Choice of commuting mode among employees: Do home neighborhood environment, worksite neighborhood environment, and worksite policy and supports matter?

BACKGROUND: Promoting the use of public transit and active transport (walking and cycling) instead of car driving is an appealing strategy to increase overall physical activity.

PURPOSE: To quantify the combined associations between self-reported home and worksite neighborhood environments, worksite support and policies, and employees' commuting modes.

METHOD: Between 2012 and 2013, participants residing in four Missouri metropolitan areas were interviewed via telephone (n = 1,338) and provided information on socio-demographic characteristics, home and worksite neighborhoods, and worksite support and policies. Commuting mode was self-reported and categorized into car driving, public transit, and active commuting. Commuting distance was calculated using geographic information systems. Commuters providing completed data were included in the analysis. Multivariate logistic regression models were used to examine the correlates of using public transit and active commuting.

RESULT: The majority of participants reported commuting by driving (88.9%); only 4.9% used public transit and 6.2% used active modes. After multivariate adjustment, having transit stops within 10-15 minutes walking distance from home (p=0.05) and using worksite incentive for public transit (p<0.001) were associated with commuting by public transit. Commuting distance (p<0.001) was negatively associated with active commuting. Having free or low cost recreation facilities around the worksite (p=0.04) and using bike facilities to lock bikes at the worksite (p<0.001) were associated with active commuting.

CONCLUSION: Both environment features and worksite supports and policies are associated with the choice of commuting mode. Future studies should use longitudinal designs to investigate the potential of promoting alternative commuting modes through worksite efforts that support sustainable commuting behaviors as well as the potential of built environment improvements.

Can publicly available webcameras and mechanical Turks be used to evaluate physical activity policy and built environment change?

Introduction: Fewer than 50% of adults and 40% of youth meet US CDC guidelines for physical activity (PA) with the built environment (BE) a culprit for limited PA. A challenge in evaluating policy and BE change is the forethought to capture a priori PA behaviors and the ability to eliminate bias in post-change environments. The present objective was to analyze existing public data feeds to quantify effectiveness of BE interventions. The Archive of Many Outdoor Scenes (AMOS) has collected 135 million images of outdoor environments from 12,000 webcams since 2006. Many of these environments have experienced BE change. Methods: One example of BE change is the addition of protected bike lanes and a bike share program in Washington, DC.Weselected an AMOS webcam that captured this change. AMOS captures a photograph from eachwebcamevery half hour.AMOScaptured the 120 webcam photographs between 0700 and 1900 during the first work week of June 2009 and the 120 photographs from the same week in 2010. We used the Amazon Mechanical Turk (MTurk) website to crowd-source the image annotation. MTurk workers were paid US$0.01 to mark each pedestrian, cyclist and vehicle in a photograph. Each image was coded 5 unique times (n=1200). The data, counts of transportation mode, was downloaded to SPSS for analysis. Results: The number of cyclists per scene increased four-fold between 2009 and 2010 (F=36.72, p=0.002). There was no significant increase in pedestrians between the two years, however there was a significant increase in number of vehicles per scene (F=16.81, p

European Union Biomedical Research Law and Policy and Citizen Science

In this chapter I focus on the EU's emerging biomedical research law and policy and examine the development of citizen science in this setting. The chapter argues that while what the analysis reveals might not be specific to the EU, attention to this organisation underlines important but often overlooked aspects of citizen science. That is, citizen science is (being) made less about promoting substantive involvement by citizens in the fashioning of biomedical trajectories and their empowerment as participants that pursue aims defined by themselves rather than others. Instead citizen science is underpinned by a more longstanding EU level approach to participation in science-based issues that sees it being harnessed, shaped and directed towards supporting the production and legitimation of organisational identity and sociotechnical order (in this case the EU’s). Within biomedical research law and policy citizen science might therefore be expected to support market-optimised biomedical futures and a dynamic internal market and economy. Citizen science is thereby implicated in the delineation of the boundaries of responsibility and accountability (and blame) for the (non-)realisation of public health priorities and objectives. In this way law and policy on participation and citizen science might support current research trajectories that do not serve all health needs.

How Prepared are UK Medical Graduates for Practice? Final report from a programme of research commissioned by the General Medical Council

This programme of research aimed to understand the extent to which current UK medical graduates are prepared for practice. Commissioned by the General Medical Council, we conducted: (1) A Rapid Review of the literature between 2009 and 2013; (2) narrative interviews with a range of stakeholders; and (3) longitudinal audio-diaries with Foundation Year 1 doctors. The Rapid Review (RR) resulted in data from 81 manuscripts being extracted and mapped against a coding framework (including outcomes from Tomorrow's Doctors (2009) (TD09)). A narrative synthesis of the data was undertaken. Narrative interviews were conducted with 185 participants from 8 stakeholder groups: F1 trainees, newly registered trainee doctors, clinical educators, undergraduate and postgraduate deans and foundation programme directors, other healthcare professionals, employers, policy and government and patient and public representatives. Longitudinal audio-diaries were recorded by 26 F1 trainees over 4 months. The data were analysed thematically and mapped against TD09. Together these data shed light onto how preparedness for practice is conceptualised, measured, how prepared UK medical graduates are for practice, the effectiveness of transition interventions and the currently debated issue of bringing full registration forward to align with medical students’ graduation. Preparedness for practice was conceptualised as both a long- and short-term venture that included personal readiness as well as knowledge, skills and attitudes. It has mainly been researched using self-report measures of generalised incidents that have been shown to be problematic. In terms of transition interventions: assistantships were found to be valuable and efficacious for proactive students as team members, shadowing is effective when undertaken close to employment/setting of F1 post and induction is generally effective but of inconsistent quality. The August transition was highlighted in our interview and audio-diary data where F1s felt unprepared, particularly for the step-change in responsibility, workload, degree of multitasking and understanding where to go for help. Evidence of preparedness for specific tasks, skills and knowledge was contradictory: trainees are well prepared for some practical procedures but not others, reasonably well prepared for history taking and full physical examinations, but mostly unprepared for adopting an holistic understanding of the patient, involving patients in their care, safe and legal prescribing, diagnosing and managing complex clinical conditions and providing immediate care in medical emergencies. Evidence for preparedness for interactional and interpersonal aspects of practice was inconsistent with some studies in the RR suggesting graduates were prepared for team working and communicating with colleagues and patients, but other studies contradicting this. Interview and audio-diary data highlights concerns around F1s preparedness for communicating with angry or upset patients and relatives, breaking bad news, communicating with the wider team (including interprofessionally) and handover communication. There was some evidence in the RR to suggest that graduates were unprepared for dealing with error and safety incidents and lack an understanding of how the clinical environment works. Interview and audio-diary data backs this up, adding that F1s are also unprepared for understanding financial aspects of healthcare. In terms of being personally prepared, RR, interview and audio diary evidence is mixed around graduates’ preparedness for identifying their own limitations, but all data points to graduates’ difficulties in the domain of time management. In terms of personal and situational demographic factors, the RR found that gender did not typically predict perceptions of preparedness, but graduates from more recent cohorts, graduate entry students, graduates from problem based learning courses, UK educated graduates and graduates with an integrated degree reported feeling better prepared. The longitudinal audio-diaries provided insights into the preparedness journey for F1s. There seems to be a general development in the direction of trainees feeling more confident and competent as they gain more experience. However, these developments were not necessarily linear as challenging circumstances (e.g. new specialty, new colleagues, lack of staffing) sometimes made them feel unprepared for situations where they had previously indicated preparedness.

Safeguarding and promoting children in maternity services- implications for policy and practice

The article debates the issues involved in safeguarding and protecting children in maternity services and offers implications for professional practice. Midwives and other staff who work as members of the maternity team have a safeguarding role to play in the identification of babies and children who have been abused, or at risk of abuse, and in subsequent intervention and protection services. The study highlights how domestic violence increases during pregnancy and the postpartum period, and is significantly related to all types of child maltreatment up to the child's fifth year, and children under one being at the highest risk of injury, or death. Close inter-agency liaison is required with midwives who are accountable and not afraid to challeneg hiostorical working practices.

An analysis of Child Care Policy and Practice in Barnardo’s Macedon and Sharonmore residential homes in Northern Ireland during the period 1952 – 1990, the period under investigation by the Inquiry.

Report to examine the nature and extent of any abuse in Barnardo’s Macedon and Sharonmore residential homes in Northern Ireland and to determine whether that abuse was caused or facilitated by failings on the part of Barnardo’s, and whether they were systemic in nature. Abuse and systemic failings as defined in the document published by the Inquiry in June 2013 “Definition of Abuse and Systemic Failings”.

Devolution, Social Policy and Education: Some Observations from Northern Ireland

Many commentaries on social policy in the UK assume that policy as developed in England applies to the constituent countries of Wales, Scotland and Northern Ireland. However, the advent of political devolution in the last five years is slowly being reflected in the literature. This paper takes education policy in Northern Ireland and discusses recent policy developments in the light of the 1998 Belfast Agreement. The Agreement, it is suggested, is providing a framework which promotes equality, human rights and inclusion in policy making. Some early indications of this are discussed and some of the resultant policy dilemmas are assessed. The paper concludes that accounts of policy development
in the UK, which ignore the multi-level policy-making contexts created by devolution, do
a disservice to the subject.