Driving ability, mental illness and psychotropic medication in the elderly

Fitness to drive in elderly drivers is most commonly discussed with a focus on cognitive impairment. Therefore, this article is focussing on mental illness and the use of psychotropic drugs in elderly drivers, which can both interfere with fitness to drive. Based on a detailed literature review and on clinical judgement, we propose signposts and "red flags" to judge the individual risks. Health professionals dealing with elderly patients should in particular be aware of the dangers related to cumulative risks and need to inform the patients appropriately. For medico-legal reasons the information provided to patients must be written down in the medical record. Individual counselling is important as fitness to drive is a complex topic.

Étude de la relation entre le champ visuel et le champ visuel utile chez les personnes atteintes d'hémianopsie

Mémoire numérisé par la Direction des bibliothèques de l'Université de Montréal.

Étude de la relation entre le champ visuel et le champ visuel utile chez les personnes atteintes d'hémianopsie

Mémoire numérisé par la Direction des bibliothèques de l'Université de Montréal.

Étude des besoins décisionnels des aînés atteints de la maladie d’Alzheimer et de leurs proches aidants pour favoriser la prise de décision partagée en soins de première ligne

L’objectif de cette étude était d’évaluer les besoins décisionnels et de prioriser cinq décisions difficiles et fréquentes des aînés atteints de la maladie d’Alzheimer (MA) et leurs proches pour développer un programme de formation axé sur la décision partagée combiné avec des outils d’aide à la décision. Un sondage électronique de type Delphi avec 33 experts a permis d’établir un consensus sur cinq décisions. Les résultats concernent la décision des proches de recourir à une intervention de soutien (sélectionné par 83% des experts), la décision de recourir à des interventions pour réduire l’agitation, l’agressivité et les symptômes psychotiques (79%), déterminer l’objectif des soins chez les aînés atteints de la MA au stade avancé (66%), arrêter ou non la conduite automobile (66%) et établir ou non un régime de protection (62%). L’identification de ces besoins décisionnels médicaux et psychosociaux pourra aiguiller différentes parties prenantes dans le développement d’interventions pour faciliter la prise de décision. Mots clés : maladie d’Alzheimer, proches aidants, soins de première ligne, décision partagée, analyse de besoins, méthode Delphi

Point de vue des toxicomanes sur les sources de motivation qui sont à la base de leurs changements de comportements

La problématique de cette recherche trouve son existence dans le fait que la motivation du toxicomane est un secteur d'activités humaines qui pose des problèmes importants tant sur le plan social et individuel qu'au point de vue de l'intervention thérapeutique. Ces derniers se manifestent à travers des ennuis sociaux comme celui de la conduite automobile avec facultés affaiblies, de l'absentéisme et des accidents au travail et parfois de la consommation et du commerce de drogues illicites. Le problème existe aussi au plan individuel: abandons et échecs scolaires, séparations et divorces, maladies physiques et troubles émotionnels. Au niveau thérapeutique, le taux de succès dépasse rarement les 35%, l'abandon au cours du processus de réadaptation est fréquent et le niveau de récidives ou de rechutes est élevé. À travers les différentes approches utilisées pour mesurer le degré de motivation à changer de comportements de la part du toxicomane (motivation et psychanalyse, motivation et behaviorisme, motivation et cognitivisme), l'auteure de cette recherche suggère que la motivation du toxicomane soit examinée sous une nouvelle perspective. Elle propose de demander individuellement l'opinion de toxicomanes non pas simplement à ne plus consommer mais à tout ce qui touche à l'ensemble de leur vie courante. Cette étude présente ainsi la perception de toxicomanes sur les sources de motivations qui sont sous-jacentes à certaines modifications de comportements. Au terme de la lecture de ce mémoire, le lecteur ou la lectrice connaîtra l'opinion de toxicomanes sur les motifs prioritaires qui génèrent le démarrage, la mise en mouvement, la motivation nécessaire à une modification de comportements. La méthode utilisée dans cette recherche s'inspire des travaux réalisés par Erick Klinger, professeur de psychologie à l'université du Minnesota, aux États-Unis. L'auteure a traduit, adapté et préexpérimenté le questionnaire sur les structures de motivations tiré de l'étude de Klinger et Cox, Motivational Structure Questionnaire. (Klinger, E., & Cox, W.M., 1986). Ce questionnaire présente vingt-sept activités de la vie courante qui peuvent présenter suffisamment d'intérêt pour mettre une personne en mouvement. Une question a été posée à quatre-vingt toxicomanes de la région de Sherbrooke qui ont fait une demande d'aide pour leur réadaptation. La question posée était: "Qu'est qui vous motive à changer de comportements?" Il s'avère que les toxicomanes interrogés accordent une grande importance à plus de douze motifs (motivations) autres que l'alcool, les drogues et les médicaments lorsqu'ils désirent changer. Pour l'auteure, ces résultats sont surprenants. L'idée de départ étant qu'il existe possiblement diverses raisons qui conduisent un ou une toxicomane vers une ressource d'aide mais pas autant que ce que l'étude en dénombre […].

Diabète et conduite: réflexions et atelier pratique [Diabetes and driving: thoughts and educational perspectives].

In Switzerland over 200'000 people with diagnosed diabetes drive a car. Their physicians endorse many roles: usual medical care as well as informing properly about driving recommandations and handling the legal issues behing the licensing procedure. Ability to drive can be impaired in three ways: hypogylcemia, diabetes complications and hyperglycemia. Hypoglycemia is the main risk factor of vehicle accident for diabetic drivers and frequent while driving. However few accidents are reported due to hypoglycemia. Swiss medical guidelines about diabetes and driving mention the requested conditions, but practically how should we do? We sought to answear by creating a specific educationnal program focused on hypoglycemia management. Building patient knowledges through experiences is the main goal of the course diabetes and driving.

Anaerobic sequencing batch biofilm reactor applied to automobile industry wastewater treatment: Volumetric loading rate and feed strategy effects

This paper presents a technological viability study of wastewater treatment in an automobile industry by an anaerobic sequencing batch biofilm reactor containing immobilized biomass (AnSBBR) with a draft tube. The reactor was operated in 8-h cycles, with agitation of 400 rpm, at 30 degrees C and treating 2.0 L wastewater per cycle. Initially the efficiency and stability of the reactor were studied when supplied with nutrients and alkalinity. Removal efficiency of 88% was obtained at volumetric loading rate (VLR) of 3.09 mg COD/L day. When VLR was increased to 6.19 mg COD/L day the system presented stable operation with reduction in efficiency of 71%. In a second stage the AnSBBR was operated treating wastewater in natura, i.e., without nutrients supplementation, only with alkalinity, thereby changing feed strategy. The first strategy consisted in feeding 2.0 L batch wise (10 min), the second in feeding 1.0 L of influent batch wise (10 min) and an additional 1.0 L fed-batch wise (4 h), both dewatering 2.0 L of the effluent in 10 min. The third one maintained 1.0 L of treated effluent in the reactor, without discharging, and 1.0 L of influent was fed fed-batch wise (4 h) with dewatering 1.0 L of the effluent in 10 min. For all implemented strategies (VLR of 1.40, 2.57 and 2.61 mg COD/L day) the system presented stability and removal efficiency of approximately 80%. These results show that the AnSBBR presents operational flexibility, as the influent can be fed according to industry availability. In industrial processes this is a considerable advantage, as the influent may be prone to variations. Moreover, for all the investigated conditions the kinetic parameters were obtained from fitting a first-order model to the profiles of organic matter, total volatile acids and methane concentrations. Analysis of the kinetic parameters showed that the best strategy is feeding 1.0 L of influent batchwise (10 min) and 1.0 L fed-batch wise (4 h) in 8-h cycle. (c) 2007 Elsevier B.V. All rights reserved.

Instrumented indentation testing of an epoxy adhesive used in automobile body assembling

Instrumented indentation has been used to investigate the mechanical properties of BETAMATE 1496 (R) Epoxy adhesive. The properties of the adhesive were analyzed by measuring its hardness and its Young`s modulus in samples extracted from six different positions of the front door of a commercial passenger vehicle in two phases of processing: after application of the adhesive in the door assembling (""pre-cured"" state) and after final cure in the painting oven (""cured"" state). Special attention was given to setting the optimal parameters (""creep"" time and unloading time step) for the instrumented indentation testing for the present application. Young`s modulus values around 1.1 +/- 0.2 GPa and hardness values around 0.15 +/- 0.05 GPa were obtained for all samples, irrespective of the variation of the indentation parameters in the testing procedure and of the relative position of the adhesive in the door frame in both states. (C) 2008 Elsevier Ltd. All rights reserved.

Greenhouse gases emission from soil contaminated with automobile industry residue in Brazil

Solid waste of the automobile industry containing large amounts of heavy metals might affect the emission of greenhouse gases (GHG) when applied to the soil. Accumulation of inorganic chemical elements in the environment generally occurs due to human activity (industry, agriculture, mining and waste landfills). Residues from human activities may release heavy metals to the soil solution, causing toxicity to plants and other soil organisms. Heavy metals may also be adsorbed to clay minerals and/or complexed by the soil organic matter, becoming a potential source of pollutants. Not much is known about the behavior of solid wastes in tropical soil as regarded as source of greenhouse gases (GHG). The emission of GHG (CO(2), CH(4) and N(2)O) was evaluated in incubated soil samples collected in an area contaminated with a solid residue from an automobile industry. Samples were randomly collected at 0 to 0.2 m (a mix of soil and residue), 0.2 to 0.4 m (only residue) and 0.4 to 0.6 m (only soil). A contiguous uncontaminated area, cultivated with sugarcane, was also sampled following the same protocol. Canonical Discriminant Analysis and Principal Component Analysis were applied to the data to evaluate the GHG emission rates. Emission rates of GHG were greater in the samples from the contaminated than the sugarcane area, particularly high during the first days of incubation. CO(2) emissions were greater in samples collected at the upper layer for both areas, while CH(4) and N(2)O emissions were similar in all samples. The emission rates of CH(4) were the most efficient variables to differentiate contaminated and uncontaminated areas.

MDAI: Model based Design in Automobile Industry

It is proposed a new approach based on a methodology, assisted by a tool, to create new products in the automobile industry based on previous defined processes and experiences inspired on a set of best practices or principles: it is based on high-level models or specifications; it is component-based architecture centric; it is based on generative programming techniques. This approach follows in essence the MDA (Model Driven Architecture) philosophy with some specific characteristics. We propose a repository that keeps related information, such as models, applications, design information, generated artifacts and even information concerning the development process itself (e.g., generation steps, tests and integration milestones). Generically, this methodology receives the users' requirements to a new product (e.g., functional, non-functional, product specification) as its main inputs and produces a set of artifacts (e.g., design parts, process validation output) as its main output, that will be integrated in the engineer design tool (e.g. CAD system) facilitating the work.

Futures of automobile industry and challenges on sustainable development and mobility

Portugal had only very few foresight exercises on the automobile sector, and the most recent one was a survey held in a project on work organisation systems in the automobile industry, its recent historical paths and the special strategies of location of companies (the WorTiS project). This involved several teams with different disciplinary backgrounds and from two Portuguese universities. The provisional main results of the first round of a Delphi survey held in Portugal on the automotive sector were already published, but a further analysis was not yet done. This foresight survey was done under the WorTiS project, developed in 2004 by IET – Research Centre on Enterprise and Work Innovation (at FCT-UNL), and financed by the Portuguese Ministry of Science and Technology. Some of this experience on foresight analysis is also been transferred to other projects, namely the WORKS project on work organisation restructuring in the knowledge society that received the support from EC and still is running. The majority of experts considered having an average of less knowledge in almost all the scenario topics presented. This means that information on the automotive industry is not spread enough among academics or experts in related fields (regional scientists, innovation economists, engineers, sociologists). Some have a good knowledge but in very specialised fields. Others have expertise on foresight, or macroeconomics, or management sciences, but feel insecure on issues related with futures of automobile sector. Nevertheless, we considered specially the topics where the experts considered themselves to have some knowledge. There were no “irrelevant” topics considered as such by the expert panel. There are also no topics that are not considered a need for co-operation. The lack of technological infrastructures was not considered as a hindered factor for the accomplishment of any scenario. The experts’ panel considered no other international competence besides US, Japan or Germany in these topics. Special focus will be made in this paper on the topic 2. Public policy and automobile industries, and more specifically on the technological and/or research policies issues, where one can specify the automobile’s role in transport policies with further implications like environment, safety, energy, mobility.

Multicriteria decision making: a case study in the automobile industry

Multi-criteria decision analysis(MCDA) has been one of the fastest-growing areas of operations research during the last decades. The academic attention devoted to MCDA motivated the development of a great variety of approaches and methods within the field. These methods distinguish themselves in terms of procedures, theoretical assumptions and type of decision addressed. This diversity poses challenges to the process of selecting the most suited method for a specific real-world decision problem. In this paper we present a case study in a real-world decision problem arising in the painting sector of an automobile plant. We tackle the problem by resorting to the well-known AHP method and to the MCDA method proposed by Pereira and Fontes (2012) (MMASSI). By relying on two, rather than one, MCDA methods we expect to improve the confidence and robustness of the obtained results. The contributions of this paper are twofold: first, we intend to investigate the contrasts and similarities of the results obtained by distinct MCDA approaches (AHP and MMASSI); secondly, we expect to enrich the literature of the field with a real-world MCDA case study on a complex decision making problem since there is a paucity of applied research work addressing real decision problems faced by organizations.

Multicriteria decision making: a case study in the automobile industry

Multi-criteria decision analysis (MCDA) has been one of the fastest-growing areas of operations research during the last decades. The academic attention devoted to MCDA motivated the development of a great variety of approaches and methods within the field. These methods distinguish themselves in terms of procedures, theoretical assumptions and type of decision addressed. This diversity poses challenges to the process of selecting the most suited method for a specific real-world decision problem. In this paper we present a case study in a real-world decision problem arising in the painting sector of an automobile plant. We tackle the problem by resorting to the well-known AHP method and to the MCDA method proposed by Pereira and Fontes (2012) (MMASSI). By relying on two, rather than one, MCDA methods we expect to improve the confidence and robustness of the obtained results. The contributions of this paper are twofold: first, we intend to investigate the contrasts and similarities of the results obtained by distinct MCDA approaches (AHP and MMASSI); secondly, we expect to enrich the literature of the field with a real-world MCDA case study on a complex decision making problem since there is a paucity of applied research work addressing real decision problems faced by organizations.

Evaluating vehicle painting plans in an automobile assembly plant using an integrated AHP-PROMETHEE approach

The painting activity is one of the most complex and important activities in automobile manufacturing. The inherent complexity of the painting activity and the frequent need for repainting usually turn the painting process into a bottleneck in automobile assembly plants, which is reflected in higher operating costs and longer overall cycle times. One possible approach for optimizing the performance of the paint shop is to improve the efficiency of the color planning. This can be accomplished by evaluating the relative merits of a set of vehicle painting plans. Since this problem has a multicriteria nature, we resort to the multicriteria decision analysis (MCDA) methodology to tackle it. A recent trend in the MCDA field is the development of hybrid approaches that are used to achieve operational synergies between different methods. Here we apply, for the first time, an integrated approach that combines the strengths of the analytic hierarchy process (AHP) and the Preference Ranking Organization METHod for Enrichment Evaluations (PROMETHEE), aided by Geometrical Analysis for Interactive Aid (GAIA), to the problem of assessing alternative vehicle painting plans. The management of the assembly plant found the results of value and is currently using them in order to schedule the painting activities such that an enhancement of the operational efficiency of the paint shop is obtained. This efficiency gain has allowed the management to bid for a new automobile model to be assembled at this specific plant.