Refine
Document Type
- Article (3) (remove)
Language
- English (3) (remove)
Keywords
- Safety (3) (remove)
Institute
- Abteilung Verhalten und Sicherheit im Verkehr (3) (remove)
There is considerable evidence for the negative effects of driver distraction on road safety. In many experimental studies, drivers have been primarily viewed as passive receivers of distraction. Thus, there is a lack of research on the mediating role of their self-regulatory behavior. The aim of the current study was to compare drivers' performance when engaged in a system-paced secondary task with a self-paced version of this task and how both differed from baseline driving performance without distraction. Thirty-nine participants drove in a simulator while performing a secondary visual"manual task. One group of drivers had to work on this task in predefined situations under time pressure, whereas the other group was free to decide when to work on the secondary task (self-regulation group). Drivers' performance (e.g., lateral and longitudinal control, brake reaction times) was also compared with a baseline condition without any secondary task. For the system-paced secondary task, distraction was associated with high decrements in driving performance (especially in keeping the lateral position). No effects were found for the number of collisions, probably because of the lower driving speeds while distracted (compensatory behavior). For the self-regulation group, only small impairments in driving performance were found. Drivers engaged less in the secondary task during foreseeable demanding or critical driving situations. Overall, drivers in the self-regulation group were able to anticipate the demands of different traffic situations and to adapt their engagement in the secondary task, so that only small impairments in driving performance occurred. Because in real traffic drivers are mostly free to decide when to engage in secondary tasks, it can be concluded that self-regulation should be considered in driver distraction research to ensure ecological validity.
Chronic non-cancer pain (CNCP) is a major health problem. Patients are increasingly treated with chronic opioid therapy (COT). Several laboratory studies have demonstrated that long-term use of opioids does not generally impair driving related skills. But there is still a lack of studies investigating on-the-road driving performance in actual traffic. The present study assessed the impact of COT on road-tracking and car-following performance in CNCP patients. Twenty CNCP patients, long-term treated with stable doses of opioid analgesics, and 19 healthy controls conducted standardized on-the-road driving tests in normal traffic. Performance of controls with a blood alcohol concentration (BAC) of 0.5 g/L was used as a reference to define clinically relevant changes in driving performance. Standard Deviation of Lateral Position (SDLP), a measure of road-tracking control, was 2.57 cm greater in CNCP patients than in sober controls. This difference failed to reach statistical significance in a superiority test. Equivalence testing indicated that the 95% CI around the mean SDLP change was equivalent to the SDLP change seen in controls with a BAC of 0.5 g/L and did not include zero. When corrected for age differences between groups the 95% CI widened to include both the alcohol reference criterion and zero. No difference was found in car-following performance. Driving performance of CNCP patients did not significantly differ from that of controls due to large inter-individual variations. Hence in clinical practice determination of fitness to drive of CNCP patients who receive opioid treatments should be based on an individual assessment.
Trauma management (TM) covers two types of medical treatment: the initial one provided by Emergency Medical Services (EMS) and a further one provided by permanent medical facilities. There is a consensus in the professional literature that to reduce the severity and the number of road crash victims, the TM system should provide rapid and adequate initial care of injury, combined with sufficient further treatment at a hospital or trauma centre. Recognizing the important role of TM for reducing road crash injury outcome, it was decided, within the EU funded SafetyNet project, to develop road safety performance indicators (SPIs) which would characterize the level of TM systems" performance in European countries and enable country comparisons. The concept of TM SPIs was developed based on a literature study of performance indicators in TM, a survey of available practices in Europe and data availability examinations. A set of TM SPIs was introduced including 14 indicators which characterize five issues such as: availability of EMS stations; availability and composition of EMS medical staff; availability and composition of EMS transportation units; characteristics of the EMS response time, and availability of trauma beds in permanent medical facilities. Basic information on the TM systems was collected in close cooperation with the national expert group. A dataset with TM SPIs for 21 countries was created. It was demonstrated that the countries can be compared using selected TM SPIs. Moreover, a more general comparison of the TM systems' performance in the countries is possible, using multiple ranking and statistical weighting techniques. By both methods, final estimates were received enabling the recognition of groups of countries with similar levels of the TM system's performance. The results of various trials were consistent as to the recognition of countries with high or low level of the TM systems" performance, where in grouping countries with intermediate levels of the TM system's performance some differences were observed. The SafetyNet project's practice demonstrated that data collection for estimating TM SPIs is not an easy task but is realizable for the majority of countries. The TM SPIs" message is currently limited to the availability of trauma care services. Further development of the TM SPIs should focus on characteristics of actual treatment supplied, based on combined police and medical road crash related databases.