Self-Rated Distress Related to Medical Conditions is Associated with Future Crashes or Traffic Offences in Older Drivers

Ageing is associated with the development of medical conditions, both acute and chronic. The aim of this study was to determine whether medical factors were associated with subsequent self- and officially-reported crashes and traffic offences in a group of cognitively healthy older drivers. We surveyed medical conditions, medications taken for these conditions, and the amount of subjective distress associated with medical conditions in a group of 56 drivers aged 72-85 years for a period of 24 months. We also compared exposure to driving at baseline to the number of crashes or offences at 24 months. We found no relationship between the number of medical conditions or medications taken and whether a participant had a crash or offence. However, those who reported more subjective distress associated with their condition/s were more likely to have a crash or offence during the study period. Drivers who had a crash or offence also had a higher mean driving exposure. However, there was no relationship between reported distress and driving exposure which indicates that these may be independent risk factors for experiencing a crash or traffic offence

Prediction of Driving Ability in People With Dementia- and Non- Dementia-Related Brain Disorders

Brain disorders can impair physical and cognitive functions necessary for safe driving. Two hundred people with brain disorders referred for a driving assessment were recruited and their performance on a computerized battery of sensory-motor and cognitive tests (SMCTests) and a blinded on-road assessment determined. Based on SMCTests performance, binary logistic regression (BLR) and nonlinear causal resource analysis (NCRA) models classified on-road pass or fail with 70% accuracy. Greater accuracy could be achieved by splitting referrals into two groups: (1) Dementia and (2) Non-dementia-related brain disorders. BLR models classified on-road driving outcome as pass or fail with accuracies of 76% (Dementia) and 75% (Non-dementia), while NCRA models had accuracies of 77% (Dementia) and 80% (Non-dementia). Measures of attention were most critical for predicting driving ability in the dementia group. In the non-dementia group, prediction of driving ability was most accurate with assessment of a broader range of sensory-motor and cognitive functions. Compared to BLR, NCRA was able to identify and use additional measures to improve accuracy. NCRA is also better able to accommodate outliers due to it being a non-linear modelling method based upon individual performance-limiting impairments. We propose three main factors underlying sub-optimal prediction of driving ability based on SMCTests performance: (1) there are one or more functions important for driving ability which are not currently assessed with SMCTests – these could be sensory-motor or cognitive or other (e.g., attitude, confidence, insight, road code knowledge); (2) suboptimal classification/prediction techniques or models; or (3) inaccuracies in the on-road driving assessments

Evidence of package trading in a mature multi-species ITQ market

In multi-species fisheries managed under ITQs, the existence of joint production may lead to complex catch-quota balancing issues. Previous modelling and experimental research suggest that, in such fisheries, some fishers may benefit from the ability to trade packages of fishing quotas, rather than fulfil their quota needs by simultaneously bidding on separate single-species quota markets. This note presents evidence of naturally occurring package trades in a real fishery. Based on this evidence, we suggest that further empirical and modelling research is required on the potential and limitations of package quota trading in mixed fisheries managed with ITQs. © 2014

Palaeoscolecids from the Ludlow Series of Leintwardine, Herefordshire ( UK ): the latest occurrence of palaeoscolecids in the fossil record

The documentation of cuticular micro‐ornament is vital for the taxonomic assignment of palaeoscolecids: vermiform lower Palaeozoic ecdysozoans interpreted as stem‐group priapulans or early diverging panarthropods. This is due to the absence of the character‐rich proboscis and tail hooks in palaeoscolecid material not from Burgess Shale‐type Konservat‐Lagerstätten. Here, the cuticular micro‐ornamentation of palaeoscolecids from the upper Silurian (Ludlow) fauna of Leintwardine (Herefordshire, England), is described using scanning electron microscopy and reflectance transformation imaging. This material is taxonomically unstable because it was included in an effective wastebasket genus (Protoscolex) long before these imaging techniques were developed. The Leintwardine material is shown to be most closely comparable to a palaeoscolecid from the Darriwilian (Middle Ordovician) of the Builth–Llandrindod inlier, Powys, Wales, and is transferred accordingly to Radnorscolex Botting et al. as Radnorscolex latus (Bather). The Leintwardine fauna represents the uppermost stratigraphic occurrence of palaeoscolecids, constrained to the Saetograptus leintwardinensis Zone (lower Ludfordian), and the comparatively sparse Silurian palaeoscolecid record is subsequently discussed. It is hypothesized that palaeoscolecids may have become extinct during the mid‐Ludfordian Lau Event, the onset of which is recorded in the biozone immediately above the Leintwardine fauna (Bohemograptus Zone). Finally, the British palaeoscolecid fauna is summarized, including a new record from the Dapingian (Middle Ordovician) of Carmarthenshire, South Wales

Driving Assessment and Subsequent Driving Outcome: A Prospective Study of Safe and Unsafe Healthy Driver Groups

Older drivers are an increasingly numerous section of the population who are often targeted for driving assessment. Little is known as to whether onroad driving assessments result in an older driver population who have fewer negative driving events. Fifty-eight healthy older drivers (mean age 77, range 71- 84, no diagnosis of neurological disorder), completed a non-enforced on-road driving assessment and detailed sensory-motor and cognitive testing. Selfreported and official data regarding crashes and traffic offences were collected for both the five years prior to the on-road assessment, and the 12 months following in order to determine whether those who received a Fail score on the on-road assessment had higher rates of negative driving events than those who passed (43 passed, 15 failed). No increase in adverse outcomes was found either retrospectively or prospectively for those who failed the on-road assessment. Similarly there were no significant differences in cognitive, sensory-motor, and demographic variables between those who passed and failed. Healthy older drivers who failed the on-road assessment did not show evidence of poorer driving behaviour even at the level of descriptive statistics

DNA damage activates a complex transcriptional response in murine lymphocytes that includes both physiological and cancer-predisposition programs

BACKGROUND: Double strand (ds) DNA breaks are a form of DNA damage that can be generated from both genotoxic exposures and physiologic processes, can disrupt cellular functions and can be lethal if not repaired properly. Physiologic dsDNA breaks are generated in a variety of normal cellular functions, including the RAG endonuclease-mediated rearrangement of antigen receptor genes during the normal development of lymphocytes. We previously showed that physiologic breaks initiate lymphocyte development-specific transcriptional programs. Here we compare transcriptional responses to physiological DNA breaks with responses to genotoxic DNA damage induced by ionizing radiation. RESULTS: We identified a central lymphocyte-specific transcriptional response common to both physiologic and genotoxic breaks, which includes many lymphocyte developmental processes. Genotoxic damage causes robust alterations to pathways associated with B cell activation and increased proliferation, suggesting that genotoxic damage initiates not only the normal B cell maturation processes but also mimics activated B cell response to antigenic agents. Notably, changes including elevated levels of expression of Kras and mmu-miR-155 and the repression of Socs1 were observed following genotoxic damage, reflecting induction of a cancer-prone phenotype. CONCLUSIONS: Comparing these transcriptional responses provides a greater understanding of the mechanisms cells use in the differentiation between types of DNA damage and the potential consequences of different sources of damage. These results suggest genotoxic damage may induce a unique cancer-prone phenotype and processes mimicking activated B cell response to antigenic agents, as well as the normal B cell maturation processes

Topical silver diamine fluoride for managing dental caries in children and adults

This is a protocol for a Cochrane Review (Intervention). The objectives are as follows: To assess the effects of silver diamine fluoride in arresting and preventing caries in deciduous and permanent teeth (coronal and root caries) compared to any other intervention including placebo or no treatment.</p

Are environmental risk factors for current wheeze in the International Study of Asthma and Allergies in Childhood (ISAAC) phase three due to reverse causation?

BACKGROUND: Phase Three of the International Study of Asthma and Allergies in Childhood (ISAAC) measured the global prevalence of symptoms of asthma in children. We undertook comprehensive analyses addressing risk factors for asthma symptoms in combination, at both the individual and the school level, to explore the potential role of reverse causation due to selective avoidance or confounding by indication. OBJECTIVE: To explore the role of reverse causation in risk factors of asthma symptoms. METHODS: We compared two sets of multilevel logistic regression analyses, using (a) individual level exposure data and (b) school level average exposure (ie prevalence), in two different age groups. In individual level analyses, reverse causation is a possible concern if individual level exposure statuses were changed as a result of asthma symptoms or diagnosis. School level analyses may suffer from ecologic confounding, but reverse causation is less of a concern because individual changes in exposure status as a result of asthma symptoms would only have a small effect on overall school exposure levels. RESULTS: There were 131 924 children aged 6-7 years (2428 schools, 25 countries) with complete exposure, outcome and confounder data. The strongest associations in individual level analyses (fully adjusted) were for current paracetamol use (odds ratio = 2.06; 95% confidence interval 1.97-2.16), early life antibiotic use (1.65; 1.58-1.73) and open fire cooking (1.44; 1.26-1.65). In school level analyses, these risk factors again showed increased risks. There were 238 586 adolescents aged 13-14 years (2072 schools, 42 countries) with complete exposure, outcome and confounder data. The strongest associations in individual level analyses (fully adjusted) were for current paracetamol use (1.80; 1.75-1.86), cooking on an open fire (1.32; 1.22-1.43) and maternal tobacco use (1.23; 1.18-1.27). In school level analyses, these risk factors again showed increased risks. CONCLUSIONS & CLINICAL RELEVANCE: These analyses strengthen the potentially causal interpretation of previously reported individual level findings, by providing evidence against reverse causation