Assessment of patients' medical fitness to drive by primary care physicians: A cross-sectional study

Objectives: Motor vehicle collisions (MVCs) are a significant health burden in Saudi Arabia. The literature has consistently indicated that chronic medical conditions, such as diabetes, heart disease, stroke, obstructive sleep apnea, and neurodevelopmental disorders, increase the risk of MVCs. Therefore, assessment of driver fitness by primary care physicians (PCPs) remains a major health intervention that might reduce MVCs. We studied the practices of PCPs in assessing medical fitness to drive in at-risk patients.

Methods: We conducted a cross-sectional study of all 88 government-funded primary care centers in the city of Riyadh, Saudi Arabia. We administered a self-reported questionnaire to PCPs that inquired about their driving risk assessment for specific medical conditions.

Results: Among all PCPs and centers, 189 PCPs (63%) from 74 centers (84%) participated in our survey. The mean age of the PCPs was 40 ± 10 years, and 108 (57%) were men. The average clinical experience of the group was 13 ± 9 years. Fewer than half of PCPs considered diabetes mellitus (45%) and obstructive sleep apnea (46%) as potential risks for MVCs. Approximately 45% of PCPs did not notify any authority or relatives of potential driving issues that they noticed in their patients. Only 15% of the participants believed that PCPs were responsible for alerting authorities about their fitness to drive.

Conclusions: PCPs did not adequately assess their patients' driving history and eligibility. Efforts are needed to improve awareness among PCPs regarding the effects of chronic medical conditions on driving.     

Quantified risk assessment on life and property loss from road collision vehicle fires with hydrogen-fueled tank

Hydrogen fuel cell vehicles pose hazards different from conventional vehicles. This paper performs a risk assessment on road collision vehicle fires with hydrogen-fueled tank of 70 MPa. The high voltage battery fire caused by road collision can lead to onboard hydrogen release or explosion. Events progressions are analyzed and typical hydrogen consequences are evaluated quantitatively, including hydrogen jet fires and tank catastrophic rupture. Perimeters around the accident scene are proposed for the safety of general public and first responders, respectively. Risks of fatalities, injuries, and damages are all quantified in financial terms to make it possible to combine and compare.     

南宁市区交通环境空气颗粒物中碳组分的污染特征分析研究

含碳颗粒物是大气颗粒物的重要组成部分,对人体健康产生很大的威胁.分别于2012年夏季及2013年冬季在南宁市选取六条主要交通干道采集了PM10、PM2.5样品,分析测定了其中的碳组分.结果表明,碳组分浓度季节变化明显.碳组分在细颗粒物中占有比重比在可吸入颗粒物中大.存在二次有机碳污染.对8种碳组分丰度分析说明南宁市大气颗粒物中碳组分的主要来源是燃煤、机动车尾气及生物质样品燃烧.     

Deep chlorophyll maximum distribution in the central Tyrrhenian Sea described by a towed undulating vehicle

The towed undulating vehicle (TUV), named SARAGO, was used for two fine-scale surveys between the Italian and the Sardinian coasts during the Astraea 2 cruise (6-7 and 26-27 September 1995), studying the deep chlorophyll maximum distribution. SARAGO sections identify a sub-surface doming with higher chlorophyll a and primary production concentrations in the upwelling area of a cyclonic gyre region, detected by sea-surface temperature images. In the first section, the cyclone presents a double doming, in density and salinity, with shallower and concentrated patches of chlorophyll a for about 2 miles. Twenty days later, the second section shows that the gyre changes shape and extension, showing a single doming with higher primary production and chlorophyll a concentrations, distributed over a large area of about 40 nautical miles. SARAGO allows analysis of this high-variability phenomenon (cyclonic gyre) and allows concentrated patches (2 nm) to be identified, thus proving the importance of TUVs in the study of mesoscale processes.     

北京市发展CNG汽车的条件与前景分析

北京市汽车排放污染物贡献率已达到：HC73.5％，CO63．4％，NOx46％。用CNG代替汽油作汽车燃料，可使CO减少97％、HC减少72％、NOx减少39％、CO2减少24％、SO2减少90％。建立CNG加气站和CNG汽车改装这两个CNG应用关键问题在技术上、经济上都是可行的。北京市CNG燃料来源有保障。北京市车辆都比较适合使用CNG气体燃料。北京有很强的CNG汽车产业科技力量。对北京市当前发展CNG汽车产业提出了一些建议。     

Pedestrian fatalities, Atlanta Metropolitan Statistical Area and United States, 2000-2004

Motor vehicle crashes killed almost 5,000 pedestrians in 2005 in the United States. Pedestrian risk may be higher in areas characterized by urban sprawl. From 2000 to 2004, pedestrian fatality rates declined in the United States, but the Atlanta metropolitan statistical area did not experience the same decline. Pedestrian fatality rates for males, Hispanics, and the 15–34 and 35–54 year age groups were higher in Atlanta than in the United States overall. Pedestrian safety interventions should be targeted to high-risk populations and localized pedestrian settings.     

Seat Belt Use in States and Territories with Primary and Secondary Laws -- United States, 2006

Problem

Motor-vehicle crashes are a leading cause of death in the United States. In the event of a crash, seat belts are highly effective in preventing serious injury and death.

Methods

Data from the 2006 Behavioral Risk Factor Surveillance System were used to calculate prevalence of seat belt use by state and territory and by type of state seat belt law (primary vs. secondary enforcement).

Results

In 2006, seat belt use among adults ranged from 58.3% to 91.9% in the states and territories. Seat belt use was 86.0% in states and territories with primary enforcement laws and 75.9% in states with secondary enforcement laws.

Discussion

Seat belt use continues to increase in the United States. Primary enforcement laws remain a more effective strategy than secondary enforcement laws in getting motor-vehicle occupants to wear their seat belts.     

Preferred modes of travel among older adults: What factors affect the choice to walk instead of drive?

Introduction

There are many factors that influence older adults' travel choices. This paper explores the associations between mode of travel choice for a short trip and older adults' personal characteristics.

Methods

This study included 406 drivers over the age of 64 who were enrolled in a large integrated health plan in the United States between 1991 and 2001. Bivariate analyses and generalized linear modeling were used to examine associations between choosing to walk or drive and respondents' self-reported general health, physical and functional abilities, and confidence in walking and driving.

Results

Having more confidence in their ability to walk versus drive increased an older adult's likelihood of walking to make a short trip by about 20% (PR = 1.22; 95% CI: 1.06-1.40), and walking for exercise increased the likelihood by about 50% (PR = 1.53; 95% CI = 1.22-1.91). Reporting fair or poor health decreased the likelihood of walking, as did cutting down on the amount of driving due to a physical problem.

Discussion

Factors affecting a person's decision to walk for exercise may not be the same as those that influence their decision to walk as a mode of travel. It is important to understand the barriers to walking for exercise and walking for travel to develop strategies to help older adults meet both their exercise and mobility needs. Impact on Industry: Increasing walking over driving among older adults may require programs that increase confidence in walking and encourage walking for exercise.     

Age group differences in collision risk

Introduction

The purpose of the current study was to examine differences in factors associated with self-reported collision involvement of three age groups of drivers based on a large representative sample of Ontario adults. Method: This study was based on data from the CAMH Monitor, an ongoing cross-sectional telephone survey of Ontario adults 18 years and older from 2002 to 2005. Three age groups were examined: 18-34 (n = 1,294), 35-54 (n = 2,428), and 55+ (n = 1,576). For each age group sample, a logistic regression analysis was conducted of self-reported collision involvement in the last 12 months by risk factor measures of driving exposure (kilometers driven in a typical week, driving is stressful, and driving on busy roads), consuming five or more drinks of alcohol on one occasion (past 12 months), cannabis use (lifetime, and past 12 months), and driving after drinking among drinkers (past 12 months), controlling for demographics (gender, region, income, and marital status). Results: The study identified differences in factors associated with self-reported collision involvement of the three age groups of adult drivers. The logistic regression model for the youngest group revealed that drivers who reported that driving was stressful at least some of the time, drank five or more drinks on an occasion, and drove after drinking had an increased risk of collision involvement. For the middle age group, those who reported using cannabis in the last 12 months had significantly increased odds of reporting collision involvement. None of the risk factor measures showed significant associations with collision risk for older drivers (aged 55+). Impact: The results suggest potential areas for intervention and new directions for future research.