Driving under the influence of alcohol: a sequence analysis approach

Driving under the influence of alcohol is a contributing factor to a number of road traffic accidents. There is, however, a lack of research into the behaviours that lead to drink driving. The current research used a novel approach, behaviour sequence analysis, to investigate the chains of behaviours that lead to drink driving. Statements were taken from individuals (N?=?60) in an interview, reporting a time they had consumed alcohol and driven a vehicle. Statements were coded and the sequences of behavioural pairs were analysed. Results were presented in a state transition diagram, and indicated a variety of behavioural sequences leading to drink driving. A significant chain of events showed that individuals who had attempted to calculate their blood alcohol concentration and then drive a vehicle felt unsafe to drive, after driving. Also, many individuals did not intend to drink and drive; however, influences such as peer pressure and being surrounded by alcohol lead to them being more likely to consume multiple alcoholic drinks, and then drive a vehicle. The current research outlines future research, and implications for polices and laws on behaviours that surround drink driving, as well as providing a new method for research.     

Markers of chronic alcohol use in hair: comparison of ethyl glucuronide and cocaethylene in cocaine users

Two direct ethanol metabolites, namely ethyl glucuronide (EtG) and cocaethylene (CE), in the hair of cocaine (COC) users were compared in this study. Hair samples (n=68) were submitted to the determination of EtG (by liquid chromatography-electrospray-tandem mass spectrometry) and of COC and metabolites, including CE (by gas chromatography-mass spectrometry). Quantitative and qualitative results were compared. No quantitative correlation was found between EtG and CE, as well as between EtG and the cocaethylene concentration divided by the concentration of COC and its metabolites (benzoylecgonine and ecgonine methylester, as COC equivalents). Nevertheless, many factors are supposed to affect the amount of the two substances incorporated in the hair matrix, such as the subject's habits in ethanol and COC use, genetic variability in the metabolism of both substances, and the different chemical and physical properties of EtG and CE. When establishing a cut-off of 4 pg/mg for EtG and of 200 pg/mg for CE, 47 samples tested positive for EtG and 41 samples tested positive for CE; 12 samples out of the 47 EtG-positives tested negative for CE (25%), whereas 6 samples out of the 41 CE-positives tested negative for EtG (15%). According to these data, EtG appears to be a more sensitive and specific marker of non-moderate alcohol users than CE.     

Paradigm Shift for the Alcohol Breath Test

Abstract: The alcohol breath test (ABT) has been used for quantification of ethyl alcohol in individuals suspected of driving under the influence for more than 50 years. In this time, there has been little change in the concepts underlying this single breath test. The old model, which assumes that end‐exhaled breath alcohol concentration is closely related to alveolar air alcohol concentration, is no longer acceptable. This paper reviews experimental research and mathematical modeling which has evaluated the pulmonary exchange processes for ethyl alcohol. Studies have shown that alcohol exchanges dynamically with the airway tissue both during inspiration and expiration. The airway tissue interaction makes it impossible to deliver air with alveolar alcohol concentration to the mouth. It is concluded that the ABT is dependent on physiological factors that need to be assessed for accurate testing.     

血液乙醇同源化合物分析及其法医学意义

酒精饮料申除含多量乙醇外,还含有微量甲醇、杂醇等乙醇同源化合物,且具有和乙醇类似的代谢及药代动力学特征,均参与肝ADH代谢,并与乙醇存在条件性竞争抑制。利用其代谢特性,在某些复杂醉酒驾车案件的法医学调查中,可根据血液中乙醇同源化合物的定量检测结果,结合对应血液乙醇质量浓度,帮助核实或推算饮酒者申诉的饮酒时间的真实性。     

Evaluating a natural experiment in alcohol policy

Research Summary
This study examines the effects of a dramatic change in alcohol licensing policy on the practice of liquor retailing across a metropolitan urban region. The policy was enacted to remove fixed closing times and to install staggered closing times across regions where it potentially would reduce violent crime and disorder. We found great variation in the extent to which the provisions of the policies were installed as intended.
Policy Implications
The findings suggest that prior consideration for how policy interventions will be applied to real-world settings is important to the validity of research evaluations. Understanding and monitoring variation in the implementation of an intervention is a vital prerequisite to the evaluation of outcomes. Without knowledge of the real-world application of an intervention, researchers risk attributing causal effects to a prevention initiative that might have been absent or only partially received.     

Low blood alcohol levels. Experimental study on attention and body sway control functions

Objective

Attempting to prevent alcohol-related road accidents requires sensitive, reliable and easy-to-use methods and instruments for ascertaining drivers’ state of intoxication. This paper examines the scientific validity of a method for assessing psychomotor performance combining measurement of neurosensory functions with the effect of low blood alcohol levels: body sway control and attention functions.

Methods

A double-blind, placebo-controlled study, with cross-over and random distribution on the effects of low blood alcohol levels. Psychomotor performance and body sway control were studied in 16 healthy volunteers after they had drunk a small dose of ethyl alcohol (0.5 g/kg) or placebo. Neurosensory and psychomotor functions were assessed by a Divided Attention Test (DAT), composed of the association between one test exploring short-term memory (Memory Test) and one exploring attention (Response Competition Test). Alterations in body sway were recorded by stabilometry. Tests were administered at 30, 60, 120 and 180 min after intake of alcohol. After a wash-out period of at least one week, subjects repeated the test after taking a second dose of alcohol or placebo. Blood alcohol concentrations were monitored by analysis of concentrations in expired air.

Results

A BAC under 50 mg/dL did not reveal statistically significant impaired memory capacities or motor coordination. Instead, statistically significant oscillations of body sway were measured (p-values = 0.0001), especially when stabilometry was associated with deviant stimuli like those of the DAT (p-values = 0.0001).

Conclusions

This study showed: (1) impaired performance, at the limits of statistical significance, on a complex psychometric test like the DAT; (2) some cognitive, attentive and visual perceptive functions are not compromised or at least not in a statistically significant manner; (3) a considerable alteration in the capacity for control of body sway after intake of alcohol becomes further and massively impaired when deviant stimuli are given; (4) this impairment appeared early and was more marked 1 and 2 h after intake of alcohol.     

Post-mortem blood alcohol concentration of the traffic accident victims and changes in DUI legislation in Slovenia 1980–2006

This study aims to contribute to the analysis of the impact of alcohol consumption on road traffic safety in Slovenia and to evaluate the effectiveness of the changes in road traffic safety legislation concerning this issue within the period 1980–2006. For this purpose we have performed a retrospective analysis of 1913 autopsy reports on traffic casualties, with an emphasis on their blood alcohol concentration (BAC), mode of participation in traffic (drivers, pedestrians, etc.) and the impact of legislation changes. In addition, we have analysed the relations between BAC, the time and day of death and the gender of victims. Changes in the legislation were made in 1981, 1985, 1988, 1989, 1990, 1998 and 2005, yet only those made in 1981, 1990 and 1998 resulted in the increase of the actual fines. Within the observed period there was a substantial reduction in the average BAC in almost all of the categories of traffic participants (pedestrians: from 1.20 to 0.73; passengers: from 1.08 to 0.56; cyclists: from 1.11 to 0.56; motorcyclists: from 0.68 to 0.33) except in the category of drivers (negligible reduction from 0.81 to 0.76). Insufficient improvement in the latter category is extremely important, because many sober vulnerable traffic participants become victims of drunk drivers. Further concern arises from the finding that heavily drinking drivers are not responsive to penalty increases. We came to the conclusion that, in addition to raising fines and expanding penalty points, the introduction and effective enforcement of complex legislative measures together with wide community action are necessary to resolve DUI problems in Slovenia.     

Describing the feasibility of using case management in a specialist forensic substance misuse intervention for UK veterans: a case study

Veterans with mental health problems are a high-risk group for substance misuse difficulties and are over-represented in forensic settings. Yet, there are few substance misuse services available for this population. Evidence suggests that case management can provide effective interventions for veterans with substance misuse problems. However, there is little research to show its effectiveness in the UK. The present study reported on the implementation and preliminary outcomes of the Veterans Forensic Substance Misuses Service (VFSMS), piloted within a prison setting, to demonstrate the feasibility of the service. The VFSMS operated in four stages: Assessing needs, developing case management plans, providing bespoke support and developing discharge plans. Case studies were used to demonstrate this process, with measures of alcohol use and recovery showing outcomes for each case. Findings from three case studies suggested that case management was a feasible approach, with a range of interventions being used, including substance misuse and mental health services, plus housing and employment services. Outcome measures suggested that alcohol and substance misuse recovery improved following the VFSMS intervention. While the scope of the findings is limited, they suggested that case management is a feasible substance misuse intervention, with preliminary findings showing improvements in substance misuse outcomes.     

从尼采的悲剧学说解读盖茨比的悲剧性

本文运用尼采的悲剧学说对菲茨杰拉德的小说《了不起的盖茨比》中的主人公盖茨进行分析,旨在阐明盖茨比集日神精神和酒神精神于一体,是理智和激情的混合体,在社会悲剧大背景中注定他的个人遭遇是无法避免的,由此为人们理解其悲剧性提供一个新的途径。