Belfast Without Sight: Exploring Geographies of Blindness

In this paper (he transformed spaces of visually impaired and blind people is explored through a detailed analysis of interview transcripts with twenty seven visually impaired people living in or around Belfast. Data were collected using a structured open-ended interview and were analysed within NUD-IST, a qualitative data analysis package. Analysis revealed that visually impaired people become spatially confused (e.g. lost or disorientated) for two primary reasons. "Self-produced" confusion is spatial confusion caused by the misperception/miscognition of a route (e.g. miscounting intersections). "Situational" confusion is spatial confusion caused by a permanent or temporary localised occurrences such as road works, vehicles parked on pavements, and street furniture. Both types of spatial confusion were found to induce feelings of fear and anxiety, leading to a loss of selfconfidence, embarrassment and frustration, which in turn led to less independent travel and exploration, and constrained patterns of spatial behaviour. Respondents detailed a number of strategies for coping with spatial confusion. In addition, they assessed methods to make Belfast more navigable including environmental modifications and orientation and mobility aid

Belfast Without Sight: Exploring Geographies of Blindness

In this paper (he transformed spaces of visually impaired and blind people is explored through a detailed analysis of interview transcripts with twenty seven visually impaired people living in or around Belfast. Data were collected using a structured open-ended interview and were analysed within NUD-IST, a qualitative data analysis package. Analysis revealed that visually impaired people become spatially confused (e.g. lost or disorientated) for two primary reasons. "Self-produced" confusion is spatial confusion caused by the misperception/miscognition of a route (e.g. miscounting intersections). "Situational" confusion is spatial confusion caused by a permanent or temporary localised occurrences such as road works, vehicles parked on pavements, and street furniture. Both types of spatial confusion were found to induce feelings of fear and anxiety, leading to a loss of selfconfidence, embarrassment and frustration, which in turn led to less independent travel and exploration, and constrained patterns of spatial behaviour. Respondents detailed a number of strategies for coping with spatial confusion. In addition, they assessed methods to make Belfast more navigable including environmental modifications and orientation and mobility aid

Antarctic climate and ice-sheet configuration during the early Pliocene interglacial at 4.23Ma

The geometry of Antarctic ice sheets during warm periods of the geological past is difficult to determine from geological evidence, but is important to know because such reconstructions enable a more complete understanding of how the ice-sheet system responds to changes in climate. Here we investigate how Antarctica evolved under orbital and greenhouse gas conditions representative of an interglacial in the early Pliocene at 4.23Ma, when Southern Hemisphere insolation reached a maximum. Using offline-coupled climate and ice-sheet models, together with a new synthesis of high-latitude palaeoenvironmental proxy data to define a likely climate envelope, we simulate a range of ice-sheet geometries and calculate their likely contribution to sea level. In addition, we use these simulations to investigate the processes by which the West and East Antarctic ice sheets respond to environmental forcings and the timescales over which these behaviours manifest. We conclude that the Antarctic ice sheet contributed 8.6±2.8m to global sea level at this time, under an atmospheric CO2 concentration identical to present (400ppm). Warmer-than-present ocean temperatures led to the collapse of West Antarctica over centuries, whereas higher air temperatures initiated surface melting in parts of East Antarctica that over one to two millennia led to lowering of the ice-sheet surface, flotation of grounded margins in some areas, and retreat of the ice sheet into the Wilkes Subglacial Basin. The results show that regional variations in climate, ice-sheet geometry, and topography produce long-term sea-level contributions that are non-linear with respect to the applied forcings, and which under certain conditions exhibit threshold behaviour associated with behavioural tipping points

The Effect of Spatial Tasks on Visually Impaired Peoples' Wayfinding Abilities

Thirty-eight people with visual impairments learned a 483-meter novel route through a university campus in four groups: verbalization, modeling, pointing, and control. The performance of all four groups improved with greater experience of the route, but the modeling group improved more than did the control group

Fasting triglycerides are positively associated with cardiovascular mortality risk in people with diabetes

Aims: We investigated the association of fasting triglycerides with cardiovascular disease (CVD) mortality. Methods and results: This cohort study included US adults from the National Health and Nutrition Examination Surveys from 1988 to 2014. CVD mortality outcomes were ascertained by linkage to the National Death Index records. Cox proportional hazards models were used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) of triglycerides for CVD mortality. The cohort included 26 570 adult participants, among which 3978 had diabetes. People with higher triglycerides had a higher prevalence of diabetes at baseline. The cohort was followed up for a mean of 12.0 years with 1492 CVD deaths recorded. A 1-natural-log-unit higher triglyceride was associated with a 30% higher multivariate-adjusted risk of CVD mortality in participants with diabetes (HR, 1.30; 95% CI, 1.08–1.56) but not in those without diabetes (HR, 0.95; 95% CI, 0.83–1.07). In participants with diabetes, people with high triglycerides (200–499 mg/dL) had a 44% (HR, 1.44; 95% CI, 1.12–1.85) higher multivariate-adjusted risk of CVD mortality compared with those with normal triglycerides (<150 mg/dL). The findings remained significant when diabetes was defined by fasting glucose levels alone, or after further adjustment for the use of lipid-lowering medications, or after the exclusion of those who took lipid-lowering medications. Conclusion: This study demonstrates that fasting triglycerides of ≥200 mg/dL are associated with an increased risk of CVD mortality in patients with diabetes but not in those without diabetes. Future clinical trials of new treatments to lower triglycerides should focus on patients with diabetes

Dietary fatty acids and mortality risk from heart disease in US adults: an analysis based on NHANES

We investigated the association of dietary intake of major types of fatty acids with heart disease mortality in a general adult cohort with or without a prior diagnosis of myocardial infarction (MI). This cohort study included US adults who attended the National Health and Nutrition Examination Surveys from 1988 to 2014. Heart disease mortality was ascertained by linkage to the National Death Index records through 31 December 2015. Cox proportional hazards models were used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) of fatty acid intake for heart disease mortality. This cohort included 45,820 adults among which 1,541 had a prior diagnosis of MI. Participants were followed up for 532,722 person-years (mean follow-up, 11.6 years), with 2,313 deaths recorded from heart disease being recorded. Intake of saturated (SFAs) and monounsaturated fatty acids (MUFAs) was associated with heart disease mortality after adjustment for all the tested confounders. In contrast, a 5% higher calorie intake from polyunsaturated fatty acids (PUFAs) was associated with a 9% (HR, 0.91; 95% CI 0.83–1.00; P = 0.048) lower multivariate-adjusted risk of heart disease mortality. Sub-analyses showed that this inverse association was present in those without a prior diagnosis of MI (HR,0.89; 95% CI 0.80–0.99) but not in those with the condition (HR, 0.94; 95% CI 0.75–1.16). The lack of association in the MI group could be due to a small sample size or severity and procedural complications (e.g., stenting and medication adherence) of the disease. Higher PUFA intake was associated with a favourable lipid profile. However, further adjustment for plasma lipids did not materially change the inverse association between PUFAs and heart disease mortality. Higher intake of PUFAs, but not SFAs and MUFAs, was associated with a lower adjusted risk of heart disease mortality in a large population of US adults supporting the need to increase dietary PUFA intake in the general public

Peripheral arterial disease (PAD) – A challenging manifestation of atherosclerosis

The diagnosis of peripheral arterial disease (PAD) is not always evident as symptoms and signs may show great variation. As all grades of PAD are linked to both an increased risk for cardiovascular complications and adverse limb events, awareness of the condition and knowledge about diagnostic measures, prevention and treatment is crucial. This article presents in a condensed form information on PAD and its management

Cruisers in the City of Helsinki : Staging the Mobility of Cruise Passengers

International cruise passengers moving in urban destinations have particular time limitation that can make enabling and disabling elements of mobility meaningful on the quality of their visit. Identifying these elements is essential to improve their independent movement. Based on a staging mobilities framework that considers the dimensions of physical settings, material spaces, design (PMD), social interactions (SI) and embodied performances (EP) in situ, the research has analysed location-specific information in Helsinki, a popular port of call in the Baltic Sea. The study has used go-along observations and mobile application in data collection. The produced dataset was analysed by combining GIS-methods and content analyses. As a result, five categories were identified under the dimension of PMD: wayfinding tools, unexpected situations, lack of rest spots and walkability. Categories identified under the dimension of SI were local people, service providers and travel companions, and other tourists. Categories identified under the dimension of EP were traffic behaviour, occasioned activities, sense of direction, planning, and time-related anxiety. Urban destinations such as Helsinki can apply these results in practice, to make the movement of independently moving cruise passengers as effortless as possible, contributing to a better experience of the city space for both tourists and other city users. The proposed methodology could also be used to analyse other mobility-related phenomena.Peer reviewe

Efficacy of brief behavioral counselling by allied health professionals to promote physical activity in people with peripheral arterial disease (BIPP): study protocol for a multi-center randomized controlled trial

Background: Physical activity is recommended for people with peripheral arterial disease (PAD), and can improve walking capacity and quality of life; and reduce pain, requirement for surgery and cardiovascular events. This trial will assess the efficacy of a brief behavioral counselling intervention delivered by allied health professionals to improve physical activity in people with PAD. Methods: This is a multi-center randomised controlled trial in four cities across Australia. Participants (N = 200) will be recruited from specialist vascular clinics, general practitioners and research databases and randomised to either the control or intervention group. Both groups will receive usual medical care, a written PAD management information sheet including advice to walk, and four individualised contacts from a protocol-trained allied health professional over 3 months (weeks 1, 2, 6, 12). The control group will receive four 15-min telephone calls with general discussion about PAD symptoms and health and wellbeing. The intervention group will receive behavioral counselling via two 1-h face-to-face sessions and two 15-min telephone calls. The counselling is based on the 5A framework and will promote interval walking for 3 × 40 min/week. Assessments will be conducted at baseline, and 4, 12 and 24 months by staff blinded to participant allocation.Objectively assessed outcomes include physical activity (primary), sedentary behavior, lower limb body function, walking capacity, cardiorespiratory fitness, event-based claudication index, vascular interventions, clinical events, cardiovascular function, circulating markers, and anthropometric measures. Self-reported outcomes include physical activity and sedentary behavior, walking ability, pain severity, and health-related quality of life. Data will be analysed using an intention-to-treat approach. An economic evaluation will assess whether embedding the intervention into routine care would likely be value for money. A cost-effectiveness analysis will estimate change in cost per change in activity indicators due to the intervention, and a cost-utility analysis will assess change in cost per quality-adjusted life year. A full uncertainty analysis will be undertaken, including a value of information analysis, to evaluate the economic case for further research. Discussion: This trial will evaluate the efficacy and cost-effectiveness of a brief behavioral counselling intervention for a common cardiovascular disease with significant burden. Trial registration: ACTRN 12614000592640 Australian New Zealand Clinical Trials Registry. Registration Date 4 June 2014