Barriers to effective implementation of end-of-life vehicle management in Indonesia.

Effective end-of-life vehicle (ELV) management is crucial for minimizing the environmental and health impacts of Indonesia's growing automotive industry. However, proper ELV management has received limited attention. To bridge this gap, we conducted a qualitative study to identify barriers to effective ELV management in Indonesia's automotive sector. Through in-depth interviews with key stakeholders and a strengths, weaknesses, opportunities, and threats analysis, we identified internal and external factors influencing ELV management. Our findings reveal major barriers, including inadequate government regulation and enforcement, insufficient infrastructure and technology, low education and awareness, and a lack of financial incentives. We also identified internal factors such as limited infrastructure, inadequate strategic planning, and challenges in waste management and cost collection methods. Based on these findings, we recommend a comprehensive and integrated approach to ELV management involving enhanced coordination among government, industry, and stakeholders. The government should enforce regulations and provide financial incentives to encourage proper ELV management practices. Industry players should invest in technology and infrastructure to support effective ELV treatment. By addressing these barriers and implementing our recommendations, policymakers can develop sustainable ELV management policies and decisions in Indonesia's fast-paced automotive sector. Our study contributes valuable insights to guide the development of effective strategies for ELV management and sustainability in Indonesia.

Associations between biopsychosocial factors and transportation patterns of older adults residing in Klang Valley, Malaysia.

Introduction: Aging is associated with physiological changes in multiple systems in the body and may impact the transportation choices of older adults. In this study, we examine the associations between biopsychosocial factors and the transportation choices of Malaysian older adults. Methods: One hundred and nineteen (119) older adults, aged 60 and above, living in Klang Valley, Malaysia were recruited for this cross-sectional study. Participants were interviewed face-to-face to obtain sociodemographic data, health status (whether there were and, if yes, the number of comorbidities), outdoor mobility and transportation patterns, Instrumental Activity Daily Living (IADL) status and cognitive function. Participants' physical performance (dominant handgrip strength, 10-m walk, and timed up and go tests), hearing threshold (pure tone audiometry), and vision function (visual acuity, contrast sensitivity) were measured. Transportation patterns of older adults were categorized into three groups, that is, flexible (using public transport and/or private vehicles), using only private vehicles and restricted (relying on others or walking). Results: Further information is needed to enable such older adults as older women, those with comorbidities and poorer functional status to access transportation, especially to meet their health care needs. Discussion: The majority (51%) of participants were in the 'using only private vehicles' group, followed by the 'flexibles' (25%) and the 'restricted' (24%). Factors significantly associated with the restricted transportation group were: (a) being female (AdjOR 15.39, 95% CI 0.86-23.39, p < 0.001); (b) being Malay (AdjOR 21.72, 95% CI 0.36-16.12, p < 0.001); (c) having higher number of comorbidities (AdjOR 14.01, 95% CI 0.20-13.21, p = 0.007); and (d) being dependent in IADL (AdjOR 13.48, 95% CI 0.51-1.78, p = 0.002).

Improving Older People's Lives Through Digital Technology and Practices.

The Aging and Technology special issue showcases twelve papers spanning a range and diversity of international scholarly research within the field of ageing and technology. The collection of papers demonstrates the positive impact technology can have on the lives of older people including improving cognitive performance, physical and mental health and people's daily activities and practices. There are still barriers to use, including psychological issues of motivation, attitudes, privacy and trust and social issues involving learning to use the technology. In conclusion, to help overcome these barriers, it is recommended that research and development of technology involves older people as co-developers working with stakeholders from different disciplines and backgrounds.

Intergenerational Effects on the Impacts of Technology Use in Later Life: Insights from an International, Multi-Site Study.

As the use of technology becomes further integrated into the daily lives of all persons, including older adults, it is important to investigate how the perceptions and use of technology intersect with intergenerational relationships. Based on the international multi-centered study Technology In Later Life (TILL), this paper emphasizes the perceptions of older adults and the interconnection between technology and intergenerational relationships are integral to social connectedness with others. Participants from rural and urban sites in Canada and the UK (n = 37) completed an online survey and attended a focus group. Descriptive and thematic analyses suggest that older adults are not technologically adverse and leverage intergenerational relationships with family and friends to adjust to new technologies and to remain connected to adult children and grandchildren, especially when there is high geographic separation between them. Participants referenced younger family members as having introduced them to, and having taught them how to use, technologies such as digital devices, computers, and social networking sites. The intergenerational support in the adoption of new technologies has important implications for helping older persons to remain independent and to age in place, in both age-friendly cities and in rural communities. The findings contribute to the growing literature in the fields of gerontology and gerontechnology on intergenerational influences and the impacts of technology use in later life and suggest the flexibility and willingness of older persons to adopt to new technologies as well as the value of intergenerational relationships for overcoming barriers to technology adoption.

Developing A Model of Mobility Capital for An Ageing Population.

Driving a car meets older people's needs, providing utility (getting from A to B), psychosocial (providing identity and roles and feelings of independence and normality) and aesthetic (mobility for its own sake) mobilities. Giving up driving is related to poorer health and wellbeing. This paper addresses how older people cope when they give up driving, using Bourdieu's theory of capital as a way of categorising different barriers and enablers to managing without a car in a hypermobile society. Older people are most likely to mention barriers and enablers to mobility relating to infrastructure capital (technology, services, roads, pavements, finance and economics), followed by social capital (friends, family, neighbourhood and community). Cultural capital (norms, expectations, rules, laws) and individual capital (skills, abilities, resilience, adaptation and desire and willingness to change) are less important but still significantly contribute to older people's mobility. Implications for policy and practice suggest that provision for older people beyond the car must explore capital across all four of the domains.

Older Adults' Perceptions of ICT: Main Findings from the Technology In Later Life (TILL) Study.

Technology is entwined in 21st Century society, and within the lives of people across all ages. The Technology In Later Life (TILL) study is the first piece of work contributing to the impact, behavior, and perception of technology use, by adults aged ≥70 years, residing in rural and suburban areas. TILL is an international, multi-centred, multi-methods study investigating and conceptualizing how various technologies impact the lives of older adults; residing in urban and rural locations in the United Kingdom (UK) and Canada. This in-depth study recruited 37 participants via a multi-methods approach. Analysis of the findings ascertained two overarching themes: facilitators of technology use (i.e., sharing of information and feeling secure), and detractors of technology (i.e., feelings of apprehension of use). Proposed recommendations include promotion of technology from a strengths-based perspective focusing on positive opportunities technology to improve health and wellbeing, creating a peer support network to assist with learning of new technology, and the need to examine further how intergenerational relationships may be enhanced through the use of technology. The distinction of these themes narrates to the originality of this initial study and milieu of recruited participants, intersecting across the fields of gerontology, geography, social sciences, and gerontechnology.

The stigmatisation of source isolation: a literature review.

BACKGROUND: Isolation precautions in patients with multi-drug-resistant bacteria and other communicable infectious agents can be associated with adverse effects. Patients' perspectives of isolation suggest that the imposed environment and procedures create barriers to their physical, social and emotional needs. AIMS: The purpose of this paper is to review the literature to uncover any reliable evidence supporting the assertion that stigma is a significant characteristic of the experience of source isolation in healthcare settings. METHODS: The methodological framework of Arksey and O'Malley was applied to this review. A total of 14 papers identified from 189 abstracts screened were included in the review. RESULTS: The research reviewed suggests a clear association between stigmatisation and isolation in which stigma does have a direct negative effect on patients placed in hospital isolation. None of the studies found evidence to the contrary. CONCLUSIONS: The implications of this literature review for policy-makers and healthcare professionals suggest that when isolation or other forms of constraint are implemented and in use, patients must be provided with strengthened forms of support, including social and emotional support, and given access to healthcare of optimal quality to prevent the associated adverse effects of isolation as much as possible.

Including household effects in Big Data research: the experience of building a longitudinal residence algorithm using linked administrative data in Wales.

The effect of the wider social-environment on physical and emotional health has long been an area of study. Extrapolating the impact of the individual's immediate environment, such as living with a smoker or caring for a chronically-ill child, would potentially reduce confounding effects in health-related research. Surveys, including the UK Census, are beginning to collect data on household composition. However, these surveys are expensive, time consuming, and, as such, are only completed by a subsection of the population. Large-scale, linked databanks, such as the SAIL Databank at Swansea University, which hold routinely collected secondary use clinical and administrative datasets, are broader in scope, both in terms of the nature of the data held, and the population. The SAIL databank includes demographic data and a geographic indicator that makes it possible to identify groups of people that share accommodation, and in some cases the familial relationships among them. This paper describes a method for creating households, including considerations for how that information can be securely shared for research purposes. This approach has broad implications in Wales and beyond, opening up possibilities for more detailed population-level research that includes consideration of residential social interactions.

Older People's External Residential Assessment Tool (OPERAT): a complementary participatory and metric approach to the development of an observational environmental measure.

BACKGROUND: The potential for environmental interventions to improve health and wellbeing has assumed particular importance in the face of unprecedented population ageing. However, presently observational environmental assessment tools are unsuitable for 'all ages'. This article describes the development of the Older People's External Residential Assessment Tool (OPERAT). METHODS: Potential items were identified through review and consultation with an Expert Advisory Group. Items were ranked according the importance ascribed to them by older people who responded to a survey distributed by 50+ forum in Wales (N = 545). 40 highly ranked items were selected for the OPERAT pilot. An observational assessment was conducted in 405 postcodes in Wales. Items validated with data from a survey of older residents (N = 500) in the postcode areas were selected for statistical modelling (Kendall's Tau-b, p < .05). Data reduction techniques (exploratory factor analysis with Geomin rotation) identified the underlying factor structure of OPERAT. Items were weighted (Thurstone scaling approach) and scores calculated for each domain. Internal consistency: all items were tested for scale-domain total correlation (Spearman's rank). Construct validity: correlation analysis examined the associations between domains and the extent to which participants enjoyed living in the area, felt that it was a desirable place to live, or felt safe at night or during the day (Spearman's rank). Usability: analysis of variance compared mean OPERAT domain scores between neighbourhoods that were homogenous in terms of (a) deprivation (quintiles of the Townsend Index) and (b) geographic settlement type. Inter-rater reliability: Krippendorff's alpha was used to evaluate inter-rater consistency in ten postcode areas. RESULTS: A four factor model was selected as the best interpretable fit to the data. The domains were named Natural Elements, Incivilities and Nuisance; Navigation and Mobility; and Territorial Functioning. Statistical tests demonstrated good internal consistency, convergent validity, utility and inter-rater reliability. CONCLUSIONS: Participatory approaches to research and robust statistical testing are not mutually exclusive. OPERAT can be used to assess the suitability of external residential environments for older people with different physical and cognitive capacities, living in rural or urban areas. OPERAT can be used to help plan residential environments that are friendly for all ages.

Examining the process of driving cessation in later life.

Driving cessation for many older people is associated with a poorer quality of life and can lead to health problems such as depression. This paper aims to reveal the process of giving-up driving, examining in particular triggers for giving-up driving, how information on alternative modes of transport is sought and how new transport and travel behaviour is integrated into older people's lives. It examines the challenges faced and how these are overcome and what impact the process has on self-reported quality of life, as articulated by the participants themselves. To this end, twenty-one individuals from three locations in the United Kingdom (UK) were followed over a period of 10 months, through five waves of data collection. Each participant took part in three interviews, a focus group and completed a diary of travel behaviour. Findings suggest that although a similar pattern was found between the trigger and life post-car, not all older people go through the stages of giving-up driving in the same way. Instead, a range of responses are seen, from contemplation of gradually reducing driving, through to stopping abruptly, with the route taken having consequences for the eventual outcome for any individual. Triggers for contemplating driving cessation could be varied and often involved health and social factors. Importantly, people who engaged in pre-planning reported a relatively higher quality of life beyond the car, whilst for those who were more reactive and engaged in little or no pre-planning a poorer quality of life resulted. In addition (and in conjunction with planning), other factors, such as flexibility in travel destinations, the role of family and friends, and wider support networks are also seen as important. With such evidence of the importance of pre-planning it is suggested that more could be done to support giving-up driving and encouraging contemplation at a younger age to mitigate the negative effects experienced by some.

Public attitudes towards motorcyclists' safety: a qualitative study from the United Kingdom.

The aim of the reported research was to examine the perceptions of road user safety amongst different road users and examine the link between attitudes, empathy and skill in motorcycle safety behaviour. Motorcyclists were perceived by the study participants, members of the public at four different locations at the UK (including motorcyclists and non-motorcyclists), as a group be at a high risk of accidents on the road. This was due to perceived behavioural characteristics of motorcyclists--who were viewed as 'thrill seekers'--as well as observed behaviours on the road. This, coupled with the physical vulnerability and excessive speeds, meant that motorbike driving was considered by the study participants as the least safe form of road use. There was broad agreement that motorcycling was dangerous as a whole, but not all motorcyclists were necessarily risky riders. The issue of 'competitive space' emerged between car drivers and motorcyclists in particular and it was suggested that there was a lack of mutual awareness and considerations between the two groups. Generally, greatest empathy comes from drivers who are motorcyclists themselves. Engineering, education, enforcement interventions were investigated. These were aimed at two main areas: normalising safer driving behaviours for motorcyclists and increasing awareness of bikes for motorists--particularly in relation to reducing speed limits at urban junctions. Finally, the idea of risk mapping and reduced speed limits on rural roads was seen as potentially effective--particularly as certain motorcyclists highlighted that they changed their riding behaviours by increasing speed and taking greater risks on these roads.

Equine road user safety: public attitudes, understandings and beliefs from a qualitative study in the United Kingdom.

Horse riders represent a significant group of vulnerable road user and are involved in a number of accidents and near misses on the road. Despite this horse riders have received little attention both in terms of academic research and transport policy. Based on literature on vulnerable road user safety, including attitudes to road user safety and behaviour of drivers and their relationship with cyclists and motorcyclists, this paper examines the attitudes and reported behaviour of drivers and horse riders. A total of 46 participants took part in six focus groups divided into four groups of drivers with little or no horse riding experience and two groups of frequent horse riders. Each group investigated five key topic areas stemming from the literature review on vulnerable road users including hazard perception, risk perception, emotion, attitudes to sharing the road and empathy. It was found that drivers and horse riders are not always aware of the same hazards in the road and that this may lead drivers to under-estimate the risk when encountering horses. Drivers often had good intentions to overtake horses safely, but were unaware of how vulnerable passing very wide and slow made them feel until they had begun the manoeuvre and hence quickly reduced such feelings either by speeding up or cutting in too soon. However, other than this, drivers had good skills when encountering horses. But these skills could be impeded by frustration when encountering a slow moving horse which was further compounded by a feeling, mainly by younger drivers, that horse riding was for leisure and as such should not get in the way of necessary work journeys. There is a need for drivers to be more aware of the potential hazards a horse rider faces on the road and these could be achieved through inducing empathy amongst drivers for horse riders, creating nudges for drivers in the environment and better education for drivers.

Exploring older drivers' perceptions of driving.

This research uses grounded theory to assess the driving needs of 29 older car drivers using four data collection techniques (two waves of focus groups, an interview and a driver diary). Findings suggest that older drivers view themselves as having better driving skills and attitude towards driving compared to when they were younger and compared to other drivers. In addition, they have a good ability to adapt to their changing physiology. Nevertheless, they report difficulty in assessing their own driving ability and cite they would like help to increase self-awareness about the driving task. In addition, the participants report having increasing difficulty in not having enough time to read, compute and comprehend road signs, maintaining a constant speed at the speed-limit, increased tiredness and fatigue and increased sensitivity to glare. The findings suggest given an iterative, qualitative methodology where driving issues are focused upon, older drivers can become more self-aware of their driving limitations and discuss these aspects in the context of ageing physiology.

Attitudes towards vehicle driving behaviour: categorising and contextualising risk.

In driving motorised vehicles, the amount of risk accepted varies between individuals. Traditional theories of risk have tended to focus on a lack of skill as a function of risk taking and have ignored social motivations and attitudes for engaging in risk. This study aims to categorise and contextualise risk taking behaviour in relation to car driving through studying the motivations and attitudes towards risk. The results were tested on a representative sample (n=1655) of the UK driving population and four groups were identified based on motivations; those that took risk unintentionally formed the largest group. Three smaller groups who took deliberate risks were also found, a reactive risk taking group who took risks when reacting to stress or being in a hurry, a calculated risk taking group who took risks when they felt it was safe to do so, such as late at night or on well-known roads, and a continuous risk taking group who frequently took risks for their own sake.

Workforce planning and education: mapping competencies, skills and standards in mental health.

This paper aims to identify and critically analyse the provision and commissioning of relevant training for multidisciplinary mental health practitioners in the South West region of England. Data were collected from 45 education and training providers across the region. A total of 132 courses were examined through analysis of a questionnaire and a further 82 courses were studied in more depth through interviews and focus groups, alongside a textual analysis of course documents. Data generated from the analyses were mapped against the competencies and skills outlined in The Capable Practitioner [SCMH, 2001. The Capable Practitioner, Sainsbury Centre for Mental Health, London.] document and National Occupational Standards for Mental Health [Skills for Health, 2004. National Occupational Standards for Mental Health. Available from: (last accessed 17.11.04).]. The findings confirmed that significant gaps exist in training and education. While some aspects of The Capable Practitioner and National Occupational Standards for Mental Health are covered well by courses provided for mental health practitioners in the region, other aspects are missed completely. Recommendations are made for further research, with the suggestion of using an action research and co-operative enquiry method to identify with participants if courses should be developed to cover these areas or if the standards themselves should be adapted. Reflections on the methodological framework and subsequent limitations of the study are outlined.