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 973 records · Page 54Linked to original sources
PubMed2005

Actual driving performance and psychomotor function in healthy subjects after acute and subchronic treatment with escitalopram, mirtazapine, and placebo: a crossover trial.

OBJECTIVE: The effects of escitalopram 10 to 20 mg/day and mirtazapine 30 to 45 mg/day on actual driving and psychomotor performance of 18 healthy subjects were determined in a randomized, double-blind, placebo-controlled, multiple-dose, 3-way crossover trial. METHOD: Each treatment period lasted for 15 days and was separated from the next period by a washout period of at least 13 days. Subjects received an evening dose of escitalopram 10 mg, mirtazapine 30 mg, or placebo from days 1 to 7 and an evening dose of escitalopram 20 mg, mirtazapine 45 mg, or placebo from days 8 to 15. On days 2, 9, and 16, reflecting acute period, dose increase, and steady state, respectively, the Road Tracking Test was performed. The main parameter was standard deviation of lateral position. Psychomotor performance was also assessed on days 2, 9, and 16 by laboratory computer tasks. Subjective sleep quality was measured with the Groninger Sleep Quality Scale, and mood was measured by visual analogue scales. RESULTS: Treatment differences were apparent during the acute treatment period, in which subjects treated with mirtazapine 30 mg performed less well on the driving test as compared to placebo. The Divided Attention Task results also revealed a significant increase in tracking error after a single dose of mirtazapine 30 mg as compared to placebo. Mirtazapine decreased feelings of alertness and contentedness. Mirtazapine did not affect performance on days 9 and 16 of treatment. Escitalopram did not affect driving, psychomotor performance, or subjective mood throughout treatment. CONCLUSION: Driving performance, as well as psychomotor functioning, was not affected by escitalopram treatment in healthy subjects. Driving performance was significantly impaired after ingestion of mirtazapine 30 mg during the acute treatment period.

Adult↗
PubMed1993

Prediction of behind-the-wheel driving performance in patients with cerebral brain damage: a discriminant function analysis.

Rehabilitation specialists, particularly occupational therapists, are often involved in evaluating clients' fitness to resume driving after cerebral damage due to head injury or stroke. Their available methods include separate or combined administration of predriver, simulator, and behind-the-wheel evaluations. However, use of these methods without a theoretical model on which to base test selection has yielded some criticism and little research about the effectiveness of these methods in predicting driving performance. Using the authors' Cybernetic Model of Driving as the basis for assessing abilities and behaviors relevant to driving outcome, this study sought to determine the effectiveness of the evaluation methods by discriminant analysis and measurements of sensitivity in predicting behind-the-wheel failures. Comprehensive evaluations of 106 patients revealed that residual deficits in cognition per se did not render a person unfit to drive and underscored the importance of considering behaviors in determining fitness. The methods of evaluation were shown to be relatively sensitive in predicting outcome; off-road and on-road evaluation reached sensitivities of 90% and 92% with the inclusion of behavioral measures. Formulae for predicting outcome based on methods of evaluation are provided and reasons for failures in behind-the-wheel evaluations are discussed.

Adolescent↗
PubMed2002

Lormetazepam effects on daytime vigilance, psychomotor performance and simulated driving in young adult healthy volunteers.

OBJECTIVE: To assess the residual effects of lormetazepam on daytime vigilance, psychomotor performance and simulated driving in adult healthy volunteers. MATERIAL: Twelve subjects (7 women, 5 men), aged 27 - 38 years (mean 31). METHOD: Subjects received lormetazepam 1 mg tablet and placebo for 3 days at nighttime in a randomized, double-blind, crossover design, with a 1-week interval between medications. On the morning following the last drug administration, the subjects completed a 15-min battery of neuropsychological tests aimed at assessing memory and attention, performed simple and choice visual reaction times, and self-rated their own level of sleepiness using the Epworth sleepiness scale. Afterwards, an interactive, computer-based driving simulator (STISIM) was used to assess the effect of the study drugs on driving ability, followed by the multiple sleep latency test (MSLT). RESULTS: The findings showed that participants had similar performance when treated with lormetazepam and placebo. Indeed, as compared with baseline, neuropsychological tests, visual reaction times, sleep latency using the MSLT and driving ability showed no deterioration following either placebo or active medication. CONCLUSIONS: The data suggest that 3-day use of lormetazepam 1 mg/day neither influences daytime vigilance nor impairs psychomotor task performance and simulated driving. Results confirm previous evidence that the intermediate-acting hypnotic benzodiazepine lormetazepam is devoid of residual effects in respect to psychomotor ability. However, caution should be exercised in the interpretation of the results due to the limited sensitivity of the study.

Adult↗
PubMed1982

Does diazepam affect driving ability?

Landauer (Med J Aust, 1981; 1: 624-626) contended that diazepam medication should not preclude car driving, since it relieves anxiety, aggression and depression. There is no clear evidence that diazepam's therapeutic effect improves driving. The bulk of evidence suggests that diazepam is harmful to driving ability even in appropriate patient populations. The detrimental effects of alcohol on driving ability are also exacerbated by diazepam. I would recommend that patients taking diazepam should avoid driving, especially if they have taken any alcohol.

Accidents, Traffic↗
PubMedDate not supplied

Parental predictors of teen driving risk.

OBJECTIVES: To determine the nature and prevalence of parental involvement with teen driving and its relationship to teen driving risk. METHODS: A statewide sample of 424 Maryland parents and their provisionally licensed teenagers were interviewed. RESULTS: Parents were unaware of the extent to which their teens had engaged in high-risk traffic events, such as being distracted by friends or driving too fast. Teens who were allowed unsupervised access to a car at least several times a week were 3 times as likely to have driven too fast than were those who had access once a month or less. The frequency of parental teaching of driving skills was not strongly related to teen risk taking. CONCLUSION: The need to increase parents' capacity to impose and enforce driving restrictions on provisionally licensed teen drivers is indicated.

Adolescent↗
PubMed2001

3,4-Methylenedioxymethamphetamine (MDMA, ecstasy) and driving impairment.

3,4-Methylenedioxymethamphetamine, or MDMA, is increasing in popularity in the United States as a drug of abuse. It has stimulant and empathogenic mood altering properties with the potential to affect psychomotor skills and impact driving. This report reviews the literature relating to the relevant psychomotor effects of the drug, the relationship between dose and blood concentrations, and studies and case reports on specific effects of the drug on driving. The latter reports include both laboratory driving simulator studies and anecdotal reports, and case series. We also report details of eighteen cases of apparent MDMA impaired driving, including six drivers whose blood tested positive for MDMA alone. Most subjects displayed muscle twitching and body tremors, dilated pupils, slow pupillary reaction to light, elevated pulse and blood pressure, lack of balance and coordination, and most were perspiring profusely. Five of the six subjects were given field sobriety tests (one leg stand, walk and turn test), and all five performed poorly. There was no clear correlation between the blood concentration of MDMA and the specific demeanor of the subject. These findings are consistent with other reports, and lead to the conclusion that MDMA use is not consistent with safe driving, and that impairment of various types may persist for a considerable time after last use.

Adolescent↗
PubMed1975

[Double blind study on the effects of automobile driving with automatic and standard transmission on various physiological parameters].

The main factors studied were the overall energy output and, in particular, the effects on the respiratory, cardiac and circulatory systems. The basic result was to demonstrate that while driving there occur more or less marked physiological modifications to these systems, which can be determined as to quantity; it seems clear that during particularly difficult conditions at the wheel or in subjects whose health is less than perfect, this can go as far as pathological situations. The values of catecholamines and their metabolites in the blood and urine were chosen as evaluation parameters. Catecholamines--that is, adrenaline, noradrenaline and dopamine--are substances produced by the adrenal glands; they play an essential part in the "functioning" of the sympathetic nervous system (which has important tasks, such as that of regulating the organism's equilibrium especially in reactions to sudden events or emergency situations) and are a reliable indication of effort and stress. Their action is seen in stimulation of the nervous system, cardiac agitation, an increase in blood pressure and in the production of lactic acid, increases in the basal metabolism, and so on. An excessive amount of these substances in the blood can cause real damage, above all to the heart and brain, especially in organs already affected in some way. The subjects studied were healthy volunteers, ranging in age between 20 and 35 and of comparable height and weight. A sort of "cross-over" experiment was carried out, so that the same subject was first studied driving with one type of gear change and then, two days later, was studied in the same experimental conditions but driving a vehicle with the other type of gear change. Analysis of the blood and urine sample was carried out in "single blind-test" conditions, in the sense that the research worker did not know where the samples came from. The biochemical analyses of the blood were: 1) Gas-analysis; 2) Hemochrome; 3)LDH-SGOT-Alkaline phosphatase; 4)Noradrenaline; 5)Cortisol. The following urine analyses were made: 1)Total catecholamines; 2)Vanillylmandelic acid. Clinical tests included: 1. Measurement of arterial pressure, at the beginning, at the end and during the driving period at the 30th and 90th minute. 2. Measurement of cardiac frequency,at the beginning, at the end and during the driving period at the same times. Blood pressure was measured by the auscultatory method, using an armband apparatus with aneroid capsule; cardiac frequency was measured at the wrist using the simple palpatory method, per 60 seconds.

Adult↗
PubMed2003

Drinking, cannabis use and driving among Ontario students.

Little is known about the risk of injury among adolescents who drive after the use of alcohol or cannabis or ride in cars driven by drunk drivers. We examined data from self-administered interviews with 1846 students in grades 7 to 13 who participated in the 2001 Ontario Student Drug Use Survey about their experiences related to alcohol, cannabis and driving during the 12 months preceding the survey. In all, 31.9% of the students reported being a passenger in a car driven by a drunk driver; of the students in grades 10 to 13 who had a driver's licence, 15.1% reported driving within an hour after consuming 2 or more drinks, and 19.7% reported driving within an hour after using cannabis. Our study shows that a sizeable proportion of adolescents are exposed to alcohol- and drug-related driving risks.

Adolescent↗
PubMed2003

[Epilepsy and driving in Argentina. A new proposal].

Current laws and regulations concerning epilepsy patients and driving exist in different countries all over the world. Patient's seizure-free intervals, physician's responsibilities, type of seizures and other requirements make these laws and regulations vary from country to country and even from state to state in the same country. In Argentina, in law No. 24.449, Decree Regulation No. 779/95, article 33 on Physical Aptitude, epilepsy is included, and the NE02 code "bans" anyone with epilepsy from being licensed; while NE03 "bans" anyone with an abnormal electroencephalogram. Based on laws from Argentina and foreign countries regarding driving and other issues that concern people with epilepsy, we propose that: 1) Physicians must counsel patients on their responsibilities over their disease and driving, and document on the medical record that this has been done. 2) Patients must take 1-year seizure-free period before being licensed again. 3) Patients are compelled to an annual medical update and to disclose the antiepileptic drugs (AED's) they are taking. 4) Driving restriction for patients having their AED's reduced or switched, during that period and up to six-months after finishing the process. 5) Doctors are not obliged to report to the State cases with seizures or epilepsy. 6) In paragraph "Neurological Aptitudes Criteria", about NE02 and NE03 Codes, the expression "inept" should be switched to "to be evaluated". 7) Ban a person with any history of seizure or epilepsy from being licensed to drive school buses, trucks and public transportation. These changes in our regulations will have the following advantages: 1) An increase in the number of reports to Motor Vehicle Authorities. 2) An improvement of the clinical/neurological controls. 3) They also will avoid, in great proportion, seizure-related motor vehicle crashes and property damage. 4) The up-dating of our laws/regulations/codes. 5) Not only because of medical, but also for its legal and social implications: a) protect physicians from being drawn into the legal foray, b) epileptic patients are legally protected, c) increase the security in the streets and therefore in our community.

Accidents, Traffic↗
PubMed2004

[Visual aptitude for automobile driving].

Visual function is crucial in driving and is one of the links which determine the medical aptitude to this activity. The ophthalmologist has important medical and moral responsibilities and has more than one mission in the determination of the aptitude to driving. The evaluation of the aptitude of the (future) driver is based on different legal criteria (Belgian Royal Orders dated on 23-03-1998 and 05-09-2002) whose requirements are in accordance with EC reglementation and are different according as the motor vehicles are used for private or professional purposes. Social and psychological consequences of driving incapacity may be important as far as the real impact of vision alterations on the incidence of motor vehicle crashes is still to be clearly determined. The knowledge of the repercussions of different diseases such as ametropia, age related effects, loss of vision in one eye, cataract, glaucomatous neuropathy, laser treatments,... on car driving can help the ophthalmologist to improve his judgment on the patient's real driving aptitude and the quality of his counselling if needed.

Accidents, Traffic↗
PubMed2004

[Association between the functional monoamine oxidase A gene polymorphism and aggressively driving behavior].

OBJECTIVE: This study is purposed to explore the relationship between aggressively driving behavior and functional polymorphism in the promoter region of the monoamine oxidase-A (MAOA) gene. METHODS: A total of 348 automobile drivers were investigated with Deffenbacher's driver anger scale, driving vengeance questionnaire (DVQ) and driver aggression behavior questionnaire. Eighty-eight drivers were selected as more, medium and less aggressive group, each. Polymerase chain reaction (PCR) and 2.5% agarose gel electrophoresisi were adopted to detect the polymorphism of functional 30 bp-uVNTR in the promoter region of the X-chromosomal MAOA gene and their frequencies of varied genotypes were estimated. RESULTS: Two alleles with 3 and 4 repeats of 30 bp-uVNTR were detected in the drivers. Among the more aggressive group, number of the allele with 3 repeats of 30 bp-uVNTR (63/88) was significantly more than that with 4 repeats (25/88) (chi(2) = 10.21, P < 0.01), and number of the allele with 4 repeats of 30 bp-uVNTR was more in the less aggressive group, indicating that persons with allele of 3 repeats of 30 bp VNTR were more aggressive in their driving than those with 4 repeats. CONCLUSIONS: Aggressively driving behavior in drivers possibly related to their functional MAOA-uVNTR polymorphism. Effect of the gene on aggressively driving behavior should be further studied.

Adult↗
PubMed2005

In-office evaluation of medical fitness to drive: practical approaches for assessing older people.

OBJECTIVE: To provide background for physicians'in-office assessment of medical fitness to drive, including legal risks and responsibilities. To review opinion-based approaches and current attempts to promote evidence-based strategies for this assessment. QUALITY OF EVIDENCE: MEDLINE, EMBASE, CINAHL, PsyclNFO, Ageline, and Sociofile were searched from 1966 on for articles on health-related and medical aspects of fitness to drive. More than 1500 papers were reviewed to find practical approaches to, or guidelines for, assessing medical fitness to drive in primary care. Only level III evidence was found. No evidence-based approaches were found. MAIN MESSAGE: Three practical methods of assessment are discussed: the American Medical Association guidelines, SAFE DRIVE, and CanDRIVE. CONCLUSION: There is no evidence-based information to help physicians make decisions regarding medical fitness to drive. Current approaches are primarily opinion-based and are of unknown predictive value. Research initiatives, such as the CanDRIVE program of the Canadian Institutes of Health Research, can provide empiric data that would allow us to move from opinion to evidence.

Aged↗
PubMed2005

[Synthetic effect analysis of heart rate variability and blood pressure variability on driving mental fatigue].

Driving mental fatigue is a substantial problem and threatens people's health and life. This investigation was made to evaluate the driving mental fatigue based on power spectral analysis of heart rate variability (HRV) and blood pressure variability (BPV) synthetically. Twenty health male subjects (28.8 +/- 4.3 years) were required to perform the simulated driving for 90 min. The frequency domain indices of HRV such as low frequency (0.04-0.15 Hz, LF), high frequency (0.15-0.4 Hz, HF), LF/HF together with the indices of hemodynamics such as blood pressure (BP) and heart rate (HR) of the subjects were calculated and anlyzed after the simulated driving. The results showed that sympathetic activity of the subjects enhanced after the simulated driving while parasympathetic activities decreased. The sympathovagal balance was also improved. Remarkable linear correlations were observed between all the corresponding indices of HRV and BPV (P<0.05). The findings suggested that the evaluation of autonomic activities by means of multi-variable synthetic effect analysis is scientific and objective.

Adult↗
PubMedDate not supplied

[Mobile phone use while driving in Florence health district area].

The practice of driving while using hand-held mobile phones is diffused in numerous countries, even though it has been demonstrated that they increase the risk of traffic accidents, and such use has consequently been prohibited. Because of the lack of Italian data on the spread of this behaviour a study was done in June 2004 on drivers' use of hand-held mobile phones in the Florence Health Authority area. The study was performed by direct observation from 4 watching-points (1 for each zone) which allowed for observation of several types of vehicles, on varying road conditions, in 5 hour time bands. Overall, 9387 vehicles were observed and the prevalence of mobile phone use while driving was found to be 1.8%. The greatest prevalence of mobile phone use was found in the following conditions: in the Northwest zone (2.8%), in the city suburbs (2.8%), on Tuesdays (3.0%), among drivers not using safety belts (3.0%), and among subjects driving alone (2.1%). Logistic regression analysis has shown a statistically significant association between mobile phone use and the zone, the number of persons in the vehicle, and seat belt use. Mobile phone use while driving is therefore a diffused practice that is particularly common among drivers who engage in other high-risk driving behaviours.

Accidents, Traffic↗
PubMed1991

Cessation of driving and unsafe motor vehicle operation by dementia patients.

We surveyed 522 consecutive patients from a dementia clinic to assess duration of driving after disease onset and instances of unsafe motor vehicle operation in the preceding 6 months. Among the 333 patients licensed to drive at the onset of dementia, the median duration of driving after onset was 28.6 months. Patients with a clinical diagnosis of Alzheimer's disease drove significantly longer than those with other dementia syndromes. Of the 93 patients still driving at the time of the survey, approximately one third were reported to have had at least one form of unsafe motor vehicle operation in the past 6 months, including 21 patients with motor vehicle accidents. Motor vehicle accidents were associated with use of prescription medications with sedative properties and with lower subjective ratings of the patient's driving ability by the informant.

Accidents, Traffic↗
PubMed1986

Autodestruction and nonexistence: two distinct aspects of the death drive.

The concept of the death drive is more frequently employed by European than by American psychoanalysts, although it is not unanimously accepted even by the former. In recent years there have been attempts to disconnect the longstanding theoretical link between the drive and aggression, in keeping with the observations of various nondestructive components of the death drive. A hitherto unmentioned aspect of this drive is the yearning for nonexistence, a shadow-like counterpoise to life, expressed by two analysands. Both had childhood histories of life-threatening disease without sufficient compensatory maternal presence at the time. Both displayed massive dissociation from their own body and its vital functions, as well as from objects and their representations. The death drive could be viewed as a continuum with the autodestructive aspect, or the striving for death, at one end, and the component of nonbeing, or the yearning for nonexistence, at the other end.

Attitude to Death↗
PubMedDate not supplied

[The driving license and epilepsy (author's transl)].

Italy is one of the few countries in Europe with no legislation specifically concerning driving licenses and epilepsy. We made a survey of 321 epileptics all over 18 years of age; 80,4% of them had epilepsy (temporal lobe). 47,7% of the 321 had a driving license, 2,8% had their license withdrawn because of epilepsy. The frequency of attacks among those with licenses was as follows: 52,9% rarely had attacks (1 every 2 years or even less often), 17,7% had attacks yearly and 29,4% had frequent attacks (1 a month, 1 a week or even daily). About 2% of the patients examined had had accidents because of attacks; none of the accidents were very serious. In spite of the lack of legislation, a high number of patients has driving license. However our investigations have shown that they were careful in their driving and scrupulous about treatment and medical check-ups. The main problem is that epileptics with a driving license may encounter serious difficulties with insurance companies if they have a car accident. It is to be hoped that in Italy appropriate measures are taken parallel to those of other European Countries.

Accidents, Traffic↗
PubMedDate not supplied

[Neurological diseases and driving].

Traffic accidents (TA) are, after heart disease, cancer and stroke, the fourth death cause among the general population. Although the number of AT caused by diseases-excluding alcoholism- seems to be reduced, interaction between organic pathology and functional ability increases the importance of this problem. This paper revises the literature on the relation between AT and specific neurological diseases: epilepsy, obstructive sleep apnea syndrome (SAS), stroke, dementia and Parkinson disease. Also, the problems and the role of the neurologist in assessing driving ability in patients with brain damage is analyzed, with special reference to the legal condition in Spain. The insufficiency of diagnostic labels as predictors of driving ability is stressed; the group of patients affected by these pathologies does not present greater TA risk than young drivers twice that of the general population. In the cases of epilepsy, SAS and ECV, which can cause episodic driving inability, defining recurrence probabilities and finding regulation formulas is the task of clinical epidemiologists and the regulative authorities. In the case of dementia, Parkinson disease and ECV, causing psychomotor performance deterioration, the basic problem, complicated by the presence of comorbility in these patients, is the development of valid clinical scales for driving ability assessment. The regulative authorities need simple measures which are often difficult to develop. Meanwhile, it is the task of the neurologist, as part of the therapeutic intervention during the medical encounter, to discuss driving risks with each patient.

Accidents, Traffic↗