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AIMS: To investigate psychosocial characteristics and problems of a representative sample of Swedish drunk drivers with special consideration of the gender of the driver; analyze criminal records of the drivers before and after enrollment in the study; identify psychosocial predictors of relapse to drunk driving. METHODS: Psychosocial characteristics were assessed by the Addiction Severity Index (ASI). Alcohol problems were additionally assessed by the Alcohol Use Disorders Identification Test (AUDIT). Criminal records were collected for the five year period before the enrollment, and for the subsequent two years, from Sweden's official crime statistics. RESULTS: About half of the investigated drivers had other psychosocial problems besides the drink driving offence. Female drivers had more alcohol, drug, psychiatric and relational problems, including with parents when growing up, than male drivers, but less previous and subsequent criminality. Heavily drunk drivers (blood alcohol concentration > or = 0.1%) had more problems with alcohol, legal status and employment and support than the other drunk drivers. Problems with legal status, family and social relations and alcohol use increased the risk of relapse in drunk driving, while medical problems seemed to be a protective factor. Different ASI risk factors were identified for relapse in either traffic offences or other crimes. CONCLUSIONS: As well as the drunk driving offence, drunk drivers often have other psychosocial problems, female drivers in particular. Already the blood alcohol concentration per se gives some indication of the psychosocial problem profile of a drunk driver and the ASI profile has some prognostic value for relapse in drunk driving. [ABSTRACT FROM AUTHOR]

Whereas hormonal therapy (HT) may increase the risk of coronary heart disease (CHD) and stroke in menopausal women, epidemiological studies (protection in premenopausal women) suggest and experimental studies (prevention of fatty streak development in animals) demonstrate a major atheroprotective action of estradiol (E2). The understanding of the deleterious and beneficial effects of estrogens is thus required at both a cellular and molecular level. Both the endothelium and the immuno-inflammatory system play a key role in the development of fatty streak deposit as well as in the rupture of the atherosclerotic plaque. Whereas E2 favors an anti-inflammatory effect in vitro (cultured cells), it rather elicits a pro-inflammatory response in vivo at the level of several subpopulations of the immuno-inflammatory system, which could contribute to plaque destabilization. E2 promotes beneficial actions on the endothelium such as nitric oxide and prostacyclin production. E2 actions are essentially mediated by two molecular targets: estrogen receptor α (ER-α) and β (ER-β, but the former appears to mediate most of the actions of E2 on the endothelium and on the immune system. ER-α modulates target gene transcription through two activation functions (AF), AF-I and AF-2, even though signalling via ER-α located at the plasma membrane (responsible for membrane-initiated steroid signalling [MISS]/ [extra-genomic]) can also lead to an indirect effect on gene transcription. Recently, we demonstrated that ER-α AF-I is not required for the vasculoprotective actions of E2, whereas it is necessary for the effects of E2 on its reproductive targets. These results suggest that selective estrogen receptor modulators stimulating ER-α with minimal activation of ER-α AF-I could retain beneficial vascular actions, while minimizing the sexual effects. [ABSTRACT FROM AUTHOR]

Twelve subjects drove on a closed 5-km track until they fell asleep behind the wheel or quitted for other reasons. The instances of falling asleep occurred after 7 to 12 hours of driving. Falling asleep could be characterized by nodding of the head, closing of the eyes and the car continuing in its previous course. On none of these occasions did the experimenter have to take over the control of the car and all subjects woke by themselves. The average duration between three instances of falling asleep was 24 min. After a break with a brisk walk the subjects fell asleep again after an average of 23 min. Two preceding sessions of 3 hours of driving on a motorway with subsidiary reaction time measurements predicted (r= — 0·72 and —0·17) the endurance on the closed track. [ABSTRACT FROM PUBLISHER]

Indirect psychological or physiological measures of driving performance are often used without supporting evidence, or even comment, on their validity. In this validation the performance of ten subjects on a subsidiary reaction time (RT) task and a visual detection task was correlated. On the RT task, 93 dB auditory signals were presented with an average intersignal interval of SO s. On the detection task, the subjects had to brake as fast as possible when they perceived a 40 × 40 cm obstacle at the side of the road. Over the test of three hours, in night driving conditions on a closed 5 km track, the correlation between group averages was —0.78 and the average within-subject correlation was —0.47. From these results, and a discussion of the predictive and the construct validity of the RT-task, it is concluded that subsidiary RT may be used as a valid indicator of changes in efficiency of driving performance. [ABSTRACT FROM PUBLISHER]

A reaction time (RT) task was used in three conditions, each lasting 2 h, during which six female subjects: (i) drove on a 5 km closed track, (ii) were driven as passenger on the same track, and (iii) were tested in a stationary vehicle. There was an increase in RT only in the driving condition. Furthermore, there was a progressively greater increase in RT over the three successive test sessions, independent of the order in which conditions were tested. Measurement of hoart-rato (HE) showed that HR deereasod only in the driving and the passenger conditions, and that the docreaso in HR became progressively smaller over the three sossions. Consequently RT-data and HR-data (interpreted as indicating lovel of arousal) provided contra-indications of changes in driving proficiency. [ABSTRACT FROM PUBLISHER]

1. The interindividual differences in serum concentrations of dextromethorphan (DM) and its metabolites were studied in 29 healthy subjects given 120 mg orally. They were also phenotyped according to the urinary ratio of debrisoquine and 4-hydroxy-debrisoquine. 2. Four (14%) subjects were found to be poor metabolizers (PM) with a dextromethorphan/dextrorphan metabolite ratio in plasma of 3.6 or more compared with extensive metabolizers (EM) with a ratio of 0.11 or less. Significant levels of 3-hydroxymorphinan were measurable in all individuals except two, both of whom were PMs. This subdivision corresponded to the phenotype determined by the metabolic ratio of debrisoquine (r = 0.92). 3. Twelve of the 29 subjects reported adverse drug reactions after dextromethorphan administration compared with none after placebo. [ABSTRACT FROM AUTHOR]

From accident statistics a difference was hypothesized between experienced and inexperienced drivers in vulnerability to continuous driving. This difference was used as a basis for a comparison of changes in autonomic measures and reaction time over driving time. The result showed significant effects of experience on both types of measures. Heart-rate pointed to experienced and reaction time pointed to inexperienced drivers as being the most vulnerable to continuous driving. This contradiction was solved with reference to statistical data and validation of the reaction time task. Thus in this study reaction time was preferred to the autonomic measures [ABSTRACT FROM PUBLISHER]