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Open Access Publications from the University of California

Scholarly Works (38 results)

  • Article
Policy Briefs (2020)
Distracted driving is a factor in approximately 3,000 crashrelated fatalities in the United States each year. Studies have shown that the risk of a crash is four to six times greater while using a cell phone, with even higher rates for texting. Despite public warnings and laws, smartphone tasks that require devoted attention, such as texting, emailing, or web browsing, remain common while driving. Most states restrict hands-held cell phone use, including talking and texting, but none have addressed handsfree use, which can also be extremely distracting. Additionally, there is growing evidence that the effects associated with phone use linger beyond the initial loss of attention, known as a “hangover” effect, and are associated with hazardous driving behavior. Researchers at the Schools of Medicine and Engineering at UC San Diego recently concluded an experimental study on driving safety in which 97 participants were asked to perform simulated driving tasks while receiving a handsfree call or short text message. Researchers measured each participant’s driving reactions (i.e., change in speed, amount of swerving, and drifting outside one’s lane), whether they responded to visual cues at the edges of the screen (simulating rear view mirrors), and how much of the road ahead drivers focused on after being distracted.
    Cover page: Handsfree Cellphone Use Has Lingering Negative Effects on Driving Performance
    • Article
    Specialist Research Meetings—Papers and Reports (2006)
    The two-and-a-half day workshop in Santa Barbara (December 2006) focused on the role of digital gazetteers in geo-referencing applications, starting with overviews of the state-of-the-art and current activities and leading to a consensus on the opportunities and directions for collaboration and the advancement of a research and practice agenda. The workshop was convened by the National Center for Geographic Information & Analysis (NCGIA) and the Redlands Institute, with sponsorship from the National Geospatial-Intelligence Agency.
      Cover page: Digital Gazetteer & Practice Workshop, Summary Report
      • Article
      • Peer Reviewed
      UC San Diego Previously Published Works (2024)
      In this Viewpoint, we provide an overview of the worsening trend of traumatic injuries across the United States-Mexico border after its recent fortification and height extension to 30-feet. We further characterize the international factors driving migration and the current U.S. policies and political climate that will allow this public health crisis to progress. Finally, we provide recommendations involving prevention efforts, effective resource allocation, and advocacy that will start addressing the humanitarian and economic consequences of current U.S. border policies and infrastructure.
        Cover page: A border health crisis at the United States-Mexico border: an urgent call to action.
        • Thesis
        • Peer Reviewed
        UC San Diego Electronic Theses and Dissertations (2019)

        Background: The facts are not in dispute. Globally, road traffic injuries (RTIs) are one of the three leading causes of death among people aged 5 to 44 years and responsible for 1.35 million annual deaths and 20-50 million non-fatal injuries. In sub-Saharan Africa, the burden of RTIs is disproportionately high among commercial motorcycle users. However, region-specific associated factors that predispose crash and injury among commercial motorcycle users are not fully understood. The objectives of this dissertation were to: 1) Estimate the prevalence of crashes and examine associated factors among commercial motorcycle riders and passengers; 2) Estimate injury prevalence and identify associated factors among commercial motorcycle riders; and 3) Provide an overview of patterns, severity, and post-crash management of injuries among commercial motorcycle riders.

        Methods: From July 12 to 26, 2017, a cross-sectional study collected data from 829 consented commercial motorcycle riders and passengers in Bamenda, Cameroon. Participants aged 18 years or older were administered a questionnaire about demographics, crash, and injury characteristics. In addition, participants involved in a crash reported information related to the most severe crash and the most recent crash within the past 12 months, when applicable.

        Results: A total of 67.2% commercial motorcycle users (77.4% riders, 46.3% passengers) were ever involved in a crash. The prevalence of crash involvement among commercial motorcycle users within the past 12 months was 17.9% (21.5% riders, 5.7% passengers). Among riders ever involved in a crash, 80.8% sustained one or more anatomic injuries amounting to 685 injuries. In addition, 80.2% of riders sustained one or more anatomic injuries at the most recent crash within the past 12 months for a total of 112 injuries. Findings from this dissertation showed that speeding riders who currently smoked, carried more than two passengers, and had three or more years of riding experience were at increased odds of crash involvement. Furthermore, most injuries sustained were to the extremities and head and neck anatomic regions with abrasions, swellings, and lacerations as the most common types of injuries.

        Conclusion: This study offers insight to the elevated crash and injury burden among commercial motorcycle users and associated factors. Findings suggest the importance of additional research efforts focused on strategies to prevent crash and mitigate injury.

          Cover page: Epidemiology of crashes and injuries among commercial motorcyclists in Bamenda, Cameroon: A cross-sectional study
          • Article
          • Peer Reviewed
          UC San Diego Previously Published Works (2016)

          Background

          An estimated one in five drivers will be over 65 by 2030. Compared with their younger counterparts, older adults are more likely to experience health and functional impairments, including cognitive dysfunction, which may interfere with their ability to drive safely. Law enforcement officers, as part of the public safety community, need help in developing the necessary skills to identify and manage these medically affected drivers.

          Methods

          To address this need, in partnership with the California Highway Patrol (CHP), Training, Research and Education for Driving Safety (TREDS) at the University of California, San Diego, developed a certified two-hour training curriculum. To complement the training, the TREDS team also developed a roadside screening tool to assess for disorientation related to person, place, and time. The tool was developed, validated with a sample of persons with dementia compared to cognitively normal controls, and deployed in the training. A total of 2,018 police officers received instruction at 103 training sessions.

          Results

          At baseline, prior to training, only 26 % of officers had reported drivers to the Department of Motor Vehicles in the previous 6 months. After training, 96 % stated they were likely to use their standard reporting forms, and 90 % reported they were likely to use the roadside screening tool.

          Conclusions

          The certified training and tool were well received and resulted in changes to knowledge, attitudes, and intention to incorporate their new knowledge and tools into roadside screening.
            Cover page: Development of a curriculum and roadside screening tool for Law enforcement identification of medical impairment in aging drivers
            • Article
            • Peer Reviewed
            UC San Diego Previously Published Works (2024)
            Limited research exists examining self-perceived vision and driving ability among individuals with glaucoma, and this study assessed the relationship between glaucoma, visual field, and visual acuity with driving capability. 137 individuals with glaucoma and 75 healthy controls were asked to evaluate self-rated vision, self-perceived driving ability, and self-perceived distracted driving. Visual acuity and visual field measurements were also obtained. Multivariable linear regressions were run to test each visual measure with driving outcomes. The average age was 72.2 years, 57.3% were male, and 72.5% were White. There were significant associations for a one-point increase in visual field and quality of corrected vision (RR = 1.06; 95% CI = 1.03-1.10), day vision (RR = 1.05; 95% CI = 1.03-1.08), night vision (RR = 1.08; 95% CI = 1.05-1.13), visual acuity score and higher quality of corrected of vision (RR = .41; 95% CI = .22-.77), day vision (RR = .39; 95% CI=.22-.71), and night vision (RR = .41; 95% CI = .18-.94); visual acuity score and ability to drive safely compared to other drivers your age (RR = .53; 95% CI = .29-.96). Individuals with poorer visual acuity and visual fields rate their vision and ability to drive lower than those with better vision, and this information will allow clinicians to understand where to target interventions to enhance safe driving practices.
              Cover page: Distracted Driving and Driving Patterns in Older Drivers With Glaucoma.
              • Article
              • Peer Reviewed
              UC San Diego Previously Published Works (2019)
              We investigated associations between changes in depression and body composition over a 12-month weight loss trial. Of the 298 adults (BMI > 27 m/kg2), 219 with complete depression and body composition data were included. A 10-item Center for Epidemiologic Studies Depression Scale measured depression; dual-energy X-ray absorptiometry measured body composition. Multinomial logistic regression predicted reliable changes in depression by BMI, body fat (BF) and visceral adiposity (VAT). Multiplicative interaction terms tested modification by sex and ethnicity. Participants with increases in body composition were less likely to experience improvements in depression (BMI: RRR = 0.79 (0.68-0.91), p < 0.01; BF: RRR = 0.97 (0.94 - 0.99), p = 0.01; VAT: RRR = 0.99 (0.98-1.00), p = 0.02), but not worsening of depression (BMI: RRR = 1.29 (0.96-1.73), p = 0.10; BF: RRR = 1.04 (0.99-1.09), p = 0.15; VAT: RRR = 1.01 (1.00-1.03), p = 0.18). Sex and ethnicity interaction terms were not significant. However, the relationship was only significant among females, among non-Latinos for BMI and BF, and among Latinos for VAT. Our study supports the association between depression and obesity and highlights the need for longitudinal studies investigating VAT and depression in diverse ethnic groups.
                Cover page: Associations between reliable changes in depression and changes in BMI, total body fatness and visceral adiposity during a 12-month weight loss trial.
                • Multimedia
                Symposium 2023 (2023)
                Gestational diabetes mellitus (GDM) that affects 2-10% of pregnancies in the United States is a harbinger of future GDM, type 2 Diabetes Mellitus, Hypertension, and cardiovascular disease. This risk can be significantly reduced with weight loss. Lifestyle changes are often intensive processes that require involvement in a program with skilled and certified educators such as Center for disease control and prevention’s (CDC) National Diabetes Prevention Program (DPP), however due to insufficient provider knowledge and the time lapse between GDM and development of type 2 DM, the risk is often forgotten or lost in the transition of healthcare from a women’s obstetric care to primary care. This QI project sought to address this issue with a multifaceted approach to the issue and incorporates community involvement, multispecialty collaboration, and health communication.A community needs assessment was conducted through focus group interviews of women with history of GDM. 8 demographically diverse women were interviewed. Key findings of the study were unawareness about DPP among women and interest and motivation to commit to these programs if provided the opportunity. A major aspect of the project is collaborations of Obstetrics, primary care, and population health departments at UCSD with CDC certified DPPs. Local and nationwide DPPs were contacted to gain information on program resources, referral requirements and cost. An external referral system to the various DPPs was proposed to representatives from Obstetrics and population health and is under consideration.Certified Diabetes Educators (CDE) at UCSD were educated in DPP. Educational handouts and PowerPoint slides were developed and provided to the health educators to pass on to their GDM patients. A webpage with DPP resources was developed and captured in a QR code that is printed on a magnet to be handed out during delivery. Behavioral changes require readiness in an individual, which sometimes takes time. The magnet will provide a steady, reiterating reminder for the women after delivery to enroll in a National Diabetes prevention program when they are ready. Evaluation of this QI project will be through data gathered from collaborating DPPs. Quality measures will include 1. Referral rates from UCSD, 2. Enrolment rates, 3. rates of completion of at least 9 months in the program and, 4. rate of accomplishment of weight loss goals. The evaluations will be performed at 6 and 12 months.
                • 1 supplemental ZIP
                • Article
                • Peer Reviewed
                UC San Diego Previously Published Works (2017)

                Background

                The purpose of this study was to review to review the reported associations of depression and antidepressants with motor vehicle crashes.

                Purpose

                A literature search for material published in the English language between January, 1995, and October, 2015, in bibliographic databases was combined with a search for other relevant material referenced in the retrieved articles.

                Methods

                Retrieved articles were systematically reviewed for inclusion criteria: 19 epidemiological studies (17 case-control and 2 cohort studies) fulfilled the inclusion criteria by estimating the crash risk associated with depression and/or psychotropic medications in naturalistic settings.

                Results

                The estimates of the odds ratio (OR) of crash involvement associated with depression ranged from 1.78 to 3.99. All classes of antidepressants were reported to have side effects with the potential to affect driving safety. The majority of studies of antidepressant effects on driving reported an elevated crash risk, and ORs ranged from 1.19 to 2.03 for all crashes, and 3.19 for fatal crashes. In meta-analysis, depression was associated with approximately 2-fold increased crash risk (summary OR = 1.90; 95% CI, 1.06 to 3.39), and antidepressants were associated with approximately 40% increased crash risk (summary OR = 1.40; 95%CI, 1.18 to 1.66).

                Conclusion

                Based on the findings of the studies reviewed, depression, antidepressants or the combination of depression and antidepressants may pose a potential hazard to driving safety. More research is needed to understand the individual contributions of depression and the medications used to treat depression.
                  Cover page: Depression, antidepressants and driving safety
                  • Article
                  • Peer Reviewed
                  UC San Diego Previously Published Works (2010)
                  Background This study describes the barriers to effective and timely LTBI treatment encountered in a research study on INH adherence in Latino adolescents. Method Participant study logs were reviewed, results of continuing medical education pretests for medical providers were examined, and participating medical facilities were contacted in order to construct a profile of multi-level barriers to LTBI treatment. Results A total of 285 TST positive Latino (96%) high school students were recruited into the trial. We encountered a lack of understanding of the gravity of tuberculosis infection among both the public and providers of health care. Parents and adolescents cited competing priorities, transportation problems and financial constraints as reasons for non-compliance. Discussion Improved education of the public and physicians is needed regarding the gravity of the disease and the value of treatment, as well as public and financial support for LTBI treatment by both the government and the medical community.
                    Cover page: Multi-Level Barriers to LTBI Treatment: A Research Note
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