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At least 793 records · Page 44Linked to original sources
PubMed1997

An evaluation of the effectiveness of alcohol treatment, driver license actions and jail terms in reducing drunk driving recidivism in California.

AIM: There has been long-standing interest in determining which sanctions work best to reduce drunk driving. This study examines the effectiveness of alcohol treatment, driver license actions and jail terms in reducing drunk-driving recidivism. DESIGN: This quasi-experimental study examines the relationships between the sanctions that drivers convicted of driving-under-the-influence (DUI) receive and their subsequent reconviction of DUI, while statistically controlling for pre-existing differences among groups receiving different sanctions. Separate analyses were conducted for subjects having 0, 1 or 2 or more prior DUI convictions on their driving record. SETTING: The study analyzes drunk driving reacidivism throughout the state of California. Participants. All drivers holding a California driver license who were convicted of DUI by a California court during 1990 and 1991 were selected for inclusion in the study. MEASUREMENTS: A number of demographic, prior personal driving history and surrogate traffic environment measures were collected and used as covariates in the analyses. Data were also gathered on subsequent DUI reconvictions, and the number of days to first subsequent DUI reconviction, and used as outcome variables in the study. FINDINGS: Results of the analyses showed that for all levels of prior DUI convictions, combining alcohol treatment with either driver license restriction or suspension is associated with the lowest DUI recidivism rates. CONCLUSIONS: Based on this research, and the results of prior studies, it can be persuasively argued that combining license actions with alcohol treatment represents the most effective sanction combination for combating DUI recidivism.

Alcohol Drinking↗
PubMed1998

[Continued driving habits of patients diagnosed with excessive daytime sleepiness].

OBJECTIVE: Description of driving behaviour of patients with excessive daytime sleepiness (EDS) and the influence on their driving of diagnosis, therapy, legal guidelines and advices. DESIGN: Inventory based on questionnaires. SETTING: Centre for Sleep and Wake Disorders, The Hague, the Netherlands. METHODS: All patients with EDS who were in a stable condition for at least 6 months after therapy were sent a questionnaire (n = 138). The questions concerned actual driving behaviour, EDS and the effects of diagnosis, therapy and advice given by the Centre. RESULTS: The response was 67% (n = 92). Eighteen patients had never driven a car. Eighteen of the other 74 patients quit driving or drove less. Fifty-six patients did not change their behaviour or drove even more. There was little effect on driving behaviour of diagnosis, therapy and advice to stop driving. CONCLUSION: Patients with EDS often participate as drivers in modern traffic. Legal guidelines and advice given by physicians have only little influence on this behaviour. As general measures seem to be ineffective, approaches tailored to the individual patient may lead to more acceptable results.

Adolescent↗
PubMed1997

[Opioids and driving ability].

INTRODUCTION: Clinical observations of patients under oral opioid treatment suggest that the initially appearing central side effects such as sedation, dizziness or drowsiness decrease after a few weeks of treatment. However, it is still unclear whether long-term treatment with opioids impairs complex psychomotor functions such as driving a car. METHODS: Twenty patients on stable dosages of oral opioids were examined using a driving simulator. The patients were regular car drivers and not older than 70 years. Additionally, every patient had to complete a questionnaire for mental condition and vigilance and the "d II" letter cancellation task. Control groups tested in the same way were: patients before an elective operation after taking benzodiazepines for sedation, volunteers after alcohol consumption (0.80 per thousand ), physicians on call with less than 4 h of sleep and healthy volunteers without any medication. RESULTS: Some of the patients treated with opioids reacted as fast as medication-free volunteers. There were no significant differences between the reaction times of older patients (>50 years) receiving opioids in comparison to the group of older healthy volunteers. The same result was obtained in the letter cancellation task. No differences could be seen between medication-free volunteers and patients receiving opioids with regard to tasks of visual or motor control skills. The volunteers under influence of alcohol and the patients under benzodiazepines had a considerable decrease in performance. CONCLUSIONS: Long-term therapy with opioids does not inevitably impair complex skills, but the decision to permit driving a car can only be made in the individual case. PRACTICAL RECOMMENDATIONS: At the beginning of therapy with opioids the physician has to fulfil his duty to inform the patient of any possible dangers of treatment. From the medical point of view, driving must be prohibited until a stable opioid dosage is reached. Any changes in dosage (increase, reduction), change of the opioid and poor general condition independent of the opioid therapy must result in prohibition of car driving. Continuous control of the therapy with documentation is a duty of the physician. The written documentation should include the patients' physical and mental condition, side effects and the therapeutic result. From the medical point of view, driving can be possible when dosage treatment and general condition remain stable. In any case, the doctor has to remind the patient of the responsibility of critical self-examination. In doubt, special performance investigation should be taken into consideration.

English Abstract↗
PubMed1987

Influence of the cycle length of basic drive on induction of sustained ventricular tachycardia associated with coronary artery disease.

The relation between the cycle length of basic drive during programmed ventricular stimulation and the coupling intervals at which sustained monomorphic ventricular tachycardia (VT) was initiated was analyzed in patients with coronary artery disease and documented sustained VT. The study included 28 patients in whom hemodynamically tolerable, monomorphic sustained VT was inducible at different cycle lengths of basic drive during the same electrophysiologic study. The stimulation protocol included single or double premature stimuli during paced ventricular rhythms at different cycle lengths of basic drive. The coupling intervals of premature stimuli for induction of VT (considered the outer margin of the echo zone) during step 1 of the stimulation protocol (basic drive at cycle lengths of 500 or 430 ms) were compared with those during step 2 (basic drive at cycle lengths of 370 or 330 ms). The mean cycle length of induced sustained VT was 370 +/- 79 ms. The mode of induction of VT remained the same in 23 patients (single or double premature stimuli); in 5 patients, fewer premature stimuli were required during step 2 than step 1. By moving from step 1 to step 2, VT could be induced at longer coupling intervals of the premature stimuli in 23 patients (82.1%). The mean increase in the sum of the coupling intervals was 52 +/- 37 ms. In 5 patients, the coupling intervals either did not change from step 1 to step 2 (n = 1) or decreased by an average of -40 +/- 14.1 ms. The results suggest that inducibility of VT is favored by a decrease in the cycle length of basic drive.(ABSTRACT TRUNCATED AT 250 WORDS)

Aged↗
PubMed1984

Reflex hypoxic drive to respiration during the menstrual cycle.

We studied a maximum fall in VE (max delta VE) produced by 20 sec O2 breathing and its percentage of resting VE (reflex hypoxic drive) on 9 menstruating women, in order to examine menstrual phase effect on reflex hypoxic drive. During the luteal phase, resting PAO2 was higher by 4.8 mm Hg and PACO2 was lower by 3.0 mm Hg than during the follicular phase. In spite of these changes in the alveolar gases, reflex hypoxic drive was greater in the luteal phase (14.4%) than in the follicular phase (9.3%). Resting VE in the luteal phase was 7.8% greater than that in the follicular phase. Contribution of the augmented hypoxic drive to the increased resting VE in the luteal phase, calculated as delta (max delta VE)/delta VE (%), was 59 +/- 29% (mean +/- SE). These results suggest that progesterone-induced hyperventilation, as occurs in the luteal phase, is elicited partly by mediating an increase in reflex hypoxic drive which is probably produced centrally even in hyperoxia and hypocapnia, but the role of augmented hypoxic drive is highly variable among subjects.

Adult↗
PubMed2006

The 'drive for activity' and "restlessness" in anorexia nervosa: potential pathways.

This paper discusses the hypothesis that a 'drive for activity" in the presence of physiological and endocrine changes consistent with starvation is a characteristic symptom of acute anorexia nervosa (AN). This 'drive for movement', along with alertness and lack of fatigue, so unlike the motor slowing and loss of energy observed in simple starvation has been recognized in AN throughout history, but has received little attention in the past fifty years. Clinical reports and experimental evidence suggest that 'restlessness' and a 'drive for activity' vary in intensity, they appears to be starvation-dependent and to wane with food intake. Central nervous system (CNS) systems known to be involved in mediating activity and arousal levels that are altered by the negative energy expenditure in AN are reviewed. Among these, the corticotropin-releasing hormone (CRH) system, the melanocyte stimulating hormone/agouti-related protein (MSH/AGRP) system and the norepinephrine/epinephrine (NE/EPI) and dopamine (DA) system may contribute to the 'drive for activity' and alertness in AN. AN appears to represent a disorder of gene/environment interaction. Future research will reveal whether in individuals predisposed to AN, the 'drive for activity' reflects the reactivation of mechanisms important in food scarcity, controlled by one or more evolutionary conserved genes including those regulating foraging behavior. Recognition of the 'drive for activity' as a diagnostic symptom of AN and its assessment prior to re-nutrition would permit clarification of its role in the etiology of AN.

Anorexia Nervosa↗
PubMed2006

Synergetic driving concepts for bundled miniature ultrasonic linear motors.

Rotary ultrasonic motors have found broad industrial application in camera lens drives and other systems. Linear ultrasonic motors in contrast have only found limited applications. The main reason for the limited range of application of these very attractive devices seems to be their small force and power range. Attempts to build linear ultrasonic motors for high forces and high power applications have not been truly successful yet. To achieve larger force and higher power, multiple miniaturized motors can be combined. This approach, however, is not as simple as it appears at first glance. The electromechanical behaviour of the individual motors differs slightly due to manufacturing and assembly tolerances. The individual motor characteristics are strongly dependent on the driving parameters (frequency, voltage, temperature, pre-stress, etc.) and the driven load and the collective behaviour of the swarm of motors is not just the linear superposition of the individual drive's forces. Thus, the bundle of motors has to be synchronized and controlled appropriately in order to obtain an optimized drive that is not oversized and costly. We have investigated driving and control strategies of a set of linear ultrasonic motors. Our contribution will be divided into three main parts. In part I ultrasonic linear motors will be introduced. In part II driving strategies for a single motor as well as for a bundle of motors will be presented. These concepts will be verified by simulation results and experimental data. In part III a simplified model for the motor's electromechanical behaviour will be given.

Journal Article↗
PubMed2001

Alcohol/drug abuse, driving convictions, and risk-taking dispositions among trauma center patients.

The objective of this study was to evaluate the relationship between alcohol/drug abuse diagnoses, driving convictions (speeding, reckless driving, impaired driving, license violations), and risk-taking dispositions among a series of injured drivers admitted to a trauma center. The driving records of 778 patients were linked to diagnoses of psychoactive substance use disorders (PSUDs), admission blood alcohol concentration (BAC), mode of injury, and results of a risk-taking disposition survey. Twenty-nine percent of patients had one or more convictions in the 3 years before injury. Types of violation were not related to mode of injury. Although there was a positive association between prior impaired-driving convictions, current alcohol dependence, and a BAC + status, a consistent pattern relative to other violations, PSUDs, and BAC status was not apparent. Risk-taking disposition scale scores indicated that patients without PSUDs and without convictions tended toward less risk-taking behavior than patients with PSUDs and with convictions. The complex inter-relationships between PSUDs, risk-taking dispositions, and being convicted of driving dangerously require additional study so that intervention programs and injury prevention initiatives can be targeted effectively.

Accidents, Traffic↗
PubMed1997

Young male drinkers and impaired driving intervention: results of a U.S. telephone survey.

The present study examines the role of interveners in the driving behavior of a group of drivers at higher risk for involvement in a fatal, alcohol-related motor vehicle accident than the general population, based on their demographic characteristics. The sample consisted of men, aged 21-34 years, living in areas where alcohol-involved motor vehicle fatalities most commonly occur. More than one-half (55%) of these men reported having been the target of an intervention to prevent them from drinking and driving. The variables most strongly associated with having been the target of an intervention were: involvement in an accident after drinking; frequency of driving after drinking too much to drive safely; binge drinking; reporting that it takes ten or more drinks to feel drunk. Age, total alcohol consumption and the relationship between the target and the intervener predicted intervention success. Persons who have close relationships with drinking drivers, particularly wives/girlfriends, are most likely to be successful in preventing these men from drinking and driving. To the extent they can be encouraged to safely intervene, wives/girlfriends and close friends may be potential targets for messages promoting informal social control of drinking and driving.

Accidents, Traffic↗
PubMed1998

Drive-up liquor windows and convicted drunk drivers: a comparative analysis of place of purchase.

This study examined alcohol purchase locations of convicted drunk drivers to determine the characteristics and arrest circumstances of offenders who bought alcohol at a drive-up liquor window compared with those who obtained alcohol elsewhere. Logistic regression analyses were used to assess the relationship between purchase location and the characteristics of 2,544 drunk drivers convicted in Santa Fe, NM, from 1986 to 1995. Analyses were performed to determine whether the place of purchase was related to arrest circumstances. The results revealed that drive-up windows were the preferred place of purchase of package liquor by offenders who bought the alcohol that they drank prior to arrest. The odds of being Hispanic (p < 0.0001), a high-risk problem drinker (p < 0.01), and drinking in the vehicle prior to arrest (p < 0.01) were significantly higher for drive-up window users than for offenders who purchased package liquor elsewhere. Based on these analyses, this study concludes that a statistically significant relationship exists between the use of drive-up windows and certain high-risk drinking behaviors. This increased use among vulnerable populations suggests that drive-up windows may facilitate alcohol misuse in these populations and thereby contribute to drunk driving.

Accidents, Traffic↗
PubMed1997

Relationship between motor unit short-term synchronization and common drive in human first dorsal interosseous muscle.

We assessed the strength of motor unit (MU) short-term synchronization and common fluctuations in mean firing rate (common drive) in the same pairs of MUs in order to evaluate whether these features of voluntary MU discharge arise from a common mechanism. Shared, branched-axon inputs, with the most important being widely divergent monosynaptic projections to motoneurons from motor cortical cells, are regarded as the principal determinants of MU short-term synchronization. It is not known to what extent these synaptic inputs are responsible for common drive behaviour of MUs. MU spike trains from 77 pairs of concurrently active MUs in first dorsal interosseous muscle of 17 subjects were discriminated with the high reliability needed for common drive analysis. For each MU pair, the data used for comparison of the two analyses of correlated MU discharge came from a single trial (1-5 min duration) of isometric abduction of the index finger. Linear regression revealed a weak, significant positive correlation between the strength of MU short-term synchronization and the strength of common drive in the MU pairs (r2 = 0.06, P < 0.05, n = 77), which was slightly stronger when MU pairs with broad synchronous peaks (> 20 ms) were excluded (r2 = 0.09, P < 0.05, n = 63). These data suggest that less than 10% of the variation in the strength of common drive exhibited by pairs of MUs could be accounted for by differences in the strength of MU short-term synchronization. These two phenomena are therefore likely to arise predominantly from separate mechanisms. At least under these task conditions, the widely divergent, branched-axon inputs from single corticospinal neurons which are important in the generation of MU short-term synchronization play only a minor role in the production of common drive of MU discharge rates.

Adolescent↗
PubMed2003

Non-driving intersegmental knee moments in cycling computed using a model that includes three-dimensional kinematics of the shank/foot and the effect of simplifying assumptions.

Assessing the importance of non-driving intersegmental knee moments (i.e. varus/valgus and internal/external axial moments) on over-use knee injuries in cycling requires the use of a three-dimensional (3-D) model to compute these loads. The objectives of this study were: (1) to develop a complete, 3-D model of the lower limb to calculate the 3-D knee loads during pedaling for a sample of the competitive cycling population, and (2) to examine the effects of simplifying assumptions on the calculations of the non-driving knee moments. The non-driving knee moments were computed using a complete 3-D model that allowed three rotational degrees of freedom at the knee joint, included the 3-D inertial loads of the shank/foot, and computed knee loads in a shank-fixed coordinate system. All input data, which included the 3-D segment kinematics and the six pedal load components, were collected from the right limb of 15 competitive cyclists while pedaling at 225 W and 90 rpm. On average, the peak varus and internal axial moments of 7.8 and 1.5 N m respectively occurred during the power stroke whereas the peak valgus and external axial moments of 8.1 and 2.5 N m respectively occurred during the recovery stroke. However, the non-driving knee moments were highly variable between subjects; the coefficients of variability in the peak values ranged from 38.7% to 72.6%. When it was assumed that the inertial loads of the shank/foot for motion out of the sagittal plane were zero, the root-mean-squared difference (RMSD) in the non-driving knee moments relative to those for the complete model was 12% of the peak varus/valgus moment and 25% of the peak axial moment. When it was also assumed that the knee joint was revolute with the flexion/extension axis perpendicular to the sagittal plane, the RMSD increased to 24% of the peak varus/valgus moment and 204% of the peak axial moment. Thus, the 3-D orientation of the shank segment has a major affect on the computation of the non-driving knee moments, while the inertial contributions to these loads for motions out of the sagittal plane are less important.

Adolescent↗
PubMed2002

Motoneuronal drive during human walking.

Recent technical advances have made it possible to reveal some of the inputs that drive spinal motoneurones during normal human walking. These techniques are based either on a temporary removal of the drive to the motoneurones or on an analysis of the coupling of motor unit activity. During walking a sudden unloading of the plantarflexor muscles leads to a pronounced drop in the soleus EMG activity. This unloading effect is caused by cessation of activity in the sensory afferents, which mediate positive feedback from the active muscles in the stance phase. Somewhat surprisingly the drop in EMG activity following unloading is still observed when Ia afferents are blocked, suggesting that these afferents do not make an important contribution to the motoneuronal drive. It would seem that gr. Ib and/or gr. II afferents are the main contributors to the positive feedback. It has been known for a long time that transcranial magnetic stimulation (TMS) at low intensities may selectively activate local inhibitory circuits in the cortex. At such low intensities TMS applied over the motor cortex may thus inhibit the output from the cortex. The removal of the corticospinal drive in this way may be revealed as a drop in EMG activity from the active muscle. During walking TMS may evoke such a drop in EMG activity from the active muscles, which demonstrates that the corticospinal tract makes a contribution to the muscle activity. Time- and frequency domain analysis of motor unit activity have been shown to be effective tools in the analysis of synaptic drive to spinal motoneurones during tonic voluntary contraction. Applying these techniques to human walking reveals that motor units recorded from the same muscle or from close synergists show short-term synchrony and coherence in the 15-20 Hz frequency band. However, motor units from muscles acting at different joints show no coupling. This suggests that leg muscles are generally activated relatively independently of each other during human walking. These techniques show great promises for revealing changes in the sensory and corticospinal drive to motoneurones in relation to different tasks as well as in patients after injury to the central motor system.

Animals↗
PubMed2003

The meiotic drive system on maize abnormal chromosome 10 contains few essential genes.

In maize, a distal portion of abnormal chromosome 10 (Ab10) causes the meiotic drive of itself as well as many unlinked heterochromatic regions known as knobs. The Ab10 drive system, which encodes trans- as well as cis-acting components, occupies a large region of chromosome 10L equivalent to approximately 3% of the genome. Here we describe five new structural mutations of Ab10 (five deletions and a duplication) that arose from a screen for meiotic drive mutants. The high frequency of breakage events, detected both genetically and cytologically, suggest that the chromosome may be especially unstable. Very large deletions within the drive system are female-transmissible and plants homozygous for deficiencies lacking much of this interval can be grown to maturity. The data suggest that few genes required for normal growth and development lie within the portion of Ab10 responsible for meiotic drive. These and other published data suggest that meiotic drive systems tend to evolve in gene-sparse or otherwise information-poor regions of the genome where they are less likely to negatively affect individual fitness.

Chromosome Aberrations↗
PubMed1997

Prevalence and effectiveness of self-regulatory techniques used to avoid drunk driving.

Research suggests that drinkers often use personal self-regulatory techniques to avoid drunk driving. A population-representative sample of 427 people at high risk of drunk driving were interviewed to examine the extent to which they used self-regulatory techniques. Most popular techniques were limiting drinks to a predetermined number, organizing another driver, catching a taxi, and spontaneously delaying or avoiding driving after alcohol has been consumed. After controlling exposure to demographic and drinking behavior variables, limiting drinks to a predetermined number was the only technique associated with a reduced likelihood of drunk driving. Respondents who used taxis and drank low-alcohol beer were more likely to report drunk driving, as were those who spontaneously decided to delay or avoid driving after drinking. Although interpretation of the findings is constrained by the cross-sectional survey methodology, further investigations may lead to the development of countermeasures which promote the use of appropriate techniques.

Accidents, Traffic↗
PubMed2001

Regulation of appetite: role of leptin in signalling systems for drive and satiety.

BACKGROUND: The healthy regulation of appetite involves a balance between excitatory (drive) and inhibitory (satiety) processes. For many years research has concentrated on the identification of signalling systems that mediate satiety to the relative exclusion of drive-inducing biological events. However, the so-called long-term regulation of body weight has recently been given substance by the identification of a chemical signal believed to link the brain with adipose tissue stores. ANALYSIS: This signal, leptin, is in position to modulate the expression of a drive to eat. Studies on the relationship between leptin and perceived hunger, and on the eating behaviour of leptin-deficient individuals, are consistent with the intervention of leptin in a drive system. The contrast between the roles of leptin and serotonin in appetite regulation reflects the difference between drive-signalling and satiety signalling processes. CONCLUSION: It is proposed that leptin modulates the drive signals arising from the metabolic demand for energy but also shows some properties of a post-prandial satiety signal.

Animals↗
PubMedDate not supplied

Patient-related blood drives.

Ten patient-related blood drives were evaluated and compared to five other blood drives. The patient-related blood drives were easier to organize, more fruitful, and more satisfying for the donors and workers. The authors suggest a role for patient-related blood drives in the present recruitment system and discuss how hospitals and blood centers can coordinate their efforts to have this type of blood drive. Finally, it is suggested that patient-related blood drives can increase recruitment, especially in large metropolitan areas that suffer from chronic blood shortages.

Adult↗
PubMedDate not supplied

Flexible adaptation to changing task demands in severe closed head injury patients: a driving simulator study.

The assessment of fitness to drive in patients with closed head injury (CHI) does not usually include executive functioning. Executive functions may be particularly important for the tactical (e.g. anticipatory adaptation of speed) and strategical (e.g. choice of route and time) aspects of driving. The literature lacks evidence on the tactical aspects, which are critical in the assessment of actual driving. Executive functioning was therefore assessed in a task context relevant to tactical decision making in driving. Twenty very severe chronic CHI patients and 20 healthy control subjects were tested with a driving simulator test and an extended neuropsychological test battery. In the driving simulator test, executive function was operationally defined as the flexible adaptation to changing task demands. A specific feature of the test was the experimental control for slow information processing, a persistent sequel of severe CHI. Given this control for slow information processing, it was found that patients were unimpaired in their flexible adaptations. Similar findings were obtained with a neuropsychological test battery. Patients were consistently slower, but planning and flexibility were found to be unimpaired.

Journal Article↗