scholarly journals The Impact of Advanced Age on Driving Safety in Adults with Medical Conditions

Gerontology ◽  
2018 ◽  
Vol 64 (3) ◽  
pp. 291-299 ◽  
Author(s):  
Sanghee Moon ◽  
Maud Ranchet ◽  
Abiodun Emmanuel Akinwuntan ◽  
Mark Tant ◽  
David Brian Carr ◽  
...  
Keyword(s):  
Motor Vehicle ◽  
Oldest Old ◽  
Advanced Age ◽  
Driving Safety ◽  
Medical Conditions ◽  
Fitness To Drive ◽  
Middle Aged ◽  
Safe Driving ◽  
History Of ◽  
The Impact

Background: Adults aged 85 and older, often referred to as the oldest-old, are the fastest-growing segment of the population. The rapidly increasing number of older adults with chronic and multiple medical conditions poses challenges regarding their driving safety. Objective: To investigate the effect of advanced age on driving safety in drivers with medical conditions. Methods: We categorized 3,425 drivers with preexisting medical conditions into four age groups: middle-aged (55–64 years, n = 1,386), young-old (65–74 years, n = 1,013), old-old (75–84 years, n = 803), or oldest-old (85 years and older, n = 223). All underwent a formal driving evaluation. The outcome measures included fitness to drive recommendation by the referring physician, comprehensive fitness to drive decision from an official driving evaluation center, history of motor vehicle crashes (MVCs), and history of traffic violations. Results: The oldest-old reported more cardiopulmonary and visual conditions, but less neurological conditions than the old-old. Compared to the middle-aged, the oldest-old were more likely to be considered unfit to drive by the referring physicians (odds ratio [OR] = 4.47, 95% confidence interval [CI] 2.20–9.10) and by the official driving evaluation center (OR = 2.74, 95% CI 1.87–4.03). The oldest-old reported more MVCs (OR = 2.79, 95% CI 1.88–4.12) compared to the middle-aged. Conclusion: Advanced age adversely affected driving safety outcomes. The oldest-old are a unique age group with medical conditions known to interfere with safe driving. Driving safety strategies should particularly target the oldest-old since they are the fastest-growing group and their increased frailty is associated with severe or fatal injuries due to MVCs.

scholarly journals 0404 Jewish-Arab Disparities in Sleep Behaviors and Differential Ethnic Impact on Daytime Functioning, Driving Safety, and Health in Israel

SLEEP ◽  
2020 ◽  
Vol 43 (Supplement_1) ◽  
pp. A154-A155
Author(s):  
E Rosenberg ◽  
M L Perlis ◽  
S Parthasarathy ◽  
G Jean-Louis ◽  
S Chakravorty ◽  
...  
Keyword(s):  
Sleep Disturbance ◽  
Sleep Duration ◽  
Functional Impairment ◽  
Motor Vehicle ◽  
Health And Safety ◽  
Population Based ◽  
Driving Safety ◽  
Drowsy Driving ◽  
The Impact ◽  
Sleep Difficulties

Abstract Introduction In Israel, those with Arabic as compared to Jewish ethnicity, exhibit poorer health and motor vehicle safety behaviors. Their ethnic differences in sleep duration and quality may modulate their vulnerabilities to these behaviors. Methods 7,230 Israeli individuals (N=5,880 Jewish and N=1350 Arabic) responded to the 2017 Israeli Bureau of Statistics population-based survey of households. Variables were self-reported. Outcomes included sleepiness, sleep medications, functional impairment, drowsy driving, overall health, 1-year health change, and obesity. Predictors included categorical sleep duration (<=5, 6, 7, 8 [reference], or >=9 hours) and sleep disturbance in the past month (none [reference], mild [1/week], moderate [2-3/week], or severe [>3/week]). Covariates included age, sex, and financial status. Ethnicity (Jewish/Arabic) was treated as a predictor of sleep and behavioral outcomes. Results When compared to normal (8-hour) sleepers, Jewish as compared to Arabic individuals were more likely to to sleep <=5h (RRR=3.99, p<0.0005), 6h (RRR=4.65, p<0.0005), and 7h (RRR=3.34, p<0.0005), and were more likely to report severe sleep difficulties (RRR=1.49, p<0.0005) and sleepiness (oOR=1.52, p< 0.0005). Yet, they were less likely to report functional impairment (oOR=0.65, p<0.0005), drowsy driving (OR=0.58, p<0.0005), worse health (oOR=0.51, p<0005), worsening health (oOR=0.70, p<0.0005), or obesity (OR=0.64, p<0.0005). Significant ethnicity by sleep duration interactions (p<0.05) characterized sleepiness, sleep medications, functional impairment, health, and health change. Moreover, significant ethnicity by sleep disturbance interactions (p<0.05) characterized the same outcomes, in addition to drowsy driving. Overall, the impact of sleep duration and sleep difficulties was generally greater among Arabs for all variables. Conclusion Despite Jewish individuals endorsing relatively shorter sleep and more severe sleep difficulties, Arabs seem to be more vulnerable to the health and functional outcomes. This finding may explain some of the discrepancies in the health and safety outcomes between these ethnic groups. Support Dr. Grandner is supported by R01MD011600

Application of Advanced Driver-Assistance Systems in Police Vehicles

2021 ◽  
pp. 036119812110171
Author(s):  
Vanessa Nasr ◽  
David Wozniak ◽  
Farzaneh Shahini ◽  
Maryam Zahabi
Keyword(s):  
Police Officers ◽  
Motor Vehicle ◽  
Detection System ◽  
Driving Safety ◽  
Driver Assistance ◽  
Driver Assistance Systems ◽  
Advanced Driver Assistance Systems ◽  
Assistance Systems ◽  
Police Vehicles ◽  
The Impact

Motor vehicle crashes are one of the leading causes of injuries and deaths for police officers. Advanced driver-assistance systems (ADAS) are driving control systems that have been found to improve civilian drivers’ safety; however, the impact of ADAS on police officers’ driving safety has yet to be investigated thoroughly. Disparities between driver states and tasks performed while driving between police and civilian drivers necessitate this distinction. This study identified the types of ADAS used in police vehicles, their impact on officers’ safety, and proposed potential future ADAS features to be implemented in police vehicles. A systematic literature review was conducted using Google Scholar, Compendex, Web of Science, Transport Research International Documentation (TRID), and Google Patents databases to identify the most prevalent police vehicles used in the U.S., available ADAS features in those vehicles, and the impact of ADAS on officers’ safety. A list of recommended ADAS features was developed based on the review of literature, authors’ knowledge and experience in the field, and the findings of an online survey with 73 police officers. Results indicated the addition of multiple ADAS features including the front vehicle detection system, intersection collision avoidance, evasive steering systems, left turn assist, traffic sign detection system, traffic jam assist, two lane and lane-ending detection, wrong-way alert, and autonomous highway driving features have the potential to improve officer safety and performance while driving. However, there was a void of studies focused on ADAS effects on police driving safety which needs to be addressed in future investigations.

scholarly journals Inclusion of medical fitness to drive in medical postgraduate training curricula

2020 ◽  
Author(s):  
Laith Al Azawi ◽  
Aisling O’Byrne ◽  
Lily Roche ◽  
Desmond O’Neill ◽  
Margaret Ryan
Keyword(s):  
Medical Condition ◽  
Well Being ◽  
List Type ◽  
Medical Conditions ◽  
Specialist Training ◽  
Fitness To Drive ◽  
Safe Driving ◽  
Training Schemes ◽  
The Uk ◽  
Medical Fitness

AbstractBackgroundTransport mobility, and access to driving, is an important factor in social inclusion and well-being. Doctors have an important role to play in supporting safe mobility through applying the knowledge developed in the field of traffic medicine and incorporating state of the art national and international medical fitness to drive (MFTD) guidelines. Little is known about the profile of MFTD in postgraduate curricula for core and higher specialist training.AimsWe profiled the inclusion of MFTD in the curricula of postgraduate core, higher and streamlined medical and surgical specialties in the Republic of Ireland and the UK. Methods: All publicly available syllabi of basic and higher/ streamlined specialist training in postgraduate medical and surgical colleges in both jurisdictions were analysed (N = 122).ResultsIn Ireland, 25% of basic training schemes included MFTD in the curriculum. Two-thirds of curricula of higher specialty and streamlined training schemes also included MFTD. For the UK, 44% of core and 36% of higher training schemes curricula included MFTD. Just under one-quarter of all curricula reviewed included MFTD for more than one medical condition or treatment. Common topics in both Irish and UK curricula included seizures/epilepsy, syncope and visual disturbances.ConclusionThere are notable deficits in MFTD training for specialists in Ireland and the UK. Common conditions which can significantly impair MFTD such as stroke, diabetes and alcohol use disorders are severely underrepresented and curricula should be revisited to include relevant training and guidance for MFTD for trainees.Main MessagesDoctors have an important role in supporting safe driving among patients with a range of medical conditionsBasic and higher specialist training curricula in a range of specialities in the British Isles are deficient in content relating to medical fitness to driveCurricular development for specialist training should include provision of concise and speciality-relevant guidance on medical fitness to driveResearch QuestionsWhat barriers exist currently to the inclusion of medical fitness to drive and how could these be mitigated?What are the specialty-relevant prioritizations of medical conditions related to medical fitness to drive for inclusion in each curriculum?What resources and evidence are available to specialist training programmes to support the guidance for medical fitness to drive in their curricula?

Risk of incident fractures in individuals hospitalised due to unexplained syncope and orthostatic hypotension

BMC Medicine ◽  
2021 ◽  
Vol 19 (1) ◽  
Author(s):  
Madeleine Johansson ◽  
Cecilia Rogmark ◽  
Richard Sutton ◽  
Artur Fedorowski ◽  
Viktor Hamrefors
Keyword(s):  
Orthostatic Hypotension ◽  
Cox Regression ◽  
Main Diagnosis ◽  
Middle Aged ◽  
Increased Risk ◽  
History Of ◽  
Unexplained Syncope ◽  
The Mean ◽  
The Impact ◽  
The Relationship

Abstract Background Impaired orthostatic blood pressure response and syncope confer a high risk of falls and trauma. The relationship between a history of unexplained syncope and orthostatic hypotension (OH) with subsequent fractures, however, has not been thoroughly examined. In this study, we aimed to investigate the relationship between previous hospital admissions due to unexplained syncope and OH and incident fractures in a middle-aged population. Methods We analysed a large population-based prospective cohort of 30,399 middle-aged individuals (age, 57.5 ± 7.6; women, 60.2%). We included individuals hospitalised due to unexplained syncope or OH as the main diagnosis. Multivariable-adjusted Cox regression analysis was applied to assess the impact of unexplained syncope and OH hospitalisations on subsequent incident fractures. Results During a follow-up period of 17.8 + 6.5 years, 8201 (27%) subjects suffered incident fractures. The mean time from baseline and first admission for syncope (n = 493) or OH (n = 406) was 12.6 ± 4.2 years, and the mean age of the first hospitalisation was 74.6 ± 7.4 years. Individuals with incident fractures were older, more likely to be women, and had lower BMI, higher prevalence of prevalent fractures, and family history of fractures. Multivariable-adjusted Cox regression showed an increased risk of incident fractures following hospitalisations due to unexplained syncope (HR 1.20; 95% CI 1.02–1.40; p = 0.025) and OH (HR 1.42; 95% CI 1.21–1.66; p < 0.001) compared with unaffected individuals. Conclusions Individuals hospitalised due to unexplained syncope and orthostatic hypotension have an increased risk of subsequent fractures. Our findings suggest that such individuals should be clinically assessed for their syncope aetiology, with preventative measures aimed at fall and fracture risk assessment and management.

scholarly journals Variability of Gravel Pavement Roughness: An Analysis of the Impact on Vehicle Dynamic Response and Driving Comfort

2021 ◽  
Vol 11 (16) ◽  
pp. 7582
Author(s):  
Vidas Žuraulis ◽  
Henrikas Sivilevičius ◽  
Eldar Šabanovič ◽  
Valentin Ivanov ◽  
Viktor Skrickij
Keyword(s):  
High Speed ◽  
Ambient Air ◽  
Dynamic Responses ◽  
Driving Safety ◽  
Vehicle Dynamic ◽  
Safe Driving ◽  
Evaluation Indexes ◽  
Road Pavement ◽  
Driving Speed ◽  
The Impact

Gravel pavement has lower construction costs but poorer performance than asphalt surfaces on roads. It also emits dust and deforms under the impact of vehicle loads and ambient air factors; the resulting ripples and ruts constantly deepen, and therefore increase vehicle vibrations and fuel consumption, and reduce safe driving speed and comfort. In this study, existing pavement quality evaluation indexes are analysed, and a methodology for adapting them for roads with gravel pavement is proposed. We report the measured wave depth and length of gravel pavement profile using the straightedge method on a 160 m long road section at three stages of road utilization. The measured pavement elevation was processed according to ISO 8608, and the frequency response of a vehicle was investigated using simulations in MATLAB/Simulink. The international roughness index (IRI) analysis showed that a speed of 30–45 km/h instead of 80 km/h provided the objective results of the IRI calculation on the flexible pavement due to the decreasing velocity of a vehicle’s unsprung mass on a more deteriorated road pavement state. The influence of the corrugation phenomenon of gravel pavement was explored, identifying specific driving safety and comfort cases. Finally, an increase in the dynamic load coefficient (DLC) at a low speed of 30 km/h on the most deteriorated pavement and a high speed of 90 km/h on the middle-quality pavement demonstrated the demand for timely gravel pavement maintenance and the complicated prediction of a safe driving speed for drivers. The main relevant objectives of this study are the adaptation of a road roughness indicator to gravel pavement, including the evaluation of vehicle dynamic responses at different speeds and pavement deterioration states.

scholarly journals Sleep and the Fitness to Drive: A Swiss Perspective

2021 ◽  
Author(s):  
Stefan Lakämper ◽  
Kristina Keller
Keyword(s):  
Traffic Safety ◽  
Legal Medicine ◽  
Behavioral Patterns ◽  
Medical Conditions ◽  
Fitness To Drive ◽  
Medical Assessment ◽  
Safe Driving ◽  
Traffic Medicine ◽  
Swiss Law ◽  
Tiered System

Medical conditions and behavioral patterns affecting sleep are a largely underestimated threat to traffic safety. Unsupervised or even illegal self-treatment of sleep issues by, for example, anti-histamines, cannabis products, or stimulants, questions safe driving and the fitness to drive as well as low compliance/adherence to treatments (CPAP, medication, etc.) of medical conditions, such as OSAS, or narcolepsy. In such cases, Swiss law calls for a medical assessment of the fitness to drive by experts in traffic medicine. With increasing complexity, this medical assessment is escalated in a four-tiered system of qualified experts, ranging from a qualified practitioner to experts in traffic medicine, at, for example, an Institute for Legal Medicine. The following overview provides insight in the Swiss framework of traffic medicine assessments that – with all caveats and potential drawbacks – helps mitigating the risk of sleep-related accidents. For this, we first introduce Swiss traffic medicine and then argue for consistent terms and measurements to assess sleepy driving. A concise summary of those sleep related conditions most relevant in traffic medicine is followed by an overview over potential issues of sleep-medication.

Analysis of driving simulator performance for post-call orthopaedic surgery residents

2021 ◽  
pp. postgradmedj-2021-139908
Author(s):  
Louis C Grandizio ◽  
Daniela F Barreto Rocha ◽  
J Alexander Holbert ◽  
Elizabeth J Pavis ◽  
David Hopkins ◽  
...  
Keyword(s):  
Orthopaedic Surgery ◽  
Driving Simulator ◽  
Motor Vehicle ◽  
Primary Outcome Measure ◽  
Motor Vehicle Accidents ◽  
Driving Safety ◽  
Secondary Outcome ◽  
Vehicle Accidents ◽  
Single Night ◽  
The Impact

PurposeDespite the associations between workhours, fatigue and motor vehicle accidents, driving abilities for residents post-call have been infrequently analysed. Our purpose was to compare orthopaedic surgery resident performance on a driving simulator after a night of call compared with their baseline.Study designAll residents from a single orthopaedic programme were asked to complete baseline and post-call driving simulator assessments and surveys. The primary outcome measure was brake reaction time (BRT) and secondary outcome measures included lane variance, speed variance and accidents on the driving simulator.ResultsAll 19 orthopaedic residents agreed to participate. Compared with the baseline assessment, residents demonstrated significantly higher levels of sleepiness on the Stanford Sleepiness Scale post-call (1.6 vs 3.4; p<0.0001). Despite higher levels of fatigue post-call, there was no statistically significant differences between baseline and post-call assessments for mean BRT, accidents, lane variation and speed variation.ConclusionsThese data suggest that for orthopaedic residents, driving simulator performance does not appear to be worse after a single night of call compared with baseline. Future collaborative, multicentre investigations on post-call driving safety that incorporate different call types and frequencies are necessary to better define the impact of post-call fatigue on driving performance. Recognising that motor vehicle accidents remain the leading cause of death for people under the age of 30 years, these continued areas of study are necessary to truly establish a culture of resident safety.

scholarly journals Benign Metastasizing Leiomyoma of the Uterus with Pulmonary and Bone Metastases

2021 ◽  
Vol 2021 ◽  
pp. 1-5
Author(s):  
Parikshit Padhi ◽  
Margarita Topalovski
Keyword(s):  
Motor Vehicle ◽  
Motor Vehicle Accident ◽  
Rare Condition ◽  
Middle Aged ◽  
Benign Metastasizing Leiomyoma ◽  
Spindle Cell Neoplasm ◽  
Aged Woman ◽  
History Of ◽  
Metastasizing Leiomyoma ◽  
Leiomyoma Of The Uterus

Benign metastasizing leiomyoma (BML) is a rare spindle cell neoplasm seen in middle-aged women who have a history of leiomyoma of the uterus. The most common sites of metastases are the lungs; however, other sites of spread have been documented. These tumors by definition have no malignant features on histology and tend to be estrogen and progesterone positive. We present a middle-aged woman who was incidentally found to have multiple pulmonary nodules and a mass on her sternum after she was involved in a motor vehicle accident. She had a history of uterine leiomyoma and had undergone a hysterectomy ten years prior to the accident. Biopsies were performed of the lung nodules and sternum mass and compared to her hysterectomy specimen, and they were identical, and hence, she was diagnosed with BML. Due to the growing tumor of her sternum, she was started on tamoxifen with stability of her tumors. These tumors, since they are benign, tend to have an indolent course. However, in the instances that treatment is warranted, options include surgery or antiestrogen therapy. We will be discussing the pathogenesis, histological findings, and treatment options of this rare condition. Our case is unique because BML in general do not tend to spread to multiple organs and tend to be limited to one site of disease.

scholarly journals Variability of Gravel Pavement Roughness: Analysis of the Impact on Vehicle Response and Driving Comfort

2021 ◽  
Author(s):  
Vidas Žuraulis ◽  
Henrikas Sivilevičius ◽  
Eldar Šabanovič ◽  
Valentin Ivanov ◽  
Viktor Skrickij
Keyword(s):  
High Speed ◽  
Ambient Air ◽  
Driving Safety ◽  
Safe Driving ◽  
Pavement Maintenance ◽  
Evaluation Indexes ◽  
Road Pavement ◽  
Driving Speed ◽  
Roughness Analysis ◽  
The Impact

The gravel road pavement has a lower construction cost but poorer performance than the asphalt surface. It also emits dust and deforms under the impact of vehicle loads and ambient air factors. The resulting ripples and ruts are constantly deepening, increasing vehicle vibrations and fuel consumption, reducing safe driving speed and comfort. In this article, existing pavement quality evaluation indexes are analysed, and a methodology for their adaptation for roads with gravel pavement is proposed. This article reports the measured wave depth and length of the gravel pavement profile by the straightedge method of a 160 m long road section in three road exploitation stages. The measured pavement elevation was processed according to ISO 8608, and vehicle frequency response has been investigated using simulations in MATLAB/Simulink. The applied International Roughness Index (IRI) analysis showed that a speed of 30-45 km/h instead of 80 km/h provides the objective results of IRI calculation on the flexible pavement due to a decreasing velocity of vehicle's unsprung mass on a more deteriorated road pavement state. The influence of the corrugation phenomenon of gravel pavement has been explored, identifying specific driving safety and comfort cases. Finally, an increase in the Dynamic Load Coefficient (DLC) at a low speed of 30 km/h on the most deteriorated pavement and a high speed of 90 km/h on the middle-quality pavement demonstrates the demand for timely gravel pavement maintenance and the complicated prediction of a safe driving speed for drivers.

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