La prise de conscience de l’implication des médicaments dans la genèse des accidents de la route date d’une vingtaine d’années. Les médicaments psycho-actifs peuvent altérer les capacités de conduite par leur action sur le système nerveux (par exemple, un effet sédatif le lendemain d’une prise d’hypnotique). D’autres médicaments sont susceptibles d’affecter les fonctions psychomotrices par leur action sur les fonctions physiologiques (tel que les hypoglycémies liées à un traitement antidiabétique). L’étude CESIR-A a été mise en place pour contribuer à la connaissance du lien épidémiologique entre médicaments et accidents de la route. L’étude utilise trois bases de données françaises : le Système National d’Information Inter-Régimes de l’Assurance Maladie (SNIIR-AM), les Procès Verbaux d’accidents (PV) et les Bulletins d’Analyse des Accidents Corporels de la circulation (BAAC). L’appariement de ces données a conduit à l’inclusion de 72,685 conducteurs impliqués dans un accident corporel sur la période juillet 2005-mai 2008. L’analyse a été réalisée grâce à deux méthodes: une analyse cas-témoin comparant les responsables aux non-responsables des accidents et une analyse dite en case-crossover. Les périodes d’exposition aux médicaments ont été estimées à partir des dates de délivrances de médicaments prescrits, puis remboursés par l’assurance maladie. L’étude des médicaments regroupés selon les quatre niveaux de risque sur la conduite définis par l’Agence Française de Sécurité Sanitaire des Produits de Santé (AFSSAPS) [du niveau 0 (pas de risque) au niveau 3 (risque élevé)], a montré que les utilisateurs de médicaments prescrits de niveau 2 et de niveau 3 ont un risque significativement plus élevé d’être responsables de leur accident (OR=1,31 [1,24-1,40] et OR=1,25 [1,12-1,40], respectivement). La fraction de risque attribuable à l’utilisation de ces médicaments était de 3,3% [2,7%-3,9%]. Le risque d’être responsable d’un accident était augmenté chez les utilisateurs de zolpidem (OR=1,28 [1,07-1,53]) mais pas chez les utilisateurs de zopiclone ou de benzodiazépines hypnotiques. Plus particulièrement, ce risque était augmenté chez les 139 conducteurs ayant eu plus d’un comprimé de zolpidem délivré par jour au cours des cinq mois précédant l’accident (OR=2,38 [1,61-3,52]). L’analyse case-crossover a mis en évidence un sur-risque d’accident de la route chez les utilisateurs de benzodiazépines hypnotiques seulement (OR=1,42 [1,09-1,85]). Les conducteurs exposés aux hypnotiques partagent les mêmes caractéristiques au regard du type d’accident, qui survenaient plus fréquemment sur autoroute. Dans notre base de données, 196 conducteurs ont été exposés à la buprénorphine et/ou à la méthadone, le jour de leur accident. Cette population spécifique était jeune, essentiellement masculine, avec d’importantes co-consommations, notamment d’alcool de médicaments de niveau 3. Les conducteurs exposés à la buprénorphine et/ou à la méthadone présentaient un risque accru d’être responsables de leur accident (OR= 2,19 [1,51-3,16]). Notre étude fournit des informations importantes sur la contribution des médicaments au risque d’accident de la route. D’après nos résultats, la classification de l’AFSSAPS semble appropriée concernant les médicaments de niveaux 2 et 3. Les sur-risques d’être responsable d’un accident chez les exposés au zolpidem ou aux traitements de substitution pourraient être liés, au moins en partie, au comportement à risque de ces conducteurs. L’amélioration du comportement des conducteurs représente un des défis pour la sécurité routière. L’objectif de la classification française et de la signalétique apposée sur les boîtes de médicaments est donc de fournir aux patients une information appropriée sur les effets des médicaments sur leur capacité de conduite. / In recent decades, attention has been increasingly focused on the impact of disabilities and medicinal drug use on road safety. Psychoactive medicines may impair driving abilities due to their action on the central nervous system (e.g. sedation in the morning following administration of a hypnotic), while other medicines may affect psychomotor functions by their action on physiological functions (e.g hypoglycaemic seizures related to diabetic treatment). The CESIR-A project was set up to improve the epidemiological knowledge on medicines and the risk of road traffic crashes. The study matched three French nationwide databases: the national healthcare insurance database, police reports, and the police national database of injurious crashes, leading to the inclusion of 72,685 drivers involved in an injurious road traffic crash from July 2005 to May 2008. Two methods were performed for data analysis: a case-control analysis in which cases where responsible drivers and controls non-responsible ones and a case-crossover analysis. Medicine exposures were estimated from prescription drug dispensations in the healthcare reimbursement database. The study of medicines grouped according to the four levels of driving impairment risk of the French classification system [from 0 (no risk) to 3 (high risk)], showed that users of level 2 and level 3 prescribed medicines were at higher risk of being responsible for the crash (OR=1.31 [1.24-1.40] and OR=1.25 [1.12-1.40], respectively). The fraction of road traffic crashes attributable to levels 2 and 3 medicines was 3.3% [2.7%-3.9%]. Zolpidem use was associated with an increased risk of being responsible for a road traffic crash (OR=1.28 [1.07-1.53]) whereas use of zopiclone and benzodiazepine hypnotics use was not. Responsibility risk was only increased in the 139 drivers with dispensing of more than one pill of zolpidem a day during the five months before the crash (OR=2.38 [1.61-3.52]). Case-crossover analysis showed an increased risk of crash for benzodiazepine hypnotic users only (OR=1.42 [1.09-1.85]). Hypnotic users shared similar crash characteristics, with crashes more likely to occur on highways. In our database, 196 drivers were exposed to buprenorphine and/or methadone on the day of crash. This specific population was young, essentially males, with important co-consumption of other substances, in particular alcohol and level 3 medicines. Injured drivers exposed to buprenorphine and/or methadone on the day of crash, had an increased risk of being responsible (OR=2.19 [1.51-3.16]). The case cross-over analysis did not demonstrate any association (OR=1.26 [0.93 - 1.70]). Our study provides evidence of the contribution of medicines to the risk of road traffic crashes. According to our results, the French risk classification seems relevant regarding medicines classified as levels 2 and 3 of risk for road traffic crashes. The observed increased risks of being responsible for a crash for zolpidem and substitution maintenance treatment users may be linked to risky behaviors. Improving driver behaviour is one of the challenges for road safety. Providing patients with proper information on the potential effect of medicines on their driving abilities is the main objective of drug and risk classifications such as the French one.

The thesis aims to describe main relationships between road traffic and its environmental impact. It has to explain general concept, definition of basic negatives and disadvantages of the road traffic environmental influence and ways how to face up to them. One of fundamental components of the thesis is represented by an chapter about road traffic's external costs and possible approaches of their elimination. It pushes ahead the internalizing externalities. Analytic part of the thesis refers to one concrete traffic fabric situated in the centre of medium-sized city with a view to changes of environment characteristics of the whole territory and to changes of traffic situation in the city. The fabric is monitored in the course of all phases -- from first suggestions for the final commissioning.

Yes / Introduction: Around 1.35 million deaths are caused by Road Traffic Injuries (RTIs) each year. This study aimed to explore the perceptions of Vanuatu's Health Care Workers (HCWs) regarding the existing preventative strategies for RTI. Materials and methods: In 2020, this study used qualitative approaches to collect data from HCWs using Focus Group Discussions (FGDs). Study participants were self-identified Ni-Vanuatu HCWs who had been serving for more than 6 months in three main hospitals where the study was conducted and purposive sampling was used to gather the study participants. To guide the FGDs, a semi-structured open-ended questionnaire was created. Thematic analysis was used to processed the data obtained, based on predetermined themes that were based on theory while also enabling the data to determine new themes. Result: From 5 FGDs with 22 HCWs who were emergency nurses, doctors and public health officers, data saturation was reached. The study yielded five main themes and sixteen subthemes. The relevance and trends of RTI, barriers to effective care, pre-hospital management capacity, barriers to pre-hospital care and addressing RTI were among the key subjects. The findings suggest that addressing health institutional leadership and resources will improve prevention of RTIs. Conclusion: Prevention of RTIs is hindered by the lack of health institutional capacities in terms of leadership and resources that include emergency equipment, financial and trained human resources. The health sector should consider developing stronger leadership in road safety to be an essential part of its core business. / We acknowledge with gratitude the Vanuatu Government through the Training and scholarship units under the Ministry of Education, for the financial support towards this study.

No description available.

no / The acoustical effects of hedges result from a combination of physical noise reduction and their influences on perception. This study investigates the physical noise reduction so as to enable estimation of its relative importance. Different in-situ methods have been used to measure noise shielding by hedges. These include a statistical pass-by experiment where the real insertion loss of a hedge could be measured, three controlled pass-by experiments using a reference microphone at close distance, and transmission loss measurements using a point source. Thick dense hedges are found to provide only a small total A-weighted light vehicle noise reduction at low speeds. Measured insertion losses range from 1.1 dBA to 3.6 dBA. The higher noise reductions are found to be associated with an increased ground effect.

A partir dos anos 1980, iniciou-se na França o uso de misturas asfálticas de módulo elevado (EME - Enrobé à Module Éleve) em intervenções de pavimentos para a restauração de vias urbanas e de trechos de rodovias sujeitas a tráfego pesado e intenso. Estas experiências tiveram como principais finalidades reduzir a deformabilidade e as espessuras das camadas do pavimento, elevando sua rigidez e melhorando seu comportamento mecânico quanto à deformação permanente e à vida de fadiga, em comparação com outros materiais convencionais. Com base nos estudos paramétricos, esta pesquisa analisa as deflexões, tensões e deformações atuantes nas diversas camadas da estrutura de um pavimento, a fim de estudar o comportamento de camadas de EME empregadas nos serviços de restauração. Desde que sejam conhecidas as condições estruturais do pavimento existente e do futuro tráfego, pode-se definir rapidamente as características geométricas e mecânicas das misturas de EME a serem empregadas nas camadas sobrejacentes das restaurações de pavimentos. São apresentados os ensaios laboratoriais com misturas de EME para definição do projeto de mistura, comportamento mecânico, Prensa de Cisalhamento Giratória (PCG - Presse à Cisaillement Giratoire) e deformação permanente, cujos resultados atenderam às especificações técnicas. Esta pesquisa conta com a execução de um Trecho Experimental na rodovia Presidente Dutra, localizado no município de Jacareí/SP, que é sujeita a tráfego pesado e intenso. Durante a sua execução, não foram verificadas dificuldades adicionais de usinagem e de execução em pista. Neste trecho composto de três diferentes seções experimentais, variando-se a espessura da camada de base de módulo elevado, foi avaliado e comprovado o bom comportamento estrutural do pavimento com mistura de EME como base asfáltica para restauração do pavimento de rodovia com tráfego muito pesado. / Since 80s it has started in France the use of high modulus asphalt concrete (EME - Enrobé à Module Éleve) in pavement interventions for the restoration of urban roads and some sections of highways with heavy and high traffic. Those experiences had the main purpose of reducing deformability and decreasing layers thicknesses of the pavement, which could raise its strength and improve its mechanical behavior, concerning rutting and fatigue life, in comparison to other conventional materials. Based on a parametric studies, this research analyses deflections, tensions and deformations that act in all pavement structure for studying the behavior of EME layers in restorations. Since structural conditions of the existing pavement and the future traffic are known, it can be rapidly defined the geometrical and mechanical characteristics of EME mixtures for being used as wearing courses in pavement restorations. Laboratory tests were carried out with EME in terms of mixture design, mechanical behavior, French gyratory compaction (PCG - Presse à Cisaillement Giratoire) and rutting and the results were in compliance with technical specifications. This research includes a trial section on Presidente Dutra highway in Jacareí city/SP, which is a heavy and high trafficked road. During the construction, no additional difficulties in mixing and laydown operations were found. This test track composed of three sections with different thicknesses of EME as a base layer was evaluated, and proved the good structural behavior of EME mixture as an asphalt base layer for pavement rehabilitation of a very high trafficked road.

Objectives.The general objectives of this dissertationwere to examine the effects of acute exposure to meaningfulirrelevant speech and road traffic noise on memory performance,and to explore annoyance responses to noise exposure in theschool environment for pupils and teachers in different agegroups. Methods. The thesis comprises seven papers, representingdifferent methodological approaches: experiments, surveystudies and interviews. In the experiments, reported in PapersI-V, 288 pupils and teachers participated in the age groups,13-14 years (n=96), 18-20 years (n=96), 35-45 years (n=48) and55-65 years (n=48). The subjects were randomly assigned to oneof three conditions: (a) meaningful irrelevant speech, (b) roadtraffic noise, and (c) silence. The equivalent sound level inthe noise conditions was set to 66 dB(A). A test batteryreflecting episodic and semantic memory were used. The surveystudies, reported in Paper VI and VII, included 207 pupils(M=13.5) and 166 teachers (M=45.9). Two separate questionnairesmainly comprising items about annoyance, noise sensitivity andstress symptoms were administered. Paper VI presents results offocus group interviews (n=16) treating the main topics:disturbing sounds, emotions, ongoing activity, and suggestionsconcerning future changes. Results. The overall findings showedthat both noise sources affected episodic and semantic memoryto the same degree for all age groups. The results indicatedthat the similarity of semantic content between noise and thetask at hand was not the only suitable explanation model, sincea non-speech noise impaired memory as much as speech. Resultsalso indicated that attention effects did notmediate the obtained noise effects and that the noise effectsdid not differ between age groups. Therefore, it seemedunlikely that different memory and attentional capacities stoodout as explanatory factors of the memory effects. Sinceperformances of both episodic and semantic memory tasks wereimpaired, the explanation based on level of access to long-termmemory was also ruled out. However, the episodic memory task,reading comprehension, stood out to be most impaired by noise,suggesting that complexity of the task to perform was ofimportance. For reading comprehension there was also adifferent noise pattern obtained. Participants performance wasin this task, more impaired by meaningful irrelevant speechthan by road traffic noise. This effect indicated thatmeaningful irrelevant speech might reduce the availablecognitive resources necessary for learning the text. Theannoyance models derived from the survey studies indicated thatsensitivity acted as a mediator between hearing status andannoyance, with stress symptoms as an outcome. Whetherannoyance arises or not was also determined by control andpredictability of the noise. In the interviews a differentannoyance pattern was found, in that stress symptoms appearedto be a determinant of annoyance. To be involved, respected,take own responsibility and respect others were suggestions onhow to change the environment to become more silent. Conclusions.For both pupils and teachers acute exposureto meaningful irrelevant speech and road traffic noiseinfluenced both the achieving and providing of knowledge. Acommon annoyance pattern was also found for pupils andteachers, where individual and situational factors were ofimportance. To achieve a more silent school environment in thefuture, the pupils pointed out that the interaction betweenthemselves and their teachers was of importance. Key words:Noise, meaningful irrelevant speech, roadtraffic noise, memory, age groups, school environment, pupils,teachers

Objectives.The general objectives of this dissertationwere to examine the effects of acute exposure to meaningfulirrelevant speech and road traffic noise on memory performance,and to explore annoyance responses to noise exposure in theschool environment for pupils and teachers in different agegroups. Methods. The thesis comprises seven papers, representingdifferent methodological approaches: experiments, surveystudies and interviews. In the experiments, reported in PapersI-V, 288 pupils and teachers participated in the age groups,13-14 years (n=96), 18-20 years (n=96), 35-45 years (n=48) and55-65 years (n=48). The subjects were randomly assigned to oneof three conditions: (a) meaningful irrelevant speech, (b) roadtraffic noise, and (c) silence. The equivalent sound level inthe noise conditions was set to 66 dB(A). A test batteryreflecting episodic and semantic memory were used. The surveystudies, reported in Paper VI and VII, included 207 pupils(M=13.5) and 166 teachers (M=45.9). Two separate questionnairesmainly comprising items about annoyance, noise sensitivity andstress symptoms were administered. Paper VI presents results offocus group interviews (n=16) treating the main topics:disturbing sounds, emotions, ongoing activity, and suggestionsconcerning future changes. Results. The overall findings showedthat both noise sources affected episodic and semantic memoryto the same degree for all age groups. The results indicatedthat the similarity of semantic content between noise and thetask at hand was not the only suitable explanation model, sincea non-speech noise impaired memory as much as speech. Resultsalso indicated that attention effects did notmediate the obtained noise effects and that the noise effectsdid not differ between age groups. Therefore, it seemedunlikely that different memory and attentional capacities stoodout as explanatory factors of the memory effects. Sinceperformances of both episodic and semantic memory tasks wereimpaired, the explanation based on level of access to long-termmemory was also ruled out. However, the episodic memory task,reading comprehension, stood out to be most impaired by noise,suggesting that complexity of the task to perform was ofimportance. For reading comprehension there was also adifferent noise pattern obtained. Participants performance wasin this task, more impaired by meaningful irrelevant speechthan by road traffic noise. This effect indicated thatmeaningful irrelevant speech might reduce the availablecognitive resources necessary for learning the text. Theannoyance models derived from the survey studies indicated thatsensitivity acted as a mediator between hearing status andannoyance, with stress symptoms as an outcome. Whetherannoyance arises or not was also determined by control andpredictability of the noise. In the interviews a differentannoyance pattern was found, in that stress symptoms appearedto be a determinant of annoyance. To be involved, respected,take own responsibility and respect others were suggestions onhow to change the environment to become more silent. Conclusions.For both pupils and teachers acute exposureto meaningful irrelevant speech and road traffic noiseinfluenced both the achieving and providing of knowledge. Acommon annoyance pattern was also found for pupils andteachers, where individual and situational factors were ofimportance. To achieve a more silent school environment in thefuture, the pupils pointed out that the interaction betweenthemselves and their teachers was of importance. Key words:Noise, meaningful irrelevant speech, roadtraffic noise, memory, age groups, school environment, pupils,teachers

Cooperative traffic safety applications such as lane change or overtaking assistance have the potential to reduce the number of road fatalities. Many emerging traffic safety applications are based on IEEE 802.11p and periodic position messages, so-called cooperative awareness messages (CAM) being broadcasted by all vehicles. In Europe, ETSI defines a periodic report rate of 2 Hz for CAMs. Although a high report rate is the key to early hazard detection, the 2 Hz rate has been chosen to avoid congestion in settings where the vehicle density is high, e.g., on major highways and in urban scenarios. However, on rural roads with a limited number of communicating vehicles, a report rate of 2 Hz leads to unnecessary delay in cooperative awareness. By adapting the CAM report rate depending on the specific application and road traffic density, and by making use of the priority levels provided by the 802.11p quality of service mechanism, we show that hazards can be detected earlier and the available bandwidth is used more efficiently, while not overexploiting the network resources. / <p>©2011 IEEE. Personal use of this material is permitted. However, permission to reprint/republish this material for advertising or promotional purposes or for creating new collective works for resale or redistribution to servers or lists, or to reuse any copyrighted component of this work in other works must be obtained from the IEEE.</p><p></p><p>Category number CFP11VTF-ART; Code 87844</p>

<p><b>Objectives.</b>The general objectives of this dissertationwere to examine the effects of acute exposure to meaningfulirrelevant speech and road traffic noise on memory performance,and to explore annoyance responses to noise exposure in theschool environment for pupils and teachers in different agegroups.</p><p><b>Methods</b>. The thesis comprises seven papers, representingdifferent methodological approaches: experiments, surveystudies and interviews. In the experiments, reported in PapersI-V, 288 pupils and teachers participated in the age groups,13-14 years (n=96), 18-20 years (n=96), 35-45 years (n=48) and55-65 years (n=48). The subjects were randomly assigned to oneof three conditions: (a) meaningful irrelevant speech, (b) roadtraffic noise, and (c) silence. The equivalent sound level inthe noise conditions was set to 66 dB(A). A test batteryreflecting episodic and semantic memory were used. The surveystudies, reported in Paper VI and VII, included 207 pupils(M=13.5) and 166 teachers (M=45.9). Two separate questionnairesmainly comprising items about annoyance, noise sensitivity andstress symptoms were administered. Paper VI presents results offocus group interviews (n=16) treating the main topics:disturbing sounds, emotions, ongoing activity, and suggestionsconcerning future changes. Results. The overall findings showedthat both noise sources affected episodic and semantic memoryto the same degree for all age groups. The results indicatedthat the similarity of semantic content between noise and thetask at hand was not the only suitable explanation model, sincea non-speech noise impaired memory as much as speech.</p><p><b>Results</b>also indicated that attention effects did notmediate the obtained noise effects and that the noise effectsdid not differ between age groups. Therefore, it seemedunlikely that different memory and attentional capacities stoodout as explanatory factors of the memory effects. Sinceperformances of both episodic and semantic memory tasks wereimpaired, the explanation based on level of access to long-termmemory was also ruled out. However, the episodic memory task,reading comprehension, stood out to be most impaired by noise,suggesting that complexity of the task to perform was ofimportance. For reading comprehension there was also adifferent noise pattern obtained. Participants performance wasin this task, more impaired by meaningful irrelevant speechthan by road traffic noise. This effect indicated thatmeaningful irrelevant speech might reduce the availablecognitive resources necessary for learning the text. Theannoyance models derived from the survey studies indicated thatsensitivity acted as a mediator between hearing status andannoyance, with stress symptoms as an outcome. Whetherannoyance arises or not was also determined by control andpredictability of the noise. In the interviews a differentannoyance pattern was found, in that stress symptoms appearedto be a determinant of annoyance. To be involved, respected,take own responsibility and respect others were suggestions onhow to change the environment to become more silent.</p><p><b>Conclusions.</b>For both pupils and teachers acute exposureto meaningful irrelevant speech and road traffic noiseinfluenced both the achieving and providing of knowledge. Acommon annoyance pattern was also found for pupils andteachers, where individual and situational factors were ofimportance. To achieve a more silent school environment in thefuture, the pupils pointed out that the interaction betweenthemselves and their teachers was of importance.</p><p><b>Key words:</b>Noise, meaningful irrelevant speech, roadtraffic noise, memory, age groups, school environment, pupils,teachers</p>