Initiating dialogue between stakeholders and establishing a common language for community severance through cross disciplinary workshops

The concept of community severance has slowly been making its way into concrete transport plans and policies but it still lacks a consensual definition. This is because the issue has been approached by researchers from a range of disciplines, which have specific and diverse ways of constructing scientific knowledge. The objective of this paper, the first in a series of working papers to be generated by the Street Mobility and Network Accessibility research project is to build bridges between these different approaches and provide a base for the integration of community severance into public policy. The paper is the outcome of a series of workshops attended by a cross-disciplinary team of researchers and stakeholders, including policy-makers and local practitioners. On the basis of these discussions, a framework for cross-disciplinary research on community severance is developed, taking into consideration the chain of direct and indirect effects of transport infrastructure and motorised traffic and the range and complexity in the methodologies used for analysing and formulating solutions to the problem. In a second stage, we examine the consistency between this framework and the opinions and experiences of stakeholders

Macular Pigment Spatial Profiles in a Healthy Asian Population

Purpose: Reduced macular pigment optical density (MPOD) has been associated with age-related macular degeneration (ARMD). MP spatial profiles tend to follow either an exponential curve or exhibit a secondary peak up to 2° eccentricity in 40% to 50% of Caucasian subjects. A higher incidence of secondary peak profiles has been reported in ethnicities with low ARMD prevalence using fundus autofluorescence image analysis. The aim of this study was to investigate the distribution of MP spatial profiles in healthy Asian subjects. Methods: MP spatial profiles were measured using heterochromatic flicker photometry (Ophthalmic Physiol Opt. 30:470-483,2010) in 55 Asian subjects (mean age 21 ± 3 years). Secondary peak classification was based on the MPOD at 0.8° or at 1.8° being 0.10 log units (the average within subject standard deviation at each location) greater than the value predicted by the exponential fit. The remaining subjects were allocated to the single peak subgroup. The average blue light transmittance (Tav) and the average MPOD (ODav) between 0° and 1.8° were calculated. Results: According to our criterion, 25 subjects (45%) had secondary peak spatial profiles. Mean MPOD at 0.8° was significantly higher in subjects with a secondary peak (0.52 ± 0.12 log units) when compared to the single peak subgroup (0.41 ± 0.12 log units; t = -3.53, p = 0.001), but not at 0° (0.61 ± 0.13 log units versus 0.53 ± 0.19 log units; t = -1.79, p = 0.08, respectively). Percentage Tav was significantly Abstract Print View 07/01/2015 13:40 http://www.abstractsonline.com/Plan/AbstractPrintView.aspx?mID…ac-84e1-16d2b30126d4&cKey=993b1a7a-895d-4049-b8fd-0bfb18b9d371 Page 2 of 2 decreased in subjects with secondary peak profiles (40 ± 8%) compared to those with single peak profiles (46 ± 10%; t = 2.31, p = 0.03). ODav was significantly greater in subjects with secondary (0.41 ± 0.09) versus single peak profiles (0.35 ± 0.10; t = -2.29, p = 0.03). Conclusions: Significant differences in blue light transmittance and average MPOD up to 1.8° were found between exponential and secondary peak MP profiles. Subjects exhibiting a secondary peak were better protected against the damaging effects of blue light. However, the incidence of secondary peak MP profiles in Asian subjects was similar to that previously recorded in Caucasians, suggesting that factors other than racial differences in secondary peak frequency may explain the ethnic influence on ARMD prevalence

From the axial line to the walked line: Evaluating the utility of commercial and user-generated street network datasets in space syntax analysis

Data availability, reliability and cost are some of the most constraining factors in space syntax analysis and wider commercial acceptance. In recent years user-created Volunteered Geographic Information (VGI) that is free to all via the Internet has gained wider acceptance and proven reliability (Haklay, 2010). Furthermore it has the property of being created by the people who inhabit the spaces being mapped; therefore it captures local knowledge and detail to a far greater degree than commercial mapping agencies. From a space syntax perspective it also relates more closely to the pedestrian network as it is used on foot and captures details of pedestrian routes through the urban fabric that other road-centric data sources ignore. This paper demonstrates the methodological approaches and analytic outcomes of a space syntax sensitivity analysis of Open Street Map (OSM) VGI road network data, the UK national mapping agency Ordnance Survey Integrated Transport Network (ITN) road data and a hand-drawn Axial map for four areas within the Greater London Region. The space syntax segment analysis was completed within the Depthmap application. The segment analysis was completed on the ITN model, OSM model and hand-drawn model separately and then it was carried out on a combined model of the ITN and OSM that integrated all the network elements from both. The integration and comparison of the network models was carried out through the usage of a new algorithm currently under development at University College London that identifies and extracts the differences between two line network datasets (Koukoletsos, forthcoming) and standard GIS processing techniques. The space syntax measures were evaluated on four areas in outer London that are the focus of the Adaptable Suburbs project at the Bartlett School of Graduate Studies. The analysis was carried out using length-weighted angular segment and choice analysis at radii 800m, 2000m and n (Turner, 2007). Comparative statistics were then generated for the areas to evaluate the analysis outcomes of the different network models. The London-wide network that was created through the combination of the OSM and ITN networks had a total length of 32,000km representing an increase of approximately 20% over the Ordnance Survey ITN network. The dramatic increase in network length alone demonstrates the divergent realities of the two mapping techniques and the representation of the world that they capture. It is anticipated that the sensitivity analysis will find that there was no significant difference in the global syntax values between the ITN and OSM and Axial models but at the local level the additional network segments for pedestrian routes within the OSM data will provide greater network accuracy and syntax values that model the reality on the ground better than the Ordnance Survey ITN model. Furthermore it captures potential pedestrian routes that are not present in the other data sets. The work carried out seeks to understand whether Volunteered Geographic Information is a viable alternative to official mapping sources when creating models for analysis of small urban areas. If this proves to be the case such data would provide not only a cost effective alternative to commercially produced data but indeed a more reliable network model for the analysis to be carried out. Open source geographic data have the capability to improve and enrich space syntax analysis whilst removing high price barriers that commercial data sources impose

Macular pigment spatial profiles in South Asian and white subjects

Purpose: Variability in central macular pigment optical density (MPOD) has been reported amongst healthy individuals. These variations seem to be related to risk factors of age-related macular degeneration, such as female gender, smoking, and ethnicity. This study investigates the variations in MPOD spatial profiles amongst ethnicities. Methods: Using heterochromatic flicker photometry (HFP), MPOD was measured at 7 retinal locations in 54 healthy young South Asian and 19 White subjects of similar age. Macular pigment spatial profiles were classified as either typical ‘exponential’, atypical ‘ring-like’ or atypical ‘central dip’. Results: Central MPOD was significantly greater in South Asian (0.56 ± 0.17) compared to White subjects (0.45 ± 0.18; P = 0.015). Integrated MPOD up to 1.8° i.e. MPODav(0-1.8) was also significantly increased in Asian (0.34 ± 0.09) versus White subjects (0.27 ± 0.10; P = 0.003). MPODav(0-1.8) was significantly increased in all subjects presenting a ring-like profile (0.35 ± 0.08) or central dip profile (0.39 ± 0.09), compared to typical exponential profiles (0.28 ± 0.09; P < 0.0005). We found a statistically significant association between ethnicity and spatial profile type (P = 0.008), whereby an exponential profile was present in 79% of White compared to 41% of the South Asian subjects. Conclusion: Central MPOD, MPODav(0-1.8), and the prevalence of atypical spatial profiles were significantly increased in South Asian compared to White subjects. Atypical profiles resulted in increased integrated MPOD up to 1.8° and may therefore offer enhanced macular protection from harmful blue light

Relationship between Macular Pigment and Foveal Anatomic Architecture in an Asian Population

Purpose: The extent to which reduced macular pigment optical density (MPOD) contributes to the prevalence of age related macular degeneration (ARMD) in Caucasians compared to other ethnicities has often been questioned. Foveal architecture may be related to MPOD and hence be a contributing factor. Previous studies have reported race-linked differences in peak MPOD and its central spatial distribution. This study investigates the relationship between MPOD and foveal architecture in an adult Asian population. Methods: The spatial profile of MPOD was assessed in 55 healthy Asian subjects (mean age 21 ± 4 years) using heterochromatic flicker photometry (Ophthalmic Physiol Opt. 30:470-483,2010). High-resolution macular thickness maps were obtained using a spectral-domain optical coherence tomography (Spectralis OCT, Heidelberg, Germany). The following relationships were investigated: 1) Peak MPOD (at 0° eccentricity) and minimal foveal thickness (MFT) measured manually at the point of sharpest foveal reflex; 2) Peak MPOD and central foveal thickness (CFT: average retinal thickness within central 1mm circle of the ETDRS grid); 3) Peak MPOD and foveal width (FW: measured from crest to crest); 4) MFT and FW; 5) Average MPOD absorption (ODav; over an area subtending ±2.8° centred at the fovea) and FW; and 6) ODav and CFT. Results: The peak MPOD values (mean 0.56 ± 0.17 log units) and the corresponding MFT showed good correlation (R2 = 0.34 p<0.0005). A moderate correlation was found between peak MPOD and CFT (R2 = 0.12; p=0.01). A weaker, but significant negative correlation was found between FW and CFT (R2 = 0.22; p<0.0005) and between FW and MFT (R2 = 0.1; p=0.03). In contrast, no correlation was found between FW and peak MPOD (p=0.84), FW and ODav (p=0.406), or ODav and CFT (p=0.593). Conclusion: The current findings suggest that minimal foveal thickness is a better predictor value for MPOD compared to the central foveal thickness and average retinal thickness given by the OCT. The expectation that a larger foveal pit area may contain more macular pigment because of longer cone axon fibres is not supported by our findings in the Asian subject group. Our results suggest that differences in foveal architecture can explain some of the measured variations in MPOD

Urban transport and community severance: linking research and policy to link people and places

Urban transport infrastructure and motorised road traffic contribute to the physical or psychological separation of neighbourhoods, with possible effects on the health and wellbeing of local residents. This issue, known as "community severance", has been approached by researchers from a range of disciplines, which have different ways of constructing scientific knowledge. The objective of this paper is to build bridges between these different approaches and provide a basis for the integration of the issue into public policy. A framework for cross-disciplinary research on community severance is developed, built on the results of two workshops attended by researchers from different disciplines. This framework takes into consideration the chain of direct and indirect effects of transport infrastructure and motorised traffic on local communities and the complexity in the methods used for analysing and formulating solutions to the problem. The framework is then compared with the views of practitioners, based on discussions held in a third and final workshop. It was concluded that to better understand community severance, researchers should frame their work in relation to that of other disciplines and develop tools that reflect the diversity of local contexts and stakeholders, balancing complexity with applicability

Interprofessional curriculum on environmental and social determinants of health in rural Kenya: Aga Khan University East Africa University of California San Francisco integrated primary health care program

The Aga Khan University East Africa (AKU)-University of California San Francisco (UCSF) Integrated Primary Health Care Program (IPHC) is a public–private partnership with community and government to strengthen the primary health care (PHC) system in Kenya. IPHC provides opportunities for health professions students to work and learn together in the rural and underserved district of Kaloleni

Use of folk remedies among patients in Karachi, Pakistan

BACKGROUND: The concept that food is medicine is being practiced in certain parts of the world, with positive outcomes on health of the population. We have such practice in Pakistan but it needs to be brought in line with the available scientific evidence. METHODS: The study was conducted on 270 patients, visiting the Family Practice Center, the Aga Khan University, Karachi. A questionnaire was used to collect information on the demographic profile, and the use of folk remedies for medicinal uses. RESULTS: Substantial use of folk remedies for different medical conditions has been documented. The remedies included cinnamon, ginger, cloves, cordimon, sesame oil, poppy seeds, honey, lemon, table salt, eggs and curd. The medical conditions in which folk remedies are used in respondents\u27 view, include conditions such as common cold, cough and flu to more serious conditions such as asthma, jaundice and heat stroke.CONCLUSIONS: We have found a substantial use of folk remedies for treatment of medical conditions. There is a need to organize their use on scientific lines

Distribution of lower urinary tract symptoms (LUTS) in adult women

OBJECTIVE: To determine the distribution of lower urinary tract symptoms in adult women and the frequency with which the women consulted a health care provider for their symptoms. DESIGN: Cross-sectional analytical study. PLACE AND DURATION OF STUDY: Community Health Center of Aga Khan University Hospital from November 1st to 30th, 2002. SUBJECTS AND METHODS: A trained interviewer administered a structured questionnaire to women patients or attendants aged 18 years and older coming to the center. RESULTS: Fifty-two percent of the study subjects reported having at least one or more urinary complaints in the past. Stress incontinence was the highest reported complaint (38.4%) followed by burning (34.4%), frequency (26%), painful micturition (20.4%), urge incontinence (18.8 %), incomplete emptying of bladder (14.4%), dribbling (12.4%) and poor stream (8.4%). Forty-three percent of the women with LUTS never consulted a health care provider for their problem.CONCLUSION: Although the distribution of LUTS among females was found to be high, the patients did not consider it important enough to consult a health care provider. There is a need to create awareness among females regarding LUTS and the need to consult a health care provider for their problems