A Design Framework of Medical Wayfinding Signs for the Elderly: Based on the Situational Cognitive Commonness

Older people in China have a poor understanding of hospital signage. To address this problem, in this study, we combined the theories of situated cognition and cognitive commonness in order to introduce the three main factors that affect the generation of situational cognitive commonness: composition of the situation, familiarity, and concreteness. We used these theories to construct a methodological framework for the design of geriatric hospital wayfinding signs that were based on situational cognitive commonness. The design of nine healthcare signs for Chinese national standards were used as examples in the study. First, users who were familiar with medical scenarios were asked to draw concrete cognitive conception graphics for the purposes of individual wayfinding targets from both physical and social situations. Next, we coded and grouped the generated graphics based on their situational features in order to extract groups of representative common graphics. Finally, we reorganized the common graphics and developed concrete designs, which were tested by the judgment test. The wayfinding signs designed according to the methodological framework of this study effectively improved the understanding of hospital signage among older Chinese people. This study took geriatric hospital wayfinding signs as the examples to provide a feasible theoretical basis and research reference for symbol design.

A History of the Radiation Warning Sign

ABSTRACT

This paper provides a history of the radiation warning sign with a focus on the period from 1946 to 1948. It employs previously unpublished material from the University of California Radiation Laboratory's Health Chemistry Group, the memoirs of John Gifford, and an account by George Warlick. Also considered is an alternative version of the sign's origin described by Cyrill Orly.

Scientometric Analysis of Safety Sign Research: 1990-2019

The purpose of this paper is to summarize the research themes and hotspots of safety signs research between 1990 and 2019 through the scientometric analysis method. In total, 3102 articles of literature from the Web of Science core database were analyzed by the CiteSpace visualization tool and the results were displayed in mapping knowledge domains. The overall characteristics analysis showed that safety sign is an emerging research field in a rapid development stage—81.4% of the literature works were published in the past ten years, and the United States was in the leading position, followed by China and Canada. The keyword co-occurrence analysis indicated that traffic signs and driving safety were the most popular research topics and have been combined with simulation technology in recent years, whereby individual mental health has been added as an influential factor. The journals and category co-citation analysis showed that the safety signs research involved many subjects, mainly engineering, transportation and public safety. The results indicated that the safety signs research is multi-disciplinary, and it will continue to develop in various scientific domains in the future. The conclusions can provide help and reference for potential readers, as well as help with the sustainable development of safety signs research.

Effects of Semantic Congruence on Sign Identification: An ERP Study

OBJECTIVE

The purpose of this study was to investigate the effects of semantic congruence and incongruence on sign identification by using event-related potentials (ERPs).

BACKGROUND

Sign systems have crucial roles in public spaces and traffic facilities. Poorly designed signs can easily confuse pedestrians and drivers and reduce the efficiency of public activities and urban administration.

METHOD

Thirty-one participants completed a sign identification experiment independently in a laboratory setting. Experimental materials were selected from GB/T 10001, a Chinese national recommendation standard that is officially named Public Information Graphical Symbols for Use on Signs. All ERP data were processed using MATLAB 13b, and behavioral data were analyzed using Stata 14.

RESULTS

N170, P200, N300, and N400 components were induced during semantic processing. Statistical analysis revealed that semantic congruence has a main effect on N300 in the frontal region and has a main effect on N400 at FZ in the frontal region, CPZ in the parietal-central region, and PZ in the parietal region. Amplitudes of N300 induced by picture-word matching were considerably different between the two experimental conditions at electrodes FZ and FCZ. Amplitudes of N400 were significantly larger in the incongruent condition than in the congruent condition.

CONCLUSION

The study demonstrated that N300 and N400 are promising indicators for measuring semantic congruence in future sign design.

APPLICATION

Our findings provide ERP indicators for measuring the semantic congruence of sign design, which can be easily applied to improve the efficiency of sign design and sign comprehension.

Inattentional blindness and information relevance of variable message signs

It has been suggested that Variable Message Signs (VMS) become less effective at communicating important traffic information when irrelevant information is also displayed on them. The purpose of this study was to examine if practice reading irrelevant information on a VMS influenced compliance with, and memory for a detour message. Thirty-nine participants were randomly assigned to one of three groups who drove a simulated road; one receiving only a detour message on the VMS, one group received irrelevant VMS messages before the detour message, and a third group received the same messages but the detour message was inconsistent with their destination. Of interest were both the participants' compliance with the target detour message, as well as their later recall and recognition of the message. The results suggested that, first and foremost, there was significantly lower compliance with the detour message when it had been preceded by irrelevant messages on the VMS. All of the groups showed reasonably good memory for the detour message. The implications of the present study are that presentation of irrelevant messages, including advertisements and safety slogans, may result in reduced compliance to traffic-relevant messages on VMSs.

Motivational signage increases stair usage on a Hispanic serving institution

Objective: Stair climbing is considered a good physical activity. Motivational signage has been successful in promoting stair usage in various settings. This study was to investigate the effects of motivational signage on stair usage in a Hispanic serving institution. Participants: A total of 31,067 pedestrians were observed from February to March 2013. Methods: Stair usage was monitored for 9 h per day each week at phase 1 (baseline), 2 (intervention), and 3 (post-intervention). Results: Overall, participants' stair usage was higher during phase 2 (49.0%) and phase 3 (48.0%), compared with phase 1 (39.7%). The participants during phase 2 and 3 were more likely to use the stairs compared to participants during phase 1, regardless of floor level (3-story or 4-story building), status (student or staff/faculty), and time of day (7:30-10:29, 10:30-13:29, or 13:30-16:30) (p < .001). Conclusion: Motivational signage can effectively encourage more stair usage, and hence promote healthy behavior in a predominantly Hispanic-serving institution.

Signage Interventions for Stair Climbing at Work: More than 700,000 Reasons for Caution

Increased stair climbing reduces cardiovascular disease risk. While signage interventions for workplace stair climbing offer a low-cost tool to improve population health, inconsistent effects of intervention occur. Pedestrian movement within the built environment has major effects on stair use, independent of any health initiative. This paper used pooled data from UK and Spanish workplaces to test the effects of signage interventions when pedestrian movement was controlled for in analyses. Automated counters measured stair and elevator usage at the ground floor throughout the working day. Signage interventions employed previously successful campaigns. In the UK, minute-by-minute stair/elevator choices measured effects of momentary pedestrian traffic at the choice-point (n = 426,605). In Spain, aggregated pedestrian traffic every 30 min measured effects for ‘busyness’ of the building (n = 293,300). Intervention effects on stair descent (3 of 4 analyses) were more frequent than effects on stair climbing, the behavior with proven health benefits (1 of 4 analyses). Any intervention effects were of small magnitude relative to the influence of pedestrian movement. Failure to control for pedestrian movement compromises any estimate for signage effectiveness. These pooled data provide limited evidence that signage interventions for stair climbing at work will enhance population health.

Designing in-vehicle signs for connected vehicle features: Does appropriateness guarantee comprehension?

This paper discusses the design and evaluation of connected and cooperative vehicle in-vehicle sign designs displayed on a mobile phone: Emergency Electronic Brake Lights (EEBL), Emergency Vehicle Warning (EVW), Traffic Condition Warning, and Road Works Warning. Appropriateness and comprehension of each design alternative were assessed using quantitative (i.e. Likert scales) and qualitative (i.e. open-ended questions) methods. Forty-four participants took part in the study and were shown twelve dashboard camera videos presenting a total of eleven designs alternatives, displayed with or without a legend. Despite their appropriateness, EEBL and EVW signs displayed with a legend were better comprehended and less ambiguous than those displayed without a legend. Moreover, displaying a legend below the signs to warn drivers of an emergency braking ahead was efficient in low visibility condition and could potentially increase safety in critical situations.

Using GIS to simulate tsunami evacuation guidance signs for the hearing impaired

The Nankai Trough in Japan has been identified as a geological feature that could cause extensive damage in the event of a major earthquake. In this study, we investigated the impact of effective guidance signs for hearing-impaired individuals requiring special care when escaping to a tsunami evacuation building (emergency evacuation location) using geographical information system (GIS) and viewshed analysis. We selected an area we considered would suffer severe damage following a major earthquake and tsunami; we identified difficulties in the provision of escape routes. Using GIS, we determined the time required for escape and tsunami arrival time if effective signs were installed; we undertook such analysis using the height data of buildings in the target area. With effectively installed guidance signs, the average required evacuation time was 36.88 minutes; without such signs (which is currently the case in the target area), the average time was 47.10 minutes: that would result in citizens getting caught by the tsunami. Installing effective guidance signs would allow hearing-impaired individuals to escape to an evacuation building before being hit by the tsunami.

Expert evaluation of traffic signs: conventional vs. alternative designs

Traffic sign comprehension is significantly affected by their compliance with ergonomics design principles. Despite the UN Convention, designs vary among countries. The goal of this study was to establish theoretical and methodological bases for evaluating the design of conventional and alternative signs. Thirty-one conventional signs and 1-3 alternatives for each conventional sign were evaluated for their compliance with three ergonomics guidelines for sign design: physical and conceptual compatibility, familiarity and standardisation. Twenty-seven human factors and ergonomics experts from 10 countries evaluated the signs relative to their compliance with the guidelines. Analysis of variance across alternatives revealed that for 19 of the 31 signs, an alternative design received a significantly higher rating in its ergonomics design than the conventional sign with the same meaning. We also found a very high correlation between the experts' ratings and comprehension from previous studies. In conclusion, many countries use signs for which better alternative designs exist, and therefore UN Convention signs should be re-examined, and ergonomics experts evaluation can serve as a good surrogate for road users' comprehension surveys. Practitioner summary: This study presents theoretical and methodological bases for evaluating the design of UN Conventional and alternative traffic signs. Human factors and ergonomics experts evaluated 31 conventional and 68 alternative road signs, based on ergonomics principles for sign design. Results indicated the need to re-examine poorly designed UN Convention signs.

An evaluation of tactile symbols in public environment for the visually impaired

This study evaluated the identification performance of a set of tactile symbols used in public environments for the visually impaired. A questionnaire survey was carried out to investigate the public environment needs from 60 visually impaired associations. A two-stage experiment with a matching test was then conducted to explore the identification efficiency of graphic tactile public information symbols. Eighty-one students were recruited as participants from a school for the visually impaired. The survey results show that fourteen public buildings were frequently visited and ten architectural elements were mostly needed by the visually impaired. The experimental results showed the correct response of graphic symbols tested in both two-stage experiments could meet the identification criterion of 90% and even better except for the escalator/elevator with 87.0% in the second stage. Relevant confusion among the graphic symbols tested was found. Some suggestions were made in the study.

What color are emergency exit signs? Egress behavior differs from verbal report

Illuminated emergency exit signs inform building occupants about safe egress routes in emergencies. These exit signs are often found in the presence of other colored signs, which may distract occupants when searching for safe exits. Such distractions can lead to confusing and even harmful outcomes, especially if occupants misinterpret the sign colors, mistaking non-exit signs for exit signs. We studied which colored signs people were most likely to infer were exit signs in a simulated emergency evacuation using virtual reality (VR). Participants were immersed in a virtual room with two doors (left and right), and an illuminated sign with different colored vertical bars above each door. They saw all pairwise combinations of six sign colors across trials. On each trial, a fire alarm sounded, and participants walked to the door that they thought was the exit. We tested two hypotheses: a local exposure hypothesis that color inferences are determined by exit sign colors in the local environment (i.e., red) and a semantic association hypothesis that color inferences are determined by color-concept associations (i.e. green associated with "go" and "safety"). The results challenged the local exposure hypothesis and supported the semantic association hypothesis. Participants predominantly walked toward green signs, even though the exit signs in the local environment-including the building where the experiment took place-were red. However, in a post-experiment survey, most participants reported that exit signs should be red. The results demonstrated a dissociation between the way observers thought they would behave in emergency situations (red = exit) and the way they did behave in simulated emergencies (green = exit). These findings have implications for the design of evacuation systems. Observers, and perhaps designers, do not always anticipate how occupants will behave in emergency situations, which emphasizes the importance of behavioral evaluations for egress safety.

An analysis of escalator-related injuries in metro stations in China, 2013-2015

In order to reduce the probability and severity of escalator-related injuries and enhance the safety of passengers, this study analyzed 950 escalator-related injuries in Guangzhou metro stations to identify the characteristics and the risk factors associated with escalator-related injuries in China. The data extracted from Management Information System of Guangzhou Metro covers the site and time of the accident, age and gender of the victims, escalator condition and injury information. The results from the statistical analysis indicated that the majority of the escalator-related injuries was caused by failing to stand firm (287 cases, 30.2%), passengers carrying out other tasks (214 cases, 22.5%), not holding the handrail (168 cases, 17.7%) and unhealthy passengers (18 cases, 9.3%). Age was associated with all factors except for need for an ambulance and the distribution law of these factors differed with age groups. Elderly passengers (aged 66 years and above) accounted for the highest proportion of all injuries (49.1%), and failing to stand firm (18.63%) was the main cause of escalator-related injuries of elderly passengers. The most common mechanism of injury for all age groups was a fall, accounting for (51.0%) injuries. Proportion of injuries caused by a fall increased with age, whereas injuries attributed to entrapment decreased. Female passengers (65.9%) were more likely to be involved escalator-related injuries than male passengers (34.1%), while male passengers were more likely to have accidents caused by unhealthy physical condition than female passengers. These results based on the analysis of current accident data can be used to help metro operation corporation develop effective injury prevention measures and document the need for continued improvement of escalator safety in metro stations.

Using Wayfinding Data to Understand Patient Travel Within a Medical Center

Navigating through parking lots, public areas, and hallways is a stressful task for patients visiting large medical centers. Little is known about the patient experience from when they arrive at a medical center to when they check-in at their clinic. In a pilot study, we used requests for wayfinding directions from a mobile application to form a network of patient movement through the Vanderbilt University Medical Center (VUMC). From September 2016 to September 2017, patients using the wayfinding application made 3493 requests using the VUMC WalkWays application. Results show that patients frequently request directions from parking garages, on-site eateries, and the emergency room. We calculated the approximate distance patients walked to determine the extent to which associated clinical areas were co-located. Applied more generally, medical centers could use similar technologies to inform clinic placement, signage design, and resource allocation to improve the patient experience and operational efficiency.

Transitions within a safe road system

As drivers move through the road transport system they are exposed to a range of different situations and road conditions in a relatively short space of time. Drivers' expectations about what will happen on different types of roads have strong effects on their speed choices, and where they look and what they attend to. As a result it is important to assist drivers to change their expectations when they transition from one road type to another. In this experiment we investigated the effectiveness of different centreline road markings in preparing for a horizontal curve as drivers moved from a motorway to a two-lane rural country road. Fifty individuals were recruited to participate in a video-based simulated driving task to compare three centreline marking types in terms of their effects on speed choice and reactions to a driving hazard (horizontal curve). Although a complex marking previously associated with high risk produced the largest speed reductions during the transition from the motorway, it was the centreline more traditionally associated with rural country roads (dashed white centreline) that was associated with the best hazard reactions post-transition (brake reaction time and speed reduction before a horizontal curve). The findings demonstrated that the look of a road needs to convey a clear and unambiguous message to drivers. The transition to a two-star rural road is best achieved by making the road look like a typical two-star road as soon as possible.

Safety and operational impacts of setting speed limits below engineering recommendations

This study quantifies the operational and safety impacts of setting posted speed limits below engineering recommendations using field data from rural roads in Montana. Vehicle operating speeds and historical crash data were collected at multiple sites with posted speed limits set equal to engineering recommendations and sites with posted speed limits set lower than engineering recommendations. Linear, quantile and logistic regression models were estimated to predict mean operating speed, 85th percentile operating speed and speed limit compliance, respectively, as a function of various roadway characteristics and level of speed enforcement. The Empirical-Bayes before-after approach was also used to develop crash modification factors (CMFs) that describe the expected change in total and fatal + injury crash frequency when setting posted speed limits lower than engineering recommendations. Because safety data were collected over a long time period, temporal adjustments were incorporated to account for yearly changes in crash reporting, traffic characteristics and other variables. The results revealed that speed limit compliance worsened as the difference between the engineering recommended and posted speed limits increased. The presence of verified heavy police enforcement reduced both mean and 85th-percentile operating speeds by approximately 4 mph and increased speed limit compliance. The safety analysis found a statistically significant reduction in total, fatal + injury, and property damage only (PDO) crash frequency at locations with posted speed limits set 5 mph lower than engineering recommendations. Locations with posted speed limits set 10 mph lower than engineering recommendations experienced a decrease in total and PDO crash frequency, but an increase in fatal + injury crash frequency. The safety effects of setting speed limits 15 to 25 mph lower than engineering recommendations were less clear, as the results were not statistically significant, likely due to the small sample of sites included in the evaluation. Overall, the results suggest that setting posted speed limits 5 mph lower than the engineering recommended practice may result in operating speeds that are more consistent with the posted speed limits and overall safety benefits.

The relationship between the demographic, personal, and social factors of Malaysian motorcyclists and risk taking behavior at signalized intersections

In the context of road safety, risk-taking is undoubtedly one of the main contributory factors in road accidents. The actual forces which influence individuals to take such risks, nevertheless, are still not fully understood. To address this, this study was therefore conducted to investigate the relationship of the demographic, personal, and social factors of motorcyclists, with a specific focus on their risk-taking behavior at signalized intersections in Malaysia. This study adopted the quantitative method using cross-sectional questionnaire surveys and involved 251 respondents. The demographic factors were analyzed using the t-test and an ANOVA Scheffe Post-Hoc test, while the motorcyclists' personal and social characteristics were analyzed with multiple linear regression. The findings indicate that the individuals who were greater risk takers at signalized intersections were teenage motorcyclists (16-25 years old) who had finished their education before taking their high school diploma, and who also received a lower than average monthly income from private sector firms. The actual experience of accidents was also shown to be positively related to this risk-taking behavior. In addition, in term of personal and social factors, results showed that, for these individuals, there was a significant difference between the strength of peer influence and that of parental and spouse guidance. However, there was no significant difference in the risk-taking behavior of Malaysian motorcyclists riding at signalized intersections for the following factors: between genders, in terms of accident involvement, in terms of enforcement of traffic regulations, and prevention steps and confidence level after being involved in an accident.

Identifying the safety factors over traffic signs in state roads using a panel quantile regression approach

OBJECTIVE

This study intended to investigate the interactions between accident rate and traffic signs on state roads located in Croatia and accommodate the heterogeneity attributed to unobserved factors. Data from 130 state roads between 2012 and 2016 were collected from Traffic Accident Database System maintained by the Republic of Croatia's Ministry of the Interior.

METHODS

To address the heterogeneity, a panel quantile regression model was proposed, in which a quantile regression model offers a more complete view and a highly comprehensive analysis of the relationship between accident rate and traffic signs, and the panel data model accommodates the heterogeneity attributed to unobserved factors.

RESULTS

Results revealed that (1) low visibility of material damage (MD) and death or injury (DI) increased the accident rate; (2) the number of mandatory signs and the number of warning signs were more likely to reduce the accident rate; (3) the average speed limit and the number of invalid traffic signs per kilometer exhibited a high accident rate.

CONCLUSIONS

To our knowledge, this study is the first attempt to analyze the interactions between accident consequences and traffic signs by employing a panel quantile regression model; by including visibility, the present study demonstrates that low visibility causes a relatively higher risk of MD and DI. It is noteworthy that average speed limit positively corresponds with accident rate; the number of mandatory signs and the number of warning signs are more likely to reduce the accident rate; and the number of invalid traffic signs per kilometer is significant for the accident rate; thus, regular maintenance should be performed for a safer roadway environment.

How to warn drivers in various safety-critical situations - Different strategies, different reactions

Technological advances allow supporting drivers in a multitude of occasions, ranging from comfort enhancement to collision avoidance, for example through driver warnings, which are especially crucial for traffic safety. This psychological driving simulator experiment investigated how to warn drivers visually in order to prevent accidents in various safety-critical situations. Collision frequencies, driving behavior and subjective evaluations of situation criticality, warning understandability and helpfulness of sixty drivers were measured in two trials of eight scenarios each (within-subjects factors). The warning type in the head-up display (HUD) varied (between-subjects) in its strategy (attention-/reaction-oriented) and specificity (generic/specific) over four warning groups and a control group without a warning. The results show that the scenarios differed in their situation criticality and drivers adapted their reactions accordingly, which underlines the importance of testing driver assistance systems in diverse scenarios. Besides some learning effects over the trials, all warned drivers showed faster and stronger brake reactions. Some warning concepts were understood better than others, but all were accepted. Generic warnings were effective, yet the warning strategy should adapt to situation requirements and/or driver behavior. A stop symbol as reaction generic warning is recommendable for diverse kinds of use cases, leading to fast and strong reactions. However, for rather moderate driver reactions an attention generic approach with a caution symbol might be more suitable. Further research should investigate multi-stage warnings with adaptive strategies for application to various situations including other modalities and false alarms.

Increasing the default interletter spacing of words can help drivers to read traffic signs at longer distances

Would an increase in the default interletter spacing improve the legibility of words in traffic signs? Previous evidence on traffic sign design and recent studies on the cognitive processes involved in visual word recognition have provided conflicting results. The present work examined whether an increase in the default interletter spacing would improve the search of a word in direction traffic signs. To achieve this objective, twenty-two drivers participated in a driving simulation experiment. They followed a highway route and indicated whether a target place name was present among a set of distractors shown on direction traffic signs along the route. We compared the default interletter spacing of the Spanish "CC Rige" font (which is based on the internationally-used Transport font) and a 2.5-times expanded interletter spacing. The results revealed that the drivers were able to give a correct response at a distance to the traffic sign that was on average longer in the expanded than in the default spacing condition. This advantage in the legibility distance was observed in the absence of significant differences in reading accuracy, gaze behavior, or driving performance measures. Therefore, the evidence provided supports that drivers can benefit from a slight increase in interletter spacing relative to the standard spacing. Some of the design factors influencing this effect are discussed.

Using road markings as a continuous cue for speed choice

The potential for using road markings to indicate speed limits was investigated in a driving simulator over the course of two sessions. Two types of experimental road markings, an "Attentional" set designed to provide visually distinct cues to indicate speed limits of 60, 80 and 100 km/h, and a "Perceptual" set designed to also affect drivers' perception of speed, were compared to a standard undifferentiated set of markings. Participants (n = 20 per group) were assigned to one of four experimental groups (Attentional-Explicit, Attentional-Implicit, Perceptual-Explicit, Perceptual-Implicit) or a Control group (n = 22; standard road markings). The Explicit groups were instructed about the meaning of the road markings while those in the Implicit and Control groups did not receive any explanation. Participants drove five 10 km simulated roads containing three speed zones (60, 80 and 100 km/h) during the first session. The participants returned to the laboratory approximately 3 days later to drive five more trials including roads they had not seen before, a trial that included a secondary task, and a trial where speed signs were removed and only markings were present. The findings indicated that both types of road markings improved drivers' compliance with speed limits compared to the control group, but that explicit instruction as to the meaning of the markings was needed to realise their full benefit. Although previous research has indicated the benefit of road markings used as warnings to indicate speed reductions in advance of horizontal or vertical curves, the findings of the present experiment also suggest that systematically associating road markings with specific speed limits may be a useful way to improve speed limit compliance and increase speed homogeneity.

Speeding in highway work zone: An Evaluation of methods of speed control

Highway workers frequently work in close proximity of live traffic in highway work zones, traffic accidents therefore have devastating effects on worker safety. In order to reduce the potential for such accidents, methods involving use of advisory signs and police presence have been used to mitigate accident risks and improve safety for highway workers. This research evaluates the magnitude of the speeding problem in highway work zones and the effects of four levels of police presence on improving work zone safety. Speed data were collected in six different work zone locations in northern and southern California and used to determine the magnitude and nature of speeding problem in highway work zones. In addition data were collected over 11 test-days in four work zones with four levels of police presence: radar speed display with police decal and lighting, passive use of a police vehicle with radar speed display, passive use of a police vehicle without radar speed display, and active police speed enforcement near work zones. This paper analyzes this data using statistical methods to evaluate the effectiveness of these different methods of speed control on the safety of the work zone. Four Measures of Effectiveness (MOE) were used in this evaluation consisting of average speed reduction, speed variance, 85th percentile speed, and proportion of high speed vehicles. The results indicate that all levels of police presence provided statistically significant improvements in one or more of the MOEs.

Is there sufficient evidence regarding signage-based stair use interventions? A sequential meta-analysis

OBJECTIVE

The proliferation of studies using motivational signs to promote stair use continues unabated, with their oft-cited potential for increasing population-level physical activity participation. This study examined all stair use promotional signage studies since 1980, calculating pre-estimates and post-estimates of stair use. The aim of this project was to conduct a sequential meta-analysis to pool intervention effects, in order to determine when the evidence base was sufficient for population-wide dissemination.

DESIGN

Using comparable data from 50 stair-promoting studies (57 unique estimates) we pooled data to assess the effect sizes of such interventions.

RESULTS

At baseline, median stair usage across interventions was 8.1%, with an absolute median increase of 2.2% in stair use following signage-based interventions. The overall pooled OR indicated that participants were 52% more likely to use stairs after exposure to promotional signs (adjusted OR 1.52, 95% CI 1.37 to 1.70). Incremental (sequential) meta-analyses using z-score methods identified that sufficient evidence for stair use interventions has existed since 2006, with recent studies providing no further evidence on the effect sizes of such interventions.

CONCLUSIONS

This analysis has important policy and practice implications. Researchers continue to publish stair use interventions without connection to policymakers' needs, and few stair use interventions are implemented at a population level. Researchers should move away from repeating short-term, small-scale, stair sign interventions, to investigating their scalability, adoption and fidelity. Only such research translation efforts will provide sufficient evidence of external validity to inform their scaling up to influence population physical activity.

Smokefree signage at New Zealand racecourses and sports facilities with outdoor stands

Smokefree signage is crucial to the implementation of smokefree policies for outdoor venues and for facilitating smoking denormalisation. Such signage helps to communicate the expected norms for not smoking at venues. Therefore, we aimed to identify such signage at racecourses and sports facilities that had outdoor stands. We surveyed the entrances of 25 racecourse and 25 sport facilities with outdoor stands, across New Zealand. There were smokefree signs at the main entrances of 40% of the sports facilities with outdoor stands, and at 16% of the 25 other entrances. None of the horse/greyhound racecourses had smokefree signage at any of their entrances.

Work zone sign design for increased driver compliance and worker safety

Many studies have investigated the effect of dynamic message signs (DMS) on drivers' speed reduction and compliance in work zones, yet only a few studies have examined the design of sign content of DMS. The purpose of this study was to develop design standards for DMS to improve driver compliance and worker safety. This study investigated the impact of sign content, frame refresh rate, and sign placement on driver speed reduction, compliance, and eye movements. A total of 44 participants were recruited for this study. Each participant completed 12 simulated driving tasks in a high-fidelity driving simulator. A small-scale field study was also conducted to test the effect of DMS on vehicle speed in a highway work zone. Results showed sign content and placement had no impact on speed reduction and compliance. However, sign frame refresh rate was found to have a significant effect on drivers' initial speed and speed reduction. Participants had longer fixation duration on DMS when worker presence was mentioned in the sign content. Results of the field study suggested that the DMS is most effective at night.

Improvement of the performance of animal crossing warning signs

INTRODUCTION

Animal-vehicle collisions (AVCs) can result in serious injury and death to drivers, animals' death, and significant economic costs. However, the cost effectiveness of the majority of AVC mitigation measures is a significant issue.

METHOD

A mobile-based data collection effort was deployed to measure signs under the Utah Department of Transportation's (UDOT) jurisdiction. The crash data were obtained from the UDOT risk management database. ArcGIS was employed to link these two data sets and extract animal-related crashes and signs. An algorithm was developed to process the data and identify AVCs that occurred within sign recognition distance. Kernel density estimation (KDE) technique was applied to identify potential crash hotspots.

RESULTS

Only 2% of AVCs occurred within the recognition distance of animal crossing signs. Almost 58% of animal-related crashes took place on the Interstate and U.S. highways, wherein only 30% of animal crossing signs were installed. State routes with a higher average number of signs experienced a lower number of AVCs per mile. The differences between AVCs that occurred within versus outside of sign recognition distance were not statistically significant regarding crash severity, time of crash, weather condition, driver age, vehicle speed, and type of animal. It is more likely that drivers become accustomed to deer crossing signs than cow signs.

CONCLUSIONS

Based on the historical crash data and landscape structure, with attention given to the low cost safety improvement methods, a combination of different types of AVC mitigation measures can be developed to reduce the number of animal-related crashes. After an in-depth analysis of AVC data, warning traffic signs, coupled with other low cost mitigation countermeasures can be successfully placed in areas with higher priority or in critical areas. Practical applications: The findings of this study assist transportation agencies in developing more efficient mitigation measures against AVCs.

Signage as a tool for behavioral change: Direct and indirect routes to understanding the meaning of a sign

Signs, prompts, and symbols are a common means to change behavior in our society. Understanding the psychological mechanisms by which signage influences behavior is a critical first step to achieve the desired outcome. In the current research, we propose a theoretical model of sign-to-behavior process. The model suggests that when one encounters a sign, it is encoded to construct an action representation (comprehension process), which is then acted on unless its enactment is inhibited (decision process). We test the implications of the model in two studies. In support of our hypothesis, for unfamiliar signs, clarity of purpose predicts perceived effectiveness of a sign; however, for familiar signs, clarity of purpose does not matter. Insights gained from the studies will help to design effective signs. Practical implications of the model are discussed, and future research directions are outlined.

Representativity and univocity of traffic signs and their effect on trajectory movement in a driving simulation task: Warning signs

OBJECTIVE

The effect of traffic signs on the behavior of drivers is not completely understood. Knowing about how humans process the meaning of signs (not just by learning but instinctively) will improve reaction time and decision making when traveling. The economic, social, and psychological consequences of car accidents are well known.

METHODS

This study sounds out which traffic signs are more ergonomic for participants, from a cognitive point of view, and determines, at the same time, their effect in participants' movement trajectories in a driving simulation task.

RESULTS

Results point out that the signs least representative of their meaning produce a greater deviation from the center of the road than the most representative ones.

CONCLUSIONS

This study encourages both an in-depth analysis of the effect on movement of roadside signs and the study of how this effect can be modified by the context in which these signs are presented (with the aim to move the research closer to and analyze the data in real contexts). The goal is to achieve clarity of meaning and lack of counterproductive effects on the trajectory of representative signs (those that provoke fewer mistakes in the decision task).

Age-related differences in decision-making for digital escape route signage under strenuous emergency conditions of tilted passenger ships

This age-differentiated study investigated preferences for new digital, situation-adaptive escape route signage with informative and flashing elements under simulated emergency conditions of tilted passenger ships. The decision-making behaviour of 26 young (20-30 years) and 26 elderly (60-77 years) participants was observed in four conditions varying in applied stressors and in level versus uphill walking at 7° and 14°. In line with previous studies, decisions of young participants were significantly influenced by flashing elements on signs. In contrast, elderly participants based their decisions significantly stronger on integrated information about the sign's updatedness and reported irritation by flashing elements. These preferences were also persistent under increased mental, emotional and physical strain, evaluated by ratings and (psycho-)physiological measures. The findings demonstrate the importance to carefully design digital, situation-adaptive signage for passenger ships in a way that it not only attracts attention but also inspires trust especially for the elderly population.

Dissuasive exit signage for building fire evacuation

This work presents the result of a questionnaire study which investigates the design of dissuasive emergency signage, i.e. signage conveying a message of not utilizing a specific exit door. The work analyses and tests a set of key features of dissuasive emergency signage using the Theory of Affordances. The variables having the largest impact on observer preference, interpretation and noticeability of the signage have been identified. Results show that features which clearly negate the exit-message of the original positive exit signage are most effective, for instance a red X-marking placed across the entirety of the exit signage conveys a clear dissuasive message. Other features of note are red flashing lights and alternation of colour. The sense of urgency conveyed by the sign is largely affected by sensory inputs such as red flashing lights or other features which cause the signs to break the tendencies of normalcy.

Factors influencing experience in crowds - The participant perspective

Humans encounter crowd situations on a daily basis, resulting in both negative and positive experiences. Understanding how to optimise the participant experience of crowds is important. In the study presented in this paper, 5 focus groups were conducted (35 participants, age range: 21-71 years) and 55 crowd situations observed (e.g. transport hubs, sport events, retail situations). Influences on participant experience in crowds identified by the focus groups and observations included: physical design of crowd space and facilities (layout, queuing strategies), crowd movement (monitoring capacity, pedestrian flow), communication and information (signage, wayfinding), comfort and welfare (provision of facilities, environmental comfort), and public order. It was found that important aspects affecting participant experience are often not considered systematically in the planning of events or crowd situations. The findings point to human factors aspects of crowds being overlooked, with the experiences of participants often poor.

Flying solo: A review of the literature on wayfinding for older adults experiencing visual or cognitive decline

Accessible tourism is a growing market within the travel industry, but little research has focused on travel barriers for older adults who may be experiencing visual and cognitive decline as part of the normal aging process, illness, or other disabling conditions. Travel barriers, such as difficulty finding one's way throughout an airport, may adversely affect older adults' travel experience, thereby reducing their desire to travel. This review of the literature investigates wayfinding strategies to ensure that older passengers who have planned to travel independently can do so with dignity. These include facility planning and design strategies (e.g., layout, signage) and technological solutions. Although technological approaches, such as smart phone apps, appear to offer the most promising new solutions for enhancing airport navigation, more traditional approaches, such as designing facilities with an intuitive building layout, are still heavily relied upon in the aviation industry. While there are many design guidelines for enhancing wayfinding for older adults, many are not based on scientific investigation.

Seamless patient journeys the goal

Chris Wiegand, CEO of Jibestream, a software development company for digital interactive technologies with bases in Toronto and Arlington, Virginia, explains how technologies including Wi-Fi, GPS, RFID, and Bluetooth LE are enhancing wayfinding in healthcare facilities, and, in the process, simplifying the patient journey and helping reduce the stress and anxiety often associated with a visit to the hospital.

Introduction of the development of the mo- bile smartphone application, "PWH easyGo" to help patients and visitors to navigate differ- ent departments and facilities on the hospital premises with ease

"PWH easyGo" is a mobile smartphone application (app) designed to help patients and visitors to look for different departments and facilities on the hospital premises. Posters with QR code are displayed at various hospital entrances. Users with the app installed can scan the QR codes printed on posters on site or manually select their current locations and destinations in the app, and the system will display the relevant routes with photos. It is the first such app developed by the Hong Kong Hospital Authority and is available for download at Apple store (iOS version) and Play Store (Android version).

Restoration of motion-blurred image based on border deformation detection: a traffic sign restoration model

Due to the rapid development of motor vehicle Driver Assistance Systems (DAS), the safety problems associated with automatic driving have become a hot issue in Intelligent Transportation. The traffic sign is one of the most important tools used to reinforce traffic rules. However, traffic sign image degradation based on computer vision is unavoidable during the vehicle movement process. In order to quickly and accurately recognize traffic signs in motion-blurred images in DAS, a new image restoration algorithm based on border deformation detection in the spatial domain is proposed in this paper. The border of a traffic sign is extracted using color information, and then the width of the border is measured in all directions. According to the width measured and the corresponding direction, both the motion direction and scale of the image can be confirmed, and this information can be used to restore the motion-blurred image. Finally, a gray mean grads (GMG) ratio is presented to evaluate the image restoration quality. Compared to the traditional restoration approach which is based on the blind deconvolution method and Lucy-Richardson method, our method can greatly restore motion blurred images and improve the correct recognition rate. Our experiments show that the proposed method is able to restore traffic sign information accurately and efficiently.

Driver behavior in use of guide and logo signs under distraction and complex roadway conditions

White-on-blue logo signs on the sides of highways are typically used to notify drivers of food, gas, and lodging at an upcoming interchange. The current research assessed driver performance and attention allocation in a simulated freeway driving task when exposed to six-panel logo signs, nine-panel logo signs, mileage guide signs, and roadway work zones both with and without an in-car navigation device. The objective was to identify the impact of signage types on driver behavior under realistic driving conditions. Results revealed glance durations and fixation frequencies to guide signs to be significantly lower than with six-panel and nine-panel logo signs, but no differences were found between six-panel and nine-panel logo signs. There were also statistical differences among the independent variables for speed deviation and lane deviation, but magnitudes were not large enough to be considered practically significant in terms of driving safety. Overall, there were minor differences in sign processing time between logo signs and mileage guide signs, but such differences did not translate to degradations in vehicle control.

Seamless personal health information system in cloud computing

Noncontact ECG measurement has gained popularity these days due to its noninvasive and conveniences to be applied on daily life. This approach does not require any direct contact between patient's skin and sensor for physiological signal measurement. The noncontact ECG measurement is integrated with mobile healthcare system for health status monitoring. Mobile phone acts as the personal health information system displaying health status and body mass index (BMI) tracking. Besides that, it plays an important role being the medical guidance providing medical knowledge database including symptom checker and health fitness guidance. At the same time, the system also features some unique medical functions that cater to the living demand of the patients or users, including regular medication reminders, alert alarm, medical guidance, appointment scheduling. Lastly, we demonstrate mobile healthcare system with web application for extended uses, thus health data are clouded into web server system and web database storage. This allows remote health status monitoring easily and so forth it promotes a cost effective personal healthcare system.

Effects of competing environmental variables and signage on route-choices in simulated everyday and emergency wayfinding situations

This study examined the relative influence of environmental variables (corridor width and brightness) and signage (directional and exit signs), when presented in competition, on participants' route-choices in two situational variables (everyday vs. emergency), during indoor wayfinding in virtual environments. A virtual reality-based methodology was used. Thus, participants attempted to find a room (everyday situation) in a virtual hotel, followed by a fire-related emergency egress (emergency situation). Different behaviours were observed. In the everyday situation, for no-signs condition, participants choose mostly the wider and brighter corridors, suggesting a heavy reliance on the environmental affordances. Conversely, for signs condition, participants mostly complied with signage, suggesting a greater reliance on the signs rather than on the environmental cues. During emergency, without signage, reliance on environmental affordances seems to be affected by the intersection type. In the sign condition, the reliance on environmental affordances that started strong decreases along the egress route.

Learning and recognition of on-premise signs from weakly labeled street view images

Camera-enabled mobile devices are commonly used as interaction platforms for linking the user's virtual and physical worlds in numerous research and commercial applications, such as serving an augmented reality interface for mobile information retrieval. The various application scenarios give rise to a key technique of daily life visual object recognition. On-premise signs (OPSs), a popular form of commercial advertising, are widely used in our living life. The OPSs often exhibit great visual diversity (e.g., appearing in arbitrary size), accompanied with complex environmental conditions (e.g., foreground and background clutter). Observing that such real-world characteristics are lacking in most of the existing image data sets, in this paper, we first proposed an OPS data set, namely OPS-62, in which totally 4649 OPS images of 62 different businesses are collected from Google's Street View. Further, for addressing the problem of real-world OPS learning and recognition, we developed a probabilistic framework based on the distributional clustering, in which we proposed to exploit the distributional information of each visual feature (the distribution of its associated OPS labels) as a reliable selection criterion for building discriminative OPS models. Experiments on the OPS-62 data set demonstrated the outperformance of our approach over the state-of-the-art probabilistic latent semantic analysis models for more accurate recognitions and less false alarms, with a significant 151.28% relative improvement in the average recognition rate. Meanwhile, our approach is simple, linear, and can be executed in a parallel fashion, making it practical and scalable for large-scale multimedia applications.

The influence of environmental features on route selection in an emergency situation

Understanding the influence of external information at a lower level of awareness during the processes of route selection could be a key factor to predict user's movements within complex buildings, avoiding wayfinding problems and improving egress in emergency situations. This study aims to verify whether corridor intersection configuration attributes, such as width and brightness, act as factors of attraction to improve the affordance of indoor hallways during an emergency egress situation, using a VR-based methodology. The main hypotheses are that users tend to move along either, wider or brighter corridors. Thirty volunteers participated in this study, moving along 57 different corridors, according to the experimental conditions of the study. The results suggest that people prefer to follow brighter pathways in "T-type" and "F-type" intersections, and wider corridors in "T-type" intersections. In situations where these variables are in conflict, there is a preference for brighter paths in both intersection configurations.