Serotonergic Markers in Atopic Dermatitis.

Stress and anxiety may worsen atopic dermatitis (AD) through the serotonin system. Serotonergic expression was measured in 28 patients with AD in relation to extent of the disease (SCORing of Atopic Dermatitis; SCORAD), pruritus intensity (visual analogue scale; VAS), anxiety traits (Swedish Universities Scales of Personality; SSP) and depression (Montgomery-Åsberg Depression Rating Scale-Self assessment; MADRS-S). Biopsies were taken from lesional and non-lesional AD skin, and investigated for expression of serotonin, its receptors 5-HT1A and 5-HT2, and serotonin transporter protein (SERT), using immunohistochemistry. 5-HT1AR-immunoreactivity (ir) was higher in lesional skin in apical epidermis and in mast cell-like cells in dermis, and 5-HT2AR-ir in apical epidermis and on blood vessels. In contrast, a basement membrane 5-HT2AR-ir signal was higher in non-lesional skin. The distribution of SERT-ir in the basal epidermal layer was higher in lesional skin. Positive and negative correlations were found between serotonergic markers and SCORAD, inflammation, pruritus intensity, anxiety traits, and depression score, indicating that serotonergic mechanisms are involved in AD.

A sustainable city environment through child safety and mobility-a challenge based on ITS?

Our cities should be designed to accommodate everybody, including children. We will not move toward a more sustainable society unless we accept that children are people with transportation needs, and 'bussing' them around, or providing parental limousine services at all times, will not lead to sustainability. Rather, we will need to make our cities walkable for children, at least those above a certain age. Safety has two main aspects, traffic safety and personal safety (risk of assault). Besides being safe, children will also need an urban environment with reasonable mobility, where they themselves can reach destinations with reasonable effort; else they will still need to be driven. This paper presents the results of two expert questionnaires focusing on the potential safety and mobility benefits to child pedestrians of targeted types of intelligent transportation systems (ITS). Five different types of functional requests for children were identified based on previous work. The first expert questionnaire was structured to collect expert opinions on which ITS solutions or devices would be, and why, the most relevant ones to satisfy the five different functional requests of child pedestrians. Based on the first questionnaire, fifteen problem areas were defined. In the second questionnaire, the experts ranked the fifteen areas, and prioritized related ITS services, according to their potential for developing ITS services beneficial to children. Several ITS systems for improving pedestrian quality are discussed. ITS services can be used when a pedestrian route takes them to a dangerous street, dangerous crossing point or through a dangerous neighborhood. An improvement of safety and other qualities would lead to increased mobility and a more sustainable way of living. Children would learn how to live to support their own health and a sustainable city environment. But it will be up to national, regional and local governments, through their ministries and agencies and public works departments, to promote, fund, and possibly mandate such systems. It is clear that we need to offer an acceptable level of convenience, efficiency, comfort, safety and security to pedestrians but it is less clear if society will prioritize resources toward this.

Distance between speed humps and pedestrian crossings: does it matter?

Speed humps are a common physical measure installed at pedestrian crossings to reduce vehicle speeds therefore improve the safety and mobility of pedestrians at the crossing. The aim of this study was to determine whether variations in distance between speed humps and pedestrian crossings contribute differently to the safety and mobility of pedestrians and cyclists, especially children and the elderly, and if so, how. Three sites in Sweden were studied, where vehicle speed measurements and video filming at the site resulted in manually coded, road user behaviour of 1972 pedestrians and cyclists. Road user behaviour at three test sites and two comparison sites equipped with speed cushion at distances of about 5m and 10 m from the pedestrian crossing, i.e. about one or two car lengths, were studied. As vehicle speeds were somewhat lower at the pedestrian crossing when the distance between the speed cushion to the pedestrian crossing was greater, and there were positive aspects regarding the mobility of the pedestrians and cyclists, a greater distance of about 10 m or two car lengths between the hump and the pedestrian crossing is suggested. The present study only covers speed cushions, but the same distance is also regarded as important when installing other types of physical measures to reduce vehicle speed.

Pedestrians in wintertime-effects of using anti-slip devices.

Pedestrians slipping and falling is a major safety problem around the world, not least in countries with long winters such as Sweden. About 25000-30000 people need medical care every year for treatment of fall injuries in Sweden. Use of appropriate shoes and anti-slip devices are examples of individual measures that have been suggested to prevent slipping and falling. An intervention study was performed during the period February to April 2008. The study, which focused on healthy adults in northern Sweden, examined the effect of using anti-slip devices on daily walking journeys and prevention of slip and falls. The respondents were divided into three groups: an Intervention Group, a Control Group, with similar distribution of gender and age, and a Comparison Group. Four questionnaires were distributed: (1) background, (2) daily diary of distance walked and occurrence of incidents or accidents reported weekly, (3) detailed incident or fall report and (4) experiences of using anti-slip devices for those who used these devices during the trial period. Half of the respondents stated that they had previous experience of using anti-slip devices. In this study, 52% of the respondents used anti-slip devices. Anti-slip devices improve the walking capability during wintertime. Among those using appropriate anti-slip devices, the average daily walking distance was found to be statistically significantly longer compared to people not using anti-slip devices. This study indicates that an increase in daily walking distance can be made without increasing the risk of slips/falls when using anti-slip devices. The study also indicates that by using appropriate anti-slip devices and having information about when and where to use them, based on their design, people avoid having slips and falls. The respondents experienced in using anti-slip devices in this study will continue to use them and will also recommend others to use anti-slip devises.

The role of optical coherence tomography in the detection of pituitary adenoma.

PURPOSE: To analyse retinal nerve fibre layer (RNFL) thickness in eyes with compression of the optic chiasm by a pituitary adenoma. RNFL thickness was analysed with optical coherence tomography (OCT) and compared to visual field measurements using high-pass resolution perimetry (HRP). METHODS: Sixteen eyes from eight patients with pituitary adenoma were studied. All had bitemporal visual field depression caused by compression of the optic chiasm. Patients were submitted to an ophthalmic examination more than 14 months after surgery (seven patients had undergone trans-sphenoidal and one trans-cranial adenomectomy). The examination included HRP, fundus photography and measurement of the peripapillar RNFL thickness using OCT. RESULTS: In spite of temporal visual field depression, not all eyes showed reduced RNFL thickness by OCT. This was also true for some eyes in which RNFL was judged to be reduced on fundus photographs. Contrary to our expectations, RNFL thickness in the nasal quadrant was normal in nine of the 16 eyes. Corresponding figures for the superior, inferior and temporal quadrants were eight, six and five, respectively. The overall RNFL thickness, as measured by OCT, did not correlate well with neural capacity, which is an index of remaining retino-cortical neural channels in HRP. CONCLUSION: RNFL thickness as measured with OCT was reduced in most, but not all, eyes with temporal field depression caused by chiasmal compression. The pattern of RNFL loss did not correlate well with the visual field defect. Sensitivity of RNFL thickness measurement in OCT was low. The method has limited value in the diagnosis of pituitary tumour compression.

Short-term effects of countermeasures for improved safety and mobility at marked pedestrian crosswalks in Borås, Sweden.

The Swedish code concerning car drivers' responsibility to give way to pedestrians was strengthened in 2000. The primary aim of this study is to evaluate the short-term effects of the change in code. Another goal is to look at the effects of the reconstruction of four sites in Borås, Sweden. One site had changes made prior to the change of code, two test sites had countermeasures implemented during the study, and one comparison site was left unchanged. All the sites were chosen because schools were situated nearby. The focus of the evaluation was on children and elderly as pedestrians and cyclists. The goal of traffic calming of a 90 percentile driving speed below 30 km/h was not fulfilled at any of the test sites. A conclusion is that the height of a speed cushion is important. After the speed cushions were lowered from 70 mm to 55 mm, the 90 percentile speed increased from 34 km/h to 41 km/h. Sites with no speed cushions had much higher speeds. The design of an intersection influences road users' behavior. At the site where one crosswalk was removed, pedestrians that were using the remaining marked crosswalk were given way to less frequently than at the other sites. At intersections where most pedestrians used marked crosswalks, the children benefited the most in mobility. At the intersection where pedestrians used marked crosswalks to a lower extent after reconstruction, children and the elderly had the smallest increase in frequency of being given way to. After reconstruction to a court-yard street, the pedestrians were given way to a lower extent compared with the other sites, though the vehicle speeds were the lowest observed at this study. At the sites were no physical changes were made, the change of code improved driver yield behavior, but no more towards children than other age groups.

Safe pedestrian crossings for children and elderly.

In May 2000, the Swedish code governing the conduct of drivers at marked crosswalks became stricter with the intent to improve safety and mobility for pedestrians. A crash analysis based on a macro study of all of Sweden suggests that the injury risk in marked, not reconstructed, crosswalks increased by 27% for pedestrians and 19% for bicyclists. The reason for this may be that pedestrians get a false sense of safety with the new code. Reconstructions aiming at lowering speeds are indeed needed for the change of code to be positive. The 90-percentile speed should not exceed 30 km/h or safety will deteriorate. However, low speed by itself may not guarantee optimal safety. Safety can be further improved at sites, which already have been reconstructed to ensure low speeds. Results based on field data collected at sites close to schools in Malmö, Trollhättan and Borås in Sweden, and in-depth studies and other analyses of Finnish and Swedish police-reported crashes, suggest that safety of children and elderly is further improved at sites where visibility, orientation and clarity are sufficient. Also, marking crosswalks may increase yield rates (expected improvement 6%) towards pedestrians; and speed cushions situated at a longer distance from the marked crosswalk increase yield rates towards pedestrians and cyclists compared to speed cushions closer by.