Obstacles and risks in the traffic environment for users of powered wheelchairs in Sweden

ObjectiveAccording to the European Union, fatal\ua0road accidents\ua0involving Vulnerable Road Users (VRUs) are equal in proportion to fatal car road accidents (46%). VRUs include individuals with mobility challenges such as the elderly and Powered Wheelchair (PWC) users. The aim of this interdisciplinary qualitative study was to identify obstacles and risks for PWC users by exploring their behaviour and experiences in traffic environments.MethodsVideos and in-depth interviews with 13 PWC users aged 20–66 were analysed for this study. The interviews and videos, which include real-life outdoor observations, originate from a qualitative study exploring experiences of PWC use on a daily basis in Sweden. Underlying causal factors to identified risks and obstacles were identified, based on human, vehicle (PWC) and environmental factors in accordance with the Haddon Matrix.ResultsThe results show significant potential for improvement within all three perspectives of the Haddon Matrix used in the analysis. Participants faced and dealt with various obstacles and risks in order to reach their destination. For example, this includes uneven surfaces, differences in ground levels, steep slopes, as well as interactions with other road users and the influence of weather conditions, resulting in PWC users constantly accommodating and coping with the shortcomings of the vehicle and the environment.ConclusionsThere are still major challenges with regard to preventing obstacles and risks in the traffic environment for PWC users. To discern PWC users in traffic accident and injury data bases, a start would be to register type of aid used for persons involved in an accident. Furthermore, to emphasise PWC users’ role as VRUs, it may also be advantageous to describe them as drivers rather than users when navigating the traffic environment. Given the limited sample, further research covering more data from a broader perspective would be beneficial. By incorporating emerging knowledge of PWC users’ prerequisites and needs, and including them in research and traffic planning, the society will grow safer and more inclusive, and become better prepared for meeting future demands on accessibility from an\ua0aging population

Разработка модуля контроля температуры в печи разогрева гудрона

Purpose: To explore the experiences of using an electric wheelchair in daily living. Methods: Fifteen participants, eight women and seven men, living in different parts of a Nordic country were interviewed. The interviews were conducted in the home or at the workplace. Open-ended questions were used. The data were collected and analyzed according to the grounded theory. Results: Analysis resulted in one core category: "Integrating the electric wheelchair - a manifold process", describing a process commencing from initial resistance against use of an electric wheelchair, to acceptance with various extent of integration. Six categories emerged that represent this core process: incorporating the electric wheelchair into the self-identity process, calculating functional consequences, encountering the reactions of others, facing duality in movability, using proactive strategies, and being at the mercy of the system. Findings indicate that the integration process is complex and manifold. Practical, personal, and social dimensions were intertwined and significantly involved. Conclusions: Integrating an electric wheelchair is a process closely connected to symbolic value, usability, community mobility and identity. These aspects should be considered in the production, prescription, and adaptation processes. Implications for Rehabilitation Integrating an electric wheelchair is a process closely connected to symbolic value, usability, community mobility, and identity. These aspects should be considered in the wheelchair production, prescription, and adaptation processes

Using a head-mounted camera to infer attention direction

A head-mounted camera was used to measure head direction. The camera was mounted to the forehead of 20 6- and 20 12-month-old infants while they watched an object held at 11 horizontal (-80 degrees to + 80 degrees) and 9 vertical (-48 degrees to + 50 degrees) positions. The results showed that the head always moved less than required to be on target. Below 30 degrees in the horizontal dimension, the head undershoot of object direction was less than 5 degrees. At 80 degrees, however, the undershoot was substantial or between 10 degrees and 15 degrees. In the vertical dimension, the undershoot was larger than in the horizontal dimension. At 30 degrees, the undershoot was around 25% in the downward direction and around 40% in the upward direction. The size of the undershoot was quite consistent between conditions. It was concluded that the head-mounted camera is a useful indicator of horizontal looking direction in a free looking situation where the head is only turned moderately from a straight ahead position

Bronchiolitis needs a revisit: Distinguishing between virus entities and their treatments

Current data indicate that the “bronchiolitis” diagnosis comprises more than one condition. Clinically, pathophysiologically, and even genetically three main clusters of patients can be identified among children suffering from severe bronchiolitis (or first wheezing episode): (a) respiratory syncytial virus (RSV)-induced bronchiolitis, characterized by young age of the patient, mechanical obstruction of the airways due to mucus and cell debris, and increased risk of recurrent wheezing. For this illness, an effective prophylactic RSV-specific monoclonal antibody is available; (b) rhinovirus-induced wheezing, associated with atopic predisposition of the patient and high risk of subsequent asthma development, which may, however, be reversed with systemic corticosteroids in those with severe illness; and (c) wheeze due to other viruses, characteristically likely to be less frequent and severe. Clinically, it is important to distinguish between these partially overlapping patient groups as they are likely to respond to different treatments. It appears that the first episode of severe bronchiolitis in under 2-year-old children is a critical event and an important opportunity for designing secondary prevention strategies for asthma. As data have shown bronchiolitis cannot simply be diagnosed using a certain cutoff age, but instead, as we suggest, using the viral etiology as the differentiating factor.</p

Infants React Differently to Adults’ Noncontingent Responding Depending on the Adult’s Activity

Two experiments examined 12- to 13-month-old infants’ reactions to noncontingent responding by the parent (Experiment 1, 40 infants) or by an unfamiliar adult (Experiment 2, 40 infants). During the initial play phase, the adult was either reading a book or using his or her mobile phone, resulting in a response delay when the infant would seek the adult’s attention. During the test phase, the infants were shown an ambiguous toy as the adult simultaneously conveyed positive information. The infants in the mobile-phone condition looked for a shorter time at the adult than did the infants in the book condition, regardless of the familiarity of the adult. The findings indicate that the type of activity that caused the adults’ lack of contingent responsiveness differentially influenced the infants’ reactions to the adults’ noncontingent responding

A gender perspective on rehabilitation for patients with neck and back pain in primary health care

Introduction Gender as a social and cultural construction has an impact on physiotherapist and patient beliefs, understanding, and behaviour and could affect physiotherapy encounters. Gender studies in early rehabilitation are scarce. The aim of this thesis was to study gender during different parts of the rehabilitation process for primary health care patients with neck and back pain. Method The analyses are based on data from three different samples. One sample is composed of physiotherapists and two samples consist of patients consulting primary health care providers because of neck and back pain. All data were gathered from primary health care provided in Västerbotten County. Baseline data on 73 physiotherapists and 586 of their patients with neck and back pain were collected by questionnaire during three consecutive days in 2006. Patient data included affected pain site and treatment procedures used by the physiotherapist (Study I). Differences in treatment procedures used by female and male physiotherapists and differences in use for female or male patients were analysed using Chi square-test, Fisher’s exact tests, Mann-Whitney U tests and logistic regressions with cluster analysis. Thematised interviews with 12 patients were made before the patient’s first appointment with a physiotherapist or doctor and repeated after three months. Data were analysed according to grounded theory (Study II) and qualitative content analysis (Study III). A comprehensive questionnaire was answered at the first appointment when patients sought a physiotherapist in primary health care. The questionnaires included questions about pain intensity, self-rated health, function, psychological stress reactions, domestic work, work environment, self-efficacy and kinesiophobia. Response patterns were linked to the International Classification of Functioning Disability and Health (ICF) and analysed using principal component analysis (PCA) and partial least squares projections to latent structures (PLS). Result Patients were given the same treatment procedures irrespective of gender. The treatment procedures most often used were training of joint motion (48%), training of muscle functions and strength training (31%), massage (31%), physical treatment (28%), information about health/ill health (24%), and acupuncture (18%). Female and male physiotherapists used the same treatment procedures with a few exceptions. Female physiotherapists used treatment for mental functions and acupuncture more often than male physiotherapists. The women gave their patients a unique mixture of treatment procedures more frequently (43%) compared to their male colleagues (25%). Male physiotherapists used more training of joint motion. "To be confirmed" emerged as the core category when analysing interviews that considered expectations or experiences. Five categories were extracted: "To be taken seriously", "To get an explanation", "To be individually assessed and treated", "To be invited to participate", and "To be taken care of in a trustworthy environment". These were factors leading to confirmation. Two ideal types were identified: "confident" and "ambiguous". The "confident" did not doubt their right to health care and blamed their work for causing the pain. They related to a positive identity of strong or hard working. The "ambiguous" were afraid of being regarded as old, whining women and not being taken seriously. They were ashamed of having neck or back pain and blamed themselves; they thought they were not fit enough. The ideal types were not completely defined by gender, but more men were among the "confident" ideal type and more women were among the "ambiguous" type. Patients reacted differently to feelings of being confirmed or not, and this depended on whether they were the "confident" or "ambiguous" ideal type. The "confident" were satisfied and reacted with reorientation when they felt confirmed, even if they were not totally cured. When not confirmed, the "confident" reacted with anger, frustration, and feelings of shame or remained proud and blamed the health care personnel for being incompetent. The "ambiguous" also were satisfied and felt reoriented when they were confirmed. They then moved from being an "ambiguous" type to a more "confident" type. When the "ambiguous" were not confirmed in healthcare, they became dissatisfied and unhappy. They doubted the assessment, felt forlorn, and felt increased shame. Not being confirmed was experienced more negatively by women than by men irrespective of ideal type. Interesting information was found about how patients view their body in relation to pain during analysis of expectations and experiences in study II interviews. This led to Study III. In study III, "Fear of hurting the fragile body" emerged as an interview theme. Five categories supported or undermined beliefs about pain and physical activity: "The mechanical body", "Messages about activity", "Earlier experiences of pain and activity", "To be a good citizen", and "Support to be active". Patients thought their pain was due to tissue damage and viewed their bodies in a mechanical way. Clear messages from health care personnel about activity led to less fear of physical activity. Vague and contradictory messages led to more fear. Gender-stereotyped messages were given to patients. "The take it carefully" was such a message, and was more often to women when women were thought to be weak and in need of training. Another message was "Pain goes with heavy work". This message was more often given to men when men were thought to be strong and not in need of training. Earlier experiences of pain and activity could have been positive or negative. If positive, the experiences led to less fear of engaging in physical activity. A wish to be a good citizen, such as being a good parent, led to patients being more engaged in child care and playing more than they thought was good for their pain. Women, more than men, expressed avoidance of sick leave because they did not want to be a burden to society or to their work colleagues. Patients were anxious about how to do the "correct" exercises to avoid further injury. Practical support and a follow up to adjust the training program were important to reduce the fear of engaging in physical activity and to maintain motivation. One hundred and eighteen patients (84 women and 34 men) completed the questionnaire. PCA of all questions identified five significant components. The model explained 37% of the variance. The predictive power was 17%. PC1 explained 17% of the variance and the predictive power was 0.13%. PC1 was mainly explained by questions classified in ICF as Activity and Participation. These included questions about physical function and self-efficacy (classified as Content of Thought). Questions about support (classified as Environmental Factors) and stress reactions (classified as Body Function (Emotional Functions)) mainly explained PC2. PC3 was mainly explained by reported pain and symptoms from muscles (classified as Body Functions) and domestic work and leisure time activities (classified as Activity and Participation). There were differences in t-scores between women and men in PC2 (p=0.045) and PC3 (p=0.003). Variables that discriminated between women and men were questions about stress reactions and support at work in PC2, and questions about pain intensity and domestic work in PC3. Conclusion As a physiotherapist working with neck and back pain rehabilitation patients, it is important to be aware of both one’s own and the patient’s preconceptions about women and men. It is also important to be aware of the impact of gender on the professional role when choosing treatment procedures in order to ensure that choices will be based on evidence of effectiveness and not from stereotypes. Awareness of the patient’s individual needs and subsequent adaptation of treatments is also important. Some patients display a negative self-assessment and shame. They need more support to be able to reorient. Unless these patients are confirmed, they are at risk of prolonged disability. Gender stereotypes can hinder rehabilitation of neck and back pain if women are seen as weak and in need of protection and men are seen as strong and not in need of preventive muscle training. When assessing neck and back pain patients with questionnaires, gender has less significance than when asking questions about physical function and self-efficacy. Questions about emotions of stress reactions, support at work, and pain intensity contribute to gender differences for women. Questions on the level of domestic work contribute to gender differences for men

How Does Preschoolers’ Conformity Relate to Parental Style, Anonymous Sharing, and Obedience?

Children, just like adults, conform to peer testimony when making ostensibly easy decisions. Yet, some are more prone to conform than others and little is known about which factors contribute to this variability. In the current study, we aimed to investigate the reasons for individual differences in conformity by examining potential correlates of experimentally-elicited conformity in a sample of Swedish 3.5-year-olds (N  = 55; 56%girls). Specifically, we asked whether conformity was socialized by parents via their parental style and whether conformity is correlated with the behaviors of anonymous sharing or obedience, which might each share a common motivation with conformity. Our data showed that children’s conformity was associated with fathers’, but not mothers’, authoritarian parental style and with anonymous sharing, but not obedience. The findings lend support to the notions that authoritarian parental style encourages conformist behavior, and that conformity is correlated with anonymous sharing behavior

Slutrapport för FOI-projektet Samverkan för bättre underhåll på järnvägen

”Samverkan för bättre underhåll på järnvägen” är arbetsnamnet på Pilot 2: ”Samverkan kring innovation från sensorsystem”, som ingår i FOI-projektet ”Verksamhetsutveckling och innovation i värdenätverk” (portfölj nr 6). Detta forsknings- och innovationsprojekt syftade till att utveckla ny kunskap om innovation i samverkan genom att utveckla och pröva en metod för skapande av en mer innovativ arbetsorganisation tillsammans med strategiskt viktiga kunder och andra intressenter. Projektets inleddes i december 2015 och avslutades i september 2016. Projektet hade fokus på samverkansinsatser för gemensam utveckling mellan Trafikverket, dess medarbetare och prioriterade kunder och andra samarbetsparterners/intressenter. En av ambitionerna var att även inom Trafikverket engagera personal i innovativt arbete i nya konstellationer. Med utgångspunkt från trendanalyser och scenarier som skapas av deltagande medarbetare, kunder och andra aktörer och intressenter utvecklas nya idéer som utvärderas, varvid ett gemensamt förändringsarbete planeras och påbörjas. Samtidigt, genom medarbetarnas medverkan och engagemang, inventeras framtida kompetensbehov inom Trafikverket och branschen. Processen planerades, följdes, leddes, dokumenterades och utvärderades av forskare.”Samverkan för bättre underhåll på järnvägen” var inriktat på insamling av sensordata från fordon i trafik, som kan kopplas till status och händelser i järnvägens infrastruktur. Järnvägsbranschen var väl representerad i projektet och arbetet bedrevs med stort engagemang och lyckat resultat.Att arbeta i innovationsprojekt var för många nytt och kräver att man släpper givna ramar och mönster. Det gäller att tänka fritt och nytt. Det skapades ett mycket gott samarbetsklimat i projektet och det kontreta resultatet av projektets arbete blev initiering av en fortsättning i ett nytt FOI-projekt ; ”Planering samt genomförande av Pilotprojekt i Portfölj 6, Samverkan för bättre underhåll på järnväg”. Detta projekt startades upp under hösten 2016.Rör Pilotprojekt 2 ” Proaktivt anläggningsunderhåll genom insamling av avvikelsedata från fordon” inom verksamhetsutveckling och innovation i värdenätver