913 resultados para medication, driving, impairment, warnings, outpatient, health behaviour, health action process approach, road safety, France, Australia


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Objective The main aim of this study was to identify young drivers' underlying beliefs (i.e., behavioral, normative, and control) regarding initiating, monitoring/reading, and responding to social interactive technology (i.e., functions on a Smartphone that allow the user to communicate with other people). Method This qualitative study was a beliefs elicitation study in accordance with the Theory of Planned Behavior and sought to elicit young drivers' behavioral (i.e., advantages, disadvantages), normative (i.e., who approves, who disapproves), and control beliefs (i.e., barriers, facilitators) which underpin social interactive technology use while driving. Young drivers (N = 26) aged 17 to 25 years took part in an interview or focus group discussion. Results While differences emerged between the three behaviors of initiating, monitoring/reading, and responding for each of the behavioral, normative, and control belief categories, the strongest distinction was within the behavioral beliefs category (e.g., communicating with the person that they were on the way to meet was an advantage of initiating; being able to determine whether to respond was an advantage of monitoring/reading; and communicating with important people was an advantage of responding). Normative beliefs were similar for initiating and responding behaviors (e.g., friends and peers more likely to approve than other groups) and differences emerged for monitoring/reading (e.g., parents were more likely to approve of this behavior than initiating and responding). For control beliefs, there were differences between the beliefs regarding facilitators of these behaviors (e.g., familiar roads and conditions facilitated initiating; having audible notifications of an incoming communication facilitated monitoring/reading; and receiving a communication of immediate importance facilitated responding); however, the control beliefs that presented barriers were consistent across the three behaviors (e.g., difficult traffic/road conditions). Conclusion The current study provides an important addition to the extant literature and supports emerging research which suggests initiating, monitoring/reading, and responding may indeed be distinct behaviors with different underlying motivations.

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Sleep disturbance after mild traumatic brain injury (mTBI) is commonly reported as debilitating and persistent. However, the nature of this disturbance is poorly understood. This study sought to characterize sleep after mTBI compared with a control group. A cross-sectional matched case control design was used. Thirty-three persons with recent mTBI (1–6 months ago) and 33 age, sex, and ethnicity matched controls completed established questionnaires of sleep quality, quantity, timing, and sleep-related daytime impairment. The mTBI participants were compared with an independent sample of close-matched controls (CMCs; n=33) to allow partial internal replication. Compared with controls, persons with mTBI reported significantly greater sleep disturbance, more severe insomnia symptoms, a longer duration of wake after sleep onset, and greater sleep-related impairment (all medium to large effects, Cohen's d>0.5). No differences were found in sleep quantity, timing, sleep onset latency, sleep efficiency, or daytime sleepiness. All findings except a measure of sleep timing (i.e., sleep midpoint) were replicated for CMCs. These results indicate a difference in the magnitude and nature of perceived sleep disturbance after mTBI compared with controls, where persons with mTBI report poorer sleep quality and greater sleep-related impairment. Sleep quantity and timing did not differ between the groups. These preliminary findings should guide the provision of clearer advice to patients about the aspects of their sleep that may change after mTBI and could inform treatment selection.

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Objectives Self-regulation refers to the practice of using self-imposed restrictions to protect oneself from situations that are, or are perceived to be, unsafe. Within the driving context, self-regulation refers the compensatory practices that some older adults adopt to restrict their driving to situations in which they feel safe. However, the way in which demographic, functional, and psychosocial factors, and the interactions between these factors, influence older adults’ driving self-regulation is not well understood. Improving this understanding could lead to new ways of considering the mobility concerns faced by older drivers. Method A systematic review of the current literature was conducted to explore this issue. Twenty-nine empirical studies investigating the factors associated with older adults’ self-regulatory driving behaviors were examined. Results The review findings were used to construct the Multilevel Older Persons Transportation and Road Safety (MOTRS) model. The MOTRS model proposes that individual and environmental factors such as age, gender, and the availability of alternative transportation predict older adults’ practice of driving-related self-regulation. However, these variables influence self-regulation through psychosocial variables such as driving confidence, affective attitude, and instrumental attitude toward driving. Discussions The MOTRS model extends previous attempts to model older adults’ driving by focusing on a novel target, driving self-regulation, and by including a wider range of predictors identified on the basis of the systematic literature review. This focus enables consideration of broader mobility issues and may inform new strategies to support the mobility of older adults.

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Newly licenced drivers are disproportionately represented in traffic injuries and crash statistics. Despite the implementation of countermeasures designed to improve safety, such as graduated driver licencing (GDL) schemes, many young drivers do not comply with road rules. This study used a reconceptualised deterrence theory framework to investigate young drivers’ perceptions of the enforcement of road rules in general and those more specifically related to GDL. A total of 236 drivers aged 17–24 completed a questionnaire assessing their perceptions of various deterrence mechanisms (personal and vicarious) and their compliance with both GDL-specific and general road rules. Hierarchical multiple regressions conducted to explore noncompliant behaviour revealed that, contrary to theoretical expectations, neither personal nor vicarious punishment experiences affected compliance in the expected direction. Instead, the most influential factors contributing to noncompliance were licence type (P2) and, counterintuitively, having previously been exposed to enforcement. Parental enforcement was also significant in the prediction of transient rule violations, but not fixed rule violations or overall noncompliance. Findings are discussed in light of several possibilities, including an increase in violations due to more time spent on the road, an ‘emboldening effect’ noted in prior studies and possible conceptual constraints regarding the deterrence variables examined in this study.

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This program of research used a mixed methods approach to explore the cultural, social and psychosocial factors that influence women's alcohol consumption. Results indicated that there were a number of common influencing factors across women of all ages but also a number of key influences and behaviours that were distinct for younger and older women. These findings emphasised the need for age-specific interventions that target these influences to reduce women's exposure to alcohol-related harm. This research is one of the first studies to examine alcohol consumption of both younger and older women.

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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 parental 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). 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. 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.

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The Queensland Transport Industry Workplace Health Intervention project was a Participatory Action Research (PAR) project to investigate the effectiveness of workplace-based nutrition and physical activity health promotion interventions for truck drivers in transport industry workplaces in south-east Queensland. The project was conducted by a research team at the Queensland University of Technology (QUT), and was funded by the Queensland Government under the Healthier.Happier.Workplaces initiative.

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Objective Relatively high rates of child restraint inappropriate use, misuse and faults in the installation of restraints have suggested a crucial need for public education messages to raise parental awareness of the need to use restraints correctly. This project involved the devising and pilot testing of message concepts, filming of a television advertisement (the TVC), and the evaluation of the TVC. This paper focuses specifically upon the evaluation of the TVC. The development and evaluation of the TVC were guided by an extended Theory of Planned Behaviour which comprised the standard constructs of attitude, subjective norm, and perceived behavioural control as well as the additional constructs of group norm and descriptive norm. The study also explored the extent to which parents with low and high intentions to self-check restraint/s differed on salient beliefs regarding the behaviour. Methods An online survey of parents (N = 384) was conducted where parents were randomly assigned to either an Intervention group (n = 161), and therefore viewed the advertisement within the survey, or the Control group (n = 223) and therefore did not view the advertisement. Results Following a one-off exposure to the TVC, the results indicated that, although not a significant difference, parents in the Intervention group reported stronger intentions (M = 4.43, SD = .74) to self-check restraints than parents in the Control group (M = 4.18, SD = .86). Also, parents in the Intervention group (M = 4.59, SD = .47) reported significantly higher levels of perceived behavioural control than parents in the Control group (M = 4.40, SD = .73). The regression results revealed that, for parents in the Intervention group, attitude and group norm were significant predictors of parental intentions to self-check their child restraint. Finally, the exploratory analyses of parental beliefs suggested that those parents with low intentions to self-check child restraints were significantly more likely than high intenders to agree that they did not have enough time to check restraints or that having a child in a restraint is more important than checking the installation of the restraint. Conclusion Overall, the findings provide some support for the persuasiveness of the child restraint TVC and provide insight into the factors influencing reported parental intentions as well as salient beliefs underpinning self-checking of restraints. Interventions that attempt to increase parental perceptions of the importance of self-checking restraints regularly and brevity of the time involved in doing so may be effective.

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Do you know how to drive a train? If you don’t you probably believe that you have a fair idea of what it’s all about. Forget what you know, or think you know. Trains are heavy and fast but they feel and handle like driving on ice so they take a long time to stop. The braking distances for a typical piece of track are unlike anything you will have experienced before. With that in mind, imagine you were driving with a bit of dew, or grease, or millipede over the track. You would lose traction and slip everywhere. To avoid this, you would need a compensatory driving strategy. You could drive more slowly, or brake sooner, or change how you brake. Your experience and intuition would lead the way. Folks, this is why it’s called “driving by the seat of your pants”...

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As China continues to motorise rapidly, solutions are needed to reduce the burden of road trauma that is spread inequitably across the community. Little is currently known about how new drivers are trained to deal with on-road challenges, and little is also known about the perceptions, behaviours and attitudes of road users in China. This paper reports on a pilot study conducted in a driver retraining facility in one Chinese city where people who have had their licence suspended for accrual of 12 demerit points in a one year period must attend compulsory retraining in order to regain their licence. A sample of 239 suspended drivers responded to an anonymous questionnaire that sought information about preferred driving speeds and perceptions of safe driving speeds across two speed zones. Responses indicated that speeds higher than the posted limits were commonly reported, and that there was incongruence between preferred and safe speeds, such that a greater proportion of drivers reported preferred speeds that were substantially faster than what were reported as safe speeds. Participants with more driving experience reported significantly fewer crashes than newly licensed drivers (less than 2 years licensed) but no differences were found in offences when compared across groups with different levels of driving experience. Perceptions of risky behaviours were assessed by asking participants to describe what they considered to be the most dangerous on-road behaviours. Speeding and drink driving were the most commonly reported by far, followed by issues such as fatigue, ignoring traffic rules, not obeying traffic rules, phone use while driving, and non-use of seatbelts, which attracted an extremely low response which seems consistent with previously reported low belt wearing rates, unfavourable attitudes towards seatbelt use, and low levels of enforcement. Finally, observations about culturally specific considerations are made from previous research conducted by the authors and others. Specifically, issues of saving face and the importance and pervasiveness of social networks and social influence are discussed with particular regard to how any future countermeasures need to be informed by a thorough understanding of Chinese customs and culture.

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The number of pedestrian victims at Australian and foreign level crossings has remained stable over the past decade and it continues to be a significant problem. To examine the factors contributing to pedestrians’ unsafe crossing behaviours, direct observations were conducted at three black spot urban level crossings in Brisbane for a total of 45 h during morning and afternoon peak. In total, 129 pedestrians transgressed the active controls. More transgressions were observed at the crossings located in more populated suburbs in close proximity to large shopping centres and school zones, whereas the smallest number of transgressions were observed at the least populated locations. In addition to characteristics associated with the larger socio-economic area, the patterns of transgression could be associated with the properties of the existing safety equipment and the design of each level crossing (i.e. location of the platforms, number of rail tracks). Indeed, the largest number of crossed unoccupied but “at risk” rail tracks (where a train could have passed), was observed at the crossing with the least transgressions. Contrary to previous findings, younger adults were the most frequent transgressors. School children and elderly were most likely to transgress in groups. Potential directions for future research and more effective measures are discussed.

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Obstructive sleep apnoea (OSA) is a chronic condition in which the upper airways collapse repeatedly during sleep, completely or partially obstructing breathing. This obstruction leads to chronic intermittent hypoxia and severe sleep fragmentation, disrupting the restorative functions of sleep. Beebe and Gozal (2002)a developed a theory which hypothesises that disruption of the restorative functions of sleep lead to a chronic low level brain damage most evident in executive functions (EF). Neuropsychological testing of EF, volumetric MRI, magnetic resonance spectroscopy, event related potentials and CSF biomarkers all provide support for this theory. Little research has been done to explore the nature of the subjective complaint and it’s impact on the activities of daily living.

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Pollution on electrical insulators is one of the greatest causes of failure of substations subjected to high levels of salinity and environmental pollution. Considering leakage current as the main indicator of pollution on insulators, this paper focus on establishing the effect of the environmental conditions on the risk of failure due to pollution on insulators and determining the significant change in the magnitude of the pollution on the insulators during dry and humid periods. Hierarchical segmentation analysis was used to establish the effect of environmental conditions on the risk of failure due to pollution on insulators. The Kruskal-Wallis test was utilized to determine the significant changes in the magnitude of the pollution due to climate periods. An important result was the discovery that leakage current was more common on insulators during dry periods than humid ones. There was also a higher risk of failure due to pollution during dry periods. During the humid period, various temperatures and wind directions produced a small change in the risk of failure. As a technical result, operators of electrical substations can now identify the cause of an increase in risk of failure due to pollution in the area. The research provides a contribution towards the behaviour of the leakage current under conditions similar to those of the Colombian Caribbean coast and how they affect the risk of failure of the substation due to pollution.

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Background Understanding how different socioeconomic indicators are associated with transport modes provide insight into which interventions might contribute to reducing socioeconomic inequalities in health. The purpose of this study was to examine associations between neighbourhood-level socioeconomic disadvantage, individual-level socioeconomic position (SEP) and usual transport mode. Methods This investigation included 11,036 residents from 200 neighbourhoods in Brisbane, Australia. Respondents self-reported their usual transport mode (car or motorbike, public transport, walking or cycling). Indicators for individual-level SEP were education, occupation, and household income; and neighbourhood disadvantage was measured using a census-derived index. Data were analysed using multilevel multinomial logistic regression. High SEP respondents and residents of the most advantaged neighbourhoods who used a private motor vehicle as their usual form of transport was the reference category. Results Compared with driving a motor vehicle, the odds of using public transport were higher for white collar employees (OR1.68, 95%CrI 1.41-2.01), members of lower income households (OR 1.71 95%CrI 1.25-2.30), and residents of more disadvantaged neighbourhoods (OR 1.93, 95%CrI 1.46-2.54); and lower for respondents with a certificate-level education (OR 0.60, 95%CrI 0.49-0.74) and blue collar workers (OR 0.63, 95%CrI 0.50-0.81). The odds of walking for transport were higher for the least educated (OR 1.58, 95%CrI 1.18-2.11), those not in the labour force (OR 1.94, 95%CrI 1.38-2.72), members of lower income households (OR 2.10, 95%CrI 1.23-3.64), and residents of more disadvantaged neighbourhoods (OR 2.73, 95%CrI 1.46-5.24). The odds of cycling were lower among less educated groups (OR 0.31, 95% CrI 0.19-0.48). Conclusion The relationships between socioeconomic characteristics and transport modes are complex, and provide challenges for those attempting to encourage active forms of transportation. Further work is required exploring the individual- and neighbourhood-level mechanisms behind transport mode choice, and what factors might influence individuals from different socioeconomic backgrounds to change to more active transport modes.

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Safety culture is a term with numerous definitions in the literature. Many authors advocate a prescriptive approach to safety culture in which if an organisation has certain levels of externally prescribed systems and structures in place it has a “good safety culture”. Conversely, other researchers suggest an anthropological approach of exploring deep meanings and understandings present within an organisation’s workforce. In a recent published review, the authors presented an alternative view to safety culture, in which the anthropological aspects of safety culture interact with the structures and systems in place within an organisation to result in behavioural patterns. This can be viewed as a human factors approach to safety culture in which, through understanding the specific interactions between the culture of a workforce and external organisational elements, organisational structures and systems can be optimised in order to shape worker behaviour and improve safety. This paper presents findings from a recent investigation of safety culture in the Australian heavy vehicle (transport) industry. Selected results are discussed to explore how understanding culture can provide direction to the optimisation of organisational structures and systems to match worker culture and thus improve safety. Specifically the value placed on personal experience and stories, as well as on both time and money are discussed, and interventions that are suited to these aspects of the culture are discussed. These findings demonstrate the importance of shifting beyond mere prescriptive and interpretive approaches to safety culture and instead to focus on the interaction between cultural and contextual elements to optimise organisational structures and systems.