Objective: To identify the most appropriate metric to determine the effectiveness of mobile speed cameras in reducing road traffic related injuries. Design: Controlled before and after study which compares two methods for examining the local effectiveness of mobile speed cameras-a circular zone around the camera and a route based method to define exposure at various distances from sites. Setting: South Wales, UK. Subjects: Persons injured by road traffic before and after intervention. Intervention: Use of mobile speed cameras at 101 sites. Main outcome measures: Rate ratio of injurious crashes at intervention and control sites. Results: Camera sites had lower than expected numbers of injurious crashes up to 300 metres using circles and up to 500 metres using routes. Routes methods indicated a larger effect than the circles method except in the 100 metres nearest sites. A 500 metre route method was used to investigate the effect within strata of time after intervention, time of day, speed limit, and type of road user injured. The number of injurious crashes after intervention was substantially reduced (rate ratio 0.49, 95% confidence interval 0.42 to 0.57) and sustained throughout two years after intervention. Significant decreases occurred in daytime and night time, on roads with speed limits of 30 and 60-70 miles/hour and for crashes that injured pedestrians, motorcycle users, and car occupants. Conclusions: The route based method is the better method of measure effectiveness at distances up to 500 metres. This method demonstrates a 51% reduction in injurious crashes.A lthough road traffic crashes and collisions are a leading cause of death and disability among people aged under 35 years, 1 there is a paucity of research evaluating the effectiveness of road safety interventions published in academic journals. 2 In the United Kingdom, one controversial approach is the use of mobile speed cameras. These capture the license plate of passing vehicles exceeding a speed above the legal limit and mail a fine and penalty points to the driver of the vehicle. Unlike static speed cameras, which are operated remotely from permanent camera housings at the roadside, mobile cameras operate in this situation from parked marked vehicles and can be quickly moved from one site to another. Mobile cameras tend to be rotated around a much larger number of sites than static cameras and are almost exclusively used during daylight hours, whereas static cameras typically operate around the clock all year. These differences result in fewer hours of operation at each mobile camera site compared with static camera sites. Mobile cameras might be expected to be less effective than static cameras, when measured as reductions in injurious crashes per annum because of the differences in enforcement intensity.Evaluations of static speed cameras in the United Kingdom have shown significant decreases in numbers of injurious crashes near camera sites.3 4 A meta-analysis merging the results of 10 local effects of camera studies, which included stati...

Access for the total population does not imply equity of access for subgroups of the population. Comparisons of access between scenarios are dependent on which measure of access is the indicator of choice. Results are sensitive to the road network travel speeds and further local validation may be necessary. This method can provide explicit information to health service planners on the effects on equity of access from a change in service configuration.

Council tax valuation bands (CTVBs) are a categorisation of household property value in Great Britain. The aim of the study was to assess the CTVB as a measure of socio-economic status by comparing the strength of the associations between selected health and lifestyle outcomes and CTVBs with two measures of socio-economic status: the National Statistics Socio-Economic Classification (NS-SEC) and the 2001 UK census-based Townsend deprivation index. Methods:Cross-sectional analysis of data on 12,092 respondents (adjusted response 62.7%) to the Caerphilly Health and Social Needs Study, a postal questionnaire survey undertaken in Caerphilly county borough, southeast Wales, UK. The CTVB was assigned to each individual by matching the sampling frame to the local authority council tax register. Crude and age-gender adjusted odds ratios for each category of CTVB, NS-SEC and fifth of the ward distribution of Townsend scores were estimated for smoking, poor diet, obesity, and limiting long-term illness using logistic regression. Mean mental (MCS) and physical (PCS) component summary scores of the ShortForm SF-36 health status questionnaire were estimated in general linear models.Results: There were significant trends in odds ratios across the CTVB categories for all outcomes, most marked for smoking and mental and physical health status. The adjusted odds ratio for being a smoker in the lowest versus highest CTVB category was 3.80 (95% CI: 3.06, 4.71), compared to 3.00 (95% CI: 2.30, 3.90) for the NS-SEC 'never worked and long-term unemployed' versus 'higher managerial and professional' categories, and 1.61 (95% CI: 1.42, 1.83) for the most deprived versus the least deprived Townsend fifth. The difference in adjusted mean MCS scores was 5.9 points on the scale for CTVB, 9.2 for NS-SEC and 3.2 for the Townsend score. The values for the adjusted mean PCS scores were 6.3 points for CTVB, 11.3 for NS-SEC, and 2.5 for the Townsend score.

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Background: Assessment of the spatial accessibility of hospital accident and emergency departments as perceived by local residents has not previously been investigated. Perceived accessibility may affect where, when, and whether potential patients attend for treatment. Using data on 11,853 respondents to a population survey in Caerphilly county borough, Wales, UK, we present an analysis comparing the accessibility of accident and emergency departments as reported by local residents and drive-time to the nearest accident and emergency department modelled using a geographical information system (GIS).