On-Scene Injury Severity Prediction (OSISP) Algorithm for Truck Occupants

Objective: The aim of this study is to develop an on-scene injury severity prediction (OSISP) algorithm for truck occupants using only accident characteristics that are feasible to assess at the scene of the accident. The purpose of developing this algorithm is to use it as a basis for a field triage tool used in traffic accidents involving trucks. In addition, the model can be valuable for recognizing important factors for improving triage protocols used in Sweden and possibly in other countries with similar traffic environments and prehospital procedures.

Methods: The scope is adult truck occupants involved in traffic accidents on Swedish public roads registered in the Swedish Traffic Accident Data Acquisition (STRADA) database for calendar years 2003 to 2013. STRADA contains information reported by the police and medical data on injured road users treated at emergency hospitals. Using data from STRADA, 2 OSISP multivariate logistic regression models for deriving the probability of severe injury (defined here as having an Injury Severity Score [ISS] > 15) were implemented for light and heavy trucks; that is, trucks with weight up to 3,500 kg and ??16,500 kg, respectively. A 10-fold cross-validation procedure was used to estimate the performance of the OSISP algorithm in terms of the area under the receiver operating characteristic curve (AUC).

Results: The rate of belt use was low, especially for heavy truck occupants. The OSISP models developed for light and heavy trucks achieved cross-validation AUC of 0.81 and 0.74, respectively. The AUC values obtained when the models were evaluated on all data without cross-validation were 0.87 for both light and heavy trucks. The difference in the AUC values with and without use of cross-validation indicates overfitting of the model, which may be a consequence of relatively small data sets. Belt use stands out as the most valuable predictor in both types of trucks; accident type and age are important predictors for light trucks.

Conclusions: The OSISP models achieve good discriminating capability for light truck occupants and a reasonable performance for heavy truck occupants. The prediction accuracy may be increased by acquiring more data. Belt use was the strongest predictor of severe injury for both light and heavy truck occupants. There is a need for behavior-based safety programs and/or other means to encourage truck occupants to always wear a seat belt.     

Governing Quasi-Public Network Services for adaptation to climate change

Adaptation takes place in both private and public sectors, or as an interrelation between the two, and often under the realm of public regulation. Thispaper uses the Swedish and the Norwegian electricity grid sector, as providers of a vital public good under strict public regulation, to analyse reforms' effects on adaptive capacity in this area. The paper shows that transformational changes in both sectors during the 1990s shifted both the formal organisational structure (rules and regulations), as well as the organisational culture, in the direction of economic efficiency. These two dimensions individually reduced adaptive capacity to climate change, although differently in the two countries. However, the formal structure and organisational culture also yielded substantial influence on each other. This leads to the conclusion that when designing public regulations and implementing reforms, organisational culture must be considered in the design. Also the paper contests previous findings in the literature by showing that under given conditions there exist some substitution between the two dimensions in influencing adaptive capacity, implying that both dimensions should be included when analysing adaptation since analysing them in isolation is likely to lead to wrong conclusions.