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Sample records for older drivers at-risk

  1. Electronic Health Record Tools to Care for At-Risk Older Drivers: A Quality Improvement Project.

    Casey, Colleen M; Salinas, Katherine; Eckstrom, Elizabeth

    2015-06-01

    Evaluating driving safety of older adults is an important health topic, but primary care providers (PCP) face multiple barriers in addressing this issue. The study's objectives were to develop an electronic health record (EHR)-based Driving Clinical Support Tool, train PCPs to perform driving assessments utilizing the tool, and systematize documentation of assessment and management of driving safety issues via the tool. The intervention included development of an evidence-based Driving Clinical Support Tool within the EHR, followed by training of internal medicine providers in the tool's content and use. Pre- and postintervention provider surveys and chart review of driving-related patient visits were conducted. Surveys included self-report of preparedness and knowledge to evaluate at-risk older drivers and were analyzed using paired t-test. A chart review of driving-related office visits compared documentation pre- and postintervention including: completeness of appropriate focused history and exam, identification of deficits, patient education, and reporting to appropriate authorities when indicated. Data from 86 providers were analyzed. Pre- and postintervention surveys showed significantly increased self-assessed preparedness (p < .001) and increased driving-related knowledge (p < .001). Postintervention charts showed improved documentation of correct cognitive testing, more referrals/consults, increased patient education about community resources, and appropriate regulatory reporting when deficits were identified. Focused training and an EHR-based clinical support tool improved provider self-reported preparedness and knowledge of how to evaluate at-risk older drivers. The tool improved documentation of driving-related issues and led to improved access to interdisciplinary care coordination. Published by Oxford University Press on behalf of the Gerontological Society of America 2015.

  2. Evaluating Older Drivers' Skills

    2013-05-01

    Research has demonstrated that older drivers pose a higher risk of involvement in fatal crashes at intersections than : younger drivers. Age-triggered restrictions are problematic as research shows that the majority of older people : have unimpaired ...

  3. Older drivers : a review.

    Hakamies-Blomqvist, L. Sirén, A. & Davidse, R.J.

    2004-01-01

    The proportion of senior citizens (aged 65+) will grow from about 15 per cent in the year 2000 to about 30 per cent in the year 2050. The share of older drivers in the driver population will grow even faster because of increasing licensing rates among the ageing population. Older drivers do not have

  4. Older Californians At Risk for

    Wallace, Steven; Pourat,, Nadereh; Durazo, Eva; Leos, Rosana

    2010-01-01

    This policy brief examines the growing rate of repeated falls among senior citizens, comparing data from the 2003 and 2007 California Health Interview Survey (CHIS). The authors found that over half million older Californians (565,000) fell more than once in 2007—about 100,00 more seniors with repeated falls than in 2003. National guidelines by the American Geriatrics Society (AGS) and a recent synthesis of the scientific literature recommend reducing the risk of falling by older adu...

  5. OLDER DRIVERS AND ADAS

    Ragnhild J. DAVIDSE

    2006-01-01

    Next, based on the available literature, relevant ADAS are discussed in terms of their availability, their effects on safety and the willingness of older drivers to use and buy them. One of the conclusions is that only very few of the types of support that are thought to be most beneficial to the safety of older drivers are provided by the ADAS that are currently available.

  6. Older Persons at Risk of Hospital Readmission

    Pedersen, Mona Kyndi

    Hospital readmission is common and considered an adverse health outcome in older persons. Acute readmission of recently discharged patients puts additional pressure on clinical resources within health care services and support. Despite the frequency of readmissions, affecting health and wellbeing...... of older persons, there is still a relatively incomplete understanding of the broader array of factors pertaining to hospital readmission. The current evidence on risk factors for hospital readmission is not adequate to identify person at risk of readmission in a heterogeneous population of older persons....... Few studies have explored patients’ experiences of circumstances and incidents leading to readmission. This thesis uses a mixed methods approach and combines quantitative as well as qualitative data to explore and identify risk factors and predictors of hospital readmission. Use of health care...

  7. Health care providers and older adult service organizations to assist in the prevention and early recognition of Florida's at-risk drivers.

    2015-06-01

    As a next step in the Florida Department of Transportation (FDOT) plan to reduce the number of traffic injury : and fatality crashes among Floridas older adult population, SRA Research Group (SRA) conducted a health care : needs assessment to supp...

  8. Alcohol and older drivers' crashes.

    2014-09-01

    Researchers have examined the effects of alcohol consumption : on older adults functioning, and some have : addressed alcohols effects on older drivers crash risk. : Generally, the findings have shown that alcohol is less : likely to be a fa...

  9. Cognitive characteristics of older Japanese drivers.

    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.

  10. Cognitive characteristics of older Japanese drivers

    Susilowati Indri H

    2012-02-01

    Full Text Available Abstract 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.

  11. Adapting Interpersonal Psychotherapy for Older Adults at Risk for Suicide

    Heisel, Marnin J.; Talbot, Nancy L.; King, Deborah A.; Tu, Xin M.; Duberstein, Paul R.

    2014-01-01

    Objective To pilot a psychological intervention adapted for older adults at-risk for suicide. Design A focused, uncontrolled, pre-to-post-treatment psychotherapy trial. All eligible participants were offered the study intervention. Setting Outpatient mental healthcare provided in the psychiatry department of an academic medical center in a mid-sized Canadian city. Participants Seventeen English-speaking adults 60 years or older, at- risk for suicide by virtue of current suicide ideation, death ideation, and/or recent self-injury. Intervention A 16-session course of Interpersonal Psychotherapy (IPT) adapted for older adults at-risk for suicide who were receiving medication and/or other standard psychiatric treatment for underlying mood disorders. Measurements Participants completed a demographics form, screens for cognitive impairment and alcohol misuse, a semi-structured diagnostic interview, and measures of primary (suicide ideation and death ideation), and secondary study outcomes (depressive symptom severity; social adjustment and support; psychological well-being), and psychotherapy process measures. Results Participants experienced significant reductions in suicide ideation, death ideation, and depressive symptom severity, and significant improvement in perceived meaning in life, social adjustment, perceived social support, and other psychological well-being variables. Conclusions Study participants experienced enhanced psychological well-being and reduced symptoms of depression and suicide ideation over the course of IPT adapted for older adults at-risk for suicide. Larger, controlled trials are needed to further evaluate the impact of this novel intervention and to test methods for translating and integrating focused interventions into standard clinical care with at-risk older adults. PMID:24840611

  12. Adapting interpersonal psychotherapy for older adults at risk for suicide.

    Heisel, Marnin J; Talbot, Nancy L; King, Deborah A; Tu, Xin M; Duberstein, Paul R

    2015-01-01

    To pilot a psychological intervention adapted for older adults at risk for suicide. A focused, uncontrolled, pre-to-post-treatment psychotherapy trial. All eligible participants were offered the study intervention. Outpatient mental health care provided in the psychiatry department of an academic medical center in a mid-sized Canadian city. Seventeen English-speaking adults 60 years or older, at risk for suicide by virtue of current suicide ideation, death ideation, and/or recent self-injury. A 16-session course of Interpersonal Psychotherapy (IPT) adapted for older adults at risk for suicide who were receiving medication and/or other standard psychiatric treatment for underlying mood disorders. Participants completed a demographics form, screens for cognitive impairment and alcohol misuse, a semi-structured diagnostic interview, and measures of primary (suicide ideation and death ideation) and secondary study outcomes (depressive symptom severity, social adjustment and support, psychological well-being), and psychotherapy process measures. Participants experienced significant reductions in suicide ideation, death ideation, and depressive symptom severity, and significant improvement in perceived meaning in life, social adjustment, perceived social support, and other psychological well-being variables. Study participants experienced enhanced psychological well-being and reduced symptoms of depression and suicide ideation over the course of IPT adapted for older adults at risk for suicide. Larger, controlled trials are needed to further evaluate the impact of this novel intervention and to test methods for translating and integrating focused interventions into standard clinical care with at-risk older adults. Copyright © 2015 American Association for Geriatric Psychiatry. Published by Elsevier Inc. All rights reserved.

  13. Education for older drivers in the future

    Esko Keskinen

    2014-07-01

    Five presumptions have to be considered when addressing future education for older drivers: 1. Driving a car will continue to be one element of mobility in the future; 2. Older people want to be able to keep driving; 3. Safety will be an even more important factor in mobility in the future; 4. Ecological values will be more important in the future; and 5. Innovative technological applications will be more important in the future. Hierarchical models of driving are suitable in increasing understanding of older drivers' needs and abilities. The highest levels of the driving hierarchy in the Goals for Driver Education (GDE model are especially important for the safety of both young and elderly drivers. In these highest levels goals for life, skills for living, and social environment affect everyday decision making in general but also driving, which has an impact on driver safety. Giving up driving is very much a social decision and should be taken as such. However, the highest levels of the driving hierarchy are by nature inaccessible to teacher-centered instruction These levels require more coaching-like education methods where the learner takes the central role and the teacher helps the drivers understand their own abilities and limitations in traffic. Testing and selecting older drivers to enhance safety is not, according to research findings, working in a proper way. Older drivers do not so much need more information concerning traffic rules, etc., but rather better understanding of themselves, their health restrictions, their skills, and their abilities to ensure daily mobility. Their closest companions also need tools to help them in discussions of traffic safety issues affecting older drivers.

  14. Naturalistic distraction and driving safety in older drivers.

    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.

  15. Identification of older hospitalized patients at risk for functional decline

    Hoogerduijn, J.G.

    2011-01-01

    Between 30% and 60% of older patients experience functional decline after hospitalization, resulting in a decline in health-related quality of life and autonomy. This is associated with increased risk of readmission, nursing home placement and mortality, increased length of hospital stay and

  16. Improvements in Symbol Sign Design To Aid Older Drivers

    1995-08-01

    Studies have shown that older drivers have higher rates of accidents, injuries, and fatalities on a per-mile-driven basis. A major cause of roadway accidents for older drivers is failure to heed traffic signs. Previous research found that older drive...

  17. Challenges for Older Drivers in Urban, Suburban, and Rural Settings

    Rashmi P. Payyanadan

    2018-03-01

    Full Text Available Along with age-related factors, geographical settings—urban, suburban, and rural areas—also contribute to the differences in fatal crashes among older drivers. These differences in crash outcomes might be attributed to the various driving challenges faced by older drivers residing in different locations. To understand these challenges from the perspective of the older driver, a focus group study was conducted with drivers 65 and older from urban, suburban, and rural settings. Guided-group interviews were used to assess driving challenges, mobility options, opportunities for driver support systems (DSS, and alternate transportation needs. Content analysis of the interview responses resulted in four categories representing common challenges faced by older drivers across the settings: behavior of other drivers on the road, placement of road signs, reduced visibility of road signs due to age-related decline, and difficulties using in-vehicle technologies. Six categories involved location-specific challenges such as heavy traffic situations for urban and suburban drivers, and multi-destination trips for rural drivers. Countermeasures implemented by older drivers to address these challenges primarily involved route selection and avoidance. Technological advances of DSS systems provide a unique opportunity to support the information needs for route selection and avoidance preferences of drivers. Using the content analysis results, a framework was built to determine additional and modified DSS features to meet the specific challenges of older drivers in urban, suburban, and rural settings. These findings suggest that there is heterogeneity in the driving challenges and preferences of older drivers based on their location. Consequently, DSS technologies and vehicle automation need to be tailored to not only meet the driving safety and mobility needs of older drivers as a population, but also to their driving environment.

  18. Visual Scanning Training For Older Drivers: A Literature Review

    2018-04-01

    This literature review focuses on older drivers' visual scanning ability and on evaluations of training in visual scanning skills for older adults, updating a previous review of studies published from 1997 to 2008 describing age-related functional ch...

  19. Intersection assistance : A safe solution for older drivers?

    Dotzauer, Mandy; Caljouw, Simone R.; de Waard, Dick; Brouwer, Wiebo H.

    2013-01-01

    Within the next few decades, the number of older drivers operating a vehicle will increase rapidly (Eurostat, 2011). As age increases so does physical vulnerability, age-related impairments, and the risk of being involved in a fatal crashes. Older drivers experience problems in driving situations

  20. Older drivers' risks of at-fault motor vehicle collisions.

    Ichikawa, Masao; Nakahara, Shinji; Taniguchi, Ayako

    2015-08-01

    In aging societies, increasing numbers of older drivers are involved in motor vehicle collisions (MVCs), and preserving their safety is a growing concern. In this study, we focused on whether older drivers were more likely to cause MVCs and injuries than drivers in other age groups. To do so we compared at-fault MVC incidence and resulting injury risks by drivers' ages, using data from Japan, a country with a rapidly aging population. The at-fault MVC incidence was calculated based on distance traveled made for non-commercial purposes, and the injury risks posed to at-fault drivers and other road users per at-fault MVCs. We used MVC data for 2010 from the National Police Agency of Japan and driving exposure data from the Nationwide Person Trip Survey conducted by a Japanese governmental ministry in 2010. The at-fault MVC incidence showed a U-shaped curve across the drivers' ages, where teenage and the oldest drivers appeared to be the highest risk groups in terms of causing MVCs, and the incidence was higher for female drivers after age 25. The injury risk older drivers posed to other vehicle occupants because of their at-fault MVCs was lower than for drivers in other age groups, while their own injury risk appeared much higher. As the number of older drivers is increasing, efforts to reduce their at-fault MVCs appear justified. Copyright © 2015 Elsevier Ltd. All rights reserved.

  1. Does automatic transmission improve driving behavior in older drivers?

    Selander, Helena; Bolin, Ingrid; Falkmer, Torbjörn

    2012-01-01

    Most older drivers continue to drive as they age. To maintain safe and independent transport, mobility is important for all individuals, but especially for older drivers. The objective of this study was to investigate whether automatic transmission, compared with manual transmission, may improve the driving behavior of older drivers. In total, 31 older drivers (mean age 75.2 years) and 32 younger drivers - used as a control group (mean age 39.2 years) - were assessed twice on the same fixed route; once in a car with manual transmission and once in a car with automatic transmission. The cars were otherwise identical. The driving behavior was assessed with the Ryd On-Road Assessment driving protocol. Time to completion of left turns (right-hand side driving) and the impact of a distraction task were measured. The older group had more driving errors than the younger group, in both the manual and the automatic transmission car. However, and contrary to the younger drivers, automatic transmission improved the older participants' driving behavior as demonstrated by safer speed adjustment in urban areas, greater maneuvering skills, safer lane position and driving in accordance with the speed regulations. Switching to automatic transmission may be recommended for older drivers as a means to maintain safe driving and thereby the quality of their transport mobility. Copyright © 2011 S. Karger AG, Basel.

  2. Intersection negotiation problems of older drivers. Volume 1

    1998-09-01

    This project included a background literature synthesis and observational field study. The research goals were to document driving problems and errors at intersections, for older drivers using their own cars to travel familiar and unfamiliar routes, ...

  3. Taxonomy of Older Driver Behaviors and Crash Risk : Appendix C

    2012-02-01

    This projects objectives were to identify risky behaviors, driving habits, and exposure patterns that have been shown to increase the likelihood of crash involvement among older drivers; and to classify these crash-contributing factors according t...

  4. Older drivers and ADAS : which systems improve road safety?

    Davidse, R.J.

    2006-01-01

    In the coming decades, the number of older drivers that experiences difficulties in traffic as a result of functional limitations will strongly increase. Advanced Driver Assistance Systems (ADAS) could resolve some of these difficulties, by providing personal assistance in a road environment that

  5. A One-to-One Programme for At-Risk Readers Delivered by Older Adult Volunteers

    Fives, Allyn; Kearns, Noreen; Devaney, Carmel; Canavan, John; Russell, Dan; Lyons, Rena; Eaton, Patricia; O'Brien, Aoife

    2013-01-01

    This paper is based on a randomized controlled trial (RCT) evaluation of a reading programme delivered by older adult volunteers for at-risk early readers. Wizards of Words (WoW) was targeted at socially disadvantaged children in first and second grade experiencing delays in reading but who were not eligible for formal literacy supports. The…

  6. Survival of cognitively impaired older hospitalized patients at risk of malnutrition

    Neelemaat, F.; Bijland, L.R.; Thijs, A.; Seidell, J.C.; van Bokhorst-de van der Schueren, M.A.E.

    2012-01-01

    Introduction: In our society offering extra nutritional support is a standard for malnourished patients at admission to hospital. Whether cognitively impaired, older, hospitalized patients at risk of malnutrition would also benefit from this regimen is unknown. This study assesses their 3-months and

  7. Predicting influenza vaccination intent among at-risk chinese older adults in Hong Kong.

    Yu, Doris S F; Low, Lisa P L; Lee, Iris F K; Lee, Diana T F; Ng, Wai Man

    2014-01-01

    Older adults with major chronic illnesses are very susceptible to influenza and its serious complications, but many do not obtain vaccinations. Little is known about factors associated with intention to obtain influenza vaccination among at-risk Chinese older adults in Hong Kong. The aim of this study was to identify factors associated with intent to obtain influenza vaccination among at-risk Chinese older adults in Hong Kong. This multicenter descriptive correlational study recruited a convenience sample of 306 Chinese older adults with medical risk factors for influenza and its serious complications from the general outpatient clinics in Hong Kong. Interviews were conducted to assess intent to obtain influenza vaccination for the coming year, health beliefs about influenza, and discomfort following past vaccinations. The current influenza vaccination rate was 58.5%; only 36.3% intended to get vaccinated the following year. After controlling for clinical and demographic factors in a logistic regression model, perceived susceptibility predicted intention to obtain future vaccination (OR = 1.42, 95% CI [1.14, 1.78]), whereas postvaccination discomfort was negatively associated with intention (OR = 0.063, 95% CI [0.006, 0.63]). Intention to obtain influenza vaccination was low among at-risk Chinese older adults. Strengthening health beliefs and creating strategies to provide positive influenza vaccination experiences are possible approaches to interventions to improve uptake of influenza vaccination rates.

  8. Implications of advanced vehicle technologies for older drivers.

    Molnar, Lisa J; Eby, David W

    2017-09-01

    Advances are being made in vehicle technologies that may help older adults compensate for some of the declines in abilities associated with aging. These advances hold promise for increasing vehicle safety, reducing injuries, and making the driving task more comfortable. However, important research gaps remain with regard to how various advanced technologies impact the safety of older drivers, as well as older drivers' perceptions about these technologies. This special issue contains seven original contributions that address these issues. Specific topics include the: congruence of design guidelines with the needs and abilities of older drivers, transfer of control between automated and manual driving, use of in-vehicle monitoring technology, motivations for technology use and assigned meanings, technology valuation, and effects on driving behavior. Copyright © 2017 Elsevier Ltd. All rights reserved.

  9. Symbol signing design for older drivers

    1997-07-01

    This project evaluated the effectiveness of symbol traffic signs for young, middle-aged and elderly drivers. Daytime legibility distance and comprehension of 85 symbols in the Manual on Uniform Traffic Control Devices (MUTCD) were measured. Legibilit...

  10. Screening older adults at risk of falling with the Tinetti balance scale.

    Raîche, M; Hébert, R; Prince, F; Corriveau, H

    2000-09-16

    In a prospective study of 225 community dwelling people 75 years and older, we tested the validity of the Tinetti balance scale to predict individuals who will fall at least once during the following year. A score of 36 or less identified 7 of 10 fallers with 70% sensitivity and 52% specificity. With this cut-off score, 53% of the individuals were screened positive and presented a two-fold risk of falling. These characteristics support the use of this test to screen older people at risk of falling in order to include them in a preventive intervention.

  11. Intersection assistance: a safe solution for older drivers?

    Dotzauer, Mandy; Caljouw, Simone R; de Waard, Dick; Brouwer, Wiebo H

    2013-10-01

    Within the next few decades, the number of older drivers operating a vehicle will increase rapidly (Eurostat, 2011). As age increases so does physical vulnerability, age-related impairments, and the risk of being involved in a fatal crashes. Older drivers experience problems in driving situations that require divided attention and decision making under time pressure as reflected by their overrepresentation in at-fault crashes on intersections. Advanced Driver Assistance Systems (ADAS) especially designed to support older drivers crossing intersections might counteract these difficulties. In a longer-term driving simulator study, the effects of an intersection assistant on driving were evaluated. 18 older drivers (M=71.44 years) returned repeatedly completing a ride either with or without a support system in a driving simulator. In order to test the intersection assistance, eight intersections were depicted for further analyses. Results show that ADAS affects driving. Equipped with ADAS, drivers allocated more attention to the road center rather than the left and right, crossed intersections in shorter time, engaged in higher speeds, and crossed more often with a critical time-to-collision (TTC) value. The implications of results are discussed in terms of behavioral adaptation and safety. Copyright © 2013 Elsevier Ltd. All rights reserved.

  12. Leukoaraiosis significantly worsens driving performance of ordinary older drivers.

    Kimihiko Nakano

    Full Text Available BACKGROUND: Leukoaraiosis is defined as extracellular space caused mainly by atherosclerotic or demyelinated changes in the brain tissue and is commonly found in the brains of healthy older people. A significant association between leukoaraiosis and traffic crashes was reported in our previous study; however, the reason for this is still unclear. METHOD: This paper presents a comprehensive evaluation of driving performance in ordinary older drivers with leukoaraiosis. First, the degree of leukoaraiosis was examined in 33 participants, who underwent an actual-vehicle driving examination on a standard driving course, and a driver skill rating was also collected while the driver carried out a paced auditory serial addition test, which is a calculating task given verbally. At the same time, a steering entropy method was used to estimate steering operation performance. RESULTS: The experimental results indicated that a normal older driver with leukoaraiosis was readily affected by external disturbances and made more operation errors and steered less smoothly than one without leukoaraiosis during driving; at the same time, their steering skill significantly deteriorated. CONCLUSIONS: Leukoaraiosis worsens the driving performance of older drivers because of their increased vulnerability to distraction.

  13. Near peripheral motion contrast threshold predicts older drivers' simulator performance.

    Henderson, Steven; Gagnon, Sylvain; Collin, Charles; Tabone, Ricardo; Stinchcombe, Arne

    2013-01-01

    Our group has previously demonstrated that peripheral motion contrast threshold (PMCT) is significantly associated with self-reported accident risk of older drivers (questionnaire assessment), and with Useful Field of View(®) subtest 2 (UFOV2). It has not been shown, however, that PMCT is significantly associated with driving performance. Using the method of descending limits (spatial two-alternative forced choice) we assessed motion contrast thresholds of 28 young participants (25-45), and 21 older drivers (63-86) for 0.4 cycle/degree drifting Gabor stimuli at 15° eccentricity and examined whether it was related to performance on a simulated on-road test and to a measure of visual attention (UFOV(®) subtests 2 and 3). Peripheral motion contrast thresholds (PMCT) of younger participants were significantly lower than older participants. PMCT and UFOV2 significantly predicted driving examiners' scores of older drivers' simulator performance, as well as number of crashes. Within the older group, PMCT correlated significantly with UFOV2, UFOV3, and age. Within the younger group, PMCT was not significantly related to either UFOV(®) scores or age. Partial correlations showed that: substantial association between PMCT and UFOV2 was not age-related (within the older driver group); PMCT and UFOV2 tapped a common visual function; and PMCT assessed a component not captured by UFOV2. PMCT is potentially a useful assessment tool for predicting accident risk of older drivers, and for informing efforts to develop effective countermeasures to remediate this functional deficit as much as possible. Copyright © 2012 Elsevier Ltd. All rights reserved.

  14. Older drivers and rapid deceleration events: Salisbury Eye Evaluation Driving Study.

    Keay, Lisa; Munoz, Beatriz; Duncan, Donald D; Hahn, Daniel; Baldwin, Kevin; Turano, Kathleen A; Munro, Cynthia A; Bandeen-Roche, Karen; West, Sheila K

    2013-09-01

    Drivers who rapidly change speed while driving may be more at risk for a crash. We sought to determine the relationship of demographic, vision, and cognitive variables with episodes of rapid decelerations during five days of normal driving in a cohort of older drivers. In the Salisbury Eye Evaluation Driving Study, 1425 older drivers aged 67-87 were recruited from the Maryland Motor Vehicle Administration's rolls for licensees in Salisbury, Maryland. Participants had several measures of vision tested: visual acuity, contrast sensitivity, visual fields, and the attentional visual field. Participants were also tested for various domains of cognitive function including executive function, attention, psychomotor speed, and visual search. A custom created driving monitoring system (DMS) was used to capture rapid deceleration events (RDEs), defined as at least 350 milli-g deceleration, during a five day period of monitoring. The rate of RDE per mile driven was modeled using a negative binomial regression model with an offset of the logarithm of the number of miles driven. We found that 30% of older drivers had one or more RDE during a five day period, and of those, about 1/3 had four or more. The rate of RDE per mile driven was highest for those drivers drivingRDE's were more likely to have better scores in cognitive tests of psychomotor speed and visual search, and have faster brake reaction time. Further, greater average speed and maximum speed per driving segment was protective against RDE events. In conclusion, contrary to our hypothesis, older drivers who perform rapid decelerations tend to be more "fit", with better measures of vision and cognition compared to those who do not have events of rapid deceleration. Copyright © 2012 Elsevier Ltd. All rights reserved.

  15. Correlates of alcohol abstinence and at-risk alcohol consumption in older adults with depression: the NESDO study

    van den Berg, J.F.; Kok, R.M.; van Marwijk, H.W.J.; van der Mast, R.C.; Naarding, P.; Voshaar, R.C.O.; Stek, M.L.; Verhaak, P.F.M.; de Waal, M.W.M.; Comijs, H.C.

    2014-01-01

    Objectives To compare alcohol use between depressed and nondepressed older adults, and to investigate correlates of alcohol abstinence and at-risk alcohol consumption in depressed older adults. Design Cross-sectional study. Setting Netherlands Study of Depression in Older Persons (NESDO).

  16. Correlates of alcohol abstinence and at-risk alcohol consumption in older adults with depression : the NESDO study

    van den Berg, Julia F.; Kok, Rob M.; van Marwijk, Harm W. J.; van der Mast, Roos C.; Naarding, Paul; Oude Voshaar, Richard C.; Stek, Max L.; Verhaak, Peter F. M.; de Waal, Margot W. M.; Comijs, Hannie C.

    OBJECTIVES: To compare alcohol use between depressed and nondepressed older adults, and to investigate correlates of alcohol abstinence and at-risk alcohol consumption in depressed older adults. DESIGN: Cross-sectional study. SETTING: Netherlands Study of Depression in Older Persons (NESDO).

  17. Correlates of Alcohol Abstinence and At-Risk Alcohol Consumption in Older Adults with Depression: the NESDO Study

    Berg, J. van den; Kok, R.M.; Marwijk, H.W.J. van; Mast, R.C. van der; Naarding, P.; Oude Voshaar, R.C.; Stek, M.L.; Verhaak, P.F.; Waal, M.W. de; Comijs, H.C.

    2014-01-01

    OBJECTIVES: To compare alcohol use between depressed and nondepressed older adults, and to investigate correlates of alcohol abstinence and at-risk alcohol consumption in depressed older adults. DESIGN: Cross-sectional study. SETTING: Netherlands Study of Depression in Older Persons (NESDO).

  18. Correlates of alcohol abstinence and at-risk alcohol consumption in older adults with depression: the NESDO Study.

    Berg, J.F. van den; Kok, R.M.; Marwijk, H.W.J. van; Mast, R.C. van der; Naarding, P.; Oude Voshaar, R.C.; Stek, M.L.; Verhaak, P.F.M.; Waal, M.W.M. de; Comijs, H.C.

    2014-01-01

    Objectives: To compare alcohol use between depressed and nondepressed older adults, and to investigate correlates of alcohol abstinence and at-risk alcohol consumption in depressed older adults. Design: Cross-sectional study. Setting: Netherlands Study of Depression in Older Persons (NESDO).

  19. Keeping Older Drivers Safe on the Road

    2010-03-15

    In this podcast, Rebecca Naumann, MPH, an epidemiologist from CDC's Injury Center, talks about steps older adults can take to stay safer on the road.  Created: 3/15/2010 by National Center for Injury Prevention and Control, Division of Unintentional Injury Prevention.   Date Released: 3/15/2010.

  20. Exploring older driver crash trend: New Jersey case study

    Vanvi Trieu

    2014-04-01

    Full Text Available Older drivers age 65 and above are known to experience greater risk on the roadway as well as increasing the risk to other roadway users. Within the next 20 years, their population is expected to increase from 41 million in 2011 to 70 million in 2030. To address this foreseeable change, the nation's recent Moving Ahead for Progress in the 21st Century (MAP-21 act requires state and local governments to examine older drivers and pedestrian risks and implement countermeasures as appropriate. This research was conducted to assist agencies in strategising for future plans, programmes and initiatives to better address the problem presented. This was accomplished by performing a detailed engineering analysis on crash data of older drivers over a 10-year period (2003–2012 from the state of New Jersey to identify crash trends and characteristics. A major finding from this research was the increase in fatal crashes of older drivers as a function of age. Top-ranking collision types with other vehicles and non-vehicles were identified. Crashes as a function of seasonal change, climate and lighting conditions were also examined.

  1. Naturalistic speeding data: Drivers aged 75 years and older

    Anna Chevalier

    2016-09-01

    Full Text Available The data presented in this article are related to the research article entitled “A longitudinal investigation of the predictors of older drivers׳ speeding behavior” (Chevalier et al., 2016 [1], wherein these speed events were used to investigate older drivers speeding behavior and the influence of cognition, vision, functional decline, and self-reported citations and crashes on speeding behavior over a year of driving. Naturalistic speeding behavior data were collected for up to 52 weeks from volunteer drivers aged 75–94 years (median 80 years, 52% male living in the suburban outskirts of Sydney. Driving data were collected using an in-vehicle monitoring device. Global Positioning System (GPS data were recorded at each second and determined driving speed through triangulation of satellite collected location data. Driving speed data were linked with mapped speed zone data based on a service-provider database. To measure speeding behavior, speed events were defined as driving 1 km/h or more, with a 3% tolerance, above a single speed limit, averaged over 30 s. The data contains a row per 124,374 speed events. This article contains information about data processing and quality control. Keywords: Older drivers, Speed, Road safety, Naturalistic, In-vehicle monitoring, Device

  2. Cognitive screening of older drivers does not produce safety benefits

    Siren, Anu Kristiina; Meng, Annette

    2012-01-01

    Although screening policies for older drivers based on chronological age are widely used in many countries, previous research has shown that increasing age does not cause higher crash rates and that consequently, chronological age per se is at best only a weak predictor of safe driving performanc...... is an example of a political measure that intuitively makes sense, but fails to produce the desired benefits. On the contrary, on a system level, it decreases the overall safety and is connected to various direct and indirect costs........ Previous research on age-based mandatory screening of older drivers has not been able to demonstrate any safety benefits from screening measures.The present study is a population-based evaluation of the safety effects that the introduction of the cognitive test as an age-based screening tool has had...

  3. Older drivers with cognitive impairments : issues of detection and assessment

    Lundberg, Catarina

    2003-01-01

    Older drivers are often presented as a traffic safety problem . Age-related medical conditions such as dementias and stroke impair cognitive functions that are crucial for safe driving Uncertainty remains regarding the most appropriate clinical methods to assess driving fitness in these patient groups. Furthermore, preclinical dementia and cognitive impairment may affect driving performance and lead to an increased crash risk. The first general aim of the thesis was to inve...

  4. A RE-ASSESSMENT OF OLDER DRIVERS AS A ROAD SAFETY RISK

    Jim LANGFORD

    2006-01-01

    Full Text Available Older drivers are frequently viewed as overly represented in crashes, particularly when crash involvement per distance travelled is considered. This perception has led to a call for tighter licensing conditions for older drivers, a policy which inevitably results in mobility restrictions for at least some drivers. However there is a growing body of research evidence which shows that as a group, older drivers represent no greater road risk than drivers from other age groups once different levels of driving activity are taken into account. This paper has examined aspects of older drivers' fitness to drive based on survey data and off-road and on-road driving performance from a sample of 905 New Zealand older drivers. The results show that policies which target all older drivers and lead to licensing and mobility restrictions cannot be justified from a safety basis.

  5. Community Weight Loss to Combat Obesity and Disability in At-Risk Older Adults.

    Rejeski, W Jack; Ambrosius, Walter T; Burdette, Jonathan H; Walkup, Michael P; Marsh, Anthony P

    2017-10-12

    Among older, overweight, and obese adults with either cardiovascular disease or the metabolic syndrome, reduced mobility and loss of leg strength are important risk factors for morbidity, disability, and mortality. It is unclear whether community-based approaches to weight loss may be an effective solution to this public health challenge. An 18-month three-site, randomized controlled trial conducted by YMCA staff, with blinded assessors, enrolled 249 older, overweight, and obese adults with either cardiovascular disease or metabolic syndrome with randomization to three interventions: weight loss alone (WL), weight loss + aerobic training (WL + AT), and weight loss + resistance training (WT + RT). The dual primary outcomes were 400-m walk time in seconds and knee extensor strength in Newton meters. All groups lost weight from baseline: average baseline adjusted change of -6.1% (95% confidence interval [CI]: -7.5 to -4.7) for WL only, -8.6% (95% CI: -10.0 to -7.2) for WL + AT, and -9.7% (95% CI: -11.1 to -8.4) for WL + RT. Combined, the two physical activity + WL training groups had greater improvement in walk time than WL alone (mean difference 16.9 seconds [95% CI: 9.7 to 24.0], p < .0001). Baseline adjusted change in knee extensor strength was no greater with WL + RT than WL + AT (mean difference -3.6 Nm [95% CI: -7.5 to 0.3], p = .07). At risk, older, overweight and obese adults can achieve clinically significant reductions in body weight with community-based weight loss programs. The change in percent weight loss and improvements in mobility are significantly enhanced when either RT or AT is combined with dietary WL. © The Author 2017. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  6. Naturalistic validation of an on-road driving test of older drivers.

    Ott, Brian R; Papandonatos, George D; Davis, Jennifer D; Barco, Peggy P

    2012-08-01

    The objective was to compare a standardized road test to naturalistic driving by older people who may have cognitive impairment to define improvements that could potentially enhance the validity of road testing in this population. Road testing has been widely adapted as a tool to assess driving competence of older people who may be at risk for unsafe driving because of dementia; however, the validity of this approach has not been rigorously evaluated. For 2 weeks, 80 older drivers (38 healthy elders and 42 with cognitive impairment) who passed a standardized road test were video recorded in their own vehicles. Using a standardized rating scale, 4 hr of video was rated by a driving instructor. The authors examine weighting of individual road test items to form global impressions and to compare road test and naturalistic driving using factor analyses of these two assessments. The road test score was unidimensional, reflecting a major factor related to awareness of signage and traffic behavior. Naturalistic driving reflected two factors related to lane keeping as well as traffic behavior. Maintenance of proper lane is an important dimension of driving safety that appears to be relatively underemphasized during the highly supervised procedures of the standardized road test. Road testing in this population could be improved by standardized designs that emphasize lane keeping and that include self-directed driving. Additional information should be sought from observers in the community as well as crash evidence when advising older drivers who may be cognitively impaired.

  7. Naturalistic Validation of an On-Road Driving Test of Older Drivers

    Ott, Brian R.; Papandonatos, George D.; Davis, Jennifer D.; Barco, Peggy P.

    2013-01-01

    Objective The objective was to compare a standardized road test to naturalistic driving by older people who may have cognitive impairment to define improvements that could potentially enhance the validity of road testing in this population. Background Road testing has been widely adapted as a tool to assess driving competence of older people who may be at risk for unsafe driving because of dementia; however, the validity of this approach has not been rigorously evaluated. Method For 2 weeks, 80 older drivers (38 healthy elders and 42 with cognitive impairment) who passed a standardized road test were video recorded in their own vehicles. Using a standardized rating scale, 4 hr of video was rated by a driving instructor. The authors examine weighting of individual road test items to form global impressions and to compare road test and naturalistic driving using factor analyses of these two assessments. Results The road test score was unidimensional, reflecting a major factor related to awareness of signage and traffic behavior. Naturalistic driving reflected two factors related to lane keeping as well as traffic behavior. Conclusion Maintenance of proper lane is an important dimension of driving safety that appears to be relatively underemphasized during the highly supervised procedures of the standardized road test. Application Road testing in this population could be improved by standardized designs that emphasize lane keeping and that include self-directed driving. Additional information should be sought from observers in the community as well as crash evidence when advising older drivers who may be cognitively impaired. PMID:22908688

  8. Older drivers' attitudes about instrument cluster designs in vehicles.

    Owsley, Cynthia; McGwin, Gerald; Seder, Thomas

    2011-11-01

    Little is known about older drivers' preferences and attitudes about instrumentation design in vehicles. Yet visual processing impairments are common among older adults and could impact their ability to interface with a vehicle's dashboard. The purpose of this study is to obtain information from them about this topic, using focus groups and content analysis methodology. A trained facilitator led 8 focus groups of older adults. Discussion was stimulated by an outline relevant to dashboard interfaces, audiotaped, and transcribed. Using multi-step content analysis, a trained coder placed comments into thematic categories and coded comments as positive, negative, or neutral in meaning. Comments were coded into these categories: gauges, knobs/switches, interior lighting, color, lettering, symbols, location, entertainment, GPS, cost, uniformity, and getting information. Comments on gauges and knobs/switches represented half the comments. Women made more comments about getting information; men made more comments about uniformity. Positive and negative comments were made in each category; individual differences in preferences were broad. The results of this study will be used to guide the design of a population-based survey of older drivers about instrument cluster format, which will also examine how their responses are related to their visual processing capabilities. Copyright © 2011 Elsevier Ltd. All rights reserved.

  9. Assisting the older driver : intersection design and in-car devices to improve the safety of the older driver. Proefschrift Rijksuniversiteit Groningen RUG, Groningen.

    Davidse, R.J.

    2007-01-01

    In this thesis, the main focus was on assistive devices that may improve and prolong the safe mobility of older drivers. Older drivers form a group of road users that is getting more and more attention in road safety research and policy. An important reason for this growing interest is the increase

  10. Good Old Gamers, Good Drivers: Results from a correlational experiment among older drivers

    Suchada Vichitvanichphong

    2016-03-01

    Full Text Available In many situations, driving is essential for senior citizens to maintain their independent lifestyle. A systematic literature review was conducted that summarized the age-related physical, visual and cognitive functional declines and their associated risk to driving. Based on these findings, we explored whether the skills required in playing Xbox Kinect video games were correlated with measures of driving performance among older drivers. Fifty-two participants, 65 years of age or older (Mean = 72; SD = 3.84; range 65 – 85 years; 29 males who have access to a car and drive frequently were invited to play Just dance, Table Tennis (ping pong, Bowling, and Dr Kawashima’s Brain Training Exercises on an Xbox Kinect 360. Participants also completed a 25-minute on-road driving task along a predetermined route to assess and identify critical driving errors using a similar instrument as that used by a driving license tester. Bivariate correlation examined the relationship between game scores and these objective driving skills. There was a significant correlation between the Xbox Kinect video games and on-road driving scores (r = 0.861, p <0.001, indicating that ‘good gamers are good drivers’. This was correlation was significant for the males (r = 0.864, p <0.001 as well as for the females (r = 0.878, p <0.001. We suggest that performance on Xbox games may be a suitable, cost-effective and less-risky indicator of on-road driving skills for older drivers, particularly in jurisdictions in which mandatory testing of older citizens has been introduced or is being considered as a requirement in the driver licensing process.

  11. Naturalistic rapid deceleration data: Drivers aged 75 years and older

    Anna Chevalier

    2016-12-01

    Full Text Available The data presented in this article are related to the research manuscript “Predictors of older drivers’ involvement in rapid deceleration events”, which investigates potential predictors of older drivers’ involvement in rapid deceleration events including measures of vision, cognitive function and driving confidence (A. Chevalier et al., 2016 [1]. In naturalistic driving studies such as this, when sample size is not large enough to allow crashes to be used to investigate driver safety, rapid deceleration events may be used as a surrogate safety measure. Naturalistic driving data were collected for up to 52 weeks from 182 volunteer drivers aged 75–94 years (median 80 years, 52% male living in the suburban outskirts of Sydney. Driving data were collected using an in-vehicle monitoring device. Accelerometer data were recorded 32 times per second and Global Positioning System (GPS data each second. To measure rapid deceleration behavior, rapid deceleration events (RDEs were defined as having at least one data point at or above the deceleration threshold of 750 milli-g (7.35 m/s2. All events were constrained to a maximum 5 s duration. The dataset provided with this article contains 473 events, with a row per RDE. This article also contains information about data processing, treatment and quality control. The methods and data presented here may assist with planning and analysis of future studies into rapid deceleration behaviour using in-vehicle monitoring.

  12. Can older "at risk" adults benefit from psychoeducation targeting healthy brain aging?

    Norrie, Louisa M; Diamond, Keri; Hickie, Ian B; Rogers, Naomi L; Fearns, Samantha; Naismith, Sharon L

    2011-04-01

    Multifactorial strategies that prevent or delay the onset or progress of cognitive decline and dementia are needed, and should include education regarding recognized risk factors. The current study sought to investigate whether older adults "at risk" of cognitive decline benefit from psychoeducation targeting healthy brain aging. 65 participants (mean age 64.8 years, SD 9.6) with a lifetime history of major depression; vascular risk as evidenced by at least one vascular risk factor; and/or subjective or objective memory impairment were allocated to weekly psychoeducation sessions or a waitlist control group. The small group sessions were conducted over ten weeks by a team of medical and allied health professionals with expertise in late-life depression and cognition. Sessions focused on modifiable risk factors for cognitive decline including vascular risk, diet, exercise, depression, anxiety and sleep disturbance, as well as providing practical strategies for memory and cognition. Both the psychoeducation and waitlist group completed a 20-item knowledge test at baseline and follow-up. Participants in the psychoeducation group were asked to complete follow-up self-report satisfaction questionnaires. Repeated measures ANOVA showed a significant interaction effect depicting improvements in knowledge associated with psychoeducation, corresponding to an improvement of 15% from baseline. Satisfaction data additionally showed that 92.3% of participants rated the program as "good" to "excellent", and over 90% suggested they would recommend it to others. A group-based psychoeducation program targeting healthy brain aging is effective in improving knowledge. Additionally, it is acceptable and rated highly by participants.

  13. Napping in older people 'at risk' of dementia: relationships with depression, cognition, medical burden and sleep quality.

    Cross, Nathan; Terpening, Zoe; Rogers, Naomi L; Duffy, Shantel L; Hickie, Ian B; Lewis, Simon J G; Naismith, Sharon L

    2015-10-01

    Sleep disturbance is prevalent in older adults, particularly so in those at a greater risk of dementia. However, so far the clinical, medical and neuropsychological correlates of daytime sleep have not been examined. The aims of this study were to investigate the characteristics and effects of napping using actigraphy in older people, particularly in those 'at risk' of dementia. The study used actigraphy and sleep diaries to measure napping habits in 133 older adults 'at risk' of dementia (mean age = 65.5 years, SD = 8.4 years), who also underwent comprehensive medical, psychiatric and neuropsychological assessment. When defined by actigraphy, napping was present in 83.5% (111/133) of participants; however, duration and timing varied significantly among subjects. Nappers had significantly greater medical burden and body mass index, and higher rates of mild cognitive impairment. Longer and more frequent naps were associated with poorer cognitive functioning, as well as higher levels of depressive symptoms, while the timing of naps was associated with poorer nocturnal sleep quality (i.e. sleep latency and wake after sleep onset). This study highlights that in older adults 'at risk' of dementia, napping is associated with underlying neurobiological changes such as depression and cognition. Napping characteristics should be more routinely monitored in older individuals to elucidate their relationship with psychological and cognitive outcomes. © 2015 European Sleep Research Society.

  14. Women and stroke patients are more at risk for fall- related injury among older persons

    Sulistyowati Tuminah Darjoko

    2016-05-01

    Women and stroke sufferers were at higher risk of fall-related injury among older persons. Prevention of fall-related injury should be done by older persons through periodic control of their health condition.

  15. An examination of the environmental, driver and vehicle factors associated with the serious and fatal crashes of older rural drivers.

    Thompson, J P; Baldock, M R J; Mathias, J L; Wundersitz, L N

    2013-01-01

    Motor vehicle crashes involving rural drivers aged 75 years and over are more than twice as likely to result in a serious or fatal injury as those involving their urban counterparts. The current study examined some of the reasons for this using a database of police-reported crashes (2004-2008) to identify the environmental (lighting, road and weather conditions, road layout, road surface, speed limit), driver (driver error, crash type), and vehicle (vehicle age) factors that are associated with the crashes of older rural drivers. It also determined whether these same factors are associated with an increased likelihood of serious or fatal injury in younger drivers for whom frailty does not contribute to the resulting injury severity. A number of environmental (i.e., undivided, unsealed, curved and inclined roads, and areas with a speed limit of 100km/h or greater) and driver (i.e., collision with a fixed object and rolling over) factors were more frequent in the crashes of older rural drivers and additionally associated with increased injury severity in younger drivers. Moreover, when these environmental factors were entered into a logistic regression model to predict whether older drivers who were involved in crashes did or did not sustain a serious or fatal injury, it was found that each factor independently increased the likelihood of a serious or fatal injury. Changes, such as the provision of divided and sealed roads, greater protection from fixed roadside objects, and reduced speed limits, appear to be indicated in order to improve the safety of the rural driving environment for drivers of all ages. Additionally, older rural drivers should be encouraged to reduce their exposure to these risky circumstances. Copyright © 2012 Elsevier Ltd. All rights reserved.

  16. Fatigue in Younger and Older Drivers: Effectiveness of an Alertness-Maintaining Task.

    Song, Woojin; Woon, Fu L; Doong, Alice; Persad, Carol; Tijerina, Louis; Pandit, Pooja; Cline, Carol; Giordani, Bruno

    2017-09-01

    The aim of this study was to examine the effects of an alertness-maintaining task (AMT) in older, fatigued drivers. Fatigue during driving increases crash risk, and previous research suggests that alertness and driving in younger adults may be improved using a secondary AMT during boring, fatigue-eliciting drives. However, the potential impact of an AMT on driving has not been investigated in older drivers whose ability to complete dual tasks has been shown to decline and therefore may be negatively affected with an AMT in driving. Younger ( n = 29) and older drivers ( n = 39) participated in a 50-minute simulated drive designed to induce fatigue, followed by four 10-minute sessions alternating between driving with and without an AMT. Younger drivers were significantly more affected by fatigue on driving performance than were older drivers but benefitted significantly from the AMT. Older drivers did not demonstrate increased driver errors with fatigue, and driving did not deteriorate significantly during participation in the AMT condition, although their speed was significantly more variable with the AMT. Consistent with earlier research, an AMT applied during fatiguing driving is effective in improving alertness and reducing driving errors in younger drivers. Importantly, older drivers were relatively unaffected by fatigue, and use of an AMT did not detrimentally affect their driving performance. These results support the potential use of an AMT as a new automotive technology to improve fatigue and promote driver safety, though the benefits of such technology may differ between different age groups.

  17. PILOT RESULTS ON FORWARD COLLISION WARNING SYSTEM EFFECTIVENESS IN OLDER DRIVERS.

    Lester, Benjamin D; Sager, Lauren N; Dawson, Jeffrey; Hacker, Sarah D; Aksan, Nazan; Rizzo, Matthew; Kitazaki, Satoshi

    2015-06-01

    Advanced Driver Assistance Systems (ADAS) have largely been developed with a "one-size-fits-all" approach. This approach neglects the large inter-individual variability in perceptual and cognitive abilities that affect aging ADAS users. We investigated the effectiveness of a forward collision warning (FCW) with fixed response parameters in young and older drivers with differing levels of cognitive functioning. Drivers responded to a pedestrian stepping into the driver's path on a simulated urban road. Behavioral metrics included response times (RT) for pedal controls and two indices of risk penetration (e.g., maximum deceleration and minimum time-to-collision (TTC)). Older drivers showed significantly slower responses at several time points compared to younger drivers. The FCW facilitated response times (RTs) for older and younger drivers. However, older drivers still showed smaller safety gains compared to younger drivers at accelerator pedal release and initial brake application when the FCW was active. No significant differences in risk metrics were observed within the condition studied. The results demonstrate older drivers likely differ from younger drivers using a FCW with a fixed parameter set. Finally, we briefly discuss how future research should examine predictive relationships between domains of cognitive functioning and ADAS responses to develop parameter sets to fit the individual.

  18. Behavioral adaptation of young and older drivers to an intersection crossing advisory system

    Dotzauer, Mandy; de Waard, Dick; Caljouw, Simone R.; Poehler, Gloria; Brouwer, Wiebo H.

    An advanced driver assistance system (ADAS) provided information about the right of way regulation and safety to cross an upcoming intersection. Effects were studied in a longer-term study involving 18 healthy older drivers between the ages of 65 and 82 years and 18 healthy young drivers between the

  19. Evaluation of older driver head functional range of motion using portable immersive virtual reality.

    Chen, Karen B; Xu, Xu; Lin, Jia-Hua; Radwin, Robert G

    2015-10-01

    The number of drivers over 65 years of age continues to increase. Although neck rotation range has been identified as a factor associated with self-reported crash history in older drivers, it was not consistently reported as indicators of older driver performance or crashes across previous studies. It is likely that drivers use neck and trunk rotation when driving, and therefore the functional range of motion (ROM) (i.e. overall rotation used during a task) of older drivers should be further examined. Evaluate older driver performance in an immersive virtual reality, simulated, dynamic driving blind spot target detection task. A cross-sectional laboratory study recruited twenty-six licensed drivers (14 young between 18 and 35 years, and 12 older between 65 to 75 years) from the local community. Participants were asked to detect targets by performing blind spot check movements while neck and trunk rotation was tracked. Functional ROM, target detection success, and time to detection were analyzed. In addition to neck rotation, older and younger drivers on average rotated their trunks 9.96° and 18.04°, respectively. The younger drivers generally demonstrated 15.6° greater functional ROM (p<.001), were nearly twice as successful in target detection due to target location (p=.008), and had 0.46 s less target detection time (p=.016) than the older drivers. Assessing older driver functional ROM may provide more comprehensive assessment of driving ability than neck ROM. Target detection success and time to detection may also be part of the aging process as these measures differed between driver groups. Copyright © 2015 Elsevier Inc. All rights reserved.

  20. At risk, infected, and invisible: older gay men and HIV/AIDS.

    Grossman, A H

    1995-01-01

    Older gay men over the age of 50 have been and continue to be an invisible part of the HIV/AIDS epidemic. The reasons for this phenomenon are many, but among them are societal beliefs, myths, and stereotypes emanating from ageism and homophobia. In addition, HIV/AIDS is sometimes misdiagnosed in older adults because many of its symptoms mimic other illness that affect older people. Among the HIV risk factors of older gay men are internalized homophobia, denial of risk, alcohol and other substance use, and anonymous sexual encounters. The challenge for nurses and other providers is to reach, educate, and assist older gay men effectively in changing and maintaining safe behaviors when they are engaging in sexual and drug-using behaviors that can transmit HIV.

  1. Reduced glomerular filtration rate and its association with clinical outcome in older patients at risk of vascular events: secondary analysis.

    Ford, Ian

    2009-01-20

    Reduced glomerular filtration rate (GFR) is associated with increased cardiovascular risk in young and middle aged individuals. Associations with cardiovascular disease and mortality in older people are less clearly established. We aimed to determine the predictive value of the GFR for mortality and morbidity using data from the 5,804 participants randomized in the Prospective Study of Pravastatin in the Elderly at Risk (PROSPER).

  2. Cognitive Reserve as a Protective Factor in Older HIV-Positive Patients at Risk for Cognitive Decline

    Foley, Jessica M.; Ettenhofer, Mark L.; Kim, Michelle S.; Behdin, Nina; Castellon, Steven A.; Hinkin, Charles H.

    2012-01-01

    The present study examined the impact of cognitive reserve in maintaining intact neuropsychological (NP) function among older HIV-positive individuals, a uniquely at-risk subgroup. Participants included 129 individuals classified by HIV serostatus, age group, and NP impairment. A three-way analysis of variance (ANOVA) followed by a series of within-group ANOVA and multiple regression analyses were conducted to investigate the pattern of cognitive reserve (vs. other protective) influence among...

  3. Occupational therapists lead a national injury prevention strategy to help older drivers.

    Craik, Janet M

    2011-04-01

    As older adults are the fastest growing segment of the driving population, the Canadian Association of Occupational Therapists (CAOT) has taken older driver safety as a key priority. The purpose of this paper is to present the National Blueprint for Injury Prevention in Older Drivers (Blueprint) and its related activities. Since 2006, CAOT has been working on initiatives relating to the National Blueprint for Injury Prevention in Older Drivers. The most recent activities include the launch of informational brochures and a website. The Blueprint and its related activities were developed with the intent to prolong safe driving among older adults in Canada, and to propose future actions to be addressed by all stakeholders interested in older driver safety.

  4. The impact of Stereotype Threat on the simulated driving performance of older drivers.

    Joanisse, Mélanie; Gagnon, Sylvain; Voloaca, Mihnea

    2013-01-01

    Older drivers are perceived as being dangerous and overly cautious by other drivers. We tested the hypothesis that this negative stereotype has a direct influence on the performance of older drivers. Based on the Stereotype Threat literature, we predicted that older driving performance would be altered after exposure to a Stereotype Threat. Sixty-one older drivers aged 65 and above completed a simulated driving assessment course. Prior to testing, half of the participants were told that the objective of the study was to investigate why older adults aged 65 and above were more implicated in on-road accidents (Stereotype Threat condition) and half were showed a neutral statement. Results confirmed that exposure to the threat significantly altered driving performance. Older adults in the Stereotype Threat condition made more driving mistakes than those in the control group. Interestingly, under a Stereotype Threat condition, older adults tended to commit more speeding infractions. We also observed that domain identification (whether driving is deemed important or not) moderated the impact of the threat. Taken together, these results support recent older drivers' performance models suggesting that the interaction between individual and social factors need to be considered when examining older drivers' performance. Copyright © 2012 Elsevier Ltd. All rights reserved.

  5. Individualised dietary counselling for nutritionally at-risk older patients following discharge from acute hospital to home

    Munk, T; Tolstrup, U; Beck, A M

    2016-01-01

    Background: Many older patients are undernourished after hospitalisation. Undernutrition impacts negatively on physical function and the ability of older patients to perform activities of daily living at home after discharge from acute hospital. The present study aimed to evaluate the evidence...... for an effect of individualised dietary counselling following discharge from acute hospital to home on physical function, and, second, on readmissions, mortality, nutritional status, nutritional intake and quality of life (QoL), in nutritionally at-risk older patients. Methods: A systematic review of randomised......% CI = 0.08-1.95, P = 0.03). Meta-analyses revealed no significant effect on physical function assessed using hand grip strength, and similarly on mortality. Narrative summation of effects on physical function using other instruments revealed inconsistent effects. Meta-analyses were not conducted on Qo...

  6. Older drivers' acceptance of in-vehicle systems and the effect it has on safety.

    2014-06-01

    Older drivers make up the fastest growing : segment of the : driving population and are : , : in general, unde : rrepresented in : vehicle crashes due to their self : - : restrictive driving habits. : However, as the baby : - : boomer generation : ag...

  7. Taxonomy of Older Driver Behaviors and Crash Risk : with Appendices A and B

    2012-02-01

    This projects objectives were to identify risky behaviors, driving habits, and exposure patterns that have been shown to increase the likelihood of crash involvement among older drivers; and to classify these crash-contributing factors according t...

  8. Proactive vs. reactive car driving: EEG evidence for different driving strategies of older drivers

    Wascher, Edmund; Getzmann, Stephan

    2018-01-01

    Aging is associated with a large heterogeneity in the extent of age-related changes in sensory, motor, and cognitive functions. All these functions can influence the performance in complex tasks like car driving. The present study aims to identify potential differences in underlying cognitive processes that may explain inter-individual variability in driving performance. Younger and older participants performed a one-hour monotonous driving task in a driving simulator under varying crosswind conditions, while behavioral and electrophysiological data were recorded. Overall, younger and older drivers showed comparable driving performance (lane keeping). However, there was a large difference in driving lane variability within the older group. Dividing the older group in two subgroups with low vs. high driving lane variability revealed differences between the two groups in electrophysiological correlates of mental workload, consumption of mental resources, and activation and sustaining of attention: Older drivers with high driving lane variability showed higher frontal Alpha and Theta activity than older drivers with low driving lane variability and—with increasing crosswind—a more pronounced decrease in Beta activity. These results suggest differences in driving strategies of older and younger drivers, with the older drivers using either a rather proactive and alert driving strategy (indicated by low driving lane variability and lower Alpha and Beta activity), or a rather reactive strategy (indicated by high driving lane variability and higher Alpha activity). PMID:29352314

  9. Effects of in-car support on mental workload and driving performance of older drivers

    Davidse, R.J.; Hagenzieker, M.; van Wolffelaar, P.C.; Brouwer, W.H.

    Objective: This study examined the extent to which driving performance of 10 older (70-88 years old) and 30 younger participants (30-50 years old) improves as a result of support by a driver assistance system. Background: Various studies have indicated that advanced driver assistance systems (ADAS)

  10. Behind the wheel: community consultation informs adaptation of safe-transport program for older drivers.

    Coxon, Kristy; Keay, Lisa

    2015-12-09

    Safe-transport is important to well-being in later life but balancing safety and independence for older drivers can be challenging. While self-regulation is a promising tool to promote road safety, more research is required to optimise programs. Qualitative research was used to inform the choice and adaptation of a safe-transport education program for older drivers. Three focus groups were conducted with older drivers living in northwest Sydney to explore four key areas related to driving in later life including aged-based licensing, stopping or limiting driving, barriers to driving cessation and alternative modes of transportation. Data were analysed using content analysis. Four categories emerged from the data; bad press for older drivers, COMPETENCE not age, call for fairness in licensing regulations, and hanging up the keys: It's complicated! Two key issues being (1) older drivers wanted to drive for as long as possible but (2) were not prepared for driving cessation; guided the choice and adaption of the Knowledge Enhances Your Safety (KEYS) program. This program was adapted for the Australian context and focus group findings raised the need for practical solutions, including transport alternatives, to be added. Targeted messages were developed from the data using the Precaution Adoption Process Model (PAPM), allowing the education to be tailored to the individual's stage of behaviour change. Adapting our program based on insights gained from community consultation should ensure the program is sensitive to the needs, skills and preferences of older drivers.

  11. A brief peripheral motion contrast threshold test predicts older drivers' hazardous behaviors in simulated driving.

    Henderson, Steven; Woods-Fry, Heather; Collin, Charles A; Gagnon, Sylvain; Voloaca, Misha; Grant, John; Rosenthal, Ted; Allen, Wade

    2015-05-01

    Our research group has previously demonstrated that the peripheral motion contrast threshold (PMCT) test predicts older drivers' self-report accident risk, as well as simulated driving performance. However, the PMCT is too lengthy to be a part of a battery of tests to assess fitness to drive. Therefore, we have developed a new version of this test, which takes under two minutes to administer. We assessed the motion contrast thresholds of 24 younger drivers (19-32) and 25 older drivers (65-83) with both the PMCT-10min and the PMCT-2min test and investigated if thresholds were associated with measures of simulated driving performance. Younger participants had significantly lower motion contrast thresholds than older participants and there were no significant correlations between younger participants' thresholds and any measures of driving performance. The PMCT-10min and the PMCT-2min thresholds of older drivers' predicted simulated crash risk, as well as the minimum distance of approach to all hazards. This suggests that our tests of motion processing can help predict the risk of collision or near collision in older drivers. Thresholds were also correlated with the total lane deviation time, suggesting a deficiency in processing of peripheral flow and delayed detection of adjacent cars. The PMCT-2min is an improved version of a previously validated test, and it has the potential to help assess older drivers' fitness to drive. Copyright © 2015 Elsevier Ltd. All rights reserved.

  12. Cognitive person variables in the delay of gratification of older children at risk.

    Rodriguez, M L; Mischel, W; Shoda, Y

    1989-08-01

    The components of self-regulation were analyzed, extending the self-imposed delay of gratification paradigm to older children with social adjustment problems. Delay behavior was related to a network of conceptually relevant cognitive person variables, consisting of attention deployment strategies during delay, knowledge of delay rules, and intelligence. A positive relationship was demonstrated between concurrent indexes of intelligence, attention deployment, and actual delay time. Moreover, attention deployment, measured as an individual differences variable during the delay process, had a direct, positive effect on delay behavior. Specifically, as the duration of delay and the frustration of the situation increased, children who spent a higher proportion of the time distracting themselves from the tempting elements of the delay situation were able to delay longer. The effect of attention deployment on delay behavior was significant even when age, intelligence, and delay rule knowledge were controlled. Likewise, delay rule knowledge significantly predicted delay time, even when age, attention deployment, and intelligence were controlled.

  13. The role of simulation in the assessment of older drivers.

    Sommer, Sascha; Rothermel, Stefan; Henriksson, Per; de Waard, Dick; Brookhuis, Karel; Sommer, Sascha; Verwey, Willem B.

    2003-01-01

    Within the project AGILE an assessment system for ageing drivers is developed. A multi-tier procedure including simulator-based diagnostic tests is will be created. Objective driver performance measurement, design of risky scenarios to test performance limits and high face validity are benefits of

  14. Author Correction: Reliability and feasibility of gait initiation centre-of-pressure excursions using a Wii® Balance Board in older adults at risk of falling.

    Lee, James; Webb, Graham; Shortland, Adam P; Edwards, Rebecca; Wilce, Charlotte; Jones, Gareth D

    2018-05-12

    In the original publication, the article title was incorrectly published as 'Reliability and feasibility of gait initiation centre-of-pressure excursions using a Wii® Balance Board in older adults at risk of failing'. The correct title should read as 'Reliability and feasibility of gait initiation centre-of-pressure excursions using a Wii® Balance Board in older adults at risk of falling'.

  15. COMPARISON OF SEVERITY AFFECTING FACTORS BETWEEN YOUNG AND OLDER DRIVERS INVOLVED IN SINGLE VEHICLE CRASHES

    Sunanda DISSANAYAKE, Ph.D., P.E.

    2004-01-01

    Full Text Available Single vehicle crashes contribute to a significant amount of fatalities in the United States. At the same time, fatality crash involvement rates of young and older drivers are well above the average and both groups are identified as critical groups when it comes to highway safety. Therefore, the study described in this paper developed separate models to predict crash severity of single vehicle crashes by young and older drivers. By using the models, factors affecting towards increased crash severity were identified for each group and comparisons were made. Almost all the common identified factors influenced both driver groups in the same manner except in the case of alcohol and drug usage, which indicated an interesting finding in the case of crash severity of older drivers. Speeding and non-usage of a restraint device were the two most important factors affecting towards increased crash severity for both driver groups at all severity levels. Additionally, ejection and existence of curve/grade were determinants of higher young driver crash severity at all levels. For older drivers, having a frontal impact point was a severity determinant at all levels. County of residence and weather condition were not effective in making any changes with respect to crash severity at any level, while some other factors had a minimal affect. Findings of this study are beneficial in investigating the potential ways of reducing crash severity, which could also be influential in reducing the occurrence of crashes as well.

  16. A study of at-fault older drivers in light-vehicle crashes in Singapore.

    Chin, Hoong Chor; Zhou, Mo

    2018-03-01

    A number of studies on motor vehicle crashes have suggested that older drivers are more likely to be at-fault compared to younger drivers. The objective of this paper is to identify factors that contribute to older drivers (aged 65 and above) being at fault in light vehicle crashes in Singapore. Based on 3 years of crash data, the calibrated binary logit model shows that older drivers are more likely to be at fault during peak periods and festive seasons between November to February, as well as at gore areas of expressways, intersections. Curb lanes of multi-lane roads and single-lane roads are also found to increase the odds of older drivers being at fault. Furthermore, older drivers appear to have more problems on roads with wet surfaces and speed limits of 60 km/h and 70 km/h. In the light of an aging population in Singapore, it is imperative that more targeted countermeasures be taken from multiple perspectives to lower such risks. Copyright © 2018 Elsevier Ltd. All rights reserved.

  17. Dizziness in older people: at risk of shared therapeutic nihilism between patient and physician. A qualitative study.

    Stam, Hanneke; Wisse, Marjanne; Mulder, Bram; van der Wouden, Johannes C; Maarsingh, Otto R; van der Horst, Henriëtte E

    2016-07-16

    Dizziness-related impairment is a strong predictor for an unfavourable course of dizziness in older people. In this study we explored the experiences of older patients with significant dizziness-related impairment and their wishes and expectations regarding general practitioner (GP) care. Knowing the expectations and priorities of people with dizziness may enable the GP to provide tailor-made care, which in turn may substantially increase the quality of life and decrease the use and costs of health care. We conducted a qualitative study with semi-structured interviews. We selected patients from ten Dutch general practices. Patients were invited to participate in the study if they were ≥ 65 years, visited their GP because of dizziness and were significantly impaired due to dizziness (Dizziness Handicap Inventory ≥ 30). We applied content analysis to the semi-structured interviews. Thirteen participants participated, seven were female. Analysis of the interviews resulted in the overall theme "Dizziness in older people: at risk of shared therapeutic nihilism by the patient and the GP". Firstly, this can explained by the fact that participants frequently presented dizziness as a secondary complaint when they visited the GP for another complaint. Secondly, participants reported that the GP often could not help them with any treatment. Despite a poor therapeutic outcome, the vast majority of participants was satisfied how the GP handled their dizziness. Yet, understanding the cause of dizziness seems important for dizzy older patients. Despite significant dizziness-related impairment, older dizzy patients may not present dizziness as main reason for encounter. Presenting dizziness as a secondary complaint may give GPs the - wrong - impression that the dizziness-related impairment is only mild. GPs need to be aware of this potential underreporting. Knowing the cause of dizziness seems important for older patients. Yet, GPs regularly did not succeed in

  18. Association between unsafe driving performance and cognitive-perceptual dysfunction in older drivers.

    Park, Si-Woon; Choi, Eun Seok; Lim, Mun Hee; Kim, Eun Joo; Hwang, Sung Il; Choi, Kyung-In; Yoo, Hyun-Chul; Lee, Kuem Ju; Jung, Hi-Eun

    2011-03-01

    To find an association between cognitive-perceptual problems of older drivers and unsafe driving performance during simulated automobile driving in a virtual environment. Cross-sectional study. A driver evaluation clinic in a rehabilitation hospital. Fifty-five drivers aged 65 years or older and 48 drivers in their late twenties to early forties. All participants underwent evaluation of cognitive-perceptual function and driving performance, and the results were compared between older and younger drivers. The association between cognitive-perceptual function and driving performance was analyzed. Cognitive-perceptual function was evaluated with the Cognitive Perceptual Assessment for Driving (CPAD), a computer-based assessment tool consisting of depth perception, sustained attention, divided attention, the Stroop test, the digit span test, field dependency, and trail-making test A and B. Driving performance was evaluated with use of a virtual reality-based driving simulator. During simulated driving, car crashes were recorded, and an occupational therapist observed unsafe performances in controlling speed, braking, steering, vehicle positioning, making lane changes, and making turns. Thirty-five older drivers did not pass the CPAD test, whereas all of the younger drivers passed the test. When using the driving simulator, a significantly greater number of older drivers experienced car crashes and demonstrated unsafe performance in controlling speed, steering, and making lane changes. CPAD results were associated with car crashes, steering, vehicle positioning, and making lane changes. Older drivers who did not pass the CPAD test are 4 times more likely to experience a car crash, 3.5 times more likely to make errors in steering, 2.8 times more likely to make errors in vehicle positioning, and 6.5 times more likely to make errors in lane changes than are drivers who passed the CPAD test. Unsafe driving performance and car crashes during simulated driving were more

  19. A qualitative exploration of self-regulation behaviors among older drivers.

    Donorfio, Laura K M; Mohyde, Maureen; Coughlin, Joseph; D'Ambrosio, Lisa

    2008-01-01

    While much of the research on aging and driving has focused on sensory and motor changes, little is known about older drivers and the actual self-regulation adjustments they employ to continue driving safely. This research looks at how older drivers have made changes to driving patterns and behaviors that have allowed them to continue to drive without compromising their perceived safety, independence, and quality of life. Nine focus groups were held with older men and women aged 58 to 89 years. Some of the major themes that emerged were the following: older adults are very aware of age-related changes to driving; they perceive that self-regulation behaviors change with age; and they view transportation alternatives as limited or nonexistent. Policy implications include developing functional transit programs for older adults and car manufacturer training workshops to educate older adults on the safety features of newly purchased automobiles.

  20. Driving with advanced vehicle technology: A qualitative investigation of older drivers' perceptions and motivations for use.

    Gish, Jessica; Vrkljan, Brenda; Grenier, Amanda; Van Miltenburg, Benita

    2017-09-01

    For older drivers, in-vehicle technology offers much potential to improve safety and increase longevity of retaining both licensure and community mobility. However, little is known about how older drivers perceive Advanced Vehicle Technologies (AVTs) based on everyday driving experience. Interviews with 35 older drivers (20 men; 15 women) aged 60-85 who owned a vehicle with at least two AVTs (e.g., back-up camera, lane departure warning) were conducted to explore the meanings that older drivers assigned to AVTs and motivations for use, including whether age-related functional changes were part of their automobile purchase decision. Findings indicate that age-related changes are not a primary reason for why older adults seek out AVTs, but they still perceived and experienced AVTs to counteract age-related changes in driving performance based upon changes they felt occurring within the body. Older drivers also described AVTs as generating a sense of comfort behind-the-wheel. Comfort with this technology was equated with convenience, ease of use, and increased feelings of safety. Discussion emphasizes how assessments of the quality of driving performance and value of technology occur in relation to an aging body. Copyright © 2016 Elsevier Ltd. All rights reserved.

  1. Prevalence of at-risk drinking among Brazilian truck drivers and its interference on the performance of executive cognitive tasks.

    de Oliveira, Lucio Garcia; Leopoldo, Kae; Gouvea, Marcela Julio Cesar; Barroso, Lucia Pereira; Gouveia, Paula Adriana Rodrigues; Muñoz, Daniel Romero; Leyton, Vilma

    2016-09-01

    Binge drinking (BD) has been associated with an increase in the risk of alcohol-related injuries. Alcohol continues to be the main substance consumed by truck drivers, a population of special concern, since they are often involved in traffic accidents. The aim of this study was to estimate the prevalence of BD and its interference in the executive functioning among truck drivers in Sao Paulo, Brazil. A non-probabilistic sample of 684 truck drivers was requested to answer a structured research instrument on their demographic data and alcohol use. They performed cognitive tests to assess their executive functioning and inventories about confounding variables. The participants were then divided according to their involvement in BD. 17.5% of the interviewees have reported being engaged in BD. Binge drinkers showed a better performance on one test, despite having done so at the expense of more mistakes and lower accuracy. More interestingly, binge drinkers took three seconds longer than non-binge drinkers to inhibit an inadequate response, which is worrisome in the context of traffic. Overall, the deleterious effect of BD on performance remained after controlling for the effects of confounding variables in regression logistic models. As the use of alcohol among truck drivers may be as a way to get by with their work conditions, we believe that a negotiation between their work organization and public authorities would reduce such use, preventing negative interferences on truck drivers' cognitive functioning, which by its turn may also prevent traffic accidents. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  2. Nutritional advice in older patients at risk of malnutrition during treatment for chemotherapy: a two-year randomized controlled trial.

    Bourdel-Marchasson, Isabelle; Blanc-Bisson, Christelle; Doussau, Adélaïde; Germain, Christine; Blanc, Jean-Frédéric; Dauba, Jérôme; Lahmar, Cyril; Terrebonne, Eric; Lecaille, Cédric; Ceccaldi, Joël; Cany, Laurent; Lavau-Denes, Sandrine; Houede, Nadine; Chomy, François; Durrieu, Jessica; Soubeyran, Pierre; Senesse, Pierre; Chene, Geneviève; Fonck, Mariane

    2014-01-01

    We tested the effect of dietary advice dedicated to increase intake in older patients at risk for malnutrition during chemotherapy, versus usual care, on one-year mortality. We conducted a multicentre, open-label interventional, stratified (centre), parallel randomised controlled trial, with a 1∶1 ratio, with two-year follow-up. Patients were aged 70 years or older treated with chemotherapy for solid tumour and at risk of malnutrition (MNA, Mini Nutritional Assessment 17-23.5). Intervention consisted of diet counselling with the aim of achieving an energy intake of 30 kCal/kg body weight/d and 1.2 g protein/kg/d, by face-to-face discussion targeting the main nutritional symptoms, compared to usual care. Interviews were performed 6 times during the chemotherapy sessions for 3 to 6 months. The primary endpoint was 1-year mortality and secondary endpoints were 2-year mortality, toxicities and chemotherapy outcomes. Between April 2007 and March 2010 we randomised 341 patients and 336 were analysed: mean (standard deviation) age of 78.0 y (4·9), 51.2% male, mean MNA 20.2 (2.1). Distribution of cancer types was similar in the two groups; the most frequent were colon (22.4%), lymphoma (14.9%), lung (10.4%), and pancreas (17.0%). Both groups increased their dietary intake, but to a larger extent with intervention (pnutritional status changes was found. Response to chemotherapy was also similar between the groups. Early dietary counselling was efficient in increasing intake but had no beneficial effect on mortality or secondary outcomes. Cancer cachexia antianabolism may explain this lack of effect. ClinicalTrials.gov NCT00459589.

  3. Physician input and licensing of at-risk drivers: a review of all-inclusive medical evaluation forms in the US and Canada.

    Meuser, Thomas M; Berg-Weger, Marla; Niewoehner, Patricia M; Harmon, Annie C; Kuenzie, Jill C; Carr, David B; Barco, Peggy P

    2012-05-01

    This article details a systematic review of medical evaluation forms in support of licensing decisions for medically at-risk drivers. Comparisons were made between all-inclusive forms utilized by 52 State and Provincial Departments of Motor Vehicles (DMVs) in the US and Canada. Comparisons focused on length, format, content, instructional quality, medical coverage, ease of use, and other qualitative characteristics. Median page length was 2 (range 1-10), and mean word count was 1083 (494-3884). Common response options included open-ended (98%), forced choice (87%), and check box (81%). While the majority of forms (77%) required driver consent, only 24% requested information from the driver. Less than half (46%) included text on confidentiality protection. While all forms requested general medical information, just over half included specific sections for vision (54%) and cognitive/neurological conditions (56%). Most forms (81%) required that a judgment be made concerning driver safety, and half prompted for possible license restrictions. Criterion-based quality ratings were assigned on a five-point Likert scale by group consensus. One third of forms were rated as marginal or poor in comprehensiveness and utility, and just two garnered an excellent overall rating. Findings are discussed relative to current research on driver fitness and elements of a proposed model form. Best practice recommendations include a page length limitation, emphasis on in-person evaluation (i.e., as opposed to a records-only review), prompts to collect crash and other driving history information, clear instructions and stepwise format, content prompts across relevant medical categories, documentation of functional status and impairment levels, options for driving with restrictions in lieu of de-licensing, and emphasis on relative (vs. absolute) clinical judgments of overall driver safety. Copyright © 2011 Elsevier Ltd. All rights reserved.

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

    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.

  5. Older Driver Safety: A Survey of Psychologists' Attitudes, Knowledge, and Practices.

    Love, Janet; Tuokko, Holly

    2016-09-01

    Using an online survey, we examined the knowledge, attitudes, and practices with respect to older driver safety concerns of clinical psychologists from across Canada who self-identified as working with at least some drivers over 60 years of age. Eighty-four psychologists completed the survey, and many were aware of the issues relevant to older driver safety, although only about half reported that assessing fitness to drive was an important issue in their practice. The majority (75%) reported that they would benefit from education concerning evaluation of fitness to drive. The primary recommendation emerging from this investigation is to increase efforts to inform and educate psychologists about driving-related assessment and regulatory issues in general, and specifically with respect to older adults. As the population ages, it is of growing importance for all health care providers to understand the influence of mental health conditions-including cognitive impairment and dementia-on driving skills.

  6. Active training and driving-specific feedback improve older drivers' visual search prior to lane changes

    Lavallière Martin

    2012-03-01

    Full Text Available Abstract Background Driving retraining classes may offer an opportunity to attenuate some effects of aging that may alter driving skills. Unfortunately, there is evidence that classroom programs (driving refresher courses do not improve the driving performance of older drivers. The aim of the current study was to evaluate if simulator training sessions with video-based feedback can modify visual search behaviors of older drivers while changing lanes in urban driving. Methods In order to evaluate the effectiveness of the video-based feedback training, 10 older drivers who received a driving refresher course and feedback about their driving performance were tested with an on-road standardized evaluation before and after participating to a simulator training program (Feedback group. Their results were compared to a Control group (12 older drivers who received the same refresher course and in-simulator active practice as the Feedback group without receiving driving-specific feedback. Results After attending the training program, the Control group showed no increase in the frequency of the visual inspection of three regions of interests (rear view and left side mirrors, and blind spot. In contrast, for the Feedback group, combining active training and driving-specific feedbacks increased the frequency of blind spot inspection by 100% (32.3 to 64.9% of verification before changing lanes. Conclusions These results suggest that simulator training combined with driving-specific feedbacks helped older drivers to improve their visual inspection strategies, and that in-simulator training transferred positively to on-road driving. In order to be effective, it is claimed that driving programs should include active practice sessions with driving-specific feedbacks. Simulators offer a unique environment for developing such programs adapted to older drivers' needs.

  7. Active training and driving-specific feedback improve older drivers' visual search prior to lane changes.

    Lavallière, Martin; Simoneau, Martin; Tremblay, Mathieu; Laurendeau, Denis; Teasdale, Normand

    2012-03-02

    Driving retraining classes may offer an opportunity to attenuate some effects of aging that may alter driving skills. Unfortunately, there is evidence that classroom programs (driving refresher courses) do not improve the driving performance of older drivers. The aim of the current study was to evaluate if simulator training sessions with video-based feedback can modify visual search behaviors of older drivers while changing lanes in urban driving. In order to evaluate the effectiveness of the video-based feedback training, 10 older drivers who received a driving refresher course and feedback about their driving performance were tested with an on-road standardized evaluation before and after participating to a simulator training program (Feedback group). Their results were compared to a Control group (12 older drivers) who received the same refresher course and in-simulator active practice as the Feedback group without receiving driving-specific feedback. After attending the training program, the Control group showed no increase in the frequency of the visual inspection of three regions of interests (rear view and left side mirrors, and blind spot). In contrast, for the Feedback group, combining active training and driving-specific feedbacks increased the frequency of blind spot inspection by 100% (32.3 to 64.9% of verification before changing lanes). These results suggest that simulator training combined with driving-specific feedbacks helped older drivers to improve their visual inspection strategies, and that in-simulator training transferred positively to on-road driving. In order to be effective, it is claimed that driving programs should include active practice sessions with driving-specific feedbacks. Simulators offer a unique environment for developing such programs adapted to older drivers' needs.

  8. Cognitive functioning differentially predicts different dimensions of older drivers' on-road safety.

    Aksan, Nazan; Anderson, Steve W; Dawson, Jeffrey; Uc, Ergun; Rizzo, Matthew

    2015-02-01

    The extent to which deficits in specific cognitive domains contribute to older drivers' safety risk in complex real-world driving tasks is not well understood. We selected 148 drivers older than 70 years of age both with and without neurodegenerative diseases (Alzheimer disease-AD and Parkinson disease-PD) from an existing driving database of older adults. Participant assessments included on-road driving safety and cognitive functioning in visuospatial construction, speed of processing, memory, and executive functioning. The standardized on-road drive test was designed to examine multiple facets of older driver safety including navigation performance (e.g., following a route, identifying landmarks), safety errors while concurrently performing secondary navigation tasks ("on-task" safety errors), and safety errors in the absence of any secondary navigation tasks ("baseline" safety errors). The inter-correlations of these outcome measures were fair to moderate supporting their distinctiveness. Participants with diseases performed worse than the healthy aging group on all driving measures and differences between those with AD and PD were minimal. In multivariate analyses, different domains of cognitive functioning predicted distinct facets of driver safety on road. Memory and set-shifting predicted performance in navigation-related secondary tasks, speed of processing predicted on-task safety errors, and visuospatial construction predicted baseline safety errors. These findings support broad assessments of cognitive functioning to inform decisions regarding older driver safety on the road and suggest navigation performance may be useful in evaluating older driver fitness and restrictions in licensing. Copyright © 2014 Elsevier Ltd. All rights reserved.

  9. Passengers at risk: a multi-level analysis of the decision to travel with a drunk driver.

    Nazif-Muñoz, José Ignacio; Blank-Gomel, Aharon

    2017-06-01

    To assess the impact of demographic, intrapersonal and environmental factors on the likelihood in Chile of becoming a passenger of an alcohol-impaired driver (PAID). Multi-level cross-sectional study. Data were acquired from two large-scale household surveys of representative samples of Chile's Metropolitan Region. The study included 1341 individuals ≥ 16 years; 696 of them reported engaging in PAID. The primary outcome was self-reported frequencies of having accepted a ride with an alcohol-impaired driver. PAID was associated significantly with 'age' [odds ratio (OR) = 0.99, 95% confidence interval (CI) = 0.98-0.99, P = 0.03], 'traffic safety beliefs' (OR = 0.17, 95% CI = 0.078-0.44, P = 0.00), 'time exposure as passenger' (OR = 1.00, 95% CI = 1.00-1.01, P = 0.00) and 'sex' (OR = 0.67, 95% CI = 0.53-0.87, P = 0.00). In women, PAID was associated with 'age' (OR = 0.98, 95% CI = 0.97-0.99, P = 0.02), 'traffic safety beliefs' (OR = 0.17, 95% CI = 0.05-0.59, P = 0.00) and 'low quality of public bus stops' (OR = 0.97, 95% CI = 0.98-0.99, P = 0.01). Younger women with high education levels were more likely to engage in PAID than younger women with low education levels. In men, PAID was associated with 'traffic safety beliefs' (OR = 0.13, 95% CI = 0.02-0.63, P = 0.01) and 'time exposure as passenger' (OR = 1.00, 95% CI = 1.00-1.01, P = 0.02). In Chile, men are at higher risk of becoming a passenger of an alcohol-impaired driver (PAID) than women. In women, PAID appears to be associated with lower traffic safety beliefs, lower quality of public bus stations and an interaction between education and age. In men, PAID is associated with lower traffic safety beliefs and higher time exposure as passenger. © 2017 Society for the Study of Addiction.

  10. Nutritional advice in older patients at risk of malnutrition during treatment for chemotherapy: a two-year randomized controlled trial.

    Isabelle Bourdel-Marchasson

    Full Text Available We tested the effect of dietary advice dedicated to increase intake in older patients at risk for malnutrition during chemotherapy, versus usual care, on one-year mortality.We conducted a multicentre, open-label interventional, stratified (centre, parallel randomised controlled trial, with a 1∶1 ratio, with two-year follow-up. Patients were aged 70 years or older treated with chemotherapy for solid tumour and at risk of malnutrition (MNA, Mini Nutritional Assessment 17-23.5. Intervention consisted of diet counselling with the aim of achieving an energy intake of 30 kCal/kg body weight/d and 1.2 g protein/kg/d, by face-to-face discussion targeting the main nutritional symptoms, compared to usual care. Interviews were performed 6 times during the chemotherapy sessions for 3 to 6 months. The primary endpoint was 1-year mortality and secondary endpoints were 2-year mortality, toxicities and chemotherapy outcomes.Between April 2007 and March 2010 we randomised 341 patients and 336 were analysed: mean (standard deviation age of 78.0 y (4·9, 51.2% male, mean MNA 20.2 (2.1. Distribution of cancer types was similar in the two groups; the most frequent were colon (22.4%, lymphoma (14.9%, lung (10.4%, and pancreas (17.0%. Both groups increased their dietary intake, but to a larger extent with intervention (p<0.01. At the second visit, the energy target was achieved in 57 (40.4% patients and the protein target in 66 (46.8% with the intervention compared respectively to 13 (13.5% and 20 (20.8% in the controls. Death occurred during the first year in 143 patients (42.56%, without difference according to the intervention (p = 0.79. No difference in nutritional status changes was found. Response to chemotherapy was also similar between the groups.Early dietary counselling was efficient in increasing intake but had no beneficial effect on mortality or secondary outcomes. Cancer cachexia antianabolism may explain this lack of effect.ClinicalTrials.gov NCT

  11. Nutritional Advice in Older Patients at Risk of Malnutrition during Treatment for Chemotherapy: A Two-Year Randomized Controlled Trial

    Bourdel-Marchasson, Isabelle; Blanc-Bisson, Christelle; Doussau, Adélaïde; Germain, Christine; Blanc, Jean-Frédéric; Dauba, Jérôme; Lahmar, Cyril; Terrebonne, Eric; Lecaille, Cédric; Ceccaldi, Joël; Cany, Laurent; Lavau-Denes, Sandrine; Houede, Nadine; Chomy, François; Durrieu, Jessica; Soubeyran, Pierre; Senesse, Pierre; Chene, Geneviève; Fonck, Mariane

    2014-01-01

    Objective We tested the effect of dietary advice dedicated to increase intake in older patients at risk for malnutrition during chemotherapy, versus usual care, on one-year mortality. Method We conducted a multicentre, open-label interventional, stratified (centre), parallel randomised controlled trial, with a 1∶1 ratio, with two-year follow-up. Patients were aged 70 years or older treated with chemotherapy for solid tumour and at risk of malnutrition (MNA, Mini Nutritional Assessment 17–23.5). Intervention consisted of diet counselling with the aim of achieving an energy intake of 30 kCal/kg body weight/d and 1.2 g protein/kg/d, by face-to-face discussion targeting the main nutritional symptoms, compared to usual care. Interviews were performed 6 times during the chemotherapy sessions for 3 to 6 months. The primary endpoint was 1-year mortality and secondary endpoints were 2-year mortality, toxicities and chemotherapy outcomes. Results Between April 2007 and March 2010 we randomised 341 patients and 336 were analysed: mean (standard deviation) age of 78.0 y (4·9), 51.2% male, mean MNA 20.2 (2.1). Distribution of cancer types was similar in the two groups; the most frequent were colon (22.4%), lymphoma (14.9%), lung (10.4%), and pancreas (17.0%). Both groups increased their dietary intake, but to a larger extent with intervention (p<0.01). At the second visit, the energy target was achieved in 57 (40.4%) patients and the protein target in 66 (46.8%) with the intervention compared respectively to 13 (13.5%) and 20 (20.8%) in the controls. Death occurred during the first year in 143 patients (42.56%), without difference according to the intervention (p = 0.79). No difference in nutritional status changes was found. Response to chemotherapy was also similar between the groups. Conclusion Early dietary counselling was efficient in increasing intake but had no beneficial effect on mortality or secondary outcomes. Cancer cachexia antianabolism may explain this

  12. Toward best practice in Human Machine Interface design for older drivers: A review of current design guidelines.

    Young, K L; Koppel, S; Charlton, J L

    2017-09-01

    Older adults are the fastest growing segment of the driving population. While there is a strong emphasis for older people to maintain their mobility, the safety of older drivers is a serious community concern. Frailty and declines in a range of age-related sensory, cognitive, and physical impairments can place older drivers at an increased risk of crash-related injuries and death. A number of studies have indicated that in-vehicle technologies such as Advanced Driver Assistance Systems (ADAS) and In-Vehicle Information Systems (IVIS) may provide assistance to older drivers. However, these technologies will only benefit older drivers if their design is congruent with the complex needs and diverse abilities of this driving cohort. The design of ADAS and IVIS is largely informed by automotive Human Machine Interface (HMI) guidelines. However, it is unclear to what extent the declining sensory, cognitive and physical capabilities of older drivers are addressed in the current guidelines. This paper provides a review of key current design guidelines for IVIS and ADAS with respect to the extent they address age-related changes in functional capacities. The review revealed that most of the HMI guidelines do not address design issues related to older driver impairments. In fact, in many guidelines driver age and sensory cognitive and physical impairments are not mentioned at all and where reference is made, it is typically very broad. Prescriptive advice on how to actually design a system so that it addresses the needs and limitations of older drivers is not provided. In order for older drivers to reap the full benefits that in-vehicle technology can afford, it is critical that further work establish how older driver limitations and capabilities can be supported by the system design process, including their inclusion into HMI design guidelines. Copyright © 2016 Elsevier Ltd. All rights reserved.

  13. Cost-effectiveness analysis of a multifactorial fall prevention intervention in older home care clients at risk for falling.

    Isaranuwatchai, Wanrudee; Perdrizet, Johnna; Markle-Reid, Maureen; Hoch, Jeffrey S

    2017-09-01

    Falls among older adults can cause serious morbidity and pose economic burdens on society. Older age is a known risk factor for falls and age has been shown to influence the effectiveness of fall prevention programs. To our knowledge, no studies have explicitly investigated whether cost-effectiveness of a multifactorial fall prevention intervention (the intervention) is influenced by age. This economic evaluation explores: 1) the cost-effectiveness of a multifactorial fall prevention intervention compared to usual care for community-dwelling adults ≥ 75 years at risk of falling in Canada; and 2) the influence of age on the cost-effectiveness of the intervention. Net benefit regression was used to examine the cost-effectiveness of the intervention with willingness-to-pay values ranging from $0-$50,000. Effects were measured as change in the number of falls, from baseline to 6-month follow-up. Costs were measured using a societal perspective. The cost-effectiveness analysis was conducted for both the total sample and by age subgroups (75-84 and 85+ years). For the total sample, the intervention was not economically attractive. However, the intervention was cost-effective at higher willingness-to-pay (WTP) (≥ $25,000) for adults 75-84 years and at lower WTP (cost-effectiveness of the intervention depends on age and decision makers' WTP to prevent falls. Understanding the influence of age on the cost-effectiveness of an intervention may help to target resources to those who benefit most. Retrospectively registered. Clinicaltrials.gov identifier: NCT00463658 (18 April 2007).

  14. The older adult road user : recommendations for driver assistance

    Wilschut, E.S.; Kroon, E.C.M.; Goede, M. de; Cremers, A.H.M.; Hoedemaeker, D.M.

    2014-01-01

    The number of older road users is getting increasingly larger in Europe. Therefore policy makers pay more attention to the abilities and limitations of this group of road users. Providing accessible and comfortable assistance and safety functions for mobility is a key challenge in the objective of

  15. Projecting Fatalities in Crashes Involving Older Drivers, 2000-2025

    Hu, P.S.

    2001-03-23

    As part of this research effort, we developed a new methodology for projecting elderly traffic crash fatalities. This methodology separates exposure to crashes from crash risk per se, and further divides exposure into two components, the number of miles driven and the likelihood of being a driver. This component structure permits conceptually different determinants of traffic fatalities to be projected separately and has thorough motivation in behavioral theory. It also permits finer targeting of particular aspects of projections that need improvement and closer linking of projections to possible policy instruments for influencing them.

  16. Older driver involvements in police reported crashes and fatal crashes: trends and projections

    Lyman, S; Ferguson, S; Braver, E; Williams, A

    2002-01-01

    Objectives: Older drivers have become a larger part of the driving population and will continue to do so as the baby boomers reach retirement age. The purpose of this study was to identify the potential effects of this population increase on highway safety.

  17. US policies to enhance older driver safety: a systematic review of the literature.

    Dugan, Elizabeth; Barton, Kelli N; Coyle, Caitlin; Lee, Chae Man

    2013-01-01

    The purpose of this study was to conduct a systematic review of the literature related to state policies concerning older drivers and to draw policy conclusions about which policies appear to work to reduce older driver crashes and to identify areas needed for further research. Specific policies examined in this paper concern medical reporting and medical review, license renewal processes, and driver testing. A study was included in the systematic review if it met the following criteria: published in English between 1991and January 2013; included data on human subjects aged 65 and older residing in the United States; included information on at least one policy related to older drivers; and had a transportation-related outcome variable (e.g., crash, fatality, renewal). A total of 29 studies met inclusion criteria. Twenty-two studies investigated license renewal and seven articles examined medical reporting. In-person license renewal requirements were associated with reduced risk for fatal crashes. Restricted licenses were associated with reduced number of miles driven per week. More intensive renewal requirements and being the subject of a medical report to the licensing authority was associated with delicensure. Given the importance of driving to mobility, quality of life, and public safety, more research is needed.

  18. Older drivers' opinions of criteria that inform the cars they buy: A focus group study.

    Zhan, Jenny; Porter, Michelle M; Polgar, Jan; Vrkljan, Brenda

    2013-12-01

    Safe driving in older adulthood depends not only on health and driving ability, but also on the driving environment itself, including the type of vehicle. However, little is known about how safety figures into the older driver's vehicle selection criteria and how it ranks among other criteria, such as price and comfort. For this purpose, six focus groups of older male and female drivers (n=33) aged 70-87 were conducted in two Canadian cities to explore vehicle purchasing decisions and the contribution of safety in this decision. Themes emerged from the data in these categories: vehicle features that keep them feeling safe, advanced vehicular technologies, factors that influence their car buying decisions, and resources that inform this decision. Results indicate older drivers have gaps with respect to their knowledge of safety features and do not prioritize safety at the time of vehicle purchase. To maximize the awareness and uptake of safety innovations, older consumers would benefit from a vehicle design rating system that highlights safety as well as other features to help ensure that the vehicle purchased fits their lifestyle and needs. Copyright © 2013 Elsevier Ltd. All rights reserved.

  19. Effects of in-car support on mental workload and driving performance of older drivers.

    Davidse, Ragnhild J; Hagenzieker, Marjan P; van Wolffelaar, Peter C; Brouwer, Wiebo H

    2009-08-01

    This study examined the extent to which driving performance of 10 older (70-88 years old) and 30 younger participants (30-50 years old) improves as a result of support by a driver assistance system. Various studies have indicated that advanced driver assistance systems (ADAS) may provide tailored assistance for older drivers and thereby improve their safe mobility. While drivers followed an urban route in a driving simulator, an ADAS provided them with prior knowledge on the next intersection. The system was evaluated in terms of effects on workload and safety performance. Messages informing drivers about the right-of-way regulation, obstructed view of an intersection, and safe gaps to join or cross traffic streams led to safer driving performance. A message regarding an unexpected one-way street led to fewer route errors. In general, effects were the same for all age groups. Workload was not reduced by the support system. The evaluated support system shows promising effects for all age groups. Longer evaluation periods are needed to determine long-term effects. The messages provided by the evaluated system are currently not provided by existing ADAS such as advanced cruise control and navigation systems, but they could possibly be added to them in the future.

  20. Planning for a Nondriving Future: Behaviors and Beliefs Among Middle-Aged and Older Drivers.

    Harmon, Annie C; Babulal, Ganesh; Vivoda, Jonathon M; Zikmund-Fisher, Brian J; Carr, David B

    2018-01-01

    Despite the reality of older adults living many years after driving cessation, few prepare for the eventuality; empirically, planning for a nondriving future has not been directly quantified or explored. The following study quantifies 1) the extent of current drivers' planning, 2) specific planning behaviors, 3) beliefs about benefits of planning, 4) drivers' intention to plan more for future transportation needs, and 5) group differences associated with planning. In a predominantly female, black, urban sample of current drivers ages 53-92, fewer than half (42.1%) had planned at all for a nondriving future, with correspondingly low levels of planning behaviors reported. However, over 80% believed planning would help them meet their needs post-cessation and transition emotionally to being a nondriver. Most (85%) intended to plan more in the future as well, indicating further potential openness to the topic. Drivers who planned were older, drove less frequently, limited their driving to nearby places, reported less difficulty believing they would become a nondriver, and expected to continue driving three years less than non-planners. These findings suggest that drivers' perceived nearness to driving cessation impacts planning for future transportation needs, and existing perceived benefits of planning may provide leverage to motivate action.

  1. Older drivers' self-assessed driving skills, driving-related stress and self-regulation in traffic

    Siren, Anu Kristiina; Meng, Annette

    2013-01-01

    Previous research on older drivers has indicated connections between self-rated driving ability, confidence in their own driving, driving-related stress, and self-regulatory behaviour. However, more systematic associations between older drivers' perceptions on their own driving and self......-regulation or driver stress and self-regulation behaviour, and possible gender differences in these, have not been obtained in previous studies. The aim of the present study was to gain a better understanding of older drivers' self-regulatory driving and the motivators behind this behaviour, by placing this behaviour...... and avoidance than situations related to infrastructure, and women were more likely to report discomfort and avoidance of driving situations. The results suggest that older drivers generally show good self-judgement of changes in their driving skills and acknowledge the different types of skills comprised...

  2. Driving with Pets as a Risk Factor for Motor Vehicle Collisions among Older Drivers

    Blunck, Hallie; Owsley, Cynthia; MacLennan, Paul A.; McGwin, Gerald

    2015-01-01

    Increasing rates of distraction-related motor vehicle collisions (MVCs) continue to raise concerns regarding driving safety. This study sought to evaluate a novel driving-related distraction, driving with a pet, as a risk factor for MVCs among older, community dwelling adults. Two thousand licensed drivers aged 70 and older were identified, of whom 691 reported pet ownership. Comparing pet owners who did and did not drive with their pets, neither overall MVC rates (rate ratio [RR] 0.97 95% confidence interval [CI] 0.75–1.26) nor at-fault MVC rates (RR 0.84 95% CI 0.57–1.24) were elevated. However, those who reported always driving with a pet in the vehicle had an elevated MVC rate (RR 1.89 95% CI 1.10–3.25), as compared to those who did not drive with a pet. The MVC rate was not increased for those reporting only sometimes or rarely driving with a pet in the vehicle. The current study demonstrates an increased risk of MVC involvement in those older drivers who always take a pet with them when they drive a vehicle. When confronted with an increased cognitive or physical workload while driving, elderly drivers in prior studies have exhibited slower cognitive performance and delayed response times in comparison to younger age groups. Further study of pet-related distracted driving behaviors among older drivers as well as younger populations with respect to driver safety and performance is warranted to appropriately inform the need for policy regulation on this issue. PMID:23708755

  3. Prevalence, attitudes, and knowledge of in-vehicle technologies and vehicle adaptations among older drivers.

    Eby, David W; Molnar, Lisa J; Zakrajsek, Jennifer S; Ryan, Lindsay H; Zanier, Nicole; Louis, Renée M St; Stanciu, Sergiu C; LeBlanc, David; Kostyniuk, Lidia P; Smith, Jacqui; Yung, Raymond; Nyquist, Linda; DiGuiseppi, Carolyn; Li, Guohua; Mielenz, Thelma J; Strogatz, David

    2018-04-01

    The purpose of the present study was to gain a better understanding of the types of in-vehicle technologies being used by older drivers as well as older drivers' use, learning, and perceptions of safety related to these technologies among a large cohort of older drivers at multiple sites in the United States. A secondary purpose was to explore the prevalence of aftermarket vehicle adaptations and how older adults go about making adaptations and how they learn to use them. The study utilized baseline questionnaire data from 2990 participants from the Longitudinal Research on Aging Drivers (LongROAD) study. Fifteen in-vehicle technologies and 12 aftermarket vehicle adaptations were investigated. Overall, 57.2% of participants had at least one advanced technology in their primary vehicle. The number of technologies in a vehicle was significantly related to being male, having a higher income, and having a higher education level. The majority of respondents learned to use these technologies on their own, with "figured-it-out-myself" being reported by 25%-75% of respondents across the technologies. Overall, technologies were always used about 43% of the time, with wide variability among the technologies. Across all technologies, nearly 70% of respondents who had these technologies believed that they made them a safer driver. With regard to vehicle adaptations, less than 9% of respondents had at least one vehicle adaptation present, with the number of adaptations per vehicle ranging from 0 to 4. A large majority did not work with a professional to make or learn about the aftermarket vehicle adaptation. Copyright © 2018 Elsevier Ltd. All rights reserved.

  4. An analysis on older driver's driving behavior by GPS tracking data: Road selection, left/right turn, and driving speed

    Yanning Zhao

    2018-02-01

    Full Text Available With the high older-related accident ratio and increasing population aging problem, understanding older drivers' driving behaviors has become more and more important for building and improving transportation system. This paper examines older driver's driving behavior which includes road selection, left/right turn and driving speed. A two-month experiment of 108 participants was carried out in Aichi Prefecture, Japan. Since apparently contradictory statements were often drawn in survey-based or simulators-based studies, this study collected not only drivers' basic information but also GPS data. Analysis of road selection demonstrates that older drivers are reluctant to drive on expressway not only in short trips but also in long trips. The present study did not find significant difference between older drivers and others while turning at the intersections. To investigate the impact factors on driving speed, a random-effects regression model is constructed with explanatory variables including age, gender, road types and the interaction terms between age and road types. Compared with other variables, it fails to find that age (60 years old or over has significant impact on driving speed. Moreover, the results reflect that older drivers drive even faster than others at particular road types: national road and ordinary municipal road. The results in this study are expected to help improve transportation planning and develop driving assistance systems for older drivers.

  5. Traffic Safety of Older Drivers in Various Types of Road Intersections

    Tomaž Tollazzi

    2010-05-01

    Full Text Available In industrialized countries people over 50 years of age represent a rapidly growing part of population. Their lifestyle is also becoming more active, which means that the percentage of older drivers in the population of all drivers is also increasing. Many different studies have shown that elderly drivers are more frequently involved in specific types of accidents, especially at intersections. In the past 15 years there was a trend of increasing popularity of roundabouts in Slovenia. Their introduction was generally supported by the arguments of increased traffic-flow capacity and traffic safety as well. The studies on which these arguments are based were performed with an “ideal” type of driver in mind; the one that fully understands new rules and reacts correctly in all situations that may occur at such intersections, where there are no light signals to guide them. An elderly person does not necessarily conform to that ideal and if the percentage of elderly drivers became significant, the premises of the above mentioned studies may not be correct anymore which in turn implies that their results could also be questioned. The present study concentrated on the evaluation of traffic safety of elderly drivers, at various types of intersection, from their own perspective. Various statistical analyses of obtained data were performed. The most important finding was that we may claim, with high degree of probability, that the average person of the age of over 60 feels more unsafe at double-lane roundabouts than they would feel had the same intersection been equipped with traffic lights. Elderly traffic participants will always cause more accidents or participate in them due to hazardous factors. Challenge, arising from many different studies and researches, is in studying what measures and solutions can reduce the risk for elderly participants. KEYWORDS: traffic safety, road intersections, roundabouts, elderly people, older drivers

  6. Associations of physical activity with driving-related cognitive abilities in older drivers: an exploratory study.

    Marmeleira, José; Ferreira, Inês; Melo, Filipe; Godinho, Mário

    2012-10-01

    The purpose of this study was to examine the associations between hysical activity and driving-related cognitive abilities of older drivers. Thirty-eight female and male drivers ages 61 to 81 years (M = 70.2, SD = 5.0) responded to the International Physical Activity Questionnaire and were assessed on a battery of neuropsychological tests, which included measures of visual attention, executive functioning, mental status, visuospatial ability, and memory. A higher amount of reported physical activity was significantly correlated with better scores on tests of visual processing speed and divided visual attention. Higher amounts of physical activity was significantly associated with a better composite score for visual attention, but its correlation with the composite score for executive functioning was not significant. These findings support the hypothesis that pzhysical activity is associated with preservation of specific driving-related cognitive abilities of older adults.

  7. USING THE SAFE SYSTEM APPROACH TO KEEP OLDER DRIVERS SAFELY MOBILE

    Jim LANGFORD

    2006-01-01

    Full Text Available In 2003, Australian road transport jurisdictions collectively accepted that the greatest road safety gains would be achieved through adopting a Safe System approach, derived from Sweden's Vision Zero and the Netherlands' Sustainable Safety strategies. A key objective of all three approaches is to manage vehicles, the road infrastructure, speeds, road users and the interactions between these components, to ensure that in the event of crashes, crash energies will remain at levels that minimize the probability of death and serious injury. Older drivers pose a particular challenge to the Safe System approach, given particularly their greater physical frailty, their driving patterns and for some at least, their reduced fitness to drive. This paper has analyzed the so-called ‘older driver problem’ and identified a number of key factors underpinning their crash levels, for which countermeasures can be identified and implemented within a Safe System framework. The recommended countermeasures consist of: (1 safer roads, through a series of design improvements particularly governing urban intersections; (2 safer vehicles, through both the promotion of crashworthiness as a critical consideration when purchasing a vehicle and the wide use of developed and developing ITS technologies; (3 safer speeds especially at intersections; and (4 safer road users, through both improved assessment procedures to identify the minority of older drivers with reduced fitness to drive and educational efforts to encourage safer driving habits particularly but not only through self-regulation.

  8. [Visual abilities of older drivers--review of driving simulator studies].

    Andysz, Aleksandra; Merecz, Dorota

    2012-01-01

    In the member countries of the year Organization for Economic Co-operation and Development (OECD), one in four people will reach the age of 65 or more by 2030 and their population aged over 80 will triple by 2050. Changes that occur in the demographic structure of developed countries will affect traffic area. Most of the on-road existing solutions is inadequate for older people with diminished cognitive and motor abilities. In this group, difficulties in driving performance are associated with reduced cognitive efficiency, vision and hearing loss, and general psychomotor slowing. The presented review focuses on the studies of a useful field of view, an indicator considered to be a valid predictor of road accidents, divided attention, susceptibility to distraction and visual search strategies. The major questions of these studies were: which vision parameters determine safe driving, what degree of their deterioration causes significant risk and whether there are opportunities for their rehabilitation. The results indicate that older drivers do exhibit vision and attention deficits, but their engagement in a wide range of compensatory behaviors and effective visual search strategies compensate for these deficits. This shows that older drivers cannot be clearly classified as a group of particular risk for causing road traffic accidents. We should not be alarmed by a growing group of active senior drivers. We should rather use the advantages of available methods, including driving simulators, to predict how the traffic environment will look like in the close future and how to make it friendly and safe for everyone.

  9. Functional MRI Assessment of Task-Induced Deactivation of the Default Mode Network in Alzheimer?s Disease and At-Risk Older Individuals

    Pihlajam?ki, Maija; Sperling, Reisa A.

    2009-01-01

    Alzheimer’s disease (AD) is the most common form of dementia in old age, and is characterized by prominent impairment of episodic memory. Recent functional imaging studies in AD have demonstrated alterations in a distributed network of brain regions supporting memory function, including regions of the default mode network. Previous positron emission tomography studies of older individuals at risk for AD have revealed hypometabolism of association cortical regions similar to the metabolic abno...

  10. Older driver fitness-to-drive evaluation using naturalistic driving data.

    Guo, Feng; Fang, Youjia; Antin, Jonathan F

    2015-09-01

    As our driving population continues to age, it is becoming increasingly important to find a small set of easily administered fitness metrics that can meaningfully and reliably identify at-risk seniors requiring more in-depth evaluation of their driving skills and weaknesses. Sixty driver assessment metrics related to fitness-to-drive were examined for 20 seniors who were followed for a year using the naturalistic driving paradigm. Principal component analysis and negative binomial regression modeling approaches were used to develop parsimonious models relating the most highly predictive of the driver assessment metrics to the safety-related outcomes observed in the naturalistic driving data. This study provides important confirmation using naturalistic driving methods of the relationship between contrast sensitivity and crash-related events. The results of this study provide crucial information on the continuing journey to identify metrics and protocols that could be applied to determine seniors' fitness to drive. Published by Elsevier Ltd.

  11. Is More Better? - Night Vision Enhancement System's Pedestrian Warning Modes and Older Drivers.

    Brown, Timothy; He, Yefei; Roe, Cheryl; Schnell, Thomas

    2010-01-01

    Pedestrian fatalities as a result of vehicle collisions are much more likely to happen at night than during day time. Poor visibility due to darkness is believed to be one of the causes for the higher vehicle collision rate at night. Existing studies have shown that night vision enhancement systems (NVES) may improve recognition distance, but may increase drivers' workload. The use of automatic warnings (AW) may help minimize workload, improve performance, and increase safety. In this study, we used a driving simulator to examine performance differences of a NVES with six different configurations of warning cues, including: visual, auditory, tactile, auditory and visual, tactile and visual, and no warning. Older drivers between the ages of 65 and 74 participated in the study. An analysis based on the distance to pedestrian threat at the onset of braking response revealed that tactile and auditory warnings performed the best, while visual warnings performed the worst. When tactile or auditory warnings were presented in combination with visual warning, their effectiveness decreased. This result demonstrated that, contrary to general sense regarding warning systems, multi-modal warnings involving visual cues degraded the effectiveness of NVES for older drivers.

  12. Measuring Appetite with the Simplified Nutritional Appetite Questionnaire Identifies Hospitalised Older People at Risk of Worse Health Outcomes.

    Pilgrim, A L; Baylis, D; Jameson, K A; Cooper, C; Sayer, A A; Robinson, S M; Roberts, H C

    2016-01-01

    Poor appetite is commonly reported by older people but is rarely measured. The Simplified Nutritional Appetite Questionnaire (SNAQ) was validated to predict weight loss in community dwelling older adults but has been little used in hospitals. We evaluated it in older women on admission to hospital and examined associations with healthcare outcomes. Longitudinal observational with follow-up at six months. Female acute Medicine for Older People wards at a University hospital in England. 179 female inpatients. Age, weight, Body Mass Index (BMI), grip strength, SNAQ, Barthel Index Score, Mini Mental State Examination (MMSE), Geriatric Depression Scale: Short Form (GDS-SF), Malnutrition Universal Screening Tool (MUST), category of domicile and receipt of care were measured soon after admission and repeated at six month follow-up. The length of hospital stay (LOS), hospital acquired infection, readmissions and deaths by follow-up were recorded. 179 female participants mean age 87 (SD 4.7) years were recruited. 42% of participants had a low SNAQ score (appetite). A low SNAQ score was associated with an increased risk of hospital acquired infection (OR 3.53; 95% CI: 1.48, 8.41; p=0.004) and with risk of death (HR 2.29; 95% CI: 1.12, 4.68; p = 0.023) by follow-up. Poor appetite was common among the older hospitalised women studied, and was associated with higher risk of poor healthcare outcomes.

  13. Older drivers with cognitive impairment: Perceived changes in driving skills, driving-related discomfort and self-regulation of driving

    Meng, A.; Siren, A.; Teasdale, Thomas William

    2013-01-01

    The results of a previous study indicate that in general, older drivers who recognise cognitive problems show realistic self-assessment of changes in their driving skills and that driving-related discomfort may function as an indirect monitoring of driving ability, contributing to their safe...... drivers may recognise cognitive problems, they tend not to recognise changes to their driving, which may reflect reluctance to acknowledge the impact of cognitive impairment on their driving. Furthermore, the results suggest that driving-related discomfort plays an important role in the self......-regulation of driving among cognitively impaired older drivers. However, it is less clear what triggers driving-related discomfort among cognitively impaired older drivers indicating that it may be a less reliable aspect of their self-monitoring of driving ability....

  14. Effect of statin use on mobility disability and its prevention in at-risk older adults: the LIFE study

    BACKGROUND: HMG-CoA reductase inhibitors (statins) are among the most commonly prescribed classes of medications. Although their cardiovascular benefits and myalgia risks are well documented, their effects on older adults initiating an exercise training program are less understood. METHODS: 1,635 s...

  15. The NPs Role of Assessing and Intervening with Older Adult Drivers

    Tamatha Arms

    2016-01-01

    Full Text Available As the silver tsunami continues, assessing and intervening with older adult drivers are becoming an essential aspect of the comprehensive geriatric exam. The current lack of time efficient clinical guidelines is a concern and barrier for NPs. The purpose of this study was to identify strategies currently used by NPs. The critical incident technique was used to obtain data from a convenience sample of NPs. A total of 89 incidents were collected. The perspective of the NP can provide important information for developing clinical guidelines to promote individual and community safety.

  16. The Long-Term Benefits of Increased Aspirin Use by At-Risk Americans Aged 50 and Older.

    David B Agus

    Full Text Available The usefulness of aspirin to defend against cardiovascular disease in both primary and secondary settings is well recognized by the medical profession. Multiple studies also have found that daily aspirin significantly reduces cancer incidence and mortality. Despite these proven health benefits, aspirin use remains low among populations targeted by cardiovascular prevention guidelines. This article seeks to determine the long-term economic and population-health impact of broader use of aspirin by older Americans at higher risk for cardiovascular disease.We employ the Future Elderly Model, a dynamic microsimulation that follows Americans aged 50 and older, to project their lifetime health and spending under the status quo and in various scenarios of expanded aspirin use. The model is based primarily on data from the Health and Retirement Study, a large, representative, national survey that has been ongoing for more than two decades. Outcomes are chosen to provide a broad perspective of the individual and societal impacts of the interventions and include: heart disease, stroke, cancer, life expectancy, quality-adjusted life expectancy, disability-free life expectancy, and medical costs. Eligibility for increased aspirin use in simulations is based on the 2011-2012 questionnaire on preventive aspirin use of the National Health and Nutrition Examination Survey. These data reveal a large unmet need for daily aspirin, with over 40% of men and 10% of women aged 50 to 79 presenting high cardiovascular risk but not taking aspirin. We estimate that increased use by high-risk older Americans would improve national life expectancy at age 50 by 0.28 years (95% CI 0.08-0.50 and would add 900,000 people (95% CI 300,000-1,400,000 to the American population by 2036. After valuing the quality-adjusted life-years appropriately, Americans could expect $692 billion (95% CI 345-975 in net health benefits over that period.Expanded use of aspirin by older Americans with

  17. The Long-Term Benefits of Increased Aspirin Use by At-Risk Americans Aged 50 and Older.

    Agus, David B; Gaudette, Étienne; Goldman, Dana P; Messali, Andrew

    2016-01-01

    The usefulness of aspirin to defend against cardiovascular disease in both primary and secondary settings is well recognized by the medical profession. Multiple studies also have found that daily aspirin significantly reduces cancer incidence and mortality. Despite these proven health benefits, aspirin use remains low among populations targeted by cardiovascular prevention guidelines. This article seeks to determine the long-term economic and population-health impact of broader use of aspirin by older Americans at higher risk for cardiovascular disease. We employ the Future Elderly Model, a dynamic microsimulation that follows Americans aged 50 and older, to project their lifetime health and spending under the status quo and in various scenarios of expanded aspirin use. The model is based primarily on data from the Health and Retirement Study, a large, representative, national survey that has been ongoing for more than two decades. Outcomes are chosen to provide a broad perspective of the individual and societal impacts of the interventions and include: heart disease, stroke, cancer, life expectancy, quality-adjusted life expectancy, disability-free life expectancy, and medical costs. Eligibility for increased aspirin use in simulations is based on the 2011-2012 questionnaire on preventive aspirin use of the National Health and Nutrition Examination Survey. These data reveal a large unmet need for daily aspirin, with over 40% of men and 10% of women aged 50 to 79 presenting high cardiovascular risk but not taking aspirin. We estimate that increased use by high-risk older Americans would improve national life expectancy at age 50 by 0.28 years (95% CI 0.08-0.50) and would add 900,000 people (95% CI 300,000-1,400,000) to the American population by 2036. After valuing the quality-adjusted life-years appropriately, Americans could expect $692 billion (95% CI 345-975) in net health benefits over that period. Expanded use of aspirin by older Americans with elevated risk

  18. Can an e-learning course improve nursing care for older people at risk of delirium: a stepped wedge cluster randomised trial.

    van de Steeg, Lotte; IJkema, Roelie; Langelaan, Maaike; Wagner, Cordula

    2014-05-27

    Delirium occurs frequently in older hospitalised patients and is associated with several adverse outcomes. Ignorance among healthcare professionals and a failure to recognise patients suffering from delirium have been identified as the possible causes of poor care. The objective of the study was to determine whether e-learning can be an effective means of improving implementation of a quality improvement project in delirium care. This project aims primarily at improving the early recognition of older patients who are at risk of delirium. In a stepped wedge cluster randomised trial an e-learning course on delirium was introduced, aimed at nursing staff. The trial was conducted on general medical and surgical wards from 18 Dutch hospitals. The primary outcome measure was the delirium risk screening conducted by nursing staff, measured through monthly patient record reviews. Patient records from patients aged 70 and over admitted onto wards participating in the study were used for data collection. Data was also collected on the level of delirium knowledge of these wards' nursing staff. Records from 1,862 older patients were included during the control phase and from 1,411 patients during the intervention phase. The e-learning course on delirium had a significant positive effect on the risk screening of older patients by nursing staff (OR 1.8, p-value e-learning course also showed a significant positive effect on nurses' knowledge of delirium. Nurses who undertook a delirium e-learning course showed a greater adherence to the quality improvement project in delirium care. This improved the recognition of patients at risk and demonstrated that e-learning can be a valuable instrument for hospitals when implementing improvements in delirium care. The Netherlands National Trial Register (NTR). NTR2885.

  19. Can an e-learning course improve nursing care for older people at risk of delirium: a stepped wedge cluster randomised trial

    2014-01-01

    Background Delirium occurs frequently in older hospitalised patients and is associated with several adverse outcomes. Ignorance among healthcare professionals and a failure to recognise patients suffering from delirium have been identified as the possible causes of poor care. The objective of the study was to determine whether e-learning can be an effective means of improving implementation of a quality improvement project in delirium care. This project aims primarily at improving the early recognition of older patients who are at risk of delirium. Methods In a stepped wedge cluster randomised trial an e-learning course on delirium was introduced, aimed at nursing staff. The trial was conducted on general medical and surgical wards from 18 Dutch hospitals. The primary outcome measure was the delirium risk screening conducted by nursing staff, measured through monthly patient record reviews. Patient records from patients aged 70 and over admitted onto wards participating in the study were used for data collection. Data was also collected on the level of delirium knowledge of these wards’ nursing staff. Results Records from 1,862 older patients were included during the control phase and from 1,411 patients during the intervention phase. The e-learning course on delirium had a significant positive effect on the risk screening of older patients by nursing staff (OR 1.8, p-value e-learning course also showed a significant positive effect on nurses’ knowledge of delirium. Conclusions Nurses who undertook a delirium e-learning course showed a greater adherence to the quality improvement project in delirium care. This improved the recognition of patients at risk and demonstrated that e-learning can be a valuable instrument for hospitals when implementing improvements in delirium care. Trial registration The Netherlands National Trial Register (NTR). Trial number: NTR2885. PMID:24884739

  20. The Drive-Wise Project: Driving Simulator Training increases real driving performance in healthy older drivers

    Gianclaudio eCasutt

    2014-05-01

    Full Text Available Background: Age-related cognitive decline is often associated with unsafe driving behavior. We hypothesized that 10 active training sessions in a driving simulator increase cognitive and on-road driving performance. In addition, driving simulator training should outperform cognitive training.Methods: Ninety-one healthy active drivers (62 – 87 years were randomly assigned to either (1 a driving simulator training group, (2 an attention training group (vigilance and selective attention, or (3 a control group. The main outcome variables were on-road driving and cognitive performance. Seventy-seven participants (85% completed the training and were included in the analyses. Training gains were analyzed using a multiple regression analysis with planned comparisons.Results: The driving simulator training group showed an improvement in on-road driving performance compared to the attention training group. In addition, both training groups increased cognitive performance compared to the control group. Conclusion: Driving simulator training offers the potential to enhance driving skills in older drivers. Compared to the attention training, the simulator training seems to be a more powerful program for increasing older drivers’ safety on the road.

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

    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

  2. Is More Better? — Night Vision Enhancement System’s Pedestrian Warning Modes and Older Drivers

    Brown, Timothy; He, Yefei; Roe, Cheryl; Schnell, Thomas

    2010-01-01

    Pedestrian fatalities as a result of vehicle collisions are much more likely to happen at night than during day time. Poor visibility due to darkness is believed to be one of the causes for the higher vehicle collision rate at night. Existing studies have shown that night vision enhancement systems (NVES) may improve recognition distance, but may increase drivers’ workload. The use of automatic warnings (AW) may help minimize workload, improve performance, and increase safety. In this study, we used a driving simulator to examine performance differences of a NVES with six different configurations of warning cues, including: visual, auditory, tactile, auditory and visual, tactile and visual, and no warning. Older drivers between the ages of 65 and 74 participated in the study. An analysis based on the distance to pedestrian threat at the onset of braking response revealed that tactile and auditory warnings performed the best, while visual warnings performed the worst. When tactile or auditory warnings were presented in combination with visual warning, their effectiveness decreased. This result demonstrated that, contrary to general sense regarding warning systems, multi-modal warnings involving visual cues degraded the effectiveness of NVES for older drivers. PMID:21050616

  3. Unique factors that place older Hispanic women at risk for HIV: intimate partner violence, machismo, and marianismo.

    Cianelli, Rosina; Villegas, Natalia; Lawson, Sarah; Ferrer, Lilian; Kaelber, Lorena; Peragallo, Nilda; Yaya, Alexandra

    2013-01-01

    Hispanic women who are 50 years of age and older have been shown to be at increased risk of acquiring HIV infection due to age and culturally related issues. The purpose of our study was to investigate factors that increase HIV risk among older Hispanic women (OHW) as a basis for development or adaptation of an age and culturally tailored intervention designed to prevent HIV-related risk behaviors. We used a qualitative descriptive approach. Five focus groups were conducted in Miami, Florida, with 50 participants. Focus group discussions centered around eight major themes: intimate partner violence (IPV), perimenopausal-postmenopausal-related biological changes, cultural factors that interfere with HIV prevention, emotional and psychological changes, HIV knowledge, HIV risk perception, HIV risk behaviors, and HIV testing. Findings from our study stressed the importance of nurses' roles in educating OHW regarding IPV and HIV prevention. Copyright © 2013 Association of Nurses in AIDS Care. Published by Elsevier Inc. All rights reserved.

  4. Older Drivers' Reasons for Reducing the Overall Amount of Their Driving and for Avoiding Selected Driving Situations

    Meng, Annette; Siren, Anu Kristiina

    2015-01-01

    that the reduction in driving and avoidance of driving situations are separate types of self-regulatory behavior; that self-regulation of driving is an automatic process, in which older drivers are not aware that they are compensating for functional loss; and that it is important to acknowledge gender differences......Structured telephone interviews were conducted with 840 older drivers to explore their reasons for self-regulating their driving. The main reason for reduced driving was having fewer activities to drive to, and for avoidance of driving situations, reasons also included not liking or feeling...

  5. Effects of vertical and side-alternating vibration training on fall risk factors and bone turnover in older people at risk of falls.

    Corrie, Heather; Brooke-Wavell, Katherine; Mansfield, Neil J; Cowley, Alison; Morris, Robert; Masud, Tahir

    2015-01-01

    whole-body vibration training may improve neuromuscular function, falls risk and bone density, but previous studies have had conflicting findings. this study aimed to evaluate the influence of vertical vibration (VV) and side-alternating vibration (SV) on musculoskeletal health in older people at risk of falls. single-blind, randomised, controlled trial comparing vibration training to sham vibration (Sham) in addition to usual care. participants were 61 older people (37 women and 24 men), aged 80.2 + 6.5 years, referred to an outpatient falls prevention service. participants were randomly assigned to VV, SV or Sham in addition to the usual falls prevention programme. Participants were requested to attend three vibration sessions per week for 12 weeks, with sessions increasing to six, 1 min bouts of vibration. Falls risk factors and neuromuscular tests were assessed, and blood samples collected for determination of bone turnover, at baseline and following the intervention. chair stand time, timed-up-and-go time, fear of falling, NEADL index and postural sway with eyes open improved in the Sham group. There were significantly greater gains in leg power in the VV than in the Sham group and in bone formation in SV and VV compared with the Sham group. Conversely, body sway improved less in the VV than in the Sham group. Changes in falls risk factors did not differ between the groups. whole-body vibration increased leg power and bone formation, but it did not provide any additional benefits to balance or fall risk factors beyond a falls prevention programme in older people at risk of falls. © The Author 2014. Published by Oxford University Press on behalf of the British Geriatrics Society. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  6. Dynamic balance and stepping versus tai chi training to improve balance and stepping in at-risk older adults.

    Nnodim, Joseph O; Strasburg, Debra; Nabozny, Martina; Nyquist, Linda; Galecki, Andrzej; Chen, Shu; Alexander, Neil B

    2006-12-01

    To compare the effect of two 10-week balance training programs, Combined Balance and Step Training (CBST) versus tai chi (TC), on balance and stepping measures. Prospective intervention trial. Local senior centers and congregate housing facilities. Aged 65 and older with at least mild impairment in the ability to perform unipedal stance and tandem walk. Participants were allocated to TC (n = 107, mean age 78) or CBST, an intervention focused on improving dynamic balance and stepping (n = 106, mean age 78). At baseline and 10 weeks, participants were tested in their static balance (Unipedal Stance and Tandem Stance (TS)), stepping (Maximum Step Length, Rapid Step Test), and Timed Up and Go (TUG). Performance improved more with CBST than TC, ranging from 5% to 10% for the stepping tests (Maximum Step Length and Rapid Step Test) and 9% for TUG. The improvement in TUG represented an improvement of more than 1 second. Greater improvements were also seen in static balance ability (in TS) with CBST than TC. Of the two training programs, in which variants of each program have been proven to reduce falls, CBST results in modest improvements in balance, stepping, and functional mobility versus TC over a 10-week period. Future research should include a prospective comparison of fall rates in response to these two balance training programs.

  7. Screening for Older Emergency Department Inpatients at Risk of Prolonged Hospital Stay: The Brief Geriatric Assessment Tool

    Launay, Cyrille P.; de Decker, Laure; Kabeshova, Anastasiia; Annweiler, Cédric; Beauchet, Olivier

    2014-01-01

    Background The aims of this study were 1) to confirm that combinations of brief geriatric assessment (BGA) items were significant risk factors for prolonged LHS among geriatric patients hospitalized in acute care medical units after their admission to the emergency department (ED); and 2) to determine whether these combinations of BGA items could be used as a prognostic tool of prolonged LHS. Methods Based on a prospective observational cohort design, 1254 inpatients (mean age ± standard deviation, 84.9±5.9 years; 59.3% female) recruited upon their admission to ED and discharged in acute care medical units of Angers University Hospital, France, were selected in this study. At baseline assessment, a BGA was performed and included the following 6 items: age ≥85years, male gender, polypharmacy (i.e., ≥5 drugs per day), use of home-help services, history of falls in previous 6 months and temporal disorientation (i.e., inability to give the month and/or year). The LHS in acute care medical units was prospectively calculated in number of days using the hospital registry. Results Area under receiver operating characteristic (ROC) curves of prolonged LHS of different combinations of BGA items ranged from 0.50 to 0.57. Cox regression models revealed that combinations defining a high risk of prolonged LHS, identified from ROC curves, were significant risk factors for prolonged LHS (hazard ratio >1.16 with P>0.010). Kaplan-Meier distributions of discharge showed that inpatients classified in high-risk group of prolonged LHS were discharged later than those in low-risk group (Prisk factors for prolonged LHS but their prognostic value was poor in the studied sample of older inpatients. PMID:25333271

  8. Screening for older emergency department inpatients at risk of prolonged hospital stay: the brief geriatric assessment tool.

    Launay, Cyrille P; de Decker, Laure; Kabeshova, Anastasiia; Annweiler, Cédric; Beauchet, Olivier

    2014-01-01

    The aims of this study were 1) to confirm that combinations of brief geriatric assessment (BGA) items were significant risk factors for prolonged LHS among geriatric patients hospitalized in acute care medical units after their admission to the emergency department (ED); and 2) to determine whether these combinations of BGA items could be used as a prognostic tool of prolonged LHS. Based on a prospective observational cohort design, 1254 inpatients (mean age ± standard deviation, 84.9±5.9 years; 59.3% female) recruited upon their admission to ED and discharged in acute care medical units of Angers University Hospital, France, were selected in this study. At baseline assessment, a BGA was performed and included the following 6 items: age ≥85years, male gender, polypharmacy (i.e., ≥5 drugs per day), use of home-help services, history of falls in previous 6 months and temporal disorientation (i.e., inability to give the month and/or year). The LHS in acute care medical units was prospectively calculated in number of days using the hospital registry. Area under receiver operating characteristic (ROC) curves of prolonged LHS of different combinations of BGA items ranged from 0.50 to 0.57. Cox regression models revealed that combinations defining a high risk of prolonged LHS, identified from ROC curves, were significant risk factors for prolonged LHS (hazard ratio >1.16 with P>0.010). Kaplan-Meier distributions of discharge showed that inpatients classified in high-risk group of prolonged LHS were discharged later than those in low-risk group (PLHS of all combinations was poor with sensitivity under 77%, a high variation of specificity (from 26.6 to 97.4) and a low likelihood ratio of positive test under 5.6. Combinations of 6-item BGA tool were significant risk factors for prolonged LHS but their prognostic value was poor in the studied sample of older inpatients.

  9. First and second eye cataract surgery and driver self-regulation among older drivers with bilateral cataract: a prospective cohort study.

    Agramunt, Seraina; Meuleners, Lynn B; Fraser, Michelle L; Chow, Kyle C; Ng, Jonathon Q; Raja, Vignesh

    2018-02-17

    Driving a car is the most common form of transport among the older population. Common medical conditions such as cataract, increase with age and impact on the ability to drive. To compensate for visual decline, some cataract patients may self-regulate their driving while waiting for cataract surgery. However, little is known about the self-regulation practices of older drivers throughout the cataract surgery process. The aim of this study is to assess the impact of first and second eye cataract surgery on driver self-regulation practices, and to determine which objective measures of vision are associated with driver self-regulation. Fifty-five older drivers with bilateral cataract aged 55+ years were assessed using the self-reported Driving Habits Questionnaire, the Mini-Mental State Examination and three objective visual measures in the month before cataract surgery, at least one to three months after first eye cataract surgery and at least one month after second eye cataract surgery. Participants' natural driving behaviour in four driving situations was also examined for one week using an in-vehicle monitoring device. Two separate Generalised Estimating Equation logistic models were undertaken to assess the impact of first and second eye cataract surgery on driver-self-regulation status and which changes in visual measures were associated with driver self-regulation status. The odds of being a self-regulator in at least one driving situation significantly decreased by 70% after first eye cataract surgery (OR: 0.3, 95% CI: 0.1-0.7) and by 90% after second eye surgery (OR: 0.1, 95% CI: 0.1-0.4), compared to before first eye surgery. Improvement in contrast sensitivity after cataract surgery was significantly associated with decreased odds of self-regulation (OR: 0.02, 95% CI: 0.01-0.4). The findings provide a strong rationale for providing timely first and second eye cataract surgery for older drivers with bilateral cataract, in order to improve their mobility and

  10. Screening for older emergency department inpatients at risk of prolonged hospital stay: the brief geriatric assessment tool.

    Cyrille P Launay

    Full Text Available The aims of this study were 1 to confirm that combinations of brief geriatric assessment (BGA items were significant risk factors for prolonged LHS among geriatric patients hospitalized in acute care medical units after their admission to the emergency department (ED; and 2 to determine whether these combinations of BGA items could be used as a prognostic tool of prolonged LHS.Based on a prospective observational cohort design, 1254 inpatients (mean age ± standard deviation, 84.9±5.9 years; 59.3% female recruited upon their admission to ED and discharged in acute care medical units of Angers University Hospital, France, were selected in this study. At baseline assessment, a BGA was performed and included the following 6 items: age ≥85years, male gender, polypharmacy (i.e., ≥5 drugs per day, use of home-help services, history of falls in previous 6 months and temporal disorientation (i.e., inability to give the month and/or year. The LHS in acute care medical units was prospectively calculated in number of days using the hospital registry.Area under receiver operating characteristic (ROC curves of prolonged LHS of different combinations of BGA items ranged from 0.50 to 0.57. Cox regression models revealed that combinations defining a high risk of prolonged LHS, identified from ROC curves, were significant risk factors for prolonged LHS (hazard ratio >1.16 with P>0.010. Kaplan-Meier distributions of discharge showed that inpatients classified in high-risk group of prolonged LHS were discharged later than those in low-risk group (P<0.003. Prognostic value for prolonged LHS of all combinations was poor with sensitivity under 77%, a high variation of specificity (from 26.6 to 97.4 and a low likelihood ratio of positive test under 5.6.Combinations of 6-item BGA tool were significant risk factors for prolonged LHS but their prognostic value was poor in the studied sample of older inpatients.

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

    Sherrilene Classen

    2008-01-01

    Full Text Available Sherrilene Classen1,2, Ellen DS Lopez3, Sandra Winter2, Kezia D Awadzi4, Nita Ferree5, Cynthia W Garvan61Department of Occupational Therapy, College of Public Health and Health Professions (CPHHP, University of Florida (UF, Gainesville, FL, USA; 2PhD Program in Rehabilitation Science, CPHHP, UF Gainesville, FL, USA; 3Department of Behavioral Science and Community Health, CPHHP, UF, Gainesville, FL, USA; 4Department of Health Services Research, Management, and Policy, CPHHP, UF, Gainesville, FL, USA; 5Health Science Center Libraries, UF, Gainesville, FL, USA; 6Division of Biostatistics, College of Medicine, UF, Gainesville, FL, USAAbstract: 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

  12. Measuring situational avoidance in older drivers: An application of Rasch analysis.

    Davis, Jessica; Conlon, Elizabeth; Ownsworth, Tamara; Morrissey, Shirley

    2016-02-01

    Situational avoidance is a form of driving self-regulation at the strategic level of driving behaviour. It has typically been defined as the purposeful avoidance of driving situations perceived as challenging or potentially hazardous. To date, assessment of the psychometric properties of existing scales that measure situational avoidance has been sparse. This study examined the contribution of Rasch analysis to the situational avoidance construct. Three hundred and ninety-nine Australian drivers (M=66.75, SD=10.14, range: 48-91 years) completed the Situational Avoidance Questionnaire (SAQ). Following removal of the item Parallel Parking, the scale conformed to a Rasch model, showing good person separation, sufficient reliability, little disordering of thresholds, and no evidence of differential item functioning by age or gender. The residuals were independent supporting the assumption of unidimensionality and in conforming to a Rasch model, SAQ items were found to be hierarchical or cumulative. Increased avoidance was associated with factors known to be related to driving self-regulation more broadly, including older age, female gender, reduced driving space and frequency, reporting a change in driving in the past five years and poorer indices of health (i.e., self-rated mood, vision and cognitive function). Overall, these results support the use of the SAQ as a psychometrically sound measure of situational avoidance. Application of Rasch analysis to this area of research advances understanding of the driving self-regulation construct and its practice by drivers in baby boomer and older adult generations. Copyright © 2015 Elsevier Ltd. All rights reserved.

  13. Letting in-vehicle navigation lead the way: Older drivers' perceptions of and ability to follow a GPS navigation system.

    Stinchcombe, Arne; Gagnon, Sylvain; Kateb, Matthew; Curtis, Meredith; Porter, Michelle M; Polgar, Jan; Bédard, Michel

    2017-09-01

    In-vehicle navigation systems have the potential to simplify the driving task by reducing the drivers' need to engage in wayfinding, especially in unfamiliar environments. This study sought to characterize older drivers' overall assessment of using in-vehicle GPS technology as part of a research study and to explore whether the use of this technology has an impact on participants' driving behaviour. Forty-seven older drivers completed an on-road evaluation where directions were provided by an in-vehicle GPS navigation system and their behaviour was recorded using video technology. They later completed a questionnaire to assess their perception of the navigation system. After the study, participants were grouped based on whether they were able to accurately follow the instructions provided by the navigation system. The results indicated that most drivers were satisfied with the navigation technology and found the directions it provided to be clear. There were no statistically significant differences in the number of on-road errors committed by drivers who did not follow the directions from the navigation system in comparison to drivers who did follow the directions. Copyright © 2016 Elsevier Ltd. All rights reserved.

  14. DIVIDED ATTENTION IN EXPERIENCED YOUNG AND OLDER DRIVERS - LANE TRACKING AND VISUAL ANALYSIS IN A DYNAMIC DRIVING SIMULATOR

    BROUWER, WH; WATERINK, W; VANWOLFFELAAR, PC; ROTHENGATTER, T

    1991-01-01

    A simulated driving task that required the simultaneous execution of two continuous visual tasks was administered to 12 healthy young (mean age 26.1 years) and 12 healthy older (mean age 64.4 years) experienced and currently active drivers. The first task was a compensatory lane-tracking task

  15. Examining physiological responses across different driving maneuvers during an on-road driving task: a pilot study comparing older and younger drivers.

    Koppel, S; Kuo, J; Berecki-Gisolf, J; Boag, R; Hue, Y-X; Charlton, J L

    2015-01-01

    This pilot study aimed to investigate physiological responses during an on-road driving task for older and younger drivers. Five older drivers (mean age = 74.60 years [2.97]) and 5 younger drivers (mean age = 30.00 years [3.08]) completed a series of cognitive assessments (Montreal Cognitive Assessment [MoCA], Mini Mental Status Examination [MMSE]; Trail Making Test [Trails A and Trails B]) and an on-road driving task along a predetermined, standardized urban route in their own vehicle. Driving performance was observed and scored by a single trained observer using a standardized procedure, where driving behaviors (appropriate and inappropriate) were scored for intersection negotiation, lane changing, and merging. During the on-road driving task, participants' heart rate (HR) was monitored with an unobtrusive physiological monitor. Younger drivers performed significantly better on all cognitive assessments compared to older drivers (MoCA: t(8) = 3.882, P task revealed a high level of appropriate overall driving behavior (M = 87%, SD = 7.62, range = 73-95%), including intersection negotiation (M = 89%, SD = 8.37%), lane changing (M = 100%), and merging (M = 53%, SD = 28.28%). The overall proportion of appropriate driving behavior did not significantly differ across age groups (younger drivers: M = 87.6%, SD = 9.04; older drivers: M = 87.0%, SD = 6.96; t(8) = 0.118, P =.91). Although older drivers scored lower than younger drivers on the cognitive assessments, there was no indication of cognitive overload among older drivers based on HR response to the on-road driving task. The results provide preliminary evidence that mild age-related cognitive impairment may not pose a motor vehicle crash hazard for the wider older driver population. To maintain safe mobility of the aging population, further research into the specific crash risk factors in the older driver population is warranted.

  16. Functional MRI Assessment of Task-Induced Deactivation of the Default Mode Network in Alzheimer’s Disease and At-Risk Older Individuals

    Maija Pihlajamäki

    2009-01-01

    Full Text Available Alzheimer’s disease (AD is the most common form of dementia in old age, and is characterized by prominent impairment of episodic memory. Recent functional imaging studies in AD have demonstrated alterations in a distributed network of brain regions supporting memory function, including regions of the default mode network. Previous positron emission tomography studies of older individuals at risk for AD have revealed hypometabolism of association cortical regions similar to the metabolic abnormalities seen in AD patients. In recent functional magnetic resonance imaging (fMRI studies of AD, corresponding brain default mode regions have also been found to demonstrate an abnormal fMRI task-induced deactivation response pattern. That is, the relative decreases in fMRI signal normally observed in the default mode regions in healthy subjects performing a cognitive task are not seen in AD patients, or may even be reversed to a paradoxical activation response. Our recent studies have revealed alterations in the pattern of deactivation also in elderly individuals at risk for AD by virtue of their APOE e4 genotype, or evidence of mild cognitive impairment (MCI. In agreement with recent reports from other groups, these studies demonstrate that the pattern of fMRI task-induced deactivation is progressively disrupted along the continuum from normal aging to MCI and to clinical AD and more impaired in e4 carriers compared to non-carriers. These findings will be discussed in the context of current literature regarding functional imaging of the default network in AD and at-risk populations.

  17. Sensorimotor and postural control factors associated with driving safety in a community-dwelling older driver population.

    Lacherez, Philippe; Wood, Joanne M; Anstey, Kaarin J; Lord, Stephen R

    2014-02-01

    To establish whether sensorimotor function and balance are associated with on-road driving performance in older adults. The performance of 270 community-living adults aged 70-88 years recruited via the electoral roll was measured on a battery of peripheral sensation, strength, flexibility, reaction time, and balance tests and on a standardized measure of on-road driving performance. Forty-seven participants (17.4%) were classified as unsafe based on their driving assessment. Unsafe driving was associated with reduced peripheral sensation, lower limb weakness, reduced neck range of motion, slow reaction time, and poor balance in univariate analyses. Multivariate logistic regression analysis identified poor vibration sensitivity, reduced quadriceps strength, and increased sway on a foam surface with eyes closed as significant and independent risk factors for unsafe driving. These variables classified participants into safe and unsafe drivers with a sensitivity of 74% and specificity of 70%. A number of sensorimotor and balance measures were associated with driver safety and the multivariate model comprising measures of sensation, strength, and balance was highly predictive of unsafe driving in this sample. These findings highlight important determinants of driver safety and may assist in developing efficacious driver safety strategies for older drivers.

  18. Auditory Memory Decay as Reflected by a New Mismatch Negativity Score Is Associated with Episodic Memory in Older Adults at Risk of Dementia

    Daria Laptinskaya

    2018-02-01

    Full Text Available The auditory mismatch negativity (MMN is an event-related potential (ERP peaking about 100–250 ms after the onset of a deviant tone in a sequence of identical (standard tones. Depending on the interstimulus interval (ISI between standard and deviant tones, the MMN is suitable to investigate the pre-attentive auditory discrimination ability (short ISIs, ≤ 2 s as well as the pre-attentive auditory memory trace (long ISIs, >2 s. However, current results regarding the MMN as an index for mild cognitive impairment (MCI and dementia are mixed, especially after short ISIs: while the majority of studies report positive associations between the MMN and cognition, others fail to find such relationships. To elucidate these so far inconsistent results, we investigated the validity of the MMN as an index for cognitive impairment exploring the associations between different MMN indices and cognitive performance, more specifically with episodic memory performance which is among the most affected cognitive domains in the course of Alzheimer’s dementia (AD, at baseline and at a 5-year-follow-up. We assessed the amplitude of the MMN for short ISI (stimulus onset asynchrony, SOA = 0.05 s and for long ISI (3 s in a neuropsychologically well-characterized cohort of older adults at risk of dementia (subjective memory impairment, amnestic and non-amnestic MCI; n = 57. Furthermore, we created a novel difference score (ΔMMN, defined as the difference between MMNs to short and to long ISI, as a measure to assess the decay of the auditory memory trace, higher values indicating less decay. ΔMMN and MMN amplitude after long ISI, but not the MMN amplitude after short ISI, was associated with episodic memory at baseline (β = 0.38, p = 0.003; β = −0.27, p = 0.047, respectively. ΔMMN, but not the MMN for long ISIs, was positively associated with episodic memory performance at the 5-year-follow-up (β = 0.57, p = 0.013. The results suggest that the MMN after long

  19. No Evidence That Short-Term Cognitive or Physical Training Programs or Lifestyles Are Related to Changes in White Matter Integrity in Older Adults at Risk of Dementia.

    Fissler, Patrick; Müller, Hans-Peter; Küster, Olivia C; Laptinskaya, Daria; Thurm, Franka; Woll, Alexander; Elbert, Thomas; Kassubek, Jan; von Arnim, Christine A F; Kolassa, Iris-Tatjana

    2017-01-01

    Cognitive and physical activities can benefit cognition. However, knowledge about the neurobiological mechanisms underlying these activity-induced cognitive benefits is still limited, especially with regard to the role of white matter integrity (WMI), which is affected in cognitive aging and Alzheimer's disease. To address this knowledge gap, we investigated the immediate and long-term effects of cognitive or physical training on WMI, as well as the association between cognitive and physical lifestyles and changes in WMI over a 6-month period. Additionally, we explored whether changes in WMI underlie activity-related cognitive changes, and estimated the potential of both trainings to improve WMI by correlating training outcomes with WMI. In an observational and interventional pretest, posttest, 3-month follow-up design, we assigned 47 community-dwelling older adults at risk of dementia to 50 sessions of auditory processing and working memory training ( n = 13), 50 sessions of cardiovascular, strength, coordination, balance and flexibility exercises ( n = 14), or a control group ( n = 20). We measured lifestyles trough self-reports, cognitive training skills through training performance, functional physical fitness through the Senior Fitness Test, and global cognition through a cognitive test battery. WMI was assessed via a composite score of diffusion tensor imaging-based fractional anisotropy (FA) of three regions of interest shown to be affected in aging and Alzheimer's disease: the genu of corpus callosum, the fornix, and the hippocampal cingulum. Effects for training interventions on FA outcomes, as well as associations between lifestyles and changes in FA outcomes were not significant. Additional analyses did show associations between cognitive lifestyle and global cognitive changes at the posttest and the 3-month follow-up (β ≥ 0.40, p ≤ 0.02) and accounting for changes in WMI did not affect these relationships. The targeted training outcomes were

  20. Auditory Memory Decay as Reflected by a New Mismatch Negativity Score Is Associated with Episodic Memory in Older Adults at Risk of Dementia.

    Laptinskaya, Daria; Thurm, Franka; Küster, Olivia C; Fissler, Patrick; Schlee, Winfried; Kolassa, Stephan; von Arnim, Christine A F; Kolassa, Iris-Tatjana

    2018-01-01

    The auditory mismatch negativity (MMN) is an event-related potential (ERP) peaking about 100-250 ms after the onset of a deviant tone in a sequence of identical (standard) tones. Depending on the interstimulus interval (ISI) between standard and deviant tones, the MMN is suitable to investigate the pre-attentive auditory discrimination ability (short ISIs, ≤ 2 s) as well as the pre-attentive auditory memory trace (long ISIs, >2 s). However, current results regarding the MMN as an index for mild cognitive impairment (MCI) and dementia are mixed, especially after short ISIs: while the majority of studies report positive associations between the MMN and cognition, others fail to find such relationships. To elucidate these so far inconsistent results, we investigated the validity of the MMN as an index for cognitive impairment exploring the associations between different MMN indices and cognitive performance, more specifically with episodic memory performance which is among the most affected cognitive domains in the course of Alzheimer's dementia (AD), at baseline and at a 5-year-follow-up. We assessed the amplitude of the MMN for short ISI (stimulus onset asynchrony, SOA = 0.05 s) and for long ISI (3 s) in a neuropsychologically well-characterized cohort of older adults at risk of dementia (subjective memory impairment, amnestic and non-amnestic MCI; n = 57). Furthermore, we created a novel difference score (ΔMMN), defined as the difference between MMNs to short and to long ISI, as a measure to assess the decay of the auditory memory trace, higher values indicating less decay. ΔMMN and MMN amplitude after long ISI, but not the MMN amplitude after short ISI, was associated with episodic memory at baseline ( β = 0.38, p = 0.003; β = -0.27, p = 0.047, respectively). ΔMMN, but not the MMN for long ISIs, was positively associated with episodic memory performance at the 5-year-follow-up ( β = 0.57, p = 0.013). The results suggest that the MMN after long ISI might be

  1. Exercise electrocardiogram in middle-aged and older leisure time sportsmen: 100 exercise tests would be enough to identify one silent myocardial ischemia at risk for cardiac event.

    Hupin, David; Edouard, Pascal; Oriol, Mathieu; Laukkanen, Jari; Abraham, Pierre; Doutreleau, Stéphane; Guy, Jean-Michel; Carré, François; Barthélémy, Jean-Claude; Roche, Frédéric; Chatard, Jean-Claude

    2018-04-15

    The importance of exercise electrocardiogram (ECG) has been controversial in the prevention of cardiac events among sportsmen. The aim of this study was to determine the frequency of silent myocardial ischemia (SMI) from an exercise ECG and its relationship with induced coronary angiographic assessment and potentially preventable cardiac events. This prospective cohort study included leisure time asymptomatic sportsmen over 35years old, referred from 2011 to 2014 in the Sports Medicine Unit of the University Hospital of Saint-Etienne. Of the cohort of 1500 sportsmen (1205 men; mean age 50.7±9.4years; physical activity level 32.8±26.8MET-h/week), 951 (63%) had at least one cardiovascular disease (CVD) risk factor. Family history, medical examination and standard resting 12-lead were collected. A total of 163 exercise ECGs (10.9%) were defined as positive, most of them due to SMI (n=129, 8.6%). SMI was an indication for coronary angiography in 23 cases, leading to 17 documented SMIs (1.1%), including 11 significant stenoses requiring revascularization. In multivariate logistic regression analysis, a high risk of CVD (OR=2.65 [CI 95%: 1.33-5.27], p=0.005) and an age >50years (OR=2.71 [CI 95%: 1.65-4.44], p<0.0001) were independently associated with confirmed SMI. The association of positive exercise ECG with significant coronary stenosis was stronger among sportsmen with CVD risk factors and older than 50years. Screening by exercise ECG can lower the risk of cardiac events in middle-aged and older sportsmen. One hundred tests would be enough to detect one silent myocardial ischemia at risk for cardiac event. Copyright © 2017 Elsevier B.V. All rights reserved.

  2. Do older drivers with bilateral cataract self-regulate their driving while waiting for first eye cataract surgery?

    Agramunt S

    2017-11-01

    Full Text Available Seraina Agramunt,1 Lynn B Meuleners,1 Michelle L Fraser,1 Kyle C Chow,1 Jonathon Q Ng,2,3 Vignesh Raja,4 Nigel Morlet2,3 1Curtin-Monash Accident Research Centre (C-MARC, Curtin University, Faculty of Health Sciences, Perth, Australia; 2Eye & Vision Epidemiology Research (EVER Group, Perth, Australia; 3School of Population and Global Health, The University of Western Australia, Perth, Australia; 4Sir Charles Gairdner Hospital, Perth, Australia Objectives: To analyze the association between visual impairment and driver self-regulation among a cohort of older drivers waiting for first eye cataract surgery.Methods: Ninety-six drivers with bilateral cataract aged 55+ years were assessed before first eye cataract surgery. Data collection consisted of a researcher-administered questionnaire, objective visual measures (visual acuity, contrast sensitivity and stereopsis, a visual attention test (the useful field of view test and a cognitive test (the Mini-Mental State Examination. Driver self-regulation practices were collected using the Driving Habits Questionnaire and were also measured with an in-vehicle monitoring device. Characteristics of self-regulators and non-self-regulators were compared and a logistic regression model was used to examine the association between 3 objective visual measures and driver self-regulation status.Results: After controlling for potential confounding factors, only binocular contrast sensitivity (p=0.01, age (p=0.03 and gender (p=0.03 were significantly associated with driver self-regulation status. The odds of participants with better contrast sensitivity scores (better vision self-regulating their driving in at least 1 driving situation decreased (odds ratio [OR]: 0.01, 95% CI: 0.00–0.28 while those of increasing age reported an increased odds of self-regulating their driving (OR: 1.08, 95% CI: 1.01–1.15. The odds of males self-regulating their driving was decreased compared with females (OR: 0.28, 95% CI: 0.09

  3. Health literacy of older drivers and the importance of health experience for self-regulation of driving behaviour.

    Sargent-Cox, K A; Windsor, T; Walker, J; Anstey, K J

    2011-05-01

    This study provides much needed information on the education level of older drivers regarding the impact of health conditions and medications on personal driving safety, where they source this information, and how this knowledge influences self-regulation of driving. Random and convenience sampling secured 322 Australian drivers (63.9% males) aged 65 years and over (M = 77.35 years, SD = 7.35) who completed a telephone interview. The majority of respondents (86%) had good knowledge about health conditions (health knowledge) and driving safety, however more than 50% was classified as having poor knowledge on the effects of certain medications (medication knowledge) and driving safety. Poorer health knowledge was associated with a reduced likelihood of driving over 100 km in adjusted models. Being older and having more than one medical condition was found to increase the likelihood of self-regulation of driving. Results indicate that health knowledge was less important for predicting driving behaviour than health experience. Of great interest was that up to 85.7% of respondents reported not receiving advice about the potential impact of their medical condition and driving from their doctor. The findings indicate a need for improved dissemination of evidence-based health information and education for older drivers and their doctors. Copyright © 2010 Elsevier Ltd. All rights reserved.

  4. The impact of red light running camera flashes on younger and older drivers' attention and oculomotor control.

    Wright, Timothy J; Vitale, Thomas; Boot, Walter R; Charness, Neil

    2015-12-01

    Recent empirical evidence has suggested that the flashes associated with red light running cameras (RLRCs) distract younger drivers, pulling attention away from the roadway and delaying processing of safety-relevant events. Considering the perceptual and attentional declines that occur with age, older drivers may be especially susceptible to the distracting effects of RLRC flashes, particularly in situations in which the flash is more salient (a bright flash at night compared with the day). The current study examined how age and situational factors potentially influence attention capture by RLRC flashes using covert (cuing effects) and overt (eye movement) indices of capture. We manipulated the salience of the flash by varying its luminance and contrast with respect to the background of the driving scene (either day or night scenes). Results of 2 experiments suggest that simulated RLRC flashes capture observers' attention, but, surprisingly, no age differences in capture were observed. However, an analysis examining early and late eye movements revealed that older adults may have been strategically delaying their eye movements in order to avoid capture. Additionally, older adults took longer to disengage attention following capture, suggesting at least 1 age-related disadvantage in capture situations. Findings have theoretical implications for understanding age differences in attention capture, especially with respect to capture in real-world scenes, and inform future work that should examine how the distracting effects of RLRC flashes influence driver behavior. (c) 2015 APA, all rights reserved).

  5. How do older adult drivers self-regulate? Characteristics of self-regulation classes defined by latent class analysis.

    Bergen, Gwen; West, Bethany A; Luo, Feijun; Bird, Donna C; Freund, Katherine; Fortinsky, Richard H; Staplin, Loren

    2017-06-01

    Motor-vehicle crashes were the second leading cause of injury death for adults aged 65-84years in 2014. Some older drivers choose to self-regulate their driving to maintain mobility while reducing driving risk, yet the process remains poorly understood. Data from 729 older adults (aged ≥60years) who joined an older adult ride service program between April 1, 2010 and November 8, 2013 were analyzed to define and describe classes of driving self-regulation. Latent class analysis was employed to characterize older adult driving self-regulation classes using driving frequency and avoidance of seven driving situations. Logistic regression was used to explore associations between characteristics affecting mobility and self-regulation class. Three classes were identified (low, medium, and high self-regulation). High self-regulating participants reported the highest proportion of always avoiding seven risky driving situations and the lowest driving frequency followed by medium and low self-regulators. Those who were female, aged 80years or older, visually impaired, assistive device users, and those with special health needs were more likely to be high self-regulating compared with low self-regulating. Avoidance of certain driving situations and weekly driving frequency are valid indicators for describing driving self-regulation classes in older adults. Understanding the unique characteristics and mobility limitations of each class can guide optimal transportation strategies for older adults. Published by Elsevier Ltd.

  6. Glycaemic response after intake of a high energy, high protein, diabetes-specific formula in older malnourished or at risk of malnutrition type 2 diabetes patients.

    Laksir, Hamid; Lansink, Mirian; Regueme, Sophie C; de Vogel-van den Bosch, Johan; Pfeiffer, Andreas F H; Bourdel-Marchasson, Isabelle

    2017-10-06

    Several studies with diabetes-specific formulas (DSFs) for hyperglycaemic patients in need of nutritional support have been conducted in non-malnourished patients, mainly comparing products with varying macronutrient compositions. Here, the effect of a high energy, high protein DSF on postprandial responses was compared to a product with a similar macronutrient composition in malnourished or at risk of malnutrition patients with type 2 diabetes. In this randomised, double-blind cross-over study, 20 patients were included. After overnight fasting, patients consumed 200 mL of a DSF or standard supplement (control) (19.6 g protein, 31.2 g carbohydrates and 10.6 g fat), while continuing their anti-diabetic medication. The formulas differed in type of carbohydrates and presence of fibre. The postprandial glucose, insulin and glucagon responses were monitored over 4 h. Data were analysed with a Linear Mixed Model, and results of the modified ITT population (n = 19) are shown. Postprandial glucose response as incremental area under the curve (iAUC), was lower after consumption of DSF compared with control (489.7 ± 268.5 (mean ± SD) vs 581.3 ± 273.9 mmol/L min, respectively; p = 0.008). Also, the incremental maximum concentration of glucose (iCmax) was lower for DSF vs control (3.5 ± 1.4 vs 4.0 ± 1.4 mmol/L; p = 0.007). Postprandial insulin and glucagon levels, expressed as iAUC or iCmax, were not significantly different between groups. Consumption of a high energy, high protein DSF by older malnourished or at risk of malnutrition type 2 diabetes patients resulted in a significantly lower glucose response compared to control. These data suggest that the use of a DSF is preferred for patients with diabetes in need of nutritional support. Copyright © 2017 The Authors. Published by Elsevier Ltd.. All rights reserved.

  7. Specifying the content of home-based health behaviour change interventions for older people with frailty or at risk of frailty: an exploratory systematic review.

    Gardner, Benjamin; Jovicic, Ana; Belk, Celia; Kharicha, Kalpa; Iliffe, Steve; Manthorpe, Jill; Goodman, Claire; Drennan, Vari M; Walters, Kate

    2017-02-09

    To identify trials of home-based health behaviour change interventions for frail older people, describe intervention content and explore its potential contribution to intervention effects. 15 bibliographic databases, and reference lists and citations of key papers, were searched for randomised controlled trials of home-based behavioural interventions reporting behavioural or health outcomes. Participants' homes. Community-dwelling adults aged ≥65 years with frailty or at risk of frailty. Trials were coded for effects on thematically clustered behavioural, health and well-being outcomes. Intervention content was described using 96 behaviour change techniques, and 9 functions (eg, education, environmental restructuring). 19 eligible trials reported 22 interventions. Physical functioning was most commonly assessed (19 interventions). Behavioural outcomes were assessed for only 4 interventions. Effectiveness on most outcomes was limited, with at most 50% of interventions showing potential positive effects on behaviour, and 42% on physical functioning. 3 techniques (instruction on how to perform behaviour, adding objects to environment, restructuring physical environment) and 2 functions (education and enablement) were more commonly found in interventions showing potential than those showing no potential to improve physical function. Intervention content was not linked to effectiveness on other outcomes. Interventions appeared to have greatest impact on physical function where they included behavioural instructions, environmental modification and practical social support. Yet, mechanisms of effects are unclear, because impact on behavioural outcomes has rarely been considered. Moreover, the robustness of our findings is also unclear, because interventions have been poorly reported. Greater engagement with behavioural science is needed when developing and evaluating home-based health interventions. ID=CRD42014010370. Published by the BMJ Publishing Group Limited. For

  8. Reliability and feasibility of gait initiation centre-of-pressure excursions using a Wii® Balance Board in older adults at risk of falling.

    Lee, James; Webb, Graham; Shortland, Adam P; Edwards, Rebecca; Wilce, Charlotte; Jones, Gareth D

    2018-04-17

    Impairments in dynamic balance have a detrimental effect in older adults at risk of falls (OARF). Gait initiation (GI) is a challenging transitional movement. Centre of pressure (COP) excursions using force plates have been used to measure GI performance. The Nintendo Wii Balance Board (WBB) offers an alternative to a standard force plate for the measurement of CoP excursion. To determine the reliability of COP excursions using the WBB, and its feasibility within a 4-week strength and balance intervention (SBI) treating OARF. Ten OARF subjects attending SBI and ten young healthy adults, each performed three GI trials after 10 s of quiet stance from a standardised foot position (shoulder width) before walking forward 3 m to pick up an object. Averaged COP mediolateral (ML) and anteroposterior (AP) excursions (distance) and path-length time (GI-onset to first toe-off) were analysed. WBB ML (0.866) and AP COP excursion (0.895) reliability (ICC 3,1 ) was excellent, and COP path-length reliability was fair (0.517). Compared to OARF, healthy subjects presented with larger COP excursion in both directions and shorter COP path length. OARF subjects meaningfully improved their timed-up-and-go and ML COP excursion between weeks 1-4, while AP COP excursions, path length, and confidence-in-balance remained stable. COP path length and excursion directions probably measure different GI postural control attributes. Limitations in WBB accuracy and precision in transition tasks needs to be established before it can be used clinically to measure postural aspects of GI viably. The WBB could provide valuable clinical evaluation of balance function in OARF.

  9. Assessing older drivers: a primary care protocol to evaluate driving safety risk.

    Murden, Robert A; Unroe, Kathleen

    2005-08-01

    Most articles on elder drivers offer either general advice, or review testing protocols that divide drivers into two distinct groups: safe or unsafe. We believe it is unreasonable to expect any testing to fully separate drivers into just these two mutually exclusive groups, so we offer a protocol for a more practical approach. This protocol can be applied by primary care physicians. We review the justification for the many steps of this protocol, which have branches that lead to identifying drivers as low risk, high risk (for accidents) or needing further evaluation. Options for further evaluation are provided.

  10. The Alabama VIP older driver study rationale and design: examining the relationship between vision impairment and driving using naturalistic driving techniques.

    Owsley, Cynthia; McGwin, Gerald; Antin, Jonathan F; Wood, Joanne M; Elgin, Jennifer

    2018-02-07

    Older drivers aged ≥70 years old have among the highest rates of motor vehicle collisions (MVC) compared to other age groups. Driving is a highly visual task, and older adults have a high prevalence of vision impairment compared to other ages. Most studies addressing visual risk factors for MVCs by older drivers utilize vehicle accident reports as the primary outcome, an approach with several methodological limitations. Naturalistic driving research methods overcome these challenges and involve installing a high-tech, unobtrusive data acquisition system (DAS) in an older driver's own vehicle. The DAS continuously records multi-channel video of driver and roadway, sensor-based kinematics, GPS location, and presence of nearby objects in front of the vehicle, providing an objective measure of driving exposure. In this naturalistic driving study, the purpose is to examine the relationship between vision and crashes and near-crashes, lane-keeping, turning at intersections, driving performance during secondary tasks demands, and the role of front-seat passengers. An additional aim is to compare results of the on-road driving evaluation by a certified driving rehabilitation specialist to objective indicators of driving performance derived from the naturalistic data. Drivers ≥70 years old are recruited from ophthalmology clinics and a previous population-based study of older drivers, with the goal of recruiting persons with wide ranging visual function. Target samples size is 195 drivers. At a baseline visit, the DAS is installed in the participant's vehicle and a battery of health and functional assessments are administered to the driver including visual-sensory and visual-cognitive tests. The DAS remains installed in the vehicle for six months while the participant goes about his/her normal driving with no imposed study restrictions. After six months, the driver returns for DAS de-installation, repeat vision testing, and an on-road driving evaluation by a certified

  11. Understanding young and older male drivers' willingness to drive while intoxicated: the predictive utility of constructs specified by the theory of planned behaviour and the prototype willingness model.

    Rivis, Amanda; Abraham, Charles; Snook, Sarah

    2011-05-01

    The present study examined the predictive utility of constructs specified by the theory of planned behaviour (TPB) and prototype willingness model (PWM) for young and older male drivers' willingness to drive while intoxicated. A cross-sectional questionnaire was employed. Two hundred male drivers, recruited via a street survey, voluntarily completed measures of attitude, subjective norm, perceived behavioural control, prototype perceptions, and willingness. Findings showed that the TPB and PWM variables explained 65% of the variance in young male drivers' willingness and 47% of the variance in older male drivers' willingness, with the interaction between prototype favourability and similarity contributing 7% to the variance explained in older males' willingness to drive while intoxicated. The findings possess implications for theory, research, and anti-drink driving campaigns. ©2010 The British Psychological Society.

  12. Effect of Speed of Processing Training on Older Driver Screening Measures

    Ranmalee Eramudugolla

    2017-10-01

    Full Text Available Objective: Computerized training for cognitive enhancement is of great public interest, however, there is inconsistent evidence for the transfer of training gains to every day activity. Several large trials have focused on speed of processing (SOP training with some promising findings for long-term effects on daily activity, but no immediate transfer to other cognitive tests. Here, we examine the transfer of SOP training gains to cognitive measures that are known predictors of driving safety in older adults.Methods: Fifty-three adults aged 65–87 years who were current drivers participated in a two group non-randomized design with repeated measures and a no-contact matched control group. The Intervention group completed an average of 7.9 (SD = 3.0 hours of self-administered online SOP training at home. Control group was matched on age, gender and test-re-test interval. Measures included the Useful Field of View (UFOV test, a Hazard Perception test, choice reaction time (Cars RT, Trail Making Test B, a Maze test, visual motion threshold, as well as road craft and road knowledge tests.Results: Speed of processing training resulted in significant improvement in processing speed on the UFOV test relative to controls, with an average change of -45.8 ms (SE = 14.5, and effect size of ω2 = 0.21. Performance on the Maze test also improved, but significant slowing on the Hazard Perception test was observed after SOP training. Training effects on the UFOV task was associated with similar effects on the Cars RT, but not the Hazard Perception and Maze tests, suggesting transfer to some but not all driving related measures. There were no effects of training on any of the other measures examined.Conclusion: Speed of processing training effects on the UFOV task can be achieved with self-administered, online training at home, with some transfer to other cognitive tests. However, differential effects of training may be observed for tasks requiring goal

  13. Effect of Speed of Processing Training on Older Driver Screening Measures.

    Eramudugolla, Ranmalee; Kiely, Kim M; Chopra, Sidhant; Anstey, Kaarin J

    2017-01-01

    Objective: Computerized training for cognitive enhancement is of great public interest, however, there is inconsistent evidence for the transfer of training gains to every day activity. Several large trials have focused on speed of processing (SOP) training with some promising findings for long-term effects on daily activity, but no immediate transfer to other cognitive tests. Here, we examine the transfer of SOP training gains to cognitive measures that are known predictors of driving safety in older adults. Methods: Fifty-three adults aged 65-87 years who were current drivers participated in a two group non-randomized design with repeated measures and a no-contact matched control group. The Intervention group completed an average of 7.9 ( SD = 3.0) hours of self-administered online SOP training at home. Control group was matched on age, gender and test-re-test interval. Measures included the Useful Field of View (UFOV) test, a Hazard Perception test, choice reaction time (Cars RT), Trail Making Test B, a Maze test, visual motion threshold, as well as road craft and road knowledge tests. Results: Speed of processing training resulted in significant improvement in processing speed on the UFOV test relative to controls, with an average change of -45.8 ms ( SE = 14.5), and effect size of ω 2 = 0.21. Performance on the Maze test also improved, but significant slowing on the Hazard Perception test was observed after SOP training. Training effects on the UFOV task was associated with similar effects on the Cars RT, but not the Hazard Perception and Maze tests, suggesting transfer to some but not all driving related measures. There were no effects of training on any of the other measures examined. Conclusion: Speed of processing training effects on the UFOV task can be achieved with self-administered, online training at home, with some transfer to other cognitive tests. However, differential effects of training may be observed for tasks requiring goal-directed search

  14. Older driver failures of attention at intersections: using change blindness methods to assess turn decision accuracy.

    Caird, Jeff K; Edwards, Christopher J; Creaser, Janet I; Horrey, William J

    2005-01-01

    A modified version of the flicker technique to induce change blindness was used to examine the effects of time constraints on decision-making accuracy at intersections on a total of 62 young (18-25 years), middle-aged (26-64 years), young-old (65-73 years), and old-old (74+ years) drivers. Thirty-six intersection photographs were manipulated so that one object (i.e., pedestrian, vehicle, sign, or traffic control device) in the scene would change when the images were alternated for either 5 or 8 s using the modified flicker method. Young and middle-aged drivers made significantly more correct decisions than did young-old and old-old drivers. Logistic regression analysis of the data indicated that age and/or time were significant predictors of decision performance in 14 of the 36 intersections. Actual or potential applications of this research include driving assessment and crash investigation.

  15. Driving habits and risk exposure in older drivers: lessons learned from the implementation of a self-regulation curriculum.

    Jones, Vanya C; Cho, Juhee; Abendschoen-Milani, Jackie; Gielen, Andrea

    2011-10-01

    This article describes the development and pilot testing of Seniors on the MOVE (Mature Operators Vehicular Education), a safe driving education program for older adults. The study aims are to describe driving experiences and habits of a community sample of older drivers and to determine whether the program reduces their driving risk exposures. A 2-group randomized design was used. Fifty-eight participants with an average age of 70 were randomly assigned to the MOVE program or a no treatment control group. MOVE is a 4-session program designed to help older drivers better understand and utilize self-regulation skills for safer driving. Baseline and 4-week follow-up questionnaires were completed by both groups, after which the control group received the MOVE program. In the total sample, 14 percent reported having ever been in a traffic crash where someone was injured, and 10 percent reported having received a traffic citation in the past 6 months. Almost one half of the sample (47%) reported thinking about reducing the amount of driving done at night. Nearly one third were thinking about reducing the amount of driving done in unfamiliar places (32%) and the number of miles driven each week (30%). Participants reported most frequently driving between 2 to 10 miles from home, on local roadways, and between 9:00 am and 4:00 pm. Based on responses to items that measured such driving habits, a risk exposure score was created by combining driving exposure variables. Participants were categorized into lower and higher driving risk exposure groups at baseline and follow-up. There were no statistical differences in changes in higher or lower risk driving exposure variables when comparing the 2 groups. Although the impact of this program on reported driving behaviors yielded null results, descriptions of older drivers' habits and plans are informative. Because many participants were thinking about making changes to their driving habits, and many already had, the need for more

  16. Driving Cessation Anno 2010 Which Older Drivers Give Up Their License and Why? Evidence From Denmark

    Siren, Anu Kristiina; Haustein, Sonja

    2016-01-01

    This study focuses on the decision to either stop or continue driving among a cohort of Danish seniors whose driving licenses expire, for the first time, at the age of 70. Based on 1,537 standardized telephone interviews with licensed drivers, we compared persons who intended to renew or not to r...

  17. Older driver estimates of driving exposure compared to in-vehicle data in the Candrive II study.

    Porter, Michelle M; Smith, Glenys A; Cull, Andrew W; Myers, Anita M; Bédard, Michel; Gélinas, Isabelle; Mazer, Barbara L; Marshall, Shawn C; Naglie, Gary; Rapoport, Mark J; Tuokko, Holly A; Vrkljan, Brenda H

    2015-01-01

    Most studies on older adults' driving practices have relied on self-reported information. With technological advances it is now possible to objectively measure the everyday driving of older adults in their own vehicles over time. The purpose of this study was to examine the ability of older drivers to accurately estimate their kilometers driven over one year relative to objectively measured driving exposure. A subsample (n = 159 of 928; 50.9% male) of Candrive II participants (age ≥ 70 years of age) was used in these analyses based on strict criteria for data collected from questionnaires as well as an OttoView-CD Autonomous Data Logging Device installed in their vehicle, over the first year of the prospective cohort study. Although there was no significant difference overall between the self-reported and objectively measured distance categories, only moderate agreement was found (weighted kappa = 0.57; 95% confidence interval, 0.47-0.67). Almost half (45.3%) chose the wrong distance category, and some people misestimated their distance driven by up to 20,000 km. Those who misjudged in the low mileage group (≤5000 km) consistently underestimated, whereas the reverse was found for those in the high distance categories (≥ 20,000); that is, they always overestimated their driving distance. Although self-reported driving distance categories may be adequate for studies entailing broad group comparisons, caution should be used in interpreting results. Use of self-reported estimates for individual assessments should be discouraged.

  18. Can an e-learning course improve nursing care for older people at risk of delirium: a stepped wedge cluster randomised trial.

    Steeg, L. van de; IJkema, R.; Langelaan, M.; Wagner, C.

    2014-01-01

    Background: Delirium occurs frequently in older hospitalised patients and is associated with several adverse outcomes. Ignorance among healthcare professionals and a failure to recognise patients suffering from delirium have been identified as the possible causes of poor care. The objective of the

  19. Health care providers and older adult service organizations to assist in the prevention and early recognition of Florida's at-risk drivers : [summary].

    2015-04-01

    Florida is well known for retirement and winter homes. Currently, over 18% of Floridians : are 65 or over, but by 2030, this is expected to be over 27%. To meet the transportation : challenges of an aging population, State Traffic Engineering and Ope...

  20. What works better for community-dwelling older people at risk to fall?: a meta-analysis of multifactorial versus physical exercise-alone interventions.

    Petridou, Eleni Th; Manti, Eirini G; Ntinapogias, Athanasios G; Negri, Eva; Szczerbinska, Katarzyna

    2009-08-01

    To compare and quantify the effectiveness of multifactorial versus exercise-alone interventions in reducing recurrent falls among community-dwelling older people. A meta-analysis of recently published studies on fall prevention interventions was conducted. Measure of the overall effectiveness was the combined risk ratio for recurrent falls, whereas heterogeneity was explored via metaregression analyses. Ten of the 52 identified studies met the preset criteria and were included in the analysis. The exercise-alone interventions were about 5 times more effective compared to multifactorial ones. Short-term interventions, smaller samples, and younger age related to better outcomes. From cost-efficiency and public health perspectives, exercise-alone interventions can be considered valuable, as they are more likely to be implemented in countries with less resources. Further qualitative research is needed, however, to explore determinants of willingness to participate and comply with interventions aiming to prevent recurrent falls among older people.

  1. Pilot study to investigate the feasibility of the Home Falls and Accidents Screening Tool (HOME FAST) to identify older Malaysian people at risk of falls.

    Romli, Muhammad Hibatullah; Mackenzie, Lynette; Lovarini, Meryl; Tan, Maw Pin

    2016-08-16

    The relationship between home hazards and falls in older Malaysian people is not yet fully understood. No tools to evaluate the Malaysian home environment currently exist. Therefore, this study aimed to pilot the Home Falls and Accidents Screening Tool (HOME FAST) to identify hazards in Malaysian homes, to evaluate the feasibility of using the HOME FAST in the Malaysian Elders Longitudinal Research (MELoR) study and to gather preliminary data about the experience of falls among a small sample of Malaysian older people. A cross-sectional pilot study was conducted. An urban setting in Kuala Lumpur. 26 older people aged 60 and over were recruited from the control group of a related research project in Malaysia, in addition to older people known to the researchers. The HOME FAST was applied with the baseline survey for the MELoR study via a face-to-face interview and observation of the home by research staff. The majority of the participants were female, of Malay or Chinese ethnicity and living with others in a double-storeyed house. Falls were reported in the previous year by 19% and 80% of falls occurred at home. Gender and fear of falling had the strongest associations with home hazards. Most hazards were detected in the bathroom area. A small number of errors were detected in the HOME FAST ratings by researchers. The HOME FAST is feasible as a research and clinical tool for the Malaysian context and is appropriate for use in the MELoR study. Home hazards were prevalent in the homes of older people and further research with the larger MELoR sample is needed to confirm the validity of using the HOME FAST in Malaysia. Training in the use of the HOME FAST is needed to ensure accurate use by researchers. 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/

  2. The Geriatric Day Hospital: Preliminary Data on an Innovative Model of Care in Brazil for Older Adults at Risk of Hospitalization.

    Aliberti, Márlon J R; Suemoto, Claudia K; Fortes-Filho, Sileno Q; Melo, Juliana A; Trindade, Carolina B; Kasai, Juliana Y T; Altona, Marcelo; Apolinario, Daniel; Jacob-Filho, Wilson

    2016-10-01

    Older adults have a greater risk of experiencing functional decline and iatrogenic complications during hospitalization than younger individuals. Geriatric day hospitals (GDHs) have been implemented mainly for rehabilitation. The goal of the current study was to expand the GDH spectrum of care to prevent hospital admissions in this population. This study details an innovative model of GDH care that offers short-term, nonrehabilitative treatment to older adults who have experienced an acute event, those with a decompensated chronic disease, or those in need of a minor procedure that would be unattainable in a regular outpatient setting. During the 6-hour visits made weekly for up to 2 months, participants receive integrated evaluations of their various health domains, education, and rapid access to examinations and procedures based on a multidisciplinary approach. In the first 6 years, 2,322 individuals attended the GDH. The analysis of a representative sample (n = 645) revealed that 81% were treated in the GDH without the need for another type of hospital care. This percentage was high for the different reasons for referral (infection, 71%; delirium, 73%; decompensated chronic disease, 81%). Between baseline and discharge, participants maintained their functional status, and their self-reported health improved. This study represents the first step in describing the role of the GDH as a possible alternative to emergency department use or hospitalization for older adults. Future studies are needed to determine the optimal individual for this model of care and to ensure its cost-effectiveness. © 2016, Copyright the Authors Journal compilation © 2016, The American Geriatrics Society.

  3. A randomized trial to evaluate the effectiveness of an individual, education-based safe transport program for drivers aged 75 years and older

    Keay Lisa

    2013-02-01

    Full Text Available Abstract 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.

  4. Whole-body electromyostimulation and protein supplementation favorably affect sarcopenic obesity in community-dwelling older men at risk: the randomized controlled FranSO study

    Kemmler W

    2017-09-01

    Full Text Available Wolfgang Kemmler,1 Anja Weissenfels,1 Marc Teschler,1 Sebastian Willert,1 Michael Bebenek,1 Mahdieh Shojaa,1 Matthias Kohl,2 Ellen Freiberger,3 Cornel Sieber,3 Simon von Stengel1 1Institute of Medical Physics, Friedrich-Alexander University of Erlangen-Nürnberg, Erlangen, Germany; 2Faculty of Medical and Life Science, University of Furtwangen, Schwenningen, Germany; 3Institute of Biomedicine of Aging, Friedrich-Alexander University of Erlangen-Nürnberg, Nürnberg, Germany Background: Sarcopenic obesity (SO is a geriatric syndrome characterized by the disproportion between the amount of lean mass and fat mass. Exercise decreases fat and maintains muscle mass; however, older people fail to exercise at doses sufficient to affect musculoskeletal and cardiometabolic risk factors. The aim of this study was to evaluate the effect of whole-body electromyostimulation (WB-EMS, a time-efficient, joint-friendly and highly individualized exercise technology, on sarcopenia and SO in older men. Materials and methods: A total of 100 community-dwelling northern Bavarian men aged ≥70 years with sarcopenia and obesity were randomly (1–1–1 assigned to either 16 weeks of 1 WB-EMS and protein supplementation (WB-EMS&P, 2 isolated protein supplementation or 3 nonintervention control. WB-EMS consisted of 1.5×20 min (85 Hz, 350 µs, 4 s of strain to 4 s of rest applied with moderate-to-high intensity while moving. We further generated a daily protein intake of 1.7–1.8 g/kg/body mass per day. The primary study end point was Sarcopenia Z-Score, and the secondary study end points were body fat rate (%, skeletal muscle mass index (SMI and handgrip strength. Results: Intention-to-treat analysis determined a significantly favorable effect of WB-EMS&P (P<0.001 and protein (P=0.007 vs control. Both groups significantly (P<0.001 lost body fat (WB-EMS&P: 2.1%; protein: 1.1% and differed significantly (P≤0.004 from control (0.3%. Differences between WB

  5. The Effect of a Patient-Provider Educational Intervention to Reduce At-Risk Drinking on Changes in Health and Health-Related Quality of Life Among Older Adults: The Project SHARE Study.

    Barnes, Andrew J; Xu, Haiyong; Tseng, Chi-Hong; Ang, Alfonso; Tallen, Louise; Moore, Alison A; Marshall, Deborah C; Mirkin, Michelle; Ransohoff, Kurt; Duru, O Kenrik; Ettner, Susan L

    2016-01-01

    At-risk drinking, defined as alcohol use that is excessive or potentially harmful in combination with select comorbidities or medications, affects about 10% of older adults in the United States and is associated with higher mortality. The Project SHARE intervention, which uses patient and provider educational materials, physician counseling, and health educator support, was designed to reduce at-risk drinking among this vulnerable population. Although an earlier study showed that this intervention was successful in reducing rates of at-risk drinking, it is unknown whether these reductions translate into improved health and health-related quality of life (HRQL). The aim of this study was to examine changes in health and HRQL of older adult at-risk drinkers resulting from a patient-provider educational intervention. A randomized controlled trial to compare the health and HRQL outcomes of patients assigned to the Project SHARE intervention vs. care as usual at baseline, 6- and 12-months post assignment. Control patients received usual care, which may or may not have included alcohol counseling. Intervention group patients received a personalized patient report, educational materials on alcohol and aging, a brief provider intervention, and a telephone health educator intervention. Current drinkers 60years and older accessing primary care clinics around Santa Barbara, California (N=1049). Data were collected from patients using baseline, 6- and 12-month mail surveys. Health and HRQL measures included mental and physical component scores (MCS and PCS) based on the Short Form-12v2 (SF-12v2), the SF-6D, which is also based on the SF-12, and the Geriatric Depression Scale (GDS). Adjusted associations of treatment assignment with these outcomes were estimated using generalized least squares regressions with random provider effects. Regressions controlled for age group, sex, race/ethnicity, marital status, education, household income, home ownership and the baseline value of

  6. A validation study comparing self-reported travel diaries and objective data obtained from in-vehicle monitoring devices in older drivers with bilateral cataract.

    Agramunt, Seraina; Meuleners, Lynn; Chow, Kyle Chi; Ng, Jonathon Q; Morlet, Nigel

    2017-09-01

    Advances in technology have made it possible to examine real-world driving using naturalistic data obtained from in-vehicle monitoring devices. These devices overcome the weaknesses of self-report methods and can provide comprehensive insights into driving exposure, habits and practices of older drivers. The aim of this study is to compare self-reported and objectively measured driving exposure, habits and practices using a travel diary and an in-vehicle driver monitoring device in older drivers with bilateral cataract. A cross-sectional study was undertaken. Forty seven participants aged 58-89 years old (mean=74.1; S.D.=7.73) were recruited from three eye clinics over a one year period. Data collection consisted of a cognitive test, a researcher-administered questionnaire, a travel diary and an in-vehicle monitoring device. Participants' driving exposure and patterns were recorded for one week using in-vehicle monitoring devices. They also completed a travel diary each time they drove a motor vehicle as the driver. Paired t-tests were used to examine differences/agreement between the two instruments under different driving circumstances. The data from the older drivers' travel diaries significantly underestimated the number of overall trips (ptravel diaries also significantly overestimated overall driving duration (ptravelled under any of the driving circumstances. The results of this study found that relying solely on self-reported travel diaries to assess driving outcomes may not be accurate, particularly for estimates of the number of trips made and duration of trips. The clear advantages of using in-vehicle monitoring devices over travel diaries to monitor driving habits and exposure among an older population are evident. Copyright © 2016 Elsevier Ltd. All rights reserved.

  7. Free and Cued Memory in relation to Biomarker-Defined Abnormalities in Clinically Normal Older Adults and Those at Risk for Alzheimer’s Disease

    Papp, Kathryn V.; Amariglio, Rebecca E.; Mormino, Elizabeth; Hedden, Trey; Dekhytar, Maria; Johnson, Keith A.; Sperling, Reisa A.; Rentz, Dorene M.

    2015-01-01

    Objectives Furthering our understanding of the relationship between amyloidosis (Aβ), neurodegeneration (ND), and cognition is imperative for early identification and early intervention of Alzheimer’s disease (AD). However, the subtle cognitive decline differentially associated with each biomarker-defined stage of preclinical AD has yet to be fully characterized. Recent work indicates that different components of memory performance (free and cued recall) may be differentially specific to memory decline in prodromal AD. We sought to examine the relationship between free and cued recall paradigms, in addition to global composites of memory, executive functioning, and processing speed in relation to stages of preclinical AD. Methods A total of 260 clinically normal (CN) older adults (CDR=0) from the Harvard Aging Brain study were grouped according to preclinical AD stages including Stage 0 (Aβ−/ND−), Stage 1 (Aβ+/ND−), Stage 2 (Aβ+/ND+), and suspected non-Alzheimer’s associated pathology (SNAP; Aβ−/ND+). General linear models controlling for age, sex, and education were used to assess for stage-based performance differences on cognitive composites of executive functioning, processing speed, and memory in addition to free and cued delayed recall on the Selective Reminding Test (SRT) and Memory Capacity Test (MCT). Results Global memory performance differed between preclinical stages with Stage 2 performing worse compared with Stage 0. When examining free and cued paradigms by memory test, only the MCT (and not the SRT) revealed group differences. More specifically, Stage 1 was associated with decrements in free recall compared with Stage 0 while Stage 2 was associated with decrements in both free and cued recall. There was a trend for the SNAP group to perform worse on free recall compared with Stage 0. Finally, there was no association between preclinical stage and global composites of executive functioning or processing speed. Conclusions Clinically

  8. Free and cued memory in relation to biomarker-defined abnormalities in clinically normal older adults and those at risk for Alzheimer's disease.

    Papp, Kathryn V; Amariglio, Rebecca E; Mormino, Elizabeth C; Hedden, Trey; Dekhytar, Maria; Johnson, Keith A; Sperling, Reisa A; Rentz, Dorene M

    2015-07-01

    Furthering our understanding of the relationship between amyloidosis (Aβ), neurodegeneration (ND), and cognition is imperative for early identification and early intervention of Alzheimer's disease (AD). However, the subtle cognitive decline differentially associated with each biomarker-defined stage of preclinical AD has yet to be fully characterized. Recent work indicates that different components of memory performance (free and cued recall) may be differentially specific to memory decline in prodromal AD. We sought to examine the relationship between free and cued recall paradigms, in addition to global composites of memory, executive functioning, and processing speed in relation to stages of preclinical AD. A total of 260 clinically normal (CN) older adults (CDR=0) from the Harvard Aging Brain study were grouped according to preclinical AD stages including Stage 0 (Aβ-/ND-), Stage 1 (Aβ+/ND-), Stage 2 (Aβ+/ND+), and suspected non-Alzheimer's associated pathology (SNAP; Aβ-/ND+). General linear models controlling for age, sex, and education were used to assess for stage-based performance differences on cognitive composites of executive functioning, processing speed, and memory in addition to free and cued delayed recall on the Selective Reminding Test (SRT) and Memory Capacity Test (MCT). Global memory performance differed between preclinical stages with Stage 2 performing worse compared with Stage 0. When examining free and cued paradigms by memory test, only the MCT (and not the SRT) revealed group differences. More specifically, Stage 1 was associated with decrements in free recall compared with Stage 0 while Stage 2 was associated with decrements in both free and cued recall. There was a trend for the SNAP group to perform worse on free recall compared with Stage 0. Finally, there was no association between preclinical stage and global composites of executive functioning or processing speed. Clinically normal older adults with underlying evidence of

  9. Multiple-modality exercise and mind-motor training to improve cardiovascular health and fitness in older adults at risk for cognitive impairment: A randomized controlled trial.

    Boa Sorte Silva, Narlon C; Gregory, Michael A; Gill, Dawn P; Petrella, Robert J

    The effects of multiple-modality exercise on arterial stiffening and cardiovascular fitness has not been fully explored. To explore the influence of a 24-week multiple-modality exercise program associated with a mind-motor training in cardiovascular health and fitness in community-dwelling older adults, compared to multiple-modality exercise (M2) alone. Participants (n=127, aged 67.5 [7.3] years, 71% females) were randomized to either M4 or M2 groups. Both groups received multiple-modality exercise intervention (60min/day, 3days/week for 24-weeks); however, the M4 group underwent additional 15min of mind-motor training, whereas the M2 group received 15min of balance training. Participants were assessed at 24-weeks and after a 28-week non-contact follow-up (52-weeks). at 52-weeks, the M4 group demonstrated a greater VO2max (ml/kg/min) compared to the M2 group (mean difference: 2.39, 95% CI: 0. 61 to 4.16, p=0.009). Within-group analysis indicated that the M4 group demonstrated a positive change in VO2max at 24-weeks (mean change: 1.93, 95% CI: 0.82 to 3.05, p=0.001) and 52-weeks (4.02, 95% CI: 2.71 to 5.32, p=0.001). Similarly, the M2 group increased VO2max at 24-weeks (2.28, 95% CI: 1.23 to 3.32, pMind-motor training associated with multiple-modality exercise can positively impact cardiovascular fitness to the same extent as multiple-modality exercise alone. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  10. Projecting Fatalities in Crashes Involving Older Drivers, 2000–2025, CRADA No. ORNL98-0500 Final Report

    Hu, Patricia S. [ORNL; Jones, Donald W. [ORNL; Reuscher, Timothy [Oak Ridge Institute for Science and Education; Schmoyer, Richard S. [ORNL; Truett, Lorena F. [ORNL

    2000-04-01

    At the turn of the century – the 20th century that is – the median age in the United States was under 30 years; America was 60% rural in nature; and there were only 36 highway fatalities all year. As we leave the 20th century behind, the route into the 21st century is very different. “Intelligent” cars speed down multi-lane “smart” highways in a nation that is 75% urban. According to the Federal Highway Administration’s Highway Statistics, there are 28,000 times more vehicles on the road in 2000 than there were in 1900, and these vehicles travel about 2.6 trillion miles each year. Annual fatalities resulting from highway crashes have also increased – by over 1100%. We see other changes as well. The face of America is changing. It is growing older. In 2025, persons 65 and over will make up 18.5% of the total population. The number of persons aged 85 and over is increasing more rapidly than any other age group. More importantly, the elderly are taking more trips, driving further, and continuing to drive much later in life. These conditions lead to concerns about traffic safety. Although the elderly are healthier and drive safer cars than they did just two decades ago, their frailty makes them more susceptible to injury than younger persons involved in traffic crashes of the same severity. In addition, visual, physical, and cognitive skills, all of which contribute to driving abilities, decrease with advancing age. The familiar “U”-shaped curve depicting the rate of fatalities per vehicle miles traveled, shows that the elderly experience a higher highway fatality rate than any other age group except teenagers. While the overall number of highway fatalities has decreased regularly since 1972, the number of fatalities of elderly travelers has continued to increase steadily. This increase is cause for concern for both the elderly driver and for other persons on the roads who migh tbe placed in danger through crashes involving elderly drivers.

  11. 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.

    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 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.

  12. The Aerobic and Cognitive Exercise Study (ACES for Community-Dwelling Older Adults With or At-Risk for Mild Cognitive Impairment (MCI: Neuropsychological, Neurobiological and Neuroimaging Outcomes of a Randomized Clinical Trial

    Cay Anderson-Hanley

    2018-05-01

    Full Text Available Prior research has found that cognitive benefits of physical exercise and brain health in older adults may be enhanced when mental exercise is interactive simultaneously, as in exergaming. It is unclear whether the cognitive benefit can be maximized by increasing the degree of mental challenge during exercise. This randomized clinical trial (RCT, the Aerobic and Cognitive Exercise Study (ACES sought to replicate and extend prior findings of added cognitive benefit from exergaming to those with or at risk for mild cognitive impairment (MCI. ACES compares the effects of 6 months of an exer-tour (virtual reality bike rides with the effects of a more effortful exer-score (pedaling through a videogame to score points. Fourteen community-dwelling older adults meeting screening criteria for MCI (sMCI were adherent to their assigned exercise for 6 months. The primary outcome was executive function, while secondary outcomes included memory and everyday cognitive function. Exer-tour and exer-score yielded significant moderate effects on executive function (Stroop A/C; d's = 0.51 and 0.47; there was no significant interaction effect. However, after 3 months the exer-tour revealed a significant and moderate effect, while exer-score showed little impact, as did a game-only condition. Both exer-tour and exer-score conditions also resulted in significant improvements in verbal memory. Effects appear to generalize to self-reported everyday cognitive function. Pilot data, including salivary biomarkers and structural MRI, were gathered at baseline and 6 months; exercise dose was associated with increased BDNF as well as increased gray matter volume in the PFC and ACC. Improvement in memory was associated with an increase in the DLPFC. Improved executive function was associated with increased expression of exosomal miRNA-9. Interactive physical and cognitive exercise (both high and low mental challenge yielded similarly significant cognitive benefit for adherent s

  13. The Aerobic and Cognitive Exercise Study (ACES) for Community-Dwelling Older Adults With or At-Risk for Mild Cognitive Impairment (MCI): Neuropsychological, Neurobiological and Neuroimaging Outcomes of a Randomized Clinical Trial.

    Anderson-Hanley, Cay; Barcelos, Nicole M; Zimmerman, Earl A; Gillen, Robert W; Dunnam, Mina; Cohen, Brian D; Yerokhin, Vadim; Miller, Kenneth E; Hayes, David J; Arciero, Paul J; Maloney, Molly; Kramer, Arthur F

    2018-01-01

    Prior research has found that cognitive benefits of physical exercise and brain health in older adults may be enhanced when mental exercise is interactive simultaneously, as in exergaming. It is unclear whether the cognitive benefit can be maximized by increasing the degree of mental challenge during exercise. This randomized clinical trial (RCT), the Aerobic and Cognitive Exercise Study (ACES) sought to replicate and extend prior findings of added cognitive benefit from exergaming to those with or at risk for mild cognitive impairment (MCI). ACES compares the effects of 6 months of an exer-tour (virtual reality bike rides) with the effects of a more effortful exer-score (pedaling through a videogame to score points). Fourteen community-dwelling older adults meeting screening criteria for MCI (sMCI) were adherent to their assigned exercise for 6 months. The primary outcome was executive function, while secondary outcomes included memory and everyday cognitive function. Exer-tour and exer-score yielded significant moderate effects on executive function (Stroop A/C; d 's = 0.51 and 0.47); there was no significant interaction effect. However, after 3 months the exer-tour revealed a significant and moderate effect, while exer-score showed little impact, as did a game-only condition. Both exer-tour and exer-score conditions also resulted in significant improvements in verbal memory. Effects appear to generalize to self-reported everyday cognitive function. Pilot data, including salivary biomarkers and structural MRI, were gathered at baseline and 6 months; exercise dose was associated with increased BDNF as well as increased gray matter volume in the PFC and ACC. Improvement in memory was associated with an increase in the DLPFC. Improved executive function was associated with increased expression of exosomal miRNA-9. Interactive physical and cognitive exercise (both high and low mental challenge) yielded similarly significant cognitive benefit for adherent s

  14. Osteo-cise: Strong Bones for Life: Protocol for a community-based randomised controlled trial of a multi-modal exercise and osteoporosis education program for older adults at risk of falls and fractures

    Gianoudis Jenny

    2012-05-01

    maximal muscle strength, balance and function (four square step test, functional reach test, timed up-and-go test and 30-second sit-to-stand, falls incidence and health-related quality of life. Cost-effectiveness will also be assessed. Discussion The findings from the Osteo-cise: Strong Bones for Life study will provide new information on the efficacy of a targeted multi-modal community-based exercise program incorporating high velocity resistance training, together with an osteoporosis education and behavioural change program for improving multiple risk factors for falls and fracture in older adults at risk of fragility fracture. Trial registration Australian New Zealand Clinical Trials Registry reference ACTRN12609000100291

  15. Resourceful or At Risk

    Højen-Sørensen, Anna-Katharina

    Introduction: Social categories are used to determine which individuals are at an increased risk of unfavorable outcomes and they are a vital tool for the development of targeted interventions. This presentation takes a critical look at the Resourceful and At Risk categories, that are often emplo...... employed in research and social work, and investigate the possible consequences of the preconceptions born out of these categories....

  16. Programs at risk

    Jones, , R.

    Declaring that “these lists represent the smoke behind which a fire may be raging,” Senator John Glenn (D.-Ohio), chairman of the Senate Government Affairs committee, has released a list prepared by the Office of Management and Budget of 73 government programs “in which hundreds of billions of federal dollars are at risk.”The National Aeronautics and Space Administration and Department of Energy are among the 16 federal departments and agencies having programs that Glenn feels could be “our next HUDs.” The secret list is not of programs where losses have occurred, but only where safeguards are thought to be insufficient.

  17. A Neuropsychological Instrument Measuring Age-Related Cerebral Decline in Older Drivers : Development, Reliability, and Validity of MedDrive.

    Vaucher, Paul; cardoso, isabel; Veldstra, Janet; Herzig, Daniela; Mangin, Patrice; Herzog, Micheal; Favrat, Bernard

    2014-01-01

    When facing age-related cerebral decline, older adults are unequally affected by cognitive impairment without us knowing why. To explore underlying mechanisms and find possible solutions to maintain life-space mobility, there is a need for a standardized behavioral test that relates to behaviors in

  18. Aging baby boomers--a blessing or challenge for driver licensing authorities.

    Dobbs, Bonnie M

    2008-08-01

    In less than 5 years, the first wave of baby boomers will begin turning 65, with the last wave of boomers entering their senior years in January 2029. Currently, boomers make up a significant percentage of the population in Canada, the United States, and other developed countries. The baby boom generation has had a profound impact on our society over the last six decades, and this large cohort will continue to exert its influence for several decades to come. Central to this article is the rapid growth in the number of persons 65 years of age and older, beginning in 2011, with a corresponding increase in the number of older drivers. The demographic shift has important implications for licensing authorities, the regulatory bodies charged with licensing and 'fitness to drive' decisions. The objectives of this paper are to summarize the published scientific literature on licensing policies and procedures currently in use for older drivers, discuss their limitations, and provide recommendations for meeting the upcoming challenges of an aging baby boomer population of drivers. Online searches were conducted using the following databases: PsycINFO, MEDLINE, Scopus, and TRIS. Google and Google Scholar also were searched for scientific articles. References identified from database and online searches were examined for relevant articles. A number of studies have investigated the utility of different licensing policies and procedures for identifying older drivers who may be at risk for impaired driving performance. Overall, results suggest that current policies and procedures are ineffective in identifying high-risk older drivers. The results also emphasize the need for a different approach for the identification of high risk older drivers by licensing agencies. Recommendations to assist with that goal are provided. The aging of the baby boomer population, combined with the projected high crash rates for this cohort of drivers as it moves through the senior years, underscores

  19. Backtesting Value-at-Risk

    Pajhede, Thor

    2017-01-01

    Testing the validity of value-at-risk (VaR) forecasts, or backtesting, is an integral part of modern market risk management and regulation. This is often done by applying independence and coverage tests developed by Christoffersen (International Economic Review, 1998; 39(4), 841–862) to so...

  20. A randomized controlled trial of physical activity with individual goal-setting and volunteer mentors to overcome sedentary lifestyle in older adults at risk of cognitive decline: the INDIGO trial protocol.

    Cox, Kay L; Cyarto, Elizabeth V; Etherton-Beer, Christopher; Ellis, Kathryn A; Alfonso, Helman; Clare, Linda; Liew, Danny; Ames, David; Flicker, Leon; Almeida, Osvaldo P; LoGiudice, Dina; Lautenschlager, Nicola T

    2017-09-13

    Increasing physical activity (PA) effectively in those who are inactive is challenging. For those who have subjective memory complaints (SMC) or mild cognitive impairment (MCI) this is a greater challenge necessitating the need for more engaging and innovative approaches. The primary aim of this trial is to determine whether a home-based 6-month PA intervention with individual goal-setting and peer mentors (GM-PA) can significantly increase PA levels in insufficiently active older adults at increased risk of developing Alzheimer's disease (AD). Community living 60-80 year olds with SMC or MCI who do not engage in more than 60 min per week of moderate intensity PA will be recruited from memory clinics and the community via media advertisements to participate in this randomized, single-blind controlled trial. All participants will receive an individually tailored home-based PA program of 150 min of moderate intensity walking/week for 6 months. The intervention group will undertake individual goal-setting and behavioral education workshops with mentor support via telephone (GM-PA). Those randomized to the control group will have standard education workshops and Physical Activity Liaison (PAL) contact via telephone (CO-PA). Increase in PA is the primary outcome, fitness, cognitive, personality, demographic and clinical parameters will be measured and a health economic analysis performed. A saliva sample will be collected for APOE e4 genotyping. All participants will have a goal-setting interview to determine their PA goals. Active volunteers aged 50-85 years will be recruited from the community randomized and trained to provide peer support as mentors (intervention group) or PALS (control group) for the 6-month intervention. Mentors and PALS will have PA, exercise self-efficacy and mentoring self-efficacy measured. Participants in both groups are asked to attend 3 workshops in 6 months. At the first workshop, they will meet their allocated Mentor or PAL who will

  1. Methodology to evaluate teen driver training programs : [brief].

    2014-03-01

    In the United States, teenage drivers are more at risk of being involved in crashes than : any other age group. Statistics reveal a clear need for improving teenagers driving : skills, judgment and behavior. Driver education programs are a crucial...

  2. Analysis of the Fiscal Resources Supporting At-Risk Youth, Ages 13-24, in Hawaii

    Silloway, Torey; Connors-Tadros, Lori; Dahlin, Melissa

    2012-01-01

    Hawaii's largest populations of at-risk youth include those youth who have dropped out of school, are at-risk of not completing high school, and youth who have completed school but are still not prepared for the workforce. Depending on estimates used, between 20 and 25 percent of Hawaiian youth are at risk of dropping out school. For older youth,…

  3. DRIVER INATTENTION

    Richard TAY

    2004-01-01

    Full Text Available Driver inattention, especially driver distraction, is an extremely influential but generally neglected contributing factor of road crashes. This paper explores some of the common behaviours associated with several common forms of driver inattention, with respect to their perceived crash risks, rates of self-reported behaviours and whether drivers regulate such behaviours depending on the road and traffic environment, and provides some policy recommendations to address issues raised.

  4. Bivariate value-at-risk

    Giuseppe Arbia

    2007-10-01

    Full Text Available In this paper we extend the concept of Value-at-risk (VaR to bivariate return distributions in order to obtain measures of the market risk of an asset taking into account additional features linked to downside risk exposure. We first present a general definition of risk as the probability of an adverse event over a random distribution and we then introduce a measure of market risk (b-VaR that admits the traditional b of an asset in portfolio management as a special case when asset returns are normally distributed. Empirical evidences are provided by using Italian stock market data.

  5. Delineating organs at risk in radiation therapy

    Ausili Cèfaro, Giampiero; Perez, Carlos A

    2014-01-01

    This book offers an invaluable guide to the delineation of organs at risk of toxicity in patients undergoing radiotherapy. It details the radiological anatomy of organs at risk as seen on typical radiotherapy planning CT scans.

  6. Medical review practices for driver licensing volume 3: guidelines and processes in the United States.

    2017-04-01

    This is the third of three reports examining driver medical review practices in the United States and how : they fulfill the basic functions of identifying, assessing, and rendering licensing decisions on medically or : functionally at-risk drivers. ...

  7. New, Occasional, and Frequent Use of Zolpidem or Zopiclone (Alone and in Combination) and the Risk of Injurious Road Traffic Crashes in Older Adult Drivers: A Population-Based Case-Control and Case-Crossover Study.

    Nevriana, Alicia; Möller, Jette; Laflamme, Lucie; Monárrez-Espino, Joel

    2017-08-01

    Previous studies on the effect of zolpidem or zopiclone use on the risk of road traffic crashes (RTCs) have shown mixed results. Our objective was to determine the association between zolpidem or zopiclone use (as separate drugs or combined) and the occurrence of injurious RTCs among older adult drivers. This was a population-based matched case-control and case-crossover study based on secondary data linked together from Swedish national registers. Cases were drivers aged 50-80 years involved in a vehicle crash resulting in injuries between January 2006 and December 2009 for the case-control study (n = 27,096) and from February 2006 to December 2009 for the case-crossover study (n = 26,586). For the first design, four controls were matched to each case by sex, age, and residential area, and exposure was categorized into new, occasional, and frequent use of zolpidem only, zopiclone only, and combined zolpidem and zopiclone. For the case-crossover study, newly dispensed zolpidem or zopiclone users were assessed during the 28 days prior to the crash and compared with an equally long control period using a 12-week washout period. Matched adjusted odds ratios (OR) were computed using conditional logistic regression. Increased ORs for all users were observed. In the case-control study, the highest odds were seen among newly initiated zolpidem-only users involved in single-vehicle crashes (adjusted OR 2.27; 95% confidence interval [CI] 1.21-4.24), followed by frequent combined zolpidem and zopiclone users [adjusted OR 2.20; CI 1.21-4.00]. In the case-crossover, newly initiated treatment with zolpidem or zopiclone showed an increased risk that was highest in the 2 weeks after the start of the treatment (OR 2.66; 95% CI 1.04-6.81). These results provide more compelling evidence for the role of zolpidem or zopiclone in the occurrence of RTCs among older adults, not only in frequent users, but also at the beginning of treatment.

  8. At-Risk Students Fact Sheet

    Montana Office of Public Instruction, 2016

    2016-01-01

    Montana's definition of a basic system of quality public elementary and secondary schools includes educational programs for at-risk students (20-9-309, MCA). State statute defines an at-risk student as a "student who is affected by environmental conditions that negatively impact the student's educational performance or threaten a student's…

  9. Supporting At-Risk Learners: Introduction

    Hutchinson, Nancy

    2015-01-01

    In its final report, the At-risk Working Group, which reported to the Ontario Minister of Education, described at-risk secondary students as performing significantly below the provincial standard, failing to meet curriculum expectations, and being disengaged from school (O'Connor, 2003, p. 5). In this special issue, authors examine this topic,…

  10. Validity and usability of a safe driving behaviors measure for older adults : strategy for congestion mitigation.

    2012-01-01

    Statistics project that crash/injury/fatality rates of older drivers will increase with the future growth of : this population. Accurate and precise measurement of older driver behaviors becomes imperative to : curtail these crash trends and resultin...

  11. At-Risk-of-Poverty Threshold

    Táňa Dvornáková

    2012-06-01

    Full Text Available European Statistics on Income and Living Conditions (EU-SILC is a survey on households’ living conditions. The main aim of the survey is to get long-term comparable data on social and economic situation of households. Data collected in the survey are used mainly in connection with the evaluation of income poverty and determinationof at-risk-of-poverty rate. This article deals with the calculation of the at risk-of-poverty threshold based on data from EU-SILC 2009. The main task is to compare two approaches to the computation of at riskof-poverty threshold. The first approach is based on the calculation of the threshold for each country separately,while the second one is based on the calculation of the threshold for all states together. The introduction summarizes common attributes in the calculation of the at-risk-of-poverty threshold, such as disposable household income, equivalised household income. Further, different approaches to both calculations are introduced andadvantages and disadvantages of these approaches are stated. Finally, the at-risk-of-poverty rate calculation is described and comparison of the at-risk-of-poverty rates based on these two different approaches is made.

  12. Biodiversity at risk under future cropland expansion and intensification.

    Kehoe, Laura; Romero-Muñoz, Alfredo; Polaina, Ester; Estes, Lyndon; Kreft, Holger; Kuemmerle, Tobias

    2017-08-01

    Agriculture is the leading driver of biodiversity loss. However, its future impact on biodiversity remains unclear, especially because agricultural intensification is often neglected, and high path-dependency is assumed when forecasting agricultural development-although the past suggests that shock events leading to considerable agricultural change occur frequently. Here, we investigate the possible impacts on biodiversity of pathways of expansion and intensification. Our pathways are not built to reach equivalent production targets, and therefore they should not be directly compared; they instead highlight areas at risk of high biodiversity loss across the entire option space of possible agricultural change. Based on an extensive database of biodiversity responses to agriculture, we find 30% of species richness and 31% of species abundances potentially lost because of agricultural expansion across the Amazon and Afrotropics. Only 21% of high-risk expansion areas in the Afrotropics overlap with protected areas (compared with 43% of the Neotropics). Areas at risk of biodiversity loss from intensification are found in India, Eastern Europe and the Afromontane region (7% species richness, 13% abundance loss). Many high-risk regions are not adequately covered by conservation prioritization schemes, and have low national conservation spending and high agricultural growth. Considering rising agricultural demand, we highlight areas where timely land-use planning may proactively mitigate biodiversity loss.

  13. Early Interventions for At-Risk Students.

    Huxman, Frankie; Klassen, Eydie; Koontz, Barbara; Nottingham, Cheryl; Vierthaler, Charlene

    This is a report on a school-wide ethnographic study of intervention strategies for at-risk students in kindergarten through second grade. A group of 5 teachers from an elementary school of approximately 250 students in a Midwest community of about 18,000 people (2 first-grade teachers, 2 second-grade teachers, and 1 music teacher) comprised the…

  14. Health at risk in immigration detention facilities

    Ioanna Kotsioni

    2013-09-01

    Full Text Available Since 2004 Médecins Sans Frontières (MSF has provided medical and psychosocial support for asylum seekers and migrants held in different immigration detention facilities across Europe (in Greece, Malta, Italy and Belgium where the life, health and human dignity of vulnerable people are being put at risk.

  15. Alternative Certified Teachers and Children at Risk

    Tissington, Laura D.; Grow, Amani

    2007-01-01

    Special education programs that serve at-risk students are facing very real personnel needs that colleges and universities alone cannot meet. Alternative certification programs (ACP) may help meet these needs. Effective university-school district partnership programs that include critical teaching training components may offer an attractive…

  16. Ten Years after "A Nation at Risk."

    Asayesh, Gelareh

    1993-01-01

    In April 1983, the National Commission on Excellence in Education issued a 32-page report ("A Nation at Risk") calling for drastic educational reforms. A decade later, four top education reformers--John Goodlad, Henry Levin, Phillip Schlechty, and Ted Sizer--assess this document and its legacy. Most see substantial progress despite the…

  17. Engaging At-Risk Students with Technology.

    Duttweiler, Patricia Cloud

    1992-01-01

    Educational technology can be used to engage students in interesting activities through which teachers can present skills, concepts, and problems to be solved. At-risk students benefit from the investigation of relevant real world problems and the immediate feedback and privacy that technology affords. (EA)

  18. Value-at-Risk and Extreme Returns

    J. Daníelsson (Jón); C.G. de Vries (Casper)

    1997-01-01

    textabstractAccurate prediction of the frequency of extreme events is of primary importance in many financial applications such as Value-at-Risk (VaR) analysis. We propose a semi-parametric method for VaR evaluation. The largest risks are modelled parametrically, while smaller risks are captured by

  19. School Engagement for Academically At-Risk Students: A Participatory Research Project

    O'Toole, Nadia; Due, Clemence

    2015-01-01

    While past literature has explored school engagement in older students, there is less research for younger children specifically, and very little which engages children themselves in the research process. This paper provides insight into school engagement for academically at-risk students in the second year of school through a participatory…

  20. Brand value at risk from climate change

    NONE

    2005-11-15

    This report focuses on how climate change will become more visible as an issue over the next 5 years, from extreme weather events, to press coverage of the political debate over issues such as post-2012 international emissions regulation and the need or otherwise for nuclear power. The report stresses that in this context, climate change could become a mainstream consumer issue by 2010. How much this matters to companies will depend upon their sector. The report analyses six sectors in detail: Airlines and Food and Beverages were found to have the highest intangible value at risk (50% and 10% of market value respectively) - interestingly more than Oil and Gas. Results for our other four sectors - Oil and Gas, Retail, Banking and Telecommunications - were much lower at less than 2-3% of market value; however even this small percentage can still equate to several billions of pounds in value in the UK market (FTSE All Share) alone. The analysis has focused on consumer brand value. Other reputational elements at risk include a company's reputation amongst its business customers, staff, suppliers, shareholders and regulators. The findings raise a series of challenging questions. If brand value is at risk from climate change, there is an opportunity for differentiation against competitors. Forward looking companies at least need to assess the risks and issues, to avoid falling behind in such a mainstream consumer issue. Companies also need to understand the response time. How long is the lead time for a supermarket to start offering a local alternative to long-haul fresh vegetables? How does this compare to the time it would take for an airline to replace an ageing fleet stock? In many cases, even though the consumer interest may be several years away, action is needed now. (UK)

  1. Issues in Value-at-Risk Modeling and Evaluation

    J. Daníelsson (Jón); C.G. de Vries (Casper); B.N. Jorgensen (Bjørn); P.F. Christoffersen (Peter); F.X. Diebold (Francis); T. Schuermann (Til); J.A. Lopez (Jose); B. Hirtle (Beverly)

    1998-01-01

    textabstractDiscusses the issues in value-at-risk modeling and evaluation. Value of value at risk; Horizon problems and extreme events in financial risk management; Methods of evaluating value-at-risk estimates.

  2. Banking Firm, Equity and Value at Risk

    Udo Broll

    2012-12-01

    Full Text Available The paper focuses on the interaction between the solvency probability of a banking firm and the diversification potential of its asset portfolio when determining optimal equity capital. The purpose of this paper is to incorporate value at risk (VaR into the firm-theoretical model of a banking firm facing the risk of asset return. Given the necessity to achieve a confidence level for solvency, we demonstrate that diversification reduces the amount of equity. Notably, the VaR concept excludes a separation of equity policy and asset-liability management.

  3. Estimation of value at risk and conditional value at risk using normal mixture distributions model

    Kamaruzzaman, Zetty Ain; Isa, Zaidi

    2013-04-01

    Normal mixture distributions model has been successfully applied in financial time series analysis. In this paper, we estimate the return distribution, value at risk (VaR) and conditional value at risk (CVaR) for monthly and weekly rates of returns for FTSE Bursa Malaysia Kuala Lumpur Composite Index (FBMKLCI) from July 1990 until July 2010 using the two component univariate normal mixture distributions model. First, we present the application of normal mixture distributions model in empirical finance where we fit our real data. Second, we present the application of normal mixture distributions model in risk analysis where we apply the normal mixture distributions model to evaluate the value at risk (VaR) and conditional value at risk (CVaR) with model validation for both risk measures. The empirical results provide evidence that using the two components normal mixture distributions model can fit the data well and can perform better in estimating value at risk (VaR) and conditional value at risk (CVaR) where it can capture the stylized facts of non-normality and leptokurtosis in returns distribution.

  4. Data at Risk and Research Libraries

    Choudhury, S.

    2017-12-01

    Research libraries have recently engaged in data rescue events amidst growing concerns about access to federal data sets. While these efforts are well intentioned, libraries run the risk of ignoring a long established history of activities and accomplishments by other communities focused on data at risk, many of which are represented at forums such as AGU. Under the auspices of the Data Conservancy, the Sheridan Libraries at Johns Hopkins University hosted an event in July 2017 that convened members of various communities including ESIP, RDA, Data Rescue Boulder, Association of Research Libraries, the Fedora repository platform, the Open Science Framework and the Interplanetary File System or IPFS (via the Data Together Network). This group identified a potential role for research libraries to partner with existing players in the data at risk community by focusing on a distributed preservation network as part of a coordinated collection development program. This session will offer an opportunity to hear about this potential role for research libraries and to provide feedback about its viability and utility.

  5. Medical review practices for driver licensing volume 2: case studies of medical referrals and licensing outcomes in Maine, Ohio, Oregon, Texas, Washington, and Wisconsin.

    2017-03-01

    This is the second of three reports examining driver medical review practices in the United States and how : they fulfill the basic functions of identifying, assessing, and rendering licensing decisions on medically at-risk : drivers. This volume pre...

  6. VALUE AT RISK - CORPORATE RISK MEASUREMENT

    Anis Cecilia-Nicoleta

    2011-12-01

    Full Text Available The notion of 'risk' is used in a number of sciences. The Faculty of Law studies the risk depending on its legality. The Accident Theory applies this term to describe the damage and the disasters. One can find studies on the risks in the works of psychology, philosophy, medicine and within each of these areas the study of the risk is based on the given science subject and, of course, on their methods and approaches. Such a variety of risk study is explained by the diversity of this phenomenon. Under the market economy conditions, the risk is an essential component of any economic agent management policy, of the approach developed by this one, a strategy that depends almost entirely on individual ability and capacity to anticipate his evolution and to exploit his opportunities, assuming a so-called 'risk of business failure.' There are several ways to measure the risks in projects, one of the most used methods to measure this being the Value at Risk(VaR. Value at Risk (VaR was made famous by JP Morgan in the mid 1990s, by introducing the RiskMetrics approach, and hence, by far, has been sanctioned by several Governing Bodies throughout the world bank. In short, it measures the value of risk capital stocks in a given period at a certain probability of loss. This measurement can be modified for risk applications through, for example, the potential loss values affirmation in a certain amount of time during the economic life of the project- clearly, a project with a lower VaR is better. It should be noted that it is not always possible or advisable for a company to limit itself to the remote analysis of each risk because the risks and their effects are interdependent and constitute a system .In addition, there are risks which, in combination with other risks, tend to produce effects which they would not have caused by themselves and risks that tend to offset and even cancel each other out.

  7. Examination of Supplemental Driver Training and Online Basic Driver Education

    2012-06-01

    This report describes supplemental driver training programs and online basic driver education. It coves supplemental driver training that : focused on knowledge and skills beyond those normally found in traditional driver education delivered in the U...

  8. Online driver's license renewal.

    2015-09-01

    The Kentucky Department of Vehicle Regulation is exploring the possibility of developing and implementing online : drivers license renewal. The objective of this project was to: 1) evaluate online drivers license and REAL ID renewal : programs ...

  9. Identifying Children in Middle Childhood Who Are at Risk for Reading Problems.

    Speece, Deborah L; Ritchey, Kristen D; Silverman, Rebecca; Schatschneider, Christopher; Walker, Caroline Y; Andrusik, Katryna N

    2010-06-01

    The purpose of this study was to identify and evaluate a universal screening battery for reading that is appropriate for older elementary students in a response to intervention model. Multiple measures of reading and reading correlates were administered to 230 fourth-grade children. Teachers rated children's reading skills, academic competence, and attention. Children were classified as not-at-risk or at-risk readers based on a three-factor model reflecting reading comprehension, word recognition/decoding, and word fluency. Predictors of reading status included group-administered tests of reading comprehension, silent word reading fluency, and teacher ratings of reading problems. Inclusion of individually administered tests and growth estimates did not add substantial variance. The receiver-operator characteristic curve analysis yielded an area under the curve index of 0.90, suggesting this model may both accurately and efficiently screen older elementary students with reading problems.

  10. Coping strategies in individuals at risk and not at risk of mobile phone addiction

    Dziurzyńska Ewa

    2016-12-01

    Full Text Available The aim of the present study was to provide an answer to the question of whether, and what, differences in stress coping strategies could be found between university students at risk and those not at risk of mobile phone addiction. The study included 408 students aged 19 to 28 years. The following instruments were used: a sociodemographic questionnaire, the Mobile Phone Addiction Assessment Questionnaire (in Polish, Kwestionariusz do Badania Uzależnienia od Telefonu Komórkowego, KBUTK by Pawłowska and Potembska, and the Coping with Stress Questionnaire (SVF by Janke, Erdmann, and Boucsein, translated into Polish by Januszewska. The results of the study showed that individuals at risk of mobile phone addiction were more likely to cope with stress by seeking substitute gratification, reacting with resignation, passivity, dejection and hopelessness, blaming themselves, pitying themselves and looking for support. They also tended to ruminate over their suffering, withdraw from social interactions, react with aggression and/or take to drinking.

  11. Philippines: street children, children at risk.

    Tantoco, F G

    1993-01-01

    Almost 2 million of Manila's 2.5 million children younger than 15 years old live on or below the poverty line. 75,000 of these children live on the streets after having run away from home or being abandoned. They beg, steal, scavenge for food, and sell newspapers, cigarettes, and leis. About 20,000 of the street children prostitute themselves. It is these latter children and adolescents who are at particular risk of HIV infection. Studies in the Philippines indicate that 91% of reported HIV infections are among individuals aged 15-44, the male/female infection ratio is one to one, the transmission rate is 45%, and the most common mode of transmission is through heterosexual intercourse. The high incidence of child sexual abuse and child prostitution in the Philippines would suggest that there are a significant number of children and adolescents under age 15 who are infected with HIV. Caritas Manila has developed an information, education, and communication program for HIV/AIDS prevention focusing upon individuals who have direct influence upon and are in direct contact with people: clergy, religious and civic associations, educators, and social and health workers. Caritas has also to a limited extent reached out directly to populations at risk, while collaborating with human rights advocacy groups and networking with other children-oriented agencies in the interest of providing resources to street children. Efforts must be made to protect the rights of children and provide them with an environment conducive to their growth and development. The author notes how off-duty policemen in Manila help real estate developers forcibly eject the poor from their shelters to clear the way for the construction of new infrastructure without concern for the legal processes and requirements in the humane and peaceful relocation of the homeless poor. Many women and children are hurt and killed in the process. It has also been reported that off-duty policemen in Rio de Janeiro

  12. Comparing complete and partial classification for identifying customers at risk

    Bloemer, J.M.M.; Brijs, T.; Swinnen, S.P.; Vanhoof, K.

    2003-01-01

    This paper evaluates complete versus partial classification for the problem of identifying customers at risk. We define customers at risk as customers reporting overall satisfaction, but these customers also possess characteristics that are strongly associated with dissatisfied customers. This

  13. Development and Initial Validation of a Parent Report Measure of the Behavioral Development of Infants at Risk for Autism Spectrum Disorders

    Feldman, Maurice A.; Ward, Rebecca A.; Savona, Danielle; Regehr, Kaleigh; Parker, Kevin; Hudson, Melissa; Penning, Henderika; Holden, Jeanette J. A.

    2012-01-01

    We developed and evaluated a new parent report instrument--Parent Observation of Early Markers Scale (POEMS)--to monitor the behavioral development of infants at risk for autism spectrum disorder (ASD) because they have older affected siblings. Parents of 108 at-risk infants (74 males, 34 females) completed the POEMS from child age 1-24 months.…

  14. National Driver Register (NDR) -

    Department of Transportation — Information regarding individuals who have had their driver licenses revoked, suspended or otherwise denied for cause, or who have been convicted of certain traffic...

  15. Diagnostic tools for identifying sleepy drivers in the field.

    2013-05-06

    The overarching goal of this project was to identify and evaluate cognitive and behavioral indices that are sensitive to sleep : deprivation and may help identify commercial motor vehicle drivers (CMV) who are at-risk for driving in a sleep deprived ...

  16. Young novice drivers.

    2013-01-01

    In The Netherlands, young novice drivers (18-24 years of age) show a crash rate that is five times higher than that of experienced drivers (30-59 years of age). The rate of young males is even seven times as high. The main reasons are lack of driving experience and hazardous behaviour typical of

  17. Criteria for driver impairment

    Brookhuis, K.A.; De Waard, D.; Fairclough, S.H

    2003-01-01

    Most traffic accidents can be attributed to driver impairment, e.g. inattention, fatigue, intoxication, etc. It is now technically feasible to monitor and diagnose driver behaviour with respect to impairment with the aid of a limited number of in-vehicle sensors. However, a valid framework for the

  18. A Simple Wave Driver

    Temiz, Burak Kagan; Yavuz, Ahmet

    2015-01-01

    This study was done to develop a simple and inexpensive wave driver that can be used in experiments on string waves. The wave driver was made using a battery-operated toy car, and the apparatus can be used to produce string waves at a fixed frequency. The working principle of the apparatus is as follows: shortly after the car is turned on, the…

  19. Substance Use and Cognitive Function as Drivers of Condomless Anal Sex Among HIV-Positive Gay, Bisexual, and Other Men Who Have Sex with Men Aged 50 and Older: The Gold Studies.

    Kupprat, Sandra A; Krause, Kristen D; Ompad, Danielle C; Halkitis, Perry N

    2017-12-01

    Substance use has been linked to the sexual transmission of HIV among gay, bisexual, and other men who have sex with men (MSM) across the lifespan. Among older, HIV-positive, MSM populations, cognitive dysfunction associated with age and HIV disease progression also may play a role in sexual risk-taking. People aged 50 years and older represent a growing proportion of the overall HIV-positive population. This study aimed to explore relationships between substance use and cognitive function, and their impact on condomless anal sex (CAS) among HIV-positive gay, bisexual, and other MSM aged 50 years and older. Data from a cross-sectional study of HIV-positive MSM, aged 50 and older (N = 169) were gathered using a computer-assisted survey, researcher-administered behavioral and neurocognitive measures. More than 50% of the men used substances and had one or more cognitive impairments. However, only 25% were at higher risk for dementia (i.e., two or more cognitive impairments). Multivariable modeling indicated that use of alcohol to intoxication and date of HIV diagnosis were the strongest predictors of CAS in both a model that included dementia risk and a model that included impaired executive function risk. Current illicit substance use was a significant predictor of CAS only in the model that included dementia risk. Those with better cognitive and executive function had higher odds of CAS. However, only executive function was a significant cognitive predictor of CAS. Further research is needed to clarify the impact of cognitive function and substance use on sexual risk behaviors as these HIV-positive men achieve normal life expectancies, while continuing to use substances and engage in CAS. Furthermore, addiction treatment remains a critical need for this group even as they transition into later adulthood.

  20. Car drivers' perceptions of electronic stability control (ESC) systems.

    Vadeby, Anna; Wiklund, Mats; Forward, Sonja

    2011-05-01

    As a way to reduce the number of car crashes different in-car safety devices are being introduced. In this paper one such application is being investigated, namely the electronic stability control system (ESC). The study used a survey method, including 2000 private car drivers (1000 driving a car with ESC and 1000 driving a car without ESC). The main objective was to investigate the effect of ESC on driver behaviour. Results show that drivers report that they drive even more carelessly when they believe that they have ESC, than when they do not. Men are more risk prone than women and young drivers more than older drivers. Using the theory of planned behaviour the results show that attitude, subjective norm and perceived control explain between 62% and 67% of driver's variation of intentions to take risks. When descriptive norm was added to the model a small but statistically significant increase was found. The study also shows that more than 35% erroneously believe that their car is equipped with an ESC system. These findings may suggest that driver behaviour could reduce the positive effect ESC has on accidents. It also shows that drivers who purchase a new car are not well informed about what kind of safety devices the car is equipped with. These findings highlight the need for more targeted information to drivers. Copyright © 2010 Elsevier Ltd. All rights reserved.

  1. Reliability of drivers in urban intersections.

    Gstalter, Herbert; Fastenmeier, Wolfgang

    2010-01-01

    The concept of human reliability has been widely used in industrial settings by human factors experts to optimise the person-task fit. Reliability is estimated by the probability that a task will successfully be completed by personnel in a given stage of system operation. Human Reliability Analysis (HRA) is a technique used to calculate human error probabilities as the ratio of errors committed to the number of opportunities for that error. To transfer this notion to the measurement of car driver reliability the following components are necessary: a taxonomy of driving tasks, a definition of correct behaviour in each of these tasks, a list of errors as deviations from the correct actions and an adequate observation method to register errors and opportunities for these errors. Use of the SAFE-task analysis procedure recently made it possible to derive driver errors directly from the normative analysis of behavioural requirements. Driver reliability estimates could be used to compare groups of tasks (e.g. different types of intersections with their respective regulations) as well as groups of drivers' or individual drivers' aptitudes. This approach was tested in a field study with 62 drivers of different age groups. The subjects drove an instrumented car and had to complete an urban test route, the main features of which were 18 intersections representing six different driving tasks. The subjects were accompanied by two trained observers who recorded driver errors using standardized observation sheets. Results indicate that error indices often vary between both the age group of drivers and the type of driving task. The highest error indices occurred in the non-signalised intersection tasks and the roundabout, which exactly equals the corresponding ratings of task complexity from the SAFE analysis. A comparison of age groups clearly shows the disadvantage of older drivers, whose error indices in nearly all tasks are significantly higher than those of the other groups

  2. At-Risk Youth Appearance and Job Performance Evaluation

    Freeburg, Beth Winfrey; Workman, Jane E.

    2008-01-01

    The goal of this study was to identify the relationship of at-risk youth workplace appearance to other job performance criteria. Employers (n = 30; each employing from 1 to 17 youths) evaluated 178 at-risk high school youths who completed a paid summer employment experience. Appearance evaluations were significantly correlated with evaluations of…

  3. Value-at-risk estimation with fuzzy histograms

    Almeida, R.J.; Kaymak, U.

    2008-01-01

    Value at risk (VaR) is a measure for senior management that summarises the financial risk a company faces into one single number. In this paper, we consider the use of fuzzy histograms for quantifying the value-at-risk of a portfolio. It is shown that the use of fuzzy histograms provides a good

  4. Integrating Fine Arts Instruction with At Risk Students.

    Brieger, Charles; Kendall-Dudley, Lori; Sarmiento, Patty

    This report details a program design for improving fine arts instruction among at-risk students. The participants were in a second and third grade bilingual class and a first-through third-grade learning disabled and behavior disordered class in an at-risk elementary school along with a heterogeneous fourth-grade class in a neighboring Midwest…

  5. Mentoring At-Risk Students in a Remedial Mathematics Course

    Khazanov, Leonid

    2011-01-01

    A peer mentoring program has been implemented to support a group of at-risk students enrolled in two sections of an elementary algebra course at an urban community college. Peer mentors were recruited from advanced mathematics classes and trained to provide individualized tutoring and mentoring support to at-risk students. The results show that…

  6. Identifying populations at risk from environmental contamination from point sources

    Williams, F; Ogston, S

    2002-01-01

    Objectives: To compare methods for defining the population at risk from a point source of air pollution. A major challenge for environmental epidemiology lies in correctly identifying populations at risk from exposure to environmental pollutants. The complexity of today's environment makes it essential that the methods chosen are accurate and sensitive.

  7. Protection of Marine Fish Stocks at Risk of Extinction

    J.A. Musick; S.A. Berkeley; G.M. Cailliet; M. Camhi; G. Huntsman; M. Nammack; Melvin L. Warren

    2000-01-01

    The American Fisheries Society (AFS) recommends that registory agencies closely scrutinize both marine fish and invertebrate stocks that may be at risk of extinction and take remedial action before populations are threatened or endungered. Initial AFS analyses of marine stocks at risk in North America show at least four primary geographic "hot spots" with...

  8. Volume dose of organs at risk in the irradiated volume

    Hishikawa, Yoshio; Tanaka, Shinichi; Miura, Takashi

    1984-01-01

    Absorbed dose of organs at risk in the 50% irradiated volume needs to be carefully monitored because there is high risk of radiation injury. This paper reports on the histogram of threedimensional volume dose of organs at risk, which is obtained by computer calculation of CT scans. In order to obtain this histogram, CT is first performed in the irradiation field. The dose in each pixel is then examined by the computer as to each slice. After the pixels of all slices in the organ at risk of the irradiated field are classified according to the doses, the number of pixels in the same dose class is counted. The result is expressed in a histogram. The histogram can show the differences of influence to organs at risk given by various radiation treatment techniques. Total volume dose of organs at risk after radiotherapy can also be obtained by integration of each dose of different treatment techniques. (author)

  9. Driver alcohol involvement in fatal crashes by age group and vehicle type

    2006-07-01

    The data in this research note demonstrate that while the overall proportion of passenger vehicle drivers with alcohol in fatal crashes is lower in older age groups, the median blood : alcohol concentration (BAC) is generally higher for those age gro...

  10. Evaluating PROMIS Physical Function Measures in Older Adults at Risk for Alzheimer’s Disease

    Curtis Tatsuoka PhD

    2016-09-01

    Full Text Available Activities of daily living can be affected by cognitive decline. Self-report measurement of functioning is attractive due to ease of data collection, low cost, and accessibility via technology-assisted means, and for understanding patient perspective. A concern is with reliability of such measurement as cognitive decline occurs. We compared a widely used, self-report “legacy” measure of functioning, Lawton and Brody’s Instrumental Activities of Daily Living Scale (IADLS, with a subset of physical functioning items from the Patient-Reported Outcomes Measurement Information System (PROMIS. The study sample consisted of 304 individuals of varying cognitive status: normal, mild cognitive impairment (MCI, or early dementia. An expert consensus method was used to select PROMIS functional items most relevant to neurocognitive disorder and to identify major functional sub-domains. Selected PROMIS functional subscales and the IADLS were then evaluated with respect to cognitive status. Few PROMIS functional items were useful in identifying MCI, while we reaffirmed the utility of the IADLS. Also, even mild depression levels were found to have negative effects on functioning according to both PROMIS and IADLS.

  11. Driver behavior in traffic.

    2012-02-01

    Existing traffic analysis and management tools do not model the ability of drivers to recognize their environment and respond to it with behaviors that vary according to the encountered driving situation. The small body of literature on characterizin...

  12. General oilfield driver improvement

    Johnson, G.

    1997-01-01

    The general oilfield driver improvement (GODI) course was discussed. The course is offered to truckers in the oil and gas industry to help reduce accidents and injuries. Oilfield trucking is one of the most accident and injury prone sectors in the Alberta economy. This paper presented Heck's Trucking company's experience in sending its employees on the course. Drivers were taught (1) the National safety code requirements, (2) Commercial Vehicle Safety Alliance requirements, (3) occupational health and safety concerns, (4) vehicle dimension and GVW restrictions, (5) hours of service regulations, (6) log book and pre-trip inspection requirements, (7) workplace hazardous material information, and (8) transportation of dangerous goods. Overall, the course was judged to provide excellent training before sending drivers into the field. The employee, the customer, and the company, all stand to benefit from having rigorous and uniform standards for all drivers in the oil and gas industry

  13. Internet driver education study.

    2010-05-01

    Incorporating technology through online courses, including drivers education (DE), is the wave of the future for : learning. While many states allow online DE as an accepted method of learning, Wisconsin currently only allows it on a : limited bas...

  14. VD-411 branch driver

    Gorbunov, N.V.; Karev, A.G.; Mal'tsev, Eh.I.; Morozov, B.A.

    1985-01-01

    The VD-411 branch driver for CAMAC moduli control by the SM-4 computer is described. The driver realizes data exchange with moduli disposed in 28 crates grouped in 4 branches. Data exchange can be carried out either in the program regime or in the regime of direct access to the memory. Fulfilment of 11 block regimes and one program regime is provided for. A possibility of individual programming of exchange methods in block regimes is left for users for organisation of quicker and most flexible data removal from the CAMAC moduli. In the regime of direct access the driver provides data transmission at the size up to 64 Kwords placing it in the computer memory of 2 M byte. High rate of data transmission and the developed system of interruptions ensure efficient utilization of the VD-411 branch driver at data removal from facilities in high energy physics experiments

  15. Truck Drivers' Use of the Internet: A Mobile Health Lifeline.

    Heaton, Karen; Combs, Bryan; Griffin, Russell

    2017-06-01

    Because of their social isolation, irregular and unpredictable schedules, limited access to health care, and long periods of travel, long-haul truckers may benefit from the use of mobile health applications on Internet-capable devices. The purpose of this study was to determine Internet access and usage among a sample of long-haul truck drivers. In this cross-sectional study, truck drivers completed a pencil and paper survey with questions on demographics, work and health histories, and Internet access and usage for both personal and job reasons. A total of 106 truck drivers were recruited from trucking industry trade shows, by word of mouth, and directly from trucking companies. Overall, the truck drivers' use of the Internet was limited. Their usage for personal and job-related reasons differed. Social connectivity and access to health and wellness information were important during personal usage time. Job-related Internet use was highly practical, and applied to seeking information for directions and maps, fuel stops and pricing, and communicating with employers or transmitting documents. Age and experience were associated with Internet use. Younger, less-experienced drivers used the Internet more than older, experienced drivers. Targeted mobile health messaging may be a useful tool to inform truck drivers of health conditions and plans, and may provide links to primary care providers needing to monitor or notify drivers of diagnostic results or treatment plans.

  16. Acoustic Levitation With One Driver

    Wang, T. G.; Rudnick, I.; Elleman, D. D.; Stoneburner, J. D.

    1985-01-01

    Report discusses acoustic levitation in rectangular chamber using one driver mounted at corner. Placement of driver at corner enables it to couple effectively to acoustic modes along all three axes. Use of single driver reduces cost, complexity and weight of levitation system below those of three driver system.

  17. Characteristics of Chinese Driver Behavior

    Li, J.

    2014-01-01

    The high growth rate of vehicle ownership and many novel drivers in China determine the special features of Chinese driver behavior. This thesis introduces a comparative study on driver behavior by the analysis of saturation flow at urban intersections, Driver Behavior Questionnaire surveys, focus

  18. Prevention of pressure sores by identifying patients at risk.

    Andersen, K E; Jensen, O; Kvorning, S A; Bach, E

    1982-01-01

    The risk of pressure sores developing in patients admitted with acute conditions was assessed by a simple risk score system based on age, reduced mobility, incontinence, pronounced emaciation, redness over bony prominences, unconsciousness, dehydration, and paralysis in a prospective clinical study. During seven months in 1977, 600 of 3571 patients were classified as at risk. Of these 35 (5.8%) developed sores compared with five (0.2%) of those not at risk. The results of this study compared with those over the same period in 1976 show that close observation of at-risk patients and early detection of pressure sores prevents their development. PMID:6803980

  19. Tracking progress in teenage driver crash risk in the United States since the advent of graduated driver licensing programs.

    McCartt, Anne T; Teoh, Eric R

    2015-06-01

    This study examined U.S. teenagers' crash rates since 1996, when the first graduated driver licensing (GDL) program in the United State was implemented. Passenger vehicle driver crash involvement rates for 16-19 and 30-59 (middle-aged) year-olds were examined, using data from the Fatality Analysis Reporting System, National Automotive Sampling System General Estimates System, Census Bureau, and National Household Travel Surveys. Per capita fatal and police-reported crash rates in 2012 were lower for 16year-olds than for middle-aged drivers but older teenagers' rates were higher. Mileage-based fatal and police-reported crash rates in 2008 were higher for teenagers than for middle-aged drivers and higher for 16-17year-olds than for older teenagers. In 1996-2012, teenagers' per capita fatal and police-reported crash rates declined sharply, especially for 16-17year-olds, and more so than for middle-aged drivers. Substantial declines also occurred in teenagers' mileage-based fatal and police-reported crash rates from 1995-96 to 2008, generally more so than for middle-aged drivers. Regarding factors in fatal crashes in 1996 and 2012, proportions of young teenagers' crashes occurring at night and with multiple teenage passengers declined, more so than among older teenagers and middle-aged drivers. The proportion of fatally injured drivers who had been drinking declined for teenagers but changed little for middle-aged drivers. Improvements were not apparent in rates of driver errors or speeding among teenage drivers in fatal crashes. Teenage drivers' crash risk dropped during the period of implementation of GDL laws, especially fatal crash types targeted by GDL. However, teenagers' crash risk remains high, and important crash factors remain unaddressed by GDL. Although this study was not designed to examine the role of GDL, the results are consistent with the increased presence of such laws. More gains are achievable if states strengthen their laws. Copyright © 2015

  20. Validity and Usability of a Safe Driving Behavior Measure for Older Adults

    2012-10-15

    With the aging of the Baby Boomers and ensuing Gray Tsunami in Florida leading the USA, older : drivers who are unfit to drive must be identified. The gold standard on-road test is expensive, : sophisticated, not available to many older drivers, and ...

  1. Mobility and safety issues in drivers with dementia.

    Carr, David B; O'Neill, Desmond

    2015-10-01

    Although automobiles remain the mobility method of choice for older adults, late-life cognitive impairment and progressive dementia will eventually impair the ability to meet transport needs of many. There is, however, no commonly utilized method of assessing dementia severity in relation to driving, no consensus on the specific types of assessments that should be applied to older drivers with cognitive impairment, and no gold standard for determining driving fitness or approaching loss of mobility and subsequent counseling. Yet, clinicians are often called upon by patients, their families, health professionals, and driver licensing authorities to assess their patients' fitness-to-drive and to make recommendations about driving privileges. We summarize the literature on dementia and driving, discuss evidenced-based assessments of fitness-to-drive, and outline the important ethical and legal concerns. We address the role of physician assessment, referral to neuropsychology, functional screens, dementia severity tools, driving evaluation clinics, and driver licensing authority referrals that may assist clinicians with an evaluation. Finally, we discuss mobility counseling (e.g. exploration of transportation alternatives) since health professionals need to address this important issue for older adults who lose the ability to drive. The application of a comprehensive, interdisciplinary approach to the older driver with cognitive impairment will have the best opportunity to enhance our patients' social connectedness and quality of life, while meeting their psychological and medical needs and maintaining personal and public safety.

  2. Reducing casualties involving young drivers and riders in Europe.

    Atchison, L.

    2017-01-01

    Young drivers and riders aged 15-25 are more likely to be killed on Europe’s roads than their older counterparts, despite continued improvements in road safety. Road collisions remain one of the highest external causes of death for young people. The risks are especially high for young males and for

  3. Driver memory for in-vehicle visual and auditory messages

    1999-12-01

    Three experiments were conducted in a driving simulator to evaluate effects of in-vehicle message modality and message format on comprehension and memory for younger and older drivers. Visual icons and text messages were effective in terms of high co...

  4. J-Educators Must Deal with "A Nation at Risk."

    Craig, J. Robert

    1985-01-01

    Suggests that mass communication educators need to interpret the literacy called for in "A Nation at Risk" to include media literacy: responsible awareness of media effects, media criticism and ethics, nontraditional media technologies, and media issues and problems. (HTH)

  5. Value at Risk models for Energy Risk Management

    Novák, Martin

    2010-01-01

    The main focus of this thesis lies on description of Risk Management in context of Energy Trading. The paper will predominantly discuss Value at Risk and its modifications as a main overall indicator of Energy Risk.

  6. Anxiety in women "at risk' of developing breast cancer.

    Thirlaway, K.; Fallowfield, L.; Nunnerley, H.; Powles, T.

    1996-01-01

    Do family history clinics offering counselling, surveillance and preventative programmes alleviate or exacerbate anxiety in women at a high risk of developing breast cancer? In this study risk perceptions and anxiety of 99 'at risk' women participating in the Tamoxifen Prevention Trial were compared with those of 87 'at risk' women not attending any specialist clinic who were recruited from the National Breast Screening Programme (NBSP). Most anxiety was found in NBSP women with a family hist...

  7. Obstetrical complications in people at risk for developing schizophrenia

    Ballon, Jacob S; Seeber, Katherine; Cadenhead, Kristin S

    2007-01-01

    Many factors have been associated with the development of schizophrenia, yet few studies have looked at these same factors in individuals considered at risk for schizophrenia, but who have not yet reached diagnostic threshold. The rate of obstetrical complications was assessed as part of a comprehensive battery in subjects at risk (N=52), or in the first episode of schizophrenia (N=18), and in normal comparison subjects (N=43). The rate of obstetrical complications was increased in the at ris...

  8. The social values at risk from sea-level rise

    Graham, Sonia; Barnett, Jon; Fincher, Ruth; Hurlimann, Anna; Mortreux, Colette; Waters, Elissa

    2013-01-01

    Analysis of the risks of sea-level rise favours conventionally measured metrics such as the area of land that may be subsumed, the numbers of properties at risk, and the capital values of assets at risk. Despite this, it is clear that there exist many less material but no less important values at risk from sea-level rise. This paper re-theorises these multifarious social values at risk from sea-level rise, by explaining their diverse nature, and grounding them in the everyday practices of people living in coastal places. It is informed by a review and analysis of research on social values from within the fields of social impact assessment, human geography, psychology, decision analysis, and climate change adaptation. From this we propose that it is the ‘lived values’ of coastal places that are most at risk from sea-level rise. We then offer a framework that groups these lived values into five types: those that are physiological in nature, and those that relate to issues of security, belonging, esteem, and self-actualisation. This framework of lived values at risk from sea-level rise can guide empirical research investigating the social impacts of sea-level rise, as well as the impacts of actions to adapt to sea-level rise. It also offers a basis for identifying the distribution of related social outcomes across populations exposed to sea-level rise or sea-level rise policies

  9. The social values at risk from sea-level rise

    Graham, Sonia, E-mail: sonia.graham@unimelb.edu.au [Department of Resource Management and Geography, The University of Melbourne, 221 Bouverie St., Carlton, Victoria 3053 (Australia); Barnett, Jon, E-mail: jbarn@unimelb.edu.au [Department of Resource Management and Geography, The University of Melbourne, 221 Bouverie St., Carlton, Victoria 3053 (Australia); Fincher, Ruth, E-mail: r.fincher@unimelb.edu.au [Department of Resource Management and Geography, The University of Melbourne, 221 Bouverie St., Carlton, Victoria 3053 (Australia); Hurlimann, Anna, E-mail: anna.hurlimann@unimelb.edu.au [Faculty of Architecture, Building and Planning, The University of Melbourne, Architecture and Planning Building, Parkville, Victoria 3010 (Australia); Mortreux, Colette, E-mail: colettem@unimelb.edu.au [Department of Resource Management and Geography, The University of Melbourne, 221 Bouverie St., Carlton, Victoria 3053 (Australia); Waters, Elissa, E-mail: elissa.waters@unimelb.edu.au [Department of Resource Management and Geography, The University of Melbourne, 221 Bouverie St., Carlton, Victoria 3053 (Australia)

    2013-07-15

    Analysis of the risks of sea-level rise favours conventionally measured metrics such as the area of land that may be subsumed, the numbers of properties at risk, and the capital values of assets at risk. Despite this, it is clear that there exist many less material but no less important values at risk from sea-level rise. This paper re-theorises these multifarious social values at risk from sea-level rise, by explaining their diverse nature, and grounding them in the everyday practices of people living in coastal places. It is informed by a review and analysis of research on social values from within the fields of social impact assessment, human geography, psychology, decision analysis, and climate change adaptation. From this we propose that it is the ‘lived values’ of coastal places that are most at risk from sea-level rise. We then offer a framework that groups these lived values into five types: those that are physiological in nature, and those that relate to issues of security, belonging, esteem, and self-actualisation. This framework of lived values at risk from sea-level rise can guide empirical research investigating the social impacts of sea-level rise, as well as the impacts of actions to adapt to sea-level rise. It also offers a basis for identifying the distribution of related social outcomes across populations exposed to sea-level rise or sea-level rise policies.

  10. Space-Time Analysis to Identify Areas at Risk of Mortality from Cardiovascular Disease

    Poliany C. O. Rodrigues

    2015-01-01

    Full Text Available This study aimed at identifying areas that were at risk of mortality due to cardiovascular disease in residents aged 45 years or older of the cities of Cuiabá and Várzea Grande between 2009 and 2011. We conducted an ecological study of mortality rates related to cardiovascular disease. Mortality rates were calculated for each census tract by the Local Empirical Bayes estimator. High- and low-risk clusters were identified by retrospective space-time scans for each year using the Poisson probability model. We defined the year and month as the temporal analysis unit and the census tracts as the spatial analysis units adjusted by age and sex. The Mann-Whitney U test was used to compare the socioeconomic and environmental variables by risk classification. High-risk clusters showed higher income ratios than low-risk clusters, as did temperature range and atmospheric particulate matter. Low-risk clusters showed higher humidity than high-risk clusters. The Eastern region of Várzea Grande and the central region of Cuiabá were identified as areas at risk of mortality due to cardiovascular disease in individuals aged 45 years or older. High mortality risk was associated with socioeconomic and environmental factors. More high-risk clusters were observed at the end of the dry season.

  11. Objective Understanding of Front-of-Package Nutrition Labels among Nutritionally At-Risk Individuals.

    Ducrot, Pauline; Méjean, Caroline; Julia, Chantal; Kesse-Guyot, Emmanuelle; Touvier, Mathilde; Fezeu, Léopold K; Hercberg, Serge; Péneau, Sandrine

    2015-08-24

    In the ongoing debate about front-of-package (FOP) nutrition labels, little data exist regarding nutritionally at-risk populations, although they are critical targets of prevention programs. This study aimed to compare the impact of FOP labels on the ability to rank products according to their nutritional quality among French adults potentially at risk of poor dietary quality (N = 14,230). Four labels were evaluated: Guideline Daily Amounts (GDA), Multiple Traffic Lights (MTL), 5-Color Nutrition Label (5-CNL), Green Tick (Tick), along with a reference without label. Mixed models were used to assess how individual characteristics and FOP labels were associated with the ability to rank products. Older participants and those with a lower educational level, income, nutritional knowledge, and likelihood of reading nutrition facts were less skilled at ranking food products according to nutritional quality. Compared with individual characteristics, nutrition labels had an increased impact on food product ranking ability. Overall, 5-CNL corresponded to the highest rate of correct responses, followed by MTL, GDA, and Tick (p < 0.0001). The strongest impact of 5-CNL was observed among individuals with no nutritional knowledge (odds ratio (OR): 20.24; 95% confidence interval (CI): 13.19-31.06). Therefore, 5-CNL appeared to be effective at informing consumers, including those who are nutritionally at-risk, about the nutritional quality of food products.

  12. Objective Understanding of Front-of-Package Nutrition Labels among Nutritionally At-Risk Individuals

    Pauline Ducrot

    2015-08-01

    Full Text Available In the ongoing debate about front-of-package (FOP nutrition labels, little data exist regarding nutritionally at-risk populations, although they are critical targets of prevention programs. This study aimed to compare the impact of FOP labels on the ability to rank products according to their nutritional quality among French adults potentially at risk of poor dietary quality (N = 14,230. Four labels were evaluated: Guideline Daily Amounts (GDA, Multiple Traffic Lights (MTL, 5-Color Nutrition Label (5-CNL, Green Tick (Tick, along with a reference without label. Mixed models were used to assess how individual characteristics and FOP labels were associated with the ability to rank products. Older participants and those with a lower educational level, income, nutritional knowledge, and likelihood of reading nutrition facts were less skilled at ranking food products according to nutritional quality. Compared with individual characteristics, nutrition labels had an increased impact on food product ranking ability. Overall, 5-CNL corresponded to the highest rate of correct responses, followed by MTL, GDA, and Tick (p < 0.0001. The strongest impact of 5-CNL was observed among individuals with no nutritional knowledge (odds ratio (OR: 20.24; 95% confidence interval (CI: 13.19–31.06. Therefore, 5-CNL appeared to be effective at informing consumers, including those who are nutritionally at-risk, about the nutritional quality of food products.

  13. Schoolbus driver performance can be improved with driver training ...

    and compares the school transport driver performance with that of general motorists. Despite concerns that ... To compare Safe Travel to School Programme driver safety perfor- .... The SA government has recognised the challenges faced with.

  14. Anxiety in women "at risk' of developing breast cancer.

    Thirlaway, K.; Fallowfield, L.; Nunnerley, H.; Powles, T.

    1996-01-01

    Do family history clinics offering counselling, surveillance and preventative programmes alleviate or exacerbate anxiety in women at a high risk of developing breast cancer? In this study risk perceptions and anxiety of 99 'at risk' women participating in the Tamoxifen Prevention Trial were compared with those of 87 'at risk' women not attending any specialist clinic who were recruited from the National Breast Screening Programme (NBSP). Most anxiety was found in NBSP women with a family history. Women attending the family history clinic and participating in the trial had anxiety scores comparable with 86 women recruited from the NBSP who did not have a family history. We conclude that such specialist clinics do not see a selected group of the most anxious 'at risk' women nor does participation in tamoxifen prevention programmes appear to increase anxiety. PMID:8645590

  15. Estimating and mapping the population at risk of sleeping sickness.

    Pere P Simarro

    Full Text Available Human African trypanosomiasis (HAT, also known as sleeping sickness, persists as a public health problem in several sub-Saharan countries. Evidence-based, spatially explicit estimates of population at risk are needed to inform planning and implementation of field interventions, monitor disease trends, raise awareness and support advocacy. Comprehensive, geo-referenced epidemiological records from HAT-affected countries were combined with human population layers to map five categories of risk, ranging from "very high" to "very low," and to estimate the corresponding at-risk population.Approximately 70 million people distributed over a surface of 1.55 million km(2 are estimated to be at different levels of risk of contracting HAT. Trypanosoma brucei gambiense accounts for 82.2% of the population at risk, the remaining 17.8% being at risk of infection from T. b. rhodesiense. Twenty-one million people live in areas classified as moderate to very high risk, where more than 1 HAT case per 10,000 inhabitants per annum is reported.Updated estimates of the population at risk of sleeping sickness were made, based on quantitative information on the reported cases and the geographic distribution of human population. Due to substantial methodological differences, it is not possible to make direct comparisons with previous figures for at-risk population. By contrast, it will be possible to explore trends in the future. The presented maps of different HAT risk levels will help to develop site-specific strategies for control and surveillance, and to monitor progress achieved by ongoing efforts aimed at the elimination of sleeping sickness.

  16. SCALE system driver

    Petrie, L.M.

    1984-01-01

    The SCALE driver was designed to allow implementation of a modular code system consisting of control modules, which determine the calculation path, and functional modules, which perform the basic calculations. The user can either select a control module and have that module determine the execution path, or the user can select functional modules directly by input

  17. Simulators in driver training.

    2009-01-01

    In 2010, about 150 driving simulators were being used for the basic driver training in the Netherlands. According to theories about how people learn, simulator training has both advantages and disadvantages. In order to be able to learn something from a simulator, its technical quality must be

  18. Space Age Driver Education

    Gray, Walter W.

    1970-01-01

    Describes experimental Driver and Traffic Safety Education Center--a project involving a five-phase instructional program, a variety of teaching innovations, and a specially-constructed facility which includes a classroom building, multiple car driving range, simulators, communications equipment, and the most recent electronic teaching devices.…

  19. Beginning teenage drivers

    2010-01-01

    Teen drivers have the highest crash risk of any age group. Per mile traveled, they have the highest involvement rates in all types of crashes, from those involving only property damage to those that are fatal. The problem is worst among 16 year-olds,...

  20. GPS Usage in a Population of Low-Vision Drivers.

    Cucuras, Maria; Chun, Robert; Lee, Patrick; Jay, Walter M; Pusateri, Gregg

    2017-01-01

    We surveyed bioptic and non-bioptic low-vision drivers in Illinois, USA, to determine their usage of global positioning system (GPS) devices. Low-vision patients completed an IRB-approved phone survey regarding driving demographics and usage of GPS while driving. Participants were required to be active drivers with an Illinois driver's license, and met one of the following criteria: best-corrected visual acuity (BCVA) less than or equal to 20/40, central or significant peripheral visual field defects, or a combination of both. Of 27 low-vision drivers, 10 (37%) used GPS while driving. The average age for GPS users was 54.3 and for non-users was 77.6. All 10 drivers who used GPS while driving reported increased comfort or safety level. Since non-GPS users were significantly older than GPS users, it is likely that older participants would benefit from GPS technology training from their low-vision eye care professionals.

  1. Social Support and Personal Agency in At-Risk Mothers

    María José Rodrigo

    2011-04-01

    Full Text Available This study investigated: a mothers´ use and satisfaction with informal and formal supports in at-risk psychosocial contexts, and b the relationships between satisfaction with help and the mothers´ perception of their role (personal agency. Self-report data about the use and satisfaction with sources of help, and levels of internal control, self-efficacy, couple agreement, role difficulty and motivation for change were obtained from 519 mothers referred by Social Services and 519 non-referred mothers. Results indicated that at-risk mothers relied less upon close informal support and more on formal support than non atrisk mothers. They were also more satisfied with the formal sources of support and had lower levels of personal agency. There were beneficial effects of satisfaction with informal help and school support on several aspects of personal agency for both groups. However, satisfaction with school and social services support had a detrimental effect on couple agreement in the at-risk group. Implications of the results for providing social support to at-risk families are discussed.

  2. The Video Toaster Meets Science + English + At-Risk Students.

    Perryess, Charlie

    1992-01-01

    Describes an experimental Science-English class for at-risk students which was team taught and used technology--particularly a Video Toaster (a videotape editing machine)--as a motivator. Discusses procedures for turning videotape taken on field trips into three- to five-minute student productions on California's water crisis. (SR)

  3. Probabilistic fuzzy systems in value-at-risk estimation

    Almeida, R.J.; Kaymak, U.

    2009-01-01

    Value-at-risk (VaR) is a popular measure for quantifying the market risk that a financial institution faces into a single number. Owing to the complexity of financial markets, the risks associated with a portfolio varies over time. Consequently, advanced methods of VaR estimation use parametric

  4. Linguistic Intervention Techniques for At-Risk English Language Learners

    Schneider, Elke; Evers, Tsila

    2009-01-01

    In U.S. public schools, the population of nonnative speakers of English who are at risk for failing language requirements is growing. This article presents multisensory structured language (MSL) teaching strategies to remediate these students' difficulties in reading, writing, and speaking English. These strategies are underscored by recent…

  5. Credit Rationing Effects of Credit Value-at-Risk

    J.F. Slijkerman; D.J.C. Smant (David); C.G. de Vries (Casper)

    2004-01-01

    textabstractBanks provide risky loans to firms which have superior information regarding the quality of their projects. Due to asymmetric information the banks face the risk of adverse selection. Credit Value-at-Risk (CVaR) regulation counters the problem of low quality, i.e. high risk, loans and

  6. Gun Safety Management with Patients at Risk for Suicide

    Simon, Robert I.

    2007-01-01

    Guns in the home are associated with a five-fold increase in suicide. All patients at risk for suicide must be asked if guns are available at home or easily accessible elsewhere, or if they have intent to buy or purchase a gun. Gun safety management requires a collaborative team approach including the clinician, patient, and designated person…

  7. Forecasting Value-at-Risk for Crude-Oil Exposures

    Høg, Esben; Tsiaras, Leonidas

    2009-01-01

    The purpose of this paper is to forecast and evaluate Value-At-Risk for crude-oil exposures. We examine the performance of a GARCH-type based model with lagged implied volatility entering the variance equation as explanatory variable for the predicted variance. The forecasted Values-at...

  8. Students "At Risk": Stereotypes and the Schooling of Black Boys

    James, Carl E.

    2012-01-01

    This article examines how stereotypes operate in the social construction of African Canadian males as "at risk" students. Cultural analysis and critical race theory are used to explain how the stereotypes of the youth as immigrant, fatherless, troublemaker, athlete, and underachiever contribute to their racialization and marginalization…

  9. Predictors of Maternal Sensitivity in At-Risk Families

    Neuhauser, Alex

    2018-01-01

    Maternal sensitivity is of central importance to a child's healthy development. This study examines how different types of psychosocial stress originating from the child, the parents, the context, and overall stress relate to maternal sensitivity. Psychosocial stress and its impact on maternal sensitivity are assessed in an at-risk sample of 248…

  10. Reading Fluency Instruction for Students at Risk for Reading Failure

    Ring, Jeremiah J.; Barefoot, Lexie C.; Avrit, Karen J.; Brown, Sasha A.; Black, Jeffrey L.

    2013-01-01

    The important role of reading fluency in the comprehension and motivation of readers is well documented. Two reading rate intervention programs were compared in a cluster-randomized clinical trial of students who were considered at-risk for reading failure. One program focused instruction at the word level; the second program focused instruction…

  11. Integrating Technology into the Curriculum for "At-Risk" Youth

    McCall, Denise

    2009-01-01

    This Independent Learning Project (ILP) discusses the best practices in educational technology to improve the behavior, instruction, and learning of at-risk youth, for whom technology offers unique opportunities. Research is compiled from numerous scholarly print and online sources. A guide for teachers provides detailed strategies, software…

  12. Collaborating To Enhance Resilience in Rural At-Risk Students.

    Finley, Mary K.

    This paper links areas of research with implications for community prevention strategies aimed at high-risk children. Collaborative efforts to reduce the number of at-risk children in rural communities can be advanced by merging knowledge from the following areas: (1) the causal pathways leading to substance abuse and identification of risk…

  13. Event-based historical value-at-risk

    Hogenboom, F.P.; Winter, Michael; Hogenboom, A.C.; Jansen, Milan; Frasincar, F.; Kaymak, U.

    2012-01-01

    Value-at-Risk (VaR) is an important tool to assess portfolio risk. When calculating VaR based on historical stock return data, we hypothesize that this historical data is sensitive to outliers caused by news events in the sampled period. In this paper, we research whether the VaR accuracy can be

  14. Women at Risk of Physical Intimate Partner Violence: A ...

    Intimate Partner Violence (IPV) is prevalent in Nigeria but a culture of silence exists, making it difficult to identify women at risk. A descriptive cross-sectional survey was employed to determine the prevalence and predictors of physical IPV in a low income, high density community in south west Nigeria. Among 924 interviews ...

  15. Optimal portfolio selection for cashflows with bounded capital at risk

    Vyncke, D.; Goovaerts, M.J.; Dhaene, J.L.M.; Vanduffel, S.

    2005-01-01

    We consider a continuous-time Markowitz type portfolio problem that consists of minimizing the discounted cost of a given cash-fl ow under the constraint of a restricted Capital at Risk. In a Black-Scholes setting, upper and lower bounds are obtained by means of simple analytical expressions that

  16. Decomposing Portfolio Value-at-Risk: A General

    W.G.P.M. Hallerbach (Winfried)

    1999-01-01

    textabstractAn intensive and still growing body of research focuses on estimating a portfolio’s Value-at-Risk. Depending on both the degree of non-linearity of the instruments comprised in the portfolio and the willingness to make restrictive assumptions on the underlying statistical distributions,

  17. Value at risk, bank equity and credit risk

    Broll, Udo; Wahl, Jack E.

    2003-01-01

    We study the implications of the value at risk concept for the bank's optimum amount of equity capital under credit risk. The market value of loans is risky and lognormally distributed. We show that the required equity capital depends upon managerial and market factors. Furthermore, the bank's equity and asset/liability management has to be addressed simultaneously by bank managers.

  18. Forecasting Value-at-Risk Under Temporal and Portfolio Aggregation

    H.J.W.G. Kole (Erik); T.D. Markwat (Thijs); A. Opschoor (Anne); D.J.C. van Dijk (Dick)

    2016-01-01

    textabstractWe examine the impact of temporal and portfolio aggregation on the quality of Value-at-Risk (VaR) forecasts over a horizon of ten trading days for a well-diversified portfolio of stocks, bonds and alternative investments. The VaR forecasts are constructed based on daily, weekly or

  19. Educators and Programs Reaching Out to At-Risk Youth.

    Lee, M. Linda

    1990-01-01

    Presents examples of how using technology can help raise self-esteem and improve academic performance for students who are identified as being at-risk. Topics discussed include the use of computer labs, filmstrips, and videos to strengthen academic skills, and to deal with such social issues as drop-outs, alcoholism, pregnancy, and suicide. Two…

  20. Congenital syphilis - who is at risk? | Venter | South African Medical ...

    The prevalence of syphilis (or positive serology) in pregnant mothers delivering at Baragwanath Hospital, Johannesburg, was assessed in order to try to establish the prevalence of congenital syphilis and possibly to identify a specific population at risk. From August 1985 to January 1986 all mothers admitted to the major ...

  1. Suicide Interventions Targeted toward At-Risk Youth

    Langhinrichsen-Rohling, Jennifer; Lamis, Dorian A.; McCullars, Adrianne

    2012-01-01

    Suicide is currently the third leading cause of death among youth; it has been named a public health concern. A number of programs have been developed to prevent suicide; many of these involve intervening with youth who are known to be at-risk because of their depression, expressed suicide ideation, or previous suicide attempts. This paper serves…

  2. Empowering At-Risk Students through Appreciative Inquiry

    San Martin, Teresa L.; Calabrese, Raymond L.

    2011-01-01

    Purpose: The purpose of this study is to identify how at-risk high school students in an alternative school describe how they best learn and to extrapolate their preferred learning practices to improve teacher pedagogical practices. Design/methodology/approach: The authors used a qualitative case study design to facilitate the first two stages of…

  3. Do the designated drivers of college students stay sober?

    Timmerman, Mary Ann; Geller, E Scott; Glindemann, Kent E; Fournier, Angela K

    2003-01-01

    By numerous accounts, alcohol abuse is considered the number one drug problem facing young people today. Alcohol consumption and its negative consequences, especially those due to drinking and driving, continue to have devastating effects on the college student population. This field study examined the blood alcohol concentration (BAC) levels of male and female designated drivers (DD), non-DD, and their respective passengers as they were leaving drinking establishments in a university town. Also investigated were the effects of group size and gender on DD use. A 2 Gender x 2 Driver type (DD vs. non-DD) analysis of variance (ANOVA) for BAC indicated significant main effects for Gender and Driver type, with higher BAC for men and non-DD (p'shome with a male DD may still be at risk for the negative consequences of drunk driving.

  4. Negativity Bias in Dangerous Drivers.

    Jing Chai

    Full Text Available The behavioral and cognitive characteristics of dangerous drivers differ significantly from those of safe drivers. However, differences in emotional information processing have seldom been investigated. Previous studies have revealed that drivers with higher anger/anxiety trait scores are more likely to be involved in crashes and that individuals with higher anger traits exhibit stronger negativity biases when processing emotions compared with control groups. However, researchers have not explored the relationship between emotional information processing and driving behavior. In this study, we examined the emotional information processing differences between dangerous drivers and safe drivers. Thirty-eight non-professional drivers were divided into two groups according to the penalty points that they had accrued for traffic violations: 15 drivers with 6 or more points were included in the dangerous driver group, and 23 drivers with 3 or fewer points were included in the safe driver group. The emotional Stroop task was used to measure negativity biases, and both behavioral and electroencephalograph data were recorded. The behavioral results revealed stronger negativity biases in the dangerous drivers than in the safe drivers. The bias score was correlated with self-reported dangerous driving behavior. Drivers with strong negativity biases reported having been involved in mores crashes compared with the less-biased drivers. The event-related potentials (ERPs revealed that the dangerous drivers exhibited reduced P3 components when responding to negative stimuli, suggesting decreased inhibitory control of information that is task-irrelevant but emotionally salient. The influence of negativity bias provides one possible explanation of the effects of individual differences on dangerous driving behavior and traffic crashes.

  5. Adolescents at risk of psychosis: a comparison of the "At risk mental state" and Multiple Complex Developmental Disorder

    Sprong, M.

    2008-01-01

    Comparing vulnerability markers for psychosis in different high-risk populations will ultimately lead to more insight into the causes of the syndrome and a more accurate identification of at-risk individuals. This dissertation concentrated on the comparison of two groups of adolescents that are at

  6. Automobile Driver Fingerprinting

    Enev Miro

    2016-01-01

    Full Text Available Today’s automobiles leverage powerful sensors and embedded computers to optimize efficiency, safety, and driver engagement. However the complexity of possible inferences using in-car sensor data is not well understood. While we do not know of attempts by automotive manufacturers or makers of after-market components (like insurance dongles to violate privacy, a key question we ask is: could they (or their collection and later accidental leaks of data violate a driver’s privacy? In the present study, we experimentally investigate the potential to identify individuals using sensor data snippets of their natural driving behavior. More specifically we record the in-vehicle sensor data on the controllerarea- network (CAN of a typical modern vehicle (popular 2009 sedan as each of 15 participants (a performed a series of maneuvers in an isolated parking lot, and (b drove the vehicle in traffic along a defined ~ 50 mile loop through the Seattle metropolitan area. We then split the data into training and testing sets, train an ensemble of classifiers, and evaluate identification accuracy of test data queries by looking at the highest voted candidate when considering all possible one-vs-one comparisons. Our results indicate that, at least among small sets, drivers are indeed distinguishable using only incar sensors. In particular, we find that it is possible to differentiate our 15 drivers with 100% accuracy when training with all of the available sensors using 90% of driving data from each person. Furthermore, it is possible to reach high identification rates using less than 8 minutes of training data. When more training data is available it is possible to reach very high identification using only a single sensor (e.g., the brake pedal. As an extension, we also demonstrate the feasibility of performing driver identification across multiple days of data collection

  7. Driver feedback mobile APP

    Soriguera Marti, F.; Miralles Miquel, E.

    2016-07-01

    This paper faces the human factor in driving and its consequences for road safety. It presents the concepts behind the development of a smartphone app capable of evaluating drivers’ performance. The app provides feedback to the driver in terms of a grade (between 0 and 10) depending on the aggressiveness and risks taken while driving. These are computed from the cumulative probability distribution function of the jerks (i.e. the time derivative of acceleration), which are measured using the smartphones’ accelerometer. Different driving contexts (e.g. urban, freeway, congestion, etc.) are identified applying cluster analysis to the measurements, and treated independently. Using regression analysis, the aggressiveness indicator is related to the drivers' safety records and to the probability of having an accident, through the standard DBQ - Driving Behavior Questionnaire. Results from a very limited pilot test show a strong correlation between the 99th percentile of the jerk measurements and the DBQ results. A linear model is fitted. This allows quantifying the safe driving behavior only from smartphone measurements. Finally, this indicator is translated into a normalized grade and feedback to the driver. This feedback will challenge the driver to train and to improve his performance. The phone will be blocked while driving and will incorporate mechanisms to prevent bad practices, like competition in aggressive driving. The app is intended to contribute to the improvement of road safety, one of the major public health problems, by tackling the human factor which is the trigger of the vast majority of traffic accidents. Making explicit and quantifying risky behaviors is the first step towards a safer driving. (Author)

  8. Consistency between subjectively and objectively measured hazard perception skills among young male drivers

    Abele, Liva; Haustein, Sonja; Møller, Mette

    2018-01-01

    . Subjective measures of HPS include self-reports derived based on the Hazard Perception Questionnaire (HPQ), Driving Skill Questionnaire (DSQ), and Brief Sensation Seeking Scale (BSSS). Results show that drivers who respond to the hazards on time, as compared to drivers who do not respond, have higher scores......Young male drivers have lower hazard perception skills (HPS) than older and more experienced drivers and a tendency to overestimate their skills in hazardous situations. Both factors contribute to an over-representation in traffic accidents. Based on a sample of 63 drivers aged 18-24, this study...... negatively when the hazard is visible. To enhance the HPS among young drivers, the results of this study suggest that specific hazard perception training is relevant, especially for hazards that require more advanced HPS....

  9. Education and driver-training

    Andrej Justinek

    1999-12-01

    Full Text Available The characteristics of the driver are manifested in his/her behaviour. For safe driving one must have a driver's knowledge. The contents of educational material are determined by law, and are both theoretical and practical, yet frequently they do not suffice to meet the requirements of safe driving. In this paper, the author suggests that, in the training of drivers, more educational elements should be included, such a would have  an effective influence on the driver's moti ves and attitudes. The driver's motives - which may result in incorrect driving­ are diverse: most often, the default is overspeeding, even though the drivers always over-estimate the potential time gain. In fact, over-fast driving is a way of satisfying other, different needs; and, above all, it is a form of compensation for unsettled life problems, and at the same time an indication of the driver's personal inability to cope with stress.

  10. Driver distraction by smartphone use (WhatsApp) in different age groups.

    Ortiz, C; Ortiz-Peregrina, S; Castro, J J; Casares-López, M; Salas, C

    2018-08-01

    This paper investigates the effect that texting with WhatsApp, one of the most common applications for instant messaging, exerts on driving performance. Because distracted driving also affects older drivers, who can have seriously compromised vision, we also analysed the associations between visual-function parameters and driving performance. A total of 75 drivers, experienced in sending WhatsApp messages (≥10WhatsApp messages/week), participated in this study and were divided into four age categories. Visual-function tests included contrast sensitivity with and without glare, retinal straylight and objective assessment of optical quality. Simulated driving performance was assessed under a baseline driving condition (without distraction) as well as a texting condition (WhatsApp messages) while driving. The participants used their own mobile phone. Lastly, objective results of driving performance were compared with subjective self-report data from the Driver Behaviour Questionnaire (DBQ). The analysis indicated that functional changes occurring with age, such as a lower contrast sensitivity and greater retinal straylight, were correlated with a higher number of collisions, longer distances driven outside the lane, and greater standard deviation of lateral position (SDLP). The results showed a significant main effect of age for the driving-performance parameters. Also, compared to the baseline, texting WhatsApp messages while driving worsens driving performance for all age groups, most notably among older participants. Thus, the older drivers' SDLP was ∼14% higher than that for the baseline average of all the other drivers and rose to 29% under distraction, reflecting the impact of secondary tasks. The negative effect of the use of the smartphone during driving was also reflected in the number of collisions, with a greater risk of accidents in all the groups of drivers (by 8.3% for young adults, 25.0% for adults, 80.5% for middle-aged adults, and 134.5% for older

  11. Changes in At-Risk American Men’s Crime and Substance Use Trajectories Following Fatherhood

    Kerr, David C. R.; Capaldi, Deborah M.; Owen, Lee D.; Wiesner, Margit; Pears, Katherine C.

    2011-01-01

    Fatherhood can be a turning point in development and in men’s crime and substance use trajectories. At-risk boys (N = 206) were assessed annually from ages 12 to 31 years. Crime, arrest, and tobacco, alcohol, and marijuana use trajectories were examined. Marriage was associated with lower levels of crime and less frequent substance use. Following the birth of a first biological child, men’s crime trajectories showed slope decreases, and tobacco and alcohol use trajectories showed level decreases. The older men were when they became fathers, the greater the level decreases were in crime and alcohol use and the less the slope decreases were in tobacco and marijuana use. Patterns are consistent with theories of social control and social timetables. PMID:21984846

  12. Are professional drivers less sleepy than non-professional drivers?

    Anund, Anna; Ahlström, Christer; Fors, Carina; Åkerstedt, Torbjörn

    2018-01-01

    Objective It is generally believed that professional drivers can manage quite severe fatigue before routine driving performance is affected. In addition, there are results indicating that professional drivers can adapt to prolonged night shifts and may be able to learn to drive without decreased performance under high levels of sleepiness. However, very little research has been conducted to compare professionals and non-professionals when controlling for time driven and time of day. Method The aim of this study was to use a driving simulator to investigate whether professional drivers are more resistant to sleep deprivation than non-professional drivers. Differences in the development of sleepiness (self-reported, physiological and behavioral) during driving was investigated in 11 young professional and 15 non-professional drivers. Results Professional drivers self-reported significantly lower sleepiness while driving a simulator than non-professional drivers. In contradiction, they showed longer blink durations and more line crossings, both of which are indicators of sleepiness. They also drove faster. The reason for the discrepancy in the relation between the different sleepiness indicators for the two groups could be due to more experience to sleepiness among the professional drivers or possibly to the faster speed, which might unconsciously have been used by the professionals to try to counteract sleepiness. Conclusion Professional drivers self-reported significantly lower sleepiness while driving a simulator than non-professional drivers. However, they showed longer blink durations and more line crossings, both of which are indicators of sleepiness, and they drove faster.

  13. Psychic pathology of anthropogenic accidents at risk enterprises

    Pukhovskij, N.N.

    1993-01-01

    The literary data on the clinic and pathogenesis distinctions of traumatic and posttraumatic stress following the accidents are analyzed. The inner contradictory character of the Chernobyl NPP operators reaction to psychodraumatic situation is revealed. A number of concepts liable to discussion is given: inner contradiction of the reactions to traumatic stress on account of accidents at risk cuterprises puts forward the way for psychology evolution in process, besides, posttraumatic stress may be considered as one of the stages of such evolution; the misuse of spirits by the persons with traumatic stress appeared on account of accidents at risk enterprises puts forward the way for the subsequent evolution towards psychic degeneration; the prevailing effect of the reality denial among the personnel of the risk enterprises may form a muthcreative attitude to technical sphere and play a certain role in the emergence of anthropogenic accidents at these enterprises. 22 refs

  14. Reaching and Supporting At-Risk Community Based Seniors: Results of a Multi-church Partnership.

    Ellis, Julie L; Morzinski, Jeffrey A

    2018-04-26

    The purpose of this study was to determine the impact of a nurse-led, church-based educational support group for "at-risk," older African Americans on hospitalization and emergency department use. Study nurses enrolled 81 "at-risk" older adult members of ten churches. Participants completed a trifold pamphlet identifying personal health information and support, and they attended eight monthly educational/support group sessions in their church during the 10-month intervention. Study nurses completed a risk assessment interview with each senior both pre- and post-participation. The study nurse completed post-program assessments with 64 seniors, a 79% retention rate. At the program's conclusion researchers conducted a focus group with the study RNs and used an anonymous written survey to gather participant appraisals of program elements. Neither hospitalization nor emergency department/urgent care usage was significantly different from pre- to post-program. Session attendance was moderate to high and over half of the seniors brought a family member or friend to one or more sessions. The majority of seniors initiated positive health changes (e.g., smoking cessation, weight loss, or diet changes). Participants expressed high satisfaction and expressed satisfaction to perceive that they were supporting other seniors in their community. We conclude that this intervention was successful in engaging and motivating seniors to initiate health behavior change and contributed to a health-supportive church-based community. To demonstrate a statistically significant difference in hospital and ED usage, however, a stronger intervention or a larger sample size is needed.

  15. Fetal alcohol-spectrum disorders: identifying at-risk mothers

    Montag AC

    2016-07-01

    Full Text Available Annika C Montag Department of Pediatrics, Division of Dysmorphology and Teratology, University of California San Diego, San Diego, CA, USA Abstract: Fetal alcohol-spectrum disorders (FASDs are a collection of physical and neuro­behavioral disabilities caused by prenatal exposure to alcohol. To prevent or mitigate the costly effects of FASD, we must identify mothers at risk for having a child with FASD, so that we may reach them with interventions. Identifying mothers at risk is beneficial at all time points, whether prior to pregnancy, during pregnancy, or following the birth of the child. In this review, three approaches to identifying mothers at risk are explored: using characteristics of the mother and her pregnancy, using laboratory biomarkers, and using self-report assessment of alcohol-consumption risk. At present, all approaches have serious limitations. Research is needed to improve the sensitivity and specificity of biomarkers and screening instruments, and to link them to outcomes as opposed to exposure. Universal self-report screening of all women of childbearing potential should ideally be incorporated into routine obstetric and gynecologic care, followed by brief interventions, including education and personalized feedback for all who consume alcohol, and referral to treatment as indicated. Effective biomarkers or combinations of biomarkers may be used during pregnancy and at birth to determine maternal and fetal alcohol exposure. The combination of self-report and biomarker screening may help identify a greater proportion of women at risk for having a child with FASD, allowing them to access information and treatment, and empowering them to make decisions that benefit their children. Keywords: fetal alcohol-spectrum disorder (FASD, alcohol, pregnancy, screening, biomarkers, SBIRT

  16. The Dataset of Countries at Risk of Electoral Violence

    Birch, Sarah; Muchlinski, David

    2017-01-01

    Electoral violence is increasingly affecting elections around the world, yet researchers have been limited by a paucity of granular data on this phenomenon. This paper introduces and describes a new dataset of electoral violence – the Dataset of Countries at Risk of Electoral Violence (CREV) – that provides measures of 10 different types of electoral violence across 642 elections held around the globe between 1995 and 2013. The paper provides a detailed account of how and why the dataset was ...

  17. Quantile uncertainty and value-at-risk model risk.

    Alexander, Carol; Sarabia, José María

    2012-08-01

    This article develops a methodology for quantifying model risk in quantile risk estimates. The application of quantile estimates to risk assessment has become common practice in many disciplines, including hydrology, climate change, statistical process control, insurance and actuarial science, and the uncertainty surrounding these estimates has long been recognized. Our work is particularly important in finance, where quantile estimates (called Value-at-Risk) have been the cornerstone of banking risk management since the mid 1980s. A recent amendment to the Basel II Accord recommends additional market risk capital to cover all sources of "model risk" in the estimation of these quantiles. We provide a novel and elegant framework whereby quantile estimates are adjusted for model risk, relative to a benchmark which represents the state of knowledge of the authority that is responsible for model risk. A simulation experiment in which the degree of model risk is controlled illustrates how to quantify Value-at-Risk model risk and compute the required regulatory capital add-on for banks. An empirical example based on real data shows how the methodology can be put into practice, using only two time series (daily Value-at-Risk and daily profit and loss) from a large bank. We conclude with a discussion of potential applications to nonfinancial risks. © 2012 Society for Risk Analysis.

  18. Value at Risk on Composite Price Share Index Stock Data

    Oktaviarina, A.

    2018-01-01

    The financial servicest authority was declared Let’s Save Campaign on n commemoration of the World Savings Day that falls on this day, October 31, 2016. The activity was greeted enthusiastically by Indonesia Stock Exchange by taking out the slogan Let’s Save The Stocks. Stock is a form of investment that is expected to benefit in the future despite has risks. Value at Risk (VaR) is a method that can measure how much the risk of a financial investment. Composite Stock Price Indeks is the stock price index used by Indonesia Stock Exchange as stock volatility benchmarks in Indonesia. This study aimed to estimate Value at Risk (VaR) on closing price Composite Price Share Index Stock data on the period 20 September 2016 until 20 September 2017. Box-Pierce test results p value=0.9528 which is greater than a, that shows homoskedasticity. Value at Risk (VaR) with Variance Covariance Method is Rp.3.054.916,07 which means with 99% confindence interval someone who invests Rp.100.000.000,00 will get Rp.3.054.916,07 as a maximum loss.

  19. Neural Correlates of Cognitive Intervention in Persons at Risk of Developing Alzheimer’s disease

    SM Hadi eHosseini

    2014-08-01

    Full Text Available Cognitive training is an emergent approach that has begun to receive increased attention in recent years as a non-pharmacological, cost-effective intervention for Alzheimer’s disease (AD. There has been increasing behavioral evidence regarding training-related improvement in cognitive performance in early stages of AD. Although these studies provide important insight about the efficacy of cognitive training, neuroimaging studies are crucial to pinpoint changes in brain structure and function associated with training and to examine their overlap with pathology in AD. In this study, we reviewed the existing neuroimaging studies on cognitive training in persons at risk of developing AD to provide an overview of the overlap between neural networks rehabilitated by the current training methods and those affected in AD. The data suggest a consistent training-related increase in brain activity in medial temporal, prefrontal, and posterior default mode networks, as well as increase in gray matter structure in frontoparietal and entorhinal regions. This pattern differs from the observed pattern in healthy older adults that shows a combination of increased and decreased activity in response to training. Detailed investigation of the data suggests that training in persons at risk of developing AD mainly improves compensatory mechanisms and partly restores the affected functions. While current neuroimaging studies are quite helpful in identifying the mechanisms underlying cognitive training, the data calls for future multi-modal neuroimaging studies with focus on multi-domain cognitive training, network level connectivity, and individual differences in response to training.

  20. Neural correlates of cognitive intervention in persons at risk of developing Alzheimer’s disease

    Hosseini, S. M. Hadi; Kramer, Joel H.; Kesler, Shelli R.

    2014-01-01

    Cognitive training is an emergent approach that has begun to receive increased attention in recent years as a non-pharmacological, cost-effective intervention for Alzheimer’s disease (AD). There has been increasing behavioral evidence regarding training-related improvement in cognitive performance in early stages of AD. Although these studies provide important insight about the efficacy of cognitive training, neuroimaging studies are crucial to pinpoint changes in brain structure and function associated with training and to examine their overlap with pathology in AD. In this study, we reviewed the existing neuroimaging studies on cognitive training in persons at risk of developing AD to provide an overview of the overlap between neural networks rehabilitated by the current training methods and those affected in AD. The data suggest a consistent training-related increase in brain activity in medial temporal, prefrontal, and posterior default mode networks, as well as increase in gray matter structure in frontoparietal and entorhinal regions. This pattern differs from the observed pattern in healthy older adults that shows a combination of increased and decreased activity in response to training. Detailed investigation of the data suggests that training in persons at risk of developing AD mainly improves compensatory mechanisms and partly restores the affected functions. While current neuroimaging studies are quite helpful in identifying the mechanisms underlying cognitive training, the data calls for future multi-modal neuroimaging studies with focus on multi-domain cognitive training, network level connectivity, and individual differences in response to training. PMID:25206335

  1. What's different about older people.

    Crome, Peter

    2003-10-01

    Older people can be regarded as a marginalised group within society from a number of perspectives including that of health. When it comes to the use of medication older people have suffered from a double whammy. Not only are they more at risk from the adverse effects of drugs but also their involvement in clinical trials has been limited so that rational prescribing both to maximise benefit and to reduce risk has been problematic. Their special problems have been recognised formerly by the Department of Health in its NSF for Older People [National Service Framework for Older People. Department of Health, London (2001a)], [Medicines and Older People. Implementing medicines-related aspects of the NSF for Older People. Department of Health (2001b)]. Early studies focussed on compliance, the avoidance of poly-pharmacy and the high prevalence of adverse effects of drugs and the reasons for this. Studies in long-stay patients showed dramatic differences in pharmacokinetics between such older people and young healthy volunteers. Initially such differences were ascribed to age alone and the overall message became "start low and go slow". Studies in healthy older people then revealed that age differences in drug metabolism were, as a rule, not so marked although clearance of renally excreted drugs was reduced in line with the age associated decline in renal function. Including older people in clinical trials poses challenges. Many traditional trialists do not have ready access to older people, co-morbidity and poly-pharmacy are common and most people feel reluctant to ask older people to take part in complex and potentially hazardous trials. Concern about compliance is unwarranted. Adverse events may be more serious. Thus in a younger patient postural hypotension may make a subject unsteady but in an older subject the unsteadiness may lead to a fall, the fall to a fracture, and the fracture to poor recovery. The choice of end-points is crucial. Although reduction of

  2. The reaction times of drivers aged 20 to 80 during a divided attention driving.

    Svetina, Matija

    2016-11-16

    Many studies addressing age-related changes in driving performance focus on comparing young vs. older drivers, which might lead to the biased conclusion that driving performance decreases only after the age of 65. The main aim of the study was to show that changes in driving performance are progressive throughout the adult years. A sample of 351 drivers aged 20 to 80 was assessed for their reaction times while driving between road cones. The drivers were exposed to 2 conditions varying according to task complexity. In single task conditions, the drivers performed a full stopping maneuver at a given signal; in dual task conditions, the drivers were distracted before the signal for stopping maneuver was triggered. Reaction times were compared across conditions and age groups. The results showed that both reaction times and variability of driving performance increased progressively between the ages of 20 and 80. The increase in both reaction times and variability was greater in the complex task condition. The high-performing quarter of elderly drivers performed equally well or better than younger drivers did. The data clearly supported the claim that driving performance changes steadily across age groups: both mean reaction time and interindividual variability progressively increase with age. In addition, a significant group of older drivers was identified who did not show the expected age-related decrease in performance. The findings have important implications, suggesting that in relation to driving, aging is a progressive phenomenon and may lead to variety of driving performance; age-related studies of driving performance should put more emphasis on investigating changes across the whole driver age range rather than only comparing younger and older drivers.

  3. ISAF'S Afghan Truck Drivers: The Overlooked Counterinsurgency Population

    Myron Varouhakis

    2015-12-01

    Full Text Available A yearlong U.S. Army field study in Afghanistan examined the demographics and threat perceptions of one of the most-at-risk populations, that of Afghan truck drivers working for NATO’s International Security Assistance Force Afghanistan (ISAF. The study collected data from 766 Afghan truck drivers at the U.S.-operated Kandahar Airfield in ISAF’s Regional Command South. The findings show a wide diversity in age of the Afghan drivers as well as in terms of their home province. The findings also show that although all Afghan truck drivers had acute awareness and understanding of the high risks and dangers of the job, they all noted that the attractive salary and scarcity of jobs were dominant reasons for staying on the job. Findings also reveal a strong resentment among the Afghan truck drivers about their treatment by ISAF soldiers, as for the lack of protection for them and their families after the 2014 departure of NATO forces. The findings can provide significant insights and enhance the understanding of scholars, counterinsurgency strategists, policymakers, and military planners about “Host Country Nationals” as an important population of the human terrain.

  4. Heavy ion driver technology

    Keefe, D.

    1988-09-01

    Major differences between fusion drivers and traditional accelerators include the following. The final beam current needed (/approximately/20 kA in a short pulse) is very much larger for a driver; such beams are dominated by repulsive space-charge effects since, even at 10 GeV, the ions are non-relativistic (v/c = 0.3). Also, the optical quality of the beams (called emittance by accelerator people) must be extremely good to ensure a suitably small focal spot at the pellet. Two schemes, one with a rf linac and storage rings, the other with a single-pass current-amplifying induction linac, are under study, the latter exclusively in the US. The induction linac approach lends itself to an examination in a sequence of scaled-down laboratory experiments since the most difficulties are expected to occur at the low energy end. Experiments and simulation have centered on a study of the transverse and longitudinal control of space-charge-dominated beams which are best described in terms of a non-neutral plasma rather than the traditional single-particle dynamics picture. An understanding of the high-current instability limits is required for arriving at a safe driver design. The final on-target beam current is so high that it must be carried in 16 separate focusing channels leading into the combustion chamber. While the energy deposition of the ions is expected to be entirely classical, there is a wealth of plasma physics phenomena to be explored (by theory and simulation) in the final propagation of these beams through the low-density gas in the chamber and in the environment of the hot target; it is important that none of these could result in a significant portion of the beam missing the focal spot. 13 refs., 9 figs., 1 tab

  5. Drivers for Welfare Innovation

    Wegener, Charlotte

    2015-01-01

    Innovation has become a key goal towards which teaching and workplace learning needs to be directed. Now perceived as germane and even necessary in almost all kinds of welfare work, the innovation potential in everyday practices and ways of allowing for employer creativity have become a highly...... on the empirical material, the paper proposes a ‘driver’ model for context sensitive research of innovation in welfare workplaces. The model involves three elements which can be regarded as drivers for innovation: i) craft (i.e. professional skills and knowledge), ii) levers (i.e. experiments and adjustment...

  6. Compliance with driver's license laws and illegal licensing among commercial bus drivers in Lagos, Nigeria: policy implications and evidence for action.

    Okafor, I P; Odeyemi, K A; Dolapo, D C; Adegbola, A A

    2014-09-01

    To determine the level of compliance with driver's license laws among commercial bus drivers in Lagos, Nigeria. Two intercity motor parks were selected by simple random sampling and all consenting minibus drivers participated in the study. Key Informant Interviews (KIIs) were also conducted with selected officials in the driver training and licensing authorities. Compliance with the minimum age for driving was high (93.6%), so also was having driving test prior to driver's license procurement (83.3%). Formal driver training and VA testing were very low, (26.1% and 32.9% respectively) Overall, only 9.3% of them were found to have fulfilled all the pre-license obligations before obtaining their first driver's license. The odds of a driver with a secondary education having formal driver training is 3.33 times higher than those with no education (OR 3.33, 95% CI 1.01-11.35). Drivers who were 60 years or older were 3.62 times more likely to be compliant than those who were between 20-29 years (OR 3.62, 95% CI 0.56-29.19). For the 98.3% of them who possessed valid licenses, 52.3% of them obtained them illegally. All the key officials saw RTIs as a serious public health problem but faced several challenges in the course of their work. Overall compliance with pre-license regulations was very poor. There is need for a review and strict enforcement of driver's license laws to improve compliance. Also vital are fostering inter-sectoral collaboration and improvement in the operations of all establishments involved in driver training and license procurement in Nigeria.

  7. Protein and energy supplementation in elderly people at risk from malnutrition.

    Milne, Anne C; Potter, Jan; Vivanti, Angela; Avenell, Alison

    2009-04-15

    Evidence for the effectiveness of nutritional supplements containing protein and energy, often prescribed for older people, is limited. Malnutrition is more common in this age group and deterioration of nutritional status can occur during illness. It is important to establish whether supplementing the diet is an effective way of improving outcomes for older people at risk from malnutrition. This review examined trials for improvement in nutritional status and clinical outcomes when extra protein and energy were provided, usually as commercial 'sip-feeds'. We searched The Cochrane Library, MEDLINE, EMBASE, Healthstar, CINAHL, BIOSIS, CAB abstracts. We also hand searched nutrition journals and reference lists and contacted 'sip-feed' manufacturers. Randomised and quasi-randomised controlled trials of oral protein and energy supplementation in older people, with the exception of groups recovering from cancer treatment or in critical care. Two reviewers independently assessed trials prior to inclusion and independently extracted data and assessed trial quality. Authors of trials were contacted for further information as necessary. Sixty-two trials with 10,187 randomised participants have been included in the review. Maximum duration of intervention was 18 months. Most included trials had poor study quality. The pooled weighted mean difference (WMD) for percentage weight change showed a benefit of supplementation of 2.2% (95% confidence interval (CI) 1.8 to 2.5) from 42 trials. There was no significant reduction in mortality in the supplemented compared with control groups (relative risk (RR) 0.92, CI 0.81 to 1.04) from 42 trials. Mortality results were statistically significant when limited to trials in which participants (N = 2461) were defined as undernourished (RR 0.79, 95% CI 0.64 to 0.97).The risk of complications was reduced in 24 trials (RR 0.86, 95% CI 0.75 to 0.99). Few trials were able to suggest any functional benefit from supplementation. The WMD for length

  8. Driver Distraction in Public Transport

    YOUNG, K; SALMON, P; REGAN MICHAEL, M

    2007-01-01

    There is converging evidence that driver distraction is a contributing factor in car crashes, in Australia and overseas. Surprisingly, no known previous research has attempted to identify and assess the potentially distracting activities undertaken by the drivers of public passenger vehicles. This paper describes research undertaken on this issue. The research was partitioned into three phases: an analysis of the functions and tasks currently undertaken by public passenger vehicle drivers; th...

  9. At-Risk/Problematic Shopping and Gambling in Adolescence.

    Yip, Sarah W; Mei, Songli; Pilver, Corey E; Steinberg, Marvin A; Rugle, Loreen J; Krishnan-Sarin, Suchitra; Hoff, Rani A; Potenza, Marc N

    2015-12-01

    Elevated levels of both pathological gambling (PG) and problem shopping (PS) have been reported among adolescents, and each is associated with a range of other negative health/functioning measures. However, relationships between PS and PG, particularly during adolescence, are not well understood. In this study, we explored the relationship between different levels of problem-gambling severity and health/functioning characteristics, gambling-related social experiences, gambling behaviors and motivations among adolescents with and without at-risk/problematic shopping (ARPS). Survey data from Connecticut high school students (n = 2,100) were analyzed using bivariate analyses and logistic regression modeling. Although at-risk/problematic gambling (ARPG) was not increased among adolescents with ARPS, adolescents with ARPG (vs non-gamblers) were more likely to report having experienced a growing tension or anxiety that could only be relieved by shopping and missing other obligations due to shopping. In comparison to the non-ARPS group, a smaller proportion of respondents in the ARPS group reported paid part-time employment, whereas a greater proportion of respondents reported excessive gambling by peers and feeling concerned over the gambling of a close family member. In general, similar associations between problem-gambling severity and measures of health/functioning and gambling-related behaviors and motivations were observed across ARPS and non-ARPS adolescents. However, associations were weaker among ARPS adolescents for several variables: engagement in extracurricular activities, alcohol and caffeine use and gambling for financial reasons. These findings suggest a complex relationship between problem-gambling severity and ARPS. They highlight the importance of considering co-occurring risk behaviors such as ARPS when treating adolescents with at-risk/problem gambling.

  10. Bank Lending Policy, Credit Scoring and Value at Risk

    Jacobson, Tor; Roszbach, Kasper

    1998-01-01

    In this paper we apply a bivariate probit model to investigate the implications of bank lending policy. In the first equation we model the bank´s decision to grant a loan, in the second the probability of default. We confirm that banks provide loans in a way that is not consistent with default risk minimization. The lending policy must thus either be inefficient or be the result of some other type of optimizing behavior than expected profit maximization. Value at Risk, being a value weighted ...

  11. Value at risk methodologies: Developments, implementation and evaluation

    Dong, Simin

    2006-01-01

    Value at Risk (VaR) is a useful concept in risk disclosure, especially for financial institutions. In this paper, the origin and development as well as the regulatory requirement of VaR are discussed. Furthermore, a hypothetical foreign currency forward contract is used as an example to illustrate the implementation of VaR. Back testing is conducted to test the soundness of each VaR model. Analysis in this paper shows that historical simulation and Monte Carlo simulation approaches have more ...

  12. Medical review practices for driver licensing : Volume 1 : a case study of guidelines and processes in seven U.S. States.

    2016-10-01

    This report is the first of three examining driver medical review practices in the United States and how they fulfilled the basic functions of identifying, assessing, and rendering licensing decisions on medically at-risk drivers. The aim was not to ...

  13. Older workers

    Ybema,J.F.; Giesen, F.

    2014-01-01

    Due to an ageing population and global economic competition, there is a societal need for people to extend their working lives while maintaining high work productivity. This article presents an overview of the labour participation, job performance, and job characteristics of older workers in the

  14. Therapeutic product disposition in at-risk populations

    Foster, B. C.

    2009-01-01

    In an emergency situation, such as a chemical, biological, radionuclide, nuclear or explosion (CBRNE) event, all patient populations are at increased risk of serious adverse events. Therapeutic product (TP) safety and efficacy depend on the disposition of the product through absorption, distribution, metabolism and excretion. The ability of a patient to benefit from or merely tolerate a TP can be modified by many factors, including but not limited to culture, diet, disease, environmental contaminants, genetic predisposition, stress and socioeconomic status and recent life experiences. Metabolism is considered to have the greatest effect on safety and efficacy, as chemicals not metabolised can accumulate to toxic levels. Inter-individual variances in most drug metabolism enzymes may range up to greater than 1000-fold. The fetus, neonates, infants, individuals with hormonal change, infection or prior exposure to licit or illicit products and the elderly are more susceptible to increased risk of serious adverse health effects. The critically ill are the most at risk. The at-risk populations for a serious adverse event are dependent then on the CBRNE event, their physical and cognitive states and the inter-individual intrinsic and extrinsic factors that affect TP disposition. (authors)

  15. Engaging at-risk youth through self-directed learning

    Thieme Hennis

    2017-07-01

    Full Text Available The large number of young people in Europe who lack formal qualifications constitutes a considerable concern in terms of individual, social and economic consequences. The influx of young migrants into Europe is making this issue even more significant. To avoid social exclusion and youth unemployment, and to ensure economic progress, the European Union (EU and national governments are providing a variety of educational opportunities for these young people. As traditional approaches have not proved particularly successful, an alternative approach has been developed that seems to overcome previous limitations. This approach is characterized by a focus on learners’ agency and identity, and offers young at-risk learners a different, more intrinsically motivating learning experience. The approach was implemented in 12 pilots in six different European countries, including several with migrant youth from different regions of the world. The main result presented here is a comprehensive design framework developed on the basis of a cross-case analysis. The framework includes design principles concerning the organization, as well as the pedagogy, of engaging at-risk youth.

  16. Family and Individual Factors in the at Risk Population

    Masoud Mohammadi

    2005-04-01

    Full Text Available Objective: Based on the past studies in the filed of substance abuse, this study is to compare at risk populations regarding to familial and individual factors. Materials & Methods: this study have been done on 716 at risk individual in 11 city of Fars province. Research tools includes:1- locus of control inventory 2- Attachment styles scale 3- Parental Bonding Instrument 4- Resilience Scale 5- Coping Skills Inventory 6- Self Esteem scale. Results: there was a significant difference between normal and user and abuser groups. In resiliency, self esteem, problem oriented coping skills, caring and secure attachment normal group had a higher scores. But in ambivalent attachment style, external locus of control, emotion oriented and less benefit coping skills, normal group had a lower scores. In resiliency, ambivalent attachment style, problem oriented coping skills, and less benefit coping skills there was significant differences between user and abuser groups. But this was not true for caring, overprotection, secure attachment, locus of control, self esteem, and emotion oriented coping skills. Conclusion: according to these finding and in order to development and promotion of resiliency for substance abuse, preventive intervention should focus on educating parents and caregivers in the field of caring, enough protection, developing secure attachment, strategies for development and maintenance of self esteem, internal locus of control, and use of problem oriented coping skills. Psychological interventions also can use these finding in order to focus their therapy goals.

  17. Criminal justice continuum for opioid users at risk of overdose.

    Brinkley-Rubinstein, Lauren; Zaller, Nickolas; Martino, Sarah; Cloud, David H; McCauley, Erin; Heise, Andrew; Seal, David

    2018-02-24

    The United States (US) is in the midst of an epidemic of opioid use; however, overdose mortality disproportionately affects certain subgroups. For example, more than half of state prisoners and approximately two-thirds of county jail detainees report issues with substance use. Overdose is one of the leading causes of mortality among individuals released from correctional settings. Even though the criminal justice (CJ) system interacts with a disproportionately high number of individuals at risk of opioid use and overdose, few CJ agencies screen for opioid use disorder (OUD). Even less provide access to medication assisted treatment (e.g. methadone, buprenorphine, and depot naltrexone), which is one of the most effective tools to combat addiction and lower overdose risk. However, there is an opportunity to implement programs across the CJ continuum in collaboration with law enforcement, courts, correctional facilities, community service providers, and probation and parole. In the current paper, we introduce the concept of a "CJ Continuum of Care for Opioid Users at Risk of Overdose", grounded by the Sequential Intercept Model. We present each step on the CJ Continuum and include a general overview and highlight opportunities for: 1) screening for OUD and overdose risk, 2) treatment and/or diversion, and 3) overdose prevention and naloxone provision. Copyright © 2018 Elsevier Ltd. All rights reserved.

  18. Early Gadolinium Enhancement for Determination of Area at Risk

    Hammer-Hansen, Sophia; Leung, Steve W; Hsu, Li-Yueh

    2017-01-01

    OBJECTIVES: The aim of this study was to determine whether early gadolinium enhancement (EGE) by cardiac magnetic resonance (CMR) in a canine model of reperfused myocardial infarction depicts the area at risk (AAR) as determined by microsphere blood flow analysis. BACKGROUND: It remains controver......OBJECTIVES: The aim of this study was to determine whether early gadolinium enhancement (EGE) by cardiac magnetic resonance (CMR) in a canine model of reperfused myocardial infarction depicts the area at risk (AAR) as determined by microsphere blood flow analysis. BACKGROUND: It remains...... requires pathological validation. METHODS: Eleven dogs underwent 2 h of coronary artery occlusion and 48 h of reperfusion before imaging at 1.5-T. EGE imaging was performed 3 min after contrast administration with coverage of the entire left ventricle. Late gadolinium enhancement imaging was performed...... on native T1 and T2 maps. The size of EGE was significantly greater than the infarct by triphenyltetrazolium chloride (44.1 ± 15.8% vs. 20.7 ± 14.4%; p gadolinium enhancement (44.1 ± 15.8% vs. 23.5 ± 12.7%; p

  19. Adverse drug reactions in older patients during hospitalisation: are they predictable?

    O'Connor, Marie N

    2012-11-01

    adverse drug reactions (ADRs) are a major cause of morbidity and healthcare utilisation in older people. The GerontoNet ADR risk score aims to identify older people at risk of ADRs during hospitalisation. We aimed to assess the clinical applicability of this score and identify other variables that predict ADRs in hospitalised older people.

  20. Undernutrition: who cares? Perspectives of dietitians and older adults on undernutrition

    Beelen, J.; Vasse, Emmelyne; Ziylan, C.; Janssen, N.; Roos, de N.M.; Groot, de C.P.G.M.

    2017-01-01

    Background: Many older adults are at risk of undernutrition. Dietitians play a key role in the management and treatment of undernutrition, but older adults have difficulties to comply with dietetic recommendations. This qualitative study investigated which barriers older adults experience in

  1. Car drivers with dementia: Different complications due to different etiologies?

    Piersma, Dafne; de Waard, Dick; Davidse, Ragnhild; Tucha, Oliver; Brouwer, Wiebo

    2016-01-01

    Older drivers with dementia are an at-risk group for unsafe driving. However, dementia refers to various etiologies and the question is whether dementias of different etiology have similar effects on driving ability. The literature on the effects of dementia of various etiologies on driving ability is reviewed. Studies addressing dementia etiologies and driving were identified through PubMed, PsychINFO, and Google Scholar. Early symptoms and prognoses differ between dementias of different etiology. Therefore, different etiologies may represent different likelihoods with regard to fitness to drive. Moreover, dementia etiologies could indicate the type of driving problems that can be expected to occur. However, there is a great lack of data and knowledge about the effects of almost all etiologies of dementia on driving. One could hypothesize that patients with Alzheimer's disease may well suffer from strategic difficulties such as finding a route, whereas patients with frontotemporal dementia are more inclined to make tactical-level errors because of impaired hazard perception. Patients with other dementia etiologies involving motor symptoms may suffer from problems on the operational level. Still, the effects of various etiologies of dementias on driving have thus far not been studied thoroughly. For the detection of driving difficulties in patients with dementia, structured interviews with patients but also their family members appear crucial. Neuropsychological assessment could support the identification of cognitive impairments. The impact of such impairments on driving could also be investigated in a driving simulator. In a driving simulator, strengths and weaknesses in driving behavior can be observed. With this knowledge, patients can be advised appropriately about their fitness to drive and options for support in driving (e.g., compensation techniques, car adaptations). However, as long as no valid, reliable, and widely accepted test battery is available for

  2. Youth at Risk: A Resource for Counselors, Teachers and Parents. Part 3. Working with Youth at Risk: Behavioral Issues and Interventions.

    Kempley, Frances A.; And Others

    This document consists of Part 3 of a book of readings on at-risk youth designed to provide information and strategies for counselors, teachers, parents, administrators, social workers, and others who work with youth at risk. It includes six readings, each dealing with a specific behavior that places a young person at risk. "The Secret and…

  3. The Effect of Working Conditions to the Health Status in Taxi and Bus Drivers in Canakkale, Turkey; Community Based Study

    Aysegul Uludag

    2016-04-01

    Full Text Available Aim: The growing taxi and bus driver workforce is at risk for poor health status, obesity, hypertension, metabolic syndrome and with increased risk for cardiovascular disease. We aimed to determine the relationship between working conditions and health status in taxi and bus drivers. Material and Method: This study is a descriptive study. The population of the study was taxi and bus drivers in central of Canakkale. There were total 250 taxi and bus drivers who registered in The Chamber of Canakkale Drivers and Vehicle. We reached the 70 taxi drivers and 93 bus drivers. The participants were visited at their workplace. We performed the questionnaire that include the socio-demografic features, habits, the working conditions. We evaluated the blood pressure, waist-hip measurements and capillary blood glucose at any time. Results: Total of the 163 men drivers were enrolled the study. Nine (12.9% taxi drivers and 6 (6.5% bus drivers were hipertensive, and 1 taxi driver and 2 bus drivers with random capillary blood glucose levels higher than 200 mg. The prevalence of hypertension was 9.2%, diabetes mellitus was 1.8, obesity was 49.4%. Discussion: Drivers have many risk factors for CVD like stress and immobility. In our study, the socio-demografic and working conditions are limited for explaining the risk for hipertension, diabetes mellitus and obesity in drivers in Canakkale. These study have to be done in metropolitan cities. In this aspect, the drivers can be evaluated in their own living spaces and working conditions.

  4. Driver training in steps (DTS).

    2010-01-01

    For some years now, it has been possible in the Netherlands to follow a Driver Training in Steps (DTS) as well as the regular driver training. The DTS is a structured training method with clear training objectives which are categorized in four modules. Although the DTS is considerably better than

  5. Petrochemical industry drivers

    Sedriks, W.

    1995-01-01

    Extensive analyses of profit-ability and pricing over the years have shown that the trends seen in the petrochemical industry have two dominant drivers, namely, industry experience curves (reflecting continuous process improvement and cost savings) and profitability cycles. Any outlook for the future must examine both of these facets. The author's algorithm for price projections has two primary terms: a cost-related one and a supply/demand-related one. Both are strong functions of experience curves; the latter is also a prime function of cyclicality. At SRI International. To arrive at medium-term quantitative projections, SRI typically creates a consistent base-case scenario that more or less mirrors the past but also incorporates observed directional changes. In this article the author examines in detail how these scenarios are used for projection. He describes experience curves, ethylene/gross domestic product (GDP) penetration levels, industry structure, and cyclicality as they apply to ethylene prices

  6. Drivers of Collaborative Advantage

    Weihe, Gudrid

    processes and behavioural dimensions is practically non-existent. This article tries to remedy the current gap in the literature by reviewing research findings on interfirm collaboration (alliances). On that basis a conceptual framework for analyzing partnership processes is developed. Finally......, the antecedents of collaborative advantage are theoretically examined, and the organizational competences contributing to collaborative success are identified. The conclusion is that operational processes and social dynamics are vital drivers of collaborative advantage. Another significant conclusion...... is that public management research can benefit from drawing upon existing alliance research. Alliance scholars have during the past couple of decades accumulated an impressive amount of knowledge on different aspects of inter-firm cooperation, and therefore the learning potential for public management scholars...

  7. Alternate laser fusion drivers

    Pleasance, L.D.

    1979-11-01

    One objective of research on inertial confinement fusion is the development of a power generating system based on this concept. Realization of this goal will depend on the availability of a suitable laser or other system to drive the power plant. The primary laser systems used for laser fusion research, Nd 3+ : Glass and CO 2 , have characteristics which may preclude their use for this application. Glass lasers are presently perceived to be incapable of sufficiently high average power operation and the CO 2 laser may be limited by and issues associated with target coupling. These general perceptions have encouraged a search for alternatives to the present systems. The search for new lasers has been directed generally towards shorter wavelengths; most of the new lasers discovered in the past few years have been in the visible and ultraviolet region of the spectrum. Virtually all of them have been advocated as the most promising candidate for a fusion driver at one time or another

  8. Fragility non-hip fracture patients are at risk.

    Gosch, M; Druml, T; Nicholas, J A; Hoffmann-Weltin, Y; Roth, T; Zegg, M; Blauth, M; Kammerlander, C

    2015-01-01

    Fragility fractures are a growing worldwide health care problem. Hip fractures have been clearly associated with poor outcomes. Fragility fractures of other bones are common reasons for hospital admission and short-term disability, but specific long-term outcome studies of non-hip fragility fractures are rare. The aim of our trial was to evaluate the 1-year outcomes of non-hip fragility fracture patients. This study is a retrospective cohort review of 307 consecutive older inpatient non-hip fracture patients. Patient data for analysis included fracture location, comorbidity prevalence, pre-fracture functional status, osteoporosis treatments and sociodemographic characteristics. The main outcomes evaluated were 1-year mortality and post-fracture functional status. As compared to the expected mortality, the observed 1-year mortality was increased in the study group (17.6 vs. 12.2 %, P = 0.005). After logistic regression, three variables remained as independent risk factors for 1-year mortality among non-hip fracture patients: malnutrition (OR 3.3, CI 1.5-7.1), Charlson comorbidity index (CCI) (OR 1.3, CI 1.1-1.5) and the Parker Mobility Score (PMS) (OR 0.85, CI 0.74-0.98). CCI and PMS were independent risk factors for a high grade of dependency after 1 year. Management of osteoporosis did not significantly improve after hospitalization due to a non-hip fragility fracture. The outcomes of older non-hip fracture patients are comparable to the poor outcomes of older hip fracture patients, and appear to be primarily related to comorbidities, pre-fracture function and nutritional status. The low rate of patients on osteoporosis medications likely reflects the insufficient recognition of the importance of osteoporosis assessment and treatment in non-hip fracture patients. Increased clinical and academic attention to non-hip fracture patients is needed.

  9. Power Plant Retirements: Trends and Possible Drivers

    Mills, Andrew D. [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Wiser, Ryan H. [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Seel, Joachim [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States)

    2017-11-29

    This paper synthesizes available data on historical and planned power plant retirements. Specifically, we present data on historical generation capacity additions and retirements over time, and the types of plants recently retired and planned for retirement. We then present data on the age of plants that have recently retired or that have plans to retire. We also review the characteristics of plants that recently retired or plan to retire vs. those that continue to operate, focusing on plant size, age, heat rate, and SO2 emissions. Finally, we show the level of recent thermal plant retirements on a regional basis and correlate those data with a subset of possible factors that may be contributing to retirement decisions. This basic data synthesis cannot be used to precisely estimate the relative magnitude of retirement drivers. Nor do we explore every possible driver for retirement decisions. Moreover, future retirement decisions may be influenced by different factors than those that have affected past decisions. Nonetheless, it is clear that recently retired plants are relatively old, and that plants with stated planned retirement dates are—on average—no younger. We observe that retired plants are smaller, older, less efficient, and more polluting than operating plants. Based on simple correlation graphics, the strongest predictors of regional retirement differences appear to include SO2 emissions rates (for coal), planning reserve margins (for all thermal units), variations in load growth or contraction (for all thermal units), and the age of older thermal plans (for all thermal units). Additional apparent predictors of regional retirements include the ratio of coal to gas prices and delivered natural gas prices. Other factors appear to have played lesser roles, including the penetration variable renewable energy (VRE), recent non-VRE capacity additions, and whether the region hosts an ISO/RTO.

  10. Aquatic characterization for resources at risk in eastern Canada

    Fraser, A S

    1986-12-01

    To ascertain quantitative estimates of resources at risk for eastern Canada, linkage must be made between geological terrain sensitivity to acid deposition and water chemistry. An evaluation has been made of watershed areas principally in the Province of Quebec to identify and characterize factors related to LRTAP effects. The watershed areas are geographically located within the bounds of the high sulphate deposition zone of the continental plume. To identify specific test watersheds for detailed analysis, alkalinity frequency distributions were computed. A selection of watersheds has been made that spans the Pre-Cambrian shield region of the Laurentian highlands, the St. Lawrence lowlands and the Gaspe Peninsula. There is evidence that areas in the far eastern areas of Quebec, removed from strong anthropogenic sources may be considered as approaching critical levels of alkalinity. Ionic composition for selected watersheds display similar chemical characteristics. These differences have been assessed in light of the common effects of sulphate deposition. 11 references.

  11. Activity and vulnerability: what family arrangements are at risk?

    Lena Lavinas

    Full Text Available The purpose of this article is to compare different family models according to the typology proposed by the IBGE (Brazilian Institute of Geography and Statistics, or National Census Bureau, to verify whether families headed by women really represent the most vulnerable or "at-risk" family arrangement. The latter is the commonsense notion that legitimizes the framework of feminization of poverty, in vogue in the last two decades and with considerable impact on the design of anti-poverty social policies. The current empirical study disaggregates the employment data (employment rate, mean wages, workweek not only by gender (identifying differences between men and women, but also breaking down the data for women, comparing the situation of women heads-of-families versus wives. In terms of women's full participation in the work market, the effect of conjugality is even more harmful than motherhood (presence of children.

  12. Male reproductive organs are at risk from environmental hazards

    Bonde, Jens Peter

    2010-01-01

    are the best documented risk factors for impaired male reproductive function and include physical exposures (radiant heat, ionizing radiation, high frequency electromagnetic radiation), chemical exposures (some solvents as carbon disulfide and ethylene glycol ethers, some pesticides as dibromochloropropane......, ethylendibromide and DDT/DDE, some heavy metals as inorganic lead and mercury) and work processes such as metal welding. Improved working conditions in affluent countries have dramatically decreased known hazardous workplace exposures, but millions of workers in less affluent countries are at risk from...... as phthalates, bisphenol A and boron that are present in a large number of industrial and consumer products entails a risk remains to be established. The same applies to psychosocial stressors and use of mobile phones. Finally, there are data indicating a particular vulnerability of the fetal testis...

  13. Effectiveness of a Handwriting Intervention With At-Risk Kindergarteners.

    Zylstra, Sheryl Eckberg; Pfeiffer, Beth

    2016-01-01

    We examined the effectiveness of an occupational therapist-led handwriting intervention for special education and at-risk kindergarteners. We incorporated a two-group, pretest-posttest design. Both groups consisted of kindergarteners receiving individualized education program (IEP) or Response to Intervention (RtI) support. An occupational therapist provided biweekly group handwriting instruction using the Size Matters Handwriting Program to students in the intervention group (n = 23). The control group (n = 12) received the standard handwriting instruction. Students in the intervention group demonstrated significantly greater gains in handwriting legibility than students in the control group. Students in the intervention group also demonstrated significantly greater gains in the prereading skills of uppercase letter recognition, lowercase letter recognition, and letter sound recognition. This study provides preliminary support for an occupational therapist-led handwriting intervention to improve writing legibility and letter recognition in kindergarteners receiving RtI and IEP supports. Copyright © 2016 by the American Occupational Therapy Association, Inc.

  14. Coping styles in healthy individuals at risk of affective disorder

    Vinberg, Maj; Froekjaer, Vibe Gedsoe; Kessing, Lars Vedel

    2010-01-01

    Coping styles may influence the perceived life stress experienced by an individual and, therefore, also be critical in the development of affective disorders. This study examined whether familial risk of affective disorder is associated with the use of maladaptive coping styles, in healthy...... individuals. One hundred twelve high-risk and 78 low-risk individuals were identified through nation-wide registers and invited to participate in an extensive psychiatric evaluation including the Coping Inventory for Stressful Situations. The high-risk individuals used more Emotion-oriented (p = 0.......001) and Avoidance coping (p = 0.04) than individuals not at risk. Adjusted for gender, age, years of education, and recent stressful life events the high-risk individuals used more emotion-oriented coping (p = 0.03). In conclusion, maladaptive coping style may represent a trait marker for mood disorder improving...

  15. High-sulfur coal: tonnage and money at risk

    McMahan, R.L.; Knutson, K.S.

    1991-01-01

    More than 286 million tons of coal exceeds the Phase I standard i.e. 2.5 lb SO 2 per mmBtu, of the US Clean Air Act (1990). 85 mmtpy goes to currently scrubbed or unaffected (i.e. small) units. This leaves 201 mmtpy of high-sulphur coal at risk. 129 mmtpy of this is moving on a spot basis or is shipped under contracts that expire by 1995. This leaves about 72 mmtpy of captive and longterm contracts which many utility fuel buyers assume will be cancelled or renegotiated at a lower price. The legal position remains uncertain. However, the massive cancellation and/or renegotiation of existing contracts will have a tremendous economic impact on the coal industry. The resultant price change will in turn influence decisions to scrub or switch to low sulphur coals. 2 figs., 2 tabs

  16. Forecasting Value-at-Risk under Different Distributional Assumptions

    Manuela Braione

    2016-01-01

    Full Text Available Financial asset returns are known to be conditionally heteroskedastic and generally non-normally distributed, fat-tailed and often skewed. These features must be taken into account to produce accurate forecasts of Value-at-Risk (VaR. We provide a comprehensive look at the problem by considering the impact that different distributional assumptions have on the accuracy of both univariate and multivariate GARCH models in out-of-sample VaR prediction. The set of analyzed distributions comprises the normal, Student, Multivariate Exponential Power and their corresponding skewed counterparts. The accuracy of the VaR forecasts is assessed by implementing standard statistical backtesting procedures used to rank the different specifications. The results show the importance of allowing for heavy-tails and skewness in the distributional assumption with the skew-Student outperforming the others across all tests and confidence levels.

  17. Multiple zone power forwards. A value at risk framework

    Demers, Jean-Guy

    2009-01-01

    Over the 1990s, deregulated power markets in New-England provided zones with fluctuating spot prices. Such prices have a notoriously high volatility, owing to the difficulty of storing electrical energy and the delays needed to adjust generation levels. In this context, forward contracts have become increasingly popular and understanding their dynamic is a problem facing many market players. This paper proposes a parsimonious parametric model, based on the price series of all n-month forward contracts (n = 1,2,3..), encompassing multiple zones. The model is then used for value at risk forecasts, which are backtested and compared with the ones in use by the risk management unit of an important electricity producer. Extensions to include natural gas and power-relevant oil-based future markets are discussed. (author)

  18. Anybody can do Value at Risk: A Nonparametric Teaching Study

    Robert J Powell

    2012-03-01

    Full Text Available Value at Risk (VaR has become a benchmark methodology among investors and banks for measuring market risk. Commercially available modelling packages can be both expensive and inflexible, thereby restricting their use by academic researchers and teachers. Usingnonparametric methodology, this paper provides a step-by-step teaching study on how to use Excel to construct a VaR spreadsheet for an individual asset as well as for a portfolio. This can benefit financial modelling teachers by providing them with a readily useable teaching study on how to model VaR, as well as benefit researchers by showing them how to construct an inexpensive and flexible VaR model.

  19. Can statistical data qualify assessments of children at risk?

    Søbjerg, Lene Mosegaard; Villumsen, Anne Marie Anker; Klitbjerg-Nielsen, Christina

    and parents that are already registered in the municipality such as home address and school records. A similar tool is being developed in a social work research project in Denmark. The idea is to include risk and protection factors such as information about health, school absenteeism and family circumstances......Every day municipalities across Europe (and beyond) receive notifications about children at risk. The notifications come from teachers, health professionals, social workers, neighbors, or anyone else who sees a child, which appears not to thrive. The assessment and validation of whether the child...... significantly from case to case. Third, the relative importance of the different risk and protection factors is complex and difficult to assess – especially when the social worker has to assess both immediate danger as well as risk of long term failure-to-thrive. Internationally, different risk assessment tools...

  20. Couples at risk for transmission of alcoholism: protective influences.

    Bennett, L A; Wolin, S J; Reiss, D; Teitelbaum, M A

    1987-03-01

    A two-generation, sociocultural model of the transmission of alcoholism in families was operationalized and tested. Sixty-eight married children of alcoholic parents and their spouses were interviewed regarding dinner-time and holiday ritual practices in their families of origin, and heritage and ritual practices in the couples' current generation. Coders rated transcribed interviews along 14 theory-derived predictor variables, nine for the family of origin and five for the current nuclear family. Multiple regression analysis was applied in a two-step hierarchical method, with the dependent variable being transmission of alcoholism to the couple. The 14 predictor variables contributed significantly (p less than .01) to the couple's alcoholism outcome. A general theme of selective disengagement and reengagement for couples in families at risk for alcoholism recurrence is discussed.

  1. Depression and HIV risk behavior practices among at risk women.

    Klein, Hugh; Elifson, Kirk W; Sterk, Claire E

    2008-01-01

    In this study, we examined the relationship between depression and HIV-related risk behavior practices in a sample of 250 at risk, predominantly African American women living in the Atlanta, Georgia metropolitan area. Interviews were conducted between August 1997 and August 2000. Street outreach efforts were used to identify potential study participants, with further expansion of the sample via targeted sampling and ethnographic mapping procedures. Our conceptual model hypothesized a relationship between depression and HIV risk in which depression and condom-related attitudes were construed as intervening (or mediating) variables. A multivariate analysis was used to determine the relationship between depression and women's risk behaviors. The results showed that depression was a key-mediating variable, having its primary influence on women's risky practices through its impact upon their attitudes toward using condoms. Factors associated with depression, included religiosity, closeness of family relationships, financial problems, childhood maltreatment experiences, and drug-related problems. The implications of these findings for prevention and intervention efforts are: (1) heightening faith community involvement and religious participation to decrease depression; (2) working with women whose familial bonds are in need of strengthening to combat depression; (3) providing mental health and counseling services to women who were emotionally and/or sexually abused during their formative years seems to help these women to recover from unresolved issues that may be fueling depression; (4) assisting at risk women who need training in money management issues to minimize their risk for depression; and (5) helping women drug abusers to receive treatment for their drug problems to combat their depression and lower their HIV risk.

  2. Seroprevalence of Leptospira antibodies among populations at risk

    Abdul-Baki Abdullah Al-Robasi

    2015-03-01

    Full Text Available Objective: This study was performed to assess the Leptospira IgG antibodies seroprevalence among populations at risk in Hodeida Governorate, Yemen. Methods: A total of 200 subjects (136 males and 64 females participated in this study during June and December 2012.They represented 10 sewage workers, 22 butchers, 16 construction workers, 108 agriculture workers, 20 hospital sanitary workers and 24 blood donors. Predesigned questionnaires and consent were taken from each individual. Blood samples were collected from subjects, and the sera were tested by ELISA to detect the presence of leptospira IgG antibodies. The possible related factors for seropositivity were evaluated. Results: Leptospira IgG antibodies were found positive in 42% of the participants. The highest seroprevalence level was detected in sewage workers (80%, followed by hospital sanitary workers (60%, construction workers (37.5% and farmers (37%. The lowest of antibodies was in butchers (36.4%. Seroprevalence among blood donors was 25% which was comparatively less than of the populations at risk. Seropositivity of Leptospira IgG antibodies was found higher among males than females (42.6% vs. 34.4%. The highest Leptospira antibodies seropositivity was among elderly participants (81.8%. The seropositivity of antibodies in population live in rural and urban areas was not significant differences. As for closely contacting with animals, the highest antibodies were discovered in people who had goats (80% and sheep (60.9%. Conclusion: Individuals engaged in risk activities are often exposed to leptospiral infection. Therefore, control and prevention policy toward these people are necessary. J Microbiol Infect Dis 2015;5(1: 1-4

  3. Sexting and sexual behavior in at-risk adolescents.

    Houck, Christopher D; Barker, David; Rizzo, Christie; Hancock, Evan; Norton, Alicia; Brown, Larry K

    2014-02-01

    This study aimed to examine the prevalence of sexting behaviors (sexually explicit messages and/or pictures) among an at-risk sample of early adolescents as well as the associations between sexting behaviors and sexual behaviors, risk-related cognitions, and emotional regulation skills. It also aimed to determine whether differences in risk were associated with text-based versus photo-based sexts. Seventh-grade adolescents participating in a sexual risk prevention trial for at-risk early adolescents completed a computer-based survey at baseline regarding sexting behavior (having sent sexually explicit messages and/or pictures), sexual activities, intentions to have sex, perceived approval of sexual activity, and emotional regulation skills. Twenty-two percent of the sample reported having sexted in the past 6 months; sexual messages were endorsed by 17% (n = 71), sexual messages and photos by 5% (n = 21). Pictures were endorsed significantly more often by females (χ(2)[2] = 7.33, P = .03) and Latinos (χ(2)[2] = 7.27, P = .03). Sexting of any kind was associated with higher rates of engaging in a variety of sexual behaviors, and sending photos was associated with higher rates of sexual activity than sending text messages only. This was true for a range of behaviors from touching genitals over clothes (odds ratio [OR] = 1.98, P = .03) to oral sex (OR = 2.66, P Sexting behavior (both photo and text messages) was not uncommon among middle school youth and co-occurred with sexual behavior. These data suggest that phone behaviors, even flirtatious messages, may be an indicator of risk. Clinicians, parents, and health programs should discuss sexting with early adolescents.

  4. Sexting and Sexual Behavior in At-Risk Adolescents

    Barker, David; Rizzo, Christie; Hancock, Evan; Norton, Alicia; Brown, Larry K.

    2014-01-01

    OBJECTIVES: This study aimed to examine the prevalence of sexting behaviors (sexually explicit messages and/or pictures) among an at-risk sample of early adolescents as well as the associations between sexting behaviors and sexual behaviors, risk-related cognitions, and emotional regulation skills. It also aimed to determine whether differences in risk were associated with text-based versus photo-based sexts. METHODS: Seventh-grade adolescents participating in a sexual risk prevention trial for at-risk early adolescents completed a computer-based survey at baseline regarding sexting behavior (having sent sexually explicit messages and/or pictures), sexual activities, intentions to have sex, perceived approval of sexual activity, and emotional regulation skills. RESULTS: Twenty-two percent of the sample reported having sexted in the past 6 months; sexual messages were endorsed by 17% (n = 71), sexual messages and photos by 5% (n = 21). Pictures were endorsed significantly more often by females (χ2[2] = 7.33, P = .03) and Latinos (χ2[2] = 7.27, P = .03). Sexting of any kind was associated with higher rates of engaging in a variety of sexual behaviors, and sending photos was associated with higher rates of sexual activity than sending text messages only. This was true for a range of behaviors from touching genitals over clothes (odds ratio [OR] = 1.98, P = .03) to oral sex (OR = 2.66, P Sexting behavior (both photo and text messages) was not uncommon among middle school youth and co-occurred with sexual behavior. These data suggest that phone behaviors, even flirtatious messages, may be an indicator of risk. Clinicians, parents, and health programs should discuss sexting with early adolescents. PMID:24394678

  5. Limitations of the planning organ at risk volume (PRV) concept.

    Stroom, Joep C; Heijmen, Ben J M

    2006-09-01

    Previously, we determined a planning target volume (PTV) margin recipe for geometrical errors in radiotherapy equal to M(T) = 2 Sigma + 0.7 sigma, with Sigma and sigma standard deviations describing systematic and random errors, respectively. In this paper, we investigated margins for organs at risk (OAR), yielding the so-called planning organ at risk volume (PRV). For critical organs with a maximum dose (D(max)) constraint, we calculated margins such that D(max) in the PRV is equal to the motion averaged D(max) in the (moving) clinical target volume (CTV). We studied margins for the spinal cord in 10 head-and-neck cases and 10 lung cases, each with two different clinical plans. For critical organs with a dose-volume constraint, we also investigated whether a margin recipe was feasible. For the 20 spinal cords considered, the average margin recipe found was: M(R) = 1.6 Sigma + 0.2 sigma with variations for systematic and random errors of 1.2 Sigma to 1.8 Sigma and -0.2 sigma to 0.6 sigma, respectively. The variations were due to differences in shape and position of the dose distributions with respect to the cords. The recipe also depended significantly on the volume definition of D(max). For critical organs with a dose-volume constraint, the PRV concept appears even less useful because a margin around, e.g., the rectum changes the volume in such a manner that dose-volume constraints stop making sense. The concept of PRV for planning of radiotherapy is of limited use. Therefore, alternative ways should be developed to include geometric uncertainties of OARs in radiotherapy planning.

  6. At risk of pressure ulcers - a nursing diagnosis

    Ľubica Poledníková

    2016-05-01

    Full Text Available Aim: The aim of the study was content validation of the nursing diagnosis of at Risk of Impaired Skin Integrity by a sample of Slovak nurse-experts. It focuses on identifying the major risk factors in pressure ulcer development. Design: Retrospective study. Methods: The Diagnostic Content Validity Model designed by Fehring was used for validation of the nursing diagnosis; we used it to establish the significance of the risk factors of the nursing diagnosis of at Risk of Impaired Skin Integrity in relation to pressure ulcer development. Correlation analysis was used for evaluation of the relationships between the risk factors. The sample consisted of 126 nurse-experts in accordance with modified Fehring criteria. Results: Out of 23 items, the nurses rated nine as significant (the most frequently present risk factors (the weighted scores are shown in brackets: physical immobilisation (0.92, skeletal prominence (0.9, imbalanced nutritional state (0.86, moisture (0.86, mechanical factors (e.g., shearing forces, pressure, restraint (0.84, a Norton Scale score of 14 ≥ points (0.81, hyperthermia (0.81, excretions (0.77, and extremes of age (0.76. Statistically significant correlations, which are positive and range between 0.2 and 0.4, were found between some risk factors. The strongest correlations were found between moisture and mechanical factors (r = 0.4008 and moisture and physical immobilization (r = 0.3072. Conclusion: Using the DCV model, the experts identified nine significant risk factors which can be predictors of pressure ulcer development.

  7. Perceptions regarding genetic testing in populations at risk for nephropathy.

    Freedman, Barry I; Fletcher, Alison J; Sanghani, Vivek R; Spainhour, Mitzie; Graham, Angelina W; Russell, Gregory B; Cooke Bailey, Jessica N; Iltis, Ana S; King, Nancy M P

    2013-01-01

    Population ancestry-based differences exist in genetic risk for many kidney diseases. Substantial debate remains regarding returning genetic test results to participants. African-Americans (AAs) and European-Americans (EAs) at risk for end-stage kidney disease were queried for views on the value and use of genetic testing in research. A standardized survey regarding attitudes toward genetic testing was administered to 130 individuals (64 AA, 66 EA) with first-degree relatives on dialysis. Fisher's exact test was used to assess differences in participant attitudes between population groups. Mean (SD) age of surveyed AAs and EAs was 45.5 (12.8) and 50.5 (14.4) years, respectively (p = 0.04), with similar familial relationships (p = 0.22). AAs and EAs wished to know their test results if risk could be: (1) reduced by diet or exercise (100 and 98%, p = 0.99); (2) reduced by medical treatment (100 and 98%, p = 0.99), or (3) if no treatments were available (90 and 82%, p = 0.21). If informed they lacked a disease susceptibility variant, 87% of AAs and 88% of EAs would be extremely or pretty likely to inform family members (p = 0.84). If informed they had a disease susceptibility variant, 92% of AAs and 89% of EAs would be extremely or pretty likely to inform their family (p = 0.43). Attitudes toward obtaining and using genetic test results for disease in research contexts were similar in AAs and EAs at risk for end-stage kidney disease. A substantial majority would want information regardless of available treatments and would share the information with the family. These results have important implications for patient care, study design and the informed consent process. © 2013 S. Karger AG, Basel.

  8. Social support for schoolchildren at risk of social exclusion

    Ivanauskiene V.

    2012-10-01

    Full Text Available Social exclusion is a wider concept than poverty and includes not only material conditions but also inability to participate in economic, social, political and cultural life. The essence of social exclusion is social relationships (more exactly breaking off relationships, which may mean not only pushing away some members of the society, but also breaking off relationships with the society from the side of a person himself/herself. The reasons of origin of social exclusion may be legal, political, economical, social and cultural. Nowadays social exclusion is predetermined by social-economic factors. According to Poviliūnas (2001, the problems of children’s social exclusion may be solved ensuring proper education, care of public health, safety and minimal life standard. Growing aggression and violence of schoolchildren and their social exclusion are nowadays an important issue of political debate and media reports. Often schoolchildren face the risk of social exclusion at school during the period of adolescence. The risk also depends on the social status of their family in the society and the relationship of the family members. The aim of the article is to identify characteristic features of schoolchildren at risk of social exclusion and analyze social support provided for them. A quantitative research was carried out to achieve the aim. The method of data collection is a questionnaire. 105 teachers working in 3 secondary schools in Lithuania participated in the research. The research results revealed that most often schoolchildren face the risk of social exclusion at school during adolescence period. They are characterized as incommunicative, unsociable, passive, and shy, do not trust others, are vulnerable, have learning problems and avoid collaborative activities. These schoolchildren usually come from families of social risk or single parent families. The support provided at school by teachers to schoolchildren at risk of social exclusion

  9. A holistic perspective on corporate sustainability drivers

    Lozano, R.

    2013-01-01

    Since company boards are increasingly discussing 'sustainability', it becomes necessary to examine the nature of sustainability drivers. Most approaches to corporate sustainability drivers have focused either on internal or external drivers. This paper is aimed at providing a more holistic

  10. A holistic perspective on corporate sustainability drivers

    Lozano, Rodrigo|info:eu-repo/dai/nl/36412380X

    2015-01-01

    Since company boards are increasingly discussing 'sustainability', it becomes necessary to examine the nature of sustainability drivers. Most approaches to corporate sustainability drivers have focused either on internal or external drivers. This paper is aimed at providing a more holistic

  11. The effects of age, gender, and crash types on drivers' injury-related health care costs.

    Shen, Sijun; Neyens, David M

    2015-04-01

    There are many studies that evaluate the effects of age, gender, and crash types on crash related injury severity. However, few studies investigate the effects of those crash factors on the crash related health care costs for drivers that are transported to hospital. The purpose of this study is to examine the relationships between drivers' age, gender, and the crash types, as well as other crash characteristics (e.g., not wearing a seatbelt, weather condition, and fatigued driving), on the crash related health care costs. The South Carolina Crash Outcome Data Evaluation System (SC CODES) from 2005 to 2007 was used to construct six separate hierarchical linear regression models based on drivers' age and gender. The results suggest that older drivers have higher health care costs than younger drivers and male drivers tend to have higher health care costs than female drivers in the same age group. Overall, single vehicle crashes had the highest health care costs for all drivers. For males older than 64-years old sideswipe crashes are as costly as single vehicle crashes. In general, not wearing a seatbelt, airbag deployment, and speeding were found to be associated with higher health care costs. Distraction-related crashes are more likely to be associated with lower health care costs in most cases. Furthermore this study highlights the value of considering drivers in subgroups, as some factors have different effects on health care costs in different driver groups. Developing an understanding of longer term outcomes of crashes and their characteristics can lead to improvements in vehicle technology, educational materials, and interventions to reduce crash-related health care costs. Copyright © 2015 Elsevier Ltd. All rights reserved.

  12. Heavy-ion driver design and scaling

    Bieri, R.; Monsler, M.; Meier, W.; Stewart, L.

    1992-01-01

    Parametric models for scaling heavy-ion driver designs are described. Scaling of target performance and driver cost is done for driver parameters including driver energy, number of beams, type of superconductor used in focusing magnets, maximum magnetic field allowed at the superconducting windings, linear quadrupole array packing fraction mass, and ion charge state. The cumulative accelerator voltage and beam currents are determined from the Maschke limits on beam current for each choice of driver energy and post-acceleration pulse duration. The heavy-ion driver is optimized over the large available driver parameter space. Parametric studies and the choice of a base driver model are described in a companion paper

  13. Women at risk: Gender inequality and maternal health.

    Banda, Pamela C; Odimegwu, Clifford O; Ntoimo, Lorretta F C; Muchiri, Evans

    2017-04-01

    Gender inequality has been documented as a key driver of negative health outcomes, especially among women. However, studies have not clearly examined the role of gender inequality in maternal health in an African setting. Therefore, the authors of this study examined the role of gender inequality, indicated by lack of female autonomy, in exposing women to maternal health risk. Data were obtained from the 2007 Zambia Demographic and Health Survey on a weighted sample of 3,906 married or partnered women aged 15-49 years. Multivariable analyses revealed that low autonomy in household decision power was associated with maternal health risk (Odds Ratio (OR) = 1.52, p < .001). Autonomy interacted with household wealth showed that respondents who were in the wealthier households and had low autonomy in household decision power (OR = 2.03, p < .05) were more likely to be exposed to maternal health risk than their counterparts who had more autonomy. Efforts to lower women's exposure to maternal mortality and morbidity in Zambia should involve interventions to alter prevailing gender norms that limit women's active participation in decisions about their own health during pregnancy and delivery.

  14. What puts heart failure patients at risk for poor medication adherence?

    Knafl GJ

    2014-07-01

    Full Text Available George J Knafl,1 Barbara Riegel2,31School of Nursing, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA; 2School of Nursing, University of Pennsylvania, Philadelphia, PA, USA; 3Leonard Davis Institute, University of Pennsylvania, Philadelphia, PA, USABackground: Medication nonadherence is a major cause of hospitalization in patients with heart failure (HF, which contributes enormously to health care costs. We previously found, using the World Health Organization adherence dimensions, that condition and patient level factors predicted nonadherence in HF. In this study, we assessed a wider variety of condition and patient factors and interactions to improve our ability to identify those at risk for hospitalization. Materials and methods: Medication adherence was measured electronically over the course of 6 months, using the Medication Event Monitoring System (MEMS. A total of 242 HF patients completed the study, and usable MEMS data were available for 218 (90.1%. Participants were primarily white (68.3%, male (64.2%, and retired (44.5%. Education ranged from 8–29 years (mean, 14.0 years; standard deviation, 2.9 years. Ages ranged from 30–89 years (mean, 62.8 years; standard deviation, 11.6 years. Analyses used adaptive methods based on heuristic searches controlled by cross-validation scores. First, individual patient adherence patterns over time were used to categorize patients in poor versus better adherence types. Then, risk factors for poor adherence were identified. Finally, an effective model for predicting poor adherence was identified based on identified risk factors and possible pairwise interactions between them. Results: A total of 63 (28.9% patients had poor adherence. Three interaction risk factors for poor adherence were identified: a higher number of comorbid conditions with a higher total number of daily medicines, older age with poorer global sleep quality, and fewer months since diagnosis of HF with poorer

  15. The differences of movement between children at risk of developmental coordination disorder and those not at risk

    Adrián Agricola

    2015-09-01

    Full Text Available Background: Developmental coordination disorder (DCD is a syndrome unexplained by medical condition, which is marked by defects in the development of motor coordination. Children with this impairment are more dependent on visual information to perform movements than their typically developing (TD peers. Objective: The main aim of the research was to create a checklist for the evaluation of the head and limb movement while walking. After that, based on this tool, to find differences in the movement of various body segments in children at risk of DCD (DCDr compared to typically developing children under different visual conditions. Methods: A total of 32 children aged 8.7 ± 1.1 years participated in this study. The Movement Assessment Battery for Children - 2nd edition (MABC-2 was used to make a classification of motor competence level of the participants. PLATO goggles were used to make four different visual conditions. All trials were recorded. Based on the video analysis we completed a qualitative checklist. Results: The analysis between the children from the DCDr group and TD children showed significant differences in the head (p = .023 and the arm (p = .005 movements, in body position (p = .002 and total summary score (p = .001. The main effects of visual conditions showed significant differences in all cases; in the head (p = .015, with the arm (p = .006, trunk (p =  .009, leg (p = .001 movements, in body position (p = .001 and also in the total summary score (p = .001. The interaction between groups and visual conditions was significant in leg movements (p = .007 and body position (p = .002. Conclusions: This study has shown which movements of body segments are most affected by different visual conditions and how children at risk of DCD are dependent on visual perception.

  16. Older adult opinions of "advance driving directives".

    Betz, Marian E; Lowenstein, Steven R; Schwartz, Robert

    2013-01-01

    Discussions about driving cessation are difficult. "Advance driving directives" (ADDs), like advance directives for end-of-life care, would allow drivers to designate someone to help make driving decisions for them in the future. It is not known if older drivers support the concept of ADDs. Cross-sectional study of a convenience sample of English-speaking drivers (55+ years) at 2 independent living facilities and 2 community centers who completed anonymous surveys. Of 168 participants, 80% were female; the median age was 76.5 years (range = 56-93 years). Most (74%) drove daily or almost daily, and 7% reported a crash in the past year. Few had spoken with someone about driving safety (5%) or their wishes when driving skills decline (21%). Of the few who had discussed this topic, 83% had spoken with a family member; only 17% had spoken with a health care provider. However, participants were open to driving discussions, and 54% said they would be willing to complete an ADD if recommended. Of these, 79% said it was "likely" or "very likely" they would comply with the directive in the future. Most (73%) supported mandatory, age-based retesting; the median recommended testing age suggested was 80 years. More participants thought the driver (71%), a family member (61%), or a physician (59%) should determine license revocation for an unsafe driver, rather than the department of motor vehicles (32%). Many older drivers may be open to discussing their driving plans with physicians and family members. ADDs may facilitate these discussions in the present and help define driving-related wishes in the future.

  17. Schoolbus driver performance can be improved with driver training ...

    The Safe Travel to School Programme was recently implemented by a national child safety agency, with a focus on driver road safety awareness, defensive ... of a vehicle telematics tracking system with regular, individual driving behaviour ...

  18. Neurovascular Structures at Risk With Curved Retrograde TTC Fusion Nails.

    de Cesar Netto, Cesar; Johannesmeyer, David; Cone, Brent; Araoye, Ibukunoluwa; Hudson, Parke William; Sahranavard, Bahman; Johnson, Michael; Shah, Ashish

    2017-10-01

    The purpose of this study was to assess the risk of iatrogenic injury to plantar neurovascular structures of the foot during insertion of a curved retrograde tibiotalocalcaneal (TTC) fusion nail. Ten below-knee thawed fresh-frozen cadaveric specimens underwent curved retrograde nailing of the ankle. The shortest distance between the nail and the main plantar neurovascular branches and injured structures were recorded during dissection. We also evaluated the relative position of these structures along 2 lines (AB, connecting the calcaneus to the first metatarsal, and BC, connecting the first and fifth metatarsal). The lateral plantar artery was found to be in direct contact with the nail 70% of the time, with a macroscopic laceration 30% of the time. The Baxter nerve was injured 20% of the time, as was the lateral plantar nerve. The medial plantar artery and nerve were never injured. The most proximal structure to cross line AB was the Baxter nerve followed by the lateral plantar artery, the nail, the lateral plantar nerve, and the medial plantar nerve. Our cadaveric anatomic study found that the most common structures at risk for iatrogenic injury by lateral curved retrograde TTC fusion nails were the lateral plantar artery and nerve, and the Baxter nerve. Determination of a true neurovascular safe zone is challenging and therefore warrants careful operative dissection to minimize neurovascular injuries.

  19. Anatomical contouring variability in thoracic organs at risk

    McCall, Ross, E-mail: rmccall86@gmail.com [Medical Dosimetry Program, University of Wisconsin, La Crosse, WI (United States); MacLennan, Grayden; Taylor, Matthew; Lenards, Nishele [Medical Dosimetry Program, University of Wisconsin, La Crosse, WI (United States); Nelms, Benjamin E. [Canis Lupus LLC, Madison, WI (United States); Koshy, Matthew; Lemons, Jeffrey [Department of Radiation and Cellular Oncology, University of Chicago, Chicago, IL (United States); Hunzeker, Ashley [Medical Dosimetry Program, University of Wisconsin, La Crosse, WI (United States)

    2016-01-01

    The purpose of this study was to determine whether contouring thoracic organs at risk was consistent among medical dosimetrists and to identify how trends in dosimetrist's education and experience affected contouring accuracy. Qualitative and quantitative methods were used to contextualize the raw data that were obtained. A total of 3 different computed tomography (CT) data sets were provided to medical dosimetrists (N = 13) across 5 different institutions. The medical dosimetrists were directed to contour the lungs, heart, spinal cord, and esophagus. The medical dosimetrists were instructed to contour in line with their institutional standards and were allowed to use any contouring tool or technique that they would traditionally use. The contours from each medical dosimetrist were evaluated against “gold standard” contours drawn and validated by 2 radiation oncology physicians. The dosimetrist-derived contours were evaluated against the gold standard using both a Dice coefficient method and a penalty-based metric scoring system. A short survey was also completed by each medical dosimetrist to evaluate their individual contouring experience. There was no significant variation in the contouring consistency of the lungs and spinal cord. Intradosimetrist contouring was consistent for those who contoured the esophagus and heart correctly; however, medical dosimetrists with a poor metric score showed erratic and inconsistent methods of contouring.

  20. Multifractality and value-at-risk forecasting of exchange rates

    Batten, Jonathan A.; Kinateder, Harald; Wagner, Niklas

    2014-05-01

    This paper addresses market risk prediction for high frequency foreign exchange rates under nonlinear risk scaling behaviour. We use a modified version of the multifractal model of asset returns (MMAR) where trading time is represented by the series of volume ticks. Our dataset consists of 138,418 5-min round-the-clock observations of EUR/USD spot quotes and trading ticks during the period January 5, 2006 to December 31, 2007. Considering fat-tails, long-range dependence as well as scale inconsistency with the MMAR, we derive out-of-sample value-at-risk (VaR) forecasts and compare our approach to historical simulation as well as a benchmark GARCH(1,1) location-scale VaR model. Our findings underline that the multifractal properties in EUR/USD returns in fact have notable risk management implications. The MMAR approach is a parsimonious model which produces admissible VaR forecasts at the 12-h forecast horizon. For the daily horizon, the MMAR outperforms both alternatives based on conditional as well as unconditional coverage statistics.

  1. ESTIMASI NILAI CONDITIONAL VALUE AT RISK MENGGUNAKAN FUNGSI GAUSSIAN COPULA

    HERLINA HIDAYATI

    2015-11-01

    Full Text Available Copula is already widely used in financial assets, especially in risk management. It is due to the ability of copula, to capture the nonlinear dependence structure on multivariate assets. In addition, using copula function doesn’t require the assumption of normal distribution. There fore it is suitable to be applied to financial data. To manage a risk the necessary measurement tools can help mitigate the risks. One measure that can be used to measure risk is Value at Risk (VaR. Although VaR is very popular, it has several weaknesses. To overcome the weakness in VaR, an alternative risk measure called CVaR can be used. The porpose of this study is to estimate CVaR using Gaussian copula. The data we used are the closing price of Facebook and Twitter stocks. The results from the calculation using 90%  confidence level showed that the risk that may be experienced is at 4,7%, for 95% confidence level it is at 6,1%, and for 99% confidence level it is at 10,6%.

  2. Forecasting Value-at-Risk Using High-Frequency Information

    Huiyu Huang

    2013-06-01

    Full Text Available in the prediction of quantiles of daily Standard&Poor’s 500 (S&P 500 returns we consider how to use high-frequency 5-minute data. We examine methods that incorporate the high frequency information either indirectly, through combining forecasts (using forecasts generated from returns sampled at different intraday interval, or directly, through combining high frequency information into one model. We consider subsample averaging, bootstrap averaging, forecast averaging methods for the indirect case, and factor models with principal component approach, for both direct and indirect cases. We show that in forecasting the daily S&P 500 index return quantile (Value-at-Risk or VaR is simply the negative of it, using high-frequency information is beneficial, often substantially and particularly so, in forecasting downside risk. Our empirical results show that the averaging methods (subsample averaging, bootstrap averaging, forecast averaging, which serve as different ways of forming the ensemble average from using high-frequency intraday information, provide an excellent forecasting performance compared to using just low-frequency daily information.

  3. Predicting post-vaccination autoimmunity: who might be at risk?

    Soriano, Alessandra; Nesher, Gideon; Shoenfeld, Yehuda

    2015-02-01

    Vaccinations have been used as an essential tool in the fight against infectious diseases, and succeeded in improving public health. However, adverse effects, including autoimmune conditions may occur following vaccinations (autoimmune/inflammatory syndrome induced by adjuvants--ASIA syndrome). It has been postulated that autoimmunity could be triggered or enhanced by the vaccine immunogen contents, as well as by adjuvants, which are used to increase the immune reaction to the immunogen. Fortunately, vaccination-related ASIA is uncommon. Yet, by defining individuals at risk we may further limit the number of individuals developing post-vaccination ASIA. In this perspective we defined four groups of individuals who might be susceptible to develop vaccination-induced ASIA: patients with prior post-vaccination autoimmune phenomena, patients with a medical history of autoimmunity, patients with a history of allergic reactions, and individuals who are prone to develop autoimmunity (having a family history of autoimmune diseases; asymptomatic carriers of autoantibodies; carrying certain genetic profiles, etc.). Copyright © 2014 Elsevier Ltd. All rights reserved.

  4. The Mediterranean and Black Sea fisheries at risk from overexploitation.

    Athanassios C Tsikliras

    Full Text Available The status of the Mediterranean and Black Sea fisheries was evaluated for the period 1970-2010 on a subarea basis, using various indicators including the temporal variability of total landings, the number of recorded stocks, the mean trophic level of the catch, the fishing-in-balance index and the catch-based method of stock classification. All indicators confirmed that the fisheries resources of the Mediterranean and Black Sea are at risk from overexploitation. The pattern of exploitation and the state of stocks differed among the western (W, central (C and eastern (E Mediterranean subareas and the Black Sea (BS, with the E Mediterranean and BS fisheries being in a worst shape. Indeed, in the E Mediterranean and the BS, total landings, mean trophic level of the catch and fishing-in-balance index were declining, the cumulative percentage of overexploited and collapsed stocks was higher, and the percentage of developing stocks was lower, compared to the W and C Mediterranean. Our results confirm the need for detailed and extensive stock assessments across species that will eventually lead to stocks recovering through conservation and management measures.

  5. Is the human nasal cavity at risk from inhaled radionuclides?

    Boecker, B.B.; Hahn, F.F.; Cuddihy, R.G.; Snipes, M.B.; McClellan, R.O.

    1986-01-01

    In a series of three life-span studies in which beagle dogs inhaled relatively soluble forms of beta-emitting radionuclides, a number of cancers of the nasal cavity have arisen at long times after the inhalation exposure. No such cancers were observed in the control dogs. Data obtained in other studies involving serial sacrifice of dogs that received these radionuclides in similar forms have shown that high local concentrations of the radionuclides can persist in nasal turbinates for long periods of time, depending on the physical half-life of the radionuclide inhaled. Several nasal carcinomas have also been observed in dogs injected with 137 CsCl in which the relative concentrations of beta activity in the turbinate region were not as pronounced as in the above studies. Similar risks of sinonasal cancer were calculated for dogs in each of these studies regardless of differences in radionuclide, dosimetry, and route of administration. Since sinonasal cancers have occurred in people exposed to alpha-emitting radionuclides, it is reasonable to assume this could occur with beta emitters as well. Radiation protection guidelines should account for the sinonasal region being at risk. 23 refs., 1 fig., 6 tabs

  6. Don’t put your family at risk

    Computer Security Team

    2013-01-01

    How easy is it to fall into the trap of cyber-criminals? Get one’s online banking password stolen? Lose photos to third parties? It's easier than you think. One single click to open a malicious attachment or a malicious web page is sufficient to put your family at risk.   Sometimes adversaries even call you in order to get their malicious job done. Once their malware is installed on your home computer, it records all your activity, monitors your online banking activities, steals your passwords, activates your computer’s microphone and camera, and sends all that data back to the adversary. This person can now do whatever they want: take money from your bank account, order books with your Amazon password, deface your Facebook profiles, send strange messages to your peers, or post the captured images of your daughter in front of the computer on dodgy web sites. Not only can you lose (lots of!) money, but having strange messages sent on your b...

  7. Are online gamblers more at risk than offline gamblers?

    Kairouz, Sylvia; Paradis, Catherine; Nadeau, Louise

    2012-03-01

    To characterize and compare sociodemographic profiles, game-play patterns, and level of addictive behaviors among adults who gamble online and those who do not, and to examine if, at the population level, online gambling is associated with more risky behaviors than offline gambling. Respondents were 8,456 offline gamblers and 111 online gamblers who participated in a population-based survey conducted in the province of Québec, in 2009. The study sample is representative of adult general population. There is an unequal distribution of online gambling in the population. A disproportionate number of men, young people, and students say they participate in online gambling. Poker players are overrepresented among online gamblers and gambling behaviors tend to be more excessive on the Internet. Compared with offline gamblers, online gamblers report more co-occurring risky behaviors, namely alcohol and cannabis use. Those who gamble online appear to be more at risk for gambling-related problems, but the present findings alone cannot be used as evidence for that conclusion. Future research designs could combine longitudinal data collection and multilevel analyses to provide more insight into the causal mechanisms associated with online gambling.

  8. Research on driver fatigue detection

    Zhang, Ting; Chen, Zhong; Ouyang, Chao

    2018-03-01

    Driver fatigue is one of the main causes of frequent traffic accidents. In this case, driver fatigue detection system has very important significance in avoiding traffic accidents. This paper presents a real-time method based on fusion of multiple facial features, including eye closure, yawn and head movement. The eye state is classified as being open or closed by a linear SVM classifier trained using HOG features of the detected eye. The mouth state is determined according to the width-height ratio of the mouth. The head movement is detected by head pitch angle calculated by facial landmark. The driver's fatigue state can be reasoned by the model trained by above features. According to experimental results, drive fatigue detection obtains an excellent performance. It indicates that the developed method is valuable for the application of avoiding traffic accidents caused by driver's fatigue.

  9. Teen driver cell phone blocker.

    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...

  10. Differentiating Community Dwellers at Risk for Pathological Narcissism From Community Dwellers at Risk for Psychopathy Using Measures of Emotion Recognition and Subjective Emotional Activation.

    Fossati, Andrea; Somma, Antonella; Pincus, Aaron; Borroni, Serena; Dowgwillo, Emily A

    2017-06-01

    The Italian translations of the Pathological Narcissism Inventory (PNI) and Triarchic Psychopathy Measure (TriPM) were administered to 609 community dwelling adults. Participants who scored in the upper 10% of the distribution of the PNI total score were assigned to the group of participants at risk for pathological narcissism, whereas participants who scored in the upper 10% of the distribution of the TriPM total score were assigned to the group of participants at risk for psychopathy. The final sample included 126 participants who were administered the Reading the Mind in the Eyes Test (RMET) and emotion-eliciting movie clips. Participants at risk for pathological narcissism scored significantly lower on the RMET total score than participants who were not at risk for pathological narcissism. Participants at risk for psychopathy showed a significant reduction in the subjective experience of disgust, fear, sadness, and tenderness compared to participants who were not at risk for psychopathy.

  11. Margins for geometric uncertainty around organs at risk in radiotherapy

    McKenzie, Alan; Herk, Marcel van; Mijnheer, Ben

    2002-01-01

    Background and purpose: ICRU Report 62 suggests drawing margins around organs at risk (ORs) to produce planning organ at risk volumes (PRVs) to account for geometric uncertainty in the radiotherapy treatment process. This paper proposes an algorithm for drawing such margins, and compares the recommended margin widths with examples from clinical practice and discusses the limitations of the approach. Method: The use of the PRV defined in this way is that, despite the geometric uncertainties, the dose calculated within the PRV by the treatment planning system can be used to represent the dose in the OR with a certain confidence level. A suitable level is where, in the majority of cases (90%), the dose-volume histogram of the PRV will not under-represent the high-dose components in the OR. In order to provide guidelines on how to do this in clinical practice, this paper distinguishes types of OR in terms of the tolerance doses relative to the prescription dose and suggests appropriate margins for serial-structure and parallel-structure ORs. Results: In some instances of large and parallel ORs, the clinician may judge that the complication risk in omitting a margin is acceptable. Otherwise, for all types of OR, systematic, treatment preparation uncertainties may be accommodated by an OR→PRV margin width of 1.3Σ. Here, Σ is the standard deviation of the combined systematic (treatment preparation) uncertainties. In the case of serial ORs or small, parallel ORs, the effects of blurring caused by daily treatment execution errors (set-up and organ motion) should be taken into account. Near a region of high dose, blurring tends to shift the isodoses away from the unblurred edge as shown on the treatment planning system by an amount that may be represented by 0.5σ. This margin may be used either to increase or to decrease the margin already calculated for systematic uncertainties, depending upon the size of the tolerance dose relative to the detailed planned dose

  12. [Obesity and complementary feeding time: a period at risk].

    Vidailhet, M

    2010-12-01

    Relation between rapid growth during the first months of life and secondary risk of excessive adiposity is well demonstrated. Many works have indicated a birth feeding effect on weight gain during the first year of life and a protective effect towards later childhood and adult obesity. However all these studies are observational and several works denied this protective effect. Concerning complementary feeding, 3 interventional, randomized, studies achieved between 4 and 6 months of age, showed a good regulation of caloric intake and no weight gain modification due to complementary foods. Most of others studies are observational and don't show any relation between time of introduction of complementary foods and later fat mass. However 3 recent studies indicate, respectively at 7, 10 and 42 years of age, an increased adiposity, suggesting the possibility of a programmed excessive fat gain induced by an early complementary foods introduction. Very few studies have evaluated, besides the time of weaning, the kind, quantity and caloric density of foods used as complements, whereas other recent studies show the importance of appetite differences since the first months of life and the importance of genetic influence on these variations. Others works have emphasized the possible role of an excessive protein intake during the first 2 years of life. So, it appears that it may be necessary to pay attention not only on the date, but also on the kind and quantity of complementary foods, particularly in infants at risk for obesity, because of parental obesity, rapid weight growth or an excessive appetite. Copyright © 2010 Elsevier Masson SAS. All rights reserved.

  13. Identifying nursing home residents at risk for falling.

    Kiely, D K; Kiel, D P; Burrows, A B; Lipsitz, L A

    1998-05-01

    To develop a fall risk model that can be used to identify prospectively nursing home residents at risk for falling. The secondary objective was to determine whether the nursing home environment independently influenced the development of falls. A prospective study involving 1 year of follow-up. Two hundred seventy-two nursing homes in the state of Washington. A total of 18,855 residents who had a baseline assessment in 1991 and a follow-up assessment within the subsequent year. Baseline Minimum Data Set items that could be potential risk factors for falling were considered as independent variables. The dependent variable was whether the resident fell as reported at the follow-up assessment. We estimated the extrinsic risk attributable to particular nursing home environments by calculating the annual fall rate in each nursing home and grouping them into tertiles of fall risk according to these rates. Factors associated independently with falling were fall history, wandering behavior, use of a cane or walker, deterioration of activities of daily living performance, age greater than 87 years, unsteady gait, transfer independence, wheelchair independence, and male gender. Nursing home residents with a fall history were more than three times as likely to fall during the follow-up period than residents without a fall history. Residents in homes with the highest tertile of fall rates were more than twice as likely to fall compared with residents of homes in the lowest tertile, independent of resident-specific risk factors. Fall history was identified as the strongest risk factor associated with subsequent falls and accounted for the vast majority of the predictive strength of the model. We recommend that fall history be used as an initial screener for determining eligibility for fall intervention efforts. Studies are needed to determine the facility characteristics that contribute to fall risk, independent of resident-specific risk factors.

  14. Youth at risk of physical inactivity may benefit more from activity-related support than youth not at risk

    Schmalz Dorothy L

    2006-03-01

    Full Text Available Background This study examines whether associations between activity-related support and adolescents' physical activity differ for adolescents at high versus low risk of physical inactivity. Methods: Participants included 202 middle-school-aged girls (N = 92 and boys (N = 110. Physical activity was assessed using three self-report questionnaires. Activity-related support from mothers, fathers, siblings, and peers was assessed using the Activity Support Scale. Perceived sport competence was assessed using the Physical Activity Self Description Questionnaire. Participants' height and weight were measured and used to calculate their age- and sex-adjusted Body Mass Index percentile. Participants were classified as being at high risk for physical inactivity if they fulfilled two of the following three criteria: (1 overweight; (2 female; or (3 having low perceived sport competence. Results: Activity-related support from all sources was associated with higher levels of physical activity among adolescents. A stronger association between activity support and physical activity was found for adolescents at high risk for physical inactivity in comparison to adolescents at low risk. Conclusions: Findings from this study suggest that the activity-related support from family and friends may be an effective tool in promoting physical activity among youth at risk of physical inactivity.

  15. Driver style and driver skills – clustering drivers differing in their potential danger in traffic

    Martinussen, Laila Marianne; Møller, Mette; Prato, Carlo Giacomo

    The Driver Behavior Questionnaire (DBQ) and the Driver Skill Inventory (DSI) are two of the most frequently used measures of driving style and driving skill. The motivation behind the present study was to test drivers’ insight into their own driving ability based on a combined use of the DBQ......, annual mileage and accident involvement. 3908 drivers aged 18–84 participated in the survey. The results suggested that the drivers have good insight into their own driving ability, as the driving skill level mirrored the frequency of aberrant driving behaviors. K-means cluster analysis revealed four...... distinct clusters that differed in the frequency of aberrant driving behavior and driving skills, as well as individual characteristics and driving related factors such as annual mileage, accident frequency and number of tickets and fines. Thus, two sub-groups were identified as more unsafe than the two...

  16. Locomotor diseases among male long-haul truck drivers and other professional drivers

    Jensen, Anker; Kaerlev, Linda; Tüchsen, Finn

    2007-01-01

    -249) and for other truck drivers (SHR: 130, 95% CI: 108-156) compared to bus drivers (SHR: 110, 95% CI: 79-149). All drivers had high SHR for lesions of the ulnar nerve (SHR: 159, 95% CI: 119-207), especially bus drivers (SHR: 197, 95% CI: 116-311). Long-haul truck drivers had high SHRs for synovitis and bursitis...

  17. Evaluability Assessment of a National Driver Retraining Program: Are We Evaluating in the Right Lane?

    Joanisse, Melanie; Stinchcombe, Arne; Yamin, Stephanie

    2010-01-01

    An evaluability assessment (EA) of the 55 Alive program, a national older driver refresher course aimed at improving driving skills, was conducted. This EA adds to the evaluation literature as previous outcome evaluations neglected to explore whether this program was prepared for such assessments. A mixed-method protocol was executed across three…

  18. A simulation-based assessment approach to increase safety among senior drivers.

    2013-04-01

    Statistics show that in the U.S., there are about 38 million licensed drivers over age 65; about 1/8 of our : population. By 2024, this figure will DOUBLE to 25%. The current research is intended to address the : driving capabilities of our older pop...

  19. Comparative demography of an at-risk African elephant population.

    George Wittemyer

    Full Text Available Knowledge of population processes across various ecological and management settings offers important insights for species conservation and life history. In regard to its ecological role, charisma and threats from human impacts, African elephants are of high conservation concern and, as a result, are the focus of numerous studies across various contexts. Here, demographic data from an individually based study of 934 African elephants in Samburu, Kenya were summarized, providing detailed inspection of the population processes experienced by the population over a fourteen year period (including the repercussions of recent increases in illegal killing. These data were compared with those from populations inhabiting a spectrum of xeric to mesic ecosystems with variable human impacts. In relation to variability in climate and human impacts (causing up to 50% of recorded deaths among adults, annual mortality in Samburu fluctuated between 1 and 14% and, unrelatedly, natality between 2 and 14% driving annual population increases and decreases. Survivorship in Samburu was significantly lower than other populations with age-specific data even during periods of low illegal killing by humans, resulting in relatively low life expectancy of males (18.9 years and females (21.8 years. Fecundity (primiparous age and inter-calf interval were similar to those reported in other human impacted or recovering populations, and significantly greater than that of comparable stable populations. This suggests reproductive effort of African savanna elephants increases in relation to increased mortality (and resulting ecological ramifications as predicted by life history theory. Further comparison across populations indicated that elongated inter-calf intervals and older ages of reproductive onset were related to age structure and density, and likely influenced by ecological conditions. This study provides detailed empirical data on elephant population dynamics strongly

  20. Comparative demography of an at-risk African elephant population.

    Wittemyer, George; Daballen, David; Douglas-Hamilton, Iain

    2013-01-01

    Knowledge of population processes across various ecological and management settings offers important insights for species conservation and life history. In regard to its ecological role, charisma and threats from human impacts, African elephants are of high conservation concern and, as a result, are the focus of numerous studies across various contexts. Here, demographic data from an individually based study of 934 African elephants in Samburu, Kenya were summarized, providing detailed inspection of the population processes experienced by the population over a fourteen year period (including the repercussions of recent increases in illegal killing). These data were compared with those from populations inhabiting a spectrum of xeric to mesic ecosystems with variable human impacts. In relation to variability in climate and human impacts (causing up to 50% of recorded deaths among adults), annual mortality in Samburu fluctuated between 1 and 14% and, unrelatedly, natality between 2 and 14% driving annual population increases and decreases. Survivorship in Samburu was significantly lower than other populations with age-specific data even during periods of low illegal killing by humans, resulting in relatively low life expectancy of males (18.9 years) and females (21.8 years). Fecundity (primiparous age and inter-calf interval) were similar to those reported in other human impacted or recovering populations, and significantly greater than that of comparable stable populations. This suggests reproductive effort of African savanna elephants increases in relation to increased mortality (and resulting ecological ramifications) as predicted by life history theory. Further comparison across populations indicated that elongated inter-calf intervals and older ages of reproductive onset were related to age structure and density, and likely influenced by ecological conditions. This study provides detailed empirical data on elephant population dynamics strongly influenced by human

  1. Effect of sex education programme on at-risk sexual behaviour of ...

    Effect of sex education programme on at-risk sexual behaviour of ... that place them at risk for Sexually Transmitted Diseases (STDs). ... The treatment group evaluated the intervention programme positively and their knowledge of sexual health ...

  2. How Many People Are Affected by or at Risk for Endometriosis?

    ... Share Facebook Twitter Pinterest Email Print How many people are affected by or at risk for endometriosis? ... Gynecology, 202 , 534.e1–534.e6. How many people are affected by or at risk for endometriosis? ...

  3. METHODS OF VOCATIONAL TRAINING FOR OLDER WORKERS IN THE FRENCH NATIONAL RAILWAYS.

    COQUERET, A.

    WHEN THE FRENCH NATIONAL RAILWAY CONVERTED FROM STEAM TO AN ELECTRIC AND DIESEL-ELECTRIC TRACTION SYSTEM, IT WAS NECESSARY TO RETRAIN OLDER (OVER 40) SKILLED WORKERS--DRIVERS, LOCOMOTIVE MAINTENANCE MEN AND SUPERVISORS OF WORKSHOPS AND DEPOTS. THE INTELLECTUAL AND EMOTIONAL DIFFICULTIES OF OLDER PERSONS IN RETRAINING WERE TAKEN INTO CONSIDERATION…

  4. IFE Power Plant design principles. Drivers. Solid state laser drivers

    Nakai, S.; Andre, M.; Krupke, W.F.; Mak, A.A.; Soures, J.M.; Yamanaka, M.

    1995-01-01

    The present status of solid state laser drivers for an inertial confinement thermonuclear fusion power plant is discussed. In particular, the feasibility of laser diode pumped solid state laser drivers from both the technical and economic points of view is briefly reviewed. Conceptual design studies showed that they can, in principle, satisfy the design requirements. However, development of new solid state materials with long fluorescence lifetimes and good thermal characteristics is a key issue for laser diode pumped solid state lasers. With the advent of laser diode pumping many materials which were abandoned in the past can presently be reconsidered as viable candidates. It is also concluded that it is important to examine the technical requirements for solid state lasers in relation to target performance criteria. The progress of laser diode pumped lasers in industrial applications should also be closely watched to provide additional information on the economic feasibility of this type of driver. 15 refs, 9 figs, 2 tabs

  5. Staying on track: behavioral engagement of at-risk and non-at-risk students in post-secondary vocational education

    Elffers, L.

    2013-01-01

    Behavioral disengagement from school is a proximal predictor of dropout. Therefore, the enhancement of behavioral engagement is a useful point of entry for dropout prevention. In this study, we examine the behavioral engagement of at-risk and non-at-risk students in Dutch senior vocational education

  6. Sexual behavior among truck drivers.

    Singh, Rajiv Kumar; Joshi, Hari Shankar

    2012-01-01

    A cross-sectional study was conducted on Lucknow highway in Bareilly district of Uttar Pradesh to study the knowledge of truck drivers about HIV transmission and prevention and to study the sexual behaviour of these drivers with reference to HIV/AIDS. Age, marital status, education, income, drinking alcohol, length of stay away from home, knowledge about transmission and prevention of HIV, and HIV-prone behavior of truck drivers were studied. Chi-square, mean, and SD were calculated. In all, 289 (97.6%) drivers had heard about HIV/AIDS. Only 242 (81.8%) were aware of HIV transmission by heterosexual route. Misconceptions such as HIV transmission by mosquito bites, living in same room, shaking hands, and sharing food were found. Out of 174 (58.8%) who visited Commercial Sex Workers (CSW), 146 (83.9%) used a condom. 38 (12.8%) visited more than 5 CSW in the last 3 months. Time away from home on the road, marital status, alcohol use, and income class were associated with visiting CSW. High-risk behavior was established in the study population. Safe sex and use of condoms need to be promoted among the truck drivers and better condom availability needs to be assured on highways.

  7. Mentoring At-Risk Middle School Students to Reduce Communication Apprehension

    Jones, Kevin T.; Procopio, Claire H.

    2017-01-01

    Research has demonstrated the efficacy of mentoring at-risk students in a number of fields from physical education to math and science. While separate research has found that many at-risk students lack effective communication skills, little research has explored the potential of communication mentoring in improving at-risk students' communication…

  8. French Immersion Experience and Reading Skill Development in At-Risk Readers

    Kruk, Richard S.; Reynolds, Kristin A. A.

    2012-01-01

    We tracked the developmental influences of exposure to French on developing English phonological awareness, decoding and reading comprehension of English-speaking at-risk readers from Grade 1 to Grade 3. Teacher-nominated at-risk readers were matched with not-at-risk readers in French immersion and English language programs. Exposure to spoken…

  9. Depression in Older Adults

    ... here Home » Depression In Older Adults: More Facts Depression In Older Adults: More Facts Depression affects more ... combination of both. [8] Older Adult Attitudes Toward Depression: According to a Mental Health America survey [9] ...

  10. Cancer in Older Adults

    ... Home > Navigating Cancer Care > For Older Adults For Older Adults A full-text transcript is available. More than ... Advanced Cancer For Children For Teens For Young Adults For Older Adults Aging and Cancer Cancer Care Decisions for ...

  11. Older Adults and Alcohol

    ... Other Psychiatric Disorders Other Substance Abuse HIV/AIDS Older Adults A national 2008 survey found that about 40 ... of adults ages 65 and older drink alcohol. Older adults can experience a variety of problems from drinking ...

  12. Atypical audiovisual speech integration in infants at risk for autism.

    Jeanne A Guiraud

    Full Text Available The language difficulties often seen in individuals with autism might stem from an inability to integrate audiovisual information, a skill important for language development. We investigated whether 9-month-old siblings of older children with autism, who are at an increased risk of developing autism, are able to integrate audiovisual speech cues. We used an eye-tracker to record where infants looked when shown a screen displaying two faces of the same model, where one face is articulating/ba/and the other/ga/, with one face congruent with the syllable sound being presented simultaneously, the other face incongruent. This method was successful in showing that infants at low risk can integrate audiovisual speech: they looked for the same amount of time at the mouths in both the fusible visual/ga/- audio/ba/and the congruent visual/ba/- audio/ba/displays, indicating that the auditory and visual streams fuse into a McGurk-type of syllabic percept in the incongruent condition. It also showed that low-risk infants could perceive a mismatch between auditory and visual cues: they looked longer at the mouth in the mismatched, non-fusible visual/ba/- audio/ga/display compared with the congruent visual/ga/- audio/ga/display, demonstrating that they perceive an uncommon, and therefore interesting, speech-like percept when looking at the incongruent mouth (repeated ANOVA: displays x fusion/mismatch conditions interaction: F(1,16 = 17.153, p = 0.001. The looking behaviour of high-risk infants did not differ according to the type of display, suggesting difficulties in matching auditory and visual information (repeated ANOVA, displays x conditions interaction: F(1,25 = 0.09, p = 0.767, in contrast to low-risk infants (repeated ANOVA: displays x conditions x low/high-risk groups interaction: F(1,41 = 4.466, p = 0.041. In some cases this reduced ability might lead to the poor communication skills characteristic of autism.

  13. Examination of supplemental driver training and online basic driver education courses : traffic tech.

    2012-08-01

    The first six months of unsupervised driving are the most : hazardous in a novice drivers driving experience. Most : States adopted graduated driver licensing (GDL) systems : to give novice drivers experience in a protective environment, : gradual...

  14. Key drivers of airline loyalty.

    Dolnicar, Sara; Grabler, Klaus; Grün, Bettina; Kulnig, Anna

    2011-10-01

    This study investigates drivers of airline loyalty. It contributes to the body of knowledge in the area by investigating loyalty for a number of a priori market segments identified by airline management and by using a method which accounts for the multi-step nature of the airline choice process. The study is based on responses from 687 passengers. Results indicate that, at aggregate level, frequent flyer membership, price, the status of being a national carrier and the reputation of the airline as perceived by friends are the variables which best discriminate between travellers loyal to the airline and those who are not. Differences in drivers of airline loyalty for a number of segments were identified. For example, loyalty programs play a key role for business travellers whereas airline loyalty of leisure travellers is difficult to trace back to single factors. For none of the calculated models satisfaction emerged as a key driver of airline loyalty.

  15. Evaluation of Traffic Accident Risk in In-City Bus Drivers: The Use of Berlin Questionnaire

    Ekren, Pervin Korkmaz; Uysal, Funda Elmas; Başoğlu, Özen K.

    2018-01-01

    OBJECTIVES Traffic accidents associated with high mortality rate may produce serious problems especially in highways. Obstructive sleep apnea (OSA) has been associated with a high risk for traffic accidents due to excessive daytime sleepiness even in in-city drivers. In the present study, it was aimed to evaluate the rate of OSA symptoms and to identify risk factors associated with traffic accidents in in-city bus drivers. MATERIAL AND METHODS A self-administered questionnaire including demographic and anthropometric features, sleep and work schedules, Berlin questionnaire, Epworth sleepiness score (ESS), and history of traffic accidents was used. RESULTS The questionnaire was conducted for 1400 male bus drivers (mean age, 38.0±6.4 y, body mass index, 27.8±3.9 kg/m2). A total of 1058 (75.6%) drivers had one or more accidents while driving bus. According to the Berlin questionnaire, 176 (12.6%) drivers were found to have high OSA risk and the accident rate was 83.0% in high-risk group, whereas 74.5% of low-risk drivers had accidents (p=0.043). The drivers with a history of traffic accident were older (p=0.030), had higher ESS (p=0.019), and were more in the high-risk OSA group according to the Berlin questionnaire (p=0.015). In multivariate linear regression analysis, traffic accident was associated with only Berlin questionnaire (p=0.015). CONCLUSION The present results support that city bus drivers with high OSA risk according to Berlin questionnaire have increased accident rates. Therefore, we suggest using Berlin questionnaire for screening sleep apnea not only in highway drivers but also in in-city bus drivers. PMID:29755810

  16. Impact of gender, organized athletics, and video gaming on driving skills in novice drivers.

    Wayne, Nancy L; Miller, Gregory A

    2018-01-01

    Given that novice drivers tend to be young, and teenagers and young adult drivers are involved in the greatest number of accidents, it is important that we understand what factors impact the driving skills of this population of drivers. The primary aim of the present study was to understand the impact of gender, organized athletics, and video gaming on driving skills of novice drivers under real-world driving conditions. Novice driving students having less than five hours driving experience previous to a normal driving lesson were evaluated on their self-confidence (self-reported) prior to the lesson and driving skill evaluated by their instructor during the course of the lesson. Information was collected about gender, age, whether or not the students were involved in organized athletics, and the extent of their video game playing. There was no impact of gender or extent of video game playing on driving skills. Females were significantly less self-confident with driving than males, but this did not translate to gender differences in driving skills. Being involved in organized athletics-either currently or in the past-significantly enhanced driving skills in both females and males. Finally, novice drivers' age was negatively correlated with driving skills. That is, younger novice drivers (especially males) had better driving skills than older novice drivers. This is counter to popular belief that young drivers lack technical driving skills because they have less experience behind the wheel. Based on the results of the current study, we hypothesize that the relatively high accident rate of younger drivers (especially male drivers) is most likely due to inattention to safety considerations rather than lack of technical driving ability.

  17. What are the impacts of giving up the driver license?

    Siren, Anu Kristiina; Haustein, Sonja

    2013-01-01

    Objectives: Driving cessation is a gradual process, where driver’s self-regulation plays an important role. Age-based license renewal procedures may interfere with this process and trigger premature driving cessation. The present study compares drivers aged 69 years at the baseline who either renewed their driver’s license (“renewers”) or did not (“non-renewers”) over a two-year period.Methods: Data were collected by interviewing a sample of older Danish people in 2009 (n = 1,792) and in 2012...

  18. UWB dual burst transmit driver

    Dallum, Gregory E [Livermore, CA; Pratt, Garth C [Discovery Bay, CA; Haugen, Peter C [Livermore, CA; Zumstein, James M [Livermore, CA; Vigars, Mark L [Livermore, CA; Romero, Carlos E [Livermore, CA

    2012-04-17

    A dual burst transmitter for ultra-wideband (UWB) communication systems generates a pair of precisely spaced RF bursts from a single trigger event. An input trigger pulse produces two oscillator trigger pulses, an initial pulse and a delayed pulse, in a dual trigger generator. The two oscillator trigger pulses drive a gated RF burst (power output) oscillator. A bias driver circuit gates the RF output oscillator on and off and sets the RF burst packet width. The bias driver also level shifts the drive signal to the level that is required for the RF output device.

  19. The effect of feedback on attitudes toward cellular phone use while driving: a comparison between novice and experienced drivers.

    Wang, Ying; Zhang, Wei; Reimer, Bryan; Lavallière, Martin; Lesch, Mary F; Horrey, William J; Wu, Su

    2010-10-01

    To assess and compare the effectiveness of a simulation-based approach to change drivers' attitudes toward cellular phone use while driving for younger novice and older experienced drivers. Thirty young novice drivers were tested on a driving simulator in this study. Their performance in dealing with driving tasks was measured for a single task and dual tasks (driving while using a cellular phone) and compared to 30 older experienced drivers tested previously in another study. Half of the younger drivers received video-based feedback regarding their performance in the two conditions, with an emphasis on the contribution of dual-tasking to degraded performance. The other half did not receive any performance feedback. Drivers' perceptions and attitudes toward cellular phone use while driving were investigated by a questionnaire before, immediately after, and again one month following the simulation-based testing for both groups of drivers (feedback; no feedback). All drivers (including the novice and experienced) reported willingness to engage in driving and talking on a cellular phone in some situations. The simulated driving test showed that a secondary cellular phone task significantly degraded driving performance for both the novice and the experienced drivers. The feedback treatment group (both the novice and the experienced) showed significant attitude change toward cellular phone use while driving (toward being less favorable), whereas the control group had no attitude change. At the one-month follow-up, the benefit of feedback was sustained more so in the experienced driver group than the novice driver group, although both groups still benefited relative to the control conditions. Simulation-based feedback training is promising for short-term education in novice drivers but may be more effective in the long-term for drivers with higher levels of experience. Drivers with more experience appear to have a greater, more sustained benefit from the training than

  20. Truck drivers' opinion on road safety in Tanzania--a questionnaire study.

    Kircher, Katja; Andersson, Jan

    2013-01-01

    Even though the traffic fatality risk (fatalities per 100,000 inhabitants) in Tanzania is quite low, the fatality rate (fatalities per 10,000 vehicles) is one of the highest in the world. With increasing vehicle density this means that the number of people dying in traffic will increase dramatically in the near future. Therefore, it is important to implement measures to increase traffic safety as soon as possible, and in order to be able to do this in an efficient way, it is important to investigate where the main problems lie. Within the European Union (EU) project ASSET-Road a questionnaire study on road safety was conducted with 250 truck drivers in Tanzania. The study was done to increase the knowledge about the situation of the Tanzanian truckers, who are the most frequent road users in the country. The drivers were interviewed in 3 different towns in southern Tanzania, and participation was voluntary. The questionnaire treated demographics, the state of the drivers' vehicles, the frequency of breakdowns, and the maintenance of the vehicles. Further questions concerned driver behavior, crash involvement, crash risk, and crash mitigation. The drivers who participated in the study were predominantly male and their average age was 36 years. Truck drivers reported driving 10.6 h without a break on average, with several drivers reporting that they had to drive 24 h without rest. Around 40 percent of the trucks did not have any seat belts installed, with a larger share of older trucks lacking belts. Most of the drivers who had seat belts reported using them, however. Almost 40 percent of the drivers reported being involved in at least one crash, and 45 percent of those drivers had experienced fatal crashes. This underlines that the crash frequency per vehicle is very high, and the results are often severe, especially when heavy vehicles are involved. When asked what the 3 most common crash causations were, driver-related causes were named frequently. Drivers were

  1. Pedestrian fatalities and injuries involving Irish older people.

    Martin, A J

    2012-02-01

    BACKGROUND: It has been established internationally that road traffic accidents (RTAs) involving older drivers follow clearly different patterns of timing, location and outcomes from those of younger age groups. Older pedestrians are also a vulnerable group and fewer analyses have been undertaken of the phenomenology of their injuries and fatalities. We studied the pattern of pedestrian RTAs in Ireland over a five-year period with the aim of identifying differences between older pedestrians (aged 65 or older) and younger adults. METHODS: We examined the datasets of the Irish National Road Authority (now the Road Safety Authority) from 1998-2002. We analysed patterns of crashes involving older pedestrians (aged 65) and compared them with younger adults (aged 18-64). RESULTS: Older people represented 36% (n = 134) of pedestrian fatalities and 23% of serious injuries while they only account for 19% of total RTAs. Mortality in RTA is more than doubled for older pedestrians compared to younger adults (RR 2.30). Most accidents involving older pedestrians happen in daylight with good visibility (56%) and in good weather conditions (77%). CONCLUSIONS: Older pedestrians are particularly vulnerable in RTAs. These occur more frequently during daylight hours and in good weather conditions. This may point to a need for prevention strategies that are targeted at the traffic environment and other road users rather than at older people.

  2. Development of a preliminary risk index to identify trauma patients at risk for an unplanned intubation.

    Kim, Dennis; Kobayashi, Leslie; Chang, David; Fortlage, Dale; Coimbra, Raul

    2014-01-01

    The development of respiratory failure requiring an emergent unplanned intubation (UI) is a potentially preventable complication associated with increased morbidity and mortality. The objective of this study was to develop a clinical risk index for UI based on readily available clinical data to assist in the identification of trauma patients at risk for this complication. We also sought to determine the impact of UI on patient outcomes. This is a 3-year retrospective analysis of our Level 1 trauma center registry to identify all patients requiring a UI. Patients who required a UI were compared with patients who were never intubated. An additive risk index consisting of 10 clinical variables was created using the final significant variables from a stepwise logistic regression model. The sensitivity and specificity of every possible index score were calculated and added together to calculate the "gain in certainty" values. During the 3-year period, 7,552 patients were admitted, of whom 967 (12.8%) required intubation. Of these, 55 (5.7%) underwent a UI. The final risk index consisted of 10 variables as follows: age 55 years to 64 years, age 65 years or older, male sex, Glasgow Coma Scale (GCS) score of 9 to 13, seizures, chronic obstructive pulmonary disease, traumatic brain injury, four or more rib fractures, spine fractures, and long-bone fractures. Gain in certainty was maximized at an index score of 4, with the highest combined sensitivity and specificity of 86.0% and 74.9%, respectively. The probability of UI increased from 0.9% at a score of 1 to 2.9% at 4 and 43% at 9. UI was associated with increased overall complications, length of stay, and mortality (p the development of an additive risk index. Prospective validation of the risk index is potentially warranted. Diagnostic study, level III.

  3. Attitudes toward menopause in HIV-infected and at-risk women

    Diana Hartel

    2008-09-01

    Full Text Available Diana Hartel1, Yungtai Lo1, Carolyn Bauer2, Nancy Budner1, Andrea A Howard1, Michelle Floris-Moore1, Julia H Arnsten1,2, Nanette Santoro3, Ellie E Schoenbaum1,2,31Departments of Epidemiology and Population Health, 2Medicine, and 3Obstetrics and Gynecology and Women’s Health, Montefiore Medical Center and Albert Einstein College of Medicine, Bronx, NY, USAObjective: To study attitudes toward menopause in women with or at risk of human immunodeficiency virus (HIV aged 35 to 60 in New York City, NY, USA.Design: Data were obtained at the baseline interview in a cohort study of menopause. Of 502 participating women, 92 were postmenopausal and 162 were perimenopausal.Results: Overall, 37.5% of women had a relatively favorable attitude toward menopause. African Americans had a 72% greater odds of a positive attitude (OR = 1.72, 95% CI 1.16–2.57 than all other groups after adjusting for covariates. Hispanic women had the least favorable view of menopause. Experience of >3 menopausal symptoms and negative life events—being a witness to a murder, and the death of a child—were significantly associated with negative attitudes towards menopause (OR = 0.62, 95% CI 0.42–0.93 and OR = 0.64, 95% CI 0.43–0.93, respectively. Depressive symptoms, street drug use, and having a domestic partner, which is significant in single variable analyses, did not remain independent predictors in multivariate results. HIV status, menopause status, and age at interview were not associated with menopause attitudes.Conclusions: HIV-infected, drug-using, low-income women showed generally unfavorable attitudes towards menopause. High stress life events coupled with a high prevalence of depressive symptoms indicate this population has special needs marked by the menopause transition into older age.Keywords: menopause, attitudes, HIV, street drug users

  4. Group Music Therapy as a Preventive Intervention for Young People at Risk: Cluster-Randomized Trial.

    Gold, Christian; Saarikallio, Suvi; Crooke, Alexander Hew Dale; McFerran, Katrina Skewes

    2017-07-01

    Music forms an important part of the lives and identities of adolescents and may have positive or negative mental health implications. Music therapy can be effective for mental disorders such as depression, but its preventive potential is unknown. The aim of this study was to examine whether group music therapy (GMT) is an effective intervention for young people who may be at risk of developing mental health problems, as indicated via unhealthy music use. The main question was whether GMT can reduce unhealthy uses of music and increase potentials for healthy uses of music, compared to self-directed music listening (SDML). We were also interested in effects of GMT on depressive symptoms, psychosocial well-being, rumination, and reflection. In an exploratory cluster-randomized trial in Australian schools, 100 students with self-reported unhealthy music use were invited to GMT (weekly sessions over 8 weeks) or SDML. Changes in the Healthy-Unhealthy Music Scale (HUMS) and mental health outcomes were measured over 3 months. Both interventions were well accepted. No effects were found between GMT and SDML (all p > 0.05); both groups tended to show small improvements over time. Younger participants benefited more from GMT, and older ones more from SDML (p = 0.018). GMT was associated with similar changes as SDML. Further research is needed to improve the processes of selecting participants for targeted interventions; to determine optimal dosage; and to provide more reliable evidence of effects of music-based interventions for adolescents. © the American Music Therapy Association 2017. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com

  5. A Prospective Study of Pravastatin in the Elderly at Risk (PROSPER): Screening Experience and Baseline Characteristics.

    Ford, Ian

    2002-05-20

    BACKGROUND: PROSPER was designed to investigate the benefits of treatment with pravastatin in elderly patients for whom a typical doctor might consider the prescription of statin therapy to be a realistic option. METHODS: The PROspective Study of Pravastatin in the Elderly at Risk (PROSPER) is a randomised, double blind, placebo-controlled trial to test the hypothesis that treatment with pravastatin (40 mg\\/day) will reduce the risk of coronary heart disease death, non-fatal myocardial infarction, and fatal or non-fatal stroke in elderly men and women with pre-existing vascular disease or with significant risk of developing this condition. RESULTS: In Scotland, Ireland, and the Netherlands, 23,770 individuals were screened, and 5,804 subjects (2,804 men and 3,000 women), aged 70 to 82 years (average 75 years) and with baseline cholesterol 4.0-9.0 mmol\\/l, were randomised. Randomised subjects had similar distributions with respect to age, blood pressure, and body mass index when compared to the entire group of screenees, but had a higher prevalence of smoking, diabetes, hypertension, and a history of vascular disease. The average total cholesterol level at baseline was 5.4 mmol\\/l (men) and 6.0 mmol\\/l (women). CONCLUSIONS: Compared with previous prevention trials of cholesterol-lowering drugs, the PROSPER cohort is significantly older and for the first time includes a majority of women. The study, having achieved its initial goal of recruiting more than 5,500 elderly high-risk men and women, aims to complete all final subject follow-up visits in the first half of 2002 with the main results being available in the fourth quarter of 2002.

  6. A Prospective Study of Pravastatin in the Elderly at Risk (PROSPER): Screening Experience and Baseline Characteristics

    Ford, Ian; Blauw, Gerard Jan; Murphy, Michael B; Shepherd, James; Cobbe, Stuart M; Bollen, Edward LEM; Buckley, Brendan M; Jukema, J Wouter; Hyland, Michael; Gaw, Allan; Lagaay, A Margot; Perry, Ivan J; Macfarlane, Peter; Norrie, John; Meinders, A Edo; Sweeney, Brian J; Packard, Chris J; Westendorp, Rudi GJ; Twomey, Cillian; Stott, David J

    2002-01-01

    Background PROSPER was designed to investigate the benefits of treatment with pravastatin in elderly patients for whom a typical doctor might consider the prescription of statin therapy to be a realistic option. Methods The PROspective Study of Pravastatin in the Elderly at Risk (PROSPER) is a randomised, double blind, placebo-controlled trial to test the hypothesis that treatment with pravastatin (40 mg/day) will reduce the risk of coronary heart disease death, non-fatal myocardial infarction, and fatal or non-fatal stroke in elderly men and women with pre-existing vascular disease or with significant risk of developing this condition. Results In Scotland, Ireland, and the Netherlands, 23,770 individuals were screened, and 5,804 subjects (2,804 men and 3,000 women), aged 70 to 82 years (average 75 years) and with baseline cholesterol 4.0–9.0 mmol/l, were randomised. Randomised subjects had similar distributions with respect to age, blood pressure, and body mass index when compared to the entire group of screenees, but had a higher prevalence of smoking, diabetes, hypertension, and a history of vascular disease. The average total cholesterol level at baseline was 5.4 mmol/l (men) and 6.0 mmol/l (women). Conclusions Compared with previous prevention trials of cholesterol-lowering drugs, the PROSPER cohort is significantly older and for the first time includes a majority of women. The study, having achieved its initial goal of recruiting more than 5,500 elderly high-risk men and women, aims to complete all final subject follow-up visits in the first half of 2002 with the main results being available in the fourth quarter of 2002. PMID:12097148

  7. A Prospective Study of Pravastatin in the Elderly at Risk (PROSPER: Screening Experience and Baseline Characteristics

    Lagaay A Margot

    2002-05-01

    Full Text Available Abstract Background PROSPER was designed to investigate the benefits of treatment with pravastatin in elderly patients for whom a typical doctor might consider the prescription of statin therapy to be a realistic option. Methods The PROspective Study of Pravastatin in the Elderly at Risk (PROSPER is a randomised, double blind, placebo-controlled trial to test the hypothesis that treatment with pravastatin (40 mg/day will reduce the risk of coronary heart disease death, non-fatal myocardial infarction, and fatal or non-fatal stroke in elderly men and women with pre-existing vascular disease or with significant risk of developing this condition. Results In Scotland, Ireland, and the Netherlands, 23,770 individuals were screened, and 5,804 subjects (2,804 men and 3,000 women, aged 70 to 82 years (average 75 years and with baseline cholesterol 4.0–9.0 mmol/l, were randomised. Randomised subjects had similar distributions with respect to age, blood pressure, and body mass index when compared to the entire group of screenees, but had a higher prevalence of smoking, diabetes, hypertension, and a history of vascular disease. The average total cholesterol level at baseline was 5.4 mmol/l (men and 6.0 mmol/l (women. Conclusions Compared with previous prevention trials of cholesterol-lowering drugs, the PROSPER cohort is significantly older and for the first time includes a majority of women. The study, having achieved its initial goal of recruiting more than 5,500 elderly high-risk men and women, aims to complete all final subject follow-up visits in the first half of 2002 with the main results being available in the fourth quarter of 2002.

  8. Speech preference is associated with autistic-like behavior in 18-months-olds at risk for Autism Spectrum Disorder.

    Curtin, Suzanne; Vouloumanos, Athena

    2013-09-01

    We examined whether infants' preference for speech at 12 months is associated with autistic-like behaviors at 18 months in infants who are at increased risk for autism spectrum disorder (ASD) because they have an older sibling diagnosed with ASD and in low-risk infants. Only low-risk infants listened significantly longer to speech than to nonspeech at 12 months. In both groups, relative preference for speech correlated positively with general cognitive ability at 12 months. However, in high-risk infants only, preference for speech was associated with autistic-like behavior at 18 months, while in low-risk infants, preference for speech correlated with language abilities. This suggests that in children at risk for ASD an atypical species-specific bias for speech may underlie atypical social development.

  9. Drivers' attitudes toward front or rear child passenger belt use and seat belt reminders at these seating positions.

    Kidd, David G; McCartt, Anne T

    2014-01-01

    Passengers, especially those in rear seating positions, use seat belts less frequently than drivers. In-vehicle technology can inform drivers when their passengers are unbuckled and encourage passengers to use belts. The current study collected information about drivers' attitudes toward passenger belt use and belt reminders for front passengers and children in back seats. A national telephone survey of 1218 people 18 and older was conducted, of which 477 respondents were drivers who transport a front seat passenger at least once a week and 254 were drivers who transport an 8- to 15-year-old child in the back seat. Respondents were asked about their attitudes toward belt use by their front passengers or rear child passengers and preferences for different passenger belt reminder features. Ninety percent of drivers who regularly transport front seat passengers said that the passengers always use seat belts. Reported belt use was even higher among 8- to 15-year-old children in the back seat (97%). Among the drivers whose children do not always buckle up, about half said their child unbuckled the belt during the trip. Almost every full-time belt use driver (96%) would encourage front passengers to buckle up if not belted, compared to 57 percent of part-time belt users and nonusers. In contrast, nearly every driver who transports children in the back seat would encourage their belt use, regardless of the driver's belt use habits. Most drivers who transport front passengers wanted passenger belt reminders to encourage passengers to buckle up. Most of these drivers wanted a chime/buzzer or warning light or text display and wanted the reminder to last indefinitely. Most drivers who transport child passengers in the rear seat wanted the vehicle to indicate whether child passengers are unbuckled. A large majority of these drivers wanted notifications via a visual diagram of seating positions and belt use, a chime/buzzer, and a warning light or text display. These drivers

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

    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.

  11. Drivers and Limits for Transport

    Kristensen, Niels Buus; Nielsen, Thomas A. Sick; Gudmundsson, Henrik

    This report summarizes key outcomes of the study ’Drivers and Limits’ that was supported for the period 2009-2013 by a research grant from the Danish Strategic Research Council. The project investigated - for the empirical context of Denmark - key driving forces behind transport growth, as well...

  12. Modeling taxi driver anticipatory behavior

    Zheng, Zhong; Rasouli, S.; Timmermans, H.J.P.

    2018-01-01

    As part of a wider behavioral agent-based model that simulates taxi drivers’ dynamic passenger-finding behavior under uncertainty, we present a model of strategic behavior of taxi drivers in anticipation of substantial time varying demand at locations such as airports and major train stations. The

  13. Driver Psychology during Automated Platooning

    Heikoop, D.D.

    2017-01-01

    With the rapid increase in vehicle automation technology, the call for understanding how humans behave while driving in an automated vehicle becomes more urgent. Vehicles that have automated systems such as Lane Keeping Assist (LKA) or Adaptive Cruise Control (ACC) not only support drivers in their

  14. Nonmagnetic driver for piezoelectric actuators

    Ekhtiari, Marzieh

    2014-01-01

    actuator drive is the only form-fit continuous drive solution currently available for the development of high performance nonmagnetic motors. In this research focus will be on the non magnetic compact high efficiency driver for the piezo actuators and on employing energy recovery from the capacitive...

  15. Is a driver's license age waiver worth a teen's life?

    Porter, Dawn M; Miller, Beverly K; Mullins, Samantha H; Porter, Mary E; Aitken, Mary E

    2018-04-10

    Motor vehicle crashes are the leading cause of death for teens 14-19 years of age, with younger teen drivers at higher risk than older teens. Graduated driver licensing has been proven to reduce teen driver-related motor vehicle crashes and fatalities. Arkansas allows parents to request age waivers, which allow a teen to obtain a license for independent driving before the sixteenth birthday. The objectives of this study were to: (1) determine the prevalence of age waivers issued in Arkansas and (2) determine motor vehicle crash risks associated with 14 and 15 year old drivers. This is a brief report on an informative query exploring risk factors related to age waivers. Publicly available databases were utilized for across state comparisons. The Web-based Injury Statistics Query and Reporting Systems (WISQARS) was utilized to calculate motor vehicle crash crude death rates. National Highway Traffic Safety Administration data were utilized to identify seat belt use rates. The Fatal Analysis Reporting System (FARS) was utilized to identify crash fatality risks for 14 and 15 year old drivers in Arkansas (N = 24). Age waiver data were obtained from the Arkansas Driver Control Administration. De-identified data on fatal crashes and rates of age waiver issuance in Arkansas for 14 and 15 year olds from 2004 through 2016 were calculated. We reviewed crash data for 14 and 15 year old drivers in Arkansas between 2004 and 2014 to determine fatality risks. Thirty-one out of seventy-five counties in Arkansas were above the state age waiver issuance rate of 30.4 per 1000 14 to 15 year old teens. Among the four states that had similar age waivers for 14 to 15 year olds, Arkansas had the highest motor vehicle death rate of 10.2 per 100,000 young teens and the lowest seat belt use rate at 73%. Arkansas had the highest reported teen crash fatality rates among 4 states with age waivers. The volume of age waivers issued in Arkansas is concerning. Further research is needed

  16. Free electron laser as a fusion driver

    Prosnitz, D.; Schlitt, L.

    1981-01-01

    The Free Electron Laser (FEL) is shown to be a potentially attractive solution to the problem of finding a suitable short wavelength fusion driver. The design of a 3 MJ, 250 nm FEL fusion driver is discussed

  17. Anthropogenic Drivers of Ecosystem Change: an Overview

    Gerald C. Nelson

    2006-12-01

    Full Text Available This paper provides an overview of what the Millennium Ecosystem Assessment (MA calls "indirect and direct drivers" of change in ecosystem services at a global level. The MA definition of a driver is any natural or human-induced factor that directly or indirectly causes a change in an ecosystem. A direct driver unequivocally influences ecosystem processes. An indirect driver operates more diffusely by altering one or more direct drivers. Global driving forces are categorized as demographic, economic, sociopolitical, cultural and religious, scientific and technological, and physical and biological. Drivers in all categories other than physical and biological are considered indirect. Important direct drivers include changes in climate, plant nutrient use, land conversion, and diseases and invasive species. This paper does not discuss natural drivers such as climate variability, extreme weather events, or volcanic eruptions.

  18. Effects of major-road vehicle speed and driver age and gender on left-turn gap acceptance.

    Yan, Xuedong; Radwan, Essam; Guo, Dahai

    2007-07-01

    Because the driver's gap-acceptance maneuver is a complex and risky driving behavior, it is a highly concerned topic for traffic safety and operation. Previous studies have mainly focused on the driver's gap acceptance decision itself but did not pay attention to the maneuver process and driving behaviors. Using a driving simulator experiment for left-turn gap acceptance at a stop-controlled intersection, this study evaluated the effects of major traffic speed and driver age and gender on gap acceptance behaviors. The experiment results illustrate relationships among drivers' left-turn gap decision, driver's acceleration rate, steering action, and the influence of the gap-acceptance maneuver on the vehicles in the major traffic stream. The experiment results identified an association between high crash risk and high traffic speed at stop-controlled intersections. The older drivers, especially older female drivers, displayed a conservative driving attitude as a compensation for reduced driving ability, but also showed to be the most vulnerable group for the relatively complex driving maneuvers.

  19. The Addenbrooke's Cognitive Examination Revised as a potential screening test for elderly drivers.

    Ferreira, Inês S; Simões, Mário R; Marôco, João

    2012-11-01

    Considerable research has shown that neuropsychological tests are predictive of real-world driving ability. The Mini-Mental State Examination (MMSE) is a brief cognitive test that has been commonly used in the assessment of older drivers. However, this test has inherent problems that limit its validity to evaluate cognitive abilities related to driving and to screen for driving impairments in non-demented people. Therefore, it is useful to test new screening instruments that may predict potential unsafe drivers who require an in-depth neuropsychological assessment in a specialised centre. To date, the utility of the Addenbrooke's Cognitive Examination Revised (ACE-R) as an indicator of driving ability has not been established. In the current study, fifty older drivers (mean age=73.1 years) who were referred for a psychological assessment, the protocol of which included the ACE-R, underwent an on-road driving test. Using linear discriminant analyses, the results highlighted the higher classification accuracy of the ACE-R compared to the MMSE score, particularly for detecting unsafe drivers. Measures of visuospatial and executive functions, which are not incorporated in the MMSE score, had an incremental value in the prediction of driving ability. This emerging brief cognitive test may warrant additional study for use in the fitness to drive assessment of older adults. Copyright © 2012 Elsevier Ltd. All rights reserved.

  20. 49 CFR 396.13 - Driver inspection.

    2010-10-01

    ... ADMINISTRATION, DEPARTMENT OF TRANSPORTATION FEDERAL MOTOR CARRIER SAFETY REGULATIONS INSPECTION, REPAIR, AND MAINTENANCE § 396.13 Driver inspection. Before driving a motor vehicle, the driver shall: (a) Be satisfied that the motor vehicle is in safe operating condition; (b) Review the last driver vehicle inspection...

  1. School Bus Accidents and Driver Age.

    McMichael, Judith

    The study examines the rates and types of school bus accidents according to the age of the school bus driver. Accident rates in North Carolina for the school year 1971-72 were analyzed using three sources of data: accident reports, driver and mileage data, and questionnaires administered to a sample of school bus drivers. Data were obtained on…

  2. among Taxi Drivers in Addis Ababa, Ethiopia

    user

    Long years of driving [AOR =4.6 (95%CI, 1.6-12.9)], involvement in a similar activity prior to becoming taxi driver .... full time taxi driver; produce a valid driving license; .... Self-employee .... professional car drivers in Dhaka city, Bangladesh.

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

    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.

  4. 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.

    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.

  5. Sustained Intervention Effects on Older Adults' Attitudes toward Alcohol and Medication Interactions

    Zanjani, Faika; Allen, Hannah; Schoenberg, Nancy; Martin, Catherine; Clayton, Richard

    2018-01-01

    Background: Older adults are at risk for experiencing alcohol and medication interactions (AMIs) given their concomitant alcohol and medication use. However, there have been limited efforts to develop and evaluate AMI prevention interventions. Purpose: The current study examined sustained intervention effects on older adults' attitudes, awareness,…

  6. Factors Affecting Mobility in Community-dwelling Older Koreans with Chronic Illnesses

    Hye-A Yeom, PhD, RN, ANP-C

    2015-03-01

    Conclusions: A high-risk group for mobility limitation includes low income, sedentary older men who are at risk for increased fatigue and sleep deficit. Further research should incorporate other psychological and lifestyle factors such as depression, smoking, drinking behavior, and/or obesity into the prediction model of mobility to generate specific intervention strategies for mobility enhancement recommendations for older adults.

  7. Volvo drivers' experiences with advanced crash avoidance and related technologies.

    Eichelberger, Angela H; McCartt, Anne T

    2014-01-01

    Crash avoidance technologies can potentially prevent or mitigate many crashes, but their success depends in part on driver acceptance. Owners of 2010-2012 model Volvo vehicles with several technologies were interviewed about their experiences. Interviews were conducted in summer 2012 with 155 owners of vehicles with City Safety as a standard feature; 145 owners with an optional technology package that included adaptive cruise control, distance alert, collision warning with full auto brake (and pedestrian detection on certain models), driver alert control, and lane departure warning; and 172 owners with both City Safety and the technology package. The survey response rates were 21 percent for owners with City Safety, 30 percent for owners with the technology package, and 27 percent for owners with both. Ten percent of owners opted out before the telephone survey began, and 18 percent declined to participate when called. Despite some annoyance, most respondents always leave the systems on, although fewer do so for lane departure warning (59%). For each of the systems, at least 80 percent of respondents with the system would want it on their next vehicle. Many respondents reported safer driving habits with the systems (e.g., following less closely with adaptive cruise control, using turn signals more often with lane departure warning). Fewer respondents reported potentially unsafe behavior, such as allowing the vehicle to brake for them at least some of the time. About one third of respondents experienced autonomous braking when they believed they were at risk of crashing, and about one fifth of respondents thought it had prevented a crash. About one fifth of respondents with the technology package reported that they were confused or misunderstood which safety system had activated in their vehicle. Consistent with the results for early adopters in the previous survey of Volvo and Infiniti owners, the present survey found that driver acceptance of the technologies

  8. Impact of gender, organized athletics, and video gaming on driving skills in novice drivers

    Miller, Gregory A.

    2018-01-01

    Given that novice drivers tend to be young, and teenagers and young adult drivers are involved in the greatest number of accidents, it is important that we understand what factors impact the driving skills of this population of drivers. The primary aim of the present study was to understand the impact of gender, organized athletics, and video gaming on driving skills of novice drivers under real-world driving conditions. Novice driving students having less than five hours driving experience previous to a normal driving lesson were evaluated on their self-confidence (self-reported) prior to the lesson and driving skill evaluated by their instructor during the course of the lesson. Information was collected about gender, age, whether or not the students were involved in organized athletics, and the extent of their video game playing. There was no impact of gender or extent of video game playing on driving skills. Females were significantly less self-confident with driving than males, but this did not translate to gender differences in driving skills. Being involved in organized athletics—either currently or in the past—significantly enhanced driving skills in both females and males. Finally, novice drivers’ age was negatively correlated with driving skills. That is, younger novice drivers (especially males) had better driving skills than older novice drivers. This is counter to popular belief that young drivers lack technical driving skills because they have less experience behind the wheel. Based on the results of the current study, we hypothesize that the relatively high accident rate of younger drivers (especially male drivers) is most likely due to inattention to safety considerations rather than lack of technical driving ability. PMID:29364957

  9. Driving while black: a comparison of the beliefs, concerns, and behaviors of black and white Maryland drivers.

    Debnam, Katrina J; Beck, Kenneth H

    2011-12-01

    The National Highway Traffic Safety Administration suggests that given the changing demographics of the United States it is important to examine motor vehicle statistics by race and ethnicity. The current study sought to explore differences in traffic safety concerns and driving behaviors between black and white drivers. An annual, anonymous, random-digit-dial telephone survey was used to collect data between 2003 and 2009 from Maryland drivers. Drivers (N = 5503) were assessed regarding their driving behaviors and perceived risk of receiving a traffic violation. Results showed that black drivers perceived a greater likelihood of being stopped for driving under the influence (DUI), for not wearing a seat belt and for speeding than white drivers. These differences were found among drivers with or without a history of being ticketed. Black drivers were also more likely to report a variety of risky driving behaviors than white drivers. However, black drivers were not more likely to report receiving a ticket or citation in the last month after controlling for demographic factors, risky driving behaviors, and geographic region of the state, where traffic enforcement may vary. Findings indicate that black drivers are not more likely to be ticketed, despite perceptual biases that may exist among some drivers. These differences appear to be explained by demographic as well as regional factors. These results highlight the need for more research to understand the potential differences in driving behaviors between racial and ethnic groups. More research is also needed to develop countermeasures for racial and ethnic groups most at risk for motor vehicle violations and crashes.

  10. Project Healthy Bones: An Osteoporosis Prevention Program for Older Adults.

    Klotzbach-Shimomura, Kathleen

    2001-01-01

    Project Healthy Bones is a 24-week exercise and education program for older women and men at risk for or who have osteoporosis. The exercise component is designed to improve strength, balance, and flexibility. The education curriculum stresses the importance of exercise, nutrition, safety, drug therapy, and lifestyle factors. (SK)

  11. Prevalence of driver physical factors leading to unintentional lane departure crashes.

    Cicchino, Jessica B; Zuby, David S

    2017-07-04

    Some lane-keeping assist systems in development and production provide autonomous braking and steering to correct unintentional lane drift but otherwise require drivers to fully control their vehicles. The goal of this study was to quantify the proportion of drivers involved in unintentional lane drift crashes who would be unable to regain control of their vehicles to inform the design of such systems. The NHTSA's National Motor Vehicle Crash Causation Survey collected in-depth, on-scene data for a nationally representative sample of 5,470 U.S. police-reported passenger vehicle crashes during 2005-2007 that occurred between 6 a.m. and midnight and for which emergency medical services were dispatched. The physical states of drivers involved in the 631 lane drift crashes in the sample, which represented 259,034 crashes nationally, were characterized. Thirty-four percent of drivers who crashed because they drifted from their lanes were sleeping or otherwise incapacitated. These drivers would be unlikely to regain full control of their vehicles if an active safety system prevented their initial drift. An additional 13% of these drivers had a nonincapacitating medical issue, blood alcohol concentration (BAC) ≥ 0.08%, or other physical factor that may not allow them to regain full vehicle control. When crashes involved serious or fatal injuries, 42% of drivers who drifted were sleeping or otherwise incapacitated, and an additional 14% were impacted by a nonincapacitating medical issue, BAC ≥ 0.08%, or other physical factor. Designers of active safety systems that provide autonomous lateral control should consider that a substantial proportion of drivers at risk of lane drift crashes are incapacitated. Systems that provide only transient corrective action may not ultimately prevent lane departure crashes for these drivers, and drivers who do avoid lane drift crashes because of these systems may be at high risk of other types of crashes when they attempt to regain

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

    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.

  13. Highway crash rates and age-related driver limitations: Literature review and evaluation of data bases

    Hu, P.S. [Oak Ridge National Lab., TN (United States); Young, J.R. [Tennessee Univ., Knoxville, TN (United States); Lu, An [Oak Ridge Associated Universities, Inc., TN (United States)

    1993-08-01

    American society is undergoing a major demographic transformation that is resulting in a larger proportion of older individuals in the population. Moreover, recent travel surveys show that an increasing number of older individuals are licensed to drive and that they drive more than their same age cohort a decade ago. However, they continue to take shorter trips than younger drivers and they avoid driving during congested hours. This recent demographic transformation in our society, the graying of America, coupled with the increasing mobility of the older population impose a serious highway safety issue that cannot be overlooked. Some of the major concerns are the identification of ``high-risk`` older drivers and the establishment of licensing guidelines and procedures that are based on conclusive scientific evidence. Oak Ridge National Laboratory`s (ORNL) objectives in this project can be characterized by the following tasks: Review and evaluate the 1980 American Association of Motor Vehicle Administrators (AAMVA) and National Highway Traffic Safety Administration (NHTSA) licensing guidelines. Determine whether the license restriction recommended in the 1980 AAMVA and NHTSA guidelines was based on scientific evidence or on judgement of medical advisors. Identify in the scientific literature any medical conditions which are found to be highly associated with highway crashes, and which are not mentioned in the 1980 guidelines. Summarize States` current licensing practices for drivers with age-related physical and mental limitations. Identify potential data sources to establish conclusive evidence on age-related functional impairments and highway crashes.

  14. Factors affecting self-regulatory driving practices among older adults.

    Molnar, Lisa J; Charlton, Judith L; Eby, David W; Langford, Jim; Koppel, Sjaan; Kolenic, Giselle E; Marshall, Shawn

    2014-01-01

    The primary objective of this study was to better understand how self-regulatory driving practices at multiple levels of driver decision making are influenced by various factors. Specifically, the study investigated patterns of tactical and strategic self-regulation among a sample of 246 Australian older drivers. Of special interest was the relative influence of several variables on the adoption of self-regulation, including self-perceptions of health, functioning, and abilities for safe driving and driving confidence and comfort. The research was carried out at the Monash University Accident Research Centre, as part of its Ozcandrive study, a partnership with the Canadian Driving Research Initiative for Vehicular Safety in the Elderly (Candrive), and in conjunction with the University of Michigan Transportation Research Institute (UMTRI). Candrive/Ozcandrive represents the first study to follow a large group of older drivers over several years and collect comprehensive self-reported and objectively derived data on health, functioning, and driving. This study used a subset of data from the Candrive/Ozcandrive study. Upon enrolling in the study, participants underwent a comprehensive clinical assessment during which data on visual, cognitive, and psychomotor functioning were collected. Approximately 4 months after study enrollment, participants completed the Advanced Driving Decisions and Patterns of Travel (ADDAPT) questionnaire, a computer-based self-regulation instrument developed and pilot-tested at UMTRI. Self-regulation among older adults was found to be a multidimensional concept. Rates of self-regulation were tied closely to specific driving situations, as well as level of decision making. In addition, self-regulatory practices at the strategic and tactical levels of decision making were influenced by different sets of factors. Continuing efforts to better understand the self-regulatory practices of older drivers at multiple levels of driver performance and

  15. HIV Transmission: Myths about Casual Contact and Fear about Medical Procedures Persist Among Older Adults.

    Hughes, Anne K; Alford, Kristen R

    2017-01-02

    HIV infection among older adults is increasing. Previous research suggests that many older adults do not see themselves as at risk for HIV and that many subscribe to myths related to HIV transmission. In this focus group study (N = 48) we solicited the beliefs that older adults held about HIV. The older adults in this study were knowledgeable about how HIV is typically transmitted. However, we also identified that they subscribed to misconceptions regarding casual contact transmission and were fearful of transmission from the medical system. Educational efforts aimed at older adults must be tailored to address these persistent misconceptions.

  16. Factors Contributing to Crashes among Young Drivers

    Lyndel J. Bates

    2014-08-01

    Full Text Available Young drivers are the group of drivers most likely to crash. There are a number of factors that contribute to the high crash risk experienced by these drivers. While some of these factors are intrinsic to the young driver, such as their age, gender or driving skill, others relate to social factors and when and how often they drive. This article reviews the factors that affect the risk of young drivers crashing to enable a fuller understanding of why this risk is so high in order to assist in developing effective countermeasures.

  17. Visualization drivers for Geant4

    Beretvas, Andy

    2005-01-01

    This document is on Geant 4 visualization tools (drivers), evaluating pros and cons of each option, including recommendations on which tools to support at Fermilab for different applications. Four visualization drivers are evaluated. They re OpenGL, HepRep, DAWN and VRML. They all have good features, OpenGL provides graphic output with out an intermediate file. HepRep provides menus to assist the user. DAWN provides high quality plots and even for large files produces output quickly. VRML uses the smallest disk space for intermediate files. Large experiments at Fermilab will want to write their own display. They should proceed to make this display graphics independent. Medium experiment will probably want to use HepRep because of it's menu support. Smaller scale experiments will want to use OpenGL in the spirit of having immediate response, good quality output and keeping things simple

  18. Global desertification: Drivers and feedbacks

    D'Odorico, Paolo; Bhattachan, Abinash; Davis, Kyle F.; Ravi, Sujith; Runyan, Christiane W.

    2013-01-01

    Desertification is a change in soil properties, vegetation or climate, which results in a persistent loss of ecosystem services that are fundamental to sustaining life. Desertification affects large dryland areas around the world and is a major cause of stress in human societies. Here we review recent research on the drivers, feedbacks, and impacts of desertification. A multidisciplinary approach to understanding the drivers and feedbacks of global desertification is motivated by our increasing need to improve global food production and to sustainably manage ecosystems in the context of climate change. Classic desertification theories look at this process as a transition between stable states in bistable ecosystem dynamics. Climate change (i.e., aridification) and land use dynamics are the major drivers of an ecosystem shift to a “desertified” (or “degraded”) state. This shift is typically sustained by positive feedbacks, which stabilize the system in the new state. Desertification feedbacks may involve land degradation processes (e.g., nutrient loss or salinization), changes in rainfall regime resulting from land-atmosphere interactions (e.g., precipitation recycling, dust emissions), or changes in plant community composition (e.g., shrub encroachment, decrease in vegetation cover). We analyze each of these feedback mechanisms and discuss their possible enhancement by interactions with socio-economic drivers. Large scale effects of desertification include the emigration of “environmental refugees” displaced from degraded areas, climatic changes, and the alteration of global biogeochemical cycles resulting from the emission and long-range transport of fine mineral dust. Recent research has identified some possible early warning signs of desertification, which can be used as indicators of resilience loss and imminent shift to desert-like conditions. We conclude with a brief discussion on some desertification control strategies implemented in different

  19. Food hygiene challenges in older people: Intergenerational learning as a health asset

    Wythe, H.; Wilkinson, C.; Orme, J.; Meredith, L.; Weitkamp, E.

    2013-01-01

    Older people are more at risk of contracting foodborne infections, however the majority remain well despite the physical, social and cognitive challenges of older age. Future healthcare strategies targeting older people can be informed by exploring the food history and current context of their lives and what 'assets' they employ to successfully consume ‘safe’ food in the home. Phase I: Socio-demographic, health and asset related data collection through a researcher completed questionnaire i) ...

  20. Perceptions of Breast Cancer Screening in Older Chinese Women: A Meta-Ethnography

    Banning, M; Shia, N

    2014-01-01

    In Eastern Asia, as the incidence of breast cancer continues to increase yet compliance with breast cancer screening in older Chinese women who are at risk of early stage breast cancer is poor. This meta-ethnography explored breast cancer awareness, attitudes and breast screening behaviour in older Chinese women. Nine qualitative studies were appraised using CASP tools. Many Chinese women believed that illness is preordained, therefore mammography was a futile exercise. Older Chinese women he...

  1. Driver competence performance indicators using OTMR

    Hassan EL Rashidy, R.A.

    2016-07-01

    The current practice for assessing driver competence performance is in-cab riding by driver managers. However, this paper investigates whether real-world driving data extracted from on-train monitoring recorders data (OTMR) can be used to assess the driver performance. A number of indicators were used to evaluate the drivers’ performance. These include: their use of the emergency bypass switch, the driver's reminder appliance as well as the driver’s reaction time. A study case illustrated the applicability of OTMR data to estimate the proposed indicators, which suggests that the indicators can be useful in the driver management system in addition to the current indicators. Furthermore, the proposed indicators could be used to tailor the driver training schemes up to their individual needs and evaluate their effectiveness. They could even be used for improving driver competence performance and reducing crash involvement by revealing potentially detrimental driving performance. (Author)

  2. Driving fatigue in professional drivers: a survey of truck and taxi drivers.

    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

  3. Experimental Research in Boost Driver with EDLCs

    Matsumoto, Hirokazu

    The supply used in servo systems tends to have a high voltage in order to reduce loss and improve the response of motor drives. We propose a new boost motor driver that comprises EDLCs. The proposed driver has a simple structure, wherein the EDLCs are connected in series to the supply, and comprises a charge circuit to charge the EDLCs. The proposed driver has three advantages over conventional boost drivers. The first advantage is that the driver can easily attain the stable boost voltage. The second advantage is that the driver can reduce input power peaks. In a servo system, the input power peaks become greater than the rated power in order to accelerate the motor rapidly. This implies that the equipments that supply power to servo systems must have sufficient power capacity to satisfy the power peaks. The proposed driver can suppress the increase of the power capacity of supply facilities. The third advantage is that the driver can store almost all of the regenerative energy. Conventional drivers have a braking resistor to suppress the increase in the DC link voltage. This causes a considerable reduction in the efficiency. The proposed driver is more efficient than conventional drivers. In this study, the experimental results confirmed the effectiveness of the proposed driver and showed that the drive performance of the proposed driver is the same as that of a conventional driver. Furthermore, it was confirmed that the results of the simulation of a model of the EDLC module, whose capacitance is dependent on the frequency, correspond well with the experimental results.

  4. Stroke education for the at-risk elderly: Do words really matter?

    Tricia Olea Santos

    2014-03-01

    Full Text Available “You can do nothing to bring the dead to life; but you can do much to save the living” Statement of the problem According to the Center for Disease Control (2011, stroke is the fourth leading causes of death in the United States and the leading cause of long-term severe disability. Health disparities are indicated, with a higher incidence of stroke among ethnic minorities as compared to Caucasian Americans. The CDC (2011 further states that older individuals who survive a stroke are more likely to experience moderate-to-severe disability. Health prevention and promotion campaigns have begun investigating the role of information structure in educating at-risk individuals (Kreuter & McClure, 2004. Information structure, commonly in the form of narrative and expository discourse, has been compared especially across ethnic groups. For example, nutritional information in the context of narratives are perceived by Hispanic Americans as more believable compared to expository text (Slater, Buller, Waters, Archibeque, and LeBlanc, 2003. With regard to cancer screenings, illness narratives are more likely to result in better comprehension and compliance among African Americans (Kreuter, Holmes, Alcaraz, et al., 2010; Dillard, Fagerlin, Cin, Zikmund-Fisher & Ubel, 2010. Although stroke narratives in aphasia have been studied for decades, the role of this information structure in preventing stroke has yet to be investigated among the at-risk elderly. This study focuses on stroke prevention via two commonly used forms of information structure: narrative and expository discourse. It further investigates how elderly individuals recall medical categories essential to constructing an illness: symptoms, timeline, consequences, causes and treatment. The study specifically addresses stroke education among Elderly Filipino Americans. Despite being a highly collectivistic and well-educated group (McBride, 2002, Filipino Americans tend to have a short lifespan and

  5. 26 CFR 5.1502-45 - Limitation on losses to amount at risk.

    2010-04-01

    ... 26 Internal Revenue 14 2010-04-01 2010-04-01 false Limitation on losses to amount at risk. 5.1502... Limitation on losses to amount at risk. (a) In general—(1) Scope. This section applies to a loss of any subsidiary if the common parent's stock meets the stock ownership requirement described in section 465(a)(1...

  6. Remain or React: The Music Education Profession's Responses to "Sputnik" and "A Nation at Risk"

    Kapalka Richerme, Lauren

    2012-01-01

    The 1957 launch of "Sputnik" and the 1983 publication of "A Nation at Risk" shifted national education policy. Music educators promoted an "intrinsic value" of music philosophy following "Sputnik" and music advocacy through politics and public performances following "A Nation at Risk." Examining the history of both the intrinsic value philosophy…

  7. The Effects of the Interactive Strategies Approach on At-Risk Kindergartners' Spelling

    Lee, Sun Hwa; Scanlon, Donna M.

    2015-01-01

    This study focused on examining the effects of early literacy intervention on the emergence and development of at-risk kindergartners' spelling. Spelling data were selected from Scanlon et al.'s (2005) study which demonstrated the efficacy of reading intervention in reducing the incidence of at-risk children who show reading difficulties…

  8. The At-Risk Student's Journey with Online Course Credit: Looking at Perceptions of Care

    Barnett, Karis K.

    2016-01-01

    Studies addressing at-risk students' perceptions of valuable caring relationships within their unique online environment are rare. While the phrase at-risk has a variety of meanings, this study examined the term pertaining to students who were labeled due to endangerment of not graduating from high school based on their life circumstances. Through…

  9. Autonomy and Responsibility: Online Learning as a Solution for At-Risk High School Students

    Lewis, S.; Whiteside, A.; Garrett Dikkers, A.

    2014-01-01

    In this three-year, mixed methods case study, the benefits and challenges of online learning for at-risk high school students were examined. A key finding was that at-risk students identify the benefits and challenges of online learning to be the same. While students appreciate the opportunity to work ahead and study at their own pace, they see it…

  10. Art Therapy Programs with At-Risk Students in Public Schools

    Varallo, Patrick A.

    2012-01-01

    Educating and meeting the multiple needs of students at risk of low academic achievement has been a growing concern for public schools in the United States. Many at-risk students require alternative school-based interventions. This study examined the operation, premise, and objectives of art therapy integrated in 14 school districts across the…

  11. Long-Term Mentors' Perceptions of Building Mentoring Relationships with At-Risk Youth

    Smith, Cindy Ann; Newman-Thomas, Cathy; Stormont, Melissa

    2015-01-01

    Youth mentoring, defined within this study, as the pairing of a youth at risk with a caring adult, is an intervention that is often used for youth at risk for academic and social failure. We sought to understand mentors' perspectives of the fundamental elements that foster positive mentor--mentee relationships that build resiliency and increase…

  12. Students in a School Environment: A Project Focused on Family Involvement of At-Risk

    Denney, Pat

    2011-01-01

    This project examined family involvement of at risk students in mid-west communities. The purpose of this project was to study the affect of family involvement on at-risk student achievement. The redefining of the perception of America has resulted in a crisis of academic performance in the traditionally slow-changing education systems. This topic…

  13. Experienced continuity of care in patients at risk for depression in primary care

    Uijen, Annemarie A.; Schers, Henk J.; Schene, Aart H.; Schellevis, Francois G.; Lucassen, Peter; van den Bosch, Wil J. H. M.

    2014-01-01

    Existing studies about continuity of care focus on patients with a severe mental illness. Explore the level of experienced continuity of care of patients at risk for depression in primary care, and compare these to those of patients with heart failure. Explorative study comparing patients at risk

  14. Identifying Students at Risk: An Examination of Computer-Adaptive Measures and Latent Class Growth Analysis

    Keller-Margulis, Milena; McQuillin, Samuel D.; Castañeda, Juan Javier; Ochs, Sarah; Jones, John H.

    2018-01-01

    Multitiered systems of support depend on screening technology to identify students at risk. The purpose of this study was to examine the use of a computer-adaptive test and latent class growth analysis (LCGA) to identify students at risk in reading with focus on the use of this methodology to characterize student performance in screening.…

  15. Developing a Model for Identifying Students at Risk of Failure in a First Year Accounting Unit

    Smith, Malcolm; Therry, Len; Whale, Jacqui

    2012-01-01

    This paper reports on the process involved in attempting to build a predictive model capable of identifying students at risk of failure in a first year accounting unit in an Australian university. Identifying attributes that contribute to students being at risk can lead to the development of appropriate intervention strategies and support…

  16. Threats to at-risk species in America's private forests: a Forests on the Edge report

    Mary A. Carr; Ronald E. McRoberts; Lisa G. Mahal; Sara J. Comas

    2010-01-01

    More than 4,600 native animal and plant species associated with private forests in the United States are at risk of decline or extinction. This report identifies areas across the conterminous United States where at-risk species habitats in rural private forests are most likely to decrease because of increases in housing density from 2000 to 2030. We also identify areas...

  17. Modeling Success: Using Preenrollment Data to Identify Academically At-Risk Students

    Gansemer-Topf, Ann M.; Compton, Jonathan; Wohlgemuth, Darin; Forbes, Greg; Ralston, Ekaterina

    2015-01-01

    Improving student success and degree completion is one of the core principles of strategic enrollment management. To address this principle, institutional data were used to develop a statistical model to identify academically at-risk students. The model employs multiple linear regression techniques to predict students at risk of earning below a…

  18. Identifying Learning Patterns of Children at Risk for Specific Reading Disability

    Barbot, Baptiste; Krivulskaya, Suzanna; Hein, Sascha; Reich, Jodi; Thuma, Philip E.; Grigorenko, Elena L.

    2016-01-01

    Differences in learning patterns of vocabulary acquisition in children at risk (+SRD) and not at risk (-SRD) for Specific Reading Disability (SRD) were examined using a microdevelopmental paradigm applied to the multi-trial Foreign Language Learning Task (FLLT; Baddeley et al., 1995). The FLLT was administered to 905 children from rural…

  19. Work and Family Plans among At-Risk Israeli Adolescents: A Mixed-Methods Study

    Cinamon, Rachel Gali; Rich, Yisrael

    2014-01-01

    Quantitative methods were used to investigate attributions of importance to work and family roles and anticipated work--family conflict and facilitation among 353 at-risk Israeli male and female adolescents. Qualitative interviews conducted with 26 of the at-risk youth explored future work and family perceptions. Findings indicated that both sexes…

  20. School-Based Drug Prevention among At-Risk Adolescents: Effects of ALERT Plus

    Longshore, Douglas; Ellickson, Phyllis L.; McCaffrey, Daniel F.; St. Clair, Patricia A.

    2007-01-01

    In a recent randomized field trial, Ellickson et al. found the Project ALERT drug prevention curriculum curbed alcohol misuse and tobacco and marijuana use among eighth-grade adolescents. This article reports effects among ninth-grade at-risk adolescents. Comparisons between at-risk girls in ALERT Plus schools (basic curriculum extended to ninth…

  1. A Critical Constructionist View of "At-Risk" Youth in Alternative Education

    Touzard, Rachelle Silverstein

    2010-01-01

    Family therapists and school counselors are increasingly called upon to provide services for youth in alternative education (Carver, Lewis, & Tice, 2010). Alternative education systems are programs for youth who have been defined as at risk. This study explored the at-risk discourse and asked the questions (a) how do youth and staff define the…

  2. Identifying At-Risk Students in General Chemistry via Cluster Analysis of Affective Characteristics

    Chan, Julia Y. K.; Bauer, Christopher F.

    2014-01-01

    The purpose of this study is to identify academically at-risk students in first-semester general chemistry using affective characteristics via cluster analysis. Through the clustering of six preselected affective variables, three distinct affective groups were identified: low (at-risk), medium, and high. Students in the low affective group…

  3. The effects of texting on driving performance in a driving simulator: the influence of driver age.

    Rumschlag, Gordon; Palumbo, Theresa; Martin, Amber; Head, Doreen; George, Rajiv; Commissaris, Randall L

    2015-01-01

    texters (N=23) revealed that text task duration was significantly correlated with the number of Lane Excursions. The present studies confirm past reports that texting impairs driving simulator performance. Moreover, the present study demonstrates that for highly skilled texters, the effects of texting on driving are actually worse for older drivers. Given the increasing frequency of texting while driving within virtually all age groups, these data suggest that 'no texting while driving' education and public service messages need to be continued, and they should be expanded to target older drivers as well. Copyright © 2014 Elsevier Ltd. All rights reserved.

  4. Self-rated driving and driving safety in older adults.

    Ross, Lesley A; Dodson, Joan E; Edwards, Jerri D; Ackerman, Michelle L; Ball, Karlene

    2012-09-01

    Many U.S. states rely on older adults to self-regulate their driving and determine when driving is no longer a safe option. However, the relationship of older adults' self-rated driving in terms of actual driving competency outcomes is unclear. The current study investigates self-rated driving in terms of (1) systematic differences between older adults with high (good/excellent) versus low (poor/fair/average) self-ratings, and (2) the predictive nature of self-rated driving to adverse driving outcomes in older adults (n=350; mean age 73.9, SD=5.25, range 65-91). Adverse driving outcomes included self-reported incidences of (1) being pulled over by the police, (2) receiving a citation, (3) receiving a recommendation to cease or limit driving, (4) crashes, and (5) state-reported crashes. Results found that older drivers with low self-ratings reported more medical conditions, less driving frequency, and had been given more suggestions to stop/limit their driving; there were no other significant differences between low and high self-raters. Logistic regression revealed older drivers were more likely to have a state-reported crash and receive a suggestion to stop or limit driving. Men were more likely to report all adverse driving outcomes except for receiving a suggestion to stop or limit driving. Regarding self-rated driving, older adults with high ratings were 66% less likely (OR=0.34, 95% CI=0.14-0.85) to have received suggestions to limit or stop driving after accounting for demographics, health and driving frequency. Self-ratings were not predictive of other driving outcomes (being pulled over by the police, receiving a citation, self-reported crashes, or state-reported crashes, ps>0.05). Most older drivers (85.14%) rated themselves as either good or excellent drivers regardless of their actual previous citation or crash rates. Self-rated driving is likely not related to actual driving proficiency as indicated by previous crash involvement in older adults

  5. Toyota drivers' experiences with Dynamic Radar Cruise Control, Pre-Collision System, and Lane-Keeping Assist.

    Eichelberger, Angela H; McCartt, Anne T

    2016-02-01

    Advanced crash avoidance and driver assistance technologies potentially can prevent or mitigate many crashes. Previous surveys with drivers have found favorable opinions for many advanced technologies; however, these surveys are not necessarily representative of all drivers or all systems. As the technologies spread throughout the vehicle fleet, it is important to continue studying driver acceptance and use of them. This study focused on 2010-2013 Toyota Sienna and Prius models that were equipped with adaptive cruise control, forward collision avoidance, and lane departure warning and prevention (Prius models only). Telephone interviews were conducted in summer 2013 with 183 owners of vehicles with these technologies. About 9 in 10 respondents wanted adaptive cruise control and forward collision avoidance on their next vehicle, and 71% wanted lane departure warning/prevention again. Males and females reported some differences in their experiences with the systems; for example, males were more likely to have turned on lane departure warning/prevention than females, and when using this system, males reported more frequent warnings than did females. Relative to older drivers, drivers age 40 and younger were more likely to have seen or heard a forward collision warning. Consistent with the results in previous surveys of owners of luxury vehicles, the present survey found that driver acceptance of the technologies was high, although less so for lane departure warning/prevention. Experiences with the Toyota systems differed by driver age and gender to a greater degree than in previous surveys, suggesting that the responses of drivers may begin to differ as crash avoidance technology becomes available on a wider variety of vehicles. Crash avoidance technologies potentially can prevent or mitigate many crashes, but their success depends in part on driver acceptance. These systems will be effective only to the extent that drivers use them. Copyright © 2015 Elsevier Ltd and

  6. Driver style and driver skill – Clustering sub-groups of drivers differing in their potential danger in traffic

    Martinussen, Laila Marianne; Møller, Mette; Prato, Carlo Giacomo

    The Driver Behavior Questionnaire (DBQ) and the Driver Skill Inventory (DSI) are two of the most frequently used measures of self-reported driving style and driving skill. The motivation behind the present study was to test drivers’ consistency or judgment of their own self-reported driving ability...... based on a combined use of the DBQ and the DSI. Moreover, the joint use of the two instruments was applied to identify sub-groups of drivers that differ in their potential danger in traffic (as measured by frequency of aberrant driving behaviors and level of driving skills), as well as to test whether...... the sub-groups of drivers differed in characteristics such as age, gender, annual mileage and accident involvement. 3908 drivers aged 18–84 participated in the survey. The results suggested that the drivers are consistent in their reporting of driving ability, as the self-reported driving skill level...

  7. Drivers 55 Plus: Test Your Own Performance. A Self-Rating Form of Questions, Facts and Suggestions for Safe Driving.

    Malfetti, James L.; Winter, Darlene J.

    This booklet contains a 15-question rating form that provides some guidance to older drivers in beginning to assess their driving skills. The pages following the self-rating form discuss the various questions on the form. After a general introduction, the discussion is divided into five areas that traffic safety authorities have judged critical to…

  8. [Prevalence and risk factors of attention disorders of professional drivers in Morocco].

    Laraqui, Siham; Hossini, Omar Laraqui; Tripodi, Dominique; Manar, Nadia; Aoudi, Yasmine El; Caubet, Alain; Verger, Christian; Ghailane, Tarik; Laraqui, Chakib El Houssine

    2011-01-01

    We aimed to evaluate the prevalence and risk factors of professional drivers' vigilance disorders in Morocco. This transversal epidemiological multicentric study concerned 5,566 professional drivers of taxis (2,134), buses (1,158) and trucks (2,274). We used an anonymous individual questionnaire of 4 sections: socioprofessional and sanitary characteristics of drivers, working conditions, sleeping habits, symptoms of sleep problems and favouring factors. Drivers were a population at risk: high body mass index (62.2%), toxic habits (smoking: 50.6%; alcohol: 12.9%; cannabis use: 11.7%), pathological antecedents (27%) and consumption of psychotropic drugs (4%). Their working conditions were difficult and sleeping problems were frequent. The mean daily hours of work was 10.6 ± 1.6, and mean sleep duration 6.5 ± 1.3 hr. Insomnia was 40.2%, abnormally high Epworth scores 36.3% and sleepiness when driving 53.4%. Information and education on the dangers of sleepiness while driving is necessary, as is respect for regulations on work duration. The extension of the occupational health system to this type of activity would help improve road security and protect the health of professional drivers and road users.

  9. Work-related stress and role of personality in a sample of Italian bus drivers.

    Bergomi, Margherita; Modenese, Alberto; Ferretti, Enrica; Ferrari, Angela; Licitra, Giuseppe; Vivoli, Roberto; Gobba, Fabriziomaria; Aggazzotti, Gabriella

    2017-01-01

    Several studies have shown that professional drivers are at risk of developing work-related stress. Stress may be responsible for a variety of adverse effects and may also be associated with an increased number of accidents. Perform an integrated, objective and subjective evaluation of work-related stress in bus drivers, that also considered the role of personality traits. Salivary α-amylase and cortisol were measured in 42 bus drivers. Subjective stress evaluation was performed with the Perceived Stress Scale (PSS-10) and Driver Stress Inventory (DSI). To evaluate personality traits, we administered the Eysenck Personality Questionnaire-Revised (EPQ-R) and the Impulsivity Inventory (IVE). Salivary biomarkers showed no associations with PSS-10 and personality traits. Cortisol levels were positively correlated with fatigue (r = 0.44) at the middle of the work-shift and with aggression (r = 0.51) at the end of a day off. At the end of the work-shift, cortisol levels were negatively correlated with hazard monitoring (r = -0.37) and salivary α-amylase was positively correlated with thrill-seeking (r = 0.36). Neuroticism (β= 0.44) and impulsiveness (β= 0.38) were predictors of perceived stress by multiple regression. An integrated method, considering both objective and subjective indicators, seems adequate to evaluate work-related stress in professional drivers. Personality traits are relevant in determining perception of stress.

  10. Dominant drivers of business students

    Radu Cătălina

    2017-07-01

    Full Text Available Taibi Kahler wrote in 1974 a theory about five main drivers that could explain people’s motivation and a series of positive and negative behavior patterns: Be Strong, Be Perfect, Hurry Up, Try Hard and Please People. Of course, we consider there is no absolute positive or negative behavior, since (1 everything needs to be analyzed by taking into account the context and (2 any behavior pattern can mean a series of advantages as long as people understand their own values, beliefs, attitudes and behaviors. It would be interesting to link Kahler’s drivers to the educational process, in order to be able to adapt our courses and our teaching styles to students’ requirements and also to the requirements in the labor market. Our paper is built on literature review and a questionnaire applied to a sample of 607 students in Bucharest University of Economic Studies, Romania. Information was processed with Microsoft Excel 2013, in order to look at the main working styles our students have, at the main explanations for the differences between them and in order to test a series of hypotheses. We were interested to look at the main traits of the current generation of students in our university: dominant drivers, roles of managers and specialists, the attractiveness of the entrepreneurial career path, etc. and at a series of patterns (i.e. gender-related differences. We consider results of this study are useful both for teaching and research purposes. In terms of teaching, we plan to adapt our educational methods in order to improve the educational process.

  11. Knowledge, Risk Perception and Practice Regarding Tuberculosis Transmission among Long Distance Bus Drivers in Addis Ababa, Ethiopia: A Cross Sectional Study.

    Gebrehiwot, Tsegaye Tewelde; Tesfamichael, Fessahaye Alemseged

    2017-11-01

    Window opening during bus transportation is recommended as a tuberculosis prevention strategy.Yet, drivers are affected by lack knowledge and risk perception of passengers and assistants. Boosting knowledge of and notifying the high risk of tuberculosis transmission for every passenger could be too costly. However, strategies targeting bus drivers as key agents unlike targeting all passengers might be less costly for window opening. Data were collected from November 18/2014 to December 21/2014 in inter-region bus stations of Addis Ababa using cross sectional study design. Samples of 306 participants were selected using simple random sampling, and data were collected through face-to-face interview. Data were entered into Epi-data version 3.1 andanalyzed using IBM SPSS version 21. From a sample of 306 bus drivers, 303 were interviewed. Nine in ten and nearly half of participants believed in the need for opening all windows and avoiding overcrowding of passengers as TB preventive measures respectively. Few bus drivers (7.3%) believed that bus drivers and their assistants could be at risk of tuberculosis. The majority (85.7%) of bus drivers opened side window the whole day without precondition. Hearing tuberculosis related information from radio was a promoting factor for tuberculosis preventive measures among bus drivers. Tuberculosis preventive practices and knowledge of bus drivers seempositive (opportunities), despite their low risk perception (challenge). Using the opportunity, further empowering bus drivers to persuade passengers and assistants to open all the rest of the windows is needed.

  12. Improving access to geriatric mental health services: a randomized trial comparing treatment engagement with integrated versus enhanced referral care for depression, anxiety, and at-risk alcohol use.

    Bartels, Stephen J; Coakley, Eugenie H; Zubritsky, Cynthia; Ware, James H; Miles, Keith M; Areán, Patricia A; Chen, Hongtu; Oslin, David W; Llorente, Maria D; Costantino, Giuseppe; Quijano, Louise; McIntyre, Jack S; Linkins, Karen W; Oxman, Thomas E; Maxwell, James; Levkoff, Sue E

    2004-08-01

    The authors sought to determine whether integrated mental health services or enhanced referral to specialty mental health clinics results in greater engagement in mental health/substance abuse services by older primary care patients. This multisite randomized trial included 10 sites consisting of primary care and specialty mental health/substance abuse clinics. Primary care patients 65 years old or older (N=24,930) were screened. The final study group consisted of 2,022 patients (mean age=73.5 years; 26% female; 48% ethnic minority) with depression (N=1,390), anxiety (N=70), at-risk alcohol use (N=414), or dual diagnosis (N=148) who were randomly assigned to integrated care (mental health and substance abuse providers co-located in primary care; N=999) or enhanced referral to specialty mental health/substance abuse clinics (i.e., facilitated scheduling, transportation, payment; N=1,023). Seventy-one percent of patients engaged in treatment in the integrated model compared with 49% in the enhanced referral model. Integrated care was associated with more mental health and substance abuse visits per patient (mean=3.04) relative to enhanced referral (mean=1.91). Overall, greater engagement was predicted by integrated care and higher mental distress. For depression, greater engagement was predicted by integrated care and more severe depression. For at-risk alcohol users, greater engagement was predicted by integrated care and more severe problem drinking. For all conditions, greater engagement was associated with closer proximity of mental health/substance abuse services to primary care. Older primary care patients are more likely to accept collaborative mental health treatment within primary care than in mental health/substance abuse clinics. These results suggest that integrated service arrangements improve access to mental health and substance abuse services for older adults who underuse these services.

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

    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.

  14. Scorecard implementation improves identification of postpartum patients at risk for venous thromboembolism.

    Berkin, Jill A; Lee, Colleen; Landsberger, Ellen; Chazotte, Cynthia; Bernstein, Peter S; Goffman, Dena

    2016-07-01

    To evaluate if an intensive educational intervention in the use of a standardized venous thromboembolism (VTE) risk assessment tool (scorecard) improves physicians' identification and chemoprophylaxis of postpartum patients at risk for VTE. After implementation of a VTE scorecard and prior to an intensive educational intervention, postpartum patients (n = 140) were evaluated to assess scorecard completion, risk factors, and chemoprophylaxis. A performance improvement campaign focusing on patient safety, VTE prevention, and scorecard utilization was then conducted. Evaluation of the same parameters was subsequently performed for a similar group of patients (n = 133). Differences in scorecard utilization and risk assessment were tested for statistical significance. Population-at-risk rates were similar in both assessment periods (31.4% vs 28.6%; p = NS). The greatest risk factors included cesarean delivery, body mass index (BMI) >30 and age >35. Scorecard completion rates for all patients increased in the postintervention period (15.7% vs 67.7%; p scorecard completion rates for the at-risk population also improved (20% vs 79%; p risk with completed scorecards had higher prophylaxis rates than those at risk without scorecards (73% vs 25%; p = .03). At-risk patients with completed scorecards had 2.6 times more orders for chemoprophylaxis than at-risk patients without scorecards in both time periods (odds ratio [OR] = 8.4; 95% confidence interval [CI] 3.1-22.8). Utilization of a VTE scorecard coupled with an educational intervention for health care providers increases detection and chemoprophylaxis orders for at-risk patients. Encouraging universal scorecard assessment standardizes identification and chemoprophylaxis of at-risk patients who were otherwise not perceived to be at risk. © 2016 American Society for Healthcare Risk Management of the American Hospital Association.

  15. Microprocessor-based stepping motor driver

    Halbig, J.K.; Klosterbuer, S.F.

    1979-09-01

    The Pion Generation for Medical Irradiations (PIGMI) program at the Los Alamos Scientific Laboratory requires a versatile stepping motor driver to do beam diagnostic measurements. A driver controlled by a microprocessor that can move eight stepping motors simultaneously was designed. The driver can monitor and respond to clockwise- and counterclockwise-limit switches, and it can monitor a 0- to 10-V dc position signal. The software controls start and stop ramping and maximum stepping rates. 2 figures, 1 table

  16. Atypical Cry Acoustics in 6-Month-Old Infants at Risk for Autism Spectrum Disorder

    Sheinkopf, Stephen J.; Iverson, Jana M.; Rinaldi, Melissa L.; Lester, Barry M.

    2012-01-01

    This study examined differences in acoustic characteristics of infant cries in a sample of babies at risk for autism and a low-risk comparison group. Cry samples derived from vocal recordings of 6-month-old infants at risk for autism spectrum disorder (ASD; n = 21) and low-risk infants (n = 18) were subjected to acoustic analyses using analysis software designed for this purpose. Cries were categorized as either pain-related or non-pain-related based on videotape coding. At-risk infants produ...

  17. Vaccine induced Hepatitis A and B protection in children at risk for cystic fibrosis associated liver disease.

    Shapiro, Adam J; Esther, Charles R; Leigh, Margaret W; Dellon, Elisabeth P

    2013-01-30

    Hepatitis A (HAV) and Hepatitis B (HBV) infections can cause serious morbidity in patients with liver disease, including cystic fibrosis associated liver disease (CFALD). HAV and HBV vaccinations are recommended in CFALD, and maintenance of detectable antibody levels is also recommended with chronic liver disease. A better understanding of factors predicting low HAV and HBV antibodies may help physicians improve protection from these viruses in CFALD patients. We examined HAV and HBV vaccine protection in children at risk for CFALD. Clinical and vaccine histories were reviewed, and HAV and HBV antibody titers measured. Those with no vaccination history or low HAV or HBV titers received primary or booster vaccinations, and responses were measured. Thirty-four of 308 children were at risk for CFALD per project criteria. Ten had previous HAV vaccination, of which 90% had positive anti-HAV antibodies. Thirty-three of 34 had previously received primary HBV vaccination (most in infancy), but only 12 (35%) had adequate anti-HBs levels (≥10mIU/mL). Children with adequate anti-HBs levels were older at first HBV vaccine (median 2.3 vs. 0.1 years, p<0.01), and at final HBV vaccine (median 4.0 vs. 0.8 years, p=0.01). Fourteen of 19 (74%) responded to HBV boosters. Z-scores for BMI at HBV booster were significantly lower in booster non-responders (p=0.04). Children at increased risk of CFALD have inadequate HAV and HBV antibody levels, and HBV antibody protection can be enhanced through vaccine boosters. HBV antibody titers should be assessed in CFALD patients with a history of vaccination, particularly in those who received HBV vaccines in infancy or who are malnourished. Copyright © 2012 Elsevier Ltd. All rights reserved.

  18. Economic drivers of mineral supply

    Wagner, Lorie A.; Sullivan, Daniel E.; Sznopek, John L.

    2003-01-01

    The debate over the adequacy of future supplies of mineral resources continues in light of the growing use of mineral-based materials in the United States. According to the U.S. Geological Survey, the quantity of new materials utilized each year has dramatically increased from 161 million tons2 in 1900 to 3.2 billion tons in 2000. Of all the materials used during the 20th century in the United States, more than half were used in the last 25 years. With the Earth?s endowment of natural resources remaining constant, and increased demand for resources, economic theory states that as depletion approaches, prices rise. This study shows that many economic drivers (conditions that create an economic incentive for producers to act in a particular way) such as the impact of globalization, technological improvements, productivity increases, and efficient materials usage are at work simultaneously to impact minerals markets and supply. As a result of these economic drivers, the historical price trend of mineral prices3 in constant dollars has declined as demand has risen. When price is measured by the cost in human effort, the price trend also has been almost steadily downward. Although the United States economy continues its increasing mineral consumption trend, the supply of minerals has been able to keep pace. This study shows that in general supply has grown faster than demand, causing a declining trend in mineral prices.

  19. Effect of drivers' age and push button locations on visual time off road, steering wheel deviation and safety perception.

    Dukic, T; Hanson, L; Falkmer, T

    2006-01-15

    The study examined the effects of manual control locations on two groups of randomly selected young and old drivers in relation to visual time off road, steering wheel deviation and safety perception. Measures of visual time off road, steering wheel deviations and safety perception were performed with young and old drivers during real traffic. The results showed an effect of both driver's age and button location on the dependent variables. Older drivers spent longer visual time off road when pushing the buttons and had larger steering wheel deviations. Moreover, the greater the eccentricity between the normal line of sight and the button locations, the longer the visual time off road and the larger the steering wheel deviations. No interaction effect between button location and age was found with regard to visual time off road. Button location had an effect on perceived safety: the further away from the normal line of sight the lower the rating.

  20. ASSESSMENT OF THE GENERAL PSYCHOLOGICAL AND FUNCTIONAL CHARACTERISTICS CAUSED BY VIBRATIONS AT DRIVERS OF HEAVY MOTOR VEHICLES

    Sanela Čajlaković Kurtalić

    2014-09-01

    Full Text Available In this paper we presented a research that estimates general psychological and functional characteristics of motor vehicle drivers, with the goal of determining the adverse effects of noise and vibration on the drivers. The study was conducted on a sample of 56 participants, professional drivers of motor vehicles, randomly chosen from companies of various types operating in transport of passengers and goods. For the evaluation of the results,we used descriptive and correlational analysis. The results showed that there were significant negative side effects caused by the nature of work of drivers, especially those under the influence of noise and vibration, which are even more significant in older participants and those with more years of service and those who spend more time driving during the interval of 24 hours , as well as those who drive heavier vehicles.

  1. Identification of patients at risk for ischaemic cerebral complications after carotid endarterectomy with TCD monitoring

    Horn, J; Naylor, A R; Laman, D M

    2005-01-01

    Transcranial Doppler (TCD) monitoring for micro embolic signals (MES), directly after carotid endarterectomy (CEA) may identify patients at risk of developing ischaemic complications. In this retrospective multicentre study, this hypothesis was investigated....

  2. University of the Free State medical students' view of at-risk drinking ...

    2009-03-01

    Mar 1, 2009 ... Medical students' view of what constitutes at-risk drinking behaviour is ... several forms of cancer.5 Individual susceptibility to alcohol-related complications .... marijuana, tranquillisers and miscellaneous substances. In each.

  3. MYPLAN - A Mobile Phone Application for Supporting People at Risk of Suicide

    Skovgaard Larsen, Jette L; Frandsen, Hanne; Erlangsen, Annette

    2016-01-01

    describes MYPLAN, a mobile phone application designed to support people at risk of suicide by letting them create a safety plan. METHOD: MYPLAN was developed in collaboration with clinical psychiatric staff at Danish suicide preventive clinics. The mobile application lets the user create an individualized......BACKGROUND: Safety plans have been suggested as an intervention for people at risk of suicide. Given the impulsive character of suicidal ideation, a safety plan in the format of a mobile phone application is likely to be more available and useful than traditional paper versions. AIMS: The study......,000 times. Users at risk of suicide as well as clinical staff have provided positive feedback on the mobile application. CONCLUSION: Support via mobile phone applications might be particularly useful for younger age groups at risk of suicide as well as in areas or countries where support options are lacking...

  4. Multivariate Fréchet copulas and conditional value-at-risk

    Werner Hürlimann

    2004-01-01

    is similar but not identical to the convex family of Fréchet. It is shown that the distribution and stop-loss transform of dependent sums from this multivariate family can be evaluated using explicit integral formulas, and that these dependent sums are bounded in convex order between the corresponding independent and comonotone sums. The model is applied to the evaluation of the economic risk capital for a portfolio of risks using conditional value-at-risk measures. A multivariate conditional value-at-risk vector measure is considered. Its components coincide for the constructed multivariate copula with the conditional value-at-risk measures of the risk components of the portfolio. This yields a “fair” risk allocation in the sense that each risk component becomes allocated to its coherent conditional value-at-risk.

  5. Encouraging the Disuse of Illicit Drugs Among At-Risk Youth.

    Cheung, Chau-kiu; Ngai, Steven Sek-yum

    2016-05-01

    Youth at risk of illicit drug abuse and other delinquent acts are the target of social work services. Preventing or discouraging the use of illicit drugs among at-risk youth is a long-standing practical and research concern. For this reason, the preventive function of courage is a research gap the present study seeks to fill. The study collected data from 169 at-risk youths and their social workers with two-wave panel surveys. Results show that courage in Wave 1 presented a strong negative effect on illicit drug use in Wave 2 in the youth, controlling for illicit drug use in Wave 1 and background characteristics. Moreover, the negative effect was stronger when Wave 1 drug use was more likely. These results imply the helpfulness of encouraging at-risk youth to gather courage to resist the temptation to use illicit drugs. © The Author(s) 2014.

  6. Q-methodology to identify young adult renal transplant recipients at risk for nonadherence

    M. Moors-Tielen (Mirjam); A.L. van Staa (AnneLoes); S. Jedeloo (Susan); N.J.A. van Exel (Job); W. Weimar (Willem)

    2008-01-01

    textabstractBACKGROUND. Young adult renal transplant recipients may display patterns of behavior that affect graft survival. The present study aimed to identify young adults at risk for nonadherent behavior by investigating their attitudes about posttransplant health lifestyle. METHOD. A

  7. Exploring Clinical Rotation Competence Improvements after Interpersonal Skills Development in At-Risk Medical Students

    Sri Linuwih Menaldi

    2014-12-01

    Full Text Available AbstractPrior to admission, medical students were subject to psychological tests to measure their logical thinking skills and personality, hence predicting their ability to complete their studies. The results showed 56,45% of medical students obtained recommendation category 4 (doubtful and 5 (not recommended, two categories which are considered to be at-risk group with a very small probability of completing their studies. These results predicted that students in the mentioned groups will have difficulties in achieving the clinical competence level required by the Indonesian Doctors’ Competency Standard (IDCS. The aim of the study was to investigate clinical competency achievement by at-risk medical students in the third year, after following interpersonal skills development training program on July 2011. This research used qualitative study design through psychological examination, written self-reflection and in-depth interview after the training. Interpersonal skills development training for at-risk medical students gave positive effects to theircharacter development for the helping profession. It was concluded that interpersonal skills training could help improve medical student’s achievement of clinical competence especially for at-risk group in their clinical rotations stage.Keywords: medical students, at-risk group, interpersonal skills, clinical competence AbstrakPada mahasiswa kedokteran yang baru masuk dilakukan pemeriksaan psikologis untuk memperoleh gambaran penalaran dan kepribadian untuk memprediksi kemampuan mahasiswa dalam menyelesaikan pendidikan. Berdasarkan pemeriksaan tersebut diperoleh 56,45% mahasiswa dengan hasil uji psikometrik kategori rekomendasi 4 (diragukan dan 5 (tidak disarankan yang disebut sebagai kelompok at-risk. Kelompok at risk memiliki peluang keberhasilan rendah untuk menyelesaikan pendidikan dan akan mengalami kesulitan mencapai kompetensi klinik sesuai Standar Kompetensi Dokter Indonesia. Tujuan

  8. Drivers' reactions to sudden lead car braking under varying workload conditions; towards a driver support system.

    Schaap, Nina; van der Horst, A.R.A.; van Arem, Bart; Brookhuis, K.A.

    2008-01-01

    At urban intersections drivers handle multiple tasks simultaneously, making urban driving a complex task. An advanced driver assistance system may support drivers in this specific driving task, but the design details of such a system need to be determined before they can be fully deployed. A driving

  9. Identification of patients at risk for ischaemic cerebral complications after carotid endarterectomy with TCD monitoring

    Horn, J; Naylor, A R; Laman, D M

    2005-01-01

    Transcranial Doppler (TCD) monitoring for micro embolic signals (MES), directly after carotid endarterectomy (CEA) may identify patients at risk of developing ischaemic complications. In this retrospective multicentre study, this hypothesis was investigated.......Transcranial Doppler (TCD) monitoring for micro embolic signals (MES), directly after carotid endarterectomy (CEA) may identify patients at risk of developing ischaemic complications. In this retrospective multicentre study, this hypothesis was investigated....

  10. Reading curriculum-based measurement: screening Portuguese students at risk for dyslexia

    Vaz, Paula Marisa Fortunato; Martins, Ana Paula Loução

    2016-01-01

    This poster presentation will present results from a study developed within the rst level of support, primary prevention, which was focused on identifying and preventing academic problems from occurring in those students enrolled in a school setting. How progress measurement was used in reading comprehension as a universal school screening system for third-grade Portuguese students will be analyzed. Results for level and growth in both groups of students at risk and not at risk and the risk ...

  11. Estimation of the value-at-risk parameter: Econometric analysis and the extreme value theory approach

    Mladenović Zorica

    2006-01-01

    Full Text Available In this paper different aspects of value-at-risk estimation are considered. Daily returns of CISCO, INTEL and NASDAQ stock indices are analyzed for period: September 1996 - September 2006. Methods that incorporate time varying variability and heavy tails of the empirical distributions of returns are implemented. The main finding of the paper is that standard econometric methods underestimate the value-at-risk parameter if heavy tails of the empirical distribution are not explicitly taken into account. .

  12. Pain in cognitively impaired older persons.

    Parmelee, P A

    1996-08-01

    To summarize, there has been shamefully little empirical research directly examining the prevalence and correlates of pain among cognitively impaired older people. Even less is known about techniques for assessing and managing pain in this group. Existing evidence suggests that cognitively impaired older persons may voice fewer complaints about pain, but there is no reason to believe that they are in fact at less risk of pain than their cognitively intact age-mates. Rather, for whatever reason, persons with cognitively deficits appear to be less inclined to report pain than are intact elders of similar health status. This reporting difference may account at least in part for the fact that pain is less likely to be treated aggressively among cognitively impaired individuals. Unfortunately, knowing the reason for this state of affairs does not mitigate its implication: cognitive deficits place frail older persons at risk of unnecessary pain simply because it is not properly identified. Data reviewed in this chapter suggest that accurate assessment of pain in cognitively impaired older persons, far from being impossible, may actually be only slightly more demanding than it is in intact individuals. Even among markedly impaired elders, self-reports should certainly be taken as valid indicators; early evidence suggests promising avenues for developing reliable, clear-cut guidelines for the nonverbal assessment of pain in very severely demented individuals. As the nation grows older and medical care advances, a growing proportion of individuals can expect to live well into their eighth and even ninth decades. Unfortunately, with this extended life span comes increased likelihood of both cognitive impairment and pain. Thus, expansion of our repertoire of techniques for assessing and managing pain among cognitively impaired older persons must be a central priority for research on pain in late life.

  13. What are the impacts of giving up the driver license?

    Siren, Anu Kristiina; Haustein, Sonja

    Objectives: Driving cessation is a gradual process, where driver’s self-regulation plays an important role. Age-based license renewal procedures may interfere with this process and trigger premature driving cessation. The present study compares drivers aged 69 years at the baseline who either...... should try to prevent unwarranted mobility loss. Licensing policies signaling that in old age continuing to drive is an exception rather than the rule may work against this goal....... renewed their driver’s license (“renewers”) or did not (“non-renewers”) over a two-year period. Methods: Data were collected by interviewing a sample of older Danish people in 2009 (n = 1,792) and in 2012 (n = 863). The standardized interviews covered respondents’ background information, health and well...

  14. Development of an Integrated Theory of Surgical Recovery in Older Adults.

    Ann DiMaria-Ghalili, Rose

    2016-01-01

    Experts argue the health care system is not prepared to meet the unique needs of older surgical patients, including how to provide the best care during the recovery phase. Nutrition plays a critical role in the recovery of surgical patients. Since older adults are at risk for malnutrition, examining the role of nutrition as a mediator for surgical recovery across the care continuum in older adults is critical. Presently there is a paucity of frameworks, models, and guidelines that integrate the role of nutrition on the trajectory of postoperative recovery in older surgical patients. The purpose of this article is to introduce the Integrated Theory of Surgical Recovery in Older Adults, an interdisciplinary middle-range theory, so that scholars, researchers, and clinicians can use this framework to promote recovery from surgery in older adults by considering the contribution of mediators of recovery (nutritional status, functional status, and frailty) unique to the older adults.

  15. Physics at an upgraded Fermilab proton driver

    Geer, S.; /Fermilab

    2005-07-01

    In 2004 the Fermilab Long Range Planning Committee identified a new high intensity Proton Driver as an attractive option for the future, primarily motivated by the recent exciting developments in neutrino physics. Over the last few months a physics study has developed the physics case for the Fermilab Proton Driver. The potential physics opportunities are discussed.

  16. Functional Bus Driver-Pupil Passenger Relationships.

    Farmer, Ernest

    1987-01-01

    Successful school bus drivers bring much more than mechanical know-how to the job. They develop good rapport with students while acting to bring undesirable student behavior under control. Drivers must also show an interest in students' welfare and have a good sense of humor. (MLH)

  17. Cedar Avenue driver assist system evaluation report.

    2011-12-01

    This paper summarizes an evaluation of the Driver Assist System (DAS) used by the Minnesota Valley Transit Authority (MTVA) for bus shoulder operations. The DAS is a GPS-based technology suite that provides lane-position feedback to the driver via a ...

  18. Driver electronic device use in 2013.

    2015-04-01

    The percentage of drivers text-messaging or visibly manipulating : hand-held devices increased from 1.5 percent in : 2012 to 1.7 percent in 2013; however, this was not a statistically : significant increase. Driver hand-held cell phone : use decrease...

  19. Vehicle and driver scheduling for public transit.

    2009-08-01

    The problem of driver scheduling involves the construction of a legal set of shifts, including allowance : of overtime, which cover the blocks in a particular vehicle schedule. A shift is the work scheduled to be performed by : a driver in one day, w...

  20. Traffic Safety through Driver Assistance and Intelligence

    Heiner Bubb

    2011-05-01

    BMW, Daimler, Audi, Citroen, Lexus, VW, Opel, Peugeot, Renault, Chevrolet, Saab and Bosch. Both the contributions of research work concerning driving behavior analysis and driver assistance systems have to be aligned with a permanently updated interaction within the system of driver, vehicle and road traffic environment.