The Fort Collins commuter study: Variability in personal exposure to air pollutants by microenvironment.

This study investigated the role of microenvironment on personal exposures to black carbon (BC), fine particulate mass (PM2.5 ), carbon monoxide (CO), and particle number concentration (PNC) among adult residents of Fort Collins, Colorado, USA. Forty-four participants carried a backpack containing personal monitoring instruments for eight nonconsecutive 24-hour periods. Exposures were apportioned into five microenvironments: Home, Work, Transit, Eateries, and Other. Personal exposures exhibited wide heterogeneity that was dominated by within-person variability (both day-to-day and between microenvironment variability). Linear mixed-effects models were used to compare mean personal exposures in each microenvironment, while accounting for possible within-person correlation. Mean personal exposures during Transit and at Eateries tended to be higher than exposures at Home, where participants spent the majority of their time. Compared to Home, mean exposures to BC in Transit were, on average, 129% [95% confidence interval: 101% 162%] higher and exposures to PNC were 180% [101% 289%] higher in Eateries.

Challenges in Creating a Mobile Digital Tutor for Clinical Communications Training.

Doctor-patient communication is a crucial element in effective medical care, and the striking health disparities evident in patients with Type II Diabetes may in part be caused by physicians' difficulties in establishing effective communication with patients who differ from them racially, culturally, and economically. REPEAT (Realizing Enhanced Patient Encounters through Aiding and Training) is a digital tutor developed to help solve this problem. REPEAT teaches and coaches learners to improve their general and disparities-focused clinical communication skills using simulated encounters with computer-generated Synthetic Standardized Patients (SSPs) and augments experiential learning in virtual encounters by applying customized, context-sensitive, learner-focused scaffolding. REPEAT authoring tools enable rapid development of learning content, allowing economical transferability to other domains. Key human factors challenges and their design solution in REPEAT are discussed.

The Fort Collins Commuter Study: Impact of route type and transport mode on personal exposure to multiple air pollutants.

Traffic-related air pollution is associated with increased mortality and morbidity, yet few studies have examined strategies to reduce individual exposure while commuting. The present study aimed to quantify how choice of mode and route type affects personal exposure to air pollutants during commuting. We analyzed within-person difference in exposures to multiple air pollutants (black carbon (BC), carbon monoxide (CO), ultrafine particle number concentration (PNC), and fine particulate matter (PM2.5)) during commutes between the home and workplace for 45 participants. Participants completed 8 days of commuting by car and bicycle on direct and alternative (reduced traffic) routes. Mean within-person exposures to BC, PM2.5, and PNC were higher when commuting by cycling than when driving, but mean CO exposure was lower when cycling. Exposures to CO and BC were reduced when commuting along alternative routes. When cumulative exposure was considered, the benefits from cycling were attenuated, in the case of CO, or exacerbated, in the case of particulate exposures, owing to the increased duration of the commute. Although choice of route can reduce mean exposure, the effect of route length and duration often offsets these reductions when cumulative exposure is considered. Furthermore, increased ventilation rate when cycling may result in a more harmful dose than inhalation at a lower ventilation rate.