Showcase continued: GoWell

There is a large body of evidence showing that living in a deprived neighbourhood is associated with poor health and life chances and there is an expectation that improvement to housing and neighbourhood conditions will improve health, however there is a lack of robust evidence to inform what matters most. In 2005, and in collaboration with colleagues in the Department of Urban Studies at the University of Glasgow and the Glasgow Centre for Population Health, researchers in the Unit designed and implemented a multi-method evaluation (GoWell) to assess the effects of regeneration of a £1.2 billion programme of housing (70,000 homes) and area regeneration (15 neighbourhoods) across Glasgow at the individual, community and city-wide level including the development of an economic evaluation of this complex intervention. This longitudinal study is the largest of its kind in the world in examining how national policy goals related to communities, regeneration and health are achieved at the local level

Lack of agreement between measured and self-reported distance from public green parks in Glasgow, Scotland

<p><b>Background:</b></p> <p>Reviews have reported mixed findings for associations between physical activity and proximity to a range of environmental resources. Initially most studies used self reported proximity, but more are now using GIS techniques to measure proximity objectively. We know little about the extent of agreement between self reported and directly measured proximity of the same resource.</p> <p><b>Methods:</b></p> <p>We used previously collected data in a community survey in Glasgow in which 658 respondents aged around 40 and 60 were asked whether they lived within half a mile of a public park. We compared their answers with GIS measures of whether there was a park within a half mile service area of their home (and whether their home was within a half mile crow fly buffer of a park).</p> <p><b>Results:</b></p> <p>Agreement was poor; percentage agreement between measured network distance and reported residence within 0.5 miles of a park was 62.0%, and the kappa value was 0.095. Agreement was no higher than poor in any socio-demographic subgroup, or when using crow fly buffers instead of service areas.</p> <p><b>Conclusion:</b></p> <p>One should be cautious about assuming that respondents' self reports of proximity to a resource are a valid proxy for actual distance, or vice versa. Further research is needed to establish whether actual or self-reported proximity predict physical activity or other behaviours, and if so which is the strongest predictor. Further, qualitative study, also needs to examine the basis of people's judgements about the location of resources, and the possibility that these are shaped by their social and personal significance.</p&gt

Changes over time in population level transport satisfaction and mode of travel: a 13 year repeat cross-sectional study, UK

Aim: The aim of the study was to examine changes over time in satisfaction with usual transport mode, explore individual and area level characteristics as mediators in the likelihood of transport satisfaction, and whether any changes in transport satisfaction varied by these factors over time. Methods: Adults from West Central Scotland, United Kingdom, who participated at both waves of the repeat cross-sectional ‘Transport, Health and Well-being Study’ conducted in 1997 (n=2735) and 2010 (n=2024) were assessed. Individuals completed a detailed postal questionnaire at both time points including self-rated satisfaction with usual transport mode (using a seven point scale subsequently dichotomised to a binary outcome of satisfied (1–2) and other (3–7)). Participants reported usual transport mode for travel to various destinations. A multilevel logistic regression model was used and individuals were nested within areas (c. 4000 population). Results: At the 2010 sweep, two thirds (n=1345) of individuals were satisfied with their transport choice. Those with fair/poor health were less satisfied with their usual transport compared to those in better health (Odds Ratio (OR) 0.49, p<0.001). Access to a car was associated with overall transport satisfaction (OR 2.63, p<0.001) and the effect of deprivation on transport satisfaction was mitigated when adjusted by household car access. Transport satisfaction increased more from 1997 to 2010 for retired individuals compared to those in employment (OR 1.40, p=0.032), and for those who travelled by public transport (OR 2.39, p=0.005) and using multiple modes (OR 2.19, p<0.001) compared to those who travelled by car. Conclusions: The proportion of those who travelled using public transport, active modes or by multiple mode increased journey satisfaction over time at a greater rate than those who travelled by car, highlighting that continued efforts should be made to promote these more active transport modes which have potential to impact on health

Reuse as heuristic : from transmission to nurture in learning activity design

In recent years a combination of ever more flexible and sophisticated Web technologies and an explosion in the quantity of online content has sparked learning technologists around the world to pursue the promise of the 'reusable learning object' or RLO with the idea that RLOs could be reused in different educational contexts, thereby providing greater overall flexibility and return on investment. In 2002 the ACETS Project undertook a three-year study in the UK to investigate whether RLOs worked in practice and how the pursuit of reuse affected the teacher and their teaching. Teachers working in healthcare-related subjects in Higher and Further Education were asked to create an original learning design or activity from third-party digital resources and to reflect both on the process and its outcomes. The expectation was that teachers would be the ones selecting and reusing third-party materials. This paper describes how one of the ACETS exemplifiers reinterpreted this remit, challenged the anticipated transmissive model of learning, and instead, gave their students an opportunity to create their own original learning designs and learning activities from third-party digital resources. By describing the educational enhancements, the resulting heightened levels of critical thinking, and sensitivity to patient needs, 'reuse' will be shown to be an effective heuristic for student self-direction and professional development

To fail is human: remediating remediation in medical education.

IntroductionRemediating failing medical learners has traditionally been a craft activity responding to individual learner and remediator circumstances. Although there have been moves towards more systematic approaches to remediation (at least at the institutional level), these changes have tended to focus on due process and defensibility rather than on educational principles. As remediation practice evolves, there is a growing need for common theoretical and systems-based perspectives to guide this work.MethodsThis paper steps back from the practicalities of remediation practice to take a critical systems perspective on remediation in contemporary medical education. In doing so, the authors acknowledge the complex interactions between institutional, professional, and societal forces that are both facilitators of and barriers to effective remediation practices.ResultsThe authors propose a model that situates remediation within the contexts of society as a whole, the medical profession, and medical education institutions. They also outline a number of recommendations to constructively align remediation principles and practices, support a continuum of remediation practices, destigmatize remediation, and develop institutional communities of practice in remediation.DiscussionMedical educators must embrace a responsible and accountable systems-level approach to remediation if they are to meet their obligations to provide a safe and effective physician workforce

The validity of the Youth Physical Activity Questionnaire in 12-13 year old Scottish adolescents

Background: The development of accurate methods to measure health-behaviours forms an integral component in behavioural epidemiology. Population surveillance of physical activity often relies on self/proxy reported questionnaires due to cost and relative ease of administration. The aim of this study was to examine the criterion validity and measurement agreement between the Youth Physical Activity Questionnaire (YPAQ) and accelerometry before being included in a Scotland-wide study. Methods: Forty four participants (12–13 years old; 61% girls) completed the YPAQ following 7 days wearing the Actigraph GT3X+. Mean moderate-to-vigorous physical activity (MVPA) per day was derived from YPAQ and accelerometer and validity was assessed using Spearman's correlation; Bland-Altman plots examined absolute agreement between methods. Results: Pearson's and Spearman’s correlations between YPAQ and accelerometer were r = 0.47 and rs = 0.39 (p<0.01) respectively. The YPAQ over reported mean MVPA by 25.6 ± 50.2 minutes (95% CI 10.4-40.9 minutes; p <0.001), with 95% limits of agreement of −72.69 minutes and + 123.99 minutes. Evidence of underreporting at lower levels of activity and over reporting at higher levels of activity was evident (Pearson's r=0.81), in addition to heteroscedasticity, where variances increased as MVPA increased. Conclusions: Although a moderate correlation between the two methods was apparent, the YPAQ should not be used interchangeably with accelerometry. The YPAQ does demonstrate a reasonable ability to rank MVPA, although it tends to under-report lower levels and over-report higher levels. This, and other administering factors, should be taken into consideration if being used for group or individual level analyses

Are perceived neighbourhood problems associated with the likelihood of smoking?

<p><b>Objective:</b></p> <p>To explore associations between residents’ perceptions of the local residential environment and the likelihood of their smoking.</p> <p><b>Design:</b></p> <p>Using data (n = 2615) from the West of Scotland Twenty-07 Study, separately by gender, cross-sectional associations between respondents’ perceptions of neighbourhood (perceived absence of goods, incivilities and physical environmental problems) and the likelihood of being a current smoker and the amount smoked were examined.</p> <p><b>Results:</b></p> <p>Perceived neighbourhood problems are associated with the likelihood of smoking but mainly among those with the most negative view of the local neighbourhood. Perceptions of the provision of neighbourhood amenities seems to be more strongly associated with women’s than men’s smoking status, whereas the perceived quality of the local neighbourhood appears to be a better predictor of men’s smoking.</p> <p><b>Conclusions:</b></p> <p>Efforts to reduce smoking levels among more deprived groups may need to pay more attention to the role of local environmental conditions in influencing smoking behaviour.</p&gt

GoWell East Headline Indicators Comparison Report

This report outlines results for our GoWell East study within four separate chapters, that are focused on the Scottish Government, Commonwealth Games legacy themes: 1) Active; 2) Flourishing; 3) Sustainable; and 4) Connected. Results are presented for the longitudinal cohort analysis, wave 1-wave 2, and in addition, within the chapters focusing on the Active and Flourishing themes, data will be presented by gender and age. The findings highlight that the vast majority of people living near the Games venues in the East End continue to be supportive of the fact that Glasgow hosted the Games, and that most of those who experienced inconvenience at the time of the event thought it was worth it

Graffiti, greenery, and obesity in adults: secondary analysis of European cross sectional survey

Obesity levels are high and increasing worldwide. Being overweight is linked with increased death rates and contributes to a wide range of conditions, including ischaemic heart disease, hypertension, stroke, diabetes, certain cancers, and diseases of the gall bladder.1 The principal cause of obesity is an imbalance between energy intake and energy expenditure. And there is growing recognition that, independently of individual characteristics, place of residence may be associated with health outcomes, including body size2 and health related behaviours, such as level of physical exercise.3 Few studies have explored which features of the local neighbourhood might be related to these outcomes or behaviours, although perceived attractiveness has been found to be related to levels of physical activity.4 Levels of incivilities, such as litter and graffiti, are associated with poorer health outcomes such as general wellbeing but not, to our knowledge, with levels of physical activity. Few studies use objectively measured indicators of the residential environment or similar research instruments across different settings. Based on our previous work, we hypothesised that areas which are pleasant with lots of greenery and few incivilities might encourage people to take exercise and thereby influence levels of obesity

Evaluating a virtual learning environment in the context of its community of practice

The evaluation of virtual learning environments (VLEs) and similar applications has, to date, largely consisted of checklists of system features, phenomenological studies or measures of specific forms of educational efficacy. Although these approaches offer some value, they are unable to capture the complex and holistic nature of a group of individuals using a common system to support the wide range of activities that make up a course or programme of study over time. This paper employs Wenger's theories of 'communities of practice' to provide a formal structure for looking at how a VLE supports a pre-existing course community. Wenger proposes a Learning Architecture Framework for a learning community of practice, which the authors have taken to provide an evaluation framework. This approach is complementary to both the holistic and complex natures of course environments, in that particular VLE affordances are less important than the activities of the course community in respect of the system. Thus, the VLE's efficacy in its context of use is the prime area of investigation rather than a reductionist analysis of its tools and components. An example of this approach in use is presented, evaluating the VLE that supports the undergraduate medical course at the University of Edinburgh. The paper provides a theoretical grounding, derives an evaluation instrument, analyses the efficacy and validity of the instrument in practice and draws conclusions as to how and where it may best be used