First and second eye cataract surgery and driver self-regulation among older drivers with bilateral cataract: A prospective cohort study

Background: Driving a car is the most common form of transport among the older population. Common medical conditions such as cataract, increase with age and impact on the ability to drive. To compensate for visual decline, some cataract patients may self-regulate their driving while waiting for cataract surgery. However, little is known about the self-regulation practices of older drivers throughout the cataract surgery process. The aim of this study is to assess the impact of first and second eye cataract surgery on driver self-regulation practices, and to determine which objective measures of vision are associated with driver self-regulation. Methods: Fifty-five older drivers with bilateral cataract aged 55+ years were assessed using the self-reported Driving Habits Questionnaire, the Mini-Mental State Examination and three objective visual measures in the month before cataract surgery, at least one to three months after first eye cataract surgery and at least one month after second eye cataract surgery. Participants' natural driving behaviour in four driving situations was also examined for one week using an in-vehicle monitoring device. Two separate Generalised Estimating Equation logistic models were undertaken to assess the impact of first and second eye cataract surgery on driver-self-regulation status and which changes in visual measures were associated with driver self-regulation status. Results: The odds of being a self-regulator in at least one driving situation significantly decreased by 70% after first eye cataract surgery (OR: 0.3, 95% CI: 0.1-0.7) and by 90% after second eye surgery (OR: 0.1, 95% CI: 0.1-0.4), compared to before first eye surgery. Improvement in contrast sensitivity after cataract surgery was significantly associated with decreased odds of self-regulation (OR: 0.02, 95% CI: 0.01-0.4). Conclusions: The findings provide a strong rationale for providing timely first and second eye cataract surgery for older drivers with bilateral cataract, in order to improve their mobility and independence

Prevalence of Potentially Inappropriate Medication use in older drivers

Background Potentially Inappropriate Medication (PIM) use has been studied in a variety of older adult populations across the world. We sought to examine the prevalence and correlates of PIM use in older drivers. Methods We applied the American Geriatrics Society 2015 Beers Criteria to baseline data collected from the “brown-bag” review of medications for participants of the Longitudinal Research on Aging Drivers (LongROAD) study to examine the prevalence and correlates of PIM use in a geographically diverse, community-dwelling sample of older drivers (n = 2949). Proportions of participants who used one or more PIMs according to the American Geriatrics Society 2015 Beers Criteria, and estimated odds ratios (ORs) and 95% confidence intervals (CIs) of PIM use associated with participant characteristics were calculated. Results Overall, 18.5% of the older drivers studied used one or more PIM. The most commonly used therapeutic category of PIM was benzodiazepines (accounting for 16.6% of the total PIMs identified), followed by nonbenzodiazepine hypnotics (15.2%), antidepressants (15.2%), and first-generation antihistamines (10.5%). Compared to older drivers on four or fewer medications, the adjusted ORs of PIM use were 2.43 (95% CI 1.68–3.51) for those on 5–7 medications, 4.19 (95% CI 2.95–5.93) for those on 8–11 medications, and 8.01 (95% CI 5.71–11.23) for those on ≥12 medications. Older drivers who were female, white, or living in urban areas were at significantly heightened risk of PIM use. Conclusion About one in five older drivers uses PIMs. Commonly used PIMs are medications known to impair driving ability and increase crash risk. Implementation of evidence-based interventions to reduce PIM use in older drivers may confer both health and safety benefits. Trial registration Not applicable

Prevalence of Potentially Inappropriate Medication use in older drivers

Abstract Background Potentially Inappropriate Medication (PIM) use has been studied in a variety of older adult populations across the world. We sought to examine the prevalence and correlates of PIM use in older drivers. Methods We applied the American Geriatrics Society 2015 Beers Criteria to baseline data collected from the “brown-bag” review of medications for participants of the Longitudinal Research on Aging Drivers (LongROAD) study to examine the prevalence and correlates of PIM use in a geographically diverse, community-dwelling sample of older drivers (n = 2949). Proportions of participants who used one or more PIMs according to the American Geriatrics Society 2015 Beers Criteria, and estimated odds ratios (ORs) and 95% confidence intervals (CIs) of PIM use associated with participant characteristics were calculated. Results Overall, 18.5% of the older drivers studied used one or more PIM. The most commonly used therapeutic category of PIM was benzodiazepines (accounting for 16.6% of the total PIMs identified), followed by nonbenzodiazepine hypnotics (15.2%), antidepressants (15.2%), and first-generation antihistamines (10.5%). Compared to older drivers on four or fewer medications, the adjusted ORs of PIM use were 2.43 (95% CI 1.68–3.51) for those on 5–7 medications, 4.19 (95% CI 2.95–5.93) for those on 8–11 medications, and 8.01 (95% CI 5.71–11.23) for those on ≥12 medications. Older drivers who were female, white, or living in urban areas were at significantly heightened risk of PIM use. Conclusion About one in five older drivers uses PIMs. Commonly used PIMs are medications known to impair driving ability and increase crash risk. Implementation of evidence-based interventions to reduce PIM use in older drivers may confer both health and safety benefits. Trial registration Not applicable.https://deepblue.lib.umich.edu/bitstream/2027.42/152209/1/12877_2019_Article_1287.pd

Investigating older adults’ preferences for functions within a human-machine interface designed for fully autonomous vehicles

© Springer International Publishing AG, part of Springer Nature 2018. Compared to traditional cars, where the driver has most of their attention allocated on the road and on driving tasks, in fully autonomous vehicles it is likely that the user would not need to intervene with driving related functions meaning that there will be little need for HMIs to have features and functionality relating to these factors. However, there will be an opportunity for a range of other interactions with the user. As such, designers and researchers need to have an understanding of what is actually needed or expected and how to balance the type of functionality they make available. Also, in HMI design, the design principles need to be considered in relation to a range of user characteristics, such as age, and sensory, cognitive and physical ability and other impairments. In this study, we proposed an HMI specially designed for connected autonomous vehicles with a focus on older adults. We examined older adults’ preferences of CAV HMI functions, and, the degree to which individual differences (e.g., personality, attitude towards computers, trust in technology, cognitive functioning) correlate with preferences for these functions. Thirty-one participants (M age = 67.52, SD = 7.29), took part in the study. They had to interact with the HMI and rate its functions based on the importance and likelihood of using them. Results suggest that participants prefer adaptive HMIs, with journey planner capabilities. As expected, as it is a CAV HMI, the Information and Entertainment functions are also preferred. Individual differences have limited relationship with HMI preferences

A systematic review of evidence for fitness-to-drive among people with the mental health conditions of schizophrenia, stress/anxiety disorder, depression, personality disorder and obsessive compulsive disorder

BACKGROUND: Limited evidence exists regarding fitness-to-drive for people with the mental health conditions of schizophrenia, stress/anxiety disorder, depression, personality disorder and obsessive compulsive disorder (herein simply referred to as 'mental health conditions'). The aim of this paper was to systematically search and classify all published studies regarding driving for this population, and then critically appraise papers addressing assessment of fitness-to-drive where the focus was not on the impact of medication on driving. METHODS: A systematic search of three databases (CINAHL, PSYCHINFO, EMBASE) was completed from inception to May 2016 to identify all articles on driving and mental health conditions. Papers meeting the eligibility criteria of including data relating to assessment of fitness-to-drive were critically appraised using the American Academy of Neurology and Centre for Evidence-Based Medicine protocols. RESULTS: A total of 58 articles met the inclusion criteria of driving among people with mental health conditions studied, and of these, 16 contained data and an explicit focus on assessment of fitness-to-drive. Assessment of fitness-to-drive was reported in three ways: 1) factors impacting on the ability to drive safely among people with mental health conditions, 2) capability and perception of health professionals assessing fitness-to-drive of people with mental health conditions, and 3) crash rates. The level of evidence of the published studies was low due to the absence of controls, and the inability to pool data from different diagnostic groups. Evidence supporting fitness-to-drive is conflicting. CONCLUSIONS: There is a relatively small literature in the area of driving with mental health conditions, and the overall quality of studies examining fitness-to-drive is low. Large-scale longitudinal studies with age-matched controls are urgently needed in order to determine the effects of different conditions on fitness-to-drive

MANAGING RISK FOR SUCCESS IN A SOUTH AFRICAN ENGINEERING AND CONSTRUCTION PROJECT ENVIRONMENT

<p>ENGLISH ABSTRACT: The role that project risk management plays in ensuring the successful delivery of engineering and construction projects in South Africa is addressed in this paper. A survey questionnaire was developed to establish approaches used for risk management, and tools and techniques for risk identification. The findings revealed that project risk management had a significant role to play in the success of projects in South Africa. Respondents whose organisations practised structured risk management processes reported success in their projects. The main challenge was found to be in the implementation of risk management tools and techniques. Thus it became apparent that widespread adoption of project risk management in South Africa seemed to be impeded by a low knowledge and skills base, especially in terms of its application.</p><p>AFRIKAANSE OPSOMMING: Die rol wat projekrisikobestuur in die suksesvolle aflewering van ingenieurs- en konstruksieprojekte in Suid-Afrika speel word hier aangespreek.’n Vraelys is ontwikkel om benaderings tot risikobestuur asook toerusting en tegnieke vir risikoidentifisering te ondersoek. Die belangrikste bevinding is dat risikobestuur ’n belangrike rol speel in die sukses van projekte in Suid-Afrika. Die implementering van risikobestuurtoerusting en - tegnieke is aangedui as een van die grootste uitdagings wat oorkom moet word. Dit blyk dat die algemene aanvaarding van projekrisikobestuur in die Suid-Afrikaanse konteks bemoeilik word deur lae vlakke van kennis en vaardigheid.</p&gt