Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “Drive”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 559 records · Page 31Linked to original sources
PubMed2002

Assessing functional status: exploring the relationship between the multiple sclerosis functional composite and driving.

OBJECTIVE: To explore the relationship between the Multiple Sclerosis Functional Composite (MSFC), which is comprised of 3 clinical dimensions (arm and hand function, leg function and ambulation, cognition), and an everyday functional skill, driving performance. DESIGN: Cohort study. SETTING: Medical rehabilitation research organization. PARTICIPANTS: Twenty-nine individuals with documented multiple sclerosis (MS) and limited motor decrements. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: Driving-related skills were measured by using the overall category rating from the Useful Field of View (UFOV) Test, its 3 subtests, the error and latency scores from the Neurocognitive Driving Test (NDT), subjective (self-report) and objective (Department of Motor Vehicles [DMV] reports) reported driving experience, and number of motor vehicle crashes. Within the group, differences were explored between participants rated as low risk versus moderate-high risk on the UFOV overall score and between participants who reported a change in driving habits after MS versus those who reported no change. RESULTS: The overall MSFC score correlated significantly with the UFOV overall score, the visual-information processing and selective attention subtests of the UFOV, the NDT latency score, as well as with the number of days a week the individual drove and the number of crashes reported by the DMV. An examination of the MSFC components revealed that the cognition component was significantly related to the UFOV overall score, all 3 subtests of the UFOV, and the NDT latency score. The arm and hand function component correlated significantly with NDT latency and the selective attention subtest of the UFOV. Individuals classified as low risk on the UFOV overall had more education, better MSFC scores, and lower NDT latency scores. Only the overall MSFC score distinguished those who reported a change in driving habits after onset of MS. CONCLUSIONS: Problems with everyday functional skills such as driving are accurately identified through the use of the overall MSFC and its components.

Adult↗
PubMed2006

The effects of lumbar massage on muscle fatigue, muscle oxygenation, low back discomfort, and driver performance during prolonged driving.

An increasing dependence of society on automobiles for both work and leisure and the corresponding increase in time spent seated in the car has been correlated with a greater risk of low back pain and absence from work (Porter and Gyi 2002). This study examined the effects of three types of lumbar massage units on seating comfort, muscle fatigue, muscle oxygenation, muscle blood flow and driving performance during a 1 h simulated driving task. Electromyographic (EMG) signals were recorded from the right and left thoracic and lumbar erector spinae musculature. Average EMG (AEMG), mean power frequency (MPF), gaps and amplitude probability distribution function (APDF) parameters were analysed from the three massage seats and compared to a control seat. Near infrared spectroscopy (NIRS) and skin temperature from the right thoracic and lumbar erector spinae were used as an indication of muscle oxygenation and blood flow throughout the driving task. Ratings of perceived discomfort were used to assess driver discomfort, and driving performance was assessed by calculating mean lap times for the duration of each driving trial. The results showed statistically significant increases in skin temperature compared with the control seat after 60 min of driving. The NIRS results reflected these trends although the results were not statistically significant. AEMG and MPF measures showed no significant differences between the seats. MPF measures were found to increase over time, effects attributed to increases in muscle temperature. Gaps and APDF analyses revealed greater rest times and lower activation levels, respectively, with the control seat, which could result in increased loading of passive structures. This study demonstrated the beneficial effects of lumbar massage systems in increasing muscle blood flow and oxygenation. Although EMG parameters were not significantly different, the trends support the significant blood flow results. Future research should include longer driving times and adjustments in EMG measures to account for the effects of increasing muscle temperature on AEMG and MPF measures.

Adult↗
PubMedDate not supplied

Visual attention and older drivers: the contribution of inhibition of return to safe driving.

Increasing data suggest that visual attention may be impaired in some older drivers, and that such impairment may be related to poorer driving abilities and a higher crash risk. Because effective scanning of the environment is important for safe driving, the authors sought to examine the relationship between a reflexive visual attention mechanism and driving. To examine this issue the authors conducted a preliminary study using the inhibition of return (IOR) paradigm, which has been labeled as a fundamental search mechanism. Forty-one drivers aged 55 and over completed two on-road driving evaluations and IOR testing. After accounting for the contribution of age, IOR statistically predicted overall driving evaluation scores (p = .045), and the number of errors in scanning the environment (p = .031). To the authors' knowledge these findings represent the first documentation of a relationship between IOR and driving. The results are informative regarding the importance of reflexive visual attention mechanisms towards safe driving.

Aged↗
PubMed2006

Drinking-driving fatalities and consumption of beer, wine and spirits.

Drinking-driving is a leading cause of preventable morbidity and mortality in Canada. The purpose of this paper was to examine factors that influenced drinking driver deaths in Ontario. We examined the impact of per capita consumption of total alcohol, and of beer, wine and spirits separately, on drinking-driving deaths in Ontario from 1962 to 1996, as well as the impact of the introduction of Canada's per se law and the founding of People to Reduce Impaired Driving Everywhere - Mothers Against Drunk Driving (PRIDE - MADD) Canada. We utilised time-series analyses with autoregressive integrated moving average (ARIMA) modelling. As total alcohol consumption increased, drinking driving fatalities increased. The introduction of Canada's per se law, and of PRIDE-MADD Canada, acted to reduce drinking driving death rates. Among the specific beverage types, only consumption of beer had a significant impact on drinking driver deaths. Several factors were identified that acted to increase and decrease drinking driver death rates. Of particular interest was the observation of the impact of beer consumption on these death rates. In North America, beer is taxed at a lower rate than other alcoholic beverages. The role of taxation policies as determinants of drinking-driving deaths is discussed.

Accidents, Traffic↗
PubMed2003

A survey of the effects of fatigue on driving in people with multiple sclerosis.

PURPOSE: To examine the effect of fatigue on driving in patients with multiple sclerosis (MS). METHOD: A questionnaire on driving was sent to 192 people with MS and 192 controls who were relatives or close friends of the people with MS. RESULTS: Replies were received from 75 MS patients (39%) and 63 controls (32%). MS patients' ability to drive was more often affected by fatigue, leg problems, numbness and eye problems than controls. The MS group reported driving shorter distances and shorter times than controls, and that fatigue had a significant effect on their ability to drive. The driving plans of MS patients were affected by fatigue. CONCLUSION: Fatigue affected the driving of MS patients, but it was not the only factor and should be considered in relation to other symptoms of MS.

Adult↗
PubMed2006

Validation of an electronic device for measuring driving exposure.

OBJECTIVE: This study sought to evaluate an on-board diagnostic system (CarChip) for collecting driving exposure data in older drivers. METHODS: Drivers (N = 20) aged 60 to 86 years from Winnipeg and surrounding communities participated. Information on driving exposure was obtained via the CarChip and global positioning system (GPS) technology on a driving course, and obtained via the CarChip and surveys over a week of driving. Velocities and distances were measured over the road course to validate the accuracy of the CarChip compared to GPS for those parameters. RESULTS: The results show that the CarChip does provide valid distance measurements and slightly lower maximum velocities than GPS measures. From the results obtained in this study, it was determined that retrospective self-reports of weekly driving distances are inaccurate. CONCLUSIONS: Therefore, an on-board diagnostic system (OBDII) electronic device like the CarChip can provide valid and detailed information about driving exposure that would be useful for studies of crash rates or driving behavior.

Age Factors↗
PubMedDate not supplied

Low educational performance is associated with drunk driving: a 31-year follow-up of the northern Finland 1966 birth cohort.

AIMS: We studied the relationship between drunk driving offences, school performance and adult educational achievements. METHODS: Data from the Northern Finland 1966 Birth Cohort were linked with official criminality files and National Education registers. The cohort members were studied prospectively covering the period from pregnancy to 31 years of age. Drunk driving (one to two arrests) and recidivist drunk driving (three or more arrests) were treated as outcome variables and their relation to school performance was studied by cross-tabulation and to adult educational achievements (two levels of education) by logistic regression analysis, adjusting for parental social class and psychiatric morbidity. RESULTS: Drunk drivers had a statistically significantly worse school performance compared with controls. Male cohort members who had remained at the basic educational level had an elevated risk for drunk driving [odds ratio (OR) 3.0, 95% confidence interval (CI) 2.3-3.8]. The corresponding adjusted ORs for recidivist drunk driving and female drunk driving were 8.6 (95% CI 5.1-14.4) and 7.0 (95% CI 3.3-14.8), respectively. CONCLUSIONS: These results are unlikely to be directly causal; however, educational failures seem to be part of the complex causal pathway to drunk driving and even to alcohol-related disorders.

Achievement↗
PubMed2006

Driving cessation and consumption expenses in the later years.

OBJECTIVES: This study examined the association between consumption and driving status among older persons within the context of selected variables, including self-rated health and functional status. METHODS: The data were from the 1998, 2000, and 2002 Health and Retirement Study and the 2003 Health and Retirement Study Consumption and Activities Mail Survey. We conducted Tobit regression analyses on five consumption categories of basic needs (such as food) and higher order needs (such as trips and dining out). RESULTS: Consumption and driving status were significantly associated, showing that driving cessation was related to a 46% to 63% reduction in spending on trips, tickets, and dining out. Another significant relationship emerged between consumption and having never driven. Driving cessation was minimally related to consumption of basic needs (such as food and clothing) and was more strongly associated with higher order needs (such as trips). DISCUSSION: The findings demonstrate the association between older people's driving status and consumption, specifically higher order activities. Older persons who drive and, presumably, have more opportunities to go to stores, restaurants, and other outside events, spend more on food, tickets, and dining out than those who cease driving or have never driven. Although the direction of causality remains unclear, these findings have implications for those concerned with alternative transportation resources for older adults.

Aged↗
PubMed1993

Driving cessation and changes in mileage driven among elderly individuals.

The factors associated with driving cessation, number of miles driven, and changes in mileage were assessed in a community-living elderly population. A driving survey was administered in 1989 to surviving members of the New Haven EPESE cohort. Of 1,331 respondents, 456 had driven and 139 had stopped driving between 1983 and 1989. Independent predictors of driving cessation from a multiple logistic regression model included higher age, lower income, not working, neurologic disease, cataracts, lower physical activity level, and functional disability. These risk factors were combined to assess their ability to predict driving cessation. If no factors were present, no subjects stopped driving; if one or two factors were present, 17 percent stopped; if three or more factors were present, 49 percent stopped. Along with the expected medical factors, physical activity level and social and economic factors contributed to driving cessation. High mileage drivers tended to be younger, active males who still worked. Increasing age and disability were associated with mileage reduction compared to five years earlier.

Activities of Daily Living↗
PubMed1994

Performance-based driving evaluation of the elderly driver: safety, reliability, and validity.

BACKGROUND: Our driving population is aging and faces increased risk for injury and death from motor vehicle crashes. Clinicians are often asked to judge the driving safety of their patients without adequate guidelines. This article describes the development of a systematic performance-based road test for measuring driving skills of elderly drivers and its correlation with cognitive measures. METHODS: This was a prospective, masked, observational study in which a driving instructor's global scores ("criterion standard") and cognitive test scores were correlated with research driving scores created by two independent research raters sitting in the back seat of the care during each driving test. A convenience sample of 30 licensed drivers with a broad range of cognitive skills, over age 60, were studied on a closed course and in traffic. RESULTS: Statistically significant correlations were observed between the "criterion standard" and closed course scores (r = .35, p < .05) and between the "criterion standard" and in-traffic scores (r = .64, p < .01). Significant correlations were obtained between in-traffic and cognitive test scores, e.g., Mini-Mental State Exam (r = .72, p < .01). Inter-rater reliability on the closed course was .84 and on the in-traffic component was .74. Internal consistency for the closed course was .78 and for in-traffic was .89. CONCLUSION: This study documented the safety, reliability, and validity of a systematic road test for elderly drivers with a range of cognitive skills. Larger studies are needed to determine the cognitive factors that independently predict driving performance.

Aged↗
PubMed2006

Driving and dementia in older adults: Implementation and evaluation of a continuing education project.

PURPOSE: We aimed to develop and evaluate a multimedia workshop curriculum to educate physicians and other health professionals about (a) driving-related assessment in older adults with dementia, and (b) strategies to encourage driving retirement for impaired individuals. DESIGN AND METHODS: A curriculum developed by the Older Drivers Project of the American Medical Association was expanded for presentation by a multidisciplinary team. One pilot and seven test workshops were offered. A program evaluation method-testing knowledge, confidence, attitudes, and practice behaviors-was employed at four points in time: T1 (Time 1; pretest focusing on the previous 12 months), T2 (Time 2; same-day post-test), T3 (Time 3; post-test at 3 months), and T4 (Time 4; post-test at 12 months). RESULTS: At T1, participants (N = 147) expressed high agreement that an assessment of driving ability is an important issue in clinical dementia care, but they reported low knowledge of assessment strategies, resources, and state reporting requirements. Modest gains in knowledge and confidence were demonstrated at both T3 (n = 93) and T4 (n = 63). In addition, the frequency of driving-related practice behaviors (i.e., incorporation of driving-related questions into clinical evaluation, chart documentation, reporting of impaired drivers) had increased significantly by T3 and T4. IMPLICATIONS: The results indicate that a focused workshop curriculum, with practical and immediate applications to care, can motivate measurable changes in clinical practice. Once they are informed, health professionals can address issues of driving ability in older patients with dementia and, with the support of available resources, encourage impaired individuals to retire from driving for the safety of everyone on the road.

Aged↗
PubMedDate not supplied

Assessment of driving capability through the use of clinical and psychomotor tests in relation to blood cannabinoids levels following oral administration of 20 mg dronabinol or of a cannabis decoction made with 20 or 60 mg Delta9-THC.

Delta(9)-Tetrahydrocannabinol (THC) is frequently found in the blood of drivers suspected of driving under the influence of cannabis or involved in traffic crashes. The present study used a double-blind crossover design to compare the effects of medium (16.5 mg THC) and high doses (45.7 mg THC) of hemp milk decoctions or of a medium dose of dronabinol (20 mg synthetic THC, Marinol on several skills required for safe driving. Forensic interpretation of cannabinoids blood concentrations were attempted using the models proposed by Daldrup (cannabis influencing factor or CIF) and Huestis and coworkers. First, the time concentration-profiles of THC, 11-hydroxy-Delta(9)-tetrahydrocannabinol (11-OH-THC) (active metabolite of THC), and 11-nor-9-carboxy-Delta(9)-tetrahydrocannabinol (THCCOOH) in whole blood were determined by gas chromatography-mass spectrometry-negative ion chemical ionization. Compared to smoking studies, relatively low concentrations were measured in blood. The highest mean THC concentration (8.4 ng/mL) was achieved 1 h after ingestion of the strongest decoction. Mean maximum 11-OH-THC level (12.3 ng/mL) slightly exceeded that of THC. THCCOOH reached its highest mean concentration (66.2 ng/mL) 2.5-5.5 h after intake. Individual blood levels showed considerable intersubject variability. The willingness to drive was influenced by the importance of the requested task. Under significant cannabinoids influence, the participants refused to drive when they were asked whether they would agree to accomplish several unimportant tasks, (e.g., driving a friend to a party). Most of the participants reported a significant feeling of intoxication and did not appreciate the effects, notably those felt after drinking the strongest decoction. Road sign and tracking testing revealed obvious and statistically significant differences between placebo and treatments. A marked impairment was detected after ingestion of the strongest decoction. A CIF value, which relies on the molar ratio of main active to inactive cannabinoids, greater than 10 was found to correlate with a strong feeling of intoxication. It also matched with a significant decrease in the willingness to drive, and it matched also with a significant impairment in tracking performances. The mathematic model II proposed by Huestis et al. (1992) provided at best a rough estimate of the time of oral administration with 27% of actual values being out of range of the 95% confidence interval. The sum of THC and 11-OH-THC blood concentrations provided a better estimate of impairment than THC alone. This controlled clinical study points out the negative influence on fitness to drive after medium or high dose oral THC or dronabinol.

Administration, Oral↗
PubMed1991

Driving and arthritis.

In a 3-year period, 94 patients with driving difficulties due to a variety of musculoskeletal disorders were assessed by the occupational therapy department of a rheumatology unit. The individual's ability to carry out each part of the driving process was recorded and the patients were classified into six broad categories. While some parts of the driving process often proved difficult, patterns of disability were found with different musculoskeletal disorders. Almost all of these difficulties could be overcome by simple modifications to vehicle or driving technique. Only one severely disabled individual required referral to a specialized mobility unit, while two individuals were found to be unsafe. Thus, almost all arthritic individuals are able to continue driving with the help of simple modifications. By providing an unsophisticated driving assessment service, a rheumatology unit can enable patients to continue driving and so maintain independence.

Arthritis↗
PubMed1997

The 1994 International Consensus Conference on Dementia and Driving: a brief report. Swedish National Road Administration.

A possible relationship exists between the increased relative crash risk of older drivers and the prevalence of age-related diseases such as dementia. However, although dementia effects cognitive functions essential for safe driving, the evaluation of driving competence in demented persons is problematic. A clear-cut policy, intended chiefly for primary care physicians, is still lacking. In recognition of this fact, the Swedish National Road Administration invited a group of researchers to review existing research and to formulate a consensus on the issue of driving and dementia. The consensus group suggested that physicians should routinely make a cursory evaluation of the mental condition of their older driving patients. When signs of cognitive impairment are detected, possible influence on visuospatial skills, attention, judgment, and memory functions should be carefully considered. Information from caregivers on past and current driving performance as well as functions relating to activities of daily living (ADL) should be taken into account. Consensus was reached that a diagnosis of moderate to severe dementia indicates sufficient cognitive impairment to preclude driving. In addition, diagnosed mildly demented individuals or nondiagnosed cognitively impaired individuals with functional deterioration should be considered for specialized assessment of driving competence.

Automobile Driving↗
PubMed1994

A cross-study comparison of the effects of moclobemide and brofaromine on actual driving performance and estimated sleep.

Results from two separate studies were combined to compare the acute and subchronic effects of two monoamine oxidase-A (MAO-A) inhibitors, moclobemide and brofaromine, on actual driving performance and sleep. Both studies were conducted according to a double-blind, crossover design involving 18 patients receiving moclobemide and 16 patients receiving brofaromine. Patients were administered either moclobemide 200 mg b.i.d., mianserin 10 mg. t.i.d., and placebo (study 1), or brofaromine 50 and 75 mg b.i.d., doxepin 25 mg t.i.d., and placebo (study 2) for 8 consecutive days. A standardized driving test was conducted on day 1 and day 8 of treatment. Daily logs of estimated sleep duration and quality were obtained. Neither moclobemide nor brofaromine impaired driving performance. Some indication, although statistically not significant, was found that moclobemide improved driving performance on day 1. Brofaromine 75 mg significantly improved driving performance on day 8 of treatment. No significant difference between the effects of both drugs was found in a cross-study comparison. Moclobemide did not affect any sleep parameter, whereas brofaromine shortened sleep duration and decreased sleep quality. On day 1, mianserin and doxepin impaired driving. Impairment dissipated after 8 days of treatment with doxepine but not during treatment with mianserin. Sleep duration was prolonged during treatment with both drugs, whereas sleep quality remained unaffected. It is concluded that both MAO-A inhibitors are safe drugs with respect to driving.

Adult↗
PubMed2004

Impact of methylphenidate delivery profiles on driving performance of adolescents with attention-deficit/hyperactivity disorder: a pilot study.

OBJECTIVE: Adolescents with attention-deficit/hyperactivity disorder (ADHD) are at high risk for driving accidents. One dose of methylphenidate (MPH) improves simulator driving performances of ADHD-diagnosed adolescents at 1.5 hours post-dose. However, little is known about the effects of different MPH delivery profiles on driving performance throughout the day. METHOD: This randomized, crossover, single-blind study compared osmotic, controlled-release oral system (OROS) MPH (Concerta) given q.d. to immediate-release MPH (Ritalin) given in equal doses t.i.d. on driving performance among six male ADHD-diagnosed adolescent drivers aged 16 to 19 years. Under each treatment condition, participants were maintained on their medication dosage for 7 days, then drove a sophisticated driving simulator at 2 p.m., 5 p.m., 8 p.m., and 11 p.m. The primary outcome measure was each participant's computer-quantified Impaired Driving Score (IDS). RESULTS: IDS worsened in the evenings for participants receiving MPH t.i.d. but remained stable when they received once-daily OROS MPH. Participants performed significantly better when receiving OROS MPH q.d. compared with MPH t.i.d. (F = 9.3, df = 1, p =.004). When MPH was given t.i.d., IDS significantly worsened beginning at 8 p.m. compared to OROS MPH (p =.01). CONCLUSIONS: Participants demonstrated significantly less variability and better driving performance when receiving OROS MPH q.d. compared to MPH t.i.d., particularly in the evenings.

Adolescent↗
PubMed2000

Effect of stimulant medication on driving performance of young adults with attention-deficit hyperactivity disorder: a preliminary double-blind placebo controlled trial.

Driving performance of adult males with attention-deficit hyperactivity disorder (ADHD) was compared with matched controls in a double-blind (Ritalin vs. placebo) cross-over design, using a high-fidelity driving simulator. Seven ADHD and six non-ADHD drivers (mean age 22) were screened to rule out comorbidity and assess for ADHD, and then admitted to the General Clinical Research Center to control diet and sleep before testing. At 0800 and 1530, subjects consumed either a placebo or Ritalin pill in a counter-balanced manner, and at 0930 and 1700, subjects drove the simulator. After both drives, subjects rated their driving performance. Compared with non-ADHD subjects, ADHD subjects had more career driving accidents (p < .04) and motor vehicle violations (p = .059), drove worse on the simulator under placebo condition (p < .05), demonstrated significant improvement under the Ritalin condition (p < .05), rated themselves as driving poorer during the placebo condition (p = .05), and tended to perceive their driving to be better during the Ritalin condition (p = .07). This would suggest that individuals with ADHD should have the therapeutic benefit of a stimulant medication when operating a vehicle.

Accidents, Traffic↗
PubMed2001

Comparison of driving performance of young and old drivers (with and without visual impairment) measured during in-traffic conditions.

PURPOSE: The aim of this study was to determine whether visual impairment and age affected driver performance and safety rated during in-traffic driving conditions. METHODS: Participants included 30 younger, 25 middle-aged, and 35 older subjects with normal vision and 47 older subjects with visual impairment. All subjects were legally eligible to drive. Driving performance was assessed during in-traffic conditions by a professional driving instructor and an occupational therapist using specific scoring criteria. RESULTS: Group allocation significantly affected driving performance as assessed by the driving instructor and occupational therapist (p < 0.05). The driving instructor and occupational therapist scores were highly correlated (r = 0.76). Of the drivers who were scored as being unsafe, all were older and the majority (75%) had visual impairment. DISCUSSION: Older drivers with or without visual impairment were rated as being less safe than the younger and middle-aged drivers with normal vision.

Adult↗