Narcolepsy, driving and traffic safety

Driving performance in narcolepsy patients is often affected. This is predominantly caused by excessive daytime sleepiness and disturbed vigilance. To a lesser extent cataplexy and sleep paralysis may play a role as well. This chapter discusses experimental studies assessing driving performance in both treated and untreated patients with narcolepsy. Driving simulator studies, on-road tests in actual traffic, and psychological test batteries show that untreated narcolepsy may significantly impair driving ability and increase the risk of becoming involved in traffic accidents. However, much more research is needed to evaluate the effects of narcolepsy treatment on driving in normal traffic, and epidemiological data on traffic accident risks should be gathered. Relatively few studies have been performed to examine effects of narcolepsy treatment on driving ability. Up to now driving improvement has been demonstrated in patients who are successfully treated with methamphetamine and modafinil. Future driving studies should examine the effect of other treatment options

Anemia prevalence in women of reproductive age in low- and middle-income countries between 2000 and 2018

Anemia is a globally widespread condition in women and is associated with reduced economic productivity and increased mortality worldwide. Here we map annual 2000–2018 geospatial estimates of anemia prevalence in women of reproductive age (15–49 years) across 82 low- and middle-income countries (LMICs), stratify anemia by severity and aggregate results to policy-relevant administrative and national levels. Additionally, we provide subnational disparity analyses to provide a comprehensive overview of anemia prevalence inequalities within these countries and predict progress toward the World Health Organization’s Global Nutrition Target (WHO GNT) to reduce anemia by half by 2030. Our results demonstrate widespread moderate improvements in overall anemia prevalence but identify only three LMICs with a high probability of achieving the WHO GNT by 2030 at a national scale, and no LMIC is expected to achieve the target in all their subnational administrative units. Our maps show where large within-country disparities occur, as well as areas likely to fall short of the WHO GNT, offering precision public health tools so that adequate resource allocation and subsequent interventions can be targeted to the most vulnerable populations.Peer reviewe