Differences in cognitive process-related skills between taxi and non-taxi drivers between 50 and 70 years old.

This study investigated differences between 50- to 70-yr.-old taxi and non-taxi drivers with respect to cognitive process-related skills. Psychological indicators associated with perceptuomotor, attentional, and spatial memory recall abilities were collected for 173 taxi drivers (7 women, 166 men; M age = 57.5 yr.) and 175 non-taxi drivers (85 women, 90 men; M age = 58.2 yr.). The taxi drivers had shorter reaction times and motor times in response to stimuli in simple stimulus-response tasks. There was an age-related decline in monocular vision detection on both sides, processing speed for fovea stimuli, and higher-level cognition for drivers. Accordingly, the frontal visual information processing speed of the taxi drivers was superior to the non-taxi drivers, but a distinct age-related decline was observed for all drivers.

The response patterns of young bicyclists to a right-turning motorcycle: a simulator study.

This study was designed to assess how bicyclists (30 men, 30 women) responded to right-turning motorised vehicles, which is a risky situation for bicyclists, and employed a scenario in which a motorcycle made a right turn in front of a bicyclist. The factors of speed difference and cut-in time gap were generated to objectively investigate steering control, speed, and the associated collisions in a bicycle simulator. There was no effect for sex, but as expected, for shorter cut-in time gaps, the steering angles were smaller (deflected to the right to avoid the passing motorcycle), the speeds were lower, and the variations in the steering angle and speed were larger. Variations in the steering angle and speed were unexpectedly lower for larger speed differences than for smaller speed differences. Response patterns comprised 5 patterns: early response and quickly depress the brake, last-moment response and slowly depress the brake, late response and quickly depress the brake, very late response and quickly depress the brake, and no response. Larger speed differences and the no-response pattern resulted in two collisions. Individuals with less experience may not have associated speed differences with potential dangers.

Responses in a manual tracking and visual detection task.

To investigate interference between the sustained and occasional attention required in driving, performance of 36 participants engaged in a focal manual tracking task and a peripheral detection task, representing sustained and occasional attention, respectively, was studied. Error ratio, tracking distance, tracking speed, and root mean squared tracking distance error were taken for manual tracking, and response times were measured on the detection task. Analysis indicated that multiple tasks or highly sustained attentional demands preceded lower performance on sustained attention tasks. Performance on occasional attention tasks after multiple tasks may also decrease, but occasional attention performance improved when the participants were engaged concurrently in a task involving higher sustained attention. Furthermore, the association between sustained and occasional attention was strengthened as the number of tasks or the demands of sustained attention increased.

Driver fatigue and highway driving: a simulator study.

Long duration of driving is a significant cause of fatigue-related accidents on motorways or major roadways. The fatigue caused by driving for extended periods acutely impairs driver alertness and performance and can compromise transportation safety. This study quantitatively measured the progression of driver fatigue and identified the conservative safe duration of continuous highway driving. Thirty young male subjects were analyzed during 90 min of laboratory-simulated highway driving. Sleepiness ratings (SSS) and reaction time (RT) tests were used to assess impairment of driver alertness and vigilance. Additionally, various measures of driving performance recorded throughout the experiment were used to measure temporal deterioration of driver performance from alert to fatigued using principal component analysis (PCA). The analytical results revealed that SSS scores, reaction times (RTs) and unstable driving performance significantly increased over time, indicating that excessive driving time is a significant fatigue factor and potential cause of fatigue-related accidents. Moreover, the analytical results indicated that 80 min was the safe limit for monotonous highway driving. Based on the experimental findings of this study, public awareness of the adverse affects of driver fatigue during long-distance driving should be enhanced. This study provides explicit information of fatigue development that can be used to prevent fatigue-related accidents.

Differences in urban and rural accident characteristics and medical service utilization for traffic fatalities in less-motorized societies.

INTRODUCTION: Fatalities from traffic accidents in less-motorized societies are an important global issue. We aimed to characterize the geographic differences of fatalities in such societies to facilitate the development of targeted interventions. METHOD: This study linked police reports, hospital data, and vital registration data from Taiwan with special reference to accident factors in pre-hospital deaths and medical care in hospital deaths. RESULTS: A higher percentage of pre-hospital deaths were observed following rural as compared to urban traffic accidents. The deaths due to rural accidents can be attributed to lower use of restraints (i.e., helmets or seat belts), lower percentage of motorcyclists, and more highway accidents. A higher percentage of victims in rural accidents were transported to distant medical centers rather than to local hospitals. CONCLUSION: Specific interventions, such as intelligent emergency medical systems, campaigns for helmets and seat belt usage, enforcement of helmets and seat belt use, and speed control measures should be targeted to rural areas. IMPACT ON INDUSTRY: Cooperation between the vehicle industry and emergency medical providers in rural traffic accident rescue teams may decrease the numbers of deaths in these regions.

The assessment of stability and reliability of a virtual reality-based intravenous injection simulator.

The aim of this study was to validate the feasibility of a virtual reality-based (without haptic feedback) intravenous injection system as an effective tool for computer-assisted instruction and training. The stability and reliability of the system were assessed. A personal computer, a needle/catheter device, and a data acquisition interface are included in this system. Using Virtual Reality Modeling Language, an interactive virtual environment was developed. Ten participants, ranging from 20 to 28 years of age, were recruited for this study. The self-learning and training procedures encompassed an intravenous catheterization process. The experimental results showed that after a few trials, the change in task time was not obvious in each trial, and the error frequency decreased slightly with more trials. High intraclass correlation coefficients also were obtained for task time and error frequency by analyzing the test-retest reliability. These results indicated that the system was stable and that the system reliability was acceptable.

Rectification of legibility distance in a driving simulator.

Visual differences lead to differences in the legibility distances of traffic signs between driving simulators and real road environments. To ensure that the legibility distance in a simulator is similar to that in the real world, this study proposes a theoretical equation for predicting legibility distance and a simple algorithm for determining the magnifying power of a traffic sign for a display system in a simulator. Experiments of traffic sign recognition using a simulator were conducted under quasi-static and dynamic driving conditions. On-road tests were also carried out under quasi-static and dynamic driving conditions. Thirty healthy and non-disabled volunteers were recruited. The experimental results showed that the proposed theoretical equation for predicting legibility distance and the simple algorithm for determining the magnifying power of traffic signs reduced the difference in legibility distances between the simulator and real road environment under quasi-static and dynamic driving conditions.

Use of virtual reality to improve upper-extremity control in children with cerebral palsy: a single-subject design.

BACKGROUND AND PURPOSE: Virtual reality (VR) creates an exercise environment in which the intensity of practice and positive feedback can be systematically manipulated in various contexts. The purpose of this study was to investigate the training effects of a VR intervention on reaching behaviors in children with cerebral palsy (CP). PARTICIPANTS: Four children with spastic CP were recruited. METHOD: A single-subject design (A-B with follow-up) was used. All children were evaluated with 3 baseline, 4 intervention, and 2 follow-up measures. A 4-week individualized VR training program (2 hours per week) with 2 VR systems was applied to all children. The outcome measures included 4 kinematic parameters (movement time, path length, peak velocity, and number of movement units) for mail-delivery activities in 3 directions (neutral, outward, and inward) and the Fine Motor Domain of the Peabody Developmental Motor Scales-Second Edition (PDMS-2). Visual inspection and the 2-standard-deviation-band method were used to compare the outcome measures. RESULTS: Three children who had normal cognition showed improvements in some aspects of reaching kinematics, and 2 children's change scores on the PDMS-2 reached the minimal detectable change during the intervention. The improvements in kinematics were partially maintained during follow-up. DISCUSSION AND CONCLUSION: A 4-week individualized VR training program appeared to improve the quality of reaching in children with CP, especially in children with normal cognition and good cooperation. The training effects were retained in some children after the intervention.

Using data linkage to generate 30-day crash-fatality adjustment factors for Taiwan.

Different countries have their own police reporting time standards for counting the number of fatalities in reported crashes. A rapid estimation method (such as adjustment factor) for the comparison is important. The data-linkage technique was used to combine police-reported crash data and vital registration data, in order to generate 30-day fatality adjustment factors for various reporting time standards, which could also shed light on the fatal injury trend over time. The major findings were as follows. Firstly, a conservative 30-day fatality adjustment factor for the first day (or 24 h) would be 1.54 (or 1.35) in an area with a large motorcycle population, like Taiwan. This produced 20-40% higher 30-day fatalities than UK Transport Research Laboratory predicted, and 15-25% higher fatalities than those in Europe/Japan. Secondly, after excluding motorcycle impacts, the Taiwanese factors suggested 8-14% higher fatalities within 30 days than those in Europe/Japan. Third, motorcycle fatalities influenced the overall 30-day fatality trend within 3 days. In the future, both the police under-reporting problem and the motorcycle/overall fatal injury pattern within 3 days after crashing in developing countries like Taiwan merit further investigation.

A virtual reality-based system for hand function analysis.

The goal of this study was to demonstrate the usability and usefulness of virtual reality technology in assessing hand functions. Ten healthy, non-disabled right-handed adult volunteers were recruited. Each volunteer used a dataglove to insert three-dimensional virtual representations of a cylinder and a prism into the target holes. To verify the reliability of the tests, each subject was retested twice. The performance testing assessed the visual-motor coordination a person needs to achieve a task accurately and within a set time. For each trial, the root mean square (RMS) value of the hand movement trajectory was projected onto the X, Y, and Z axes. This projection enabled us to measure the extent of the genuine, summative displacement of the manipulating hand. The reproducibility of the virtual reality assessment was analyzed using the intraclass correlation (ICC) approach. The total ICC values of 10 subjects demonstrated a high task completion time and RMS on the X and Z axes for the transferring of the prism. However, the values were low for the transferring of the cylinder. Because the individual coefficients of variations (CVs) varied widely in the moving of both the cylinder and the prism, the total (CVs) showed a high reading for the task completion time. Although rehabilitation clinics routinely carry out peg-moving exercises for disabled patients, our model provides a valuable quantitative real time and off-line measure of whole hand functions.

Evaluation of computer-assisted multimedia instruction in intravenous injection.

The purpose of this study was to develop a computer-assisted multimedia training course for intravenous injection and evaluate its effect on the knowledge and self-perceived performance of intravenous injection for novice nurses. Eighty-one novice nurses randomly assigned to the experimental group and control group participated a designed training procedure and took pretest and posttests. The test results were analyzed using statistical methods. From the study it could be concluded that the training course had a significant effect on the intravenous injection's knowledge. Besides, a high rate of satisfaction for the multimedia program showed the self-developed program was successful.

The use of a quasi-naturalistic riding method to investigate bicyclists' behaviors when motorists pass.

The present study aimed to investigate how motorized vehicle-related factors, road-related factors, and bicyclist-related factors influenced motorists' decisions about initial passing distances and bicyclists' behaviors after the motorists started to pass. A quasi-naturalistic riding method was used for thirty-four participating bicyclists riding an instrumented bicycle in real traffic. The study included 1380 incidents of left-side passing by motorists and revealed that the factors studied influenced both the motorists' initial passing distance and the bicyclists' position (lateral distance from the passing motorists), wheel angle, and speed control behaviors while the motorists passed. Some factors were related to the motorized vehicles; for example, the initial passing distance and the mean lateral distances were smaller when motorcycles passed than when cars and small trucks passed. The bicyclists demonstrated weaker lateral stability when they were passed by buses. In addition, a longer passing time caused the bicyclists to demonstrate cautious but less stable riding behaviors. For road-related factors, a clear and longitudinal solid line separation helped to maintain a greater lateral distance between motorists and bicyclists and assist the bicyclists in riding out of the motorists' path, maintaining a low speed, and remaining stable. Moreover, when bicyclists avoided road surface hazards, they reduced the initial passing distances that the motorists had chosen. Considering bicyclist-related factors, the motorists selected a greater initial passing distance for female bicyclists. There were also gender differences related to the bicyclists' lateral control, and differences in road use experience may explain this gender difference. Furthermore, the bicyclists' wheel angle, speed, and speed variation affected the motorists' initial passing distance. The present study demonstrated that the quasi-naturalistic riding method is capable of collecting rich data concerning bicyclists' behaviors, which could potentially be utilized in various types of studies. However, this method requires a large sample and considerable time and effort for data processing.

Risk factors for child and adolescent occupants, bicyclists, and pedestrians in motorized vehicle collisions.

OBJECTIVE: The aim was to use similar population data to examine the relative risk of collision injury among children of different ages and adolescents involved in various collision types and to elucidate the possible risk factors related to road collisions involving children and adolescents in a large, 2-wheeled vehicle environment. METHODS: We used data from a society with a large population of motorcyclists to examine the relative risk of injury among children and adolescents aged 0 to 6, 7 to 9, 10 to 12, 13 to 15, and 16 to 17 years old who were involved in single motorized vehicle, multiple motorized vehicle, bicycle-to-vehicle, and pedestrian-to-vehicle collisions. Police reports for 73,232 collision injuries between the years 2003 and 2009 were analyzed using multicategory logit models of the 4 collision types. RESULTS: Young (particularly 0- to 6-year-old) child bicyclists and pedestrians were the most sensitive to several factors. In collisions, young child bicyclists making U-turns or being struck by forward-moving or right-turning motorized vehicles, on local roads, during the daytime, or at locations without traffic signals had the greatest risk of injury. Similarly, young child pedestrians running, during the daytime, or at locations without traffic signals had a significant risk of injury. After controlling for other factors, we found that 4-wheeled motorized vehicles, not motorcycles, presented a higher risk for injury to child passengers, bicyclists, and pedestrians. CONCLUSIONS: The risk of collision injury varied for the different groups of children in the 4 collision types. To reduce the risk of injury for young children, we recommend the development of road-crossing training tools for parents. In addition, the behaviors of children should be taken into consideration when developing in-vehicle assistance systems.

Integrated model of simulated occupant injury risk and real medical costs.

INTRODUCTION: The purpose of this study was to develop an integrated methodology that links occupant injury risk functions, estimated in the laboratory, with real world medical treatment costs by using the abbreviated injury score (AIS). Using our model, the expected medical treatment costs for crash injuries to various body regions and of different severities can be investigated. METHODS: First, the simulation results are compared with NHTSA crash data. We used a modified kinematics simulation model that incorporates an F=E(b) function as a supplement to the previous Steffan's model to obtain a more accurate acceleration history a(t). Second, head injury criteria HIC(36) can be calculated from a(t), and we use the injury probability P as a function of HIC(36,) as proposed by Kuppa, to obtain the injury risk function for various AIS values. Third, medical treatment cost models for various AIS values can be calculated by using a regression cost model with real world data. Finally, the injury risk function and medical treatment cost models are linked through AIS values. We establish an integrated methodology and predict medical costs and car safety data using real world police reports, medical treatment costs, and laboratory simulation results. RESULTS: Using head injuries in frontal crashes as an example, we focus on simulation parameters for different vehicle models, with and without airbags. We specifically examine impact closing speed, Delta-V, and impact directions. CONCLUSION: Simulation results can be used to supplement insufficient real crash data, in particular DeltaV, and injury risk results from police crash reports. IMPACT ON INDUSTRY: The proposed integrated methodology may provide the vehicle industry with a new safety assessment method. Real crash data coupling provides consumers with more realistic and applicable information.

Evidence for the selective attention mechanism and dual-task interference.

In order to explore the selective attention mechanism and the dual-task information-processing model, two experiments were carried out involving a visual search task and a visual detection task. The results showed that the early period of attention selection is controlled in a bottom-up manner. With respect to the dual-task information-processing model, the results showed that the central information-processing model would include a sequence model for tasks that use the same perception resource, causing a bottleneck in information processing. Our study suggests that a simple and prominent signal could be used to attract drivers' attention prior to the emergent events. Moreover, any human-machine interface design in driving-associated systems should consider this information-processing bottleneck. With respect to signal type, targeted and easy to categorize were two useful elements to consider.

Psychological benefits of virtual reality for patients in rehabilitation therapy.

CONTEXT: Whether virtual rehabilitation is beneficial has not been determined. OBJECTIVE: To investigate the psychological benefits of virtual reality in rehabilitation. DESIGN: An experimental group underwent therapy with a virtual-reality-based exercise bike, and a control group underwent the therapy without virtual-reality equipment. SETTING: Hospital laboratory. PATIENTS: 30 patients suffering from spinal-cord injury. INTERVENTION: A designed rehabilitation therapy. MAIN OUTCOME MEASURES: Endurance, Borg's rating-of-perceived-exertion scale, the Activation-Deactivation Adjective Check List (AD-ACL), and the Simulator Sickness Questionnaire. RESULTS: The differences between the experimental and control groups were significant for AD-ACL calmness and tension. CONCLUSION: A virtual-reality-based rehabilitation program can ease patients' tension and induce calm.

Survival hazards of road environment factors between motor-vehicles and motorcycles.

Motorcycles are frequently used in middle- and low-income societies. They are often involved in crashes, and account for a noticeable percentage of fatalities secondary to crashes. Comparing motor-vehicle occupants and motorcycle riders, the present study examined the survival hazard of crash injuries with respect to road environmental factors (i.e., area, road type, and location). We investigated the effects of such factors on survival and survival time after crashes via a binary logistic regression analysis and a Cox proportional hazard regression analysis, respectively. Results indicated that, for both motor-vehicle occupants and motorcycle riders, the fatal prevalence, occurrence likelihood, and risk based on time were decreased in urban areas and elevated on highways. The three indexes were also higher for motor-vehicle occupants on non-straight or non-level roadway sections. The prevalence of death on local roads and at intersections was relatively higher for motorcycle riders compared to motor-vehicle occupants. Speed may contribute to the survival hazard with respect to road environment factors. Speed management initiatives account for hazardous roadway, curve alignment re-examination, and increased traffic enforcement density are suggested. Collaboration among the roadway authorities, vehicle industry, and medical systems for a timely rescue is also advised. In addition, the attention to crashes at intersections and on local roads is a promising intervention for motorcycle riders.

Mortality burden from motor vehicle accidents in Taiwan.

OBJECTIVE: To examine the risk factors contributing to the mortality burden due to road traffic accidents (RTA) in Taiwan. DESIGN: We compared RTA years of life lost (YLL) rates of Taiwan with those of the surrounding region. We also investigated the risk factors described by the police in a Linked Database combined from police-reported accident data and vital registration data. SAMPLE: RTA deaths (3,234 males/1,160 females) in vital registration data and the deaths (2,918 males/1,063 females) in the Linked Database were used. MEASUREMENT: YLL and YLL rate. RESULTS: (1) YLL rates for 15-29 year olds were the highest for Taiwan and the surrounding region. (2) The YLL rate was remarkably high in the first 2 years of the legal motorcycle licensing age for males riding motorcycles. (3) The YLL rates were usually higher during the day, but were higher for young males at night. (4) Overall, the YLL rates were higher when multiple vehicles were involved and for motorcycles with large engines; however, the rate was higher for motorcycles with small engines for the older female group. CONCLUSIONS: The burden due to premature mortality in RTA showed gender disparities and varied by age among personal, environment, and structure factors.

Driving performance assessment: effects of traffic accident location and alarm content.

According to accident statistics for Taiwan, the two most common traffic accident locations in urban areas are roadway segments and intersections. On roadway segments, most collisions are due to drivers not noticing the status of leading vehicle. At intersections, most collisions are due to the other driver failing to obey traffic signs. Using a driving simulator equipped with a collision warning system, this study investigated driving performance at different accident locations and between different alarm contents, and identified the relationship between crash occurrences and driving performance. Thirty participants, aged 20-29 years, were recruited in this study. Driving performance measures were perception-reaction time, movement-reaction time, speed and a crash. Experimental results indicated that due to different demands for processing information under different traffic conditions, driving performance differed at the two traffic accident locations. On a roadway segment, perception-reaction time for a beep was shorter than the time for a speech message. Nevertheless, at an intersection, a speech message was a great help to drivers and, thus, perception-reaction time was effectively reduced. In addition, logistic regression analysis indicates that perception-movement time had the greatest influence on crash occurrence.

The use of virtual reality computer simulation in learning Port-A cath injection.

Cost-benefit management trends in Taiwan healthcare settings have led nurses to perform more invasive skills, such as Port-A cath administration of medications. Accordingly, nurses must be well-prepared prior to teaching by the mentor and supervision method. The purpose of the current study was to develop a computer-assisted protocol using virtual reality (VR) in performing Port-A cath as a training program for novice nurses. A pre-tested and post-tested control group experimental design was used in this study. Seventy-seven novice nurses were invited from one large medical center hospital in North Taiwan. Thirty-seven and forty nurses were randomly assigned to experimental and control groups. First, we designed a 40 minute port-A cath injection VR simulation. Then, the experimental group practiced this simulation two times over 3 weeks. The control group attended the traditional class. The post-test 1 was right after completion of the simulation practice. The post-test 2 was after the second simulation practice in 3 weeks. The results showed that most novice nurses lacked Port-A cath experience both in the classroom and during the period of their practice training. The knowledge score regarding the Port-A cath technique was significantly higher in the nurses that participated in the simulation training than in the control group. The novice nurses were most satisfied with the reduction in their fear of performing the Port-A cath technique and their enhanced clinical skills. VR simulation significantly reduced error rates and increased correct equipment selection, showing that nurses who participated in the simulation may be better prepared for inserting Port-A cath.