Relationship between spatial proximity and travel-to-work distance : the effect of the compact city

In this paper, an assessment is made of the relationship between selected aspects of spatial proximity (density, diversity, minimum commuting distance, jobs-housing balance and job accessibility) and reported commuting distances in Flanders (Belgium). Results show that correlations may depend on the considered trip end. For example, a high residential density, a high degree of spatial diversity and a high level of job accessibility are all associated with a short commute by residents, while a high job density is associated with a long commute by employees. A jobs-housing balance close to one is associated with a short commute, both by residents and by employees. In general, it appears that the alleged sustainability benefits of the compact city model are still valid in a context of continuously expanding commuting trip lengths

Multidisciplinary teams, and parents, negotiating common ground in shared-care of children with long-term conditions: A mixed methods study

Background: Limited negotiation around care decisions is believed to undermine collaborative working between parents of children with long-term conditions and professionals, but there is little evidence of how they actually negotiate their respective roles. Using chronic kidney disease as an exemplar this paper reports on a multi-method study of social interaction between multidisciplinary teams and parents as they shared clinical care. Methods. Phases 1 and 2: a telephone survey mapping multidisciplinary teams' parent-educative activities, and qualitative interviews with 112 professionals (Clinical-psychologists, Dietitians, Doctors, Nurses, Play-specialists, Pharmacists, Therapists and Social-workers) exploring their accounts of parent-teaching in the 12 British children's kidney units. Phase 3: six ethnographic case studies in two units involving observations of professional/parent interactions during shared-care, and individual interviews. We used an analytical framework based on concepts drawn from Communities of Practice and Activity Theory. Results: Professionals spoke of the challenge of explaining to each other how they are aware of parents' understanding of clinical knowledge, and described three patterns of parent-educative activity that were common across MDTs: Engaging parents in shared practice; Knowledge exchange and role negotiation, and Promoting common ground. Over time, professionals had developed a shared repertoire of tools to support their negotiations with parents that helped them accomplish common ground during the practice of shared-care. We observed mutual engagement between professionals and parents where a common understanding of the joint enterprise of clinical caring was negotiated. Conclusions: For professionals, making implicit knowledge explicit is important as it can provide them with a language through which to articulate more clearly to each other what is the basis of their intuition-based hunches about parents' support needs, and may help them to negotiate with parents and accelerate parents' learning about shared caring. Our methodology and results are potentially transferrable to shared management of other conditions. © 2013 Swallow et al.; licensee BioMed Central Ltd

Early Identification of Type 2 Diabetes: Policy should be aligned with health systems strengthening

This article does not have an abstract

X-Ray Observations of Type Ia Supernovae with Swift: Evidence for Circumstellar Interaction for SN 2005ke

We present a study of the early (days to weeks) X-ray and UV properties of eight Type Ia supernovae (SNe Ia) which have been extensively observed with the X-Ray Telescope (XRT) and UV/Optical Telescope (UVOT) onboard Swift, ranging from 5-132 days after the outburst. SN 2005ke is tentatively detected (at a 3-3.6 sigma level of significance) in X-rays based on deep monitoring with the XRT ranging from 8 to 120 days after the outburst. The inferred X-ray luminosity [(2+/-1) x 10^{38} ergs/s; 0.3-2 keV band] is likely caused by interaction of the SN shock with circumstellar material (CSM), deposited by a stellar wind from the progenitor's companion star with a mass-loss rate of ~ 3 x 10^{-6} M_sun/yr (v_w/10 km/s). Evidence of CSM interaction in X-rays is independently confirmed by an excess of UV emission as observed with the UVOT onboard Swift, starting around 35 days after the explosion. The non-detection of SN 2005ke with Chandra 105 days after the outburst implies a rate of decline steeper than L_x \propto t^{-0.75}, consistent with the decline expected from the interaction of the SN shock with a spherically symmetric CSM (t^{-1}). None of the other seven SNe Ia is detected in X-rays or shows a UV excess, which allows us to put tight constraints on the mass-loss rates of the progenitor systems.Comment: 12 pages, 3 figures, accpeted for publication in ApJ

"Practical Knowledge" and Perceptions of Antibiotics and Antibiotic Resistance Among Drugsellers in Tanzanian Private Drugstores.

Studies indicate that antibiotics are sold against regulation and without prescription in private drugstores in rural Tanzania. The objective of the study was to explore and describe antibiotics sale and dispensing practices and link it to drugseller knowledge and perceptions of antibiotics and antibiotic resistance. Exit customers of private drugstores in eight districts were interviewed about the drugstore encounter and drugs bought. Drugsellers filled in a questionnaire with closed- and open-ended questions about antibiotics and resistance. Data were analyzed using mixed quantitative and qualitative methods. Of 350 interviewed exit customers, 24% had bought antibiotics. Thirty percent had seen a health worker before coming and almost all of these had a prescription. Antibiotics were dispensed mainly for cough, stomachache, genital complaints and diarrhea but not for malaria or headache. Dispensed drugs were assessed as relevant for the symptoms or disease presented in 83% of all cases and 51% for antibiotics specifically. Non-prescribed drugs were assessed as more relevant than the prescribed. The knowledge level of the drugseller was ranked as high or very high by 75% of the respondents. Seventy-five drugsellers from three districts participated. Seventy-nine percent stated that diseases caused by bacteria can be treated with antibiotics but 24% of these also said that antibiotics can be used for treating viral disease. Most (85%) said that STI can be treated with antibiotics while 1% said the same about headache, 4% general weakness and 3% 'all diseases'. Seventy-two percent had heard of antibiotic resistance. When describing what an antibiotic is, the respondents used six different kinds of keywords. Descriptions of what antibiotic resistance is and how it occurs were quite rational from a biomedical point of view with some exceptions. They gave rise to five categories and one theme: Perceiving antibiotic resistance based on practical experience. The drugsellers have considerable "practical knowledge" of antibiotics and a perception of antibiotic resistance based on practical experience. In the process of upgrading private drugstores and formalizing the sale of antibiotics from these outlets in resource-constrained settings, their "practical knowledge" as well as their perceptions must be taken into account in order to attain rational dispensing practices

Spectrum and Morphology of the Two Brightest Milagro Sources in the Cygnus Region: MGRO J2019+37 and MGRO J2031+41

The Cygnus region is a very bright and complex portion of the TeV sky, host to unidentified sources and a diffuse excess with respect to conventional cosmic-ray propagation models. Two of the brightest TeV sources, MGRO J2019+37 and MGRO J2031+41, are analyzed using Milagro data with a new technique, and their emission is tested under two different spectral assumptions: a power law and a power law with an exponential cutoff. The new analysis technique is based on an energy estimator that uses the fraction of photomultiplier tubes in the observatory that detect the extensive air shower. The photon spectrum is measured in the range 1 to 200 TeV using the last 3 years of Milagro data (2005-2008), with the detector in its final configuration. MGRO J2019+37 is detected with a significance of 12.3 standard deviations ($\sigma$), and is better fit by a power law with an exponential cutoff than by a simple power law, with a probability $>98$% (F-test). The best-fitting parameters for the power law with exponential cutoff model are a normalization at 10 TeV of $7^{+5}_{-2}\times10^{-10}$ $\mathrm{s^{-1}\: m^{-2}\: TeV^{-1}}$, a spectral index of $2.0^{+0.5}_{-1.0}$ and a cutoff energy of $29^{+50}_{-16}$ TeV. MGRO J2031+41 is detected with a significance of 7.3$\sigma$, with no evidence of a cutoff. The best-fitting parameters for a power law are a normalization of $2.4^{+0.6}_{-0.5}\times10^{-10}$ $\mathrm{s^{-1}\: m^{-2}\: TeV^{-1}}$ and a spectral index of $3.08^{+0.19}_{-0.17}$. The overall flux is subject to an $\sim$30% systematic uncertainty. The systematic uncertainty on the power law indices is $\sim$0.1. A comparison with previous results from TeV J2032+4130, MGRO J2031+41 and MGRO J2019+37 is also presented.Comment: 11 pages, 10 figure

Andalusia, Spain: An Assessment of Coastal Scenery

The 1101 km length of the Andalusian coast (Spain) was assessed for coastal scenery at 45 specific locations. Selected areas covered resort (3), urban (19), village (8), rural (10) and remote (5) bathing areas. Scenery was analyzed for physical and human parameters via 26 selected parameters. These parameters were obtained by interviews of 4500 people on European beaches. Each parameter was assessed via a one-to-five-point attribute scale, which essentially ranged from presence/absence or poor quality (1), to excellent/outstanding (5). Results were subsequently weighted by interviewing 4600 bathing area users (not all 26 parameters have equal weight) and subjected to fuzzy logic mathematics in order to reduce recorder subjectivity. High weighted averages for attributes 4 and 5 (excellent/outstanding) reflected high scenic quality, vice versa for attributes 1 and 2. Sites were classified into five classes ranging from Class 1 sites having top grade scenery to Class 5, poor scenery. Seven sites each were found in Classes 1 and 2; 10 sites each in Classes 3 and 5; 11 sites in Class 4. The finest coastal scenery was found in remote areas whilst urban areas scored mainly as Class 3 or 4. Three out of the ten rural sites had Class 3 and 4 values assigned them whereas the rest scored as Class 1 and 2; village sites invariably had scores within Class 3 and 4. Of the three resort sites investigated, one scored as a Class 1 site, the others as Class 3