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Objective: This study seeks to determine where patients in a rehabilitation hospital keep the greatest percentage of their belongings, that is, in/on the nightstand or on the over-the-bed table. Background: This study provides an inventory of patient items located on the over-the-bed table and in/on the nightstand. Understanding the functions of furnishings within the patient room is key for future preparation for designing a next-generation over-the-bed table or for redesigning a more useful nightstand. Methods: The contents on the top of the nightstand; the contents in the top, middle, and bottom drawers of the nightstand; items next to the nightstand; and the contents on the over-the-bed table within patient rooms were inventoried and placed into categories using similar, patient item categories as the Brooks et al. (2011) study, which examined the contents of the nightstand and the over-the-bed table in assisted living and skilled nursing facilities. Results: Overall, patients in a rehabilitation hospital had a greater percentage of their belongings on the top of the nightstand as compared to their belongings located in all three combined drawers of the nightstand. Overall, patients had a greater percentage of their belongings located on the over-the-bed table as compared to their belongings located on the nightstand. Conclusions: Tabletop surface area was used extensively in patient rooms at a rehabilitation hospital, but nightstand drawers were underutilized.

OBJECTIVE: This article presents the results of an exploratory study in which 14 clinical and staff subject matter experts (SMEs) at a regional rehabilitation hospital were interviewed in order to understand how and why over-the-bed tables are used. BACKGROUND: It is important to understand how and why a device or environment is used when designing it, and not just what features and functions are preferred. This knowledge is valuable both for contextualizing user feature and function preferences and for characterizing and prioritizing design challenges and opportunities. METHODS: Fourteen hospital clinical and support staff subject-matter experts participated in semi-structured interviews with scenario enactments in a medium-fidelity, full-scale mock-up of a typical patient room. During these interviews, they interacted with two personas played by actors and were asked to enact an example of a normal visit, from entering the room through treatment/service and then exiting. Data were analyzed via methodological triangulation including frequency analysis, content analysis, and affinity diagramming. RESULTS: The results include a use-case analysis with illustrative sketches, a list of needs statements, and final observations. CONCLUSIONS: Successfully using the over-the-bed table is dependent upon proper positioning, especially in bed during meals. There are fewer problems associated with over-the-bed table use while seated in a chair than when in the bed. The over-the-bed table is a key component in acute care, inpatient therapies. Clinicians are generally open to “smart” furniture in the patient room but question its cost-effectiveness, robustness, and flexibility.

Background: A person’s ability to safely drive while immobilized is not well defined. Steering ability with a spinner knob during immobilization is unknown. The goal of this study is to further clarify the effect of immobilization on steering reaction time and accuracy with and without a steering wheel spinner knob. Methods: Twenty participants were enrolled in this crossover trial using a driving simulator with an automatic transmission. Five conditions were tested in a counterbalanced order. Steering reaction time and accuracy (number of errors on a dynamic steering task at 2 difficulty levels) were measured. Participants were allowed to steer with the immobilized extremity. Results: No significant differences in reaction time were observed between any conditions. Both immobilized conditions and difficulty level of the steering task led to diminished accuracy compared with controls, resulting in significantly more errors. The use of a spinner knob significantly improved the accuracy for the condition with the sugar-tong splint during the easier steering task, but this improvement was not observed in the harder steering task. There were no differences between conditions based on gender or observed use of the immobilized arm. Conclusions: Immobilization had a negative effect on steering accuracy for both the wrist splint and the sugar-tong splint condition, which may negatively impact driving ability of immobilized patients. Immobilization, regardless of spinner knob use, did not significantly impact steering reaction time. The steering wheel spinner knob did not consistently improve accuracy, and further study is needed to determine its utility.

The aging population is increasing in the United States, Europe, and parts of Asia. By 2030, the number of people in the United States aged 65 and older will be nearly double that of the year 2000 (U.S. Census, 2000). According to Coughlin (1999), one of the most important requirements of this century will be for society to respond to the needs and preferences of the increasing number of older adults. Because assisted living may not be a viable option for many older adults in the future, the home may become the primary environment in which older adults will need assistance (Forlizzi, DiSalvo & Gemperle, 2004).Recently, to meet this demand there has been a surge in "smart'" technologies focusing on elder care development, including devices that can monitor and enhance living situations (Coughlin, D'Ambrosio, Reimer, & Pratt, 2007). The current study sought to determine the characteristics desired for three different novel nightstand designs from a variety of user groups in anticipation of incorporating new technologies into nightstand designs. Participants included community-dwelling older adults, university students, employees at a rehabilitation facility, and patients at the same rehabilitation facility.As individuals age or experience injuries that cause them to face life with reduced mobility, even mundane daily tasks frequently require intervention from others. This need for personal assistance is often a reason for a functionally compromised individual to move into an institutional care setting. One way to help reduce the necessity of this move may be by adopting technological capabilities in one's home, such as a novel nightstand. Failure to adopt technology in both independent living settings and institutional elder-care facilities might be associated with the cost of new technologies. Also, assistive technologies may not be utilized because an individual does not want to admit to being weak or needing help (Hirsch et al., 2003). For these reasons, the current research is useful because it examines what a range of potential users including older adults, patients, employees, and family members (represented in this study by university students) may want and need. Differences in user wants and needs may point to unique characteristics that designers should consider.The current study was preceded by a series of studies examining novel nightstands. First, the authors' lab inventoried nursing homes and rehabilitation facilities to determine the items that residents (N = 28) kept on and in their nightstands (Brooks et al., 2011). The major finding was that users keep the majority of their belongings on top of the nightstand, rather than in the nightstand. The limited mobility of patients as well as the inclined seating position common in hospital beds helps explain the storage of items on top of the nightstand rather than in drawers and the frequent use of the over-the-bed table. Keeping items on top of the nightstand keeps them within reach, and the over-the-bed table may be preferred because of its ability to move into a more convenient position than the nightstands, which are typically immobile.Information gathered from the inventory was then used to guide the design of an automated nightstand prototype. To incorporate what seemed to be the most beneficial feature of the over-the-bed table, a pull-out tray was added to the design of the novel nightstand. Computer two-dimensional (2-D) images of the nightstand were developed and shared with focus groups consisting of 36 community-dwelling seniors as well as 36 university students, all of whom provided feedback on the prototype nightstand (Smolentzov et al., 2009). Focus group results confirmed that potential users were receptive to the idea of novel furniture designs; however, using the 2-D images proved to be ineffective because the complexity and dynamic movements of the prototypes could not be fully conveyed.In preparation for the third study, interactive computer models were created using Google SketchUp. …

Objective: Two studies were conducted to obtain an understanding of the types of items seniors keep in their nightstands and to understand how users feel about the possibility of “smart” furniture. Background: To enable aging in place and universal design, it is vital to understand the needs of a broad range of aging individuals, especially since there is little research on nightstand usage and design. Methods: Study 1 allowed for the development of a structured inventory of nightstand use today in assisted living and rehabilitation facilities. Study 1 led to Study 2, demonstrating the need to conceptualize new ideas for smart nightstands. Feedback was obtained from intergenerational participants who could discuss their needs and preferences for a smart nightstand. Results: In Study 1, more than 150 items were recorded and categorized into 25 different groups. The authors found that participants utilized the top portion of their nightstand as opposed to the lower sections; most items were found on top of the nightstand or in the top drawer. In Study 2, the authors found that the vast majority of participants are willing to consider the use of a smart nightstand. Participants discussed key functions and design preferences, which included carefully designed storage, the ability to move the nightstand up and down, contemporary design, and interaction through voice activation. Conclusion: Existing nightstands do not meet the needs of current users. This research provides greater understanding of the existing limitations associated with nightstands. Study 2 confirmed that user-centered design and the use of technology can be used to enhance daily living. Smart furniture may play a role in promoting the health and independence of diverse user groups.

Systematic approaches for presenting medical information to seniors have not been widely explored and published. Prior to incorporating a mobility and physical functioning measure into clinical practice, meaningful and understandable reporting formats were needed for patients. It was important for seniors with varying educational and cognitive levels to understand the information. Testing was conducted in three phases with 28 participants in the final phase. Volunteers included seniors with a broad range of physical functioning. Focus groups and interviews evaluated prototype reports using several presentation styles, graph orientations, and levels of detail/abstraction. Ease of incorporation into both paper and electronic medical records was also considered. The final product reflects the preferences of the older participants as well as design constraints and consideration for how the reports would be presented in paper and electronic format. To maximize health literacy, all medical reports would benefit from user-centered design.

A new driving simulator task was developed with the long-term goal of aiding rehabilitation specialists who work with drivers who may have functional impairments. This simulated driving task was designed to measure a driver's ability to respond to two types of visual stimuli - brake lights of a lead vehicle and targets presented at different eccentricities along the horizon. Three driving scenarios were developed for the study. The first two were used to examine the effect of A-pillar occlusion on the target detection task. The target locations used in the third scenario were chosen to examine the effect of eccentricity on target reaction time when the participant was required to make head movements to locate and respond to targets. This third scenario revealed age-related differences in the capability to locate and respond to visual stimuli in the periphery of the driving environment. This may be due to the decrements in psychomotor ability observed in older adults. This scenario is expected to have utility in clinical settings.

One aspect of electronic map displays that has been under examination since their invention is the effect of map configuration, i.e., rotating, track-up vs. fixed, north-up maps, on different navigational tasks. Research has shown that people perform some navigation tasks better with track-up maps, and other navigation tasks better with north-up maps. In the current experiment ( N = 16), we investigated how the performance of three common navigation tasks performed as part of an aerial reconnaissance simulation (i.e., cardinal direction judgments, route following and map memory) were affected by an interface factor, map configuration (track-up vs. north-up), and by an individual differences factor, differences in spatial ability. The cardinal direction judgment and route following tasks showed improved accuracy with the track-up map configuration; whereas the map reconstruction task was better facilitated by the north-up map configuration. Spatial abilities were also associated with differences in performance on the three navigation tasks. Spatial abilities and the map-configuration manipulation showed similar strength of association with navigation performance (similar effect size).

An analysis of the effect of wireless telephone communication using text and voice modalities as well as an Apple iPod on lane keeping, speed, speed variability, lateral speed, and lane position variability was conducted with a driving simulator. Participants (young adult licensed drivers) drove in an unusually curvy simulated driving environment while using wireless devices, controlling an iPod, and participating in conversations and word games. As expected on the basis of previous research, lane-keeping performance was robust for voice communication tasks; however, the text messaging and iPod tasks that required significant manual manipulation of the device resulted in significant decrements in lane-keeping performance. In addition, all wireless communication tasks and the iPod task resulted in significant increases in speed variability throughout the driving scenario. Lateral speed increases occurred for all wireless communication tasks other than the cellular phone conversation as well as the iPod task. Increases in lane position variability were observed for the text messaging conditions. In addition to establishing the dramatic performance decrement caused by text messaging tasks, this experiment suggests that driving performance may be affected by distraction in ways not captured by lane-keeping measures alone and explores potential alternative measures of driving performance that may be useful for identifying and quantifying the effects of distracted driving.

Exploring how biological motion can make pedestrians more conspicuous to drivers at night, one-hundred-and-twenty participants were driven along an open-road route at night and pressed a button whenever they recognized that a pedestrian was present. A test pedestrian wearing black clothing alone or with 302 cm2 of retroreflective markings in one of four configurations either stood still or walked in place on an unilluminated sidewalk. Participants' response distances were maximal for the full biological-motion configuration and remained surprisingly long when convenient subsets of reflective markers were positioned on the pedestrian's ankles and wrists. When the pedestrian wore a reflective vest, the responses were no better than when he wore no reflective markings. The biological-motion advantage actually results from interacting form-perception and motion-perception mechanisms. These results confirm that basic perceptual phenomena—observers' sensitivity to human form and motion—can be harnessed to reduce an important problem of traffic safety.

In response to a federal mandate, all new light passenger vehicles in the United States will soon be required to include tire pressure monitoring systems (TPMSs) that alert drivers when one or more tires become 25% or more underinflated relative to the pressure level recommended by the vehicle manufacturer. Although the goal of TPMSs is to reduce the population of underinflated tires, their ultimate effect on tire pressure in consumer vehicles is unknown. Tire pressure and survey data were collected from approximately 1,200 vehicles that had just entered a rest area from an Interstate highway. Comparisons between vehicles with and without a TPMS were made from 864 vehicles in the full sample and from a subset of 123 target vehicles. The presence of TPMSs was generally associated with a small (0.7 to 1.5 psi) but significant decrease in the severity of tire underinflation. In addition, vehicles equipped with TPMSs were significantly less likely to have at least one tire that was 25% or more underinflated. The effect of TPMSs on tire pressure might have been larger had the systems been designed to activate at a less severe underinflation level. Less than 2% of survey respondents believed that TPMSs should have a trigger threshold as extreme as the currently mandated 25% threshold. Surveys also revealed that drivers without a TPMS do not report large differences in their tire maintenance behaviors relative to drivers with a TPMS and that more than 25% of drivers of vehicles with a TPMS are unaware that their vehicle is so equipped.

Drivers routinely overdrive their headlights at night. The selective degradation hypothesis predicts that drivers' overconfidence is a consequence of their ability to steer being preserved even though their ability to see details is impaired. This study investigated the extent to which drivers (18 to 78 years) understand that their ability to steer is preserved in low luminances. Participants estimated their ability to steer before driving a curvy, simulated roadway. Steering performance (but not acuity) was largely intact even in extremely low luminances. Particularly at lower luminances, however, drivers steered better than they had predicted. In the dimmest condition, participants drove outside their lane only 25% as often as they had predicted. These findings support the selective degradation hypothesis, help explain drivers' overconfidence at night, and reflect the fact that drivers do not understand that the ability to see details and the ability to steer are supported by separate neural mechanisms.

How much insight do individuals have into their own visual abilities? This study investigated the extent to which individuals from 18 to 78 years old can accurately predict their own acuity under a broad range of luminances. New psychophysically based methods were developed to facilitate direct comparisons between individuals' estimates of their own visual acuity and their actual acuity. While all age groups appreciate that reductions in luminance have negative consequences on acuity, both younger and middle-age adults underestimated their ability to see in dim conditions. Older adults, however, overestimated their ability to see. These results fail to support the hypothesis that seniors would be the most aware of their limited visual abilities at night. Future research should explore why some seniors are comfortable driving at night while others are not.

Most young drivers are comfortable driving at night despite the increased danger. The selective degradation hypothesis predicts that drivers' overconfidence at night is a consequence of their ability to steer being preserved even though their ability to recognize details is impaired. To test this hypothesis, ten participants drove a curvy simulated roadway with varying levels of luminance, blur, and visual field size. Steering performance, but not visual acuity, was degraded when the visual field was reduced. Acuity, but not steering performance, was severely degraded by extreme blur and extremely low luminance. These findings support the selective degradation hypothesis, suggest that separate neural mechanisms support visual recognition and visual guidance skills, and emphasize the problems that occur when unexpected low contrast objects are present in the roadway environment at night.

This study investigated the types of strategies experienced navigators use to make cardinal direction judgments. While these judgments are important and necessary in navigation, people are generally poor at this task. Verbal protocol analysis revealed the strategies used by pilots in making cardinal direction judgments. These strategies were then compared to those previously identified using less experienced, non-pilot navigators (Gugerty & Brooks, 2001). Prior research on navigation tasks has pointed to mental rotation as the most common primary strategy. Our protocol analysis revealed a strategy not previously identified for other navigational tasks, heading referencing, suggesting that people often use a strategy involving little mental rotation for cardinal direction judgments. Individual participants used one of three patterns of primary strategies: mental rotation only, heading referencing only, or a combination of mental rotation and heading referencing. The novices relied equally on mental rotation and heading referencing while the pilots' primary strategy was heading referencing.

Pedestrians dramatically overestimate their own visibility at night. This is likely to result in pedestrians unknowingly engaging in dangerous behavior. To determine the extent to which pedestrians' estimates of their own visibility are influenced by educational interventions, clothing reflectance, and headlamp beam setting, participants in 2 experiments estimated their own nighttime visibility by walking toward a stationary car to the point where they believed they were just recognizable as a pedestrian. In the first experiment 48 university students were tested and in the second experiment 9 high-school driver education students were tested. Overall, participants failed to appreciate the benefits of reflective clothing and of high-beam illumination. However, the participants in Experiment 1 who had heard a relevant lecture several weeks earlier gave estimates that were 10% shorter than did a control group. Participants in Experiment 2 heard a more focused and graphicintensive lecture and gave estimates that were 56% shorter than did a control group. Potential applications of this research include increasing pedestrian safety by designing and implementing research-based public education campaigns aimed at reducing pedestrians' overestimates of their own nighttime visibility.

This study investigated whether situation awareness training over and above current training practices could increase novice process control operators' system performance and situation awareness. We examined the possibility of explicitly training novices in such a way that they could quickly acquire some of the functional characteristics of experts and thereby more quickly improve performance and avoid errors. To answer this question, 24 two-member crews controlled a simulated process control plant. Participants who were exposed to the situation awareness training had better overall system performance in terms of both system stability and deviation from optimal operating conditions. Surprisingly, paper and pencil measures of the operators' situation awareness showed no significant increase in situation awareness after training. It appears as if carefully designed training programs have the potential to significantly increase novice operators' performance.

In Experiment 1, 29 participants performed a simulated driving task both alone and while talking with another participant. Half of the non-driving participants could see the driving scene (in-person communication group) and half could not (remote communication group). When participants performed the driving task while talking with a partner, their situation awareness was significantly less than when they performed only the driving task. Thus, concurrent verbal interactions degraded situation awareness for the driving task. However, the amount of degradation in situation awareness during in-person and remote interactions did not differ significantly. The pace of the in-person and remote verbal interactions differed, suggesting that remote verbal interactions may be more difficult for drivers. Also, drivers talking with remote partners generated more long pauses than drivers talking with in-person partners, suggesting that drivers engaged in remote verbal interactions were modulating their verbalizations in order to maintain adequate driving performance. Experiment 2 replicated the finding that both in-person and remote verbal interactions degraded driving situation awareness, with no significant difference in the amount of degradation for the two types of verbal interaction.