Findings from measuring door-to-door travellers’ travel satisfaction with traditional and smartphone app survey methods in eight European cities

This study investigates how different travel satisfaction survey methods influence the reported level of door-to-door travel satisfaction among travellers. The travel satisfaction measurement survey tools tested consisted of two types of smartphone applications (a satellite navigation app and a game app), an on-line survey, a paper-based semi-structured questionnaire and a focus group. Each of the measurement tools comprised of a similar set of questions, but in different formats, aimed at exploring the pros and cons of each tool among different group of travellers. In total, 5,275 valid responses were collected during the survey period from eight European cities and five FIA (Federation Internationale de I'Automobile) national motorist networks. The analysis results, with ordered logit model of travellers' reported overall satisfaction, showed that the travel satisfaction reported by different survey methods and different travel modes and user groups, correlated with distinct groups of key determinants. The relationship between and within these key determinants, however, was far from straight forward. Some were more complex than others. Some issues, such as parking availability and security, that are mostly discussed by policy makers and users may not be the ones that directly correlate with the users' overall travel satisfactions. Consistent with previous studies, the travellers' mood and previous experience influenced the reported overall journey satisfaction

The elegans of spindle assembly

The Caenorhabditis elegans one-cell embryo is a powerful system in which to study microtubule organization because this large cell assembles both meiotic and mitotic spindles within the same cytoplasm over the course of 1 h in a stereotypical manner. The fertilized oocyte assembles two consecutive acentrosomal meiotic spindles that function to reduce the replicated maternal diploid set of chromosomes to a single-copy haploid set. The resulting maternal DNA then unites with the paternal DNA to form a zygotic diploid complement, around which a centrosome-based mitotic spindle forms. The early C. elegans embryo is amenable to live-cell imaging and electron tomography, permitting a detailed structural comparison of the meiotic and mitotic modes of spindle assembly

Prevalence, associated factors and outcomes of pressure injuries in adult intensive care unit patients: the DecubICUs study

Funder: European Society of Intensive Care Medicine; doi: http://dx.doi.org/10.13039/501100013347Funder: Flemish Society for Critical Care NursesAbstract: Purpose: Intensive care unit (ICU) patients are particularly susceptible to developing pressure injuries. Epidemiologic data is however unavailable. We aimed to provide an international picture of the extent of pressure injuries and factors associated with ICU-acquired pressure injuries in adult ICU patients. Methods: International 1-day point-prevalence study; follow-up for outcome assessment until hospital discharge (maximum 12 weeks). Factors associated with ICU-acquired pressure injury and hospital mortality were assessed by generalised linear mixed-effects regression analysis. Results: Data from 13,254 patients in 1117 ICUs (90 countries) revealed 6747 pressure injuries; 3997 (59.2%) were ICU-acquired. Overall prevalence was 26.6% (95% confidence interval [CI] 25.9–27.3). ICU-acquired prevalence was 16.2% (95% CI 15.6–16.8). Sacrum (37%) and heels (19.5%) were most affected. Factors independently associated with ICU-acquired pressure injuries were older age, male sex, being underweight, emergency surgery, higher Simplified Acute Physiology Score II, Braden score 3 days, comorbidities (chronic obstructive pulmonary disease, immunodeficiency), organ support (renal replacement, mechanical ventilation on ICU admission), and being in a low or lower-middle income-economy. Gradually increasing associations with mortality were identified for increasing severity of pressure injury: stage I (odds ratio [OR] 1.5; 95% CI 1.2–1.8), stage II (OR 1.6; 95% CI 1.4–1.9), and stage III or worse (OR 2.8; 95% CI 2.3–3.3). Conclusion: Pressure injuries are common in adult ICU patients. ICU-acquired pressure injuries are associated with mainly intrinsic factors and mortality. Optimal care standards, increased awareness, appropriate resource allocation, and further research into optimal prevention are pivotal to tackle this important patient safety threat

Correction to: Prevalence, associated factors and outcomes of pressure injuries in adult intensive care unit patients: the DecubICUs study

The original version of this article unfortunately contained a mistake

Guide to alcohol and drug misuse in the workplace 2010.

This document sets out the Irish Civil Service Alcohol and Drug Misuse Policy for employers and employees. Section 1 Health information p.6 Section 2 Advice for employers p.10 Section 3 Advice for employees p.13 Section 4 Employee assistance service p.15 Section 5 Frequently asked questions (FAQs) p.16 Section 6 Department of Finance Circular 08/2009 p.1

Frameworks for self-management support for chronic disease: a cross-country comparative document analysis

Abstract Background In a number of countries, frameworks have been developed to improve self-management support (SMS) in order to reduce the impact of chronic disease. The frameworks potentially provide direction for system-wide change in the provision of SMS by healthcare systems. Although policy formulation sets a foundation for health service reform, little is currently known about the processes which underpin SMS framework development as well as the respective implementation and evaluation plans. Methods The aim of this study was to conduct a cross-country comparative document analysis of frameworks on SMS for chronic diseases in member countries of the Organisation for Economic Cooperation and Development. SMS frameworks were sourced through a systematic grey literature search and compared through document analysis using the Health Policy Triangle framework focusing on policy context, contents, actors involved and processes of development, implementation and evaluation. Results Eight framework documents published from 2008 to 2017 were included for analysis from: Scotland, Wales, Ireland, Manitoba, Queensland, Western Australia, Tasmania and the Northern Territory. The number of chronic diseases identified for SMS varied across the frameworks. A notable gap was a lack of focus on multimorbidity. Common courses of action across countries included the provision of self-management programmes for individuals with chronic disease and education to health professionals, though different approaches were proposed. The ‘actors’ involved in policy formulation were inconsistent across countries and it was only clear from two frameworks that individuals with chronic disease were directly involved. Half of the frameworks had SMS implementation plans with timelines. Although all frameworks referred to the need for evaluation of SMS implementation, few provided a detailed plan. Conclusions Differences across frameworks may have implications for their success including: the extent to which people with chronic disease are involved in policy making; the courses of action taken to enhance SMS; and planned implementation processes including governance and infrastructure. Further research is needed to examine how differences in frameworks have affected implementation and to identify the critical success factors in SMS policy implementation

Effects of an Extract of the Brown Seaweed <i>Ascophylum nodosum</i> on Postprandial Glycaemic Control in Healthy Subjects: A Randomized Controlled Study

The effects of the consumption of an extract of the brown seaweed Ascophyllum nodosum (BSW) on postprandial glucose and insulin responses to white bread were investigated in an acute, randomized, double-blind, three-arm, crossover, controlled trial in healthy, normoglycemic subjects. Sixteen subjects were administered either control white bread (50 g total digestible carbohydrates) or white bread with 500 mg or 1000 mg of BSW extract. Biochemical parameters were measured in venous blood over 3 h. Significant inter-individual variation in the glycaemic response to white bread was observed. Analysis of the responses of all subjects to either 500 mg or 1000 mg of BSW extract versus control revealed no significant effects of treatments. The variation in response to the control was used to classify individuals into glycaemic responders and non-responders. In the sub-cohort of 10 subjects with peak glucose levels after white bread above 1 mmol/L, we observed a significant decrease in maximum levels of plasma glucose after the intervention meal with 1000 mg of extract compared with the control. No adverse effects were reported. Further work is warranted to define all factors that determine “responders” to the effects of brown seaweed extracts and identify the cohort that would benefit the most from their consumption

The effect of breathing retraining using metronome-based acoustic feedback on exercise endurance in COPD: A randomized trial

Background: During exercise training patients with COPD can entrain their breathing pattern to visual feedback cues as to achieve a slower respiratory rate and prolong exhalation. The result is an improvement in exercise tolerance and a reduction in dynamic hyperinflation. Acoustic stimuli, including metronome-generated acoustic stimuli, can entrain human movements. Accordingly, we hypothesized that exercise duration and dynamic hyperinflation would be less after exercise-training plus breathing retraining using a metronome-based acoustic feedback system than after exercise-training alone. Methods: Of 205 patients with COPD (FEV1=44±16% predicted (±SD)) recruited, 119 were randomly assigned to exercise training plus breathing-retraining using acoustic feedback (n=58) or exercise training alone (n=61). Patients exercised on a treadmill thrice-weekly for twelve weeks. Before and at completion of training, patients underwent constant-load treadmill testing with inspiratory capacity measures every 2 minutes. Results: At completion of training, improvements in exercise duration in the breathing-retraining plus exercise training and exercise training alone groups were similar (p=0.35). At isotime, inspiratory capacity increased (less exercise-induced dynamic hyperinflation) by 3% (p=0.001) in the breathing-retraining plus exercise training group and remained unchanged in the exercise alone group. The between-group change in inspiratory capacity, however, was not significant (p=0.08). Conclusions: In patients with COPD, breathing-retraining using a metronome-based acoustic feedback did not result in improved exercise endurance or decreased dynamic hyperinflation when compared to exercise training alone

Imagine Our Norcross: Planning for immigrant Integration

In the spring of 2015, a group of researchers from Georgia Tech’s School of City and Regional Planning created a studio project to collect information about the immigrant populations living and doing business in the city of Norcross, Georgia, as well as the unincorporated parts of the Gwinnett Village Community Improvement District (CID). The goal of the studio was to provide the city of Norcross and the Gwinnett Village CID with two sets of information: one, a portrait of the overall immigrant community—how and where people lived; where they worked; where they played, argued, shopped, and prayed—and two, what this community would need in order to become more engaged in the area’s civic and economic life.City of Norcross, GAGwinnett Village Community Improvement DistrictLatin American AssociationAsian Americans Advancing Justice (AAAJ), Atlant