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We introduce a pair of domestic, robotic furnishings aimed at improving the ability of people to live and work independently. The robotic pair--a mobile, robot-cube and a continuum-robotic lamp-- work together with their human cohabitants to perform routine tasks of daily living enumerated in the 'CS-PFP10' protocol used by rehabilitation therapists to evaluate the capacity for independent living. The iterative design and basic behaviors of the robot pair are considered in this paper, as are results from a formative user evaluation involving older adults and a second study involving twelve clinical staff from a rehabilitation hospital. Finally, we offer recommendations that generalize to related efforts. As robots will inevitably become part of domestic routines, reporting on this robot pair serves as a design exemplar for future development of domestic robots that enable and dignify older individuals.

Objective: This article presents the results of an exploratory study in which 14 healthcare subject matter experts (H-SMEs) in addition to four research and design subject matter experts (RD-SMEs) at a regional rehabilitation hospital engaged in a series of complementary, participatory activities in order to design an assistive robotic table (ART). Background: As designers, human factor experts, and healthcare professionals continue to work to integrate assistive human–robot technologies in healthcare, it is imperative to understand how the technology affects patient care from clinicians’ perspectives. Method: Fourteen clinical H-SMEs rated a subset of conceptual ART design ideas; participated in the iterative design process of ART; and evaluated a final cardboard prototype, the rehabilitation hospital’s current over-the-bed table (OBT), an ART built with true materials, and two therapy surface prototypes. Four RD-SMEs conducted a heuristic evaluation on the ART built with true materials. Data were analyzed by frequency and content analysis. Results: The results include a design and prototype for the next generation ART and a pneumatically controlled therapy surface, a broadened list of specifications for the future design and implementation of assistive robotic furniture, and final observations. Conclusion: When compared to the rehabilitation hospital’s current OBT, the developed ART in this study was successful. Designing novel features is dependent upon ensuring patient safety. The inclusion of clinicians in the participatory iterative design and evaluation process and the use of personas provided a broadened list of specifications for the successful implementation of assistive robotic furniture.

Recognition of human gestures is an active area of research integral for the development of intuitive human-machine interfaces for ubiquitous computing and assistive robotics. In particular, such systems are key to effective environmental designs that facilitate aging in place. Typically, gesture recognition takes the form of template matching in which the human participant is expected to emulate a choreographed motion as prescribed by the researchers. A corresponding robotic action is then a one-to-one mapping of the template classification to a library of distinct responses. In this paper, we explore a recognition scheme based on the growing neural gas (GNG) algorithm that places no initial constraints on the user to perform gestures in a specific way. Motion descriptors extracted from sequential skeletal depth data are clustered by GNG and mapped directly to a robotic response that is refined through reinforcement learning. A simple good/bad reward signal is provided by the user. This paper presents results that show that the topology-preserving quality of GNG allows generalization between gestured commands. Experimental results using an automated reward are presented that compare learning results involving single nodes versus results involving the influence of node neighborhoods. Although separability of input data influences the speed of learning convergence for a given neighborhood radius, it is shown that learning progresses toward emulation of an associative memory that maps input gesture to desired action.

To investigate the use and potential for patient acceptance of the DrivingHealth(®) Inventory (DHI) in clinical practice, we administered the DHI to 360 community dwelling volunteers over age 50 at a Southeastern US rehabilitation hospital. Volunteers also completed surveys to document their health, driving habits, and impressions of the DHI. Volunteers reported strong agreement with statements that indicated that they believe the DHI measures abilities important for safe driving and that they would be willing to listen to advice about driving and safe mobility from medical professionals; however, responses to some items were more positive among drivers whose DHI results indicated no apparent loss of function that could impair driving. These results support the use of the DHI in clinical practice as a tool to raise awareness of factors that correlate to driving; however, further research will be necessary to investigate how the DHI may benefit diverse clinical populations. Experiences with using DHI as part of clinical practice are also discussed.

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.

More severe vertebral fractures have more personal impact. In the European Prospective Osteoporosis Study, more severe vertebral collapse was predictable from prior fracture characteristics. Subjects with bi-concave or crush fractures at baseline had a 2-fold increase in incident fracture size and thus increased risk of a disabling future fracture. Introduction: According to Euler's buckling theory, loss of horizontal trabeculae in vertebrae increases the risk of fracture and suggests that the extent of vertebral collapse will be increased in proportion. We tested the hypothesis that the characteristics of a baseline deformity would influence the size of a subsequent deformity. Methods: In 207 subjects participating in the European Prospective Osteoporosis Study who suffered an incident spine fracture in a previously normal vertebra, we estimated loss of volume (fracture size) from plane film images of all vertebral bodies that were classified as having a new fracture. The sum of the three vertebral heights (anterior, mid-body, and posterior) obtained at follow-up was subtracted from the sum of the same measures at baseline. Each of the summed height loss for vertebrae with a McCloskey-Kanis deformity on the second film was expressed as a percentage. Results and Conclusions: In univariate models, the numbers of baseline deformities and the clinical category of the most severe baseline deformity were each significantly associated with the size of the most severe incident fracture and with the cumulated sum of all vertebral height losses. In multivariate modeling, age and the clinical category of the baseline deformity (crush > bi-concave > uni-concave > wedge) were the strongest determinants of both more severe and cumulative height loss. Baseline biconcave and crush fractures were associated at follow-up with new fractures that were approximately twice as large as those seen with other types of deformity or who previously had undeformed spines. In conclusion, the characteristics of a baseline vertebral deformity determines statistically the magnitude of vertebral body volume lost when a subsequent fracture occurs. Because severity of fracture and number of fractures are determinants of impact, the results should improve prediction of the future personal impact of osteoporosis once a baseline prevalent deformity has been identified.

Multimodal forms of human-robot interaction (HRI) including non-verbal forms promise easily adopted and intuitive use models for assistive devices. The research described in this paper targets an assistive robotic appliance which learns a user’s gestures for activities performed in a healthcare or aging in place setting. The proposed approach uses the Growing Neural Gas (GNG) algorithm in combination with the Q-Learning paradigm of reinforcement learning to shape robotic motions over time. Neighborhoods of nodes in the GNG network are combined to collectively leverage past learning by the group. Connections between nodes are assigned weights based on frequency of use which can be viewed as measures of electrical resistance. In this way, the GNG network may be traversed based on distances computed in the same manner as resistance in an electrical circuit. It is shown that this distance metric provides faster convergence of the algorithm when compared to shortest path neighborhood learning.

Particularly in the health and rehabilitation sector where cost and space are constraints, clinicians need smaller driving simulators. Because of the limited projected field of view (PFOV) afforded by these displays, it was desirable to extend the virtual or geometric field of view (GFOV) beyond that natively afforded by the PFOV. In Study 1, user feedback was gathered from our target user population on two display configurations: (1) a single large LCD; and (2) three smaller LCD screens. Participants were also exposed to four GFOV settings (65°, 80°, 95°, 110°) using either display. The majority of participants preferred and were most comfortable with the three-screen configuration with the highest GFOV setting tested (110°). In order for driving simulation to produce realistic experiences, drivers’ perception of speed should correspond with real world experiences. However, changing the PFOV/GFOV ratio has been shown to alter perceived speed. Therefore, the purpose of Study 2 was to better understand the relationship between speed perception and the GFOV/PFOV ratio in a way that would be useful to simulation practitioners using a small-footprint driving simulator. Using the DriveSafety CDS-250, participants performed a speed matching task using six different GFOV conditions while the PFOV was held constant. Target speeds were presented in three appropriate simulated environments: 25 mph in a residential area, 45 mph in a commercial area, and 65 mph on a freeway. In general, perceived speed was found to decrease with larger GFOVs. However, no GFOV tested produced accurate speed perception; on average, all participants underestimated their speeds using all GFOVs.

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. …

Introduction Research has shown that both pedestrians and drivers drastically overestimate pedestrians' nighttime visibility (NHSTSA, 2008a, 2008b; Owens & Sivak, 1996) and fail to appreciate the safety benefits of proven conspicuity aids. One solution is educational intervention (Tyrrell, Patton, & Brooks, 2004); however, the on-road assessment of its effectiveness is expensive and time consuming. Method Experiment One introduces a computer-based alternative to the field-based approach, successfully replicating the previous study's trends among 94 students who either receive or do not receive an educational lecture. Experiment Two utilizes the simulation's portability to determine if professional roadway workers have a more accurate understanding of pedestrian conspicuity than students. Results: Results among 88 workers show they do not significantly appreciate the advantages of effective retroflective material configurations or vehicle headlamp settings, for example, any better than non-lectured students in Experiment One. Impact: The study's results demonstrate the need for education among all pedestrians and the benefits of efficient testing methods.

Physicians have the potential to serve as an important portal for information gathering, assessment, counseling, and reporting older driver fitness, as almost all older adults require medical care and have a primary care physician. However, there are few studies that have evaluated physician knowledge about, attitudes toward, and performance of older driver fitness assessment. Two pilot studies were conducted to assess physician knowledge and attitudes and aid understanding of physician knowledge of legal reporting requirements regarding older driver medical fitness. Results suggest that although physicians believe that patients should be evaluated for safe driving, many physicians do not routinely assess fitness to drive and few feel qualified to do so. It also appears that physicians may not be adequately knowledgeable about laws about reporting unsafe drivers. Thus, occupational therapy practitioners have an opportunity to educate about driving as a complex instrumental activity of daily living.

Driving in fog is a potentially dangerous activity that has been investigated in a number of different ways; however, most have focused on identifying the underlying perceptual changes that result in an inability to perceive speed of vehicle motion. Although the previous research has identified the perceptual changes associated with driving in fog and shows that people are highly likely to perceive their speed to be higher than it actually is, these research studies have not investigated driving behavior when drivers are allowed to maintain speed as they feel appropriate and make use of the vehicle's speedometer. In addition, much of the existing research focuses on speed perception and presents a limited view of other driving performance metrics in terms of lane keeping and event detection. The current study addresses these issues utilizing a driving simulator-based method where fog is simulated as a distance dependent contrast reduction while having participants drive at speeds they feel are appropriate. A number of different instructions and speed feedback mechanisms were tested in order to determine how drivers react when driving in varying levels of fog. Results also include lane keeping measures in order to assess whether drivers are willing to drive at speeds where their lane keeping performance is degraded due to the reduced visibility. Results indicate that, in general, drivers do not tend to slow down significantly until visibility distance is drastically reduced by fog; however, lane keeping ability is maintained throughout most of the range of visibility distances. Lane keeping ability was reduced only when fog results in visibility distances

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.

While driving simulators are a valuable tool for assessing multiple dimensions of driving performance under relatively safe conditions, researchers and practitioners must be prepared for participants that suffer from simulator sickness. This paper describes multiple theories of motion sickness and presents a method for assessing and reacting to simulator sickness symptoms. Results showed that this method identified individuals who were unable to complete a driving simulator study due to simulator sickness with greater than 90% accuracy and that older participants had a greater likelihood of simulator sickness than younger participants. Possible explanations for increased symptoms experienced by older participants are discussed as well as implications for research ethics and simulator sickness prevention.

Vertebral height ratios are used to define vertebral deformity in clinical and epidemiologic studies of vertebral osteoporosis. However, few data have been obtained on the variation in these ratios in different populations using standard methods. We examined vertebral morphometric measurements obtained in a population survey from three centers: Malmo (Sweden), Montceau-les-Mines (France), and Graz (Austria), to study the influence of sex and the population center on vertebral height ratios. Radiographs were obtained according to a standardized protocol, and morphometric measurements, anterior height Ha, central height Hc, and posterior height Hp, made in Berlin. The height ratios anterior, Ha/Hp, central, Hc/Hp, posterior I, Hp/Hp', and posterior II, Hp/Hp" (Hp' = posterior height of vertebrae above, Hp" = posterior height of vertebrae below) were calculated for each vertebra from T4 to L4. The mean and standard deviation of these ratios for each sex and each center were derived using a statistical trimming procedure to normalize the distribution. Threshold values for defining grade 1 and grade 2 deformities, wedge, biconcavity, and compression, were calculated using these parameters. Anterior and central vertebral height ratios were smaller in males than females (p < 0.01). There were significant differences between the three centers (p < 0.01) both in the trimmed mean values for anterior and central vertebral height ratios and in the thresholds derived using standard criteria for defining wedge and biconcavity deformity. The data confirm the impression from single-center studies that vertebral height ratios vary between populations and suggest that reference values for vertebral height ratios should be derived separately for males and females within individual populations whenever possible.

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).

Seven head and neck cancer patients participated in a driving evaluation in a driving simulator. Radiation dose on the temporal lobes was moderately associated with time to complete a cognitive test and with driving performance. Results indicated that incidental irradiation may contribute to a decrease in cognition and in unsafe driving performance, which seems to be time-dependent.

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.

This article reports on two studies that explored the effects of severe visual challenges on steering performance in visually healthy young drivers. The experiments explored the extent to which induced blur, educed luminance, and reduced visual fields affect drivers' steering performance in a driving simulator. In the first experiment, 10 young drivers (median age 21.2 years) drove at approximately 89 km/h (55 mph) along a curvy roadway while being exposed to blur, luminance, and visual field manipulations. In the second experiment, a different group of 10 young drivers (median age 18.5 years) drove while exposed to 7 visual field sizes (1.7 to 150 degrees). Steering was shown to be sensitive to a reduced field size but not to the blur and luminance challenges. Acuity, on the other hand, was sensitive to the blur and luminance challenges but not to reduced field size. The authors conclude that in healthy young drivers, steering performance is remarkably robust to severe blur and to extremely low luminances. Thus steering performance is preserved at night even when the ability to recognize objects and hazards is not. The authors call for additional research to investigate the other hypothesis hinted at by these studies: that drivers fail to understand the extent to which their visual abilities are degraded at night.

This study focused on how teams allocated attention between a driving-related spatial task and a verbal task, and how different kinds of verbal interactions affected performance of the driving-related task. In Experiment 1, 29 two-person teams performed an interactive verbal task while one team member also performed a simulated driving task. Of the team members performing only the verbal task, half could see their partner's spatial situation, as a car passenger can (in-person condition), and half were remotely located, similar to someone speaking to a driver using a cell-phone. Teams interacted verbally at an overall slower rate during remote than in-person interactions, suggesting that remote verbal interactions are more difficult than in-person interactions. Verbal interactions degraded situation awareness for driving-related information while performing the spatial task; and this degradation was not greater during remote than in-person interactions. Experiment 2 used a faster-paced verbal task and found greater degradation of situation awareness due to the verbal task. These findings are potentially relevant to the issue of how passenger and cell-phone conversations affect driving performance.

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 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.

The Summary In 27 centres across Europe, the prevalence of deforming spinal Scheuermann's disease in age-stratified population-based samples of over 10,000 men and women aged 50+ averaged 8 % in each sex, but was highly variable between centres. Low DXA BMD was un-associated with Scheuermann's, helping the differential diagnosis from osteoporosis. Introduction This study aims to assess the prevalence of Scheuermann's disease of the spine across Europe in men and women over 50 years of age, to quantitate its association with bone mineral density (BMD) and to assess its role as a confounder for the radiographic diagnosis of osteoporotic fracture. Methods In 27 centres participating in the population-based European Vertebral Osteoporosis Study (EVOS), standardised lateral radiographs of the lumbar and of the thoracic spine from T4 to L4 were assessed in all those of adequate quality. The presence of Scheuermann's disease, a confounder for prevalent fracture in later life, was defined by the presence of at least one Schmorl's node or irregular endplate together with kyphosis (sagittal Cobb angle > 40A degrees between T4 and T12) or a wedged-shaped vertebral body. Alternatively, the (rare) Edgren-Vaino sign was taken as diagnostic. The 6-point-per-vertebral-body (13 vertebrae) method was used to assess osteoporotic vertebral shape and fracture caseness. DXA BMD of the L2-L4 and femoral neck regions was measured in subsets. We also assessed the presence of Scheuermann's by alternative published algorithms when these used the radiographic signs we assessed. Results Vertebral radiographic images from 4486 men and 5655 women passed all quality checks. Prevalence of Scheuermann's varied considerably between centres, and based on random effect modelling, the overall European prevalence using our method was 8 % with no significant difference between sexes. The highest prevalences were seen in Germany, Sweden, the UK and France and low prevalences were seen in Hungary, Poland and Slovakia. Centre-level prevalences in men and women were highly correlated. Scheuermann's was not associated with BMD of the spine or hip. Conclusions Since most of the variation in population impact of Scheuermann's was unaccounted for by the radiological and anthropometric data, the search for new genetic and environmental determinants of this disease is encouraged.

An inevitable new frontier for the CHI community is the development of complex, larger-scale, cyber-physical artifacts where advancements in design, computing and robotics converge. Presented here is a design exemplar: the Assistive, Robotic Table (ART), the key component of our envisioned home suite of networked, robotic furnishings for hospitals and homes, promoting wellbeing and independent living. We begin with the motivations for ART, and present our iterative, five-phase, participatory design-and-evaluation process involving clinicians at a rehabilitation hospital, focusing here on the final usability study. From our wide-ranging design-research activities, which may be characterized as research through design, we found ART to be promising but also challenging. As a design exemplar, ART offers invaluable lessons to the CHI community as it comes to design larger-scale, cyber-physical artifacts cultivating interactions across people and their surroundings that define places of social, cultural and psychological significance.

Gesture-based interfaces offer the possibility of an intuitive command language for assistive robotics and ubiquitous computing. As an individual’s health changes with age, their ability to consistently perform standard gestures may decrease, particularly towards the end of life. Thus, such interfaces will need to be capable of learning commands which are not choreographed ahead of time by the system designers. This circumstance illustrates the need for a system which engages in lifelong learning and is capable of discerning new gestures and the user’s desired response to them. This paper describes an innovative approach to lifelong learning based on clustered gesture representations identified through the Growing Neural Gas algorithm. The simulated approach utilizes a user-generated reward signal to progressively refine the response of an assistive robot toward a preferred goal configuration.

There are few data exploring clustering of osteoporotic fractures within families. The aim of this study was to determine the influence of maternal and paternal history of hip fracture on the risk of vertebral deformity. 12,816 men and women aged 50 to 75 years were recruited from population based sampling frames across Europe. Subjects were invited to attend by letter of invitation for an interviewer administered questionnaire and lateral spinal radiographs. Vertebral deformity was defined morphometrically using the McCloskey-Kanis method. 6.4% of men and 7.1% of women reported that their mother had suffered a hip fracture, while 1.7% of both men and women reported that their father had suffered a hip fracture. A maternal history of hip fracture was associated with a modest increased risk of vertebral deformity in men [odds ratio (OR) 1.3, 95% confidence interval (CI) 1.0-1.8], the risk being greater among those aged 65 years and over (OR = 1.5; 95% CI 1.0-2.4) and in those from low prevalence areas. There was no increased risk in women. Paternal history of hip fracture was not associated with vertebral deformity in either sex. In conclusion, maternal history of hip fracture appears to be a risk factor for vertebral deformity, particularly in men.

Inevitably, assistive robotics will become integral to the everyday lives of a human population that is increasingly mobile, older, urban-centric and networked. How will we communicate with such robots, and how will they communicate with us? We make the case for a relatively "artificial" mode of nonverbal human-robot communication [NVC] to avoid unnecessary distraction for people, busily conducting their lives via human-human, natural communication. We propose that this NVC be conveyed by familiar lights and sounds, and elaborate here early experiments with our NVC platform in a rehabilitation hospital. Our NVC platform was perceived by medical staff as a desirable and expedient communication mode for human-robot interaction [HRI] in clinical settings, suggesting great promise for our mode of human-robot communication for this and other applications and environments involving intimate HRI.

Lean body stature and tallness have both been identified as risk factors for hip fracture. In this study, height and weight data from a multinational multicenter study were used' to compare Oslo, which has some of the highest incidence rates of hip fracture ever reported, to other regions of Europe, with respect to height and body mass index. More than 17, 000 subjects in six age strata (50–54, 55–59, 60–64, 65–69, 70–74, 75+ years) from 36 centers in 19 European countries were enrolled in the European Vertebral Osteoporosis Study (EVOS), which included standardized height and weight measurements. We found that men in Oslo were 4.3 cm taller than men in western Europe, 5.0 cm taller than men in eastern Europe, and 8.6 cm taller than men in southern Europe. Oslo women were also taller, by 2.2 cm compared to women in western Europe, 2.7 cm compared to women in eastern Europe, and 5.2 cm compared to women in southern Europe. In all age groups, except women aged 55–59 years, mean body mass index (BMI) was lowest in Oslo. Nearly twice as many had a BMI less than 22.0 kg/m2 in Oslo compared to the other regions combined (11.1% vs. 6.6% in men and 19.2% vs. 9.9% in women). This study indicates that the people of Oslo are taller and leaner than people in other regions of Europe. This may in part explain the higher incidence of hip fracture in the population of Oslo.

Healthcare is becoming more digital and technological, but healthcare environments have not yet become embedded with digital technologies to support the most productive (physical) interaction between medical patients, clinical staff and the physical artifacts that surround and envelop them. This shortcoming is an opportunity for the architecture and robotics communities to interface with each other and the everyday users of healthcare environments. Our extended lab focused ten weeks on sketching in hardware a robotic, patient-room ecosystem we call home+ with the help of clinicians at the Roger C. Peace Rehabilitation Hospital of the Greenville Hospital System University Medical Center [GHS]. This early prototyping effort represents our vision for the larger robotic patient room, and identifies opportunities for more focused work on an Assistive Robotic Table (ART).

While much research exists on occupant packaging both proprietary and in the literature, more detailed research regarding user preferences for subjective ratings of steering wheel designs is sparse in published literature. This study aimed to explore the driver interactions with production steering wheels in four vehicles by using anthropometric data, driver hand placement, and driver grip design preferences for Generation-Y and Baby Boomers. In this study, participants selected their preferred grip diameter, responded to a series of questions about the steering wheel grip as they sat in four vehicles, and rank ordered their preferred grip design. Thirty-two male participants (16 Baby Boomers between ages 47 and 65 and 16 Generation-Y between ages 18 and 29) participated in the study. Drivers demonstrated different gripping behavior between vehicles and between groups. Recommendations for future work in steering wheel grip design and naturalistic driver hand positioning are discussed.

Recognition of human gestures is an active area of research integral to the development of intuitive human-machine interfaces for ubiquitous computing and assistive robotics. In particular, such systems are key to effective environmental designs which facilitate aging in place. Typically, gesture recognition takes the form of template matching in which the human participant is expected to emulate a choreographed motion as prescribed by the researchers. The robotic response is then a one-to-one mapping of the template classification to a library of distinct responses. In this paper, we explore a recognition scheme based on the Growing Neural Gas (GNG) algorithm which places no initial constraints on the user to perform gestures in a specific way. Skeletal depth data collected using the Microsoft Kinect sensor is clustered by GNG and used to refine a robotic response associated with the selected GNG reference node. We envision a supervised learning paradigm similar to the training of a service animal in which the response of the robot is seen to converge upon the user's desired response by taking user feedback into account. This paper presents initial results which show that GNG effectively differentiates between gestured commands and that, using automated (policy based) feedback, the system provides improved responses over time.

BACKGROUND The European Vertebral Osteoporosis Study Group (EVOS) developed a questionnaire, back translated into 14 different European languages, for use in a multinational epidemiological study of vertebral osteoporosis. We investigated the reproducibility of this questionnaire in four of the participating study centres. METHODS In all 151 men and women, aged 50-85 years, from Lubeck (Germany), Malmo (Sweden), Warsaw (Poland) and Oviedo (Northern Spain), were retested with the questionnaire on two occasions using a different observer within a 28-day period. RESULTS Questions relating to personal or medical history were more reproducible than questions concerning subjective symptoms or aspects of lifestyle. The level of agreement for the non-ordinal categorical variables, as estimated by kappa, varied from 0.38 to 1.00 across the four centres. Agreement for the multicategory ordinal, mainly lifestyle, questions was in general poorer though improved when a weighted analysis was performed. For continuous data the 95% limits of agreement were narrow, and there was no evidence of bias between interviewers. There were no important differences in reproducibility across the four centres for either categorical or continuous data. CONCLUSION The study indicates that the questionnaire may produce useful and comparable information concerning risk factors for osteoporosis across different countries and in different languages. It also highlights that questionnaire instruments designed for use in multinational population-based studies may provide data of comparable quality across a range of settings.

One method to adjust speed perception in a driving simulator is to adjust the rendered, geometric field of view (GFOV); however, little is known regarding users’ sensitivity to changing the GFOV. The current research examined 24 licensed drivers’ subjective experience with changes in GFOV during a speed matching task when examining the relationship between speed estimate and GFOV in a small-footprint driving simulator. Following the completion of the speed-matching task, participants were asked three questions regarding (1) strategy used to match speed: “What strategies did you use to complete the speed matching task?”; (2) awareness of GFOV setting: “Did you notice any changes in the simulation at any time during the experiment?”; and (3) subjective accuracy: “How accurate do you think you were in performing the task on a one to ten scale, one being ‘extremely inaccurate’ and ten being ‘extremely accurate’?” Results indicated participants were not (directly) aware of changes in the GFOV; some misattributed the change in GFOV to a change in the vehicle’s acceleration rate. Furthermore, many participants’ cited strategies that were later categorized as ‘using optic flow’ and, in general, were unsure about their accuracy in the task.

The objective of this study was to determine the effect of once-yearly zoledronic acid on the number of days of back pain and the number of days of disability (ie, limited activity and bed rest) owing to back pain or fracture in postmenopausal women with osteoporosis. This was a multicenter, randomized, double-blind, placebo-controlled trial in 240 clinical centers in 27 countries. Participants included 7736 postmenopausal women with osteoporosis. Patients were randomized to receive either a single 15-minute intravenous infusion of zoledronic acid (5 mg) or placebo at baseline, 12 months, and 24 months. The main outcome measures were self-reported number of days with back pain and the number of days of limited activity and bed rest owing to back pain or a fracture, and this was assessed every 3 months over a 3-year period. Our results show that although the incidence of back pain was high in both randomized groups, women randomized to zoledronic acid experienced, on average, 18 fewer days of back pain compared with placebo over the course of the trial (p = .0092). The back pain among women randomized to zoledronic acid versus placebo resulted in 11 fewer days of limited activity (p = .0017). In Cox proportional-hazards models, women randomized to zoledronic acid were about 6% less likely to experience 7 or more days of back pain [relative risk (RR) = 0.94, 95% confidence interval (CI) 0.90–0.99] or limited activity owing to back pain (RR = 0.94, 95% CI 0.87–1.00). Women randomized to zoledronic acid were significantly less likely to experience 7 or more bed-rest days owing to a fracture (RR = 0.58, 95% CI 0.47–0.72) and 7 or more limited-activity days owing to a fracture (RR = 0.67, 95% CI 0.58–0.78). Reductions in back pain with zoledronic acid were independent of incident fracture. Our conclusion is that in women with postmenopausal osteoporosis, a once-yearly infusion with zoledronic acid over a 3-year period significantly reduced the number of days that patients reported back pain, limited activity owing to back pain, and limited activity and bed rest owing to a fracture.

While high-technology has become pervasive in hospitals, domestic environments remain essentially low-tech and conventional, despite the care needs of an aging population wishing to age in place. In response, an interdisciplinary team - robotics engineer, architect, human factors psychologist and gerontologist - are designing, constructing, field testing, and evaluating comforTABLE, an intelligent environment for aging in place. comforTABLE is designed to increase the quality of life of both healthy individuals as well as persons with impaired mobility by intelligently supporting the physical organization of their immediate environment. While comforTABLE features intelligent behavior and robotic elements, comforTABLE aims to help people do things for themselves. This paper introduces the motivations for comforTABLE, presents its three intelligent, networked components and describes scenarios of how the system might operate in domestic situations.