Audiovisual presentation of variable message signs improves message processing in distracted drivers during partially automated driving.

INTRODUCTION: Highly automated driving is expected to reduce the accident risk occurrence by human errors, but it can also increase driver distraction. Previous evidence shows that auditory signals can help drivers take over in critical situations. However, it is still uncertain whether the potential benefit of verbal auditory signals could be generalized to driving situations where drivers are visually and auditorily distracted. METHOD: Our first objective was to compare the effectiveness of complementary audio messages (audio + visual condition) and visual only (visual condition) variable message signs (VMS) messages. The second objective was to explore the potential use of oral messages with traffic information to help highly-automated vehicle drivers identify critical situations. Eye-tracking data were also registered. Twenty-four volunteers participated in a driving simulator study, completing two tasks: (a) a TV series task, where they had to pay attention to an episode of a TV series while traveling along the route; and (b) a VMS task, where they had to recover the manual control of the car if the VMS message was a 'critical message.' RESULTS: General results showed that, when the audio was available, the participants: (a) had a higher ability to discriminate the VMS messages, (b) were less conservative, (c) responded earlier, and (d) their pattern of fixations was more efficient. A complementary analysis showed that the counterbalance order was a moderating factor for the discrimination ability and the response distance measures. This evidence suggests a potential learning effect, not cancelled by counterbalancing the order of the conditions. CONCLUSION: The processing of traffic messages may improve when provided as oral and visual messages. PRACTICAL APPLICATIONS: These results would be of special interest for engineers designing highly automated cars, considering that the design of automated systems must ensure that the driver's attention is sufficient to take over control.

Finding a City Name in a Traffic Sign: Effects of Word Case and Visual Motion.

OBJECTIVES: To investigate the word recognition effects of the use of all-uppercase (e.g., VALENCIA) or titled-case (e.g., Valencia) for city names in traffic signs, controlling for word size, and comparing stationary and dynamic viewing situations. BACKGROUND: Prior studies provide mixed evidence regarding the effects of word case on the recognition of city names in traffic signs. Moreover, the evidence on the potential impact of visual motion on these effects is scarce. METHOD: We carried out an experimental study using simulated traffic signs. The task was to indicate, for each sign, whether it contained a given city name or not (word search task, 50% positive trials). Visual motion of signs was manipulated as a between-participants factor: stationary (the sign was still) versus dynamic (the sign expanded as if the participant was approaching to it). Word case was manipulated as a within-participants factor: all-uppercase versus two titled-case conditions varying in font size: width-matched titled-case and point size-matched titled-case. RESULTS: In both the stationary and dynamic conditions, all-uppercase resulted in more incorrect responses and slower latencies than width-matched titled-case. When compared to point size-matched titled-case, all-uppercase produced slower correct responses in the stationary condition, whereas faster in the dynamic condition. CONCLUSION: Other factors being equal, all-uppercase city names will be recognized worse than their titled-case versions in traffic signs, both in stationary and dynamic situations. APPLICATION: Results in the current experimental study would be of interest in the design of traffic signs and other circumstances in which text is presented in motion.

Messages beyond the phone: Processing variable message signs while attending hands-free phone calls.

We examined the effects of different types of cognitive distraction coming from a hands-free phone conversation on the processing of information provided by variable message signs (VMS), on driving performance indicators, and on a physiological index of mental effort (heart rate). Participants drove a route in a driving simulator and had to respond to VMS messages under three conditions: no-distraction, visuospatial distraction (attending phone calls with questions inducing visuospatial processing), and conceptual distraction (attending phone calls with questions requiring semantic memory). Results showed more errors responding to VMS messages in the visuospatial distraction condition. In addition, both types of questions increased the intraindividual variability of response distances and the heart rate, as compared to the no-distraction condition. These results provide new evidence that talking on a hands-free phone entails costs in the processing of traffic information (in particular, text messages displayed on VMS) and it increases the driver's cognitive effort. Interestingly, the cognitive distraction had no effect on the driver's control of the vehicle speed or lateral position. Therefore, the effects of potential risk factors can critically vary among the different driving subtasks due to modulatory factors, such as the level of attentional task demands (relatively high in the processing of messages on VMS, but relatively low in controlling the speed and lateral position of the vehicle in quiet traffic conditions). In consequence, the current paper provides new evidence to discuss hands-free phone policies and highlights the importance of designing technological countermeasures to prevent drivers missing critical information displayed on VMS.

Visual Attention, Orthographic Word Recognition, and Executive Functioning in Children With ADHD, Dyslexia, or ADHD + Dyslexia.

Objective: The current study examined the differences in visual selective attention, orthographic word recognition, and executive functioning. Method: One hundred and forty Ecuadorian children in third and fifth grades of elementary school (8-10 years old) participated in the study-35 with only dyslexia (DD), 35 with the combined type of attention deficit and hyperactivity disorder (ADHD-C), 35 with disorders (DD + ADHD-C), and 35 typical development children (TD). Results: The Ecuadorian children with DD and/or ADHD-C in this age range usually have difficulties in visual selective attention, and also in orthographic word recognition. The executive functioning results showed that such functioning was worse in the ADHD-C groups (with or without DD), but not in the DD group, supporting the dissociation between DD and ADHD-C in executive functioning in this population. Conclusion: The DD + ADHD-C comorbidity produces worse deficits compared to DD, but not compared to ADHD-C, supporting the idea that there are common factors in DD and ADHD-C.

Better read it to me: Benefits of audio versions of variable message signs in drivers with dyslexia.

Adults with dyslexia may find difficulties in reading the messages on variable message signs (VMS) while driving. These signs are an essential part of the traffic communication systems, aimed at informing road users of special circumstances, such as congestion, traffic diversion, or unexpected events. A driving simulation experiment was conducted to test if complementary audio versions of the VMS would be helpful for drivers with dyslexia. Twenty adults with dyslexia and 20 matched controls participated. They were asked to classify the messages displayed on VMS posted along a simulated route, which was completed twice: one with text VMS (visual condition), and another one with text VMS plus complementary audio messages (audio + visual condition). The results showed that in the ordinary, visual condition, the participants with dyslexia needed to be closer to the VMS than controls to correctly classify the message, but, crucially, these group differences vanished when the driver received an audio version of the message (audio + visual condition). Moreover, the availability of audio versions had positive effects for all participants, as shown by higher accuracy in the message classification task, as well as better driving performance. Therefore, technologies aimed at providing audio versions of VMS can help drivers with dyslexia. A mobile application, READit VMS, which is able to provide real-time complementary audio versions of VMS, is presented as an example.

Early Signs of Emotional Recognition Deficits in Adolescent High-Binge Drinkers.

Background: Emotional dysregulation, measured with face recognition tasks, is prevalent in alcohol use disorders (AUD), constituting a risk factor for alcohol use and relapse. It is not clear however whether emotional dysregulation is a by-product of alcohol consumption, or if it can act as a predisposing factor for AUD. Objective: Our aim was to examine early signs of emotional dysregulation in adolescent drinkers. Method: Twenty-four high-school students and 24 university students completed two tasks. On the first one, participants had to gradually increment the emotional content of different faces until they could perceive an emotional expression (emotion perception threshold task). We also examined the propensity to perceive fearful expressions in an emotion identification task. Participants were semantically primed with emotion words (i.e., "fear"), and they then had to indicate whether a neutral-fearful facial composite matched the prime. Results: Using repeated-measures ANOVAS, in the emotion perception threshold task, "happy" faces were the easiest to detect and "sad" ones the hardest. For high school students there was a differential response pattern depending on binge scores, such that High-binge drinkers found it easier to detect a sad face but harder to detect a happy one compared to Low-binge drinkers. In the facial emotion identification task, Low-binge drinkers observed more fearful expressions compared to High-binge drinkers. Conclusions: Differences in emotional processing in young adolescents depending on drinking habits point towards the relevance of emotional dysregulation as an early sign of AUD. These findings could help develop novel diagnostic and treatment tools for young populations.

Difficulties of Drivers With Dyslexia When Reading Traffic Signs: Analysis of Reading, Eye Gazes, and Driving Performance.

A group of adult individuals with dyslexia and a matched group of normally reading individuals participated in a driving simulation experiment. Participants were asked to read the word presented on every direction traffic sign encountered along a route, as far as possible from the sign, maintaining driving performance. Word frequency and word length were manipulated as within-subject factors. We analyzed (a) reading accuracy, (b) how far the sign was when the participant started to give the response, (c) where the participant looked during the time leading up to the response, and (d) the variability of the vehicle's speed during that time and during driving on similar segments of the route that did not present the traffic signs. Individuals with dyslexia showed lower levels of performance in the reading task, the roles of word frequency and word length were more influential for them, and there was larger variability of the vehicle's speed during the time they were attempting to read the traffic sign, which did not occur during their driving on similar segments that did not present the targeted traffic signs. Therefore, the specific needs of individuals with dyslexia on the road should be considered in plans aimed at increasing traffic safety and fluidity.

Increasing the default interletter spacing of words can help drivers to read traffic signs at longer distances.

Would an increase in the default interletter spacing improve the legibility of words in traffic signs? Previous evidence on traffic sign design and recent studies on the cognitive processes involved in visual word recognition have provided conflicting results. The present work examined whether an increase in the default interletter spacing would improve the search of a word in direction traffic signs. To achieve this objective, twenty-two drivers participated in a driving simulation experiment. They followed a highway route and indicated whether a target place name was present among a set of distractors shown on direction traffic signs along the route. We compared the default interletter spacing of the Spanish "CC Rige" font (which is based on the internationally-used Transport font) and a 2.5-times expanded interletter spacing. The results revealed that the drivers were able to give a correct response at a distance to the traffic sign that was on average longer in the expanded than in the default spacing condition. This advantage in the legibility distance was observed in the absence of significant differences in reading accuracy, gaze behavior, or driving performance measures. Therefore, the evidence provided supports that drivers can benefit from a slight increase in interletter spacing relative to the standard spacing. Some of the design factors influencing this effect are discussed.

Legibility of Text and Pictograms in Variable Message Signs: Can Single-Word Messages Outperform Pictograms?

OBJECTIVE: The current research shows the advantage of single-word messages in the particular case of variable message signs (VMSs) with a high aspect ratio. BACKGROUND: Early studies on traffic sign design proposed that pictorial information would advantage equivalent text messages in static signs. METHOD: We used a driving simulator to present individually 36 VMSs, showing six words (e.g., "congestion") and six danger signs (e.g., congestion traffic sign). In Experiment 1, 18 drivers read aloud the text or orally identified the pictograms as soon as they could correctly do it. In Experiment 2, a different sample of 18 drivers gave a motor response, according to the meaning of the message. We analyzed the legibility distance and accuracy, driving performance (speed variability), and glance behavior. RESULTS: Our results show that single-word messages were associated with better performance (farther reading distances) and required less visual demands (fewer glances and less glancing times) than pictograms. CONCLUSION: As typical configurations of VMSs usually have a high aspect ratio, and thus allow large character heights, single-word messages can outperform the legibility of pictograms. However, the final advantage of text or pictorial messages would depend on several factors, such as the driver's knowledge of the language and the pictogram set, the use of single or multiple words, the particular design and size of critical details in letters and pictograms, environmental factors, and driver age. APPLICATION: Potential applications include the design of VMSs and other devices aimed at displaying text and/or pictograms with a high aspect ratio.

Can colours be used to segment words when reading?

Rayner, Fischer, and Pollatsek (1998, Vision Research) demonstrated that reading unspaced text in Indo-European languages produces a substantial reading cost in word identification (as deduced from an increased word-frequency effect on target words embedded in the unspaced vs. spaced sentences) and in eye movement guidance (as deduced from landing sites closer to the beginning of the words in unspaced sentences). However, the addition of spaces between words comes with a cost: nearby words may fall outside high-acuity central vision, thus reducing the potential benefits of parafoveal processing. In the present experiment, we introduced a salient visual cue intended to facilitate the process of word segmentation without compromising visual acuity: each alternating word was printed in a different colour (i.e., ). Results only revealed a small reading cost of unspaced alternating colour sentences relative to the spaced sentences. Thus, present data are a demonstration that colour can be useful to segment words for readers of spaced orthographies.

Is there a genuine advantage to the upper part of words during lexical access? Evidence from the Stroop task.

A number of recent visual-word recognition and reading experiments have concluded that the upper part of words is more important for lexical access than is the lower part, which conforms with Huey's (1908) observation. Here, we examined whether this phenomenon may simply be due to the fact that words in Indo-European languages tend to have a higher number of confusable letters in the lower than in the upper part. We manipulated the letter ambiguity of the upper and lower parts of words in two experiments in which we asked participants to report the presentation color of the upper and lower parts of color words and noncolor words, and in a baseline condition, of strings of &s (Stroop task). In Experiment 1, the lower part of noncolor words was more ambiguous than the upper part (upward-unbalanced words), whereas in Experiment 2, the ambiguities of the two parts of the noncolor words were similar (balanced words). For the upward-unbalanced noncolor words, the magnitude of lexical interference (relative to the baseline condition) was greater for the upper than for the lower part. Critically, the differences vanished when this factor was controlled (i.e., balanced words; Exp. 2). Thus, the apparent bias in favor of the upper part of words can be parsimoniously described as an idiosyncratic feature of the words' component letters.

Wertheim's hypothesis on 'highway hypnosis': empirical evidence from a study on motorway and conventional road driving.

This paper aims to study the phenomenon known as 'highway hypnosis' or 'driving without attention mode', which has been defined as a state showing sleepiness signs and attention slip resulting from driving a motor vehicle for a long period in a highly predictable environment with low event occurrence, this being the case with motorways and very familiar roads [Highway hypnosis: a theoretical analysis. In: Gale, A.G., Brown, I.D., Haslegrave, C.M., Moorhead, I., Taylor, S. (Eds.), Vision in Vehicles-III. Elsevier, North-Holland, pp. 467-472]. According to Wertheim's hypothesis on 'highway hypnosis', long-term driving on motorways and conventional roads, e.g. main roads, secondary roads--implies differences in the predictability of the movement pattern of the visual stimulation, in the eye musculature activity and in the type of feedback used in visual information processing (mostly extra-retinal on motorways and retinal and extra-retinal on conventional roads). All this ultimately leads to alertness differences between both road types. Our research is intended to provide empirical evidence from the hypothesis, based on the data recorded during the actual driving experience of a group of subjects on a motorway and a conventional road. We studied whether or not significant alertness differences were found-measured by EEG data relative to time periods of on-target eye-tracking performance--between motorway and conventional road driving. Our results partially support the hypothesis, as drowsiness proved to be higher on motorways than on conventional roads during the final driving period but not during the starting stage, when the opposite trend was noticed. This result could be explained by the fact that during the first driving periods the effects of the stimulus movement predictability had not yet become apparent, since they tend to show after a long drive.

Driving on the motorway: the effect of alternating speed on driver's activation level and mental effort.

When most of the driving tasks are performed automatically, a driver's level of alertness may decline, as has been pointed out in the study of the phenomenon called 'highway hypnosis'. One possible countermeasure is to periodically vary the speed (Wertheim 1978), but the authors have not found any studies that directly assess the effectiveness of this countermeasure. The objective of our study has been to provide empirical evidence regarding the effects of this strategy on the level of driver activation on a motorway route in real traffic. In the present study activation level as indexed by a relative measure based on slow EEG activity tended to be significantly higher when speed was modified periodically than when it remained constant. In addition, this index tended to be progressively higher when the speed was constant during the first part of the route, while the same thing did not occur when the speed was modified periodically. Finally, no significant differences between the constant and varying speed conditions were obtained with respect to any of the cardiovascular indices related to the effort put into driving and the stress experienced in the situation.

Efecto de una intervención educativa sobre la adherencia al tratamiento antibiótico en población infantil en atención primaria / The effect of an educative intervention on adherence to antibiotic treatment in infants in primary health care

Introducción. En 1997 se realizó un estudio sobre adherencia al tratamiento antibiótico infantil en 6 centros de salud, hallándose que era muy baja. Se decidió realizar en dos de los centros (adherencia 21 por ciento) una intervención educativa basada en el Modelo de Creencias en Salud con el objetivo de valorar si con ello mejoraba la adherencia. Material y métodos. La población estaba constituida por los responsables de niños de 0 a 10 años con un proceso agudo que recibían tratamiento antibiótico por vía oral. El instrumento de medida fue el test de Morisky-Green mediante encuesta telefónica. El estudio fue prospectivo y se estudiaron variables sociodemográficas, el motivo, tipo y duración del tratamiento antibiótico y la adherencia. Resultados. La adherencia global varió de un 21,1 por ciento antes, a un 42,6 por ciento después de la intervención (p = 0,009). En el análisis multivariable resultaron estadísticamente significativas la intervención (OR, 3,17; IC 95 por ciento, 1,53-6,26) y el centro (OR, 3,18; IC 95 por ciento, 1,55-6,50), no existiendo interacción entre ellas. Conclusiones. A pesar de que incluso las intervenciones más efectivas no conllevan mejoras sustanciales en la adherencia y los resultados de los tratamientos, la utilización de un modelo de intervención capaz de provocar un cambio de conducta ha confirmado su eficacia en este caso (AU)