bluuebunny/crossref_metadata_2025 huggingface dataset:
Users of Transport Modes and Multimodal Travel Behavior
Authors: Kuhnimhof Tobias , Chlond Bastian , Von Der Ruhren Stefan
Published: May 2018

Results are presented from analysis of individual mode choice behavior in the longitudinal section in Germany. The findings show that about half of German drivers also use public transport. Because they use different modes, they can be characterized as multimodals. This group will constitute an increasing share of the public transport clientele in coming decades because the decline of captive public transport riders is foreseeable. Therefore it is necessary to understand multimodal behavior because in an environment where travelers have increasing options, it is important to know how they make use of their options. It was found that multimodals employ public transport for specific purposes, whereas the car is universal. Less than 20% of multimodals use public transport on a regular basis, for example, to commute. Most multimodals use it occasionally. Multimodals opt for public transport in specific situations because it is the better option and not because there is no car available. Although for families the car is often the better choice, single persons tend to be more multimodal. Commuting by public transport was found to be a gateway to the use of public transport for other purposes.
Impact of Life-Course Events on Car Ownership
Authors: Prillwitz Jan , Harms Sylvia , Lanzendorf Martin
Published: May 2018

This study focuses on the impact of life-course events on car ownership and, ultimately, on travel behavior to provide a basis for measures influencing people toward a more sustainable mobility. The theoretical background for the analysis is the mobility biographies approach. This approach assumes that travel behavior is mainly habitual, and therefore, only relatively seldom do windows of opportunity open for behavioral changes when travel decisions are considered more intensively. Car ownership is used in the analysis as a proxy for actual travel behavior. Hence, the results may deliver some insight on the effect of key events in a person's or household's life on travel behavior and, further, the potential of soft policy intervention measures to change daily mobility. The German Socioeconomic Panel is used for the empirical analysis. The results show the importance of life-course events for travel behavior. Besides the household status variables of age, number of cars, and weighted monthly income, four key events have a strong impact on car ownership growth: the changing number of adults in a household, birth of the first child, changing weighted monthly income, and change of residence from a regional core to a regional core area. Expected influences from relocations with a spatial structural change have not been proved so far.
Modeling Transfers in Multimodal Trips
Authors: Hoogendoorn-Lanser Sascha , Van Nes Rob , Hoogendoorn Serge P.
Published: May 2018

Transfers are essential parts of multimodal trips. A detailed description of the transfer process identifies time, costs, and effort related to the different stages of the transfer process. Since inclusion of multiple transfer attributes generally leads to high correlations between parameter estimates, most travel choice models only distinguish a small number of transfer attributes. When attributes are highly correlated, it is difficult to establish their impact on the travel choice process, especially when more advanced random utility models are used. By analyzing path-size logit models that differ in the way the transfer process is accounted for, combinations of transfer attributes that best reflect the role of transfers in the travel choice process are established. The analysis uses revealed-preference data on interurban multimodal train trip making in the Netherlands. Apart from log likelihood values, correlations between different classes of transfer attributes are used to evaluate the different models. It is shown that it is better to exclude the number of transfers from the utility specification because its inclusion results in high correlations with other transfer attributes. Correlations are explained from the different stages in the transfer process to which transfer attributes relate. In addition, it is demonstrated that transfers can alternatively be accounted for by representing the transfer process in travel choice models at a high detail level and thereby prevent high correlations. It turns out that the best model contains mode indicators, railway station indicators, parking costs, transfer walking times, and transfer waiting times.
Drive or Walk?
Authors: Shay Elizabeth , Fan Yingling , Rodríguez Daniel A. , Khattak Asad J.
Published: May 2018

An extensive body of literature has developed on the relationship between the physical environment and travel behavior. Although many studies have found that neotraditional neighborhood development supports nonautomobile travel by providing good street connectivity, pedestrian and cycling facilities, and internal destinations, questions remain about the travel behavior of individuals within such neighborhoods. This study uses travel diaries to examine utilitarian trip-making behavior within a neotraditional neighborhood and compares total trips with mode-specific (i.e., walk and drive) trips. Negative binomial regression is used to examine the effect of a set of independent variables, including personal and household characteristics, select attitudinal factors, and distance from residences to the commercial center. It is found that within the neotraditional neighborhood, walk trips drop off quickly with increasing distance to destinations, whereas drive trips increase. The analysis demonstrates the importance of short distances for within-neighborhood travel and the merit in considering trips separately for walk and drive modes to avoid obscuring important factors associated with trip making.
Cognitive Mapping, Travel Behavior, and Access to Opportunity
Authors: Mondschein Andrew , Blumenberg Evelyn , Taylor Brian D.
Published: May 2018

Past theoretical and empirical research on cognitive mapping is combined with the authors’ initial research to suggest how cognitive mapping might be employed to understand and predict travel behavior better, with an emphasis on how spatial cognition shapes access to opportunity. It is argued that the path-based cumulative process of spatial learning—during which the cognitive map develops through wayfinding and travel experience—affects accessibility by determining whether and how destinations are encoded into a person's cognitive map. Variations in cognitive mapping, spatial knowledge, and resultant travel behavior can occur between individuals or among groups in systematic ways. Some of these differences are related to previous travel experience, including experience with travel modes. Such variations in spatial knowledge can result in different levels of functional accessibility despite similar locations, demographics, and other factors thought to influence travel behavior. The initial survey in three Los Angeles, California, neighborhoods suggests that cognitive mapping is influenced by neighborhood and travel mode experience in addition to demographic characteristics. Modally constructed cognitive maps, which likely vary systematically by location and socioeconomic status, may affect perceived opportunities in ways that travel behavior researchers are only beginning to understand. To a carless job seeker, job opportunities not easily reached by transit are effectively out of reach and even transparent. Modally constructed cognitive maps, in other words, are essential to understanding both travel behavior and accessibility in cities.
Transit Attractiveness
Authors: Kopp J. Christopher , Moriarty Joseph A. , Pitstick Mark E.
Published: May 2018

Transit performance measures typically have focused on attributes of service supply, such as capacity, passenger loading, frequency, and reliability. These measures are effective in describing the quality of transit service available at a given location, but they do not describe how well transit serves actual passenger trips from that location to potential destinations. To support the Regional Transportation Authority's objective of increasing the total number of trips for which transit is an attractive travel alternative, a methodology was developed to evaluate the relative attractiveness of travel by public transit and personal automobile on a sample of origin–destination pairs throughout the Chicago, Illinois, metropolitan region. Transit attractiveness was computed by using a logit mode choice framework that compared the utility of travel by transit, auto, and park-and-ride for various components of travel time and travel cost. To make the comparisons as customer-focused as possible, travel utility between the sampled origins and destinations was derived from actual automobile and transit itineraries generated by publicly available web-based trip planners. This paper describes the methodology and how it was applied in northeastern Illinois to identify ways to serve activity centers better by improving transit accessibility from many other places, and it discusses potential ways of generalizing the approach for use in other regions faced with similar challenges in planning transit systems.
Interoperable Transit Smart Card Systems
Authors: Yoh Allison C. , Iseki Hiroyuki , Taylor Brian D. , King David A.
Published: May 2018

The array of institutional factors affecting public transit operators’ adoption of interoperable smart cards for regional, multioperator fare collection systems is examined. Although many transit agencies have implemented smart card technologies as stand-alone systems that cannot be used on other systems, others have done so as part of regional partner schemas in which multiple agencies with contiguous or overlapping service areas develop compatible systems. Through a review of the literature and in-depth interviews with industry experts, it was found that whereas interoperable systems have the benefit of allowing riders to use one fare card across multiple operators, such systems have proved difficult to form and coordinate as they require consensus among multiple parties. Four main institutional issues hindering implementation were identified: ( a) staff and officials are often hesitant to relinquish local control over fare policies and collection because individual transit agencies are guided by different missions or priorities and tend to serve different markets of user groups; ( b) the future of smart card technology is uncertain; ( c) decentralized systems of decision making mean that inter-jurisdictional governance structures tend to be far more informal than intraorganizational operations and management; and ( d) transit agencies typically lack the institutional capacity to comprehensively evaluate the costs and benefits of interoperable systems—and as a result, there are few rigorous evaluations of smart cards. Absent careful evaluations of costs and benefits, it cannot be known whether interoperable smart cards are overdue or premature. Thus, transit agencies’ motivations to pursue smart cards are likely to remain ambiguous, and implementation is likely to remain halting.
New Technologies for Sustainable Urban Transportation in Europe
Authors: Parent Michel
Published: May 2018

In the past few years, the European Commission has financed several projects to examine how new technologies could improve the sustainability of European cities. These technologies concern new public transportation modes such as guided buses to form high-capacity networks similar to light rail but at a lower cost and with better flexibility, personal rapid transit, and cybercars (small urban vehicles with fully automatic driving capabilities to be used in carsharing mode, mostly as a complement to mass transport). They also concern private vehicles with technologies that could improve the efficiency of the vehicles as well as their safety (Intelligent Speed Adaptation, Adaptive Cruise. Control, Stop&Go, Lane Keeping) and how these new vehicles can complement mass transport in the form of carsharing services.
Relocation Simulation Model for Multiple-Station Shared-Use Vehicle Systems
Authors: Kek Alvina G. H. , Cheu Ruey Long , Chor Miaw Ling
Published: May 2018

A shared-use vehicle system has a small number of vehicles reserved exclusively for use by a relatively larger group of members. Challenged by accessible and economical public transportation systems, multiple-station shared-use vehicle companies are driven to gain a competitive edge by using an operator-based relocation system to ensure privacy, simplicity, and convenience to their users. To help operators identify measures to maximize resources and enhance service levels, a simulation model is developed, with an emphasis on operator-based relocation techniques. A qualitative analysis conducted on operator-based relocation systems provides insights on the key issues involved and their influences over each other. On the basis of this analysis, a time-stepping simulation model is developed, and three performance indicators are proposed to evaluate the effectiveness of the different relocation techniques. The model has been validated by using commercially operational data from a local shared-use vehicle company. With the existing operational data as the base scenario, two proposed relocation techniques, namely, shortest time and inventory balancing techniques, and various operating parameters are studied. The simulation results have shown that if the inventory balancing relocation technique is used, the system can afford a 10% reduction in car park lots and 25% reduction in staff strength, generating cost savings of approximately 12.8% without lowering the level of service for users.
Impact of Public Transit on Employment Status
Authors: Yi Chang
Published: May 2018

The impact of public transit on employment status of individuals is analyzed. The role of public transportation in employment appears in two policy debates regarding the spatial mismatch hypothesis and the role of public or private mobility to help the unemployed to gain employment. However, research studies dealing with the two debates produced conflicting results, and the impact of public transit has not been fully accounted for in explaining employment outcomes. A study was done to disaggregate analysis to explain employment status of individuals in the Houston, Texas, metropolitan area as a function of the access to public transit, job accessibility by transit, and household car ownership. The results of the study indicate that job accessibility by public transit has significant impacts on employment levels. However, it is questionable if improving physical access to public transit can significantly help the poor, although it may be effective for enhancing the employment levels of individuals with regular access to private vehicles. Although private mobility also appears significant for improving employment status of the economically disadvantaged, job accessibility by public transit has a stronger effect in increasing the levels of employment than private vehicles. The study defies the contention that public transit is helpless for the under-privileged of the society. Therefore, it is important to continue policy efforts in progress to improve regional public transit service.
Explaining Variation in Transit Ridership in U.S. Metropolitan Areas between 1990 and 2000
Authors: Thompson Gregory L. , Brown Jeffrey R.
Published: May 2018

Between 1990 and 2000, transit patronage increased by around 7% in the United States, but there has been wide variation around this mean. Most research attributes variation in ridership change to a combination of socioeconomic and land use factors, which are beyond a transit agency's control, and service and fare policy decisions, which are within an agency's control. A study built on this earlier work by examining ridership change at the metropolitan scale for all metropolitan statistical areas (MSAs) in the United States that had more than 500,000 people at the time of the 2000 census. The study incorporates several measures of service quality in order to evaluate the relative efficacy of policy decisions about service coverage, frequency, and orientation (central business district radial versus multidestination system orientation). The multivariate analysis shows that transit is growing most rapidly in the nontraditional markets of the West but that much of the regional variation is a function of the particular service coverage, frequency, and orientation decisions made by transit agencies in this region. Service coverage and frequency are the most powerful explanatory variables for variation in ridership change among MSAs with 1 million to 5 million people, whereas a multidestination service orientation is the most important explanation for variation in ridership change among MSAs with 500,000 to 1 million people.
Sketch Models to Forecast Commuter and Light Rail Ridership
Authors: Lane Clayton , DiCarlantonio Mary , Usvyat Len
Published: May 2018

Ridership potential is among the most valuable attributes to understand about a proposed light or commuter rail line during early stages of project development, yet few nationally relevant sketch-level tools exist for feasibility analyses. Research was done to develop a nationally applicable, sketch-level ridership forecasting tool for light rail and commuter rail. The study collected current ridership, demographic, and transportation system data from 17 U.S. regions, including 58 commuter rail corridors, 22 light rail corridors, and 1,218 stations, and it tested 163 possible explanatory variables. The effort yielded two multivariable regression equations that show close relationships between actual and predicted values, with adjusted R-squared values of 0.97 for commuter rail and 0.92 for light rail. The models also validate well to existing rail systems in six regions and successfully predict actual line ridership with adjusted R-squared values of 0.84 for commuter rail and 0.47 for light rail. The new models improve on previous tools by introducing sensitivity to reverse-commute trips and special transportation hubs or ports and by introducing transportation-system variables to measure the impacts of faster operating speeds, lower fares, or shorter midday headways. The models require readily available data and use simple form, making the tool technically accessible to a large number of transportation planners. An apples-to-apples comparison with similar sketch models developed nearly a decade ago in TCRP Report 16 shows that the new tools perform consistently better, explaining between 31% and 213% more variation in observed rail boardings among the same validation data sets.
Simple Method of Predicting Travel Speed on Urban Arterial Streets for Planning Applications
Authors: Tarko Andrew P. , Choocharukul Kasem , Bhargava Abhishek , Sinha Kumares C.
Published: May 2018

Travel speed is a key measure of effectiveness in evaluating urban arterials. The Highway Capacity Manual (HCM) methodology of predicting speeds along urban streets requires complex calculations and input not typically available in long-range planning. The use of default values is therefore necessary. This paper demonstrates that a simple and practical method of estimating travel speed along urban arterial streets is possible. An equation derived from the HCM delay formula and calibrated with the results obtained from CORSIM, a microsimulation model, is proposed. The equation requires neither signal characteristics nor detailed traffic and geometry information about arterial intersections. The proposed model of travel speed along urban arterials uses only input available to planners. The model is evaluated with the results obtained from a field study in Lafayette, Indiana. Despite its limited scope of input and simple structure, the model properly replicates the trends found in the field. The model overestimates the actual speeds by 18%, and a simple adjustment factor removes the bias.
Probabilistic Analysis of Highway Capacity Manual Delay for Signalized Intersections
Authors: Ji Xiaojin (Jerry) , Prevedouros Panos D.
Published: May 2018

“Uncertainty analysis” is a new term in traffic capacity analysis, but it is routine in other areas of civil engineering. A probabilistic method, based on uncertainty and sensitivity analysis methods, to incorporate uncertainty of inputs into the existing Highway Capacity Manual deterministic delay model is proposed. Uncertainty analysis is the core of the probabilistic method for propagating the uncertainty of inputs into the uncertainty of the output. Sensitivity analysis is a supplement to uncertainty analysis to guide the data collection, refine uncertainty analysis, and help explain the results of uncertainty analysis. Results of the probabilistic method provide users with a comprehensive view of the level of service (LOS) of a signalized intersection that is more realistic and robust than that of the current method. A case study demonstrates the application of the proposed probabilistic method. With the proposed method, outputs change from a single delay value and LOS letter to mean value, standard deviation, confidence interval, and probability density function for the delay and likelihood percentages for each applicable LOS category such as C (10%), D (76%), and E (14%). This paper also initiates a summary of available field data on uncertain input values for capacity analysis of signalized intersections. A value of 0.05 is likely appropriate for the coefficient of variation for saturation flow, traffic volume, peak hour factor, and green. A value of 0.03 is likely appropriate for cycle length. The two arrival types next to the most probable one should be considered for determining the progression factor.
Enhanced Design Guidelines for Interchange Loop Ramps
Authors: Torbic Darren J. , Brewer Marcus A.
Published: May 2018

The objective of this research was to develop improved design guidance for interchange loop ramps. Despite their long use, there is little research on the design, safety, and operational characteristics of loop ramps. An observational field study was conducted to investigate the relationship between speed and lane position of vehicles and design elements of the ramp proper, and differences in performance between single-lane and multi-lane loop ramps. An assessment was also undertaken to determine how well crash prediction methods in the Highway Safety Manual (HSM) represent the safety performance of two ramp types with distinctly different geometrics: loop and diamond ramps. Based on the research results, recommendations regarding the design of the loop ramp proper, applicable at service interchanges are as follows: (a) for a given radius and design speed, recommended lane and shoulder widths for loop ramps are provided that are expected to induce speeds at or below the ramp design speed, result in similar levels of safety, and encourage drivers to stay within their intended travel lane; (b) regarding multi-lane loop ramps, outside lane widths of 12 ft for entrance ramps and 14 ft for exit ramps are sufficient to accommodate traffic comprised primarily of passenger vehicles, but if the outside lane is expected to accommodate moderate to high volumes of trucks, the outside lane width should be increased; and (c) when implementing the HSM ramp crash prediction methodology, calibration factors should be calculated separately for diamond and loop ramps.
Effect of Loading Waveform Pattern and Rest Period on Fatigue Life of Asphalt Concrete Using Viscoelastic Continuum Damage Model
Authors: Zeiada Waleed Abdelaziz , Gudipudi Padmini P. , Underwood B. Shane , Souliman Mena I.
Published: May 2018

Fatigue cracking is one of the most critical types of distress in asphalt pavements and is due to actions of repetitive traffic loading over time. The fatigue life of asphalt concrete is often estimated from laboratory experiments where the performance depends directly on the test method, loading conditions, temperature, rest period, and aging in addition to the composition and properties of the mixture itself. The uniaxial fatigue test has become a popular method for developing constitutive models that describe the fatigue behavior of asphalt concrete mixture owing to the uniform states of stress across the specimen section. This study investigates the effect of the loading waveform (sinusoidal versus haversine) and rest period (continuous versus intermittent) on the laboratory fatigue life of asphalt concrete mixtures. The fatigue analysis was performed using the simplified viscoelastic continuum damage (S-VECD) approach where the damage characteristic (C-S) curves were established for all the cases, and then used to estimate the fatigue laws through simulated predictions. The proposed uniaxial fatigue test and analysis method were able to determine the fatigue life relationships of asphalt concrete mixture at different waveform and rest period conditions with a reduced testing time compared to other traditional testing and analysis methods. Overall, both rest period and waveform pattern were found to affect the laboratory fatigue life of asphalt concrete mixture. Model predictions show that pulse-rest loading yields an equivalent fatigue life to continuous loading at strain values that are approximately four times greater.
Undocumented, to DACAmented, to DACAlimited: Narratives of Latino Students With DACA Status
Authors: Benuto Lorraine T. , Casas Jena B. , Cummings Caroline , Newlands Rory
Published: May 2018

The Deferred Action for Childhood Arrivals (DACA) executive order intended to protect undocumented youth from deportation and mitigate the negative impact of their undocumented status. Using qualitative methods, eight DACA recipients were interviewed. Participants were primarily females, ranged in age from 19 and 27 years old, and had immigrated from Mexico. Our findings revealed that as participants grew up, they experienced a sense of liminality, or “non-belonging”; however, upon receiving DACA status, these feelings of liminality were temporarily abated. Problematically, as our participants encountered the limitations of DACA, their feelings of liminality returned. While DACA increases access to education, health care, and legal system participation, it only temporarily mitigates the impact of having an undocumented status. The ramifications of the sense of liminality that occur with being undocumented is discussed and policy reforms in areas of federal and state educational policy and immigration policy are suggested.
The Power of Positive Thinking: A Hidden Curriculum for Precarious Times
Authors: McLean Scott , Dixit Jaya
Published: May 2018

In this article, we explore the relationship between adult education and socioeconomic precariousness, through extending existing scholarship regarding the concept of the hidden curriculum. We analyze transcripts of 134 qualitative interviews undertaken to explore the learning experiences associated with reading self-help books in the domains of career and financial success, health and well-being, and interpersonal relationships. We find that, in addition to facilitating learning connected to the reasons for which people seek out books, self-help reading encourages people to be positive, optimistic, and confident; to stop thinking negatively; and to change their interpretation of themselves and their lives. We argue that the hidden curriculum of positive thinking both reflects and reproduces the cultural logic of precariousness that characterizes contemporary labor markets and domestic relationships, and we encourage adult educators to apply the concept of hidden curriculum to the critical study of other forms of educational practice.
Rape Myth Acceptance in Contemporary Times: A Comparative Study of University Students in India and the United Kingdom
Authors: Barn Ravinder , Powers Ráchael A.
Published: May 2018

Much of the literature on rape, victim blaming, and rape myth acceptance is focused on the United States, and there is a general dearth of such scholarly activity in other countries. This article offers insights on university students’ perspectives in two new country contexts—India and the United Kingdom. A total of 693 students contributed to the data collection for this study. Rape myth acceptance was fairly low for both countries, however, students in India were more likely to endorse rape myths. Several demographic characteristics were significant for rape myth acceptance in each country. This study makes an important contribution to the extant literature to address paucity of knowledge and promote understandings to help develop country-specific and appropriate policy, practice, and education and awareness programs. In particular, the study provides novel comparative findings on rape myth acceptance in new country contexts to help advance academic thinking in this area of work.
Breastfeeding Practices Among Hispanic and Non-Hispanic Women at the Postpartum Visit
Authors: Garrett Cameryn C. , Azimov Michelle , Campwala Khozema , Sarmiento Maria , Linton Kristen Faye
Published: May 2018

Background:

Breastfeeding is an active area in public health advocacy. Despite documented benefits for infants and mothers, exclusive breastfeeding is not universal. Ethnicity, among other variables, has been shown to influence breastfeeding practice.

Research aim:

Our study aimed to determine which variables are associated with infant feeding patterns at the postpartum visit; compare the sociodemographic variables associated with infant feeding patterns between Hispanic and non-Hispanic mothers; and determine the odds of exclusive breastfeeding, mixed feeding, and exclusive formula feeding associated with sociodemographic characteristics.

Methods:

A retrospective, cross-sectional two-group comparison design was used. Hispanic and non-Hispanic women’s ( N = 666) infant feeding patterns at 6-week postpartum were analyzed. Group comparisons were made of the demographic characteristics and infant feeding practice.

Results:

Thirty-four percent of Hispanic participants reported exclusive breastfeeding compared with 59% of non-Hispanic White participants. Language and body mass index were significantly associated with infant feeding patterns among Hispanic participants. Compared with non-Hispanic White participants, Hispanic participants had increased odds of reporting mixed feeding and exclusive formula feeding.

Conclusion:

Breastfeeding initiatives should target English-speaking Hispanic mothers and obese Hispanic mothers to align breastfeeding rates with medical recommendations. Healthcare providers may benefit from additional training to address barriers to breastfeeding among obese women and to provide culturally sensitive support that encourages continued breastfeeding in this population.
Fly Away From the Nest? A Configurational Analysis of Family Embeddedness and Individual Attributes in the Entrepreneurial Entry Decision by Next-Generation Members
Authors: Pittino Daniel , Visintin Francesca , Lauto Giancarlo
Published: May 2018

This study aims to determine how family embeddedness conditions combine with the goals and attributes of individuals with a family business background to engender to two patterns of entrepreneurship: succession in the family business and foundation of a new venture. Our empirical study is conducted using 169 cases of entrepreneurs operating in Italy. Inductively building on the configurations derived from the analysis, we suggest a series of theoretical propositions focusing on family embeddedness, individual attributes, and entrepreneurial paths of next-generation family business members.
Level of Cultural Self-Efficacy of Colombian Nursing Professionals and Related Factors
Authors: Herrero-Hahn Raquel , Rojas Juan Guillermo , Montoya-Juárez Rafael , García-Caro María Paz , Hueso-Montoro César
Published: May 2018

Purpose: To describe the level of cultural self-efficacy of Colombian nursing professionals and determine the main influencing factors. Method: A descriptive, analytical cross-sectional study was conducted in 211 nursing professionals selected by systematic random sampling for a finite population, using the Colombian version of the Cultural Self-Efficacy Scale. After descriptive statistical analysis, nonparametric tests were applied to determine between-variable associations, followed by multiple linear regression analysis. Results: The mean Cultural Self-Efficacy Scale score was 2.58. An association with sex and age ( p < .05) was observed in regression analysis. The mean score for knowledge of cultural concepts was 3.20 and associated with age, years of experience, educational level, and cross-cultural experiences ( p < .05). The mean score for confidence in performing cultural nursing skills was 3.29. Conclusions and Implications for Practice: The cultural self-efficacy level of this sample of nursing professionals, with their consequent capacity to provide culturally competent care, is moderate and is associated with sex and age. Confidence in knowledge of cultural concepts is affected by age, educational level, years of experience, and cross-cultural experiences. This evidence supports the implementation of changes to improve the cultural knowledge and therefore cultural self-efficacy of these professionals.
Breaking Out of the Bubble Putting Simulation Into Context to Increase Immersion and Performance
Authors: Backlund Per , Maurin Söderholm Hanna , Engström Henrik , Andersson Hagiwara Magnus , Lebram Mikael
Published: May 2018

Objective.Simulation based training with full-size mannequins is a prominent means of training within the healthcare sector. Prehospital missions include all parts of the healthcare process which take place before a patient is handed over to the receiving hospital. This implies that the context for prehospital care is varied and potentially challenging or dangerous in several ways. In this article we present a study which explores immersion and performance by emergency medical services (EMS) professionals in in a training situation which takes the specifics of prehospital interventions into account.

Methods. The study was carried out as a field experiment at an ambulance unit. The experiment was designed to compare the differences between two types of medical scenarios: basic and contextualized. We analyzed the levels of immersion throughout the scenarios and then team performance was evaluated by independent experts. Both analyses were made by observing video recordings from multiple camera angles with a custom made analysis tool.

Results. Our results show that the contextualization of a medical scenario increases both immersion as measured by the Immersion Score Rating Instrument (ISRI) and team performance as measured by the Global Rating Scale (GRS). The overall ISRI score was higher in the contextualized condition as compared to the basic condition, with an average team wise difference of 2.94 (sd = 1.45). This difference is significant using a paired, two-tailed t-test (p<.001). The GRS score was higher for overall clinical performance in the contextualized scenario with an average team wise difference of 0.83 (sd = 0.83, p=.005).

Conclusions. Full-size mannequin simulation based training for EMS professionals may be enhanced by contextualizing the medical scenarios. The main benefits are that the contextualized scenarios better take prehospital medical challenges into account and allow participants to perform better.
The Utility of Anti-Inflammatory Agents in Cardiovascular Disease
Authors: Kottoor Santhosh J. , Arora Rohit R.
Published: May 2018

Approximately 40% of heart attack survivors remain at increased risk of recurrent cardiovascular events, despite the current treatment options showing that atherothrombosis is not exclusively a disorder of lipoprotein aggregation in the arterial wall. Clinical and experimental data suggest that inflammation plays an important role in atherothrombosis independent of the cholesterol level. Acute-phase reactants, such as C-reactive protein, increase in patients with coronary artery disease and are known to predict adverse outcomes in such patients. The recent CANTOS trial published in The New England Journal of Medicine provides evidence that interleukin-1β along with other cytokines play central roles in the inflammatory reaction that drives the interleukin-6 signaling pathway and have profound effects on cardiovascular outcomes. Several other ongoing studies are focused on multiple immune mediators involved in this process to support the inflammatory hypothesis of cardiovascular diseases. These new classes of drugs could represent the biggest breakthrough in cardiovascular medicine, which could have the greatest impact on cardiovascular mortality since the advent of statins. The drug canakinumab has shown promise in lowering atherosclerosis, and other drugs, such as colchicine and methotrexate, are gaining interest and are being investigated in multiple ongoing trials. A major concern is the affordability of these drugs, as most cardiovascular diseases are noted among people of lower socioeconomic statuses. The LoDoCo trial showed some benefits of colchicine, and whether this old drug can be marketed with a new label for cardiovascular disease remains in question. Therefore, a clear understanding of the different inflammatory pathways involved in atherosclerosis is needed to help develop more effective treatment modalities that will benefit humankind.
Effort–Reward Imbalance and Overcommitment at Work: Associations With Police Burnout
Authors: Violanti John M. , Mnatsakanova Anna , Andrew Michael E. , Allison Penelope , Gu Ja Kook , Fekedulegn Desta
Published: May 2018

The present study examined associations of effort–reward imbalance (ERI) and overcommitment at work with burnout among police officers using data from 200 (mean age = 46 years, 29% women) officers enrolled in the Buffalo Cardio-Metabolic Occupational Police Stress Study. ERI and overcommitment were assessed using Siegrist’s “effort/reward” questionnaire. The Maslach Burnout Inventory-General Survey was used to assess burnout and its three subscales (exhaustion, cynicism, and professional efficacy). Analysis of covariance was used to examine mean values of burnout scores across quartiles of ERI and overcommitment. Linear regression was used to test for linear trend. ERI and overcommitment were positively and significantly associated with cynicism and exhaustion (trend p value < .001), while professional efficacy showed an inverse association with overcommitment ( p = .026). Cynicism and exhaustion scores were significantly higher in officers who reported both overcommitment and ERI compared with their counterparts ( p < .001). The results suggest that ERI and overcommitment at work are determinants of higher cynicism and exhaustion. The inverse association of overcommitment with professional efficacy (an indicator of engagement at work) suggests that extreme involvement in work may negatively affect efficacy. Overcommitment may be related to a need for approval and inability of officers to withdraw from work, even in an off-duty status. Police agencies should consider organizational remedies to maintain acceptable levels of commitment by officers. In addition, there is a need to monitor and improve effort–reward imbalance experienced by officers.
Active damping of sound transmission through an electrorheological fluid-actuated sandwich cylindrical shell
Authors: Hasheminejad Seyyed M , Cheraghi Masoud , Jamalpoor Ali
Published: May 2018

An exact model is proposed for sound transmission through a sandwich cylindrical shell of infinite extent that includes a tunable electrorheological fluid core, and is obliquely insonified by a plane progressive acoustic wave. The basic formulation utilizes Hamilton’s variational principle, the classical and ﬁrst order shear deformation shell theories, the Kelvin–Voigt viscoelastic damping model (for the electrorheological fluid-core layer), and the wave equations for internal/external acoustic domains coupled by the proper fluid/structure compatibility relations. The Fourier–Bessel series expansions are used to arrange the governing (coupled) system equations in state-space form. The classical Sliding Mode Control law is then applied to semi-actively reduce sound transmission through the composite cylinder by smart variation of stiffness and damping characteristics of the electrorheological fluid-core actuator layer according to the control command. Numerical results present both the uncontrolled and controlled sound transmission loss spectra of the sandwich cylindrical shell at three angles of incidence for three distinct sets of material input parameters that represent the electric-field dependency of the complex shear modulus of the electrorheological fluid-core layer. The superior soundproof performance of electrorheological fluid-based sliding mode control system in avoiding the highly detrimental sound transmission loss dips occurring throughout the critical resonance and coincidence regions is demonstrated. Likewise, remarkable enhancements in the sound insulation characteristics of the electrorheological fluid-actuated structure utilizing the first or second electrorheological fluid material model are achieved within the stiffness-controlled region, especially at lower frequencies in near-grazing incidence situation. A number of limiting cases are introduced and validity of the formulation is confirmed by comparison with the available data.
Projections of hip arthroplasty in OECD countries up to 2050
Authors: Pabinger Christof , Lothaller Harold , Portner Nicole , Geissler Alexander
Published: May 2018

Objective:

The study aims to estimate the future demand of hip arthroplasty for OECD countries and to compare the results with earlier studies.

Design:

Based on data availability and validity 20 countries out of the OECD sample have been selected for projection analysis. Using historic data (1995–2012) and multiple linear regression technics a projection model was designed by an iterative process considering different explanatory variables such as health care expenditure, age groups, and projection time frames.

Results:

The utilisation of hip implants in OECD countries continues to grow by a compound annual growth rate (CAGR) of 1.2%, leading to an increase from 1.8 million per year in 2015 to 2.8 (2.6–2.9) in the year 2050. The mean utilisation rate (incidence) of hip implants will increase from 184 (143–312) to 275 (174–457) per 100.000 total population in the same time. Australia, Ireland, Norway, Switzerland and other countries will face a significant increase of utilisation of hip implants between +95% and +120% from 2015 to 2050.

Conclusions:

Hip arthroplasty continues to rise significantly over the next 35 years. Therefore, some countries will face an exponential use of hip arthroplasty of additional 100% or more and thus challenges for their health care budgets. Revision burden will increase disproportionately. Thus, health technology assessment (HTA) for medical devices, longevity and quality control will become more relevant.
The external obturator footprint as a landmark in total hip arthroplasty through a direct anterior approach: a CT-based analysis
Authors: Rüdiger Hannes A , Fritz Benjamin , Impellizzeri Franco M , Leunig Michael , Pfirrmann Christian W , Sutter Reto
Published: May 2018

Background:

Anatomical landmarks for templating of total hip arthroplasty (THA) that are visible both during surgery and on radiographs are rare. If surgery is performed through a direct anterior approach the external obturator tendon (EO) is consistently visible. To use this point as a reference the exact position and dimensions of the footprint need to be known.

Aim:

To determine the location and dimension of the EO footprint on pelvic radiographs by correlating the EO anatomy in CT scans with conventional radiographs.

Methods:

CT scans and radiographs of 200 patients were analysed. The EO tendon was identified on CT scans; the height of its footprint, and its distance to the tip of the greater trochanter and to the anatomical axis of the femur was measured. The accuracy and inter-rater reliability in the identification of the EO footprint was determined.

Results:

The EO tendon was visible on all CT scans and it’s footprint was identifiable on all corresponding radiographs. It’s cranio-caudal dimension was 6.4 ± 1.4 mm. It’s distance to the tip of the greater trochanter was 16.0 ± 3.1 mm. The EO footprint was located 5.2 ± 3.7 mm lateral to the femoral anatomical axis. There was no significant difference regarding the accuracy of EO footprint localisation on radiographs among the 2 readers.

Conclusion:

The EO footprint on the greater trochanter is consistently visible on CT scans and radiographs. As the variability of the footprint dimension is small, this structure may serve as a useful landmark in THA, particularly when performed through a direct anterior approach.
A logic model for pharmaceutical care
Authors: Moltó-Puigmartí Carolina , Vonk Robert , van Ommeren Gerlise , Hegger Ingrid
Published: May 2018

Objectives

To develop a logic model for pharmaceutical care that can be used by stakeholders as a tool to support innovation and to monitor the performance of the pharmaceutical care system in the Netherlands and abroad. The ultimate aim of such a system is the responsible provision of drug therapy to improve patients’ quality of life.

Methods

The logic model for pharmaceutical care was created following a process consisting of four steps: (1) a literature review to identify what pharmaceutical care is and what elements it consists of; (2) separate interviews with 10 stakeholder organizations to discuss the results of the literature review; (3) construction of the logic model based on the findings from steps 1 and 2; and (4) separate interviews with three stakeholder organizations to discuss and fine-tune the model. This project was carried out by the National Institute for Public Health and the Environment ( Rijksinstituut voor Volksgezondheid en Milieu) in the Netherlands.

Results

According to the proposed logic model, pharmaceutical care is care defined as: (1) patient-centred; (2) effective and safe; (3) efficient and affordable; (4) in physical, financial and timely ways; and (5) with minimal environmental impact.

Conclusion

The proposed logic model provides stakeholders with a common framework for the innovation or further development of pharmaceutical care.
Moment redistribution in cold-formed steel sleeved and overlapped two-span purlin systems
Authors: Kyvelou Pinelopi , Hui Chi , Gardner Leroy , Nethercot David A
Published: May 2018

Cold-formed steel purlin systems with overlapped or sleeved connections are alternatives to continuous two-span systems and exhibit different degrees of continuity. Both connection types are highly favourable in practice since they are both strategically placed over an interior support to provide additional moment resistance and rotational capacity where the corresponding demands are at their largest, thus improving the overall structural efficiency. Until recently, full-scale testing has been the most common way of investigating the structural behaviour of such systems. In this study, numerical modelling, capable of capturing the complex contact interactions and instability phenomena, is employed. The developed finite element models are first validated against data from physical tests on cold-formed steel beams featuring sleeved and overlapped connections that have been previously reported in the literature. Following their validation, the models are employed for parametric studies, based on which the structural behaviour of the examined systems is explored, while the applicability of conventional plastic design as well as of a previously proposed design approach is investigated. Finally, the efficiency of these systems in terms of load-carrying capacity is compared with their equivalent continuous two-span systems.