Illegal road crossing behavior of pedestrians at overpass locations: Factors affecting gap acceptance, crossing times and overpass use

Evaluating current and future pedestrian mid-block crossing safety treatments using virtual reality simulation

Virtual reality (VR) simulation offers a proactive, cost effective, immersive, and low risk platform for studying pedestrian safety. Within immersive virtual environments (IVEs), existing and alternative design conditions and intelligent transportation systems (ITS) technologies can be directly compared, prior to real-world implementation, to assess the impacts alternatives may have on pedestrian safety, perception, and behavior. Environmental factors can be controlled within IVEs so that test trials are replicable and directly comparable. Coupled with stated preference feedback, participants' observed preferences and behavior provide a comprehensive understanding of the impacts of proposed design alternatives. This research presents a case study of pedestrian behavior with three different mid-block crossing safety treatments modeled within a one-to-one scale IVE replication of a real-world location in Charlottesville, Virginia. The three safety treatments consider both passive and active collision avoidance designs and technologies, including (1) the existing painted crosswalk, (2) the addition of rectangular rapid flashing beacons (RRFBs), and (3) a pedestrian to everything (P2X) ITS phone application. Additionally, this paper demonstrates a VR simulation experimental design and framework for testing pedestrian safety treatments within naturalistic and replicable IVEs to assess both stated and observed preferences and behaviors of pedestrians. Repeated measures ANOVA indicated changes in both accepted gap size (p = 0.001) and crossing speed (p < 0.001) with alternative safety treatments. Generalized mixed models showed that pedestrians waited for statistically larger gap sizes (p = 0.02) without the assistance of alternative safety technologies (RRFBs and P2X application) and pedestrians crossed the street significantly faster (p = 0.001) without the alternative safety technologies, leading to unsafe dashing behavior. Through post-experiment surveys, it was found that participants perceived the As Built environment to be the least safe of the three treatments and that their sense of risk within the IVE was realistic. Considering both the observed crossing behavior and stated feedback, pedestrians exhibited intentionally unsafe darting behavior without assistive safety technology. This study demonstrates how VR simulation may be leveraged to study both stated preferences and observed behavior for understanding the safety implications of alternative roadway designs, providing a proactive approach for assessing and designing for pedestrian safety.

Effectiveness of road safety interventions: An evidence and gap map

Background

Road Traffic injuries (RTI) are among the top ten leading causes of death in the world resulting in 1.35 million deaths every year, about 93% of which occur in low- and middle-income countries (LMICs). Despite several global resolutions to reduce traffic injuries, they have continued to grow in many countries. Many high-income countries have successfully reduced RTI by using a public health approach and implementing evidence-based interventions. As many LMICs develop their highway infrastructure, adopting a similar scientific approach towards road safety is crucial. The evidence also needs to be evaluated to assess external validity because measures that have worked in high-income countries may not translate equally well to other contexts. An evidence gap map for RTI is the first step towards understanding what evidence is available, from where, and the key gaps in knowledge.

Objectives

The objective of this evidence gap map (EGM) is to identify existing evidence from all effectiveness studies and systematic reviews related to road safety interventions. In addition, the EGM identifies gaps in evidence where new primary studies and systematic reviews could add value. This will help direct future research and discussions based on systematic evidence towards the approaches and interventions which are most effective in the road safety sector. This could enable the generation of evidence for informing policy at global, regional or national levels.

Search Methods

The EGM includes systematic reviews and impact evaluations assessing the effect of interventions for RTI reported in academic databases, organization websites, and grey literature sources. The studies were searched up to December 2019.

Selection Criteria

The interventions were divided into five broad categories: (a) human factors (e.g., enforcement or road user education), (b) road design, infrastructure and traffic control, (c) legal and institutional framework, (d) post-crash pre-hospital care, and (e) vehicle factors (except car design for occupant protection) and protective devices. Included studies reported two primary outcomes: fatal crashes and non-fatal injury crashes; and four intermediate outcomes: change in use of seat belts, change in use of helmets, change in speed, and change in alcohol/drug use. Studies were excluded if they did not report injury or fatality as one of the outcomes.

Data Collection and Analysis

The EGM is presented in the form of a matrix with two primary dimensions: interventions (rows) and outcomes (columns). Additional dimensions are country income groups, region, quality level for systematic reviews, type of study design used (e.g., case-control), type of road user studied (e.g., pedestrian, cyclists), age groups, and road type. The EGM is available online where the matrix of interventions and outcomes can be filtered by one or more dimensions. The webpage includes a bibliography of the selected studies and titles and abstracts available for preview. Quality appraisal for systematic reviews was conducted using a critical appraisal tool for systematic reviews, AMSTAR 2.

Main Results

The EGM identified 1859 studies of which 322 were systematic reviews, 7 were protocol studies and 1530 were impact evaluations. Some studies included more than one intervention, outcome, study method, or study region. The studies were distributed among intervention categories as: human factors (n = 771), road design, infrastructure and traffic control (n = 661), legal and institutional framework (n = 424), post-crash pre-hospital care (n = 118) and vehicle factors and protective devices (n = 111). Fatal crashes as outcomes were reported in 1414 records and non-fatal injury crashes in 1252 records. Among the four intermediate outcomes, speed was most commonly reported (n = 298) followed by alcohol (n = 206), use of seatbelts (n = 167), and use of helmets (n = 66). Ninety-six percent of the studies were reported from high-income countries (HIC), 4.5% from upper-middle-income countries, and only 1.4% from lower-middle and low-income countries. There were 25 systematic reviews of high quality, 4 of moderate quality, and 293 of low quality.

Authors' Conclusions

The EGM shows that the distribution of available road safety evidence is skewed across the world. A vast majority of the literature is from HICs. In contrast, only a small fraction of the literature reports on the many LMICs that are fast expanding their road infrastructure, experiencing rapid changes in traffic patterns, and witnessing growth in road injuries. This bias in literature explains why many interventions that are of high importance in the context of LMICs remain poorly studied. Besides, many interventions that have been tested only in HICs may not work equally effectively in LMICs. Another important finding was that a large majority of systematic reviews are of low quality. The scarcity of evidence on many important interventions and lack of good quality evidence-synthesis have significant implications for future road safety research and practice in LMICs. The EGM presented here will help identify priority areas for researchers, while directing practitioners and policy makers towards proven interventions.

Modelling the utilization rates of pedestrian crosswalks

A zebra crossing is a form of pedestrian crossing provision point on roads that have significant volumes of traffic. It is one of the safety measures employed to reduce avoidable pedestrian-motorist conflicts and accidents on such roads. In the past several studies have been conducted on the behaviours of road users (pedestrians and motorists) especially on non-signal intersections. Although, various recommendations and solutions have been proffered to the many road-crossing challenges. But there has been little to no change in pedestrians' perceptions and preferences of zebra crossing. Contemporary researches have tried to rectify this by applying several models to rate the use of pedestrian zebra crossing. This study uses a Regression Model Techniques to analyse factors influencing utilization rate of pedestrian zebra crossing. In this study, 450 samples were collected from 12 locations, covering school, public building, residential and business areas to examine the utilization rate of the zebra crossing by pedestrians. To examine the significance level on the crossing utilization rates by pedestrian at 95% confidence interval, a pedestrian utilization rate (PUR) was acting as the dependent variable and the remaining variables served as the independent variables. The Multiple Linear Regression (MLR) model was also used to determine the utilization rate needed to develop the zebra crossing utilization model. From the findings, the calibrated R2 value was discovered to be at 0.937 and the descriptive statistics of MLR test, t and p-values, were also found within an acceptable range. The result also showed that, out of all the variables which were used, only three have a significant effect on the utilization rates of pedestrian zebra crossing while the remaining variables have an insignificant effect. The study concluded that among the different variables, Guardrail, number of lanes and Width of zebra crossing were the most influential variables. It is believed that the conclusions drawn from this research are expected to be useful to improve the state of pedestrian facilities in Malaysia.

Structural equation modeling of pedestrian behavior at footbridges in Ghana

This study was undertaken to fill the information gap by exploring pedestrian behavior at footbridges in the Greater Accra and Kumasi Metropolitan areas of Ghana. Further, the study modelled the behavior of 69,840 pedestrians at the footbridges using Structural Equation Modeling (SEM). Pedestrians were observed as users and non-users of seven selected footbridges in the morning (7:00 am-9:00 am), afternoon (11:00 am-1:00 pm), and evening (3:00 pm-5:00 pm) periods for seven consecutive days (Monday to Sunday). Selected footbridges were characterized by traffic generators as schools, shopping malls, bus stops, office complexes, and restaurants in different matrices. The results showed that 30.7% of the observed pedestrians did not use the footbridges, males and young pedestrians were more likely not to use the footbridges as opposed to females and the elderly with more than half of observed pedestrians carrying luggage or load. Footbridge users were more likely to talk and hold phones than non-users and the elderly were more likely to run and ride compared to young pedestrians. Officials of the National Road Safety Authority should carry out effective public education on pedestrian safety targeting males and young pedestrians to encourage the use of pedestrian footbridges.

A Geographical and Temporal Risk Evaluation Method for Red-Light Violations by Pedestrians at Signalized Intersections: Analysis and Results of Suzhou, China

Red-light violations of pedestrians crossing at signal intersections is one of the key factors in pedestrian traffic accidents. Even though there are various studies on pedestrian behavior and pedestrian traffic conflicts, few focus on the risk of different crosswalks for the violating pedestrian group. Due to the spatio-temporal nature of violation risk, this study proposes a geographical and temporal risk evaluation method for pedestrian red-light violations, which combines actual survey and video acquisition. First, in the geographical-based risk evaluation, the pedestrian violation rate at signal intersections is investigated by Pearson correlation analysis to extract the significant influencing factors from traffic conditions, built environment, and crosswalk facilities. Second, in the temporal-based risk evaluation, the survival analysis method is developed to quantify the risk of pedestrian violation in different scenarios as time passes by. Finally, this study selects 16 typical signalized intersections in Suzhou, China, with 881 pedestrian crosswalk violations from a total size of 4586 pedestrians as survey cases. Results indicate that crossing distance, traffic volume on the crosswalk, red-light time, and crosswalk-type variables all contribute to the effect of pedestrian violation from a geographical perspective, and the installation of waiting refuge islands has the most significant impact. From the temporal perspective, the increases in red-light time, number of lanes, and traffic volume have a mitigating effect on the violations with pedestrian waiting time increases. This study aims to provide a development-oriented path by proposing an analytical framework that reconsiders geographical and temporal risk factors of violation. The findings could help transport planners understand the effect of pedestrian violation-related traffic risk and develop operational measures and crosswalk design schemes for controlling pedestrian violations occurring in local communities.

An integrated text mining, literature review, and meta-analysis approach to investigate pedestrian violation behaviours

The goal of this study is to provide an overview of previous research that investigated pedestrian violation behaviour, with a focus on identifying the contributing factors of such behaviour, its impact on pedestrian safety, the mitigation strategies, the limitations of current studies, and the future research directions. To that end, the Latent Dirichlet Allocation (LDA) text mining method was applied to extract a comprehensive list of studies that were conducted during the past 21 years related to pedestrian violation behaviours. Using the extracted studies, a multi-sectional literature review was developed to provide a comprehensive understanding of the different aspects related to pedestrian violations. Afterward, a meta-analysis was undertaken, using the studies that reported quantitative results, in order to obtain the average impact of the different contributing factors on the frequency of pedestrian violations. The study found that pedestrian violations are one of the hazardous behaviours that contribute to both the frequency and severity of pedestrian-vehicle collisions. According to the literature, the waiting time at the curbside, traffic volume, walking speed, pedestrian distraction, the presence of bus stops and schools, and the presence of on-street parking are among the key factors that increase the likelihood of pedestrian violations. The study has also reviewed a wide range of strategies that can be used to mitigate violations and reduce the safety consequences of such behaviour, including simple engineering-based countermeasures, enforcement, solutions that rely on advanced in-vehicle technologies, and infrastructure connectivity features, educational programs, and public campaigns.

Modern Urban Transport Infrastructure Solutions to Improve the Safety of Children as Pedestrians and Cyclists

This article presents the issues and needs for modern solutions in building urban infrastructure, based on the smart city idea to improve the living standards of residents. Particular attention is paid to one of the most important aspects of life, related to road safety of children as pedestrians and cyclists. Pedestrian sidewalks and bicycle paths with high pedestrian traffic are classified as dangerous areas in many countries. More than 3% of the injuries and fatalities among pedestrian road users that are victims of accidents occur due to crossing the road. Therefore, it is necessary to apply various technical infrastructure solutions to improve the safety of this group of inhabitants. The scientific purpose of this article is the assessment of the safety level of children in pedestrian and bicycle traffic and the analysis of road solutions supporting the maintenance of high-level city safety. The research was based on the analysis of statistical data of accidents and the diagnostic survey method determining the safety of the inhabitants of southern Poland. As a result, an analysis of the level of child safety in urban traffic was developed, as well as key factors affecting the levels of road safety, based on the opinions of respondents. Potential places with the greatest risk of collision with minors have also been identified. There are also proposals for infrastructure solutions aimed at minimising accident risk levels in designated areas.

Analysis of pedestrians' behaviour: A segmentation approach based on latent variables

Crash statistics indicate that the number of pedestrian fatalities has been increasing at an alarming rate in Iran. Crossing over non-designed places is a main cause of traffic crashes among pedestrians. This study aimed to investigate how perceptions about walking facilities and risk-taking affect pedestrians' crossing behaviour. A stated preference questionnaire was designed and a random sample of 390 pedestrians were interviewed face-to-face in two regions of Tehran with three options for pedestrians to cross (overpass, zebra crossing, and non-designed places (NDP)). Exploratory factor analysis (EFA) resulted in three latent dimensions: risk-taking/conformity, pedestrians' perception of overpass, and NDP. Then, data were classified based on latent variables using K-means cluster analysis. Clustering resulted in four groups: group 1 (Cautious; negative perception of overpasses; positive perception of NDP), group 2 (Cautious; negative perception of overpasses; negative perception of NDP), group 3 (Cautious; positive perception of overpasses; negative perception of NDP), and group 4 (Risk-taker; negative perception of overpasses; negative perception of NDP). Finally, a Multinomial Logit Model (MNL) was developed for four groups of pedestrians. The results show that pedestrians' behaviour differentiate based on latent variables. It was found that being accompanied by a child increases the probability of using an overpass even for pedestrians in group 4 with high risk-taking propensity, but it was more important for pedestrians in group 3 who held positive perceptions of overpasses and negative perceptions of NDP. Also, during congestion, group 4 was more inclined to cross at NDP. It was concluded that in the first group, unsafe choices among student respondents could be associated with their facility perceptions rather than their risk-taking/conformity. Results of this study can be helpful in selecting more appropriate locations for overpasses and crosswalks installation based on pedestrians' behaviour.

Evaluation of pedestrian critical gap and crossing speed at midblock crossing using image processing

Pedestrians confront risky situations at midblock sections due to the unyielding behavior of drivers. Thus, pedestrians have to wait for an appropriate gap to cross. This research investigates pedestrians' gap acceptance and crossing speed for midblock crossings by image processing methods in Izmir, Turkey. A total of 498 pedestrians have been tracked at two midblock crossings. The data were collected for one hour at each midblock crossing during the evening peak hour between 5.00-6.00 p.m. Three synchronized cameras were used to record pedestrian crossings. Then, by using image processing, vehicle and pedestrian trajectories have been obtained. Two cameras were mounted on telescopic tripods reaching up to 9 m, and the third camera was used to identify pedestrians' gender better. The parameters extracted from the recordings are; pedestrians' gender, group size, whether they carried items or not, and their accepted/rejected gaps. Pedestrian and item detection has been performed by YOLOv3 and YOLACT models. The accepted and rejected time gaps were extracted for pedestrians, excluding the pedestrians who crossed between stopped vehicles and crossed when an approaching vehicle did not exist within 100 m from the midblock crossing. Raff's method was used to estimate the critical gap using accepted/rejected gaps. The critical gaps ranged between 4.1 s and 6.2 s. The 15th percentile crossing speeds were found to be similar, ranging between 0.78 m/s and 0.80 m/s.

The Role and Importance of a Footbridge Suspended over a Highway in the Opinion of Its Users—Trabzon (Turkey)

In the urban landscape, footbridges appeared along with the development of urbanization through the implementation of more complex spatial structures. The introduction of transport transit to cities or sometimes urban gravity towards the important communication routes imposed their construction in order to ensure pedestrians’ safety and smooth flow of traffic. The aim of the study is to determine how an overpass in the city of Trabzon is used by people of different ages, the security and motivation problem, the possibility of a footbridge, and how an overpass is perceived as a crossing over a highway. The study addresses the problem of safety and motivation related to the use of an overpass by people of different ages and is focused on the perception of an overpass as a crossing over a highway. The overpass connects the northern part of the city with the parking lot and the seaside boulevards in Trabzon. It has been constructed over the road no. D010, also known as the Black Sea Coastal Highway. In total, 124 members of the urban population who used the overpass participated in a questionnaire, which included multiple-choice and open-ended questions. The ‘Semantic Differential Scale’ was also used to evaluate the results. The research revealed that the respondents who chose the road through the overpass for safety in most cases used it relatively rarely (59%). People who used the footbridge every day or frequently marked safety as the reason in 39% of cases only. This means that as pedestrians use the overpass more often, they begin to notice other functional features of the footbridge. The results of the study showed that the overpass was most frequently used for the purpose of going down to the coast (76.0%), although 51.2% reported rarely using the overpass, which showed it was used very little by pedestrians.

Propensities of red light running of pedestrians at the two-stage crossings with split pedestrian signal phases

Two-stage crossing with a median refuge island is commonly installed at the busy urban signalized intersections. To accommodate for the high traffic flow in different directions, split phasing is often applied for pedestrians' right of way of the two crossing stages. Previous studies mainly focus on the time delay, capacity and operation efficiency of two-stage crossings. It is rare that safety of two-stage crossings is investigated. Crossing behaviors and propensities of red light running at the two crossing stages (i.e. from the curbside to a central island, and then to another side of the road) are different from that of single stage crossing. Also, there could be interferences in the crossing behaviors and situational features between the two stages. This study aims to identify the personal characteristics, traffic attributes and environmental factors that affect the red light running propensities of pedestrians at the two-stage crossings, based on the video observation surveys at six urban signal intersections in Hong Kong. Random parameter logit regression approach is applied to measure the association between possible factors and propensities of red light running of pedestrians, with which the effect of unobserved heterogeneity is accounted. Results indicate that, other than the pedestrians' characteristics, pedestrian signal of the second stage, maximum waiting time and traffic flow significantly affect the propensity of red light running in the first stage. Also, there are significant interaction effects between pedestrians' characteristics and situational features on the propensity. On the other hand, pedestrians' waiting time before crossing the first stage significantly affects the propensity of red light running in the second stage. Findings are indicative to the design of pedestrian crossing, signal time plan and effective enforcement and education strategies that can deter against the red light running behaviors of pedestrians. Therefore, safety of two-stage signalized crossings can be enhanced.

Cyclists’ Crossing Intentions When Interacting with Automated Vehicles: A Virtual Reality Study

Most of cyclists’ fatalities originate from collisions with motorized vehicles. It is expected that automated vehicles (AV) will be safer than human-driven vehicles, but this depends on the nature of interactions between non-automated road users, among them cyclists. Little research on the interactions between cyclists and AVs exists. This study aims to determine the main factors influencing cyclists’ crossing intentions when interacting with an automated vehicle as compared to a conventional vehicle (CV) using a 360° video-based virtual reality (VR) method. The considered factors in this study included vehicle type, gap size between cyclist and vehicle, vehicle speed, and right of way. Each factor had two levels. In addition, cyclist’s self-reported behavior and trust in automated vehicles were also measured. Forty-seven participants experienced 16 different crossing scenarios in a repeated measures study using VR. These scenarios are the result of combinations of the studied factors at different levels. In total, the experiment lasted 60 min. The results show that the gap size and the right of way were the primary factors affecting the crossing intentions of the individuals. The vehicle type and vehicle speed did not have a significant effect on the crossing intentions. Finally, the 360° video-based VR method scored relatively high as a research method and comparable with the results of a previous study investigating pedestrians’ crossing intentions confirming its suitability as a research methodology to study cyclists’ crossing intentions.

Underestimation tendencies of vehicle speed by pedestrians when crossing unmarked roadway

To make safe road crossing decisions, the pedestrians need to estimate the distance and speed of oncoming vehicles, in order to make conclusions about the available time gap they need for their road crossing. Since the speed represents combination of distance and time, we focused on pedestrians' ability to estimate the speed of the oncoming vehicles accurately. The aim of this study was to find some characteristics important for the speed mis-estimation tendencies and its values. Seventy participants estimated speed 3920 times in total. Research included three experiments. One vehicle participated in the first experiment, while second and third experiments involved two vehicles, with various combinations of vehicle positions and speeds. Initially it was determined that the pedestrians had tendencies to speed underestimation rather than its overestimation and accurate estimation. When the participants estimated the speed of one vehicle, they were more inclined to underestimation of higher speeds (over 50 km/h). On the other hand, in the situations where the participants estimated the speed of two vehicles, they showed a serious tendency towards underestimation of lower speeds (under 50 km/h) which was completely opposite. The factors such as driving experience, age and gender were identified as statistically important in terms of speed underestimation value. We determined that an increase in task complexity, with introduction of a larger number of vehicles, resulted in more severe speed underestimation. Finally, we identified some of the most risky traffic situations in terms of speed underestimation tendencies showed by our participants.

Pedestrian Road Crossing at Uncontrolled Mid-Block Locations: Does the Refuge Island Increase Risk?

The study investigates the behaviour of pedestrians crossing a road with a refuge island in an urban area to assess whether refuge islands deliver their expected benefit. This type of pedestrian crossings aims at providing a half-way shelter and protection while pedestrians are crossing a road with two-traffic streams. Data has been collected using two video cameras from an urban location in Edinburgh on gaps in traffic flow, rejected and accepted gaps, and critical gaps of pedestrians while crossing from the curb or the median. Data have also been examined to estimate and assess vehicle and pedestrians’ speeds, vehicle type, waiting time, group size and other demographic characteristics of pedestrians. The statistical modelling techniques used include Multiple Linear Regression and Generalised Estimating Equations (GEE). The results show that the critical gap for crossing from the median to the curb is much shorter than that from the curb to the median. Pedestrians appear to be less cautious when crossing from the median to the curb as they are more likely to accept a shorter gap in traffic. This could indicate a shortfall in the design and/or operation of this type of crossing. Further considerations and investigation of what measures could be implemented to enhance safety and reduce risky behaviour at this type of crossing are recommended and certainly encouraged.

Investigation of Critical Gap for Pedestrian Crossing Using Fuzzy Logic System

This paper assesses pedestrian crossing behavior and critical gaps at a two-way midblock crossing location. A critical gap is the shortest gap that a pedestrian accepts when crossing a road. A dataset was collected in 2017 in Edinburgh (UK). The analysis was performed using the fuzzy logic system. The adopted membership function of the fuzzy logic system is of a triangular form since it has a simple and convenient structure. The input variables that are used in the analysis are the number and length of rejected gaps and length of accepted gaps at the crossing location. The output variables are the critical gaps. The results show that assessing critical gap estimation of pedestrians crossing using fuzzy logic is achievable and produces reasonable values that are comparable to values that are reported in the literature. This outcome improves the understanding of pedestrian crossing behavior and could therefore have implications for transport infrastructure design. Further analysis using additional parameters including waiting time and demographic characteristics and alternative forms for membership functions are strongly encouraged.

The Evaluation of Trauma Care: The Comparison of 2 High-Level Pediatric Emergency Departments in the United States and Turkey

OBJECTIVE

The purpose of the study is to compare the outcomes of pediatric trauma patients with motor vehicle crashes (MVCs) and motor vehicle versus pedestrian crashes (MPCs) at a level 1 pediatric trauma center in the United States and a pediatric trauma center in Turkey.

METHODS

The medical records of all pediatric MVC and MPC subjects presenting to the emergency departments (EDs) of a level 3 hospital in Turkey (Izmir Tepecik Training and Research Hospital [ITTRH]) and a level 1 pediatric trauma center in the United States (Children's Medical Center Dallas [CMCD]) over a 1-year period were reviewed. Data that were collected include patient demographics, prehospital report (mechanism of injury, mode of transportation), injury severity score (ISS), abbreviated injury scale score, Glasgow Coma Scale score, ED length of stay, ED interventions, ED and hospital disposition, and mortality. Patients with moderate (ISS, 5-15) and severe (ISS, >15) trauma scores were included in the study.

RESULTS

One hundred six patient charts from the ITTRH and 125 patient charts from the CMCD with moderate and severe ISS due to MVCs and MPCs were reviewed. Most of the patients were pedestrians (86%) in the ITTRH group and passengers (60%) in the CMCD group. The percentage of patients transferred by ambulance (ground or air) to the CMCD and the ITTRH was 97.9% and 85%, respectively. Fifteen percent of ITTRH patients and 2.1% of CMCD patients arrived by private vehicle. Emergency department arrival ISS and Glasgow Coma Scale were similar between the 2 hospitals (P > 0.05). The overall mortality rate in the study population was 8.8% (11/125) at the CMCD and 4.7% (5/106) at the ITTRH. (P = 0.223). Blood product utilization was significantly higher in the CMCD group compared with the ITTRH group (P = 0.005). The use of hypertonic saline/mannitol/hyperventilation in patients with significant head trauma and increased intracranial pressure was higher in the ITTRH group (P = 0.000).

CONCLUSIONS

This is the first study that compared pediatric trauma care and outcome at a level 1 pediatric trauma center in the United States and a pediatric hospital in Turkey. Our findings highlight the opportunities to improve pediatric trauma care in Turkey. Specifically, there is a need for national trauma registries, enhanced trauma education, and standardized trauma patient care protocols. In addition, efforts should be directed toward improving prehospital care through better integration within the health care system and physician participation in educating prehospital providers. Data and organized trauma care will be instrumental in system-wide improvement and developing appropriate injury-prevention strategies.

Pedestrian overpass use and its relationships with digital and social distractions, and overpass characteristics

Pedestrian deaths and injuries are a major health issue in both developed and developing countries. In Vietnam, pedestrians account for about 10-11% of all road traffic deaths, while their travel distance contributes to approximately 2.4% of the total distance travelled by all modes. This paper aims to explore the use of pedestrian overpasses and identify influencing factors, particularly with regards to social and digital distractions, and overpass characteristics. An observational survey was conducted in Hanoi, Vietnam, in March 2017 at ten pedestrian overpasses. Behaviours of 608 pedestrians, including those who used an overpass to cross and those who illegally crossed, were observed. The rates of overpass usage varied significantly, between 35.9% and 96.5%. Modelling results suggest that pedestrians tended to compensate for the risks of illegal crossing by forming group and avoiding digital and social distractions (i.e., calling, operating a mobile phone's screen, listening to music, or talking to other pedestrians while crossing). In addition, overpass usage decreased with taller overpasses, but increased with wider overpasses. Effects of gender, weather, and illegal crossing speed on overpass use were also discussed.

The perception of Malaysian pedestrians toward the use of footbridges

OBJECTIVE

The footbridge is a vital structure in the road network and a cornerstone among crossing facilities. Yet, it suffers from low usage by pedestrians as they try to cross the street on the level. This study aims to analyze the perceptions of Malaysian pedestrians toward the use of footbridges with the consideration of different factors.

METHOD

The study was carried out by collecting data from field observation and questionnaire distribution on the street among the public. The data were statistically analyzed by applying multiple linear regression models and a series of chi-square tests.

RESULTS

The study found that the most influential factor cited by pedestrians in decision making regarding using a footbridge is the existence of an escalator. Being in a hurry and the fear of heights were significantly associated with choosing not to use a footbridge. Zebra crossing was chosen as the most favorable type of crossing facility by the majority of respondents. In addition, installation of a fence and barriers was proposed as an effective procedure to prevent jaywalking. To construct new and efficient footbridges in the future, the study suggests consideration of traffic volume, posted speed limit, and the number of lanes, because these are the most influential factors to predict the usage rate.

CONCLUSIONS

The study encourages decision makers and stakeholders to consider providing escalators for new footbridges to enhance the safety of pedestrians.

Modeling pedestrian gap crossing index under mixed traffic condition

INTRODUCTION

There are a variety of challenges faced by pedestrians when they walk along and attempt to cross a road, as the most recorded accidents occur during this time. Pedestrians of all types, including both sexes with numerous aging groups, are always subjected to risk and are characterized as the most exposed road users. The increased demand for better traffic management strategies to reduce the risks at intersections, improve quality traffic management, traffic volume, and longer cycle time has further increased concerns over the past decade.

METHOD

This paper aims to develop a sustainable pedestrian gap crossing index model based on traffic flow density. It focusses on the gaps accepted by pedestrians and their decision for street crossing, where (Log-Gap) logarithm of accepted gaps was used to optimize the result of a model for gap crossing behavior. Through a review of extant literature, 15 influential variables were extracted for further empirical analysis. Subsequently, data from the observation at an uncontrolled mid-block in Jalan Ampang in Kuala Lumpur, Malaysia was gathered and Multiple Linear Regression (MLR) and Binary Logit Model (BLM) techniques were employed to analyze the results.

RESULTS AND CONCLUSIONS

From the results, different pedestrian behavioral characteristics were considered for a minimum gap size model, out of which only a few (four) variables could explain the pedestrian road crossing behavior while the remaining variables have an insignificant effect. Among the different variables, age, rolling gap, vehicle type, and crossing were the most influential variables. The study concludes that pedestrians' decision to cross the street depends on the pedestrian age, rolling gap, vehicle type, and size of traffic gap before crossing.

PRACTICAL APPLICATIONS

The inferences from these models will be useful to increase pedestrian safety and performance evaluation of uncontrolled midblock road crossings in developing countries.