Capturing ergonomics requirements in the global automotive industry

This thesis examines the issues surrounding the collection and dissemination of customer ergonomics requirements in the automotive industry. The aim of the research is to develop a Toolset of methods, known as the Lifestyle Scenario Toolset, for gathering customer requirements in overseas markets, and for presenting the information collected to design teams, taking a user-centred design approach. The Toolset was developed and evaluated with the co-operation of employees from a major UK automotive company. Four studies were conducted, the first comprised a series of interviews to establish the needs of both the data gatherers and data users for a Toolset of methods to collect and communicate overseas customer information. The data gatherers were drawn from the company's Market Researchers, Ergonomists and people responsible for the company's overseas operations. The data users were the design team responsible for the development of the company's next generation 4X4 vehicle. Results showed that the data collection tools which formed part I of the Toolset should be quick to use, require no ergonomics expertise to implement and be cost effective to use. The interviews with data users identified the need for tools which could communicate customer ergonomics requirements to them in a way which fitted in with their current working practices. In addition the tools needed to communicate information in language which was familiar to the design team, and be visually based where possible. The second study explored the development of suitable data collection tools for inclusion in the Lifestyle Scenario Toolset. Building on the needs identified in the first study together with information from the current literature a number of data collection tools were developed for inclusion in part I of the Lifestyle Scenario Toolset. These tools were a questionnaire, driving diary and photographs, focus group, ergonomics audit and background information tool. The tools were designed to collect a range of different data types, e.g. qualitative, quantitative, pictorial and customer verbatims, to provide a rich picture of users and their activities. The tools were used in a field trial to collect data from overseas customers about their ergonomics requirements and the tasks they carried out using their vehicle, in the context of their lifestyle. The third study focused on the development of a set of tools to communicate the data collected in part 1 of the Toolset, to the design team who would use it in their work. The data communication tools were developed to provide information to design teams at a number of levels, enabling them to use the data at an appropriate level for their needs. High level summaries of each of the tools were developed and scenarios presented on storyboards were used to integrate information from all of the data collection tools to provide detailed information about customers' ergonomics requirements and lifestyle. The data communication tools also used a variety of data types and presentation mediums, such as pictures, graphs and customer quotes to increase the richness of the data presented. The fourth study involved the evaluation of the suitability of the Toolset for collecting and communicating overseas customer ergonomics requirements. The data gatherers, and data users (design team) carried out a field trial using the Toolset to establish its usefulness to them in their work. The results of the evaluation showed that the data gatherers found the Toolset easy to implement and were able to use it to pick up overseas customers ergonomics requirements. The communication tools were able to provide the design team with new and useful customer ergonomics information, in a range of formats which they felt comfortable using in their work. The implementation of a user-centred design approach to the development of methods for collecting and communicating overseas customer ergonomics requirements enabled the creation of a Toolset which met the needs of the people who will use it. This increased its acceptance by people in the company and thus the likelihood of the Lifestyle Scenario Toolset's continued use within the company

A narrative review of literature on the use of health and social care by older trans adults: what can United Kingdom services learn?

This article has been accepted for publication and will appear in a revised form, subsequent to peer review and/or editorial input by Cambridge University Press, in Ageing & Society published by Cambridge University Press. Copyright The Author(s), 2021.We carried out a narrative review and thematic analysis of literature on the physical healthcare, mental healthcare and social care of trans older adults to ascertain what is known about older trans adults’ contacts with and use of health and social care. Thirty papers were found: a majority originated in the United States. Five themes were identified: experience of discrimination/ prejudice and disrespect; health inequalities; socioeconomic inequalities; positive practice; and staff training and education. The first three themes present challenges for providers and service users. Experiences of discrimination/ prejudice and disrespect over the course of their lives powerfully influence how older trans adults engage with care services and practitioners. Health and socio-economic inequalities suggest that older trans adults are likely to have greater need of services and care. The remaining two themes offer opportunities for service improvement. We conclude that more research is needed, that there is a strong argument for taking a life course perspective in a spirit of cultural humility, and that contextual societal factors influence service users and providers. We identify positive trans-inclusive practices which we commend to services. More needs to be done now to make older adult services appropriate and welcoming for trans service users

Attitudes of Female Warders towards inmate who self-harm: A pilot Exploratory Study from an Inner-city Prison in South India

Self-harm is a global public health challenge. The management and treatment of those who self-harm is emotionally challenging, and can sometimes manifest in negative attitudes amongst staff who provide care. Health professional’s attitudes towards deliberate self-harm have been studied globally, however, evidence regarding prison staff attitudes is sparse, and particularly lacking in India. The primary aim of this study was to explore the attitudes of female prison warders towards prison inmates who self-harm in an Indian setting. A cross-sectional survey using a questionnaire to measure knowledge and attitudes was administered to prison warders from one city prison in South India. Out of the 210 approached to participate, 170 female warders completed the survey questionnaire. In general, sociodemographic factors of the prison warders were unrelated to their attitudes towards self-harm, and a negligible few had received any training specific to self-harm. A series of educational and skills recommendations have been developed from the study, which can be used to inform intervention initiatives and further, provide a basis for cross-cultural professional comparison studies. Current resources, cultures, practice and context must be considered in any future interventions aimed at progressing the evidence base further. In addition, training and education for staff should include information on knowledge and attitudes about causes, reasons, motivations, forms and purpose of self-harm. Records of staff responses to those who self-harm, irrespective of setting, should include assessment, management, interventions undertaken and incorporated daily practice. Importantly, this work may influence prisoner treatment outcomes and is worthy of further study

Hydromechanical characterisation of a highly expansive clay

The hydromechanical properties of a South African expansive clay are reported. In this study,swell potential and swell pressure were assessed by two oedometric approaches, namely, the loading after wetting test and the wetting after loading test. The data indicate that predictions of swell pressure from the two approaches remain similar, whereas greater predictions of heave are obtained for the loading after wetting approach. It is also observed that the magnitude of predicted heave from the loading after wetting test is dependent on the soaking stress considered, with greater swell being obtained for lower soaking stresses. Measurements of primary drying and wetting curves illustrate appreciable hysteresis in the intermediate suction range (≈17 MPa). The discrepancy of this finding with that of a previous study is attributed to differences in fabric. Additionally, when examining the volumetric response of a sample subjected to a drying and wetting path, negligible hysteresis is observed when void ratio is plotted as a function of gravimetric water content. Conversely, when the shrinkage/swell curves are plotted in terms of suction, irreversibly volumetric changes are apparent

Exergames for falls prevention in sheltered homes:A feasibility study

Introduction:Falls prevention is a global priority given its substantial impact on older adults and cost to healthcare systems. Advances in telerehabilitation technology such as `exergaming’ show potential for delivering accessible, engaging exercise programs for older adults. This study aimed to establish the feasibility, acceptability and usability of exergaming in sheltered housing.Methods: A mixed-methods study with participants randomised in 2 sheltered housing facilities to intervention (n = 1 home, 12 participants) and control (n = 1 home 2, 12 participants) provided usual care for all, (physiotherapy prescribed strength and balance exercises and falls prevention advice) and a 6-week supervised exergaming programme (MIRA) offered 3 times per week to the intervention group only. At 6 weeks, feasibility, usability and acceptability outcomes were collected and analysed using descriptive statistics; qualitative focus groups with participants and interviews with staff were also completed and thematically analysed to elicit barriers and facilitators to usability and acceptability.Results: Mean exercise per week increased from 10.6 to 14.1 minutes in the control group and 9.6 to 36.8 minutes in the intervention group. All study processes and measures appeared feasible; 72% of those invited consented to taking part and 92% completed 6-week follow-up. Individual domains for the System Usability Scores (SUS) showed participants felt veryconfident’usingthesystemwith⊃port(70%),wod−’sinℎℎ⊃or(70%),̲like to use exergames frequently’ (50%) and found the system easy→use’(90%).However,theyalsofe&lt;they→’(90%).,ℎ&lt;ℎneeded to learn a lot at the beginning’ (40%) and would `need technical support’ (70%) for independent use of the exergames. Mean overall SUS was 63 reflecting moderate usability for independent use. Qualitative data indicated exergames were well received and highlighted motivational and social aspects; costs and set up. Staff also felt exergaming complemented traditional care.Discussion: Our study contributes to the evidence guiding the use of exergames to deliver suitable falls prevention interventions for older adults within sheltered housing in community settings.<br/

Exergames for falls prevention in sheltered homes:A feasibility study

Introduction:Falls prevention is a global priority given its substantial impact on older adults and cost to healthcare systems. Advances in telerehabilitation technology such as `exergaming’ show potential for delivering accessible, engaging exercise programs for older adults. This study aimed to establish the feasibility, acceptability and usability of exergaming in sheltered housing.Methods: A mixed-methods study with participants randomised in 2 sheltered housing facilities to intervention (n = 1 home, 12 participants) and control (n = 1 home 2, 12 participants) provided usual care for all, (physiotherapy prescribed strength and balance exercises and falls prevention advice) and a 6-week supervised exergaming programme (MIRA) offered 3 times per week to the intervention group only. At 6 weeks, feasibility, usability and acceptability outcomes were collected and analysed using descriptive statistics; qualitative focus groups with participants and interviews with staff were also completed and thematically analysed to elicit barriers and facilitators to usability and acceptability.Results: Mean exercise per week increased from 10.6 to 14.1 minutes in the control group and 9.6 to 36.8 minutes in the intervention group. All study processes and measures appeared feasible; 72% of those invited consented to taking part and 92% completed 6-week follow-up. Individual domains for the System Usability Scores (SUS) showed participants felt veryconfident’usingthesystemwith⊃port(70%),wod−’sinℎℎ⊃or(70%),̲like to use exergames frequently’ (50%) and found the system easy→use’(90%).However,theyalsofe&lt;they→’(90%).,ℎ&lt;ℎneeded to learn a lot at the beginning’ (40%) and would `need technical support’ (70%) for independent use of the exergames. Mean overall SUS was 63 reflecting moderate usability for independent use. Qualitative data indicated exergames were well received and highlighted motivational and social aspects; costs and set up. Staff also felt exergaming complemented traditional care.Discussion: Our study contributes to the evidence guiding the use of exergames to deliver suitable falls prevention interventions for older adults within sheltered housing in community settings.<br/

The impact of physical activity and exercise interventions on symptoms for women experiencing menopause: overview of reviews

Background Women experiencing problematic menopausal symptoms report lower health-related quality of life and greater healthcare use than women without symptoms. Not all women want to or are able to take hormone replacement therapy. Strengthening the evidence for menopause symptom-management options, including physical activity, improves agency for women. Aim This overview assesses effectiveness of physical activity and exercise interventions targeting women experiencing menopause symptoms. Methods Medline, Embase, CINAHL, Scopus, The Cochrane Database of Systematic Reviews and Social Science Citation Index were searched (June 2023) for systematic reviews of physical activity and exercise interventions targeting women experiencing menopause. Reviews were assessed using AMSTAR-2 and a best-evidence approach to synthesis without meta-analysis (SWIM) was adopted. The protocol was registered on PROSPERO (CRD42022298908). Results Seventeen reviews included 80 unique relevant primary studies with 8983 participants. There is evidence showing improvement of physical, urogenital, and total symptoms following yoga interventions. Evidence for vasomotor and psychological symptoms was inconclusive. Findings for aerobic exercise were inconclusive although there were some examples of beneficial effects on total and vasomotor symptoms. Evidence was very limited for other types of physical activity and impact on physical, sexual and urogenital symptoms. Conclusion There is some evidence that yoga, and to lesser extent, aerobic exercise may be beneficial for some menopause symptoms, but there is insufficient evidence to recommend a particular form of exercise. Current reviews categorise women on menopause status; broadening this to include ethnicity, income status, employment and other factors will allow better understanding of context for successful interventions

Exergames for falls prevention in sheltered homes: a feasibility study

IntroductionFalls prevention is a global priority given its substantial impact on older adults and cost to healthcare systems. Advances in telerehabilitation technology such as `exergaming’ show potential for delivering accessible, engaging exercise programs for older adults. This study aimed to establish the feasibility, acceptability and usability of exergaming in sheltered housing.MethodsA mixed-methods study with participants randomised in 2 sheltered housing facilities to intervention (n = 1 home, 12 participants) and control (n = 1 home 2, 12 participants) provided usual care for all, (physiotherapy prescribed strength and balance exercises and falls prevention advice) and a 6-week supervised exergaming programme (MIRA) offered 3 times per week to the intervention group only. At 6 weeks, feasibility, usability and acceptability outcomes were collected and analysed using descriptive statistics; qualitative focus groups with participants and interviews with staff were also completed and thematically analysed to elicit barriers and facilitators to usability and acceptability.ResultsMean exercise per week increased from 10.6 to 14.1 minutes in the control group and 9.6 to 36.8 minutes in the intervention group. All study processes and measures appeared feasible; 72% of those invited consented to taking part and 92% completed 6-week follow-up. Individual domains for the System Usability Scores (SUS) showed participants felt `very confident’ using the system with support (70%), would `like to use exergames frequently’ (50%) and found the system `easy to use’ (90%). However, they also felt they `needed to learn a lot at the beginning’ (40%) and would `need technical support’ (70%) for independent use of the exergames. Mean overall SUS was 63 reflecting moderate usability for independent use. Qualitative data indicated exergames were well received and highlighted motivational and social aspects; costs and set up. Staff also felt exergaming complemented traditional care.DiscussionOur study contributes to the evidence guiding the use of exergames to deliver suitable falls prevention interventions for older adults within sheltered housing in community settings

The association between delirium and falls in older adults in the community: a systematic review and meta-analysis

\ua9 The Author(s) 2024. Published by Oxford University Press on behalf of the British Geriatrics Society. OBJECTIVE: Systematically review and critically appraise the evidence for the association between delirium and falls in community-dwelling adults aged ≥60 years. METHODS: We searched EMBASE, MEDLINE, PsycINFO, Cochrane Database of Systematic Reviews, CINAHL and Evidence-Based Medicine Reviews databases in April 2023. Standard methods were used to screen, extract data, assess risk of bias (using Newcastle-Ottawa scale), provide a narrative synthesis and, where appropriate, conduct meta-analysis. RESULTS: We included 8 studies, with at least 3505 unique participants. Five found limited evidence for an association between delirium and subsequent falls: one adjusted study showed an increase in falls (risk ratio 6.66; 95% confidence interval (CI) 2.16-20.53), but the evidence was low certainty. Four non-adjusted studies found no clear effect. Three studies (one with two subgroups treated separately) found some evidence for an association between falls and subsequent delirium: meta-analysis of three adjusted studies showed an increase in delirium (pooled odds ratio 2.01; 95% CI 1.52-2.66); one subgroup of non-adjusted data found no clear effect. Number of falls and fallers were reported in the studies. Four studies and one subgroup were at high risk of bias and one study had some concerns. CONCLUSIONS: We found limited evidence for the association between delirium and falls. More methodologically rigorous research is needed to understand the complex relationship and establish how and why this operates bidirectionally. Studies must consider confounding factors such as dementia, frailty and comorbidity in their design, to identify potential modifying factors involved. Clinicians should be aware of the potential relationship between these common presentations