Cardiac cycle timing intervals in university varsity athletes.

Cardiac cycle timing events in varsity athletes serve an important function for baseline assessment but are not reported in the literature. The purpose of this study was to characterise the cardiac cycle timing intervals and contractility parameters in university-level varsity athletes. 152 males and 93 females were assessed using a non-invasive seismocardiography cardiac sensor attached to the sternum for 1-minute. Shorter isovolumic relaxation time (IVRT), systolic time, mitral valve open to E-wave (MVO to E) time, rapid ejection period (REP), atrial systole to mitral valve closure (AS to MVC) time, and diastolic performance index (IVRT/systolic time) were found in females, while heart rate was lower in males. Varying differences in timing intervals were found between sports. Systolic times were longer in male and female basketball players, while diastole was shortest in male football players, who also had higher heart rates than the other male sport athletes. These results add reference cardiac cycle timing data to the literature and imply that male and female athletes show different cardiac characteristics. Team differences suggest that different training for different sports can result in unique cardiac function changes, however, these appear to be related to the sex of the participants. The addition of these cardiac cycle timing intervals adds a valuable comparative tool to better understand cardiac physiology in the varsity athletic population.HIGHLIGHTS Given the lack of data in the literature on athlete's cardiac cycle timing intervals, we provide normative values for healthy, university varsity athletes, including stratification by sex and sport.Male and female athletes show different cardiac cycle timing intervals, including the systolic and isovolumic relaxation timing intervals.Differences in cardiac cycle timing intervals are also present when comparing different sports.

Cardiac cycle timing and contractility following acute sport-related concussion.

Cardiac sequelae following sport-related concussion are not well understood. This study describes changes in the cardiac cycle timing intervals and contractility parameters during the acute phase of concussion. Twelve athletes (21 ± 2 years, height = 182 ± 9 cm, mass = 86 ± 15 kg, BMI = 26 ± 3 kg/m2) were assessed within 5 days of sustaining a diagnosed concussion against their own pre-season baseline. A non-invasive cardiac sensor (LLA RecordisTM) was used to record the cardiac cycle parameters of the heart for 1 minute during supine rest. Cardiac cycle timing intervals (Isovolumic relaxation and contraction time, Mitral valve open to E wave, Rapid ejection period, Atrial systole to mitral valve closure, Systole, and Diastole) and contractile forces (Twist force and Atrial systole: AS) were compared. Systolic time significantly decreased during acute concussion (p = 0.034). Magnitude of AS significantly increased during acute concussion (p = 0.013). These results imply that concussion can result in altered systolic function.

Self-regulation differences across learner and probationary drivers: The impact on risky driving behaviours.

Risky driving behaviours are a known contributor to young drivers' overrepresentation in road trauma, with self-regulation suggested as an important associated construct, but yet to be extensively explored. The aims of this study were to examine the utility of self-determination theory in explaining risky driving behaviours and to explore differences between young Learner and Provisional (P1)- licensed drivers in regard to their self-regulated safety orientation and engagement in risky driving behaviours. Learners (n = 1038) and P1(n = 589) drivers, aged 16-19 years, responded to a 91-item online survey, including self-regulated safety orientation items adapted from self-determination theory and inattentive and intentional risky driving behaviour items. Results showed that self-determination theory had good predictive power for the two types of risky driving behaviours for both licence groups. Learner and P1 drivers' engagement in risky behaviours was similar, however, the relative importance of self-regulated safety orientation elements to reduced engagement in these behaviours differed. Learners' engagement in intentional risky behaviours reflected greater perceived effort/importance and pressure/tension compared to P1 drivers. Greater effort/importance is an overarching indicator of internalised regulation concerning safe driving behaviours, which might be primed when first exposed to driving. However, greater perceived pressure/tension suggests that internalisation of self-regulatory processes is being suppressed during the Learner phase. This might stem from the required presence of driver trainers and supervisory drivers, as well as interactions with other road users. Whilst only tentative explanations in this first exploration, the findings suggest there is potential for greater efforts in Learner driver training and supervision to encompass the types of skills and learning that encourage the development of self-regulation to reduce risky driving behaviours during both the Learner and P1 stage. These findings contribute to the limited research regarding self-regulation by young novice drivers and informs a better understanding of the psychological influences of engagement in risky driving behaviours, including the first such examination among early independent licensed drivers.

Higher-order driving instruction and opportunities for improvement: Exploring differences across learner driver experience.

INTRODUCTION: Few studies have investigated what guidance occurs during the Learner phase of driving, particularly during formal lessons. The objective of this research was threefold: (a) investigate functional and higher-order driving instruction (HO-DI) in formal Learner lessons, (b) explore teaching approaches within the context of a theoretical framework, and (c) investigate variation in these three elements of instruction as a function of Learner driving experience. The theoretical framework developed to guide this research integrated the constructivist Goals for Driver Education and self-determination theory. METHOD: Professional instruction was explored through naturalistic observation; 15 instructors provided GoPro recordings of 110 driving lessons with Learners aged 16-19 years (n = 96) at varying levels of experience: Early (<20 logbook hours), Mid (21-70 h), and Late (71->100 h). RESULTS: Employing a previously-developed coding taxonomy, instructor guidance opportunities were identified as 15% HO-DI, 73% functional instruction, and 12% untaken or missed HO-DI. Functional instruction peaked in the Mid Phase, while HO-DI was prominent in the Early phase suggesting missed opportunities in the later phases when use of silence peaked. Some elements of self-determination theory's needs-supportive model were readily identified in teaching approaches, such as feedback. CONCLUSIONS: An understanding of functional and HO-DI, including teaching strategies, was established within the context of an integrated theoretical framework, with different trajectories across Learner experience identified. Teaching strategies reflected constructivism and self-determination theory providing theoretical support for these frameworks to be applied in future driver training studies. Continued research efforts are needed to understand how best to balance functional and HO-DI to maximize young novice drivers' learning prior to independent driving, particularly during the late Learner period. Practical Applications: Naturalistic observation of current HO-DI and teaching approaches supports the feasibility of integrating recommended improvements arising from the theoretical framework within current practice, with practical implications for improvements to industry training.

Association between higher-order driving instruction and risky driving behaviours: Exploring the mediating effects of a self-regulated safety orientation.

Adolescents' risky driving behaviours contribute to their over-representation in road trauma. Higher-order driving instruction is suggested to reduce such behaviours. To sustain positive behaviours in the long-term, self-determination theory identifies self-regulation as fundamental. The current research explored associations between higher-order driving instruction, risky driving behaviours, and a self-regulated safety orientation. Learner drivers (n = 544), aged 16-19 years, responded to a 91-item survey. Self-regulated safety orientation was found to fully mediate the relationship between higher-order driving instruction and inattentive risky driving behaviours, and between anticipatory higher-order driving instruction and intentional risky driving behaviours. A partial mediation was found between self-regulatory higher-order instruction and intentional risky driving behaviours. These results support that higher-order driving instruction, delivered to develop a self-regulated safety orientation, has potential to reduce young novice drivers' risky driving behaviours. Further research is recommended to triangulate these results through direct observation and longitudinal evaluation.

Fast and furious: A neglected issue in health promotion among young drivers.

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.

Development of a higher-order instruction coding taxonomy for observational data: Initial application to professional driving instruction.

Development of a higher-order instruction taxonomy, informed by best practice in driver education (Goals for Driver Education) and self-determination theory (guiding teaching strategies), was tested. Inter-coder reliability was assessed by coding 93 data elements from 5-min clips from three driving instructors. Seventy-three instruction and 32 teaching approach codes were selected. Reliability between two independent coders was high (IOC = 94.6%). Application to data from 17 randomly-selected, 1-h lessons (n = 3 driving instructors) in a pilot study of professional learner driver lessons assessed taxonomy validity. Missed, taken, and untaken opportunities for higher-order instruction via 9 instruction and 19 teaching-approach categories were identified. Reliability assessment and taxonomy application demonstrates evidence to facilitate a comprehensive understanding of driving instruction content and quality, with implications for assessing and evaluating the impact of higher-order instruction in relation to driving and other safety-critical sectors requiring higher-order skills.

A qualitative exploration of driving stress and driving discourtesy.

BACKGROUND: Driving courtesy, and conversely driving discourtesy, recently has been of great interest in the public domain. In addition, there has been increasing recognition of the negative impact of stress upon the individual's health and wellbeing, with a plethora of interventions aimed at minimising stress more generally. The research literature regarding driving dis/courtesy, in comparison, is scant, with a handful of studies examining the dis/courteous driving behaviour of road users, and the relationship between driving discourtesy and driving stress. AIM: To examine courteous and discourteous driving experiences, and to explore the impact of stress associated with such driving experiences. METHOD: Thirty-eight drivers (20 females) from the Sunshine Coast region volunteered to participate in one of four 1-1.5 h focus groups. Content analysis used the verbatim utterances captured via an Mp3 device. RESULTS: Three themes pertaining to stressful and discourteous interactions were identified. Theme one pertained to the driving context: road infrastructure (eg, roundabouts, roadwork), vehicles (eg, features), location (eg, country vs city, unfamiliar areas), and temporal aspects (eg, holidays). Theme two pertained to other road users: their behaviour (eg, tailgating, merging), and unknown factors (eg, illicit and licit drug use). Theme three pertained to the self as road user: their own behaviours (eg, deliberate intimidation), and their emotions (eg, angry reaction to other drivers, being in control). DISCUSSION AND CONCLUSIONS: Driving dis/courtesy and driving stress is a complex phenomenon, suggesting complex intervention efforts are required. Driving discourtesy was reported as being highly stressful, therefore intervention efforts which encourage driving courtesy and which foster emotional capacity to cope with stressful circumstances appear warranted.

Young drivers and their cars: Safe and sound or the perfect storm?

Consistent with the experiences in high-income countries, young drivers remain overrepresented in road trauma statistics in low- and middle-income countries. This article pursues the emerging interest of approaching the young driver problem from a systems thinking perspective in order to design and deliver robust countermeasures. Specifically, the focus of this paper is the cars driven by young drivers. The study of vehicles' characteristics and their interaction with driving behaviour is, more often than not, considered a minor concern when developing countermeasures in young drivers' safety not only in developed nations, but especially in developing nations. Participants completed an online survey containing the 44-item Behaviour of Young Novice Drivers Scale Spanish version (BYNDS-Sp), in addition to providing information regarding their vehicle, any crash involvement, and driving offences. Based on the vehicle model information, the assessment of vehicle safety was conducted for three safety programs (ANCAP, Latin NCAP, U.S. NCAP). Young drivers in Colombia reported a breadth of risky driving behaviours worth targeting in broader interventions. For example, interventions can target speeding, particularly as three quarters of the participants drove small-medium cars associated with poorer road safety outcomes. Moreover, risky driving exposure was highly prevalent amongst the young driver participants, demonstrating the need for them to be driving the safest vehicles possible. It is noteworthy that few cars were able to be assessed by the Latin NCAP (with half of the cars rated having only 0-2 star ratings), and that there was considerable discrepancy between ANCAP, U.S. NCAP, and Latin NCAP ratings. The need for system-wide strategies to increase young driver road safety-such as improved vehicle safety-is vital to improve road safety outcomes in jurisdictions such as Colombia. Such improvements may also require systemic changes such as enhanced vehicle safety rating scales and investigation of the nature of vehicles sold in developing nations, particularly as these vehicles typically contain fewer safety features than their counterparts sold in developed nations.

The sex disparity in risky driving: A survey of Colombian young drivers.

OBJECTIVE: The overrepresentation of young drivers in poor road safety outcomes has long been recognized as a global road safety issue. In addition, the overrepresentation of males in crash statistics has been recognized as a pervasive young driver problem. Though progress in road safety evidenced as a stabilization and/or reduction in poor road safety outcomes has been made in developed nations, less-developed nations contribute the greatest road safety trauma, and developing nations such as Colombia continue to experience increasing trends in fatality rates. The aim of the research was to explore sex differences in self-reported risky driving behaviors of young drivers, including the associations with crash involvement, in a sample of young drivers attending university in Colombia. METHODS: The Spanish version of the Behaviour of Young Novice Drivers Scale (BYNDS-Sp) was applied in an online survey to a sample of 392 students (225 males) aged 16-24 years attending a major university. Appropriate comparative statistics and logistic regression modeling were used when analyzing the data. RESULTS: Males reported consistently more risky driving behaviors, with approximately one quarter of all participants reporting risky driving exposure. Males reported greater crash involvement, with violations such as speeding associated with crash involvement for both males and females. CONCLUSION: Young drivers in Colombia appear to engage in the same risky driving behaviors as young drivers in developed nations. In addition, young male drivers in Colombia reported greater engagement in risky driving behaviors than young female drivers, a finding consistent with the behaviors of young male drivers in developed nations. As such, the research findings suggest that general interventions such as education, engineering, and enforcement should target transient rule violations such as speeding and using a handheld mobile phone while driving for young drivers in Colombia. Future research should investigate how these interventions could be tailored specifically for the Colombian cultural context, including how their effects can be evaluated, prior to implementation.

An analysis of child deaths by suicide in Queensland Australia, 2004-2012. What are we missing from a preventative health services perspective?

BACKGROUND: This article analyzes case descriptions of child suicides from 2004 to 2012 to inform future policy and practice. METHODS: Quantitative data and case descriptions for 159 child suicides (less than 18 years) in Queensland, Australia, were analyzed quantitatively using SPSS and qualitatively using automated content analysis (Leximancer). RESULTS: More than three quarters of child suicides involved hanging and 81% of suicides occurred in the family home. Less than 20% of the deceased left a note, however there was evidence of planning in 54% of cases. Most common triggering events were family conflicts. CONCLUSIONS: Effective suicide prevention interventions require a comprehensive understanding of risk factors. Quality of case descriptions varied widely, which can hamper injury prevention efforts through an incomplete understanding of characteristics of and important factors in child suicide. Additional attention and resources dedicated to this public health issue could enhance the development and implementation of effective intervention strategies targeting child and adolescent suicide.

Are you okay to drive? Commuting behavior and blood alcohol concentrations among restaurant diners.

OBJECTIVE: Drink driving is widely recognized as a major road safety problem. In Australia, health promotion messages encourage monitoring the number of standard drinks consumed prior to driving. This pilot research aimed to investigate commuting behavior and blood alcohol concentration (BAC) of diners, including intended drivers, at Sunshine Coast restaurants. METHODS: Five hundred and forty-four diners (n = 260 males) consented to participate in a brief interview and to use a breathalyzer device to measure their BAC. RESULTS: Forty percent of participants advised they don't drink and drive (34% of males, 45% of females; 67.25% of <17-20 years, 30.5% of 50-59 years), and of the remaining participants, 75% advised they count the number of their drinks (69% of males, 84% of females; 32% of <17-20 years, 82% of 50-59 years), while 10% of participants monitored their BAC by how they were feeling (12% of males, 6% of females). Thirty-seven percent of participants said it was easy/very easy to estimate their BAC (41% of males; 33% of females; 21% of <17-20 years, 43% of 50-59 years). The actual BAC was less than expected for 56% of participants, with one-third underestimating BAC and some intended drivers having an actual BAC in excess of the 0.05 limit. CONCLUSIONS: Given the proportion of diners who reported they count the number of drinks, or use feelings as a way to gauge BAC, coupled with the considerable proportion who underestimated their BAC, a safer public health message is to avoid driving if you intend to drink. In addition, targeted intervention for experienced drivers (and, arguably, drinkers) appears warranted, as every participant aged less than 21 years who stated he or she would drive home indeed had a zero BAC. Interestingly every female driver who stated she would be driving home also had a legal BAC, suggesting gender-specific intervention.

Provisional drivers' perceptions of the impact of displaying P plates.

OBJECTIVE: P plates (or decals) identify a driver's license status to other road users. They are a compulsory part of the graduated driver licensing system in Queensland, Australia, for drivers on a P1 (provisional 1) or P2 (provisional 2) license. This study explored the perceptions of young drivers regarding the display of P plates (decals) in Queensland, Australia. METHODS: In this study, 226 young drivers with a provisional (intermediate/restricted) license completed a 30-min online survey between October 2013 and June 2014. t Tests were used to compare the opinions of people who displayed their plates nearly always with those who displayed them less frequently. RESULTS: Participants approved of the requirement to display P plates with 69% of those on a P1 license and 79% on a P2 license supporting the condition to display P1 (red) plates. Participants on a P1 license (62%) and a P2 license (68%) also approved the requirement to display P2 (green) plates. However, young drivers also perceived that the display of P plates (measured from 1 = never to 5 = nearly all the time) enabled newly licensed drivers to be targeted by police and other drivers (those who do not always display P plates: M = 3.72, SD = 0.94; those who nearly always display P plates: M = 3.43, SD = 1.09). CONCLUSIONS: The study findings suggest that participants who nearly always display their P plates are more likely to report that having to display their plates resulted in them driving more carefully.

Obstacles to engaging in young driver licensing: Perspectives of parents.

INTRODUCTION: Young novice drivers remain at greater risk of injury and death despite a wealth of interventions including graduated driver licensing (GDL) programs. The key to implementing safer practices inherent in GDL appears to lie with optimising the role of parents. This qualitative research explored the parent's perspectives of obstacles to engaging in the driver licensing process within a GDL program. Parents also shared advice on what they found helpful, and where relevant, recommended changes in the process to enable safer practices for young drivers. METHOD: Twenty-three parents (aged 35-60 years, M=49.52, SD=8.01, 11 males) participated in semi-structured interviews regarding licensing experiences with their young driver children. The young drivers included learner (n=11), provisional (restricted/intermediate) (n=9) and open (unrestricted/full) licence drivers (n=3), ranging from 16 to 24 years (M=18.04, SD=2.21, 13 males). FINDINGS AND CONCLUSIONS: Content analysis revealed that most obstacles were encountered at the learner licensing phase, with the parent-reported difficult temperament of the learner driver the most prominent. Unsurprisingly, advice to other parents to be patient and remain calm featured heavily during the same phase. Anxiety from not having control of the vehicle was another obstacle at the learner phase, translating to anxieties for child safety in the early stages of provisional driving. Recommendations for the current GDL included more rigorous road rule testing, with general support for the program, professional driver training at learner and provisional stages facilitated parental engagement through the licensing phases. PRACTICAL APPLICATIONS: The findings overwhelmingly suggest a need for parents to be educated regarding their importance in, and of, the driver licensing process, and the efficacy of their instruction, content and practices.

Young driver risky behaviour and predictors of crash risk in Australia, New Zealand and Colombia: Same but different?

Young drivers remain overrepresented in road crashes around the world, with road injury the leading cause of death among adolescents. In addition, the majority of road traffic crashes, fatalities and injuries occur in low- and middle-income countries. All young drivers are at risk due to a breadth of age- and inexperience-related factors; however it is well recognised that young drivers may also intentionally engage in risky driving behaviours which increase their crash risk. The aim of this paper is to examine the self-reported risky driving behaviour of young drivers in Australia, New Zealand (high-income countries), and Colombia (middle-income country), and to explore the utility of a crash risk assessment model in these three countries. Young drivers aged 16-25 years completed the Behaviour of Young Novice Drivers Scale (BYNDS), in addition to self-reporting crash involvement and driving offences. A hierarchical segmentation analysis via decision trees was used to study the relationship between self-reported crashes and risky driving. Young drivers in Colombia reported more risky driving than young drivers in New Zealand, and considerably more risky driving than young drivers in Australia. Significant differences among and across countries in individual BYNDS items were found, and 23.5% of all participants reported they had been involved in a road crash. Handheld mobile phone usage was the strongest predictor of crashes, followed by driving after drinking alcohol, and carrying friends as passengers. Country of origin predicted mobile phone usage, with New Zealand and Colombia grouped in the same decision tree branch which implies no significant differences in the behaviour between these countries. Despite cultural differences in licensing programs and enforcement, young drivers reported engaging in a similar breadth of risky behaviours. Road crashes were explained by mobile phone usage, drink driving and driving with passengers, suggesting interventions should target these three risk factors. Whilst New Zealand and Australia have implemented graduated driver licensing programs, are geographical neighbours, and are high-income countries, the finding that behaviours of young drivers in New Zealand and Colombia were more similar than those of young drivers in New Zealand and Australia merits further investigation.

A call to improve sampling methodology and reporting in young novice driver research.

Young drivers continue to be over-represented in road crash fatalities despite a multitude of research, communication and intervention. Evidence-based improvement depends to a great extent upon research methodology quality and its reporting, with known limitations in the peer-review process. The aim of the current research was to review the scope of research methodologies applied in 'young driver' and 'teen driver' research and their reporting in four peer-review journals in the field between January 2006 and December 2013. In total, 806 articles were identified and assessed. Reporting omissions included participant gender (11% of papers), response rates (49%), retention rates (39%) and information regarding incentives (44%). Greater breadth and specific improvements in study designs and reporting are thereby identified as a means to further advance the field.

Validation of the Behaviour of Young Novice Drivers Scale (BYNDS) in a New Zealand young driver population.

The Behaviour of Young Novice Drivers Scale, the BYNDS (Scott-Parker et al., 2010), is a reliable and valid self-report 44-item instrument which explores the frequency of a breadth of risky driving behaviours which appear to place young and novice drivers at an increased risk of road crash injury. As part of a larger collaborative research project, the Australian-developed BYNDS was piloted in a sample of 20 young New Zealand drivers n=14 aged 16-18 years, 9 males; n=6 aged 19-24 years, 2 males. The wording of 21 BYNDS items was modified to reflect the cultural context of the participating New Zealand drivers. The refined BYNDS was applied in a sample of 325 young drivers n=116 aged 16-18 years, 65 males; n=209 aged 19-24 years, 98 males, and the factor structure examined, including exploratory factor analysis for each gender. The 5-factor structure of the BYNDS was supported, with young drivers reporting considerable engagement in risky driving exposure, moderate engagement in transient violations and mood-related driving, and less fixed violations and driving misjudgements. Risky driving exposure was predictive of self-reported crash involvement for both males and females, suggesting targeted intervention regarding when, and the circumstances under which, the young driver is on the road.