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PubMed1996

Bilateral effects of unilateral visual cortex lesions in human.

We studied the vision of 12 patients with unilateral lesions of the visual cortex. All had a VI-type scotoma located in the contralateral visual fields, as expected, and visual acuity of 20/30 or better. Our aim was to test the hypothesis that they also had a visual deficit in their ipsilesional or 'good' visual fields. The first experiment tested the subjects' ability to respond to transient signals presented at unpredictable temporal intervals and spatial locations amongst many spatially random and identical distracter elements. The results showed that, compared with controls, the lesion group had a significantly reduced sensitivity to signal and increased response times affecting both hemifields. In a second experiment, we tested the useful field of view (UFOV) in two of the patients under conditions of differing attention demand. Both showed bilateral constriction, compatible with the results of the first experiment. One possible explanation for the bilateral effects of unilateral occipital lobe lesions is damage to interhemispheric connections along their presplenial course, affecting the synthesis of visual information from both hemifields (i.e. the interhemispheric diaschisis effects put forth by von Monakow). The trouble is task dependent and can be construed as a global reduction in visual attention capacity. It is subtle in comparison with the contralesional V1-type scotoma that Holmes measured, yet may account for unexplained complaints of reduced performance in some patients, particularly in tasks with high visual information processing demands, such as reading and automobile driving.

Adult↗
PubMed1998

Perception of movement and shape in Alzheimer's disease.

Alzheimer's disease is the most prevalent cause of abnormal cognitive decline in older adults and commonly affects visual function. Recent evidence suggests that Alzheimer's disease impairs the processing of visual motion, but these conclusions are based on conflicting results in the few cases studied, and the processing of complex motion images has not been investigated. In the present study of motion processing in Alzheimer's disease we assessed visual functions in 63 adults: 41 with mild to moderate Alzheimer's disease (mean age 72.3 years) and 22 without dementia (mean age 71.7 years). Processing of motion cues was tested with computer animation sequences known as random-dot cinematograms, which resemble the stimuli used to define motion processing deficits in primates with lesions of cortical area MT. Results showed that participants with Alzheimer's disease required significantly greater thresholds for perceiving shapes defined by motion cues compared with participants without dementia (P = 0.0005). There were no significant differences between the two groups (P < 0.05) in static visual acuity, static spatial contrast sensitivity and, surprisingly, dynamic visual acuity, which was normal, and motion direction discrimination, which was relatively spared. We conclude that mild to moderate Alzheimer's disease has significant effects on the perception of structure from motion with relative sparing of motion direction discrimination. We cannot exclude a contribution by retinal pathology, but retinal dysfunction alone cannot explain the pattern of defects we observed. The complex motion image processing deficit we identified is likely to have a cerebral basis and has the potential to affect navigation and the recognition of objects in relative motion, as encountered during walking and automobile driving.

Aged↗
PubMed2002

Does vehicle color influence the risk of being passively involved in a collision?

BACKGROUND: Bright- or light-colored vehicles are sometimes regarded as safer because they are presumably more visible. We examined the effect of vehicle color on the risk of being passively involved in a collision. METHODS: This paired case-control study used data from the Spanish database of traffic crashes. We selected those collisions from 1993 to 1999 in which only one of the drivers committed an infraction. The violators constituted the control group; the other drivers formed the case group. Information about the color of the vehicle and other confounding variables was also collected. RESULTS: When white was compared with the remaining colors, a protective estimate was obtained (adjusted odds ratio [aOR] = 0.97; 95% confidence interval = 0.94-1.00). The results were similar for light colors (white plus yellow) compared with all remaining colors (aOR = 0.96; 0.94-0.99). The protective effect of light colors was specifically observed for open roads and under daylight conditions. It was stronger in conditions other than good weather (aOR = 0.91; 0.86-0.99) than in good weather conditions. CONCLUSIONS: Light colors (white and yellow) were associated with a slightly lower risk of being passively involved in a collision, although only under certain environmental conditions.

Accidents, Traffic↗
PubMed1989

Static stability as a predictor of overturn in fatal motor vehicle crashes.

Fatal Accident Reporting System (FARS) files for the years 1981-1984 were examined for rollover crash involvement of 15 utility and passenger vehicle make-models for which static stability values (1/2 track width divided by height of center of gravity) were published. The values ranged from highs of 1.57-1.62 for the pre-1979 Ford LTD, the pre-1979 Chevrolet Nova, and the pre-1982 Pontiac Firebird to lows of 1.01-1.07 for the Jeep CJ-5 and CJ-7 and the pre-1978 Ford Bronco. Rollover as the first harmful event and as the most harmful event per 100,000 vehicles registered was strongly predicted by stability. Stability was unrelated to nonrollover crashes. The low-stability vehicles were much more likely to roll over on the road rather than after leaving the road. Other road, driver, and environmental risk factors recorded in the FARS files were not correlated to stability in such a way as to explain the high rollover of low-stability vehicles. Using Federal Highway Administration vehicle mileage estimates, calculations were made of the mileages under various conditions which the vehicles with low stability values would have to have been driven if mileage or hazardous-condition differences rather than stability differences accounted for their substantially higher fatal rollover fatal crash rates. This analysis indicates that fatal rollover rates of low-stability vehicles could not have occurred at reasonable mileage.

Accidents, Traffic↗
PubMed2005

The current status of road user injuries among the elderly in Germany: a medical and technical accident analysis.

BACKGROUND: The incidence and treatment of injuries involving the elderly road user are of increasing importance for all fields of trauma care to ensure the best possible outcomes. METHODS: Traffic accident reports were analyzed through technical and medical investigation for the involvement of elderly citizens. RESULTS: In 12,309 documented traffic accidents between 1985 and 1998, 1,843 elderly citizens (65 years and older) were involved, 1,260 of which were reported to have been injured. The mean Injury Severity Score among the injured elderly citizens was 7.3. Of the injured elderly road users, 39.5% were car occupants, 27.4% were bicyclists, 29.6% were pedestrians, 1.8% were truck occupants, and 1.7% were motorcyclists. Of the elderly road users in cars, 53% were not injured, in contrast to only 1.1% of the bicyclists and 0.8% of the pedestrians. Serious or severe injuries (Maximum Abbreviated Injury Scale, >/=2] occurred for 36.5% of the injured elderly road users as car occupants (unrestrained, 58%; restrained, 34%), 57.4% as bicyclists, and 65.4% as pedestrians CONCLUSION: A high rate of motor injuries is associated with vehicle accidents and increased levels of severity among the elderly population. This finding is especially evident for elder pedestrians and bicyclists. Also of note, the elderly even appear to be at risk for sustaining an increased level of injury severity when they are restrained or belt protected.

Abbreviated Injury Scale↗
PubMed2005

Motorcycle accident risk could be inflated by a time to arrival illusion.

PURPOSE: Drivers adopt smaller safety margins when pulling out in front of motorcycles compared with cars. This could partly account for why the most common motorcycle/car accident involves a car violating a motorcyclist's right of way. One possible explanation is the size-arrival effect in which smaller objects are perceived to arrive later than larger objects. That is, drivers may estimate the time to arrival of motorcycles to be later than cars because motorcycles are smaller. METHODS: We investigated arrival time judgments using a temporal occlusion paradigm. Drivers recruited from the student population (n = 28 and n = 33) saw video footage of oncoming vehicles and had to press a response button when they judged that vehicles would reach them. RESULTS: In experiment 1, the time to arrival of motorcycles was estimated to be significantly later than larger vehicles (a car and a van) for different approach speeds and viewing times. In experiment 2, we investigated an alternative explanation to the size-arrival effect: that the smaller size of motorcycles places them below the threshold needed for observers to make an accurate time to arrival judgment using tau. We found that the motorcycle/car difference in arrival time estimates was maintained for very short occlusion durations when tau could be estimated for both motorcycles and cars. CONCLUSIONS: Results are consistent with the size-arrival effect and are inconsistent with the tau threshold explanation. Drivers estimate motorcycles will reach them later than cars across a range of conditions. This could have safety implications.

Accidents, Traffic↗
PubMed2005

Spine and spinal cord injury in motor vehicle crashes: a function of change in velocity and energy dissipation on impact with respect to the direction of crash.

OBJECTIVE: To examine the effect of change in velocity (DeltaV) and energy dissipation (IE) on impact, above and below the test levels for Federal MVC Safety Standards, on the incidence of spine fractures (SF), spinal cord injury (SCI)), SF mortality and the associated injury patterns in Frontal (F) and Lateral (L) MVCs. Comparison of 214 patients with SF or SCI with 938 patients who did not have SF or SCI. METHODS: 1152 MVC adult drivers or front-seat passengers (701 F & 451 L) evaluated at 10 Level I CIREN study Trauma Centers together with vehicle and crash scene engineering reconstruction. Patient seat belt (SB) and/or airbag (AB) use correlated with clinical, or autopsy findings. RESULTS: The relationship between DeltaV and IE rose exponentially as DeltaV increased. Of the 1152 patients, all with AIS> or =3 injuries, there were 214 patients with spine fractures of AIS > or =2. In FMVCs there were more SF patients with Cervical SF than in LMVCs (68F versus 64 L) and more Thoracic (35F versus 21L) and Lumbar (39F versus 16L) SF. However, the incidence of spinal cord injury was greatest in the Cervical SF (33%), compared with the Thoracic SF (18%), or Lumbar SF (2%). Most important, in FMVCs 49% of SF, 47% of SCI and 71% of the SF deaths (p < 0.05) occurred at > mean of 47.4 kph. In contrast, in LMVCs 51% of SF, 52% of SCI and 67% of the SF deaths occurred at DeltaV > mean of 35.3 kph. However, 80% of all deaths in SCI occurred in Cervical SF cases, in these 74% also had a brain injury. In contrast, the deaths in Thoracic SF were due to combinations of brain (45%), thorax (95%) or associated pelvic fracture injuries (50%). Airbag (AB), or Seat belt (SB) restraints appeared to protect FMVC SF patients from SCI at lower DeltaV, but 84% of Cervical SCI patients at DeltaV > 47 kph had AB protection and in a few cases the AB appeared responsible for the SCI. In contrast, 82% of Lumbar SF patients had SB, but in FMVCs where jackknifing due to backloading occurred, improper SB positioning may have contributed to the SF. CONCLUSIONS: The implication for SCI in both front seat drivers and passengers in either FMVC or LMVC crashes above their respective DeltaV means is that improved spine fracture protection is necessary at higher DeltaV levels. More effective safety systems to prevent Cervical SCIs should be developed using two-level frontal and side AB & SB+pretensioner devices, which protect against SF at DeltaV both at and 1SD above the FMVC (47 & 72 kph = 30 & 45 mph) and LMVC (35 & 54 kph =22 & 34 mph) means.

Acceleration↗
PubMed2006

Parental knowledge on car safety for children: an Israeli survey.

The objective of this study was to assess the level of parental car safety knowledge and actual behavior regarding their children under the age of 15 years. This study forms part of the National Center for Child Safety and Health in Israel (Beterem) program to examine awareness on child safety. Seven hundred and five Jewish families with at least one child at home younger than 15 years (a total of 1,345 children) were used as a randomized sample of the Jewish population. A telephone survey was conducted by professional interviewers using a questionnaire developed by injury prevention specialists consisting of seven knowledge questions and a diagram that described the usual seating positions and restraining method of the family members in the family car. Concerning knowledge about injury prevention, the rate of incorrect answers was high, 64% in regard to the proper car seats for age and 84% in regard to the age for booster seats. Sixty five percent of parents did not know what a booster seat was and 54% did not know that the proper place for children was in the back seat. The average of incorrect answers was 4.86 out of 7 (SD=1.45) correlated with low socioeconomic status. Concerning care safety behavior 60% percent of babies and 38% of toddlers were not restrained properly. This study should alert planners and policy makers to the need of implementation of educational prevention programs for the Israeli public of parents concerning car safety for children in order to reduce childhood injury.

Adolescent↗
PubMed1992

The use of microcomputer-based psychomotor tests for the evaluation of benzodiazepine effects on human performance: a review with emphasis on temazepam.

1. The literature relating to the effects of benzodiazepines in general, and temazepam in particular, on human psychomotor performance as assessed using microcomputer-based testing batteries is surveyed. 2. The adverse effects of central nervous system depressants on performance is an important mediocolegal issue and frequently comes into question in on-the-road and on-the-job accidents. The use of microcomputer-based testing batteries allows for performance evaluation both in the laboratory and at-the-scene, as well as providing the opportunity to model a large number of different behaviours required in routine yet complex psychomotor tasks. 3. The conclusions in general are: (1) The benzodiazepines as a class of drugs impair both cognitive and motor performance. These effects are often subtle when low doses are involved or when testing occurs the morning following evening administration of the medication. (2) No single psychomotor task adequately simulates complex daily tasks such as automobile driving. A battery of tests that evaluates a number of the components of such tasks is necessary to determine adequately the full range of effects of these medications.

Benzodiazepines↗
PubMedDate not supplied

Reflex absence epilepsy.

Epilepsy can be triggered by many unusual mechanisms. Some are exceedingly rare and bizarre, seemingly confined to one patient. This article reports the case of a 20-year-old woman who has had absence epilepsy for 11 years that is evoked by thinking or talking about driving an automobile. This stimulus consistently precipitated absence seizures, as defined by clinical and electroencephalographic criteria. An emotionally traumatic early childhood event may play a role in the triggering mechanism. A similar case has not been reported.

Adult↗