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.

Epidemiological data of seasonal variation in mood and behaviour

The aim of this study was to measure seasonal variation in mood and behaviour. The dual vulnerability and latitude effect hypothesis, the risk of increased appetite, weight and other seasonal symptoms to develop metabolic syndrome, and perception of low illumination in quality of life and mental well-being were assessed. These variations are prevalent in persons who live in high latitudes and need balancing of metabolic processes to adapt to environmental changes due to seasons. A randomized sample of 8028 adults aged 30 and over (55% women) participated in an epidemiological health examination study, The Health 2000, applying the probability proportional to population size method for a range of socio-demographic characteristics. They were present in a face-to-face interview at home and health status examination. The questionnaires included the modified versions of the Seasonal Pattern Assessment Questionnaire (SPAQ) and Beck Depression Inventory (BDI), the Health Related Quality of Life (HRQoL) instrument 15D, and the General Health Questionnaire (GHQ). The structured and computerized Munich Composite International Diagnostic Interview (M-CIDI) as part of the interview was used to assess diagnoses of mental disorders, and, the National Cholesterol Education Program Adult Treatment Panel III (NCEP-ATPIII) criteria were assessed using all the available information to detect metabolic syndrome. A key finding was that 85% of this nationwide representative sample had seasonal variation in mood and behaviour. Approximately 9% of the study population presented combined seasonal and depressive symptoms with a significant association between their scores, and 2.6% had symptoms that corresponded to Seasonal Affective Disorder (SAD) in severity. Seasonal variations in weight and appetite are two important components that increase the risk of metabolic syndrome. Other factors such as waist circumference and major depressive disorder contributed to the metabolic syndrome as well. Persons reported of having seasonal symptoms were associated with a poorer quality of life and compromised mental well-being, especially if indoors illumination at home and/or at work was experienced as being low. Seasonal and circadian misalignments are suggested to associate with metabolic disorders, and could be remarked if individuals perceive low illumination levels at home and/or at work that affect the health-related quality of life and mental well-being. Keywords: depression, health-related quality of life, illumination, latitude, mental well-being, metabolic syndrome, seasonal variation, winter.

Portrait of Irene Kuhn Portraits; Women

Irene Kuhn and her family lived downstairs from the Roth family at Schneckenburgerstrasse 42, Munich. Her sister, and perhaps Irene also emigrated to London. Their mother Nelly Kuhn died in 1938. It is not known what happened to their father Albert.

Johanna Roedelheimer holding her infant daughter Ilse Portraits; Women

Johanna Roedelheimer, born 27 August 1898 in Munich, was a cousin of Bruno Roth. She was deported with her daughter to Kaunas in November 1941, both were murdered there.

Julius Spanier Collection 1900-1959

Obituaries; photos with family; newspaper clippings.

Max Jacobsen Collection 1803-1894

Photocopies of documents: on the Schutzjude Moses Jacob during the Napoleonic Wars (1803-1813); other documents relating to Jewish life in Hamburg; graduating diploma from "Hoehere Buergerschule" (1866); excerpt from letter of Louis Jacobsen to his son living in Leedsat the occasion of the outbreak of the Prussian French War (1870); letter of G. Roemer to Louis Jacobsen (1866) after he was refused the marriage with Emilie Jacobsen; partial translation of will of Nathan Joseph living in Wittingen (1844); excerpt from letter of Emilie Heine to her son Ludwig who is a first-year medical student in Munich (1894).

From the Mists of Time 1924-1991

Fragments from a childhood between the wars.

Tolle Jahre Versuch einer Lebensbeschreibung

Description of the author’s family background. His paternal family owned a tobacco and cigarres business in Ulm, which was transferred to Munich in 1888. The maternal family in Frankfurt am Main had a textile export business. Recollections of his schooldays at the Catholic St. Anna Schule. Antisemitic encounters at the local Gymnasium. Description of life in the 19th century. Reverence for the local royalties. The family was involved in the Zionist movement, as were most of the members of their local synagoge.

[Memoiren] : [1887-1933].

Childhood and education in Munich; assimilated bourgeois Jewish family; father was a lawyer and titular professor; writer Ludwig Thoma assistant of his father; vacations in Marienbad; military service; university studies in Munich with Lujo Brentano; apprenticeship as lawyer; political interest and joining of SPD; contacts with later Bavarian president Kurt Eisner; as soldier in World War I; diplomatic mission in Tirol during last days of World War I; refused to take part in Bavarian revolution of November 1918, but close contacts with Eisner government; exact account of two Bavarian soviet republics in 1919 and their protagonists (Gustav Landauer, Erich Muehsam, Eugen Levine); Bavarian politics and justice 1919-1933; description of Paul Nikolaus Cossmann and his reactionary journal "Sueddeutsche Monatshefte"; advocate of Eisner's secretary Felix Fechenbach in political trial against accusations by Cossmann; expulsion of East European Jews by Bavarian government 1923; Hitler coup attempt 1923; election campaign March 1933; Nazi takeover of power in Bavaria; dismissal as lawyer; decision to emigrate.

Anfang - Mitte - Ende 1893-1914

Childhood in traditional Jewish atmosphere; description of general and Jewish life in Frankfurt am Main; family life; education in Jewish school "Philantropin"; university education in Heidelberg, Leipzig, Munich, Berlin and Marburg; military service prior to World War I.

Walter, Greta and Karl Loewenstein Collection. 1821-2004 Bulk: 1933-1989

This collection holds papers of members of the Loewenstein family, especially Walter and Karl Loewenstein. Among the papers here are examples of Walter Loewenstein's writing, documentation of life in Rietberg in Westphalia (Germany) during the late 1930s and early 1940s, and correspondence concerning the fate of several family members during this time. Papers relating to Karl Loewenstein focus on his wartime activities. The genealogy of the Brandenstein family is also represented here along with a few papers of other family members. The collection consists of unpublished manuscripts, correspondence, photographs, official and restitution documentation, notebooks and notes, genealogical research, and fliers.

[Memoirs].

Philipp Loewenfeld (Munich 1887 - New York 1963) was a lawyer and Social Democrat in Munich. He joined the SPD in 1912 and was a delegate to the Bavarian congress of soviets in February 1919. Loewenfeld was a prominent lawyer in political trials in Weimar Germany. In 1933 he emigrated to Switzerland, in 1938 to the USA.

"From Ghetto to Ghetto" : [1900-1933].

Childhood and education in Grodno and Lemberg; poor family background; active as soccer player; acting school of Max Reinhardt in Berlin; engagements in Munich, Zurich and Frankfurt; visit to Poland and short engagement with Yiddish theater troupe; description of theater in Weimar Germany; activities in "Juedischer Kulturbund" after 1933; main role in Kulturbund performance of "Nathan the Wise".