Critical Flicker Fusion Frequency: A Marker of Cerebral Arousal During Modified Gravitational Conditions Related to Parabolic Flights.

evaluation of human brain performance and arousal remains challenging during operational circumstances, hence the need for a rapid, reliable and reproducible tool. Here we hypothesized that the Critical flicker fusion frequency (CFFF) reflecting/requiring visual integration, visuo-motor skills and decision-taking process might be a powerful, fast and simple tool in modified gravity environments. Therefore 11 male healthy volunteers were assessed for higher cognitive functions with CFFF during parabolic flights.

An International Approach to Enhancing a National Guideline on Driving and Dementia.

Purpose Of Review: The purpose of this study was to update a national guideline on assessing drivers with dementia, addressing limitations of previous versions which included a lack of developmental rigor and stakeholder involvement.

Methods: An international multidisciplinary team reviewed 104 different recommendations from 12 previous guidelines on assessing drivers with dementia in light of a recent review of the literature. Revised guideline recommendations were drafted by consensus.

Alzheimer's disease and driving: review of the literature and consensus guideline from Belgian dementia experts and the Belgian road safety institute endorsed by the Belgian Medical Association.

Alzheimer's disease (AD) is a highly prevalent condition and its prevalence is expected to further increase due to the aging of the general population. It is obvious that the diagnosis of AD has implications for driving. Finally, driving discussions are also emotionally charged because driving is associated with independence and personal identity.

Update on the Risk of Motor Vehicle Collision or Driving Impairment with Dementia: A Collaborative International Systematic Review and Meta-Analysis.

Guidelines that physicians use to assess fitness to drive for dementia are limited in their currency, applicability, and rigor of development. Therefore, we performed a systematic review to determine the risk of motor vehicle collisions (MVCs) or driving impairment caused by dementia, in order to update international guidelines on driving with dementia. Seven literature databases (MEDLINE, CINAHL, Embase, etc.

Comparison of Unsafe Driving Across Medical Conditions.

Objective: To compare risks of unsafe driving in patients with medical conditions.

Methods: This large population-based study included all patients who were referred for a fitness-to-drive evaluation at an official driving evaluation center in 2013 and 2014. Risks of unsafe driving included physician's fitness-to-drive recommendation, comprehensive fitness-to-drive decision, motor vehicle crash history, and traffic violation history.

Safety effects of dynamic speed limits on motorways.

Dynamic speed limits (DSL) are limits that change according to real-time traffic, road or weather conditions. In DSL-schemes road users are typically informed of speed limit changes by electronic signs that are housed within gantries situated above lanes. Dynamic speed limit systems are increasingly applied worldwide, usually on motorways.

Fitness-to-drive Disagreements in Individuals With Dementia.

Purpose Of The Study: We sought to investigate the agreement between medical and practical fitness-to-drive recommendations in active drivers with dementia.

Design And Methods: In this retrospective study, 68 patients underwent medical, visual, and road tests at an official center of the Belgian Road Safety Institute. Physicians provided medical fitness-to-drive recommendations using 1 of 3 categories (favorable, reserved, or unfavorable).

Fitness-to-drive agreements after stroke: medical versus practical recommendations.

Background And Purpose: Physicians often struggle to screen out patients who are no longer fit to drive after stroke. The agreement between the recommendations of physicians and on-road assessors with regard to fitness to drive after stroke was investigated.

Methods: In this retrospective study, 735 patients with stroke underwent medical, visual and road tests at an official fitness-to-drive center of the Belgian Road Safety Institute.

Comorbidity in Drivers with Parkinson's Disease.

Objectives: To determine the effect of comorbidity on fitness-to-drive recommendations that physicians and on-road driving assessors make and to investigate the agreement in fitness-to-drive recommendations between physicians and on-road driving assessors.

Design: Retrospective.

Setting: Data on comorbidities associated with Parkinson's disease (PD) and fitness-to-drive recommendations were investigated.

Agreement Between Physician's Recommendation and Fitness-to-Drive Decision in Multiple Sclerosis.

Objective: To investigate the agreement of fitness-to-drive decisions made by the referring physicians and by the on-road assessors in individuals with multiple sclerosis (MS).

Design: Retrospective analysis.

Setting: Driving institute.

Impact of alcohol checks and social norm on driving under the influence of alcohol (DUI).

This study investigated the influence of alcohol checks and social norm on self-reported driving under the influence of alcohol above the legal limit (DUI). The analysis was based on the responses of 12,507 car drivers from 19 European countries to the SARTRE-4 survey (2010). The data were analysed by means of a multiple logistic regression-model on two levels: (1) individual and (2) national level.

Latent risk and trend models for the evolution of annual fatality numbers in 30 European countries.

In this paper a unified methodology is presented for the modelling of the evolution of road safety in 30 European countries. For each country, annual data of the best available exposure indicator and of the number of fatalities were simultaneously analysed with the bivariate latent risk time series model. This model is based on the assumption that the amount of exposure and the number of fatalities are intrinsically related.

On-road driving impairments in Huntington disease.

Objective: To determine the driving skill impairments and underlying visual, motor, and cognitive deficits that lead to failure on road testing in manifest Huntington disease (HD).

Methods: Certified driving assessment experts scored performance on 13 specific on-road driving skills in 30 persons with HD and 30 controls and issued a pass/fail decision based on their overall impression. These on-road skill items were mapped onto an existing theoretical framework that categorized driving skills into operational, tactical, visuo-integrative, and mixed clusters.

National roadside survey of child restraint system use in Belgium.

In September 2011 the Belgian Road Safety Institute (BRSI) conducted its first roadside survey of child restraint system (CRS) use and misuse. The aim of this study was to obtain population-bases estimates of the prevalence of use and misuse of CRS and to identify predictors of misuse on the basis of observations in real traffic conditions. The survey was conducted on randomly selected sites across the country, stratified across various types of journeys.

Multilevel analysis in road safety research.

Hierarchical structures in road safety data are receiving increasing attention in the literature and multilevel (ML) models are proposed for appropriately handling the resulting dependences among the observations. However, so far no empirical synthesis exists of the actual added value of ML modelling techniques as compared to other modelling approaches. This paper summarizes the statistical and conceptual background and motivations for multilevel analyses in road safety research.

Determinants of fitness to drive in Huntington disease.

Objectives: To identify the most accurate clinical predictors of fitness to drive (FTDr) in Huntington disease (HD).

Methods: This cross-sectional study included 60 active drivers: 30 patients with manifest HD (8 women) and 30 age- and gender-matched healthy controls. Mean (SD) age of the HD group was 50 (12) years and median (Q1-Q3) disease duration was 24 (12-48) months.

Multilevel modeling in traffic safety research: two empirical examples illustrating the consequences of ignoring hierarchies.

Objectives: This commentary illustrates the advantages of multilevel modeling compared to statistical techniques that ignore hierarchies, based on two empirical traffic safety examples.

Methods: The common concept shared by different definitions of multilevel modeling is identified and illustrated. Each definition defines multilevel modeling in its own way but they all refer to hierarchies.

Perception of road accident causes.

A theoretical two-dimensional model on prevalence and risk was developed. The objective of this study was to validate this model empirically to answer three questions: How do European drivers perceive the importance of several causes of road accidents? Are there important differences in perceptions between member states? Do these perceptions reflect the real significance of road accident causes? Data were collected from 23 countries, based on representative national samples of at least 1000 respondents each (n=24,372). Face-to-face interviews with fully licensed, active car drivers were conducted using a questionnaire containing closed answer questions.