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A decrease in unsustainable mobility is needed for everyday mobility as well as for leisure travel, here defined as overnight travel for longer distances, in order to reach decarbonisation goals. So far studies that explicitly target both are rare. The survey presented here examines socio-psychological and socio-economic variables that might influence individual use of more or less sustainable transport modes for everyday mobility and for long-distance leisure travel. It was conducted through an online questionnaire among a sample of n = 1982 residents in Germany, representative of the German population holding a drivers' license in terms of age and gender. Use of transport mode (the dependent variable) was operationalized by contrasting (a) car travel (considered the unsustainable mode) versus other transport modes for everyday mobility and (b) plane trips (the unsustainable mode) versus other transport modes for long-distance leisure travel. Respondents reported past transport mode use and intentions for future transport. Independent variables were transport habits, self-efficacy beliefs, awareness of need, awareness of consequences, perceived behavioural control, personal and social norms, non-moral aspects, emotional consequences, further negative or positive consequences (i.e., the socio-psychological variables), and socio-economic variables. Together, the socio-psychological and socio-economic variables explained significant portions of the variance in the dependent variables. Socio-economic factors were stronger predictors for everyday mobility than for long-distance leisure travel. Perceived behavioural control was an overall consistent and strong predictor, increasing the likelihood of more sustainable travel mode use. We discuss entry points for interventions based on our findings.

Reduksjon av flyreiser har høy innvirkning på den individuelles bidrag til å begrense klimaforandringene, og under Covid-19-pandemien var det restriksjoner på flyreiser. «The habit-discontinuity hypothesis» foreslår at når vaner blir forstyrret av forandringer i konteksten, er det større sannsynlighet for at vanene blir revurdert og endret. Kan Covid-19-pandemien fungere som en forandring i konteksten som kan føre til en reduksjon i flyreiser i forbindelse med ferier? Tidligere forskning har funnet at tidligere atferd, sosiale normer og mestringstro er assosiert med sannsynligheten for atferdsendringer. Forskningsmålet for denne studien (N = 2057) er å undersøke om deltakere har intensjoner om å endre antall flyreiser i forbindelse med ferier, og den relative påvirkningen av tidligere atferd, sosiale normer og mestringstro. Data ble samlet inn gjennom en nasjonal spørreundersøkelse og en lineær multippel regresjonsanalyse ble gjennomført. Funnene viser at 66.4% skal fly på ferie som tidligere, og 25.7% har tenkt å redusere ferie-flyreiser. I tillegg er det en signifikant effekt av tidligere fly-atferd, sosiale normer og mestringstro på «fremtidig flyreise-hyppighet». Samlet sett konkluderer oppgaven med at Covid-19-pandemien antakelig ikke fungerer som en kontekstforandring som fører til reduksjon i ferie-flyreiser og at dette er påvirket av tidligere hyppig fly-atferd, lav mestringstro og å tenke at å redusere flyreiser ikke er en norm. Videre diskuteres mulige forklaringer for hvorfor pandemien ser ut til å ikke føre til varige bærekraftige forandringer og forslag til videre studier. Hovedoppgave psykologprogrammet PROPSY317 PRPSYK

In the present article we investigate the geography and magnitude of the climate footprint of long-distance travel with Brussels, Belgium, as a destination. The internationally networked position of this city goes hand in hand with a strong dependence on international mobility, which largely materializes in impressive volumes of long-distance travel and associated consumption of important amounts of fossil fuel. Despite a surge in concerns about global warming, the climate footprint of most international travel, notably air travel, is not included in the official national and regional climate inventories, or in other words, it is not territorialized. The official climate footprint of the Brussels-Capital Region attained 3.7 Mton CO2eq per year (in 2017). Based on our exploratory calculations, however, the total estimated climate footprint of all Brussels-bound international travel equalled an additional 2.7 Mton CO2eq. In terms of geographical distribution, over 70% of international travellers to Brussels come from Europe, while these represent only 15% of the climate footprint of all international travel to Brussels. We conclude that the practice of not allocating emissions caused by international travel to territorial units has kept the magnitude and complexity of this problem largely under the radar and contributes to the lack of societal support for curbing growth of international aviation., info:eu-repo/semantics/published

BACKGROUND: Middle ear (ME) barotraumas are the most common condition in aviation medicine, sometimes seriously compromising flight safety. Considering this and the ever-increasing amount of commercial aviation, a detailed overview is warranted.METHODS: In this survey study, an anonymous, electronic questionnaire was distributed to commercial aircrew of the three major commercial airlines operating in Finland (N 3799), covering 93% of the target population (i.e., all commercial aircrew operating in Finland, N 4083). Primary outcomes were self-reported prevalence, clinical characteristics, and health and occupational effects of ME barotraumas in flight. Secondary outcomes were adjusted odds ratios (OR) for frequency of ME barotraumas with respect to possible risk factors.RESULTS: Response rate was 47% (N 1789/3799), with 85% (N 1516) having experienced ME barotraumas in flight. Of those affected, 60% had used medications, 5% had undergone surgical procedures, and 48% had been on sick leave due to ME barotraumas (40% during the last year). Factors associated with ME barotraumas included a high number of upper respiratory tract infections [3 URTIs/yr vs. 0 URTIs/yr: OR, 9.02; 95% confidence interval (CI) 3.9920.39] and poor subjective performance in Valsalva (occasionally vs. always successful: OR, 7.84; 95% CI 3.9715.51) and Toynbee (occasionally vs. always successful: OR, 9.06; 95% CI 2.6730.78) maneuvers.CONCLUSION: ME barotraumas were reported by 85% of commercial aircrew. They lead to an increased need for medications, otorhinolaryngology-related surgical procedures, and sickness absence from flight duty. Possible risk factors include a high number of URTIs and poor performance in pressure equalization maneuvers.Lindfors OH, Ketola KS, Klockars TK, Leino TK, Sinkkonen ST. Middle ear barotraumas in commercial aircrew. Aerosp Med Hum Perform. 2021; 92(3):182189.

Self-care is essential in the long-term management of chronic heart failure. Heart failure guidelines stress the importance of patient education on treatment adherence, lifestyle changes, symptom monitoring and adequate response to possible deterioration. Self-care is related to medical and person-centred outcomes in patients with heart failure such as better quality of life as well as lower mortality and readmission rates. Although guidelines give general direction for self-care advice, health care professionals working with patients with heart failure need more specific recommendations. The aim of the management recommendations in this paper is to provide practical advice for health professionals delivering care to patients with heart failure. Recommendations for nutrition, physical activity, medication adherence, psychological status, sleep, leisure and travel, smoking, immunization and preventing infections, symptom monitoring, and symptom management are consistent with information from guidelines, expert consensus documents, recent evidence and expert opinion. Jaarsma, T (corresponding author), Univ Linkoping, Fac Hlth Sci, Kungsgatan 40, S-60174 Norrkoping, Sweden. tiny.jaarsma@liu.se

This is a cross-sectional study of patients who received a COVID-19 diagnosis between December 30, 2019 and February 7, 2020 at Tongji Hospital. A total of 102 patients (48 Male [47%] and 54 Female [53%]) with clinical symptoms, Rt, and chest Computed Tomography (CT) abnormalities were identified with a clinical diagnosis of COVID-19. Patients had a mean [SD] gestational age of 57.63 [14.90] years. Of a total of 102 patients identified, 72 patients (36 men [50%] and 36 women [50%]; mean [SD] age, 58.68 [14.81] years) were confirmed to have COVID-19 by laboratory diagnosis with a SARS-CoV-2 RT-PCR assay. Only two patients (2.78%) with conjunctivitis were identified from 72 patients with a laboratory confirmed COVID-19. Of those two patients, SARS-CoV-2 RNA fragments were found in ocular discharges by SARS-CoV-2 RT-PCR in only one patient. Our findings suspect the incidence of SARS-CoV-2 infection through the ocular surface is extremely low, while the nosocomial infection of SARS-CoV-2 through the eyes after occupational exposure is a potential route. To lower the SARS-CoV-2 nosocomial infection, all health care professionals should wear protective goggles. The inefficient diagnostic method and the sampling time lag may contribute to the lower positive rate of conjunctival swab samples of SARS-CoV-2.

While growing rates of air-travel contributes to large amounts of global emissions – and a substantial part of the environmental footprints of those who fly – it has not yet been subject to strict environmental regulations. Arguably, working towards sustainable mobilities will require to achieve a greater understanding of the roles, meanings, and implications of consumer air-travel. Recognising that the environmental issue of aeromobility hinges on both social and material factors, this thesis presents a practice-theoretical investigation into the ways in which 13 Norwegian environmentalists negotiate their own aeromobilities as environmentally conscious consumers, based on qualitative interviews. Framing air-travel as a social practice, the thesis has provided some tools for moving past the moral impasse of whether or not flying is justifiable; instead putting the focus on what aeromobility means for consumers, why they continue to fly, and, as an extension of this, how aeromobilities change and become (un)sustainable. The analyses demonstrated that the environmentalists were highly self-reflexive and spent much time and effort negotiating their (aero)mobilities. Adopting sustainable mobility practices was generally hard work requiring personal sacrifices. When construed as a practice in its own right, air-travel was thought of as environmentally damaging; something of excess, an overused privilege. As part of other practices, however, aeromobility became an important tool; an enabler of opportunities and positive experiences. The analyses emphasise the notion that air-travel is not only a practice in its own right, but part of many other practices with wider socio-environmental implications. The implication of this is that achieving more sustainable mobilities might require attention to not only the modes of transport in question, but to the wider social practices in which different mobilities are part. Based on the analyses, the discussion adds a new layer to the conceptualisation of aeromobility. It proposes that contemporary aeromobility can be thought of as an unsustainable “system” comprised of material and (infra)structural as well as socio-cultural and affective components, woven together through complex logics which inform consumers’ mobility practices in such a way that aeromobility is reproduced.

Publisher's version (útgefin grein), Negative relationships between urban density and greenhouse gas emissions from daily travel are well established in the literature. However, recent research suggests that higher urban density is associated with higher emissions from long-distance leisure travel, such as car weekend trips and international flights. This article presents the first systematic review of empirical evidence on these associations and discusses potential explanations. A two-step article selection process yielded 27 empirical articles, complemented by one article published during the review process. When international travel is included in the analysis, the results suggest that residents of the largest cities, and particularly those from centrally located and densely built areas, travel more to cover long distances than do others, after controlling for demographic and socioeconomic variables. When only domestic travel is included, residents of larger settlements and areas of higher density engage in less long-distance travel for leisure purposes than those living in smaller settlements and sparsely built areas. The results of the review are indicative and warrant more research. Generalization is currently limited because of the wide variety of travel behavior measures used, consideration of different travel modes and trip purposes, and geographic scope. There is a strong need for replication of the results using consistent methodology, using data from longer and more recent time spans, and expanding to more diverse geographical settings, especially outside Europe. The systematic review is followed by a narrative review of theoretical explanations of the associations. The most common explanations include: rebound effects, the compensation hypothesis, access to transport infrastructure, urban lifestyles, sociopsychological characteristics, and social networks. Socioeconomic variables are controlled in a majority of the reviewed studies, and business travel is excluded from the review, so the concentration of wealth and business in cities may explain the findings only to some extent. Nonetheless, there is not enough empirical evidence on the causal character of the associations and therefore further qualitative and multidisciplinary work is needed. Compact city and urban densification policies are not strongly challenged by current evidence, and most common policy recommendations point to including air travel into carbon taxing or quota schemes., University of Iceland Research Fund

Highlights • Scoping review: mathematical models for global disease spread. • Extracted information: modelling method, input and validation data sources. • Model validation uncommon, perhaps a result of limited data availability. • Commercial data use has implications for review and reproducibility of results., Mathematical models can aid in the understanding of the risks associated with the global spread of infectious diseases. To assess the current state of mathematical models for the global spread of infectious diseases, we reviewed the literature highlighting common approaches and good practice, and identifying research gaps. We followed a scoping study method and extracted information from 78 records on: modelling approaches; input data (epidemiological, population, and travel) for model parameterization; model validation data. We found that most epidemiological data come from published journal articles, population data come from a wide range of sources, and travel data mainly come from statistics or surveys, or commercial datasets. The use of commercial datasets may benefit the modeller, however makes critical appraisal of their model by other researchers more difficult. We found a minority of records (26) validated their model. We posit that this may be a result of pandemics, or far-reaching epidemics, being relatively rare events compared with other modelled physical phenomena (e.g. climate change). The sparsity of such events, and changes in outbreak recording, may make identifying suitable validation data difficult. We appreciate the challenge of modelling emerging infections given the lack of data for both model parameterisation and validation, and inherent complexity of the approaches used. However, we believe that open access datasets should be used wherever possible to aid model reproducibility and transparency. Further, modellers should validate their models where possible, or explicitly state why validation was not possible.

Introduction Epidemiological studies suggest that hypobaric hypoxia at high altitude poses a risk for developing venous thromboembolism. The cause of this observed hypercoagulability remains unclear. Therefore, this study aimed to investigate the effect of hypobaric hypoxia at 3,883 m above sea level on thrombin generation and platelet activation. Methods After complying with medical ethical procedures, 18 participants were recruited, of whom 1 had to leave the study prematurely due to mild acute mountain sickness. Blood was drawn first at 50 m above sea level and second at 3,883 m altitude after gradual acclimatization for 6 days. Thrombin generation was measured in whole blood, platelet-rich plasma and platelet-poor plasma. Platelet activation was assessed using a whole blood flow-cytometric assay. Coagulation factor levels, D-dimer levels and markers of dehydration and inflammation were measured. Results Hypobaric hypoxia at 3,883 m altitude caused increased thrombin generation, measured as peak height and endogenous thrombin potential, in whole blood, platelet-rich and platelet-poor plasma without or at low tissue factor concentration. The elevated thrombin generation was mediated by increased factor VIII levels and not caused by dehydration or inflammation. In contrast, spontaneous and agonist-induced platelet activation was decreased at high altitude. Conclusion Hypobaric hypoxia causes increased factor VIII-mediated thrombin generation. The hypercoagulability was balanced by decreased platelet activation. These findings may explain why venous, and not arterial thrombotic events occur more frequently at high altitude.

Hypoxia (oxygen deprivation) is known to be associated with deep vein thrombosis and venous thromboembolism. We attempted to get a better comprehension of its mechanism by going to high altitude, thereby including the potential contributing role of physical activity. Two groups of 15 healthy individuals were exposed to hypoxia by going to an altitude of 3900 meters, either by climbing actively (active group) or transported passively by cable car (passive group). Both groups were tested for plasma fibrinogen, von Willebrand factor and factor VIII levels, fibrinolysis, thrombin generating capacity, heart rate, oxygen saturation levels and blood pressure. As a control for the passive group, 7 healthy volunteers stayed immobile in bed for 7 days at normoxic conditions. The heart rate increased and oxygen saturation levels decreased with increasing altitude. Fibrinolysis and fibrinogen levels were not affected. Factor VIII and von Willebrand factor levels levels increased significantly in the active group, but not in the passive group. Plasma thrombin generation remained unchanged in both the active and passive group with increasing altitude and during 7 days of immobility in healthy subjects. However, by applying whole blood thrombin generation, we found an increased peak height and endogenous thrombin potential, and a decreased lagtime and time-to-peak with increasing levels of hypoxia in both groups. In conclusion, by applying whole blood thrombin generation we demonstrated that hypoxia causes a prothrombotic state. As thrombin generation in plasma did not increase, our results suggest that the cellular part of the blood is involved in the prothrombotic phenotype induced by hypoxia.

Although flight phobia is very common in the general population, knowledge of the underlying mechanisms is limited. The aim of the current study is to determine whether hypoxia is selectively associated with flight anxiety. We wanted to explore levels of oxygen saturation (SpO2) and the associated subjective somatic sensations in flight phobics and controls. The data collected in this study were obtained from 103 participants: 54 had flight phobia, 49 were controls. SpO2 as well as a subjective report of somatic sensations and anxiety were measured during short haul flights, both at ground level and at cruising altitude. Results indicated that both flight phobics and controls showed a comparable clinical significant decrease in SpO2 from sea level to cruising altitude. Next, at ground level the flight phobic group reported more somatic sensations, most likely due to the elevated levels of anxiety at that point. However, at cruising altitude the flight phobic group still reported more somatic sensations while the level of anxiety was no longer significantly different from controls. This finding points to altered symptom perception in flight phobia and stresses the importance of somatic sensations in this particular phobia.

Reducing the number of contacts between passengers on an airplane can potentially curb the spread of infectious diseases. In this paper, a social force based pedestrian movement model is formulated and applied to evaluate the movement and contacts among passengers during boarding and deplaning of an airplane. Within the social force modeling framework, we introduce location dependence on the self-propelling momentum of pedestrian particles. The model parameters are varied over a large design space and the results are compared with experimental observations to validate the model. This model is then used to assess the different approaches to minimize passenger contacts during boarding and deplaning of airplanes. We find that smaller aircrafts are effective in reducing the contacts between passengers. Column wise deplaning and random boarding are found to be two strategies that reduced the number of contacts during passenger movement, and can potentially lower the likelihood of infection spread.