Background: The relationship between reproductive health disorders and lifestyle factors in middle-aged and older men is not clear. The aim of this study is to describe lifestyle and biomedical associations as possible causes of erectile dysfunction (ED), prostate disease (PD), lower urinary tract symptoms (LUTS) and perceived symptoms of androgen deficiency (pAD) in a representative population of middle-aged and older men, using the Men in Australia Telephone Survey (MATeS). Methods: A representative sample (n = 5990) of men aged 40+ years, stratified by age and State, was contacted by random selection of households, with an individual response rate of 78%. All men participated in a 20-minute computer-assisted telephone interview exploring general and reproductive health. Associations between male reproductive health disorders and lifestyle and biomedical factors were analysed using multivariate logistic regression (odds ratio [95% confidence interval]). Variables studied included age, body mass index, waist circumference, smoking, alcohol consumption, physical activity, co-morbid disease and medication use for hypertension, high cholesterol and symptoms of depression. Results: Controlling for age and a range of lifestyle and co-morbid exposures, sedentary lifestyle and being underweight was associated with an increased likelihood of ED (1.4 [1.1-1.8]; 2.9 [1.5-5.8], respectively) and pAD (1.3 [1.1-1.7]; 2.7 [1.4-5.0], respectively. Diabetes and cardiovascular disease were both associated with ED, with hypertension strongly associated with LUTS and pAD. Current smoking (inverse association) and depressive symptomatology were the only variables independently associated with PD. All reproductive disorders showed consistent associations with depression (measured either by depressive symptomatology or medication use) in both age-adjusted and multivariate analyses. Conclusion: A range of lifestyle factors, more often associated with chronic disease, were significantly associated with male reproductive health disorders. Education strategies directed to improving general health may also confer benefits to male reproductive health.

Purpose Secondary task engagement that distracts the driver is a contributing factor to motor vehicle crashes among adults. However, the association between eye glance duration and crash risk with novice teenage drivers has not been determined. Methods Vehicles of 42 newly-licensed teenage drivers were instrumented with cameras, accelerometers, GPS, and other devices. Data were collected continuously for 18 months. Crashes and near crashes (CNCs) were identified by examining highly elevated gravitational force events. Video footage of the 6 seconds prior to each CNC and randomly sampled non-CNC road segments were coded for the duration of eye glances off the forward roadway and the presence of secondary task engagement. The likelihood (odds ratios) of CNC due to eye glance behavior was calculated by comparing the prevalence of secondary task engagement and duration of eyes off road prior to CNC with the prevalence and duration of eyes off road during non-CNC road segments. Results Crash risk increased with the duration of single longest glance during all secondary tasks (OR=3.8 for >2s) and wireless secondary task engagement (OR=5.5 for >2s). Single longest glance provided a more consistent estimate of crash risk than total time eyes off the forward roadway. Conclusions Eyes glances away from forward roadway involving secondary tasks increased the likelihood of CNC. The longer the duration of eye glance away from the road the greater the risk, regardless of type of secondary task. Education and policy discouraging secondary task engagement, particularly for prolonged periods, is warranted.

A systematic review of the literature was conducted to appraise the evidence from epidemiological studies of crash risk in young drivers accompanied by passengers, compared with solo driving. Databases searched included the Cochrane Library, Embase, Scopus, Transportation Research Information Services, and Web of Science for studies published between January 1, 1989 and August 1, 2013. Epidemiological studies were selected for review if they focused on crashes of young drivers (≤24 years old) and included both a no-passenger comparison group and some measure of exposure to enable calculation of risk estimates. Fifteen articles (17 studies) were selected; seven studies reported on fatal crashes and 10 on nonfatal or combined fatal/nonfatal crashes. Studies on fatal crashes showed increased risk, compared with solo driving, for young drivers with at least one passenger (significant risk estimates ranging from 1.24 to 1.89) and two or more passengers versus solo driving (1.70–2.92). Increased risk was also found for fatal crashes and for combined or nonfatal crashes with male versus female passengers (1.53–2.66) and for younger versus older drivers (1.42–3.14). Results more clearly indicate increased risk for passenger presence in fatal crashes than that in nonfatal or combined fatal/nonfatal crashes. Findings of this review, based on correlational studies, support licensing policies that limit the presence and number of young passengers for young drivers.

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The young driver problem is typified by high crash rates early in licensure that decline with experience, but are higher initially and decline more slowly for the youngest novices. Despite considerable effort, only Graduated Driver Licensing System (GDLS) policies have been shown to improve novice young driver safety outcomes. Unfortunately, GDLS policies are mostly limited to countries with a relatively young licensure age. Meanwhile, it is not entirely clear how GDLS and other young driver transportation safety efforts, including driver training and testing, supervised practice and parental management of young drivers, can best be configured. Notably, professional training can foster improvements in vehicle management skills that are necessary, but do not assure safe driving behavior. Substantial recent research has focused on training methods to improve driving skills, but the safety benefits of driver training have not been established. While prolonged practice driving increases experience and provides supervisors with opportunities to prepare novices for independent driving, the transition to independent driving challenges novices to employ, on their own, poorly-mastered skills under unfamiliar and complex driving conditions. Licensing policies and parental management practices can limit the complexity of driving conditions while novices gain needed driving experience. Nevertheless, an emerging body of literature suggests that future advances in training and supervision of novice teenage drivers might best focus on the translation of learning to independent driving by fostering safe driving attitudes and norms, judgment, dedicated attention to driving tasks and self-control at the wheel.