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    <copyright>Copyright © 2026. National Academy of Sciences. All rights reserved.</copyright>
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    <managingEditor>tris-trb@nas.edu (Bill McLeod)</managingEditor>
    <webMaster>tris-trb@nas.edu (Bill McLeod)</webMaster>
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      <title>The Commercial Motor Vehicle Driver Medical Examination: Practical Issues</title>
      <link>https://trid.trb.org/View/925984</link>
      <description><![CDATA[This article will discuss how the commercial motor vehicle driver medical examination aims to ensure that commercial drivers can safely perform all driving and nondriving work-related tasks. In conducting the examination and completing the related certification, the medical examiner must follow mandated medical standards and consider medical advisory criteria. Examiners should consider the substantial expert guidance provided in making certification determinations. For several common conditions, regulations and guidance are currently under review by medical review boards and expert panels, and major updates are likely in the near future. In addition, legislative changes are likely to require specific training and certification for medical examiners. These changes aim to increase the effectiveness of the commercial motor vehicle driver medical examination as a public health safeguard by reducing commercial motor vehicle crashes.]]></description>
      <pubDate>Thu, 19 Aug 2010 11:18:19 GMT</pubDate>
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      <title>Older Adult Drivers with Cognitive Impairment</title>
      <link>https://trid.trb.org/View/815419</link>
      <description><![CDATA[With the number of cognitively impaired drivers increasing, family physicians are more likely to become involved in decisions about cessation of driving privileges among older patients. Physicians who care for cognitively impaired older adults should routinely ask about driving status. In patients who continue to drive, physicians should assess pertinent cognitive domains, determine the severity and etiology of the dementia, and screen for risky driving behaviors. Cognitive impairment detected by office-based tests may indicate that the patient is at risk of a motor vehicle crash. Referral for performance-based road testing may further clarify risk and assist in making driving recommendations. Physicians should assist families in the difficult process of driving cessation, including providing information about Web sites and other resources and clarifying the appropriate state regulations. Some states require reporting of specific medical conditions to their departments of motor vehicles.]]></description>
      <pubDate>Fri, 21 Sep 2007 13:53:21 GMT</pubDate>
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      <title>Child Safety Seat Counseling</title>
      <link>https://trid.trb.org/View/763305</link>
      <description><![CDATA[Child safety seats and automobile safety belts protect children in a car crash if they are used correctly, but if a child does not fit in the restraint correctly, it can lead to injury.  This article helps physicians come up-to-date on the current guidelines for child safety seats and to know which types of seats are available and most appropriate.  The author uses three memory keys to help guide appropriate child safety seat choice:  Backwards is Best; 20-40-80; and Boost Until Big Enough.  The first, Backwards is Best, reminds physicians that infants are safest in a head-on crash when they are facing backward.  The second, 20-40-80, cues the physician that children may need to change to a different seat when they reach 20, 40 and 80 pounds.  The third cue, Boost Until Big Enough, emphasizes that children need to use booster seats until they are big enough to fit properly into an adult safety belt.  One chart summarizes five different types of child safety seats, their intended occupant size, restraint characteristics, and usage warnings.  The article concludes with a brief discussion of the appropriate use of safety belts once the child is large enough to for the seat belts to fit correctly.]]></description>
      <pubDate>Mon, 28 Nov 2005 09:11:00 GMT</pubDate>
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      <title>CHILDHOOD AUTOMOTIVE SAFETY</title>
      <link>https://trid.trb.org/View/203007</link>
      <description><![CDATA[Automobile accidents are the number one killer of children between the ages of one and 14 years, and many of these fatalities could be prevented by the use of proper restraint systems.  Unfortunately, family physicians and pediatricians have been uninformed in this aspect of preventive medicine, and have consequently been negligent in informing parents about automobile safety.  Counseling of parents on the proper use of car seats should begin in the prenatal period and should continue during regular pediatric checkups.  Some of the existing apathy about child restraints can be offset by understanding parents' excuses for not using these protective devices (e.g. child safe in parent's arms, expense, child too young to ride in car seat, child's dislike for riding in seat, inconvenience, not needed for short trips, and fear that child might be trapped in car during an accident).  The validity of these excuses is easily challenged; parental objections must be countered for effective counseling.  Infants should ride in a rearward-facing device in a semireclining position. The device should contain energy-absorbing padding and its own harness system; the entire restraint should be held in place by a standard lap belt.  Three types of devices are available for the older child: older child car seat, protective plastic shield, and safety harness.  The restraints are usually outgrown when the child weighs 40 lb., is 40 in. tall, or is four years old.  From then until he is 55 in. tall, only a standard lap seat belt is required.  The standard seat belt/shoulder harness system can be used after the child is 55 in. tall.  A child should be seated in the rear of the car if possible, and any restraint is better than none.  It is noted that restrained children are better behaved and that child restraints are often combined with other articles of juvenile furniture.]]></description>
      <pubDate>Wed, 30 May 1984 00:00:00 GMT</pubDate>
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