An investigation into technologies to detect impaired performance due to driver fatigue was undertaken. From this, a new forced-choice stimulus-reaction device was developed specifically to detect driver impairment in operators of haul trucks in open cut mines. The device was developed in conjunction with personnel from the mining industry to suit the harsh conditions of the mining environment. The technology was trialled in three open cut mines and in a driving simulator at Murdoch University in Western Australia. Data were collected on the performance of drivers and analysed to validate the technology. A significant positive correlation was found between measures of reduced operator reaction performance and measures of eye closure. It was found that the device detected few false alarms and missed few bouts of tiredness as indicated by eye closures. It is suggested that the device would be a useful tool to assist with the detection of driver fatigue in open cut mining environments. The forced-choice reaction-monitoring device was used to assess the performance of drivers in a gold mine in Kalgoorlie, Western Australia. The fly-in-fly-out haul truck drivers worked 14 consecutive 12-hour night shifts, had a day off, then worked 13 consecutive 12-hour day shifts. A total of more than 3,500 hours of real-time objective performance data were collected and analysed. The main findings were that the objective performance data showed patterns of low performance that did not fit some of the performance data that would be expected from examination of past literature. Many findings are discussed in light of these anomalies. Another important finding is that the subject’s background and sleep pathology is a possible predictor for poor performance on the forced-choice reaction task. The system was also used to measure the performance of drivers with rising blood alcohol levels in a driving simulator. Subjects drank vodka with a mixer while driving for two hours starting at both 20:00 hrs and 22:00 hrs, with a week in between the two trials. The fatigue monitor detected reaction times slower than 3 SD of baseline performance at low levels of BAC. Performance at 22:00 hrs was marginally more impaired than performance at 20:00 hrs. Drivers at low BAC levels tended to compensate easier on the reaction task at 20:00 hrs compared to at 22:00 hrs. The ARRB fatigue monitor shows good capacity to detect poor performance due to low and medium measures of BAC. The research undertaken within this thesis has provided data that challenges contemporary research that generally suggests that time on task is one of the largest influences of fatigue at work. It appears that both circadian influences and individual lifestyle habits will have an equal or greater impact on fatigue risk at work.

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The vehicle routing problem (VRP), is a classic optimization problem that aims to determine the optimal set of routes for a fleet of vehicles to meet the demands of a set of customers. The VRP has been studied for many decades and as such, there are many variants and extensions to the original problem. The research presented here focuses on two different types of vehicle routing and scheduling planning problems: car shipping and fatigue-aware scheduling. In addition to modeling and solving the car shipping problem, this research presents a novel way for ways in which drivers can describe their route preferences in a decision support system. This work also introduces the first fatigue-aware vehicle scheduling problem called the Truck Driver Scheduling Problem with Fatigue Management (TDSPFM). The TDSPFM is utilized to produce schedules that keep the drivers more alert than existing commercial vehicle regulations. Finally, this work analyzes the effect of the starting alertness level on driver alertness for the remainder of the work week and examines a critical shortcoming in existing regulations. / Ph. D.

Syfte. Syftet med studien var att undersöka och beskriva arbetsterapeuters erfarenheter av att använda arbetsterapeutiska interventioner för personer med multipel skleros (MS). Metod. Ett bekvämlighetsurval användes. Förfrågan skickades ut i gruppen “Arbetsterapeuter på facebook” samt att arbetsterapeuter som arbetade med personer med MS söktes upp via hemsidor på internet och kontaktades för att rekryteras som deltagare i studien. För att besvara syftet valdes en kvalitativ ansats och för att samla in data till studien genomfördes semistrukturerade intervjuer. Insamlad data analyserades genom kvalitativ innehållsanalys. Resultat. Analysen resulterade i fyra kategorier: “Fatigue management kurs” som beskrev hur arbetsterapeuten arbetar med aktivitetsbalans, vardagsstruktur, energibesparande strategier samt vikten av vila. “Att bedriva arbetsterapeutiska interventioner i grupp” belyste hur gruppdynamikens positiva effekter bidrog i arbetet med personer med MS när kognitionsträning, handträning och skapande aktivitet bedrivs i grupp. “Individuella arbetsterapeutiska interventioner” beskrev interventioner som är individanpassade utifrån personer med MS unika behov som exempelvis bostadsanpassning, kompensatoriska hjälpmedel och aktivitetsträning. “Arbetsterapeutens yrkesspecifika kompetenser” beskrev arbetsterapeuters förankring och kompetens i ett klientcentrerat och evidensbaserat arbetssätt, förmåga till teamarbete, förbättrings- och utvecklingsarbete samt färdighet att coacha personer med MS. Slutsats. Fatigue management kurs är en viktig arbetsterapeutisk gruppintervention för personer med MS som ska erbjudas redan i ett tidigt skede i sjukdomsförloppet. Individanpassade hjälpmedel behövs för personer med MS för att underlätta i vardagen. Arbetsterapeuterna måste ställa krav på arbetsgivaren för att kunna avsätta tid till förbättring och kompetensutveckling. Digitala verktyg behöver användas för att gynna personer med MS rehabilitering även under en pandemi. Större studier behövs för att lyfta fram ett större nationellt perspektiv, samt även för att undersöka vilka villkor som behövs för att implementera nationella riktlinjer på ett mer effektivt sätt och mer jämnt inom Sverige. / Purpose. The purpose of the study was to investigate and describe occupational therapists' experiences of using occupational therapy interventions for people with multiple Sclerosis (MS). Method. A convenience sample was used. The request was sent out in the group "Occupational therapists on facebook" and occupational therapists who worked with people with MS were searched via websites on the internet and contacted to be recruited as participants in the study. To answer the purpose, a qualitative approach was chosen and to collect data for the study, semi-structured interviews were conducted. Results. The analysis resulted in four categories: “Fatigue management course” which described how the occupational therapist works with occupational balance, everyday structure, energy saving strategies and the importance of rest. “Conducting occupational therapy interventions in groups” highlighted how the positive effects of group dynamics contributed to the work with people with MS when cognitive training, hand training and creative activity were conducted in groups. “Individual occupational therapy interventions” described interventions that are individualized for people with MS unique needs such as housing adaptation, compensatory aids and activity training. “The occupational therapist's profession-specific competencies” described occupational therapists' abutment and competence in a client-centered and evidence-based approach, ability to teamwork, improvement and development work and ability to coach people with MS. Conclusion. Fatigue management course is an extremely important occupational therapy group intervention for people with MS that should be offered at an early stage of the disease. Individually adapted aids are needed for people with MS to make everyday life easier. Occupational therapists must make demands for improvement and skills development. Digital tools need to be used to benefit people with MS rehabilitation even during a pandemic. Larger studies are needed to highlight a larger national perspective, as well as to investigate what conditions are needed to implement national guidelines in a more efficient way and more evenly within Sweden.

Medical mistakes made during the fatigue state result in the spread of infection, diagnostic error, psychological distress, poor patient outcomes, and ultimately, loss of life. Alarmingly, the fatigue-management systems put forth by government agency have failed to reduce the risks of fatigue in physicians. A shift from “one size fits all” approaches for fatigue management, to individualized fatigue assessment and training, is required. To date, no validated measures of fatigue are feasible for use as portable, on-site assessments. Here, I propose the use new portable EEG technologies recently validated for the collection of ERP data, as a basis for a portable fatigue assessment that is cost effective, portable, and efficient enough to be used in medical professionals. Over the course of three experiments I have provided data to support the use of the MUSE portable EEG headband, in combination with short oddball task to assess fatigue related neural impacts. Results of these experiments indicate that the P300 component is reduced in fatigued subjects in comparison to non-fatigued, and further that there is a strong correlation between subjective fatigue severity and P300 amplitude. / Graduate

Bakgrund: Fatigue är ett tillstånd av utmattning som gör det svårt för individer att bilda aktivitetsmönster samt skapa aktivitetsbalans i vardagen. Fatigue kan påverka människans uthållighet, vilket kan leda till att man tappar ork och motivationen. Arbetsterapeutens roll är att bidra med hjälp i form av behandlingsmetoder och/eller strategier som kan hjälpa personer att klara av sin vardag trots sin funktionsnedsättning, sjukdom eller skada. Fatigue management är en gruppintervention som ska hjälpa personer med fatigue att lära sig hantera fatigue i sin vardag. Syfte: Att beskriva arbetsterapeuters erfarenheter av att använda den manualbaserade gruppinterventionen “Fatigue management, en sex-veckors kurs för att lära sig hantera fatigue i sin vardag”, och dess innehåll. Metod: Studien hade en kvalitativ design där data samlades in med hjälp av semistrukturerade intervjuer med åtta arbetsterapeuter. Data analyserades med kvalitativ innehållsanalys. Resultat: Arbetsterapeuter har blandade erfarenheter/upplevelser kring den manualbaserade gruppinterventionen, bland annat när det kommer till; Kartläggning av fatigue, upplägget vid varje kurstillfälle, undervisningsformen, hemuppgifter och vilka modifieringar som behövs utföras för att förbättra interventionen. Dessa aspekter delas in i tre kategorier; Viktiga komponenter gruppinterventionen, Fördjupad bedömning- att förstå deltagare och Förslag till ytterligare utveckling av kursen. Slutsats: Arbetsterapeuter upplever att den manualbaserade gruppinterventionen “Fatigue management: en sex-veckors kurs för att lära sig hantera fatigue i sin vardag” är en behandlingsmetod som är effektiv, men samtidigt är interventionen i behov av att moderniserad/utvecklas. En moderniserad version av manualen skulle bidra till att stärka den terapeutiska alliansen mellan patienter och arbetsterapeuter.