This research directly assesses older people’s neural activation in response to a changing urban environment while walking, as measured by electroencephalography (EEG). The study builds on previous research that shows changes in cortical activity while moving through different urban settings. The current study extends this methodology to explore previously unstudied outcomes in older people aged 65 years or more (n = 95). Participants were recruited to walk one of six scenarios pairing urban busy (a commercial street with traffic), urban quiet (a residential street) and urban green (a public park) spaces in a counterbalanced design, wearing a mobile Emotiv EEG headset to record real-time neural responses to place. Each walk lasted around 15 min and was undertaken at the pace of the participant. We report on the outputs for these responses derived from the Emotiv Affectiv Suite software, which creates emotional parameters (‘excitement’, ‘frustration’, ‘engagement’ and ‘meditation’) with a real-time value assigned to them. The six walking scenarios were compared using a form of high dimensional correlated component regression (CCR) on difference data, capturing the change between one setting and another. The results showed that levels of ‘engagement’were higher in the urban green space compared to those of the urban busy and urban quiet spaces, whereas levels of ‘excitement’ were higher in the urban busy environment compared with those of the urban green space and quiet urban space. In both cases, this effect is shown regardless of the order of exposure to these different environments. These results suggest that there are neural signatures associated with the experience of J Urban Health DOI 10.1007/s11524-017-0191-9 C. Neale (*) : S. Cinderby Stockholm Environment Institute, Environment Department, University of York, York, England e-mail: chris.neale@york.ac.uk P. Aspinall School of Built Environment, Heriot-Watt University, Edinburgh, Scotland J. Roe Center for Design and Health, School of Architecture, University of Virginia, Charlottesville, VA, USA S. Tilley :C. W. Thompson OPENspace Research Centre, Edinburgh College of Art, University of Edinburgh, Edinburgh, Scotland P. Mavros ETH-Centre, Singapore, Singapore R. Coyne Edinburgh School of Architecture and Landscape Architecture, University of Edinburgh, Edinburgh, Scotland N. Thin School of Social and Political Science, University of Edinburgh, Edinburgh, Scotland G. Bennett The Stats People, Sevenoaks, Kent, England, UK different urban spaces whichmay reflect the older age of the sample as well as the condition of the spaces themselves. The urban green space appears to have a restorative effect on this group of older adults.

This research directly assesses older people’s neural activation in response to a changing urban environment while walking, as measured by electroencephalography (EEG). The study builds on previous research that shows changes in cortical activity while moving through different urban settings. The current study extends this methodology to explore previously unstudied outcomes in older people aged 65 years or more ( n = 95). Participants were recruited to walk one of six scenarios pairing urban busy (a commercial street with traffic), urban quiet (a residential street) and urban green (a public park) spaces in a counterbalanced design, wearing a mobile Emotiv EEG headset to record real-time neural responses to place. Each walk lasted around 15 min and was undertaken at the pace of the participant. We report on the outputs for these responses derived from the Emotiv Affectiv Suite software, which creates emotional parameters (‘excitement’, ‘frustration’, ‘engagement’ and ‘meditation’) with a real-time value assigned to them. The six walking scenarios were compared using a form of high dimensional correlated component regression (CCR) on difference data, capturing the change between one setting and another. The results showed that levels of ‘engagement’ were higher in the urban green space compared to those of the urban busy and urban quiet spaces, whereas levels of ‘excitement’ were higher in the urban busy environment compared with those of the urban green space and quiet urban space. In both cases, this effect is shown regardless of the order of exposure to these different environments. These results suggest that there are neural signatures associated with the experience of different urban spaces which may reflect the older age of the sample as well as the condition of the spaces themselves. The urban green space appears to have a restorative effect on this group of older adults.

Purpose: To quantify the influence of spectral domain optical coherence tomography (SDOCT) on decision-making in patients with suspected glaucoma.Methods: A prospective cross-sectional study involving 40 eyes of 20 patients referred by community optometrists due to suspected glaucoma. All patients had disc photographs and standard automated perimetry (SAP), and results were presented to 13 ophthalmologists who estimated pre-test probability of glaucoma (0-100%) for a total of 520 observations. Ophthalmologists were then permitted to modify probabilities of disease based on SDOCT retinal nerve fiber layer (RNFL) measurements (post-test probability). The effect of information from SDOCT on decision to treat, monitor, or discharge was assessed. Agreement among graders was assessed using intraclass correlation coefficients (ICC) and correlated component regression (CCR) was used to identify variables influencing management decisions.Results: Patients had an average age of 69.0 10.1 years, SAP mean deviation of 2.71 +/- 3.13 dB, and RNFL thickness of 86.2 +/- 16.7 m. Average pre-test probability of glaucoma was 37.0 +/- 33.6% with SDOCT resulting in a 13.3 +/- 18.1% change in estimated probability. Incorporating information from SDOCT improved agreement regarding probability of glaucoma (ICC = 0.50 (95% CI 0.38 to 0.64) without SDOCT versus 0.64 (95% CI 0.52 to 0.76) with SDOCT). SDOCT led to a change from decision to treat or monitor to discharge in 22 of 520 cases and a change from discharge to treat or monitor in 11 of 520 cases. Pre-test probability and RNFL thickness were predictors of post-test probability of glaucoma, contributing 69 and 31% of the variance in post-test probability, respectively.Conclusions: Information from SDOCT altered estimated probability of glaucoma and improved agreement among clinicians in those suspected of having the disease.