Spatial navigation ability is associated with the assessment of smoothness of driving during changing lanes in older drivers

"Regulating my anxiety worsens the safety of my driving": The synergistic influence of spatial anxiety and Self-regulation on driving behavior

Spatial Anxiety (SA) can be defined as the fear and apprehension experienced during tasks that require spatial thinking and may negatively impact the execution of daily actions. Although it has been explored in several research fields, limited research has explored the effects of SA on specific driving behaviours. In the current study, it was hypothesised that the severity of SA affects risky driving behaviours, and that this relationship is mediated by the driver's self-regulation abilities. Self-reported SA symptoms, driving self-regulation abilities, and risky driving behaviours (i.e., errors, violations, and lapses) were examined in 838 Italian drivers. Data were analysed through linear regressions and path analysis models, controlling for sociodemographic variables. The results showed the negative effects of SA on driving errors and lapses. As hypothesised, a driver's self-regulation abilities mediated the influence of SA on driving lapses, but not on errors nor violations. These findings suggest that the inclination to self-regulate the SA experienced while driving contribute to increase the occurrence of driving lapses. Showing specific pathways through which SA impacts risky driving, these results provide valuable insights for the development of 'driver-focused' road safety interventions.

The economic burden of zoonotic Plasmodium knowlesi malaria on households in Sabah, Malaysia compared to malaria from human-only Plasmodium species

Background

The emergence of the zoonotic monkey parasite Plasmodium knowlesi as the dominant cause of malaria in Malaysia has disrupted current national WHO elimination goals. Malaysia has free universal access to malaria care; however, out-of-pocket costs are unknown. This study estimated household costs of illness attributable to malaria due to P. knowlesi against other non-zoonotic Plasmodium species infections in Sabah, Malaysia.

Methodology/Principal Findings

Household costs were estimated from patient-level surveys collected from four hospitals between 2013 and 2016. Direct costs including medical and associated travel costs, and indirect costs due to lost productivity were included. One hundred and fifty-two malaria cases were enrolled: P. knowlesi (n=108), P. vivax (n=22), P. falciparum (n=16), and P. malariae (n=6). Costs were inflated to 2022 Malaysian Ringgits and reported in United States dollars (US$). Across all cases, the mean total costs were US$138 (SD=108), with productivity losses accounting for 58% of costs (US$80; SD=73). P. vivax had the highest mean total household cost at US$210, followed by P. knowlesi (US$127), P. falciparum (US$126), and P. malariae (US$105). Most patients (80%) experienced direct health costs above 10% of monthly income, with 58 (38%) patients experiencing health spending over 25% of monthly income, consistent with catastrophic health expenditure.

Conclusions/Significance

Despite Malaysia's free health-system care for malaria, patients and families face other related medical, travel, and indirect costs. Household out-of-pocket costs were driven by productivity losses; primarily attributed to infections in working-aged males in rural agricultural-based occupations. Costs for P. knowlesi were comparable to P. falciparum and lower than P. vivax. The higher P. vivax costs related to direct health facility costs for repeat monitoring visits given the liver-stage treatment required.

AUTHOR SUMMARY

Knowlesi malaria is due to infection with a parasite transmitted by mosquitos from monkeys to humans. Most people who are infected work or live near the forest. It is now the major type of malaria affecting humans in Malaysia. The recent increase of knowlesi malaria cases in humans has impacted individuals, families, and health systems in Southeast Asia. Although the region has made substantial progress towards eliminating human-only malaria species, knowlesi malaria threatens elimination targets as traditional control measures do not address the parasite reservoir in monkeys. The economic burden of illness due to knowlesi malaria has not previously been estimated or subsequently compared with other malaria species. We collected data on the cost of illness to households in Sabah, Malaysia, to estimate their related total economic burden. Medical costs and time off work and usual activities were substantial in patients with the four species of malaria diagnosed during the time of this study. This research highlights the financial burden which households face when seeking care for malaria in Malaysia, despite the free treatment provided by the government.

Evaluating the impact of a darts game intervention on cognitive function in older adults with and without mild cognitive impairment: a pilot study

Introduction

The current study investigated the relationship between the characteristics of a darts game, including the throwing motion toward a target, and mild cognitive impairment (MCI). To this end, we examined the associations between cognitive function and mental health, and the shift in center of gravity while throwing darts. In a preliminary investigation, a 1-month dart game intervention was conducted among older individuals living in the community. The participants were divided into the non-MCI and MCI groups, and the relationship between center of gravity movement during throwing and the presence of dementia was examined.

Methods

The intervention lasted for 1 month and was tested on healthy older individuals (aged ≥ 65 years) recruited from the community. The Japanese version of the Montreal Cognitive Assessment and the Trail Making Test was used to assess cognitive function. Mental health was evaluated using the Kessler Psychological Distress Scale and the Subjective Well-being Inventory. The center of pressure was analyzed to determine the center of gravity shift during dart throwing.

Results

The analysis of factors influencing the determination of the MCI score during the intervention revealed a tendency for the center of gravity shift to be associated as a protective factor in the non-MCI group, although this association did not reach statistical significance (odds ratio = 0.942, p = 0.084). In the MCI group, a significant effect of age was observed in the MCI score (odds ratio = 1.539, p = 0.007).

Conclusion

The current findings suggest that conducting center of gravity shift testing could potentially provide a helpful tool for predicting early decline in cognitive function.

The effect of negative emotion processing on spatial navigation: an experimental study using virtual reality

Finding one's way in unfamiliar environments is an essential ability. When navigating, people are overwhelmed with an enormous amount of information. However, some information might be more relevant than others. Despite the mounting knowledge about the mechanisms underlying orientational skills, and the notable effects of facial emotions on human behavior, little is known about emotions' effects on spatial navigation. Hereby, this study aimed to explore how exposure to others' negative emotional facial expressions affects wayfinding performances. Moreover, gender differences that characterize both processes were considered. Fifty-five participants (31 females) entered twice in three realistic virtual reality environments: the first time, to encode a route to find an object and then to recall the learned path to reach the same object again. In between the two explorations of the virtual environment, participants were asked to undergo a gender categorization task during which they were exposed to sixty faces showing either neutral, fearful, or angry expressions. Results showed a significant interaction between emotions, time, and gender. In particular, the exposition to fearful faces, but not angry and neutral ones, decreased males' wayfinding performances (i.e., travel times and distance travelled), while females' performances were unaffected. Possible explanations for such gender and emotional dissimilarities are discussed.

Efficacy of Corsi Block Tapping Task training for improving visuospatial skills: a non-randomized two-group study

Even though impaired visuospatial abilities can negatively affect daily functioning, there are very few training programs that attempt to improve visuospatial abilities. The purpose of this study was to examine if a single training session with a computerized version of the Corsi Block Tapping Task could improve mental rotation skills. Fifty-three young adults were assigned to one of two groups: (1) control group (mean age = 21.4; 10 females), who had 20 min of rest after their baseline assessment, or (2) training group (mean age = 21.5; 17 females), who had 20 min of training on the Corsi Block Tapping Task after their baseline assessment. The primary outcome was reaction time on a computer-based mental rotation task, and it was assessed both before and after the rest or training. There was a significant interaction between time (pre vs. post) and group (control vs. training) on mental rotation performance (p = 0.04), with the training group performing on average 124 ms faster on accurate trials than the control group at post-test. This preliminary study suggested that improving mental rotation may be feasible through targeted cognitive training. Future studies will consider multiple sessions of Corsi Block Tapping Task training to maximize training benefits (i.e., dose-response), as well as longer term retention in cognitively intact and impaired individuals.

Reassessing Fitness-to-Drive in Drinker Drivers: The Role of Cognition and Personality

Drunken driving is among the main challenges for road safety by causing worldwide motor-vehicle crashes with severe injuries and deaths. The reassessment of fitness-to-drive in drivers stopped for drunken driving includes mainly psychological examinations. The present study aimed to investigate the effectiveness and the consistency of selected variables of different psychological driving-related dimensions (i.e., cognitive skills and personality) in discriminating 90 male drinker drivers (DD) from matched non-drinkers controls. The Montreal Cognitive Assessment (MoCA), the Mental Rotation Test (MRT), and the Perspective-Taking Test (PT) were administered to assess overall cognitive functioning, and object- and self-based spatial transformation abilities, respectively. Participants completed a computerized test measuring resilience of attention (DT), reaction times (RT), and perceptual speed (ATAVT). The Personality Psychopathology Five scales (i.e., PSY-5: Aggressiveness-AGGR, Psychoticism-PSYC, Disconstraint-DISC, Negative-Emotionality-NEGE, and Introversion-INTR) the validity scale (L) and the dissimulation index (F-K) were scored from the Minnesota Multiphasic Personality Inventory (MMPI-2). A logistic binomial regression analysis (backward subtraction method) was used to identify discriminant predictors. A prediction analysis (ROC curve method) was performed on the final model. Results showed that the scores obtained in MRT, DT, and the personality measures of PSYC, DISC, NEGE, and INTR significantly discriminated DD from their matched controls with moderate-to-good values of accuracy (0.79), sensitivity (0.80), and specificity (0.79), as well as a good AUC value (0.89). In some cases, the personality dimensions provided—reliable—unexpected results. Low scores of PSYC, NEGE, and INTR were found to predict the membership to the DD group; results are discussed with reference to response management. Personality measures should be assessed with particular attention in a forensic context because they are more prone to be feigned than cognitive ones. Overall, the present study confirmed the relevance of integrating different driving-related psychological dimensions in the evaluation of fitness-to-drive showing the usefulness of standardized tools for the reassessment of drinker drivers.

Cognitive Efficiency and Fitness-to-Drive along the Lifespan: The Mediation Effect of Visuospatial Transformations

The way people represent and transform visuospatial information affects everyday activities including driving behavior. Mental rotation and perspective taking have recently been found to predict cognitive prerequisites for fitness-to-drive (FtD). We argue that the relationship between general cognitive status and FtD is mediated by spatial transformation skills. Here, we investigated the performance in the Mental Rotation Test (MRT) and the Perspective-Taking Test (PT) of 175 male active drivers (aged from 18 to 91 years), by administering the Montreal Cognitive Assessment (MoCA) to measure their global cognitive functioning. All participants were submitted to a computerized driving assessment measuring resilience of attention (DT), reaction speed (RS), motor speed (MS), and perceptual speed (ATAVT). Significant results were found for the effect of global cognitive functioning on perceptual speed through the full mediation of both mental rotation and perspective-taking skills. The indirect effect of global cognitive functioning through mental rotation was only found to significantly predict resilience of attention whereas the indirect effect mediated by perspective taking only was found to significantly predict perceptual speed. Finally, the negative effect of age was found on each driving measure. Results presented here, which are limited to male drivers, suggest that general cognitive efficiency is linked to spatial mental transformation skills and, in turn, to driving-related cognitive tasks, contributing to fitness-to-drive in the lifespan.