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Environmental risk factors for railway suicide: a nationwide analysis of England's mainline network (2019-2021)
Get PDFObjective
Suicide is the leading cause of death on the railway networks, yet little is known about the geography and socio-environmental determinants of such deaths in England.
Method
We analyzed official records of all suspected suicides recorded on England’s mainline railway from April 2019 to March 2021 (N = 436), alongside area-level data (e.g., deprivation and urbanicity) and railway characteristics (e.g., station size). We used SaTScan’s Poisson discrete scan statistic to detect spatial–temporal clusters and compared suicides at station and non-station locations, including stations with no recorded suicides over the study period.
Results
Most railway suicides—particularly those occurring at stations—took place in urban areas, typically at locations with a very low incidence of previous suicides. A large majority (84.5%) lived within 2 miles of a station and died close to home (median 2.1 miles) or their last known location (1.5 miles). Suicides occurred most often at stations (43.3%), followed by trackside locations (37.6%), foot/level crossing (15.1%) or other rail areas (3.9%). These were often not the nearest station to the deceased (59.6%), but were generally smaller and more likely to be served by fast/non-stopping trains. Across the network, stations without suicides were far less likely to be served by such trains (66% vs. 94.3%; OR = 6.62, 95% CI 3.33–13.18).
Conclusions
Urbanicity and the availability of non-stopping train services are key predictors of railway suicide. Restricting access to high-speed trains—especially at smaller urban stations and at non-station locations—could be an effective element of broader strategies and local partnership approaches to prevent suicide
When words fail: higher cooperation in the absence of communication in the prisoner's dilemma
Get PDFThe Prisoner's Dilemma has a structure that rewards bilateral trust, but carries the risk of the sucker's payoff (your opponent gets everything, you get nothing). We investigated two factors that might influence a player's cooperativeness: (1) communication between players about their intentions, and (2) trait agreeableness. In a multi-level design (10 rounds per game), participants were allocated to either a communication or non-communication condition. In the communication condition, the participants could choose one of four short statements to convey to the opponent: (1) they will cooperate, (2) cooperate if they know the opponent will cooperate, (3) they will defect, or (4) choose not to communicate. After seeing each other's message, players made their decision (cooperate or defect) with no further communication and could change their strategy. In the non-communication condition, there was zero communication between players. After the game ended, participants completed an agreeableness questionnaire. Using a Bayesian analysis, we found that cooperation was about 20 % higher in the non-communication condition. We also found dishonest communication (offering to cooperate, but then defecting) led to a breakdown in cooperation and points accumulated. We found no significant effects of agreeableness. In summary, players focused on the opponent's actions more than their words
Validity of three commercial devices for recording movement velocity in the Bulgarian split squat
Get PDFThis study aimed to assess the validity of three commercial devices in recording mean velocity (MV) and peak velocity (PV) during a unilateral resistance exercise. 18 strength-trained and healthy males performed repetitions of Bulgarian split squats at loads ranging from 40% to 90% of their one-repetition maximum. The MV and PV were simultaneously recorded by GymAware, PUSH, My Lift and compared to Vicon for all repetitions. Concurrent validity was assessed through a linear mixed model, as well as mean difference (MD), mean absolute error (MAE) and Hedge’s g effect sizes. GymAware was found to be valid in MV (MD = -0.02 to -0.01m/s, MAE = 0.02 to 0.03m/s, g = -0.08 to -0.19) and PV (MD = 0.01 to 0.05m/s, MAE = 0.05 to 0.07m/s, g = -0.06 to -0.22) recordings. Significant differences were identified between GymAware, PUSH, My Lift and Vicon for both MV (p < 0.01) and PV (p < 0.01) assessments. Moreover, when comparing the MV and PV recorded by PUSH and My Lift to Vicon, larger MD and MAE, and trivial to moderate effects were also evident. Therefore, our findings suggest that GymAware could be an alternative for recording MV and PV during unilateral resistance exercises
Soft law regulation and labour rights reporting: a deficit in moral legitimacy?
Get PDFThis paper compares and contrasts British and German transnational corporations’ (TNCs) reporting on the labour rights of workers in their global value chains (GVCs) for the years 2012 and 2018, using the Global Reporting Initiative (GRI) guidelines – an initiative that comes under the category of soft law regulation. Between these dates, regulatory changes took place in Britain and in the EU which had relevance to the reporting of labour rights issues more generally. Simultaneously the GRI reporting guidelines shifted to more flexible requirements in the transition from G3.1 to G4. This paper examines the consequences of these changes and finds that, in combination, these changes did not lead TNCs to improving the labour rights reporting. The paper suggests that even though reporting to international guidelines tends to be context-based, there was some convergence in this broadly negative outcome. This all suggests that there was an element of regulatory capture in the shifts to softer regulatory regimes. Conceptually, this points to a reduction in substantive disclosures and leads to a deficit in moral legitimacy and its displacement by more pragmatic legitimacy
Using surveillance technologies to prevent suicides in public spaces: ethical, legal, acceptable?
Get PDFSuicide is a global health problem, so understanding what types of prevention and interventions are effective in reducing suicides is essential. The potential for technologies to help reduce suicides and increase interventions in public spaces is a rapidly expanding field (e.g. closed circuit television (CCTV)) being activated when a person crosses a dangerous boundary. Yet, there is little evidence as to whether suicide surveillance technologies work in the way they are supposed to. Although surveillance in public spaces is not new, there are distinct challenges related to suicide prevention: for example, if smart surveillance identifies a person who may be suicidal, what happens next, who (if anyone) responds to them, and do potential responders have appropriate training? An added challenge is that some technologies are controversial (e.g. those that could be used to track people's movements). Hence, understanding their ethics, legality and acceptability are important. However, to date this is an under-explored topic. This position paper situates some of the ethical, legal and acceptability issues which specifically relate to the use of surveillance technologies in the field of suicide prevention
Transforming ideas into impact: the MIH approach to entrepreneurial ecosystems
No full textDiscover how the Middlesex Innovation Hub (MIH) integrates the Entrepreneurial and Engaged University Canvas by ACEEU and the Advance HE Framework for Enterprise and Entrepreneurship Education to create an entrepreneurial ecosystem. This presentation showcases MIH’s success in fostering interdisciplinary collaboration and preparing students to drive economic innovation and social impact through entrepreneurial initiatives. By aligning these frameworks, MIH empowers students to develop skills, launch startups, and contribute to economic stability and growth. Attendees will learn how to apply these frameworks to build entrepreneurial ecosystems that enhance employability, support diverse learners, and deliver societal outcomes
Developing and validating an evidence-based health promotion program for reproductive donors reflecting their challenges in the process of donation decision-making: a multi-method study protocol
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The demand for reproductive donation has increased globally. Donors face various challenges, which make decision-making difficult for them and may impact their health and quality of life. It seems that there is no ongoing, holistic healthcare program for reproductive donors in the fertility clinics. To fill this knowledge gap, the current study explores Iranian reproductive donors’ challenges in the process of donation decision-making to incorporate the findings in developing and validating a needs-based and evidence-based health promotion program.
Methods
This multi-method study will be conducted in three stages. Stage one will employ a qualitative design based on grounded theory methodology to conduct interviews with participants, including embryo, oocyte, and sperm donors, as well as other key informants such as gynecologists, urologists, midwives, psychologists, and donors’ family members, across three cities in Iran. Using purposeful and theoretical sampling, data will be collected by face-to-face, in-depth semi-structured interviews and analyzed by the constant comparison method adopted by Corbin and Strauss. Stage two will focus on planning a health promotion program, incorporating qualitative data collected in stage one into the stages of program planning. The program planning will be based on the six steps of the Public Health Ontario model. In the third stage, the program will be validated by the nominal group technique.
Discussion
The theoretical framework generated at the first stage will demonstrate reproductive donors’ concerns regarding donation decision-making, the context in which they make their decisions, the strategies they adopt to respond to their issues, and their consequences. It will demonstrate conditions that facilitate or hinder donors’ decision-making. The findings of this stage will inform the development of a health promotion program, which will be evidence-based and tailored to the needs of reproductive donors and the sociocultural context in which they undergo the donation process. This program, subject to validation by experts, could be adopted by fertility centers to enhance reproductive donors’ health and quality of life. The findings of this study can be used as a basis for further relevant research
Changes in lung volume and ventilation during apnoea of prematurity using EIT
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Central Apnoea of prematurity (AoP) is a common complication in preterm infants. AoP impact oxygenation but it is unclear what its effect is on lung volume and ventilation distribution. Electrical Impedance Tomography is a technique able to continuously and bedside monitor lung volume changes in preterm infants.
Methods
In a subset of preterm infants of the CRADL project (Continuous Regional Analysis device for neonate Lung) we extracted, using a self-developed automatic detection algorithm and followed by a hand check central AoP, EIT tracings. These EIT tracings were analysed pre-, during and post apnoea for changes in relative end expiratory lung impedance (EELI), tidal volume, breathing rate, minute volume and ventilation distribution.
Results
In 15 preterm infants, 203 apnoeas were identified and included into this study. During apnoeas a significant drop (p < 0.05) in relative EELI was seen but this restored to pre-apnoea levels, mediated by an increased median tidal volume (0.43 AU [0.34–0.57] to 0.57 AU [0.47–0.70], p < 0.05). Ventilation distribution on a regional level (right—left, anterior—posterior or centre of ventilation) showed no changes pre- and post- apnoea.
Conclusion
Central AoP results in a significant decrease in EELI but this restores to pre-apnoea levels by compensatory increased tidal volume. No changes in ventilation distribution were detected after an apnoea
Design and simulation-based testing of a mobile application for self-care management in type 2 diabetes mellitus and prediabetes
Get PDFMobile health applications are increasingly recognized as valuable tools for supporting self-care management among individuals with type 2 diabetes mellitus (T2DM) and prediabetes. This study explores the development and testing of NusaCare, a mobile app designed to assist patients through lifestyle tracking, education, and personalized interventions. Using a co-design approach, the process began with desk reviews and focus group discussions to gather initial insights. A pre-simulation phase followed, during which prototypes were tested and refined. The final prototype was evaluated in a simulation involving 61 participants, revealing that the challenges feature (70%) and food tracking (42.86%) were the most frequently used features. Post-intervention feedback highlighted the app’s usability and its potential to enhance self-care behaviors. This study emphasizes the importance of engaging users in co-design processes to develop effective mobile health interventions for managing prediabetes and T2DM
Validating nonverbal cues for assessing physician empathy in telemedicine: a Delphi study
Get PDFNonverbal communication is essential in physician–patient interaction, especially in telemedicine where verbal cues may be limited. This study aimed to identify and validate key nonverbal cues for assessing physician empathy in telemedicine consultations through a Delphi method. A three-round Delphi study was conducted from June to November 2022, involving various experts, including academics, healthcare professionals, AI/telemedicine researchers, industry professionals, and patients. Experts evaluated the importance, validity, and reliability of potential nonverbal cues. Consensus was determined based on median responses and expert scoring percentages, with statistical agreement and stability assessed using Kendall’s coefficient of concordance (Kendall’s W) and Wilcoxon signed-rank test. Analyses were conducted using SPSS, version 23.0 with significance set at p < 0.05. Of the 72 experts invited, 37 (51%) agreed to participate, with 35 completing the first round (95% completion rate). Eight significant nonverbal cues were identified in the first round, though one did not reach consensus. The second round obtained an 89% response rate (31/35), with three new cues introduced; one did not reach consensus. Round 3 achieved a 94% response rate (29/31), finalizing nine key cues: facial expression, eye contact, tone of voice, smiling, head nodding, body posture, hand gesture, distance, and environmental cues. Among these, facial expression, eye contact, and tone of voice were identified as the most crucial. Inter-expert agreement was statistically significant across all items with strong agreement on the importance (W = 0.739, p < 0.001), good agreement on their validity (W = 0.689, p < 0.001), and moderate agreement on their reliability (W = 0.452, p < 0.001). This study highlights the importance of specific nonverbal cues in telemedicine, particularly facial expression, eye contact, and tone of voice. It provides a validated foundation for developing tools to enhance physician–patient interactions and potentially improve health outcomes in telemedicine