Tracking job and housing dynamics with smartcard data

Residential locations, the jobs–housing relationship, and commuting patterns are key elements to understand urban spatial structure and how city dwellers live. Their successive interaction is important for various fields including urban planning, transport, intraurban migration studies, and social science. However, understanding of the long-term trajectories of workplace and home location, and the resulting commuting patterns, is still limited due to lack of year-to-year data tracking individual behavior. With a 7-y transit smartcard dataset, this paper traces individual trajectories of residences and workplaces. Based on in-metro travel times before and after job and/or home moves, we find that 45 min is an inflection point where the behavioral preference changes. Commuters whose travel time exceeds the point prefer to shorten commutes via moves, while others with shorter commutes tend to increase travel time for better jobs and/or residences. Moreover, we capture four mobility groups: home mover, job hopper, job-and-residence switcher, and stayer. This paper studies how these groups trade off travel time and housing expenditure with their job and housing patterns. Stayers with high job and housing stability tend to be home (apartment unit) owners subject to middle- to high-income groups. Home movers work at places similar to stayers, while they may upgrade from tenancy to ownership. Switchers increase commute time as well as housing expenditure via job and home moves, as they pay for better residences and work farther from home. Job hoppers mainly reside in the suburbs, suffer from long commutes, change jobs frequently, and are likely to be low-income migrants.

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Investigating Sustainable Commuting Patterns by Socio-Economic Factors

Sustainability ◽

10.3390/su13042180 ◽

2021 ◽

Vol 13 (4) ◽

pp. 2180 ◽

Cited By ~ 1

Author(s):

Woo Jang ◽

Fei Yuan ◽

Jose Javier Lopez

Keyword(s):

Low Income ◽

Older Workers ◽

Central City ◽

Minority Group ◽

Primary Data ◽

Economic Factors ◽

Group Status ◽

Multiple Variables ◽

Commuting Patterns ◽

Socio Economic Factors

This research aims to analyze how modes of transportation differ according to socio-economic factors in an urban space. The study area is Ramsey County, the most densely populated county in Minnesota. The primary data used were from the recent 2012–2016 Census Transportation Planning Products (CTPP). We performed regression models to identify the relationship between mode of transport and socio-economic variables, and further analyzed disaggregate trip data to provide a more realistic evaluation of commuting patterns by use of multiple variables in combination. The research found that sustainable commuting patterns correlated significantly with both poverty and minority group status, but bore no significant relationship to older workers. Additionally, there was a significant correlation between commuting alone by car with both minority group status and older workers, but not with poverty. This research also confirmed that the sustainable commuting patterns of the working poor were mostly located in the downtown area, while causes of low-income workers driving alone typically involved much longer commutes to and from points throughout the study area, suggesting that more efficient commutes are a significant quality of life factor for the urban poor when evaluating residential and employment opportunities in the central city.

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A Cohort Study: Evaluating Self-Efficacy in Adolescents Attending a Tailored Youth-Informed Breastfeeding Program

10.1101/2020.02.10.20021808 ◽

2020 ◽

Author(s):

Christina M. Cantin ◽

Wendy E. Peterson ◽

Amisha Agarwal ◽

Jemila S. Hamid ◽

Bianca Stortini ◽

...

Keyword(s):

Cohort Study ◽

Peer Support ◽

Adolescent Mothers ◽

Low Income ◽

Self Efficacy ◽

Short Form ◽

Post Intervention ◽

Non Profit ◽

Before And After ◽

Support Housing

ABSTRACTAdolescents (≤19 years of age) have lower rates of breastfeeding (BF) compared to older mothers. BF self-efficacy (SE), defined as a mother’s confidence in her ability to breastfeed her infant, has been identified as an important factor influencing BF outcomes. An innovative youth-informed BF program for young women was designed and implemented, which included staff training, a prenatal BF class and BF peer support. The objective of this cohort study was to evaluate the effectiveness of the program in improving young mother’s BF SE.Participants were pregnant adolescents recruited from a large urban non-profit social service outreach centre. The Breastfeeding Self-Efficacy Scale-Short Form (BSES-SF) was administered to participants before and after participating in the BF program. BSES-SF scores were summed to determine a composite score and compared descriptively using mean score. Un-aggregated, item-by-item, comparison of pre-vs post-BF program scores were also compared to examine improvements in SE. A total of 20 adolescent mothers (mean age = 16.6) attended the BF program. An increase in the total BSES-SF score was observed based on descriptively comparing the mean pre vs post intervention.Prenatal education and peer support adapted to the needs of adolescent mothers was associated with increased BSES-SF. These results are promising given that clients attending programs at this agency have low-income, low educational attainment, variable family support, housing instability, and are at-risk for not breastfeeding. Future studies with larger cohort are required to further validate and establish generalizability, as well as to determine the effect on BF duration rates.

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Healthcare hackathons: fostering medical education through innovation in a developing country: a case study from Pakistan

BMJ Innovations ◽

10.1136/bmjinnov-2019-000400 ◽

2020 ◽

Vol 7 (1) ◽

pp. 103-108

Author(s):

Waqaas Akmal Butt ◽

Qurratulain Shahood ◽

Walid Hussain Farooqi ◽

Kulsoom Ghias ◽

Saniya Sabzwari ◽

...

Keyword(s):

Medical Education ◽

Low Income ◽

Teaching And Learning ◽

Postgraduate Medical Education ◽

Learning Potential ◽

Learning Tool ◽

Middle Income ◽

Alternative Teaching ◽

Before And After

BackgroundHackathons aim to develop solutions to preidentified problem domains and catalyse startup cultures. Recently, the teaching and learning potential of hackathons has also been documented. In this study, we make the case for utilisation of hackathons as an alternative teaching and learning tool geared towards entrepreneurship and as an opportunity for interprofessional integration.MethodsThis research study followed up with participants from the third hackathon at the Aga Khan University in Karachi, Pakistan. Hack MedEd was about solutions to problems of undergraduate and postgraduate medical education with an emphasis on low-income to middle-income countries. Participant evaluation data were filled at the end of the hackathon and gathered from three focused group discussions (FGDs): immediately before and after the event, a delayed follow-up after 11 months was recorded.ResultsOf 116 participants, the majority (71%) were under 30 years old, and over half were female. The evaluations provided by hackers were positive overall with a mean score of 4.37 out of 5 on a Likert Scale. During the FGDs, participants spoke positively of the process and felt that, by the end of the hackathon, they had learnt something new. In the delayed follow-up FGD, teams that had undergone incubation expressed that they had gained a critical and simple skillset that they might not have acquired otherwise.ConclusionHackathons business incubation programmes may be considered an alternative teaching and learning tool—especially for individuals studying or working within the healthcare discipline within low-resource settings.

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Health Outcomes of an Integrated Behaviour-Centred Water, Sanitation, Hygiene and Food Safety Intervention–A Randomised before and after Trial

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph17082648 ◽

2020 ◽

Vol 17 (8) ◽

pp. 2648 ◽

Cited By ~ 2

Author(s):

Tracy Morse ◽

Elizabeth Tilley ◽

Kondwani Chidziwisano ◽

Rossanie Malolo ◽

Janelisa Musaya

Keyword(s):

Low Income ◽

Diarrhoeal Disease ◽

Control Group ◽

Food Hygiene ◽

Children Under Five ◽

Under Five ◽

Cluster Group ◽

Point Reduction ◽

Before And After ◽

The Impact

Diarrhoeal disease in children under five in low income settings has been associated with multiple environmental exposure pathways, including complementary foods. Conducted from February to December 2018 in rural Malawi, this before and after trial with a control used diarrhoeal disease as a primary outcome, to measure the impact of a food hygiene intervention (food hygiene + handwashing) relative to a food hygiene and water, sanitation and hygiene (WASH) intervention (food hygiene + handwashing + faeces management + water management). The 31-week intervention was delivered by community-based coordinators through community events (n = 2), cluster group meetings (n = 17) and household visits (n = 14). Diarrhoeal disease was self-reported and measured through an end line survey, and daily diaries completed by caregivers. Difference-in-differences results show a 13-percentage point reduction in self-reported diarrhoea compared to the control group. There were also significant increases in the presence of proxy measures in each of the treatment groups (e.g., the presence of soap). We conclude that food hygiene interventions (including hand washing with soap) can significantly reduce diarrhoeal disease prevalence in children under five years in a low-income setting. Therefore, the promotion of food hygiene practices using a behaviour-centred approach should be embedded in nutrition and WASH policies and programming.

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The Association of Knowledge, Attitudes and Access with Park Use before and after a Park-Prescription Intervention for Low-Income Families in the U.S.

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph17030701 ◽

2020 ◽

Vol 17 (3) ◽

pp. 701 ◽

Cited By ~ 2

Author(s):

Nooshin Razani ◽

Nancy K. Hills ◽

Doug Thompson ◽

George W. Rutherford

Keyword(s):

Low Income ◽

Secondary Data ◽

Family Characteristics ◽

Urban Setting ◽

Park Use ◽

Before And After ◽

Unit Increase ◽

Low Income Families ◽

Perceived Access

We conducted secondary data analyses of pooled data from a clinical trial that prescribed park visits to children and their caregivers in a low-income, urban setting. Data were collected at the prescribing visit (baseline) and at one and three months of follow up from 78 families. Family characteristics were identified at baseline; regression models were used to explore changes during follow up in associations of park use with knowledge, attitudes and perceived access to parks. At baseline, park users differed from non-users in demographics, knowledge of park locations, attitudes about the value of park visits, but not affinity for nature. Park users were also more likely than non-users to feel that their neighborhood was safe for children to play in. Changes in knowledge of park locations, nature affinity, and perceived access to parks were each significantly associated with increased park use by families at one and three months after the park prescription. Adjusting for age, gender, race, poverty, and US birth, increases in knowing the location of parks were associated with an increase of 0.27 weekly park visits (95% CI 0.05, 0.49; p = 0.016); increases in feeling a caregiver had money to visit parks were associated with 0.48 more weekly park visits (95% CI 0.28, 0.69; p < 0.001); increases in perceived money for park outings were associated with 0.24 increased park visits per week (95% CI 0.05, 0.42; p = 0.01); each unit increase in nature affinity was associated with 0.34 more weekly park visits (95% CI 0.09, 0.59; p = 0.007). In other words, knowing where to go, valuing nature, and having time, and money contributed to increased likelihood of visiting a park. We discuss in terms of health behavior theory how demographics, knowledge, attitudes and perceived barriers to park use can inform park prescription interventions.

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Impact of Instituting General Anesthesia on Oral Sedation Care in a Tertiary Care Pediatric Dental Clinic

Anesthesia Progress ◽

10.2344/anpr-66-02-02 ◽

2019 ◽

Vol 66 (4) ◽

pp. 183-191 ◽

Cited By ~ 1

Author(s):

David L Moore ◽

Lili Ding ◽

Gang Yang ◽

Stephen Wilson

Keyword(s):

General Anesthesia ◽

Operating Room ◽

Low Income ◽

Tertiary Care ◽

Adverse Event Rate ◽

Dental Clinic ◽

Dental Services ◽

Serious Adverse Events ◽

Before And After ◽

Oral Sedation

Tertiary pediatric medical centers disproportionately care for low-income, underserved children with significant dental needs. Long wait times for hospital operating room treatment increase tooth loss rather than restoration. Oral sedation has commonly been provided to avoid the long waits for operating room treatment. However, this can be challenging with young, anxious patients. High failure rates and repeat visits for oral sedation have resulted in continued waiting for definitive dental services in the operating room. The Division of Dentistry requested the Department of Anesthesiology to create a general anesthesia program in the dental clinic to increase the use of anesthesia services but align the cost of the anesthetic with the revenue stream. Our aim was to objectively measure the performance of a dental clinic anesthesia service by comparing the percentage of case completions, percentage of complete radiographs, and number of serious adverse events to clinic-based oral sedations. We were also interested in total number of cases completed. We retrospectively studied data regarding an in-office general anesthesia (IOGA) program for dentistry and compared it to oral sedations before and after instituting the IOGA program. Patients received either a general endotracheal anesthetic or nonintubated total intravenous general anesthesia. Successful case completion increased from 88.6% (oral sedation) to 99.5% (IOGA). One hundred percent of IOGA cases had complete radiographs, as opposed to 63.4% for oral sedation. This was an increase from 53.5% from the previous 2 years with oral sedation. Serious adverse event rate was 0% (0/508) for oral sedation and 0.2% (1/418) for IOGA. Comparing 2 years before and after IOGA revealed a decrease in oral sedations from 930 to 508, whereas IOGA increased from 0 to 418 cases. Anesthesia services in dental clinic increased complete dental care and complete radiographs, reduced failed sedations, and were performed safely.

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Evaluating Medicare Performance: Perceptions of Performance Pre- and Post- ACA

World Journal of Social Science ◽

10.5430/wjss.v7n2p28 ◽

2020 ◽

Vol 7 (2) ◽

pp. 28

Author(s):

Ashleigh Chinelo Oguagha ◽

Nickesha Joan Lambert

Keyword(s):

Low Income ◽

Medicare Beneficiary ◽

National Level ◽

Life Time ◽

The Elderly ◽

The United States ◽

Health Coverage ◽

Single Payer ◽

Before And After ◽

Performance Perceptions

Medicare is a national single-payer system that provides health coverage for the elderly, disabled, and terminally ill in the United States. Rising enrollment, costs, and decreases in financing options may affect the way Medicare performs. This study aimed to investigate participants’ perceptions of Medicare performance before and after the Affordable Care Act. A 3-part questionnaire was created and validated for use in this study. Respondents affiliated with several social work agencies were invited via email to participate in this study. 287 out of 519 invited questionnaires were used in data analyses. 27.5% of respondents reported being currently enrolled in Medicare, while 33.2% reported lifetime enrollment. Overall, retired/disabled, elderly and low-income participants reported currently or ever using Medicare. One’s perception of Medicare performance was determined by their status as a Medicare beneficiary. Medicare service efficacy was rated more positively over-time by current and life-time enrollees; additionally, Medicare performance was determined to be better in 2013 than in 2009. Ultimately, this study showed that health service and financial fairness factors are indicative of Medicare performance. Additional research should explore possible implications for the healthcare field as well as formulate a broad range of possible management and/or improvement strategies. Lastly, differences in performance across years can inform decision-makers and bolster the fundamental foundation of health policies at the state and national level.

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Does Money Matter More in the Country? Education Funding Reductions and Achievement in Kansas, 2010–2018

AERA Open ◽

10.1177/2332858420963685 ◽

2020 ◽

Vol 6 (4) ◽

pp. 233285842096368

Author(s):

Emily Rauscher

Keyword(s):

Low Income ◽

Rural Areas ◽

Economies Of Scale ◽

State Level ◽

Department Of Education ◽

Block Grant ◽

Short Term ◽

Rural Districts ◽

Before And After ◽

Funding Cuts

The U.S. Department of Education made recent technical changes reducing eligibility for the Rural and Low-Income School Program. Given smaller budgets and lower economies of scale, rural districts may be less able to absorb short-term funding cuts and experience stronger negative achievement effects. Kansas implemented a state-level finance change (block grant funding) after 2015, which froze district revenue regardless of enrollment and reduced funding in districts where enrollment increased. Difference-in-differences models compare achievement before and after block grant implementation to estimate effects of funding cuts separately in rural and nonrural districts. Between-state and within-state comparisons offer complementary identification strategies in which the strengths of one approach help address limitations of the other. Revenue/spending reductions are similar by geography but represent a larger fraction of rural district budgets. Results indicate that revenue reductions have larger implications for achievement in rural areas, where they represent a larger proportion of the total budget.

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Indirect Effects of 10-Valent Pneumococcal Conjugate Vaccine Against Adult Pneumococcal Pneumonia in Rural Western Kenya

Clinical Infectious Diseases ◽

10.1093/cid/ciz139 ◽

2019 ◽

Vol 69 (12) ◽

pp. 2177-2184 ◽

Cited By ~ 2

Author(s):

Godfrey M Bigogo ◽

Allan Audi ◽

Joshua Auko ◽

George O Aol ◽

Benjamin J Ochieng ◽

...

Keyword(s):

Blood Culture ◽

Conjugate Vaccine ◽

Low Income ◽

Indirect Effects ◽

Pneumococcal Conjugate Vaccine ◽

Pneumococcal Pneumonia ◽

Low Income Countries ◽

Western Kenya ◽

Before And After ◽

Rate Ratios

Abstract Background Data on pneumococcal conjugate vaccine (PCV) indirect effects in low-income countries with high human immunodeficiency virus (HIV) burden are limited. We examined adult pneumococcal pneumonia incidence before and after PCV introduction in Kenya in 2011. Methods From 1 January 2008 to 31 December 2016, we conducted surveillance for acute respiratory infection (ARI) among ~12 000 adults (≥18 years) in western Kenya, where HIV prevalence is ~17%. ARI cases (cough or difficulty breathing or chest pain, plus temperature ≥38.0°C or oxygen saturation <90%) presenting to a clinic underwent blood culture and pneumococcal urine antigen testing (UAT). We calculated ARI incidence and adjusted for healthcare seeking. The proportion of ARI cases with pneumococcus detected among those with complete testing (blood culture and UAT) was multiplied by adjusted ARI incidence to estimate pneumococcal pneumonia incidence. Results Pre-PCV (2008–2010) crude and adjusted ARI incidences were 3.14 and 5.30/100 person-years-observation (pyo), respectively. Among ARI cases, 39.0% (340/872) had both blood culture and UAT; 21.2% (72/340) had pneumococcus detected, yielding a baseline pneumococcal pneumonia incidence of 1.12/100 pyo (95% confidence interval [CI]: 1.0–1.3). In each post-PCV year (2012–2016), the incidence was significantly lower than baseline; with incidence rate ratios (IRRs) of 0.53 (95% CI: 0.31–0.61) in 2012 and 0.13 (95% CI: 0.09–0.17) in 2016. Similar declines were observed in HIV-infected (IRR: 0.13; 95% CI: 0.08–0.22) and HIV-uninfected (IRR: 0.10; 95% CI: 0.05–0.20) adults. Conclusions Adult pneumococcal pneumonia declined in western Kenya following PCV introduction, likely reflecting vaccine indirect effects. Evidence of herd protection is critical for guiding PCV policy decisions in resource-constrained areas.

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Visualizations of Travel Time Performance Based on Vehicle Reidentification Data

Transportation Research Record Journal of the Transportation Research Board ◽

10.3141/2646-10 ◽

2017 ◽

Vol 2646 (1) ◽

pp. 84-92 ◽

Cited By ~ 2

Author(s):

Stanley Ernest Young ◽

Elham Sharifi ◽

Christopher M. Day ◽

Darcy M. Bullock

Keyword(s):

Travel Time ◽

Performance Measures ◽

Traffic Control ◽

Cumulative Distribution ◽

Travel Time Reliability ◽

Travel Times ◽

Traffic Patterns ◽

Before And After ◽

Vehicle Reidentification ◽

Arterial Performance

This paper provides a visual reference of the breadth of arterial performance phenomena based on travel time measures obtained from reidentification technology that has proliferated in the past 5 years. These graphical performance measures are revealed through overlay charts and statistical distribution as revealed through cumulative frequency diagrams (CFDs). With overlays of vehicle travel times from multiple days, dominant traffic patterns over a 24-h period are reinforced and reveal the traffic behavior induced primarily by the operation of traffic control at signalized intersections. A cumulative distribution function in the statistical literature provides a method for comparing traffic patterns from various time frames or locations in a compact visual format that provides intuitive feedback on arterial performance. The CFD may be accumulated hourly, by peak periods, or by time periods specific to signal timing plans that are in effect. Combined, overlay charts and CFDs provide visual tools with which to assess the quality and consistency of traffic movement for various periods throughout the day efficiently, without sacrificing detail, which is a typical byproduct of numeric-based performance measures. These methods are particularly effective for comparing before-and-after median travel times, as well as changes in interquartile range, to assess travel time reliability.

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