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ABSTRACT While individual studies from several South American countries have shown driving while intoxicated to be a problem, there are no objective systematically collected alcohol-associated driving data obtained in most South American countries. This limits their ability to implement and enforce targeted prevention strategies, evaluate whether proven prevention efforts from North America (particularly the United States and Canada) can be transferred to the South, and to sustain momentum for the improvement of road safety by demonstrating that previously implemented legal and policy changes are effective. The aim of this paper is to discuss the abysmal differences that exist between northern and southern American countries regarding the current status of driving while intoxicated prevention strategies-their implementation, impacts and effects-using Brazil as a case example. We propose a three-pronged approach to close this northern-southern American gap in driving while intoxicated prevention and intervention: (a) systematic collection on road traffic crash/injury/death as well as risk factor data, (b) passage of laws without loopholes requiring compliance with blood alcohol concentration testing and (c) provision of appropriate training and equipment to the police in concomitance with vigilant enforcement. Resources and energies must be put towards data collection, implementation of prevention strategies and enforcement in order to decrease the unacceptably high rates of these preventable driving while intoxicated deaths. [ABSTRACT FROM AUTHOR]

The authors discuss the commentaries on their paper on the effectiveness of reducing the blood alcohol concentration (BAC) from 0.08 to 0.05 as a alcohol limit for drivers. They state their gratitude to the commentaries given by doctor Mary Sheehan and chief executive officer (CEO) Stephen K. Talpins. They also mention that lowering the BAC limit could portray the public that the law becomes stricter to reduce the accidents because of drivers drunkenness.

The author comments on the paper "Why don't northern American solutions to drinking and driving work in southern America?" by F. Pechansky and A. Chandran, which addresses the lack of policies regarding drinking and driving. According to her, lack of data or laws is not a problem in Brazil but lapses in the enforcement of existing laws is. She refers to several studies on drunk driving and suggests acquiring a better understanding of the problem through research and monitoring.

Abstract: Driving regulations are complex, particularly for neurological conditions, but accurate application of restrictions is important. This study was designed to investigate knowledge of the Austroads guidelines in medical students, neurological trainees and consultant neurologists using a questionnaire addressing both private and commercial licence restrictions related to five common neurological conditions, namely transient ischaemic attack (TIA), vasovagal episode, unwitnessed blackout, first epileptic seizure and benign paroxysmal positional vertigo. In total, 118 of the 120 returned responses could be analysed. Overall, 50% of all responses were correct. Respondents performed better for private than commercial licences, and consultants performed better than trainees and students. The highest proportion of correct answers was seen for vasovagal attack, and the lowest for TIA. In summary, knowledge of driving restrictions was relatively poor, and regular consultation of the guidelines is recommended. A larger study is warranted and increased education at both medical school and postgraduate levels should be considered. [ABSTRACT FROM AUTHOR]

The author comments on "Why don't northern American solutions to drinking and driving work in southern America?" by F. Pechansky and A. Chandran about the status of control and prevention of driving while intoxicated (DWI) in Brazil. Although he agrees with the study, he highlights that Mothers Against Drunk Driving (MADD) group of victims of DWI has been an extreme force for change in U.S. cultural views on DWI. He also mentions the importance of working with communities and advocacy groups.

The author comments on the article "Why don't northern American solutions to drinking and driving work in southern America?" by F. Pechansky and A. Chandran. She highlights the points addressed by the authors of the study regarding aspects lacking in Brazil and notes that the issue of advocacy and active popular support is not taken into consideration by the study. She opines that active participation as a critical factor to tackle the state of affairs of drinking and driving rates.

A large literature has documented significant public health benefits associated with the minimum legal drinking age in the USA, particularly because of the resulting effects on motor vehicle accidents. These benefits form the primary basis for continued efforts to restrict youth access to alcohol. It is important to keep in mind that policymakers have a wide variety of alcohol-control options available to them, and understanding how these policies may complement or substitute for one another can improve policy making moving forward. Towards this end, we propose that investigating the causal effects of the minimum legal drinking age in New South Wales, Australia, provides a particularly informative case study, because Australian states are among the world leaders in their efforts against drunk driving. Using an age-based regression discontinuity design applied to restricted-use data from several sources, we find no evidence that legal access to alcohol has effects on motor vehicle accidents of any type in New South Wales, despite having large effects on drinking and on hospitalizations due to alcohol abuse. Copyright © 2015 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

Aims To examine gradual change in debt problems, divorce and income among men in Finland before and after a first conviction for driving under the influence ( DUI). Design and Setting A register-based longitudinal study conducted in Finland between 1999 and 2013. Participants A nationally representative sample of 70 659 Finnish males born between 1918 and 1983, and a subsample of males ( n = 1782) who had their first DUI conviction during 2005-2012. Measurements Descriptive statistics showing the socio-demographic and economic determinants of DUI. The main analysis was based on a longitudinal, within-individual setting. The impact of DUI on debt problems, divorce and income was analysed using random effects regression models. Findings DUI offenders were more likely to be younger and to have lower education and income than the non- DUI group. Criminal convictions were also more common among DUI offenders. Debt problems, divorce and loss of income were more likely after the DUI incident than before. The already increasing level of debt problems accelerated after the incident and divorce rates increased after the DUI incident, whereas the decrease in income was gradual over the whole observation period. Conclusions Among men in Finland, DUI offences are more common among vulnerable social groups. The first drunk-driving conviction among men in Finland constitutes a significant life event that appears to increase the likelihood of financial problems and divorce. [ABSTRACT FROM AUTHOR]

The National Transportation Safety Board recently recommended that states establish a per se blood alcohol concentration ( BAC) limit of 0.05 or lower for all drivers who are not already required to adhere to lower BAC limits in a national effort to reduce alcohol-impaired driving. There is strong evidence for adopting this recommendation. A comprehensive review of the literature on BAC limits was conducted. The research indicates that virtually all drivers are impaired regarding at least some driving performance measures at a 0.05 BAC. The risk of being involved in a crash increases significantly at 0.05 BAC and above. The relative risk of being killed in a single-vehicle crash with BACs of 0.05-0.079 is 7-21 times higher than for drivers at 0.00 BAC. Lowering the BAC limit from 0.08 to 0.05 has been a proven effective countermeasure in numerous countries around the world. Most Americans do not believe a person should drive after having two or three drinks in 2 hours. It takes at least four drinks for the average 170-pound male to exceed 0.05 BAC in 2 hours (three drinks for the 137-pound female). Most industrialized nations have established a 0.05 BAC limit or lower for driving. Progress in reducing the proportion of drivers in fatal crashes with illegal BACs has stalled over the past 15 years. Lowering the BAC limit for driving from the current 0.08 to 0.05 has substantial potential to reduce the number of people who drink and drive in the United States and get involved in fatal crashes. [ABSTRACT FROM AUTHOR]

Young male drivers are overrepresented in road-related fatalities. Speeding represents a pervasive and significant contributor to road trauma. Antispeeding messages represent a long-standing strategy aimed at discouraging drivers from speeding. These messages, however, have not always achieved their persuasive objectives that may be due, in part, to them not always targeting the most salient beliefs underpinning the speeding behavior of particular driver groups. The current study elicited key beliefs underpinning speeding behavior as well as strategies used to avoid speeding, using a well-validated belief-based model, the theory of planned behavior, and in-depth qualitative methods. To obtain the most comprehensive understanding about the salient beliefs and strategies of young male drivers, how such beliefs and strategies compared with those of drivers of varying ages and gender, was also explored. Overall, 75 males and females (aged 17-25 or 30-55) participated in group discussions. The findings revealed beliefs that were particularly relevant to young males and that would likely represent key foci for developing message content. For instance, the need to feel in control and the desire to experience positive affect when driving were salient advantages; while infringements were a salient disadvantage and, in particular, the loss of points and the implications associated with potential license loss as opposed to the monetary (fine) loss (behavioral beliefs). For normative influences, young males appeared to hold notable misperceptions (compared with other drivers, such as young females); for instance, young males believed that females/girlfriends were impressed by their speeding. In the case of control beliefs, the findings revealed low perceptions of control with respect to being able to not speed and a belief that something 'extraordinary' would need to happen for a young male driver to lose control of their vehicle while speeding. The practical implications of the findings, in terms of providing suggestions for devising the content of antispeeding messages, are discussed. [ABSTRACT FROM AUTHOR]

The article presents an overview of the various rehabilitation concepts used to re-train driving skills in people with neurological conditions, including stroke, Alzheimer's disease and Parkinson's disease. It discusses the difficulties encountered during attempts to implement the concepts in rehabilitation or driving assessment centers. The article provides recommendations to streamline the license re-certification procedures.

By 1998, all states had passed laws lowering the legal blood alcohol content for drivers under 21 to effectively zero. Theory shows these laws have ambiguous effects on overall fatalities and economic efficiency, and the data show they have little effect on driver behavior. A panel analysis of the 1988–2000 Fatality Analysis Reporting System indicates that zero tolerance laws have no material influence on the level of fatalities, while quantile regression reveals virtually no change in the distribution of blood alcohol content among drivers involved in fatal accidents. ( JEL: I18, K32, D11) [ABSTRACT FROM AUTHOR]

Summary: Purpose: The driving regulations in Japan were amended in 2002, which lifted the absolute ban on driving by persons with epilepsy (PWE) and granted licenses to PWE after a 2-year seizure-free period. Methods: To survey the effect of the new driving regulations, we sent questionnaires both to the driving authorities (DAs) and to doctors of the Japan Epilepsy Society (JES). Results: Around 1,400 PWE legally obtained a driving license within 1 year after the amendment, licenses were rejected in 157, and 61 had the license withheld for <6 months. In most cases, the attending doctor assessed fitness for driving; 171 doctors responded to the questionnaire. One third of them commented on a positive change in attitude of PWE with respect to driving. Their main remarks included the need to shorten the seizure- free period to qualify for fitness to drive and the need for special guidelines for conditions such as rare seizure occurrence, recently diagnosed epilepsy, or reflex epilepsy. Problems of assessment identified included difficulty in deciding the time for reassessment, distress of PWE over cancellation of license, cost of the assessment, responsibility of the assessing doctors in case of seizure recurrence, and protection of privacy. They requested the DAs to promote publicity about the information and asked the JES to establish a guideline for assessing fitness to drive. Conclusions: The results highlighted the need for cooperation between the DAs and the JES for further amendment of the regulations as well as the importance of education for the public, patients, and professionals. [ABSTRACT FROM AUTHOR]

A letter to the editor is presented which is concerned with research which investigated state driving laws in all 50 U.S. states and the impact they had on automobile accident rates.

The article reports on research which was conducted with family members of Japanese elders with dementia to determine what sort of supports could be provided to help the elders remain independent. Researchers conducted an online survey with 2,000 Japanese people aged 40 and older with an elder who was classified as needing support. They found that the support that was most needed by the elders was providing then with opportunities and places that were easily accessible in their community.