Medicines and driving: evaluation of training and software support for patient counselling by pharmacists

Background : The consumption of some psychotropic medicines has a negative effect on the fitness to drive. Pharmacists are expected to give useful advice to patients on their participation in traffic. However, almost no information is available on this topic. Objective : To assess the effect of training and implementation of new dispensing guidelines with regard to driving-impairing medicines, in two types of dispensing support tools. User acceptance was measured as well as the effect on pharmacists' attitudes & awareness, self-reported behaviour and knowledge. Setting Pharmacists from East Flanders in Belgium. Methods : Two intervention groups and a control group participated. The intervention groups followed a training and were provided with a dispensing support tool containing information on the effect of medicines on driving ability, which was either stand-alone (USB stick) or integrated into the daily used software (ViaNova). The three groups filled out a questionnaire prior to and after the intervention period. Main outcome measure : Answers to a pre/post-questionnaire on attitudes and awareness, self-reported behaviour, knowledge and user acceptance. Results : Many pharmacists were already strongly interested in the topic at the beginning of the study. Positive changes in attitude, self-reported behaviour and knowledge were measured mostly in the group of pharmacists for which the information was integrated in their daily used software. These pharmacists asked significantly more about the patients' driving experience, informed them more about driving-related risk and gave more detailed information on impairing effects of medicines. The knowledge of the participating pharmacists on the topic 'medicines and driving' remained generally low. The participants acknowledge the importance of being aware of the topic medicines and driving but they report a lack of information or education. They strongly prefer a tool that integrates the information in their daily used software. Conclusion : Dispensing support tools with information on the potential impairing effect of a medicine on the fitness to drive increases awareness, reported risk communication behaviour as well as knowledge of pharmacists on this topic. Computerised dispensing support tools are most effective when the information is integrated into the daily used dispensing software

Guest Editorial. The ESRA initiative: Towards global monitoring and analysis of road safety performanc

1. Road safety performance indicators 2. ESRA initiative 3. Position of ESRA2 in IATSS 4. Importance of the results presented in this special feature 5. Closing remark

Naturalistic driving observations within ERSO, deliverable 6.1

This deliverable reports the outcome of the first task which was to generate an inventory of variables and measurement tools necessary to monitor road safety through Naturalistic Driving Observations. This was achieved by performing the following activities: 1. Generating an inventory of relevant variables to monitor road safety within ERSO. 2. Generating an inventory of relevant variables to monitor through naturalistic driving observation. 3. Combining 1 and 2 to define the variables to be measured within ERSO by naturalistic driving observation

The ESRA initiative: global approach to monitor driving under influence of alcohol and drugs across 48 countries

peer reviewedIntroduction and aims. ESRA (E-Survey of Road users’ Attitudes) is a joint initiative of road safety institutes and research centres from all over the world. The aim is to collect and analyse comparable data on road safety performance, in particular road safety culture and behaviour of road users. The ESRA data are used as a basis for a large set of road safety indicators. These provide scientific evidence for policy making at national and international levels. The ESRA initiative is managed by the ESRA Steering Group, a consortium currently consisting of ten organisations across the world and led by Vias institute (Belgium). Already two editions of ESRA have taken place (ESRA2, ESRA2). In total 36 partners from 60 countries have already participated in this initiative. The objective of this presentation is to give an overview of the updated results on driving under influence, covering 48 countries (ESRA2). Focus is on self-reported driving under the influence of alcohol, drugs and medicines and different road user types. More details on related behaviour believes will be presented in an other presentation at this conference. Method. ESRA2 data were collected through online panel surveys (2018-2020), using a representative sample of the national adult populations in each participating country. A jointly developed questionnaire was translated into 62 national language versions. The themes covered include self-reported behaviour, attitudes and opinions on unsafe behaviour in traffic, enforcement experiences and support for policy measures. The survey addresses different road safety topics and targets not only car drivers but also moped riders and motorcyclists, cyclists and pedestrians. Results and Discussion. The results from ESRA2 (N= 45,114) show that the regional means for car drivers reporting drink-driving in the last month ranged from 11% (America) to 19% (Asia/Oceania), for drug-driving from 5% (Europe) to 20% (Asia/Oceania) and for driving after taking medication that may affect the driving ability from 15% (America) to 26% (Asia/Oceania). The national results differ substantially, ranging from 4-31% for alcohol, 6-30% for drugs, and 2-33% for medication. In contrast, the proportion of two-wheeled vehicle users reporting drink-driving differs little between regions: from 18% in Africa to 21% in America among moped and motorcyclists, and from 15% in America to 19% in Asia/Oceania among cyclists. Conclusion. There are notable disparities in self-reported impaired car driving between the countries. The national differences are smaller for self-reported impaired riding of two-wheeled vehicles. ESRA aims at monitoring these differences over time. The next edition (ESRA3) will be launched in spring 2023. It is still possible to join ESRA3 (deadline 20th October, 2022). Contact us if this interests you: [email protected]

Car drivers' road safety performance. A benchmark across 32 countries

The road safety performance of a country and the success of policy measures can be measured and monitored in different ways. In addition to the traditional road safety indicators based on the number of fatalities or injured people in road traffic crashes, complementary road safety performance indicators can be used in relation to vehicles, infrastructure, or road users' behaviour. The last-mentioned can be based on data from roadside surveys or from questionnaire surveys. However, results of such surveys are seldom comparable across countries due to differences in aims, scope, or methodology. This paper is based on the second edition of the E-Survey of Road Users' Attitudes (ESRA), an online survey carried out in 2018, and includes data from more than 35,000 road users across 32 countries. The objective is to present the main results of the ESRA survey regarding the four most important risky driving behaviours in traffic: driving under the influence (alcohol/drugs), speeding, mobile phone use while driving, and fatigued driving. The paper explores several aspects related to these behaviours as car driver, such as the self-declared behaviours, acceptability and risk perception, support for policy measures, and opinions on traffic rules and penalties. Results show that despite the high perception of risk and low acceptability of all the risky driving behaviours analysed, there is still a high percentage of car drivers who engage in risky behaviours in traffic in all the regions analysed. Speeding and the use of a mobile phone while driving were the most frequent self-declared behaviours. On the other hand, driving under the influence of alcohol or drugs was the least declared behaviour. Most respondents support policy measures to restrict risky behaviour in traffic and believe that traffic rules are not being checked regularly enough, and should be stricter. The ESRA survey proved to be a valuable source of information to understand the causes underlying road traffic crashes. It offers a unique database and provides policy makers and researchers with valuable insights into public perception of road safety

Acute mental stress drives vascular inflammation and promotes plaque destabilization in mouse atherosclerosis

Publisher Copyright: © 2021 The Author(s). Published by Oxford University Press on behalf of the European Society of Cardiology.Aims: Mental stress substantially contributes to the initiation and progression of human disease, including cardiovascular conditions. We aim to investigate the underlying mechanisms of these contributions since they remain largely unclear. Methods and results: Here, we show in humans and mice that leucocytes deplete rapidly from the blood after a single episode of acute mental stress. Using cell-tracking experiments in animal models of acute mental stress, we found that stress exposure leads to prompt uptake of inflammatory leucocytes from the blood to distinct tissues including heart, lung, skin, and, if present, atherosclerotic plaques. Mechanistically, we found that acute stress enhances leucocyte influx into mouse atherosclerotic plaques by modulating endothelial cells. Specifically, acute stress increases adhesion molecule expression and chemokine release through locally derived norepinephrine. Either chemical or surgical disruption of norepinephrine signalling diminished stress-induced leucocyte migration into mouse atherosclerotic plaques. Conclusion: Our data show that acute mental stress rapidly amplifies inflammatory leucocyte expansion inside mouse atherosclerotic lesions and promotes plaque vulnerability.publishersversionPeer reviewe

Identification and safety effects of road user related measures. Deliverable 4.2 of the H2020 project SafetyCube

Safety CaUsation, Benefits and Efficiency (SafetyCube) is a European Commission supported Horizon 2020 project with the objective of developing an innovative road safety Decision Support System (DSS). The DSS will enable policy-makers and stakeholders to select and implement the most appropriate strategies, measures, and cost-effective approaches to reduce casualties of all road user types and all severities. This document is the second deliverable (4.2) of work package 4, which is dedicated to identifying and assessing road safety measures related to road users in terms of their effectiveness. The focus of deliverable 4.2 is on the identification and assessment of countermeasures and describes the corresponding operational procedure and outcomes. Measures which intend to increase road safety of all kind of road user groups have been considered [...continues]