Ambulation in adults with myelomeningocele. Is it possible to predict the level of ambulation in early life?

DEFF Research Database (Denmark)

Seitzberg, A.; Lind, M.; Biering-Sørensen, Fin

2008-01-01

OBJECTIVE: The objective of this study was to evaluate the prediction of ambulation in adults with myelomeningocele from muscle strength testing and ambulation in early life. MATERIALS AND METHODS: Fifty-two myelomeningocele (MMC) individuals at the age 18-37 years at follow-up were studied....... Information on muscle strength and ambulatory function in early life was retrieved from medical records. The motor levels determined by the muscle strength were used to predict ambulatory function later in life. At follow-up, a clinical examination was performed. RESULTS: Of 20 MMC individuals assessed...... life than predicted. Good strength in quadriceps muscles gave significant better prospect for adult walking. Of the 52 participants, 41 retained their ambulation status from 5-8 years of age. CONCLUSION: For MMC individuals with motor levels L3-L5, adult ambulatory function cannot be determined from...

42 CFR 414.620 - Publication of the ambulance fee schedule.

Science.gov (United States)

2010-10-01

... 42 Public Health 3 2010-10-01 2010-10-01 false Publication of the ambulance fee schedule. 414.620... SERVICES (CONTINUED) MEDICARE PROGRAM PAYMENT FOR PART B MEDICAL AND OTHER HEALTH SERVICES Fee Schedule for Ambulance Services § 414.620 Publication of the ambulance fee schedule. Changes in payment rates resulting...

Managing the impact of growing low-acuity demand on ambulance services

OpenAIRE

KATHRYN JEAN EASTWOOD

2018-01-01

Increasing demand for emergency ambulances places a substantial burden on ambulance services. Many cases are low-acuity, having no urgent clinical need for paramedic treatment. Ambulance Victoria implemented a secondary telephone triage services to divert low-acuity cases away from emergency ambulances to more appropriate care. This research found this ‘Referral Service’ has had a substantial impact upon emergency operations, referring over 70% of the cases it managed away from emergency am...

42 CFR 410.40 - Coverage of ambulance services.

Science.gov (United States)

2010-10-01

..., which are defined in § 414.605 of this chapter: (1) Basic life support (BLS) (emergency and nonemergency). (2) Advanced life support, level 1 (ALS1) (emergency and nonemergency). (3) Advanced life support... Coverage of ambulance services. (a). Basic rules. Medicare Part B covers ambulance services if the...

THE MOSCOW AMBULANCE STATION. FROM THE SOURSE TO THE PRESENT

Directory of Open Access Journals (Sweden)

N. F. Plavunov

2017-01-01

Full Text Available This article is devoted to 130th anniversary and publication of academic writings of Alexander Puchkov — Doctor of Med. Sci., Honored Doctor of Russian Soviet Federative Socialist Republic. He was permanent leader of Moscow Ambulance Station from 1923 to 1952. Data presented in Puchkov’s articles were used to compare performance of work of Moscow ambulance in it’s formative period and our days. This article shows specificities, characteristics and environment of Moscow ambulance in 1926 and 2016. For example, the number of brigades had increased by 67,9 times (from 15 in 1926 to 1018 in 2016. Average time of arrival to accident is 10-12 minutes is same for 1926 and 2016. The proportion of pediatric interventions (from birth to 15 years old had increased. Analysis of indicators allows to look at development of Moscow ambulance station from it’s formative period to our days. Fundamental principles laid down by A. Puchkov last in many cases in work of Moscow Ambulance in our days. Ambulance doctors continue to provide medical assistance promptly in the framework spelt out more than 90 years ago.

Basic life support and automated external defibrillator skills among ambulance personnel

DEFF Research Database (Denmark)

Nielsen, Anne Møller; Isbye, Dan Lou; Lippert, Freddy Knudsen

2012-01-01

Ambulance personnel play an essential role in the 'Chain of Survival'. The prognosis after out-of-hospital cardiac arrest was dismal on a rural Danish island and in this study we assessed the cardiopulmonary resuscitation performance of ambulance personnel on that island.......Ambulance personnel play an essential role in the 'Chain of Survival'. The prognosis after out-of-hospital cardiac arrest was dismal on a rural Danish island and in this study we assessed the cardiopulmonary resuscitation performance of ambulance personnel on that island....

Energy expenditure during ambulation with ortho crutches and axillary crutches.

Science.gov (United States)

Hinton, C A; Cullen, K E

1982-06-01

Thirteen normal male college students were studied during unassisted ambulation and nonweight-bearing ambulation with Ortho crutches and axillary crutches to determine energy expenditure. Subjects walked at self-selected velocities. Energy expenditure was determined by analyzing expired air collected by a calorimeter. Heart rate was monitored by telemetry. During the first 2.5 minutes of walking, heart rate and energy expenditure were significantly greater for ambulation with axillary crutches than with Ortho crutches. After 11.5 minutes of walking, no difference in energy cost was found between crutch types; however, heart rate increased significantly (p less than .01) during ambulation with axillary crutches. Differences in energy cost and heart rate were attributed to increased upper extremity work performed when using axillary crutches. We concluded that during nonweight-bearing ambulation for short periods of time or over a short distance, the Ortho crutch is less taxing in terms of energy cost and heart rate demands.

Patients' experiences of cold exposure during ambulance care.

Science.gov (United States)

Aléx, Jonas; Karlsson, Stig; Saveman, Britt-Inger

2013-06-06

Exposure to cold temperatures is often a neglected problem in prehospital care. Cold exposure increase thermal discomfort and, if untreated causes disturbances of vital body functions until ultimately reaching hypothermia. It may also impair cognitive function, increase pain and contribute to fear and an overall sense of dissatisfaction. The aim of this study was to investigate injured and ill patients' experiences of cold exposure and to identify related factors. During January to March 2011, 62 consecutively selected patients were observed when they were cared for by ambulance nursing staff in prehospital care in the north of Sweden. The field study was based on observations, questions about thermal discomfort and temperature measurements (mattress air and patients' finger temperature). Based on the observation protocol the participants were divided into two groups, one group that stated it was cold in the patient compartment in the ambulance and another group that did not. Continuous variables were analyzed with independent sample t-test, paired sample t-test and dichotomous variables with cross tabulation. In the ambulance 85% of the patients had a finger temperature below comfort zone and 44% experienced the ambient temperature in the patient compartment in the ambulance to be cold. There was a significant decrease in finger temperature from the first measurement indoor compared to measurement in the ambulance. The mattress temperature at the ambulance ranged from -22.3°C to 8.4°C. Cold exposure in winter time is common in prehospital care. Sick and injured patients immediately react to cold exposure with decreasing finger temperature and experience of discomfort from cold. Keeping the patient in the comfort zone is of great importance. Further studies are needed to increase knowledge which can be a base for implications in prehospital care for patients who probably already suffer for other reasons.

Patients’ experiences of cold exposure during ambulance care

Science.gov (United States)

2013-01-01

Background Exposure to cold temperatures is often a neglected problem in prehospital care. Cold exposure increase thermal discomfort and, if untreated causes disturbances of vital body functions until ultimately reaching hypothermia. It may also impair cognitive function, increase pain and contribute to fear and an overall sense of dissatisfaction. The aim of this study was to investigate injured and ill patients’ experiences of cold exposure and to identify related factors. Method During January to March 2011, 62 consecutively selected patients were observed when they were cared for by ambulance nursing staff in prehospital care in the north of Sweden. The field study was based on observations, questions about thermal discomfort and temperature measurements (mattress air and patients’ finger temperature). Based on the observation protocol the participants were divided into two groups, one group that stated it was cold in the patient compartment in the ambulance and another group that did not. Continuous variables were analyzed with independent sample t-test, paired sample t-test and dichotomous variables with cross tabulation. Results In the ambulance 85% of the patients had a finger temperature below comfort zone and 44% experienced the ambient temperature in the patient compartment in the ambulance to be cold. There was a significant decrease in finger temperature from the first measurement indoor compared to measurement in the ambulance. The mattress temperature at the ambulance ranged from −22.3°C to 8.4°C. Conclusion Cold exposure in winter time is common in prehospital care. Sick and injured patients immediately react to cold exposure with decreasing finger temperature and experience of discomfort from cold. Keeping the patient in the comfort zone is of great importance. Further studies are needed to increase knowledge which can be a base for implications in prehospital care for patients who probably already suffer for other reasons. PMID:23742143

Community ambulation: influences on therapists and clients reasoning and decision making.

Science.gov (United States)

Corrigan, Rosemary; McBurney, Helen

2008-01-01

Community ambulation is an important element of a rehabilitation training programme and its achievement is a goal shared by rehabilitation professionals and clients. The factors that influence a physiotherapist's or health professionals decision making around the preparation of a client for community ambulation and the factors that influence a client's decision to return to walking in their community are unclear. To review the available literature about the factors that have influenced the reasoning and decision making of rehabilitation therapists and clients around the topic of ambulation in the community. Three separate searches of the available literature were undertaken using Ovid, Cinahl, ProQuest, Medline and Ebscohost databases. Databases were searched from 1966 to October 2006.The first search explored the literature for factors that influence the clinical reasoning of rehabilitation therapists. The second search explored the literature for factors that influence client's decision to ambulate in the community. A third search was undertaken to explore the literature for the demands of community ambulation in rural communities. Very few studies were found that explored community ambulation in the context of clinical reasoning and decision making, the facilitators and barriers to a clients return to ambulation in their community or the demands of ambulation in a rural community. Consideration of the environment is key to the successful return to walking in the community of clients with mobility problems yet little literature has been found to guide physiotherapist's decision making about preparing a clients to return to walking in the community. An individual's participation in their society is also a result of the interaction between their personal characteristics and his or her environment. The influence of these characteristics may vary from one individual to another yet the factors that influence a person's decision to return to walking in their community

Microbial air quality and bacterial surface contamination in ambulances during patient services.

Science.gov (United States)

Luksamijarulkul, Pipat; Pipitsangjan, Sirikun

2015-03-01

We sought to assess microbial air quality and bacterial surface contamination on medical instruments and the surrounding areas among 30 ambulance runs during service. We performed a cross-sectional study of 106 air samples collected from 30 ambulances before patient services and 212 air samples collected during patient services to assess the bacterial and fungal counts at the two time points. Additionally, 226 surface swab samples were collected from medical instrument surfaces and the surrounding areas before and after ambulance runs. Groups or genus of isolated bacteria and fungi were preliminarily identified by Gram's stain and lactophenol cotton blue. Data were analyzed using descriptive statistics, t-test, and Pearson's correlation coefficient with a p-value of less than 0.050 considered significant. The mean and standard deviation of bacterial and fungal counts at the start of ambulance runs were 318±485cfu/m(3) and 522±581cfu/m(3), respectively. Bacterial counts during patient services were 468±607cfu/m(3) and fungal counts were 656±612cfu/m(3). Mean bacterial and fungal counts during patient services were significantly higher than those at the start of ambulance runs, p=0.005 and p=0.030, respectively. For surface contamination, the overall bacterial counts before and after patient services were 0.8±0.7cfu/cm(2) and 1.3±1.1cfu/cm(2), respectively (pair samples and bacterial counts on medical instruments and allocated areas. This study revealed high microbial contamination (bacterial and fungal) in ambulance air during services and higher bacterial contamination on medical instrument surfaces and allocated areas after ambulance services compared to the start of ambulance runs. Additionally, bacterial and fungal counts in ambulance air showed a significantly positive correlation with the bacterial surface contamination on medical instruments and allocated areas. Further studies should be conducted to determine the optimal intervention to reduce

Efficacy and safety of intravenous fentanyl administered by ambulance personnel

DEFF Research Database (Denmark)

Friesgaard, Kristian Dahl; Nikolajsen, Lone; Giebner, Matthias

2016-01-01

BACKGROUND: Management of pain in the pre-hospital setting is often inadequate. In 2011, ambulance personnel were authorized to administer intravenous fentanyl in the Central Denmark Region. The aim of this study was to evaluate the efficacy and safety of intravenous fentanyl administered...... by ambulance personnel. METHODS: Pre-hospital medical charts from 2348 adults treated with intravenous fentanyl by ambulance personnel during a 6-month period were reviewed. The primary outcome was the change in pain intensity on a numeric rating scale (NRS) from before fentanyl treatment to hospital arrival...... patients (1.3%) and hypotension observed in 71 patients (3.0%). CONCLUSION: Intravenous fentanyl caused clinically meaningful pain reduction in most patients and was safe in the hands of ambulance personnel. Many patients had moderate to severe pain at hospital arrival. As the protocol allowed higher doses...

Patients' perception of the ambulance services at Hospital Universiti Sains Malaysia.

Science.gov (United States)

Anisah, A; Chew, K S; Mohd Shaharuddin Shah, C H; Nik Hisamuddin, N A R

2008-08-01

Little is known regarding public opinion of prehospital care in Malaysia. This study was conducted to find out the public's perception and expectations of the ambulance services in one of the university hospitals in Malaysia. A six-month prospective cross-sectional study to look at patients' perception of Hospital Universiti Sains Malaysia's (HUSM) ambulance service was conducted from February 2006 to July 2006. Upon arrival at the hospital, patients or their relatives (who used our hospital's ambulances) were interviewed with a set of questions regarding their perception of the ambulance services and were asked to rate the perception on a Likert Scale from 1 to 10. A convenient sampling method was applied. A total of 87 samples were obtained. Despite the many problems faced by the ambulance service in HUSM, the mean score for each of the questions on patient's perception ranged from 9.33 to 9.70 out of 10. The questions with the highest mean score, which were both 9.70 each, were related to staff attentiveness and staff gentleness. Patients' perceptions can be very subjective, but until further similar studies could be carried out in other parts of Malaysia, this set of data merely represents a numerical measure of public perception of the ambulance services from HUSM.

29 CFR 553.215 - Ambulance and rescue service employees.

Science.gov (United States)

2010-07-01

... activities, the applicable standard is the one which applies to the activity in which the employee spends the majority of work time during the work period. (b) Ambulance and rescue service employees of public agencies... 29 Labor 3 2010-07-01 2010-07-01 false Ambulance and rescue service employees. 553.215 Section 553...

Complexity, fractal dynamics and determinism in treadmill ambulation: Implications for clinical biomechanists.

Science.gov (United States)

Hollman, John H; Watkins, Molly K; Imhoff, Angela C; Braun, Carly E; Akervik, Kristen A; Ness, Debra K

2016-08-01

Reduced inter-stride complexity during ambulation may represent a pathologic state. Evidence is emerging that treadmill training for rehabilitative purposes may constrain the locomotor system and alter gait dynamics in a way that mimics pathological states. The purpose of this study was to examine the dynamical system components of gait complexity, fractal dynamics and determinism during treadmill ambulation. Twenty healthy participants aged 23.8 (1.2) years walked at preferred walking speeds for 6min on a motorized treadmill and overground while wearing APDM 6 Opal inertial monitors. Stride times, stride lengths and peak sagittal plane trunk velocities were measured. Mean values and estimates of complexity, fractal dynamics and determinism were calculated for each parameter. Data were compared between overground and treadmill walking conditions. Mean values for each gait parameter were statistically equivalent between overground and treadmill ambulation (P>0.05). Through nonlinear analyses, however, we found that complexity in stride time signals (P<0.001), and long-range correlations in stride time and stride length signals (P=0.005 and P=0.024, respectively), were reduced on the treadmill. Treadmill ambulation induces more predictable inter-stride time dynamics and constrains fluctuations in stride times and stride lengths, which may alter feedback from destabilizing perturbations normally experienced by the locomotor control system during overground ambulation. Treadmill ambulation, therefore, may provide less opportunity for experiencing the adaptability necessary to successfully ambulate overground. Investigators and clinicians should be aware that treadmill ambulation will alter dynamic gait characteristics. Copyright © 2016 Elsevier Ltd. All rights reserved.

Air ambulance services--integrated emergency care.

Science.gov (United States)

Ferdinand, M

1994-10-01

In the name of cost-conscious care, air ambulance program directors and service contractors are seeing the dawn of integrated networks as a boon to their business. As integrated networks form, facilities will become increasingly specialized in the types of services they provide. Patients will need to be moved around the system, resulting in more frequent patient transport and more points of transfer. Many programs are considering aircraft replacement and additions, rather than leasing. Financial benefits could come on depreciation and the high resale value of aircraft. Unless reimbursement levels increase, more program mergers and affiliations may take place to spread and reduce cost. Air ambulance services will increasingly become part of a facility's strategic plan.

Lower air temperature is associated with ambulance transports and death in Takamatsu area, Japan.

Science.gov (United States)

Mochimasu, Kazumi Dokai; Miyatake, Nobuyuki; Tanaka, Naoko; Kinoshita, Hiroshi

2014-07-01

The aim of this study was to investigate the linkage among ambulance transports, the number of death and air temperature in Takamatsu area, Japan. Monthly data of ambulance transports (total and acute disease) and the number of death from 2004 to 2012 were obtained from Fire Department Service in Takamatsu and Takamatsu city official website, Japan. Climate parameters for required period were also obtained from Japan Meteorological Agency. Population data in Takamatsu area were also used to adjust ambulance transports and the number of death. The linkage among ambulance transports, the number of death and climate parameters was evaluated by ecological analysis. Total ambulance transports (/a hundred thousand people/day) and ambulance transports due to acute disease (/a hundred thousand people/day) were 12.3 ± 0.9 and 6.8 ± 0.7, respectively. The number of death (/a hundred thousand people/day) was 2.5 ± 0.4. By quadratic curve, ambulance transports due to acute disease and the number of death were significantly correlated with the parameters of air temperature. However, the number of death was the highest in January and the lowest in August. Although higher air temperature was only associated with higher ambulance transports, lower air temperature was associated with both higher ambulance transports and the number death in Takamatsu area, Japan.

Evaluating public ambulance service levels by applying a GIS based ...

African Journals Online (AJOL)

Ambulance vehicles are required to respond rapidly to medical emergencies. A number of factors may affect response times, most importantly the location of emergency services stations, the number of ambulance vehicles available at each station, road conditions and traffic volumes. To support spatial planning and provide ...

Reassurance as a key outcome valued by emergency ambulance service users: a qualitative interview study.

Science.gov (United States)

Togher, Fiona J; O'Cathain, Alicia; Phung, Viet-Hai; Turner, Janette; Siriwardena, Aloysius Niroshan

2015-12-01

There is an increasing need to assess the performance of emergency ambulance services using measures other than the time taken for an ambulance to arrive on scene. In line with government policy, patients and carers can help to shape new measures of ambulance service performance. To investigate the aspects of emergency ambulance service care valued by users. Qualitative interview study. One of 11 ambulance services in England. Twenty-two users and eight of their spouses (n = 30). Users of the emergency ambulance service, experiencing different types of ambulance service response, valued similar aspects of their pre-hospital care. Users were often extremely anxious about their health, and the outcome they valued was reassurance provided by ambulance service staff that they were receiving appropriate advice, treatment and care. This sense of being reassured was enhanced by the professional behaviour of staff, which instilled confidence in their care; communication; a short wait for help; and continuity during transfers. A timely response was valued in terms of allaying anxiety quickly. The ability of the emergency ambulance service to allay the high levels of fear and anxiety felt by users is crucial to the delivery of a high quality service. Measures developed to assess and monitor the performance of emergency ambulance services should include the proportion of users reporting feeling reassured by the response they obtained. © 2014 John Wiley & Sons Ltd.

Offload zone patient selection criteria to reduce ambulance offload delay

NARCIS (Netherlands)

Laan, Corine Maartje; Vanberkel, Peter T.; Boucherie, Richardus J.; Carter, Alix J.E.

2016-01-01

Emergency department overcrowding is a widespread problem and often leads to ambulance offload delay. If no bed is available when a patient arrives, the patient has to wait with the ambulance crew. A recent Canadian innovation is the offload zone—an area where multiple patients can wait with a

The linkage among ambulance transports, death and climate parameters in Asahikawa City, Japan.

Science.gov (United States)

Kataoka, Hiroaki; Mochimasu, Kazumi Dokai; Katayama, Akihiko; Kanda, Kanae Oda; Sakano, Noriko; Tanaka, Keiko; Miyatake, Nobuyuki

2015-01-01

The aim of this study was to investigate the linkage among climate parameters, total ambulance transports and the number of deaths in Asahikawa City in northern Japan. Monthly data on total ambulance transports and the number of deaths from January 2004 to December 2011 were obtained from Asahikawa City Fire Department and the Asahikawa City official website. Climate parameters for the required period were also obtained from the Japan Meteorological Agency, Japan. To adjust for the population, we also used monthly population data on Asahikawa City. The linkage among climate parameters, total ambulance transports and the number of deaths was evaluated by ecological analysis. The mean air temperature in the Asahikawa area was 7.3 ± 10.1 °C. Total ambulance transports (/a hundred thousand people/day) and the number of deaths (/a hundred thousand people/day) were 10.0 ± 0.6 and 2.6 ± 0.3, respectively. Using quadratic curves, total ambulance transports and the number of deaths were weakly correlated with some climate parameters. The number of deaths was weakly and positively correlated with total ambulance transports. A weak linkage among climate parameters, total ambulance transports and the number of deaths was noted in Asahikawa City, Japan. However, these associations were not as high as expected.

Ambulance Work : Relationships between occupational demands, individual characteristics and health-related outcomes

OpenAIRE

Aasa, Ulrika

2005-01-01

Although musculoskeletal disorders (MSDs) and other health complaints are an occupational problem for ambulance personnel, there is a lack of knowledge regarding work-related factors associated with MSDs and other health complaints. The overall aim of this thesis was to investigate the relationships between occupational demands, individual characteristics and health-related outcomes among ambulance personnel. A random sample of 234 female and 953 male ambulance personnel participated in a nat...

Simulation-based decision support framework for dynamic ambulance redeployment in Singapore.

Science.gov (United States)

Lam, Sean Shao Wei; Ng, Clarence Boon Liang; Nguyen, Francis Ngoc Hoang Long; Ng, Yih Yng; Ong, Marcus Eng Hock

2017-10-01

Dynamic ambulance redeployment policies tend to introduce much more flexibilities in improving ambulance resource allocation by capitalizing on the definite geospatial-temporal variations in ambulance demand patterns over the time-of-the-day and day-of-the-week effects. A novel modelling framework based on the Approximate Dynamic Programming (ADP) approach leveraging on a Discrete Events Simulation (DES) model for dynamic ambulance redeployment in Singapore is proposed in this paper. The study was based on the Singapore's national Emergency Medical Services (EMS) system. Based on a dataset comprising 216,973 valid incidents over a continuous two-years study period from 1 January 2011-31 December 2012, a DES model for the EMS system was developed. An ADP model based on linear value function approximations was then evaluated using the DES model via the temporal difference (TD) learning family of algorithms. The objective of the ADP model is to derive approximate optimal dynamic redeployment policies based on the primary outcome of ambulance coverage. Considering an 8min response time threshold, an estimated 5% reduction in the proportion of calls that cannot be reached within the threshold (equivalent to approximately 8000 dispatches) was observed from the computational experiments. The study also revealed that the redeployment policies which are restricted within the same operational division could potentially result in a more promising response time performance. Furthermore, the best policy involved the combination of redeploying ambulances whenever they are released from service and that of relocating ambulances that are idle in bases. This study demonstrated the successful application of an approximate modelling framework based on ADP that leverages upon a detailed DES model of the Singapore's EMS system to generate approximate optimal dynamic redeployment plans. Various policies and scenarios relevant to the Singapore EMS system were evaluated. Copyright © 2017

Impact of Air Temperature on London Ambulance Call-Out Incidents and Response Times

Directory of Open Access Journals (Sweden)

Marliyyah A. Mahmood

2017-08-01

Full Text Available Ambulance services are in operation around the world and yet, until recently, ambulance data has only been used for operational purposes rather than for assessing public health. Ambulance call-out data offers new and valuable (near real-time information that can be used to assess the impact of environmental conditions, such as temperature, upon human health. A detailed analysis of London ambulance data at a selection of dates between 2003 and 2015 is presented and compared to London temperature data. In London, the speed of ambulance response begins to suffer when the mean daily air temperature drops below 2 °C or rises above 20 °C. This is explained largely by the increased number of calls past these threshold temperatures. The baseline relationships established in this work will inform the prediction of likely changes in ambulance demand (and illness types that may be caused by seasonal temperature changes and the increased frequency and intensity of extreme/severe weather events, exacerbated by climate change, in the future.

Ambulance Reasonable Charge Public Use Files

Data.gov (United States)

U.S. Department of Health & Human Services — The Ambulance Reasonable Charge public use files for calendar years (CY) 2003 through 2005 are located in the Downloads section below. These public use files are...

Telestroke ambulances in prehospital stroke management: concept and pilot feasibility study.

Science.gov (United States)

Liman, Thomas G; Winter, Benjamin; Waldschmidt, Carolin; Zerbe, Norman; Hufnagl, Peter; Audebert, Heinrich J; Endres, Matthias

2012-08-01

Pre- and intrahospital time delays are major concerns in acute stroke care. Telemedicine-equipped ambulances may improve time management and identify patients with stroke eligible for thrombolysis by an early prehospital stroke diagnosis. The aims of this study were (1) to develop a telestroke ambulance prototype; (2) to test the reliability of stroke severity assessment; and (3) to evaluate its feasibility in the prehospital emergency setting. Mobil, real-time audio-video streaming telemedicine devices were implemented into advanced life support ambulances. Feasibility of telestroke ambulances and reliability of the National Institutes of Health Stroke Scale assessment were tested using current wireless cellular communication technology (third generation) in a prehospital stroke scenario. Two stroke actors were trained in simulation of differing right and left middle cerebral artery stroke syndromes. National Institutes of Health Stroke Scale assessment was performed by a hospital-based stroke physician by telemedicine, by an emergency physician guided by telemedicine, and "a posteriori" on the basis of video documentation. In 18 of 30 scenarios, National Institutes of Health Stroke Scale assessment could not be performed due to absence or loss of audio-video signal. In the remaining 12 completed scenarios, interrater agreement of National Institutes of Health Stroke Scale examination between ambulance and hospital and ambulance and "a posteriori" video evaluation was moderate to good with weighted κ values of 0.69 (95% CI, 0.51-0.87) and 0.79 (95% CI, 0.59-0.98), respectively. Prehospital telestroke examination was not at an acceptable level for clinical use, at least on the basis of the used technology. Further technical development is needed before telestroke is applicable for prehospital stroke management during patient transport.

Ambulance traffic accidents in Taiwan.

Science.gov (United States)

Chiu, Po-Wei; Lin, Chih-Hao; Wu, Chen-Long; Fang, Pin-Hui; Lu, Chien-Hsin; Hsu, Hsiang-Chin; Chi, Chih-Hsien

2018-04-01

Ambulance traffic accidents (ATAs) are the leading cause of occupation-related fatalities among emergency medical service (EMS) personnel. We aim to use the Taiwan national surveillance system to analyze the characteristics of ATAs and to assist EMS directors in developing policies governing ambulance operations. A retrospective, cross-sectional and largely descriptive study was conducted using Taiwan national traffic accidents surveillance data from January 1, 2011 to October 31, 2016. Among the 1,627,217 traffic accidents during the study period, 715 ATAs caused 8 deaths within 24 h and 1844 injured patients. On average, there was one ATA for every 8598 ambulance runs. Compared to overall traffic accidents, ATAs were 1.7 times more likely to result in death and 1.9 times more likely to have injured patients. Among the 715 ATAs, 8 (1.1%) ATAs were fatal and 707 (98.9%) were nonfatal. All 8 fatalities were associated with motorcycles. The urban areas were significantly higher than the rural areas in the annual number of ATAs (14.2 ± 7.3 [7.0-26.7] versus 3.1 ± 1.9 [0.5-8.4], p = 0.013), the number of ATA-associated fatalities per year (0.2 ± 0.2 [0.0-0.7] versus 0.1 ± 0.1 [0.0-0.2], p = 0.022), and the annual number of injured patients (who needed urgent hospital visits) in ATAs (19.4 ± 7.3 [10.5-30.9] versus 5.2 ± 3.8 [0.9-15.3], p traffic accident reporting system should be built to provide EMS policy guidance for ATA reduction and outcome improvements. Copyright © 2018. Published by Elsevier B.V.

Is the Ability to Ambulate Associated with Better Employment Outcomes in Participants with Traumatic Spinal Cord Injury?

Science.gov (United States)

Krause, James S.

2010-01-01

The author compares current employment status after spinal cord injury between participants who were independent in ambulation (required no assistance from others) and those who were dependent in ambulation (required assistance from at least one other person to ambulate). Those who were independent of assistance from others in ambulation were…

[The Swedish ambulance services 1935-1936 of Gunnar Agge].

Science.gov (United States)

Gustavsson, Pär; Nilsson, Peter M

2006-01-01

The fact that Sweden has been spared from war on its soil for almost 200 years, has not stopped Swedish citizens from participating in conflicts worldwide during this period. This has been described, especially from the soldiers perspective. The contribution of Swedish physicians has not been written about to the same extent. When Mussolini's Italy in October 1935 invaded the poor and underdeveloped country of Ethiopia (former Abyssinia) an ambulance was immediately organized by the Swedish Red Cross. To lead such an expedition, a great knowledge of Ethiopian culture och maybe most importantly, of the weather and geographical conditions, was undoubtedly demanded. Therefore, the Swedish Red Cross turned to two Ethiopian veterans. Doctor Fride Hylander, a missionary-son who had been working on a hospital project in the Ethiopian province of Harrar and his friend since school years, doctor Gunnar Agge, were assigned the leadership of the ambulance. Dr Agge had also participated in improving the Ethiopian health care both in Harrar and later as civilian and military doctor in the province of Ogaden, where he was medically responsible for the more than 9 000 men strong army that the Ethiopian emperor had stationed there after Italian provocations. Most of the other members of the ambulance were handpicked by these two leaders and many of them had, just like themselves, a stong religious belief. A money-raise was immediately initiated and in less than six weeks 700 000 Swedish crowns had been collected, more then twice the sum the ambulance was calculated to cost. In early november 1935 the ambulance was clear to go. Their primary objective was to travel through British Somaliland and establish a field-hospital in the province of Harrar. However, the Ethiopian emperor had other things in mind. He wanted to reorganize the ambulance and divide it in two and place it closer to the front line. The ambulance decided to go along with his wish. Both groups started eventually

Using a discrete-event simulation to balance ambulance availability and demand in static deployment systems.

Science.gov (United States)

Wu, Ching-Han; Hwang, Kevin P

2009-12-01

To improve ambulance response time, matching ambulance availability with the emergency demand is crucial. To maintain the standard of 90% of response times within 9 minutes, the authors introduce a discrete-event simulation method to estimate the threshold for expanding the ambulance fleet when demand increases and to find the optimal dispatching strategies when provisional events create temporary decreases in ambulance availability. The simulation model was developed with information from the literature. Although the development was theoretical, the model was validated on the emergency medical services (EMS) system of Tainan City. The data are divided: one part is for model development, and the other for validation. For increasing demand, the effect was modeled on response time when call arrival rates increased. For temporary availability decreases, the authors simulated all possible alternatives of ambulance deployment in accordance with the number of out-of-routine-duty ambulances and the durations of three types of mass gatherings: marathon races (06:00-10:00 hr), rock concerts (18:00-22:00 hr), and New Year's Eve parties (20:00-01:00 hr). Statistical analysis confirmed that the model reasonably represented the actual Tainan EMS system. The response-time standard could not be reached when the incremental ratio of call arrivals exceeded 56%, which is the threshold for the Tainan EMS system to expand its ambulance fleet. When provisional events created temporary availability decreases, the Tainan EMS system could spare at most two ambulances from the standard configuration, except between 20:00 and 01:00, when it could spare three. The model also demonstrated that the current Tainan EMS has two excess ambulances that could be dropped. The authors suggest dispatching strategies to minimize the response times in routine daily emergencies. Strategies of capacity management based on this model improved response times. The more ambulances that are out of routine duty

[The correlation between personality characteristics and burnout syndrome in emergency ambulance workers].

Science.gov (United States)

Bergmueller, A; Zavgorodnii, I; Zavgorodnia, N; Kapustnik, W; Boeckelmann, I

The work in Emergency Medical Ambulance Service is one of the professions, which is accompanied by high psychological and emotional stress. The aim was to determine the risk of professional burnout syndrome of Emergency Medical Ambulance Service staff and the relationship between burnout syndrome and personality. Ninety-seven doctors (57 women and 40 men, aged 37.0±12.21) of Emergency Medical Ambulance Service were interviewed using the MBI-GS questionnaire and the Freiburg personality questionnaire (FPI). Correlation and regression analysis were used. Nine (11.5%) of respondents had a risk of burnout syndrome and 28 (35.9%) had some symptoms. In the group, aged 45 years and older, the risk of burnout syndrome was not identified. The staff of Emergency Medical Ambulance Service is characterized by stable personality features. It is necessary to identify the prevalence of burnout syndrome and also to identity the causes for its prevention and development of measures on the increase of personal stress resilience.

Urban sprawl and delayed ambulance arrival in the U.S.

Science.gov (United States)

Trowbridge, Matthew J; Gurka, Matthew J; O'Connor, Robert E

2009-11-01

Minimizing emergency medical service (EMS) response time is a central objective of prehospital care, yet the potential influence of built environment features such as urban sprawl on EMS system performance is often not considered. This study measures the association between urban sprawl and EMS response time to test the hypothesis that features of sprawling development increase the probability of delayed ambulance arrival. In 2008, EMS response times for 43,424 motor-vehicle crashes were obtained from the Fatal Analysis Reporting System, a national census of crashes involving > or =1 fatality. Sprawl at each crash location was measured using a continuous county-level index previously developed by Ewing et al. The association between sprawl and the probability of a delayed ambulance arrival (> or =8 minutes) was then measured using generalized linear mixed modeling to account for correlation among crashes from the same county. Urban sprawl is significantly associated with increased EMS response time and a higher probability of delayed ambulance arrival (p=0.03). This probability increases quadratically as the severity of sprawl increases while controlling for nighttime crash occurrence, road conditions, and presence of construction. For example, in sprawling counties (e.g., Fayette County GA), the probability of a delayed ambulance arrival for daytime crashes in dry conditions without construction was 69% (95% CI=66%, 72%) compared with 31% (95% CI=28%, 35%) in counties with prominent smart-growth characteristics (e.g., Delaware County PA). Urban sprawl is significantly associated with increased EMS response time and a higher probability of delayed ambulance arrival following motor-vehicle crashes in the U.S. The results of this study suggest that promotion of community design and development that follows smart-growth principles and regulates urban sprawl may improve EMS performance and reliability.

Evaluating public ambulance service levels by applying a GIS based accessibility analysis approach

CSIR Research Space (South Africa)

Baloyi, Ethel

2017-08-01

Full Text Available Ambulance vehicles are required to respond rapidly to medical emergencies. A number of factors may affect response times, most importantly the location of emergency services stations, the number of ambulance vehicles available at each station, road...

Paramedic identification of acute pulmonary edema in a metropolitan ambulance service.

Science.gov (United States)

Williams, Teresa A; Finn, Judith; Celenza, Antonio; Teng, Tiew-Hwa; Jacobs, Ian G

2013-01-01

Acute pulmonary edema (APE) is a common cause of acute dyspnea. In the prehospital setting, it is often difficult to differentiate APE from other causes of shortness of breath (SOB). Radiography and echocardiography aid in the identification of APE but are often not available. There is little information on how accurately ambulance paramedics identify patients with APE. Objectives. This study aimed to 1) describe the prehospital clinical presentation and management of patients with a clinical diagnosis of APE and 2) compare the accuracy of coding of APE by paramedics against the emergency department (ED) medical discharge diagnosis. This study included a retrospective cohort of all patients who had episodes identified as APE by ambulance paramedics and were transported to a metropolitan hospital ED in 2011. Two databases were used: an ambulance database and the Emergency Department Information System. The ED medical discharge diagnosis (using International Statistical Classification of Diseases and Related Problems, 10th Revision, Australian Modification [ICD-10-AM] codes) was used as the comparator with paramedic-assigned problem codes for APE. The outcomes for the study were the positive predictive value, i.e., the proportion of patients identified as having APE in the ambulance database who also had an ED discharge diagnosis of APE, and the sensitivity of paramedic identification of APE, i.e., the proportion of patients with an ED discharge diagnosis of APE that were correctly identified as APE by the ambulance paramedics. Four hundred ninety-five patients were transported to an ED with APE identified by the paramedics as the primary problem code. Shortness of breath, crepitations, high systolic blood pressure, and chest pain were the most common presenting signs and symptoms. Pink frothy sputum was rare (3% of patient episodes of APE). One hundred eighty-six patients received an ED discharge diagnosis of APE, i.e., a positive predictive value of 41%. Of 631 ED

An integration of Emergency Department Information and Ambulance Systems.

Science.gov (United States)

Al-Harbi, Nada; El-Masri, Samir; Saddik, Basema

2012-01-01

In this paper we propose an Emergency Department Information System that will be integrated with the ambulance system to improve the communication, enhance the quality of provided emergency services and facilitate information sharing. The proposed system utilizes new advanced technologies such as mobile web services that overcome the problems of interoperability between different systems, HL7 and GPS. The system is unique in that it allows ambulance officers to locate the nearest specialized hospital and allows access to the patient's electronic health record as well as providing the hospital with required information to prepare for the incoming patient.

Reflective and collaborative skills enhances Ambulance nurses' competence - A study based on qualitative analysis of professional experiences.

Science.gov (United States)

Wihlborg, Jonas; Edgren, Gudrun; Johansson, Anders; Sivberg, Bengt

2017-05-01

The Swedish ambulance health care services are changing and developing, with the ambulance nurse playing a central role in the development of practice. The competence required by ambulance nurses in the profession remains undefined and provides a challenge. The need for a clear and updated description of ambulance nurses' competence, including the perspective of professional experiences, seems to be essential. The aim of this study was to elucidate ambulance nurses' professional experiences and to describe aspects affecting their competence. For data collection, the study used the Critical Incident Technique, interviewing 32 ambulance nurses. A qualitative content analysis was applied. This study elucidates essential parts of the development, usage and perceptions of the competence of ambulance nurses and how, in various ways, this is affected by professional experiences. The development of competence is strongly affected by the ability and possibility to reflect on practice on a professional and personal level, particularly in cooperation with colleagues. Experiences and communication skills are regarded as decisive in challenging clinical situations. The way ambulance nurses perceive their own competence is closely linked to patient outcome. The results of this study can be used in professional and curriculum development. Copyright © 2016 Elsevier Ltd. All rights reserved.

Ambulation and survival following surgery in elderly patients with metastatic epidural spinal cord compression.

Science.gov (United States)

Itshayek, Eyal; Candanedo, Carlos; Fraifeld, Shifra; Hasharoni, Amir; Kaplan, Leon; Schroeder, Josh E; Cohen, José E

2017-12-28

Metastatic epidural spinal cord compression (MESCC) is a disabling consequence of disease progression. Surgery can restore/preserve physical function, improving access to treatments that increase duration of survival; however, advanced patient age may deter oncologists and surgeons from considering surgical management. Evaluate the duration of ambulation and survival in elderly patients following surgical decompression of MESCC. Retrospective file review of a prospective database, under IRB waiver of informed consent, of consecutive patients treated in an academic tertiary care medical center from 8/2008-3/2015. Patients ≥65 years presenting neurological and/or radiological signs of cord compression due to metastatic disease, who underwent surgical decompression. Duration of ambulation and survival. Patients underwent urgent multidisciplinary evaluation and surgery. Ambulation and survival were compared with age, pre- and postoperative neurological (American Spinal Injury Association [ASIA] Impairment Scale [AIS]) and performance status (Karnofsky Performance Status [KPS], and Tokuhashi Score using Kruskal-Wallis and Wilcoxon signed-rank tests, Pearson correlation coefficient, Cox regression model, log rank analysis, and Kaplan Meir analysis. 40 patients were included (21 male, 54%; mean age 74 years, range 65-87). Surgery was performed a mean 3.8 days after onset of motor symptoms. Mean duration of ambulation and survival were 474 (range 0-1662) and 525 days (range 11-1662), respectively; 53% of patients (21/40) survived and 43% (17/40) retained ambulation for ≥1 year. There was no significant relationship between survival and ambulation for patients aged 65-69, 70-79, or 80-89, although Kaplan Meier analysis suggested stratification. There was a significant relationship between duration of ambulation and pre- and postoperative AIS (p=0.0342, p=0.0358, respectively) and postoperative KPS (p=0.0221). Tokuhashi score was not significantly related to duration of

Trends in diagnostic patterns and mortality in emergency ambulance service patients in 2007-2014

DEFF Research Database (Denmark)

Christensen, Erika Frischknecht; Bendtsen, Mette Dahl; Larsen, Thomas Mulvad

2017-01-01

) to allow comparison by year, with 2007 as reference year. RESULTS: The annual number of emergency ambulance service patients increased from 24.3 in 2007 to 40.2 in 2014 per 1000 inhabitants. The proportions of women increased from 43.1% to 46.4% and of patients aged 60+ years from 39.9% to 48......: Population-based cohort study with linkage of Danish national registries. SETTING: The North Denmark Region in 2007-2014. PARTICIPANTS: Cohort of 148 757 patients transported to hospital by ambulance after calling emergency services. MAIN OUTCOME MEASURES: The number of emergency ambulance service patients......, the incidence of emergency ambulance service patients, the proportion of women, elderly, and non-specific diagnoses increased. The level of comorbidity increased substantially, whereas the 1-day and 30-day mortality decreased....

Trends in diagnostic patterns and mortality in emergency ambulance service patients in 2007-2014

DEFF Research Database (Denmark)

Christensen, Erika Frischknecht; Bendtsen, Mette Dahl; Larsen, Thomas Mulvad

) to allow comparison by year, with 2007 as reference year. RESULTS: The annual number of emergency ambulance service patients increased from 24.3 in 2007 to 40.2 in 2014 per 1000 inhabitants. The proportions of women increased from 43.1% to 46.4% and of patients aged 60+ years from 39.9% to 48......: Population-based cohort study with linkage of Danish national registries. SETTING: The North Denmark Region in 2007-2014. PARTICIPANTS: Cohort of 148 757 patients transported to hospital by ambulance after calling emergency services. MAIN OUTCOME MEASURES: The number of emergency ambulance service patients......, the incidence of emergency ambulance service patients, the proportion of women, elderly, and non-specific diagnoses increased. The level of comorbidity increased substantially, whereas the 1-day and 30-day mortality decreased....

Ambulance services in London and Great Britain from 1860 until today: a glimpse of history gleaned mainly from the pages of contemporary journals.

Science.gov (United States)

Pollock, Alexander

2013-03-01

Little has been published on the subject of civil ambulance services and their development from the mid-19th century in the UK until modern times. There is limited secondary literature available which provides useful background information on the subject and most organisations may give brief histories of their early days but these sources lack historical adequacy in terms of detail. This article shows part of the uncertain path which the history followed towards the service which we enjoy today. From the pages of the British Medical Journal and the Lancet and Hansard, the battle to set up the service is followed and an indication of the drivers towards change over the period is revealed in the attitudes expressed. In particular, the two World Wars are seen to be the stepwise stimuli to providing a necessary service to the British population where the will to achieve this had hitherto been lacking at a parliamentary level. The history of the London Ambulance Service is chosen because more is written about it in these journals but services in other British cities and the USA are mentioned since they played a part in influencing change.

Performance of an automated external defibrillator in a moving ambulance vehicle.

Science.gov (United States)

Yun, Jong Geun; Jeung, Kyung Woon; Lee, Byung Kook; Ryu, Hyun Ho; Lee, Hyoung Youn; Kim, Mu Jin; Heo, Tag; Min, Yong Il; You, Yeonho

2010-04-01

The available data suggest that automated external defibrillators (AED) can be safely used in vibration-like moving conditions such as rigid inflatable boats and aircraft environments. However, little literature exists examining their performance in a moving ambulance. The present study was undertaken to determine whether an AED is able to analyse the heart rhythm correctly during ambulance transport. An ambulance was driven on paved (20-100 km/h) and unpaved (10 km/h) roads. The performance of two AED devices (CU ER 2, CU Medical Systems Inc., Korea, and Heartstart MRx, Phillips, USA) was determined in a moving ambulance using manikins. Vibration intensity was measured simultaneously with a digital vibrometer. AED performance was then evaluated again on manikins and on a swine model under simulated vibration intensities (0.5-5m/s(2)) measured by the vibrometer in the previous phase of the investigation. The vibration intensity increased with increasing speeds on paved roads (1.98+/-0.44 m/s(2) at 100 km/h). While driving on unpaved roads, it increased to 6.40+/-1.06 m/s(2). Both AED algorithms analysed the heart rhythm correctly under resting state. When tested on pigs, both algorithms showed substantially degraded performances, even at low vibration intensities of 0.5-1m/s(2), which corresponded to vibration intensities while driving on paved roads at 20-60 km/h. This study also showed that electrocardiograms generated on manikins were more resistant to motion artifacts than were the pig electrocardiograms. Ambulance personnel should consider the possibility of misinterpretation by an AED when this device is used while transporting a patient. Copyright (c) 2010 Elsevier Ireland Ltd. All rights reserved.

The Fire Brigade acquires a new ambulance with all the bells and whistles!

CERN Multimedia

Anaïs Schaeffer

2012-01-01

On 19 April the Fire Brigade unveiled its latest acquisition: a brand-new ambulance specially designed for CERN.   One of the Fire Brigade's two ambulances has just been replaced by a state-of-the-art vehicle tailor-made to meet CERN's unique requirements. At 4.6 metres long it's much more spacious than its predecessors, providing plenty of room for patient, doctor and paramedic. The ambulance's design and manufacture are the result of a successful collaboration between the Fire Brigade and the technicians from Profile Vehicles, the Finnish company that won the contract following a call for tenders launched in June 2011. "It took us six months to finalise the specification for our new ambulance," explains Patrick Berlinghi, who is responsible for the Fire Brigade's logistics. "We wanted it to be spacious enough for us to be able to work comfortably and to have the latest safety and patient care equipment.  We also reques...

Improving community ambulation after hip fracture: protocol for a randomised, controlled trial

Directory of Open Access Journals (Sweden)

D Orwig

2017-01-01

Discussion: This multicentre randomised study will be the first to test whether a home-based multi-component physiotherapy intervention targeting specific precursors of community ambulation (PUSH is more likely to lead to community ambulation than a home-based non-specific multi-component physiotherapy intervention (PULSE in older adults after hip fracture. The study will also estimate the potential economic value of the interventions.

Economic regulation of ambulance services in California.

Science.gov (United States)

Narad, R A

1997-01-01

This study was intended to identify economic regulatory programs used by California counties (including ambulance franchising and rate setting), to inventory their foci and application, and to identify differences around the state. By studying the variety of programs used in one state, this study establishes a framework for evaluation of state and local regulatory programs elsewhere. This study surveyed all California local EMS agencies (LEMSAs); these are California's equivalent of regional EMS organizations. The survey achieved a 100% response rate, and all data involve population parameters obviating the need for inferential statistics. Seventy-three percent of California counties use economic regulations. Large-population counties and those that operate their own LEMSAs are more likely to use economic regulations than are small counties and those that participate in multicounty EMS agencies. Despite a preference for competition in the authorizing statute, most franchises were granted without competition to existing providers. The majority of franchises in the state were granted to public services. Most ambulance rate setting occurs outside of a competitive process. Economic regulations that were intended to provide a structured marketplace are often being used to protect existing providers, particularly public services, from competition. The growing interest by fire departments in entering the market for emergency ambulance service, along with the existing bias toward them in granting of franchises, does not bode well for use of the competitive process. The growth of managed care may change or eliminate the need for economic regulations but, if they are to continue, more state oversight should be considered.

Suicidal ideation and suicide attempts in a nationwide sample of operational Norwegian ambulance personnel.

Science.gov (United States)

Sterud, Tom; Hem, Erlend; Lau, Bjørn; Ekeberg, Oivind

2008-01-01

This is the first paper on suicidal ideation and attempts among ambulance personnel. This study aimed to investigate levels of suicidal ideation and suicide attempts among ambulance personnel, and to identify important correlates and the factors to which ambulance personnel attribute their serious suicidal ideation. A comprehensive nationwide questionnaire survey of 1,180 operational ambulance personnel was conducted. Measurements included: Paykel's Suicidal Feelings in the General Population questionnaire, the Hospital Anxiety and Depression scale, the Subjective Health Complaints Questionnaire, the Maslach Burnout Inventory, the Job Satisfaction Scale, the Basic Character Inventory, and the Rosenberg Self-Esteem Scale. Lifetime prevalence ranged from 28% for feelings that life was not worth living to 10.4% for seriously considered suicide and 3.1% for a suicide attempt. Serious suicidal ideation was independently associated with job-related emotional exhaustion (feelings of being overextended and depleted of resources) (OR 1.5, 95% CI 1.1-2.0) and bullying at work (OR 1.7, 95% CI 1.02-2.7), younger age, not married/cohabitant, depression symptoms, low self-esteem and the personality trait reality weakness. In general, suicidal thoughts were hardly attributable to working conditions, since only 1.8% of ambulance personnel attributed suicidal ideation to work problems alone. In conclusion, ambulance personnel reported a moderate level of suicidal ideation and suicide attempts. Although serious suicidal ideation was rarely attributed to working conditions in general, this study suggests that job-related factors like emotional exhaustion and bullying may be of importance.

Open field modifications needed to measure, in the mouse, exploration- driven ambulation and fear of open space.

OpenAIRE

Vidal Gómez, José

2014-01-01

The open field test is used to assess ambulation and anxiety; one way to assess anxiety is to compare ambulation in the center with ambulation in the periphery: the more anxious is the mouse, the less it moves in the center. The results of this report cast doubts on the generality of that rule, because they show that ambulation, both in the center and in the periphery, depends on the mouse strain and on the size of the open field; specifically, in a brightly lit open-field of moderate size (3...

Factors associated with utilization of motorcycle ambulances by pregnant women in rural eastern Uganda: a cross-sectional study.

Science.gov (United States)

Ssebunya, Rogers; Matovu, Joseph K B

2016-03-03

Evidence suggests that use of motorcycle ambulances can help to improve health facility deliveries; however, few studies have explored the motivators for and barriers to their usage. We explored the factors associated with utilization of motorcycle ambulances by pregnant women in eastern Uganda. This was a cross-sectional, mixed-methods study conducted among 391 women who delivered at four health facilities supplied with motorcycle ambulances in Mbale district, eastern Uganda, between April and May 2014. Quantitative data were collected on socio-demographic and economic characteristics, pregnancy and delivery history, and community and health facility factors associated with utilization of motorcycle ambulances using semi-structured questionnaires. Qualitative data were collected on the knowledge and attitudes towards using motorcycle ambulances by pregnant women through six focus group discussions. Using STATA v.12, we computed the characteristics of women using motorcycle ambulances and used a logistic regression model to assess the correlates of utilization of motorcycle ambulances. Qualitative data were analyzed manually using a master sheet analysis tool. Of the 391 women, 189 (48.3%) reported that they had ever utilized motorcycle ambulances. Of these, 94.7% were currently married or living together with a partner while 50.8% earned less than 50,000 Uganda shillings (US $20) per month. Factors independently associated with use of motorcycle ambulances were: older age of the mother (≥35 years vs ≤24 years; adjusted Odds Ratio (aOR) = 4.3, 95% CI: 2.03, 9.13), sharing a birth plan with the husband (aOR = 2.5, 95% CI: 1.19, 5.26), husband participating in the decision to use the ambulance (aOR =3.22, 95% CI: 1.92, 5.38), and having discussed the use of the ambulance with a traditional birth attendant (TBA) before using it (aOR =3.12, 95% CI: 1.88, 5.19). Qualitative findings indicated that community members were aware of what motorcycle ambulances

A comparison of general and ambulance specific stressors: predictors of job satisfaction and health problems in a nationwide one-year follow-up study of Norwegian ambulance personnel

Directory of Open Access Journals (Sweden)

Lau Bjørn

2011-03-01

Full Text Available Abstract Objectives To address the relative importance of general job-related stressors, ambulance specific stressors and individual characteristics in relation to job satisfaction and health complaints (emotional exhaustion, psychological distress and musculoskeletal pain among ambulance personnel. Materials and methods A nationwide prospective questionnaire survey of ambulance personnel in operational duty at two time points (n = 1180 at baseline, T1 and n = 298 at one-year follow up, T2. The questionnaires included the Maslach Burnout Inventory, The Job Satisfaction Scale, Hopkins Symptom Checklist (SCL-10, Job Stress Survey, the Norwegian Ambulance Stress Survey and the Basic Character Inventory. Results Overall, 42 out of the possible 56 correlations between job stressors at T1 and job satisfaction and health complaints at T2 were statistically significant. Lower job satisfaction at T2 was predicted by frequency of lack of leader support and severity of challenging job tasks. Emotional exhaustion at T2 was predicted by neuroticism, frequency of lack of support from leader, time pressure, and physical demands. Adjusted for T1 levels, emotional exhaustion was predicted by neuroticism (beta = 0.15, p Psychological distress at T2 was predicted by neuroticism and lack of co-worker support. Adjusted for T1 levels, psychological distress was predicted by neuroticism (beta = 0.12, p Musculoskeletal pain at T2 was predicted by, higher age, neuroticism, lack of co-worker support and severity of physical demands. Adjusted for T1 levels, musculoskeletal pain was predicted neuroticism, and severity of physical demands (beta = 0.12, p Conclusions Low job satisfaction at T2 was predicted by general work-related stressors, whereas health complaints at T2 were predicted by both general work-related stressors and ambulance specific stressors. The personality variable neuroticism predicted increased complaints across all health outcomes.

Results of a prospective randomized controlled trial of early ambulation for patients with lower extremity autografts.

Science.gov (United States)

Lorello, David John; Peck, Michael; Albrecht, Marlene; Richey, Karen J; Pressman, Melissa A

2014-01-01

It is common practice to keep those patients with lower extremity autografts immobile until post-operative day (POD) 5. There is however inherent risks associated with even short periods of immobility. As of now there are no randomized controlled trials looking at early ambulation of patients with lower extremity autografts in the burn community.The objective of this study was to show that patients who begin ambulation within 24 hours of lower extremity autografting will have no increased risk of graft failure than those patients who remain immobile until POD 5. Thirty-one subjects who received autografts to the lower extremity were randomized after surgery into either the early ambulation group (EAG;17 subjects) or the standard treatment group (STG;14 subjects). Those subjects randomized to the EAG began ambulating with physical therapy on POD 1. Subjects in the STG maintained bed rest until POD 5. There was no difference in the number of patients with graft loss in either the EAG or STG on POD 5, and during any of the follow-up visits. No subjects required regrafting. There was a significant difference in the mean minutes of ambulation, with the EAG ambulating longer than the STG (EAG 23.4 minutes [SD 12.03], STG 14.1 [SD 9.00], P=.0235) on POD 5. Burn patients with lower extremity autografts can safely ambulate on POD 1 without fear of graft failure compared with those patients that remain on bed rest for 5 days.

Using genetic algorithms to optimise current and future health planning - the example of ambulance locations

Directory of Open Access Journals (Sweden)

Suzuki Hiroshi

2010-01-01

Full Text Available Abstract Background Ambulance response time is a crucial factor in patient survival. The number of emergency cases (EMS cases requiring an ambulance is increasing due to changes in population demographics. This is decreasing ambulance response times to the emergency scene. This paper predicts EMS cases for 5-year intervals from 2020, to 2050 by correlating current EMS cases with demographic factors at the level of the census area and predicted population changes. It then applies a modified grouping genetic algorithm to compare current and future optimal locations and numbers of ambulances. Sets of potential locations were evaluated in terms of the (current and predicted EMS case distances to those locations. Results Future EMS demands were predicted to increase by 2030 using the model (R2 = 0.71. The optimal locations of ambulances based on future EMS cases were compared with current locations and with optimal locations modelled on current EMS case data. Optimising the location of ambulance stations locations reduced the average response times by 57 seconds. Current and predicted future EMS demand at modelled locations were calculated and compared. Conclusions The reallocation of ambulances to optimal locations improved response times and could contribute to higher survival rates from life-threatening medical events. Modelling EMS case 'demand' over census areas allows the data to be correlated to population characteristics and optimal 'supply' locations to be identified. Comparing current and future optimal scenarios allows more nuanced planning decisions to be made. This is a generic methodology that could be used to provide evidence in support of public health planning and decision making.

Factors affecting ambulance utilization for asthma attack treatment: understanding where to target interventions.

Science.gov (United States)

Raun, L H; Ensor, K B; Campos, L A; Persse, D

2015-05-01

Asthma is a serious, sometimes fatal condition, in which attacks vary in severity, potentially requiring emergency medical services (EMS) ambulance treatment. A portion of asthma attacks requiring EMS ambulance treatment may be prevented with improved education and access to care. The aim of this study was to identify areas of the city with high rates of utilization of EMS ambulance for treatment, and the demographics, socio-economic status, and time of day associated with these rates, to better target future interventions to prevent emergencies and reduce cost. A cross-sectional study was conducted on individuals in Houston, TX (USA) requiring ambulance treatment for asthma attacks from 2004 to 2011. 12,155 EMS ambulance-treated asthma attack cases were linked to census tracts. High rate treatment areas were identified with geospatial mapping. Census tract demographic characteristics of these high rate areas were compared with the remainder of the city using logistic regression. The association between case level demographics and the time of day of asthma attack within the high rate area was also assessed with logistic regression. EMS ambulance-treated high rate areas were identified and found to have a utilization incidence rate over six times higher per 100,000 people than the remainder of the city. There is an increased risk of location in this high rate area with a census tract level increase of percent of population: earning less than $10,000 yearly income (RR 1.21, 1.16-1.26), which is black (RR 1.08, 1.07-1.10), which is female (RR 1.34, 1.20-1.49) and have obtained less than a high school degree (RR 1.02, 1.01-1.03). Within the high rate area, case level data indicates an increased risk of requiring an ambulance after normal doctor office hours for men compared with women (RR 1.13, 1.03-1.22), for black compared with Hispanic ethnicity (RR 1.31, 1.08-1.59), or for adults (less than 41 and greater than 60) compared with children. Interventions to prevent

Masculinity and Lifting Accidents among Danish Ambulance Personnel

DEFF Research Database (Denmark)

Hansen, Claus D.; Nielsen, Kent J

Background Work injuries related to lifting are the most prevalent among ambulance personnel (AP) despite the introduction of ‘assistive technologies’ (AT) that help reduce situations of manual lifting. One third of the AP report using AT only ‘sometimes’ and 10% report having lifted a patient...... alone. Aim This presentation investigates whether failure to use AT is linked to male ambulance workers’ gender identity? Is lifting patients alone a way of performing masculinity for AP’s? Method Data is taken from MARS, a panel study of AP workers in Denmark (n = 1606). Information from questionnaires...... measuring traditional male role norms (MRNI), safety attitudes and safety behavior will be linked to company register information on work injuries categorized as lifting accidents. Logistic regression is used to analyse associations between masculinity, lifting behavior, and lifting accidents. Results...

EFFECTIVENESS OF SCHEDULED AMBULATION ON EARLY POSTOPERATIVE OUTCOME AMONG PATIENTS WHO HAVE UNDERGONE ABDOMINAL HYSTERECTOMY

Directory of Open Access Journals (Sweden)

Rinku Girija

2017-01-01

Full Text Available BACKGROUND Abdominal hysterectomy is one of the most frequently performed surgical procedures in women. The non-ambulatory postoperative period is a high risk period for the development of various complications like wound infection, venous stasis, lower respiratory infection, secondary haemorrhage, deep vein thrombosis, pulmonary embolism, paralytic ileus etc. Prolonged surgery, delayed ambulation and not feeding the patient within 48 hours of surgery are often associated with post-operative morbidity and mortality. This study aims to assess the effectiveness of Scheduled Ambulation on early post-operative outcome among patients undergone abdominal hysterectomy by introduction of Scheduled Ambulation from second day of surgery. MATERIALS AND METHODS Method used is quantitative and quasi experimental post-test control method. Scheduled ambulation technique and pattern were taught pre operatively to 35 patients consecutively selected from general and post-operative ward who formed the experimental group. They were given scheduled ambulation from second to fifth post-operative days and results analysed. Another 35 patients taken as control were given the routine post-operative care. Data Analysis- was performed using SPSS version 17.0. Between group comparisons, quantitative variables analysed by Chisquare test p value >0, 05 considered significant. RESULTS The indication of hysterectomy was fibroid uterus in 80% of the control group and 88, 6% of the experimental group. 51.4% of the hysterectomies were encountered in the age group 40-49 years. There was a statistically significant reduction in the severity of pain, fatigue, postural hypotension and risk for developing Deep vein thrombosis in the experimental group on practicing Scheduled Ambulation from second to fifth post-operative days. CONCLUSION Scheduled ambulation helped the abdominal hysterectomy patients to recover from fatigue, pain, postural hypotension and risk for Deep vein thrombosis

Higher energy prices are associated with diminished resources, performance and safety in Australian ambulance systems.

Science.gov (United States)

Brown, Lawrence H; Chaiechi, Taha; Buettner, Petra G; Canyon, Deon V; Crawford, J Mac; Judd, Jenni

2013-02-01

To evaluate the impact of changing energy prices on Australian ambulance systems. Generalised estimating equations were used to analyse contemporaneous and lagged relationships between changes in energy prices and ambulance system performance measures in all Australian State/Territory ambulance systems for the years 2000-2010. Measures included: expenditures per response; labour-to-total expenditure ratio; full-time equivalent employees (FTE) per 10,000 responses; average salary; median and 90th percentile response time; and injury compensation claims. Energy price data included State average diesel price, State average electricity price, and world crude oil price. Changes in diesel prices were inversely associated with changes in salaries, and positively associated with changes in ambulance response times; changes in oil prices were also inversely associated with changes in salaries, as well with staffing levels and expenditures per ambulance response. Changes in electricity prices were positively associated with changes in expenditures per response and changes in salaries; they were also positively associated with changes in injury compensation claims per 100 FTE. Changes in energy prices are associated with changes in Australian ambulance systems' resource, performance and safety characteristics in ways that could affect both patients and personnel. Further research is needed to explore the mechanisms of, and strategies for mitigating, these impacts. The impacts of energy prices on other aspects of the health system should also be investigated. © 2013 The Authors. ANZJPH © 2013 Public Health Association of Australia.

Assessment of prehospital medical care for the patients transported to emergency department by ambulance

Directory of Open Access Journals (Sweden)

Sehnaz Akın Paker

2015-09-01

Full Text Available Objectives: In our study we aimed to investigate the quality and quantity of medical management inside ambulances for 14 and over 14 years old patients transported to a level three emergency department (ED. Material and methods: Our study was conducted prospectively at a level three ED. 14 and over 14 years old patients who were transported to the ED by ambulance were included in the study consecutively. “Lack of vital rate” was described as missing of one or more of five vital rates during ambulance transportation. Both of two attending emergency physicians evaluated the medical procedures and management of patients at the ambulance simultaneously and this was recorded on the study forms. Results: Four hundred and fifty six patients were included in the study. Missing vital signs were identified for 90.1% (n = 322 of the patients that were transported by physicians and 92.4% (n = 73 of the patients that were transported by paramedics. For five patients with cardiac arrest two (33.3% had cardiopulmonary resuscitation (CPR, one (20% was intubated, one (20% received adrenaline. Out of 120 patients, needed spinal immobilization, 69 (57.5% had spinal board. Cervical collar usage was 65.1% (n = 69 We have revealed that 316 (69.3% patients did not receive at least one of the necessary medical intervention or treatment. Conclusion: During ambulance transportation, life-saving procedures like cardiopulmonary resuscitation, vital sign measurement, crucial treatment administration, endotracheal intubation, defibrillation, fracture immobilization were not performed adequately. Increasing the training on the deficient interventions and performing administrative inspections may improve quality of patient care. Keywords: Emergency department, Ambulance, Prehospital emergency care

Cost-efficient evaluation of ambulance services for community ...

African Journals Online (AJOL)

A total of 12,674 victims were transported to different tares of hospital and referrals ... The mean cost-efficiency (technical) of Machakos ambulance transport services was 90.6% (C.I 82.7% - 98.2%). ... EMAIL FULL TEXT EMAIL FULL TEXT

METABOLIC SYNDROME AND DAILY AMBULATION IN CHILDREN, ADOLESCENTS, AND YOUNG ADULTS

Science.gov (United States)

Gardner, Andrew W.; Parker, Donald E.; Krishnan, Sowmya; Chalmers, Laura J.

2012-01-01

Purposes To compare daily ambulatory measures in children, adolescents, and young adults with and without metabolic syndrome, and to assess which metabolic syndrome components, demographic measures, and body composition measures are associated with daily ambulatory measures. Methods Two-hundred fifty subjects between the ages of 10 and 30 years were assessed on metabolic syndrome components, demographic and clinical measures, body fat percentage, and daily ambulatory strides, durations, and cadences during seven consecutive days. Forty-five of the 250 subjects had metabolic syndrome, as defined by the International Diabetes Federation. Results Subjects with metabolic syndrome ambulated at a slower daily average cadence than those without metabolic syndrome (13.6 ± 2.2 strides/min vs. 14.9 ± 3.2 strides/min; p=0.012), and they had slower cadences for continuous durations of 60 minutes (p=0.006), 30 minutes (p=0.005), 20 minutes (p=0.003), 5 minutes (p=0.002), and 1 minute (p=0.001). However, the total amount of time spent ambulating each day was not different (p=0.077). After adjustment for metabolic syndrome status, average cadence is linearly associated with body fat percentage (pmetabolic syndrome ambulate more slowly and take fewer strides throughout the day than those without metabolic syndrome, even though the total amount of time spent ambulating is not different. Furthermore, the detrimental influence of metabolic syndrome on ambulatory cadence is primarily a function of body fatness. PMID:22811038

A decision making method based on interval type-2 fuzzy sets: An approach for ambulance location preference

Directory of Open Access Journals (Sweden)

Lazim Abdullah

2018-01-01

Full Text Available Selecting the best solution to deploy an ambulance in a strategic location is of the important variables that need to be accounted for improving the emergency medical services. The selection requires both quantitative and qualitative evaluation. Fuzzy set based approach is one of the well-known theories that help decision makers to handle fuzziness, uncertainty in decision making and vagueness of information. This paper proposes a new decision making method of Interval Type-2 Fuzzy Simple Additive Weighting (IT2 FSAW as to deal with uncertainty and vagueness. The new IT2 FSAW is applied to establish a preference in ambulance location. The decision making framework defines four criteria and five alternatives of ambulance location preference. Four experts attached to a Malaysian government hospital and a university medical center were interviewed to provide linguistic evaluation prior to analyzing with the new IT2 FSAW. Implementation of the proposed method in the case of ambulance location preference suggests that the ‘road network’ is the best alternative for ambulance location. The results indicate that the proposed method offers a consensus solution for handling the vague and qualitative criteria of ambulance location preference.

The Barbados Emergency Ambulance Service: High Frequency of Nontransported Calls

Directory of Open Access Journals (Sweden)

Sherwin E. Phillips

2012-01-01

Full Text Available Objectives. There are no published studies on the Barbados Emergency Ambulance Service and no assessment of the calls that end in nontransported individuals. We describe reasons for the nontransport of potential clients. Methods. We used the Emergency Medical Dispatch (Medical Priority Dispatch System instrument, augmented with five local call types, to collect information on types of calls. The calls were categorised under 7 headings. Correlations between call types and response time were calculated. Results. Most calls were from the category medical (54%. Nineteen (19% percent of calls were in the non-transported category. Calls from call type Cancelled accounted for most of these and this was related to response time, while Refused service was inversely related (. Conclusions. The Barbados Ambulance Service is mostly used by people with a known illness and for trauma cases. One-fifth of calls fall into a category where the ambulance is not used often due to cancellation which is related to response time. Other factors such as the use of alternative transport are also important. Further study to identify factors that contribute to the non-transported category of calls is necessary if improvements in service quality are to be made.

The pattern of ambulance arrivals in the emergency department of an acute care hospital in Singapore

OpenAIRE

Seow, E; Wong, H; Phe, A

2001-01-01

Methods—All (13 697) ambulance arrivals in 1996 to the ED of Tan Tock Seng Hospital were studied and where relevant compared with the walk in and total arrivals of the same year. The following data were obtained from computer records: (a) patients' demographic data; (b) number of ambulance arrivals by hour; (c) the classification of the ambulance arrivals by emergency or non-emergency, trauma or non-trauma; (d) cause of injury for trauma cases; (e) discharge status.

A correction factor for estimating statewide agricultural injuries from ambulance reports.

Science.gov (United States)

Scott, Erika E; Earle-Richardson, Giulia; Krupa, Nicole; Jenkins, Paul

2011-10-01

Agriculture ranks as one of the most hazardous industries in the nation. Agricultural injury surveillance is critical to identifying and reducing major injury hazards. Currently, there is no comprehensive system of identifying and characterizing fatal and serious non-fatal agricultural injuries. Researchers sought to calculate a multiplier for estimating the number of agricultural injury cases based on the number of times the farm box indicator was checked on the ambulance report. Farm injuries from 2007 that used ambulance transport were ascertained for 10 New York counties using two methods: (1) ambulance reports including hand-entered free text; and (2) community surveillance. The resulting multiplier that was developed from contrasting these two methods was then applied to the statewide Emergency Medical Services database to estimate the total number of agricultural injuries for New York state. There were 25,735 unique ambulance runs due to injuries in the 10 counties in 2007. Among these, the farm box was checked a total of 90 times. Of these 90, 63 (70%) were determined to be agricultural. Among injury runs where the farm box was not checked, an additional 59 cases were identified from the free text. Among these 122 cases (63 + 59), four were duplicates. Twenty-four additional unique cases were identified from the community surveillance for a total of 142. This yielded a multiplier of 142/90 = 1.578 for estimating all agricultural injuries from the farm box indicator. Sensitivity and specificity of the ambulance report method were 53.4% and 99.9%, respectively. This method provides a cost-effective way to estimate the total number of agricultural injuries for the state. However, it would not eliminate the more labor intensive methods that are required to identify of the actual individual case records. Incorporating an independent source of case ascertainment (community surveillance) increased the multiplier by 17%. Copyright © 2011 Elsevier Inc. All rights

The risk ogf high-risk jobs : psychological health consequences in forensic physicians and ambulance workers

NARCIS (Netherlands)

Ploeg, E. van der

2003-01-01

The risk of high-risk jobs: Psychological health consequences in forensic doctors and ambulance workers This thesis has shown that forensic physicians and ambulance personnel frequently suffer from psychological complaints as a result of dramatic events and sources of chronic work stress. A

Stress and organization change in the ambulance service

NARCIS (Netherlands)

Wastell, D.; Newman, M.

1996-01-01

The development of information systems (IS) is a problematic process that all too often ends in failure. This paper reports a comparative analysis of two projects involving the computerisation of ambulance control-room operations in London and Manchester. The outcomes were strikingly different. In

Point prevalence of suboptimal footwear features among ambulant older hospital patients: implications for fall prevention.

Science.gov (United States)

Chari, Satyan R; McRae, Prue; Stewart, Matthew J; Webster, Joan; Fenn, Mary; Haines, Terry P

2016-09-01

Objective The aim of the present study was to establish the point prevalence of 'suboptimal' features in footwear reported to have been used by older hospital patients when ambulating, and to explore underpinning factors for their choice of footwear. Method A cross-sectional investigation was undertaken on 95 of 149 eligible in-patients across 22 high fall-risk wards in a large metropolitan hospital in Brisbane, Australia. Results Over 70% of participants experienced an unplanned admission. Although most participants had access to some form of footwear in hospital (92%), nearly all reported ambulating in footwear with 'suboptimal' features (99%). Examples included slippers (27%), backless slippers (16%) or bare feet (27%). For patients who ambulated in bare feet, only one-third reported 'lack of access to footwear' as the primary cause, with others citing foot wounds, pain, oedema and personal choice as the main reason for bare foot ambulation. Conclusions Admitted patients frequently use footwear with 'suboptimal' features for ambulation in hospital. While some footwear options (for example well-fitting slippers) could be suited for limited in-hospital ambulation, others are clearly hazardous and might cause falls. Since footwear choices are influenced by multiple factors in this population, footwear education strategies alone may be insufficient to address the problem of hazardous footwear in at-risk patients. Footwear requirements may be more effectively addressed within a multidisciplinary team approach encompassing foot health, mobility and safety. What is known about the topic? Accidental falls while ambulating are an important health and safety concern for older people. Because certain footwear characteristics have been negatively linked to posture and balance, and specific footwear types linked to falls among seniors, the use of footwear with fewer suboptimal characteristics is generally recommended as a means of reducing the risk of falling. While footwear

Design and methods of European Ambulance Acute Coronary Syndrome Angiography Trial (EUROMAX)

DEFF Research Database (Denmark)

Steg, Philippe Gabriel; van 't Hof, Arnoud; Clemmensen, Peter

2013-01-01

In patients with ST-segment elevation myocardial infarction (STEMI) triaged to primary percutaneous coronary intervention (PCI), anticoagulation often is initiated in the ambulance during transfer to a PCI site. In this prehospital setting, bivalirudin has not been compared with standard-of-care ......In patients with ST-segment elevation myocardial infarction (STEMI) triaged to primary percutaneous coronary intervention (PCI), anticoagulation often is initiated in the ambulance during transfer to a PCI site. In this prehospital setting, bivalirudin has not been compared with standard...

Walker devices and microswitch technology to enhance assisted indoor ambulation by persons with multiple disabilities: three single-case studies.

Science.gov (United States)

Lancioni, Giulio E; Singh, Nirbhay N; O'Reilly, Mark F; Sigafoos, Jeff; Oliva, Doretta; Campodonico, Francesca; Buono, Serafino

2013-07-01

These three single-case studies assessed the use of walker devices and microswitch technology for promoting ambulation behavior among persons with multiple disabilities. The walker devices were equipped with support and weight lifting features. The microswitch technology ensured that brief stimulation followed the participants' ambulation responses. The participants were two children (i.e., Study I and Study II) and one man (i.e., Study III) with poor ambulation performance. The ambulation efforts of the child in Study I involved regular steps, while those of the child in Study II involved pushing responses (i.e., he pushed himself forward with both feet while sitting on the walker's saddle). The man involved in Study III combined his poor ambulation performance with problem behavior, such as shouting or slapping his face. The results were positive for all three participants. The first two participants had a large increase in the number of steps/pushes performed during the ambulation events provided and in the percentages of those events that they completed independently. The third participant improved his ambulation performance as well as his general behavior (i.e., had a decline in problem behavior and an increase in indices of happiness). The wide-ranging implications of the results are discussed. Copyright © 2013 Elsevier Ltd. All rights reserved.

Effectiveness of media awareness campaigns on the proportion of vehicles that give space to ambulances on roads: An observational study.

Science.gov (United States)

Shaikh, Shiraz; Baig, Lubna A; Polkowski, Maciej

2017-01-01

The findings of the Health Care in Danger project in Karachi suggests that there is presence of behavioral negligence among vehicle operators on roads in regards to giving way to ambulances. A mass media campaign was conducted to raise people's awareness on the importance of giving way to ambulances. The main objective of this study was to determine the effectiveness of the campaign on increasing the proportion of vehicles that give way to ambulances. This was a quasi-experimental study that was based on before and after design. Three observation surveys were carried out in different areas of the city in Karachi, Pakistan before, during and after the campaign by trained observers who recorded their findings on a checklist. Each observation was carried out at three different times of the day for at least two days on each road. The relationship of the media campaign with regards to a vehicle giving space to an ambulance was calculated by means of odds ratios and 95% confidence intervals using multivariate logistic regression. Overall, 245 observations were included in the analysis. Traffic congestion and negligence/resistance, by vehicles operators who were in front of the ambulance, were the two main reasons why ambulances were not given way. Other reasons include: sudden stops by minibuses and in the process causing obstruction, ambulances not rushing through to alert vehicle operators to give way and traffic interruption by VIP movement. After adjustment for site, time of day, type of ambulance and number of cars in front of the ambulance, vehicles during (OR=2.13, 95% CI=1.22-3.71, p=0.007) and after the campaign (OR=1.73, 95% CI=1.02-2.95, p=0.042) were significantly more likely give space to ambulances. Mass media campaigns can play a significant role in changing the negligent behavior of people, especially when the campaign conveys a humanitarian message such as: giving way to ambulances can save lives.

A new vibration isolation bed stage with magnetorheological dampers for ambulance vehicles

International Nuclear Information System (INIS)

Chae, Hee Dong; Choi, Seung-Bok

2015-01-01

The vibration experienced in an ambulance can lead to secondary injury to a patient and discourage a paramedic from providing emergency care. In this study, with the goal of resolving this problem, a new vibration isolation bed stage associated with magnetorheological (MR) dampers is proposed to ensure ride quality as well as better care for the patient while he/she is being transported. The bed stage proposed in this work can isolate vibrations in the vertical, rolling and pitching directions to reflect the reality that occurs in the ambulance. Firstly, an appropriate-sized MR damper is designed based on the field-dependent rheological properties of MR fluid, and the damping force characteristics of a MR damper are evaluated as a function of the current. A mechanical model of the proposed vibration isolation bed stage is then established to derive the governing equations of motion. Subsequently, a sliding mode controller is formulated to control the vibrations caused from the imposed excitation signals; those signals are directly measured using a real ambulance subjected to bump-and-curve road conditions. Using the controller based on the dynamic motion of the bed stage, the vibration control performance is evaluated in both the vertical and pitch directions. It is demonstrated that the magnitude of the vibration in the patient compartment of the ambulance can be significantly reduced by applying an input current to the MR dampers installed for the new bed stage. (technical note)

Improving the coding and classification of ambulance data through the application of International Classification of Disease 10th revision.

Science.gov (United States)

Cantwell, Kate; Morgans, Amee; Smith, Karen; Livingston, Michael; Dietze, Paul

2014-02-01

This paper aims to examine whether an adaptation of the International Classification of Disease (ICD) coding system can be applied retrospectively to final paramedic assessment data in an ambulance dataset with a view to developing more fine-grained, clinically relevant case definitions than are available through point-of-call data. Over 1.2 million case records were extracted from the Ambulance Victoria data warehouse. Data fields included dispatch code, cause (CN) and final primary assessment (FPA). Each FPA was converted to an ICD-10-AM code using word matching or best fit. ICD-10-AM codes were then converted into Major Diagnostic Categories (MDC). CN was aligned with the ICD-10-AM codes for external cause of morbidity and mortality. The most accurate results were obtained when ICD-10-AM codes were assigned using information from both FPA and CN. Comparison of cases coded as unconscious at point-of-call with the associated paramedic assessment highlighted the extra clinical detail obtained when paramedic assessment data are used. Ambulance paramedic assessment data can be aligned with ICD-10-AM and MDC with relative ease, allowing retrospective coding of large datasets. Coding of ambulance data using ICD-10-AM allows for comparison of not only ambulance service users but also with other population groups. WHAT IS KNOWN ABOUT THE TOPIC? There is no reliable and standard coding and categorising system for paramedic assessment data contained in ambulance service databases. WHAT DOES THIS PAPER ADD? This study demonstrates that ambulance paramedic assessment data can be aligned with ICD-10-AM and MDC with relative ease, allowing retrospective coding of large datasets. Representation of ambulance case types using ICD-10-AM-coded information obtained after paramedic assessment is more fine grained and clinically relevant than point-of-call data, which uses caller information before ambulance attendance. WHAT ARE THE IMPLICATIONS FOR PRACTITIONERS? This paper describes

Self-paced brain-computer interface control of ambulation in a virtual reality environment

Science.gov (United States)

Wang, Po T.; King, Christine E.; Chui, Luis A.; Do, An H.; Nenadic, Zoran

2012-10-01

Objective. Spinal cord injury (SCI) often leaves affected individuals unable to ambulate. Electroencephalogram (EEG) based brain-computer interface (BCI) controlled lower extremity prostheses may restore intuitive and able-body-like ambulation after SCI. To test its feasibility, the authors developed and tested a novel EEG-based, data-driven BCI system for intuitive and self-paced control of the ambulation of an avatar within a virtual reality environment (VRE). Approach. Eight able-bodied subjects and one with SCI underwent the following 10-min training session: subjects alternated between idling and walking kinaesthetic motor imageries (KMI) while their EEG were recorded and analysed to generate subject-specific decoding models. Subjects then performed a goal-oriented online task, repeated over five sessions, in which they utilized the KMI to control the linear ambulation of an avatar and make ten sequential stops at designated points within the VRE. Main results. The average offline training performance across subjects was 77.2±11.0%, ranging from 64.3% (p = 0.001 76) to 94.5% (p = 6.26×10-23), with chance performance being 50%. The average online performance was 8.5±1.1 (out of 10) successful stops and 303±53 s completion time (perfect = 211 s). All subjects achieved performances significantly different than those of random walk (p prosthesis systems may be feasible.

Perioperative transfusion threshold and ambulation after hip revision surgery

DEFF Research Database (Denmark)

Nielsen, Kamilla; Johansson, Pär I; Dahl, Benny

2014-01-01

BACKGROUND: Transfusion with red blood cells (RBC) may be needed during hip revision surgery but the appropriate haemoglobin concentration (Hb) threshold for transfusion has not been well established. We hypothesized that a higher transfusion threshold would improve ambulation after hip revision...... surgery. METHODS: The trial was registered at Clinicaltrials.gov ( NCT00906295). Sixty-six patients aged 18 years or older undergoing hip revision surgery were randomized to receive RBC at a Hb threshold of either 7.3 g/dL (restrictive group) or 8.9 g/dL (liberal group). Postoperative ambulation...... received RBC. CONCLUSIONS: A Hb transfusion threshold of 8.9 g/dL was associated with a statistically significantly faster TUG after hip revision surgery compared to a threshold of 7.3 g/dL but the clinical importance is questionable and the groups did not differ in Hb at the time of testing....

Effect evaluation of a heated ambulance mattress-prototype on thermal comfort and patients' temperatures in prehospital emergency care - an intervention study.

Science.gov (United States)

Aléx, Jonas; Karlsson, Stig; Björnstig, Ulf; Saveman, Britt-Inger

2015-01-01

Background The ambulance milieu does not offer good thermal comfort to patients during the cold Swedish winters. Patients' exposure to cold temperatures combined with a cold ambulance mattress seems to be the major factor leading to an overall sensation of discomfort. There is little research on the effect of active heat delivered from underneath in ambulance care. Therefore, the aim of this study was to evaluate the effect of an electrically heated ambulance mattress-prototype on thermal comfort and patients' temperatures in the prehospital emergency care. Methods A quantitative intervention study on ambulance care was conducted in the north of Sweden. The ambulance used for the intervention group (n=30) was equipped with an electrically heated mattress on the regular ambulance stretcher whereas for the control group (n=30) no active heat was provided on the stretcher. Outcome variables were measured as thermal comfort on the Cold Discomfort Scale (CDS), subjective comments on cold experiences, and finger, ear and air temperatures. Results Thermal comfort, measured by CDS, improved during the ambulance transport to the emergency department in the intervention group (p=0.001) but decreased in the control group (p=0.014). A significant higher proportion (57%) of the control group rated the stretcher as cold to lie down compared to the intervention group (3%, pthermal comfort and may prevent the negative consequences of cold stress.

Effect evaluation of a heated ambulance mattress-prototype on thermal comfort and patients' temperatures in prehospital emergency care--an intervention study.

Science.gov (United States)

Aléx, Jonas; Karlsson, Stig; Björnstig, Ulf; Saveman, Britt-Inger

2015-01-01

The ambulance milieu does not offer good thermal comfort to patients during the cold Swedish winters. Patients' exposure to cold temperatures combined with a cold ambulance mattress seems to be the major factor leading to an overall sensation of discomfort. There is little research on the effect of active heat delivered from underneath in ambulance care. Therefore, the aim of this study was to evaluate the effect of an electrically heated ambulance mattress-prototype on thermal comfort and patients' temperatures in the prehospital emergency care. A quantitative intervention study on ambulance care was conducted in the north of Sweden. The ambulance used for the intervention group (n=30) was equipped with an electrically heated mattress on the regular ambulance stretcher whereas for the control group (n=30) no active heat was provided on the stretcher. Outcome variables were measured as thermal comfort on the Cold Discomfort Scale (CDS), subjective comments on cold experiences, and finger, ear and air temperatures. Thermal comfort, measured by CDS, improved during the ambulance transport to the emergency department in the intervention group (p=0.001) but decreased in the control group (p=0.014). A significant higher proportion (57%) of the control group rated the stretcher as cold to lie down compared to the intervention group (3%, pthermal comfort and may prevent the negative consequences of cold stress.

Early Ambulation Decreases Length of Hospital Stay, Perioperative Complications and Improves Functional Outcomes in Elderly Patients Undergoing Surgery for Correction of Adult Degenerative Scoliosis.

Science.gov (United States)

Adogwa, Owoicho; Elsamadicy, Aladine A; Fialkoff, Jared; Cheng, Joseph; Karikari, Isaac O; Bagley, Carlos

2017-09-15

Ambispective cohort review. To examine the effects of early mobilization on patient outcomes, complications profile, and 30-day readmission rates. Prolonged immobilization after surgery can result in functional decline and an increased risk of hospital-associated complications. We conducted an ambispective study of 125 elderly patients (>65 years) undergoing elective spinal surgery for correction of adult degenerative scoliosis. We identified all unplanned readmissions within 30 days of discharge. Unplanned readmissions were defined to have occurred as a result of either a surgical or a nonsurgical complication. "Days of immobility" was defined as the number of days until a patient moved out of bed beyond a chair. Patients in the top and bottom quartiles were dichotomized into "early ambulators" and "late ambulators", respectively. Early ambulators were ambulatory within 24 hours of surgery, whereas late ambulators were ambulatory at a minimum of 48 hours after surgery. Complication rates, duration of hospital stay, and 30-day readmission rates were compared between early ambulators and late ambulators. Baseline characteristics were similar between both cohorts. Compared with patients with a longer duration of immobility (i.e., late ambulators), the prevalence of at least one perioperative complication was significantly lower in the early ambulators cohort (30% vs. 54%, P = 0.06). The length of inhospital stay was 34% shorter in the early ambulators cohort (5.33 days vs. 8.11 days, P = 0.01). Functional independence was superior in the early ambulators cohort, with the majority of patients discharged directly home after surgery compared with late ambulators (71.2% vs. 22.0%, P = 0.01). Early ambulation after surgery significantly reduces the incidence of perioperative complications, shortens duration of inhospital stay, and contributes to improved perioperative functional status in elderly patients. Even a delay of 24 hours to ambulation is

Otimização da localização das bases de ambulâncias e do dimensionamento das suas regiões de cobertura em rodovias Optimizing the location of ambulance bases and the districting of their covering regions on highways

Directory of Open Access Journals (Sweden)

Ana Paula Iannoni

2008-01-01

Full Text Available Neste artigo combinamos extensões do modelo hipercubo de filas com algoritmos genéticos para otimizar a configuração e operação de sistemas médicos emergenciais em rodovias. Inicialmente apresentamos um método para localizar as bases de ambulâncias ao longo da rodovia, de forma a otimizar as principais medidas de desempenho do sistema. Em seguida estendemos a abordagem para apoiar duas decisões combinadas: a localização das bases de ambulâncias e o dimensionamento das regiões de cobertura de cada base na rodovia. Por exemplo, a abordagem permite determinar os locais para posicionar as bases de ambulâncias e dimensionar os tamanhos das suas áreas de atuação, tais que minimizem o tempo médio de resposta aos usuários e/ou o desbalanceamento das cargas de trabalho das ambulâncias do sistema. Para ilustrar a aplicação dos métodos propostos, analisamos os resultados de dois estudos de caso em rodovias brasileiras.In this paper we combine extensions of the hypercube queueing model with genetic algorithms to optimize the configuration and operation of emergency medical systems on highways. Initially we present a method to locate the ambulance bases along the highway so that the main system performance measures are optimized. Then we extend the approach to support combined decisions: the location of ambulance bases and the districting of the covering regions of each base on the highway. For instance, the approach can search for locals to place the ambulance bases and determine the sizes of their operation areas, such that the mean user response time and/or the ambulance workload imbalance are minimized. To illustrate the application of the proposed methods, we analyze the results of two case studies of Brazilian highways.

Basic life support and automated external defibrillator skills among ambulance personnel: a manikin study performed in a rural low-volume ambulance setting

Directory of Open Access Journals (Sweden)

Nielsen Anne

2012-05-01

Full Text Available Abstract Background Ambulance personnel play an essential role in the ‘Chain of Survival’. The prognosis after out-of-hospital cardiac arrest was dismal on a rural Danish island and in this study we assessed the cardiopulmonary resuscitation performance of ambulance personnel on that island. Methods The Basic Life Support (BLS and Automated External Defibrillator (AED skills of the ambulance personnel were tested in a simulated cardiac arrest. Points were given according to a scoring sheet. One sample t test was used to analyze the deviation from optimal care according to the 2005 guidelines. After each assessment, individual feedback was given. Results On 3 consecutive days, we assessed the individual EMS teams responding to OHCA on the island. Overall, 70% of the maximal points were achieved. The hands-off ratio was 40%. Correct compression/ventilation ratio (30:2 was used by 80%. A mean compression depth of 40–50 mm was achieved by 55% and the mean compression depth was 42 mm (SD 7 mm. The mean compression rate was 123 per min (SD 15/min. The mean tidal volume was 746 ml (SD 221 ml. Only the mean tidal volume deviated significantly from the recommended (p = 0.01. During the rhythm analysis, 65% did not perform any visual or verbal safety check. Conclusion The EMS providers achieved 70% of the maximal points. Tidal volumes were larger than recommended when mask ventilation was applied. Chest compression depth was optimally performed by 55% of the staff. Defibrillation safety checks were not performed in 65% of EMS providers.

Ambulance Dispatches From Unaffected Areas After the Great East Japan Earthquake: Impact on Emergency Care in the Unaffected Areas.

Science.gov (United States)

Hagihara, Akihito; Onozuka, Daisuke; Nagata, Takashi; Abe, Takeru; Hasegawa, Manabu; Nabeshima, Yoshihiro

2015-12-01

Although dispatching ambulance crews from unaffected areas to a disaster zone is inevitable when a major disaster occurs, the effect on emergency care in the unaffected areas has not been studied. We evaluated whether dispatching ambulance crews from unaffected prefectures to those damaged by the Great East Japan Earthquake was associated with reduced resuscitation outcomes in out-of-hospital cardiac arrest (OHCA) cases in the unaffected areas. We used the Box-Jenkins transfer function model to assess the relationship between ambulance crew dispatches and return of spontaneous circulation (ROSC) before hospital arrival or 1-month survival after the cardiac event. In a model whose output was the rate of ROSC before hospital arrival, dispatching 1000 ambulance crews was associated with a 0.474% decrease in the rate of ROSC after the dispatch in the prefectures (p=0.023). In a model whose output was the rate of 1-month survival, dispatching 1000 ambulance crews was associated with a 0.502% decrease in the rate of 1-month survival after the dispatch in the prefectures (p=0.011). The dispatch of ambulances from unaffected prefectures to earthquake-stricken areas was associated with a subsequent decrease in the ROSC and 1-month survival rates in OHCA cases in the unaffected prefectures.

Patterns of emergency ambulance use, 2009-13: a comparison of older people living in Residential Aged Care Facilities and the Community.

Science.gov (United States)

Dwyer, R; Gabbe, B; Tran, T D; Smith, K; Lowthian, J A

2018-04-24

to examine demand for emergency ambulances by older people. retrospective cohort study using secondary analysis of routinely collected clinical and administrative data from Ambulance Victoria, and population data from the Australian Bureau of Statistics and the Australian Institute of Health and Welfare. Victoria, Australia. people aged 65 years and over, living in Residential Aged Care Facilities (RACF) and the community, attended by emergency ambulance paramedics, 2009-13. rates of emergency ambulance attendance. older people living in RACF experienced high rates of emergency ambulance attendance, up to four times those for age- and sex-matched people living in the community. Rates remained constant during the study period equating to a consistent, 1.45% average annual increase in absolute demand. Rates peak among the 80-84-year group where the number of attendances equates to greater than one for every RACF-dwelling person each year. Increased demand was associated with winter months, increasing age and being male. these data provide strong evidence of high rates of emergency ambulance use by people aged 65 years and over living in RACF. These results demonstrate a clear relationship between increased rate of ambulance use among this vulnerable group of older Australians and residence, sex, age and season. Overall, absolute demand continues to increase each year adding to strain on health resources. Additional research is needed to elucidate individual characteristics, illness and health system contributors to ambulance use to inform strategies to appropriately reduce demand.

R.I.P. squad bench. European ambulances designed around the patient, not the vehicle.

Science.gov (United States)

Heightman, A J

2013-07-01

You can see and hear more about my journey throughout Germany and England in a special, archived, free Webcast on jems.com. And in future articles, videos and Web presentations, you'll see and learn about the different EMS delivery models I saw, the men and women whom I met and rode with on calls, and, most importantly, their impressive attitude about patient care, customer service and safety. Progressive American and Canadian ambulance manufacturers now agree with safety experts and forward-thinking ambulance operators that the squad bench is dead. These manufacturers now offer innovative seats that are much safer and functional than those coffin-like obstructions that gobbled up so much space in our rigs for the past three decades. Design your next ambulance around the needs and safety of your crews and their patients, and spec a patient compartment that is laid out logiclaly and efficient.

Evaluating public ambulance service levels by applying a GIS based ...

African Journals Online (AJOL)

Hunadi Mokgalaka

based analysis of ambulance response time was undertaken. The purpose was to .... He tested the travel time of the primary response vehicles and ..... Real CORP Proceedings / Tagungsband, ISBN: 978-3-9502139-7-3, pp, 22-25, viewed 18.

Effect of Positioning and Early Ambulation on Coronary Angiography Complications: a Randomized Clinical Trial.

Science.gov (United States)

Abdollahi, Ali Akbar; Mehranfard, Shahzad; Behnampour, Nasser; Kordnejad, Abdol Mohamad

2015-06-01

After coronary angiography to prevent potential complications, patients are restricted to 4-24 hours bed rest in the supine position due to the complications. This study was designed to assess the effect of changing position and early ambulation on low back pain, urinary retention, bleeding and hematoma after cardiac catheterization. In this clinical trial, 140 patients by using a convenience sampling randomly divided into four 35-individual groups. The patients in the control group were in the supine position for 6 hours without a movement. Change position was applied to the second group (based on a specific protocol), early ambulation was applied to the third group and both early ambulation and change position were applied to the fourth group. Then, severity of bleeding, hematoma, back pain and urinary retention were measured at zero, 1, 2, 4, 6, and 24 hours after angiography. The data was collected through an individual data questionnaire, Numerical Rating Scale (NRS) of pain and Kristin Swain's check list was applied to evaluate the severity of bleeding and hematoma. None of patients developed vascular complications. Incidence of urinary retention was higher in the control group, although this difference was not significant. The mean of pain intensity in the fourth and sixth hours showed a significant difference. Based on the findings of this study, changing patients' position can be safe and they can be ambulated early after angiography.

Radiology trainer. Surgical ambulance. Revision 2. rev. and enl. ed.

International Nuclear Information System (INIS)

Ackermann, Ole; Barkhausen, Joerg

2013-01-01

The radiology trainer for surgical ambulance includes informative X-ray imaging examples for the following issues: zygoma, nasal bone, spinal cord, clavicle, shoulder, upper arms, elbow, forearms, wrist, hand, phalanx, thorax, sternum, pelvis, abdomen, hips, femur, knee, lower leg, ankle, feet.

Predictors of workplace violence among ambulance personnel : A longitudinal study.

NARCIS (Netherlands)

van der Velden, Peter; Bosmans, Mark; van der Meulen, Erik

Abstract Aim To examine predictors of repeated confrontations with workplace violence among ambulance personnel, the proportion of exposure to potentially traumatic events that are aggression-related and to what extent personnel was able to prevent escalations. Although previous research assessed

Optimizing the location of ambulances in Tijuana, Mexico.

Science.gov (United States)

Dibene, Juan Carlos; Maldonado, Yazmin; Vera, Carlos; de Oliveira, Mauricio; Trujillo, Leonardo; Schütze, Oliver

2017-01-01

In this work we report on modeling the demand for Emergency Medical Services (EMS) in Tijuana, Baja California, Mexico, followed by the optimization of the location of the ambulances for the Red Cross of Tijuana (RCT), which is by far the largest provider of EMS services in the region. We used data from more than 10,000 emergency calls surveyed during the year 2013 to model and classify the demand for EMS in different scenarios that provide different perspectives on the demand throughout the city, considering such factors as the time of day, work and off-days. A modification of the Double Standard Model (DSM) is proposed and solved to determine a common robust solution to the ambulance location problem that simultaneously satisfies all specified constraints in all demand scenarios selecting from a set of almost 1000 possible base locations. The resulting optimization problems are solved using integer linear programming and the solutions are compared with the locations currently used by the Red Cross. Results show that demand coverage and response times can be substantially improved by relocating the current bases without the need for additional resources. Copyright © 2016 Elsevier Ltd. All rights reserved.

Does use of the recognition of stroke in the emergency room stroke assessment tool enhance stroke recognition by ambulance clinicians?

Science.gov (United States)

Fothergill, Rachael T; Williams, Julia; Edwards, Melanie J; Russell, Ian T; Gompertz, Patrick

2013-11-01

U.K ambulance services assess patients with suspected stroke using the Face Arm Speech Test (FAST). The Recognition Of Stroke In the Emergency Room (ROSIER) tool has been shown superior to the FAST in identifying strokes in emergency departments but has not previously been tested in the ambulance setting. We investigated whether ROSIER use by ambulance clinicians can improve stroke recognition. Ambulance clinicians used the ROSIER in place of the FAST to assess patients with suspected stroke. As the ROSIER includes all FAST elements, we calculated a FAST score from the ROSIER to enable comparisons between the two tools. Ambulance clinicians' provisional stroke diagnoses using the ROSIER and calculated FAST were compared with stroke consultants' diagnosis. We used stepwise logistic regression to compare the contribution of individual ROSIER and FAST items and patient demographics to the prediction of consultants' diagnoses. Sixty-four percent of strokes and 78% of nonstrokes identified by ambulance clinicians using the ROSIER were subsequently confirmed by a stroke consultant. There was no difference in the proportion of strokes correctly detected by the ROSIER or FAST with both displaying excellent levels of sensitivity. The ROSIER detected marginally more nonstroke cases than the FAST, but both demonstrated poor specificity. Facial weakness, arm weakness, seizure activity, age, and sex predicted consultants' diagnosis of stroke. The ROSIER was not better than the FAST for prehospital recognition of stroke. A revised version of the FAST incorporating assessment of seizure activity may improve stroke identification and decision making by ambulance clinicians.

Dyspnea in the ambulance - etiology, mortality, and point-of-care diagnostics

DEFF Research Database (Denmark)

Bøtker, Morten Thingemann

2016-01-01

dyspnea in the ambulance requires identification of high-risk groups and early correct treatment. Bringing forward simplified versions of advanced diagnostic modalities known from the hospital as point-of-care diagnostics already in the ambulance may aid the discrimination of underlying conditions causing......, we included all patients dialing the emergency number (1-1-2) due to a medical emergency in three of five Danish regions. For identification of highrisk patients and evaluation of electrocardiogram-based triage, we compared short-term mortality between patients included in the first study based...... that are highly prioritized in emergency medical services – including chest pain and trauma. Whether this increased mortality can be ascribed to an older age and comorbidity among patients suffering dyspnea, or if modifiable risk factors are also present, is unsettled. Improving outcome for patients suffering...

Day-to-day consistency of lower extremity kinematics during stair ambulation in 24-45 years old athletes.

Science.gov (United States)

Husa-Russell, Johanna; Ukelo, Thomas; List, Renate; Lorenzetti, Silvio; Wolf, Peter

2011-04-01

Before making interpretations on the effects of interventions or on the features of pathological gait patterns during stair ambulation, the day-to-day consistency of the investigated variables must be established. In this article, the day-to-day consistency was determined for kinematic variables during barefoot stair ambulation. Ten healthy athletes performed two gait analysis sessions, at least one week apart, utilizing a marker set of 47 skin markers, and a functional joint center/axes determination. Being found on limits of agreement and mean differences between the repeated stair ambulation sessions, totally 43 ranges of motions were examined at the hip, knee, ankle, and midfoot joints. The day-to-day consistency was generally in the magnitude of three degrees, irrespective of test condition, investigated joint, or regarded cardinal body plane. The reported values of the day-to-day consistency provide guidelines to distinguish between pathological and healthy gait patterns, and thresholds to determine minimal effects of interventions during stair ambulation. Copyright © 2011 Elsevier B.V. All rights reserved.

An association between fine particulate matter (PM2.5) levels and emergency ambulance dispatches for cardiovascular diseases in Japan.

Science.gov (United States)

Ichiki, Toshihiro; Onozuka, Daisuke; Kamouchi, Masahiro; Hagihara, Akihito

2016-11-01

The aim of this study is to determine whether short-term exposure to fine particulate matter (PM 2.5 ) is associated with emergency ambulance dispatches for cardiovascular diseases in Japan. The nationwide data on emergency dispatches of ambulance for cardiovascular diseases classified as I00-I99 by International Classification of Diseases-10th revision in 30 Japanese prefectures between April 1 and December 31, in 2010 were analyzed. Data on weather variability including PM 2.5 , temperature and relative humidity were acquired from ambient air pollution monitoring stations. Conditional Poisson regression models were used to estimate the prefecture-specific effects of PM 2.5 on morbidity, and adjust for confounding factors. A meta-analysis was then applied to pool estimates at the 30-prefecture level. A total of 160,566 emergency ambulance dispatches for cardiovascular diseases were reported during the study period. The risk of emergency ambulance dispatch for cardiovascular diseases significantly increased with an increase in the exposure to PM 2.5 in Fukuoka and Iwate Prefectures. However, we found no statistically significant associations between PM 2.5 and emergency ambulance dispatches in the pooled analysis (odds ratio 1.00, 95 % confidence interval 0.99-1.00). Heterogeneity was not observed between prefectures (Cochran Q test, p = 0.187, I 2  = 18.4 %). Exposure to PM 2.5 is not associated with overall emergency ambulance dispatches for cardiovascular diseases in Japan.

Effect of Positioning and Early Ambulation on Coronary Angiography Complications: a Randomized Clinical Trial

Directory of Open Access Journals (Sweden)

Ali Akbar Abdollahi

2015-06-01

Full Text Available Introduction: After coronary angiography to prevent potential complications, patients are restricted to 4-24 hours bed rest in the supine position due to the complications. This study was designed to assess the effect of changing position and early ambulation on low back pain, urinary retention, bleeding and hematoma after cardiac catheterization. Methods: In this clinical trial, 140 patients by using a convenience sampling randomly divided into four 35-individual groups. The patients in the control group were in the supine position for 6 hours without a movement. Change position was applied to the second group (based on a specific protocol, early ambulation was applied to the third group and both early ambulation and change position were applied to the fourth group. Then, severity of bleeding, hematoma, back pain and urinary retention were measured at zero, 1, 2, 4, 6, and 24 hours after angiography. The data was collected through an individual data questionnaire, Numerical Rating Scale (NRS of pain and Kristin Swain’s check list was applied to evaluate the severity of bleeding and hematoma. Results: None of patients developed vascular complications. Incidence of urinary retention was higher in the control group, although this difference was not significant. The mean of pain intensity in the fourth and sixth hours showed a significant difference.Conclusion: Based on the findings of this study, changing patients’ position can be safe and they can be ambulated early after angiography.

Bed rest versus early ambulation with standard anticoagulation in the management of deep vein thrombosis: a meta-analysis.

Directory of Open Access Journals (Sweden)

Zhenlei Liu

Full Text Available Bed rest has been considered as the cornerstone of management of deep vein thrombosis (DVT for a long time, though it is not evidence-base, and there is growing evidence favoring early ambulation.Electronic databases including Medline, PubMed, Cochrane Library and three Chinese databases were searched with key words of "deep vein thrombosis", "pulmonary embolism", "venous thrombosis", "bed rest", "immobilization", "mobilization" and "ambulation". We considered randomized controlled trials, prospective or retrospective cohort studies that compared the outcomes of acute DVT patients managed with early ambulation versus bed rest, in addition to standard anticoagulation. Meta-analysis pertaining to the incidence of new pulmonary embolism (PE, progression of DVT, and DVT related deaths were conducted, as well as the extent of remission of pain and edema.13 studies were included with a total of 3269 patients. Compared to bed rest, early ambulation was not associated with a higher incidence of new PE, progression of DVT, or DVT related deaths (RD -0.03, 95% CI -0.05∼ -0.02; Z = 1.24, p = 0.22; random effect model, Tau2 = 0.01. Moreover, if the patients suffered moderate or severe pain initially, early ambulation was related to a better outcome, with respect to remission of acute pain in the affected limb (SMD 0.42, 95%CI 0.09∼0.74; Z = 2.52, p = 0.01; random effect model, Tau2 = 0.04. Meta-analysis of alleviation of edema cannot elicit a solid conclusion because of significant heterogeneity among the few studies.Compared to bed rest, early ambulation of acute DVT patients with anticoagulation was not associated with a higher incidence of new PE, progression of DVT, and DVT related deaths. Furthermore, for the patients suffered moderate or severe pain initially, a better outcome can be seen in early ambulation group, regarding to the remission of acute pain in the affected limb.

What an ambulance nurse needs to know: a content analysis of curricula in the specialist nursing programme in prehospital emergency care.

Science.gov (United States)

Sjölin, Helena; Lindström, Veronica; Hult, Håkan; Ringsted, Charlotte; Kurland, Lisa

2015-04-01

In Sweden, ambulances must be staffed by at least one registered nurse. Twelve universities offer education in ambulance nursing. There is no national curriculum for detailed course content and there is a lack of knowledge about the educational content that deals with the ambulance nurse practical professional work. The aim of this study was to describe the content in course curricula for ambulance nurses. A descriptive qualitative research design with summative content analysis was used. Data were generated from 49 courses in nursing and medical science. The result shows that the course content can be described as medical, nursing and contextual knowledge with a certain imbalance with largest focus on medical knowledge. There is least focus on nursing, the registered nurses' main profession. This study clarifies how the content in the education for ambulance nurses in Sweden looks today but there are reasons to discuss the content distribution. Copyright © 2014 Elsevier Ltd. All rights reserved.

Treatment of presumed acute cardiogenic pulmonary oedema in an ambulance system by nurses using Boussignac continuous positive airway pressure

NARCIS (Netherlands)

Dieperink, Willem; Weelink, E. E. M.; van der Horst, I. C. C.; de Vos, R.; Jaarsma, T.; Aarts, L. P. H. J.; Zijlstra, F.; Nijsten, M. W. N.

Background: Early initiation of continuous positive airway pressure (CPAP) applied by face mask benefits patients with acute cardiogenic pulmonary oedema (ACPE). The simple disposable Boussignac CPAP (BCPAP) has been used in ambulances by physicians. In the Netherlands, ambulances are manned by

Respiratory, cardiovascular and metabolic responses during different modes of overground bionic ambulation in persons with motor-incomplete spinal cord injury: A case series

Directory of Open Access Journals (Sweden)

Jochen Kressler

2017-09-01

Full Text Available Objective: To investigate the effects of overground bionic ambulation with variable assistance on cardiorespiratory and metabolic responses in persons with motor-incomplete spinal cord injury. Design: Case series. Subjects: Four participants with chronic, motor-incomplete spinal cord injury. Methods: Subjects completed a maximal graded exercise test on an arm-ergometer and 3 6-min bouts of overground bionic ambulation using different modes of assistance, i.e. Maximal, Adaptive, Fixed. Cardiorespiratory (oxygen consumption and metabolic (caloric expenditure and substrate utilization measures were taken using a mobile metabolic cart at each overground bionic ambulation assistance. Results: Cardiorespiratory responses ranged from low (24% VO2peak for the least impaired and fittest individual to supramaximal (124% VO2peak for the participant with the largest impairments and the lowest level of fitness. Different overground bionic ambulation assistive modes elicited small (3–8% VO2peak differences in cardiorespiratory responses for 3 participants. One participant had a large (28% VO2peak difference in cardiorespiratory responses to different modes of overground bionic ambulation. Metabolic responses mostly tracked closely with cardiorespiratory responses. Total energy expenditure ranged from 1.39 to 7.17 kcal/min. Fat oxidation ranged from 0.00 to 0.17 g/min across participants and different overground bionic ambulation modes. Conclusion: Overground bionic ambulation with variable assistance can substantially increase cardiorespiratory and metabolic responses; however, these responses vary widely across participants and overground bionic ambulation modes.

Automated personnel-assets-consumables-drug tracking in ambulance services for more effective and efficient medical emergency interventions.

Science.gov (United States)

Utku, Semih; Özcanhan, Mehmet Hilal; Unluturk, Mehmet Suleyman

2016-04-01

Patient delivery time is no longer considered as the only critical factor, in ambulatory services. Presently, five clinical performance indicators are used to decide patient satisfaction. Unfortunately, the emergency ambulance services in rapidly growing metropolitan areas do not meet current satisfaction expectations; because of human errors in the management of the objects onboard the ambulances. But, human involvement in the information management of emergency interventions can be reduced by electronic tracking of personnel, assets, consumables and drugs (PACD) carried in the ambulances. Electronic tracking needs the support of automation software, which should be integrated to the overall hospital information system. Our work presents a complete solution based on a centralized database supported by radio frequency identification (RFID) and bluetooth low energy (BLE) identification and tracking technologies. Each object in an ambulance is identified and tracked by the best suited technology. The automated identification and tracking reduces manual paper documentation and frees the personnel to better focus on medical activities. The presence and amounts of the PACD are automatically monitored, warning about their depletion, non-presence or maintenance dates. The computerized two way hospital-ambulance communication link provides information sharing and instantaneous feedback for better and faster diagnosis decisions. A fully implemented system is presented, with detailed hardware and software descriptions. The benefits and the clinical outcomes of the proposed system are discussed, which lead to improved personnel efficiency and more effective interventions. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

[Examination of work-related stress and coping strategies among ambulance- and air-ambulance workers].

Science.gov (United States)

Schiszler, Bence; Karamánné Pakai, Annamária; Szabó, Zoltán; Raposa, László Bence; Pónusz, Róbert; Radnai, Balázs; Endrei, Dóra

2016-11-01

Among Hungary's health sector workers the presence of a high level of stress is known, which can affect the individual. The aim of the authors was to uncover major risk factors causing work-related stress, as well as its extent, and positive and negative coping strategies among ground and aerial rescue workers. From June until October 2015, a national survey was conducted among Hungarian rescue workers. An own questionnaire and Rahe Stress and coping validated short questionnaire online form were used. A total of 141 persons took part in the survey. As compared to air-ambulance workers, ground rescue workers were exposed to higher work-related stress effects (pStress and Coping Index effective coping mechanisms were observed among air rescue workers (pstress reduction. Orv. Hetil., 2016, 157(45), 1802-1808.

Effect evaluation of a heated ambulance mattress-prototype on thermal comfort and patients’ temperatures in prehospital emergency care – an intervention study

Directory of Open Access Journals (Sweden)

Jonas Aléx

2015-09-01

Full Text Available Background: The ambulance milieu does not offer good thermal comfort to patients during the cold Swedish winters. Patients’ exposure to cold temperatures combined with a cold ambulance mattress seems to be the major factor leading to an overall sensation of discomfort. There is little research on the effect of active heat delivered from underneath in ambulance care. Therefore, the aim of this study was to evaluate the effect of an electrically heated ambulance mattress-prototype on thermal comfort and patients’ temperatures in the prehospital emergency care. Methods: A quantitative intervention study on ambulance care was conducted in the north of Sweden. The ambulance used for the intervention group (n=30 was equipped with an electrically heated mattress on the regular ambulance stretcher whereas for the control group (n=30 no active heat was provided on the stretcher. Outcome variables were measured as thermal comfort on the Cold Discomfort Scale (CDS, subjective comments on cold experiences, and finger, ear and air temperatures. Results: Thermal comfort, measured by CDS, improved during the ambulance transport to the emergency department in the intervention group (p=0.001 but decreased in the control group (p=0.014. A significant higher proportion (57% of the control group rated the stretcher as cold to lie down compared to the intervention group (3%, p<0.001. At arrival, finger, ear and compartment air temperature showed no statistical significant difference between groups. Mean transport time was approximately 15 minutes. Conclusions: The use of active heat from underneath increases the patients’ thermal comfort and may prevent the negative consequences of cold stress.

Knee disarticulation : Survival, wound healing and ambulation. A historic cohort study

NARCIS (Netherlands)

Ten Duis, K.; Bosmans, J. C.; Voesten, H. G. J.; Geertzen, J. H. B.; Dijkstra, P. U.

2009-01-01

The aim of this study was to analyze survival, wound healing and ambulation after knee disarticulation (KD). A historic cohort study using medical records and nursing home records was performed. Data included demographics, reason for amputation, concomitant diseases, survival, wound healing,

The relationship between airborne fine particle matter and emergency ambulance dispatches in a southwestern city in Chengdu, China

International Nuclear Information System (INIS)

Liu, Ruicong; Zeng, Jie; Jiang, Xianyan; Chen, Jianyu; Gao, Xufang; Zhang, Li; Li, Tiantian

2017-01-01

High levels of fine particulate matter (PM 2.5 ) are known to cause adverse effects to human health. The goal of this study was to estimate the acute health effects of short-term exposure to ambient PM 2.5 by analyzing cause-specific emergency ambulance dispatches as the endpoint in Chengdu, a city in Sichuan Province in southwest China. The ambient PM 2.5 concentration of Chengdu reached 63 μg/m 3 in 2015. Data related to the causes of specific emergency ambulance dispatches, air pollution, and meteorological conditions were collected from 2013 to 2015 (1095 days). A generalized additive model (GAM) was constructed to control the confounding conditions and to estimate the effects of PM 2.5 on human health conditions. Emergency ambulance dispatches for all causes with (RR for lag0 = 1.0010, 95%CI: 1.0002, 1.0019) or without injuries (RR for lag0 = 1.0012, 95%CI: 1.0002, 1.0022), respiratory diseases (RR for lag0 = 1.0051, 95%CI: 1.0012, 1.0089), and cardiovascular diseases (RR for lag0 = 1.0041, 95%CI: 1.0009, 1.0074) were associated with ambient PM 2.5 concentrations in Chengdu. In addition, the effects of PM 2.5 were not confounded by ozone. - Highlights: • Short-term exposure to PM 2.5 was associated to emergency ambulance dispatches. • PM 2.5 strongly affected ambulance dispatches for respiratory and cardiovascular diseases. • High PM 2.5 levels induced acute health effects in Chengdu and other east China cities. - PM 2.5 strongly affected emergency ambulance dispatches for respiratory and cardiovascular diseases in Chengdu, a southwestern city in China.

Benefits of glucocorticoids in non-ambulant boys/men with Duchenne muscular dystrophy: A multicentric longitudinal study using the Performance of Upper Limb test.

Science.gov (United States)

Pane, Marika; Fanelli, Lavinia; Mazzone, Elena Stacy; Olivieri, Giorgia; D'Amico, Adele; Messina, Sonia; Scutifero, Marianna; Battini, Roberta; Petillo, Roberta; Frosini, Silvia; Sivo, Serena; Vita, Gian Luca; Bruno, Claudio; Mongini, Tiziana; Pegoraro, Elena; De Sanctis, Roberto; Gardani, Alice; Berardinelli, Angela; Lanzillotta, Valentina; Carlesi, Adelina; Viggiano, Emanuela; Cavallaro, Filippo; Sframeli, Maria; Bello, Luca; Barp, Andrea; Bianco, Flaviana; Bonfiglio, Serena; Rolle, Enrica; Palermo, Concetta; D'Angelo, Grazia; Pini, Antonella; Iotti, Elena; Gorni, Ksenija; Baranello, Giovanni; Bertini, Enrico; Politano, Luisa; Sormani, Maria Pia; Mercuri, Eugenio

2015-10-01

The aim of this study was to establish the possible effect of glucocorticoid treatment on upper limb function in a cohort of 91 non-ambulant DMD boys and adults of age between 11 and 26 years. All 91 were assessed using the Performance of Upper Limb test. Forty-eight were still on glucocorticoid after loss of ambulation, 25 stopped steroids at the time they lost ambulation and 18 were GC naïve or had steroids while ambulant for less than a year. At baseline the total scores ranged between 0 and 74 (mean 41.20). The mean total scores were 47.92 in the glucocorticoid group, 36 in those who stopped at loss of ambulation and 30.5 in the naïve group (p < 0.001). The 12-month changes ranged between -20 and 4 (mean -4.4). The mean changes were -3.79 in the glucocorticoid group, -5.52 in those who stopped at loss of ambulation and -4.44 in the naïve group. This was more obvious in the patients between 12 and 18 years and at shoulder and elbow levels. Our findings suggest that continuing glucocorticoids throughout teenage years and adulthood after loss of ambulation appears to have a beneficial effect on upper limb function. Copyright © 2015 The Authors. Published by Elsevier B.V. All rights reserved.

Ambulance cardiopulmonary resuscitation: outcomes and associated factors in out-of-hospital cardiac arrest.

Science.gov (United States)

Rosell Ortiz, Fernando; García Del Águila, Javier; Fernández Del Valle, Patricia; J Mellado-Vergel, Francisco; Vergara-Pérez, Santiago; R Ruiz-Montero, María; Martínez-Lara, Manuela; J Gómez-Jiménez, Francisco; Gonzáez-Lobato, Ismael; García-Escudero, Guillermo; Ruiz-Bailén, Manuel; Caballero-García, Auxiliadora; Vivar-Díaz, Itziar; Olavarría-Govantes, Luis

2018-06-01

To assess factors associated with survival of out-of-hospital cardiac arrest (OHCA) in patients who underwent cardiopulmonary resuscitation (CPR) during ambulance transport. Retrospective analysis of a registry of OHCA cases treated between 2008 and 2014. We included patients who had not recovered circulation at the time it was decided to transport to a hospital and who were rejected as non-heart-beating donors. Multivariate analysis was used to explore factors associated with the use of ambulance CPR, survival, and neurologic outcome. Out of a total of 7241 cases, 259 (3.6%) were given CPR during emergency transport. The mean (SD) age was 51.6 (23.6) years; 27 (10.1%) were aged 16 years or younger. The following variables were associated with the use of CPR during transport: age 16 years or under (odds ratio [OR], 6.48; 95% CI, 3.91-10.76); P<.001)], witnessed OHCA (OR, 1.62; 95% CI, 1.16-2.26; P=.004), cardiac arrest outside the home (OR, 3.17; 95% CI, 2.38-4.21; P<.001), noncardiac cause (OR, 1.47; 95% CI, 1.07-2.02; P=.019], initially shockable rhythm (OR, 1.67; 95% CI, 1.17-2.37; P=.004), no prior basic life support (OR, 3.48; 95% CI, 2.58-4.70; P<.001), and orotracheal intubation (OR, 1.93; 95% CI, 1.24-2.99; P=.003). One patient (0.38%) survived to discharge with good neurologic outcome. Ambulance CPR by a physician on board is applied in few OHCA cases. Young patient age, cardiac arrest outside the home, the presence of a witness, lack of a shockable rhythm on responder arrival, lack of basic life support prior to responder arrival, noncardiac cause, and orotracheal intubation are associated with the use of ambulance CPR, a strategy that can be considered futile.

Effects of high ambient temperature on ambulance dispatches in different age groups in Fukuoka, Japan.

Science.gov (United States)

Kotani, Kazuya; Ueda, Kayo; Seposo, Xerxes; Yasukochi, Shusuke; Matsumoto, Hiroko; Ono, Masaji; Honda, Akiko; Takano, Hirohisa

2018-01-01

The elderly population has been the primary target of intervention to prevent heat-related illnesses. According to the literature, the highest risks have been observed among the elderly in the temperature-mortality relationship. However, findings regarding the temperature-morbidity relationship are inconsistent. This study aimed to examine the association of temperature with ambulance dispatches due to acute illnesses, stratified by age group. Specifically, we explored the optimum temperature, at which the relative health risks were found to be the lowest, and quantified the health risk associated with higher temperatures among different age groups. We used the data for ambulance dispatches in Fukuoka, Japan, during May and September from 2005 to 2012. The data were grouped according to age in 20-year increments. We explored the pattern of the association of ambulance dispatches with temperature using a smoothing spline curve to identify the optimum temperature for each age group. Then, we applied a distributed lag nonlinear model to estimate the risks of the 85th-95th percentile temperature relative to the overall optimum temperature, for each age group. The relative risk of ambulance dispatches at the 85th and 95th percentile temperature for all ages was 1.08 [95% confidence interval (CI): 1.05, 1.12] and 1.12 (95% CI: 1.08, 1.16), respectively. In comparison, among age groups, the optimum temperature was observed as 25.0°C, 23.2°C, and 25.3°C for those aged 0-19, 60-79, and ≥80, respectively. The optimum temperature could not be determined for those aged 20-39 and 40-59. The relative risks of high temperature tended to be higher for those aged 20-39 and 40-59 than those for other age groups. We did not find any definite difference in the effect of high temperature on ambulance dispatches for different age groups. However, more measures should be taken for younger and middle-aged people to avoid heat-related illnesses.

Effects of international football matches on ambulance call profiles and volumes during the 2006 World Cup.

Science.gov (United States)

Deakin, Charles D; Thompson, Fizz; Gibson, Caroline; Green, Mark

2007-06-01

Prompt ambulance attendance is aimed at improving patient care. With finite resources struggling to meet performance targets, unforeseen demand precludes the ability to tailor resources to cope with increased call volumes, and can have a marked detrimental effect on performance and hence patient care. The effects of the 2006 World Cup football matches on call volumes and profiles were analysed to understand how public events can influence demands on the ambulance service. All emergency calls to the Hampshire Ambulance Service NHS Trust (currently the Hampshire Division of South Central Ambulance Service, Winchester, UK) during the first weekend of the 2006 World Cup football matches were analysed by call volume and classification of call (call type). On the day of the first football match, call volume was over 50% higher than that on a typical Saturday, with distinct peaks before and after the inaugural match. Call profile analysis showed increases in alcohol-related emergencies, including collapse, unconsciousness, assault and road traffic accidents. The increase in assaults was particularly marked at the end of each match and increased again into the late evening. A detailed mapping of call volumes and profiles during the World Cup football shows a significant increase in overall emergency calls, mostly alcohol related. Mapping of limited resources to these patterns will allow improved responses to emergency calls.

Mission impossible or border security – Practical and effective infection control on air ambulances

Directory of Open Access Journals (Sweden)

M. Kuhn*

2013-12-01

These principles have been applied to our air ambulance system based from Lanseria International Airport. By combining preventative and control measures, there has been no breach in our infection control strategies, as evidenced by no growth noted on specific and random swabs even when more and more ”super bugs” are being identified in hospital. As an air ambulance service flying patients from various African countries, we have the responsibility to conduct our own ”Border Security” to keep our hospitals, patients, aircraft and crews clean and safe. In this presentation we will share our ”Border Security” principles and experiences with the audience.

Utility of Ambulance Data for Real-Time Syndromic Surveillance: A Pilot in the West Midlands Region, United Kingdom.

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Todkill, Dan; Loveridge, Paul; Elliot, Alex J; Morbey, Roger A; Edeghere, Obaghe; Rayment-Bishop, Tracy; Rayment-Bishop, Chris; Thornes, John E; Smith, Gillian

2017-12-01

Introduction The Public Health England (PHE; United Kingdom) Real-Time Syndromic Surveillance Team (ReSST) currently operates four national syndromic surveillance systems, including an emergency department system. A system based on ambulance data might provide an additional measure of the "severe" end of the clinical disease spectrum. This report describes the findings and lessons learned from the development and preliminary assessment of a pilot syndromic surveillance system using ambulance data from the West Midlands (WM) region in England. Hypothesis/Problem Is an Ambulance Data Syndromic Surveillance System (ADSSS) feasible and of utility in enhancing the existing suite of PHE syndromic surveillance systems? An ADSSS was designed, implemented, and a pilot conducted from September 1, 2015 through March 1, 2016. Surveillance cases were defined as calls to the West Midlands Ambulance Service (WMAS) regarding patients who were assigned any of 11 specified chief presenting complaints (CPCs) during the pilot period. The WMAS collected anonymized data on cases and transferred the dataset daily to ReSST, which contained anonymized information on patients' demographics, partial postcode of patients' location, and CPC. The 11 CPCs covered a broad range of syndromes. The dataset was analyzed descriptively each week to determine trends and key epidemiological characteristics of patients, and an automated statistical algorithm was employed daily to detect higher than expected number of calls. A preliminary assessment was undertaken to assess the feasibility, utility (including quality of key indicators), and timeliness of the system for syndromic surveillance purposes. Lessons learned and challenges were identified and recorded during the design and implementation of the system. The pilot ADSSS collected 207,331 records of individual ambulance calls (daily mean=1,133; range=923-1,350). The ADSSS was found to be timely in detecting seasonal changes in patterns of respiratory

HOMING PLACE: TOWARDS A PARTICIPATORY, AMBULANT AND CONVERSIVE METHODOLOGY

OpenAIRE

Myers, Misha

2009-01-01

The practice-as-research project Homing Place proposes a transferable percipient-led methodology of performance and research activated by ambulant and conversive mechanisms as the culmination of this research. The thesis is comprised of a range of activity that represents a moment and way of writing practice. Three artworks that comprise part of the practical component of this thesis--- way from home, Take me to a place and Yodel Rodeo-- each involved participation and contribu...

[Ambulant compression therapy for crural ulcers; an effective treatment when applied skilfully].

Science.gov (United States)

de Boer, Edith M; Geerkens, Maud; Mooij, Michael C

2015-01-01

The incidence of crural ulcers is high. They reduce quality of life considerably and create a burden on the healthcare budget. The key treatment is ambulant compression therapy (ACT). We describe two patients with crural ulcers whose ambulant compression treatment was suboptimal and did not result in healing. When the bandages were applied correctly healing was achieved. If correctly applied ACT should provide sufficient pressure to eliminate oedema, whilst taking local circumstances such as bony structures and arterial qualities into consideration. To provide pressure-to-measure regular practical training, skills and regular quality checks are needed. Knowledge of the properties of bandages and the proper use of materials for padding under the bandage enables good personalised ACT. In trained hands adequate compression and making use of simple bandages and dressings provides good care for patients suffering from crural ulcers in contrast to inadequate ACT using the same materials.

[Índice de Saturación Modificado y Ambulancias (ISMA): Ambulance assignment and remote Emergency Room Bed Reservation].

Science.gov (United States)

Polanco-González, Carlos; Castañón-González, Jorge Alberto; Villanueva-Martínez, Sebastián; Samaniego-Mendoza, José Lino; Buhse, Thomas

2015-01-01

In most places all over the world–including our country–services in emergency rooms are oversaturated. This situation frequently forces the continuously arriving ambulances to be redirected to other medical units, delaying the admission of patients moved and thus adversely affecting their physical condition. To introduce an improvement to the Índicede Saturación Modificado computational system, which monitors the degree of saturation of a network of emergency medical services, to include a network of ambulances, enabling in the system: (i) the effective allocation of ambulances to the site of the accident, or severe clinical event, and (ii) the remote booking of beds in the nearest and least saturated emergency room available. The evaluation and connectivity of the computational improvement to the Índicede Saturación Modificado system was carried out with a computational test verifying these two aspects, using only differences in postal codes, for time measuring. The verification of its sustainability online showed the new Índice de Saturación Modificado y Ambulancias system (ISMA) has a robust structure capable of being adapted to mobile phones, laptops or tablets, and can efficiently administrate: (i) the quantification of excessive demand in the emergency room services of a hospital network, (ii) the allocation of ambulances attending the site of the event or contingency, and (iii) the allocation of ambulances and patients, in the best distance-time conditions, from the site of the accident or clinical event to the nearest and least saturated emergency room service. This administrative management tool is efficient and simple to use, and it optimally relates independent service networks.

Barriers to Implementation of Recommendations for Transport of Children in Ground Ambulances.

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Woods, Rashida H; Shah, Manish; Doughty, Cara; Gilchrest, Anthony

2017-10-16

The National Highway Traffic Safety Administration (NHTSA) released draft recommendations in 2010 on the safe transport of children in ground ambulances. The purpose of this study was to assess awareness of these guidelines among emergency medical service (EMS) agencies and to identify implementation barriers. We conducted a cross-sectional, anonymous online survey of 911-responding, ground transport EMS agencies in Texas. Demographics, modes of transport based on case scenarios, and barriers to implementation were assessed. Of 62 eligible EMS agencies that took the survey, 35.7% were aware of the NHTSA guidelines, 62.5% agreed they would improve safety, and 41.1% planned to implement them. Seventy-five percent of EMS agencies used the ideal or acceptable alternative to transport children requiring continuous monitoring, and 69.5% chose ideal or acceptable alternatives for children requiring spinal immobilization. The ideal or acceptable alternative was not chosen for children who were not injured or ill (93.2%), ill or injured but not requiring continuous monitoring (53.3%), and situations when multiple patients required transport (57.6%). The main requirements for implementation were provider education, ambulance interior modifications, new guidelines in the EMS agency, and purchase of new equipment. Few EMS agencies are aware of the NHTSA guidelines on safe transport of children in ground ambulances. Although most agencies appropriately transport children who require monitoring, interventions, or spinal immobilization, they use inappropriate means to transport children in situations with multiple patients, lack of injury or illness, or lack of need for monitoring.

Effects of weather conditions on emergency ambulance calls for acute coronary syndromes

Science.gov (United States)

Vencloviene, Jone; Babarskiene, Ruta; Dobozinskas, Paulius; Siurkaite, Viktorija

2015-08-01

The aim of this study was to evaluate the relationship between weather conditions and daily emergency ambulance calls for acute coronary syndromes (ACS). The study included data on 3631 patients who called the ambulance for chest pain and were admitted to the department of cardiology as patients with ACS. We investigated the effect of daily air temperature ( T), barometric pressure (BP), relative humidity, and wind speed (WS) to detect the risk areas for low and high daily volume (DV) of emergency calls. We used the classification and regression tree method as well as cluster analysis. The clusters were created by applying the k-means cluster algorithm using the standardized daily weather variables. The analysis was performed separately during cold (October-April) and warm (May-September) seasons. During the cold period, the greatest DV was observed on days of low T during the 3-day sequence, on cold and windy days, and on days of low BP and high WS during the 3-day sequence; low DV was associated with high BP and decreased WS on the previous day. During June-September, a lower DV was associated with low BP, windless days, and high BP and low WS during the 3-day sequence. During the warm period, the greatest DV was associated with increased BP and changing WS during the 3-day sequence. These results suggest that daily T, BP, and WS on the day of the ambulance call and on the two previous days may be prognostic variables for the risk of ACS.

Feasibility, Reliability and Predictive Value Of In-Ambulance Heart Rate Variability Registration

NARCIS (Netherlands)

Yperzeele, Laetitia; van Hooff, Robbert-Jan; De Smedt, Ann; Nagels, Guy; Hubloue, Ives; De Keyser, Jacques; Brouns, Raf

2016-01-01

Background Heart rate variability (HRV) is a parameter of autonomic nervous system function. A decrease of HRV has been associated with disease severity, risk of complications and prognosis in several conditions. Objective We aim to investigate the feasibility and the reliability of in-ambulance HRV

[Structure Parameters and Quality Outcomes of Ambulant Home-care].

Science.gov (United States)

Suhr, Ralf; Raeder, Kathrin; Kuntz, Simone; Strube-Lahmann, Sandra; Latendorf, Antje; Klingelhöfer-Noe, Jürgen; Lahmann, Nils

2018-05-14

So far, there are few data available on the changes of ambulant home-care in Germany over the last decades. Therefore, the aim of this research was to provide structure data on nursing personnel, funding, size, regional differences, and training needs of ambulant home-care services in Germany. In addition, a possible association between structure parameters and quality outcomes for pressure ulcer and malnutrition was investigated. In 2015, a multicenter cross-sectional study was conducted in home-care services in Germany. Structure data from 99 randomly selected home-care services as well as data on pressure ulcers and malnutrition of 903 care-dependent clients were analyzed. The median (home-care services. From a cut-off of 20,000 inhabitants, a region was considered urban. The average prevalence for decubitus and malnutrition (BMIhome-care service, and possible associations with structure parameters were analyzed using a multiple linear regression model. The proportion of registered nurses in non-private (private) home-care services was 60.6% (52.3%). The proportion of employees with a 200- h basic qualification in nursing was higher in private (12.5 vs. 4.7%), small home-care services (14.0 vs. 5.8%) and in urban regions (11.5 vs 5.7%). In average, registered nurses working in small home-care services spent significantly more time per client than the ones working in large services (3.8 vs. 2.9 h/week). The highest need for further training was shown on the subjects of pain, medication and cognitive impairment. No statistically significant correlation could be found between the average decubitus prevalence and structure parameters. Only the association between malnutrition prevalence and the proportion of registered nurses was statistically significant. The present representative study provides structure data on nursing personnel, funding, size, regional differences, and training needs of ambulant home-care services in Germany that could be used as a baseline

Multi-Agent Simulation of Allocating and Routing Ambulances Under Condition of Street Blockage after Natural Disaster

Science.gov (United States)

Azimi, S.; Delavar, M. R.; Rajabifard, A.

2017-09-01

In response to natural disasters, efficient planning for optimum allocation of the medical assistance to wounded as fast as possible and wayfinding of first responders immediately to minimize the risk of natural disasters are of prime importance. This paper aims to propose a multi-agent based modeling for optimum allocation of space to emergency centers according to the population, street network and number of ambulances in emergency centers by constraint network Voronoi diagrams, wayfinding of ambulances from emergency centers to the wounded locations and return based on the minimum ambulances travel time and path length implemented by NSGA and the use of smart city facilities to accelerate the rescue operation. Simulated annealing algorithm has been used for minimizing the difference between demands and supplies of the constrained network Voronoi diagrams. In the proposed multi-agent system, after delivering the location of the wounded and their symptoms, the constraint network Voronoi diagram for each emergency center is determined. This process was performed simultaneously for the multi-injuries in different Voronoi diagrams. In the proposed multi-agent system, the priority of the injuries for receiving medical assistance and facilities of the smart city for reporting the blocked streets was considered. Tehran Municipality District 5 was considered as the study area and during 3 minutes intervals, the volunteers reported the blocked street. The difference between the supply and the demand divided to the supply in each Voronoi diagram decreased to 0.1601. In the proposed multi-agent system, the response time of the ambulances is decreased about 36.7%.

The effect of early ambulation on the incidence of neurological complication after spinal anesthesia with lidocaine

Directory of Open Access Journals (Sweden)

Reihanak Talakoub

2015-01-01

Full Text Available Background: Transient neurological symptoms (TNS, was described in patients recovering from spinal anesthesia with lidocaine but its etiology remains unknown this study was evaluated the influence of ambulation time on the occurrence of TNSs after spinal anesthesia with lidocaine 5%. Materials and Methods: This randomized clinical trial was conducted on 60 patients with American Society of Anesthesiologists Grades I and II, who were candidates for lower abdominal surgery in supine or lithotomy positions. Patients were randomly divided into early ambulation group (Group A who were asked to start walking as soon as the anesthesia was diminished or to the late ambulation group (Group B who walked after at least 12 h bedridden. Participants were contacted 2 days after spinal anesthesia to assess any type of pain at surgical or anesthesia injection site, muscle weakness, fatigue, vertigo, nausea, vomiting, headache, and difficult urination or defecation. Results: Four subjects (13.3% in Group A and two patients (6.7% in Group B had pain at anesthesia injection site (P = 0.019. Fourteen patients in Group A (46.7% and six patients in Group B (20% had post-dural puncture headache (P = 0.014. Participants in Group B reported difficult urination more than Group A (P = 0.002. there were not statistically significant differences between two groups regarding frequency of fatigue, muscle weakness, vertigo, nausea, vomiting, difficult defecation, paresthesia, and the mean of visual analogue scale at the surgical site. Conclusion: Early ambulation after spinal anesthesia with lidocaine did not increase the risk of neurologic complication.

Effect of introduction of electronic patient reporting on the duration of ambulance calls.

Science.gov (United States)

Kuisma, Markku; Väyrynen, Taneli; Hiltunen, Tuomas; Porthan, Kari; Aaltonen, Janne

2009-10-01

We examined the effect of the change from paper records to the electronic patient records (EPRs) on ambulance call duration. We retrieved call duration times 6 months before (group 1) and 6 months after (group 2) the introduction of EPR. Subgroup analysis of group 2 was fulfilled depending whether the calls were made during the first or last 3 months after EPR introduction. We analyzed 37 599 ambulance calls (17 950 were in group 1 and 19 649 were in group 2). The median call duration in group 1 was 48 minutes and in group 2 was 49 minutes (P = .008). In group 2, call duration was longer during the first 3 months after EPR introduction. In multiple linear regression analysis, urgency category (P introduction was noticed, reflecting adaptation process to a new way of working.

Long-term outcome of neurosurgical untethering on neurosegmental motor and ambulation levels

NARCIS (Netherlands)

Schoenmakers, M. A. G. C.; Gooskens, R. H. J. M.; Gulmans, V. A. M.; Hanlo, P. W.; Vandertop, W. P.; Uiterwaal, C. S. P. M.; Helders, P. J. M.

2003-01-01

The aim of this study was to determine the long-term outcome of neurosurgical untethering on neurosegmental motor level and ambulation level in children with tethered spinal cord syndrome. Forty-four children were operated on (17 males, 27 females; mean age at operation 6 years 2 months, SD 5

Development and Pilot Testing of 24/7 In-Ambulance Telemedicine for Acute Stroke : Prehospital Stroke Study at the Universitair Ziekenhuis Brussel-Project

NARCIS (Netherlands)

Espinoza, Alexis Valenzuela; Van Hooff, Robbert-Jan; De Smedt, Ann; Moens, Maarten; Yperzeele, Laetitia; Nieboer, Koenraad; Hubloue, Ives; de Keyser, Jacques; Convents, Andre; Tellez, Helio Fernandez; Dupont, Alain; Putman, Koen; Brouns, Raf

2016-01-01

Background: In-ambulance telemedicine is a recently developed and a promising approach to improve emergency care. We implemented the first ever 24/7 in-ambulance telemedicine service for acute stroke. We report on our experiences with the development and pilot testing of the Prehospital Stroke Study

Identification and characteristics of biological agents in work environment of medical emergency services in selected ambulances

Directory of Open Access Journals (Sweden)

Agata Bielawska-Drózd

2017-08-01

Full Text Available Objectives: Assessment of microbial air quality and surface contamination in ambulances and administration offices as a control place without occupational exposure to biological agents; based on quantitative and qualitative analysis of bacteria, yeasts and filamentous fungi found in collected samples. Material and Methods: The sampling was done by wet cyclone technology using the Coriolis recon apparatus, imprint and swab methods, respectively. In total, 280 samples from 28 ambulances and 10 offices in Warszawa were tested. Data was analyzed using Shapiro-Wilk normality test, Kruskal-Wallis test with α = 0.05. P value ≤ 0.05 was considered as significant. Results: The levels of air contamination were from 0 to 2.3×101 colony-forming unit (CFU/m3 for bacteria and for yeast and filamentous fungi were from 0 to 1.8×101 CFU/m3. The assessment of office space air samples has shown the following numbers of microorganisms: bacteria from 3.0×101 to 4.2×101 CFU/m3 and yeast and filamentous fungi from 0 to 1.9×101 CFU/m3. For surface contamination the mean bacterial count in ambulances has been between 1.0×101 and 1.3×102 CFU/25 cm2 and in offices – between 1.1×101 and 8.5×101 CFU/25 cm2. Mean fungal count has reached the level from 2.8×100 to 4.2×101 CFU/25 cm2 in ambulances and 1.3×101 to 5.8×101 CFU/25 cm2 in offices. The qualitative analysis has revealed the presence of Acinetobacter spp. (surfaces, coagulase – negative Staphylococci (air and surfaces, Aspergillus and Penicillium genera (air and surfaces. Conclusions: The study has revealed a satisfactory microbiological quantity of analyzed air and surface samples in both study and control environments. However, the presence of potentially pathogenic microorganisms in the air and on surfaces in ambulances may endanger the medical emergency staff and patients with infection. Disinfection and cleaning techniques therefore should be constantly developed and implemented. Int J Occup

Identification and characteristics of biological agents in work environment of medical emergency services in selected ambulances.

Science.gov (United States)

Bielawska-Drózd, Agata; Cieślik, Piotr; Wlizło-Skowronek, Bożena; Winnicka, Izabela; Kubiak, Leszek; Jaroszuk-Ściseł, Jolanta; Depczyńska, Daria; Bohacz, Justyna; Korniłłowicz-Kowalska, Teresa; Skopińska-Różewska, Ewa; Kocik, Janusz

2017-06-19

Assessment of microbial air quality and surface contamination in ambulances and administration offices as a control place without occupational exposure to biological agents; based on quantitative and qualitative analysis of bacteria, yeasts and filamentous fungi found in collected samples. The sampling was done by wet cyclone technology using the Coriolis recon apparatus, imprint and swab methods, respectively. In total, 280 samples from 28 ambulances and 10 offices in Warszawa were tested. Data was analyzed using Shapiro-Wilk normality test, Kruskal-Wallis test with α = 0.05. P value ≤ 0.05 was considered as significant. The levels of air contamination were from 0 to 2.3×101 colony-forming unit (CFU)/m3 for bacteria and for yeast and filamentous fungi were from 0 to 1.8×101 CFU/m3. The assessment of office space air samples has shown the following numbers of microorganisms: bacteria from 3.0×101 to 4.2×101 CFU/m3 and yeast and filamentous fungi from 0 to 1.9×101 CFU/m3. For surface contamination the mean bacterial count in ambulances has been between 1.0×101 and 1.3×102 CFU/25 cm2 and in offices - between 1.1×101 and 8.5×101 CFU/25 cm2. Mean fungal count has reached the level from 2.8×100 to 4.2×101 CFU/25 cm2 in ambulances and 1.3×101 to 5.8×101 CFU/25 cm2 in offices. The qualitative analysis has revealed the presence of Acinetobacter spp. (surfaces), coagulase - negative Staphylococci (air and surfaces), Aspergillus and Penicillium genera (air and surfaces). The study has revealed a satisfactory microbiological quantity of analyzed air and surface samples in both study and control environments. However, the presence of potentially pathogenic microorganisms in the air and on surfaces in ambulances may endanger the medical emergency staff and patients with infection. Disinfection and cleaning techniques therefore should be constantly developed and implemented. Int J Occup Med Environ Health 2017;30(4):617-627. This work is available in Open Access

Predictors of workplace violence among ambulance personnel: a longitudinal study

OpenAIRE

van der Velden, Peter G.; Bosmans, Mark W.G.; van der Meulen, Erik

2015-01-01

Abstract Aim To examine predictors of repeated confrontations with workplace violence among ambulance personnel, the proportion of exposure to potentially traumatic events that are aggression-related and to what extent personnel was able to prevent escalations. Although previous research assessed the prevalences among this group, little is known about predictors, to what extent PTE’s are WPV-related and their abilities to prevent escalations. Design A longitudinal study with a 6 months’ time ...

Exploration of contextual factors in a successful quality improvement collaborative in English ambulance services: cross‐sectional survey

Science.gov (United States)

Phung, Viet‐Hai; Essam, Nadya; Asghar, Zahid; Spaight, Anne

2015-01-01

Abstract Rationale, aims and objectives Clinical leadership and organizational culture are important contextual factors for quality improvement (QI) but the relationship between these and with organizational change is complex and poorly understood. We aimed to explore the relationship between clinical leadership, culture of innovation and clinical engagement in QI within a national ambulance QI Collaborative (QIC). Methods We used a self‐administered online questionnaire survey sent to front‐line clinicians in all 12 English ambulance services. We conducted a cross‐sectional analysis of quantitative data and qualitative analysis of free‐text responses. Results There were 2743 (12% of 22 117) responses from 11 of the 12 participating ambulance services. In the 3% of responders that were directly involved with the QIC, leadership behaviour was significantly higher than for those not directly involved. QIC involvement made no significant difference to responders' perceptions of the culture of innovation in their organization, which was generally considered poor. Although uptake of QI methods was low overall, QIC members were significantly more likely to use QI methods, which were also significantly associated with leadership behaviour. Conclusions Despite a limited organizational culture of innovation, clinical leadership and use of QI methods in ambulance services generally, the QIC achieved its aims to significantly improve pre‐hospital care for acute myocardial infarction and stroke. We postulate that this was mediated through an improvement subculture, linked to the QIC, which facilitated large‐scale improvement by stimulating leadership and QI methods. Further research is needed to understand success factors for QI in complex health care environments. PMID:26303398

Abnormalities of left colonic motility in ambulant nonconstipated patients with irritable bowel syndrome

NARCIS (Netherlands)

Clemens, C. H. M.; Samsom, M.; van Berge Henegouwen, G. P.; Smout, A. J. P. M.

2003-01-01

Our objective was to evaluate left colonic motility patterns recorded under physiological conditions during 24 hr in fully ambulant nonconstipated IBS patients compared to healthy controls. A 42-hr manometry of the left colon was performed in 11 nonconstipated IBS patients and 10 age- and

Aspects of neutrality: two Dutch ambulances at the eastern front in the First World War.

Science.gov (United States)

van Bergen, Leo

2010-01-01

The paper looks at two First World War ambulance teams which distinctly differed from each other, both in the way they perceived the war and the places at the front where they worked. The first was working on the Serbian side and the second on the Austrian-Hungarian. The questions raised are: how was medical neutrality defined (was it defined at all)? Was neutrality maintained, and if so how? The writings of several protagonists are closely examined, and placed in context, to show that total neutrality was not adhered to by the physicians and nurses of these ambulances. Apparently neutrality in wartime is difficult, even for men and women coming from a neutral country with an occupation seen as essentially neutral.

Training Persons with Spinal Cord Injury to Ambulate Using a Powered Exoskeleton

Science.gov (United States)

Asselin, Pierre K.; Avedissian, Manuel; Knezevic, Steven; Kornfeld, Stephen; Spungen, Ann M.

2016-01-01

Powered exoskeletons have become available for overground ambulation in persons with paralyses due to spinal cord injury (SCI) who have intact upper extremity function and are able to maintain upright balance using forearm crutches. To ambulate in an exoskeleton, the user must acquire the ability to maintain balance while standing, sitting and appropriate weight shifting with each step. This can be a challenging task for those with deficits in sensation and proprioception in their lower extremities. This manuscript describes screening criteria and a training program developed at the James J. Peters VA Medical Center, Bronx, NY to teach users the skills needed to utilize these devices in institutional, home or community environments. Before training can begin, potential users are screened for appropriate range of motion of the hip, knee and ankle joints. Persons with SCI are at an increased risk of sustaining lower extremity fractures, even with minimal strain or trauma, therefore a bone mineral density assessment is performed to reduce the risk of fracture. Also, as part of screening, a physical examination is performed in order to identify additional health-related contraindications. Once the person has successfully passed all screening requirements, they are cleared to begin the training program. The device is properly adjusted to fit the user. A series of static and dynamic balance tasks are taught and performed by the user before learning to walk. The person is taught to ambulate in various environments ranging from indoor level surfaces to outdoors over uneven or changing surfaces. Once skilled enough to be a candidate for home use with the exoskeleton, the user is then required to designate a companion-walker who will train alongside them. Together, the pair must demonstrate the ability to perform various advanced tasks in order to be permitted to use the exoskeleton in their home/community environment. PMID:27340808

Manager-employee interaction in ambulance services: an exploratory study of employee perspectives on management communication.

Science.gov (United States)

Nordby, Halvor

2015-01-01

Managers of ambulance stations face many communicative challenges in their interaction with employees working in prehospital first-line services. The article presents an exploratory study of how paramedics experience these challenges in communication with station leaders. On the basis of a dialogue perspective in qualitative method, 24 paramedics were interviewed in one-to-one and focus group settings. Naturalistic and phenomenological approaches were used to analyze the interviews. All the paramedics said that they wished to be more involved in decision processes and that station managers should provide better explanations of information "from above." The paramedics understood that it was difficult for the managers to find time for extensive dialogue, but many thought that the managers should give more priority to communication. The paramedics' views correspond to theoretical assumptions in human resource management. According to this model, employees should be involved in decision processes on management levels, as long as it is realistically possible to do so. Furthermore, expressing emotional support and positive attitudes does not take much time, and the study suggests that many ambulance managers should focus more on interpersonal relations to employees. It has been extensively documented that management communication affects organizational performance. The study indicates that managers of ambulance stations should be more aware of how their leadership style affects professional commitment and motivation in the first-line services.

Demand for Emergency Services Trends in New South Wales Years 2010-2014 (DESTINY): Age and Clinical Factors Associated with Ambulance Transportation to Emergency Departments.

Science.gov (United States)

Dinh, Michael M; Muecke, Sandy; Berendsen Russell, Saartje; Chalkley, Dane; Bein, Kendall J; Muscatello, David; Nagaraj, Guruprasad; Paoloni, Richard; Ivers, Rebecca

2016-01-01

The study aimed to analyze ambulance transportations to Emergency Departments (EDs) in New South Wales (NSW) and to identify temporal changes in demographics, acuity, and clinical diagnoses. This was a retrospective analysis of a population based registry of ED presentations in New South Wales. The NSW Emergency Department data collection (EDCC) collects patient level data on presentations to designated EDs across NSW. Patients that presented to EDs by ambulance between January 2010 and December 2014 were included. Patients dead on arrival, transferred from another hospital, or planned ED presentations were excluded. A total of 10.8 million ED attendances were identified of which 2.6 million (23%) were transported to ED by ambulance. The crude rate of ambulance transportations to EDs across all ages increased by 3.0% per annum over the five years with the highest rate observed in those 85 years and over (620.5 presentations per 1,000 population). There was an increase in the proportion of category 1 and 2 (life-threatening or potentially life-threatening) cases from 18.1% to 24.0%. Demand for ambulance services appears to be driven by older patients presenting with higher acuity problems. Alternative models of acute care for elderly patients need to be planned and implemented to address these changes.

Five-year mortality after acute poisoning treated in ambulances, an emergency outpatient clinic and hospitals in Oslo.

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Lund, Cathrine; Bjornaas, Mari A; Sandvik, Leiv; Ekeberg, Oivind; Jacobsen, Dag; Hovda, Knut E

2013-08-21

The long-term mortality after prehospital treatment for acute poisoning has not been studied previously. Thus, we aimed to estimate the five-year mortality and examine the causes of death and predictors of death for all acutely poisoned patients treated in ambulances, the emergency outpatient clinic, and hospitals in Oslo during 2003-2004. A prospective cohort study included all adults (≥16 years; n=2045, median age=35 years, male=58%) who were discharged after treatment for acute poisoning in ambulances, the emergency outpatient clinic, and the four hospitals in Oslo during one year. The patients were observed until the end of 2008. Standardized mortality rates (SMRs) were calculated and multivariate Cox regression analysis was applied. The study comprised 2045 patients; 686 treated in ambulances, 646 treated in the outpatient clinic, and 713 treated in hospitals. After five years, 285 (14%) patients had died (four within one week). The SMRs after ambulance, outpatient, and hospital treatment were 12 (CI 9-14), 10 (CI 8-12), and 6 (CI 5-7), respectively. The overall SMR was 9 (CI 8-10), while the SMR after opioid poisoning was 27 (CI 21-32). The most frequent cause of death was accidents (38%). In the regression analysis, opioids as the main toxic agents (HR 2.3, CI 1.6-3.0), older age (HR 1.6, CI 1.5-1.7), and male sex (HR 1.4, CI 1.1-1.9) predicted death, whereas the treatment level did not predict death. The patients had high mortality compared with the general population. Those treated in hospital had the lowest mortality. Opioids were the major predictor of death.

Use of 3G mobile phone links for teleconsultation between a moving ambulance and a hospital base station.

Science.gov (United States)

Banitsas, Konstantinos A; Perakis, Konstantinos; Tachakra, Sapal; Koutsouris, Dimitrios

2006-01-01

We developed a mobile teleconsultation system based on third-generation mobile phone links. The system comprised a laptop computer and a digital camcorder. It was installed inside an ambulance to allow video-conferencing between the moving vehicle and a doctor at a base station. In addition to video and voice, high-quality still images could also be transmitted. A series of 17 trial runs with real ambulance patients was conducted in the city of Athens. In general, the videoconferencing sessions produced relatively clear video. The bandwidth was high enough for a satisfactory video of 10-15 frames/s. During a total testing period of 23 h and in an area of about 180 km2, there were nine instances of signal loss, amounting to a total of 17 min. The general opinion formed by the doctors was that the system produced good results. All initial diagnoses made using the system agreed with the final diagnoses of the patients. The study showed that the mobile system could reduce the time before an ambulance patient is seen by a doctor.

Non-technical skills evaluation in the critical care air ambulance environment: introduction of an adapted rating instrument--an observational study.

Science.gov (United States)

Myers, Julia A; Powell, David M C; Psirides, Alex; Hathaway, Karyn; Aldington, Sarah; Haney, Michael F

2016-03-08

In the isolated and dynamic health-care setting of critical care air ambulance transport, the quality of clinical care is strongly influenced by non-technical skills such as anticipating, recognising and understanding, decision making, and teamwork. However there are no published reports identifying or applying a non-technical skills framework specific to an intensive care air ambulance setting. The objective of this study was to adapt and evaluate a non-technical skills rating framework for the air ambulance clinical environment. In the first phase of the project the anaesthetists' non-technical skills (ANTS) framework was adapted to the air ambulance setting, using data collected directly from clinician groups, published literature, and field observation. In the second phase experienced and inexperienced inter-hospital transport clinicians completed a simulated critical care air transport scenario, and their non-technical skills performance was independently rated by two blinded assessors. Observed and self-rated general clinical performance ratings were also collected. Rank-based statistical tests were used to examine differences in the performance of experienced and inexperienced clinicians, and relationships between different assessment approaches and assessors. The framework developed during phase one was referred to as an aeromedical non-technical skills framework, or AeroNOTS. During phase two 16 physicians from speciality training programmes in intensive care, emergency medicine and anaesthesia took part in the clinical simulation study. Clinicians with inter-hospital transport experience performed more highly than those without experience, according to both AeroNOTS non-technical skills ratings (p = 0.001) and general performance ratings (p = 0.003). Self-ratings did not distinguish experienced from inexperienced transport clinicians (p = 0.32) and were not strongly associated with either observed general performance (r(s) = 0.4, p = 0

A Survey of Restraint Methods for the Safe Transport of Children in Ground Ambulances.

Science.gov (United States)

Woods, Rashida H; Shah, Manish; Doughty, Cara; Gilchrest, Anthony

2018-03-01

The National Highway Traffic Safety Administration (NHTSA) released draft recommendations in 2010 on the safe transport of children in ground ambulances. The purpose of this study was to assess awareness of these guidelines among emergency medical service (EMS) agencies and to identify implementation barriers. We conducted a cross-sectional, anonymous online survey of 911-responding, ground transport EMS agencies in Texas. Demographics, modes of transport based on case scenarios, and barriers to implementation were assessed. Of 62 eligible EMS agencies that took the survey, 35.7% were aware of the NHTSA guidelines, 62.5% agreed they would improve safety, and 41.1% planned to implement them. Seventy-five percent of EMS agencies used the ideal or acceptable alternative to transport children requiring continuous monitoring, and 69.5% chose ideal or acceptable alternatives for children requiring spinal immobilization. The ideal or acceptable alternative was not chosen for children who were not injured or ill (93.2%), ill or injured but not requiring continuous monitoring (53.3%), and situations when multiple patients required transport (57.6%). The main requirements for implementation were provider education, ambulance interior modifications, new guidelines in the EMS agency, and purchase of new equipment. Few EMS agencies are aware of the NHTSA guidelines on safe transport of children in ground ambulances. Although most agencies appropriately transport children who require monitoring, interventions, or spinal immobilization, they use inappropriate means to transport children in situations with multiple patients, lack of injury or illness, or lack of need for monitoring.

Management of patients brought in by ambulance to the emergency department: role of the Advanced Musculoskeletal Physiotherapist.

Science.gov (United States)

Kinsella, Rita; Collins, Tom; Shaw, Bridget; Sayer, James; Cary, Belinda; Walby, Andrew; Cowan, Sallie

2017-05-09

Objective The aim of the present study was to evaluate the role of the Advanced Musculoskeletal Physiotherapist (AMP) in managing patients brought in by ambulance to the emergency department (ED). Methods This study was a dual-centre observational study. Patients brought in by ambulance to two Melbourne hospitals over a 12-month period and seen by an AMP were compared with a matched group seen by other ED staff. Primary outcome measures were wait time and length of stay (LOS) in the ED. Results Data from 1441 patients within the Australasian Triage Scale (ATS) Categories 3-5 with musculoskeletal complaints were included in the analysis. Subgroup analysis of 825 patients aged ≤65 years demonstrated that for Category 4 (semi-urgent) patients, the median wait time to see the AMP was 9.5min (interquartile range (IQR) 3.25-18.00min) compared with 25min (IQR 10.00-56.00min) to see other ED staff (P ≤ 0.05). LOS analysis was undertaken on patients discharged home and demonstrated that there was a 1.20 greater probability (95% confidence interval 1.07-1.35) that ATS Category 4 patients managed by the AMP were discharged within the 4-hour public hospital target compared with patients managed by other ED staff: 87.04% (94/108) of patients managed by the AMPs met this standard compared with 72.35% (123/170) of patients managed by other ED staff (P=0.002). Conclusions Patients aged ≤65 years with musculoskeletal complaints brought in by ambulance to the ED and triaged to ATS Category 4 are likely to wait less time to be seen and are discharged home more quickly when managed by an AMP. This study has added to the evidence that AMPs improve patient flow in the ED, freeing up time for other ED staff to see higher-acuity, more complex patients. What is known about the topic? There is a growing body of evidence establishing that AMPs improve the flow of patients presenting with musculoskeletal conditions to the ED through reduced wait times and LOS and, at the same time

Psychometric properties of the Cumulated Ambulation Score

DEFF Research Database (Denmark)

Ferriero, Giorgio; Kristensen, Morten T; Invernizzi, Marco

2018-01-01

INTRODUCTION: In the geriatric population, independent mobility is a key factor in determining readiness for discharge following acute hospitalization. The Cumulated Ambulation Score (CAS) is a potentially valuable score that allows day-to-day measurements of basic mobility. The CAS was developed...... and validated in older patients with hip fracture as an early postoperative predictor of short-term outcome, but it is also used to assess geriatric in-patients with acute medical illness. Despite the fast- accumulating literature on the CAS, to date no systematic review synthesizing its psychometric properties....... Of 49 studies identified, 17 examined the psychometric properties of the CAS. EVIDENCE SYNTHESIS: Most papers dealt with patients after hip fracture surgery, and only 4 studies assessed the CAS psychometric characteristics also in geriatric in-patients with acute medical illness. Two versions of CAS...

Noise exposure during ambulance flights and repatriation operations.

Science.gov (United States)

Küpper, Thomas E; Zimmer, Bernd; Conrad, Gerson; Jansing, Paul; Hardt, Aline

2010-01-01

Although ambulance flights are routine work and thousands of employees work in repatriation organizations, there is no data on noise exposure which may be used for preventive advice. We investigated the noise exposure of crews working in ambulance flight organizations for international patient repatriation to get the data for specific guidelines concerning noise protection. Noise levels inside Learjet 35A, the aircraft type which is most often used for repatriation operations, were collected from locations where flight crews typically spend their time. A sound level meter class 1 meeting the DIN IEC 651 requirements was used for noise measurements, but several factors during the real flight situations caused a measurement error of ~3%. Therefore, the results fulfill the specifications for class 2. The data was collected during several real repatriation operations and was combined with the flight data (hours per day) regarding the personnel to evaluate the occupationally encountered equivalent noise level according to DIN 45645-2. The measured noise levels were safely just below the 85 dB(A) threshold and should not induce permanent threshold shifts, provided that additional high noise exposure by non-occupational or private activities was avoided. As the levels of the noise produced by the engines outside the cabin are significantly above the 85 dB(A) threshold, the doors of the aircraft must be kept closed while the engines are running, and any activity performed outside the aircraft - or with the doors opened while the engines are running - must be done with adequate noise protection. The new EU noise directive (2003/10/EG) states that protective equipment must be made available to the aircrew to protect their hearing, though its use is not mandatory.

Posicionamento de ambulâncias do SAMU através de Programação Inteira e Teoria de Filas

Directory of Open Access Journals (Sweden)

Bruno Barreto

Full Text Available Resumo: A configuração de redes logísticas para serviços de emergência é questão estratégica de imensa importância, visto que pequenas variações no tempo de resposta podem implicar na morte do solicitante. Partindo dessa premissa, o trabalho propõe novas alternativas de posicionamento para as ambulâncias do sistema SAMU na cidade de Duque de Caxias, RJ, capazes de reduzir o tempo de resposta do serviço. Essas propostas de reposicionamento das ambulâncias foram construídas em duas etapas: na primeira, dois modelos de Programação Inteira foram aplicados para se obter soluções que provejam maior cobertura à população. Posteriormente, o Modelo do Hipercubo foi empregado para avaliar a disponibilidade dos servidores, dentre outros indicadores de desempenho relevantes, como o tempo médio de resposta e a taxa de ocupação das ambulâncias.

Examination of Supplemental Driver Training and Online Basic Driver Education

Science.gov (United States)

2012-06-01

This report describes supplemental driver training programs and online basic driver education. It coves supplemental driver training that : focused on knowledge and skills beyond those normally found in traditional driver education delivered in the U...

Pre-Hospital Fast Positive Cases Identified by DFB Ambulance Paramedics – Final Clinical Diagnosis

LENUS (Irish Health Repository)

Feeney, A

2016-04-01

Ischaemic stroke clinical outcomes are improved by earlier treatment with intravenous thrombolysis. An existing pathway at the Mater University Hospital for assessment of suspected acute stroke in the Emergency Department was updated, aiming to shorten ‘door to needle time’. This study examines the final clinical diagnosis of Dublin Fire Brigade Ambulance Paramedic identified Face Arm Speech Test (FAST) positive patients presenting to the Emergency Department over a 7 month period. A retrospective analysis was carried out of 177 consecutive FAST positive patients presenting between March and November 2014. The final clinical diagnosis was acute stroke in 57.1% (n=101) of patients. Of these, 76 were ischaemic strokes of whom 56.5% (n=43) were thrombolysed. In the pre-hospital setting Ambulance Paramedics can identify, with reasonable accuracy, acute stroke using the FAST test. Over half of the ischaemic stroke patients presenting via this pathway can be treated with intravenous thrombolysis

Are professional drivers less sleepy than non-professional drivers?

Science.gov (United States)

Anund, Anna; Ahlström, Christer; Fors, Carina; Åkerstedt, Torbjörn

2018-01-01

Objective It is generally believed that professional drivers can manage quite severe fatigue before routine driving performance is affected. In addition, there are results indicating that professional drivers can adapt to prolonged night shifts and may be able to learn to drive without decreased performance under high levels of sleepiness. However, very little research has been conducted to compare professionals and non-professionals when controlling for time driven and time of day. Method The aim of this study was to use a driving simulator to investigate whether professional drivers are more resistant to sleep deprivation than non-professional drivers. Differences in the development of sleepiness (self-reported, physiological and behavioral) during driving was investigated in 11 young professional and 15 non-professional drivers. Results Professional drivers self-reported significantly lower sleepiness while driving a simulator than non-professional drivers. In contradiction, they showed longer blink durations and more line crossings, both of which are indicators of sleepiness. They also drove faster. The reason for the discrepancy in the relation between the different sleepiness indicators for the two groups could be due to more experience to sleepiness among the professional drivers or possibly to the faster speed, which might unconsciously have been used by the professionals to try to counteract sleepiness. Conclusion Professional drivers self-reported significantly lower sleepiness while driving a simulator than non-professional drivers. However, they showed longer blink durations and more line crossings, both of which are indicators of sleepiness, and they drove faster.

DRIVER INATTENTION

Directory of Open Access Journals (Sweden)

Richard TAY

2004-01-01

Full Text Available Driver inattention, especially driver distraction, is an extremely influential but generally neglected contributing factor of road crashes. This paper explores some of the common behaviours associated with several common forms of driver inattention, with respect to their perceived crash risks, rates of self-reported behaviours and whether drivers regulate such behaviours depending on the road and traffic environment, and provides some policy recommendations to address issues raised.

Mobile phone technology identifies and recruits trained citizens to perform CPR on out-of-hospital cardiac arrest victims prior to ambulance arrival.

Science.gov (United States)

Ringh, Mattias; Fredman, David; Nordberg, Per; Stark, Tomas; Hollenberg, Jacob

2011-12-01

In a two-parted study, evaluate a new concept were mobile phone technology is used to dispatch lay responders to nearby out-of-hospital cardiac arrests (OHCAs). Mobile phone positioning systems (MPS) can geographically locate selected mobile phone users at any given moment. A mobile phone service using MPS was developed and named Mobile Life Saver (MLS). Simulation study: 25 volunteers named mobile responders (MRs) were connected to MLS. Ambulance time intervals from 22 consecutive OHCAs in 2005 were used as controls. The MRs randomly moved in Stockholm city centre and were dispatched to simulated OHCAs (identical to controls) if they were within a 350 m distance. Real life study: during 25 weeks 1271-1801 MRs trained in CPR were connected to MLS. MLS was activated at the dispatch centre in parallel with ambulance dispatch when an OHCA was suspected. The MRs were dispatched if they were within 500 m from the suspected OHCA. Simulation study: mean response time for the MRs compared to historical ambulance time intervals was reduced by 2 min 20s (44%), pMobile phone technology can be used to identify and recruit nearby CPR-trained citizens to OHCAs for bystander CPR prior to ambulance arrival. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

Osteogenesis imperfecta in childhood: effects of spondylodesis on functional ability, ambulation and perceived competence

NARCIS (Netherlands)

Tolboom, N.; Cats, E. A.; Helders, P. J. M.; Pruijs, J. E. H.; Engelbert, R. H. H.

2004-01-01

We studied the effects of spondylodesis on spinal curvature, functional outcome, level of ambulation and perceived competence in 11 children with osteogenesis imperfecta (OI). Mean age at surgical intervention was 13.1 years (SD 2.5 years) and follow-up amounted to 3.4 years (SD 2.3 years). Spinal

Development and pilot testing of 24/7 in-ambulance telemedicine for acute stroke : prehospital stroke study at the Universitair Ziekenhuis Brussel-project

OpenAIRE

Espinoza, Alexis Valenzuela; Van Hooff, Robbert-Jan; De Smedt, Ann; Moens, Maarten; Yperzeele, Laetitia; Nieboer, Koenraad; Hubloue, Ives; de Keyser, Jacques; Convents, Andre; Tellez, Helio Fernandez; Dupont, Alain; Putman, Koen; Brouns, Raf

2016-01-01

Abstract: Background: In-ambulance telemedicine is a recently developed and a promising approach to improve emergency care. We implemented the first ever 24/7 in-ambulance telemedicine service for acute stroke. We report on our experiences with the development and pilot testing of the Prehospital Stroke Study at the Universitair Ziekenhuis Brussel (PreSSUB) to facilitate a wider spread of the knowledge regarding this technique. Methods: Successful execution of the project involved the develop...

Development and Pilot Testing of 24/7 In-Ambulance Telemedicine for Acute Stroke: Prehospital Stroke Study at the Universitair Ziekenhuis Brussel-Project

OpenAIRE

Espinoza, Alexis Valenzuela; Van Hooff, Robbert-Jan; De Smedt, Ann; Moens, Maarten; Yperzeele, Laetitia; Nieboer, Koenraad; Hubloue, Ives; de Keyser, Jacques; Convents, Andre; Tellez, Helio Fernandez; Dupont, Alain; Putman, Koen; Brouns, Raf

2016-01-01

Background: In-ambulance telemedicine is a recently developed and a promising approach to improve emergency care. We implemented the first ever 24/7 in-ambulance telemedicine service for acute stroke. We report on our experiences with the development and pilot testing of the Prehospital Stroke Study at the Universitair Ziekenhuis Brussel (PreSSUB) to facilitate a wider spread of the knowledge regarding this technique. Methods: Successful execution of the project involved the development and v...

Driving fatigue in professional drivers: a survey of truck and taxi drivers.

Science.gov (United States)

Meng, Fanxing; Li, Shuling; Cao, Lingzhi; Li, Musen; Peng, Qijia; Wang, Chunhui; Zhang, Wei

2015-01-01

Fatigue among truck drivers has been studied extensively; however, less is known regarding the fatigue experience of taxi drivers in heavily populated metropolitan areas. This study aimed to compare the differences and similarities between truck and taxi driver fatigue to provide implications for the fatigue management and education of professional drivers. A sample of 274 truck drivers and 286 taxi drivers in Beijing was surveyed via a questionnaire, which included items regarding work characteristics, fatigue experience, accident information, attitude toward fatigue, and methods of counteracting fatigue. Driver fatigue was prevalent among professional drivers, and it was even more serious for taxi drivers. Taxi drivers reported more frequent fatigue experiences and were involved in more accidents. Among the contributing factors to fatigue, prolonged driving time was the most important factor identified by both driver groups. Importantly, the reason for the engagement in prolonged driving was neither due to the lack of awareness concerning the serious outcome of fatigue driving nor because of their poor detection of fatigue. The most probable reason was the optimism bias, as a result of which these professional drivers thought that fatigue was more serious for other drivers than for themselves, and they thought that they were effective in counteracting the effect of fatigue on their driving performance. Moreover, truck drivers tended to employ methods that require stopping to counteract fatigue, whereas taxi drivers preferred methods that were simultaneous with driving. Although both driver groups considered taking a nap as one of the most effective means to address fatigue, this method was not commonly used. Interestingly, these drivers were aware that the methods they frequently used were not the most effective means to counteract fatigue. This study provides knowledge on truck and taxi drivers' characteristics in fatigue experience, fatigue attitude, and

EFFECT OF SHOE RAISE ALONG WITH MOTOR RELEARNING PROGRAMME (MRP ON AMBULATION IN CHRONIC STROKE

Directory of Open Access Journals (Sweden)

Gajanan Bhalerao

2016-06-01

Full Text Available Background: Stroke subjects face reduced tolerance to activity and sedentary lifestyle due to various impairments, such as muscle weakness, pain, spasticity, and poor balance. Thus, loss of independent ambulation especially outdoors is generally observed in them. Methods: Chronic stroke patients (> 6 months with Functional Ambulation Category score > 2 and able to walk at least 10 meters of distance with and without assistance from a tertiary healthcare centre were selected and treated. Subjects were randomly divided into 2 groups control group (n=14 and experimental group (n=13. Each group received Motor Relearning Programme for 60 minutes, 6 times a week for 4 weeks. The experimental group received an additional shoe-raise of 1 cm on the unaffected side along with while ambulating during therapy as well as at home. Pre and post treatment the patients were assessed for spatio-temporal parameters using foot print analysis method and Rivermead Visual Gait Assessment (RVGA Score using RVGA scale. Results: There was significant improvement seen in almost all the spatio-temporal gait parameters and RVGA score in within group analysis. Whereas on between group the results from between group comparison suggests that subjects in MRP with shoe-raise group showed better results in spatio-temporal parameters of gait than subjects receiving MRPalone. But there was no additional benefit of shoe-raise seen on RGVA score and angle of toe-out parameter. Conclusion: Additional use of shoe-raise helps to improve spatio-temporal gait parameters. However, there was no additional change seen in RVGA score.

The importance of manager support for the mental health and well-being of ambulance personnel.

Science.gov (United States)

Petrie, Katherine; Gayed, Aimée; Bryan, Bridget T; Deady, Mark; Madan, Ira; Savic, Anita; Wooldridge, Zoe; Counson, Isabelle; Calvo, Rafael A; Glozier, Nicholas; Harvey, Samuel B

2018-01-01

Interventions to enhance mental health and well-being within high risk industries such as the emergency services have typically focused on individual-level factors, though there is increasing interest in the role of organisational-level interventions. The aim of this study was to examine the importance of different aspects of manager support in determining the mental health of ambulance personnel. A cross-sectional survey was completed by ambulance personnel across two Australian states (N = 1,622). Demographics, manager support and mental health measures were assessed. Hierarchical multiple linear regressions were conducted to determine the explanatory influence of the employee's perception of the priority management places upon mental health issues (manager psychosocial safety climate) and managers' observed behaviours (manager behaviour) on employee common mental disorder and well-being within ambulance personnel. Of the 1,622 participants, 123 (7.6%) were found to be suffering from a likely mental disorder. Manager psychosocial safety climate accounted for a significant amount of the variance in levels of employee common mental health disorder symptoms (13%, pManager behaviour had a lesser, but still statistically significant influence upon symptoms of common mental disorder (7% of variance, pmanagement places on mental health and managers' actual behaviour are related but distinct concepts, and each appears to impact employee mental health. While the overall variance explained by each factor was limited, the fact that each is potentially modifiable makes this finding important and highlights the significance of organisational and team-level interventions to promote employee well-being within emergency services and other high-risk occupations.

North Star Ambulatory Assessment, 6-minute walk test and timed items in ambulant boys with Duchenne muscular dystrophy.

Science.gov (United States)

Mazzone, Elena; Martinelli, Diego; Berardinelli, Angela; Messina, Sonia; D'Amico, Adele; Vasco, Gessica; Main, Marion; Doglio, Luca; Politano, Luisa; Cavallaro, Filippo; Frosini, Silvia; Bello, Luca; Carlesi, Adelina; Bonetti, Anna Maria; Zucchini, Elisabetta; De Sanctis, Roberto; Scutifero, Marianna; Bianco, Flaviana; Rossi, Francesca; Motta, Maria Chiara; Sacco, Annalisa; Donati, Maria Alice; Mongini, Tiziana; Pini, Antonella; Battini, Roberta; Pegoraro, Elena; Pane, Marika; Pasquini, Elisabetta; Bruno, Claudio; Vita, Giuseppe; de Waure, Chiara; Bertini, Enrico; Mercuri, Eugenio

2010-11-01

The North Star Ambulatory Assessment is a functional scale specifically designed for ambulant boys affected by Duchenne muscular dystrophy (DMD). Recently the 6-minute walk test has also been used as an outcome measure in trials in DMD. The aim of our study was to assess a large cohort of ambulant boys affected by DMD using both North Star Assessment and 6-minute walk test. More specifically, we wished to establish the spectrum of findings for each measure and their correlation. This is a prospective multicentric study involving 10 centers. The cohort included 112 ambulant DMD boys of age ranging between 4.10 and 17 years (mean 8.18±2.3 DS). Ninety-one of the 112 were on steroids: 37/91 on intermittent and 54/91 on daily regimen. The scores on the North Star assessment ranged from 6/34 to 34/34. The distance on the 6-minute walk test ranged from 127 to 560.6 m. The time to walk 10 m was between 3 and 15 s. The time to rise from the floor ranged from 1 to 27.5 s. Some patients were unable to rise from the floor. As expected the results changed with age and were overall better in children treated with daily steroids. The North Star assessment had a moderate to good correlation with 6-minute walk test and with timed rising from floor but less with 10 m timed walk/run test. The 6-minute walk test in contrast had better correlation with 10 m timed walk/run test than with timed rising from floor. These findings suggest that a combination of these outcome measures can be effectively used in ambulant DMD boys and will provide information on different aspects of motor function, that may not be captured using a single measure. Copyright © 2010. Published by Elsevier B.V.

Assessment of consent models as an ethical consideration in the conduct of prehospital ambulance randomised controlled clinical trials: a systematic review

Directory of Open Access Journals (Sweden)

Stephanie Armstrong

2017-09-01

Full Text Available Abstract Background We sought to understand the main ethical considerations when conducting clinical trials in the prehospital ambulance based setting. Methods A systematic review of the literature on randomised controlled trials in ambulance settings was undertaken. A search of eight databases identified published studies involving recruitment of ambulance service users. Four independent authors undertook abstract and full-text reviews to determine eligibility and extract relevant data. The data extraction concentrated on ethical considerations, with any discussion of ethics being included for further analysis. The resultant data were combined to form a narrative synthesis. Results In all, 56 papers were identified as meeting the inclusion criteria. Issues relating to consent were the most significant theme identified. Type of consent differed depending on the condition or intervention being studied. The country in which the research took place did not appear to influence the type of consent, apart from the USA where exception from consent appeared to be most commonly used. A wide range of terms were used to describe consent. Conclusions Consent was the main ethical consideration in published ambulance based research. A range of consent models were used ranging from informed consent to exception from consent (waiver of consent. Many studies cited international guidelines as informing their choice of consent model but diverse and sometimes confused terms were used to describe these models. This suggests that standardisation of consent models and the terminology used to describe them is warranted.

Assessment of consent models as an ethical consideration in the conduct of prehospital ambulance randomised controlled clinical trials: a systematic review.

Science.gov (United States)

Armstrong, Stephanie; Langlois, Adele; Laparidou, Despina; Dixon, Mark; Appleton, Jason P; Bath, Philip M; Snooks, Helen; Siriwardena, A Niroshan

2017-09-16

We sought to understand the main ethical considerations when conducting clinical trials in the prehospital ambulance based setting. A systematic review of the literature on randomised controlled trials in ambulance settings was undertaken. A search of eight databases identified published studies involving recruitment of ambulance service users. Four independent authors undertook abstract and full-text reviews to determine eligibility and extract relevant data. The data extraction concentrated on ethical considerations, with any discussion of ethics being included for further analysis. The resultant data were combined to form a narrative synthesis. In all, 56 papers were identified as meeting the inclusion criteria. Issues relating to consent were the most significant theme identified. Type of consent differed depending on the condition or intervention being studied. The country in which the research took place did not appear to influence the type of consent, apart from the USA where exception from consent appeared to be most commonly used. A wide range of terms were used to describe consent. Consent was the main ethical consideration in published ambulance based research. A range of consent models were used ranging from informed consent to exception from consent (waiver of consent). Many studies cited international guidelines as informing their choice of consent model but diverse and sometimes confused terms were used to describe these models. This suggests that standardisation of consent models and the terminology used to describe them is warranted.

Development and Pilot Testing of 24/7 In-Ambulance Telemedicine for Acute Stroke: Prehospital Stroke Study at the Universitair Ziekenhuis Brussel-Project.

Science.gov (United States)

Valenzuela Espinoza, Alexis; Van Hooff, Robbert-Jan; De Smedt, Ann; Moens, Maarten; Yperzeele, Laetitia; Nieboer, Koenraad; Hubloue, Ives; de Keyser, Jacques; Convents, Andre; Fernandez Tellez, Helio; Dupont, Alain; Putman, Koen; Brouns, Raf

2016-01-01

In-ambulance telemedicine is a recently developed and a promising approach to improve emergency care. We implemented the first ever 24/7 in-ambulance telemedicine service for acute stroke. We report on our experiences with the development and pilot testing of the Prehospital Stroke Study at the Universitair Ziekenhuis Brussel (PreSSUB) to facilitate a wider spread of the knowledge regarding this technique. Successful execution of the project involved the development and validation of a novel stroke scale, design and creation of specific hardware and software solutions, execution of field tests for mobile internet connectivity, design of new care processes and information flows, recurrent training of all professional caregivers involved in acute stroke management, extensive testing on healthy volunteers, organisation of a 24/7 teleconsultation service by trained stroke experts and 24/7 technical support, and resolution of several legal issues. In all, it took 41 months of research and development to confirm the safety, technical feasibility, reliability, and user acceptance of the PreSSUB approach. Stroke-specific key information can be collected safely and reliably before and during ambulance transportation and can adequately be communicated with the inhospital team awaiting the patient. This paper portrays the key steps required and the lessons learned for successful implementation of a 24/7 expert telemedicine service supporting patients with acute stroke during ambulance transportation to the hospital. © 2016 S. Karger AG, Basel.

Posicionamento de ambulâncias do SAMU através de Programação Inteira e Teoria de Filas

OpenAIRE

Barreto,Bruno; Alexandrino,Fernando; Coelho,Ormeu

2016-01-01

Resumo: A configuração de redes logísticas para serviços de emergência é questão estratégica de imensa importância, visto que pequenas variações no tempo de resposta podem implicar na morte do solicitante. Partindo dessa premissa, o trabalho propõe novas alternativas de posicionamento para as ambulâncias do sistema SAMU na cidade de Duque de Caxias, RJ, capazes de reduzir o tempo de resposta do serviço. Essas propostas de reposicionamento das ambulâncias foram construídas em duas etapas: na p...

Locomotor diseases among male long-haul truck drivers and other professional drivers

DEFF Research Database (Denmark)

Jensen, Anker; Kaerlev, Linda; Tüchsen, Finn

2007-01-01

-249) and for other truck drivers (SHR: 130, 95% CI: 108-156) compared to bus drivers (SHR: 110, 95% CI: 79-149). All drivers had high SHR for lesions of the ulnar nerve (SHR: 159, 95% CI: 119-207), especially bus drivers (SHR: 197, 95% CI: 116-311). Long-haul truck drivers had high SHRs for synovitis and bursitis...

Rehabilitation of children and infants with osteogenesis imperfecta. A program for ambulation.

Science.gov (United States)

Gerber, L H; Binder, H; Weintrob, J; Grange, D K; Shapiro, J; Fromherz, W; Berry, R; Conway, A; Nason, S; Marini, J

1990-02-01

Management of children and infants with osteogenesis imperfecta (OI) poses difficult decisions for pediatricians, orthopedists, and physiatrists. These children are frequently frail with disabling bone and joint deformities and fractures. In an eight-year cumulative management of 12 children with OI, a comprehensive program included strengthening exercises to the pelvic girdle and lower extremity muscles, in addition to pool exercises and molded seating to support upright posture. Long leg braces were fitted when the children were able to sit unsupported. All 12 were fitted with braces; nine were functional ambulators, and three were home ambulators. Six children required femoral plating or rodding, two of whom subsequently had the metal removed. Lower extremity fractures averaged one and one-half per year prior to bracing for nine children who had fractures. There was 0.83 fracture per year for the ten children who had fractures after bracing. The degree of femoral bowing increased in four, decreased in four, and remained unchanged in four, while the degree of tibial bowing increased in two, decreased in nine, and remained unchanged in one during the observation period. A comprehensive rehabilitation program and long leg bracing with surgical operations on the femur result in a high level of functional activity for children with OI with an acceptable level of risk for fracture.

75 FR 62639 - Air Ambulance and Commercial Helicopter Operations, Part 91 Helicopter Operations, and Part 135...

Science.gov (United States)

2010-10-12

... helicopter air ambulance operators implement a safety management system program that includes sound risk... partially address NTSB Safety Recommendation A-09-89 regarding the implementation of sound risk management... documents. Authority for This Rulemaking The FAA's authority to issue rules on aviation safety is found in...

Telehealth-Enabled Emergency Medical Services Program Reduces Ambulance Transport to Urban Emergency Departments.

Science.gov (United States)

Langabeer, James R; Gonzalez, Michael; Alqusairi, Diaa; Champagne-Langabeer, Tiffany; Jackson, Adria; Mikhail, Jennifer; Persse, David

2016-11-01

Emergency medical services (EMS) agencies transport a significant majority of patients with low acuity and non-emergent conditions to local emergency departments (ED), affecting the entire emergency care system's capacity and performance. Opportunities exist for alternative models that integrate technology, telehealth, and more appropriately aligned patient navigation. While a limited number of programs have evolved recently, no empirical evidence exists for their efficacy. This research describes the development and comparative effectiveness of one large urban program. The Houston Fire Department initiated the Emergency Telehealth and Navigation (ETHAN) program in 2014. ETHAN combines telehealth, social services, and alternative transportation to navigate primary care-related patients away from the ED where possible. Using a case-control study design, we describe the program and compare differences in effectiveness measures relative to the control group. During the first 12 months, 5,570 patients participated in the telehealth-enabled program, which were compared against the same size control group. We found a 56% absolute reduction in ambulance transports to the ED with the intervention compared to the control group (18% vs. 74%, P models are effective at reducing unnecessary ED ambulance transports and increasing EMS unit productivity. This provides support for broader EMS mobile integrated health programs in other regions.

The importance of manager support for the mental health and well-being of ambulance personnel.

Directory of Open Access Journals (Sweden)

Katherine Petrie

Full Text Available Interventions to enhance mental health and well-being within high risk industries such as the emergency services have typically focused on individual-level factors, though there is increasing interest in the role of organisational-level interventions. The aim of this study was to examine the importance of different aspects of manager support in determining the mental health of ambulance personnel. A cross-sectional survey was completed by ambulance personnel across two Australian states (N = 1,622. Demographics, manager support and mental health measures were assessed. Hierarchical multiple linear regressions were conducted to determine the explanatory influence of the employee's perception of the priority management places upon mental health issues (manager psychosocial safety climate and managers' observed behaviours (manager behaviour on employee common mental disorder and well-being within ambulance personnel. Of the 1,622 participants, 123 (7.6% were found to be suffering from a likely mental disorder. Manager psychosocial safety climate accounted for a significant amount of the variance in levels of employee common mental health disorder symptoms (13%, p<0.01 and well-being (13%, p<0.01. Manager behaviour had a lesser, but still statistically significant influence upon symptoms of common mental disorder (7% of variance, p<0.01 and well-being (10% of variance, p<0.05. The perceived importance management places on mental health and managers' actual behaviour are related but distinct concepts, and each appears to impact employee mental health. While the overall variance explained by each factor was limited, the fact that each is potentially modifiable makes this finding important and highlights the significance of organisational and team-level interventions to promote employee well-being within emergency services and other high-risk occupations.

Driver style and driver skill – Clustering sub-groups of drivers differing in their potential danger in traffic

DEFF Research Database (Denmark)

Martinussen, Laila Marianne; Møller, Mette; Prato, Carlo Giacomo

The Driver Behavior Questionnaire (DBQ) and the Driver Skill Inventory (DSI) are two of the most frequently used measures of self-reported driving style and driving skill. The motivation behind the present study was to test drivers’ consistency or judgment of their own self-reported driving ability...... based on a combined use of the DBQ and the DSI. Moreover, the joint use of the two instruments was applied to identify sub-groups of drivers that differ in their potential danger in traffic (as measured by frequency of aberrant driving behaviors and level of driving skills), as well as to test whether...... the sub-groups of drivers differed in characteristics such as age, gender, annual mileage and accident involvement. 3908 drivers aged 18–84 participated in the survey. The results suggested that the drivers are consistent in their reporting of driving ability, as the self-reported driving skill level...

Kin-Driver: a database of driver mutations in protein kinases.

Science.gov (United States)

Simonetti, Franco L; Tornador, Cristian; Nabau-Moretó, Nuria; Molina-Vila, Miguel A; Marino-Buslje, Cristina

2014-01-01

Somatic mutations in protein kinases (PKs) are frequent driver events in many human tumors, while germ-line mutations are associated with hereditary diseases. Here we present Kin-driver, the first database that compiles driver mutations in PKs with experimental evidence demonstrating their functional role. Kin-driver is a manual expert-curated database that pays special attention to activating mutations (AMs) and can serve as a validation set to develop new generation tools focused on the prediction of gain-of-function driver mutations. It also offers an easy and intuitive environment to facilitate the visualization and analysis of mutations in PKs. Because all mutations are mapped onto a multiple sequence alignment, analogue positions between kinases can be identified and tentative new mutations can be proposed for studying by transferring annotation. Finally, our database can also be of use to clinical and translational laboratories, helping them to identify uncommon AMs that can correlate with response to new antitumor drugs. The website was developed using PHP and JavaScript, which are supported by all major browsers; the database was built using MySQL server. Kin-driver is available at: http://kin-driver.leloir.org.ar/ © The Author(s) 2014. Published by Oxford University Press.

Quality of closed chest compression on a manikin in ambulance vehicles and flying helicopters with a real time automated feedback.

Science.gov (United States)

Havel, Christof; Schreiber, Wolfgang; Trimmel, Helmut; Malzer, Reinhard; Haugk, Moritz; Richling, Nina; Riedmüller, Eva; Sterz, Fritz; Herkner, Harald

2010-01-01

Automated verbal and visual feedback improves quality of resuscitation in out-of-hospital cardiac arrest and was proven to increase short-term survival. Quality of resuscitation may be hampered in more difficult situations like emergency transportation. Currently there is no evidence if feedback devices can improve resuscitation quality during different modes of transportation. To assess the effect of real time automated feedback on the quality of resuscitation in an emergency transportation setting. Randomised cross-over trial. Medical University of Vienna, Vienna Municipal Ambulance Service and Helicopter Emergency Medical Service Unit (Christophorus Flugrettungsverein) in September 2007. European Resuscitation Council (ERC) certified health care professionals performing CPR in a flying helicopter and in a moving ambulance vehicle on a manikin with human-like chest properties. CPR sessions, with real time automated feedback as the intervention and standard CPR without feedback as control. Quality of chest compression during resuscitation. Feedback resulted in less deviation from ideal compression rate 100 min(-1) (9+/-9 min(-1), ptime. Applied work was less in the feedback group compared to controls (373+/-448 cm x compression; ptime automated feedback improves certain aspects of CPR quality in flying helicopters and moving ambulance vehicles. The effect of feedback guidance was most pronounced for chest compression rate. Copyright 2009 Elsevier Ireland Ltd. All rights reserved.

Feasibility of AmbulanCe-Based Telemedicine (FACT) Study : Safety, Feasibility and Reliability of Third Generation Ambulance Telemedicine

NARCIS (Netherlands)

Yperzeele, Laetitia; Van Hooff, Robbert-Jan; De Smedt, Ann; Espinoza, Alexis Valenzuela; Van Dyck, Rita; Van de Casseye, Rohny; Convents, Andre; Hubloue, Ives; Lauwaert, Door; De Keyser, Jacques; Brouns, Raf

2014-01-01

Background: Telemedicine is currently mainly applied as an in-hospital service, but this technology also holds potential to improve emergency care in the prehospital arena. We report on the safety, feasibility and reliability of in-ambulance teleconsultation using a telemedicine system of the third

Body weight-supported bedside treadmill training facilitates ambulation in ICU patients: An interventional proof of concept study

NARCIS (Netherlands)

Sommers, Juultje; Wieferink, Denise C.; Dongelmans, Dave A.; Nollet, Frans; Engelbert, Raoul H. H.; van der Schaaf, Marike

2017-01-01

Purpose: Early mobilisation is advocated to improve recovery of intensive care unit (ICU) survivors. However, severe weakness in combination with tubes, lines and machinery are practical barriers for the implementation of ambulation with critically ill patients. The aim of this study was to explore

Driver style and driver skills – clustering drivers differing in their potential danger in traffic

DEFF Research Database (Denmark)

Martinussen, Laila Marianne; Møller, Mette; Prato, Carlo Giacomo

The Driver Behavior Questionnaire (DBQ) and the Driver Skill Inventory (DSI) are two of the most frequently used measures of driving style and driving skill. The motivation behind the present study was to test drivers’ insight into their own driving ability based on a combined use of the DBQ......, annual mileage and accident involvement. 3908 drivers aged 18–84 participated in the survey. The results suggested that the drivers have good insight into their own driving ability, as the driving skill level mirrored the frequency of aberrant driving behaviors. K-means cluster analysis revealed four...... distinct clusters that differed in the frequency of aberrant driving behavior and driving skills, as well as individual characteristics and driving related factors such as annual mileage, accident frequency and number of tickets and fines. Thus, two sub-groups were identified as more unsafe than the two...

Schoolbus driver performance can be improved with driver training ...

African Journals Online (AJOL)

and compares the school transport driver performance with that of general motorists. Despite concerns that ... To compare Safe Travel to School Programme driver safety perfor- .... The SA government has recognised the challenges faced with.

Heavy-ion driver parametric studies and choice of a base 5 mega-joule driver design

International Nuclear Information System (INIS)

Bieri, R.; Meier, W.

1992-01-01

Parametric studies to optimize heavy-ion driver designs are described and an optimized 5 MJ driver design is described. Parametric studies are done on driver parameters including driver energy, number of beams, type of superconductor used in focusing magnets, maximum magnetic field allowed at the superconducting windings, axial quadrupole field packing fraction, ion mass, and ion charge state. All modeled drivers use the maximum beam currents allowed by the Maschke limits; driver scaling is described in a companion paper. The optimized driver described is conservative and cost effective. The base driver direct costs are only $120/Joule, and the base driver uses no recirculation, beam combination, or beam separation. The low driver cost achieved is due, in part, to the use of compact Nb 3 Sn quadrupole arrays, but results primarily from optimization over the large, multi-dimensional, parameter space available for heavy-ion drivers

Hospital survival upon discharge of ill‐neonates transported by ground or air ambulance to a tertiary center

Directory of Open Access Journals (Sweden)

Jorge Luis Alvarado‐Socarras

2016-05-01

Conclusions: Mode of transport was not associated with the outcome. In Colombia, access to medical services through air transport is a good option for neonates in critical condition. Further studies would determine the optimum distance (time of transportation to obtain good clinical outcomes according type of ambulance.

Peripubertal castration of male rats, adult open field ambulation and partner preference behavior.

Science.gov (United States)

Brand, T; Slob, A K

1988-09-15

The validity of the hypothesis put forward earlier, that testicular secretions during puberty have an organizing effect on open field ambulation was examined. Male rats were castrated or sham-operated at days 21, 43 or 70. At the age of 17 weeks the males were tested in an automated, octagonal open field (3 consecutive days, 3 min/day) for locomotor activity. Male rats castrated at day 21 or day 43 ambulated more than sham-castrated controls. Males castrated at day 70 did not differ from sham-castrated controls. It thus appears that pubertal testicular secretion(s) organize adult open field locomotor activity in male rats. From 18 weeks of age partner preference behavior was tested in the same open field apparatus with one adjacent cage containing an ovariectomized female and an opposite one containing an ovariectomized female brought into heat. The females in the adjacent cages were separated from the experimental males in the octagonal cage by wire mesh. Peripubertally castrated males did not show a clear-cut partner preference, whereas the intact males preferred the vicinity of the estrous female. There were no differences among the males castrated either before, during or after puberty. Testosterone treatment (crystalline T in silastic capsules) caused peripubertally castrated males to prefer the estrous female. Thus, adult partner preference behavior does not seem to be organized by peripubertal testicular androgens.

Action observation training of community ambulation for improving walking ability of patients with post-stroke hemiparesis: a randomized controlled pilot trial.

Science.gov (United States)

Park, Hyun-Ju; Oh, Duck-Won; Choi, Jong-Duk; Kim, Jong-Man; Kim, Suhn-Yeop; Cha, Yong-Jun; Jeon, Su-Jin

2017-08-01

To investigate the effects of action observation training involving community-based ambulation for improving walking ability after stroke. Randomized, controlled pilot study. Inpatient rehabilitation hospital. A total of 25 inpatients with post-stroke hemiparesis were randomly assigned to either the experimental group ( n = 12) or control group ( n = 13). Subjects of the experimental group watched video clips demonstrating four-staged ambulation training with a more complex environment factor for 30 minutes, three times a week for four weeks. Meanwhile, subjects of the control group watched video clips, which showed different landscape pictures. Walking function was evaluated before and after the four-week intervention using a 10-m walk test, community walk test, activities-specific balance confidence scale, and spatiotemporal gait measures. Changes in the values for the 10-m walk test (0.17 ±0.19 m/s vs. 0.05 ±0.08 m/s), community walk test (-151.42 ±123.82 seconds vs. 67.08 ±176.77 seconds), and activities-specific balance confidence (6.25 ±5.61 scores vs. 0.72 ±2.24 scores) and the spatiotemporal parameters (i.e. stride length (19.00 ±11.34 cm vs. 3.16 ±11.20 cm), single support (5.87 ±5.13% vs. 0.25 ±5.95%), and velocity (15.66 ±12.34 cm/s vs. 2.96 ±10.54 cm/s)) indicated a significant improvement in the experimental group compared with the control group. In the experimental group, walking function and ambulation confidence was significantly different between the pre- and post-intervention, whereas the control group showed a significant difference only in the 10-m walk test. Action observation training of community ambulation may be favorably used for improving walking function of patients with post-stroke hemiparesis.

Negativity Bias in Dangerous Drivers.

Directory of Open Access Journals (Sweden)

Jing Chai

Full Text Available The behavioral and cognitive characteristics of dangerous drivers differ significantly from those of safe drivers. However, differences in emotional information processing have seldom been investigated. Previous studies have revealed that drivers with higher anger/anxiety trait scores are more likely to be involved in crashes and that individuals with higher anger traits exhibit stronger negativity biases when processing emotions compared with control groups. However, researchers have not explored the relationship between emotional information processing and driving behavior. In this study, we examined the emotional information processing differences between dangerous drivers and safe drivers. Thirty-eight non-professional drivers were divided into two groups according to the penalty points that they had accrued for traffic violations: 15 drivers with 6 or more points were included in the dangerous driver group, and 23 drivers with 3 or fewer points were included in the safe driver group. The emotional Stroop task was used to measure negativity biases, and both behavioral and electroencephalograph data were recorded. The behavioral results revealed stronger negativity biases in the dangerous drivers than in the safe drivers. The bias score was correlated with self-reported dangerous driving behavior. Drivers with strong negativity biases reported having been involved in mores crashes compared with the less-biased drivers. The event-related potentials (ERPs revealed that the dangerous drivers exhibited reduced P3 components when responding to negative stimuli, suggesting decreased inhibitory control of information that is task-irrelevant but emotionally salient. The influence of negativity bias provides one possible explanation of the effects of individual differences on dangerous driving behavior and traffic crashes.

Education and driver-training

Directory of Open Access Journals (Sweden)

Andrej Justinek

1999-12-01

Full Text Available The characteristics of the driver are manifested in his/her behaviour. For safe driving one must have a driver's knowledge. The contents of educational material are determined by law, and are both theoretical and practical, yet frequently they do not suffice to meet the requirements of safe driving. In this paper, the author suggests that, in the training of drivers, more educational elements should be included, such a would have  an effective influence on the driver's moti ves and attitudes. The driver's motives - which may result in incorrect driving­ are diverse: most often, the default is overspeeding, even though the drivers always over-estimate the potential time gain. In fact, over-fast driving is a way of satisfying other, different needs; and, above all, it is a form of compensation for unsettled life problems, and at the same time an indication of the driver's personal inability to cope with stress.

Reducing risky driver behaviour through the implementation of a driver risk management system

Directory of Open Access Journals (Sweden)

Rose Luke

2014-11-01

Full Text Available South Africa has one of the highest incidences of road accidents in the world. Most accidents are avoidable and are caused by driver behaviour and errors. The purpose of this article was to identify the riskiest driver behaviours in commercial fleets in South Africa, to determine the business impact of such behaviour, to establish a framework for the management of risky driver behaviour and to test the framework by applying a leading commercial driver behaviour management system as a case study. The case study comprised three South African commercial fleets. Using data from these fleets, critical incident triangles were used to determine the ratio data of risky driver behaviour to near-collisions and collisions. Based on managing the riskiest driver behaviours as causes of more serious incidents and accidents, the results indicated that through the implementation of an effective driver risk management system, risky incidents were significantly reduced.

Assessing drivers' response during automated driver support system failures with non-driving tasks.

Science.gov (United States)

Shen, Sijun; Neyens, David M

2017-06-01

With the increase in automated driver support systems, drivers are shifting from operating their vehicles to supervising their automation. As a result, it is important to understand how drivers interact with these automated systems and evaluate their effect on driver responses to safety critical events. This study aimed to identify how drivers responded when experiencing a safety critical event in automated vehicles while also engaged in non-driving tasks. In total 48 participants were included in this driving simulator study with two levels of automated driving: (a) driving with no automation and (b) driving with adaptive cruise control (ACC) and lane keeping (LK) systems engaged; and also two levels of a non-driving task (a) watching a movie or (b) no non-driving task. In addition to driving performance measures, non-driving task performance and the mean glance duration for the non-driving task were compared between the two levels of automated driving. Drivers using the automated systems responded worse than those manually driving in terms of reaction time, lane departure duration, and maximum steering wheel angle to an induced lane departure event. These results also found that non-driving tasks further impaired driver responses to a safety critical event in the automated system condition. In the automated driving condition, driver responses to the safety critical events were slower, especially when engaged in a non-driving task. Traditional driver performance variables may not necessarily effectively and accurately evaluate driver responses to events when supervising autonomous vehicle systems. Thus, it is important to develop and use appropriate variables to quantify drivers' performance under these conditions. Copyright © 2017 Elsevier Ltd and National Safety Council. All rights reserved.

The analysis of the cases of circulatory and respiratory arrest in the work of the Regional Unit of Ambulance Service - Sródmieście Station.

Science.gov (United States)

Chemperek, Ewa; Mikuła, Agnieszka; Goniewicz, Mariusz; Krawczyk, Wojciech

2004-01-01

The major causes of deaths all over the world are circulatory system diseases, neoplasms and injuries. Each man can become a participant of the event which results in life-threatening emergencies and the most immediate possible actions are essential. The period of time for starting efficient life-restoration actions is very short, estimated at 4-5 minutes. Ambulance Service is a medical organization created to apply aid in life-threatening emergencies. The standards of the developed western countries determine the arrival time at 7-10 minutes from the call time. Both first-aid applied by the accident witnesses and efficient actions of ambulance service have significance for effective pre-hospital aid and increasing the chances of survival of people in need. The study analysed emergency records of the ambulance cars of the Regional Unit of Ambulance Service - Sródmieście Station in Lublin in the year 2000. 3,723 calls were recorded. In 142 cases complete resuscitation actions were carried out due to circulatory and respiratory arrest. The records selected this way went through a detailed analysis. In 3.8% of the interventions of emergency teams the necessity of applying advanced life support was observed. The time of arrival at the scene, transport of the patient to the admission room as well as efficiency of resuscitation comply with the European standards. The efficiency of resuscitation actions estimated at 51.4% depended on the age of the patient, the cause of circulatory and respiratory arrest and ambulance arrival time. Taking up basic life support by witnesses of the event was observed in 2.8% of cases, in 8.5% aid was applied by the medical staff members who happened to be at the scene.

Modeling of Driver Steering Operations in Lateral Wind Disturbances toward Driver Assistance System

Science.gov (United States)

Kurata, Yoshinori; Wada, Takahiro; Kamiji, Norimasa; Doi, Shun'ichi

Disturbances decrease vehicle stability and increase driver's mental and physical workload. Especially unexpected disturbances such as lateral winds have severe effect on vehicle stability and driver's workload. This study aims at building a driver model of steering operations in lateral wind toward developing effective driver assistance system. First, the relationship between the driver's lateral motion and its reactive quick steering behavior is investigated using driving simulator with lateral 1dof motion. In the experiments, four different wind patterns are displayed by the simulator. As the results, strong correlation was found between the driver's head lateral jerk by the lateral disturbance and the angular acceleration of the steering wheel. Then, we build a mathematical model of driver's steering model from lateral disturbance input to steering torque of the reactive quick feed-forward steering based on the experimental results. Finally, validity of the proposed model is shown by comparing the steering torque of experimental results and that of simulation results.

Examination of supplemental driver training and online basic driver education courses : traffic tech.

Science.gov (United States)

2012-08-01

The first six months of unsupervised driving are the most : hazardous in a novice drivers driving experience. Most : States adopted graduated driver licensing (GDL) systems : to give novice drivers experience in a protective environment, : gradual...

An application of the driver behavior questionnaire to Chinese carless young drivers.

Science.gov (United States)

Zhang, Qian; Jiang, Zuhua; Zheng, Dongpeng; Wang, Yifan; Man, Dong

2013-01-01

Carless young drivers refers to those drivers aged between 18 and 25 years who have a driver's license but seldom have opportunities to practice their driving skills because they do not have their own cars. Due to China's lower private car ownership, many young drivers turn into carless young drivers after licensure, and the safety issue associated with them has become a matter of great concern in China. Because few studies have examined the driving behaviors of these drivers, this study aims to utilize the Driver Behavior Questionnaire (DBQ) to investigate the self-reported driving behaviors of Chinese carless young drivers. A total of 523 Chinese carless young drivers (214 females, 309 males) with an average age of 21.91 years completed a questionnaire including the 27-item DBQ and demographics. The data were first randomized into 2 subsamples for factor analysis and then combined together for the following analyses. Both an exploratory factor analysis (EFA, n = 174) and a confirmatory factor analysis (CFA, n = 349) were performed to investigate the factor structure of the DBQ. Correlation analysis was conducted to examine the relationships between the demographics and the DBQ scales' variables. Multivariate linear regression and logistic regression were performed to investigate the prediction of the DBQ scales and crash involvement in the previous year. The EFA produced a 4-factor structure identified as errors, violations, attention lapses, and memory lapses, and the CFA revealed a good model fit after the removal of one item with a low factor loading and the permission of the error covariance between some items. The Chinese carless young drivers reported a comparatively low level of aberrant driving behaviors. The 3 most frequently reported behaviors were all lapses and the 3 least were all violations. Gender was the only significant predictor of the 2 lapses scales and lifetime mileage was the only significant predictor of the violations scale. Only the

Reducing Ambulance Diversion at Hospital and Regional Levels: Systemic Review of Insights from Simulation Models

OpenAIRE

Delgado, M. Kit; Meng, Lesley J.; Mercer, Mary P.; Pines, Jesse M.; Owens, Douglas K.; Zaric, Gregory S.

2013-01-01

Introduction: Optimal solutions for reducing diversion without worsening emergency department (ED) crowding are unclear. We performed a systematic review of published simulation studies to identify: 1) the tradeoff between ambulance diversion and ED wait times; 2) the predicted impact of patient flow interventions on reducing diversion; and 3) the optimal regional strategy for reducing diversion. Methods: Data Sources: Systematic review of articles using MEDLINE, Inspec, Scopus. Additional st...

Task-specific gross motor skills training for ambulant school-aged children with cerebral palsy: a systematic review.

Science.gov (United States)

Toovey, Rachel; Bernie, Charmaine; Harvey, Adrienne R; McGinley, Jennifer L; Spittle, Alicia J

2017-01-01

The primary objective is to systematically evaluate the evidence for the effectiveness of task-specific training (TST) of gross motor skills for improving activity and/or participation outcomes in ambulant school-aged children with cerebral palsy (CP). The secondary objective is to identify motor learning strategies reported within TST and assess relationship to outcome. Systematic review. Relevant databases were searched for studies including: children with CP (mean age >4 years and >60% of the sample ambulant); TST targeting gross motor skills and activity (skill performance, gross motor function and functional skills) and/or participation-related outcomes. Quality of included studies was assessed using standardised tools for risk of bias, study design and quality of evidence across outcomes. Continuous data were summarised for each study using standardised mean difference (SMD) and 95% CIs. Thirteen studies met inclusion criteria: eight randomised controlled trials (RCTs), three comparative studies, one repeated-measures study and one single-subject design study. Risk of bias was moderate across studies. Components of TST varied and were often poorly reported. Within-group effects of TST were positive across all outcomes of interest in 11 studies. In RCTs, between-group effects were conflicting for skill performance and functional skills, positive for participation-related outcomes (one study: Life-HABITS performance SMD=1.19, 95% CI 0.3 to 2.07, pmotor function. The quality of evidence was low-to-moderate overall. Variability and poor reporting of motor learning strategies limited assessment of relationship to outcome. Limited evidence for TST for gross motor skills in ambulant children with CP exists for improving activity and participation-related outcomes and recommendations for use over other interventions are limited by poor study methodology and heterogeneous interventions. PROSPERO ID42016036727.

Characteristics of Chinese Driver Behavior

NARCIS (Netherlands)

Li, J.

2014-01-01

The high growth rate of vehicle ownership and many novel drivers in China determine the special features of Chinese driver behavior. This thesis introduces a comparative study on driver behavior by the analysis of saturation flow at urban intersections, Driver Behavior Questionnaire surveys, focus

Living in critical times: The impact of critical incidents on frontline ambulance personnel--a qualitative perspective.

LENUS (Irish Health Repository)

Gallagher, Sharon

2007-01-01

Little is known about the impact of Critical Incidents (CIs) on the lives of ambulance personnel. One-to-one interviews were conducted with 27 participants who had experienced CIs during the previous 12 months in order to: assess the nature and impact of CIs on health and well-being; examine attitudes toward support services; and explore barriers to service use. The results showed that incidents involving children, suicides, and grotesque mutilation were the most distressing. Participants reported a wide range of physical and mental health problems including sleep difficulties, angry outbursts, irrationality and feelings of alienation. Key themes included: low support service uptake due to fears relating to confidentiality and machismo; a perceived lack of concern and support from management; and a need for professional counselling and stress awareness training. Emergency Medical Controllers (EMCs) also reported a number of difficulties unique to their role. The findings suggest that exposure to CIs has a significant impact on health and well-being; this has important implications for recognizing and appropriately addressing the health and training needs of ambulance personnel, including the effective management of Critical Incident Stress.

Referral to the Hospital And Emergency Ambulance Service Uses Patterns of the Inmates and Convicts

Directory of Open Access Journals (Sweden)

Emine Oncu

2014-03-01

Full Text Available Aim: The purpose of this study was to determine the reasons for referral to the hospital and 112 emergency ambulance service uses patterns of the inmates and convicts in an E type prison. Material and Method: In this descriptive study, it was evaluated the prison records associated with referral to the hospital and 112 emergency ambulance service uses for one year in 2010- 2011. Of the statistical analysis, descriptive statistics, chi-square test and Fisher%u2019s Exact Test were used. Results: All inmates and convicts were man, the median of age was 30,0 (min 18- max 68 years and substance use was 34,5%. The number of prisoners were referred to the hospital 815, total referrals were 1491; (referrals ranged from one to six and most common in January; and according to frequency, reasons of the referral were eyes problems, musculoskeletal disorders and psychological problems. Emergency medical service was used for in medical causes (78,3%, accident, trauma and injuries (16,4%, suicide (5,3%. Discussion: Findings from the study show that prisoners are more likely to have suffered physical and mental health problems that compared to the rest of society and have significantly high substance use rates.

Acoustic Levitation With One Driver

Science.gov (United States)

Wang, T. G.; Rudnick, I.; Elleman, D. D.; Stoneburner, J. D.

1985-01-01

Report discusses acoustic levitation in rectangular chamber using one driver mounted at corner. Placement of driver at corner enables it to couple effectively to acoustic modes along all three axes. Use of single driver reduces cost, complexity and weight of levitation system below those of three driver system.

Home Discharge and Out-of-Hospital Follow-Up of Total Artificial Heart Patients Supported by a Portable Driver System

Science.gov (United States)

2014-01-01

To enhance ambulation and facilitate hospital discharge of total artificial heart (TAH)–supported patients, we adapted a mobile ventricular assistance device (VAD) driver (Excor) for TAH use and report on the performance of Excor-driven TAH patients discharged home. Ten patients stabilized on a TAH, driven by the CSS (“Circulatory Support System”), were progressively switched over to the Excor in hospital over 14 days as a pilot, with daily hemodynamics and laboratory parameters measured. Twenty-two stable TAH patients were subsequently placed on the Excor, trained, and discharged home. Clinical and hemodynamic parameters were followed. All pilot study patients were clinically stable on the Excor, with no decrease in TAH output noted (6.3 + 0.3 L/min [day 1] vs. 5.8 + 0.2 L/min [day 14], p = 0.174), with a trend suggesting improvement of both hepatic and renal function. Twenty-two TAH patients were subsequently successfully discharged home on the portable driver and were supported out of hospital for up to 598 days (range, 2–598; mean = 179 ± 140 days), remaining ambulatory, New York Heart Association (NYHA) class I or II, and free of readmission for 88.5% of the time of support. TAH patients may be effectively and safely supported by a mobile drive system. As such, the utility of the TAH may be extended to support patients beyond the hospital, at home, with overall ambulatory freedom. PMID:24577369

Managing emergency department overcrowding via ambulance diversion: a discrete event simulation model.

Science.gov (United States)

Lin, Chih-Hao; Kao, Chung-Yao; Huang, Chong-Ye

2015-01-01

Ambulance diversion (AD) is considered one of the possible solutions to relieve emergency department (ED) overcrowding. Study of the effectiveness of various AD strategies is prerequisite for policy-making. Our aim is to develop a tool that quantitatively evaluates the effectiveness of various AD strategies. A simulation model and a computer simulation program were developed. Three sets of simulations were executed to evaluate AD initiating criteria, patient-blocking rules, and AD intervals, respectively. The crowdedness index, the patient waiting time for service, and the percentage of adverse patients were assessed to determine the effect of various AD policies. Simulation results suggest that, in a certain setting, the best timing for implementing AD is when the crowdedness index reaches the critical value, 1.0 - an indicator that ED is operating at its maximal capacity. The strategy to divert all patients transported by ambulance is more effective than to divert either high-acuity patients only or low-acuity patients only. Given a total allowable AD duration, implementing AD multiple times with short intervals generally has better effect than having a single AD with maximal allowable duration. An input-throughput-output simulation model is proposed for simulating ED operation. Effectiveness of several AD strategies on relieving ED overcrowding was assessed via computer simulations based on this model. By appropriate parameter settings, the model can represent medical resource providers of different scales. It is also feasible to expand the simulations to evaluate the effect of AD strategies on a community basis. The results may offer insights for making effective AD policies. Copyright © 2012. Published by Elsevier B.V.

Assessing the relationship between the Driver Behavior Questionnaire and the Driver Skill Inventory: Revealing sub-groups of drivers

DEFF Research Database (Denmark)

Martinussen, Laila Marianne; Møller, Mette; Prato, Carlo Giacomo

2014-01-01

The Driver Behavior Questionnaire and the Driver Skill Inventory are two of the most frequently used measures of self-reported driving style and driving skill. The motivation behind the present study was to identify sub-groups of drivers that potentially act dangerously in traffic (as measured...... self-reported driving skills and whether the reported skill level was reflected in the reported aberrant driving behaviors. 3908 drivers aged 18–84 participated in the survey. K-means cluster analysis revealed four distinct sub-groups that differed in driving skills and frequency of aberrant driving...... by frequency of aberrant driving behaviors and level of driving skills), as well as to test whether the sub-groups differ in characteristics such as age, gender, annual mileage and accident involvement. Furthermore, the joint analysis of the two instruments was used to test drivers’ assessment of their own...

Heavy-ion driver design and scaling

International Nuclear Information System (INIS)

Bieri, R.; Monsler, M.; Meier, W.; Stewart, L.

1992-01-01

Parametric models for scaling heavy-ion driver designs are described. Scaling of target performance and driver cost is done for driver parameters including driver energy, number of beams, type of superconductor used in focusing magnets, maximum magnetic field allowed at the superconducting windings, linear quadrupole array packing fraction mass, and ion charge state. The cumulative accelerator voltage and beam currents are determined from the Maschke limits on beam current for each choice of driver energy and post-acceleration pulse duration. The heavy-ion driver is optimized over the large available driver parameter space. Parametric studies and the choice of a base driver model are described in a companion paper

Older drivers : a review.

NARCIS (Netherlands)

Hakamies-Blomqvist, L. Sirén, A. & Davidse, R.J.

2004-01-01

The proportion of senior citizens (aged 65+) will grow from about 15 per cent in the year 2000 to about 30 per cent in the year 2050. The share of older drivers in the driver population will grow even faster because of increasing licensing rates among the ageing population. Older drivers do not have

Comparing population and incident data for optimal air ambulance base locations in Norway.

Science.gov (United States)

Røislien, Jo; van den Berg, Pieter L; Lindner, Thomas; Zakariassen, Erik; Uleberg, Oddvar; Aardal, Karen; van Essen, J Theresia

2018-05-24

Helicopter emergency medical services are important in many health care systems. Norway has a nationwide physician manned air ambulance service servicing a country with large geographical variations in population density and incident frequencies. The aim of the study was to compare optimal air ambulance base locations using both population and incident data. We used municipality population and incident data for Norway from 2015. The 428 municipalities had a median (5-95 percentile) of 4675 (940-36,264) inhabitants and 10 (2-38) incidents. Optimal helicopter base locations were estimated using the Maximal Covering Location Problem (MCLP) optimization model, exploring the number and location of bases needed to cover various fractions of the population for time thresholds 30 and 45 min, in green field scenarios and conditioned on the existing base structure. The existing bases covered 96.90% of the population and 91.86% of the incidents for time threshold 45 min. Correlation between municipality population and incident frequencies was -0.0027, and optimal base locations varied markedly between the two data types, particularly when lowering the target time. The optimal solution using population density data put focus on the greater Oslo area, where one third of Norwegians live, while using incident data put focus on low population high incident areas, such as northern Norway and winter sport resorts. Using population density data as a proxy for incident frequency is not recommended, as the two data types lead to different optimal base locations. Lowering the target time increases the sensitivity to choice of data.

Telehealth-Enabled Emergency Medical Services Program Reduces Ambulance Transport to Urban Emergency Departments

Directory of Open Access Journals (Sweden)

James Robert Langabeer

2016-11-01

Full Text Available Introduction Emergency medical services (EMS agencies transport a significant majority of patients with low acuity and non-emergent conditions to local emergency departments (ED, affecting the entire emergency care system’s capacity and performance. Opportunities exist for alternative models that integrate technology, telehealth, and more appropriately aligned patient navigation. While a limited number of programs have evolved recently, no empirical evidence exists for their efficacy. This research describes the development and comparative effectiveness of one large urban program. Methods The Houston Fire Department initiated the Emergency Telehealth and Navigation (ETHAN program in 2014. ETHAN combines telehealth, social services, and alternative transportation to navigate primary care-related patients away from the ED where possible. Using a case-control study design, we describe the program and compare differences in effectiveness measures relative to the control group. Results During the first 12 months, 5,570 patients participated in the telehealth-enabled program, which were compared against the same size control group. We found a 56% absolute reduction in ambulance transports to the ED with the intervention compared to the control group (18% vs. 74%, P<.001. EMS productivity (median time from EMS notification to unit back in service was 44 minutes faster for the ETHAN group (39 vs. 83 minutes, median. There were no statistically significant differences in mortality or patient satisfaction. Conclusion We found that mobile technology-driven delivery models are effective at reducing unnecessary ED ambulance transports and increasing EMS unit productivity. This provides support for broader EMS mobile integrated health programs in other regions.

Feasibility of AmbulanCe-Based Telemedicine (FACT study: safety, feasibility and reliability of third generation in-ambulance telemedicine.

Directory of Open Access Journals (Sweden)

Laetitia Yperzeele

Full Text Available Telemedicine is currently mainly applied as an in-hospital service, but this technology also holds potential to improve emergency care in the prehospital arena. We report on the safety, feasibility and reliability of in-ambulance teleconsultation using a telemedicine system of the third generation.A routine ambulance was equipped with a system for real-time bidirectional audio-video communication, automated transmission of vital parameters, glycemia and electronic patient identification. All patients ( ≥ 18 years transported during emergency missions by a Prehospital Intervention Team of the Universitair Ziekenhuis Brussel were eligible for inclusion. To guarantee mobility and to facilitate 24/7 availability, the teleconsultants used lightweight laptop computers to access a dedicated telemedicine platform, which also provided functionalities for neurological assessment, electronic reporting and prehospital notification of the in-hospital team. Key registrations included any safety issue, mobile connectivity, communication of patient information, audiovisual quality, user-friendliness and accuracy of the prehospital diagnosis.Prehospital teleconsultation was obtained in 41 out of 43 cases (95.3%. The success rates for communication of blood pressure, heart rate, blood oxygen saturation, glycemia, and electronic patient identification were 78.7%, 84.8%, 80.6%, 64.0%, and 84.2%. A preliminary prehospital diagnosis was formulated in 90.2%, with satisfactory agreement with final in-hospital diagnoses. Communication of a prehospital report to the in-hospital team was successful in 94.7% and prenotification of the in-hospital team via SMS in 90.2%. Failures resulted mainly from limited mobile connectivity and to a lesser extent from software, hardware or human error. The user acceptance was high.Ambulance-based telemedicine of the third generation is safe, feasible and reliable but further research and development, especially with regard to high

Coupling the effect of mental practice and Pilates on ambulation of individuals with multiple sclerosis: Five case studies

Directory of Open Access Journals (Sweden)

Darshpreet Kaur

2016-01-01

Full Text Available Pilates, a popular form of exercise, greatly emphasizes on the strengthening of the core muscles; however, the efficacy of exercise program can be impaired in patients with cognitive impairments. To bridge this gap, mental practice of a desired task can help to mentally simulate a given action and retain many properties of the corresponding real action. This study tries to gain preliminary understanding on the effectiveness of the combination of mental practice and core-strengthening Pilates exercises. To explore the effectiveness of mental practice and Pilates-based training on core strength, balance and mobility in multiple sclerosis (MS patients. This study highlights a single center case series describing the outcomes in ambulant patients with MS treated with mental practice and Pilates. Five volunteer ambulant individuals with stable relapsing-remitting MS participated in 20 individualized sessions, spread over 10-week duration. Pilates with mental practice session was delivered by a physiotherapist. Each session comprised 20 min of mental practice followed by 40 min of core-strengthening Pilates exercises. All the included patients were screened with Movement Imagery Questionnaire-Revised Second Version to determine if they are were able to effectively engage in imagery practice. A range of outcomes were measured: Timed up and go, chair stand test, curl-ups, the abdominal angle through leg raises, and the Activities-specific Balance Confidence Scale before and after the intervention. Group data analysis indicated significant improvement between baseline and post-intervention phases for all the tested parameters. This study provides preliminary insight into this novel combination technique to improve balance and mobility in ambulant people with MS. Mental practice played an important role in keeping the patient's compliance, which was analyzed through structured interviews. Variations in response to the intervention are evident.

Cognitive characteristics of older Japanese drivers.

Science.gov (United States)

Susilowati, Indri H; Yasukouchi, Akira

2012-02-29

Some causes of accidents among older drivers are: not paying attention to traffic signals; missing stop lines; and having to deal with and misjudging emergency situations. These causes of accidents reveal problems with attention and cognition. Such incidents are also related to driver perception and stress-coping mechanisms. It is important to examine the relation of stress reactions to attention and cognition as a factor influencing the causes of accidents commonly involving older drivers. Subjects were 10 young drivers (23.3 ± 3.33 years) and 25 older drivers divided into two groups (older1 [60 to 65 years] and older2 [> 65 years]). This study revealed the correlation within driver stress inventory and driver coping questionnaires parameters was observed only in older drivers. They also needed a longer response time for Trail Making Test A and B. The factors affected the attention and cognition of older drivers by age but not driving experience itself, and coping parameters such as emotion focus, reappraisal, and avoidance were not included as stress inventory parameters. Being prone to fatigue was less for younger drivers than older drivers. Because they have shorter distances, shorter drive times, and no need for expressways, older drivers also had a significantly lower risk of thrill-seeking behaviour and more patience. The intervention addressing their attention skills, aggressive feelings, and emotion focus should be considered. The technological improvements in cars will make older drivers feel safer and make driving easier which might lower the attention paid to the road, and regular driving training might be needed to assess and enhance their safety.

A Movement Monitor Based on Magneto-Inertial Sensors for Non-Ambulant Patients with Duchenne Muscular Dystrophy: A Pilot Study in Controlled Environment.

Directory of Open Access Journals (Sweden)

Anne-Gaëlle Le Moing

Full Text Available Measurement of muscle strength and activity of upper limbs of non-ambulant patients with neuromuscular diseases is a major challenge. ActiMyo® is an innovative device that uses magneto-inertial sensors to record angular velocities and linear accelerations that can be used over long periods of time in the home environment. The device was designed to insure long-term stability and good signal to noise ratio, even for very weak movements. In order to determine relevant and pertinent clinical variables with potential for use as outcome measures in clinical trials or to guide therapy decisions, we performed a pilot study in non-ambulant neuromuscular patients. We report here data from seven Duchenne Muscular Dystrophy (DMD patients (mean age 18.5 ± 5.5 years collected in a clinical setting. Patients were assessed while wearing the device during performance of validated tasks (MoviPlate, Box and Block test and Minnesota test and tasks mimicking daily living. The ActiMyo® sensors were placed on the wrists during all the tests. Software designed for use with the device computed several variables to qualify and quantify muscular activity in the non-ambulant subjects. Four variables representative of upper limb activity were studied: the rotation rate, the ratio of the vertical component in the overall acceleration, the hand elevation rate, and an estimate of the power of the upper limb. The correlations between clinical data and physical activity and the ActiMyo® movement parameters were analyzed. The mean of the rotation rate and mean of the elevation rate appeared promising since these variables had the best reliability scores and correlations with task scores. Parameters could be computed even in a patient with a Brooke functional score of 6. The variables chosen are good candidates as potential outcome measures in non-ambulant patients with Duchenne Muscular Dystrophy and use of the ActiMyo® is currently being explored in home environment

A Movement Monitor Based on Magneto-Inertial Sensors for Non-Ambulant Patients with Duchenne Muscular Dystrophy: A Pilot Study in Controlled Environment.

Science.gov (United States)

Le Moing, Anne-Gaëlle; Seferian, Andreea Mihaela; Moraux, Amélie; Annoussamy, Mélanie; Dorveaux, Eric; Gasnier, Erwan; Hogrel, Jean-Yves; Voit, Thomas; Vissière, David; Servais, Laurent

2016-01-01

Measurement of muscle strength and activity of upper limbs of non-ambulant patients with neuromuscular diseases is a major challenge. ActiMyo® is an innovative device that uses magneto-inertial sensors to record angular velocities and linear accelerations that can be used over long periods of time in the home environment. The device was designed to insure long-term stability and good signal to noise ratio, even for very weak movements. In order to determine relevant and pertinent clinical variables with potential for use as outcome measures in clinical trials or to guide therapy decisions, we performed a pilot study in non-ambulant neuromuscular patients. We report here data from seven Duchenne Muscular Dystrophy (DMD) patients (mean age 18.5 ± 5.5 years) collected in a clinical setting. Patients were assessed while wearing the device during performance of validated tasks (MoviPlate, Box and Block test and Minnesota test) and tasks mimicking daily living. The ActiMyo® sensors were placed on the wrists during all the tests. Software designed for use with the device computed several variables to qualify and quantify muscular activity in the non-ambulant subjects. Four variables representative of upper limb activity were studied: the rotation rate, the ratio of the vertical component in the overall acceleration, the hand elevation rate, and an estimate of the power of the upper limb. The correlations between clinical data and physical activity and the ActiMyo® movement parameters were analyzed. The mean of the rotation rate and mean of the elevation rate appeared promising since these variables had the best reliability scores and correlations with task scores. Parameters could be computed even in a patient with a Brooke functional score of 6. The variables chosen are good candidates as potential outcome measures in non-ambulant patients with Duchenne Muscular Dystrophy and use of the ActiMyo® is currently being explored in home environment. ClinicalTrials.gov NCT

Cognitive characteristics of older Japanese drivers

Directory of Open Access Journals (Sweden)

Susilowati Indri H

2012-02-01

Full Text Available Abstract Background Some causes of accidents among older drivers are: not paying attention to traffic signals; missing stop lines; and having to deal with and misjudging emergency situations. These causes of accidents reveal problems with attention and cognition. Such incidents are also related to driver perception and stress-coping mechanisms. It is important to examine the relation of stress reactions to attention and cognition as a factor influencing the causes of accidents commonly involving older drivers. Finding Subjects were 10 young drivers (23.3 ± 3.33 years and 25 older drivers divided into two groups (older1 [60 to 65 years] and older2 [> 65 years]. This study revealed the correlation within driver stress inventory and driver coping questionnaires parameters was observed only in older drivers. They also needed a longer response time for Trail Making Test A and B. The factors affected the attention and cognition of older drivers by age but not driving experience itself, and coping parameters such as emotion focus, reappraisal, and avoidance were not included as stress inventory parameters. Being prone to fatigue was less for younger drivers than older drivers. Because they have shorter distances, shorter drive times, and no need for expressways, older drivers also had a significantly lower risk of thrill-seeking behaviour and more patience. Conclusion The intervention addressing their attention skills, aggressive feelings, and emotion focus should be considered. The technological improvements in cars will make older drivers feel safer and make driving easier which might lower the attention paid to the road, and regular driving training might be needed to assess and enhance their safety.

Assisting Driver Sovereignty : A Fail-Safe Design Approach to Driver Distraction

NARCIS (Netherlands)

Van Gijssel, A.

2013-01-01

This thesis investigates the potential of a fail-safe approach to driver distraction through novel interface concepts for integrated Advanced Driver Assistance Systems (ADAS). Traffic accidents are a negative side effect of the universal and economical desire for mobility. The year 2009 saw the

Novice drivers' individual trajectories of driver behavior over the first three years of driving.

Science.gov (United States)

Roman, Gabriela D; Poulter, Damian; Barker, Edward; McKenna, Frank P; Rowe, Richard

2015-09-01

Identifying the changes in driving behavior that underlie the decrease in crash risk over the first few months of driving is key to efforts to reduce injury and fatality risk in novice drivers. This study represented a secondary data analysis of 1148 drivers who participated in the UK Cohort II study. The Driver Behavior Questionnaire was completed at 6 months and 1, 2 and 3 years after licensure. Linear latent growth models indicated significant increases across development in all four dimensions of aberrant driving behavior under scrutiny: aggressive violations, ordinary violations, errors and slips. Unconditional and conditional latent growth class analyses showed that the observed heterogeneity in individual trajectories was explained by the presence of multiple homogeneous groups of drivers, each exhibiting specific trajectories of aberrant driver behavior. Initial levels of aberrant driver behavior were important in identifying sub-groups of drivers. All classes showed positive slopes; there was no evidence of a group of drivers whose aberrant behavior decreased over time that might explain the decrease in crash involvement observed over this period. Male gender and younger age predicted membership of trajectories with higher levels of aberrant behavior. These findings highlight the importance of early intervention for improving road safety. We discuss the implications of our findings for understanding the behavioral underpinnings of the decrease in crash involvement observed in the early months of driving. Copyright © 2015 The Authors. Published by Elsevier Ltd.. All rights reserved.

"The little squealer" or "the virtual guardian angel"? Young drivers' and their parents' perspective on using a driver monitoring technology and its implications for parent-young driver communication.

Science.gov (United States)

Guttman, Nurit; Gesser-Edelsburg, Anat

2011-02-01

In-vehicle driving monitoring technologies have the potential to enable young drivers to learn from self-assessment. However, their use is largely dependent on parental involvement. A total of 79 interviews were conducted with young drivers and parents regarding this technology and its use. Most had the experience of having an in-vehicle data recorder installed in the vehicle driven by the young drivers. Parents and the young drivers expressed both appreciation as well as reservations about its potential as a means to enhance the driving safety of young drivers. A surprising finding was that some parents did not check the feedback and said they relied on the young driver to do so. Main concerns related to privacy, parent-young driver relationship, self-esteem and confidence, constructive use of the feedback data, and the limitations of the documentation that can be done by the technology. Providing parents and young drivers with a support system and tools to discuss and utilize the feedback are underscored. Challenges include addressing the invasion of young drivers' privacy and gender differences, and using the monitoring-capacity of the technology to enhance safe driving practices. Implications for programs to enhance communication and a dialogical approach between parents and young drivers are discussed. Copyright © 2010 Elsevier Ltd. All rights reserved.

Effects of adductor-canal-blockade on pain and ambulation after total knee arthroplasty

DEFF Research Database (Denmark)

Jenstrup, M T; Jæger, P; Lund, J

2012-01-01

Total knee arthroplasty (TKA) is associated with intense post-operative pain. Besides providing optimal analgesia, reduction in side effects and enhanced mobilization are important in this elderly population. The adductor-canal-blockade is theoretically an almost pure sensory blockade. We hypothe...... hypothesized that the adductor-canal-blockade may reduce morphine consumption (primary endpoint), improve pain relief, enhance early ambulation ability, and reduce side effects (secondary endpoints) after TKA compared with placebo.......Total knee arthroplasty (TKA) is associated with intense post-operative pain. Besides providing optimal analgesia, reduction in side effects and enhanced mobilization are important in this elderly population. The adductor-canal-blockade is theoretically an almost pure sensory blockade. We...

Young novice drivers.

NARCIS (Netherlands)

2013-01-01

In The Netherlands, young novice drivers (18-24 years of age) show a crash rate that is five times higher than that of experienced drivers (30-59 years of age). The rate of young males is even seven times as high. The main reasons are lack of driving experience and hazardous behaviour typical of

Driver behavior analysis for right-turn drivers at signalized intersections using SHRP 2 naturalistic driving study data.

Science.gov (United States)

Wu, Jianqing; Xu, Hao

2017-12-01

Understanding driver behavior is important for traffic safety and operation, especially at intersections where different traffic movements conflict. While most driver-behavior studies are based on simulation, this paper documents the analysis of driver-behavior at signalized intersections with the SHRP 2 Naturalistic Driving Study (NDS) data. This study analyzes the different influencing factors on the operation (speed control) and observation of right-turn drivers. A total of 300 NDS trips at six signalized intersections were used, including the NDS time-series sensor data, the forward videos and driver face videos. Different factors of drivers, vehicles, roads and environments were studied for their influence on driver behavior. An influencing index function was developed and the index was calculated for each influencing factor to quantitatively describe its influencing level. The influencing index was applied to prioritize the factors, which facilitates development and selection of safety countermeasures to improve intersection safety. Drivers' speed control was analyzed under different conditions with consideration of the prioritized influencing factors. Vehicle type, traffic signal status, conflicting traffic, conflicting pedestrian and driver age group were identified as the five major influencing factors on driver observation. This research revealed that drivers have high acceleration and low observation frequency under Right-Turn-On-Red (RTOR), which constituted potential danger for other roadway users, especially for pedestrians. As speed has a direct influence on crash rates and severities, the revealed speed patterns of the different situations also benefit selection of safety countermeasures at signalized intersections. Published by Elsevier Ltd.

Experimental Research in Boost Driver with EDLCs

Science.gov (United States)

Matsumoto, Hirokazu

The supply used in servo systems tends to have a high voltage in order to reduce loss and improve the response of motor drives. We propose a new boost motor driver that comprises EDLCs. The proposed driver has a simple structure, wherein the EDLCs are connected in series to the supply, and comprises a charge circuit to charge the EDLCs. The proposed driver has three advantages over conventional boost drivers. The first advantage is that the driver can easily attain the stable boost voltage. The second advantage is that the driver can reduce input power peaks. In a servo system, the input power peaks become greater than the rated power in order to accelerate the motor rapidly. This implies that the equipments that supply power to servo systems must have sufficient power capacity to satisfy the power peaks. The proposed driver can suppress the increase of the power capacity of supply facilities. The third advantage is that the driver can store almost all of the regenerative energy. Conventional drivers have a braking resistor to suppress the increase in the DC link voltage. This causes a considerable reduction in the efficiency. The proposed driver is more efficient than conventional drivers. In this study, the experimental results confirmed the effectiveness of the proposed driver and showed that the drive performance of the proposed driver is the same as that of a conventional driver. Furthermore, it was confirmed that the results of the simulation of a model of the EDLC module, whose capacitance is dependent on the frequency, correspond well with the experimental results.

Driver competence performance indicators using OTMR

Energy Technology Data Exchange (ETDEWEB)

Hassan EL Rashidy, R.A.

2016-07-01

The current practice for assessing driver competence performance is in-cab riding by driver managers. However, this paper investigates whether real-world driving data extracted from on-train monitoring recorders data (OTMR) can be used to assess the driver performance. A number of indicators were used to evaluate the drivers’ performance. These include: their use of the emergency bypass switch, the driver's reminder appliance as well as the driver’s reaction time. A study case illustrated the applicability of OTMR data to estimate the proposed indicators, which suggests that the indicators can be useful in the driver management system in addition to the current indicators. Furthermore, the proposed indicators could be used to tailor the driver training schemes up to their individual needs and evaluate their effectiveness. They could even be used for improving driver competence performance and reducing crash involvement by revealing potentially detrimental driving performance. (Author)

Online driver's license renewal.

Science.gov (United States)

2015-09-01

The Kentucky Department of Vehicle Regulation is exploring the possibility of developing and implementing online : drivers license renewal. The objective of this project was to: 1) evaluate online drivers license and REAL ID renewal : programs ...

Effect of Planned Early Recommended Ambulation Technique on Selected Post caesarean Biophysiological Health Parameters

Directory of Open Access Journals (Sweden)

Jyoti V. Dube

2014-01-01

Full Text Available Background: Caesarean section has been a part of human culture since ancient times. It has been used effectively throughout the 20th century and among the major abdominal surgeries, it is the most common, oldest worldwide surgery performed in obstetrics. Despite the life saving advantages, there are several adverse consequences of caesarean delivery for a woman and to her household. The rate and risk of these complications increases due to the increasing incidence mainly in countries like India. The role of nurse midwife is to act in the best interest of patient and newborn and make the patient independent in carrying out the activities of daily living as soon as possible. This can lead to a faster recovery and shorter hospital stay. Also it can indirectly help in reducing the complications associated with prolonged bed rest and can improve the maternal newborn bonding. Aim and Objectives: The present study was done to evaluate the effect of planned early ambulation on selected biophysiological health parameters of post caesarean patients. Material and Methods: The study included total 500 study subjects, 250 in experimental and 250 in control group. Quasi experimental approach with multiple time series design was adopted for the study. The experimental group was given an early planned recommended ambulation technique starting from the day of surgery. This consisted of deep breathing exercise, cough exercise, leg exercise and early mobilization. Over and above, the routine general health care was given by the doctors and nurses. The control group received only by routine general care by doctors and nurses and mobilization on third post operative day as per strategy adopted by the hospital. The deep breathing exercises, coughing exercises and leg exercises were not given routinely and hence were not given to the control group. Post caesarean biophysiological parameters chart was used to assess the selected parameters for first five post operative

Exploratory multinomial logit model-based driver injury severity analyses for teenage and adult drivers in intersection-related crashes.

Science.gov (United States)

Wu, Qiong; Zhang, Guohui; Ci, Yusheng; Wu, Lina; Tarefder, Rafiqul A; Alcántara, Adélamar Dely

2016-05-18

Teenage drivers are more likely to be involved in severely incapacitating and fatal crashes compared to adult drivers. Moreover, because two thirds of urban vehicle miles traveled are on signal-controlled roadways, significant research efforts are needed to investigate intersection-related teenage driver injury severities and their contributing factors in terms of driver behavior, vehicle-infrastructure interactions, environmental characteristics, roadway geometric features, and traffic compositions. Therefore, this study aims to explore the characteristic differences between teenage and adult drivers in intersection-related crashes, identify the significant contributing attributes, and analyze their impacts on driver injury severities. Using crash data collected in New Mexico from 2010 to 2011, 2 multinomial logit regression models were developed to analyze injury severities for teenage and adult drivers, respectively. Elasticity analyses and transferability tests were conducted to better understand the quantitative impacts of these factors and the teenage driver injury severity model's generality. The results showed that although many of the same contributing factors were found to be significant in the both teenage and adult driver models, certain different attributes must be distinguished to specifically develop effective safety solutions for the 2 driver groups. The research findings are helpful to better understand teenage crash uniqueness and develop cost-effective solutions to reduce intersection-related teenage injury severities and facilitate driver injury mitigation research.

Trauma care in Scotland: effect of rurality on ambulance travel times and level of destination healthcare facility.

Science.gov (United States)

Yeap, E E; Morrison, J J; Apodaca, A N; Egan, G; Jansen, J O

2014-06-01

The aim of this study was to determine the effect of rurality on the level of destination healthcare facility and ambulance response times for trauma patients in Scotland. We used a retrospective analysis of pre-hospital data routinely collected by the Scottish Ambulance Service from 2009-2010. Incident locations were categorised by rurality, using the Scottish urban/rural classification. The level of destination healthcare facility was coded as either a teaching hospital, large general hospital, general hospital, or other type of facility. A total of 64,377 incidents met the inclusion criteria. The majority of incidents occurred in urban areas, which mostly resulted in admission to teaching hospitals. Incidents from other areas resulted in admission to a lower-level facility. The majority of incidents originating in very remote small towns and very remote rural areas were treated in a general hospital. Median call-out times and travel times increased with the degree of rurality, although with some exceptions. Trauma is relatively rare in rural areas, but patients injured in remote locations are doubly disadvantaged by prolonged pre-hospital times and admission to a hospital that may not be adequately equipped to deal with their injuries. These problems may be overcome by the regionalisation of trauma care, and enhanced retrieval capability.

Body weight-supported bedside treadmill training facilitates ambulation in ICU patients: An interventional proof of concept study.

Science.gov (United States)

Sommers, Juultje; Wieferink, Denise C; Dongelmans, Dave A; Nollet, Frans; Engelbert, Raoul H H; van der Schaaf, Marike

2017-10-01

Early mobilisation is advocated to improve recovery of intensive care unit (ICU) survivors. However, severe weakness in combination with tubes, lines and machinery are practical barriers for the implementation of ambulation with critically ill patients. The aim of this study was to explore the feasibility of Body Weight-Supported Treadmill Training (BWSTT) in critically ill patients in the ICU. A custom build bedside Body Weight-Supported Treadmill was used and evaluated in medical and surgical patients in the ICU. Feasibility was evaluated according to eligibility, successful number of BWSTT, number of staff needed, adverse events, number of patients that could not have walked without BWSTT, patient satisfaction and anxiety. Twenty participants, underwent 54 sessions BWSTT. Two staff members executed the BWSTT and no adverse events occurred. Medical equipment did not have to be disconnected during all treatment sessions. In 74% of the sessions, the participants would not have been able to walk without the BWSTT. Patient satisfaction with BWSTT was high and anxiety low. This proof of concept study demonstrated that BWSTT is safe, reduces staff resource, and facilitates the first time to ambulation in critically ill patients with severe muscle weakness in the ICU. Copyright © 2017 Elsevier Inc. All rights reserved.

Evaluating Older Drivers' Skills

Science.gov (United States)

2013-05-01

Research has demonstrated that older drivers pose a higher risk of involvement in fatal crashes at intersections than : younger drivers. Age-triggered restrictions are problematic as research shows that the majority of older people : have unimpaired ...

Prediction of postoperative morbidity, mortality and rehabilitation in hip fracture patients: the cumulated ambulation score

DEFF Research Database (Denmark)

Foss, Nicolai Bang; Kristensen, Morten Tange; Kehlet, Henrik

2006-01-01

fracture patients with an independent walking function admitted from their own home. Rehabilitation followed a well-defined multimodal rehabilitation regimen and discharge criteria. MAIN OUTCOME MEASURE: Admission tests with a new mobility score to assess prefracture functional mobility and a short mental......OBJECTIVE: To validate the cumulated ambulation score as an early postoperative predictor of short-term outcome in hip fracture patients. DESIGN: Prospective, descriptive study. SETTING: An orthopaedic hip fracture unit in a university hospital. PATIENTS: Four hundred and twenty-six consecutive hip...... of short-term postoperative outcome after hip fracture surgery....

Inertial confinement fusion driver enhancements: Final focusing systems and compact heavy-ion driver designs

International Nuclear Information System (INIS)

Bieri, R.L.

1991-01-01

Required elements of an inertial confinement fusion power plant are modeled and discussed. A detailed analysis of two critical elements of candidate drivers is done, and new component designs are proposed to increase the credibility and feasibility of each driver system. An analysis of neutron damage to the final elements of a laser focusing system is presented, and multilayer -- dielectric mirrors are shown to have damage lifetimes which axe too short to be useful in a commercial power plant. A new final-focusing system using grazing incidence metal mirrors to protect sensitive laser optics is designed and shown to be effective in extending the lifetime of the final focusing system. The reflectivities and damage limits of grazing incidence metal mirrors are examined in detail, and the required mirror sizes are shown to be compatible with the beam sizes and illumination geometries currently envisioned for laser drivers. A detailed design and analysis is also done for compact arrays of superconducting magnetic quadrupoles, which are needed in a multi-beam heavy-ion driver. The new array model is developed in more detail than some previous conceptual designs and models arrays which are more compact than arrays scaled from existing single -- quadrupole designs. The improved integrated model for compact arrays is used to compare the effects of various quadrupole array design choices on the size and cost of a heavy-ion driver. Array design choices which significantly affect the cost of a heavy-ion driver include the choice of superconducting material and the thickness of the collar used to support the winding stresses. The effect of these array design choices on driver size and cost is examined and the array model is used to estimate driver cost savings and performance improvements attainable with aggressive quadrupole array designs with high-performance superconductors

Longitudinal effect of eteplirsen versus historical control on ambulation in Duchenne muscular dystrophy

Science.gov (United States)

Goemans, Nathalie; Lowes, Linda P.; Alfano, Lindsay N.; Berry, Katherine; Shao, James; Kaye, Edward M.; Mercuri, Eugenio; Hamid, Hoda Abdel; Byrne, Barry J.; Connolly, Anne M.; Dracker, Robert A.; Matthew Frank, L.; Heydemann, Peter T.; O'Brien, Kevin C.; Sparks, Susan E.; Specht, Linda A.; Rodino‐Klapac, Louise; Sahenk, Zarife; Al‐Zaidy, Samiah; Cripe, Linda H.; Lewis, Sarah; M, Pane; E, Mazzone; S, Messina; GL, Vita; Bertini, D Amico A; Casimiro, Berardinelli A; Y, Torrente; F, Magri; GP, Comi; G, Baranello; T, Mongini; A, Pini; R, Battini; E, Pegoraro; C, Bruno; L, Politano; S, Previtali

2016-01-01

Objective To continue evaluation of the long‐term efficacy and safety of eteplirsen, a phosphorodiamidate morpholino oligomer designed to skip DMD exon 51 in patients with Duchenne muscular dystrophy (DMD). Three‐year progression of eteplirsen‐treated patients was compared to matched historical controls (HC). Methods Ambulatory DMD patients who were ≥7 years old and amenable to exon 51 skipping were randomized to eteplirsen (30/50mg/kg) or placebo for 24 weeks. Thereafter, all received eteplirsen on an open‐label basis. The primary functional assessment in this study was the 6‐Minute Walk Test (6MWT). Respiratory muscle function was assessed by pulmonary function testing (PFT). Longitudinal natural history data were used for comparative analysis of 6MWT performance at baseline and months 12, 24, and 36. Patients were matched to the eteplirsen group based on age, corticosteroid use, and genotype. Results At 36 months, eteplirsen‐treated patients (n = 12) demonstrated a statistically significant advantage of 151m (p < 0.01) on 6MWT and experienced a lower incidence of loss of ambulation in comparison to matched HC (n = 13) amenable to exon 51 skipping. PFT results remained relatively stable in eteplirsen‐treated patients. Eteplirsen was well tolerated. Analysis of HC confirmed the previously observed change in disease trajectory at age 7 years, and more severe progression was observed in patients with mutations amenable to exon skipping than in those not amenable. The subset of patients amenable to exon 51 skipping showed a more severe disease course than those amenable to any exon skipping. Interpretation Over 3 years of follow‐up, eteplirsen‐treated patients showed a slower rate of decline in ambulation assessed by 6MWT compared to untreated matched HC. Ann Neurol 2016;79:257–271 PMID:26573217

Anthropogenic Drivers of Ecosystem Change: an Overview

Directory of Open Access Journals (Sweden)

Gerald C. Nelson

2006-12-01

Full Text Available This paper provides an overview of what the Millennium Ecosystem Assessment (MA calls "indirect and direct drivers" of change in ecosystem services at a global level. The MA definition of a driver is any natural or human-induced factor that directly or indirectly causes a change in an ecosystem. A direct driver unequivocally influences ecosystem processes. An indirect driver operates more diffusely by altering one or more direct drivers. Global driving forces are categorized as demographic, economic, sociopolitical, cultural and religious, scientific and technological, and physical and biological. Drivers in all categories other than physical and biological are considered indirect. Important direct drivers include changes in climate, plant nutrient use, land conversion, and diseases and invasive species. This paper does not discuss natural drivers such as climate variability, extreme weather events, or volcanic eruptions.

Drivers' reactions to sudden lead car braking under varying workload conditions; towards a driver support system.

NARCIS (Netherlands)

Schaap, Nina; van der Horst, A.R.A.; van Arem, Bart; Brookhuis, K.A.

2008-01-01

At urban intersections drivers handle multiple tasks simultaneously, making urban driving a complex task. An advanced driver assistance system may support drivers in this specific driving task, but the design details of such a system need to be determined before they can be fully deployed. A driving

General oilfield driver improvement

International Nuclear Information System (INIS)

Johnson, G.

1997-01-01

The general oilfield driver improvement (GODI) course was discussed. The course is offered to truckers in the oil and gas industry to help reduce accidents and injuries. Oilfield trucking is one of the most accident and injury prone sectors in the Alberta economy. This paper presented Heck's Trucking company's experience in sending its employees on the course. Drivers were taught (1) the National safety code requirements, (2) Commercial Vehicle Safety Alliance requirements, (3) occupational health and safety concerns, (4) vehicle dimension and GVW restrictions, (5) hours of service regulations, (6) log book and pre-trip inspection requirements, (7) workplace hazardous material information, and (8) transportation of dangerous goods. Overall, the course was judged to provide excellent training before sending drivers into the field. The employee, the customer, and the company, all stand to benefit from having rigorous and uniform standards for all drivers in the oil and gas industry

VD-411 branch driver

International Nuclear Information System (INIS)

Gorbunov, N.V.; Karev, A.G.; Mal'tsev, Eh.I.; Morozov, B.A.

1985-01-01

The VD-411 branch driver for CAMAC moduli control by the SM-4 computer is described. The driver realizes data exchange with moduli disposed in 28 crates grouped in 4 branches. Data exchange can be carried out either in the program regime or in the regime of direct access to the memory. Fulfilment of 11 block regimes and one program regime is provided for. A possibility of individual programming of exchange methods in block regimes is left for users for organisation of quicker and most flexible data removal from the CAMAC moduli. In the regime of direct access the driver provides data transmission at the size up to 64 Kwords placing it in the computer memory of 2 M byte. High rate of data transmission and the developed system of interruptions ensure efficient utilization of the VD-411 branch driver at data removal from facilities in high energy physics experiments

Driver Distraction in Public Transport

OpenAIRE

YOUNG, K; SALMON, P; REGAN MICHAEL, M

2007-01-01

There is converging evidence that driver distraction is a contributing factor in car crashes, in Australia and overseas. Surprisingly, no known previous research has attempted to identify and assess the potentially distracting activities undertaken by the drivers of public passenger vehicles. This paper describes research undertaken on this issue. The research was partitioned into three phases: an analysis of the functions and tasks currently undertaken by public passenger vehicle drivers; th...

Criteria for driver impairment

NARCIS (Netherlands)

Brookhuis, K.A.; De Waard, D.; Fairclough, S.H

2003-01-01

Most traffic accidents can be attributed to driver impairment, e.g. inattention, fatigue, intoxication, etc. It is now technically feasible to monitor and diagnose driver behaviour with respect to impairment with the aid of a limited number of in-vehicle sensors. However, a valid framework for the

Practice and perception of first aid among lay first responders in a southern district of India.

Science.gov (United States)

Pallavisarji, Uthkarsh; Gururaj, Gopalkrishna; Girish, Rao Nagaraja

2013-01-01

Injuries rank among the leading causes of morbidity and mortality worldwide, and are steadily increasing in developing countries like India. However, it is often possible to minimize injury and crash consequences by providing effective pre-hospital services promptly. In most low-and middle-income countries (LMICs), transportation of road traffic victims, is usually provided by relatives, taxi drivers, truck drivers, police officers and other motorists who are often untrained. The current study was conducted to understand the current practice and perception of first aid among lay first responders in a rural southern district of India. The current cross sectional descriptive study was conducted in the southern district of Tumkur in India within three months from January to March 2011 and covered the population including all police, ambulance personnel, taxi drivers, bus and auto drivers, and primary and middle school teachers within the study area. Nearly 60% of the responders had witnessed more than two emergencies in the previous six months and 55% had actively participated in helping the injured person. The nature of the help was mainly by calling for an ambulance (41.5%), transporting the injured (19.7%) and consoling the victim (14.9%). Majority (78.1%) of the responders informed that they had run to the victim (42.4%) or had called for an ambulance. The predominant reason for not providing help was often the 'fear of legal complications' (30%) that would follow later. Significant number (81.4%) of respondents reported that they did not have adequate skills to manage an emergency and were willing to acquire knowledge and skills in first aid to help victims. Regular and periodical community-based first aid training programs for first care responders will help to provide care and improve outcomes for injured persons.

49 CFR 396.13 - Driver inspection.

Science.gov (United States)

2010-10-01

... ADMINISTRATION, DEPARTMENT OF TRANSPORTATION FEDERAL MOTOR CARRIER SAFETY REGULATIONS INSPECTION, REPAIR, AND MAINTENANCE § 396.13 Driver inspection. Before driving a motor vehicle, the driver shall: (a) Be satisfied that the motor vehicle is in safe operating condition; (b) Review the last driver vehicle inspection...

Reducing Ambulance Diversion at Hospital and Regional Levels: Systemic Review of Insights from Simulation Models

Directory of Open Access Journals (Sweden)

M Kit Delgado

2013-09-01

Full Text Available Introduction: Optimal solutions for reducing diversion without worsening emergency department (ED crowding are unclear. We performed a systematic review of published simulation studies to identify: 1 the tradeoff between ambulance diversion and ED wait times; 2 the predicted impact of patient flow interventions on reducing diversion; and 3 the optimal regional strategy for reducing diversion.Methods: Data Sources: Systematic review of articles using MEDLINE, Inspec, Scopus. Additional studies identified through bibliography review, Google Scholar, and scientific conference proceedings. Study Selection: Only simulations modeling ambulance diversion as a result of ED crowding or inpatient capacity problems were included. Data extraction: Independent extraction by two authors using predefined data fields.Results: We identified 5,116 potentially relevant records; 10 studies met inclusion criteria. In models that quantified the relationship between ED throughput times and diversion, diversion was found to only minimally improve ED waiting room times. Adding holding units for inpatient boarders and ED-based fast tracks, improving lab turnaround times, and smoothing elective surgery caseloads were found to reduce diversion considerably. While two models found a cooperative agreement between hospitals is necessary to prevent defensive diversion behavior by a hospital when a nearby hospital goes on diversion, one model found there may be more optimal solutions for reducing region wide wait times than a regional ban on diversion.Conclusion: Smoothing elective surgery caseloads, adding ED fast tracks as well as holding units for inpatient boarders, improving ED lab turnaround times, and implementing regional cooperative agreements among hospitals. [West J Emerg Med. 2013;14(5:489-498.

Effects of Weather and Heliophysical Conditions on Emergency Ambulance Calls for Elevated Arterial Blood Pressure

Directory of Open Access Journals (Sweden)

Jone Vencloviene

2015-02-01

Full Text Available We hypothesized that weather and space weather conditions were associated with the exacerbation of essential hypertension. The study was conducted during 2009–2010 in the city of Kaunas, Lithuania. We analyzed 13,475 cards from emergency ambulance calls (EACs, in which the conditions for the emergency calls were made coded I.10–I.15. The Kaunas Weather Station provided daily records of air temperature (T, wind speed (WS, relative humidity, and barometric pressure (BP. We evaluated the associations between daily weather variables and daily number of EACs by applying a multivariate Poisson regression. Unfavorable heliophysical conditions (two days after the active-stormy geomagnetic field or the days with solar WS > 600 km/s increased the daily number of elevated arterial blood pressure (EABP by 12% (RR = 1.12; 95% confidence interval (CI 1.04–1.21; and WS ≥ 3.5 knots during days of T < 1.5 °C and T ≥ 12.5 °C by 8% (RR = 1.08; CI 1.04–1.12. An increase of T by 10 °C and an elevation of BP two days after by 10 hPa were associated with a decrease in RR by 3%. An additional effect of T was detected during days of T ≥ 17.5 °C only in females. Women and patients with grade III arterial hypertension at the time of the ambulance call were more sensitive to weather conditions. These results may help in the understanding of the population’s sensitivity to different weather conditions.

IFE Power Plant design principles. Drivers. Solid state laser drivers

International Nuclear Information System (INIS)

Nakai, S.; Andre, M.; Krupke, W.F.; Mak, A.A.; Soures, J.M.; Yamanaka, M.

1995-01-01

The present status of solid state laser drivers for an inertial confinement thermonuclear fusion power plant is discussed. In particular, the feasibility of laser diode pumped solid state laser drivers from both the technical and economic points of view is briefly reviewed. Conceptual design studies showed that they can, in principle, satisfy the design requirements. However, development of new solid state materials with long fluorescence lifetimes and good thermal characteristics is a key issue for laser diode pumped solid state lasers. With the advent of laser diode pumping many materials which were abandoned in the past can presently be reconsidered as viable candidates. It is also concluded that it is important to examine the technical requirements for solid state lasers in relation to target performance criteria. The progress of laser diode pumped lasers in industrial applications should also be closely watched to provide additional information on the economic feasibility of this type of driver. 15 refs, 9 figs, 2 tabs

Data and methods for studying commercial motor vehicle driver fatigue, highway safety and long-term driver health.

Science.gov (United States)

Stern, Hal S; Blower, Daniel; Cohen, Michael L; Czeisler, Charles A; Dinges, David F; Greenhouse, Joel B; Guo, Feng; Hanowski, Richard J; Hartenbaum, Natalie P; Krueger, Gerald P; Mallis, Melissa M; Pain, Richard F; Rizzo, Matthew; Sinha, Esha; Small, Dylan S; Stuart, Elizabeth A; Wegman, David H

2018-03-09

This article summarizes the recommendations on data and methodology issues for studying commercial motor vehicle driver fatigue of a National Academies of Sciences, Engineering, and Medicine study. A framework is provided that identifies the various factors affecting driver fatigue and relating driver fatigue to crash risk and long-term driver health. The relevant factors include characteristics of the driver, vehicle, carrier and environment. Limitations of existing data are considered and potential sources of additional data described. Statistical methods that can be used to improve understanding of the relevant relationships from observational data are also described. The recommendations for enhanced data collection and the use of modern statistical methods for causal inference have the potential to enhance our understanding of the relationship of fatigue to highway safety and to long-term driver health. Copyright © 2018 The Authors. Published by Elsevier Ltd.. All rights reserved.

Training of Ambulance Personnel and Others Responsible for Emergency Care of the Sick and Injured at the Scene and During Transport.

Science.gov (United States)

National Academy of Sciences - National Research Council, Washington, DC. Div. of Medical Sciences.

Ambulance personnel must be able to (1) appraise the extent of first aid rendered by others, (2) carry out additional measures at the scene and en route, (3) operate vehicles safely, (4) maintain communication with traffic authorities, dispatchers, and emergency departments, and (5) keep records for medical and other authorities. Guidelines for…

A model of survival following pre-hospital cardiac arrest based on the Victorian Ambulance Cardiac Arrest Register.

Science.gov (United States)

Fridman, Masha; Barnes, Vanessa; Whyman, Andrew; Currell, Alex; Bernard, Stephen; Walker, Tony; Smith, Karen L

2007-11-01

This study describes the epidemiology of sudden cardiac arrest patients in Victoria, Australia, as captured via the Victorian Ambulance Cardiac Arrest Register (VACAR). We used the VACAR data to construct a new model of out-of-hospital cardiac arrest (OHCA), which was specified in accordance with observed trends. All cases of cardiac arrest in Victoria that were attended by Victorian ambulance services during the period of 2002-2005. Overall survival to hospital discharge was 3.8% among 18,827 cases of OHCA. Survival was 15.7% among 1726 bystander witnessed, adult cardiac arrests of presumed cardiac aetiology, presenting in ventricular fibrillation or ventricular tachycardia (VF/VT), where resuscitation was attempted. In multivariate logistic regression analysis, bystander CPR, cardiac arrest (CA) location, response time, age and sex were predictors of VF/VT, which, in turn, was a strong predictor of survival. The same factors that affected VF/VT made an additional contribution to survival. However, for bystander CPR, CA location and response time this additional contribution was limited to VF/VT patients only. There was no detectable association between survival and age younger than 60 years or response time over 15min. The new model accounts for relationships among predictors of survival. These relationships indicate that interventions such as reduced response times and bystander CPR act in multiple ways to improve survival.

Geographic information system data from ambulances applied in the emergency department: effects on patient reception.

Science.gov (United States)

Raaber, Nikolaj; Duvald, Iben; Riddervold, Ingunn; Christensen, Erika F; Kirkegaard, Hans

2016-03-31

Emergency departments (ED) recognize crowding and handover from prehospital to in-hospital settings to be major challenges. Prehospital Geographical Information Systems (GIS) may be a promising tool to address such issues. In this study, the use of prehospital GIS data was implemented in an ED in order to investigate its effect on 1) wait time and unprepared activations of Trauma Teams (TT) and Medical Emergency Teams (MET) and 2) nurses' perceptions regarding patient reception, workflow and resource utilization. From May 1st 2014 to October 31th 2014, GIS data was displayed in the ED. Data included real-time estimated time of arrival, distance to ED, dispatch criteria, patient data and ambulance contact information. Data was used by coordinating nurses for time activation of TT and MET involved in the initial treatment of severely-injured or critically-ill patients. In addition, it was used as a logistics tool for handling all other patients transported by ambulance to the ED. The study followed a mixed-methods design, consisting of a quantitative study (before and after intervention) and a qualitative study (survey and interviews). Participants included all patients received by TT or MET and coordinating nurses in the ED. 1.) Quantitative: 599 patients were included. The median wait time for TT and MET was 5 min both before and after the GIS intervention, showing no difference (p = 0.18). A significant reduction in the subgroup of waits >10 min was found (p GIS data as a tool to optimize resource utilization and quality of all patients' reception, critically or non-critically ill. No substantial disadvantages were reported. The contradiction of measured median wait time and nurses perceived improved timing of team activation may result from having both RT- ETA and supplemental patient information not only for seriously-injured or critically-ill patients received by the TT and MET, but for all patients transported by ambulance. The reduction in waits > 10

Planning like an Olympian. How London Ambulance Service successfully handled their 'summer of sport'.

Science.gov (United States)

Killens, Jason

2013-03-01

LOCOG Medical managed thousands of patient contacts across all the Games venues without our intervention. A polyclinic in the athlete's village had extensive diagnostic options, including X-ray and magnetic resonance imaging for athletes and the Olympic family. These helped limit the number of patients who needed transport to the ED. Although the delivery was seamless, there were "behind the scenes" moments in the final stages of planning that made us think. We received additional requests for ambulance cover at training venues that hadn't been planned for on short notice. In addition, the torch relay attracted bigger crowds than initially planned for. Some of the planning assumptions and agreements changed on short notice for various reasons. This meant we had to adjust our plans while also solving human resource issues that you would expect to see among a workforce of around 500 across a six-week period. As part of the National Health Service (NHS) ambulance service Games cohort, more than 500 staff were deployed across 18 venues and 30 days of sport in London. In doing so, they delivered in excess of 165,000 hours of standby and care, responded to nearly 1,500 Games-related incidents and conveyed 800 patients to emergency departments across the capital. After such an influx, it wasn't easy to return to business as usual. Officials with previous host cities had advised us that there would be a feeling of "what next" once the Games concluded. When I first heard this, I thought the opposite would be the case. I expected feeling relieved of overwhelming emotion as well as from the exhaustion of the long days. I do have to say that although this was the case, it's also true that there is a "post Games" come down. We had just been part of a fantastic summer of sport with a brilliant medal tally from Team Great Britain and Paralympics Great Britain that, of course, helped the euphoria. But we did feel real sense of uncertainty about what to do next. We had spent five

Drivers' reactions to sudden braking by lead car under varying workload conditions; towards a driver support system

NARCIS (Netherlands)

Schaap, T. W.; van der Horst, A. R. A.; van Arem, B.; Brookhuis, K. A.

2008-01-01

At urban intersections drivers handle multiple tasks simultaneously, making urban driving a complex task. An advanced driver assistance system may support drivers in this specific driving task, but the design details of such a system need to be determined before they can be fully deployed. A driving

Fusion of optimized indicators from Advanced Driver Assistance Systems (ADAS) for driver drowsiness detection.

Science.gov (United States)

Daza, Iván García; Bergasa, Luis Miguel; Bronte, Sebastián; Yebes, Jose Javier; Almazán, Javier; Arroyo, Roberto

2014-01-09

This paper presents a non-intrusive approach for monitoring driver drowsiness using the fusion of several optimized indicators based on driver physical and driving performance measures, obtained from ADAS (Advanced Driver Assistant Systems) in simulated conditions. The paper is focused on real-time drowsiness detection technology rather than on long-term sleep/awake regulation prediction technology. We have developed our own vision system in order to obtain robust and optimized driver indicators able to be used in simulators and future real environments. These indicators are principally based on driver physical and driving performance skills. The fusion of several indicators, proposed in the literature, is evaluated using a neural network and a stochastic optimization method to obtain the best combination. We propose a new method for ground-truth generation based on a supervised Karolinska Sleepiness Scale (KSS). An extensive evaluation of indicators, derived from trials over a third generation simulator with several test subjects during different driving sessions, was performed. The main conclusions about the performance of single indicators and the best combinations of them are included, as well as the future works derived from this study.

Fusion of Optimized Indicators from Advanced Driver Assistance Systems (ADAS for Driver Drowsiness Detection

Directory of Open Access Journals (Sweden)

Iván G. Daza

2014-01-01

Full Text Available This paper presents a non-intrusive approach for monitoring driver drowsiness using the fusion of several optimized indicators based on driver physical and driving performance measures, obtained from ADAS (Advanced Driver Assistant Systems in simulated conditions. The paper is focused on real-time drowsiness detection technology rather than on long-term sleep/awake regulation prediction technology. We have developed our own vision system in order to obtain robust and optimized driver indicators able to be used in simulators and future real environments. These indicators are principally based on driver physical and driving performance skills. The fusion of several indicators, proposed in the literature, is evaluated using a neural network and a stochastic optimization method to obtain the best combination. We propose a new method for ground-truth generation based on a supervised Karolinska Sleepiness Scale (KSS. An extensive evaluation of indicators, derived from trials over a third generation simulator with several test subjects during different driving sessions, was performed. The main conclusions about the performance of single indicators and the best combinations of them are included, as well as the future works derived from this study.

Microprocessor-based stepping motor driver

International Nuclear Information System (INIS)

Halbig, J.K.; Klosterbuer, S.F.

1979-09-01

The Pion Generation for Medical Irradiations (PIGMI) program at the Los Alamos Scientific Laboratory requires a versatile stepping motor driver to do beam diagnostic measurements. A driver controlled by a microprocessor that can move eight stepping motors simultaneously was designed. The driver can monitor and respond to clockwise- and counterclockwise-limit switches, and it can monitor a 0- to 10-V dc position signal. The software controls start and stop ramping and maximum stepping rates. 2 figures, 1 table

Advanced driver assistance systems for teen drivers: Teen and parent impressions, perceived need, and intervention preferences.

Science.gov (United States)

Weiss, Eve; Fisher Thiel, Megan; Sultana, Nahida; Hannan, Chloe; Seacrist, Thomas

2018-02-28

From the advent of airbags to electronic stability control, technological advances introduced into automobile design have significantly reduced injury and death from motor vehicle crashes. These advances are especially pertinent among teen drivers, a population whose leading cause of death is motor vehicle crashes. Recently developed advanced driver assistance systems (ADAS) have the potential to compensate for skill deficits and reduce overall crash risk. Yet, ADAS is only effective if drivers are willing to use it. Limited research has been conducted on the suitability of ADAS for teen drivers. The goal of this study is to identify teen drivers' perceived need for ADAS, receptiveness to in-vehicle technology, and intervention preferences. The long-term goal is to understand public perceptions and barriers to ADAS use and to help determine how these systems must evolve to meet the needs of the riskiest driving populations. Three focus groups (N = 24) were conducted with licensed teen drivers aged 16-19 years and 2 focus groups with parents of teen drivers (N = 12). Discussion topics included views on how ADAS might influence driving skills and behaviors; trust in technology; and data privacy. Discussions were transcribed; the team used conventional content analysis and open coding methods to identify 12 coding domains and code transcripts with NVivo 10. Interrater reliability testing showed moderate to high kappa scores. Overall, participants recognized potential benefits of ADAS, including improved safety and crash reduction. Teens suggested that ADAS is still developing and therefore has potential to malfunction. Many teens reported a greater trust in their own driving ability over vehicle technology. They expressed that novice drivers should learn to drive on non-ADAS-equipped cars and that ADAS should be considered a supplemental aid. Many teens felt that overreliance on ADAS may increase distracted driving or risky behaviors among teens. Parents also

Cumulated Ambulation Score to evaluate mobility is feasible in geriatric patients and in patients with hip fracture

DEFF Research Database (Denmark)

Kristensen, Morten Tange; Jakobsen, Thomas Linding; Nielsen, Jesper Westphal

2012-01-01

Regaining basic mobility independence is considered important for elderly hospitalised patients. The Cumulated Ambulation Score (CAS) is a valid tool for evaluating these patients' basic mobility (getting in and out of bed, sit-to-stand from a chair and walking) in orthopaedic wards, and its use ...... is recommended in Denmark for patients with hip fracture. The aims of the present study were to evaluate the feasibility of the CAS in a geriatric ward and to describe its use after hip fracture in Denmark....

Factors Contributing to Crashes among Young Drivers

Directory of Open Access Journals (Sweden)

Lyndel J. Bates

2014-08-01

Full Text Available Young drivers are the group of drivers most likely to crash. There are a number of factors that contribute to the high crash risk experienced by these drivers. While some of these factors are intrinsic to the young driver, such as their age, gender or driving skill, others relate to social factors and when and how often they drive. This article reviews the factors that affect the risk of young drivers crashing to enable a fuller understanding of why this risk is so high in order to assist in developing effective countermeasures.

Effects of a Static Bicycling Programme on the Functional Ability of Young People with Cerebral Palsy Who Are Non-Ambulant

Science.gov (United States)

Williams, Heather; Pountney, Teresa

2007-01-01

This study investigated the effects of exercise on the motor function of 11 young people (10 females, one male; age range 11-15y; mean age 12y 7mo [SD 1y 4mo]) with cerebral palsy (CP) who were non-ambulant (Gross Motor Function Classification System Levels IV or V), using an adapted static bicycle. Three participants had dyskinetic quadriplegia,…

Important information for drivers in France

CERN Multimedia

2012-01-01

From 1 July 2012, any driver of a motorised road vehicle, excluding two- or three-wheeled vehicles whose engine capacity does not exceed 50cm3, must be in possession of a breathalyser in full working order. With effect from 1 November 2012*, drivers failing to produce a breathalyser run the risk of being served with an 11 euro fine. A breathalyser is used to measure the alcohol content in the motorist's breath. The permissible level of alcohol for drivers is less than 0.5 g of alcohol per litre of blood, or 0.25 mg of alcohol per litre of air exhaled. The obligation to have a breathalyser on board the vehicle also applies to all drivers on the French part of the CERN site. All vehicles belonging to or leased by the Organization must also carry a breathalyser together with all the requisite documentation (cf. Operational Circular No. 4). Drivers of privately owned vehicles can obtain breathalysers from car accessory dealers, service stations or pharmacies, etc. Drivers of vehicles belonging to or l...

Psychological influences for the driver by the changes of running circumstance; Jidosha no soko kankyo henka no driver eno shinriteki eikyo

Energy Technology Data Exchange (ETDEWEB)

Okura, S; Yokomori, M; Yamaguchi, S [Meijo University, Nagoya (Japan)

1997-10-01

A driver is influenced psychologically by the cars proceeding on the street and the cars parked on the shoulder which come into the front view. The traffic accidents are caused when these influences put a lot of stress on a driver. In this report, we study the relations between the road traffic condition on the streets and the highway and the driver`s psychological and psysiological responses by using the driver`s front view, sweating and pulse rate. 6 refs., 8 figs.

School Bus Accidents and Driver Age.

Science.gov (United States)

McMichael, Judith

The study examines the rates and types of school bus accidents according to the age of the school bus driver. Accident rates in North Carolina for the school year 1971-72 were analyzed using three sources of data: accident reports, driver and mileage data, and questionnaires administered to a sample of school bus drivers. Data were obtained on…

78 FR 76757 - Regulatory Guidance on Hours of Service of Drivers Rest Break Requirement; Drivers Who Become...

Science.gov (United States)

2013-12-19

... limitations for unforeseen reasons, is the driver in violation of the Sec. 395.3 rest break provision if more... unforeseen reasons, is not in violation of the Sec. 395.3 rest-break requirements if 8 or more hours have... Regulatory Guidance on Hours of Service of Drivers Rest Break Requirement; Drivers Who Become Ineligible for...

Driver-centred vehicle automation: using network analysis for agent-based modelling of the driver in highly automated driving systems.

Science.gov (United States)

Banks, Victoria A; Stanton, Neville A

2016-11-01

To the average driver, the concept of automation in driving infers that they can become completely 'hands and feet free'. This is a common misconception, however, one that has been shown through the application of Network Analysis to new Cruise Assist technologies that may feature on our roads by 2020. Through the adoption of a Systems Theoretic approach, this paper introduces the concept of driver-initiated automation which reflects the role of the driver in highly automated driving systems. Using a combination of traditional task analysis and the application of quantitative network metrics, this agent-based modelling paper shows how the role of the driver remains an integral part of the driving system implicating the need for designers to ensure they are provided with the tools necessary to remain actively in-the-loop despite giving increasing opportunities to delegate their control to the automated subsystems. Practitioner Summary: This paper describes and analyses a driver-initiated command and control system of automation using representations afforded by task and social networks to understand how drivers remain actively involved in the task. A network analysis of different driver commands suggests that such a strategy does maintain the driver in the control loop.

Tracking progress in teenage driver crash risk in the United States since the advent of graduated driver licensing programs.

Science.gov (United States)

McCartt, Anne T; Teoh, Eric R

2015-06-01

This study examined U.S. teenagers' crash rates since 1996, when the first graduated driver licensing (GDL) program in the United State was implemented. Passenger vehicle driver crash involvement rates for 16-19 and 30-59 (middle-aged) year-olds were examined, using data from the Fatality Analysis Reporting System, National Automotive Sampling System General Estimates System, Census Bureau, and National Household Travel Surveys. Per capita fatal and police-reported crash rates in 2012 were lower for 16year-olds than for middle-aged drivers but older teenagers' rates were higher. Mileage-based fatal and police-reported crash rates in 2008 were higher for teenagers than for middle-aged drivers and higher for 16-17year-olds than for older teenagers. In 1996-2012, teenagers' per capita fatal and police-reported crash rates declined sharply, especially for 16-17year-olds, and more so than for middle-aged drivers. Substantial declines also occurred in teenagers' mileage-based fatal and police-reported crash rates from 1995-96 to 2008, generally more so than for middle-aged drivers. Regarding factors in fatal crashes in 1996 and 2012, proportions of young teenagers' crashes occurring at night and with multiple teenage passengers declined, more so than among older teenagers and middle-aged drivers. The proportion of fatally injured drivers who had been drinking declined for teenagers but changed little for middle-aged drivers. Improvements were not apparent in rates of driver errors or speeding among teenage drivers in fatal crashes. Teenage drivers' crash risk dropped during the period of implementation of GDL laws, especially fatal crash types targeted by GDL. However, teenagers' crash risk remains high, and important crash factors remain unaddressed by GDL. Although this study was not designed to examine the role of GDL, the results are consistent with the increased presence of such laws. More gains are achievable if states strengthen their laws. Copyright © 2015

Research on driver fatigue detection

Science.gov (United States)

Zhang, Ting; Chen, Zhong; Ouyang, Chao

2018-03-01

Driver fatigue is one of the main causes of frequent traffic accidents. In this case, driver fatigue detection system has very important significance in avoiding traffic accidents. This paper presents a real-time method based on fusion of multiple facial features, including eye closure, yawn and head movement. The eye state is classified as being open or closed by a linear SVM classifier trained using HOG features of the detected eye. The mouth state is determined according to the width-height ratio of the mouth. The head movement is detected by head pitch angle calculated by facial landmark. The driver's fatigue state can be reasoned by the model trained by above features. According to experimental results, drive fatigue detection obtains an excellent performance. It indicates that the developed method is valuable for the application of avoiding traffic accidents caused by driver's fatigue.

Study on driving control behavior for lane change maneuver. Analysis of expert driver using neural network system; Shasen henkoji no driver sosa tokusei. Neural network system ni yoru jukuren driver no kaiseki

Energy Technology Data Exchange (ETDEWEB)

Yang, Z; Okayama, T; Katayama, T [Japan Automobile Research Institute Inc., Tsukuba (Japan); Kageyama, I [Nihon University, Tokyo (Japan)

1997-10-01

In order to study driver steering control behavior for vehicle, a driver model for single-lane change maneuver is constructed by a neural network system concerned with the man-machine-environment system. And, using sensitivity analysis, it is found that the model represent the driver control behavior, and the relation between the driver control behavior and vehicle responses. The sensitivity analysis is also examined by applying to the 2nd order predictive driver model. The validity of the sensitivity analysis is confirmed. 5 refs., 8 figs.

A Simple Wave Driver

Science.gov (United States)

Temiz, Burak Kagan; Yavuz, Ahmet

2015-01-01

This study was done to develop a simple and inexpensive wave driver that can be used in experiments on string waves. The wave driver was made using a battery-operated toy car, and the apparatus can be used to produce string waves at a fixed frequency. The working principle of the apparatus is as follows: shortly after the car is turned on, the…

Do young novice drivers overestimate their driving skills more than experienced drivers? : different methods lead to different conclusions.

NARCIS (Netherlands)

Craen, S. de Twisk, D.A.M. Hagenzieker, M.P. Elffers, H. & Brookhuis, K.A.

2011-01-01

In this study the authors argue that drivers have to make an assessment of their own driving skills, in order to sufficiently adapt to their task demands in traffic. There are indications that drivers in general, but novice drivers in particular, overestimate their driving skills. However, study

[Occupational stress situation analysis of different types of train drivers].

Science.gov (United States)

Zhou, Wenhui; Gu, Guizhen; Wu, Hui; Yu, Shanfa

2014-11-01

To analyze the status of occupational stress in different types of train drivers. By using cluster sampling method, a cross-sectional study was conducted in 1 339 train drivers (including 289 passenger train drivers, 637 freight trains drivers, 339 passenger shunting train drivers, and 74 high speed rail drivers) from a Railway Bureau depot. The survey included individual factors, occupational stress factors, stress response factors and stress mitigating factors. The occupational stress factors, stress response factors and mitigating factors were measured by the revised effort-reward imbalance (ERI) model questionnaires and occupational stress measurement scale. By using the method of covariance analysized the difference of occupational stress factors of all types train drivers, the method of Stepwise regression was used to analyze the effection (R(2)) of occupational stress factors and stress mitigating factors on stress response factors. Covariance analysis as covariates in age, education level, length of service and marital status showed that the scores of ERI (1.58 ± 0.05), extrinsic effort (19.88 ± 0.44), rewards (23.43 ± 0.43), intrinsic effort (17.86 ± 0.36), physical environment (5.70 ± 0.22), social support (30.51 ± 0.88) and daily tension (10.27 ± 0.38 ) of high speed rail drivers were higher than other drivers (F values were 6.06, 11.32, 7.05, 13.25, 5.20, 9.48 and 6.14 respectively, P occupational stress factors and mitigating factors to depressive symptoms of train drivers was high speed rail drivers (R(2) = 0.64), passenger train drivers (R(2) = 0.44), passenger shunting train drivers (R(2) = 0.39), freight trains drivers (R(2) = 0.38); job satisfaction of train drivers was high speed rail drivers (R(2) = 0.68), passenger train drivers (R(2) = 0.62), freight trains drivers (R(2) = 0.43), passenger shunting train drivers(R(2) = 0.38); to daily tension of train drivers was high speed rail drivers (R(2) = 0.54), passenger train drivers (R(2) = 0

Reliability of drivers in urban intersections.

Science.gov (United States)

Gstalter, Herbert; Fastenmeier, Wolfgang

2010-01-01

The concept of human reliability has been widely used in industrial settings by human factors experts to optimise the person-task fit. Reliability is estimated by the probability that a task will successfully be completed by personnel in a given stage of system operation. Human Reliability Analysis (HRA) is a technique used to calculate human error probabilities as the ratio of errors committed to the number of opportunities for that error. To transfer this notion to the measurement of car driver reliability the following components are necessary: a taxonomy of driving tasks, a definition of correct behaviour in each of these tasks, a list of errors as deviations from the correct actions and an adequate observation method to register errors and opportunities for these errors. Use of the SAFE-task analysis procedure recently made it possible to derive driver errors directly from the normative analysis of behavioural requirements. Driver reliability estimates could be used to compare groups of tasks (e.g. different types of intersections with their respective regulations) as well as groups of drivers' or individual drivers' aptitudes. This approach was tested in a field study with 62 drivers of different age groups. The subjects drove an instrumented car and had to complete an urban test route, the main features of which were 18 intersections representing six different driving tasks. The subjects were accompanied by two trained observers who recorded driver errors using standardized observation sheets. Results indicate that error indices often vary between both the age group of drivers and the type of driving task. The highest error indices occurred in the non-signalised intersection tasks and the roundabout, which exactly equals the corresponding ratings of task complexity from the SAFE analysis. A comparison of age groups clearly shows the disadvantage of older drivers, whose error indices in nearly all tasks are significantly higher than those of the other groups

Minimally Invasive Posterior Stabilization Improved Ambulation and Pain Scores in Patients with Plasmacytomas and/or Metastases of the Spine

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Joseph H. Schwab

2011-01-01

Full Text Available Background. The incidence of spine metastasis is expected to increase as the population ages, and so is the number of palliative spinal procedures. Minimally invasive procedures are attractive options in that they offer the theoretical advantage of less morbidity. Purpose. The purpose of our study was to evaluate whether minimally invasive posterior spinal instrumentation provided significant pain relief and improved function. Study Design. We compared pre- and postoperative pain scores as well as ambulatory status in a population of patients suffering from oncologic conditions in the spine. Patient Sample. A consecutive series of patients with spine tumors treated minimally invasively with stabilization were reviewed. Outcome Measures. Visual analog pain scale as well as pre- and postoperative ambulatory status were used as outcome measures. Methods. Twenty-four patients who underwent minimally invasive posterior spinal instrumentation for metastasis were retrospectively reviewed. Results. Seven (29% patients were unable to ambulate secondary to pain and instability prior to surgery. All patients were ambulating within 2 to 3 days after having surgery (=0.01. The mean visual analog scale value for the preoperative patients was 2.8, and the mean postoperative value was 1.0 (=0.001. Conclusion. Minimally invasive posterior spinal instrumentation significantly improved pain and ambulatory status in this series.

The impact of fatigue on the non-technical skills performance of critical care air ambulance clinicians.

Science.gov (United States)

Myers, J A; Powell, D M C; Aldington, S; Sim, D; Psirides, A; Hathaway, K; Haney, M F

2017-11-01

The relationship between fatigue-related risk and impaired clinical performance is not entirely clear. Non-technical factors represent an important component of clinical performance and may be sensitive to the effects of fatigue. The hypothesis was that the sum score of overall non-technical performance is degraded by fatigue. Nineteen physicians undertook two different simulated air ambulance missions, once when rested, and once when fatigued (randomised crossover design). Trained assessors blinded to participants' fatigue status performed detailed structured assessments based on expected behaviours in four non-technical skills domains: teamwork, situational awareness, task management, and decision making. Participants also provided self-ratings of their performance. The primary endpoint was the sum score of overall non-technical performance. The main finding, the overall non-technical skills performance rating of the clinicians, was better in rested than fatigued states (mean difference with 95% CI, 2.8 [2.2-3.4]). The findings remained consistent across individual non-technical skills domains; also when controlling for an order effect and examining the impact of a number of possible covariates. There was no difference in self-ratings of clinical performance between rested and fatigued states. Non-technical performance of critical care air transfer clinicians is degraded when they are fatigued. Fatigued clinicians may fail to recognise the degree to which their performance is compromised. These findings represent risk to clinical care quality and patient safety in the dynamic and isolated environment of air ambulance transfer. © 2017 The Acta Anaesthesiologica Scandinavica Foundation. Published by John Wiley & Sons Ltd.

De verkeersonveiligheid van hulpverleningsvoertuigen. Consult ten behoeve van de Koninklijke Nederlandse Toeristenbond ANWB.

NARCIS (Netherlands)

Oei, H.-l.

1986-01-01

Drivers on emergency vehicles (ambulances, fire engines, police cars) which have to fulfil an urgent task and which make use of particular competencies, show often a driving behaviour with an increased risk. Each year more than hundred victims are killed or injured in accidents in which emergency

77 FR 19026 - Designation of Syrian Arab Republic for Temporary Protected Status

Science.gov (United States)

2012-03-29

... Syrian military have also shot unarmed protestors, including children, medical doctors, ambulance drivers..., and a higher drop is expected in 2012. Tourism, which accounted for 6 to 9 percent of Syria's gross... also indicate that medical doctors providing treatment to wounded members of the opposition have been...

Salud/Servicios Personales. Libro del Profesor. (Health/Personal Services. Teacher's Guide). B2. CHOICE (Challenging Options in Career Education).

Science.gov (United States)

Mid-Hudson Migrant Education Center, New Paltz, NY.

Written in Spanish, the guide comprises the first grade unit of a career education curriculum developed for migrant students. The guide covers 12 health and personal service occupations--blacksmith, television repairer, hairdresser/barber, day care worker, waitress, gas station attendant, family doctor, ambulance driver/attendant, dietician,…

Schoolbus driver performance can be improved with driver training, safety incentivisation, and vehicle roadworthy modifications

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A van Niekerk

2017-03-01

Full Text Available In South Africa (SA, the school transport industry provides millions of children with a means of travelling to and from school. The industry has, however, been reported to be plagued by widespread safety concerns. The consequent road traffic incidents have often been attributed to driver factors, including driving in excess of legal speeds or at inappropriate speeds; driving while under the influence of alcohol, while sleepy or fatigued; or driving without using protective equipment for vehicle occupants. There are currently very few SA interventions that specifically target this important industry role-player. The Safe Travel to School Programme was recently implemented by a national child safety agency, with a focus on driver road safety awareness, defensive driver training, eye- testing, vehicle roadworthy inspections with selected upgrades, incentives for safe performance, and implementation of a vehicle telematics tracking system with regular, individual driving behaviour information updates. This quasi-experimental study offers an evaluation of the initial impact on safety performance of this telematics-based driver and vehicle safety intervention in terms of speeding, acceleration, braking, cornering, and time-of-day driving, and compares the school transport driver performance with that of general motorists. Despite concerns that some school transport vehicles are used for multiple purposes outside of school transport duties, at night, and for longer distances, overall these vehicles recorded lower percentages of speeding, lower harsh braking, and lower average harsh cornering and acceleration than general drivers.

20 CFR 404.1008 - Agent-driver or commission-driver, full-time life insurance salesman, home worker, or traveling...

Science.gov (United States)

2010-04-01

... commission-driver, full-time life insurance salesman, home worker, or traveling or city salesman. (a) General... 20 Employees' Benefits 2 2010-04-01 2010-04-01 false Agent-driver or commission-driver, full-time life insurance salesman, home worker, or traveling or city salesman. 404.1008 Section 404.1008...

among Taxi Drivers in Addis Ababa, Ethiopia

African Journals Online (AJOL)

user

Long years of driving [AOR =4.6 (95%CI, 1.6-12.9)], involvement in a similar activity prior to becoming taxi driver .... full time taxi driver; produce a valid driving license; .... Self-employee .... professional car drivers in Dhaka city, Bangladesh.

A holistic perspective on corporate sustainability drivers

NARCIS (Netherlands)

Lozano, R.

2013-01-01

Since company boards are increasingly discussing 'sustainability', it becomes necessary to examine the nature of sustainability drivers. Most approaches to corporate sustainability drivers have focused either on internal or external drivers. This paper is aimed at providing a more holistic

A holistic perspective on corporate sustainability drivers

NARCIS (Netherlands)

Lozano, Rodrigo|info:eu-repo/dai/nl/36412380X

2015-01-01

Since company boards are increasingly discussing 'sustainability', it becomes necessary to examine the nature of sustainability drivers. Most approaches to corporate sustainability drivers have focused either on internal or external drivers. This paper is aimed at providing a more holistic

Naturalistic distraction and driving safety in older drivers.

Science.gov (United States)

Aksan, Nazan; Dawson, Jeffrey D; Emerson, Jamie L; Yu, Lixi; Uc, Ergun Y; Anderson, Steven W; Rizzo, Matthew

2013-08-01

In this study, we aimed to quantify and compare performance of middle-aged and older drivers during a naturalistic distraction paradigm (visual search for roadside targets) and to predict older drivers performance given functioning in visual, motor, and cognitive domains. Distracted driving can imperil healthy adults and may disproportionally affect the safety of older drivers with visual, motor, and cognitive decline. A total of 203 drivers, 120 healthy older (61 men and 59 women, ages 65 years and older) and 83 middle-aged drivers (38 men and 45 women, ages 40 to 64 years), participated in an on-road test in an instrumented vehicle. Outcome measures included performance in roadside target identification (traffic signs and restaurants) and concurrent driver safety. Differences in visual, motor, and cognitive functioning served as predictors. Older drivers identified fewer landmarks and drove slower but committed more safety errors than did middle-aged drivers. Greater familiarity with local roads benefited performance of middle-aged but not older drivers.Visual cognition predicted both traffic sign identification and safety errors, and executive function predicted traffic sign identification over and above vision. Older adults are susceptible to driving safety errors while distracted by common secondary visual search tasks that are inherent to driving. The findings underscore that age-related cognitive decline affects older drivers' management of driving tasks at multiple levels and can help inform the design of on-road tests and interventions for older drivers.

[Customer orientation in ambulant medicine].

Science.gov (United States)

Heinrich, M

2014-07-01

Due to developments of the health market, economic aspects of the health system are more relevant. In this upcoming market the patient is regarded as customer and the doctor as provider of medical services. Studies on customer orientation in the ambulant medicine lag behind this dynamic. An aim of the study is to comprehend the attitudes of the doctors referring to the customer orientation. In a second step the findings are discussed according to statements of health-care paticipants. Developments in role comprehension of doctor and patient are focused to gain results in scientific and practical applications. Guideline-supported, partly narrative interviews with n=9 gynaecologists and n=11 general practitioners in Freiburg/Germany are recorded, transcribed and reviewed in a qualitative analysis. The statements of the doctors show patient satisfaction has an incremental meaning sspecially regarding the sequence of patient relationship and economic management of the doctor's workplace. The doctor's role comprehension meets with a refusal of the role of salesman and the patient as customer. The method of interviews is suitable to gather empirical impressions of the doctors. The control sample is adequate, however a bias due to inhomogeneous thematic affinitiy and local social-demographics might be possible. The customer orientation has become an important factor in doctor-patient relationtships. The relevance of the doctor-patient conversation and the risk of misuse of the patient confidence are mentioned by the doctors. The doctor as paternalistic care provider gives way to the customer-focused service provider. The doctor's necessity of autonomyssss and dependency on patient satisfaction have potential for conflict. Intensive mention of customer orientation in medicine in the media emphasises its importance. Rational handling with the possibilities of individual health markets is a prospective challange. Further research could be established in all aspects of

OLDER DRIVERS AND ADAS

Directory of Open Access Journals (Sweden)

Ragnhild J. DAVIDSE

2006-01-01

Next, based on the available literature, relevant ADAS are discussed in terms of their availability, their effects on safety and the willingness of older drivers to use and buy them. One of the conclusions is that only very few of the types of support that are thought to be most beneficial to the safety of older drivers are provided by the ADAS that are currently available.

Truck Drivers And Risk Of STDs Including HIV

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Bansal R.K

1995-01-01

Full Text Available Research Question: Whether long distance truck drivers are at a higher risk of contracting and transmitting STDs including HIV? Objectives: i To study the degree of knowledge of HIV and AIDS among long- distance truck drivers. ii Assess their sexual behaviour including condom use. iii Explore their prevailing social influences and substance abuse patterns. iv Explore their treatment seeking bahaviour as regards STDs. v Deduce their risk of contracting and transmitting STDs including HIV. Study Design: Cross- sectional interview. Setting: Transport Nagar, Indore (M.P Participants: 210 senior drivers (First drivers and 210 junior drivers (Second drivers. Study Variables: Extra-Marital sexual intercourse, condom usage, past and present history of STDs, treatment and counseling, substance abuse, social â€" cultural milieu. Outcome Variables: Risk of contraction of STDs. Statistical Analysis: Univariate analysis. Results: 94% of the drivers were totally ignorant about AIDS. 82.9% and 43.8 % of the senior and junior drivers had a history of extra- marital sex and of these only 2 regularly used condoms. 13.8% and 3.3 % of the senior and junior drivers had a past or present history suggestive of STD infection. Alcohol and Opium were regularly used by them. Conclusion: The studied drivers are at a high risk of contracting and transmitting STDs including HIV.

Sexual behavior among truck drivers.

Science.gov (United States)

Singh, Rajiv Kumar; Joshi, Hari Shankar

2012-01-01

A cross-sectional study was conducted on Lucknow highway in Bareilly district of Uttar Pradesh to study the knowledge of truck drivers about HIV transmission and prevention and to study the sexual behaviour of these drivers with reference to HIV/AIDS. Age, marital status, education, income, drinking alcohol, length of stay away from home, knowledge about transmission and prevention of HIV, and HIV-prone behavior of truck drivers were studied. Chi-square, mean, and SD were calculated. In all, 289 (97.6%) drivers had heard about HIV/AIDS. Only 242 (81.8%) were aware of HIV transmission by heterosexual route. Misconceptions such as HIV transmission by mosquito bites, living in same room, shaking hands, and sharing food were found. Out of 174 (58.8%) who visited Commercial Sex Workers (CSW), 146 (83.9%) used a condom. 38 (12.8%) visited more than 5 CSW in the last 3 months. Time away from home on the road, marital status, alcohol use, and income class were associated with visiting CSW. High-risk behavior was established in the study population. Safe sex and use of condoms need to be promoted among the truck drivers and better condom availability needs to be assured on highways.

Compliance with driver's license laws and illegal licensing among commercial bus drivers in Lagos, Nigeria: policy implications and evidence for action.

Science.gov (United States)

Okafor, I P; Odeyemi, K A; Dolapo, D C; Adegbola, A A

2014-09-01

To determine the level of compliance with driver's license laws among commercial bus drivers in Lagos, Nigeria. Two intercity motor parks were selected by simple random sampling and all consenting minibus drivers participated in the study. Key Informant Interviews (KIIs) were also conducted with selected officials in the driver training and licensing authorities. Compliance with the minimum age for driving was high (93.6%), so also was having driving test prior to driver's license procurement (83.3%). Formal driver training and VA testing were very low, (26.1% and 32.9% respectively) Overall, only 9.3% of them were found to have fulfilled all the pre-license obligations before obtaining their first driver's license. The odds of a driver with a secondary education having formal driver training is 3.33 times higher than those with no education (OR 3.33, 95% CI 1.01-11.35). Drivers who were 60 years or older were 3.62 times more likely to be compliant than those who were between 20-29 years (OR 3.62, 95% CI 0.56-29.19). For the 98.3% of them who possessed valid licenses, 52.3% of them obtained them illegally. All the key officials saw RTIs as a serious public health problem but faced several challenges in the course of their work. Overall compliance with pre-license regulations was very poor. There is need for a review and strict enforcement of driver's license laws to improve compliance. Also vital are fostering inter-sectoral collaboration and improvement in the operations of all establishments involved in driver training and license procurement in Nigeria.

Driver steering model for closed-loop steering function analysis

Science.gov (United States)

Bolia, Pratiksh; Weiskircher, Thomas; Müller, Steffen

2014-05-01

In this paper, a two level preview driver steering control model for the use in numerical vehicle dynamics simulation is introduced. The proposed model is composed of cascaded control loops: The outer loop is the path following layer based on potential field framework. The inner loop tries to capture the driver's physical behaviour. The proposed driver model allows easy implementation of different driving situations to simulate a wide range of different driver types, moods and vehicle types. The expediency of the proposed driver model is shown with the help of developed driver steering assist (DSA) function integrated with a conventional series production (Electric Power steering System with rack assist servo unit) system. With the help of the DSA assist function, the driver is prevented from over saturating the front tyre forces and loss of stability and controllability during cornering. The simulation results show different driver reactions caused by the change in the parameters or properties of the proposed driver model if the DSA assist function is activated. Thus, the proposed driver model is useful for the advanced driver steering and vehicle stability assist function evaluation in the early stage of vehicle dynamics handling and stability evaluation.

An examination of the environmental, driver and vehicle factors associated with the serious and fatal crashes of older rural drivers.

Science.gov (United States)

Thompson, J P; Baldock, M R J; Mathias, J L; Wundersitz, L N

2013-01-01

Motor vehicle crashes involving rural drivers aged 75 years and over are more than twice as likely to result in a serious or fatal injury as those involving their urban counterparts. The current study examined some of the reasons for this using a database of police-reported crashes (2004-2008) to identify the environmental (lighting, road and weather conditions, road layout, road surface, speed limit), driver (driver error, crash type), and vehicle (vehicle age) factors that are associated with the crashes of older rural drivers. It also determined whether these same factors are associated with an increased likelihood of serious or fatal injury in younger drivers for whom frailty does not contribute to the resulting injury severity. A number of environmental (i.e., undivided, unsealed, curved and inclined roads, and areas with a speed limit of 100km/h or greater) and driver (i.e., collision with a fixed object and rolling over) factors were more frequent in the crashes of older rural drivers and additionally associated with increased injury severity in younger drivers. Moreover, when these environmental factors were entered into a logistic regression model to predict whether older drivers who were involved in crashes did or did not sustain a serious or fatal injury, it was found that each factor independently increased the likelihood of a serious or fatal injury. Changes, such as the provision of divided and sealed roads, greater protection from fixed roadside objects, and reduced speed limits, appear to be indicated in order to improve the safety of the rural driving environment for drivers of all ages. Additionally, older rural drivers should be encouraged to reduce their exposure to these risky circumstances. Copyright © 2012 Elsevier Ltd. All rights reserved.

Using shadow page cache to improve isolated drivers performance.

Science.gov (United States)

Zheng, Hao; Dong, Xiaoshe; Wang, Endong; Chen, Baoke; Zhu, Zhengdong; Liu, Chengzhe

2015-01-01

With the advantage of the reusability property of the virtualization technology, users can reuse various types and versions of existing operating systems and drivers in a virtual machine, so as to customize their application environment. In order to prevent users' virtualization environments being impacted by driver faults in virtual machine, Chariot examines the correctness of driver's write operations by the method of combining a driver's write operation capture and a driver's private access control table. However, this method needs to keep the write permission of shadow page table as read-only, so as to capture isolated driver's write operations through page faults, which adversely affect the performance of the driver. Based on delaying setting frequently used shadow pages' write permissions to read-only, this paper proposes an algorithm using shadow page cache to improve the performance of isolated drivers and carefully study the relationship between the performance of drivers and the size of shadow page cache. Experimental results show that, through the shadow page cache, the performance of isolated drivers can be greatly improved without impacting Chariot's reliability too much.

Education for older drivers in the future

Directory of Open Access Journals (Sweden)

Esko Keskinen

2014-07-01

Five presumptions have to be considered when addressing future education for older drivers: 1. Driving a car will continue to be one element of mobility in the future; 2. Older people want to be able to keep driving; 3. Safety will be an even more important factor in mobility in the future; 4. Ecological values will be more important in the future; and 5. Innovative technological applications will be more important in the future. Hierarchical models of driving are suitable in increasing understanding of older drivers' needs and abilities. The highest levels of the driving hierarchy in the Goals for Driver Education (GDE model are especially important for the safety of both young and elderly drivers. In these highest levels goals for life, skills for living, and social environment affect everyday decision making in general but also driving, which has an impact on driver safety. Giving up driving is very much a social decision and should be taken as such. However, the highest levels of the driving hierarchy are by nature inaccessible to teacher-centered instruction These levels require more coaching-like education methods where the learner takes the central role and the teacher helps the drivers understand their own abilities and limitations in traffic. Testing and selecting older drivers to enhance safety is not, according to research findings, working in a proper way. Older drivers do not so much need more information concerning traffic rules, etc., but rather better understanding of themselves, their health restrictions, their skills, and their abilities to ensure daily mobility. Their closest companions also need tools to help them in discussions of traffic safety issues affecting older drivers.

Voluntary Ambulation by Upper Limb-Triggered HAL® in Patients with Complete Quadri/Paraplegia Due to Chronic Spinal Cord Injury.

Science.gov (United States)

Shimizu, Yukiyo; Kadone, Hideki; Kubota, Shigeki; Suzuki, Kenji; Abe, Tetsuya; Ueno, Tomoyuki; Soma, Yuichiro; Sankai, Yoshiyuki; Hada, Yasushi; Yamazaki, Masashi

2017-01-01

Patients with complete paraplegia after spinal cord injury (SCI) are unable to stand or walk on their own. Standing exercise decreases the risk of decubitus ulcers, osteoporosis, and joint deformities in patients with SCI. Conventional gait training for complete paraplegia requires excessive upper limb usage for weight bearing and is difficult in cases of complete quadriplegia. The purpose of this study was to describe voluntary ambulation triggered by upper limb activity using the Hybrid Assistive Limb® (HAL) in patients with complete quadri/paraplegia after chronic SCI. Four patients (3 men, 1 woman) were enrolled in this study. The mean patient age ± standard deviation was 37.2 ± 17.8 (range, 20-67) years. Clinical evaluation before intervention revealed the following findings: case 1, neurological level C6, American Spinal Cord Injury Association impairment scale (AIS) grade B; case 2, T6, AIS A; case 3, T10 AIS A; and case 4, T11, AIS A. The HAL intervention consisted of 10 sessions. Each HAL session lasted 60-90 min. The HAL electrodes for hip and knee flexion-extension were placed on the anterior and posterior sides of the upper limbs contralaterally corresponding to each of the lower limbs. Surface electromyography (EMG) was used to evaluate muscle activity of the tensor fascia lata and quadriceps femoris (Quad) in synchronization with a Vicon motion capture system. The modified Ashworth scale (mAs) score was also evaluated before and after each session. All participants completed all 10 sessions. Cases 1, 2, and 3 demonstrated significant decreases in mAs score after the sessions compared to pre-session measurements. In all cases, EMG before the intervention showed no apparent activation in either Quad. However, gait phase dependent activity of the lower limb muscles was seen during voluntarily triggered ambulation driven by upper limb muscle activities. In cases 3 and 4, active contraction in both Quads was observed after intervention. These findings

Voluntary Ambulation by Upper Limb-Triggered HAL® in Patients with Complete Quadri/Paraplegia Due to Chronic Spinal Cord Injury

Directory of Open Access Journals (Sweden)

Yukiyo Shimizu

2017-11-01

Full Text Available Patients with complete paraplegia after spinal cord injury (SCI are unable to stand or walk on their own. Standing exercise decreases the risk of decubitus ulcers, osteoporosis, and joint deformities in patients with SCI. Conventional gait training for complete paraplegia requires excessive upper limb usage for weight bearing and is difficult in cases of complete quadriplegia. The purpose of this study was to describe voluntary ambulation triggered by upper limb activity using the Hybrid Assistive Limb® (HAL in patients with complete quadri/paraplegia after chronic SCI. Four patients (3 men, 1 woman were enrolled in this study. The mean patient age ± standard deviation was 37.2 ± 17.8 (range, 20–67 years. Clinical evaluation before intervention revealed the following findings: case 1, neurological level C6, American Spinal Cord Injury Association impairment scale (AIS grade B; case 2, T6, AIS A; case 3, T10 AIS A; and case 4, T11, AIS A. The HAL intervention consisted of 10 sessions. Each HAL session lasted 60–90 min. The HAL electrodes for hip and knee flexion-extension were placed on the anterior and posterior sides of the upper limbs contralaterally corresponding to each of the lower limbs. Surface electromyography (EMG was used to evaluate muscle activity of the tensor fascia lata and quadriceps femoris (Quad in synchronization with a Vicon motion capture system. The modified Ashworth scale (mAs score was also evaluated before and after each session. All participants completed all 10 sessions. Cases 1, 2, and 3 demonstrated significant decreases in mAs score after the sessions compared to pre-session measurements. In all cases, EMG before the intervention showed no apparent activation in either Quad. However, gait phase dependent activity of the lower limb muscles was seen during voluntarily triggered ambulation driven by upper limb muscle activities. In cases 3 and 4, active contraction in both Quads was observed after intervention

The importance of sight for drivers

Directory of Open Access Journals (Sweden)

Alicja Pas-Wyroślak

2013-06-01

Full Text Available Sight is the basic sense for drivers. Condition of the eye determines correct, comfortable and safe performance of the work as drivers. This article presents various factors influencing the sight condition. There are two groups of factors, external (environment, the kind and time of work, stress caused by work and internal (systemic and local disorders. All these factors can reduce significantly visual functions, such as visual acuity, field of vision, color vision, strereoscopic vision, twilight vision and glare sensitivity. There are also presented actual requirements for drivers and causes of the car accidents in various age groups. Impairments in vision functions can be dangerous for both the driver and other road users. Med Pr 2013;64(3:419–425

Redesign of Transjakarta Bus Driver's Cabin

Science.gov (United States)

Mardi Safitri, Dian; Azmi, Nora; Singh, Gurbinder; Astuti, Pudji

2016-02-01

Ergonomic risk at work stations with type Seated Work Control was one of the problems faced by Transjakarta bus driver. Currently “Trisakti” type bus, one type of bus that is used by Transjakarta in corridor 9, serving route Pinang Ranti - Pluit, gained many complaints from drivers. From the results of Nordic Body Map questionnaires given to 30 drivers, it was known that drivers feel pain in the neck, arms, hips, and buttocks. Allegedly this was due to the seat position and the button/panel bus has a considerable distance range (1 meter) to be achieved by drivers. In addition, preliminary results of the questionnaire using Workstation Checklist identified their complaints about uncomfortable cushion, driver's seat backrest, and the exact position of the AC is above the driver head. To reduce the risk level of ergonomics, then did research to design the cabin by using a generic approach to designing products. The risk analysis driver posture before the design was done by using Rapid Upper Limb Assessment (RULA), Rapid Entire Body Assessment (REBA), and Quick Exposure Checklist (QEC), while the calculation of the moment the body is done by using software Mannequin Pro V10.2. Furthermore, the design of generic products was done through the stages: need metric-matrix, house of quality, anthropometric data collection, classification tree concept, concept screening, scoring concept, design and manufacture of products in the form of two-dimensional. While the design after design risk analysis driver posture was done by using RULA, REBA, and calculation of moments body as well as the design visualized using software 3DMax. From the results of analysis before the draft design improvements cabin RULA obtained scores of 6, REBA 9, and the result amounted to 57.38% QEC and moment forces on the back is 247.3 LbF.inch and on the right hip is 72.9 LbF.in. While the results of the proposed improvements cabin design RULA obtained scores of 3, REBA 4, and the moment of force on

Workshop on transport for a common ion driver

International Nuclear Information System (INIS)

Olson, C.C.; Lee, E.; Langdon, B.

1994-01-01

This report contains research in the following areas related to beam transport for a common ion driver: multi-gap acceleration; neutralization with electrons; gas neutralization; self-pinched transport; HIF and LIF transport, and relevance to common ion driver; LIF and HIF reactor concepts and relevance to common ion driver; atomic physics for common ion driver; code capabilities and needed improvement

Driver training in steps (DTS).

NARCIS (Netherlands)

2010-01-01

For some years now, it has been possible in the Netherlands to follow a Driver Training in Steps (DTS) as well as the regular driver training. The DTS is a structured training method with clear training objectives which are categorized in four modules. Although the DTS is considerably better than

The impact of post-resuscitation feedback for paramedics on the quality of cardiopulmonary resuscitation.

Science.gov (United States)

Bleijenberg, Eduard; Koster, Rudolph W; de Vries, Hendrik; Beesems, Stefanie G

2017-01-01

The Guidelines place emphasis on high-quality cardiopulmonary resuscitation (CPR). This study aims to measure the impact of post-resuscitation feedback on the quality of CPR as performed by ambulance personnel. Two ambulances are dispatched for suspected cardiac arrest. The crew (driver and paramedic) of the first arriving ambulance is responsible for the quality of CPR. The crew of the second ambulance establishes an intravenous access and supports the first crew. All resuscitation attempts led by the ambulance crew of the study region were reviewed by two research paramedics and structured feedback was given based on defibrillator recording with impedance signal. A 12-months period before introduction of post-resuscitation feedback was compared with a 19-months period after introduction of feedback, excluding a six months run-in interval. Quality parameters were chest compression fraction (CCF), chest compression rate, longest peri-shock pause and longest non-shock pause. In the pre-feedback period 55 cases were analyzed and 69 cases in the feedback period. Median CCF improved significantly in the feedback period (79% vs 86%, presuscitation feedback improves the quality of resuscitation, significantly increasing CCF and decreasing the duration of longest non-shock pauses. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Visual behaviour analysis and driver cognitive model

Energy Technology Data Exchange (ETDEWEB)

Baujon, J.; Basset, M.; Gissinger, G.L. [Mulhouse Univ., (France). MIPS/MIAM Lab.

2001-07-01

Recent studies on driver behaviour have shown that perception - mainly visual but also proprioceptive perception - plays a key role in the ''driver-vehicle-road'' system and so considerably affects the driver's decision making. Within the framework of the behaviour analysis and studies low-cost system (BASIL), this paper presents a correlative, qualitative and quantitative study, comparing the information given by visual perception and by the trajectory followed. This information will help to obtain a cognitive model of the Rasmussen type according to different driver classes. Many experiments in real driving situations have been carried out for different driver classes and for a given trajectory profile, using a test vehicle and innovative, specially designed, real-time tools, such as the vision system or the positioning module. (orig.)

SPIDER: A Framework for Understanding Driver Distraction.

Science.gov (United States)

Strayer, David L; Fisher, Donald L

2016-02-01

The objective was to identify key cognitive processes that are impaired when drivers divert attention from driving. Driver distraction is increasingly recognized as a significant source of injuries and fatalities on the roadway. A "SPIDER" model is developed that identifies key cognitive processes that are impaired when drivers divert attention from driving. SPIDER is an acronym standing for scanning, predicting, identifying, decision making, and executing a response. When drivers engage in secondary activities unrelated to the task of driving, SPIDER-related processes are impaired, situation awareness is degraded, and the ability to safely operate a motor vehicle may be compromised. The pattern of interference helps to illuminate the sources of driver distraction and may help guide the integration of new technology into the automobile. © 2015, Human Factors and Ergonomics Society.

Association of Bystander Cardiopulmonary Resuscitation and Survival According to Ambulance Response Times After Out-of-Hospital Cardiac Arrest.

Science.gov (United States)

Rajan, Shahzleen; Wissenberg, Mads; Folke, Fredrik; Hansen, Steen Møller; Gerds, Thomas A; Kragholm, Kristian; Hansen, Carolina Malta; Karlsson, Lena; Lippert, Freddy K; Køber, Lars; Gislason, Gunnar H; Torp-Pedersen, Christian

2016-12-20

response time in this study) to 5 minutes. The absolute survival associated with bystander CPR declined rapidly with time. Yet bystander CPR while waiting for an ambulance was associated with a more than doubling of 30-day survival even in case of long ambulance response time. Decreasing ambulance response time by even a few minutes could potentially lead to many additional lives saved every year. © 2016 American Heart Association, Inc.

High current, high bandwidth laser diode current driver

Science.gov (United States)

Copeland, David J.; Zimmerman, Robert K., Jr.

1991-01-01

A laser diode current driver has been developed for free space laser communications. The driver provides 300 mA peak modulation current and exhibits an optical risetime of less than 400 ps. The current and optical pulses are well behaved and show minimal ringing. The driver is well suited for QPPM modulation at data rates up to 440 Mbit/s. Much previous work has championed current steering circuits; in contrast, the present driver is a single-ended on/off switch. This results in twice the power efficiency as a current steering driver. The driver electrical efficiency for QPPM data is 34 percent. The high speed switch is realized with a Ku-band GaAsFET transistor, with a suitable pre-drive circuit, on a hybrid microcircuit adjacent to the laser diode.

18- to 24-year-olds : young drivers.

NARCIS (Netherlands)

2016-01-01

The fatality rate (fatalities per distance travelled) of young drivers (18- to 24-year-olds) is more than five times higher than that of drivers between the ages of 30 and 59 years. The fatality rate of young males is even as much as ten times higher. The high risk of young drivers is due to both

Look-ahead driver feedback and powertrain management

Energy Technology Data Exchange (ETDEWEB)

Verma, Rajeev [Eaton Corporation, Menomonee Falls, WI (United States)

2014-12-31

Commercial medium and heavy vehicles, though only a small portion of total vehicle population, play a significant role in energy consumption. In 2012, these vehicles accounted for about 5775.5 trillion btu of energy consumption and 408.8 million tons of CO2 emissions annually, which is a quarter of the total energy burden of highway transportation in the United States [1]. This number is expected to surpass passenger car fuel use within the next few decades. In the meantime, most commercial vehicle fleets are running at a very low profit margin. It is a well known fact that fuel economy can vary significantly between drivers, even when they operate the same vehicle on the same route. According to the US Environmental Protection Agency (EPA) and Natural Resource Canada (NRCan), there is up to 35% fuel economy difference between drivers within the same commercial fleet [2] [3], [4]. Similar results were obtained from a Field Operation Test conducted by Eaton Corporation [5]. During this test as much as 30% fuel economy difference was observed among pick-up-and-delivery drivers and 11% difference was observed among line-haul drivers. The driver variability can be attributed to the fact that different drivers react differently to driving conditions such as road grade, traffic, speed limits, etc. For instance, analysis of over 600k miles of naturalistic heavy duty truck driving data [5] indicates that an experienced driver anticipates a downhill and eases up on the throttle to save fuel while an inexperienced driver lacks this judgment.

Schoolbus driver performance can be improved with driver training ...

African Journals Online (AJOL)

The Safe Travel to School Programme was recently implemented by a national child safety agency, with a focus on driver road safety awareness, defensive ... of a vehicle telematics tracking system with regular, individual driving behaviour ...

Interfacility transfer of pregnant women using publicly funded emergency call centre-based ambulance services: a cross-sectional analysis of service logs from five states in India.

Science.gov (United States)

Singh, Samiksha; Doyle, Pat; Campbell, Oona Mr; Oakley, Laura; Rao, Gv Ramana; Murthy, Gvs

2017-06-09

To estimate the proportion of interfacility transfers (IFTs) transported by '108' ambulances and to compare the characteristics of the IFTs and non-IFTs to understand the pattern of use of '108' services for pregnant women in India. A cross-sectional analysis of '108' ambulance records from five states for the period April 2013 to March 2014. Data were obtained from the call centre database for the pregnant women, who called '108'. Proportion of all pregnancies and institutional deliveries in the population who were transported by '108', both overall and for IFT. Characteristics of the women transported; obstetric emergencies, the distances travelled and the time taken for both IFT and non-IFT. The '108' ambulances transported 6 08 559 pregnant women, of whom 34 993 were IFTs (5.8%) in the five states. We estimated that '108' transferred 16.5% of all pregnancies and 20.8% of institutional deliveries. Only 1.2% of all institutional deliveries in the population were transported by '108' for IFTs-lowest 0.6% in Gujarat and highest 3.0% in Himachal Pradesh. Of all '108' IFTs, only 8.4% had any pregnancy complication. For all states combined, on adjusted analysis, IFTs were more likely than non-IFTs to be for older and younger women or from urban areas, and less likely to be for women from high-priority districts, from backward or scheduled castes, or women below the poverty line. Obstetric emergencies were more than twice as likely to be IFTs as pregnant women without obstetric emergencies (OR=2.18, 95% CI 2.09 to 2.27). There was considerable variation across states. Only 6% institutional deliveries made use of the '108' ambulance for IFTs in India. The vast majority did not have any complication or emergency. The '108' service may need to consider strategies to prioritise the transfer of women with obstetric emergency and those requiring IFT, over uncomplicated non-IFT. © Article author(s) (or their employer(s) unless otherwise stated in the text of the

Testing a structural model of young driver willingness to uptake Smartphone Driver Support Systems.

Science.gov (United States)

Kervick, Aoife A; Hogan, Michael J; O'Hora, Denis; Sarma, Kiran M

2015-10-01

There is growing interest in the potential value of using phone applications that can monitor driver behaviour (Smartphone Driver Support Systems, 'SDSSs') in mitigating risky driving by young people. However, their value in this regard will only be realised if young people are willing to use this technology. This paper reports the findings of a study in which a novel structural model of willingness to use SDSSs was tested. Grounded in the driver monitoring and Technology Acceptance (TA) research literature, the model incorporates the perceived risks and gains associated with potential SDSS usage and additional social cognitive factors, including perceived usability and social influences. A total of 333 smartphone users, aged 18-24, with full Irish driving licenses completed an online questionnaire examining willingness or Behavioural Intention (BI) to uptake a SDSS. Following exploratory and confirmatory factor analyses, structural equation modelling indicated that perceived gains and social influence factors had significant direct effects on BI. Perceived risks and social influence also had significant indirect effects on BI, as mediated by perceived gains. Overall, this model accounted for 72.5% of the variance in willingness to uptake SDSSs. Multi-group structural models highlighted invariance of effects across gender, high and low risk drivers, and those likely or unlikely to adopt novel phone app technologies. These findings have implications for our understanding of the willingness of young drivers to adopt and use SDSSs, and highlight potential factors that could be targeted in behavioural change interventions seeking to improve usage rates. Copyright © 2015 Elsevier Ltd. All rights reserved.

TRENDS AND ISSUES IN SAFE DRIVER ASSISTANCE SYSTEMS

Directory of Open Access Journals (Sweden)

Sadayuki TSUGAWA

2006-01-01

Full Text Available In recent years, ITS projects in Japan, Europe and the US have been characterized by a strong emphasis on safe driver assistance systems designed to prevent traffic accidents. As it has become clear that eradicating accidents will be impossible by means of vehicle passive safety and single-vehicle active safety efforts alone, research and development of systems for preventing accidents through road-vehicle cooperation and vehicle-vehicle cooperation have been promoted in Japan (ASV, AHS, Europe (PReVENT, SAFESPOT and the US (VII. The key to such technology is road-to-vehicle communications and inter-vehicle communications. On the other hand, a number of driver assistance systems have been brought to market, including lidar-based forward collision warnings, ACC, lane keeping support and drowsiness warnings, but their penetration rates in Japan are extremely low. Furthermore, one major challenge is that safe driver assistance systems based on road-vehicle and vehicle-vehicle cooperation are premised upon a high penetration rate. Finally, we introduce a system for improving driver acceptance of safe driver assistance systems based on driver monitoring and forward monitoring as well as cooperative driver assistance systems for elderly drivers, an issue now receiving attention in Japan.

Older drivers' risks of at-fault motor vehicle collisions.

Science.gov (United States)

Ichikawa, Masao; Nakahara, Shinji; Taniguchi, Ayako

2015-08-01

In aging societies, increasing numbers of older drivers are involved in motor vehicle collisions (MVCs), and preserving their safety is a growing concern. In this study, we focused on whether older drivers were more likely to cause MVCs and injuries than drivers in other age groups. To do so we compared at-fault MVC incidence and resulting injury risks by drivers' ages, using data from Japan, a country with a rapidly aging population. The at-fault MVC incidence was calculated based on distance traveled made for non-commercial purposes, and the injury risks posed to at-fault drivers and other road users per at-fault MVCs. We used MVC data for 2010 from the National Police Agency of Japan and driving exposure data from the Nationwide Person Trip Survey conducted by a Japanese governmental ministry in 2010. The at-fault MVC incidence showed a U-shaped curve across the drivers' ages, where teenage and the oldest drivers appeared to be the highest risk groups in terms of causing MVCs, and the incidence was higher for female drivers after age 25. The injury risk older drivers posed to other vehicle occupants because of their at-fault MVCs was lower than for drivers in other age groups, while their own injury risk appeared much higher. As the number of older drivers is increasing, efforts to reduce their at-fault MVCs appear justified. Copyright © 2015 Elsevier Ltd. All rights reserved.

Myocardial infarction in Swedish subway drivers.

Science.gov (United States)

Bigert, Carolina; Klerdal, Kristina; Hammar, Niklas; Gustavsson, Per

2007-08-01

Particulate matter in urban air is associated with the risk of myocardial infarction in the general population. Very high levels of airborne particles have been detected in the subway system of Stockholm, as well as in several other large cities. This situation has caused concern for negative health effects among subway staff. The aim of this study was to investigate whether there is an increased incidence of myocardial infarction among subway drivers. Data from a population-based case-control study of men aged 40-69 in Stockholm County in 1976-1996 were used. The study included all first events of myocardial infarction in registers of hospital discharges and deaths. The controls were selected randomly from the general population. National censuses were used for information on occupation. Altogether, 22 311 cases and 131 496 controls were included. Among these, 54 cases and 250 controls had worked as subway drivers. The relative risk of myocardial infarction among subway drivers was not increased. It was 0.92 [95% confidence interval (95% CI) 0.68-1.25] when the subway drivers were compared with other manual workers and 1.06 (95% CI 0.78-1.43) when the subway drivers were compared with all other gainfully employed men. Subgroup analyses indicated no influence on the risk of myocardial infarction from the duration of employment, latency time, or time since employment stopped. Subway drivers in Stockholm do not have a higher incidence of myocardial infarction than other employed persons.

Driver's Behavior Modeling Using Fuzzy Logic

Directory of Open Access Journals (Sweden)

Sehraneh Ghaemi

2010-01-01

Full Text Available In this study, we propose a hierarchical fuzzy system for human in a driver-vehicle-environment system to model takeover by different drivers. The driver's behavior is affected by the environment. The climate, road and car conditions are included in fuzzy modeling. For obtaining fuzzy rules, experts' opinions are benefited by means of questionnaires on effects of parameters such as climate, road and car conditions on driving capabilities. Also the precision, age and driving individuality are used to model the driver's behavior. Three different positions are considered for driving and decision making. A fuzzy model called Model I is presented for modeling the change of steering angle and speed control by considering time distances with existing cars in these three positions, the information about the speed and direction of car, and the steering angle of car. Also we obtained two other models based on fuzzy rules called Model II and Model III by using Sugeno fuzzy inference. Model II and Model III have less linguistic terms than Model I for the steering angle and direction of car. The results of three models are compared for a driver who drives based on driving laws.

High frequency MOSFET gate drivers technologies and applications

CERN Document Server

Zhang, Zhiliang

2017-01-01

This book describes high frequency power MOSFET gate driver technologies, including gate drivers for GaN HEMTs, which have great potential in the next generation of switching power converters. Gate drivers serve as a critical role between control and power devices.

[Ambulance services in Copenhagen, Odense and Ringkøbing County. Results of the spot test conducted by the Ministry of Health and the County Councils Association in 1990. 1. Epidemiological data].

Science.gov (United States)

Trier, H; Larsen, C F

1992-02-17

In 1990, The Danish Ministry of Health and the County Council Association undertook a spot test investigation of the activities in connection with 3,182 emergency ambulance services (AU) in the Municipality of Copenhagen (a city), the Odense district (a large provincial town) and the County of Ringkøbing (a mixed rural and urban region). The investigation included data collected by the ambulance staff before hospitalization and the diagnoses on discharge from casualty and hospital departments. The frequency of AU per 1,000 population was found to be 101 annually in Copenhagen, 44 in Odense and 19 in the County of Ringkøbing. More than 10% of the services in all three regions did not result in transport of the patient to hospital treatment. The average age of the patients was 52 years in Copenhagen compared with 44 years in the other two regions. The age-specific frequency of AU for patients aged 0-4 year-old was nine times as great in Copenhagen than in Odense and the County of Ringkøbing and, where patients aged more than 80 years were concerned, the frequency was 4-10 times as great. In all three regions, the activities of ambulance services were most numerous between 6-16 hours and lowest during the period 0-6 hours. Services to patients' homes constituted 44-46% and to traffic regions 32-40%. Services on account of illness constituted 41-45% and, on account of accidents, 27-35%. In cases of rapid emergency transport (using signals), 78% of the ambulances had reached the patient within five minutes in Copenhagen as compared with 44% in Odense and the County of Ringkøbing.(ABSTRACT TRUNCATED AT 250 WORDS)

Fighting against a shortage of truck drivers in logistics: Measures that employers can take to promote drivers' work ability and health.

Science.gov (United States)

Staats, Ulrike; Lohaus, Daniela; Christmann, Alina; Woitschek, Michèle

2017-01-01

For several years, the transportation industry has been concerned about a severe shortage of professional truck drivers. Studies investigating the reasons found that poor working conditions and stresses and strains resulting from physiological and psychological job demands have had a negative impact on drivers' health and ability to work. Nevertheless, until now, most employers have refrained from offering measures to support the work ability and well-being of drivers, mainly due to financial pressures in the industry. The present study was aimed at designing adequate and affordable measures to support drivers' health. With reference to the Work Ability Index and the house of work ability (Ilmarinen & Tuomi, 2004), 56 truck drivers participated in guided interviews about their working conditions and health-related problems as well as their attitudes, experiences, and desires with respect to being offered supportive measures by their employers. The measures derived are specific and realizable and expected to be widely accepted by professional drivers. They are designed to elicit a positive attitude in the drivers toward exercising and to help them overcome related psychological barriers. The implementation of the recommended measures can be expected to support drivers' work ability and help reduce the frictional costs of their employers.

Peptic ulcer among urban bus drivers in Denmark

DEFF Research Database (Denmark)

Netterstrøm, Bo; Juel, K

1990-01-01

As part of a survey on the work environment of bus drivers, 2045 (83%) of 2465 male bus drivers in the three major cities in Denmark in 1978 answered a postal questionnaire on health and working conditions. In order to evaluate the relative occurrence of peptic ulcer among the bus drivers, a follow......-up study was also conducted. All hospital discharges with a peptic ulcer diagnosis among the bus drivers were registered from the Danish National Patient Register. All Danish men were used as reference group. On the basis of the 1978-questionnaire association between occupational and psychosocial factors...... and subsequent hospital discharge with a peptic ulcer diagnosis was studied. The prevalence of abdominal pain alleviated by food intake was 12% among bus drivers and 6% in the reference group. The incidence of hospital discharge with duodenal ulcer among younger bus drivers was twice the incidence among Danish...

Driver citation/carrier data relationship project

Science.gov (United States)

1996-09-01

The Driver/Carrier Relationship Project was commissioned to address three issues. The first was to determine if drivers of commercial motor vehicles get tickets at a different rate, depending on the carrier that they are working for. The second issue...

Driver electronic device use in 2013.

Science.gov (United States)

2015-04-01

The percentage of drivers text-messaging or visibly manipulating : hand-held devices increased from 1.5 percent in : 2012 to 1.7 percent in 2013; however, this was not a statistically : significant increase. Driver hand-held cell phone : use decrease...

Automobile Driver Fingerprinting

Directory of Open Access Journals (Sweden)

Enev Miro

2016-01-01

Full Text Available Today’s automobiles leverage powerful sensors and embedded computers to optimize efficiency, safety, and driver engagement. However the complexity of possible inferences using in-car sensor data is not well understood. While we do not know of attempts by automotive manufacturers or makers of after-market components (like insurance dongles to violate privacy, a key question we ask is: could they (or their collection and later accidental leaks of data violate a driver’s privacy? In the present study, we experimentally investigate the potential to identify individuals using sensor data snippets of their natural driving behavior. More specifically we record the in-vehicle sensor data on the controllerarea- network (CAN of a typical modern vehicle (popular 2009 sedan as each of 15 participants (a performed a series of maneuvers in an isolated parking lot, and (b drove the vehicle in traffic along a defined ~ 50 mile loop through the Seattle metropolitan area. We then split the data into training and testing sets, train an ensemble of classifiers, and evaluate identification accuracy of test data queries by looking at the highest voted candidate when considering all possible one-vs-one comparisons. Our results indicate that, at least among small sets, drivers are indeed distinguishable using only incar sensors. In particular, we find that it is possible to differentiate our 15 drivers with 100% accuracy when training with all of the available sensors using 90% of driving data from each person. Furthermore, it is possible to reach high identification rates using less than 8 minutes of training data. When more training data is available it is possible to reach very high identification using only a single sensor (e.g., the brake pedal. As an extension, we also demonstrate the feasibility of performing driver identification across multiple days of data collection

Effects of cellular telephone manipulation on driver`s performance; Jidosha untenchu no keitai denwa shiyo sosa ni kanrensuru mondai no kenkyu

Energy Technology Data Exchange (ETDEWEB)

Tokunaga, R; Ozawa, M; Hagiwara, T [Hokkaido University, Sapporo (Japan); Takagi, H; Shimojo, A [Civil Engineering Research Institute of Hokkaido, Hokkaido (Japan)

1997-10-01

The present evaluates effects of cellular telephone manipulation on driver`s performance. The major independent variables were the reaction time and the mental workload. Hart et al. proposed the concept of the subjective mental workload. Experiments were conduced using a driving simulator without motion. Findings showed that the hands free system may provide less effect than the cellular telephone on the passenger seat on driver`s reaction time and mental workload. 4 refs., 2 tabs., 5 figs.

Predictors of workplace violence among ambulance personnel: a longitudinal study.

Science.gov (United States)

van der Velden, Peter G; Bosmans, Mark W G; van der Meulen, Erik

2016-04-01

To examine predictors of repeated confrontations with workplace violence among ambulance personnel, the proportion of exposure to potentially traumatic events that are aggression-related and to what extent personnel was able to prevent escalations. Although previous research assessed the prevalences among this group, little is known about predictors, to what extent PTE's are WPV-related and their abilities to prevent escalations. A longitudinal study with a 6 months' time interval ( N  =   103). At T1 demographics, workplace violence and potentially traumatic events in the past year, mental health, personality, handling of rules, coping and social organizational stressors were assessed. Confrontations with aggression were also examined at T2. Multivariate logistic regression analyses showed that only problems with superiors independently predicted repeated verbal aggression and that only the (absence of the) ability to compromise very easily predicted repeatedly being on guard and repeatedly confronted with any form of aggression. Due to very low prevalences, we could not examine predictors of repeated confrontations with physical aggression ( N  =   5) and serious threat ( N  =   7). A large majority reported that in most workplace violence cases they could prevent further escalations. About 2% reported a potentially traumatic event in the year before T1 that was WPV related and perceived as very stressful.

Do young novice drivers overestimate their driving skills?

NARCIS (Netherlands)

Craen, S. de Twisk, D.A.M. Hagenzieker, M.P. Elffers, H. & Brookhuis, K.A.

2007-01-01

In this study the authors argue that, in order to sufficiently adapt to task demands in traffic, drivers have to make an assessment of their own driving skills. There are indications that drivers in general, and novice drivers in particular, overestimate their driving skills. The objective of this

Modeling driver stop/run behavior at the onset of a yellow indication considering driver run tendency and roadway surface conditions.

Science.gov (United States)

Elhenawy, Mohammed; Jahangiri, Arash; Rakha, Hesham A; El-Shawarby, Ihab

2015-10-01

The ability to model driver stop/run behavior at signalized intersections considering the roadway surface condition is critical in the design of advanced driver assistance systems. Such systems can reduce intersection crashes and fatalities by predicting driver stop/run behavior. The research presented in this paper uses data collected from two controlled field experiments on the Smart Road at the Virginia Tech Transportation Institute (VTTI) to model driver stop/run behavior at the onset of a yellow indication for different roadway surface conditions. The paper offers two contributions. First, it introduces a new predictor related to driver aggressiveness and demonstrates that this measure enhances the modeling of driver stop/run behavior. Second, it applies well-known artificial intelligence techniques including: adaptive boosting (AdaBoost), random forest, and support vector machine (SVM) algorithms as well as traditional logistic regression techniques on the data in order to develop a model that can be used by traffic signal controllers to predict driver stop/run decisions in a connected vehicle environment. The research demonstrates that by adding the proposed driver aggressiveness predictor to the model, there is a statistically significant increase in the model accuracy. Moreover the false alarm rate is significantly reduced but this reduction is not statistically significant. The study demonstrates that, for the subject data, the SVM machine learning algorithm performs the best in terms of optimum classification accuracy and false positive rates. However, the SVM model produces the best performance in terms of the classification accuracy only. Copyright © 2015 Elsevier Ltd. All rights reserved.

Determinants and Drivers of Infectious Disease Threat Events in Europe.

Science.gov (United States)

Semenza, Jan C; Lindgren, Elisabet; Balkanyi, Laszlo; Espinosa, Laura; Almqvist, My S; Penttinen, Pasi; Rocklöv, Joacim

2016-04-01

Infectious disease threat events (IDTEs) are increasing in frequency worldwide. We analyzed underlying drivers of 116 IDTEs detected in Europe during 2008-2013 by epidemic intelligence at the European Centre of Disease Prevention and Control. Seventeen drivers were identified and categorized into 3 groups: globalization and environment, sociodemographic, and public health systems. A combination of >2 drivers was responsible for most IDTEs. The driver category globalization and environment contributed to 61% of individual IDTEs, and the top 5 individual drivers of all IDTEs were travel and tourism, food and water quality, natural environment, global trade, and climate. Hierarchical cluster analysis of all drivers identified travel and tourism as a distinctly separate driver. Monitoring and modeling such disease drivers can help anticipate future IDTEs and strengthen control measures. More important, intervening directly on these underlying drivers can diminish the likelihood of the occurrence of an IDTE and reduce the associated human and economic costs.

The driver, the road, the rules … and the rest? A systems-based approach to young driver road safety.

Science.gov (United States)

Scott-Parker, B; Goode, N; Salmon, P

2015-01-01

The persistent overrepresentation of young drivers in road crashes is universally recognised. A multitude of factors influencing their behaviour and safety have been identified through methods including crash analyses, simulated and naturalistic driving studies, and self-report measures. Across the globe numerous, diverse, countermeasures have been implemented; the design of the vast majority of these has been informed by a driver-centric approach. An alternative approach gaining popularity in transport safety is the systems approach which considers not only the characteristics of the individual, but also the decisions and actions of other actors within the road transport system, along with the interactions amongst them. This paper argues that for substantial improvements to be made in young driver road safety, what has been learnt from driver-centric research needs to be integrated into a systems approach, thus providing a holistic appraisal of the young driver road safety problem. Only then will more effective opportunities and avenues for intervention be realised. Copyright © 2014 Elsevier Ltd. All rights reserved.

Licensing and Other Controls of the Drinking Driver.

Science.gov (United States)

Waller, Patricia F.

Driver licensing, the only state program with the opportunity for routine personal contact with every driver, has unmatched potential for both general and specific countermeasures to the problem of drunk driving. General countermeasures apply to large groups of drivers prior to the occurrence of any infraction. They may be considered basically…

Functional Bus Driver-Pupil Passenger Relationships.

Science.gov (United States)

Farmer, Ernest

1987-01-01

Successful school bus drivers bring much more than mechanical know-how to the job. They develop good rapport with students while acting to bring undesirable student behavior under control. Drivers must also show an interest in students' welfare and have a good sense of humor. (MLH)

Challenges for Older Drivers in Urban, Suburban, and Rural Settings

Directory of Open Access Journals (Sweden)

Rashmi P. Payyanadan

2018-03-01

Full Text Available Along with age-related factors, geographical settings—urban, suburban, and rural areas—also contribute to the differences in fatal crashes among older drivers. These differences in crash outcomes might be attributed to the various driving challenges faced by older drivers residing in different locations. To understand these challenges from the perspective of the older driver, a focus group study was conducted with drivers 65 and older from urban, suburban, and rural settings. Guided-group interviews were used to assess driving challenges, mobility options, opportunities for driver support systems (DSS, and alternate transportation needs. Content analysis of the interview responses resulted in four categories representing common challenges faced by older drivers across the settings: behavior of other drivers on the road, placement of road signs, reduced visibility of road signs due to age-related decline, and difficulties using in-vehicle technologies. Six categories involved location-specific challenges such as heavy traffic situations for urban and suburban drivers, and multi-destination trips for rural drivers. Countermeasures implemented by older drivers to address these challenges primarily involved route selection and avoidance. Technological advances of DSS systems provide a unique opportunity to support the information needs for route selection and avoidance preferences of drivers. Using the content analysis results, a framework was built to determine additional and modified DSS features to meet the specific challenges of older drivers in urban, suburban, and rural settings. These findings suggest that there is heterogeneity in the driving challenges and preferences of older drivers based on their location. Consequently, DSS technologies and vehicle automation need to be tailored to not only meet the driving safety and mobility needs of older drivers as a population, but also to their driving environment.

Eight months of emergency services by ambulance (with doctor on board) of the Emergency Department of Prato, Italy.

Science.gov (United States)

Olia, P M; Mollica, T V; Querci, A

2002-11-01

The aim of the present study was to analyse the types of calls attended by the authors in their ambulance, assigned to one sector of the urban area of Prato. We analysed 1060 consecutive calls carried out by our ambulance; 33 calls (3.1%), cancelled for various reasons, were excluded from statistical analysis. The calls regarded 1027 patients, 549 (53.5%) males and 478 (46.5%) females. 46% of calls concerned non trauma cases, 17% trauma cases and 7.2% transfers between hospitals. Calls in the non trauma group were for dyspnea (16.7%), unconsciousness (16.6%), chest pain (11.8%), cerebrovascular pathology (7.7%), mental disorders (7.1%), abdominal pain (5.1%), use of psychotropic substances (4%) and convulsions (3.2%). Support to patients with terminal cancer accounted for 2.3% of cases, metabolic disorders 2.2%, hypertensive events 2.1%, tachycardia 1.9%, vertigo 1.9%, allergies 1%, obstetric pathology 0.5% and cardiorespiratory resuscitation 2,2%. Thirteen point seven percent were miscellaneous, including poisonings, migraines, haemorrhages and flu syndromes. Trauma cases included road accidents (62.6%), falls (27%), aggression (6.9%), work-related accidents (3.5%). The percentage of trauma cases (17%) was similar to that reported for a Swedish urban area (20%). Cases of cardiorespiratory resuscitation were 1.65% of our calls, compared to 1.73% and 1.8% reported in Northeastern Germany and Taiwan. Although prehospital emergency medical services are organised differently in different countries, our data suggest that emergency medical services in our area have a percentage distribution of case types similar to services in other countries.

How to identify the key factors that affect driver perception of accident risk. A comparison between Italian and Spanish driver behavior.

Science.gov (United States)

de Oña, Juan; de Oña, Rocio; Eboli, Laura; Forciniti, Carmen; Mazzulla, Gabriella

2014-12-01

Road crashes can be caused by different factors, including infrastructure, vehicles, and human variables. Many research studies have focused solely on identifying the key factors that cause road crashes. From these studies, it emerged that human factors have the most relevant impact on accident severity. More specifically, accident severity depends on several factors related directly to the driver, i.e., driving experience, driver's socio-economic characteristics, and driving behavior and attitudes. In this paper, we investigate driver behaviors and attitudes while driving and specifically focus on different methods for identifying the factors that most affect the driver's perception of accident risk. To this end, we designed and conducted a survey in two different European contexts: the city of Cosenza, which is located in the south of Italy, and the city of Granada, which is located in the south of Spain. Samples of drivers were contacted for their opinions on certain aspects of driving rules and attitudes while driving, and different types of questions were addressed to the drivers to assess their judgments of these aspects. Consequently, different methods of data analysis were applied to determine the aspects that heavily influence driver perception of accident risk. An experiment based on the stated preferences (SP) was carried out with the drivers, and the SP data were analyzed using an ordered probit (OP) model. Interesting findings emerged from different analyses of the data and from the comparisons among the data collected in the two different territorial contexts. We found that both Italian and Spanish drivers consider driving in an altered psychophysical state and violating the overtaking rules to be the most risky behaviors. Copyright © 2014 Elsevier Ltd. All rights reserved.

Emergency Victim Care. A Training Manual for Emergency Medical Technicians. Module 2. Equipment, Safe Driving Practices, Legal Aspects, Controlling the Situation, Action Evaluation Conference. Revised.

Science.gov (United States)

Ohio State Dept. of Education, Columbus. Div. of Vocational Education.

This student manual, the second in a set of 14 modules, is designed to train emergency medical technicians (EMTs) in Ohio. The module contains five sections that cover the following course content: ambulance equipment, safe driving practices for emergency vehicle drivers, legal aspects of the EMT's job, how to maintain control at an accident scene…

Discriminating Drivers through Human Factor and Behavioral Difference

Directory of Open Access Journals (Sweden)

Ju Seok Oh

2011-05-01

Full Text Available Since Greenwood and Woods' (1919 study in tendency of accident, many researchers have insisted that various human factors (sensation seeking, anger, anxiety are highly correlated with reckless driving and traffic accidents. Oh and Lee (2011 designed the Driving Behavior Determinants Questionnaire, a psychological tool to predict danger level of drivers and discriminate them into three groups (normal, unintentionally reckless, and intentionally reckless by their characteristics, attitude, and expected reckless behavior level. This tool's overall accuracy of discrimination was 70%. This study aimed to prove that the discrimination reflects the behavioral difference of drivers. Twenty-four young drivers were requested to react to the visual stimuli (tests for subjective speed sense, simple visual reaction time, and left turning at own risk. The results showed no differences in subjective speed sense among the driver groups, which means drivers' excessive speeding behaviors occur due to intention based on personality and attitude, not because of sensory disorders. In addition, there were no differences in simple reaction time among driver groups. However, the results of the ‘Left turning at drivers’ own risk task” revealed significant group differences. All reckless drivers showed a greater degree of dangerous left turning behaviors than the normal group did.

High-Voltage LED Light Engine with Integrated Driver

Energy Technology Data Exchange (ETDEWEB)

Soer, Wouter [Lumileds LLC, San Jose, CA (United States)

2016-02-29

LED luminaires have seen dramatic changes in cost breakdown over the past few years. The LED component cost, which until recently was the dominant portion of luminaire cost, has fallen to a level of the same order as the other luminaire components, such as the driver, housing, optics etc. With the current state of the technology, further luminaire performance improvement and cost reduction is realized most effectively by optimization of the whole system, rather than a single component. This project focuses on improving the integration between LEDs and drivers. Lumileds has developed a light engine platform based on low-cost high-power LEDs and driver topologies optimized for integration with these LEDs on a single substrate. The integration of driver and LEDs enables an estimated luminaire cost reduction of about 25% for targeted applications, mostly due to significant reductions in driver and housing cost. The high-power LEDs are based on Lumileds’ patterned sapphire substrate flip-chip (PSS-FC) technology, affording reduced die fabrication and packaging cost compared to existing technology. Two general versions of PSS-FC die were developed in order to create the desired voltage and flux increments for driver integration: (i) small single-junction die (0.5 mm²), optimal for distributed lighting applications, and (ii) larger multi-junction die (2 mm² and 4 mm²) for high-power directional applications. Two driver topologies were developed: a tapped linear driver topology and a single-stage switch-mode topology, taking advantage of the flexible voltage configurations of the new PSS-FC die and the simplification opportunities enabled by integration of LEDs and driver on the same board. A prototype light engine was developed for an outdoor “core module” application based on the multi-junction PSS-FC die and the single-stage switch-mode driver. The light engine meets the project efficacy target of 128 lm/W at a luminous flux

Creative prosthetic foot selection enables successful ambulation in stiletto high heels.

Science.gov (United States)

Russell Esposito, Elizabeth; Lipe, Delbert H; Rábago, Christopher A

2017-11-01

Walking in high heels presents biomechanical challenges, yet they remain part of many women's attire. However, women with a lower limb amputation are limited in available footwear options. Case description and methods: This case study is in response to one patient's assertion that she walked better and more symmetrically in heels than flat shoes with her below-knee prosthesis. She underwent gait analysis in athletic shoes and 10-cm stiletto high heels worn with a pediatric running foot to determine if these claims could be substantiated through biomechanical measures. Global gait asymmetry indices were calculated. Findings and outcomes: Asymmetry indices were nearly identical between athletic shoes and heels but joint-level findings differed substantially. Ankle mechanics were more symmetrical in heels but hip mechanics were less. The maintenance of symmetry in stiletto high heels does not imply maintenance of gait quality, as high heels are known to adversely affect some components walking mechanics. Clinical relevance Returning to high-heel wear is achievable for prosthesis users. Accommodations can be made using creativity in prosthetic foot selection to enable successful ambulation; however, attention to gait mechanics may be important for patient safety.

A learning-based autonomous driver: emulate human driver's intelligence in low-speed car following

Science.gov (United States)

Wei, Junqing; Dolan, John M.; Litkouhi, Bakhtiar

2010-04-01

In this paper, an offline learning mechanism based on the genetic algorithm is proposed for autonomous vehicles to emulate human driver behaviors. The autonomous driving ability is implemented based on a Prediction- and Cost function-Based algorithm (PCB). PCB is designed to emulate a human driver's decision process, which is modeled as traffic scenario prediction and evaluation. This paper focuses on using a learning algorithm to optimize PCB with very limited training data, so that PCB can have the ability to predict and evaluate traffic scenarios similarly to human drivers. 80 seconds of human driving data was collected in low-speed (car-following scenarios. In the low-speed car-following tests, PCB was able to perform more human-like carfollowing after learning. A more general 120 kilometer-long simulation showed that PCB performs robustly even in scenarios that are not part of the training set.

[Health reasons for work disability among municipal transport drivers].

Science.gov (United States)

Szubert, Zuzanna; Sobala, Wojciech

2005-01-01

The health condition of public transport drivers is one of the factors playing a role in assuring safety of passengers taking use of this kind of transportation means. Therefore, the assessment of pathologies occurring in this occupational group is essential from the prevention point of view. Drivers employed in the municipal transport system are at particular risk. The aim of the study was to define health reasons of work disability among bus and tram drivers in general and to indicate pathologies responsible for disabilities in particular. The study covered 940 drivers (including 788 men and 152 women) employed in a municipal transportation enterprise during the years 1996-2000. Bus (30%) and tram (22%) drivers as well as transport service workers (48%), aged over 45 years, but under the retirement age, were eligible for the study. The analysis of temporary work disability during a five-year period was based on sickness absence, sickness absence rate and the average duration of sickness absence. The analysis revealed that diseases of the circulatory system form the major group of pathologies responsible for total sickness absence among bus drivers (43%), tram drivers (27%) and transport service workers (27%). These disease are also a leading cause of earlier retirement. They mostly include ischemic heart disease in bus drivers and hypertension in tram drivers. Cancers (pleura, kidney and eye) were responsible for 9% of sickness absence in the group of male tram drivers, whereas endocrine, nutritional and metabolic diseases and immunity disorders (diabetes, disorders of thyroid gland) in 16% of female tram drivers. Diseases of the musculoskeletal system were major causes of sickness absence among female tram drivers (24%), whereas malignant and benign neoplasms of breast and uterine myoma in 24% of female transport service workers. The results of the analysis are in agreement with the literature findings and provide explicit evidence that employment in the

A COOPERATIVE ASSISTANCE SYSTEM BETWEEN VEHICLES FOR ELDERLY DRIVERS

Directory of Open Access Journals (Sweden)

Naohisa HASHIMOTO

2009-01-01

Full Text Available This paper proposes a new concept of elderly driver assistance systems, which performs the assistance by cooperative driving between two vehicles, and describes some experiments with elderly drivers. The assistance consists of one vehicle driven by an elderly driver called a guest vehicle and the other driven by a assisting driver called a host vehicle, and the host vehicle assists or escorts the guest vehicle through the inter-vehicle communications. The functions of the systems installed on a single-seat electric vehicle are highly evaluated by subjects of elderly drivers in virtual streets on a test track.

A driver-adaptive stability control strategy for sport utility vehicles

Science.gov (United States)

Zhu, Shenjin; He, Yuping

2017-08-01

Conventional vehicle stability control (VSC) systems are designed for average drivers. For a driver with a good driving skill, the VSC systems may be redundant; for a driver with a poor driving skill, the VSC intervention may be inadequate. To increase safety of sport utility vehicles (SUVs), this paper proposes a novel driver-adaptive VSC (DAVSC) strategy based on scaling the target yaw rate commanded by the driver. The DAVSC system is adaptive to drivers' driving skills. More control effort would be exerted for drivers with poor driving skills, and vice versa. A sliding mode control (SMC)-based differential braking (DB) controller is designed using a three degrees of freedom (DOF) yaw-plane model. An eight DOF nonlinear yaw-roll model is used to simulate the SUV dynamics. Two driver models, namely longitudinal and lateral, are used to 'drive' the virtual SUV. By integrating the virtual SUV, the DB controller, and the driver models, the performance of the DAVSC system is investigated. The simulations demonstrate the effectiveness of the DAVSC strategy.

Real-time driver fatigue detection based on face alignment

Science.gov (United States)

Tao, Huanhuan; Zhang, Guiying; Zhao, Yong; Zhou, Yi

2017-07-01

The performance and robustness of fatigue detection largely decrease if the driver with glasses. To address this issue, this paper proposes a practical driver fatigue detection method based on face alignment at 3000 FPS algorithm. Firstly, the eye regions of the driver are localized by exploiting 6 landmarks surrounding each eye. Secondly, the HOG features of the extracted eye regions are calculated and put into SVM classifier to recognize the eye state. Finally, the value of PERCLOS is calculated to determine whether the driver is drowsy or not. An alarm will be generated if the eye is closed for a specified period of time. The accuracy and real-time on testing videos with different drivers demonstrate that the proposed algorithm is robust and obtain better accuracy for driver fatigue detection compared with some previous method.

Railway suicide: the psychological effects on drivers.

Science.gov (United States)

Farmer, R; Tranah, T; O'Donnell, I; Catalan, J

1992-05-01

People have jumped (or fallen) in front of trains on the London Underground system in increasing numbers throughout the twentieth century. During the past decade there have been about 100 such incidents each year, of which around 90 would involve the train driver witnessing his train strike the person on the track. Most are suicides or attempts at suicide. They represent major unexpected and violent events in the lives of the train drivers and it might be expected that some of them would respond by developing a post-traumatic stress reaction of the type identified by Horowitz (1976) or other adverse psychological reactions or both. The research reported in this paper was designed to characterize the range of responses of drivers to the experiences of killing or injuring members of the public during the course of their daily work. It was found that 16.3% of the drivers involved in incidents did develop post-traumatic stress disorder and that other diagnoses, e.g. depression and phobic states, were present in 39.5% of drivers when interviewed one month after the incident.

Cross-cultural differences in drivers' speed choice.

Science.gov (United States)

Wallén Warner, Henriette; Ozkan, Türker; Lajunen, Timo

2009-07-01

The aim of the present study was to examine if there are any cross-cultural differences between Swedish and Turkish drivers' rating of the variables in the theory of planned behaviour (TPB) with regard to complying with the speed limit. A sample of 219 Swedish and 252 Turkish drivers completed a questionnaire including questions based on the theory of planned behaviour (i.e. regarding attitude, subjective norm, perceived behavioural control, intention and behaviour). The results show that country differences in drivers' intention to comply with the speed limit as well as their self-reported compliance could be explained by differences found in their attitude, subjective norm and perceived behavioural control. Furthermore, drivers who live in a country with fewer road traffic fatalities (i.e. Sweden), compared with drivers who live in a country with more road traffic fatalities (i.e. Turkey), reported a more positive attitude towards complying with the speed limit, a more positive subjective norm, a higher perceived behavioural control, a higher intention and a larger proportion of the time spent complying.

Views of US drivers about driving safety.

Science.gov (United States)

Williams, Allan F

2003-01-01

To assess how drivers view dangers on the highway, what motivates them to drive safely, how they say they reduce their crash and injury risk, and how they rate their own driving skills. Most drivers rated their skills as better than average. The biggest motivating factor for safe driving was concern for safety of others in their vehicle, followed by negative outcomes such as being in a crash, increased insurance costs, and fines. The greatest threats to their safety were thought to be other drivers' actions that increase crash risk such as alcohol impairment or running red lights. In terms of reducing crashes and injuries, drivers tended to focus on actions they could take such as driving defensively or using seat belts. There was less recognition of the role of vehicles and vehicle features in crash or injury prevention. Knowing how drivers view themselves and others, their concerns, and their motivations and techniques for staying out of trouble on the roads provides insight into the difficulty of changing driving practices.

Community-acquired pneumonia; Ambulant erworbene Pneumonien

Energy Technology Data Exchange (ETDEWEB)

Poetter-Lang, S.; Herold, C.J. [Medizinische Universitaet Wien, Department of Biomedical Imaging and Image-guided Therapy, Allgemeines Krankenhaus, Wien (Austria)

2017-01-15

The diagnosis of community-acquired pneumonia (CAP) is often not possible based only on the clinical symptoms and biochemical parameters. For every patient with the suspicion of CAP, a chest radiograph in two planes should be carried out. Additionally, a risk stratification for the decision between outpatient therapy or hospitalization is recommended. Based on the evaluation of the different radiological patterns as well as their extent and distribution, a rough allocation to so-called pathogen groups as well as a differentiation between viral and bacterial infections are possible; however, because different pathogens cause different patterns an accurate correlation is not feasible by relying purely on imaging. The radiological findings serve as proof or exclusion of pneumonia and can also be used to evaluate the extent of the disease (e.g. monolobular, multilobular, unilateral or bilateral). In cases of prolonged disease, suspicion of complications (e.g. pleural effusion or empyema, necrotizing pneumonia or abscess) or comorbid conditions (e.g. underlying pulmonary or mediastinal diseases) computed tomography is an important diagnostic tool in addition to chest radiography. Ultrasound is often used to diagnose pleural processes (e.g. parapneumonic effusion or pleural empyema). (orig.) [German] Anhand der klinischen Symptome und laborchemischen Befundkonstellation alleine ist es oft nicht moeglich, die Diagnose einer ambulant erworbenen Pneumonie (''community-acquired pneumonia'', CAP) zu stellen. Bei jedem Patienten mit Verdacht auf CAP sollte eine Roentgenthoraxaufnahme in 2 Ebenen angefertigt werden. Weiter muss eine Risikostratifizierung im Sinne der Entscheidung ambulante Therapie vs. Hospitalisierung erfolgen. Anhand der Analyse radiologischer Muster sowie deren Verteilung und Ausdehnung koennen eine grobe Zuordnung zu sogenannten Erregergruppen sowie eine Differenzierung zwischen viralen und bakteriellen Infektionen gelingen. Da

Impact Driver With Integral Sliding Hammer

Science.gov (United States)

Wallace, Bilby J.

1987-01-01

Tool combines impact driver with sliding dead-blow hammer. Used for any purpose for which ordinary impact driver used; tightening fasteners or driving starter holes for drill. Tool protects user from accidental injury and surrounding equipment from damage that might occur from ordinary arm-wielded hammer. Especially useful in underwater work.

X3 expansion tube driver gas spectroscopy and temperature measurements

Science.gov (United States)

Parekh, V.; Gildfind, D.; Lewis, S.; James, C.

2018-07-01

The University of Queensland's X3 facility is a large, free-piston driven expansion tube used for super-orbital and high Mach number scramjet aerothermodynamic studies. During recent development of new scramjet test flow conditions, experimentally measured shock speeds were found to be significantly lower than that predicted by initial driver performance calculations. These calculations were based on ideal, isentropic compression of the driver gas and indicated that loss mechanisms, not accounted for in the preliminary analysis, were significant. The critical determinant of shock speed is peak driver gas sound speed, which for a given gas composition depends on the peak driver gas temperature. This temperature may be inaccurately estimated if an incorrect fill temperature is assumed, or if heat losses during driver gas compression are significant but not accounted for. For this study, the ideal predicted peak temperature was 3750 K, without accounting for losses. However, a much lower driver temperature of 2400 K is suggested based on measured experimental shock speeds. This study aimed to measure initial and peak driver gas temperatures for a representative X3 operating condition. Examination of the transient temperatures of the driver gas and compression tube steel wall during the initial fill process showed that once the filling process was complete, the steady-state driver gas temperature closely matched the tube wall temperature. Therefore, while assuming the gas is initially at the ambient laboratory temperature is not a significant source of error, it can be entirely mitigated by simply monitoring tube wall temperature. Optical emission spectroscopy was used to determine the driver gas spectra after diaphragm rupture; the driver gas emission spectrum exhibited a significant continuum radiation component, with prominent spectral lines attributed to contamination of the gas. A graybody approximation of the continuum suggested a peak driver gas temperature of

X3 expansion tube driver gas spectroscopy and temperature measurements

Science.gov (United States)

Parekh, V.; Gildfind, D.; Lewis, S.; James, C.

2017-11-01

The University of Queensland's X3 facility is a large, free-piston driven expansion tube used for super-orbital and high Mach number scramjet aerothermodynamic studies. During recent development of new scramjet test flow conditions, experimentally measured shock speeds were found to be significantly lower than that predicted by initial driver performance calculations. These calculations were based on ideal, isentropic compression of the driver gas and indicated that loss mechanisms, not accounted for in the preliminary analysis, were significant. The critical determinant of shock speed is peak driver gas sound speed, which for a given gas composition depends on the peak driver gas temperature. This temperature may be inaccurately estimated if an incorrect fill temperature is assumed, or if heat losses during driver gas compression are significant but not accounted for. For this study, the ideal predicted peak temperature was 3750 K, without accounting for losses. However, a much lower driver temperature of 2400 K is suggested based on measured experimental shock speeds. This study aimed to measure initial and peak driver gas temperatures for a representative X3 operating condition. Examination of the transient temperatures of the driver gas and compression tube steel wall during the initial fill process showed that once the filling process was complete, the steady-state driver gas temperature closely matched the tube wall temperature. Therefore, while assuming the gas is initially at the ambient laboratory temperature is not a significant source of error, it can be entirely mitigated by simply monitoring tube wall temperature. Optical emission spectroscopy was used to determine the driver gas spectra after diaphragm rupture; the driver gas emission spectrum exhibited a significant continuum radiation component, with prominent spectral lines attributed to contamination of the gas. A graybody approximation of the continuum suggested a peak driver gas temperature of

Understanding Factors of Distraction among Intrastate Bus Driver

Directory of Open Access Journals (Sweden)

Yunos Muhammad Nur Annuar Mohd

2017-01-01

Full Text Available The increase in number of the world population have affected the demand for public transport especially in larger cities. Intrastate buses are chosen as the main public transport by many people due to its affordable fares. Therefore, a better performance of the intrastate bus drivers would be significant to cater the high demand. Nevertheless, distraction among the intrastate bus drivers have been found as one of the major factors that could affect the performance of the drivers. Therefore, the objective of this paper is to provide a better understanding on the factors of distraction among intrastate bus drivers. This paper refers to findings from previous researches which are related to this field of study. In conclusion, this paper will provide a list of factors of distraction among the intrastate bus drivers which may degrade their performance.

Development of pulsed high current drivers for fast Z-pinch

International Nuclear Information System (INIS)

Sun Fengju; Qiu Aici; Zeng Zhengzhong; Zeng Jiangtao; Kuai Bin; Yang Hailiang

2006-01-01

It is required that the peak current of high power pulsed drive for fast Z-pinch reaches 60 MA to realize inertial confine fusion (ICF) and high yield (HY). With the conventional technological methods similar to the Z or Saturn apparatus, increasing driver current further is impractical and difficult according to the cost, structure complexity and reliability of the driver, so it is necessary to develop novel fast pulsed high current driver. The present art-of-state and trends of fast Z-pinch driver are summarized, and the typical conceptual designs and technological methods on ICF/HY PRS (plasma radiation source) and destroying-level super X-ray simulators in USA and Russia are outlined, such as HCEI's UGXX1 driver and new Saturn driver based on fast linear transformer driver (FLTD) and novel driver based on fast Marx generator (FMG) with current of 15 MA. The crucial technological problems and requirements to investigate in the future are presented. (authors)

Does early training improve driving skills of young novice French drivers?

Science.gov (United States)

Freydier, Chloé; Berthelon, Catherine; Bastien-Toniazzo, Mireille

2016-11-01

The aim of this research was to study drivers' performances and divided attention depending on their initial training. The performances of young novice drivers who received early training, traditionally trained drivers and more experienced drivers were compared during a dual task consisting of a simulated car-following task and a number' parity judgment task. It was expected that, due to their limited driving experience, the young novice drivers would have more difficulty in adequately distributing their attention between the two tasks. Poorer performances by novice drivers than experienced drivers were therefore expected. The results indicate that traditionally trained drivers had more difficulties in speed regulation and maintaining their position in the lane than drivers with early training and experienced drivers. Performance impairment linked to driving inexperience was also found in the secondary task. The results were interpreted regarding the attentional resources involved in driving with a secondary task and supported the positive effects of French early training. Copyright © 2016 Elsevier Ltd. All rights reserved.

Estimating likelihood of future crashes for crash-prone drivers

Directory of Open Access Journals (Sweden)

Subasish Das

2015-06-01

Full Text Available At-fault crash-prone drivers are usually considered as the high risk group for possible future incidents or crashes. In Louisiana, 34% of crashes are repeatedly committed by the at-fault crash-prone drivers who represent only 5% of the total licensed drivers in the state. This research has conducted an exploratory data analysis based on the driver faultiness and proneness. The objective of this study is to develop a crash prediction model to estimate the likelihood of future crashes for the at-fault drivers. The logistic regression method is used by employing eight years' traffic crash data (2004–2011 in Louisiana. Crash predictors such as the driver's crash involvement, crash and road characteristics, human factors, collision type, and environmental factors are considered in the model. The at-fault and not-at-fault status of the crashes are used as the response variable. The developed model has identified a few important variables, and is used to correctly classify at-fault crashes up to 62.40% with a specificity of 77.25%. This model can identify as many as 62.40% of the crash incidence of at-fault drivers in the upcoming year. Traffic agencies can use the model for monitoring the performance of an at-fault crash-prone drivers and making roadway improvements meant to reduce crash proneness. From the findings, it is recommended that crash-prone drivers should be targeted for special safety programs regularly through education and regulations.

Systems analysis for modular versus multi-beam HIF drivers

International Nuclear Information System (INIS)

Meier, W.R.; Logan, B.G.

2004-01-01

Previous modeling for HIF drivers concentrated on designs in which 100 or more beams are grouped in an array and accelerated through a common set of induction cores. The total beam energy required by the target is achieved by the combination of final ion energy, current per beam and number of beams. Economic scaling favors a large number of small (∼1 cm dia.) beams. An alternative architecture has now been investigated, which we refer to as a modular driver. In this case, the driver is subdivided into many (>10) independent accelerators with one or many beams each. A key objective of the modular driver approach is to be able to demonstrate all aspects of the driver (source-to-target) by building a single, lower cost module compared to a full-scale, multi-beam driver. We consider and compare several design options for the modular driver including single-beam designs with solenoid instead of quadrupole magnets in order to transport the required current per module in a single beam, solenoid/quad combinations, and multi-beam, all-quad designs. The drivers are designed to meet the requirements of the hybrid target, which can accommodate a larger spot size than the distributed radiator target that was used for the Robust Point Design. We compare the multi-beam and modular driver configuration for a variety and assumptions and identify key technology advances needed for the modular design

Car drivers' perceptions of electronic stability control (ESC) systems.

Science.gov (United States)

Vadeby, Anna; Wiklund, Mats; Forward, Sonja

2011-05-01

As a way to reduce the number of car crashes different in-car safety devices are being introduced. In this paper one such application is being investigated, namely the electronic stability control system (ESC). The study used a survey method, including 2000 private car drivers (1000 driving a car with ESC and 1000 driving a car without ESC). The main objective was to investigate the effect of ESC on driver behaviour. Results show that drivers report that they drive even more carelessly when they believe that they have ESC, than when they do not. Men are more risk prone than women and young drivers more than older drivers. Using the theory of planned behaviour the results show that attitude, subjective norm and perceived control explain between 62% and 67% of driver's variation of intentions to take risks. When descriptive norm was added to the model a small but statistically significant increase was found. The study also shows that more than 35% erroneously believe that their car is equipped with an ESC system. These findings may suggest that driver behaviour could reduce the positive effect ESC has on accidents. It also shows that drivers who purchase a new car are not well informed about what kind of safety devices the car is equipped with. These findings highlight the need for more targeted information to drivers. Copyright © 2010 Elsevier Ltd. All rights reserved.

How driving duration influences drivers' visual behaviors and fatigue ...

African Journals Online (AJOL)

unhcc

Eye fixations express the focus of driver's visual attention on driving, ... driver's attention is attracted by fatigue. The second ... was divided into seven refined categories (see Table 1), ...... driver fatigue in terms of line crossing: a pilot study.

Discovery of cancer common and specific driver gene sets

Science.gov (United States)

2017-01-01

Abstract Cancer is known as a disease mainly caused by gene alterations. Discovery of mutated driver pathways or gene sets is becoming an important step to understand molecular mechanisms of carcinogenesis. However, systematically investigating commonalities and specificities of driver gene sets among multiple cancer types is still a great challenge, but this investigation will undoubtedly benefit deciphering cancers and will be helpful for personalized therapy and precision medicine in cancer treatment. In this study, we propose two optimization models to de novo discover common driver gene sets among multiple cancer types (ComMDP) and specific driver gene sets of one certain or multiple cancer types to other cancers (SpeMDP), respectively. We first apply ComMDP and SpeMDP to simulated data to validate their efficiency. Then, we further apply these methods to 12 cancer types from The Cancer Genome Atlas (TCGA) and obtain several biologically meaningful driver pathways. As examples, we construct a common cancer pathway model for BRCA and OV, infer a complex driver pathway model for BRCA carcinogenesis based on common driver gene sets of BRCA with eight cancer types, and investigate specific driver pathways of the liquid cancer lymphoblastic acute myeloid leukemia (LAML) versus other solid cancer types. In these processes more candidate cancer genes are also found. PMID:28168295

Lane-changing model with dynamic consideration of driver's propensity

Science.gov (United States)

Wang, Xiaoyuan; Wang, Jianqiang; Zhang, Jinglei; Ban, Xuegang Jeff

2015-07-01

Lane-changing is the driver's selection result of the satisfaction degree in different lane driving conditions. There are many different factors influencing lane-changing behavior, such as diversity, randomicity and difficulty of measurement. So it is hard to accurately reflect the uncertainty of drivers' lane-changing behavior. As a result, the research of lane-changing models is behind that of car-following models. Driver's propensity is her/his emotion state or the corresponding preference of a decision or action toward the real objective traffic situations under the influence of various dynamic factors. It represents the psychological characteristics of the driver in the process of vehicle operation and movement. It is an important factor to influence lane-changing. In this paper, dynamic recognition of driver's propensity is considered during simulation based on its time-varying discipline and the analysis of the driver's psycho-physic characteristics. The Analytic Hierarchy Process (AHP) method is used to quantify the hierarchy of driver's dynamic lane-changing decision-making process, especially the influence of the propensity. The model is validated using real data. Test results show that the developed lane-changing model with the dynamic consideration of a driver's time-varying propensity and the AHP method are feasible and with improved accuracy.

Optimizing the Universal Robots ROS driver

DEFF Research Database (Denmark)

Andersen, Thomas Timm

improvement both in terms of faster reaction as well as making it possible to control the robot using either ros_control or ordinary joint speed commands, which is required for many types of sensory based control like visual servoing. The developed driver is compared to the drivers already existing in the ROS...

Dynamic Characteristics of DC Servo Motor Driven by Conventional Servo Driver: Estimation of Circuit Constants in Conventional Servo Driver

OpenAIRE

酒井, 史敏; 神谷, 好承; 関, 啓明; 疋津, 正利

2000-01-01

DC servo motors that are made as manufactured goods in the factory are widely used as actuators for driving many automatic machines. Then the manufactured driver (amplifier) that is matched to its servo motor is coveniently chosen to drive when aiming at high performance of the motion control. Motion of motor that is driven by the manufactured servo driver has very complicated dynamic characteristics. In this study, it is tried to make clear about inner composition of the servo driver through...

75 FR 32983 - Commercial Driver's License (CDL) Standards: Exemption

Science.gov (United States)

2010-06-10

...-28480] Commercial Driver's License (CDL) Standards: Exemption AGENCY: Federal Motor Carrier Safety... commercial driver's license (CDL) as required by current regulations. FMCSA reviewed NAAA's application for... demonstrate alternatives its members would employ to ensure that their commercial motor vehicle (CMV) drivers...

Drivers and moderators of business decline

Directory of Open Access Journals (Sweden)

Marius Pretorius

2010-12-01

Full Text Available Purpose: Reports of business failure elicit various reactions, while research in this domain often appears to be limited by a lack of access to information about failure and by the negativity that surrounds it. Those who have experienced failure do not readily talk about it, or they disappear from the radar screen of researchers. Yet failure is preceded by decline which, when focused on strategically, can reduce eventual failures if early action is taken. The main purpose of this study is to develop a conceptual framework or typology of the drivers and moderators of business decline. Design/methodology/approach: After applying the "grounded theory" approach to the academic literature on decline and failure, a conceptual framework for the variables that drive and moderate business decline is proposed. Findings: The study proposes that decline has three core drivers, three peripheral drivers and four moderators. The core drivers identified are: resource munificence; leadership as origin; and causality (strategic versus operational origin of decline. The three peripheral drivers are: unique preconditions; continuous decisions impact; and extremes dichotomy. The study describes four moderators of the drivers: life cycle stage; stakeholder perspective; quantitative versus qualitative nature of signs and causes; and finally the age and size effects. Research limitations/implications: The proposed conceptual framework is based on literature only, although it has found support during discussions with practitioners. It is proposed to readers of this journal for scrutiny and validation. Practical implications: Strategists need to understand what drives decline in order to act timeously; practitioners who have an insight into the moderators with their impacts could make better decisions in response to decline in organisations and possibly avoid business failure. Originality/Value: Understanding business decline is still a huge theoretical challenge, which

Tarantula: Killing driver bugs before they hatch

DEFF Research Database (Denmark)

Lawall, Julia Laetitia; Muller, Gilles; Urunuela, Richard

2005-01-01

The Linux operating system is undergoing continual evolution. Evolution in the kernel and generic driver modules often triggers the need for corresponding evolutions in specific device drivers. Such collateral evolutions are tedious, because of the large number of device drivers, and error......-prone, because of the complexity of the code modifications involved. We propose an automatic tool, Tarantula, to aid in this process. In this paper, we examine some recent evolutions in Linux and the collateral evolutions they trigger, and assess the corresponding requirements on Tarantula....

Physical characteristics of experienced and junior open-wheel car drivers.

Science.gov (United States)

Raschner, Christian; Platzer, Hans-Peter; Patterson, Carson

2013-01-01

Despite the popularity of open-wheel car racing, scientific literature about the physical characteristics of competitive race car drivers is scarce. The purpose of this study was to compare selected fitness parameters of experienced and junior open-wheel race car drivers. The experienced drivers consisted of five Formula One, two GP2 and two Formula 3 drivers, and the nine junior drivers drove in the Formula Master, Koenig, BMW and Renault series. The following fitness parameters were tested: multiple reactions, multiple anticipation, postural stability, isometric upper body strength, isometric leg extension strength, isometric grip strength, cyclic foot speed and jump height. The group differences were calculated using the Mann-Whitney U-test. Because of the multiple testing strategy used, the statistical significance was Bonferroni corrected and set at P < 0.004. Significant differences between the experienced and junior drivers were found only for the jump height parameter (P = 0.002). The experienced drivers tended to perform better in leg strength (P = 0.009), cyclic foot speed (P = 0.024) and grip strength (P = 0.058). None of the other variables differed between the groups. The results suggested that the experienced drivers were significantly more powerful than the junior drivers: they tended to be quicker and stronger (18% to 25%) but without statistical significance. The experienced drivers demonstrated excellent strength and power compared with other high-performance athletes.

Free electron laser as a fusion driver

International Nuclear Information System (INIS)

Prosnitz, D.; Schlitt, L.

1981-01-01

The Free Electron Laser (FEL) is shown to be a potentially attractive solution to the problem of finding a suitable short wavelength fusion driver. The design of a 3 MJ, 250 nm FEL fusion driver is discussed

Traffic safety issues in North Dakota : phase II : driver knowledge, attitude, behavior and beliefs : focus group : young male drivers

Science.gov (United States)

2008-10-01

Traffic safety is a widespread social concern. Tackling the problem requires understanding the people : who are driving. This includes information about driver behavior, but also about perceptions these drivers : hold regarding their driving. North D...

Detecting Driver Drowsiness Based on Sensors: A Review

Directory of Open Access Journals (Sweden)

Kenneth Sundaraj

2012-12-01

Full Text Available In recent years, driver drowsiness has been one of the major causes of road accidents and can lead to severe physical injuries, deaths and significant economic losses. Statistics indicate the need of a reliable driver drowsiness detection system which could alert the driver before a mishap happens. Researchers have attempted to determine driver drowsiness using the following measures: (1 vehicle-based measures; (2 behavioral measures and (3 physiological measures. A detailed review on these measures will provide insight on the present systems, issues associated with them and the enhancements that need to be done to make a robust system. In this paper, we review these three measures as to the sensors used and discuss the advantages and limitations of each. The various ways through which drowsiness has been experimentally manipulated is also discussed. We conclude that by designing a hybrid drowsiness detection system that combines non-intusive physiological measures with other measures one would accurately determine the drowsiness level of a driver. A number of road accidents might then be avoided if an alert is sent to a driver that is deemed drowsy.

Driver's mental workload prediction model based on physiological indices.

Science.gov (United States)

Yan, Shengyuan; Tran, Cong Chi; Wei, Yingying; Habiyaremye, Jean Luc

2017-09-15

Developing an early warning model to predict the driver's mental workload (MWL) is critical and helpful, especially for new or less experienced drivers. The present study aims to investigate the correlation between new drivers' MWL and their work performance, regarding the number of errors. Additionally, the group method of data handling is used to establish the driver's MWL predictive model based on subjective rating (NASA task load index [NASA-TLX]) and six physiological indices. The results indicate that the NASA-TLX and the number of errors are positively correlated, and the predictive model shows the validity of the proposed model with an R 2 value of 0.745. The proposed model is expected to provide a reference value for the new drivers of their MWL by providing the physiological indices, and the driving lesson plans can be proposed to sustain an appropriate MWL as well as improve the driver's work performance.

Theoretical models of drivers behavior on the road

Directory of Open Access Journals (Sweden)

Marcin Piotr Biernacki

2017-06-01

Full Text Available Understanding of mechanisms and factors responsible for the driver behavior on the road is the subject of ongoing interest to transportation psychologists, occupational doctors and engineers. Models of driver behavior are a key point for the understanding the mechanisms and factors which may cause limitations to the optimal functioning on the road. They also systematize knowledge about the factors responsible for the behavior of the driver and thus constitute a starting point for formulating empirical or diagnostic hypotheses. The aim of this study is to present models of driver behavior from the descriptive and functional perspectives. Med Pr 2017;68(3:401–411

Integrated Context-Aware Driver Assistance System Architecture

Directory of Open Access Journals (Sweden)

Elhadi M. Shakshuki

2013-01-01

Full Text Available Recently, significant improvements have been made in the area of vehicular communication systems. Furthermore, vehicle-to-vehicle communication is considered a key concept for keeping roads safe. An efficient implementation of these systems is necessary to ensure the safety of driving situations and to reduce the collision rates. This paper proposes a Context-Aware Driver Assistance System that links drivers with the physical environment surrounding them using multiple types of sensors and traffic systems as well as considering the senior driver's difficulties and the system processing time. This is achieved by developing a warning system that assists drivers to avoid collisions and improve their response times. The proposed system architecture consists of a set of components to process the user's request such as parking assistance, and to provide responses and advices when needed. These components include communication, knowledge exchange, knowledge update, and context-history. Also, it includes other processes such as context-history manipulation, hazard detection, and hazard detection control. The main goal of the proposed system is to reduce the number of car accidents and improve driver's decisions. The NXT Robotic environment is used to demonstrate the feasibility of the proposed system.

Análise da configuração de SAMU utilizando múltiplas alternativas de localização de ambulâncias Analysis of SAMU configuration using multiple alternatives of ambulance location

Directory of Open Access Journals (Sweden)

Regiane Máximo de Souza

2013-06-01

Full Text Available O Sistema de Atendimento Móvel de Urgência (SAMU no Brasil é um sistema médico emergencial de responsabilidade do poder público, em que a demanda de usuários em uma região urbana é usualmente separada por subregiões e classes de chamados emergenciais. Essa demanda pode mudar de forma significativa ao longo do dia, geograficamente e temporalmente, devido à sua natureza aleatória, mas também devido aos diferentes padrões de comportamentos da população ao longo do dia. Por exemplo, tipicamente há menos demanda durante a noite do que de dia. Os objetivos deste trabalho são: verificar se o conhecido modelo hipercubo de filas espacialmente distribuídas é adequado para analisar medidas de desempenho do SAMU, tais como tempos médios de resposta aos usuários, e utilizar este modelo para analisar múltiplas alternativas de localização das ambulâncias, explorando variações importantes da demanda e do serviço ao longo do dia. Para verificar a viabilidade e a aplicabilidade desta abordagem, foi realizado um estudo de caso no SAMU de Ribeirão Preto-SP.The Brazilian emergency medical system SAMU (Sistema de Atendimento Móvel de Urgência is an emergency medical system of public government liability, in which the users' service demand in an urban region is usually separated into subregions and classes of emergency calls. This demand can change substantially during the day, geographically and temporally, due to its random nature and also to the different behavior patterns of the population throughout the day. For instance, typically there is less demand during the night hours than during the day. The goals of this study are to verify whether the hypercube queuing model is adequate to analyze performance measures of SAMU, such as mean response times to the users, and use this model to analyze multiple alternatives of ambulance location considering significant variations in the demand and service throughout the day. In order to verify

U.S. DOE driver development for ICF

International Nuclear Information System (INIS)

Sluyter, M.M.

1995-01-01

The goal of the Department of Energy (DOE) supported Inertial Confinement Fusion (ICF) Program is to produce pure fusion ignition with fusion yields of 200 to 1000 millions of joules, which could find several applications in the defence and in the electric power generation. The National Ignition Facility will operate in both direct and indirect driver modes, with a glass laser driver. However two other options have been developed to increase the energy efficiency: the Light Ion Pulsed Power program and the NIKE KrF laser. Heavy ion drivers are also investigated -Abstract only-. (TEC)

Will the Driver Seat Ever Be Empty?

OpenAIRE

Fraichard , Thierry

2014-01-01

Self-driving technologies have matured and improved to the point that, in the past few years, self-driving cars have been able to safely drive an impressive number of kilometers. It should be noted though that, in all cases, the driver seat was never empty: a human driver was behind the wheel, ready to take over whenever the situation dictated it. This is an interesting paradox since the point of a self-driving car is to remove the most unreliable part of the car, namely the human driver. So,...

Driver feedback mobile APP

Energy Technology Data Exchange (ETDEWEB)

Soriguera Marti, F.; Miralles Miquel, E.

2016-07-01

This paper faces the human factor in driving and its consequences for road safety. It presents the concepts behind the development of a smartphone app capable of evaluating drivers’ performance. The app provides feedback to the driver in terms of a grade (between 0 and 10) depending on the aggressiveness and risks taken while driving. These are computed from the cumulative probability distribution function of the jerks (i.e. the time derivative of acceleration), which are measured using the smartphones’ accelerometer. Different driving contexts (e.g. urban, freeway, congestion, etc.) are identified applying cluster analysis to the measurements, and treated independently. Using regression analysis, the aggressiveness indicator is related to the drivers' safety records and to the probability of having an accident, through the standard DBQ - Driving Behavior Questionnaire. Results from a very limited pilot test show a strong correlation between the 99th percentile of the jerk measurements and the DBQ results. A linear model is fitted. This allows quantifying the safe driving behavior only from smartphone measurements. Finally, this indicator is translated into a normalized grade and feedback to the driver. This feedback will challenge the driver to train and to improve his performance. The phone will be blocked while driving and will incorporate mechanisms to prevent bad practices, like competition in aggressive driving. The app is intended to contribute to the improvement of road safety, one of the major public health problems, by tackling the human factor which is the trigger of the vast majority of traffic accidents. Making explicit and quantifying risky behaviors is the first step towards a safer driving. (Author)

A novel active heads-up display for driver assistance.

Science.gov (United States)

Doshi, Anup; Cheng, Shinko Yuanhsien; Trivedi, Mohan Manubhai

2009-02-01

In this paper, we introduce a novel laser-based wide-area heads-up windshield display which is capable of actively interfacing with a human as part of a driver assistance system. The dynamic active display (DAD) is a unique prototype interface that presents safety-critical visual icons to the driver in a manner that minimizes the deviation of his or her gaze direction without adding to unnecessary visual clutter. As part of an automotive safety system, the DAD presents alerts in the field of view of the driver only if necessary, which is based upon the state and pose of the driver, vehicle, and environment. This paper examines the effectiveness of DAD through a comprehensive comparative experimental evaluation of a speed compliance driver assistance system, which is implemented on a vehicular test bed. Three different types of display protocols for assisting a driver to comply with speed limits are tested on actual roadways, and these are compared with a conventional dashboard display. Given the inclination, drivers who are given an overspeed warning alert reduced the time required to slow down to the speed limit by 38% (p system.

Estimating likelihood of future crashes for crash-prone drivers

OpenAIRE

Subasish Das; Xiaoduan Sun; Fan Wang; Charles Leboeuf

2015-01-01

At-fault crash-prone drivers are usually considered as the high risk group for possible future incidents or crashes. In Louisiana, 34% of crashes are repeatedly committed by the at-fault crash-prone drivers who represent only 5% of the total licensed drivers in the state. This research has conducted an exploratory data analysis based on the driver faultiness and proneness. The objective of this study is to develop a crash prediction model to estimate the likelihood of future crashes for the a...

Cedar Avenue driver assist system evaluation report.

Science.gov (United States)

2011-12-01

This paper summarizes an evaluation of the Driver Assist System (DAS) used by the Minnesota Valley Transit Authority (MTVA) for bus shoulder operations. The DAS is a GPS-based technology suite that provides lane-position feedback to the driver via a ...

PILOT RESULTS ON FORWARD COLLISION WARNING SYSTEM EFFECTIVENESS IN OLDER DRIVERS.

Science.gov (United States)

Lester, Benjamin D; Sager, Lauren N; Dawson, Jeffrey; Hacker, Sarah D; Aksan, Nazan; Rizzo, Matthew; Kitazaki, Satoshi

2015-06-01

Advanced Driver Assistance Systems (ADAS) have largely been developed with a "one-size-fits-all" approach. This approach neglects the large inter-individual variability in perceptual and cognitive abilities that affect aging ADAS users. We investigated the effectiveness of a forward collision warning (FCW) with fixed response parameters in young and older drivers with differing levels of cognitive functioning. Drivers responded to a pedestrian stepping into the driver's path on a simulated urban road. Behavioral metrics included response times (RT) for pedal controls and two indices of risk penetration (e.g., maximum deceleration and minimum time-to-collision (TTC)). Older drivers showed significantly slower responses at several time points compared to younger drivers. The FCW facilitated response times (RTs) for older and younger drivers. However, older drivers still showed smaller safety gains compared to younger drivers at accelerator pedal release and initial brake application when the FCW was active. No significant differences in risk metrics were observed within the condition studied. The results demonstrate older drivers likely differ from younger drivers using a FCW with a fixed parameter set. Finally, we briefly discuss how future research should examine predictive relationships between domains of cognitive functioning and ADAS responses to develop parameter sets to fit the individual.

Skylab IMSS checklist application study for emergency medical care. [emergency medical care operations involving the use and operation of the portable ambulance module

Science.gov (United States)

Carl, J. G.; Furukawa, S.

1975-01-01

A manual is presented that provides basic technical documentation to support the operation and utilization of the Portable Ambulance Module (PAM) in the field. The PAM is designed to be used for emergency resuscitation and victim monitoring. The functions of all the controls, displays, and stowed equipment of the unit are defined. Supportive medical and physiological data in those areas directly related to the uses of the PAM unit are presented.

The driver as archetype for driver assistance systems? A driver-model based approach for the development of situation-adaptive DAS; Der Fahrer als Vorbild fuer Fahrerassistenzsysteme? Ein Fahrermodellbasierter Ansatz zur Entwicklung von situationsadaptiven FAS

Energy Technology Data Exchange (ETDEWEB)

Benmimoun, A. [Inst. fuer Kraftfahrwesen, RWTH-Aachen, Aachen (Germany)

2004-07-01

A new approach for the development of advanced driver assistance systems is presented. The keynote of this new approach is to use the driver model of the traffic simulation tool PELOPS as a control algorithm and to apply it to a vehicle. The fact, that the human driving behaviour is the starting point of the development, is the main advantage of this new approach. Thus important aspects for the development of driver assistance systems like a situation-adaptive and reliable control, understandable behaviour and the consideration of driver-individual parameters are integrated in the controller design from the beginning. An application example of the new approach is shown. (orig.)

Secondary Behavior of Drivers on Cell Phones.

Science.gov (United States)

Farmer, Charles M; Klauer, Sheila G; McClafferty, Julie A; Guo, Feng

2015-01-01

The objective of this study was to determine whether cell phone use by drivers leads to changes in the frequency of other types of potentially distracting behavior. There were 2 main questions of interest: (1) As each driver changes cell phone use, does he or she change the amount of driving time spent on other distracting behavior? (2) As each driver changes cell phone use, does he or she change the amount of driving time spent looking away from the driving task? Day-to-day driving behavior of 105 volunteer subjects was monitored over a period of 1 year. The amount of driving time during each trip spent on tasks secondary to driving (or looking away from the driving task) was correlated to the amount of time on a cell phone, taking into account the relationships among trips taken by the same driver. Drivers spent 42% of the time engaging in at least one secondary activity. Drivers were talking on a cell phone 7% of the time, interacting in some other way with a cell phone 5% of the time, and engaging in some other secondary activity (sometimes in conjunction with cell phone use) 33% of the time. Other than cell phone use, the most common secondary activities were interacting with a passenger (12% of driving time), holding but not otherwise interacting with an object (6%), and talking/singing/dancing to oneself (5%). Drivers were looking straight forward 81% of the time, forward left or right 5% of time, in a mirror 4% of the time, and elsewhere (eyes off driving task) 10% of time. On average, for each 1 percentage point increase in cell phone talking, the other secondary behavior rate decreased by 0.28 percentage points (P cell phone interaction per trip, the other secondary behavior rate decreased by 0.08 percentage points (P =.0558), but the rate of eyes off driving task increased by 0.06 percentage points (P cell phone can be distracting from the driving task, other secondary activities can be equally or more distracting, at least as measured by eye glances

Young Drivers Perceptual Learning Styles Preferences and Traffic Accidents

Directory of Open Access Journals (Sweden)

Svetlana Čičević

2011-05-01

Full Text Available Young drivers are over-represented in crash and fatality statistics. One way of dealing with this problem is to achieve primary prevention through driver education and training. Factors of traffic accidents related to gender, age, driving experience, and self-assessments of safety and their relationship to perceptual learning styles (LS preferences have been analyzed in this study. The results show that auditory is the most prominent LS. Drivers in general, as well as drivers without traffic accidents favour visual and tactile LS. Both inexperienced and highly experienced drivers show relatively high preference of kinaesthetic style. Yet, taking into account driving experience we could see that the role of kinaesthetic LS is reduced, since individual LS has become more important. Based on the results of this study it can be concluded that a multivariate and multistage approach to driver education, taking into account differences in LS preferences, would be highly beneficial for traffic safety.

Microcontroller based driver alertness detection systems to detect drowsiness

Science.gov (United States)

Adenin, Hasibah; Zahari, Rahimi; Lim, Tiong Hoo

2018-04-01

The advancement of embedded system for detecting and preventing drowsiness in a vehicle is a major challenge for road traffic accident systems. To prevent drowsiness while driving, it is necessary to have an alert system that can detect a decline in driver concentration and send a signal to the driver. Studies have shown that traffc accidents usually occur when the driver is distracted while driving. In this paper, we have reviewed a number of detection systems to monitor the concentration of a car driver and propose a portable Driver Alertness Detection System (DADS) to determine the level of concentration of the driver based on pixelated coloration detection technique using facial recognition. A portable camera will be placed at the front visor to capture facial expression and the eye activities. We evaluate DADS using 26 participants and have achieved 100% detection rate with good lighting condition and a low detection rate at night.

Pattern of Eye Diseases among Commercial Intercity Vehicle Drivers ...

African Journals Online (AJOL)

Objective: To determine the pattern of eye diseases among commercial intercity vehicle drivers (CIVDs) in Ilorin, Nigeria. Design: A cross-sectional descriptive study. Methodology: Out of the estimated 450 drivers operating in the five major motor parks for CIVDs in Ilorin, 399 consecutive drivers participated in the study.

The case for driver science in motorsport: a review and recommendations.

Science.gov (United States)

Potkanowicz, Edward S; Mendel, Ronald W

2013-07-01

When discussing sports and the athletes who participate in them, it has long been recognized that fitness is a prerequisite for optimal performance. The goal of training to improve fitness levels in athletes is ultimately to minimize the stress that the body experiences during competition. When it comes to the topic of racecar drivers, however, drivers and their trainers have largely been left to their own devices to figure out the stressors and the areas of specific training focus. Unfortunately, racecar drivers have battled the stereotype that they are not athletes, and with little regard for them as athletes, drivers are seldom the focus of scientific research related to their performance. Like the cars they drive, driver-athletes are complex, but from a physiological perspective. However, unlike the cars they drive, driver-athletes have not been examined, evaluated, and tweaked to the same degree. The purpose of this review is two-fold: first, by examining the available literature, to make the case for new research into the driver's role in the driver-car system (i.e. driver science) and the stresses experienced; second, to make the case for more extensive use of microtechnology in the real-time monitoring of driver-athletes. With the miniaturization of sensors and the advent of portable data storage devices, the prospect of quantifying the stresses unique to the driver are no longer as daunting, and the relative impossibility and difficulties associated with measuring the driver-athlete in real-time no longer need to be as challenging. Using microtechnology in the assessment of the driver-athlete and with a more public discussion and dissemination of information on the topic of driver science, the scientific community has the opportunity to quantify that which has been largely assumed and speculated. The current article will offer the following recommendations: first, rather than examining a singular physiological stressor, to examine the interaction of

Vehicle and driver scheduling for public transit.

Science.gov (United States)

2009-08-01

The problem of driver scheduling involves the construction of a legal set of shifts, including allowance : of overtime, which cover the blocks in a particular vehicle schedule. A shift is the work scheduled to be performed by : a driver in one day, w...

A programmable CCD driver circuit for multiphase CCD operation

International Nuclear Information System (INIS)

Ewin, A.J.; Reed, K.V.

1989-01-01

A programmable CCD driver circuit was designed to drive CCD's in multiphased modes. The purpose of the drive electronics was to operate developmental CCD imaging arrays for NASA's Moderate Resolution Imaging Spectrometer - Tiltable (MODIS-T). Five prototype arrays were designed. Valid's Graphics Editor (GED) was used to design the driver. With this driver design, any of the five arrays can be readout. Designing the driver with GED allowed functional simulation, timing verification, and certain packaging analyses to be done on the design before fabrication. The driver verified its function with the master clock running up to 10 MHz. This suggests a maximum rate of 400 Kpixels/sec. Timing and packaging parameters were verified. the design uses 54 TTL component chips

European advanced driver training programs: Reasons for optimism

Directory of Open Access Journals (Sweden)

Simon Washington

2011-03-01

This paper reviews the predominant features and empirical evidence surrounding post licensing advanced driver training programs focused on novice drivers. A clear articulation of differences between the renewed and current US advanced driver training programs is provided. While the individual quantitative evaluations range from marginally to significantly effective in reducing novice driver crash risk, they have been criticized for evaluation deficiencies ranging from small sample sizes to confounding variables to lack of exposure metrics. Collectively, however, the programs sited in the paper suggest at least a marginally positive effect that needs to be validated with further studies. If additional well controlled studies can validate these programs, a pilot program in the US should be considered.

Key drivers of airline loyalty.

Science.gov (United States)

Dolnicar, Sara; Grabler, Klaus; Grün, Bettina; Kulnig, Anna

2011-10-01

This study investigates drivers of airline loyalty. It contributes to the body of knowledge in the area by investigating loyalty for a number of a priori market segments identified by airline management and by using a method which accounts for the multi-step nature of the airline choice process. The study is based on responses from 687 passengers. Results indicate that, at aggregate level, frequent flyer membership, price, the status of being a national carrier and the reputation of the airline as perceived by friends are the variables which best discriminate between travellers loyal to the airline and those who are not. Differences in drivers of airline loyalty for a number of segments were identified. For example, loyalty programs play a key role for business travellers whereas airline loyalty of leisure travellers is difficult to trace back to single factors. For none of the calculated models satisfaction emerged as a key driver of airline loyalty.

A RE-ASSESSMENT OF OLDER DRIVERS AS A ROAD SAFETY RISK

Directory of Open Access Journals (Sweden)

Jim LANGFORD

2006-01-01

Full Text Available Older drivers are frequently viewed as overly represented in crashes, particularly when crash involvement per distance travelled is considered. This perception has led to a call for tighter licensing conditions for older drivers, a policy which inevitably results in mobility restrictions for at least some drivers. However there is a growing body of research evidence which shows that as a group, older drivers represent no greater road risk than drivers from other age groups once different levels of driving activity are taken into account. This paper has examined aspects of older drivers' fitness to drive based on survey data and off-road and on-road driving performance from a sample of 905 New Zealand older drivers. The results show that policies which target all older drivers and lead to licensing and mobility restrictions cannot be justified from a safety basis.

Semi-Automated Analysis of Diaphragmatic Motion with Dynamic Magnetic Resonance Imaging in Healthy Controls and Non-Ambulant Subjects with Duchenne Muscular Dystrophy

Directory of Open Access Journals (Sweden)

Courtney A. Bishop

2018-01-01

Full Text Available Subjects with Duchenne Muscular Dystrophy (DMD suffer from progressive muscle damage leading to diaphragmatic weakness that ultimately requires ventilation. Emerging treatments have generated interest in better characterizing the natural history of respiratory impairment in DMD and responses to therapy. Dynamic (cine Magnetic Resonance Imaging (MRI may provide a more sensitive measure of diaphragm function in DMD than the commonly used spirometry. This study presents an analysis pipeline for measuring parameters of diaphragmatic motion from dynamic MRI and its application to investigate MRI measures of respiratory function in both healthy controls and non-ambulant DMD boys. We scanned 13 non-ambulant DMD boys and 10 age-matched healthy male volunteers at baseline, with a subset (n = 10, 10, 8 of the DMD subjects also assessed 3, 6, and 12 months later. Spirometry-derived metrics including forced vital capacity were recorded. The MRI-derived measures included the lung cross-sectional area (CSA, the anterior, central, and posterior lung lengths in the sagittal imaging plane, and the diaphragm length over the time-course of the dynamic MRI. Regression analyses demonstrated strong linear correlations between lung CSA and the length measures over the respiratory cycle, with a reduction of these correlations in DMD, and diaphragmatic motions that contribute less efficiently to changing lung capacity in DMD. MRI measures of pulmonary function were reduced in DMD, controlling for height differences between the groups: at maximal inhalation, the maximum CSA and the total distance of motion of the diaphragm were 45% and 37% smaller. MRI measures of pulmonary function were correlated with spirometry data and showed relationships with disease progression surrogates of age and months non-ambulatory, suggesting that they provide clinically meaningful information. Changes in the MRI measures over 12 months were consistent with weakening of

High intertester reliability of the cumulated ambulation score for the evaluation of basic mobility in patients with hip fracture

DEFF Research Database (Denmark)

Kristensen, Morten Tange; Andersen, Lene; Bech-Jensen, Rie

2009-01-01

OBJECTIVE: To examine the intertester reliability of the three activities of the Cumulated Ambulation Score (CAS) and the total CAS, and to define limits for the smallest change in basic mobility that indicates a real change in patients with hip fracture. DESIGN: An intertester reliability study....... SETTING: An acute 20-bed orthopaedic hip fracture unit. SUBJECTS: Fifty consecutive patients with a median age of 83 (25-75% quartile, 68-86) years. INTERVENTIONS: The CAS, which describes the patient's independency in three activities - (1) getting in and out of bed, (2) sit to stand from a chair, and (3...

ST-segment resolution with bivalirudin versus heparin and routine glycoprotein IIb/IIIa inhibitors started in the ambulance in ST-segment elevation myocardial infarction patients transported for primary percutaneous coronary intervention

DEFF Research Database (Denmark)

Van't Hof, Arnoud; Giannini, Francesco; Ten Berg, Jurrien

2017-01-01

BACKGROUND: Myocardial reperfusion after primary percutaneous coronary intervention (PCI) can be assessed by the extent of post-procedural ST-segment resolution. The European Ambulance Acute Coronary Syndrome Angiography (EUROMAX) trial compared pre-hospital bivalirudin and pre-hospital heparin o...

Crash probability estimation via quantifying driver hazard perception.

Science.gov (United States)

Li, Yang; Zheng, Yang; Wang, Jianqiang; Kodaka, Kenji; Li, Keqiang

2018-07-01

Crash probability estimation is an important method to predict the potential reduction of crash probability contributed by forward collision avoidance technologies (FCATs). In this study, we propose a practical approach to estimate crash probability, which combines a field operational test and numerical simulations of a typical rear-end crash model. To consider driver hazard perception characteristics, we define a novel hazard perception measure, called as driver risk response time, by considering both time-to-collision (TTC) and driver braking response to impending collision risk in a near-crash scenario. Also, we establish a driving database under mixed Chinese traffic conditions based on a CMBS (Collision Mitigation Braking Systems)-equipped vehicle. Applying the crash probability estimation in this database, we estimate the potential decrease in crash probability owing to use of CMBS. A comparison of the results with CMBS on and off shows a 13.7% reduction of crash probability in a typical rear-end near-crash scenario with a one-second delay of driver's braking response. These results indicate that CMBS is positive in collision prevention, especially in the case of inattentive drivers or ole drivers. The proposed crash probability estimation offers a practical way for evaluating the safety benefits in the design and testing of FCATs. Copyright © 2017 Elsevier Ltd. All rights reserved.

Intersection assistance: a safe solution for older drivers?

Science.gov (United States)

Dotzauer, Mandy; Caljouw, Simone R; de Waard, Dick; Brouwer, Wiebo H

2013-10-01

Within the next few decades, the number of older drivers operating a vehicle will increase rapidly (Eurostat, 2011). As age increases so does physical vulnerability, age-related impairments, and the risk of being involved in a fatal crashes. Older drivers experience problems in driving situations that require divided attention and decision making under time pressure as reflected by their overrepresentation in at-fault crashes on intersections. Advanced Driver Assistance Systems (ADAS) especially designed to support older drivers crossing intersections might counteract these difficulties. In a longer-term driving simulator study, the effects of an intersection assistant on driving were evaluated. 18 older drivers (M=71.44 years) returned repeatedly completing a ride either with or without a support system in a driving simulator. In order to test the intersection assistance, eight intersections were depicted for further analyses. Results show that ADAS affects driving. Equipped with ADAS, drivers allocated more attention to the road center rather than the left and right, crossed intersections in shorter time, engaged in higher speeds, and crossed more often with a critical time-to-collision (TTC) value. The implications of results are discussed in terms of behavioral adaptation and safety. Copyright © 2013 Elsevier Ltd. All rights reserved.

Driver's anger state identification by using facial expression in ...

African Journals Online (AJOL)

Preventive safety system of vehicle is highlighted to reduce the number of traffic accidents. Driver's state adaptive driving safety system may be one of candidates of the safety system. Identifying driver's psychosomatic states is indispensable to establish those safety systems. Anger of driver state is often seen in traffic ...

Steering disturbance rejection using a physics-based neuromusculoskeletal driver model

Science.gov (United States)

Mehrabi, Naser; Sharif Razavian, Reza; McPhee, John

2015-10-01

The aim of this work is to develop a comprehensive yet practical driver model to be used in studying driver-vehicle interactions. Drivers interact with their vehicle and the road through the steering wheel. This interaction forms a closed-loop coupled human-machine system, which influences the driver's steering feel and control performance. A hierarchical approach is proposed here to capture the complexity of the driver's neuromuscular dynamics and the central nervous system in the coordination of the driver's upper extremity activities, especially in the presence of external disturbance. The proposed motor control framework has three layers: the first (or the path planning) plans a desired vehicle trajectory and the required steering angles to perform the desired trajectory; the second (or the musculoskeletal controller) actuates the musculoskeletal arm to rotate the steering wheel accordingly; and the final layer ensures the precision control and disturbance rejection of the motor control units. The physics-based driver model presented here can also provide insights into vehicle control in relaxed and tensed driving conditions, which are simulated by adjusting the driver model parameters such as cognition delay and muscle co-contraction dynamics.

ITER driver blanket, European Community design

International Nuclear Information System (INIS)

Simbolotti, G.; Zampaglione, V.; Ferrari, M.; Gallina, M.; Mazzone, G.; Nardi, C.; Petrizzi, L.; Rado, V.; Violante, V.; Daenner, W.; Lorenzetto, P.; Gierszewski, P.; Grattarola, M.; Rosatelli, F.; Secolo, F.; Zacchia, F.; Caira, M.; Sorabella, L.

1993-01-01

Depending on the final decision on the operation time of ITER (International Thermonuclear Experimental Reactor), the Driver Blanket might become a basic component of the machine with the main function of producing a significant fraction (close to 0.8) of the tritium required for the ITER operation, the remaining fraction being available from external supplies. The Driver Blanket is not required to provide reactor relevant performance in terms of tritium self-sufficiency. However, reactor relevant reliability and safety are mandatory requirements for this component in order not to significantly afftect the overall plant availability and to allow the ITER experimental program to be safely and successfully carried out. With the framework of the ITER Conceptual Design Activities (CDA, 1988-1990), a conceptual design of the ITER Driver Blanket has been carried out by ENEA Fusion Dept., in collaboration with ANSALDO S.p.A. and SRS S.r.l., and in close consultation with the NET Team and CFFTP (Canadian Fusion Fuels Technology Project). Such a design has been selected as EC (European Community) reference design for the ITER Driver Blanket. The status of the design at the end of CDA is reported in the present paper. (orig.)

SSCL DD2 driver port and project update

International Nuclear Information System (INIS)

Mestad, S.L.

1994-01-01

A paper previously published in the 1992 ICHEP proceedings outlined the SSC's need for a high speed, high capacity tape drive to store detector data. Also described were stages and lessons learned while developing a custom device driver for the Ampex DD2 tape drive on a Silicon Graphics 4D/310. This paper updates the work on the SGI driver and describes the efforts in porting the driver to a Sun Microsystems 670 server

SSCL DD2 driver port and project update

International Nuclear Information System (INIS)

Mestad, S.L.

1993-04-01

A paper previously published in the 1992 ICHEP proceedings outlined the SSC's need for a high speed, high capacity tape drive to store detector data. Also described were stages and lessons learned while developing a custom device driver for the Ampex DD2 tape drive on a Silicon Graphics 4D/310. This paper updates the work on the SGI driver and describes the efforts in porting the driver to a Sun Microsystems 670 server

SUBJECTIVE METHODS FOR ASSESSMENT OF DRIVER DROWSINESS

Directory of Open Access Journals (Sweden)

Alina Mashko

2017-12-01

Full Text Available The paper deals with the issue of fatigue and sleepiness behind the wheel, which for a long time has been of vital importance for the research in the area of driver-car interaction safety. Numerous experiments on car simulators with diverse measurements to observe human behavior have been performed at the laboratories of the faculty of the authors. The paper provides analysis and an overview and assessment of the subjective (self-rating and observer rating methods for observation of driver behavior and the detection of critical behavior in sleep deprived drivers using the developed subjective rating scales.

Cyclist-related content in novice driver education and training.

Science.gov (United States)

Bonham, Jennifer; Johnson, Marilyn

2018-02-01

In Australia, the increasing public profile and policy interest in cycling contrasts with variable cycling participation rates across jurisdictions (Australian Bicycle Council, 2017) and lack of cyclist-specific infrastructure. Cyclists and drivers often share road space, usually without indication from the built environment about how to maximise each other's safety and utility. Yet despite this regular interaction, cyclists are largely absent from the driver licensing process in Australia. That is, novice drivers are not taught how to share the road with cyclists. This case study used a mixed methods approach to examine the cyclist-related content in the Graduated Driver Licensing System (GDLS) in the Australian Capital Territory (ACT). The case study was conducted in four stages: 1) content analysis of all documents used through the GDLS; 2) observations of the Road Ready course and learner driver lessons; 3) online survey; and, 4) semi-structured interviews. Cyclists are rarely mentioned in the GDLS in the ACT and references often constructed cyclists as problematic or were based in instructors' personal opinion (rather than scripted responses). Outcomes from this study have directly informed a new vulnerable road user driver licence competency in the ACT and findings include recommendations for greater inclusion of cyclists in the driver licensing system. Copyright © 2017 Elsevier Ltd. All rights reserved.

Induction linac drivers for commercial heavy-ion beam fusion

International Nuclear Information System (INIS)

Keefe, D.

1987-11-01

This paper discusses induction linac drivers necessary to accelerate heavy ions at inertial fusion targets. Topics discussed are: driver configurations, the current-amplifying induction linac, high current beam behavior and emittance growth, new considerations for driver design, the heavy ion fusion systems study, and future studies. 13 refs., 6 figs., 1 tab

An evidence-based review: distracted driver.

Science.gov (United States)

Llerena, Luis E; Aronow, Kathy V; Macleod, Jana; Bard, Michael; Salzman, Steven; Greene, Wendy; Haider, Adil; Schupper, Alex

2015-01-01

Cell phone use and texting are prevalent within society and have thus pervaded the driving population. This technology is a growing concern within the confines of distracted driving, as all diversions from attention to the road have been shown to increase the risk of crashes. Adolescent, inexperienced drivers, who have the greatest prevalence of texting while driving, are at a particularly higher risk of crashes because of distraction. Members of the Injury Control Violence Prevention Committee of the Eastern Association for the Surgery of Trauma performed a PubMed search of articles related to distracted driving and cell phone use as a distractor of driving between 2000 and 2013. A total of 19 articles were found to merit inclusion as evidence in the evidence-based review. These articles provided evidence regarding the relationship between distracted driving and crashes, cell phone use contributing to automobile accidents, and/or the relationship between driver experience and automobile accidents. (Adjust methods/results sections to the number of articles that correctly corresponds to the number of references, as well as the methodology for reference inclusion.) Based on the evidence reviewed, we can recommend the following. All drivers should minimize all in-vehicle distractions while on the road. All drivers should not text or use any touch messaging system (including the use of social media sites such as Facebook and Twitter) while driving. Younger, inexperienced drivers should especially not use cell phones, texting, or any touch messaging system while driving because they pose an increased risk for death and injury caused by distractions while driving.

Driver behaviour in motorway car-following transitions and driver support systems

NARCIS (Netherlands)

Feenstra, P.; Horst, A.R.A. van der

2006-01-01

Co-operative driving with speed adaptation functionality has great potential to improve traffic-throughput, traffic-safety, and environmental-impact on heavily used traffic-infrastructures. A driving-simulator study was performed to investigate the driver behaviour with respect to such

Traffic Safety through Driver Assistance and Intelligence

Directory of Open Access Journals (Sweden)

Heiner Bubb

2011-05-01

BMW, Daimler, Audi, Citroen, Lexus, VW, Opel, Peugeot, Renault, Chevrolet, Saab and Bosch. Both the contributions of research work concerning driving behavior analysis and driver assistance systems have to be aligned with a permanently updated interaction within the system of driver, vehicle and road traffic environment.

Continuous traffic flow modeling of driver support systems in multiclass traffic with intervehicle communication and drivers in the loop

NARCIS (Netherlands)

Tampere, C.; Hoogendoorn, S.P.; van Arem, Bart

2009-01-01

This paper presents a continuous traffic-flow model for the explorative analysis of advanced driver-assistance systems (ADASs). Such systems use technology (sensors and intervehicle communication) to support the task of the driver, who retains full control over the vehicle. Based on a review of

Predicting Ambulance Time of Arrival to the Emergency Department Using Global Positioning System and Google Maps

Science.gov (United States)

Fleischman, Ross J.; Lundquist, Mark; Jui, Jonathan; Newgard, Craig D.; Warden, Craig

2014-01-01

Objective To derive and validate a model that accurately predicts ambulance arrival time that could be implemented as a Google Maps web application. Methods This was a retrospective study of all scene transports in Multnomah County, Oregon, from January 1 through December 31, 2008. Scene and destination hospital addresses were converted to coordinates. ArcGIS Network Analyst was used to estimate transport times based on street network speed limits. We then created a linear regression model to improve the accuracy of these street network estimates using weather, patient characteristics, use of lights and sirens, daylight, and rush-hour intervals. The model was derived from a 50% sample and validated on the remainder. Significance of the covariates was determined by p times recorded by computer-aided dispatch. We then built a Google Maps-based web application to demonstrate application in real-world EMS operations. Results There were 48,308 included transports. Street network estimates of transport time were accurate within 5 minutes of actual transport time less than 16% of the time. Actual transport times were longer during daylight and rush-hour intervals and shorter with use of lights and sirens. Age under 18 years, gender, wet weather, and trauma system entry were not significant predictors of transport time. Our model predicted arrival time within 5 minutes 73% of the time. For lights and sirens transports, accuracy was within 5 minutes 77% of the time. Accuracy was identical in the validation dataset. Lights and sirens saved an average of 3.1 minutes for transports under 8.8 minutes, and 5.3 minutes for longer transports. Conclusions An estimate of transport time based only on a street network significantly underestimated transport times. A simple model incorporating few variables can predict ambulance time of arrival to the emergency department with good accuracy. This model could be linked to global positioning system data and an automated Google Maps web

Mandatory Driver Training and Road Safety: The Quebec Experience.

Science.gov (United States)

Potvin, Louise; And Others

1988-01-01

1983 legislation making driver training courses mandatory for any person in Quebec seeking a first driver's license had no effect on the risk of accident or the mortality/morbidity rate for newly licensed drivers over 18. However, since 1983 more women under 18 are becoming licensed, and their risks may be increased. (Author/BJV)

The micro-step motor controller protocol and driver

International Nuclear Information System (INIS)

Hong, Kwang Pyo; Lee, Chang Hee; Moon, Myung Kook; Choi, Bung Hun; Choi, Young Hyun; Cheon, Jong Gu

2004-11-01

We developed the communication protocol which is a main kernel of motor control firmware program that is used at HANARO neutron spectrometer now. This protocol driver divide into as a 4 group(Serial protocol, DLL, Active-X, Labview driver), so end-user can control the motor control as easily by PC RS232/422 port and have a merits as follows: Support a Low Level/High level driver, Support a Network Connectivity function by using High level Driver, One Server can services many client request. By using this protocol, The End-user can be easily makes a application motor control program and developed another application system program by using several kinds of programming tools under Widows and Linux based operation systems

Road Rage Menace: A Cross-sectional Study to Assess Driver Anger Level in Public Motor Vehicle Drivers in a City in Central India

Directory of Open Access Journals (Sweden)

Sanjay Dixit

2011-07-01

Full Text Available Introduction: Road rage and aggressive driving is a prevalent condition in today’s society due to motorists’ frustrations during heavy traffic volumes. Objective: This study was done to assess the level of anger amongst the drivers of public transport vehicles in Indore, using Driving Anger Scale (DAS by Deffenbacher et. al. and various factors affecting it. Material and Methods: A cross-sectional study was conducted among 135 drivers of Public transport vehicle drivers (Star bus, City-van and star cab drivers in Indore to assess their anger level using Driving Anger Scale. The participants were required to record the amount of anger they would experience in response to each item in the scale (1=not at all angry, 2=a little angry, 3=some anger, 4=much anger, 5=very much angry. Results: The mean DAS score in Indore was found to be 3.013 and in the three organizations namely Star bus drivers, City van drivers and Star cab drivers was 2.92, 3.08 and 3.04 respectively. The DAS score of drivers with respect to the 6 sub-scales were: hostile gestures (Star bus -3.42,City van -3.67,Star cab -3.38, slow driving (Star bus -2.73,City van driv-2.78,Star cab-3.17, traffic obstructions (Star bus-2.85,City van -3.25,Star cab-3.18, discourtesy (Star bus -3.23,City van-3.33,Star cab -3.25and police presence (Star bus -2.15,City van -1.99,Star cab -2.78, illegal driving (Star bus -3.04,City van -3.14,Star cab -2.89. The DAS scores of the drivers did not vary significantly with age group, experience, and educational qualification. Conclusion: Though DAS scores did not vary between the three groups of drivers, however average level anger for various given circumstances commonly found in the Indian traffic scenario was on the higher side.

Cooperative advanced Driver assistance Systems - Technological measures for data privacy compliance

OpenAIRE

Jäger, Hubert; Schnieder, Lars

2016-01-01

Cooperative advanced driver assistance systems (ADAS) will contribute to road traffic safety: Critical situations will be detected, the driver alerted and control of the vehicle interfered with automatically. However, the introduction of such driver assistance systems presupposes that data privacy issues have already been solved in advance. A necessary condition for the driver to accept and trust new Driver assistance systems is that his/her personal and personally identifiable data will be t...

Combining coordination of motion actuators with driver steering interaction.

Science.gov (United States)

Tagesson, Kristoffer; Laine, Leo; Jacobson, Bengt

2015-01-01

A new method is suggested for coordination of vehicle motion actuators; where driver feedback and capabilities become natural elements in the prioritization. The method is using a weighted least squares control allocation formulation, where driver characteristics can be added as virtual force constraints. The approach is in particular suitable for heavy commercial vehicles that in general are over actuated. The method is applied, in a specific use case, by running a simulation of a truck applying automatic braking on a split friction surface. Here the required driver steering angle, to maintain the intended direction, is limited by a constant threshold. This constant is automatically accounted for when balancing actuator usage in the method. Simulation results show that the actual required driver steering angle can be expected to match the set constant well. Furthermore, the stopping distance is very much affected by this set capability of the driver to handle the lateral disturbance, as expected. In general the capability of the driver to handle disturbances should be estimated in real-time, considering driver mental state. By using the method it will then be possible to estimate e.g. stopping distance implied from this. The setup has the potential of even shortening the stopping distance, when the driver is estimated as active, this compared to currently available systems. The approach is feasible for real-time applications and requires only measurable vehicle quantities for parameterization. Examples of other suitable applications in scope of the method would be electronic stability control, lateral stability control at launch and optimal cornering arbitration.

THE RELATION BETWEEN DRIVER BEHAVIOR AND INTELLIGENT TRANSPORT SYSTEM

Directory of Open Access Journals (Sweden)

Alica Kalašová

2017-12-01

Full Text Available The main objective of Slovakia’s transport policy is to reduce the number of traffic accidents and increase safety on our roads. Implementation of intelligent transport systems presents one of the possibilities how to meet this goal. Acceptance of these systems by motor vehicle drivers and other road traffic participants is necessary in order for them to fulfill their purpose. Only if the drivers will accept intelligent transport systems, it is possible to flexibly and effectively manage road traffic flexibly and effectively. From the perspective of a driver it concerns, in particular, the possibility of using alternative routes when traffic accidents or other obstacles occurs on the route that would significantly affect the continuity and safety of road traffic. Thanks to these technologies, it is possible to choose the appropriate route while driving, of course based on the criterion, which the driver considers the most important during the transport from origin to destination (driving time, distance from origin to destination, fuel consumption, quality of infrastructure. Information isare provided to the driver through variable message signs or directly in the vehicle (RDS-TMC. Another advantage of intelligent transport systems is a positive impact on psychological well-being of the driver while driving. Additional information about the possible obstacles, weather conditions and dangerous situations that occur on the roads as well as alternative routes are provided to the driver well in advance. This paper is mainly focused on how the drivers perceive the influence of intelligent transport systems in Žilina region.

Highly automated driving, secondary task performance, and driver state.

Science.gov (United States)

Merat, Natasha; Jamson, A Hamish; Lai, Frank C H; Carsten, Oliver

2012-10-01

A driving simulator study compared the effect of changes in workload on performance in manual and highly automated driving. Changes in driver state were also observed by examining variations in blink patterns. With the addition of a greater number of advanced driver assistance systems in vehicles, the driver's role is likely to alter in the future from an operator in manual driving to a supervisor of highly automated cars. Understanding the implications of such advancements on drivers and road safety is important. A total of 50 participants were recruited for this study and drove the simulator in both manual and highly automated mode. As well as comparing the effect of adjustments in driving-related workload on performance, the effect of a secondary Twenty Questions Task was also investigated. In the absence of the secondary task, drivers' response to critical incidents was similar in manual and highly automated driving conditions. The worst performance was observed when drivers were required to regain control of driving in the automated mode while distracted by the secondary task. Blink frequency patterns were more consistent for manual than automated driving but were generally suppressed during conditions of high workload. Highly automated driving did not have a deleterious effect on driver performance, when attention was not diverted to the distracting secondary task. As the number of systems implemented in cars increases, an understanding of the implications of such automation on drivers' situation awareness, workload, and ability to remain engaged with the driving task is important.

29 CFR 541.504 - Drivers who sell.

Science.gov (United States)

2010-07-01

... DELIMITING THE EXEMPTIONS FOR EXECUTIVE, ADMINISTRATIVE, PROFESSIONAL, COMPUTER AND OUTSIDE SALES EMPLOYEES Outside Sales Employees § 541.504 Drivers who sell. (a) Drivers who deliver products and also sell such products may qualify as exempt outside sales employees only if the employee has a primary duty of making...

High speed CAMAC differential branch highway driver

International Nuclear Information System (INIS)

McMillan, D.E.; Nelson, R.O.; Poore, R.V.; Sunier, J.W.; Ross, J.J.

1979-01-01

A new CAMAC branch driver is described that incorporates several unusual features which combine to give reliable, high-speed performance. These include balanced line driver/receivers, stored CAMAC command lists, 8 DMA channels, pseudo LAMS, hardware priority encoding of LAMS, and hardware-implemented Q-controlled block transfers. 3 figures

The impact of later trading hours for hotels on levels of impaired driver road crashes and driver breath alcohol levels.

Science.gov (United States)

Chikritzhs, Tanya; Stockwell, Tim

2006-09-01

To examine the impact of later trading hours for licensed hotels in Perth, Western Australia on levels of associated impaired driver road crashes and driver breath alcohol levels (BALs). Police data on the "last place of drinking" for impaired drivers involved in road crashes and their corresponding BALs were examined to identify those associated with Perth hotels between 1 July 1990 and 30 June 1997. During this period, 43 (23%) of the 186 hotels meeting study criteria were granted an Extended Trading Permit for 1 a.m. closing (ETP hotels), while the rest continued to close at midnight (non-ETP hotels). Time-series analyses employing multiple linear regressions were applied to determine whether an association existed between the introduction of extended trading and (i) monthly levels of impaired driver road crashes associated with ETP hotels and (ii) driver BALs associated with ETP hotels. Trends associated with non-ETP hotels were included as controls and possible confounders were considered. After controlling for the trend in crash rates associated with non-ETP hotels and the introduction of mobile police breath testing stations to Perth freeways, a significant increase in monthly crash rates for ETP hotels was found. This relationship was largely accounted for by higher volumes of high-alcohol content beer, wine and spirits purchased by ETP hotels. No relation was found between driver BALs and the introduction of ETPs. Late trading was associated with increased levels of impaired driver road crashes and alcohol consumption, particularly high-risk alcoholic beverages. Greater numbers of patrons and characteristics specific to clientele of hotels which applied for late trading hours (i.e. younger age, greater propensity to drunk-drive, preference for high-risk beverages) were suggested as having contributed to this increase.

Effectiveness of Taxicab Security Equipment in Reducing Driver Homicide Rates

Science.gov (United States)

Menéndez, Cammie K.C.; Amandus, Harlan E.; Damadi, Parisa; Wu, Nan; Konda, Srinivas; Hendricks, Scott A.

2015-01-01

Background Taxicab drivers historically have had one of the highest work-related homicide rates of any occupation. In 2010 the taxicab driver homicide rate was 7.4 per 100,000 drivers, compared to the overall rate of 0.37 per 100,000 workers. Purpose Evaluate the effectiveness of taxicab security cameras and partitions on citywide taxicab driver homicide rates. Methods Taxicab driver homicide rates were compared in 26 major cities in the U.S. licensing taxicabs with security cameras (n=8); bullet-resistant partitions (n=7); and cities where taxicabs were not equipped with either security cameras or partitions (n=11). News clippings of taxicab driver homicides and the number of licensed taxicabs by city were used to construct taxicab driver homicide rates spanning 15 years (1996–2010). Generalized estimating equations were constructed to model the Poisson-distributed homicide rates on city-specific safety equipment installation status, controlling for city homicide rate and the concurrent decline of homicide rates over time. Data were analyzed in 2012. Results Cities with cameras experienced a threefold reduction in taxicab driver homicides compared with control cities (RR=0.27; 95% CI=0.12, 0.61; p=0.002). There was no difference in homicide rates for cities with partitions compared with control cities (RR=1.15; 95% CI=0.80, 1.64; p=0.575). Conclusions Municipal ordinances and company policies mandating security cameras appear to be highly effective in reducing taxicab driver deaths due to workplace violence. PMID:23790983

Observed and projected drivers of emerging infectious diseases in Europe.

Science.gov (United States)

Semenza, Jan C; Rocklöv, Joacim; Penttinen, Pasi; Lindgren, Elisabet

2016-10-01

Emerging infectious diseases are of international concern because of the potential for, and impact of, pandemics; however, they are difficult to predict. To identify the drivers of disease emergence, we analyzed infectious disease threat events (IDTEs) detected through epidemic intelligence collected at the European Centre for Disease Prevention and Control (ECDC) between 2008 and 2013, and compared the observed results with a 2008 ECDC foresight study of projected drivers of future IDTEs in Europe. Among 10 categories of IDTEs, foodborne and waterborne IDTEs were the most common, vaccine-preventable IDTEs caused the highest number of cases, and airborne IDTEs caused the most deaths. Observed drivers for each IDTE were sorted into three main groups: globalization and environmental drivers contributed to 61% of all IDTEs, public health system drivers contributed to 21%, and social and demographic drivers to 18%. A multiple logistic regression analysis showed that four of the top five drivers for observed IDTEs were in the globalization and environment group. In the observational study, the globalization and environment group was related to all IDTE categories, but only to five of eight categories in the foresight study. Directly targeting these drivers with public health interventions may diminish the chances of IDTE occurrence from the outset. © 2016 New York Academy of Sciences.

Police Mental Health Partnership project: Police Ambulance Crisis Emergency Response (PACER) model development.

Science.gov (United States)

Huppert, David; Griffiths, Matthew

2015-10-01

To review internationally recognized models of police interactions with people experiencing mental health crises that are sometimes complex and associated with adverse experience for the person in crisis, their family and emergency service personnel. To develop, implement and review a partnership model trial between mental health and emergency services that offers alternative response pathways with improved outcomes in care. Three unique models of police and mental health partnership in the USA were reviewed and used to develop the PACER (Police Ambulance Crisis Emergency Response) model. A three month trial of the model was implemented and evaluated. Significant improvements in response times, the interactions with and the outcomes for people in crisis were some of the benefits shown when compared with usual services. The pilot showed that a partnership involving mental health and police services in Melbourne, Australia could be replicated based on international models. Initial data supported improvements compared with usual care. Further data collection regarding usual care and this new model is required to confirm observed benefits. © The Royal Australian and New Zealand College of Psychiatrists 2015.

Dominant role of drivers' attitude in prevention of road traffic crashes: a study on knowledge, attitude, and practice of drivers in Iran.

Science.gov (United States)

Mirzaei, Ramazan; Hafezi-Nejad, Nima; Sadegh Sabagh, Mohammad; Ansari Moghaddam, Alireza; Eslami, Vahid; Rakhshani, Fatemeh; Rahimi-Movaghar, Vafa

2014-05-01

Evaluating the relation between Iranian drivers' knowledge, attitude, and practice (KAP) regarding traffic regulations, and their deterministic effect on road traffic crashes (RTCs). Two cities of Tehran and Zahedan, Iran. A cross-sectional study was designed. Using a simplified cluster sampling design, 2200 motor vehicle drivers including 1200 in Tehran and 1000 in Zahedan were selected. Sixty locations in Tehran and 50 in Zahedan were chosen. In each pre-identified location, 20 adult drivers were approached consecutively. A questionnaire developed by researchers was filled by each participant. The questionnaire had four sections including items assessing the demographics, knowledge, attitude and practice of drivers toward traffic regulations. Logistic regression analysis was used to evaluate the relationship between the RTCs and KAP variables. The study sample consisted of 619 (28.1%) occupational and 1580 (71.8%) private drivers. Among them, 86.4% were male. The median age was 33.6 ± 10.83. Drivers in Tehran and Zahedan had no significant differences between their mean scores of KAP items of the questionnaire. Higher knowledge, safer attitude, and safer practice were associated with a decreased number of RTC. After adjusting for possible confounders, increase of one standard deviation in attitude and practice scores (but not knowledge) resulted in 26.4% and 18.5% decrease in RTC, respectively. Finally, considering knowledge, attitude and practice of drivers in one model to assess their mutual effect, it was shown that only attitude is significantly associated with a decrease of RTC (OR=0.76, P=0.007). Increase in attitude and practice accompanied with decreased number of RTCs in Iranian drivers. Specifically, drivers' attitude had the crucial effect. It is not knowledge and standard traffic education; rather it is how such education is registered as an attitude that translates what is being learned into actions. Without safer attitude, even safer self

Lower back pain and absenteeism among professional public transport drivers.

Science.gov (United States)

Kresal, Friderika; Roblek, Vasja; Jerman, Andrej; Meško, Maja

2015-01-01

Drivers in public transport are subjected to lower back pain. The reason for the pain is associated with the characteristics of the physical position imposed on the worker while performing the job. Lower back pain is the main cause of absenteeism among drivers. The present study includes 145 public transport drivers employed as professional drivers for an average of 14.14 years. Analysis of the data obtained in the study includes the basic descriptive statistics, χ(2) test and multiple regression analysis. Analysis of the incidence of lower back pain showed that the majority of our sample population suffered from pain in the lower back. We found that there are no statistically significant differences between the groups formed by the length of service as a professional driver and incidence of lower back pain; we were also interested in whether or not the risk factors of lower back pain affects the absenteeism of city bus drivers. Analysis of the data has shown that the risk factors of pain in the lower part of the spine do affect the absenteeism of city bus drivers.

National Driver Register (NDR) -

Data.gov (United States)

Department of Transportation — Information regarding individuals who have had their driver licenses revoked, suspended or otherwise denied for cause, or who have been convicted of certain traffic...

Influence of multiple global change drivers on terrestrial carbon storage

DEFF Research Database (Denmark)

Yue, Kai; Fornara, Dario A; Yang, Wanqin

2017-01-01

The interactive effects of multiple global change drivers on terrestrial carbon (C) storage remain poorly understood. Here, we synthesise data from 633 published studies to show how the interactive effects of multiple drivers are generally additive (i.e. not differing from the sum of their indivi......The interactive effects of multiple global change drivers on terrestrial carbon (C) storage remain poorly understood. Here, we synthesise data from 633 published studies to show how the interactive effects of multiple drivers are generally additive (i.e. not differing from the sum...... additive effects of multiple global change drivers into future assessments of the C storage ability of terrestrial ecosystems....

Driver ASICs for Advanced Deformable Mirrors, Phase II

Data.gov (United States)

National Aeronautics and Space Administration — The overall goal of the SBIR program is to develop a new Application Specified Integrated Circuit (ASIC) driver to be used in driver electronics of a deformable...

What the drivers do and do not tell you: using verbal protocol analysis to investigate driver behaviour in emergency situations.

Science.gov (United States)

Banks, Victoria A; Stanton, Neville A; Harvey, Catherine

2014-01-01

Although task analysis of pedestrian detection can provide us with useful insights into how a driver may behave in emergency situations, the cognitive elements of driver decision-making are less well understood. To assist in the design of future Advanced Driver Assistance Systems, such as Autonomous Emergency Brake systems, it is essential that the cognitive elements of the driving task are better understood. This paper uses verbal protocol analysis in an exploratory fashion to uncover the thought processes underlying behavioural outcomes represented by hard data collected using the Southampton University Driving Simulator.

Beginning teenage drivers

Science.gov (United States)

2010-01-01

Teen drivers have the highest crash risk of any age group. Per mile traveled, they have the highest involvement rates in all types of crashes, from those involving only property damage to those that are fatal. The problem is worst among 16 year-olds,...

49 CFR 383.51 - Disqualification of drivers.

Science.gov (United States)

2010-10-01

... parking violation) arising in connection with a fatal accident 60 days 60 days 120 days 120 days. (6... less than 120 days No less than 1 year. (4) The driver fails to have sufficient space to drive... driver fails to negotiate a crossing because of insufficient undercarriage clearance * * * No less than...

Does automatic transmission improve driving behavior in older drivers?

Science.gov (United States)

Selander, Helena; Bolin, Ingrid; Falkmer, Torbjörn

2012-01-01

Most older drivers continue to drive as they age. To maintain safe and independent transport, mobility is important for all individuals, but especially for older drivers. The objective of this study was to investigate whether automatic transmission, compared with manual transmission, may improve the driving behavior of older drivers. In total, 31 older drivers (mean age 75.2 years) and 32 younger drivers - used as a control group (mean age 39.2 years) - were assessed twice on the same fixed route; once in a car with manual transmission and once in a car with automatic transmission. The cars were otherwise identical. The driving behavior was assessed with the Ryd On-Road Assessment driving protocol. Time to completion of left turns (right-hand side driving) and the impact of a distraction task were measured. The older group had more driving errors than the younger group, in both the manual and the automatic transmission car. However, and contrary to the younger drivers, automatic transmission improved the older participants' driving behavior as demonstrated by safer speed adjustment in urban areas, greater maneuvering skills, safer lane position and driving in accordance with the speed regulations. Switching to automatic transmission may be recommended for older drivers as a means to maintain safe driving and thereby the quality of their transport mobility. Copyright © 2011 S. Karger AG, Basel.

Evaluation of a program to enhance young drivers' safety in Israel.

Science.gov (United States)

Toledo, Tomer; Lotan, Tsippy; Taubman-Ben-Ari, Orit; Grimberg, Einat

2012-03-01

Young drivers in Israel, as in other parts of the world, are involved in car crashes more than any other age group. The graduated driver licensing system in Israel requires that all new drivers be accompanied by an experienced driver whenever they drive for the first 3 months after obtaining a driving license. In an effort to make the accompanied driving phase more effective, a novel program which targets both young drivers and their parents was initiated in 2005. The program administers a personal meeting with the young driver and the accompanying parent scheduled for the beginning of the accompanied driving phase. In this meeting guidance is given regarding best practices for undertaking the accompanied driving, as well as tips for dealing with in-vehicle parent-teen dynamics. Through 2008, almost 130,000 families of young drivers have participated in the program. In order to evaluate the effectiveness of the program, injury crash records of the young drivers who participated in the program were compared with those of all other young drivers that were licensed at the same time period. The results obtained indicate statistically significant lower crash records for young drivers that participated in the program. Limitations of the evaluation related to self-selection biases are discussed, and practical implications are suggested. Copyright © 2011 Elsevier Ltd. All rights reserved.

Multiple logistic regression model of signalling practices of drivers on urban highways

Science.gov (United States)

Puan, Othman Che; Ibrahim, Muttaka Na'iya; Zakaria, Rozana

2015-05-01

Giving signal is a way of informing other road users, especially to the conflicting drivers, the intention of a driver to change his/her movement course. Other users are exposed to hazard situation and risks of accident if the driver who changes his/her course failed to give signal as required. This paper describes the application of logistic regression model for the analysis of driver's signalling practices on multilane highways based on possible factors affecting driver's decision such as driver's gender, vehicle's type, vehicle's speed and traffic flow intensity. Data pertaining to the analysis of such factors were collected manually. More than 2000 drivers who have performed a lane changing manoeuvre while driving on two sections of multilane highways were observed. Finding from the study shows that relatively a large proportion of drivers failed to give any signals when changing lane. The result of the analysis indicates that although the proportion of the drivers who failed to provide signal prior to lane changing manoeuvre is high, the degree of compliances of the female drivers is better than the male drivers. A binary logistic model was developed to represent the probability of a driver to provide signal indication prior to lane changing manoeuvre. The model indicates that driver's gender, type of vehicle's driven, speed of vehicle and traffic volume influence the driver's decision to provide a signal indication prior to a lane changing manoeuvre on a multilane urban highway. In terms of types of vehicles driven, about 97% of motorcyclists failed to comply with the signal indication requirement. The proportion of non-compliance drivers under stable traffic flow conditions is much higher than when the flow is relatively heavy. This is consistent with the data which indicates a high degree of non-compliances when the average speed of the traffic stream is relatively high.

The Drivers of Success in Business Model Transformation

Directory of Open Access Journals (Sweden)

Nenad Savič

2016-01-01

Full Text Available Existing empirical literature on business models is still inconclusive about the key drivers of successful business model transformation. The paper explores this issue by using a single longitudinal case study design in combination with grounded theory approach on a medium-sized, high-tech and globally oriented company. Based on on-site visits, interviews and secondary documentation data analysis, the study identifies six generic drivers of successful business model transformation: transformational leadership, discovery driven decision-making, industry improvement – customer specific orientation, content-oriented communication, self-initiative collaborators, and phased separation strategy. The new drivers supplement our existing knowledge on how successful transformation takes place and add to existing drivers, while extensive discussion of their implications may help the managers to execute business transformations more effectively.

Rational-driver approximation in car-following theory

Science.gov (United States)

Lubashevsky, Ihor; Wagner, Peter; Mahnke, Reinhard

2003-11-01

The problem of a car following a lead car driven with constant velocity is considered. To derive the governing equations for the following car dynamics a cost functional is constructed. This functional ranks the outcomes of different driving strategies, which applies to fairly general properties of the driver behavior. Assuming rational-driver behavior, the existence of the Nash equilibrium is proved. Rational driving is defined by supposing that a driver corrects continuously the car motion to follow the optimal path minimizing the cost functional. The corresponding car-following dynamics is described quite generally by a boundary value problem based on the obtained extremal equations. Linearization of these equations around the stationary state results in a generalization of the widely used optimal velocity model. Under certain conditions (the “dense traffic” limit) the rational car dynamics comprises two stages, fast and slow. During the fast stage a driver eliminates the velocity difference between the cars, the subsequent slow stage optimizes the headway. In the dense traffic limit an effective Hamiltonian description is constructed. This allows a more detailed nonlinear analysis. Finally, the differences between rational and bounded rational driver behavior are discussed. The latter, in particular, justifies some basic assumptions used recently by the authors to construct a car-following model lying beyond the frameworks of rationality.

Free-piston driver performance characterisation using experimental shock speeds through helium

Science.gov (United States)

Gildfind, D. E.; James, C. M.; Morgan, R. G.

2015-03-01

Tuned free-piston driver operation involves configuring the driver to produce a relatively steady blast of driver gas over the critical time scales of the experiment. For the purposes of flow condition development and parametric studies, it is useful to establish some average working values of the driver pressure and temperature for a given driver operating condition. However, in practise, these averaged values need to produce sufficiently accurate estimates of performance. In this study, two tuned driver conditions in the X2 expansion tube have been used to generate shock waves through a helium test gas. The measured shock speeds have then been used to calculate the effective driver gas pressure and temperature after diaphragm rupture. Since the driver gas is typically helium, or a mixture of helium and argon, and the test gas is also helium, ideal gas assumptions can be made without significant loss of accuracy. The technique is applicable to tuned free-piston drivers with a simple area change, as well as those using orifice plates. It is shown that this technique can be quickly used to establish average working driver gas properties which produce very good estimates of actual driven shock speed, across a wide range of operating conditions. The use of orifice plates to control piston dynamics at high driver gas sound speeds is also discussed in the paper, and a simple technique for calculating the restriction required to modify an established safe condition for use with lighter gases, such as pure helium, is presented.

Chinese carless young drivers' self-reported driving behavior and simulated driving performance.

Science.gov (United States)

Zhang, Qian; Jiang, Zuhua; Zheng, Dongpeng; Man, Dong; Xu, Xunnan

2013-01-01

Carless young drivers refers to those drivers aged between 18 and 25 years who have a driver's license but seldom have opportunities to practice their driving skills because they do not have their own cars. Due to China's lower private car ownership, many young drivers become carless young drivers after licensure, and the safety issue associated with them has raised great concern in China. This study aims to provide initial insight into the self-reported driving behaviors and simulated driving performance of Chinese carless young drivers. Thirty-three carless young drivers and 32 young drivers with their own cars (as a comparison group) participated in this study. A modified Driver Behavior Questionnaire (DBQ) with a 4-factor structure (errors, violations, attention lapses, and memory lapses) was used to study carless young drivers' self-reported driving behaviors. A simulated driving experiment using a low-cost, fixed-base driving simulator was conducted to measure their simulated driving performance (errors, violations, attention lapses, driving maintenance, reaction time, and accidents). Self-reported DBQ outcomes showed that carless young drivers reported similar errors, more attention lapses, fewer memory lapses, and significantly fewer violation behaviors relative to young drivers with their own cars, whereas simulated driving results revealed that they committed significantly more errors, attention lapses, and violation behaviors than the comparison group. Carless young drivers had a lower ability to maintain the stability of speed and lane position, drove more cautiously approaching and passing through red traffic lights, and committed more accidents during simulated driving. A tendency to speed was not found among carless young drivers; their average speed and speeding frequency were all much lower than that of the comparison group. Lifetime mileage was the only significant predictor of carless young drivers' self-reported violations, simulated violations

Violence against ambulance personnel: a retrospective cohort study of national data from Safe Work Australia

Directory of Open Access Journals (Sweden)

Brian J Maguire

2018-03-01

Full Text Available Objectives and importance: Paramedics have high rates of occupational injury and fatality. The objective of this study is to describe their specific risks of violence-related injury. Study type: This retrospective cohort study is an examination of retrospective data provided by Safe Work Australia (SWA. Methods: An examination of the 300 cases of serious claims of injury related to assaults, violence, harassment and bullying that occurred among individuals identified as ambulance officers and paramedics in Australia from 2001 to 2014. Paramedic risks likely vary by exposures such as hours worked and call volume. To examine how those exposures may influence risk, the available data were used to estimate rates based on hours worked and call volume. Results: The data show that, for serious injuries among paramedics in Australia between 2001 and 2014, the total number of violence-related cases increased from 5 to 40 per year; the number of cases of injury secondary to assault tripled from 10 to 30; and the rate of cases by call volume doubled from 6 to 12. The cost of these injuries was approximately AUD$250 000 for the year 2013–14. The median time at work lost per individual case of ‘work-related harassment and/or workplace bullying’ was 9.6 weeks. Although females comprised 32% of the paramedic workforce, they were the victims in 42% of cases of exposure to violence and 40% of harassment cases. Conclusions: Although anecdotal reports indicate that some interventions have been attempted, violence against paramedics continues to be a growing problem in Australia. The data presented in this study allow for a better understanding of the problem and can support efforts by ambulance service administrators, physicians, paramedics and university researchers to work together to develop and publish evidence based, cost-effective solutions to reduce the risk of workplace violence. Effective solutions will likely be multifaceted and include training

Solid state light source driver establishing buck or boost operation

Science.gov (United States)

Palmer, Fred

2017-08-29

A solid state light source driver circuit that operates in either a buck convertor or a boost convertor configuration is provided. The driver circuit includes a controller, a boost switch circuit and a buck switch circuit, each coupled to the controller, and a feedback circuit, coupled to the light source. The feedback circuit provides feedback to the controller, representing a DC output of the driver circuit. The controller controls the boost switch circuit and the buck switch circuit in response to the feedback signal, to regulate current to the light source. The controller places the driver circuit in its boost converter configuration when the DC output is less than a rectified AC voltage coupled to the driver circuit at an input node. The controller places the driver circuit in its buck converter configuration when the DC output is greater than the rectified AC voltage at the input node.

Obstacles to engaging in young driver licensing: Perspectives of parents.

Science.gov (United States)

Naz, Sehana; Scott-Parker, Bridie

2017-02-01

Young novice drivers remain at greater risk of injury and death despite a wealth of interventions including graduated driver licensing (GDL) programs. The key to implementing safer practices inherent in GDL appears to lie with optimising the role of parents. This qualitative research explored the parent's perspectives of obstacles to engaging in the driver licensing process within a GDL program. Parents also shared advice on what they found helpful, and where relevant, recommended changes in the process to enable safer practices for young drivers. Twenty-three parents (aged 35-60 years, M=49.52, SD=8.01, 11 males) participated in semi-structured interviews regarding licensing experiences with their young driver children. The young drivers included learner (n=11), provisional (restricted/intermediate) (n=9) and open (unrestricted/full) licence drivers (n=3), ranging from 16 to 24 years (M=18.04, SD=2.21, 13 males). Content analysis revealed that most obstacles were encountered at the learner licensing phase, with the parent-reported difficult temperament of the learner driver the most prominent. Unsurprisingly, advice to other parents to be patient and remain calm featured heavily during the same phase. Anxiety from not having control of the vehicle was another obstacle at the learner phase, translating to anxieties for child safety in the early stages of provisional driving. Recommendations for the current GDL included more rigorous road rule testing, with general support for the program, professional driver training at learner and provisional stages facilitated parental engagement through the licensing phases. The findings overwhelmingly suggest a need for parents to be educated regarding their importance in, and of, the driver licensing process, and the efficacy of their instruction, content and practices. Copyright © 2016 Elsevier Ltd. All rights reserved.

Study on driver model for hybrid truck based on driving simulator experimental results

Directory of Open Access Journals (Sweden)

Dam Hoang Phuc

2018-04-01

Full Text Available In this paper, a proposed car-following driver model taking into account some features of both the compensatory and anticipatory model representing the human pedal operation has been verified by driving simulator experiments with several real drivers. The comparison between computer simulations performed by determined model parameters with the experimental results confirm the correctness of this mathematical driver model and identified model parameters. Then the driver model is joined to a hybrid vehicle dynamics model and the moderate car following maneuver simulations with various driver parameters are conducted to investigate influences of driver parameters on vehicle dynamics response and fuel economy. Finally, major driver parameters involved in the longitudinal control of drivers are clarified. Keywords: Driver model, Driver-vehicle closed-loop system, Car Following, Driving simulator/hybrid electric vehicle (B1

The Effect of Passengers on Teen Driver Behavior

Science.gov (United States)

2012-04-01

A number of studies have shown that passengers substantially increase the risk of crashes for young, novice drivers. This increased risk may result from distractions that young passengers create for drivers. Alternatively, the presence of passengers ...

Using Shadow Page Cache to Improve Isolated Drivers Performance

Directory of Open Access Journals (Sweden)

Hao Zheng

2015-01-01

Full Text Available With the advantage of the reusability property of the virtualization technology, users can reuse various types and versions of existing operating systems and drivers in a virtual machine, so as to customize their application environment. In order to prevent users’ virtualization environments being impacted by driver faults in virtual machine, Chariot examines the correctness of driver’s write operations by the method of combining a driver’s write operation capture and a driver’s private access control table. However, this method needs to keep the write permission of shadow page table as read-only, so as to capture isolated driver’s write operations through page faults, which adversely affect the performance of the driver. Based on delaying setting frequently used shadow pages’ write permissions to read-only, this paper proposes an algorithm using shadow page cache to improve the performance of isolated drivers and carefully study the relationship between the performance of drivers and the size of shadow page cache. Experimental results show that, through the shadow page cache, the performance of isolated drivers can be greatly improved without impacting Chariot’s reliability too much.

Parent attitudes toward integrating parent involvement into teenage driver education courses.

Science.gov (United States)

Hartos, Jessica; Huff, David C

2008-01-01

The widespread adoption of graduated driver licensing (GDL) policies has effectively reduced crash risk for young drivers; however, parents must support, reinforce, and enforce GDL for it to be effective, and research indicates that parents need better information and instruction for adhering to GDL requirements, conducting supervised practice driving, and restricting independent teenage driving. Because teenagers in most states must take driver education to enter the licensing process prior to age 18, integrating parent involvement into driver education may be an effective way to inform and instruct parents on a large scale about teen driver safety. This study assessed parent attitudes (overall and by rural status, minority status, and income level) toward integrating parent involvement into teenage driver education classes. In this study, 321 parents of teenagers enrolled in driver education classes across the state of Montana completed surveys about current involvement in driver education and attitudes toward required involvement. The results indicated that parents were not very involved currently in their teenagers' driver education classes, but 76% reported that parents should be required to be involved. If involvement were required, parents would prefer having written materials sent home, access to information over the Internet, or discussions in person with the instructor; far fewer would prefer to attend classes or behind-the-wheel driving instruction. There were few differences in parent attitudes by rural or minority status but many by income level. Compared to higher income parents, lower income parents were more likely to endorse required parent involvement in teenage driver education classes and to want parent information from driver education about many teen driving issues. That the majority of parents are open to required involvement in their teenagers' driver education classes is promising because doing so could better prepare parents to understand

Truck Drivers' Use of the Internet: A Mobile Health Lifeline.

Science.gov (United States)

Heaton, Karen; Combs, Bryan; Griffin, Russell

2017-06-01

Because of their social isolation, irregular and unpredictable schedules, limited access to health care, and long periods of travel, long-haul truckers may benefit from the use of mobile health applications on Internet-capable devices. The purpose of this study was to determine Internet access and usage among a sample of long-haul truck drivers. In this cross-sectional study, truck drivers completed a pencil and paper survey with questions on demographics, work and health histories, and Internet access and usage for both personal and job reasons. A total of 106 truck drivers were recruited from trucking industry trade shows, by word of mouth, and directly from trucking companies. Overall, the truck drivers' use of the Internet was limited. Their usage for personal and job-related reasons differed. Social connectivity and access to health and wellness information were important during personal usage time. Job-related Internet use was highly practical, and applied to seeking information for directions and maps, fuel stops and pricing, and communicating with employers or transmitting documents. Age and experience were associated with Internet use. Younger, less-experienced drivers used the Internet more than older, experienced drivers. Targeted mobile health messaging may be a useful tool to inform truck drivers of health conditions and plans, and may provide links to primary care providers needing to monitor or notify drivers of diagnostic results or treatment plans.

Improving drivers' knowledge of road rules using digital games.

Science.gov (United States)

Li, Qing; Tay, Richard

2014-04-01

Although a proficient knowledge of the road rules is important to safe driving, many drivers do not retain the knowledge acquired after they have obtained their licenses. Hence, more innovative and appealing methods are needed to improve drivers' knowledge of the road rules. This study examines the effect of game based learning on drivers' knowledge acquisition and retention. We find that playing an entertaining game that is designed to impart knowledge of the road rules not only improves players' knowledge but also helps them retain such knowledge. Hence, learning by gaming appears to be a promising learning approach for driver education. Copyright © 2013 Elsevier Ltd. All rights reserved.

Investigating the impact of static roadside advertising on drivers' situation awareness.

Science.gov (United States)

Young, Kristie L; Stephens, Amanda N; Logan, David B; Lenné, Michael G

2017-04-01

Roadside advertising has the potential to create a crash risk for drivers as it may distract attention from driving at critical times. In an on-road instrumented vehicle study, we examined if and how static advertising billboards affect drivers' situation awareness across different driving environments. Nineteen fully licensed drivers drove an instrumented vehicle around a 38 km urban test route comprising freeway, busy urban retail and arterial road sections. The route contained a number of static billboards. Drivers provided continuous verbal protocols throughout the drive. Results indicated that the structure and content of drivers' situation awareness was not appreciably affected by the billboards in any of the road environments examined. Drivers focused their attention on the billboards when driving demand was low, such as when driving on the freeway with light to moderate traffic, in lower speed zones, or when stationary. However, when drivers were required to perform a manoeuvre or driving demands increased, drivers directed less attention to the billboards and focussed their awareness on the immediate driving task. This suggests that drivers can, at least under some conditions, effectively self-regulate their attention to billboards when required to focus on the immediate traffic or driving situation. Copyright © 2016 Elsevier Ltd. All rights reserved.

Quantitative analysis of the relationship between driver`s behavior and vehicle motion; Sharyo unten ni taisuru untensha no kyodo no teiryoka bunseki ni tsuite

Energy Technology Data Exchange (ETDEWEB)

Nakagawa, H; Matsuura, Y [Osaka Sangyo University, Osaka (Japan); Masuda, T

1997-10-01

In order to study the subject of driving safety about the human-vehicle interaction, driver`s maneuvering behavior was shot by CCD-cameras installed in a cabin and the motion of traveling vehicle was simultaneously taken by VTR-cameras set on the test course. These pictures were analyzed using the three-dimensional image processing system (Peak Motus system). Consequently, this system was effectively able to use for these measurements and analysis and introduced the correlation between the vehicle movement and the driver`s action. 4 refs., 12 figs., 2 tabs.

About Assessment Criteria of Driver's Accidental Abilities

Science.gov (United States)

Lobanova, Yuliya I.; Glushko, Kirill V.

2016-01-01

The article points at the importance of studying the human factor as a cause of accidents of drivers, especially in loosely structured traffic situations. The description of the experiment on the measurement of driver's accidental abilities is given. Under accidental ability is meant the capability to ensure the security of driving as a behavior…

SmartDriver for school bus : participant's handbook

International Nuclear Information System (INIS)

2007-01-01

SmartDriver is a key component of Natural Resources Canada's ecoENERGY for fleets program. The aim of the ecoENERGY initiative is to introduce fleets to energy-efficient practices for reducing fuel consumption and emissions and to help drivers adopt the driving practices outlined in the SmartDriver training materials. The handbook was designed as part of a comprehensive media package that included a CD-ROM with audio-visual components. The package was developed as a training strategy for fuel-efficient driving skills. The first module contained information on air pollution and techniques that drivers can adopt to reduce particulate matter, smog, greenhouse gas (GHG) emissions. An outline of new engine technologies developed to reduce emissions was also provided. The second module discussed various vehicle factors that influence fuel efficiency. Alternative fuels were reviewed, and vehicle components were discussed in relation to improving fuel economy. The module also included preventive maintenance tips as well as engine starting techniques and methods for reducing time spent idling. Various activities and games related to improving fuel efficiency were also included. 17 figs

An Overview on Study of Identification of Driver Behavior Characteristics for Automotive Control

Directory of Open Access Journals (Sweden)

Na Lin

2014-01-01

Full Text Available Driver characteristics have been the research focus for automotive control. Study on identification of driver characteristics is provided in this paper in terms of its relevant research directions and key technologies involved. This paper discusses the driver characteristics based on driver’s operation behavior, or the driver behavior characteristics. Following the presentation of the fundamental of the driver behavior characteristics, the key technologies of the driver behavior characteristics are reviewed in detail, including classification and identification methods of the driver behavior characteristics, experimental design and data acquisition, and model adaptation. Moreover, this paper discusses applications of the identification of the driver behavior characteristics which has been applied to the intelligent driver advisory system, the driver safety warning system, and the vehicle dynamics control system. At last, some ideas about the future work are concluded.

UWB dual burst transmit driver

Science.gov (United States)

Dallum, Gregory E [Livermore, CA; Pratt, Garth C [Discovery Bay, CA; Haugen, Peter C [Livermore, CA; Zumstein, James M [Livermore, CA; Vigars, Mark L [Livermore, CA; Romero, Carlos E [Livermore, CA

2012-04-17

A dual burst transmitter for ultra-wideband (UWB) communication systems generates a pair of precisely spaced RF bursts from a single trigger event. An input trigger pulse produces two oscillator trigger pulses, an initial pulse and a delayed pulse, in a dual trigger generator. The two oscillator trigger pulses drive a gated RF burst (power output) oscillator. A bias driver circuit gates the RF output oscillator on and off and sets the RF burst packet width. The bias driver also level shifts the drive signal to the level that is required for the RF output device.

Do advertisements at the roadside distract the driver?

Science.gov (United States)

Kettwich, Carmen; Klinger, Karsten; Lemmer, Uli

2008-04-01

Nowadays drivers have to get along with an increasing complex visual environment. More and more cars are on the road. There are not only distractions available within the vehicle, like radio and navigation system, the environment outside the car has also become more and more complex. Hoardings, advertising pillars, shop fronts and video screens are just a few examples. For this reason the potential risk of driver distraction is rising. But in which way do the advertisements at the roadside influence the driver's attention? The investigation which is described is devoted to this topic. Various kinds of advertisements played an important role, like illuminated and non-illuminated posters as well as illuminated animated ads. Several test runs in an urban environment were performed. The gaze direction of the driver's eye was measured with an eye tracking system. The latter consists of three cameras which logged the eye movements during the test run and a small-sized scene camera recording the traffic scene. 16 subjects (six female and ten male) between 21 and 65 years of age took part in this experiment. Thus the driver's fixation duration of the different advertisements could be determined.

ISAF'S Afghan Truck Drivers: The Overlooked Counterinsurgency Population

Directory of Open Access Journals (Sweden)

Myron Varouhakis

2015-12-01

Full Text Available A yearlong U.S. Army field study in Afghanistan examined the demographics and threat perceptions of one of the most-at-risk populations, that of Afghan truck drivers working for NATO’s International Security Assistance Force Afghanistan (ISAF. The study collected data from 766 Afghan truck drivers at the U.S.-operated Kandahar Airfield in ISAF’s Regional Command South. The findings show a wide diversity in age of the Afghan drivers as well as in terms of their home province. The findings also show that although all Afghan truck drivers had acute awareness and understanding of the high risks and dangers of the job, they all noted that the attractive salary and scarcity of jobs were dominant reasons for staying on the job. Findings also reveal a strong resentment among the Afghan truck drivers about their treatment by ISAF soldiers, as for the lack of protection for them and their families after the 2014 departure of NATO forces. The findings can provide significant insights and enhance the understanding of scholars, counterinsurgency strategists, policymakers, and military planners about “Host Country Nationals” as an important population of the human terrain.

Continuous traffic flow modeling of driver support systems in multiclass traffic with inter-vehicle communication and drivers in the loop

NARCIS (Netherlands)

Tampere, C.M.J.; Hoogendoorn, S.P.; Arem, B. van

2009-01-01

This paper presents a continuous traffic-flow model for the explorative analysis of advanced driver-assistance systems (ADASs). Such systems use technology (sensors and intervehicle communication) to support the task of the driver, who retains full control over the vehicle. Based on a review of

Driver education practices in selected states : traffic tech.

Science.gov (United States)

2011-07-01

Teen drivers have the highest crash rate per mile driven of any : age group (Williams, Ferguson, & Wells, 2005). Immaturity and : inexperience are two explanations for why novice teen drivers : have such a high crash risk (Arnett, 1992; Mayhew, Simps...

Methodology to evaluate teen driver training programs : [brief].

Science.gov (United States)

2014-03-01

In the United States, teenage drivers are more at risk of being involved in crashes than : any other age group. Statistics reveal a clear need for improving teenagers driving : skills, judgment and behavior. Driver education programs are a crucial...

Physics at an upgraded Fermilab proton driver

Energy Technology Data Exchange (ETDEWEB)

Geer, S.; /Fermilab

2005-07-01

In 2004 the Fermilab Long Range Planning Committee identified a new high intensity Proton Driver as an attractive option for the future, primarily motivated by the recent exciting developments in neutrino physics. Over the last few months a physics study has developed the physics case for the Fermilab Proton Driver. The potential physics opportunities are discussed.

Prevalence of Psychoactive Drug Use by Taxi Drivers in Nigeria ...

African Journals Online (AJOL)

Aim: To ascertain the prevalence and nature of psychoactive drug use amongst taxi drivers in Nigeria. Materials and Method: A total of 192 taxi drivers in Enugu, South East Nigeria was studied using a questionnaire. Information obtained from the questionnaire included socio-demographic characteristics of the drivers, ...

49 CFR 604.8 - Leasing FTA funded equipment and drivers.

Science.gov (United States)

2010-10-01

... 49 Transportation 7 2010-10-01 2010-10-01 false Leasing FTA funded equipment and drivers. 604.8... ADMINISTRATION, DEPARTMENT OF TRANSPORTATION CHARTER SERVICE Exceptions § 604.8 Leasing FTA funded equipment and drivers. (a) A recipient may lease its FTA-funded equipment and drivers to registered charter providers...

GPS Usage in a Population of Low-Vision Drivers.

Science.gov (United States)

Cucuras, Maria; Chun, Robert; Lee, Patrick; Jay, Walter M; Pusateri, Gregg

2017-01-01

We surveyed bioptic and non-bioptic low-vision drivers in Illinois, USA, to determine their usage of global positioning system (GPS) devices. Low-vision patients completed an IRB-approved phone survey regarding driving demographics and usage of GPS while driving. Participants were required to be active drivers with an Illinois driver's license, and met one of the following criteria: best-corrected visual acuity (BCVA) less than or equal to 20/40, central or significant peripheral visual field defects, or a combination of both. Of 27 low-vision drivers, 10 (37%) used GPS while driving. The average age for GPS users was 54.3 and for non-users was 77.6. All 10 drivers who used GPS while driving reported increased comfort or safety level. Since non-GPS users were significantly older than GPS users, it is likely that older participants would benefit from GPS technology training from their low-vision eye care professionals.

Research on Taxi Driver Strategy Game Evolution with Carpooling Detour

Directory of Open Access Journals (Sweden)

Wei Zhang

2018-01-01

Full Text Available For the problem of taxi carpooling detour, this paper studies driver strategy choice with carpooling detour. The model of taxi driver strategy evolution with carpooling detour is built based on prospect theory and evolution game theory. Driver stable strategies are analyzed under the conditions of complaint mechanism and absence of mechanism, respectively. The results show that passenger’s complaint mechanism can effectively decrease the phenomenon of driver refusing passengers with carpooling detour. When probability of passenger complaint reaches a certain level, the stable strategy of driver is to take carpooling detour passengers. Meanwhile, limiting detour distance and easing traffic congestion can decrease the possibility of refusing passengers. These conclusions have a certain guiding significance to formulating taxi policy.

Knowledge of commercial bus drivers about road safety measures in Lagos, Nigeria.

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Okafor Ifeoma, P; Odeyemi Kofoworola, A; Dolapo Duro, C

2013-01-01

Road traffic injuries have persisted as a serious public health problem and much of the health burden is in developing countries. Over-speeding, poor enforcement of traffic regulations and commuter buses have been highly implicated in road traffic injuries in developing countries. The aim of this study was to determine drivers' knowledge of selected road safety measures, i.e. the pre-requisites for driver's license, road signs and speed limits. This was a cross-sectional study carried out in Lagos, Nigeria. Simple random sampling was used to select the two motor parks used for the study and all the consenting commercial minibus drivers operating within the parks (407) were included in the study. Data was collected with a pre-tested, structured, interviewer-administered questionnaire and analyzed with epi-info statistical software. Two hundred and sixty-one (64.1%) of them knew that Visual Acuity test should be done before obtaining driver's license and 53.8% knew the correct minimum age for obtaining driver's license. Only 1% of the drivers had correct knowledge of the driver's license authorities in Nigeria. The drivers had poor knowledge of road signs (59.0%) and poor knowledge of maximum speed limits (100%). The oldest, least educated and least experienced drivers had the poorest level of knowledge. The drivers demonstrated poor knowledge of road safety measures. There is need for driver education to improve their knowledge.

Linear transformer driver for pulse generation

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Kim, Alexander A; Mazarakis, Michael G; Sinebryukhov, Vadim A; Volkov, Sergey N; Kondratiev, Sergey S; Alexeenko, Vitaly M; Bayol, Frederic; Demol, Gauthier; Stygar, William A

2015-04-07

A linear transformer driver includes at least one ferrite ring positioned to accept a load. The linear transformer driver also includes a first power delivery module that includes a first charge storage devices and a first switch. The first power delivery module sends a first energy in the form of a first pulse to the load. The linear transformer driver also includes a second power delivery module including a second charge storage device and a second switch. The second power delivery module sends a second energy in the form of a second pulse to the load. The second pulse has a frequency that is approximately three times the frequency of the first pulse. The at least one ferrite ring is positioned to force the first pulse and the second pulse to the load by temporarily isolating the first pulse and the second pulse from an electrical ground.

Design and simulation of advanced charge recovery piezoactuator drivers

International Nuclear Information System (INIS)

Biancuzzi, G; Lemke, T; Woias, P; Goldschmidtboeing, F; Ruthmann, O; Schrag, H J; Vodermayer, B; Schmid, T

2010-01-01

The German Artificial Sphincter System project aims at the development of an implantable sphincter prosthesis driven by a piezoelectrically actuated micropump. The system has been designed to be fully implantable, i.e. the power supply is provided by a rechargeable lithium polymer battery. In order to provide sufficient battery duration and to limit battery dimensions, special effort has to be made to minimize power consumption of the whole system and, in particular, of the piezoactuator driver circuitry. Inductive charge recovery can be used to recover part of the charge stored within the actuator. We are going to present a simplified inductor-based circuit capable of voltage inversion across the actuator without the need of an additional negative voltage source. The dimension of the inductors required for such a concept is nevertheless significant. We therefore present a novel alternative concept, called direct switching, where the equivalent capacitance of the actuator is charged directly by a step-up converter and discharged by a step-down converter. We achieved superior performance compared to a simple inductor-based driver with the advantage of using small-size chip inductors. As a term of comparison, the performance of the aforementioned drivers is compared to a conventional driver that does not implement any charge recovery technique. With our design we have been able to achieve more than 50% reduction in power consumption compared to the simplest conventional driver. The new direct switching driver performs 15% better than an inductor-based driver. A novel, whole-system SPICE simulation is presented, where both the driving circuit and the piezoactuator are modeled making use of advanced nonlinear models. Such a simulation is a precious tool to design and optimize piezoactuator drivers

Gaze position modulates the effectiveness of forward collision warnings for drowsy drivers.

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Gaspar, John G; Schwarz, John-Chris W; Brown, Timothy L; Kang, Julie

2017-12-22

Advanced driver assistance systems (ADAS) have the potential to prevent crashes and reduce their severity. Forward collision warnings (FCW) are quickly becoming standard across vehicle lineups and may prevent frontal crashes by alerting drivers. Previous research has demonstrated the effectiveness of FCW for distracted drivers, but their effectiveness for other types of impairment remains unknown. Like distraction, drowsiness can impair driver response time and lead to crashes. The goal of the present study was to evaluate the effectiveness of FCW for moderately and severely drowsy drivers using a high-fidelity driving simulator. Drowsy drivers were divided into three warning conditions during a revealed stop vehicle forward collision event: An auditory alert, a haptic seat vibration, and a no warning baseline. Results indicate that FCW were effective at speeding drowsy driver response, but only when the drowsy drivers were looking away from the forward roadway at the onset of the event. These results have important implications for ADAS technology and driver state monitoring systems. Copyright © 2017 Elsevier Ltd. All rights reserved.

An assessment of deforestation and forest degradation drivers in developing countries

International Nuclear Information System (INIS)

Hosonuma, Noriko; Herold, Martin; De Sy, Veronique; De Fries, Ruth S; Brockhaus, Maria; Verchot, Louis; Angelsen, Arild; Romijn, Erika

2012-01-01

Countries are encouraged to identify drivers of deforestation and forest degradation in the development of national strategies and action plans for REDD+. In this letter we provide an assessment of proximate drivers of deforestation and forest degradation by synthesizing empirical data reported by countries as part of their REDD+ readiness activities, CIFOR country profiles, UNFCCC national communications and scientific literature. Based on deforestation rate and remaining forest cover 100 (sub)tropical non-Annex I countries were grouped into four forest transition phases. Driver data of 46 countries were summarized for each phase and by continent, and were used as a proxy to estimate drivers for the countries with missing data. The deforestation drivers are similar in Africa and Asia, while degradation drivers are more similar in Latin America and Asia. Commercial agriculture is the most important driver of deforestation, followed by subsistence agriculture. Timber extraction and logging drives most of the degradation, followed by fuelwood collection and charcoal production, uncontrolled fire and livestock grazing. The results reflect the most up to date and comprehensive overview of current national-level data availability on drivers, which is expected to improve over time within the frame of the UNFCCC REDD+ process. (letter)

Investigations on Driver Unique Identification from Smartphone’s GPS Data Alone

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Arijit Chowdhury

2018-01-01

Full Text Available Driver identification is an emerging area of interest in vehicle telematics, automobile control, and insurance. Recent body of works indicates that it may be possible to uniquely identify a driver using multiple dedicated sensors. In this paper, we present an approach for driver identification using smartphone GPS data alone. For our experiments, we collected data from 38 drivers for two months. We quantified the driver’s natural style by extracting a set of 137 statistical features from data generated for each completed trip. The analysis shows that, for the “driver identification” problem, an average accuracy of 82.3% is achieved for driver groups of 4-5 drivers. This is comparable to the state of the arts where mostly a multisensor approach has been taken. Further, it is shown that certain behavioral attributes like high driving skill impact identification accuracy. We observe that Random Forest classifier offers the best results. These results have great implications for various stakeholders since the proposed method can identify a driver based on his/her naturalistic driving style which is quantified in terms of statistical parameters extracted from only GPS data.

Driver trust in five driver assistance technologies following real-world use in four production vehicles.

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Kidd, David G; Cicchino, Jessica B; Reagan, Ian J; Kerfoot, Laura B

2017-05-29

Information about drivers' experiences with driver assistance technologies in real driving conditions is sparse. This study characterized driver interactions with forward collision warning, adaptive cruise control, active lane keeping, side-view assist, and lane departure warning systems following real-world use. Fifty-four Insurance Institute for Highway Safety employees participated and drove a 2016 Toyota Prius, 2016 Honda Civic, 2017 Audi Q7, or 2016 Infiniti QX60 for up to several weeks. Participants reported mileage and warnings from the technologies in an online daily-use survey. Participants reported their level of agreement with five statements regarding trust in an online post-use survey. Responses were averaged to create a composite measure of trust ranging from -2 (strongly disagree) to +2 (strongly agree) for each technology. Mixed-effect regression models were constructed to compare trust among technologies and separately among the study vehicles. Participants' free-response answers about what they liked least about each system were coded and examined. Participants reported driving 33,584 miles during 4 months of data collection. At least one forward collision warning was reported in 26% of the 354 daily reports. The proportion of daily reports indicating a forward collision warning was much larger for the Honda (70%) than for the Audi (18%), Infiniti (15%), and Toyota (10%). Trust was highest for side-view assist (0.98) and lowest for active lane keeping (0.20). Trust in side-view assist was significantly higher than trust in active lane keeping and lane departure warning (0.53). Trust in active lane keeping was significantly lower than trust in adaptive cruise control (0.67) and forward collision warning (0.71). Trust in adaptive cruise control was higher for the Audi (0.72) and Toyota (0.75) compared with the Honda (0.30), and significantly higher for the Infiniti (0.93). Trust in Infiniti's side-view assist (0.58) was significantly lower than

First and second eye cataract surgery and driver self-regulation among older drivers with bilateral cataract: a prospective cohort study.

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Agramunt, Seraina; Meuleners, Lynn B; Fraser, Michelle L; Chow, Kyle C; Ng, Jonathon Q; Raja, Vignesh

2018-02-17

Driving a car is the most common form of transport among the older population. Common medical conditions such as cataract, increase with age and impact on the ability to drive. To compensate for visual decline, some cataract patients may self-regulate their driving while waiting for cataract surgery. However, little is known about the self-regulation practices of older drivers throughout the cataract surgery process. The aim of this study is to assess the impact of first and second eye cataract surgery on driver self-regulation practices, and to determine which objective measures of vision are associated with driver self-regulation. Fifty-five older drivers with bilateral cataract aged 55+ years were assessed using the self-reported Driving Habits Questionnaire, the Mini-Mental State Examination and three objective visual measures in the month before cataract surgery, at least one to three months after first eye cataract surgery and at least one month after second eye cataract surgery. Participants' natural driving behaviour in four driving situations was also examined for one week using an in-vehicle monitoring device. Two separate Generalised Estimating Equation logistic models were undertaken to assess the impact of first and second eye cataract surgery on driver-self-regulation status and which changes in visual measures were associated with driver self-regulation status. The odds of being a self-regulator in at least one driving situation significantly decreased by 70% after first eye cataract surgery (OR: 0.3, 95% CI: 0.1-0.7) and by 90% after second eye surgery (OR: 0.1, 95% CI: 0.1-0.4), compared to before first eye surgery. Improvement in contrast sensitivity after cataract surgery was significantly associated with decreased odds of self-regulation (OR: 0.02, 95% CI: 0.01-0.4). The findings provide a strong rationale for providing timely first and second eye cataract surgery for older drivers with bilateral cataract, in order to improve their mobility and

Aggressive behaviour of drivers in Slovakia affecting road safety

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Zuzana KRCHOVÁ

2012-01-01

Full Text Available Driving a car does not mean only controlling it and bringing it to the destination but it is also a social interaction of drivers towards each other, where emotions play an important role. Destructive emotions e.g. anger worsen the ability of making a decision. And it also holds for the people behind the steering wheel.Abroad, the questionnaires used for the detection of potential aggressive drivers, or diagnostics of drivers who already have a driving license, have a form of survey. In year 2010 was realized a questionnaire about aggressive behavior of drivers in Slovak republic from which came out very interesting information. Some information is mentioned in this paper.

Factors associated with suicide ideation among subway drivers in Korea.

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Byun, Junsu; Kim, Hyoung-Ryoul; Lee, Hye-Eun; Kim, Se-Eun; Lee, Jongin

2016-01-01

There were several suicide events of subway drivers in Korea. The aim of this study is to explore work-related factors associated with suicide ideation among subway drivers. We analyzed data from 980 male subway drivers. A section of the Korean version of the Composite International Diagnostic Interview (K-CIDI 2.1) was administered by trained interviewers to judge whether a driver has suicide ideation and to diagnose psychiatric disorders. A questionnaire was also administered to collect data on sociodemographic characteristics, work environments, occupational stress, person under train (PUT) experience, and work-related problems. Occupational stress was examined by using the Korean Occupational Stress Scale (KOSS). Logistic regression was applied to evaluate the association between work-related factors and suicide ideation among subway drivers. Regarding work-related problems, conflict with passengers and sudden stops due to the emergency bell were significantly associated with suicide ideation. MDD, PTSD, and panic disorder were strongly associated with suicide ideation. In the analysis of occupational stress, insufficient job control (OR 2.34) and lack of reward (OR 2.52) were associated with suicide ideation even after being adjusted for psychiatric disorders and other work-related factors. Insufficient job control and lack of reward were associated with suicide ideation among subway drivers. Strategies for drivers to have autonomy while working and to achieve effort-reward balance should be implemented. Furthermore, drivers who have experienced negative work-related problems should be managed appropriately.

Impact of an implanted neuroprosthesis on community ambulation in incomplete SCI.

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Lombardo, Lisa M; Kobetic, Rudolf; Pinault, Gilles; Foglyano, Kevin M; Bailey, Stephanie N; Selkirk, Stephen; Triolo, Ronald J

2018-03-01

Test the effect of a multi-joint control with implanted electrical stimulation on walking after spinal cord injury (SCI). Single subject research design with repeated measures. Hospital-based biomechanics laboratory and user assessment of community use. Female with C6 AIS C SCI 30 years post injury. Lower extremity muscle activation with an implanted pulse generator and gait training. Walking speed, maximum distance, oxygen consumption, upper extremity (UE) forces, kinematics and self-assessment of technology. Short distance walking speed at one-year follow up with or without stimulation was not significantly different from baseline. However, average walking speed was significantly faster (0.22 m/s) with stimulation over longer distances than volitional walking (0.12 m/s). In addition, there was a 413% increase in walking distance from 95 m volitionally to 488 m with stimulation while oxygen consumption and maximum upper extremity forces decreased by 22 and 16%, respectively. Stimulation also produced significant (P ≤ 0.001) improvements in peak hip and knee flexion, ankle angle at foot off and at mid-swing. An implanted neuroprosthesis enabled a subject with incomplete SCI to walk longer distances with improved hip and knee flexion and ankle dorsiflexion resulting in decreased oxygen consumption and UE support. Further research is required to determine the robustness, generalizability and functional implications of implanted neuroprostheses for community ambulation after incomplete SCI.

Objectively measured work load, health status and sickness absence among Danish ambulance personnel. A longitudinal study

DEFF Research Database (Denmark)

Hansen, Claus D.

2013-01-01

Background: Reviews show that ambulance personnel (AP) have an increased risk of work-related health problems especially musculoskeletal disorders. Because of the unpredictable character of the AP’s work environment, standard measures of work environment exposures are imprecise. The aim...... of this presentation is to examine the associations between objectively measured work load taken from the company register, health and long-term sickness absence (LTSA) in 1-year follow up period. Methods: Data is taken from the first round of MARS – Men, accidents, risk and safety, a two wave panel study of AP...... workers in Denmark (n = 1606) collected in winter 2010/11. The response rate to the questionnaire was 62% in the baseline. The respondents were asked about health status, physical (DMQ) and psychosocial work environment factors (COPSOQ). Information from the company register about work load (e.g. mean...

Identifying Cancer Driver Genes Using Replication-Incompetent Retroviral Vectors

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Victor M. Bii

2016-10-01

Full Text Available Identifying novel genes that drive tumor metastasis and drug resistance has significant potential to improve patient outcomes. High-throughput sequencing approaches have identified cancer genes, but distinguishing driver genes from passengers remains challenging. Insertional mutagenesis screens using replication-incompetent retroviral vectors have emerged as a powerful tool to identify cancer genes. Unlike replicating retroviruses and transposons, replication-incompetent retroviral vectors lack additional mutagenesis events that can complicate the identification of driver mutations from passenger mutations. They can also be used for almost any human cancer due to the broad tropism of the vectors. Replication-incompetent retroviral vectors have the ability to dysregulate nearby cancer genes via several mechanisms including enhancer-mediated activation of gene promoters. The integrated provirus acts as a unique molecular tag for nearby candidate driver genes which can be rapidly identified using well established methods that utilize next generation sequencing and bioinformatics programs. Recently, retroviral vector screens have been used to efficiently identify candidate driver genes in prostate, breast, liver and pancreatic cancers. Validated driver genes can be potential therapeutic targets and biomarkers. In this review, we describe the emergence of retroviral insertional mutagenesis screens using replication-incompetent retroviral vectors as a novel tool to identify cancer driver genes in different cancer types.

Risky behavior of drivers of motorized two wheeled vehicles in India.

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Dandona, Rakhi; Kumar, G Anil; Dandona, Lalit

2006-01-01

Motorized two-wheeled vehicles (MTV) account for a large proportion of road traffic in India and the riders of these vehicles have a high risk of road traffic injuries. We report on the availability of drivers licenses, use of a helmet, driver behavior, and condition of vehicles for MTV drivers in Hyderabad, a city in India Drivers of a MTV aged >16 years were interviewed at petrol filling stations There were 4,183 MTV drivers who participated in the study. Four hundred sixty one (11%; 95% CI 9.7-12.3%) drivers had not obtained a drivers license and 798 (21.4%) had obtained a license without taking the mandatory driving test. Two thousand nine hundred twenty (69.8%; 95% CI 67.9-71.7%) drivers reported no/very occasional use of a helmet, the significant predictors of which included that those driving borrowed a MTV (odds ratio 7.90; 95% CI 3.40-18.40) or driving moped/scooterette/scooter as compared with motorcycle (3.32; 2.76-3.98), lower education (3.10; 2.66-3.61), age >45 years (2.41; 1.63-3.57), and males (1.57; 1.16-2.13). Two thousand five hundred and eight (59.9%) drivers reported committing a traffic law violation at least once within the last 3 months. Overall, 1,222 (29.2%) drivers reported ever being caught by traffic police for a traffic law violation with data on violations available for 1,205 of these drivers, of whom 680 (56.4%) paid a fine, 310 (25.7%) paid by bribe, and 215 (17.8%) made no payment. The proportion of those who did not make payment for committed violation was significantly higher among females (46.8%) than males (16.3%). Two thousand fifty two (49%) of all MTVs had no rearview mirror These data suggest the need to enact and enforce policy interventions for improving the drivers license system, mandatory use of a helmet, effective traffic law enforcement, and ensuring good vehicle condition to reduce the risk factors that potentially contribute to mortality and morbidity in road traffic crashes in MTV drivers in Indian cities.

Modeling and Recognizing Driver Behavior Based on Driving Data: A Survey

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Wenshuo Wang

2014-01-01

Full Text Available In recent years, modeling and recognizing driver behavior have become crucial to understanding intelligence transport systems, human-vehicle systems, and intelligent vehicle systems. A wide range of both mathematical identification methods and modeling methods of driver behavior are presented from the control point of view in this paper based on the driving data, such as the brake/throttle pedal position and the steering wheel angle, among others. Subsequently, the driver’s characteristics derived from the driver model are embedded into the advanced driver assistance systems, and the evaluation and verification of vehicle systems based on the driver model are described.

Truck drivers' opinion on road safety in Tanzania--a questionnaire study.

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Kircher, Katja; Andersson, Jan

2013-01-01

Even though the traffic fatality risk (fatalities per 100,000 inhabitants) in Tanzania is quite low, the fatality rate (fatalities per 10,000 vehicles) is one of the highest in the world. With increasing vehicle density this means that the number of people dying in traffic will increase dramatically in the near future. Therefore, it is important to implement measures to increase traffic safety as soon as possible, and in order to be able to do this in an efficient way, it is important to investigate where the main problems lie. Within the European Union (EU) project ASSET-Road a questionnaire study on road safety was conducted with 250 truck drivers in Tanzania. The study was done to increase the knowledge about the situation of the Tanzanian truckers, who are the most frequent road users in the country. The drivers were interviewed in 3 different towns in southern Tanzania, and participation was voluntary. The questionnaire treated demographics, the state of the drivers' vehicles, the frequency of breakdowns, and the maintenance of the vehicles. Further questions concerned driver behavior, crash involvement, crash risk, and crash mitigation. The drivers who participated in the study were predominantly male and their average age was 36 years. Truck drivers reported driving 10.6 h without a break on average, with several drivers reporting that they had to drive 24 h without rest. Around 40 percent of the trucks did not have any seat belts installed, with a larger share of older trucks lacking belts. Most of the drivers who had seat belts reported using them, however. Almost 40 percent of the drivers reported being involved in at least one crash, and 45 percent of those drivers had experienced fatal crashes. This underlines that the crash frequency per vehicle is very high, and the results are often severe, especially when heavy vehicles are involved. When asked what the 3 most common crash causations were, driver-related causes were named frequently. Drivers were

Augmented Reality Cues and Elderly Driver Hazard Perception

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Schall, Mark C.; Rusch, Michelle L.; Lee, John D.; Dawson, Jeffrey D.; Thomas, Geb; Aksan, Nazan; Rizzo, Matthew

2013-01-01

Objective Evaluate the effectiveness of augmented reality (AR) cues in improving driving safety in elderly drivers who are at increased crash risk due to cognitive impairments. Background Cognitively challenging driving environments pose a particular crash risk for elderly drivers. AR cueing is a promising technology to mitigate risk by directing driver attention to roadway hazards. This study investigates whether AR cues improve or interfere with hazard perception in elderly drivers with age-related cognitive decline. Methods Twenty elderly (Mean= 73 years, SD= 5 years), licensed drivers with a range of cognitive abilities measured by a speed of processing (SOP) composite participated in a one-hour drive in an interactive, fixed-base driving simulator. Each participant drove through six, straight, six-mile-long rural roadway scenarios following a lead vehicle. AR cues directed attention to potential roadside hazards in three of the scenarios, and the other three were uncued (baseline) drives. Effects of AR cueing were evaluated with respect to: 1) detection of hazardous target objects, 2) interference with detecting nonhazardous secondary objects, and 3) impairment in maintaining safe distance behind a lead vehicle. Results AR cueing improved the detection of hazardous target objects of low visibility. AR cues did not interfere with detection of nonhazardous secondary objects and did not impair ability to maintain safe distance behind a lead vehicle. SOP capacity did not moderate those effects. Conclusion AR cues show promise for improving elderly driver safety by increasing hazard detection likelihood without interfering with other driving tasks such as maintaining safe headway. PMID:23829037

Teen Drivers' Perceptions of Their Peer Passengers: Qualitative Study.

Science.gov (United States)

Ehsani, Johnathon P; Haynie, Denise L; Luthers, Christina; Perlus, Jessamyn; Gerber, Eli; Ouimet, Marie Claude; Klauer, Sheila G; Simons-Morton, Bruce