A Feasibility Randomized Trial Evaluating Safe Peds: A Virtual Reality Training Program to Teach Children When to Cross Streets Safely.

OBJECTIVE: Injury as pedestrians is a leading contributor to childhood deaths. This study evaluated the effectiveness of Safe Peds, a fully immersive virtual reality training program to teach children when to cross street safely, with the focus on a number of foundational skills and practicing these in traffic situations of varying complexity. METHODS: Children 7-10 years old were randomly assigned to a control (N = 31) or intervention (N = 26) group. Eligibility criteria included English speaking and typically developing. Testing took place on campus. All children completed pre- and post-testing measures, with those in the intervention group receiving training in between. Training comprised 1 session with 3 phases for a total of up to 1.5 hr and was tailored to each child's performance over trials. On each trial, children decided when to cross and fully executed this crossing, with measures automatically taken by the system as they did so. RESULTS: Negative binomial regression and analysis of covariance tests were applied, predicting post-test scores while controlling for pre-test scores, age, and sex. The intervention was effective in improving children's street crossing skills, including stopping and checking skills (stop at the curb, look left/right/left, check for traffic before crossing the yellow line), and choosing safe inter-vehicle gaps. Children in the control group did not show significant improvements in any crossing skills. CONCLUSIONS: The Safe Peds program effectively teaches children skills to support their deciding when to safely cross in a variety of traffic situations. Implications for pedestrian injury are discussed.

Mechanically assisted walking training for walking, participation, and quality of life in children with cerebral palsy.

BACKGROUND: Cerebral palsy is the most common physical disability in childhood. Mechanically assisted walking training can be provided with or without body weight support to enable children with cerebral palsy to perform repetitive practice of complex gait cycles. It is important to examine the effects of mechanically assisted walking training to identify evidence-based treatments to improve walking performance. OBJECTIVES: To assess the effects of mechanically assisted walking training compared to control for walking, participation, and quality of life in children with cerebral palsy 3 to 18 years of age. SEARCH METHODS: In January 2020, we searched CENTRAL, MEDLINE, Embase, six other databases, and two trials registers. We handsearched conference abstracts and checked reference lists of included studies. SELECTION CRITERIA: Randomized controlled trials (RCTs) or quasi-RCTs, including cross-over trials, comparing any type of mechanically assisted walking training (with or without body weight support) with no walking training or the same dose of overground walking training in children with cerebral palsy (classified as Gross Motor Function Classification System [GMFCS] Levels I to IV) 3 to 18 years of age. DATA COLLECTION AND ANALYSIS: We used standard methodological procedures expected by Cochrane. MAIN RESULTS: This review includes 17 studies with 451 participants (GMFCS Levels I to IV; mean age range 4 to 14 years) from outpatient settings. The duration of the intervention period (4 to 12 weeks) ranged widely, as did intensity of training in terms of both length (15 minutes to 40 minutes) and frequency (two to five times a week) of sessions. Six studies were funded by grants, three had no funding support, and eight did not report information on funding. Due to the nature of the intervention, all studies were at high risk of performance bias. Mechanically assisted walking training without body weight support versus no walking training Four studies (100 participants) assessed this comparison. Compared to no walking, mechanically assisted walking training without body weight support increased walking speed (mean difference [MD] 0.05 meter per second [m/s] [change scores], 95% confidence interval [CI] 0.03 to 0.07; 1 study, 10 participants; moderate-quality evidence) as measured by the Biodex Gait Trainer 2™ (Biodex, Shirley, NY, USA) and improved gross motor function (standardized MD [SMD] 1.30 [postintervention scores], 95% CI 0.49 to 2.11; 2 studies, 60 participants; low-quality evidence) postintervention. One study (30 participants) reported no adverse events (low-quality evidence). No study measured participation or quality of life. Mechanically assisted walking training without body weight support versus the same dose of overground walking training Two studies (55 participants) assessed this comparison. Compared to the same dose of overground walking, mechanically assisted walking training without body weight support increased walking speed (MD 0.25 m/s [change or postintervention scores], 95% CI 0.13 to 0.37; 2 studies, 55 participants; moderate-quality evidence) as assessed by the 6-minute walk test or Vicon gait analysis. It also improved gross motor function (MD 11.90% [change scores], 95% CI 2.98 to 20.82; 1 study, 35 participants; moderate-quality evidence) as assessed by the Gross Motor Function Measure (GMFM) and participation (MD 8.20 [change scores], 95% CI 5.69 to 10.71; 1 study, 35 participants; moderate-quality evidence) as assessed by the Pediatric Evaluation of Disability Inventory (scored from 0 to 59), compared to the same dose of overground walking training. No study measured adverse events or quality of life. Mechanically assisted walking training with body weight support versus no walking training Eight studies (210 participants) assessed this comparison. Compared to no walking training, mechanically assisted walking training with body weight support increased walking speed (MD 0.07 m/s [change and postintervention scores], 95% CI 0.06 to 0.08; 7 studies, 161 participants; moderate-quality evidence) as assessed by the 10-meter or 8-meter walk test. There were no differences between groups in gross motor function (MD 1.09% [change and postintervention scores], 95% CI -0.57 to 2.75; 3 studies, 58 participants; low-quality evidence) as assessed by the GMFM; participation (SMD 0.33 [change scores], 95% CI -0.27 to 0.93; 2 studies, 44 participants; low-quality evidence); and quality of life (MD 9.50% [change scores], 95% CI -4.03 to 23.03; 1 study, 26 participants; low-quality evidence) as assessed by the Pediatric Quality of Life Cerebral Palsy Module (scored 0 [bad] to 100 [good]). Three studies (56 participants) reported no adverse events (low-quality evidence). Mechanically assisted walking training with body weight support versus the same dose of overground walking training Three studies (86 participants) assessed this comparison. There were no differences between groups in walking speed (MD -0.02 m/s [change and postintervention scores], 95% CI -0.08 to 0.04; 3 studies, 78 participants; low-quality evidence) as assessed by the 10-meter or 5-minute walk test; gross motor function (MD -0.73% [postintervention scores], 95% CI -14.38 to 12.92; 2 studies, 52 participants; low-quality evidence) as assessed by the GMFM; and participation (MD -4.74 [change scores], 95% CI -11.89 to 2.41; 1 study, 26 participants; moderate-quality evidence) as assessed by the School Function Assessment (scored from 19 to 76). No study measured adverse events or quality of life. AUTHORS' CONCLUSIONS: Compared with no walking, mechanically assisted walking training probably results in small increases in walking speed (with or without body weight support) and may improve gross motor function (with body weight support). Compared with the same dose of overground walking, mechanically assisted walking training with body weight support may result in little to no difference in walking speed and gross motor function, although two studies found that mechanically assisted walking training without body weight support is probably more effective than the same dose of overground walking training for walking speed and gross motor function. Not many studies reported adverse events, although those that did appeared to show no differences between groups. The results are largely not clinically significant, sample sizes are small, and risk of bias and intensity of intervention vary across studies, making it hard to draw robust conclusions. Mechanically assisted walking training is a means to undertake high-intensity, repetitive, task-specific training and may be useful for children with poor concentration.

Gait Training Using the Honda Walking Assistive Device® in a Patient Who Underwent Total Hip Arthroplasty: A Single-Subject Study.

BACKGROUND AND OBJECTIVES: The Honda Walking Assistive device® (HWA) is a light and easywearable robot device for gait training, which assists patients' hip flexion and extension movementsto guide hip joint movements during gait. However, the safety and feasibility of robot-assisted gaittraining after total hip arthroplasty (THA) remains unclear. Thus, we aimed to evaluate the safetyand feasibility of this gait training intervention using HWA in a patient who underwent THA. MATERIALS AND METHODS: The patient was a 76-year-old woman with right hip osteoarthritis. Gaittraining using HWA was implemented for 20 sessions in total, five times per week from 1 week to5 weeks after THA. Self-selected walking speed (SWS), step length (SL), cadence, timed up and go(TUG), range of motion (ROM) of hip extension, and hip abduction and extension torque weremeasured preoperatively, and at 1 (pre-HWA), 2, 3, 4, 5 (post-HWA), and 10 weeks (follow-up) afterTHA. The gait patterns at SWS without HWA were measured by using three-dimensional (3D) gaitanalysis and an integrated electromyogram (iEMG). RESULTS: The patient completed 20 gait trainingsessions with no adverse event. Hip abduction torque at the operative side, hip extension torque,SWS, SL, and cadence were higher at post-HWA than at pre-HWA. In particular, SWS, TUG, andhip torque were remarkably increased 3 weeks after THA and improved to almost the same levelsat follow-up. Maximum hip extension angle and hip ROM during gait were higher at post-HWAthan at pre-HWA. Maximum and minimum anterior pelvic tilt angles were lower at post-HWA thanat pre-HWA. The iEMG of the gluteus maximus and gluteus medius in the stance phase were lowerat post-HWA than preoperatively and at pre-HWA. CONCLUSIONS: In this case, the gait training usingHWA was safe and feasible, and could be effective for the early improvement of gait ability, hipfunction, and gait pattern after THA.

A Pilot Randomized Controlled Trial Testing the Effectiveness of a Pedestrian Training Program That Teaches Children Where and How to Cross the Street Safely.

Objective: Pedestrian injury is a leading cause of injury-related mortality for children. This pilot randomized controlled trial tested the efficacy of a training program to teach where and how to cross safely. Methods: Using fully immersive virtual reality technology, 142 children 7-10 years of age were recruited, with 130 completing crossing measures before (pretest) and immediately after (posttest) training. Training comprised 1.5 hr, was tailored to each child's performance over trials, and focused on either where to cross (n = 44 children completed testing) or how to cross safely (n = 43); corresponding control groups comprised 22 and 21 children, respectively. Following training, children in the intervention groups completed additional tasks to test conceptual knowledge and generalization of learning. Children in the control groups spent the same time as those in training groups but played a video game that used the same game controller but provided no training in street crossing. Results: The primary outcomes were errors in crossing at posttest, controlling for pretest error scores. Children in the intervention group made from 75% to 98% fewer errors at posttest than control children for all pedestrian safety variables related to where and how to cross safely, with effect sizes (incidence rate ratios) varying between 0.02 and 0.25. They also showed a generalization of what they had learned and applied this knowledge to novel posttraining situations. Conclusion: Training within a virtual pedestrian environment can successfully improve children's conceptual understanding and crossing behaviors for both where and how to cross streets safely.

Educating and Engaging Older Adults in the Sure Steps® Fall Prevention Program.

Falls are the leading cause of fatal and nonfatal injuries among adults 65 years and older. Each year, one in three older adults experiences a fall, and people who fall are more likely to fall again. According to the National Council on Aging (2017), instituting evidence-based falls prevention programs can significantly decrease falls. The purpose of this article is to describe a pilot study that examined the impact of the Sure Steps Fall Prevention Program on incidence of falls among adults 65 and older living in their home. A convenience sample of 10 community-dwelling participants aged 65 and older was recruited. After the Sure Steps Fall Prevention Program was implemented, participants were contacted by telephone monthly for 1 year. None of the participants reported falls during that time. Based on the findings of this pilot study, the Visiting Nurse Association implemented the Sure Steps Fall Prevention Program into their other four clinical sites.

STEP-UP: Study of the Effectiveness of a Patient Ambulation Protocol.

Immobility in hospitalized patients, particularly the elderly, can lead to serious untoward events. A pragmatic ambulation program that could be incorporated easily into clinicians' practice routines significantly improved ambulation in hospitalized patients compared to usual care with no organized emphasis on ambulation.

Effectiveness of an Activity Tracker- and Internet-Based Adaptive Walking Program for Adults: A Randomized Controlled Trial.

BACKGROUND: The benefits of physical activity are well documented, but scalable programs to promote activity are needed. Interventions that assign tailored and dynamically adjusting goals could effect significant increases in physical activity but have not yet been implemented at scale. OBJECTIVE: Our aim was to examine the effectiveness of an open access, Internet-based walking program that assigns daily step goals tailored to each participant. METHODS: A two-arm, pragmatic randomized controlled trial compared the intervention to no treatment. Participants were recruited from a workplace setting and randomized to a no-treatment control (n=133) or to treatment (n=132). Treatment participants received a free wireless activity tracker and enrolled in the walking program, Walkadoo. Assessments were fully automated: activity tracker recorded primary outcomes (steps) without intervention by the participant or investigators. The two arms were compared on change in steps per day from baseline to follow-up (after 6 weeks of treatment) using a two-tailed independent samples t test. RESULTS: Participants (N=265) were 66.0% (175/265) female with an average age of 39.9 years. Over half of the participants (142/265, 53.6%) were sedentary (<5000 steps/day) and 44.9% (119/265) were low to somewhat active (5000-9999 steps/day). The intervention group significantly increased their steps by 970 steps/day over control (P<.001), with treatment effects observed in sedentary (P=.04) and low-to-somewhat active (P=.004) participants alike. CONCLUSIONS: The program is effective in increasing daily steps. Participants benefited from the program regardless of their initial activity level. A tailored, adaptive approach using wireless activity trackers is realistically implementable and scalable. TRIAL REGISTRATION: Clinicaltrials.gov NCT02229409, https://clinicaltrials.gov/ct2/show/NCT02229409 (Archived by WebCite at http://www.webcitation.org/6eiWCvBYe).

How do children learn to cross the street? The process of pedestrian safety training.

OBJECTIVE: Pedestrian injuries are a leading cause of child death and may be reduced by training children to cross streets more safely. Such training is most effective when children receive repeated practice at the complex cognitive-perceptual task of judging moving traffic and selecting safe crossing gaps, but there is limited data on how much practice is required for children to reach adult levels of functioning. Using existing data, we examined how children's pedestrian skills changed over the course of 6 pedestrian safety training sessions, each composed of 45 crossings within a virtual pedestrian environment. METHODS: As part of a randomized controlled trial on pedestrian safety training, 59 children ages 7-8 crossed the street within a semi-immersive virtual pedestrian environment 270 times over a 3-week period (6 sessions of 45 crossings each). Feedback was provided after each crossing, and traffic speed and density were advanced as children's skill improved. Postintervention pedestrian behavior was assessed a week later in the virtual environment and compared to adult behavior with identical traffic patterns. RESULTS: Over the course of training, children entered traffic gaps more quickly and chose tighter gaps to cross within; their crossing efficiency appeared to increase. By the end of training, some aspects of children's pedestrian behavior was comparable to adult behavior but other aspects were not, indicating that the training was worthwhile but insufficient for most children to achieve adult levels of functioning. CONCLUSIONS: Repeated practice in a simulated pedestrian environment helps children learn aspects of safe and efficient pedestrian behavior. Six twice-weekly training sessions of 45 crossings each were insufficient for children to reach adult pedestrian functioning, however, and future research should continue to study the trajectory and quantity of child pedestrian safety training needed for children to become competent pedestrians.

Using a Virtual Environment to Examine How Children Cross Streets: Advancing Our Understanding of How Injury Risk Arises.

PURPOSE: To examine how risk of injury can arise for child pedestrians. METHODS: Using a highly immersive virtual reality system interfaced with a 3-D movement measurement system, younger (M = 8 years) and older (M = 10 years) children's crossing behaviors were measured under conditions that introduced variation in vehicle speed, distance, and intervehicle gaps. RESULTS: Children used distance cues in deciding when to cross; there were no age or sex differences. This increased risk of injury in larger intervehicle gaps because they started late and did not monitor traffic or adjust walking speed as they crossed. In contrast, injury risk in smaller intervehicle gaps of equal risk (i.e., same time to contact) occurred because crossing behavioral adjustments (starting early, increasing walking speed while crossing) were not sufficient. CONCLUSIONS: Dependence on distance cues increases children's risk of injury as pedestrians when crossing in a variety of traffic situations.

Does the speed of the treadmill influence the training effect in people learning to walk after stroke? A double-blind randomized controlled trial.

OBJECTIVE: To compare the effectiveness of high-speed treadmill training and progressive treadmill training for stroke patients. DESIGN: A double-blind, randomized controlled trial. SETTING: Inpatient rehabilitation hospital. PARTICIPANTS: A total of 61 ambulatory stroke patients. INTERVENTIONS: Patients in both groups underwent treadmill training for 30 minutes with conventional intervention. The progressive training group (n = 31) was trained to walk on a treadmill with a stepwise increase of speed over the treatment period. The high-speed training group (n = 30) trained to begin at 1.2-1.3 m/s, which is faster than the mean speed of stroke patients. All participants underwent 20 training sessions for five weeks. MAIN MEASURES: Timed up-and-go test, 10-m walk test, 6-minute walk test, and both step lengths and cadence. RESULTS: There were significant improvements in the results of the timed up-and-go test (-1.96 vs. -5.02 seconds), 10-m walk test (0.30 vs. 0.47 m/s), 6-minute walk test (38.35 vs. 64.40 m), and in the step length of the affected side (0.14 vs. 0.19 m) and the unaffected side (0.10 vs. 0.12 m) in the high-speed training group compared with those in the progressive training group (p < 0.05). Step width was not changed in either group (p > 0.05). CONCLUSION: These results suggest that high-speed training is an effective method for improving the walking ability of stroke patients.

Randomized controlled trial to evaluate the effectiveness of a video game as a child pedestrian educational tool.

BACKGROUND: Injury is the number one cause of death and disability in children in the United States and an increasingly important public health problem globally. While prevention of injuries is an important goal, prevention efforts are currently fragmented, poorly funded, and rarely studied. Among school-aged children, pedestrian crashes are a major mechanism of injury. We hypothesized that we could develop a game-based educational tool that would be effective in teaching elementary school children the principles of pedestrian safety. METHODS: Between November 2011 and June 2013, second- and third-grade children in Los Angeles Unified School District were randomly assigned to play a unique interactive video game (Ace's Adventure) about pedestrian safety or to a traditional didactic session about pedestrian safety. A pretest and posttest were administered to the study participants. Afterward, study participants were observed for appropriate pedestrian behavior on a simulated street set called Street Smarts. All statistical analyses were performed using SAS version 9.2. RESULTS: A total of 348 study participants took the pretest and posttest. There were 180 who were randomized to the didactic and 168 who were randomized to the video game. The didactic group demonstrated a higher mean score increase (1.01, p < 0.0001) as compared with the video game group (0.44, p < 0.0001). However, observation of study participants revealed that participants who played the video game, as compared with the didactic group, more frequently exhibited appropriate behavior during the following: exiting a parked car (p = 0.01), signaling to a car that was backing up (p = 0.01), signaling to a stopped car (p = 0.0002), and crossing the street (p = 0.01). CONCLUSION: Students who played the educational video game about pedestrian safety performed similarly to those who attended a more traditional and labor-intensive didactic learning. Innovative educational methods, such as game playing, could significantly change our approach to injury prevention and have the potential to decrease the burden of injury among children worldwide.

Training children in pedestrian safety: distinguishing gains in knowledge from gains in safe behavior.

Pedestrian injuries contribute greatly to child morbidity and mortality. Recent evidence suggests that training within virtual pedestrian environments may improve children's street crossing skills, but may not convey knowledge about safety in street environments. We hypothesized that (a) children will gain pedestrian safety knowledge via videos/software/internet websites, but not when trained by virtual pedestrian environment or other strategies; (b) pedestrian safety knowledge will be associated with safe pedestrian behavior both before and after training; and (c) increases in knowledge will be associated with increases in safe behavior among children trained individually at streetside locations, but not those trained by means of other strategies. We analyzed data from a randomized controlled trial evaluating pedestrian safety training. We randomly assigned 240 children ages 7-8 to one of four training conditions: videos/software/internet, virtual reality (VR), individualized streetside instruction, or a no-contact control. Both virtual and field simulations of street crossing at 2-lane bi-directional mid-block locations assessed pedestrian behavior at baseline, post-training, and 6-month follow-up. Pedestrian knowledge was assessed orally on all three occasions. Children trained by videos/software/internet, and those trained individually, showed increased knowledge following training relative to children in the other groups (ps < 0.01). Correlations between pedestrian safety knowledge and pedestrian behavior were mostly non-significant. Correlations between change in knowledge and change in behavior from pre- to post-intervention also were non-significant, both for the full sample and within conditions. Children trained using videos/software/internet gained knowledge but did not change their behavior. Children trained individually gained in both knowledge and safer behavior. Children trained virtually gained in safer behavior but not knowledge. If VR is used for training, tools like videos/internet might effectively supplement training. We discovered few associations between knowledge and behavior, and none between changes in knowledge and behavior. Pedestrian safety knowledge and safe pedestrian behavior may be orthogonal constructs that should be considered independently for research and training purposes.

Teaching children to cross streets safely: a randomized, controlled trial.

OBJECTIVE: Child pedestrian injury is a global public health challenge. This randomized, controlled trial considered comparative efficacy of individualized streetside training, training in a virtual pedestrian environment, training using videos and Web sites, plus no-training control, to improve children's street-crossing ability. METHODS: Pedestrian safety was evaluated among 231 7- and 8-year-olds using both streetside (field) and laboratory-based (virtual environment) trials before intervention group assignment, immediately posttraining, and 6 months posttraining. All training groups received 6 30-min sessions. Four outcomes assessed pedestrian safety: start delay (temporal lag before initiating crossing), hits/close calls (collisions/near-misses with vehicles in simulated crossings), attention to traffic (looks left and right, controlled for time), and missed opportunities (safe crossing opportunities that were missed). RESULTS: Results showed training in the virtual pedestrian environment and especially individualized streetside training resulted in safer pedestrian behavior postintervention and at follow-up. As examples, children trained streetside entered safe traffic gaps more quickly posttraining than control group children and children trained streetside or in the virtual environment had somewhat fewer hits/close calls in postintervention VR trials. Children showed minimal change in attention to traffic posttraining. Children trained with videos/websites showed minimal learning. CONCLUSION: Both individualized streetside training and training within virtual pedestrian environments may improve 7- and 8-year-olds' street-crossing safety. Individualized training has limitations of adult time and labor. Virtual environment training has limitations of accessibility and cost. Given the public health burden of child pedestrian injuries, future research should explore innovative strategies for effective training that can be broadly disseminated.

Pedestrians' estimates of their own visibility: a simple and effective computer-based technique.

INTRODUCTION: Research has shown that both pedestrians and drivers drastically overestimate pedestrians' nighttime visibility (NHSTSA, 2008a, 2008b; Owens & Sivak, 1996) and fail to appreciate the safety benefits of proven conspicuity aids. One solution is educational intervention (Tyrrell, Patton, & Brooks, 2004); however, the on-road assessment of its effectiveness is expensive and time consuming. METHOD: Experiment One introduces a computer-based alternative to the field-based approach, successfully replicating the previous study's trends among 94 students who either receive or do not receive an educational lecture. Experiment Two utilizes the simulation's portability to determine if professional roadway workers have a more accurate understanding of pedestrian conspicuity than students. RESULTS: RESULTS among 88 workers show they do not significantly appreciate the advantages of effective retroflective material configurations or vehicle headlamp settings, for example, any better than non-lectured students in Experiment One. IMPACT: The study's results demonstrate the need for education among all pedestrians and the benefits of efficient testing methods.

Walking away from type 2 diabetes: trial protocol of a cluster randomised controlled trial evaluating a structured education programme in those at high risk of developing type 2 diabetes.

BACKGROUND: The prevention of type 2 diabetes is a recognised health care priority globally. Within the United Kingdom, there is a lack of research investigating optimal methods of translating diabetes prevention programmes, based on the promotion of a healthy lifestyle, into routine primary care. This study aims to establish the behavioural and clinical effectiveness of a structured educational programme designed to target perceptions and knowledge of diabetes risk and promote a healthily lifestyle, particularly increased walking activity, in a multi-ethnic population at a high risk of developing type 2 diabetes. DESIGN: Cluster randomised controlled trial undertaken at the level of primary care practices. Follow-up will be conducted at 12, 24 and 36 months. The primary outcome is change in objectively measured ambulatory activity. Secondary outcomes include progression to type 2 diabetes, biochemical variables (including fasting glucose, 2-h glucose, HbA1c and lipids), anthropometric variables, quality of life and depression. METHODS: 10 primary care practices will be recruited to the study (5 intervention, 5 control). Within each practice, individuals at high risk of impaired glucose regulation will be identified using an automated version of the Leicester Risk Assessment tool. Individuals scoring within the 90th percentile in each practice will be invited to take part in the study. Practices will be assigned to either the control group (advice leaflet) or the intervention group, in which participants will be invited to attend a 3 hour structured educational programme designed to promote physical activity and a healthy lifestyle. Participants in the intervention practices will also be invited to attend annual group-based maintenance workshops and will receive telephone contact halfway between annual sessions. The study will run from 2010-2014. DISCUSSION: This study will provide new evidence surrounding the long-term effectiveness of a diabetes prevention programme run within routine primary care in the United Kingdom. TRIAL REGISTRATION: ClinicalTrials.Gov identifier: NCT00941954.

Exploring patterns of movement suspension in pedestrian mobility.

One of the main tasks in analyzing pedestrian movement is to detect places where pedestrians stop, as those places usually are associated with specific human activities, and they can allow us to understand pedestrian movement behavior. Very few approaches have been proposed to detect the locations of stops in positioning data sets, and they often are based on selecting the location of candidate stops as well as potential spatial and temporal thresholds according to different application requirements. However, these approaches are not suitable for analyzing the slow movement of pedestrians where the inaccuracy of a nondifferential global positioning system commonly used for movement tracking is so significant that it can hinder the selection of adequate thresholds. In this article, we propose an exploratory statistical approach to detect patterns of movement suspension using a local indicator of spatial association (LISA) in a vector space representation. Two different positioning data sets are used to evaluate our approach in terms of exploring movement suspension patterns that can be related to different landscapes: players of an urban outdoor mobile game and visitors of a natural park. The results of both experiments show that patterns of movement suspension were located at places such as checkpoints in the game and different attractions and facilities in the park. Based on these results, we conclude that using LISA is a reliable approach for exploring movement suspension patterns that represent the places where the movement of pedestrians is temporally suspended by physical restrictions (e.g., checkpoints of a mobile game and the route choosing points of a park).

A silver lining? The connection between gasoline prices and obesity.

I find evidence of a negative association between gasoline prices and body weight using a fixed effects model with several robustness checks. I also show that increases in gas prices are associated with additional walking and a reduction in the frequency with which people eat at restaurants, explaining their effect on weight. My estimates imply that 8% of the rise in obesity between 1979 and 2004 can be attributed to the concurrent drop in real gas prices, and that a permanent $1 increase in gasoline prices would reduce overweight and obesity in the United States by 7% and 10%.

The impact of weight and fat mass loss and increased physical activity on physical function in overweight, postmenopausal women: results from the Women on the Move Through Activity and Nutrition study.

OBJECTIVE: The aim of this study was to determine whether changes in leisure time physical activity (LTPA) and body composition reflect concomitant changes in 400-meter walk time. METHODS: Data were collected at the baseline and 48-month visits in the Women on the Move Through Activity and Nutrition study. At baseline, participants (n = 508) were randomized to the lifestyle intervention or health education group. The lifestyle intervention focused on weight (7%-10%) and waist circumference reduction through healthy lifestyle behavior change. Change in walk time over 48 months was the primary outcome. Secondary measures included change in LTPA and body composition measures including, body weight, body mass index, waist circumference, and dual-energy x-ray absorptiometry--derived fat and lean mass. RESULTS: Increased LTPA and reductions in body weight, body mass index, waist circumference, and fat mass were associated with decreased walk time from baseline to 48 months (P < 0.01). After stratification by group, LTPA was no longer significantly related to walk time in the health education group. CONCLUSIONS: Increased LTPA and weight loss resulted in improved physical function, as measured by the 400-meter walk, in a group of overweight, postmenopausal women. These findings support the use of the 400-meter walk to evaluate progress in physical activity or weight loss programs.

The impact of transit-oriented development on housing prices in San Diego, CA.

This research measures the influence of transit-oriented development (TOD) on the San Diego, CA, condominium market. Many view TOD as a key element in creating a less auto dependent and more sustainable transport system. Price premiums indicate a potential for a market-driven expansion of TOD inventory. A hedonic price model is estimated to isolate statistically the effect of TOD. This includes interaction terms between station distance and various measures of pedestrian orientation. The resulting model shows that station proximity has a significantly stronger impact when coupled with a pedestrian-oriented environment. Conversely, station area condominiums in more auto-oriented environments may sell at a discount. This indicates that TOD has a synergistic value greater than the sum of its parts. It also implies a healthy demand for more TOD housing in San Diego.