Behavioral and environmental interventions for reducing motor vehicle trauma.
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The effect of central and paracentral visual field defects on driving abilities has until now received little attention. To date studies and surveys have concentrated on visual acuity and peripheral field loss. Here we summarise for the first time those diseases causing central visual field defects likely to be associated with binocular visual acuity adequate for driving.
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The purpose of this article is to review the literature on the ability of individuals with dementia to drive an automobile. Based on a review of the literature, several factors were identified that may be useful in differentiating between people with dementia who presently remain safe drivers from those who have progressed to impaired driving. These factors include disease duration and severity, sex, patient self-assessment, family assessment, neuropsychological measures, findings on road evaluations, and driving simulator testing. The approach of the physician to driving and dementia is addressed, including in-office screening, referral for on-road driving assessments, and the potential for physician reporting to state agencies.
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Vision, viewing efficiency, visual attention, and on-road driving performance were assessed in 100 participants with central and/or peripheral visual field defects caused by ocular pathology. Driving was evaluated by the Dutch driving license authority making use of the protocol for investigating practical fitness to drive. A smaller percentage of participants with central visual field defects passed the on-road driving test, in comparison with participants with peripheral or mild field defects. The predictive power of a model based on the current vision requirements for driving significantly increased when taking compensatory viewing efficiency into account. The results of the latter model were comparable to those of a model based on tests of visual attention and contrast sensitivity. Despite the increased explained variance of practical fitness to drive when taking higher-order visual functions into account, sensitivity and specificity remained quite low, limiting the use of these tests in identifying unfit drivers. Actual or potential applications of this research include the development of training programs to improve practical fitness to drive in drivers with visual field defects.
OBJECTIVES: We describe intervention effects on parent limits on novice teenage driving. METHODS: We recruited parents and their 16-year-old children (n = 469) with learner's permits and randomized them from August 2000 to March 2003. Intervention families received persuasive newsletters related to high-risk teenage driving and a parent-teenager driving agreement; comparison families received standard information on driver safety. We conducted interviews when the adolescents obtained a learner's permit, upon licensure, and at 3, 6, and 12 months postlicensure. RESULTS: Intervention parents and teenagers reported stricter limits on teen driving compared with the comparison group at 12 months, with direct effects through 3 months and indirect effects through 12 months postlicensure. CONCLUSIONS: A simple behavioral intervention was efficacious in increasing parental restriction of high-risk teen driving conditions among newly licensed drivers.
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BACKGROUND: The purpose of this study was to determine when patients recover the ability to safely operate the brakes of an automobile following operative repair of an ankle fracture. METHODS: A computerized driving simulator was developed and tested. Eleven healthy volunteers were tested once to establish normal mean values (Group I), and a group of thirty-one volunteers with a fracture of the right ankle were tested at six, nine, and twelve weeks following operative repair (Group II). The subjects were tested with a series of driving scenarios (city, suburban, and highway). Scores on the Short Form Musculoskeletal Assessment were recorded at six, nine, and twelve weeks and were compared with the results of the driving test. We investigated the effect of the time of the visit and of the testing condition on the braking times. RESULTS: The total braking time was 1079 msec for Group I and 1330, 1172, and 1160 msec for Group II at six, nine, and twelve weeks, respectively, postoperatively (p = 0.0094). The total braking time consistently improved for each of the driving scenarios at each successive data point (p = 0.05). The increase in the total braking time at six weeks meant an increase in the distance traveled by the automobile before braking of 22 ft (6.7 m) at 60 mph (96.6 km/hr), and the increase at nine weeks meant an increase of 8 ft (2.4 m) at 60 mph. The functional outcome improved at each successive visit, although no significant association was found between the functional scores and normalization of total braking time. CONCLUSION: By nine weeks, the total braking time of patients who have undergone fixation of a displaced right ankle fracture returns to the normal, baseline value.
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This study investigated different measures of speed and acceleration as indicators of safe driving style. 58 young males drove a 7.1-km test route twice in an instrumented car. Drivers were instructed to drive as they usually do. Driving style was measured by both site-specific measures (speed on a crest and speed and lateral acceleration in a sharp and a gentle curve) and general measures (maximum speed and lateral and longitudinal accelerations over the route). Analysis of variance (accident involvement x mileage) showed that drivers who had had prior accidents drove at higher speed and higher accelerations on a sharp curve than accident-free drivers. Drivers involved with accidents drove at higher maximum speed, left accelerations (at right-hand curves), and Equivalent Vector Acceleration, a mean parameter of accelerations, than accident-free drivers. However, multiple regression analysis indicated that only maximum speed predicted the number of accidents significantly. In conclusion, maximum speed seemed to be a convenient and robust measure of a safe driving style.
208 motorists were observed at Florida International University, in Miami, Florida as part of a study of the influence of speed humps on motorists' behavior at pedestrian crossings. It was hypothesized that the presence of a speed hump will affect motorists' behavior by compelling them either to yield or stop at a pedestrian crossing to enable a pedestrian to cross safely. A between-subjects experimental design was employed to measure motorists' reactions. Analysis indicated that the relationship is strong between drivers' behavior and the presence or absence of this roadway stimulus. There was also evidence that female drivers may take more precautionary actions than male drivers. This information is useful for roadway designers and traffic psychologists.
Recently, concern has grown about the extent to which wireless telephone use by motor vehicle drivers constitutes a threat to traffic safety. This experiment investigated the effect of the intensity of wireless telephone conversations on reaction time (RT) for a braking response. Using a laboratory station to mimic the foot activity in driving, 16 adults were instructed to release the accelerator pedal and depress the brake pedal as quickly as possible following the activation of a red brake light. Mean RT was measured for 5 conditions which manipulated the intensity of a conversation, i.e., demand for attention, conducted on a wireless telephone. Analysis indicated that wireless telephone use caused a decrement in RT, however, there was no significant effect associated with intensity of the conversation across intensity.