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TRB’s Commercial Truck and Bus Safety Synthesis Program (CTBSSP) Synthesis 19: Effects of Psychoactive Chemicals on Commercial Driver Health and Performance: Stimulants, Hypnotics, Nutritional, and Other Supplements identifies available information and research gaps relating to the use of chemical substances by commercial drivers and is intended to provide up-to-date information to inform decision makers about the near-, mid-, and long-range planning needs for research and educational outreach programs.
There are approximately 4,000 fatalities in crashes involving trucks and buses in the United States each year. Though estimates are wide-ranging, possibly 10 to 20 percent of these crashes might have involved fatigued drivers. The stresses associated with their particular jobs (irregular schedules, etc.) and the lifestyle that many truck and bus drivers lead, puts them at substantial risk for insufficient sleep and for developing short- and long-term health problems. Commercial Motor Vehicle Driver Fatigue, Long-Term Health and Highway Safety assesses the state of knowledge about the relationship of such factors as hours of driving, hours on duty, and periods of rest to the fatigue experienced by truck and bus drivers while driving and the implications for the safe operation of their vehicles. This report evaluates the relationship of these factors to drivers' health over the longer term, and identifies improvements in data and research methods that can lead to better understanding in both areas.
Fatigue is a recognized problem in many facets of the human enterprise. It is not confined to any one area of activity but enters all situations in which humans have to perform for extended intervals of time. Most problematic are the circumstances in which obligatory action is continuous and the results of failure are evidently serious or even catastrophic. Therefore, the modern media especially highlights fatigue-related failures in industries such as transportation, materials processing and healthcare. It can be, and indeed is, no coincidence that most of the spectacular failures in process control that have resulted in the world's largest industrial accidents have occurred in the small hours of the morning when the circadian rhythm is lowest and operator fatigue itself peaks. While there have been legislative efforts made at state, federal and international levels to regulate working hours of employees, the appropriate implementation of such legislation is still a long way off. The Handbook of Operator Fatigue provides a comprehensive account of the subject to serve as the definitive reference work for researchers, students and practitioners alike. The volume features 30 chapters written by experts from around the world to address each important facet of fatigue, including: the scale of the fatigue problem (Section I), the nature of fatigue (Section II), how to assess fatigue (Section III), the impact of fatigue on health (Section IV), fatigue in the workplace (Section V), the neurological basis of fatigue (VI), sleep disorders (VII), and the design of countermeasures to fatigue (VIII).
In the world of transportation, fatigue is a silent killer that can affect us all. Understanding fatigue, including how to manage it to minimize safety risk, is of great importance. However, while it is one thing to recognize that fatigue is a critical safety issue, it is quite another to set up a successful, scientifically informed fatigue risk management programme. This book is here to help. It has been carefully designed as a comprehensive reference point, bringing together international expertise from leaders in fatigue science, and showcasing valuable insights from transportation industry practitioners. The 40 authored chapters are divided into six sections, to better understand fatigue science, the consequences of fatigue in transportation, contributors to fatigue, managing fatigue and promoting alertness, real world case studies of fatigue management in practice, and future perspectives. While it is possible to read each chapter in isolation, most will be gained by reading the book as a whole. Each chapter starts with an abstract overview and concludes with summary bullet points, creating a handy "quick check" for key points. This accessible text is for those who are interested in supporting alert and safe transportation operations. It is suitable for professionals, transport managers, government advisors, policy makers, students, academics, and anyone who wants to learn more. All transport modes (road, rail, maritime and aviation) are considered. For anyone waking up to the complex challenge of fatigue management, this handbook is a must.
A comprehensive approach to accurate ADHD diagnosis In Essentials of ADHD Assessment in Children and Adolescents, the authors provide a clear and informative road map for practitioners seeking to conduct state-of-the-art assessments for one of the most common disorders of childhood. Drawing upon years of experience in conducting diagnostic evaluations of ADHD following best-practice standards, they emphasize the importance of a comprehensive evaluation, incorporating data from multiple sources, using multiple methods, and interpreting findings within the appropriate developmental and cultural contexts. The major components of an ADHD evaluation (interviews, rating scales, cognitive testing, observation, record review) are reviewed in detail. Expert guidance is provided for resolving the most common challenges in assessing ADHD, including differentiating symptoms from normal development, dealing with discrepant data, differential diagnosis, and considering comorbidity. The latest scholarly literature is integrated with the authors' practical recommendations to provide clinicians with the concepts and tools needed for effective and accurate assessment of ADHD, addressing such topics as: When inattention is ADHD, and when it may be emotional or neurological Which disorders may masquerade as or present with ADHD The elements of accurate ADHD testing and the reasons behind them Integrating results of a multi-modal approach into an ADHD assessment An indispensable professional resource for practicing clinicians, Essentials of ADHD Assessment for Children and Adolescents is a reader-friendly guide to providing a thorough, responsible ADHD evaluation.
This volume makes a contribution to the field of neurolaw by investigating issues raised by the development, use, and regulation of neurointerventions. The broad range of topics covered in these chapters reflects neurolaw's growing social import, and its rapid expansion as an academic field of inquiry. Some authors investigate the criminal justice system's use of neurointerventions to make accused defendants fit for trial, to help reform convicted offenders, or to make condemned inmates sane enough for execution, while others interrogate the use, regulation, and social impact of cognitive enhancement medications and devices. Issues raised by neurointervention-based gay conversion "therapy", efficacy and safety of specific neurointervention methods, legitimacy of their use and regulation, and their implications for authenticity, identity, and responsibility are among the other topics investigated. Dwelling on neurointerventions also highlights tacit assumptions about human nature that have important implications for jurisprudence. For all we know, at present such things as people's capacity to feel pain, their sexuality, and the dictates of their conscience, are unalterable. But neurointerventions could hypothetically turn such constants into variables. The increasing malleability of human nature means that analytic jurisprudential claims (true in virtue of meanings of jurisprudential concepts) must be distinguished from synthetic jurisprudential claims (contingent on what humans are actually like). Looking at the law through the lens of neurointerventions thus also highlights the growing need for a new distinction between analytic jurisprudence and synthetic jurisprudence to tackle issues that increasingly malleable humans will face when they encounter novel opportunities and challenges.
This expert compendium surveys the current state of military psychology across the branches of service at the clinical, research, consulting, and organizational levels. Its practical focus examines psychological adjustment pre- and post-deployment, commonly-encountered conditions (e.g., substance abuse), and the promotion of well-being, sleep, mindfulness, and resilience training. Coverage pays particular attention to uses of psychology in selection and assessment of service personnel in specialized positions, and training concerns for clinicians and students choosing to work with the military community. Chapters also address topics of particular salience to a socially conscious military, including PTSD, sexual harassment and assault, women’s and LGBT issues, suicide prevention, and professional ethics. Among the specific chapters topics covered: · Military deployment psychology: psychologists in the forward environment. · Stress and resilience in married military couples. · Assessment and selection of high-risk operational personnel: processes, procedures, and underlying theoretical constructs. · Understanding and addressing sexual harassment and sexual assault in the US military. · Virtual reality applications for the assessment and treatment of PTSD. · Plus international perspectives on military psychology from China, Australia, India, and more. Grounding its readers in up-to-date research and practice, Military Psychology will assist health psychologists, clinical psychologists, psychiatrists, and clinical social workers in understanding and providing treatment for military populations, veterans, and their families, as well as military psychologists in leadership and consulting positions.

Halcion

Committee on Halcion: An Assessment of Data Adequacy and Confidence

Published: 1997-12-15

Total Pages: 177


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Regulatory agencies within the United States and the United Kingdom, among several other countries, have reviewed extensively the safety and efficacy of Halcion (triazolam)--a once commonly used hypnotic drug. Concerns began to emerge about the safety of Halcion when a Dutch physician reported a possible link between it and a syndrome that included such effects as depression, amnesia, hallucinations, and increased anxiety. In addition, in 1991 its manufacturer, Upjohn, noted that "errors had been identified in a report of one of the clinical studies included in the original" application for approval. Since then, the drug has been removed from the market in several countries, whereas in the United States and Canada, the drug's labeling has been modified to reduce the recommended dose and duration of treatment and to heighten awareness of possible side effects. Yet different data and analyses have resulted in conflicting messages that are difficult to reconcile and interpret. In response to a request from the Food and Drug Administration to resolve these controversial issues related to the safety and efficacy of Halcion, this IOM book assesses the adequacy of the drug's clinical trials; the quality and quantity of data on adverse reactions; overall confidence in the data on effectiveness, adverse events, and side effects at different doses; and whether additional studies are needed.