Aggressive driving: a preliminary analysis of a serious threat to motorists in a large metropolitan area

OBJECTIVE: Aggressive driving is consistently rated as the leading concern of motorists in our metropolitan area, ahead of even "drunken driving." Few objective data exist on the incidence of aggressive driving. The purpose of this study was to determine the incidence of selected aggressive driving behaviors and to establish a baseline for future interventions and research. METHODS: Speeding, traffic signal violations ("red-light running"), and stop-sign violations were studied. Speeding data were recorded by inductance loops embedded in major roadways (n = 10). Data were collected from red-light cameras (n = 73 cameras, 82 sites) and by trained observers at intersections with traffic signals (n = 15) or stop signs (n = 15). Data included total traffic volume, numbers of violations, and each violator's speed. RESULTS: The majority of motorists on major roadways drive at speeds exceeding the speed limit and between 40% and 80% of vehicles were traveling at 10 mph or more over the speed limit. Red-light running occurred at equivalent rates both by camera (1.5 violations/1,000 vehicles) and by observer (1.3 violations/1,000 vehicles). The absolute numbers of red-light violations were extremely high (approximately 30,000 per month), and 16% violated the signal at > 10 mph above the speed limit. The incidence of "at-speed" (i.e., without slowing) stop-sign violations was dramatic (17.5 violations/1,000 vehicles). These were confirmed by video review and represent high risk for crashes. CONCLUSION: Aggressive driving behaviors are frequent and often include very dangerous actions. Currently available deterrents appear to have limited impact in our congested area. Inadequate resources for enforcement and limited public awareness may be partially responsible. We have adopted a multidisciplinary approach to this serious problem including public education, stepped-up enforcement, and psychological treatments.     

The usefulness of elemental iron for cereal flour fortification: a SUSTAIN Task Force report. Sharing United States Technology to Aid in the Improvement of Nutrition

Fortification of cereal flours may be a useful public health strategy to combat iron deficiency. Cereal flours that are used shortly after production (e.g., baking flour) can be fortified with soluble iron compounds, such as ferrous sulfate, whereas the majority of flours stored for longer periods is usually fortified with elemental iron powders to avoid unacceptable sensory changes. Elemental iron powders are less well absorbed than soluble iron compounds and they vary widely in their absorption depending on manufacturing method and physicochemical characteristics. Costs vary with powder type, but elemental iron powders are generally less expensive than ferrous sulfate. This review evaluates the usefulness of the different elemental iron powders based on results from in vitro studies, rat assays, human bioavailability studies, and efficacy studies monitoring iron status in human subjects. It concludes that, at the present time, only electrolytic iron powder can be recommended as an iron fortificant. Because it is only approximately half as well absorbed as ferrous sulfate, it should be added to provide double the amount of iron.     

Systematic overview of quality of life studies for breast cancer

BACKGROUND: The concept of quality of life (QOL) is essentially subjective, determined from the patient's point of view. Thus, an appropriate investigation and analysis of QOL as an indicator of medical treatment outcome is a task of some difficulty. The physician-led QOL assessment studies to date in Japan have suffered from insufficient knowledge and understanding of the diverse factors contributing to QOL, thereby contributing to a dearth of quality studies. Given this background, the Japanese Breast Cancer Society has established a Task Force for the development of guidelines to properly conduct QOL assessment studies. The present article reports the results of a large-scale systematic overview of QOL assessment studies for breast cancer patients that was undertaken as one part of this project. METHODS: Six databases were used in this overview: MEDLINE, CINAHL, CANCERLIT, EMBASE, PsychINFO, and Japan Centra Revuo Medicina. The search period was 1982-1999 for CINAHL, and 1990-1999 for the others. Following a check of the titles, important information was recorded on relevance and data collection forms. RESULTS: A systematic search was conducted of the literature on QOL assessment studies for breast cancer patients, and 1,954 articles were extracted from a check of titles. Using the relevance and data collection forms, the number of articles was further narrowed to 126. These articles were then classified according to the type and design of the study, the number of QOL and psychological measures used, frequency of use of each measure, and study focus and type of intervention. The results were then compiled. CONCLUSION: To date there have been almost no appropriate systematic overviews or guidelines issued for QOL assessment studies related to breast cancer, even on the international level. The results of the present study may contribute high-quality QOL information for evidence-based medicine, as it continues to gain global prevalence.