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Tirla L, Sârbescu P, Rusu A. Assessing the effectiveness of psychoeducational interventions on driving behavior: A systematic review and meta-analysis. ACCIDENT; ANALYSIS AND PREVENTION 2024; 199:107496. [PMID: 38359672 DOI: 10.1016/j.aap.2024.107496] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/09/2023] [Revised: 01/10/2024] [Accepted: 02/02/2024] [Indexed: 02/17/2024]
Abstract
This review aimed to quantitatively summarize the evidence concerning the effectiveness of psychoeducational interventions on driving behavior. A final pool of 138 studies, totaling approximately 97,000 participants, was included in the analyses and covered all types of driving behavior targeted by the interventions. Using a random effects model, significant results were found for almost all driving outcomes, both post-intervention and long-term. The strongest effect was for reducing distracted driving at post-intervention (d = 1.87 [1.12, 2.60], Z = 4.94, p < 0.001). The only non-significant effects were for reducing errors in the long term (d = 0.50 [-0.87, 1.86], Z = 0.71, p = 0.48) and driving under the influence at post-intervention (d = 0.35 [0.00, 0.71], Z = 1.96, p = 0.05). Concerning which type of intervention was more effective, feedback, training and motivational ones appear to work best. Educational interventions show only weak effects, while awareness interventions seem mostly ineffective. Overall, our results show that most interventions can reduce different types of driving behaviors, but there are specific aspects to be considered based on the targeted behavior.
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Lee PL, Huang CK, Chen YY, Chang HH, Cheng CH, Lin YC, Lin CL. Enhancing Cognitive Function in Older Adults through Processing Speed Training: Implications for Cognitive Health Awareness. Healthcare (Basel) 2024; 12:532. [PMID: 38470642 PMCID: PMC10930606 DOI: 10.3390/healthcare12050532] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2023] [Revised: 01/31/2024] [Accepted: 02/15/2024] [Indexed: 03/14/2024] Open
Abstract
It may be possible to enhance adults' cognitive health and promote healthy aging through processing speed training using the Useful Field of View (UFOV) related activities and software. This study investigated the impact of utilizing UFOV on processing speed improvement in older adults in response to the growing global attention on cognitive health and aging issues. In this quasi-experimental study, 22 individuals (mean age ± SD = 71.9 ± 4.8) participated in the experimental group, and 20 community-based participants (mean age ± SD = 67.1 ± 4.8) were in the control group. The intervention involved ten sessions of UFOV training, each lasting 60 min, conducted twice a week for the experimental group while the control group engaged in volunteer service activities. Measurements of Counting Back, Fabrica, Double-Decision, and Hawkeye were administered to all participants before and after the intervention. The results showed significant improvements in the experimental group for the four measurements (p ≤ 0.01, 0.05, 0.001, 0.001) and non-significant gains in the control group (p ≥ 0.05) for all. Furthermore, mixed repeated-measures ANOVA analysis, with time 1 pre-test measures as the covariate, revealed significant interaction effects between time and group for all measurement indicators (p = 0.05, 0.01, 0.05) except for Fabrica (p > 0.05). In conclusion, these findings support the effectiveness of UFOV cognitive training interventions in enhancing specific cognitive abilities.
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Affiliation(s)
- Pai-Lin Lee
- Graduate School of Adult Education, National Kaohsiung Normal University, Kaohsiung 80201, Taiwan
| | - Chih-Kun Huang
- Department of Social Work, National Quemoy University, Kinmen 892009, Taiwan;
| | - Yi-Yi Chen
- Wenzao Chinese Language Center, Wenzao Ursuline University of Languages, Kaohsiung 807679, Taiwan;
| | - Hui-Hsiang Chang
- Center for English Language Teaching, Wenzao Ursuline University of Languages, Kaohsiung 807679, Taiwan;
| | - Chun-Hua Cheng
- Occupational Therapy Department, Kaohsiung Municipal Kai-Syuan Psychiatric Hospital, Kaohsiung 802511, Taiwan;
| | - Yu-Chih Lin
- Division of General Internal Medicine, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung 807377, Taiwan;
| | - Chia-Li Lin
- Department of International Business, Ming Chuan University, Taipei 111, Taiwan;
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Peterson CM, Leslie A, Flannagan CA, Nelson TF. On the road to retirement: Predicting nighttime driving difficulty and cessation using self-reported health factors. JOURNAL OF TRANSPORT & HEALTH 2024; 34:101724. [PMID: 38855420 PMCID: PMC11160935 DOI: 10.1016/j.jth.2023.101724] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2024]
Abstract
Introduction Older drivers now expect to drive longer than previous cohorts and will make up about 25% of licensed U.S. drivers by 2050. Identifying early predictors of nighttime driving difficulty, a precursor to driving retirement, can inform screening procedures and timely linkage to interventions supporting driving or transitioning to driving cessation. Methods We examined self-reported physical and mental health baseline predictors of greater nighttime driving difficulty in five and ten years using weighted multivariate logistic analyses of 2261 drivers, aged 57 to 85, from the National Social Life, Health, and Aging Project (NSHAP). Transition matrix models describe probabilities of having greater, lesser, or the same nighttime driving difficulty after five years based on baseline driving conditions and the significant logistic model factors. We built a transition matrix tool that offers users the ability to calculate expected probabilities of change in nighttime driving difficulty based on the identified salient factors. Results Five-year predictors of greater nighttime driving difficulty included perceived poor physical health (OR = 3.75), limitations to activities of daily living (ADLs; OR = 1.97), and clinical levels of depressive and anxiety symptoms (OR = 1.63; OR = 1.71). Excellent physical health (OR = 0.52), mental health (OR = 0.60), and any frequency of physical activity compared to 'never' were protective (OR = 0.37-0.51). Physical health, walking pain, and limitations to ADLs were predictive at ten-years. Transition models showed physical health and anxiety were most indicative of greater nighttime driving difficulty at 5-years for those reporting no difficulty at baseline, but limitations to ADLs were more predictive otherwise. Conclusions Lay practitioners could capitalize on the use of self-report screening measures to identify older adults who may experience near-term nighttime driving difficulty. Earlier identification may better guide long-term driving retirement planning or engagement in appropriate health interventions. The transition matrix modeling tool is freely available to facilitate development and validation of related measures.
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Affiliation(s)
- Colleen M. Peterson
- Transportation Research Institute, University of Michigan, Ann Arbor, MI, USA
| | - Andrew Leslie
- Transportation Research Institute, University of Michigan, Ann Arbor, MI, USA
| | | | - Toben F. Nelson
- Division of Epidemiology & Community Health, School of Public Health, University of Minnesota, USA
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Ishii H, Okubo Y, Doi T, Tsutsumimoto K, Nakakubo S, Kurita S, Uemura K, Misu S, Sawa R, Hashiguchi Y, Shimada H, Arai H. Effect of driving training on car crashes and driving skills in older people: A systematic review and meta-analysis. Geriatr Gerontol Int 2023; 23:771-778. [PMID: 37828779 DOI: 10.1111/ggi.14702] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2023] [Revised: 09/13/2023] [Accepted: 09/29/2023] [Indexed: 10/14/2023]
Abstract
The primary aim of this systematic review was to examine the efficacy of driving interventions with regard to a reduction in motor vehicle crashes and improvements in driving skills among older people. The secondary aim was to identify the optimal type (on-road or off-road) and dosage (period, sessions, and duration) of driving interventions for improving driving skills in older people. We searched MEDLINE, EMBASE, PsycINFO, and Scopus of Systematic Reviews for papers published from their inception to December 1, 2020, as well as the reference lists of the included papers. The selected studies were randomized controlled trials examining the effects of driving interventions among community-dwelling older drivers aged 65 years and over. A meta-analysis of two studies (n = 960) showed that driving interventions significantly reduced the number of motor vehicle crashes per person-years. Ten studies (n = 575) were included in the meta-analysis showing that the interventions significantly improved the driving skill scores. Driving skill scores significantly improved after on-road training, and in interventions of at least 3 h, 3 sessions, and 3 weeks. Driving interventions significantly improve driving skills and reduce motor vehicle crashes among older drivers aged 65 years and over. On-road training is more efficacious than off-road training and driving interventions of at least 3 h taking place in 3 sessions over a period of 3 weeks may be required to improve driving skills in older drivers. Geriatr Gerontol Int 2023; 23: 771-778.
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Affiliation(s)
- Hideaki Ishii
- Department of Physical Therapy, School of Health Sciences at Narita, International University of Health and Welfare, Narita City, Japan
- Department of Preventive Gerontology, Center for Gerontology and Social Science, Research Institute, National Center for Geriatrics and Gerontology, Obu City, Japan
| | - Yoshiro Okubo
- Falls, Balance and Injury Research Centre, Neuroscience Research Australia, Sydney, Australia
- School of Population Health, University of New South Wales, Sydney, Australia
| | - Takehiko Doi
- Department of Preventive Gerontology, Center for Gerontology and Social Science, Research Institute, National Center for Geriatrics and Gerontology, Obu City, Japan
| | - Kota Tsutsumimoto
- Department of Preventive Gerontology, Center for Gerontology and Social Science, Research Institute, National Center for Geriatrics and Gerontology, Obu City, Japan
| | - Sho Nakakubo
- Department of Preventive Gerontology, Center for Gerontology and Social Science, Research Institute, National Center for Geriatrics and Gerontology, Obu City, Japan
| | - Satoshi Kurita
- Department of Preventive Gerontology, Center for Gerontology and Social Science, Research Institute, National Center for Geriatrics and Gerontology, Obu City, Japan
| | - Kazuki Uemura
- Department of Preventive Gerontology, Center for Gerontology and Social Science, Research Institute, National Center for Geriatrics and Gerontology, Obu City, Japan
- Graduate School of Rehabilitation Science, Osaka Metropolitan University, Habikino City, Japan
| | - Shogo Misu
- Department of Preventive Gerontology, Center for Gerontology and Social Science, Research Institute, National Center for Geriatrics and Gerontology, Obu City, Japan
- Department of Physical Therapy, Faculty of Nursing and Rehabilitation, Konan Women's University, Kobe, Japan
| | - Ryuichi Sawa
- Department of Preventive Gerontology, Center for Gerontology and Social Science, Research Institute, National Center for Geriatrics and Gerontology, Obu City, Japan
- Department of Physical Therapy, Faculty of Health Science, Juntendo University, Tokyo, Japan
| | - Yu Hashiguchi
- Department of Preventive Gerontology, Center for Gerontology and Social Science, Research Institute, National Center for Geriatrics and Gerontology, Obu City, Japan
- Department of Physical Therapy, Faculty of Rehabilitation, Gunma Paz University, Takasaki-shi, Japan
| | - Hiroyuki Shimada
- Department of Preventive Gerontology, Center for Gerontology and Social Science, Research Institute, National Center for Geriatrics and Gerontology, Obu City, Japan
| | - Hidenori Arai
- National Center for Geriatrics and Gerontology, Obu City, Japan
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Ortmann N, Haddad YK, Beck L. Special Report from the CDC: Provider knowledge and practices around driving safety and fall prevention screening and recommendations for their older adult patients, DocStyles 2019. JOURNAL OF SAFETY RESEARCH 2023; 86:401-408. [PMID: 37718068 DOI: 10.1016/j.jsr.2023.06.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Accepted: 06/30/2023] [Indexed: 09/19/2023]
Abstract
INTRODUCTION Falls and motor-vehicle crashes (MVCs) are leading causes of unintentional injury deaths among older adults (65+) in the United States. Injury prevention resources exist to help healthcare providers reduce fall and MVC risk among older adult patients. However, awareness of these resources among healthcare providers is unclear. METHODS Questions were included in the 2019 DocStyles survey that assessed healthcare provider awareness of three injury prevention resources: (1) the American Geriatrics Society's (AGS's) Clinician's Guide to Assessing and Counseling Older Drivers, (2) the Clinical Assessment of Driving Related Skills (CADReS), and (3) the Centers for Disease Control and Prevention's (CDC) Stopping Elderly Accidents, Deaths, and Injuries (STEADI) initiative. We also explored the circumstances and current practices for counseling older adult patients on fall prevention and driving safety. RESULTS Only 20% of providers reported awareness of any of the injury prevention resources. Providers were more likely to report either screening for fall risk or unsafe driving when an older adult presented with a fall concern (74.5%) or driving concern or recent crash (85.1%), compared to annual screening for fall risk (67.7%) or driving safety (47.7%). More providers reported discussing the increased fall or MVC risk associated with patient medications, referring patient for driving fitness evaluations, or discussing alternative transportation options with the patient after adverse events or patient-initiated concerns compared to routine annual discussions. CONCLUSION Healthcare gaps persist in the screening and assessment of older adult risk factors for falls and unsafe driving. Limited provider awareness of clinical resources related to preventing older adult falls and unsafe driving may be contributing to these healthcare gaps. PRACTICAL APPLICATIONS Improving healthcare provider awareness of these resources could help them identify older adults at risk of a fall or MVC and promote injury prevention efforts in their clinical practices.
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Affiliation(s)
- Neil Ortmann
- Division of Injury Prevention, National Center of Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, GA, USA; Cherokee Nation Operational Solutions, Atlanta, GA, USA.
| | - Yara K Haddad
- Division of Injury Prevention, National Center of Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Laurie Beck
- Division of Injury Prevention, National Center of Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, GA, USA
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Li J, Guo F, Li W, Tian B, Chen Z, Qu S. Research on driving behavior characteristics of older drivers based on drivers' behavior graphs analysis. Heliyon 2023; 9:e18756. [PMID: 37588609 PMCID: PMC10425892 DOI: 10.1016/j.heliyon.2023.e18756] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2023] [Revised: 07/25/2023] [Accepted: 07/26/2023] [Indexed: 08/18/2023] Open
Abstract
Considerable evidence suggests that the decline in physiological abilities prevalent in older drivers leads to a reduction in the visual and psychomotor functions required for safe driving. The purpose of this study is to further investigate the differences in driving behavior between older and younger drivers and to describe the change process of driving behavior. In this study, 19 younger and older drivers each were recruited for a driving simulation experiment that included five scenarios. Driving operation data, eye movement data, and physiological data of drivers in five conflict scenarios were collected. The differences in driving behaviors between the two groups were also compared and analyzed, on which the thresholds of different driving behavior nodes were determined and driving behavior graphs were established. The results show that the eye movement nodes of older drivers appear later in five scenarios, the operational nodes of older people appear later in two steering scenarios, and are closer to those of younger drivers in three straight ahead scenarios, indicating that older drivers were later in observing and collecting traffic information, and later in applying brakes and steering to avoid conflicts when steering. The study provides a reference for the analysis of driving behavior and driving safety of older people.
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Affiliation(s)
- Jingyang Li
- Faculty of Transportation and Engineering, Kunming University of Science and Technology, Chenggong Campus, Kunming 650500, China
| | - Fengxiang Guo
- Faculty of Transportation and Engineering, Kunming University of Science and Technology, Chenggong Campus, Kunming 650500, China
| | - Wei Li
- National Engineering Laboratory for Surface Transportation Weather Impacts Prevention, Broadvision Engineering Consultants Co., Ltd., Kunming 650000, China
| | - Bijiang Tian
- National Engineering Laboratory for Surface Transportation Weather Impacts Prevention, Broadvision Engineering Consultants Co., Ltd., Kunming 650000, China
| | - Zheng Chen
- Faculty of Transportation and Engineering, Kunming University of Science and Technology, Chenggong Campus, Kunming 650500, China
| | - Sirou Qu
- Faculty of Transportation and Engineering, Kunming University of Science and Technology, Chenggong Campus, Kunming 650500, China
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7
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Stants H. Low Vision and Driving. TOPICS IN GERIATRIC REHABILITATION 2022. [DOI: 10.1097/tgr.0000000000000371] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/12/2023]
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The role of immune checkpoint inhibitors in clinical practice: an analysis of the treatment patterns, survival and toxicity rates by sex. J Cancer Res Clin Oncol 2022:10.1007/s00432-022-04309-2. [PMID: 35997822 DOI: 10.1007/s00432-022-04309-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2022] [Accepted: 08/15/2022] [Indexed: 10/15/2022]
Abstract
PURPOSE Our aim is to describe the role of immune checkpoint inhibitors (ICI) in clinical practice by providing the patient and tumor characteristics as well as survival and toxicity rates by sex. METHODS We used electronic health records to identify patients treated at the Cancer Center of the University Hospital Bern, Switzerland between January 1, 2017 and June 16, 2021. RESULTS We identified 5109 patients, 689 of whom (13.5%) received at least one dose of ICI. The fraction of patients who were prescribed ICI increased from 8.6% in 2017 to 22.9% in 2021. ICI represented 13.2% of the anticancer treatments in 2017 and increased to 28.2% in 2021. The majority of patients were male (68.7%), who were older than the female patients (median age 67 vs. 61 years). Over time, adjuvant and first line treatments increased for both sexes. Lung cancer and melanoma were the most common cancer types in males and females. The incidence of irAEs was higher among females (38.4% vs. 28.1%) and lead more often to treatment discontination in females than in males (21.1% vs. 16.8%). Independent of sex, the occurrence of irAEs was associated with greater median overall survival (OS, not reached vs. 1.1 years). Female patients had a longer median OS than males (1.9 vs. 1.5 years). CONCLUSIONS ICI play an increasingly important role in oncology. irAEs are more frequent in female patients and are associated with a longer OS. More research is needed to understand the association between patient sex and toxicity and survival.
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Betz ME, Hill LL, Fowler NR, DiGuiseppi C, Han SD, Johnson RL, Meador L, Omeragic F, Peterson RA, Matlock DD. "Is it time to stop driving?": A randomized clinical trial of an online decision aid for older drivers. J Am Geriatr Soc 2022; 70:1987-1996. [PMID: 35441700 DOI: 10.1111/jgs.17791] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2022] [Revised: 02/24/2022] [Accepted: 03/11/2022] [Indexed: 11/26/2022]
Abstract
BACKGROUND Many older adults face the difficult decision of when to stop driving. We sought to test whether an online driving decision aid (DDA) would improve decision quality. METHODS This prospective two-arm randomized trial enrolled English-speaking licensed drivers (age ≥70 years) without significant cognitive impairment but with ≥1 diagnosis associated with increased likelihood of driving cessation; all participants received primary care in clinics associated with study sites in three states. The intervention was the online Healthwise® DDA for older adults addressing "Is it time to stop driving?"; control was web-based information for older drivers only. The primary outcome was decision conflict as estimated by the Decisional Conflict Scale (DCS; lower scores indicate higher quality). Secondary outcomes were knowledge and decision self-efficacy about driving decisions. We examined postrandomization differences in primary and secondary outcomes by study arm using generalized linear mixed-effects models with adjustment for site and prerandomization scores. RESULTS Among 301 participants (mean age: 77.1 years), 51.2% identified as female and the majority as non-Hispanic (99.0%) and white (95.3%); 98.0% lived in an urban area. Participant characteristics were similar by study arm but differed across sites. Intervention participants had a lower mean DCS score (12.3 DDA vs 15.2 control; adjusted mean ratio [AMR] 0.76, 95%CI 0.61-0.95; p = 0.017). Intervention participants had higher mean knowledge scores (88.9 DDA vs. 79.9 control; OR 1.13, 95%CI 1.01-1.27, p = 0.038); there was no difference between groups in self-efficacy scores. The DDA had high acceptability; 86.9% of those who viewed it said they would recommend it to others in similar situations. CONCLUSIONS The online Healthwise® DDA decreased decision conflict and increased knowledge in this sample of English-speaking, older adults without significant cognitive impairment, although most chose to continue driving. Use of such resources in clinical or community settings may support older adults as they transition from driving to other forms of mobility. TRIAL REGISTRATION ClinicalTrials.gov identifier "Advancing Understanding of Transportation Options (AUTO)" NCT04141891.
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Affiliation(s)
- Marian E Betz
- Department of Emergency Medicine, University of Colorado, School of Medicine, Aurora, Colorado, USA.,Geriatric Research Education and Clinical Center, Rocky Mountain Regional VA Medical Center, Aurora, Colorado, USA
| | - Linda L Hill
- Department of Family Medicine and Public Health, University of California San Diego, San Diego, California, USA
| | - Nicole R Fowler
- Department of Medicine, Indiana University School of Medicine, Indianapolis, Indiana, USA.,Indiana University Center for Aging Research, Indianapolis, Indiana, USA
| | - Carolyn DiGuiseppi
- Department of Epidemiology, Colorado School of Public Health, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA
| | - S Duke Han
- Department of Family Medicine, Keck School of Medicine of the University of Southern California, Los Angeles, California, USA
| | - Rachel L Johnson
- Department of Biostatistics & Informatics, Colorado School of Public Health, Aurora, Colorado, USA
| | - Lauren Meador
- Department of Emergency Medicine, University of Colorado, School of Medicine, Aurora, Colorado, USA
| | - Faris Omeragic
- Department of Emergency Medicine, University of Colorado, School of Medicine, Aurora, Colorado, USA
| | - Ryan A Peterson
- Department of Biostatistics & Informatics, Colorado School of Public Health, Aurora, Colorado, USA
| | - Daniel D Matlock
- Geriatric Research Education and Clinical Center, Rocky Mountain Regional VA Medical Center, Aurora, Colorado, USA.,Division of Geriatric Medicine, University of Colorado, School of Medicine, Aurora, Colorado, USA
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Beck LF, Luo F, West BA. Examining Patterns of Driving Avoidance Behaviors Among Older People Using Latent Class Analysis. J Appl Gerontol 2022; 41:1752-1762. [PMID: 35441554 DOI: 10.1177/07334648221086953] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Objectives: Some older drivers choose to avoid certain situations where they do not feel confident driving. Little is known about the process by which older drivers may use avoidance in transitioning to non-driving. Methods: We analyzed 2015 ConsumerStyles data for 1198 drivers aged 60+. Driving patterns were examined by sociodemographic and driving characteristics. Avoidance classes were characterized by latent class analysis. Results: Among drivers 60+, 79% reported driving 3+ days/week and 84% reported good to excellent health. We identified four driving avoidance classes (low, mild, moderate, and high). High- (versus low-) avoidance drivers were more likely female, 75+, not White/non-Hispanic, and to have income <$25,000/year. Discussion: Avoidance of selected driving behaviors may be one component of a multi-step process supporting the transition to non-driving. Drivers displaying avoidance behaviors may be receptive to resources to prepare for this transition and minimize negative health and quality of life outcomes that accompany driving cessation.
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Affiliation(s)
- Laurie F Beck
- Centers for Disease Control and Prevention, 1242National Center for Injury Control and Prevention, Atlanta, GA, USA
| | - Feijun Luo
- Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Atlanta, GA, USA
| | - Bethany A West
- Centers for Disease Control and Prevention, 1242National Center for Injury Control and Prevention, Atlanta, GA, USA
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11
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Prohn MJ, Herbig B. Traffic safety knowledge gain of ambulance drivers after simulator-based training. BMC MEDICAL EDUCATION 2022; 22:216. [PMID: 35354466 PMCID: PMC8969364 DOI: 10.1186/s12909-022-03279-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 05/07/2021] [Accepted: 03/21/2022] [Indexed: 06/14/2023]
Abstract
BACKGROUND Compared to other road users, ambulance drivers are at a higher accident risk while driving with warning lights and sirens. No standard exists for training or education for emergency medical service employees driving ambulances. Training programs should positively influence knowledge. However, knowledge gain can be influenced by several different factors. This study developed a knowledge test for ambulance drivers to determine influencing factors on knowledge and its gain by simulator-based training. METHODS Two parallel knowledge test forms with 20 questions each were designed in several steps and tested on up to 174 participants. Questionnaires were used to study associated and influencing factors, such as objective experience, subjective attitudes, personality, motivation and demographic data. RESULTS Test construction showed good overall parallelism of the two tests as well as reliability and sensitivity. There was no correlation between subjective and objective knowledge gain, but participants with higher subjective knowledge gain showed a higher variation in objective knowledge. Younger age, higher qualification, higher number of license classes, fewer traffic violations, and more traffic safety trainings were positively associated with knowledge, whereas less yearly driving mileage, more traffic safety trainings, and higher risk sensitivity positively influenced knowledge gain through the training. CONCLUSION Knowledge and its gain through training are very low. Reasons for the lack of predictive power of some variables, such as motivation, personality and attitudes, are discussed. This study presents a new tool for testing knowledge on driving with warning lights and sirens. It shows the need for objective testing and for further research in this special area.
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Affiliation(s)
- Maria J. Prohn
- Institute and Clinic for Occupational, Social and Environmental Medicine, University Hospital, LMU Munich, Ziemssenstr. 5, 80336 Munich, Germany
| | - Britta Herbig
- Institute and Clinic for Occupational, Social and Environmental Medicine, University Hospital, LMU Munich, Ziemssenstr. 5, 80336 Munich, Germany
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12
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Kraft JN, Albizu A, O'Shea A, Hausman HK, Evangelista ND, Boutzoukas E, Hardcastle C, Van Etten EJ, Bharadwaj PK, Song H, Smith SG, DeKosky S, Hishaw GA, Wu S, Marsiske M, Cohen R, Alexander GE, Porges E, Woods AJ. Functional Neural Correlates of a Useful Field of View (UFOV)-Based fMRI Task in Older Adults. Cereb Cortex 2021; 32:1993-2012. [PMID: 34541604 PMCID: PMC9070333 DOI: 10.1093/cercor/bhab332] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Revised: 08/10/2021] [Accepted: 08/11/2021] [Indexed: 11/13/2022] Open
Abstract
Declines in processing speed performance occur in aging and are a critical marker of functional independence in older adults. Studies suggest that Useful Field of View (UFOV) training may ameliorate cognitive decline. Despite its efficacy, little is known about the neural correlates of this task. Within the current study, 233 healthy older adults completed a UFOV-based task while undergoing functional magnetic resonance imaging (fMRI). During the "stimulus" portion of this task, participants must identify a target in the center of the screen and the location of a target in the periphery, among distractors. During the "probe" portion, participants must decide if the object in the center and the location of the target in the periphery were identical to the "stimulus" screen. Widespread bilateral whole-brain activation was observed when activation patterns of the "probe" contrast were subtracted from the "stimulus" contrast. Conversely, the subtraction of "stimulus" from "probe" was associated with discrete activation patterns consisting of 13 clusters. Additionally, when evaluating the variance associated with task accuracy, specific subregions were identified that may be critical for task performance. Our data elucidate the functional neural correlates of a UFOV-based task, a task used in both cognitive training paradigms and assessment of function.
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Affiliation(s)
- Jessica N Kraft
- Center for Cognitive Aging and Memory, McKnight Brain Institute, University of Florida, Gainesville, FL 32610, USA.,Department of Neuroscience, College of Medicine, University of Florida, Gainesville, FL 32610, USA
| | - Alejandro Albizu
- Center for Cognitive Aging and Memory, McKnight Brain Institute, University of Florida, Gainesville, FL 32610, USA.,Department of Neuroscience, College of Medicine, University of Florida, Gainesville, FL 32610, USA
| | - Andrew O'Shea
- Center for Cognitive Aging and Memory, McKnight Brain Institute, University of Florida, Gainesville, FL 32610, USA.,Department of Clinical and Health Psychology, College of Public Health and Health Professions, University of Florida, Gainesville, FL 32610, USA
| | - Hanna K Hausman
- Center for Cognitive Aging and Memory, McKnight Brain Institute, University of Florida, Gainesville, FL 32610, USA.,Department of Clinical and Health Psychology, College of Public Health and Health Professions, University of Florida, Gainesville, FL 32610, USA
| | - Nicole D Evangelista
- Center for Cognitive Aging and Memory, McKnight Brain Institute, University of Florida, Gainesville, FL 32610, USA.,Department of Clinical and Health Psychology, College of Public Health and Health Professions, University of Florida, Gainesville, FL 32610, USA
| | - Emanuel Boutzoukas
- Center for Cognitive Aging and Memory, McKnight Brain Institute, University of Florida, Gainesville, FL 32610, USA.,Department of Clinical and Health Psychology, College of Public Health and Health Professions, University of Florida, Gainesville, FL 32610, USA
| | - Cheshire Hardcastle
- Center for Cognitive Aging and Memory, McKnight Brain Institute, University of Florida, Gainesville, FL 32610, USA.,Department of Clinical and Health Psychology, College of Public Health and Health Professions, University of Florida, Gainesville, FL 32610, USA
| | - Emily J Van Etten
- Brain Imaging, Behavior and Aging Laboratory, Department of Psychology and Evelyn F. McKnight Brain Institute, University of Arizona, Tucson, AZ 85721, USA
| | - Pradyumna K Bharadwaj
- Brain Imaging, Behavior and Aging Laboratory, Department of Psychology and Evelyn F. McKnight Brain Institute, University of Arizona, Tucson, AZ 85721, USA
| | - Hyun Song
- Brain Imaging, Behavior and Aging Laboratory, Department of Psychology and Evelyn F. McKnight Brain Institute, University of Arizona, Tucson, AZ 85721, USA
| | - Samantha G Smith
- Brain Imaging, Behavior and Aging Laboratory, Department of Psychology and Evelyn F. McKnight Brain Institute, University of Arizona, Tucson, AZ 85721, USA
| | - Steven DeKosky
- Center for Cognitive Aging and Memory, McKnight Brain Institute, University of Florida, Gainesville, FL 32610, USA.,Department of Neurology, College of Medicine, University of Florida, Gainesville, FL 32610, USA
| | - Georg A Hishaw
- Department of Psychiatry, Neuroscience and Physiological Sciences Graduate Interdisciplinary Programs, and BIO5 Institute, University of Arizona and Arizona Alzheimer's Consortium, Phoenix, AZ 85014, USA
| | - Samuel Wu
- Department of Biostatistics, College of Public Health and Health Professions, University of Florida, Gainesville, FL 32610, USA
| | - Michael Marsiske
- Center for Cognitive Aging and Memory, McKnight Brain Institute, University of Florida, Gainesville, FL 32610, USA.,Department of Clinical and Health Psychology, College of Public Health and Health Professions, University of Florida, Gainesville, FL 32610, USA
| | - Ronald Cohen
- Center for Cognitive Aging and Memory, McKnight Brain Institute, University of Florida, Gainesville, FL 32610, USA.,Department of Clinical and Health Psychology, College of Public Health and Health Professions, University of Florida, Gainesville, FL 32610, USA
| | - Gene E Alexander
- Department of Neurology, College of Medicine, University of Florida, Gainesville, FL 32610, USA.,Department of Psychiatry, Neuroscience and Physiological Sciences Graduate Interdisciplinary Programs, and BIO5 Institute, University of Arizona and Arizona Alzheimer's Consortium, Phoenix, AZ 85014, USA
| | - Eric Porges
- Center for Cognitive Aging and Memory, McKnight Brain Institute, University of Florida, Gainesville, FL 32610, USA.,Department of Clinical and Health Psychology, College of Public Health and Health Professions, University of Florida, Gainesville, FL 32610, USA
| | - Adam J Woods
- Center for Cognitive Aging and Memory, McKnight Brain Institute, University of Florida, Gainesville, FL 32610, USA.,Department of Neuroscience, College of Medicine, University of Florida, Gainesville, FL 32610, USA.,Department of Clinical and Health Psychology, College of Public Health and Health Professions, University of Florida, Gainesville, FL 32610, USA
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Biernacki MP, Lewkowicz R. How do older drivers perceive visual information under increasing cognitive load? Significance of personality on-road safety. ACCIDENT; ANALYSIS AND PREVENTION 2021; 157:106186. [PMID: 34004466 DOI: 10.1016/j.aap.2021.106186] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/06/2020] [Revised: 04/08/2021] [Accepted: 05/10/2021] [Indexed: 06/12/2023]
Abstract
The ability to properly receive information and respond to stimuli is a prerequisite for road safety. The aim of this study was to determine the changes in oculomotor activity under conditions of increasing cognitive load depending on personality traits in older drivers (65 years and above). We assessed 44 male active drivers (M = 69, SD = 8.1) in a road traffic simulator in the dual-task paradigm: n-back reaction test (central task) and memory test (peripheral task). During the test in the simulator, oculomotor activity was recorded. Drivers' personality traits were determined using the EPQ-R questionnaire. With the increase of cognitive load in drivers with high levels of neuroticism and extraversion, the time of saccades and fixation significantly increased. The decrease in the effectiveness of visual attention shifting in older drivers intensified as the difficulty of performing tasks increased and manifested itself in longer saccade and fixation times. A higher level of neuroticism and the resulting stress and emotional tension can translate into a greater tendency to make mistakes in older drivers.
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Affiliation(s)
- Marcin Piotr Biernacki
- Military Institute of Aviation Medicine, Department of Aviation Physiology, Warsaw, Poland.
| | - Rafał Lewkowicz
- Military Institute of Aviation Medicine, Simulator Study and Aeromedical Training Division, 54/56 Krasinskiego Street, Warsaw, Poland.
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