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At least 1,117 records · Page 62Linked to original sources
PubMed1995

Decision making in altered states: effects of alcohol on attitudes toward drinking and driving.

A laboratory experiment and 2 field studies tested the hypothesis that alcohol affects attitudes and intentions toward drinking and driving. Sober and intoxicated participants completed a questionnaire assessing their attitudes and intentions to drink and drive in a number of situations. Results indicated that when asked general or noncontingent questions, sober and intoxicated participants were equally negative about this behavior. However, when a contingency was embedded in the question (e.g., "would you drink and drive only a short distance?"), intoxicated participants were significantly less negative about drinking and driving. These results are consistent with alcohol myopia (C. M. Steele & R. A. Josephs, 1990)--the notion that alcohol intoxication decreases cognitive capacity so that people are more likely to attend to only the most salient cues.

Adult↗
PubMed2004

The relationship between neuropsychological functioning and driving ability in dementia: a meta-analysis.

A meta-analysis of 27 primary studies was conducted to examine the relationship between neuropsychological functioning and driving ability for adults with dementia. When studies using a control group were included, the relationship between cognitive measures and on-road or non-road driving measures was significant for all reported domains; mean correlations ranged from.35 to.65. Caregiver reports of driving ability and cognitive variables were correlated significantly only on measures of mental status and visuospatial skills. When studies using a control group were excluded, moderate mean correlations were observed for visuospatial skills and on-road or non-road measures, and for mental status with non-road tests. Other effects were small or nonsignificant. Implications for basing driving recommendations on neuropsychological testing are discussed.

Aged↗
PubMed2006

Development of a measure of drinking and driving expectancies for youth.

The present study constructs and provides initial validation for a measure of positive expectancies for drinking and driving for use with adolescents and young adults (PEDD-Y). In Study 1, items were generated through open-ended responses from high school- and college-age youth. Data collected from a 2nd sample of college students (n = 404) identified a 29 item, 4 factor questionnaire. Two of the PEDD-Y factors (Convenience, Avoiding Consequences) explained additional variance in drinking and driving behavior above and beyond other cognitions about drinking and driving. Study 2 extended these results to a high school sample (n = 185). Study 3 demonstrated test-retest reliability of the PEDD-Y in college-age youth (n = 165). These results provide initial evidence for the utility of the PEDD-Y in assessing drinking and driving risk in adolescents and college students.

Adolescent↗
PubMed1999

Altering the pattern of panretinal photocoagulation: could the visual field for driving be preserved?

PURPOSE: To identify the area of retina required to provide the visual field for driving and to investigate whether the pattern of panretinal photocoagulation (PRP) for proliferative diabetic retinopathy could be altered to avoid treatment in this area whilst leaving the total number of burns constant. METHODS: A mathematical model of the emmetropic eye is used to calculate retinal dimensions corresponding to different angles of visual field. These are used to define retinal regions that correspond to the UK DVLC visual field criteria and regions that lie outside this area. Further calculation estimates the number of laser burns applied within these regions for both 500 microns and 200 microns diameter spot sizes and various burn spacings. RESULTS: Modelling of the number of burns applied in the normal pattern of PRP agrees with the number required to control proliferative retinopathy. Reducing burn spacing or extending treatment up to the ora serrata allows application of sufficient burns to control the disease without encroaching on areas of the retina that provide the driving field. CONCLUSION: It is theoretically possible to alter the pattern of PRP to avoid treatment in retinal areas concerned with the driving visual field whilst leaving the total number of burns constant. This suggests that a clinical trial of such a pattern PRP could be performed to assess adequate control of proliferative retinopathy along with preservation of the visual field required for driving.

Automobile Driving↗
PubMed1996

Predicting underage drinking and driving behaviors.

A social-psychological model of underage drinking and driving (DUI) and riding with drinking drivers (RWDD) was tested with data from a random digit dial telephone survey of 706 16-20-year-old drivers from seven western states in the United States. Consistent with the model, a structural equations analysis indicated that DUI and RWDD were primarily predicted by (a) expectancies regarding the physical risks of DUI, (b) normative beliefs about the extent to which friends would disapprove of DUI, (c) control beliefs about the ease or difficulty of avoiding DUI and RWDD and (d) drinking. Expectancies concerning enforcement had a significant effect on RWDD, but not on DUI. Among the background and environmental variables included in the analysis, only night-time driving and age had significant direct effects on DUI and RWDD. Drinking and involvement in risky driving had indirect effects on DUI and RWDD that were mediated through expectancies and normative beliefs. Males, European Americans, Latinos, respondents who drove more frequently and respondents who were less educated held beliefs that were more favorable toward DUI and RWDD, drank more and engaged more frequently in risky driving. As a result, such individuals may be at greater risk for DUI and RWDD.

Adolescent↗
PubMed2003

The effects of drinking-driving laws: a test of the differential deterrence hypothesis.

AIMS: Ontario introduced an Administrative Driver's Licence Suspension (ADLS) law in 1996, whereby a person with a blood alcohol level over the legal limit of 80 mg%, or who refused to provide a breath sample, would have his or her driver's licence suspended immediately for a period of 90 days. We test the differential deterrence hypothesis which would predict that social or lighter drinkers would be more affected by the Administrative Driver's License Suspension law than heavier drinkers. DESIGN: Data from the 1996 and 1997 cycles of the Ontario Drug Monitor, a general population survey of Ontario adults (monthly cross-sectional surveys), were employed (response rate 64-67%). Analyses were restricted to drivers who reported at least some drinking during the last year (n = 3827). The total number of drinks consumed during the past 12 months was analysed with analysis of variance. FINDINGS: We found that the mean alcohol consumption of those who reported drinking-driving increased significantly after the ADLS was introduced, whereas the alcohol consumption of those who did not drive after drinking remained the same. CONCLUSIONS: The limits of this study include a lack of comparison data from regions without ADLS, a reliance on self-report measures, possible age restrictions of the findings and the fact that only an inferential test of the differential deterrence hypothesis is permitted by the data. Despite these limitations, these findings are consistent with the prediction that lighter or more moderate drinkers will tend to stop driving after drinking completely, and thus drop out of the drinking-driving population when the ADLS law was introduced, leaving heavier drinkers in this population. It will be important to continue to examine the dynamics of differential deterrence over a longer interval.

Adult↗
PubMed1999

Simple reaction time, duration of driving and sleep deprivation in young versus old automobile drivers.

Car accidents are one of the major causes of death in modern society and sleepiness is identified as one major risk factor. The purposes of the present study were: (1) to relate the sleep loss and driving time to a performance indicator and (2) to identify risk factors of performance decrement. We investigated 294 drivers (age < 30 years, n = 100; age > or = 30 years, n = 194) who drove into a rest stop area. All were asked to fill out a questionnaire about the drive and previous sleep/wake pattern, and to carry out a 10 min, simple reaction time (RT) test. The level of performance is identified by the 10% slowest RTs. Multiple regression analysis, with the mean of the 10% Slowest RTs as the dependent variable, showed that age, duration of drive, and duration (shortness) of previous breaks were the main predictors. Our study suggests that public awareness may need to be raised with respect excessive length of driving, especially in young drivers.

Adult↗
PubMed2002

Motor vehicle crashes and abnormal driving behaviours in patients with dementia in Mendoza, Argentina.

Studies conducted in industrialized countries have shown that elderly demented subjects have increased risk of car accidents. However, there is no information about the effect of dementia on driving habits in non-industrialized countries. The number of motor vehicle crashes (MVC) and abnormal driving behaviours (ADB) (e.g. not recognizing traffic lights, driving in the middle of the road, etc.) were assessed with a semi-structured interview in 56 demented subjects and 31 elderly controls, all of whom were active drivers, at the Regional Registry of Dementia in Mendoza. Detailed neurological, psychiatric and neuropsychological examinations were also conducted on each subject. The presence of dementia and sex (male) predicted ADB, MVC and number of MVC (two or more). Among demented patients, ADB and MVC were associated with sex (male) and number of MVC was associated with sex (male) and Blessed Dementia Rating Scale for activities of daily living scores. Neither ADB, MCV, or number of MVC were associated with education level, or with cognitive or psychiatric measures. These findings showed that in developing countries, dementia has a significant contribution to MVC and ADB, as occurs in industrialized nations. Consequently, legislation to curb the risk of accidents caused by demented patients should be implemented. Furthermore, physicians must encourage demented patients (or their families) to discontinue driving, even those with mild dementia syndrome.

Accidents, Traffic↗
PubMed2002

Self-reported driving, cognitive status, and physician awareness of cognitive impairment.

OBJECTIVES: To assess self-reported driving rates in older people and correlate these data with cognitive status and physician recognition of cognitive impairment. DESIGN: Cross-sectional study. SETTING: A multiphysician private practice clinic in a primarily Asian-American community of Honolulu, Hawaii. PARTICIPANTS: Two hundred ninety-seven ambulatory patients aged 65 and older. MEASUREMENTS: Cognitive function was assessed by physician interview using the Cognitive Abilities Screening Instrument (CASI) and proxy informant data. Subjects' self-reported driving status. Outpatient medical records were reviewed. RESULTS: Sixty percent of the studied population reported that they currently drove. This rate decreased from 73.3% (148/202) for subjects with good CASI performance (CASI 282) to 37.5% (21/56) for subjects with intermediate CASI performance (CASI 74-81.9) and further to 23.7% (9/38)for subjects with poor CASI performance (CASI <74). Further analysis of drivers with intermediate and poor CASI performance scores revealed that almost none of their physicians recognized that these drivers had cognitive problems(4.8% (1/21) of drivers with intermediate CASI performance and 11.1% (1/9) of drivers with poor CASI performance). CONCLUSION: In this convenience sample of older drivers, driving rates dropped precipitously with poorer performance on cognitive tests, yet a significant percentage of individuals with intermediate or poor cognitive test performance reported that they currently drove. This poor performance was often unrecognized by their physicians. Low recognition rates could affect physicians' interventions to curb unsafe driving.

Aged↗
PubMed2003

A continuing medical education initiative for canadian primary care physicians: the driving and dementia toolkit: a pre- and postevaluation of knowledge, confidence gained, and satisfaction.

This study examined the effect of the Driving and Dementia Toolkit on physician knowledge and confidence gained and the anticipated change in patient assessment and evaluated the extent to which physicians found the material to be useful. Before receiving the driving toolkit, 301 randomly selected primary care physicians received a copy of the pretest questionnaire; 145 responded and met the eligibility criteria. This group was then sent the toolkit, a satisfaction a survey, and a posttest questionnaire. Physicians were faxed the questionnaires (with up to three reminders) and telephoned if necessary. Changes in pre- and posttest results were analyzed using the McNemar test and Wilcoxon signed rank test nonparametric procedures included in SPSS, Version 10.0, and paired-samples t test. Pre- and posttest data were available and could be matched for 86 physicians (59.3%) response. Knowledge and confidence increased significantly (P</=.05) for most of the toolkit content questions. There was also a clear intent on the part of study participants to begin including additional pertinent questions in the patient/caregivers interview when assessing a patient's fitness to drive. On a scale from 1 (low) to 10 (high), overall satisfaction with the toolkit rated an average of 8.4. Use of the toolkit resulted in a clear improvement in physicians' reported knowledge of and confidence in dealing with dementia and driving. Future applications of similar innovative continuing education models can be used for other areas such as disclosure of dementia diagnosis, capacity assessments, or end-of life issues.

Attitude of Health Personnel↗
PubMed2000

Self-reported sleepiness while driving as a risk factor for traffic accidents in patients with obstructive sleep apnoea syndrome and in non-apnoeic snorers.

The obstructive sleep apnoea syndrome (OSAS) is a condition causing daytime sleepiness and has been related to an increased risk for traffic accidents. However, the evidence linking severity of OSAS to a higher rate of automobile crashes is based on limited data. The aims of this study were to study the traffic accident rate in the last 5 years in patients referred to our sleep clinic because of clinical suspicion of OSAS and to analyse variables related to an increased risk for traffic accidents. A series of 189 consecutive patients with a driving license referred for a sleep study because of OSAS clinical suspicion and a control group (CG) of 40 hospital staff workers who denied snoring, matched for age and sex with the study population, were studied. Patients underwent a full-night polysomnography and both patients and the CG completed a self-answered questionnaire. One hundred and twenty-two patients were diagnosed as OSAS and 67 patients as non-apnoeic snorers (NAS). The self-reported number of accidents was significantly higher in OSAS patients compared with CG. The self-reported number of times off the road was significantly higher in OSAS patients compared with NAS and with CG. Variables associated with an increased risk for traffic accidents were self-reported sleepiness while driving (OR 5, 95%CI 2.3-10.9), having quit driving because of sleepiness (OR 3, 95%CI 1.1-8.6) and being currently working (OR 2.8, 95%CI 1.1-7.7). We conclude that self-reported sleepiness while driving is associated with an increased risk for traffic accidents in OSAS patients and in NAS. We suggest that this symptom can be used to alert patients and to give priority in the sleep clinic for study and treatment.

Accidents, Traffic↗
PubMed2004

[Flunitrazepam and driving ability].

Major contributions to the investigation of the influence of drugs on driving ability come from experimental studies as apart from epidemiological studies. Regarding experimental studies, the results of a single study are essentially determined by the experimental design. An established assessment of the risk of a drug in regard to driving ability should not be based on either a single study or on synopses, which record only a few studies without detailed information. This article presents an overview of published studies that directly or indirectly deal with the influence of flunitrazepam on driving ability. Benzodiazepines in particular, and amongst these especially flunitrazepam are brought into connection with the impairment of driving ability. This approach emphasises differences regarding the dosages used, the experimental designs and the methods of testing. For reasons of clarity the article on flunitrazepam is subdivided into the topics of acute effects, residual effects, and effects after subchronic application. Different results are reported. A statistical analysis in terms of a meta-analysis was not carried out due to a lack of standardization of the studies.

Anti-Anxiety Agents↗
PubMed1984

Alcohol interaction of lormetazepam, mepindolol sulphate and diazepam measured by performance on the driving simulator.

Sixteen healthy volunteers of a mean age of means = 26.4 years took part in a driving simulator test in an eightfold crossover study under double-blind conditions. The additional influence of alcohol was tested acutely after a single administration of 2 mg lormetazepam, a new, highly effective derivative from the benzodiazepine class, 10 mg mepindolol sulphate, a new betablocker without sedating properties, and 10 mg diazepam. All drugs were compared with placebo and the test was performed 1, 2 and 3 hours after oral intake. The aim was to investigate particularly the risks relevant in road traffic caused by simultaneous intake of these substances with alcohol. For this purpose, besides the driving simulator, an accurate reaction test ( WDG ) and self-rating scales were used, the latter in order to assess subjective stress and anxiety levels. Lormetazepam, due to its strong sedating property, showed a reduction in driving performance and an increase in reaction time and pulse rate as compared with placebo, and these effects were highly potentiated by alcohol. Mepindolol sulphate expectedly reduced pulse rate when compared with placebo, otherwise there were no significant differences. Diazepam, when compared with placebo, like lormetazepam caused a reduction in driving performance and reaction capacity and an increase in pulse rate, but intensity and duration of this effect were less than with lormetazepam and did not reach statistical significance. No significant potentiating effects were observed after the additional application of alcohol.

Adult↗
PubMed2000

Inhaled patient-administered nitrous oxide/oxygen mixture does not impair driving ability when used as analgesia during screening flexible sigmoidoscopy.

BACKGROUND: Entonox (nitrous oxide/oxygen mixture) has an analgesic effect, but its use is currently contraindicated in patients who plan to drive after its administration. We assessed the effect on driving ability of Entonox used as analgesia in patients undergoing screening flexible sigmoidoscopy. METHODS: Forty men and 40 women scheduled for screening flexible sigmoidoscopy who had not driven to the examination site were recruited together with a matched control subject from the same list. Before the examination complex motor skills were assessed in both groups using an adaptive tracking task, previously demonstrated to be the most sensitive test for detecting impairment of driving ability due to drugs. During the examination Entonox analgesia was available to the study group only, and after the screening examination complex motor function was retested on the same computer. RESULTS: Both groups improved their computer score on repeat testing, by 0.53 (range -1.9 to 4.6) in the study group and by 0.44 (range -0.6 to 2.5) in the control group. CONCLUSIONS: These data strongly support the view that Entonox analgesia does not impair driving ability. In the context of screening flexible sigmoidoscopy its use may lead to an increase in compliance.

Ambulatory Surgical Procedures↗
PubMed2004

Perceptual lane width, wide perceptual road centre markings and driving speeds.

The possibility that driving speeds could be reduced through the use of lane delineation was explored. Using a high-fidelity driving simulator, 28 experienced drivers were measured on seven two-lane rural roads with lane widths of 3.6, 3.0, or 2.5 m, and with either a standard centreline (control), a wide painted hatched road centre marking, or a wide white gravel road centre marking. Driving speeds were reduced on the narrowest lane width road, and further reduced on straight road sections that contained the centre marking with painted hatching. It was concluded that the narrow lane width increased steering workload and reduced speeds through a speed-steering workload trade-off, whilst the hatched road centre marking enhanced peripheral visual speed perception, leading to higher speed estimations and slower speeds. Therefore, narrowing the lane width below 3.0 m by using a painted hatched road centre marking should be an effective way to reduce driving speeds.

Acceleration↗
PubMed1995

Aberrant driving behaviour: errors and violations.

The present study was a replication of the research of Reason et al. (1990). Its aim was to confirm the distinction between driving errors and violations in a Western Australian driving population. Sixty-one male drivers and 74 female drivers completed a questionnaire containing items on driver demographics, driving penalties incurred, driving convictions and accident history and driver behavioral aberrations drawn from the Driver Behaviour Questionnaire (DBQ). In agreement with Reason et al. factor analysis revealed three factors; in the present study these were general errors, dangerous errors, and dangerous violations. Young drivers committed more dangerous errors and dangerous violations than older drivers. Females reported more dangerous errors than males. Males reported more dangerous violations than females. Drivers who reported a high level of road exposure and those who reported having been convicted for speeding reported more dangerous violations. Differences in the results of the two studies can largely by accounted for by differences in the representation of age and gender in the two populations studied.

Accidents, Traffic↗
PubMed1989

Attributional differences for driving while impaired: a comparison of alcoholics, inmates, and impaired drivers.

This study examines the differences among attributions for reasons for arrest and attributions for blame among groups of Canadian alcoholics, correctional facility inmates, and impaired drivers. Multiple-recidivist impaired driving offenders were more likely to attribute blame for impaired driving behavior to the mental-element factor alcoholism, even though they possessed lower General Alcoholism Scale (Wanberg, Horn, & Foster, 1977) scores than alcoholic subjects. They did not differ in their attributions to luck versus motivation or to general driving ability in their assessment of the reasons for arrest but did view the task of driving well while drunk as being less difficult than other groups. Inconsistencies in responses regarding responsibility for behavior are related to attribution theories which differentiate between perceptions of controllability and intentionality.

Adult↗
PubMed1986

Task and driving performance of patients with a severe concussion of the brain.

Patients who had sustained a severe concussion of the brain more than 2 years earlier were tested in choice reaction time tasks in the laboratory in order to investigate their impaired reactive capacity. The focus of investigation was whether specific stages in the chain of the information process are affected by the injury. In addition, driving skills were measured in an instrumented car to determine if reaction time performance is predictive of car driving. In general, patients were much slower than control subjects, both in the reaction time and in the driving tasks. The results obtained in the reaction time tasks provide no conclusive evidence, however, that severe concussion of the brain affects particular stages in information processing. Reaction time tasks appear to have predictive value for the ability to drive a car.

Accidents, Traffic↗