scholarly journals Explaining the Association between Driver’s Age and the Risk of Causing a Road Crash through Mediation Analysis

2020 ◽  
Vol 17 (23) ◽  
pp. 9041
Author(s):  
Karoline Gomes-Franco ◽  
Mario Rivera-Izquierdo ◽  
Luis Miguel Martín-delosReyes ◽  
Eladio Jiménez-Mejías ◽  
Virginia Martínez-Ruiz
Keyword(s):  
Confidence Interval ◽  
Mediation Analysis ◽  
Odds Ratio ◽  
Age Groups ◽  
Older Drivers ◽  
Crash Risk ◽  
Direct Path ◽  
Driving Behaviors ◽  
Age Related ◽  
Road Crash

It has been widely reported that younger and older drivers have an excess risk of causing a road crash. Two casual hypotheses may coexist: the riskier driving behaviors and age-related mechanisms in extreme age groups (direct path) and the different environmental and vehicle circumstances (indirect path). Our aim was to quantify, through a mediation analysis, the percentage contribution of both paths. A case-control study was designed from the Spanish Register of Road Crashes with victims from 2014 to 2017. Assuming a quasi-induced exposure approach, controls were non-responsible drivers involved in clean collisions between two or more vehicles (n = 52,131). Responsible drivers for these collisions plus drivers involved in single crashes constituted the case group (n = 82,071). A logit model in which the outcome was the log (odds) of causing a road crash and the exposure was age groups was adjusted for driver, vehicle and environmental factors. The highest crash risk was observed in extreme age groups, compared to the 35–44 year old age group: the youngest (18–24 years old, odds ratio = 2.14, 95% confidence interval: 2.06–2.24) and the oldest drivers (>74 years old, odds ratio = 3.30, 95% confidence interval: 3.04–2.58). The mediation analysis identified the direct path as the main explanatory mechanism for these increases: 89% in the youngest and 93% in the oldest drivers. These data support the hypothesis that the excess crash risk observed for younger and older drivers is mainly related to their higher frequency of risky driving behaviors and age-related loss of capabilities. Preventive strategies in extreme-aged drivers should focus on decreasing these behaviors.

scholarly journals Association of Photopic and Mesopic Contrast Sensitivity in older drivers with risk of motor vehicle collision using naturalistic driving data

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Cynthia Owsley ◽  
Thomas Swain ◽  
Rong Liu ◽  
Gerald McGwin ◽  
Mi Young Kwon
Keyword(s):  
Older Adults ◽  
Contrast Sensitivity ◽  
Motor Vehicle ◽  
Age Groups ◽  
Time Of Day ◽  
Motor Vehicle Crash ◽  
Older Drivers ◽  
Crash Risk ◽  
Sensitivity Testing ◽  
Naturalistic Driving

Abstract Background Older drivers have a crash rate nearly equal to that of young drivers whose crash rate is the highest among all age groups. Contrast sensitivity impairment is common in older adults. The purpose of this study is to examine whether parameters from the photopic and mesopic contrast sensitivity functions (CSF) are associated with incident motor vehicle crash involvement by older drivers. Methods This study utilized data from older drivers (ages ≥60 years) who participated in the Strategic Highway Research Program Naturalistic Driving Study, a prospective, population-based study. At baseline participants underwent photopic and mesopic contrast sensitivity testing for targets from 1.5–18 cycles per degree. Model fitting generated area under the log CSF (AULCSF) and peak log sensitivity. Participant vehicles were instrumented with sensors that captured continuous driving data when the vehicle was operating (accelerometers, global positioning system, forward radar, 4-channel video). They participated for 1–2 years. Crashes were coded from the video and other data streams by trained analysts. Results The photopic analysis was based on 844 drivers, and the mesopic on 854 drivers. Photopic AULCSF and peak log contrast sensitivity were not associated with crash rate, whether defined as all crashes or at-fault crashes only (all p > 0.05). Mesopic AULCSF and peak log sensitivity were associated with an increased crash rate when considered for all crashes (rate ratio (RR): 1.36, 95% CI: 1.06–1.72; RR: 1.28, 95% CI: 1.01–1.63, respectively) and at-fault crashes only (RR: 1.50, 95% CI: 1.16–1.93; RR: 1.38, 95% CI: 1.07–1.78, respectively). Conclusions Results suggest that photopic contrast sensitivity testing may not help us understand future crash risk at the older-driver population level. Results highlight a previously unappreciated association between older adults’ mesopic contrast sensitivity deficits and crash involvement regardless of the time of day. Given the wide variability of light levels encountered in both day and night driving, mesopic vision tests, with their reliance on both cone and rod vision, may be a more comprehensive assessment of the visual system’s ability to process the roadway environment.

scholarly journals Driving Anger, Aberrant Driving Behaviors, and Road Crash Risk: Testing of a Mediated Model

2019 ◽  
Vol 16 (3) ◽  
pp. 297 ◽  
Author(s):  
Tingru Zhang ◽  
Alan H.S. Chan ◽  
Hongjun Xue ◽  
Xiaoyan Zhang ◽  
Da Tao
Keyword(s):  
Risk Factors ◽  
Road Safety ◽  
Road Traffic ◽  
Crash Risk ◽  
Traffic Crashes ◽  
Road Traffic Crashes ◽  
Driving Anger ◽  
Driving Behaviors ◽  
Scale Scores ◽  
Road Crash

With the dramatic increase in motorization, road traffic crashes have become the leading cause of death in China. To reduce the losses associated with road safety problems, it is important to understand the risk factors contributing to the high crash rate among Chinese drivers. This study investigated how driving anger and aberrant driving behaviors are related to crash risk by proposing and testing one mediated model. In this model, the effects of driving anger on road crash risk were mediated by aberrant driving behaviors. However, unlike previous studies, instead of using the overall scale scores, the subscales of driving anger and aberrant driving behaviors were used to establish the mediated model in this study. To test the validity of this model, an Internet-based questionnaire, which included various measures of driving anger, aberrant driving, and road crash history, was completed by a sample of 1974 Chinese drivers. The results showed that the model fitted the data very well and aberrant driving behaviors fully mediated the effects of driving anger on road crash risk. Findings from the present study are useful for the development of countermeasures to reduce road traffic crashes in China.

Epidemiological investigation of euthanasia in an Ontario animal shelter

2017 ◽  
Vol 20 (6) ◽  
pp. 479-486 ◽  
Author(s):  
Rachael Mozes ◽  
David L Pearl ◽  
Lee Niel ◽  
J Scott Weese
Keyword(s):  
Risk Factors ◽  
Confidence Interval ◽  
Odds Ratio ◽  
Age Groups ◽  
Quadratic Term ◽  
Epidemiological Investigation ◽  
Animal Shelter ◽  
Factors Associated

Objectives The objective was to evaluate factors associated with euthanasia in an animal shelter in Kitchener-Waterloo, Ontario, Canada. Methods Data from 3737 cats admitted to the shelter between January and December 2011 were evaluated. Results Overall, 1989/3737 (53%) of admitted cats were euthanized. Male cats had greater odds of being euthanized than females (odds ratio [OR] 1.63, 95% confidence interval [CI] 1.29–2.05; P <0.001) and surrendered cats were more likely to be euthanized than strays (OR 38.0, 95% CI 14.8–97.69; P <0.001). Black cats were more likely to be euthanized than cats of another color (OR 1.45, 95% CI 1.16–1.80; P <0.001). Cats that spent >5 days in the shelter were more likely to be euthanized than those that spent <5 days in the shelter (OR 1.57, 95% CI 1.25–1.97; P <0.001). Cats that spent >20 days in the shelter were less likely to be euthanized than those that spent <5 days in the shelter (OR 0.26, 95% CI 0.19–0.34; P <0.001). Age, an age quadratic term, neuter status and interactions among these variables were statistically significant; the odds of unneutered animals being euthanized was high and relatively stable across age groups, but in neutered animals the odds of being euthanized increased with age before plateauing in older cats. Conclusions and relevance With >50% of the cats admitted to the shelter in 2011 euthanized, it is important to understand the contributing risk factors that predispose shelter cats to euthanasia and what changes can be made to the shelter system and in owner education to lower the incidence of euthanasia.

scholarly journals Physical Activity in Older Cancer Survivors: What Role Do Multimorbidity and Perceived Disability Play?

2020 ◽  
Vol 28 (2) ◽  
pp. 311-319 ◽  
Author(s):  
Shirley M. Bluethmann ◽  
Wayne Foo ◽  
Renate M. Winkels ◽  
Scherezade K. Mama ◽  
Kathryn H. Schmitz
Keyword(s):  
Physical Activity ◽  
Confidence Interval ◽  
Cancer Survivors ◽  
Odds Ratio ◽  
Age Groups ◽  
Chronic Obstructive ◽  
Behavioral Risk ◽  
Obstructive Pulmonary Disease ◽  
Exercise Interventions ◽  
Perceived Disability

Purpose: (a) To describe the relationship of multimorbidity and physical activity (PA) in cancer survivors and (b) to explore perceived disability and PA in middle-aged and older survivors. Methods: The authors analyzed the data from cancer survivors (N = 566), identified using the Pennsylvania Cancer Registry, who responded to a Behavioral Risk Factor Surveillance System-derived questionnaire. They created age groups (e.g., 45–54 years, 55–64 years, 65–74 years, and 75 years and older) and calculated a composite score of eight common comorbidities (e.g., chronic obstructive pulmonary disease, heart disease) to assess multimorbidity. Logistic regression was used to estimate the association of demographic and behavioral/clinical risk factors (e.g., multimorbidity, perceived disability, body mass index) with PA. Results: Most respondents were females (62%), older (mean age = 68 years) and represented diverse cancer sites, including breast (n = 132), colorectal (n = 102), gynecologic (n = 106), prostate (n = 111), and lung (n = 80). PA participation was mixed; 44% of survivors reported achieving >150 min of aerobic PA, but half of lung and 37% of gynecologic survivors reported no PA (0 min/week). Higher multimorbidity (odds ratio = 0.82, confidence  interval [0.69, 0.98], p < .05), obesity (odds ratio = 0.51, confidence  interval [0.30, 0.86], p < .05), and perceived disability (odds ratio = 0.49, confidence  interval [0.32, 0.77], p < .001) were negatively associated with PA participation. Strength training was suboptimal across all survivors. Conclusion: Most older survivors experienced comorbid conditions, and this was associated with less PA. Survivors who perceived themselves as disabled or who were obese were half as likely as others to participate in PA. This suggests an increasing need to address both physical and psychological limitations in designing PA interventions for real-world needs. Exercise interventions that address the unique needs of older survivors for multimorbidity, obesity, and perceived disability may strengthen opportunities for PA.

Smart In-Vehicle Technologies and Older Drivers: A Scoping Review

2019 ◽  
Vol 39 (2) ◽  
pp. 97-107 ◽  
Author(s):  
Sherrilene Classen ◽  
Mary Jeghers ◽  
Jane Morgan-Daniel ◽  
Sandra Winter ◽  
Luther King ◽  
...  
Keyword(s):  
Scoping Review ◽  
Older Drivers ◽  
Crash Risk ◽  
Cognitive Workload ◽  
Driving Simulators ◽  
Age Related ◽  
Driving Assistance ◽  
Vehicle Information ◽  
Vehicle Technologies ◽  
The Impact

In-vehicle technologies may decrease crash risk in drivers with age-related declines. Researchers determined the impact of in-vehicle information systems (IVIS) or advanced driving assistance systems (ADAS) on driving. Through a scoping review, the effect of IVIS or ADAS on older drivers’ convenience (i.e., meets one’s needs), comfort (i.e., physical or psychological ease), or safety (i.e., absence of errors or crashes) was examined. Researchers synopsized findings from 28 studies, including driving simulators and on-road environments. Findings indicated that IVIS or ADAS enhanced safety and mitigated age-related declines. Notably, IVIS may reduce cognitive workload, but may jeopardize safety if the systems are overly complicated. The ADAS enhanced safety and comfort by increasing speed control, lane maintenance, and braking responses. However, no studies addressed convenience. In-vehicle technologies may enhance safety and comfort while driving, if one’s cognitive workload is not compromised. Naturalistic studies are needed to elucidate the risks and benefits of IVIS and ADAS for older drivers.

Experimental Intercomparisons of Younger and Older Driver Perceptions

1993 ◽  
Vol 36 (3) ◽  
pp. 239-253 ◽  
Author(s):  
Thomas M. Nelson ◽  
Bruce Evelyn ◽  
Robert Taylor
Keyword(s):  
Peer Group ◽  
Older Drivers ◽  
Age Group ◽  
Safety Hazards ◽  
Safe Driving ◽  
Older Driver ◽  
Driving Behaviors ◽  
Age Related ◽  
Positive Impression ◽  
Education Courses

Drivers over sixty-five years of age and drivers under twenty-one years of age have the highest relative frequency of crashes resulting in injury and death. Attitudes of these two groups were investigated using questionnaires. One hundred twenty-seven (127) younger and one hundred eight (108) older drivers who had voluntarily registered in driving education courses satisfactorily completed questionnaires about attitudes and behaviors pertinent to safe driving. Half of each sample rated the average driver in their age group and the average driver in the opposite age group as regarded thirty-three attitudes promoting safe driving, twenty courteous safe driving behaviors and eleven discourteous, unsafe driving behaviors. Data shows that younger drivers viewed older drivers as overly cautious, too slow to act and apt to cause accidents, and rated their peers as overly aggressive and discourteous. Older drivers characterized younger drivers as deficient in courtesy and safe driving practices, and they rated their peers as cautious, courteous, and aware of age-related limitations. The findings indicate that each group was aware that safety hazards are created by drivers in their age group. It also shows that both groups had a positive impression of some driving practices of their age group, and that the other group was depreciated. The outcome confirms and expands upon conclusions derived from less formal studies about how drivers perceive other roadway users. It also specifies the extent to which particular attitudes and driving practices are attributed to the peer group and to the opposite age group.

Systemic activation of the complement system in patients with advanced age-related macular degeneration

2019 ◽  
Vol 30 (5) ◽  
pp. 1061-1068 ◽  
Author(s):  
Anne M Lynch ◽  
Naresh Mandava ◽  
Jennifer L Patnaik ◽  
Ashley A Frazer-Abel ◽  
Brandie D Wagner ◽  
...  
Keyword(s):  
Confidence Interval ◽  
Macular Degeneration ◽  
Complement System ◽  
Odds Ratio ◽  
Adjusted Odds Ratio ◽  
Geographic Atrophy ◽  
Age Related Macular Degeneration ◽  
Advanced Age ◽  
Age Related ◽  
The Complement System

Purpose: To examine the role of systemic activation of the complement system (assessed by levels of circulating C3a, Ba, and sC5b-9) in patients (n = 122) with advanced age-related macular degeneration, geographic atrophy, and neovascular age-related macular degeneration, compared with cataract controls (n = 27). Methods: Plasma complement factors were measured using enzyme-linked immunosorbent assays. Statistical analysis included univariate and multivariate logistic regression (p < 0.05). Results: Adjusted for age, the odds ratios of C3a and sC5b-9 for any advanced age-related macular degeneration were 1.78 (95% confidence interval = 1.16–2.73, p < 0.01) and 1.20 (95% confidence interval = 1.04–1.39, p = 0.01), respectively. We found a significantly elevated adjusted odds ratio of C3a (adjusted odds ratio = 1.71, 95% confidence interval = 1.12–2.60, p = 0.01) and sC5b-9 (adjusted odds ratio = 1.22, 95% confidence interval = 1.04–1.43, p = 0.01) for neovascular age-related macular degeneration. Adjusted for age, neither C3a, sC5b-9, nor Ba were associated with geographic atrophy. Conclusion: We suggest a role for elevated plasma levels of C3a and sC5b-9 in patients with neovascular age-related macular degeneration. The study’s results reinforce the need for more investigation to assess the impact of therapeutic interventions targeted at the complement signaling pathways in age-related macular degeneration.

scholarly journals An Investigation of the Effects of Driver Age When Using Novel Navigation Systems in a Head-Up Display

2019 ◽  
Vol 27 (1) ◽  
pp. 32-45
Author(s):  
Sanna M. Pampel ◽  
Katherine Lamb ◽  
Gary Burnett ◽  
Lee Skrypchuk ◽  
Chrisminder Hare ◽  
...  
Keyword(s):  
Augmented Reality ◽  
Real World ◽  
Mental Workload ◽  
Driving Performance ◽  
Older Drivers ◽  
The Other ◽  
Crash Risk ◽  
Navigation Systems ◽  
Success Rates ◽  
Age Related

Although drivers gain experience with age, many older drivers are faced with age-related deteriorations that can lead to a higher crash risk. Head-Up Displays (HUDs) have been linked to significant improvements in driving performance for older drivers by tackling issues related to aging. For this study, two Augmented Reality (AR) HUD virtual car navigation solutions were tested (one screen-fixed, one world-fixed), aiming to improve navigation performance and reduce the discrepancy between younger and older drivers by aiding the appropriate allocation of attention and easing interpretation of navigational information. Twenty-five participants (12 younger, 13 older) undertook a series of drives within a medium-fidelity simulator with three different navigational conditions (virtual car HUD, static HUD arrow graphic, and traditional head-down satnav). Results showed that older drivers tended to achieve navigational success rates similar to the younger group, but experienced higher objective mental workload. Solely for the static HUD arrow graphic, differences in most workload questionnaire items and objective workload between younger and older participants were not significant. The virtual car led to improved navigation performance of all drivers, compared to the other systems. Hence, both AR HUD systems show potential for older drivers, which needs to be further investigated in a real-world driving context.

SIDE EFFECTS OF PTU AND MMI IN THE TREATMENT OF HYPERTHYROIDISM: A SYSTEMATIC REVIEW AND META-ANALYSIS

2020 ◽  
Vol 26 (2) ◽  
pp. 207-217 ◽  
Author(s):  
Wenshu Yu ◽  
Na Wu ◽  
Ling Li ◽  
Junwu Wang ◽  
Hong OuYang ◽  
...  
Keyword(s):  
Confidence Interval ◽  
Odds Ratio ◽  
Meta Analysis ◽  
Age Groups ◽  
Antithyroid Drug ◽  
Late Pregnancy ◽  
First Trimester ◽  
Group Differences ◽  
Antithyroid Drugs ◽  
The Impact

Objective: The present study aimed to investigate the adverse effects of the antithyroid drugs propylthiouracil (PTU) and methimazole (MMI)/carbimazole (CMZ) in treating hyperthyroidism. Methods: Qualitative analysis was performed for studies identified in a literature search up to April 20, 2019, and 30 studies were selected for meta-analysis. The study designs included case-control, randomized controlled, and retrospective cohort. Patients were in four age groups: childhood, gestating mothers, older adults, and other ages, and all were receiving PTU or MMI/CMZ. Adverse reactions to MMI/CMZ and PTU were evaluated and compared. Results: Odds of liver function injury were higher in the PTU group than in the MMI/CMZ group (odds ratio [OR], 2.40; 95% confidence interval [CI], 1.16 to 4.96; P = .02). Odds of elevated transaminase were much higher in the PTU group than in the MMI/CMZ group (OR, 3.96; 95% CI, 2.49 to 6.28; P<.00001). No significant between-group differences were found in odds of elevated bilirubin, agranulocytosis, rash, or urticaria; incidence of other adverse events; or in children. Odds of birth defects during the first trimester of pregnancy were higher in the MMI/CMZ group than in the PTU group (OR, 1.29; 95% CI, 1.09 to 1.53; P = .003). Conclusion: The impact of PTU on liver injury and transaminase levels is greater than that of MMI/CMZ, but no significant between-group differences are found in the drugs' effects on bilirubin, agranulocytosis and rash, urticaria, or in children. In treating pregnancy-related hyperthyroidism, PTU should be used in the first trimester and MMI reserved for use in late pregnancy. Abbreviations: ALT = alanine aminotransferase; ATD = antithyroid drug; CI = confidence interval; CMZ = carbimazole; GD = Graves disease; MMI = methimazole; MTU = methylthiouracil; NOS = Newcastle-Ottawa Scale; OR = odds ratio; PTU = propylthiouracil; RAI = radioactive iodine

Risk of Respiratory Illness Associated with Day-care Attendance: A Nationwide Study

PEDIATRICS ◽  
1991 ◽  
Vol 87 (1) ◽  
pp. 62-69 ◽  
Author(s):  
Eugene S. Hurwitz ◽  
Walter J. Gunn ◽  
Paul F. Pinsky ◽  
Lawrence B. Schonberger
Keyword(s):  
Confidence Interval ◽  
Day Care ◽  
Odds Ratio ◽  
Age Groups ◽  
Respiratory Illness ◽  
The United States ◽  
Respiratory Illnesses ◽  
Regular Care ◽  
Increased Risk ◽  
Older Siblings

The risk of respiratory and other illnesses in children (age groups: 6 weeks through 17 months, 18 through 35 months, and 36 through 59 months) in various types of day-care facilities was studied. Children considered exposed to day care were those who were enrolled in day care with at least one unrelated child for at least 10 hours per week in each of the 4 weeks before the interview; unexposed children were not enrolled in any regular child care with unrelated children and did not have siblings younger than 5 years of age receiving regular care with unrelated children. Although an increased risk of respiratory illness was associated with attending day care for children in all three age groups, this risk was statistically significant only for children 6 weeks through 17 months of age (odds ratio = 1.6; 95% confidence interval = 1.1 to 2.4) and children 18 through 35 months of age who had no older siblings (odds ratio = 3.4; 95% confidence interval = 2.0 to 6.0). In contrast, day-care attendance was not associated with an increased risk of respiratory illness in children 18 through 35 months of age with older siblings (odds ratio = 1.0). For children aged 6 weeks through 17 months, the exposure to older siblings was associated with an increased risk of respiratory illness; however, for children aged 36 through 59 months, older siblings were protective against respiratory illness. In addition, for the children in each age group currently in day care, increased duration of past exposure to day care was associated with a decreased risk of respiratory illness. It is estimated that during the period of the study approximately 10% of respiratory illnesses in the United States in children younger than 5 years of age were attributable to day-care attendance.

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