oad). A matched strategy was used to select sites. ‘High-risk sites’ were those involved inthree or more RTCs in a prece<strong>de</strong>nt three-year period, whereas ‘low-risk sites’ were those notinvolved in a RTC, during the same period. For each high-risk site, a low-risk site wasrandomly selected on the same road section. Hazard perception was assessed by showingvi<strong>de</strong>os of these sites to voluntary Pakistani drivers. Ethical approval of the study <strong>de</strong>sign wasobtained from the Aga Khan University (AKU) Ethics Research Committee in May 2009(Reference ERC/2009/1179).Site selectionIn Pakistan, National Highway & Motorway Police (NHMP) regional office wasvisited in June 2009. Crash reports and registers for the three-year period from Jan 1, 2006 toDec 12, 2008 were retrieved and photocopied. High-risk sites with given kilometer locationwere then i<strong>de</strong>ntified with Global Positioning System (GPS) coordinates with help of a policeofficer. Similarly, traffic police offices in Cameroon were visited and such sites weresubsequently i<strong>de</strong>ntified in June 2007 (Bhatti, Sobngwi-Tambekou, Lagar<strong>de</strong>, & Salmi). Thetwo road sections were filmed from a four-wheeled sedan car moving within the authorizedspeed limit (July 2009 in Pakistan and July 2007 in Cameroon). All high- and low-risk siteswere then i<strong>de</strong>ntified by linking GPS coordinates to the vi<strong>de</strong>os. For each high-risk site, a lowrisksite was randomly selected out of all sites on the same road section which were notinvolved in crashes.Vi<strong>de</strong>o setsTo measure hazard perception, vi<strong>de</strong>o of sites were cut so that each vi<strong>de</strong>o showed a500-meter-long road section during 30 seconds, including the last 100 m corresponding to thehigh- or low-risk site. Further, a yellow indicator blinked five times to help drivers i<strong>de</strong>ntifythe site for which they had to emit a judgment on hazard perception during vi<strong>de</strong>o projection.We <strong>de</strong>termined sample size to be 26 pairs of sites, assuming that 95% of the high-risk siteswould be i<strong>de</strong>ntified as dangerous and 80% of the low-risk sites as not dangerous with aprecision of 7.5 (Flahault, Cadilhac, & Thomas, 2005).Participant selectionParticipants were Pakistani nationals residing in Karachi, aged 18 years or more, witha valid driving permit, who had driven a motorized vehicle on the Karachi-Hala road sectionin the previous seven days. Random sampling was not possible because of heavy-traffic andhigher speed conditions on this road section (Hijar, Carrillo, Flores, Anaya, & Lopez, 2000).Thus, a convenience, but representative, sampling method was used to recruit 100 drivers. Forthis, we <strong>de</strong>termined the drivers’ sex and vehicular distribution by observing traffic from apilot study (N=5 496). It was observed that cars accounted for 39.1%, heavy trucks for 36.5%,minibuses and mini-trucks for 7.8%, buses for 9.6%, and motorcycles for 6.3% of the vehiclesentering Karachi. Distribution of cars and heavy vehicles was similar to that recor<strong>de</strong>d byhighway authority (NHA, 2008). Almost all drivers were men (99.9%). Based on thesefindings, personal vehicle male drivers were invited from a roadsi<strong>de</strong> gas station at start of thehighway near Karachi, and commercial vehicle drivers were invited from transport companyoffices at six different locations in Karachi.Data collectionFace-to-face interviews with drivers were conducted in Urdu language. These were<strong>de</strong>veloped from an English language questionnaire using back translation, in<strong>de</strong>pen<strong>de</strong>ntlinguistic verification, and testing on five drivers. Interviews were either conducted at the AgaKhan University (AKU) Campus or at the company offices in separate rooms. Driver-related126
variables inclu<strong>de</strong>d socio-<strong>de</strong>mographic variables (age, sex, marital status, education, an<strong>de</strong>mployment), whether driving permit was issued without practical test, frequency of reportedrisky driving behaviors (sleepy driving, cell phone use while driving, seat-belt use, traffictickets, driving while intoxicated during previous three months), and involvement in RTCduring previous year.Using 17-inch vi<strong>de</strong>o screens, five test vi<strong>de</strong>os (three from Pakistan and two fromCameroon) were shown to drivers before presenting selected sites. The or<strong>de</strong>r of sites wasrandomly drawn for each participant. To avoid confusion from right- and left-hand drivingpracticed in Cameroon and Pakistan, site vi<strong>de</strong>os from Cameroon followed those fromPakistan. For each vi<strong>de</strong>o shown, drivers were asked to report their perception of site andtraffic, on a four-level scale; 1/ Certainly safe, 2/ Probably safe, 3/ Probably dangerous,4/ Certainly dangerous. Further, they were asked to record their preferred speed (in km/h) foreach site.Each site was characterized by the main investigator, using <strong>de</strong>finitions used in ourprevious study conducted in Cameroon (Bhatti et al.). Site-related variables assessed werebuilt-up or rural area, horizontal and vertical road profile, road width, surface regularity, vergeslope, <strong>de</strong>pth at 10 m from the verge, location and type of nearby obstacles (within a roaddistance of 50 m in each direction), horizontal marking, vertical road signs, and presence ofan intersection or a U-turn. Traffic-related variables assessed were traffic moving in same oropposite direction, visible pe<strong>de</strong>strian, motorcyclist, or heavy vehicle, rain or wet surface,maneuvering vehicle (crossing or overtaking), and number of lanes (Sümer, Ünal, Birdal,Çinar, & Çevikoglu, 2007).AnalysisProportions of site- and driver-related characteristics were computed. Discordance (D)of appreciation for a matched high- and low-risk site pair was <strong>de</strong>fined as “minor” whendifference of hazard perception level was one on the Likert scale and “major” when the leveldifference was more than one. Positive sign (D + ) was used to show that hazard perceptionlevel was higher for the high-risk site than its matched low-risk site, and negative sign (D - ) toshow that hazard perception level was lower for high-risk site than its matched low-risk site.Wilcoxon test was used to assess whether these discordances were significantly higher orlower for high-risk site than low-risk site. Similarly, differences in reported speeds formatched high- and low-risk site pairs were compared using a paired t test. Correlationsbetween reported speeds for high- and low-risk site pairs were assessed by intra-classcorrelation coefficient (ICC).Associations of driver-, site-, and traffic-factors with road hazard perception levelwere assessed using logistic regression (mo<strong>de</strong>l 1) with a backward selection strategyincluding significant (P
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Université Victor Segalen Bordeaux
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Publications (peer-reviewed).......
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Index of figuresFigure 1. Traffic f
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AbbreviationsAKUAVCIBMIEASESSDALYDW
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AbstractBackground: Interurban traf
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L'objectif de cette thèse était d
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2. Background2.1 Road injury burden
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2.4 Multiple factors involved in tr
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Figure 4. Percentage difference of
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2.7 Interurban road safety research
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ObjectivesThe objectives of this fi
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ResultsCrash burdenA total of 935 R
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Figure 7. Monthly trend of traffic
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Injury outcome patternsMost of inju
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MethodsThe study setting was 196-km
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patients. In the ED, those with NIS
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Table 6. Traffic injuries reported
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5. Analytical StudiesPrevious liter
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under supervision of Dr. Sobngwi-Ta
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Table 9. Situational variables at c
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MethodsStudy design and settingStud
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to Dec 08 were retrieved and photoc
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normal zones. However, this associa
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MethodsStudy design and settingsThe
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Figure 14. Picture extracted of a h
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located in built-up area in Pakista
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Table 15. Differences in hazard per
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6. Discussion6.1 Originality of stu
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Although adjustments are possible,
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observational studies on how the de
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to understand the deficiencies in t
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[24] Damsere-Derry J, Afukaar FK, D
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[69] Central Intelligence Agency. T
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[111] Geurts K, Wets G, Brijs T, Va
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[154] Rosenbloom T, Shahar A, Elhar
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4. Farooq U, Bhatti JA, Siddiq M, M
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Appendix 1: Literature review on in
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- Page 90 and 91: BACKGROUNDPakistan, located at the
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- Page 112 and 113: 1. INTRODUCTIONWith the aging of hi
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- Page 118 and 119: 21. Sobngwi-Tambekou J, Bhatti J, K
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- Page 124 and 125: ABSTRACTObjectives: Interurban road
- Page 128 and 129: SitesOut of 131 crash sites identif
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