Medicines and driving: evaluation of training and software support for patient counselling by pharmacists

Background : The consumption of some psychotropic medicines has a negative effect on the fitness to drive. Pharmacists are expected to give useful advice to patients on their participation in traffic. However, almost no information is available on this topic. Objective : To assess the effect of training and implementation of new dispensing guidelines with regard to driving-impairing medicines, in two types of dispensing support tools. User acceptance was measured as well as the effect on pharmacists' attitudes & awareness, self-reported behaviour and knowledge. Setting Pharmacists from East Flanders in Belgium. Methods : Two intervention groups and a control group participated. The intervention groups followed a training and were provided with a dispensing support tool containing information on the effect of medicines on driving ability, which was either stand-alone (USB stick) or integrated into the daily used software (ViaNova). The three groups filled out a questionnaire prior to and after the intervention period. Main outcome measure : Answers to a pre/post-questionnaire on attitudes and awareness, self-reported behaviour, knowledge and user acceptance. Results : Many pharmacists were already strongly interested in the topic at the beginning of the study. Positive changes in attitude, self-reported behaviour and knowledge were measured mostly in the group of pharmacists for which the information was integrated in their daily used software. These pharmacists asked significantly more about the patients' driving experience, informed them more about driving-related risk and gave more detailed information on impairing effects of medicines. The knowledge of the participating pharmacists on the topic 'medicines and driving' remained generally low. The participants acknowledge the importance of being aware of the topic medicines and driving but they report a lack of information or education. They strongly prefer a tool that integrates the information in their daily used software. Conclusion : Dispensing support tools with information on the potential impairing effect of a medicine on the fitness to drive increases awareness, reported risk communication behaviour as well as knowledge of pharmacists on this topic. Computerised dispensing support tools are most effective when the information is integrated into the daily used dispensing software

Guest Editorial. The ESRA initiative: Towards global monitoring and analysis of road safety performanc

1. Road safety performance indicators 2. ESRA initiative 3. Position of ESRA2 in IATSS 4. Importance of the results presented in this special feature 5. Closing remark

Naturalistic driving observations within ERSO, deliverable 6.1

This deliverable reports the outcome of the first task which was to generate an inventory of variables and measurement tools necessary to monitor road safety through Naturalistic Driving Observations. This was achieved by performing the following activities: 1. Generating an inventory of relevant variables to monitor road safety within ERSO. 2. Generating an inventory of relevant variables to monitor through naturalistic driving observation. 3. Combining 1 and 2 to define the variables to be measured within ERSO by naturalistic driving observation

The ESRA initiative: global approach to monitor driving under influence of alcohol and drugs across 48 countries

peer reviewedIntroduction and aims. ESRA (E-Survey of Road users’ Attitudes) is a joint initiative of road safety institutes and research centres from all over the world. The aim is to collect and analyse comparable data on road safety performance, in particular road safety culture and behaviour of road users. The ESRA data are used as a basis for a large set of road safety indicators. These provide scientific evidence for policy making at national and international levels. The ESRA initiative is managed by the ESRA Steering Group, a consortium currently consisting of ten organisations across the world and led by Vias institute (Belgium). Already two editions of ESRA have taken place (ESRA2, ESRA2). In total 36 partners from 60 countries have already participated in this initiative. The objective of this presentation is to give an overview of the updated results on driving under influence, covering 48 countries (ESRA2). Focus is on self-reported driving under the influence of alcohol, drugs and medicines and different road user types. More details on related behaviour believes will be presented in an other presentation at this conference. Method. ESRA2 data were collected through online panel surveys (2018-2020), using a representative sample of the national adult populations in each participating country. A jointly developed questionnaire was translated into 62 national language versions. The themes covered include self-reported behaviour, attitudes and opinions on unsafe behaviour in traffic, enforcement experiences and support for policy measures. The survey addresses different road safety topics and targets not only car drivers but also moped riders and motorcyclists, cyclists and pedestrians. Results and Discussion. The results from ESRA2 (N= 45,114) show that the regional means for car drivers reporting drink-driving in the last month ranged from 11% (America) to 19% (Asia/Oceania), for drug-driving from 5% (Europe) to 20% (Asia/Oceania) and for driving after taking medication that may affect the driving ability from 15% (America) to 26% (Asia/Oceania). The national results differ substantially, ranging from 4-31% for alcohol, 6-30% for drugs, and 2-33% for medication. In contrast, the proportion of two-wheeled vehicle users reporting drink-driving differs little between regions: from 18% in Africa to 21% in America among moped and motorcyclists, and from 15% in America to 19% in Asia/Oceania among cyclists. Conclusion. There are notable disparities in self-reported impaired car driving between the countries. The national differences are smaller for self-reported impaired riding of two-wheeled vehicles. ESRA aims at monitoring these differences over time. The next edition (ESRA3) will be launched in spring 2023. It is still possible to join ESRA3 (deadline 20th October, 2022). Contact us if this interests you: [email protected]

Targeted apoptosis in ovarian cancer cells through mitochondrial dysfunction in response to Sambucus nigra agglutinin

Ovarian carcinoma (OC) patients encounter the severe challenge of clinical management owing to lack of screening measures, chemoresistance and finally dearth of non-toxic therapeutics. Cancer cells deploy various defense strategies to sustain the tumor microenvironment, among which deregulated apoptosis remains a versatile promoter of cancer progression. Although recent research has focused on identifying agents capable of inducing apoptosis in cancer cells, yet molecules efficiently breaching their survival advantage are yet to be classified. Here we identify lectin, Sambucus nigra agglutinin (SNA) to exhibit selectivity towards identifying OC by virtue of its specific recognition of α-2, 6-linked sialic acids. Superficial binding of SNA to the OC cells confirm the hyper-sialylated status of the disease. Further, SNA activates the signaling pathways of AKT and ERK1/2, which eventually promotes de-phosphorylation of dynamin-related protein-1 (Drp-1). Upon its translocation to the mitochondrial fission loci Drp-1 mediates the central role of switch in the mitochondrial phenotype to attain fragmented morphology. We confirmed mitochondrial outer membrane permeabilization resulting in ROS generation and cytochrome-c release into the cytosol. SNA response resulted in an allied shift of the bioenergetics profile from Warburg phenotype to elevated mitochondrial oxidative phosphorylation, altogether highlighting the involvement of mitochondrial dysfunction in restraining cancer progression. Inability to replenish the SNA-induced energy crunch of the proliferating cancer cells on the event of perturbed respiratory outcome resulted in cell cycle arrest before G2/M phase. Our findings position SNA at a crucial juncture where it proves to be a promising candidate for impeding progression of OC. Altogether we unveil the novel aspect of identifying natural molecules harboring the inherent capability of targeting mitochondrial structural dynamics, to hold the future for developing non-toxic therapeutics for treating OC

Glycobiology of cell death: when glycans and lectins govern cell fate

Although one typically thinks of carbohydrates as associated with cell growth and viability, glycosylation also has an integral role in many processes leading to cell death. Glycans, either alone or complexed with glycan-binding proteins, can deliver intracellular signals or control extracellular processes that promote initiation, execution and resolution of cell death programs. Herein, we review the role of glycans and glycan-binding proteins as essential components of the cell death machinery during physiologic and pathologic settings.Fil: Lichtenstein, Rachel. Ben-Gurion University of the Negev. Faculty of Engineering. Department of Biotechnology Engineering; IsraelFil: Rabinovich, Gabriel Adrian. Consejo Nacional de Investigaciones Científicas y Técnicas. Instituto de Biología y Medicina Experimental (i); Argentina. Universidad de Buenos Aires. Facultad de Cs.exactas y Naturales. Departamento de Quimica Biologica; Argentin

Car drivers' road safety performance. A benchmark across 32 countries

The road safety performance of a country and the success of policy measures can be measured and monitored in different ways. In addition to the traditional road safety indicators based on the number of fatalities or injured people in road traffic crashes, complementary road safety performance indicators can be used in relation to vehicles, infrastructure, or road users' behaviour. The last-mentioned can be based on data from roadside surveys or from questionnaire surveys. However, results of such surveys are seldom comparable across countries due to differences in aims, scope, or methodology. This paper is based on the second edition of the E-Survey of Road Users' Attitudes (ESRA), an online survey carried out in 2018, and includes data from more than 35,000 road users across 32 countries. The objective is to present the main results of the ESRA survey regarding the four most important risky driving behaviours in traffic: driving under the influence (alcohol/drugs), speeding, mobile phone use while driving, and fatigued driving. The paper explores several aspects related to these behaviours as car driver, such as the self-declared behaviours, acceptability and risk perception, support for policy measures, and opinions on traffic rules and penalties. Results show that despite the high perception of risk and low acceptability of all the risky driving behaviours analysed, there is still a high percentage of car drivers who engage in risky behaviours in traffic in all the regions analysed. Speeding and the use of a mobile phone while driving were the most frequent self-declared behaviours. On the other hand, driving under the influence of alcohol or drugs was the least declared behaviour. Most respondents support policy measures to restrict risky behaviour in traffic and believe that traffic rules are not being checked regularly enough, and should be stricter. The ESRA survey proved to be a valuable source of information to understand the causes underlying road traffic crashes. It offers a unique database and provides policy makers and researchers with valuable insights into public perception of road safety