Naturalistic Driving Behaviour and Self-Regulation Practices Among Older Drivers with Bilateral Cataract: a Prospective Cohort Study

This naturalistic study examined older drivers before first eye, after first eye, and after second eye cataract surgery by examining how objective visual measures and other factors influenced driving habits, exposure, adverse events and driver self-regulation. The results provide evidence for timely cataract surgery, the inclusion of contrast sensitivity when assessing fitness to drive for older drivers and driver self-regulation as a strategy to improve road safety as older drivers wait for cataract surgery

A validation study comparing self-reported travel diaries and objective data obtained from in-vehicle monitoring devices in older drivers with bilateral cataract

Background: Advances in technology have made it possible to examine real-world driving using naturalistic data obtained from in-vehicle monitoring devices. These devices overcome the weaknesses of self-report methods and can provide comprehensive insights into driving exposure, habits and practices of older drivers. Aim: The aim of this study is to compare self-reported and objectively measured driving exposure, habits and practices using a travel diary and an in-vehicle driver monitoring device in older drivers with bilateral cataract. Methods: A cross-sectional study was undertaken. Forty seven participants aged 58-89 years old (mean. =74.1; S.D. =7.73) were recruited from three eye clinics over a one year period. Data collection consisted of a cognitive test, a researcher-administered questionnaire, a travel diary and an in-vehicle monitoring device. Participants' driving exposure and patterns were recorded for one week using in-vehicle monitoring devices. They also completed a travel diary each time they drove a motor vehicle as the driver. Paired t-tests were used to examine differences/agreement between the two instruments under different driving circumstances. Results: The data from the older drivers' travel diaries significantly underestimated the number of overall trips (p < 0.001), weekend trips (p. =0.002) and trips during peak hour (p. =0.004). The travel diaries also significantly overestimated overall driving duration (p. &lt;. 0.001) and weekend driving duration (p. =0.003), compared to the data obtained from the in-vehicle monitoring devices. No significant differences were found between instruments for kilometres travelled under any of the driving circumstances.Conclusions: The results of this study found that relying solely on self-reported travel diaries to assess driving outcomes may not be accurate, particularly for estimates of the number of trips made and duration of trips. The clear advantages of using in-vehicle monitoring devices over travel diaries to monitor driving habits and exposure among an older population are evident

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

La remémoration du passé et l'imagination du futur chez les personnes présentant une prédisposition aux obsessions-compulsions

Le but de cette étude est de tester l'hypothèse de Brüne (2006), selon laquelle le TOC se situerait sur un continuum de stratégies d'évitement de la menace. Quarante et un volontaires issus de la population générale ont effectué les tâches de fluence d'événements futurs, de fluences verbales phonémiques et sémantiques et de mémoire autobiographique et d'imagination du futur. L'OCI-R, la CES-D et le STAI-T ont été administrés. Deux groupes ont été crées (bas SOC vs hauts SOC) sur la base des scores des participants à l'OCI-R. Les hauts SOC rapportent plus d'événements catégoriques et moins d'événements spécifiques (effet marginal) que les bas SOC. La neutralisation corrèle de façon négative avec la fluence future (effet marginal) et la spécificité des événements futurs. Les obsessions corrèlent de façon négative avec la spécificité des événements futurs (effet marginal)

Stratégies de coping et régulation émotionnelle chez des patients présentant un mésusage d'alcool: évaluation et intervention de deux cas cliniques

Selon la littérature, il existerait un lien entre le stress et la dépendance à l'alcool. Ainsi l'alcool serait une stratégie de régulation émotionnelle et de coping permettant de faire face aux situations stressantes. Il permettrait de réguler non seulement les affects négatifs, mais également les affects positifs. Face aux situations stressantes, les personnes alcoolodépendantes privilégieraient le coping centré sur l'émotion et auraient moins fréquemment recours au coping centré sur la tâche. En outre, elles auraient également fréquemment recours aux stratégies de coping d'évitement qui seraient des prédicteurs de la fréquence de consommation d'alcool. Par ailleurs, les personnes présentant plus de stratégies de régulation maladaptives consommeraient également plus d'alcool que celles qui ont recours à des stratégies de régulation émotionnelle plus adaptives. Ce travail investigue les stratégies de coping et de régulation émotionnelle de deux patients en crise qui présentent un mésusage d'alcool. Ils ont pu bénéficier d'une évaluation et d'une prise en charge individuelle, au sein d'un Centre de Thérapies Brèves (CTB)

The Cataract Extraction and Driving Ability Research Study Protocol: characterisation of deficits in driving performance and self-regulation among older drivers with bilateral cataract.

PURPOSE: Cataract is one of the leading causes of visual impairment in Australia. As more older adults are driving, the number of people with cataract on the roads will increase. A greater understanding of the effects of cataract and cataract surgery on driving performance and driver self-regulation is essential to improve road safety. This proposed study will examine the effects of bilateral cataract surgery on driving outcomes including driving performance and driver self-regulation. METHODS: A 3-year prospective study will be undertaken in Western Australia (WA) and New South Wales (NSW). Three hundred participants (n=150 from WA and n=150 from NSW) aged &gt;60 years with bilateral cataract will be assessed at three time points: the month before first-eye cataract surgery, 1-3 months after first-eye cataract surgery and 3 months after second-eye cataract surgery. Driving performance will be assessed using a driving simulator and driver self-regulation patterns measured using in-vehicle driver-monitoring devices. Objective visual measures, quality of life and self-reported driving difficulties will also be collected at the three assessments. CONCLUSIONS: The study results may impact on ophthalmology, optometry and general medical practices in terms of the driving advice provided to patients with bilateral cataract and those undergoing cataract surgery. The information gained from this study will allow these professionals to advise patients about specific driving difficulties they may face at different stages of cataract surgery and appropriate self-regulation practices. The results will be of use to licensing authorities in the assessment of 'fitness to drive'