Active transport can contribute to physical activity accumulation and improved health in adults. The built environment is an established associate of active transport behaviours; however, assessment of environmental features encountered during journeys remains challenging. The purpose of this study was to examine the utility of wearable cameras to objectively audit and quantify environmental features along work-related walking and cycling routes.
A convenience sample of employed adults was recruited in New Zealand, in June 2011. Participants wore a SenseCam for all journeys over three weekdays and completed travel diaries and demographic questionnaires. SenseCam images for work-related active transport journeys were coded for presence of environmental features hypothesised to be related to active transport. Differences in presence of features by transport mode and in participant-reported and SenseCam-derived journey duration were determined using two-sample tests of proportion and an independent samples t-test, respectively.
Fifteen adults participated in the study, yielding 1749 SenseCam images from 30 work-related active transport journeys for coding. Significant differences in presence of features were found between walking and cycling journeys. Almost a quarter of images were uncodeable due to being too dark to determine features. There was a non-significant tendency for respondents to under-report their journey duration.
This study provides proof of concept for the use of the SenseCam to capture built environment data in real time that may be related to active transportation. Further work is required to test and refine coding methodologies across a range of settings, travel behaviours, and demographic groups.
Walking; Cycling; SenseCam; Measure; Physical activity
Daily cycling to work has been shown to improve physical performance and health in men and women. It is very common in the Netherlands: the most recent data show that one quarter of commuting journeys are by bicycle. However, despite the effort going into campaigns to promote commuter cycling, about 30% of commuter journeys up to 5 kilometers are still by car. The question is how to stimulate commuter cycling more effectively. This article aims to contribute to a better understanding of the perceived barriers and facilitators of cyclists/non-cyclists and personal factors associated with commuter cycling.
A random sample of 799 Dutch employees (response rate 39.6%) completed an internet survey, which comprised two parts. One part of the questionnaire focused on the determinants of cycling behavior including equal numbers of personal, social factors and environmental factors. The other component focused on assessing data on physical activity (PA) behavior. Descriptive and logistic regression analyses were used to analyze factors associated with commuter cycling.
Meeting the physical activity guideline was positively associated with commuter cycling. Television viewing and working full-time were negatively associated. Twenty-six percent of the participants met the PA guideline simply by cycling to work, with health as the main reason. The main barriers for non-cyclists (60%) were perspiration when arriving at work, weather and travelling time. Shorter travelling times compared with other transportation modes were an important facilitator. Environmental factors were positively related to more frequent and more convenient commuter cycling, but they were hardly mentioned by non-cyclists.
This study shows that a relatively large group fulfils the PA recommendations merely by cycling to work. Personal factors (i.e., perceived time and distance) are major barriers to commuter cycling and should be targeted in cycling campaigns, especially in subgroups living within cycling distance to work. Targeting environmental determinants in such campaigns seems to be less important in the Netherlands.
Small increases in walking or cycling for transport could contribute to population health improvement. We explore the individual, workplace and environmental characteristics associated with the incorporation of walking and cycling into car journeys.
In 2009, participants from the Commuting and Health in Cambridge study (UK) reported transport modes used on the commute in the last week as well as individual, workplace and environmental characteristics. Logistic regression was used to assess the explanatory variables associated with incorporating walking or cycling into car commuting journeys.
31% of car commuters (n = 419, mean age 43.3 years, SD 0.3) regularly incorporated walking or cycling into their commute. Those without access to car parking at work (OR: 26.0, 95% CI:11.8 to 57.2) and who reported most supportive environments for walking and cycling en route to work (highest versus lowest tertile, OR: 2.7, 95% CI 1.4 to 5.5) were more likely to incorporate walking or cycling into their car journeys.
Interventions that provide pleasant and convenient routes, limit or charge for workplace car parking and provide free off-site car parking may encourage car commuters to incorporate walking and cycling into car journeys. The effects of such interventions remain to be evaluated.
► Walking or cycling for transport could contribute to population health improvement. ► We explore why commuters incorporate walking and cycling into car journeys. ► Supportive environments and lack of workplace car parking were important contributors.
Walking; Health promotion; Health behaviour; Physical activity
The Journey Project, part of the Virginia Commonwealth University Libraries' Social Work Information Specialist in Context Fellowship, was designed to merge social work and consumer health librarianship skills in order to improve the provision of health information to patients. A resource notebook was created encompassing the many dimensions of cancer health information. A social work informationist distributed the notebooks and provided individualized consultations with respect to patients' health information needs. Areas of congruence as well as key differences between social work and consumer health librarianship emerged during the course of the project. Merging the two professions into the role of a social work informationist increased the ability to attend holistically to clients' health information needs.
Formal pathways models outline that patients should receive information in order to experience a coherent journey but do not describe an active role for patients or their relatives. The aim of this is paper is to articulate and discuss the active role of patients during their cancer trajectories.
Methods and theory
An in-depth case study of patient trajectories at a Danish hospital and surrounding municipality using individual interviews with patients. Theory about trajectory and work by Strauss was included.
Patients continuously took initiatives to organize their treatment and care. They initiated processes in the trajectories, and acquired information, which they used to form their trajectories. Patients presented problems to the healthcare professionals in order to get proper help when needed.
Work done by patients was invisible and not perceived as work. The patients’ requests were not sufficiently supported in the professional organisation of work or formal planning. Patients’ insertion and use of information in their trajectories challenged professional views and working processes. And the design of the formal pathway models limits the patients’ active participation. When looking at integrated care from the perspective of patients, the development of a more holistic and personalized approach is needed.
patient role; patient trajectory; pathway models; cancer
The author takes on the task of describing the interface between emotion and cognition by way of a narrative about psychology, and its meaning to his life. Using time as an overall metaphor, or perhaps a foundation stone underpinning a series of seemingly unconnected events, some insight is given into the author's personal life. The author invokes the works of feminist philosopher and author, Susan Faludi, to portray some aspects of his journey through fantasy, and then the reality of a disparate practice on two continents in psychology and neuropsychology. With particular reference to Faludi's portrayal of men as failed heroes without a role in modern society, the author discovers that all of his work with others has been a work with his own troubled soul, and his failed heroism. Calling on his early role models, and life with and without a sense of purpose, he learns from his clients the value of courage and patience, a spiritual as well as intellectual journey that leads him to become many things to many people in order to heal them, and himself.
Psychological Practice; Feminism; Existential Measning; Constructivism; Systems Theory; Heroism; Masculine Identity
Few studies have examined the effect of working night shift and long distance commuting. We examined the association between several sleep related and demographic variables, commuting distance, night work and use of mobile phones on driving performance. We used a prospective design to recruit participants and conducted a telephone survey (n = 649). The survey collected demographic and journey details, work and sleep history and driving performance concerning the day the participant was recruited. Participants also completed the Karolinska Sleepiness Scale and the Epworth Sleepiness Scale. Night workers reported significantly more sleepiness, shorter sleep duration and commuting longer distances. Seven variables were significant predictors of lane crossing. The strongest predictor was acute sleepiness (OR = 5.25, CI, 1.42–19.49, p<0.01) followed by driving ≥150 kms (OR = 3.61, CI, 1.66–7.81, p<0.001), obtaining less than 10 hours sleep in the previous 48 hours (OR = 2.58, CI, 1.03–6.46, p<0.05), driving after night shift (OR = 2.19, CI, 1.24–3.88, p<0.001), being <43 years old (OR = 1.95, CI, 1.11–3.41, p<0.05) and using mobile phones during the journey (OR = 1.90, CI, 1.10–3.27, p<0.05). Sleep related variables, long-distance commuting and night work have a major impact on lane crossing. Several interventions should be considered to reduce the level of sleepiness in night workers.
Perceptions of the environment appear to be associated with walking and cycling. We investigated the reasons for walking and cycling to or from work despite reporting an unsupportive route environment in a sample of commuters.
This mixed-method analysis used data collected as part of the Commuting and Health in Cambridge study. 1164 participants completed questionnaires which assessed the travel modes used and time spent on the commute and the perceived environmental conditions on the route to work. A subset of 50 also completed qualitative interviews in which they discussed their experiences of commuting. Participants were included in this analysis if they reported unsupportive conditions for walking or cycling on their route (e.g. heavy traffic) in questionnaires, walked or cycled all or part of the journey to work, and completed qualitative interviews. Using content analysis of these interviews, we investigated their reasons for walking or cycling.
340 participants reported walking or cycling on the journey to work despite unsupportive conditions, of whom 15 also completed qualitative interviews. From these, three potential explanations emerged. First, some commuters found strategies for coping with unsupportive conditions. Participants described knowledge of the locality and opportunities for alternative routes more conducive to active commuting, as well as their cycling experience and acquired confidence to cycle in heavy traffic. Second, some commuters had other reasons for being reliant on or preferring active commuting despite adverse environments, such as childcare arrangements, enjoyment, having more control over their journey time, employers’ restrictions on car parking, or the cost of petrol or parking. Finally, some survey respondents appeared to have reported not their own environmental perceptions but those of others such as family members or ‘the public’, partly to make a political statement regarding the adversity of active commuting in their setting.
Participants report walking and cycling to work despite adverse environmental conditions. Understanding this resilience might be just as important as investigating ‘barriers’ to cycling. These findings suggest that developing knowledge of safe walking and cycling routes, improving cycling confidence and restricting workplace parking may help to encourage walking and cycling to and from work.
Mixed methods; Transport; Active commuting; Environmental perceptions
To test the impact of the implementation of Magnet principles of improving nurses’ work environments.
Magnet hospital designation developed in the United States in the 1980s to recognise hospitals that had created excellent patient care environments and supported the professional practice of nursing. A pilot initiative in England was the first test of the applicability of Magnet standards outside the US.
Research methods included surveys of nurses in the demonstration hospital in a predesign and postdesign and comparisons to survey results of nurses practicing in a national sample of 30 National Health Service Trusts.
Prior to beginning the Magnet journey, the demonstration hospital had a nurse work environment that was somewhat less positive than the national sample NHS hospitals. Nurses practicing in the demonstration hospital were somewhat less satisfied with their jobs than nurses in other NHS hospitals. Following a two-year period during which the evidence-based Magnet standards were implemented and Magnet Designation was awarded, the quality of the nurse practice environment had improved significantly, as had job satisfaction of nurses and their appraisals of the quality of patient care. The quality of the nurse practice environment after Magnet designation was better than that of a national sample of NHS trusts. Improved nurse outcomes were because of the improved practice environment rather than staffing enhancements.
Implementation of the Magnet hospital intervention was associated with a significantly improved nursing work environment as well as improved job-related outcomes for nurses and markers for quality of patient care. Relevance to clinical practice. Nurses can use Magnet principles to improve the quality of their work environments.
Magnet hospitals; nurses; nursing
In 2009, UCSF embarked on a journey to utilize industry-backed application standards to extend our research networking tool of choice, Profiles, into a software platform. The goal of this work was to bring extended data and functionality to our researchers’ online environment and make it easier to share independently-developed software innovations with others. We used the OpenSocial standard to achieve these ends. In 2012 we extended the OpenSocial standard to support RDF and the VIVO Ontology in an effort titled “Open Research Network Gadgets” or ORNG. Our work has been adopted by two major academic open source research networking tools – Harvard Catalyst Profiles and VIVO, and the ORNG standard is now available for use by the 50+ institutions that use recent versions of the two software products.
Research assessing the efficacy of court-mandated domestic violence treatment continues to yield inconsistent results. The current study examined whether Journey to Change, a Transtheoretical Model of Behavior Change-based treatment adjunct that consists of three computer-administered sessions and a print guide, could improve outcomes.
492 male domestic violence offenders attending court-mandated batterer treatment were assigned to Usual Care (UC) or Usual Care + Journey to Change (UC + Journey).
Compared to UC, participants receiving UC + Journey were significantly more likely to be in the Action stage at the end of treatment, and to seek help and services outside of group. Based on victim reports, the UC + Journey group was significantly less likely than UC to engage in physical violence during the 12-month follow-up. Both groups were equally likely to drop out of court-mandated treatment and to have further domestic violence-related police involvement. However, among participants with police involvement, the UC + Journey group had lower rates of documented violence and physical injury.
The pattern of findings across the multiple outcomes suggests that the Journey to Change program holds promise for improving some outcomes for domestic violence offenders in treatment, and warrants further investigation.
domestic violence offenders; batterer treatment; stages of change; Transtheoretical Model of Behavior Change; computer-tailored intervention
INTRODUCTION: All urology departments are under considerable pressure to comply with the UK Government's implementation of the 2-week rule for suspected cancer referrals. A prospective audit was planned to begin 6 months after introduction of cancer referral guidelines and a central data collection process, to investigate the local workload generated by these referrals, and compliance with the 2-week rule. METHODS: Data were collected prospectively over an 8-week period. All referral letters were examined by an independent urologist for any of the criteria defined by the regional tumour working group as suspicious of urological cancer. For suspected cancer referrals, the patient journey was followed to assess efficiency of the referral process. Results were compared with figures for '2-week rule' referrals for the Trust obtained from the UK Department of Health (DoH) website. RESULTS: In all, 234 GP referrals were reviewed, 82 fitting regional criteria for suspected cancer. Of these, (i) 13% were either marked urgent with a clear statement of 'cancer' or included a clear request to be seen within 2 weeks; (ii) 23% included no implication of cancer; (iii) 72% were seen in haematuria clinic, median time to clinic visit being 56.5 days, none complying with the 2-week rule; and (iv) of referrals not seen in haematuria clinic, median time to clinic was 21 days, with 34% compliance. With more stringent definitions of a cancer referral, DoH figures for the Trust recorded just 18 referrals over 3 months, with 89% compliance. DISCUSSION: GP referral letters meeting guidelines for suspected cancer often failed to imply or mention this. Compliance with the 2-week rule was poor, especially for the haematuria clinic. This is variably attributable to wording of GP letters, communication issues, and the sheer load of patients to be seen. CONCLUSION: DoH criteria for cancer referrals grossly underestimate the true magnitude of workload demanded of the service.
It is time for the noon conference. Your job is to impart a career‐changing experience in ethics to a group of students and interns gathered from four different schools with varying curriculums in ethics. They have just finished 1½ h of didactic sessions and lunch. One third of them were on call last night. Your first job is to keep them awake. The authors argue that this “tragic case” approach to ethics education is of limited value because it limits understanding of moral problems to dilemmas; negates the moral agency of the student; encourages solutions that are merely intellectual; and suggests that ethical encounters are a matter for experts. The authors propose an alternative that focuses on three issues: the provider‐patient relationship, the relationships between providers in the everyday world of health work and, the social position of healthcare providers in society. In this approach, teachers are not experts but more like guides on a journey who help students to learn that much of ethical practice comprises living through difficult situations of caring for vulnerable others and who help students to navigate some of these difficulties.
Plasmodium sporozoites make a remarkable journey from the skin, where they are deposited by an infected Anopheline mosquito, to the liver, where they invade hepatocytes and develop into exoerythrocytic stages. Although much work has been done to elucidate the molecular mechanisms by which sporozoites invade hepatocytes, little is known about the interactions between host and parasite before the sporozoite enters the blood circulation. It has always been assumed that sporozoites rapidly exit the injection site, making their interactions with the host at this site, brief and difficult to study. Using quantitative PCR, we determined the kinetics with which sporozoites leave the injection site and arrive in the liver and found that the majority of infective sporozoites remain in the skin for hours. We then performed sub-inoculation experiments which confirmed these findings and showed that the pattern of sporozoite exit from the injection site resembles a slow trickle. Last, we found that drainage of approximately 20% of the sporozoite inoculum to the lymphatics is associated with a significant enlargement of the draining lymph node, a response not observed after intravenous inoculation. These findings indicate that there is ample time for host and parasite to interact at the inoculation site and are of relevance to the pre-erythrocytic stage malaria vaccine effort.
The apicoplast is a relict plastid found in many medically important apicomplexan parasites, such as Plasmodium and Toxoplasma. Phylogenetic analysis and the presence of four bounding membranes indicate that the apicoplast arose from a secondary endosymbiosis. Here we review what has been discovered about the complex journey proteins take to reach compartments of the apicoplast. The targeting sequences for luminal proteins are well-defined, but those routing proteins to other compartments are only beginning to be studied. Recent work suggests that the trafficking mechanisms involve a variety of molecules of different phylogenetic origins. We highlight some remaining questions regarding protein trafficking to this divergent organelle.
A radio series about the work of ethics committees, which demonstrates the web of personal and professional relationships that surround the patient journey, impresses Daniel K Sokol
Diagnosis of strongyloidiasis using stool examination remains unsatisfactory due to the lack of sensitivity and fastidious techniques. In this work, we investigated the value of an anti-Strongyloides IgG enzyme immunoassay (EIA), using a panel of 207 sera retrospectively collected from patients with definitive diagnoses of strongyloidiasis (n = 57), other helminthic infections (n = 46), eosinophilia without parasitic infection diagnosis (n = 54), and digestive disturbances following a tropical journey (n = 30) and from 20 negative controls. By following a receiver operating characteristic (ROC) curve analysis, it was possible to optimize the test to reach a sensitivity of 91.2% and a specificity of 93.3%, with 92.8% of patients correctly classified. Considering the incidence of strongyloidiasis diagnosed in our own laboratory, the negative predictive value was calculated at 99.9%. In conclusion, this test is very rapid and easy to perform and may be valuable for diagnosis of strongyloidiasis both in cases where the infection is unrevealed by a parasitological stool examination and in patients at risk for severe clinical forms, such as patients receiving immunosuppressive therapy.
Numerous epidemiological studies have demonstrated adverse health effects of a sedentary life style, on the one hand, and of acute and chronic exposure to traffic-related air pollution, on the other. Because physical exercise augments the amount of inhaled pollutants, it is not clear whether cycling to work in a polluted urban environment should be encouraged or not. To address this conundrum we investigated if a bicycle journey along a busy commuting road would induce changes in biomarkers of pulmonary and systematic inflammation in a group of healthy subjects.
38 volunteers (mean age: 43 ± 8.6 years, 26% women) cycled for about 20 minutes in real traffic near a major bypass road (road test; mean UFP exposure: 28,867 particles per cm3) in Antwerp and in a laboratory with filtered air (clean room; mean UFP exposure: 496 particles per cm3). The exercise intensity (heart rate) and duration of cycling were similar for each volunteer in both experiments. Exhaled nitric oxide (NO), plasma interleukin-6 (IL-6), platelet function, Clara cell protein in serum and blood cell counts were measured before and 30 minutes after exercise.
Percentage of blood neutrophils increased significantly more (p = 0.004) after exercise in the road test (3.9%; 95% CI: 1.5 to 6.2%; p = 0.003) than after exercise in the clean room (0.2%; 95% CI: -1.8 to 2.2%, p = 0.83). The pre/post-cycling changes in exhaled NO, plasma IL-6, platelet function, serum levels of Clara cell protein and number of total blood leukocytes did not differ significantly between the two scenarios.
Traffic-related exposure to particles during exercise caused a small increase in the distribution of inflammatory blood cells in healthy subjects. The health significance of this isolated change is unclear.
Plasmodium requires an obligatory life stage in its mosquito host. The parasites encounter a number of insults while journeying through this host and have developed mechanisms to avoid host defenses. Lysozymes are a family of important antimicrobial immune effectors produced by mosquitoes in response to microbial challenge.
A mosquito lysozyme was identified as a protective agonist for Plasmodium. Immunohistochemical analyses demonstrated that Anopheles gambiae lysozyme c-1 binds to oocysts of Plasmodium berghei and Plasmodium falciparum at 2 and 5 days after infection. Similar results were observed with Anopheles stephensi and P. falciparum, suggesting wide occurrence of this phenomenon across parasite and vector species. Lysozyme c-1 did not bind to cultured ookinetes nor did recombinant lysozyme c-1 affect ookinete viability. dsRNA-mediated silencing of LYSC-1 in Anopheles gambiae significantly reduced the intensity and the prevalence of Plasmodium berghei infection. We conclude that this host antibacterial protein directly interacts with and facilitates development of Plasmodium oocysts within the mosquito.
This work identifies mosquito lysozyme c-1 as a positive mediator of Plasmodium development as its reduction reduces parasite load in the mosquito host. These findings improve our understanding of parasite development and provide a novel target to interrupt parasite transmission to human hosts.
The Yale Medical Orchestra displayed exceptional talent and inspiration as it performed a timeless composition to celebrate Yale School of Medicine’s bicentennial anniversary during a December 2010 concert. Under the leadership of musical directors Robert Smith and Adrian Slywotzky, the richly emotional meditations of Mendelssohn, Dvorak, Schubert, and Yale’s own Thomas C. Duffy filled the minds and hearts of an audience as diverse as the orchestra. I intend to retrace the steps of that melodic journey in this essay, fully aware of the limits imposed on me to recreate the aural art form through the medium of text. While these symbols can be pale representations of the beauty and complexity of the music, I hope they will be the building blocks for the emotional experience of the audience. I describe the works’ inception and their salient musical features and then review what we know about the effects of melody, meter, and timbre on our brains. My intentions are to provide evidence to encourage the further use of music as a tool in medical practice, provide interest in the works explored by the Yale orchestra, support the orchestra itself, and investigate a personal passion.
Yale Symphony Orchestra; music therapy; sound perception; primary auditory cortex; Mozart effect
Liposomes are frequently used as pharmaceutical nanocarriers to deliver poorly water-soluble drugs such as temoporfin, cyclosporine A, amphotericin B, and paclitaxel to their target site. Optimal drug delivery depends on understanding the release kinetics of the drug molecules from the host liposomes during the journey to the target site and at the target site. Transfer of drugs in model systems consisting of donor liposomes and acceptor liposomes is known from experimental work to typically exhibit a first-order kinetics with a simple exponential behavior. In some cases, a fast component in the initial transfer is present, in other cases the transfer is sigmoidal. We present and analyze a theoretical model for the transfer that accounts for two physical mechanisms, collisions between liposomes and diffusion of the drug molecules through the aqueous phase. Starting with the detailed distribution of drug molecules among the individual liposomes, we specify the conditions that lead to an apparent first-order kinetic behavior. We also discuss possible implications on the transfer kinetics of (1) high drug loading of donor liposomes, (2) attractive interactions between drug molecules within the liposomes, and (3) slow transfer of drugs between the inner and outer leaflets of the liposomes.
Recent theoretical models of hippocampal function suggest that the hippocampus plays a critical role in the memory for the overlapping sequences of events that comprise episodic memory. Consistent with this idea, the firing of hippocampal ‘place cells’ have been shown to represent not only location, but also the context or episode in which the location occurs. Thus, hippocampal neurons fire differently in the same location depending on the particular journey or sequence of places in which the subject is travelling. Further, recent work in rats has shown that hippocampal lesions impair memory for sequences of odors and the ability to disambiguate overlapping sequences of odors. We therefore recorded the activity of hippocampal complex-spike cells during a disambiguation of odor sequences task in which the two sequences shared three common odors. Consistent with data from spatial memory tasks, we found that 26 of 44 complex-spike cells fired differentially in the periods prior to, or during the presentation of the ambiguous odors depending on the sequence in which the odors were presented. This finding further supports the idea that the hippocampus is critical for episodic memory, and extends the physiological evidence to suggest that the hippocampal neurons play a broader role representing sequences of both spatial and non-spatial information.
hippocampus; episodic memory; sequence learning; orbitofrontal cortex; place cell; olfactory learning
Bringing the vision that monoclonal antibodies (mAbs) could be medicinal “magic bullets” into practice has been a long and challenging journey which began in 1975 when Kohler and Milstein made it possible to generate these homogenous, highly specific homing devices. In the last 35 years, many hurdles have slowed the manifestation of this dream, including: target location; host species, specificity, and subclass of the mAb; immunogenicity of murine mAbs; mAb pharmacokinetics (i.e. hepatic and renal clearance); and mAb form (i.e. natural, conjugated to a toxin or radionuclide, humanized murine mAbs, scFvs). The work involved in overcoming these factors explains why few mAb's have been made it to the clinic in more than 3 decades later. Nonetheless, over 20 mAbs have been FDA-approved for human use since 1994. Since the total global therapeutic monoclonal antibody market increased from $40 billion in 2009 to $45 billion in 2010, pursuit of these “magic bullets” is unlikely to wane anytime soon. This workshop is a roundtable format what where we will collectively discuss what we have learned on this long road of bringing mAbs to the clinic and try and look forward to where we are going.
One of the goals of the 2011 International Year of Chemistry is to celebrate the contributions of women to science. A question that has been frequently asked in this regard is... Why is it necessary to highlight women in the "age of equality"? The reasons are varied but the facts are that many women scientists worked in obscurity throughout the 19th and even well into the 20th century, sometimes publishing anonymously to be heard. This celebration of Women in Science is one way to recognize both the resiliency and passion of these women. As part of this celebration, Chemistry Central Journal's Thematic Series of "Women in Chemistry" includes this article describing the path several women took as they pursued chemistry careers spanning the latter part of the 20th century and into the early 21st century. Sharon Haynie, Nancy Jones, Cheryl Martin, Paula Olsiewski, Mary Roberts and Amber Hinkle each have unique story of their personal journey from childhood to adulthood. As you read these stories, listen generously, and feel free to share your own stories, comments and thoughts.
Network structure varies across cities. This variation may yield important knowledge about how the internal structure of the city affects its performance. This paper systematically compares a set of surface transportation network structure variables (connectivity, hierarchy, circuity, treeness, entropy, accessibility) across the 50 largest metropolitan areas in the United States. A set of scaling parameters are discovered to show how network size and structure vary with city size. These results suggest that larger cities are physically more inter-connected. Hypotheses are presented as to why this might obtain. This paper then consistently measures and ranks access to jobs across 50 US metropolitan areas. It uses that accessibility measure, along with network structure variables and city size to help explain journey-to-work time and auto mode share in those cities. A 1 percent increase in accessibility reduces average metropolitan commute times by about 90 seconds each way. A 1 percent increase in network connectivity reduces commute time by 0.1 percent. A 1 percent increase in accessibility results in a 0.0575 percent drop in auto mode share, while a 1 percent increase in treeness reduces auto mode share by 0.061 percent. Use of accessibility and network structure measures is important for planning and evaluating the performance of network investments and land use changes.