Land-use and transport policies contribute to worldwide epidemics of injuries and non-communicable diseases through traffic exposure, noise, air pollution, social isolation, low physical activity, and sedentary behaviours. Motorised transport is a major cause of the greenhouse gas emissions that are threatening human health. Urban and transport planning and urban design policies in many cities do not reflect the accumulating evidence that, if policies would take health effects into account, they could benefit a wide range of common health problems. Enhanced research translation to increase the influence of health research on urban and transport planning decisions could address many global health problems. This paper illustrates the potential for such change by presenting conceptual models and case studies of research translation applied to urban and transport planning and urban design. The primary recommendation of this paper is for cities to actively pursue compact and mixed-use urban designs that encourage a transport modal shift away from private motor vehicles towards walking, cycling, and public transport. This Series concludes by urging a systematic approach to city design to enhance health and sustainability through active transport and a move towards new urban mobility. Such an approach promises to be a powerful strategy for improvements in population health on a permanent basis.
The methodological issues surrounding the use of a privileged access interviewer team to generate a network sample of drug users are examined. Traditionally network samples have tended to be used by qualitative researchers. Privileged access interviewing provides a mechanism for the application of a structured instrument to a network sampling model. In doing so some problematic issues in this area for structured methodology are overcome, reduced or standardized. The use of this method is appraised in terms of meeting the methodological requirements of the Drug Transitions study. The practical experiences of our group in using a privileged access interviewer team to interview more than 400 heroin users, many of whom were not in contact with treatment services, are discussed. This method is most appropriate for the quick collection of data, from diverse networks of drug users, by use of a structured instrument. Success is likely to be dependent on careful implementation. The ongoing monitoring of data quality is of particular importance, as is good management practice and the establishment of supportive and non exploitative relationships with the interviewer team.
SUMMARY A regional population‐based survey identified six patients with pyridoxine dependency. Four presented on the first day of life and the other two at 1 and 8 months of age. Apart from multiple seizure types, other presenting features included jitteriness; encephalopathy, at first thought to be hypoxic‐ischaemic; hepatomegaly, and abdominal distension with bilious vomiting. Later problems included break‐through fits with fever; transient visual agnosia; squint; severe articulatory apraxia; motor delay with later dyspraxia; macrocephaly. and post‐haemorrhagic hydrocephalus. Magnetic resonance imaging showed variable structural abnormalities in all the early onset cases. Psychometric assessment revealed a stereotyped pattern of intelligence scale subtest scores, with a specific impairment of expressive verbal ability. In a prospective open study over one year, an.‐ increased dose of pyridoxine was associated with an improvement in IQ, particularly in performance subtests. Pyridoxine dependency is more common than has been thought. It has a wider range of clinical features than the classical neonatal seizures and causes specific impairments of higher function, some of which may be reversible. The dosage of pyridoxine should be optimal for IQ as well as seizure control. RÉSUMÉ Comitialité pyridoxine‐dépendaiite Caractéristiques déinograpliiques, cliniques. IRM et psychométriques. Effet de dose sur le Ql Une étude de population régionale identifia six patients pyridoxine‐dépendants. Quatre cas se révélèrent le jour de la naissance, et les deux autres à I et 8 mois d'âge. En dehors d'une comitialité d'aspect variable, les autres caractéristiques présentes incluaicnt le sautillement permanent; une encéphalopathie rattachée initialement a une origine hypoxique‐ischémique; une hépatomégalie, et une distension abdominalc et vomisserrients biljaires. Les problèmes ultérieurs incluaienl des crises hyperthermiques soudaines; une agnosie visuelle transitoire; un strabisme; une apraxic articulatoire sévère; un retard motcur avec dyspraxic ultérieure; unc macrocéphalie, et une hydrocéphalic post‐hémorragique. L'imageric de résonance magnétique révélait des anomalies structurales variables dans tous les cas à début précoce. L'évaluation psychométrique révélait un groupement stéréotypé des scores aux subtests d'échellc d'intelligence, avec un trouble spécifique de l'aptitudc a l'expression verbale. Lors d'une etude prospective ouvertc sur un an. une dose accrue de pyridoxine se traduisit par un progrès du Ql, particulièrement dans les subtests de performance. La dépéndance à la pyridoxine est plus fréquente qu'il n'a été pense. La variété des manifestations cliniqucs déborde les classiques crises néonatales et cause des altérations spécifiques des fonctions supérieurcs, certaines étant réversibles. Le dosage de la pyridoxine doit etre maintenu optimal pour le Ql aussi bien que pour le contrôle des crises. ZUSAMMENFASSUNG Pyridoxin abháuingige Anfälle: denwgntphische, klinische. MRl bezogene ttnd psychomeirische Merkmale. Einf...
If these findings are confirmed in larger studies, educational and preventative efforts may need to acknowledge the positive personal and social functions which different substances serve for young people. The results also call into question the extent to which the experience of negative effects influences future patterns of use.
The present study looks at the association between drug and alcohol use and sexual risk behaviours in a sample of 51 women who were currently working as prostitutes and also currently using opiates and/or stimulants. Most women reported regularly using condoms with clients but a substantial minority sometimes had unprotected sex with clients. There was no overall association between any of the drug use variables (including the use of crack cocaine) and the likelihood of unprotected sex. The use of drugs appears to have affected the sexual practices of different women in different ways: a substantial minority (just under a quarter of the sample) reported that for them, drug use did reduce the chances that they would use a condom. There was a link between willingness to have unprotected sex for more money and drinking larger amounts and drinking more often. The results also indicate that these women were exposed to a variety of health risks, including sharing injecting equipment and having unprotected sex with their regular partner who was often a current or former drug injector. A sub-sample (n = 34) completed a confidential questionnaire which showed that one-third had previously had at least one sexually transmitted disease and 15% of them had been infected during the previous year. These findings about rates of STD infection raise questions about the extent to which self-reported condom use by prostitutes can be used as an indicator of actual levels of infection risk.
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