminalística que considerou o motorista do ônibus culpado pela ocorrência, sendo atualmente objeto de processo criminal correndo o risco de ser condenado e preso. Conclusão - O acidente foi um evento complexo, com a interação entre, pelo menos os seguintes componentes: o sistema de transporte rodoviário urbano, com destaque para a ação do motorista do ônibus; o transporte ferroviário e o trabalho dos maquinistas dos trens; o sistema de controle da PN que envolve o trabalho dos canceleiros encarregados da sinalização de aproximação dos trens; a concepção, gestão e manutenção da segurança da PN, o sistema viário urbano que inclui a iluminação pública / Introduction - The railway crossing with the road on the same level is called Grade Crossing (GC), which present low incidence of accidents, however, when they happen, they usually present high rates of severity. On September 8th, 2010, in Americana-SP, there was an accident involving two trains and one bus on a GC, with ten people died and seventeen were injured, four of which were registered as work accident. Aim - To analyze the immediate and latent causes of the accident attempting to avoid or minimize the chances of similar events to happen in the future. Method Case study that was performed by means of research from articles, books, newspapers and TV reports about the subject. After this phase, interviews were carried out with people involved in the accident, like watchmen, bus drivers and train operators. The Model of Analysis and Prevention of Work Accidents (MAPA), which proposes a systemic approach of the event, was used as a guide. Results - The site is poorly lit and with the presence buildings that obstruct the visualization of the trains coming to it. This GC has intense traffic of pedestrians and cars when the traffic signal is closed. The driver said that the red traffic signal was only triggered when the bus was in the middle of GC, moments before the collision. The work conditions bus drivers and driver of train are inadequate with a frequent practice of overtime and sometimes not respected the legal range of 11 hours between one day and another. At the time the accident happened, there were only symbolic barriers. The system of communication among watchmen, bus drivers and train operators depends on the human action being considered weak. The people interviewed said they had seen accidents on GC, which confirmed the fragility of the system. The accident was investigated by the Institute of Forensic Science which has considered the bus driver guilty of the occurrence, nowadays being object of criminal procedure and may be condemned and arrested. Conclusion - The accident was a complex event, with the interaction among, at least: the system of urban road transport, especially the action of the bus driver; the rail transport and the work of trains operators; the control system of GC, that involves the work of watchmen that are responsible by traffic signal at the approaching of trains; those in charge of design, management and maintenance of safety issues in the GCs and those in charge of the urban road system that includes lighting

L’accident vasculaire cérébral, est une pathologie aigüe et grave, qui peut conduire au décès rapide du patient ou à un handicap neurologique sévère, moteur et/ou cognitif. Dans les situations les plus sévères, l’action médicale amène à envisager des limitations ou arrêt de certains traitements si le pronostic s’avère « catastrophique », signifiant le plus souvent le risque d’un handicap « inacceptable ».L’action médicale dans ces situations est particulièrement complexe. Elle pose la question de la finalité de l’acte médical au regard de la qualité de vie future du patient, qui suppose l’estimation délicate de la valeur de la vie, prédiction par essence incertaine. Mais si le pronostic tient une place centrale dans cette action, d’autres facteurs jouent également un rôle déterminant, comme celui du contexte. Ce travail de thèse propose une exploration des notions de pronostic et de « proportionnalité des soins » et une approche éthique reposant sur la prise en compte de la complexité et la délibération aristotélicienne. / Stroke is an acute and severe pathology, which can lead to rapid death or severe neurological motor and / or cognitive disability. In the most severe situations, medical action leads to consider withholding or withdrawal of treatments, if the prognosis appears to be "catastrophic", meaning most often the risk of "unacceptable" disability.The medical action in these situations is particularly complex. It raises the question of the purpose of the medical act in relation to the future quality of life of the patient, which involves the delicate estimate of the value of life, prediction inherently uncertain. But if the prognosis holds a central place in this action, other factors also play a role, such as the context. This thesis offers an exploration of the concepts of prognosis and “proportionality care” and an ethical approach based on taking into account the complexity and Aristotelian deliberation.

This study provides, via personal interviews, a qualitative examination of police, district attorneys, public defenders and private attorneys who were involved in traffic accident investigation and criminal court adjudication in Chattanooga, Tennessee. These data were compiled to develop a profile of the actors and their involvement in the process of a criminal charge stemming from a traffic accident. The literature suggests that the actors work as a team to process a case from investigation to adjudication; however, the actors in Chattanooga, Tennessee were fragmented in their handling of a case. This study collectively examines police and attorneys in relation to traffic issues.

Nonadherence to best practice guidelines in early mobilization in acute stroke increases the time from admission to mobilization and may increase residual long-term stroke effects. Early mobilization following an acute stroke is known to decrease long-term and secondary disability. The purpose of this project was to decrease the time from admission to mobilization in the acute stroke patient population by improving knowledge of best-practice guidelines in early mobility using an educational intervention for advanced practice nurse practitioners, physicians, and registered nurses. The practice-focused question for this project asked whether a staff educational program based on best-practice guidelines would decrease the time from admission to early mobilization in the acute stroke patient within the first 48 hours of admission. Rosswurm and Larrabee 6-step model was used for this staff education project. A review of the literature indicated sources of evidence from peer-reviewed journals, which were used to support the staff education project and establish best practices in mobilization for the acute stroke patient. A before-and-after design was used to evaluate time from admission to mobilization within the first 48 hours in 40 acute ischemic stroke adult patients following educational intervention for 35 acute stroke staff. Data were collected and analyzed using descriptive statistics. Findings revealed a decrease in time from admission to mobilization by 18.59%. Findings may be used to promote best practices in other units within the hospital and may be used to decrease the residual long-term effects of a stroke, improve activities of daily living, decrease the length of hospital stay, and decrease the long-term cost and burden of stroke.

Contexte : il est possible qu’une victime subisse de multiples conséquences d’accident de la route,conséquences pouvant retentir durablement sur sa vie. Cependant, peu d’études permettent de connaitre leprofil du blessé grave ainsi que les facteurs prédictifs de son devenir. De plus, il existe peu d'outilsprédictifs servant à prédire les conséquences post-accidentelles. L’objectif de la thèse est de caractériserces conséquences, de chercher les éléments pronostiques de gravité des conséquences un an aprèsl’accident et de donner une évaluation, à partir de données réelles, de la qualité de prédiction del’indicateur de déficience à un an appelé IIS (Injury Impairment Score - un indice de déficience - défini apriori à partir des lésions- et utilisé fréquemment).Méthodes : la thèse est réalisée dans le cadre de la cohorte ESPARR (Étude et Suivi d’une Populationd’Accidentés de la Route dans le Rhône), qui s’appuie sur les données du Registre des accidents de lacirculation du Rhône, et qui inclut 1372 sujets blessés dans des accidents de la route dont 1168 sujets âgésde 16 ans et plus. Parmi ces sujets, 886 adultes ont répondu à un questionnaire de suivi à un an, 616 sujetsont des données complètes et sont classés dans des groupes homogènes en fonction de leur devenir à unan par l'analyse des correspondances multiples et la méthode de classification hiérarchique. L’analyse desfacteurs prédictifs de leur appartenance à un de ces groupes de victimes, mesurés à la date de l'accident, aété effectuée à l’aide de modèles de régressions logistiques multinomiales pondérés. L'évaluation de l'IISsur les données réelles est réalisée en regardant la cohérence entre l'IIS et les différents facteurs mesurés àun an.Résultats : cinq groupes homogènes au niveau des conséquences de l’accident à un an ont été identifiés :le groupe-1 contient 206 sujets, dont une majorité est considérée en bonne récupération ; le groupe-2concerne les sujets ayant uniquement des conséquences physiques ; les groupes 3, 4 et 5 concernent lessujets ayant des conséquences multiples. À part les conséquences physiques en lien avec les sujets dansces groupes, certains plus en lien avec des répercussions sur la vie social (groupe-3), d’autres en lien avecdes difficultés sociales ou environnementales (groupe-4). Le groupe-5 comprend tous les sujets quisouffrent de syndrome post-commotionnel de la population d’étude. Après avoir ajusté sur plusieursvariables recueillies lors de l'accident, notre étude montre que, en plus des facteurs déjà évoqués dans lalittérature (âge, gravité…), le niveau de fragilité socioéconomique et le fait d'avoir un proche blessé dansl'accident sont également des facteurs prédisant le devenir des victimes d’un accident. En ce qui concernel'évaluation de l'IIS sur les données réelles, nous trouvons que le niveau des conséquences prédites par l’IIS ne correspond pas parfaitement à celui observé en réalité à un an quels que soient les facteurs mesurés.Conclusion : un an après l’accident, de nombreuses victimes d'accident de la route, même parmi cellessouffrant de lésions légères, continuent de présenter de multiples problèmes tant sur leur santé physiqueque mentale, sur le plan social ainsi que sur leur environnement. Dans une perspective de réadaptation à lavie quotidienne, ces résultats peuvent être utiles à l’amélioration de la prise en charge des accidentés de laroute. / Background: it is possible that victims can suffer from multiple problems after an accident, and this canbe seen in the people with the most serious consequences. However, few studies allow us to know theprofile and prognostic factors of severity of consequences after the accident in this population of victims.Moreover, there are few tools to predict 1-year post-traumatic sequelae in road crash victims.The thesis aims to determine subgroups of victims with similar outcomes 1 year after the crash andpredictive factors for attribution to these subgroups and validate sequelae prediction by the InjuryImpairment Score (IIS), in comparison with the one year outcomes.Methods: the thesis is a part of the broader ESPARR study based on the Rhône Registry of Road TrafficCasualties. The ESPARR cohort comprised 1,372 subjects, including 1,168 aged 16 years. Among 886adult subjects who responded to a follow-up questionnaire one year later, the main analysis was carriedout on 616 participants, who completed a self-report questionnaire on health, social, emotional andfinancial status 1 year after a crash. The multiple correspondence analysis and hierarchical clusteringmethod was implemented to produce homogeneous road-crash victim subgroups according to differencesin outcome. Baseline (time of accident) predictive factors for subgroup attribution were analysed onweighted multinomial logistic regression models. We used outcomes data at 1-year follow-up of roadinjury to validate the ability of IIS to predict sequelae.Results: five different victim groups were identified in terms of consequences one year after the crash:one group (206 subjects, 33.4%) presented few problems, one group with essentially physical sequelae,one group with essentially physical and social problems, and two groups presented many problems (oneincluded more victims with psychological problem and less environment problem). As well as the knownprognostic factors of age, initial injury severity and lesion type, socioeconomic fragility and the fact of arelative being involved in the accident emerged as being predictive of poor outcome one year later. IIS, inthis injured population, failed to predict sequelae one year later as measured by real data.Conclusion: one year after a road accident, victims may still experience multiple problems in terms notonly of physical health but also of mental health, social life and environment. Poor outcome may bepredicted both from accident-related factors and from victims' socioeconomic fragility. These findings areuseful in guiding prevention in terms not only of recovery of health status but also of recovery of sociallife in the best possible environment.