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PubMed2004

Evaluating the effectiveness of Snoezelen on women who have a dementing illness.

This paper reports on a study using a single case study design with four women who were in the moderate to severe stages of dementia. The aims of the study were (i) to explore the effectiveness of Snoezelen on women who have a dementing illness and to ascertain the short-term effectiveness after treatment has ceased and (ii) to explore how older women with a dementing illness responded to individual pieces of equipment in the room. The four women were involved in Snoezelen sessions twice a week for a period of 4 weeks. Observations were made of mood/behavior using the Interact and Interact short rating scales by Baker & Dowling (1995). A Likert scale of measurement was applied to each item on the rating scales ranging from 5 'nearly all the time' to 1 'not at all' to produce quantitative data. The four women's responses to equipment were recorded during each Snoezelen session and a Likert scale of measurement was applied to each piece of equipment ranging from +3 'strong positive' to -3 'strong negative' to produce quantitative data. Detailed accounts of the four women's verbal responses were recorded to produce qualitative data and were thematically analysed. All data collected was recorded in the form of line graphs. It was concluded that there was an overall positive mood/behavior change lasting 30 minutes after the end of the Snoezelen session for all patients. However, the benefits of 'before', 'during' and 'after' Snoezelen sessions showed no increase over the 8 sessions indicating that the benefits of the Snoezelen sessions were not long-term. In terms of 'response to equipment' this was generally a positive experience. It is concluded that the results of this study support the notion that Snoezelen environments offer a valuable adjunct to the care of older people with a dementing illness.

Adult↗

PubMed2006

Empirical Bayes before-after safety studies: lessons learned from two decades of experience and future directions.

The empirical Bayes (EB) methodology has been applied for over 20 years now in conducting statistically defendable before-after studies of the safety effect of treatments applied to roadway sites. The appeal of the methodology is that it corrects for regression to the mean and traffic volume and other changes not due to the measure. There is, therefore, a natural tendency to put a stamp of approval on any study that uses this methodology, and to assume that the results can then be used in specifying crash modification factors for use in developing treatments for hazardous locations, or in designing new roads using tools such as the interactive highway safety design model (IHSDM). At the other extreme are skeptics who suggest that the increased sophistication and data needs of the EB methodology are not worth the effort since alternative, less complex methods can produce equally valid results. The primary objective of this paper is to capitalize on experience gained from two decades of conducting EB studies around the world to illustrate that the EB methodology, if properly undertaken, produces results that could be substantially different and less biased than those from more conventional types of studies. A secondary objective is to emphasize that caution is needed in assessing the validity of studies undertaken with the EB methodology and in using these results for providing crash modification factors. To this end, a number of issues that are critical to the proper conduct and interpretation of EB evaluations are raised and illustrated based on lessons learned from recent experience with these studies. These include: amalgamating the effects on different crash types; the specification of the reference/comparison groups; and accounting for traffic volume changes. Current and future directions, including the improvements offered by a full Bayes approach, are discussed.

Accidents, Traffic↗

PubMed2004

Evaluation of heritage trees for conservation and management in Guangzhou City (China).

The recent fast pace of urbanization in China and other developing countries has exerted pressure on urban trees, which constitute a key urban environmental asset. The most outstanding trees should be treated as natural-cum-cultural heritage. Guangzhou City's growth has threatened its rich urban-tree endowment, a diversified assemblage of 200,000 trees represented by 254 species and located in three major habitats: roadside, park, and institutional grounds. Mainly based on age and performance, 348 trees were officially designated as heritage specimens. They were evaluated in the field for tree dimensions, habitat, performance, and landscape contribution, to establish enhanced conservation and management strategies. With only 25 species, heritage trees were dominated by five cultivated natives and encompass some of the city's rare species; some common urban-forest species were not represented. Older districts and roadside habitats, despite their compact town plan and limited growing space, had the largest tree dimensions and largest share of heritage trees. Many heritage trees were large with long life expectancy and the potential for biomass expansion, and had pivotal cityscape impacts where they occur. Old neighborhoods, traditional haven for the arborescent treasure, are being changed by construction activities and periodic typhoon and windstorm damages. Increasing development density could degrade the heritage trees and their growing space, and reduce tree quality and life span. Upgrading the statutory-administrative systems and arboricultural care can enhance long-term survival of the precious natural-cum-cultural heritage. The experience of Guangzhou in identifying and preserving its high-quality urban trees can provide management strategies for other cities.

China↗

PubMed2001

Local people's perceptions of planning and management issues in Prespes Lakes National Park, Greece.

Local people's perceptions of planning and management issues were investigated in Prespes Lakes National Park in north-western Greece, 24 years after designation. Ensued conflicts due to lack of local community participation in the designation procedure and in the decision-making process thereafter necessitated this research. Knowledge of the park and its aims, source of information about aims, necessity for works and facilities, attitudes toward certain policies, and effectiveness of administration and management scheme, were studied by means of a questionnaire survey. Respondents were contacted by systematic sampling, which resulted in 201 cases for analysis. Poor knowledge of aims associated with education of people was revealed and the managing authority (the Forest Service) as source of information was mentioned in only one case. Forest recreation facilities and improvement of accessibility were considered of high priority, as means of possible tourism development of the area. A policy of non-intensive agriculture with compensation for loss of income, if the wetlands of the park were in danger, seems acceptable, younger ages accepting it more easily. The need for a new administration and management scheme with the participation of local communities in the decision-making process was revealed, supported mainly by the younger age groups. Finally, the results indicated that the information derived from such research could help managers of protected areas to resolve arising conflicts.

Adult↗

PubMed2001

Novel boom/skirt systems for improvement of water quality in estuarial impoundments subject to saline influx.

The recent popularity of esturial barrage construction in the UK has been driven largely by commercial and amenity interests arising from the need to rehabilitate tracts of derelict urban land. Formation of a permanent water body to replace the tidal regime hides unsightly mud banks and facilities ready access for water based recreation. Unfortunately, in most cases, and presumably arising from upstream extreme flood risk assessment, the barrier is designed to overtop under the highest (spring) tidal peaks so allowing a substantial influx of heavier saltwater into the impoundment on a regular basis. This might well substantially exceed influx via any navigational lock operations. The problem created by the salt water is that its greater density causes stratification in the impounded water body. In times of low freshwater flow little mixing takes place and the normal action of the wind, in circulating and aerating the water body, will only extend within the lighter and often thin surface freshwater layer. The consequence is that little reoxygenation of the lower layers takes place leading to depressed dissolved oxygen levels and possible anoxia. Sluice provision in the barrage may be ineffective in expelling the saline layers, so this water remains near stagnant and deteriorates in quality due to sediment oxygen demands until a major fluvial flood, or new saline influx, is able to effectively mix the waters. Conventional continuous surface releases through fish pass and/or by crest overspill ensure the preferential release of the freshwater rather than the problematic saltwater. Retrofitting of novel low cost floating boom/skirt baffle system is proposed here for alleviation of the problem.

Animals↗

PubMed2005

Accident prediction model for railway-highway interfaces.

Considerable past research has explored relationships between vehicle accidents and geometric design and operation of road sections, but relatively little research has examined factors that contribute to accidents at railway-highway crossings. Between 1998 and 2002 in Korea, about 95% of railway accidents occurred at highway-rail grade crossings, resulting in 402 accidents, of which about 20% resulted in fatalities. These statistics suggest that efforts to reduce crashes at these locations may significantly reduce crash costs. The objective of this paper is to examine factors associated with railroad crossing crashes. Various statistical models are used to examine the relationships between crossing accidents and features of crossings. The paper also compares accident models developed in the United States and the safety effects of crossing elements obtained using Korea data. Crashes were observed to increase with total traffic volume and average daily train volumes. The proximity of crossings to commercial areas and the distance of the train detector from crossings are associated with larger numbers of accidents, as is the time duration between the activation of warning signals and gates. The unique contributions of the paper are the application of the gamma probability model to deal with underdispersion and the insights obtained regarding railroad crossing related vehicle crashes.

Accidents↗

PubMedDate not supplied

Unsafe to play? Neighborhood disorder and lack of safety predict reduced physical activity among urban children and adolescents.

PURPOSE: Lack of physical activity is associated with increased risk of overweight and cardiovascular disease, conditions associated with lower socioeconomic status (SES). Associations between activity levels of urban youth and limited access to safe recreation areas in their neighborhoods of residence were investigated. DESIGN: Analyses of data from the Project on Human Development in Chicago Neighborhoods, a multilevel longitudinal study of families and communities, are reported. SETTING: Chicago, Illinois. SUBJECTS: Individual-level data were obtained from 1378 youth 11 to 16 years old and caregivers living in 80 neighborhood clusters. Neighborhood-level data were collected from 8782 community residents and videotapes of 15,141 block faces. MEASURES: Parental estimates of hours youth spent in recreational programming were used to estimate physical activity. A scale of residents' assessment of neighborhood safety for children's play was created; disorder measures came from videotaped observations. RESULTS: Physical activity averaged 2.7 hours/week (SD = 5.0), varying significantly across neighborhoods. Using hierarchical linear regression, SES, age, and male gender, but not body mass index, were independently associated with physical activity. Lower neighborhood safety and social disorder were significantly associated with less activity, controlling for demographics. CONCLUSIONS: One mechanism for reduced physical activity among youth may be the influence of unsafe neighborhoods. Neighborhood interventions to increase safety and reduce disorder may be efficacious in increasing physical activity, thereby reducing risk of overweight and cardiovascular disease.

Adolescent↗

PubMed1993

Modeling vehicle accidents and highway geometric design relationships.

The statistical properties of four regression models--two conventional linear regression models and two Poisson regression models--are investigated in terms of their ability to model vehicle accidents and highway geometric design relationships. Potential limitations of these models pertaining to their underlying distributional assumptions, estimation procedures, functional form of accident rate, and sensitivity to short road sections, are identified. Important issues, such as the treatment of vehicle exposure and traffic conditions, and data uncertainties due to sampling and nonsampling errors, are also discussed. Roadway and truck accident data from the Highway Safety Information System (HSIS), a highway safety data base administered by the Federal Highway Administration (FHWA), have been employed to illustrate the use and the limitations of these models. It is demonstrated that the conventional linear regression models lack the distributional property to describe adequately random, discrete, nonnegative, and typically sporadic vehicle accident events on the road. As a result, these models are not appropriate to make probabilistic statements about vehicle accidents, and the test statistics derived from these models are questionable. The Poisson regression models, on the other hand, possess most of the desirable statistical properties in developing the relationships. However, if the vehicle accident data are found to be significantly overdispersed relative to its mean, then using the Poisson regression models may overstate or understate the likelihood of vehicle accidents on the road. More general probability distributions may have to be considered.

Accidents, Traffic↗

PubMed2005

A comparison of foot/ground interaction during stair negotiation and level walking in young and older women.

Stair design and environmental conditions may play a role in slip accidents on stairs in the workplace, but little is known about the slip resistance requirements on stairs compared to level walking. Older adults have an increased risk of falling compared to younger adults and may be at greater risk during stair negotiation. The purpose of this study was to determine whether the ground reaction force profiles and peak required coefficient of friction (RCOF) differed between young and elderly women or between stair ascent, stair descent and overground walking. While there was a trend towards less risky stair descent behaviour in the older women in terms of their peak RCOF values during stair descent, the increased vertical loading rate in the older women may imply reduced dynamic balance control. The largest mean RCOF peaks occurred during stair ascent in both young and older women, but there were several overground walking trials in both groups and a few stair descent trials of the young women, which resulted in RCOF peaks greater than 0.5. These results should be considered when choosing stair surface materials, particularly in occupational and outdoor settings where the tread surfaces may become wet or contaminated.

Accidental Falls↗

PubMed2006

The relationship between access and quality of urban green space with population physical activity.

OBJECTIVES: This study examined the association between access to quality urban green space and levels of physical activity. STUDY DESIGN: A cross-sectional examination of the relationship between access to quality urban green space and level of recreational physical activity in 4950 middle-aged (40-70 years) respondents from the European Prospective Investigation into Cancer and Nutrition (EPIC), who resided in Norwich, UK. METHODS: Using geographic information systems (GIS), three measures of access to open green space were calculated based on distance only, distance and size of green space and distance, size and quality of green space. Multiple regression models were used to determine the relationship between the three indicators of access to open green space and level of recreational physical activity. RESULTS: There was no evidence of clear relationships between recreational activity and access to green spaces. Non-significant associations were apparent for all variables, and there was no evidence of a clear trend in regression coefficients across quartiles of access for either the distance, size adjusted, and quality and size-adjusted models. Furthermore, the neighbourhood measures of access to green spaces showed non-significant associations with recreational physical activity. CONCLUSIONS: Access to urban green spaces does not appear to be associated with population levels of recreational physical activity in our sample of middle-aged adults.

Adult↗

PubMed2004

Forest health, collective behaviors, and management.

This study compares community-based managed forests under different purposes of management, namely, state-driven "conservation" or community-designed utilization in two villages located in the Sopsai watershed, Nan Province, northern Thailand. The forest health under different intensity of uses is assessed in association with the collective behaviors and long-term purposes embedded in village social-cultural context. The study found no significant differences in forest succession and proportion in diameter at 1.3 m (dbh) class and height-class distribution of the forest under different use intensity. The forest for utilization also showed higher density and basal area of the local preferred species than the "conservation" forest. In the utilization forest, we also found a higher number of multipurpose and preferred species than in the "conservation" forest, which actually responded to the needs of the community in the long term to have more wood products (both firewood and timbers). The community-based forest management (CBFM) for utilization can also lead to natural regeneration and biodiversity similar to "conservation" forests. Through CBFM, forest resources can be managed to maintain the healthy condition under different intensities and respond to both community needs and external expectation. The findings also emphasize the importance of recognizing community needs and management objectives in watershed restoration and improving the productivity of forests under collective management.

Conservation of Natural Resources↗

PubMedDate not supplied

Potential for microbial contamination of ADD-Vantage admixtures.

OBJECTIVE: To test for potential bacterial contamination of the ADD-Vantage system when the components are assembled in various hospital environments. STUDY DESIGN: One hundred fifty ADD-Vantage units were assembled by three different people in three separate locations within a hospital. Each person assembled ten units per day; the study spanned five days. After 72 hours of incubation, units were inspected for evidence of contamination. SETTING: ADD-Vantage units were assembled by a pharmacist in a laminar-flow hood, a pharmacy student using the pharmacy counter, and a nurse at a patient's bedside table. Personnel at each site wore their regular work attire. Each person observed handwashing techniques normally used during routine working hours. DATA EXTRACTION: Positive results were sent to the hospital microbiology laboratory for determination of growth type. RESULTS: After 72 hours, none of the systems exhibited microbial growth on visual inspection. No differences in microbial contamination of the ADD-Vantage systems relative to assembly site, day of assembly, or person performing the assembly were observed. The incidence of contamination was calculated at less than seven percent. CONCLUSIONS: There is minimal risk of bacterial contamination when ADD-Vantage systems are compounded either on a pharmacy counter or at a patient's bedside. Larger samples must be studied in order to detect differences in the incidence of contamination among assembly sites.

Cimetidine↗

PubMed2003

Environmental conditions and variation in levels of sun exposure among children in child care.

Sun exposure in childhood is 1 of the risk factors for developing skin cancer, yet little is known about levels of exposure at this age. This is particularly important in countries with high levels of ultraviolet radiation (UVR) such as Australia. Among 49 children 3 to 5 years of age attending child care centers, UVR exposure was studied under 4 conditions in a repeated measures design; sunny days, cloudy days, teacher's instruction to stay in the shade, and a health professionals instruction to apply sunscreen. Three different data collection methods were employed: (a) completion of questionnaire or diary by parents and researcher, (b) polysulphone dosimeter readings, and (c) observational audits (video recording). Results of this study indicated that more than half the children had been sunburnt (pink or red) and more than a third had experienced painful sunburn (sore or tender) in the last summer. Most wore short sleeve shirts, short skirts or shorts and cap, that do not provide optimal levels of skin protection. However, sunscreen was applied to all exposed parts before the children went out to the playground. Over the period of 1 hr (9-10 a.m.) the average amount of time children spent in full sun was 22 min. On sunny days there was more variation across children in the amount of sun exposure received. While the potential amount of UVR exposure for young children during the hour they were outside on a sunny day was 1.45 MED (Minimum Erythemal Dose), they received on average 0.35 MED, which is an insufficient amount to result in an erythemal response on fair skin even without the use of sunscreen.

Australia↗

PubMed2003

Effectiveness of constructed overland flow areas in decreasing diffuse pollution from forest drainages.

Forestry is the largest scale human impact affecting catchments in Finland and a prominent source of diffuse pollution in many water courses. Among the forestry activities, draining of wetlands had the most pronounced impacts on sediment, nutrient, and metal loading in the past. At present, renovation of old ditches and fertilization of peatlands constitute the major risk of forestry-induced diffuse pollution. Contemporary forestry aims at decreasing this risk with various riparian buffer strip designs. Among such designs, creation of overland flow areas by plugging the outlet ditches is increasingly used. Our objectives were to evaluate the potential of constructed overland flow areas to function as riparian buffers and estimate the quality and quantity of diffuse pollution from old versus recent forest drainages. We studied retention and release of pollutants from 20 constructed, 2- to 10-m-wide overland flow areas receiving drainage water from forested peatlands. Drainage waters were sampled above and below the plugged ditches three times per year from 1998 to 1999. Chemical oxygen demand and nutrient and metal loads and concentrations varied strongly between seasons, years, and drainage areas. Areas subjected to recent ditch renovations and fertilizations had clearly elevated seasonal loads and concentrations of total phosphorus (TP), PO4, Fe, and Al in comparison to old treatment areas. Especially TP loads were high above the national average values measured for forestry-induced diffuse pollution. In general, water quality above and below the buffer strips did not differ significantly. Our results indicate that plugged outlet ditches and associated narrow overland flow areas do not function as proper buffers in peatland areas. We suggest that wider buffers with extensive overland flow areas are needed in order to control diffuse pollution from forested and drained peatlands.

Diffusion↗

PubMed2005

An ergonomics intervention program to prevent worker injuries in a metal autoparts factory.

An ergonomics intervention program (EIP) was conducted with male employees working in the pressing and storage sections of a metal autoparts factory in Samut Prakan Province, Thailand. The objectives of this study were to assess the causes of injuries in the pressing and storage sections of that factory, and to improve working conditions by reducing worker injuries from accidents and low back muscular discomfort, using an EIR The study design used a participatory research approach which was quasi-experimental with pretest-posttest evaluations, with a non-equivalent control group. A total of 172 male participants working in Building A were the target group for assessing causes of injury. A retrospective study of official accident information, and questionnaires for general information, health and muscular discomfort, injury frequency rate (IFR), injury severity rate (ISR), medical expenses, and EIP design. Two groups of employees volunteered for the study on muscular back discomfort. The first group of 35 persons volunteered to participate in the EIP (EIP group), and the second 17 persons from Building B did not (non-EIP group). The EIP was composed of 4 major categories: (1) engineering improvement, (2) change in personal protective equipment, (3) environmental improvement, (4) administrative intervention, training, and health education. Low back muscular discomfort was measured through questionnaires on subjective feelings of muscular discomfort, and by surface electromyography (sEMG). Muscle activities were measured by sEMG of the left and right erector spinae and multifidus muscles, and evaluated by multivariate test for dependent samples (paired observation), and multivariate test for two independent samples. After EIP, IFR decreased 65.46%, ISR decreased 41.02%, and medical expenses decreased 42.79%. The low back muscular loads of the EIP group were significantly reduced, with a 95% confidence level (p < 0.05) while those of the non-EIP group were not. Subjective feelings of muscular discomfort, determined by Wilcoxon Signed Ranks test, showed that after applying the EIP to the EIP group, the mean scores for general bodily discomfort and low back muscular discomfort in the EIP group had significantly reduced, while those of the non-EIP group increased, (p < 0.05).

Accidents, Occupational↗

PubMed1990

The value of assessing falls in an elderly population. A randomized clinical trial.

OBJECTIVE: To measure the effects of a specialized postfall assessment intended to detect causes and underlying risk factors for falls, and to recommend preventive and therapeutic interventions. DESIGN: Randomized, controlled trial. SETTING: A long-term residential care facility for elderly persons. SUBJECTS: Within 7 days of a fall, 160 ambulatory subjects (mean age, 87 years) were randomly assigned to receive either a comprehensive postfall assessment (intervention group, n = 79) or usual care (control group, n = 81). INTERVENTION: The postfall assessment included a detailed physical examination and environmental assessment by a nurse practitioner; laboratory tests; electrocardiogram; and 24-hour Holter monitoring. Probable cause or causes for the fall, identified risk factors, and therapeutic recommendations were given to the patient's primary physician. MEASUREMENTS AND MAIN RESULTS: Through use of the assessment, many remediable problems (for example, weakness, environmental hazards, orthostatic hypotension, drug side effects, gait dysfunction) were detected. At the end of the 2-year follow-up period, the intervention group had 26% fewer hospitalizations (P less than 0.05) and a 52% reduction in hospital days (P less than 0.01) compared with controls. Patients in the intervention group had 9% fewer falls and 17% fewer deaths than controls by 2 years, but these trends were not statistically significant. CONCLUSIONS: Our study suggests that falls are a marker of underlying disorders easily identifiable by a careful postfall assessment, which in turn can reduce disability and costs.

Accidental Falls↗

PubMed2004

Deflector designs for fish habitat restoration.

Paired current deflectors are structures that are installed on each bank of a river to locally reduce the width of the channel, thereby creating flow acceleration and promoting scouring. These instream habitat structures have been used extensively in restoration projects to create pool habitat for fish, but there are many discrepancies in deflector design recommendations in terms of orientation, height, and length. Our objectives were to (1) examine how the angle, height, and length of paired deflectors affect scour hole dimensions and potential for bank erosion; and (2) test the applicability to paired deflectors of existing equations for scour hole depth and volume. Three deflector angles (45 degrees, 90 degrees, and 135 degrees), two deflector heights (with flow under and over the deflector height), and two lengths (reducing the width by 25% and 50%) were investigated using uniform sand in a laboratory flume. Results showed a 26-30% smaller scour depth resulting from 45 degrees deflectors than from 90 degrees deflectors and a 5-10% smaller scour depth for 135 degrees deflectors compared to 90 degrees deflectors. The volume of scour and the potential for bank erosion were greater when flow was under the height of the deflectors rather than overtopping and when the length of deflector was increased. When flow was under the deflector height, 135 degrees deflectors had the highest amount of bank erosion; whereas during overtopping flow conditions, 90 degrees deflectors had the greatest bank erosion potential. Values predicted by the model of Kuhnle and others were closest to observed scour depth and volume measurements. The assumption that upstream-oriented deflectors always generate the largest scour should be revised.

Animals↗

PubMed1989

A method to cope with the random errors of observed accident rates in regression analysis.

The paper is concerned with linear multiregression analysis on accident rates related to road geometric design elements. Supposing that a data set of accident records and geometric design elements of a certain stretch of a road is given, there are two steps for regression analysis: first, division of the road into a number of segments; and second, application of regression analysis to the set of segments. The main interest of the present paper is the first step. Occurrence of a traffic accident in a road segment is a stochastic event and an observed accident rate in a segment contains a certain magnitude of random error that deteriorates the explanatory power and reliability of the regression analysis. Random errors are required to be appropriately controlled for an effective regression analysis. The first part of the paper discusses how to evaluate a random error contained in an accident rate of a road segment and shows that a random error depends on the number of accidents and vehicle-kilometerage of the segment. It is then shown that random errors of the segment should be as much as possible equal to each other and small enough compared with the accident rate variance based on the discussion of how the random errors affect the efficiency of regression analysis. Several alternative criteria on the random errors for dividing a road into segments are proposed and numerical examples of Tokyo-Kobe Expressway are presented to examine the appropriateness of the alternative criteria. One of them is finally recommended as the most practically useful criterion.

Accidents, Traffic↗