COSMOS - Congestion management strategies and methods in urban sites.

The paper describes the strategies for Congestion and Incident Management (CIM) on the basis of Automatic Congestion and Incident Detection (ACID) that COSMOS will develop, implement in SCOOT, UTOPIA and MOTION, and validate and demonstrate in London, Piraeus and Torino. Four levels of operation were defined for CIM: strategies, tactics, tools and realisation. The strategies for CIM form the top level of this hierarchy. They have to reflect the strategic requirements of the system operators. The tactics are the means that can be employed by the strategies to achieve particular goals in particular situations. The tools that are used by the tactics relate to the elements of the signal plan and the ways in which they can be modified. Strategies, tactics and tools are generally common to all three systems, while the realisation of individual strategies and tactical decisions, through the use of particular common sets of tools, will generally be system specific. For the covering abstract, see IRRD 490001.

Self-management of coronary heart disease in angina patients after percutaneous coronary intervention: A mixed methods study.

After having elective percutaneous coronary intervention (PCI) patients are expected to self-manage their coronary heart disease (CHD) by modifying their risk factors, adhering to medication and effectively managing any recurring angina symptoms but that may be ineffective. Objective: Explore how patients self-manage their coronary heart disease (CHD) after elective PCI and identify any factors that may infl uence that. Design and method: This mixed methods study recruited a convenience sample of patients (n=93) approximately three months after elective PCI. Quantitative data were collected using a survey and were subject to univariate, bivariate and multi-variate analysis. Qualitative data from participant interviews was analysed using thematic analysis. Findings: After PCI, 74% of participants managed their angina symptoms inappropriately. Younger participants and those with threatening perceptions of their CHD were more likely to know how to effectively manage their angina symptoms. Few patients adopted a healthier lifestyle after PCI. Qualitative analysis revealed that intentional non-adherence to some medicines was an issue. Some participants felt unsupported by healthcare providers and social networks in relation to their self-management. Participants reported strong emotional responses to CHD and this had a detrimental effect on their self-management. Few patients accessed cardiac rehabilitation.