OBJECTIVE: This study aimed to examine if the General Health Questionnaire (GHQ)-12 and Kessler 6 (K6) assess the same underlying construct and to develop a score conversion table for the two scales.
METHODS: A random sample of 4303 people who completed both the GHQ-12 and K6 in 2021 were analyzed. Exploratory bifactor analysis evaluated if both scales measured the same construct, and Rasch analysis assessed item severities. The scales were transformed using Equipercentile equivalence for comparability and score conversion. Agreement was estimated with Cohen\'s Kappa coefficient, along with raw positive and negative agreement.
RESULTS: We found that the two scales measure the same phenomenon to the extent that they can be made equivalent. Conversion tables between GHQ-12 and K6 are presented. Applying the commonly used cut-off of ≥3 on the GHQ-12 bi-modal scoring, we found that the best corresponding cut-off on the K6 would be ≥8. The prevalence of psychological distress was then 22% with GHQ-12% and 21% with K6.
CONCLUSIONS: The GHQ-12 and K6 measure the same construct and corresponding cut-off scores on one scale were found for the other scale. This is valuable for longitudinal studies or time series where one scale has replaced the other scale.

Despite numerous theoretical and empirical studies exploring the spatial needs of road users, a significant gap remains in validating these findings with extensive real-world data sets. This study presents the idea of \"safe spaces,\" outlining the buffer zones that both walkers and e-bicyclists maintain when crossing streets, while also taking safety and psychological well-being into consideration. We used drones to gather the study\'s trajectory data at three significant crossings in Xi\'an, China. Multi-coordinate system transformation enabled us to determine the relative positions of individuals and moving objects within their visual domain. Relative position frequency heat maps were generated to explore safe distance demands in different directions. The safety space was then fitted using the least squares method. Our research demonstrates that whereas e-bicyclists maintain semi-elliptical safe spaces at street crossings, walkers maintain semi-circular safe spaces, and the sizes of these zones increase in direct proportion to their relative speeds. However, the safe space size oscillates within a defined range above a particular speed threshold. Notably, e-bicyclists require larger safety distances forward and are more sensitive to speed variations. Our knowledge of the dynamics of safe spaces for walkers and e-bicyclists at street crossings is improved by this work, with emphasis on the role of speed and pedestrian numbers in shaping these spaces. The incorporation of real-world data from drone footage significantly strengthens the validity and reliability of our findings, bridging a crucial empirical gap in the existing literature. Additionally, this paper introduces a crowding coefficient based on safe space and proposes a new method using safe space to aid traffic conflict metrics PET, providing valuable insights for identifying crowd congestion levels and capturing traffic conflict events. The practical implications of our findings extend to urban planning, traffic management, and safety of vulnerable road users. Ultimately, this research contributes to the development of safer and more efficient urban environments for all road users.

While physical inactivity can contribute to chronic diseases, regular activity like walking can help prevent them. In 2010, one in three adults in the U.S. Virgin Islands (USVI) was physically inactive, higher than most U.S. states and territories. There are few walkable destinations and sidewalks along streets in the USVI. Since community- and street-scale design features can influence walking, we convened a 3-day walkability institute in the USVI to (1) learn about physical activity and best practices for design and (2) develop public health infrastructure that supports implementation. Island teams were formed to develop and implement a territory-wide action plan, focused on passing a Complete Streets policy, and demonstration projects on the islands of St. Croix, St. John, and St. Thomas to advance and pass this policy. An example of the demonstration projects and their significance is the completed one in St. Croix, which is the focus of this article.
Island teams applied critical components of functioning program infrastructure as described in the Component Model of Infrastructure (CMI) such as engaged data, multilevel leadership, responsive plans and planning, and networked partnerships. We evaluated whether a crosswalk installation in St. Croix could alter driver and pedestrian behavior and create a safer environment for pedestrians. Observers recorded pedestrian crossing time, driver speed, and other behaviors before and after crosswalk installation.
Pedestrians took significantly fewer average seconds to cross the street in the postdemonstration period (9.83) compared with predemonstration (13.4) (p = .03). Average car speed declined between the predemonstration (24.3) and long-term demonstration periods (p < .01) and from the postdemonstration (24.7) to the long-term demonstration period (18.2) (p < .01). A greater percentage of pedestrians used the crosswalk to cross the street between the postdemonstration (12.5%) and long-term demonstration periods (53.7%) (p < .01).
The demonstration project in St. Croix shows that improvements to built environment infrastructure can increase safety for pedestrians, thus improving walkability in the USVI. We discuss the importance of CMI elements observed in the success of the St. Croix demonstration and its effectiveness in promoting a Complete Streets policy and the lack of these elements on St. John hindering progress there. Public health practitioners can apply the CMI to future physical activity promotion projects in the USVI and other settings as having functioning program infrastructure helps overcome challenges including natural disasters and a global pandemic and can achieve progress toward sustained policy and systems change.

Despite the international efforts to improve pedestrian safety in different regions of the world, pedestrian fatalities still account for around one-third of annual road traffic deaths. Residential areas are commonly characterized by high pedestrian flows, making pedestrian safety a highpriority public health issue. Different types of treatments such as ITS-based, road markings, and physical treatments have been implemented to improve pedestrian safety, however, their efficiency varies between different locations worldwide. Therefore, this study aims to compare different innovative crosswalk treatments and to investigate their impacts on driving behavior in residential areas using a driving simulator. In our study, we juxtapose five different types of treatments with the untreated control condition. The treatments included two ITS-based solutions [LED pavement lights (ITS_LED) and Variable Message Sign (ITS_VMS)]; two different road markings [yellow zigzag marking (Marking_zigzag) and white road narrowing marking with the word SLOW written in the middle (Marking_narrowing)] and a physical road narrowing treatment (Physical_narrowing). Each of the tested conditions (control condition and treatment conditions) was tested with a Yield/Stop-controlled marked crosswalk located in a residential area with a posted speed limit of 50 km/h for two different situations. In the first situation, there was no pedestrian at the crosswalk (Situation PA), while in the second situation, a pedestrian was present at the crosswalk (Situation PP). Sixty-one volunteers possessing a valid Qatari driving license participated in the experiment. The study results showed that compared to the control condition, Physical_narrowing, ITS_VMS, and Marking_narrowing conditions helped to improve the yielding rates by 12.7 %. In terms of drivers\' speed behavior, even though a pedestrian was not present at the crosswalk in Situation PA, physical_narrowing performed best by lowering the mean travel speed by around 10.1 km/h at the conflict location compared to the control location. Finally, the participants rated the physical_narrowing condition highest among the tested conditions. Based on the findings of the study, we conclude that the physical_narrowing treatment outperform other studied treatments since it significantly limits the freedom of drivers to maneuver, forcing them to slow down and give priority to crossing pedestrians.

To develop and validate bi-directional crosswalks between the Oxford Hip Score (OHS) and HOOS-12 summary impact score, and between the Oxford Knee Score (OKS) and KOOS-12 summary impact score.
Data were sourced from the Australian Orthopaedic Association National Joint Replacement Registry Patient-Reported Outcome Measures Program. Patients undergoing primary joint replacement for osteoarthritis who completed the OHS and HOOS-12 or OKS and KOOS-12 instruments were included in the analysis. An equipercentile method was used to create four crosswalks, with the distribution of scores smoothed using log-linear models prior to equating. Crosswalk validity was assessed through comparison of actual vs derived scores, Pearson correlation coefficients, root mean square errors (RMSE) and Bland-Altman plots.
Paired OHS/HOOS-12 data and paired OKS/KOOS-12 data were available for 4,513 patients undergoing total hip replacement and 5,942 patients undergoing total knee replacement, respectively. Minimal differences were observed between actual and crosswalk-derived mean scores (actual OHS 27.55 vs derived OHS 27.56; actual HOOS-12 53.28 vs derived HOOS-12 53.31; actual OKS 27.34 vs derived OKS 27.34; actual KOOS-12 50.51 vs derived KOOS-12 50.58). High correlation was observed between actual and derived scores (Pearson\'s r for hip-specific instruments: 0.943-0.946; Pearson\'s r for knee-specific instruments: 0.925-0.931). Plotted actual vs mean derived scores also indicated robust concordance across the breadth of the instrument scales.
These crosswalks provide close approximations of actual OHS, OKS, HOOS-12 and KOOS-12 scores, as indicated by multiple validation metrics. They offer a resource for clinicians, researchers and arthroplasty registries to support PROMs score conversion and data harmonisation efforts.

At \"semi-controlled\" crosswalks with yield signs and markings, negotiations as to the right-of-way occur frequently between pedestrians and motorists, to determine who should proceed first. This kind of \"negotiation\" often leads to traffic delay and potential conflicts. To minimize misunderstandings between pedestrian and motorist that can have serious safety consequences, it is essential that we understand the decision-making process as the \"players\" interact in real street-crossing situations. This paper employs a game-theoretic approach to investigate the joint behaviors of pedestrians and motorists from the perspective of safety. Assuming bounded rationality for each player, the quantal response equilibrium is a special kind of game with incomplete information. Explanatory variables such as conflicting risks and time savings can be incorporated into the payoff functions of the \"players\" via expected utility functions. Finally, model parameters can be estimated using an expectation maximization algorithm. The game-theoretic framework is applied to model pedestrian-motorist interactions at a semi-controlled crosswalk on a university campus. The estimation results indicate that the likelihood of pedestrian-vehicle conflict can be quantified. The results can lead to control measures that facilitate the negotiation between pedestrian and motorist and reduce the conflict risk at semi-controlled crosswalks.

Safety of pedestrians depends, among other factors, on their behavior while crossing the road. This study aims to assess behaviors of pedestrians at signalized crosswalks.
Following a literature review and a pilot study, 25 vital pedestrian crossing factors and behaviors were determined. Then data was randomly collected for 708 pedestrians at 10 lighted crossings in Sharjah (UAE), five at road intersections and five mid-block crossings.
Results indicated that 17.4% of pedestrians observed crossed partly or fully on red and that crossing speed was 1.22 m/s, on the average, which is slightly faster than most speeds recorded in the literature. Moreover, female pedestrians were more likely to cross while chatting with others, less likely to cross on red, and more likely to walk slower than male pedestrians. Results also showed that pedestrians who crossed at road intersections walked slower than those who crossed at mid-block crossings. It was also found that longer red pedestrian times and narrower roads tended to encourage pedestrians to cross on red and that the majority of pedestrians did not look around before crossing.
Use of the Health Belief Model for pedestrian safety are discussed.

BACKGROUND: Substantial investment has gone into research on the efficacy and effectiveness of pharmaceutical and nonpharmacologic interventions for chronic pain. However, synthesizing this extensive literature is challenging because of differences in the outcome measures used in studies of similar or competing interventions. The absence of a common metric makes it difficult to replicate findings, pool data from multiple studies, resolve conflicting conclusions, or reach consensus when interpreting findings.
METHODS: This study has a seven-member Advisory Council of chronic pain experts. Preliminary analyses will be performed on data from several large existing datasets; intermediate analyses will be performed using primary data collected from Amazon\'s Mechanical Turk (MTurk); and cross-validation will use primary data collected from a nationally-representative, probability-based panel. Target sample size for both primary datasets is 1500. The three study aims are as follows: Aim 1 will develop and evaluate links between the 29-item Patient-Reported Outcomes Measurement Information System (PROMIS®-29) and legacy measures used for chronic pain such as the Roland-Morris Disability Questionnaire (RMDQ) and the Oswestry Disability Index (ODI). We will assess the best method of score linking and create crosswalk tables. Aim 2 will evaluate and refine the Impact Stratification Score (ISS) based on 9 PROMIS-29 items and proposed by the NIH Research Task Force on chronic low back pain. We will evaluate the ISS in terms of other indicators of condition severity and patient prognosis and outcomes and identify cut-points to stratify chronic pain patients into subgroups. Aim 3 will evaluate the strengths and limitations of MTurk as a data collection platform for estimating chronic pain by comparing its data to other data sources.
CONCLUSIONS: The accomplishment of Aims 1 and 2 will allow direct comparison of results across past and future studies of chronic pain. These comparisons will help us to understand different results from seemingly similar studies, and to determine the relative effectiveness of all pharmaceutical and nonpharmacologic interventions for chronic pain across different trials. Aim 3 findings will provide valuable information to researchers about the pros and cons of using the MTurk platform for research-based data collection.
BACKGROUND: ClinicalTrials.gov: NCT04426812 ; June 10, 2020.

Traffic fatalities are the second cause of violent deaths in Colombia. However, due to the signing of the peace agreement and the growing number of fatalities in road crashes, it is possible that soon traffic fatalities will be the primary cause of violent deaths in the country, particularly in urban areas. This study is an exploratory analysis focused on identifying the main factors associated with the severity of traffic crashes in urban areas, using Cartagena as a case study. We analyzed three levels of crash severity, namely fatal, injury, and property-damage-only, considering factors in several different dimensions: victim, vehicle, road infrastructure, traffic and control, day and time, and environmental factors. A modeling approach based on multinomial ordered discrete models was used to properly identify the main factors associated with the severity levels. We found that the probability of fatal accidents is higher on streets with speed limits over 40 km/h, and that males and people aged 60 years or older are the victims with the most significant risk of fatal crashes. Motorcycles were also identified as vehicles with the highest probability of fatal crashes in the city. We showed that the probability of fatal crashes occurring is higher on streets where pedestrian bridges, traffic lights, and crosswalks are present. These findings are worthy because, in Colombia and other developing countries, the authorities normally expect to reduce the probability of fatal accidents through investments in pedestrian bridges, signaling devices, and crosswalk markings. However, according to our results, it possibly will not occur unless further countermeasures are taken. Based on these findings, reducing speed limits, operational improvements at signalized intersections, zero tolerance for traffic violations related to pedestrians, an awareness campaign on pedestrian safety focused on males and people aged 60 or older, and improving motorcycle safety are the countermeasures we proposed. Furthermore, as the authorities make significant efforts to investing in pedestrian bridges, we propose a further investigation into the traffic crashes in streets where there is this infrastructure since more severe events occur near them.

\"Semi-controlled\" crosswalks are unsignalized, but clearly marked with \"yield to pedestrian within crosswalk\" signs. Ideally, pedestrians can cross the street immediately after they arrive at the curb. However, real world observations show that pedestrians and vehicles are often involved in non-verbal \"negotiations\" to decide who should proceed first. This kind of \"negotiation\" often causes delays for both parties and may lead to unsafe situations. The study in this paper was based on video recordings of the waiting behaviors of 2059 pedestrians interacting with 1003 motorists at selected semi-controlled crosswalks. One such location experienced a conversion from one-way operation to two-way operation, which provided a rare opportunity for a before-and-after study at that location. Multi-state Markov models were introduced as a novel approach to correlate the dynamic process between recurrent events. Time-varying covariates related to pedestrian characteristics, traffic condition, and vehicle dynamics (distance and speed) turned out to be significant. The analytical method developed in this study provides a tool to dynamically model pedestrian waiting decisions with uncertainties. Model results reveal that, after the conversion from one-way to two-way operation, the probability of a pedestrian accepting a lag decreases from 69.7% to just below 60% on the same street. In addition, pedestrians are more hesitant to cross a two-way street than a one-way street. Countermeasures that increase motorist yielding rate or reduce pedestrian confusion will enhance safety such crossing locations.