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Objectives: To review literature and guidelines related to the process of determining driving safety in people with dementia., Method: Four electronic databases were searched in December 2016/January 2017. We limited our search to literature and guidelines published in the UK, USA, Canada, New Zealand and Australia., Results: General practitioners are primarily responsible for driver licensing; however, they often feel ill-equipped and it can compromise the therapeutic relationship. Occupational therapist driving assessment is considered as the 'gold-standard' but is costly and often not available. Medical advisory boards assist the assessment process by providing independent licencing decisions., Conclusions: General practitioner training, funding for occupational therapist driving assessment and the establishment of a medical advisory board could be considered to improve the current practice of driving assessment in dementia.

Issues Addressed: This paper investigates the influence of mood while driving, advocates for identifying high-risk groups and detects associations between mood while driving and risky driving behaviours. While commensurate studies regarding aggressive driving have confirmed significant detriments in driving performance, little scholarly research has studied the gaps and opportunities at the intersection of mood and risky driving in young drivers., Methods: A cross-sectional design was implemented using 660 young drivers (17-25 years) from Australia (34.7%) and Colombia (65.3%), who completed the Behaviour of Young Novice Drivers Scale (BYNDS). Cluster analysis differentiated young drivers across two groups: high-risk and low-risk driving while influenced by mood. Hierarchical segmentation analysis explored the relationship between driver mood and self-reported risky driving behaviour., Results: Young drivers reported frequent driving while influenced by mood. The typical risky driving behaviours of young drivers who are emotion-affected are transient violations (eg, speeding) and risky exposure (eg, driving tired)., Conclusions: Risky driving behaviours that have been found to increase the risk of road injury (speeding, fatigued driving) and to decrease the survivability of road crashes (speeding) are inextricably intertwined with the influence of driver mood upon driving behaviour at an international level. Driver mood is a neglected issue in health promotion programs for young drivers. SO WHAT?: Current health promotion interventions for young drivers safety such as Graduated Driver Licensing may not prevent driving while influenced by mood. Additional strategies are required to minimise the exposure to driving while affected by negative mood., (© 2018 Australian Health Promotion Association.)

Objectives: What are we teaching drivers about safely interacting with cyclists? This is the main objective of the Cycle Aware project. As part of the study, a teaching and learning package is being developed to fill this gap in Australia., Methods: Cycle Aware is a major national project that takes a mixed methods approach to investigate how cyclists are taught to share the road with cyclists when learning to drive. The project has five stages: (1) a national review of the driver licensing documentation; (2) interviews with key stakeholders (n = 35) involved with novice driver education; (3) analysis of cyclist-novice driver crash data to identify the most frequent crash types; (4) develop a teaching and learning package (Cycle Aware Package), and; trial and evaluate Cycle Aware Package., Results: Overall, drivers are taught little about sharing the road with cyclists. Representation of cyclists in government documentation is mixed and mostly negative and interviews identified driver-cyclist tensions related to attitudes and awareness of sharing the road. Crash types were similar among novice and experienced drivers. The Cycle Aware Package is being finalised and will be trialled in South Australia and Northern Territory in early 2019., Conclusions: Cycle Aware will provide new insights into the way drivers are taught to share the road with cyclists. The Cycle Aware Package with interactive online content and driver competencies will facilitate a new approach to addressing this gap among Australia drivers.

Introduction: With an ageing population, policy makers need to balance active ageing needs with older driver safety. In 2009, a survey of licensing policies for taxi drivers in Singapore, Hong Kong and Australia was undertaken for an evidence-based review of policies., Methods: Licensing requirements collected using semi-structured questionnaires were compared descriptively and with evidence from licensing policies on older drivers., Results: All the regions used medical certifications with vision screening. The frequency of medical certification varied according to the renewal cycle and age. Medical guidelines on fitness to drive were available in Australia and Singapore. Legislation for self-reporting of medical conditions by drivers existed in Australia and Hong Kong. Legislation for reporting at-risk drivers by doctors was limited to two Australian states. There were differences in the minimum age and driving experience criteria, the use of practical training, written and English tests, age-based screening, mandatory retirement age, refresher courses, off- and on-road tests., Conclusion: Medical screening for at-risk drivers remains crucial. Age-based mandatory retirement policy at 73 years in Singapore is contrary to evidence-based practice. The lack of legislation for self-reporting of illness by drivers, the high minimum age criteria and therapy driving assessments for healthy taxi drivers are also unique to Singapore. There was stricter age-based relicensing from the age of 65 years in some Australian states and in Singapore. Continuing education for doctors, multi-tier screening for at-risk drivers and licensing policy changes are indicated.

Regina v Gillett deals with a man who did not disclose his epilepsy when seeking a drivers licence. Subsequently, he had a seizure while driving, causing an accident in which three people died. He was found guilty but appealed. During the trial to decide whether Gillett was guilty of dangerous driving occasioning death, the judge decided that the Austroads fitness-to-drive guidelines were extraneous to legal consideration of the acceptable risk to be attached to chronic medical conditions. Although the appeal was unsuccessful with respect to guilt and sentencing, it did reinstate the relevance of the Austroads guidelines when evaluating suitable risk with respect to potentially dangerous drivers. We suggest that even greater protection can be afforded to the community if a clearly enunciated warning, outlining a driver's responsibilities, were to appear on each drivers license.

There are still many countries, which have not yet developed uniform recommendations on how to certify fitness to drive among people with diabetes mellitus. Studies on this problem from the European Union emphasize that recommendations issued in Canada, Australia and New Zealand are most unequivocal. There are a lot of factors affecting fitness to drive, therefore, assessing medical fitness to drive among driver candidates, as well as of persons who have a driving license but are obliged to extend its validity is absolutely essential. Health impairments may influence the ability to drive and lead to serious consequences. In all countries under study, the incidence and unawareness of hypoglycemia is the most important risk factor that influences fitness to drive. It is also important to take into consideration the current treatment modality. The presence and progress of chronic diabetic complications, which may influence driving must be assessed. Diabetes mellitus is a complex problem. Certifying fitness to drive among people with diabetes, the risk of road traffic accident for an individual and for other participants need to be well balanced.

Most licensing jurisdictions in Australia currently employ age-based assessment programs as a means to manage older driver safety, yet available evidence suggests that these programs have no safety benefits. This paper describes a community referral-based model license re assessment procedure for identifying and assessing potentially unsafe drivers. While the model was primarily developed for assessing older driver fitness to drive, it could be applicable to other forms of driver impairment associated with increased crash risk. It includes a three-tier process of assessment, involving the use of validated and relevant assessment instruments. A case is argued that this process is a more systematic, transparent and effective process for managing older driver safety and thus more likely to be widely acceptable to the target community and licensing authorities than age-based practices.

Unlabelled: Certifying the competence of neurosurgeons is a process of critical importance to the people of Australia and New Zealand. This process of certification occurs largely through the summative assessment of trainees involved in higher neurosurgical training. Assessment methods in higher training in neurosurgery vary widely between nations. However, there are no data about the 'utility' (validity, reliability, educational impact) of any national (or bi-national) neurosurgical training system. The utility of this process in Australia and New Zealand is difficult to study directly because of the small number of trainees and examiners involved in the certifying assessments. This study is aimed at providing indirect evidence of utility by studying a greater number of trainees and examiners during a formative assessment conducted at a training seminar in Neurosurgery in April 2005., Aim: To evaluate an essay examination for neurosurgical trainees for its validity, reliability and educational impact., Methods: A short answer essay examination was undertaken by 59 trainees and corrected by up to nine examiners per part of question. The marking data were analysed. An evaluation questionnaire was answered by 48 trainees. Eight trainees who successfully passed the Fellowship examination who had also taken the short essay examination underwent a semi-structured interview., Results: The essay examination was found to be neither reliable (generalisability coefficient of 0.56 if the essay paper had comprised 6 questions) nor valid. Furthermore, evidence suggests that such an examination may encourage a pursuit of declarative knowledge at the expense of competence in performing neurosurgery., Conclusion: This analysis is not directly applicable to the Fellowship examination itself. However, this study does suggest that the effect of assessment instruments upon neurosurgical trainees' learning strategies should be carefully considered.

Background: The national standards for assessing private and commercial vehicle drivers have recently been revised and combined into a single publication 'Assessing Fitness to Drive', published by Austroads. The new publication provides greater clarity of medical criteria for general practitioners and specialists and also details useful management guidelines., Objective: This article introduces GPs to the new standards, outlines the key changes and implications for practice and highlights several medical, legal and ethical issues., Discussion: Assessment of fitness to drive is a common issue in patient management and one that carries significant health, safety and lifestyle consequences both for the drivers themselves and other road users.