'It's pathological': Exploring gaps in the whole-systems approach for managing operations and safety risk at a fully automatic rail level crossing

There are 23,500 level crossings in Australia. In these risky environments, it is important to understand what human factor issues are present and how road users and pedestrians engage with crossings. On-site observations were performed over a 2-day period at a 3-track active crossing. This was followed by 52 interviews with level crossing users. Over 700 separate violations were recorded, with representations in multiple categories (e.g. going through flashing lights >2s after starting flashing; stopping on crossing). Time stamping revealed that the crossing was active for 59% of the time in some morning periods and trains could take up to 4-min to arrive following first activation. Users experienced frustration due to delays caused by the frequency of trains, which increased likelihood of risk-taking. Analysis of interview data identified themes associated with congestion, safety, and violations. This work offers insight into context specific issues associated with active level crossing protection

Adopt, adapt, and improve: Assessment of a new driver display in rail

This project evaluated the impact of a new enhanced information display intended as a cognitive aid on the operating performance of Locomotive Engineers (i.e. Train Drivers) within a large New Zealand freight rail network. The display previewed the upcoming route and presented information capable of optimising the performance of the locomotive. It did not exert any direct influence over the train and therefore did not take any decision-making capacity away from the driver. The addition of this technology represented a step-change for the organisation and a considerable investment for furthering safety and performance by improving the situation awareness of train drivers. Improving situation awareness is likely to lead to improved decision-making and hence performance and safety (Endsley, 1999) However, given the impact on ways of working for the train driver, and on the development of the organisation, acquiring insight into the cognitive, organisational and/or physical ergonomics impact of the technology was critical and attracted the need for a human factors assessment

Cognitive Remediation Works But How Should We Provide It? An Adaptive Randomized Controlled Trial of Delivery Methods Using a Patient Nominated Recovery Outcome in First-Episode Participants

BACKGROUND AND HYPOTHESIS: Cognitive remediation (CR) benefits cognition and functioning in psychosis but we do not know the optimal level of therapist contact, so we evaluated the potential benefits of different CR modes. STUDY DESIGN: A multi-arm, multi-center, single-blinded, adaptive trial of therapist-supported CR. Participants from 11 NHS early intervention psychosis services were independently randomized to Independent, Group, One-to-One, or Treatment-as-usual (TAU). The primary outcome was functional recovery (Goal Attainment Scale [GAS]) at 15-weeks post randomization. Independent and TAU arms were closed after an interim analysis, and three informative contrasts tested (Group vs One-to-One, Independent vs TAU, Group + One-to-One vs TAU). Health economic analyses considered the cost per Quality Adjusted Life Year (QALY). All analyses used intention-to-treat principles. STUDY RESULTS: We analyzed 377 participants (65 Independent, 134 Group, 112 One-to-One, 66 TAU). GAS did not differ for Group vs One-to-One: Cohen's d: 0.07, -0.25 to 0.40 95% CI, P = .655; Independent vs TAU: Cohen's d: 0.07, -0.41 to 0.55 95% CI, P = .777. GAS and the cognitive score improved for Group + One-to-One vs TAU favoring CR (GAS: Cohen's d: 0.57, 0.19-0.96 95% CI, P = .003; Cognitive score: Cohens d: 0.28, 0.07-0.48 95% CI, P = .008). The QALY costs were £4306 for Group vs TAU and £3170 for One-to-One vs TAU. Adverse events did not differ between treatment methods and no serious adverse events were related to treatment. CONCLUSIONS: Both active therapist methods provided cost-effective treatment benefiting functional recovery in early psychosis and should be adopted within services. Some individuals benefited more than others so needs further investigation. TRIAL REGISTRATION: ISRCTN14678860 https://doi.org/10.1186/ISRCTN14678860Now closed

A mathematical model of aging-related and cortisol induced hippocampal dysfunction

<p>Abstract</p> <p>Background</p> <p>The hippocampus is essential for declarative memory synthesis and is a core pathological substrate for Alzheimer's disease (AD), the most common aging-related dementing disease. Acute increases in plasma cortisol are associated with transient hippocampal inhibition and retrograde amnesia, while chronic cortisol elevation is associated with hippocampal atrophy. Thus, cortisol levels could be monitored and managed in older people, to decrease their risk of AD type hippocampal dysfunction. We generated an in silico<it/>model of the chronic effects of elevated plasma cortisol on hippocampal activity and atrophy, using the systems biology mark-up language (SBML). We further challenged the model with biologically based interventions to ascertain if cortisol associated hippocampal dysfunction could be abrogated.</p> <p>Results</p> <p>The in silico<it/>SBML model reflected the in vivo<it/>aging of the hippocampus and increased plasma cortisol and negative feedback to the hypothalamic pituitary axis. Aging induced a 12% decrease in hippocampus activity (HA), increased to 30% by acute and 40% by chronic elevations in cortisol. The biological intervention attenuated the cortisol associated decrease in HA by 2% in the acute cortisol simulation and by 8% in the chronic simulation.</p> <p>Conclusion</p> <p>Both acute and chronic elevations in cortisol secretion increased aging-associated hippocampal atrophy and a loss of HA in the model. We suggest that this first SMBL model, in tandem with in vitro<it/>and in vivo<it/>studies, may provide a backbone to further frame computational cortisol and brain aging models, which may help predict aging-related brain changes in vulnerable older people.</p

Governing cities for sustainable energy:The UK case

AbstractThe dependence of cities on intensive consumption of energy from fossil fuels is a major cause of climate disruption, and there is increasing interest in the potential for city governments to facilitate a transition to sustainable energy. Little is known, however, about the extent or structures of current urban energy initiatives. Our paper addresses this gap by mapping UK local authority energy plans and project investments and exploring governance processes in three leading cities. It uses socio-technical and urban studies' perspectives on neo-liberal governing and energy systems to interpret findings. This reveals both the gap between local ambitions and capacity to implement plans, and the potential for translation of neo-liberal governing into contrasting commercial and community urban energy enterprises, prefiguring different energy futures. Overall, however, the neo-liberal framework is associated with small scale and uneven initiatives, with limited contribution to a systemic shift to sustainable cities

Watershed features and stream water quality: Gaining insight through path analysis in a Midwest urban landscape, U.S.A.

Urban stream condition is often degraded by human activities in the surrounding watershed. Given the complexity of urban areas, relationships among variables that cause stream degradation can be difficult to isolate. We examined factors affecting stream condition by evaluating social, terrestrial, stream hydrology and water quality variables from 20 urban stream watersheds in central Iowa, U.S.A. We used path analysis to examine and quantify social and ecological factors related to variation in stream conditions. Path models supported hypotheses that stream water quality was influenced by variables in each category. Specifically, one path model indicated that increased stream water conductivity was linked to high road density, which itself was associated with high human population density. A second path model revealed nitrogen concentration in stream water was positively related to watershed area covered by cropland, and that cropland increased as human population density declined. A third path model indicated phosphorus concentration in stream water declined as percent of watershed residents with college education increased, although the mechanism underlying this relationship was unclear and could have been an artifact of lower soil-derived nutrient input from watersheds dominated by paved surfaces. To improve environmental conditions in urban streams, land use planning strategies should include limiting or reducing road density near streams, installing treatment trains for surface water runoff associated with roads, and establishing vegetated buffer zones to reduce inputs of road salt and other pollutants. Additionally, education/outreach should be conducted with residents to increase understanding of how their own behaviors influence stream water quality.This article is from Landscape and Urban Planning 143 (2015): 219, doi: 10.1016/j.landurbplan.2015.08.001.</p

International genome-wide meta-analysis identifies new primary biliary cirrhosis risk loci and targetable pathogenic pathways.

Primary biliary cirrhosis (PBC) is a classical autoimmune liver disease for which effective immunomodulatory therapy is lacking. Here we perform meta-analyses of discovery data sets from genome-wide association studies of European subjects (n=2,764 cases and 10,475 controls) followed by validation genotyping in an independent cohort (n=3,716 cases and 4,261 controls). We discover and validate six previously unknown risk loci for PBC (Pcombined<5 × 10(-8)) and used pathway analysis to identify JAK-STAT/IL12/IL27 signalling and cytokine-cytokine pathways, for which relevant therapies exist

Is CBT useful in vocational rehabilitation for people with a psychiatric disability?

People with a psychiatric disability can experience difficulty in gaining and maintaining employment. Some of these difficulties are related to problems in managing employment-related stress. The aim of this study was to pilot a vocationally-oriented cognitive behavioral therapy (CBT) training program for people receiving public mental health services in Australia. Thirteen participants completed the program and reported significant improvements in general mental health, optimism and attitudes to work following training. The utility of CBT approaches to vocational rehabilitation for people with a psychiatric disability requires rigorous testing. It is likely that this approach may best be used in conjunction with other programs such as supported employment