Making Sense of a New Transport System: An Ethnographic Study of the Cambridgeshire Guided Busway

An increase in public transport use has the potential to contribute to improving population health, and there is growing interest in innovative public transport systems. Yet how new public transport infrastructure is experienced and integrated (or not) into daily practice is little understood. We investigated how the Cambridgeshire Guided Busway, UK, was used and experienced in the weeks following its opening, using the method of participant observation (travelling on the busway and observing and talking to passengers) and drawing on Normalization Process Theory to interpret our data. Using excerpts of field notes to support our interpretations, we describe how the ease with which the new transport system could be integrated into existing daily routines was important in determining whether individuals would continue to use it. It emerged that there were two groups of passengers with different experiences and attitudes. Passengers who had previously travelled frequently on regular bus services did not perceive the new system to be an improvement; consequently, they were frustrated that it was differentiated from and not coherent with the regular system. In contrast, passengers who had previously travelled almost exclusively by car appraised the busway positively and perceived it to be a novel and superior form of travel. Our rich qualitative account highlights the varied and creative ways in which people learn to use new public transport and integrate it into their everyday lives. This has consequences for the introduction and promotion of future transport innovations. It is important to emphasise the novelty of new public transport, but also the ways in which its use can become ordinary and routine. Addressing these issues could help to promote uptake of other public transport interventions, which may contribute to increasing physical activity and improving population health. © 2013 Jones et al

Simultaneous chronic rupture of quadriceps tendon and contra-lateral patellar tendon in a patient affected by tertiary hyperparatiroidism

Spontaneous ruptures of the extensor mechanism of the knee are very rare. They tend to increase considerably in patients with metabolic diseases such as chronic renal failure, hyperparathyroidism, diabetes, gout, and systemic lupus erythematosus. The reported case regards a 48-year-old man with chronic, spontaneous and simultaneous quadriceps, and contra-lateral patellar tendon rupture. The patient suffered from chronic renal failure and for the past year from tertiary hyperparathyroidism. Ruptured tendons were repaired and both knee were evaluated monthly for the next 12 months. Good functional recovery was achieved on both knees without relapse. This case emphasizes the importance of long-term high parathyroid hormone level in the etiology of tendons ruptures

Add Health Wave IV Documentation: Measures of Glucose Homeostasis

During Wave IV, Add Health collected biological specimens from a large, nationally representative sample of young adults. Given the size of the Wave IV sample, its geographic distribution, and in-home setting of the respondent interviews, biological specimen collection involved practical, relatively non-invasive, cost-efficient and innovative methods. These methods included collection of capillary whole blood via finger prick by trained and certified field interviewers, its in situ desiccation, then shipment, assay and archival of dried blood spots. The collection of capillary whole blood followed the collection of cardiovascular and anthropometric measures (Entzel et al., 2009) and saliva (in preparation). It preceded the collection of data on respondent use of prescription and select over-the-counter medications (Tabor et al., 2010). Further details on the design of Add Health Waves I-IV, are available elsewhere (Harris, 2011). Included in the Add Health Wave IV data are two measures of glucose homeostasis based on assay of the dried blood spots: • Glucose (mg/dl) and • Hemoglobin A1c (HbA1c, %). To facilitate analysis and interpretation of HbA1c, the restricted-use Add Health Wave IV data also include a trichotomous flag distinguishing the original (0) from two types (1,2) of inter-converted assay results (see Section 4.2.3.3): • Convert (0,1,2) Moreover, the restricted-use Add Health Wave IV data include six constructed measures: • Fasting duration (h) • Classification of fasting glucose (ADA, 2011) • Classification of non-fasting glucose (ADA, 2011) • Classification of HbA1c (ADA, 2011) • Anti-diabetic medication use • Joint classification of glucose, HbA1c, self-reported history of diabetes, and anti-diabetic medication use. This document summarizes the rationale, equipment, protocol, assay, internal quality control, data cleaning, external quality control, and classification procedures for each measure listed above. Documentation of other (metabolic; inflammatory; immune; genetic) measures based on assay of the dried blood spots and genotyping of DNA extracted from salivary buccal cells will be provided in separate reports

Add Health Wave IV Documentation: Measures of Inflammation and Immune Function

During Wave IV, Add Health collected biological specimens from a large, nationally representative sample of young adults. Given the size of the Wave IV sample, its geographic distribution, and in-home setting of the respondent interviews, biological specimen collection involved practical, relatively non-invasive, cost-efficient and innovative methods. These methods included collection of capillary whole blood via finger prick by trained and certified field interviewers, its in situ desiccation, then shipment, assay and archival of dried blood spots. The collection of capillary whole blood followed the collection of cardiovascular and anthropometric measures (Entzel et al, 2009) and saliva (Smolen et al, 2012). It preceded the collection of data on respondent use of prescription and select over-the-counter medications (Tabor et al, 2010). Further details on the design of Add Health Waves I-IV, are available elsewhere (Harris, 2011). Included in the Add Health Wave IV data are two measures of inflammation and immune function based on assay of the dried blood spots: • High Sensitivity C-Reactive Protein (hsCRP, mg/L) and • Epstein Barr Viral Capsid Antigen IgG (EBV, AU/ml) To facilitate analysis and interpretation of hsCRP and EBV, the restricted-use Add Health Wave IV data also include two data quality flags and 11constructed measures: • CRP_FLAG • EBV_FLAG • Classification of hsCRP (Pearson et al, 2003) • Count of Common Subclinical Symptoms (Vaidya et al, 2006) • Count of Common Infectious or Inflammatory Diseases • NSAID/Salicylate Medication Use in the Past 24 Hours • NSAID/Salicylate Medication Use in the Past 4 Weeks • Cox-2 Inhibitor Medication Use in the Past 4 Weeks • Inhaled Corticosteroid Medication Use in the Past 4 Weeks • Corticotropin/Glucocorticoid Medication Use in the Past 4 Weeks • Anti-rheumatic/Anti-psoriatic Medication Use in the Past 4 Weeks • Immunosuppressive Medication Use in the Past 4 Weeks • Anti-inflammatory Medication Use. This document summarizes the rationale, equipment, protocol, assay, internal quality control, data cleaning, external quality control, and classification procedures for each measure listed above. Measures of glucose homeostasis and candidate genes are documented elsewhere 3 (Whitsel et al, 2012; Smolen et al, 2012). Documentation of lipids will be provided in a separate report

Toxicology evaluation of radiotracer doses of 3'-deoxy-3'-[18F]fluorothymidine (18F-FLT) for human PET imaging: Laboratory analysis of serial blood samples and comparison to previously investigated therapeutic FLT doses

Background: 18F-FLT is a novel PET radiotracer which has demonstrated a strong potential utility for imaging cellular proliferation in human tumors in vivo. To facilitate future regulatory approval of 18F-FLT for clinical use, we wished to demonstrate the safety of radiotracer doses of 18F-FLT administered to human subjects, by: 1) performing an evaluation of the toxicity of 18F-FLT administered in radiotracer amounts for PET imaging, 2) comparing a radiotracer dose of FLT to clinical trial doses of FLT. Methods: Twenty patients gave consent to a 18F-FLT injection, subsequent PET imaging, and blood draws. For each patient, blood samples were collected at multiple times before and after 18F-FLT PET. These samples were assayed for a comprehensive metabolic panel, total bilirubin, complete blood and platelet counts. 18F-FLT doses of 2.59 MBq/Kg with a maximal dose of 185 MBq (5 mCi) were used. Blood time-activity curves were generated for each patient from dynamic PET data, providing a measure of the area under the FLT concentration curve for 12 hours (AUC12). Results: No side effects were reported. Only albumin, red blood cell count, hematocrit and hemoglobin showed a statistically significant decrease over time. These changes are attributed to IV hydration during PET imaging and to subsequent blood loss at surgery. The AUC12 values estimated from imaging data are not significantly different from those found from serial measures of FLT blood concentrations (p = 0.66). The blood samples-derived AUC12 values range from 0.232 ng*h/mL to 1.339 ng*h/mL with a mean of 0.802 � 0.303 ng*h/mL. This corresponds to 0.46% to 2.68% of the lowest and least toxic clinical trial AUC12 of 50 ng*h/mL reported by Flexner et al (1994). This single injection also corresponds to a nearly 3,000-fold lower cumulative dose than in Flexner's twice daily trial. Conclusion: This study shows no evidence of toxicity or complications attributable to 18F-FLT injected intravenously.This study was supported by NIH grant R01 CA115559, 1R01 CA107264, and 1R01 CA80907

Add Health Wave IV Documentation: Lipids

During Wave IV, Add Health collected biological specimens from a large, nationally representative sample of young adults. Given the size of the Wave IV sample, its geographic distribution, and in-home setting of the respondent interviews, biological specimen collection involved practical, relatively non-invasive, cost-efficient and innovative methods. These methods included collection of capillary whole blood via finger prick by trained and certified field interviewers, its in situ desiccation, then shipment, assay and archival of dried blood spots. The collection of capillary whole blood followed the collection of cardiovascular and anthropometric measures (Entzel et al. 2009) and saliva (Smolen et al. 2013). It preceded the collection of data on respondent use of prescription and select over-the-counter medications (Tabor et al. 2010). Further details on the design of Add Health Waves I-IV, are available elsewhere (Harris 2012; Harris et al. in press). Included in the Add Health Wave IV restricted use and public use data are thirteen constructed measures designed to facilitate analysis and interpretation of lipids results: • Total cholesterol decile • High-density lipoprotein cholesterol decile • Triglycerides decile • Total cholesterol measurement method • High-density lipoprotein cholesterol measurement method • Triglycerides measurement method • Low-density lipoprotein cholesterol decile • Non-high-density lipoprotein cholesterol decile • Total to high-density lipoprotein cholesterol ratio decile • Fasting duration • Fasted for nine hours or more • Antihyperlipidemic medication use • Hyperlipidemia. This document summarizes the rationale, equipment, protocol, assay, internal quality control, data cleaning, external quality control, and classification procedures for each measure listed above. Measures of glucose homeostasis, inflammation, immune function, and candidate genes are documented elsewhere (Whitsel et al. 2012a, 2012b; Smolen et al. 2013)

Blood spot–based measures of glucose homeostasis and diabetes prevalence in a nationally representative population of young US adults

We investigated under-studied, biomarker-based diabetes among young U.S. adults, traditionally characterized by low cardiovascular disease risk

Interprofessional Education: An evaluation of a joint learning workshop for podiatry and pharmacy students

"Interprofessional Education occurs when two or more professionals learn with, from and about each other to improve collaboration and the quality of care" (CAIPE 2002). Interprofessional education forms part of the Standards for the Initial Education and Training of Pharmacists. Working with and understanding the role of another profession has been shown to positively impact on the quality of care of the patient. Following positive pharmacy student feedback from visits to podiatry clinics an interprofessional learning workshop with case - based scenarios was developed. These were based on patients with high risk medical conditions that would impact on the work of both professions. Data from the feedback forms was evaluated and analysed to determine whether the workshop increased knowledge of the British National Formulary (BNF), the prescribing process and gave an insight in to the role of other healthcare professionals. We discuss how the student’s learning has been enhanced by the contribution of another professional group. The workshop was positively received. Students were observed working together discussing the patients’ conditions and issues relating to their care. This initially revolved around the students’ area of knowledge; however, as the session progressed it became apparent that the students were learning with, from and about each other for the benefit of patient care

Walking to work in Canada: health benefits, socio-economic characteristics and urban-regional variations

<p>Abstract</p> <p>Background</p> <p>There is mounting concern over increasing rates of physical inactivity and overweight/obesity among children and adult in Canada. There is a clear link between the amount of walking a person does and his or her health. The purpose of this paper is to assess the health factors, socio-economic characteristics and urban-regional variations of walking to work among adults in Canada.</p> <p>Methods</p> <p>Data is drawn from two cycles of the Canadian Community Health Survey: 2001 and 2005. The study population is divided into three groups: non-walkers, lower-duration walkers and high-duration walkers. Logistic regression modeling tests the association between levels of walking and health related outcomes (diabetes, high blood pressure, stress, BMI, physical activity), socio-economic characteristics (sex, age, income, education) and place of residence (selected Census Metropolitan Areas).</p> <p>Results</p> <p>In 2005, the presence of diabetes and high blood pressure was not associated with any form of walking. Adults within the normal weight range were more likely to be high-duration walkers. Females and younger people were more likely to be lower-duration walkers but less likely to be high-duration walkers. There was a strong association between SES (particularly relative disadvantage) and walking to work. In both 2001 and 2005, the conditions influencing walking to work were especially prevalent in Canada's largest city, Toronto, as well as in several small to medium sized urban areas including Halifax, Kingston, Hamilton, Regina, Calgary and Victoria.</p> <p>Conclusion</p> <p>A number of strategies can be followed to increase levels of walking in Canada. It is clear that for many people walking to work is not possible. However, strategies can be developed to encourage adults to incorporate walking into their daily work and commuting routines. These include mass transit walking and workplace walking programs.</p