Systematic screening for unsafe driving due to medical conditions: Still debatable

<p>Abstract</p> <p>Background</p> <p>Assessing people's ability to drive has become a public health concern in most industrialized countries. Although age itself is not a predictive factor of an increased risk for dangerous driving, the prevalence of medical conditions that may impair driving increases with age. Because the implementation of a screening for unsafe driving due to medical conditions is a public health issue, its usefulness should be judged using standardised criteria already proposed for screening for chronic disease. The aim of this paper is to propose standardised criteria suitable to assess the scientific validity of screening for unsafe driving due to medical conditions, and identify potential issues to be clarified before screening can be implemented and effective.</p> <p>Discussion</p> <p>Using criteria developed for screening for chronic diseases and published studies on driving with medical conditions, we specify six criteria to judge the opportunity of screening for unsafe driving due to medical conditions. This adaptation was needed because of the complexity of the natural history of medical conditions and their potential consequences on driving and road safety. We then illustrate that published studies pleading for or against screening for unsafe driving due to medical conditions fail to provide the needed documentation. Individual criteria were mentioned in 3 to 72% of 36 papers pleading for or against screening. Quantitative estimates of relevant indicators were provided in at most 42% of papers, and some data, such as the definition of an appropriate unsafe driving period were never provided.</p> <p>Summary</p> <p>The standardised framework described in this paper provides a template for assessing the effectiveness (or lack of effectiveness) of proposed measures for screening for unsafe driving due to medical conditions. Even if most criteria were mentioned in the published literature pleading for or against such a screening, the failure to find quantitative and evidence-based estimates of relevant indicators provides useful insight for further research.</p

A psycho-Geoinformatics approach for investigating older adults’ driving behaviours and underlying cognitive mechanisms

Introduction: Safe driving constantly challenges the driver’s ability to respond to the dynamic traffic scene under space and time constraints. It is of particular importance for older drivers to perform sufficient visual and motor actions with effective coordination due to the fact of age-related cognitive decline. However, few studies have been able to integrate drivers’ visual-motor behaviours with environmental information in a spatial-temporal context and link to the cognitive conditions of individual drivers. Little is known about the mechanisms that underpin the deterioration in visual-motor coordination of older drivers. Development: Based on a review of driving-related cognitive decline in older adults and the context of driver-vehicle-environment interactions, this paper established a conceptual framework to identify the parameters of driver’s visual and motor behaviour, and reveal the cognitive process from visual search to vehicle control in driving. The framework led to a psycho-geoinformatics approach to measure older drivers’ driving behaviours and investigate the underlying cognitive mechanisms. The proposed data collection protocol and the analysis and assessments depicted the psycho-geoinformatics approach on obtaining quantified variables and the key means of analysis, as well as outcome measures. Conclusions: Recordings of the driver and their interactions with the vehicle and environment at a detailed scale give a closer assessment of the driver’s behaviours. Using geoinformatics tools in driving behaviours assessment opens a new era of research with many possible analytical options, which do not have to rely on human observations. Instead, it receives clear indicators of the individual drivers’ interactions with the vehicle and the traffic environment. This approach should make it possible to identify lower-performing older drivers and problematic visual and motor behaviours, and the cognitive predictors of risky driving behaviours. A better targeted regulation and tailored intervention programs for older can be developed by further research

Dviejų trumpų psichometrinių depresijos pažinimo funkcijos mastų diagnostinis tikslumas: vyresnio amžiaus ambulatorinių pacientų studija

We compared the diagnostic accuracy (sensitivity and specificity) of the Geriatric Depression Scale (GDS) and the Mini-Mult Depression Scale (Mini-D) in a sample of 87 geriatric medical outpatients who were classified as depressed or non-depressed with the DSM-III-based Symptom Checklist for Major Depressive Disorders (SCMDD). In addition, we evaluated the relationship between GDS and Mini-D depression classifications and performances on three tests of the overall cognitive functioning. Although GDS and Mini-D classifications were in moderate agreement with those of the SCMDD (71%), the former measure produced more false-positive errors and the latter produced more false-negative errors. Because neither the GDS nor the Mini-D affords entirely satisfactory diagnostic accuracy, appreciation of these operating characteristics will enable practitioners to select the instrument that yields the most acceptable balance of Type I and Type II errors within their particular clinical settings. Although participants demonstrated signs of a mild cognitive compromise, no relationship was noted between depression classification and overall cognitive functioning. We believe that this finding reflects our dichotomous, rather than continuous, operationalization of “depression”.Lyginome Senyvųjų depresijos skalės (Geriatric Depression Scale) ir Mažosios daugkartinės depresijos skalės (Mini-Mult Depression Scale) diagnostinį tikslumą (jautrumą ir tikslų apibrėžimą). Tyrime dalyvavo 87 senyvi gydomi pacientai, kai kurie jų buvo depresyvūs, o kai kurie nedepresyvūs (buvo naudojamasi DSM-III simptomų sąrašu, nurodančiu didžiosios depresijos sutrikimą (SCMDD)). Be to, įvertinome Senyvųjų depresijos skalės ir Mažosios daugkartinės depresijos skalės klasifikacijų santykį naudodami tris bendro pažinimo funkcijos testus. Nors Senyvųjų depresijos skalė ir Mažoji daugkartinės depresijos skalė pagal DSM-III sąrašą rodė vidutinį lygumą (71 %), pirmoji grupė darė daugiau pozityvių klaidų, o antroji – daugiau negatyvių klaidų. Kadangi nei Senyvųjų depresijos skalės, nei Mažosios daugkartinės depresijos skalbės diagnostinis tikslumas nėra pakankamas, dėmesio atkreipimas į šias charakteristikas turėtų paskatinti naudojančiuosius jas savo klinikiniame darbe pasirinkti priemonę, kurios 1-o ir 2-o tipo klaidų balansas geriausias. Nors pacientų pažinimo sutrikimo požymiai buvo neryškūs, jokio santykio tarp depresijos klasifikacijos ir bendro pažinimo funkcionavimo neaptikome. Manome, kad šis rezultatas rodo, jog, vartojant „depresijos“ sąvoką, yra dichotomija, o ne vientisumas

Benchmark study on fuel bundle degradation in the phebus FPT2 test using state-of-the-art severe accident analysis codes

This paper presents the results of posttest calculations of thephebus FPT2 experiment. While the exercise concentrates mainly on code-to-code benchmarking, a comparison is also made with selected experimental results. The test scenario with the appropriate initial and boundary conditions was provided by the Institut de Radioprotection et de SÛreté Nucléaire. For the analyses, seven severe accident analysis codes were used: ASTEC, ATHLET-CD, MELCOR, ICARE2, ICARE/CATHARE, SCDAP/RELAP5, and RELAP/SCDAPSIM. The calculations focused on the following phenomena occurring in the FPT2 bundle: thermal behavior; hydrogen production, mainly due to cladding oxidation; severe degradation of irradiated fuel; and the release of fission products, control rod, and structure materials. Using the same postdefined boundary and initial conditions, the code-data differences are typically within 10% for most parameters, and not more than 25%. More importantly, the codes were able to capture the major features of the transient evolution. Given that Phebus FPT2 exhibited almost all of the major low-pressure severe accident phenomena except for core cooling by water injection and late-phase core melt behavior in the lower head, the results engender a degree of confidence in the code predictive capability for sequences similar toFPT2

Synthesis and Characterization of Novel Heterocyclic Chalcones from 1-Phenyl-1H-pyrazol-3-ol

An efficient synthetic route to construct diverse pyrazole-based chalcones from 1-phenyl-1H-pyrazol-3-ols bearing a formyl or acetyl group on the C4 position of pyrazole ring, employing a base-catalysed Claisen–Schmidt condensation reaction, is described. Isomeric chalcones were further reacted with N-hydroxy-4-toluenesulfonamide and regioselective formation of 3,5-disubstituted 1,2-oxazoles was established. The novel pyrazole-chalcones and 1,2-oxazoles were characterized by an in-depth analysis of NMR spectral data, which were obtained through a combination of standard and advanced NMR spectroscopy techniques