Self-reported safety belt use among emergency department patients in Boston, Massachusetts

BACKGROUND: Safety belt use is 80% nationally, yet only 63% in Massachusetts. Safety belt use among potentially at-risk groups in Boston is unknown. We sought to assess the prevalence and correlates of belt non-use among emergency department (ED) patients in Boston. METHODS: A cross-sectional survey with systematic sampling was conducted on non-urgent ED patients age ≥18. A closed-ended survey was administered by interview. Safety belt use was defined via two methods: a single-item and a multiple-item measure of safety belt use. Each was scored using a 5-point frequency scale. Responses were used to categorize safety belt use as 'always' or less than 'always'. Outcome for multivariate logistic regression analysis was safety belt use less than 'always'. RESULTS: Of 478 patients approached, 381 (80%) participated. Participants were 48% female, 48% African-American, 40% White, median age 39. Among participants, 250 (66%) had been in a car crash; 234 (61%) had a valid driver's license, and 42 (11%) had been ticketed for belt non-use. Using two different survey measures, a single-item and a multiple-item measure, safety belt use 'always' was 51% and 36% respectively. According to separate regression models, factors associated with belt non-use included male gender, alcohol consumption >5 drinks in one episode, riding with others that drink and drive, ever receiving a citation for belt non-use, believing that safety belt use is 'uncomfortable', and that 'I just forget', while 'It's my usual habit' was protective. CONCLUSION: ED patients at an urban hospital in Boston have considerably lower self-reported safety belt use than state or national estimates. An ED-based intervention to increase safety belt use among this hard-to-reach population warrants consideration

The Effects of Demographics, Functioning, and Perceptions on the Relationship between Self-Reported and Objective Measures of Driving Exposure and Patterns among Older Adults.

The exploratory study reported here was intended to examine: how strongly subjectively reported driving avoidance behaviors (commonly referred to as self-regulation) and exposure were related to their objectively measured counterparts and whether it depended on the specific behavior; the extent to which gender and age play a role in the association between subjectively reported driving avoidance behaviors and exposure and their objectively measured counterparts; and the extent to which demographics, health and functioning, driving-related perceptions, and cognition influence the association between subjective and objective driving avoidance behaviors overall. The study used data from the Longitudinal Research on Aging Drivers (LongROAD) study, a multisite, prospective cohort study designed to generate empirical data for understanding the role of medical, behavioral, environmental, and technological factors in driving safety during the process of aging. Objective driving measures were derived from GPS/datalogger data from 2131 LongROAD participants’ vehicles. The corresponding subjective measures came from a comprehensive questionnaire administered to participants at baseline that asked them to report on their driving exposure, patterns, and other aspects of driving. Several other variables used in the analyses came from the comprehensive questionnaire and an in-person clinical assessment administered to participants at baseline. A series of simple linear and logistic models were fitted to examine the relationship between the subjective and objective driving measures of interest, and a multivariable analysis was conducted to examine the potential role of selected factors in the relationship between objective and subjective driving avoidance behaviors. Results of the models are presented and overall findings are discussed within the context of the existing research literature.http://deepblue.lib.umich.edu/bitstream/2027.42/193082/2/nihms959301.pdfPublished versio

All Are Not Created Equal: Assessing Initial Driving Self-Regulation Behaviors Among Older Adults

Introduction: Mobility is closely tied to the ability to safely drive. In older adulthood, many people begin to avoid difficult driving situations, such as driving at night, during rush hour, on freeways, or in unfamiliar areas. Reasons for such avoidance include driving self-regulation (SR; an intentional response to perceived difficulty), lifestyle changes, or preference. Most previous research has not made distinctions between these reasons, has not compared driving avoidance situations, and has not differentiated between those early in the SR process from those farther along. This study addressed those issues by comparing each of the aforementioned driving avoidance behaviors as one's initial SR behavior. Methods: A total of 1554 older drivers from the AAA Longitudinal Research on Aging Drivers study were analyzed. Multinomial regression was used to determine how demographics, function, and driving-related factors were related to a difference in the odds of reporting one initial SR behavior compared to each of the others. Results: The most common initial SR behavior was avoidance of nighttime driving (57.59%), followed by avoidance of rush hour driving (26.96%), driving in unfamiliar areas (10.81%), and driving on freeways (4.63%). A variety of demographic and function variables were associated with a difference in the odds of the initial SR behaviors, including gender, race, income, anxiety, driving responsibility, having rides available, driving abilities, and driving comfort. Conclusions: Nighttime avoidance is the most common initial SR behavior. Variables specifically related to situational driving comfort and driving ability were the best predictors of differences in driving SR.http://deepblue.lib.umich.edu/bitstream/2027.42/193063/2/1-s2.0-S2214140521003406-main.pdfPublished versio

The Influence of Hearing Impairment on Driving Avoidance Among a Large Cohort of Older Drivers

As people age, some of the commonly experienced psychomotor, visual, and cognitive declines can interfere with the ability to safely drive, often leading to situational avoidance of challenging driving situations. The effect of hearing impairment on these avoidance behaviors has not been comprehensively studied. Data from the American Automobile Association (AAA) Longitudinal Research on Aging Drivers (LongROAD) study were used to assess the effect of hearing impairment on driving avoidance, using three measures of hearing. Results indicated that hearing loss plays a complex role in driving avoidance, and that an objective hearing measure was a stronger predictor than hearing aid use and self-rated hearing. Greater hearing impairment was related to less nighttime and freeway driving, more trips farther than 15 mi from home, and lower odds of avoiding peak driving times. The moderating influence of hearing on both vision and cognition is also discussed, along with study implications and future research.http://deepblue.lib.umich.edu/bitstream/2027.42/193065/2/vivoda-et-al-2021-the-influence-of-hearing-impairment-on-driving-avoidance-among-a-large-cohort-of-older-drivers.pdfPublished versio

Genetics and Genomics of Carrot Biotic Stress

International audienceCarrot (Daucus carota ssp. sativus) production can be affected by a wide range of pests and pathogens. At least five diseases of carrot are caused by bacterial pathogens, 36 by fungal and oomycete pathogens, two by phytoplasmas, and 13 by viruses; and seven genera of nematodes and two genera of parasitic plants affect carrot. In addition, numerous insect and mite pests can cause losses. There have been extensive efforts to select carrot cultivars with partial or complete resistance to many of these pathogens and pests, and to identify wild species with resistance to specific biotic stresses for introgression into breeding populations and commercial cultivars. For some pathogens and pests, significant advances have been made at identifying resistance and mapping that resistance to the carrot genome. For others, resistance has been identified, but the genetic basis is yet to be determined. For a majority of these diverse stresses, however, there has been little success at identifying highly effective resistance and understanding the genetic basis of resistance. The diversity of stresses as well as interactions among these pests and pathogens can complicate efforts to develop cultivars with resistance to all key biotic stresses in a region that also meet market and consumer expectations. New approaches to identifying resistant material and speeding traditional breeding are being developed with molecular breeding tools, including simple sequence repeat markers and deep-coverage libraries of the carrot genome. These valuable genomic resources will enhance efforts to identify and breed for resistance to carrot pests and pathogens