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1. Crash rates over time among younger and older drivers in the SHRP 2 naturalistic driving study

   https://doi.org/2020.03.001  

   Bruce G. Simons-Morton, Pnina Gershon ( June 2020 , Journal of safety research)

   null (Ed.)

   To examine crash rates over time among 16–17-year-old drivers compared to older drivers. Methods: Data were from a random sample of 854 of the 3,500 study participants in SHRP 2, a U.S.national, naturalistic driving (instrumented vehicle) study. Crashes/10,000 miles by driver age group, 3-month period, and sex were examined within generalized linear mixed models. Results: Analyses of individual differences between age cohorts indicated higher incidence rates in the 16–17-year old cohort relative to older age groups each of the first four quarters (except the first quarter compared to 18 – 20 year old drivers) with incident rate ratios (IRR) ranging from 1.98 to 18.90, and for the full study period compared with drivers 18–20 (IRR = 1.69, CI = 1.00, 2.86), 21 to 25 (IRR = 2.27, CI = 1.31, 3.91), and 35 to 55 (IRR = 4.00, CI = 2.28, 7.03). Within the 16–17-year old cohort no differences were found in rates among males and females and the decline in rates over the 24-month study period was not significant. Conclusions: The prolonged period of elevated crash rates suggests the need to enhance novice young driver prevention approaches such as Graduated Driver’s Licensing limits, parent restrictions, and postlicensure supervision and monitoring. Practical Applications: Increases are needed in Graduated Driver’s Licensing limits, parent restrictions, and postlicensure supervision and monitoring. 

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2. Near crash characteristics among risky drivers using the SHRP2 naturalistic driving study

   https://doi.org/10.1016/j.jsr.2020.03.012  

   Seacrist, Thomas ; Douglas, Ethan C. ; Hannan, Chloe ; Rogers, Rachel ; Belwadi, Aditya ; Loeb, Helen ( April 2020 , Journal of safety research)

   null (Ed.)

   Problem: Previous research have focused extensively on crashes, however near crashes provide additional data on driver errors leading to critical events as well as evasive maneuvers employed to avoid crashes. The Strategic Highway Research Program 2 (SHRP2) Naturalistic Driving Study contains extensive data on real world driving and offers a reliable methodology to study near crashes. The current study utilized the SHRP2 database to compare the rate and characteristics associated with near crashes among risky drivers. Methods: A subset from the SHRP2 database consisting of 4,818 near crashes for teen (16–19 yrs), young adult (20–24 yrs), adult (35–54 yrs), and older (70+ yrs) drivers was used. Near crashes were classified into seven incident types: rear-end, road departure, intersection, head-on, side-swipe, pedestrian/cyclist, and animal. Near crash rates, incident type, secondary tasks, and evasive maneuvers were compared across age groups. For rear-end near crashes, near crash severity, max deceleration, and time-to-collision at braking were compared across age. Results: Near crash rates significantly decreased with increasing age (p < 0.05). Young drivers exhibited greater rear-end (p < 0.05) and road departure (p < 0.05) near crashes compared to adult and older drivers. Intersection near crashes were the most common incident type among older drivers. Evasive maneuver type did not significantly vary across age groups. Near crashes exhibited a longer time-to-collision at braking (p < 0.01) compared to crashes. Summary: These data demonstrate increased total near crash rates among young drivers relative to adult and older drivers. Prevalence of specific near crash types also differed across age groups. Timely execution of evasive maneuvers was a distinguishing factor between crashes or near crashes. Practical Applications: These data can be used to develop more targeted driver training programs and help OEMs optimize ADAS to address the most common errors exhibited by risky drivers. 

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3. Predicting Participant Compliance With Fitness Tracker Wearing and Ecological Momentary Assessment Protocols in Information Workers: Observational Study

   https://doi.org/10.2196/22218  

   Martinez, Gonzalo J ; Mattingly, Stephen M ; Robles-Granda, Pablo ; Saha, Koustuv ; Sirigiri, Anusha ; Young, Jessica ; Chawla, Nitesh ; De Choudhury, Munmun ; D'Mello, Sidney ; Mark, Gloria ; et al ( January 2021 , JMIR mHealth and uHealth)

   Background Studies that use ecological momentary assessments (EMAs) or wearable sensors to track numerous attributes, such as physical activity, sleep, and heart rate, can benefit from reductions in missing data. Maximizing compliance is one method of reducing missing data to increase the return on the heavy investment of time and money into large-scale studies. Objective This paper aims to identify the extent to which compliance can be prospectively predicted from individual attributes and initial compliance. Methods We instrumented 757 information workers with fitness trackers for 1 year and conducted EMAs in the first 56 days of study participation as part of an observational study. Their compliance with the EMA and fitness tracker wearing protocols was analyzed. Overall, 31 individual characteristics (eg, demographics and personalities) and behavioral variables (eg, early compliance and study portal use) were considered, and 14 variables were selected to create beta regression models for predicting compliance with EMAs 56 days out and wearable compliance 1 year out. We surveyed study participation and correlated the results with compliance. Results Our modeling indicates that 16% and 25% of the variance in EMA compliance and wearable compliance, respectively, could be explained through a survey of demographics and personality in a held-out sample. The likelihood of higher EMA and wearable compliance was associated with being older (EMA: odds ratio [OR] 1.02, 95% CI 1.00-1.03; wearable: OR 1.02, 95% CI 1.01-1.04), speaking English as a first language (EMA: OR 1.38, 95% CI 1.05-1.80; wearable: OR 1.39, 95% CI 1.05-1.85), having had a wearable before joining the study (EMA: OR 1.25, 95% CI 1.04-1.51; wearable: OR 1.50, 95% CI 1.23-1.83), and exhibiting conscientiousness (EMA: OR 1.25, 95% CI 1.04-1.51; wearable: OR 1.34, 95% CI 1.14-1.58). Compliance was negatively associated with exhibiting extraversion (EMA: OR 0.74, 95% CI 0.64-0.85; wearable: OR 0.67, 95% CI 0.57-0.78) and having a supervisory role (EMA: OR 0.65, 95% CI 0.54-0.79; wearable: OR 0.66, 95% CI 0.54-0.81). Furthermore, higher wearable compliance was negatively associated with agreeableness (OR 0.68, 95% CI 0.56-0.83) and neuroticism (OR 0.85, 95% CI 0.73-0.98). Compliance in the second week of the study could help explain more variance; 62% and 66% of the variance in EMA compliance and wearable compliance, respectively, was explained. Finally, compliance correlated with participants’ self-reflection on the ease of participation, usefulness of our compliance portal, timely resolution of issues, and compensation adequacy, suggesting that these are avenues for improving compliance. Conclusions We recommend conducting an initial 2-week pilot to measure trait-like compliance and identify participants at risk of long-term noncompliance, performing oversampling based on participants’ individual characteristics to avoid introducing bias in the sample when excluding data based on noncompliance, using an issue tracking portal, and providing special care in troubleshooting to help participants maintain compliance. 

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4. Use of oral diabetes medications and the risk of incident dementia in US veterans aged ≥60 years with type 2 diabetes

   https://doi.org/10.1136/bmjdrc-2022-002894  

   Tang, Xin ; Brinton, Roberta Diaz ; Chen, Zhao ; Farland, Leslie V ; Klimentidis, Yann ; Migrino, Raymond ; Reaven, Peter ; Rodgers, Kathleen ; Zhou, Jin J ( September 2022 , BMJ Open Diabetes Research & Care)

   Introduction Studies have reported that antidiabetic medications (ADMs) were associated with lower risk of dementia, but current findings are inconsistent. This study compared the risk of dementia onset in patients with type 2 diabetes (T2D) treated with sulfonylurea (SU) or thiazolidinedione (TZD) to patients with T2D treated with metformin (MET). Research design and methods This is a prospective observational study within a T2D population using electronic medical records from all sites of the Veterans Affairs Healthcare System. Patients with T2D who initiated ADM from January 1, 2001, to December 31, 2017, were aged ≥60 years at the initiation, and were dementia-free were identified. A SU monotherapy group, a TZD monotherapy group, and a control group (MET monotherapy) were assembled based on prescription records. Participants were required to take the assigned treatment for at least 1 year. The primary outcome was all-cause dementia, and the two secondary outcomes were Alzheimer’s disease and vascular dementia, defined by International Classification of Diseases (ICD), 9th Revision, or ICD, 10th Revision, codes. The risks of developing outcomes were compared using propensity score weighted Cox proportional hazard models. Results Among 559 106 eligible veterans (mean age 65.7 (SD 8.7) years), the all-cause dementia rate was 8.2 cases per 1000 person-years (95% CI 6.0 to 13.7). After at least 1 year of treatment, TZD monotherapy was associated with a 22% lower risk of all-cause dementia onset (HR 0.78, 95% CI 0.75 to 0.81), compared with MET monotherapy, and 11% lower for MET and TZD dual therapy (HR 0.89, 95% CI 0.86 to 0.93), whereas the risk was 12% higher for SU monotherapy (HR 1.12 95% CI 1.09 to 1.15). Conclusions Among patients with T2D, TZD use was associated with a lower risk of dementia, and SU use was associated with a higher risk compared with MET use. Supplementing SU with either MET or TZD may partially offset its prodementia effects. These findings may help inform medication selection for elderly patients with T2D at high risk of dementia. 

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5. The association of criminal justice supervision setting with overdose mortality: a longitudinal cohort study

   https://doi.org/10.1111/add.15077  

   Binswanger, Ingrid A. ; Nguyen, Anh P. ; Morenoff, Jeffrey D. ; Xu, Stanley ; Harding, David J. ( May 2020 , Addiction)

   Despite the high prevalence of substance use among people in the US criminal justice system, little is known about the incidence of overdose mortality by use patterns, drug convictions and supervision setting. We examined the associations between these characteristics and overdose mortality.

   Retrospective cohort study.

   Individuals sentenced to prison, jail, probation or jail plus probation for a felony conviction in Michigan, USA from 2003 to 2006.

   Using the National Death Index, we assessed overdose mortality to December 2012. We calculated overdose mortality rates by pre‐sentence opioid use, drug convictions and supervision setting. Multivariable analyses were conducted using competing risks regression with time‐varying covariates.

   Among 140 266 individuals followed over a mean of 7.84 years [standard deviation (SD) = 1.52], 14.9% of the 1131 deaths were due to overdose (102.8 per 100 000 person‐years). Over the follow‐up, more than half of overdose deaths occurred in the community (57.7%), nearly a third (28.8%) on probation and 12.8% on parole. The adjusted risk of overdose death was lower on probation [hazard ratio (HR) = 0.71, 95% confidence interval (CI) = 0.60, 0.85] than in the community without probation or parole (HR = 1.00) but not significantly different on parole (HR = 1.13, 95% CI = 0.87, 1.47). Pre‐sentence daily opioid use (HR = 3.54, 95% CI = 3.24, 3.87) was associated with an increased risk. Drug possession (HR = 1.11, 95% CI = 0.93, 1.31) and delivery convictions (HR = 0.92, 95% CI = 0.77, 1.09) were not significantly associated with overdose mortality.

   Based on the absolute or relative risk, parole, probation and community settings are appropriate settings for enhanced overdose prevention interventions. Ensuring that individuals with pre‐sentence opioid use have access to harm reduction and drug treatment services may help to prevent overdose among people involved with the criminal justice system.

    

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