A Comprehensive Safety Analysis of Diverging Diamond Interchanges

As the population grows and the travel demands increase, alternative interchange designs are becoming increasingly popular. The diverging diamond interchange is one alternative design that has been implemented in the United States. This design can accommodate higher flow and unbalanced flow as well as improve safety at the interchange. As the diverging diamond interchange is increasingly considered as a possible solution to problematic interchange locations, it is imperative to investigate the safety effects of this interchange configuration. This report describes the selection of a comparison group of urban diamond interchanges, crash data collection, calibration of functions used to estimate the predicted crash rate in the before and after periods and the Empirical Bayes before and after analysis technique used to determine the safety effectiveness of the diverging diamond interchanges in Utah. A discussion of pedestrian and cyclist safety is also included. The analysis results demonstrated statistically significant decreases in crashes at most of the locations studied. This analysis can be used by UDOT and other transportation agencies as they consider the implementation of the diverging diamond interchanges in the future

The price is right: making workplace wellness financially sustainable

Purpose – The public health argument for developing and maintaining workplace wellness programmes in organisations is well‐documented, particularly within the healthcare sector which aims to “set the example” for workplace health. However, workplace wellness also makes good business sense, since it is established that investing in employee health can reduce absenteeism, improve job satisfaction and productivity and enhance corporate image. Organisations often place workplace wellness low in their priorities. The purpose of this paper is to present the case for an initial resource investment and top‐level support to pump‐prime a financially sustainable, and even profitable, programme. Design/methodology/approach – A discussion is presented based on academic literature and practical applications from the authors' experiences in practice. Findings – The authors use their own in‐house scheme, “Q‐active” as a case example based in an NHS Trust setting, to demonstrate how such schemes can be developed and successfully implemented and maintained in practice. The paper presents the use of the Business Healthcheck Tool for developing a business case for such schemes. Originality/value – Workplace wellness schemes are financially viable and can become a vital part of a large organisations' infrastructure embedded within policies and internal “health culture”

Effects of text messaging in addition to emails on physical activity among university and college employees in the UK

Objectives To test the effects of adding text messages to weekly email communications on recipients’ total physical activity (leisure-time; workplace; domestic and garden; and active transportation) in employees of universities and colleges in the UK. Methods A randomised trial with two study groups (email only or email plus text messaging for 12 weeks) was implemented at five workplaces. Data were collected at baseline, immediately after, and four weeks after the intervention. Intervention effects on physical activity were evaluated using latent growth modelling. Results Total physical activity decreased over time in both groups but the decrease was non-significant. The only significant difference between groups was found for workplace physical activity, with the group receiving emails and text messages having a linear decrease of 2.81 Metabolic Equivalent h/week (β = −0.31, p = 0.035) compared to the email only group. Conclusions Sending employees two additional text messages resulted in less physical activity. Further investigation is needed to understand whether text messaging may play a beneficial role in promoting physical activity in workplace settings

Reasons for participating and not participating in a e-health workplace physical activity intervention

Purpose – The purpose of this paper is to investigate the reasons for participating and not participating in an e-health workplace physical activity (PA) intervention. Design/methodology/approach – Semi-structured interviews and two focus groups were conducted with a purposive sample of employees who enrolled and participated in the intervention and with those who did not complete enrolment, hence did not participate in it. Data were examined using thematic analysis according to the clusters of “reasons for participation” and for “non-participation”. Findings – Reported reasons for participation included a need to be more active, to increase motivation to engage in PA, and to better manage weight. Employees were attracted by the perceived ease of use of the programme and by the promise of receiving reminders. Many felt encouraged to enrol by managers or peers. Reported reasons for non-participation included lack of time, loss of interest towards the programme, or a lack of reminders to complete enrolment. Practical implications – Future e-health workplace behavioural interventions should consider focusing on employees’ needs and motivators to behaviour change, provide regular reminders for participants to complete enrolment and ensure that procedures are completed successfully. Barriers to participation could be identified through formative research with the target population and feasibility studies. Originality/value – This study combines a qualitative analysis of the reasons why some employees decided to enrol in a workplace PA intervention and why some others did not. This study highlights factors to consider when designing, implementing and promoting similar interventions and that could inform strategies to enhance participation in workplace PA interventions

Influencing organisational change in the NHS: lessons learned from workplace wellness initiatives in practice

This article presents a discussion of the key issues in influencing organisational change in NHS settings, in the development of workplace wellness interventions to improve employee health and wellbeing. To tackle poor public health and associated rising healthcare costs, there must be a focus on the root cause of many preventable diseases – unhealthy lifestyle choices. Workplace wellness initiatives are now an important prevention strategy adopted by socially responsible organisations to target the health and wellbeing of working age adults. Lessons learned from initiatives in secondary care suggest that effective implementation requires change in organisational ‘health culture’, through a combination of education, behaviour change intervention, needs-based facilities, and services and strategies for developing supportive and health-promoting work environments. Most of all, employers must demonstrate a commitment to health and wellness that is fully integrated with their mission, values and long-term vision, paving theway for sustainable lifestyle changes. Evaluation systems must be in place to measure the impact and outcomes of wellness schemes

Patient Perspectives on Medication Assisted Therapy in Vermont

Introduction. Medication-Assisted Therapy (MAT) for opioid addiction has dramatically increased in Vermont, supported by a novel statewide system that integrates specialty treatment centers ( Hubs ) with primary care office-based opioid therapy ( Spokes ). In 2010, Vermont had the highest per capita buprenorphine use in the US. Previous studies of patient perspectives of MAT have identified social barriers, rigid program rules, and concerns about withdrawal and relapse as common causes of treatment failure. Our goal was to elicit patient perspectives on barriers and enablers of successful MAT to further inform system refinement. Methods. An interview guide was developed based on previous literature as well as discussions with program leadership, staff and clinicians, and community stakeholders. Responses were organized using thematic content analysis with consensus across seven interviewers and two analysts. The interviews were conducted with 44 patients enrolled in MAT at two Hub sites in Burlington, VT in October 2016. Results. The median age of subjects was 34 years, 34% were employed at least part-time, and 72% were female. Half reported a mental health condition and 20% reported chronic pain. Barriers included transportation (25%), lack of stable housing, and stigma (41%). Enablers included feeling supported (82% felt well-supported; 52% felt supported by healthcare professionals). Subjects expressed high confidence in the treatment system and high self-efficacy for sobriety. Conclusions. Patients in MAT have complex medical, mental health, social, personal, and work lives. A comprehensive system that addresses this wide range of domains is critical to achieving optimal outcomes.https://scholarworks.uvm.edu/comphp_gallery/1245/thumbnail.jp

Reduction of dynatomic curves

The dynatomic modular curves parametrize polynomial maps together with a point of period $n$. It is known that the dynatomic curves $Y_1(n)$ are smooth and irreducible in characteristic 0 for families of polynomial maps of the form $f_c(z) = z^m +c$ where $m\geq 2$. In the present paper, we build on the work of Morton to partially characterize the primes $p$ for which the reduction modulo $p$ of $Y_1(n)$ remains smooth and/or irreducible. As an application, we give new examples of good reduction of $Y_1(n)$ for several primes dividing the ramification discriminant when $n=7,8,11$. The proofs involve arithmetic and complex dynamics, reduction theory for curves, ramification theory, and the combinatorics of the Mandelbrot set