---

The project is defined in order to reduce accidents caused by drivers of public vehicles. In the first phase, we will hold the educational workshops with drivers of public vehicles. The teachers of these workshops are the best professors in the field of Road Safety. The main topics of the program are non-standard roads and drowsiness, nutrition and drowsiness, sign and symptoms in sleep medicine, prevention of drowsiness, and conditions of inside the car.

---

Road traffic accidents account for approximately 3000 deaths on a daily basis, and 50 million injuries and 1.2 million deaths each year. In low-income and middle income countries, road traffic accidents account for 85% of deaths and 90% of annual disability. Casualties of this magnitude are a serious problem throughout the world and create a significant impact on society. In addition, neurological disorders due to traffic accidents are a major problem for the health system. Prevention of road accidents saves life and reduces the morbidity and the rate of neurological disorders. Iran and other Middle Eastern countries have one of the highest incidences of fatality rates due to road traffic crashes in the world. To develop effective road safety programs in the region, establish and maintain regional road safety partnerships, and attract funds and resources, a close cooperation among the countries in this region is essential.

---

Road traffic injuries are an ongoing global health burden and cause more than 1.2 million deaths per year. In Europe, the annual socioeconomic impact accounts for €130 billion. In 2011, the United Nations set a special focus on road safety and injury prevention by the proclamation of the “Decade of Action for Road Safety.” This initiative focuses mainly on developing countries. In Germany, many measures have been undertaken to improve the mortality rates associated with traffic injuries. Among these are countrywide mandatory helmet laws for motorcyclists, speed limits on the Autobahn, speed limit reinforcements associated with fines in and outside the cities, and a network of overlapping rescue helicopter coverage throughout the country. Despite a general decrease in mortality, the European Commission in 2001 set a new law to reduce the number of road traffic fatalities by another 50%. Until 2009, a reduction of more than one third (38%) was achieved. The improvements observed seem to be a result of improvements in education, engineering, and technical improvements in active and passive car safety. These have had effects for cyclists and pedestrians, as well. In addition, a 1% reduction of distance traveled by motorized vehicles has occurred, which may have contributed toa decreased incidence of accidents (1.8%). Based on these prerequisites, this article provides an overview on the current situation in Europe and focuses on 2 questions: 1. How can the improvements in road traffic–associated fatalities in Europe be explained? 2. Is there a special patient group that should be aimed at in the future? The observed decline of fatalities over the last decades can be explained by different factors. The highest number of fatalities was observed in the age group between 15 and 29 years. Furthermore, most pronounced decrease in fatalities was found for children younger than 14 years of age (55%). The age group between 15 and 24 years demonstrated a decrease of 40%. In elderly persons, the reduction was only 9%. This may be explained by the fact that more elderly people continue to drive. Moreover, if involved in a car accident, their chances of death are higher than in all other age groups.

---

Each year over 50 million humans are injured worldwide in traffic accidents (WHO). 1,200000 fatalities are registered at the same time. Everybody agrees, that we must fight against. Beside law enforcement, education, car technology and road construction a well organized rescue chain is mandatory, chain links are: Emergency call center (Europe TEL. 112), SAR system, Treatment in a competent hospital, Early rehabilitation. In Germany the trauma surgeon is the "Team Leader" Emergency medical doctors (trauma surgeon, anesthologist …) are treating the polytrauma patient at the scene. By helicopter or ambulance the patient is transported to a trauma center with the necessary specialists (neurosurgeon, visceralsurgeon, orthopedic trauma surgeon). The knowledge of all trauma centers is collected in a register and shared with the governement (laws), car manufactorers (safer cars) and all interested institutions. It is evidence based that due to this organisation the number of fatalities and heavy injuries are diminished from year to year, not only in Germany but in all European countries as well.

---

Without any doubt, road safety (RS) needs a precise planning in road accident prevention. RS effects on different fields of the life. Therefore, response to this need in order to promote the RS as well as to save more lives is the most asset in each country. In the recent years, statistics have been shown that the numbers of mortalities due to road crashes decreased. This shows the true motion to improve the roads facilities and safety. It can be useful in all sectors and area in road engineering and cultural and social fields. In this regard, some points need more attention in RS such as to recognize the black spots, to arrange the police forces in appropriate situations, to interact with relevant organizations, to prepare the traffic signs.

---

Ninety percent of road traffic deaths occur in low- and middle-income countries, which claim less than half the world's registered vehicle fleet. Iran and Georgia have a strategic position in the region and as a bridge connect Europe to Asia. Almost all over the world countries are planning and implementing solutions to stop tsunami of road accidents. In this paper the main challenges of road safety in both countries have been discussed and then using a road safety survey among Iranian-Georgian experts, main findings and priorities have been identified and compared. Comparison of surveys showed that we have lots of similar problems in both countries that mainly come from cultural unsafe habits and also level of perceived risk by road users. Since both countries have close cultures are categorized as middle income countries it could be predicted that successful efforts in one country could be possibly effective in another one. At the end an example of root cause analysis for aggressive driving problem is provided to clarify the possible solutions for future teamwork. Necessarily same solutions do not lead to successful achievements. Cultural norms, educational and enforcement methods vary from one country to another and to stop wasting the time it is better to start regional road safety cooperation for sharing the experiences and benefit each other.

---

Occupational road traffic crashes account for a large portion of killed and seriously injured road traffic victims. Several organizations have introduced driver-training programs in order to determine a safety culture and improve the safety of employees and society, as well as to comply with insurance company requests to reduce risks. The aim of these programs is to identify and promote desirable traits and remove attitudes and behaviors that are associated with higher crash involvement. The factors, which predict involvement in road traffic collisions, were driver personality behavior attitude and personal exposure are important determinants. It does show that driver attitudes and behaviors are a predictor of crash involvement, although their impact seems lower than exposure variables such as mileage, hours driven and having an aggressive personality. Where this is impossible or unpractical, efforts to assess attitudes and behaviors associated with poor driving and to improve these through training and other interventions do appear to be validated as worthwhile. It is useful for greater effort to be taken by organizations to promote a safety culture and make use of education programs to improve driver related attitudes and behavior. Hazard perception and knowledge of the Rules do not appear to be strong predictors of accident involvement, but they are important in underpinning attitude, behavior, personality and exposure. Absolutely, where practical, the attention of safety programs should be directed to those with aggressive, impulsive and impatient personalities. The findings support that drivers with these personality types have greater involvement in road traffic collisions.

---

Alzheimer's disease (AD), a common and debilitating neurodegenerative disorder, affect more than 65 million individuals throughout the world. This disability plays a crucial role in daily activities such as driving. Several studies have investigated the relationship between cognitive functions and driving safety. The current study revises the literature on the relation between road safety and AD. Results from a recent study showed that a person with moderate to severe dementia is certainly no longer fit to drive, whereas driving ability may be maintained in mild dementia for some time. So, impaired driving performance in elder compared to younger is the main reason for their driving cessation. It is suggested that driving competence must be addressed because many older adults with dementia continue to drive.

---

Spinal cord injuries (SCI) are highly disabling and injuries. This study aims to describe the demographic and epidemiologic data on auto accident patients who were admitted at Khatam Alanbia hospital. The results obtained from 73 SCI patients treated on the SCI inpatient units of the Khatam Alanbia Hospital (from March 2009 to March 2013) were evaluated retrospectively. Then patient gender, age at time of injury and etiology of injury, neurologic level, and movement status were analyzed. The study sample was limited patients with a history of motor vehicle collisions. In total, 69 (94.52%) of the patients were male and 4 (5.48%) were female. The mean age at time of injury was 25.8±7.84 years. In all, the level of injury of 13 (17.8%) of the patients were cervical, 44 (60.3%) thoracic, 12 (16.4%) lumbar and 4 (5.5%) thoracolumbar. 58 (79.5%) of patients were wheelchair bound, 4 (5.5%) moved by using cane and 11 (15.1) needed help to move. The findings showed SCI because of road traffic accident is more common in early age and majority of them became wheelchair bound. Thoracic level is the most injured level. Further research to establish the protective interventions is required.

---

Sleep deprivation (SD) increases the risk of human-error related accidents and a major cause of motor vehicle accidents. The overall prevalence of insufficient sleep in adults has been estimated at 20%. According to a comprehensive study prevalence of daytime sleepiness, among young adults (age 21 to 30 years), the average nocturnal sleep time during weekdays was 6.7 hours and on weekends was 7.4 hours. Studies in young adults indicate that 8 to 9 hours of extended nocturnal sleep are needed to resolve sleepiness caused by decreased sleep time. Driving is a complex task, which can be broken down into specific cognitive processes. Sleep-deprived driving is the operation of a motor vehicle while being cognitively impaired by a lack of sleep. Results of a 1998 survey showed, 23% of adults have fallen asleep while driving. There is not accurate statistical document of sleep deprivation related events in Iran. Total SD impairs attention and working memory, but it also affects other functions, such as long-term memory and decision-making. Partial SD is found to influence attention, especially vigilance. Thus, by attention to frequent incidence of sleep deprivation and extensive effects of SD on cognitive functions during driving, modification of sleep time in order to prevention of insufficient time, could be valuable way to increase safe driving and prevent motor vehicle accidents.

---

Frustrating situations that impede or prevent some form of ongoing goal-directed behavior are believed to act as a catalyst for aggressive behavior. From social learning approaches aggression is a learned response through observation or imitation of socially relevant others. Many psychological factors are at play in aggressive driving and many may prove difficult to control. Human beings are naturally prone to territoriality and have the tendency to view their vehicle as an extension of their personal domain. They feel threatened by other vehicles and respond aggressively or out of an instinct of self-protection. Nowadays, aggressive responses are common among Iranian people specially drivers. Road traffic accidents (RTAs) are leading causes of death and serious injury in military organizations. It has been estimated that annually one million people die in road traffic accidents worldwide. According to accident statistics, 9.1 Finns, 8.9 Dutch, and 7.5 Britons per one billion vehicle kilometers were killed in traffic accidents in 2002 whereas the corresponding figure for Greeks and Turks were 26.7 and 73, respectively. Based on statistics of 1390 in Iran, 38.28/100 persons died during last decade. Most road traffic accidents can be directly attributed to human factors as a sole or a contributory factor such as mood. In this review study, we compared relation between RTA and aggressive characteristics of drivers in Iran and UK. Previously published results indicated Iranian drivers behave more aggressively in anger situation than the British drivers. Finally, it can be concluded that the high rate of motor vehicle accidents in Iranian population may be caused from more aggressive temper of Iranians. Whereas, a broad range of risky driving behaviors contribute to RTAs, preventing or changing these offers promise for accident prevention.

---

Iran and neighboring countries have a very high rate of road accidents with thousands of victims per year. In last 20 years, more than half million Iranian were killed in road accidents millions suffering from injuries. As you know unintentional inures are a leading cause of death among children and young adult. “Shefa” Neuroscience Research Center is working on different scientific researches on neuroscience as well as working on the treatment of the related diseases. Furthermore, it is planned to have a comprehensive program on the prevention of road accidents and neurotrauma. Road safety publicity can be used to achieve various aims and objectives. In general, the aims of such publicity are to change the road user’s behavior, attitude or knowledge in order to increase road safety. Mass media campaigns can achieve the following: increase awareness of a behavior, raise the level of information about a topic or issue, help form beliefs, especially where they are not firmly held, make a topic more salient and sensitize the audience to other forms of communication, stimulate interpersonal influences via conversations with others (e.g. Police, teachers, or parents), generate information seeking by individuals, and reinforce existing beliefs and behaviors.

---

The proportion of elderly in the general population is rising, resulting in greater numbers of Drivers with neurodegenerative disorders such as Alzheimer’s disease (AD) and Parkinson’s disease (PD). Alzheimer’s disease is a progressive neurodegenerative disorder typified by memory impairment with executive dysfunction, motor problems, and/or language difficulties. Parkinson’s disease is a progressive neurodegenerative disease that impairs ability to execute conscious physical movement in addition to other motor functions. What is more, mood disturbances may occur as well. However, PD appears to be associated with decreased driving and increased crashes, especially in those with worse motor and cognitive dysfunction. A review panel found that drivers with mild cognitive impairment (MCI)-very mild AD (Clinical Dementia Rating Scale [CDR]=0.5) - have impairments similar to drivers aged 16–21 or those driving under the influence of alcohol at a blood alcohol concentration<0.08%. They were also recommended to reassess dementia severity and driving fitness every 6 months, but quit driving in mild AD (CDR=1) due to history of increased crashes and poor driving performance. In conclusion, Medical diagnosis or a clinician’s assessments alone are not accurate enough to determine driving competence in those with dementia. Although neuropsychological tests help them to understand associations of driver performance with cognitive impairment, a general lack of validated cut off scores makes it impossible to employ these tests in a standardized fashion to advice patients. Furthermore, there are no established guidelines on driver’s follow-up timing with mild dementia recommendations range from 6 months or less than a year. Thus, medical diagnosis or age alone is not reliable enough to predict driver safety, crashes, or revoke the driving privileges of these drivers. In addition, outlining the evolution of driving safety, understanding the mechanisms of driving impairment, and developing a reliable and efficient standardized test battery for prediction of driver safety in neurodegenerative disorder informed healthcare providers to advise their patients about neurodegenerative disorders with more certainty, affected policy, and develop rehabilitative measures for driving.

---

Road safety is a great subject to engage children and young people. It's a very important subject because everyone uses roads and road danger impacts on everyone. Children don't have the same ability to judge distances, speed, and noise direction. Therefore, it's really important to ensure that children have a good understanding of basic street safety when they start walking around the local and city streets without parents. Road safety education is a lifelong learning process, and educational measures need to be appropriate to the child’s stage of development, starting with practical pedestrian and then cyclist skills, but increasingly involving higher-level skills to match children’s increasing independence as pedestrians, cyclists and ultimately young adult drivers. All road users have a task to keep children safe, so it is also important to target drivers through training and publicity and to make parents aware of their key role in improving the safety of their children. In conclusion, parents are important role models for their children and can inculcate safe behavior through example, for instance in the use of seat belts and in their behavior as pedestrians.

---

Head trauma is the most common form of accidental injury among children, which is a source of concern for parents and pediatricians. After head trauma, children may be loss of intellectual function. Most head trauma in children is minor and not related with brain injury or long-term outcome. However, a small number of children may have a clinically important traumatic brain injury. The incidence of neurobehavioral outcome in children who have maintained minor head injury is argumentative. Headaches were a more frequent problem in the head-trauma patients. Management has focused on limiting progression of the primary brain injury and minimizing secondary brain injury. Children who have sustained minor head trauma manifest substantial functional morbidity despite the rarity of physical outcome. This functional morbidity probably reflects parental overreaction and possibly family dysfunction. It is recommended that pediatricians who have defined that a child's head injury is mild should focus parental education on the rarity of physical outcome and the importance of the child's returning to a normal routine.

---

Globally around 38 million people die each year as a result of non communicable diseases (NCDs) in which 42% (~ 16 million) are premature deaths (below the age of 70). Nine voluntary global targets were set by World Health Organization to control above mentioned premature deaths. Iran added 4 more targets to it, including 20% reduction in the mortality rate due to road traffic injuries. The need to include road traffic injuries among the first priorities of the public health agenda has been increasingly recognized in Iran. This recognition is based on the growing evidence and awareness about the magnitude of road traffic injuries in our country. A comprehensive literature review was conducted and all related national and international reference documents were reviewed. Iranian national service framework was prepared to emphasis the role of health sector in this area containing 8 strategic objectives and 64 strategies to be achieved by 2025.

---

Roads are crucial to our everyday lives as we use them  by driving, riding, walking or travelling as a pedestrian. Worldwide, more than  1.2 million people are killed on roads every year and up to 50 million more are injured; with most casualties from developing countries. In addition to different disabilities, road.accidents cause extensive psychological disorders and grief, and occasionally economic hardship for families. Furthermore, road accidents cost societies precious resources, diverting these from other health as well as development challenges. This is essential for.each country to address all these points in order to save the lives of thousands of human annually and protect their society resources.

---

We are concerned: The number of Road Traffic Fatalities is rising since 2014 again, in Germany, in the European :union:, in the USA, after a continuous decline over the last 40 years. Many reasons are discussed:  Human behaviour, e.g. texting while driving; no respect for traffic rules; daily life competition, who will be the fastest; more traffic, more vehicles, more kilometres driven. The industry would be able to provide a much better safety on our roads, but more safety is expensive and lower the profit. Governments worldwide are not willing to implement stronger regulations against the financial interest of their manufacturers. This is a deadly one way, which we must overcome. Cross Professional Competence will show the public the great chance to lower the burden of traffic injuries: Police, Red Crescent-Red Cross, Medical Doctors and Hospitals, Fire Department, Kindergarden-Schools and Universities, Villages and Cities must work together to provide the most effective Rescue Chain The injured human is competent guided from the scene of accident to the adequate hospital and after acute treatment send to a rehabilitation centre to regain his full pre-accident activity. The “ RESCUE CHAIN “ is as strong as its weakest chain-link The WHO 5 Pillar organigram :  Road safety Management – Safer Road and Mobility – Safer Vehicles – Safer Road User – Post Crash Response can be the basis for a understanding. For a better cooperation CROSS PROFESSIONAL COMPETENCE. Is required. and has to be demonstrated in public: Report from the accident, rescue chain helicopter, hospital treatment, shock room and rehabilitation with the victim back to his normal life. With the public opinion on our side, politicians will listen and implement necessary laws.

---

Human factors issues associated with roadway design and operations are critical components of improving highway safety. First, the three major components of highway safety are driver behavior, vehicle safety, and roadway safety. The general philosophy in roadside safety follows the priorities of (1) remove the hazard, (2) relocate the hazard, (3) make the hazard forgiving, and (4) shield the hazard. Roadway safety refers to that portion of overall highway safety that is determined by the roadway’s physical features such as road design, roadway signs, pavement markings, operating conditions, roadside objects (such as utility poles, signs, trees, guardrails), bridges, and intersections. It should be kept in mind that traffic barriers and crash cushions are hazards in themselves, and their use is limited to situations in which the severity of impacting the traffic barrier or crash cushion is less than that of impacting the hazard the barrier or crash cushion is shielding. The personal and economic costs of highway crashes to our citizens and communities are enormous.  Here are a few points to consider: Unlike driver behavior and vehicle design, where significant gains have been made, the percentage of deaths related to crashes with roadside hazards has actually increased over the past two decades.