| 1. |
- Almberg, Maria, et al.
(författare)
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Experiences of facilitators or barriers in driving education from learner and novice drivers with ADHD or ASD and their driving instructors
- 2017
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Ingår i: Developmental Neurorehabilitation. - : Taylor & Francis. - 1751-8423 .- 1751-8431. ; 20:2, s. 59-67
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Tidskriftsartikel (refereegranskat)abstract
- Background: Little is known about whether individuals with autism spectrum disorder (ASD) or attention deficit hyperactive disorder (ADHD) experience any specific facilitators or barriers to driving education.Objective: To explore the facilitators or barriers to driving education experienced by individuals with ASD or ADHD who obtained a learner’s permit, from the perspective of the learner drivers and their driving instructors.Methods: Data were collected from 33 participants with ASD or ADHD, and nine of their driving instructors.Results: Participants with ASD required twice as many driving lessons and more on-road tests than those with ADHD. Participants with ADHD repeated the written tests more than those with ASD. Driving license theory was more challenging for individuals with ADHD, whilst individuals with ASD found translating theory into practice and adjusting to “unfamiliar” driving situations to be the greatest challenges.Conclusion: Obtaining a driving license was associated with stressful training experience.
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| 2. |
- Filtness, Ashleigh J, et al.
(författare)
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Sleep-related eye symptoms and their potential for identifying driver sleepiness
- 2014
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Ingår i: Journal of Sleep Research. - : Wiley. - 0962-1105 .- 1365-2869. ; 23:5, s. 568-75
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Tidskriftsartikel (refereegranskat)abstract
- The majority of individuals appear to have insight into their own sleepiness, but there is some evidence that this does not hold true for all, for example treated patients with obstructive sleep apnea. Identification of sleep-related symptoms may help drivers determine their sleepiness, eye symptoms in particular show promise. Sixteen participants completed four motorway drives on two separate occasions. Drives were completed during daytime and night-time in both a driving simulator and on the real road.Ten eye symptoms were rated at the end of each drive, and compared with driving performance and subjective and objective sleep metrics recorded during driving. 'Eye strain', 'difficulty focusing', 'heavy eyelids' and 'difficulty keeping the eyes open' were identified as the four key sleep-related eye symptoms. Drives resulting in these eye symptoms were more likely to have high subjective sleepiness and more line crossings than drives where similar eye discomfort was not reported. Furthermore, drivers having unintentional line crossings were likely to have 'heavy eyelids' and 'difficulty keeping the eyes open'. Results suggest that drivers struggling to identify sleepiness could be assisted with the advice 'stop driving if you feel sleepy and/or have heavy eyelids or difficulty keeping your eyes open'.
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| 3. |
- Åkerstedt, Torbjörn, et al.
(författare)
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Subjective sleepiness is a sensitive indicator of insufficient sleep and impaired waking function
- 2014
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Ingår i: Journal of Sleep Research. - : Wiley. - 0962-1105 .- 1365-2869. ; 23:3, s. 240-252
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Tidskriftsartikel (refereegranskat)abstract
- The main consequence of insufficient sleep is sleepiness. While measures of sleep latency, continuous encephalographical/electro-oculographical (EEG/EOG) recording and performance tests are useful indicators of sleepiness in the laboratory and clinic, they are not easily implemented in large, real-life field studies. Subjective ratings of sleepiness, which are easily applied and unobtrusive, are an alternative, but whether they measure sleepiness sensitively, reliably and validly remains uncertain. This review brings together research relevant to these issues. It is focused on the Karolinska Sleepiness Scale (KSS), which is a nine-point Likert-type scale. The diurnal pattern of sleepiness is U-shaped, with high KSS values in the morning and late evening, and with great stability across years. KSS values increase sensitively during acute total and repeated partial sleep deprivation and night work, including night driving. The effect sizes range between 1.5 and 3. The relation to driving performance or EEG/EOG indicators of sleepiness is highly significant, strongly curvilinear and consistent across individuals. High (>6) KSS values are associated particularly with impaired driving performance and sleep intrusions in the EEG. KSS values are also increased in many clinical conditions such as sleep apnea, depression and burnout. The context has a strong influence on KSS ratings. Thus, physical activity, social interaction and light exposure will reduce KSS values by 1-2 units. In contrast, time-on-task in a monotonous context will increase KSS values by 1-2 units. In summary, subjective ratings of sleepiness as described here is as sensitive and valid an indicator of sleepiness as objective measures, and particularly suitable for field studies.
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| 4. |
- Sjörs Dahlman, Anna, 1981-, et al.
(författare)
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The hypothalamo–pituitary–adrenal axis and the autonomic nervous system in burnout
- 2021
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Ingår i: Handbook of Clinical Neurology. - : Elsevier B.V.. - 0072-9752. ; , s. 83-94, s. 83-94
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Bokkapitel (övrigt vetenskapligt/konstnärligt)abstract
- Burnout constitutes a serious health concern in the modern working environment. It is a stress-related condition that has developed as a result of a prolonged psychosocial stress exposure causing a persistent mismatch between demands and resources. The main symptom is emotional exhaustion, but physical fatigue, diminished professional efficacy, cynicism, and cognitive impairments are also associated with this condition. Burnout has been used both as a psychologic term in occupational settings and as a clinical diagnosis in patient populations, and there is currently no universally accepted definition and diagnostic criteria of burnout. It has been hypothesized that the two main stress response systems, the autonomic nervous system (ANS) and the hypothalamus–pituitary–adrenal axis (HPA axis), are involved in the pathogenesis of burnout. A common hypothesis is that in the early stages of chronic stress, the HPA axis and sympathetic ANS activity tend to be higher, while it will decrease with a longer duration of chronic stress to ultimately reach a state of hypoactivity in clinical burnout. The current research in this field shows many contradictory results. Thus there is no compelling evidence of either ANS or HPA dysfunction in burnout. However, there is partial support for the hypothesis of HPA and sympathetic hyperactivity in early stages, and HPA hyporeactivity and low vagal activity in more severe burnout cases, but high-quality studies investigating the causal links are still lacking. © 2021 Elsevier B.V.
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| 5. |
- Forsman, Åsa, 1972-, et al.
(författare)
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Injury crashes and the relationship with disease causing excessive daytime sleepiness
- 2021
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Ingår i: Traffic Injury Prevention. - : Informa UK Limited. - 1538-9588 .- 1538-957X. ; 22:4, s. 272-277
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Tidskriftsartikel (refereegranskat)abstract
- Objective: The objective of this study was to understand the relationship between some of the most common diseases that are known to contribute to excessive daytime sleepiness (EDS) and traffic injury crashes. Specific focus was on the relationship between disease and crash type (single-vehicle or multiple-vehicle crash) and between disease and injury severity.Methods: This registry-based study considered all passenger car drivers involved in a crash in Sweden between 2011 and 2016 who were 40 years or older at the time of the crash (n = 54,090). For each crash-involved driver, selected medical diagnoses registered from 1997 until the day before the crash were extracted from the National Patient Register. The drivers were assigned to 1 of 4 groups, depending on prior diseases: sleep apnea (SA; group 1, n = 2,165), sleep disorders (group 2, n = 724), Parkinson's or epilepsy (group 3, n = 645) and a reference group (group 4, n = 50,556). Logistic regression analysis compared single-vehicle crashes with multiple-vehicle crashes and moderately/severely injured drivers with slightly/uninjured drivers.Results: Drivers with EDS-related diseases (groups 1-3) had higher probability of a single-vehicle crash than a multiple-vehicle crash compared to the reference group. The most sizeable effect was found for Parkinson's/epilepsy with an odds ratio (OR) of 2.5 (confidence interval [CI], 2.1-3.0). For multiple-vehicle crashes, the probability of a moderate/severe injury was higher for drivers with other sleep disorders (OR = 1.5; CI, 1.0-2.2) and Parkinson's/epilepsy (OR = 1.6; CI, 1.1-2.3) compared to the reference group.Conclusions: This study has made first steps toward understanding the relationship between some of the most common diseases that are known to contribute to EDS and crashes. Having Parkinson's/epilepsy, in particular, elevated the probability of a single-vehicle crash compared to a multiple-vehicle crash. A single-vehicle crash was seen as indicative of causing a crash; thus, having Parkinson's/epilepsy could be interpreted as a risk factor for crash involvement. Having Parkinson's/epilepsy, as well as other sleep disorders, was also related to more severe outcomes in multiple-vehicle crashes, given that a crash occurred. This was not identified in single-vehicle crashes.
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| 6. |
- Kjeldgard, L., et al.
(författare)
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Bicycle crashes and sickness absence - a population-based Swedish register study of all individuals of working ages
- 2019
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Ingår i: Bmc Public Health. - : Springer Science and Business Media LLC. - 1471-2458. ; 19
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Tidskriftsartikel (refereegranskat)abstract
- BackgroundIn recent years, bicycle injuries have increased, yet little is known about the impact of such injures on sickness absence (SA) and disability pension (DP). The aim was to explore SA and DP among individuals of working ages injured in a bicycle crash.MethodA nationwide register-based study, including all individuals aged 16-64years and living in Sweden, who in 2010 had in- or specialized out-patient healthcare (including emergency units) after a bicycle crash. Information on age, sex, sociodemographics, SA, DP, crash type, injury type, and injured body region was used. We analyzed individuals with no SA or DP, with ongoing SA or full-time DP already at the time of the crash, and with new SA >14days in connection to the crash. Crude and adjusted odds ratios (OR) with 95% confidence intervals for new SA were estimated by logistic regression.ResultsIn total, 7643 individuals had healthcare due to a new bicycle crash (of which 85% were single-bicycle crashes). Among all, 10% were already on SA or full-time DP at the time of the crash, while 18% had a new SA spell. The most common types of injuries were external injuries (38%) and fractures (37%). The body region most frequently injured was the upper extremities (43%). Women had higher OR (1.40; 1.23-1.58) for new SA than men, as did older individuals compared with younger (OR 2.50; 2.02-3.09, for ages: 55-64 vs. 25-34). The injury types with the highest ORs for new SA, compared with the reference group external injuries was fractures (8.04; 6.62-9.77) and internal injuries (7.34; 3.67-14.66). Individuals with traumatic brain injury and injuries to the vertebral column and spinal cord had higher ORs for SA compared with other head, face, and neck injuries (2.72; 1.19-6.22 and 3.53; 2.24-5.55, respectively).ConclusionsIn this explorative nationwide study of new bicycle crashes among individuals of working ages, 18% had a new SA spell in connection to the crash while 10% were already on SA or DP. The ORs for new SA were higher among women, older individuals, and among individuals with a fracture.
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| 7. |
- Leo, Christoph, et al.
(författare)
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Analysis of Swedish and Dutch accident data on cyclist injuries in cyclist-car collisions
- 2019
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Ingår i: Traffic Injury Prevention. - : Informa UK Limited. - 1538-957X .- 1538-9588. ; 20:sup2, s. 160-162
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Tidskriftsartikel (refereegranskat)abstract
- Objective: To reduce the number of severe injuries sustained by cyclists in crashes with vehicles, it is important to understand which kinds of injuries are occurring to identify what should be assessed by means of virtual testing. Method: A detailed analysis of injuries was made based on Swedish and Dutch accident data. The most frequently injured body regions and the most frequent single injuries of these body regions were analysed. Results: Cyclists most frequently injured their heads, upper and lower extremities, and bone fractures as well as brain injuries were identified as one of the most important injuries. Conclusions: For the virtual assessment of cyclist protection, injury predictors for long bone, skull and pelvic fractures as well as brain injuries are required in Human Body Models.
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| 8. |
- Sjörs Dahlman, Anna, et al.
(författare)
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Growth factors and neurotrophins in patients with stress-related exhaustion disorder
- 2019
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Ingår i: Psychoneuroendocrinology. - : Elsevier BV. - 0306-4530 .- 1873-3360. ; 109
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Tidskriftsartikel (refereegranskat)abstract
- © 2019 The Authors Growth factors, such as vascular endothelial growth factor (VEGF) and epidermal growth factor (EGF), and neurotrophic factors, including brain-derived neurotophic factor (BDNF), have attracted attention in studies of the biological effects of long-term stress exposure due to their neuroprotective roles. This study investigated whether circulating levels of EGF, VEGF and BDNF were altered in individuals with stress-related exhaustion disorder. Forty patients diagnosed with exhaustion disorder and 40 healthy subjects (50% women) provided fasting blood samples for analysis of EGF, VEGF, and BDNF in plasma. We found significantly lower levels of EGF, VEGF, and BDNF in patients with ED compared to healthy controls. This pattern was seen in both male and female patients. Given the important roles of BDNF and VEGF for brain plasticity and neurogenesis, decreased levels after long-term stress exposure could indicate increased risk of neuronal damage and cognitive impairments in this patient group.
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| 9. |
- Kirk, Alan, et al.
(författare)
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Bus and coach passenger casualties in non-collision incidents
- 2001
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Ingår i: Proceedings of the conference Traffic Safety on Three Continents. - Linköping : Statens väg- och transportforskningsinstitut. ; , s. 451-464
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- Two major bus safety reports have recently been completed at ICE. Firstly the "Assessment of Passenger Safety in Local Service PSVs", for the Department of the Environment, Transport and the Regions (DETR), assesses the impact of the Disability Discrimination Act (DDA) and the Disabled Persons Transport Advisory Committee (DIPTAC) regulations on bus travel. Secondly, "Real World Bus and Coach Accident Data from Eight European Countries", for Task 1.1 of the Enhanced Bus and Coach Occupant Safety project (European Commission 5th Framework Project no. 1999-RD.11130), is a collation of European data that identifies the important issues in bus and coach occupant safety. It has become evident during these projects that non-collision incidents are an important part in the injury experience of bus casualties, especially for elderly occupants. By consideration of both national statistics and in-depth cases a picture has been formed of the bus and coach casualty population and the types of incidents in which these people are injured. These statistics have been presented, along with possible reasons for such a high proportion of casualties occurring in non-collision incidents and recommendations have been made that would lessen the risk of these injuries occurring, through better design and operational changes. These injuries occur due to a combination of factors. Occupants can fall due to slipping or tripping on poorly designed floor surfaces or in wet weather conditions. Or falls can occur due to acceleration forces as the bus brakes or pulls away. When these falls occur the design of the interior can present an injury risk. In recent years bus design has changed as a result of new regulations to allow a wider population to use buses, especially with the introduction of low floor access. These features promote easier boarding and alighting and allow less mobile members of the population to make use of bus travel. Unfortunately this may also increase the likelihood of these more vulnerable people receiving injuries on the vehicle. Many of the issues addressed are particularly relevant to elderly people, small children and their caretakers.
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| 10. |
- Williams, Tricia
(författare)
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Safedrive Medical : Assessing Fitness to Drive
- 2013
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Ingår i: Proceedings of the 16th International Conference Road Safety on Four Continents. - Linköping : Statens väg- och transportforskningsinstitut.
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- This paper describes the development and content of SafeDrive Medical, and the preliminary results and implications of an evaluation. The findings show that participants found the program useful and user friendly, and were confident in being able to assess and identify at-risk drivers. It is important that health professionals are educated in which medical conditions and disabilities can affect safe driving and therefore need to be reported to VicRoads, and how to advise their patients accordingly. As such, VicRoads developed SafeDrive Medical Seminars to educate health professionals in assessing fitness to drive. These were delivered free of charge to health professionals who attended after business hours. To provide a program which health professionals could undertake in their own time, an online version of SafeDrive Medical was developed in 2005. In 2012 SafeDrive Medical was redeveloped to align with the new Assessing Fitness to Drive for commercial and private vehicle drivers: medical standards for licensing and clinical management guidelines, March 2012. In the state of Victoria (Australia) the licensing system is based on fitness to drive and people can drive to any age as long as they are safe to do so. There is no mandatory reporting of at-risk patients by health professionals, as this may deter drivers from seeking the necessary medical treatment.
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