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

Research protocol: general practice organ donation intervention-a feasibility study (GPOD)

BACKGROUND: New interventions are required to increase the number of people donating their organs after death. In the United States of America (USA), general practice has proved to be a successful location to increase organ donor registration. However, a dearth of research exists examining this in the United Kingdom (UK). due to the unique challenges presented by the National Health Service (NHS). This protocol outlines a feasibility study to assess whether UK general practice is a feasible and acceptable location for organ donation intervention targeting NHS Organ Donor Register (NHS ODR) membership. METHODS: The primary intervention element, prompted choice, requires general practice to ask patients in consultations if they wish to join the NHS ODR. Two additional intervention techniques will be used to support prompted choice: staff training and leaflets and posters. The intervention will run for 3 months (April-July 2018) followed by a period of data collection. The following methods will be used to assess feasibility, acceptability and fidelity: registration data, a training evaluation survey, focus groups with staff and online surveys for staff and patients. DISCUSSION: By examining the feasibility, acceptability and fidelity of a prompted choice intervention in UK general practice, important knowledge can be gathered on whether it is a suitable location to conduct this. Additional learning can also be gained generally for implementing interventions in general practice. This could contribute to the knowledge base concerning the feasibility of NHS general practice to host interventions

Dissecting the Shared Genetic Architecture of Suicide Attempt, Psychiatric Disorders, and Known Risk Factors

BACKGROUND: Suicide is a leading cause of death worldwide, and nonfatal suicide attempts, which occur far more frequently, are a major source of disability and social and economic burden. Both have substantial genetic etiology, which is partially shared and partially distinct from that of related psychiatric disorders. METHODS: We conducted a genome-wide association study (GWAS) of 29,782 suicide attempt (SA) cases and 519,961 controls in the International Suicide Genetics Consortium (ISGC). The GWAS of SA was conditioned on psychiatric disorders using GWAS summary statistics via multitrait-based conditional and joint analysis, to remove genetic effects on SA mediated by psychiatric disorders. We investigated the shared and divergent genetic architectures of SA, psychiatric disorders, and other known risk factors. RESULTS: Two loci reached genome-wide significance for SA: the major histocompatibility complex and an intergenic locus on chromosome 7, the latter of which remained associated with SA after conditioning on psychiatric disorders and replicated in an independent cohort from the Million Veteran Program. This locus has been implicated in risk-taking behavior, smoking, and insomnia. SA showed strong genetic correlation with psychiatric disorders, particularly major depression, and also with smoking, pain, risk-taking behavior, sleep disturbances, lower educational attainment, reproductive traits, lower socioeconomic status, and poorer general health. After conditioning on psychiatric disorders, the genetic correlations between SA and psychiatric disorders decreased, whereas those with nonpsychiatric traits remained largely unchanged. CONCLUSIONS: Our results identify a risk locus that contributes more strongly to SA than other phenotypes and suggest a shared underlying biology between SA and known risk factors that is not mediated by psychiatric disorders

Can a brief educational intervention improve parents' knowledge of healthy children's sleep? A pilot-test

Objective: Insufficient and poor quality sleep is prevalent in children, and is a significant public health concern due to the negative consequences for health. Certain sleep-related behaviours are associated with improved sleep, and sleep behaviours are amenable to efforts targeted towards behaviour change. Parental educational interventions have been successful at improving parents' knowledge and children's health outcomes in some areas of health, but no population-based educational interventions have been designed to improve parents' knowledge of healthy children's sleep. This study aimed to design and test an educational tool to increase caregivers' knowledge of healthy children's sleep in a primary care setting. Setting: A hospital-based pediatric primary care clinic where children attend for well-child and sick visits. Method: Parents of 95 children aged three months to 12 years completed two surveys, one prior to and one after receiving the intervention. The surveys assessed children's sleep habits (pre-intervention) and parental sleep beliefs and sleep knowledge (pre- and post-intervention). The intervention was a short, informational brochure. Results: Following the intervention there was a significant increase in parents' knowledge regarding children's healthy sleep, and in the number of parents who planned to make positive behaviour changes regarding their child's sleep practices. Conclusion: Simple written educational interventions may be effective tools with which to increase parents' knowledge and promote healthy sleep behaviours in children. © The Author(s) 2012

Adiposity and cortisol response to stress in Indian adolescents

Objective We examined associations of different adiposity measures with cortisol responses during the Trier Social Stress Test for children (TSST-C). Design Descriptive study. Setting Holdsworth Memorial Hospital, Mysore, India. Participants Adolescents aged 13.5y from a birth cohort were recruited (N=269, 133 boys). Methods The stressor (TSST-C) was 5-minutes each of public speaking and mental arithmetic tasks in front of two unfamiliar ‘judges’. Salivary cortisol concentrations were measured at baseline and at regular intervals after TSST-C. Weight, height, sub scapular and triceps skinfold thickness, and waist and hip circumference were measured, and percentage body fat was estimated (fat%; bioimpedance). Body mass index (BMI) and Waist-to-hip ratio (WHR) were calculated. All variables were converted into within-cohort SD scores before analysis. Stressinduced change in cortisol concentrations from baseline (cortisol response) was examined in relation to adiposity. Results Stress increased cortisol concentrations significantly from baseline (mean (SD): 5.5 (6.4) ng/mL; P&lt;0.001). Higher WHR was associated with lower cortisol response at 20 and 30-minutes after stress (~0.13 SD decrease in cortisol response per SD higher WHR, P&lt;0.05). Higher fat% was also associated with lower cortisol response only in girls 20-minutes post-stress (0.23 SD lower response per SD higher fat%, P=0.004). Sum of skinfold thickness and BMI were not associated with cortisol responses. Conclusions Abdominal adiposity is associated with reduced hypothalamic-pituitary-adrenal axis reactivity to stress in this adolescent population.<br/

Adiposity and cortisol response to stress in Indian adolescents

Objective We examined associations of different adiposity measures with cortisol responses during the Trier Social Stress Test for children (TSST-C). Design Descriptive study. Setting Holdsworth Memorial Hospital, Mysore, India. Participants Adolescents aged 13.5y from a birth cohort were recruited (N=269, 133 boys). Methods The stressor (TSST-C) was 5-minutes each of public speaking and mental arithmetic tasks in front of two unfamiliar ‘judges’. Salivary cortisol concentrations were measured at baseline and at regular intervals after TSST-C. Weight, height, sub scapular and triceps skinfold thickness, and waist and hip circumference were measured, and percentage body fat was estimated (fat%; bioimpedance). Body mass index (BMI) and Waist-to-hip ratio (WHR) were calculated. All variables were converted into within-cohort SD scores before analysis. Stressinduced change in cortisol concentrations from baseline (cortisol response) was examined in relation to adiposity. Results Stress increased cortisol concentrations significantly from baseline (mean (SD): 5.5 (6.4) ng/mL; P Conclusions Abdominal adiposity is associated with reduced hypothalamic-pituitary-adrenal axis reactivity to stress in this adolescent population.<br /

Dry getting drier – The future of transnational river basins in Iberia

Study region: Main international rivers of Iberia (SW Europe): Douro, Tagus and Guadiana. Study focus: Iberia has long suffered from water scarcity which will worsen with projected reductions in rainfall and increases in temperature. Nonetheless, there has been almost no research concerning the future discharges of these rivers. We examine an ensemble of climate model projections from CMIP5 RCP 8.5 and use two downscaling methods to produce a range of changes in discharge using a physically-based, spatially-distributed hydrological model (SHETRAN) for historical (1961–1990) and future (2040–2070) periods. New hydrological insights for the region: There is uncertainty in the sign of change in high (winter) discharges but most model runs show decreases in monthly, seasonal and annual discharges for all basins; especially for medium and low discharges, with all but one run showing future decreases. The magnitude of these decreases varies significantly for different CMIP5 ensemble members. However, autumn shows the biggest decreases (reaching −61% for the Douro, −71% in the Tagus, and −92% for the Guadiana) and the reductions are consistently larger for the Guadiana. This is the first study to explore a wide range of possible futures for these international basins. We show that, despite uncertainties in model projections, there is common behavior with reductions in mean and especially in low discharges which will have important implications for water resources, populations, ecology and agriculture