Capacity building in Obstetrics and Gynaecology through academic partnerships to improve global women's health beyond 2015

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/109872/1/bjo13176.pd

Risk of increasing temperature due to climate change on operation of the Spanish rail network

The rail network in Spain is around 16.000 km of Iberian, standard and narrow gauge, connecting the main population cities and hubs of transport. Due to its geographical location in southern Europe, during the summer months the entire network is subjected to high temperatures variations, including heat wave events, where temperatures become exceptionally elevates. With the use of continuous welded rails and the absence of expansion joints, temperature changes in rails results in significant compressive stresses. Moreover, climate models considers that extreme temperatures are going to become more frequent and intense in the next decades. Thus, understanding the nature of buckling events is required to identify potential causes and develop adaptation strategies and safety procedures. However, the impact in the railway infrastructure in Spain have not been fully addressed due to the differences in local environmental parameters and track characteristics, among others. In this study, the issue of potential impacts of temperatures on the Spanish railway network are analyzed in terms of average track buckling failures until 2030. The approach addresses the frequency of future buckling events considering the spatial and temporal distribution to establish trends between climate projections and track buckling events. Therefore, this work is of significant importance for planning, design and maintenance, providing a predictive track maintenance regime in order to assist the decision-making process.Villalba Sanchis, I.; Insa Franco, R.; Salvador Zuriaga, P.; Martínez Fernández, P. (2020). Risk of increasing temperature due to climate change on operation of the Spanish rail network. Elsevier. 1-8. https://doi.org/10.1016/j.trpro.2020.02.056S1

Patient enablement requires physician empathy: a cross-sectional study of general practice consultations in areas of high and low socioeconomic deprivation in Scotland

<b>Background</b> Patient 'enablement' is a term closely aligned with 'empowerment' and its measurement in a general practice consultation has been operationalised in the widely used patient enablement instrument (PEI), a patient-rated measure of consultation outcome. However, there is limited knowledge regarding the factors that influence enablement, particularly the effect of socio-economic deprivation. The aim of the study is to assess the factors influencing patient enablement in GP consultations in areas of high and low deprivation.<p></p> <b>Methods</b> A questionnaire study was carried out on 3,044 patients attending 26 GPs (16 in areas of high socio-economic deprivation and 10 in low deprivation areas, in the west of Scotland). Patient expectation (confidence that the doctor would be able to help) was recorded prior to the consultation. PEI, GP empathy (measured by the CARE Measure), and a range of other measures and variables were recorded after the consultation. Data analysis employed multi-level modelling and multivariate analyses with the PEI as the dependant variable.<p></p> <b>Results</b> Although numerous variables showed a univariate association with patient enablement, only four factors were independently predictive after multilevel multivariate analysis; patients with multimorbidity of 3 or more long-term conditions (reflecting poor chronic general health), and those consulting about a long-standing problem had reduced enablement scores in both affluent and deprived areas. In deprived areas, emotional distress (GHQ-caseness) had an additional negative effect on enablement. Perceived GP empathy had a positive effect on enablement in both affluent and deprived areas. Maximal patient enablement was never found with low empathy.<p></p> <b>Conclusions</b> Although other factors influence patient enablement, the patients' perceptions of the doctors' empathy is of key importance in patient enablement in general practice consultations in both high and low deprivation settings

Interaction between motor vehicles and bicycles at two-lane roundabouts: a driving volatility-based analysis

Drivers' instantaneous decisions regarding speed and acceleration/deceleration, as well as the time rate of acceleration change (jerk) can result in a volatility driving behaviour with significant impact on cyclist safety. The contribution of this article is the assessment of driving volatility in motor vehicle (MV)-bicycle interactions at two-lane roundabouts. Traffic flow and bicycle GPS data were collected from two two-lane roundabouts. Then, traffic, emissions and safety models were used to evaluate volatility impacts on safety, pollutant emissions and traffic performance. The findings showed jerk have an impact on driving volatility between MVs and bicycles, regardless of roundabout design with higher amplitude of variation for MVs. However, MVs had higher acceleration-deceleration variation than bicycles.publishe