Walking and cycling interactions on shared-use paths

Central to this research are the interactions that take place between cyclists and pedestrians on shared-use paths and the impact of these on journey experiences. This research proposes that as active travel is promoted and as walking and cycling targets are set in the UK, there is a potential for levels of active travel to increase; putting pressure on shared-use paths, and potentially degrading journey experiences. Previous research on shared-use paths focuses on the observable aspects of shared path relations, such as visible collisions and conflict. However, this thesis suggests that it is necessary to investigate shared-path interactions in more depth, not only focusing on the visible signs of conflict but also examining the non-visible experiential interactions. Thus, this research addresses the following questions:-What are the different kinds of interactions that occur on shared-use paths?-How do path users experience and share the path? -What are the respondents’ expectations and attitudes towards the path?-What are the practice and policy options in relation to enhancing shared-path experiences?-Are video recordings a useful aid to in-depth interviews?The Bristol-Bath railway path (Bristol, UK) was chosen as a case study site and a two phased data collection strategy was implemented. Phase I included on-site intercept surveys with cyclists and pedestrians along the path. Phase II involved a novel mobile method; using video recordings of the participants’ shared-use path journeys as a discussion tool during in-depth interviews. Phase II enabled a more detailed exploration of the path users’ experiences from a personal point of view. By implementing these methods and applying a novel theoretical framework (combining mobilities and social psychology theory), this research has uncovered findings relevant to practice and theory. Exploring path user interactions revealed the types of coping strategies used by the respondents to share space. The findings also highlighted that different sensory aspects are prominent for cyclists and pedestrians. Processes associated with path-user identities and path-identity were also uncovered as important aspects of shared-path experiences. The usefulness of video mobile methods in accessing the experiential aspects of walking and cycling interactions has also been highlighted. The conclusion considers these findings and sets out recommendations including a code of conduct and an identity-influencing strategy for the path, along with ideas for future research

Multi-Task Neuromuscular Generalization and Changes Through the Lifespan

Mobility in everyday life requires executing and shifting between a broad assortment of functional tasks and resisting disturbances that could cause falls. Though the importance of successfully performing a variety of functional tasks is recognized and incorporated in clinical assessments (e.g., the Timed-Up-and-Go Test, Berg Balance Scale), little is understood about the underlying neuromuscular control required, or how it changes with age. The neuromuscular control for functional tasks such as walking is typically studied in isolation, or with variations on the same task. Characterizing the coordination required to produce and shift between a wider variety of tasks and resist external disturbances is crucial to understanding mobility in daily life, not just within a controlled lab environment. In this work, we identify patterns of multi-muscle coordination (motor modules) across functional tasks in healthy young, middle-aged, and older adults. We demonstrate that healthy young adults recruit common motor modules across voluntary functional tasks (walking, turning, and chair transfers), and characterize changes associated with age. Additionally, we investigate whether motor modules are shared between reactive balance and these voluntary tasks, and whether there are age-related changes here. Identifying age-related changes in multi-muscle coordination can lead to a better understanding of the neuromuscular control underlying mobility changes due to normal aging. Further, fully characterizing changes in neuromuscular control that are due to normal aging can provide a basis for identifying the changes associated with impairments that commonly occur in older adults (e.g., stroke)

Review of Current Research on the Health of Refugees and Asylum-Seekers in Ireland

This review of current research on refugees and asylum-seekers in Ireland was commissioned by the Northern Area Health Board (NAHB). The Health Services Research Centre at the Department of Psychology, Royal College of Surgeons in Ireland conducted the study. The study team comprised Ms.Sarah Delaney, (anthropologist and research officer) and Professor Hannah McGee (psychologist and Centre Director). The study aimed to provide a national review of recent and current health-related research on refugees and asylum-seekers in Ireland. The study also identified priority areas for future research, and made recommendations as to the most effective methods of addressing these priorities

Walking and cycling on shared-use paths: The user perspective

© 2016, ICE Publishing: All rights reserved. Shared-use paths are those used by pedestrians and cyclists, either designed for them to mix freely within the space (unsegregated) or with the space allocated to each group by surface markings and signage (segregated). Mobility policy in a number of states is promoting greater use of shared-use paths, but there is only limited knowledge about the user experience, which can be expected to influence patronage. The paper examines experiences of user behaviour and user segregation, drawing on quantitative and qualitative research with pedestrians and cyclists on a heavily used, width-constrained path in Bristol, UK. It has been observed that pedestrians have a modest preference for segregation, while cyclists prefer non-segregation. Both groups exhibited varied, sometimes conflicting perceptions about how users should interact. It is concluded that it will not always be possible to optimise infrastructure design for all users and therefore recommended that the wider context of policy objectives and alternative routes for different user types be considered during design decisions. Whichever approach is taken to segregation, user communities will generally benefit from clear codes of conduct to promote a shared user culture. In the case of unsegregated paths, the separation of flows based on direction, rather than mode, of travel is recommended

What predicts depression in cardiac patients: Sociodemographic factors, disease severity or theoretical vulnerabilities?

Depression is associated with increased cardiovascular risk in patients with acute coronary syndrome (ACS), but some argue that elevated depression is actually a marker of cardiovascular disease severity. Therefore, disease indices should be better predictors of depression than established theoretical causes of depression (interpersonal life events, reinforcing events, cognitive distortions, type D personality). However, little theory-based research has been conducted in this area. In a cross-sectional design, hospitalised ACS patients (n=336) completed questionnaires assessing depressive symptoms and vulnerabilities. Nested logistic regression assessed the relative contribution of demographic or vulnerability factors, or disease indices or vulnerabilities to depression. In multivariate analysis, all vulnerabilities were independent significant predictors of depression. Demographic variables accounted fo

Depressive symptoms in persons with acute coronary syndrome: specific symptom scales and prognosis

Objective To determine which particular depressive symptom scales, derived from three scales, predicted poorer prognosis in persons with acute coronary syndrome (ACS). Methods Hospitalised ACS patients (n=408) completed questionnaires (depression, vital exhaustion). Mokken scaling derived unidimensional scales. Major cardiac events (cardiac mortality, ACS, unplanned revascularisation) were assessed at median 67 weeks post-event. Results Only depressive symptoms of fatigue-sadness predicted prognosis in univariate (hazard ratio [HR]=1.8, 95% CI 1.1–3.0, p=0.025) and multivariate analysis (HR=1.8, 95% CI 1.1–2.9, p=0.025). Symptoms of anhedonia (HR=1.6, 95% CI 0.9–2.8, p=0.102) and depressive cognitions (HR=1.3, 95% CI 0.7–2.2, p=0.402) did not. Conclusion Symptoms of fatigue-sadness, but not other symptoms, were associated with increased risk of major cardiac events. Depression should be considered as a multidimensional, rather than a unidimensional, entity when designing interventions

Health Services Survey

Health Services Survey The agency we partnered with is a nonprofit organization committed to serving the needs of women and their families who are experiencing unstable or absent housing. They help to provide emergency shelter to families across five locations in the Seattle area and provide services surrounding housing, healthcare, employment, and community. They also have specialty programs aimed at providing services to children who are medically fragile and require specialized care, and families who have recently given birth and are still in the recovery and bonding stages. All this work is delivered with the values of love, equity, stewardship, collaboration, responsiveness, and accountability. After learning more about the agency and touring their facilities, they shared their need for a tool that would help them evaluate the usefulness and satisfaction, and identify any unmet needs provided by the Health Services team. The goal of our project was to create a survey that was informative, easy to read, accessible in a variety of languages, and sustainable for future use. Background The guest populations at the shelter consist of mainly women and children, with some households that include men, who are experiencing or struggling with the lack of safety, stability, and housing. According to our agency’s 2021 Annual Report, more than 80% of their guests identify as Black, Indigenous, or People of Color, and 30-40% of our guests are immigrants or refugees with the majority from East Africa (Mary’s Place, n.d.). Ranging from newborns to seniors, the guests represent diverse backgrounds in race, ethnicity, class, sexual orientation, education, and life experience. Additionally, the shelter welcomes and provides accommodations for guests with disabilities and mental health issues. People experiencing unstable or absent housing face a variety of unique medical and behavioral health needs that commonly go unmet due to a wide range of barriers to accessing routine, as well as preventative care (Thorndike et al., 2022). Data gathered from surveys and interviews with individuals experiencing homelessness showed that 73% of the respondents reported at least one unmet health need. Some of these needs included an inability to obtain needed medical or surgical care (32%), prescription medications (36%), mental health care (21%), eyeglasses (41%), and dental care (41%; Baggett et al., 2010). Furthermore, given the agency’s target population is it important to note that women have higher rates of mental health diagnoses and suicidal thoughts and attempts. (Kneck et al., 2022). All these statistics helped form our survey to address the specific healthcare needs of the agency\u27s target population. Activities and Methods The rationale behind our project was focused on a clear expression from our agency liaison that this survey was a necessary piece for the agency to understand any unmet health needs of their guests, as well as gain an understanding of guest satisfaction with the Health Services team. Moreover, we conducted a review of the literature which showed that most health survey tools operate under the assumption that the participants are equipped with stable housing, and therefore are equipped with resources such as running water, electricity, and access to food and safe food storage (Gordon et al., 2019). Knowing that a health survey tool fitting the needs of the organization was not available for them to utilize, our goal in creating the survey was to curate it to the diverse population served by the agency. First, we conducted an assessment by using the windshield survey (Stanley, 2021). This allowed us to familiarize ourselves with the community and take inventory of the resources present. We collected data on the physical environment, economic features, available services, and social aspects of the community. We also utilized the agency’s website and annual report to gather additional assessment data. Our group used a logic model outline to help craft our goals and equip us with a roadmap to follow throughout our project. A Gantt chart was also utilized weekly to plan out our activities and determine as a group who was responsible for a given task (Agency for Healthcare Research and Quality, n.d.). We then crafted a nursing diagnosis that was appropriate for the need that the agency wanted us to fill: Readiness for enhanced knowledge related to the organization’s desire to increase health service use and evaluate satisfaction by guests. We also utilized the socio-ecological model (SEM) as a framework for our project. The SEM model is used to identify influences of community engagement in health programs to better understand systematic barriers and enablers to community engagement (Caperon et al., 2022). This model was relevant to our project since we sought to create a tool that would increase guest engagement with the current health services offered by our agency and identify barriers to guests accessing care at the shelter. Outcomes/Limitations Our group conducted a literature review to help identify the specific topics and questions we would include in our survey as well as specific topics to be covered that were requested by the agency. With the communication of feedback from the Health Services team, we successfully completed our goal of creating a final survey that will be translated into a variety of languages and will continue to be sustainable for future use. We placed value and importance on equality by not administering the English version of the survey until the survey was fully translated into a multitude of languages that aligned with the population at the agency. With that in mind, we also were aware of translation and possible educational barriers of the guest population which we addressed by running our survey through the Flesch-Kincaid Grade Level (FKGL) calculator that 5 analyzes the readability of a text according to the years of education typically required for that level of literacy (Wrigley Kelly et al., 2021). To ensure the survey is readable and widely accessible, we kept it at a “secondary language” (L2) level which is explained as the reading literacy of grades fourth through sixth (Commissaire & Demont, 2021). Though our group was not able to administer and analyze the final survey ourselves due to the time limitation, we ultimately generated the evidence-based tool that the agency will administer when the translated versions are all available. Conclusion Overall, the intended outcome of this project was to create a sustainable tool for the agency. This tool will allow them to evaluate the usefulness of their health services and the satisfaction of the guests. They expressed that the goal is to utilize this tool at all of their locations and at regular intervals in the future. The data collected from this tool would be used to delegate resources to the services guests find most useful, identify gaps where guests’ needs are not being met and adjust their programming accordingly to fill any of those gaps. Ultimately, the greater impact of our project in improving the agency’s health service usage and delivery would be to increase positive health outcomes and improve health literacy among their guests. These changes could help create new partnership opportunities and increase funding that would then expand the agency’s reach to better serve more families in the Greater Seattle area. References Agency for Healthcare Research and Quality. (n.d.). Gantt Chart. https://digital.ahrq.gov/healthit-tools-and-resources/evaluation-resources/workflow-assessment-health-it-toolkit/allworkflow-tools/gantt-chart Baggett, T. P., O’Connell, J. J., Singer, D. E., & Rigotti, N. A. (2010). The unmet health care needs of homeless adults: A national study. American Journal of Public Health, 100(7), 1326–1333. https://doi.org/10.2105/AJPH.2009.180109 Caperon, L., Saville, F., & Ahern, S. (2022). Developing a socio-ecological model for community engagement in a health program in an underserved urban area. PLoS ONE, 17(9), 1–18. https://doi.org/10.1371/journal.pone.0275092 Commissaire, E., & Demont, E. (2022). Investigating L2 reading aloud and silent reading in typically developing readers and dyslexic adolescents from grades 6 to 9. Dyslexia (Chichester, England), 28(1), 40–59. https://doi.org/10.1002/dys.1693 Gordon, S. J., Grimmer, K., Bradley, A., Direen, T., Baker, N., Marin, T., Kelly, M. T., Gardner, S., Steffens, M., Burgess, T., Hume, C., & Oliffe, J. L. (2019). Health assessments and screening tools for adults experiencing homelessness: A systematic review. BMC public health, 19(1), 994. https://doi.org/10.1186/s12889-019-7234-y Kneck, Å., Klarare, A., Mattsson, E., & Salzmann-Erikson, M. (2022). Reflections on health among women in homelessness: A qualitative study. Journal of Psychiatric and Mental Health Nursing, 29(5), 709–720. https://doi.org/10.1111/jpm.12859 Mary’s Place. (n.d.). About Us. https://www.marysplaceseattle.org/about-us Rector, C. L., & Stanley, M. J. (2021). Community and public health nursing: Promoting the public\u27s health (10th ed.). Wolters Kluwer, Philadelphia. Thorndike, A. L., Yetman, H. E., Thorndike, A. N., Jeffrys, M., & Rowe, M. (2022). Unmet health needs and barriers to health care among people experiencing homelessness in San Francisco’s Mission District: A qualitative study. BMC Public Health, 22(1), 1–8. https://doi.org/10.1186/s12889-022-13499-w Wrigley Kelly, N. E., Murray, K. E., McCarthy, C., & O\u27Shea, D. B. (2021). An objective analysis of quality and readability of online information on COVID-19. Health and Technology, 11(5), 1093–1099. https://doi.org/10.1007/s12553-021-00574-

"Tell them you smoke, you'll get more breaks"::a qualitative study of occupational and social contexts of young adult smoking in Scotland

Menier Jean J. Réhabilitation du genre Coleobothrus Enderlein et description d'une espèce nouvelle de l'Est africain : Coleobothrus germeauxi [Col. Scolytidae]. In: Bulletin de la Société entomologique de France, volume 78 (5-6), Mai-juin 1973. pp. 205-209

Third National Survey of Cardiac Rehabilitation Service Provision in Ireland: progress on the 1999 National Cardiovascular Health Strategy Recommendations

Background: The National Cardiovascular Health Strategy, including specific plans for cardiac rehabilitation, was launched in Ireland in 1999. A survey of cardiac rehabilitation services was conducted in 2006 to evaluate progress on service provision. Aim: To establish levels of service provision and service formats of cardiac rehabilitation services in 2005, compare them with the status pre-Strategy (1998) and to ascertain areas in which additional resources may be needed to achieve the 10 national recommendations for cardiac rehabilitation. Method: All hospitals in Ireland (n=37) admitting cardiac patients to a coronary or intensive care unit completed surveys by postal questionnaire or telephone follow-up. Results: All hospitals provided Phase I, 97% (36 hospitals) provided Phase II and 95% (35 hospitals) provided Phase III outpatient programmes. Forty–three percent (16 hospitals) provided a formal phase IV programme. Lack of staff (66%) and lack of available space (23%) were cited as the greatest barriers to programme development. Expanding the service to provide cardiac rehabilitation to other types of patient was deemed the most important area for development by 34% of centres. The development and provision of Phase III was prioritised by 39% while 18% prioritised the provision of Phase IV. Although professional input has increased substantially since 1998 (from a mean of 45.9 hours per week in 1998 to a mean of 135 hours per week in 2005, centres reported several concerns with staffing levels. Eleven cardiac rehabilitation centres were being run single-handedly by cardiac rehabilitation coordinators. There was also great variation in recommended multidisciplinary input across centres. Twenty-four centres had dedicated facilities with 10 sharing facilities. Thirty-one centres had an exercise area and 19 had a separate education area. Conclusions: There have been substantial achievements towards the Cardiovascular Health Strategy target of providing cardiac rehabilitation services for all relevant hospitals in Ireland over the past seven years. The next challenge is to ensure that all those who could benefit in each centre is provided with the opportunity to take part in all phases of Cardiac Rehabilitation