Effectiveness of a Brief Parent-Directed Teen Driver Safety Intervention (Checkpoints) Delivered by Driver Education Instructors

PubMed Central

Zakrajsek, Jennifer S.; Shope, Jean T.; Greenspan, Arlene I.; Wang, Jing; Bingham, C. Raymond; Simons-Morton, Bruce G.

2014-01-01

Background The Checkpoints program (Checkpoints) uses a Parent-Teen Driving Agreement (PTDA) to help parents monitor teens' driving, and has shown efficacy in increasing parental restrictions on teens' driving and decreasing teens' risky driving. In previous trials, research staff administered Checkpoints. This study examined the effectiveness of Checkpoints when delivered by driver educators. It was hypothesized that Checkpoints would result in more PTDA use, greater PTDA limits on higher risk driving situations, and less high-risk driving. Methods Eight trained driving instructors were randomly assigned to intervention or control groups in a group randomized trial. Instructors enrolled 148 parent-teen dyads (intervention = 99, control = 49); 35% of those eligible. Intervention parents joined teens for a 30-minute Checkpoints session during driver education. The session included a video, persuasive messages, discussion, and PTDA initiation. Teens completed four surveys: baseline, licensure, and 3- and 6-months post-licensure. Results Intervention teens were more likely to report that they used a PTDA (OR= 15.92, p = .004) and had restrictions on driving with teen passengers (OR = 8.52, p = .009), on weekend nights (OR = 8.71, p = .021), on high-speed roads (OR = 3.56, p = .02), and in bad weather (b = .51, p = .05) during the first six months of licensure. There were no differences in offenses or crashes at six months, but intervention teens reported less high-risk driving (p = .04). Conclusions Although challenges remain to encourage greater parent participation, Checkpoints conducted by driver education instructors resulted in more use of PTDAs, greater restrictions on high-risk driving, and less high-risk driving. Including Checkpoints in driver education parent meetings/classes has potential to enhance teen driver safety. PMID:23481298

The contribution of parents' driving behavior, family climate for road safety, and parent-targeted intervention to young male driving behavior.

PubMed

Taubman-Ben-Ari, Orit; Musicant, Oren; Lotan, Tsippy; Farah, Haneen

2014-11-01

One of the prominent issues in contemporary research on young drivers deals with the mechanisms underlying parents' influences on their offspring's driving behavior. The present study combines two sets of data: the first gathered from in-vehicle data recorders tracking the driving of parents and their teenage sons, and the second derived from self-report questionnaires completed by the young drivers. The aim was to evaluate the contribution of parents' driving behavior, participation in a parent-targeted intervention, and the teen drivers' perception of the family climate for road safety, to the driving behavior of young drivers during solo driving. The data was collected over the course of 12 months, beginning with the licensure of the teen driver, and examined a sample of 166 families who were randomly assigned to one of three intervention groups (receiving different forms of feedback) or a control group (with no feedback). Findings indicate that young male drivers' risky driving events rate was positively associated with that of their parents. In addition, any type of intervention led to a lower rate of risky driving events among young drivers compared to the control group. Finally, a higher perception of parents as not committed to safety and lower perceived parental monitoring were related to a higher risky driving events rate among young drivers. The results highlight the need to consider a complex set of antecedents in parents' attitudes and behavior, as well as the family's safety atmosphere, in order to better understand young drivers' risky driving. The practical implications refer to the effective use of the family as a lever in the attempt to promote safety awareness among young drivers. Copyright © 2014 Elsevier Ltd. All rights reserved.

Accident Prevention through Driving Skills Assessment and Interventions for Older Drivers: A Programmatic Research Project.

ERIC Educational Resources Information Center

Yee, Darlene; Melichar, Joseph F.

A study examined the effectiveness of a new computer-based multiphasic approach to identifying "at-risk" older drivers and remediating deficits in their driving and traffic safety attitudes, knowledge, and skills. Data collected from 250 older drivers in 3 states were used to develop specifications for computer-based driver improvement modules.…

The influence of anger, impulsivity, sensation seeking and driver attitudes on risky driving behaviour among post-graduate university students in Durban, South Africa.

PubMed

Bachoo, Shaneel; Bhagwanjee, Anil; Govender, Kaymarlin

2013-06-01

Road traffic accidents (RTAs) constitute a serious global health risk, and evidence suggests that young drivers are significantly overrepresented among those injured or killed in RTAs. This study explores the role of anger, impulsivity, sensation seeking and driver attitudes as correlates for risky driving practices among drivers, drawing comparisons between age and gender. The study used a cross-sectional survey design, with a sample of 306 post-graduate university students from two universities in Durban, South Africa, who completed the self-administered questionnaire. The results indicate that drivers with higher driver anger, sensation seeking, urgency, and with a lack of premeditation and perseverance in daily activities were statistically more likely to report riskier driving acts. Males reported significantly more acts of risky driving behaviour (RDB) than females. Driver attitudes significantly predicted self-reported acts of RDB on most indicators. Older drivers (25 years and older) had safer driver attitudes and a lower sense of sensation seeking and urgency in life. Interventions targeting young drivers, which focus on impeding the manifestation of anger, impulsivity and sensation seeking are recommended. Also, the empirical support for the attitude-behaviour hypothesis evidenced in this study vindicates the development or continuation of interventions that focus on this dynamic. Copyright © 2013 Elsevier Ltd. All rights reserved.

Effectiveness of Parent-Focused Interventions to Increase Teen Driver Safety:A Critical Review

PubMed Central

Curry, Allison E.; Peek-Asa, Corinne; Hamann, Cara J.; Mirman, Jessica H.

2015-01-01

Purpose We critically reviewed recent parent-directed teen driving interventions in order to summarize their success in meeting stated goals; identify promising intervention components and knowledge gaps; aid in the selection, adaptation, and dissemination of effective interventions; and guide future research efforts. Methods We focused on interventions that included a direct parent component, explicitly stated outcomes related to the teen and/or their parents, were evaluated for parent or teen outcomes, targeted drivers under age 21, and had at least one evaluation study published since 1990 and in English. We conducted a comprehensive systematic search of 26 online databases between November 2013 and January 2014 and identified 34 papers representing 18 interventions. Results Several interventions—in particular those that had an active engagement component, incorporated an in-vehicle data recorder system, and had a strong conceptual approach—show promise in improving parental supervisory behaviors during the learner and early independent phases, increasing teen driver skill acquisition, and reducing teens' risky driving behaviors. Conclusions We identify essential characteristics of effective parent-involved teen driving interventions and their evaluation studies, propose a comprehensive and multi-tiered approach to intervention, and discuss several research areas and overarching issues for consideration. PMID:26112737

Perceptions of Heat Risk to Health: A Qualitative Study of Professional Bus Drivers and Their Managers in Jinan, China

PubMed Central

Zhou, Lin; Xin, Zheng; Bai, Li; Wan, Fangjun; Wang, Yongming; Sang, Shaowei; Liu, Shouqin; Zhang, Ji; Liu, Qiyong

2014-01-01

Summer extreme heat threatens the health of individuals, especially persons who are involved in outdoor activities. Ensuring the normal function of a city, bus drivers are among those who participate in outdoor physical activities and are exposed to excessive heat in hot summer weather. This qualitative study was performed to explore professional bus drivers’ in-depth views of extreme heat risks to their health, and ultimately develop targeted advice and policy interventions for city bus drivers. An interview-based study was performed among professional bus drivers in Jinan, China, including four focus groups with professional bus drivers (n = 37) and three interviews with their managers (n = 14). Five central themes or categories from the bus driver interviews were found: concerns about summer heat; health effects related to extreme heat; adaptive measures; barriers in implementing these adaptive measures; and suggested interventions. The beneficial role of cooling facilities (particularly air-conditioning) during extreme heat are addressed. The barriers not only impede the implementation of behavioral adaptive measures but also enhance the negative attitudes of bus drivers towards their effectiveness. The responsibilities of managers in promoting preventive actions are addressed. PMID:24477213

Driver behavior following an automatic steering intervention.

PubMed

Fricke, Nicola; Griesche, Stefan; Schieben, Anna; Hesse, Tobias; Baumann, Martin

2015-10-01

The study investigated driver behavior toward an automatic steering intervention of a collision mitigation system. Forty participants were tested in a driving simulator and confronted with an inevitable collision. They performed a naïve drive and afterwards a repeated exposure in which they were told to hold the steering wheel loosely. In a third drive they experienced a false alarm situation. Data on driving behavior, i.e. steering and braking behavior as well as subjective data was assessed in the scenarios. Results showed that most participants held on to the steering wheel strongly or counter-steered during the system intervention during the first encounter. Moreover, subjective data collected after the first drive showed that the majority of drivers was not aware of the system intervention. Data from the repeated drive in which participants were instructed to hold the steering wheel loosely, led to significantly more participants holding the steering wheel loosely and thus complying with the instruction. This study seems to imply that without knowledge and information of the system about an upcoming intervention, the most prevalent driving behavior is a strong reaction with the steering wheel similar to an automatic steering reflex which decreases the system's effectiveness. Results of the second drive show some potential for countermeasures, such as informing drivers shortly before a system intervention in order to prevent inhibiting reactions. Copyright © 2015 Elsevier Ltd. All rights reserved.

Effectiveness of Parent-Focused Interventions to Increase Teen Driver Safety: A Critical Review.

PubMed

Curry, Allison E; Peek-Asa, Corinne; Hamann, Cara J; Mirman, Jessica H

2015-07-01

We critically reviewed recent parent-directed teen driving interventions to summarize their success in meeting stated goals; identify promising intervention components and knowledge gaps; aid in the selection, adaptation, and dissemination of effective interventions; and guide future research efforts. We focused on interventions that included a direct parent component, explicitly stated outcomes related to the teen and/or their parents, were evaluated for parent or teen outcomes, targeted drivers younger than the age of 21 years, and had at least one evaluation study published since 1990 and in English. We conducted a comprehensive systematic search of 26 online databases between November 2013 and January 2014 and identified 34 articles representing 18 interventions. Several interventions-in particular, those that had an active engagement component, incorporated an in-vehicle data recorder system, and had a strong conceptual approach-show promise in improving parental supervisory behaviors during the learner and early independent phases, increasing teen driver skill acquisition, and reducing teens' risky driving behaviors. We identify essential characteristics of effective parent-involved teen driving interventions and their evaluation studies, propose a comprehensive and multitiered approach to intervention, and discuss several research areas and overarching issues for consideration. Copyright © 2015 Society for Adolescent Health and Medicine. All rights reserved.

Injury prevention programs against distracted driving among students.

PubMed

Joseph, Bellal; Haider, Ansab; Hassan, Ahmed; Kulvatunyou, Narong; Bains, Sandeep; Tang, Andrew; Zangbar, Bardiya; OʼKeeffe, Terence; Vercruysse, Gary; Gries, Lynn; Rhee, Peter

2016-07-01

Motor vehicle crashes are the leading cause of death and nonfatal injury among young adults. The aims of this study were to assess the magnitude of distracted driving (DD) among students and to examine the effectiveness of awareness campaign against DD. We hypothesized that DD is prevalent among students and educational efforts such as DD awareness campaign can effectively reduce it. This study was conducted within the University of Arizona that has a student enrollment of 42,000 students. We conducted our prospective interventional study in four phases at the university campus. Phase 1 involved 1-week preintervention observation, Phase 2 involved 1-week intervention, Phase 3 involved 1-week postintervention observation, and Phase 4 involved 1-week 6-month postintervention observation. We used a combination of e-mails, pamphlets, interactive sessions, and banners as intervention tools in student union. Our primary outcome was the prevalence of DD before, after, and 6 months after intervention. A total of 47,764 observations (before, 14,844; after, 17,939; 6 months after, 14,981) were performed. During the study period, overall rate of DD rate among the students was 8.8 (5.4) per 100 drivers (texting, 4.8 [3.7] per 100 drivers; talking, 3.9 [2.0] per 100 drivers).The baseline rate of DD among students during the phase one was 9.0 (1.2) per 100 drivers (texting, 4.8 [1.7] per 100 drivers; talking, 4.1 [1.1] per 100 drivers). Following intervention, there was a 32% significant reduction in overall DD (9.0 [1.2] vs. 6.1 [1.7], p < 0.001) in the immediate postintervention phase; however, the rate of DD returned to baseline at 6 months after intervention and trended toward increase (9.0 [1.2] vs. 11.1 [8.4], p = 0.34). DD is prevalent among university students. Following a comprehensive preventive campaign against DD, there was a 32% reduction in the rate of DD in the immediate postintervention period. However, a single episode of intervention did not have a sustainable preventive effect on the DD, and the rate increased to the baseline at 6-month follow-up. Targeting DD with a successful injury prevention campaign with repeated boosters may decrease its prevalence among the students.

The development of an intervention programme to reduce whole-body vibration exposure at work induced by a change in behaviour: a study protocol

PubMed Central

Tiemessen, Ivo JH; Hulshof, Carel TJ; Frings-Dresen, Monique HW

2007-01-01

Background Whole body vibration (WBV) exposure at work is common and studies found evidence that this exposure might cause low back pain (LBP). A recent review concluded there is a lack of evidence of effective strategies to reduce WBV exposure. Most research in this field is focussed on the technical implications, although changing behaviour towards WBV exposure might be promising as well. Therefore, we developed an intervention programme to reduce WBV exposure in a population of drivers with the emphasis on a change in behaviour of driver and employer. The hypothesis is that an effective reduction in WBV exposure, in time, will lead to a reduction in LBP as WBV exposure is a proxy for an increased risk of LBP. Methods/Design The intervention programme was developed specifically for the drivers of vibrating vehicles and their employers. The intervention programme will be based on the most important determinants of WBV exposure as track conditions, driving speed, quality of the seat, etc. By increasing knowledge and skills towards changing these determinants, the attitude, social influence and self-efficacy (ASE) of both drivers and employers will be affected having an effect on the level of exposure. We used the well-known ASE model to develop an intervention programme aiming at a change or the intention to change behaviour towards WBV exposure. The developed programme consists of: individual health surveillance, an information brochure, an informative presentation and a report of the performed field measurements. Discussion The study protocol described is advantageous as the intervention program actively tries to change behaviour towards WBV exposure. The near future will show if this intervention program is effective by showing a decrease in WBV exposure. PMID:18005400

Teen driver cell phone blocker.

DOT National Transportation Integrated Search

2012-02-01

This study was a randomized control intervention to measure the effectiveness of a cellular phone control device : that communicates with the vehicles of teen drivers to deny them access to their phone while driving for the : purpose of reducing dist...

Improved self-confidence was a mechanism of action in two geriatric trials evaluating physical interventions.

PubMed

Peduzzi, Peter; Guo, Zhenchao; Marottoli, Richard A; Gill, Thomas M; Araujo, Katy; Allore, Heather G

2007-01-01

To evaluate the mechanisms of action in two successful geriatric clinical trials that tested multicomponent physical conditioning programs and to determine whether the pathways for overall benefit were through improvement in physical ability and/or self-confidence. PREHAB and DRIVER were conducted by the Yale Pepper Center. PREHAB participants received an individualized program that focused on the impairments present (standardly tailored design); DRIVER participants received the entire intervention (global design). PREHAB enrolled 188 community-living persons, aged 75 years or older, who were physically frail but ambulatory; DRIVER enrolled 178 drivers aged 70 years or older with physical impairments associated with poor driving performance. The primary outcome for PREHAB was a disability score and for DRIVER it was a driving score; potential mediators were measures of physical ability and self-confidence. In PREHAB, pathways for the intervention were established through improvement in physical ability and self-confidence. In DRIVER, there was some evidence for a pathway through improved driving self-confidence but not through physical ability; however, the intervention effect was largely unexplained. Multicomponent physical interventions may operate through psychological mechanisms, and these mechanisms should be anticipated in trial designs so that the component effects can be suitably evaluated.

Young drivers' optimism bias for accident risk and driving skill: Accountability and insight experience manipulations.

PubMed

White, Melanie J; Cunningham, Lauren C; Titchener, Kirsteen

2011-07-01

This study aimed to determine whether two brief, low cost interventions would reduce young drivers' optimism bias for their driving skills and accident risk perceptions. This tendency for such drivers to perceive themselves as more skillful and less prone to driving accidents than their peers may lead to less engagement in precautionary driving behaviours and a greater engagement in more dangerous driving behaviour. 243 young drivers (aged 17-25 years) were randomly allocated to one of three groups: accountability, insight or control. All participants provided both overall and specific situation ratings of their driving skills and accident risk relative to a typical young driver. Prior to completing the questionnaire, those in the accountability condition were first advised that their driving skills and accident risk would be later assessed via a driving simulator. Those in the insight condition first underwent a difficult computer-based hazard perception task designed to provide participants with insight into their potential limitations when responding to hazards in difficult and unpredictable driving situations. Participants in the control condition completed only the questionnaire. Results showed that the accountability manipulation was effective in reducing optimism bias in terms of participants' comparative ratings of their accident risk in specific situations, though only for less experienced drivers. In contrast, among more experienced males, participants in the insight condition showed greater optimism bias for overall accident risk than their counterparts in the accountability or control groups. There were no effects of the manipulations on drivers' skills ratings. The differential effects of the two types of manipulations on optimism bias relating to one's accident risk in different subgroups of the young driver sample highlight the importance of targeting interventions for different levels of experience. Accountability interventions may be beneficial for less experienced young drivers but the results suggest exercising caution with the use of insight type interventions, particularly hazard perception style tasks, for more experienced young drivers typically still in the provisional stage of graduated licensing systems. Copyright © 2011 Elsevier Ltd. All rights reserved.

The Effects of Prompting and Feedback on Drivers' Stopping at Stop Signs

PubMed Central

Austin, John; Hackett, Stacey; Gravina, Nicole; Lebbon, Angela

2006-01-01

Complete stops at a high-traffic intersection on the campus of a public university were increased with a prompting and consequence intervention. Data were collected at two opposing stop signs (Stop A and Stop B); however, the intervention was implemented only at Stop A. During the intervention, a volunteer stood next to Stop A holding a poster that read, “Please Stop—I Care,” with “Thank You For Stopping” on the reverse side. The poster was held by the volunteer so that drivers approaching Stop A could read the sign. Drivers approaching Stop B could see the volunteer but could not read the sign. When vehicles approaching Stop A made a complete stop, the volunteer flashed the “thank you” side of the poster to the driver. The strategy was evaluated using a multielement design. The intervention increased stops completed at Stop A from a baseline average of 13% to an intervention average of 52%. Stop B also showed improved stopping, from a baseline average of 6% to an intervention average of 28%. Data showed no relation between complete stops made and the drivers' use of turn signals and safety belts. PMID:16602391

Translation to Primary Care of an Effective Teen Safe Driving Program for Parents.

PubMed

Shope, Jean T; Zakrajsek, Jennifer S; Finch, Stacia; Bingham, C Raymond; O'Neil, Joseph; Yano, Stephen; Wasserman, Richard; Simons-Morton, Bruce

2016-10-01

Addressing teen driver crashes, this study adapted an effective Checkpoints(TM) program for parents of teen drivers for dissemination by primary care practitioners (PCPs) and the web; distributed the PCP/web program through pediatric practices; and examined dissemination to/implementation by parents. The website, youngDRIVERparenting.org, and brief intervention protocol were developed. PCPs delivered interventions and materials to parents, referred them to the website, and completed follow-up surveys. Google Analytics assessed parents' website use. Most PCPs reported delivering interventions with fidelity, and thought the program important and feasible. Brief interventions/website referrals, averaging 4.4 minutes, were delivered to 3465 (87%) of 3990 eligible parents by 133 PCPs over an 18-week average. Website visits (1453) were made by 42% of parents, who spent on average 3:53 minutes viewing 4.2 topics. This program costs little (its website, training and promotional materials are available) and could be one component of a comprehensive approach to reducing teen driver crashes. © The Author(s) 2016.

Impact of a driver intervention program on DWI recidivism and problem drinking

DOT National Transportation Integrated Search

1985-12-01

This was a natural history study comparing the effects of a brief jail sentence, suspended sentence/fine, or a therapeutic intervention known as The Weekend Intervention Program (WIP) on drunk driving recidivism and alcohol-related crashes, Offenders...

Extracting Fitness Relationships and Oncogenic Patterns among Driver Genes in Cancer.

PubMed

Zhang, Xindong; Gao, Lin; Jia, Songwei

2017-12-25

Driver mutation provides fitness advantage to cancer cells, the accumulation of which increases the fitness of cancer cells and accelerates cancer progression. This work seeks to extract patterns accumulated by driver genes ("fitness relationships") in tumorigenesis. We introduce a network-based method for extracting the fitness relationships of driver genes by modeling the network properties of the "fitness" of cancer cells. Colon adenocarcinoma (COAD) and skin cutaneous malignant melanoma (SKCM) are employed as case studies. Consistent results derived from different background networks suggest the reliability of the identified fitness relationships. Additionally co-occurrence analysis and pathway analysis reveal the functional significance of the fitness relationships with signaling transduction. In addition, a subset of driver genes called the "fitness core" is recognized for each case. Further analyses indicate the functional importance of the fitness core in carcinogenesis, and provide potential therapeutic opportunities in medicinal intervention. Fitness relationships characterize the functional continuity among driver genes in carcinogenesis, and suggest new insights in understanding the oncogenic mechanisms of cancers, as well as providing guiding information for medicinal intervention.

Value drivers: an approach for estimating health and disease management program savings.

PubMed

Phillips, V L; Becker, Edmund R; Howard, David H

2013-12-01

Health and disease management (HDM) programs have faced challenges in documenting savings related to their implementation. The objective of this eliminate study was to describe OptumHealth's (Optum) methods for estimating anticipated savings from HDM programs using Value Drivers. Optum's general methodology was reviewed, along with details of 5 high-use Value Drivers. The results showed that the Value Driver approach offers an innovative method for estimating savings associated with HDM programs. The authors demonstrated how real-time savings can be estimated for 5 Value Drivers commonly used in HDM programs: (1) use of beta-blockers in treatment of heart disease, (2) discharge planning for high-risk patients, (3) decision support related to chronic low back pain, (4) obesity management, and (5) securing transportation for primary care. The validity of savings estimates is dependent on the type of evidence used to gauge the intervention effect, generating changes in utilization and, ultimately, costs. The savings estimates derived from the Value Driver method are generally reasonable to conservative and provide a valuable framework for estimating financial impacts from evidence-based interventions.

Health promotion in the trucking setting: Understanding Dutch truck drivers' road to healthy lifestyle changes.

PubMed

Boeijinga, Anniek; Hoeken, Hans; Sanders, José

2016-10-17

The working environment, the nature of the work, and the characteristics of truck drivers as a social group typically pose great challenges for the truck drivers' health and health promotion activities aiming to improve it. The purpose was to obtain a better understanding of (a) Dutch truck drivers' perceptions of health and lifestyle themes, and (b) the challenges they experience in their pursuit of a more healthy lifestyle, as a guiding framework for the development of health interventions targeting this occupational group. In this qualitative study, we conducted and analyzed 20 semi-structured interviews and seven cases of participant observations with Dutch truck drivers. Grounded theory was used to analyze the data. Our findings illustrate that Dutch truck drivers wish to improve their lifestyle but have unproductive associations with concepts of healthy living as well as a tendency to downplay their health risks. In addition, they experience barriers within their work and personal environment that prevent them from translating their intentions into actual lifestyle changes. Based on the insights derived from the interviews, we discuss recommendations for the development of more effective health promotion interventions for truck drivers.

Using haptic feedback to increase seat belt use of service vehicle drivers.

DOT National Transportation Integrated Search

2011-01-01

This study pilot-tested a new application of a technology-based intervention to increase seat belt use. The technology was based on a : contingency in which unbelted drivers experienced sustained haptic feedback to the gas pedal when they exceeded 25...

Improving seat belt use among teen drivers: findings from a service-learning approach.

PubMed

Goldzweig, Irwin A; Levine, Robert S; Schlundt, David; Bradley, Richard; Jones, Gennifer D; Zoorob, Roger J; Ekundayo, O James

2013-10-01

Low seat belt use and higher crash rates contribute to persistence of motor vehicle crashes as the leading cause of teenage death. Service-learning has been identified as an important component of public health interventions to improve health behavior. A service-learning intervention was conducted in eleven selected high schools across the United States in the 2011-2012 school year. Direct morning and afternoon observations of seat belt use were used to obtain baseline observations during the fall semester and post-intervention observations in the spring. The Mann-Whitney U test for 2 independent samples was used to evaluate if the intervention was associated with a statistically significant change in seat belt use. We identified factors associated with seat belt use post-intervention using multivariable logistic regression. Overall seat belt use rate increased by 12.8%, from 70.4% at baseline to 83.2% post-intervention (p<0.0001). A statistically significant increase in seat belt use was noted among white, black, and Hispanic teen drivers. However, black and Hispanic drivers were still less likely to use seat belts while driving compared to white drivers. Female drivers and drivers who had passengers in their vehicle had increased odds of seat belt use. A high school service-learning intervention was associated with improved seat belt use regardless of race, ethnicity, or gender, but did not eliminate disparities adversely affecting minority youth. Continuous incorporation of service-learning in high school curricula could benefit quality improvement evaluations aimed at disparities elimination and might improve the safety behavior of emerging youth cohorts. Copyright © 2013 Elsevier Ltd. All rights reserved.

Drivers of sustained hygiene behaviour change: A case study from mid-western Nepal.

PubMed

McMichael, Celia; Robinson, Priscilla

2016-08-01

Behaviour change is central to the prevention of many population health problems, yet it is typically difficult to initiate and sustain. This paper reports on an evaluation of a water, sanitation and hygiene (WASH) intervention in mid-western Nepal, with particular focus on the drivers and barriers for handwashing with soap/ash and elimination of open defecation. The research was conducted during October-November 2014, two and half years following the intervention's end-point. Qualitative data were collected from the target community (n = 112) via group discussions, interviews and drawings/stories of 'most significant change'. Households' handwashing/water facilities and toilets were observed. Analysis was informed by a model that highlights environmental, psychosocial and technological factors that shape hygiene behaviours across multiple levels, from the habitual to the structural (Dreibelbis et al. 2013). Findings indicate the intervention has supported development of new norms around hygiene behaviours. Key drivers of sustained hygiene behaviour were habit formation, emotional drivers (e.g. disgust, affiliation), and collective action and civic pride; key constraints included water scarcity and socio-economic disadvantage. Identifying and responding to the drivers and constraints of hygiene behaviour change in specific contexts is critical to sustained behaviour change and population health impact. Copyright © 2016 Elsevier Ltd. All rights reserved.

COMPARING THE IMPAIRMENT PROFILES OF OLDER DRIVERS AND NON-DRIVERS: TOWARD THE DEVELOPMENT OF A FITNESS-TO-DRIVE MODEL

PubMed Central

Antin, Jonathan F.; Stanley, Laura M.; Guo, Feng

2011-01-01

The purpose of this research effort was to compare older driver and non-driver functional impairment profiles across some 60 assessment metrics in an initial effort to contribute to the development of fitness-to-drive assessment models. Of the metrics evaluated, 21 showed statistically significant differences, almost all favoring the drivers. Also, it was shown that a logistic regression model comprised of five of the assessment scores could completely and accurately separate the two groups. The results of this study imply that older drivers are far less functionally impaired than non-drivers of similar ages, and that a parsimonious model can accurately assign individuals to either group. With such models, any driver classified or diagnosed as a non-driver would be a strong candidate for further investigation and intervention. PMID:22058607

Driver rehabilitation: a systematic review of the types and effectiveness of interventions used by occupational therapists to improve on-road fitness-to-drive.

PubMed

Unsworth, Carolyn A; Baker, Anne

2014-10-01

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. 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. 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). 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. Crown Copyright © 2014. Published by Elsevier Ltd. All rights reserved.

The Supporting a Teen's Effective Entry to the Roadway (STEER) Program: Feasibility and Preliminary Support for a Psychosocial Intervention for Teenage Drivers with ADHD

ERIC Educational Resources Information Center

Fabiano, Gregory A.; Hulme, Kevin; Linke, Stuart; Nelson-Tuttle, Chris; Pariseau, Meaghan; Gangloff, Brian; Lewis, Kemper; Pelham, William E.; Waschbusch, Daniel A.; Waxmonsky, James G.; Gormley, Matthew; Gera, Shradha; Buck, Melina

2011-01-01

Teenage drivers with attention-deficit/hyperactivity disorder (ADHD) are at considerable risk for negative driving outcomes, including traffic citations, accidents, and injuries. Presently, no efficacious psychosocial interventions exist for teenage drivers with ADHD. The Supporting a Teen's Effective Entry to the Roadway (STEER) program is a…

The Implementation of Internet Interventions for Depression: A Scoping Review.

PubMed

Drozd, Filip; Vaskinn, Linda; Bergsund, Hans Bugge; Haga, Silje Marie; Slinning, Kari; Bjørkli, Cato Alexander

2016-09-08

Depression is one of the most common mental health problems among adults, but effective treatments are not widely accessible. The Internet holds promise as a cost-effective and convenient delivery platform of interventions for depression. However, studies suggest that Internet interventions are not widely available in routine settings. The aim of this study was to review the literature and examine whether there are systematic differences in reporting of the various implementation components on Internet interventions for depression, and then to examine what is known about and is characteristic of the implementation of these Internet interventions in regular care settings. We performed a scoping review, drawing upon a broad range of the literature on Internet interventions for depression in regular care, and used the active implementation framework to extract data. Overall, the results suggested that knowledge about the implementation of Internet interventions for depression in regular care is limited. However, guided support from health professionals emphasizing program adherence and recruitment of end users to the interventions emerged as 2 main themes. We identified 3 additional themes among practitioners, including their qualifications, training, and supervision, but these were scarcely described in the literature. The competency drivers (ie, staff and user selection, training, and supervision) have received the most attention, while little attention has been given to organizational (ie, decision support, administration, and system intervention) and leadership drivers. Research has placed little emphasis on reporting on the implementation of interventions in practice. Leadership and organizational drivers, in particular, have been largely neglected. The results of this scoping review have implications for future research and efforts to successfully implement Internet interventions for depression in regular care.

The Implementation of Internet Interventions for Depression: A Scoping Review

PubMed Central

Vaskinn, Linda; Bergsund, Hans Bugge; Haga, Silje Marie; Slinning, Kari; Bjørkli, Cato Alexander

2016-01-01

Background Depression is one of the most common mental health problems among adults, but effective treatments are not widely accessible. The Internet holds promise as a cost-effective and convenient delivery platform of interventions for depression. However, studies suggest that Internet interventions are not widely available in routine settings. Objective The aim of this study was to review the literature and examine whether there are systematic differences in reporting of the various implementation components on Internet interventions for depression, and then to examine what is known about and is characteristic of the implementation of these Internet interventions in regular care settings. Methods We performed a scoping review, drawing upon a broad range of the literature on Internet interventions for depression in regular care, and used the active implementation framework to extract data. Results Overall, the results suggested that knowledge about the implementation of Internet interventions for depression in regular care is limited. However, guided support from health professionals emphasizing program adherence and recruitment of end users to the interventions emerged as 2 main themes. We identified 3 additional themes among practitioners, including their qualifications, training, and supervision, but these were scarcely described in the literature. The competency drivers (ie, staff and user selection, training, and supervision) have received the most attention, while little attention has been given to organizational (ie, decision support, administration, and system intervention) and leadership drivers. Conclusions Research has placed little emphasis on reporting on the implementation of interventions in practice. Leadership and organizational drivers, in particular, have been largely neglected. The results of this scoping review have implications for future research and efforts to successfully implement Internet interventions for depression in regular care. PMID:27608548

Sleep, Dietary, and Exercise Behavioral Clusters Among Truck Drivers With Obesity: Implications for Interventions.

PubMed

Olson, Ryan; Thompson, Sharon V; Wipfli, Brad; Hanson, Ginger; Elliot, Diane L; Anger, W Kent; Bodner, Todd; Hammer, Leslie B; Hohn, Elliot; Perrin, Nancy A

2016-03-01

The objectives of the study were to describe a sample of truck drivers, identify clusters of drivers with similar patterns in behaviors affecting energy balance (sleep, diet, and exercise), and test for cluster differences in health safety, and psychosocial factors. Participants' (n = 452, body mass index M = 37.2, 86.4% male) self-reported behaviors were dichotomized prior to hierarchical cluster analysis, which identified groups with similar behavior covariation. Cluster differences were tested with generalized estimating equations. Five behavioral clusters were identified that differed significantly in age, smoking status, diabetes prevalence, lost work days, stress, and social support, but not in body mass index. Cluster 2, characterized by the best sleep quality, had significantly lower lost workdays and stress than other clusters. Weight management interventions for drivers should explicitly address sleep, and may be maximally effective after establishing socially supportive work environments that reduce stress exposures.

The Behavioral Economics of Drunk Driving

PubMed Central

Sloan, Frank A.; Eldred, Lindsey; Xu, Yanzhi

2014-01-01

This study investigates whether drinker-drivers attributes are associated with imperfect rationality or irrationality. Using data from eight U.S. cities, we determine whether drinker-drivers differ from other drinkers in cognitive ability, ignorance of driving while intoxicated (DWI) laws, have higher rates of time preference, are time inconsistent, and lack self-control on other measures. We find that drinker-drivers are relatively knowledgeable about DWI laws and do not differ on two of three study measures of cognitive ability from other drinkers. Drinker-drivers are less prone to plan events involving drinking, e.g., selecting a designated driver in advance of drinking, and are more impulsive. Furthermore, we find evidence in support of hyperbolic discounting. In particular, relative to non-drinker-drivers, the difference between short- and long-term discount rates is much higher for drinker-drivers than for other drinkers. Implications of our findings for public policy, including incapacitation, treatment, and educational interventions, are discussed. PMID:24603444

Engagement with the TeenDrivingPlan and diversity of teens' supervised practice driving: lessons for internet-based learner driver interventions.

PubMed

Winston, Flaura K; Mirman, Jessica H; Curry, Allison E; Pfeiffer, Melissa R; Elliott, Michael R; Durbin, Dennis R

2015-02-01

Inexperienced, less-skilled driving characterises many newly licensed drivers and contributes to high crash rates. A randomised trial of TeenDrivingPlan (TDP), a new learner driver phase internet-based intervention, demonstrated effectiveness in improving safety relevant, on-road driving behaviour, primarily through greater driving practice diversity. To inform future learner driver interventions, this analysis examined TDP use and its association with practice diversity. Posthoc analysis of data from teen/parent dyads (n=107), enrolled early in learner phase and assigned to treatment arm in randomised trial. Inserted software beacons captured TDP use data. Electronic surveys completed by parents and teens assessed diversity of practice driving and TDP usability ratings at 24 weeks (end of study period). Most families (84%) used TDP early in the learner period; however, the number of TDP sessions in the first week was three times higher among dyads who achieved greater practice diversity than those with less. By week five many families still engaged with TDP, but differences in TDP use could not be detected between families with high versus low practice diversity. Usability was not a major issue for this sample based on largely positive user ratings. An engaging internet-based intervention, such as TDP, can support families in achieving high practice diversity. Future learner driver interventions should provide important information early in the learner period when engagement is greatest, encourage continued learning as part of logging practice drives, and incorporate monitoring software for further personalisation to meet family needs. NCT01498575. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Increasing Parent Limits on Novice Young Drivers: Cognitive Mediation of the Effect of Persuasive Messages

ERIC Educational Resources Information Center

Simons-Morton, Bruce G.; Hartos, Jessica L.; Leaf, William A.; Preusser, David F.

2006-01-01

This report describes intervention effects on parent-imposed driving limits on novice young drivers at licensure. Parent-adolescent dyads (4,344) completed baseline surveys at permit and were randomly assigned to intervention or comparison groups. Intervention families received persuasive communications related to protection motivation theory…

Occupational therapists' capacity-building needs related to older driver screening, assessment, and intervention: a Canadawide survey.

PubMed

Korner-Bitensky, Nicol; Menon, Anita; von Zweck, Claudia; Van Benthem, Kathy

2010-01-01

Older driver safety is a growing concern. We identified capacity-building needs of occupational therapists related to older driver screening, assessment, and intervention. A Canadawide survey was undertaken involving 133 occupational therapists working with an older clientele. A standardized questionnaire elicited information regarding (1) actual practices related to older driver screening, assessment, and intervention; (2) perceived competence; and (3) need for continuing education. Occupational therapists were twice as likely to use screening tools rather than in-depth assessments (n = 79 vs. n = 37). Only 25 occupational therapists offered on-road assessment, and even fewer offered retraining (n = 11). Occupational therapists more often felt very competent in domains related to screening as opposed to assessment, and most were interested in continuing education. Driving services offered were primarily related to screening compared with assessment or intervention. Occupational therapists would benefit from driving-related professional training aimed at enhancing professional capacity in this arena.

Effect of tailored on-road driving lessons on driving safety in older adults: A randomised controlled trial.

PubMed

Anstey, Kaarin J; Eramudugolla, Ranmalee; Kiely, Kim M; Price, Jasmine

2018-06-01

We evaluated the effectiveness of individually tailored driving lessons compared with a road rules refresher course for improving older driver safety. Two arm parallel randomised controlled trial, involving current drivers aged 65 and older (Mean age 72.0, 47.4% male) residing in Canberra, Australia. The intervention group (n = 28) received a two-hour class-based road rules refresher course, and two one-hour driving lessons tailored to improve poor driving skills and habits identified in a baseline on-road assessment. The control group (n = 29) received the road rules refresher course only. Tests of cognitive performance, and on-road driving were conducted at baseline and at 12-weeks. Main outcome measure was the Driver safety rating (DSR) on the on-road driving test. The number of Critical Errors made during the on-road was also recorded. 55 drivers completed the trial (intervention group: 27, control group: 28). Both groups showed reduction in dangerous/hazardous driver errors that required instructor intervention. From baseline to follow-up there was a greater reduction in the number of critical errors made by the intervention group relative to the control group (IRR = 0.53, SE = 0.1, p = .008). The intervention group improved on the DSR more than the control group (intervention mean change = 1.07 SD = 2.00, control group mean change = 0.32 SD = 1.61). The intervention group had 64% remediation of unsafe driving, where drivers who achieved a score of 'fail' at baseline, 'passed' at follow-up. The control group had 25% remediation. Tailored driving lessons reduced the critical driving errors made by older adults. Longer term follow-up and larger trials are required. Copyright © 2018 Elsevier Ltd. All rights reserved.

Analysis of naturalistic driving videos of fleet services drivers to estimate driver error and potentially distracting behaviors as risk factors for rear-end versus angle crashes.

PubMed

Harland, Karisa K; Carney, Cher; McGehee, Daniel

2016-07-03

The objective of this study was to estimate the prevalence and odds of fleet driver errors and potentially distracting behaviors just prior to rear-end versus angle crashes. Analysis of naturalistic driving videos among fleet services drivers for errors and potentially distracting behaviors occurring in the 6 s before crash impact. Categorical variables were examined using the Pearson's chi-square test, and continuous variables, such as eyes-off-road time, were compared using the Student's t-test. Multivariable logistic regression was used to estimate the odds of a driver error or potentially distracting behavior being present in the seconds before rear-end versus angle crashes. Of the 229 crashes analyzed, 101 (44%) were rear-end and 128 (56%) were angle crashes. Driver age, gender, and presence of passengers did not differ significantly by crash type. Over 95% of rear-end crashes involved inadequate surveillance compared to only 52% of angle crashes (P < .0001). Almost 65% of rear-end crashes involved a potentially distracting driver behavior, whereas less than 40% of angle crashes involved these behaviors (P < .01). On average, drivers spent 4.4 s with their eyes off the road while operating or manipulating their cell phone. Drivers in rear-end crashes were at 3.06 (95% confidence interval [CI], 1.73-5.44) times adjusted higher odds of being potentially distracted than those in angle crashes. Fleet driver driving errors and potentially distracting behaviors are frequent. This analysis provides data to inform safe driving interventions for fleet services drivers. Further research is needed in effective interventions to reduce the likelihood of drivers' distracting behaviors and errors that may potentially reducing crashes.

Occupational Fatalities Among Driver/Sales Workers and Truck Drivers in the United States, 2003–2008

PubMed Central

Chen, Guang X.; Amandus, Harlan E.; Wu, Nan

2015-01-01

Background This study provides a national profile of occupational fatalities among truck drivers and driver-sales workers. Methods Data from the 2003–2008 Census of Fatal Occupational Injuries were used. Cases were extracted specifically for occupational subcategories included in the Driver/Sales Workers and Truck Drivers occupational category: Driver/Sales Workers, Heavy and Tractor-Trailer Truck Drivers, and Light Truck or Delivery Services Drivers. Results In 2003–2008, the group Driver/Sales Workers and Truck Drivers had 5,568 occupational fatalities, representing 17% of all occupational fatalities in the United States. The majority of these fatalities were in the subgroup Heavy and Tractor-Trailer Truck Drivers (85%) and due to transportation incidents (80%). Older and male drivers had higher fatality rates than their counterparts. Conclusions Findings suggest a need for targeted interventions to reduce highway fatalities among heavy truck drivers. Better employment data are needed to separate the three occupational subcategories by worker characteristic and employment history for use in research and prevention efforts. PMID:24811905

Identification of differences between rural and urban safety cultures.

PubMed

Rakauskas, Michael E; Ward, Nicholas J; Gerberich, Susan G

2009-09-01

The prevailing risk of traffic fatalities is much larger in rural areas compared to urban areas. A number of explanations have been offered to explain this including road design, emergency medical service proximity, and human factors. This research explored the potential contribution of rural driver attitudes that may underlie the increased fatal crash risk in rural environments. This analysis examined differences between rural and urban drivers in terms of self-reported risk taking for driving behaviors associated with fatal crashes and attitudes toward safety interventions using a large-scale survey. The results suggested that rural drivers engage in riskier behavior, such as not wearing seatbelts, because they have lower perceptions of the risks associated with such behaviors. Results also suggested that vehicle type (e.g., pickup trucks versus passenger vehicles) may be related to seatbelt compliance and frequency of driving under the influence of alcohol. Rural drivers perceived the utility of government-sponsored traffic safety interventions to be lower than their urban counterparts. This study provides insights into the role of the human factor in rural fatal crashes and provides policy suggestions for developing safety interventions that are designed with respect to the psychosocial factors that define the rural culture.

Strengthening the enabling environment for women and girls: what is the evidence in social and structural approaches in the HIV response?

PubMed Central

Hardee, Karen; Gay, Jill; Croce-Galis, Melanie; Peltz, Amelia

2014-01-01

There is growing interest in expanding public health approaches that address social and structural drivers that affect the environment in which behaviour occurs. Half of those living with HIV infection are women. The sociocultural and political environment in which women live can enable or inhibit their ability to protect themselves from acquiring HIV. This paper examines the evidence related to six key social and structural drivers of HIV for women: transforming gender norms; addressing violence against women; transforming legal norms to empower women; promoting women’s employment, income and livelihood opportunities; advancing education for girls and reducing stigma and discrimination. The paper reviews the evidence for successful and promising social and structural interventions related to each driver. This analysis contains peer-reviewed published research and study reports with clear and transparent data on the effectiveness of interventions. Structural interventions to address these key social and structural drivers have led to increasing HIV-protective behaviours, creating more gender-equitable relationships and decreasing violence, improving services for women, increasing widows’ ability to cope with HIV and reducing behaviour that increases HIV risk, particularly among young people. PMID:24405664

Strengthening the enabling environment for women and girls: what is the evidence in social and structural approaches in the HIV response?

PubMed

Hardee, Karen; Gay, Jill; Croce-Galis, Melanie; Peltz, Amelia

2014-01-01

There is growing interest in expanding public health approaches that address social and structural drivers that affect the environment in which behaviour occurs. Half of those living with HIV infection are women. The sociocultural and political environment in which women live can enable or inhibit their ability to protect themselves from acquiring HIV. This paper examines the evidence related to six key social and structural drivers of HIV for women: transforming gender norms; addressing violence against women; transforming legal norms to empower women; promoting women's employment, income and livelihood opportunities; advancing education for girls and reducing stigma and discrimination. The paper reviews the evidence for successful and promising social and structural interventions related to each driver. This analysis contains peer-reviewed published research and study reports with clear and transparent data on the effectiveness of interventions. Structural interventions to address these key social and structural drivers have led to increasing HIV-protective behaviours, creating more gender-equitable relationships and decreasing violence, improving services for women, increasing widows' ability to cope with HIV and reducing behaviour that increases HIV risk, particularly among young people.

Driver characteristics associated with child safety seat usage in Malaysia: a cross-sectional study.

PubMed

Kulanthayan, S; Razak, Ahmad; Schenk, Ellen

2010-03-01

The rapidly motorizing environment in Malaysia has made child occupant safety a current public health concern. The usage of child safety seats (CSS) is a widely regarded intervention to enhance child occupant safety, yet no study has been conducted on CSS in Malaysia. This study aims to determine the CSS usage rates in Malaysia and to assess driver characteristics that are associated with CSS usage. Nine variables - urban versus rural study location, age, gender, marital status, educational status, monthly family income, number of children present in the vehicle, distance traveled to the study location, and attitude - were examined through a cross-sectional study of interviewing drivers of 230 vehicles transporting at least one child <10 years of age at the time of the study. The vehicles were also observed for whether or not there was a CSS present. The interviews were conducted at six sampling locations - three urban and three rural - in the state of Melaka. 27.4% of the drivers were found to be using at least one CSS at the time of the survey. Among the nine variables studied, three of the driver characteristics showed statistical significance (p<0.05) with CSS usage: age (p=0.047), educational status (p=0.009), and attitude (p=0.009). This study begins to create knowledge on child occupant safety in Malaysia. The results indicate that interventional efforts should focus on educational programs geared toward drivers that are less educated or extended family members who inconsistently transport young children. Furthermore, any educational efforts could be strongly enhanced by legislation mandating the use of CSS. Every effort should be made to thoroughly assess the effectiveness of any educational or legislative activities that are implemented. Copyright 2009 Elsevier Ltd. All rights reserved.

Evaluating the effectiveness of a road safety education intervention for pre-drivers: an application of the theory of planned behaviour.

PubMed

Poulter, Damian R; McKenna, Frank P

2010-06-01

Young drivers are overrepresented in road traffic fatalities and collisions. Attempts to address this problem with pre-driver education have not met with unambiguous success. However, there is a lack of research on whether pre-driver education can change psychological antecedents to behaviour. The framework of the theory of planned behaviour (TPB) was employed to assess the effectiveness of an educational intervention used across the UK that aims to improve attitudes to road safety in pre-drivers. Secondary school students aged 15-16 years participated in the research, drawn from 12 schools in the UK. A total of 199 students took part in Expt 1 and 430 in Expt 2. Expt 1 employed a within-participants design to measure any changes in road safety beliefs from pre- to post-intervention and 5-month follow-up. Expt 2 used a between-participants design to test whether any changes were genuine or due to experimenter effects. Results of Expt 1 revealed a small, short-term improvement in some pre-driver beliefs immediately following the educational intervention, but no effect on other beliefs, and some evidence of unintended outcomes. The small, significant improvements found in Expt 1 were replicated in Expt 2, which is consistent with there being a genuine effect. Considering evidence from both experiments suggests the effectiveness of road safety education interventions are at best short term, and limited to some but not all psychological factors, with some risk of unintended consequences.

Conditions that Influence Drivers' Yielding Behavior for Uncontrolled Crossings

ERIC Educational Resources Information Center

Bourquin, Eugene; Emerson, Robert Wall; Sauerburger, Dona

2011-01-01

Pedestrians with visual impairments need to cross streets where traffic signals and traffic signage are not present. This study examined the influences of several interventions, including a pedestrian's use of a mobility cane, on the behavior of drivers when they were expected to yield to a pedestrian crossing at an uncontrolled crossing.…

Predicting and Reducing Driving Mishaps Among Drivers With Type 1 Diabetes

PubMed Central

Gonder-Frederick, Linda A.; Singh, Harsimran; Ingersoll, Karen S.; Banton, Tom; Grabman, Jesse H.; Schmidt, Karen; Clarke, William

2017-01-01

OBJECTIVE Two aims of this study were to develop and validate A) a metric to identify drivers with type 1 diabetes at high risk of future driving mishaps and B) an online intervention to reduce mishaps among high-risk drivers. RESEARCH DESIGN AND METHODS To achieve aim A, in study 1, 371 drivers with type 1 diabetes from three U.S. regions completed a series of established questionnaires about diabetes and driving. They recorded their driving mishaps over the next 12 months. Questionnaire items that uniquely discriminated drivers who did and did not have subsequent driving mishaps were assembled into the Risk Assessment of Diabetic Drivers (RADD) scale. In study 2, 1,737 drivers with type 1 diabetes from all 50 states completed the RADD online. Among these, 118 low-risk (LR) and 372 high-risk (HR) drivers qualified for and consented to participate in a 2-month treatment period followed by 12 monthly recordings of driving mishaps. To address aim B, HR participants were randomized to receive either routine care (RC) or the online intervention “DiabetesDriving.com” (DD.com). Half of the DD.com participants received a motivational interview (MI) at the beginning and end of the treatment period to boost participation and efficacy. All of the LR participants were assigned to RC. In both studies, the primary outcome variable was driving mishaps. RESULTS Related to aim A, in study 1, the RADD demonstrated 61% sensitivity and 75% specificity. Participants in the upper third of the RADD distribution (HR), compared with those in the lower third (LR), reported 3.03 vs. 0.87 mishaps/driver/year, respectively (P < 0.001). In study 2, HR and LR participants receiving RC reported 4.3 and 1.6 mishaps/driver/year, respectively (P < 0.001). Related to aim B, in study 2, MIs did not enhance participation or efficacy, so the DD.com and DD.com + MI groups were combined. DD.com participants reported fewer hypoglycemia-related driving mishaps than HR participants receiving RC (P = 0.01), but more than LR participants receiving RC, reducing the difference between the HR and LR participants receiving RC by 63%. HR drivers differed from LR drivers at baseline across a variety of hypoglycemia and driving parameters. CONCLUSIONS The RADD identified higher-risk drivers, and identification seemed relatively stable across time, samples, and procedures. This 11-item questionnaire could inform patients at higher risk, and their clinicians, that they should take preventive steps to reduce driving mishaps, which was accomplished in aim B using DD.com. PMID:28404657

Using trip diaries to mitigate route risk and risky driving behavior among older drivers.

PubMed

Payyanadan, Rashmi P; Maus, Adam; Sanchez, Fabrizzio A; Lee, John D; Miossi, Lillian; Abera, Amsale; Melvin, Jacob; Wang, Xufan

2017-09-01

To reduce exposure to risky and challenging driving situations and prolong mobility and independence, older drivers self-regulate their driving behavior. But self-regulation can be challenging because it depends on drivers' ability to assess their limitations. Studies using self-reports, survey data, and hazard and risk perception tests have shown that driving behavior feedback can help older drivers assess their limitations and adjust their driving behavior. But only limited work has been conducted in developing feedback technology interventions tailored to meet the information needs of older drivers, and the impact these interventions have in helping older drivers self-monitor their driving behavior and risk outcomes. The vehicles of 33 drivers 65 years and older were instrumented with OBD2 devices. Older drivers were provided access to customized web-based Trip Diaries that delivered post-trip feedback of the routes driven, low-risk route alternatives, and frequency of their risky driving behaviors. Data were recorded over four months, with baseline driving behavior collected for one month. Generalized linear mixed effects regression models assessed the effects of post-trip feedback on the route risk and driving behaviors of older drivers. Results showed that post-trip feedback reduced the estimated route risk of older drivers by 2.9% per week, and reduced their speeding frequency on average by 0.9% per week. Overall, the Trip Diary feedback reduced the expected crash rate from 1 in 6172 trips to 1 in 7173 trips, and the expected speeding frequency from 46% to 39%. Thus providing older drivers with tailored feedback of their driving behavior and crash risk could help them appropriately self-regulate their driving behavior, and improve their crash risk outcomes. Copyright © 2016 Elsevier Ltd. All rights reserved.

The efficacy of a first aid training course for drivers: an experience from northern Iran.

PubMed

Vakili, Mohammad Ali; Mohjervatan, Ali; Heydari, Seyed Taghi; Akbarzadeh, Armin; Hosini, Nazanin Sadat; Alizad, Farideh; Arasteh, Peyman; Moghasemi, Mohammad Javad

2014-01-01

To evaluate the efficacy of a first aid training course for a group of drivers. This study comprised 500 drivers, randomly selected from the road transport companies. They underwent a course of first aid training and the results were evaluated at 0-3 and 4-6 months after training. Both quantitative and qualitative improvements were observed in the drivers'efficacy in giving first aid. Also the rate of correct interventions was higher at 4-6 months than at 0-3 months. The exception was airway management which was not favorably improved after training. The first aid training course for drivers is beneficial and helpful for prehospital care system in road traffic accidents.

Restraint use law enforcement intervention in Latino communities.

PubMed

Schaechter, Judy; Uhlhorn, Susan B

2011-11-01

Motor vehicle crashes are the leading cause of death for U.S. Latinos aged 1 to 35 years. Restraint use is an effective means of prevention of motor vehicle crash injury. Effective interventions to raise restraint use include the following: legislation, law enforcement, education, and equipment distribution. The effects of law enforcement interventions in Latino immigrant communities are understudied. We measured the community-level effect of a combined intervention that included warnings and citations phase enforcement in Latino communities. We designed and implemented in two of three Latino-majority communities a multicomponent intervention consisting of a community awareness campaign, restraint use education with equipment distribution, and a two-staged law enforcement intervention. Restraint use observations were conducted in all three communities at baseline, after the warnings phase and again after the citations phase of the intervention were completed. The combined intervention of community awareness, education, child passenger restraint distribution, and law enforcement focused on educational traffic stops with incentives and warnings was associated with a significant increase in both driver and child passenger restraint use in one intervention community, but only driver restraint increased to a level of significance in the other intervention community; significant increase was also noted among nonintervention drivers. The citations phase of the intervention did not result in a significant increase in restraint use and was complicated by interruptions due to unlicensed drivers. The combined effort of community awareness, education, equipment distribution and law enforcement intervention that included incentives and warnings may be effective at increasing seat belt use in Latino communities without the need for citations.

The behavioral economics of drunk driving.

PubMed

Sloan, Frank A; Eldred, Lindsey M; Xu, Yanzhi

2014-05-01

This study investigates whether drinker-drivers attributes are associated with imperfect rationality or irrationality. Using data from eight U.S. cities, we determine whether drinker-drivers differ from other drinkers in cognitive ability, ignorance of driving while intoxicated (DWI) laws, have higher rates of time preference, are time inconsistent, and lack self-control on other measures. We find that drinker-drivers are relatively knowledgeable about DWI laws and do not differ on two of three study measures of cognitive ability from other drinkers. Drinker-drivers are less prone to plan events involving drinking, e.g., selecting a designated driver in advance of drinking, and are more impulsive. Furthermore, we find evidence in support of hyperbolic discounting. In particular, relative to non-drinker-drivers, the difference between short- and long-term discount rates is much higher for drinker-drivers than for other drinkers. Implications of our findings for public policy, including incapacitation, treatment, and educational interventions, are discussed. Copyright © 2014 Elsevier B.V. All rights reserved.

It's up to you: a multi-message, phased driver facility campaign to increase organ donation registration rates in Illinois.

PubMed

Quick, Brian; Harrison, Tyler R; King, Andy J; Bosch, Dave

2013-01-01

The present project applied successful strategies employed in previous driver facility campaigns occurring during the inception of a registry to examine whether these approaches are effective in growing a mature registry, a registry where the majority of individuals have had the opportunity to register as an organ donor. Driver facilities (N = 40) in Illinois with high (n = 20) and low (n = 20) organ donation registration percentages were selected and served as either intervention or control sites for the campaign. Among facilities with historically high and low registration percentages, support for the campaign was found with the intervention facilities experiencing higher organ donation registration rates compared with control facilities. In addition, the results provide partial support for the effectiveness of employing a multi-message, phased driver facility intervention in states with a mature registry. The practical implications of utilizing driver facility campaigns in states with an established first-person consent registry also are discussed. © 2013 John Wiley & Sons A/S.

Taxi Cab Syndrome: A Review of the Extensive Genitourinary Pathology Experienced by Taxi Cab Drivers and What We Can Do to Help

PubMed Central

Mass, Alon Y; Goldfarb, David S; Shah, Ojas

2014-01-01

This review consolidates knowledge regarding the extensive genitourinary pathology experienced by taxi cab drivers. Taxi cab, livery, truck, and other drivers all objectively and subjectively may have more voiding dysfunction, infertility, urolithiasis, bladder cancer, and urinary infections as compared with nonprofessional drivers; this is called taxi cab syndrome. Together with governmental and medical assistance, simple interventions—such as education, the addition of taxi relief stations, and possibly the use of sanitary urinary collection devices—to curb the progression of genitourinary disease in taxi drivers should be prospectively studied. It is postulated that many of these interventions may also benefit other groups of occupationally related infrequent voiders. PMID:25337038

Step On It! Impact of a Workplace New York City Taxi Driver Health Intervention to Increase Necessary Health Care Access

PubMed Central

Gany, Francesca; Bari, Sehrish; Gill, Pavan; Loeb, Rebecca

2015-01-01

Objectives. We describe the impact of the Step On It! intervention to link taxi drivers, particularly South Asians, to health insurance enrollment and navigate them into care when necessary. Methods. Step On It! was a worksite initiative held for 5 consecutive days from September 28 to October 2, 2011, at John F. Kennedy International Airport in New York City. Data collected included sociodemographics, employment, health care access and use, height, weight, blood pressure, and random plasma glucose. Participants were given their results, counseled by a medical professional, and invited to participate in free workshops provided by partner organizations. Results. Of the 466 drivers participated, 52% were uninsured, and 49% did not have a primary care provider. Of 384 drivers who had blood pressure, glucose, or both measured, 242 (63%) required urgent or regular follow-up. Of the 77 (32%) requiring urgent follow-up, 50 (65%) sought medical care at least once, of whom 13 (26%) received a new diagnosis. Of the 165 (68%) requiring regular follow-up, 68 (41%) sought medical care at least once, of whom 5 (7%) received a new diagnosis. Conclusions. This study provides encouraging results about the potential impact of an easy-to-deliver, easily scalable workplace intervention with a large, vulnerable population. PMID:25211738

Motivating drivers to correctly adjust head restraints: assessing effectiveness of three different interventions.

PubMed

Fockler, S K; Vavrik, J; Kristiansen, L

1998-11-01

Three types of driver educational strategies were tested to determine the most effective approach for motivating drivers to adjust their head restraints to the correct vertical position: (1) a human interactive personal contact with a member of an ICBC-trained head restraint adjustment team, (2) a passive video presentation of the consequences of correct and incorrect head restraint adjustment, and (3) an interactive three-dimensional kinetic model showing the consequences of correct and incorrect head restraint adjustment. An experimental pretest-posttest control group design was used. A different educational treatment was used in each of three lanes of a vehicle emissions testing facility, with a fourth lane with no intervention serving as a control group. Observational and self-reported data were obtained from a total of 1,974 vehicles entering and exiting the facility. The human intervention led to significantly more drivers actually adjusting their head restraints immediately after the intervention than the passive video or interactive kinetic model approaches, which were both no different from the control group. The human intervention was recommended as the most effective and was implemented successfully on a limited basis during 3 months of 1995 and again during 3 months of 1996.

Observed and projected drivers of emerging infectious diseases in Europe.

PubMed

Semenza, Jan C; Rocklöv, Joacim; Penttinen, Pasi; Lindgren, Elisabet

2016-10-01

Emerging infectious diseases are of international concern because of the potential for, and impact of, pandemics; however, they are difficult to predict. To identify the drivers of disease emergence, we analyzed infectious disease threat events (IDTEs) detected through epidemic intelligence collected at the European Centre for Disease Prevention and Control (ECDC) between 2008 and 2013, and compared the observed results with a 2008 ECDC foresight study of projected drivers of future IDTEs in Europe. Among 10 categories of IDTEs, foodborne and waterborne IDTEs were the most common, vaccine-preventable IDTEs caused the highest number of cases, and airborne IDTEs caused the most deaths. Observed drivers for each IDTE were sorted into three main groups: globalization and environmental drivers contributed to 61% of all IDTEs, public health system drivers contributed to 21%, and social and demographic drivers to 18%. A multiple logistic regression analysis showed that four of the top five drivers for observed IDTEs were in the globalization and environment group. In the observational study, the globalization and environment group was related to all IDTE categories, but only to five of eight categories in the foresight study. Directly targeting these drivers with public health interventions may diminish the chances of IDTE occurrence from the outset. © 2016 New York Academy of Sciences.

Self-Control Behavior of Drinking Drivers beyond the Context of a Behavioral Self-Control Program.

ERIC Educational Resources Information Center

Werch, Chudley E.

This paper reports on the post hoc analysis of specific types of self-control behaviors being employed by drinking drivers who were exposed to a behavioral self-control training program. The underlying assumption of this study is that the success of health promotion and intervention programs most probably depends on the development of greater…

RAPID SITUATION ASSESSMENTS OF ALCOHOL AND SUBSTANCE USE AMONG COMMERCIAL VEHICLE DRIVERS IN NIGERIA.

PubMed

Lasebikan, V O; Ayinde, O

2012-11-01

To describe the current situation with respect to substance use and related harms among commercial vehicle drivers, and to identify a range of interventions that could be feasibly implemented to minimise harms related to substance use. Observational and group interviews. Four different motor parks in Ibadan, Nigeria. Data were obtained from a sample of commercial vehicle drivers, community and members of the law enforcement agencies. Widespread use of psychoactive substances was reported. New trend of local alcohol beverage generally called 'sepe' tended to have replaced older ones such as palm wine. All substances of abuse were freely available and openly displayed at motor parks except for cocaine and narcotics. There was poor law provision and enforcement of laws prohibiting sale and use around motor parks or while driving. This study shows the feasibility and value of conducting rapid assessments among commercial vehicle drivers in Nigeria. One outcome of this study is the development of a guide on rapid assessment of alcohol and other substance use assessment and a measure of brief intervention among them. Presentation of these findings should contribute to increased awareness and improved response from the government.

THE ROLE OF EMPLOYERS IN FACILITATING SMOKING CESSATION AMONG STAFF: PERSPECTIVE OF DRIVERS IN A NIGERIAN UNIVERSITY.

PubMed

Olumide, A O; Owoaje, Eme T

2017-12-01

Several interventions have been instituted to encourage smoking cessation among smokers. Many adults are currently working and spend several hours a day at work. Employers thus have a role to play in encouraging staff who smoke to quit. This study investigated the perception of drivers employed in the University of Ibadan, Nigeria on the role of their employers in facilitating smoking cessation among staff who smoke. All 176 drivers employed by the University and who were available on the days of the interviews were interviewed. A semi-structured questionnaire was used to obtain information on drivers' opinion on the role of employers in facilitating smoking cessation among staff. All the drivers were male and had a mean age of 51.2 ± 5.8 years. Five (2.8%) drivers were current smokers. One hundred and thirty-six (77.3%) drivers were of the opinion that their employers had a role to play in encouraging smoking cessation among staff who smoke. They felt this could be done by organizing workshops to sensitize staff on the dangers of smoking 73 (53.7%), educating staff about the health effects of smoking 26 (19.1%) and arresting staff caught smoking during official hours 20 (14.7%). Many of the drivers felt that their employers had a role to play in encouraging smoking cessation among staff. The University authorities should build on this and take specific steps to institute a comprehensive workplace antitobacco policy which includes smoking cessation interventions to assist staff who smoke to quit.

Awareness tool for safe and responsible driving (OSCAR): a potential educational intervention for increasing interest, openness and knowledge about the abilities required and compensatory strategies among older drivers.

PubMed

Levasseur, Mélanie; Audet, Thérèse; Gélinas, Isabelle; Bédard, Michel; Langlais, Marie-Ève; Therrien, France-Hélène; Renaud, Judith; Coallier, Jean-Claude; D'Amours, Monia

2015-01-01

This pilot study aimed to verify the impact of the awareness tool for safe and responsible driving (OSCAR) on older adults' (1) interest, openness, and knowledge about the abilities and compensatory strategies required for safe driving; (2) awareness of changes that have occurred in their own driving abilities; and (3) actual utilization of compensatory strategies. A preexperimental design, including a pretest (T0) and posttest (T1) 8 to 10 weeks after exposure to the intervention, was used with 48 drivers aged between 67 and 84. The participants had a valid driving license and drove at least once a week. Overall, the results demonstrate that OSCAR increased interest, openness, and knowledge about the abilities and compensatory strategies of older drivers (P <.01). After exposure to OSCAR, the majority of the participants confirmed that changes had occurred in at least one of their abilities. Moreover, half of the older drivers reported having started using 6 or more compensatory strategies. In summary, in addition to increasing older adults' interest, openness, and knowledge to discussion about driving, OSCAR also improved awareness of the changes that could negatively impact safe driving and enhanced utilization of compensatory strategies. While promoting safe driving and the prevention of crashes and injuries, this intervention could ultimately help older adults maintain or increase their transportation mobility. More studies are needed to further evaluate OSCAR and identify ways to improve its effectiveness.

Evaluation of a Local Designated Driver and Responsible Server Program to Prevent Drinking and Driving.

ERIC Educational Resources Information Center

Simons-Morton, Bruce G.; Cummings, Sharon Snider

1997-01-01

Evaluates the impact of beverage servers' interventions at five establishments participating in the Houston Techniques for Effective Alcohol Management (TEAM) program. The intervention included server training, a designated-driver program, and "Safe Ride Home" taxi vouchers. Findings are discussed within the context of scant public and…

Background music as a risk factor for distraction among young-novice drivers.

PubMed

Brodsky, Warren; Slor, Zack

2013-10-01

There are countless beliefs about the power of music during driving. The last thing one would think about is: how safe is it to listen or sing to music? Unfortunately, collisions linked to music devices have been known for some time; adjusting the radio controls, swapping tape-cassettes and compact-discs, or searching through MP3 files, are all forms of distraction that can result in a near-crash or crash. While the decrement of vehicular performance can also occur from capacity interference to central attention, whether or not music listening is a contributing factor to distraction is relatively unknown. The current study explored the effects of driver-preferred music on driver behavior. 85 young-novice drivers completed six trips in an instrumented Learners Vehicle. The study found that all participants committed at-least 3 driver deficiencies; 27 needed a verbal warning/command and 17 required a steering or braking intervention to prevent an accident. While there were elevated positive moods and enjoyment for trips with driver-preferred music, this background also produced the most frequent severe driver miscalculations and inaccuracies, violations, and aggressive driving. However, trips with music structurally designed to generate moderate levels of perceptual complexity, improved driver behavior and increased driver safety. The study is the first within-subjects on-road high-dose double-exposure clinical-trial investigation of musical stimuli on driver behavior. Copyright © 2013 Elsevier Ltd. All rights reserved.

Driving with a partially autonomous forward collision warning system: how do drivers react?

PubMed

Muhrer, Elke; Reinprecht, Klaus; Vollrath, Mark

2012-10-01

The effects of a forward collision warning (FCW) and braking system (FCW+) were examined in a driving simulator study analyzing driving and gaze behavior and the engagement in a secondary task. In-depth accident analyses indicate that a lack of appropriate expectations for possible critical situations and visual distraction may be the major causes of rear-end crashes. Studies with FCW systems have shown that a warning alone was not enough for a driver to be able to avoid the accident. Thus,an additional braking intervention by such systems could be necessary. In a driving simulator experiment, 30 drivers took part in a car-following scenario in an urban area. It was assumed that different lead car behaviors and environmental aspects would lead to different drivers' expectations of the future traffic situation. Driving with and without FCW+ was introduced as a between-subjects factor. Driving with FCW+ resulted in significantly fewer accidents in critical situations. This result was achieved by the system's earlier reaction time as compared with that of drivers. The analysis of the gaze behavior showed that driving with the system did not lead to a stronger involvement in secondary tasks. The study supports the hypotheses about the importance of missing expectations for the occurrence of accidents. These accidents can be prevented by an FCW+ that brakes autonomously. The results indicate that an autonomous braking intervention should be implemented in FCW systems to increase the effectiveness of these assistance systems.

Effectiveness of two interventions in preventing traffic accidents: a systematic review.

PubMed

Porchia, B R; Baldasseroni, A; Dellisanti, C; Lorini, C; Bonaccorsi, G

2014-01-01

The prevention of road traffic accidents should be considered a serious public health concern, since they are the eighth leading cause of death globally and the main cause of death for young people aged 15-29. Evidences from many countries show that successes in preventing road traffic injuries can be achieved through concerted efforts at national level. The aim of our study was to assess the effectiveness of two interventions to prevent road traffic accidents: the introduction of graduated driver licensing (GDL) and the interventions to improve pedestrian and cyclist visibility. Our search started with a scoping review on the interventions to prevent road traffic accidents to allow the development of a logical framework of traffic accidents. Specific and answerable questions formulated according to PICO scheme and combinations of keywords were used to perform a systematic search in the following databases: Pubmed, Cochrane Database of Systematic Reviews, Database of Abstracts of Reviews of Effects (DARE), Health Evidence, Transport Research International Documentation (TRID) and Google. References of selected papers were searched. Only systematic reviews and meta-analyses were eligible. No temporal limits or linguistic filters were applied. 160 systematic reviews and meta-analyses were found for the question of the introduction of GDL program and 188 on the improvement of visibility in cyclists and pedestrians. After selection, four papers were included in qualitative synthesis for each question. All included studies underwent quality evaluation. GDL programs seem to be effective in reducing crash rates among young drivers, in particular in 16 year-old. Programs with more restrictions seem also to reduce fatal events. To improve visibility of pedestrians and cyclists, street lighting has been suggested as an intervention able to improve driver's visual capabilities and ability to detect roadway hazards and to prevent car crashes. Visibility aids (fluorescent materials, lamps, flashing lights and retroreflective materials) have the potential to increase visibility and enable drivers to detect pedestrians and cyclists earlier. The two interventions seem to be effective, but further examinations are needed to measure long-term effects. It is necessary to provide feasible studies in local context to estimate the impact of introduction of GDL programs or of some of their components and to improve interventions to increase visibility of pedestrians and cyclists.

Prevalence and factors associated with road traffic crash among taxi drivers in Hanoi, Vietnam.

PubMed

La, Quang Ngoc; Lee, Andy H; Meuleners, Lynn B; Van Duong, Dat

2013-01-01

Injury due to road traffic crash is a major cause of ill health and premature deaths in developing countries. Taxis provide a main mode of public transport in Vietnam but there has been little research on the risk of crash for taxi drivers. This retrospective study collected information on taxi crashes for the period 2006-2009 by interviewing drivers from five taxi companies in Hanoi, Vietnam, using a structured questionnaire. Of the total 1214 participants recruited, 276 drivers reported at least one crash, giving an overall crash prevalence of 22.7%. Among the crashed group, 50 drivers (18.1%) were involved in two to four crashes. Logistic regression analysis further identified age of driver, type of driving licence, employment status, perceived sufficiency of income, seat-belt usage, and traffic infringement history to be significantly associated with the crash risk. Further prospective and qualitative studies are recommended to provide detailed crash characteristics as well as behaviour and perception of taxi drivers, so that an effective intervention can be developed to improve road safety and to prevent injury of these commercial drivers. Copyright © 2012 Elsevier Ltd. All rights reserved.

Drivers within natural drinking groups: an exploration of role selection, motivation, and group influence on driver sobriety.

PubMed

Lange, James E; Johnson, Mark B; Reed, Mark B

2006-01-01

Young people consume alcohol almost exclusively in social contexts, but natural drinking group dynamics are poorly understood. Our research focuses on the drivers' role within natural drinking groups. We conducted breath-test surveys of existing groups of young people at the US/Mexico border crossing before they headed to Tijuana bars, and surveyed them again upon their return. Results indicated an individual's perception of other group member's drinking plans predicts drinking intentions to a greater degree for passengers than drivers. Additionally, drivers who anticipated heavy drinking among other group members returned to the United States with BACs nearly identical to drivers who reported that other group members would not drink at all. This suggests drivers were resistant to normative pressures to drink. Evidence that group-dynamic variables may impact drinking behavior underscores the importance of systematic exploration of natural drinking groups. Furthermore, the knowledge gleaned from studying the dynamics and decision making processes of natural drinking groups could be used to design intervention designed to increase designated driver use and to reduce drinking among designated drivers.

Relationships of working conditions, health problems and vehicle accidents in bus rapid transit (BRT) drivers.

PubMed

Gómez-Ortiz, Viviola; Cendales, Boris; Useche, Sergio; Bocarejo, Juan P

2018-04-01

The aim of this study was to estimate accident risk rates and mental health of bus rapid transit (BRT) drivers based on psychosocial risk factors at work leading to increased stress and health problems. A cross-sectional research design utilized a self-report questionnaire completed by 524 BRT drivers. Some working conditions of BRT drivers (lack of social support from supervisors and perceived potential for risk) may partially explain Bogota's BRT drivers' involvement in road accidents. Drivers' mental health problems were associated with higher job strain, less support from co-workers, fewer rewards and greater signal conflict while driving. To prevent bus accidents, supervisory support may need to be increased. To prevent mental health problems, other interventions may be needed such as reducing demands, increasing job control, reducing amount of incoming information, simplifying current signals, making signals less contradictory, and revising rewards. © 2018 Wiley Periodicals, Inc.

HIV/AIDS Prevention among the Male Population: Results of a Peer Education Program for Taxicab and Tricycle Drivers in the Philippines

ERIC Educational Resources Information Center

Morisky, Donald E.; Nguyen, Chrystene; Ang, Alfonso; Tiglao, Teodora V.

2005-01-01

This study assesses the results of a 2-year community-based peer education program aimed at increasing HIV/AIDS knowledge, attitudes toward condoms, and condom use behavior among taxicab and tricycle drivers in the Philippines. Pretest, posttest, and follow-up data were collected throughout the educational intervention program. The results of the…

Population-based health promotion perspective for older driver safety: Conceptual framework to intervention plan

PubMed Central

Classen, Sherrilene; Lopez, Ellen DS; Winter, Sandra; Awadzi, Kezia D; Ferree, Nita; Garvan, Cynthia W

2007-01-01

The topic of motor vehicle crashes among the elderly is dynamic and multi-faceted requiring a comprehensive and synergistic approach to intervention planning. This approach must be based on the values of a given population as well as health statistics and asserted through community, organizational and policy strategies. An integrated summary of the predictors (quantitative research), and views (qualitative research) of the older drivers and their stakeholders, does not currently exist. This study provided an explicit socio-ecological view explaining the interrelation of possible causative factors, an integrated summary of these causative factors, and empirical guidelines for developing public health interventions to promote older driver safety. Using a mixed methods approach, we were able to compare and integrate main findings from a national crash dataset with perspectives of stakeholders. We identified: 11 multi-causal factors for safe elderly driving; the importance of the environmental factors - previously underrated in the literature- interacting with behavioral and health factors; and the interrelatedness among many socio-ecological factors. For the first time, to our knowledge, we conceptualized the fundamental elements of a multi-causal health promotion plan, with measurable intermediate and long-term outcomes. After completing the detailed plan we will test the effectiveness of this intervention on multiple levels. PMID:18225470

Weight Control Intervention for Truck Drivers: The SHIFT Randomized Controlled Trial, United States

PubMed Central

Wipfli, Brad; Thompson, Sharon V.; Elliot, Diane L.; Anger, W. Kent; Bodner, Todd; Hammer, Leslie B.; Perrin, Nancy A.

2016-01-01

Objectives. To evaluate the effectiveness of the Safety and Health Involvement For Truckers (SHIFT) intervention with a randomized controlled design. Methods. The multicomponent intervention was a weight-loss competition supported with body weight and behavioral self-monitoring, computer-based training, and motivational interviewing. We evaluated intervention effectiveness with a cluster-randomized design involving 22 terminals from 5 companies in the United States in 2012 to 2014. Companies were required to provide interstate transportation services and operate at least 2 larger terminals. We randomly assigned terminals to intervention or usual practice control conditions. We assessed participating drivers (n = 452) at baseline and 6 months. Results. In an intent-to-treat analysis, the postintervention difference between groups in mean body mass index change was 1.00 kilograms per meters squared (P < .001; intervention = −0.73; control = +0.27). Behavioral changes included statistically significant improvements in fruit and vegetable consumption and physical activity. Conclusions. Results establish the effectiveness of a multicomponent and remotely administered intervention for producing significant weight loss among commercial truck drivers. PMID:27463067

Weight Control Intervention for Truck Drivers: The SHIFT Randomized Controlled Trial, United States.

PubMed

Olson, Ryan; Wipfli, Brad; Thompson, Sharon V; Elliot, Diane L; Anger, W Kent; Bodner, Todd; Hammer, Leslie B; Perrin, Nancy A

2016-09-01

To evaluate the effectiveness of the Safety and Health Involvement For Truckers (SHIFT) intervention with a randomized controlled design. The multicomponent intervention was a weight-loss competition supported with body weight and behavioral self-monitoring, computer-based training, and motivational interviewing. We evaluated intervention effectiveness with a cluster-randomized design involving 22 terminals from 5 companies in the United States in 2012 to 2014. Companies were required to provide interstate transportation services and operate at least 2 larger terminals. We randomly assigned terminals to intervention or usual practice control conditions. We assessed participating drivers (n = 452) at baseline and 6 months. In an intent-to-treat analysis, the postintervention difference between groups in mean body mass index change was 1.00 kilograms per meters squared (P < .001; intervention = -0.73; control = +0.27). Behavioral changes included statistically significant improvements in fruit and vegetable consumption and physical activity. Results establish the effectiveness of a multicomponent and remotely administered intervention for producing significant weight loss among commercial truck drivers.

Evaluating the Effectiveness of a Road Safety Education Intervention for Pre-Drivers: An Application of the Theory of Planned Behaviour

ERIC Educational Resources Information Center

Poulter, Damian R.; McKenna, Frank P.

2010-01-01

Background: Young drivers are overrepresented in road traffic fatalities and collisions. Attempts to address this problem with pre-driver education have not met with unambiguous success. However, there is a lack of research on whether pre-driver education can change psychological antecedents to behaviour. Aims: The framework of the theory of…

Insights into workplace bullying: psychosocial drivers and effective interventions

PubMed Central

Escartín, Jordi

2016-01-01

Research on effectiveness of workplace bullying interventions has lagged behind descriptive studies on this topic. The literature on bullying intervention research has only recently expanded to a point that allows for synthesis of findings across empirical studies. This study addresses the question of whether workplace bullying can be reduced in prevalence and consequences, if so to what extent and by which strategies and interventions. It opens with a brief overview of the nature of bullying at work and discussion of some precursors and existing interventions. However, its principal focus is on the findings obtained from selected (quasi-) experimental longitudinal studies on antibullying interventions, drawing together the results of studies conducted in Europe, USA, and Australia, including several economic sectors, and concerned about primary, secondary, and tertiary prevention programs and strategies. Additional emphasis is considered from the psychosocial drivers highlighted both from prescriptive and cross-sectional studies and factual empirical studies. One randomized control study and seven quasiexperimental longitudinal studies were identified by searching electronic databases and bibliographies and via contact with experts. The majority of outcomes evidenced some level of change, mostly positive, suggesting that workplace bullying interventions are more likely to affect knowledge, attitudes, and self-perceptions, but actual bullying behaviors showed much more mixed results. In general, growing effectiveness was stated as the level of intervention increased from primary to tertiary prevention. However, methodological problems relating to the evaluation designs in most studies do not allow direct attribution of these findings to the interventions. Overall, the evaluation of antibullying interventions must flourish and be improved, requiring close cooperation between practitioners and academics to design, implement, and evaluate effective interventions based on grounded theoretical and methodological approaches. Finally, this systematic review highlights future directions for enhancing the adoption, high-quality implementation, and dissemination of evidence-based workplace bullying prevention and intervention programs. PMID:27382343

Effect of Maryland's 2011 Alcohol Sales Tax Increase on Alcohol-Positive Driving.

PubMed

Lavoie, Marie-Claude; Langenberg, Patricia; Villaveces, Andres; Dischinger, Patricia C; Simoni-Wastila, Linda; Hoke, Kathleen; Smith, Gordon S

2017-07-01

The 2011 Maryland alcohol sales tax increase from 6% to 9% provided an opportunity to evaluate the impact on rates of alcohol-positive drivers involved in injury crashes. Maryland police crash reports from 2001 to 2013 were analyzed using an interrupted time series design and a multivariable analysis employing generalized estimating equations models with a negative binomial distribution. Data were analyzed in 2014-2015. There was a significant gradual annual reduction of 6% in the population-based rate of all alcohol-positive drivers (p<0.03), and a 12% reduction for drivers aged 15-20 years (p<0.007), and 21-34 years (p<0.001) following the alcohol sales tax increase. There were no significant changes in rates of alcohol-positive drivers aged 35-54 years (rate ratio, 0.98; 95% CI=0.89, 1.09). Drivers aged ≥55 years had a significant immediate 10% increase in the rate of alcohol-positive drivers (rate ratio, 1.10; 95% CI=1.04, 1.16) and a gradual increase of 4.8% per year after the intervention. Models using different denominators and controlling for multiple factors including a proxy for unmeasured factors found similar results overall. The 2011 Maryland alcohol sales tax increase led to a significant reduction in the rate of all alcohol-positive drivers involved in injury crashes especially among drivers aged 15-34 years. This is the first study to examine the impact of alcohol sales taxes on crashes; previous research focused on excise tax. Increasing alcohol taxes is an important but often neglected intervention to reduce alcohol-impaired driving. Copyright © 2017 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.

INCREASING FOLLOWING HEADWAY WITH PROMPTS, GOAL SETTING, AND FEEDBACK IN A DRIVING SIMULATOR

PubMed Central

Arnold, Michelle L; Van Houten, Ron

2011-01-01

We evaluated the effects of prompting, goal setting, and feedback on following headway of young drivers in a simulated driving environment and assessed whether changes produced in following headway were associated with reductions in hard braking when drivers were and were not using cell phones. Participants were 4 university students. During baseline, drivers spent half of the time talking on cell phones while driving. At the start of the intervention, drivers were prompted to increase following headway while on the cell phones and were provided a specific target for following headway. Drivers were given feedback on increasing following headway when on cell phones at the end of each session. The intervention package was associated with an increase in following headway and a decrease in hard braking when participants were on and off the cell phones. Cell phone use did not affect any of the measures. PMID:21709782

COLLISION AVOIDANCE TRAINING USING A DRIVING SIMULATOR IN DRIVERS WITH PARKINSON’S DISEASE: A PILOT STUDY

PubMed Central

Dawson, Jeffrey D.; Rizzo, Matthew; Anderson, Steven W.; Dastrup, Elizabeth; Uc, Ergun Y.

2011-01-01

Summary Parkinson’s disease (PD) impairs driving performance, and simulator studies have shown increased crashes compared to controls. In this pilot study, eight drivers with PD participated in three drive sessions with multiple simulator intersections of varying visibility and traffic load, where an incurring vehicle posed a crash risk. Over the course of the three sessions (once every 1–2 weeks), we observed reduction in crashes (p=0.059) and reaction times (p=0.006) to the vehicle incursion. These findings suggest that our simulator training program is feasible and potentially useful in drivers with PD. Future research questions include transfer of training to different driving tasks, duration of benefit, and the effect on long term real life outcomes in comparison to a standard intervention (e.g., driver education class) in a randomized trial. PMID:24273752

Health assessment of taxi drivers in the city of Tshwane.

PubMed

Ramukumba, Tendani S; Mathikhi, Makwena S

2016-11-30

Taxi driving seems to be a strenuous occupation. There was evidence-based paucity of literature on health assessment of taxi drivers. Meanwhile taxi drivers of South Africa were burdened by communicable and non-communicable diseases including high-level exposure to injuries and criminal attacks. Health assessment of this cohort group enables mitigation to engage in appropriation of relevant interventions related to the occupational needs of taxi drivers. The objective of the study was to conduct health assessment of taxi drivers in the city of Tshwane to identify health risk factors. An exploratory, descriptive and quantitative survey was conducted and anthropometric measurements of blood pressure, body mass index and waist circumference were monitored and recorded on a convenience sample of 69 taxi drivers in Tshwane Municipality. Consent was sought from individual taxi drivers who participated in the study, while taxi rank queue marshals assisted with smooth running of the process. Data were gathered using a questionnaire. Data analysis was performed using statistical STATA II with the assistance of a statistician. The study found that taxi drivers were obese, hypertensive, had type II diabetes-related risk factors, including unhealthy life style practices. The results indicate that the general health of taxi drivers impacts their occupation. The findings implicate that the health status of taxi operators in Tshwane was a serious concern and urgent concerted effort is needed to engage in lifestyle modification of taxi drivers. The need for health promotion and formalised occupational health services was recommended.

Cognitive-behavioral treatment of high anger drivers.

PubMed

Deffenbacher, Jerry L; Filetti, Linda B; Lynch, Rebekah S; Dahlen, Eric R; Oetting, Eugene R

2002-08-01

Relaxation and cognitive-relaxation interventions were compared to a no treatment control in the treatment of high anger drivers. The cognitive portion of the cognitive-relaxation condition adapted the style of Beck's cognitive therapy, particularly use of Socratic questions and behavioral experiments and tryouts, to driving anger reduction. Both interventions lowered indices of driving anger and hostile and aggressive forms of expressing driving anger and increased adaptive/constructive ways of expressing driving anger. The cognitive-relaxation intervention also lowered the frequency of risky behavior. Both interventions lowered trait anger as well. Limitations and implications for treatment and research were discussed.

Graduated driver licensing for reducing motor vehicle crashes among young drivers.

PubMed

Russell, Kelly F; Vandermeer, Ben; Hartling, Lisa

2011-10-05

Graduated driver licensing (GDL) has been proposed as a means of reducing crash rates among novice drivers by gradually introducing them to higher risk driving situations. To examine the effectiveness of GDL in reducing crash rates among young drivers. Studies were identified through searching MEDLINE, EMBASE, CINAHL, Healthstar, Web of Science, NTIS Bibliographic Database, TRIS Online, SIGLE, the World Wide Web, conference proceedings, consultation with experts and reference lists in relevant published literature. The searches were conducted from the time of inception to May 2009, and the Cochrane Injuries Group conducted an updated search of the TRANSPORT database in September 2009. Studies were included if: 1) they compared outcomes pre- and post-implementation of a GDL program within the same jurisdiction, 2) comparisons were made between jurisdictions with and without GDL, or 3) both. Studies had to report at least one objective, quantified outcome. Results were not pooled due to substantial heterogeneity. Percentage change was calculated for each year after the intervention, using one year prior to the intervention as baseline. Results were adjusted by internal controls. Analyses were stratified by denominators (population, licensed drivers). Results were calculated for the different crash types and presented for 16 year-olds alone as well as all teenage drivers. We included 34 studies evaluating 21 GDL programs and 2 analyses of >40 US states. GDL programs were implemented in the US (n=16), Canada (n=3), New Zealand (n=1), and Australia (n=1) and varied in their restrictions during the intermediate stage. Based on the Insurance Institute for Highway Safety (IIHS) classification, eleven programs were good, four were fair, five were marginal, one was poor and two could not be assessed. Reductions in crash rates were seen in all jurisdictions and for all crash types. Among 16 year-old drivers, the median decrease in per population adjusted overall crash rates during the first year was 15.5% (range -27 to -8%, five studies). There was a decrease in per population adjusted injury crash rates (median -21%, range -46 to -2%, five studies). Results for all teenage drivers, rates per licensed driver, and rates adjusting for internal controls were generally reduced when comparing within jurisdictions. GDL is effective in reducing crash rates among young drivers, although the magnitude of the effect varies. The conclusions are supported by consistent findings, temporal relationship, and plausibility of the association. Stronger GDL programs (i.e. more restrictions or higher quality based on IIHS classification) appear to result in greater fatality reduction. Future studies should focus on which components and combination of components yield the greatest reductions.

Negative affect and drinking drivers: a review and conceptual model linking dissonance, efficacy and negative affect to risk and motivation for change.

PubMed

Wells-Parker, Elisabeth; Mann, Robert E; Dill, Patricia L; Stoduto, Gina; Shuggi, Rania; Cross, Ginger W

2009-05-01

This review summarizes evidence on negative affect among drinking drivers. Elevations in negative affect, including depressed mood, anxiety and hostility, have long been noted in convicted drinking drivers, and recent evidence suggests an association between negative affect and driving after drinking in the general population. Previous efforts to understand the significance of this negative affective state have ranged from suggestions that it may play a causal role in drinking driving to suggestions that it may interfere with response to treatment and remedial interventions. Recent studies have uncovered an important paradox involving negative affect among convicted drinking drivers (hereafter DUI offenders). DUI offenders with high levels of negative affect recidivated more frequently following a DUI program than did those reporting no or minimal negative affect. However, when a brief supportive motivational intervention was added to the program, offenders with high negative affect levels showed lower recidivism rates than did those with no or minimal negative affect. The review includes studies from the general literature on alcohol treatment in which the same negative affect paradox was reported. In an attempt to understand this paradox, we present a conceptual model involving well-established psychological processes, with a focus on salient discrepancy, the crucial component of cognitive dissonance. In this model, negative affect plays an important role in motivating both continued high-risk drinking as well as therapeutic change. This model suggests that links between motivational states and negative affective processes may be more complex than previously thought. Implications for intervention with DUI offenders are discussed.

Collision Avoidance, Driver Support and Safety Intervention Systems

NASA Astrophysics Data System (ADS)

Gilling, Simon P.

Autonomous Intelligent Cruise Control (AICC) will be marketed by a number of vehicle manufacturers before the end of the decade. This paper will describe AICC and the next generation systems currently being developed and validated within the EC Fourth Framework project, Anti-Collision Autonomous Support and Safety Intervention SysTem (AC ASSIST).The currently available cruise control systems which maintain a fixed speed are a well-known form of longitudinal driver support. The fixed speed cruise control becomes less useful with increased traffic volumes, as the driver must disable the system when a slower preceding vehicle is encountered.

Countermeasures to Improve the Driving Performance of Older Drivers.

ERIC Educational Resources Information Center

Ashman, Richard D.; And Others

1994-01-01

In a 2-year project, 105 older drivers were given physical therapy (flexibility exercises), perceptual therapy (to improve visual discrimination), and driver education; traffic engineering modifications were also made. All four interventions improved performance an average of 7.9%. Engineering was most cost effective on high-volume roads, the…

Driving and Low Vision: An Evidence-Based Review of Rehabilitation

ERIC Educational Resources Information Center

Strong, J. Graham; Jutai, Jeffrey W.; Russell-Minda, Elizabeth; Evans, Mal

2008-01-01

This systematic review of the effectiveness of driver rehabilitation interventions found that driver training programs enhance driving skills and awareness, but further research is needed to determine their effectiveness in improving driving performance of drivers with low vision. More research is also needed to determine the effectiveness of low…

Personality and attitudes as predictors of risky driving among older drivers.

PubMed

Lucidi, Fabio; Mallia, Luca; Lazuras, Lambros; Violani, Cristiano

2014-11-01

Although there are several studies on the effects of personality and attitudes on risky driving among young drivers, related research in older drivers is scarce. The present study assessed a model of personality-attitudes-risky driving in a large sample of active older drivers. A cross-sectional design was used, and structured and anonymous questionnaires were completed by 485 older Italian drivers (Mean age=68.1, SD=6.2, 61.2% males). The measures included personality traits, attitudes toward traffic safety, risky driving (errors, lapses, and traffic violations), and self-reported crash involvement and number of issued traffic tickets in the last 12 months. Structural equation modeling showed that personality traits predicted both directly and indirectly traffic violations, errors, and lapses. More positive attitudes toward traffic safety negatively predicted risky driving. In turn, risky driving was positively related to self-reported crash involvement and higher number of issued traffic tickets. Our findings suggest that theoretical models developed to account for risky driving of younger drivers may also apply in the older drivers, and accordingly be used to inform safe driving interventions for this age group. Copyright © 2014 Elsevier Ltd. All rights reserved.

Driver-initiated distractions: examining strategic adaptation for in-vehicle task initiation.

PubMed

Horrey, William J; Lesch, Mary F

2009-01-01

Today, drivers are faced with many in-vehicle activities that are potentially distracting. In many cases, they are not passive recipients of these tasks; rather, drivers decide whether or not (or how) to perform them. In this study, we examined whether drivers, given knowledge of the upcoming road demands, would strategically delay performing in-vehicle activities until demands were reduced. Twenty drivers drove an instrumented van around a closed track that was divided into sections of varying demands and difficulty. Drivers were asked to perform one of four in-vehicle tasks (e.g., phone conversation; read a text message; find an address; pick up an object on the floor); however, they were free to decide when to initiate these tasks, provided they finish them before a given deadline. Although drivers were fully aware of the relative demands of the road, they did not tend to strategically postpone tasks--a finding that was consistent across the different tasks (p >.05). Rather, drivers tended to initiate tasks regardless of the current driving conditions. This strategy frequently led to driving errors. Given the control that drivers have over many in-vehicle distractions, interventions that focus on strategic decisions and planning may have merit.

Advanced driver assistance systems for teen drivers: Teen and parent impressions, perceived need, and intervention preferences.

PubMed

Weiss, Eve; Fisher Thiel, Megan; Sultana, Nahida; Hannan, Chloe; Seacrist, Thomas

2018-02-28

From the advent of airbags to electronic stability control, technological advances introduced into automobile design have significantly reduced injury and death from motor vehicle crashes. These advances are especially pertinent among teen drivers, a population whose leading cause of death is motor vehicle crashes. Recently developed advanced driver assistance systems (ADAS) have the potential to compensate for skill deficits and reduce overall crash risk. Yet, ADAS is only effective if drivers are willing to use it. Limited research has been conducted on the suitability of ADAS for teen drivers. The goal of this study is to identify teen drivers' perceived need for ADAS, receptiveness to in-vehicle technology, and intervention preferences. The long-term goal is to understand public perceptions and barriers to ADAS use and to help determine how these systems must evolve to meet the needs of the riskiest driving populations. Three focus groups (N = 24) were conducted with licensed teen drivers aged 16-19 years and 2 focus groups with parents of teen drivers (N = 12). Discussion topics included views on how ADAS might influence driving skills and behaviors; trust in technology; and data privacy. Discussions were transcribed; the team used conventional content analysis and open coding methods to identify 12 coding domains and code transcripts with NVivo 10. Interrater reliability testing showed moderate to high kappa scores. Overall, participants recognized potential benefits of ADAS, including improved safety and crash reduction. Teens suggested that ADAS is still developing and therefore has potential to malfunction. Many teens reported a greater trust in their own driving ability over vehicle technology. They expressed that novice drivers should learn to drive on non-ADAS-equipped cars and that ADAS should be considered a supplemental aid. Many teens felt that overreliance on ADAS may increase distracted driving or risky behaviors among teens. Parents also expressed skepticism for the technology but felt that it would likely be a useful support for teen drivers after the initial learning phase. This study elicited important end-user viewpoints by exploring the intersection between advanced automobile safety technology and human perception for the particular use case of teen drivers. For example, despite evidence that teens are the highest risk driving population, teens trust their own driving skills and competence more than in-vehicle technology. This understanding will ultimately advance the safety of teen drivers by identifying barriers to effective ADAS use.

Critical review and analysis of the impact of the physical infrastructure on the driving ability, performance, and safety of older adults.

PubMed

Bohr, Paula Christine

2008-01-01

Literature on the impact of physical infrastructure on older adult safe driving performance was reviewed in 2005 as part of the American Occupational Therapy Association's Evidence-Based Literature Review Project. Existing guidelines for driving environments, related to changes in visual, cognitive, and psychomotor abilities associated with the aging process (as published in the Highway Design Handbook for Older Drivers and Pedestrians, Federal Highway Administration, 2001), are exhaustive, but the authors made no attempt to critically assess the strength of the study design or level of evidence. In laboratory studies since 1999, the interventions lacked applicability to real-life driving environments. Further investigation of the effectiveness of best practice interventions and how the driving environment can better accommodate the needs of older drivers is needed. Occupational therapy interventions that focus on the occupation of driving and compensation and education strategies that allow older adults to drive safely as long as possible are included.

Costs of a work-family intervention: evidence from the work, family, and health network.

PubMed

Barbosa, Carolina; Bray, Jeremy W; Brockwood, Krista; Reeves, Daniel

2014-01-01

To estimate the cost to the workplace of implementing initiatives to reduce work-family conflict. Prospective cost analysis conducted alongside a group-randomized multisite controlled experimental study, using a microcosting approach. An information technology firm. Employees (n = 1004) and managers (n = 141) randomized to the intervention arm. STAR (Start. Transform. Achieve. Results.) to enhance employees' control over their work time, increase supervisor support for employees to manage work and family responsibilities, and reorient the culture toward results. A taxonomy of activities related to customization, start-up, and implementation was developed. Resource use and unit costs were estimated for each activity, excluding research-related activities. Economic costing approach (accounting and opportunity costs). Sensitivity analyses on intervention costs. The total cost of STAR was $709,654, of which $389,717 was labor costs and $319,937 nonlabor costs (including $313,877 for intervention contract). The cost per employee participation in the intervention was $340 (95% confidence interval: $330-$351); $597 ($561-$634) for managers and $300 ($292-$308) for other employees (2011 prices). A detailed activity costing approach allows for more accurate cost estimates and identifies key drivers of cost. The key cost driver was employees' time spent on receiving the intervention. Ignoring this cost, which is usual in studies that cost workplace interventions, would seriously underestimate the cost of a workplace initiative.

The effects of social interactions with in-vehicle agents on a driver's anger level, driving performance, situation awareness, and perceived workload.

PubMed

Jeon, Myounghoon; Walker, Bruce N; Gable, Thomas M

2015-09-01

Research has suggested that interaction with an in-vehicle software agent can improve a driver's psychological state and increase road safety. The present study explored the possibility of using an in-vehicle software agent to mitigate effects of driver anger on driving behavior. After either anger or neutral mood induction, 60 undergraduates drove in a simulator with two types of agent intervention. Results showed that both speech-based agents not only enhance driver situation awareness and driving performance, but also reduce their anger level and perceived workload. Regression models show that a driver's anger influences driving performance measures, mediated by situation awareness. The practical implications include design guidelines for the design of social interaction with in-vehicle software agents. Copyright © 2015 Elsevier Ltd and The Ergonomics Society. All rights reserved.

School start times and teenage driver motor vehicle crashes.

PubMed

Foss, Robert D; Smith, Richard L; O'Brien, Natalie P

2018-04-26

Shifting school start times to 8:30 am or later has been found to improve academic performance and reduce behavior problems. Limited research suggests this may also reduce adolescent driver motor vehicle crashes. A change in the school start time from 7:30 am to 8:45 am for all public high schools in one North Carolina county presented the opportunity to address this question with greater methodologic rigor. We conducted ARIMA interrupted time-series analyses to examine motor vehicle crash rates of high school age drivers in the intervention county and 3 similar comparison counties with comparable urban-rural population distribution. To focus on crashes most likely to be affected, we limited analysis to crashes involving 16- & 17-year-old drivers occurring on days when school was in session. In the intervention county, there was a 14% downward shift in the time-series following the 75 min delay in school start times (p = .076). There was no change approaching statistical significance in any of the other three counties. Further analysis indicated marked, statistically significant shifts in hourly crash rates in the intervention county, reflecting effects of the change in school start time on young driver exposure. Crashes from 7 to 7:59 am decreased sharply (-25%, p = .008), but increased similarly from 8 to 8:59 am (21%, p = .004). Crashes from 2 to 2:59 pm declined dramatically (-48%, p = .000), then increased to a lesser degree from 3 to 3:59 pm (32%, p = .024) and non-significantly from 4 to 4:59 (19%, p = .102). There was no meaningful change in early morning or nighttime crashes, when drowsiness-induced crashes might have been expected to be most common. The small decrease in crashes among high school age drivers following the shift in school start time is consistent with the findings of other studies of teen driver crashes and school start times. All these studies, including the present one, have limitations, but the similar findings suggest that crashes and school start times are indeed related, with earlier start times equating to more crashes. Later high school start times (>8:30 am) appear to be associated with lower adolescent driver crash rates, but additional research is needed to confirm this and to identify the mechanism by which this occurs (reduced drowsiness or reduced exposure). Copyright © 2018 Elsevier Ltd. All rights reserved.

Influences on youthful driving behavior and their potential for guiding interventions to reduce crashes.

PubMed

Shope, J T

2006-06-01

This paper presents an organized, comprehensive view of the factors known to influence young drivers' behavior and how those factors might inform interventions to reduce crashes. This effort was done from the perspective of a public health professional, with a background in health behavior and health education, interested in preventing injury and death among young people from motor vehicle crashes. The author's own studies, selected relevant literature, observation, and experience were considered and organized. A framework of six categories of influences on youthful driving behavior was developed, including the following elements: driving ability, developmental factors, personality factors, demographics, the perceived environment, and the driving environment. It is apparent that a complex set of many different factors influences young drivers' behavior. To reduce crashes, comprehensive, multilevel interventions are needed that target those factors in the framework that are amenable to change.

Influences on youthful driving behavior and their potential for guiding interventions to reduce crashes

PubMed Central

Shope, J T

2006-01-01

This paper presents an organized, comprehensive view of the factors known to influence young drivers' behavior and how those factors might inform interventions to reduce crashes. This effort was done from the perspective of a public health professional, with a background in health behavior and health education, interested in preventing injury and death among young people from motor vehicle crashes. The author's own studies, selected relevant literature, observation, and experience were considered and organized. A framework of six categories of influences on youthful driving behavior was developed, including the following elements: driving ability, developmental factors, personality factors, demographics, the perceived environment, and the driving environment. It is apparent that a complex set of many different factors influences young drivers' behavior. To reduce crashes, comprehensive, multilevel interventions are needed that target those factors in the framework that are amenable to change. PMID:16788115

Naturalistic distraction and driving safety in older drivers.

PubMed

Aksan, Nazan; Dawson, Jeffrey D; Emerson, Jamie L; Yu, Lixi; Uc, Ergun Y; Anderson, Steven W; Rizzo, Matthew

2013-08-01

In this study, we aimed to quantify and compare performance of middle-aged and older drivers during a naturalistic distraction paradigm (visual search for roadside targets) and to predict older drivers performance given functioning in visual, motor, and cognitive domains. Distracted driving can imperil healthy adults and may disproportionally affect the safety of older drivers with visual, motor, and cognitive decline. A total of 203 drivers, 120 healthy older (61 men and 59 women, ages 65 years and older) and 83 middle-aged drivers (38 men and 45 women, ages 40 to 64 years), participated in an on-road test in an instrumented vehicle. Outcome measures included performance in roadside target identification (traffic signs and restaurants) and concurrent driver safety. Differences in visual, motor, and cognitive functioning served as predictors. Older drivers identified fewer landmarks and drove slower but committed more safety errors than did middle-aged drivers. Greater familiarity with local roads benefited performance of middle-aged but not older drivers.Visual cognition predicted both traffic sign identification and safety errors, and executive function predicted traffic sign identification over and above vision. Older adults are susceptible to driving safety errors while distracted by common secondary visual search tasks that are inherent to driving. The findings underscore that age-related cognitive decline affects older drivers' management of driving tasks at multiple levels and can help inform the design of on-road tests and interventions for older drivers.

Extending parental mentoring using an event-triggered video intervention in rural teen drivers.

PubMed

McGehee, Daniel V; Raby, Mireille; Carney, Cher; Lee, John D; Reyes, Michelle L

2007-01-01

Teen drivers are at high risk for car crashes, especially during their first years of licensure. Providing novice teen drivers and their parents with a means of identifying their risky driving maneuvers may help them learn from their mistakes, thereby reducing their crash propensity. During the initial phase of learning, adult or parental supervision often provides such guidance. However, once teens obtain their license, adult supervision is no longer mandated, and teens are left to themselves to continue the learning process. This study is the first of its type to enhance this continued learning process using an event-triggered video device. By pairing this new technology with parental feedback in the form of a weekly video review and graphical report card, we extend parents' ability to teach their teens even after they begin driving independently. Twenty-six 16- to 17-year-old drivers were recruited from a small U.S. Midwestern rural high school. We equipped their vehicles with an event-triggered video device, designed to capture 20-sec clips of the forward and cabin views whenever the vehicle exceeded lateral or forward threshold accelerations. Preliminary findings suggest that combining this emerging technology with parental weekly review of safety-relevant incidents resulted in a significant decrease in events for the more at-risk teen drivers. Implications for how such an intervention could be implemented within GDL are also discussed.

Graduated driver licensing for reducing motor vehicle crashes among young drivers.

PubMed

Hartling, L; Wiebe, N; Russell, K; Petruk, J; Spinola, C; Klassen, T P

2004-01-01

Graduated driver licensing (GDL) has been proposed as a means of reducing crash rates among novice drivers by gradually introducing them to higher risk driving situations. To examine the effectiveness of GDL systems in reducing crash rates of young drivers. Studies were identified through searches of MEDLINE, EMBASE, CINAHL, Healthstar, Web of Science, NTIS Bibliographic Database, TRIS Online, SIGLE, the World Wide Web, relevant conference proceedings, consultation with experts and authors, and reference lists. The search was not restricted by language or publication status. Studies were included if: 1) they compared outcomes pre- and post-implementation of a GDL program within the same jurisdiction, 2) comparisons were made between jurisdictions with and without GDL, or 3) both. Studies had to report at least one objective, quantified outcome. Two reviewers independently screened searches and assessed the full text of potentially relevant studies for inclusion using a standard form. Data were extracted by one reviewer and checked by a second. Additional data were requested from authors. Results were not pooled due to substantial heterogeneity between studies. Percentage change was calculated for each year after the intervention, using one year prior to the intervention as the baseline rate. Results were adjusted by internal controls. Analyses were stratified by different denominators (population, licensed drivers). Results were calculated for the different crash types (overall, injury, fatal, night-time, alcohol, and those resulting in hospitalization). Results were presented for 16 year-olds alone and all teenage drivers combined. We included 13 studies evaluating 12 GDL programs that were implemented between 1979 and 1998 in the US (n=7), Canada (3), New Zealand (1), and Australia (1). Programs varied in their restrictions during the intermediate stage: e.g. night curfews (8); limitations of extra passengers (2); roadway restrictions (1). Based on the Insurance Institute for Highway Safety classification scheme, no programs were good, six were acceptable, five were marginal, and one was poor. Reductions in crash rates were seen in all jurisdictions and for all crash types. Among 16 year-old drivers, the median decrease in per population overall crash rates during the first year was 31% (range 26-41%). Per population injury crash rates were similar (median 28%, range 4-43%). Results for all teenage drivers, rates per licensed driver, and rates adjusting for internal controls were generally reduced when comparing within jurisdictions. The existing evidence shows that GDL is effective in reducing the crash rates of young drivers, although the magnitude of the effect is unclear. The conclusions are supported by consistent direction of the findings, and the temporal relationship and plausibility of the association. The reviewers have made recommendations for primary research on GDL (e.g. study methods, standardized reporting of outcomes and results, long-term follow-up). The project has also shown what is needed to carry out systematic reviews of observational studies (e.g. quality assessment instruments).

Determining skill transferability of action games as a method to reduce in-vehicle phone distractions.

PubMed

Rupp, M; McConnell, D S; Smither, J A

2012-01-01

Distracted driving has been shown to be a safety issue in numerous studies. To combat this problem, in-vehicle technology, legislation, media interventions, and other methods have been proposed and attempted. However research indicates that the drivers themselves may circumvent, ignore, or not be able to react in time for these interventions to be effective. Therefore research into training programs for drivers may improve reaction time under distraction. Research indicates that action game players have faster reaction times and more attentional resources than non-players on paper-based tests. However, transferability to driving has not been studied yet. This paper outlines a study to determine if action game players perform better at a driving task based on frequency of game-play. Participants will be placed into two groups of play (high vs. low) and tested against two levels of distraction (none vs. phone conversation). It is expected that participants who play higher frequency of action games will perform better under distraction than lower frequency players. Driver performance, conversation recall, frequency and durations of eye fixations will be analyzed based on previous research which has validated those variables as a measure of distraction and higher workload.

The driver, the road, the rules … and the rest? A systems-based approach to young driver road safety.

PubMed

Scott-Parker, B; Goode, N; Salmon, P

2015-01-01

The persistent overrepresentation of young drivers in road crashes is universally recognised. A multitude of factors influencing their behaviour and safety have been identified through methods including crash analyses, simulated and naturalistic driving studies, and self-report measures. Across the globe numerous, diverse, countermeasures have been implemented; the design of the vast majority of these has been informed by a driver-centric approach. An alternative approach gaining popularity in transport safety is the systems approach which considers not only the characteristics of the individual, but also the decisions and actions of other actors within the road transport system, along with the interactions amongst them. This paper argues that for substantial improvements to be made in young driver road safety, what has been learnt from driver-centric research needs to be integrated into a systems approach, thus providing a holistic appraisal of the young driver road safety problem. Only then will more effective opportunities and avenues for intervention be realised. Copyright © 2014 Elsevier Ltd. All rights reserved.

Transport company safety climate-The impact on truck driver behavior and crash involvement.

PubMed

Sullman, Mark J M; Stephens, Amanda N; Pajo, Karl

2017-04-03

The present study investigated the relationships between safety climate and driving behavior and crash involvement. A total of 339 company-employed truck drivers completed a questionnaire that measured their perceptions of safety climate, crash record, speed choice, and aberrant driving behaviors (errors, lapses, and violations). Although there was no direct relationship between the drivers' perceptions of safety climate and crash involvement, safety climate was a significant predictor of engagement in risky driving behaviors, which were in turn predictive of crash involvement. This research shows that safety climate may offer an important starting point for interventions aimed at reducing risky driving behavior and thus fewer vehicle collisions.

Novice drivers' individual trajectories of driver behavior over the first three years of driving.

PubMed

Roman, Gabriela D; Poulter, Damian; Barker, Edward; McKenna, Frank P; Rowe, Richard

2015-09-01

Identifying the changes in driving behavior that underlie the decrease in crash risk over the first few months of driving is key to efforts to reduce injury and fatality risk in novice drivers. This study represented a secondary data analysis of 1148 drivers who participated in the UK Cohort II study. The Driver Behavior Questionnaire was completed at 6 months and 1, 2 and 3 years after licensure. Linear latent growth models indicated significant increases across development in all four dimensions of aberrant driving behavior under scrutiny: aggressive violations, ordinary violations, errors and slips. Unconditional and conditional latent growth class analyses showed that the observed heterogeneity in individual trajectories was explained by the presence of multiple homogeneous groups of drivers, each exhibiting specific trajectories of aberrant driver behavior. Initial levels of aberrant driver behavior were important in identifying sub-groups of drivers. All classes showed positive slopes; there was no evidence of a group of drivers whose aberrant behavior decreased over time that might explain the decrease in crash involvement observed over this period. Male gender and younger age predicted membership of trajectories with higher levels of aberrant behavior. These findings highlight the importance of early intervention for improving road safety. We discuss the implications of our findings for understanding the behavioral underpinnings of the decrease in crash involvement observed in the early months of driving. Copyright © 2015 The Authors. Published by Elsevier Ltd.. All rights reserved.

Effects of altruism and burnout on driving behavior of bus drivers.

PubMed

Shi, Xia; Zhang, Liang

2017-05-01

Personality traits predict driving behaviors. However, the mechanism underlying this relationship has not been adequately investigated in professional drivers. The current study investigated the relationship between altruistic personality and aberrant driving behaviors, and the potential role of burnout. A total of 194 bus drivers completed questionnaires including measures of altruism, burnout and aberrant driving behaviors (aggressive violations, ordinary violations, errors, and lapses). The results showed that altruism was negatively correlated with burnout, and with all the four subcategories of aberrant driving behavior. Burnout fully mediated the relationship between altruism and aggressive violations, and partially mediated the relationship between altruism and lapses. These findings can be applied in the bus drivers' selection and interventions for burnout in order to improve the safety of public transport. Copyright © 2017 Elsevier Ltd. All rights reserved.

Combined structural interventions for gender equality and livelihood security: a critical review of the evidence from southern and eastern Africa and the implications for young people.

PubMed

Gibbs, Andrew; Willan, Samantha; Misselhorn, Alison; Mangoma, Jaqualine

2012-06-14

Young people in southern and eastern Africa remain disproportionately vulnerable to HIV with gender inequalities and livelihood insecurities being key drivers of this. Behavioural HIV prevention interventions have had weak outcomes and a new generation of structural interventions have emerged seeking to challenge the wider drivers of the HIV epidemic, including gender inequalities and livelihood insecurities. We searched key academic data bases to identify interventions that simultaneously sought to strengthen people's livelihoods and transform gender relationships that had been evaluated in southern and eastern Africa. Our initial search identified 468 articles. We manually reviewed these and identified nine interventions that met our criteria for inclusion. We clustered the nine interventions into three groups: microfinance and gender empowerment interventions; supporting greater participation of women and girls in primary and secondary education; and gender empowerment and financial literacy interventions. We summarise the strengths and limitations of these interventions, with a particular focus on what lessons may be learnt for young people (18-24). Our review identified three major lessons for structural interventions that sought to transform gender relationships and strengthen livelihoods: 1) interventions have a narrow conceptualisation of livelihoods, 2) there is limited involvement of men and boys in such interventions, 3) studies have typically been done in stable populations. We discuss what this means for future interventions that target young people through these methods.

Combined structural interventions for gender equality and livelihood security: a critical review of the evidence from southern and eastern Africa and the implications for young people

PubMed Central

Gibbs, Andrew; Willan, Samantha; Misselhorn, Alison; Mangoma, Jaqualine

2012-01-01

Background Young people in southern and eastern Africa remain disproportionately vulnerable to HIV with gender inequalities and livelihood insecurities being key drivers of this. Behavioural HIV prevention interventions have had weak outcomes and a new generation of structural interventions have emerged seeking to challenge the wider drivers of the HIV epidemic, including gender inequalities and livelihood insecurities. Methods We searched key academic data bases to identify interventions that simultaneously sought to strengthen people's livelihoods and transform gender relationships that had been evaluated in southern and eastern Africa. Our initial search identified 468 articles. We manually reviewed these and identified nine interventions that met our criteria for inclusion. Results We clustered the nine interventions into three groups: microfinance and gender empowerment interventions; supporting greater participation of women and girls in primary and secondary education; and gender empowerment and financial literacy interventions. We summarise the strengths and limitations of these interventions, with a particular focus on what lessons may be learnt for young people (18–24). Conclusions Our review identified three major lessons for structural interventions that sought to transform gender relationships and strengthen livelihoods: 1) interventions have a narrow conceptualisation of livelihoods, 2) there is limited involvement of men and boys in such interventions, 3) studies have typically been done in stable populations. We discuss what this means for future interventions that target young people through these methods. PMID:22713350

Estimating the over-involvement of suspended, revoked, and unlicensed drivers as at-fault drivers in California fatal crashes.

PubMed

Brar, Sukhvir S

2014-09-01

Quasi-induced exposure analysis was used to estimate annual fatal crash involvement rates for validly licensed, suspended or revoked (S/R), and unlicensed drivers in California from 1987 through 2009 using fatal crash data obtained from the National Highway Traffic Safety Administration's Fatality Analysis Reporting System and crash culpability determinations from the California Highway Patrol's Statewide Integrated Traffic Records System. Although there was some year-to-year fluctuation in the annual estimates, S/R and unlicensed drivers were over-involved as at-fault drivers in fatal crashes during every year of the 23-year time period relative to validly licensed drivers. The fatal crash involvement ratios combined across all years were 0.86 for validly licensed drivers, 2.23 for S/R drivers, and 2.34 for unlicensed drivers. Hence, compared to validly licensed drivers, the odds of being at-fault for a fatal crash were 160% higher for S/R drivers (involvement ratio=2.60) and 173% higher for unlicensed drivers (involvement ratio=2.73). The excess risks of S/R and unlicensed drivers are somewhat lower than estimates found in a prior study using the same technique, but the results nonetheless provide evidence that S/R and unlicensed drivers are much more hazardous on the road than are validly licensed drivers and emphasize the importance of using strong countermeasures-including vehicle impoundment-to reduce their high crash risk. These findings support interventions to help reduce driving among S/R and unlicensed drivers. Published by Elsevier Ltd.

Risky driving behaviors for road traffic accident among drivers in Mekele city, Northern Ethiopia

PubMed Central

2011-01-01

Background Due to its perception as a disease of development, road traffic accident and related injuries tend to be under recognized as a major health problem in developing countries. However, majority of the world's fatalities on the roads occur in low income and middle income countries. Since the main cause of road traffic accident is attributed to human risky behaviors, it is important to identify significant factors for risky behaviors of drivers. Methods A quantitative cross-sectional study with a sample size of 350 drivers was conducted in April 2011. The study was conducted among Taxi, Bajaj (three tire vehicles) and private owned car drivers. After proportion to size allocation for Taxi (75), Baja (103) and private owned car (172) drivers, we used systematic random sampling method to identify illegible study subjects. Data was collected with face to face interview using a pretested questioner. Univariate, bivariate and multivariate analysis was done using SPSS version 16. Results The mean age of the respondents was 28.7 (SD 9.9). Majority were 339 (96.9%) males. Significant number of the study subjects 233 (66.6%) had risky driving behaviors. More than a quarter 100 (28.6%) had less knowledge about basic traffic signs. Majority of drivers 181 (51.7%) had negative attitude towards risky driving behaviors. Significant percent of them 148 (42.3%) had a habit of using mobile phone while driving vehicle and 28 (9.7%) had experience of driving after drinking alcohol. All the Bajaj, 97(62.6%) house car and 58(37.4%) taxi unfasten their seat belt while driving. Majority 303 (86.6%) followed the recommended speed limit of driving. About 66 (18.9%) of them had experience of punishment or warning by traffic polices in the previous 1 year and 77 (22%) ever had car accident while driving. Conclusions Drivers of secondary education and with high average monthly income were more likely to have risky driving behavior. Having supportive attitude towards risky driving behaviors and not getting advice about risky driving from significant others increases the likelihood of developing risky driving behavior. Interventions targeted at developing negative attitude towards risky driving behaviors on drivers and significant others should be implemented to bring positive behavior change. The interventions need to be segmented with educational status and income. PMID:22166174

Supplemental Driver Safety Program Development Volume II--Pilot and Field Test Module Materials. Final Report.

ERIC Educational Resources Information Center

McPherson, Kenard; Weidman, James R.

This volume contains materials to supplement existing driver education programming offered by high schools to youthful (16- to 18-year old) drivers. Section I contains three drinking/driving modules: an information-only module, a self-image module, and a three-unit peer intervention module. An instructor's guide provided for each module includes…

A Qualitative Study of Migrant-related Stressors, Psychosocial Outcomes and HIV Risk Behavior among Truck Drivers in Zambia

PubMed Central

Ncube, Nomagugu; Simona, Simona J.; Kansankala, Brian; Sinkala, Emmanuel; Raidoo, Jasmin

2017-01-01

Truck drivers are part of mobile populations which have been noted as a key population at risk of HIV in Zambia. This study was aimed at 1) determining Potentially Traumatic Events (PTEs), labor migrant-related stressors, psychosocial problems and HIV risk behaviors among truck drivers in Zambia and 2) examining the relationship between PTEs, migrant-related stressors, psychosocial outcomes and HIV sexual risk behavior among truck drivers in Zambia. We conducted fifteen semi-structured interviews with purposively sampled male truck drivers at trucking companies in Lusaka, Zambia. Findings indicate that truck drivers experience multiple stressors and potentially traumatic incidences, including delays and long waiting hours at borders, exposure to crime and violence, poverty, stress related to resisting temptation of sexual interactions with sex workers or migrant women, and job-related safety concerns. Multiple psychosocial problems such as intimate partner violence, loneliness, anxiety and depression-like symptoms were noted. Transactional sex, coupled with inconsistent condom use were identified as HIV sexual risk behaviors. Findings suggest the critical need to develop HIV prevention interventions which account for mobility, potentially traumatic events, psychosocial problems, and the extreme fear of HIV testing among this key population. PMID:27681145

Effect of free distribution of safety equipment on usage among motorcycle-taxi drivers in Tanzania--A cluster randomised controlled trial.

PubMed

Sumner, Steven A; Pallangyo, Anthony J; Reddy, Elizabeth A; Maro, Venance; Pence, Brian W; Lynch, Catherine; Turner, Elizabeth L; Egger, Joseph R; Thielman, Nathan M

2014-11-01

Deaths due to road traffic injuries, particularly motorcycle crashes, have increased rapidly in many African nations and context-specific strategies to improve preventative behaviours are needed. Although adhering to conspicuity measures by wearing reflective safety vests is a highly effective crash prevention strategy and mandated by law among motorcycle-taxi drivers in some African countries, actual use is currently low. We aimed to test whether eliminating cost-barriers through the provision of free reflective, fluorescent motorcycle safety vests would lead to increased utilisation among a high-risk population of motorcycle-taxi drivers in Tanzania. A cluster randomised controlled trial was conducted among 180 motorcycle-taxi drivers. Participants randomised to the intervention arm (90) received free, reflective, fluorescent vests; participants randomised to the control arm (90) did not receive free vests. Participants' use of reflective vests was then observed on city streets over a three month period and differential uptake was estimated using mixed-effects logistic regression. Baseline use of reflective vests was 3.3% in both arms. Seventy-nine drivers in the intervention arm and 82 drivers in the control arm were observed during follow-up. The average proportion of observations during which motorcycle drivers were using a reflective vest was 9.5% in the intervention arm, compared to 2.0% in the control arm (odds ratio: 5.5, 95% confidence interval: 1.1-26.9, p-value: 0.04). Although distribution of free reflective vests led to a statistically significant increase in vest usage, the absolute increase was modest. Additional strategies beyond removing economic barriers are important to augment adherence to road safety behaviours for injury prevention. Copyright © 2014 Elsevier Ltd. All rights reserved.

Drivers of land use/land cover changes in Munessa-Shashemene landscape of the south-central highlands of Ethiopia.

PubMed

Kindu, Mengistie; Schneider, Thomas; Teketay, Demel; Knoke, Thomas

2015-07-01

Understanding drivers of changes in land use/land cover (LULC) is essential for modeling future dynamics or development of management strategies to ameliorate or prevent further decline of natural resources. In this study, an attempt has been made to identify the main drivers behind the LULC changes that had occurred in the past four decades in Munessa-Shashemene landscape of the south-central highlands of Ethiopia. The datasets required for the study were generated through both primary and secondary sources. Combination of techniques, including descriptive statistics, GIS-based processing, and regression analyses were employed for data analyses. Changes triggered by the interplay of more than 12 drivers were identified related to social, economic, environmental, policy/institutional, and technological factors. Specifically, population growth, expansion of cultivated lands and settlements, livestock ranching, cutting of woody species for fuelwood, and charcoal making were the top six important drivers of LULC change as viewed by the local people and confirmed by quantitative analyses. Differences in respondents' perceptions related to environmental (i.e., location specific) and socioeconomic determinants (e.g., age and literacy) about drivers were statically significant (P = 0.001). LULC changes were also determined by distances to major drivers (e.g., the further a pixel is from the road, the less likelihood of changes) as shown by the landscape level analyses. Further studies are suggested targeting these drivers to explore the consequences and future options and formulate intervention strategies for sustainable development in the studied landscape and elsewhere with similar geographic settings.

Naturalistic distraction and driving safety in older drivers

PubMed Central

Aksan, Nazan; Dawson, Jeffrey D.; Emerson, Jamie L.; Yu, Lixi; Uc, Ergun Y.; Anderson, Steven W.; Rizzo, Matthew

2013-01-01

Objective This study aimed to quantify and compare performance of middle-aged and older drivers during a naturalistic distraction paradigm (visual search for roadside targets) and predict older driver performance given functioning in visual, motor, and cognitive domains. Background Distracted driving can imperil healthy adults and may disproportionally affect the safety of older drivers with visual, motor, and cognitive decline. Methods Two hundred and three drivers, 120 healthy older (61 men and 59 women, ages 65 years or greater) and 83 middle-aged drivers (38 men and 45 women, ages 40–64 years), participated in an on-road test in an instrumented vehicle. Outcome measures included performance in roadside target identification (traffic signs and restaurants) and concurrent driver safety. Differences in visual, motor, and cognitive functioning served as predictors. Results Older drivers identified fewer landmarks and drove slower but committed more safety errors than middle-aged drivers. Greater familiarity with local roads benefited performance of middle-aged but not older drivers. Visual cognition predicted both traffic sign identification and safety errors while executive function predicted traffic sign identification over and above vision. Conclusion Older adults are susceptible to driving safety errors while distracted by common secondary visual search tasks that are inherent to driving. The findings underscore that age-related cognitive decline affects older driver management of driving tasks at multiple levels, and can help inform the design of on-road tests and interventions for older drivers. PMID:23964422

High-risk behaviors and experiences with traffic law among night drivers in Curitiba, Brazil.

PubMed

Ulinski, Sandra L; Moysés, Simone T; Werneck, Renata I; Moysés, Samuel J

2016-01-08

To explore high-risk behaviors and experiences with traffic law among night drivers in Curitiba, Brazil. Data from 398 drivers on sociodemographic parameters, high-risk behaviors, experiences with traffic law, and traffic law violations were collected through interviews conducted at sobriety checkpoints. Exploratory-descriptive and analytical statistics were used. The mean age of the participants was 32.6±11.2 years (range, 18 to 75 years). Half of the drivers reported having driven after drinking in the last year, predominantly single men aged 18 to 29 years who drive cars and drink alcohol frequently. Only 55% of the drivers who had driven after drinking in the last year self-reported some concern about being detected in a police operation. A significant association was found between sociodemographic variables and behavior, which can help tailor public interventions to a specific group of drivers: young men who exhibit high-risk behaviors in traffic, such as driving after drinking alcohol, some of whom report heavy alcohol consumption. This group represents a challenge for educational and enforcement interventions, particularly because they admit to violating current laws and have a low perception of punishment due to the low risk of being detected by the police.

Medication and Driving-Appropriate Interventions.

PubMed

Hitosugi, Masahito

2017-01-01

Sudden illness while driving has been identified as a major cause of vehicle collisions, accounting for approximately 1 in 10 collisions. Because most drivers who experience sudden illnesses while driving do not perform avoidance maneuvers, the improvement of drivers' health is being promoted as a traffic safety strategy. Although stroke, heart disease, and epilepsy are common causes of sudden illness, common symptoms, such as abdominal cramps, vertigo, and syncope can also cause problems during driving. We found that regular referral to physicians was significantly less common among drivers who experienced health-related vehicle collisions or incidents. Inadequate control of chronic disease might lead to unusual symptoms and the onset of major attacks. Medications are prescribed to patients to relieve their symptoms and/or bring their diseases under control. However, pharmacists and doctors should ensure that patients are treated with appropriate medications to avoid drivers being distracted due to adverse reactions to medications. The author suggests that it is important to keep drivers in good health and administer appropriate medications if necessary. Both pharmacists and doctors should warn drivers that sudden illness or medication-associated distractions can cause vehicle collisions. Such interventions might contribute to reducing the frequency of sudden illness-related vehicle collisions.

Can providing feedback on driving behavior and training on parental vigilant care affect male teen drivers and their parents?

PubMed

Farah, Haneen; Musicant, Oren; Shimshoni, Yaara; Toledo, Tomer; Grimberg, Einat; Omer, Haim; Lotan, Tsippy

2014-08-01

This study focuses on investigating the driving behavior of young novice male drivers during the first year of driving (three months of accompanied driving and the following nine months of solo driving). The study's objective is to examine the potential of various feedback forms on driving to affect young drivers' behavior and to mitigate the transition from accompanied to solo driving. The study examines also the utility of providing parents with guidance on how to exercise vigilant care regarding their teens' driving. Driving behavior was evaluated using data collected by In-Vehicle Data Recorders (IVDR), which document events of extreme g-forces measured in the vehicles. IVDR systems were installed in 242 cars of the families of young male drivers, however, only 217 families of young drivers aged 17-22 (M=17.5; SD=0.8) completed the one year period. The families were randomly allocated into 4 groups: (1) Family feedback: In which all the members of the family were exposed to feedback on their own driving and on that of the other family members; (2) Parental training: in which in addition to the family feedback, parents received personal guidance on ways to enhance vigilant care regarding their sons' driving; (3) Individual feedback: In which family members received feedback only on their own driving behavior (and were not exposed to the data on other family members); (4) CONTROL: Group that received no feedback at all. The feedback was provided to the different groups starting from the solo period, thus, the feedback was not provided during the supervised period. The data collected by the IVDRs was first analyzed using analysis of variance in order to compare the groups with respect to their monthly event rates. Events' rates are defined as the number of events in a trip divided by its duration. This was followed by the development and estimation of random effect negative binomial models that explain the monthly event rates of young drivers and their parents. The study showed that: (1) the Parental training group recorded significantly lower events rates (-29%) compared to the CONTROL group during the solo period; (2) although directed mainly at the novice drivers, the intervention positively affected also the behavior of parents, with both fathers and mothers in the Parental training group improving their driving (by -23% for both fathers and mothers) and mothers improving it also in the Family feedback group (by -30%). Thus, the intervention has broader impact effect beside the targeted population. It can be concluded that providing feedback on driving behavior and parental training in vigilant care significantly improves the driving behavior of young novice male drivers. Future research directions could include applying the intervention to a broader population, with larger diversity with respect to their driving records, culture, and behaviors. The challenge is to reach wide dissemination of IVDR for young drivers accompanied by parents' involvement, and to find the suitable incentives for its sustainability. Copyright © 2013 Elsevier Ltd. All rights reserved.

Cognitive characteristics of older Japanese drivers.

PubMed

Susilowati, Indri H; Yasukouchi, Akira

2012-02-29

Some causes of accidents among older drivers are: not paying attention to traffic signals; missing stop lines; and having to deal with and misjudging emergency situations. These causes of accidents reveal problems with attention and cognition. Such incidents are also related to driver perception and stress-coping mechanisms. It is important to examine the relation of stress reactions to attention and cognition as a factor influencing the causes of accidents commonly involving older drivers. Subjects were 10 young drivers (23.3 ± 3.33 years) and 25 older drivers divided into two groups (older1 [60 to 65 years] and older2 [> 65 years]). This study revealed the correlation within driver stress inventory and driver coping questionnaires parameters was observed only in older drivers. They also needed a longer response time for Trail Making Test A and B. The factors affected the attention and cognition of older drivers by age but not driving experience itself, and coping parameters such as emotion focus, reappraisal, and avoidance were not included as stress inventory parameters. Being prone to fatigue was less for younger drivers than older drivers. Because they have shorter distances, shorter drive times, and no need for expressways, older drivers also had a significantly lower risk of thrill-seeking behaviour and more patience. The intervention addressing their attention skills, aggressive feelings, and emotion focus should be considered. The technological improvements in cars will make older drivers feel safer and make driving easier which might lower the attention paid to the road, and regular driving training might be needed to assess and enhance their safety.

Cognitive characteristics of older Japanese drivers

PubMed Central

2012-01-01

Background Some causes of accidents among older drivers are: not paying attention to traffic signals; missing stop lines; and having to deal with and misjudging emergency situations. These causes of accidents reveal problems with attention and cognition. Such incidents are also related to driver perception and stress-coping mechanisms. It is important to examine the relation of stress reactions to attention and cognition as a factor influencing the causes of accidents commonly involving older drivers. Finding Subjects were 10 young drivers (23.3 ± 3.33 years) and 25 older drivers divided into two groups (older1 [60 to 65 years] and older2 [> 65 years]). This study revealed the correlation within driver stress inventory and driver coping questionnaires parameters was observed only in older drivers. They also needed a longer response time for Trail Making Test A and B. The factors affected the attention and cognition of older drivers by age but not driving experience itself, and coping parameters such as emotion focus, reappraisal, and avoidance were not included as stress inventory parameters. Being prone to fatigue was less for younger drivers than older drivers. Because they have shorter distances, shorter drive times, and no need for expressways, older drivers also had a significantly lower risk of thrill-seeking behaviour and more patience. Conclusion The intervention addressing their attention skills, aggressive feelings, and emotion focus should be considered. The technological improvements in cars will make older drivers feel safer and make driving easier which might lower the attention paid to the road, and regular driving training might be needed to assess and enhance their safety. PMID:22738158

Video and non-video feedback interventions for teen drivers.

DOT National Transportation Integrated Search

2016-07-01

In-vehicle feedback technologies, including some that use video, help parents monitor and mentor their young drivers. While different feedback technologies have been shown to reduce some risky driving behaviors, teens and parents cite privacy concern...

Sleep, Dietary, and Exercise Behavioral Clusters among Truck Drivers with Obesity: Implications for Interventions

PubMed Central

Olson, Ryan; Thompson, Sharon V.; Wipfli, Brad; Hanson, Ginger; Elliot, Diane L.; Anger, W. Kent; Bodner, Todd; Hammer, Leslie B.; Hohn, Elliot; Perrin, Nancy A.

2015-01-01

Objective Our objectives were to describe a sample of truck drivers, identify clusters of drivers with similar patterns in behaviors affecting energy balance (sleep, diet, and exercise), and test for cluster differences in health and psychosocial factors. Methods Participants’ (n=452, BMI M=37.2, 86.4% male) self-reported behaviors were dichotomized prior to hierarchical cluster analysis, which identified groups with similar behavior co-variation. Cluster differences were tested with generalized estimating equations. Results Five behavioral clusters were identified that differed significantly in age, smoking status, diabetes prevalence, lost work days, stress, and social support, but not in BMI. Cluster 2, characterized by the best sleep quality, had significantly lower lost workdays and stress than other clusters. Conclusions Weight management interventions for drivers should explicitly address sleep, and may be maximally effective after establishing socially supportive work environments that reduce stress exposures. PMID:26949883

Chinese carless young drivers' self-reported driving behavior and simulated driving performance.

PubMed

Zhang, Qian; Jiang, Zuhua; Zheng, Dongpeng; Man, Dong; Xu, Xunnan

2013-01-01

Carless young drivers refers to those drivers aged between 18 and 25 years who have a driver's license but seldom have opportunities to practice their driving skills because they do not have their own cars. Due to China's lower private car ownership, many young drivers become carless young drivers after licensure, and the safety issue associated with them has raised great concern in China. This study aims to provide initial insight into the self-reported driving behaviors and simulated driving performance of Chinese carless young drivers. Thirty-three carless young drivers and 32 young drivers with their own cars (as a comparison group) participated in this study. A modified Driver Behavior Questionnaire (DBQ) with a 4-factor structure (errors, violations, attention lapses, and memory lapses) was used to study carless young drivers' self-reported driving behaviors. A simulated driving experiment using a low-cost, fixed-base driving simulator was conducted to measure their simulated driving performance (errors, violations, attention lapses, driving maintenance, reaction time, and accidents). Self-reported DBQ outcomes showed that carless young drivers reported similar errors, more attention lapses, fewer memory lapses, and significantly fewer violation behaviors relative to young drivers with their own cars, whereas simulated driving results revealed that they committed significantly more errors, attention lapses, and violation behaviors than the comparison group. Carless young drivers had a lower ability to maintain the stability of speed and lane position, drove more cautiously approaching and passing through red traffic lights, and committed more accidents during simulated driving. A tendency to speed was not found among carless young drivers; their average speed and speeding frequency were all much lower than that of the comparison group. Lifetime mileage was the only significant predictor of carless young drivers' self-reported violations, simulated violations, speed, and reaction time, whereas no significant predictor was found for young drivers with their own cars. Carless young drivers had poorer driving performance and were more overconfident of their self-reported driving skills compared to those young drivers with greater access to vehicles. Given that the lifetime mileage positively predicted the simulated violations measure of carless young drivers, immediate interventions are needed to help them increase driving exposure and gain driving experience gradually before moving to more challenging on-road driving tasks. Supplemental materials are available for this article.

[Development and evaluation of a small group-based cardiocerebrovascular disease prevention education program for male bus drivers].

PubMed

Kim, Eun Young; Hwang, Seon Young

2012-06-01

This study was conducted to examine effects of a small group-based cardiocerebrovascular disease (CVD) prevention education program on knowledge, stage of change and health behavior among male bus drivers with CVD risk factors. A non-equivalent control group pretest-posttest design was used. Participants were 68 male bus drivers recruited from two urban bus companies. Participants from the two groups were selected by matching age, education and risk factors. Experimental group (n=34) received a small group-based CVD prevention education program 8 times over 6 weeks and 3 times through telephone interviews at 2-week intervals. Data were collected between December, 2010 and March, 2011, and were analyzed using chi-square test, t-test, and repeated measure analysis of variance with SPSS/Win18.0. Experimental group showed significantly higher scores in CVD prevention knowledge (p<.001) and health behavior (p<.001) at 6 and 12 weeks after intervention. Participants in pre-contemplation and contemplation stages made progress to contemplation and action. This was significantly better at 6 and 12 weeks after intervention (p<.001). Results suggest that small group-based education programs for CVD prevention are effective in increasing knowledge, stage of change, and health behavior to prevent CVD among male bus drivers with CVD risk.

Evaluating large-scale health programmes at a district level in resource-limited countries.

PubMed

Svoronos, Theodore; Mate, Kedar S

2011-11-01

Recent experience in evaluating large-scale global health programmes has highlighted the need to consider contextual differences between sites implementing the same intervention. Traditional randomized controlled trials are ill-suited for this purpose, as they are designed to identify whether an intervention works, not how, when and why it works. In this paper we review several evaluation designs that attempt to account for contextual factors that contribute to intervention effectiveness. Using these designs as a base, we propose a set of principles that may help to capture information on context. Finally, we propose a tool, called a driver diagram, traditionally used in implementation that would allow evaluators to systematically monitor changing dynamics in project implementation and identify contextual variation across sites. We describe an implementation-related example from South Africa to underline the strengths of the tool. If used across multiple sites and multiple projects, the resulting driver diagrams could be pooled together to form a generalized theory for how, when and why a widely-used intervention works. Mechanisms similar to the driver diagram are urgently needed to complement existing evaluations of large-scale implementation efforts.

What We Know About ADHD and Driving Risk: A Literature Review, Meta-Analysis and Critique

PubMed Central

Jerome, Laurence; Segal, Alvin; Habinski, Liat

2006-01-01

Introduction This article examines the literature on ADHD and unintentional driving injury. This literature has emerged over the last decade as part of the burgeoning epidemic of road traffic death and injury which is the number one cause of death in young adults in North America. Methods The available literature on observational outcome studies and experimental pharmacological interventions is critically reviewed. A meta-analysis of behavioral outcomes and a review of effect size of pharmacological studies are presented. Results Current data support the utility of stimulant medication in improving driving performance in younger ADHD drivers. A conceptual model of risk factors in young ADHD drivers is offered. Conclusion The current state of screening instruments for identifying high risk subjects within this clinical group is summarized along with a final section on emerging trends and future prospects for intervention. PMID:18392181

Step On It! - Workplace cardiovascular risk assessment of New York City yellow taxi drivers

PubMed Central

Gany, Francesca; Bari, Sehrish; Gill, Pavan; Ramirez, Julia; Ayash, Claudia; Loeb, Rebecca; Aragones, Abraham; Leng, Jennifer

2015-01-01

Background Multiple factors associated with taxi driving can increase the risk of cardiovascular disease (CVD) in taxi drivers. Methods This paper describes the results of Step On It!, which assessed CVD risk factors among New York City taxi drivers at John F. Kennedy International Airport. Drivers completed an intake questionnaire and free screenings for blood pressure, glucose and body mass index (BMI). Results 466 drivers participated. 9% had random plasma glucose values >200 mg/dl. 77% had elevated BMIs. Immigrants who lived in the U.S. for >10 years had 2.5 times the odds (CI: 1.1–5.9) of having high blood pressure compared to newer immigrants. Discussion Abnormalities documented in this study were significant, especially for immigrants with greater duration of residence in the U.S., and underscore the potential for elevated CVD risk in this vulnerable population, and the need to address this risk through frameworks that utilize multiple levels of intervention. PMID:25680879

[Spanish drivers' beliefs about speed. Speeding is a major issue of road safety].

PubMed

Montoro González, Luis; Roca Ruiz, Javier; Lucas-Alba, Antonio

2010-11-01

Extending and updating our knowledge concerning drivers' motivational and cognitive processes is of essential importance if we are to apply policies with long-lasting effects. This study presents data from a representative national survey analyzing the Spanish drivers' beliefs about speed, the risks of speeding, the degree of violation of speed-limits and the reasons for speeding. Results indicate that Spanish drivers rate speeding as a serious offence, yet not among the most dangerous ones. All in all, they claim to comply mostly with the speed limits. However, some interesting violation patterns emerge: observance is lower for generic speed limits according to road type (vs. specific limits shown by certain road signs), and particularly in motorways (vs. single carriageways and urban areas). Risk perception and reasons for speeding emerge as the main factors predicting the levels of speed violations reported. Results suggest that any effective intervention strategy should consider such factors, namely the link between speed, road safety, and drivers' specific reasons for speeding.

Psychophysiological responses to short-term cooling during a simulated monotonous driving task.

PubMed

Schmidt, Elisabeth; Decke, Ralf; Rasshofer, Ralph; Bullinger, Angelika C

2017-07-01

For drivers on monotonous routes, cognitive fatigue causes discomfort and poses an important risk for traffic safety. Countermeasures against this type of fatigue are required and thermal stimulation is one intervention method. Surprisingly, there are hardly studies available to measure the effect of cooling while driving. Hence, to better understand the effect of short-term cooling on the perceived sleepiness of car drivers, a driving simulator study (n = 34) was conducted in which physiological and vehicular data during cooling and control conditions were compared. The evaluation of the study showed that cooling applied during a monotonous drive increased the alertness of the car driver. The sleepiness rankings were significantly lower for the cooling condition. Furthermore, the significant pupillary and electrodermal responses were physiological indicators for increased sympathetic activation. In addition, during cooling a better driving performance was observed. In conclusion, the study shows generally that cooling has a positive short-term effect on drivers' wakefulness; in detail, a cooling period of 3 min delivers best results. Copyright © 2017 Elsevier Ltd. All rights reserved.

Young drivers and their cars: Safe and sound or the perfect storm?

PubMed

Oviedo-Trespalacios, Oscar; Scott-Parker, Bridie

2018-01-01

Consistent with the experiences in high-income countries, young drivers remain overrepresented in road trauma statistics in low- and middle-income countries. This article pursues the emerging interest of approaching the young driver problem from a systems thinking perspective in order to design and deliver robust countermeasures. Specifically, the focus of this paper is the cars driven by young drivers. The study of vehicles' characteristics and their interaction with driving behaviour is, more often than not, considered a minor concern when developing countermeasures in young drivers' safety not only in developed nations, but especially in developing nations. Participants completed an online survey containing the 44-item Behaviour of Young Novice Drivers Scale Spanish version (BYNDS-Sp), in addition to providing information regarding their vehicle, any crash involvement, and driving offences. Based on the vehicle model information, the assessment of vehicle safety was conducted for three safety programs (ANCAP, Latin NCAP, U.S. NCAP). Young drivers in Colombia reported a breadth of risky driving behaviours worth targeting in broader interventions. For example, interventions can target speeding, particularly as three quarters of the participants drove small-medium cars associated with poorer road safety outcomes. Moreover, risky driving exposure was highly prevalent amongst the young driver participants, demonstrating the need for them to be driving the safest vehicles possible. It is noteworthy that few cars were able to be assessed by the Latin NCAP (with half of the cars rated having only 0-2 star ratings), and that there was considerable discrepancy between ANCAP, U.S. NCAP, and Latin NCAP ratings. The need for system-wide strategies to increase young driver road safety-such as improved vehicle safety-is vital to improve road safety outcomes in jurisdictions such as Colombia. Such improvements may also require systemic changes such as enhanced vehicle safety rating scales and investigation of the nature of vehicles sold in developing nations, particularly as these vehicles typically contain fewer safety features than their counterparts sold in developed nations. Copyright © 2017 Elsevier Ltd. All rights reserved.

HIV/AIDS Prevention Among the Male Population: Results of a Peer Education Program for Taxicab and Tricycle Drivers in the Philippines

PubMed Central

Morisky, Donald E.; Nguyen, Chrystene; Ang, Alfonso; Tiglao, Teodora V.

2011-01-01

This study assesses the results of a 2-year community-based peer education program aimed at increasing HIV/AIDS knowledge, attitudes toward condoms, and condom use behavior among taxicab and tricycle drivers in the Philippines. Pretest, posttest, and follow-up data were collected throughout the educational intervention program. The results of the repeated measures analysis of variance (ANOVA) indicate a significant change on knowledge about HIV/AIDS from baseline to posttest and from posttest to follow-up (F = 449.27, df = 2, p < .001). There was also a significant change on attitudes about condom use from baseline to posttest and from posttest to follow-up (F = 425.19, df = 2, p = 0.001), and a significant effect on condom use behavior with commercial sex workers from baseline to posttest and follow-up (F = 428.31, df = 2, p = .001). The peer-mediated intervention was found to be an effective means of HIV/AIDS prevention among taxi and tricycle drivers in the Philippines. PMID:15642754

An integrated approach to evaluate policies for controlling traffic law violations.

PubMed

Mehmood, Arif

2010-03-01

Modeling dynamics of the driver behavior is a complex problem. In this paper a system approach is introduced to model and to analyze the driver behavior related to traffic law violations in the Emirate of Abu Dhabi. This paper demonstrates how the theoretical relationships between different factors can be expressed formally, and how the resulting model can assist in evaluating potential benefits of various policies to control the traffic law violations Using system approach, an integrated dynamic simulation model is developed, and model is tested to simulate the driver behavior for violating traffic laws during 2002-2007 in the Emirate of Abu Dhabi. The dynamic simulation model attempts to address the questions: (1) "what" interventions should be implemented to reduce and eventually control traffic violations which will lead to improving road safety and (2) "how" to justify those interventions will be effective or ineffective to control the violations in different transportation conditions. The simulation results reveal promising capability of applying system approach in the policy evaluation studies. Copyright 2009 Elsevier Ltd. All rights reserved.

Deterministic Evolutionary Trajectories Influence Primary Tumor Growth: TRACERx Renal.

PubMed

Turajlic, Samra; Xu, Hang; Litchfield, Kevin; Rowan, Andrew; Horswell, Stuart; Chambers, Tim; O'Brien, Tim; Lopez, Jose I; Watkins, Thomas B K; Nicol, David; Stares, Mark; Challacombe, Ben; Hazell, Steve; Chandra, Ashish; Mitchell, Thomas J; Au, Lewis; Eichler-Jonsson, Claudia; Jabbar, Faiz; Soultati, Aspasia; Chowdhury, Simon; Rudman, Sarah; Lynch, Joanna; Fernando, Archana; Stamp, Gordon; Nye, Emma; Stewart, Aengus; Xing, Wei; Smith, Jonathan C; Escudero, Mickael; Huffman, Adam; Matthews, Nik; Elgar, Greg; Phillimore, Ben; Costa, Marta; Begum, Sharmin; Ward, Sophia; Salm, Max; Boeing, Stefan; Fisher, Rosalie; Spain, Lavinia; Navas, Carolina; Grönroos, Eva; Hobor, Sebastijan; Sharma, Sarkhara; Aurangzeb, Ismaeel; Lall, Sharanpreet; Polson, Alexander; Varia, Mary; Horsfield, Catherine; Fotiadis, Nicos; Pickering, Lisa; Schwarz, Roland F; Silva, Bruno; Herrero, Javier; Luscombe, Nick M; Jamal-Hanjani, Mariam; Rosenthal, Rachel; Birkbak, Nicolai J; Wilson, Gareth A; Pipek, Orsolya; Ribli, Dezso; Krzystanek, Marcin; Csabai, Istvan; Szallasi, Zoltan; Gore, Martin; McGranahan, Nicholas; Van Loo, Peter; Campbell, Peter; Larkin, James; Swanton, Charles

2018-04-19

The evolutionary features of clear-cell renal cell carcinoma (ccRCC) have not been systematically studied to date. We analyzed 1,206 primary tumor regions from 101 patients recruited into the multi-center prospective study, TRACERx Renal. We observe up to 30 driver events per tumor and show that subclonal diversification is associated with known prognostic parameters. By resolving the patterns of driver event ordering, co-occurrence, and mutual exclusivity at clone level, we show the deterministic nature of clonal evolution. ccRCC can be grouped into seven evolutionary subtypes, ranging from tumors characterized by early fixation of multiple mutational and copy number drivers and rapid metastases to highly branched tumors with >10 subclonal drivers and extensive parallel evolution associated with attenuated progression. We identify genetic diversity and chromosomal complexity as determinants of patient outcome. Our insights reconcile the variable clinical behavior of ccRCC and suggest evolutionary potential as a biomarker for both intervention and surveillance. Copyright © 2018 Francis Crick Institute. Published by Elsevier Inc. All rights reserved.

Parents' and peers' contribution to risky driving of male teen drivers.

PubMed

Taubman - Ben-Ari, Orit; Kaplan, Sigal; Lotan, Tsippy; Prato, Carlo Giacomo

2015-05-01

The current study joins efforts devoted to understanding the associations of parents' personality, attitude, and behavior, and to evaluating the added contribution of peers to the driving behavior of young drivers during their solo driving. The study combines data gathered using in-vehicle data recorders from actual driving of parents and their male teen driver with data collected from self-report questionnaires completed by the young drivers. The sample consists of 121 families, who participated in the study for 12 months, beginning with the licensure of the teen driver. The current examination concentrates on the last 3 months of this first year of driving. The experimental design was based on a random control assignment into three treatment groups (with different forms of feedback) and a control group (with no feedback). Findings indicate that the parents' (especially the fathers') sensation seeking, anxiety, and aggression, as well as their risky driving events rate were positively associated with higher risky driving of the young driver. In addition, parents' involvement in the intervention, either by feedback or by training, led to lower risky driving events rate of young drivers compared to the control group. Finally, higher cohesion and adaptability mitigated parents' model for risky driving, and peers norms' of risky driving were associated with higher risk by the teen drivers. We conclude by claiming that there is an unequivocal need to look at a full and complex set of antecedents in parents' personality, attitudes, and behavior, together with the contribution of peers to the young drivers' reckless driving, and address the practical implications for road safety. Copyright © 2015 Elsevier Ltd. All rights reserved.

Sleep quality in long haul truck drivers: A study on Iranian national data.

PubMed

Sadeghniiat-Haghighi, Khosro; Yazdi, Zohreh; Kazemifar, Amir-Mohammad

2016-08-01

Iran has a high rate of road traffic accidents. Poor quality of sleep brings about loss of attention, which is an important cause of road traffic accidents particularly in monotonous roads. The causes of poor quality of sleep in occupational drivers are multifactorial. The objective of the present study was to assess the prevalence of poor sleep quality among occupational drivers with rotating work schedules and analyze its different risk factors. 2200 professional long-haul truck drivers who had been referred to the Occupational Health Clinic for routine education course were invited. We obtained data from eight provinces from various parts of Iran during 2012-2013. Data were collected using a questionnaire including questions about demographic and job characteristics. Pittsburg Sleep Quality Index (PSQI) was used to assess drivers' sleep quality. Mean working (driving) time was (9.3±2.5) hours daily and (55.5 ± 18.29) hours weekly. About 23.5% of the drivers reported history of smoking, 14.5% had low job satisfaction and 60% had irregular work schedule. 16.4% of drivers had an accidents leading to injury during the past five years. The mean PSQI score was 4.2 ± 2.7; 54% had a PSQI>5 (poor quality of sleep). Multivariate logistic regression showed that smoking, job satisfaction, history of accidents, shift work and work hours per day were the most important risk factors for poor sleep quality. Results obtained from the current study showed a high prevalence of poor quality of sleep among professional drivers. It warrants more attention to this significant problem using some measures to improve working conditions in professional drivers, as well as health promotion interventions.

Driver education: Enhancing knowledge of sleep, fatigue and risky behaviour to improve decision making in young drivers.

PubMed

Alvaro, Pasquale K; Burnett, Nicole M; Kennedy, Gerard A; Min, William Yu Xun; McMahon, Marcus; Barnes, Maree; Jackson, Melinda; Howard, Mark E

2018-03-01

This study assessed the impact of an education program on knowledge of sleepiness and driving behaviour in young adult drivers and their performance and behaviour during simulated night driving. Thirty-four participants (18-26 years old) were randomized to receive either a four-week education program about sleep and driving or a control condition. A series of questionnaires were administered to assess knowledge of factors affecting sleep and driving before and after the four-week education program. Participants also completed a two hour driving simulator task at 1am after 17 h of extended wakefulness to assess the impact on driving behaviour. There was an increase in circadian rhythm knowledge in the intervention group following the education program. Self-reported risky behaviour increased in the control group with no changes in other aspects of sleep knowledge. There were no significant differences in proportion of intervention and control participants who had microsleeps (p ≤ .096), stopped driving due to sleepiness (p = .107), recorded objective episodes of drowsiness (p = .455), and crashed (p = .761), although there was a trend towards more control participants having microsleeps and stopping driving. Those in the intervention group reported higher subjective sleepiness at the end of the drive [M = 6.25, SD = 3.83, t(31) = 2.15, p = .05] and were more likely to indicate that they would stop driving [M = 3.08, SD = 1.16, t(31) = 2.24, p = .04]. The education program improved some aspects of driver knowledge about sleep and safety. The results also suggested that the education program lead to an increased awareness of sleepiness. Education about sleep and driving could reduce the risk of drowsy driving and associated road trauma in young drivers, but requires evaluation in a broader sample with assessment of real world driving outcomes. Copyright © 2017 Elsevier Ltd. All rights reserved.

Storybridging: Four steps for constructing effective health narratives

PubMed Central

Boeijinga, Anniek; Hoeken, Hans; Sanders, José

2017-01-01

Objective: To develop a practical step-by-step approach to constructing narrative health interventions in response to the mixed results and wide diversity of narratives used in health-related narrative persuasion research. Method: Development work was guided by essential narrative characteristics as well as principles enshrined in the Health Action Process Approach. Results: The ‘storybridging’ method for constructing health narratives is described as consisting of four concrete steps: (a) identifying the stage of change, (b) identifying the key elements, (c) building the story, and (d) pre-testing the story. These steps are illustrated by means of a case study in which an effective narrative health intervention was developed for Dutch truck drivers: a high-risk, underprivileged occupational group. Conclusion: Although time and labour intensive, the Storybridging approach suggests integrating the target audience as an important stakeholder throughout the development process. Implications and recommendations are provided for health promotion targeting truck drivers specifically and for constructing narrative health interventions in general. PMID:29276232

Driving Intervention for Returning Combat Veterans.

PubMed

Classen, Sherrilene; Winter, Sandra; Monahan, Miriam; Yarney, Abraham; Link Lutz, Amanda; Platek, Kyle; Levy, Charles

2017-04-01

Increased crash incidence following deployment and veterans' reports of driving difficulty spurred traffic safety research for this population. We conducted an interim analysis on the efficacy of a simulator-based occupational therapy driving intervention (OT-DI) compared with traffic safety education (TSE) in a randomized controlled trial. During baseline and post-testing, OT-Driver Rehabilitation Specialists and one OT-Certified Driver Rehabilitation Specialist measured driving performance errors on a DriveSafety CDS-250 high-fidelity simulator. The intervention group ( n = 13) received three OT-DI sessions addressing driving errors and visual-search retraining. The control group ( n = 13) received three TSE sessions addressing personal factors and defensive driving. Based on Wilcoxon rank-sum analysis, the OT-DI group's errors were significantly reduced when comparing baseline with Post-Test 1 ( p < .0001) and comparing the OT-DI group with the TSE group at Post-Test 1 ( p = .01). These findings provide support for the efficacy of the OT-DI and set the stage for a future effectiveness study.

ALCOHOL AND DISTRACTION INTERACT TO IMPAIR DRIVING PERFORMANCE

PubMed Central

Harrison, Emily L. R.; Fillmore, Mark T.

2011-01-01

Background Recognition of the risks associated with alcohol intoxication and driver distraction has led to a wealth of simulated driving research aimed at studying the adverse effects of each of these factors. Research on driving has moved beyond the individual, separate examination of these factors to the examination of potential interactions between alcohol intoxication and driver distraction. In many driving situations, distractions are commonplace and might have little or no disruptive influence on primary driving functions. Yet, such distractions might become disruptive to a driver who is intoxicated. Methods The present study examined the interactive impairing effects of alcohol intoxication and driver distraction on simulated driving performance in 40 young adult drivers using a divided attention task as a distracter activity. The interactive influence of alcohol and distraction was tested by having drivers perform the driving task under four different conditions: 0.65 g/kg alcohol; 0.65 g/kg alcohol + divided attention; placebo; and placebo + divided attention. Results As hypothesized, divided attention had no impairing effect on driving performance in sober drivers. However, under alcohol, divided attention exacerbated the impairing effects of alcohol on driving precision. Conclusions Alcohol and distraction continue to be appropriate targets for research into ways to reduce the rates of driving-related fatalities and injuries. Greater consideration of how alcohol and distraction interact to impair aspects of driving performance can further efforts to create prevention and intervention measures to protect drivers, particularly young adults. PMID:21277119

Alcohol and distraction interact to impair driving performance.

PubMed

Harrison, Emily L R; Fillmore, Mark T

2011-08-01

Recognition of the risks associated with alcohol intoxication and driver distraction has led to a wealth of simulated driving research aimed at studying the adverse effects of each of these factors. Research on driving has moved beyond the individual, separate examination of these factors to the examination of potential interactions between alcohol intoxication and driver distraction. In many driving situations, distractions are commonplace and might have little or no disruptive influence on primary driving functions. Yet, such distractions might become disruptive to a driver who is intoxicated. The present study examined the interactive impairing effects of alcohol intoxication and driver distraction on simulated driving performance in 40 young adult drivers using a divided attention task as a distracter activity. The interactive influence of alcohol and distraction was tested by having drivers perform the driving task under four different conditions: 0.65 g/kg alcohol; 0.65 g/kg alcohol+divided attention; placebo; and placebo+divided attention. As hypothesized, divided attention had no impairing effect on driving performance in sober drivers. However, under alcohol, divided attention exacerbated the impairing effects of alcohol on driving precision. Alcohol and distraction continue to be appropriate targets for research into ways to reduce the rates of driving-related fatalities and injuries. Greater consideration of how alcohol and distraction interact to impair aspects of driving performance can further efforts to create prevention and intervention measures to protect drivers, particularly young adults. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

Seat belt and child seat use in Lipetskaya Oblast, Russia: frequencies, attitudes, and perceptions.

PubMed

Ma, Sai; Tran, Nhan; Klyavin, Vladimir E; Zambon, Francesco; Hatcher, Kristin W; Hyder, Adnan A

2012-01-01

Despite the importance of understanding seat belt use patterns among drivers and passengers for the purpose of direct interventions or monitoring improvements, no study has described wearing rates for all seat positions in Russia. This study describes observed seat belt use and knowledge, attitudes, and perceptions of seat belt use in Lipetskaya Oblast, Russia. An observational study on the use of seat belts and child restraints in the Lipetskaya region conducted during October 2010 collected data in 6 districts and on 3 different road types. A roadside survey gathered information on knowledge, attitudes, and perceptions toward the use of seat belts from randomly selected drivers. Frequencies of seat belt use by seat position, gender, and road type were calculated. A multivariable logit model disclosed the associations between seat belt use and sociodemographic factors. The study design permitted comparison of observed seat belt use to self-reported seat belt use. A total of 25,795 vehicles and 39,833 drivers and passengers contributed observations. Overall, 55 percent of drivers were observed to be using seat belts. More than half (58%) of front seat passengers wore seat belts and only 9 percent of back seat passengers were observed to be wearing seat belts; 11 percent of cars with children had any type of child safety measure. Drivers on urban roads were less likely to wear seat belts compared to those on main highways and rural roads. Nearly 60 percent of survey respondents mentioned "seat belts save lives," and more than half mentioned law requirements and fines. Although the observed seat belt use in Lipetskaya Oblast is much higher than previous estimates in Russia, overall wearing rates remain far from universal. Rear seat passengers and children are particularly at risk. Because combined education and enforcement has proven to be effective elsewhere, such interventions are needed to improve seat belt use.

The effect of stricter licensing on road traffic injury events involving 15 to 17-year-old moped drivers in Sweden: A time series intervention study.

PubMed

Bonander, Carl; Andersson, Ragnar; Nilson, Finn

2015-10-01

This study aimed to evaluate and quantify the effect of the introduction of the AM driving license on non-fatal moped-related injuries in Sweden. With the introduction of the new license category in October 2009, prospective moped drivers are now required to pass a mandatory theory test following a practical and theoretical course. In addition, obtaining a license to operate a moped is now considerably more costly. Time series intervention analysis on monthly aggregated injury data (1st Jan 2007-31st Dec 2013) was performed using generalized additive models for location, shape and scale (GAMLSS) to quantify the effect size on injury events involving teenage (15-17 years) moped drivers, while controlling for trend and seasonality. Exposure was adjusted for by using the number of registered mopeds in traffic as a proxy. The introduction of AM license was associated with a 41% reduction in the rate of injury events involving 15-year-old moped drivers (IRR 0.59 [95% CI: 0.48-0.72]), and a 39% and 36% decrease in those involving 16-year-old (IRR 0.61 [95% CI: 0.48-0.79]) and 17-year-old drivers (IRR 0.64 [95% CI: 0.46-0.90]), respectively. The effect in the 15-year-old stratum was decreased roughly by half after adjusting for exposure, but remained significant, and the corresponding estimates in the other age groups did not change noticeably. This study provides quasi-experimental evidence of an effect on non-fatal moped-related injuries as a result of stricter licensing rules. Only part of the effect could be explained by a reduction in the number of mopeds in traffic, indicating that other mechanisms must be studied to fully understand the cause of the reduction in injuries. Copyright © 2015 Elsevier Ltd. All rights reserved.

Reading text while driving: understanding drivers' strategic and tactical adaptation to distraction.

PubMed

Liang, Yulan; Horrey, William J; Hoffman, Joshua D

2015-03-01

In this study, we investigated how drivers adapt secondary-task initiation and time-sharing behavior when faced with fluctuating driving demands. Reading text while driving is particularly detrimental; however, in real-world driving, drivers actively decide when to perform the task. In a test track experiment, participants were free to decide when to read messages while driving along a straight road consisting of an area with increased driving demands (demand zone) followed by an area with low demands. A message was made available shortly before the vehicle entered the demand zone. We manipulated the type of driving demands (baseline, narrow lane, pace clock, combined), message format (no message, paragraph, parsed), and the distance from the demand zone when the message was available (near, far). In all conditions, drivers started reading messages (drivers' first glance to the display) before entering or before leaving the demand zone but tended to wait longer when faced with increased driving demands. While reading messages, drivers looked more or less off road, depending on types of driving demands. For task initiation, drivers avoid transitions from low to high demands; however, they are not discouraged when driving demands are already elevated. Drivers adjust time-sharing behavior according to driving demands while performing secondary tasks. Nonetheless, such adjustment may be less effective when total demands are high. This study helps us to understand a driver's role as an active controller in the context of distracted driving and provides insights for developing distraction interventions. © 2014, Human Factors and Ergonomics Society.

Crash risk and aberrant driving behaviors among bus drivers: the role of personality and attitudes towards traffic safety.

PubMed

Mallia, Luca; Lazuras, Lambros; Violani, Cristiano; Lucidi, Fabio

2015-06-01

Several studies have shown that personality traits and attitudes toward traffic safety predict aberrant driving behaviors and crash involvement. However, this process has not been adequately investigated in professional drivers, such as bus drivers. The present study used a personality-attitudes model to assess whether personality traits predicted aberrant self-reported driving behaviors (driving violations, lapses, and errors) both directly and indirectly, through the effects of attitudes towards traffic safety in a large sample of bus drivers. Additionally, the relationship between aberrant self-reported driving behaviors and crash risk was also assessed. Three hundred and one bus drivers (mean age=39.1, SD=10.7 years) completed a structured and anonymous questionnaire measuring personality traits, attitudes toward traffic safety, self-reported aberrant driving behaviors (i.e., errors, lapses, and traffic violations), and accident risk in the last 12 months. Structural equation modeling analysis revealed that personality traits were associated to aberrant driving behaviors both directly and indirectly. In particular altruism, excitement seeking, and normlessness directly predicted bus drivers' attitudes toward traffic safety which, in turn, were negatively associated with the three types of self-reported aberrant driving behaviors. Personality traits relevant to emotionality directly predicted bus drivers' aberrant driving behaviors, without any mediation of attitudes. Finally, only self-reported violations were related to bus drivers' accident risk. The present findings suggest that the hypothesized personality-attitudes model accounts for aberrant driving behaviors in bus drivers, and provide the empirical basis for evidence-based road safety interventions in the context of public transport. Copyright © 2015 Elsevier Ltd. All rights reserved.

Trends in size of tropical deforestation events signal increasing dominance of industrial-scale drivers

NASA Astrophysics Data System (ADS)

Austin, Kemen G.; González-Roglich, Mariano; Schaffer-Smith, Danica; Schwantes, Amanda M.; Swenson, Jennifer J.

2017-05-01

Deforestation continues across the tropics at alarming rates, with repercussions for ecosystem processes, carbon storage and long term sustainability. Taking advantage of recent fine-scale measurement of deforestation, this analysis aims to improve our understanding of the scale of deforestation drivers in the tropics. We examined trends in forest clearings of different sizes from 2000-2012 by country, region and development level. As tropical deforestation increased from approximately 6900 kha yr-1 in the first half of the study period, to >7900 kha yr-1 in the second half of the study period, >50% of this increase was attributable to the proliferation of medium and large clearings (>10 ha). This trend was most pronounced in Southeast Asia and in South America. Outside of Brazil >60% of the observed increase in deforestation in South America was due to an upsurge in medium- and large-scale clearings; Brazil had a divergent trend of decreasing deforestation, >90% of which was attributable to a reduction in medium and large clearings. The emerging prominence of large-scale drivers of forest loss in many regions and countries suggests the growing need for policy interventions which target industrial-scale agricultural commodity producers. The experience in Brazil suggests that there are promising policy solutions to mitigate large-scale deforestation, but that these policy initiatives do not adequately address small-scale drivers. By providing up-to-date and spatially explicit information on the scale of deforestation, and the trends in these patterns over time, this study contributes valuable information for monitoring, and designing effective interventions to address deforestation.

The sex disparity in risky driving: A survey of Colombian young drivers.

PubMed

Oviedo-Trespalacios, Oscar; Scott-Parker, Bridie

2018-01-02

The overrepresentation of young drivers in poor road safety outcomes has long been recognized as a global road safety issue. In addition, the overrepresentation of males in crash statistics has been recognized as a pervasive young driver problem. Though progress in road safety evidenced as a stabilization and/or reduction in poor road safety outcomes has been made in developed nations, less-developed nations contribute the greatest road safety trauma, and developing nations such as Colombia continue to experience increasing trends in fatality rates. The aim of the research was to explore sex differences in self-reported risky driving behaviors of young drivers, including the associations with crash involvement, in a sample of young drivers attending university in Colombia. The Spanish version of the Behaviour of Young Novice Drivers Scale (BYNDS-Sp) was applied in an online survey to a sample of 392 students (225 males) aged 16-24 years attending a major university. Appropriate comparative statistics and logistic regression modeling were used when analyzing the data. Males reported consistently more risky driving behaviors, with approximately one quarter of all participants reporting risky driving exposure. Males reported greater crash involvement, with violations such as speeding associated with crash involvement for both males and females. Young drivers in Colombia appear to engage in the same risky driving behaviors as young drivers in developed nations. In addition, young male drivers in Colombia reported greater engagement in risky driving behaviors than young female drivers, a finding consistent with the behaviors of young male drivers in developed nations. As such, the research findings suggest that general interventions such as education, engineering, and enforcement should target transient rule violations such as speeding and using a handheld mobile phone while driving for young drivers in Colombia. Future research should investigate how these interventions could be tailored specifically for the Colombian cultural context, including how their effects can be evaluated, prior to implementation.

Child Passenger Deaths Involving Alcohol-Impaired Drivers

PubMed Central

Quinlan, Kyran; Shults, Ruth A.; Rudd, Rose A.

2017-01-01

BACKGROUND AND OBJECTIVE Approximately 1 in 5 child passenger deaths in the United States involves an alcohol-impaired driver, most commonly the child’s own driver. The objective of this study was to document recent trends and state-specific rates of these deaths. METHODS A descriptive analysis of 2001–2010 Fatality Analysis Reporting System data for child passengers aged <15 years killed in alcohol-impaired driving crashes. Driver impairment was defined as a blood alcohol concentration of ≥0.08 g/dL. RESULTS During 2001–2010, 2344 children <15 years were killed in crashes involving at least 1 alcohol-impaired driver. Of these children, 1515 (65%) were riding with an impaired driver. Annual deaths among children riding with an alcohol-impaired driver decreased by 41% over the decade. Among the 37 states included in the state-level analysis, Texas (272) and California (135) had the most children killed while riding with an impaired driver and South Dakota (0.98) and New Mexico (0.86) had the highest annualized child passenger death rates (per 100 000 children). Most (61%) child passengers of impaired drivers were unrestrained at the time of the crash. One-third of the impaired drivers did not have a valid driver’s license. CONCLUSIONS Alcohol-impaired driving remains a substantial threat to the safety of child passengers in the United States, and typically involves children being driven by impaired drivers. This risk varies meaningfully among states. To make further progress, states and communities could consider increased use of effective interventions and efforts aimed specifically at protecting child passengers from impaired drivers. PMID:24799550

Driving styles among young novice drivers--the contribution of parental driving styles and personal characteristics.

PubMed

Miller, Gila; Taubman-Ben-Ari, Orit

2010-03-01

As part of the effort to ascertain why young drivers are more at risk for car crashes, attention has recently turned to the effects of family, including the intergenerational transmission of driving styles from parents to offspring. The current study sought to further understanding of the nature and aspects of the family influence with the help of Bowen's family systems theory. In Phase 1 of the prospective study, 130 young driving students completed questionnaires tapping personal and personality measures, and their parents completed driving-related instruments. In Phase 2, a year after the young drivers had obtained their driver's license, they were administered the same questionnaires their parents had previously completed. The results show significant correlations between the parents' driving styles and those of their offspring a year after licensure. Furthermore, differentiation of self and self-efficacy in newly acquired driving skills were found to moderate or heighten the similarity between the driving styles of parents and their offspring. For young drivers reporting anxiety in Phase 1, this was associated with a reported anxious driving style a year later. Among young female drivers, anxiety was also associated with a reckless and careless style. Higher sensation seeking was related to higher reckless driving among young male drivers. The findings are discussed in the context of adolescence and the role of the study variables in the development and intergenerational transmission of driving styles. In addition to its theoretical contribution to the realms of intergenerational transmission in general, and young drivers in particular, the study may have practical implications for both family therapy and the design of driving interventions. Copyright 2009 Elsevier Ltd. All rights reserved.

Cyclists and drivers in road interactions: A comparison of perceived crash risk.

PubMed

Chaurand, Nadine; Delhomme, Patricia

2013-01-01

Today's increase in the number of cyclists has triggered a change in the interactions to be handled by road users. However, few studies have investigated crash risk perceived by cyclists interacting with other users, and few have compared cyclists' and drivers' perceptions of crash risk in bike-car interactions, the most dangerous situation for cyclists. Our aims here are to study perceived crash risk (no matter the seriousness of the crash) in six common road situations during which cyclist crashes are frequent and also to study cyclists' and drivers' perceived risk in bike-car interactions, in comparison to other interaction types (cyclist vs. cyclist and driver vs. driver). We predicted that perceived risk of being involved in a crash during a particular interaction would be greater when in interaction with a car than with a bike, and that drivers would perceive more risk than cyclists would. We also predicted that perceived risk would decrease with drivers' and cyclists' experience of their transportation mode and their perceived control over the interaction situation. We ran an online survey on two samples, experienced cyclists (N=336) and non-cyclist car drivers (N=92). Participants evaluated their personal risk - as cyclists or as drivers - of being involved in a road crash if they were in an interaction with a bike or a car for each of six risky road situations. Experience was measured in terms of years of vehicle driving and driven km; perceived control was measured in terms of perceived skill and responsibility for the risky behavior. The results validated our hypotheses: perceived risk was higher for car drivers than for cyclists and for interacting with a car than with a bike. The implications of these results for interventions to improve road safety for both cyclists and car drivers are discussed. Copyright © 2012 Elsevier Ltd. All rights reserved.

Prevalence and drivers of HIV stigma among health providers in urban India: implications for interventions.

PubMed

Ekstrand, Maria L; Ramakrishna, Jayashree; Bharat, Shalini; Heylen, Elsa

2013-11-13

HIV stigma inflicts hardship and suffering on people living with HIV (PLHIV) and interferes with both prevention and treatment efforts. Health professionals are often named by PLHIV as an important source of stigma. This study was designed to examine rates and drivers of stigma and discrimination among doctors, nurses and ward staff in different urban healthcare settings in high HIV prevalence states in India. This cross-sectional study enrolled 305 doctors, 369 nurses and 346 ward staff in both governmental and non-governmental healthcare settings in Mumbai and Bengaluru, India. The approximately one-hour long interviews focused on knowledge related to HIV transmission, personal and professional experiences with PLHIV, instrumental and symbolic stigma, endorsement of coercive policies, and intent to discriminate in professional and personal situations that involve high and low risk of fluid exposure. High levels of stigma were reported by all groups. This included a willingness to prohibit female PLHIV from having children (55 to 80%), endorsement of mandatory testing for female sex workers (94 to 97%) and surgery patients (90 to 99%), and stating that people who acquired HIV through sex or drugs "got what they deserved" (50 to 83%). In addition, 89% of doctors, 88% of nurses and 73% of ward staff stated that they would discriminate against PLHIV in professional situations that involved high likelihood of fluid exposure, and 57% doctors, 40% nurses and 71% ward staff stated that they would do so in low-risk situations as well. Significant and modifiable drivers of stigma and discrimination included having less frequent contact with PLHIV, and a greater number of transmission misconceptions, blame, instrumental and symbolic stigma. Participants in all three groups reported high rates of endorsement of coercive measures and intent to discriminate against PLHIV. Stigma and discrimination were associated with multiple modifiable drivers, which are consistent with previous research, and which need to be targeted in future interventions. Stigma reduction intervention programmes targeting healthcare providers in urban India need to address fear of transmission, improve universal precaution skills, and involve PLHIV at all stages of the intervention to reduce symbolic stigma and ensure that relevant patient interaction skills are taught.

Assessment of perceived injury risks and priorities among truck drivers and trucking companies in Washington State.

PubMed

Spielholz, Peregrin; Cullen, Jennifer; Smith, Caroline; Howard, Ninica; Silverstein, Barbara; Bonauto, David

2008-01-01

The trucking industry experiences one of the highest work-related injury rates. Little work has been conducted previously in the United States to assess the hazards, needs, and injury prevention priorities in trucking. Two separate industry-wide surveys of 359 trucking companies and 397 commercial truck drivers were conducted in Washington State. Trucking companies and drivers both ranked musculoskeletal and slip, trip, fall injuries as the top two priorities. Controlling heavy lifting, using appropriate equipment, and addressing slippery surfaces were frequently listed as solutions. There appears to be a gap in safety climate perception between workers and employers. However, driver and company priorities agreed with industry workers' compensation claims. There is room for safety program management improvement in the industry. The study findings detail opportunities for prioritizing and reducing injuries. This information can be used to focus and design interventions for the prevention of work-related injuries while improving industry competitiveness.

It Comes With the Job: Work Organizational, Job Design, and Self-Regulatory Barriers to Improving the Health Status of Train Drivers.

PubMed

Naweed, Anjum; Chapman, Janine; Allan, Matthew; Trigg, Joshua

2017-03-01

This study aimed to examine the impacts of key barriers to improving the occupational health status of Australian train drivers. From May to June, 2015, five semi-structured qualitative focus groups were conducted with 29 train drivers from South Australian, Victorian, and New South Wales-based rail organizations in Australia. Occupational health was impeded by multiple barriers regarding sleep (patterns/fatigue), diet (planning/context), mental health (occupational stress), rostering (low autonomy), sedentary time, low fitness motivation, and family/social life conflicts. Work organizational barriers included communication issues, low organizational support, and existing social norms. Job design barriers included rostering, fatigue, stimulant reliance, and family/social life imbalances. Self-regulatory barriers included dietary and exercise patterns habits and patterns. Occupational health interventions for Australian train drivers must address work organizational, job design, and self-regulatory barriers to healthier lifestyle behaviors.

Evaluating social outcomes of HIV/AIDS interventions: a critical assessment of contemporary indicator frameworks

PubMed Central

Mannell, Jenevieve; Cornish, Flora; Russell, Jill

2014-01-01

Introduction Contemporary HIV-related theory and policy emphasize the importance of addressing the social drivers of HIV risk and vulnerability for a long-term response. Consequently, increasing attention is being given to social and structural interventions, and to social outcomes of HIV interventions. Appropriate indicators for social outcomes are needed in order to institutionalize the commitment to addressing social outcomes. This paper critically assesses the current state of social indicators within international HIV/AIDS monitoring and evaluation frameworks. Methods We analyzed the indicator frameworks of six international organizations involved in efforts to improve and synchronize the monitoring and evaluation of the HIV/AIDS response. Our analysis classifies the 328 unique indicators according to what they measure and assesses the degree to which they offer comprehensive measurement across three dimensions: domains of the social context, levels of change and organizational capacity. Results and discussion The majority of indicators focus on individual-level (clinical and behavioural) interventions and outcomes, neglecting structural interventions, community interventions and social outcomes (e.g. stigma reduction; community capacity building; policy-maker sensitization). The main tool used to address social aspects of HIV/AIDS is the disaggregation of data by social group. This raises three main limitations. Indicator frameworks do not provide comprehensive coverage of the diverse social drivers of the epidemic, particularly neglecting criminalization, stigma, discrimination and gender norms. There is a dearth of indicators for evaluating the social impacts of HIV interventions. Indicators of organizational capacity focus on capacity to effectively deliver and manage clinical services, neglecting capacity to respond appropriately and sustainably to complex social contexts. Conclusions Current indicator frameworks cannot adequately assess the social outcomes of HIV interventions. This limits knowledge about social drivers and inhibits the institutionalization of social approaches within the HIV/AIDS response. We conclude that indicator frameworks should expand to offer a more comprehensive range of social indicators for monitoring and evaluation and to include indicators of organizational capacity to tackle social drivers. While such expansion poses challenges for standardization and coordination, we argue that the complexity of interventions producing social outcomes necessitates capacity for flexibility and local tailoring in monitoring and evaluation. PMID:25160645

Promoting driving safety for teens and adults.

PubMed

Wilson, D; Molloy-Martinez, T

1989-10-01

Traffic accidents are a major cause of death and disability, accounting for significant numbers of brain injuries. The purpose of this article is to discuss those conditions that can affect driver safety. The role of the nurse practitioner in primary prevention involves assessing the health status of drivers, including risk-taking behavior, age-related factors, use of alcohol and medications, and chronic illnesses and physical conditions that can result in driver impairment. Interventions can include patient education, anticipatory guidance, role-playing, referral for skill-building or driver evaluation, and reporting potentially unsafe drivers in keeping with state guidelines. Practitioner involvement in grass-roots community groups is encouraged.

Meta-analysis of graduated driver licensing laws: effectiveness of specific program components : traffic tech.

DOT National Transportation Integrated Search

2015-11-01

Graduated driver licensing (GDL) programs in the United States do not represent a single homogeneous intervention; rather, they contain different combinations and variations of program components. Programs vary by the duration of each stage of the GD...

Evolution of Controllability in Interbank Networks

NASA Astrophysics Data System (ADS)

Delpini, Danilo; Battiston, Stefano; Riccaboni, Massimo; Gabbi, Giampaolo; Pammolli, Fabio; Caldarelli, Guido

2013-04-01

The Statistical Physics of Complex Networks has recently provided new theoretical tools for policy makers. Here we extend the notion of network controllability to detect the financial institutions, i.e. the drivers, that are most crucial to the functioning of an interbank market. The system we investigate is a paradigmatic case study for complex networks since it undergoes dramatic structural changes over time and links among nodes can be observed at several time scales. We find a scale-free decay of the fraction of drivers with increasing time resolution, implying that policies have to be adjusted to the time scales in order to be effective. Moreover, drivers are often not the most highly connected ``hub'' institutions, nor the largest lenders, contrary to the results of other studies. Our findings contribute quantitative indicators which can support regulators in developing more effective supervision and intervention policies.

A driver-adaptive stability control strategy for sport utility vehicles

NASA Astrophysics Data System (ADS)

Zhu, Shenjin; He, Yuping

2017-08-01

Conventional vehicle stability control (VSC) systems are designed for average drivers. For a driver with a good driving skill, the VSC systems may be redundant; for a driver with a poor driving skill, the VSC intervention may be inadequate. To increase safety of sport utility vehicles (SUVs), this paper proposes a novel driver-adaptive VSC (DAVSC) strategy based on scaling the target yaw rate commanded by the driver. The DAVSC system is adaptive to drivers' driving skills. More control effort would be exerted for drivers with poor driving skills, and vice versa. A sliding mode control (SMC)-based differential braking (DB) controller is designed using a three degrees of freedom (DOF) yaw-plane model. An eight DOF nonlinear yaw-roll model is used to simulate the SUV dynamics. Two driver models, namely longitudinal and lateral, are used to 'drive' the virtual SUV. By integrating the virtual SUV, the DB controller, and the driver models, the performance of the DAVSC system is investigated. The simulations demonstrate the effectiveness of the DAVSC strategy.

Boosting restraint norms: a community-delivered campaign to promote booster seat use.

PubMed

Bryant-Stephens, Tyra; Garcia-Espana, J Felipe; Winston, Flaura K

2013-01-01

The objective of this study was to evaluate the effectiveness of a theoretically grounded community-delivered marketing campaign to promote belt-positioning booster seat (BPB) use among vulnerable populations when disseminated by community members. A prospective, nonrandomized community intervention trial was conducted to evaluate the "Boosting Restraint Norms" social marketing campaign delivered by community partners in Norristown, Pennsylvania (intervention community), between October 2008 and November 2008. York, Pennsylvania, served as the comparison community. In total, 800 vehicles with 822 children aged 4 to 7 years were observed for BPB use, the primary outcome of interest, at baseline (September 2008) and at 6 months after intervention (April 2009). During the study period, a 28 percent increase in the prevalence of BPB use at 6 months was observed in the intervention community with no change in the prevalence of BPB use in the comparison community. After adjustment for child age and gender, vehicle type, driver gender, and driver level, BPB use increased from 39 to 50 percent in the intervention community. The "Boosting Restraint Norms" social marketing campaign, distributed through community organizations combined with caregiver education and a one-time free distribution of BPBs, was effective in increasing BPB use. This study demonstrates the feasibility of utilizing community organizations with established audiences to spread the "No Regrets" messaging of the campaign in the community. This study also indicates that spreading evidence-based messages in this manner may effectively change behavior in populations that are often hard to reach. Future studies are needed in which this methodology is tested in additional communities and rural settings.

Predictors of intrinsic motivation behind seatbelt use in a country where current use is low.

PubMed

Milder, Caitlin M; Gupta, Shivam; Ozkan, Türker; Hoe, Connie; Lajunen, Timo

2013-12-01

Seatbelt use is a major determinant of a driver's safety on the road. In Turkey and other middle-income countries, seatbelt use is lower than in high-income countries and contributes to the higher burden of road traffic injuries. Assessing factors behind drivers' motivations to wear seatbelts can help determine appropriate interventions for specific subpopulations. To analyze the factors predictive of whether drivers who wear seatbelts in Afyonkarahisar and Ankara, Turkey do so because they believe seatbelts can save their lives. As part of the monitoring and evaluation of the Bloomberg Philanthropies Global Road Safety Programme, 817 drivers were randomly recruited in Afyonkarahisar and Ankara, Turkey, to participate in roadside interviews. Logistic regression was run on data from 408 drivers who claimed they always wore seatbelts. Predictors were driver's city, driver's age group (30 and younger, 31 to 40, and over 40 years), whether at least one passenger was in the car, and an interaction term between age group and whether passengers were in the car. The outcome variable of interest was whether drivers wore seatbelts because they believed seatbelts can save their lives, referred to in this paper as "selection of Reason 3." The odds of selecting Reason 3 were 2.45 (95% CI: 1.40-4.31) times higher in Ankara than in Afyonkarahisar, 2.52 (95% CI: 1.38-4.60) and 3.65 (95% CI: 1.92-6.95) times higher for drivers aged 31-40 and drivers over the age of 40 than for drivers 30 years of age and younger, respectively, and 5.89 (95% CI: 2.02-17.23), 7.22 (95% CI: 1.61-32.42), and 0.83 (95% CI: 0.32-2.19) times higher for drivers traveling with passengers who were 30 years of age and younger, between 31 and 40, and over 40 than for drivers traveling without passengers in these age groups, respectively. Drivers with passengers had higher odds of selecting Reason 3, especially younger drivers who are more likely to succumb to peer pressure. Older drivers had higher odds of selecting Reason 3. Peer groups and peer education campaigns may have an impact. Education interventions combined with extrinsic campaigns can be aimed at younger drivers to increase and maintain adherence in the population. Copyright © 2013 Elsevier Ltd. All rights reserved.

Evaluation of an occupational health intervention programme on whole‐body vibration in forklift truck drivers: a controlled trial

PubMed Central

Hulshof, C T J; Verbeek, J H A M; Braam, I T J; Bovenzi, M; van Dijk, F J H

2006-01-01

Objectives To evaluate process and outcome of a multifaceted occupational health intervention programme on whole‐body vibration (WBV) in forklift truck drivers. Methods An experimental pretest/post‐test control group study design. The authors trained occupational health services (OHS) in the experimental group in the use of the programme. OHS in the control group were asked to deliver care as usual. In total, 15 OHS, 32 OHS professionals, 26 companies, and 260 forklift drivers were involved. Post‐test measurements were carried out one year after the start of the programme. Results Baseline data before the start of the programme showed no difference between experimental and control group. Results of the outcome evaluation indicate a slight, although not statistically significant, reduction of WBV exposure in the experimental group (p = 0.06). Process evaluation revealed a positive influence on company policy toward WBV, attitude and intended behaviour of forklift drivers, and a trend towards an increase in knowledge of OHS professionals and company managers. The number of observed control measures with a major impact (levelling of surface and reduction of speed) was rather low. In those cases where control measures had been taken, there was a significant reduction in WBV exposure. This limited effect of the programme might be caused by the short period of follow up and the dropout of participants. The feasibility and the usefulness of the programme within the OHS setting were rated good by the participants. Conclusions This programme to decrease WBV exposure was partially effective. Significant effects on intermediate objectives were observed. More research on the effectiveness of intervention in the field of WBV is needed. PMID:16551762

Teen Drivers' Perceptions of Inattention and Cell Phone Use While Driving.

PubMed

McDonald, Catherine C; Sommers, Marilyn S

2015-01-01

Inattention to the roadway, including cell phone use while driving (cell phone calls, sending and reading texts, mobile app use, and Internet use), is a critical problem for teen drivers and increases risk for crashes. Effective behavioral interventions for teens are needed in order to decrease teen driver inattention related to cell phone use while driving. However, teens' perceptions of mobile device use while driving is a necessary component for theoretically driven behavior change interventions. The purpose of this study was to describe teen drivers' perceptions of cell phone use while driving in order to inform future interventions to reduce risky driving. We conducted 7 focus groups with a total of 30 teen drivers, ages 16-18, licensed for ≤ 1 year in Pennsylvania. The focus group interview guide and analysis were based on the Theory of Planned Behavior, identifying the attitudes, perceived behavioral control, and norms about inattention to the roadway. Directed descriptive content analysis was used to analyze the focus group interviews. All focus groups were coded by 2 research team members and discrepancies were reconciled. Themes were developed based on the data. Teens had a mean age of 17.39 (SD = 0.52), mean length of licensure of 173.7 days (SD = 109.2; range 4-364), were 50% male and predominately white (90%) and non-Hispanic (97%). From the focus group data, 3 major themes emerged: (1) Recognizing the danger but still engaging; (2) Considering context; and (3) Formulating safer behaviors that might reduce risk. Despite recognizing that handheld cell phone use, texting, and social media app use are dangerous and distracting while driving, teens and their peers often engaged in these behaviors. Teens described how the context of the situation contributed to whether a teen would place or answer a call, write or respond to a text, or use a social media app. Teens identified ways in which they controlled their behaviors, although some still drew attention away from the roadway. Cell phone use while driving is a contributor to motor vehicle crashes in teens, and effective interventions to decrease risks are needed. Teens viewed some types of cell phone use as unsafe and describe methods in which they control their behaviors. However, some of their methods still take attention off the primary task of driving. Teens could benefit from behavior change interventions that propose strategies to promote focused attention on the roadway at all times during the driving trip.

An analysis of health promotion materials for Dutch truck drivers: Off target and too complex?

PubMed

Boeijinga, Anniek; Hoeken, Hans; Sanders, José

2017-01-01

Despite various health promotion initiatives, unfavorable figures regarding Dutch truck drivers' eating behaviors, exercise behaviors, and absenteeism have not improved. The aim was to obtain a better understanding of the low level of effectiveness of current health interventions for Dutch truck drivers by examining to what extent these are tailored to the target group's particular mindset (focus of content) and health literacy skills (presentation of content). The article analyzes 21 health promotion materials for Dutch truck drivers using a two-step approach: (a) an analysis of the materials' focus, guided by the Health Action Process Approach; and (b) an argumentation analysis, guided by pragma-dialectics. The corpus analysis revealed: (a) a predominant focus on the motivation phase; and (b) in line with the aim of motivating the target group, a consistent use of pragmatic arguments, which were typically presented in an implicit way. The results indicate that existing health promotion materials for Dutch truck drivers are not sufficiently tailored to the target group's mindset and health literacy skills. Recommendations are offered to develop more tailored/effective health interventions targeting this high-risk, underserved occupational group.

Driving decisions when leaving electronic music dance events: driver, passenger, and group effects.

PubMed

Johnson, Mark B; Voas, Robert B; Miller, Brenda A

2012-01-01

The goal of this article was to identify characteristics of drivers and passengers that predicted peer groups whose drivers exit dance clubs with alcohol levels indicative of impairment (blood alcohol content [BAC] ≥ 0.05 g/dL). We used the portal survey methodology to randomly sample groups of electronic music dance event (EMDE) patrons as they entered and exited a club. From May through November 2010, data were collected from 38 EMDEs hosted by 8 clubs in the San Francisco Bay area. Data included in these analyses are results from breath samples for measuring BAC and self-report data on demographics, recent drinking history drinking, drinking intentions, travel to and from the clubs, and the familiarity/experience with other group members. These data were collected from a subset of 175 drivers and 272 passengers. Although drivers drank less than passengers, one driver in 5 groups had a BAC indicative of elevated crash risk (BAC ≥ 0.05 g/dL). Groups of drivers and/or passengers with a recent history of binge drinking were more likely to have drivers with BACs ≥ 0.05 g/dL. One unanticipated finding was that drivers who knew more group members relatively well were more likely to exit the club with a BAC ≥ 0.05 g/dL. Additionally, we found that groups with all female passengers were at greater risk for having a driver whose BAC was ≥ 0.05 g/dL. Some group characteristics predicted drivers who exit clubs with BACs ≥ 0.05 g/dL. One intervention strategy to promote safety might be to encourage group members to reconsider who is sober enough to drive away from the club; for some groups, a change of drivers would be a safer choice, because a passenger may have a relatively safe BAC. Groups of females appear to have a particularly elevated risk of having a driver whose BAC exceeds 0.05 g/dL, and new intervention efforts should be particularly directed to these at-risk groups.

Holding on and letting go: the perspectives of pre-seniors and seniors on driving self-regulation in later life.

PubMed

Rudman, Deborah Laliberte; Friedland, Judith; Chipman, Mary; Sciortino, Paola

2006-01-01

Although decisions related to driving are vital to well-being in later life, little is known about how aging drivers who do not experience a medical condition that requires driving cessation regulate their driving. This exploratory, qualitative study used focus groups with 79 such community-dwelling individuals to examine driving self-regulation from the perspective of pre-senior (aged 55-64) drivers, senior (aged 65 years or over) drivers, and senior ex-drivers. Themes resulting from inductive analysis addressed the importance of driving, mechanisms of self-monitoring and self-regulation, people who influenced decision making, and opinions regarding licensing regulations. A preliminary model of the process of self-regulation that highlights intrapersonal, interpersonal, and environmental influences on why, how, and when aging drivers adapt or cease driving is presented. The model identifies areas for future research to enhance understanding of this process, including the effectiveness of self-regulation. Findings suggest that increased public awareness of issues related to driving and aging could assist aging drivers, their families, and their family physicians in optimizing driving safety for this population. Since a near accident or accident was seen as the only factor that would lead many informants to stop driving and few informants planned for driving cessation, there is a need for interventions that help aging drivers make the transition to ex-driver in a timely and personally acceptable way.

Driving anger and its relationships with type A behavior patterns and trait anger: Differences between professional and non-professional drivers

PubMed Central

Feng, Zhongxiang; Yang, Miaomiao; Ma, Changxi; Jiang, Kang; Lei, Yewei; Huang, Wenjuan; Huang, Zhipeng; Zhan, Jingjing; Zhou, Muxiong

2017-01-01

The present study examined the types of situations that caused Chinese professional and non-professional drivers to become angry and investigated the differences in driving-elicited anger, considering the influences of type A behavior pattern and trait anger between the two groups. The 20-item revised Driving Anger Scale (DAS) was used to assess a sample of 232 drivers (57% professional, 43% non-professional). The non-professional drivers reported significantly higher levels of anger than the professional drivers on the overall Driving Anger Scale (DAS) and the traffic obstructions and discourtesy subscales. In both groups, the preferred driving speeds were positively related to driving anger. Furthermore, drivers with a type A personality exhibited higher overall driving anger scores and higher anger scores in response to traffic obstructions and slow driving than drivers with a type B personality. Trait anger was significantly related to driving anger in both groups. In the non-professional group, type A behavior patterns (TABPs) and time hurry (TH) were positively correlated with anger evoked by slow driving. In the professional group, TABPs, TH and competitive hostility (CH) were positively related to driving anger, and the TABPs exerted an indirect effect on driving anger by mediating the influence of trait anger. Overall, these findings provide a theoretical basis for implementing targeted interventions for driving anger in both professional and non-professional drivers. PMID:29253004

Linking mind wandering tendency to risky driving in young male drivers.

PubMed

Albert, Derek A; Ouimet, Marie Claude; Jarret, Julien; Cloutier, Marie-Soleil; Paquette, Martin; Badeau, Nancy; Brown, Thomas G

2018-02-01

Risky driving is a significant contributor to road traffic crashes, especially in young drivers. Transient mind wandering states, an internal form of distraction, are associated with faster driving, reduced headway distance, slower response times, reduced driver vigilance, and increased crash risk. It is unclear whether a trait tendency to mind wander predicts risky driving, however. Mind wandering is also associated with poor executive control, but whether this capacity moderates the putative link between mind wandering tendency and risky driving is uncertain. The present study tested whether mind wandering tendency predicts risky driving behaviour in young male drivers aged 18-21 (N=30) and whether this relationship is mediated by driver vigilance and moderated by executive control capacity. Mind wandering was measured with the Sustained Attention to Response Task (SART) and the Daydreaming Frequency Scale (DDFS). Risky driving was assessed by mean speed in a driving simulator and driver vigilance was quantified by horizontal eye movements measured with eye tracking. Results showed that greater mind wandering tendency based on SART performance significantly predicts faster mean speed, confirming the main hypothesis. Neither driver vigilance mediated nor executive control capacity moderated this relationship as hypothesized. These findings speak to the complexity of individual differences in mind wandering. Overall, mind wandering tendency is a significant marker of risky driving in young drivers, which could guide the development of targeted interventions. Copyright © 2017 Elsevier Ltd. All rights reserved.

Is it reliable to assess visual attention of drivers affected by Parkinson's disease from the backseat?—a simulator study

PubMed Central

Lee, Hoe C.; Yanting Chee, Derserri; Selander, Helena; Falkmer, Torbjorn

2012-01-01

Background Current methods of determining licence retainment or cancellation is through on-road driving tests. Previous research has shown that occupational therapists frequently assess drivers’ visual attention while sitting in the back seat on the opposite side of the driver. Since the eyes of the driver are not always visible, assessment by eye contact becomes problematic. Such procedural drawbacks may challenge validity and reliability of the visual attention assessments. In terms of correctly classified attention, the aim of the study was to establish the accuracy and the inter-rater reliability of driving assessments of visual attention from the back seat. Furthermore, by establishing eye contact between the assessor and the driver through an additional mirror on the wind screen, the present study aimed to establish how much such an intervention would enhance the accuracy of the visual attention assessment. Methods Two drivers with Parkinson's disease (PD) and six control drivers drove a fixed route in a driving simulator while wearing a head mounted eye tracker. The eye tracker data showed where the foveal visual attention actually was directed. These data were time stamped and compared with the simultaneous manual scoring of the visual attention of the drivers. In four of the drivers, one with Parkinson's disease, a mirror on the windscreen was set up to arrange for eye contact between the driver and the assessor. Inter-rater reliability was performed with one of the Parkinson drivers driving, but without the mirror. Results Without mirror, the overall accuracy was 56% when assessing the three control drivers and with mirror 83%. However, for the PD driver without mirror the accuracy was 94%, whereas for the PD driver with a mirror the accuracy was 90%. With respect to the inter-rater reliability, a 73% agreement was found. Conclusion If the final outcome of a driving assessment is dependent on the subcategory of a protocol assessing visual attention, we suggest the use of an additional mirror to establish eye contact between the assessor and the driver. The clinicians’ observations on-road should not be a standalone assessment in driving assessments. Instead, eye trackers should be employed for further analyses and correlation in cases where there is doubt about a driver's attention. PMID:22461850

A predictive control framework for torque-based steering assistance to improve safety in highway driving

NASA Astrophysics Data System (ADS)

Ercan, Ziya; Carvalho, Ashwin; Tseng, H. Eric; Gökaşan, Metin; Borrelli, Francesco

2018-05-01

Haptic shared control framework opens up new perspectives on the design and implementation of the driver steering assistance systems which provide torque feedback to the driver in order to improve safety. While designing such a system, it is important to account for the human-machine interactions since the driver feels the feedback torque through the hand wheel. The controller should consider the driver's impact on the steering dynamics to achieve a better performance in terms of driver's acceptance and comfort. In this paper we present a predictive control framework which uses a model of driver-in-the-loop steering dynamics to optimise the torque intervention with respect to the driver's neuromuscular response. We first validate the system in simulations to compare the performance of the controller in nominal and model mismatch cases. Then we implement the controller in a test vehicle and perform experiments with a human driver. The results show the effectiveness of the proposed system in avoiding hazardous situations under different driver behaviours.

Driving Green: Toward the Prediction and Influence of Efficient Driving Behavior

NASA Astrophysics Data System (ADS)

Newsome, William D.

Sub-optimal efficiency in activities involving the consumption of fossil fuels, such as driving, contribute to a miscellany of negative environmental, political, economic and social externalities. Demonstrations of the effectiveness of feedback interventions can be found in countless organizational settings, as can demonstrations of individual differences in sensitivity to feedback interventions. Mechanisms providing feedback to drivers about fuel economy are becoming standard equipment in most new vehicles, but vary considerably in their constitution. A keystone of Radical Behaviorism is the acknowledgement that verbal behavior appears to play a role in mediating apparent susceptibility to influence by contingencies of varying delay. In the current study, samples of verbal behavior (rules) were collected in the context of a feedback intervention to improve driving efficiency. In an analysis of differences in individual responsiveness to the feedback intervention, the rate of novel rules per week generated by drivers is revealed to account for a substantial proportion of the variability in relative efficiency gains across participants. The predictive utility of conceptual tools, such as the basic distinction among contingency-shaped and rule governed behavior, the elaboration of direct-acting and indirect-acting contingencies, and the psychological flexibility model, is bolstered by these findings.

Alternative methods for safety analysis and intervention for contracting commercial vehicles and drivers in Connecticut

DOT National Transportation Integrated Search

2012-06-01

This study evaluated Connecticuts current system for qualifying contractors for : the use of commercial vehicles on state contracts, identifies its impacts, and : makes recommendations on how the state should revise the current system. The : prima...

Improving Collaborative Behaviour Planning in Adult Auditory Rehabilitation: Development of the I-PLAN Intervention Using the Behaviour Change Wheel.

PubMed

Barker, Fiona; Lusignan, Simon de; Deborah, Cooke

2018-05-18

The consequences of poorly managed hearing loss can be ameliorated with hearing aid use but rates of use are sub-optimal. The impact of audiologist behaviour on subsequent use, particularly over the long term, is unknown. This study aimed to describe the role of the behaviour change wheel in developing an intervention to introduce and embed particular clinical behaviours into adult hearing aid fitting consultations, within the framework of the Medical Research Council guidance on complex interventions. Following the steps of the behaviour change wheel, audiologist behaviours that might influence hearing aid use were identified based on a systematic review and qualitative work with audiologists. An analysis, using the COM-B model, identified potential drivers of the target behaviours. This was used to select intervention functions and behaviour change techniques likely to influence behaviour in this context. The target behaviours were as follows: giving information about the benefits of hearing aid use and the negative consequences of non-use, providing prompts for use and engaging in collaborative behavioural planning for use. The behavioural analysis suggested that psychological capability, opportunity and motivation were potential drivers of these behaviours. The intervention functions of education, coercion, training, environmental restructuring, modelling and enablement were selected and combined to develop a single complex intervention that seeks to address the target behaviours.

Examination of a dual-process model predicting riding with drinking drivers.

PubMed

Hultgren, Brittney A; Scaglione, Nichole M; Cleveland, Michael J; Turrisi, Rob

2015-06-01

Nearly 1 in 5 of the fatalities in alcohol-related crashes are passengers. Few studies have utilized theory to examine modifiable psychosocial predictors of individuals' tendencies to be a passenger in a vehicle operated by a driver who has consumed alcohol. This study used a prospective design to test a dual-process model featuring reasoned and reactive psychological influences and psychosocial constructs as predictors of riding with drinking drivers (RWDD) in a sample of individuals aged 18 to 21. College students (N = 508) completed web-based questionnaires assessing RWDD, psychosocial constructs (attitudes, expectancies, and norms), and reasoned and reactive influences (intentions and willingness) at baseline (the middle of the spring semester) and again 1 and 6 months later. Regression was used to analyze reasoned and reactive influences as proximal predictors of RWDD at the 6-month follow-up. Subsequent analyses examined the relationship between the psychosocial constructs as distal predictors of RWDD and the mediation effects of reasoned and reactive influences. Both reasoned and reactive influences predicted RWDD, while only the reactive influence had a significant unique effect. Reactive influences significantly mediated the effects of peer norms, attitudes, and drinking influences on RWDD. Nearly all effects were constant across gender except parental norms (significant for females). Findings highlight that the important precursors of RWDD were reactive influences, attitudes, and peer and parent norms. These findings suggest several intervention methods, specifically normative feedback interventions, parent-based interventions, and brief motivational interviewing, may be particularly beneficial in reducing RWDD. Copyright © 2015 by the Research Society on Alcoholism.

“Every disease…man can get can start in this cab”: Focus groups to identify South Asian taxi drivers’ knowledge, attitudes and beliefs about cardiovascular disease and its risks

PubMed Central

Gany, Francesca M; Gill, Pavan P; Ahmed, Ayaz; Acharya, Sudha; Leng, Jennifer

2017-01-01

Background South Asian (SA) taxi drivers potentially possess a double epidemiologic risk for cardiovascular disease (CVD) due to their ethnicity and occupation. This study investigates SA taxi drivers’ knowledge, attitudes, beliefs about general health, CVD and approaches to reduce CVD risk. Method Five focus groups were conducted with 31 SA taxi drivers in the participants’ primary language (Bengali, Hindi, Urdu or Punjabi). Audio-recordings of the sessions were transcribed, translated and entered into ATLAS.ti 6.2 for coding and analysis. Results SA drivers in an urban setting perceive themselves to be at high risk for CVD because of high work-related stress, physical inactivity, poor diet and poor health care access. Participants attributed their occupation to increasing risk for heart disease; none believed that being SA increased their risk. Discussion Interventions to lower CVD risk among SA taxi drivers should be multi-level and involve the individual drivers and the taxi industry. PMID:22843321

A qualitative study exploring child marriage practices among Syrian conflict-affected populations in Lebanon.

PubMed

Mourtada, Rima; Schlecht, Jennifer; DeJong, Jocelyn

2017-01-01

Recent reports have suggested that child marriage among Syrians may be increasing as a result of displacement and conflict. This study sought to gather qualitative data about the factors that promote child marriage practices among Syrian refugees in Al Marj area in the Bekaa valley, Lebanon, where the majority of Syrian refugees have settled in Lebanon. The second aim of this study was to generate recommendations on how to mitigate the drivers and consequences of child marriage practices based on the findings. Eight focus group discussions were conducted separately with married and unmarried young women and mothers and fathers of married and unmarried women. Furthermore, researchers conducted 11 key informant interviews with service providers and stakeholders to understand how conflict and displacement influenced marriage practices of Syrian refugees in Al Marj community. Although child marriage was a common practice in pre-conflict Syria, new factors seem to contribute to a higher risk of child marriage among Syrian refugees in Lebanon. Respondents cited conflict- and displacement-related safety issues and feeling of insecurity, the worsening of economic conditions, and disrupted education for adolescent women as driving factors. Service providers, young women, and parents also reported changes in some marriage practices, including a shorter engagement period, lower bride price, change in cousin marriage practices, and a reduced age at marriage. Recommendations for interventions to mitigate the drivers of child marriage and its negative consequences should be built on a clear understanding of the local refugee context and the drivers of child marriage in refugee settings. Interventions should involve multiple stakeholders, they should be adjusted to target each specific context, age group and marital status. For these interventions to be effective, they should be addressed concurrently, and they should be delivered in a culturally sensitive and practical manner.

Evolution of Controllability in Interbank Networks

PubMed Central

Delpini, Danilo; Battiston, Stefano; Riccaboni, Massimo; Gabbi, Giampaolo; Pammolli, Fabio; Caldarelli, Guido

2013-01-01

The Statistical Physics of Complex Networks has recently provided new theoretical tools for policy makers. Here we extend the notion of network controllability to detect the financial institutions, i.e. the drivers, that are most crucial to the functioning of an interbank market. The system we investigate is a paradigmatic case study for complex networks since it undergoes dramatic structural changes over time and links among nodes can be observed at several time scales. We find a scale-free decay of the fraction of drivers with increasing time resolution, implying that policies have to be adjusted to the time scales in order to be effective. Moreover, drivers are often not the most highly connected “hub” institutions, nor the largest lenders, contrary to the results of other studies. Our findings contribute quantitative indicators which can support regulators in developing more effective supervision and intervention policies. PMID:23568033

Age vs. experience : evaluation of a video feedback intervention for newly licensed teen drivers.

DOT National Transportation Integrated Search

2013-02-06

This project examines the effects of age, experience, and video-based feedback on the rate and type of safety-relevant events captured on video event : recorders in the vehicles of three groups of newly licensed young drivers: : 1. 14.5- to 15.5-year...

Alcohol and highway safety : screening and brief intervention for alcohol problems as a community approach to improving traffic safety.

DOT National Transportation Integrated Search

2013-09-01

Only a small fraction of the impaired drivers who are at risk for alcohol-impaired-driving crashes are arrested. These include drivers who drink regularly or occasionally to intoxication before they drive. Researchers have estimated the probability o...

Effectiveness of Health Promotion Programmes for Truck Drivers: A Systematic Review

ERIC Educational Resources Information Center

Ng, Mandy K.; Yousuf, Bilal; Bigelow, Philip Lloyd; Van Eerd, Dwayne

2015-01-01

Objective: To review the characteristics of effective health promotion interventions for reducing chronic diseases and their risk factors in truck drivers. Methods: MEDLINE (PubMed), SCOPUS, Web of Science Conference Proceedings, CINAHL (Cumulative Index to Nursing and Allied Health Literature), and the National Transportation Library were…

Adolescent Problem Behavior and Problem Driving in Young Adulthood

ERIC Educational Resources Information Center

Bingham, C. Raymond; Shope, Jean T.

2004-01-01

Motor vehicle crashes are the leading cause of death among drivers younger than age 35, making problem driving behavior among young drivers a significant public concern. Effective intervention requires a better understanding of the antecedents of problem driving. Problem behavior theory, social control theory, and Kandel's model of substance use…

Strategies to Reduce Hospitalizations of Children With Medical Complexity Through Complex Care: Expert Perspectives.

PubMed

Coller, Ryan J; Nelson, Bergen B; Klitzner, Thomas S; Saenz, Adrianna A; Shekelle, Paul G; Lerner, Carlos F; Chung, Paul J

Interventions to reduce disproportionate hospital use among children with medical complexity (CMC) are needed. We conducted a rigorous, structured process to develop intervention strategies aiming to reduce hospitalizations within a complex care program population. A complex care medical home program used 1) semistructured interviews of caregivers of CMC experiencing acute, unscheduled hospitalizations and 2) literature review on preventing hospitalizations among CMC to develop key drivers for lowering hospital utilization and link them with intervention strategies. Using an adapted version of the RAND/UCLA Appropriateness Method, an expert panel rated each model for effectiveness at impacting each key driver and ultimately reducing hospitalizations. The complex care program applied these findings to select a final set of feasible intervention strategies for implementation. Intervention strategies focused on expanding access to familiar providers, enhancing general or technical caregiver knowledge and skill, creating specific and proactive crisis or contingency plans, and improving transitions between hospital and home. Activities aimed to facilitate family-centered, flexible implementation and consideration of all of the child's environments, including school and while traveling. Tailored activities and special attention to the highest utilizing subset of CMC were also critical for these interventions. A set of intervention strategies to reduce hospitalizations among CMC, informed by key drivers, can be created through a structured, reproducible process. Both this process and the results may be relevant to clinical programs and researchers aiming to reduce hospital utilization through the medical home for CMC. Copyright © 2017 Academic Pediatric Association. Published by Elsevier Inc. All rights reserved.

Evaluating the Effectiveness of a Front Windshield Sticker Reminder in Reducing Texting while Driving in Young Adults

PubMed Central

Eriksson, Sven; Metcalf, David

2016-01-01

Texting while driving is a dangerous activity that is on the rise in the United States (U.S.). Since 2011 there has been a 17% increase in the number of people injured in a motor vehicle crash involving a distracted driver. Bans on the act of texting and driving have already taken place in 46 states in the U.S., but studies have shown that they are ineffective. An unstudied method of reducing texting while driving is sticker reminders. Sticker reminders have already been proven to be an effective intervention in the realm of driver safety; one study found that a “Buckle-Up” dashboard sticker doubled the use of safety belts by front seat passengers. In this study, 104 medical students aged 21 - 29, from the University of Central Florida (UCF) College of Medicine were randomly divided into two groups, an interventional group receiving a “Drive in the Moment” windshield sticker, and a control group not receiving the sticker. Both groups took a pre- and post-survey that recorded self-reported texting and driving frequency. The results showed that the sticker intervention significantly reduced reported rates of sending texts while driving, reading texts while driving, and using social media while driving (p < 0.05). The results of this study suggest that a novel sticker-intervention could potentially serve as a point of attack when addressing the growing and dangerous texting while driving the epidemic. PMID:27555989

The effect of performance feedback on drivers' hazard perception ability and self-ratings.

PubMed

Horswill, Mark S; Garth, Megan; Hill, Andrew; Watson, Marcus O

2017-04-01

Drivers' hazard perception ability has been found to predict crash risk, and novice drivers appear to be particularly poor at this skill. This competency appears to develop only slowly with experience, and this could partially be a result of poor quality performance feedback. We report an experiment in which we provided high-quality artificial feedback on individual drivers' performance in a validated video-based hazard perception test via either: (1) a graph-based comparison of hazard perception response times between the test-taker, the average driver, and an expert driver; (2) a video-based comparison between the same groups; or (3) both. All three types of feedback resulted in both an improvement in hazard perception performance and a reduction in self-rated hazard perception skill, compared with a no-feedback control group. Video-based and graph-based feedback combined resulted in a greater improvement in hazard perception performance than either of the individual components, which did not differ from one another. All three types of feedback eliminated participants' self-enhancement bias for hazard perception skill. Participants judged both interventions involving video feedback to be significantly more likely to improve their real-world driving than the no feedback control group. While all three forms of feedback had some value, the combined video and graph feedback intervention appeared to be the most effective across all outcome measures. Copyright © 2017 Elsevier Ltd. All rights reserved.

ASCERTAINMENT OF ON-ROAD SAFETY ERRORS BASED ON VIDEO REVIEW

PubMed Central

Dawson, Jeffrey D.; Uc, Ergun Y.; Anderson, Steven W.; Dastrup, Elizabeth; Johnson, Amy M.; Rizzo, Matthew

2011-01-01

Summary Using an instrumented vehicle, we have studied several aspects of the on-road performance of healthy and diseased elderly drivers. One goal from such studies is to ascertain the type and frequency of driving safety errors. Because the judgment of such errors is somewhat subjective, we applied a taxonomy system of 15 general safety error categories and 76 specific safety error types. We also employed and trained professional driving instructors to review the video data of the on-road drives. In this report, we illustrate our rating system on a group of 111 drivers, ages 65 to 89. These drivers made errors in 13 of the 15 error categories, comprising 42 of the 76 error types. A mean (SD) of 35.8 (12.8) safety errors per drive were noted, with 2.1 (1.7) of them being judged as serious. Our methodology may be useful in applications such as intervention studies, and in longitudinal studies of changes in driving abilities in patients with declining cognitive ability. PMID:24273753

Driver behaviour profiles for road safety analysis.

PubMed

Ellison, Adrian B; Greaves, Stephen P; Bliemer, Michiel C J

2015-03-01

Driver behaviour is a contributing factor in over 90 percent of road crashes. As a consequence, there is significant benefit in identifying drivers who engage in unsafe driving practices. Driver behaviour profiles (DBPs) are introduced here as an approach for evaluating driver behaviour as a function of the risk of a casualty crash. They employ data collected using global positioning system (GPS) devices, supplemented with spatiotemporal information. These profiles are comprised of common risk scores that can be used to compare drivers between each other and across time and space. The paper details the development of these DBPs and demonstrates their use as an input into modelling the factors that influence driver behaviour. The results show that even having controlled for the influence of the road environment, these factors remain the strongest predictors of driver behaviour suggesting different spatiotemporal environments elicit a variety of psychological responses in drivers. The approach and outcomes will be of interest to insurance companies in enhancing the risk-profiling of drivers with on-road driving and government through assessing the impacts of behaviour-change interventions. Copyright © 2015 Elsevier Ltd. All rights reserved.

An application of the driver behavior questionnaire to Chinese carless young drivers.

PubMed

Zhang, Qian; Jiang, Zuhua; Zheng, Dongpeng; Wang, Yifan; Man, Dong

2013-01-01

Carless young drivers refers to those drivers aged between 18 and 25 years who have a driver's license but seldom have opportunities to practice their driving skills because they do not have their own cars. Due to China's lower private car ownership, many young drivers turn into carless young drivers after licensure, and the safety issue associated with them has become a matter of great concern in China. Because few studies have examined the driving behaviors of these drivers, this study aims to utilize the Driver Behavior Questionnaire (DBQ) to investigate the self-reported driving behaviors of Chinese carless young drivers. A total of 523 Chinese carless young drivers (214 females, 309 males) with an average age of 21.91 years completed a questionnaire including the 27-item DBQ and demographics. The data were first randomized into 2 subsamples for factor analysis and then combined together for the following analyses. Both an exploratory factor analysis (EFA, n = 174) and a confirmatory factor analysis (CFA, n = 349) were performed to investigate the factor structure of the DBQ. Correlation analysis was conducted to examine the relationships between the demographics and the DBQ scales' variables. Multivariate linear regression and logistic regression were performed to investigate the prediction of the DBQ scales and crash involvement in the previous year. The EFA produced a 4-factor structure identified as errors, violations, attention lapses, and memory lapses, and the CFA revealed a good model fit after the removal of one item with a low factor loading and the permission of the error covariance between some items. The Chinese carless young drivers reported a comparatively low level of aberrant driving behaviors. The 3 most frequently reported behaviors were all lapses and the 3 least were all violations. Gender was the only significant predictor of the 2 lapses scales and lifetime mileage was the only significant predictor of the violations scale. Only the violations factor was found to be significantly predictive of crash involvement in the previous year. The current study provides evidence that the DBQ can successfully be utilized to examine the self-reported driving behaviors of Chinese carless young drivers. However, the factor structure as well as the level of reported aberrant driving behaviors suggests that Chinese carless young drivers are a special population and thus should be treated differently when interventions are performed. Supplemental materials are available for this article.

Mindfulness predicts less texting while driving among young adults: Examining attention- and emotion-regulation motives as potential mediators

PubMed Central

Feldman, Greg; Greeson, Jeff; Renna, Megan; Robbins-Monteith, Kendra

2011-01-01

Many young adult drivers read and send text messages while driving despite clear safety risks. Understanding predictors of texting-while-driving may help to indentify relevant targets for interventions to reduce this dangerous behavior. The present study examined whether individual differences in mindfulness is associated with texting-while-driving in a sample of young-adult drivers. Using path analysis, we tested whether this relationship would be mediated by the degree to which individuals use text-messaging as a means of reducing unpleasant emotions (emotion-regulation motives) and the degree to which individuals limit texting in order to focus on present-moment experiences (attention-regulation motives). Individuals lower in mindfulness reported more frequent texting-while-driving and this relationship appeared to be mediated primarily by emotion-regulation motives. Results may help inform the development of mindfulness-based interventions to prevent texting-while-driving. PMID:22031789

Activities of the Bloomberg Philanthropies Global Road Safety Programme (formerly RS10) in Russia: promising results from a sub-national project.

PubMed

Slyunkina, Ekaterina S; Kliavin, Vladimir E; Gritsenko, Elena A; Petruhin, Alexandr B; Zambon, Francesco; He, Huan; Hyder, Adnan A

2013-12-01

In Russia, the high Road Traffic Injuries (RTIs) rate has been attributed to two well-known risk factors - the low rates of seatbelt and child restraints use and speeding. Despite the importance of understanding both speeding and seatbelt use patterns for the purpose of direct interventions or monitoring road safety situation, no study has assessed the current status of speeding among all vehicles and seatbelt wearing rates among all vehicle occupants in Russia. We are aware that alcohol is a known risk factor for RTI in the country however the work focused on seat belts and speed. This research was conducted as part of the Bloomberg Philanthropies Global Road Safety Programme and focuses on observed speeding and seatbelt use in two Russian regions: Lipetskaya and Ivanovskaya Oblast. Data was collected through observational surveys on selected roads in the two interventions sites (Lipetskaya and Ivanovskaya Oblast) between October 2010 and March 2013. The percentage of seatbelt use by drivers and passengers and the percentage of speeding vehicles by speed limit and road types were calculated. Observational studies on speeding show signs that drivers are speeding less from the first survey held in July 2011 in Lipetskaya Oblast and March 2012 in Ivanovksya Oblast. Overall the observational studies showed a consistent reduction in the proportion of vehicles exceeding the speed limit: from 54.7% (2012) to 40.1% (2013) in Ivanovskaya Oblast and from 47.0% (2011) to 26.1% (2013) in Lipetskaya Oblast. Observational studies on seatbelt use demonstrate an increase in seatbelt wearing rates from the first survey held in October 2010 in Lipetskaya Oblast and April 2011 in Ivanovskaya Oblast. The overall prevalence of seatbelt use increased from 52.4% (2010) to 73.5% (2013) amongst all occupants in Lipetskaya Oblast and from 47.5% (2011) to 88.8% (2013) in Ivanovskaya Oblast. Preliminary results show some promising signs that speeding and seatbelt use are moving in the right direction in both intervention sites subsequent to the various countermeasures being implemented under the Global Road Safety Programme. The study demonstrates the need for further targeted interventions to increase drivers' compliance with the speed limit and seatbelt use. However, it is too early to draw any definite conclusions or to fully attribute the effect to the interventions. Copyright © 2013 Elsevier Ltd. All rights reserved.

Bus drivers' exposure to bullying at work: an occupation-specific approach.

PubMed

Glasø, Lars; Bele, Edvard; Nielsen, Morten Birkeland; Einarsen, Ståle

2011-10-01

The present study employs an occupation-specific approach to examine bus drivers' exposure to bullying and their trait anger, job engagement, job satisfaction and turnover intentions. A total of 1,023 bus drivers from a large public transport organization participated in the study. The findings show that bus driving can be a high risk occupation with regard to bullying, since 70% of the bus drivers had experienced one or more acts typical of bullying during the last six months. As many as 11% defined themselves as victims of bullying, 33% of whom (i.e. 3.6% of the total sample) see themselves as victims of frequent bullying. Colleagues were most frequently reported as perpetrators. Exposure to bullying was negatively related to job engagement and job satisfaction and positively related to turnover intentions. Job engagement and job satisfaction mediated the relationship between bullying and intention to leave, respectively. Trait anger had an interaction effect on the relationship between bullying and turnover intentions. This study indicates that workplace bullying has context-specific aspects that require increased use of context-specific policies and intervention methods. © 2011 The Authors. Scandinavian Journal of Psychology © 2011 The Scandinavian Psychological Associations.

Opportunities and limitations for intersection collision intervention-A study of real world 'left turn across path' accidents.

PubMed

Sander, Ulrich

2017-02-01

Turning across the path of oncoming vehicle accidents are frequent and dangerous. To date not many car manufacturers have introduced Automated Emergency Braking (AEB) systems addressing this type of conflict situation, but it is foreseeable that these scenarios will be part of the Euro NCAP 2020 rating. Nine out of ten collisions are caused by the driver of the turning vehicle. An AEB system evaluating the ego and conflict vehicle driver's possibilities to avoid a pending crash by either braking or steering was specified for application in various constellations of vehicle collisions. In virtual simulation, AEB system parameters were varied, covering parameters that are relevant for driver comfort such as longitudinal and lateral acceleration (to define avoidance possibilities), expected steering maneuvers to avoid conflict, and intervention response characteristics (brake delay and ramp up) to assess the safety benefit. The reference simulation showed a potential of the AEB system in the turning vehicle to avoid approximately half of the collisions. An AEB system of the straight going vehicle was less effective. The effectiveness of the turning vehicle's AEB system increases if spatial limitations for the collision-avoidance steering maneuver are known. Such information could be provided by sensors detecting free space in or around the road environment or geographical information shared via vehicle to cloud communication. AEB interventions rarely result in collision avoidance for turning vehicles with speeds above 40km/h or for straight going vehicles with speeds above 60km/h. State of the art field-of-views of forward looking sensing systems designed for AEB rear-end interventions are capable of addressing turning across path situations. Copyright © 2016 Elsevier Ltd. All rights reserved.

A call to improve sampling methodology and reporting in young novice driver research.

PubMed

Scott-Parker, B; Senserrick, T

2017-02-01

Young drivers continue to be over-represented in road crash fatalities despite a multitude of research, communication and intervention. Evidence-based improvement depends to a great extent upon research methodology quality and its reporting, with known limitations in the peer-review process. The aim of the current research was to review the scope of research methodologies applied in 'young driver' and 'teen driver' research and their reporting in four peer-review journals in the field between January 2006 and December 2013. In total, 806 articles were identified and assessed. Reporting omissions included participant gender (11% of papers), response rates (49%), retention rates (39%) and information regarding incentives (44%). Greater breadth and specific improvements in study designs and reporting are thereby identified as a means to further advance the field. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

Increasing motorist compliance and caution at stop signs.

PubMed Central

Van Houten, R; Retting, R A

2001-01-01

This study evaluated strategies to improve motorist compliance and caution at three stop-sign-controlled intersections with a history of motor vehicle crashes. The primary intervention was a light-emitting diode (LED) sign that featured animated eyes scanning left and right to prompt drivers to look left and right for approaching traffic. Data were scored from videotape on the percentage of drivers coming to a complete stop and the percentage of drivers looking right before entering the intersection. Observational data were collected on the percentage of right-angle conflicts (defined as braking suddenly or swerving from the path to avoid an intersection crash). The introduction of the LED sign according to a multiple baseline across the three intersections was associated with an increase in the percentage of vehicles coming to a complete stop at all three intersections and a small increase in the percentage of drivers looking right before entering the intersections. Conflicts between vehicles on the major and minor road were also reduced following the introduction of the animated eyes prompt. PMID:11421311

A technology to measure multiple driving behaviors without self-report or participant reactivity.

PubMed Central

Boyce, T E; Geller, E S

2001-01-01

An in-vehicle information system (IVIS) was used to videotape drivers (N = 61) without their knowledge while driving 22 miles in normal traffic. The drivers were told that they were participating in a study of direction following and map reading. Two data-coding procedures were used to analyze videotapes. Safety-related behaviors were counted during consecutive 15-s intervals of a driving trial, and the occurrence of certain safety-related behaviors was assessed under critical conditions. These two methods of data coding were assessed for practicality, reliability, and sensitivity. Interobserver agreement for the five different driving behaviors ranged from 85% to 95%. Within-subject variability in safe driving was more pronounced among younger drivers and decreased as a function of age. Contrary to previous research that has relied on self-reports, driver risk taking did not vary significantly as a function of gender. These results are used to illustrate the capabilities of the technology introduced here to design and evaluate behavior-analytic interventions to increase safe driving. PMID:11317986

Effects of Self Stretching on Pain and Musculoskeletal Symptom of Bus Drivers

PubMed Central

Lee, Jung-Ho; Gak, Hwang Bo

2014-01-01

[Purpose] The aim of this study was to evaluate the musculoskeletal symptoms, pain and risk of postures as well as the effects of stretching exercise on the work-related symptoms and pain of bus drivers. [Subjects and Methods] Eighty-one drivers were randomly recruited from a bus corporation for this study. Information about pain levels, painful regions, and general characteristics of subjects was obtained using the symptom research form (KOSHA Code H-30-2003). The level of pain was assessed on a scale of numeric rating scale (NRS) which is divided by 10. Ergonomic posture assessment was conducted using the rapid upper limb assessment (RULA). Self-stretching exercise was performed for 4 weeks by the bus drivers who suffered from neck and shoulder pain. [Results] Musculoskeletal symptoms were present in the order of shoulder, neck, lower back and lower extremities. Compared with other jobs, the final score, and the action level of bus drivers were very high, showing 57.6% of action levels 3 and 4. A statistically significant decrease of pain was shown after the self-stretching intervention. There was also a significant decrease of musculoskeletal symptoms in the neck and shoulders after the self-stretching exercise. [Conclusion] Performing stretching for musculoskeletal symptoms had a positive influence on the symptoms and reduced pain. PMID:25540496

The Health, Mobility & Safety Lab at San Francisco State University.

ERIC Educational Resources Information Center

Yee, Darlene; Melichar, Joseph F.

The purpose of this research project at San Francisco State University was to develop and evaluate integrated assessment and intervention strategies to locate the "at risk" older driver and remediate deficits in knowledge or skills about driving and traffic safety. The identification of the "at risk" older driver should suggest…

Parenting and the Young Driver Problem

PubMed Central

Simons-Morton, Bruce G.; Ouimet, Marie Claude; Catalano, Richard F.

2008-01-01

Crash rates increase sharply at the age teenagers begin to drive and remain elevated relative to adult levels well into the twenties. Parents have important roles to play in managing the risk for teenage drivers before and after licensure. Parents can be involved in their teenagers’ driving, allowing them to test for permit and licensure, supervising practice driving, providing access to a vehicle, and setting and enforcing limits on driving privileges after licensure. However, the management practices of many parents may not be sufficient to provide safety effects. The literature indicates that the two most important decisions parents can make to reduce teenagers driving risk is to delay licensure and impose limits on high-risk driving conditions (such as driving at night and with teenage passengers) during the first year of licensure. Two intervention programs have been shown to increase parent limit setting as a means of reducing risky driving behaviors and improving driving performance among novice teenage drivers. This article describes the contexts of and opportunities for parent involvement in teenage driving and the efficacy of interventions to increase and improve parental management of young drivers. PMID:18702985

Attitudinal segmentaion of drivers in Pakistan: The potential for effective road safety campaigns.

PubMed

Batool, Zahara; Carsten, Oliver

2018-05-01

Deviant driving behaviors are considered as the main cause of Road Traffic Accidents in Pakistan. This research is founded on the premise that driving behaviors are mediated by attitudinal and motivational factors. It advocates that rather than simply aggregating drivers' responses or a-priori classification of them based on their personal characteristics, adoption of segmentation technique is more useful to look at multiple factors provoking aberrant driving behavior in combination and not just in isolation. For this, the study generated an Attitudinal Questionnaire, inspired by the Ajzen's Theory of Planned Behavior (TPB: Ajzen, 1991), and extended violation-scale of modified Driver Behavior Questionnaire (DBQ: Lawton et al., 1997). Attitudinal and behavioral items are first factor analyzed. Then, cluster analysis is performed on extracted attitudinal factors which classified sample driving population into four relatively homogenous and distinct groups of drivers. The results demonstrated the explanatory utility of the market segmentation approach to systematically relate the interaction between attitudes, behaviors and socio-demographic characteristics of drivers. It is concluded that the approach is successful in distinguishing safe drivers from unsafe driver and therefore, can legitimately form the basis of road safety interventions. Finally, the findings are used to recommend targeted information-based road safety solutions with a focus on the diverse characteristics of each of the identified segments. Copyright © 2017 Elsevier Ltd. All rights reserved.

Association of Subway Driver's Depressive Symptoms and Experience of Work-Related Problems.

PubMed

Jo, Sun-Jin; Yim, Hyeon Woo; Kim, Hyoung-Ryoul; Lee, Kang Sook; Park, Jong-Ik; Chang, Sung Man

2010-12-03

Subway drivers experience various types of work-related problems during their driving, and those experiences can act as risk factors for depressive symptoms. This study was conducted to investigate the association between work-related problems and subway driver's depressive symptoms. We recruited all of the 961 current subway drivers of a subway company located in Seoul, South Korea and conducted a survey of their socio-demographic and vocational characteristics, hospital visits as an outpatient or inpatient, and work-related problem experiences during the last year. Work-related problems included an accident resulting in death or injury, a conflict with a customer, a sudden stop from an emergency bell, or a near accident. Depressive symptoms were measured with the Center for Epidemiologic Studies-Depression (CES-D) instrument. The survey was performed using a self-report questionnaire from April 16 to July 13, 2007. The data of 827 drivers (86.2%) were analyzed. Experience of a conflict with a passenger (p=0.011), a sudden stop from an emergency bell (p=0.001), or a near accident (p=0.001) increased the prevalence of depressive symptoms among subway drivers. A multiple logistic regression analysis revealed that a sudden stop from an emergency bell increased the risk of depressive symptoms significantly (OR=2.59, p=0.026). Near accidents were marginally associated with a higher risk for depressive symptoms (OR=1.62, p=0.062). The experience of a sudden stop from an emergency bell increased subway driver's depressive symptoms, and near accidents may increase the risk of depressive symptoms. Therefore, interventions for the drivers who had experienced these work-related problems are needed.

Beyond general behavioral theories: structural discrepancy in young motorcyclist's risky driving behavior and its policy implications.

PubMed

Chung, Yi-Shih; Wong, Jinn-Tsai

2012-11-01

While many studies examine the mean score differences of psychological determinants between heterogeneous driver groups, this study reveals a structural discrepancy in a causal behavioral framework. Using young motorcyclists (ages 18-28) as subjects, this study investigates the various roles of key influential factors in determining risky driving behavior. Multi-group analysis of structural equation modeling shows that age and gender are two factors that can effectively distinguish heterogeneous driver groups exhibiting different decision-making mechanisms in shaping their risky driving behaviors. When encountering undesirable traffic conditions, road rage can immediately increase male motorcyclists' intentions to engage in risky driving behaviors; on the other hand, young female motorcyclists further calculate their perceived risk to determine whether to engage in risky driving behaviors. This result shows that there is a significant link between risk perception and traffic condition awareness for experienced drivers (ages 25-28), but not for younger drivers (ages 18-24). This finding shows that while well-developed theories such as planned behavior and risk homeostasis provide general frameworks to explain risky driving behavior, heterogeneous driver groups may exhibit structural discrepancies that reflect their various decision-making mechanisms. This suggests that, in addition to mean differences, understanding structural discrepancies among heterogeneous groups could help researchers identify effective intervention strategies. Copyright © 2011 Elsevier Ltd. All rights reserved.

Prevalence and drivers of HIV stigma among health providers in urban India: implications for interventions

PubMed Central

Ekstrand, Maria L; Ramakrishna, Jayashree; Bharat, Shalini; Heylen, Elsa

2013-01-01

Introduction HIV stigma inflicts hardship and suffering on people living with HIV (PLHIV) and interferes with both prevention and treatment efforts. Health professionals are often named by PLHIV as an important source of stigma. This study was designed to examine rates and drivers of stigma and discrimination among doctors, nurses and ward staff in different urban healthcare settings in high HIV prevalence states in India. Methods This cross-sectional study enrolled 305 doctors, 369 nurses and 346 ward staff in both governmental and non-governmental healthcare settings in Mumbai and Bengaluru, India. The approximately one-hour long interviews focused on knowledge related to HIV transmission, personal and professional experiences with PLHIV, instrumental and symbolic stigma, endorsement of coercive policies, and intent to discriminate in professional and personal situations that involve high and low risk of fluid exposure. Results High levels of stigma were reported by all groups. This included a willingness to prohibit female PLHIV from having children (55 to 80%), endorsement of mandatory testing for female sex workers (94 to 97%) and surgery patients (90 to 99%), and stating that people who acquired HIV through sex or drugs “got what they deserved” (50 to 83%). In addition, 89% of doctors, 88% of nurses and 73% of ward staff stated that they would discriminate against PLHIV in professional situations that involved high likelihood of fluid exposure, and 57% doctors, 40% nurses and 71% ward staff stated that they would do so in low-risk situations as well. Significant and modifiable drivers of stigma and discrimination included having less frequent contact with PLHIV, and a greater number of transmission misconceptions, blame, instrumental and symbolic stigma. Participants in all three groups reported high rates of endorsement of coercive measures and intent to discriminate against PLHIV. Stigma and discrimination were associated with multiple modifiable drivers, which are consistent with previous research, and which need to be targeted in future interventions. Conclusions Stigma reduction intervention programmes targeting healthcare providers in urban India need to address fear of transmission, improve universal precaution skills, and involve PLHIV at all stages of the intervention to reduce symbolic stigma and ensure that relevant patient interaction skills are taught. PMID:24242265

Effectiveness of Occupation-Based Interventions to Improve Areas of Occupation and Social Participation After Stroke: An Evidence-Based Review

PubMed Central

Chuh, Adrianna; Floyd, Tracy; McInnis, Karen; Williams, Elizabeth

2015-01-01

This evidence-based review examined the evidence supporting the use of occupation-based interventions to improve areas of occupation and social participation poststroke. A total of 39 studies met the inclusion criteria and were critically evaluated. Most of the literature targeted activity of daily living (ADL)–based interventions and collectively provided strong evidence for the use of occupation-based interventions to improve ADL performance. The evidence related to instrumental ADLs was much more disparate, with limited evidence to support the use of virtual reality interventions and emerging evidence to support driver education programs to improve occupational performance poststroke. Only 6 studies addressed leisure, social participation, or rest and sleep, with sufficient evidence to support only leisure-based interventions. The implications of this review for research, education, and practice in occupational therapy are also discussed. PMID:25553745

Relationships between thrill seeking, speeding attitudes, and driving violations among a sample of motorsports spectators and drivers.

PubMed

Yıldırım-Yenier, Zümrüt; Vingilis, Evelyn; Wiesenthal, David L; Mann, Robert E; Seeley, Jane

2016-01-01

Motor racing includes high speed driving and risky maneuvers and can result in negative outcomes for both spectators and drivers. Interest in motorsports is also associated with risky driving attitudes and behaviors on public roads as well as with individual difference variables, such as sensation seeking. However, whether the links between motorsports involvement and risky driving tendencies differ for spectators and drivers has remained mainly unexamined. The aim of this study was to investigate the relationships between thrill seeking, attitudes toward speeding, and self-reported driving violations among a sample of motorsports spectators and drivers. A web-based survey was conducted and sampled 408 members and visitors of car club and racing websites in Ontario, Canada. The questionnaire included measures of (i) motorsports involvement, (ii) thrill seeking (Driver Thrill Seeking Scale), (iii) attitudes (Attitudes toward Speed Limits on Roadways and Competitive Attitudes toward Driving Scale); (iv) self-reported driving violations (adapted from Driver Behaviour Questionnaire), and (v) background variables. Path analysis was performed to test the relationships among the variables. For both spectators and drivers, thrill seeking directly predicted driving violations; competitive attitudes toward driving further mediated this relationship. Attitudes toward speed limits, however, mediated the relationship between thrill seeking and violations only for drivers. We observed significant relationships among individual difference measures, motorsports involvement, speeding attitudes and violations that may inform road safety interventions, including differences in the relationships among thrill seeking, speeding attitudes, and violations for motorsports spectators and drivers. Copyright © 2015 Elsevier Ltd. All rights reserved.

Competition for land

PubMed Central

Smith, Pete; Gregory, Peter J.; van Vuuren, Detlef; Obersteiner, Michael; Havlík, Petr; Rounsevell, Mark; Woods, Jeremy; Stehfest, Elke; Bellarby, Jessica

2010-01-01

A key challenge for humanity is how a future global population of 9 billion can all be fed healthily and sustainably. Here, we review how competition for land is influenced by other drivers and pressures, examine land-use change over the past 20 years and consider future changes over the next 40 years. Competition for land, in itself, is not a driver affecting food and farming in the future, but is an emergent property of other drivers and pressures. Modelling studies suggest that future policy decisions in the agriculture, forestry, energy and conservation sectors could have profound effects, with different demands for land to supply multiple ecosystem services usually intensifying competition for land in the future. In addition to policies addressing agriculture and food production, further policies addressing the primary drivers of competition for land (population growth, dietary preference, protected areas, forest policy) could have significant impacts in reducing competition for land. Technologies for increasing per-area productivity of agricultural land will also be necessary. Key uncertainties in our projections of competition for land in the future relate predominantly to uncertainties in the drivers and pressures within the scenarios, in the models and data used in the projections and in the policy interventions assumed to affect the drivers and pressures in the future. PMID:20713395

Backing collisions: a study of drivers' eye and backing behaviour using combined rear-view camera and sensor systems.

PubMed

Hurwitz, David S; Pradhan, Anuj; Fisher, Donald L; Knodler, Michael A; Muttart, Jeffrey W; Menon, Rajiv; Meissner, Uwe

2010-04-01

Backing crash injures can be severe; approximately 200 of the 2,500 reported injuries of this type per year to children under the age of 15 years result in death. Technology for assisting drivers when backing has limited success in preventing backing crashes. Two questions are addressed: Why is the reduction in backing crashes moderate when rear-view cameras are deployed? Could rear-view cameras augment sensor systems? 46 drivers (36 experimental, 10 control) completed 16 parking trials over 2 days (eight trials per day). Experimental participants were provided with a sensor camera system, controls were not. Three crash scenarios were introduced. Parking facility at UMass Amherst, USA. 46 drivers (33 men, 13 women) average age 29 years, who were Massachusetts residents licensed within the USA for an average of 9.3 years. Interventions Vehicles equipped with a rear-view camera and sensor system-based parking aid. Subject's eye fixations while driving and researcher's observation of collision with objects during backing. Only 20% of drivers looked at the rear-view camera before backing, and 88% of those did not crash. Of those who did not look at the rear-view camera before backing, 46% looked after the sensor warned the driver. This study indicates that drivers not only attend to an audible warning, but will look at a rear-view camera if available. Evidence suggests that when used appropriately, rear-view cameras can mitigate the occurrence of backing crashes, particularly when paired with an appropriate sensor system.

Driving Comparisons Between Young Adults with Autism Spectrum Disorder and Typical Development.

PubMed

Patrick, Kristina E; Hurewitz, Felicia; McCurdy, Mark D; Agate, Frederic Taylor; Daly, Brian P; Tarazi, Reem A; Chute, Douglas L; Schultheis, Maria T

2018-05-18

Many individuals with autism spectrum disorder (ASD) are reluctant to pursue driving because of concerns about their ability to drive safely. This study aimed to assess differences in simulated driving performance in young adults with ASD and typical development, examining relationships between driving performance and the level of experience (none, driver's permit, licensed) across increasingly difficult driving environments. Participants included 50 English-speaking young adults (16-26 years old) with ASD matched for sex, age, and licensure with 50 typically-developing (TD) peers. Participants completed a structured driving assessment using a virtual-reality simulator that included increasingly complex environmental demands. Differences in mean speed and speed and lane variability by diagnostic group and driving experience were analyzed using multilevel linear modeling. Young adults with ASD demonstrated increased variability in speed and lane positioning compared with controls, even during low demand tasks. When driving demands became more complex, group differences were moderated by driving experience such that licensed drivers with ASD drove similarly to TD licensed drivers for most tasks, whereas unlicensed drivers with ASD had more difficulty with speed and lane management than TD drivers. Findings suggest that young adults with ASD may have more difficulty with basic driving skills than peers, particularly in the early stages of driver training. Increased difficulty compared with peers increases as driving demands become more complex, suggesting that individuals with ASD may benefit from a slow and gradual approach to driver training. Future studies should evaluate predictors of driving performance, on-road driving, and ASD-specific driving interventions.

The Predictive Influence of Youth Assets on Drinking and Driving Behaviors in Adolescence and Young Adulthood.

PubMed

Haegerich, Tamara M; Shults, Ruth A; Oman, Roy F; Vesely, Sara K

2016-06-01

Drinking and driving among adolescents and young adults remains a significant public health burden. Etiological research is needed to inform the development and selection of preventive interventions that might reduce alcohol-involved crashes and their tragic consequences. Youth assets-that is, skills, competencies, relationships, and opportunities-can help youth overcome challenges, successfully transition into adulthood, and reduce problem behavior. We examined the predictive influence of individual, relationship, and community assets on drinking and driving (DD) and riding with a drinking driver (RDD). We assessed prospective relationships through analysis of data from the Youth Assets Study, a community-based longitudinal study of socio-demographically diverse youth. Results from calculation of marginal models using a Generalized Estimating Equation approach revealed that parent and peer relationship and school connectedness assets reduced the likelihood of both drinking and driving and riding with a drinking driver approximately 1 year later. The most important and consistent asset that influenced DD and RDD over time was parental monitoring, highlighting the role of parental influence extending beyond the immediate teen driving context into young adulthood. Parenting-focused interventions could influence factors that place youth at risk for injury from DD to RDD, complementing other evidence-based strategies such as school-based instructional programs and zero tolerance Blood Alcohol Concentration laws for young and inexperienced drivers.

Let them experience a ride under the influence of alcohol; a successful intervention program?

PubMed

Brookhuis, K A; de Waard, D; Steyvers, F J J M; Bijsterveld, H

2011-05-01

A considerable amount of all traffic accidents can be attributed to driving under the influence of alcohol. In particular the group of drivers aged 18-24 years is involved in many serious traffic accidents where alcohol turns out to be a major factor. In fact this age group shows about three times as many alcohol related traffic fatalities as all other categories of road users. The intervention program "Alcohol-free on the road" (Dutch: "Alcoholvrij op weg") aims to enhance young people's awareness of the effects of alcohol by letting them personally experience the effect of alcohol on their driving abilities. To this end, young drivers were invited to a closed circuit and allowed to drive first sober and then intoxicated, guided and guarded by driving instructors. Based on several other studies it was thought that a realistic experience of the effects of alcohol on driving abilities may contribute to a better understanding of the impact of alcohol and may stimulate attitudes that are needed to support the conscious decision not to drive while intoxicated. After more than ten years of running and data collection, 1200 young drivers have participated in the intervention program. In a quasi-experimental study with a non-equivalent group design, the program is evaluated in order to assess its effectiveness both with respect to the attitudes of the participants and the actual relevant behaviour in the years after the alcohol experience intervention program they attended, i.e. the incidence of actually driving under the influence of alcohol. To do this, a questionnaire was sent to a subset (415) of the participants who have completed the program, along with a control group (450), to compare attitudes and actual behaviour. In addition, the Public Prosecutor checked the files of those who responded, for the occurrence of driving under the influence of alcohol. The group that participated in the alcohol intervention program showed more awareness about the dangers of driving while intoxicated than the control group, and this group reported improved alcohol law compliance. Furthermore, less participants in the intervention program than in the control group were present in the Public Prosecutor files, respectively 0.7% and 4.2%. Hence, the alcohol driving experience intervention program might turn out to be effective and successful in decreasing driving under the influence of alcohol. Although the results of the present study are no more than suggestive, they may be considered a first step towards demonstrating the effectiveness of this type of intervention. However, the intervention is unique and warrants a more robust evaluation. A large-sized randomized controlled trial should be conducted in the next phase to confirm the findings that the intervention program is a suitable educational tool to decrease driving under the influence of alcohol. The present paper serves to raise awareness of this intervention and its potential. Copyright © 2010 Elsevier Ltd. All rights reserved.

Effects of a Safe Transportation Educational Program for Older Drivers on Driving Exposure and Community Participation: A Randomized Controlled Trial.

PubMed

Coxon, Kristy; Chevalier, Anna; Brown, Julie; Clarke, Elizabeth; Billot, Laurent; Boufous, Soufiane; Ivers, Rebecca; Keay, Lisa

2017-03-01

To ascertain whether a safe-transportation program can change driving exposure while maintaining community participation of older drivers. Randomized controlled trial. Northwest Sydney. Drivers aged 75 and older (mean 80 ± 4) (n = 380). Intervention group participated in an individualized, one-on-one safe-transportation program adapted from the Knowledge Enhances Your Safety curriculum. A registered occupational therapist delivered the intervention in two sessions held approximately 1 month apart. An in-vehicle monitoring device hardwired into participants' vehicles measured driving exposure. Community participation was measured using the Keele Assessment of Participation. A staging algorithm based on the Precaution Adoption Process Model measured behavior change toward increased and sustained driving self-regulation. Main outcomes were distance driven per week over 12 months and community participation. Secondary outcomes were behavior change, depressive symptoms, and alternate transportation use. Generalized estimating equations were used to model effect on driving exposure, adjusting for weekly measures, and ordinal regression was used to analyze differences in behavior change profiles between groups using an intention-to-treat approach. Participants were randomized after baseline assessment-190 each to the intervention and control groups. One hundred eighty-three of 190 completed the intervention and 366 of 380 completed the study. On average, participants drove 140 ± 167 km/wk. Although there was no significant difference between the groups in distance driven per week over 12 months (between-group difference -5.5 km, 95% confidence interval (CI) = -24.5-13.5 km, p = .57), intervention group participants showed greater readiness to engage in self-regulatory driving practices, such as reporting avoiding driving at night or at rush hours, than control group participants (odds ratio (OR) = 1.6, 95% CI = 1.1-2.3, P = .02). At 12 months, use of alternate transportation was similar (between-group difference 0.1, 95% CI = -1.4-1.6, P = .90). Although there was no difference in community participation (between-group difference -0.1, 95% CI = -0.6-0.3, P = .59), older drivers with low function in the intervention group were 3.1 times as likely to report depressive symptoms (95% CI = 1.04-9.2, P = .04) than those with low function in the control group. An individualized safe-transportation program can promote behavior change but did not translate to significant differences in weekly mileage after 12 months. Longer follow-up may detect changes over time. © 2016, Copyright the Authors Journal compilation © 2016, The American Geriatrics Society.

Obesity prevention in children.

PubMed

Moreno, Luis A; Bel-Serrat, Silvia; Santaliestra-Pasías, Alba M; Rodríguez, Gerardo

2013-01-01

The prevalence of childhood overweight and obesity continues to be unacceptably high and of public health concern in Europe. During childhood and adolescence, environmental factors are the main drivers of obesity development. Obesity is caused by a chronic energy imbalance involving both dietary intake and physical activity patterns. Several risk factors are influencing obesity development, even starting in the prenatal period. From birth, along life, mainly diet and physical activity/inactivity are the most important drivers on top of genetic susceptibility. The first years of life can therefore be crucial to start preventive interventions that can have an impact on lifestyle and on later overweight and obesity. Schools are an attractive and popular setting for implementing interventions for children. Interventions including a community component are considered to be the most effective. Obesity control will require policy interventions to improve the environments that promote poor dietary intake and physical inactivity rather than individually focused interventions. More solid institutional and health policies are needed together with more effective interventions to obtain evident changes for the prevention of excess adiposity among children. Copyright © 2013 S. Karger AG, Basel.

Drivers of Emerging Infectious Disease Events as a Framework for Digital Detection.

PubMed

Olson, Sarah H; Benedum, Corey M; Mekaru, Sumiko R; Preston, Nicholas D; Mazet, Jonna A K; Joly, Damien O; Brownstein, John S

2015-08-01

The growing field of digital disease detection, or epidemic intelligence, attempts to improve timely detection and awareness of infectious disease (ID) events. Early detection remains an important priority; thus, the next frontier for ID surveillance is to improve the recognition and monitoring of drivers (antecedent conditions) of ID emergence for signals that precede disease events. These data could help alert public health officials to indicators of elevated ID risk, thereby triggering targeted active surveillance and interventions. We believe that ID emergence risks can be anticipated through surveillance of their drivers, just as successful warning systems of climate-based, meteorologically sensitive diseases are supported by improved temperature and precipitation data. We present approaches to driver surveillance, gaps in the current literature, and a scientific framework for the creation of a digital warning system. Fulfilling the promise of driver surveillance will require concerted action to expand the collection of appropriate digital driver data.

Evaluation of an in-vehicle monitoring system (IVMS) to reduce risky driving behaviors in commercial drivers: Comparison of in-cab warning lights and supervisory coaching with videos of driving behavior.

PubMed

Bell, Jennifer L; Taylor, Matthew A; Chen, Guang-Xiang; Kirk, Rachel D; Leatherman, Erin R

2017-02-01

Roadway incidents are the leading cause of work-related death in the United States. The objective of this research was to evaluate whether two types of feedback from a commercially available in-vehicle monitoring system (IVMS) would reduce the incidence of risky driving behaviors in drivers from two companies. IVMS were installed in 315 vehicles representing the industries of local truck transportation and oil and gas support operations, and data were collected over an approximate two-year period in intervention and control groups. In one period, intervention group drivers were given feedback from in-cab warning lights from an IVMS that indicated occurrence of harsh vehicle maneuvers. In another period, intervention group drivers viewed video recordings of their risky driving behaviors with supervisors, and were coached by supervisors on safe driving practices. Risky driving behaviors declined significantly more during the period with coaching plus instant feedback with lights in comparison to the period with lights-only feedback (ORadj=0.61 95% CI 0.43-0.86; Holm-adjusted p=0.035) and the control group (ORadj=0.52 95% CI 0.33-0.82; Holm-adjusted p=0.032). Lights-only feedback was not found to be significantly different than the control group's decline from baseline (ORadj=0.86 95% CI 0.51-1.43; Holm-adjusted p>0.05). The largest decline in the rate of risky driving behaviors occurred when feedback included both supervisory coaching and lights. Supervisory coaching is an effective form of feedback to improve driving habits in the workplace. The potential advantages and limitations of this IVMS-based intervention program are discussed. Published by Elsevier Ltd.

Evaluation of an in-vehicle monitoring system (IVMS) to reduce risky driving behaviors in commercial drivers: Comparison of in-cab warning lights and supervisory coaching with videos of driving behavior

PubMed Central

Bell, Jennifer L.; Taylor, Matthew A.; Chen, Guang-Xiang; Kirk, Rachel D.; Leatherman, Erin R.

2017-01-01

Problem Roadway incidents are the leading cause of work-related death in the United States. Methods The objective of this research was to evaluate whether two types of feedback from a commercially available in-vehicle monitoring system (IVMS) would reduce the incidence of risky driving behaviors in drivers from two companies. IVMS were installed in 315 vehicles representing the industries of local truck transportation and oil and gas support operations, and data were collected over an approximate two-year period in intervention and control groups. In one period, intervention group drivers were given feedback from in-cab warning lights from an IVMS that indicated occurrence of harsh vehicle maneuvers. In another period, intervention group drivers viewed video recordings of their risky driving behaviors with supervisors, and were coached by supervisors on safe driving practices. Results Risky driving behaviors declined significantly more during the period with coaching plus instant feedback with lights in comparison to the period with lights-only feedback (ORadj = 0.61 95% CI 0.43–0.86; Holm-adjusted p = 0.035) and the control group (ORadj = 0.52 95% CI 0.33–0.82; Holm-adjusted p = 0.032). Lights-only feedback was not found to be significantly different than the control group's decline from baseline (ORadj = 0.86 95% CI 0.51–1.43; Holm-adjusted p > 0.05). Conclusions The largest decline in the rate of risky driving behaviors occurred when feedback included both supervisory coaching and lights. Practical applications Supervisory coaching is an effective form of feedback to improve driving habits in the workplace. The potential advantages and limitations of this IVMS-based intervention program are discussed. PMID:28160807

Reading Text While Driving

PubMed Central

Horrey, William J.; Hoffman, Joshua D.

2015-01-01

Objective In this study, we investigated how drivers adapt secondary-task initiation and time-sharing behavior when faced with fluctuating driving demands. Background Reading text while driving is particularly detrimental; however, in real-world driving, drivers actively decide when to perform the task. Method In a test track experiment, participants were free to decide when to read messages while driving along a straight road consisting of an area with increased driving demands (demand zone) followed by an area with low demands. A message was made available shortly before the vehicle entered the demand zone. We manipulated the type of driving demands (baseline, narrow lane, pace clock, combined), message format (no message, paragraph, parsed), and the distance from the demand zone when the message was available (near, far). Results In all conditions, drivers started reading messages (drivers’ first glance to the display) before entering or before leaving the demand zone but tended to wait longer when faced with increased driving demands. While reading messages, drivers looked more or less off road, depending on types of driving demands. Conclusions For task initiation, drivers avoid transitions from low to high demands; however, they are not discouraged when driving demands are already elevated. Drivers adjust time-sharing behavior according to driving demands while performing secondary tasks. Nonetheless, such adjustment may be less effective when total demands are high. Application This study helps us to understand a driver’s role as an active controller in the context of distracted driving and provides insights for developing distraction interventions. PMID:25850162

A rear-end collision risk assessment model based on drivers' collision avoidance process under influences of cell phone use and gender-A driving simulator based study.

PubMed

Li, Xiaomeng; Yan, Xuedong; Wu, Jiawei; Radwan, Essam; Zhang, Yuting

2016-12-01

Driver's collision avoidance performance has a direct link to the collision risk and crash severity. Previous studies demonstrated that the distracted driving, such as using a cell phone while driving, disrupted the driver's performance on road. This study aimed to investigate the manner and extent to which cell phone use and driver's gender affected driving performance and collision risk in a rear-end collision avoidance process. Forty-two licensed drivers completed the driving simulation experiment in three phone use conditions: no phone use, hands-free, and hand-held, in which the drivers drove in a car-following situation with potential rear-end collision risks caused by the leading vehicle's sudden deceleration. Based on the experiment data, a rear-end collision risk assessment model was developed to assess the influence of cell phone use and driver's gender. The cell phone use and driver's gender were found to be significant factors that affected the braking performances in the rear-end collision avoidance process, including the brake reaction time, the deceleration adjusting time and the maximum deceleration rate. The minimum headway distance between the leading vehicle and the simulator during the rear-end collision avoidance process was the final output variable, which could be used to measure the rear-end collision risk and judge whether a collision occurred. The results showed that although cell phone use drivers took some compensatory behaviors in the collision avoidance process to reduce the mental workload, the collision risk in cell phone use conditions was still higher than that without the phone use. More importantly, the results proved that the hands-free condition did not eliminate the safety problem associated with distracted driving because it impaired the driving performance in the same way as much as the use of hand-held phones. In addition, the gender effect indicated that although female drivers had longer reaction time than male drivers in critical situation, they were more quickly in braking with larger maximum deceleration rate, and they tended to keep a larger safety margin with the leading vehicle compared to male drivers. The findings shed some light on the further development of advanced collision avoidance technologies and the targeted intervention strategies about cell phone use while driving. Copyright © 2016 Elsevier Ltd. All rights reserved.

"Good Passengers and Not Good Passengers:" Adolescent Drivers' Perceptions About Inattention and Peer Passengers.

PubMed

McDonald, Catherine C; Sommers, Marilyn S

The purpose of this qualitative focus group elicitation research study was to explore teen driver perceptions of peer passengers and driver inattention. We utilized focus groups for data collection and content analysis to analyze the data, both of which were guided by the theory of planned behavior. We conducted 7 focus groups with 30 teens, ages 16-18, licensed for ≤1year to examine attitudes, perceived behavioral control, and norms related to driving inattention and peer passengers. The sample was 50% male, mean age 17.39 (SD 0.52) with mean length of licensure 173.7days (SD 109.2). Three themes emerged: 1) "Good and not good" passengers; 2) Passengers and technology as harmful and helpful; and 3) The driver is in charge. While passengers can be a source of distraction, our participants also identified passenger behaviors that reduced risk, such as assistance with technology and guidance for directions. An understanding of teens' perceptions of peer passengers can contribute to the development of effective interventions targeting teen driver inattention. Nurses are well-positioned to contribute to these teen crash prevention efforts. Copyright © 2016 Elsevier Inc. All rights reserved.

Substance use and social, health and safety-related factors among fatally injured drivers.

PubMed

Karjalainen, Karoliina; Blencowe, Tom; Lillsunde, Pirjo

2012-03-01

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. 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. 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. 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. Copyright © 2011 Elsevier Ltd. All rights reserved.

Impact of a participatory organizational intervention on job characteristics and job stress.

PubMed

Mikkelsen, A; Saksvik, P O

1999-01-01

Increased employee control and participation are recommended to achieve both "flexible organization" and improvements in health, as outlined in occupational stress intervention models. This study evaluates the impact of a participatory organizational intervention on job stress and job characteristics. The intervention was carried out in two post offices in the Norwegian Postal Service. "Local theories" were seen as the key drivers for organizational improvement and increased control. The underlying dynamics of the intervention were to manipulate employees' learning opportunity and decision authority so as to improve work environment and health. Work groups, in dialogue with a steering committee, conducted diagnosis, action planning, and action taking. Work conditions deteriorated during the observation period in the control groups. In one of the intervention groups, this negative trend was reduced by the intervention. Lack of positive results in the other intervention group may have been due to organizational restructuring and turbulence.

Wrong-way driving crashes on French divided roads.

PubMed

Kemel, Emmanuel

2015-02-01

The objective of divided roads is to increase users' safety by posting unidirectional traffic flows. It happens however that drivers proceed in the wrong direction, endangering themselves as well as other users. The crashes caused by wrong-way drivers are generally spotlighted by the media and call for public intervention. This paper proposes a characterization of wrong-way driving crashes occurring on French divided road on the 2008-2012 period. The objective is to identify the factors that delineate between wrong-way driving crashes and other crashes. Building on the national injury road crash database, 266 crashes involving a wrong-way driver were identified. Their characteristics (related to timing, location, vehicle and driver) are compared to those of the 22,120 other crashes that occurred on the same roads over the same period. The comparison relies on descriptive statistics, completed by a logistic regression. Wrong-way driving crashes are rare but severe. They are more likely to occur during night hours and on non-freeway roads than other crashes. Wrong-way drivers are older, more likely to be intoxicated, to be locals, to drive older vehicles, mainly passenger cars without passengers, than other drivers. The differences observed across networks can help prioritizing public intervention. Most of the identified WW-driving factors deal with cognitive impairment. Therefore, the specific countermeasures such as alternative road signs should be designed for and tested on cognitively impaired drivers. Nevertheless, WW-driving factors are also risk factors for other types of crashes (e.g. elderly driving, drunk driving and age of the vehicle). This suggests that, instead of (or in addition to) developing WW-driving specific countermeasures, managing these risk factors would help reducing a larger number of crashes. Copyright © 2014 Elsevier Ltd. All rights reserved.

Bus drivers' mental conditions and their relation to bus passengers' accidents with a focus on the psychological stress concept.

PubMed

Yamada, Yasuyuki; Mizuno, Motoki; Sugiura, Miyuki; Tanaka, Sumio; Mizuno, Yuki; Yanagiya, Toshio; Hirosawa, Masataka

2008-06-01

The purpose of this study was to clarify the psychological factors of bus drivers' instability that were related to bus passengers' accidents according to the hypothesis model based on the stress concept of Lazarus and Folkman (1984). This research was carried out in 2006. Participants of the study were 39 Japanese male bus drivers. Their average age was 40.2 (SD: 11.1). The average duration of employment was 4.5 (SD:6.1) years. A questionnaire was used that was composed of items concerning the frequency of bus passengers' accidents, performance of safe driving, job stressors, stress reaction and recognition from others. Based on the results, a model assuming that stress reaction caused by job stressors disturbed the bus driver's safe driving and was associated with passengers' accidents in the bus was verified to some degree. Especially, melancholy and tired feeling toward passengers showed a strong relation to the passengers' accidents in the bus. This suggested much room for intervention. Moreover, the recognition from others of their job was confirmed to act as a control factor of the stress reaction.

Does Needle Rotation Improve Lesion Targeting?

PubMed Central

Badaan, Shadi; Petrisor, Doru; Kim, Chunwoo; Mozer, Pierre; Mazilu, Dumitru; Gruionu, Lucian; Patriciu, Alex; Cleary, Kevin; Stoianovici, Dan

2011-01-01

Background Image-guided robots are manipulators that operate based on medical images. Perhaps the most common class of image-guided robots are robots for needle interventions. Typically, these robots actively position and/or orient a needle guide, but needle insertion is still done by the physician. While this arrangement may have safety advantages and keep the physician in control of needle insertion, actuated needle drivers can incorporate other useful features. Methods We first present a new needle driver that can actively insert and rotate a needle. With this device we investigate the use of needle rotation in controlled in-vitro experiments performed with a specially developed revolving needle driver. Results These experiments show that needle rotation can improve targeting and may reduce errors by as much as 70%. Conclusion The new needle driver provides a unique kinematic architecture that enables insertion with a compact mechanism. Perhaps the most interesting conclusion of the study is that lesions of soft tissue organs may not be perfectly targeted with a needle without using special techniques, either manually or with a robotic device. The results of this study show that needle rotation may be an effective method of reducing targeting errors. PMID:21360796

A pilot hospital-school educational program to address teen motor vehicle safety.

PubMed

Unni, Purnima; Morrow, Stephen E; Shultz, Barbara L; Tian, Tina T

2013-10-01

Texting while driving has emerged as a significant distracted driving behavior among teenage drivers. A unique hospital-school collaborative pilot intervention (called "Be in the Zone" or "BITZ") was implemented to combat this growing problem. This intervention was hypothesized to lead to a decline in texting while driving among high school students. This collaborative intervention consisted of two separate phases. In Phase 1, small groups of high school student leaders participated in a half-day interactive educational session in a pediatric hospital. Pre- and post-follow-up surveys were administered to this group. In Phase 2, these same students took the lessons they learned from the hospital to plan and implement a yearlong peer-to-peer campaign that focused on a clear "no texting while driving" message at their schools. Two unannounced driver observations were conducted to evaluate the effectiveness of the pilot program. Sixty-one high school students participated in Phase 1. Self-reported texting while driving rates decreased significantly among the participants after Phase 1. Two schools were recruited to participate in Phase 2. Unannounced driver observations were conducted before the campaign and toward the end of the campaign. Postintervention, there was a significant decrease in the percentage of drivers who texted while driving. Preliminary results from this pilot program suggest that a strategy of combining hospital-school partnerships with a peer-driven educational approach can be effective in reducing texting while driving among teenagers in the short-term.

Effects of a computer-based training module on drivers' willingness to engage in distracting activities.

PubMed

Horrey, William J; Lesch, Mary F; Kramer, Arthur F; Melton, David F

2009-08-01

This study examines the effect of a computer-based training module on drivers' attitudes and behaviors with respect to in-vehicle distraction. Research findings on the negative performance implications of distraction call for the need to mitigate these adverse effects. Forty drivers (ages 18 to 20 yrs) were divided into two groups: a training group that completed the module and a control group that viewed an unrelated video. The training promoted enhanced metacognitive skills (e.g., planning, monitoring) and strategies to deal with distraction. Measures of willingness to perform in-vehicle activities while driving (involving the use of short videos) were assessed before and after the intervention. Drivers also performed in-vehicle tasks while driving an instrumented vehicle on a closed test track. Following the training, drivers in the training group showed a decline in their ratings of willingness to engage in distracting activities along with a corresponding increase in perceived risk. In contrast, ratings from drivers in the control group did not change on any measures. Drivers in the training group were also more likely to perform in-vehicle tasks while the vehicle was parked compared with the control group-an obvious safety benefit. However, there was no observable benefit of training for drivers who performed the distracting tasks while the vehicle was in motion. There may be some promise to such a training approach. The implications for distraction and training are discussed. Training general skills in dealing with potentially distracting in-vehicle tasks may help offset some of the negative outcomes associated with their use.

Motorized mobility scooters – The use of training/intervention and technology for improving driving skills in aging adults - A Mini-Review

PubMed Central

Toosizadeh, Nima; Bunting, Matthew; Howe, Carol; Mohler, Jane; Sprinkle, Jonathan; Najafi, Bijan

2014-01-01

Background Motorized mobility scooters (MMS) have become the most acceptable powered assistive device for those with impaired mobility, who have sufficient upper body strength and dexterity, and postural stability. Although several benefits have been attributed to MMS usage, there are likewise risks of use, including injuries and even deaths. Objective The aim of the current review was to summarize results from clinical studies regarding the enhancement of MMS driver safety with a primary focus on improving driving skills/performance using clinical approaches. We addressed three main objectives: 1) to identify and summarize any available evidence (strong, moderate, or weak evidence based on the quality of studies) regarding improved driving skills/performance following training/intervention; 2) to identify types of driving skills/performance that might be improved by training/intervention; and 3) to identify the use of technology in improving MMS performance or training procedure. Methods Articles were searched for in the following medical and engineering electronic databases: PubMed, Cochrane Library, Web of Science, ClinicalTrials.gov, PsycINFO, CINAHL, ERIC, EI Compendix, IEEE Explore, and REHABDATA. Inclusion criteria included: aging adults or those with ambulatory problems; intervention or targeted training; and clinical trial. Outcomes included: MMS skills/performance. Results Six articles met the inclusion criteria and are analyzed in this review. Four of the six articles contained training approaches for MMS drivers including skill trainings using real MMS inside and outside (i.e., in community) and in a 3D virtual environment. The other two studies contain infrastructural assessments (i.e., the minimum space required for safe maneuverability of MMS users) and additional mobility assistance tools to improve maneuverability and to enhance driving performance. Conclusions Results from the current review showed improved driving skills/performance by training, infrastructural assessments, and incorporating mobility assistance tools. MMS driving skills that can be improved through driver training include: weaving, negotiating with and avoiding pedestrian interference, simultaneous reading of signs and obstacle avoidance in path, level driving, forward and reverse driving, figure 8s, turning in place, crossing left slope, maneuvering down a 2-inch curb, and driving up and down inclines. However, several limitations exist in the available literature regarding evidence of improved driving skills/performance following training/intervention, such as small sample sizes, lack of control groups and statistical analysis. PMID:24481257

Land use patterns and related carbon losses following deforestation in South America

NASA Astrophysics Data System (ADS)

De Sy, V.; Herold, M.; Achard, F.; Beuchle, R.; Clevers, J. G. P. W.; Lindquist, E.; Verchot, L.

2015-12-01

Land use change in South America, mainly deforestation, is a large source of anthropogenic CO2 emissions. Identifying and addressing the causes or drivers of anthropogenic forest change is considered crucial for global climate change mitigation. Few countries however, monitor deforestation drivers in a systematic manner. National-level quantitative spatially explicit information on drivers is often lacking. This study quantifies proximate drivers of deforestation and related carbon losses in South America based on remote sensing time series in a systematic, spatially explicit manner. Deforestation areas were derived from the 2010 global remote sensing survey of the Food and Agricultural Organisation Forest Resource Assessment. To assess proximate drivers, land use following deforestation was assigned by visual interpretation of high-resolution satellite imagery. To estimate gross carbon losses from deforestation, default Tier 1 biomass levels per country and eco-zone were used. Pasture was the dominant driver of forest area (71.2%) and related carbon loss (71.6%) in South America, followed by commercial cropland (14% and 12.1% respectively). Hotspots of deforestation due to pasture occurred in Northern Argentina, Western Paraguay, and along the arc of deforestation in Brazil where they gradually moved into higher biomass forests causing additional carbon losses. Deforestation driven by commercial cropland increased in time, with hotspots occurring in Brazil (Mato Grosso State), Northern Argentina, Eastern Paraguay and Central Bolivia. Infrastructure, such as urban expansion and roads, contributed little as proximate drivers of forest area loss (1.7%). Our findings contribute to the understanding of drivers of deforestation and related carbon losses in South America, and are comparable at the national, regional and continental level. In addition, they support the development of national REDD+ interventions and forest monitoring systems, and provide valuable input for statistical analysis and modelling of underlying drivers of deforestation.

Progress towards understanding the ecology and epidemiology of malaria in the western Kenya highlands: opportunities and challenges for control under climate change risk.

PubMed

Githeko, A K; Ototo, E N; Guiyun, Yan

2012-01-01

Following severe malaria epidemics in the western Kenya highlands after the late 1980s it became imperative to undertake eco-epidemiological assessments of the disease and determine its drivers, spatial-temporal distribution and control strategies. Extensive research has indicated that the major biophysical drivers of the disease are climate change and variability, terrain, topography, hydrology and immunity. Vector distribution is focalized at valley bottoms and abundance is closely related with drainage efficiency, habitat availability, stability and productivity of the ecosystems. Early epidemic prediction models have been developed and they can be used to assess climate risks that warrant extra interventions with a lead time of 2-4 months. Targeted integrated vector management strategies can significantly reduce the cost on the indoor residual spraying by targeting the foci of transmission in transmission hotspots. Malaria control in the highlands has reduced vector population by 90%, infections by 50-90% in humans and in some cases transmission has been interrupted. Insecticide resistance is increasing and as transmission decreases so will immunity. Active surveillance will be required to monitor and contain emerging threats. More studies on eco-stratification of the disease, based on its major drivers, are required so that interventions are tailored for specific ecosystems. New and innovative control interventions such as house modification with a one-application strategy may reduce the threat from insecticide resistance and low compliance associated with the use of ITNs. Copyright © 2011 Elsevier B.V. All rights reserved.

Association of Metabolic Syndrome and Albuminuria with Cardiovascular Risk in Occupational Drivers

PubMed Central

Chen, Szu-Chia; Chang, Jer-Ming; Lin, Ming-Yen; Hou, Meng-Ling; Tsai, Jer-Chia; Hwang, Shang-Jyh; Chen, Hung-Chun

2013-01-01

Background and Aim Metabolic syndrome (MetS) and albuminuria increase cardiovascular risk. However, in occupational drivers, the clinical significance of albuminuria and its association with MetS remain unclear. We investigated the prevalence of MetS, albuminuria and cardiovascular risk, and its associated risk factors in occupational drivers; Methods 441 occupational drivers and 432 age- and sex-stratified matched counterpart controls were enrolled. MetS was defined using Adult Treatment Panel III for Asians. Albuminuria was defined as urine albumin-to-creatinine ratio ≥ 30 mg/g. Cardiovascular disease risk was evaluated by Framingham Risk Score (FRS); Results A significantly higher prevalence of MetS (43.1% vs. 25.5%, p < 0.001), albuminuria (12.0% vs. 5.6%, p = 0.001) and high FRS risk ≥ 10% of 10-year risk (46.9% vs. 35.2%, p < 0.001) was found in occupational drivers compared with their counterpart controls. Multiple logistic regression analysis showed that old age, a history of diabetes, gout and betel nut chewing, less exercise and albuminuria (odds ratio [OR], 2.75; p = 0.01) were risk factors for MetS, while a history of renal disease, diabetes and hypertension, and MetS (OR, 2.28; p = 0.01) were risk factors for albuminuria in occupational drivers; Conclusions Our study demonstrated that MetS and albuminuria were public health problems in occupational drivers. An education program for promoting healthy lifestyle and a regular occupational health visit for early detection and interventions should be established. PMID:24201129

Using Social Judgment Theory method to examine how experienced occupational therapy driver assessors use information to make fitness-to-drive recommendations

PubMed Central

Harries, Priscilla; Davies, Miranda

2015-01-01

Introduction As people with a range of disabilities strive to increase their community mobility, occupational therapy driver assessors are increasingly required to make complex recommendations regarding fitness-to-drive. However, very little is known about how therapists use information to make decisions. The aim of this study was to model how experienced occupational therapy driver assessors weight and combine information when making fitness-to-drive recommendations and establish their level of decision agreement. Method Using Social Judgment Theory method, this study examined how 45 experienced occupational therapy driver assessors from the UK, Australia and New Zealand made fitness-to-drive recommendations for a series of 64 case scenarios. Participants completed the task on a dedicated website, and data were analysed using discriminant function analysis and an intraclass correlation coefficient. Results Accounting for 87% of the variance, the cues central to the fitness-to-drive recommendations made by assessors are the client’s physical skills, cognitive and perceptual skills, road law craft skills, vehicle handling skills and the number of driving instructor interventions. Agreement (consensus) between fitness-to-drive recommendations was very high: intraclass correlation coefficient = .97, 95% confidence interval .96–.98). Conclusion Findings can be used by both experienced and novice driver assessors to reflect on and strengthen the fitness-to-drive recommendations made to clients. PMID:26435572

The impact of an educational intervention on parents' decisions to vaccinate their <60-month-old children against influenza

PubMed Central

Choi, Aery; Kim, Yun Kyung; Eun, Byung Wook; Jo, Dae Sun

2017-01-01

Purpose Seasonal influenza can be prevented by vaccination. Disease prevention in children aged <60 months is of particular importance because of the associated familial and societal burden. Considering that caretakers make the decision to vaccinate their children, the identification of drivers and barriers to vaccination is essential to increase influenza vaccination coverage. Methods A total of 639 parents participated in the pre- and posteducational survey and 450 parents participated in the study via telephone interviews. The participating parents were asked to rank their agreement with each statement of the survey questionnaire on a scale from 1 (strongly disagree) to 5 (strongly agree), and the scores between pre- and postintervention were compared. Results Before the educational intervention, 105 out of 639 participants reported not to agree to vaccinate their children against influenza. After the intervention, 46 out of the 105 parents changed their opinions about childhood vaccination. The physicians' recommendation received the highest agreement score and was the most important driver to vaccination, whereas the cost of vaccination was the strongest factor for not vaccinating children. In general, the participants significantly changed the agreement scores between pre- and postintervention. However, the unfavorable opinions about vaccination and the convenience of receiving the influenza vaccine did not change significantly. Conclusion The results of this study indicate that a specific educational intervention involving caregivers is very effective in increasing the influenza vaccination coverage of children aged less than 60 months. PMID:29042867

Risky behavior of drivers of motorized two wheeled vehicles in India.

PubMed

Dandona, Rakhi; Kumar, G Anil; Dandona, Lalit

2006-01-01

Motorized two-wheeled vehicles (MTV) account for a large proportion of road traffic in India and the riders of these vehicles have a high risk of road traffic injuries. We report on the availability of drivers licenses, use of a helmet, driver behavior, and condition of vehicles for MTV drivers in Hyderabad, a city in India Drivers of a MTV aged >16 years were interviewed at petrol filling stations There were 4,183 MTV drivers who participated in the study. Four hundred sixty one (11%; 95% CI 9.7-12.3%) drivers had not obtained a drivers license and 798 (21.4%) had obtained a license without taking the mandatory driving test. Two thousand nine hundred twenty (69.8%; 95% CI 67.9-71.7%) drivers reported no/very occasional use of a helmet, the significant predictors of which included that those driving borrowed a MTV (odds ratio 7.90; 95% CI 3.40-18.40) or driving moped/scooterette/scooter as compared with motorcycle (3.32; 2.76-3.98), lower education (3.10; 2.66-3.61), age >45 years (2.41; 1.63-3.57), and males (1.57; 1.16-2.13). Two thousand five hundred and eight (59.9%) drivers reported committing a traffic law violation at least once within the last 3 months. Overall, 1,222 (29.2%) drivers reported ever being caught by traffic police for a traffic law violation with data on violations available for 1,205 of these drivers, of whom 680 (56.4%) paid a fine, 310 (25.7%) paid by bribe, and 215 (17.8%) made no payment. The proportion of those who did not make payment for committed violation was significantly higher among females (46.8%) than males (16.3%). Two thousand fifty two (49%) of all MTVs had no rearview mirror These data suggest the need to enact and enforce policy interventions for improving the drivers license system, mandatory use of a helmet, effective traffic law enforcement, and ensuring good vehicle condition to reduce the risk factors that potentially contribute to mortality and morbidity in road traffic crashes in MTV drivers in Indian cities.

Terrorism and hazardous material trucking: promoting perceived collective efficacy for terrorism prevention.

PubMed

James, Keith

2008-01-01

Hazardous-material trucking has recently been identified as an area of high potential risk for terrorism. Some recent theory and case study papers have argued for the importance of collective efficacy to disaster-response, terrorism prevention, and other rare-but-risky events. Therefore, a study based on the collective efficacy literature was done to test an intervention for increasing perceived collective efficacy for terrorism prevention among Canadian hazardous-material truck drivers. Results supported the impact of the intervention in increasing perceived efficacy for terrorism prevention. Implications for theory, research, and application are discussed.

Novice drivers' risky driving behavior, risk perception, and crash risk: findings from the DRIVE study.

PubMed

Ivers, Rebecca; Senserrick, Teresa; Boufous, Soufiane; Stevenson, Mark; Chen, Huei-Yang; Woodward, Mark; Norton, Robyn

2009-09-01

We explored the risky driving behaviors and risk perceptions of a cohort of young novice drivers and sought to determine their associations with crash risk. Provisional drivers aged 17 to 24 (n = 20 822) completed a detailed questionnaire that included measures of risk perception and behaviors; 2 years following recruitment, survey data were linked to licensing and police-reported crash data. Poisson regression models that adjusted for multiple confounders were created to explore crash risk. High scores on questionnaire items for risky driving were associated with a 50% increased crash risk (adjusted relative risk = 1.51; 95% confidence interval = 1.25, 1.81). High scores for risk perception (poorer perceptions of safety) were also associated with increased crash risk in univariate and multivariate models; however, significance was not sustained after adjustment for risky driving. The overrepresentation of youths in crashes involving casualties is a significant public health issue. Risky driving behavior is strongly linked to crash risk among young drivers and overrides the importance of risk perceptions. Systemwide intervention, including licensing reform, is warranted.

Driver sleepiness on YouTube: A content analysis.

PubMed

Hawkins, A N; Filtness, A J

2017-02-01

Driver sleepiness is a major contributor to severe crashes and fatalities on our roads. Many people continue to drive despite being aware of feeling tired. Prevention relies heavily on education campaigns as it is difficult to police driver sleepiness. The video sharing social media site YouTube is extremely popular, particularly with at risk driver demographics. Content and popularity of uploaded videos can provide insight into the quality of publicly accessible driver sleepiness information. The purpose of this research was to answer two questions; firstly, how prevalent are driver sleepiness videos on YouTube? And secondly, what are the general characteristics of driver sleepiness videos in terms of (a) outlook on driver sleepiness, (b) tone, (c) countermeasures to driver sleepiness, and, (d) driver demographics. Using a keywords search, 442 relevant videos were found from a five year period (2nd December 2009-2nd December 2014). Tone, outlook, and countermeasure use were thematically coded. Driver demographic and video popularity data also were recorded. The majority of videos portrayed driver sleepiness as dangerous. However, videos that had an outlook towards driver sleepiness being amusing were viewed more often and had more mean per video comments and likes. Humorous videos regardless of outlook, were most popular. Most information regarding countermeasures to deal with driver sleepiness was accurate. Worryingly, 39.8% of videos with countermeasure information contained some kind of ineffective countermeasure. The use of humour to convey messages about the dangers of driver sleepiness may be a useful approach in educational interventions. Copyright © 2015 Elsevier Ltd. All rights reserved.

HIV risk behaviors differ by workplace stability among Mexican female sex workers with truck driver clientele.

PubMed

Chen, Nadine E; Strathdee, Steffanie A; Rangel, Gudelia; Patterson, Thomas L; Uribe-Salas, Felipe J; Rosen, Perth; Villalobos, Jorge; Brouwer, Kimberly C

2012-12-28

In a study of female sex workers (FSW) servicing truck driver clients in Mexican border cities, we evaluated differences in HIV/STI risk behaviors by workplace. Cross-sectional study of FSW servicing truck drivers in Mexico: 100 from Nuevo Laredo (U.S. border); 100 from Ciudad Hidalgo (Guatemalan border). Main outcome was unstable workplace, defined as primary place of sex work in a public place (street, vehicle, gas station, etc.) vs. stable workplace (bar, brothel, and hotel). Logistic regression was used to identify correlates associated with trading sex at unstable workplaces in the last month. Of the FSW surveyed, 18% reported an unstable workplace. The majority of FSW surveyed were young (<30), single, had <9 th grade education, and had worked in the sex trade for a median of 4.9 years. After controlling for study site, FSW with unstable vs. stable workplaces were more likely to have a majority/all truck driver clientele, but were less likely to have visited a gynecologist in the last year (OR 0.1, 95%CI 0.03-0.4) or ever had an HIV test (OR 0.1, 95%CI 0.06-0.3), and there was a trend towards lower condom use self-efficacy scores (OR 0.8 per unit increase, 95%CI 0.7-1.0). On multivariate regression, unstable workplace was associated with having majority/all truck driver clientele, being surveyed in Nuevo Laredo, and decreased odds of ever having an HIV test. Among Mexican FSW with truck driver clients, providing safe indoor spaces for sex work may help facilitate public health interventions that improve HIV/STI and reproductive health outcomes.

The Effects of Prompting and Feedback on Drivers' Stopping at Stop Signs

ERIC Educational Resources Information Center

Austin, John; Hackett, Stacey; Gravina, Nicole; Lebbon, Angela

2006-01-01

Complete stops at a high-traffic intersection on the campus of a public university were increased with a prompting and consequence intervention. Data were collected at two opposing stop signs (Stop A and Stop B); however, the intervention was implemented only at Stop A. During the intervention, a volunteer stood next to Stop A holding a poster…

Backing collisions: a study of drivers’ eye and backing behaviour using combined rear-view camera and sensor systems

PubMed Central

Hurwitz, David S; Pradhan, Anuj; Fisher, Donald L; Knodler, Michael A; Muttart, Jeffrey W; Menon, Rajiv; Meissner, Uwe

2012-01-01

Context Backing crash injures can be severe; approximately 200 of the 2,500 reported injuries of this type per year to children under the age of 15 years result in death. Technology for assisting drivers when backing has limited success in preventing backing crashes. Objectives Two questions are addressed: Why is the reduction in backing crashes moderate when rear-view cameras are deployed? Could rear-view cameras augment sensor systems? Design 46 drivers (36 experimental, 10 control) completed 16 parking trials over 2 days (eight trials per day). Experimental participants were provided with a sensor camera system, controls were not. Three crash scenarios were introduced. Setting Parking facility at UMass Amherst, USA. Subjects 46 drivers (33 men, 13 women) average age 29 years, who were Massachusetts residents licensed within the USA for an average of 9.3 years. Interventions Vehicles equipped with a rear-view camera and sensor system-based parking aid. Main Outcome Measures Subject’s eye fixations while driving and researcher’s observation of collision with objects during backing. Results Only 20% of drivers looked at the rear-view camera before backing, and 88% of those did not crash. Of those who did not look at the rear-view camera before backing, 46% looked after the sensor warned the driver. Conclusions This study indicates that drivers not only attend to an audible warning, but will look at a rear-view camera if available. Evidence suggests that when used appropriately, rear-view cameras can mitigate the occurrence of backing crashes, particularly when paired with an appropriate sensor system. PMID:20363812

Risk and type of crash among young drivers by rurality of residence: findings from the DRIVE Study.

PubMed

Chen, H Y; Ivers, R Q; Martiniuk, A L C; Boufous, S; Senserrick, T; Woodward, M; Stevenson, M; Williamson, A; Norton, R

2009-07-01

Most previous literature on urban/rural differences in road crashes has a primary focus on severe injuries or deaths, which may be largely explained by variations of medical resources. Little has been reported on police-reported crashes by geographical location, or crash type and severity, especially among young drivers. DRIVE is a prospective cohort study of 20,822 drivers aged 17-24 in NSW, Australia. Information on risk factors was collected via online questionnaire and subsequently linked to police-reported crashes. Poisson regression was used to analyse risk of various crash types by three levels of rurality of residence: urban, regional (country towns and surrounds) and rural. Compared to urban drivers, risk of crash decreased with increasing rurality (regional adjusted RR: 0.7, 95% CI 0.6-0.9; rural adjusted RR: 0.5, 95% CI 0.3-0.7). Among those who crashed, risk of injurious crash did not differ by geographic location; however, regional and rural drivers had significantly higher risk of a single versus multiple vehicle crash (regional adjusted RR 1.8, 95% CI 1.3-2.5; rural adjusted RR: 2.0, 95% CI 1.1-3.6), which was explained by speeding involvement and road alignment at the time or site of crash. Although young urban drivers have a higher crash risk overall, rural and regional residents have increased risk of a single vehicle crash. Interventions to reduce single vehicle crashes should aim to address key issues affecting such crashes, including speeding and specific aspects of road geometry.

Fatal crash involvement of unlicensed young drivers: county level differences according to material deprivation and urbanicity in the United States.

PubMed

Hanna, Christian L; Laflamme, Lucie; Bingham, C Raymond

2012-03-01

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). 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. 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. 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). 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. Copyright © 2011. Published by Elsevier Ltd.

Road traffic crash risk associated with benzodiazepine and z‐hypnotic use after implementation of a colour‐graded pictogram: a responsibility study

PubMed Central

Luxcey, Audrey; Contrand, Benjamin; Gadegbeku, Blandine; Delorme, Bernard; Tricotel, Aurore; Moore, Nicholas; Salmi, Louis‐Rachid; Lagarde, Emmanuel

2016-01-01

Aims To assess potential change in medicine exposure and association with the risk of road traffic crash across a time period that started before the implementation of a grading system warning of the effect of medicine on driving performance. Methods Data from three French national databases were extracted and matched: the national health care insurance database, police reports and the national police database of injurious crashes. Drivers involved in such crashes in France, from July 2005 to December 2011 and identified by their national identifier, were included. Association with the risk of crash was estimated using a case–control analysis comparing benzodiazepine and z‐hypnotic use among drivers responsible or not responsible for the crash. Results Totals of 69 353 responsible and 73 410 non‐responsible drivers involved in an injurious crash were included. Exposure to benzodiazepine anxiolytics was associated with an increased risk of being responsible for a road traffic crash during the pre‐intervention period (OR = 1.42 [1.24–1.62]). The association disappeared in the post‐intervention period, but became significant again thereafter. The risk of being responsible for a crash increased in users of z‐hypnotics across the study period. Conclusions Our results question the efficacy of the measures implemented to promote awareness about the effects of medicines on driving abilities. Prevention policies relating to the general driving population, but also to healthcare professionals, should be reviewed. PMID:27544927

Socioeconomic status and risk of car crash injury, independent of place of residence and driving exposure: results from the DRIVE Study.

PubMed

Chen, H Y; Ivers, R Q; Martiniuk, A L C; Boufous, S; Senserrick, T; Woodward, M; Stevenson, M; Norton, R

2010-11-01

Previous studies that found increased crash risks for young drivers of low socioeconomic status (SES) have failed to adjust for factors such as driving exposure and rural residence. This aim of this study is to examine the independent effect of SES on crash risk, adjusting for such factors, and to examine the relationship between injury severity following a crash and SES. Information on risk factors for crash collected from 20,822 newly licenced drivers aged 17-24 years in New South Wales, Australia, as part of the DRIVE Study was prospectively linked to hospitalisation data. SES was classified as high, moderate or low based on the Australia 2001 Socio-Economic Index for Areas. Poisson regression was used to model risk of crash-related hospitalisation by SES, adjusting for confounders. Two measures of injury severity--urgency of treatment and length of hospital stay--were examined by SES. Results of multivariable analysis showed that drivers from low SES areas had increased relative risk (RR 1.8, 95% CI 1.1 to 3.1) of crash-related hospitalisation compared to drivers from high SES areas. This increased risk remained when adjusting for confounders including driving exposure and rurality (RR 1.9, 95% CI 1.1 to 3.2). No significant association was found between injury severity and SES. The higher risk of crash-related hospitalisation for young drivers from low SES areas is independent of driving exposure and rural-urban differences. This finding may help improve and better target interventions for youth of low SES.

Current Trends in Exercise Intervention Research, Technology, and Behavioral Change Strategies for People With Disabilities: A Scoping Review.

PubMed

Lai, Byron; Young, Hui-Ju; Bickel, C Scott; Motl, Robert W; Rimmer, James H

2017-10-01

This review synthesized physical activity and exercise intervention literature for the past 10 yrs for people with physical and cognitive disabilities including intervention characteristics, behavior change strategies, and types of technologies used to improve targeted outcomes. Systematic searches yielded 132 eligible studies. The major disability groups were multiple sclerosis (41%), stroke (15%), and spinal cord injury (12%). Research designs primarily involved randomized controlled trials (61%) versus quasi-experimental designs (39%). Approximately 20% of the interventions used some form of the following technology: information and communication technology (48%), interactive technology (37%), or electronic gauges (30%). Eighteen percent of studies used intervention strategies based on behavioral theory, which was typically combined with technology to promote activity and increase adherence in generally larger study samples. The three prevailing theories included social cognitive theory (58%), supportive accountability theory (21%), and transtheoretical model (21%). Upon completing the intervention, studies reported primarily significant outcomes (80%). Exercise research for PWD has grown in both quantity and quality, but several gaps remain. Study findings provide a roadmap for future exercise trials on understudied populations and highlight technology and behavior change theory as drivers of future intervention research.

The impact of in-vehicle cell-phone use on accidents or near-accidents among college students.

PubMed

Seo, Dong-Chul; Torabi, Mohammad R

2004-01-01

With in-vehicle use of cell phones rapidly increasing, the safety of young drivers, who represent 14% of licensed drivers but 26% of drivers involved in fatal crashes, may be disproportionately threatened. The authors used a questionnaire to examine the association between in-vehicle cell-phone use and accidents or near-accidents among 1,291 conveniently recruited college students in 4 states. Of the 1,185 respondents who were drivers, 87% had a cell phone, and 86% of the cell-phone owners reported talking while driving at least occasionally. Of the 762 reported accidents or near-accidents, 21% (n = 159) involved at least 1 of the drivers talking while driving. Chi-square tests and logistic regression analyses showed that the frequency, not the duration, of drivers talking while driving was related to experiencing accidents or near-accidents. Differences between drivers who used cell phones and nonusers in unsafe driving behaviors and attitudes were also examined, and target groups for intervention efforts against talking on a cell phone while driving are suggested.

Improving the safety of aging road users: a mini-review.

PubMed

Boot, Walter R; Stothart, Cary; Charness, Neil

2014-01-01

Older drivers are at greatest risk for injury or death as a result of a car crash. In this mini-review, we outline the normative age-related changes to perceptual, cognitive, and motor abilities that contribute to increased crash risk and decreased comfort with driving, and highlight specific driving scenarios and conditions that are particularly challenging for aging road users. Adopting a person-environment fit framework, we discuss how the roadway environment can be modified to better match the abilities of the aging driver. We also review evidence for the efficacy of training interventions that aim to change the abilities and strategies of the aging driver to better match the demands of the driving environment. Evidence suggests that specific changes to the roadway and driver training strategies can bring the abilities of the older driver back into alignment with the demands of the driving task. A focus on both approaches will help ensure the safety of all road users as the number of aging drivers greatly increases over the next few decades.

Obesity and Other Risk Factors: The National Survey of U.S. Long-Haul Truck Driver Health and Injury

PubMed Central

Sieber, W. Karl; Robinson, Cynthia F.; Birdsey, Jan; Chen, Guang X.; Hitchcock, Edward M.; Lincoln, Jennifer E.; Nakata, Akinori; Sweeney, Marie H.

2015-01-01

Background Drivers of heavy and tractor-trailer trucks accounted for 56% of all production and nonsupervisory employees in the truck transportation industry in 2011. There are limited data for illness and injury in long-haul truck drivers, which prompted a targeted national survey. Methods Interviewers collected data during 2010 from 1,670 long-haul truck drivers at 32 truck stops across the 48 contiguous United States that were used to compute prevalence estimates for self-reported health conditions and risk factors. Results Obesity (69% vs. 31%, P <0.01) and current smoking (51% vs. 19%, P <0.01) were twice as prevalent in long-haul truck drivers as in the 2010 U.S. adult working population. Sixty-one percent reported having two or more of the risk factors: hypertension, obesity, smoking, high cholesterol, no physical activity, 6 or fewer hours of sleep per 24-hr period. Conclusion Survey findings suggest a need for targeted interventions and continued surveillance for long-haul truck drivers. PMID:24390804

Reducing young driver road trauma: guidance and optimism for the future

PubMed Central

Senserrick, T M

2006-01-01

This paper highlights lessons from each of the Expert Panel papers in the present supplement that provide guidance for future research and initiatives. Although some shortfalls still remain in our understanding, it is argued that much has been learned and we are ready for more translation, implementation, and evaluation of multilevel interventions to help reduce young driver road trauma. Non‐use of restraints, speeding, driving at night and with passengers, and fatigue are highlighted as key risk factors to address. “Best practice” intervention is proposed as implementing and strengthening graduated driver licensing systems and complementary candidate programs and research, such as hazard perception training programs. A schematic cognitive‐perceptual model to explain the crash sequence process is explored. There is optimism that meaningful impacts can be made, especially coupled with the advances in vehicle technologies, but caution is necessary in the absence of targeted “real world” evaluations and broader implementation and diffusion strategies. PMID:16788114

The contribution of alcohol to serious car crash injuries.

PubMed

Connor, Jennie; Norton, Robyn; Ameratunga, Shanthi; Jackson, Rod

2004-05-01

Alcohol impairment of drivers is considered the most important contributing cause of car crash injuries. The burden of injury attributable to drinking drivers has been estimated only indirectly. We conducted a population-based case-control study in Auckland, New Zealand between April 1998 and July 1999. Cases were 571 car drivers involved in crashes in which at least 1 occupant was admitted to the hospital or killed. Control subjects were 588 car drivers recruited on public roads, representative of driving in the region during the study period. Participants completed a structured interview and had blood or breath alcohol measurements. Drinking alcohol before driving was strongly associated with injury crashes after controlling for known confounders. This was true for several measures of alcohol consumption: for self-report of 2 or more 12-g alcoholic drinks in the preceding 6 hours compared with none, the odds ratio (OR) was 7.9 (95% confidence interval = 3.4-18); for blood alcohol concentration 3 to 50 mg/100 mL compared with <3 mg/100 mL, the OR was 3.2 (1.1-10); and for blood alcohol concentration greater than 50 mg/100 mL compared with <3 mg/100 mL, the OR was 23 (9-56). Approximately 30% of car crash injuries in this population were attributable to alcohol, with two-thirds involving drivers with blood alcohol concentration in excess of 150 mg/100 mL. Equal proportions of alcohol-related injury crashes were attributable to drivers with blood alcohol concentrations of 3 to 50 mg/100 mL as those with levels of 51 to 150 mg/100 mL. Evidence about the proportion of crashes attributable to drivers at different blood alcohol concentrations can inform the prioritization of interventions that target different groups of drivers. These data indicate where there is the most potential for reduction of the injury burden.

Lesion complexity drives the cost of superficial femoral artery endovascular interventions

PubMed Central

Walker, Karen L.; Nolan, Brian W.; Columbo, Jesse A.; Rzucidlo, Eva M.; Goodney, Philip P.; Walsh, Daniel B.; Atkinson, Benjamin J.; Powell, Richard J.

2017-01-01

Objective Patients who undergo endovascular treatment of superficial femoral artery (SFA) disease vary greatly in lesion complexity and treatment options. This study examined the association of lesion severity and cost of SFA stenting and to determine if procedure cost affects primary patency at 1 year. Methods A retrospective record review identified patients undergoing initial SFA stenting between January 1, 2010, and February 1, 2012. Medical records were reviewed to collect data on demographics, comorbidities, indication for the procedure, TransAtlantic Inter-Society Consensus (TASC) II severity, and primary patency. The interventional radiology database and hospital accounting database were queried to determine cost drivers of SFA stenting. Procedure supply cost included any item with a bar code used for the procedure. Associations between cost drivers and lesion characteristics were explored. Primary patency was determined using Kaplan-Meier survival curves and a log-rank test. Results During the study period, 95 patients underwent stenting in 98 extremities; of these, 61% of SFA stents were performed for claudication, with 80% of lesions classified as TASC II A or B. Primary patency at 1 year was 79% for the entire cohort. The mean total cost per case was $10,333. Increased procedure supply cost was associated with adjunct device use, the number of stents, and TASC II severity. Despite higher costs of treating more complex lesions, primary patency at 1 year was similar at 80% for high-cost (supply cost >$4000) vs 78% for low-cost (supply cost <$4000) interventions. Conclusions SFA lesion complexity, as defined by TASC II severity, drives the cost of endovascular interventions but does not appear to disadvantage patency at 1 year. Reimbursement agencies should consider incorporating disease severity into reimbursement algorithms for lower extremity endovascular interventions. PMID:26206581

Lesion complexity drives the cost of superficial femoral artery endovascular interventions.

PubMed

Walker, Karen L; Nolan, Brian W; Columbo, Jesse A; Rzucidlo, Eva M; Goodney, Philip P; Walsh, Daniel B; Atkinson, Benjamin J; Powell, Richard J

2015-10-01

Patients who undergo endovascular treatment of superficial femoral artery (SFA) disease vary greatly in lesion complexity and treatment options. This study examined the association of lesion severity and cost of SFA stenting and to determine if procedure cost affects primary patency at 1 year. A retrospective record review identified patients undergoing initial SFA stenting between January 1, 2010, and February 1, 2012. Medical records were reviewed to collect data on demographics, comorbidities, indication for the procedure, TransAtlantic Inter-Society Consensus (TASC) II severity, and primary patency. The interventional radiology database and hospital accounting database were queried to determine cost drivers of SFA stenting. Procedure supply cost included any item with a bar code used for the procedure. Associations between cost drivers and lesion characteristics were explored. Primary patency was determined using Kaplan-Meier survival curves and a log-rank test. During the study period, 95 patients underwent stenting in 98 extremities; of these, 61% of SFA stents were performed for claudication, with 80% of lesions classified as TASC II A or B. Primary patency at 1 year was 79% for the entire cohort. The mean total cost per case was $10,333. Increased procedure supply cost was associated with adjunct device use, the number of stents, and TASC II severity. Despite higher costs of treating more complex lesions, primary patency at 1 year was similar at 80% for high-cost (supply cost >$4000) vs 78% for low-cost (supply cost <$4000) interventions. SFA lesion complexity, as defined by TASC II severity, drives the cost of endovascular interventions but does not appear to disadvantage patency at 1 year. Reimbursement agencies should consider incorporating disease severity into reimbursement algorithms for lower extremity endovascular interventions. Copyright © 2015 Society for Vascular Surgery. Published by Elsevier Inc. All rights reserved.

Interventions for violence prevention among young female hawkers in motor parks in south-western Nigeria: a review of effectiveness.

PubMed

Fawole, Olufunmilayo I; Ajuwon, Ademola J; Osungbade, Kayode O; Faweya, Olufemi C

2003-04-01

An intervention study was carried out among hawkers, drivers, instructors, police and judicial officers to reduce the incidence of violence against young female hawkers in three states of south-western Nigeria. Knowledge and experience of violence among the hawkers before and after the interventions were then compared. Findings show that they had greater knowledge of the different types of violence (p < 0.05), were more aware of their vulnerability to violence (99.4% after compared to 82.7% before intervention) and sought help or redress (76.3% after compared to 45.8% before intervention) following violent acts. Sexual violence was the commonest type experienced (30.4% and 15.7% at base line and end line respectively). The rate of violence also decreased. We conclude that multidisciplinary interventions that empower women economically and educationally and involve all stakeholders are effective in preventing violence against women.

Men's violence against women and men are inter-related: Recommendations for simultaneous intervention

PubMed Central

Fleming, Paul J.; Gruskin, Sofia; Rojo, Florencia; Dworkin, Shari L.

2015-01-01

Men are more likely than women to perpetrate nearly all types of interpersonal violence (e.g. intimate partner violence, murder, assault, rape). While public health programs target prevention efforts for each type of violence, there are rarely efforts that approach the prevention of violence holistically and attempt to tackle its common root causes. Drawing upon theories that explain the drivers of violence, we examine how gender norms, including norms and social constructions of masculinity, are at the root of most physical violence perpetration by men against women and against other men. We then argue that simply isolating each type of violence and constructing separate interventions for each type is inefficient and less effective. We call for recognition of the commonalities found across the drivers of different types of violence and make intervention recommendations with the goal of seeking more long-standing solutions to violence prevention. PMID:26482359

Testing a structural model of young driver willingness to uptake Smartphone Driver Support Systems.

PubMed

Kervick, Aoife A; Hogan, Michael J; O'Hora, Denis; Sarma, Kiran M

2015-10-01

There is growing interest in the potential value of using phone applications that can monitor driver behaviour (Smartphone Driver Support Systems, 'SDSSs') in mitigating risky driving by young people. However, their value in this regard will only be realised if young people are willing to use this technology. This paper reports the findings of a study in which a novel structural model of willingness to use SDSSs was tested. Grounded in the driver monitoring and Technology Acceptance (TA) research literature, the model incorporates the perceived risks and gains associated with potential SDSS usage and additional social cognitive factors, including perceived usability and social influences. A total of 333 smartphone users, aged 18-24, with full Irish driving licenses completed an online questionnaire examining willingness or Behavioural Intention (BI) to uptake a SDSS. Following exploratory and confirmatory factor analyses, structural equation modelling indicated that perceived gains and social influence factors had significant direct effects on BI. Perceived risks and social influence also had significant indirect effects on BI, as mediated by perceived gains. Overall, this model accounted for 72.5% of the variance in willingness to uptake SDSSs. Multi-group structural models highlighted invariance of effects across gender, high and low risk drivers, and those likely or unlikely to adopt novel phone app technologies. These findings have implications for our understanding of the willingness of young drivers to adopt and use SDSSs, and highlight potential factors that could be targeted in behavioural change interventions seeking to improve usage rates. Copyright © 2015 Elsevier Ltd. All rights reserved.

Behavioural informatics for improving water hygiene practice based on IoT environment.

PubMed

Fu, Yang; Wu, Wenyan

2018-02-01

The development of Internet of Things (IoT) and latest Information and Communication Technologies (ICT) have changed the nature of healthcare monitoring and health behaviour intervention in many applications. Water hygiene and water conservation behaviour intervention as important influence factors to human health are gaining much attentions for improving sustained sanitation practice. Based on face-to-face delivery, typical behaviour intervention method is costly and hardly to provide all day access to personalised intervention guidance and feedbacks. In this study, we presented a behavioural information system and water use behaviour model using IoT platform. Using Expanded Theory of Planned Behaviour (ETPB) and adopted structure equation model, this study offers a solution for understanding the behaviour intervention mechanism and methodology for developing empirical model. A case study of behaviour intervention model is presented by utilising residential water conservation behaviour data collected in China. Results suggested that cultural differences have significant influences on the understanding of intervention drivers, promoting projects and increasing awareness, which could improve the behaviour intervention efficiency and further facilitate the improvement of water hygiene practice. The performance evaluation of water saving dimension is discussed as well in the paper. Copyright © 2017 Elsevier Inc. All rights reserved.

The influence of sensitivity to reward and punishment, propensity for sensation seeking, depression, and anxiety on the risky behaviour of novice drivers: a path model.

PubMed

Scott-Parker, Bridie; Watson, Barry; King, Mark J; Hyde, Melissa K

2012-05-01

Young novice drivers are significantly more likely to be killed or injured in car crashes than older, experienced drivers. Graduated driver licensing (GDL), which allows the novice to gain driving experience under less-risky circumstances, has resulted in reduced crash incidence; however, the driver's psychological traits are ignored. This paper explores the relationships between gender, age, anxiety, depression, sensitivity to reward and punishment, sensation-seeking propensity, and risky driving. Participants were 761 young drivers aged 17-24 (M=19.00, SD=1.56) with a Provisional (intermediate) driver's licence who completed an online survey comprising socio-demographic questions, the Impulsive Sensation Seeking Scale, Kessler's Psychological Distress Scale, the Sensitivity to Punishment and Sensitivity to Reward Questionnaire, and the Behaviour of Young Novice Drivers Scale. Path analysis revealed depression, reward sensitivity, and sensation-seeking propensity predicted the self-reported risky behaviour of the young novice drivers. Gender was a moderator; and the anxiety level of female drivers also influenced their risky driving. Interventions do not directly consider the role of rewards and sensation seeking, or the young person's mental health. An approach that does take these variables into account may contribute to improved road safety outcomes for both young and older road users. ©2011 The British Psychological Society.

A multidimensional intergenerational model of young males' driving styles.

PubMed

Gil, Shani; Taubman-Ben-Ari, Orit; Toledo, Tomer

2016-12-01

This study examines the associations between fathers' driving styles, the family's general and driving-related atmosphere, and the young drivers' motivations, on one hand, and young males' driving styles, on the other. The 242 father and son pairs that participated in the study independently completed several self-report questionnaires at different points in time within the first year after licensure of the young drivers. A structural equation model (SEM) was developed, in which the contribution of fathers' driving style and their sons' perceptions of the general family relations, the family climate for road safety (FCRS), and costs and benefits of driving, to the driving styles of the young male drivers was examined. The SEM estimation results show direct as well as indirect significant effects between the various dimensions. The FCRS factors of non-commitment and messages, and the cost of thrill, were found to be the strongest mediators between the fathers' driving style and the family cohesion, on one hand, and the driving style of the young driver, on the other. These results may be useful in pointing out directions for the development of interventions that could assist in reducing the involvement of youngsters in risky driving and car crashes, and encourage safe and considerate driving. Copyright © 2016 Elsevier Ltd. All rights reserved.

Food, health, and complexity: towards a conceptual understanding to guide collaborative public health action.

PubMed

Majowicz, Shannon E; Meyer, Samantha B; Kirkpatrick, Sharon I; Graham, Julianne L; Shaikh, Arshi; Elliott, Susan J; Minaker, Leia M; Scott, Steffanie; Laird, Brian

2016-06-08

What we eat simultaneously impacts our exposure to pathogens, allergens, and contaminants, our nutritional status and body composition, our risks for and the progression of chronic diseases, and other outcomes. Furthermore, what we eat is influenced by a complex web of drivers, including culture, politics, economics, and our built and natural environments. To date, public health initiatives aimed at improving food-related population health outcomes have primarily been developed within 'practice silos', and the potential for complex interactions among such initiatives is not well understood. Therefore, our objective was to develop a conceptual model depicting how infectious foodborne illness, food insecurity, dietary contaminants, obesity, and food allergy can be linked via shared drivers, to illustrate potential complex interactions and support future collaboration across public health practice silos. We developed the conceptual model by first conducting a systematic literature search to identify review articles containing schematics that depicted relationships between drivers and the issues of interest. Next, we synthesized drivers into a common model using a modified thematic synthesis approach that combined an inductive thematic analysis and mapping to synthesize findings. The literature search yielded 83 relevant references containing 101 schematics. The conceptual model contained 49 shared drivers and 227 interconnections. Each of the five issues was connected to all others. Obesity and food insecurity shared the most drivers (n = 28). Obesity shared several drivers with food allergy (n = 11), infectious foodborne illness (n = 7), and dietary contamination (n = 6). Food insecurity shared several drivers with infectious foodborne illness (n = 9) and dietary contamination (n = 9). Infectious foodborne illness shared drivers with dietary contamination (n = 8). Fewer drivers were shared between food allergy and: food insecurity (n = 4); infectious foodborne illness (n = 2); and dietary contamination (n = 1). Our model explicates potential interrelationships between five population health issues for which public health interventions have historically been siloed, suggesting that interventions targeted towards these issues have the potential to interact and produce unexpected consequences. Public health practitioners working in infectious foodborne illness, food insecurity, dietary contaminants, obesity, and food allergy should actively consider how their seemingly targeted public health actions may produce unintended positive or negative population health impacts.

Relationship of aggression, negative affect, substance use problems, and childhood delinquency to DWI recidivism.

PubMed

Linn, Braden K; Nochajski, Thomas; Wieczorek, William

2016-01-01

Driving under the influence remains a pervasive problem. Approximately 30% of those arrested for impaired driving offenses each year are repeat offenders, suggesting that current rehabilitative efforts are not sufficiently effective for reducing driving while intoxicated (DWI) recidivism. Aggression, negative affect, substance use problems, and childhood delinquency have been noted in the population of impaired drivers, but study of these variables on recidivism has been limited. The aim of the current study was to examine the effects of aggression, negative affect, substance use problems, and childhood delinquency on DWI recidivism among first time offenders. In 1992, 6436 individuals in impaired driver programs in New York State were surveyed. A total of 3511 individuals provided names so that state driver abstracts could be reviewed in the future. A total of 2043 matches were found and 1770 remained after excluding those with previous DWI convictions. Driver records were reviewed in 2010 and 2012, providing between 18 and 20 years of follow-up. During the follow-up period, 16.5% of individuals were arrested for an impaired driving offense. Multivariate analysis suggested that recidivism was a function of several problems, including: alcohol problem severity, aggression, negative affect, drug problem severity, criminal history, and childhood delinquency. Impaired driving programs should assess for childhood delinquency, aggressive tendencies, and negative affect as these constructs, along with substance use, are evident among impaired drivers who recidivate. Interventions addressing aggression and negative affect may ultimately prove useful in reducing recidivism.

Time spent sitting during and outside working hours in bus drivers: A pilot study.

PubMed

Varela-Mato, Veronica; Yates, Thomas; Stensel, David J; Biddle, Stuart J H; Clemes, Stacy A

2016-06-01

This cross-sectional pilot study objectively measured sedentary and non-sedentary time in a sample of bus drivers from the East Midlands, United Kingdom. Participants wore an activPAL3 inclinometer for 7 days and completed a daily diary. Driver's blood pressure, heart rate, waist circumference and body composition were measured objectively at the outset. The proportions of time spent sedentary and non-sedentary were calculated during waking hours on workdays and non-workdays and during working-hours and non-working-hours on workdays. 28 (85% of those enrolled into the study) provided valid objective monitoring data (89.3% male, [median ± IQR] age: 45.2 ± 12.8 years, BMI 28.1 ± 5.8 kg/m(2)). A greater proportion of time was spent sitting on workdays than non-workdays (75% [724 ± 112 min/day] vs. 62% [528 ± 151 min/day]; p < 0.001), and during working-hours than non-working-hours (83% [417 ± 88 min/day] vs. 68% [307 ± 64 min/day]; p < 0.001) on workdays. Drivers spent less than 3% of their overall time stepping. Bus drivers accumulate high levels of sitting time during working-hours and outside working-hours. Interventions are urgently needed in this at-risk group, which should focus on reducing sitting and increasing movement during breaks and increasing physical activity during leisure time to improve cardiovascular health.

Time spent sitting during and outside working hours in bus drivers: A pilot study

PubMed Central

Varela-Mato, Veronica; Yates, Thomas; Stensel, David J.; Biddle, Stuart J.H.; Clemes, Stacy A.

2015-01-01

This cross-sectional pilot study objectively measured sedentary and non-sedentary time in a sample of bus drivers from the East Midlands, United Kingdom. Participants wore an activPAL3 inclinometer for 7 days and completed a daily diary. Driver's blood pressure, heart rate, waist circumference and body composition were measured objectively at the outset. The proportions of time spent sedentary and non-sedentary were calculated during waking hours on workdays and non-workdays and during working-hours and non-working-hours on workdays. 28 (85% of those enrolled into the study) provided valid objective monitoring data (89.3% male, [median ± IQR] age: 45.2 ± 12.8 years, BMI 28.1 ± 5.8 kg/m2). A greater proportion of time was spent sitting on workdays than non-workdays (75% [724 ± 112 min/day] vs. 62% [528 ± 151 min/day]; p < 0.001), and during working-hours than non-working-hours (83% [417 ± 88 min/day] vs. 68% [307 ± 64 min/day]; p < 0.001) on workdays. Drivers spent less than 3% of their overall time stepping. Bus drivers accumulate high levels of sitting time during working-hours and outside working-hours. Interventions are urgently needed in this at-risk group, which should focus on reducing sitting and increasing movement during breaks and increasing physical activity during leisure time to improve cardiovascular health. PMID:26844184

North-South Corridor Demonstration Project: Ethical and Logistical Challenges in the Design of a Demonstration Study of Early Antiretroviral Treatment for Long Distance Truck Drivers along a Transport Corridor through South Africa, Zimbabwe, and Zambia

PubMed Central

Gomez, G. B.; Venter, W. D. F.; Lange, J. M. A.; Rees, H.; Hankins, C.

2013-01-01

Background. Long-distance truck drivers are at risk of acquiring and transmitting HIV and have suboptimal access to care. New HIV prevention strategies using antiretroviral drugs to reduce transmission risk (early antiretroviral therapy (ART) at CD4 count >350 cells/μL) have shown efficacy in clinical trials. Demonstration projects are needed to evaluate “real world” programme effectiveness. We present the protocol for a demonstration study to evaluate the feasibility, acceptability, and cost of an early ART intervention for HIV-positive truck drivers along a transport corridor across South Africa, Zimbabwe, and Zambia, as part of an enhanced strategy to improve treatment adherence and retention in care. Methods and Analysis. This demonstration study would follow an observational cohort of truck drivers receiving early treatment. Our mixed methods approach includes quantitative, qualitative, and economic analyses. Key ethical and logistical issues are discussed (i.e., choice of drug regimen, recruitment of participants, and monitoring of adherence, behavioural changes, and adverse events). Conclusion. Questions specific to the design of tailored early ART programmes are amenable to operational research approaches but present substantial ethical and logistical challenges. Addressing these in demonstration projects can inform policy decisions regarding strategies to reduce health inequalities in access to HIV prevention and treatment programmes. PMID:23606977

Impaired driving from medical conditions: A 70-year-old man trying to decide if he should continue driving

PubMed Central

Rizzo, Matthew

2012-01-01

Some medical disorders can impair performance, increasing the risk of driving safety errors that can lead to vehicle crashes. The causal pathway often involves a concatenation of factors or events, some of which can be prevented or controlled. Effective interventions can operate before, during, or after a crash occurs at the levels of driver capacity, vehicle and road design, and public policy. A variety of systemic, neurological, psychiatric, and developmental disorders put drivers at potential increased risk of a car crash in the short or long term. Medical diagnosis and age alone are usually insufficient criteria for determining fitness to drive. Strategies are needed for determining what types and levels of reduced function provide a threshold for disqualification in drivers with medical disorders. Evidence of decreased mileage, self-restriction to driving in certain situations, collisions, moving violations, aggressive driving, sleepiness, alcohol abuse, metabolic disorders, and multiple medications may trigger considerations of driver safety. A general framework for evaluating driver fitness relies on a functional evaluation of multiple domains (cognitive, motor, perceptual, and psychiatric) that are important for safe driving and can be applied across many disorders, including conditions that have rarely been studied with respect to driving, and in patients with multiple conditions and medications. Neurocognitive tests, driving simulation, and road tests provide complementary sources of evidence to evaluate driver safety. No single test is sufficient to determine who should drive and who should not. PMID:21364126

A method to model anticipatory postural control in driver braking events.

PubMed

Östh, Jonas; Eliasson, Erik; Happee, Riender; Brolin, Karin

2014-09-01

Human body models (HBMs) for vehicle occupant simulations have recently been extended with active muscles and postural control strategies. Feedback control has been used to model occupant responses to autonomous braking interventions. However, driver postural responses during driver initiated braking differ greatly from autonomous braking. In the present study, an anticipatory postural response was hypothesized, modelled in a whole-body HBM with feedback controlled muscles, and validated using existing volunteer data. The anticipatory response was modelled as a time dependent change in the reference value for the feedback controllers, which generates correcting moments to counteract the braking deceleration. The results showed that, in 11 m/s(2) driver braking simulations, including the anticipatory postural response reduced the peak forward displacement of the head by 100mm, of the shoulder by 30 mm, while the peak head flexion rotation was reduced by 18°. The HBM kinematic response was within a one standard deviation corridor of corresponding test data from volunteers performing maximum braking. It was concluded that the hypothesized anticipatory responses can be modelled by changing the reference positions of the individual joint feedback controllers that regulate muscle activation levels. The addition of anticipatory postural control muscle activations appears to explain the difference in occupant kinematics between driver and autonomous braking. This method of modelling postural reactions can be applied to the simulation of other driver voluntary actions, such as emergency avoidance by steering. Copyright © 2014. Published by Elsevier B.V.

Impaired driving from medical conditions: a 70-year-old man trying to decide if he should continue driving.

PubMed

Rizzo, Matthew

2011-03-09

Some medical disorders can impair performance, increasing the risk of driving safety errors that can lead to vehicle crashes. The causal pathway often involves a concatenation of factors or events, some of which can be prevented or controlled. Effective interventions can operate before, during, or after a crash occurs at the levels of driver capacity, vehicle and road design, and public policy. A variety of systemic, neurological, psychiatric, and developmental disorders put drivers at potential increased risk of a car crash in the short or long term. Medical diagnosis and age alone are usually insufficient criteria for determining fitness to drive. Strategies are needed for determining what types and levels of reduced function provide a threshold for disqualification in drivers with medical disorders. Evidence of decreased mileage, self-restriction to driving in certain situations, collisions, moving violations, aggressive driving, sleepiness, alcohol abuse, metabolic disorders, and multiple medications may trigger considerations of driver safety. A general framework for evaluating driver fitness relies on a functional evaluation of multiple domains (cognitive, motor, perceptual, and psychiatric) that are important for safe driving and can be applied across many disorders, including conditions that have rarely been studied with respect to driving, and in patients with multiple conditions and medications. Neurocognitive tests, driving simulation, and road tests provide complementary sources of evidence to evaluate driver safety. No single test is sufficient to determine who should drive and who should not.

On the road again after traumatic brain injury: driver safety and behaviour following on-road assessment and rehabilitation.

PubMed

Ross, Pamela; Ponsford, Jennie L; Di Stefano, Marilyn; Charlton, Judith; Spitz, Gershon

2016-01-01

To examine pre- and post-injury self-reported driver behaviour and safety in individuals with traumatic brain injury (TBI) who returned to driving after occupational therapy driver assessment and on-road rehabilitation. A self-report questionnaire, administered at an average of 4.5 years after completing an on-road driver assessment, documenting pre- and post-injury crash rates, near-crashes, frequency of driving, distances driven, driving conditions avoided and navigation skills, was completed by 106 participants, who had either passed the initial driver assessment (pass group n = 74), or required driver rehabilitation, prior to subsequent assessments (rehabilitation group n = 32). No significant difference was found between pre- and post-injury crash rates. Compared to pre-injury, 36.8% of drivers reported limiting driving time, 40.6% drove more slowly, 41.5% reported greater difficulty with navigating and 20.0% reported more near-crashes. The rehabilitation group (with greater injury severity) was significantly more likely to drive less frequently, shorter distances, avoid: driving with passengers, busy traffic, night and freeway driving than the pass group. Many drivers with moderate/severe TBI who completed a driver assessment and rehabilitation program at least 3 months post-injury, reported modifying their driving behaviour, and did not report more crashes compared to pre-injury. On-road driver training and training in navigation may be important interventions in driver rehabilitation programs. Driver assessment and on-road retraining are important aspects of rehabilitation following traumatic brain injury. Many drivers with moderate/severe TBI, reported modifying their driving behaviour to compensate for ongoing impairment and continued to drive safely in the longer term. Navigational difficulties were commonly experienced following TBI, suggesting that training in navigation may be an important aspect of driver rehabilitation.

Candidate change agent identification among men at risk for HIV infection

PubMed Central

Schneider, John A.; McFadden, Rachel B.; Laumann, Edward O.; Kumar, SG Prem; Gandham, Sabitha R.; Oruganti, Ganesh

2012-01-01

Despite limited HIV prevention potency, peer-based programs have become one of the most often used HIV prevention approaches internationally. These programs demonstrate a need for greater specificity in peer change agent (PCA) recruitment and social network evaluation. In the present three-phase study based in India (2009–2010), we first explored the nature of friendship among truck-drivers, a group of men at high risk for HIV infection, in order to develop a thorough understanding of the social forces that contribute to and maintain their personal networks. This was accomplished in the first two study phases, through a combination of focus group discussions (n=5 groups), in-depth qualitative interviews (n=20), and personal network analyses (n=25) of truck-drivers to define friendship and deepen our understanding of friendship across geographic spaces. Measures collected in phases I and II included friend typologies, discussion topics, social network influences, advice-giving, and risk reduction. Outcomes were assessed through an iterative process of qualitative textual analysis and social network analysis. The networks of truck-drivers were found to comprise three typologies: close friends, parking lot friends, and other friends. From these data, we developed an algorithmic approach to the identification of a candidate PCA within a high-risk man’s personal network. In stage III we piloted field-use of this approach to identify and recruit PCAs, and further evaluated their potential for intervention through preliminary analysis of the PCA’s own personal networks. An instrument was developed to translate what social network theory and analysis has taught us about egocentric network dynamics into a real-world methodology for identifying intervention-appropriate peers within an individual’s personal network. Our approach can be tailored to the specifications of any high-risk population, and may serve to enhance current peer-based HIV interventions. PMID:22762951

Using the event analysis of systemic teamwork (EAST) to explore conflicts between different road user groups when making right hand turns at urban intersections.

PubMed

Salmon, Paul M; Lenne, Michael G; Walker, Guy H; Stanton, Neville A; Filtness, Ashleigh

2014-01-01

Collisions between different types of road users at intersections form a substantial component of the road toll. This paper presents an analysis of driver, cyclist, motorcyclist and pedestrian behaviour at intersections that involved the application of an integrated suite of ergonomics methods, the Event Analysis of Systemic Teamwork (EAST) framework, to on-road study data. EAST was used to analyse behaviour at three intersections using data derived from an on-road study of driver, cyclist, motorcyclist and pedestrian behaviour. The analysis shows the differences in behaviour and cognition across the different road user groups and pinpoints instances where this may be creating conflicts between different road users. The role of intersection design in creating these differences in behaviour and resulting conflicts is discussed. It is concluded that currently intersections are not designed in a way that supports behaviour across the four forms of road user studied. Interventions designed to improve intersection safety are discussed. Practitioner Summary: Intersection safety currently represents a key road safety issue worldwide. This paper presents a novel application of a framework of ergonomics methods for studying differences in road user behaviour at intersections. The findings support development of interventions that consider all road users as opposed to one group in isolation.

Neonatal, infant and under-five mortalities in Nigeria: An examination of trends and drivers (2003-2013).

PubMed

Morakinyo, Oyewale Mayowa; Fagbamigbe, Adeniyi Francis

2017-01-01

Neonatal (NMR), infant (IMR) and under-five (U5M) mortality rates remain high in Nigeria. Evidence-based knowledge of trends and drivers of child mortality will aid proper interventions needed to combat the menace. Therefore, this study assessed the trends and drivers of NMR, IMR, and U5M over a decade in Nigeria. A nationally representative data from three consecutive Nigeria Demographic and Household Surveys (NDHS) was used. A total of 66,158 live births within the five years preceding the 2003 (6029), 2008 (28647) and 2013 (31482) NDHS were included in the analyses. NMR was computed using proportions while IMR and U5 were computed using life table techniques embedded in Stata version 12. Probit regression model and its associated marginal effects were used to identify the predisposing factors to NMR, IMR, and U5M. The NMR, IMR, and U5M per 1000 live births in 2003, 2008 and 2013 were 52, 41, 39; 100, 75, 69; and 201, 157, 128 respectively. The NMR, IMR, and U5M were consistently lower among children whose mothers were younger, living in rural areas and from richer households. Generally, the probability of neonate death in 2003, 2008 and 2013 were 0.049, 0.039 and 0.038 respectively, the probability of infant death was 0.093, 0.071 and 0.064 while the probability of under-five death was 0.140, 0.112 and 0.092 for the respective survey years. While adjusting for other variables, the likelihood of infant and under-five deaths was significantly reduced across the survey years. Maternal age, mothers' education, place of residence, child's sex, birth interval, weight at birth, skill of birth attendant, delivery by caesarean operation or not significantly influenced NMR, IMR, and U5M. The NMR, IMR, and U5M in Nigeria reduced over the studied period. Multi-sectoral interventions targeted towards the identified drivers should be instituted to improve child survival.

An observational study of secondary task engagement while driving on urban streets in Iranian Safe Communities.

PubMed

Torkamannejad Sabzevari, Javad; Nabipour, Amir Reza; Khanjani, Narges; Molaei Tajkooh, Ali; Sullman, Mark J M

2016-11-01

In Iran the prevalence of traffic injuries and death from vehicle collisions are high. Driver engagement in non-driving-related tasks has been previously identified as an important contributing factor to crashes. Therefore, the objective of the present study was to investigate the prevalence of drivers' engagement in potentially distracting activities in Kashmar, Khalilabad and Bardaskan, which are three Iranian International Safe Communities. Observations took place at 12 randomly selected roadside locations in each city, which were comprised of six main streets and six side streets. In total 7979 drivers were observed. The prevalence rates of potentially distracting activities in Kashmar, Khalilabad and Bardaskan were 24.3%, 26% and 24.9%, respectively. In both Kashmar and Khalilabad the most frequently observed secondary tasks were drivers talking to passengers (10.6% and 11.5%, respectively) followed by mobile phone use (3.4% and 4.0%, respectively). Although in Bardaskan the most commonly observed secondary task was also talking to passengers (12.7%), the second most common was reaching for an object (3.2%). In all three cities younger drivers were significantly more likely to be observed engaged in a secondary task while driving. Furthermore, involvement in secondary tasks while driving was significantly higher amongst females and those driving on a working day. The percentage of drivers identified as potentially distracted in these three Safe Communities was worryingly high. Thus, interventions should be integrated into the WHO Safe Community network in these cities, including: education regarding the risks associated with engaging in secondary activities while driving, law enforcement, tougher legislation, periodic assessment, raising public awareness, as well as attracting political and social support. Copyright © 2016 Elsevier Ltd. All rights reserved.

Quantifying the association between obesity, automobile travel, and caloric intake.

PubMed

Behzad, Banafsheh; King, Douglas M; Jacobson, Sheldon H

2013-02-01

The objective of this study is to assess the association between average adult body mass index (BMI), automobile travel, and caloric intake in the US in order to predict future trends of adult obesity. Annual BMI data (1984-2010) from the Behavioral Risk Factor Surveillance System (BRFSS), vehicle miles traveled data (1970-2009) from the Federal Highway Administration, licensed drivers data (1970-2009) from the Federal Highway Administration, and adult average daily caloric intake data (1970-2009) from the US Department of Agriculture were collected. A statistical model is proposed to capture multicollinearity across the independent variables. The proposed statistical model provides an estimate of changes in the average adult BMI associated with changes in automobile travel and caloric intake. According to this model, reducing daily automobile travel by one mile per driver would be associated with a 0.21 kg/m(2) reduction in the national average BMI after six years. Reducing daily caloric intake by 100 calories per person would be associated with a 0.16 kg/m(2) reduction in the national average BMI after three years. Making small changes in travel or diet choices may lead to comparable obesity interventions, implying that travel-based interventions may be as effective as dietary interventions. Copyright © 2012 Elsevier Inc. All rights reserved.

Prevalence of metabolic syndrome in Iranian professional drivers: results from a population based study of 12,138 men.

PubMed

Mohebbi, Iraj; Saadat, Soheil; Aghassi, Mohammadreza; Shekari, Mahsa; Matinkhah, Maghsuod; Sehat, Shadi

2012-01-01

It is evident that professional driving is associated with substantial changes in lifestyle habits. Professional drivers are prone to metabolic syndrome (MetS) and its complications because their working environment is characterized by numerous stress factors such as lack of physical activity due to working in a fixed position, disruption in diet, and irregular sleep habits. The aim of the present study was to estimate the prevalence of MetS among long distance drivers residing in West Azerbaijan province in Iran. To assess the prevalence of metabolic syndrome among professional long distance drivers, 12138 participants were enrolled in this cross sectional study. The MetS was defined using International Diabetes Federation criteria. Among 12138 participants, 3697 subjects found to be MetS. The crude and age-adjusted rates of MetS were 30.5% and 32.4% respectively. Based on Body mass index (BMI), 5027 subjects (41.4%) were overweight (BMI ≥ 25.01-30 kg/m2), and 2592 (21.3%) were obese (BMI ≥ 30.01 kg/m2). The presence of central obesity was more common than other components. The associations of MetS with BMI, pack-year smoking, age, weekly driving duration and driving experiences were significant in the logistic regression. By increasing BMI, pack-year smoking, age, weekly driving duration and driving experiences, odds ratio of MetS was increased. The study suggests that MetS has become a noteworthy health problem among Iranian long distance drivers. This might be due to the following facts: sitting in a fixed position for long hours while working, cigarette smoking, job stress, unhealthy diet and lack of physical activity. Educational programs should be established for promoting healthy lifestyle and also for early detection and appropriate interventions.

A human body model with active muscles for simulation of pretensioned restraints in autonomous braking interventions.

PubMed

Osth, Jonas; Brolin, Karin; Bråse, Dan

2015-01-01

The aim of this work is to study driver and passenger kinematics in autonomous braking scenarios, with and without pretensioned seat belts, using a whole-body finite element (FE) human body model (HBM) with active muscles. Upper extremity musculature for elbow and shoulder flexion-extension feedback control was added to an HBM that was previously complemented with feedback controlled muscles for the trunk and neck. Controller gains were found using a radial basis function metamodel sampled by making 144 simulations of an 8 ms(-2) volunteer sled test. The HBM kinematics, interaction forces, and muscle activations were validated using a second volunteer data set for the passenger and driver positions, with and without 170 N seat belt pretension, in 11 ms(-2) autonomous braking deceleration. The HBM was then used for a parameter study in which seat belt pretension force and timing were varied from 170 to 570 N and from 0.25 s before to 0.15 s after deceleration onset, in an 11 ms(-2) autonomous braking scenario. The model validation showed that the forward displacements and interaction forces of the HBM correlated with those of corresponding volunteer tests. Muscle activations and head rotation angles were overestimated in the HBM when compared with volunteer data. With a standard seat belt in 11 ms(-2) autonomous braking interventions, the HBM exhibited peak forward head displacements of 153 and 232 mm for the driver and passenger positions. When 570 N seat belt pretension was applied 0.15 s before deceleration onset, a reduction of peak head displacements to 60 and 75 mm was predicted. Driver and passenger responses to autonomous braking with standard and pretensioned restraints were successfully modeled in a whole-body FE HBM with feedback controlled active muscles. Variations of belt pretension force level and timing revealed that belt pretension 0.15 s before deceleration onset had the largest effect in reducing forward head and torso movement caused by the autonomous brake intervention. The displacement of the head relative to the torso for the HBM is quite constant for all variations in timing and belt force; it is the reduced torso displacements that lead to reduced forward head displacements.

The impact of driving cessation on older Kuwaiti adults: implications to occupational therapy.

PubMed

Al-Hassani, Samar B; Alotaibi, Naser M

2014-07-01

Older adults consider driving as a fundamental part of their identity and independence. In most western countries, driving cessation has been recognized as a major issue affecting their health and well-being. This study aimed to compare older Kuwaiti adults who were active drivers and those who had ceased driving, and to explore the impact of driving cessation on the psychological well-being and lifestyle of older ex-drivers. Participants included 114 community-dwelling older adults aged 55 years and older. A questionnaire based on the driving rehabilitation literature was administered along with the Geriatric Depression Scale (GDS). Results indicated that active drivers did not place greater importance on driving and spend more time in leisure pursuits. The overarching feelings following driving cessation were loss of control over one's life and an increased sense of dependency. Driving cessation also contributed to a reduced ability to perform family duties, and it was associated with giving up previously performed leisure activities. Our findings indicate that driving cessation adversely affects older adults' independence and role performance. Older ex-drivers may require assistance and intervention to facilitate their psychological well-being and community participation.

Dimensions of driving anger and their relationships with aberrant driving.

PubMed

Zhang, Tingru; Chan, Alan H S; Zhang, Wei

2015-08-01

The purpose of this study was to investigate the relationship between driving anger and aberrant driving behaviours. An internet-based questionnaire survey was administered to a sample of Chinese drivers, with driving anger measured by a 14-item short Driving Anger Scale (DAS) and the aberrant driving behaviours measured by a 23-item Driver Behaviour Questionnaire (DBQ). The results of Confirmatory Factor Analysis demonstrated that the three-factor model (hostile gesture, arrival-blocking and safety-blocking) of the DAS fitted the driving anger data well. The Exploratory Factor Analysis on DBQ data differentiated four types of aberrant driving, viz. emotional violation, error, deliberate violation and maintaining progress violation. For the anger-aberration relation, it was found that only "arrival-blocking" anger was a significant positive predictor for all four types of aberrant driving behaviours. The "safety-blocking" anger revealed a negative impact on deliberate violations, a finding different from previously established positive anger-aberration relation. These results suggest that drivers with different patterns of driving anger would show different behavioural tendencies and as a result intervention strategies may be differentially effective for drivers of different profiles. Copyright © 2015 Elsevier Ltd. All rights reserved.

“Good passengers and not good passengers:” Adolescent drivers’ perceptions about inattention and peer passengers

PubMed Central

Sommers, Marilyn S.

2016-01-01

Purpose The purpose of this qualitative focus group elicitation research study was to explore teen driver perceptions of peer passengers and driver inattention. Design & Methods We utilized focus groups for data collection and content analysis to analyze the data, both of which were guided by the Theory of Planned Behavior. We conducted 7 focus groups with 30 teens, ages 16–18, licensed for ≤1 year to examine attitudes, perceived behavioral control, and norms related to driving inattention and peer passengers. Results The sample was 50% male, mean age 17.39 (sd 0.52) with mean length of licensure 173.7 days (sd 109.2). Three themes emerged: 1) “Good and not good” passengers; 2) Passengers and technology as harmful and helpful; and 3) The driver is in charge. Conclusions While passengers can be a source of distraction, our participants also identified passenger behaviors that reduced risk, such as assistance with technology and guidance for directions. Practical Implications An understanding of teens’ perceptions of peer passengers can contribute to the development of effective interventions targeting teen driver inattention. Nurses are well-positioned to contribute to these teen crash prevention efforts. PMID:27496828

Driving risk and rural life: everyday and reconstructed realities.

PubMed

Rothe, J P; Elgert, L

2005-05-01

This article details the complex network of circumstances and meanings that influence rural people's driving behavior, and describes the manner in which some rural drivers' relevant social patterns support the everyday reality of driving and risk taking on rural roads. To fulfill the purpose of the study, 20 focus group interviews were conducted with 212 rural citizens in Alberta, Canada. The findings indicate that rural drivers routinely break traffic laws because: they do not perceive the harm in breaking laws, they believe that breaking laws is a natural thing to do, they negotiate the efficacy of laws according to their personal situations, and they believe in the maxim that the "ends justify the means. " It is common for rural drivers to break or "negotiate" traffic laws if it helps them in their work lives or in fulfillment of their immediate needs. They judge some traffic laws as unreasonable and question their effect on safety. Hence, they do not feel committed to universally honoring traffic laws. This information can be used to design intervention strategies for rural traffic safety that are relevant to rural drivers and thereby have optimal opportunity for success.

Hand-held cell phone use while driving legislation and observed driver behavior among population sub-groups in the United States.

PubMed

Rudisill, Toni M; Zhu, Motao

2017-05-12

Cell phone use behaviors are known to vary across demographic sub-groups and geographic locations. This study examined whether universal hand-held calling while driving bans were associated with lower road-side observed hand-held cell phone conversations across drivers of different ages (16-24, 25-59, ≥60 years), sexes, races (White, African American, or other), ruralities (suburban, rural, or urban), and regions (Northeast, Midwest, South, and West). Data from the 2008-2013 National Occupant Protection Use Survey were merged with states' cell phone use while driving legislation. The exposure was presence of a universal hand-held cell phone ban at time of observation. Logistic regression was used to assess the odds of drivers having a hand-held cell phone conversation. Sub-groups differences were assessed using models with interaction terms. When universal hand-held cell phone bans were effective, hand-held cell phone conversations were lower across all driver demographic sub-groups and regions. Sub-group differences existed among the sexes (p-value, <0.0001) and regions (p-value, 0.0003). Compared to states without universal hand-held cell phone bans, the adjusted odds ratio (aOR) of a driver hand-held phone conversation was 0.34 [95% confidence interval (CI): 0.28, 0.41] for females versus 0.47 (CI 0.40, 0.55) for males and 0.31 (CI 0.25, 0.38) for drivers in Western states compared to 0.47 (CI 0.30, 0.72) in the Northeast and 0.50 (CI 0.38, 0.66) in the South. The presence of universal hand-held cell phone bans were associated lower hand-held cell phone conversations across all driver sub-groups and regions. Hand-held phone conversations were particularly lower among female drivers and those from Western states when these bans were in effect. Public health interventions concerning hand-held cell phone use while driving could reasonably target all drivers.

Continuing to drive while sleepy: the influence of sleepiness countermeasures, motivation for driving sleepy, and risk perception.

PubMed

Watling, Christopher N; Armstrong, Kerry A; Obst, Patricia L; Smith, Simon S

2014-12-01

Driver sleepiness is a major contributor to road crashes. The current study sought to examine the association between perceptions of effectiveness of six sleepiness countermeasures and their relationship with self-reports of continuing to drive while sleepy among 309 drivers after controlling for the influence of age, sex, motivation for driving sleepy, and risk perception of sleepy driving. The results demonstrate that the variables of age, sex, motivation, and risk perception were significantly associated with self-reports of continuing to drive while sleepy and only one countermeasure was associated with self-reports of continuing to drive while sleepy. Further, it was found that age differences in self-reports of continuing to drive while sleepy was mediated by participants' motivation and risk perception. These findings highlight modifiable factors that could be focused on with interventions that seek to modify drivers' attitudes and behaviours of driving while sleepy. Copyright © 2014 Elsevier Ltd. All rights reserved.

Non-coding recurrent mutations in chronic lymphocytic leukaemia.

PubMed

Puente, Xose S; Beà, Silvia; Valdés-Mas, Rafael; Villamor, Neus; Gutiérrez-Abril, Jesús; Martín-Subero, José I; Munar, Marta; Rubio-Pérez, Carlota; Jares, Pedro; Aymerich, Marta; Baumann, Tycho; Beekman, Renée; Belver, Laura; Carrio, Anna; Castellano, Giancarlo; Clot, Guillem; Colado, Enrique; Colomer, Dolors; Costa, Dolors; Delgado, Julio; Enjuanes, Anna; Estivill, Xavier; Ferrando, Adolfo A; Gelpí, Josep L; González, Blanca; González, Santiago; González, Marcos; Gut, Marta; Hernández-Rivas, Jesús M; López-Guerra, Mónica; Martín-García, David; Navarro, Alba; Nicolás, Pilar; Orozco, Modesto; Payer, Ángel R; Pinyol, Magda; Pisano, David G; Puente, Diana A; Queirós, Ana C; Quesada, Víctor; Romeo-Casabona, Carlos M; Royo, Cristina; Royo, Romina; Rozman, María; Russiñol, Nuria; Salaverría, Itziar; Stamatopoulos, Kostas; Stunnenberg, Hendrik G; Tamborero, David; Terol, María J; Valencia, Alfonso; López-Bigas, Nuria; Torrents, David; Gut, Ivo; López-Guillermo, Armando; López-Otín, Carlos; Campo, Elías

2015-10-22

Chronic lymphocytic leukaemia (CLL) is a frequent disease in which the genetic alterations determining the clinicobiological behaviour are not fully understood. Here we describe a comprehensive evaluation of the genomic landscape of 452 CLL cases and 54 patients with monoclonal B-lymphocytosis, a precursor disorder. We extend the number of CLL driver alterations, including changes in ZNF292, ZMYM3, ARID1A and PTPN11. We also identify novel recurrent mutations in non-coding regions, including the 3' region of NOTCH1, which cause aberrant splicing events, increase NOTCH1 activity and result in a more aggressive disease. In addition, mutations in an enhancer located on chromosome 9p13 result in reduced expression of the B-cell-specific transcription factor PAX5. The accumulative number of driver alterations (0 to ≥4) discriminated between patients with differences in clinical behaviour. This study provides an integrated portrait of the CLL genomic landscape, identifies new recurrent driver mutations of the disease, and suggests clinical interventions that may improve the management of this neoplasia.

Individualized assessment of driving fitness for older individuals with health, disability, and age-related concerns.

PubMed

Wheatley, Carol J; Di Stefano, Marilyn

2008-08-01

Driver licensing agencies are faced with an increasing population of drivers who are seeking to maintain driving privileges whilst coping with functional changes associated with health, disability, or aging-related issues. Some of these changes impact upon the motor, sensory, and cognitive capacities essential for safe motor vehicle operation. The driver assessment process, as provided by occupational therapists and other professionals trained in the techniques of driver rehabilitation, can provide objective data to identify driver strengths and limitations and options available to increase mobility independence via consideration of adaptive mobility equipment, vehicle choice, driver training, or alternative transportation if necessary. This article provides an overview of the driver rehabilitation specialist's assessment and training process, with an analysis of the key issues related to this form of assessment and the need for further research. The basic driver rehabilitation process is outlined including examples of common deficits, assessment considerations, and intervention approaches. The clinical and on-road assessment procedures are described, with illustrations of the reasoning process that leads to a determination of the person's overall driving competence and rehabilitation recommendations. A review of the literature is provided that examines the currently available documentation that supports this assessment and rehabilitation process. The article concludes with a review of current literature that examines the claim that detailed clinical and on-road assessment, as provided by driver rehabilitation specialists, is currently the best method for assisting drivers with complex health, disability, or aging-related issues to resume or retain driving privileges.

The American Medical Association Older Driver Curriculum for health professionals: changes in trainee confidence, attitudes, and practice behavior.

PubMed

Meuser, Thomas M; Carr, David B; Irmiter, Cheryl; Schwartzberg, Joanne G; Ulfarsson, Gudmundur F

2010-01-01

Few gerontology and geriatrics professionals receive training in driver fitness evaluation, state reporting of unfit drivers, or transportation mobility planning yet are often asked to address these concerns in the provision of care to older adults. The American Medical Association (AMA) developed an evidence-based, multi-media Curriculum to promote basic competences. This study evaluated reported changes in practice behaviors 3 months posttraining in 693 professionals trained via the AMA approach. Eight Teaching Teams, designated and trained by AMA staff, offered 22 training sessions across the United States in 2006 to 2007. Trainees (67% female; mean age 46) completed a pretest questionnaire and a posttest administered by mail. Physicians were the largest professional group (32%). Although many trainees acknowledged having conversations with patients about driving at pretest, few endorsed utilizing specific techniques recommended by the AMA prior to this training. The posttest response rate was 34% (n = 235). Significant improvements in reported attitudes, confidence, and practices were found across measured items. In particular, posttest data indicated new adoption of in-office screening techniques, chart documentation of driver safety concerns, and transportation alternative planning strategies. Findings suggest that a well-designed, one-time continuing education intervention can enhance health professional confidence and clinical practice concerning driver fitness evaluation and mobility planning. Targeted dissemination of this Curriculum (in-person and online) will allow more to benefit in the future.

Effects of Age-Related Macular Degeneration on Driving Performance

PubMed Central

Wood, Joanne M.; Black, Alex A.; Mallon, Kerry; Kwan, Anthony S.; Owsley, Cynthia

2018-01-01

Purpose To explore differences in driving performance of older adults with age-related macular degeneration (AMD) and age-matched controls, and to identify the visual determinants of driving performance in this population. Methods Participants included 33 older drivers with AMD (mean age [M] = 76.6 ± 6.1 years; better eye Age-Related Eye Disease Study grades: early [61%] and intermediate [39%]) and 50 age-matched controls (M = 74.6 ± 5.0 years). Visual tests included visual acuity, contrast sensitivity, visual fields, and motion sensitivity. On-road driving performance was assessed in a dual-brake vehicle by an occupational therapist (masked to drivers' visual status). Outcome measures included driving safety ratings (scale of 1–10, where higher values represented safer driving), types of driving behavior errors, locations at which errors were made, and number of critical errors (CE) requiring an instructor intervention. Results Drivers with AMD were rated as less safe than controls (4.8 vs. 6.2; P = 0.012); safety ratings were associated with AMD severity (early: 5.5 versus intermediate: 3.7), even after adjusting for age. Drivers with AMD had higher CE rates than controls (1.42 vs. 0.36, respectively; rate ratio 3.05, 95% confidence interval 1.47–6.36, P = 0.003) and exhibited more observation, lane keeping, and gap selection errors and made more errors at traffic light–controlled intersections (P < 0.05). Only motion sensitivity was significantly associated with driving safety in the AMD drivers (P = 0.005). Conclusions Drivers with early and intermediate AMD can exhibit impairments in their driving performance, particularly during complex driving situations; motion sensitivity was most strongly associated with driving performance. These findings have important implications for assessing the driving ability of older drivers with visual impairment. PMID:29340641

On the road again: concurrency and condom use among Uganda truck drivers.

PubMed

Costenbader, Elizabeth C; Lancaster, Kathryn; Bufumbo, Leonard; Akol, Angela; Guest, Greg

2015-01-01

Long-distance truck drivers have been shown to be a critical population in the spread of HIV in Africa. In 2009, surveys with 385 Ugandan long-distance truck drivers measured concurrency point prevalence with two methods; it ranged from 37.4% (calendar-method) to 50.1% (direct question). The majority (84%) of relationships reported were long-term resulting in a long duration of overlap (average of 58 months) across concurrent partnerships. Only 7% of these men reported using any condoms with their spouses during the past month. Among all non-spousal relationships, duration of relationship was the factor most strongly associated with engaging in unprotected sex in the past month in a multivariable analyses controlling for partner and relationship characteristics. Innovative intervention programs for these men and their partners are needed that address the realities of truck drivers' lifestyles.

Driving to Better Health: Cancer and Cardiovascular Risk Assessment among Taxi Cab Operators in Chicago

PubMed Central

Apantaku-Onayemi, Funmi; Baldyga, William; Amuwo, Shaffdeen; Adefuye, Adedeji; Mason, Terry; Mitchell, Robin; Blumenthal, Daniel S.

2014-01-01

While a number of investigations of the health of taxi cab drivers have been conducted in Europe, Asia, and Africa, virtually none have been conducted in the United States. We undertook a survey of taxi cab operators in the Chicago area to understand better their health status and health promotion practices. The survey was completed by a convenience sample of 751 Chicago taxi drivers. Taxi drivers had low rates of insurance coverage, fruit and vegetable consumption, and physical activity compared with the general Chicago population. Participation in cancer screening tests was also lower for this group. A high proportion of taxi drivers are immigrants. They tend to be highly educated and report a readiness to engage in more health-promoting behaviors. Further research is needed to develop a targeted intervention for this population. PMID:22643623

Motivational Interviewing Support for a Behavioral Health Internet Intervention for Drivers with Type 1 Diabetes

PubMed Central

Ingersoll, Karen S.; Banton, Thomas; Gorlin, Eugenia; Vajda, Karen; Singh, Harsimran; Peterson, Ninoska; Gonder-Frederick, Linda; Cox, Daniel J.

2015-01-01

While Internet interventions can improve health behaviors, their impact is limited by program adherence. Supporting program adherence through telephone counseling may be useful, but there have been few direct tests of the impact of support. We describe a Telephone Motivational Interviewing (MI) intervention targeting adherence to an Internet intervention for drivers with Type 1 Diabetes, DD.com, and compare completion of intervention benchmarks by those randomized to DD.com plus MI vs. DD.com only. The goal of the pre-intervention MI session was to increase the participant's motivation to complete the Internet intervention and all its assignments, while the goal of the post-treatment MI session was to plan for maintaining changes made during the intervention. Sessions were semi-structured and partially scripted to maximize consistency. MI Fidelity was coded using a standard coding system, the MITI. We examined the effects of MI support vs. no support on number of days from enrollment to program benchmarks. Results show that MI sessions were provided with good fidelity. Users who received MI support completed some program benchmarks such as Core 4 (t176 df= -2.25; p<.03) and 11 of 12 monthly driving diaries significantly sooner, but support did not significantly affect time to intervention completion (t177 df= -1.69; p<. 10) or rates of completion. These data suggest that there is little benefit to therapist guidance for Internet interventions including automated email prompts and other automated minimal supports, but that a booster MI session may enhance collection of follow-up data. PMID:25774342

Age and gender differences in conviction and crash occurrence subsequent to being directed to Iowa's driver improvement program.

PubMed

Zhang, Wei; Gkritza, Konstantina; Keren, Nir; Nambisan, Shashi

2011-10-01

This paper investigates potential gender and age differences in conviction and crash occurrence subsequent to being directed to attend Iowa's Driver Improvement Program (DIP). Binary logit models were developed to investigate the factors that influence conviction occurrence after DIP by gender and age. Because of the low crash occurrence subsequent to DIP, association rules were applied to investigate the factors that influence crash occurrence subsequent to DIP, in lieu of econometric models. There were statistical significant differences by driver gender, age, and conviction history in the likelihood of subsequent convictions. However, this paper found no association between DIP outcome, crash history, and crash occurrence. Evaluating the differences in conviction and crash occurrence subsequent to DIP between female and male drivers, and among different age groups can lead to improvements of the effectiveness of DIPs and help to identify low-cost intervention measures, customized based on drivers' gender and age, for improving driving behaviors. Copyright © 2011 National Safety Council and Elsevier Ltd. All rights reserved.

Manual transmission enhances attention and driving performance of ADHD adolescent males: pilot study.

PubMed

Cox, Daniel J; Punja, Mohan; Powers, Katie; Merkel, R Lawrence; Burket, Roger; Moore, Melissa; Thorndike, Frances; Kovatchev, Boris

2006-11-01

Inattention is a major contributor to driving mishaps and is especially problematic among adolescent drivers with ADHD, possibly contributing to their 2 to 4 times higher incidence of collisions. Manual transmission has been demonstrated to be associated with greater arousal. This study tests the hypotheses that manual transmission, compared to automatic transmission, would be associated with better attention and performance on a driving simulator. Ten adolescent drivers with ADHD practice driving on the simulator in the manual and automatic mode. Employing a single-blind, cross-over design, participants drive the simulator at 19:30 and 22:30 hr for 30 min in both transmissions and rate their attention to driving. Subjectively, participants report being more attentive while driving in manual transmission mode. Objectively, participants drive safer in the manual transmission mode. Although in need of replication, this pilot study suggests a behavioral intervention to improve driving performance among ADHD adolescents.

Evaluation of a high visibility enforcement project focused on passenger vehicles interacting with commercial vehicles.

PubMed

Thomas, F Dennis; Blomberg, Richard D; Peck, Raymond C; Cosgrove, Linda A; Salzberg, Philip M

2008-01-01

In 2004, Washington State applied NHTSA's High Visibility Enforcement model used in the Click It or Ticket seat belt campaign in an attempt to reduce unsafe driving behaviors around commercial motor vehicles (CMVs). The program was called Ticketing Aggressive Cars and Trucks (TACT). This paper details the methods used to evaluate the program's effectiveness and the results of the evaluation. Four high-crash interstate highway corridors, each approximately 25 miles in length, were selected. Two of these corridors received TACT media messages and increased enforcement over an 18-month period while two comparison corridors did not receive any increased media or enforcement. A total of 4,737 contacts were made with drivers during the two enforcement waves, and 72% of these contacts led to a citation. Drivers at the intervention sites who said they saw or heard any of the TACT messages increased from 17.7% in the pre period to a high of 67.3% in the post periods. Drivers at the intervention sites also reported increased exposure to the core message of leaving more space when passing trucks (14% pre to 40% post period). The percentage of drivers who said they leave more room when passing trucks than when passing cars rose from 16% in the pre period to 24% in the post period at the intervention sites, while comparison sites showed no change. Over 150 hours of video recorded by law enforcement officers in unmarked vehicles were utilized to examine violation rates and severity of violations before and after the intervention campaigns. Statistical analyses showed that violation rates were reduced significantly at the intervention sites (between 23% and 46%), while remaining constant at the comparison sites. Analyses of the video data also showed that the seriousness of the residual violations at the intervention sites decreased. Overall, the evaluation results provide a consistent picture of the effectiveness of the TACT pilot project. Success was demonstrated at every step - messages were received and understood, knowledge was changed in the intended direction, self reported driving behavior around large trucks improved, and observed driving behaviors confirmed the self reports. After this initial success in Washington State, the TACT model will continue to be implemented and evaluated by FMCSA in an attempt to validate the program. Based on the results of this study and the consistent positive results found for other sTEP projects, it is likely that TACT will show continued success in a variety of settings and will help reduce the number and severity of crashes involving CMVs. Future research should attempt to use many of the methods described here to further validate the methods for not only evaluations of TACT programs, but also for any other highway safety programs that require measurements of the program's effectiveness.

[An intercept survey on the status of driving after alcohol drinking among motor vehicle drivers in 6 counties of Zhejiang, China].

PubMed

Zhao, Ming; Zhang, Xin-wei; Song, Xiao-chun; Bao, Ping; Zhou, Peng; Zou, Yun

2012-12-01

To investigate the status of driving after drinking alcohol among motor vehicle drivers and to provide evidence for the development of specific interventions. A 7-day intercept survey on driving after alcohol drinking, having drinking habit or driving after getting drunk, among motor vehicle drivers, was conducted in 6 counties of Zhejiang province, 2010. 16 467 motor vehicle drivers were included in the survey. Rates of driving after drinking alcohol [blood alcohol concentration (BAC) > 0 mg/100 ml], having habit of drinking alcohol (20 mg/100 ml ≤ BAC < 80 mg/100 ml) and driving after being drunk (BAC ≥ 80 mg/100 ml), were 1.82%, 1.03% and 0.27% respectively. Rates of driving after drinking alcohol, having habit of drink alcohol and driving and drunk-driving among the drivers from urban areas were significantly higher than those of drivers from rural areas, and those rates of male drivers were significantly higher than female drivers as well. 60.20% of drivers after drinking alcohol, were 35 to 49 year-olds, and the three above said rates all increased along with age. The highest above said three rates were observed at 23:00 PM and 1:00 AM. Compared with other motor vehicle drivers, motorcyclists possessed the highest rates of the three items, as 9.27%, 5.01% and 1.57% respectively. Driving after drinking alcohol among motor vehicle drivers still prevailed in Zhejiang, especially between 23:00 PM and 1:00 AM. Drivers from the cities, being male or motorcyclists were among the high-risk populations that called for special attention to be paid in the future, including law enforcement and health promotion to fight against the problem.

[Human risk factors and injuries due to road accidents: analysis of current data].

PubMed

Marchetti, Pierpaolo; Morandi, Anna; Lombardo, Carlo; Gigli Berzolari, Francesca; Bruno, Vincenzo; Marinoni, Alessandra

2009-01-01

several studies have shown that most road accidents are due to human factors, and that these are strongly linked to a drive's age and sex. The aim of this study is to test the role that some human factors play in road accidents by analysing current road accident data in the Province of Pavia, in Northern Italy. road accidents that occurred in 2004 were analysed by integrating the paper database of the vehicle licensing office, properly computerised, with the 911 database of the Province of Pavia. This study has been carried out by analysing 1.347 road accidents and the associated 2.908 drivers of motorised vehicles. Northern Italy, the Province of Pavia. the death rate of drivers of 2-wheeled vehicles is almost nine times higher than that of 4-wheeled vehicles. Analysis shows that females are twice as exposed to road accidents than males; it also shows the benefits of extensive road education training and of being aged 30-64 and older. Drivers who have already been punished and have had their driving license scores reduced are likely to respond rapidly when in a dangerous situation and also to be without blame after an accident. Motorcycle riders are 25 times more likely to suffer serious injury than drivers of cars. Additionally, the risk of a woman being seriously injured is higher than for a man. females, young drivers and motorcycle riders who have not previously been penalised for a previous traffic violation have a higher risk of being seriously injured; females and motorcycle riders are also at greater risk of being seriously injured. We hope that this analysis will be used to improve preventative interventions for road accidents.r.

HIV Risk Behaviours Differ by Workplace Stability Among Mexican Female Sex Workers With Truck Driver Clientele

PubMed Central

Chen, Nadine E.; Strathdee, Steffanie A.; Rangel, Gudelia; Patterson, Thomas L.; Uribe-Salas, Felipe J.; Rosen, Perth; Villalobos, Jorge; Brouwer, Kimberly C.

2012-01-01

Background In a study of female sex workers (FSWs) servicing truck driver clients in Mexican border cities, we evaluated differences in HIV/STI risk behaviours determined by workplace. Design and Methods Our study was cross-sectional and its population comprised 100 FSWs from Nuevo Laredo (US border) and 100 FSWs from Ciudad Hidalgo (Guatemalan border). The main outcome was primary place of sex work defined as unstable (street, vehicle, gas station, etc.) vs stable (bar, brothel, and hotel). Logistic regression was used to identify correlates associated with trading sex at unstable workplaces in the last month. Results Of the FSWs surveyed, 18% reported an unstable workplace. The majority of FSWs surveyed were young (<30 years), single, had <9th grade education, and had worked in the sex trade for a median of 4.9 years. After controlling for study site, FSWs with unstable vs stable workplaces were more likely to have a majority/all truck driver clientele, but were less likely to have visited a gynaecologist in the last year (OR 0.1, 95% CI 0.03-0.4) or ever had an HIV test (OR 0.1, 95% CI 0.06-0.3), and there was a trend towards lower condom use self-efficacy scores (OR 0.8 per unit increase, 95% CI 0.7-1.0). On multivariate regression, unstable workplace was associated with having majority/all truck driver clientele, being surveyed in Nuevo Laredo, and decreased odds of ever having an HIV test. Conclusions Among Mexican FSWs with truck driver clients, providing safe indoor spaces for sex work may help facilitate public health interventions that improve HIV/STI prevention and reproductive health outcomes. PMID:24724056

Perceived enjoyment, concentration, intention, and speed violation behavior: Using flow theory and theory of planned behavior.

PubMed

Atombo, Charles; Wu, Chaozhong; Zhang, Hui; Wemegah, Tina D

2017-10-03

Road accidents are an important public health concern, and speeding is a major contributor. Although flow theory (FLT) is a valid model for understanding behavior, currently the nature of the roles and interplay of FLT constructs within the theory of planned behavior (TPB) framework when attempting to explain the determinants of motivations for intention to speed and speeding behavior of car drivers is not yet known. The study aims to synthesize TPB and FLT in explaining drivers of advanced vehicles intentions to speed and speed violation behaviors and evaluate factors that are critical for explaining intention and behavior. The hypothesized model was validated using a sample collected from 354 fully licensed drivers of advanced vehicles, involving 278 males and 76 females on 2 occasions separated by a 3-month interval. During the first of the 2 occasions, participants completed questionnaire measures of TPB and FLT variables. Three months later, participants' speed violation behaviors were assessed. The study observed a significant positive relationship between the constructs. The proposed model accounted for 51 and 45% of the variance in intention to speed and speed violation behavior, respectively. The independent predictors of intention were enjoyment, attitude, and subjective norm. The independent predictors of speed violation behavior were enjoyment, concentration, intention, and perceived behavioral control. The findings suggest that safety interventions for preventing speed violation behaviors should be aimed at underlying beliefs influencing the speeding behaviors of drivers of advanced vehicles. Furthermore, perceived enjoyment is of equal importance to driver's intention, influencing speed violation behavior.

The impact of an m-Health financial incentives program on the physical activity and diet of Australian truck drivers.

PubMed

Gilson, Nicholas D; Pavey, Toby G; Wright, Olivia Rl; Vandelanotte, Corneel; Duncan, Mitch J; Gomersall, Sjaan; Trost, Stewart G; Brown, Wendy J

2017-05-18

Chronic diseases are high in truck drivers and have been linked to work routines that promote inactivity and poor diets. This feasibility study examined the extent to which an m-Health financial incentives program facilitated physical activity and healthy dietary choices in Australian truck drivers. Nineteen men (mean [SD] age = 47.5 [9.8] years; BMI = 31.2 [4.6] kg/m 2 ) completed the 20-week program, and used an activity tracker and smartphone application (Jawbone UP™) to regulate small positive changes in occupational physical activity, and fruit, vegetable, saturated fat and processed/refined sugar food/beverage choices. Measures (baseline, end-program, 2-months follow-up; April-December 2014) were accelerometer-determined proportions of work time spent physically active, and a workday dietary questionnaire. Statistical (repeated measures ANOVA) and thematic (interviews) analyses assessed program impact. Non-significant increases in the mean proportions of work time spent physically active were found at end-program and follow-up (+1%; 7 mins/day). Fruit (p = 0.023) and vegetable (p = 0.024) consumption significantly increased by one serve/day at end-program. Non-significant improvements in saturated fat (5%) and processed/refined sugar (1%) food/beverage choices were found at end-program and follow-up. Overall, 65% (n = 11) of drivers demonstrated positive changes in physical activity, and at least one dietary choice (e.g. saturated fat) at follow-up. Drivers found the financial incentives component of the program to be a less effective facilitator of change than the activity tracker and smartphone application, although this technology was easier to use for monitoring of physical activity than healthy dietary choices. Not all drivers benefitted from the program. However, positive changes for different health behaviours were observed in the majority of participants. Outcomes from this feasibility study inform future intervention development for studies with larger samples. ANZCTR12616001513404 . Registered November 2nd, 2016 (retrospectively registered).

Adaptive Capacity and Social-Environmental Change: Theoretical and Operational Modeling of Smallholder Coffee Systems Response in Mesoamerican Pacific Rim

NASA Astrophysics Data System (ADS)

Eakin, Hallie; Bojórquez-Tapia, Luis A.; Diaz, Rafael Monterde; Castellanos, Edwin; Haggar, Jeremy

2011-03-01

Communities who rely directly on the natural environment for their survival typically have developed risk management strategies to enable them to avoid dangerous thresholds of change to their livelihoods. Development policy appropriate for natural resource-based communities requires an understanding of the primary drivers of social-ecological change, the ways in which affected households autonomously respond to such drivers, and the appropriate avenues for intervention to reduce vulnerability. Coffee has been, and still remains, one of the most important commodities of the Mesoamerican region, and hundreds of thousands of smallholder households in the region are dependent in some way on the coffee industry for their livelihood stability. We used the Analytical Network Process to synthesize expert knowledge on the primary drivers of livelihood change in the region as well as the most common household strategies and associated capacities necessary for effective response. The assessment identified both gradual systemic processes as well as specific environmental and market shocks as significant drivers of livelihood change across the region. Agronomic adjustments and new forms of social organization were among the more significant responses of farmers to these changes. The assessment indicates that public interventions in support of adaptation should focus on enhancing farmers' access to market and technical information and finance, as well as on increasing the viability of farmers' organizations and cooperatives.

Adaptive capacity and social-environmental change: theoretical and operational modeling of smallholder coffee systems response in Mesoamerican Pacific Rim.

PubMed

Eakin, Hallie; Bojórquez-Tapia, Luis A; Monterde Diaz, Rafael; Castellanos, Edwin; Haggar, Jeremy

2011-03-01

Communities who rely directly on the natural environment for their survival typically have developed risk management strategies to enable them to avoid dangerous thresholds of change to their livelihoods. Development policy appropriate for natural resource-based communities requires an understanding of the primary drivers of social-ecological change, the ways in which affected households autonomously respond to such drivers, and the appropriate avenues for intervention to reduce vulnerability. Coffee has been, and still remains, one of the most important commodities of the Mesoamerican region, and hundreds of thousands of smallholder households in the region are dependent in some way on the coffee industry for their livelihood stability. We used the Analytical Network Process to synthesize expert knowledge on the primary drivers of livelihood change in the region as well as the most common household strategies and associated capacities necessary for effective response. The assessment identified both gradual systemic processes as well as specific environmental and market shocks as significant drivers of livelihood change across the region. Agronomic adjustments and new forms of social organization were among the more significant responses of farmers to these changes. The assessment indicates that public interventions in support of adaptation should focus on enhancing farmers' access to market and technical information and finance, as well as on increasing the viability of farmers' organizations and cooperatives.

Effect of a behaviour-change intervention on handwashing with soap in India (SuperAmma): a cluster-randomised trial.

PubMed

Biran, Adam; Schmidt, Wolf-Peter; Varadharajan, Kiruba Sankar; Rajaraman, Divya; Kumar, Raja; Greenland, Katie; Gopalan, Balaji; Aunger, Robert; Curtis, Val

2014-03-01

Diarrhoea and respiratory infections are the two biggest causes of child death globally. Handwashing with soap could substantially reduce diarrhoea and respiratory infections, but prevalence of adequate handwashing is low. We tested whether a scalable village-level intervention based on emotional drivers of behaviour, rather than knowledge, could improve handwashing behaviour in rural India. The study was done in Chittoor district in southern Andhra Pradesh, India, between May 24, 2011, and Sept 10, 2012. Eligible villages had a population of 700-2000 people, a state-run primary school for children aged 8-13 years, and a preschool for children younger than 5 years. 14 villages (clusters) were selected, stratified by population size (<1200 vs >1200), and randomly assigned in a 1:1 ratio to intervention or control (no intervention). Clusters were enrolled by the study manager. Random allocation was done by the study statistician using a random number generator. The intervention included community and school-based events incorporating an animated film, skits, and public pledging ceremonies. Outcomes were measured by direct observation in 20-25 households per village at baseline and at three follow-up visits (6 weeks, 6 months, and 12 months after the intervention). Observers had no connection with the intervention and observers and participant households were told that the study was about domestic water use to reduce the risk of bias. No other masking was possible. The primary outcome was the proportion of handwashing with soap at key events (after defecation, after cleaning a child's bottom, before food preparation, and before eating) at all follow-up visits. The control villages received a shortened version of the intervention before the final follow-up round. Outcome data are presented as village-level means. Handwashing with soap at key events was rare at baseline in both the intervention and control groups (1% [SD 1] vs 2% [1]). At 6 weeks' follow-up, handwashing with soap at key events was more common in the intervention group than in the control group (19% [SD 21] vs 4% [2]; difference 15%, p=0·005). At the 6-month follow-up visit, the proportion handwashing with soap was 37% (SD 7) in the intervention group versus 6% (3) in the control group (difference 31%; p=0·02). At the 12-month follow-up visit, after the control villages had received the shortened intervention, the proportion handwashing with soap was 29% (SD 9) in the intervention group and 29% (13) in the control group. This study shows that substantial increases in handwashing with soap can be achieved using a scalable intervention based on emotional drivers. Wellcome Trust, SHARE. Copyright © 2014 Biran et al. Open Access article distributed under the terms of CC BY. Published by .. All rights reserved.

Last Call: decreasing drunk driving among 21-34-year-old bar patrons.

PubMed

Rivara, Frederick P; Boisvert, Deanne; Relyea-Chew, Annemarie; Gomez, Tony

2012-01-01

Any effort to decrease the toll of drunk driving must include efforts directed at people who drink in bars, particularly young adults who use motor vehicles after drinking. We designed a multifaceted social marketing campaign, Last Call, to increase the use of designated drivers and safe rides homes among 21-34-year olds. There were three components to the intervention: (1) use of taxi stands to promote taxi use; (2) point-of-sale information to patrons at partner bars and (3) a mass media campaign to support the designated driver/safe ride home message. Among the heaviest drinkers, the programme significantly increased the use of designated drivers and increased the use of taxis by 63%.

Young novice drivers and the risky behaviours of parents and friends during the provisional (intermediate) licence phase: a brief report.

PubMed

Scott-Parker, Bridie; Watson, Barry; King, Mark J; Hyde, Melissa K

2014-08-01

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. 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. 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. 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. Copyright © 2013 Elsevier Ltd. All rights reserved.

Obstacles to engaging in young driver licensing: Perspectives of parents.

PubMed

Naz, Sehana; Scott-Parker, Bridie

2017-02-01

Young novice drivers remain at greater risk of injury and death despite a wealth of interventions including graduated driver licensing (GDL) programs. The key to implementing safer practices inherent in GDL appears to lie with optimising the role of parents. This qualitative research explored the parent's perspectives of obstacles to engaging in the driver licensing process within a GDL program. Parents also shared advice on what they found helpful, and where relevant, recommended changes in the process to enable safer practices for young drivers. Twenty-three parents (aged 35-60 years, M=49.52, SD=8.01, 11 males) participated in semi-structured interviews regarding licensing experiences with their young driver children. The young drivers included learner (n=11), provisional (restricted/intermediate) (n=9) and open (unrestricted/full) licence drivers (n=3), ranging from 16 to 24 years (M=18.04, SD=2.21, 13 males). Content analysis revealed that most obstacles were encountered at the learner licensing phase, with the parent-reported difficult temperament of the learner driver the most prominent. Unsurprisingly, advice to other parents to be patient and remain calm featured heavily during the same phase. Anxiety from not having control of the vehicle was another obstacle at the learner phase, translating to anxieties for child safety in the early stages of provisional driving. Recommendations for the current GDL included more rigorous road rule testing, with general support for the program, professional driver training at learner and provisional stages facilitated parental engagement through the licensing phases. The findings overwhelmingly suggest a need for parents to be educated regarding their importance in, and of, the driver licensing process, and the efficacy of their instruction, content and practices. Copyright © 2016 Elsevier Ltd. All rights reserved.

Noise induced hearing loss risk assessment in truck drivers.

PubMed

Karimi, Ali; Nasiri, Saleh; Kazerooni, Farshid Khodaparast; Oliaei, Mohammad

2010-01-01

Hearing sense is one of the key elements which may have impact on the driver's task quality. This cross-sectional study investigates the hearing status of 500 truck drivers by pure tone audiometry (AC) in one of the cities in Fars province, Iran. Hearing threshold levels of the subjects were measured in frequencies of 500Hz-8000Hz. Screening and determination of permanent threshold shift (PTS) was the first aim of this study. Hence tests were done at least 16 hours after any exposure to noticeable sound. The effect of age as a confounding factor was considered using ISO equation and subtracted from whole hearing threshold. The threshold of 25 dB HL and above was considered abnormal but the calculation of hearing was also carried out using 0 dB HL as reference. Subjects were categorized into two groups on the basis of working experience and the hearing threshold of 25 dB was considered a boundary of normal hearing sense. The results of Pearson Chi-Square test showed that working experience as an independent variable has significant contributing effect on hearing thresholds of truck drivers in frequencies of 500, 1000, 2000 and 4000 Hz (p greater than 0.05). Also, it was shown that currently nine and 12.6 % of truck drivers suffer from impaired hearing sense in left and right respectively (hearing threshold level greater than 25 dB) in mid frequencies (500, 1000, 2000 Hz) and 45% in high frequencies of both ears (4000 and 8000 Hz). The results indicated that hearing damage of professional drivers was expected to occur sooner at 4000 and 8000 Hz than lower frequencies. Finally it was deduced that the occupational conditions of truck drivers may have bilateral, symmetrical harmful effect on hearing threshold sense in all frequencies mainly in frequency of 4000 Hz, so health surveillance programs such as education and periodic medical examinations are emphasized for pre-diagnosing and prevention of any possible impairment and an urgent need to take up some interventions such as better maintenance of roads, automobile industry efforts to reduce the noise level emission of vehicles and reducing number of working hours per day of drivers are highlighted to improve the harmful working conditions of truck drivers.

A Review on Cost-Effectiveness and Cost-Utility of Psychosocial Care in Cancer Patients

PubMed Central

Jansen, Femke; van Zwieten, Valesca; Coupé, Veerle M. H.; Leemans, C. René; Verdonck-de Leeuw, Irma M.

2016-01-01

Several psychosocial care interventions have been found effective in improving psychosocial outcomes in cancer patients. At present, there is increasingly being asked for information on the value for money of this type of intervention. This review therefore evaluates current evidence from studies investigating cost-effectiveness or cost-utility of psychosocial care in cancer patients. A systematic search was conducted in PubMed and Web of Science yielding 539 unique records, of which 11 studies were included in the study. Studies were mainly performed in breast cancer populations or mixed cancer populations. Studied interventions included collaborative care (four studies), group interventions (four studies), individual psychological support (two studies), and individual psycho-education (one study). Seven studies assessed the cost-utility of psychosocial care (based on quality-adjusted-life-years) while three studies investigated its cost-effectiveness (based on profile of mood states [mood], Revised Impact of Events Scale [distress], 12-Item Health Survey [mental health], or Fear of Progression Questionnaire [fear of cancer progression]). One study did both. Costs included were intervention costs (three studies), intervention and direct medical costs (five studies), or intervention, direct medical, and direct nonmedical costs (three studies). In general, results indicated that psychosocial care is likely to be cost-effective at different, potentially acceptable, willingness-to-pay thresholds. Further research should be performed to provide more clear information as to which psychosocial care interventions are most cost-effective and for whom. In addition, more research should be performed encompassing potential important cost drivers from a societal perspective, such as productivity losses or informal care costs, in the analyses. PMID:27981151

Efficacy of a family-focused intervention for young drivers with attention-deficit hyperactivity disorder

PubMed Central

Fabiano, Gregory A.; Schatz, Nicole K.; Morris, Karen L.; Willoughby, Michael T.; Vujnovic, Rebecca K.; Hulme, Kevin F.; Riordan, Jessica; Howard, Marlana; Hennessy, Dwight; Lewis, Kemper; Hawk, Larry; Wylie, Amanda; Pelham, William E.

2016-01-01

Objective Teenage drivers diagnosed with attention-deficit/hyperactivity disorder (ADHD) are at significant risk for negative driving outcomes related to morbidity and mortality. However, there are few viable psychosocial treatments for teens with ADHD and none focus on the key functional area of driving. The Supporting the Effective Entry to the Roadway (STEER) program was evaluated in a clinical trial to determine whether it improved family functioning as a proximal outcome and driving behavior as a distal outcome. Method One hundred seventy-two teenagers with ADHD, combined type, were randomly assigned to STEER or a driver education driver practice program (DEDP). Results Relative to parents in the DEDP condition, parents in STEER were observed to be less negative at post-treatment and 6-month follow-up, but not at 12-month follow-up and there were no significant differences for observed positive parenting. Relative to teens in the DEDP condition, teens in STEER reported lower levels of risky driving behaviors at post-treatment and six-month follow-up, but not at 12-month follow-up. They were not observed to differ on objective observations of risky driving or citations/accidents. Conclusions The STEER program for novice drivers with ADHD was effective in reducing observations of negative parenting behavior and teen self reports of risky driving relative to DEDP; groups did not significantly differ on observations of positive parenting or driving behaviors. Public Health Significance Statement Families with a teenager with ADHD may benefit from engaging in behavioral parent training around the transition to independent driving, especially via reductions in negative parenting. Teenagers with ADHD self-reported fewer risky driving behaviors within the family-focused intervention, but these findings were not replicated on objective observations of driving. PMID:27618640

The combination of two training approaches to improve older adults' driving safety.

PubMed

Bédard, Michel; Porter, Michelle M; Marshall, Shawn; Isherwood, Ivy; Riendeau, Julie; Weaver, Bruce; Tuokko, Holly; Molnar, Frank; Miller-Polgar, Jan

2008-03-01

An increasing number of older adults rely on the automobile for transportation. Educational approaches based on the specific needs of older drivers may help to optimize safe driving. We examined if the combination of an in-class education program with on-road education would lead to improvements in older drivers' knowledge of safe driving practices and on-road driving evaluations. We used a multisite, randomized controlled trial approach. Participants in the intervention group received the in-class and on-road education; those in the control group waited and were offered the education afterwards. We measured knowledge of safe driving practices before and after the in-class component of the program and on-road driving skills before and after the whole program. Participants' knowledge improved from 61% of correct answers before the in-class education component to 81% after (p < .001). The on-road evaluation results suggested improvements on some aspects of safe driving (e.g., moving in roadway, p < .05) but not on others. The results of this study demonstrate that education programs focused on the needs of older drivers may help improve their knowledge of safe driving practices and actual driving performance. Further research is required to determine if these changes will affect other variables such as driver confidence and crash rates.

Burden of malaria in mobile populations in the Greater Accra region, Ghana: a cross- sectional study.

PubMed

Diallo, Nouhoum; Akweongo, Patricia; Maya, Ernest; Aikins, Moses; Sarfo, Bismark

2017-03-09

The burden of malaria in mobile populations remains poorly documented in sub-Saharan Africa. This study determined the prevalence of malaria among hawkers and long-distance truck drivers in the Greater Accra region of Ghana. A cross-sectional design using consecutive sampling method between June and July 2016 in Accra and Tema in Ghana was used in this study. The study population was hawkers who roam and sleep in the Market Streets, and long-distance truck drivers. Participants completed closed ended interview questionnaires on socio-demographic characteristics, primary residence and knowledge about malaria. Rapid diagnostic test and thick blood smears of each participant were stained with Giemsa and read using microscopy. Geographical position system (GPS) was used to collect the station locations of these mobile populations. The overall prevalence of malaria was 15.1% and Plasmodium falciparum was responsible for all malaria infection. The malaria prevalence was 18.9 and 10.9% respectively among hawkers and truck drivers (p < 0.05). The hawkers, the single and the no formal educated participants were more likely to get malaria than the long-distance truck drivers (OR = 1.91, 95% CI 1.07-3.42), the married (OR = 1.94 95% CI 1.11-3.40) and the educated participants (OR = 2.56 95% CI 1.10-5.93), respectively. After controlling for other variables, marital status (OR = 2.60 95% CI 1.43- 4.73) and educational level (OR = 2.70 95% CI 1.08-6.77) were statistically significantly associated with malaria. This study demonstrated that the prevalence of malaria is high among hawkers and long distance truck drivers. Sociodemographic characteristics, such as marital status, occupation and educational level are significantly associated with malaria. The station locations as determined by GPS technology will make these mobile populations easier to reach for any malaria intervention.

Contrasting Causal Effects of Workplace Interventions.

PubMed

Izano, Monika A; Brown, Daniel M; Neophytou, Andreas M; Garcia, Erika; Eisen, Ellen A

2018-07-01

Occupational exposure guidelines are ideally based on estimated effects of static interventions that assign constant exposure over a working lifetime. Static effects are difficult to estimate when follow-up extends beyond employment because their identifiability requires additional assumptions. Effects of dynamic interventions that assign exposure while at work, allowing subjects to leave and become unexposed thereafter, are more easily identifiable but result in different estimates. Given the practical implications of exposure limits, we explored the drivers of the differences between static and dynamic interventions in a simulation study where workers could terminate employment because of an intermediate adverse health event that functions as a time-varying confounder. The two effect estimates became more similar with increasing strength of the health event and outcome relationship and with increasing time between health event and employment termination. Estimates were most dissimilar when the intermediate health event occurred early in employment, providing an effective screening mechanism.

Sharing control with haptics: seamless driver support from manual to automatic control.

PubMed

Mulder, Mark; Abbink, David A; Boer, Erwin R

2012-10-01

Haptic shared control was investigated as a human-machine interface that can intuitively share control between drivers and an automatic controller for curve negotiation. As long as automation systems are not fully reliable, a role remains for the driver to be vigilant to the system and the environment to catch any automation errors. The conventional binary switches between supervisory and manual control has many known issues, and haptic shared control is a promising alternative. A total of 42 respondents of varying age and driving experience participated in a driving experiment in a fixed-base simulator, in which curve negotiation behavior during shared control was compared to during manual control, as well as to three haptic tunings of an automatic controller without driver intervention. Under the experimental conditions studied, the main beneficial effect of haptic shared control compared to manual control was that less control activity (16% in steering wheel reversal rate, 15% in standard deviation of steering wheel angle) was needed for realizing an improved safety performance (e.g., 11% in peak lateral error). Full automation removed the need for any human control activity and improved safety performance (e.g., 35% in peak lateral error) but put the human in a supervisory position. Haptic shared control kept the driver in the loop, with enhanced performance at reduced control activity, mitigating the known issues that plague full automation. Haptic support for vehicular control ultimately seeks to intuitively combine human intelligence and creativity with the benefits of automation systems.

Association between commercial vehicle driver at-fault crashes involving sleepiness/fatigue and proximity to rest areas and truck stops.

PubMed

Bunn, Terry L; Slavova, Svetla; Rock, Peter J

2017-11-22

There is ongoing concern at the national level about the availability of adequate commercial vehicle rest areas and truck stops for commercial vehicle drivers to rest or to wait for a delivery window. A retrospective case-control study was conducted to determine the association between the occurrence of sleepiness/fatigue-related (cases) vs. all other human factor-related commercial vehicle driver at-fault crashes (controls) and proximity to rest areas, weigh stations with rest havens, and truck stops. Commercial vehicle driver at-fault crashes involving sleepiness/fatigue were more likely to occur on roadways where the nearest rest areas/weigh stations with rest havens/truck stops were located 20 miles or more from the commercial vehicle crash site (Odds Ratio [OR]=2.32; Confidence Interval [CI] 1.615, 3.335] for 20-39.9 miles vs. <20 miles; and OR=6.788 [CI 2.112, 21.812] for 40+ miles) compared to commercial vehicle at-fault driver crashes with human factors other than sleepiness/fatigue cited in crash reports. Commercial vehicle driver at-fault crashes involving sleepiness/fatigue also were more likely to occur on parkways compared to interstates (adjusted OR=3.747 [CI 2.83, 4.95]), during nighttime hours (adjusted OR=6.199 [CI 4.733, 8.119]), and on dry pavement (adjusted OR 1.909, [CI 1.373, 2.655]). The use of statewide crash data analysis coupled with ArcGIS mapping capabilities provided the opportunity to both statistically determine and to visualize the association between rest area/weigh station with rest haven/truck stop distance and the occurrence of commercial vehicle driver at-fault crashes involving sleepiness/fatigue. Implementation and evaluation of commercial vehicle employer policies and interventions such as the use of commercial vehicle driver fatigue alert systems may help to reduce fatigue and sleepiness in commercial vehicle drivers. These results can be used by state and local highway transportation officials to inform and increase truck parking availability, especially on parkways. Copyright © 2017 Elsevier Ltd. All rights reserved.

Improving the Safety of Aging Road Users – A Mini-Review

PubMed Central

Boot, Walter R.; Stothart, Cary; Charness, Neil

2014-01-01

Older drivers are at greatest risk for injury or death as a result of a car crash. In this mini-review we outline the normative age-related changes to perceptual, cognitive, and motor abilities that contribute to increased crash risk and decreased comfort with driving, and highlight specific driving scenarios and conditions that are particularly challenging for aging road users. Adopting a person-environment fit framework, we discuss how the roadway environment can be modified to better match the abilities of the aging driver. We also review evidence for the efficacy of training interventions intent on changing the abilities and strategies of the aging driver to better match the demands of the driving environment. Evidence suggests that specific changes to the roadway and driver training strategies can bring the abilities of the older driver back into alignment with the demands of the driving task. A focus on both approaches will help ensure the safety of all road users as the number of aging road users greatly increases over the next few decades. PMID:23989044

Explicit and implicit processes in behavioural adaptation to road width.

PubMed

Lewis-Evans, Ben; Charlton, Samuel G

2006-05-01

The finding that drivers may react to safety interventions in a way that is contrary to what was intended is the phenomenon of behavioural adaptation. This phenomenon has been demonstrated across various safety interventions and has serious implications for road safety programs the world over. The present research used a driving simulator to assess behavioural adaptation in drivers' speed and lateral displacement in response to manipulations of road width. Of interest was whether behavioural adaptation would occur and whether we could determine whether it was the result of explicit, conscious decisions or implicit perceptual processes. The results supported an implicit, zero perceived risk model of behavioural adaptation with reduced speeds on a narrowed road accompanied by increased ratings of risk and a marked inability of the participants to identify that any change in road width had occurred.

Economic viability of Stratified Medicine concepts: An investor perspective on drivers and conditions that favour using Stratified Medicine approaches in a cost-contained healthcare environment.

PubMed

Fugel, Hans-Joerg; Nuijten, Mark; Postma, Maarten

2016-12-25

Stratified Medicine (SM) is becoming a natural result of advances in biomedical science and a promising path for the innovation-based biopharmaceutical industry to create new investment opportunities. While the use of biomarkers to improve R&D efficiency and productivity is very much acknowledged by industry, much work remains to be done to understand the drivers and conditions that favour using a stratified approach to create economically viable products and to justify the investment in SM interventions as a stratification option. In this paper we apply a decision analytical methodology to address the economic attractiveness of different SM development options in a cost-contained healthcare environment. For this purpose, a hypothetical business case in the oncology market has been developed considering four feasible development scenarios. The article outlines the effects of development time and time to peak sales as key economic value drivers influencing profitability of SM interventions under specific conditions. If regulatory and reimbursement challenges can be solved, decreasing development time and enhancing early market penetration would most directly improve the economic attractiveness of SM interventions. Appropriate tailoring of highly differentiated patient subgroups is the prerequisite to leverage potential efficiency gains in the R&D process. Also, offering a better targeted and hence ultimately more cost-effective therapy at reimbursable prices will facilitate time to market access and allow increasing market share gains within the targeted populations. Copyright © 2016 Elsevier B.V. All rights reserved.

Identifying beliefs underlying pre-drivers' intentions to take risks: An application of the Theory of Planned Behaviour.

PubMed

Rowe, Richard; Andrews, Elizabeth; Harris, Peter R; Armitage, Christopher J; McKenna, Frank P; Norman, Paul

2016-04-01

Novice motorists are at high crash risk during the first few months of driving. Risky behaviours such as speeding and driving while distracted are well-documented contributors to crash risk during this period. To reduce this public health burden, effective road safety interventions need to target the pre-driving period. We use the Theory of Planned Behaviour (TPB) to identify the pre-driver beliefs underlying intentions to drive over the speed limit (N=77), and while over the legal alcohol limit (N=72), talking on a hand-held mobile phone (N=77) and feeling very tired (N=68). The TPB explained between 41% and 69% of the variance in intentions to perform these behaviours. Attitudes were strong predictors of intentions for all behaviours. Subjective norms and perceived behavioural control were significant, though weaker, independent predictors of speeding and mobile phone use. Behavioural beliefs underlying these attitudes could be separated into those reflecting perceived disadvantages (e.g., speeding increases my risk of crash) and advantages (e.g., speeding gives me a thrill). Interventions that can make these beliefs safer in pre-drivers may reduce crash risk once independent driving has begun. Copyright © 2015 Elsevier Ltd. All rights reserved.

Quantifying the drivers of water security risks in a complex northern deltaic ecosystem

NASA Astrophysics Data System (ADS)

Rokaya, P.; Wheater, H. S.; Lindenschmidt, K. E.

2017-12-01

There is still a need for improved, scientific evaluations of potential impacts of a changing flow regime on the northern deltaic ecosystems. This is particularly the case for the Slave River Delta (SRD) which is believed to be drying. Although streamflow regulation in the major headwater tributary and climate change have been presented as major contributors of hydro-ecological change in the SRD, a wide range of drivers such as large scale water withdrawal, land-use change and flow modulation by the upstream delta (i.e. the Peace-Athabasca Delta) could pose challenges to water security. However, limited numbers of studies with inadequate data make it difficult to understand the principal drivers of the hydro-ecological changes. One of the least explored drivers is the upstream delta which attenuates the peak flows, retains the floodwater and reduces the downstream flood intensity. This can have significant impact on the productivity and ecological diversity of the SRD, which are governed by water and nutrient-rich sediment supplied during flood events. Thus, the Slave River basin presents a complex river system where multiple drivers are in interplay resulting in a different (new) flow regime. However, any river flow alterations could significantly affect this ecologically and socio-economically delicate ecosystem. In this study, we investigate the critical challenges related to water security in a complex deltaic ecosystem, quantifying the relative impacts of climate change, human interventions and the upstream delta on the SRD. We demonstrate that the sustainability issues of northern deltaic systems are dynamic, complex and multi-faceted, and require an understanding of intricate relationships and feedback mechanisms between human and natural systems.

Vehicle ownership and other predictors of teenagers risky driving behavior: Evidence from a naturalistic driving study.

PubMed

Gershon, Pnina; Ehsani, Johnathon; Zhu, Chunming; O'Brien, Fearghal; Klauer, Sheila; Dingus, Tom; Simons-Morton, Bruce

2018-06-08

Risky driving behavior may contribute to the high crash risk among teenage drivers. The current naturalistic driving study assessed predictors for teenagers' kinematic risky driving (KRD) behavior and the interdependencies between them. The private vehicles of 81 novice teenage drivers were equipped with data acquisition system that recorded driving kinematics, miles driven, and video recordings of the driver, passengers and the driving environment. Psychosocial measures were collected using questionnaires administered at licensure. Poisson regression analyses and model selection were used to assess factors associated with teens' risky driving behavior and the interactions between them. Driving own vs shared vehicle, driving during the day vs at night, and driving alone vs with passengers were significantly associated with higher KRD rates (Incidence rate ratios (IRRs) of 1.60, 1.41, and 1.28, respectively). Teenagers reporting higher vs lower levels of parental trust had significantly lower KRD rates (IRR = 0.58). KRD rates were 88% higher among teenagers driving with a passenger in their own vehicle compared to teenagers driving with a passenger in a shared vehicle. Similarly, KRD rates during the day were 74% higher among teenagers driving their own vehicle compared to those driving a shared vehicle. Novice teenagers' risky driving behavior varied according to driver attributes and contextual aspects of the driving environment. As such, examining teenagers' risky driving behavior should take into account multiple contributing factors and their interactions. The variability in risky driving according to the driving context can inform the development of targeted interventions to reduce the crash risk of novice teenage drivers. Copyright © 2018 Elsevier Ltd. All rights reserved.

Prediction of Chinese Drivers' Intentions to Park Illegally in Emergency Lanes: An Application of the Theory of Planned Behavior.

PubMed

Zheng, Yubing; Ma, Yang; Guo, Lixin; Cheng, Jianchuan; Zhang, Yunlong

2018-06-21

Illegal parking in emergency lanes (paved highway shoulders) is becoming a serious road safety issue in China. The aim of this study was: 1) to examine the utility of the theory of planned behavior (TPB) extended with descriptive norm, past behavior, facilitating and deterring circumstances, sensation seeking and invulnerability in predicting Chinese drivers' intentions in illegal emergency lane parking; 2) to investigate whether respondents' demographic characteristics would impact their views towards the behavior and predictive patterns of intentions; 3) to identify significant predictors of intentions. In this cross-sectional study, eligible respondents were all qualified Chinese drivers. A self-administered questionnaire was employed to collect data including demographic information, descriptive norm, past behavior, facilitating and deterring circumstances, sensation seeking and scenario-based invulnerability combined with TPB constructs. Descriptive statistics, MANOVAs and a series of hierarchical multiple linear regression analyses were conducted in SPSS. A total of 435 qualified drivers (234 males and 201 females) with a mean age of 35.2 years (S.D.=10.3) were included in analysis. The descriptive analysis showed that most participants reported weak intentions (M = 2.35) to park illegally in emergency lanes with negative attitude (M = 3.19), low perceived support (M = 2.91) and high control (M = 5.08) over the behavior. The model succeeded in explaining 64% of the variance in intentions for the whole sample, and principal TPB components accounted for 21% of variance in intentions after demographic variables were controlled. MANOVAs revealed that significant differences of respondents' opinions towards illegal emergency lane parking were only found between better-educated drivers (with college education background) and less-educated ones. Separate regression analyses revealed that predictive pattern of better-educated participants also differed significantly from that of less-educated ones. The study revealed that perceived behavioral control, past behavior, facilitating circumstance and invulnerability emerged as consistently significant predictors of Chinese drivers' intentions to park illegally in emergency lanes. Findings of this study may have some practical implications in developing multi-faced interventions or education process for illegal emergency lane parking in China.

Fully Automated Driving: Impact of Trust and Practice on Manual Control Recovery.

PubMed

Payre, William; Cestac, Julien; Delhomme, Patricia

2016-03-01

An experiment was performed in a driving simulator to investigate the impacts of practice, trust, and interaction on manual control recovery (MCR) when employing fully automated driving (FAD). To increase the use of partially or highly automated driving efficiency and to improve safety, some studies have addressed trust in driving automation and training, but few studies have focused on FAD. FAD is an autonomous system that has full control of a vehicle without any need for intervention by the driver. A total of 69 drivers with a valid license practiced with FAD. They were distributed evenly across two conditions: simple practice and elaborate practice. When examining emergency MCR, a correlation was found between trust and reaction time in the simple practice group (i.e., higher trust meant a longer reaction time), but not in the elaborate practice group. This result indicated that to mitigate the negative impact of overtrust on reaction time, more appropriate practice may be needed. Drivers should be trained in how the automated device works so as to improve MCR performance in case of an emergency. The practice format used in this study could be used for the first interaction with an FAD car when acquiring such a vehicle. © 2015, Human Factors and Ergonomics Society.

Motorcycle rider conspicuity and crash related injury: case-control study.

PubMed

Wells, Susan; Mullin, Bernadette; Norton, Robyn; Langley, John; Connor, Jennie; Lay-Yee, Roy; Jackson, Rod

2004-04-10

To investigate whether the risk of motorcycle crash related injuries is associated with the conspicuity of the driver or vehicle. Population based case-control study. Auckland region of New Zealand from February 1993 to February 1996. 463 motorcycle drivers (cases) involved in crashes leading to hospital treatment or death; 1233 motorcycle drivers (controls) recruited from randomly selected roadside survey sites. Estimates of relative risk of motorcycle crash related injury and population attributable risk associated with conspicuity measures, including the use of reflective or fluorescent clothing, headlight operation, and colour of helmet, clothing, and motorcycle. Crash related injuries occurred mainly in urban zones with 50 km/h speed limit (66%), during the day (63%), and in fine weather (72%). After adjustment for potential confounders, drivers wearing any reflective or fluorescent clothing had a 37% lower risk (multivariate odds ratio 0.63, 95% confidence interval 0.42 to 0.94) than other drivers. Compared with wearing a black helmet, use of a white helmet was associated with a 24% lower risk (multivariate odds ratio 0.76, 0.57 to 0.99). Self reported light coloured helmet versus dark coloured helmet was associated with a 19% lower risk. Three quarters of motorcycle riders had their headlight turned on during the day, and this was associated with a 27% lower risk (multivariate odds ratio 0.73, 0.53 to 1.00). No association occurred between risk and the frontal colour of drivers' clothing or motorcycle. If these odds ratios are unconfounded, the population attributable risks are 33% for wearing no reflective or fluorescent clothing, 18% for a non-white helmet, 11% for a dark coloured helmet, and 7% for no daytime headlight operation. Low conspicuity may increase the risk of motorcycle crash related injury. Increasing the use of reflective or fluorescent clothing, white or light coloured helmets, and daytime headlights are simple, cheap interventions that could considerably reduce motorcycle crash related injury and death.

Motorcycle rider conspicuity and crash related injury: case-control study

PubMed Central

Wells, Susan; Mullin, Bernadette; Norton, Robyn; Langley, John; Connor, Jennie; Lay-Yee, Roy; Jackson, Rod

2004-01-01

Objective To investigate whether the risk of motorcycle crash related injuries is associated with the conspicuity of the driver or vehicle. Design Population based case-control study. Setting Auckland region of New Zealand from February 1993 to February 1996. Participants 463 motorcycle drivers (cases) involved in crashes leading to hospital treatment or death; 1233 motorcycle drivers (controls) recruited from randomly selected roadside survey sites. Main outcome measures Estimates of relative risk of motorcycle crash related injury and population attributable risk associated with conspicuity measures, including the use of reflective or fluorescent clothing, headlight operation, and colour of helmet, clothing, and motorcycle. Results Crash related injuries occurred mainly in urban zones with 50 km/h speed limit (66%), during the day (63%), and in fine weather (72%). After adjustment for potential confounders, drivers wearing any reflective or fluorescent clothing had a 37% lower risk (multivariate odds ratio 0.63, 95% confidence interval 0.42 to 0.94) than other drivers. Compared with wearing a black helmet, use of a white helmet was associated with a 24% lower risk (multivariate odds ratio 0.76, 0.57 to 0.99). Self reported light coloured helmet versus dark coloured helmet was associated with a 19% lower risk. Three quarters of motorcycle riders had their headlight turned on during the day, and this was associated with a 27% lower risk (multivariate odds ratio 0.73, 0.53 to 1.00). No association occurred between risk and the frontal colour of drivers' clothing or motorcycle. If these odds ratios are unconfounded, the population attributable risks are 33% for wearing no reflective or fluorescent clothing, 18% for a non-white helmet, 11% for a dark coloured helmet, and 7% for no daytime headlight operation. Conclusions Low conspicuity may increase the risk of motorcycle crash related injury. Increasing the use of reflective or fluorescent clothing, white or light coloured helmets, and daytime headlights are simple, cheap interventions that could considerably reduce motorcycle crash related injury and death. PMID:14742349

Flood risk (d)evolution: Disentangling key drivers of flood risk change with a retro-model experiment.

PubMed

Zischg, Andreas Paul; Hofer, Patrick; Mosimann, Markus; Röthlisberger, Veronika; Ramirez, Jorge A; Keiler, Margreth; Weingartner, Rolf

2018-05-19

Flood risks are dynamically changing over time. Over decades and centuries, the main drivers for flood risk change are influenced either by perturbations or slow alterations in the natural environment or, more importantly, by socio-economic development and human interventions. However, changes in the natural and human environment are intertwined. Thus, the analysis of the main drivers for flood risk changes requires a disentangling of the individual risk components. Here, we present a method for isolating the individual effects of selected drivers of change and selected flood risk management options based on a model experiment. In contrast to purely synthetic model experiments, we built our analyses upon a retro-model consisting of several spatio-temporal stages of river morphology and settlement structure. The main advantage of this approach is that the overall long-term dynamics are known and do not have to be assumed. We used this model setup to analyse the temporal evolution of the flood risk, for an ex-post evaluation of the key drivers of change, and for analysing possible alternative pathways for flood risk evolution under different governance settings. We showed that in the study region the construction of lateral levees and the consecutive river incision are the main drivers for decreasing flood risks over the last century. A rebound effect in flood risk can be observed following an increase in settlements since the 1960s. This effect is not as relevant as the river engineering measures, but it will become increasingly relevant in the future with continued socio-economic growth. The presented approach could provide a methodological framework for studying pathways for future flood risk evolvement and for the formulation of narratives for adapting governmental flood risk strategies to the spatio-temporal dynamics in the built environment. Copyright © 2018 Elsevier B.V. All rights reserved.

Sharing the responsibility for driver distraction across road transport systems: a systems approach to the management of distracted driving.

PubMed

Young, Kristie L; Salmon, Paul M

2015-01-01

Distracted driving is acknowledged universally as a large and growing road safety problem. Compounding the problem is that distracted driving is a complex, multifaceted issue influenced by a multitude of factors, organisations and individuals. As such, management of the problem is not straightforward. Numerous countermeasures have been developed and implemented across the globe. The vast majority of these measures have derived from the traditional reductionist, driver-centric approach to distraction and have failed to fully reflect the complex mix of actors and components that give rise to drivers becoming distracted. An alternative approach that is gaining momentum in road safety is the systems approach, which considers all components of the system and their interactions as an integrated whole. In this paper, we review the current knowledge base on driver distraction and argue that the systems approach is not currently being realised in practice. Adopting a more holistic, systems approach to distracted driving will not only improve existing knowledge and interventions from the traditional approach, but will enhance our understanding and management of distraction by considering the complex relationships and interactions of the multiple actors and the myriad sources, enablers and interventions that make up the distracted driving system. It is only by recognising and understanding how all of the system components work together to enable distraction to occur, that we can start to work on solutions to help mitigate the occurrence and consequences of distracted driving. Copyright © 2014 Elsevier Ltd. All rights reserved.

Undergraduate-driven interventions to increase representation in science classrooms

NASA Astrophysics Data System (ADS)

Freilich, M.; Aluthge, D.; Bryant, R. M.; Knox, B.; McAdams, J.; Plummer, A.; Schlottman, N.; Stanley, Z.; Suglia, E.; Watson-Daniels, J.

2014-12-01

Recognizing that racial, ethnic, and gender underrepresentation in science classrooms persists despite intervention programs and institutional commitments to diversity, a group of undergraduates from a variety of backgrounds and academic disciplines came together for a group independent study to (a) study the theoretical foundations of the current practice of science and of programs meant to increase diversity, (b) utilize the experiences of course participants and our peers to better understand the drivers of underrepresentation, and (c) design and implement interventions at Brown University. We will present on individual and small group projects designed by course members in collaboration with faculty. The projects emerged from an exploration of literature in history, philosophy, and sociology of science, as well as an examination of anthropological and psychological studies. We also evaluated the effectiveness of top-down and bottom-up approaches that have already been attempted in developing our projects. They focus on the specific problems faced by underrepresented minorities, women, LGBTQ+ people, and well-represented minorities. We will share experiences of faculty-student collaboration and engaged scholarship focused on representation in science and discuss student-designed interventions.

Neonatal, infant and under-five mortalities in Nigeria: An examination of trends and drivers (2003-2013)

PubMed Central

Fagbamigbe, Adeniyi Francis

2017-01-01

Neonatal (NMR), infant (IMR) and under-five (U5M) mortality rates remain high in Nigeria. Evidence-based knowledge of trends and drivers of child mortality will aid proper interventions needed to combat the menace. Therefore, this study assessed the trends and drivers of NMR, IMR, and U5M over a decade in Nigeria. A nationally representative data from three consecutive Nigeria Demographic and Household Surveys (NDHS) was used. A total of 66,158 live births within the five years preceding the 2003 (6029), 2008 (28647) and 2013 (31482) NDHS were included in the analyses. NMR was computed using proportions while IMR and U5 were computed using life table techniques embedded in Stata version 12. Probit regression model and its associated marginal effects were used to identify the predisposing factors to NMR, IMR, and U5M. The NMR, IMR, and U5M per 1000 live births in 2003, 2008 and 2013 were 52, 41, 39; 100, 75, 69; and 201, 157, 128 respectively. The NMR, IMR, and U5M were consistently lower among children whose mothers were younger, living in rural areas and from richer households. Generally, the probability of neonate death in 2003, 2008 and 2013 were 0.049, 0.039 and 0.038 respectively, the probability of infant death was 0.093, 0.071 and 0.064 while the probability of under-five death was 0.140, 0.112 and 0.092 for the respective survey years. While adjusting for other variables, the likelihood of infant and under-five deaths was significantly reduced across the survey years. Maternal age, mothers’ education, place of residence, child’s sex, birth interval, weight at birth, skill of birth attendant, delivery by caesarean operation or not significantly influenced NMR, IMR, and U5M. The NMR, IMR, and U5M in Nigeria reduced over the studied period. Multi-sectoral interventions targeted towards the identified drivers should be instituted to improve child survival. PMID:28793340

Effectiveness of Interventions for Prevention of Road Traffic Injuries in Iran and Some Methodological Issues: A Systematic Review.

PubMed

Azami-Aghdash, Saber; Sadeghi-Bazarghani, Homayoun; Heydari, Mahdiyeh; Rezapour, Ramin; Derakhshani, Naser

2018-04-01

To review the effectiveness of Road Traffic Injuries (RTIs) interventions implemented for prevention of RTIs in Iran and to introduce some methodological issues. Required data in this systematic review study were collected through searching the following key words: "Road Traffic Injuries", "Road Traffic accidents", "Road Traffic crashes", "prevention", and Iran in PubMed, Cochrane Library electronic databases, Google Scholar, Scopus, MagIran, SID and IranMedex. Some of the relevant journals and web sites searched manually. Reference lists of the selected articles were also checked. Gray literature search and expert contact was also conducted. Out of 569 retrieved articles, finally 8 articles included. Among the included studies the effectiveness of 10 interventions were assessed containing: seat belt, enforcements of laws and legislations, educational program, wearing helmet, Antilock Braking System (ABS), motorcyclists' penalty enforcement, pupil liaisons' education, provisional driver licensing, Road bumps and traffic improvement's plans. In 7 studies (9 interventions) reduction of RTIs rate were reported. Decreased rate of mortality from RTIs were reported in three studies. Only one study had mentioned financial issue (Anti-lock Brake System intervention). Inadequate data sources, inappropriate selection of statistical index and not mention about the control of Confounding Variables (CV), the most common methodological issues were. The results of most interventional studies conducted in Iran supported the effect of the interventions on reduction of RTIs. However due to some methodological or reporting shortcoming the results of these studies should be interpreted cautiously.

Prevalence of Metabolic Syndrome in Iranian Professional Drivers: Results from a Population Based Study of 12,138 Men

PubMed Central

Mohebbi, Iraj; Saadat, Soheil; Aghassi, Mohammadreza; Shekari, Mahsa; Matinkhah, Maghsuod; Sehat, Shadi

2012-01-01

Background It is evident that professional driving is associated with substantial changes in lifestyle habits. Professional drivers are prone to metabolic syndrome (MetS) and its complications because their working environment is characterized by numerous stress factors such as lack of physical activity due to working in a fixed position, disruption in diet, and irregular sleep habits. The aim of the present study was to estimate the prevalence of MetS among long distance drivers residing in West Azerbaijan province in Iran. Materials To assess the prevalence of metabolic syndrome among professional long distance drivers, 12138 participants were enrolled in this cross sectional study. The MetS was defined using International Diabetes Federation criteria. Results Among12138 participants, 3697 subjects found to be MetS. The crude and age-adjusted rates of MetS were 30.5% and 32.4% respectively. Based on Body mass index (BMI), 5027 subjects (41.4%) were overweight (BMI ≥25.01–30 kg/m2), and 2592 (21.3%) were obese (BMI ≥30.01 kg/m2). The presence of central obesity was more common than other components. The associations of MetS with BMI, pack-year smoking, age, weekly driving duration and driving experiences were significant in the logistic regression. By increasing BMI, pack-year smoking, age, weekly driving duration and driving experiences, odds ratio of MetS was increased. Conclusion The study suggests that MetS has become a noteworthy health problem among Iranian long distance drivers. This might be due to the following facts: sitting in a fixed position for long hours while working, cigarette smoking, job stress, unhealthy diet and lack of physical activity. Educational programs should be established for promoting healthy lifestyle and also for early detection and appropriate interventions PMID:22384075

The impacts of rest breaks and stretching exercises on lower back pain among commercial truck drivers in Iran.

PubMed

Ghasemi, Mohammad; Khoshakhlagh, Amir Hossein; Ghanjal, Ali; Yazdanirad, Saeid; Laal, Fereydoon

2018-06-07

This study aimed to determine the impacts of rest breaks and stretching exercises on lower back pain (LBP) in commercial truck drivers. This quasi-experiment was carried out on 92 truck drivers suffering from chronic LBP. Subjects were categorized into three groups (stretching exercises and rest breaks, rest breaks only and reference). Pain severity and related disability were measured at the beginning of the survey and after 6 and 12 weeks. The latter was assessed using the Oswestry low back pain disability questionnaire (OLBPDQ) and the Roland Morris questionnaire (RMQ). At the end of the intervention, the mean pain scores in the three groups were 2.72 ± 1.44, 4.11 ± 0.86 and 4.90 ± 1.31 respectively (p < 0.001). The OLBPDQ scores in group 1 (stretches and resting time breaks) were significantly lower than those in group 2 (rest break) (p = 0.009). The RMQ scores showed a significant reduction in group 1 compared with the other two groups (p = 0.001). Drivers in group 2 improved more significantly than those in group 3 regarding visual analog scale pain score (p = 0.049), OLBPDQ score (p = 0.024) and RMQ score (p = 0.011). This study provided converging results that supplementary exercises during break periods consistently help to minimize LBP and disability.

Older driver training using video and global positioning system technology--a randomized controlled trial.

PubMed

Porter, Michelle M

2013-05-01

There is emerging evidence that older driver training programs with on-road instruction are more effective than driver education programs that are conducted only in the classroom. Although most programs have provided this additional in-vehicle training with a driving instructor and a dual-braked vehicle, technology could assist in providing this feedback. It was hypothesized that participants who received video and global positioning system (GPS) feedback (Video group) in addition to classroom education would improve to a greater extent than those who received a classroom-based course alone (Education) or Control participants. Fifty-four participants (32 men and 22 women), 70-89 years old, randomized to one of the three groups, completed the study. All participants underwent pre- and postintervention driving tests, in their own vehicle, on a standardized route, that were recorded with video and GPS equipment. The Video group met with a driving instructor to receive feedback on their driving errors in their preintervention driving test. A blinded assessor scored all driving tests in random order. The Video group significantly reduced their driving errors by 25% (p < .05) following the intervention, whereas the other two groups did not change significantly. Fifty-two percent of participants from the Video group improved their global safety rating, whereas only 5.3% in the Control and 22.2% in the Education groups did. This study suggests that direct driving feedback using video and GPS technology could be an effective and novel means to provide older driver education.

Prevalence and correlates of poor sleep quality and daytime sleepiness in Belgian truck drivers.

PubMed

Braeckman, Lutgart; Verpraet, Rini; Van Risseghem, Marleen; Pevernagie, Dirk; De Bacquer, Dirk

2011-03-01

Sleepiness and sleep complaints are common among professional drivers. Sleepiness is a considerable problem not only because it affects the drivers' well-being, but also because of the consequences for performance and safety. Assessment of the (self-reported) prevalence and research into the risk factors are thus an important health issue and are also indispensable to prevent productivity loss and work-related accidents and injuries. Therefore, the aim of this study was to describe sleeping, driving, and health characteristics of Belgian truck drivers and to determine occupational and individual factors associated with poor sleep quality and daytime sleepiness. Cross-sectional data were collected using a self-administered questionnaire that included the Pittsburgh Sleep Quality Index (PSQI), Epworth Sleepiness Scale (ESS), and Berlin Questionnaire (BQ). The mean (SD) age of the 476 studied truck drivers was 42.7 (10.2) yrs and the mean (SD) body mass index was 27.3 (5.1) kg/m(2). Approximately 47% declared that they drove >50 h/wk and found their work schedule unrealistic. The mean (SD) PSQI score was 4.45 (2.7); poor quality of sleep (PSQI >5) was found in 27.2%. The mean (SD) ESS score was 6.79 (4.17); 18% had a score >10. The BQ indicated that 21.5% had a higher risk on obstructive sleep apnea. In multiple logistic regression analysis, low educational level (odds ratio [OR] 1.86), current smoking (OR 1.75), unrealistic work schedule (OR 1.75), and risk for obstructive sleep apnea (OR 2.97) were found to be independent correlates of daytime sleepiness. Poor sleep quality was significantly associated with poor self-perceived health (OR 1.95), unrealistic work schedule (OR 2.85), low job satisfaction (OR 1.91), and less driving experience (OR 1.73). These results show that poor sleep quality and daytime sleepiness were prevalent in Belgian truck drivers. Taking into account that several significant correlates with respect to these sleep problems were identified both at the individual and the occupational level, comprehensive countermeasures to improve working conditions and organization are needed, as well as health promotion interventions, to ensure the safety and well-being of truck drivers.

The effectiveness of interventions to treat hypothalamic obesity in survivors of childhood brain tumours: a systematic review.

PubMed

Wang, K-W; Chau, R; Fleming, A; Banfield, L; Singh, S K; Johnston, D L; Zelcer, S M; Rassekh, S R; Burrow, S; Valencia, M; de Souza, R J; Thabane, L; Samaan, M C

2017-08-01

Survivors of childhood brain tumours (SCBT) are at risk of type 2 diabetes and cardiovascular diseases. Obesity is a major driver of cardiometabolic diseases in the general population, and interventions that tackle obesity may lower the risk of these chronic diseases. The goal of this systematic review was to summarize current evidence for the presence of interventions to manage obesity, including hypothalamic obesity, in SCBT. The primary outcome of this review was the body mass index z-score change from baseline to the end of the intervention and/or follow-up. Literature searches were conducted in PsycINFO, CINAHL, the Cochrane Library, Medline, SPORTDiscus, EMBASE and PubMed. Two reviewers completed study evaluations independently. Eleven publications were included in this systematic review (lifestyle intervention n = 2, pharmacotherapy n = 6 and bariatric surgery n = 3). While some studies demonstrated effectiveness of interventions to manage obesity in SCBT and alter markers of obesity and cardiometabolic risk, the evidence base was limited and of low quality, and studies focused on hypothalamic obesity. We conclude that there is urgent need to conduct adequately powered trials of sufficient duration, using existing and novel therapies to manage obesity, reduce the burden of cardiometabolic disorders and improve outcomes in SCBT. © 2017 World Obesity Federation.

Driving under the influence of alcohol in Cali, Colombia: prevalence and consumption patterns, 2013.

PubMed

Bonilla-Escobar, Francisco J; Herrera-López, Martha L; Ortega-Lenis, Delia; Medina-Murillo, Jhon J; Fandiño-Losada, Andrés; Jaramillo-Molina, Ciro; Naranjo-Lujan, Salome; Izquierdo, Edda P; Vanlaar, Ward; Gutiérrez-Martínez, María I

2016-01-01

This study's goal was to establish the prevalence of driving under the influence of alcohol (DUI) and alcohol consumption patterns among drivers in Cali, Colombia, in 2013. A cross-sectional study based on a roadside survey using a stratified and multi-stage sampling design was developed. Thirty-two sites were chosen randomly for the selection of drivers who were then tested for blood alcohol concentration (BAC) and asked to participate in the survey. The prevalence of DUI was 0.88% (95% confidence intervals [95% CI] 0.26%-1.49%) with a lower prevalence when BAC was increasing. In addition, a higher prevalence was found during non-typical checkpoint hours (1.28, 95% CI -0.001%-0.03%). The overall prevalence is considered high, given the low alcohol consumption and vehicles per capita. Prevention measures are needed to reduce DUI during non-typical checkpoints and ongoing studies are required to monitor the trends and enable the assessment of interventions.

[Psychosocial aspects and accidents in land transport].

PubMed

Morales-Soto, Nelson; Alfaro-Basso, Daniel; Gálvez-Rivero, Wilfredo

2010-06-01

Road traffic accidents are a public health problem in Peru, having caused 35 596 deaths in Peru between 1998 and 2008. Lima is the most affected region, presenting 61.7% of the accidents, the annual cost reached one thousand million dollars, equivalent to a third part of the investment in health. Available studies give emphasis to the protagonists--the drivers, the pedestrians--or to equipment and roads; the laws have been modified and containment plans for accidents have been implemented, but the incidence remains the same. We raise the possibility of exploring behavioral and social factors that could be relevant in the genesis of the problem, revising those related to current disorder in transport, the behaviors of drivers and pedestrians and the permissiveness of society in general particularly of the authority. We propose research and a multidisciplinary and intersectoral intervention.

Steering teens safe: a randomized trial of a parent-based intervention to improve safe teen driving.

PubMed

Peek-Asa, Corinne; Cavanaugh, Joseph E; Yang, Jingzhen; Chande, Vidya; Young, Tracy; Ramirez, Marizen

2014-07-31

Crashes are the leading cause of death for teens, and parent-based interventions are a promising approach. We assess the effectiveness of Steering Teens Safe, a parent-focused program to increase safe teen driving. Steering Teens Safe aimed to improve parental communication with teens about safe driving using motivational interviewing techniques in conjunction with 19 safe driving lessons. A randomized controlled trial involved 145 parent-teen dyads (70 intervention and 75 control). Intervention parents received a 45-minute session to learn the program with four follow-up phone sessions, a DVD, and a workbook. Control parents received a standard brochure about safe driving. Scores were developed to measure teen-reported quantity and quality of parental communication about safe driving. The main outcome measure was a previously validated Risky Driving Score reported by teens. Because the Score was highly skewed, a generalized linear model based on a gamma distribution was used for analysis. Intervention teens ranked their parent's success in talking about driving safety higher than control teens (p = 0.035) and reported that their parents talked about more topics (non-significant difference). The Risky Driving Score was 21% lower in intervention compared to control teens (85% CI = 0.60, 1.00). Interaction between communication quantity and the intervention was examined. Intervention teens who reported more successful communication had a 42% lower Risky Driving Score (95% CI = 0.37, 0.94) than control parents with less successful communication. This program had a positive although not strong effect, and it may hold the most promise in partnership with other programs, such as Driver's Education or Graduated Driver's License policies. ClinicalTrials.gov NCT01014923. Registered Nov. 16, 2009.

[Transports: a strategic sector for our society].

PubMed

Giordano, R

2012-01-01

Transports are transmission belt of economies of different Countries. The time is the key variable, hence the economic finalism of transports that now is a theme of economic policy. The road transport sector, passengers and goods, is still a dominant sector that needs to be regulated in a market logic under the safety constraint understood in a system logic: infrastructure-vehicle-driver. The safety factor, understood as road and job safety, remains centered on the policies of intervention related to driver, whereas the most accidents in fact are due to factors related to human error and they cost in terms of social cost about 30 billion per year. The drivers' safety of commercial vehicles, professional vehicles, is a "human capital" that is little explored and that must be preserved.

Analysis of older driver safety interventions : a human factors taxonomic approach

DOT National Transportation Integrated Search

1999-03-01

The careful application of human factors design principles and guidelines is integral to : the development of safe, efficient and usable Intelligent Transportation Systems (ITS). One : segment of the driving population that may significantly benefit ...

A business case evaluation of workplace engineering noise control: a net-cost model.

PubMed

Lahiri, Supriya; Low, Colleen; Barry, Michael

2011-03-01

This article provides a convenient tool for companies to determine the costs and benefits of alternative interventions to prevent noise-induced hearing loss (NIHL). Contextualized for Singapore and in collaboration with Singapore's Ministry of Manpower, the Net-Cost model evaluates costs of intervention for equipment and labor, avoided costs of productivity losses and medical care, and productivity gains from the employer's economic perspective. To pilot this approach, four case studies are presented, with varying degrees of economic benefits to the employer, including one in which multifactor productivity is the main driver. Although compliance agencies may not require economic analysis of NIHL, given scarce resources in a market-driven economy, this tool enables stakeholders to understand and compare the costs and benefits of NIHL interventions comprehensively and helps in determining risk management strategies.

Violence and HIV/AIDS prevention among female out-of-school youths in southwestern Nigeria: lessons learnt from interventions targeted at hawkers and apprentices.

PubMed

Fawole, O I; Ajuwon, A J; Osungbade, K O

2004-12-01

Between 1997 and 2003, four studies on hawkers and apprentices in motor parks and work shops in south west, Nigeria were carried out to evaluate the effectiveness of interventions aimed at preventing HIV infection and gender based violence (GBV). The studies were in 3 phases namely baseline survey, intervention and end line survey. Interventions consisting of:--development and distribution of education materials and training programmes for the police, judiciary, instructors, drivers, traders and apprentices/hawkers, including micro-credit facilities were implemented in some of the studies. The major lessons learnt were that: Young girls working in the informal sector of the Nigerian economy face dual risks of HIV infection and GBV and yet they are seldom targets of intervention; Many had been victims of GBV and did not seek redress either because they accept it is their lot, are afraid of being stigmatized or are put off the prolonged legal system; Perpetrators tend to deny their involvement in violence; Despite the challenges involved, interventions implemented among female apprentices and hawkers, especially those that involve multiple stakeholders, made a difference in protecting this group from dual risks of GBV and HIV/AIDS infection. We recommend more intervention programmes for this population, and regulation of activities in the informal sector of the Nigerian economy.

Achieving Millennium Development Goals for health: building understanding, trust and capacity to respond.

PubMed

Downs, Timothy John; Larson, Heidi Jane

2007-10-01

Biomedical interventions promise achievement of health-related Millennium Development Goals provided social-, capacity- and knowledge-based constraints to scaling up and reaching marginalized people at risk, are addressed, and balance between prevention and treatment is struck. We argue for a new approach: multi-stakeholder capacity building and learning for empowerment: MuSCLE. MuSCLE is used as a way to frame three systemic weaknesses in traditional health science and policy approaches: (1) a lack of engagement with people at risk to build a collective understanding of the contexts of health problems, including social drivers; (2) a lack of multi-criteria evaluation of alternative interventions; (3) a lack of attention paid to integrated capacity building. The MuSCLE framework responds in three ways: (1) participatory assessment of the ecological, socio-cultural, economic and political contexts of health, identifying priorities using risk and vulnerability science, and modeling drivers; (2) selection among intervention alternatives that makes ecological, socio-cultural, economic and political tradeoffs transparent; (3) integrated capacity building for sustainable and adaptive interventions. Literature and field lessons support the argument, and guidelines are set down. A MuSCLE approach argues for a transformation in health science and policy in order to achieve Millennium Development Goals for health.

Prevalence of teen driver errors leading to serious motor vehicle crashes.

PubMed

Curry, Allison E; Hafetz, Jessica; Kallan, Michael J; Winston, Flaura K; Durbin, Dennis R

2011-07-01

Motor vehicle crashes are the leading cause of adolescent deaths. Programs and policies should target the most common and modifiable reasons for crashes. We estimated the frequency of critical reasons for crashes involving teen drivers, and examined in more depth specific teen driver errors. The National Highway Traffic Safety Administration's (NHTSA) National Motor Vehicle Crash Causation Survey collected data at the scene of a nationally representative sample of 5470 serious crashes between 7/05 and 12/07. NHTSA researchers assigned a single driver, vehicle, or environmental factor as the critical reason for the event immediately leading to each crash. We analyzed crashes involving 15-18 year old drivers. 822 teen drivers were involved in 795 serious crashes, representing 335,667 teens in 325,291 crashes. Driver error was by far the most common reason for crashes (95.6%), as opposed to vehicle or environmental factors. Among crashes with a driver error, a teen made the error 79.3% of the time (75.8% of all teen-involved crashes). Recognition errors (e.g., inadequate surveillance, distraction) accounted for 46.3% of all teen errors, followed by decision errors (e.g., following too closely, too fast for conditions) (40.1%) and performance errors (e.g., loss of control) (8.0%). Inadequate surveillance, driving too fast for conditions, and distracted driving together accounted for almost half of all crashes. Aggressive driving behavior, drowsy driving, and physical impairments were less commonly cited as critical reasons. Males and females had similar proportions of broadly classified errors, although females were specifically more likely to make inadequate surveillance errors. Our findings support prioritization of interventions targeting driver distraction and surveillance and hazard awareness training. Copyright © 2010 Elsevier Ltd. All rights reserved.

Knowledge translation and implementation in spinal cord injury: a systematic review.

PubMed

Noonan, V K; Wolfe, D L; Thorogood, N P; Park, S E; Hsieh, J T; Eng, J J

2014-08-01

To conduct a systematic review examining the effectiveness of knowledge translation (KT) interventions in changing clinical practice and patient outcomes. MEDLINE/PubMed, CINAHL, EMBASE and PsycINFO were searched for studies published from January 1980 to July 2012 that reported and evaluated an implemented KT intervention in spinal cord injury (SCI) care. We reviewed and summarized results from studies that documented the implemented KT intervention, its impact on changing clinician behavior and patient outcomes as well as the facilitators and barriers encountered during the implementation. A total of 13 articles featuring 10 studies were selected and abstracted from 4650 identified articles. KT interventions included developing and implementing patient care protocols, providing clinician education and incorporating outcome measures into clinical practice. The methods (or drivers) to facilitate the implementation included organizing training sessions for clinical staff, introducing computerized reminders and involving organizational leaders. The methodological quality of studies was mostly poor. Only 3 out of 10 studies evaluated the success of the implementation using statistical analyses, and all 3 reported significant behavior change. Out of the 10 studies, 6 evaluated the effect of the implementation on patient outcomes using statistical analyses, with 4 reporting significant improvements. The commonly cited facilitators and barriers were communication and resources, respectively. The field of KT in SCI is in its infancy with only a few relevant publications. However, there is some evidence that KT interventions may change clinician behavior and improve patient outcomes. Future studies should ensure rigorous study methods are used to evaluate KT interventions.

Depression as a systemic syndrome: mapping the feedback loops of major depressive disorder.

PubMed

Wittenborn, A K; Rahmandad, H; Rick, J; Hosseinichimeh, N

2016-02-01

Depression is a complex public health problem with considerable variation in treatment response. The systemic complexity of depression, or the feedback processes among diverse drivers of the disorder, contribute to the persistence of depression. This paper extends prior attempts to understand the complex causal feedback mechanisms that underlie depression by presenting the first broad boundary causal loop diagram of depression dynamics. We applied qualitative system dynamics methods to map the broad feedback mechanisms of depression. We used a structured approach to identify candidate causal mechanisms of depression in the literature. We assessed the strength of empirical support for each mechanism and prioritized those with support from validation studies. Through an iterative process, we synthesized the empirical literature and created a conceptual model of major depressive disorder. The literature review and synthesis resulted in the development of the first causal loop diagram of reinforcing feedback processes of depression. It proposes candidate drivers of illness, or inertial factors, and their temporal functioning, as well as the interactions among drivers of depression. The final causal loop diagram defines 13 key reinforcing feedback loops that involve nine candidate drivers of depression. Future research is needed to expand upon this initial model of depression dynamics. Quantitative extensions may result in a better understanding of the systemic syndrome of depression and contribute to personalized methods of evaluation, prevention and intervention.

Depression as a systemic syndrome: mapping the feedback loops of major depressive disorder

PubMed Central

Wittenborn, A. K.; Rahmandad, H.; Rick, J.; Hosseinichimeh, N.

2016-01-01

Background Depression is a complex public health problem with considerable variation in treatment response. The systemic complexity of depression, or the feedback processes among diverse drivers of the disorder, contribute to the persistence of depression. This paper extends prior attempts to understand the complex causal feedback mechanisms that underlie depression by presenting the first broad boundary causal loop diagram of depression dynamics. Method We applied qualitative system dynamics methods to map the broad feedback mechanisms of depression. We used a structured approach to identify candidate causal mechanisms of depression in the literature. We assessed the strength of empirical support for each mechanism and prioritized those with support from validation studies. Through an iterative process, we synthesized the empirical literature and created a conceptual model of major depressive disorder. Results The literature review and synthesis resulted in the development of the first causal loop diagram of reinforcing feedback processes of depression. It proposes candidate drivers of illness, or inertial factors, and their temporal functioning, as well as the interactions among drivers of depression. The final causal loop diagram defines 13 key reinforcing feedback loops that involve nine candidate drivers of depression. Conclusions Future research is needed to expand upon this initial model of depression dynamics. Quantitative extensions may result in a better understanding of the systemic syndrome of depression and contribute to personalized methods of evaluation, prevention and intervention. PMID:26621339

Stress-related psychosocial factors at work, fatigue, and risky driving behavior in bus rapid transport (BRT) drivers.

PubMed

Useche, Sergio A; Ortiz, Viviola Gómez; Cendales, Boris E

2017-07-01

There is consistent scientific evidence that professional drivers constitute an occupational group that is highly exposed to work related stressors. Furthermore, several recent studies associate work stress and fatigue with unsafe and counterproductive work behaviors. This study examines the association between stress-related work conditions of Bus Rapid Transport (BRT) drivers and risky driving behaviors; and examines whether fatigue is a mechanism that mediates the association between the two. A sample of 524 male Bus Rapid Transit (BRT) operators were drawn from four transport companies in Bogotá, Colombia. The participants answered a survey which included an adapted version of the Driver Behavior Questionnaire (DBQ) for BRT operators, as well as the Effort-Reward Imbalance and Job Content Questionnaires, the Subjective Fatigue subscale of the Checklist Individual Strength (CIS) and the Need for Recovery after Work Scale (NFR). Utilizing Structural Equation Models (SEM) it was found that risky driving behaviors in BRT operators could be predicted through job strain, effort-reward imbalance and social support at work. It was also found that fatigue and need for recovery fully mediate the associations between job strain and risky driving, and between social support and risky driving, but not the association between effort/reward imbalance (ERI) and risky driving. The results of this study suggest that a) stress related working conditions (Job Strain, Social Support and ERI) are relevant predictors of risky driving in BRT operators, and b) that fatigue is the mechanism which links another kind of stress related to working conditions (job strain and low social support) with risky driving. The mechanism by which ERI increases risky driving in BRT operators remains unexplained. This research suggests that in addition to the individual centered stress-reduction occupational programs, fatigue management interventions aimed to changing some working conditions may reduce risky driving behaviors and promote safety in the professional drivers' jobs and on the road. Copyright © 2017 Elsevier Ltd. All rights reserved.

Cross-sectional surveillance study to phenotype lorry drivers' sedentary behaviours, physical activity and cardio-metabolic health.

PubMed

Varela-Mato, Veronica; O'Shea, Orlagh; King, James A; Yates, Thomas; Stensel, David J; Biddle, Stuart Jh; Nimmo, Myra A; Clemes, Stacy A

2017-06-21

Elevated risk factors for a number of chronic diseases have been identified in lorry drivers. Unhealthy lifestyle behaviours such as a lack of physical activity (PA) and high levels of sedentary behaviour (sitting) likely contribute to this elevated risk. This study behaviourally phenotyped UK lorry drivers' sedentary and non-sedentary behaviours during workdays and non-workdays and examined markers of drivers cardio-metabolic health. A transport company from the East Midlands, UK. A sample of 159 male heavy goods vehicle drivers (91% white European; (median (range)) age: 50 (24, 67) years) completed the health assessments. 87 (age: 50.0 (25.0, 65.0); body mass index (BMI): 27.7 (19.6, 43.4) kg/m 2 ) provided objective information on sedentary and non-sedentary time. Participants self-reported their sociodemographic information. Primary outcomes: sedentary behaviour and PA, assessed over 7 days using an activPAL3 inclinometer. Cardio-metabolic markers included: blood pressure (BP), heart rate, waist circumference (WC), hip circumference, body composition and fasted capillary blood glucose, triglycerides, high-density lipopreotein cholesterol, low-density lipoprotein cholesterol (LDL-C) and total cholesterol (TC) levels. These cardio-metabolic markers were treated as secondary outcomes. Lorry drivers presented an unhealthy cardio-metabolic health profile (median (IQR) systolic BP: 129 (108.5, 164) mm Hg; diastolic BP: 81 (63, 104) mm Hg; BMI: 29 (20, 47) kg/m 2 ; WC: 102 (77.5, 146.5) cm; LDL-C: 3 (1, 6) mmol/L; TC: 4.9 (3, 7.5) mmol/L). 84% were overweight or obese, 43% had type 2 diabetes or prediabetes and 34% had the metabolic syndrome. The subsample of lorry drivers with objective postural data (n=87) accumulated 13 hours/day and 8 hours/day of sedentary behaviour on workdays and non-workdays (p<0.001), respectively. On average, drivers accrued 12 min/day on workdays and 6 min/day on non-workdays of moderate-to-vigorous PA (MVPA). Lorry drivers demonstrate a high-risk cardio-metabolic profile and are highly sedentary and physically inactive. Interventions to reduce sitting and increase MVPA during breaks and leisure time to improve cardio-metabolic health are urgently needed. Educational programmes to raise awareness about diet and exercise are recommended. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Building Sustainable Professional Development Programs: Applying Strategies From Implementation Science to Translate Evidence Into Practice.

PubMed

Baldwin, Constance D; Chandran, Latha; Gusic, Maryellen E

2017-01-01

Multisite and national professional development (PD) programs for educators are challenging to establish. Use of implementation science (IS) frameworks designed to convert evidence-based intervention methods into effective health care practice may help PD developers translate proven educational methods and models into successful, well-run programs. Implementation of the national Educational Scholars Program (ESP) is used to illustrate the value of the IS model. Four adaptable elements of IS are described: (1) replication of an evidence-based model, (2) systematic stages of implementation, (3) management of implementation using three implementation drivers, and (4) demonstration of program success through measures of fidelity to proven models and sustainability. Implementation of the ESP was grounded on five established principles and methods for successful PD. The process was conducted in four IS stages over 10 years: Exploration, Installation, Initial Implementation, and Full Implementation. To ensure effective and efficient processes, attention to IS implementation drivers helped to manage organizational relationships, build competence in faculty and scholars, and address leadership challenges. We describe the ESP's fidelity to evidence-based structures and methods, and offer three examples of sustainability efforts that enabled achievement of targeted program outcomes, including academic productivity, strong networking, and career advancement of scholars. Application of IS frameworks to program implementation may help other PD programs to translate evidence-based methods into interventions with enhanced impact. A PD program can follow systematic developmental stages and be operationalized by practical implementation drivers, thereby creating successful and sustainable interventions that promote the academic vitality of health professions educators.

Enhancing older driver safety: A driving survey and evaluation of the CarFit program.

PubMed

Gaines, Jean M; Burke, Kasey L; Marx, Katherine A; Wagner, Mary; Parrish, John M

2011-10-01

To evaluate CarFit, an educational program designed to promote optimal alignment of driver with vehicle. A driving activity survey was sent to 727 randomly selected participants living in retirement communities. Drivers (n=195) were assigned randomly to CarFit intervention (n=83, M age=78.1) or Comparison (n=112, M age=79.6) groups. After 6months, participants completed a post-test of driving activity and CarFit recommendations. Nonconsenting drivers were older and participated in fewer driving activities. CarFit participation was moderate (71%) with 86% of the participants receiving recommendations. 60% followed the recommendations at the 6-month re-evaluation). The CarFit (67.6%) and Comparison (59.3%) groups reported at least one type of self-regulation of driving activity at baseline. There was no significant change in the driving behaviors at the six-month follow-up. CarFit was able to detect addressable opportunities that may contribute to the safety of older drivers. CarFit recommendations may need stronger reinforcement in order to be enacted by a participant. Copyright © 2011 National Safety Council and Elsevier Ltd. All rights reserved.

Google glass: a driver distraction cause or cure?

PubMed

Sawyer, Ben D; Finomore, Victor S; Calvo, Andres A; Hancock, P A

2014-11-01

We assess the driving distraction potential of texting with Google Glass (Glass), a mobile wearable platform capable of receiving and sending short-message-service and other messaging formats. A known roadway danger, texting while driving has been targeted by legislation and widely banned. Supporters of Glass claim the head-mounted wearable computer is designed to deliver information without concurrent distraction. Existing literature supports the supposition that design decisions incorporated in Glass might facilitate messaging for drivers. We asked drivers in a simulator to drive and use either Glass or a smartphone-based messaging interface, then interrupted them with an emergency brake event. Both the response event and subsequent recovery were analyzed. Glass-delivered messages served to moderate but did not eliminate distracting cognitive demands. A potential passive cost to drivers merely wearing Glass was also observed. Messaging using either device impaired driving as compared to driving without multitasking. Glass in not a panacea as some supporters claim, but it does point the way to design interventions that effect reduced load in multitasking. Discussions of these identified benefits are framed within the potential of new in-vehicle systems that bring both novel forms of distraction and tools for mitigation into the driver's seat.

Poor weight control, alcoholic beverage consumption and sudden sleep onset at the wheel among Italian truck drivers: A preliminary pilot study.

PubMed

Rosso, Gian Luca; Montomoli, Cristina; Candura, Stefano M

2016-01-01

The aim of this study was to investigate the prevalence of obesity, alcoholic beverage consumption, unhealthy alcohol use and sudden sleep onset at the wheel among Italian truck drivers. In addition to prevalence rates, this study also aimed at investigating potential predictors for sudden-onset sleepiness and obesity. A sample of truck drivers was extracted from the database of the High Risk Professional Driver Study. Data concerning demographics, anthropometry, medical information and working conditions were collected using anonymous questionnaires. Logistic regression analyses were performed to assess the association of the reported body mass index (BMI), alcohol consumption and sudden sleep onset with working conditions and general lifestyle factors. Three hundred and thirty-five questionnaires were collected. According to their BMI, 45% of the participants were overweight and 21.4% of them were obese. Twenty-four point two percent declared they drank alcoholic beverages during working hours or work breaks and 21.3% of the drivers had an Alcohol Use Disorders Identification Test Consumption (AUDIT C) score ≥ 5 (the threshold value for unhealthy alcohol use). Forty-one point six percent of the interviewees experienced one episode of sudden sleep onset at the wheel per month (5.5% per week and 0.9% daily). Predictive factors for obesity were: length of service (odds ratio (OR) = 1.09, confidence interval (95% CI): 1.04-1.15, p < 0.001) and the AUDIT C total score (OR = 1.34, 95% CI: 1.08-1.66, p = 0.008). Predictive factors for sudden-onset sleepiness at the wheel were: age > 55 years old (OR = 5.22, 95% CI: 1.29-21.1, p = 0.020), driving more than 50 000 km per year (OR = 2.89, 95% CI: 1.37-6.11, p = 0.006) and the Chalder Fatigue Questionnaire (CFQ) score > 11 (adjusted OR = 2.97, 95% CI: 1.22-7.21, p = 0.016). This study strongly emphasizes the need for intervention in order to reduce and prevent important risk factors for the sake of road safety and truck drivers' health. This work is available in Open Access model and licensed under a CC BY-NC 3.0 PL license.

HIV risk and preventive interventions in transgender women sex workers.

PubMed

Poteat, Tonia; Wirtz, Andrea L; Radix, Anita; Borquez, Annick; Silva-Santisteban, Alfonso; Deutsch, Madeline B; Khan, Sharful Islam; Winter, Sam; Operario, Don

2015-01-17

Worldwide, transgender women who engage in sex work have a disproportionate risk for HIV compared with natal male and female sex workers. We reviewed recent epidemiological research on HIV in transgender women and show that transgender women sex workers (TSW) face unique structural, interpersonal, and individual vulnerabilities that contribute to risk for HIV. Only six studies of evidence-based prevention interventions were identified, none of which focused exclusively on TSW. We developed a deterministic model based on findings related to HIV risks and interventions. The model examines HIV prevention approaches in TSW in two settings (Lima, Peru and San Francisco, CA, USA) to identify which interventions would probably achieve the UN goal of 50% reduction in HIV incidence in 10 years. A combination of interventions that achieves small changes in behaviour and low coverage of biomedical interventions was promising in both settings, suggesting that the expansion of prevention services in TSW would be highly effective. However, this expansion needs appropriate sustainable interventions to tackle the upstream drivers of HIV risk and successfully reach this population. Case studies of six countries show context-specific issues that should inform development and implementation of key interventions across heterogeneous settings. We summarise the evidence and knowledge gaps that affect the HIV epidemic in TSW, and propose a research agenda to improve HIV services and policies for this population. Copyright © 2015 Elsevier Ltd. All rights reserved.

HIV risk and preventive interventions in transgender women sex workers

PubMed Central

Poteat, Tonia; Wirtz, Andrea L; Radix, Anita; Borquez, Annick; Silva-Santisteban, Alfonso; Deutsch, Madeline B; Khan, Sharful Islam; Winter, Sam; Operario, Don

2015-01-01

Worldwide, transgender women who engage in sex work have a disproportionate risk for HIV compared with natal male and female sex workers. We reviewed recent epidemiological research on HIV in transgender women and show that transgender women sex workers (TSW) face unique structural, interpersonal, and individual vulnerabilities that contribute to risk for HIV. Only six studies of evidence-based prevention interventions were identified, none of which focused exclusively on TSW. We developed a deterministic model based on findings related to HIV risks and interventions. The model examines HIV prevention approaches in TSW in two settings (Lima, Peru and San Francisco, CA, USA) to identify which interventions would probably achieve the UN goal of 50% reduction in HIV incidence in 10 years. A combination of interventions that achieves small changes in behaviour and low coverage of biomedical interventions was promising in both settings, suggesting that the expansion of prevention services in TSW would be highly effective. However, this expansion needs appropriate sustainable interventions to tackle the upstream drivers of HIV risk and successfully reach this population. Case studies of six countries show context-specific issues that should inform development and implementation of key interventions across heterogeneous settings. We summarise the evidence and knowledge gaps that affect the HIV epidemic in TSW, and propose a research agenda to improve HIV services and policies for this population. PMID:25059941

Gender-specific HIV prevention interventions for women who use alcohol and other drugs: The evolution of the science and future directions

PubMed Central

Wechsberg, Wendee M.; Deren, Sherry; Myers, Bronwyn; Kirtadze, Irma; Zule, William A.; Howard, Brittni; El-Bassel, Nabila

2015-01-01

The use of alcohol and other drugs (AODs) is an important driver of gender disparities in HIV prevalence. Consequently, there is a need for women-specific HIV interventions that are conceptualized to address (1) women’s risk behavior, their roles in sexual relationships, and gender power dynamics, and (2) other issues commonly faced by women who use AODs, such as gender-based violence and victimization. This article presents the evolution of HIV prevention intervention research with women who use AODs. It looks at three generations of women-focused HIV research interventions, including first-generation projects that started in the 1990s, second-generation efforts where projects expanded in scope and included adaptions of evidence-based interventions for global relevance, and finally third-generation projects currently underway that combine biobehavioral methods and are being implemented in real-world settings. Because women who use AODs continue to report risk behaviors related to HIV, emphasis should be placed on training scientists to conduct gender-specific studies, increasing funding for new studies, and advocating to ensure that stigma-free services are available for these at-risk women. PMID:25978479

What factors influence the production of orthopaedic research in East Africa? A qualitative analysis of interviews.

PubMed

Elliott, Iain S; Sonshine, Daniel B; Akhavan, Sina; Slade Shantz, Angelique; Caldwell, Amber; Slade Shantz, Jesse; Gosselin, Richard A; Coughlin, R Richard

2015-06-01

Research addressing the burden of musculoskeletal disease in low- and middle-income countries does not reflect the magnitude of the epidemic in these countries as only 9% of the world's biomedical resources are devoted to addressing problems that affect the health of 90% of the world's population. Little is known regarding the barriers to and drivers of orthopaedic surgery research in such resource-poor settings, the knowledge of which would help direct specific interventions for increasing research capacity and help surgeons from high-income countries support the efforts of our colleagues in low- and middle-income countries. We sought to identify through surveying academic orthopaedic surgeons in East Africa: (1) barriers impeding research, (2) factors that support or drive research, and (3) factors that were identified by some surgeons as barriers and others as drivers (what we term barrier-driver overlap) as they considered the production of clinical research in resource-poor environments. Semistructured interviews were conducted with 21 orthopaedic surgeon faculty members at four academic medical centers in Ethiopia, Kenya, Tanzania, and Uganda. Qualitative content analysis of the interviews was conducted using methods based in grounded theory. Grounded theory begins with qualitative data, such as interview transcripts, and analyzes the data for repeated ideas or concepts which then are coded and grouped into categories which allow for identification of subjects or problems that may not have been apparent previously to the interviewer. We identified and quantified 19 barriers to and 21 drivers of orthopaedic surgery research (mentioned n = 1688 and n = 1729, respectively). Resource, research process, and institutional domains were identified to categorize the barriers (n = 7, n = 5, n = 7, respectively) and drivers (n = 7, n = 8, n = 6, respectively). Resource barriers (46%) were discussed more often by interview subjects compared with the research process (26%) and institutional barriers (28%). Drivers of research discussed at least once were proportionally similar across the three domains. Some themes such as research ethics boards, technology, and literature access occurred with similar frequency as barriers to and drivers of orthopaedic surgery research. The barriers we identified most often among East African academic orthopaedic faculty members focused on resources to accomplish research, followed by institutional barriers, and method or process barriers. Drivers to be fostered included a desire to effect change, collaboration with colleagues, and mentorship opportunities. The identified barriers and drivers of research in East Africa provide a targeted framework for interventions and collaborations with surgeons and organizations from high-resource settings looking to be involved in global health.

Trial of a Novel Intervention to Improve Multiple Food Hygiene Behaviors in Nepal

PubMed Central

Gautam, Om Prasad; Schmidt, Wolf-Peter; Cairncross, Sandy; Cavill, Sue; Curtis, Valerie

2017-01-01

In this study, we report on the results of a trial of an intervention to improve five food hygiene behaviors among mothers of young children in rural Nepal. This novel intervention targeted five behaviors; cleanliness of serving utensils, handwashing with soap before feeding, proper storage of cooked food, and thorough reheating and water treatment. Based on formative research and a creative process using the Behavior-Centered Design approach, an innovative intervention package was designed and delivered over a period of 3 months. The intervention activities included local rallies, games, rewards, storytelling, drama, competitions linking with emotional drivers of behavior, and “kitchen makeovers” to disrupt behavior settings. The effect of the package on behavior was evaluated via a cluster-randomized before–after study in four villages with four villages serving as controls. The primary outcome was the difference in the mean cluster level proportions of mothers directly observed practicing all five food hygiene behaviors. The five targeted food hygiene behaviors were rare at baseline (composite performance of all five behaviors in intervention 1% [standard deviation (SD) = 2%] and in control groups 2% [SD = 2%]). Six weeks after the intervention, the target behaviors were more common in the intervention than in the control group (43% [SD = 14%] versus 2% [SD = 2%], P = 0.02) during follow-up. The intervention appeared to be equally effective in improving all five behaviors in all intervention clusters. This study shows that a theory-driven, systematic approach employing emotional motivators and modifying behavior settings was capable of substantially improving multiple food hygiene behaviors in Nepal. PMID:28719285

Trial of a Novel Intervention to Improve Multiple Food Hygiene Behaviors in Nepal.

PubMed

Gautam, Om Prasad; Schmidt, Wolf-Peter; Cairncross, Sandy; Cavill, Sue; Curtis, Valerie

2017-06-01

AbstractIn this study, we report on the results of a trial of an intervention to improve five food hygiene behaviors among mothers of young children in rural Nepal. This novel intervention targeted five behaviors; cleanliness of serving utensils, handwashing with soap before feeding, proper storage of cooked food, and thorough reheating and water treatment. Based on formative research and a creative process using the Behavior-Centered Design approach, an innovative intervention package was designed and delivered over a period of 3 months. The intervention activities included local rallies, games, rewards, storytelling, drama, competitions linking with emotional drivers of behavior, and "kitchen makeovers" to disrupt behavior settings. The effect of the package on behavior was evaluated via a cluster-randomized before-after study in four villages with four villages serving as controls. The primary outcome was the difference in the mean cluster level proportions of mothers directly observed practicing all five food hygiene behaviors. The five targeted food hygiene behaviors were rare at baseline (composite performance of all five behaviors in intervention 1% [standard deviation (SD) = 2%] and in control groups 2% [SD = 2%]). Six weeks after the intervention, the target behaviors were more common in the intervention than in the control group (43% [SD = 14%] versus 2% [SD = 2%], P = 0.02) during follow-up. The intervention appeared to be equally effective in improving all five behaviors in all intervention clusters. This study shows that a theory-driven, systematic approach employing emotional motivators and modifying behavior settings was capable of substantially improving multiple food hygiene behaviors in Nepal.

Effectiveness of Interventions for Prevention of Road Traffic Injuries in Iran and Some Methodological Issues: A Systematic Review

PubMed Central

Azami-Aghdash, Saber; Sadeghi-Bazarghani, Homayoun; Heydari, Mahdiyeh; Rezapour, Ramin; Derakhshani, Naser

2018-01-01

Objective: To review the effectiveness of Road Traffic Injuries (RTIs) interventions implemented for prevention of RTIs in Iran and to introduce some methodological issues. Methods: Required data in this systematic review study were collected through searching the following key words: "Road Traffic Injuries", "Road Traffic accidents", "Road Traffic crashes", “prevention”, and Iran in PubMed, Cochrane Library electronic databases, Google Scholar, Scopus, MagIran, SID and IranMedex. Some of the relevant journals and web sites searched manually. Reference lists of the selected articles were also checked. Gray literature search and expert contact was also conducted. Results: Out of 569 retrieved articles, finally 8 articles included. Among the included studies the effectiveness of 10 interventions were assessed containing: seat belt, enforcements of laws and legislations, educational program, wearing helmet, Antilock Braking System (ABS), motorcyclists' penalty enforcement, pupil liaisons’ education, provisional driver licensing, Road bumps and traffic improvement's plans. In 7 studies (9 interventions) reduction of RTIs rate were reported. Decreased rate of mortality from RTIs were reported in three studies. Only one study had mentioned financial issue (Anti-lock Brake System intervention). Inadequate data sources, inappropriate selection of statistical index and not mention about the control of Confounding Variables (CV), the most common methodological issues were. Conclusion: The results of most interventional studies conducted in Iran supported the effect of the interventions on reduction of RTIs. However due to some methodological or reporting shortcoming the results of these studies should be interpreted cautiously. PMID:29719838

Teen Drivers’ Perceptions of Inattention and Cell Phone Use While Driving

PubMed Central

Sommers, Marilyn S.

2015-01-01

Objective Inattention to the roadway, including cell phone use while driving (cell phone calls, sending and reading texts, mobile app use and internet use), is a critical problem for teen drivers and increases risk for crashes. Effective behavioral interventions for teens are needed in order to decrease teen driver inattention related to cell phone use while driving. However, teens’ perceptions of mobile device use while driving is a necessary component for theoretically driven behavior change interventions. The purpose of this study was to describe teen drivers’ perceptions of cell phone use while driving in order to inform future interventions to reduce risky driving. Methods We conducted seven focus groups with a total of 30 teen drivers, ages 16–18, licensed for ≤1 year in Pennsylvania. The focus group interview guide and analysis were based on the Theory of Planned Behavior, identifying the attitudes, perceived behavioral control, and norms about inattention to the roadway. Directed descriptive content analysis was used to analyze the focus group interviews. All focus groups were coded by two research team members and discrepancies were reconciled. Themes were developed based on the data. Results Teens had a mean age of 17.39 (sd 0.52), mean length of licensure of 173.7 days (sd 109.2; range 4–364), were 50% male and predominately white (90%) and non-Hispanic (97%). From the focus group data, three major themes emerged; (1) Recognizing the danger but still engaging; (2) Considering context; and (3) Formulating safer behaviors that might reduce risk. In spite of recognizing hand-held cell phone use, texting and social media app use are dangerous and distracting while driving, teens and their peers often engage in these behaviors. Teens described how the context of the situation contributed to whether a teen would place or answer a call, write or respond to a text, or use a social media app. Teens identified ways in which they controlled their behaviors, although some still drew attention away from the roadway. Conclusions Cell phone use while driving is a contributor to motor vehicle crashes in teens and effective interventions to decrease risks are needed. Teens viewed some types of cell phone use as unsafe and describe methods in which they control their behaviors. However, some of their methods still take attention off the primary task of driving. Teens could benefit from behavior change interventions that propose strategies to promote focused attention on the roadway at all times during the driving trip. PMID:26436243

Interventions and controls to prevent emergency service vehicle incidents: A mixed methods review.

PubMed

Bui, David P; Balland, Samantha; Giblin, Casey; Jung, Alesia M; Kramer, Sandy; Peng, Abigail; Aquino, Marie Corazon Ponce; Griffin, Stephanie; French, Dustin D; Pollack Porter, Keshia; Crothers, Steve; Burgess, Jefferey L

2018-06-01

Emergency service vehicle incidents (ESVI), including crashes, rollovers, and roadside struck-by-incidents, are a leading cause of occupational fatality and injury among firefighters and other emergency responders. Though there are numerous strategies and interventions to prevent ESVIs, the evidence base for these strategies is limited and dispersed. The goal of this study was to gather and present a review of evidence-based ESVI interventions. We searched five academic databases for articles published within the last decade featuring interventions to reduce or prevent ESVIs. We interviewed key informants from fire departments serving major metropolitan areas for additional interventions. Interventions from both sources were summarized and data on intervention effectiveness were reported when available. Sixty-five articles were included in the final review and 17 key informant interviews were completed. Most articles focused on vehicle engineering interventions (38%), followed by policy and administration interventions (26%), environmental engineering interventions (19%) and education or training (17%). Most key informants reported policy (49%) and training interventions (29%). Enhanced drivers' training and risk management programs were associated with 19-50% and 19-58% reductions in ESVIs, respectively. Only a limited number of interventions to address ESVIs had adequate outcome data. Based on the available data, training and risk management approaches may be particularly effective approaches to reducing ESVIs. Copyright © 2018 The Authors. Published by Elsevier Ltd.. All rights reserved.

Obstructive sleep apnea among express bus drivers in Malaysia: important indicators for screening.

PubMed

Yusoff, M Fadhli Mohd; Baki, Marina Mat; Mohamed, Norlen; Mohamed, A Sani; Yunus, M Razif Mohamad; Ami, Mazita; Othman, Ilhamah; Ishak, Azlan I

2010-12-01

Obstructive sleep apnea (OSA) has been identified as one of the significant risk factors for motor vehicle crashes (MVCs). In the interest of public safety, this study was conducted to determine the prevalence of OSA and its associated factors among express bus drivers in Malaysia. Identifying factors or conditions related with OSA is very important because they can be used as indicators to subject a person to a confirmatory diagnosis using polysomnography testing. Two hundred eighty-nine randomly selected express bus drivers from 5 express bus companies participated in the study. Information on demography, medical history, clinical symptoms, and signs of OSA were collected by a designated medical officer and the diagnosis of OSA was done based on the Apnea Hypopnoea Index (AHI) from polysomnography testing. Based on AHI, 128 (44.3%) subjects were diagnosed as having OSA with 83 (28.7%), 26 (9.0%), and 26 (6.6%) classified as mild, moderate, and severe OSA, respectively. Multiple logistic regression analysis results showed that age (odds ratio [OR] = 1.05, 95% confidence interval [CI] 1.01-1.09), snoring (OR = 3.54, 95% CI 1.91-6.57), body mass index (BMI; OR = 1.17, 95% CI 1.09-1.25), hypertension (OR = 1.87, 95% CI 1.02-3.40), and neck circumference (OR = 1.31, 95% CI 1.18-1.46) were significantly associated with OSA status. The results supported the need for identifying the risk group for OSA among express bus drivers and the need to diagnose them early for an early intervention.

Epidemiology of pedestrian–MVCs by road type in Cluj, Romania

PubMed Central

Hamann, Cara; Peek-Asa, Corinne; Rus, Diana

2017-01-01

Objective Pedestrian–motor vehicle (PMV) crash rates in Romania are among the highest in all of Europe. The purpose of this study was to examine the characteristics of pedestrian–MVCs in Cluj County, Romania, on the two major types of roadways: national or local. Methods Cluj County police crash report data from 2010 were used to identify pedestrian, driver and crash characteristics of pedestrian–MVCs. Crashes with available location data were geocoded and road type (national or local) for each crash was determined. Distributions of crash characteristics were examined by road type and multivariable logistic regression models were built to determine predictors of crash road type. Results Crashes occurring on national roads involved more teenagers and adults, while those on local roads involved more young children (0–12) and older adults (65+) (p<0.01). Crashes on national roads were more likely to have marked pedestrian crossings and shoulders compared with local crashes. Pedestrian–MVCs that involved a moving violation by the motorist were more likely to occur on national roadways (adjusted OR=1.93, 95% CI 1.07 to 3.49). Conclusions Pedestrian–MVCs pose a considerable health burden in Romania. Results from this study suggest that factors leading to PMV crashes on national roads are more likely to involve driver-related causes compared with local roads. Intervention priorities to reduce pedestrian crashes on national roads should be directed towards driver behaviour on national roads. Further examination of driver and pedestrian behaviours related to crash risk on both national and local roads, such as distraction and speeding, is warranted. PMID:25178278

Comparing daily drivers of problem drinking among older and younger adults: An electronic daily diary study using smartphones.

PubMed

Kuerbis, Alexis; Treloar Padovano, Hayley; Shao, Sijing; Houser, Jessica; Muench, Frederick J; Morgenstern, Jon

2018-02-01

By 2030, numbers and proportions of older adults with substance-use problems are expected to increase. While risk factors for problem drinking in late life have been identified, it remains unknown whether these factors drive daily drinking among older problem drinkers. This study examined the daily drivers of drinking among problem drinkers, moderated by age, utilizing ecological momentary assessment (EMA). Participants (N = 139), ages 20-73, received daily EMA online surveys completed via a smartphone prior to initiation of treatment. Multilevel modeling tested the moderating impact of age on within- and between-person relationships between drinking and focal predictors (mood, loneliness, boredom, stress, poor sleep, social factors, alcohol salience, commitment and confidence not to drink heavily). Older adults reported greater alcohol consumption when daily boredom levels were higher. Heavier drinking among younger adults was associated with poorer sleep quality. Greater daily confidence, daily commitment and daily alcohol salience did not impact drinking to the same extent for older adults as for younger adults. Greater person-level commitment predicted reduced drinking equivalently across age, but low person-level commitment predicted greater drinking among older adults compared to their younger counterparts. Older adults may have unique daily drivers of drinking that are not fully realized in current research and intervention efforts. Addressing the growing substance-use treatment needs among this population will require identifying the unique drivers of drinking among older adults, such as boredom, when compared to younger adults. Copyright © 2018 Elsevier B.V. All rights reserved.

Advancing gender equality to improve HIV prevention: A study of practice.

PubMed

Mannell, Jenevieve

2016-12-01

Addressing gender inequality as a social driver of HIV risk and vulnerability has become a key activity of non-governmental organisations (NGOs) in South Africa. This paper sheds light on the environmental factors that influence gender and HIV activities in this context. A multisite ethnographic study including 150 hours of participant observation and 32 in-depth interviews was conducted with 26 NGOs carrying out gender and HIV prevention interventions. Using thematic network analysis, 108 different intervention activities were identified, categorised and further analysed to explore environmental factors that influence the design and delivery of these activities. The findings highlight how practitioners draw on different theories of change about how to address the gender inequalities that contribute to HIV risk and vulnerability, which in turn influence the way interventions are delivered. Despite these theoretical differences, commonalities arise in practitioners' use of popular narratives about the right to health and lived experiences of AIDS to ensure interventions are contextually relevant and to gain buy-in from participants. Other environmental factors influencing intervention activities include the role that insecure funding for gender plays in undermining the capacity of practitioners to design interventions based on their local knowledge and experience by forcing NGOs to adapt to the priorities of international donors.

[Roadside observation on the use of safety belt in Guangzhou and Nanning cites of China].

PubMed

Li, Li-ping; Stevenson, Mark; Ivers, Rebecca; Zhou, Ying

2006-08-01

To determine the rates of correct use of safety belt (CUSB) among drivers and front seat passengers in Guangzhou and Nanning through roadside observation and to provide scientific evidence for the development of intervention plan and to strengthen road safety law enforcement. Observational sites were randomly selected from three road types (Highway, Main Street and Subordinate Street). Targeted automobiles were observed at each site at four different times and uniformed checklists were used to record safety belt use during observations. Within each vehicle, belt use by drivers of different sex, road type, workday/weekend, day/night and seating position were calculated. Data was analyzed, using Chi-square tests to compare the statistic significance. (1)The rate of CUSB and non-use rate among drivers were higher in Nanning than in Guangzhou (P= 0.00) but the rate of incorrect use was on the contrarary. (2) The rate of CUSB by front seat passengers in Guangzhou was higher than that in Nanning (P = 0.04); as well as the rate of (P = 0.00) incorrect use while the non-use rate was on the contrarary. (3)In general, the rate of CUSB was higher on highways than on local streets (P = 0.00). (4) The CUSB rate of drivers and front seat passengers was higher at daytime than at night (P = 0.00), and the rate of incorrect use was higher at working days than weekends (P = 0.00). (5) The CUSB rate was higher for female drivers than for males in Guangzhou (P = 0.00), but there no statistical significance was found in Nanning (P = 0.21). Results suggested that intervention actions should be undertaken to raise the awareness of the importance of safety belt use. Effective public information and education programs, law enforcement and mandatory safety belt use, prioritizing programs on people neglegent to the importance are necessary to increase the safety belt use and to decrease the mortality and injuries caused by traffic accidents.

Evaluation of an integrated multisector campaign to increase child helmet use in Vietnam.

PubMed

Nhan, Le Dinh Trong; Parker, Lukas; Son, Mai Thi Hoai; Parker, Erin M; Moore, Matthew R; Sidik, Mirjam; Draisin, Natalie

2017-11-25

This study presents child helmet use before, during and after implementing the Vietnamese National Child Helmet Action Plan (NCHAP) and evaluates its effect on child helmet use. The NCHAP, an integrated multisector campaign, incorporated a wide-scale public awareness campaign, school-based interventions, increased police patrolling and enforcement, and capacity building and support to relevant government departments in target provinces. In Vietnam's three largest cities, 100 schools in 20 districts were selected to monitor motorcycle helmet use behaviour. The effectiveness of the NCHAP was measured by unannounced, filmed observations of student motorcycle passengers and their adult drivers as they arrived or left their schools at four points. Baseline observations at each school were conducted in March 2014, with subsequent observations in April 2015, December 2015 and May 2016. Across the 84 218 observed students, student helmet prevalence increased from 36.1% in March 2014 to 69.3% immediately after the initiation in April 2015. Subsequent observations in December 2015 and May 2016 showed a reduction and stabilisation of helmet use, with 49.8% and 56.9% of students wearing helmets, respectively. Helmet use in students was higher when adult drivers were also wearing helmets. Integrated multisectoral interventions between governments, civil society and the corporate sector that incorporate communications, school-based education, incentives for change and police enforcement have the potential to increase helmet use among children. Future integrated campaigns may be more effective with an increased focus on parents and other adult drivers given their potential influence on child helmet use. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

The role of personality traits and driving experience in self-reported risky driving behaviors and accident risk among Chinese drivers.

PubMed

Tao, Da; Zhang, Rui; Qu, Xingda

2017-02-01

The purpose of this study was to explore the role of personality traits and driving experience in the prediction of risky driving behaviors and accident risk among Chinese population. A convenience sample of drivers (n=511; mean (SD) age=34.2 (8.8) years) completed a self-report questionnaire that was designed based on validated scales for measuring personality traits, risky driving behaviors and self-reported accident risk. Results from structural equation modeling analysis demonstrated that the data fit well with our theoretical model. While showing no direct effects on accident risk, personality traits had direct effects on risky driving behaviors, and yielded indirect effects on accident risk mediated by risky driving behaviors. Both driving experience and risky driving behaviors directly predicted accident risk and accounted for 15% of its variance. There was little gender difference in personality traits, risky driving behaviors and accident risk. The findings emphasized the importance of personality traits and driving experience in the understanding of risky driving behaviors and accident risk among Chinese drivers and provided new insight into the design of evidence-based driving education and accident prevention interventions. Copyright © 2016 Elsevier Ltd. All rights reserved.

Multidisciplinary studies of wildlife trade in primates: Challenges and priorities.

PubMed

Blair, Mary E; Le, Minh D; Sterling, Eleanor J

2017-11-01

Wildlife trade is increasingly recognized as an unsustainable threat to primate populations and informing its management is a growing focus and application of primatological research. However, management policies based on ecological research alone cannot address complex socioeconomic or cultural contexts as drivers of wildlife trade. Multidisciplinary research is required to understand trade complexity and identify sustainable management strategies. Here, we define multidisciplinary research as research that combines more than one academic discipline, and highlight how the articles in this issue combine methods and approaches to fill key gaps and offer a more comprehensive understanding of underlying drivers of wildlife trade including consumer demand, enforcement patterns, source population status, and accessibility of targeted species. These articles also focus on how these drivers interact at different scales, how trade patterns relate to ethics, and the potential effectiveness of different policy interventions in reducing wildlife trade. We propose priorities for future research on primate trade including expanding from multidisciplinary to interdisciplinary research questions and approaches co-created by research teams that integrate across different disciplines such as cultural anthropology, ecology, economics, and public policy. We also discuss challenges that limit the integration of information across disciplines to meet these priorities. © 2017 Wiley Periodicals, Inc.

Disentangling functions of online aggression: The Cyber-Aggression Typology Questionnaire (CATQ).

PubMed

Runions, Kevin C; Bak, Michal; Shaw, Thérèse

2017-01-01

Aggression in online contexts has received much attention over the last decade, yet there is a need for measures identifying the proximal psychological drivers of cyber-aggressive behavior. The purpose of this study was to present data on the newly developed Cyber-Aggression Typology Questionnaire (CATQ) designed to distinguish between four distinct types of cyber-aggression on dimensions of motivational valence and self-control. A sample 314 undergraduate students participated in the study. The results confirmed the predicted four-factor structure providing evidence for distinct and independent impulsive-aversive, controlled-aversive, impulsive-appetitive, and controlled-appetitive cyber-aggression types. Further analyses with the Berlin Cyberbullying Questionnaire, Reactive Proactive Aggression Questionnaire, and the Behavior Inhibition and Activation Systems Scale provide support for convergent and divergent validity. Understanding the motivations facilitating cyber-aggressive behavior could aid researchers in the development of new prevention and intervention strategies that focus on individual differences in maladaptive proximal drivers of aggression. Aggr. Behav. 43:74-84, 2017. © 2016 Wiley Periodicals, Inc. © 2016 Wiley Periodicals, Inc.

Field quantification of physical exposures of police officers in vehicle operation.

PubMed

McKinnon, Colin D; Callaghan, Jack P; Dickerson, Clark R

2011-01-01

Mobile police officers perform many of their daily duties in their vehicles. Combined workspace inflexibility and prolonged driving create potential musculoskeletal injury risks. Limited research exists that quantitatively describes postural and load exposures associated with mobile police work. The purpose of this study was to characterize officer activity during a typical workday and identify opportunities for ergonomic intervention. Digital video of traffic officers (N = 10) was used to classify postures according to work activity. Cumulative time in 10 activities was calculated, and a time-history of driver activity documented. Most (55.5 ± 13.4%) time was out of the vehicle, and 22.3 ± 10.5% was spent in single-arm driving. On paper documentation and mobile data terminal use were identified as in-car activities that may benefit from targeted interventions. The primary contribution of this study is characterization of daily mobile police activity and the identification of possible intervention strategies to mitigate physical exposure levels.

To delegate or not to delegate: A review of control frameworks for autonomous cars.

PubMed

Richards, Dale; Stedmon, Alex

2016-03-01

There have been significant advances in technology and automated systems that will eventually see the use of autonomous cars as commonplace on our roads. Various systems are already available that provide the driver with different levels of decision support. This paper highlights the key human factors issues associated with the interaction between the user and an autonomous system, including assistive decision support and the delegation of authority to the automobile. The level of support offered to the driver can range from traditional automated assistance, to system generated guidance that offers advice for the driver to act upon, and even more direct action that is initiated by the system itself without driver intervention. In many of these instances the role of the driver is slowly moving towards a supervisory role within a complex system rather than one of direct control of the vehicle. Different paradigms of interaction are considered and focus is placed on the partnership that takes place between the driver and the vehicle. Drawing on the wealth of knowledge that exists within the aviation domain and research literature that examines technology partnerships within the cockpit, this paper considers important factors that will assist the automotive community to understand the underlying issues of the human and their interaction within complex systems. Copyright © 2015 Elsevier Ltd and The Ergonomics Society. All rights reserved.

Reducing intraoperative red blood cell unit wastage in a large academic medical center

PubMed Central

Whitney, Gina M.; Woods, Marcella C.; France, Daniel J.; Austin, Thomas M.; Deegan, Robert J.; Paroskie, Allison; Booth, Garrett S.; Young, Pampee P.; Dmochowski, Roger R.; Sandberg, Warren S.; Pilla, Michael A.

2015-01-01

BACKGROUND The wastage of red blood cell (RBC) units within the operative setting results in significant direct costs to health care organizations. Previous education-based efforts to reduce wastage were unsuccessful at our institution. We hypothesized that a quality and process improvement approach would result in sustained reductions in intraoperative RBC wastage in a large academic medical center. STUDY DESIGN AND METHODS Utilizing a failure mode and effects analysis supplemented with time and temperature data, key drivers of perioperative RBC wastage were identified and targeted for process improvement. RESULTS Multiple contributing factors, including improper storage and transport and lack of accurate, locally relevant RBC wastage event data were identified as significant contributors to ongoing intraoperative RBC unit wastage. Testing and implementation of improvements to the process of transport and storage of RBC units occurred in liver transplant and adult cardiac surgical areas due to their history of disproportionately high RBC wastage rates. Process interventions targeting local drivers of RBC wastage resulted in a significant reduction in RBC wastage (p <0.0001; adjusted odds ratio, 0.24; 95% confidence interval, 0.15–0.39), despite an increase in operative case volume over the period of the study. Studied process interventions were then introduced incrementally in the remainder of the perioperative areas. CONCLUSIONS These results show that a multidisciplinary team focused on the process of blood product ordering, transport, and storage was able to significantly reduce operative RBC wastage and its associated costs using quality and process improvement methods. PMID:26202213

Invulnerability and the intention to drink and drive: an application of the theory of planned behavior.

PubMed

Chan, Daphne C N; Wu, Anise M S; Hung, Eva P W

2010-11-01

The present study aims at an examination, based on the theory of planned behavior (TPB), of the psychological antecedents of young Chinese people's intentions to drive after drinking. One hundred and twenty-four licensed drivers (aged from 19 to 35 years) successfully completed an online questionnaire. Using path analysis, we found the most proximal predictors of intention to be attitudes and perceived behavioral control, whereas invulnerability as well as subjective norms indirectly influenced intention by promoting favorable attitudes toward and greater perceived behavioral control over driving after alcohol use. The total explained variances in the intention to drink and drive reached 79%. The present findings highlight irrational beliefs of invulnerability and the three TPB components as potentially valid targets for prevention and intervention efforts against drinking and driving among young Chinese drivers. 2010 Elsevier Ltd. All rights reserved.

“I wasn’t texting; I was just reading an email …”: a qualitative study of distracted driving enforcement in Washington State

PubMed Central

Nevin, Paul E; Blanar, Laura; Kirk, Annie Phare; Freedheim, Amy; Kaufman, Robert; Hitchcock, Laura; Maeser, Jennifer D; Ebel, Beth E

2018-01-01

Background In response to the rise of distracted driving, many countries and most US states have adopted laws to restrict the use of handheld phones for drivers. Specific provisions of each law and the overall social mores of distracted driving influence enforceability and impact. Objectives Identify multilevel interdependent factors that influence distracted driving enforcement through the perspective of police officers. Design/methods We conducted focus group discussions with active duty law enforcement officers from three large Washington State counties. Our thematic analysis used descriptive and pattern coding that placed our findings within a social ecological framework to facilitate targeted intervention development. Results Participants reported that the distracted driving law posed challenges for consistent and effective enforcement. They emphasised the need to change social norms around distracted driving, similar to the shifts seen around impaired driving. Many participants were themselves distracted drivers, and their individual knowledge, attitude and beliefs influenced enforcement. Participants suggested that law enforcement leaders and policymakers should develop and implement policies and strategies to prioritise and motivate increased distracted driving enforcement. Conclusions Individual, interpersonal, organisational and societal factors influence enforcement of distracted driving laws. Targeted interventions should be developed to address distracted driving and sustain effective enforcement. PMID:27634839

Cross-sectional surveillance study to phenotype lorry drivers’ sedentary behaviours, physical activity and cardio-metabolic health

PubMed Central

Varela-Mato, Veronica; O’Shea, Orlagh; King, James A; Yates, Thomas; Stensel, David J; Biddle, Stuart JH; Nimmo, Myra A; Clemes, Stacy A

2017-01-01

Objectives Elevated risk factors for a number of chronic diseases have been identified in lorry drivers. Unhealthy lifestyle behaviours such as a lack of physical activity (PA) and high levels of sedentary behaviour (sitting) likely contribute to this elevated risk. This study behaviourally phenotyped UK lorry drivers’ sedentary and non-sedentary behaviours during workdays and non-workdays and examined markers of drivers cardio-metabolic health. Setting A transport company from the East Midlands, UK. Participants A sample of 159 male heavy goods vehicle drivers (91% white European; (median (range)) age: 50 (24, 67) years) completed the health assessments. 87 (age: 50.0 (25.0, 65.0); body mass index (BMI): 27.7 (19.6, 43.4) kg/m2) provided objective information on sedentary and non-sedentary time. Outcomes Participants self-reported their sociodemographic information. Primary outcomes: sedentary behaviour and PA, assessed over 7 days using an activPAL3 inclinometer. Cardio-metabolic markers included: blood pressure (BP), heart rate, waist circumference (WC), hip circumference, body composition and fasted capillary blood glucose, triglycerides, high-density lipopreotein cholesterol, low-density lipoprotein cholesterol (LDL-C) and total cholesterol (TC) levels. These cardio-metabolic markers were treated as secondary outcomes. Results Lorry drivers presented an unhealthy cardio-metabolic health profile (median (IQR) systolic BP: 129 (108.5, 164) mm Hg; diastolic BP: 81 (63, 104) mm Hg; BMI: 29 (20, 47) kg/m2; WC: 102 (77.5, 146.5) cm; LDL-C: 3 (1, 6) mmol/L; TC: 4.9 (3, 7.5) mmol/L). 84% were overweight or obese, 43% had type 2 diabetes or prediabetes and 34% had the metabolic syndrome. The subsample of lorry drivers with objective postural data (n=87) accumulated 13 hours/day and 8 hours/day of sedentary behaviour on workdays and non-workdays (p<0.001), respectively. On average, drivers accrued 12 min/day on workdays and 6 min/day on non-workdays of moderate-to-vigorous PA (MVPA). Conclusion Lorry drivers demonstrate a high-risk cardio-metabolic profile and are highly sedentary and physically inactive. Interventions to reduce sitting and increase MVPA during breaks and leisure time to improve cardio-metabolic health are urgently needed. Educational programmes to raise awareness about diet and exercise are recommended. PMID:28637722

Post conflict water management: learning from the past for recovery planning in the Orontes River basin

NASA Astrophysics Data System (ADS)

Saadé-Sbeih, Myriam; Zwahlen, François; Haj Asaad, Ahmed; Gonzalez, Raoul; Jaubert, Ronald

2016-10-01

Water management is a fundamental issue in post-conflict planning in Syria. Based on historical water balance assessment, this study identifies the drivers of the profound changes that took place in the Lebanese and Syrian parts of the Orontes River basin since the 1930s. Both drastic effects of the conflict on the hydro-system and the strong uncontrolled anthropization of the river basin prior to the crisis have to be considered in the design of recovery interventions.

Knowledge translation and implementation in spinal cord injury: a systematic review

PubMed Central

Noonan, VK; Wolfe, DL; Thorogood, NP; Park, SE; Hsieh, JT; Eng, JJ

2015-01-01

Objective To conduct a systematic review examining the effectiveness of knowledge translation (KT) interventions in changing clinical practice and patient outcomes. Methods MEDLINE/PubMed, CINAHL, EMBASE and PsycINFO were searched for studies published from January 1980 to July 2012 that reported and evaluated an implemented KT intervention in spinal cord injury (SCI) care. We reviewed and summarized results from studies that documented the implemented KT intervention, its impact on changing clinician behavior and patient outcomes as well as the facilitators and barriers encountered during the implementation. Results A total of 13 articles featuring 10 studies were selected and abstracted from 4650 identified articles. KT interventions included developing and implementing patient care protocols, providing clinician education and incorporating outcome measures into clinical practice. The methods (or drivers) to facilitate the implementation included organizing training sessions for clinical staff, introducing computerized reminders and involving organizational leaders. The methodological quality of studies was mostly poor. Only 3 out of 10 studies evaluated the success of the implementation using statistical analyses, and all 3 reported significant behavior change. Out of the 10 studies, 6 evaluated the effect of the implementation on patient outcomes using statistical analyses, with 4 reporting significant improvements. The commonly cited facilitators and barriers were communication and resources, respectively. Conclusion The field of KT in SCI is in its infancy with only a few relevant publications. However, there is some evidence that KT interventions may change clinician behavior and improve patient outcomes. Future studies should ensure rigorous study methods are used to evaluate KT interventions. PMID:24796445

High prevalence of previous arrests for illicit drug use and/or impaired driving among drivers killed in motor vehicle crashes in Sweden with amphetamine in blood at autopsy.

PubMed

Jones, Alan Wayne; Holmgren, Anita; Ahlner, Johan

2015-08-01

Amphetamine, and to a lesser extent the secondary amine methamphetamine, are major recreational drugs of abuse in Sweden. These central stimulant amines are identified in blood from roughly 50% of people arrested for driving under the influence of drugs (DUID). However, much less information is available about the presence of amphetamine in blood of drivers killed in road-traffic crashes. This retrospective 10-year study (2001-2010) used a forensic toxicology database (TOXBASE) to retrieve information about road-traffic crashes when the driver had amphetamine and/or methamphetamine in autopsy blood. Forensic toxicology results were available from over 95% of all drivers killed on Swedish roads during this 10-year period. Amphetamine was present in the blood of 106 drivers (3.9%) either alone or together with other psychoactive substances (e.g. alcohol, cannabis, diazepam, alprazolam, etc.). The vast majority of fatalities were male (95%) with a mean age (±standard deviation) of 37±11.4 years (range 16-67 years). The mean (median) and highest concentrations of amphetamine in femoral blood were 1.36 mg/L (1.0mg/L) and 6.74 mg/L, respectively. Many of the victims (75%) had been arrested previously for use of illicit drugs or DUID. The median number of previous arrests was 4 (range 0-83) and amphetamine or methamphetamine were among the drugs identified in blood samples from 89% of cases (0-100%). The high prevalence of repeat DUID offending and/or use of illicit drugs among the drivers killed in road-traffic crashes suggests that an early intervention and treatment for stimulant abuse might have been more beneficial than conventional punishments for such drug-related crimes. Copyright © 2015 Elsevier B.V. All rights reserved.

The social biography of antibiotic use in smallholder dairy farms in India.

PubMed

Chauhan, Abhimanyu Singh; George, Mathew Sunil; Chatterjee, Pranab; Lindahl, Johanna; Grace, Delia; Kakkar, Manish

2018-01-01

Antimicrobial resistance (AMR) has been identified as one of the major threats to global health, food security and development today. While there has been considerable attention about the use and misuse of antibiotics amongst human populations in both research and policy environments, there is no definitive estimate of the extent of misuse of antibiotics in the veterinary sector and its contribution to AMR in humans. In this study, we explored the drivers ofirrational usage of verterinary antibiotics in the dairy farming sector in peri-urban India. The study was conducted in the peri-urban belts of Ludhiana, Guwahati and Bangalore. A total of 54 interviews (formal and non-formal) were carried out across these three sites. Theme guides were developed to explore different drivers of veterinary antimicrobial use. Data was audio recorded and transcribed. Analysis of the coded data set was carried out using AtlasTi. Version 7. Themes emerged inductively from the set of codes. Findings were presented based on concept of 'levels of analyses'. Emergent themes were categorised as individual, health systems, and policy level drivers. Low level of knowledge related to antibiotics among farmers, active informal service providers, direct marketing of drugs to the farmers and easily available antibiotics, dispensed without appropriate prescriptions contributed to easy access to antibiotics, and were identified to be the possible drivers contributing to the non-prescribed and self-administered use of antibiotics in the dairy farms. Smallholding dairy farmers operated within very small margins of profits. The paucity of formal veterinary services at the community level, coupled with easy availability of antibiotics and the need to ensure profits and minimise losses, promoted non-prescribed antibiotic consumption. It is essential that these local drivers of irrational antibiotic use are understood in order to develop interventions and policies that seek to reduce antibiotic misuse.

The relative impact of work-related stress, life stress and driving environment stress on driving outcomes.

PubMed

Rowden, Peter; Matthews, Gerald; Watson, Barry; Biggs, Herbert

2011-07-01

Previous research has shown the association between stress and crash involvement. The impact of stress on road safety may also be mediated by behaviours including cognitive lapses, errors, and intentional traffic violations. This study aimed to provide a further understanding of the impact that stress from different sources may have upon driving behaviour and road safety. It is asserted that both stress extraneous to the driving environment and stress directly elicited by driving must be considered part of a dynamic system that may have a negative impact on driving behaviours. Two hundred and forty-seven public sector employees from Queensland, Australia, completed self-report measures examining demographics, subjective work-related stress, daily hassles, and aspects of general mental health. Additionally, the Driver Behaviour Questionnaire (DBQ) and the Driver Stress Inventory (DSI) were administered. All participants drove for work purposes regularly, however the study did not specifically focus on full-time professional drivers. Confirmatory factor analysis of the predictor variables revealed three factors: DSI negative affect; DSI risk taking; and extraneous influences (daily hassles, work-related stress, and general mental health). Moderate intercorrelations were found between each of these factors confirming the 'spillover' effect. That is, driver stress is reciprocally related to stress in other domains including work and domestic life. Structural equation modelling (SEM) showed that the DSI negative affect factor influenced both lapses and errors, whereas the DSI risk-taking factor was the strongest influence on violations. The SEMs also confirmed that daily hassles extraneous to the driving environment may influence DBQ lapses and violations independently. Accordingly, interventions may be developed to increase driver awareness of the dangers of excessive emotional responses to both driving events and daily hassles (e.g. driving fast to 'blow off steam' after an argument). They may also train more effective strategies for self-regulation of emotion and coping when encountering stressful situations on the road. Copyright © 2011 Elsevier Ltd. All rights reserved.

Risk management algorithm for rear-side collision avoidance using a combined steering torque overlay and differential braking

NASA Astrophysics Data System (ADS)

Lee, Junyung; Yi, Kyongsu; Yoo, Hyunjae; Chong, Hyokjin; Ko, Bongchul

2015-06-01

This paper describes a risk management algorithm for rear-side collision avoidance. The proposed risk management algorithm consists of a supervisor and a coordinator. The supervisor is designed to monitor collision risks between the subject vehicle and approaching vehicle in the adjacent lane. An appropriate criterion of intervention, which satisfies high acceptance to drivers through the consideration of a realistic traffic, has been determined based on the analysis of the kinematics of the vehicles in longitudinal and lateral directions. In order to assist the driver actively and increase driver's safety, a coordinator is designed to combine lateral control using a steering torque overlay by motor-driven power steering and differential braking by vehicle stability control. In order to prevent the collision while limiting actuator's control inputs and vehicle dynamics to safe values for the assurance of the driver's comfort, the Lyapunov theory and linear matrix inequalities based optimisation methods have been used. The proposed risk management algorithm has been evaluated via simulation using CarSim and MATLAB/Simulink.

Distribution and drivers of costs in type 2 diabetes mellitus treated with oral hypoglycemic agents: a retrospective claims data analysis.

PubMed

Bron, Morgan; Guerin, Annie; Latremouille-Viau, Dominick; Ionescu-Ittu, Raluca; Viswanathan, Prabhakar; Lopez, Claudia; Wu, Eric Q

2014-09-01

To describe the distribution of costs and to identify the drivers of high costs among adult patients with type 2 diabetes mellitus (T2DM) receiving oral hypoglycemic agents. T2DM patients using oral hypoglycemic agents and having HbA1c test data were identified from the Truven MarketScan databases of Commercial and Medicare Supplemental insurance claims (2004-2010). All-cause and diabetes-related annual direct healthcare costs were measured and reported by cost components. The 25% most costly patients in the study sample were defined as high-cost patients. Drivers of high costs were identified in multivariate logistic regressions. Total 1-year all-cause costs for the 4104 study patients were $55,599,311 (mean cost per patient = $13,548). Diabetes-related costs accounted for 33.8% of all-cause costs (mean cost per patient = $4583). Medical service costs accounted for the majority of all-cause and diabetes-related total costs (63.7% and 59.5%, respectively), with a minority of patients incurring >80% of these costs (23.5% and 14.7%, respectively). Within the medical claims, inpatient admission for diabetes-complications was the strongest cost driver for both all-cause (OR = 13.5, 95% CI = 8.1-23.6) and diabetes-related costs (OR = 9.7, 95% CI = 6.3-15.1), with macrovascular complications accounting for most inpatient admissions. Other cost drivers included heavier hypoglycemic agent use, diabetes complications, and chronic diseases. The study reports a conservative estimate for the relative share of diabetes-related costs relative to total cost. The findings of this study apply mainly to T2DM patients under 65 years of age. Among the T2DM patients receiving oral hypoglycemic agents, 23.5% of patients incurred 80% of the all-cause healthcare costs, with these costs being driven by inpatient admissions, complications of diabetes, and chronic diseases. Interventions targeting inpatient admissions and/or complications of diabetes may contribute to the decrease of the diabetes economic burden.

Untangling the proximate causes and underlying drivers of deforestation and forest degradation in Myanmar.

PubMed

Lim, Cheng Ling; Prescott, Graham W; De Alban, Jose Don T; Ziegler, Alan D; Webb, Edward L

2017-12-01

Political transitions often trigger substantial environmental changes. In particular, deforestation can result from the complex interplay among the components of a system-actors, institutions, and existing policies-adapting to new opportunities. A dynamic conceptual map of system components is particularly useful for systems in which multiple actors, each with different worldviews and motivations, may be simultaneously trying to alter different facets of the system, unaware of the impacts on other components. In Myanmar, a global biodiversity hotspot with the largest forest area in mainland Southeast Asia, ongoing political and economic reforms are likely to change the dynamics of deforestation drivers. A fundamental conceptual map of these dynamics is therefore a prerequisite for interventions to reduce deforestation. We used a system-dynamics approach and causal-network analysis to determine the proximate causes and underlying drivers of forest loss and degradation in Myanmar from 1995 to 2016 and to articulate the linkages among them. Proximate causes included infrastructure development, timber extraction, and agricultural expansion. These were stimulated primarily by formal agricultural, logging, mining, and hydropower concessions and economic investment and social issues relating to civil war and land tenure. Reform of land laws, the link between natural resource extraction and civil war, and the allocation of agricultural concessions will influence the extent of future forest loss and degradation in Myanmar. The causal-network analysis identified priority areas for policy interventions, for example, creating a public registry of land-concession holders to deter corruption in concession allocation. We recommend application of this analytical approach to other countries, particularly those undergoing political transition, to inform policy interventions to reduce forest loss and degradation. © 2017 The Authors. Conservation Biology published by Wiley Periodicals, Inc. on behalf of Society for Conservation Biology.

Workplace interventions to reduce HIV and TB stigma among health care workers - Where do we go from here?

PubMed

Siegel, Jacob; Yassi, Annalee; Rau, Asta; Buxton, Jane A; Wouters, Edwin; Engelbrecht, Michelle C; Uebel, Kerry E; Nophale, Letshego E

2015-01-01

Fear of stigma and discrimination among health care workers (HCWs) in South African hospitals is thought to be a major factor in the high rates of HIV and tuberculosis infection experienced in the health care workforce. The aim of the current study is to inform the development of a stigma reduction intervention in the context of a large multicomponent trial. We analysed relevant results of four feasibility studies conducted in the lead up to the trial. Our findings suggest that a stigma reduction campaign must address community and structural level drivers of stigma, in addition to individual level concerns, through a participatory and iterative approach. Importantly, stigma reduction must not only be embedded in the institutional management of HCWs but also be attentive to the localised needs of HCWs themselves.

Ecological pathways to prevention: How does the SASA! community mobilisation model work to prevent physical intimate partner violence against women?

PubMed

Abramsky, Tanya; Devries, Karen M; Michau, Lori; Nakuti, Janet; Musuya, Tina; Kiss, Ligia; Kyegombe, Nambusi; Watts, Charlotte

2016-04-16

Intimate partner violence (IPV) against women is a global public health concern. While community-level gender norms and attitudes to IPV are recognised drivers of IPV risk, there is little evidence on how interventions might tackle these drivers to prevent IPV at the community-level. This secondary analysis of data from the SASA! study explores the pathways through which SASA!, a community mobilisation intervention to prevent violence against women, achieved community-wide reductions in physical IPV. From 2007 to 2012 a cluster randomised controlled trial (CRT) was conducted in eight communities in Kampala, Uganda. Cross-sectional surveys of a random sample of community members, aged 18-49, were undertaken at baseline (n = 1583) and 4 years post intervention implementation (n = 2532). We used cluster-level intention to treat analysis to estimate SASA!'s community-level impact on women's past year experience of physical IPV and men's past year perpetration of IPV. The mediating roles of community-, relationship- and individual-level factors in intervention effect on past year physical IPV experience (women)/perpetration (men) were explored using modified Poisson regression models. SASA! was associated with reductions in women's past year experience of physical IPV (0.48, 95 % CI 0.16-1.39), as well as men's perpetration of IPV (0.39, 95 % CI 0.20-0.73). Community-level normative attitudes were the most important mediators of intervention impact on physical IPV risk, with norms around the acceptability of IPV explaining 70 % of the intervention effect on women's experience of IPV and 95 % of the effect on men's perpetration. The strongest relationship-level mediators were men's reduced suspicion of partner infidelity (explaining 22 % of effect on men's perpetration), and improved communication around sex (explaining 16 % of effect on women's experience). Reduced acceptability of IPV among men was the most important individual-level mediator (explaining 42 % of effect on men's perpetration). These results highlight the important role of community-level norm-change in achieving community-wide reductions in IPV risk. They lend strong support for the more widespread adoption of community-level approaches to preventing violence. ClinicalTrials.gov, NCT00790959 . Registered 13th November 2008. The study protocol is available at: http://www.trialsjournal.com/content/13/1/96.

Comparison of teen driver fatality rates by vehicle type in the United States.

PubMed

Trowbridge, Matthew J; McKay, Mary Pat; Maio, Ronald F

2007-10-01

To compare national fatality rates for teen drivers by vehicle type. Fatality rates were calculated for 16- to 19-year-old drivers by vehicle type using data from the Fatal Analysis Reporting System (1999-2003) and estimates of miles driven from the National Household Transportation Survey (2001). Relative fatality risks for teen drivers of sports utility vehicles (SUVs) and pickups were calculated using passenger cars as a reference. Per vehicle mile driven, the fatality risk for both male and female teens driving SUVs was decreased relative to passenger car drivers (male teens: relative risk [RR], 0.33 [95% confidence interval [CI] = 0.29 to 0.37]; female teens: RR, 0.45 [95% CI = 0.34 to 0.59]). Fatality rates for male teens driving pickups were also lower per mile driven compared with male passenger car drivers (RR, 0.55 [95% CI = 0.51 to 0.60]). Fatality rates for female teens driving pickups and passenger cars were not statistically different but appear potentially higher for pickups (RR, 1.19 [95% CI = 0.98 to 1.44]). Both SUVs and pickups demonstrated significantly higher rates of fatal rollovers than passenger cars. Female adolescent drivers of SUVs and pickups were at particularly high risk for fatal rollovers per vehicle mile driven compared with passenger cars (SUV: RR, 1.88 [95% CI = 1.19 to 2.96]; pickup: RR, 3.42 [95% CI = 2.29 to 5.10]). Fatality rates for teen drivers vary significantly by vehicle type. From 1999 to 2003 in the United States, fatal rollovers were significantly more likely per mile driven for teen drivers of both SUVs and pickups compared with passenger cars. However, overall fatality rates (i.e., all crash types) for teen drivers of SUVs and male drivers of pickups were lower per mile driven than for teen drivers of passenger cars. The results of this ecological analysis cannot predict the individual-level fatality risk for teens driving different vehicle types. However, the significant variability in fatality rates among SUVs, pickups, and passenger cars seen at a population level suggests that vehicle choice should be further explored as a potentially modifiable risk factor in interventions to address teen driver safety.

New Research Findings Since the 2007 Surgeon General’s Call to Action to Prevent and Reduce Underage Drinking: A Review

PubMed Central

Hingson, Ralph; White, Aaron

2014-01-01

Objective: In 2007, the U.S. Department of Health and Human Services issued The Surgeon General’s Call To Action To Prevent And Reduce Underage Drinking, a publication documenting a problem linked to nearly 5,000 injury deaths annually and poor academic performance, potential cognitive deficits, risky sexual behavior, physical and sexual assaults, and other substance use. This report reviews subsequent underage drinking and related traffic fatality trends and research on determinants, consequences, and prevention interventions. Method: New research reports, meta-analyses, and systematic literature reviews were examined. Results: Since the Call to Action, reductions in underage frequency of drinking, heavy drinking occasions, and alcohol-related traffic deaths that began in the 1980s when the drinking age nationally became 21 have continued. Knowledge regarding determinants and consequences, particularly the effects of early-onset drinking, parental alcohol provision, and cognitive effects, has expanded. Additional studies support associations between the legal drinking age of 21, zero tolerance laws, higher alcohol prices, and reduced drinking and related problems. New research suggests that use/lose laws, social host liability, internal possession laws, graduated licensing, and night driving restrictions reduce traffic deaths involving underage drinking drivers. Additional studies support the positive effects of individually oriented interventions, especially screening and brief motivational interventions, web and face-to-face social norms interventions, college web-based interventions, parental interventions, and multicomponent community interventions. Conclusions: Despite reductions in underage alcohol consumption and related traffic deaths, underage drinking remains an enduring problem. Continued research is warranted in minimally studied areas, such as prospective studies of alcohol and brain development, policy studies of use/lose laws, internal possession laws, social host liability, and parent–family interventions. PMID:24411808

Systematic review of military motor vehicle crash-related injuries.

PubMed

Krahl, Pamela L; Jankosky, Christopher J; Thomas, Richard J; Hooper, Tomoko I

2010-01-01

Motor vehicle crashes account for nearly one third of U.S. military fatalities annually. The objective of this review is to summarize the published evidence on injuries due specifically to military motor vehicle (MMV) crashes. A search of 18 electronic databases identified English language publications addressing MMV crash-related injuries between 1970 and 2006 that were available to the general public. Documents limited in distribution to military or government personnel were not evaluated. Relevant articles were categorized by study design. The search identified only 13 studies related specifically to MMV crashes. Most were case reports or case series (n=8); only one could be classified as an intervention study. Nine of the studies were based solely on data from service-specific military safety centers. Few studies exist on injuries resulting from crashes of military motor vehicles. Epidemiologic studies that assess injury rates, type, severity, and risk factors are needed, followed by studies to evaluate targeted interventions and prevention strategies. Interventions currently underway should be evaluated for effectiveness, and those proven effective in the civilian community, such as graduated driver licensing, should be considered for implementation and evaluation in military populations. Published by Elsevier Inc.

Health Status, Intention to Seek Health Examination, and Participation in Health Education Among Taxi Drivers in Jinan, China

PubMed Central

Yang, Yan; Fan, Xiao-sheng; Tian, Cui-huan; Zhang, Wei; Li, Jie; Li, Shu-qing

2014-01-01

Background: Taxi drivers are exposed to various risk factors such as work overload, stress, an irregular diet, and a sedentary lifestyle, which make these individuals vulnerable to many diseases. This study was designed to assess the health status of this occupational group. Objectives: The objective was to explore the health status, the intention to seek health examination, and participation in health education among taxi drivers in Jinan, China. Patients and Methods: The sample-size was determined scientifically. The systematic sampling procedure was used for selecting the sample. Four hundred taxi drivers were randomly selected from several taxi companies in Jinan. In total, 396 valid questionnaires (from 370 males and 26 females) were returned. Health status, intention to seek health examination, and participation in health education were assessed by a self-designed questionnaire. Other personal information including sex, age, ethnicity, marital status, years of employment as a taxi driver, education level, and habits were also collected. Results: This survey revealed that 54.8% of taxi drivers reported illness in the last two weeks and 44.7% of participants reported chronic diseases. The prevalence rates of hypertension, diabetes mellitus, gastroenteritis, arthritis, and heart disease were 18.2%, 8.8%, 26%, 18.4%, and 4.8% of questioned taxi drivers, respectively. Significant self-reported symptoms included fatigue, waist and back pain, headache, dyspepsia, and dry throat affecting 49.7%, 26.2%, 23.5%, 26%, and 27% of participants, respectively. In total, 90.1% of subjects thought that it was necessary to receive a regular health examination. Only 17.9% of subjects had been given information about health education, and significantly, more than 87% of subjects who had been given information about health education reported that the information had been helpful. Conclusions: Taxi drivers’ health was poor in our survey. Thus, using health education interventions to improve knowledge and change in behaviors are necessary and effective programs that improve the health of individuals in this special occupational group are needed. PMID:24910797

A qualitative exploration of driving stress and driving discourtesy.

PubMed

Scott-Parker, B; Jones, C M; Rune, K; Tucker, J

2018-05-31

Driving courtesy, and conversely driving discourtesy, recently has been of great interest in the public domain. In addition, there has been increasing recognition of the negative impact of stress upon the individual's health and wellbeing, with a plethora of interventions aimed at minimising stress more generally. The research literature regarding driving dis/courtesy, in comparison, is scant, with a handful of studies examining the dis/courteous driving behaviour of road users, and the relationship between driving discourtesy and driving stress. To examine courteous and discourteous driving experiences, and to explore the impact of stress associated with such driving experiences. Thirty-eight drivers (20 females) from the Sunshine Coast region volunteered to participate in one of four 1-1.5 h focus groups. Content analysis used the verbatim utterances captured via an Mp3 device. Three themes pertaining to stressful and discourteous interactions were identified. Theme one pertained to the driving context: road infrastructure (eg, roundabouts, roadwork), vehicles (eg, features), location (eg, country vs city, unfamiliar areas), and temporal aspects (eg, holidays). Theme two pertained to other road users: their behaviour (eg, tailgating, merging), and unknown factors (eg, illicit and licit drug use). Theme three pertained to the self as road user: their own behaviours (eg, deliberate intimidation), and their emotions (eg, angry reaction to other drivers, being in control). Driving dis/courtesy and driving stress is a complex phenomenon, suggesting complex intervention efforts are required. Driving discourtesy was reported as being highly stressful, therefore intervention efforts which encourage driving courtesy and which foster emotional capacity to cope with stressful circumstances appear warranted. Copyright © 2018. Published by Elsevier Ltd.

Indonesian railway accidents--utilizing Human Factors Analysis and Classification System in determining potential contributing factors.

PubMed

Iridiastadi, Hardianto; Ikatrinasari, Zulfa Fitri

2012-01-01

The prevalence of Indonesian railway accidents has not been declining, with hundreds of fatalities reported in the past decade. As an effort to help the National Transportation Safety Committee (NTSC), this study was conducted that aimed at understanding factors that might have contributed to the accidents. Human Factors Analysis and Classification System (HFACS) was utilized for this purpose. A total of nine accident reports (provided by the Indonesian NTSC) involving fatalities were studied using the technique. Results of this study indicated 72 factors that were closely related to the accidents. Of these, roughly 22% were considered as operator acts while about 39% were related to preconditions for operator acts. Supervisory represented 14% of the factors, and the remaining (about 25%) were associated with organizational factors. It was concluded that, while train drivers indeed played an important role in the accidents, interventions solely directed toward train drivers may not be adequate. A more comprehensive approach in minimizing the accidents should be conducted that addresses all the four aspects of HFACS.

Emotional Well-Being and Public Health: Proposal for a Model National Initiative.

PubMed

Feller, Sophie C; Castillo, Enrico G; Greenberg, Jared M; Abascal, Pilar; Van Horn, Richard; Wells, Kenneth B

In 2011, the National Prevention, Health Promotion, and Public Health Council named mental and emotional well-being as 1 of 7 priority areas for the National Prevention Strategy. In this article, we discuss emotional well-being as a scientific concept and its relevance to public health. We review evidence that supports the association between emotional well-being and health. We propose a national emotional well-being initiative and describe its 6 components: systematic measurement of emotional well-being, identification of the drivers of emotional well-being, formation of partnerships with diverse stakeholders, implementation and dissemination of evidence-based interventions to promote emotional well-being and its drivers, development of public health messaging, and identification of and strategies to address disparities in emotional well-being and its drivers. Finally, we discuss ways in which a national emotional well-being initiative would complement current public health efforts and the potential challenges to such an initiative.

Systematic Identification of Combinatorial Drivers and Targets in Cancer Cell Lines

PubMed Central

Tabchy, Adel; Eltonsy, Nevine; Housman, David E.; Mills, Gordon B.

2013-01-01

There is an urgent need to elicit and validate highly efficacious targets for combinatorial intervention from large scale ongoing molecular characterization efforts of tumors. We established an in silico bioinformatic platform in concert with a high throughput screening platform evaluating 37 novel targeted agents in 669 extensively characterized cancer cell lines reflecting the genomic and tissue-type diversity of human cancers, to systematically identify combinatorial biomarkers of response and co-actionable targets in cancer. Genomic biomarkers discovered in a 141 cell line training set were validated in an independent 359 cell line test set. We identified co-occurring and mutually exclusive genomic events that represent potential drivers and combinatorial targets in cancer. We demonstrate multiple cooperating genomic events that predict sensitivity to drug intervention independent of tumor lineage. The coupling of scalable in silico and biologic high throughput cancer cell line platforms for the identification of co-events in cancer delivers rational combinatorial targets for synthetic lethal approaches with a high potential to pre-empt the emergence of resistance. PMID:23577104

Systematic identification of combinatorial drivers and targets in cancer cell lines.

PubMed

Tabchy, Adel; Eltonsy, Nevine; Housman, David E; Mills, Gordon B

2013-01-01

There is an urgent need to elicit and validate highly efficacious targets for combinatorial intervention from large scale ongoing molecular characterization efforts of tumors. We established an in silico bioinformatic platform in concert with a high throughput screening platform evaluating 37 novel targeted agents in 669 extensively characterized cancer cell lines reflecting the genomic and tissue-type diversity of human cancers, to systematically identify combinatorial biomarkers of response and co-actionable targets in cancer. Genomic biomarkers discovered in a 141 cell line training set were validated in an independent 359 cell line test set. We identified co-occurring and mutually exclusive genomic events that represent potential drivers and combinatorial targets in cancer. We demonstrate multiple cooperating genomic events that predict sensitivity to drug intervention independent of tumor lineage. The coupling of scalable in silico and biologic high throughput cancer cell line platforms for the identification of co-events in cancer delivers rational combinatorial targets for synthetic lethal approaches with a high potential to pre-empt the emergence of resistance.

Evaluating In-Car Movements in the Design of Mindful Commute Interventions: Exploratory Study.

PubMed

Paredes, Pablo Enrique; Hamdan, Nur Al-Huda; Clark, Dav; Cai, Carrie; Ju, Wendy; Landay, James A

2017-12-04

The daily commute could be a right moment to teach drivers to use movement or breath towards improving their mental health. Long commutes, the relevance of transitioning from home to work, and vice versa and the privacy of commuting by car make the commute an ideal scenario and time to perform mindful exercises safely. Whereas driving safety is paramount, mindful exercises might help commuters decrease their daily stress while staying alert. Increasing vehicle automation may present new opportunities but also new challenges. This study aimed to explore the design space for movement-based mindful interventions for commuters. We used qualitative analysis of simulated driving experiences in combination with simple movements to obtain key design insights. We performed a semistructured viability assessment in 2 parts. First, a think-aloud technique was used to obtain information about a driving task. Drivers (N=12) were given simple instructions to complete movements (configural or breath-based) while engaged in either simple (highway) or complex (city) simulated urban driving tasks using autonomous and manual driving modes. Then, we performed a matching exercise where participants could experience vibrotactile patterns from the back of the car seat and map them to the prior movements. We report a summary of individual perceptions concerning different movements and vibrotactile patterns. Beside describing situations within a drive when it may be more likely to perform movement-based interventions, we also describe movements that may interfere with driving and those that may complement it well. Furthermore, we identify movements that could be conducive to a more relaxing commute and describe vibrotactile patterns that could guide such movements and exercises. We discuss implications for design such as the influence of driving modality on the adoption of movement, need for personal customization, the influence that social perception has on participants, and the potential role of prior awareness of mindful techniques in the adoption of new movement-based interventions. This exploratory study provides insights into which types of movements could be better suited to design mindful interventions to reduce stress for commuters, when to encourage such movements, and how best to guide them using noninvasive haptic stimuli embedded in the car seat. ©Pablo Enrique Paredes, Nur Al-Huda Hamdan, Dav Clark, Carrie Cai, Wendy Ju, James A Landay. Originally published in the Journal of Medical Internet Research (http://www.jmir.org), 04.12.2017.

Evaluating In-Car Movements in the Design of Mindful Commute Interventions: Exploratory Study

PubMed Central

Hamdan, Nur Al-Huda; Clark, Dav; Cai, Carrie; Ju, Wendy; Landay, James A

2017-01-01

Background The daily commute could be a right moment to teach drivers to use movement or breath towards improving their mental health. Long commutes, the relevance of transitioning from home to work, and vice versa and the privacy of commuting by car make the commute an ideal scenario and time to perform mindful exercises safely. Whereas driving safety is paramount, mindful exercises might help commuters decrease their daily stress while staying alert. Increasing vehicle automation may present new opportunities but also new challenges. Objective This study aimed to explore the design space for movement-based mindful interventions for commuters. We used qualitative analysis of simulated driving experiences in combination with simple movements to obtain key design insights. Methods We performed a semistructured viability assessment in 2 parts. First, a think-aloud technique was used to obtain information about a driving task. Drivers (N=12) were given simple instructions to complete movements (configural or breath-based) while engaged in either simple (highway) or complex (city) simulated urban driving tasks using autonomous and manual driving modes. Then, we performed a matching exercise where participants could experience vibrotactile patterns from the back of the car seat and map them to the prior movements. Results We report a summary of individual perceptions concerning different movements and vibrotactile patterns. Beside describing situations within a drive when it may be more likely to perform movement-based interventions, we also describe movements that may interfere with driving and those that may complement it well. Furthermore, we identify movements that could be conducive to a more relaxing commute and describe vibrotactile patterns that could guide such movements and exercises. We discuss implications for design such as the influence of driving modality on the adoption of movement, need for personal customization, the influence that social perception has on participants, and the potential role of prior awareness of mindful techniques in the adoption of new movement-based interventions. Conclusions This exploratory study provides insights into which types of movements could be better suited to design mindful interventions to reduce stress for commuters, when to encourage such movements, and how best to guide them using noninvasive haptic stimuli embedded in the car seat. PMID:29203458

Simulator study of young driver's instinctive response of lower extremity to a collision.

PubMed

Gao, Zhenhai; Li, Chuzhao; Hu, Hongyu; Zhao, Hui; Chen, Chaoyang; Yu, Huili

2016-05-18

A driver's instinctive response of the lower extremity in braking movement consists of two parts, including reaction time and braking reaction behavior. It is critical to consider these two components when conducting studies concerning driver's brake movement intention and injury analysis. The purposes of this study were to investigate the driver reaction time to an oncoming collision and muscle activation of lower extremity muscles at the collision moment. The ultimate goal is to provide data that aid in both the optimization of intervention time of an active safety system and the improvement of precise protection performance of a passive safety system. A simulated collision scene was constructed in a driving simulator, and 40 young volunteers (20 male and 20 female) were recruited for tests. Vehicle control parameters and electromyography characteristics of eight muscles of the lower extremity were recorded. The driver reaction time was divided into pre-motor time (PMT) and muscle activation time (MAT). Muscle activation level (ACOL) at the collision moment was calculated and analysed. PMT was shortest for the tibialis anterior (TA) muscle (243∼317 ms for male and 278∼438 ms for female). Average MAT of the TA ranged from 28-55 ms. ACOL was large (5∼31% for male and 5∼23% for female) at 50 km/h, but small (<12%) at 100 km/h. ACOL of the gluteus maximus was smallest (<3%) in the 25 and 100 km/h tests. ACOL of RF of men was significantly smaller than that of women at different speeds. Ankle dorsiflexion is firstly activated at the beginning of the emergency brake motion. Males showed stronger reaction ability than females, as suggested by male's shorter PMT. The detection of driver's brake intention is upwards of 55ms sooner after introducing the electromyography. Muscle activation of the lower extremity is an important factor for 50 km/h collision injury analysis. For higher speed collisions, this might not be a major factor. The activations of certain muscles may be ignored for crash injury analysis at certain speeds, such as gluteus maximus at 25 or 100 km/h. Furthermore, the activation of certain muscles should be differentiated between males and females during injury analysis.

Lifestyle counseling in overweight truck and bus drivers - Effects on dietary patterns and physical activity.

PubMed

Puhkala, Jatta; Kukkonen-Harjula, Katriina; Aittasalo, Minna; Mansikkamäki, Kirsi; Partinen, Markku; Hublin, Christer; Kärmeniemi, Paula; Sallinen, Mikael; Olkkonen, Seppo; Tokola, Kari; Ojala, Anna; Nygård, Clas-Håkan; Fogelholm, Mikael

2016-12-01

We studied dietary patterns, physical activity (PA), and monthly goal setting in a weight reduction intervention in long-distance professional drivers. The study was conducted in Finland in 2009-2012. Male drivers with waist circumference > 100 cm were randomized to a lifestyle counseling (LIFE, N = 55) and a reference (REF, N = 58) group. During 12 months, LIFE participated in 6 face-to-face and 7 telephone counseling sessions on diet and PA. Dietary patterns were assessed using an index combining food diary and counselor interview, and PA with the number of daily steps using a pedometer. Monthly lifestyle goals, perceived facilitators and barriers, and adverse effects of PA in the LIFE participants were monitored using counselors' log books. Forty-seven (85%) LIFE participants completed the 12-month program. After 12 months, the mean dietary index score improved by 12% (p = 0.002, N = 24), and the number of daily steps increased by 1811 steps (median; p = 0.01, N = 22). The most frequent dietary goals dealt with meal frequency, plate model, and intake of vegetables, fruits, and berries. The most common PA mode was walking. Typical facilitators to reach monthly lifestyle goals were support from family and friends and ailment prevention; typical barriers were working schedules and ailments. Adverse effects, most commonly musculoskeletal pain, occurred among 83% of the LIFE participants. Positive changes in lifestyle habits were observed during counseling. Monthly lifestyle counseling combining face-to-face and phone contacts seemed appropriate to long-distance drivers. Barriers for reaching lifestyle changes, and adverse effects of PA were common and need to be addressed when planning counseling. Clinical Trials NCT00893646.

Epidemiology of pedestrian-MVCs by road type in Cluj, Romania.

PubMed

Hamann, Cara; Peek-Asa, Corinne; Rus, Diana

2015-04-01

Pedestrian-motor vehicle (PMV) crash rates in Romania are among the highest in all of Europe. The purpose of this study was to examine the characteristics of pedestrian-MVCs in Cluj County, Romania, on the two major types of roadways: national or local. Cluj County police crash report data from 2010 were used to identify pedestrian, driver and crash characteristics of pedestrian-MVCs. Crashes with available location data were geocoded and road type (national or local) for each crash was determined. Distributions of crash characteristics were examined by road type and multivariable logistic regression models were built to determine predictors of crash road type. Crashes occurring on national roads involved more teenagers and adults, while those on local roads involved more young children (0-12) and older adults (65+) (p<0.01). Crashes on national roads were more likely to have marked pedestrian crossings and shoulders compared with local crashes. Pedestrian-MVCs that involved a moving violation by the motorist were more likely to occur on national roadways (adjusted OR=1.93, 95% CI 1.07 to 3.49). Pedestrian-MVCs pose a considerable health burden in Romania. Results from this study suggest that factors leading to PMV crashes on national roads are more likely to involve driver-related causes compared with local roads. Intervention priorities to reduce pedestrian crashes on national roads should be directed towards driver behaviour on national roads. Further examination of driver and pedestrian behaviours related to crash risk on both national and local roads, such as distraction and speeding, is warranted. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Community-Level HIV Stigma as a Driver for HIV Transmission Risk Behaviors and Sexually Transmitted Diseases in Sierra Leone: A Population-Based Study.

PubMed

Kelly, J Daniel; Reid, Michael J; Lahiff, Maureen; Tsai, Alexander C; Weiser, Sheri D

2017-08-01

Although HIV stigma has been identified as an important risk factor for HIV transmission risk behaviors, little is known about the contribution of community-level HIV stigma to HIV transmission risk behaviors and self-reported sexually transmitted diseases (STDs) or how gender may modify associations. We pooled data from the 2008 and 2013 Sierra Leone Demographic and Health Surveys. For HIV stigma, we examined HIV stigmatizing attitudes and HIV disclosure concerns at both individual and community levels. Outcomes of HIV transmission risk behaviors were recent condom usage, consistent condom usage, and self-reported STDs. We assessed associations with multivariable logistic regressions. We also analyzed gender as an effect modifier of these associations. Of 34,574 respondents, 24,030 (69.5%) who had heard of HIV were included in this analysis. Community-level HIV stigmatizing attitudes and disclosure concerns were associated with higher odds of self-reported STDs (adjusted odds ratio = 2.07; 95% confidence interval: 1.55 to 2.77; adjusted odds ratio = 2.95; 95% confidence interval: 1.51 to 5.58). Compared with men, community-level HIV stigmatizing attitudes among women were a stronger driver of self-reported STDs (interaction P = 0.07). Gender modified the association between community-level HIV disclosure concerns and both recent and consistent condom usage (interaction P = 0.03 and P = 0.002, respectively). Community-level HIV disclosure concerns among women were observed to be a driver of risky sex and self-reported STDs. This study shows that community-level HIV stigma may be a driver for risky sex and self-reported STDs, particularly among women. Our findings suggest that community-held stigmatizing beliefs and HIV disclosure concerns among women might be important targets for HIV stigma reduction interventions.

Motor vehicle driving in high incidence psychiatric disability: comparison of drivers with ADHD, depression, and no known psychopathology.

PubMed

Aduen, Paula A; Kofler, Michael J; Cox, Daniel J; Sarver, Dustin E; Lunsford, Erin

2015-05-01

Although not often discussed in clinical settings, motor vehicle driving is a complex multitasking endeavor during which a momentary attention lapse can have devastating consequences. Previous research suggests that drivers with high incidence psychiatric disabilities such as ADHD contribute disproportionately to collision rates, which in turn portend myriad adverse social, financial, health, mortality, and legal outcomes. However, self-referral bias and the lack of psychiatric comparison groups constrain the generalizability of these findings. The current study addressed these limitations and examined the unique associations among ADHD, Depression, and adverse driving outcomes, independent of self-selection, driving exposure, and referral bias. The Strategic Highway Research Program (SHRP-2) Naturalistic Driving Study comprises U.S. drivers from six sites selected via probability-based sampling. Groups were defined by Barkley ADHD and psychiatric diagnosis questionnaires, and included ADHD (n = 275), Depression (n = 251), and Healthy Control (n = 1828). Primary outcomes included self-reported traffic collisions, moving violations, collision-related injuries, and collision fault (last 3 years). Accounting for demographic differences, ADHD but not Depression portended increased risk for multiple violations (OR = 2.3) and multiple collisions (OR = 2.2). ADHD but not Depression portended increased risk for collision fault (OR = 2.1). Depression but not ADHD predicted increased risk for self-reported injury following collisions (OR = 2.4). ADHD appears uniquely associated with multiple collisions, multiple violations, and collision fault, whereas Depression is uniquely associated with self-reported injury following a collision. Identification of the specific mechanisms underlying this risk will be critical to designing effective interventions to improve long-term functioning for drivers with high incidence psychiatric disability. Copyright © 2015 Elsevier Ltd. All rights reserved.

A randomized controlled trial to evaluate the relative efficacy of adding voluntary counseling and testing (VCT) to information dissemination in reducing HIV-related risk behaviors among Hong Kong male cross-border truck drivers.

PubMed

Lau, Joseph T F; Tsui, Hi Yi; Cheng, Shannon; Pang, Margaret

2010-01-01

Mobile populations are vulnerable to contracting HIV. The present study aims to evaluate the relative efficacy of the voluntary counseling and testing plus information dissemination (VCT-ID) approach versus the information dissemination (ID) approach for promoting HIV preventive behaviors in a mobile population, cross-border truck drivers. A total of 301 adult male cross-border truck drivers who self-reported having had sex with female sex workers (FSW) or non-regular sex partners (NRPs) in mainland China in the last 12 months were recruited and randomized into the VCT-ID intervention group (Group I) or ID control group (Group C). Anonymous structured questionnaires, administered through a computer-assisted method, were used to collect data. At the follow-up survey (about 8-9 weeks since the baseline survey), Group I participants, as compared to Group C participants, were more likely to be consistent condom users when having sex with FSW (85.5% versus 68.5%, p<0.05) and with NRP (54.8% versus 36.4%, p<0.1), more knowledgeable about HIV, and were less likely to have contracted sexually transmitted diseases (STD) in the last two months. The VCT-ID approach is shown to be more efficacious than the ID approach in promoting safer sex and HIV-related knowledge among local cross-border truck drivers. Feasibility of providing voluntary counseling and testing (VCT) services at locations which are convenient to the target population is demonstrated. It also shows that VCT services can be used as a means of HIV prevention. The findings of this study resulted in up-scaled VCT services for the local target population.

Reducing intraoperative red blood cell unit wastage in a large academic medical center.

PubMed

Whitney, Gina M; Woods, Marcella C; France, Daniel J; Austin, Thomas M; Deegan, Robert J; Paroskie, Allison; Booth, Garrett S; Young, Pampee P; Dmochowski, Roger R; Sandberg, Warren S; Pilla, Michael A

2015-11-01

The wastage of red blood cell (RBC) units within the operative setting results in significant direct costs to health care organizations. Previous education-based efforts to reduce wastage were unsuccessful at our institution. We hypothesized that a quality and process improvement approach would result in sustained reductions in intraoperative RBC wastage in a large academic medical center. Utilizing a failure mode and effects analysis supplemented with time and temperature data, key drivers of perioperative RBC wastage were identified and targeted for process improvement. Multiple contributing factors, including improper storage and transport and lack of accurate, locally relevant RBC wastage event data were identified as significant contributors to ongoing intraoperative RBC unit wastage. Testing and implementation of improvements to the process of transport and storage of RBC units occurred in liver transplant and adult cardiac surgical areas due to their history of disproportionately high RBC wastage rates. Process interventions targeting local drivers of RBC wastage resulted in a significant reduction in RBC wastage (p < 0.0001; adjusted odds ratio, 0.24; 95% confidence interval, 0.15-0.39), despite an increase in operative case volume over the period of the study. Studied process interventions were then introduced incrementally in the remainder of the perioperative areas. These results show that a multidisciplinary team focused on the process of blood product ordering, transport, and storage was able to significantly reduce operative RBC wastage and its associated costs using quality and process improvement methods. © 2015 AABB.

Voice complaints among public transport workers in the metropolitan region of Belo Horizonte, Brazil.

PubMed

Assunção, Ada; Jardim, Renata; de Medeiros, Adriane

2013-01-01

To investigate the prevalence of voice complaints among bus transport workers in a metropolitan area in Brazil and examine whether sociodemographic and occupational factors were associated with this outcome. This study is part of a larger study that investigated the working conditions and health of drivers and conductors of urban transportation. The sample size (1,607 participants) was calculated by means of quotas and was stratified according to occupation (drivers and conductors) in the bus companies of Belo Horizonte, Betim and Contagem. Face-to-face interviews were facilitated by means of a digital questionnaire, applied by the interviewer using a netbook. The outcome variable was constructed from combining the responses to the following two questions: (1) Over the last two weeks, have you felt tired when speaking? (no/sometimes/every day). (2) Over the last two weeks, have you noticed any worsening of your voice quality? (no/sometimes/every day). Sociodemographic, lifestyle, occupational characteristic and health situation data were gathered. The prevalence found was 29% overall: 24% for drivers and 34% for conductors. Attention was drawn to positive associations with the function of conductor and with reports of exposure to vibration and thermal discomfort. Among the individual factors, only female gender reached statistical significance. Risk factors exist that justify interventions to promote voice health within the urban transport sector under study. It would be appropriate to investigate whether vibration of the whole body would influence the functioning and morphology of the larynx.

System-Level Action Required for Wide-Scale Improvement in Quality of Primary Health Care: Synthesis of Feedback from an Interactive Process to Promote Dissemination and Use of Aggregated Quality of Care Data.

PubMed

Bailie, Jodie; Laycock, Alison; Matthews, Veronica; Bailie, Ross

2016-01-01

There is an enduring gap between recommended practice and care that is actually delivered; and there is wide variation between primary health care (PHC) centers in delivery of care. Where aspects of care are not being done well across a range of PHC centers, this is likely due to inadequacies in the broader system. This paper aims to describe stakeholders' perceptions of the barriers and enablers to addressing gaps in Australian Aboriginal and Torres Strait Islander chronic illness care and child health, and to identify key drivers for improvement. This paper draws on data collected as part of a large-scale continuous quality improvement project in Australian Indigenous PHC settings. We undertook a qualitative assessment of stakeholder feedback on the main barriers and enablers to addressing gaps in care for Aboriginal and Torres Strait Islander children and in chronic illness care. Themes on barriers and enablers were further analyzed to develop a "driver diagram," an improvement tool used to locate barriers and enablers within causal pathways (as primary and secondary drivers), enabling them to be targeted by tailored interventions. We identified 5 primary drivers and 11 secondary drivers of high-quality care, and associated strategies that have potential for wide-scale implementation to address barriers and enablers for improving care. Perceived barriers to addressing gaps in care included both health system and staff attributes. Primary drivers were: staff capability to deliver high-quality care; availability and use of clinical information systems and decision support tools; embedding of quality improvement processes and data-driven decision-making; appropriate and effective recruitment and retention of staff; and community capacity, engagement and mobilization for health. Suggested strategies included mechanisms for increasing clinical supervision and support, staff retention, reorientation of service delivery, use of information systems and community health literacy. The findings identify areas of focus for development of barrier-driven, tailored interventions to improve health outcomes. They reinforce the importance of system-level action to improve health center performance and health outcomes, and of developing strategies to address system-wide challenges that can be adapted to local contexts.

Effects of Brief Alcohol Interventions on Drinking and Driving among Youth: A Systematic Review and Meta-analysis

PubMed Central

Steinka-Fry, Katarzyna T.; Tanner-Smith, Emily E.; Hennessy, Emily A.

2015-01-01

Objective Alcohol-impaired driving persists as a major cause of traffic fatalities and injuries among young drivers. This meta-analysis examined whether brief alcohol interventions were effective in reducing driving after drinking among adolescents and young adults. Method Our systematic search identified 12 experimental/quasi-experimental evaluations (16 intervention groups) that measured driving while intoxicated and related consequences and provided data for effect size calculation (N = 5,664; M age =17 years; 57% male). The studies were published between 1991 and 2011. Three-level random-effects meta-analyses using a structural equation modeling approach were used to summarize the effects of the interventions. Results Compared with controls, participants in brief alcohol interventions reported reduced drinking and driving and related consequences (ḡ = 0.15, 95% CI [0.08, 0.21]). Supplemental analyses indicated that reductions in driving while intoxicated were positively associated with the reduced post-intervention heavy use of alcohol. These findings were not attenuated by study design or implementation factors. Conclusions Brief alcohol interventions under 5 hours of contact may constitute a promising preventive approach targeting drinking and driving among adolescents and young adults. Reducing heavy episodic alcohol consumption appeared to be a major factor in reducing drunk-driving instances. Interpretation of the findings must be made with caution, however, given the possibility of publication bias and the small observed effect size. Future research should focus on the exact mechanisms of behavior change leading to beneficial outcomes of brief alcohol interventions and the potential effectiveness of combined brief interventions and other preventive approaches. PMID:26221619

A new insight on the risky behavior of motorists at railway level crossings: An observational field study.

PubMed

Liang, Ci; Ghazel, Mohamed; Cazier, Olivier; El-Koursi, El-Miloudi

2017-11-01

Accidents at railway level crossings (LXs) give rise to serious material and human damage. Particularly, collisions between trains and motorized vehicles are the most critical accidents occurring at LXs. It is worth noticing that violations committed by vehicle drivers are the primary cause of such accidents. The present study is a tentative to acquire a better understanding of risky behavior of vehicle drivers while crossing LXs during the closure cycle. Namely, risk analysis based on field measurement conducted at four automated LXs with two half barriers is performed. We focus on vehicle driver behavior during the LX closure cycle while distinguishing between different phases. In fact, the closure cycle is divided into three phases which are "Ph2 Red Flash and Siren", "Ph3 Barriers Coming Down" and "Ph4 Barriers Down"; and vehicle driver behavior in each phase as time increases is scrutinized respectively. Particularly, zigzag scenarios are detected, using an original experimental setting that we have implemented, and analyzed in detail. The main findings based on the analysis demonstrate that the peak of violation rate in the morning is later than the actual rush hour in the morning; a distinct peak of the violation rate shows on Friday, while the violation rate on weekend is fairly low; the relative violation rate of vehicles with high speed decreases continuously as time advances from Ph2 to Ph3 in the daytime; the violation rate during Ph4 decreases as Ph4 duration is prolonged, which contradicts a general speculation that a higher rate of zigzag violations would appear as the duration of Ph4 is extended. These findings open the way towards determining the impacting factors which have an important contribution to the vehicle driver decision-making in this context (e.g., traffic density, time schedule and phase duration). In addition, the outputs of the present study are conducive to identifying potential interventions to improve safety at LXs. Copyright © 2017 Elsevier Ltd. All rights reserved.

Road traffic accidents and self-reported Portuguese car driver's attitudes, behaviors, and opinions: Are they related?

PubMed

Bon de Sousa, Teresa; Santos, Carolina; Mateus, Ceu; Areal, Alain; Trigoso, Jose; Nunes, Carla

2016-10-02

This study aims to characterize Portuguese car drivers in terms of demographic characteristics, driving experience, and attitudes, opinions, and behaviors concerning road traffic safety. Furthermore, associations between these characteristics and self-reported involvement in a road traffic accident as a driver in the last 3 years were analyzed. A final goal was to develop a final predictive model of the risk of suffering a road traffic accident. A cross-sectional analytic study was developed, based on a convenience sample of 612 car drivers. A questionnaire was applied by trained interviewers, embracing various topics related to road safety such as driving under the influence of alcohol or drugs, phone use while driving, speeding, use of advanced driver assistance systems, and the transport infrastructure and environment (European Project SARTRE 4, Portuguese version). From the 52 initial questions, 19 variables were selected through principal component analysis. Then, and in addition to the usual descriptive measures, logistic binary regression models were used in order to describe associations and to develop a predictive model of being involved in a road traffic accident. Of the 612 car drivers, 37.3% (228) reported being involved in a road traffic accident with damage or injury in the past 3 years. In this group, the majority were male, older than 65, with no children, not employed, and living in an urban area. In the multivariate model, several factors were identified: being widowed (vs. single; odds ratio [OR] = 3.478, 95% confidence interval [95% CI], 1.159-10.434); living in a suburban area (vs. a rural area; OR = 5.023, 95% CI, 2.260-11.166); having been checked for alcohol once in the last 3 years (vs. not checked; OR = 3.124, 95% CI, 2.040-4,783); and seldom drinking an energetic beverage such as coffee when tired (vs. always do; OR = 6.822, 95% CI, 2.619-17.769) all suffered a higher risk of being involved in a car accident. The results obtained with regard to behavioral factors meet the majority of the risk factors associated with car accidents referred to in the literature. This study highlights the relation of relatively minor accidents (the majority with no injuries) with an urban (or semi-urban) context and involving older drivers. These accidents are not usually the focus of road safety literature (mainly death and serious health loss) but, in addition to the economic costs involved, they can have a huge impact on road safety (e.g., pedestrian). Specifically, the following interventions can be proposed: more detailed clinical examinations to identify real competencies to drive especially in older drivers (active aging can constitute a new challenge in road safety and new paradigms can arise) and education campaigns on how to cope with fatigue. Future studies in large samples and not based on self-reported behaviors should be developed.

Leptospirosis in Rio Grande do Sul, Brazil: An Ecosystem Approach in the Animal-Human Interface

PubMed Central

Schneider, Maria Cristina; Najera, Patricia; Pereira, Martha M.; Machado, Gustavo; dos Anjos, Celso B.; Rodrigues, Rogério O.; Cavagni, Gabriela M.; Muñoz-Zanzi, Claudia; Corbellini, Luis G.; Leone, Mariana; Buss, Daniel F.; Aldighieri, Sylvain; Espinal, Marcos A.

2015-01-01

Background Leptospirosis is an epidemic-prone neglected disease that affects humans and animals, mostly in vulnerable populations. The One Health approach is a recommended strategy to identify drivers of the disease and plan for its prevention and control. In that context, the aim of this study was to analyze the distribution of human cases of leptospirosis in the State of Rio Grande do Sul, Brazil, and to explore possible drivers. Additionally, it sought to provide further evidence to support interventions and to identify hypotheses for new research at the human-animal-ecosystem interface. Methodology and findings The risk for human infection was described in relation to environmental, socioeconomic, and livestock variables. This ecological study used aggregated data by municipality (all 496). Data were extracted from secondary, publicly available sources. Thematic maps were constructed and univariate analysis performed for all variables. Negative binomial regression was used for multivariable statistical analysis of leptospirosis cases. An annual average of 428 human cases of leptospirosis was reported in the state from 2008 to 2012. The cumulative incidence in rural populations was eight times higher than in urban populations. Variables significantly associated with leptospirosis cases in the final model were: Parana/Paraiba ecoregion (RR: 2.25; CI95%: 2.03–2.49); Neossolo Litolítico soil (RR: 1.93; CI95%: 1.26–2.96); and, to a lesser extent, the production of tobacco (RR: 1.10; CI95%: 1.09–1.11) and rice (RR: 1.003; CI95%: 1.002–1.04). Conclusion Urban cases were concentrated in the capital and rural cases in a specific ecoregion. The major drivers identified in this study were related to environmental and production processes that are permanent features of the state. This study contributes to the basic knowledge on leptospirosis distribution and drivers in the state and encourages a comprehensive approach to address the disease in the animal-human-ecosystem interface. PMID:26562157

Whole-body Vibration Exposure Intervention among Professional Bus and Truck Drivers: A Laboratory Evaluation of Seat-suspension Designs.

PubMed

Blood, Ryan P; Yost, Michael G; Camp, Janice E; Ching, Randal P

2015-01-01

Long-term exposure to seated whole-body vibration (WBV) is one of the leading risk factors for the development of low back disorders. Professional bus and truck drivers are regularly exposed to continuous WBV, since they spend the majority of their working hours driving heavy vehicles. This study measured WBV exposures among professional bus and truck drivers and evaluated the effects of seat-suspension designs using simulated field-collected data on a vibration table. WBV exposures were measured and compared across three different seat designs: an air-ride bus seat, an air-ride truck seat, and an electromagnetically active (EM-active) seat. Air-ride seats use a compressed-air bladder to attenuate vibrations, and they have been in operation throughout the transportation industry for many years. The EM-active seat is a relatively new design that incorporates a microprocessor-controlled actuator to dampen vibration. The vibration table simulated seven WBV exposure scenarios: four segments of vertical vibration and three scenarios that used field-collected driving data on different road surfaces-a city street, a freeway, and a section of rough roadway. The field scenarios used tri-axial WBV data that had been collected at the seat pan and at the driver's sternum, in accordance with ISO 2631-1 and 2631-5. This study found that WBV was significantly greater in the vertical direction (z-axis) than in the lateral directions (x-and y-axes) for each of the three road types and each of the three types of seats. Quantitative comparisons of the results showed that the floor-to-seat-pan transmissibility was significantly lower for the EM-active seat than for either the air-ride bus seat or the air-ride truck seat, across all three road types. This study also demonstrated that seat-suspension designs have a significant effect on the vibrations transmitted to vehicle operators, and the study's results may prove useful in designing future seat suspensions.

Leptospirosis in Rio Grande do Sul, Brazil: An Ecosystem Approach in the Animal-Human Interface.

PubMed

Schneider, Maria Cristina; Najera, Patricia; Pereira, Martha M; Machado, Gustavo; dos Anjos, Celso B; Rodrigues, Rogério O; Cavagni, Gabriela M; Muñoz-Zanzi, Claudia; Corbellini, Luis G; Leone, Mariana; Buss, Daniel F; Aldighieri, Sylvain; Espinal, Marcos A

2015-11-01

Leptospirosis is an epidemic-prone neglected disease that affects humans and animals, mostly in vulnerable populations. The One Health approach is a recommended strategy to identify drivers of the disease and plan for its prevention and control. In that context, the aim of this study was to analyze the distribution of human cases of leptospirosis in the State of Rio Grande do Sul, Brazil, and to explore possible drivers. Additionally, it sought to provide further evidence to support interventions and to identify hypotheses for new research at the human-animal-ecosystem interface. The risk for human infection was described in relation to environmental, socioeconomic, and livestock variables. This ecological study used aggregated data by municipality (all 496). Data were extracted from secondary, publicly available sources. Thematic maps were constructed and univariate analysis performed for all variables. Negative binomial regression was used for multivariable statistical analysis of leptospirosis cases. An annual average of 428 human cases of leptospirosis was reported in the state from 2008 to 2012. The cumulative incidence in rural populations was eight times higher than in urban populations. Variables significantly associated with leptospirosis cases in the final model were: Parana/Paraiba ecoregion (RR: 2.25; CI95%: 2.03-2.49); Neossolo Litolítico soil (RR: 1.93; CI95%: 1.26-2.96); and, to a lesser extent, the production of tobacco (RR: 1.10; CI95%: 1.09-1.11) and rice (RR: 1.003; CI95%: 1.002-1.04). Urban cases were concentrated in the capital and rural cases in a specific ecoregion. The major drivers identified in this study were related to environmental and production processes that are permanent features of the state. This study contributes to the basic knowledge on leptospirosis distribution and drivers in the state and encourages a comprehensive approach to address the disease in the animal-human-ecosystem interface.

School safe driving climate: Theoretical and practical considerations for promoting teen driver safety in school settings.

PubMed

Mirman, Jessica H; Roche, Brianne; Higgins-D'Alessandro, Ann

2018-06-21

The aims of this study were to extend the current literature on school climate that is focused on understanding how teacher, administrator, and student perceptions about driving-focused aspects of the social, educational, and institutional climate of schools can affect students' achievement, behavior, and adjustment towards the development of the concept of school safe driving climate (SSDC) and initiate the development of tools and processes for assessing SSDC. A mixed-methods approach was used to develop an initial version of a survey-based measure of SSDC that involved self-report surveys (students) and in-depth interviews (teachers). Exploratory factor analytic procedures identified SSDC constructs and a regression framework was used to examine associations among SSDC constructs and self-reported driver behaviors. Qualitative data were subjected to inductive analysis, with a goal of elucidating teachers' perspectives on SSDC and an SSDC intervention. The study sample consisted of 947 adolescents (48% male) from one large high school and 44 teacher advisors. Participants were recruited from a school participating in a state-wide effort to promote transportation safety through peer-led programming. Two SSDC factors were identified: Administrative Contributions to School Safety and Value of School Safety, which were associated with adolescents' perceptions of their driving behaviors. Adolescents' perceived that the intervention affected administrative safety. Teacher interviews contextualized these results and provided guidance on program revisions. Safe driving climate may be an important, modifiable, and measurable aspect of school climate. Additional research is needed to refine the assessment tool and to use it in longitudinal and experimental studies.

A program to increase seat belt use along the Texas-Mexico border.

PubMed

Cohn, Lawrence D; Hernandez, Delia; Byrd, Theresa; Cortes, Miguel

2002-12-01

A school-based, bilingual intervention was developed to increase seat belt use among families living along the Texas-Mexico border. The intervention sought to increase seat belt use by changing perceived norms within the community (i.e., making the nonuse of seat belts less socially acceptable). The intervention was implemented in more than 110 classrooms and involved more than 2100 children. Blind coding, validity checks, and reliability estimates contributed to a rigorous program evaluation. Seat belt use increased by 10% among children riding in the front seat of motor vehicles in the intervention community, as compared with a small but nonsignificant decline in use among control community children. Seat belt use among drivers did not increase.

From the Patient Perspective: the Economic Value of Seasonal and H1N1 Influenza Vaccination

PubMed Central

Lee, Bruce Y.; Bacon, Kristina; Donohue, Julie M.; Wiringa, Ann E.; Bailey, Rachel R.; Zimmerman, Richard K.

2011-01-01

Although studies have suggested that a patient’s perceived cost-benefit of a medical intervention could affect his or her utilization of the intervention, the economic value of influenza vaccine from the patient’s perspective remains unclear. Therefore, we developed a stochastic decision analytic computer model representing an adult’s decision of whether to get vaccinated. Different scenarios explored the impact of the patient being insured versus uninsured, influenza attack rate, vaccine administration costs and vaccination time costs. Results indicated that cost of avoiding influenza was fairly low, with one driver being required vaccination time. To encourage vaccination, decision makers may want to focus on ways to reduce this time, such as vaccinating at work, churches, or other normally frequented locations. PMID:21215340

Examining the aging process through the stress-coping framework: application to driving cessation in later life

PubMed Central

Choi, Moon; Adams, Kathryn Betts; Mezuk, Briana

2017-01-01

The aging process is marked by a series of transitions that influence multiple domains of well-being. One important transition for older adults is the process of driving cessation. Numerous studies have examined risk factors for driving cessation among older adults to identify at-risk older drivers for road safety. Recent research has focused on the consequences of driving cessation in later life for health and well-being. However, these reports have been largely empirical and are not drawn from a defined conceptual framework. Establishing a theoretical model of ‘how driving cessation interacts with other processes and domains of aging’ will promote synthesis of seemingly disparate findings and also link the empirical research on cessation to the broader field of gerontology. This article describes a conceptual model for articulating and examining the components of the driving cessation process based on the stress-coping paradigm. This model situates driving cessation within the context of exogenous stressors, individual vulnerabilities and coping strategies, and environmental hazards and buffers over the lifespan. This model could assist in guiding intervention strategies aimed at reducing premature driving cessation in older drivers with ameliorable impairments while assisting at-risk older drivers to reduce or stop driving in a less stressful way. PMID:21702704

Examining the aging process through the stress-coping framework: application to driving cessation in later life.

PubMed

Choi, Moon; Adams, Kathryn Betts; Mezuk, Briana

2012-01-01

The aging process is marked by a series of transitions that influence multiple domains of well-being. One important transition for older adults is the process of driving cessation. Numerous studies have examined risk factors for driving cessation among older adults to identify at-risk older drivers for road safety. Recent research has focused on the consequences of driving cessation in later life for health and well-being. However, these reports have been largely empirical and are not drawn from a defined conceptual framework. Establishing a theoretical model of 'how driving cessation interacts with other processes and domains of aging' will promote synthesis of seemingly disparate findings and also link the empirical research on cessation to the broader field of gerontology. This article describes a conceptual model for articulating and examining the components of the driving cessation process based on the stress-coping paradigm. This model situates driving cessation within the context of exogenous stressors, individual vulnerabilities and coping strategies, and environmental hazards and buffers over the lifespan. This model could assist in guiding intervention strategies aimed at reducing premature driving cessation in older drivers with ameliorable impairments while assisting at-risk older drivers to reduce or stop driving in a less stressful way.

Developing a framework of gastronomic systems research to unravel drivers of food choice.

PubMed

Cuevas, Rosa Paula; de Guia, Annalyn; Demont, Matty

2017-10-01

Nutritional and dietary interventions and the introduction of novel food products and ingredients require a thorough understanding of the drivers of food choice, which are embedded in local context and culture. We developed a framework of "gastronomic systems research" (GSR) to understand culture-specific consumer food choice, and contextualise it to a target population of urban, middle- to high-income Filipino consumers to assess the domestic niche market potential of traditional rice varieties in the Philippines. The GSR framework was contextualised through expert elicitation involving chefs and nutritionists, and validated through a consumer survey conducted during a food exposition. Using the GSR framework, we determined indicative rice consumption patterns of the target population and the specific rice quality attributes they require for specific rice-based dishes and rice consumption occasions. The GSR framework also reveals possible entry points for nutritional and dietary interventions and the introduction of novel food products and ingredients. The GSR framework, therefore, has the potential to aid policymakers and food value chain stakeholders in designing culture-sensitive and context-appropriate interventions not only to help consumers improve their diets, but also to help farmers access niche markets for novel food products and ingredients and thereby improve their livelihoods and preserve cultural heritage.

A brief tailored family-centered seat belt intervention for hospitalized trauma patients.

DOT National Transportation Integrated Search

2010-11-01

"Among children 5-19 years, the commonest cause of unintentional injury-related death is : being an occupant/driver in a motor vehicle crash (MVC). In 2006 in the United States, there : were 568,188 injuries among children (0-18) due to MVC. Of these...

Selecting at-risk populations for sexually transmitted disease/HIV intervention studies.

PubMed

Wu, Zunyou; Rotheram-Borus, Mary Jane; Detels, Roger; Li, Li; Guan, Jihui; Liang, Guojun; Yap, Lorraine

2007-12-01

This paper describes one option to select populations for randomized, controlled trials (RCT). We used a popular opinion leader intervention in Fuzhou, China, to: (1) identify population selection criteria; (2) systematically examine the suitability of potential target populations and settings; (3) briefly evaluate risk and stability in the population; and (4) evaluate regional and organizational support among administrators and government officials. After comparing migrant villagers, truck drivers, factory workers, construction workers, and market employees in five regions of China, market employees in Fuzhou were identified as the optimal target population. Markets were the optimal sites for several reasons: (1) the population demonstrated a sufficient base rate of sexually transmitted diseases; (2) the population was stable over time; (3) a sufficient number of sites of manageable sizes were available; (4) stable networks existed; (5) local gatekeepers/stakeholders supported the intervention; (6) there was organizational capacity in the local health department to mount the intervention; (7) the demographic profile was similar across potential sites; and (8) the sites were sufficiently distanced to minimize contamination. Evaluating intervention efficacy in an RCT requires a time-consuming and rigorous process that systematically and routinely documents selection criteria, evaluates multiple populations, sites, and organizations for their appropriateness.

[How to properly use the fear in AIDS intervention-the history and further of fear appeal development].

PubMed

Zhang, Ke; Du, Xiufang; Tao, Xiaorun; Zhang, Yuanyuan; Kang, Dianmin

2015-08-01

The AIDS epidemic in men who have sex wlth men (MSM) in recent years showed a sharp upward trend, looking for behavioral intervention strategies should be imperative. Fear appeals by fear prompted intervention received intervention information, provide a new breakthrough to achieve better effect of propaganda and intervention. After over 70 years development, the Fear Appeal generated from the driver model that proposed the fear decided the effectiveness of behavior intervention, to the extended parallel process model theory which integrated protection motivation theory and parallel process theory, both of which believed the fear is just one of the estimators, suggested fear is the key factor. The fear appeal theory is turning to be even more comprehensive and accurate. As an important theoretical basement, the fear appeal is still developing, and need more work to make it perfection.

Intervention improves physician counseling on teen driving safety.

PubMed

Campbell, Brendan T; Borrup, Kevin; Saleheen, Hassan; Banco, Leonard; Lapidus, Garry

2009-07-01

As part of a statewide campaign, we surveyed physician attitudes and practice regarding teen driving safety before and after a brief intervention designed to facilitate in office counseling. A 31-item self-administered survey was mailed to Connecticut physicians, and this was followed by a mailing of teen driving safety materials to physician practices in the state. A postintervention survey was mailed 8 months after the presurvey. A total of 102 physicians completed both the pre and postsurveys. Thirty-nine percent (39%) reported having had a teen in their practice die in a motor vehicle crash in the presurvey, compared with 49% in the postsurvey. Physician counseling increased significantly for a number of issues: driving while impaired from 86% to 94%; restrictions on teen driving from 53% to 64%; teen driving laws from 53% to 63%; safe vehicle from 32% to 42%; parents model safe driving from 29% to 44%; and teen-parent written contract from 15% to 37%. At baseline, the majority of physicians who provide care to teenagers in Connecticut report discussing and counseling teens on first wave teen driver safety issues (seat belts, alcohol use), but most do not discuss graduate driver licensing laws or related issues. After a brief intervention, there was a significant increase in physician counseling of teens on teen driving laws and on the use of teen-parent contracts. Additional interventions targeting physician practices can improve physician counseling to teens and their parents on issues of teen driving safety.

Critical Issues in the Development of Health Information Systems in Supporting Environmental Health: A Case Study of Ciguatera

PubMed Central

Goater, Sarah; Derne, Bonnie; Weinstein, Philip

2011-01-01

Background Emerging environmental pressures resulting from climate change and globalization challenge the capacity of health information systems (HIS) in the Pacific to inform future policy and public health interventions. Ciguatera, a globally common marine food-borne illness, is used here to illustrate specific HIS challenges in the Pacific and how these might be overcome proactively to meet the changing surveillance needs resulting from environmental change. Objectives We review and highlight inefficiencies in the reactive nature of existing HIS in the Pacific to collect, collate, and communicate ciguatera fish poisoning data currently used to inform public health intervention. Further, we review the capacity of existing HIS to respond to new data needs associated with shifts in ciguatera disease burden likely to result from coral reef habitat disruption. Discussion Improved knowledge on the ecological drivers of ciguatera prevalence at local and regional levels is needed, combined with enhanced surveillance techniques and data management systems, to capture environmental drivers as well as health outcomes data. Conclusions The capacity of public HIS to detect and prevent future outbreaks is largely dependent on the future development of governance strategies that promote proactive surveillance and health action. Accordingly, we present an innovative framework from which to stimulate scientific debate on how this might be achieved by using existing larger scale data sets and multidisciplinary collaborations. PMID:21163721

Critical issues in the development of health information systems in supporting environmental health: a case study of ciguatera.

PubMed

Goater, Sarah; Derne, Bonnie; Weinstein, Philip

2011-05-01

Emerging environmental pressures resulting from climate change and globalization challenge the capacity of health information systems (HIS) in the Pacific to inform future policy and public health interventions. Ciguatera, a globally common marine food-borne illness, is used here to illustrate specific HIS challenges in the Pacific and how these might be overcome proactively to meet the changing surveillance needs resulting from environmental change. We review and highlight inefficiencies in the reactive nature of existing HIS in the Pacific to collect, collate, and communicate ciguatera fish poisoning data currently used to inform public health intervention. Further, we review the capacity of existing HIS to respond to new data needs associated with shifts in ciguatera disease burden likely to result from coral reef habitat disruption. Improved knowledge on the ecological drivers of ciguatera prevalence at local and regional levels is needed, combined with enhanced surveillance techniques and data management systems, to capture environmental drivers as well as health outcomes data. The capacity of public HIS to detect and prevent future outbreaks is largely dependent on the future development of governance strategies that promote proactive surveillance and health action. Accordingly, we present an innovative framework from which to stimulate scientific debate on how this might be achieved by using existing larger scale data sets and multidisciplinary collaborations.

"I wasn't texting; I was just reading an email …": a qualitative study of distracted driving enforcement in Washington State.

PubMed

Nevin, Paul E; Blanar, Laura; Kirk, Annie Phare; Freedheim, Amy; Kaufman, Robert; Hitchcock, Laura; Maeser, Jennifer D; Ebel, Beth E

2017-06-01

In response to the rise of distracted driving, many countries and most US states have adopted laws to restrict the use of handheld phones for drivers. Specific provisions of each law and the overall social mores of distracted driving influence enforceability and impact. Identify multilevel interdependent factors that influence distracted driving enforcement through the perspective of police officers. We conducted focus group discussions with active duty law enforcement officers from three large Washington State counties. Our thematic analysis used descriptive and pattern coding that placed our findings within a social ecological framework to facilitate targeted intervention development. Participants reported that the distracted driving law posed challenges for consistent and effective enforcement. They emphasised the need to change social norms around distracted driving, similar to the shifts seen around impaired driving. Many participants were themselves distracted drivers, and their individual knowledge, attitude and beliefs influenced enforcement. Participants suggested that law enforcement leaders and policymakers should develop and implement policies and strategies to prioritise and motivate increased distracted driving enforcement. Individual, interpersonal, organisational and societal factors influence enforcement of distracted driving laws. Targeted interventions should be developed to address distracted driving and sustain effective enforcement. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

The multidimensional driving style inventory a decade later: Review of the literature and re-evaluation of the scale.

PubMed

Taubman-Ben-Ari, Orit; Skvirsky, Vera

2016-08-01

The Multidimensional Driving Style Inventory (MDSI; Taubman - Ben-Ari, Mikulincer, & Gillath, 2004a), a self-report questionnaire assessing four broad driving styles, has been in use for the last ten years. During that time, numerous studies have explored the associations between the MDSI factors and sociodemographic and driving-related variables. The current paper employs two large data sets to summarize the accumulated knowledge, examining MDSI factors in samples of young drivers aged 17-21 (Study 1, n=1436) and older drivers aged 22-84 (Study 2, n=3409). Findings indicate that driving-related indicators are coherently and systematically related to the four driving styles in the expected directions, revalidating the structure of the MDSI. The results also help clarify the relationships between the driving styles and variables such as gender, ethnicity, car ownership, age, and experience, and suggest that driving styles are largely unaffected by sociodemographic characteristics, except for gender and ethnicity, and appear to represent a relatively stable and universal trait. The two studies highlight the validity and reliability of the MDSI, attesting to its practical value as a tool for purposes of research, evaluation, and intervention. Copyright © 2016 Elsevier Ltd. All rights reserved.

Poor mental health status and aggression are associated with poor driving behavior among male traffic offenders

PubMed Central

Abdoli, Nasrin; Farnia, Vahid; Delavar, Ali; Esmaeili, Alirez; Dortaj, Fariborz; Farrokhi, Noorali; Karami, Majid; Shakeri, Jalal; Holsboer-Trachsler, Edith; Brand, Serge

2015-01-01

Background In Iran, traffic accidents and deaths from traffic accidents are among the highest in the world, and generally driver behavior rather than either technical failures or environmental conditions are responsible for traffic accidents. In the present study, we explored the extent to which aggressive traits, health status, and sociodemographic variables explain driving behavior among Iranian male traffic offenders. Method A total of 443 male driving offenders (mean age: M =31.40 years, standard deviation =9.56) from Kermanshah (Iran) took part in the study. Participants completed a questionnaire booklet covering sociodemographic variables, traits of aggression, health status, and driving behavior. Results Poor health status, such as symptoms of depression, anxiety, insomnia, and social dysfunction, and also higher levels of trait aggression explained poor driving behavior. Multiple regressions indicated that poor health status, but not aggression, independently predicted poor driving behavior. Conclusion Results suggest that health status concerns are associated with poor driving behavior. Prevention and intervention might therefore focus on drivers reporting poor mental health status. PMID:26316753

Distracted driving: mobile phone use while driving in three Mexican cities.

PubMed

Vera-López, Juan Daniel; Pérez-Núñez, Ricardo; Híjar, Martha; Hidalgo-Solórzano, Elisa; Lunnen, Jeffrey C; Chandran, Aruna; Hyder, Adnan A

2013-08-01

Mexico has a significant road traffic injury and mortality burden, and several states/municipalities have begun passing legislation restricting mobile phone use while driving (MPUWD). Little information is available about the prevalence of MPUWD in Mexico. This study measures the prevalence of mobile phone talking and texting among drivers in three cities, and identifies associated demographic and environmental factors. Two rounds of roadside observations from a group of randomly selected automobile drivers were conducted during 2011-2012 in Guadalajara-Zapopan, León and Cuernavaca. The overall prevalence of MPUWD was 10.78%; it was highest in Guadalajara-Zapopan (13.93%, 95% CI 12.87 to 15.05), lowest in Cuernavaca (7.42%, 95% CI 6.29 to 8.67), and remained stable over two rounds of observations, except for León, where the prevalence increased from 5.27% to 10.37% (p=0.000). Driving alone on major roads in non-taxi cars during the weekdays was associated with MPUWD. Results highlight the importance of studying the risk of mobile phone use, and designing and evaluating specific preventive interventions to address this problem in Mexico.

Refueling Behavior of Flexible Fuel Vehicle Drivers in the Federal Fleet

DOE Office of Scientific and Technical Information (OSTI.GOV)

Daley, R.; Nangle, J.; Boeckman, G.

2014-05-01

Federal fleets are a frequent subject of legislative and executive efforts to lead a national transition to alternative fuels and advanced vehicle technologies. Section 701 of the Energy Policy Act of 2005 requires that all dual-fueled alternative fuel vehicles in the federal fleet be operated on alternative fuel 100% of the time when they have access to it. However, in Fiscal Year (FY) 2012, drivers of federal flex fuel vehicles (FFV) leased through the General Services Administration refueled with E85 24% of the time when it was available--falling well short of the mandate. The U.S. Department of Energy's National Renewablemore » Energy Laboratory completed a 2-year Laboratory Directed Research and Development project to identify the factors that influence the refueling behavior of federal FFV drivers. The project began with two primary hypotheses. First, information scarcity increases the tendency to miss opportunities to purchase E85. Second, even with perfect information, there are limits to how far drivers will go out of their way to purchase E85. This paper discusses the results of the project, which included a June 2012 survey of federal fleet drivers and an empirical analysis of actual refueling behavior from FY 2009 to 2012. This research will aid in the design and implementation of intervention programs aimed at increasing alternative fuel use and reducing petroleum consumption.« less

Interactive risk analysis on crash injury severity at a mountainous freeway with tunnel groups in China.

PubMed

Huang, Helai; Peng, Yunying; Wang, Jie; Luo, Qizhang; Li, Xiang

2018-02-01

Traffic safety of freeways has attracted major concerns, especially for a mountainous freeway affected by adverse terrain conditions, constrained roadway geometry and complicated driving environments. On the basis of a comprehensive dataset collected from a mountainous freeway with a length of 61km but gathering 12 tunnels, this study seeks to examining the interactive effect of mountainous freeway alignment, driving behaviors, vehicle characteristics and environmental factors on crash severity. A classification and regression tree (CART) model is employed as it can deal with high-order interactions between explanatory variables. Results show that the driving behavior is the most important determinant for injury severity of mountainous freeway crashes, followed by the crash time, grade, curve radius and vehicle type. These variables, interacted with the factors of season and crash location, may largely account for the likelihood of high risk events which may result in severe crashes. Events associated with a notably higher probability of severe crashes include coach drivers involved in improper lane changing and other improper actions, drivers involved in speeding during afternoon or evening, drivers involved in speeding along large curve and straight segment during morning, noon or night, and drivers involved in fatigue while passing along the downgrade. Safety interventions to prevent severe crashes at the mountainous freeway include hierarchical supervision in terms of hazardous driving events, enhanced enforcement for speeding and fatigue driving, deployment of advanced driving assistance systems for fatigue driving warning, and cumulative driving time monitoring for long-distance-travel freight vehicles. Copyright © 2017 Elsevier Ltd. All rights reserved.

Teens' distracted driving behavior: Prevalence and predictors.

PubMed

Gershon, Pnina; Zhu, Chunming; Klauer, Sheila G; Dingus, Tom; Simons-Morton, Bruce

2017-12-01

Teen drivers' over-involvement in crashes has been attributed to a variety of factors, including distracted driving. With the rapid development of in-vehicle systems and portable electronic devices, the burden associated with distracted driving is expected to increase. The current study identifies predictors of secondary task engagement among teenage drivers and provides basis for interventions to reduce distracted driving behavior. We described the prevalence of secondary tasks by type and driving conditions and evaluated the associations between the prevalence of secondary task engagement, driving conditions, and selected psychosocial factors. The private vehicles of 83 newly-licensed teenage drivers were equipped with Data Acquisition Systems (DAS), which documented driving performance measures, including secondary task engagement and driving environment characteristics. Surveys administered at licensure provided psychosocial measures. Overall, teens engaged in a potentially distracting secondary task in 58% of sampled road clips. The most prevalent types of secondary tasks were interaction with a passenger, talking/singing (no passenger), external distraction, and texting/dialing the cell phone. Secondary task engagement was more prevalent among those with primary vehicle access and when driving alone. Social norms, friends' risky driving behaviors, and parental limitations were significantly associated with secondary task prevalence. In contrast, environmental attributes, including lighting and road surface conditions, were not associated with teens' engagement in secondary tasks. Our findings indicated that teens engaged in secondary tasks frequently and poorly regulate their driving behavior relative to environmental conditions. Practical applications: Peer and parent influences on secondary task engagement provide valuable objectives for countermeasures to reduce distracted driving among teenage drivers. Copyright © 2017 National Safety Council and Elsevier Ltd. All rights reserved.

Characteristics of Effective Interventions Promoting Healthy Eating for Pre-Schoolers in Childcare Settings: An Umbrella Review

PubMed Central

Coveney, John

2018-01-01

Early Childhood Education and Care (ECEC) settings have a pivotal role in shaping children’s dietary food habits by providing the contextual environment within which they develop these behaviours. This study examines systematic reviews for (1) the effectiveness of interventions to promote healthy eating in children aged 2–5 years attending centre-based childcare; (2) intervention characteristics which are associated with promoting healthy eating and; (3) recommendations for child-health policies and practices. An Umbrella review of systematic reviews was undertaken using a standardized search strategy in ten databases. Twelve systematic reviews were examined using validated critical appraisal and data extraction tools. Children’s dietary food intake and food choices were significantly influenced. Interventions to prevent obesity did not significantly change children’s anthropometric measures or had mixed results. Evidence was more convincing if interventions were multi-component, addressed physical activity and diet, targeted individual-level and environmental-level determinants and engaged parents. Positive outcomes were mostly facilitated by researchers/external experts and these results were not replicated when implemented in centres by ECEC providers without this support. The translation of expert-led interventions into practice warrants further exploration of implementation drivers and barriers. Based on the evidence reviewed, recommendations are made to inform child-health directed practices and policies. PMID:29494537

High pregnancy incidence and low contraceptive use among a prospective cohort of female entertainment and sex workers in Phnom Penh, Cambodia.

PubMed

Duff, Putu; Evans, Jennifer L; Stein, Ellen S; Page, Kimberly; Maher, Lisa

2018-05-03

While HIV and unintended pregnancies are both occupational risks faced by female sex workers, the epidemiology of pregnancy and its drivers in this population remains understudied. This includes Cambodia, where the drivers of pregnancy among female entertainment and sex workers (FESW) remain unknown. The current study aimed to examine factors associated with incident pregnancy, as well as describe contraceptive use among FESW in Phnom Penh, Cambodia. This analysis drew from the Young Women's Health Study (YWHS)-2, a 12-month observational cohort of 220 FESW aged 15-29 years, conducted between August 2009 and August 2010. Interviewer-administered questionnaires were conducted at baseline and quarterly thereafter, alongside HIV and pregnancy testing. Bivariate and multivariable extended Cox regression analysis was used to examine correlates of incident pregnancy. At baseline, 6.8% of participants were pregnant, and only 10.8% reported using hormonal contraceptives, with 11.3% reporting an abortion in the past 3 months. Pregnancy incidence was high, at 22/100 person-years (95% CI: 16.3-30.1). In multivariable analysis, younger age (19-24 years versus 25-29 years) (Adjusted Hazards Ratio (AHR): 2.28; 95% Confidence Interval (CI) 1.22-4.27), lower income (400,000-600,000 Riel (≤150$USD) versus > 600,000 Riel (> 150$USD)) (AHR 2.63; 95% CI 1.02-6.77) positively predicted pregnancy, while higher self-reported condom self-efficacy were associated with reduced pregnancy incidence (AHR 0.89; 95% CI 0.81-0.98). Results document high incidence of pregnancy and unmet reproductive health needs among FESWs in Cambodia. Findings point to an urgent need for multi-level interventions, including venue-based HIV/STI and violence prevention interventions, in the context of legal and policy reform. High pregnancy incidence in this population may also undermine recruitment and retention into HIV prevention intervention trials. The exploration of innovative and comprehensive sex worker-tailored sexual and reproductive health service models, also as part of HIV prevention intervention trials, is warranted.

Risk factors for motor vehicle crashes in older women.

PubMed

Margolis, Karen L; Kerani, Roxanne Pieper; McGovern, Paul; Songer, Thomas; Cauley, Jane A; Ensrud, Kristine E

2002-03-01

Motor vehicle crash and fatality rates are higher per mile driven for elderly drivers, with an exponential increase above age 75. Identifying elderly drivers who are at risk for automobile crashes may help direct interventions to reduce their high rate of injuries and deaths. Subjects were 1416 women aged 65 to 84 enrolled in the Portland, Ore. site of the Study of Osteoporotic Fractures. Motor vehicle crash information for the years 1986-1995 for each participant was obtained from the Oregon State Department of Transportation. Items from questionnaires, interviews, and physical examinations were tested prospectively for associations with the occurrence of motor vehicle crashes. About one third of participants (415 of 1416) had a motor vehicle crash during a mean follow-up time of 5.7 years. After adjustment for age and weekly driving mileage, risk factors significantly associated with motor vehicle crashes were a fall in the previous year [hazard ratio (HR) 1.53, 95% confidence interval (CI) 1.26-1.86], a greater orthostatic systolic blood pressure drop (HR 1.11 per 12.5 mm Hg, 95% CI 1.01-1.22), and increased foot reaction time (HR 1.10 per 0.06 second, 95% CI 1.00-1.22). Other neuromuscular tests, functional status, medical diagnoses, vision tests, and cognitive tests did not predict motor vehicle crashes in this study population. This prospective study with extended follow-up of a large cohort of elderly women has identified crash risk factors that can be measured in the clinical setting. Further study is needed to determine if interventions aimed at these risk factors can decrease the risk of motor vehicle crashes.

Effect of news coverage on the prevalence of drunk-driving behavior: evidence from a longitudinal study.

PubMed

Yanovitzky, Itzhak

2002-05-01

To examine the proposition that antidrunk driving messages in the news media contributed indirectly to the decline in drunk driving over the past two decades through their impact on related policy making processes. Time series regression techniques are applied to longitudinal data to examine the causal association between drivers' involvement in drunk-driving behavior, the volume of news coverage devoted to the drunk driving issue, and related policy making. Results show a significant contribution of news coverage to drunk-driving-related policy actions, which in turn are associated with a reduction in drunk driving among young and high-risk drivers. There was no evidence of a direct causal association between news coverage and change in drunk-driving behavior. News coverage of alcohol-related risky behaviors seems to provide a cost-effective way of reducing the prevalence of these practices by attracting institutional attention and prompting related environmental changes. Future interventions may benefit from actively seeking to influence news coverage of risky behaviors.

Systematic Characterization and Analysis of the Taxonomic Drivers of Functional Shifts in the Human Microbiome.

PubMed

Manor, Ohad; Borenstein, Elhanan

2017-02-08

Comparative analyses of the human microbiome have identified both taxonomic and functional shifts that are associated with numerous diseases. To date, however, microbiome taxonomy and function have mostly been studied independently and the taxonomic drivers of functional imbalances have not been systematically identified. Here, we present FishTaco, an analytical and computational framework that integrates taxonomic and functional comparative analyses to accurately quantify taxon-level contributions to disease-associated functional shifts. Applying FishTaco to several large-scale metagenomic cohorts, we show that shifts in the microbiome's functional capacity can be traced back to specific taxa. Furthermore, the set of taxa driving functional shifts and their contribution levels vary markedly between functions. We additionally find that similar functional imbalances in different diseases are driven by both disease-specific and shared taxa. Such integrated analysis of microbiome ecological and functional dynamics can inform future microbiome-based therapy, pinpointing putative intervention targets for manipulating the microbiome's functional capacity. Copyright © 2017 Elsevier Inc. All rights reserved.

Elderly driver retraining

DOT National Transportation Integrated Search

1982-09-01

This report documents a study of the traffic safety problems associated with elderly drivers. For the purposes of this study, "elderly drivers" are defined as drivers aged 55 years or older. The study involved five major activities. First, research w...

Self-assessed driver competence among novice drivers--a comparison of driving test candidate assessments and examiner assessments in a Dutch and Finnish sample.

PubMed

Mynttinen, Sami; Sundström, Anna; Vissers, Jan; Koivukoski, Marita; Hakuli, Kari; Keskinen, Esko

2009-01-01

This study examined novice drivers' overconfidence by comparing their self-assessed driver competence with the assessments made by driving examiners. A Finnish (n=2,739) and a Dutch sample (n=239) of drivers license candidates assessed their driver competence in six areas and took the driving test. In contrast to previous studies where drivers have assessed their skill in comparison to the average driver, a smaller proportion overestimated and a larger proportion made realistic self-assessments of their driver competence in the present study, where self-assessments were compared with examiner assessments. Between 40% and 50% of the candidates in both samples made realistic assessments and 30% to 40% overestimated their competence. The proportion of overestimation was greater in the Dutch than in the Finnish sample, which might be explained by greater possibilities for practicing self-assessment in the Finnish driver education system. Similar to other self-assessment studies that indicate that incompetence is related to overestimation, a larger proportion of candidates that failed the test overestimated their skill compared to those who passed. In contrast to other studies, males did not overestimate their skills more than females, and younger driver candidates were not more overconfident than older drivers. Although a great proportion of the candidates made a realistic assessment of their own driver competence, overestimation is still a problem that needs to be dealt with. To improve the accuracy of novice drivers' self-assessment, methods for self-assessment training should be developed and implemented in the driver licensing process.

Work-related stress in healthcare workers.

PubMed

Tomei, G; Ricci, S; Fidanza, L; Sacco, C; De Cesare, D P; Ricci, P; Pimpinella, B; Giubilati, R; Suppi, A; Anzelmo, V; Tomei, F; Casale, T; Rosati, M V

2016-01-01

In the assessment of work-related stress it is crucial to find the factors that generate and increase it in order to identify categories of individuals at risk, to plan interventions for prevention, elimination or reduction of risk. The aim of the study is to assess the subjective stress in 68 workers of a large Italian company dealing with human health, through the use of a questionnaire-indicating tool, elaborated by the Italian National Institute for insurance against accidents at work (INAIL) and developed by the Health and Safety Executive (HSE). We studied a final sample of 68 individuals (34 drivers/rescuers and 34 video display unit (VDU) operators). The questionnaire consists of 35 items (divided into six areas) with five possible answers each, that cover working conditions considered potential causes of stress. The drivers/rescuers had a better performance than the VDU operators, especially in the areas "demand", "relationships" and "role". We compared men and women in the two groups, finding that, in VDU operators, women had a better performance than men in all areas, except "role" and "changes", in which the overall scores were the same in men and women. In the drivers/rescuers women showed more critical scores in the items "relationships" and "change". The results show that: the questionnaire-indicating tool is useful, with a demonstrated effectiveness for the occupational physician during the visits and proven validity; additional future efforts should focus on understanding the psycho-social, organizational and individual problems related to stress and the consequent implementation of preventive measures.

Factors related to seatbelt-wearing among rear-seat passengers in Malaysia.

PubMed

Ng, Choy Peng; Law, Teik Hua; Wong, Shaw Voon; Kulanthayan, S

2013-01-01

The benefit of wearing a rear seatbelt in reducing the risk of motor vehicle crash-related fatalities and injuries has been well documented in previous studies. Wearing a seatbelt not only reduces the risk of injury to rear-seat passengers, but also reduces the risk of injury to front-seat occupant who could be crushed by unbelted rear-seat passengers in a motor vehicle crash. Despite the benefits of wearing a rear seatbelt, its rate of use in Malaysia is generally low. The objective of this study was to identify factors that are associated with the wearing of a seatbelt among rear-seat passengers in Malaysia. Multinomial logistic regression analysis of the results of a questionnaire survey of 1651 rear-seat passengers revealed that rear-seat passengers who were younger, male, single and less educated and who had a perception of a low level of legislation enforcement, a lower risk-aversion and less driving experience (only for passengers who are also drivers) were less likely to wear a rear seatbelt. There was also a significant positive correlation between driver seatbelt and rear seatbelt-wearing behaviour. This implies that, in regards to seatbelt-wearing behaviour, drivers are more likely to adopt the same seatbelt-wearing behaviour when travelling as rear-seat passengers as they do when driving. These findings are crucial to the development of new interventions to increase the compliance rate of wearing a rear seatbelt. Copyright © 2012 Elsevier Ltd. All rights reserved.

A novel algorithm for finding optimal driver nodes to target control complex networks and its applications for drug targets identification.

PubMed

Guo, Wei-Feng; Zhang, Shao-Wu; Shi, Qian-Qian; Zhang, Cheng-Ming; Zeng, Tao; Chen, Luonan

2018-01-19

The advances in target control of complex networks not only can offer new insights into the general control dynamics of complex systems, but also be useful for the practical application in systems biology, such as discovering new therapeutic targets for disease intervention. In many cases, e.g. drug target identification in biological networks, we usually require a target control on a subset of nodes (i.e., disease-associated genes) with minimum cost, and we further expect that more driver nodes consistent with a certain well-selected network nodes (i.e., prior-known drug-target genes). Therefore, motivated by this fact, we pose and address a new and practical problem called as target control problem with objectives-guided optimization (TCO): how could we control the interested variables (or targets) of a system with the optional driver nodes by minimizing the total quantity of drivers and meantime maximizing the quantity of constrained nodes among those drivers. Here, we design an efficient algorithm (TCOA) to find the optional driver nodes for controlling targets in complex networks. We apply our TCOA to several real-world networks, and the results support that our TCOA can identify more precise driver nodes than the existing control-fucus approaches. Furthermore, we have applied TCOA to two bimolecular expert-curate networks. Source code for our TCOA is freely available from http://sysbio.sibcb.ac.cn/cb/chenlab/software.htm or https://github.com/WilfongGuo/guoweifeng . In the previous theoretical research for the full control, there exists an observation and conclusion that the driver nodes tend to be low-degree nodes. However, for target control the biological networks, we find interestingly that the driver nodes tend to be high-degree nodes, which is more consistent with the biological experimental observations. Furthermore, our results supply the novel insights into how we can efficiently target control a complex system, and especially many evidences on the practical strategic utility of TCOA to incorporate prior drug information into potential drug-target forecasts. Thus applicably, our method paves a novel and efficient way to identify the drug targets for leading the phenotype transitions of underlying biological networks.

Research on health equity in the SDG era: the urgent need for greater focus on implementation.

PubMed

Rasanathan, Kumanan; Diaz, Theresa

2016-12-09

The tremendous increase in knowledge on inequities in health and their drivers in recent decades has not been matched by improvements in health inequities themselves, or by systematic evidence of what works to reduce health inequities. Within health equity research there is a skew towards diagnostic studies in comparison to intervention studies showing evidence of how interventions can reduce disparities. The lack of sufficient specific evidence on how to implement specific policies and interventions in specific contexts to reduce health inequities creates policy confusion and partly explains the lack of progress on health inequities. In the field of research on equity in health, the time has come to stop focusing so much energy on prevalence and pathways, and instead shift to proposing and testing solutions. Four promising approaches to do so are implementation research, natural experimental policy studies, research on buy-in by policy-makers to action on health inequities, and geospatial analysis. The case for action on social determinants and health inequities has well and truly been made. The community of researchers on health equity now need to turn their attention to supporting implementation efforts towards achievements of the Sustainable Development Goals and substantive reductions in health inequities.

New Approaches for Moving Upstream: How State and Local Health Departments Can Transform Practice to Reduce Health Inequalities

ERIC Educational Resources Information Center

Freudenberg, Nicholas; Franzosa, Emily; Chisholm, Janice; Libman, Kimberly

2015-01-01

Growing evidence shows that unequal distribution of wealth and power across race, class, and gender produces the differences in living conditions that are "upstream" drivers of health inequalities. Health educators and other public health professionals, however, still develop interventions that focus mainly on "downstream"…

Governance and networks for health co-benefits of climate change mitigation: Lessons from two Indian cities.

PubMed

Puppim de Oliveira, Jose A; Doll, Christopher N H

2016-12-01

Health has been the main driver for many urban environmental interventions, particularly in cases of significant health problems linked to poor urban environmental conditions. This paper examines empirically the links between climate change mitigation and health in urban areas, when health is the main driver for improvements. The paper aims to understand how systems of urban governance can enable or prevent the creation of health outcomes via continuous improvements in the environmental conditions in a city. The research draws on cases from two Indian cities where initiatives were undertaken in different sectors: Surat (waste) and Delhi (transportation). Using the literature on network effectiveness as an analytical framework, the paper compares the cases to identify the possible ways to strengthen the governance and policy making process in the urban system so that each intervention can intentionally realize multiple impacts for both local health and climate change mitigation in the long term as well as factors that may pose a threat to long-term progress and revert back to the previous situation after initial achievements. Copyright © 2016 Elsevier Ltd. All rights reserved.

A university-based incentive program to increase safety belt use: Toward cost-effective institutionalization

PubMed Central

Rudd, James R.; Geller, E. Scott

1985-01-01

A cost-effective incentive program to increase safety belt use was implemented by the campus police of a large university. For each of the 3-week intervention periods during three consecutive academic quarters, the 22 campus police officers recorded the license plate numbers of vehicles with drivers wearing a shoulder belt. From these numbers, 10 raffle winners were drawn who received gift certificates donated by community merchants. Faculty and staff increased their belt usage markedly as a result of the “Seatbelt Sweepstakes,” whereas students increased their belt use only slightly. A cost-effectiveness analysis indicated that the sweepstakes cost an average of $0.98 per each newly buckled driver. During each sweepstakes intervention, officers' belt usage increased significantly, but diminished to initial baseline levels after the final withdrawal of the program. Surveys of officers' opinions indicated that the police would accept the program demands as a regular task requirement. This result and the fact that program promotion and coordination were eventually taken over by two student organizations suggest that institutionalization of the “Seatbelt Sweepstakes” is feasible. ImagesFigure 1 PMID:16795689

When regulating emotions at work pays off: a diary and an intervention study on emotion regulation and customer tips in service jobs.

PubMed

Hülsheger, Ute R; Lang, Jonas W B; Schewe, Anna F; Zijlstra, Fred R H

2015-03-01

We investigated the relationship between deep acting, automatic regulation and customer tips with 2 different study designs. The first study was a daily diary study using a sample of Dutch waiters and taxi-drivers and assessed the link of employees' daily self-reported levels of deep acting and automatic regulation with the amount of tips provided by customers (N = 166 measurement occasions nested in 34 persons). Whereas deep acting refers to deliberate attempts to modify felt emotions and involves conscious effort, automatic regulation refers to automated emotion regulatory processes that result in the natural experience of desired emotions and do not involve deliberate control and effort. Multilevel analyses revealed that both types of emotion regulation were positively associated with customer tips. The second study was an experimental field study using a sample of German hairdressers (N = 41). Emotion regulation in terms of both deep acting and automatic regulation was manipulated using a brief self-training intervention and daily instructions to use cognitive change and attentional deployment. Results revealed that participants in the intervention group received significantly more tips than participants in the control group. PsycINFO Database Record (c) 2015 APA, all rights reserved.

Reducing occupational sitting: Workers' perspectives on participation in a multi-component intervention.

PubMed

Hadgraft, Nyssa T; Willenberg, Lisa; LaMontagne, Anthony D; Malkoski, Keti; Dunstan, David W; Healy, Genevieve N; Moodie, Marj; Eakin, Elizabeth G; Owen, Neville; Lawler, Sheleigh P

2017-05-30

Office workers spend much of their time sitting, which is now understood to be a risk factor for several chronic diseases. This qualitative study examined participants' perspectives following their involvement in a cluster randomised controlled trial of a multi-component intervention targeting prolonged workplace sitting (Stand Up Victoria). The intervention incorporated a sit-stand workstation, individual health coaching and organisational support strategies. The aim of the study was to explore the acceptability of the intervention, barriers and facilitators to reducing workplace sitting, and perceived effects of the intervention on workplace culture, productivity and health-related outcomes. Semi-structured interviews (n = 21 participants) and two focus groups (n = 7) were conducted with intervention participants at the conclusion of the 12 month trial and thematic analysis was used to analyse the data. Questions covered intervention acceptability, overall impact, barriers and facilitators to reducing workplace sitting, and perceived impact on productivity and workplace culture. Overall, participants had positive intervention experiences, perceiving that reductions in workplace sitting were associated with improved health and well-being with limited negative impact on work performance. While sit-stand workstations appeared to be the primary drivers of change, workstation design and limited suitability of standing for some job tasks and situations were perceived as barriers to their use. Social support from team leaders and other participants was perceived to facilitate behavioural changes and a shift in norms towards increased acceptance of standing in the workplace. Multi-component interventions to reduce workplace sitting, incorporating sit-stand workstations, are acceptable and feasible; however, supportive social and environmental conditions are required to support participant engagement. Best practice approaches to reduce workplace sitting should address the multiple levels of influence on behaviour, including factors that may act as barriers to behavioural change.

Turning movements, vehicle offsets and ageing drivers driving behaviour at channelized and unchannelized intersections.

PubMed

Choi, Jaisung; Tay, Richard; Kim, Sangyoup; Jeong, Seungwon

2017-11-01

Ageing drivers experience a higher risk of intersection crashes because of their decrease in driving efficiency, including the decline in cognitive ability, head and neck flexibility, and visual acuity. Although several studies have been conducted to examine the factors associated with ageing driver crashes at intersections, little research has been conducted to examine the differences in the factors related to ageing drivers' turning paths and intersection geometric features. This study aims to improve the safety of ageing drivers at intersections by identifying the maneuvers that are risky for them and tracking their turning movements at selected intersections. We find that ageing drivers experience more crashes at intersections than younger drivers, especially crashes involving turning movements. Furthermore, ageing drivers experience more crashes at unchannelized intersections compared to channelized intersections. In addition, this study finds that ageing drivers exhibit greater and more inconsistent offsets during turning movements compared to those of younger drivers at both channelized and unchannelized intersections. Ageing drivers also tend to make relatively sharper or tighter turns than younger drivers. Hence, transportation engineers and road safety professionals should consider appropriate countermeasures to reduce the risks of crashes involving ageing drivers at intersections. Copyright © 2017 Elsevier Ltd. All rights reserved.

Response lags and environmental dynamics of restoration efforts for Lake Rotorua, New Zealand

NASA Astrophysics Data System (ADS)

Mueller, Hannah; Hamilton, David P.; Doole, Graeme J.

2015-07-01

Regulatory responses to degradation of freshwater ecosystems have been characterized by long response times and have often failed to prevent declining health or to implement successful restoration programs. We studied environmental and management dynamics of ecosystem restoration in Lake Rotorua, New Zealand, where land use intensification is the main driver of water quality decline. Water quality decline, invasions by exotic submerged plants and occurrences of algal blooms have led to a number of in-lake interventions such as herbicide spraying (to control submerged plants) and dosing of inflows with Alum to flocculate phosphorus (and reduce algal blooms). Management of land use to reduce nutrient run-off has also been initiated. Based on the drivers-pressures-state-impact-response (DPSIR) framework, water quality changes and management responses were examined by studying research publications and data from 1922 to 2013. Multinomial regression analysis based on the generalized maximum entropy model was used to investigate the five categories of DPSIR and examine relationships of environmental dynamics and regulatory responses. We tested whether the visibility of ecosystem degradation in the public sphere, and social lag times to respond to them, were drivers of failures of these regulatory responses. Our study shows that management was reactive, and regulations often took effect only when ecosystem decline was already well advanced. There was a disconnect between land use intensification and its role in driving water quality change. Our results indicate that science can better inform management decision making by providing a holistic framework integrating ecological knowledge, economic interest and societal constraints.

Integrative Genomics Reveals Novel Molecular Pathways and Gene Networks for Coronary Artery Disease

PubMed Central

Mäkinen, Ville-Petteri; Civelek, Mete; Meng, Qingying; Zhang, Bin; Zhu, Jun; Levian, Candace; Huan, Tianxiao; Segrè, Ayellet V.; Ghosh, Sujoy; Vivar, Juan; Nikpay, Majid; Stewart, Alexandre F. R.; Nelson, Christopher P.; Willenborg, Christina; Erdmann, Jeanette; Blakenberg, Stefan; O'Donnell, Christopher J.; März, Winfried; Laaksonen, Reijo; Epstein, Stephen E.; Kathiresan, Sekar; Shah, Svati H.; Hazen, Stanley L.; Reilly, Muredach P.; Lusis, Aldons J.; Samani, Nilesh J.; Schunkert, Heribert; Quertermous, Thomas; McPherson, Ruth; Yang, Xia; Assimes, Themistocles L.

2014-01-01

The majority of the heritability of coronary artery disease (CAD) remains unexplained, despite recent successes of genome-wide association studies (GWAS) in identifying novel susceptibility loci. Integrating functional genomic data from a variety of sources with a large-scale meta-analysis of CAD GWAS may facilitate the identification of novel biological processes and genes involved in CAD, as well as clarify the causal relationships of established processes. Towards this end, we integrated 14 GWAS from the CARDIoGRAM Consortium and two additional GWAS from the Ottawa Heart Institute (25,491 cases and 66,819 controls) with 1) genetics of gene expression studies of CAD-relevant tissues in humans, 2) metabolic and signaling pathways from public databases, and 3) data-driven, tissue-specific gene networks from a multitude of human and mouse experiments. We not only detected CAD-associated gene networks of lipid metabolism, coagulation, immunity, and additional networks with no clear functional annotation, but also revealed key driver genes for each CAD network based on the topology of the gene regulatory networks. In particular, we found a gene network involved in antigen processing to be strongly associated with CAD. The key driver genes of this network included glyoxalase I (GLO1) and peptidylprolyl isomerase I (PPIL1), which we verified as regulatory by siRNA experiments in human aortic endothelial cells. Our results suggest genetic influences on a diverse set of both known and novel biological processes that contribute to CAD risk. The key driver genes for these networks highlight potential novel targets for further mechanistic studies and therapeutic interventions. PMID:25033284

The impact of driver age on lost life years for other road users in France: A population based study of crash-involved road users.

PubMed

Lafont, Sylviane; Amoros, Emmanuelle; Gadegbeku, Blandine; Chiron, Mireille; Laumon, Bernard

2008-01-01

One of the concerns in road safety is the threat older drivers may pose to other road users. Using the rate of lost life years, the present study provides a public health approach to quantify this potential threat. A total of 1570686 motorised vehicle drivers or motorcycle riders and 652246 non-drivers, i.e. vehicle passengers, pedestrians and cyclists involved in injury crashes in France between 1996 and 2004, were included in a population based cross-sectional study. Fatality rates and rate of lost life years for each crash-involved driver age class were calculated for the drivers themselves and for other road users. The study has shown a significant reduction in the rate of lost life years for crash-involved other road users (whether passengers, pedestrians, cyclists or opposing drivers) as driver age increases. Other road users lost half as many years of life when involved in crashes with drivers aged over 85 than with drivers under 65 (1.26 and 2.32 per 100 expected remaining life years, respectively). Our findings suggest that among road users involved in injury crashes, older drivers are less dangerous for the other road users. By attributing other road users' lost life years to each driver age, this study represents a new contribution to the debate about ageing and road safety.

Effective patient-provider communication about sexual concerns in breast cancer: a qualitative study.

PubMed

Reese, Jennifer Barsky; Beach, Mary Catherine; Smith, Katherine Clegg; Bantug, Elissa T; Casale, Kristen E; Porter, Laura S; Bober, Sharon L; Tulsky, James A; Daly, Mary B; Lepore, Stephen J

2017-10-01

Breast cancer patients commonly experience sexual concerns, yet rarely discuss them with clinicians. The study examined patient and provider experiences and preferences related to communication about breast cancer-related sexual concerns with the goal of informing intervention development. Patient data (n = 28) were derived from focus groups and interviews with partnered and unpartnered women treated for breast cancer reporting sexual concerns. Provider data (n = 11) came from interviews with breast cancer oncologists and nurse practitioners. Patient and provider data were analyzed separately using the framework method of qualitative analysis. Findings revealed individual and institutional barriers to effective communication about sexual concerns and highlighted key communication facilitators (e.g., a positive patient-provider relationship, patient communication as a driver of provider communication, and vice versa). Patients expressed preferences for open, collaborative communication; providers expressed preferences for focused intervention targets (identifying concerns, offering resources/referrals) and convenient format. A model of effective communication of sexual concerns was developed to inform communication interventions. Findings suggest that to improve patient-provider communication about sexual concerns, knowledge and skills-based interventions that activate patients and that equip providers for effective discussions about sexual concerns are needed, as are institutional changes that could incentivize such discussions.

Game On? Smoking Cessation Through the Gamification of mHealth: A Longitudinal Qualitative Study

PubMed Central

Eisingerich, Andreas B

2016-01-01

Background Finding ways to increase and sustain engagement with mHealth interventions has become a challenge during application development. While gamification shows promise and has proven effective in many fields, critical questions remain concerning how to use gamification to modify health behavior. Objective The objective of this study is to investigate how the gamification of mHealth interventions leads to a change in health behavior, specifically with respect to smoking cessation. Methods We conducted a qualitative longitudinal study using a sample of 16 smokers divided into 2 cohorts (one used a gamified intervention and the other used a nongamified intervention). Each participant underwent 4 semistructured interviews over a period of 5 weeks. Semistructured interviews were also conducted with 4 experts in gamification, mHealth, and smoking cessation. Interviews were transcribed verbatim and thematic analysis undertaken. Results Results indicated perceived behavioral control and intrinsic motivation acted as positive drivers to game engagement and consequently positive health behavior. Importantly, external social influences exerted a negative effect. We identified 3 critical factors, whose presence was necessary for game engagement: purpose (explicit purpose known by the user), user alignment (congruency of game and user objectives), and functional utility (a well-designed game). We summarize these findings in a framework to guide the future development of gamified mHealth interventions. Conclusions Gamification holds the potential for a low-cost, highly effective mHealth solution that may replace or supplement the behavioral support component found in current smoking cessation programs. The framework reported here has been built on evidence specific to smoking cessation, however it can be adapted to health interventions in other disease categories. Future research is required to evaluate the generalizability and effectiveness of the framework, directly against current behavioral support therapy interventions in smoking cessation and beyond. PMID:27777216

Game On? Smoking Cessation Through the Gamification of mHealth: A Longitudinal Qualitative Study.

PubMed

El-Hilly, Abdulrahman Abdulla; Iqbal, Sheeraz Syed; Ahmed, Maroof; Sherwani, Yusuf; Muntasir, Mohammed; Siddiqui, Sarim; Al-Fagih, Zaid; Usmani, Omar; Eisingerich, Andreas B

2016-10-24

Finding ways to increase and sustain engagement with mHealth interventions has become a challenge during application development. While gamification shows promise and has proven effective in many fields, critical questions remain concerning how to use gamification to modify health behavior. The objective of this study is to investigate how the gamification of mHealth interventions leads to a change in health behavior, specifically with respect to smoking cessation. We conducted a qualitative longitudinal study using a sample of 16 smokers divided into 2 cohorts (one used a gamified intervention and the other used a nongamified intervention). Each participant underwent 4 semistructured interviews over a period of 5 weeks. Semistructured interviews were also conducted with 4 experts in gamification, mHealth, and smoking cessation. Interviews were transcribed verbatim and thematic analysis undertaken. Results indicated perceived behavioral control and intrinsic motivation acted as positive drivers to game engagement and consequently positive health behavior. Importantly, external social influences exerted a negative effect. We identified 3 critical factors, whose presence was necessary for game engagement: purpose (explicit purpose known by the user), user alignment (congruency of game and user objectives), and functional utility (a well-designed game). We summarize these findings in a framework to guide the future development of gamified mHealth interventions. Gamification holds the potential for a low-cost, highly effective mHealth solution that may replace or supplement the behavioral support component found in current smoking cessation programs. The framework reported here has been built on evidence specific to smoking cessation, however it can be adapted to health interventions in other disease categories. Future research is required to evaluate the generalizability and effectiveness of the framework, directly against current behavioral support therapy interventions in smoking cessation and beyond.

Drivers of Bushmeat Hunting and Perceptions of Zoonoses in Nigerian Hunting Communities

PubMed Central

Friant, Sagan; Paige, Sarah B.; Goldberg, Tony L.

2015-01-01

Bushmeat hunting threatens biodiversity and increases the risk of zoonotic pathogen transmission. Nevertheless, limited information exists on patterns of contact with wildlife in communities that practice bushmeat hunting, especially with respect to social drivers of hunting behavior. We used interview responses from hunters and non-hunters in rural hunting communities in Nigeria to: 1) quantify contact rates with wildlife, 2) identify specific hunting behaviors that increase frequency of contact, 3) identify socioeconomic factors that predispose individuals to hunt, and 4) measure perceptions of risk. Participants engaged in a variety of behaviors that increased contact with wild animals, including: butchering to sell (37%), being injured (14%), using body parts for traditional medicine (19%), collecting carcasses found in forests and/or farms (18%), and keeping as pets (16%). Hunters came into contact with wildlife significantly more than non-hunters, even through non-hunting exposure pathways. Participants reported hunting rodents (95%), ungulates (93%), carnivores (93%), primates (87%), and bats (42%), among other prey. Reported hunting frequencies within taxonomic groups of prey were different for different hunting behaviors. Young age, lower education level, larger household size, having a father who hunts, and cultural group were all associated with becoming a hunter. Fifty-five percent of respondents were aware that they could contract diseases from wild animals, but only 26% of these individuals reported taking protective measures. Overall, hunters in this setting frequently contact a diversity of prey in risky ways, and the decision to become a hunter stems from family tradition, modified by economic necessity. Conservation and public health interventions in such settings may be most efficient when they capitalize on local knowledge and target root socio-economic and cultural drivers that lead to hunting behavior. Importantly, interventions that target consumption alone will not be sufficient; other drivers and modes of interaction with wildlife must also be considered. PMID:26001078

Utility-value intervention with parents increases students' STEM preparation and career pursuit.

PubMed

Rozek, Christopher S; Svoboda, Ryan C; Harackiewicz, Judith M; Hulleman, Chris S; Hyde, Janet S

2017-01-31

During high school, developing competence in science, technology, engineering, and mathematics (STEM) is critically important as preparation to pursue STEM careers, yet students in the United States lag behind other countries, ranking 35th in mathematics and 27th in science achievement internationally. Given the importance of STEM careers as drivers of modern economies, this deficiency in preparation for STEM careers threatens the United States' continued economic progress. In the present study, we evaluated the long-term effects of a theory-based intervention designed to help parents convey the importance of mathematics and science courses to their high-school-aged children. A prior report on this intervention showed that it promoted STEM course-taking in high school; in the current follow-up study, we found that the intervention improved mathematics and science standardized test scores on a college preparatory examination (ACT) for adolescents by 12 percentile points. Greater high-school STEM preparation (STEM course-taking and ACT scores) was associated with increased STEM career pursuit (i.e., STEM career interest, the number of college STEM courses, and students' attitudes toward STEM) 5 y after the intervention. These results suggest that the intervention can affect STEM career pursuit indirectly by increasing high-school STEM preparation. This finding underscores the importance of targeting high-school STEM preparation to increase STEM career pursuit. Overall, these findings demonstrate that a motivational intervention with parents can have important effects on STEM preparation in high school, as well as downstream effects on STEM career pursuit 5 y later.

Utility-value intervention with parents increases students’ STEM preparation and career pursuit

PubMed Central

Rozek, Christopher S.; Svoboda, Ryan C.; Harackiewicz, Judith M.; Hulleman, Chris S.; Hyde, Janet S.

2017-01-01

During high school, developing competence in science, technology, engineering, and mathematics (STEM) is critically important as preparation to pursue STEM careers, yet students in the United States lag behind other countries, ranking 35th in mathematics and 27th in science achievement internationally. Given the importance of STEM careers as drivers of modern economies, this deficiency in preparation for STEM careers threatens the United States’ continued economic progress. In the present study, we evaluated the long-term effects of a theory-based intervention designed to help parents convey the importance of mathematics and science courses to their high-school–aged children. A prior report on this intervention showed that it promoted STEM course-taking in high school; in the current follow-up study, we found that the intervention improved mathematics and science standardized test scores on a college preparatory examination (ACT) for adolescents by 12 percentile points. Greater high-school STEM preparation (STEM course-taking and ACT scores) was associated with increased STEM career pursuit (i.e., STEM career interest, the number of college STEM courses, and students’ attitudes toward STEM) 5 y after the intervention. These results suggest that the intervention can affect STEM career pursuit indirectly by increasing high-school STEM preparation. This finding underscores the importance of targeting high-school STEM preparation to increase STEM career pursuit. Overall, these findings demonstrate that a motivational intervention with parents can have important effects on STEM preparation in high school, as well as downstream effects on STEM career pursuit 5 y later. PMID:28096393

Driving fatigue in professional drivers: a survey of truck and taxi drivers.

PubMed

Meng, Fanxing; Li, Shuling; Cao, Lingzhi; Li, Musen; Peng, Qijia; Wang, Chunhui; Zhang, Wei

2015-01-01

Fatigue among truck drivers has been studied extensively; however, less is known regarding the fatigue experience of taxi drivers in heavily populated metropolitan areas. This study aimed to compare the differences and similarities between truck and taxi driver fatigue to provide implications for the fatigue management and education of professional drivers. A sample of 274 truck drivers and 286 taxi drivers in Beijing was surveyed via a questionnaire, which included items regarding work characteristics, fatigue experience, accident information, attitude toward fatigue, and methods of counteracting fatigue. Driver fatigue was prevalent among professional drivers, and it was even more serious for taxi drivers. Taxi drivers reported more frequent fatigue experiences and were involved in more accidents. Among the contributing factors to fatigue, prolonged driving time was the most important factor identified by both driver groups. Importantly, the reason for the engagement in prolonged driving was neither due to the lack of awareness concerning the serious outcome of fatigue driving nor because of their poor detection of fatigue. The most probable reason was the optimism bias, as a result of which these professional drivers thought that fatigue was more serious for other drivers than for themselves, and they thought that they were effective in counteracting the effect of fatigue on their driving performance. Moreover, truck drivers tended to employ methods that require stopping to counteract fatigue, whereas taxi drivers preferred methods that were simultaneous with driving. Although both driver groups considered taking a nap as one of the most effective means to address fatigue, this method was not commonly used. Interestingly, these drivers were aware that the methods they frequently used were not the most effective means to counteract fatigue. This study provides knowledge on truck and taxi drivers' characteristics in fatigue experience, fatigue attitude, and fatigue countermeasures, and these findings have practical implications for the fatigue management and education of professional drivers.

Association of driver air bags with driver fatality: a matched cohort study

PubMed Central

Cummings, Peter; McKnight, Barbara; Rivara, Frederick P; Grossman, David C

2002-01-01

Objective To estimate the association of driver air bag presence with driver fatality in road traffic crashes. Design Matched pair cohort study. Setting All passenger vehicle crashes in the United States during 1990-2000 inclusive. Subjects 51 031 driver-passenger pairs in the same vehicle. Main outcome measures Relative risk of death within 30 days of a crash. Results Drivers with an air bag were less likely to die than drivers without an air bag (adjusted relative risk 0.92 (95% confidence interval 0.88 to 0.96)). This estimate was nearly the same whether drivers wore a seat belt (adjusted relative risk 0.93) or not (0.91). Air bags were associated with more protection for women (0.88 (0.82 to 0.93)), than for men (0.94 (0.90 to 0.99)). Drivers wearing a seat belt were less likely to die than unbelted drivers (0.35 (0.33 to 0.36)). Belted drivers with an air bag were less likely to die than unbelted drivers without an air bag (0.32 (0.30 to 0.34)). Conclusions If the associations are causal the average risk of driver death was reduced 8% (95% confidence interval 4% to 12%) by an air bag. Benefit was similar for belted and unbelted drivers and was slightly greater for women. However, seat belts offered much more protection than air bags. What is already known on this topicStudies have estimated that driver air bags reduce the risk of death in a road vehicle crash by 10-14%These studies disagree as to whether benefit is greater for drivers wearing a seat belt or for unbelted driversWhat this study addsHaving an air bag was associated with an 8% reduction in the risk of death, whether the driver was belted or notThe reduction in risk was greater for women (12%) than for men (6%)Seat belts provided much greater protection, with seat belt use reducing the risk of death by 65% (or by 68% in combination with an air bag) PMID:12003882

Exposure to particles and nitrogen dioxide among taxi, bus and lorry drivers.

PubMed

Lewné, Marie; Nise, Gun; Lind, Marie-Louise; Gustavsson, Per

2006-03-01

The aims of this study have been to investigate the occurrence of systematic differences in the personal exposure to motor exhaust between different groups of taxi, bus and lorry drivers, and to study if these are influenced by the choice of exposure indicator. We used one indicator of the gaseous phase, nitrogen dioxide (NO(2)), and one of the particle phase (measured by DataRAM), of the exhausts. A total of 121 drivers were included in the study: 39 taxi drivers, 42 bus drivers and 40 lorry drivers. Personal measurements were performed during one working day. Nitrogen dioxide was measured with passive diffusive samplers and particles with Data-RAM, a logging instrument using nephelometric monitoring. The instrument measures particles between 0.1 and 10 microm in size. The average exposure to NO(2) for lorry drivers was 68 microg/m(3); for bus drivers 60 microg/m(3) and for taxi drivers 48 microg/m(3). For particles the exposure was 57 microg/m(3) for lorry drivers, 44 microg/m(3) for bus drivers and 26 microg/m(3) for taxi drivers. The result remained unchanged when exposures were adjusted for variation in urban background levels of NO(2) and particulate matter with an aerodynamic diameter <10 microm (PM(10)). Lorry drivers experienced the highest exposure and taxi drivers the lowest with bus drivers in an intermediate position, regardless of whether NO(2) or particles were used as exposure indicator. The levels of both NO(2) and particles were higher for bus drivers in the city than for them driving in the suburbs. Using diesel or petrol as a fuel for taxis had no influence on the exposure for the drivers, indicating that the taxi drivers' exposure mainly depends on exhaust from surrounding traffic.

Survival pattern of first accident among commercial drivers in the Greater Accra Region of Ghana.

PubMed

Nanga, Salifu; Odai, Nii Afotey; Lotsi, Anani

2017-06-01

In this study, the average accident risk of commercial drivers in the Greater Accra region of Ghana and its associated risks were examined based on a survey data collected using paper-based questionnaires from 204 commercial drivers from the Greater Accra Region of Ghana. The Cox Proportional Hazards Model was used for multivariate analysis while the Kaplan-Meier (KM) Model was used to study the survival patterns of the commercial drivers. The study revealed that the median survival time for an accident to happen is 2.50 years. Good roads provided a better chance of survival than bad roads and experienced drivers have a better chance of survival than the inexperienced drivers. Age of driver, alcohol usage of driver, marital status, condition of road and duration of driver's license were found to be related to the risk of accident. Copyright © 2017 Elsevier Ltd. All rights reserved.

Safety implications of providing real-time feedback to distracted drivers.

PubMed

Donmez, Birsen; Boyle, Linda Ng; Lee, John D

2007-05-01

A driving simulator study was conducted to assess whether real-time feedback on a driver's state can influence the driver's interaction with in-vehicle information systems (IVIS). Previous studies have shown that IVIS tasks can undermine driver safety by increasing driver distraction. Thus, mitigating driver distraction using a feedback mechanism appears promising. This study was designed to test real-time feedback that alerts drivers based on their off-road eye glances. Feedback was displayed in two display locations (vehicle-centered, and IVIS-centered) to 16 young and 13 middle-aged drivers. Distraction was observed as problematic for both age groups with delayed responses to a lead vehicle-braking event as indicated by delayed accelerator releases. Significant benefits were not observed for braking and steering behavior for this experiment, but there was a significant change in drivers' interaction with IVIS. When given feedback on their distracted state, drivers looked at the in-vehicle display less frequently regardless of where feedback was displayed in the vehicle. This indicates that real-time feedback based on the driver state can positively alter driver's engagement in distracting activities, helping them attend better to the roadway.

A New Approach to Identifying the Drivers of Regulation Compliance Using Multivariate Behavioural Models

PubMed Central

Thomas, Alyssa S.; Milfont, Taciano L.; Gavin, Michael C.

2016-01-01

Non-compliance with fishing regulations can undermine management effectiveness. Previous bivariate approaches were unable to untangle the complex mix of factors that may influence fishers’ compliance decisions, including enforcement, moral norms, perceived legitimacy of regulations and the behaviour of others. We compared seven multivariate behavioural models of fisher compliance decisions using structural equation modeling. An online survey of over 300 recreational fishers tested the ability of each model to best predict their compliance with two fishing regulations (daily and size limits). The best fitting model for both regulations was composed solely of psycho-social factors, with social norms having the greatest influence on fishers’ compliance behaviour. Fishers’ attitude also directly affected compliance with size limit, but to a lesser extent. On the basis of these findings, we suggest behavioural interventions to target social norms instead of increasing enforcement for the focal regulations in the recreational blue cod fishery in the Marlborough Sounds, New Zealand. These interventions could include articles in local newspapers and fishing magazines highlighting the extent of regulation compliance as well as using respected local fishers to emphasize the benefits of compliance through public meetings or letters to the editor. Our methodological approach can be broadly applied by natural resource managers as an effective tool to identify drivers of compliance that can then guide the design of interventions to decrease illegal resource use. PMID:27727292

Drinking driver and traffic safety project. Volume 2, Probabilities for drinking drivers

DOT National Transportation Integrated Search

1973-10-01

This is the second volume of a final report of a four-year study of drinking drivers. It includes a brief description of a prediction model developed from over 4000 cases, including drinking drivers, recidivist drinking drivers and drivers license ap...

Driver behavior analysis for right-turn drivers at signalized intersections using SHRP 2 naturalistic driving study data.

PubMed

Wu, Jianqing; Xu, Hao

2017-12-01

Understanding driver behavior is important for traffic safety and operation, especially at intersections where different traffic movements conflict. While most driver-behavior studies are based on simulation, this paper documents the analysis of driver-behavior at signalized intersections with the SHRP 2 Naturalistic Driving Study (NDS) data. This study analyzes the different influencing factors on the operation (speed control) and observation of right-turn drivers. A total of 300 NDS trips at six signalized intersections were used, including the NDS time-series sensor data, the forward videos and driver face videos. Different factors of drivers, vehicles, roads and environments were studied for their influence on driver behavior. An influencing index function was developed and the index was calculated for each influencing factor to quantitatively describe its influencing level. The influencing index was applied to prioritize the factors, which facilitates development and selection of safety countermeasures to improve intersection safety. Drivers' speed control was analyzed under different conditions with consideration of the prioritized influencing factors. Vehicle type, traffic signal status, conflicting traffic, conflicting pedestrian and driver age group were identified as the five major influencing factors on driver observation. This research revealed that drivers have high acceleration and low observation frequency under Right-Turn-On-Red (RTOR), which constituted potential danger for other roadway users, especially for pedestrians. As speed has a direct influence on crash rates and severities, the revealed speed patterns of the different situations also benefit selection of safety countermeasures at signalized intersections. Published by Elsevier Ltd.

Cognitive bias modification for social anxiety in adults who stutter: a feasibility study of a randomised controlled trial

PubMed Central

Gascoine, Sally; Carroll, Amy; Humby, Kate; Kingston, Mary; Shepstone, Lee; Risebro, Helen; Mackintosh, Bundy; Thompson, Tammy Davidson; Hodgekins, Jo

2017-01-01

Objective To determine the feasibility and acceptability of a computerised treatment for social anxiety disorder for adults who stutter including identification of recruitment, retention and completion rates, large cost drivers and selection of most appropriate outcome measure(s) to inform the design of a future definitive trial. Design Two-group parallel design (treatment vs placebo), double-blinded feasibility study. Participants: 31 adults who stutter. Intervention Attention training via an online probe detection task in which the stimuli were images of faces displaying neutral and disgusted expressions. Main outcome measures Psychological measures: Structured Clinical Interview Global Assessment of Functioning score; Liebowitz Social Anxiety Scale; Social Phobia and Anxiety Inventory; State-Trait Anxiety Inventory; Unhelpful Thoughts and Beliefs about Stuttering. Speech fluency: percent syllables stuttered. Economic evaluation: resource use questionnaire; EuroQol three-dimension questionnaire. Acceptability: Likert Scale questionnaire of experience of trial, acceptability of the intervention and randomisation procedure. Results Feasibility of recruitment strategy was demonstrated. Participant feedback indicated that the intervention and definitive trial, including randomisation, would be acceptable to adults who stutter. Of the 31 participants who were randomised, 25 provided data at all three data collection points. Conclusions The feasibility study informed components of the intervention. Modifications to the design are needed before a definitive trial can be undertaken. Trial registration number I SRCTN55065978; Post-results. PMID:29061602

A randomized trial to evaluate the effectiveness of an individual, education-based safe transport program for drivers aged 75 years and older

PubMed Central

2013-01-01

Background There are concerns over safety of older drivers due to increased crash involvement and vulnerability to injury. However, loss of driving privileges can dramatically reduce independence and quality of life for older members of the community. The aim of this trial is to examine the effectiveness of a safe transport program for drivers aged 75 years and older at reducing driving exposure but maintaining mobility. Methods and design A randomised trial will be conducted, involving 380 drivers aged 75 years and older, resident in urban and semi-rural areas of North-West Sydney. The intervention is an education program based on the Knowledge Enhances Your Safety (KEYS) program, adapted for the Australian context. Driving experience will be measured objectively using an in-vehicle monitoring device which includes a global positioning system (GPS) to assess driving exposure and an accelerometer to detect rapid deceleration events. Participation will be assessed using the Keele Assessment of Participation (KAP). Data will be analysed on an intention-to-treat basis; the primary outcomes include driving exposure, rapid deceleration events and scores for KAP. Secondary outcomes include self-reported measures of driving, socialisation, uptake of alternative forms of transport, depressive symptoms and mood. A detailed process evaluation will be conducted, including examination of the delivery of the program and uptake of alternative forms of transport. A subgroup analysis is planned for drivers with reduced function as characterized by established cut-off scores on the Drivesafe assessment tool. Discussion This randomised trial is powered to provide an objective assessment of the efficacy of an individually tailored education and alternative transportation program to promote safety of older drivers but maintain mobility. Trial registration: Australian New Zealand Clinical Trials Registry ACTRN12612000543886. PMID:23379593

Driving styles and their associations with personality and motivation.

PubMed

Taubman-Ben-Ari, Orit; Yehiel, Dalia

2012-03-01

The associations between driving styles and the Big-Five personality factors and perceived costs and benefits of driving were examined in order to obtain a more comprehensive understanding of driving styles. Questionnaires tapping driving style, personality traits, motivations for driving, and background variables were completed by 320 drivers (150 men and 170 women). The results show that each driving style is associated with a unique set of sociodemographic, personality, and motivational factors. The reckless and angry styles were both endorsed more by men than women, by younger drivers, and by those displaying higher levels of Extroversion and thrill seeking, and lower levels of Agreeableness and Conscientiousness. However, whereas the reckless style was also predicted by the perceived costs of driving-related distress, as well as higher perceived risk to life among those with higher education, the angry style was also predicted by perceptions of both control and annoyance among more educated drivers. The anxious style was endorsed more by women, and by drivers lower on Conscientiousness and higher on Neuroticism. Individuals reporting this style regard driving as a cause of distress and annoyance, and, depending on their level of education, perceive it as entailing more risk to life and as a potential damage to their self-image (higher education), or as providing more opportunities for impression management (lower education). The careful driving style was endorsed more by women, and associated with higher Agreeableness, Conscientiousness, and Openness, along with higher pleasure (especially among younger drivers), but lower thrill seeking and worries about damage to self-esteem. The discussion focuses on the importance of looking at driving styles and their predictors holistically in order to design practical interventions suited to different profiles of drivers. Copyright © 2011 Elsevier Ltd. All rights reserved.

Statistical implications of using moving violations to determine crash responsibility in young driver crashes

PubMed Central

Curry, Allison E.; Pfeiffer, Melissa R.; Myers, Rachel K.; Durbin, Dennis R.; Elliott, Michael R.

2014-01-01

Traditional methods for determining crash responsibility—most commonly moving violation citations—may not accurately characterize at-fault status among crash-involved drivers given that: (1) issuance may vary by factors that are independent of fault (e.g., driver age, gender), and (2) these methods do not capture driver behaviors that are not illegal but still indicative of fault. We examined the statistical implications of using moving violations to determine crash responsibility in young driver crashes by comparing it with a method based on crash-contributing driver actions. We selected all drivers in police-reported passenger-vehicle crashes (2010–2011) that involved a New Jersey driver <21 years old (79,485 drivers < age 21, 61,355 drivers ≥ age 21.) For each driver, crash responsibility was determined from the crash report using two alternative methods: (1) issuance of a moving violation citation; and (2) presence of a driver action (e.g., failure to yield, inattention). Overall, 18% of crash-involved drivers were issued a moving violation while 50% had a driver action. Only 32.2% of drivers with a driver action were cited for a moving violation. Further, the likelihood of being cited given the presence of a driver action was higher among certain driver subgroups—younger drivers, male drivers, and drivers in single-vehicle and more severe crashes. Specifically among young drivers, those driving at night, carrying peer passengers, and having a suspended or no license were more often cited. Conversely, fatally-injured drivers were almost never cited. We also demonstrated that using citation data may lead to statistical bias in the characterization of at-fault drivers and of quasi-induced exposure measures. Studies seeking to accurately determine crash responsibility should thoughtfully consider the potential sources of bias that may result from using legal culpability methods. For many studies, determining driver responsibility via the identification of driver actions may yield more accurate characterizations of at-fault drivers. PMID:24398139

The cost of a primary care-based childhood obesity prevention intervention

PubMed Central

2014-01-01

Background United States pediatric guidelines recommend that childhood obesity counseling be conducted in the primary care setting. Primary care-based interventions can be effective in improving health behaviors, but also costly. The purpose of this study was to evaluate the cost of a primary care-based obesity prevention intervention targeting children between the ages of two and six years who are at elevated risk for obesity, measured against usual care. Methods High Five for Kids was a cluster-randomized controlled clinical trial that aimed to modify children’s nutrition and TV viewing habits through a motivational interviewing intervention. We assessed visit-related costs from a societal perspective, including provider-incurred direct medical costs, provider-incurred equipment costs, parent time costs and parent out-of-pocket costs, in 2011 dollars for the intervention (n = 253) and usual care (n = 192) groups. We conducted a net cost analysis using both societal and health plan costing perspectives and conducted one-way sensitivity and uncertainty analyses on results. Results The total costs for the intervention group and usual care groups in the first year of the intervention were $65,643 (95% CI [$64,522, $66,842]) and $12,192 (95% CI [$11,393, $13,174]). The mean costs for the intervention and usual care groups were $259 (95% CI [$255, $264]) and $63 (95% CI [$59, $69]) per child, respectively, for a incremental difference of $196 (95% CI [$191, $202]) per child. Children in the intervention group attended a mean of 2.4 of a possible 4 in-person visits and received 0.45 of a possible 2 counseling phone calls. Provider-incurred costs were the primary driver of cost estimates in sensitivity analyses. Conclusions High Five for Kids was a resource-intensive intervention. Further studies are needed to assess the cost-effectiveness of the intervention relative to other pediatric obesity interventions. Trial registration ClinicalTrials.gov Identifier: NCT00377767. PMID:24472122

The cost of a primary care-based childhood obesity prevention intervention.

PubMed

Wright, Davene R; Taveras, Elsie M; Gillman, Matthew W; Horan, Christine M; Hohman, Katherine H; Gortmaker, Steven L; Prosser, Lisa A

2014-01-29

United States pediatric guidelines recommend that childhood obesity counseling be conducted in the primary care setting. Primary care-based interventions can be effective in improving health behaviors, but also costly. The purpose of this study was to evaluate the cost of a primary care-based obesity prevention intervention targeting children between the ages of two and six years who are at elevated risk for obesity, measured against usual care. High Five for Kids was a cluster-randomized controlled clinical trial that aimed to modify children's nutrition and TV viewing habits through a motivational interviewing intervention. We assessed visit-related costs from a societal perspective, including provider-incurred direct medical costs, provider-incurred equipment costs, parent time costs and parent out-of-pocket costs, in 2011 dollars for the intervention (n = 253) and usual care (n =192) groups. We conducted a net cost analysis using both societal and health plan costing perspectives and conducted one-way sensitivity and uncertainty analyses on results. The total costs for the intervention group and usual care groups in the first year of the intervention were $65,643 (95% CI [$64,522, $66,842]) and $12,192 (95% CI [$11,393, $13,174]). The mean costs for the intervention and usual care groups were $259 (95% CI [$255, $264]) and $63 (95% CI [$59, $69]) per child, respectively, for a incremental difference of $196 (95% CI [$191, $202]) per child. Children in the intervention group attended a mean of 2.4 of a possible 4 in-person visits and received 0.45 of a possible 2 counseling phone calls. Provider-incurred costs were the primary driver of cost estimates in sensitivity analyses. High Five for Kids was a resource-intensive intervention. Further studies are needed to assess the cost-effectiveness of the intervention relative to other pediatric obesity interventions.

Driver distraction and driver inattention: definition, relationship and taxonomy.

PubMed

Regan, Michael A; Hallett, Charlene; Gordon, Craig P

2011-09-01

There is accumulating evidence that driver distraction and driver inattention are leading causes of vehicle crashes and incidents. However, as applied psychological constructs, they have been inconsistently defined and the relationship between them remains unclear. In this paper, driver distraction and driver inattention are defined and a taxonomy is presented in which driver distraction is distinguished from other forms of driver inattention. The taxonomy and the definitions provided are intended (a) to provide a common framework for coding different forms of driver inattention as contributing factors in crashes and incidents, so that comparable estimates of their role as contributing factors can be made across different studies, and (b) to make it possible to more accurately interpret and compare, across studies, the research findings for a given form of driver inattention. Copyright © 2011 Elsevier Ltd. All rights reserved.

The effect of stress and personality on dangerous driving behavior among Chinese drivers.

PubMed

Ge, Yan; Qu, Weina; Jiang, Caihong; Du, Feng; Sun, Xianghong; Zhang, Kan

2014-12-01

The relationship between stress and road safety has been studied for many years, but the effect of global stress and its joint effect with personality on driving behavior have received little attention in previous studies. This study aimed to elucidate the impact of global stress and various personality traits on driving behavior. 242 drivers completed the Perceived Stress Scale-10 (PSS-10), the Dula Dangerous Driving Index (DDDI), and several personality trait scales related to anger, sensation seeking, and altruism. The results showed that perceived stress and sensation seeking were significantly correlated with the four subcategories of dangerous driving behavior, namely, negative cognitive/emotional driving (NCED), aggressive driving (AD), risky driving (RD), and drunk driving (DD). Moreover, anger was positively correlated with negative cognitive/emotional driving, aggressive driving, and risky driving, and altruism was negatively correlated with aggressive driving and drunk driving. Hierarchical multiple regressions were applied to analyze the mediating effect of personality traits, and the results showed that anger mediated the relationship between stress and dangerous driving behavior and that this mediating role was especially strong for negative cognitive/emotional driving and aggressive driving. Collectively, the results showed that stress is an important factor that can affect people's driving behavior but that personality traits mediate the effect of stress on driving behavior. The findings from this study regarding the relationship among stress, anger, and dangerous driving behavior could be applied in the development of intervention programs for stress and anger management in order to improve drivers' ability to manage emotional thoughts and adjust their behavior on the road. Copyright © 2014 Elsevier Ltd. All rights reserved.

Knowledge of commercial bus drivers about road safety measures in Lagos, Nigeria.

PubMed

Okafor Ifeoma, P; Odeyemi Kofoworola, A; Dolapo Duro, C

2013-01-01

Road traffic injuries have persisted as a serious public health problem and much of the health burden is in developing countries. Over-speeding, poor enforcement of traffic regulations and commuter buses have been highly implicated in road traffic injuries in developing countries. The aim of this study was to determine drivers' knowledge of selected road safety measures, i.e. the pre-requisites for driver's license, road signs and speed limits. This was a cross-sectional study carried out in Lagos, Nigeria. Simple random sampling was used to select the two motor parks used for the study and all the consenting commercial minibus drivers operating within the parks (407) were included in the study. Data was collected with a pre-tested, structured, interviewer-administered questionnaire and analyzed with epi-info statistical software. Two hundred and sixty-one (64.1%) of them knew that Visual Acuity test should be done before obtaining driver's license and 53.8% knew the correct minimum age for obtaining driver's license. Only 1% of the drivers had correct knowledge of the driver's license authorities in Nigeria. The drivers had poor knowledge of road signs (59.0%) and poor knowledge of maximum speed limits (100%). The oldest, least educated and least experienced drivers had the poorest level of knowledge. The drivers demonstrated poor knowledge of road safety measures. There is need for driver education to improve their knowledge.

Forgetting induced speeding: Can prospective memory failure account for drivers exceeding the speed limit?

PubMed

Bowden, Vanessa K; Visser, Troy A W; Loft, Shayne

2017-06-01

It is generally assumed that drivers speed intentionally because of factors such as frustration with the speed limit or general impatience. The current study examined whether speeding following an interruption could be better explained by unintentional prospective memory (PM) failure. In these situations, interrupting drivers may create a PM task, with speeding the result of drivers forgetting their newly encoded intention to travel at a lower speed after interruption. Across 3 simulated driving experiments, corrected or uncorrected speeding in recently reduced speed zones (from 70 km/h to 40 km/h) increased on average from 8% when uninterrupted to 33% when interrupted. Conversely, the probability that participants traveled under their new speed limit in recently increased speed zones (from 40 km/h to 70 km/h) increased from 1% when uninterrupted to 23% when interrupted. Consistent with a PM explanation, this indicates that interruptions lead to a general failure to follow changed speed limits, not just to increased speeding. Further testing a PM explanation, Experiments 2 and 3 manipulated variables expected to influence the probability of PM failures and subsequent speeding after interruptions. Experiment 2 showed that performing a cognitively demanding task during the interruption, when compared with unfilled interruptions, increased the probability of initially speeding from 1% to 11%, but that participants were able to correct (reduce) their speed. In Experiment 3, providing participants with 10s longer to encode the new speed limit before interruption decreased the probability of uncorrected speeding after an unfilled interruption from 30% to 20%. Theoretical implications and implications for road design interventions are discussed. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

Vital Signs: Seat Belt Use Among Long-Haul Truck Drivers — United States, 2010

PubMed Central

Chen, Guang X.; Collins, James W.; Sieber, W. Karl; Pratt, Stephanie G.; Rodríguez-Acosta, Rosa L.; Lincoln, Jennifer E.; Birdsey, Jan; Hitchcock, Edward M.; Robinson, Cynthia F.

2015-01-01

Background Motor vehicle crashes were the leading cause of occupational fatalities in the United States in 2012, accounting for 25% of deaths. Truck drivers accounted for 46% of these deaths. This study estimates the prevalence of seat belt use and identifies factors associated with nonuse of seat belts among long-haul truck drivers (LHTDs), a group of workers at high risk for fatalities resulting from truck crashes. Methods CDC analyzed data from its 2010 national survey of LHTD health and injury. A total of 1,265 drivers completed the survey interview. Logistic regression was used to examine the association between seat belt nonuse and risk factors. Results An estimated 86.1% of LHTDs reported often using a seat belt, 7.8% used it sometimes, and 6.0% never. Reporting never using a belt was associated with often driving ≥10 mph (16 kph) over the speed limit (adjusted odds ratio [AOR] = 2.9), working for a company with no written safety program (AOR = 2.8), receiving two or more tickets for moving violations in the preceding 12 months (AOR = 2.2), living in a state without a primary belt law (AOR = 2.1); and being female (AOR = 2.3). Conclusions Approximately 14% of LHTDs are at increased risk for injury and death because they do not use a seat belt on every trip. Safety programs and other management interventions, engineering changes, and design changes might increase seat belt use among LHTDs. Implications for Public Health Primary state belt laws can help increase belt use among LHTDs. Manufacturers can use recently collected anthropometric data to design better-fitting and more comfortable seat belt systems. PMID:25742382

Diabetic Driving Studies-Part 1: Brake Response Time in Diabetic Drivers With Lower Extremity Neuropathy.

PubMed

Meyr, Andrew J; Spiess, Kerianne E

Although the effect of lower extremity pathology and surgical intervention on automobile driving function has been a topic of contemporary interest, we are unaware of any analysis of the effect of lower extremity diabetic sensorimotor neuropathy on driving performance. The objective of the present case-control investigation was to assess the mean brake response time in diabetic drivers with lower extremity neuropathy compared with that of a control group and a brake response safety threshold. The driving performances of participants were evaluated using a computerized driving simulator with specific measurement of the mean brake response time and frequency of abnormally delayed brake responses. We analyzed a control group of 25 active drivers with neither diabetes nor lower extremity neuropathy and an experimental group of 25 active drivers with type 2 diabetes and lower extremity neuropathy. The experimental group demonstrated a 37.89% slower mean brake response time (0.757 ± 0.180 versus 0.549 ± 0.076 second; p < .001), with abnormally delayed responses occurring at a greater frequency (57.5% versus 3.5%; p < .001). Independent of a comparative statistical analysis, the observed mean brake response time in the experimental group was slower than the reported safety brake response threshold of 0.70 second. The results of the present investigation provide original data with respect to abnormally delayed brake responses in diabetic patients with lower extremity neuropathy and might raise the potential for impaired driving function in this population. Copyright © 2017 American College of Foot and Ankle Surgeons. Published by Elsevier Inc. All rights reserved.

Economic Evaluation of Family Planning Interventions in Low and Middle Income Countries; A Systematic Review

PubMed Central

Zakiyah, Neily; van Asselt, Antoinette D. I.; Roijmans, Frank; Postma, Maarten J.

2016-01-01

Background A significant number of women in low and middle income countries (L-MICs) who need any family planning, experience a lack in access to modern effective methods. This study was conducted to review potential cost effectiveness of scaling up family planning interventions in these regions from the published literatures and assess their implication for policy and future research. Study design A systematic review was performed in several electronic databases i.e Medline (Pubmed), Embase, Popline, The National Bureau of Economic Research (NBER), EBSCOHost, and The Cochrane Library. Articles reporting full economic evaluations of strategies to improve family planning interventions in one or more L-MICs, published between 1995 until 2015 were eligible for inclusion. Data was synthesized and analyzed using a narrative approach and the reporting quality of the included studies was assessed using the Consolidated Health Economic Evaluation Reporting Standards (CHEERS) statement. Results From 920 references screened, 9 studies were eligible for inclusion. Six references assessed cost effectiveness of improving family planning interventions in one or more L-MICs, while the rest assessed costs and consequences of integrating family planning and HIV services, concerning sub-Saharan Africa. Assembled evidence suggested that improving family planning interventions is cost effective in a variety of L-MICs as measured against accepted international cost effectiveness benchmarks. In areas with high HIV prevalence, integrating family planning and HIV services can be efficient and cost effective; however the evidence is only supported by a very limited number of studies. The major drivers of cost effectiveness were cost of increasing coverage, effectiveness of the interventions and country-specific factors. Conclusion Improving family planning interventions in low and middle income countries appears to be cost-effective. Additional economic evaluation studies with improved reporting quality are necessary to generate further evidence on costs, cost-effectiveness, and affordability, and to support increased funding and investments in family planning programs. PMID:27992552

Model driver screening and evaluation program. Volume 2, Maryland pilot older driver study

DOT National Transportation Integrated Search

2003-05-01

This research project studied the feasibility as well as the scientific validity and utility of performing functional capacity screening with older drivers. A Model Program was described encompassing procedures to detect functionally impaired drivers...

A Qualitative Study of Provider Perceptions of Influences on Uptake of Pediatric Hospital Guidelines in Lao PDR.

PubMed

Gray, Amy Z; Soukaloun, Douangdao; Soumphonphakdy, Bandith

2017-08-01

Strategies to improve the quality of hospital care are needed if ongoing gains in child health and survival are to be made. We previously reported on improvements in the quality of case management in hospitals following a guideline-based intervention in Lao PDR, with variation in the degree of change achieved between clinical conditions. This study aims to understand the factors that influenced the uptake of the guideline-based intervention, and its impact on care. This qualitative study was embedded in a mixed-methods evaluation of guideline implementation in nine hospitals in Lao PDR. Focus groups and individual interviews were conducted with 70 health staff from central, provincial, and district hospitals. The interview guide was based on the Theoretical Domains Framework. Inductive content analysis was performed on interview transcripts to identify themes, supported by field notes from the intervention. Findings were triangulated against previously reported quantitative outcomes using driver diagrams. Key influences on guidelines uptake related to the guideline and intervention (filling a void, physical accessibility, comprehensibility, training in guideline use), health staff (behavior regulation, trust in guidelines, and beliefs about consequences), and the environment (social influences particularly consensus and incorporation into clinical norms). The major barrier was family preference for treatments in conflict with guideline recommendations. This study identifies contextual factors that explain, as well as validate previously identified improvements in care following guideline implementation in Lao PDR. It provides novel understanding of why the same intervention may have a differential impact on different clinical conditions.

Adolescent drivers: a developmental perspective on risk, proficiency, and safety.

PubMed

Keating, Daniel P; Halpern-Felsher, Bonnie L

2008-09-01

Despite considerable improvement in the rates of crashes, injuries, and fatalities among adolescent drivers, attributable in part to effective interventions such as graduated driver licensing, these rates and their associated health risks remain unacceptably high. To understand the sources of risky driving among teens, as well as to identify potential avenues for further advances in prevention, this article presents a review of the relevant features of contemporary research on adolescent development. Current research offers significant advances in the understanding of the sources of safe driving, proficient driving, and risky driving among adolescents. This multifaceted perspective--as opposed to simple categorization of good versus bad driving--provides new opportunities for using insights on adolescent development to enhance prevention. Drawing on recent work on adolescent physical, neural, and cognitive development, we argue for approaches to prevention that recognize both the strengths and the limitations of adolescent drivers, with particular attention to the acquisition of expertise, regulatory competence, and self-regulation in the context of perceived risk. This understanding of adolescent development spotlights the provision of appropriate and effective scaffolding, utilizing the contexts of importance to adolescents--parents, peers, and the broader culture of driving--to support safe driving and to manage the inherent risks in learning to do so.

Does rush hour see a rush of emotions? Driver mood in conditions likely to exhibit congestion

PubMed Central

Morris, Eric A; Hirsch, Jana A.

2016-01-01

Polls show that a large portion of the public considers traffic congestion to be a problem and believes a number of policy interventions would ameliorate it. However, most of the public rejects new taxes and fees to fund these improvements. This may be because of a disconnect between the public's stated antipathy towards congestion and the recalled emotional costs congestion imposes. To explore this, we use a large and representative sample drawn from the American Time Use Survey to examine how drivers experience four emotions (happiness, sadness, stress, and fatigue), plus a constructed composite mood variable, when they travel in peak periods, in large cities, in city centers, and in combinations of these. We also explore the interactions between these indicators and trip duration. We find evidence that drivers in the largest cities at the very peak of rush hour (5:00pm-6:00pm) are in a less positive mood, presumably because of congestion. However, this effect, though significant, is small, and we find no significant results using broader definitions of the peak period. In all, our findings suggest that congestion's impact on drivers as a group is quite limited. This may help explain why the public's attitude toward painful financial trade-offs to address congestion is lukewarm. PMID:27231669

An Agent-Based Intervention to Assist Drivers Under Stereotype Threat: Effects of In-Vehicle Agents' Attributional Error Feedback.

PubMed

Joo, Yeon Kyoung; Lee-Won, Roselyn J

2016-10-01

For members of a group negatively stereotyped in a domain, making mistakes can aggravate the influence of stereotype threat because negative stereotypes often blame target individuals and attribute the outcome to their lack of ability. Virtual agents offering real-time error feedback may influence performance under stereotype threat by shaping the performers' attributional perception of errors they commit. We explored this possibility with female drivers, considering the prevalence of the "women-are-bad-drivers" stereotype. Specifically, we investigated how in-vehicle voice agents offering error feedback based on responsibility attribution (internal vs. external) and outcome attribution (ability vs. effort) influence female drivers' performance under stereotype threat. In addressing this question, we conducted an experiment in a virtual driving simulation environment that provided moment-to-moment error feedback messages. Participants performed a challenging driving task and made mistakes preprogrammed to occur. Results showed that the agent's error feedback with outcome attribution moderated the stereotype threat effect on driving performance. Participants under stereotype threat had a smaller number of collisions when the errors were attributed to effort than to ability. In addition, outcome attribution feedback moderated the effect of responsibility attribution on driving performance. Implications of these findings are discussed.

Cost of Illness of Multiple Sclerosis - A Systematic Review

PubMed Central

Ernstsson, Olivia; Gyllensten, Hanna; Alexanderson, Kristina; Tinghög, Petter; Friberg, Emilie; Norlund, Anders

2016-01-01

Background Cost-of-illness (COI) studies of Multiple Sclerosis (MS) are vital components for describing the economic burden of MS, and are frequently used in model studies of interventions of MS. We conducted a systematic review of studies estimating the COI of MS, to compare costs between studies and examine cost drivers, emphasizing generalizability and methodological choices. Material and method A literature search on studies published in English on COI of MS was performed in PubMed for the period January 1969 to January 2014, resulting in 1,326 publications. A mapping of studies using a bottom-up approach or top-down approach, respectively, was conducted for the 48 studies assessed as relevant. In a second analysis, the cost estimates were compared between the 29 studies that used a societal perspective on costs, human capital approach for indirect costs, presenting number of patients included, time-period studied, and year of price level used. Results The mapping showed that bottom-up studies and prevalence approaches were most common. The cost ratios between different severity levels within studies were relatively stable, to the ratio of 1 to 2 to 3 for disability level categories. Drugs were the main cost drivers for MS-patients with low disease severity, representing 29% to 82% of all costs in this patient group, while the main cost components for groups with more advanced MS symptoms were production losses due to MS and informal care, together representing 17% to 67% of costs in those groups. Conclusion The bottom-up method and prevalence approach dominated in studies of COI of MS. Our findings show that there are difficulties in comparing absolute costs across studies, nevertheless, the relative costs expressed as cost ratios, comparing different severity levels, showed higher resemblance. Costs of drugs were main cost drivers for less severe MS and informal care and production losses for the most severe MS. PMID:27411042

Changing drivers' minds: the evaluation of an advanced driver coaching system.

PubMed

Stanton, N A; Walker, G H; Young, M S; Kazi, T; Salmon, P M

2007-08-01

This paper reports on the study of an advanced driver coaching system. The study distinguishes between different types of post-licensure programmes in order to explore a system based on a model of identifying and responding to hazards, called 'information, position, speed, gear and acceleration' (IPSGA). Previous literature has been sceptical about the benefits of advanced driver education; thus, the current study was designed to control for the effects of coaching drivers in the 'IPSGA' system (the treatment group) against the effects of being accompanied (control group 1), as well as the mere effects of time (control group 2). Measures were taken before the driver coaching began (as a baseline measure) and again after 8 weeks (to see if any changes had occurred). These measures included driver knowledge via a post-drive interview, observations of driving skill and driver attitude using a locus of control scale. The results suggest that advanced driver coaching using the IPSGA system had a beneficial effect on all of these measures. Drivers in the coaching condition improved their situation awareness, driving skills and reduced attributions of external locus of control. The study lends support to the case for one-to-one individualized driver coaching using a systematic model of driving.

Child passengers and driver culpability in fatal crashes by driver gender.

PubMed

Maasalo, Ida; Lehtonen, Esko; Pekkanen, Jami; Summala, Heikki

2016-07-03

Studies based on accident statistics generally suggest that the presence of a passenger reduces adult drivers' accident risk. However, passengers have been reported to be a source of distraction in a remarkable portion of distraction-related crashes. Although the effect of passengers on driving performance has been studied extensively, few studies have focused on how a child passenger affects the driver.  A child in a car is a potential distractor for parents, especially for mothers of small children, who often suffer from sleep deficit. The aim of this study was to examine how the presence of child passengers of different ages is associated with a higher driver culpability, which was expected due to child-related distraction and fatigue. The analysis was based on the comprehensive data of fatal crashes studied in-depth by multidisciplinary road accident investigation teams in Finland during 1988-2012. Teams determine the primary party who had the most crucial effect on the origin of the event. We define the primary party as culpable and the others involved as nonculpable drivers. The culpability rate was defined as the percentage of culpable drivers and rates were compared for drivers with a child/teen passenger aged 0-17 years (N = 348), with an adult passenger without children (N = 324), and when driving alone (N = 579), grouped by child age and driver gender.  Drivers with specific risk-related behavior (substantial speeding, driving when intoxicated, unbelted, or without a license) were excluded from the analyses, in order to make the drivers with and without children comparable. Only drivers 26-47 years old were included, representing parents with children 0-9 years of age. Male drivers were less often culpable with 0- to 17-year-old passengers in the car than alone or with adults. This was not the case with female drivers. The gender difference in culpability was most marked with small children age 0-4 years. Female drivers' culpability rate with a 0- to 4-year-old child passenger was higher and male drivers' culpability rate was lower compared to drivers without passengers or with only adult passengers. The results indicate that female drivers are at higher risk of crashes than male drivers when driving with small children. Further research is needed to replicate this finding and to determine causal mechanisms.

The study of KBP of road construction workers of highway AIDS prevention project before and after intervention.

PubMed

Liu, Dan; Dong, Si-Ping; Gao, Guang-Ming; Fan, Ming-Yu; Zhang, Zong-Jiu; Fang, Peng-Qian

2013-10-01

To get scientific basis for further health education through the research of the road construction workers' KBP before and after the interventions of highway AIDS prevention project. Multi-stage random sampling method was employeed to select workers of 8 sites from 14 sites along highway to investigate their AIDS knowledge, belief and performance (KBP) before and after highway AIDS prevention project. Over 90% of the investigated workers had ever heard about AIDS, and the non-skilled workers of lower educational level improved more after intervention. The correct answer rate of the three transmitting ways of AIDS of drivers which is the focused group of highway before and after intervention had the obvious statistical significance (P<0.05), and the other group's correct answer rates also had improved after intervention. Most people's understanding of preventing AIDS through correct use of condoms when having sex had a statistically significant difference(P<0.05) after prevention. The rates of using condoms of foremen and skilled workers when having sex with commercial sex worker/casual partner increased after intervention. The health education of HIV among the road construction workers is effective and further health education of HIV prevention should be carried out among the road construction workers to improve their knowledge and awareness of avoiding the high-risk behaviors. Copyright © 2013 Hainan Medical College. Published by Elsevier B.V. All rights reserved.

Safe Driving Climate among Friends (SDCaF): A new scale.

PubMed

Guggenheim, Noga; Taubman-Ben-Ari, Orit

2018-01-01

Reckless driving among young people, especially young men, is a major cause of injury and fatalities the world over. Like other aspects of this age group, young drivers' driving behaviors and norms are influenced by the accepted social discourse of their peers. Yet despite extensive existing knowledge on young drivers, very few studies have dealt specifically with their characteristic friendship relations. This lacuna in the literature may reflect the absence of specific research tools for examining driving with friends. To fill this gap, we conducted a series of studies with 706 young drivers (aged 17-24) of both sexes aimed at developing and validating a multidimensional scale designed to examine the effect of the social relations of adolescents and young adults on their driving. Entitled Safe Driving Climate among Friends (SDCaF), the final scale consists of 19 items, which tap four dimensions of driving with friends: friends' pressure; social costs of driving with friends; communication with friends about driving; and shared commitment to safe driving. The validity of the scale was established by examining associations between its four dimensions and various variables of personality, friendship, and driving. The findings indicate good reliability and validity, with the three variables of resistance to peer influence, self-disclosure, and personal responsibility for safe driving yielding positive associations with the SDCaF dimensions communication and shared commitment to safe driving, and negative associations with the dimensions friends' pressure and social costs. General tendency to respond to social pressure was positively associated with the dimensions of friends' pressure and social costs, and negatively associated with shared commitment to safe driving. Gender differences were also found, with men scoring higher than women on friends' pressure, and lower than women on shared commitment to safe driving. The SDCaF can serve as a research tool, as well as a diagnostic instrument for detecting susceptibility to reckless driving among young drivers, thereby aiding in the design of targeted educational and intervention programs. Copyright © 2017 Elsevier Ltd. All rights reserved.

Critical Opportunities for Public Health Law: A Call for Action

PubMed Central

Wood, Jennifer; Burris, Scott; Wagenaar, Alexander C.; Ibrahim, Jennifer K.; Swanson, Jeffrey W.

2013-01-01

Although legal interventions are responsible for many sentinel public health achievements, law is underutilized as a tool for advancing population health. Our purpose was to identify critical opportunities for public health lawmaking. We articulated key criteria and illustrated their use with 5 examples. These opportunities involve significant health problems that are potentially amenable to change through law and for which an effective legal intervention is available: optimizing graduated driver licensing laws, increasing tax rates on alcoholic beverages, regulating sodium in foods, enacting laws to facilitate reversal of opioid overdoses, and improving mental health interventions in the college setting. We call for a national conversation about critical opportunities for public health law to advance evidence-based policymaking. PMID:24028265

Hospital cultural competency as a systematic organizational intervention: Key findings from the national center for healthcare leadership diversity demonstration project.

PubMed

Weech-Maldonado, Robert; Dreachslin, Janice L; Epané, Josué Patien; Gail, Judith; Gupta, Shivani; Wainio, Joyce Anne

Cultural competency or the ongoing capacity of health care systems to provide for high-quality care to diverse patient populations (National Quality Forum, 2008) has been proposed as an organizational strategy to address disparities in quality of care, patient experience, and workforce representation. But far too many health care organizations still do not treat cultural competency as a business imperative and driver of strategy. The aim of the study was to examine the impact of a systematic, multifaceted, and organizational level cultural competency initiative on hospital performance metrics at the organizational and individual levels. This demonstration project employs a pre-post control group design. Two hospital systems participated in the study. Within each system, two hospitals were selected to serve as the intervention and control hospitals. Executive leadership (C-suite) and all staff at one general medical/surgical nursing unit at the intervention hospitals experienced a systematic, planned cultural competency intervention. Assessments and interventions focused on three organizational level competencies of cultural competency (diversity leadership, strategic human resource management, and patient cultural competency) and three individual level competencies (diversity attitudes, implicit bias, and racial/ethnic identity status). In addition, we evaluated the impact of the intervention on diversity climate and workforce diversity. Overall performance improvement was greater in each of the two intervention hospitals than in the control hospital within the same health care system. Both intervention hospitals experienced improvements in the organizational level competencies of diversity leadership and strategic human resource management. Similarly, improvements were observed in the individual level competencies for diversity attitudes and implicit bias for Blacks among the intervention hospitals. Furthermore, intervention hospitals outperformed their respective control hospitals with respect to diversity climate. A focused and systematic approach to organizational change when coupled with interventions that encourage individual growth and development may be an effective approach to building culturally competent health care organizations.

Determination of characteristics of fatally injured drivers

DOT National Transportation Integrated Search

2001-12-01

The objective of this study was to identify driver characteristics that can be used to predict driver risk of fatal crashes. The study had 3 components: (1) Comparisons were made among drivers who were killed in single-vehicle crashes or were at faul...

Licensing procedures for older drivers.

DOT National Transportation Integrated Search

2013-09-01

This study examined the driver licensing procedures in all 50 States as they apply to the older (65+) driver. A literature review examined reports of possible declines in older driver capabilities and the ability of a driver licensing agency to scree...

Economic Evaluation of Family Planning Interventions in Low and Middle Income Countries; A Systematic Review.

PubMed

Zakiyah, Neily; van Asselt, Antoinette D I; Roijmans, Frank; Postma, Maarten J

2016-01-01

A significant number of women in low and middle income countries (L-MICs) who need any family planning, experience a lack in access to modern effective methods. This study was conducted to review potential cost effectiveness of scaling up family planning interventions in these regions from the published literatures and assess their implication for policy and future research. A systematic review was performed in several electronic databases i.e Medline (Pubmed), Embase, Popline, The National Bureau of Economic Research (NBER), EBSCOHost, and The Cochrane Library. Articles reporting full economic evaluations of strategies to improve family planning interventions in one or more L-MICs, published between 1995 until 2015 were eligible for inclusion. Data was synthesized and analyzed using a narrative approach and the reporting quality of the included studies was assessed using the Consolidated Health Economic Evaluation Reporting Standards (CHEERS) statement. From 920 references screened, 9 studies were eligible for inclusion. Six references assessed cost effectiveness of improving family planning interventions in one or more L-MICs, while the rest assessed costs and consequences of integrating family planning and HIV services, concerning sub-Saharan Africa. Assembled evidence suggested that improving family planning interventions is cost effective in a variety of L-MICs as measured against accepted international cost effectiveness benchmarks. In areas with high HIV prevalence, integrating family planning and HIV services can be efficient and cost effective; however the evidence is only supported by a very limited number of studies. The major drivers of cost effectiveness were cost of increasing coverage, effectiveness of the interventions and country-specific factors. Improving family planning interventions in low and middle income countries appears to be cost-effective. Additional economic evaluation studies with improved reporting quality are necessary to generate further evidence on costs, cost-effectiveness, and affordability, and to support increased funding and investments in family planning programs.

Framework for mapping the drivers of coastal vulnerability and spatial decision making for climate-change adaptation: A case study from Maharashtra, India.

PubMed

Krishnan, Pandian; Ananthan, Pachampalayam Shanmugam; Purvaja, Ramachandran; Joyson Joe Jeevamani, Jeyapaul; Amali Infantina, John; Srinivasa Rao, Cherukumalli; Anand, Arur; Mahendra, Ranganalli Somashekharappa; Sekar, Iyyapa; Kareemulla, Kalakada; Biswas, Amit; Kalpana Sastry, Regulagedda; Ramesh, Ramachandran

2018-05-31

The impacts of climate change are of particular concern to the coastal region of tropical countries like India, which are exposed to cyclones, floods, tsunami, seawater intrusion, etc. Climate-change adaptation presupposes comprehensive assessment of vulnerability status. Studies so far relied either on remote sensing-based spatial mapping of physical vulnerability or on certain socio-economic aspects with limited scope for upscaling or replication. The current study is an attempt to develop a holistic and robust framework to assess the vulnerability of coastal India at different levels. We propose and estimate cumulative vulnerability index (CVI) as a function of exposure, sensitivity and adaptive capacity, at the village level, using nationally comparable and credible datasets. The exposure index (EI) was determined at the village level by decomposing the spatial multi-hazard maps, while sensitivity (SI) and adaptive capacity indices (ACI) were estimated using 23 indicators, covering social and economic aspects. The indicators were identified through the literature review, expert consultations, opinion survey, and were further validated through statistical tests. The socio-economic vulnerability index (SEVI) was constructed as a function of sensitivity and adaptive capacity for planning grassroot-level interventions and adaptation strategies. The framework was piloted in Sindhudurg, a coastal district in Maharashtra, India. It comprises 317 villages, spread across three taluks viz., Devgad, Malvan and Vengurla. The villages in Sindhudurg were ranked based on this multi-criteria approach. Based on CVI values, 92 villages (30%) in Sindhudurg were identified as highly vulnerable. We propose a decision tool for identifying villages vulnerable to changing climate, based on their level of sensitivity and adaptive capacity in a two-dimensional matrix, thus aiding in planning location-specific interventions. Here, vulnerability indicators are classified and designated as 'drivers' (indicators with significantly high values and intervention priority) and 'buffers' (indicators with low-to-moderate values) at the village level. The framework provides for aggregation or decomposition of CVI and other sub-indices, in order to plan spatial contingency plans and enable swift action for climate adaptation.

Data and methods for studying commercial motor vehicle driver fatigue, highway safety and long-term driver health.

PubMed

Stern, Hal S; Blower, Daniel; Cohen, Michael L; Czeisler, Charles A; Dinges, David F; Greenhouse, Joel B; Guo, Feng; Hanowski, Richard J; Hartenbaum, Natalie P; Krueger, Gerald P; Mallis, Melissa M; Pain, Richard F; Rizzo, Matthew; Sinha, Esha; Small, Dylan S; Stuart, Elizabeth A; Wegman, David H

2018-03-09

This article summarizes the recommendations on data and methodology issues for studying commercial motor vehicle driver fatigue of a National Academies of Sciences, Engineering, and Medicine study. A framework is provided that identifies the various factors affecting driver fatigue and relating driver fatigue to crash risk and long-term driver health. The relevant factors include characteristics of the driver, vehicle, carrier and environment. Limitations of existing data are considered and potential sources of additional data described. Statistical methods that can be used to improve understanding of the relevant relationships from observational data are also described. The recommendations for enhanced data collection and the use of modern statistical methods for causal inference have the potential to enhance our understanding of the relationship of fatigue to highway safety and to long-term driver health. Copyright © 2018 The Authors. Published by Elsevier Ltd.. All rights reserved.

Assessing the Relationship between Socioeconomic Conditions and Urban Environmental Quality in Accra, Ghana

PubMed Central

Fobil, Julius; May, Juergen; Kraemer, Alexander

2010-01-01

The influence of socioeconomic status (SES) on health inequalities is widely known, but there is still poor understanding of the precise relationship between area-based socioeconomic conditions and neighborhood environmental quality. This study aimed to investigate the socioeconomic conditions which predict urban neighbourhood environmental quality. The results showed wide variation in levels of association between the socioeconomic variables and environmental conditions, with strong evidence of a real difference in environmental quality across the five socioeconomic classes with respect to total waste generation (p < 0.001), waste collection rate (p < 0.001), sewer disposal rate (p < 0.001), non-sewer disposal (p < 0.003), the proportion of households using public toilets (p = 0.005). Socioeconomic conditions are therefore important drivers of change in environmental quality and urban environmental interventions aimed at infectious disease prevention and control if they should be effective could benefit from simultaneous implementation with other social interventions. PMID:20195437

Applying comparative effectiveness research to public and population health initiatives.

PubMed

Teutsch, Steven M; Fielding, Jonathan E

2011-02-01

Comparative effectiveness research to date has focused primarily on the diagnosis and treatment of diseases and injuries in individuals. Yet the greatest drivers of people's overall health are found in their social and physical environments. We recommend that the comparative effectiveness research agenda focus on the public health issues responsible for the greatest overall illness and death levels, such as programs to increase high school graduation rates, which are strongly associated with improvements in long-term illness and death rates. In so doing, the agenda should spotlight efforts to address widely recognized social and environmental determinants of health, such as improving access to early childhood development programs and education, as well as interventions aimed at affecting climate change and addressing behavioral risk factors such as smoking. We also urge federal health agencies to invest in further development of methods to compare public health interventions and to use those methods to conduct the studies.

Firefighter perceptions of cancer risk: Results of a qualitative study.

PubMed

Anderson, David A; Harrison, Tyler R; Yang, Fan; Wendorf Muhamad, Jessica; Morgan, Susan E

2017-07-01

Recent epidemiological research on firefighters indicates an increased incidence of specific types of cancer. Intervention is needed in the fire service yet little is known about how firefighters perceive their cancer risk. Participant observation (150 h, n = 100) and focus group (n = 17) data were collected from 15 fire stations in South Florida. Firefighters had at least 3 years of experience, ranks included drivers, captains, lieutenants, and specialty captains, with a median age of 51 years. From the qualitative analysis, two major categories (direct and indirect factors) for cancer risks emerged based on participant notions of cancer risk and cancer prevention behaviors as they relate to firefighting. Firefighters perceive cancer risks as the result of performing essential job tasks and from indirect job factors related to being a firefighter. The two categories of cancer risks suggest different points of entry for intervention. © 2017 Wiley Periodicals, Inc.

Can mHealth Revolutionize the Way We Manage Adult Obesity?

PubMed

Bhardwaj, Niharika N; Wodajo, Bezawit; Gochipathala, Keerthi; Paul, David P; Coustasse, Alberto

2017-01-01

Obesity is the largest driver of chronic preventable diseases, accounting for an estimated $147 billion or 10 percent of total US healthcare costs in 2008. It has been forecasted that 42 percent of Americans will be obese by 2030. Mobile health (mHealth) technologies target and may modify the behavioral factors that lead to obesity to promote a healthy lifestyle. These technologies could potentially reduce the cost and the morbidity and mortality burden of obesity because of their inexpensive and portable nature. This study aimed to analyze the efficacy and cost-effectiveness of mHealth interventions for adult obesity in the United States. The methodology used in this study was a literature review of 54 articles. Weight, body mass index (BMI), waist circumference reductions, and favorable lifestyle behavior changes were noted across most studies. Existing data and research on efficacy and linked costs indicated that mHealth technologies were more effective than other methods and could be inexpensively delivered remotely to manage adult obesity, offering significant benefits over conventional care. Further studies on the costs and benefits of adapting such mHealth interventions in clinical settings are needed.

Factors influencing physicians' choice of workplace: systematic review of drivers of attrition and policy interventions to address them.

PubMed

El Koussa, Maria; Atun, Rifat; Bowser, Diana; Kruk, Margaret E

2016-12-01

The movement of skilled physicians from the public to the private sector is a key constraint to achieving universal health coverage and is currently affecting health systems worldwide. This systematic review aims to assess factors influencing physicians' choice of workplace, and policy interventions for retaining physicians in the public sector. Five literature databases were searched. Studies were included in the review if they focused on at least one of the following criteria: (i) incentives or motivators for retaining physicians in the public sector, (ii) pull factors that encouraged physicians to move to the private sector, (iii) push factors that forced physicians to leave the public sector, (iv) policy interventions or case studies that addressed physician retention in the public sector, and (v) qualitative reviews of policy interventions that were implemented in different health system settings. Nineteen articles met the inclusion criteria. Six major themes that affected physicians' choice of workplace were identified including: financial incentives, career development, infrastructure and staffing, professional work environment, workload and autonomy. The majority of the studies suggested that the use of financial incentives was a motivator in retaining physicians in the public sector. The review also identified policy interventions including: regulatory controls, incentives and management reforms. Regulatory controls and incentives were the two most frequently reported policy interventions. While factors affecting physicians' choice of workplace are country specific, financial incentives and professional development are core factors. Other factors are highly influenced by context, and thus, it would be useful for future cross-country research to use standardized data collection tools, allowing comparison of contextual factors as well as the examination of how context affects physician retention in the public sector.

Factors influencing physicians’ choice of workplace: systematic review of drivers of attrition and policy interventions to address them

PubMed Central

El Koussa, Maria; Atun, Rifat; Bowser, Diana; Kruk, Margaret E

2016-01-01

Objectives The movement of skilled physicians from the public to the private sector is a key constraint to achieving universal health coverage and is currently affecting health systems worldwide. This systematic review aims to assess factors influencing physicians’ choice of workplace, and policy interventions for retaining physicians in the public sector. Methods Five literature databases were searched. Studies were included in the review if they focused on at least one of the following criteria: (i) incentives or motivators for retaining physicians in the public sector, (ii) pull factors that encouraged physicians to move to the private sector, (iii) push factors that forced physicians to leave the public sector, (iv) policy interventions or case studies that addressed physician retention in the public sector, and (v) qualitative reviews of policy interventions that were implemented in different health system settings. Results Nineteen articles met the inclusion criteria. Six major themes that affected physicians’ choice of workplace were identified including: financial incentives, career development, infrastructure and staffing, professional work environment, workload and autonomy. The majority of the studies suggested that the use of financial incentives was a motivator in retaining physicians in the public sector. The review also identified policy interventions including: regulatory controls, incentives and management reforms. Regulatory controls and incentives were the two most frequently reported policy interventions. Conclusion While factors affecting physicians’ choice of workplace are country specific, financial incentives and professional development are core factors. Other factors are highly influenced by context, and thus, it would be useful for future cross–country research to use standardized data collection tools, allowing comparison of contextual factors as well as the examination of how context affects physician retention in the public sector. PMID:27648254

Driving Performance among Bioptic Telescope Users with Low Vision Two Years after Obtaining Their Driver's License: A Quasi-Experimental Study

ERIC Educational Resources Information Center

Vincent, Claude; Lachance, Jean-Paul; Deaudelin, Isabelle

2012-01-01

This study sought to compare road safety of new drivers with low vision who have followed a specific pilot bioptic training program with other groups of drivers all matched for age and driving experience. A quasi-experimental design was used two years after drivers obtained their license. Drivers were classified in the experimental group (n = 10,…