Road space reallocation in Scotland: A health impact assessment

IntroductionRoad space reallocation involves re-distributing space away from motor vehicles, including car parking and carriageway space, towards other uses. This can promote a shift to more sustainable travel modes and is likely to affect health through multiple pathways.MethodsWe conducted a health impact assessment to identify and assess the potential impacts of road space reallocation on health and health inequalities in Scotland. This involved a facilitated scoping workshop to identify potential impacts, collation of routine data, interviews with 13 key informants and a rapid review of research literature.ResultsWe found that road space reallocation could have positive impacts on health by reducing overall levels of private motorised traffic, encouraging walking, wheeling and cycling, realising benefits from alternative uses of space and supporting local businesses. There is potential for positive impact on public transport if space is reallocated to prioritise buses, but bus users can also be disadvantaged if bus routes are diverted or stops impeded. Reallocation can improve transport and health equity if it increases support for modes other than car use, but disabled people may be disadvantaged if the reallocated space, and alternative modes, are not accessible for them.ConclusionsRoad space reallocation can improve health and help reduce health inequalities. However, consideration is needed to ensure sufficient alternatives to car use are supported and the reallocated space is accessible for people with different needs. Reallocation schemes should be considered as part of a wider inclusive approach to road transport supporting active travel and public or community transport. Road space reallocation should contribute to wider place-making initiatives aiming to improve quality of local environments and meet community needs

Ethnic variations in duration of untreated psychosis: report from the CRIS-FEP study

Objectives:  There is inconsistent evidence on the influence of ethnicity on duration of untreated psychosis (DUP). We investigated ethnic differences in DUP in a large epidemiological dataset of first episode psychosis patients in an inner city area of south London, UK. Methods:  We analysed data on 558 first episode psychosis patients at the South London and Maudsley NHS Trust, between 2010 and 2012. We performed multivariable logistic regression to estimate the odds of a short DUP (≤ 6 months) by ethnic group, controlling for confounders. Results:  There was no evidence that ethnicity is associated with duration of untreated psychosis. However, we found evidence that a short DUP was strongly associated with age, living circumstances, and pathways to care variables (involuntary admission, out of office hour contact, accident and emergency referral, criminal justice agency referral and family involvement in help-seeking). Conversely, a long DUP was associated with report of social isolation, living alone, being single and General Practitioner referral. Conclusion:  Our findings suggest that indicators of social isolation were associated with long DUP. Our data also show that pathways into care characteristics play significant role in DUP. Thus, the challenge of tackling the issue of timely access to EI under the new Access and Waiting Time standard for psychosis requires a multilevel approach, including joint working with communities, public awareness of psychosis, less restrictive referral pathways and adequate resourcing of early intervention for psychosis services. These will go a long way in addressing patients’ needs rather than be determined by service structures

Coupled transcriptome and proteome analysis of human lymphotropic tumor viruses: insights on the detection and discovery of viral genes

<p>Abstract</p> <p>Background</p> <p>Kaposi's sarcoma-associated herpesvirus (KSHV) and Epstein-Barr virus (EBV) are related human tumor viruses that cause primary effusion lymphomas (PEL) and Burkitt's lymphomas (BL), respectively. Viral genes expressed in naturally-infected cancer cells contribute to disease pathogenesis; knowing which viral genes are expressed is critical in understanding how these viruses cause cancer. To evaluate the expression of viral genes, we used high-resolution separation and mass spectrometry coupled with custom tiling arrays to align the viral proteomes and transcriptomes of three PEL and two BL cell lines under latent and lytic culture conditions.</p> <p>Results</p> <p>The majority of viral genes were efficiently detected at the transcript and/or protein level on manipulating the viral life cycle. Overall the correlation of expressed viral proteins and transcripts was highly complementary in both validating and providing orthogonal data with latent/lytic viral gene expression. Our approach also identified novel viral genes in both KSHV and EBV, and extends viral genome annotation. Several previously uncharacterized genes were validated at both transcript and protein levels.</p> <p>Conclusions</p> <p>This systems biology approach coupling proteome and transcriptome measurements provides a comprehensive view of viral gene expression that could not have been attained using each methodology independently. Detection of viral proteins in combination with viral transcripts is a potentially powerful method for establishing virus-disease relationships.</p

Unravelling the spirits’ message: a study of help-seeking steps and explanatory models among patients suffering from spirit possession in Uganda

As in many cultures, also in Uganda spirit possession is a common idiom of distress associated with traumatic experiences. In the DSM-IV and -5, possession trance disorders can be classified as dissociative disorders. Dissociation in Western countries is associated with complicated, time-consuming and costly therapies. Patients with spirit possession in SW Uganda, however, often report partial or full recovery after treatment by traditional healers. The aim of this study is to explore how the development of symptoms concomitant help-seeking steps, and explanatory models (EM) eventually contributed to healing of patients with spirit possession in SW Uganda. Illness narratives of 119 patients with spirit possession referred by traditional healers were analysed using a mixed-method approach. Treatments of two-thirds of the patients were unsuccessful when first seeking help in the medical sector. Their initially physical symptoms subsequently developed into dissociative possession symptoms. After an average of two help-seeking steps, patients reached a healing place where 99% of them found satisfactory EM and effective healing. During healing sessions, possessing agents were summoned to identify themselves and underlying problems were addressed. Often-mentioned explanations were the following: neglect of rituals and of responsibilities towards relatives and inheritance, the call to become a healer, witchcraft, grief, and land conflicts. The results demonstrate that traditional healing processes of spirit possession can play a role in restoring connections with the supra-, inter-, intra-, and extra-human worlds. It does not always seem necessary to address individual traumatic experiences per se, which is in line with other research in this field. The study leads to additional perspectives on treatment of trauma-related dissociation in Western countries and on developing effective mental health services in low -and middle-income countries

The physical activity - mental wellbeing association in young people: A case study in dealing with a complex public health topic using a ‘realistic evaluation’ framework

Background: Some public health problems can be considered as complex and the evidence base associated with them narrow and ambiguous. This paper reports and reflects on our experiences of undertaking a critical evidence review in an area of this nature e the relationship between physical activity and mental wellbeing among young people. Methods: A critical literature review and wider conceptual reflection. Results: The assertion that physical activity is associated with mental wellbeing was generally upheld, though a range of quandaries were raised that suggested the narrowness of some approaches to evidence. A wider systems orientation was adopted, deploying Pawson and Tilley’s ‘Realistic Evaluation’ framework to gain insight into e what is the nature of the association, why might there be an association and how might we best deliver interventions to exploit potential association? Conclusions: The evidence broadly supported the hypothesis that physical activity has the potential to improve mental wellbeing in young people. We suggest that this more conditional position may have more utility. That is, it is best not to see the relationship as a ‘given’; it can be difficult to achieve; and can only be realised in association of a series of conducive ‘change mechanisms’