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1.
Introduction
Little is known about the trajectory of recovery in fitness-to-drive after mild traumatic brain injury (mTBI). This means that health-care professionals have limited evidence on which to base recommendations to this cohort about driving.Objective
To determine fitness-to-drive status of patients with a mTBI at 24 h and two weeks post injury, and to summarise issues reported by this cohort about return to driving.Method
Quasi-experimental case-control design. Two groups of participants were recruited: patients with a mTBI (n = 60) and a control group with orthopaedic injuries (n = 60). Both groups were assessed at 24 h post injury on assessments of fitness-to-drive. Follow-up occurred at two weeks post injury to establish driver status.Main Measures
Mini mental state examination, occupational therapy-drive home maze test (OT–DHMT), Road Law Road Craft Test, University of Queensland-Hazard Perception Test, and demographic/interview form collected at 24 h and at two weeks.Results
At the 24 h assessment, only the OT–DHMT showed a difference in scores between the two groups, with mTBI participants being significantly slower to complete the test (p = 0.01). At the two week follow-up, only 26 of the 60 mTBI participants had returned to driving. Injury severity combined with scores from the 24 h assessment predicted 31% of the variance in time taken to return to driving. Delayed return to driving was reported due to: “not feeling 100% right” (n = 14, 23%), headaches and pain (n = 12, 20%), and dizziness (n = 5, 8%).Conclusion
This research supports existing guidelines which suggest that patients with a mTBI should not to drive for 24 h; however, further research is required to map factors which facilitate timely return to driving. 相似文献2.
Background
A training method known as Episodic training has shown promise in reducing speeding behavior in young drivers (Prabhakharan and Molesworth, 2011). The present study aimed to investigate how cognitive resources are utilized to implement this behavioral change.Method
60 participants were randomly divided into four groups and completed a simulated training drive in Week 1 followed by a 10 km simulated test drive in Week 2. As part of the test drive, two groups were asked to complete a secondary task (mental arithmetic task) in addition to the test drive.Results
The results indicated that implementing a speed management strategy elicited by Episodic training was successful in isolation, but came at a cognitive trade-off when performed in conjunction with a secondary task.Conclusion
From an applied perspective, these results suggest driver training programmes should compartmentalize driver training in order to reduce the cognitive load experienced by trainee drivers, and hence facilitate in driver skill acquisition. 相似文献3.
Ramazan Mirzaei Nima Hafezi-Nejad Mohammad Sadegh Sabagh Alireza Ansari Moghaddam Vahid Eslami Fatemeh Rakhshani Vafa Rahimi-Movaghar 《Accident; analysis and prevention》2014
Objective
Evaluating the relation between Iranian drivers’ knowledge, attitude, and practice (KAP) regarding traffic regulations, and their deterministic effect on road traffic crashes (RTCs).Setting
Two cities of Tehran and Zahedan, Iran.Methods
A cross-sectional study was designed. Using a simplified cluster sampling design, 2200 motor vehicle drivers including 1200 in Tehran and 1000 in Zahedan were selected. Sixty locations in Tehran and 50 in Zahedan were chosen. In each pre-identified location, 20 adult drivers were approached consecutively. A questionnaire developed by researchers was filled by each participant. The questionnaire had four sections including items assessing the demographics, knowledge, attitude and practice of drivers toward traffic regulations. Logistic regression analysis was used to evaluate the relationship between the RTCs and KAP variables.Results
The study sample consisted of 619 (28.1%) occupational and 1580 (71.8%) private drivers. Among them, 86.4% were male. The median age was 33.6 ± 10.83. Drivers in Tehran and Zahedan had no significant differences between their mean scores of KAP items of the questionnaire. Higher knowledge, safer attitude, and safer practice were associated with a decreased number of RTC. After adjusting for possible confounders, increase of one standard deviation in attitude and practice scores (but not knowledge) resulted in 26.4% and 18.5% decrease in RTC, respectively. Finally, considering knowledge, attitude and practice of drivers in one model to assess their mutual effect, it was shown that only attitude is significantly associated with a decrease of RTC (OR = 0.76, P = 0.007).Conclusion
Increase in attitude and practice accompanied with decreased number of RTCs in Iranian drivers. Specifically, drivers’ attitude had the crucial effect. It is not knowledge and standard traffic education; rather it is how such education is registered as an attitude that translates what is being learned into actions. Without safer attitude, even safer self-reported practice will not result in lower RTCs. 相似文献4.
Aim
The aim of this study was to identify demographic and behavioural factors associated with pre-licensed driving.Method
A cohort comprising 3526 newly licensed drivers aged 15–24 years old from throughout New Zealand completed a questionnaire which sought information on pre-licensed driving behaviour and factors thought to be related to this.Results
Almost half of the participants had driven on-road prior to passing their learner license theory test; 14% had driven more than 20 times; and 7.5% had driven more than 200 km. Multivariate logistic regression showed the results differed depending on the outcome examined. In general pre-licensed driving was significantly higher among males, among Māori, those living in a rural area, and those living in an area of high deprivation. Furthermore, those who drove pre-licensed were more likely to engage in other risky behaviours such as hazardous drinking and cannabis use, and have medium to high scores for sensation seeking and aggression/hostility.Conclusion
The young people who were pre-licensed drivers displayed a range of demographic and behavioural characteristics that indicate they may be at higher crash risk than their peers who did not drive before licensing. Identifying those who drive before licensing and targeting road safety interventions towards this group may help reduce the high crash risk among novice drivers. 相似文献5.
Objective
Driver rehabilitation has the potential to improve on-road safety and is commonly recommended to clients. The aim of this systematic review was to identify what intervention approaches are used by occupational therapists as part of driver rehabilitation programmes, and to determine the effectiveness of these interventions.Method
Six electronic databases (MEDLINE, CINAHL, PsycInfo, Embase, The Cochrane Library, and OTDBase) were searched. Two authors independently reviewed studies reporting all types of research designs and for all patient populations, provided the interventions could be administered by occupational therapists. The methodological quality of studies was assessed using the ‘Downs and Black Instrument’, and the level of evidence for each intervention approach was established using ‘Centre for Evidence Based Medicine’ criteria.Results
Sixteen studies were included in the review. The most common type of intervention approach used was computer-based driving simulator training (n = 8), followed by off-road skill-specific training (n = 4), and off-road education programmes (n = 3). Car adaptations/modifications were used in one of the included studies. There was significant variability between studies with regards to frequency, duration, and total number of intervention sessions, and the diagnoses of the participants. Of the four intervention approaches, there is evidence to support the effectiveness of off-road skill-specific training (with older clients), and computer-based driving simulator training (with both older clients and participants with acquired brain injury).Conclusion
Three types of intervention approaches are commonly reported, however, there is limited evidence to determine to effectiveness of these in improving fitness-to-drive. Further research is required, with clients from a range of diagnostic groups to establish evidence-based interventions and determine their effectiveness in improving these clients’ on-road fitness-to-drive. 相似文献6.
Context
Authorizing powered two-wheeler drivers to drive in lanes reserved to buses is a measure that is sometimes mentioned to improve mobility conditions for these users. But what effect would this measure have on the safety of these users and on the safety of the other users with whom they share the traffic space?Objective
The objective of this study is to contribute elements to help answer this question. More precisely, the objective is to estimate the risk of having an accident per kilometer driven by powered two-wheeler drivers who drive in bus lanes and to compare this risk with that of powered two-wheeler drivers who drive in general traffic lanes.Method
Using the bodily injury accidents recorded by the police over two years on 13 roads in the city of Marseille and a campaign of periodical observations of powered two-wheeler traffic, we estimated the risk per kilometer driven by powered two-wheeler drivers who drive in bus lanes and compared it with that of drivers who do not drive in them.Results
The results show that the risk for powered two-wheeler drivers who drive in bus lanes of being involved in a bodily injury accident is significantly higher than the risk run by drivers who drive in general traffic lanes. For the 13 roads studied, it is on average 3.25 times higher (95% CI: 2.03; 5.21).Conclusion
In the current situation, powered two-wheeler drivers who drive in bus lanes are less safe than those who drive in general traffic lanes. The analysis of police reports suggests that part of this increased risk comes from collisions between automobile drivers turning right and powered two-wheelers driving in the bus lane who continue straight ahead. 相似文献7.
Kaarin J. Anstey Mark S. Horswill Joanne M. Wood Christopher Hatherly 《Accident; analysis and prevention》2012
Objective
The current study evaluated part of the Multifactorial Model of Driving Safety to elucidate the relative importance of cognitive function and a limited range of standard measures of visual function in relation to the Capacity to Drive Safely. Capacity to Drive Safely was operationalized using three validated screening measures for older drivers. These included an adaptation of the well validated Useful Field of View (UFOV) and two newer measures, namely a Hazard Perception Test (HPT), and a Hazard Change Detection Task (HCDT).Method
Community dwelling drivers (n = 297) aged 65–96 were assessed using a battery of measures of cognitive and visual function.Results
Factor analysis of these predictor variables yielded factors including Executive/Speed, Vision (measured by visual acuity and contrast sensitivity), Spatial, Visual Closure, and Working Memory. Cognitive and Vision factors explained 83–95% of age-related variance in the Capacity to Drive Safely. Spatial and Working Memory were associated with UFOV, HPT and HCDT, Executive/Speed was associated with UFOV and HCDT and Vision was associated with HPT.Conclusion
The Capacity to Drive Safely declines with chronological age, and this decline is associated with age-related declines in several higher order cognitive abilities involving manipulation and storage of visuospatial information under speeded conditions. There are also age-independent effects of cognitive function and vision that determine driving safety. 相似文献8.
Introduction
The aim of this study was to explore the effects of external influences on long distance trucking, in particular, incentive-based remuneration systems and the need to wait or queue to load or unload on driver experiences of fatigue.Methods
Long distance truck drivers (n = 475) were recruited at truck rest stops on the major transport corridors within New South Wales, Australia and asked to complete a survey by self-administration or interview. The survey covered demographics, usual working arrangements, details of the last trip and safety outcomes including fatigue experiences.Results
On average drivers’ last trip was over 2000 km and took 21.5 h to complete with an additional 6 h of non-driving work. Incentive payments were associated with longer working hours, greater distances driven and higher fatigue for more drivers. Drivers required to wait in queues did significantly more non-driving work and experienced fatigue more often than those who did not. Drivers who were not paid to wait did the longest trips with average weekly hours above the legal working hours limits, had the highest levels of fatigue and the highest levels of interference by work with family life. In contrast, drivers who were paid to wait did significantly less work with shorter usual hours and shorter last trips. Multivariate analysis showed that incentive-based payment and unpaid waiting in queues were significant predictors of driver fatigue.Conclusions
The findings suggest that mandating payment of drivers for non-driving work including waiting would reduce the amount of non-driving work required for drivers and reduce weekly hours of work. In turn this would reduce driver fatigue and safety risk as well as enhancing the efficiency of the long distance road transport industry. 相似文献9.
Raquel B. De Boni Francisco Inacio Bastos Mauricio de Vasconcellos Fernanda Oliveira Renata P. Limberger Flavio Pechansky 《Accident; analysis and prevention》2014
Background
Driving under the influence of multiple substances is a public health concern, but there is little epidemiological data about their combined use and putative impact on driving in low and middle-income countries where traffic crashes have been clustering in recent years. The aim of this study is to estimate the prevalence of alcohol and drug use – as well as their associated factors – among drivers in the context of alcohol outlets (AOs).Methods
A probability three-stage sample survey was conducted in Porto Alegre, Brazil. Individuals who were leaving AO were screened, with the selection of 683 drivers who met the inclusion criteria. Drivers answered a structured interview, were breathalyzed, and had their saliva collected for drug screening. Prevalences were assessed using domain estimation and logistic regression models assessed covariates associated with substance use.Findings
Benzodiazepines 3.9% (SE 2.13) and cocaine 3.8% (SE 1.3) were the most frequently detected drugs in saliva. Among drivers who were going to drive, 11% had at least one drug identified by the saliva drug screening, 0.4% two, and 0.1% three drugs in addition to alcohol. In multivariable analyses, having a blood alcohol concentration (BAC) > 0.06% was found to be associated with a 3.64 times (CI 95% 1.79–7.39) higher chance of drug detection, compared with interviewees with lower BACs.Conclusions
To drive under the influence of multiple substances is likely to be found in this setting, highlighting an association between harmful patterns of consume of alcohol and the misuse of other substances. 相似文献10.
Objective
The aim of this study was to examine different socio-demographic, health and safety-related factors, and psychoactive substance use among fatally injured drivers in road traffic accidents in Finland during 2006–2008.Methods
An accident information register maintained by the Traffic Safety Committee of Insurance Companies (VALT) of the Finnish Motor Insurers’ Centre was used as basic data, and the basic data were complemented with further toxicological analytical information retrieved from autopsy reports from the Department of Forensic Medicine, Helsinki University. The data included all the drivers (n = 556) who were driving a motor vehicle and who died in a road traffic accident in Finland during 2006–2008.Results
Of all the 556 fatally injured drivers 43% (n = 238) had psychoactive substance findings. 51% (n = 121) of substance positive drivers had a finding for alcohol only, the rest had a finding for one or more illicit/medicinal drugs impairing driving ability, and possibly also alcohol. Fatally injured drivers with alcohol findings were significantly younger (mean age 34 years) than sober drivers (mean age 44 years) or drivers with findings for drugs (mean age 45 years). Socio-demographic background did not differ substantially among drunken/drugged and sober drivers, although drivers with alcohol findings had a slightly lower education and socioeconomic position. Previous substance abuse problems were highly prevalent among drivers with substance findings and mental or both mental and physical health problems were more common among drivers with drug findings. The non-use of safety equipment and driving at a high speed were more common among fatally injured drivers with substance findings.Conclusions
Substance abuse and mental health problems, as well as reckless driving behavior were more pronounced among fatally injured drivers with substance findings when compared to sober drivers. Thus, prevention and early intervention concerning substance abuse, mental health problems and DUI are essential. Improved traffic safety cannot be achieved by means of traffic policy only, but integration with other policies, such as health and social policy should be strengthened. 相似文献11.
Bridie Scott-Parker Barry Watson Mark J. King Melissa K. Hyde 《Accident; analysis and prevention》2014
Purpose
While there is research indicating that many factors influence the young novice driver's increased risk of road crash injury during the earliest stages of their independent driving, there is a need to further understand the relationship between the perceived risky driving behaviour of parents and friends and the risky behaviour of drivers with a Provisional (intermediate) licence.Method
As part of a larger research project, 378 drivers aged 17–25 years (M = 18.22, SD = 1.59, 113 males) with a Provisional licence completed an online survey exploring the perceived riskiness of their parents’ and friends’ driving, and the extent to which they pattern (i.e. base) their driving behaviour on the driving of their parents and friends.Results
Young drivers who reported patterning their driving on their friends, and who reported they perceived their friends to be risky drivers, reported more risky driving. The risky driving behaviour of young male drivers was associated with the perceived riskiness of their fathers’ driving, whilst for female drivers the perceived riskiness of their mothers’ driving approached significance.Conclusions
The development and application of countermeasures targeting the risky behaviour of same-sex parents appears warranted by the robust research findings. In addition, countermeasures need to encourage young people in general to be non-risky drivers; targeting the negative influence of risky peer groups specifically. Social norms interventions may minimise the influence of potentially-overestimated riskiness. 相似文献12.
Introduction
Technical systems that warn or brake for vehicle–pedestrian encounters reduce injuries more effectively the earlier an intervention is initiated. However, premature intervention can irritate drivers, leading to system deactivation and, consequently, no injury reduction whatsoever. It has been proposed that no intervention should be initiated as long as attentive drivers are within their comfort zones. This study aims at quantifying driver comfort boundaries for pedestrian crossing situations to offer guidance for the appropriate timing of interventions.Methods
Sixty two volunteers drove through an intersection on a test track at 30 and 50 km/h. A pedestrian dummy was launched from behind an obstruction towards the driving path of the approaching car. Brake onset indicated discomfort. Time to collision (TTC), longitudinal and lateral distance were measured at brake onset.Results
TTC was independent of driving speed ranging from 2.1 to 4.3 s with a median of 3.2 s. Longitudinal distance ranged from 19 to 48 meters with an apparent difference between driving speeds. Lateral distances differed slightly, but significantly between driving speeds. The median was 3.1 m (3.2 m for 30 km/h and 2.9 m for 50 km/h) and values ranged from 1.9 to 4.1 m. Lateral distance in seconds ranged from 1.9 to 4.3 s with a median value of 3.1 s (3.2 s for 30 km/h and 3.0 s for 50 km/h).Discussion
TTC was independent of driving speed, trial order and volunteer age. It might be considered suitable to intervene in situations where, for example, 90% of drivers have exceeded their comfort boundary, i.e. when drivers have already initiated braking. This percentile value translates to intervention at a TTC of 2.5 s (95% confidence 2.4–2.7 s). The study was limited to Swedish nationals, fully aware drivers, and two driving speeds, but did not investigate behavioural changes due to system interaction.Conclusion
This study showed that TTC at brake onset was a suitable measure for the quantification of driver comfort boundaries in pedestrian crossing situations. All drivers applied their brakes prior to 2.1 s TTC. 相似文献13.
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D. Davenne R. Lericollais P. Sagaspe J. Taillard A. Gauthier S. Espié P. Philip 《Accident; analysis and prevention》2012
Study objective
To compare the impact of extended wakefulness (i.e., sleepiness) and prolonged driving (i.e., fatigue) at the wheel in simulated versus real-life driving conditions.Design
Participants drove on an INRETS-MSIS SIM2 simulator in a research laboratory or an open French highway during 3 nocturnal driving sessions. A dose–response design of duration of nocturnal driving was used: a 2 h short driving session (3–5 AM), a 4 h intermediate driving session (1–5 AM) and an 8 h long driving session (9 PM–5 AM).Participants
Two groups of healthy male drivers (20 for simulated driving and 14 drivers for real driving; mean age ± SD = 22.3 ± 1.6 years), free of sleep disorders.Measurements
Number of inappropriate line crossings, self-rated fatigue and sleepiness were recorded in the last hour of driving sessions to control the effects of prior waking time and time of day.Results
Compared to the daytime reference session, both simulated and real driving performance were affected by a short nocturnal driving session (P < .05 and P < .001, respectively). Extension of nocturnal driving duration affected simulated performance nonlinearly and more severely than that of real driving (P < .001).Compared to the daytime reference session, short nocturnal simulated and real driving sessions increased self-perceived fatigue and sleepiness. Real and simulated driving conditions had an identical impact on fatigue and sleepiness during extended periods of nocturnal driving.Conclusions
In healthy subjects, the INRETS-MSIS SIM2 simulator appropriately measures driving impairment in terms of inappropriate line crossings related to extended wakefulness but has limitations to measure the impact of extended driving on drivers’ performance. 相似文献16.
Michelle L. Fraser Lynn B. Meuleners Andy H. Lee Jonathon Q. Ng Nigel Morlet 《Accident; analysis and prevention》2013
Objective
To investigate self-reported driving difficulty before and after first eye cataract surgery and determine which visual measures are associated with changes in self-reported driving difficulty after surgery.Methods
A cohort of 99 older drivers with bilateral cataract were assessed the week before and 12 weeks after first eye cataract surgery. Visual measures including visual acuity, contrast sensitivity, stereopsis and useful field of view were assessed. Self-reported driving difficulty was measured via the Driving Habits Questionnaire. Cognitive status was assessed using the Mini Mental State Examination. Regression analysis was undertaken to determine the association between changes in visual measures and self-reported driving difficulty after first eye cataract surgery.Results
Overall, self-reported driving difficulty improved after first eye cataract surgery. However, 16% of participants did not improve and driving difficulty worsened in 11% following surgery. Improvement in driving difficulty score after first eye cataract surgery was associated with improved contrast sensitivity in the operated eye (p < 0.001), new glasses after surgery (p < 0.001), and fewer chronic health conditions (p = 0.016).Conclusion
Contrast sensitivity rather than visual acuity was a significant factor affecting change in self-reported driving difficulty after first eye cataract surgery for bilateral patients. This has implications for driver licensing authorities worldwide that rely heavily on visual acuity as a measure of visual fitness to drive. 相似文献17.
Objectives
This study assessed the association between county level material deprivation and urbanization with fatal road traffic crashes involving young unlicensed drivers in the United States (US).Background
Road traffic crashes have been positively associated with area deprivation and low population density but thus far few studies have been concerned specifically with young drivers, especially those that are unlicensed.Methods
A county material deprivation index was derived from the Townsend Material Deprivation Index, with variables extracted from the US Census (2000). An urbanicity scale was adapted from the US Department of Agriculture's Rural–Urban Continuum Codes (2003). Data on fatal crashes involving a young unlicensed driver during a seven-year period (2000–2006; n = 3059) were extracted from the Fatality Analysis Reporting System. The effect of deprivation and urbanicity on the odds of the occurrence of at least one fatal crash at the county level was modeled by conditional and unconditional logistic regression.Results
The conditional model found a positive association between material deprivation and a fatal crash involving a young unlicensed driver (OR = 1.19, 95% CI 1.17, 1.21). The interaction between urbanicity and material deprivation was negatively associated in suburban counties for fatal crashes (OR = 0.92, 95% CI 0.90, 0.95).Conclusions
An association with material deprivation and the likelihood of a fatal crash involving a young unlicensed driver is a new finding. It can be used to inform specific county-level interventions and promote state licensing policies to provide equity in young people's mobility regardless of where they live. 相似文献18.
Con Stough Luke A. Downey Rebecca King Katherine Papafotiou Phillip Swann Edward Ogden 《Accident; analysis and prevention》2012
Objectives
Illicit drugs such as MDMA and methamphetamine are commonly abused drugs that have also been observed to be prevalent in drivers injured in road accidents. Their exact effect on driving and driving behavior has yet to be thoroughly investigated.Methods
Sixty-one abstinent recreational users of illicit drugs comprised the participant sample, with 33 females and 28 males, mean age 25.45 years. The three testing sessions involved oral consumption of 100 mg MDMA, 0.42 mg/kg methamphetamine, or a matching placebo. The drug administration was counter-balanced, double-blind, and medically supervised. At each session driving performance was assessed 3 h and 24 h post drug administration on a computerized driving simulator.Results
At peak concentration overall impairment scores for driving (F2,118 = 9.042, p < 0.001) and signaling (F2,118 = 4.060, p = 0.020) were significantly different for the daytime simulations. Performance in the MDMA condition was worse than both the methamphetamine (p = 0.023) and placebo (p < 0.001) conditions and the methamphetamine condition was also observed to be worse in comparison to the placebo (p = 0.055). For signaling adherence, poorer signaling adherence occurred in both the methamphetamine (p = 0.006) and MDMA (p = 0.017) conditions in comparison to placebo in the daytime simulations.Conclusions
The findings of this study have for the first time illustrated how both MDMA and methamphetamine effect driving performance, and provide support for legislation regarding testing for the presence of illicit drugs in impaired or injured drivers as deterrents for driving under the influence of illicit drugs. 相似文献19.
Catherine J. Vladutiu Charles Poole Stephen W. Marshall Carri Casteel M. Kathryn Menard Harold B. Weiss 《Accident; analysis and prevention》2013
Background
Motor vehicle crashes are the leading cause of maternal injury-related mortality during pregnancy in the United States, yet pregnant women remain an understudied population in motor vehicle safety research.Methods
We estimated the risk of being a pregnant driver in a crash among 878,546 pregnant women, 16–46 years, who reached the 20th week of pregnancy in North Carolina (NC) from 2001 to 2008. We also examined the circumstances surrounding the crash events. Pregnant drivers in crashes were identified by probabilistic linkage of live birth and fetal death records and state motor vehicle crash reports.Results
During the 8-year study period, the estimated risk of being a driver in a crash was 12.6 per 1000 pregnant women. Pregnant women at highest risk of being drivers in serious crashes were 18–24 years old (4.5 per 1000; 95% confidence interval, CI,4.3, 4.7), non-Hispanic black (4.8 per 1000; 95% CI = 4.5, 5.1), had high school diplomas only (4.5 per 1000; 95% CI = 4.2, 4.7) or some college (4.1 per 1000; 95% CI = 3.9, 4.4), were unmarried (4.7 per 1000; 95% CI = 4.4, 4.9), or tobacco users (4.5 per 1000; 95% CI = 4.1, 5.0). A high proportion of crashes occurred between 20 and 27 weeks of pregnancy (45%) and a lower proportion of crashes involved unbelted pregnant drivers (1%) or airbag deployment (10%). Forty percent of crashes resulted in driver injuries.Conclusions
NC has a relatively high pregnant driver crash risk among the four U.S. states that have linked vital records and crash reports to examine pregnancy-associated crashes. Crash risks were especially elevated among pregnant women who were young, non-Hispanic black, unmarried, or used tobacco. Additional research is needed to quantify pregnant women's driving frequency and patterns. 相似文献20.
