Associations between perceived discrimination and health status among frequent Emergency Department users

Objective: Frequent Emergency Department (ED) users are vulnerable individuals and discrimination is usually associated with increased vulnerability. The aim of this study was to investigate frequent ED users' perceptions of discrimination and to test whether they were associated with increased vulnerability. Methods: In total, 250 adult frequent ED users were interviewed in Lausanne University Hospital. From a previously published questionnaire, we assessed 15 dichotomous sources of perceived discrimination. Vulnerability was assessed using health status: objective health status (evaluation by a healthcare practitioner including somatic, mental health, behavioral, and social issues - dichotomous variables) and subjective health status [self-evaluation including health-related quality of life (WHOQOL) and quality of life (EUROQOL) - mean-scores]. We computed the prevalence rates of perceived discrimination and tested associations between perceived discrimination and health status (Fischer's exact tests, Mann-Whitney U-tests)

Analysis of Automotive Cybersecurity - Attack surfaces and users’ privacy concerns

Modern automobiles are no longer just mechanical tools. The electronics and computing services they are shipping with are making them not less than a computer. They are massive kinetic devices with sophisticated computing power. Most of the modern vehicles are made with the added connectivity in mind which may be vulnerable to outside attack. Researchers have shown that it is possible to infiltrate into a vehicle’s internal system remotely and control the physical entities such as steering and brakes. It is quite possible to experience such attacks on a moving vehicle and unable to use the controls. These massive connected computers can be life threatening as they are related to everyday lifestyle. First part of this research studied the attack surfaces in the automotive cybersecurity domain. It also illustrated the attack methods and capabilities of the damages. Online survey has been deployed as data collection tool to learn about the consumers’ usage of such vulnerable automotive services. The second part of the research portrayed the consumers’ privacy in automotive world. It has been found that almost hundred percent of modern vehicles has the capabilities to send vehicle diagnostic data as well as user generated data to their manufacturers, and almost thirty five percent automotive companies are collecting them already. Internet privacy has been studies before in many related domain but no privacy scale were matched for automotive consumers. It created the research gap and motivation for this thesis. A study has been performed to use well established consumers privacy scale – IUIPC to match with the automotive consumers’ privacy situation. Hypotheses were developed based on the IUIPC model for internet consumers’ privacy and they were studied by the finding from the data collection methods. Based on the key findings of the research, all the hypotheses were accepted and hence it is found that automotive consumers’ privacy did follow the IUIPC model under certain conditions. It is also found that a majority of automotive consumers use the services and devices that are vulnerable and prone to cyber-attacks. It is also established that there is a market for automotive cybersecurity services and consumers are willing to pay certain fees to avail that.

Road network and GPS tracking with data processing and quality assessment

GPS technology has been embedded into portable, low-cost electronic devices nowadays to track the movements of mobile objects. This implication has greatly impacted the transportation field by creating a novel and rich source of traffic data on the road network. Although the promise offered by GPS devices to overcome problems like underreporting, respondent fatigue, inaccuracies and other human errors in data collection is significant; the technology is still relatively new that it raises many issues for potential users. These issues tend to revolve around the following areas: reliability, data processing and the related application. This thesis aims to study the GPS tracking form the methodological, technical and practical aspects. It first evaluates the reliability of GPS based traffic data based on data from an experiment containing three different traffic modes (car, bike and bus) traveling along the road network. It then outline the general procedure for processing GPS tracking data and discuss related issues that are uncovered by using real-world GPS tracking data of 316 cars. Thirdly, it investigates the influence of road network density in finding optimal location for enhancing travel efficiency and decreasing travel cost. The results show that the geographical positioning is reliable. Velocity is slightly underestimated, whereas altitude measurements are unreliable.Post processing techniques with auxiliary information is found necessary and important when solving the inaccuracy of GPS data. The densities of the road network influence the finding of optimal locations. The influence will stabilize at a certain level and do not deteriorate when the node density is higher.

Road safety: a priority issue for the United Nations

This issue of the Bulletin deals with road safety, which has become an urgent worldwide problem. Given the fact that road accidents are increasing, that they affect the planet's most vulnerable population (namely the lowest income groups in developing countries) and that this is becoming a genuine public health crisis, the United Nations has decided that it is urgent to address the matter. The World Health Organization (WHO) has therefore dedicated the World Health Day 2004 to road safety.Given the urgent need for action, the Chiefs of Transport of the five Regional Economic Commissions of the United Nations held a meeting in Geneva (September 2004), where they agreed to reinforce the studies and projects carried out in this area.Below is a summary of various information sources and initiatives adopted to assess and tackle this modern epidemic and offers a pessimistic outlook for 2020, when road traffic crashes will constitute the third cause of death unless serious action is taken from today.

Road-kills of the giant anteater in south-eastern Brazil: 10 years monitoring spatial and temporal determinants

Context. The giant anteater, Myrmecophaga tridactyla, is a large insectivorous mammal from Cerrado which is classified as vulnerable by the IUCN's red list. In spite of frequent giant anteater casualties, there continues to be a lack of published data on how road and landscape attributes affect road-kill rates - information that could prove useful in guiding mitigation measures.Aims. We seek to determine whether road and landscape attributes influence the incidence of road-kills of the giant anteater.Methods. From February 2002 to December 2012 (except for 2004), five roads in two regions in south-eastern Brazil were surveyed twice each month by car. We recorded temporal road-kill data for the giant anteater and related spatial road variables. These variables were also recorded at regular control sites every 2 km. We also took traffic volume data on stretches of the two roads to correlate with road-kills.Key results. Of the 45 anteater casualties recorded, there was a predominance of adult males. On roads MG-428 and SP-334, we found anteater road-kills were more common in the dry season, negatively correlated with traffic volume and related to the presence of native vegetation. Accordingly, road-kill sites tended to occur near the cerrado and grasslands and also appeared more frequently on some straight stretches of roadways. Although it was not shown to influence road-kill rates, topography data does point to regular overpass/underpass locations allowing population connectivity. Termitaria or ant nests were present at all road-kill sites, with 86% having signs of feeding.Conclusions. Native vegetation along roadways, together with straight road design, increases the probability of anteater road-kills by 40.1%.Implications. For mitigation, mowing and removing insect nests on roadsides, as well as roadside wildlife fencing in cerrado and grassland areas is suggested. Warning signs and radar to reduce vehicle speed are recommended for both human safety and anteater conservation. With regard to population connectivity, the absence of aggregated anteater road-kill data in this study meant that there were no particular crossing locations identified. However, the collected topography data do show places that could be used for roadway crossings. The measures indicated may apply to similar species and types of topography on other continents.

Mortality from road traffic accidents in Switzerland: longitudinal and spatial analyses

Road traffic accidents (RTA) are an important cause of premature death. We examined socio-demographic and geographical determinants of RTA mortality in Switzerland by linking 2000 census data to RTA mortality records 2000-2005 (ICD-10 codes V00-V99). Data from 5.5 million residents aged 18-94 years, 1744 study areas, and 1620 RTA deaths were analyzed, including 978 deaths (60.4%) in motor vehicle occupants, 254 (15.7%) in motorcyclists, 107 (6.6%) in cyclists, and 259 (16.0%) in pedestrians. Weibull survival models and Bayesian methods were used to calculate hazard ratios (HR), and standardized mortality ratios (SMR) across study areas. Adjusted HR comparing women with men ranged from 0.04 (95% CI 0.02-0.07) in motorcyclists to 0.43 (95% CI 0.32-0.56) in pedestrians. There was a u-shaped relationship with age in motor vehicle occupants and motorcyclists. In cyclists and pedestrians, mortality increased after age 55 years. Mortality was higher in individuals with primary education (HR 1.53; 95% CI 1.29-1.81), and higher in single (HR 1.24; 95% CI 1.05-1.46), widowed (HR 1.31; 95% CI 1.05-1.65) and divorced individuals (HR 1.62; 95% CI 1.33-1.97), compared to persons with tertiary education or married persons. The association with education was particularly strong for pedestrians (HR 1.87; 95% CI 1.20-2.91). RTA mortality increased with decreasing population density of study areas for motor vehicle occupants (test for trend p<0.0001) and motorcyclists (p=0.0021) but not for cyclists (p=0.39) or pedestrians (p=0.29). SMR standardized for socio-demographic and geographical variables ranged from 82 to 190. Prevention efforts should aim to reduce inequities across socio-demographic and educational groups, and across geographical areas, with interventions targeted at high-risk groups and areas, and different traffic users, including pedestrians.

Improving the analysis of road pricing acceptability surveys by using hybrid models

Several international studies have analyzed the acceptability of road pricing schemes by means of an attitude survey in combination with the results of a stated choice experiment using both a descriptive analysis and a discrete-choice model with binary choice (?accept? or ?not accept? the toll). However, the use of hybrid discrete choice models constitutes an innovative alternative for integrating subjective attitudes and perceptions deriving from the survey of attitudes with the more objective variables from the stated choice experiment. This paper analyzes the results of applying these models to measure the acceptability of interurban road pricing among different groups of stakeholders (road freight and passenger operators, highway concessionaires, and associations of private car users) with qualitatively significant opinions on road pricing measures. Our results show that hybrid models are better suited to explaining the acceptability of a road pricing scheme by different groups of stakeholders than a separate analysis of the survey of attitudes and a discrete-choice model applied on a stated choice experiment. A particular finding was that the strong psycho-social latent variable of the perception of fairness explains the rejection or acceptance of a toll scheme by road stakeholders.

Experiences on the specification of algorithms for fire and smoke control in road tunnels

The main objective of ventilation systems in case of fire is the reduction of the possible consequences by achieving the best possible conditions for the evacuation of the users and the intervention of the emergency services. The required immediate transition, from normal to emergency functioning of the ventilation equipments, is being strengthened by the use of automatic and semi-automatic control systems, what reduces the response times through the help to the operators, and the use of pre-defined strategies. A further step consists on the use of closed-loop algorithms, which takes into account not only the initial conditions but their development (air velocity, traffic situation, etc.), optimizing smoke control capacity.

Ventilation and FFFS fire tests for “Calle 30” road tunnels

Between 2003 and 2007 an urban network or road tunnels with a total constructed tubes length of 45 km was built in the city of Madrid. This amazing engineering work, known as "Calle 30 Project" counted with different kinds of tunnel typologies and ventilation systems. Due to the length of the tunnels and the impact of the work itself, the tunnels were endowed with a great variety of installations to provide the maximum levels of safety both for users and the infrastructure includieng, in some parts of the tunnel, fixed fire fighting system based on water mist. Whithin this framework a large-scale programme of fire tests was planned to study different aspects related to fire safety in the tunnels including the phenomena of the interaction between ventilation and extinguishing system. In addition, these large scale fire tests allowed fire brigades of the city of Madrid an opportunity to define operational procedures for specific fire fighting in tunnels and evaluate the possibilities of fixed fire fighting systems. The tests were carried out in the Center of Experimentation "San pedro of Anes" which includes a 600 m tunnel with a removable false ceiling for reproducing different ceiling heights and ventilation conditions (transverse and longitudinal ones). Interesting conclusions on the interaction of ventilation and water mist systems were obtained but also on other aspects including performance of water mist system in terms of reduction of gas temperatures or visibility conditions. This paper presents a description of the test's programme carried out and some previous results obtained.

Optimal safety incentives in road concession contracts

Changes in the roles of the government and the private sector in the provision of public services along with budget constraints are resulting in an increasing use of the concession approach for financing and managing roads. In the last few years, many of these contracts set up incentives linked to bonuses to encourage the concessionaire to render a better service to the users. Road safety is one the aspects on the basis of which concessionaires can be rewarded according to their performance. The goal of this paper is to evaluate whether road safety incentives are being defined in the right way nowadays in different European countries and also identify what incentives would need to be implemented to achieve a socially optimal road safety level. To that end, we develop a specific incentive for road concession contracts that encourages companies to achieve the optimal level. We apply this methodology to three case studies of concessions recently awarded in order to determine to what extend the incentives they set up are closer or farther to the optimum.

Dynamic behaviour of underspanned suspension road bridges under traffic loads

Underspanned suspension bridges are structures with important economical and aesthetic advantages, due to their high structural efficiency. However, road bridges of this typology are still uncommon because of limited knowledge about this structural system. In particular, there remains some uncertainty over the dynamic behaviour of these bridges, due to their extreme lightness. The vibrations produced by vehicles crossing the viaduct are one of the main concerns. In this work, traffic-induced dynamic effects on this kind of viaduct are addressed by means of vehicle-bridge dynamic interaction models. A finite element method is used for the structure, and multibody dynamic models for the vehicles, while interaction is represented by means of the penalty method. Road roughness is included in this model in such a way that the fact that profiles under left and right tyres are different, but not independent, is taken into account. In addition, free software {PRPgenerator) to generate these profiles is presented in this paper. The structural dynamic sensitivity of underspanned suspension bridges was found to be considerable, as well as the dynamic amplification factors and deck accelerations. It was also found that vehicle speed has a relevant influence on the results. In addition, the impact of bridge deformation on vehicle vibration was addressed, and the effect on the comfort of vehicle users was shown to be negligible.

Users guide for the wettime exposure estimation model.

Federal Highway Administration, Office of Engineering and Highway Operations Research and Development, McLean, Va.

Numerical analysis of roadside design (NARD). Volume I: users manual. Final report.

Federal Highway Administration, Office of Safety and Traffic Operations Research and Development, McLean, Va.

Highway user fees: updated data needed to determine whether all users pay their fair share.

Mode of access: Internet.

Highway-vehicle-object simulation model - 1976. Volume 1: users manual. Final report.

Federal Highway Administration, Washington, D.C.