Urban built environment configuration and psychological distress in older men: Results from the Caerphilly study

Background: Few studies have examined the impact of the built environment configuration upon mental health. The study examines the impact of objectively assessed land use and street network configuration upon psychological distress and whether this association is moderated by the natural environment and area-level deprivation. Methods. In a community sample of 687 older men from the Caerphilly Prospective Study, built environment morphological metrics (morphometrics) were related to differences in psychological distress as measured by the General Health Questionnaire. Cross-sectional data were taken from the most recent (5th) phase. A multi-level analysis with individuals nested within census-defined neighbourhoods was conducted. Environmental measures comprised GIS-constructed land use and street network metrics, slope variability and a satellite derived measure of greenness. Results: Reduced psychological distress was associated with residing in a terraced dwelling (OR = 0.48, p = 0.03), higher degrees of land-use mix (OR = 0.42, p = 0.03 for the high tertile) and having higher local-level street-network accessibility ('movement potential') (OR = 0.54, p = 0.03). Hillier topography with higher slope variability was associated with increased risks of psychological distress (OR = 1.38, p = 0.05). Conclusions: The findings support our hypothesis that built environment configuration is independently associated with psychological distress. The study underscores the need for effective intervention in the planning and design of residential built environment to achieve the goal of health-sustaining communities. © 2013 Sarkar et al.; licensee BioMed Central Ltd.published_or_final_versio

High Quality Research Environments

A major challenge facing all research communities is creating and sustaining high quality research environments. A model describing strategic social structures that constrain knowledge production suggests that targeting these structures will have greater impact than addressing issues surrounding individual lab cultures, as important as these are. A literature search identified five common themes underlying bioscience research environments comprising collaboration, data processing, confidence in data and scientists, trust, user-led development, and a deep commitment to public benefit. Club theory was used to develop a model describing the social structures that constrain and contextualise research environments. It is argued that collaboration underlies impactful science and that this is hindered by high transaction costs, and the benefits associated with competition. These combined with poorly defined property rights surrounding publicly funded data limit the ability of data markets to operate efficiently. Although the science community is best placed to provide solutions for these issues, incentivisation by funding agencies to increase the benefits of collaboration will be an accelerator. Given the complexity of emerging datasets and the collaborations need to exploit them, trust-by-design solutions are suggested. The underlying ‘glue’ that holds this activity together is the aesthetic and ethical value-base underlying good science

High Quality Research Environments

A major challenge facing all research communities is creating and sustaining high quality research environments. A model describing strategic social structures that constrain knowledge production suggests that targeting these structures will have greater impact than addressing issues surrounding individual lab cultures, as important as these are. A literature search identified five common themes underlying bioscience research environments comprising collaboration, data processing, confidence in data and scientists, trust, user-led development, and a deep commitment to public benefit. Club theory was used to develop a model describing the social structures that constrain and contextualise research environments. It is argued that collaboration underlies impactful science and that this is hindered by high transaction costs, and the benefits associated with competition. These combined with poorly defined property rights surrounding publicly funded data limit the ability of data markets to operate efficiently. Although the science community is best placed to provide solutions for these issues, incentivisation by funding agencies to increase the benefits of collaboration will be an accelerator. Given the complexity of emerging datasets and the collaborations need to exploit them, trust-by-design solutions are suggested. The underlying ‘glue’ that holds this activity together is the aesthetic and ethical value-base underlying good science

What helps and hinders the provision of healthcare that minimises treatment burden and maximises patient capacity? A qualitative study of stroke health professional perspectives

OBJECTIVES: Treatment burden is the healthcare workload experienced by individuals with long-term conditions and the impact on well-being. Excessive treatment burden can negatively affect quality-of-life and adherence to treatments. Patient capacity is the ability of an individual to manage their life and health problems and is dependent on a variety of physical, psychological and social factors. Previous work has suggested that stroke survivors experience considerable treatment burden and limitations on their capacity to manage their health. We aimed to examine the potential barriers and enablers to minimising treatment burden and maximising patient capacity faced by health professionals and managers providing care to those affected by stroke. SETTING: Primary and secondary care stroke services in a single health board area in Scotland. PARTICIPANTS: Face-to-face qualitative interviews with 21 participants including stroke consultants, nurses, physiotherapists, occupational therapists, speech and language therapists, psychologists, general practitioners and health-service managers. OUTCOME MEASURES: Data were analysed using thematic analysis to ascertain any factors that influence the provision of low-burden healthcare. RESULTS: Barriers and facilitators to the provision of healthcare that minimises treatment burden and maximises patient capacity were reported under five themes: healthcare system structure (e.g. care coordination and autonomous working); resources (e.g. availability of ward nurses and community psychologists); knowledge and awareness (e.g. adequate time and materials for optimal information delivery); availability of social care (e.g. waiting times for home adaptations or extra social support) and patient complexity (e.g. multimorbidity). CONCLUSIONS: Our findings have important implications for the design and implementation of stroke care pathways, emphasising the importance of removing barriers to health professional provision of person-centred care. This work can inform the design of interventions aimed at nurturing autonomous working by health professionals, improving communication and care coordination or ensuring availability of a named person throughout the patient journey

Dementias Platform UK (DPUK) Data Portal - supporting multi-modal data analysis, data linkage and real-world outcomes

DPUK relaunched the Data Portal in November 2017 to present openly available information on the data availability and technical capability of the Data Portal, which supports multi-modal research studies with various objectives from disease model validation to observation investigation. DPUK not only brings clinical data together from cohorts, but is now supporting multi-modal studies in genetics and imaging, as well as linkage opportunities to routine data using world-leading technical solutions to data sharing. The capacity, adaptability and sophistication of the UK Secure eResearch Platform which the Portal is housed on, allows for unprecedented levels of centralised access to rich cohort and routine data, which is consequentially leading to international collaboration and development ambition within epidemiology, bioinformatics, research methodology and technical research solutions. As of March 2018, DPUK is supporting 50 cohorts, 41 from the UK and 9 from across the rest of the world, alongside furthering links and access to routine data held in the UK and across the world. 20 research studies are underway, and the DPUK mission to enhance data science within dementia research is leading the conversation for developing a community of excellence in this field and across other research genres

Urban built environment configuration and psychological distress in older men: Results from the Caerphilly study

Background Few studies have examined the impact of the built environment configuration upon mental health. The study examines the impact of objectively assessed land use and street network configuration upon psychological distress and whether this association is moderated by the natural environment and area-level deprivation. Methods In a community sample of 687 older men from the Caerphilly Prospective Study, built environment morphological metrics (morphometrics) were related to differences in psychological distress as measured by the General Health Questionnaire. Cross-sectional data were taken from the most recent (5th) phase. A multi-level analysis with individuals nested within census-defined neighbourhoods was conducted. Environmental measures comprised GIS-constructed land use and street network metrics, slope variability and a satellite derived measure of greenness. Results Reduced psychological distress was associated with residing in a terraced dwelling (OR = 0.48, p = 0.03), higher degrees of land-use mix (OR = 0.42, p = 0.03 for the high tertile) and having higher local-level street-network accessibility (‘movement potential’) (OR = 0.54, p = 0.03). Hillier topography with higher slope variability was associated with increased risks of psychological distress (OR = 1.38, p = 0.05). Conclusions The findings support our hypothesis that built environment configuration is independently associated with psychological distress. The study underscores the need for effective intervention in the planning and design of residential built environment to achieve the goal of health-sustaining communities

Neighbourhood green space, physical function and participation in physical activities among elderly men: the Caerphilly Prospective study

Background: The built environment in which older people live plays an important role in promoting or inhibiting physical activity. Most work on this complex relationship between physical activity and the environment has excluded people with reduced physical function or ignored the difference between groups with different levels of physical function. This study aims to explore the role of neighbourhood green space in determining levels of participation in physical activity among elderly men with different levels of lower extremity physical function. Method: Using data collected from the Caerphilly Prospective Study (CaPS) and green space data collected from high resolution Landmap true colour aerial photography, we first investigated the effect of the quantity of neighbourhood green space and the variation in neighbourhood vegetation on participation in physical activity for 1,010 men aged 66 and over in Caerphilly county borough, Wales, UK. Second, we explored whether neighbourhood green space affects groups with different levels of lower extremity physical function in different ways. Results: Increasing percentage of green space within a 400 meters radius buffer around the home was significantly associated with more participation in physical activity after adjusting for lower extremity physical function, psychological distress, general health, car ownership, age group, marital status, social class, education level and other environmental factors (OR = 1.21, 95% CI 1.05, 1.41). A statistically significant interaction between the variation in neighbourhood vegetation and lower extremity physical function was observed (OR = 1.92, 95% CI 1.12, 3.28). Conclusion: Elderly men living in neighbourhoods with more green space have higher levels of participation in regular physical activity. The association between variation in neighbourhood vegetation and regular physical activity varied according to lower extremity physical function. Subjects reporting poor lower extremity physical function living in neighbourhoods with more homogeneous vegetation (i.e. low variation) were more likely to participate in regular physical activity than those living in neighbourhoods with less homogeneous vegetation (i.e. high variation). Good lower extremity physical function reduced the adverse effect of high variation vegetation on participation in regular physical activity. This provides a basis for the future development of novel interventions that aim to increase levels of physical activity in later life, and has implications for planning policy to design, preserve, facilitate and encourage the use of green space near home

Neighbourhood green space, physical function and participation in physical activities among elderly men: the Caerphilly Prospective study

Background: The built environment in which older people live plays an important role in promoting or inhibiting physical activity. Most work on this complex relationship between physical activity and the environment has excluded people with reduced physical function or ignored the difference between groups with different levels of physical function. This study aims to explore the role of neighbourhood green space in determining levels of participation in physical activity among elderly men with different levels of lower extremity physical function. Method: Using data collected from the Caerphilly Prospective Study (CaPS) and green space data collected from high resolution Landmap true colour aerial photography, we first investigated the effect of the quantity of neighbourhood green space and the variation in neighbourhood vegetation on participation in physical activity for 1,010 men aged 66 and over in Caerphilly county borough, Wales, UK. Second, we explored whether neighbourhood green space affects groups with different levels of lower extremity physical function in different ways. Results: Increasing percentage of green space within a 400 meters radius buffer around the home was significantly associated with more participation in physical activity after adjusting for lower extremity physical function, psychological distress, general health, car ownership, age group, marital status, social class, education level and other environmental factors (OR = 1.21, 95% CI 1.05, 1.41). A statistically significant interaction between the variation in neighbourhood vegetation and lower extremity physical function was observed (OR = 1.92, 95% CI 1.12, 3.28). Conclusion: Elderly men living in neighbourhoods with more green space have higher levels of participation in regular physical activity. The association between variation in neighbourhood vegetation and regular physical activity varied according to lower extremity physical function. Subjects reporting poor lower extremity physical function living in neighbourhoods with more homogeneous vegetation (i.e. low variation) were more likely to participate in regular physical activity than those living in neighbourhoods with less homogeneous vegetation (i.e. high variation). Good lower extremity physical function reduced the adverse effect of high variation vegetation on participation in regular physical activity. This provides a basis for the future development of novel interventions that aim to increase levels of physical activity in later life, and has implications for planning policy to design, preserve, facilitate and encourage the use of green space near home