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Sadler RC, Larsen K. Mapping the Way to Good Health: The Interdisciplinary Challenges of Geographers in Medical Research. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:12419. [PMID: 36231725 PMCID: PMC9564750 DOI: 10.3390/ijerph191912419] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/29/2022] [Revised: 09/27/2022] [Accepted: 09/28/2022] [Indexed: 06/16/2023]
Abstract
Geography has an important role to play in shaping the direction of medical research. In particular, its tools and theory provide essential understanding to the impacts of place on health behaviors and outcomes. Understanding some of its evolution-particularly into the subfield of medical geography-is therefore useful both for geographers and medical researchers. In this paper, we present some of the debates that geographers have grappled with, the growth of GIS (particularly in the context of medical research), some important methodological considerations that geographers help center, and some recommendations for future work at this nexus. Throughout, we speak from the perspective of geographers who have worked nearly exclusively in the health sciences since obtaining our PhDs.
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Affiliation(s)
- Richard Casey Sadler
- Division of Public Health, College of Human Medicine, Michigan State University, Flint, MI 48502, USA
- Department of Family Medicine, College of Human Medicine, Michigan State University, East Lansing, MI 48824, USA
| | - Kristian Larsen
- CAREX Canada, School of Population and Public Health, University of British Columbia, Vancouver, BC V6T 1Z4, Canada
- Department of Geography and Planning, University of Toronto, Toronto, ON M5G 1G6, Canada
- Department of Geography and Environmental Studies, Toronto Metropolitan University, Toronto, ON M5B 2K3, Canada
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Fridman L, Ling R, Rothman L, Cloutier MS, Macarthur C, Hagel B, Howard A. Effect of reducing the posted speed limit to 30 km per hour on pedestrian motor vehicle collisions in Toronto, Canada - a quasi experimental, pre-post study. BMC Public Health 2020; 20:56. [PMID: 32036789 PMCID: PMC7008529 DOI: 10.1186/s12889-019-8139-5] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2019] [Accepted: 12/30/2019] [Indexed: 01/08/2023] Open
Abstract
Background Pedestrian related deaths have recently been on the rise in Canada. The effect of changing posted speeds on the frequency and severity of pedestrian motor vehicle collisions (PMVC) is not well studied using controlled quasi-experimental designs. The objective of this study was to examine the effect of lowering speed limits from 40 km/h to 30 km/h on PMVC on local roads in Toronto, Canada. Methods A 30 km/h speed limit on local roads in Toronto was implemented between January 2015 and December 2016. Streets that remained at a 40 km/h speed limit throughout the study period were selected as comparators. A quasi-experimental, pre-post study with a comparator group was used to evaluate the effect of the intervention on PMVC rates before and after the speed limit change using repeated measures Poisson regression. PMVC data were obtained from police reports for a minimum of two years pre- and post-intervention (2013 to 2018). Results Speed limit reductions from 40 km/h to 30 km/h were associated with a 28% decrease in the PMVC incidence rate in the City of Toronto (IRR = 0.72, 95% CI: 0.58–0.89). A non-significant 7% decrease in PMVC incidence rates were observed on comparator streets that remained at 40 km/h speed limits (IRR = 0.93, 95% CI: 0.70–1.25). Speed limit reduction also influenced injury severity, with a significant 67% decrease in major and fatal injuries in the post intervention period on streets with speed limit reductions (IRR = 0.33, 95% CI: 0.13–0.85) compared with a 31% not statistically significant decrease in major and fatal injuries on comparator streets (IRR = 0.69, 95% CI: 0.37–1.31). The interaction term for group and pre-post comparisons was not statistically significant (p = 0.14) indicating that there was no evidence to suggest a pre-post difference in IRRs between the intervention and comparator streets. Conclusions Declines in the rate of PMVC were observed on roads with posted speed limit reductions from 40 km/h to 30 km/h, although this effect was not statistically greater than reductions on comparator streets.
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Affiliation(s)
- Liraz Fridman
- Departments of Paediatrics and Community Health Sciences, Cumming School of Medicine University of Calgary, Calgary, Alberta, Canada. .,Alberta Children's Hospital Research Institute, Calgary, Alberta, Canada. .,O'Brien Institute for Public Health, Calgary, Alberta, Canada. .,Hospital for Sick Children Research Institute, Toronto, Ontario, Canada. .,Hospital for Sick Children, Peter Gilgan Centre for Research and Learning, 686 Bay St, Toronto, ON, M5G0A4, Canada.
| | - Rebecca Ling
- Hospital for Sick Children Research Institute, Toronto, Ontario, Canada
| | - Linda Rothman
- School of Occupational and Public Health, Ryerson University, Toronto, Ontario, Canada
| | | | - Colin Macarthur
- Hospital for Sick Children Research Institute, Toronto, Ontario, Canada
| | - Brent Hagel
- Departments of Paediatrics and Community Health Sciences, Cumming School of Medicine University of Calgary, Calgary, Alberta, Canada.,Alberta Children's Hospital Research Institute, Calgary, Alberta, Canada.,O'Brien Institute for Public Health, Calgary, Alberta, Canada.,Sport Injury Prevention Research Centre, Faculty of Kinesiology, Calgary, Alberta, Canada
| | - Andrew Howard
- Hospital for Sick Children Research Institute, Toronto, Ontario, Canada
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Moradi A, Kavousi A, Soori H, Rahmani K. Environmental factors influencing the distribution of pedestrian traffic accidents in Iran. ARCHIVES OF TRAUMA RESEARCH 2020. [DOI: 10.4103/atr.atr_76_19] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Hagel BE, Macpherson A, Howard A, Fuselli P, Cloutier MS, Winters M, Richmond SA, Rothman L, Belton K, Buliung R, Emery CA, Faulkner G, Kennedy J, Ma T, Macarthur C, McCormack GR, Morrow G, Nettel-Aguirre A, Owens L, Pike I, Russell K, Torres J, Voaklander D, Embree T, Hubka T. The built environment and active transportation safety in children and youth: a study protocol. BMC Public Health 2019; 19:728. [PMID: 31185992 PMCID: PMC6558862 DOI: 10.1186/s12889-019-7024-6] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2019] [Accepted: 05/21/2019] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND Active transportation, such as walking and biking, is a healthy way for children to explore their environment and develop independence. However, children can be injured while walking and biking. Many cities make changes to the built environment (e.g., traffic calming features, separated bike lanes) to keep people safe. There is some research on how effective these changes are in preventing adult pedestrians and bicyclists from getting hurt, but very little research has been done to show how safe various environments are for children and youth. Our research program will study how features of the built environment affect whether children travel (e.g., to school) using active modes, and whether certain features increase or decrease their likelihood of injury. METHODS First, we will use a cross-sectional study design to estimate associations between objectively measured built environment and objectively measured active transportation to school among child elementary students. We will examine the associations between objectively measured built environment and child and youth pedestrian-motor vehicle collisions (MVCs) and bicyclist-MVCs. We will also use these data to determine the space-time distribution of pedestrian-MVCs and bicyclist-MVCs. Second, we will use a case-crossover design to compare the built environment characteristics of the site where child and youth bicyclists sustain emergency department reported injuries and two randomly selected sites (control sites) along the bicyclist's route before the injury occurred. Third, to identify implementation strategies for built environment change at the municipal level to encourage active transportation we will conduct: 1) an environmental scan, 2) key informant interviews, 3) focus groups, and 4) a national survey to identify facilitators and barriers for implementing built environment change in municipalities. Finally, we will develop a built environment implementation toolkit to promote active transportation and prevent child pedestrian and bicyclist injuries. DISCUSSION This program of research will identify the built environment associated with active transportation safety and form an evidence base from which municipalities can draw information to support change. Our team's national scope will be invaluable in providing information regarding the variability in built environment characteristics and is vital to producing evidence-based recommendations that will increase safe active transportation.
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Affiliation(s)
- Brent E. Hagel
- Departments of Pediatrics and Community Health Sciences, Cumming School of Medicine, University of Calgary, C4-434, Alberta Children’s Hospital, 28 Oki Drive NW, Calgary, Alberta T3B 6A8 Canada
| | - Alison Macpherson
- Faculty of Health, 337 Norman Bethune College, York University, BC Keele Campus, Toronto, Ontario M3J 1P3 Canada
| | - Andrew Howard
- Hospital for Sick Children, 555 University Avenue, Room S – 107, Toronto, Ontario M5G 1X8 Canada
| | - Pamela Fuselli
- Parachute Canada, 150 Eglinton Ave East, Suite 300, Toronto, Ontario M4P 1E8 Canada
| | - Marie-Soleil Cloutier
- Institut National de la Recherche Scientifique, 385, rue Sherbrooke Est, Montréal, H2X 1E3 Québec Canada
| | - Meghan Winters
- Faculty of Health Sciences, Simon Fraser University, 8888 University Drive, Burnaby, V5W 1G1 British Columbia Canada
| | - Sarah A. Richmond
- Health Promotion, Chronic Disease and Injury Prevention, Public Health Ontario, 480 University Ave, Toronto, Ontario M5G 1V2 Canada
| | - Linda Rothman
- Child Health Evaluative Sciences, Hospital for Sick Children; Dalla Lana School of Public Health, Epidemiology Division, University of Toronto, 555 University Ave, Toronto, Ontario M5G 1X8 Canada
| | - Kathy Belton
- Injury Prevention Centre, University of Alberta, 4075 RTF, 8308 114 St NW, Edmonton, Alberta T6G 2E1 Canada
| | - Ron Buliung
- Department of Geography Planning, University of Toronto, 3359 Mississauga Road N, Mississauga, Ontario L5L 1C6 Canada
| | - Carolyn A. Emery
- Sport Injury Prevention Research Centre, University of Calgary, 2500 University Dr NW, Calgary, Alberta T2N 1N4 Canada
| | - Guy Faulkner
- School of Kinesiology, University of British Columbia, Lower Mall Research Station, 2259 Lower Mall, Rm 337, Vancouver, British Columbia V6T 1Z4 Canada
| | - Jacqueline Kennedy
- Green Communities Canada, 416 Chambers Street, 2nd Floor, Peterborough, Ontario K9H 3V1 Canada
| | - Tracey Ma
- The George Institute for Global Health; School of Public Health and Community Medicine, University of New South Wales, Level 5, 1 King St, Newtown, New South Wales 2042 Australia
| | - Colin Macarthur
- Hospital for Sick Children Research Institute, 686 Bay Street, Toronto, Ontario M5T 3M6 Canada
| | - Gavin R. McCormack
- Cumming School of Medicine, University of Calgary, 3300 Hospital Dr. NW, Calgary, Alberta T2N 4N1 Canada
| | - Greg Morrow
- College of Environmental Design, University of California, 230 Wurster Hall, Berkeley, California 94720 USA
| | - Alberto Nettel-Aguirre
- Departments of Pediatrics and Community Health Sciences, Cumming School of Medicine, University of Calgary, C4-435, Alberta Children’s Hospital, 28 Oki Drive NW, Calgary, T3B 6A8 Alberta Canada
| | - Liz Owens
- Office of Traffic Safety, Alberta Transportation, Room 109, Main Floor Twin Atria Building, 4999 - 98 Avenue NW, Edmonton, Alberta T6B 2X3 Canada
| | - Ian Pike
- Department of Pediatrics, University of British Columbia; BC Injury Research and Prevention Unit, BC Children’s Hospital Research Institute, F508, 4480 Oak St, Vancouver, V6H 3V4 British Columbia Canada
| | - Kelly Russell
- Department of Pediatrics and Child Health, University of Manitoba, 656-715 McDermont Avenue, Winnipeg, Manitoba R3E 3P4 Canada
| | - Juan Torres
- Faculté de l’aménagement, Université de Montréal, C.P. 6128, succ. Centre-ville, Montréal, Québec H3C 3J7 Canada
| | - Donald Voaklander
- Injury Prevention Centre, University of Alberta, 4075 RTF, 8308 114 St NW, Edmonton, Alberta T6G 2E1 Canada
| | - Tania Embree
- Acadia University, Box 48, 32 Acadia Avenue, Wolfville, Nova Scotia B4P 2R6 Canada
| | - Tate Hubka
- Departments of Pediatrics and Community Health Sciences, Cumming School of Medicine, University of Calgary, C4-433-03, Alberta Children’s Hospital, 28 Oki Drive NW, Calgary, Alberta T3B 6A8 Canada
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Oporia F, Kisakye AN, Nuwematsiko R, Bachani AM, Isunju JB, Halage AA, Swaibu Z, Atuyambe LM, Kobusingye O. An analysis of trends and distribution of the burden of road traffic injuries in Uganda, 2011 to 2015: a retrospective study. Pan Afr Med J 2018; 31:1. [PMID: 30918535 PMCID: PMC6430845 DOI: 10.11604/pamj.2018.31.1.15223] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2018] [Accepted: 08/14/2018] [Indexed: 11/11/2022] Open
Abstract
Introduction Gobally, 1.3 million people die from road traffic injuries every year. Over 90% of these deaths occur in low-and-middle-income countries. In Uganda, between 2012 and 2014, about 53,147 road traffic injuries were reported by the police, out of which 8,906 people died. Temporal and regional distribution of these injuries is not known, hence hindering targeted interventions. We described the trends and distribution of health facility reported road traffic injuries in Uganda from 2011 to 2015. Methods We obtained monthly data on road traffic injuries, from 112 districts from the Ministry of Health Uganda. We analyzed the data retrospectively to generate descriptive statistics. Results A total of 645,805 road traffic injuries were reported from January 2011 through December 2015 and 2,807 deaths reported from 2011 through 2014. Injuries increased from 37,219 in 2011 to 222,267 in 2014 and sharply dropped in December 2015 to 57,149. Kampala region had the highest number of injuries and deaths (18.3% (117,950/645,805) and 22.6% (634/2807)) respectively whereas Karamoja had the lowest injuries and deaths (1.7% (10,823/645,805) and 0.8% (21/2807)) respectively. Children aged 0-4 years accounted for 21.9% (615/2807) deaths; mostly females 81% (498/615) were affected. Conclusion Road traffic injuries increased during 2011-2014. Injuries and deaths were highest in Kampala and lowest in Karamoja region. It was noted that health facilities mostly received serious injuries. It is likely that the burden is higher but under reported. Concerted efforts are needed to increase road safety campaigns in Kampala and surrounding regions and to link pre-hospital deaths so as to understand the burden of road traffic crashes and recommend appropriate interventions.
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Affiliation(s)
- Frederick Oporia
- Department of Disease Control and Environmental Health, Makerere University School of Public Health, Kampala, Uganda
| | - Angela Nakanwagi Kisakye
- Department of Health Policy Planning and Management, Makerere University School of Public Health, Kampala Uganda.,African Field Epidemiology Network, Lugogo House Plot 42, Lugogo Bypass, Kampala, Uganda
| | - Rebecca Nuwematsiko
- Department of Disease Control and Environmental Health, Makerere University School of Public Health, Kampala, Uganda
| | - Abdulgafoor Mahmood Bachani
- Department of International Health and Johns Hopkins International Injury Research Unit, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - John Bosco Isunju
- Department of Disease Control and Environmental Health, Makerere University School of Public Health, Kampala, Uganda
| | - Abdullah Ali Halage
- Department of Disease Control and Environmental Health, Makerere University School of Public Health, Kampala, Uganda
| | - Zziwa Swaibu
- Department of Disease Control and Environmental Health, Makerere University School of Public Health, Kampala, Uganda
| | - Lynn Muhimbuura Atuyambe
- Department of Community Health and Behavioural Sciences, Makerere University School of Public Health, Kampala, Uganda
| | - Olive Kobusingye
- Department of Disease Control and Environmental Health, Makerere University School of Public Health, Kampala, Uganda
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Lefio Á, Bachelet VC, Jiménez-Paneque R, Gomolán P, Rivas K. A systematic review of the effectiveness of interventions to reduce motor vehicle crashes and their injuries among the general and working populations. Rev Panam Salud Publica 2018; 42:e60. [PMID: 31093088 PMCID: PMC6386148 DOI: 10.26633/rpsp.2018.60] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2017] [Accepted: 12/11/2017] [Indexed: 01/08/2023] Open
Abstract
OBJECTIVE To summarize the best available international scientific evidence on the effectiveness of interventions to reduce motor vehicle collisions and their consequences among the working and general populations. METHODS A broad and systematic review was conducted of the literature available in biomedical databases and grey literature. At least two investigators working in parallel performed data extraction, synthesis, and risk of bias analysis. RESULTS Forty-one studies with low to moderate risk of bias were included. Of these, 18 had an ecological design (time series), 10 were quasi-experimental, one was a population survey, one was a randomized clinical trial, and 11 were systematic reviews. CONCLUSIONS The interventions that most consistently show a positive effect on incidence, morbidity, and mortality due to motor vehicle collisions are national policies or programs that: regulate, enforce, and penalize driving under the influence of alcohol; improve driving safety and driver conditions; improve road infrastructure with the purpose of preventing collisions; and educate and penalize drivers with a history of road violations.
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Affiliation(s)
- Álvaro Lefio
- Escuela de Salud Pública, Universidad de Chile, Santiago, Chile
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Martin JL, Wu D. Pedestrian fatality and impact speed squared: Cloglog modeling from French national data. TRAFFIC INJURY PREVENTION 2018; 19:94-101. [PMID: 28557669 DOI: 10.1080/15389588.2017.1332408] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/12/2017] [Accepted: 05/15/2017] [Indexed: 06/07/2023]
Abstract
OBJECTIVE The present study estimates pedestrians' risk of death according to impact speed when hit by a passenger car in a frontal collision. METHODS Data were coded for all fatal crashes in France in 2011 and for a random sample of 1/20th of all road injuries for the same year and weighted to take into account police underreporting of mild injury. A cloglog model was used to optimize risk adjustment for high collision speeds. The fit of the model on the data was also improved by using the square of the impact speed, which best matches the energy dissipated in the collision. RESULTS Modeling clearly demonstrated that the risk of death was very close to 1 when impact speeds exceeded 80 km/h. For speeds less than 40 km/h, because data representative of all crashes resulting in injury were used, the estimated risk of death was fairly low. However, although the curve seemed deceptively flat below 50 km/h, the risk of death in fact rose 2-fold between 30 and 40 km/h and 6-fold between 30 and 50 km/h. For any given speed, the risk of death was much higher for more elderly subjects, especially those over 75 years of age. These results concern frontal crashes involving a passenger car. Collisions involving trucks are far less frequent, but half result in the pedestrian being run over, incurring greater mortality. CONCLUSIONS For impact speeds below 60 km/h, the shape of the curve relating probability of death to impact speed was very similar to those reported in recent rigorous studies. For higher impact speeds, the present model allows the curve to rise ever more steeply, giving a much better fit to observed data. The present results confirm that, when a pedestrian is struck by a car, impact speed is a major risk factor, thus providing a supplementary argument for strict speed limits in areas where pedestrians are highly exposed.
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Affiliation(s)
- Jean-Louis Martin
- a Univ Lyon, Université Lyon 1, IFSTTAR, UMRESTTE UMR_T 9405 , Lyon , France
| | - Dan Wu
- a Univ Lyon, Université Lyon 1, IFSTTAR, UMRESTTE UMR_T 9405 , Lyon , France
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Naznin F, Currie G, Logan D. Exploring road design factors influencing tram road safety - Melbourne tram driver focus groups. ACCIDENT; ANALYSIS AND PREVENTION 2018; 110:52-61. [PMID: 29101789 DOI: 10.1016/j.aap.2017.10.017] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/27/2017] [Revised: 10/19/2017] [Accepted: 10/19/2017] [Indexed: 06/07/2023]
Abstract
Melbourne, Australia has the largest tram/streetcar network in the world including the largest mixed traffic tram operating environment. Therefore, Melbourne tram drivers are responsible for controlling one of the heaviest vehicles on road ranging from shared tram lanes to exclusive tram lanes. In addition to different tram lane configurations, tram drivers need to follow different traffic signal phases at intersections including tram priority signals as well as need to serve passengers at various types of closely spaced tram stops. Despite all these challenges, no research has explored tram driver perceptions of the risk factors on different tram route road design configurations. Therefore, the aim of this study is to investigate how tram drivers' safety perceptions alter along various tram route sections, signal settings and stop configurations. A tram driver focus group approach was adopted for this research involving thirty tram drivers (4 female and 26 male drivers). The tram drivers' age ranged from 29 to 63 years, with an average age of 47.6 years (standard deviation of 10.1 years), and their experience of tram driving ranged from 1.17 to 31 years, with an average experience of 12.5 years (standard deviation of 10.2 years). The participating tram drivers perceived that the raised tram tracks and tramways with raised yellow curbing beside tracks are safer lane priority features on the Melbourne tram network compared to full-time, part-time and mixed traffic tram lanes. They regarded 'hook turns' as a safe form of tram signal priority treatment at intersections and platform tram stops as the safest tram stop design for all passengers among all other tram stop designs in Melbourne. Findings of this research could enhance the understanding of crash risk factors for different tram route features and thus can offer effective planning strategies for transit agencies to improve tram road safety.
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Affiliation(s)
- Farhana Naznin
- Public Transport Research Group, Institute of Transport Studies, Department of Civil Engineering, Building 60, Monash University, Clayton, Victoria 3800, Australia.
| | - Graham Currie
- Public Transport Research Group, Institute of Transport Studies, Department of Civil Engineering, Building 60, Monash University, Clayton, Victoria 3800, Australia.
| | - David Logan
- Monash University Accident Research Centre, Building 70, Monash University, Clayton, Victoria 3800, Australia.
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Pirini F, Rodriguez-Torres S, Ayandibu BG, Orera-Clemente M, Gonzalez-de la Vega A, Lawson F, Thorpe RJ, Sidransky D, Guerrero-Preston R. INSIG2 rs7566605 single nucleotide variant and global DNA methylation index levels are associated with weight loss in a personalized weight reduction program. Mol Med Rep 2017; 17:1699-1709. [PMID: 29138870 PMCID: PMC5780113 DOI: 10.3892/mmr.2017.8039] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2017] [Accepted: 08/17/2017] [Indexed: 12/27/2022] Open
Abstract
Single nucleotide polymorphisms associated with lipid metabolism and energy balance are implicated in the weight loss response caused by nutritional interventions. Diet-induced weight loss is also associated with differential global DNA methylation. DNA methylation has been proposed as a predictive biomarker for weight loss response. Personalized biomarkers for successful weight loss may inform clinical decisions when deciding between behavioral and surgical weight loss interventions. The aim of the present study was to investigate the association between global DNA methylation, genetic variants associated with energy balance and lipid metabolism, and weight loss following a non-surgical weight loss regimen. The present study included 105 obese participants that were enrolled in a personalized weight loss program based on their allelic composition of the following five energy balance and lipid metabolism-associated loci: Near insulin-induced gene 2 (INSIG2); melanocortin 4 receptor; adrenoceptor β2; apolipoprotein A5; and G-protein subunit β3. The present study investigated the association between a global DNA methylation index (GDMI), the allelic composition of the five energy balance and lipid metabolism-associated loci, and weight loss during a 12 month program, after controlling for age, sex and body mass index (BMI). The results demonstrated a significant association between the GDMI and near INSIG2 locus, after adjusting for BMI and weight loss, and significant trends were observed when stratifying by gender. In conclusion, a combination of genetic and epigenetic biomarkers may be used to design personalized weight loss interventions, enabling adherence and ensuring improved outcomes for obesity treatment programs. Precision weight loss programs designed based on molecular information may enable the creation of personalized interventions for patients, that use genomic biomarkers for treatment design and for treatment adherence monitoring, thus improving response to treatment.
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Affiliation(s)
- Francesca Pirini
- Biosciences Laboratory, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, I‑47014 Meldola, Italy
| | | | - Bola Grace Ayandibu
- Department of Otolaryngology, School of Medicine, Johns Hopkins University, Baltimore, MD 21231, USA
| | - María Orera-Clemente
- Genetic Laboratory, University General Hospital Gregorio Marañón, 28007 Madrid, Spain
| | | | - Fahcina Lawson
- Department of Otolaryngology, School of Medicine, Johns Hopkins University, Baltimore, MD 21231, USA
| | - Roland J Thorpe
- Johns Hopkins University Centre for Health Disparities Solutions, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA
| | - David Sidransky
- Department of Otolaryngology, School of Medicine, Johns Hopkins University, Baltimore, MD 21231, USA
| | - Rafael Guerrero-Preston
- Department of Otolaryngology, School of Medicine, Johns Hopkins University, Baltimore, MD 21231, USA
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10
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Rothman L, Cloutier MS, Macpherson AK, Richmond SA, Howard AW. Spatial distribution of pedestrian-motor vehicle collisions before and after pedestrian countdown signal installation in Toronto, Canada. Inj Prev 2017; 25:110-115. [PMID: 28988199 DOI: 10.1136/injuryprev-2017-042378] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2017] [Revised: 09/15/2017] [Accepted: 09/18/2017] [Indexed: 11/03/2022]
Abstract
BACKGROUND Pedestrian countdown signals (PCS) have been installed in many cities over the last 15 years. Few studies have evaluated the effectiveness of PCS on pedestrian motor vehicle collisions (PMVC). This exploratory study compared the spatial patterns of collisions pre and post PCS installation at PCS intersections and intersections or roadways without PCS in Toronto, and examined differences by age. METHODS PCS were installed at the majority of Toronto intersections from 2007 to 2009. Spatial patterns were compared between 4 years of police-reported PMVC prior to PCS installation to 4 years post installation at 1864 intersections. The spatial distribution of PMVC was estimated using kernel density estimates and simple point patterns examined changes in spatial patterns overall and stratified by age. Areas of higher or lower point density pre to post installation were identified. RESULTS There were 14 911 PMVC included in the analysis. There was an overall reduction in PMVC post PCS installation at both PCS locations and non-PCS locations, with a greater reduction at non-PCS locations (22% vs 1%). There was an increase in PMVC involving adults (5%) and older adults (9%) at PCS locations after installation, with increased adult PMVC concentrated downtown, and older adult increases occurring throughout the city following no spatial pattern. There was a reduction in children's PMVC at both PCS and non-PCS locations, with greater reductions at non-PCS locations (35% vs 48%). CONCLUSIONS Results suggest that the effects of PCS on PMVC may vary by age and location, illustrating the usefulness of exploratory spatial data analysis approaches in road safety. The age and location effects need to be understood in order to consistently improve pedestrian mobility and safety using PCS.
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Affiliation(s)
- Linda Rothman
- Child Health Evaluative Science, Hospital for Sick Children, Toronto, Ontario, Canada.,Faculty of Health-School of Kinesiology & Health Science, York University, Norman Bethune College, Toronto, Ontario, Canada
| | - Marie-Soleil Cloutier
- Centre Urbanisation Culture Société, Institut National de la Recherche Scientifique, Montreal, Quebec, Canada
| | - Alison K Macpherson
- Faculty of Health-School of Kinesiology & Health Science, York University, Norman Bethune College, Toronto, Ontario, Canada
| | - Sarah A Richmond
- Faculty of Health-School of Kinesiology & Health Science, York University, Norman Bethune College, Toronto, Ontario, Canada
| | - Andrew William Howard
- Child Health Evaluative Science, Hospital for Sick Children, Toronto, Ontario, Canada
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Naznin F, Currie G, Logan D. Exploring the impacts of factors contributing to tram-involved serious injury crashes on Melbourne tram routes. ACCIDENT; ANALYSIS AND PREVENTION 2016; 94:238-244. [PMID: 27352035 DOI: 10.1016/j.aap.2016.06.008] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/29/2016] [Revised: 06/10/2016] [Accepted: 06/14/2016] [Indexed: 06/06/2023]
Abstract
Previous research is limited regarding factors influencing tram-involved serious injury crashes. The aim of this study is to identify key vehicle, road, environment and driver related factors associated with tram-involved serious injury crashes. Using a binary logistic regression modelling approach, the following factors were identified to be significant in influencing tram-involved fatal crashes in Melbourne: tram floor height, tram age, season, traffic volume, tram lane priority and tram travel speed. Low floor trams, older trams, tram priority lanes and higher tram travelling speeds are more likely to increase tram-involved fatal crashes. Higher traffic volume decreases the likelihood of serious crashes. Fatal crashes are more likely to occur during spring and summer. Findings from this study may offer ideas for future research in the area of tram safety and help to develop countermeasures to prevent specific fatality types from occurring.
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Affiliation(s)
- Farhana Naznin
- Public Transport Research Group, Institute of Transport Studies, Department of Civil Engineering, Building 60, Monash University, Clayton, Victoria 3800, Australia.
| | - Graham Currie
- Public Transport Research Group, Institute of Transport Studies, Department of Civil Engineering, Building 60, Monash University, Clayton, Victoria 3800, Australia.
| | - David Logan
- Monash University Accident Research Centre, Building 70, Monash University, Clayton, Victoria 3800, Australia.
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Naznin F, Currie G, Logan D, Sarvi M. Application of a random effects negative binomial model to examine tram-involved crash frequency on route sections in Melbourne, Australia. ACCIDENT; ANALYSIS AND PREVENTION 2016; 92:15-21. [PMID: 27035395 DOI: 10.1016/j.aap.2016.03.012] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/30/2015] [Revised: 03/14/2016] [Accepted: 03/15/2016] [Indexed: 06/05/2023]
Abstract
Safety is a key concern in the design, operation and development of light rail systems including trams or streetcars as they impose crash risks on road users in terms of crash frequency and severity. The aim of this study is to identify key traffic, transit and route factors that influence tram-involved crash frequencies along tram route sections in Melbourne. A random effects negative binomial (RENB) regression model was developed to analyze crash frequency data obtained from Yarra Trams, the tram operator in Melbourne. The RENB modelling approach can account for spatial and temporal variations within observation groups in panel count data structures by assuming that group specific effects are randomly distributed across locations. The results identify many significant factors effecting tram-involved crash frequency including tram service frequency (2.71), tram stop spacing (-0.42), tram route section length (0.31), tram signal priority (-0.25), general traffic volume (0.18), tram lane priority (-0.15) and ratio of platform tram stops (-0.09). Findings provide useful insights on route section level tram-involved crashes in an urban tram or streetcar operating environment. The method described represents a useful planning tool for transit agencies hoping to improve safety performance.
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Affiliation(s)
- Farhana Naznin
- Institute of Transport Studies, Department of Civil Engineering, Building 60, Monash University, Clayton, Victoria 3800, Australia.
| | - Graham Currie
- Institute of Transport Studies, Department of Civil Engineering, Building 60, Monash University, Clayton, Victoria 3800, Australia.
| | - David Logan
- Monash University Accident Research Centre, Building 70, Monash University, Clayton, Victoria 3800, Australia.
| | - Majid Sarvi
- Department of Infrastructure Engineering, The University of Melbourne, Australia.
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Naznin F, Currie G, Logan D, Sarvi M. Safety impacts of platform tram stops on pedestrians in mixed traffic operation: A comparison group before-after crash study. ACCIDENT; ANALYSIS AND PREVENTION 2016; 86:1-8. [PMID: 26476596 DOI: 10.1016/j.aap.2015.10.007] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/25/2015] [Revised: 10/05/2015] [Accepted: 10/07/2015] [Indexed: 06/05/2023]
Abstract
Tram stops in mixed traffic environments present a variety of safety, accessibility and transport efficiency challenges. In Melbourne, Australia the hundred year-old electric tram system is progressively being modernized to improve passenger accessibility. Platform stops, incorporating raised platforms for level entry into low floor trams, are being retro-fitted system-wide to replace older design stops. The aim of this study was to investigate the safety impacts of platform stops over older design stops (i.e. Melbourne safety zone tram stops) on pedestrians in the context of mixed traffic tram operation in Melbourne, using an advanced before-after crash analysis approach, the comparison group (CG) method. The CG method evaluates safety impacts by taking into account the general trends in safety and the unobserved factors at treatment and comparison sites that can alter the outcomes of a simple before-after analysis. The results showed that pedestrian-involved all injury crashes reduced by 43% after platform stop installation. This paper also explores a concern that the conventional CG method might underestimate safety impacts as a result of large differences in passenger stop use between treatment and comparison sites, suggesting differences in crash risk exposure. To adjust for this, a modified analysis explored crash rates (crash counts per 10,000 stop passengers) for each site. The adjusted results suggested greater reductions in pedestrian-involved crashes after platform stop installation: an 81% reduction in pedestrian-involved all injury crashes and 86% reduction in pedestrian-involved FSI crashes, both are significant at the 95% level. Overall, the results suggest that platform stops have considerable safety benefits for pedestrians. Implications for policy and areas for future research are explored.
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Affiliation(s)
- Farhana Naznin
- Institute of Transport Studies, Department of Civil Engineering, Monash University, Building 60, Clayton, Victoria 3800, Australia.
| | - Graham Currie
- Institute of Transport Studies, Department of Civil Engineering, Monash University, Building 60, Clayton, Victoria 3800, Australia.
| | - David Logan
- Monash University Accident Research Centre, Monash University, Building 70, Clayton, Victoria 3800, Australia.
| | - Majid Sarvi
- Institute of Transport Studies, Department of Civil Engineering, Monash University, Building 60, Clayton, Victoria 3800, Australia.
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Naznin F, Currie G, Sarvi M, Logan D. An empirical Bayes safety evaluation of tram/streetcar signal and lane priority measures in Melbourne. TRAFFIC INJURY PREVENTION 2015; 17:91-97. [PMID: 25837409 DOI: 10.1080/15389588.2015.1035369] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
OBJECTIVE Streetcars/tram systems are growing worldwide, and many are given priority to increase speed and reliability performance in mixed traffic conditions. Research related to the road safety impact of tram priority is limited. This study explores the road safety impacts of tram priority measures including lane and intersection/signal priority measures. METHOD A before-after crash study was conducted using the empirical Bayes (EB) method to provide more accurate crash impact estimates by accounting for wider crash trends and regression to the mean effects. Before-after crash data for 29 intersections with tram signal priority and 23 arterials with tram lane priority in Melbourne, Australia, were analyzed to evaluate the road safety impact of tram priority. RESULTS The EB before-after analysis results indicated a statistically significant adjusted crash reduction rate of 16.4% after implementation of tram priority measures. Signal priority measures were found to reduce crashes by 13.9% and lane priority by 19.4%. A disaggregate level simple before-after analysis indicated reductions in total and serious crashes as well as vehicle-, pedestrian-, and motorcycle-involved crashes. In addition, reductions in on-path crashes, pedestrian-involved crashes, and collisions among vehicles moving in the same and opposite directions and all other specific crash types were found after tram priority implementation. CONCLUSIONS Results suggest that streetcar/tram priority measures result in safety benefits for all road users, including vehicles, pedestrians, and cyclists. Policy implications and areas for future research are discussed.
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Affiliation(s)
- Farhana Naznin
- a Institute of Transport Studies , Department of Civil Engineering , Monash University , Clayton , Victoria , Australia
| | - Graham Currie
- a Institute of Transport Studies , Department of Civil Engineering , Monash University , Clayton , Victoria , Australia
| | - Majid Sarvi
- a Institute of Transport Studies , Department of Civil Engineering , Monash University , Clayton , Victoria , Australia
| | - David Logan
- b Monash University Accident Research Centre , Monash University , Clayton , Victoria , Australia
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