Deterring illegal smartphone use while driving: Are perceptions of risk information associated with the impact of informal sanctions?

Advertising campaigns have used threat appeals to increase the perceptions of risk associated with dangerous driving behaviours. Building on recent research that suggests increasing the pertinence of informal sanctions (sense of guilt, fear of peer disapproval, or fear of hurting oneself and others) decreases the likelihood of illegal smartphone engagement while driving, this study aimed to determine if perceptions of risk information, that is, how effective drivers believe the information is in deterring their illegal use, is associated with perceptions of informal sanctions. An online survey of 1027 Victorians who self-reported illegal smartphone use while driving asked participants to rate the personal deterrent effectiveness of five types of risks associated with illegal smartphone use while driving. A hierarchical linear regression model explored the associations between the most effective risks and each informal sanction. Female drivers were more likely than male drivers to experience guilt, fear of social loss and fear of physical loss when using their smartphones illegally. More frequent illegal smartphone engagement while driving was associated with decreased impact of informal sanctions. Female drivers were more likely than male drivers to perceive each risk as effective. The most effective piece of information was, "Contributes to 16% of Victorian road deaths and serious injuries annually"; it was also the least known (32.7% males, 26.7% females). This message, alongside, "Increases risk of a crash comparable to those associated with driving under the influence of alcohol or cannabis" and, "A 2 s glance at your phone while driving at 50 km/h effectively means driving blind for 27 m", were associated with stronger perceptions of guilt, fear of peer disapproval, or fear of hurting oneself and others when thinking about using a smartphone illegally while driving. These results suggest tailoring and targeting these specific risk information may be effective in deterring illegal smartphone use while driving.

"Does that mean I can't use my phone to pay when I'm in the Maccas drive thru?": Younger drivers' uncertainty and attitude toward smartphone law and punishment.

This study employed a mixed methods approach (a survey [n = 2,774] and focus groups [n = 16]) to understand the perceptions of younger drivers (18-25) on current smartphone laws in the Australian state of Victoria. First, by analysing quantitative data gathered from an online survey regarding smartphone laws, perceptions of punishment when breaking the law, and attitudes to both the law and fines, this study found younger drivers were less likely to understand the law around phone use while driving, even after direct or indirect experience with police. Additionally, the severity and impact of fines were perceived as more impactful and severe among younger drivers, women, and those on lower incomes, and the most common types of illegal use younger drivers engaged with were navigation, music applications, and hands-free calling, mostly facilitated through Bluetooth with their device placed out of sight. Consequently, focus groups were conducted with a subset of these younger drivers to explore these findings in more depth. It was revealed that smartphone laws were perceived to be ambiguous, at times unreasonable, and difficult to access conclusive information regarding the law or receive information throughout the Graduated Licencing Program. Additionally, of full licenced drivers breaking smartphone laws (n = 807), 61.7 percent never used a cradle. Among probationary drivers breaking the law (n = 209), 76.1 percent never used a cradle. This suggests rampant surreptitious illegal use. As such, younger drivers learning to drive are also learning methods to avoid punishment while breaking smartphone laws. This included not using a cradle and opting instead for Bluetooth connectivity or engaging in hand-held use, a choice that continued into Full Licensed driving. The severity of punishment was not common knowledge and was perceived to be incommensurate to the risks associated with certain types of use. In their opinion all of these factors reduced the legitimacy of the law. Addressing these factors with evidence-based countermeasures may increase compliance and road safety.

The specificity of cyclists' aggression; examination of the cycling anger expression inventory across different recipient road user groups.

While cyclist aggression is relatively rare, it has been associated with increased crash risk. Previous measures of cyclist aggression have not taken into consideration who the recipient of the aggression may be; this is likely to differ across road user types. The aim of this study was to understand if cyclists' aggression differs according to whether the recipient is a driver, pedestrian or another cyclist. To examine this, 1206 cyclists (males = 75 %; age range 18-80 years; M = 47.35 ± 11.81) completed the Cycling Anger Expression Inventory (CAX; Møller and Haustein, 2017) three times; once for each road user type. Respondents also provided information regarding their cycling anger tendencies. Open text responses regarding sources of, and responses to, anger were also sought. The measurement invariance of the three CAX models was examined to determine whether the items were interpreted in a similar manner for interactions with each road user type and to compare latent factor means. The results showed that verbal aggression was not the same across road users. However, adaptive constructive ways of dealing with anger were similar across the three types of recipients. Comparison of latent means showed that cyclists reported higher expressions of anger toward drivers than cyclists or pedestrians. Qualitative analysis of the text responses suggest this is due to the perceived risk posed by drivers combined with positive attitudes expressed towards sharing infrastructure with pedestrians and other cyclists. Based on these findings it was concluded that: i) the CAX might best be used with reference to drivers, rather than "road users", and ii) while aggression in cyclists is rare, it is more common toward drivers than other road users.

Understanding the deterrent impact formal and informal sanctions have on illegal smartphone use while driving.

The illegal use of a smartphone while driving increases the risk of crashes. As such, road authorities rely on countermeasures to reduce illegal smartphone use. Deterrence-based methods dominate road safety, however, perceptions and impact of formal (legal) and informal (non-legal) methods to deter illegal smartphone use in Australia have not yet been explored. The current study reports on a survey of 2774 drivers (47.0 % males) that own and regularly use a smartphone. The survey analysed the self-reported frequency of illegal smartphone use while driving, perceptions of formal and informal deterrence mechanisms, differences between perceived and informed deterrence, and deterrent predictors of illegal use. The findings revealed that illegal smartphone use is increasing in Victoria, Australia. Drivers that break the law perceive deterrent mechanisms significantly different from drivers that abide by the law, however, both groups view the prospect of hurting oneself as most impactful. Additionally, drivers tend to underestimate the consequences of illegal use, yet overestimate the certainty of apprehension. A binary logistic regression analysis revealed that only age, gender and informal sanctions such as social loss (stigma/peer disapproval), internal loss (shame/guilt/embarrassment), and physical loss (injury/property damage) were significant predictors of illegal use. None of the formal mechanisms were significant. Based on these findings, road safety interventions and future research should consider exploring the psychological characteristics of young people's perceptions of informal sanctions such as social loss (shame/embarrassment) and internal loss (guilt).

Self-reported mindfulness, cyclist anger and aggression.

Anger is a common behaviour exhibited by road users when one's goals are perceived to have been blocked by another. Recent research has demonstrated that, generally, cyclists tend to deal with anger in constructive ways. However, when anger does manifest, it can result in behaviours that increase their crash risk. Amongst motor vehicle drivers, mindfulness levels have been associated with less anger and appear to mediate anger and associated aggression. The current study sought to understand whether mindfulness has similar associations with anger and aggression in a sample of cyclists. A total of 583 cyclists (males = 68 %) completed an online questionnaire that sought information on their levels of mindfulness, current mindfulness practices and tendencies for anger and aggression while cycling. The relationships between these were then examined using structural equation modelling. The results showed that cyclists with higher mindfulness levels tended to report less anger across a range of situations (e.g., interactions with pedestrians, cyclists, motor vehicle drivers and police). Both direct and indirect (through anger) relationships were found between mindfulness and aggression, again showing that more mindful cyclists tended to engage in less frequent aggression. These findings align with recent research investigating this relationship amongst motor vehicle drivers and suggest that mindfulness may be a promising strategy to reduce or avoid anger and aggression in cyclists.

The Driver Behaviour Questionnaire for older drivers: Do errors, violations and lapses change over time?

The aim of the current study was to examine how self-reported aberrant driving behaviours change across a three time-points in a group of older drivers. Two hundred and twenty-seven older drivers (males = 69.6%) from the Candrive/Ozcandrive longitudinal study completed the Driving Behaviour Questionnaire (DBQ) each yearacross three time-points (i.e., Year 1, Year 2, Year 3). At the third time-point, older drivers ranged in age from 77 to 96 years (M = 81.74 years; SD = 3.44 years). A longitudinal confirmatory factor analysis showed that a modified 21-item, 3-factor (errors, lapses and violations) DBQ was invariant across the time period, suggesting that the structure of the questionnaire was stable across each time-point. Further, multiple domain latent growth analysis on the resultant factors for errors, lapses and violations showed that the frequency of errors remained similar across the three-year period, while violations and lapses showed very marginal decreases in frequency. These changes were independent of the absolute number of these behaviours; Drivers with higher violations or lapses in Year one, showed similar decreases in frequency as those who self-reported lower frequencies of the behaviours. These results suggest that the DBQ is a reliable tool to measure older drivers' self-reported aberrant driving behaviours, and that these behaviours do not show much change across time. Future research should validate the self-reported responses from the DBQ with more objective measures such as those collected through naturalistic driving study (NDS) methodology or on-road driving tasks.

Are older drivers' driving patterns during an on-road driving task representative of their real-world driving patterns?

OBJECTIVE: The current study investigated whether older drivers' driving patterns during a customized on-road driving task were representative of their real-world driving patterns. METHODS: Two hundred and eight participants (male: 68.80%; mean age = 81.52 years, SD = 3.37 years, range = 76.00-96.00 years) completed a customized on-road driving task that commenced from their home and was conducted in their own vehicle. Participants' real-world driving patterns for the preceding 4-month period were also collected via an in-car recording device (ICRD) that was installed in each participant's vehicle. RESULTS: During the 4-month period prior to completing the on-road driving task, participants' median real-world driving trip distance was 2.66 km (interquartile range [IQR] = 1.14-5.79 km) and their median on-road driving task trip distance was 4.41 km (IQR = 2.83-6.35 km). Most participants' on-road driving task trip distances were classified as representative of their real-world driving trip distances (95.2%, n = 198). CONCLUSIONS: These findings suggest that most older drivers were able to devise a driving route that was representative of their real-world driving trip distance. Future research will examine whether additional aspects of the on-road driving task (e.g., average speed, proportion of trips in different speed zones) are representative of participants' real-world driving patterns.

Mitochondria, Cybrids, Aging, and Alzheimer's Disease.

Mitochondrial and bioenergetic function change with advancing age and may drive aging phenotypes. Mitochondrial and bioenergetic changes are also documented in various age-related neurodegenerative diseases, including Alzheimer's disease (AD). In some instances AD mitochondrial and bioenergetic changes are reminiscent of those observed with advancing age but are greater in magnitude. Mitochondrial and bioenergetic dysfunction could, therefore, link neurodegeneration to brain aging. Interestingly, mitochondrial defects in AD patients are not brain-limited, and mitochondrial function can be linked to classic AD histologic changes including amyloid precursor protein processing to beta amyloid. Also, transferring mitochondria from AD subjects to cell lines depleted of endogenous mitochondrial DNA (mtDNA) creates cytoplasmic hybrid (cybrid) cell lines that recapitulate specific biochemical, molecular, and histologic AD features. Such findings have led to the formulation of a "mitochondrial cascade hypothesis" that places mitochondrial dysfunction at the apex of the AD pathology pyramid. Data pertinent to this premise are reviewed.

Toward best practice in Human Machine Interface design for older drivers: A review of current design guidelines.

Older adults are the fastest growing segment of the driving population. While there is a strong emphasis for older people to maintain their mobility, the safety of older drivers is a serious community concern. Frailty and declines in a range of age-related sensory, cognitive, and physical impairments can place older drivers at an increased risk of crash-related injuries and death. A number of studies have indicated that in-vehicle technologies such as Advanced Driver Assistance Systems (ADAS) and In-Vehicle Information Systems (IVIS) may provide assistance to older drivers. However, these technologies will only benefit older drivers if their design is congruent with the complex needs and diverse abilities of this driving cohort. The design of ADAS and IVIS is largely informed by automotive Human Machine Interface (HMI) guidelines. However, it is unclear to what extent the declining sensory, cognitive and physical capabilities of older drivers are addressed in the current guidelines. This paper provides a review of key current design guidelines for IVIS and ADAS with respect to the extent they address age-related changes in functional capacities. The review revealed that most of the HMI guidelines do not address design issues related to older driver impairments. In fact, in many guidelines driver age and sensory cognitive and physical impairments are not mentioned at all and where reference is made, it is typically very broad. Prescriptive advice on how to actually design a system so that it addresses the needs and limitations of older drivers is not provided. In order for older drivers to reap the full benefits that in-vehicle technology can afford, it is critical that further work establish how older driver limitations and capabilities can be supported by the system design process, including their inclusion into HMI design guidelines.

Pharmacologically effective red yeast rice preparations marketed as dietary supplements illustrated by a case report.

This paper reports a typical statin-related adverse reaction from a red yeast rice (RYR) supplement and the analytical findings from the supplement. It also examines the regulatory framework governing botanical supplements in Europe. Two key events that shaped the current regulatory framework are reviewed. First, the Hecht-Pharma judgement by the European Court of Justice (ECJ) that inverted the precautionary principle in the Medicines Act to a reactionary principle. Following the Hecht-Pharma judgement, pharmacological active dietary supplements can be sold until sufficient signals of harm show that they are an unregistered medicine, placing a huge burden on regulatory authorities. Secondly, the European Food Safety Authority (EFSA) in 2011 approved the first health claim for pharmacologically active RYR dietary supplements. If the current regulatory status for pharmacologically active RYR dietary supplements does not permit adequate warning and active monitoring of adverse drug reactions, then the current regulatory framework may not be adequate to ensure consumer safety.Copyright © 2016 John Wiley & Sons, Ltd.

An international study of the quality of national-level guidelines on driving with medical illness.

BACKGROUND: Medical illnesses are associated with a modest increase in crash risk, although many individuals with acute or chronic conditions may remain safe to drive, or pose only temporary risks. Despite the extensive use of national guidelines about driving with medical illness, the quality of these guidelines has not been formally appraised. AIM: To systematically evaluate the quality of selected national guidelines about driving with medical illness. DESIGN: A literature search of bibliographic databases and Internet resources was conducted to identify the guidelines, each of which was formally appraised. METHODS: Eighteen physicians or researchers from Canada, Australia, Ireland, USA and UK appraised nine national guidelines, applying the Appraisal of Guidelines for Research and Evaluation (AGREE II) instrument. RESULTS: Relative strengths were found in AGREE II scores for the domains of scope and purpose, stakeholder involvement and clarity of presentation. However, all guidelines were given low ratings on rigour of development, applicability and documentation of editorial independence. Overall quality ratings ranged from 2.25 to 5.00 out of 7.00, with modifications recommended for 7 of the guidelines. Intra-class coefficients demonstrated fair to excellent appraiser agreement (0.57-0.79). CONCLUSIONS: This study represents the first systematic evaluation of national-level guidelines for determining medical fitness to drive. There is substantive variability in the quality of these guidelines, and rigour of development was a relative weakness. There is a need for rigorous, empirically derived guidance for physicians and licensing authorities when assessing driving in the medically ill.

Examining physiological responses across different driving maneuvers during an on-road driving task: a pilot study comparing older and younger drivers.

OBJECTIVE: This pilot study aimed to investigate physiological responses during an on-road driving task for older and younger drivers. METHODS: Five older drivers (mean age = 74.60 years [2.97]) and 5 younger drivers (mean age = 30.00 years [3.08]) completed a series of cognitive assessments (Montreal Cognitive Assessment [MoCA], Mini Mental Status Examination [MMSE]; Trail Making Test [Trails A and Trails B]) and an on-road driving task along a predetermined, standardized urban route in their own vehicle. Driving performance was observed and scored by a single trained observer using a standardized procedure, where driving behaviors (appropriate and inappropriate) were scored for intersection negotiation, lane changing, and merging. During the on-road driving task, participants' heart rate (HR) was monitored with an unobtrusive physiological monitor. RESULTS: Younger drivers performed significantly better on all cognitive assessments compared to older drivers (MoCA: t(8) = 3.882, P <.01; MMSE: t(8) = 2.954, P <.05; Trails A: t(8) = -2.499, P <.05; Trails B: t(8) = -3.262, P <.05). Analyses of participants' performance during the on-road driving task revealed a high level of appropriate overall driving behavior (M = 87%, SD = 7.62, range = 73-95%), including intersection negotiation (M = 89%, SD = 8.37%), lane changing (M = 100%), and merging (M = 53%, SD = 28.28%). The overall proportion of appropriate driving behavior did not significantly differ across age groups (younger drivers: M = 87.6%, SD = 9.04; older drivers: M = 87.0%, SD = 6.96; t(8) = 0.118, P =.91). CONCLUSIONS: Although older drivers scored lower than younger drivers on the cognitive assessments, there was no indication of cognitive overload among older drivers based on HR response to the on-road driving task. The results provide preliminary evidence that mild age-related cognitive impairment may not pose a motor vehicle crash hazard for the wider older driver population. To maintain safe mobility of the aging population, further research into the specific crash risk factors in the older driver population is warranted.

Distribution of glial cells in the auditory brainstem: normal development and effects of unilateral lesion.

Auditory brainstem networks facilitate sound source localization through binaural integration. A key component of this circuitry is the projection from the ventral cochlear nucleus (VCN) to the medial nucleus of the trapezoid body (MNTB), a relay nucleus that provides inhibition to the superior olivary complex. This strictly contralateral projection terminates in the large calyx of Held synapse. The formation of this pathway requires spatiotemporal coordination of cues that promote cell maturation, axon growth, and synaptogenesis. Here we have examined the emergence of distinct classes of glial cells, which are known to function in development and in response to injury. Immunofluorescence for several astrocyte markers revealed unique expression patterns. Aldehyde dehydrogenase 1 family member L1 (ALDH1L1) was expressed earliest in both nuclei, followed by S100ß, during the first postnatal week. Glial fibrillary acidic protein (GFAP) expression was seen in the second postnatal week. GFAP-positive cell bodies remained outside the boundaries of VCN and MNTB, with a limited number of labeled fibers penetrating into the margins of the nuclei. Oligodendrocyte transcription factor 2 (OLIG2) expression revealed the presence of oligodendrocytes in VCN and MNTB from birth until after hearing onset. In addition, ionized calcium binding adaptor molecule 1 (IBA1)-positive microglia were observed after the first postnatal week. Following hearing onset, all glial populations were found in MNTB. We then determined the distribution of glial cells following early (P2) unilateral cochlear removal, which results in formation of ectopic projections from the intact VCN to ipsilateral MNTB. We found that following perturbation, astrocytic markers showed expression near the ectopic ipsilateral calyx. Taken together, the developmental expression patterns are consistent with a role for glial cells in the maturation of the calyx of Held and suggest that these cells may have a similar role in maturation of lesion-induced connections.

Hibernation site requirements of bats in man-made hibernacula in a spatial context.

Bat hibernacula selection depends on various spatial and nonspatial variables that differ widely between sites. However, previous studies have focused mainly on nonspatial variables. This research investigated factors that determined the abundance and species richness of hibernating bats in hibernation objects of the New Dutch Waterline, The Netherlands, and determined the relevant scales over which spatial factors operate using regression techniques and ecological-niche factor analyses. The effects of 32 predictor variables on several response variables, i.e., the total bat abundance, species richness, and abundance and presence of bat species, were investigated. Predictor variables were classified as internal variables (e.g., building size, climatic conditions, and human access) or external variables (e.g., ground and vegetation cover and land cover type) that were measured at different spatial scales to study the influence of the spatial context. The internal building variables (mainly the size of hibernacula and the number of hiding possibilities) affected the hibernating bat abundance and species richness. Climatic variables, such as changes in temperature and humidity, were less important. The hibernation site suitability was also influenced by spatial variables at a variety of scales, thereby indicating the importance of scale-dependent species-environment relationships. The absence of human use and public access enhanced hibernation site suitability, but the internal size-related variables had the greatest positive effect on hibernation site suitability. These results demonstrate the importance of considering the different spatial scales of the surrounding landscape to better understand habitat selection, and they offer directives to managers to optimize objects for hibernating bats and to improve management and bat conservation. The analyses have wider applications to other wildlife-habitat studies.

Development and evaluation of a driving observation schedule (DOS) to study everyday driving performance of older drivers.

This paper describes the development and evaluation of an on-road procedure, the Driving Observation Schedule (DOS), for monitoring individual driving behavior. DOS was developed for use in the Candrive/Ozcandrive five-year prospective study of older drivers. Key features included observations in drivers' own vehicles, in familiar environments chosen by the driver, with start/end points at their own homes. Participants were 33 drivers aged 75+ years, who drove their selected route with observations recorded during intersection negotiation, lane-changing, merging, low speed maneuvers and maneuver-free driving. Driving behaviors were scored by a specialist occupational therapy driving assessor and another trained observer. Drivers also completed a post-drive survey about the acceptability of DOS. Vehicle position, speed, distance and specific roadways traveled were recorded by an in-vehicle device installed in the participant's vehicle; this device was also used to monitor participants' driving over several months, allowing comparison of DOS trips with their everyday driving. Inter-rater reliability and DOS feasibility, acceptability and ecological validity are reported here. On average, drivers completed the DOS trip in 30.48min (SD=7.99). Inter-rater reliability measures indicated strong agreement between the trained and the expert observers: intra-class correlations (ICC)=0.905, CI 95% 0.747-0.965, p<0.0001; Pearson product correlation, r (18)=.83, p<0.05. Standard error of the measurement (SEM), method error (ME) and coefficient of variation (CV) measures were consistently small (3.0, 2.9 & 3.3%, respectively). Most participants reported being 'completely at ease' (82%) with the driving task and 'highly familiar with the route' (97%). Vehicle data showed that DOS trips were similar to participants' everyday driving trips in roads used, roadway speed limits, drivers' average speed and speed limit compliance. In summary, preliminary findings suggest that DOS can be scored reliably, is of feasible duration, is acceptable to drivers and representative of everyday driving. Pending further research with a larger sample and other observers, DOS holds promise as a means of quantifying and monitoring changes in older drivers' performance in environments typical of their everyday driving.

The impact of new legislation on child restraint system (CRS) misuse and inappropriate use in Australia.

OBJECTIVE: The current study aimed to investigate the incidence of child restraint system (CRS) misuse and/or inappropriate use of CRS through an Australian CRS inspection program conducted by CRS fitting specialists between October 2004 and October 2011 and to determine whether CRS misuse and/or inappropriate use of CRS changed following new Australian legislation regarding CRS and motor vehicle restraint use for children aged 7 years and under. METHODS: Participants were recruited through an advertisement for free CRS inspections displayed at childcare centers, kindergartens, community centers, hospitals, and child expos. At each inspection, a CRS fitting specialist inspected each child in their CRS while in their vehicle and reported to the owner of the CRS on the installation of the child restraint(s) and/or system(s) and any fitting faults and/or concerns with the fitting and/or use of the child restraint(s) and or system(s). RESULTS: Results are based on the inspection of 2674 CRS. Of all of the CRS inspected, the majority (79%) were reported as having at least one instance of misuse and/or inappropriate use. The most common forms of CRS misuse and/or inappropriate use observed were harness strap errors (twisted, poorly adjusted, and/or incorrectly positioned, 41%), seat belt errors (incorrectly routed, twisted, and/or incorrectly adjusted, 32%), and a missing or incorrect fitting of the gated buckle/locking clip (24%). Significant differences were found across the proportion of CRS misuse and/or inappropriate use across restraint types (infant restraint/forward-facing CRS/convertible [birth to 18 kg] CRS/convertible [8-26 kg] CRS/boosters [booster seat/cushion/booster with harness combination]), χ(2)(4) = 147.852, P < .001. CRS misuse and/or inappropriate use were most prevalent among convertible CRS (birth to 18 kg; 87%), forward-facing CRS (85%), and convertible CRS (8-26 kg; 81%), compared to infant restraints (73%) and booster seats (booster seats/cushions/boosters with H-harness combination; 65%). There was no significant difference in the proportion of CRS with misuse and/or inappropriate use across the pre- and post-legislation period (80% vs. 77%), χ(2)(1) = 1.545, P > .5. CONCLUSIONS: Based on the findings of the current study, it was concluded that, despite the introduction of new, definitive CRS legislation, CRS misuse and/or inappropriate use remains widespread in Australia. The findings highlight the need for CRS education and legislation that include information on correct CRS use, as well as information on appropriate CRS use, in order to provide specialized protection for child vehicle occupants in the event of a motor vehicle crash.

[Identification of possible cognizance parameters of "mimic disintegration" in schizophrenia using facial electromyography]. / Identifizierung möglicher Kennparameter der "mimischen Desintegration" bei schizophrenen Patienten mittels einer Gesichts-EMG-Methode.

UNLABELLED: The aim of this study was to identify signs of "mimic disintegration" in schizophrenics using a facial electromyographic (EMG) method. We compared a group of 20 unmedicated schizophrenics with a group of 20 healthy subjects, measuring the activity of three joy-relevant facial muscles (zygomaticus major, orbicularis oculi, levator labii superioris) and two nonjoy-relevant facial muscles (frontalis, corrugator supercilii) as control muscles during two consecutive presentations of an erotic slide from the International Affective Picture System. RESULT: Schizophrenics show significantly less activity of joy-relevant facial muscles and a lower smile frequency than healthy subjects. Two signs of mimic disintegration" could be identified: 1. undefined mimic reactions and 2. lack of mimic consistency. CONCLUSION: Facial EMG is a state-of-the-art method for analyzing possible signs of mimic disintegration as described by Heimann and Spoerri. We suggest further examination of the two mimic disintegration signs regarding other emotions, necessarily including more facial muscles in the testing.

Socio-economic factors that predict psychiatric admissions at a local level.

BACKGROUND: The aim of the study was to confirm the predictive relationship between socio-economic factors and psychiatric admissions at a fine grain geographical level. The strength of association was compared with those of other studies that have looked at separate diagnostic groups. METHOD: Psychiatric admissions were from electoral wards of the County of South Glamorgan, which encompasses the capital city of Wales, Cardiff. Standardized psychiatric admission ratios (SAR) for different diagnostic groups were calculated for a 5-year period. The ecological association with deprivation indices and with single variables at the level of electoral ward was examined. Of a total of 15266 psychiatric admissions, 11296 were analysed. RESULTS: Psychiatric morbidity, reflected in SAR was inversely related to socio-economic deprivation for both sexes. This applied to all diagnostic groups except organic disorders. The relationship was most marked for schizophrenia, delusional disorders and substance abuse, closely followed by personality disorders, and less for affective and neurotic disorders. Little difference existed between three composite indices of deprivation (Carstairs, Jarman, Townsend), but the marginally best predictor was that designed by Jarman. However, low rates of car ownership and high unemployment were as good at predicting SAR as any of the compound indices. CONCLUSION: Socio-economic factors account for almost 50 % of the variance in psychiatric admission rates between electoral wards. The degree of association between psychiatric morbidity and deprivation varies between diagnostic groups, arguing against a common factor linking deprivation and psychiatric admissions generally. Frequently updated unemployment figures provide nearly as useful and more immediate information than 10-yearly Census data used to calculate the deprivation indices. These figures may be used for needs assessment and targeting resources at a local level.