Challenges to Human Drivers in Increasingly Automated Vehicles.

OBJECTIVE: We examine the relationships between contemporary progress in on-road vehicle automation and its coherence with an envisioned "autopia" (automobile utopia) whereby the vehicle operation task is removed from all direct human control. BACKGROUND: The progressive automation of on-road vehicles toward a completely driverless state is determined by the integration of technological advances into the private automobile market; improvements in transportation infrastructure and systems efficiencies; and the vision of future driving as a crash-free enterprise. While there are many challenges to address with respect to automated vehicles concerning the remaining driver role, a considerable amount of technology is already present in vehicles and is advancing rapidly. METHODS: A multidisciplinary team of experts met to discuss the most critical challenges in the changing role of the driver, and associated safety issues, during the transitional phase of vehicle automation where human drivers continue to have an important but truncated role in monitoring and supervising vehicle operations. RESULTS: The group endorsed that vehicle automation is an important application of information technology, not only because of its impact on transportation efficiency, but also because road transport is a life critical system in which failures result in deaths and injuries. Five critical challenges were identified: driver independence and mobility, driver acceptance and trust, failure management, third-party testing, and political support. CONCLUSION: Vehicle automation is not technical innovation alone, but is a social as much as a technological revolution consisting of both attendant costs and concomitant benefits.

Seasonal and Weather Effects on Older Drivers' Trip Distances.

The purpose of this study was to determine if season or weather affected the objectively measured trip distances of older drivers (≥ 70 years; n = 279) at seven Canadian sites. During winter, for all trips taken, trip distance was 7 per cent shorter when controlling for site and whether the trip occurred during the day. In addition, for trips taken within city limits, trip distance was 1 per cent shorter during winter and 5 per cent longer during rain when compared to no precipitation when controlling for weather (or season respectively), time of day, and site. At night, trip distance was about 30 per cent longer when controlling for season and site (and weather), contrary to expectations. Together, these results suggest that older Canadian drivers alter their trip distances based on season, weather conditions, and time of day, although not always in the expected direction.

Older driver estimates of driving exposure compared to in-vehicle data in the Candrive II study.

OBJECTIVE: Most studies on older adults' driving practices have relied on self-reported information. With technological advances it is now possible to objectively measure the everyday driving of older adults in their own vehicles over time. The purpose of this study was to examine the ability of older drivers to accurately estimate their kilometers driven over one year relative to objectively measured driving exposure. METHODS: A subsample (n = 159 of 928; 50.9% male) of Candrive II participants (age ≥ 70 years of age) was used in these analyses based on strict criteria for data collected from questionnaires as well as an OttoView-CD Autonomous Data Logging Device installed in their vehicle, over the first year of the prospective cohort study. RESULTS: Although there was no significant difference overall between the self-reported and objectively measured distance categories, only moderate agreement was found (weighted kappa = 0.57; 95% confidence interval, 0.47-0.67). Almost half (45.3%) chose the wrong distance category, and some people misestimated their distance driven by up to 20,000 km. Those who misjudged in the low mileage group (≤5000 km) consistently underestimated, whereas the reverse was found for those in the high distance categories (≥ 20,000); that is, they always overestimated their driving distance. CONCLUSIONS: Although self-reported driving distance categories may be adequate for studies entailing broad group comparisons, caution should be used in interpreting results. Use of self-reported estimates for individual assessments should be discouraged.

A systematic review of yoga for state anxiety: considerations for occupational therapy.

BACKGROUND: State anxiety can result from a variety of life situations. This type of anxiety can disrupt occupational engagement and performance, thereby affecting rehabilitation and recovery. Occupational therapists need to address the connection between mind-body-spirit and its relationship to performance and engagement in meaningful occupations. Yoga, when used as an adjunct to therapy, has the potential to address state anxiety. PURPOSE: The aim was to systematically review the evidence concerning the effectiveness of yoga as a treatment approach for state anxiety. METHODS: Six electronic databases, the authors' own files, and the references of included studies from 1990 to July 2011 were searched. FINDINGS: A total of 25 unique studies represented by 26 publications made up the sample: two systematic reviews; 16 randomized controlled trials, and seven prospective, controlled, non-randomized studies. Evidence suggests yoga can be a viable therapeutic option for reducing state anxiety in certain situations. IMPLICATIONS: In making the determination to recommend yoga as an intervention, occupational therapists should consider the client's circumstances and values as well as the type and intensity of the yoga program.

Evaluating medically at-risk drivers: a survey of assessment practices in Canada.

BACKGROUND: Assessing medical fitness to drive (FTD) can include both off- and on-road testing, although consistency of practice is unclear. PURPOSE: To examine actual practices being used to assess FTD at driver assessment centres (DACs) across Canada. METHOD: Surveys e-mailed to 90 DACs were returned by 47 assessors. FINDINGS: The majority of respondents (89%) were occupational therapists. Assessors reported doing an average of eight FTD assessments per month (range = I to 40) at an average cost of $366 (SD = $225; range = $40 to $985). Referrals came from physicians (96%), other health professionals (70%), and licensing authorities (66%). Clients with stroke, dementia, traumatic brain injury, mild cognitive impairment, and multiple sclerosis composed 62% of estimated caseloads. Assessments took 3 hr on average (range = 1.24 to 4.5 hr); 64% reported they always took clients on road regardless of clinic results. IMPLICATIONS: Evidence-based guidelines for training and assessment are clearly needed given the inconsistency in practice.

Assessment tools for evaluating fitness to drive: a critical appraisal of evidence.

BACKGROUND: Many office-based assessment tools are used by occupational therapists to predict fitness to drive. PURPOSE: To appraise psychometric properties of such tools, specifically predictive validity for on-road performance. METHODS: A literature search was conducted to identify assessment tools and studies involving on-road outcomes (behind-the-wheel evaluation, crashes, traffic violations). Using a standardized appraisal process, reviewers rated each tool's psychometric properties, including its predictive validity with on-road performance. FINDINGS: Seventeen measures met the inclusion criteria. Evidence suggests many tools do not have cutoff scores linked with on-road outcomes, although some had stronger evidence than others. Implications. When making a determination regarding driver fitness, clinicians should consider the psychometric properties of the tool as well as existing evidence concerning its utility in predicting on-road performance. Caution is warranted in using any one office-based tool to predict driving fitness; rather, a multifactorial-based assessment approach that includes physical, cognitive, and visual-perceptual components, is recommended.

What vehicle features are considered important when buying an automobile? An examination of driver preferences by age and gender.

INTRODUCTION: Certain vehicle features can help drivers avoid collisions and/or protect occupants in the event of a crash, and therefore, might play an important role when deciding which vehicle to purchase. The objective of this study was to examine the importance attributed to key vehicle features (including safety) that drivers consider when buying a car and its association with age and gender. METHODS: A sample of 2,002 Canadian drivers aged 18 years and older completed a survey that asked them to rank the importance of eight vehicle features if they were to purchase a vehicle (storage, mileage, safety, price, comfort, performance, design, and reliability). ANOVA tests were performed to: (a) determine if there were differences in the level of importance between features and; (b) examine the effect of age and gender on the importance attributed to these features. RESULTS: Of the features examined, safety and reliability were the most highly rated in terms of importance, whereas design and performance had the lowest rating. Differences in safety and performance across age groups were dependent on gender. This effect was most evident in the youngest and oldest age groups. CONCLUSIONS: Safety and reliability were considered the most important features. Age and gender play a significant role in explaining the importance of certain features. IMPACT ON INDUSTRY: Targeted efforts for translating safety-related information to the youngest and oldest consumers should be emphasized due to their high collision, injury, and fatality rates.

The experience of participation in everyday occupations for adults with obesity.

BACKGROUND: Participation in occupations of everyday life, such as self-care, work, and leisure, contribute to health and well-being. Obesity has been shown to influence health-related quality of life, but it is unclear how obesity influences participation in specific occupations. PURPOSE: To describe the lived experience of adults with class III obesity and the associated impact on participation in occupations of daily living. METHODS: Ten adults enrolled in an obesity treatment program were interviewed. Data were interpreted using descriptive phenomenological methods. FINDINGS: Participants underscored the tensions, barriers, and coping strategies across and within specific occupations. Although participation across occupations of daily living was described, the quality and diversity of occupations was influenced by real and perceived barriers within the environment. IMPLICATIONS: Participation in daily occupations is limited for persons with class III obesity. Intervention approaches should address health-related concerns and consider environmental adaptations that facilitate meaningful engagement in everyday life.

Supporting safe driving with arthritis: developing a driving toolkit for clinical practice and consumer use.

We conducted a series of focus groups to explore the information needs of clinicians and consumers related to arthritis and driving. An open coding analysis identified common themes across both consumer and clinician-based focus groups that underscored the importance of addressing driving-related concerns and the challenges associated with assessing safety. The results revealed that although driving is critical for maintaining independence and community mobility, drivers with arthritis experience several problems that can affect safe operation of a motor vehicle. Findings from this study are part of a broader research initiative that will inform the development of the Arthritis and Driving toolkit. This toolkit outlines strategies to support safe mobility for people with arthritis and will be an important resource in the coming years given the aging population.

Driving, navigation, and vehicular technology: experiences of older drivers and their co-pilots.

OBJECTIVE: The objective of this article is to explore relationship between older drivers and their passengers (co-pilots) and potential implications of in-vehicle navigation technology on their driving safety. METHODS: Semi-structured interviews were conducted with 44 healthy, community-dwelling older adults (aged 60-83) or 22 married couples. Males identified themselves as drivers and females identified themselves as passengers (i.e., co-pilot). RESULTS: Findings indicate that operating a motor vehicle in older adulthood is a shared activity between drivers and passengers. Older drivers and co-pilots reported their level of interaction depended on their familiarity with their route. Navigating unfamiliar areas, particularly large urban centers, was identified as the most challenging driving situation. Participants identified their level of collaboration would increase with the advent of in-vehicle navigation technology. Safety concerns related to the use of this technology, included distraction of both drivers and passengers. Differences amongst couples in their perceptions of using this technology were linked to their level of experience with using other forms of technology. CONCLUSIONS: Older drivers and passengers identified working closely together when operating a motor vehicle. Further investigation into the effects of in-vehicle navigation technology on the driving safety of older drivers and their co-pilots is warranted.

Dispelling the disability stereotype: embracing a universalistic perspective of disablement.

BACKGROUND: The notion of universalism was introduced to me during my first year of PhD studies in Rehabilitation Science. During a class discussion, we debated the merits of two theoretical perspectives that offered contradicting views as to the most effective means to facilitating a shift in societal perceptions of disability. As exemplified by the World Health Organization's current model of health, the International Classification of Functioning, Disability and Health (ICF), there has been a shift from a minority group analysis towards a universalistic perspective of disablement. PURPOSE: This paper introduces readers to the underlying concepts of both minority group analysis and universalism and, in doing so, proposes that universalism is closely aligned with the underlying constructs of occupational therapy. Universalism provides a comprehensive framework that can be utilized by occupational therapists to encourage the development of health and social-related policies that promote inclusiveness, yet still the respect the differences that exist among individuals. PRACTICE IMPLICATIONS By improving their familiarity with such theories, occupational therapists may be better positioned to contribute to policy development within their respective treatment and/or community settings.