Being able to move around in the community including using different modes of transport is a prerequisite for being able to participate in activities outside home. This can be particular challenging for people with cognitive impairments. Still, research regarding public transport for people with cognitive impairments is scarce. In this narrative review scientific literature focusing on people with cognitive impairments and their needs in public transport, was identified and summarized. All aspects in the travel chain perspective were of interest. Literature search engines Scirus, Elin and Cinahl were used during the search. Thirty-four articles were included and analyzed according to which part of the travel chain they covered in the used model. The results showed that the articles were unevenly allocated to the different parts of the model. Future studies based on real-world experiences are essential, and more user-centred approaches should be adopted. Moreover, there is a need for the development and evaluation of evidence-based rehabilitation. Finally, more research is needed to foster societal awareness of the problems and needs in the public transport of people with cognitive impairments taking the whole travel chain into consideration. Normalization Integration Freedom of choice Reliable information before/during the trip Accessible Public Transport Accessible/barrier free pedestrian environment, Proximity User Perspective High operational standards, Time Security, Safety, Trained Personnel Good design for-terminals-bus stops High vehicle standards "health" AND "public transport" AND "disability"-5 ("impairment" OR "disability" OR "handicapped") AND "transport"-39.348 "health" AND "mobility"-205,923 "health" AND "mobility behaviour"-151 "health" AND "mobility"-9083 "health" AND "mobility behaviour"-0 "health" AND "public transport" AND "disability"-8 "health" AND "mobility" 5043 "health" AND "mobility behaviour"-0

The aim of this mixed methods feasibility study was to demonstrate the acceptability, practicality, and safety of training patients who regularly use deliberate self harm (DSH) to self-administer acupuncture as an alternative coping skill for emotional distress. Ten adult patients with a diagnosis of emotionally unstable personality disorder who regularly self-harmed were recruited to the study following baseline assessment by a psychiatrist. An acupuncturist taught participants to self-acupuncture. During the 6-week intervention participants recorded their emotional distress, coping behaviors, thoughts, and feelings in a diary. Face-to-face interviews were used to explore participants' motives for DSH and their experience of acupuncture. Framework analysis was conducted on interview transcripts and diary entries to identify common themes. Mood at baseline and six weeks was measured using the BDI and changes in the use of coping behaviors and acupuncture were measured using diary entries. Subjects used acupuncture regularly through the six-week intervention and over this period there was a reduction in the frequency of DSH. Qualitative analysis identified two broad themes relating to the process and the effects of acupuncture. There was wide variation in the effects experienced by subjects which broadly mapped onto to the wide range of motives behind DSH. BDI scores showed a near significant reduction (p = 0.055) from 44.4. to 34.4 over the 6-week intervention. Patients presenting with deliberate self harm can be safely trained to self-administer acupuncture as an alternative coping skill. Acceptability and effectiveness may vary between patients depending on the complex motives underlying their self-harming behavior. While the pilot study was designed to explore the feasibility of the intervention, results from this limited sample suggest that use of self-administered acupuncture may reduce the frequency of self harming behavior and reduce emotional distress as measured using the BDI.

Cognitive tests are not linked with risk of driving accidents in older adults in any useful way.

No abstract