Evaluation of the Federal Transit Administration’s Transit and Health Access Initiative: Case Highlights, Findings, and Recommendations

FTA’s Transit and Health Access Initiative provided funding for demonstration projects to test promising, replicable public transportation healthcare access solutions that support the “triple aim” of increased access to healthcare, improved health outcomes, and reduced healthcare costs. This paper highlights two compelling projects from the independent evaluation of the initiative, selected for their creative approaches and wealth of lessons learned. After in-depth case descriptions of these two projects, the authors present the overall findings and recommendations that emerged from the full evaluation effort. Overall, program participants credited the projects with significant improvements to their health. Some reported that, because of the projects, they were more active and independent, had more control over their lives, experienced less emotional hardship, and were better able to reach their goals. However, these results should be viewed in light of the caveats and limitations of relying on self-reported health data, which was often the best tool for programs unable to overcome the legal concerns surrounding health privacy laws and regulations

Smell perception during early pregnancy: no evidence of an adaptive mechanism

Objective It has been suggested that nausea and vomiting in pregnancy is an evolutionary adaptive mechanism to avoid the ingestion of potentially harmful foods. It has also been suggested that the mechanism that triggers nausea and vomiting in pregnancy may be olfaction and that olfactory senses are invoked to provide this protection. This study aimed to test this theory in a systematic design. Design Cross sectional study. Setting The antenatal department of a maternity hospital in the north of England. Sample Three groups of participants: pregnant women (n= 55), non-pregnant women (n= 42) and men (n= 48). Methods Sensitivity was tested towards the odours of six standard stimuli (half safe and half associated with potentially harmful compounds). Main outcome measures Odour rating of likeness, strength and pleasantness. Results Pregnant women rated safe and odours with potentially harmful compounds differently but not more so than men or non-pregnant women. There was no evidence that pregnancy changed the olfactory processes from the non-pregnant state and only slight differences between pregnant women and men were recorded. Conclusions There was no evidence that olfactory processes had undergone any adaptation during pregnancy. The ability to differentiate safe from potentially harmful compounds was common to all three groups studied