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  • 1.
    Ahlstrand, I.
    et al.
    School of Health Sciences, Jönköping University, Jönköping, Sweden.
    Thyberg, Ingrid
    Linköping University, Department of Clinical and Experimental Medicine, Division of Neuro and Inflammation Science. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Heart and Medicine Center, Department of Rheumatology.
    Falkmer, Torbjörn
    Linköping University, Department of Medical and Health Sciences, Division of Community Medicine. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Pain and Rehabilitation Center. School of Health Sciences, Jönköping University, Jönköping, Sweden; School of Occupational Therapy and Social Work, CHIRI, Curtin University, Perth, WA, Australia.
    Dahlström, Örjan
    Linköping University, Department of Behavioural Sciences and Learning, Disability Research. Linköping University, Faculty of Arts and Sciences. Linköping University, The Swedish Institute for Disability Research.
    Björk, Mathilda
    Linköping University, Department of Clinical and Experimental Medicine. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Heart and Medicine Center, Rehabilitation Center. School of Health Sciences, Jönköping University, Jönköping, Sweden.
    Pain and activity limitations in women and men with contemporary treated early RA compared to 10 years ago: the Swedish TIRA project2015In: Scandinavian Journal of Rheumatology, ISSN 0300-9742, E-ISSN 1502-7732, Vol. 44, no 4, p. 259-264Article in journal (Refereed)
    Abstract [en]

    Objectives: To study differences regarding pain and activity limitations during the 3 years following diagnosis in women and men with contemporary treated early RA compared with their counterparts who were diagnosed 10 years earlier. Method: This study was based on patients recruited to the Early Intervention in RA (TIRA) project. In the first cohort (TIRA-1) 320 patients were included in time for diagnosis during 1996-1998 and 463 patients were included in the second cohort (TIRA-2) during 2006-2009. Disease activity, pain intensity (Visual Analogue Scale, VAS), bodily pain (BP) in the 36-item Short Form Health Survey (SF-36), activity limitations (Health Assessment Questionnaire, HAQ), and medication were reported at inclusion and at follow-up after 1, 2, and 3 years. Results: Disease activity, pain, and activity limitations were pronounced at inclusion across both genders and in both cohorts, with some improvement observed during the first year after diagnosis. Disease activity did not differ between cohorts at inclusion but was significantly lower at the follow-ups in the TIRA-2 cohort, in which the patients were prescribed traditional disease-modifying anti-rheumatic drugs (DMARDs) and biological agents more frequently. In TIRA-2, patients reported significantly lower pain and activity limitations at all follow-ups, with men reporting lower pain than women. Women reported significantly higher activity limitations at all time points in TIRA-2. Conclusions: Pain and activity limitations were still pronounced in the contemporary treated early RA cohort compared with their counterparts diagnosed 10 years earlier and both of these factors need to be addressed in clinical settings.

  • 2.
    Ahlstrand, Inger
    et al.
    ADULT, HHJ, Hälsohögskolan, Högskolan i Jönköping.
    Björk, Mathilda
    Avd. för rehabilitering, HHJ, Hälsohögskolan, Högskolan i Jönköping.
    Thyberg, Ingrid
    Linköping University, Department of Medical and Health Sciences, Rehabilitation Medicine. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Heart and Medicine Center, Department of Rheumatology.
    Börsbo, Björn
    Linköping University, Department of Medical and Health Sciences, Rehabilitation Medicine. Linköping University, Faculty of Health Sciences.
    Falkmer, Torbjörn
    Linköping University, Department of Medical and Health Sciences, Rehabilitation Medicine. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Local Health Care Services in Central Östergötland, Habilitation in Central County.
    Pain and daily activities in Rheumatoid Arthritis2012In: Disability and Rehabilitation, ISSN 0963-8288, E-ISSN 1464-5165, Vol. 34, no 15, p. 1245-1253Article in journal (Refereed)
    Abstract [en]

    Aim: The aim of this study was to describe experiences of pain and its relationship to daily activities in people with rheumatoid arthritis (RA). Method: Seven semi-structured focus group discussions were conducted with 33 men and women of different ages with RA. Data were analysed with content analysis. Results: Pain affected everyday life and may be a barrier to perform valued activities. Regarding the impact of pain on participation and independence, personal factors and the social environment were found to be important. It could be a struggle to find the right activity balance, since it was easy to be overactive, triggering subsequent elevation of pain levels. However, the participants also described activities as a mediator of pain and a distraction from it. Conclusion: The relationship between pain and daily activities in RA was complex. Pain as an impairment was expressed to be related to activity limitations and participation restrictions, as well as to contextual factors. These findings highlight the clinical importance of paying attention to the complexity of pain and its relation to daily activities and participation.

  • 3.
    Ahlstrand, Inger
    et al.
    Hälsohögskolan, Högskolan i Jönköping, HHJ, Avd. för rehabilitering.
    Björk, Mathilda
    Hälsohögskolan, Högskolan i Jönköping, HHJ, Avd. för rehabilitering.
    Thyberg, Ingrid
    Linköping University, Department of Clinical and Experimental Medicine, Rheumatology. Linköping University, Faculty of Health Sciences.
    Börsbo, Björn
    Linköping University, Department of Clinical and Experimental Medicine, Rehabilitation Medicine. Linköping University, Faculty of Health Sciences.
    Falkmer, Torbjörn
    Hälsohögskolan, Högskolan i Jönköping, HHJ, Avd. för rehabilitering.
    Smärta och dagliga aktiviteter vid Reumatoid artrit ur ett patientperspektiv2011Conference paper (Other academic)
    Abstract [sv]

    Bakgrund: Smärta vid Reumatoid artrit (RA) ärett välkänt symtom som orsakar lidande ochaktivitetsbegränsning. Traditionellt mäts smärtainom reumatologin som smärtintensitet på enVisuell Analog Skala (VAS). Kunskapen kring hurpatienter med RA upplever smärta och dess konsekvenser är begränsad. Patientens egenbeskrivning behövs som underlag för behandlingsplanering och för att utveckla nya metoderför att beskriva problematiken.Syfte: Syftet med studien är att beskriva smärtavid RA ur ett patientperspektiv med fokus på hursmärtan påverkar dagliga aktiviteter.Metod: Patienter med diagnostiserad RA i syd-östra Sverige identifierades via Svenska Reumatologiregistret. Urvalet baserades på minst 5 årssjukdomsduration och minst 40 mm smärtintensitet på VAS vid de två senaste besöken på reumatologklinik. Sammanlagt 33 patienter, 7 män och26 kvinnor, deltog i sju fokusgrupper. Gruppernaformades utifrån kön och ålder. Intervjuguideninnehöll frågor som: Hur beskriver patienter medRA sin smärta? Vad påverkar smärtan? Vilkakonsekvenser har smärtan för aktivitetsutförande,aktivitetsbalans och undvikande av aktivitet? Enkvalitativ innehållsanalys görs.Resultat/förväntat resultat: Analyser hittills visar patienternas frustration över att inteklara det man vill eller behöver göra, beroendeav andra, minskade möjligheter till delaktigheti sociala sammanhang. Och närståendes betydelse. Analyserna visar att smärtan är relaterad till Göteborg6-8 april 201134trötthet, stress och sinnesstämning och att arbeteeller andra aktiviteter medverkar till att glömmabort smärtan och uppehålla förmåga. Analysenslutförs under hösten.Konklusion: Denna studie förväntas genererany angelägen kunskap om och förståelse försmärta.

  • 4.
    Ahlstrand, Inger
    et al.
    Jonköping University, Sweden.
    Björk, Mathilda
    Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Heart and Medicine Center, Rehabilitation Center. Linköping University, Department of Medical and Health Sciences, Division of Community Medicine. Jonköping University, Sweden.
    Thyberg, Ingrid
    Linköping University, Department of Clinical and Experimental Medicine, Division of Neuro and Inflammation Science. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Heart and Medicine Center, Department of Rheumatology.
    Falkmer, Torbjörn
    Linköping University, Department of Medical and Health Sciences, Division of Community Medicine. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Pain and Rehabilitation Center. Jonköping University, Sweden; Curtin University, Australia.
    Pain and difficulties performing valued life activities in women and men with rheumatoid arthritis2015In: Clinical Rheumatology, ISSN 0770-3198, E-ISSN 1434-9949, Vol. 34, no 8, p. 1353-1362Article in journal (Refereed)
    Abstract [en]

    This study aimed to examine the difficulties with performing valued life activities in relation to pain intensity in women and men with rheumatoid arthritis (RA). In total, 737 persons with RA (73 % women) from three rheumatology units in Sweden responded to a questionnaire measuring performance of 33 valued life activities and self-rated pain. The relationships between performance of valued life activities (VLAs) and pain (measured by visual analogue scale (VAS)) were analysed based on gender. Multiple linear regression analyses were conducted with the total VLA score as dependent variable. Women reported more pain and difficulties in performing valued life activities than men. Across genders, 85 % reported at least one valued life activity affected by RA. Significantly more women than men encountered difficulties in performing some activities such as cooking, gardening and meeting new people. Women reported higher pain intensity (35 mm) than men (31 mm). Almost all 33 difficulty ratings for valued life activities were higher among persons with high pain (greater than 40 mm) than persons with lower pain. Difficulty ratings for valued life activities correlated positively with pain in persons with lower pain, but not among those with high pain. The results highlight the importance of addressing pain, especially among women with RA, as they reported pain to impact on their valued life activities. Interestingly, this was evident also in women with lower levels of pain.

  • 5.
    Ahlstrand, Inger
    et al.
    School of Health and Welfare, Jönköping University, Jönköping, Sweden.
    Vaz, Sharmila
    School of Occupational Therapy & Social Work, CHIRI, Curtin University, Perth, WA, Australia.
    Falkmer, Torbjörn
    Linköping University, Department of Medical and Health Sciences, Division of Community Medicine. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Pain and Rehabilitation Center. School of Health and Welfare, Jönköping University, Jönköping, Sweden.
    Thyberg, Ingrid
    Linköping University, Department of Clinical and Experimental Medicine, Division of Neuro and Inflammation Science. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Heart and Medicine Center, Department of Rheumatology.
    Björk, Mathilda
    Linköping University, Department of Social and Welfare Studies, Division of Occupational Therapy. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Heart and Medicine Center, Department of Rheumatology.
    Self-efficacy and pain acceptance as mediators of the relationship between pain and performance of valued life activities in women and men with rheumatoid arthritis2017In: Clinical Rehabilitation, ISSN 0269-2155, E-ISSN 1477-0873, Vol. 31, no 6, p. 824-834Article in journal (Refereed)
    Abstract [en]

    OBJECTIVE: To study whether personal factors (self-efficacy and pain acceptance) mediate the relationship between pain and performance of valued life activities in persons with rheumatoid arthritis.

    METHODS: Persons with rheumatoid arthritis for at least four years (n = 737; 73% women) answered a questionnaire measuring self-efficacy, pain acceptance, performance of valued life activities, and self-rated pain. Relationships among these constructs were explored using univariate and multivariate analyses. Structural equation modelling was then used to examine the mediational role of personal factors on the relationship between pain and performance of valued life activities.

    RESULTS: A direct negative association between pain and performance of valued life activities was identified (Beta = .34, P < .001). This suggests that people with rheumatoid arthritis who had higher levels of pain has increased difficulties in performing valued life activities. Self-efficacy and activity engagement component of pain acceptance mediated the relationship between pain and performance of valued life activities, however the pain willingness component of pain acceptance did not influence participation in valued life activities.

    CONCLUSION: These findings highlight the importance of considering personal factors, such as pain acceptance and self-efficacy, in facilitating participation in valued life activities.

  • 6.
    Albertsson, Pontus
    et al.
    Umeå Universitet.
    Björnstig, Ulf
    Umeå Universitet.
    Petzäll, Jan
    Vägverket.
    Falkmer, Torbjörn
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Neuroscience and Locomotion, Rehabilitation Medicine. Östergötlands Läns Landsting, Local Health Care Services in Central Östergötland, Paediatric Habilitation Community Service.
    Näsman, Yvonne
    Räddningsverket, Sandö.
    Utrymningsförsök av passagerare ur buss vid brand och brandtillbud samt antalet bränder och brandtillbud i bussar i Sverige2006In: Akuttjournalen: Tidsskrift for avansert akuttmedisin, ISSN 0805-6129, E-ISSN 1500-7480, Vol. 14, p. 85-91Article in journal (Refereed)
    Abstract [sv]

       

  • 7.
    Albertsson, Pontus
    et al.
    Umeå Universitetet.
    Falkmer, Torbjörn
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Neuroscience and Locomotion, Rehabilitation Medicine. Östergötlands Läns Landsting, Local Health Care Services in Central Östergötland, Paediatric Habilitation Community Service.
    Is there a pattern in European bus and coach incidents? A literature analysis with special focus on injury causation and injury mechanisms2005In: Accident Analysis and Prevention, ISSN 0001-4575, E-ISSN 1879-2057, Vol. 37, no 2, p. 225-233Article in journal (Refereed)
    Abstract [en]

    In order to identify and describe a pattern in bus and coach incident related injuries and fatalities, and to suggest possible future measures for improvement of bus and coach safety, a literature analysis was performed. The results formed a multi-faceted pattern, which briefly can be described as follows, women travelled more frequently by bus as compared to men. Injuries sustained predominantly affected women 60 years of age and older. Of all traffic fatalities in Europe, bus and coach fatalities represented 0.3-0.5%. In the OECD countries, the risk of being killed or seriously injured was found to be seven to nine times lower for bus and coach occupants as compared to those of car occupants. Despite the fact that fatalities were more frequent on rural roads, a vast majority of all bus and coach casualties occurred on urban roads and in dry weather conditions. Boarding and alighting caused about one-third of all injury cases. Collisions were a major injury-contributing factor. Buses and coaches most frequently collided with cars, but unprotected road users were hit in about one-third of all cases of a collision, the point of impact on the bus or the coach being typically frontal or side. Rollovers occurred in almost all cases of severe coach crashes. In this type of crash projection, total ejection, partial ejection, intrusion and smoke inhalation were the main injury mechanisms and among those, ejection being the most dangerous. A 2-point belt may prevent passenger ejection, but in frontal crashes when the upper abdominal parts and the head hit the seatback in front, it could, however, contribute to head and thoracic injuries. Hence, a 3-point belt provides the best restraint in rollovers and frontal crashes. © 2004 Elsevier Ltd. All rights reserved.

  • 8.
    Albertsson, Pontus
    et al.
    Umeå Universitet.
    Falkmer, Torbjörn
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Neuroscience and Locomotion, Rehabilitation Medicine. Östergötlands Läns Landsting, Local Health Care Services in Central Östergötland, Paediatric Habilitation Community Service.
    Kirk, Alan
    Loughborough University, UK.
    Mayrhofer, Erich
    University of Technology, Graz, Austria.
    Björnstig, Ulf
    Umeå Universitet.
    Case study: 128 Injured in rollover coach crashes in Sweden - Injury outcome, mechanisms and possible effects of seat belts2006In: Safety Science, ISSN 0925-7535, E-ISSN 1879-1042, Vol. 44, no 2, p. 87-109Article in journal (Refereed)
    Abstract [en]

    The risk for injuries in rollover coach crashes are dependent on whether the occupants are belted or not. However, the influence of the different belt systems for reducing injuries has remained unclear. Since many injuries sustained are caused by impacts with the interior, passenger interactions or ejection through a window, the advantages by proper seat belt systems are evident. In this study, representing the most common serious crash scenario for serious injury, 128 injured in rollover cases were analysed with regard to the injury outcome, mechanisms and the possible injury reduction for occupants when using a safety belt. Furthermore, the different belt systems were compared to explain their contribution to increased safety. Based on medical reports and questioning of the passengers, the injuries sustained are recorded according to the AIS classification. The next step was the identification of the injury mechanisms, using the passenger statements as well as results from numerical occupant simulations. It is important to mention that this study was purely focused on detection of the injury mechanism to avoid the reported injuries. The possibility of additional injuries due to the wearing of a belt were not taken into account. However, the analysis of the 128 injured showed a considerable increase in safety for belted occupants through limiting interior contacts, minimising passenger interaction and reducing the possibility of ejection. © 2005 Elsevier Ltd. All rights reserved.

  • 9.
    Albrecht, Matthew A.
    et al.
    Curtin University, Australia .
    Stuart, Geoffrey W.
    La Trobe University, Australia .
    Falkmer, Marita
    Curtin University, Australia, Jonköping University, Sweden .
    Ordqvist, Anna
    Linköping University, Department of Medical and Health Sciences, Division of Community Medicine. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Anaesthetics, Operations and Specialty Surgery Center, Pain and Rehabilitation Center.
    Leung, Denise
    Curtin University, Australia .
    Foster, Jonathan K.
    Curtin University, Australia Health Department WA, Australia .
    Falkmer, Torbjörn
    Linköping University, Department of Medical and Health Sciences, Division of Community Medicine. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Anaesthetics, Operations and Specialty Surgery Center, Pain and Rehabilitation Center.
    Brief Report: Visual Acuity in Children with Autism Spectrum Disorders2014In: Journal of autism and developmental disorders, ISSN 0162-3257, E-ISSN 1573-3432, Vol. 44, no 9, p. 2369-2374Article in journal (Refereed)
    Abstract [en]

    Recently, there has been heightened interest in suggestions of enhanced visual acuity in autism spectrum disorders (ASD) which was sparked by evidence that was later accepted to be methodologically flawed. However, a recent study that claimed children with ASD have enhanced visual acuity (Brosnan et al. in J Autism Dev Disord 42:2491-2497, 2012) repeated a critical methodological flaw by using an inappropriate viewing distance for a computerised acuity test, placing the findings in doubt. We examined visual acuity in 31 children with ASD and 33 controls using the 2 m 2000 Series Revised Early Treatment Diabetic Retinopathy Study chart placed at twice the conventional distance to better evaluate possible enhanced acuity. Children with ASD did not demonstrate superior acuity. The current findings strengthen the argument that reports of enhanced acuity in ASD are due to methodological flaws and challenges the reported association between visual acuity and systemising type behaviours.

  • 10.
    Almberg, Maria
    et al.
    Mobil Centre Gothenburg, Sweden.
    Selander, Helena
    Mobil Centre Gothenburg, Sweden; University of Gothenburg, Sweden.
    Falkmer, Marita
    Curtin University, Australia; Jonköping University, Sweden.
    Vaz, Sharmila
    Curtin University, Australia.
    Ciccarelli, Marina
    Curtin University, Australia.
    Falkmer, Torbjörn
    Linköping University, Department of Medical and Health Sciences, Division of Community Medicine. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Pain and Rehabilitation Center. Curtin University, Australia.
    Experiences of facilitators or barriers in driving education from learner and novice drivers with ADHD or ASD and their driving instructors2017In: Developmental Neurorehabilitation, ISSN 1751-8423, E-ISSN 1751-8431, Vol. 20, no 2, p. 59-67Article in journal (Refereed)
    Abstract [en]

    Background: Little is known about whether individuals with autism spectrum disorder (ASD) or attention deficit hyperactive disorder (ADHD) experience any specific facilitators or barriers to driving education. Objective: To explore the facilitators or barriers to driving education experienced by individuals with ASD or ADHD who obtained a learners permit, from the perspective of the learner drivers and their driving instructors. Methods: Datawere collected from33 participants with ASD or ADHD, and nine of their driving instructors. Results: Participants with ASD required twice asmany driving lessons andmore on-road tests than those with ADHD. Participants with ADHD repeated the written tests more than those with ASD. Driving license theory was more challenging for individuals with ADHD, whilst individuals with ASD found translating theory into practice and adjusting to "unfamiliar driving situations to be the greatest challenges. Conclusion: Obtaining a driving license was associated with stressful training experience.

  • 11.
    Anund, Anna
    et al.
    Swedish Road and Transport Research Institute, Linköping, Sweden.
    Dukic, Tania
    Swedish Road and Transport Research Institute, Linköping, Sweden.
    Börsbo, Björn
    Linköping University, Department of Medical and Health Sciences, Rehabilitation Medicine. Linköping University, Faculty of Health Sciences.
    Falkmer, Torbjörn
    Linköping University, Department of Medical and Health Sciences, Rehabilitation Medicine. Linköping University, Faculty of Health Sciences. Curtin University of Technology, Perth, WA, Australia .
    Piloting smart safe school bus: exploration of security gains from implementation of a driver support system, additional technical equipment and intelligent bus stops2010In: European Transport Research Review, ISSN 1867-0717, E-ISSN 1866-8887, Vol. 2, no 3, p. 157-163Article in journal (Refereed)
    Abstract [en]

    Purpose

    Road crash statistics reveal that school children are frequent victims and the most risky situation is when the child is outside the bus. The aim of this pilot study was to explore possible changes in speed, implementation of routines, hazard detection and child security gains from a driver support system integrated with intelligent bus stops and additional technical equipment.

    Methods

    In total, 130 children with transmitters were using two specially equipped busses and bus stops. Speed of oncoming and overtaking cars, implementation of routines, the possibilities to discover potential hazards and experienced stress in the children were analysed by speed measurements, diary notes, questionnaires and focus group interviews.

    Results

    This pilot study exploration showed that the speeds of other road users were reduced at one of two bus stops. The driver support system was frequently used in all its parts and was considered useful by the bus drivers. It also raised the level of routines and allowed the drivers to survey the children. Children reported feeling more secure with the system running and experienced less stress as a consequence of it.

    Conclusion

    This pilot study shows that the evaluated systems may have the ability to reduce speed of other road users, raise the level of routines and make children feel more secure. Further studies are needed that apply a holistic approach on school transportation safety and security.

  • 12.
    Anund, Anna
    et al.
    VTI.
    Kronqvist, Linda
    VTI.
    Falkmer, Torbjörn
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Neuroscience and Locomotion, Rehabilitation Medicine. Östergötlands Läns Landsting, Local Health Care Services in Central Östergötland, Paediatric Habilitation Community Service.
    Är kraven på utmärkning av skolskjutsfordon utmärkta2005Report (Other academic)
  • 13.
    Barns, Angela
    et al.
    Curtin University, Perth, Western Australia, Australia.
    Svanholm, Frida
    Linköping University, Department of Medical and Health Sciences.
    Kjellberg, Anette
    Linköping University, Department of Social and Welfare Studies, Division of Occupational Therapy. Linköping University, Faculty of Medicine and Health Sciences.
    Thyberg, Ingrid
    Linköping University, Department of Clinical and Experimental Medicine, Division of Neuro and Inflammation Science. Linköping University, Faculty of Medicine and Health Sciences. Östergötlands Läns Landsting, Heart and Medicine Center, Department of Rheumatology.
    Falkmer, Torbjörn
    Linköping University, Department of Medical and Health Sciences, Division of Community Medicine. Linköping University, Faculty of Medicine and Health Sciences. Östergötlands Läns Landsting, Anaesthetics, Operations and Specialty Surgery Center, Pain and Rehabilitation Center. Curtin University, Perth, Western Australia, Australia.
    Living in the present: Women's everyday experiences of living with rheumatoid arthritis2015In: SAGE Open, ISSN 2158-2440, E-ISSN 2158-2440, Vol. 5, no 4, p. 1-13Article in journal (Refereed)
    Abstract [en]

    This article presents the findings from a qualitative research project exploring eight women’s experiences of living with rheumatoid arthritis (RA). Through semistructured interviews, the women provided insights into the physical, emotional, and social impacts of RA and the “work” involved in negotiating its influence in the everyday life. In narrating their experiences of adapting to RA, the women express a common desire for “normalcy,” to return to a time and space before the disruption of RA. The women’s accounts also emphasized the interrelatedness between bodily experience and constructions of self, highlighting the corporeal nature of RA and the constant shaping and reshaping of personal meanings and values.

  • 14.
    Bergström, Maria
    et al.
    Linköping University, Department of Social and Welfare Studies, Division of Occupational Therapy. Linköping University, Faculty of Medicine and Health Sciences.
    Ahlstrand, Inger
    Jönköping University, Sweden.
    Thyberg, Ingrid
    Linköping University, Department of Clinical and Experimental Medicine, Division of Neuro and Inflammation Science. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Heart and Medicine Center, Department of Rheumatology.
    Falkmer, Torbjörn
    Linköping University, Department of Medical and Health Sciences, Division of Community Medicine. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Pain and Rehabilitation Center. Jonköping University, Sweden; Curtin University, Australia.
    Börsbo, Björn
    Linköping University, Department of Medical and Health Sciences, Division of Community Medicine. Linköping University, Faculty of Medicine and Health Sciences.
    Björk, Mathilda
    Linköping University, Department of Social and Welfare Studies, Division of Occupational Therapy. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Heart and Medicine Center, Department of Rheumatology.
    Like the worst toothache you've had - How people with rheumatoid arthritis describe and manage pain2017In: Scandinavian Journal of Occupational Therapy, ISSN 1103-8128, E-ISSN 1651-2014, Vol. 24, no 6, p. 468-476Article in journal (Refereed)
    Abstract [en]

    Background: Rheumatoid arthritis (RA) is a chronic inflammatory disease often associated with disability. Despite new treatments, pain and activity limitations are still present. Objectives: To describe how persons with RA experience and manage pain in their daily life. Methods: Seven semi-structured focus groups (FGs) were conducted and analyzed using content analysis. Results: The analysis revealed four categories: 1) Pain expresses itself in different ways referred to pain as overwhelming, aching or as a feeling of stiffness. 2) Mitigating pain referred to the use of heat, cold, medications and activities as distractions from the pain. 3) Adapting to pain referred to strategies employed as coping mechanisms for the pain, e.g. planning and adjustment of daily activities, and use of assistive devices. 4) Pain in a social context referred to the participants social environment as being both supportive and uncomprehending, the latter causing patients to hide their pain. Conclusions: Pain in RA is experienced in different ways. This emphasizes the multi-professional team to address this spectrum of experiences and to find pain management directed to the individual experience that also include the persons social environment.

  • 15.
    Bjelkemyr, Anna
    et al.
    SAFER Vehicle and Traffic Safety Centre at Chalmers, Gothenburg, Sweden.
    Dukic, Tania
    Swedish National Road and Transport Research Institute (VTI), Gothenburg, Sweden.
    Owens, Rachel
    Curtin University, Perth, Australia.
    Falkmer, Torbjörn
    Linköping University, Department of Medical and Health Sciences, Rehabilitation Medicine. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Anaesthetics, Operations and Specialty Surgery Center, Pain and Rehabilitation Center. Curtin University, Perth, Australia.
    Lee, Hoe C.
    Curtin University, Perth, Australia.
    Support Systems Designed for Older Drivers to Achieve Safe and Comfortable Driving2013In: Journal of Transportation Technologies, ISSN 2160-0473, E-ISSN 2160-0481, Vol. 3, no 4, p. 233-240Article in journal (Refereed)
    Abstract [en]

    Background: The number of older people is increasing. Many of them expect to maintain a rich social life and to con- tinue driving at an older age. Objective: The present study investigates the mechanisms behind self-regulation and driving cessation in order to suggest development of support systems to prolong older drivers’ safe mobility. Method: Three focus groups were conducted with 19 older active drivers aged 65+ who were divided according to annual mile- age driven. Results: A content analysis revealed broad self-regulatory behaviour as already reported in the literature, e.g., avoiding driving at rush hour and at night. The participants also reported difficulty in finding the way to their final destination and an increasing need to plan their travelling. Co-piloting was a behaviour applied by couples to cope with difficulties encountered in traffic. A large part of the discussion was focused on emerging feelings of stress, anxiety and fear when driving in recent years, a feeling induced by external factors e.g., other road users’ behaviour, traffic density or high speed. Apart from health problems, high levels of stress could explain driving cessation, especially for women. An increased feeling of safety and comfort could be achieved by an increased use of support systems specifically de- signed to respond to older drivers’ needs. Conclusion: Support systems for older drivers should increase comfort and decrease their stress levels. New systems, such as co-pilot function and more developed Global Positioning System (GPS) supporting of the entire travel from door to door, should be developed to respond to the market needs.

     

  • 16.
    Björnstig, Ulf
    et al.
    Umeå Universitet.
    Albertsson, Pontus
    Umeå Universitet.
    Björnstig, Johanna
    Umeå Universitetssjukhus.
    Bylund, Per-Olof
    Umeå Universitet.
    Falkmer, Torbjörn
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Neuroscience and Locomotion, Rehabilitation Medicine. Östergötlands Läns Landsting, Local Health Care Services in Central Östergötland, Paediatric Habilitation Community Service.
    Petzäll, Jan
    Vägverket.
    Injury events among bus and coah occupants2005In: IATSS research : journal of International Association of Traffic and Safety Sciences, ISSN 0386-1112, Vol. 29Article in journal (Refereed)
  • 17.
    Black, Melissa H.
    et al.
    Curtin Univ, Australia.
    Mandi, Soheil
    Karolinska Inst, Sweden; Stockholm Hlth Care Serv, Sweden.
    Milbourn, Benjamin
    Curtin Univ, Australia.
    Thompson, Craig
    Curtin Univ, Australia.
    DAngelo, Axel
    Karolinska Inst, Sweden; Stockholm Hlth Care Serv, Sweden.
    Strom, Eva
    Swedish Publ Employment Serv, Sweden.
    Falkmer, Marita
    Curtin Univ, Australia; Jonkoping Univ, Sweden.
    Falkmer, Torbjörn
    Linköping University, Department of Medical and Health Sciences, Division of Community Medicine. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Pain and Rehabilitation Center. Curtin Univ, Australia.
    Lerner, Matthew
    SUNY Stony Brook, NY 11794 USA.
    Halladay, Alycia
    Autism Sci Fdn, NY USA.
    Gerber, Alan
    SUNY Stony Brook, NY 11794 USA.
    Esposito, Christopher
    SUNY Stony Brook, NY 11794 USA.
    Girdler, Sonya
    Curtin Univ, Australia; Curtin Univ, Australia.
    Bolte, Sven
    Curtin Univ, Australia; Karolinska Inst, Sweden; Stockholm Hlth Care Serv, Sweden; Stockholm Hlth Care Serv, Sweden.
    Perspectives of key stakeholders on employment of autistic adults across the united states, australia, and sweden2019In: Autism Research, ISSN 1939-3792, E-ISSN 1939-3806Article in journal (Refereed)
    Abstract [en]

    Despite efforts to improve employment outcomes for autistic individuals, internationally their employment rates remain low. There is a need to better understand the factors influencing successful employment for autistic adults in the labor market from the perspectives of multiple key stakeholders. This study represents the second in a series of papers conducted as part of an International Society for Autism Research policy brief aimed at improving employment outcomes for autistic individuals. A community consultation methodology using focus groups, forums, and interviews was applied with autistic individuals (n = 19), family members (n = 18), service providers (n = 21), employers (n = 11), researchers (n = 5), and advocacy group representatives (n = 5) in Australia, Sweden, and the United States, aiming to identify the factors perceived to determine gaining and maintaining employment for autistic individuals. Directed content analysis, guided by the International Classification of Functioning, Disability and Health (ICF), was conducted to investigate the key factors influencing employment outcomes for autistic individuals. Meaningful verbal concepts, or units of text with common themes, were also derived from the qualitative data and then linked and compared to the ICF Autism Spectrum Disorder (ASD) Core-sets. Across countries, activity and participation and environmental factor categories of the ICF were the most associated with employment outcomes. Results suggest that removal of environmental barriers and enhancing environmental facilitators may assist to remediate ASD-related difficulties in the workplace. Autism Res 2019, (c) 2019 International Society for Autism Research, Wiley Periodicals, Inc. Lay Summary This study sought to understand the perspectives of autistic individuals and key stakeholders on factors influencing if autistic adults get and keep jobs. Across Australia, Sweden, and the United States, focus groups and interviews were conducted to understand international perspectives on what helps and hinders getting and keeping a job for autistic individuals. The environment, including supports, relationships, attitudes, and services, were perceived to be the most important for workplace success. Intervention targeting barriers and facilitators in the workplace environment may support autistic adults to be successful in the labor market.

  • 18.
    Blane, Alison
    et al.
    Curtin Univ, Australia.
    Falkmer, Torbjörn
    Linköping University, Department of Medical and Health Sciences, Division of Community Medicine. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Pain and Rehabilitation Center. Curtin Univ, Australia; Jonkoping Univ, Sweden; La Trobe Univ, Australia.
    Lee, Hoe C.
    Curtin Univ, Australia.
    Dukic Willstrand, Tania
    Swedish Natl Rd and Transport Res Inst VTI, Sweden.
    Investigating cognitive ability and self-reported driving performance of post-stroke adults in a driving simulator2018In: Topics in Stroke Rehabilitation, ISSN 1074-9357, E-ISSN 1945-5119, Vol. 25, no 1, p. 44-53Article in journal (Refereed)
    Abstract [en]

    Background: Safe driving is a complex activity that requires calibration. This means the driver can accurately assess the level of task demand required for task completion and can accurately evaluate their driving capability. There is much debate on the calibration ability of post-stroke drivers. Objectives: The aim of this study was to assess the cognition, self-rated performance, and estimation of task demand in a driving simulator with post-stroke drivers and controls. Methods: A between-groups study design was employed, which included a post-stroke driver group and a group of similarly aged older control drivers. Both groups were observed driving in two simulator-based driving scenarios and asked to complete the NASA Task Load Index (TLX) to assess their perceived task demand and self-rate their driving performance. Participants also completed a battery of psychometric tasks to assess attention and executive function, which was used to determine whether post-stroke cognitive impairment impacted on calibration. Results: There was no difference in the amount of perceived task demand required to complete the driving task. Despite impairments in cognition, the post-stroke drivers were not more likely to over-estimate their driving abilities than controls. On average, the post-stroke drivers self-rated themselves more poorly than the controls and this rating was related to cognitive ability. Conclusion: This study suggests that post-stroke drivers may be aware of their deficits and adjust their driving behavior. Furthermore, using self-performance measures alongside a driving simulator and cognitive assessments may provide complementary fitness-to-drive assessments, as well as rehabilitation tools during post-stroke recovery.

  • 19.
    Blane, Alison
    et al.
    Curtin University, Australia.
    Lee, Hoe C.
    Curtin University, Australia.
    Falkmer, Torbjörn
    Linköping University, Department of Medical and Health Sciences, Division of Community Medicine. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Pain and Rehabilitation Center. Curtin University, Australia; Jonköping University, Sweden; La Trobe University, Australia.
    Dukic Willstrand, Tania
    Swedish National Rd and Transport Research Institute VTI, Sweden.
    Assessing Cognitive Ability and Simulator-Based Driving Performance in Poststroke Adults2017In: Behavioural Neurology, ISSN 0953-4180, E-ISSN 1875-8584, article id 1378308Article in journal (Refereed)
    Abstract [en]

    Driving is an important activity of daily living, which is increasingly relied upon as the population ages. It has been well-established that cognitive processes decline following a stroke and these processes may influence driving performance. There is much debate on the use of off-road neurological assessments and driving simulators as tools to predict driving performance; however, the majority of research uses unlicensed poststroke drivers, making the comparability of poststroke adults to that of a control group difficult. It stands to reason that in order to determine whether simulators and cognitive assessments can accurately assess driving performance, the baseline should be set by licenced drivers. Therefore, the aim of this study was to assess differences in cognitive ability and driving simulator performance in licensed community-dwelling poststroke drivers and controls. Two groups of licensed drivers (37 poststroke and 43 controls) were assessed using several cognitive tasks and using a driving simulator. The poststroke adults exhibited poorer cognitive ability; however, there were no differences in simulator performance between groups except that the poststroke drivers demonstrated less variability in driver headway. The application of these results as a prescreening toolbox for poststroke drivers is discussed.

  • 20.
    Blane, Alison
    et al.
    Curtin Univ, Australia.
    Lee, Hoe
    Curtin Univ, Australia.
    Falkmer, Torbjörn
    Linköping University, Department of Medical and Health Sciences, Division of Community Medicine. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Pain and Rehabilitation Center. Curtin Univ, Australia; Jonkoping Univ, Sweden; La Trobe Univ, Australia.
    Willstrand, Tania Dukic
    Jonkoping Univ, Sweden; Swedish Natl Rd and Transport Res Inst VTI, Sweden.
    Cognitive ability as a predictor of task demand and self-rated driving performance in post-stroke drivers - Implications for self-regulation2018In: Journal of Transport and Health, ISSN 2214-1405, E-ISSN 2214-1405, Vol. 9, p. 169-179Article in journal (Refereed)
    Abstract [en]

    Driving is a highly complex task requiring multiple cognitive processes that can be adversely affected post-stroke. It is unclear how much ability post-stroke adults have to self-evaluate their driving performance. Furthermore, the impact of cognitive decline on this evaluation has not been previously investigated. The aim of this study was to investigate the perceived level of task demand involved in driving tasks, and to examine differences between perceived and observed driving performance in post-stroke drivers in comparison to a control group. A further aim of the research was to investigate the influence of cognition on self-rated driving performance. A total of 78 participants (35 post-stroke and 43 controls) were assessed using a series of cognitive tasks and were observed whilst driving. Participants were asked to rate their own driving performance and the task demand involved while driving using the NASA Task Load Index. Between group analyses were conducted to determine differences in the level of self-rated performance and task demand. Further analyses were conducted to investigate whether cognition accounted for differences in task demand or self-rated performance. Overall, the results suggested that the post-stroke drivers exhibited deficits in cognition, but they did not report increased levels of task demand when driving. Post-stroke adults also rated themselves more conservatively than the controls for on-road performance, which was associated with their reduced propensity for risk. The study suggests that cognitive deficits may influence post-stroke drivers to amend their driving behaviour, in order to bring the task demand within a manageable level. Understanding the mechanisms involved in self-rated performance and estimations of task demand can help promote accurate self-regulation practices in post-stroke drivers. Furthermore, measuring calibration may assist practitioners with assessing fitness-to-drive, as well as with tailoring driving rehabilitation.

  • 21.
    Borgestig, Maria
    et al.
    Linköping University, Department of Social and Welfare Studies, Division of Health, Activity and Care. Linköping University, Faculty of Health Sciences.
    Falkmer, Torbjorn
    Linköping University, Department of Medical and Health Sciences, Division of Community Medicine. Linköping University, Faculty of Health Sciences. Curtin University, Australia .
    Hemmingsson, Helena
    Linköping University, Department of Social and Welfare Studies, Division of Health, Activity and Care. Linköping University, Faculty of Health Sciences.
    Improving computer usage for students with physical disabilities through a collaborative approach: A pilot study2013In: Scandinavian Journal of Occupational Therapy, ISSN 1103-8128, E-ISSN 1651-2014, Vol. 20, no 6, p. 463-470Article in journal (Refereed)
    Abstract [en]

    Objective: The aim of this study was to evaluate the effect of an assistive technology (AT) intervention to improve the use of available computers as assistive technology in educational tasks for students with physical disabilities during an ongoing school year. Methods: Fifteen students (aged 12-18) with physical disabilities, included in mainstream classrooms in Sweden, and their teachers took part in the intervention. Pre-, post-, and follow-up data were collected with Goal Attainment Scaling (GAS), a computer usage diary, and with the Psychosocial Impact of Assistive Devices Scale (PIADS). Teachers opinions of goal setting were collected at follow-up. Results: The intervention improved the goal-related computer usage in educational tasks and teachers reported they would use goal setting again when appropriate. At baseline, students reported a positive impact from computer usage with no differences over time regarding the PIADS subscales independence, adaptability, or self-esteem. Discussion: The AT intervention showed a positive effect on computer usage as AT in mainstream schools. Some additional support to teachers is recommended as not all students improved in all goal-related computer usage. A clinical implication is that students computer usage can be improved and collaboratively established computer-based strategies can be carried out by teachers in mainstream schools.

  • 22.
    Borgestig, Maria
    et al.
    Linköping University, Department of Social and Welfare Studies, Division of Health, Activity and Care. Linköping University, Faculty of Health Sciences.
    Falkmer, Torbjörn
    Linköping University, Department of Medical and Health Sciences, Rehabilitation Medicine. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Anaesthetics, Operations and Specialty Surgery Center, Pain and Rehabilitation Center. Curtin University, Perth, WA, Australia.
    Hemmingsson, Helena
    Linköping University, Department of Social and Welfare Studies, Division of Health, Activity and Care. Linköping University, Faculty of Health Sciences.
    Change in eye controlled performance over time with an eye tracker controlled system, used by children with severe physical disabilities2013In: Assistive Technology: From Research to Practice, IOS Press, 2013, Vol. 33, p. 473-477Chapter in book (Refereed)
    Abstract [en]

    The aim of this study was to describe how speed and accuracy in eye controlled computer performance changed over time for children with severe physical disabilities that used eye tracker controlled system (ETCS) in daily activities as an effect of assistive technology (AT) intervention. Data was collected with diaries and with Compass software. The preliminary results from this study from the first four children indicate that two children improved significantly in eye controlled performance up to 19 months since start of ETCS usage in daily activities.

  • 23.
    Borgestig, Maria
    et al.
    Linköping University, Faculty of Medicine and Health Sciences. Linköping University, Department of Social and Welfare Studies, Division of Occupational Therapy. Folke Bernadotte Regional Habilitation Centre and Department of Women´s and Children´s Health, Uppsala University, Uppsala, Sweden.
    Sandqvist, Jan
    Linköping University, Faculty of Medicine and Health Sciences. Linköping University, Department of Social and Welfare Studies, Division of Occupational Therapy.
    Ahlsten, Gunnar
    Folke Bernadotte Regional Habilitation Centre and Department of Women´s and Children´s Health, Uppsala University, Uppsala, Sweden.
    Falkmer, Torbjorn
    Linköping University, Department of Medical and Health Sciences, Division of Community Medicine. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Pain and Rehabilitation Center. School of Occupational Therapy & Social Work, Curtin University, Perth, WA, Australia; School of Occupational Therapy, La Trobe University, Melbourne, Victoria, Australia.
    Hemmingsson, Helena
    Linköping University, Faculty of Medicine and Health Sciences. Linköping University, Department of Social and Welfare Studies, Division of Occupational Therapy.
    Gaze-based assistive technology in daily activities in children with severe physical impairments: an intervention study2017In: Developmental Neurorehabilitation, ISSN 1751-8423, E-ISSN 1751-8431, Vol. 20, no 3, p. 129-141Article in journal (Refereed)
    Abstract [en]

    Objective: To establish the impact of a gaze-based assistive technology (AT) intervention on activity repertoire, autonomous use, and goal attainment in children with severe physical impairments, and to examine parents’ satisfaction with the gaze-based AT and with services related to the gaze-based AT intervention.

    Methods: Non-experimental multiple case study with before, after, and follow-up design. Ten children with severe physical impairments without speaking ability (aged 1–15 years) participated in gaze-based AT intervention for 9–10 months, during which period the gaze-based AT was implemented in daily activities.

    Results: Repertoire of computer activities increased for seven children. All children had sustained usage of gaze-based AT in daily activities at follow-up, all had attained goals, and parents’ satisfaction with the AT and with services was high.

    Discussion: The gaze-based AT intervention was effective in guiding parents and teachers to continue supporting the children to perform activities with the AT after the intervention program.

  • 24.
    Borgestig, Maria
    et al.
    Linköping University, Faculty of Medicine and Health Sciences. Linköping University, Department of Social and Welfare Studies, Division of Occupational Therapy. Folke Bernadotte Regional Habilitation Centre and Department of Women´s and Children´s Health, Uppsala University, Uppsala, Sweden.
    Sandqvist, Jan
    Linköping University, Faculty of Medicine and Health Sciences. Linköping University, Department of Social and Welfare Studies, Division of Occupational Therapy.
    Parsons, Richard
    School of Occupational Therapy & Social Work, Curtin University, Perth, WA, Australia.
    Falkmer, Torbjörn
    Linköping University, Department of Medical and Health Sciences, Division of Community Medicine. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Pain and Rehabilitation Center. School of Occupational Therapy & Social Work, Curtin University, Perth, WA, Australia / School of Occupational Therapy, La Trobe University, Melbourne, Victoria, Australia.
    Hemmingsson, Helena
    Linköping University, Department of Social and Welfare Studies, Division of Occupational Therapy. Linköping University, Faculty of Medicine and Health Sciences.
    Eye gaze performance for children with severe physical impairments using gaze-based assistive technology: a longitudinal study2016In: Assistive technology, ISSN 1040-0435, E-ISSN 1949-3614, Vol. 28, no 2, p. 93-102Article in journal (Refereed)
    Abstract [en]

    Gaze-based assistive technology (gaze-based AT) has the potential to provide children affected by severe physical impairments with opportunities for communication and activities. This study aimed to examine changes in eye gaze performance over time (time on task and accuracy) in children with severe physical impairments, without speaking ability, using gaze-based AT. A longitudinal study with an AB design was conducted on ten children (aged 1–15 years) with severe physical impairments, who were beginners to gaze-based AT at baseline. Thereafter, all children used the gaze-based AT in daily activities over the course of the study. Compass computer software was used to measure time on task and accuracy with eye selection of targets on screen, and tests were performed with the children at baseline, after 5 months, 9–11 months, and after 15–20 months. Findings showed that the children improved in time on task after 5 months and became more accurate in selecting targets after 15–20 months. This study indicates that these children with severe physical impairments, who were unable to speak, could improve in eye gaze performance. However, the children needed time to practice on a long-term basis to acquire skills needed to develop fast and accurate eye gaze performance.

  • 25.
    Bruce, C. R.
    et al.
    La Trobe University, Australia.
    Unsworth, C. A.
    La Trobe University, Australia; CQUniversity, Australia; Jonköping University, Sweden; Curtin University, Australia.
    Dillon, M. P.
    La Trobe University, Australia.
    Tay, R.
    RMIT University, Australia.
    Falkmer, Torbjörn
    Linköping University, Department of Medical and Health Sciences, Division of Community Medicine. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Pain and Rehabilitation Center. Curtin University, Australia.
    Bird, P.
    Gosforth Clin, Australia.
    Carey, L. M.
    La Trobe University, Australia; Florey Institute Neurosci and Mental Health Neurorehabil and, Australia.
    Hazard perception skills of young drivers with Attention Deficit Hyperactivity Disorder (ADHD) can be improved with computer based driver training: An exploratory randomised controlled trial2017In: Accident Analysis and Prevention, ISSN 0001-4575, E-ISSN 1879-2057, Vol. 109, p. 70-77Article in journal (Refereed)
    Abstract [en]

    Background: Young drivers with Attention Deficit Hyperactivity Disorder (ADHD) are at higher risk of road traffic injuries than their peers. Increased risk correlates with poor hazard perception skill. Few studies have investigated hazard perception training using computer technology with this group of drivers. Objectives: *Determine the presence and magnitude of the between-group.and within- subject change in hazard perception skills in young drivers with ADHD who receive Drive Smart training. *Determine whether training facilitated change in hazard perception is maintained over time. Methods: This was a feasibility study, randomised control trial conducted in Australia. The design included a delayed treatment for the control group. Twenty-five drivers with a diagnosis of ADHD were randomised to the Immediate Intervention or Delayed Intervention group.The Immediate Intervention group received a training session using a computer application entitled Drive Smart. The Delayed Intervention group watched a documentary video initially (control condition), followed by the Drive Smart computer training session. The participants hazard perception skill was measured using the Hazard Perception Test (HPT). Findings: After adjusting for baseline scores, there was a significant betweengroup difference in post-intervention HPT change scores in favour of the Immediate Intervention group. The magnitude of the effect was large. There was no significant within-group delayed intervention effect. A significant maintenance effect was found at 6 week follow-up for the Immediate Intervention group. Conclusions: The hazard perception skills of participants improved following training with large effect size and some maintenance of gain. A multimodal approach to training is indicated to facilitate maintenance. A full-scale trial is feasible.

  • 26.
    Buchanan, Angus
    et al.
    Curtin University, Perth, WA, Australia .
    Peterson, Sunila
    Curtin University, Perth, WA, Australia .
    Falkmer, Torbjörn
    Linköping University, Department of Medical and Health Sciences, Division of Community Medicine. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Anaesthetics, Operations and Specialty Surgery Center, Pain and Rehabilitation Center. Curtin University, Perth, WA, Australia .
    A qualitative exploration of the recovery experiences of consumers who had undertaken shared management, person-centred and self-directed services2014In: International Journal of Mental Health Systems, ISSN 1752-4458, E-ISSN 1752-4458, Vol. 8, no 23Article in journal (Refereed)
    Abstract [en]

    Background: The mental health sector across states in Australia is moving to offering individualised funds and shared management, person-centred and self-directed (SPS) services. However, little is known about the recovery experiences of consumers with mental illness who had used a SPS service that was recently introduced in Western Australia. This study explored the recovery experiences of these consumers. Methods: Data relating to sixteen consumers lived experiences were analysed using an abbreviated grounded theory approach. These data had been developed in the past by consumers, the Guides (staff) and an independent evaluator. Results: Four over-arching categories, and related sub-categories, emerged. These suggested that consumers recovery experiences included them gaining: 1) a greater sense of empowerment; 2) expanded connections with the community, others and the self; 3) an enriched sense of the self; and 4) an enhanced quality of life. Conclusions: Access to SPS services, including having access to individualised funds, high quality shared management and person-centred relationships with the Guides, and a chance to self-direct services enabled consumers to have control over all aspects of their recovery journey, facilitated change and growth, and improved their capacity to self-direct services. Most consumers encountered a number of positive recovery experiences at varied levels that enhanced their lived experiences.

  • 27.
    Bylund, P-O
    et al.
    Umeå Unviersitet.
    Wretstrand, Anders
    Lunds Universitet.
    Falkmer, Torbjörn
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Neuroscience and Locomotion, Rehabilitation Medicine. Östergötlands Läns Landsting, Local Health Care Services in Central Östergötland, Paediatric Habilitation Community Service.
    Lövgren, Anna
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Neuroscience and Locomotion, Rehabilitation Medicine.
    Petzäll, Jan
    Vägverket, Borlänge.
    Injuries in special transportation services for elderly and disabled - A multi-methodology approach to estimate incidence and societal costs2007In: Traffic Injury Prevention, ISSN 1538-9588, E-ISSN 1538-957X, Vol. 8, no 2, p. 180-188Article in journal (Refereed)
    Abstract [en]

    Objective. Previous research has shown that elderly and disabled travelers using Special Transportation Services (STS) are injured without being involved in a vehicle crash. In order to estimate the true costs for these vehicle-related injuries, the focus needs to be adjusted towards an incident/traveler-oriented perspective. The aim of the project was thus to utilize such a perspective, in order to make a best estimation of the true costs for injury incidents, related to STS in Sweden. Methods. In order to address the chosen perspective, a mixed-method approach was used, involving quantitative as well as qualitative research methods applied on four different sets of data, the hospital-based material (n = 32), two sets of STS material (n = 127), and interview-based material (n = 1,000). Results. The results showed that the injury incidence rate in STS is considerable, i.e., 3.2 per 100,000 trips (ranging from 1.5-1.9 in STS taxis and 3.6-5.6 in STS special vehicles). However, this high incidence rate is not due to road traffic crashes, but to non-collision injury incidents involving elderly and frail passengers, easily sustaining injuries from minor to moderate external violence. Typically, this violence is affecting an older female STS user, while entering and exiting the vehicle. The true costs were estimated to be $35 million per annum or $2.6 per trip. Conclusion. Future injury prevention measures should thus focus on safety in entering and exiting procedures.

  • 28.
    (Chayn) Sun, Qian
    et al.
    Curtin University, Australia.
    (Cecilia) Xia, Jianhong
    Curtin University, Australia.
    Falkmer, Torbjörn
    Linköping University, Department of Medical and Health Sciences, Division of Community Medicine. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Pain and Rehabilitation Center. Curtin University, Australia; La Trobe University, Australia.
    Lee, Hoe
    Curtin University, Australia.
    Investigating the Spatial Pattern of Older Drivers Eye Fixation Behaviour and Associations with Their Visual Capacity2016In: Journal of Eye Movement Research, E-ISSN 1995-8692, Vol. 9, no 6, article id 2Article in journal (Refereed)
    Abstract [en]

    Visual capacity generally declines as people age, yet its impact on the visual search patterns along sections of different road during actual driving still remains undocumented. This onroad driving study simultaneously recorded 30 older drivers eye movement and precise vehicle movement trajectories. The vehicle positions were linked to every identified eye fixation for each individual driver, so that the locations of the drivers gaze origin in geospatial coordinates were obtained. Spatial distribution pattern of drivers eye fixations were then mapped and analysed. In addition, the associations between older drivers visual capacity (processing speed, divided and selective attention) and their eye fixation patterns in various driving manoeuvres were investigated. The results indicate that driving scenarios have a significant impact on older drivers visual patterns. Older drivers performed more frequent eye fixations at roundabouts, while they tended to fixate on certain objects for longer periods during straight road driving. The key findings show that the processing speed and divided attention of older drivers were associated with their eye fixations at complex right-turns; drivers with a lower capacity in selective attention performed less frequent eye fixations at roundabouts. This study has also demonstrated that visualisation and spatial statistics are effective and intuitive approaches to eye movement analysis.

  • 29.
    Chee, D. Y. T.
    et al.
    Curtin University, Perth, Western Australia.
    Lee, H. C.
    Curtin University, Perth, Western Australia.
    Lee, A. H.
    Curtin University, Perth, Western Australia.
    Falkmer, Torbjörn
    Linköping University, Department of Medical and Health Sciences, Rehabilitation Medicine. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Anaesthetics, Operations and Specialty Surgery Center, Pain and Rehabilitation Center. Curtin University, Perth, Western Australia.
    Performance of drivers with Parkinson’s Disease under the effect of cognitive overloading: insinuation for assessment and training2013In: Advances in Transportation Studies, ISSN 1824-5463, no A29, p. 5-18Article in journal (Refereed)
    Abstract [en]

    Background: Signs and symptoms of Parkinson’s Disease (PD) include a combination of slowness of movement, increased tone, tremor and loss of postural reflexes. Cognitive changes and dementia can also be found in older people affected by PD. The excessive expenditure of cerebral resources in multitasks can cause cognitive overload resulting in deterioration of functional performance. Previous research has highlighted that the balance of cognitive load is essential for safe driving; however, this has not yet been researched in relation to people with PD. Coupled with mental inflexibility and sluggish reasoning, PD drivers exposed to demanding traffic scenarios may reach dangerous levels of cognitive overload. The present study employed computation of arithmetic sums as secondary task to investigate the effect of cognitive overloading on older PD drivers.

    Methodology: A pre-post case-control study design was implemented. Convenience sample of 28 mild to moderate stages of PD drivers and 30 age-matched healthy controls were recruited and their motor and cognitive functions were assessed using the Digit Vigilance Test (DVT), Perdue Pegboard, Symbol Digit Modalities Test (SDMT) and Trail-Making Test- Part A and B. Participants were then assessed twice using a driving simulator: with and without exposure to the secondary task.

    Results: When compared with healthy controls, PD drivers scored lower in motor and cognitive psychometric assessments and performed less competently in driving assessments. However, PD drivers drove more cautiously and took more time to complete all the driving tests when compared with the healthy counterparts. With the distraction of the secondary task, both the performance of PD drivers and controls declined, but PD drivers to a greater extent. The Trail-Making Test-B was found to be valuable in predicting the overall performance of PD drivers. The ability of PD participants was observed to have significant deterioration in driving through T-junctions and roundabouts.

    Conclusion: PD drivers should avoid cognitive overload caused by, for example, multitasking while driving. Cognitive overload may compound the problem of indecisiveness of the drivers; leading to inconvenience or dangers to other road users. Training of PD drivers should emphasize intersection manoeuvre management.

     

  • 30.
    Chee, Derserri Y.
    et al.
    Curtin University, Australia.
    Lee, Hoe C.
    Curtin University, Australia.
    Patomella, Ann-Helen
    Karolinska Institute, Sweden.
    Falkmer, Torbjörn
    Linköping University, Department of Medical and Health Sciences, Division of Community Medicine. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Pain and Rehabilitation Center. Curtin University, Australia.
    Driving Behaviour Profile of Drivers with Autism Spectrum Disorder (ASD)2017In: Journal of autism and developmental disorders, ISSN 0162-3257, E-ISSN 1573-3432, Vol. 47, no 9, p. 2658-2670Article in journal (Refereed)
    Abstract [en]

    The symptomatology of autism spectrum disorder (ASD) can make driving risky, but little is known about the on-road driving behaviour of individuals with ASD. This study assessed and compared the on-road driving performance of drivers with and without ASD, and explored how the symptomatology of ASD hinders or facilitates on-road driving performance. Sixteen drivers with ASD and 21 typically-developed drivers participated in the study. Drivers with ASD underperformed in vehicle manoeuvring, especially at left-turns, right-turns and pedestrian crossings. However, drivers with ASD outperformed the TD group in aspects related to rule-following such as using the indicator at roundabouts and checking for cross-traffic when approaching intersections. Drivers with ASD in the current study presented with a range of capabilities and weaknesses during driving.

  • 31.
    Chee, Derserri Yan Ting
    et al.
    Curtin Univ, Australia.
    Lee, Hoe Chung Yeung
    Curtin Univ, Australia.
    Patomella, Ann-Helen
    Karolinska Inst, Sweden.
    Falkmer, Torbjörn
    Linköping University, Department of Medical and Health Sciences, Division of Community Medicine. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Pain and Rehabilitation Center. Curtin Univ, Australia.
    Investigating the driving performance of drivers with and without autism spectrum disorders under complex driving conditions2019In: Disability and Rehabilitation, ISSN 0963-8288, E-ISSN 1464-5165, Vol. 41, no 1Article in journal (Refereed)
    Abstract [en]

    Purpose: The aim of this study was to investigate the driving performance of drivers with autism spectrum disorders under complex driving conditions. Method: Seventeen drivers with autism spectrum disorders and 18 typically developed drivers participated in a driving simulator trial. Prior to the assessment, participants completed the Driving Behaviour Questionnaire and measurements of cognitive and visual-motor ability. The driving simulation involved driving in an urban area with dense traffic and unpredictable events. Results: In comparison with the typically developed group, drivers with autism spectrum disorders reported significantly more lapses in driving, committed more mistakes on the driving simulator, and were slower to react in challenging situations, such as driving through intersections with abrupt changes in traffic lights. However, they were also less likely to tailgate other vehicles, as measured by time-to-collision between vehicles, on the driving simulator. Conclusions: The performances of licensed drivers with autism spectrum disorders appeared to be safer in respect to car-following distance but were poorer in their response to challenging traffic situations. Driver education for individuals with autism spectrum disorders should focus on quick identification of hazards, prompt execution of responses, and effective allocation of attention to reduce lapses in driving.

  • 32.
    Chen, Janice D.
    et al.
    Curtin University, Australia .
    Falkmer, Torbjörn
    Linköping University, Department of Medical and Health Sciences, Division of Community Medicine. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Anaesthetics, Operations and Specialty Surgery Center, Pain and Rehabilitation Center.
    Parsons, Richard
    Linköping University, Department of Medical and Health Sciences, Division of Community Medicine. Linköping University, Faculty of Health Sciences. Curtin Univ, Australia.
    Buzzard, Jennifer
    Hollywood Hospital, Australia .
    Ciccarelli, Marina
    Linköping University, Department of Medical and Health Sciences, Division of Community Medicine. Linköping University, Faculty of Health Sciences. Curtin Univ, Australia.
    Impact of experience when using the Rapid Upper Limb Assessment to assess postural risk in children using information and communication technologies2014In: Applied Ergonomics, ISSN 0003-6870, E-ISSN 1872-9126, Vol. 45, no 3, p. 398-405Article in journal (Refereed)
    Abstract [en]

    The Rapid Upper Limb Assessment (RULA) is an observation-based screening tool that has been used to assess postural risks of children in school settings. Studies using eye-tracking technology suggest that visual search strategies are influenced by experience in the task performed. This study investigated if experience in postural risk assessments contributed to differences in outcome scores on the RULA and the visual search strategies utilized. While wearing an eye-tracker, 16 student occupational therapists and 16 experienced occupational therapists used the RULA to assess 11 video scenarios of a child using different mobile information and communication technologies (ICT) in the home environment. No significant differences in RULA outcome scores, and no conclusive differences in visual search strategies between groups were found. RULA can be used as a screening tool for postural risks following a short training session regardless of the assessors experience in postural risk assessments.

  • 33.
    Ciccarelli, Marina
    et al.
    Curtin University, Australia.
    Chen, Janice D.
    National University of Singapore Hospital, Singapore.
    Vaz, Sharmila
    Curtin University, Australia.
    Cordier, Reinie
    Curtin University, Australia.
    Falkmer, Torbjörn
    Linköping University, Department of Medical and Health Sciences, Division of Community Medicine. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Pain and Rehabilitation Center. Curtin University, Australia.
    Managing childrens postural risk when using mobile technology at home: Challenges and strategies2015In: Applied Ergonomics, ISSN 0003-6870, E-ISSN 1872-9126, Vol. 51, p. 189-198Article in journal (Refereed)
    Abstract [en]

    Maintaining the musculoskeletal health of children using mobile information and communication technologies (ICT) at home presents a challenge. The physical environment influences postures during ICT use and can-contribute to musculoskeletal complaints. Few studies have assessed postures of children using ICT in home environments. The present study investigated the Rapid Upper Limb Assessment (RULA) scores determined by 16 novice and 16 experienced raters. Each rater viewed 11 videotaped scenarios of a child using two types of mobile ICT at home. The Grand Scores and Action Levels determined by study participants were compared to those of an ergonomist experienced in postural assessment. All postures assessed were rated with an Action Level of 2 or above; representing a postural risk that required further investigation and/or intervention. The sensitivity of RULA to assess some of the unconventional postures adopted by children in the home is questioned. (C) 2015 Elsevier Ltd and The Ergonomics Society. All rights reserved.

  • 34.
    Cordier, Reinie
    et al.
    Curtin University, Australia; James Cook University, Australia.
    Brown, Nicole
    James Cook University, Australia.
    Chen, Yu-Wei
    University of Sydney, Australia.
    Wilkes-Gillan, Sarah
    University of Sydney, Australia.
    Falkmer, Torbjörn
    Linköping University, Department of Medical and Health Sciences, Division of Community Medicine. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Pain and Rehabilitation Center. Curtin University, Australia.
    Piloting the use of experience sampling method to investigate the everyday social experiences of children with Asperger syndrome/high functioning autism2016In: Developmental Neurorehabilitation, ISSN 1751-8423, E-ISSN 1751-8431, Vol. 19, no 2, p. 103-110Article in journal (Refereed)
    Abstract [en]

    Objective: This pilot study explored the nature and quality of social experiences of children with Asperger Syndrome/High Functioning Autism (AS/HFA) through experience sampling method (ESM) while participating in everyday activities. Methods: ESM was used to identify the contexts and content of daily life experiences. Six children with AS/HFA (aged 8-12) wore an iPod Touch on seven consecutive days, while being signalled to complete a short survey. Results: Participants were in the company of others 88.3% of their waking time, spent 69.0% of their time with family and 3.8% with friends, but only conversed with others 26.8% of the time. Participants had more positive experiences and emotions when they were with friends compared with other company. Participating in leisure activities was associated with enjoyment, interest in the occasion, and having positive emotions. Conclusions: ESM was found to be helpful in identifying the nature and quality of social experiences of children with AS/HFA from their perspective.

  • 35.
    Cowan, Georgia
    et al.
    Sch Occupat Therapy Social Work and Speech Pathol, Australia.
    Earl, Robyn
    Sch Occupat Therapy Social Work and Speech Pathol, Australia.
    Falkmer, Torbjörn
    Linköping University, Department of Medical and Health Sciences, Division of Community Medicine. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Pain and Rehabilitation Center.
    Girdler, Sonya
    Sch Occupat Therapy Social Work and Speech Pathol, Australia.
    Morris, Susan L.
    Curtin Univ, Australia.
    Falkmer, Marita
    Sch Occupat Therapy Social Work and Speech Pathol, Australia; Jonkoping Univ, Sweden.
    Fixation patterns of individuals with and without Autism Spectrum disorder: Do they differ in shared zones and in zebra crossings?2018In: Journal of Transport and Health, ISSN 2214-1405, E-ISSN 2214-1405, Vol. 8, p. 112-122Article in journal (Refereed)
    Abstract [en]

    Shared zones are a contemporary traffic zone that promotes equality between multiple road users and efficiently utilizes available space, while simultaneously maintaining safety and function. As this is a relatively new traffic zone, it is important to understand how pedestrians navigate a shared zone and any potential challenges this may pose to individuals with impairments. The aim of this study was to utilize eye-tracking technology to determine fixations and fixation duration on traffic relevant objects, non-traffic relevant objects, and eye contact, in 40 individuals with and without Autism Spectrum Disorder (ASD) in a shared zone and a zebra crossing. It was assumed that individuals with ASD would make less eye contact in the shared zone compared to the group of typically developing adults. A total of 3287 fixations across the shared zone and zebra crossing were analysed for areas of interest that were traffic relevant, non-traffic relevant, and eye contact, and for fixation duration. Individuals with ASD did not display any difference in terms of eye contact in the shared zone and the zebra crossing when compared to the controls. All pedestrians were more likely to look at traffic relevant objects at the zebra crossing compared to the shared zone. Individuals with ASD had an overall shorter fixation duration compared to the control group, indicating people with ASD either process information quickly, or they do not process it for long enough, although these findings require further investigation. While shared zones have many benefits for traffic movement and environmental quality, it appeared that pedestrians displayed safer road crossing behaviours at a zebra crossing than in a shared zone, indicating that more education and environmental adaptations are required to make shared zones safe for all pedestrians.

  • 36.
    Cuomo, Belinda M.
    et al.
    Curtin University, Australia.
    Vaz, Sharmila
    Curtin University, Australia.
    Ai Lim Lee, Elinda
    Curtin University, Australia; Cooperat Research Centre Living Autism Spectrum Disorders, Australia.
    Thompson, Craig
    Curtin University, Australia; Cooperat Research Centre Living Autism Spectrum Disorders, Australia.
    Rogerson, Jessica M.
    Curtin University, Australia.
    Falkmer, Torbjörn
    Linköping University, Department of Medical and Health Sciences, Division of Community Medicine. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Pain and Rehabilitation Center. Curtin University, Australia; Cooperat Research Centre Living Autism Spectrum Disorders, Australia; Jonköping University, Sweden.
    Effectiveness of Sleep-Based Interventions for Children with Autism Spectrum Disorder: A Meta-Synthesis2017In: Pharmacotherapy, ISSN 0277-0008, E-ISSN 1875-9114, Vol. 37, no 5, p. 555-578Article, review/survey (Refereed)
    Abstract [en]

    Sleep problems are common in children with autism spectrum disorder (ASD). This meta-synthesis collated eight previously published systematic reviews examining the efficacy of sleep interventions in children with ASD in an attempt to present a clear analysis of trialed interventions. The collated reviews consider five major groups of sleep interventions for children with ASD: melatonin therapy, pharmacologic treatments other than melatonin, behavioral interventions, parent education/education programs, and alternative therapies (massage therapy, aromatherapy, and multivitamin and iron supplementation). These eight reviews were based on 38 original studies and address the efficacy of interventions across 17 sleep problem domains. The results of this meta-synthesis suggest that no single intervention is effective across all sleep problems in children with ASD. However, melatonin, behavioral interventions, and parent education/education program interventions appear the most effective at ameliorating multiple domains of sleep problems compared with other interventions. Due to the heterogeneous causative factors and presentations of disordered sleep, further research into the effectiveness of sleep interventions may target specific phenotypic subgroups rather than a broad analysis across the general ASD population. Similarly, future research needs to consider the efficacy of different polytherapeutic approaches in order to provide clinicians with evidence to inform best practice. In the meantime, this review supports clinicians decision making for a majority of the identified sleep problems in the ASD population.

  • 37.
    Dahlman, Joakim
    et al.
    Swedish Defense Research Agency, Linköping.
    Falkmer, Torbjörn
    Linköping University, Department of Medical and Health Sciences, Rehabilitation Medicine. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Sinnescentrum, Pain and Rehabilitation Centre.
    Forsman, Fredrik
    Chalmers University of Technology, Göteborg.
    Perceived motion sickness and effects on performance following naval transportation2012In: Journal of human performance in extreme environments, ISSN 1529-5168, Vol. 10, no 1Article in journal (Refereed)
    Abstract [en]

    The present study focused on the relationship between previous experiences of, and rated susceptibility to, motion sickness and its correlation to subjective measurements and actual performance. Performance was measured in terms of shooting precision among 23 participants from the Swedish amphibious corps after transportation in a small amphibious boat, while sealed off with no reference to the outside world. Self-rating questionnaires were collected regarding perceived performance and presence of motion sickness. The physiological status perceived by each participant was related to factors that generally indicate early stages of motion sickness, which also were correlated to deficits in performance. It was further shown that participants who believed that their performance could be affected by motion sickness also performed less well.

  • 38.
    Dahlman, Joakim
    et al.
    Linköping University, Department of Clinical and Experimental Medicine, Rehabilitation Medicine . Linköping University, Faculty of Health Sciences.
    Sjörs, Anna
    Linköping University, Department of Clinical and Experimental Medicine, Rehabilitation Medicine . Linköping University, Faculty of Health Sciences.
    Ledin, Torbjörn
    Linköping University, Department of Clinical and Experimental Medicine, Oto-Rhiono-Laryngology and Head & Neck Surgery . Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Reconstruction Centre, Department of ENT - Head and Neck Surgery UHL.
    Falkmer, Torbjörn
    Linköping University, Department of Clinical and Experimental Medicine, Rehabilitation Medicine . Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Local Health Care Services in Central Östergötland, Paediatric Habilitation Community Service.
    Could sound be used as a strategy for reducing symptoms of perceived motion sickness?2008In: Journal of NeuroEngineering and Rehabilitation, ISSN 1743-0003, E-ISSN 1743-0003, Vol. 5, no 35Article in journal (Refereed)
    Abstract [en]

    Background: Working while exposed to motions, physically and psychologically affects a person. Traditionally, motion sickness symptom reduction has implied use of medication, which can lead to detrimental effects on performance. Non-pharmaceutical strategies, in turn, often require cognitive and perceptual attention. Hence, for people working in high demand environments where it is impossible to reallocate focus of attention, other strategies are called upon. The aim of the study was to investigate possible impact of a mitigation strategy on perceived motion sickness and psychophysiological responses, based on an artificial sound horizon compared with a non-positioned sound source.

    Method: Twenty-three healthy subjects were seated on a motion platform in an artificial sound horizon or in non-positioned sound, in random order with one week interval between the trials. Perceived motion sickness (Mal), maximum duration of exposure (ST), skin conductance, blood volume pulse, temperature, respiration rate, eye movements and heart rate were measured continuously throughout the trials.

    Results: Mal scores increased over time in both sound conditions, but the artificial sound horizon, applied as a mitigation strategy for perceived motion sickness, showed no significant effect on Mal scores or ST. The number of fixations increased with time in the non-positioned sound condition. Moreover, fixation time was longer in the nonpositioned sound condition compared with sound horizon, indicating that the subjects used more time to fixate and, hence, assumingly made fewer saccades.

    Conclusion: A subliminally presented artificial sound horizon did not significantly affect perceived motion sickness, psychophysiological variables or the time the subjects endured the motion sickness triggering stimuli. The number of fixations and fixation times increased over time in the non-positioned sound condition.

  • 39.
    Dahlman, Joakim
    et al.
    Linköping University, Department of Clinical and Experimental Medicine, Rehabilitation Medicine . Linköping University, Faculty of Health Sciences.
    Sjörs, Anna
    Linköping University, Department of Clinical and Experimental Medicine, Rehabilitation Medicine . Linköping University, Faculty of Health Sciences.
    Lundgren, Pontus
    Östergötlands Läns Landsting, Reconstruction Centre, Department of Rehabilitation Medicine UHL.
    Ledin, Torbjörn
    Linköping University, Department of Clinical and Experimental Medicine, Oto-Rhiono-Laryngology and Head & Neck Surgery . Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Reconstruction Centre, Department of ENT - Head and Neck Surgery UHL.
    Falkmer, Torbjörn
    Linköping University, Department of Clinical and Experimental Medicine, Rehabilitation Medicine . Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Local Health Care Services in Central Östergötland, Paediatric Habilitation Community Service.
    Effects of Motion Sickness on Encoding and Retrieval2010Article in journal (Refereed)
    Abstract [en]

    Objective: In this study, possible effects of motion sickness on encoding and retrieval of words were investigated.

    Background: The impact of motion sickness on human performance has been studied with regards to psychomotor functions and over learned skills, as well as to novel situations requiring encoding and retrieval skills through the use of short term memory. In this study, possible effects of motion sickness on encoding and retrieval of words were investigated.

    Method: Forty healthy participants, half of them males, performed a continuous recognition task (CRT) during exposure to a motion sickness triggering optokinetic drum. The CRT was employed as a measurement of performance and consisted of encoding and retrieval of words. The task consisted of three consecutive phases 1) encoding of familiar words; 2) encoding and retrieval of words under the influence of motion sickness; 3) retrieval of words after exposure.

    Results: Data analysis revealed no significant differences in the ability to encode or retrieve words during motion sickness compared with a control condition. In addition, there were no significant correlations between the level of motion sickness and performance of the CRT.

    Conclusion: The results indicate that encoding and retrieval of words are not affected by moderate levels of motion sickness. Application: This research has implications for operational settings where professionals experience moderate levels of motion sickness.

  • 40.
    Donlau, M
    et al.
    Jobbtorget Linkopings Kommun.
    Falkmer, Torbjörn
    Linköping University, Department of Clinical and Experimental Medicine, Rehabilitation Medicine . Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Local Health Care Services in Central Östergötland, Paediatric Habilitation Community Service.
    Independence in the toilet activity in children and adolescents with myelomeningocele - managing clean intermittent catheterization in a hospital setting2009In: ACTA PAEDIATRICA, ISSN 0803-5253, Vol. 98, no 12, p. 1972-1976Article in journal (Refereed)
    Abstract [en]

    Aim: The aim of this study was to identify and describe gross motor, fine motor, executive and time-processing obstacles for independence in children with myelomeningocele who are treated with Clean Intermittent Catheterization and to relate their opinions about their performance in the toilet activity, and their medical records, to the observed outcome. Methods: In a hospital setting, 22 children with myelomeningocele were observed using a structured information form while performing their toilet activity, and tested for time processing ability with the Ka-Tid instrument. Results: Only five children were independent, despite the fact that 12 of 22 children were completely satisfied with their toilet activity. Neither the degree of motor impairment, nor sex or age had any significant impact on performing the toilet activity. The ability to remain focused on the toilet activity proved to have no relation to age or learning disabilities. The medical records for the children were only able to classify approximately three quarters correctly with respect to independence. The only measurement that could suggest anything in relation to a maintained focus was time processing ability. Conclusion: The children were unaware of their abilities and limitations. Time processing ability and observations are important factors to assess independence.

  • 41.
    Donlau, Marie
    et al.
    Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Local Health Care Services in Central Östergötland, Habilitation in Central County. Linköping University, Department of Clinical and Experimental Medicine, Pediatrics.
    Imms, Christine
    School of Occupational Therapy, La Trobe University and Murdoch Children’s Research Institute, Melbourne, Vic., Australia.
    Glad Mattsson, Gunilla
    Linköping University, Department of Clinical and Experimental Medicine, Pediatrics. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Centre of Paediatrics and Gynecology and Obstetrics, Department of Paediatrics in Linköping.
    Mattsson, Sven
    Linköping University, Department of Clinical and Experimental Medicine, Pediatrics. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Centre of Paediatrics and Gynecology and Obstetrics, Department of Paediatrics in Linköping.
    Sjörs, Anna
    Linköping University, Department of Clinical and Experimental Medicine, Rehabilitation Medicine. Linköping University, Faculty of Health Sciences.
    Falkmer, Torbjörn
    Linköping University, Department of Clinical and Experimental Medicine, Rehabilitation Medicine. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Local Health Care Services in Central Östergötland, Habilitation in Central County.
    Children and youth with myelomeningoceles independence in managing clean intermittent catheterization in familiar settings2011In: ACTA PAEDIATRICA, ISSN 0803-5253, Vol. 100, no 3, p. 429-438Article in journal (Refereed)
    Abstract [en]

    Aim: To examine the ability of children and youth with myelomeningocele to independently manage clean intermittent catheterization. Methods: There were 50 participants with myelomeningocele (5-18 years); 13 of them had also participated in a previous hospital-based study. Their abilities and interest in completing the toilet activity were examined at home or in school using an interview and the Canadian Occupational Performance Measure (COPM). Actual performance was observed and rated. Background variables were collected from medical records and KatAD+E tests. Results: In total, 48% were observed to perform the toilet activity independently, in comparison with 74% who self-reported independence. Univariate analyses found KatAD+E could predict who was independent. COPM failed to do so. Ability to remain focused and ambulation were predictors of independence, but age, sex and IQ were not. Multivariable analysis found time to completion to be the strongest predictor of independence. Four children were independent in their familiar environment, but not in the hospital setting, and six of 13 children maintained focus only in their familiar environment. Conclusions: Interviews were not sufficiently accurate to assess independence in the toilet activity. Instead, observations including time to completion are recommended. The execution of the toilet activity is influenced by the environmental context.

  • 42.
    Dukic, Tania
    et al.
    Chalmers Tekniska Högskola.
    Hanson, Lars
    Lunds Universitet.
    Falkmer, Torbjörn
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Neuroscience and Locomotion, Rehabilitation Medicine. Östergötlands Läns Landsting, Local Health Care Services in Central Östergötland, Paediatric Habilitation Community Service.
    Effect of drivers' age and push button locations on visual time off road, steering wheel deviation and safety perception2006In: Ergonomics, ISSN 0014-0139, E-ISSN 1366-5847, Vol. 49, no 1, p. 78-92Article in journal (Refereed)
    Abstract [en]

    The study examined the effects of manual control locations on two groups of randomly selected young and old drivers in relation to visual time off road, steering wheel deviation and safety perception. Measures of visual time off road, steering wheel deviations and safety perception were performed with young and old drivers during real traffic. The results showed an effect of both driver's age and button location on the dependent variables. Older drivers spent longer visual time off road when pushing the buttons and had larger steering wheel deviations. Moreover, the greater the eccentricity between the normal line of sight and the button locations, the longer the visual time off road and the larger the steering wheel deviations. No interaction effect between button location and age was found with regard to visual time off road. Button location had an effect on perceived safety: the further away from the normal line of sight the lower the rating. © 2006 Taylor & Francis.

  • 43.
    Earl, Robyn
    et al.
    Curtin University, Australia.
    Falkmer, Torbjörn
    Linköping University, Department of Medical and Health Sciences, Division of Community Medicine. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Pain and Rehabilitation Center. Curtin University, Australia; La Trobe University, Australia.
    Girdler, Sonya
    Curtin University, Australia.
    Dahlman, Joakim
    Chalmers, Sweden.
    Rehnberg, Anette
    Swedish Transport Adm, Sweden.
    Falkmer, Marita
    Curtin University, Australia; Jonköping University, Sweden.
    Visual search strategies of pedestrians with and without visual and cognitive impairments in a shared zone: A proof of concept study2016In: Land use policy, ISSN 0264-8377, E-ISSN 1873-5754, Vol. 57, p. 327-334Article in journal (Refereed)
    Abstract [en]

    Shared zones have gained increasing popularity in urban land use and design as a means of incorporating the needs of multiple modes of transport, while at the same time promoting social interaction between users. Interactions within shared zones are based on a set of informal social protocols, communicated via eye contact and social cues. This proof of concept study utilised eye-tracking technology to examine the visual search strategies of individuals, with and without visual and cognitive impairments as they navigated a strategically chosen shared zone. In total 3960 fixations were analysed and the fixations were distributed across the shared zone and a pedestrian crossing. Those with impairments were more likely to fixate on traffic specific areas and objects compared to those without, suggesting that they required more input ascertaining when and where it was safe to perform tasks. However, the duration of fixation was not significantly different for an object whether it was traffic related or not, indicating a global need for increased processing time of the surrounding environment. Shared zones are claimed to increase driver awareness and safety and reduce congestion, but the implications on participation and safety for those with visual and cognitive impairments is yet to be extensively explored. (C) 2016 Elsevier Ltd. All rights reserved.

  • 44.
    Earl, Robyn
    et al.
    Curtin Univ, Australia.
    Falkmer, Torbjörn
    Linköping University, Department of Medical and Health Sciences, Division of Community Medicine. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Pain and Rehabilitation Center. Curtin Univ, Australia.
    Girdler, Sonya
    Curtin Univ, Australia.
    Morris, Susan L.
    Curtin Univ, Australia.
    Falkmer, Marita
    Curtin Univ, Australia; Jonkoping Univ, Sweden.
    Viewpoints of pedestrians with and without cognitive impairment on shared zones and zebra crossings2018In: PLoS ONE, ISSN 1932-6203, E-ISSN 1932-6203, Vol. 13, no 9, article id e0203765Article in journal (Refereed)
    Abstract [en]

    Background Shared zones are characterised by an absence of traditional markers that segregate the road and footpath. Negotiation of a shared zone relies on an individuals ability to perceive, assess and respond to environmental cues. This ability may be impacted by impairments in cognitive processing, which may lead to individuals experiencing increased anxiety when negotiating a shared zone. Method Q method was used in order to identify and explore the viewpoints of pedestrians, with and without cognitive impairments as they pertain to shared zones. Results Two viewpoints were revealed. Viewpoint one was defined by "confident users" while viewpoint two was defined by users who "know what [they] are doing but drivers might not". Discussion Overall, participants in the study would not avoid shared zones. Pedestrians with intellectual disability were, however, not well represented by either viewpoint, suggesting that shared zones may pose a potential barrier to participation for this group.

  • 45.
    Elgmark Andersson, Elisabeth
    et al.
    Jonkoping University.
    Karrdahl Bedics, Beate
    Koping Hospital.
    Falkmer, Torbjörn
    Linköping University, Department of Clinical and Experimental Medicine, Rehabilitation Medicine. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Local Health Care Services in Central Östergötland, Habilitation in Central County.
    MILD TRAUMATIC BRAIN INJURIES: A 10-YEAR FOLLOW-UP2011In: JOURNAL OF REHABILITATION MEDICINE, ISSN 1650-1977, Vol. 43, no 4, p. 323-329Article in journal (Refereed)
    Abstract [en]

    Objective and design: Long-term consequences of mild traumatic brain injuries were investigated based on a 10-year follow-up of patients from a previously-published randomized controlled study of mild traumatic brain injuries. One aim was to describe changes over time after mild traumatic brain injuries in terms of the extent of persisting post-concussion symptoms, life satisfaction, perceived health, activities of daily living, changes in life roles and sick leave. Another aim was to identify differences between the intervention and control groups. Patients: The intervention group comprised 142 persons and the control group 56 persons. Methods: Postal questionnaires with a response rate of 56%. Results: No differences over time were found for the intervention and control groups in terms of post-concussion symptoms. In the intervention group some variables in life satisfaction, perceived health and daily life were decreased. Some roles had changed over the years for both groups. No other differences between the intervention and control groups were found. However, in both groups sick leave decreased. Conclusion: Early individual intervention by a qualified rehabilitation team does not appear to impact on the long-term outcome for persons with symptoms related to mild traumatic brain injuries. The status after approximately 3 weeks is indicative of the status after 10 years.

  • 46.
    Evans, Kiah L.
    et al.
    Edith Cowan University, Australia; Curtin University, Australia.
    Girdler, Sonya J.
    Edith Cowan University, Australia; Curtin University, Australia.
    Falkmer, Torbjörn
    Linköping University, Department of Medical and Health Sciences, Division of Community Medicine. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Pain and Rehabilitation Center. Curtin University, Australia; Jonköping University, Sweden; La Trobe University, Australia.
    Richmond, Janet E.
    Edith Cowan University, Australia.
    Wagman, Petra
    Jönköping University, Sweden.
    Millsteed, Jeannine
    Edith Cowan University, Australia.
    Falkmer, Marita
    Curtin University, Australia; Jonköping University, Sweden.
    Viewpoints of working sandwich generation women and occupational therapists on role balance strategies2017In: Scandinavian Journal of Occupational Therapy, ISSN 1103-8128, E-ISSN 1651-2014, Vol. 24, no 5, p. 366-382Article in journal (Refereed)
    Abstract [en]

    Occupational therapists need to be cognizant of evidence-based role balance advice and strategies that women with multigenerational caring responsibilities can implement independently or with minimal assistance, as role balance may not be the primary goal during many encounters with this population. Hence, this study aimed to identify the viewpoints on the most helpful role balance strategies for working sandwich generation women, both from their own perspectives and from the perspective of occupational therapists. This was achieved through a Q methodology study, where 54 statements were based on findings from interviews, sandwich generation literature and occupational therapy literature. In total, 31 working sandwich generation women and 42 occupational therapists completed the Q sort through either online or paper administration. The data were analysed using factor analysis with varimax rotation and were interpreted through collaboration with experts in the field. The findings revealed similarities between working sandwich generation women and occupational therapists, particularly in terms of advocating strategies related to sleep, rest and seeking practical assistance from support networks. Differences were also present, with working sandwich generation women viewpoints tending to emphasize strategies related to coping with a busy lifestyle attending to multiple responsibilities. In contrast, occupational therapy viewpoints prioritized strategies related to the occupational therapy process, such as goal setting, activity focused interventions, monitoring progress and facilitating sustainable outcomes.

  • 47.
    Evans, Kiah L.
    et al.
    Edith Cowan University, Perth, Australia .
    Millsteed, Jeannine
    Edith Cowan University, Perth, Australia .
    Richmond, Janet E.
    Edith Cowan University, Perth, Australia .
    Falkmer, Marita
    Curtin University, Perth, Australia; Jönköping University, Sweden.
    Falkmer, Torbjörn
    Linköping University, Department of Medical and Health Sciences, Division of Community Medicine. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Anaesthetics, Operations and Specialty Surgery Center, Pain and Rehabilitation Center. Curtin University, Perth, Australia, Jönköping University, Sweden; La Trobe University, Melbourne, Australia.
    Girdler, Sonya J.
    Edith Cowan University, Perth, Australia; Curtin University, Perth, Australia.
    The complexity of role balance: Support for the Model of Juggling Occupations2014In: Scandinavian Journal of Occupational Therapy, ISSN 1103-8128, E-ISSN 1651-2014, Vol. 21, no 5, p. 334-347Article in journal (Refereed)
    Abstract [en]

    Objective: This pilot study aimed to establish the appropriateness of the Model of Juggling Occupations in exploring the complex experience of role balance amongst working women with family responsibilities living in Perth, Australia. Methods: In meeting this aim, an evaluation was conducted of a case study design, where data were collected through a questionnaire, time diary, and interview. Results: Overall role balance varied over time and across participants. Positive indicators of role balance occurred frequently in the questionnaires and time diaries, despite the interviews revealing a predominance of negative evaluations of role balance. Between-role balance was achieved through compatible role overlap, buffering, and renewal. An exploration of within-role balance factors demonstrated that occupational participation, values, interests, personal causation, and habits were related to role balance. Conclusions: This pilot study concluded that the Model of Juggling Occupations is an appropriate conceptual framework to explore the complex and dynamic experience of role balance amongst working women with family responsibilities. It was also confirmed that the case study design, including the questionnaire, time diary, and interview methods, is suitable for researching role balance from this perspective.

  • 48.
    Evans, Kiah L.
    et al.
    Edith Cowan Univ, Australia; Telethon Kids Inst, Australia; Curtin Univ, Australia.
    Millsteed, Jeannine
    Edith Cowan Univ, Australia.
    Richmond, Janet E.
    Edith Cowan Univ, Australia.
    Falkmer, Marita
    Curtin Univ, Australia; Jonkoping Univ, Sweden.
    Falkmer, Torbjörn
    Linköping University, Department of Medical and Health Sciences, Division of Community Medicine. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Pain and Rehabilitation Center. Curtin Univ, Australia; Jonkoping Univ, Sweden; La Trobe Univ, Australia.
    Girdler, Sonya J.
    Edith Cowan Univ, Australia; Curtin Univ, Australia.
    The impact of within and between role experiences on role balance outcomes for working Sandwich Generation Women2019In: Scandinavian Journal of Occupational Therapy, ISSN 1103-8128, E-ISSN 1651-2014, Vol. 26, no 3, p. 184-193Article in journal (Refereed)
    Abstract [en]

    Women combining paid employment with dual caring responsibilities for children and aging parents, otherwise known as the sandwich generation, experience both benefits and costs related to role participation and quality of life. However, previous literature is inconclusive regarding the impact of this role combination on role balance. In the context of these mixed findings on role balance for working sandwich generation women, this study aimed to explore how within role characteristics and between role interactions are related to role balance for these women. This aim was achieved through the use of a questionnaire administered to 18 Australian working sandwich generation women. Data were analyzed using descriptive statistics and correlation coefficients, with findings suggesting the women studied tended to experience neither role balance or role imbalance. Within-role characteristics, particularly within the mother and family member roles, were related to role balance. In addition, between-role conflict and role interactions involving either the home maintainer or family member roles had the greatest impact on role balance.

  • 49.
    Falkmer, Marita
    et al.
    Jonköping University, Sweden; Municipal Council Norrkoping, Sweden; Curtin University, Australia.
    Anderson, Katie
    Curtin University, Australia.
    Joosten, Annette
    Curtin University, Australia.
    Falkmer, Torbjörn
    Linköping University, Department of Medical and Health Sciences, Division of Community Medicine. Linköping University, Faculty of Health Sciences. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Pain and Rehabilitation Center. Curtin University, Australia; La Trobe University, Australia; Jonköping University, Sweden.
    Parents Perspectives on Inclusive Schools for Children with Autism Spectrum Conditions2015In: International journal of disability, development and education, ISSN 1034-912X, E-ISSN 1465-346X, Vol. 62, no 1Article in journal (Refereed)
    Abstract [en]

    Children with autism spectrum conditions (ASC) increasingly participate in inclusive education. The present study reviewed studies of children with ASC for parents perceptions of aspects they believed contributed to inclusive mainstream school settings. Understanding the parental perspective on the facilitators for inclusion of their child with ASC in mainstream schools is likely to improve inclusive practice. Twenty-eight empirical articles revealed that parents perceived teachers as playing a vital role in the inclusion of their children with ASC. The school was considered important in creating an environment that enabled inclusion, particularly through positive peer relations, prevention of bullying and help from support staff. At the societal level, funding and legislative policies were considered important. By understanding these aspects, policy-makers, teachers, school administrators and therapists may better be able to address parents inclusion concerns and thereby develop strategies to improve inclusion in mainstream schools.

  • 50.
    Falkmer, Marita
    et al.
    Curtin University, Australia; Jonköping University, Sweden.
    Barnett, Tania
    Curtin University, Australia.
    Horlin, Chiara
    Curtin University, Australia.
    Falkmer, Olov
    Lund University, Sweden.
    Siljehav, Jessica
    Lund University, Sweden.
    Fristedt, Sofi
    Jonköping University, Sweden.
    Lee, Hoe C.
    Curtin University, Australia.
    Chee, Derserri Y.
    Curtin University, Australia.
    Wretstrand, Anders
    Lund University, Sweden; K2 Swedish National Knowledge Centre Public Transport, Sweden.
    Falkmer, Torbjörn
    Linköping University, Department of Medical and Health Sciences, Division of Community Medicine. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Pain and Rehabilitation Center. Curtin University, Australia; Jonköping University, Sweden.
    Viewpoints of adults with and without Autism Spectrum Disorders on public transport2015In: Transportation Research Part A: Policy and Practice, ISSN 0965-8564, E-ISSN 1879-2375, Vol. 80, p. 163-183Article in journal (Refereed)
    Abstract [en]

    Background: Public transport is low cost, allows for independence, and facilitates engagement and participation for non-drivers. However, the viewpoints of individuals with cognitive disabilities are rarely considered. In Australia, the prevalence of Autism Spectrum Disorders (ASD) is approximately 1% and increasing. Many individuals with ASD do not possess a drivers licence, indicating that access to public transport is crucial for their independence. However, at present, there is no research on the opinions of adults with ASD on public transport. Aim: To identify the viewpoints of adults with ASD regarding the barriers and facilitators of public transport usage and their transportation preferences, and to contrast these against the viewpoints of neurotypical adults. Methods: Q. method was used to identify the viewpoints of both participant groups on public transport. Participants consisted of 55 adults with a diagnosis of ASD and a contrast group of 57 neurotypical adults. Both groups completed a Q sort task which took place in either Perth or Melbourne, Australia. Results: The most prominent viewpoint indicated that both groups preferred to use public transport over driving and believed that it supported their independence. This viewpoint also indicated that both groups preferred to use electronic ticketing when using public transport. Interestingly, the second most prominent viewpoint indicated that both groups preferred to drive themselves by private car rather than use public transport. Discussion: It appears that the viewpoints of adults with and without ASD regarding public transportation were largely similar. However, questions arose about whether the preference for public transport in the ASD group may be more a result of difficulties obtaining a driving licence than a deliberate choice. The only barrier specified by adults with ASD related to crowding on public transport. Safety and convenience in relation to location and timing of services were barriers reported by neurotypical adults. (C) 2015 Elsevier Ltd. All rights reserved.

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