Endemic tuberculosis, the homeless, and public transportation: A merging of geographical information systems surveillance and the Houston Tuberculosis Initiative Surveillance project

To reach the goals established by the Institute of Medicine (IOM) and the Centers for Disease Control's (CDC) STOP TB USA, measures must be taken to curtail a future peak in Tuberculosis (TB) incidence and speed the currently stagnant rate of TB elimination. Both efforts will require, at minimum, the consideration and understanding of the third dimension of TB transmission: the location-based spread of an airborne pathogen among persons known and unknown to each other. This consideration will require an elucidation of the areas within the U.S. that have endemic TB. The Houston Tuberculosis Initiative (HTI) was a population-based active surveillance of confirmed Houston/Harris County TB cases from 1995–2004. Strengths in this dataset include the molecular characterization of laboratory confirmed cases, the collection of geographic locations (including home addresses) frequented by cases, and the HTI time period that parallels a decline in TB incidence in the United States (U.S.). The HTI dataset was used in this secondary data analysis to implement a GIS analysis of TB cases, the locations frequented by cases, and their association with risk factors associated with TB transmission. ^ This study reports, for the first time, the incidence of TB among the homeless in Houston, Texas. The homeless are an at-risk population for TB disease, yet they are also a population whose TB incidence has been unknown and unreported due to their non-enumeration. The first section of this dissertation identifies local areas in Houston with endemic TB disease. Many Houston TB cases who reported living in these endemic areas also share the TB risk factor of current or recent homelessness. Merging the 2004–2005 Houston enumeration of the homeless with historical HTI surveillance data of TB cases in Houston enabled this first-time report of TB risk among the homeless in Houston. The homeless were more likely to be US-born, belong to a genotypic cluster, and belong to a cluster of a larger size. The calculated average incidence among homeless persons was 411/100,000, compared to 9.5/100,000 among housed. These alarming rates are not driven by a co-infection but by social determinants. The unsheltered persons were hospitalized more days and required more follow-up time by staff than those who reported a steady housing situation. The homeless are a specific example of the increased targeting of prevention dollars that could occur if TB rates were reported for specific areas with known health disparities rather than as a generalized rate normalized over a diverse population. ^ It has been estimated that 27% of Houstonians use public transportation. The city layout allows bus routes to run like veins connecting even the most diverse of populations within the metropolitan area. Secondary data analysis of frequent bus use (defined as riding a route weekly) among TB cases was assessed for its relationship with known TB risk factors. The spatial distribution of genotypic clusters associated with bus use was assessed, along with the reported routes and epidemiologic-links among cases belonging to the identified clusters. ^ TB cases who reported frequent bus use were more likely to have demographic and social risk factors associated with poverty, immune suppression and health disparities. An equal proportion of bus riders and non-bus riders were cultured for Mycobacterium tuberculosis, yet 75% of bus riders were genotypically clustered, indicating recent transmission, compared to 56% of non-bus riders (OR=2.4, 95%CI(2.0, 2.8), p<0.001). Bus riders had a mean cluster size of 50.14 vs. 28.9 (p<0.001). Second order spatial analysis of clustered fingerprint 2 (n=122), a Beijing family cluster, revealed geographic clustering among cases based on their report of bus use. Univariate and multivariate analysis of routes reported by cases belonging to these clusters found that 10 of the 14 clusters were associated with use. Individual Metro routes, including one route servicing the local hospitals, were found to be risk factors for belonging to a cluster shown to be endemic in Houston. The routes themselves geographically connect the census tracts previously identified as having endemic TB. 78% (15/23) of Houston Metro routes investigated had one or more print groups reporting frequent use for every HTI study year. We present data on three specific but clonally related print groups and show that bus-use is clustered in time by route and is the only known link between cases in one of the three prints: print 22. (Abstract shortened by UMI.)^

Advanced vehicle monitoring and communication systems for bus transit: benefits and economic feasibility. Final report.

Federal Transit Administration, Washington, D.C.

Final environmental statement : crude oil transportation systems (proposed under Public Law 95-617, the Public utility regulatory policies act of 1978), Northern Tier Pipeline Company, Northwest Energy Company, Kitimat Pipe Line Ltd., Trans Mountain Oil Pipe Line Corporation /

Bibliography: p. R-1 - R-19, v.3.

Use of the Interstate Highway System right-of-way for magnetic levitation high speed transportation systems : hearing before the Subcommittee on Water Resources, Transportation, and Infrastructure of the Committee on Environment and Public Works, United States Senate, One Hundredth Congress, second session, on S. 2072 ....

"September 28, 1988"--Pt. 2.

Bustracker : digitally augmented public transportation

Public transportation is an environment with great potential for applying location-based services through mobile devices. The BusTracker study is looking at how real-time passenger information systems can provide a core platform to improve commuters’ experiences. These systems rely on mobile computing and GPS technology to provide accurate information on transport vehicle locations. BusTracker builds on this mobile computing platform and geospatial information. The pilot study is running on the open source BugLabs computing platform, using a GPS module for accurate location information.

Driver’s over-trust on Advanced Driver Assistance Systems on passively protected railway crossings

Passively protected railway crossings are a major rail safety issue in Australia. Such crossings cannot be upgraded as such crossings are too numerous and the cost involved is prohibitive. Advanced Driver Assistance Systems (ADAS) have been shown to improve road safety and are widely used. These systems could be a solution to improve safety of passively protected crossings at a lower cost. Such complementary ADAS could result in driver’s over-trust due to the absence of Humane Machine Interface reflecting the quality of the information or the state of the ADAS (failure status). This paper demonstrates that driver’s exposure to crossing exhibiting fail-safe and non-fail safe properties could result in improperly allocating trust between technologies. We conducted a driving simulator study where participants (N=58) were exposed to three types of level crossing warning system on passive and active crossings. The results show that a significant proportion of participants over-trust the ADAS. Such drivers exhibit the same driving performance with the ADAS as when exposed to infrastructure based active crossing protection. They do not take the necessary safety precautions as they have a faster speed approach, reduced number of gaze toward the rail tracks and fail to stop at the crossing.

Mobile application as a tool for urban traffic data collection and generation to advanced traveler information systems using Wi-Fi networks available in urban centers

This paper presents an Advanced Traveler Information System (ATIS) developed on Android platform, which is open source and free. The developed application has as its main objective the free use of a Vehicle-to- Infrastructure (V2I) communication through the wireless network access points available in urban centers. In addition to providing the necessary information for an Intelligent Transportation System (ITS) to a central server, the application also receives the traffic data close to the vehicle. Once obtained this traffic information, the application displays them to the driver in a clear and efficient way, allowing the user to make decisions about his route in real time. The application was tested in a real environment and the results are presented in the article. In conclusion we present the benefits of this application. © 2012 IEEE.

Integrating intelligent transportation systems within the planning process: an interim handbook.

Federal Highway Administration, Office of Traffic Management and Intelligent Systems Applications, Washington, D.C.

Intelligent Transportation Systems: real world benefits.

Transportation Department, Joint Program Office for Intelligent Transportation Systems, Washington, D.C.

Civil Aeronautics Board planning study : STOL/VTOL air transportation systems /

Cover title.

Development of a systems risk methodology for single and multi-modal transportation systems. Final report.

Transportation Department, Research and Special Programs Administration, Washington, D.C.

Increased fuel economy in transportation systems by use of energy management. Volume II - digital automotive propulsion simulator programs and description.

Transportation Department, Washington, D.C.

Increased fuel economy in transportation systems by use of energy management. Volume III. Real-time (hybrid computer) simulation program set.

Transportation Department, Washington, D.C.

Benefits of using intelligent transportation systems in work zones : a summary report /

"April 2008."

Key findings from the Intelligent Transportation Systems (ITS) Program : what have we learned? /

"September 1996."