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In recent decades, several Latin American cities have implemented policy instruments to reduce urban air pollution and traffic congestion such as license plate–based restrictions on car use. Our research analyzes the factors influencing the public acceptance of these urban policies in four cities: Bogotá, Mexico City, Santiago de Chile, and Quito. We use semi-structured interviews and digital diaries to examine participants' beliefs and emotions about vehicle restrictions as well as their daily mobility experiences. The study illustrates the importance of three main beliefs in shaping the public acceptance of the measures (perceived effectiveness, perceived fairness, and perceived personal impacts). The results also show a certain resignation on the part of the participants, accepting that the policies are necessary and, to some extent, effective in pacifying traffic and improving air quality in highly populated cities, even if the policies generate certain undesirable distributional and personal impacts. The study uncovers the importance of the local context in understanding why certain urban policies, successfully applied in other contexts, might have lower levels of public support in Latin American cities. A high population density, regulatory shortcomings, enforcement difficulties, and deficits in infrastructure and public transport all create a mobility context in which some policies to improve urban air quality and traffic congestion generate high levels of frustration and ambivalence among the residents. [ABSTRACT FROM AUTHOR]

Governments often enact driving restrictions through transportation demand management programs to solve traffic congestion and air pollution problems in a city or region by prohibiting the public from using their private vehicles during certain days. Driving restrictions are quite prevalent in cities in which many private cars are operated, including DKI Jakarta, where such a program has been implemented for several years. The purpose of this study is to estimate the effect or impact of the expansion of odd-even driving restrictions on DKI Jakarta’s ambient air quality. Carried out by regression discontinuity design, this study found that the odd-even driving restrictions do not significantly reduce DKI Jakarta’s air pollutants. Several factors that affect the restrictions’ impact include the restrictions’ selective mechanism and compensating response managed by the public. Thus, the government should improve the restriction mechanism or enact more impactful programs to solve the air quality problem in DKI Jakarta.

There is a knowledge gap on how ground-level particulate pollution affects labor productivity in emerging nations due to a lack of study, especially when it comes to outdoor work settings like couriers in the express delivery industry. Combining findings from two research projects, this paper examines the socioeconomic consequences of particulate matter and ground-level particulate pollution. Special panel dataset from China's express delivery companies are used, we study how particulate pollution affects courier productivity. The instrumental variable of our analysis was built by particulate pollution data from upwind towns. Moreover, a comparable rise in particulate levels during the 30 days caused a significant 23.7% decline in worker productivity. This draws attention to a neglected area of the economic effects of particulate pollution, especially in underdeveloped countries. Our results also highlight the wider health hazards connected to outdoor activities in high-pollution locations, drawing comparisons on outdoor exercisers and particulate matter concentrations. The critical need for coordinated policy attention addressing both ground-level Particulate and particle matters in developing nations is highlighted by the increased risk of lung function impairment among outdoor exercisers owing to excessive particulate matter concentrations. The interrelated risks that air pollution poses to public health and economic productivity are clarified by this Comprehensive viewpoint. • Examines the socioeconomic consequences of particulate matter and ground-level ozone pollution. • Using a special panel dataset from one of China's top express delivery companies. • Air pollution poses to public health and economic productivity are clarified. [ABSTRACT FROM AUTHOR]

Background: Regulatory authorities of most industrialized countries recommend 6 months of private driving restriction after implantation of a secondary prevention implantable cardioverter-defibrillator (ICD). These driving restrictions result in significant inconvenience and social implications. This study aimed to assess the incidence rate of appropriate device therapies in contemporary recipients of a secondary prevention ICD.Methods: This retrospective study at 3 Canadian tertiary care centers enrolled consecutive patients with new secondary prevention ICD implants between 2016 and 2020.Results: For a median of 760 days (324, 1190 days), 721 patients were followed up. The risk of recurrent ventricular arrhythmia was highest during the first 3 months after device insertion (34.4%) and decreased over time (10.6% between 3 and 6 months, 11.7% between 6 and 12 months). The corresponding incidence rate per 100 patient-days was 0.48 (95% CI, 0.35-0.64) at 90 days, 0.28 (95% CI, 0.17-0.45) at 180 days, and 0.21 (95% CI, 0.13-0.33) between 181 and 365 days after ICD insertion (P<0.001). The cumulative incidence of arrhythmic syncope resulting in sudden cardiac incapacitation was 1.8% within the first 90 days and subsequently dropped to 0.4% between 91 and 180 days (P<0.001) after ICD insertion.Conclusions: The incidence rate of appropriate therapies resulting in sudden cardiac incapacitation in contemporary recipients of a secondary prevention ICD is much lower than previously reported and declines significantly after the first 3 months. Lowering driving restrictions to 3 months after the index cardiac event seems safe, and revision of existing guidelines should be considered in countries still adhering to a 6-month period. Existing restrictions for private driving after implantation of a secondary prevention ICD should be reconsidered. [ABSTRACT FROM AUTHOR]

Congestion and local air pollution continue to be a serious problem in many cities around the world, partly because of an increasing and ageing car fleet. Unfortunately, the use of pricing schemes for handling these externalities, such as congestion and pollution charges, still face much resistance. To cope with it, Carlos F. Daganzo advanced an ingenious hybrid scheme that supposedly leaves everybody better off: driving restrictions with toll exemptions. We extend Daganzo's idea to include vintage exemptions in an effort to also control for the pollution externality. We then test for its Pareto-improving property using Santiago as a case study. We find the latter not to hold in that low-income drivers are strictly worse off: the gain from faster car travel in days of no restriction is not enough to compensate the loss from switching to public transport in days of restriction. To make all individuals better off, the entire toll collection ought to be recycled back into the public transport system, lowering its fares and improving its quality. If so, the most ambitious hybrid restriction format —a 5-day-a-week restriction with vintage thresholds during fall and winter— reports per-year net benefits of around 1.2 billion dollars (or 0.5% of the country's GDP), 58% of which comes from lighter traffic and the remaining 42% from cleaner air. [ABSTRACT FROM AUTHOR]

• Residents' support for congestion pricing and driving restrictions was examined. • Lower delay, car use and respiratory issues correlate with supporting both policies. • A city having a higher PM2.5 and driving bans correlates with supporting both policies. • A city's higher income inequality correlates only with supporting restrictions. • Difference in pricing vs restrictions support is largely due to city-level factors. Public support for the implementation of congestion relief policies is critical for the policies' technical and political success. To identify the personal, social, and city-level factors associated with higher acceptance towards such policies, this study uses a 2016 survey of 8178 residents from 11 cities across 10 Latin American countries collected by the Development Bank of Latin America (Corporación Andina de Fomento or CAF). We examined support for two demand-side approaches to managing the traffic congestion externality: congestion pricing – a market-based approach, and driving restrictions or bans – a command-and-control approach. Logit regression models show that personal mobility such as owning or using a private vehicle during a respondent's main commute trip are associated with decreased support, while higher congestion delay in one's commute and having a young child recently diagnosed with respiratory problems increases support for either congestion relief policy. In addition, residents of cities with higher levels of median annual particulate matter and with prior experience with traffic bans expressed higher support for either policy. Residents of cities with higher income inequality supported only driving restrictions; while those of cities with higher GDP per capita had lower support only for congestion pricing. To improve the public acceptance of congestion relief policies in Latin America, policy makers could: (1) explicitly seek to mitigate the costs it brings on individuals by investing in substitutes like public transportation; (2) promote the personal and social environmental and health benefits; (3) consider beginning with temporary, pilot programs; and in the case of driving restrictions, (4) take into account city-specific conditions related to income inequality that may influence public support for the policies. [ABSTRACT FROM AUTHOR]

With rapid economic development, air pollution became a serious problem in China. Vehicle's exhaust emissions are among the main sources of air pollution. With samples of 173 prefecture-level cities in China from 2006 to 2016, this paper takes the implementation of driving restrictions as a quasi-natural experiment to examine the relationship between driving restrictions and air quality through the difference-in-differences method based on the propensity score matching. Results indicate that driving restrictions have not improved the air quality in terms of average treatment effect as there is no clear evidence that people turn from private cars to busses or subways. Furthermore, heterogeneous effects of driving restrictions exist across different regions and cities of China. The implementation of driving restrictions has significantly positive impacts on air pollution in the Eastern and Central cities of China, while it has significantly negative effects in non-capital cities. This study implies that the development of local public transportation needs to be taken into account when formulating the policy of driving restrictions. [ABSTRACT FROM AUTHOR]

Objective: To examine the symptoms experienced and the change in driving habits in individuals with concussion. Materials and methods: A survey was created by a team of rehabilitation professionals who see persons with concussion in their clinics. The survey captured demographics, mechanism of injury, date of injury, symptoms experienced during driving, if drivers felt safe when driving, and changes in driving habits since the concussion. Non-parametric tests were used to compare symptoms experienced and driving habits across three groups which were created based on time since injury. Results: Of the 140 participants, 74% (104/140) had resumed driving after concussion; of these 27% (28/104) reported that they felt unsafe while driving. Forty-four per cent (46/104) experienced symptoms while driving, of which headache, and difficulty concentrating were the most common symptoms experienced throughout the concussion spectrum (acute to chronic phase). Most drivers (78/104, 75%) with concussion had changed their driving habits by driving less often and shorter distances, and by avoiding nighttime driving and heavy traffic areas. Conclusions: Headache and concentration problems were experienced by drivers regardless of the time since injury. Most drivers had made changes to their driving habits. Clinicians should consider the symptom burden patients experience and discuss driving restrictions to ensure driving safety. [ABSTRACT FROM AUTHOR]

Summary: The use of implantable cardioverter defibrillators (ICD) has been shown to improve survival in patients at risk of sudden cardiac death; however, due to the continuous risk of sudden loss of consciousness during arrhythmia or ICD intervention, they pose a potential risk to other road users while driving. A large number of opinions and recommendations from authorities and medical societies all over the world exist regarding driving restrictions after ICD implantation. This analysis provides an overview of the recommendations on driving restrictions from several countries. Furthermore, the use of the wearable and the subcutaneous ICD are taken into account. [ABSTRACT FROM AUTHOR]

Abstract Background Implantable cardioverter defibrillator (ICD) implantation is associated with driving restrictions which may have profound effects on the patient’s life. However, there is limited patient-reported data on the information given about driving restrictions, the adherence to the restrictions, the incidence of arrhythmic symptoms while driving, and the driving restrictions’ effect on ICD patients’ daily life and quality of life factors. A specific questionnaire was designed to investigate these objectives, intended for use in a nationwide ICD cohort. Methods The conceptual framework based on literature review and expert opinion was refined in qualitative semi-structured focus group interviews with ten ICD patients. Content validity was pursued through pre-testing, including expert review and 28 cognitive interviews with patients at all ICD implanting centres in Denmark. Finally, the Danish Pacemaker and ICD registry was used to randomly select 50 ICD patients with a first-time implantation between January 1, 2013 and November 30, 2016 for pilot testing, followed by a test-retest on 25 respondents. Test-retest agreement was assessed using kappa statistics or intraclass correlation coefficients. Results The pilot test achieved a response rate of 78%, whereof the majority were web-based (69%). Only 49% stated they had been informed about any driving restrictions after ICD implantation, whereas the number was 75% after appropriate ICD shock. Among respondents, 95% had resumed private driving, ranging from 1 to 90 days after ICD implantation. In those informed of a significant (≥ 1 month) driving ban, 55% stated the driving restrictions had impeded with daily life, especially due to limitations in maintaining employment or getting to/from work and 25% admitted they had knowingly been driving during the restricted period. There were six episodes of dizziness or palpitations not necessitating stopping the vehicle. Test-retest demonstrated good agreement of questionnaire items, with 69% of Kappa coefficients above 0.60. Conclusions We have developed a comprehensive questionnaire on ICD patients’ perspective on driving. Pre-testing and pilot testing demonstrated good content validity, feasible data collection methods, and a robust response rate. Thus, we believe the final questionnaire, distributed to almost 4000 ICD patients, will capture essential evidence to help inform driving guidelines in this population.

This review compiles scientific data about the real dangers faced by people with epilepsy (PWE) who drive. Those include risks of motor vehicle accidents (MVA) in PWE as compared with controls (individuals without epilepsy) and as compared with persons with other medical conditions that impact fitness to drive. Data regarding Accident rates as related to seizure free intervals (SFI), single vs. multiple seizure events, and/or antiseizure drug (ASD) taper and reintroduction are discussed. Variation in state, national, and international laws and guidance for non-commercial and commercial drivers is highlighted, along with some related reasons for driving restrictions. The review concludes by emphasizing the importance of physicians educating patients about local driving laws and about risks of ASD non-adherence. The need for a broader, multi-stakeholder re-examination of driving regulations for PWE is noted. [ABSTRACT FROM AUTHOR]

Rationing car use based on license plate number has become a popular policy in several cities around the world to address traffic congestion and air pollution. This paper studies the effects of the moderate and drastic driving restrictions imposed as part of the Pico y Placa program on car use and air pollution in Bogotá. Using data on ambient carbon monoxide, gasoline consumption, and vehicle sales and registrations, no evidence of an improvement in air quality or a reduction in car use is found in either phase of the program. On the contrary, there is some indication that, relative to the moderate phase, gasoline consumption, vehicle ownership, and carbon monoxide in the morning peak tended to increase slightly when drastic restrictions were implemented. [ABSTRACT FROM AUTHOR]

Highlights • Cost-effectiveness of eliminating old vehicles and driving restrictions to reduce vehicle emissions was first compared. • Consumer and government costs of eliminating old vehicles and driving restrictions were estimated using interview method. • Results showed that eliminating old vehicles was more cost-effective than driving restrictions on emission reduction. • Traffic air quality monitoring station data was used on regression model to verify driving restrictions did not have a significant effect on air quality. Abstract Motor vehicle emissions contribute significantly to air pollution in Beijing. Therefore, a number of measures have been taken to control emissions from motor vehicles, including the elimination of high-polluting old vehicles and driving restrictions. We compared the pollution reduction effects and implementation costs of these two policies. The results showed that an average annual investment of about 1.7 billion RMB was invested in a policy of eliminating old vehicles in Beijing, resulting in annual emissions reductions of about 22,600 tons of CO, 1330.2 tons of NOx, 2197 tons of HC, 78.6 tons of PM 2.5 , and 81.3 tons of PM 10. Meanwhile, a driving restrictions policy resulted in an annual loss by consumers of more than 17.84 billion RMB and annual emissions reductions of just 12,000 tons of CO, 845 tons of NOx, 1356 tons of hydrocarbons HC, 53 tons of PM 2.5 , and 57 tons of PM 10. A policy of eliminating old cars is more cost-effective than a driving restrictions policy, policy formulation should take into account the cost-effectiveness of policies. [ABSTRACT FROM AUTHOR]

Background: Implantable cardioverter defibrillator (ICD) implantation is associated with driving restrictions which may have profound effects on the patient's life. However, there is limited patient-reported data on the information given about driving restrictions, the adherence to the restrictions, the incidence of arrhythmic symptoms while driving, and the driving restrictions' effect on ICD patients' daily life and quality of life factors. A specific questionnaire was designed to investigate these objectives, intended for use in a nationwide ICD cohort.Methods: The conceptual framework based on literature review and expert opinion was refined in qualitative semi-structured focus group interviews with ten ICD patients. Content validity was pursued through pre-testing, including expert review and 28 cognitive interviews with patients at all ICD implanting centres in Denmark. Finally, the Danish Pacemaker and ICD registry was used to randomly select 50 ICD patients with a first-time implantation between January 1, 2013 and November 30, 2016 for pilot testing, followed by a test-retest on 25 respondents. Test-retest agreement was assessed using kappa statistics or intraclass correlation coefficients.Results: The pilot test achieved a response rate of 78%, whereof the majority were web-based (69%). Only 49% stated they had been informed about any driving restrictions after ICD implantation, whereas the number was 75% after appropriate ICD shock. Among respondents, 95% had resumed private driving, ranging from 1 to 90 days after ICD implantation. In those informed of a significant (≥ 1 month) driving ban, 55% stated the driving restrictions had impeded with daily life, especially due to limitations in maintaining employment or getting to/from work and 25% admitted they had knowingly been driving during the restricted period. There were six episodes of dizziness or palpitations not necessitating stopping the vehicle. Test-retest demonstrated good agreement of questionnaire items, with 69% of Kappa coefficients above 0.60.Conclusions: We have developed a comprehensive questionnaire on ICD patients' perspective on driving. Pre-testing and pilot testing demonstrated good content validity, feasible data collection methods, and a robust response rate. Thus, we believe the final questionnaire, distributed to almost 4000 ICD patients, will capture essential evidence to help inform driving guidelines in this population. [ABSTRACT FROM AUTHOR]

A common European Community driving licence was established in 1980. However, there are major differences among the countries as regards medical conditions that legally affect driving ability. This article discusses various assessment guidelines for dizzy patients. These range from a total absence of specified binding requirements in Finland or regulations open to clinical interpretation in Switzerland, to inappropriately strict regulations in Germany. We focus on requirements for patients with vestibular disorders in Germany which have been in force since 2014. These guidelines stipulate that for group 1 driving licence (private cars < 3.5 t, motorbikes): (1) patients with Menière’s disease (attacks without prodromes) must have had no attacks for 2 years before it is possible to drive again. (2) Patients with vestibular migraine without prodromes must not have had any attacks for 3 years. For a group 1 and group 2 driving licence (“professional driver”): (3) patients with bilateral vestibulopathy as a rule are considered to have a driving disability. Similarly, strict restrictions have been formulated for ocular motor disorders such as downbeat and upbeat nystagmus and for patients with functional (psychosomatic) forms of dizziness such as phobic postural vertigo. The authors represent a working group of the European Dizzynet focusing on the topic “fitness to drive with vertigo and balance disorders”. They agree that European guidelines must be revised and harmonized, for some are too strict and the required dizziness-free intervals are too long; others must be revised, for they are too lax. A common European standard is needed. [ABSTRACT FROM AUTHOR]

Little is known about the cost of environmental regulations that target households instead of firms, partly because of significant methodological and data challenges. We use the contingent valuation method to measure the costs of Mexico City's Day without Driving program, which seeks to stem pollution and traffic congestion by prohibiting vehicles from being driven one day each week. To our knowledge, ours is the first study to focus directly on using stated preference methods to isolate and estimate the private costs of an existing environmental regulation. We find that the Mexican program's costs are substantial: up to US$130 per vehicle per year, which represents 1%-2% of drivers' annual income and implies total costs of US$617 million per year. Recent research questions whether driving restrictions programs like Mexico City's actually have environmental benefits. Our results suggest that whatever benefits these programs may have, they can be quite costly. [ABSTRACT FROM AUTHOR]

Background Driving restrictions in epilepsy are intended to safeguard public and personal safety; however, these limitations inhibit socialization, restrict employment, and reduce self-esteem in patients with seizures. A large proportion of patients with seizures continue to drive, and factors leading to noncompliance with driving regulations are poorly understood. Thus, the patients' perspective on driving safety is not incorporated into the existing counseling tools on driving safety in epilepsy. The present study assessed social, economic, and psychological perceptions related to driving restrictions in patients with refractory and pharmacotherapy-controlled seizures at the single epilepsy center and identified impediments for safe driving. Methods Data were obtained from an anonymous survey completed by 25 adult patients in the presurgical group (PG) with refractory epilepsy and 46 patients in the ambulatory group (AG) with confirmed epilepsy which did not meet criteria for refractoriness. The questionnaire (administered via Research Electronic Data Capture (REDCap)) addressed seizure and driving history, knowledge of driving restrictions, and social consequences of losing driving privileges. Results Eighty-seven percent of all responders experienced seizures with alteration of awareness; however, 34% of patients continued to drive during the time when they were legally restricted, and 6% had accidents related to seizures. All responders reported their seizure status accurately to the treating physician, and 93% understood state-based driving restrictions. The median time from the last seizure was shorter, and the duration of last driving restriction was longer in the PG compared with the AG (1 vs. 20 weeks, and 12 vs. 24 weeks, respectively). Despite that, the proportions of patients driving at the time of survey were not significantly different between the two groups. Nearly 80% of all patients stated that driving restrictions reduced their quality of life, and 70% believed that these restrictions carry a social stigma. Employment was chosen to be the most affected by driving restrictions from a list of four social domains by the majority of patients in both groups. Notably, the employment rate was 26% higher in the AG compared with the PG. The lack of public transportation was regarded as a hurdle by more than 60% of patients in each group with greater than two-thirds of patients relying on other drivers for transportation. Conclusions These findings suggest that patients with refractory and pharmacotherapy-controlled seizures are similarly likely to drive a vehicle, disregarding a practitioner's advice and state restrictions. The lack of public transportation is a shared constraint and likely leads to reduced compliance with driving regulations. Driving restrictions carry social stigma and limit the employment of patients with epilepsy, regardless of the refractory seizure status. [ABSTRACT FROM AUTHOR]

Background: Dutch patients with an implantable cardioverter defibrillator (ICD) are restricted from driving for two months after implantation or shocks. This requires significant lifestyle adjustments and is one of the primary concerns of ICD patients. Previous studies indicated that compliance with the driving restrictions is poor, but insight in socio-demographic, clinical and psychological factors associated with compliance is limited. Hence, this study aimed to explore compliance with the driving restrictions and associated factors in a large sample of Dutch ICD patients. Method: Dutch ICD patients ( N = 313) completed an elaborative set of questionnaires at time of implantation and at four months after implantation, assessing socio-demographic, psychological and driving-related characteristics. Clinical data were collected from the patients' medical records. Results: A substantial subgroup (28%) of the patient sample (median age 64 (interquartile range = 55-71), 81% male) reported to have been noncompliant with the driving restrictions. Univariate analysis indicated that noncompliant patients more often considered refusing the ICD due to the restrictions, compared to compliant patients (19% versus 10%, p = 0.02). Multivariate analysis showed that the feeling of understanding the reason behind the driving restrictions was associated with better compliance (odds ratio = 2.16, 95% confidence interval 1.02-4.56, p = 0.04). No other socio-demographic, clinical, psychological or driving-related factors were associated with compliance. Conclusion: A large number of ICD patients does not comply with the driving restrictions after implantation. This study emphasised the importance of the patient's feeling of understanding the reason behind the restrictions. [ABSTRACT FROM AUTHOR]

Vehicles have recently overtaken coal to become the largest source of air pollution in urban China. Research on mobile sources of pollution has foundered due both to inaccessibility of Chinese data on health outcomes and strong identifying assumptions. To address these, we collect daily ambulance call data from the Beijing Emergency Medical Center and combine them with an idiosyncratic feature of a driving restriction policy in Beijing that references the last digit of vehicles’ license plate numbers. Because the number 4 is considered unlucky by many in China, it tends to be avoided on license plates. As a result, days on which the policy restricts license plates ending in 4 unintentionally allow more vehicles in Beijing. Leveraging this variation, we find that traffic congestion is indeed 22% higher on days banning 4 and that 24-hour average concentration of NO2 is 12% higher. Correspondingly, these short-term increases in pollution increase ambulance calls by 12% and 3% for fever and heart-related symptoms, while no effects are found for injuries. These findings suggest that traffic congestion has substantial health externalities in China but that they are also responsive to policy. [ABSTRACT FROM AUTHOR]

Driving restrictions are often introduced as an urban management method for reducing the air pollution and traffic congestion by prohibiting drivers from using their vehicles on given days, based on the last digits of vehicles’ license plates. A number of cities in developing countries have used driving restrictions. This paper proposes an empirical strategy to estimate the effects of driving restrictions on air quality. The strategy combines internet based semi-structured data source, big data processing procedure, and different estimation methods of regression discontinuity design to carry out the analysis. The results show that the driving restrictions are effective for short-run period, but are ineffective for long-run time period. Heterogeneity in short-run effect for different cut-points has also been observed. The results of the study are helpful in understanding the effectiveness of current driving restriction policies and to improve these further to achieve better results in future. [ABSTRACT FROM AUTHOR]

During the Olympic Games in 2008, a driving restriction based on vehicle license plate numbers was implemented in Beijing to mitigate air pollution and traffic congestion. Following the Games, the restriction was modified several times. This paper investigates the effects of two policy changes: a weakening policy change due to a shorter restricted time period, and a strengthening policy change due to a higher penalty for violators and the complementary car purchasing restriction. By employing a regression discontinuity design in a Tobit model, I find that the weakening policy change led to more pollution and the strengthening policy change improved air quality in restricted areas. Several robustness checks confirm the results. I also provide suggestive evidence that driving restrictions increased the use of public transportation and alleviated traffic congestion. [ABSTRACT FROM AUTHOR]

It is well established that exposure to high levels of air pollution in the short term leads to negative health outcomes; yet there exist very few policies intended to address short run spikes in air pollution. In this article we examine a policy implemented by the Government of Chile that uses temporary measures to reduce the severity and negative health impacts of poor air quality in the short run. This policy involves the announcement of "Environmental Episodes" on days forecast to have particularly poor air quality. Such Episode announcements trigger a number of government protocols and public notices intended to both improve regional air quality and encourage avoidance behaviors among the populace. By comparing days on which Episodes were announced to observationally similar days before the policy was fully implemented, we demonstrate that the announcement of an Environmental Episode reduces ambient concentrations of particulate matter in the Santiago Metropolitan Region by approximately 20% on the day of implementation, with effects persisting into subsequent days. We also find that the temporary restrictions, government actions, and informational campaigns that make up an Episode reduce mortality among the elderly on the day-of and days-after Episode implementation. Our findings suggest that the Environmental Episode program effectively addresses poor air quality in the short term and could serve as a valuable model for policymakers seeking to augment long-term air quality strategies with a means of addressing temporary spikes in local or regional air pollution levels. [ABSTRACT FROM AUTHOR]

Many older adults voluntarily restrict their driving or stop driving of their own accord. Driving behavior change may occur in stages, as predicted by the Transtheoretical Model of Behavior Change (TM). Method This study explored the process of older driver behavior change within the TM framework using interviews/focus groups with drivers and former drivers aged 71-94years. Within those groups of drivers, driving behavior was divided into two classes: those who changed their driving with age and those who did not. Those who changed their driving as they aged included people gradually imposing restrictions ("gradual restrictors") and those making plans in anticipation of stopping driving ("preparers"). Participants who did not change their driving included those who employed lifelong driving restrictions ("consistent") and those who made no changes ("non-changers"). Results Preliminary support for TM within the driving context was found; however, further exploration of driving behavior change within this framework is warranted. Practical applications It is important to continue to investigate the factors that might influence driving behavior in older adults. By promoting self-regulation in individuals, it may be possible to help older adults continue to drive, thereby improving older adult's mobility and quality of life. [ABSTRACT FROM AUTHOR]

Abstract: Background: The Checkpoints program (Checkpoints) uses a Parent-Teen Driving Agreement (PTDA) to help parents monitor teens' driving, and has shown efficacy in increasing parental restrictions on teens' driving and decreasing teens' risky driving. In previous trials, research staff administered Checkpoints. This study examined the effectiveness of Checkpoints when delivered by driver educators. It was hypothesized that Checkpoints would result in more PTDA use, greater PTDA limits on higher risk driving situations, and less high-risk driving. Methods: Eight trained driving instructors were randomly assigned to intervention or control groups in a group randomized trial. Instructors enrolled 148 parent-teen dyads (intervention = 99, control = 49); 35% of those eligible. Intervention parents joined teens for a 30-minute Checkpoints session during driver education. The session included a video, persuasive messages, discussion, and PTDA initiation. Teens completed four surveys: baseline, licensure, and 3- and 6-months post-licensure. Results: Intervention teens were more likely to report that they used a PTDA (OR= 15.92, p = .004) and had restrictions on driving with teen passengers (OR = 8.52, p = .009), on weekend nights (OR = 8.71, p = .021), on high-speed roads (OR = 3.56, p = .02), and in bad weather (b = .51, p = .05) during the first six months of licensure. There were no differences in offenses or crashes at six months, but intervention teens reported less high-risk driving (p = .04). Conclusions: Although challenges remain to encourage greater parent participation, Checkpoints conducted by driver education instructors resulted in more use of PTDAs, greater restrictions on high-risk driving, and less high-risk driving. Including Checkpoints in driver education parent meetings/classes has potential to enhance teen driver safety. [Copyright &y& Elsevier]

Brain tumors may impair functioning in several neuro-cognitive domains and interfere with sophisticated tasks, such as driving motor vehicles. No formalized national guidelines or recommendations for driving restrictions in patients with brain tumors exist in the US. We created and administered a 24 question survey to 1,157 US medical practitioners, mostly neurosurgeons, radiation oncologists, and medical oncologists, to identify their knowledge of local driving restriction laws and their practice patterns regarding driving restriction instructions to brain tumor patients. Response were collected from 251 (21.7%) and analyzed from 221 (19%) recipients. Seventy-one percent of the respondents indicated they discuss driving recommendations/restrictions with brain tumor patients, with 82% primarily basing this on seizure activity. Approximately 28% of respondents were unsure if they are required by their State's motor vehicle licensing authority to report medically impaired drivers. Respondents felt that longer periods of restriction prior to re-evaluation are warranted in patients with malignant versus benign brain tumors and high versus low grade gliomas. Only 25% of respondents use formal, standardized testing to determine driving eligibility and approximately 31% address driving restrictions in every patient with a brain tumor. This survey highlights the lack of consensus regarding the responsibilities of physicians treating brain tumor patients in designing and enforcing driving restrictions. We propose that a panel of experts generate driving restriction guidelines to be used in conjunction with objective testing of motor and sensory impairment. These would aid practitioners in developing individualized driving restrictions for every brain tumor patient. [ABSTRACT FROM AUTHOR]

The paper introduces a simple framework for analyzing the environmental effects of local transportation policies, and it reviews some evidence. In several cases, subsidies for local public transportation have led to substantial reductions in road transportation and have thereby reduced externalities. Some but not all estimates suggest positive overall welfare effects of such policies. In the rare cases where road pricing has been applied, it has helped to reduce automobile transportation, and it has led to environmental improvements. The experience with specific driving restrictions like 'days without cars' and 'low emission zones' has been mixed. Local transportation policy can have a useful role to play as a complement to national policy instruments, but neither efficiency nor effectiveness can be taken for granted. [ABSTRACT FROM AUTHOR]

Objective: Many states are considering strengthening their graduated driving licensing (GDL) systems for teenage drivers but most do not know the level of public support for proposed upgrades. This study provides a method for states to identify specific demographic groups that may differ with regard to their awareness of teen driving risks, knowledge of current GDL law, and support for GDL upgrades. Methods: A 28-item questionnaire was administered to Connecticut adults by phone survey during January 2008. We collected demographic information and whether respondents understood driving risks, were aware of the current GDL system, and whether they would support GDL upgrades. The state's motor vehicle crash file (1999-2006) was used to calculate motor vehicle crash rate among 16- and 17-year-old drivers by town and correlate that with support for GDL upgrades. Results: Eight hundred seven people were interviewed. More women than men (92% vs. 86%, p < .05) and more parents than other adults (96% vs. 84%, p < .01) were aware of the current learner's permit law. Female respondents (55% vs. 43%, p < .01) and adults who were not parents (54% vs. 45%, p < .05) were more likely to support increasing the minimum driving age. Parents were more aware than other adults (91% vs. 73%, p < .01) of the supervised driving provision. Women were more supportive of a supervised driving upgrade (83% vs. 69, p < .01). There was more support for a night restriction upgrade among other adults than parents (59% vs. 51%, p < .05), and the lowest support was in affluent towns (38%). Two thirds supported a passenger restriction upgrade with no differences based upon sex or geographic location. There was less support for an increased penalties in Fairfield County when compared to all other counties (55% vs. 63%, p < .05) and more support in Hartford County versus all other counties (70% vs. 58%, p < .05). Conclusions: Parents of Connecticut teens were more knowledgeable of current law but less supportive of GDL upgrades compared to other adults. Women were more apt to favor GDL upgrades than men. This study identifies subgroups that can be targeted for prevention activities and illustrates a useful method to assess public support for GDL upgrades. [ABSTRACT FROM AUTHOR]

The article focuses on the efficiency of an adapted Checkpoints Program which is formulated to reduce the risk to teenage driver injury in the U.S. As stated, teen drivers are at risk for accidents and injuries due to lack of driving experience and prosperity behaviors. With regards to the accidents, the Checkpoints is formulated to facilitate clear rule-setting on driving privileges during the first year of independent driving. In addition, the goal of the program is for the parents and teens to negotiate an agreement on limits related to driving at night.

This article deals with the treatment and application of cardiac biosignals, an excited accelerometer, and a gyroscope in the prevention of accidents on the road. Previously conducted studies say that the seismocardiogram is a measure of cardiac microvibration signals that allows for detecting rhythms, heart valve opening and closing disorders, and monitoring of patients' breathing. This article refers to the seismocardiogram hypothesis that the measurements of a seismocardiogram could be used to identify drivers' heart problems before they reach a critical condition and safely stop the vehicle by informing the relevant departments in a nonclinical manner. The proposed system works without an electrocardiogram, which helps to detect heart rhythms more easily. The estimation of the heart rate (HR) is calculated through automatically detected aortic valve opening (AO) peaks. The system is composed of two micro-electromechanical systems (MEMSs) to evaluate physiological parameters and eliminate the effects of external interference on the entire system. The few digital filtering methods are discussed and benchmarked to increase seismocardiogram efficiency. As a result, the fourth adaptive filter obtains the estimated HR = 65 beats per min (bmp) in a still noisy signal (SNR = −11.32 dB). In contrast with the low processing benefit (3.39 dB), 27 AO peaks were detected with a 917.56-ms peak interval mean over 1.11 s, and the calculated root mean square error (RMSE) was 0.1942 m/s2 when the adaptive filter order is 50 and the adaptation step is equal to 0.933. [ABSTRACT FROM AUTHOR]

We developed driving restrictions that are linked to specific driving errors, allowing cognitively impaired individuals to continue to independently meet mobility needs while minimizing risk to themselves and others. The purpose of this project was to evaluate the efficacy and duration expectancy of these restrictions in promoting safe continued driving. We followed 47 drivers age 60 years and older for 18 months, evaluating driving performance at 6-month intervals. Results demonstrated restricted drivers had safety profiles similar to safe drivers and gained additional driving time to transition to nondrivers. [ABSTRACT FROM AUTHOR]

Abstract: Problem: There is limited information about how parents view teen driving risks and intend to handle these risks during the licensing process, and how they will respond to graduated licensing provisions. Methods: Parents in Connecticut were interviewed when their teens got their learner''s permit. The survey was undertaken when the state did not have a midnight restriction or a passenger restriction. Results: Generally, parents were well aware of teen driving risks, thought parents should be thoroughly involved in the licensing process, and plan to be active participants themselves. Discussion: Parents were concerned about the risk of driving after midnight and already restrict that behavior. However, parents do not seem to see or understand the risks of having even one teen passenger in the vehicle. Impact on Industry: The views and existing practices of parents need to be taken into account in deciding on the provisions of graduated licensing legislation and how to best ensure acceptance and compliance. [Copyright &y& Elsevier]

Abstract: The purpose of this study was to determine whether parent-imposed limits on 16-year-old high-risk driving are stricter in Maryland (MD), a state with graduated driver licensing (GDL) than in Connecticut (CT), a non-GDL state. In both states, parents and adolescents completed telephone surveys about the restrictions that parents placed on their adolescents’ driving at night, with adolescent passengers, and at high speeds. In Maryland, surveys took place 1 month (294 parent–adolescent pairs) and 4 months (292 parent–adolescent pairs) after provisional licensure. In Connecticut, surveys took place the first month (132 pairs) and the third month (108 pairs) after adolescent licensure. The findings indicated that after controlling for demographic characteristics, Maryland parents and adolescents reported stricter parent-imposed limits for adolescent passengers, high-speed roads, weekend night driving, and overall limits. Parents in GDL states appear better able to establish and enforce adolescent driving restrictions when the licensing state stipulates, favors, and supports regulated adolescent driving. [Copyright &y& Elsevier]

Driving restrictions are a common governmental strategy to reduce airborne pollution and traffic congestion in many cities of the world. Using high-frequency data on air pollution, car trips, and mass-transit systems ridership, I evaluate the effectiveness of temporary driving bans triggered by air quality warnings in Santiago, Chile. I employ a fuzzy regression discontinuity design that uses the thresholds in the air quality index used to announce these warnings as instruments for their announcement. Results show that these temporary bans reduce car trips by 6–9% during peak hours, and by 7–8% during off-peak hours. This is consistent with air pollution reductions during peak hours, and with increases in the use of Santiago's mass-transit systems during hours the systems run with excess capacity. Increments in mass-transit ridership uncover the importance of alternative modes of transportation in securing the effectiveness of temporary driving bans. [ABSTRACT FROM AUTHOR]