Stakeholders' perceptions of programme sustainability: findings from a community-based fall prevention programme.

OBJECTIVES: Sustainability of health promotion and injury prevention programmes is a goal of practitioners and an increasingly common requirement of funding bodies. However, less is known about the views held by individual stakeholders involved in such programmes regarding their perceptions of facilitators and barriers to achieving sustainability. This paper aims to share the perceptions of programme sustainability held by key stakeholders involved in a community-based fall prevention programme in three Ontario demonstration communities in Canada. STUDY DESIGN: A qualitative case study research design. METHOD: A holistic multiple case study method was employed. In total, 45 stakeholders involved in various aspects of the project participated from three demonstration sites. Stakeholders' perceptions were gathered on the individual actions they took in an effort to promote sustainability, and the barriers they perceived as preventing or limiting sustainability. RESULTS: Stakeholders reported taking a number of actions to aid programme sustainability, with some actions deemed to be more functional in aiding sustainability than others. Common actions reported by stakeholders included partnership formation, networking and increasing community capacity. Stakeholders also perceived a number of barriers to achieving sustainability, including insufficient human and financial resources, lack of co-ordination and buy-in, heavy reliance on volunteers and an inability to mobilize physicians. Stakeholders' perceptions of sustainability were used to develop recommendations for sustainability for both communities and funding bodies. CONCLUSION: The views and experiences shared by the stakeholders in this project can serve as lessons learnt to aid in the sustainability of other health promotion and injury prevention programmes in the future.

Perceived risks to independent living: the views of older, community-dwelling adults.

The purpose of the present study was to gather the perceptions of older, community-dwelling adults about factors they considered essential for them to remain living within the community. In-depth interviews were conducted with 103 men and women over the age of 65 years who were living in their own home or apartment, within an urban center. Factors such as finances, health, family support, a sense of identity, and a feeling of independence were perceived by older adults to contribute to their ability to remain living in the community. Importantly, older adults viewed threats to this continued independent living as both (a) factors connected to losses and maintenance of capability, but also (b) as impediments to further growth of their personal well-being.

Predicting future long-term-care needs in a community.

Under current financial restraints, planning for the future long-term-care needs of older Canadians is coming under increasing scrutiny. Even though health care is moving to a community-based system (i.e., deinstitutionalization), this is not necessarily the most cost-effective strategy for severely disabled older adults. Three models are used in the present paper to estimate the number of severely disabled (two or more ADL disabilities abilities) older adults expected in the next 5 to 10 years in a small community in Northern Ontario. While mortality and disability rates are the main predictors, it was also necessary to consider additional factors particular to the community in question. It is suggested that for long-term-care planning to be effective and economically sound, similar strategies will be needed throughout Canada.

The attention demands of movements.

The probe technique has been employed extensively to measure the attention demands of movement control. Inherent in any RT paradigm is the potential confounding effect of anticipation. Experiment 1 studied this problem by varying probe frequency (or, conversely, catch-trial frequency) for three independent groups of subjects performing the same movement. Probe frequencies of one-third and two-thirds produced V-shaped curves of probe RT plotted against probe position within the movement, while a three-thirds condition was described by a negatively sloped linear function. Because of the different shaped curves it was recommended that a two-thirds frequency be adopted by all researchers in this area. Experiments 2 and 3 looked at the effects of movement length and movement time on the attention demands of movement. Shorter (11-cm) movements were more attention demanding in the middle of the movement than the longer (50-cm) movements, but movement time had no effect.

Anticipated choices among self-, informal, and formal care by older canadians.

The present research investigated factors related to the health care choices seniors anticipated making in response to hypothetical illness symptoms (e.g. rectal bleeding). After collecting demographic data, 80 seniors were presented various illness symptoms. Directly following each symptom they were asked whether they anticipated using self-, informal, or formal care to deal with the potential problem. In general, seniors with higher perceived health status anticipated using self-care. Being male and having a lower perceived health status was predictive of choosing informal care, whereas being female was predictive of anticipating using formal care. When individual symptoms were analyzed, additional predictors were identified. Judged seriousness of a symptom, experience with a symptom, and social network status were related to different anticipated health care choices for some, but not all, symptoms. Perhaps the most striking finding was the difference between males and females. Since health status between males and females was not significantly different, this difference in anticipated choice of care seemed to be linked to personal preference rather than health status per se.

Perceived mood and exercise behaviors of cardiac rehabilitation program referrals.

The objective of this study was to examine how 65 clients referred to a cardiac rehabilitation program perceived their current mood, severity of illness, exercise behaviors, and hence, quality of life. The theoretical perspective for this study was derived from King's (1981) theory of goal attainment. The individual's perceptions are a fundamental element of goal attainment. A telephone survey was developed to gather data on demographics, exercise intensity and participation, severity of illness at time of hospital discharge and time of interview as well as responses to a mood adjective check list (Lubin, 1981). Analysis indicated that exercise was a valued behavior for the majority of subjects. All subjects perceived that the severity of their heart condition had changed from more to less severe. Furthermore, those who exercised felt healthy and merry, while those who did not exercise felt miserable.

An examination of self-pacing procedures in human time estimation.

The main purpose of the present research was to investigate the role of self-pacing trial procedures in time estimation. Auditory durations of 1, 4, and 8 sec. were estimated by 12 subjects under the method of reproduction. Different features of performance were investigated using several dependent variables. When left to themselves, subjects chose a relatively short intertrial interval, the duration of which did not differ across the three criterion durations. This finding seemed best explained as an attempt by the subjects to minimize boredom and maximize alertness. Also, subjects waited for a short time before reproducing the criterion duration, and again this period did not differ across the three criterion durations. A significant relationship was found between the duration of the self-paced intertrial interval and self-paced retention interval for all criterion durations. It appeared that subjects were attempting to maximize their time-estimation performance by either minimizing the retention interval or by developing a trial-interval rhythm. Finally, subjects were more variable in their estimates as the criterion duration increased.

Weber's law for the reproduction of temporal information.

The main purpose of this research was to determine the numeric values of Weber's fraction when subjects were required to estimate temporal durations of 1, 3, 5, 7, and 9 sec. under the method of reproduction. The results provided evidence in support of a constant coefficient of proximity for time estimation of approximately 14.5%.

Effect of interpolated temporal activity on temporal short-term memory.

The purpose of this research was to determine the retroactive interference effects of a single interpolated task (i.e., one temporal duration) on the retention of a criterion duration. This research is of interest because the mnemonic structure of temporal information of different durations is uncertain. Previous research has indicated that there might be a difference in structure for durations of 1 and 4 sec., although the results are inconsistent. Thus, two criterion durations of 1 and 4 sec. and five interpolated durations (i.e., 60%, 80%, 100%, 120%, and 140% of the duration of the criterion) were utilized under the method of reproduction. In addition, subjects were instructed to use either a counting strategy or none (referred to as conscious time estimation) to facilitate the retention of the temporal information. Recall was less variable when using a counting strategy than not and when estimating 1 sec. than 4 sec. However, there was no effect of interpolated activity when comparing performance across different interpolated conditions (no interpolated activity). Apparently, one interpolated duration is not sufficient to produce structural interference with a single criterion duration.

Relationship between psychomotor functioning and health status among elderly persons?

45 older adults were tested twice per year for three years in a 9 (psychomotor) by 30 (health status, well-being) matrix of variables. That only 84 significant correlations were found suggests no relationship between psychomotor performance and health status.

Counting strategies and assimilation effects in short-term retention of temporal information.

The purpose of the present research was to examine proactive interference in general and assimilation effects (i.e., shifts in constant error caused by prior responses) in particular, when subjects used covert counting to aid their retention of the temporal information. Visually presented durations of 1, 4, and 8 sec. were estimated by 18 subjects under the method of reproduction. Three retention intervals (i.e., immediate, 15, and 30 sec.) and three intertrial intervals (i.e., immediate, 15, and 30 sec.) were employed. Analysis of constant error provided no indication that proactive interference was operating in the retention of temporal information as there was no increase in error across trials, no increase in error for longer retention intervals, and no interaction between trials and retention intervals. Also, there was no change in variable error as the retention intervals lengthened for any temporal duration except for the 4-sec. criterion. Finally, the rate of counting (counting units/sec.) was different across the durations to be remembered. The major conclusion of the present research was that counting greatly facilitates retention of temporal information as compared to retention without such a time-aiding strategy.

Fitts' reciprocal tapping task, a measure of motor capacity?

Employing Fitts' reciprocal tapping task, the capacity of the motor system in bits processed/second was assessed across different ages. In Exp. I a comparison was made among Grades 1, 5, 9, and university females. Motor capacity and average movement time/tap were significantly lower for Grade 1 girls than the other three grades. In addition, within-subject variability and percentage error rate decreased with increasing grade level. These findings were discussed in comparison to other studies looking at motor capacity changes across ages. Exp. II was designed to study the changes in motor capacity throughout 25 days of practice by two 5-yr.-old children. Two different methods were used to calculate motor capacity. One method (Kay, 1962) which assessed motor capacity separately for each tapping condition led to the conclusion that capacity increased with practice. A second method (Fitts & Peterson, 1964) treating all tapping conditions together in a regression equation and measuring capacity as the reciprocal of the slope (1/b) showed capacity to decrease with practice for one subject and oscillate with practice for the other subject. The general conclusion drawn from the two experiments was that motor capacity, as assessed by Fitts' tapping task, is not an extremely useful measure. Consideration of movement time is usually just as informative.

Postural implications of obtaining line-of-sight for seated operators of underground mining load-haul-dump vehicles.

Operators of load-haul-dump (LHD) vehicles use awkward postures that may be held statically and at extreme ranges of motion for long shift periods to spot hazards in underground mining. This study examined postural variables associated with three amounts of seat rotation intended to maximize line-of-sight during forward driving. Three different models, representing the 1st, 50th and 99th percentile male for height and weight, were positioned with appropriate hand and foot constraints in the virtual LHD cab modelled in Classic JACK v4.0. A total of 15 virtual movement strategies were developed to model the postural behaviour of typical workers and each virtual subject was tested, first with the seat in a neutral 0 degrees position and then with it rotated counter-clockwise to 20 degrees and 45 degrees . Results revealed that reductions in trunk rotation, trunk lateral bend and neck rotation were associated with the seat rotation intervention. The general relationship observed was that as seat rotation increased, view of critical visual attention locations and visible line-of-sight area increased while postural load variables decreased. For the most part, 20 degres of seat rotation was beneficial but 45 dgrees produced significantly greater changes to postural load and visible visual attention locations.

National alpine ski team career and education survey.

Past and current National Alpine Ski Team (NAST) members were surveyed via a mailed questionnaire regarding their educational progress and attainment, career path, parental education and income, as well as their perceptions as to the effect of skiing on dimensions of personal development. The questionnaire was completed by 86% of the total possible (64 of 74) respondents. Although it was found that educational progress was retarded by involvement in elite level skiing, this conclusion could only be drawn if it was assumed that in skiers between 13 and 21 years of age, each one year change in chronological age is 'normally' accompanied by similar academic progress. It was found that upon retirement from NAST 78% of the skiers continued their formal education, with a high level of success. These results were compared to other studies concerning educational attainment.

Relationships among self-reported physical activity, aerobic fitness and reaction time.

Three age groups were studied: 10-11, 17-18, and 23-24 year-olds. Significant correlations were found between aerobic fitness and physical activity level and between aerobic fitness and reaction time, in the oldest group only.

The effects of different knowledge of results spacing and summarizing techniques on the acquisition of a ballistic movement.

The present study crossed three knowledge of results summarizing techniques (single-trial KR, summary KR, and average KR) with two spacing conditions (KR on every fifth trial-20%- and KR on every trial-100%). Participants (n = 10 per group) performed 80 acquisition trials of a ballistic movement task involving both a temporal and spatial goal, followed by 30 immediate (10 min) and 30 delayed (2 days) no-KR transfer trials. For the spatial goal, performance was less accurate (absolute constant error) for the 20% spacing condition than the 100% condition during acquisition, but more accurate during delayed transfer. No effects were significant for variable error. For the temporal goal, performance was more accurate for the summary and average conditions than the single-trial KR condition; however, this effect was only present within the 20% spacing condition and only during Block 1 of acquisition. A similar effect held for variable error as well, except that the effect persisted for acquisition and transfer. It was concluded that the spacing of KR is more influential in promoting spatial accuracy than the summarizing of KR.

Adaptation to night shifts and synchronisation processes of night workers.

Human beings are accustomed to being active and awake during the day, and asleep and rest at night. Since we live in a society which is organised predominantly along daytime activity, therefore working in the night shift may deeply disrupt our social and family life. It is also a well-known fact that night shift causes fatigue and circadian disruption. The basic manifestation of fatigue and circadian rhythm has been linked to health and safety problems, involving decrements in psychophysical and physiological functions, plus subjective complaints. In this context quantitative relationships between shift work and circadian rhythm need to be assessed to explore suitable time schedule, and to minimise sleep depth and fatigue. There is also a great need to discuss circadian disruption, sleepiness and the increasing cost of work related illness among night workers. In this regard, some aspects of fatigue and circadian disruption caused from night shift work are revealed in this paper aiming to increase workers' health, safety and well being as well as productivity. Light/dark cycle and social stimuli issues acting on the circadian timing systems are also explored to solicit opinions and discussion on the controversy of night work. Suggestions are therefore likewise given to enhance workers' adaptation to night shift and synchronization process.

Ergonomics of living environment for the people with special needs.

A safe, convenient, sound and healthy living environment is the prerequisite for a good house for the people with special needs. The intention of making a house in such a way that it solves basic problems of fixture and fittings. However the construction phase of a good house is a critical to design inside and outside structures. Often the builders do not know all the factors to be considered that can maintain a safe, hygienic and healthy environment. It is believed that when housing is ergonomically furnished, then a maximum benefit will be achieved. To meet with an individual's specific needs, an analysis of user's requirement is the most important factors to be considered in the design of special houses. Users' data such as anthropometric dimension, users' choices and preferences are also necessary to design a suitable living environment. In this regard, this paper illustrates some ergonomic features to design and develop good houses in terms of how people with restricted mobility and communication can truly be helped residing in their homes and performing their daily living activities. Users' social, medical and engineering needs are highlighted following the process of disability, ageing, or impairments to achieve the maximum level of benefits, and ensuring safe and sound living.

HFs/ergonomics of assistive technology.

An assistive device is designed to accommodate the special needs of disability that can help people with physical, mental or cognitive challenges go through their day-to-day activities with less difficulty. An assistive device usually provide alternatives to functional limitations imposed by the client's disorder, and thereby minimising rehabilitation costs. It is therefore important to know about how assistive technology will function in all the possible aspects of such disabilities and impairements. When designing a technical device, particularly in conjunction with the target user group, ergonomic issues are therefore important to find out the extent to which an assistive device is convenient or not, and to check the quality performance of assistive technology. Since the question of the match or mismatch of an assistive device and a disabled person requires much attention, it is therefore suggested that paying attention on how an assistive device be ergonomically designed and developed is important. Ergonomic applications are to be applied for increasing motivation of prospective customers through innovative performance of AT. The authors believe that there are opportunities in ergonomic applications to manufacture an assistive device as unique, cost saving, and allows less exertation and reduces energy consumption when it is used. Hence this paper highlights human factors and/or ergonomics consideration in the process of design and development of assistive devices synchronising with gerontechnological research and development aiming to emphasise user's requirement.