Online Telehealth Delivery of Group Mental Health Treatment Is Safe,Feasible, and Increases Enrollment and Attendance in Post-9/11 U.S. Veterans

Post-9/11 U.S. veterans are clinically complex with multiple co-occurring health conditions that lead to increased morbidity and mortality, risk for suicide, and decreased quality of life, but underutilization and resistance to treatment remain significant problems. Increased isolation and decreased community and social support due to coronavirus disease (COVID-19) have exacerbated mental health risk. This study evaluated the safety and feasibility of home-based telemental health group workshops to improve reintegration and social connection in post-9/11 U.S. military personnel. Seventy-four (61 males/13 females) post-9/11 U.S. military veterans were randomized to receive 12 sessions of STEP-Home cognitive-behavioral group workshop or present-centered group therapy. Treatment was delivered either in person (traditional medical center setting, treatment as usual [TAU]), or via home-based synchronous videoconferencing (VC). The change to VC occurred due to social distancing guidelines during COVID-19. Mean age was 41.0 years (SD = 11.5, range 24–65). Forty-five (36 males/9 females) participated in VC and 29 (25 males/4 females) in TAU. Demographics were similar across treatment milieu. There were no differences in therapist treatment adherence for TAU versus VC. Therapist satisfaction was higher for TAU groups (q value < .05). Veterans showed higher enrollment, attendance, group cohesion, and veteran-to-veteran support for VC compared to TAU (q values < .05). Safety procedures were successfully implemented via VC. Results demonstrate the safety, feasibility, and high satisfaction of group telemental health in U.S. veterans. Higher enrollment and treatment adherence for telemental health delivery resulted in a greater likelihood of receiving an effective treatment dose than TAU. Strong group cohesion and veteran-to-veteran support were achievable via telehealth. Telemental health offers convenient, efficient, and cost-effective care options for veterans and may be particularly helpful for patients with high psychiatric burden.     

领导权力和地位对下属建言的影响——心理安全感的作用

通过实验研究(研究1、2)和多来源、多时点的实地问卷调查(研究3), 本文发现: 领导权力对下属建言有消极作用, 领导地位对下属建言有积极作用; 领导地位调节领导权力对下属建言的影响, 当领导地位较低时, 领导权力对下属建言的负面作用增强, 反之则不显著; 领导地位对权力的调节作用通过下属心理安全感传递至下属建言行为。这一研究结果有助于阐明组织层级差异(如权力、地位)是如何影响下属建言行为的。     

What constitutes traffic event severity in terms of human danger perception?

This study focuses on the severity gradation of non-collision events. Earlier theoretical work has suggested that a proper severity measure for an event should reflect the risk of personal injury, which is often split into two components, including the risk of a collision and the potential consequences had the collision taken place. While a great number of severity measures have been suggested, most of them fail to address both components, thus resulting in counter-intuitive event gradations and inconclusive outcomes in validation studies. Conversely, it has been shown that human observers often show very good agreement when given a task to rank traffic situations by their severity or level of danger. The aim of this study is to investigate in depth how human judgements of the severity of traffic situations can be expressed by means of objective safety indicators. In this study, a set of video-recorded traffic situations, in which a cyclist passes straight through an intersection while a left or right-turning motor vehicle crosses the cyclist’s path, were analysed. Binary logistic regression was used to develop models assessing the most important traffic severity indicators associated with human feelings of danger. The results showed that the initial conditions of a traffic event, defined as a start of an evasive action, contain the most important information for explaining its severity. Moreover, variables related to both proximity and collision consequences are important and should be integrated into severity measures.     

Relationship between driving styles and biological behavior of drivers in negative emotional state

ObjectiveThis paper explores the links between driving style and the biological behavior of people while driving with dangerous negative emotions (such as anger, anxiety, and fear).BackgroundIt is highly important to study the behavior of humans from varying aspects to discover the factors affecting it. Driving style, as one of the critical aspects of the human factor, and biological behavior, as a factor influencing the performance of individuals, motivate us to examine the relationship between the two.MethodFor this purpose, a test was designed to record the biological signal data, namely, the Electrocardiogram (ECG), Electroencephalogram (EEG), Electromyogram (EMG), and Electrodermal activity (EDA), in a driving simulator with driving events prompting negative emotions. The Multidimensional Driving Style Inventory (MDSI) was employed to determine the driving style of participants.ResultsCorrelation analysis was engaged for data analysis. The results showed, firstly, a significant relationship between the participants’ driving style and their biological behavior and, secondly, the highest correlation between the EEG signal and driving style. Moreover, participants with a nervous and anxious style showed maximum change in biological behavior, while those with a reckless style displayed minimum alterations in biological behavior at the time of unpleasant events during driving.ConclusionConduction of such research can help better understand the behavior of different people while facing unpleasant driving events.     

Drivers’ and cyclists’ safety perceptions in overtaking maneuvers

Drivers overtaking cyclists on rural roads are a safety concern, as drivers need to handle the interaction with the cyclist and possibly an oncoming vehicle. Improving the maneuver’s outcome requires an understanding of not only the objective, measurable safety metrics, but also the subjective, perceived safety of each road user. Previous research has shown that the perceived safety of the cyclist is most at risk at the passing moment, when driver and cyclist are closest to each other. However, to develop safety measures, it is necessary to know how both road users perceive safety, by understanding the factors that influence their perceptions during the overtaking maneuver. This study measured the perceived safety of drivers in a test-track experiment in Sweden and the perceived safety of cyclists in a field test in Spain. For both drivers and cyclists, we developed Bayesian ordinal logistic regression models of perceived safety scores that take as input objective safety metrics representing the different crash risks at the passing moment. Our results show that while drivers’ perceived safety decreases when there is an oncoming vehicle with a low time-to-collision, cyclists’ perceived safety is reduced by a small lateral clearance and a high overtaking speed. Although our datasets are heterogeneous and limited, our results are in line with previous research. In addition, the Bayesian models presented in this paper are novel and may be improved in future studies once more naturalistic data become available. We discuss how our models may support infrastructure development and regulation, policymaking, driver coaching, the development of active safety systems, and automated driving by providing a possible method for predicting perceived safety.     

Sexual behaviours among dyadic vehicle occupants

Sexual activity while driving is a risky behaviour frequently found across media. However, much is unknown about the practices and roles that dyadic occupants of vehicles (i.e. a driver and passenger) perform when engaging in sexual activity while driving. To cover this gap, a content analysis of sexually explicit media (SEM) was conducted on a sample of 208 videos taken from Pornhub.com. The videos portrayed a naturalistic driving situation of a driver of a moving vehicle engaging in sexual activity with a passenger. Videos were coded for sexual behaviours and characteristics of the vehicle occupants (gender and role). Drivers were generally male, while passengers were female. A range of sexual activities while driving were coded, including oral sex, unclothed and clothed masturbation, varying levels of nudity, and ejaculation. Drivers appear to be the focus of sexual attention, as they are generally the ones receiving sexual acts from the passenger, and predominantly ejaculating. Additionally, female passengers perform oral sex on drivers more often than male passengers, and female vehicle occupants tend to have greater levels of nudist exposure than males. This study highlights the complexities of sexual activity while driving and patterns for consideration when developing interventions.     

The implications of situation and route familiarity for driver-pedestrian interaction at uncontrolled mid-block crosswalks

Most routine daily trips take place along the same route, a fact that previous studies have not investigated together with the repeated situation of conflicting with other road users. Consequently, our study addresses driver behaviour by separating the driving experience into three categories: (i) drivers unfamiliar with the route, (ii) those route-familiar, and (iii) situation-familiar drivers. The specific case of driver-pedestrian interaction at uncontrolled mid-block crosswalks is investigated. A multi-level factorial experiment including (i) crosswalk design (linear sidewalk and curb extension), (ii) driver familiarity, and (iii) pedestrian time gap acceptance (4, 6, and 8 s) was conducted using a driving simulator. Fifty-two participants were divided into four groups and stratified by age, gender, and driving experience. The minimum instantaneous time to collision, post-encroachment time, maximum car deceleration, and maximum car speed were all used as surrogate safety measures (SSM).Route-familiarity led to higher speed, while situation-familiarity positively affected driving behaviour making drivers more inclined to decrease their speed at circa 100 m before a crosswalk. The curb extension layout enhanced pedestrian safety and mitigated any adverse effects due to familiarity, with a particularly relevant impact on SSM at low accepted time gaps for pedestrians. Situation- and route-familiarity treatment protocols lead to different behaviours among drivers, indicating a clear need to account for these two familiarity levels in experiments on safety-related countermeasures.     

Evasive action characteristics of motorcycle riders towards occluded-surprise and expected pedestrians: A pedestrian mock-up study

Evasive action performance of motorcycle riders plays a vital role in the prevention of road crashes. In possible conflicting scenarios, motorcycle riders need to respond quickly and perform evasive actions successfully to prevent collisions with other vulnerable road users such as crossing pedestrians. To study the motorcycle rider behavior in conflicts with occluded and visible pedestrians, we designed four mock-up pedestrian scenarios, which includes, two surprise scenarios, one stationary scenario, and one expected scenario. Riders’ responses to the conflicts were measured using instrumented vehicle’s trajectory. Most riders preferred deceleration over swerving at the beginning of the interaction, followed by swerving at manageable speeds. Further, the analysis of riders’ deceleration rates revealed that a linear relationship existed between the deceleration rates and time to collisions (TTC). The study also analyzed the riders’ responses using repeated-measures analysis of variance (RM-ANOVA) to check for the effect of scenario type on deceleration rates. Results indicated that scenario type significantly affected the mean deceleration rates. Further, RM-ANOVA analysis carried out on the jerk behavior of motorcycle riders indicated that there was a significant effect of scenario type on the jerk behavior. Motorcycle riders’ jerks varied linearly with TTC and motorcyclists employ relatively higher decelerations and jerks when faced with pedestrians emerging suddenly from occluded locations such as from the blind spots formed due to parked vehicles. This study helps in understanding motorcycle rider behavior in critical situations and shows the need for assistive evasive systems for motorcycle riders to mitigate collisions with other vulnerable road users.     

Guiding drivers towards safer driving speed: Exploiting visual dominance in speed adaptation

Inappropriate speed is a main cause of accidents. Drivers are often unaware of potential risks due to inadequate speed. To prevent dangerous situations, we need to understand perceptual factors influencing human speed perception. Due to the prominent role of vision in driving, we examined the effect of visuo-spatial stimuli on speed based on the optic flow. While developing an adaptive infrastructure measure to reduce speed, we conducted two consecutive studies, a driving simulator study and a field test to investigate findings further. In both studies, we placed lights on two sides of a highway exit and either illuminated them statically or activated them in a way that they appeared to be moving towards the driver. We expected drivers to slow down more when seeing static light stimuli compared to a baseline without lights. We also expected drivers to decrease speed more in conditions with oncoming lights compared to a baseline, and to static lights, due to distorted speed perception. The first study in a static driving simulator revealed no difference between conditions. In the field test, both static lights and lights moving towards the driver led to a speed reduction compared to a baseline but did not differ from one another. Lights in general led to lower driving speed, potentially due to their warning character, but we found no difference between the light conditions, suggesting that the effect might not be based on the optic flow. Future research should investigate the relationship between driven and perceived speed more closely.