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PubMed2004

The effect of infrastructure and demographic change on traffic-related fatalities and crashes: a case study of Illinois county-level data.

This paper presents analyses of data from the Highway Safety Information System (HSIS) for the State of Illinois. Our analyses focuses on whether various changes in road network infrastructure and geometric design can be associated with changes in road fatalities and reported accidents. We also evaluate models that control for demographic changes. County-level time-series data is used and fixed effect negative binomial models are estimated. Results cannot confirm the hypothesis that changes in road infrastructure and geometric design have been beneficial for safety. Increases in the number of lanes appears to be associated with both increased traffic-related accidents and fatalities. Increased lane widths appears to be associated with increased fatalities. Increases in outside shoulder width appear to be associated with a decrease in accidents. Inclusion of demographic results does not significantly change these results but does capture much of the residual time trend in the models. Potentially mis-leading results are found when the time trend is not included. In this case a negative association between vertical curvature and both accidents and fatalities. No statistical association with changes in safety is found for median widths, inside shoulder widths, and horizontal and vertical curvature.

Accidents, Traffic↗

PubMed2003

Matching marine reserve design to reserve objectives.

Recent interest in using marine reserves for marine resource management and conservation has largely been driven by the hope that reserves might counteract declines in fish populations and protect the biodiversity of the seas. However, the creation of reserves has led to dissension from some interested groups, such as fishermen, who fear that reserves will do more harm than good. These perceived differences in the effect of marine reserves on various stakeholder interests has led to a contentious debate over their merit. We argue here that recent findings in marine ecology suggest that this debate is largely unnecessary, and that a single general design of a network of reserves of moderate size and variable spacing can meet the needs and goals of most stakeholders interested in marine resources. Given the high fecundity of most marine organisms and recent evidence for limited distance of larval dispersal, it is likely that reserves can both maintain their own biodiversity and service nearby non-reserve areas. In particular, spillover of larger organisms and dispersal of larvae to areas outside reserves can lead to reserves sustaining or even increasing local fisheries. Ultimately, the success of any reserve network requires attention to the uncertainty and variability in dispersal patterns of marine organisms, clear statements of goals by all stakeholder groups and proper evaluation of reserve performance.

Conservation of Natural Resources↗

PubMed2002

The effect of individually adjusted workstations on upper quadrant posture and muscle activity in school children.

Evidence suggests there is increasing use of computers by children and poor workstation designs for children. This laboratory study investigated the effect of adjusting computer display height and desk height on upper quadrant posture and muscle activity. Thirty three children aged 4-17 years worked on a desktop computer at a standard school workstation and at a workstation adjusted to the individual, typically consisting of a lower display and desk height. The adjustments resulted in increased head tilt, neck flexion, gaze angle, cervical erector spinae activity and a trend for lower right upper trapezius activity. The recent evidence that suggests more head and neck flexion is not necessarily worse is discussed and normative values for children's head tilt and neck flexion presented. The role of forearm support in decreasing trapezius activity is also discussed.

Adolescent↗

PubMed2000

Air quality and ocular discomfort aboard commercial aircraft.

BACKGROUND: Aircraft cabin air quality has been a subject of recent public health interest. Aircraft environments are designed according to standards to ensure the comfort and well-being of the occupants. The upper and lower limits of humidity set by ASHRAE standards are based on the maintenance of acceptable thermal conditions established solely on comfort considerations, including thermal sensation, skin wetness, skin dryness, dry eyes and ocular discomfort. The purpose of this study is to investigate the influence of air (carbon dioxide level, relative humidity, and temperature) aboard commercial aircraft on ocular discomfort and dry eye of aircraft personnel and passengers. METHODS: Measurements of indoor air quality were performed in 15 different aircraft at different times and altitudes. Forty-two measurements of carbon dioxide, temperature, and humidity were performed with portable air samplers every 5 minutes. Passenger loads did not exceed 137 passengers. RESULTS: Thermal comfort rarely met ASHRAE standards. Low humidity levels and high carbon dioxide levels were found on the Airbus 320. The DC-9 had the highest humidity level and the Boeing-767 had the lowest carbon dioxide level. CONCLUSIONS: Air quality was poorest on the Airbus 320 aircraft. This poor level of air quality may cause intolerance to contact lenses, dry eyes, and may be a health hazard to both passengers and crew members. Improved ventilation and aircraft cabin micro-environments need to be made for the health and comfort of the occupants.

Air Pollution, Indoor↗

PubMed1994

Influence of a lymph node environment on invasiveness of metastatic tumor cells.

BACKGROUND: We investigated the possibility that lymph nodes might increase metastatic efficiency of tumor cells lodged there by measuring changes in tumor cell invasiveness after physical contact with an in vitro approximation of a lymph node environment. STUDY DESIGN: The experimental model involved growing Lewis lung carcinoma (LL) or B16 melanoma cells on microcarrier beads, rolling them on a "lymph node endothelial surface," which was created by growing endothelial cells on a differentiating acid extract of lymph node biomatrix, and testing the ability of those tumor cells to invade across matrigel-coated filters at rest (buffer) and in response to a chemotactic stimulus (3T3 conditioned media). RESULTS: Compared with contact with plastic, LL invasiveness was increased fivefold (buffer or conditioned media) and B16 invasiveness fourfold (conditioned media). Tumor cell invasiveness was not increased by exposure to the acid extract of biomatrix alone. Invasiveness to buffer or conditioned media after exposure to endothelial cells alone was 70 and 54 percent (LL) and 42 and 80 percent (B16), respectively, of the invasiveness induced by exposure to both. Compared with invasiveness induced by exposure to lymph node (100 percent), exposure to a "lung endothelial surface" induced invasiveness of 63 and 85 percent (LL) and 40 and 52 percent (B16) to buffer and conditioned media, respectively. Exposure to a hepatic endothelial surface induced invasiveness similar to that induced by lymph node; 90 and 82 percent (LL) and 110 and 86 percent (B16) of lymph node-induced invasiveness. CONCLUSIONS: A lymph node environment may modulate the metastatic potential of tumor cells.

Animals↗

PubMedDate not supplied

Age-related changes in perceptual and psychomotor performance: implications for engineering design.

Increased age is associated with declines in perceptual and psychomotor performance. We review several surveys of health and disability that provide functional descriptions on population trends in vision, hearing, fitness, mobility, and agility that complement laboratory studies of perceptual threshold functions. Women report and exhibit significantly greater disability than men (the exceptions being disabilities associated with hearing and flexibility), with the disability progression accelerating with age. For the growing proportion of older adults in the labor force, visual improvements can be achieved through improved lighting, increased size of visual detail, and glare avoidance. For hearing, restricting the frequency of sounds to the 1000- to 2000-Hz range, minimizing background noise, and eliminating reverberation seem prudent. For the retired population, emphasis should be placed on minimizing disability by promoting greater use of assistive devices and environmental redesign. Future laboratory studies of perceptual and psychomotor functions should attempt to sample more representatively and target underrepresented groups of older adults. New field studies are needed to bridge the gap between survey self-reports and laboratory studies and to determine the cost and benefits of redesign.

Aged↗

PubMed2005

Human resources for the control of road traffic injury.

The definition of the ideal numbers and distribution of human resources required for control of road traffic injury (RTI) is not as advanced as for other health problems. We can nonetheless identify functions that need to be addressed across the spectrum of injury control: surveillance; road safety (including infrastructure, vehicle design, and behaviour); and trauma care. Many low-cost strategies to improve these functions in low- or middle-income countries can be identified. For all these strategies, there is need for adequate institutional capacity, including funding, legal authority, and human resources. Several categories of human resources need to be developed: epidemiologists who can handle injury data, design surveillance systems, and undertake research; engineers and planners versed in safety aspects of road design, traffic flow, urban planning, and vehicle design; police and lawyers who understand the health impact of traffic law; clinicians who can develop cost-effective improvements in the entire system of trauma treatment; media experts to undertake effective behaviour change and social marketing; and economists to assist with cost-effectiveness evaluations. RTI control can be strengthened by enhancing such training in these disciplines, as well as encouraging retention of those who have the needed skills. Mechanisms to enhance collaboration between these different fields need to be promoted. Finally, the burden of RTI is borne disproportionately by the poor; in addition to technical issues, more profound equity issues must be addressed. This mandates that people from all professional backgrounds who work for RTI control should develop skills in advocacy and politics.

Accidents, Traffic↗

PubMed2004

A regional approach to projecting land-use change and resulting ecological vulnerability.

This study explores ecological vulnerability to land-use change in the U.S. Mid-Atlantic Region by spatially extrapolating land and economic development, and overlaying these projections with maps of sensitive ecological resources. As individual extrapolations have a high degree of uncertainty, five methods with different theoretical bases are employed. Confidence in projections is increased for counties targeted by two or more projection methods. A county is considered at risk if it currently supports three or more sensitive resources, and is projected to experience significant growth by the year 2010 by two or more methods. Analysis designated 19 counties and two cities as at risk, highlighting within a large region the priority areas where state and regional efforts would contribute the most to integrating environmental considerations into the process of land development. The study also found that potentially severe ecological effects of future land-use change are not limited to the outskirts of major urban areas. Recreational demands on smaller communities with mountain and coastal resources are also significant, as are initiatives to promote economic development in rural areas of high ecological quality. This approach provides a comprehensive overview of potential regional development, leading to an objective prioritization of high-risk areas. The intent is to inform local planning and decision-making so that regional and cumulative ecological degradation are minimized.

Animals↗

PubMed2006

Short-term effects of countermeasures for improved safety and mobility at marked pedestrian crosswalks in Borås, Sweden.

The Swedish code concerning car drivers' responsibility to give way to pedestrians was strengthened in 2000. The primary aim of this study is to evaluate the short-term effects of the change in code. Another goal is to look at the effects of the reconstruction of four sites in Borås, Sweden. One site had changes made prior to the change of code, two test sites had countermeasures implemented during the study, and one comparison site was left unchanged. All the sites were chosen because schools were situated nearby. The focus of the evaluation was on children and elderly as pedestrians and cyclists. The goal of traffic calming of a 90 percentile driving speed below 30 km/h was not fulfilled at any of the test sites. A conclusion is that the height of a speed cushion is important. After the speed cushions were lowered from 70 mm to 55 mm, the 90 percentile speed increased from 34 km/h to 41 km/h. Sites with no speed cushions had much higher speeds. The design of an intersection influences road users' behavior. At the site where one crosswalk was removed, pedestrians that were using the remaining marked crosswalk were given way to less frequently than at the other sites. At intersections where most pedestrians used marked crosswalks, the children benefited the most in mobility. At the intersection where pedestrians used marked crosswalks to a lower extent after reconstruction, children and the elderly had the smallest increase in frequency of being given way to. After reconstruction to a court-yard street, the pedestrians were given way to a lower extent compared with the other sites, though the vehicle speeds were the lowest observed at this study. At the sites were no physical changes were made, the change of code improved driver yield behavior, but no more towards children than other age groups.

Accident Prevention↗

PubMed2002

Theoretical understanding and methodological challenges in accessibility assessments, focusing the environmental component: an example from travel chains in urban public bus transport.

PURPOSE: In order to increase the theoretical understanding of the concept of accessibility, this paper reports the results from an exploration of methodological difficulties inherent in systematic accessibility assessments of single persons' travel chains in urban public bus transport. In addition, Special Transport Service (STS) travellers' perception of environmental demands in public transport are reported. METHODS: This study was designed to explore the environmental component in accessibility problems systematically. Twenty persons entitled to STS were recruited in order to travel by low-floor bus, Service Route Traffic (SRT) or STS. Two different methods were chosen. Critical incidents were collected during participant observation, and by means of a pilot instrument based on the Enabler Concept independent environmental assessments were performed. RESULTS: Not all environmental details registered during the participant observations were in agreement with the independent environmental assessment, and different reasons for the disagreements were reported. In addition, participants travelling by STS gave information about what hindered them from using conventional public transport. CONCLUSIONS: The theoretical understanding behind accessibility assessments has benefited from the methodological challenges mapped out in this study. In order to interpret accessibility, the individual perspective as well as the population perspective are necessary, which means that complementary methods are needed.

Aged↗

PubMed1999

Home visits by an occupational therapist for assessment and modification of environmental hazards: a randomized trial of falls prevention.

OBJECTIVE: To determine whether occupational therapist home visits targeted at environmental hazards reduce the risk of falls. DESIGN: A randomized controlled trial. SETTING: Private dwellings in the community in Sydney, Australia. PARTICIPANTS: A total of 530 subjects (mean age 77 years), recruited primarily before discharge from selected hospital wards. INTERVENTION: A home visit by an experienced occupational therapist, who assessed the home for environmental hazards and facilitated any necessary home modifications. MEASUREMENTS: The primary study outcome was falls, ascertained over a 12-month follow-up period using a monthly falls calendar. RESULTS: Thirty six percent of subjects in the intervention group had at least one fall during follow-up, compared with 45% of controls (P = .050). The intervention was effective only among subjects (n = 206) who reported having had one or more falls during the year before recruitment into the study; in this group, the relative risk of at least one fall during follow-up was 0.64 (95% confidence interval, 0.50-0.83). Similar results were obtained when falls data were analyzed using survival analysis techniques (proportional and multiplicative hazards models) and fall rates (mean number of falls per person per year). About 50% of the recommended home modifications were in place at a 12-month follow-up visit. CONCLUSIONS: Home visits by occupational therapists can prevent falls among older people who are at increased risk of falling. However, the effect may not be caused by home modifications alone. Home visits by occupational therapists may also lead to changes in behavior that enable older people to live more safely in both the home and the external environment.

Accidental Falls↗

PubMed2005

Time course of behavioral changes following basal forebrain cholinergic damage in rats: Environmental enrichment as a therapeutic intervention.

The present experiment was designed to study changes in behavior following immunolesioning of the basal forebrain cholinergic system. Rats were lesioned at 3 months of age by injection of the 192 IgG-saporin immunotoxin into the medial septum area and the nucleus basalis magnocellularis, and then tested at different times after surgery (from days 7-500) on a range of behavioral tests, administered in the following order: a nonmatching-to-position task in a T-maze, an object-recognition task, an object-location task, and an open-field activity test. The results revealed a two-way interaction between post-lesion behavioral testing time and memory demands. In the nonmatching-to-position task, memory deficits appeared quite rapidly after surgery, i.e. at a post-lesion time as short as 1 month. In the object-recognition test, memory impairments appeared only when rats were tested at late post-lesion times (starting at 15 months), whereas in the object-location task deficits were apparent at early post-lesion times (starting from 2 months). Taking the post-operative time into account, one can hypothesize that at the shortest post-lesion times, behavioral deficits are due to pure cholinergic depletion, while as the post-lesion time increases, one can speculate the occurrence of a non-cholinergic system decompensation process and/or a gradual degeneration process affecting other neuronal systems that may contribute to mnemonic impairments. Interestingly, when middle-aged rats were housed in an enriched environment, 192 IgG-saporin-lesioned rats performed better than standard-lesioned rats on both the nonmatching-to-position and the object-recognition tests. Environment enrichment had significant beneficial effects in 192 IgG-saporin-lesioned rats, suggesting that lesioned rats at late post-lesion times (over 1 year) still have appreciable cognitive plasticity.

Acetylcholine↗

PubMed2004

Trade-off analysis in the Northern Andes to study the dynamics in agricultural land use.

In this paper we hypothesize that land use change can be induced by non-linearities and thresholds in production systems that impact farmers' decision making. Tradeoffs between environmental and economic indicators is a useful way to represent dynamic properties of agricultural systems. The Tradeoff Analysis (TOA) System is software designed to implement the integrated analysis of tradeoffs in agricultural systems. The TOA methodology is based on spatially explicit econometric simulation models linked to spatially referenced bio-physical simulation models to simulate land use and input decisions. The methodology has been applied for the potato-pasture production system in the Ecuadorian Andes. The land use change literature often describes non-linearity in land use change as a result of sudden changes in the political (e.g. new agricultural policies) or environmental setting (e.g. earthquakes). However, less attention has been paid to the non-linearities in production systems and their consequences for land use change. In this paper, we use the TOA system to study agricultural land use dynamics and to find the underlying processes for non-linearities. Results show that the sources of non-linearities are in the properties of bio-physical processes and in the decision making-process of farmers.

Agriculture↗

PubMed2005

Design and evaluation of a restraint-free small animal inhalation dosing chamber.

The aim of research was to design a small, restraint free, low stress animal dosing chamber for inhalation studies, and to investigate distribution of a model drug within the chamber. A small animal dosing chamber was designed that consisted of a polymethylmethacrylate (PMMA) airtight box (40.6 x 11.4 x 21.6 cm) with a hinged top, having a nominal wall thickness of 1.25 cm. The chamber was designed to hold up to 14 mice, each having a floor area of approximately 63 cm2, in accordance with Institutional Animal Care and Use Committee (IACUC) guidelines. A "rodent proof" distribution fan was attached to the center of the hinged closure lid. The chamber was divided into 1 inch2 zones (120 in total) to enable a profile of drug distribution within the chamber to be obtained. Small holes were drilled into the side of the chamber and sealed using Parafilm to allow access to the sampling zones. Syringes (5 mL) with appropriate length polytetrafluoroethylene (PTFE) tubing were inserted into the holes to reach the sampling zones (eight on either side of the chamber giving a total of 16 zones). An aqueous caffeine solution (2% w/v) in glycerol (25% w/v) was prepared and nebulized into the chamber using an Aeroneb Pro nebulizer. Caffeine containing droplets were circulated into the chamber at a flow rate of 1.5 L/min(-1), and the air was recirculated in a closed system for a total of 20 minutes to ensure a high concentration of caffeine droplets throughout. Following nebulization, air samples (5 mL) were withdrawn from the 16 sampling zones of the sealed chamber. The process was repeated in quadruplet until a total of 64 sampling zones had been sampled. The entire experiment was also repeated with the absence of the "rodent-proof" distribution fan. Drug concentrations were calculated from a calibration curve of caffeine using UV absorbance at 272 nm. An average mass of caffeine (Standard Deviation; S.D.) of 5.0 (4.2) mg was detected throughout the chamber when the distribution fan was fitted, and caffeine 12.6 (9.7) mg was detected without the fan. This indicated that presence of the fan caused impingement of the drug on both the chamber walls and fan components; effectively removing nebulized drug from circulation within the chamber. The distribution of drug was plotted using a 3D graph; this revealed a lower concentration at the periphery and a higher concentration in the center of the chamber both with and without the distribution fan in place. In conclusion, a humane, nonrestraint rodent dosing chamber was designed for the efficient delivery of nebulized drugs for up to 14 mice simultaneously. The highest levels of the model drug caffeine were detectable throughout the small animal dosing chamber without the distribution fan. A circulation flow rate of 1.5 L/min(-1) was found to be adequate to distribute drug in the chamber. Surprisingly, the results demonstrate that avoiding the use of a distribution fan altogether maximizes the drug concentration within the chamber by reducing impingement of the nebulized drug. The small animal, restraint-free dosing chamber represents an advancement in reproducible dosing via the pulmonary route in the small animal model. The dosing chamber may be adapted to present the lung with an almost unlimited array of compounds, encompassing drugs, toxic compounds, and even pathogens, while still maintaining a relatively stress-free microenvironment for the test subject and furthermore, total safety for the operator.

Animals↗

PubMed2004

Cognitive training in home environment.

PRIMARY OBJECTIVE: To examine the efficacy of cognitive rehabilitation in the patient's home or vocational environment. RESEARCH DESIGN: Pre-post-follow-up design. METHODS AND PROCEDURES: Ten outpatients with acquired attention and memory problems received cognitive training three times weekly, for 3 weeks. They received individual attention training with Attention Process Training, training for generalization for everyday activities and education in compensatory strategies for self-selected cognitive problems. Treatment effects were evaluated with neuropsychological and occupational therapy instruments before and after the training and after 3 months on impairment, activity and participation levels. MAIN OUTCOMES AND RESULTS: The results indicated a positive effect on some measures on impairment level, but no differences on activity or participation levels at follow-up. CONCLUSIONS: The study indicates that home-based cognitive training improves some attentional and memory functions and facilitates learning of strategies. Future controlled studies are needed to confirm the results and analyse the efficacy of different aspects of home-based training.

Activities of Daily Living↗

PubMed2003

Traffic calming for the prevention of road traffic injuries: systematic review and meta-analysis.

OBJECTIVE: To assess whether area-wide traffic calming schemes can reduce road crash related deaths and injuries. DESIGN: Systematic review and meta-analysis. DATA SOURCES: Cochrane Injuries Group Specialised Register, Cochrane Central Register of Controlled Trials, Medline, EMBASE, Sociological Abstracts Science (and social science) citation index, National Technical Information service, Psychlit, Transport Research Information Service, International Road Research Documentation, and Transdoc, and web sites of road safety organisation were searched; experts were contacted, conference proceedings were handsearched, and relevant reference lists were checked. INCLUSION CRITERIA: Randomised controlled trials, and controlled before/after studies of area-wide traffic calming schemes designed to discourage and slow down through traffic on residential roads. METHODS: Data were collected on road user deaths, injuries, and traffic crashes. For each study rate ratios were calculated, the ratio of event rates before and after intervention in the traffic calmed area divided by the corresponding ratio of event rates in the control area, which were pooled to give an overall estimate using a random effects model. FINDINGS: Sixteen controlled before/after studies met our inclusion criteria. Eight studies reported the number of road user deaths: pooled rate ratio 0.63 (95% confidence interval (CI) 0.14 to 2.59). Sixteen studies reported the number of injuries (fatal and non-fatal): pooled rate ratio 0.89 (95% CI 0.80 to 1.00). All studies were in high income countries. CONCLUSION: Area-wide traffic calming in towns and cities has the potential to reduce road traffic injuries. However, further rigorous evaluations of this intervention are needed, especially in low and middle income countries.

Accidents, Traffic↗

PubMedDate not supplied

The role of "envisioning the future" in the development of resilience among at-risk youth.

The objective was to explore the process by which adolescents develop resilience and change their risk behaviors despite multiple stressors in their environment. The design was exploratory using grounded theory to understand the process from the teens' perspectives. Semistructured interviews were conducted with 32 individuals-28 adolescents (age range 16-21 years) and 4 adults (age range 32 and 72)-on two occasions. The participants used the basic social process "envisioning the future" to become resilient and stop engaging in risk behaviors. Envisioning the future included two processes "feeling competent" and "elevating expectations" that were facilitated within the context of a relationship with a reliable, caring, and competent adult. Participants in this study became resilient despite environmental stressors by setting higher expectations for themselves and feeling self-confident. The findings of this study provide information regarding the specific behaviors that promote positive outcomes in at-risk youth and suggest ways in which public health nurses can facilitate these behaviors in both the youth and their mentors.

Adaptation, Psychological↗

PubMed1999

Laparoscopic supracervical hysterectomy vs. abdominal hysterectomy in a community hospital. A cost comparison.

OBJECTIVE: To evaluate the feasibility for an institution to offer laparoscopic supracervical hysterectomy as a cost-effective alternative to total abdominal hysterectomy (TAH) in a managed care environment. STUDY DESIGN: Retrospective study in which 138 consecutive laparoscopic supracervical hysterectomies performed between December 1992 and May 1996 were reviewed and compared to 354 consecutive TAHs performed during the same period. Operating time, use of operative room supplies, length of stay and actual total, fixed and variable costs of each case were calculated for the entire hospital stay and for each hospital cost center. Differences between costs were analyzed by ANCOVA using age, patient weight, specimen weight and number of operative procedures performed at the time of hysterectomy as covariants. RESULTS: The mean operative room time was significantly greater for laparoscopic supracervical hysterectomy than for TAH (167.4 [SD 51.2] vs. 103 minutes [30.3, P < .001]). In contrast, length of stay was significantly shorter for laparoscopic supracervical hysterectomy than for TAH (0.8 [SD 1.1] vs. 3.4 days [.9, P < .001]). The adjusted mean costs of both operative room time and supplies were significantly higher for laparoscopic supracervical hysterectomy than for TAH (P < .001). In contrast, the mean cost of length of stay for laparoscopic supracervical hysterectomy was significantly lower (P < .001). However, the adjusted mean total costs of the entire hospital stay were not significantly different: $2,716 for laparoscopic supracervical hysterectomy vs. $2,702 for TAH (F = .7, P = .8). The absence of significant differences between procedures resulted from our limited use of disposable supplies (no automated stapling device) and from shorter lengths of stay, which compensated well for the higher operative room costs of time and supplies incurred with laparoscopic supracervical hysterectomy. CONCLUSION: Laparoscopic supracervical hysterectomy is, at least in the short term, a cost-effective alternative to TAH in a managed care environment.

Adult↗