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Biomedical subjects

Brian Fildes

Publications and source records attributed to Brian Fildes.

6 recordsLinked to original sources
PubMed2003

Self-regulatory behaviours of older drivers.

This study involved a survey of self-regulatory driving practices of 656 drivers aged 55 years and older. Types and prevalence of self-regulatory behaviours were described and several key characteristics of self-regulators were identified. Those who drove less than 100 kilometres per week were more likely to be female, 75+ years, retired, with arthritis, good/fair/poor ratings for decision-making, not the principal driver and not married. Those who avoided specific driving situations were also more likely to be female, 75+ years and not the principal driver. Avoidance was also associated with vision problems, lower confidence in driving situations and crash-involvement. Implications for promotion of safe driving practices are discussed.

Accidents, Traffic↗
PubMed2003

Benefits of seat belt reminder systems.

This study sought to determine whether fitting a more aggressive seat belt reminder system to new vehicles would be cost-beneficial for Australia. While seat belt wearing rates have been observed around 95% in the front seat, non-wearing rates in casualty crashes are as high as 33% among persons killed and 19% among seriously injured occupants. Benefits were computed for three device options (simple, simple-2 and complex) and three introduction scenarios (driver-only, front seat occupants and all occupants). Four levels of effectiveness were assumed, from 10% to 40%, depending on the type of device fitted. Unit benefits were computed assuming a 5% discount rate and a 15yr fleet life. Various industry experts provided the costs. The findings showed that Benefit-Cost-Ratios ranged from 4.0:1 at best (simple device for the driver only) to 0.9:1 for all seating positions. These figures are conservative, given the assumptions made and the discounted human capital methods used.

Accidents, Traffic↗
PubMed2002

Randomised factorial trial of falls prevention among older people living in their own homes.

OBJECTIVE: To test the effectiveness of, and explore interactions between, three interventions to prevent falls among older people. DESIGN: A randomised controlled trial with a full factorial design. SETTING: Urban community in Melbourne, Australia. PARTICIPANTS: 1090 aged 70 years and over and living at home. Most were Australian born and rated their health as good to excellent; just over half lived alone. INTERVENTIONS: Three interventions (group based exercise, home hazard management, and vision improvement) delivered to eight groups defined by the presence or absence of each intervention. MAIN OUTCOME MEASURE: Time to first fall ascertained by an 18 month falls calendar and analysed with survival analysis techniques. Changes to targeted risk factors were assessed by using measures of quadriceps strength, balance, vision, and number of hazards in the home. RESULTS: The rate ratio for exercise was 0.82 (95% confidence interval 0.70 to 0.97, P=0.02), and a significant effect (P<0.05) was observed for the combinations of interventions that involved exercise. Balance measures improved significantly among the exercise group. Neither home hazard management nor treatment of poor vision showed a significant effect. The strongest effect was observed for all three interventions combined (rate ratio 0.67 (0.51 to 0.88, P=0.004)), producing an estimated 14.0% reduction in the annual fall rate. The number of people needed to be treated to prevent one fall a year ranged from 32 for home hazard management to 7 for all three interventions combined. CONCLUSIONS: Group based exercise was the most potent single intervention tested, and the reduction in falls among this group seems to have been associated with improved balance. Falls were further reduced by the addition of home hazard management or reduced vision management, or both of these. Cost effectiveness is yet to be examined. These findings are most applicable to Australian born adults aged 70-84 years living at home who rate their health as good.

Accidental Falls↗
PubMed2002

Aortic injuries in side impacts: a preliminary analysis.

Injuries to the aorta are among the more serious injuries that result from vehicle impacts, and may often be fatal. This paper examined the incidence of aortic injuries in the US and UK using real-world crash data. The main outcome of interest was the level of risk associated with each principal direction of force for drivers and front seat passengers with respect to sustaining aortic injuries. The results indicate that the risk of sustaining an injury to the aorta is greater for near side crashes than for far side crashes. Further, it is apparent that given a near side crash, the risk of an aortic injury is greater on the left side of the body (and left side of the vehicle) than on the right. It was also found that the delta-V of crashes where occupants sustained an injury to the aorta was considerably higher than crashes where occupants did not sustain aortic injuries. It was speculated that the anatomical asymmetry of the thorax might play a role in the differences seen in injury risk associated with different impact directions. Limitations and further planned research are discussed.

Accidents, Traffic↗
PubMed2002

An overview of requirements for the crash protection of older drivers.

For some time now, it has been recognised that a major shift is occurring in the population age distributions of most motorised countries resulting in a growing number of older persons with an increasing need for mobility. It is expected that the mobility of older persons will become even more reliant on the motor vehicle as European countries in particular undergo transitions towards decentralisation and suburbanisation and because of the well-established longevity factor. As a group, older drivers do not currently represent a major road safety problem in most Western societies when compared with other age groups such as the young. However, they are involved in significantly more serious injury and casualty crashes per head of population. Furthermore, as older drivers are likely to become a more significant problem in the years ahead, it is now necessary to examine some vehicle design factors that affect the safety of the older driver in a crash.

Accidents, Traffic↗