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PubMed2004

The use of a cognitive battery to predict who will fail an on-road driving test.

OBJECTIVES: There is a growing need to find a valid and reliable neuropsychological battery to screen out those people who are clearly unsafe to drive following brain injury or pathology, and thus alleviate the need to refer for an on-road assessment. DESIGN: A battery of cognitive tests fine-tuned for their relevance to driving was examined in terms of its sensitivity and specificity for predicting who would fail an on-road test following brain injury or pathology. METHOD: Performance on the battery was compared to the results of an on-road driving test in a consecutive series of 142 clients referred to a driving assessment centre following brain injury or pathology. The group represented diverse neurological conditions which affect brain functioning. RESULTS: The overall accuracy rate of the battery in predicting a fail on-road was 92% and in predicting a pass on road was 71%. It was more accurate for those under 70 with 100% accuracy in predicting a fail on-road and 85% accuracy in predicting a pass on-road, but less accurate for those aged 70 or above with 85% accuracy in predicting a fail on-road and 37% accuracy in predicting a pass on-road. CONCLUSION: The battery is a useful tool in helping to determine whether someone is safe to drive following brain injury but needs to be used with far more caution for the older driver.

Adult↗
PubMed2000

Effects of vehicle interior geometry and anthropometric variables on automobile driving posture.

The effects of vehicle package, seat, and anthropometric variables on posture were studied in a laboratory vehicle mockup. Participants (68 men and women) selected their preferred driving postures in 18 combinations of seat height, fore-aft steering wheel position, and seat cushion angle. Two seats differing in stiffness and seat back contour were used in testing. Driving postures were recorded using a sonic digitizer to measure the 3D locations of body landmarks. All test variables had significant independent effects on driving posture. Drivers were found to adapt to changes in the vehicle geometry primarily by changes in limb posture, whereas torso posture remained relatively constant. Stature accounts for most of the anthropometrically related variability in driving posture, and gender differences appear to be explained by body size variation. Large intersubject differences in torso posture, which are fairly stable across different seat and package conditions, are not closely related to standard anthropometric measures. The findings can be used to predict the effects of changes in vehicle and seat design on driving postures for populations with a wide range of anthropometric characteristics.

Anthropometry↗
PubMed2002

Effect of a concurrent auditory task on visual search performance in a driving-related image-flicker task.

The effect of a concurrent auditory task on visual search was investigated using an image-flicker technique. Participants were undergraduate university students with normal or corrected-to-normal vision who searched for changes in images of driving scenes that involved either driving-related (e.g., traffic light) or driving-unrelated (e.g., mailbox) scene elements. The results indicated that response times were significantly slower if the search was accompanied by a concurrent auditory task. In addition, slower overall responses to scenes involving driving-unrelated changes suggest that the underlying process affected by the concurrent auditory task is strategic in nature. These results were interpreted in terms of their implications for using a cellular telephone while driving. Actual or potential applications of this research include the development of safer in-vehicle communication devices.

Adult↗
PubMed1999

Young novice driver subtypes: relationship to high-risk behavior, traffic accident record, and simulator driving performance.

Two studies were undertaken to obtain empirical support for the existence of driver subtypes in the young novice driver population. In Study 1, 198 participants (55% male) aged 16 to 19 completed an extensive self-report questionnaire. Five novice driver subtypes were identified through a cluster analysis of personality and driving-related measures. Two relatively high-risk or deviant subtypes (Clusters 1 and 5) were identified, characterized by high levels of driving-related aggression, competitive speed, driving to reduce tension, sensation seeking, assaultiveness, and hostility. The individuals in Cluster 5 also reported low levels of emotional adjustment and high levels of depression, resentfulness, and irritability. In Study 2, a subset of participants from each of the subtypes drove several scenarios in a driving simulator. The subtypes differed in their responses to an emergency situation and several potential traffic hazards. They also differed in the proficiency with which they could control their attention among concurrent tasks in high-workload situations. Most of the significant differences were related to lower levels of driving skill among the two most deviant subtypes (Clusters 1 and 5). The potential applications of this research include the design of training programs and other countermeasures to address the young novice driver crash problem.

Accidents, Traffic↗
PubMed2004

Relationship of retinal structural and clinical vision parameters to driving performance of diabetic retinopathy patients.

This study identifies clinical vision measures or retinal structural measures associated with the driving performance of diabetic retinopathy patients. Twenty-five licensed drivers with diabetic retinopathy (median age, 53 years; range, 34-72 years) completed clinical tests (visual acuity, letter contrast sensitivity, and Humphrey 30-2 visual fields) and structural examinations (retinal thickness analysis and fundus photograph grading of retinopathy and laser scarring). Driving performance was assessed with an interactive driving simulator and a driving history questionnaire. Increased retinal thickness was significantly correlated with a higher frequency of simulator accidents and near accidents. Laser scar grades significantly correlated with steeper brake-response slopes, increased brake-pressure standard deviation (SD), and longer response times. Subjects with focal laser scars had significantly higher average brake-pedal pressure and brake-pressure SD than subjects without focal laser scars. Retinal thickness and laser scarring correlated with driving simulator performance in subjects with diabetic retinopathy.

Accidents, Traffic↗
PubMed1993

The failure of feedback on alcohol impairment to reduce impaired driving.

We examined the effects of rules to govern drinking, individual feedback on blood alcohol concentration (BAC), and public posting of group data on impaired driving on the incidence of impaired driving. Level of impairment was determined from breath samples taken from tavern patrons. Following baseline, an intervention package consisting of (a) cards to guide patrons in pacing their drinking to stay under the legal limit, (b) individual feedback on BAC, and (c) posted group feedback on the percentage of patrons driving while impaired the preceding week was introduced in two taverns. Results indicated that the intervention package did not reduce the percentage of impaired drivers departing either tavern. The addition of a brief intensive police enforcement program directed at impaired driving produced a short-term reduction in impaired driving.

Alcohol Drinking↗
PubMed2001

A technology to measure multiple driving behaviors without self-report or participant reactivity.

An in-vehicle information system (IVIS) was used to videotape drivers (N = 61) without their knowledge while driving 22 miles in normal traffic. The drivers were told that they were participating in a study of direction following and map reading. Two data-coding procedures were used to analyze videotapes. Safety-related behaviors were counted during consecutive 15-s intervals of a driving trial, and the occurrence of certain safety-related behaviors was assessed under critical conditions. These two methods of data coding were assessed for practicality, reliability, and sensitivity. Interobserver agreement for the five different driving behaviors ranged from 85% to 95%. Within-subject variability in safe driving was more pronounced among younger drivers and decreased as a function of age. Contrary to previous research that has relied on self-reports, driver risk taking did not vary significantly as a function of gender. These results are used to illustrate the capabilities of the technology introduced here to design and evaluate behavior-analytic interventions to increase safe driving.

Adolescent↗
PubMed2005

Persistence of effects of the Checkpoints program on parental restrictions of teen driving privileges.

OBJECTIVES: We describe intervention effects on parent limits on novice teenage driving. METHODS: We recruited parents and their 16-year-old children (n = 469) with learner's permits and randomized them from August 2000 to March 2003. Intervention families received persuasive newsletters related to high-risk teenage driving and a parent-teenager driving agreement; comparison families received standard information on driver safety. We conducted interviews when the adolescents obtained a learner's permit, upon licensure, and at 3, 6, and 12 months postlicensure. RESULTS: Intervention parents and teenagers reported stricter limits on teen driving compared with the comparison group at 12 months, with direct effects through 3 months and indirect effects through 12 months postlicensure. CONCLUSIONS: A simple behavioral intervention was efficacious in increasing parental restriction of high-risk teen driving conditions among newly licensed drivers.

Accidents, Traffic↗
PubMed2006

Driving status and risk of entry into long-term care in older adults.

OBJECTIVES: Given the importance of driving in American society, older non-drivers may be unable to meet basic needs while living independently. We assessed whether not driving is an independent risk factor for entering long-term care (LTC) institutions. METHODS: Data were used from 1593 older adults who participated in the Salisbury Eye Evaluation cohort study and completed an additional telephone survey. Questions on driving status and LTC entry were obtained by self/proxy report. Cox time-dependent regression procedures were used to adjust for demographic and health factors. RESULTS: Former and never drivers had higher hazards of LTC entry after adjustment for demographic and health variables (hazard ratio [HR]=4.85; 95% confidence interval [CI]=3.26, 7.21; and HR=3.53; 95% CI=1.89, 6.58, respectively). Also, having no other drivers in the house was an independent risk factor for LTC entry (HR=1.72; 95% CI=1.15, 2.57).Discussion. Older adults are expected to make good decisions about when to stop driving, but the hardships imposed on older adults by not driving are not widely recognized. Innovative strategies to improve transportation options for older adults should be considered.

Activities of Daily Living↗
PubMed2004

Knee pain and driving duration: a secondary analysis of the Taxi Drivers' Health Study.

OBJECTIVES: We explored a postulated association between daily driving time and knee pain. METHODS: We used data from the Taxi Drivers' Health Study to estimate 1-year prevalence of knee pain as assessed by the Nordic musculoskeletal questionnaire. RESULTS: Among 1242 drivers, the prevalence of knee pain, stratified by duration of daily driving (< or = 6, > 6 through 8, > 8 through 10, and > 10 hours), was 11%, 17%, 19%, and 22%, respectively. Compared with driving 6 or fewer hours per day, the odds ratio of knee pain prevalence for driving more than 6 hours per day was 2.52 (95% confidence interval = 1.36, 4.65) after we adjusted for socioeconomic, work-related, and personal factors in the multiple logistic regression. CONCLUSIONS: The dose-related association between driving duration and knee pain raises concerns about work-related knee joint disorders among professional drivers.

Absenteeism↗
PubMed1994

Underage female DUI offenders: personality characteristics, psychosocial stressors, alcohol and other drug use, and driving-risk.

164 underage female DUI offenders were evaluated on measures of personality, driving-risk, psychosocial stressors, alcohol and other drug use, alcohol abuse, and symptoms of depression. Empirical classification of 10 groups represented five distinct types. 31 youth who were classified as Antisocial exhibited highest rates of alcohol misuse, other drug use, deviant driving behavior, traffic offenses and accidents, and psychosocial stressors. About 56% or 92 appeared to experience impaired functioning serious enough to warrant interventions more intense than educational classes. A measure of driving-risk developed and used in studies of male adults, the Donovan Research Questionnaire, did not appear to differentiate driving-risk among the young women. In contrast to male drivers, who often expressed anger or aggression through driving, most subjects appeared to react to emotion-eliciting stimuli with feelings of low self-worth or dysphoric affect rather than anger. Specialized screening suitable for young female DUI offenders should be considered.

Accidents, Traffic↗
PubMed1977

Driving records before and during methadone maintenance.

We compared the motor vehicle driving records of 104 former heroin users during 1 year of heroin use before admission to methadone maintenance with their records during 1 year after admission while they were maintained on methadone. We found a statistically significant increase in convictions for speeding from the year on heroin to the year on methadone, but no significant change in convictions for negligent collision, other moving violations, driving without a license, and in accidents. The results suggest that heroin users have slightly better driving records on heroin than they do on methadone, possibly because on heroin they drive with special care to avoid arrest. The frequency with which our subjects were involved in accidents did not differ significantly from that of all Texas licensed drivers. On the basis of this study we recommend no restriction of the driving privilege of persons maintained on methadone.

Automobile Driving↗
PubMed1995

Driving appliances for upper limb amputees.

The advice given to upper limb amputees in the United Kingdom with regard to the use of driving appliances has often been somewhat variable. At best a full rehabilitation package has been provided, including the fitting of the appliances to the person's vehicle and contact with the driver's instructor, to the other extreme of issuing driving appliances to patients with no instruction at all. Though upper limb amputations are not a relevant or prospective disability, all drivers with a "limb disability" are legally required, in the UK, to declare changes in their physical state to the Driver and Vehicle Licensing Agency. This study examines the current usage of driving appliances. It was found that the level of upper limb loss has little effect on where the driving appliance is placed or on any other aspect of driving method used.

Adult↗
PubMed1987

A 3-year follow-up of the driving status of 32 young adults with spina bifida.

Thirty-two young spina bifida adults with or without hydrocephalus were assessed for car driving potential in 1983. A postal questionnaire procedure was used to follow their decisions on driving and early driving experiences. This study reports the driving status (non-driver, learner driver or driver) of this group at December 1986 in relation to scores on the perpetual--cognitive battery completed on assessment. Results indicated that although nearly half of this group had passed the driving test, clinical assessment of cognitive functioning did not discriminate between drivers and non-drivers.

Adolescent↗
PubMed1991

Factors antecedent to impaired driving in a Canadian urban sample.

This paper explores factors antecedent to impaired driving in a Canadian urban community. Specifically, it attempts to investigate patterns of association between economic, demographic, social, and personal variables, and frequency of impaired driving. Cross-tabular analysis reveals that sex, age, marital status, employment status, occupation, standard of living, degree of loneliness, boredom, and depression are significantly associated with impaired driving. Multiple regression analysis was performed to determine which of the demographic, economic, social, and personal variables are most important in predicting impaired driving. The results indicate that three variables (standard of living satisfaction, frequency of getting together with friends, and gender) are significant predictors of impaired driving.

Adolescent↗
PubMed1992

International policies on alcohol-impaired driving: a review.

A review is presented of policies to curb alcohol-impaired driving. The principal measure applied against drinking and driving in most industrial countries is the implementation of laws limiting the amount of alcohol which can be legally consumed by a person who subsequently takes charge of a motor vehicle on a public road. This strategy seems to have been the most effective to date, although national variations in legislation, rigor of application, and the extent of public knowledge are reflected in the range of outcomes reported. The effectiveness of "random breath testing" appears to be related to the degree to which drivers believe that the law is enforced. Other strategies aimed at the reduction of drinking and driving are education, publicity, and exhortation; the rehabilitation of convicted offenders; and restrictions on the availability of alcohol. However, due to factors such as the lack of evaluation, or limited scope, or nonspecificity to drinking and driving, these measures appear to have been less successful in curbing alcohol-impaired driving than the application of legal powers.

Alcohol Drinking↗
PubMed2006

The role played by a former federal government residential school in a First Nation community's alcohol abuse and impaired driving: results of a talking circle.

OBJECTIVES: The study's objective was to better understand alcohol abuse and impaired driving behaviors in a First Nations community as it reflects systemic issues linked to historical, family and community experiences. STUDY DESIGN AND METHODS: Fifteen 18- to 29-year-old drivers participated in an exploratory eight-hour Talking Circle held according to traditional cultural practice. Four First Nations researchers, trained in Talking Circle protocol, and a Band Elder facilitated the data collection, data analysis according to emerging themes, and data verification. RESULTS: Federal government residential schools contribute to intergenerational effects which impact impaired driving in a northern First Nations community. Traditional parental role modeling has changed dramatically. Rather than guide children through a communally shared development process, many parents now expect their children to assume adult roles by expecting them to take care of their guardians when they drink excessive amounts of alcohol. Because a wall of silence exists between the young and old, many young people seek refuge with friends and peers, who subsequently influence them to abuse alcohol and engage in impaired driving. Many older Band members no longer serve as leaders for young people. Instead, they behave like peers and engage in activities that facilitate alcohol abuse and impaired driving. CONCLUSIONS: Historical institutions like federal government residential schools have contributed to systemic socio cultural problems which influence alcohol abuse and impaired driving. Hence there is a need for community-based intervention strategies that promote cultural healing. The healing journey can start with First Nations communities providing their people opportunities to share their stresses and traumas in supporting and nurturing environments.

Adolescent↗
PubMed1990

Yielding to age: when the elderly can no longer drive.

Loss of ability to drive because of declining health is a symbolic and concrete representation that the person is no longer capable of performing as he or she once did. Grieving the loss of the ability to drive is complex in that driving is associated with many interactions, such as freedom, esteem, identity, and control. Families may be reluctant to address the ability to drive safely because of fear of confrontation and their own grieving at the loss it symbolizes. Resolution of the loss of the ability to drive depends on the family's and individual's ability to work through the grieving process, concurrent losses, cognitive abilities, and the availability of resources.

Aged↗