Megatrends and the West Midlands 2021: Future Mobility

Reflecting on what would the future of mobility post-covid is important because by adapting to the current pandemic is possible to address old problems affecting not only the society but the environment and the economy. This document explores the future urban mobility considering the challenges for transport from shift to home-working; the growth in walking and cycling; car ownership and safety on public transport. Further, this document presents also how this should be seen as in the context of long-term trends, consequences of inaction and future scenarios. From the review, it can be concluded that the post-covid megatrend for mobility is based on a different urban model that prioritize walking and cycling and other forms of micromobility but also to encourage the use of public transport not only as a short term response but as a long-term national vision

Megatrends and the West Midlands 2021: Future Mobility

Reflecting on what would the future of mobility post-covid is important because by adapting to the current pandemic is possible to address old problems affecting not only the society but the environment and the economy. This document explores the future urban mobility considering the challenges for transport from shift to home-working; the growth in walking and cycling; car ownership and safety on public transport. Further, this document presents also how this should be seen as in the context of long-term trends, consequences of inaction and future scenarios. From the review, it can be concluded that the post-covid megatrend for mobility is based on a different urban model that prioritize walking and cycling and other forms of micromobility but also to encourage the use of public transport not only as a short term response but as a long-term national vision

Análisis multinivel de la relación de ambiente urbano físico construido con caminar como medio de transporte en población adulta de Cali : estudio trasversal.

La prevalencia mundial de inactividad física es alta y constituye un problema de salud pública. Caminar como medio de transporte es uno de los dominios de la actividad física que contribuye a incrementar la actividad física en la vida diaria. En diversos escenarios se han evaluado los factores que determinan su práctica en la población general, entre estos los atributos del ambiente urbano físico construido. Sin embargo, la literatura es controversial y es poca en países de bajos y medianos ingresos. Debido a la necesidad de incrementar la evidencia en el escenario local, el propósito de este estudio es evaluar la relación de los atributos del ambiente urbano físico construido con caminar como medio de transporte en población adulta de Cali

Environment and Seasons in an Aging Population: an Epidemiological Approach

Part of the increasing burden of climate change can be attributed to the increase of the population with high susceptibility to environmental challenges, due to population ageing trend worldwide. This implies that the pool of population with an age-related decline of physiological reserve capacity, deteriorated immune system response, and reduced cognitive capacity is increasing. Therefore, in order to cope with the upcoming challenges of environmental deterioration and climate change, it is necessary to enhance the adaptive capacity of the society. This involves improving our understanding of the influence of environmental factors in the health of the population, and the susceptibility of population subgroups, such as the elderly. In this thesis I examined some of the most urgent health issues that potentially will affect the susceptibility of elderly population under the upcoming challenges of climate change. This includes the seasonal variation of lifestyle factors, cardiovascular risk factors, cognition, and antibiotic resistance and exposure to air pollution. The objectives of this thesis was first, to examine the seasonal variation and explored potential underlying mechanisms of seasonality of lifestyle factors, cardiovascular risk factors, and cognition in the Rotterdam Study; as well as the seasonality of antibiotic resistance using a systematic review of the literature. Second, to examine the exposure to air pollution according to mode of transport in two systematic reviews and to describe the estimation and preliminary findings of the exposure to air pollution among a population-based cohort of adult participants living in the Ommoord district in Rotterdam. The burden of the seasonal variation of cardiovascular risk factors, insulin resistance, antimicrobial resistance, and cognition is expected to increase, as the susceptibility of the population to environmental deterioration and changes in daily temperature r

Investigation of How Road Users’ Perception and Attitudes Influence Intention to Commute by Bicycle in Mexico City

The thesis aims to explore attitudes and the perceived image of cycling in Mexico City and the extent to which this may be a deterrent for engaging in cycle commuting. It also explores the existence of attitudinal transport segments. Transport segments were investigated using a questionnaire developed by the Segment Project EU. Data about attitudes were collected in the same survey from a theory-based questionnaire developed from the Theory of Planned Behaviour (TPB), extended with constructs from the Social Comparison Theory (SCT) and the Material Possessions Model (MPM). The survey was distributed on-street and online, with a simple random sample of 401 road users. The sample characteristics were: no cyclists or infrequent cyclists, living and working in Mexico City, and aged 18-60. The results indicate that the same attitudinal transport segments identified in Europe also exist in Mexico City. They also show that cycling attributes, attitudes to cycling, social comparison, and social image and prestige were the most important factors influencing intention to cycle, explaining 42% of the variance in intention to cycle. Notably, when the evaluation of cycling was negative, the intention to commute by cycling was weaker; when the attributes of cycling and the social image linked to cycling were positive, the intention to cycle commute was strengthened. The effect of social comparison is not clearly established. Although the results from this study are specific to Mexico City, they indicate areas of interest to transportation planners in other regions, especially in those cities where intention to cycle is linked to its perceived image and there is political ambition to promote a positive image of cycling and stimulate modal shift. Moreover, this study contributes to the current literature developing applications of the TPB. Future research may include further investigating social comparison as a latent construct underlying intention to cycle

Embedding Local Community Engagement in University ‎Strategy Development: Reflections From Universities in Birmingham

This policy briefing builds on work undertaken by WMREDI in conjunction with the Centre for Local Economic Strategies (CLES) as part of a project commissioned by Birmingham City Council (BCC). Given the focus of WMREDI on better understanding and supporting the role of universities and how community engagement can help them with their mission, we undertook a desk-review of the strategies of the five Universities in Birmingham (Aston University, Birmingham City University, Newman University, The University of Birmingham and University College Birmingham) and explored the extent to which engagement is communicated and conducted as part of strategy development

Embedding Local Community Engagement in University ‎Strategy Development: Reflections From Universities in Birmingham

This policy briefing builds on work undertaken by WMREDI in conjunction with the Centre for Local Economic Strategies (CLES) as part of a project commissioned by Birmingham City Council (BCC). Given the focus of WMREDI on better understanding and supporting the role of universities and how community engagement can help them with their mission, we undertook a desk-review of the strategies of the five Universities in Birmingham (Aston University, Birmingham City University, Newman University, The University of Birmingham and University College Birmingham) and explored the extent to which engagement is communicated and conducted as part of strategy development

City-REDI Policy Briefing: Improving Understanding and Measurement of Productivity

Productivity is considered to have a direct impact on individual business success and therefore is a critical determinant of economic growth. However, understanding what productivity means varies across economic sectors and these sectoral differences in understanding productivity are also linked to differences in prioritising what is measured, and in turn, differences in actions taken to improve the firm performance. In order to improve productivity levels, it is essential to have a clear understanding of what productivity means and how can we measure it. We are seeking to address this is the gap in knowledge in our study by exploring the measurement of productivity from the managers’ perspective and also the measures used and the actions taken to improve it. In this policy brief, we are reporting the findings of our study which collected data from 300 managers’ firms in the West Midlands region, across the Business Professional and Financial Services (BPFS); Advanced Manufacturing (AM); Retail (R); and Hospitality (H) sectors. This brief provides a list of policy implications of the variation in understanding productivity and concludes with a series of recommendations for policymakers

Evidence-based guidelines for the perioperative management of oral anticoagulation with warfarin in patients scheduled for implantation of a cardiac electronic device

Introducción El manejo perioperatorio de la anticoagulación crónica representa dificultad para los médicos que realizan implantes de dispositivos de estimulación cardíaca, quienes utilizan la terapia puente con heparinas con la intención de disminuir el riesgo de sangrado. Sin embargo, este tratamiento es controversial. Objetivo Generar recomendaciones basadas en evidencia sobre el tratamiento perioperatorio de la anticoagulación de los pacientes con riesgo embólico moderado y alto, que requieren anticoagulación oral con warfarina y serán llevados a implante de dispositivos de estimulación cardíaca. Métodos Se realizó una búsqueda de la literatura para identificar guías de práctica clínica basadas en evidencia, las cuales se calificaron con la herramienta AGREE II. Se actualizó la evidencia desde el 1 de enero de 2009 hasta el 30 de noviembre de 2013, incluidas revisiones sistemáticas y experimentos clínicos. Los estudios se calificaron con los instrumentos GRADE y SIGN. Se generaron recomendaciones con metodología GRADE, llevadas a consenso formal de expertos. Resultados Las guías SIGN y CHEST tuvieron la mejor calificación con AGREE II. Con la nueva evidencia disponible proveniente de tres revisiones sistemáticas y dos experimentos clínicos, se generó recomendación fuerte a favor de continuar la anticoagulación oral con warfarina durante el perioperatorio de implante de dispositivos de estimulación cardíaca en pacientes con riesgo embólico moderado y alto. Conclusiones A partir de la nueva evidencia cambia la recomendación propuesta por las guías SIGN y CHEST. La alternativa de continuar la terapia con warfarina a cambio de realizar terapia puente, debe considerarse en la práctica clínica.Introduction The perioperative management of chronic anticoagulation concerns all physicians involved in the implantation of cardiac electronic devices (either pacemakers and cardioverter-defibrillators). Switching from warfarin to low molecular weight heparins (LMWH) has been performed to reduce the risk of bleeding. However, this approach has been shown to be controversial. Objective To generate evidence-based recommendations on the perioperative management of oral anticoagulation with warfarin in patients who will undergo the implantation of a cardiac electronic device. Methods A literature search was performed to identify evidence-based clinical practice guidelines, which were assessed using the AGREE II instrument. The guidelines were updated with systematic reviews and randomized clinical trials published from February 2009 to November 2013 comparing the continuation of warfarin versus switching to a LMWH or withholding warfarin. These studies were analyzed using the SIGN and GRADE scales to assess methodological quality. Recommendations were put forward through an expert panel. Results The guidelines with highest methodological quality were the SIGN (Scottish Intercollegiate Guidelines Network) guideline published in June 2013 and the CHEST guideline published in February 2012. The update included three systematic reviews and two randomized clinical trials. The continuation of warfarin for the perioperative management of implantable cardiac electronic devices in patients with moderate and high risk is recommended. Conclusion Based on the new evidence changes the recommendation given by the CHEST SIGN and guides. The alternative of continued therapy with warfarin in exchange for performing therapy bridge, should be considered in clinical practice

Resistencia a fármacos antituberculosis en pacientes coinfectados con tuberculosis y virus de la inmunodeficiencia humana, en un hospital de referencia de 2007 a 2010 en Cali (Colombia)

ResumenObjetivoLa resistencia a los fármacos antituberculosis es de gran interés en salud pública. La coinfección con virus de la inmunodeficiencia humana (VIH) ha cambiado el comportamiento de dicha enfermedad. El objetivo de nuestro estudio es determinar la prevalencia de la resistencia a fármacos antituberculosis en pacientes coinfectados con tuberculosis (TB)/VIH. Método: Se realizó un estudio retrospectivo a partir de la revisión de los registros clínicos de casos nuevos y fracasos de TB coinfectados con VIH que consultaron a un centro de atención de nivel IV desde 2007 a 2010 y que contaban con pruebas de susceptibilidad. Resultados: Un 52% de los pacientes procedían de Santiago de Cali, y un 8%, de Buenaventura. La TB se presentó de forma extrapulmonar en el 80% de los pacientes. Del 48% de los sujetos que conocían su estado VIH previo al diagnóstico de la TB, el 40% estaban en terapia antirretroviral. El 16% de los casos eran fracasos, entre los cuales se detectó un caso multi-drogorresistente. De los casos nuevos, se encontró monorresistencia a la isoniazida del 14%, y una resistencia total del 28%.ConclusionesSe encontró una mayor prevalencia de resistencia a la esperada en población coinfectada TB/VIH; por lo que es necesario fortalecer el trabajo en equipo entre las entida-des públicas y privadas para controlar dicha situación y fomentar el diagnóstico temprano y la realización de pruebas de susceptibilidad a fármacos antituberculosis.AbstractBackgroundResistance to anti-tuberculosis treatment is a matter of great interest in terms of public health. TB/HIV coinfection changed what was previously known about TB. Our study attempts to determine the prevalence of resistance to TB drugs among a local TB/HIV population.MethodsA retrospective study was conducted, which consisted of a review of the clinical records of new and relapsing cases of TB/HIV coinfected patients, with drug susceptibility tests, who attended an advanced medical care centre in Cali, Colombia, between 2007 and 2010.ResultsJust over half (52%) of the patients were native from Cali, and 8% were from Buenaventura. An extra-pulmonary presentation of TB was seen in 80% of the subjects. Almost half (48%) were HIV positive before the diagnosis of tuberculosis was made, 40% of whom were on HAART treatment. Of the total cases, 16% were relapses, including one case of multi-drug resistant (MDR)-TB. Among the new cases, 14% were resistant to isoniazid only, making a total of 28% being resistant to this.ConclusionsThere was a higher than expected prevalence of resistance in TB/HIV patients. There is an urgent need to improve the team work between public health organizations and private medical institutions, and this cooperation should be of great priority, as it is a means to control and promote early diagnosis with drug-susceptibility tests