Introducing Johannesburg's new cycle lanes to potential student users: experiences, impact and recommendations.

Objective: The present study evaluated an intervention designed to introduce University students as potential users of Johannesburg's cycle lanes. Participants: A total of 393 undergraduate and postgraduate students from the University of Johannesburg took part. Methods: Following cycling and safety training, participants undertook a 1.2 km supervised cycle ride between University of Johannesburg campuses using loaned bicycles. The evaluation of the intervention drew on quantitative and qualitative data collected using participant questionnaires; and fieldworkers' photographic and reflective accounts. Results: Perceived cycling competency improved following the intervention, though similar proportions of participants became more and less interested in bicycle ownership (7-8%). The physical effort entailed; and flaws in the design and maintenance of cycle lanes (that affected utility and safety) were the strongest themes emerging from the qualitative analyses. Conclusions: The supervised cycle rides improved perceived cycling competency, but also enabled participants to reappraise the potential benefits and desirability of bicycle ownership.

How might bicycle ownership/access and cycling expertise influence the design of cycling promotion interventions at the University of Johannesburg?

Objective: The present study examined potential barriers to cycle-based transport amongst undergraduate students, to inform the design of future cycling promotion interventions at the University of Johannesburg (UJ). Participants: A total of 606 first, second and third year UJ undergraduates took part. Methods: Sociodemographic and economic determinants of bicycle/car ownership, cycling competency and behavior were evaluated using data derived from a 9-item questionnaire, before and after adjustment for measured confounders. Results: While 70% of respondents knew how to cycle, only 26% owned/had access to a bicycle, and only 18% had last cycled for transport. Bicycle ownership and competency were far commoner amongst male and older participants, and those whose parents had the means to own a car. Conclusions: Interventions to promote cycle-based transport must address the many (predominantly female) students who: have limited cycling competency; do not own/have access to a bicycle; or have little/no experience of cycling for transport.

Johannesburg's 'poor housing, good health' paradox: the role of health status assessment, statistical modelling, residential context and migrant status.

OBJECTIVES: The 'poor housing, good health' paradox observed by De Wet et al. (2011) across eight of Johannesburg's poorest Wards (neighbourhoods), was re-examined using: a more generic measure of self-reported health; better-specified adjustment for measured confounders; household data from a range of Wards and income strata across Johannesburg and Gauteng; and adjustment for migrant status. STUDY DESIGN: The present study examined the relationship between (formal vs. informal) housing and self-reported health (-limited work and/or social activities) across four subsamples of respondents to the 2013 Quality of Life survey undertaken by the Gauteng City Regional Observatory: n = 1494 from households in the eight Wards examined by De Wet et al. (2011); n = 3059 from households with the lowest income tertile in Johannesburg; n = 8263 from households throughout Johannesburg; and n = 24,727 from households throughout Gauteng Province, irrespective of Ward or income. METHODS: The relationship between housing and self-reported health in each of these subsamples was examined before and after adjustment for measured confounders identified using a temporally determined causal path diagram in the form of a directed acyclic graph. RESULTS: Following adjustment for measured confounders, 'informal housing' was only associated with 'good' self-reported health in Johannesburg's poorest Wards (odds ratio [OR]: 1.39; 95% confidence interval [CI]: 1.07, 1.79) and Johannesburg as a whole (OR: 1.15; 95%CI: 1.00, 1.31). These associations were substantially attenuated following adjustment for migrant status (OR: 1.26; 95%CI: 0.97, 1.65; OR: 1.07; 95%CI: 0.93, 1.22, respectively). CONCLUSIONS: While the present study found that Johannesburg's 'poor housing, good health' paradox was still evident when using a more generic/subjective (self-reported) measure of health, the apparent paradox appears to reflect, at least in part: the differential aggregation of migrant-headed households in Johannesburg neighbourhoods exhibiting a high concentration of informal housing; and the likely impact of the health-related selection on the health of migrant-headed households.

The impact of the Occupation of Guernsey 1940-1945 on breast cancer risk factors and incidence.

To examine the impact of the German Occupation of Guernsey (1940-1945) on breast cancer risk factors and incidence. Under study were 1019 women who stayed, or whose mothers had stayed, in Guernsey, and 1358 women evacuated or born to evacuated mothers. Amongst those born 1926-1934 who remained in Guernsey, the secular trend of earlier menarche disappeared: menarche was delayed by 12 months for those born in 1930. By March 2006, 97 breast cancers had been diagnosed, 37 in the occupied group. Unusually, higher age at menarche appeared to be associated with increased risk of breast cancer (>or=14 years vs.

Patients' experiences of care provided by emergency care practitioners and traditional ambulance practitioners: a survey from the London Ambulance Service.

Patients' experiences after receiving care from emergency care practitioners (ECPs) were compared with those after receiving care from traditional ambulance practitioners using a postal questionnaire distributed to 1658 patients in London; 888 responses were received. The responses of patients receiving care from both groups were similar and largely positive. But in two areas ("thoroughness of assessment" and "explaining what would happen next"), the care provided by ECPs was experienced as considerably better. These differences were partly explained by considerably fewer patients from ECPs being conveyed to the emergency department, suggesting that empowering ECPs to explore and explain alternatives to the emergency department improves patient satisfaction.

What is the effect of adjusting for more than one measure of current body size on the relation between birthweight and blood pressure?

The statistical validity of the negative associations observed between birthweight and disease in later life has recently been questioned, because these associations might be due, in part, to inappropriate adjustment for current body size, creating a statistical artefact known as the 'reversal paradox'. The aim of this study was to explore the effect of adjusting for more than one measure of current body size on the association between birthweight and disease in later life using simulations and meta-analyses of empirical studies. The simulations examined the relation between birthweight and adult systolic blood pressure before and after adjusting for one, two or three measures of current body size by including current weight and subsequently adding body mass index and height in successive analytical models. Meta-analyses were then performed to compare the effect sizes observed among empirical studies reporting associations between birthweight and blood pressure before and after adjusting for one or two measures of current body size. The meta-analyses confirmed the results of the simulations - both showed that associations between birthweight and blood pressure tend to become increasingly negative following adjustment for current body size, and that this effect is enhanced after adjusting for additional measures of current body size.