Instruments for investigating fitness to drive - needs and expectations in primary care: a qualitative study

Background: Primary care physicians are often requested to assess their patients' fitness to drive. Little is however known on their needs to help them in this task. Aims: The aim of this study is to develop theories on needs, expectations, and barriers for clinical instruments helping physicians assess fitness to drive in primary care. Methods: This qualitative study used semi-structured interviews to investigate needs and expectations for instruments used to assess fitness to drive. From August 2011 to April 2013, we recorded opinions from five experts in traffic medicine, five primary care physicians, and five senior drivers. All interviews were integrally transcribed. Two independent researchers extracted, coded, and stratified categories relying on multi-grounded theory. All participants validated the final scheme. Results: Our theory suggests that for an instruments assessing fitness to drive to be implemented in primary care, it need to contribute to the decisional process. This requires at least five conditions: 1) it needs to reduce the range of uncertainty, 2) it needs to be adapted to local resources and possibilities, 3) it needs to be accepted by patients, 4) choices of tasks need to adaptable to clinical conditions, 5) and interpretation of results need to remain dependant of each patient's context. Discussion and conclusions: Most existing instruments assessing fitness to drive are not designed for primary care settings. Future instruments should also aim to support patient-centred dialogue, help anticipate driving cessation, and offer patients the opportunity to freely take their own decision on driving cessation as often as possible

Alternative axiomatics and complexity of deliberative STIT theories

We propose two alternatives to Xu's axiomatization of the Chellas STIT. The first one also provides an alternative axiomatization of the deliberative STIT. The second one starts from the idea that the historic necessity operator can be defined as an abbreviation of operators of agency, and can thus be eliminated from the logic of the Chellas STIT. The second axiomatization also allows us to establish that the problem of deciding the satisfiability of a STIT formula without temporal operators is NP-complete in the single-agent case, and is NEXPTIME-complete in the multiagent case, both for the deliberative and the Chellas' STIT.Comment: Submitted to the Journal of Philosophical Logic; 13 pages excluding anne

The trail making test as a screening instrument for driving performance in older drivers; a translational research.

BACKGROUND: In many countries, primary care physicians determine whether or not older drivers are fit to drive. Little, however, is known regarding the effects of cognitive decline on driving performance and the means to detect it. This study explores to what extent the trail making test (TMT) can provide indications to clinicians about their older patients' on-road driving performance in the context of cognitive decline. METHODS: This translational study was nested within a cohort study and an exploratory psychophysics study. The target population of interest was constituted of older drivers in the absence of important cognitive or physical disorders. We therefore recruited and tested 404 home-dwelling drivers, aged 70 years or more and in possession of valid drivers' licenses, who volunteered to participate in a driving refresher course. Forty-five drivers also agreed to undergo further testing at our lab. On-road driving performance was evaluated by instructors during a 45 minute validated open-road circuit. Drivers were classified as either being excellent, good, moderate, or poor depending on their score on a standardized evaluation of on-road driving performance. RESULTS: The area under the receiver operator curve for detecting poorly performing drivers was 0.668 (CI95% 0.558 to 0.778) for the TMT-A, and 0.662 (CI95% 0.542 to 0.783) for the TMT-B. TMT was related to contrast sensitivity, motion direction, orientation discrimination, working memory, verbal fluency, and literacy. Older patients with a TMT-A ≥ 54 seconds or a TMT-B ≥ 150 seconds have a threefold (CI95% 1.3 to 7.0) increased risk of performing poorly during the on-road evaluation. TMT had a sensitivity of 63.6%, a specificity of 64.9%, a positive predictive value of 9.5%, and a negative predictive value of 96.9%. CONCLUSION: In screening settings, the TMT would have clinicians uselessly consider driving cessation in nine drivers out of ten. Given the important negative impact this could have on older drivers, this study confirms the TMT not to be specific enough for clinicians to justify driving cessation without complementary investigations on driving behaviors

Colloid-stabilized emulsions: behaviour as the interfacial tension is reduced

We present confocal microscopy studies of novel particle-stabilized emulsions. The novelty arises because the immiscible fluids have an accessible upper critical solution temperature. The emulsions have been created by beginning with particles dispersed in the single-fluid phase. On cooling, regions of the minority phase nucleate. While coarsening these nuclei become coated with particles due to the associated reduction in interfacial energy. The resulting emulsion is arrested, and the particle-coated interfaces have intriguing properties. Having made use of the binary-fluid phase diagram to create the emulsion we then make use of it to study the properties of the interfaces. As the emulsion is re-heated toward the single-fluid phase the interfacial tension falls and the volume of the dispersed phase drops. Crumpling, fracture or coalescence can follow. The results show that the elasticity of the interfaces has a controlling influence over the emulsion behaviour.Comment: Submitted for the proceedings of the 6th Liquid Matter Conference, held in Utrecht (NL) in July 200

Does Treewidth Help in Modal Satisfiability?

Many tractable algorithms for solving the Constraint Satisfaction Problem (CSP) have been developed using the notion of the treewidth of some graph derived from the input CSP instance. In particular, the incidence graph of the CSP instance is one such graph. We introduce the notion of an incidence graph for modal logic formulae in a certain normal form. We investigate the parameterized complexity of modal satisfiability with the modal depth of the formula and the treewidth of the incidence graph as parameters. For various combinations of Euclidean, reflexive, symmetric and transitive models, we show either that modal satisfiability is FPT, or that it is W[1]-hard. In particular, modal satisfiability in general models is FPT, while it is W[1]-hard in transitive models. As might be expected, modal satisfiability in transitive and Euclidean models is FPT.Comment: Full version of the paper appearing in MFCS 2010. Change from v1: improved section 5 to avoid exponential blow-up in formula siz

Proving Craig and Lyndon Interpolation Using Labelled Sequent Calculi

We have recently presented a general method of proving the fundamental logical properties of Craig and Lyndon Interpolation (IPs) by induction on derivations in a wide class of internal sequent calculi, including sequents, hypersequents, and nested sequents. Here we adapt the method to a more general external formalism of labelled sequents and provide sufficient criteria on the Kripke-frame characterization of a logic that guarantee the IPs. In particular, we show that classes of frames definable by quantifier-free Horn formulas correspond to logics with the IPs. These criteria capture the modal cube and the infinite family of transitive Geach logics

As a Matter of Factions: The Budgetary Implications of Shifting Factional Control in Japan’s LDP

For 38 years, the Liberal Democratic Party (LDP) maintained single-party control over the Japanese government. This lack of partisan turnover in government has frustrated attempts to explain Japanese government policy changes using political variables. In this paper, we look for intraparty changes that may have led to changes in Japanese budgetary policy. Using a simple model of agenda-setting, we hypothesize that changes in which intraparty factions “control” the LDP affect the party’s decisions over spending priorities systematically. This runs contrary to the received wisdom in the voluminous literature on LDP factions, which asserts that factions, whatever their raison d’être, do not exhibit different policy preferences. We find that strong correlations do exist between which factions comprise the agenda-setting party “mainstream” and how the government allocates spending across pork-barrel and public goods items

Differences in weight status and energy-balance related behaviors among schoolchildren in German-speaking Switzerland compared to seven countries in Europe

BACKGROUND: Overweight in children and adolescents have increased significantly and are a major public health problem. To allow international comparisons, Switzerland joined the European study 'ENERGY' cross sectional survey consortium that investigated the prevalence of overweight and obesity as well as selected dietary, physical and sedentary behaviors of 10--12 years old pupils across seven other countries in Europe. The aims of the present study was to compare body composition and energy-balance related behaviors of Swiss schoolchildren to those of the seven European ENERGY-countries and to analyze overweight and energy-balance related behaviors of Swiss children according to socio-demographic factors. METHODS: A school-based cross-sectional study among 10--12 year old children was conducted in Switzerland and seven other European countries using a standardized protocol. Body height, weight and waist-circumference were measured by trained research assistants. Energy-balance related behaviors - i.e. selected dietary, physical activity and screen-viewing behaviors were assessed by questionnaires. Weight status and behaviors in Switzerland were compared to the seven European ENERGY countries. Within the Swiss sample, analyses stratified by gender, parental education and ethnicity were performed. RESULTS: Data of 546 Swiss children (mean age 11.6+/-0.8y, 48% girls) were obtained and compared to the EN