Working with cognitively impaired drivers: Legal issues for mental health professionals to consider

Introduction

Mental health professionals are gatekeepers of patient confidentiality. Yet, confidentiality held too strictly, by allowing a potentially dangerous driver to assume control of a car, endangers society. Recent court cases have mandated that mental health professionals must warn those who may be potentially harmed by patients. In spite of this, disagreements linger as to whether it is the responsibility of governmental agencies or mental health professionals to decide who is unfit to operate a vehicle because of cognitive impairment. Methods: This article addresses the legally relevant considerations when working with cognitively compromised individuals who operate a motor vehicle. Legal issues surrounding confidentiality, patient rights, foreseeable risk, and the duty to warn and protect are presented in order to understand their relationship to recent court rulings.

Impact on industry

The impact on the mental health care industry includes not only concerns about increased insurance premiums or costs due to alleged negligence or litigation expenses secondary to failure to ensure the safety of an impaired client under their care. Mental health care providers are aware that the welfare of clients with impairment to cognitive decision making ability may require unique considerations for safety such as ensuring safe and appropriate transportation.     

中国城市机动车行驶工况研究

采用GPS及多普勒速度仪对中国8个不同规模城市的机动车行驶工况进行测试.基于大量测试结果,采用特征参数法合成测试城市机动车行驶工况,并分析了中国城市机动车行驶工况特征.结果表明,中国不同规模的城市表现出不同的机动车行驶特征.与欧美标准工况相比,在行驶模式分布、平均车速以及加/减速等方面均存在很大差异.     

Road safety in China: Analysis of current challenges

Introduction

China has the world's largest population, and is the second largest automobile market. China's economy is booming, resulting in a rapid increase in both the road infrastructure and access to private vehicles. Along with economic growth, the ownership of motorized vehicles has almost quadrupled in the past 10 years, from 42.2 million in 1997 to 159.7 million in 2007. However, at the same time, China also has a very high number of road fatalities compared to other countries, with about 100,000 reported fatalities each year.

Method

This study analyzes the Chinese road-fatality situation to identify areas in which the total harm caused by crashes can be substantially and readily reduced. It provides a comprehensive analysis of the current road-fatality situation in China using conventional indices and the likely future trends.

Results

Four areas were identified in which countermeasures have the most potential to substantially reduce fatalities in China: pedestrians and other non-motorists, nighttime driving, vehicle passengers, and motorcycles.

Conclusion

While China faces unprecedented road safety issues, this report identifies major areas in which there are opportunities to greatly reduce total harm.     

Modeling Change-Pattern-Value Dynamics on Land Use: An Integrated GIS and Artificial Neural Networks Approach

The use of spatial methods to detect and characterize changes in land use has been attracting increasing attention from researchers. The objectives of this article were to formulate the dynamics of land use on the temporal and spatial dimensions from the perspectives of the Change-Pattern-Value (CPV) and driving mechanism, based on multitemporal remote sensing data and socioeconomic data. The Artificial Neural Networks were used to identify the factors driving changes in land use. The Pearl River Delta Region of southeast China, which was experiencing rapid economic growth and widespread land conversion, has been selected as the study region. The results show that from 1985 to 2000 in the study region (1) the most prominent characteristics of change in land use were the expansion of the urban land at the expense of farmland, forests, and grasslands, (2) the land-use pattern was being optimized during this period, (3) in an analysis of value, built-up land can yield a return of more than 30 times that of farmland, water area, and forests lands, and (4) rapid economic development, growth in population, and the development of an infrastructure were major driving factors behind ecological land loss and the nonecological land expansion.     

Agglomeration rate and action forces between atomized particles of agglomerator and inhaled-particles from coal combustion

In order to remove efficiently haled-particles emissions from coal combustions, a new way was used to put forward the process of agglomeration and the atomization was produced by the nozzle and then sprayed into the flue before precipitation devices of power station boiler in order to make inhaled-particles agglomerate into bigger particles, which can be easily removed but not change existing running conditions of boiler. According to this idea, a model is set up to study agglomeration rate and effect forces between fly ash inhaledparticles and atomized agglomerator particles. The developed agglomeration rate was expressed by relative particle number decreasing speed per unit volume. The result showed that viscosity force and flow resistance force give main influences on agglomeration effect of inhaledparticles, while springiness force and gravity have little effect on agglomeration effect of theirs. Factors influencing the agglomeration rate and effect forces are studied, including agglomerator concentration, agglomerator flux and agglomerator density, atomized-particles diameters and inhaled-particles diameter and so on.     

水质条件对膜-羧基官能团之间微观作用力的影响特征

为了探讨pH值、离子强度及膜材料对膜-污染物间相互作用力的影响特征,利用自制的典型膜污染物羧基官能团胶体探针,结合原子力显微镜定量考察了羧基官能团与PVDF及EVOH超滤膜间的相互作用力随pH值及离子强度的变化特征.结果表明:带有羧基基体的污染物与PVDF及EVOH超滤膜之间的相互作用力皆随着pH值的增大而减小;但是上述作用力随着离子强度的增加呈现特殊的变化趋势:在离子强度为0~10mmol/L时,膜-带有羧基基体的污染物之间相互作用力随着离子强度的增加而增大;在离子强度为10~500mmol/L时,膜-羧基之间相互作用力随着离子强度的增大而减小.在特定的水质条件下,EVOH-羧基间的作用力远小于PVDF-羧基之间的作用力.     

石油化工装置火灾灭火救援力量需求计算模型

消防用水流量的确定是灭火救援力量需求分析的关键,也是准确调集力量到达火灾现场实施灭火救援的前提和基础。针对《石油化工企业设计防火规范》(GB50160-2008)对石油化工装置消防用水流量的规定存在比较宽泛和模糊的问题,借鉴国外的一般做法,通过分析化工工艺装置的火灾危险性,确定石油化工装置的火灾爆炸危险性等级;再根据火灾爆炸危险性等级和装置的规模,分级确定石油化工装置一次灭火的消防用水流量;进而建立了一种基于火灾爆炸危险性分析的石油化工装置灭火救援力量需求计算模型。该模型的建立为科学准确地调集石油化工装置火灾灭火救援力量提供了重要决策依据。     

The Illinois .08 law. An evaluation

Lowering state blood alcohol concentration (BAC) limits to 0.08, though controversial, has been supported by most evaluation studies to date. The Illinois .08 BAC law implemented in 1997 provided a unique opportunity to evaluate the effect of the law without the simultaneous passage of an administrative license revocation (ALR) law, which has clouded some previous evaluations of the .08 laws. The proportion of all drinking drivers in fatal crashes was compared before versus after implementing the .08 law using time-series analysis to evaluate 12 years of fatal crash data for Illinois and five bordering states. The results showed that the proportion of drinking drivers in fatal crashes decreased by 14% in Illinois and increased by 3% in bordering states. The proportion of drinking drivers in fatal crashes in Illinois, though increasing since 1995, was sharply reduced after passage of the .08 law in 1997, saving more than 100 lives in 1998 and 1999 than it would have without the .08 law.     

Forfeiture programs in California: why so few?

PROBLEM: It is estimated that at least 75% of suspended or revoked drivers continue to drive illegally. In states like California, there are also a substantial and growing number of people who drive without ever having been licensed. Some states, such as Ohio and California, have enacted vehicle impoundment and forfeiture programs as sanctions to reduce these offenses. Published evaluations indicate that vehicle impoundment laws reduce recidivism and crash rates. However, vehicle forfeiture programs have been less successful, mostly because of low levels of enforcement. METHOD: Police officers and district attorneys from 17 jurisdictions were interviewed by phone or in person to determine current enforcement levels and impediments to more aggressive application of statutory authority. RESULTS AND DISCUSSION: The survey found that most California jurisdictions are enforcing vehicle impoundments for first-time offenders. However, very few jurisdictions were enforcing the vehicle forfeiture law for repeat offenders. Among the reasons for not enforcing the vehicle forfeiture law was a perception that it was too time-consuming and/or not a priority among prosecutors. However, a number of authorities indicated that the simple vehicle impoundment procedure is often functionally equivalent to forfeiture because many drivers fail to retrieve the vehicle at the end of the impoundment period. IMPACT ON INDUSTRY: Vehicle impoundment programs are effective mechanisms in deterring illicit driving, and states should be encouraged to initiate vehicle impoundment laws. States could achieve even greater safety benefits if vehicle forfeiture sanctions were extensively used for repeat offenders. However, based on California's experience, the incremental benefits of vehicle forfeiture (over vehicle impoundment) may not be very great.