Effects of Diabetic Neuropathy on Body Sway and Slip Perturbation Detection in Older Population

Postural control is a common mechanism to compensate for unexpected displacements of the body. In the older population, a slip or fall due to a failure of postural control is a common cause of morbidity and mortality. The ability of postural control decreases with aging or neuropathy. In this study, 2 groups, diabetics and non-diabetics in the older population, were compared to determine how patterns of postural sway during quiet standing were related to the detection of perturbation. The SLIP-FALLS system was applied to the measurement of sway and detection of perturbation. In phase 1 of the development of the predictive model, neural network algorithms were applied to find determinant variables for perturbation detection. In phase 2, a fuzzy logic inference system was developed to investigate the relationship between sway and perturbation detection. Results of this study may be applied to the design of floor mats or shoe insoles for preventing fatigue in workplaces.     

Two-Dimensional Automatic Control Modeling of a Posture Control System

A posture control model has been developed on the basis of the 2-dimensional feedback control theory. Human postural characteristics were investigated in 5 healthy participants. Tests were performed with eyes open and eyes closed. After 5 s of quiet standing, each participant was unexpectedly pulled forward by 30 mm at his pelvis height and then released. Postural sway was measured over 20 s at a rate of 100 per second. Transfer functions to represent the posture control characteristic were identified by the least squares' method. These showed good results of the model's fitness, predictability, and stability. The response of the eyes-closed condition to perturbation is more oscillatory than that of the eyes-open condition. It seems that the model identified could be applicable to ergonomics, sports, or clinical situations.     

Postural sway following prolonged exposure to an inclined surface

Fatal and non-fatal falls from elevation have been documented to be a significant issue. Historically, roofing work has been ranked among the highest in incidents of falls. Recent literature has indicated that exposure to inclined surfaces (roof) has a detrimental effect on postural stability. The purpose of this preliminary study was to determine if postural instability was found to increase following extended exposure to an inclined surface. Twenty-three participants were pre/post tested under four postural stability conditions while varying duration exposure (0.0–2.0 h) to an inclined surface. Dependent variable postural sway measures were calculated from center of pressure data derived from a portable force plate. The results indicate significant differences between pre and post-exposure measures. Specifically, the results imply that an individual is less stable directly after performing tasks on an inclined surface. These findings contribute to the literature and serve as a basis for further research into work rest cycles for those individuals who routinely work on inclined surfaces.     

Analysis of postural load during tasks related to milking cows-a case study

The aim of this study was to analyse postural load during tasks related to milking cows of 2 farmers on 2 different farms (one with a manual milk transport system, the other with a fully automated milk transport system) as a case study. The participants were full-time farmers, they were both healthy and experienced in their job. The Ovako Working Posture Analyzing System (OWAS) was used to evaluate postural load and postural risk. Postural load was medium for the farmer on the farm with a manual milk transport system and high for the farmer working on the farm with a fully automated milk transport system. Thus, it can be concluded that a higher level of farm mechanization not always mean that the farmer's postural load is lower, but limitation of OWAS should be considered.     

Disparity of a Seat Cushion and Its Influence on Postural Control

Properties of supporting surfaces of a seat have an influence on postural control. Centre of pressure (COP) displacement parameters reflect both the balance controlling process and movements of the centre of a mass of entire body. The subjects of the study were 9 healthy men. A seat cushion was examined with a 2-force platform setup. Force exertion at a seat pan and feet and COP displacement at a seat pan were measured to analyse postural control. Analysis of variance determined the differences in postural control depending on a cushion type among the subjects. Significant differences in COP displacement parameters were in COP trajectory length, medio-lateral COP displacement and COP velocity. The results of the study showed that foam cushion ensures better postural control.     

Association between older driver characteristics, on-road driving test performance, and crash liability

From May 1999, a new system for licensing older drivers was introduced in New Zealand. It included a practical on-road driving test with expanded scope, to be completed every two years from the time the driver turns 80. The relationship between crashes and test performance needed to be studied to inform the debate regarding the testing system. The population studied was all drivers who entered this licensing system during its first three years of operation. They were defined as crash involved if they were involved in an injury crash during the two years following their first licensure under the new system. Logistic regression was used to describe the risk of crash involvement in terms of driving test performance and other driver characteristics. Each driving test failure was associated with a 33% increase in the odds of crash involvement (95% CI 14% to 55%), controlling for age, gender, minor traffic violations, and whether the older driver lived with another licensed driver or not. Minor traffic violations in the two years following the driving test were associated with twice the odds of crash involvement. These results suggest that the new on-road driving test does identify older driver behaviors or limitations that are related to crash liability. It is anticipated that the results presented here will provide essential information for discussing older driver licensing systems, whose impact will grow in importance as the population of drivers ages.     

Postural Stability of Sitting Women

The study examined the utility of stabilometric dimensions and explored whether the changes in sitting postures were manifested in functional measures of postural control. Eleven women participated in the study, which used 11 chair sitting postures: arms on laps or arms right angled; armrest at a height of 17, 20 and 23 cm; with or without backrest; slouch or straight back; legs right angled at knees or crossed legs. The backrest and armrest shifted 16.3% of body weight from a seat pan. The characteristics of stabilometric dimensions evaluated the influence of seat components and sitting behaviour on postural balance. The study attempted to evaluate stability and its application in human-seat interface design.     

Falls prevention through community intervention – A Swedish example

In order to control and reduce fall-related injuries, particularly among women over the age of 55, a safety management and falls prevention campaign was structured and implemented during 2006–2007 in the small industrial town of Södertälje, Sweden. A local campaign was launched to recruit falls prevention agents, to inform key target groups in the local community, and to educate older people about fall risks. A survey showed that the campaign had a greater impact among professionals with a special relation to fall risk than among the general population. Medical records were used in the evaluation of the outcomes. The results show that between 2005 and 2007 there was a drop of fractures related to falls in the council: an overall drop of 16.7% in the population; among men 55 or older a drop of 12%, among women 55 or older a drop of 15%, among home-dwelling women 55 or older a drop of 5.7% and among women in special accommodation a drop of 44.4%. Expressed in terms of years lost to disability (YLD), the overall drop in hip fractures treated at the local hospital between 2005 and 2007 was 48%. A comparison with National medical records for the same period shows the drop for the intervention area to be much larger than that for Sweden as a whole, although the effect was not statistically significant. The study demonstrates the advantages of a broad, community-based approach to injury prevention.     

Ergonomic evaluation of a new truck seat design: a field study

A postural evaluation of commercial licensed truck drivers was conducted to determine the ergonomic benefits of a truck seat prototype in comparison with an industry standard seat. Twenty commercially licensed truck drivers were recruited to perform a 90-min driving task. Postures were assessed using accelerometers and a backrest and seat pan pressure mapping system. Subjective discomfort measurements were monitored using two questionnaires: ratings of perceived discomfort (RPD) and the automotive seating discomfort questionnaire (ASDQ). Participants reported significantly higher discomfort scores when sitting in the industry standard seat. Participants sat with more lumbar lordosis and assumed a more extended thoracic posture when seated in the prototype. Pairing the gluteal backrest panel with the adjustable seat pan also helped reduce the average sitting pressure on both the seat pan and the backrest. The prototype provided several postural benefits for commercially certified truck drivers, as it did for a young and healthy population.     

基于CAN总线的分布式安全报警系统

CAN总线是一种多主站局部网络 ,支持分布式控制系统或实时控制系统的通信功能 ,具有检错功能强 ,抗干扰 ,传输速率高等优点 ,广泛应用于工业控制领域。笔者以CAN总线技术为基础 ,用单片机和个人计算机组成分布式安全报警系统 ,该系统具有开放性、全分散体系结构、安装维护简单等特点。笔者介绍了该系统的总体构成及其软件和硬件设计。试验结果表明 ,该系统实现了事故现场、住户与住宅小区三者联系的安全报警功能。系统稳定性好 ,实时性强 ,报警准确。     

Effectiveness of mandatory license testing for older drivers in reducing crash risk among urban older Australian drivers

Most licensing jurisdictions in Australia maintain mandatory assessment programs targeting older drivers, whereby a driver reaching a specified age is required to prove his or her fitness to drive through medical assessment and/or on-road testing. Previous studies both in Australia and elsewhere have consistently failed to demonstrate that age-based mandatory assessment results in reduced crash involvement for older drivers. However studies that have based their results upon either per-population or per-driver crash rates fail to take into account possible differences in driving activity. Because some older people maintain their driving licenses but rarely if ever drive, the proportion of inactive license-holders might be higher in jurisdictions without mandatory assessment relative to jurisdictions with periodic license assessment, where inactive drivers may more readily either surrender or lose their licenses. The failure to control for possible differences in driving activity across jurisdictions may be disguising possible safety benefits associated with mandatory assessment. The current study compared the crash rates of drivers in Melbourne, Australia, where there is no mandatory assessment and Sydney, Australia, where there is regular mandatory assessment from 80 years of age onward. The crash rate comparisons were based on four exposure measures: per population, per licensed driver, per distance driven, and per time spent driving. Poisson regression analysis incorporating an offset to control for inter-jurisdictional road safety differences indicated that there was no difference in crash risk for older drivers based on population. However drivers aged 80 years and older in the Sydney region had statistically higher rates of casualty crash involvement than their Melbourne counterparts on a per license issued basis (RR: 1.15, 1.02-1.29, p=0.02) and time spent driving basis (RR: 1.19, 1.06-1.34, p=0.03). A similar trend was apparent based on distance travelled but was of borderline statistical significance (RR: 1.11, 0.99-1.25, p=0.07). Collectively, it can be inferred from these findings that mandatory license re-testing schemes of the type evaluated have no demonstrable road safety benefits overall. Further research to resolve this on-going policy debate is discussed and recommended.     

基于火探管式的锂离子电池灭火技术研究

为研究锂离子电池灭火方案,基于火探管灭火技术同时利用新型清洁灭火剂Novec 1230,组装成火探管灭火系统。在灭火测试平台上以功率为200 W的电热管作为外热源引发单电池或电池模组热失控,通过改变火探管的布置位置,记录相应的灭火行为以及灭火效率,并对实验结果进行了分析。研究结果表明,当火探管灭火系统直接布置在电池正上方时,在起火后的5.6s内控制火情;随着灭火剂用量增加可以显著降低体系温度,防止电池复燃以及连锁热失控现象发生;火探管有效覆盖区域外的失控电池作为热源将继续加热临近电池,引发连锁热失控,造成灭火系统失效;根据电池热失控后的燃烧行为以及传热行为,提出相应的火探管灭火系统复合方案。     

The effect of extending graduated driver licensing to older novice drivers in Indiana

Introduction: Graduated driver licensing (GDL) systems have been shown to reduce rates of crashes, injuries, and deaths of young novice drivers. However, approximately one in three new drivers in the United States obtain their first driver’s license at age 18 or older, and thus are exempt from most or all provisions of GDL in most states. Method: In July 2015, the state of Indiana updated its GDL program, extending its restrictions on driving at night and on carrying passengers during the first 6 months of independent driving, previously only applicable to new drivers younger than 18, to all newly-licensed drivers younger than 21 years of age. The current study examined monthly rates of crashes per licensed driver under the affected conditions (driving at night and driving with passengers) among Indiana drivers first licensed at ages 18, 19, and 20 under the updated GDL system compared with drivers licensed at the same ages under the previous GDL system. We used Poisson regression to estimate the association between the GDL system and crash rates, while attempting to control for other factors that might have also influenced crash rates. We used linear regression to estimate the association between the GDL system and the proportion of all crashes that occurred under conditions restricted by the GDL program. Results: Results showed, contrary to expectations, that rates of crashes during restricted nighttime hours and with passengers were higher among drivers licensed under the updated GDL system. This mirrored a statewide increase in crash rates among drivers of all ages over the study period and likely reflected increased overall driving exposure. The proportions of all crashes that were at night or with passengers did not change. Practical Applications: More research is needed to understand how older novice drivers respond when GDL systems originally designed for younger novice drivers are applied to them.     

The impact of intersection design on simulated driving performance of young and senior adults

PURPOSE: The Federal Highway Administration (FHWA) proposed guidelines for highway design to increase the safe driving ability of older drivers; however, little empirical evidence exists to support the effectiveness of these guidelines. The purpose of this study was to investigate the effects of implementing these guidelines (in 4 pairs of intersections) on safe driving performance of older and younger drivers using a high-fidelity driving simulator. DESIGN AND METHODS: We replicated four intersection pairs (improved versus unimproved) in a high-fidelity, virtual reality driving simulator. Simulator scenarios were created from actual road locations, replicating road geometrics and traffic control devices. The simulator's controls were integrated with an actual vehicle to make the driving experience as realistic as possible. Kinematic measures were obtained from the simulator in conjunction with driving errors recorded by trained driving evaluators sitting in the cab of the car. Thirty-nine subjects, 19 younger and 20 older adults, participated in the study. RESULTS: For the kinematic data we found greater lateral control, as indicated by significantly smaller maximum yaw during the turn phase, at all of the improved intersections when compared to the unimproved intersections. We found some significant age differences, but mostly in only one of the intersection-pairs. For the behavioral data, there were significant differences in driving errors between improved and unimproved intersections in two intersection-pairs; however, there were no significant differences in driving errors between the older and younger drivers. IMPLICATIONS: The findings suggest that both young and older drivers may benefit from roadways with safety features recommended by the FHWA guidelines as indicated by the increased lateral control of the vehicle when negotiating these intersections. These findings generate critical information for those involved in the design of roadway systems.     

Factors and challenges of driving reduction and cessation: A systematic review and meta-synthesis of qualitative studies on self-regulation

Introduction: Older adults are at a greater risk of injury and death in a motor-vehicle accident. While the ability to drive safely can be challenging with aging, the concept of self-regulation and associated support system have attracted more attention in recent years, especially in developed countries. This review describes the mechanism and summarizes the potential factors that influenced self-regulation of driving amongst older adults to provide new insights into a broader framework for transportation and safe mobility. Methods: We systematically searched 12 online databases for qualitative studies exploring the experiences of older adults aged 60 years and above on their decision to self-regulate their driving. Thematic synthesis was performed to identify elements influencing driving reduction and cessation. The confidence profile of each findings from the meta-synthesis was appraised using the Confidence in the Evidence from Reviews of Qualitative research (CERQual) tool. Results: A total of 17 studies representing views of 712 older adults from four countries were included. Three major themes were identified with each representing a transition phase that can either facilitate or hinder older drivers from ceasing completely or reducing their driving, when transitioning from pre-decision phase to post-cessation phase. Conclusions: Our findings suggest that there is a mismatch between the current traffic collation prevention measures, such as age-specific mandatory license renewal system and travel needs of older adults. As such, it is time for the authorities, researchers, and public from various fields and perspectives to collaborate, sustain, and improve safety and mobility in older adults. Practical applications: Adequate regulations and guidelines from the medical community and legal authorities are warranted to assist older adults and caregivers. Social support (e.g., feedback, assurance, or transportation support) from family members, friends, and healthcare professionals are crucial for a smooth transition. Provision of alternative transportations in rural areas are needed and future interventions should focus on engaging and educating older adults to consider alternative transportation modes for mobility. Age-specific mandatory license renewal procedure can be useful in screening for at-risk groups.     

Adaptive response criteria in road hazard detection among older drivers

Objectives: The majority of existing investigations on attention, aging, and driving have focused on the negative impacts of age-related declines in attention on hazard detection and driver performance. However, driving skills and behavioral compensation may accommodate for the negative effects that age-related attentional decline places on driving performance. In this study, we examined an important question that had been largely neglected in the literature linking attention, aging, and driving: can top-down factors such as behavioral compensation, specifically adaptive response criteria, accommodate the negative impacts from age-related attention declines on hazard detection during driving?

Methods: In the experiment, we used the Drive Aware Task, a task combining the driving context with well-controlled laboratory procedures measuring attention. We compared younger (n = 16, age 21–30) and older (n = 21, age 65–79) drivers on their attentional processing of hazards in driving scenes, indexed by percentage of correct responses and reaction time of hazard detection, as well as sensitivity and response criteria using signal detection analysis.

Results: Older drivers, in general, were less accurate and slower on the task than younger drivers. However, results from this experiment revealed that older, but not younger, drivers adapted their response criteria when the traffic condition changed in the driving scenes. When there was more traffic in the driving scene, older drivers became more liberal in their responses, meaning that they were more likely to report that a driving hazard was detected.

Conclusions: Older drivers adopt compensatory strategies for hazard detection during driving. Our findings showed that, in the driving context, even at an older age our attentional functions are still adaptive according to environmental conditions. This leads to considerations on potential training methods to promote adaptive strategies that may help older drivers maintain performance in road hazard detection.     

Factorial structure of recklessness: to what extent are older drivers different?

PROBLEM: This study tests whether the original factorial structure of a recklessness questionnaire can be maintained for the current Spanish population of older drivers. JUSTIFICATION: Our recent interest in dedicating special attention to senior citizen mobility (Monterde, 2001), is due to the impending increase of the aging population in Western countries; this has led us to reinitiate the psychometric study of the construct validity, revising and including older drivers in the psychometric aspects of those evaluation instruments that will then be used in the Spanish psycho-medical check of drivers and in research. METHODS: Factorial analysis was used to determine validity. RESULTS: There was an appearance of a different psychological pattern in elderly drivers, specifically, a psychological anxiety trait related to the task of driving. Furthermore, interesting data were found about the attitude of this sector toward the "traffic society" and toward some of the measures included in Spanish legislation that affect especially older drivers (such as the psycho-medical check). IMPACT ON INDUSTRY, RESEARCH AND PRACTICE: These results suggest the possible existence of some kind of "compensation phenomenon," which could have influence over the scores obtained and their interpretation. Consequently, the evaluation instruments should be tested and, if necessary, adapted or specifically created for use with this age group.     

Estimated benefit of automated emergency braking systems for vehicle–pedestrian crashes in the United States

Abstract

Objective: The objective of this research study is to estimate the benefit to pedestrians if all U.S. cars, light trucks, and vans were equipped with an automated braking system that had pedestrian detection capabilities.

Methods: A theoretical automatic emergency braking (AEB) model was applied to real-world vehicle–pedestrian collisions from the Pedestrian Crash Data Study (PCDS). A series of potential AEB systems were modeled across the spectrum of expected system designs. Both road surface conditions and pedestrian visibility were accounted for in the model. The impact speeds of a vehicle without AEB were compared to the estimated impact speeds of vehicles with a modeled pedestrian detecting AEB system. These impacts speeds were used in conjunction with an injury and fatality model to determine risk of Maximum Abbreviated Injury Scale of 3 or higher (MAIS 3+) injury and fatality.

Results: AEB systems with pedestrian detection capability, across the spectrum of expected design parameters, reduced fatality risk when compared to human drivers. The most beneficial system (time-to-collision [TTC]?=?1.5?s, latency = 0?s) decreased fatality risk in the target population between 84 and 87% and injury risk (MAIS score 3+) between 83 and 87%.

Conclusions: Though not all crashes could be avoided, AEB significantly mitigated risk to pedestrians. The longer the TTC of braking and the shorter the latency value, the higher benefits showed by the AEB system. All AEB models used in this study were estimated to reduce fatalities and injuries and were more effective when combined with driver braking.     

A comparison of three observational techniques for assessing postural loads in industry.

This study aims to compare 3 observational techniques for assessing postural load, namely, OWAS, RULA, and REBA. The comparison was based on the evaluation results generated by the classification techniques using 301 working postures. All postures were sampled from the iron and steel, electronics, automotive, and chemical industries, and a general hospital. While only about 21% of the 301 postures were classified at the action category/level 3 or 4 by both OWAS and REBA, about 56% of the postures were classified into action level 3 or 4 by RULA. The inter-method reliability for postural load category between OWAS and RULA was just 29.2%, and the reliability between RULA and REBA was 48.2%. These results showed that compared to RULA, OWAS, and REBA generally underestimated postural loads for the analyzed postures, irrespective of industry, work type, and whether or not the body postures were in a balanced state.