2008年广州市居民不安全驾驶行为发生率及影响因素分析

目的了解广州市居民不安全驾驶行为流行情况及影响因素,为制定道路交通安全防控政策提供依据。方法采用多阶段随机抽样,对广州市12个区/县级市6987名15～69岁常住人口进行入户面访。调查过去30天里曾驾驶机动车的人是否有不安全驾驶行为及相关因素。结果调查对象在过去30天里,不戴安全带、酒后驾驶、疲劳驾驶、无证驾驶的分别为15.0%、13.6%、16.3%和11.0%。多因素非条件Logistic回归分析发现,农村(OR=2.4)、文化程度低(OR=2.4)是不戴安全带的危险因素,35～44岁组(OR=0.4)不戴安全带发生率低于55～69岁组;男性(OR=5.2)、饮酒(OR=13.6)、农村(OR=2.0)、吸烟者(OR=1.8)是酒后驾驶的危险因素,生活和工作压力小(OR=0.1)是保护因素;男性(OR=7.0)、吸烟者(OR=1.6)是疲劳驾驶的危险因素,农村(OR=0.4)是保护因素,初中(OR=2.6)和高中/中专(OR=1.8)的疲劳驾驶率高于大专以上学历;文化程度低(OR=8.8)是无证驾驶的危险因素,男性(OR=0.4)是保护因素,25～34岁组(OR=0.2)和35～44岁组(OR=0.4)无证驾驶率低于55～69岁组。结论广州市不安全驾驶行为较普遍;应加大力度监管疲劳驾驶和酒后驾驶;中老年人不安全驾驶行为不容忽视。     

Driving for handicapped people

Physical handicaps often make it difficult to use an ordinary production car. Access can be a major problem for both driver and passenger, while the design of controls has to be matched to the functional capabilities of the individual driver. Provision of an adequate driving posture and storage for a wheelchair also have to be considered. Many of these problems can be overcome by suitable adaptations to the vehicle. Recent work in this field is reviewed to summarize the ergonomic guidelines that are available. The driving task also requires cognitive skills and adequate speeds of reaction as well as physical skills and capabilities. Better methods of assessing these are gradually being developed, but much further work is necessary in this area. Disabled drivers need instructors who are skilled in training for their special needs. New developments have occurred in powered controls and in their mode of operation, allowing greater numbers of severely disabled people to drive. Steering controls can now be produced which require virtually zero force or very little movement to operate, and driving with a single multi-function control can be expected in the very near future.     

The effect of medazepam and alcohol on cognitive and motor skills used in car driving

Questionnaires, motor-skill and cognitive tests were given to 3 groups of 12 healthy young men after administration of either 0,10 or 20 mg of medazepam (Nobrium). Tests were given both before and after experimental intoxication with 1 ml/kg bodyweight of diluted ethanol. On most tests medazepam did not interact with alcohol: no synergistic or antagonistic drug reaction was observed. A greater subjective fatigue rating by the drug groups was not confirmed by objective measures. The use of psychoactive drugs with ambulant patients is discussed and it is concluded that medazepam medication has no detrimental effect on driving ability.     

Driving performance during word generation--testing the function of human brain lateralization using fTCD in an ecologically relevant context

It has been hypothesized that cerebral lateralization of function enhances cognitive performance. Evidence was found in birds and fish. However, recent research in humans did not support this hypothesis. We aimed to replicate and extend these findings for single- and dual-task performance in an ecologically relevant task. We combined a word generation task which is assumed to be primarily processed in the left hemisphere with a driving task which is assumed to be primarily processed in the right hemisphere. For each task the individual strength and direction of hemispheric lateralization was assessed by using functional transcranial Doppler sonography (fTCD). For each subject (36 right-handed, 35 nonright-handed) performance was measured in the two single-tasks and in the dual-task condition. On average, subjects showed a left hemisphere bias for the word generation task, a right hemisphere bias for the driving task and dual-task interference. Within subjects, lateralization of language and driving were statistically independent.In accordance with earlier studies, the results show no indication of a positive effect of strength of lateralization on performance in single-tasks or dual-task efficiency. We also found no advantage of a typical compared to an atypical or a contralateral compared to an ipsilateral lateralization pattern. In right-handers, but not in nonright-handers, we even found a negative relationship between strength of lateralization and dual-task efficiency for atypically lateralized subjects. This further supports the suggestion that lateralization does not enhance cognitive performance in humans.     

Visual and Cognitive Predictors of Performance on Brake Reaction Test: Salisbury Eye Evaluation Driving Study

Objectives: Concern for driving safety has prompted research into understanding factors related to performance. Brake reaction speed (BRS), the speed with which persons react to a sudden change in driving conditions, is a measure of performance. Our aim is to determine the visual, cognitive, and physical factors predicting BRS in a population sample of 1425 older drivers. Methods: The Maryland Department of Motor Vehicles roster of persons aged 67–87 and residing in Salisbury, MD, was used for recruitment of the study population. Procedures included the following: habitual, binocular visual acuity using ETDRS charts, contrast sensitivity using a Pelli-Robson chart, visual fields assessed with a 81-point screening Humphrey field at a single intensity threshold, and a questionnaire to ascertain medical conditions. Cognitive status was assessed using a standard battery of tests for attention, memory, visuo-spatial, and scanning. BRS was assessed using a computer-driven device that measured separately the initial reaction speed (IRS) (from light change to red until removing foot from accelerator) and physical response speed (PRS) (removing foot from accelerator to full brake depression). Five trial times were averaged, and time was converted to speed. Results: The median brake reaction time varied from 384 to 5688 milliseconds. Age, gender, and cognition predicted total BRS, a non-informative result as there are two distinct parts to the task. Once separated, decrease in IRS was associated with low scores on cognitive factors and missing points on the visual field. A decrease in PRS was associated with having three or more physical complaints related to legs and feet, and poorer vision search. Vision was not related to PRS. Conclusion: We have demonstrated the importance of segregating the speeds for the two tasks involved in brake reaction. Only the IRS depends on vision. Persons in good physical condition may perform poorly on brake reaction tests if their vision or cognition is compromised.     

State of the art in hair analysis for detection of drug and alcohol abuse

Hair differs from other materials used for toxicological analysis because of its unique ability to serve as a long-term storage of foreign substances with respect to the temporal appearance in blood. Over the last 20 years, hair testing has gained increasing attention and recognition for the retrospective investigation of chronic drug abuse as well as intentional or unintentional poisoning. In this paper, we review the physiological basics of hair growth, mechanisms of substance incorporation, analytical methods, result interpretation and practical applications of hair analysis for drugs and other organic substances. Improved chromatographic–mass spectrometric techniques with increased selectivity and sensitivity and new methods of sample preparation have improved detection limits from the ng/mg range to below pg/mg. These technical advances have substantially enhanced the ability to detect numerous drugs and other poisons in hair. For example, it was possible to detect previous administration of a single very low dose in drug-facilitated crimes. In addition to its potential application in large scale workplace drug testing and driving ability examination, hair analysis is also used for detection of gestational drug exposure, cases of criminal liability of drug addicts, diagnosis of chronic intoxication and in postmortem toxicology. Hair has only limited relevance in therapy compliance control. Fatty acid ethyl esters and ethyl glucuronide in hair have proven to be suitable markers for alcohol abuse. Hair analysis for drugs is, however, not a simple routine procedure and needs substantial guidelines throughout the testing process, i.e., from sample collection to results interpretation.     

Continued Driving and Time to Transition to Nondriver Status through Error-Specific Driving Restrictions

ABSTRACT

We developed driving restrictions that are linked to specific driving errors, allowing cognitively impaired individuals to continue to independently meet mobility needs while minimizing risk to themselves and others. The purpose of this project was to evaluate the efficacy and duration expectancy of these restrictions in promoting safe continued driving. We followed 47 drivers age 60 years and older for 18 months, evaluating driving performance at 6-month intervals. Results demonstrated restricted drivers had safety profiles similar to safe drivers and gained additional driving time to transition to nondrivers.     

Drinking and driving in southeastern Brazil: Results from a roadside survey study

Objective

The objective of this study is to present data from a roadside survey study on drinking and driving and alcohol consumption in southeastern Brazil.

Methods

A cross-sectional roadside survey study using a questionnaire and breathalyzer data is the method used to determine the prevalence of drinking and driving and to examine whether socio-demographic characteristics and drivers' behavior, attitude and alcohol consumption predicted positive blood alcohol content (BAC). The data were gathered from 2005 to 2007 through roadside surveys conducted on high volume public roads in four cities in southeastern Brazil. A total of 4182 randomly selected drivers took part in the research. Of these drivers, 3488 (83.4%) completed the questionnaire and agreed to take a breath test.

Results

Overall, 24.6% of drivers had a detectable blood alcohol concentration (BAC) and 15.9% had a BAC above the legal limit (0.6 g/l) at the time of the study. Logistic regression controlling for locale (city), sex, age and marital status was used to predict whether each driver would present a positive breath test. Socio-demographic characteristics, driving behaviors and attitudes, and alcohol consumption patterns were included as predictors. These analyses indicated that those who believed drinking and driving was a serious offense were about two-thirds as likely to have a positive breath test, and that drivers reporting a pattern of regular alcohol use were three times as likely to have a positive breath test.

Conclusions

These findings indicate that drinking and driving is relatively common in Brazil, and that it occurs considerably more frequently than similar surveys suggest, is the case in other countries.     

Driver fatigue and highway driving: a simulator study

Long duration of driving is a significant cause of fatigue-related accidents on motorways or major roadways. The fatigue caused by driving for extended periods acutely impairs driver alertness and performance and can compromise transportation safety. This study quantitatively measured the progression of driver fatigue and identified the conservative safe duration of continuous highway driving. Thirty young male subjects were analyzed during 90 min of laboratory-simulated highway driving. Sleepiness ratings (SSS) and reaction time (RT) tests were used to assess impairment of driver alertness and vigilance. Additionally, various measures of driving performance recorded throughout the experiment were used to measure temporal deterioration of driver performance from alert to fatigued using principal component analysis (PCA). The analytical results revealed that SSS scores, reaction times (RTs) and unstable driving performance significantly increased over time, indicating that excessive driving time is a significant fatigue factor and potential cause of fatigue-related accidents. Moreover, the analytical results indicated that 80 min was the safe limit for monotonous highway driving. Based on the experimental findings of this study, public awareness of the adverse affects of driver fatigue during long-distance driving should be enhanced. This study provides explicit information of fatigue development that can be used to prevent fatigue-related accidents.     

A network approach to investigate the bi-hemispheric synchrony in absence epilepsy

ObjectiveOur objective was to unravel the dynamics underlying spike-and-wave discharges (SWDs) characteristic for childhood absence epilepsy.MethodsSWDs were recorded for a cohort of 28 children using magnetoencephalography. Non-linear association analyses and a graph theoretical metric of local connectedness (LoC) were utilized in a sliding window starting one s before till four s after ictal onset.ResultsA focal pattern of bilateral frontal and parietal areas with high LoC during the spikes alternated by generalized patterns during the waves was found for all children studied during generalization of the SWDs. In the interval preceding the generalization a focal parietal region was most often (16/28) encountered and less often an occipital (4/28), temporal (5/28) or frontal (3/28) region. 55% of the children with a parietal/occipital focal onset became seizure free after the administration of two anti-epileptic drugs, and only 12.5% with a temporal/frontal focal onset.ConclusionsThe transition from the interictal to the ictal state is for some of the children characterized by dominant LoC at either the parietal/occipital and for others at the frontal/temporal region.SignificanceThe focal onset of the SWDs varies in location among the children with a clinical similar profile, who, however, seemingly are differing with regard to seizure control.