INTRODUCTION: The crash risk of teens is high, with fatal crash rates of teen drivers higher than any other age group. New approaches to reduce teen traffic fatalities are clearly needed. METHOD: A possible approach to reduce the incidence of teen driver crashes and fatalities is through the use of vehicle-based intelligent driver support systems. To be most effective, the system should address the behaviors associated with an overwhelming number of teen fatal crashes: speed, low seatbelt use, and alcohol impairment. In-vehicle technology also offers an opportunity to address the issue of inexperience through enforcement of certain Graduated Driver's License provisions. RESULTS: To fully understand the capability of such technologies, there should be a concerted effort to further their development, and human factors testing should take place to understand their effects on the driver. IMPACT: If successfully implemented, a Teen Driver Support System (TDSS), such as the one described here, could significantly decrease the number of teens killed in traffic crashes. 相似文献
Graduated driver licensing (GDL) is a concept for how to transform non-drivers into reasonably safe drivers while minimizing the risks as they learn. Several state GDL programs can be improved by moving their structures closer to an adequate implementation of that concept. The learner stage of a GDL system needs to be long enough for beginners to obtain a thorough introduction to the vagaries of driving. The second or intermediate stage needs to effectively limit exposure to known high risk conditions as novices adapt to being fully in charge of the vehicle. The benefits of GDL to date are due almost entirely to the risk-reducing conditions it implements. To improve the functioning of GDL will probably require a better understanding of teen driving than we presently have. The likelihood of further gains will be enhanced by efforts to learn more about the actual causes of teen crashes, the nature and type of teen driver exposures, and what parents do with their teens during the supervised driving stage of GDL. Without a better understanding of these, and other, phenomena it will be difficult to further reduce crashes among young beginning drivers, whether through GDL enhancements or with other approaches. 相似文献
PROBLEM: It has been established that graduated licensing systems lead to crash reductions among beginning drivers. What is the contribution of the various components of graduated licensing to these reductions, and how can their effectiveness be increased? METHOD: Literature review and synthesis. RESULTS: Extended learner periods, nighttime restrictions, and passenger restrictions have contributed to crash reductions. Presently there is insufficient evidence concerning the contribution of seat belt or cell phone provisions, or contingent advancement penalties. DISCUSSION: There is more to learn about graduated licensing and its component features. However, there are ways to increase the contribution of all the components through stronger laws and greater compliance. With the right kind of community commitment and focus, substantial further reductions in young driver crashes are achievable. IMPACT ON INDUSTRY: The results can guide states in establishing graduated licensing systems that maximize crash reductions. 相似文献
PROBLEM: A stated objective of driver education in North America is to produce safer drivers, typically defined as drivers less likely to crash. This paper examines the extent to which driver education has achieved this objective independently as well as the extent to which such programs can support the success of graduated licensing in reducing young driver crashes. In so doing, it discusses past experiences, recent developments, and the future direction of driver education and training in relation to graduated driver licensing. METHOD: Literature review and synthesis. RESULTS: Driver education programs have yet to demonstrate consistent attainment of their safety objectives. Moreover, they have not been found to enhance the safety effectiveness of graduated licensing programs--indeed, some practices, for example, "time discounts" for driver education have actually had a detrimental effect on teen safety. DISCUSSION: Despite its disappointing safety record to date, it is important not to abandon driver education. In particular, there are opportunities to improve driver education so that it achieves its safety objectives, and ensure that programs in the future complement graduated driver licensing and contribute to its overall safety benefits. Current and future efforts to improve driver education and better integrate it with graduated licensing programs, however, need to be rigorously evaluated to determine what does and does not work to reduce young driver crashes, and as importantly, to understand why this is the case. IMPACT ON INDUSTRY: Improved driver education integrated with graduated driver licensing has potential safety benefits. 相似文献
The number of older drivers who might benefit from driver retraining is growing. A previous review on the effectiveness of older driver retraining included intervention studies up to 2004. The objective was to perform an updated systematic review of the effectiveness of older driver retraining for improving driving-related skills and reducing crash rates.
Method
Articles published from 2004-2008 were grouped according to the intervention provided and outcome studied. Randomized clinical trials (RCTs) were appraised using the Physiotherapy Evidence Database (PEDro) Scale and scored for quality according to their internal validity. Each intervention's effectiveness was then rated and assigned a level of evidence by combining pre- and post- 2004 findings.
Results
Three RCTs and one matched-pairs cohort design met the inclusion criteria. There is strong evidence (Level 1a) that education combined with on-road training improves driving performance and moderate evidence (Level 1b) that it improves knowledge. There is moderate evidence (Level 1b) that physical retraining improves driving performance. There is moderate evidence (Level 1b) that an educational intervention curriculum alone is not effective in reducing crashes.
Summary
The updated evidence on the effectiveness of retraining aimed at older drivers is sufficiently encouraging to merit assertive health promotion actions regarding intervention and program planning.
Impact on Industry
These positive findings warrant a comprehensive plan that has both behavioral and monetary incentives encouraging older driver participation in programs aimed at driver safety. 相似文献
In-vehicle driving monitoring technologies have the potential to enable young drivers to learn from self-assessment. However, their use is largely dependent on parental involvement.
Method
A total of 79 interviews were conducted with young drivers and parents regarding this technology and its use. Most had the experience of having an in-vehicle data recorder installed in the vehicle driven by the young drivers. Parents and the young drivers expressed both appreciation as well as reservations about its potential as a means to enhance the driving safety of young drivers.
Results
A surprising finding was that some parents did not check the feedback and said they relied on the young driver to do so. Main concerns related to privacy, parent-young driver relationship, self-esteem and confidence, constructive use of the feedback data, and the limitations of the documentation that can be done by the technology.
Conclusions
Providing parents and young drivers with a support system and tools to discuss and utilize the feedback are underscored. Challenges include addressing the invasion of young drivers’ privacy and gender differences, and using the monitoring-capacity of the technology to enhance safe driving practices. Implications for programs to enhance communication and a dialogical approach between parents and young drivers are discussed. 相似文献
Objective: Despite advances in vehicle safety systems, motor vehicle crashes continue to cause ankle fractures. This study attempts to provide insight into the mechanisms of injury and to identify the at-risk population groups.
Methods: A study was made of ankle fractures patients treated at an urban level 1 trauma center following motor vehicle crashes, with a concurrent analysis of a nationally representative crash data set. The national data set focused on ankle fractures in drivers involved in frontal crashes. Statistical analysis was applied to the national data set to identify factors associated with fracture risk.
Results: Malleolar fractures occurred most frequently in the driver's right foot due to pedal interaction. The majority of complex/open fractures occurred in the left foot due to interaction with the vehicle floor. These fractures occurred in association with a femoral fracture, but their broad injury pattern suggests a range of fracture causation mechanisms. The statistical analysis indicated that the risk of fracture increased with increasing driver body mass index (BMI) and age.
Conclusions: Efforts to reduce the risk of driver ankle injury should focus on right foot and pedal interaction. The range of injury patterns identified here suggest that efforts to minimize driver ankle fracture risk will likely need to consider injury tolerances for flexion, pronation/supination, and axial loading in order to capture the full range of injury mechanisms. In the clinical environment, physicians examining drivers after a frontal crash should consider those who are older or obese or who have severe femoral injury without concurrent head injury as highly suspicious for an ankle injury. 相似文献
Objective: The objective of this study was to determine the frequency of health care provider (HCP) driving safety/cessation-related anticipatory guidance provision and predictors of driving safety-related anticipatory guidance provision by HCPs.
Methods: HCPs in several central/upper Midwest states were surveyed about frequency of anticipatory guidance provision (n = 265).
Results: More than half of HCPs stated that they frequently or always provide driving safety/cessation-related anticipatory guidance to patients aged 85 or older, 38.7% provided this guidance to patients aged 75 to 84, and 13.7% to patients aged 65 to 74. Predictors of driving safety/cessation-related anticipatory guidance provision differed by patient age. For patients aged 65–74, HCP personal experience with a motor vehicle crash (either the HCP themselves or a friend/family member) was significant in predicting anticipatory guidance provision. However, for patients aged 75 and older, significant predictors included HCP rural practice, HCP age, and percentage of HCP patients who were older adults.
Conclusion: HCP counseling provision related to driving issues differs by patient age and several HCP characteristics, including HCP rurality, age, and personal experience with motor vehicle crashes. Because aging results in physical and mental changes that affect driving and can be identified by HCPs, HCPs are in a position to counsel patients on the potential impacts of aging on the act of driving. Future research should examine the reasons for the differences in anticipatory guidance provision found in this study. 相似文献