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Fatigue is a pervasive symptom experienced by many individuals after COVID-19. Despite its widespread occurrence, fatigue remains a poorly understood and complex phenomenon. Our aim is to evaluate the subjective experience of mental fatigue after COVID-19 and to assess its significance for daily life functioning. In this online questionnaire study (N = 220), the Fatigue Severity Scale (FSS), World Health Organization Quality-of-Life assessment (WHOQoL) and a subjective severity rating of the COVID-19 disease progression were used. For our statistical analyses we utilized independent samples t-tests, one-way ANOVA with post-hoc analyses, and a multiple regression. As expected our findings revealed the COVID group reported significantly higher levels of subjective fatigue compared to the control group. Moreover, there was a significant difference between experienced fatigue across the four severity groups. Participants who had a milder course of disease also experienced severe subjective fatigue. Subjective fatigue explained 40% variance in quality-of-life. In conclusion, severe subjective fatigue appears to be associated with increased self-reported COVID-19 symptom severity and lower quality-of-life but is already observable in milder cases. This underscores, firstly, the importance of considering also less severe cases and, secondly, the need to develop rehabilitation and psychological interventions for fatigue. [ABSTRACT FROM AUTHOR]

To prevent single-bicycle crashes, this study is the first to evaluate effects of slanted kerbstones, edge lines, shoulder strips, and edge strips on cycling behaviour of cyclists ≥50 years. In Experiment 1, 32 participants cycled on a control path and paths with edge lines, slanted kerbstones, and three types of 0.5 m wide shoulder strips (with grey artificial grass, green artificial grass, or concrete street-print). In Experiment 2, 30 participants cycled a different route including a control path and paths with edge lines or 0.3 m white edge strips. Cyclists rode closer to the main cycle path's edge in the shoulder strips conditions, although the presence of these strips resulted in a larger total distance to the verge compared to the control condition. Furthermore, cyclists cycled further from the verge in the edge strip condition than the control condition. Safety implications of the shoulder and edge strips are considered to be positive. Practitioner Summary: Older cyclists have a high risk for single-bicycle crashes (e.g. riding into the verge). In two experiments, cyclists ≥50 years cycled a route where different treatments were applied on a cycle path. Shoulder and edge strip treatments were related to more efficient path use and safer distances from the verge. Abbreviations: AGS: artificial grass strip; CL: control location; CSS: concrete street-print strip; ELC: edge line continuous; ELI: edge line intermittent; LP: lateral position; SDLP: standard deviation of the lateral position; SK: slanted kerbstones; WCES: white chippings edge strip [ABSTRACT FROM AUTHOR]

Purpose: This study aims to identify the most important factors that influence the independent bicycle use of visually impaired people in the Netherlands. Materials and methods: Both visually impaired people and professionals participated in a two-round online Delphi study (n = 42). In Round 1 the participants identified the factors which they ranked by relevance in Round 2. Results: The participants prioritised environmental factors related to the traffic situation, the characteristics of the infrastructure, and weather and light conditions (Kendall's W = 0.66). They indicated that the most influencing personal factors are related to personality, traffic experience, and personal background (W = 0.58). Glaucoma was ranked as the most relevant ophthalmic condition (W = 0.74), while glare was regarded as the most important factor with respect to the visual functions (W = 0.78). Conclusions: The factors provided by this study can be used to optimise the independent cycling mobility of visually impaired people. More research is needed to investigate, both, how and to what extent the mentioned factors influence the cycling behaviour. The results of this study can be used to set priorities during the rehabilitation and training of visually impaired people who wish to cycle independently. Visually impaired cyclists may compensate for the consequences of their visual impairments by taking alternative routes that suit their individual abilities and limitations. Since gaining and maintaining self-confidence is important for independent cycling with a visual impairment, practitioners such as mobility trainers should not only focus on cycling-related skills and abilities, but also aim to improve the self-confidence of visually impaired people who wish to cycle. [ABSTRACT FROM AUTHOR]

Cycling with a classic paper map was compared with navigating with a moving map displayed on a smartphone, and with auditory, and visual turn-by-turn route guidance. Spatial skills were found to be related to navigation performance, however only when navigating from a paper or electronic map, not with turn-by-turn (instruction based) navigation. While navigating, 25% of the time cyclists fixated at the devices that present visual information. Navigating from a paper map required most mental effort and both young and older cyclists preferred electronic over paper map navigation. In particular a turn-by-turn dedicated guidance device was favoured. Visual maps are in particular useful for cyclists with higher spatial skills. Turn-by-turn information is used by all cyclists, and it is useful to make these directions available in all devices. Practitioner Summary:Electronic navigation devices are preferred over a paper map. People with lower spatial skills benefit most from turn-by-turn guidance information, presented either auditory or on a dedicated device. People with higher spatial skills perform well with all devices. It is advised to keep in mind that all users benefit from turn-by-turn information when developing a navigation device for cyclists. [ABSTRACT FROM AUTHOR]

Objectives: There is no consensus yet on how to determine which patients with cognitive impairment are able to drive a car safely and which are not. Recently, a strategy was composed for the assessment of fitness to drive, consisting of clinical interviews, a neuropsychological assessment, and driving simulator rides, which was compared with the outcome of an expert evaluation of an on-road driving assessment. A selection of tests and parameters of the new approach revealed a predictive accuracy of 97.4% for the prediction of practical fitness to drive on an initial sample of patients with Alzheimer's dementia. The aim of the present study was to explore whether the selected variables would be equally predictive (i.e., valid) for a closely related group of patients; that is, patients with mild cognitive impairment (MCI).Methods: Eighteen patients with mild cognitive impairment completed the proposed approach to the measurement of fitness to drive, including clinical interviews, a neuropsychological assessment, and driving simulator rides. The criterion fitness to drive was again assessed by means of an on-road driving evaluation. The predictive validity of the fitness to drive assessment strategy was evaluated by receiver operating characteristic (ROC) analyses.Results: Twelve patients with MCI (66.7%) passed and 6 patients (33.3%) failed the on-road driving assessment. The previously proposed approach to the measurement of fitness to drive achieved an overall predictive accuracy of 94.4% in these patients. The application of an optimal cutoff resulted in a diagnostic accuracy of 100% sensitivity toward unfit to drive and 83.3% specificity toward fit to drive. Further analyses revealed that the neuropsychological assessment and the driving simulator rides produced rather stable prediction rates, whereas clinical interviews were not significantly predictive for practical fitness to drive in the MCI patient sample.Conclusions: The selected measures of the previously proposed approach revealed adequate accuracy in identifying fitness to drive in patients with MCI. Furthermore, a combination of neuropsychological test performance and simulated driving behavior proved to be the most valid predictor of practical fitness to drive. [ABSTRACT FROM AUTHOR]

Usage-Based Insurances (UBI) enable policyholders to actively reduce the impact of vehicle insurance costs by adopting a safer and more eco-friendly driving style. UBI is especially relevant for younger drivers, who are a high-risk population. The effectiveness of UBI should be enhanced by providing in-car feedback optimised for individual drivers. Thirty young novice drivers were therefore invited to complete six experimental drives with an in-car interface that provided real-time information on rewards gained, their driving behaviour and the speed limit. Reward size was either displayed directly in euro, indirectly as a relatively large amount of credits, or as a percentage of the maximum available bonus. Also, interfaces were investigated that provided partial information to reduce the potential for driver distraction. Compared to a control no-UBI condition, behaviour improved similarly across interfaces, suggesting that interface personalisation after an initial familiarisation period could be feasible without compromising feedback effectiveness. Practitioner Summary: User experiences and effects on driving behaviour of six in-car interfaces were compared. The interface provided information on driving behaviour and rewards in a UBI setting. Results suggest that some personalisation of interfaces may be an option after an initial familiarisation period as driving behaviour improved similarly across interfaces. [ABSTRACT FROM AUTHOR]

Objective: Older drivers with dementia are an at-risk group for unsafe driving. However, dementia refers to various etiologies and the question is whether dementias of different etiology have similar effects on driving ability.Methods: The literature on the effects of dementia of various etiologies on driving ability is reviewed. Studies addressing dementia etiologies and driving were identified through PubMed, PsychINFO, and Google Scholar.Results and Conclusions: Early symptoms and prognoses differ between dementias of different etiology. Therefore, different etiologies may represent different likelihoods with regard to fitness to drive. Moreover, dementia etiologies could indicate the type of driving problems that can be expected to occur. However, there is a great lack of data and knowledge about the effects of almost all etiologies of dementia on driving. One could hypothesize that patients with Alzheimer's disease may well suffer from strategic difficulties such as finding a route, whereas patients with frontotemporal dementia are more inclined to make tactical-level errors because of impaired hazard perception. Patients with other dementia etiologies involving motor symptoms may suffer from problems on the operational level. Still, the effects of various etiologies of dementias on driving have thus far not been studied thoroughly. For the detection of driving difficulties in patients with dementia, structured interviews with patients but also their family members appear crucial. Neuropsychological assessment could support the identification of cognitive impairments. The impact of such impairments on driving could also be investigated in a driving simulator. In a driving simulator, strengths and weaknesses in driving behavior can be observed. With this knowledge, patients can be advised appropriately about their fitness to drive and options for support in driving (e.g., compensation techniques, car adaptations). However, as long as no valid, reliable, and widely accepted test battery is available for the assessment of fitness to drive, costly on-road test rides are inevitable. The development of a fitness-to-drive test battery for patients with dementia could provide an alternative for these on-road test rides, on condition that differences between dementia etiologies are taken into consideration. [ABSTRACT FROM AUTHOR]