Measuring in-vehicle child comfort to study barriers to appropriate and correct use of restraints

Traffic crashes are the leading cause of death and injury among children aged between 4-14 years1,2 and premature graduation to adult seat belts2,3 and restraint misuse4 are common and known risk factors. Children are believed to prematurely graduate to adult belts and misuse the seat belt in booster seats if uncomfortable2,5,6. Although research has concentrated on educating parents and designing better restraints to reduce errors in use, comfort of the child in the restraint has not been studied. Currently there is no existing method for studying comfort in children in restraint systems, although self-report survey tools and pressure distribution mapping is commonly used to measure comfort among adult in vehicle seats. This poster presents preliminary results from work aimed at developing an appropriate method to measure comfort of children in vehicle restraint systems. The specific aims are to: 1. Examine the potential of using modified adult self-report/survey and pressure distribution mapping in children 2. Develop a video based, objective measure of comfort in children.

The role of comfort in child restraint use practices

Suboptimal restraint use, particularly the incorrect use of restraints, is a significant and widespread problem among child vehicle occupants, and increases the risk of injury. Previous research has identified comfort as a potential factor influencing suboptimal restraint use. Both the real comfort experienced by the child and the parent’s perception of the child’s comfort are reported to influence the optimal use of restraints. Problems with real comfort may lead the child to misuse the restraint in their attempt to achieve better comfort whilst parent-perceived discomfort has been reported as a driver for premature graduation and inappropriate restraint choice. However, this work has largely been qualitative. There has been no research that objectively studies either the association between real and parent-perceived comfort, or any association between comfort and suboptimal restraint use. One barrier to such studies is the absence of validated tools for quantifying real comfort in children. We aimed to develop methods to examine both real and parent-perceived comfort and examine their effects on suboptimal restraint use. We conducted online parent surveys (n=470) to explore what drives parental perceptions of their child’s comfort in restraint systems (study 1) and used data from field observation studies (n=497) to examine parent-perceived comfort and its relationship with observed restraint use (study 2). We developed methods to measure comfort in children in a laboratory setting (n=14) using video analysis to estimate a Discomfort Avoidance Behaviour (DAB) score, pressure mapping and adapted survey tools to differentiate between comfortable and induced discomfort conditions (study 3). The DAB rate was then used to compare an integrated booster with an add-on booster (study 4) Preliminary analysis of our recent online survey of Australian parents (study 1) indicates that 23% of parents report comfort as a consideration when making a decision to change restraints. Logistic regression modelling of data collected during the field observation study (study 2) revealed that parent-perceived discomfort was not significantly associated with premature graduation. Contrary to expectation, children of parents who reported that their child was comfortable were almost twice as likely to have been incorrectly restrained (p<0.01, 95% CI 1.24 - 2.77).In the laboratory study (study 3) we found our adapted survey tools did not provide a reliable measurement of real comfort among children. However our DAB score was able to differentiate between comfortable and induced discomfort conditions and correlated well with pressure mapping. Preliminary results from the laboratory comparison study (study 4) indicate a positive correlation between DAB rate and use errors. In experiments conducted to date, we have seen a significantly higher DAB rate in the integrated booster compared to the add-on booster (p < 0.01). However, this needs to be confirmed in a naturalistic setting and in further experiments that take length of time under observation into account. Our results suggest that while some parents report concern about their child’s comfort, parent-reported comfort levels were not associated with restraint choice. If comfort is important for optimal restraint use, it is likely to be the real comfort of the child rather than that reported by the parent. The method we have developed for studying real comfort can be used in naturalistic studies involving child occupants to further understand this relationship. This work will be of interest to vehicle and child restraint manufacturers interested in improving restraint design for young occupants as well as researchers and other stakeholders interested in reducing the incidence of restraint misuse among children.

Comfort, stability and body posture in wheelchair cushions: a preliminary study with able bodied subjects

Long term wheelchair usage has been related to a number of problems, among which pressure ulcers are one of most concern. The design of wheelchair seat cushions has been of increasing interest among researchers, as it can influence seat interface pressure and user's comfort. The aim of this study was to investigate the subjects' perception comfort, stability and body posture of six different commercially available wheelchair cushions. The evaluation was through a questionnaire, where the subjects rate their perceptions on a ten point visual analog scale after staying seated in the cushion for two minutes. The results shows that the Roho^TM aircell cushion was preferred by the users, while the least preferred one was the water cushion. Individuals' subjective perceptions may compliment objective data on seat interface pressure, thus contributing to a more complete view of the users' experience during wheelchair cushion usage.

Ingress clearance requirements and seat positioning for automatic belt systems. Final report.

Mode of access: Internet.

Comfort and convenience specifications for safety belts: shoulder belt fit, pressure and pullout forces. Final report.

National Highway Traffic Safety Administration, Washington, D.C.

Measuring the effect of patient comfort rounds on practice environment and patient satisfaction : A pilot study

Hourly rounding in the acute hospital setting has been proposed as an intervention to increase patient satisfaction and safety, and improve the nursing practice environment, but the innovation has not been adequately tested. A quasiexperimental pretest post-test non-randomized parallel group trial design was used to test the effect of hourly patient comfort rounds on patient satisfaction and nursing perceptions of the practice environment, and to evaluate research processes and instruments for a proposed larger study. A Patient Satisfaction Survey instrument was developed and used in conjunction with the Practice Environment Scale of the Nursing Work Index. Results on patient satisfaction showed no significant changes. Significant changes were found for three of the five practice environment subscales. Consistent with the aim of a pilot study, this research has provided important information related to design, instruments and process that will inform a larger sufficiently powered study.

Will insulation always bring benefits in energy saving and thermal comfort?

Building insulation is often used to reduce the conduction heat transfer through building envelope. With a higher level of insulation (or a greater R-value), the less the conduction heat would transfer through building envelope. In this paper, using building computer simulation techniques, the effects of building insulation levels on the thermal and energy performance of a sample air-conditioned office building in Australia are studied. It is found that depending on the types of buildings and the climates of buildings located, increasing the level of building insulation will not always bring benefits in energy saving and thermal comfort, particularly for internal-load dominated office buildings located in temperate/tropical climates. The possible implication of building insulation in face of global warming has also been examined. Compared with the influence of insulation on building thermal performance, the influence on building energy use is relatively small.

Domestic and international grantmaking : the comfort of codes

This paper focuses on codes of practice in domestic (in-country) and international (out of country) philanthropic giving/grantmaking, their similarities and differences. Codes of principle and practice are interesting not so much because they accurately reflect differences in practice on the ground, but rather because they indicate what is considered important or relevant, as well as aspirational. Codes tell us what people are most concerned about – what is seen to be in need of regulation or reminder.

'The comfort lies in all the things you can do': the Australian drive-in: cinema of distraction

Contrary to the claims of some film historians, the drive-in was not a uniquely American invention. Australian drive-in cinemas were, at least in the 1950s and 1960s, distinguishable from their American counterparts by virtue of the profusion of additional amusements (or distractions) they offered alongside film-viewing. This article traces the history of Australian drive-ins as ‘entertainment centres’ and ‘high temples of modernity’. It argues that the drive-in can usefully be understood as a mid-point between the domestic and public spheres, and a powerful symbol of post-WWII Australia, signifying prosperity, gathering consumer confidence and, in metropolitan areas, marking the path of urban development through its concentration in new, outer suburban areas.

Occupant comfort, the housing industry and electricity infrastructure : understanding the synergies

Despite increasingly stringent energy performance regulations for new homes, southeast Queensland has a high and growing penetration of, and reliance on, air conditioners to provide thermal comfort to housing inhabitants. This reliance impacts on electricity infrastructure investment which is the key driving force behind rising electricity prices. This paper reports initial findings of a research project that seeks to better understand three key issues: (i) how families manage their thermal comfort in summer and how well their homes limit overheating; (ii) the extent to which the homes have been constructed according to the building approval documentation; and (iii) the impact that these issues have on urban design, especially in relation to electricity infrastructure in urban developments.

Comparison of two suspension control strategies for multi-axle heavy truck

Two simple and effective control strategies for a multi-axle heavy truck, modified skyhook damping (MSD) control and proportional-integration-derivative (PID) control, were implemented into functional virtual prototype (FVP) model and compared in terms of road friendliness and ride comfort. A four-axle heavy truck-road coupling system model was established using FVP technology and validated through a ride comfort test. Then appropriate passive air suspensions were chosen to replace the rear tandem suspensions of the original truck model for preliminary optimization. The mechanical properties and time lag of dampers were taken into account in simulations of MSD and PID semi-active dampers implemented using MATLAB/Simulink. Through co-simulations with Adams and MATLAB, the effects of semi-active MSD and PID control were analyzed and compared, and control parameters which afforded the best comprehensive performance for each control strategy were chosen. Simulation results indicate that compared with the passive air suspension truck, semi-active MSD control improves both ride comfort and road-friendliness markedly, with optimization ratios of RMS vertical acceleration and RMS tyre force ranging from 10.1% to 44.8%. However, semi-active PID control only reduces vertical vibration of the driver’s seat by 11.1%, 11.1% and 10.9% on A, B and C level roads respectively. Both strategies are robust to the variation of road level.