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At least 703 records · Page 39Linked to original sources
PubMed2001

Impaired vision and other factors associated with driving cessation in the elderly: the Blue Mountains Eye Study.

The aim of present study was to review vision and other factors associated with the cessation of driving. As part of the Blue Mountains Eye Study, detailed demographic information, driving status and medical history were taken. Visual acuity was measured during a standardized refraction and visual fields documented. Potential risk factors were decided a priori. Among the 3654 Eye Study participants, 2831 (77.5%) had driven a motor vehicle in the past, of whom 2379 (84.0%) were current drivers and 452 (16.0%, 95% CI 14.6-17.4%) said they had stopped driving. Older persons and women were more likely to have stopped driving. After adjusting for age and sex, sensory impairment affecting vision and hearing, plus chronic medical conditions and benzodiazepine use were significantly associated with cessation of driving. The study found that sensory impairment, particularly visual parameters, was associated with the decision to stop driving by older subjects.

Aged↗
PubMed2000

[Are cross-eyed persons worse drivers? The effect of stereoscopic disparity on driving skills].

BACKGROUND: The motorist obtains about 90% of the information required to drive a vehicle from the sense of vision. In road traffic, various situations with respect to size, distance, and position have to be evaluated at different speeds. Does depth perception based on disparity play an essential role in these situations? METHODS: Each of ten subjects with defective stereopsis due to strabismus was compared with an age matched healthy control, who was also matched in yearly mileage, type of vehicle and duration of driving experience. After ophthalmological examination including stereotests for both distance and near, all subjects performed the following driving tests: (1) Stopping as close as possible in front of an obstacle, (2) reversing into a parking position, (3) driving a slalom parcours at the speed of 40 km/h, (4) estimating the relative position of two cars within a limited time while approaching them with 40 km/h. All tests were performed both under monocular (the non-leading eye covered) and binocular conditions. The sequence of the tests was randomized in order to minimize training effects. RESULTS: Comparing the driving performance of both groups, the controls performed significantly better (p < 0.01; ANOVA) only in the "slalom task". In "estimation of position" the controls performed significantly worse (p < 0.01; ANOVA) compared to their counterparts with defective stereopsis. A significant difference between the monocular and binocular performance was found only in the "stopping task", exclusively for the group of normals, benefitting from the binocular performance (p < 0.05; ANOVA). CONCLUSION: Stereopsis improves the driving performance only in dynamic situations at intermediate distances.

Adult↗
PubMed1980

[The concept of "drive" in German psychiatry (author's transl)].

Subject of this paper is the attempt to five a survey of the concept of "drive". Some approaches to a better understanding of drive are described: a general psychological way, a phenomenological-psychopathological way, a psychoanalytical way and a neurophysiological-neuropsychological way. The problem is discussed to seize the phenomenon of drive as a whole in contrast to the postulated numerous drives. Some clinical aspects are outlined. Finally, the suggestion is discussed to leave global characteristics as "drive" and better try--also in a clinical point of view--an exact recording in men of the drives as single phenomenons.

Drive↗
PubMed1998

[Driving behavior of patients before cataract operation--is an unlimited driver's license justifiable? Results of an analysis of 1,124 patients of the ophthalmology department of a central hospital].

BACKGROUND: The aim of the study was to evaluate the driving habits and patterns of those patients, who underwent cataract-surgery during a one year period at the Landesaugenklinik Salzburg and to compare the preoperative visual acuity with the legal requirements in effect in Austria. MATERIALS AND METHODS: The best-corrected visual acuity prior to surgery and the individual driving customs were noted on a detailed questionnaire. RESULTS: A minimum of 5.6% of the overall number of patients with cataract (not taking visual field defects into account) were driving a motor vehicle with a visual acuity not sufficient to meet current legal requirements. Considering only those drivers licence holders that admitted to still driving a motor vehicle it can be concluded that 26% have a legally unsatisfactory visual acuity. As between 28,000 and 31,000 cataract-operations are performed yearly in Austria, this study seems to clearly indicate that at least 1,600 of these persons--regardless of an additional visual field defect--are illegally driving a motor vehicle. It can be additionally concluded that the number of undetected cases is significantly higher. CONCLUSIONS: It therefore seems appropriate to call for a mandatory eye exam by a qualified ophthalmologist of all persons holding a driving licence, possibly beginning at the age of 60. The license issued thereafter should be valid for an age-related period of time only.

Accidents, Traffic↗
PubMed2001

Short cognitive/neuropsychological test battery for first-tier fitness-to-drive assessment of older adults.

Since fitness-to-drive evaluation of elderly drivers has become an important issue, we developed a short first-tier screening battery to evaluate the necessity for further referral to specialised centres. Our sample consisted of 84 subjects between 65 and 96 years who came to the Belgian Road Safety institute for a fitness-to-drive evaluation. Using cross-validated discriminant analyses, the predictive power of a battery consisting of the Trail Making Test, Part A, a visual acuity test, a clock drawing test, the Mini-Mental State Examination (MMSE) and age was analysed. The judgement by an independent driver instructor (fit-to-drive vs. not unconditional fit-to-drive), based on a real world road test was used as the dependent variable. Classification functions based on the significant discriminant function yielded a specificity score of 85% (subjects fit-to-drive correctly classified) and a sensitivity score of 80% (subjects as not unconditional fit-to-drive correctly classified). These results highlight the potential value of a short screening instrument that can be used in primary health care settings. This instrument may be useful as a first step in a multi-tier assessment procedure.

Aged↗
PubMed2000

Road-edge delineation in rural areas: effects on driving behaviour.

When driving on lower-category Dutch rural roads without any delineation, drivers are likely to drift off the road with their right-side wheels, thus incurring damage to the pavement edge or even leading to accidents. In two experiments, two types of road-edge delineation, with continuous or dashed edge lines, were compared with two control roads without lines or with only a dashed line on the road axis. The first experiment consisted of non-obtrusive video recordings of passing traffic. Vehicle position on the experimental roads was more to the road's centre than on the control roads. The second experiment was a driving test with an instrumented vehicle, during daytime lighting and during darkness. Again, vehicle lateral position was more central on the experimental roads, especially during darkness. Subjects could safely pass oncoming vehicles. Driving speed increased on the experimental roads compared with the unlined control road, but not beyond speeds found on the axis-lined control road. Driver's mental effort while driving over the experimental roads did not differ from the effort while driving over the control roads. Subjectively rated effort was higher for the unlined control road than for the three other roads. Subjects preferred the edge-lined roads to the unlined control road, but not more than the axis-lined control road. It was concluded that edge-lines may provide a simple and effective way of inducing a more favourable lateral position on rural roads without having negative effects on subjective appraisal, driving performance or mental workload.

Automobile Driving↗
PubMed1993

Decision-making style, driving style, and self-reported involvement in road traffic accidents.

In an exploratory postal survey of 711 drivers stratified by age, sex, annual mileage, and accident involvement, decision-making style was measured using a Decision-Making Questionnaire (DMQ) and driving style was assessed using a Driving Style Questionnaire (DSQ). Responses to 21 items of the DMQ formed seven independent and internally coherent dimensions according to a principal components (PC) analysis. These were labelled: control, thoroughness, instinctiveness, social resistance, hesitancy, perfectionism, and idealism. PC analysis also revealed that responses to 15 items of the DSQ formed six independent dimensions of driving style. These were labelled: speed, calmness, social resistance, focus, planning, and deviance. Multiple regression analysis indicated that drivers of 60 years and under who scored lower on thoroughness were at greater risk of a traffic accident and that this relationship was mediated by faster driving. This relationship was independent of age, sex, annual mileage and all other factors measured. In the drivers over 60 years, lower thoroughness, greater hesitancy, and faster driving were independently associated with higher accident rates independent of all other factors measured. The results provide preliminary support for the view that people import aspects of their general decision-making style into the driving situation, and that in so doing they put themselves at differential risk of having a road traffic accident.

Accidents, Traffic↗
PubMed1998

A psychophysiological investigation of the effects of driving longer-combination vehicles.

Fatigue contributes to driving-related accidents and fatalities. Cardiovascular measures such as heart rate and heart rate variability may serve as early indicators of fatigue. In the current investigation, 24 professional truck drivers drove three truck configurations: single trailer, triple trailer A-dolly, and triple trailer C-dolly on a standard route that lasted between 8 and 10 h. During the driving session, continuous measures of heart rate were quantified on-line. In addition to heart rate, two measures of heart rate variability (i.e. respiratory sinus arrhythmia and the Traube-Hering-Mayer wave or 0.1 Hz oscillation) were derived from the beat-to-beat heart rate. Independent of configuration, heart rate increased and the measures of heart rate variability decreased during the driving route. Only heart rate statistically differed among the configurations. Since heart rate is physiologically linked to metabolic output, the results suggest that the observed effect may be due to the physical demands required to drive each truck configuration. In support of this conclusion, the heart rate effect was consistent with the subjective report of task demand. The slowest heart rates were observed while driving the least demanding configuration (i.e. single trailer). The fastest heart rates were observed while driving the most demanding configuration (i.e. triple trailer A-dolly).

Adult↗
PubMed2006

The role of effort in moderating the anxiety-performance relationship: Testing the prediction of processing efficiency theory in simulated rally driving.

We tested some of the key predictions of processing efficiency theory using a simulated rally driving task. Two groups of participants were classified as either dispositionally high or low anxious based on trait anxiety scores and trained on a simulated driving task. Participants then raced individually on two similar courses under counterbalanced experimental conditions designed to manipulate the level of anxiety experienced. The effort exerted on the driving tasks was assessed though self-report (RSME), psychophysiological measures (pupil dilation) and visual gaze data. Efficiency was measured in terms of efficiency of visual processing (search rate) and driving control (variability of wheel and accelerator pedal) indices. Driving performance was measured as the time taken to complete the course. As predicted, increased anxiety had a negative effect on processing efficiency as indexed by the self-report, pupillary response and variability of gaze data. Predicted differences due to dispositional levels of anxiety were also found in the driving control and effort data. Although both groups of drivers performed worse under the threatening condition, the performance of the high trait anxious individuals was affected to a greater extent by the anxiety manipulation than the performance of the low trait anxious drivers. The findings suggest that processing efficiency theory holds promise as a theoretical framework for examining the relationship between anxiety and performance in sport.

Adult↗
PubMed2002

Driving after epilepsy surgery: effects of visual field defects and epilepsy control.

The aim of this study was to assess the eligibility to drive in patients with mesial temporal sclerosis who undergo anterior temporal lobectomy. The two major determinants in a patient's ability to drive after such surgery are visual field defects and their seizure frequency. Thirteen patients were selected. The postoperative seizure frequency was assessed using Engel's criteria. Automated static perimetry was performed which consisted of a Humphrey Field Analyser (HFA) 30-2 Test, one for each eye and a Binocular Esterman 120 Test. Seven out of the 13 (54%) selected patients had no seizures post-operatively (Engel's 1); three (23%) patients had less than two seizures per year (Engel's 2) and three (23%) had more than 90% improvement in the frequency of seizures (Engel's 3). The seven patients with no seizures postoperatively were eligible to apply for a driving licence. Automated static perimetry performed on the same patients revealed three (23%) had normal visual field or non-specific loss, seven (54%) had partial homonymous quadrantanopia, one (8%) had complete homonymous quadrantanopia and two (15%) had bilateral concentric loss attributable to vigabatrin, which may have masked any loss occurring due to surgery. Of the 13 patients, only seven (54%) passed the standardised DVLA Esterman visual field test. Of the six (46%) who failed DVLA Esterman visual field test, one had complete homonymous quadrantanopia, three had incomplete homonymous quadrantanopia and two had concentric loss (due to vigabatrin). Although seven (54%) patients passed the visual field test and seven (54%) patients were seizure free only five of the seven seizure-free patients (i.e. 38% of the total number of patients) had visual fields that would make them eligible to drive. As driving is now stated by patients' as a major factor that improves their quality of life, it is important to stress the significance of surgically induced or other iatrogenic visual field defects that may prevent them from driving prior to the operation to avoid disappointments afterwards.

Adult↗
PubMed2005

Neuropsychological assessment of geriatric driving competence.

PRIMARY OBJECTIVE: To review of studies that focus on the assessment of driving competence among the elderly who are at increased risk of being involved in automobile crashes. The current status of neuropsychological testing as a predictor of driving safety in this population is critically evaluated. MAIN OUTCOMES AND RESULTS: Several domains of neuropsychological assessment have been shown to be related to safe driving in older age groups, including vision-based testing, attention-based testing, and testing of executive functions. Use of a driving simulator to investigate crash risk has been particularly effective. CONCLUSIONS: The argument is made that a combination of test approaches be used to develop an algorithm for efficient screening of elderly drivers on a regular basis and that use of a driving simulator to measure driving performance under challenge should be incorporated as part of this evaluation.

Aged↗
PubMed2005

Return to driving after traumatic brain injury: a British perspective.

PRIMARY OBJECTIVE: To identify the current legal situation and professional practice in assisting persons with traumatic brain injury (TBI) to return to safe driving after injury. METHODS AND PROCEDURES: A brief review of relevant literature, a description of the current statutory and quasi-statutory authorities regulating return to driving after TBI in the UK and a description of the nature and resolution of clinical and practical dilemmas facing professionals helping return to safe driving after TBI. Each of the 15 UK mobility centres was contacted and literature requested; in addition a representative of each centre responded to a structured telephone survey. MAIN OUTCOME AND RESULTS: The current situation in the UK is described, with a brief analysis of the strengths and weaknesses both of the current statutory situation, and also the practical situation (driving centres), with suggestions for improvements in practice. CONCLUSION: Although brain injury may cause serious limitations in driving ability, previous drivers are not routinely assessed or advised regarding return to driving after TBI.

Adult↗
PubMed2000

An exploration of the drive for muscularity in adolescent boys and girls.

Much of the existing research on disordered eating has centered on the drive for thinness, which is most commonly observed in girls and women. The male standard of bodily attractiveness, however, is bigger, bulkier, and more muscular. Are boys and men motivated to be big and muscular in the same way that girls and women are motivated to be thin? The authors constructed a 15-item survey and administered it to 197 adolescents. The findings showed that the drive for muscularity measure displayed good reliability; that individuals high in the drive were more likely to be boys who were trying to gain both weight and muscle mass; that the drive was related to poor self-esteem and higher levels of depression among boys, but not among girls; and that the drive for muscularity was relatively unrelated to the drive for thinness.

Adolescent↗
PubMed2006

Characterizing driving patterns for Zhuhai for traffic emissions estimation.

Zhuhai, a relatively less developed city on the western coast of the Pearl River Delta (PRD) of China, is planning to undergo major development in coming years. A Hong Kong-Zhuhai-Macao Bridge project has been approved by the Central Government of China. The project will have great impact on the driving pattern and vehicular emissions to the city. This baseline study collected speed-time data of two instrumented private cars in morning and evening periods, as well as a daytime nonpeak period of >10 consecutive days in the spring and winter of 2003. The authors used the microwave speed sensor and global positioning system installed in the instrumented cars and used car-chasing technique to perform the data collection. They used the statistical package SPSS to assess the consistency, as well as to evaluate the variability of the data. Nine parameters, namely, average speed, average running speed, average acceleration rate, average deceleration rate, mean length of a driving period, time proportions of driving modes, average number of acceleration-deceleration changes, root mean square acceleration, and positive acceleration kinetic energy are calculated to represent the driving characteristics. A driving cycle for private cars was developed. If emission tests were conducted using the Zhuhai driving cycle, the level of vehicle emissions measured is likely to be in between that of the Federal Test Procedure (FTP) cycle and the Melbourne Peak cycle.

Automobile Driving↗
PubMed2007

Amnesia and driving.

Two experienced drivers who developed severe amnesia due to bilateral hippocampal lesions participated in a series of standardized challenges of driving performance and knowledge of driving rules. During drives in a high fidelity simulator and on the road in an instrumented vehicle, they demonstrated vehicle control similar to that of normal drivers on measures of steering, speed control, safety errors, and driving with distraction. Their knowledge of driving rules, safety procedures, and road sign meaning also was normal. However, both participants were impaired at following route directions, and both had unsafe responses in a difficult crash avoidance scenario on the simulator. These findings suggest that memory impairment acquired by experienced drivers does not impair most aspects of driving performance, but may increase safety risk under some challenging circumstances.

Amnesia↗
PubMed2005

The effect of a campus-community environmental alcohol prevention initiative on student drinking and driving: results from the "a matter of degree" program evaluation.

OBJECTIVE: Motor vehicle crashes involving alcohol are a major contributor to morbidity and mortality among college students in the United States. This study evaluates the effect on drinking and driving outcomes of the "A Matter of Degree" program, a campus-community coalition initiative to reduce college binge drinking. METHODS: We used a quasi-experimental longitudinal study design that compared student responses at 10 colleges participating in the program and students attending 32 similar colleges that did not participate in the program. We also divided the program sites into two groups of five according to their level of program implementation and compared each with the non-program colleges. We examined driving after any alcohol consumption and driving after five or more drinks among drinkers who drove one or more times a week per month and riding with a high or drunk driver among all students at these colleges beginning in 1997 through 2001. Outcomes were based on data collected from repeated cross-sectional surveys using the Harvard School of Public Health College Alcohol Study. Analyses were conducted using MLwiN multilevel statistical software. RESULTS: We found significant reductions in driving after drinking, driving after five or more drinks and riding with a high or drunk driver at the program colleges relative to the comparison colleges. Further analyses indicated that these reductions among the AMOD program colleges occurred at the sites with high program implementation relative to comparison sites, while no statistically significant change was noted at the program sites with low implementation. The program effect on the two drinking and driving outcomes appeared to be mediated by frequent binge drinking, while significant decline in the riding with an intoxicated driver outcome was not mediated by the individual's drinking. CONCLUSIONS: Campus-community based environmental alcohol prevention is a promising approach for reducing alcohol-impaired motor vehicle crashes among this population.

Adult↗
PubMed2005

Drug and drink driving by university students: an exploration of the influence of attitudes.

The present study aimed to gather information on drug and alcohol use, the prevalence of drink and drug driving and attitudes to both in an undergraduate university cohort (n = 275). Further, the study aimed to contribute information to aid intervention program development by determining predictors of drink and drug driving behavior. The study examines both drug and alcohol use and the influence of attitudes toward driving while under the influence of alcohol and/or drugs. Results indicated that significant proportions of university students are engaging in the risk-taking behavior of driving under the influence of drugs (25%), alcohol (14%), or both (8%). The results suggest that attitudes toward driving under the influence of alcohol and/or drugs are a strong predictor of engaging in the behavior. Peer influence emerged as a major aspect of attitudes. The results of this study provide an important beginning to understanding drink and drug driving and the influence of attitudes in the university student body.

Adolescent↗
PubMed2004

The effects of a nap opportunity in quiet and noisy environments on driving performance.

While napping has previously been shown to alleviate the effects of sleep loss, before advocating the use of naps in transport accident campaigns it is necessary to consider whether a nap opportunity in a noisy uncomfortable environment can produce the same benefits as a nap opportunity in conditions that are conducive to sleep. To examine this, eight participants drove a driving simulator for 50 min at 11:00h on three different test days. The simulator used has previously been found to be sensitive to the effects of sleep loss, alcohol consumption, and time of day. All three sessions were conducted after one night of sleep loss. Prior to driving during each session the participants either had a 60 min nap opportunity in a quiet or noisy environment, or no nap opportunity. Driving performance and reaction time while driving were measured, as were subjective sleepiness and ratings of sleep quality. No significant benefits of nap opportunities on driving performance were found. Levels of subjective sleepiness were not affected by the nap opportunity condition; however, sleep was rated as more refreshing and restful after a nap in a quiet environment compared to noisy environment. The measures of effect size reported suggest further research is required to unequivocally test the effects of nap opportunities on driving ability.

Accidents, Traffic↗