https://web.ics.purdue.edu/~duffy/IE486_Spr07/IE486_p14_Accid%20Anal%20Prv.pdf

Monotony of road environment and driver fatigue: a simulator study.

ContextSomnolence is a recognized adverse effect of dopamine agonists. Two
new dopamine agonists, pramipexole and ropinirole, have been reported to cause
sudden-onset sleep spells in patients with Parkinson disease (PD) while they
were driving. The frequency of these spells and whether driving should be
restricted has yet to be established.ObjectiveTo determine the frequency of and predictors for sudden-onset sleep
and, particularly, episodes of falling asleep while driving among patients
with PD.Design, Setting, and ParticipantsProspective survey conducted between January and April 2000 in 18 clinics
directed by members of the Canadian Movement Disorders Group; 638 consecutive
highly functional PD patients without dementia were enrolled, of whom 420
were currently drivers.Main Outcome MeasuresExcessive daytime sleepiness and sudden-onset sleep as assessed by the
Epworth Sleepiness Scale and the Inappropriate Sleep Composite Score. The
latter score, designed for this study, addressed falling asleep in unusual
circumstances. The 2 scales were combined in 3 separate formats: dozing off,
sudden unexpected sleep, and sudden blank spells.ResultsExcessive daytime sleepiness was present overall in 327 (51%) of the
638 patients and in 213 (51%) of the 420 drivers. Patients taking a variety
of different dopamine agonists had no differences in Epworth sleepiness scores,
in the composite score, or in the risk of falling asleep while driving. Sixteen
patients (3.8%) had experienced at least 1 episode of sudden onset of sleep
while driving (after the diagnosis of PD); in 3 (0.7%), it occurred without
warning. The 2 risk factors associated with falling asleep at the wheel were
the Epworth Sleepiness Scale score (odds ratio [OR], 1.14; 95% confidence
interval [CI], 1.06-1.24) and the Inappropriate Sleep Composite Score (OR,
2.54; 95% CI, 1.76-3.66). A standard Epworth Sleepiness Scale score of 7 or
higher predicted 75% of episodes of sleep behind the wheel at a specificity
of 50% (exclusion of the question related to driving provided 70% sensitivity
and 52% specificity), whereas a score of 1 on the Inappropriate Sleep Composite
Score generated a sensitivity of 52% and specificity of 82%.ConclusionsExcessive daytime sleepiness is common even in patients with PD who
are independent and do not have dementia. Sudden-onset sleep without warning
is infrequent. The Epworth score has adequate sensitivity for predicting prior
episodes of falling asleep while driving and its specificity can be increased
by use of the Inappropriate Sleep Composite Score. It is unknown if routinely
performing these assessments could be more effective in predicting future
risk for these rare sleep attacks. Patients should be warned not to drive
if they doze in unusual circumstances.

https://jamanetwork.com/journals/jama/articlepdf/194590/JOC10367.pdf

Excessive daytime sleepiness and sudden-onset sleep in Parkinson disease: a survey by the Canadian Movement Disorders Group.

We present a review of the studies that have been published about addiction to cell phones. We analyse the concept of cell phone addiction as well as its prevalence, study methodologies, psychological features and associated psychiatric comorbidities. Research in this field has generally evolved from a global view of the cell phone as a device to its analysis via applications and contents. The diversity of criteria and methodological approaches that have been used is notable, as is a certain lack of conceptual delimitation that has resulted in a broad spread of prevalent data. There is a consensus about the existence of cell phone addiction, but the delimitation and criteria used by various researchers vary. Cell phone addiction shows a distinct user profile that differentiates it from Internet addiction. Without evidence pointing to the influence of cultural level and socioeconomic status, the pattern of abuse is greatest among young people, primarily females. Intercultural and geographical differences have not been sufficiently studied. The problematic use of cell phones has been associated with personality variables such as extraversion, neuroticism, self-esteem, impulsivity, self-identity and self-image. Similarly, sleep disturbance, anxiety, stress, and, to a lesser extent, depression, which are also associated with Internet abuse, have been associated with problematic cell phone use. In addition, the present review reveals the coexistence relationship between problematic cell phone use and substance use such as tobacco and alcohol.

/pdf/cell-phone-addiction-a-review-3idlst8zf5.pdf

Cell-Phone Addiction: A Review

Objective:To review structural interventions in public health, identify distinct approaches to structural interventions, and assess their implications for HIV-prevention interventions.Method:The MEDLINE, HealthStar, PsychInfo and Sociofile databases were searched on specific health issues, types of

Structural interventions in public health.

Standardized diagnostic criteria determined by the International Restless Legs Syndrome Study Group were used to investigate the current prevalence of restless legs syndrome (RLS). Possible associations between RLS and neuropsychiatric and somatic complaints were also investigated. A random sample of 4,000 men living in central Sweden were sent a questionnaire that included questions about sleep habits, symptoms of sleepiness, and somatic and neuropsychiatric complaints. Four symptom questions accepted as minimal diagnostic criteria for RLS were also included. Odds (OR) ratios and 95% confidence interval (CI) for different variables were calculated by means of multivariate logistic regression; 5.8% of the men suffered from RLS. The prevalence of RLS increased with age. Sleep-related complaints were more frequent among the RLS sufferers. Complaints of headache at awakening and daytime headache were reported three to five times more frequently among RLS sufferers and there was a tendency toward reported social isolation related to RLS. Subjects with RLS more frequently reported depressed mood (OR, 2.6; 95% CI, 1.8–3.8), and complained more often of reduced libido (OR, 2.2; 95% CI, 1.4–3.3). RLS sufferers more frequently reported hypertension (OR, 1.5; 95% CI, 0.9–2.4) and heart problems (OR, 2.5; 95% CI, 1.4–4.3). Results show that restless legs syndrome is common among men. It is hypothesized that RLS may be associated with several somatic and neuropsychiatric symptoms. © 2001 Movement Disorder Society.

Prevalence of restless legs syndrome among men aged 18 to 64 years: An association with somatic disease and neuropsychiatric symptoms

Inattention among car drivers on a motorway section with two lanes in each direction was investigated by a combination of two different methodological approaches. First, an observer in a driving car in the non-passing (right) lane observed 1337 passing drivers; i.e., all drivers passing during the observation period. At a service area about midway along the section, 273 drivers were interviewed during the same period. The observations showed that 14% of drivers were involved in some secondary activity, with handheld mobile telephone use (which is prohibited) being the most frequent activity (5%). Involvement in secondary activities were far more frequent among drivers without passengers, with 15%, compared to 9% for drivers with passengers. For the latter, interaction with passengers was observed for 6%. The interviews made a useful supplement to roadside observations, providing prevalence estimates also for non-observable activities and states like daydreaming and listening to radio or music. Concerning passenger interaction, duration data were uncertain because many drivers tended to report total driving time with passengers rather than time interacting with them. Consequently, prevalence estimates for passenger interaction as reported in interviews were uncertain, and we therefore estimated this prevalence from observation data only. Total prevalence of secondary activities and internal states presumably implying inattention was estimated at about 24% of total driving time when based on both methods combined.

Combining roadside interviews and on-road observation for assessing prevalence of driver inattention

Norway’s penalty point system implies that traffic infractions are penalised with two or three points for full-licence drivers and four or six points for probationary-licence drivers, and when a total of eight points is reached within a three-year period the licence is revoked for a duration of six months. A web-based questionnaire was administered to four different driver samples based on number of acquired penalty points: (a) drivers with no points (n = 1206), (b) full-licence drivers with two or three points (n = 190), (c) full-licence drivers with four points or more (n = 172), and (d) probationary-licence drivers with four points or more (n = 193). Drivers with penalty points had better knowledge about the penalty points than those without penalty points. Drivers with four points or more, which means that they are close to the disqualification limit, to a greater extent replied that they have become more law-abiding, compared to those with few or no points. Also drivers without points reported that their driving was influenced by fear of penalty points. Thus, the penalty point system seems to have both a specific perceived deterrence effect on drivers who are at a high risk of losing their licence, and a general perceived deterrence effect on drivers without penalty points.

Self-reported deterrence effects of the Norwegian driver's licence penalty point system

Effects of Variable Message Signs (VMS) were investigated in a field study. 2 VMS on motorways were used in the study. On three evenings, the VMS presented alternating no message, and a message which recommends to choose an alternative route because of a closed road section. Compliance with the messages was measured by registering which proportion of vehicles chose the recommended route. Driver behaviour was registered with speed-recordings and observation of braking behaviour. Results show a large proportion of drivers complying with the messages. It was estimated that about every 5th vehicle changed route choice according to the recommendation. Almost none drove as far as the closed road segment. Speed recordings showed large speed reductions when the VMS showed messages. A much higher proportion of vehicles braked when a message was shown on the VMS than when no message was shown. Many vehicles additionally changed driving lane or made others change lane. Braking also led to increased proportions of small and very small spaces between vehicles following each other. Braking, lane changes and short distances can lead to conflicts and accidents. The results lead to the conclusion that VMS attract attention and can be effective in influencing route choice, but that VMS and driving impose conflicting attention demands on the drivers. Explanations can be located at the different levels of the driving task. On the operational level, driving can be impaired by increased visual load, e.g. due to short reading distance. The tactical level of the driving task can be affected by the attempt of the driver to gain time by reducing speed, which additionally can make lane change necessary. The strategic level of the driving task, which includes navigation, is the target level of the traffic information used in this study. Depending on formal and content aspects of the messages, the information can additionally affect driving on the operational and tactical level, by reducing available information processing capacity. Consequently, traffic information should make it possible for drivers to establish an immediate link between the message and the driving task on the target level, without detracting from driving on other levels. This can be achieved by increasing reading distance, by an appropriate design of display elements and by use of symbols corresponding to drivers mental representations of the driving task, possibly in combination with speed limits. The research has been conducted at the Institute of Transport Economics in Oslo, funded by the Norwegian Public Roads Administration. For the covering abstract see ITRD E135582.

Effects of variable message signs (vms) on driver attention and behaviour

The report describes and evaluates traffic safety measures for older drivers in Norway. Firstly, a literature review with a focus on current resarch since the year 2000 gives an overall picture of existing measures. Secondly, a review of existing and possible self-evaluation tests is made. Thirdly, the literature review and the review of self-evalution tests forms the basis for evaluating the effects of measures on traffic safety, mobility, safe mobility and viability. Seven measures of action which could be implemented in Norway are presented. - The current Norwegian driving licence policy of mandatory medical certificates for car drivers 70 years old and older should be evaluated. - The current Norwegian policy with restricted driving licences should be evaluated. - Education and training for older drivers should continue and develop to increase the effects on safe mobility. - Self-evaluation tests should be implemented step-by-step and their use should be evaluated. - Dissemination of checklists and advice to older drivers to facilitate choosing a car beneficial to safe mobility should be stimulated. - A separate signal phase for left turning vehicles in intersections regulated by traffic lights, possibly complemented by a separate lane should when possible be introduced. - Complex intersections without traffic lights should when possible be turned into roundabouts.

Fridulv Sagberg

Papers

Combining roadside interviews and on-road observation for assessing prevalence of driver inattention

Self-reported deterrence effects of the Norwegian driver's licence penalty point system

Effects of variable message signs (vms) on driver attention and behaviour

Åtgärder för äldre bilförare: effekter på trafiksäkerhet och mobilitet

Behavioural adaptation to antilock brakes: drivers keep a shorter distance.