Background Motor vehicle collisions (MVCs) are a common cause of injury and death throughout the world. Following an MVC some patients will remain in their vehicles due to injury, the potential for injury or physical obstruction. Extrication is the process of removing injured or potentially injured patients from vehicles following a motor-vehicle collision. Current extrication practices are based on the principles of 'movement minimisation' with the purpose of minimising the incidence of avoidable secondary spinal injury. Movement minimisation adds time to the process of extrication and may result in an excess morbidity and mortality for patients with time dependent injuries. The current extrication approach has evolved without the application of evidence-based medicine (EBM) principles. The principles of EBM; consideration of the relevant scientific evidence, patient values and preferences and expert clinical judgement are used as a framework for this thesis. Aims and Objectives To develop evidence-based guidance for the extrication of patients trapped in motor vehicles by applying EBM principles to this area of practice. This will be achieved through: - Describing the injury patterns, morbidity and mortality of patients involved in MVCs (trapped and not trapped). - To analyse the movement associated with and the time taken to deliver across a variety of extrication methods. - Determining the perceptions of patients who have undergone vehicle extrication and describe their experiences of extrication. - Developing consensus-based guidelines for extrication.

Collisions between animals and motor vehicles are frequent and often result in animal mortality. In Australia, macropods are regular victims of these collisions. This has serious implications for animal welfare and conservation as well as aesthetics and tourism. Collisions with large animals and secondary collisions caused by the presence of animals on road easements, can lead to serious personal injury and property damage. A range of mitigative measures to prevent animal-vehicle collisions exists, but no single measure can be fully effective and the efficacy of many mitigation measures remains untested. An integrated management approach, employing many mitigative techniques is required to reduce vehicle-animal collisions. Repellents have recently been identified as a potential mitigative measure for reducing vehicle-animal collisions. The aim of this study was to identify the potential role of repellents in reducing macropod-vehicle collisions in New South Wales. This required the identification and assessment of potential repellents since research investigating repellents in an Australian context is scant. Macropus rufogriseus banksianus was selected as a test species for this research as a high abundance of this species exists in southeastern Australia and it is a common victim of roadkill in New South Wales. Preliminary screening trials of four potential macropod repellents highlighted the utility of two of the substances: Plant Plus, a synthetic compound based on the chemistry of dog urine; and a formulation consisting of chicken eggs. Feeding by M. rufogriseus banksianus was significantly reduced when these substances were applied near feed trays. Modest results were also detected for Δ3-isopentenyl methyl sulfide (a constituent of fox urine), while a commercial animal repellent (SCAT® Bird and Animal Repellent) was ineffective in altering feeding by M. rufogriseus banksianus. A barrier trial conducted with the two most successful repellents indicated that Plant Plus was a more effective macropod repellent then the egg formulation. Plant Plus displayed qualities of an area repellent and elicited a stronger response from M. rufogriseus banksianus when compared to the egg formulation. Further captive trials determined that the habituation of response to Plant Plus by M. rufogriseus banksianus was minimal after six weeks of constant exposure and Plant Plus retained repellent properties after exposure to ambient environmental conditions for at least ten weeks. Field trials to establish the effectiveness of Plant Plus with free ranging macropods (M. rufogriseus banksianus and M. giganteus) were unsuccessful due to methodological limitations stemming from high background variance in observed responses, equipment failure and site disturbance from outside influences. The potential role of Plant Plus as a repellent for managing macropod-vehicle collisions was highlighted by the captive trials. However, several factors requiring further research were identified. This included assessing the repellent abilities of Plant Plus in the field and further defining the properties of Plant Plus with captive trials. The effects of Plant Plus on non-target species and an assessment of potential environmental impacts also requires attention. Research assessing the potential role of repellents in other management contexts in Australia would be beneficial and the identification and assessment of repellents for other species should proceed. However, in the context of assessing repellents for use in the management of vehicle-macropod collisions, immediate focus should concentrate on extending the research to assess the effects of Plant Plus with other species of large macropod, and assessing if Plant Plus can reduce the numbers of macropods in road easements.

Urban development and habitat fragmentation threaten recovery and management of the endangered Florida Key deer (Odocoileus virginianus clavium). Urban development has reduced deer dispersal from their core habitat resulting in deer “overabundance” and has increased deer-human interactions (mostly deer-vehicle collisions [DVCs]). Conversely, deer populations on outer islands have declined in recent years due to limited deer dispersal from source populations. In order to expand the Key deer’s range and reduce DVCs within their core habitat, wildlife managers determined translocations and DVC mitigation were needed. Thus, the objectives of my thesis were to determine (1) effects of translocation on the establishment of outer-island local populations, and (2) effects of United States 1 Highway (US 1) improvements (i.e., exclusion fencing, underpasses, deer guards, and extra lane creation) on DVCs and deer movements. I evaluated the efficacy of translocations by comparing annual survival and seasonal ranges between resident and translocated deer and by analyzing reproduction of translocated deer. Translocated females (yearlings and adults) had lower annual survival than resident deer. Conversely, males (yearlings and adults) demonstrated higher annual survival than resident males. Due to low sample sizes and large variation, these numbers are potentially less important than the high overall survival (only 4 of 38 died). Seasonal ranges were generally smaller for resident deer than translocated deer. I attribute differences in ranges to differences in habitat quality between the core habitat and destination islands and to use of soft releases. Presence of fawns and yearlings indicated successful reproduction of translocated deer. Overall, the project was successful in establishing populations on the destination islands. The US 1 Highway improvements reduced DVCs along the fenced section of US 1 (2003, n = 2; 2004, n = 1; 2005, n = 0); however, overall DVCs increased on Big Pine Key (1996–2000, x¯ = 79; 2003, n = 91; 2004, n = 84; 2005, n = 100). Data suggest DVCs shifted to the unfenced segment of US 1. However, monthly deer surveys also suggested an increase in deer numbers that may explain overall DVC increases observed in my study.

Roads are essential in modern societies, but as populations grow and traffic volumes rise, roads will continue to be built and expanded. As a result, the effects that roads have on wildlife will likely intensify, making it imperative that managers understand those effects so mitigation can be directed accordingly. In Utah, considerable areas of mule deer (Odocoileus hemionus) habitat have been bisected by roads. Mule deer are commonly involved in vehicle collisions and there is concern that roads and vehicle traffic are impacting populations. This project was conducted to determine the number and demographic effects of deer-vehicle collisions, to examine how movements and survival of deer were impacted by roads, and to develop a smartphone-based reporting system for wildlife-vehicle collisions. Accurate estimates of DVCs are needed to effectively mitigate the effects of roads, but great uncertainty exists with most deer-vehicle collision estimates. I estimated the number of deer-vehicle collisions using carcass surveys, while accounting for several sources of bias to improve accuracy. I estimated that 2-5 % of the statewide deer population was killed in vehicle collisions annually. The effect that vehicle collisions have on deer abundance depended not only on the number of deer killed but also on the demographic groups removed. I found that 65 % of deer killed in vehicle collisions were female and 40 % were adult females. As female deer are the primary drivers of population growth, my data suggest vehicle collisions could significantly affect population abundance. However I was unable to detect a decreasing trend in deer abundance. Deer have distinct movement patterns that affect their distribution in relationship to roads. I analyzed deer movements during two consecutive winters (2010-11 & 2011-12) to determine what effect climate had on deer movements and vehicle collision rates. I observed that as snow depth decreased, the distance that deer occurred from roads increased. As a result road crossing rates declined, as did the number of vehicle collisions. This suggests a causal mechanism by which winter conditions influence vehicle collision rates. Currently there is a need for an efficient wildlife-vehicle collision data collection. I envisioned and, working with colleagues, helped develop a smartphone-based system for reporting wildlife-vehicle collision data. The WVC Reporter system consisted of a mobile web application for data collection, a database for centralized storage of data, and a desktop application for viewing data. The system greatly improved accuracy and increased efficiency of data collection efforts, which will likely result in improved mitigation and ultimately increased safety for motorists and deer.

OBJECTIVES: To compare morbidity and mortality between pediatric victims of motor vehicle collisions (MVC) who were unrestrained to those restrained and to describe compliance with child restraint usage in our population. MATERIALS AND METHODS: A retrospective consecutive chart review study was performed on MVC victims 14 years old and younger who presented to our academic, level 1 trauma emergency department in 2003. Each patient's emergency department and hospital course was reviewed and data were collected. Odds ratios (ORs) were calculated for unrestrained children with respect to restrained children for fractures; intraabdominal injuries, intrathoracic injuries, intracranial injuries, admission, surgery, blood transfusion, intubation; and deaths. Hospital charges and length of hospital stay were compared between those unrestrained and restrained. Percentage of children unrestrained was determined. RESULTS: Of 336 patients, 81 (24%) were unrestrained. Mean hospital stay for unrestrained children was longer, 1.94 days (95% confidence interval [CI] 0.75-3.12) versus 0.098 days (95% CI 0.02-0.21). Unrestrained victims had higher mean charges, $14,754 (95% CI $7676-$21,831) versus $1996 (95% CI $1207-$2786). Admissions (OR = 14.48, 95% CI 5.91-38.63), fractures (OR = 5.85, 95% CI 2.13-16.89), intraabdominal injuries (OR = 20.16, 95% CI 2.36-930.68), and intrathoracic injuries (OR = 13.09, 95% CI 1.26-647.05) were all more likely in unrestrained patients. No restrained child had intracranial injury, whereas 9/81 (11.11%) of unrestrained did. Odds were higher in unrestrained for surgery [OR = 13.09, 95% CI 3.30-74.33] and transfusion [OR = 27.61, 95% CI 3.56-229.85]. Ten out of 81 (12.35%) of unrestrained children required intubation versus none for restrained. The only 2 mortalities were unrestrained patients. CONCLUSION: Critical injuries and cost of care are higher in unrestrained than restrained children. Improved compliance with child safety restraint in southern Arizona should decrease childhood morbidity and mortality from MVCs.

The change of a vehicle’s velocity due to an impact, DeltaV (v) is often calculated and used in the scientific investigation of road traffic collisions. Two types of model are in common use to achieve this purpose, those based on the conservation of linear and angular momentum and the CRASH model which also considers the conservation of energy. It is shown that CRASH and major implementations of the momentum models are equivalent provided certain conditions are satisfied. Explicit conversions between the main variants of the models are presented. A method is also presented which describes a new formula for determining the total work performed in causing crush to a particular vehicle. This has the advantage of incorporating restitution effects and yields identical results to the momentum only models. Although the CRASH model has received adverse criticism due to perceived inaccuracies in the results, little work has been performed to determine the theoretical limitations on accuracy. This thesis rectifies that shortcoming. A Monte Carlo simulation and analytical model are developed here to provide two independent methods for determining the overall accuracy of the CRASH method. The principal direction of force was found to be the most likely to introduce error based on the CRASH assessment. It is shown how this and other sources of error in the CRASH model can be quantified for a particular collision suggesting priorities for minimising the overall uncertainty. The data from a series of well known crash tests are used with each of the models to provide comparison and validation data. It is recognised that without additional data velocity change is of limited use for forensic investigation. However DeltaV can be used as a proxy for acceleration and is particularly useful in studies involving injury causation. A method is also presented here which uses the change in velocity sustained by a vehicle in a planar collision to estimate the velocities of a vehicle before and after a collision. This method relies solely on conservation laws and is also applicable to situations where the coefficient of restitution is non-zero. An extension to the method is also described which allows an initial estimate to be modified to generate more realistic directions of force. This extension has the desirable effect of reducing uncertainty in the estimation of the direction of force which significantly improves the overall accuracy.

No description available.

Infraestruturas lineares, como as estradas, estão por todos os lugares no mundo e os impactos causados por elas são inúmeros e intensos. Focando no impacto de mortalidade de fauna por colisão com veículos, esta tese teve o objetivo de propor diferentes abordagens para identificar locais para a implementação de medidas de mitigação desse impacto. Além da introdução geral, a tese tem três capítulos que correspondem a três artigos científicos. O primeiro capítulo explorou dados de répteis atropelados em 33 meses de monitoramento mensais em 277 km da BR-101 e avaliou tanto o padrão espacial quanto o padrão temporal de fatalidades além de estimar a magnitude de atropelamentos de répteis na estrada. O segundo e o terceiro capítulo exploram abordagens preditivas de atropelamento de fauna para dois diferentes contextos: uma única estrada e uma rede de estradas. O segundo capítulo teve o objetivo de testar se usando características da paisagem, da rodovia e dos animais, nós podemos predizer onde estão os locais com maior chance de um animal ser atropelado. Para isso, também para a BR-101, calculei a probabilidade de travessia através de mapas de conectividade e a probabilidade de colisão através de uma equação que considera o tráfego de veículos, o tamanho dos animais e dos veículos e a velocidade dos animais para duas espécies de mamíferos nativos do Brasil: o furão (Galictis cuja) e o zorrilho (Conepatus chinga). Para o terceiro capítulo, foi utilizado a rede de estradas do estado de Victoria na Austrália, na qual calculei a probabilidade de travessia e de colisão para o canguru cinza oriental (Macropus giganteus), espécie nativa da Austrália. No primeiro capítulo, demonstrei que: 15.377 cágados, lagartos e serpentes são atropelados a cada ano na BR-101 no sul do Brasil; hot moments de atropelamentos de répteis ocorreram no verão, especialmente em dezembro para lagartos e serpentes; hotspots de atropelamentos foram coincidentes para tartarugas, lagartos e serpentes; existiu um efeito positivo do tráfego e da rizicultura nos atropelamentos e negativo da silvicultura; medidas de mitigação nos hotspots prioritários poderiam evitar 45% das fatalidades de répteis. No segundo capítulo, concluí que a probabilidade de fatalidade através da multiplicação das probabilidades de travessia e colisão não teve um bom poder de predição dos atropelamentos e que a probabilidade de colisão sozinha foi melhor em predizer os atropelamentos do que a probabilidade de travessia, entretanto as espécies apresentaram padrões diferentes. No terceiro capítulo, concluí que um modelo aditivo das duas probabilidades foi melhor em predizer os atropelamentos de cangurus do que os modelos individuais de probabilidades de travessia e colisão, entretanto o modelo integrado não apresentou a predição esperada. A probabilidade de travessia foi um preditor melhor dos atropelamentos de cangurus que a probabilidade de colisão para a rede de estradas. Portanto, concluo que: 1) os atropelamentos de fauna podem ser bastante acentuados em determinados contextos e que é possível identificar locais de maior agregação que seriam efetivos para mitigação; 2) é possível usar dados de tráfego de veículos e tamanho e velocidade dos animais para predizer locais de mais atropelamentos, entretanto deve se ter cuidado pois isso é específico para cada espécie; 3) para o contexto de rede de estradas, é possível predizer o atropelamento utilizando a probabilidade de travessia e a probabilidade de colisão em um mesmo modelo. Ainda é necessário explorar outras maneiras de calcular e integrar as probabilidades aqui propostas, mas nesta tese eu demonstrei uma forma possível de predizer atropelamentos para um contexto em que não há dados dessa natureza disponíveis, seja para estradas novas ou para uma rede de estradas. / Linear infrastructures, such as roads, are worldwide and impacts caused by them are innumerable and intense. We focused on impact of road-kills due to wildlife-vehicle collisions and aimed to propose different approaches to identify locations to implement mitigation measures for this impact. Besides the general introduction, this thesis has three chapters which correspond to three scientific papers. The first chapter examined reptile road-kill data from monthly road survey during 33 months in a 277 km of BR-101 road. We evaluated spatial and temporal patterns of road-kills and estimated the magnitude of reptile road-kills on that road. The second and third chapters examined predictive approaches of wildlife road-kills for two different contexts: a single road and a road network. The second chapter aimed to test if it is possible to use of landscape, road, animals features to predict locations where there are more road-kills. For the same road (BR-101), I calculated crossing probability using connectivity maps and collision probability using an equation which considers traffic volume, animal and vehicle size, and animal speed for two native mammal species from Brazil: the Lesser Grison (Galictis cuja) and the Molina’s Hog-nosed Skunk (Conepatus chinga). To the third chapter, I used the road network of Victoria state in Australia, which I calculated crossing and collision probabilities for eastern grey kangaroo (Macropus giganteus), a native species from Australia. In the first chapter, I demonstrated that: 15,377 freshwater turtles, lizards and snakes are road-kills each year in Br-101 in Southern Brazil; road-kill hot moments occur in the summer, specially in December for lizards and snakes; road-kill hotspots are coincident among freshwater turtles, lizards and snakes; there is a positive effect of traffic and rice plantation on road-kills and a negative effect of silviculture; mitigation measures of priority hotspots could avoid 45% of reptile fatalities. In the second chapter, I concluded that fatality probability though multiplication of crossing and collision probabilities did not have a good predictive power of road-kills and collision probability alone was better to predict road-kills than crossing probability, however species showed different patterns. In the third chapter, I concluded that an additive model with the two probabilities was better to predict kangaroo road-kills than individual models of crossing and collision probabilities, however the integrated model did not present an expected prediction. Crossing probability was a better predictor of kangaroos road-kills than collision probability for the road network. Therefore, I concluded that: 1) wildlife road-kills can be really high in some contexts and it is possible to identify locations with more road-kill aggregations which would be effective for mitigation; 2) it is possible to use traffic volume, animals size and speed to predict location of road-kills, however it is specific for each species; 3) for road network context, it is possible to predict kangaroo road-kills using crossing and collision probability in the same model. Exploring another ways to calculate and integrate the probabilities used here is necessary, however in this thesis I demonstrated one possible manner to predict road-kills in a context which road-kill are not available, such as new roads or road networks.

The Department of Energy Oak Ridge Reservation (ORR) and the nearby adjoining City of Oak Ridge, Tennessee had experienced a rise in deer-vehicle collisions (DVCs) to the point where safety for employees and residents became a concern. I investigated the effect of hunting, land cover, road mileage, season, lunar phase, sex, and change in traffic patterns that coincide with work shifts on DVCs from 1975 - 2008. The study area was divided into grids of 1.5 km² each for administration and data recording by managing agencies. Statistical analyses were performed on the ORR (121 grids) and GIS analyses were performed on the entire study area that included ORR and the city of Oak Ridge (190 grids). The number of DVCs in 1975 was 16 and reached a high of 273 in 1985. Therefore, managers initiated a hunting program in 1985 and recorded deer harvest numbers by grid each year. Deer harvest has been occurring from 1985 until present, except when hunting was cancelled due to security concerns after the September 11 terrorist attacks in 2001. By 2008, the number of DVCs had decreased to 100 per year. When hunting first started in 1985, they harvested 926 deer. By 2008, that number was down to 481. I used GIS mapping to record DVCs, deer harvest per grid, landcover types, and mileage per grid to determine factors affecting DVCs on the smaller landscape. Following the initiation of annual hunts, both the annual deer harvest and the number of DVC’s have fallen, presumably because the overall deer population has declined from high pre-hunting levels. Deer harvest appears to be related to landcover characteristics, as a higher percentage of deer were harvested from forested areas than from other landcover types, as forested areas were most prominent. The months of October, November, and December had the highest DVC numbers. Increased traffic during starting and leaving shift times seem to increase the number of DVCs as well. Lunar phases only seem to significantly increase DVCs during the gestation and fawning seasons. Does are involved more frequently with DVCs than bucks during gestation, fawning and prerut, but not during the rutting season. I expect managers can use this data to guide intensive local management aimed at reducing DVCs by increasing the number of deer harvested and increased public education.

Deer-vehicle collisions (DVCs) along a 5.6-km segment of United States Highway 1 (US 1) on Big Pine Key (BPK), Florida responsible for approximately 26% of endangered Florida Key deer (Odocoileus virginianus clavium) annual mortalities. The Florida Department of Transportation (FDOT) constructed a 2.6-km long system of fencing, 2 underpasses, and 4 experimental deer guards to address DVCs along a portion of the US 1 roadway in 2001–2002. I evaluated the effectiveness of the project in reducing Key deer mortality by comparing (1) survival of radio-collared deer, (2) deer-vehicle collisions on US 1, and (3) determining the ability of deer to access the fenced segment. I found no significant difference in male or female survival. Key deer-vehicle collisions were reduced by 83–92% inside the fenced segment. However, overall US 1 Key deer-vehicle collisions did not change. Key deer entry into the fenced segment was minimized to 8 deer during the first-year resulting in 2 deer mortalities. I also assessed the potential impacts of the US 1 corridor project to Key deer movements by comparing (1) radio-collared Key deer annual ranges (2) radio-collared deer corridor movements, and (3) assessing Key deer underpass and corridor use. Female and male ranges and core areas did not change (P > 0.05). Deer movements within the US 1 corridor were comparable pre- (6 of 23 radio-collared deer crossed the corridor) and post-project (4 of 16). Infrared-triggered camera data indicate underpass movements increased over time. Collectively, post-project telemetry and camera data indicates US 1 highway improvements have not restricted Key deer movements. Hourly Key deer movement and US 1 traffic patterns were compared to annual US 1 DVCs. Hourly deer movements showed a positive correlation (P = 0.012, r = 0.505) to hourly DVCs for the full circadian period. Hourly US 1 traffic showed a significant positive relationship (P = 0.012, r = 0.787) with DVCs only during the night period. Evaluation of hourly deer movements and hourly traffic volume on US 1 found hourly DVCs to be the result of a combination between both variables.