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At least 1,171 records · Page 65Linked to original sources
PubMed1969

Some effects of motor-car driving on the normal and abnormal heart.

Electrocardiograms were recorded in experienced motor-car drivers accustomed to busy city traffic while driving their own cars along familiar routes. The majority with normal hearts or a history of coronary heart disease increased their heart rates; brief periods when the rate exceeded 140/min. were recorded in both groups. ST changes not caused by tachycardia developed in 3 out of 32 normal drivers. Of 24 drivers with coronary heart disease 13 increased their ST and T abnormalities, the changes being gross in six. A further five developed multiple ventricular ectopic beats. Two coronary drivers experienced anginal pain and two left ventricular failure. Healthy motor-racing drivers increased their heart rates to 180/min. in the few minutes before the start of a race and to above 200/min. while racing.Little or no change in the plasma catecholamine levels was noted in three coronary subjects immediately after a city drive compared with resting levels. All the racing drivers showed a considerable increase in noradrenaline, and in one instance adrenaline, immediately after racing.Persons in whom angina is easily provoked when driving or who are in borderline left ventricular failure should be advised not to drive.

Adult↗
PubMed2006

A conceptual framework for reducing risky teen driving behaviors among minority youth.

Teenage drivers, especially males, have higher rates of motor vehicle crashes and engage in riskier driving behavior than adults. Motor vehicle deaths disproportionately impact youth from poor and minority communities and in many communities there are higher rates of risky behaviors among minority youth. In this paper, the authors review the data on teens, risky driving behaviors, and morbidity and mortality. They identify areas in which known disparities exist, and examine strategies for changing teen driving behavior, identifying what has worked for improving the use of seat belts and for reducing other risky behaviors. A multifaceted, multilevel model based on ecological theory is proposed for understanding how teens make choices about driving behaviors, and to understand the array of factors that can influence these choices. The model is used to create recommendations for comprehensive intervention strategies that can be used in minority communities to reduce disparities in risk behaviors, injury, disability, and death.

Accident Prevention↗
PubMed2003

Are medical reports on fitness to drive trustworthy?

PURPOSE: Previous studies have shown that physicians often have poor knowledge of the medical restriction on fitness to drive, or submit poor quality medical reports. To determine the reliability of physicians' reports on fitness to drive, the medical data provided on the standard medical fitness form was compared with the additional data collected on repeated assessment. METHODS: A random sample of 100 applicants for a driver's licence aged more than 49 years who submitted the standard medical form were asked to provide, from their regular family doctor, confirmation of their health status and/or additional medical data in order to make a re-evaluation. RESULTS: The rate of rejection for a licence for medical reasons was 3% on the basis of the standard evaluation and 17% on the basis of the re-evaluation (p<0.001). CONCLUSION: This study shows that the random evaluation of physician assessments of applicants for a driver's licence increases the detection rate of medical problems that can affect fitness to drive. The alarming difference in the rate of rejection between the two assessments may reflect a lackadaisical attitude of medical professionals toward the licence assessment procedure and/or physician unawareness of the medical restrictions on fitness to drive. Results of this study suggest that this subject must be included in medical education programmes.

Aged↗
PubMed1994

Neural drives to breathing during exercise.

This article presents the author's views about the neural drives to breathing during exercise. Two hypotheses are developed, the first being that the rapid changes in ventilation at the start and end of exercise are due to a fast neural drive whose magnitude is related to the frequency of limb movement. Experimental data are presented that this drive persists throughout exercise but declines as exercise continues. Second, the excessive increase in ventilation that occurs above the first ventilatory threshold during an incremental exercise test is due to a heavy exercise neural drive whose magnitude is related to the motor commands to the exercising muscles. Using the electromyographical activity of the working muscles as an index of the strength of the motor commands, experimental evidence is presented showing the coincidence of the first ventilatory threshold and that for the electromyographic activity of the working muscles during incremental exercise tests.

Animals↗
PubMedDate not supplied

[Drunk driving in professional drivers in the Vía Blanca highway in Cuba].

To determine the frequency of drunk driving in professional drivers (Via Blanca, Havana City), we carried out a descriptive study of 832 drivers selected by multistage stratified sampling. A structured interview with each driver was carried out to record the variables under study, and a breath alcohol test was subsequently performed. The frequency of drunk driving was 8.18% (95% CI, 5.94%-10.42%), with a predominance of drivers with alcohol levels<or=0.24% (51.07%). Drunk driving was more frequent in "high risk" hours, in drivers aged between 40 and 49 years old (10.3%), and in those with 15 to 24 years of experience (11.02%). The frequency of drunk driving found in this study highlights the need to design traffic accident prevention strategies.

Adult↗
PubMed1999

The influence of clozapine and typical neuroleptics on information processing of the central nervous system under clinical conditions in schizophrenic disorders: implications for fitness to drive.

The present study investigates the psychomotor performance of schizophrenic inpatients receiving neuroleptic medication and comedication according to their clinical demands in regard to their fitness to drive. The hypothesis was tested that even under polydrug medication, the clozapine-treated patients (n = 10) would have a superior performance compared to the patients taking classical neuroleptics (n = 18). The data were collected by technical equipment (Act and React Testsystem) measuring reaction time, vigilance, visual perception and stress tolerance. The patients' driving ability turned out to be equally impaired in both treatment groups; 11% of the patients passed all tests without major impairment; 32% of the patients showed some impairments that required individual evaluation of their driving ability; 57% were considered to be severely impaired and driving could not be recommended. Except for one test, no significant group differences in psychomotor reaction performance were obtained. These results are discussed concerning limitations and consequences.

Adult↗
PubMed1996

Simulated driving performance in patients with obstructive sleep apnea.

To assist in determining ability to drive in patients with obstructive sleep apnea (OSA), we developed a divided attention driving test (DADT) based on the work of Moskowitz and Burns (6). We first examined its ability to detect impaired performance by testing normal subjects both sober and impaired by alcohol (mean blood alcohol level, 95 +/- 25 mg/dl). Subsequently, 21 male patients with OSA (age 49.3 +/- 12.7 [SD] yr; apnea hypopnea index [AHI] 73 +/- 29) and 21 age- and sex-matched control subjects underwent polysomnography followed by daytime sleep latency testing (MSLT). Before each day-time nap, subjects were given the DADT for 20 min. Patients who performed much worse than control subjects in all measures, with the largest difference noted in tracking error (OSA, 228 +/- 145 cm versus control 71 +/- 31 cm, p < 1 x 10(-9)). Half of the patients were worse than any control subject, with some showing performance worse than control subjects impaired by alcohol. However, MSLT and AHI explained less than 25% of the variance in tracking error, making individual prediction problematic. We concluded that in laboratory driving performance skills are markedly impaired in over half our group with sleep apnea. Further testing and comparing on-road performance should aid in predicting ability to drive.

Adult↗
PubMed2006

The effect of auditory and visual distracters on the useful field of view: implications for the driving task.

PURPOSE: The driving environment is becoming increasingly complex, including both visual and auditory distractions within the in-vehicle and external driving environments. This study was designed to investigate the effect of visual and auditory distractions on a performance measure that has been shown to be related to driving safety, the useful field of view. METHODS: A laboratory study recorded the useful field of view in 28 young visually normal adults (mean 22.6 +/- 2.2 years). The useful field of view was measured in the presence and absence of visual distracters (of the same angular subtense as the target) and with three levels of auditory distraction (none, listening only, listening and responding). RESULTS: Central errors increased significantly (P < 0.05) in the presence of auditory but not visual distracters, while peripheral errors increased in the presence of both visual and auditory distracters. Peripheral errors increased with eccentricity and were greatest in the inferior region in the presence of distracters. CONCLUSIONS: Visual and auditory distracters reduce the extent of the useful field of view, and these effects are exacerbated in inferior and peripheral locations. This result has significant ramifications for road safety in an increasingly complex in-vehicle and driving environment.

Adult↗
PubMed1990

Perception-response speed and driving capabilities of brain-damaged and older drivers.

Three experiments including reaction time (RT) tasks and driving tasks were conducted to identify variables that may be sensitive to the effects of brain damage or aging and to determine how RT tasks relate to driving performance. In Experiment 1 mean RTs of the brain-damaged and older subjects disproportionately increased relative to those of controls, with increasing difference between subsequent compound stimuli. In Experiment 2 response accuracy of brain-damaged subjects deteriorated more than that of controls when the similarity of a task to actual driving increased. In Experiment 3 brain-damaged patients were slower and less accurate than the controls on all measures of a platoon car-following task, whereas the older subjects were only less accurate. Compared with those of the controls, brake RTs of neither the older subjects nor the patients were disproportionately affected by increasing task load. Performance on the platoon driving task could be successfully predicted by a laboratory RT task on time estimation only for the brain-damaged subjects.

Adult↗
PubMed1991

Attention and driving skills in aging and Alzheimer's disease.

The number of older drivers with dementia is rising with the aging of the adult population. A public health issue is growing because of concerns about the motor vehicle accident risk posed by drivers with dementia of the Alzheimer's type (DAT) and other progressive, degenerative dementias. However, little is known about the specific perceptual/cognitive deficits contributing to impaired driving in DAT. The present paper proposes, on both theoretical and empirical grounds, that attentional skills in relation to driving should be examined in older adults with and without DAT. Such investigations should focus on normal older adults and those in the mild, early stages of dementia because the latter are the most likely among the dementia population to be still driving. Evidence is presented indicating (1) that motor vehicle accident rates are related to performance on information-processing measures of different components of attention; (2) that this relationship is greatest for measures of the switching of selective attention and less for that of divided and sustained attention (vigilance); and (3) that many of these same attentional functions, and particularly the switching of visual selective attention, are impaired in the early stages of DAT and thus may contribute to increased accident risk. Further studies of cognitive and driving performance in older drivers are necessary to establish that the attentional impairments found in mild DAT contribute to increased accident risk. Implications of these findings for driver assessment, education, and training are discussed.

Age Factors↗
PubMed1992

A ten-year follow-up of driving patterns among community-dwelling elderly.

Massachusetts Health Care Panel Study data were used to examine age-related changes in driving patterns over 10 years in a community-dwelling cohort of elders. In 1974, 86% of the men and 76% of the women reported that the automobile was their chief mode of transportation. At each follow-up, 87% or more of those who had relied on a car at the start of the study continued to rely on the automobile as their primary source of transportation. Approximately 75% or more of those who were self-reliant in driving a car at each assessment were still self-reliant at the subsequent follow-up. These prospective data clearly demonstrate that a substantial proportion of the older population in the United States continues to rely on the automobile and to drive in their eighth and ninth decades of life. Declining health status appears to be an important risk factor for losing self-reliance in driving a car in old age.

Activities of Daily Living↗
PubMed2002

Evaluating alleged drinking after driving--the hip-flask defence. Part 1. Double blood samples and urine-to-blood alcohol relationship.

This two-part article examines the strengths and weaknesses of various ways of investigating claims of drinking alcohol after driving, commonly known as the hip-flask or glove-compartment defence. In many countries the onus of proof in hip-flask cases rests on the prosecution. With good co-operation from the police and timely sampling of body fluids, such as blood and urine for forensic analysis of ethanol, useful evidence can be mustered to support or challenge the truthfulness of alleged drinking after driving. The person's blood-alcohol concentration (BAC) can be compared with values expected on the basis of the amount of alcohol consumed after driving, according to theoretical Widmark calculations. The actual BAC measured is then adjusted for the additional amount of alcohol consumed in the after-drink. Double blood samples, that is, taking two specimens of venous blood about 30-60 minutes apart and looking at the magnitude and direction of change in BAC provides little or no more information than a single blood specimen. However, the relationship between alcohol in blood and urine is very useful in hip-flask cases whereby the concentration expected in the primary urine is compared with the concentration in the bladder urine voided. The concentration of alcohol determined in a second urine sample collected 30-60 min later gives supporting evidence in hip-flask cases. A graphical method, which entails plotting ethanol concentrations in blood and urine as a function of time provides a robust and practical way to investigate hip-flask defences. In the second part of the review, congener analysis is presented, which entails comparing the concentrations of n-propanol, isobutanol and occasionally other congeners in the alcoholic beverage allegedly consumed after driving with the volatiles present in the suspect's blood and urine determined by headspace gas chromatography.

Alcohol Drinking↗
PubMed2004

Driving and dementia in Ontario: a quantitative assessment of the problem.

BACKGROUND: The population is becoming increasingly aged, and concomitantly, the prevalence of dementia is steadily rising. Persons aged 65 years and over are likely to continue driving for many years and often well into the dementia process. METHODS: Ontario Ministry of Transportation driving data, census data, and dementia prevalence data were combined to determine the number of persons with potential dementia who are driving, both now and in about 25 years' time. RESULTS: Actual and projected Ontario figures show that the number of senior drivers will increase markedly from just under 500,000 in 1986 to nearly 2,500,000 in 2028. Similarly, the number of drivers with dementia is also increasing. Although not all drivers with dementia are necessarily dangerous, most are estimated to continue driving well into the disease process. By combining the above-mentioned data sets, a best estimate of the number of drivers with dementia in Ontario was derived. It is estimated that this group has grown from just under 15,000 in 1986 to about 34,000 in 2000 and will number nearly 100,000 in 2028. INTERPRETATION: Increasingly, the responsibility for identifying drivers with dementia has fallen on the health care system, a role for which it was never designed nor equipped to handle. The risks associated with the dramatically increasing number of drivers with dementia demand a psychometrically sensitive and efficient screening procedure.

Aged↗
PubMed2003

Maze test performance and reported driving ability in early dementia.

A battery of standard neuropsychological tests examining various features of executive function, attention, and visual perception was administered to 27 subjects with questionable to mild dementia and compared to a 4-point caregiver rating scale of driving ability. Based on the results of this study, a computerized maze task, employing 10 mazes, was administered to a second sample of 40 normal elders and questionable to moderately demented drivers. Comparison was made to the same caregiver rating scale as well as to crash frequency. In the first study of neuropsychological tests, errors on Porteus Mazes emerged as the only significant predictor of driving ability in a stepwise regression analysis. In the follow-up study employing the computerized mazes, all 10 mazes were significantly related to driving ability ratings. Computerized tests of maze performance offer promise as a screening tool to identify potential driving impairment among cognitively impaired elderly and demented drivers.

Aged↗
PubMed1991

Etiology of drinking and driving among adolescents: implications for primary prevention.

A prospective study was conducted to investigate what factors are predictive of self-reported drinking and driving (DD) among adolescents. The study employs a theoretical framework taken from Problem Behavior Theory; environmental, personality, and behavioral factors are explored for their predictability of DD. A cohort of 1482 high school students completed a written survey in spring of 1986 and again in fall of 1986. The findings confirm that Problem Behavior Theory provides a useful theoretical framework with which to identify etiological factors predictive of DD among adolescents. Identified personality, perceived environmental, behavioral, and demographic factors accounted for approximately 50% of the reported variance in DD at baseline. The same factors accounted for approximately 40% percent of the variance in follow-up DD and were predictive both among the students who did not drink and drive at baseline (incidence cases), and among those students who did drink and drive at baseline (continuation versus discontinuation of the behavior). Based on these etiological data, we recommend that school-based, peer-led educational prevention programs be designed to reach young adolescents prior to the age at which a driver's license is obtained. We further recommend that the programs be broad-based and consider DD within the larger context of drinking and driving related behaviors and traffic safety in general.

Adolescent↗
PubMed1998

Older rural adults and the decision to stop driving: the influence of family and friends.

Sixty rural elders who had stopped driving as well as their friends and family members participated in a qualitative study to explore (a) the perceptions of older drivers regarding the influence of friends and family on their decision to stop driving, (b) the perceptions of friends and family regarding their influence on that decision, and (c) the impact that no longer driving had on the elder and his or her friends and family. Findings suggest that the support offered by friends and family played a significant role in the decision to stop driving. Increased loneliness and isolation impacted the older driver, although an enhanced sense of responsibility was evident among friends and family.

Adolescent↗
PubMed2002

Why rural elders drive against advice.

The purpose of this study was to describe the reasons rural elders continue to drive against the advice of health professionals, family, or friends. Interviews were conducted with a convenience sample of 45 older adults living in isolated communities with populations ranging from 225 to 8,700 residents. Findings suggest that declining health was the primary reason the participants were advised to stop driving. They refused to do so because they did not believe they were unsafe, valued their independence, and feared isolation if they could not drive. Significant reassurance that they would not be forgotten would be required for them to stop driving.

Accidents, Traffic↗
PubMed2006

Factors associated with poor compliance of patients with epilepsy driving restrictions.

The authors sought to identify factors associated with poor compliance with driving restrictions due to a diagnosis of epilepsy. They compared the demographic and clinical characteristics of 60 patients with epilepsy who, despite the authors' recommendation, continued to drive, with those of 60 age- and sex-matched epileptic patients who refrained from driving. The results showed that patients with epilepsy do not comply with driving restrictions, mainly for employment-related reasons.

Adult↗