scholarly journals Perception and Practice of Bangladeshi Adults Towards the Prevention of COVID-19: A Statistical Analysis

2021 ◽  
Vol 10 ◽  
pp. 107-117
Author(s):  
Md. Abdul Wadood ◽  
Lai Lee Lee ◽  
Md. Monimul Huq ◽  
Asma Mamun ◽  
Suhaili Mohd ◽  
...  
Keyword(s):  
Risk Perception ◽  
High Risk ◽  
Rural Areas ◽  
Urban Areas ◽  
Risk Perceptions ◽  
Early Stage ◽  
Good Practice ◽  
General Question ◽  
Average Risk ◽  
Study Results

Background: The coronavirus disease 2019 (COVID-19) has continued to spread across the world with increasing numbers of confirmed cases and deaths. Due to outbreaks of new variants of the virus and limited treatment options, positive perception and good practice of preventive guidelines have remained essential measures for the prevention of the disease and slowing down its transmission. We aimed to study perception towards COVID-19 and the practice of guidelines for preventing the disease among Bangladeshi adults during the early stage of the rapid rise of the outbreak. Methods: Data was collected data from 320 participants. For measuring their level of practice, we asked a general question: “Are you properly following the WHO-recommended guidelines to avoid COVID-19?” The frequency distribution, Chi-square (χ2) test and binary logistic regression model were used in this study. Results: The average risk perception among the participants was 3.05±0.75 (median, 3.00) (95% CI of mean: 2.96-3.13) where the score ranges from 0 (no risk) to 4 (high risk). More than 27% of participants showed high-risk perceptions. Males (p<0.05), high educated (p<0.05), rich (p<0.01), service holders (p<0.05), and younger adults (p<0.05) had higher odds of high-risk perception. More than 71% of participants had a good practice of always following the WHO guidelines to prevent COVID-19 and living locations in urban areas (p<0.01), high education (p<0.01), rich (p<0.01), and joint family (p<0.01) had the most contributions to good practice. Conclusions: The study findings revealed that special attention should be given to rural areas, and individuals of low literacy, education and socioeconomic level to more effectively prevent COVID-19.

scholarly journals Description of a pharmacist-led clinical video telehealth group clinic for opioid overdose prevention and naloxone education

2019 ◽  
Vol 9 (4) ◽  
pp. 294-297
Author(s):  
Aimee N. Jensen ◽  
Candace M. Beam ◽  
Amber R. Douglass ◽  
Jennifer E. Brabson ◽  
Michelle Colvard ◽  
...  
Keyword(s):  
At Risk ◽  
High Risk ◽  
Rural Areas ◽  
Urban Areas ◽  
Patient Specific ◽  
Opioid Overdose ◽  
Overdose Prevention ◽  
Innovative Practice ◽  
Risk Patients ◽  
Urban And Rural Areas

Abstract To achieve the nationwide goal of reducing opioid-related deaths, a clinical pharmacy specialist–led clinical video telehealth (CVT) clinic was created at a Veterans Affairs medical center (VAMC) to deliver opioid overdose prevention and naloxone education to at-risk patients. The purpose of this innovative practice was to improve access to this potentially life-saving intervention to patients across urban and rural areas. This study is a single-center, descriptive analysis of adult patients across 2 VAMC campuses and 4 community-based outpatient clinics from July 11, 2016, through December 31, 2016. The purpose of this innovative practice was to increase access to overdose education and naloxone distribution (OEND) to at-risk patients across urban and rural areas. Patient-specific factors were also examined among those receiving naloxone through the CVT clinic compared to other prescribers. During the first 6 months from the initiation of the clinic, 1 pharmacist prescribed 21% of the health care system's naloxone. These patients identified by the pharmacist-led CVT clinic were more likely to be considered high-risk due to concomitant use of opioids and benzodiazepines. In conclusion, the pharmacist-led CVT group clinic has been an efficient strategy to extend OEND services to high-risk patients beyond central, urban areas.

Risk perceptions and preparedness of typhoon disaster on coastal inhabitants in China

2011 ◽  
Vol 6 (2) ◽  
pp. 119-126 ◽  
Author(s):  
Li-Ping Jiang, PhD, RN ◽  
Lan Yao, PhD ◽  
Eleanor F. Bond, PhD, RN, FAAN ◽  
Yu-Ling Wang, MSN, RN ◽  
Li-quan Huang, MSN, RN
Keyword(s):  
Risk Perception ◽  
Emergency Preparedness ◽  
Rural Areas ◽  
Risk Perceptions ◽  
Eastern China ◽  
Coping Behavior ◽  
Sociodemographic Characteristics ◽  
Risk Area ◽  
High Risk Area ◽  
Property Losses

China is highly vulnerable to natural disasters. Southeastern China situated on the Pacific Ocean experiences severe and devastating typhoons and hydrogeological disasters every year. Although respondents are highly aware of the typhoon outbreaks, they do not have necessary precautionary actions.This retrospective study evaluates the inhabitants’ sociodemographic characteristics with risk perceptions and preparedness. Subjects (434 adults) were recruited from two rural areas in coastal south-eastern China, both with high typhoon exposure. One area (landfall area [LA]) was more severely affected than the other (surrounding area [SA]) by the 2006 typhoon “Saomai.” Subjects were interviewed using a structured questionnaire with items addressing sociodemographic characteristics and exposure to public education related to emergency preparedness, risk perception, and coping strategies. Overall, most residents (92 percent) were aware that they lived in a high-risk area. About 54.6 percent respondents chose media as the first approach to obtain preparedness education, and 32.4 percent of respondents thought that personal experience is an important tool to defend themselves from typhoon. In LA, residents perceived themselves to be at higher risk than those who lived in the SA. More than 66.5 percent of respondents were terrified by typhoon, and 62.2 percent of respondents were afraid of its recurrence. Respondents emphasized that their life style (61.4 percent), property losses (54.5 percent), and threat to life (52.4 percent) were influenced by typhoon attack. Coping behavior most likely to be adopted was “anticipatory food, water storage and residents in LA is significantly higher than SA (p 0.01). Risk perception with Spider Map analysis depicted that the item of disaster information is similar in both familiarity or dread associated with the risk axes (p 0.05). However, in rescue and recovery of typhoon items, the score of familiarity with risk and dread with the risk axes is below 2.5. Regression analyses indicated that poor coping behavior was positively associated with age, risk perception, residential location, and knowledge of preparedness. The results indicated that risk perceptions and precaution activity were strongly related with inhabitants’ sociodemographic characteristics and vulnerability of disaster-affected zone.

Survival Disparities in Patients with Lymphoma According to Place of Residence and Treatment Provider: A Population-Based Study

Blood ◽  
2008 ◽  
Vol 112 (11) ◽  
pp. 874-874
Author(s):  
Fausto R Loberiza ◽  
Anthony J Cannon ◽  
Dennis D Weisenburger ◽  
Julie M. Vose ◽  
Matt J. Moehr ◽  
...  
Keyword(s):  
Overall Survival ◽  
High Risk ◽  
Rural Areas ◽  
Urban Areas ◽  
Population Based ◽  
Place Of Residence ◽  
Community Based ◽  
Risk Levels ◽  
Risk Of Death ◽  
Risk Patients

Abstract Objectives: We evaluated the association of the primary area of residence (urban vs. rural) and treatment (trt) provider (university-based vs. community-based) with overall survival in patients with lymphoma, and determined if there are patient subgroups that could benefit from better coordination of care. Methods: We performed a population-based study in 2,330 patients with centrally confirmed lymphoma from Nebraska and surrounding states reported to the Nebraska Lymphoma Study Group between 1982 and 2006. Patient residential ZIP codes at the time to trt were used to determine rural/urban designation, household income and distance to trt center; while trt providers were categorized into university-based or community based. Multivariate analyses were used to group patients into risk levels based on 8 factors found to be associated with survival at the time of trt (age, performance score, Ann Arbor stage, presence of B symptoms, LDH levels, tumor bulk, nodal and extranodal involvement). The following categories were identified: low-risk (1–3 factors), intermediate risk (4–5 factors), and high-risk (≥6 factors). Cox proportional regression analyses, stratified by type of lymphoma (low-grade NHL, high-grade NHL and Hodgkin) were used to evaluate the association between place of residence and trt provider with overall survival. Results: Among urban residents, 321 (14%) were treated by university-based providers (UUB) and 816 (35%) were treated by community-based providers (UCB). Among rural residents, 332 (14%) were treated by university-based providers (RUB) and 861 (37%) were treated by community-based providers (RCB). Patients from rural areas were more likely to be older and Caucasian, with a lower median household income, greater travel distance to seek trt, and more likely to have high-risk disease when compared to patients from urban areas. In multivariate analysis, using all patients regardless of risk level, the relative risk of death (RR) among UUB, UCB and RUB was not statistically different. However, RCB had a higher risk of death RR 1.37, 95% CI 1.14–1.65, p=0.01; RR 1.18, 95% CI 1.04–1.33, p<0.01; and RR 1.26, 95% CI 1.06–1.49, p=0.01 when compared with UUB, UCB and RUB, respectively. This association remained true in both low- and intermediate-risk patients. Among high-risk patients, both RUB and RCB were at higher risk of death when compared with UUB or UCB, while UCB were not different from UUB. We found no differences in progression-free survival according to place of residence and trt provider. The use of stem cell transplantation was significantly higher in patients coming from urban and rural areas treated by university-based providers (UUB 19%, RUB 16%) compared to urban and rural patients treated by community-based providers (UCB 11%, RCB 10%, p < 0.01). Patients from rural areas (RUB and RCB) were slightly less likely to die from lymphoma-related causes than patients from urban areas (75% versus 80%, p=0.04). Conclusion: Overall survival in patients with lymphoma is inferior in patients coming from rural areas. This relationship varies according to treatment provider and pretreatment risk levels. Further studies in patients from rural areas are needed to understand how coordination of care is carried to design appropriate interventions that may improve the disparity noted.

scholarly journals Awareness about harmful effects of cigarette smoking among adolescents in Shamirpet mandal, Hyderabad

2018 ◽  
Vol 6 (1) ◽  
pp. 208
Author(s):  
M. Pavani Varma ◽  
K. S. V. Prasad
Keyword(s):  
Rural Areas ◽  
Urban Areas ◽  
Early Stage ◽  
Tobacco Consumption ◽  
Cross Sectional Study ◽  
Medical Sciences ◽  
Cross Sectional ◽  
Local Setting ◽  
Urban And Rural Areas ◽  
Harmful Effects

Background: Tobacco smoking is habit which usually begins in the adolescent age. It is a risk factor for many non-communicable diseases and mortality can be prevented if smoking is quit.Methods: It is a cross sectional study.2 schools were randomly selected from urban and rural areas in field practice area of Mediciti Institute of Medical Sciences. A GYTS questionnaire is modified to local setting and administered to the students.Results: A total of 367 students were enrolled. The level of awareness regarding harmful effects of tobacco consumption was good. It was 98.85% in urban areas and 94.84% in rural areas.Conclusions: As adolescent is the age of habit forming identification of the problem and correcting it at early stage itself will be beneficial for individuals, family and society. 

scholarly journals Prevalensi dan Determinan Hipertensi di Pulau Jawa, Tahun 2004

2006 ◽  
Vol 1 (2) ◽  
pp. 57
Author(s):  
Zamhir Setiawan
Keyword(s):  
Risk Factor ◽  
Rural Areas ◽  
Urban Areas ◽  
Analysis Method ◽  
Hypertension Status ◽  
Individual Level ◽  
Level Measurement ◽  
Study Results ◽  
Ecological Measurement ◽  
The Individual

Hipertensi merupakan faktor risiko utama kardiovaskuler yang merupakan penyebab utama kematian di seluruh dunia. Peningkatan umur harapan hidup dan perubahan gaya hidup meningkatkan faktor risiko hipertensi di berbagai negara. Tujuan penelitian ini (1) Mengetahui prevalensi hipertensi dan penyebarannya di Pulau Jawa tahun 2004. (2) Mengetahui faktor-faktor sosiodemografi yang berhubungan dengan kejadian hipertensi. (3) Mengetahui kontribusi dan dampak potensial masing-masing faktor tersebut. Penelitian dengan rancangan studi Ekologi Multilevel ini menggabungkan variabel tingkat pengukuran individu dengan tingkat pengukuran ekologi dalam analisis bersama, dengan unit analisis individu. Analisis kontekstual dilakukan melalui kerangka konsep hipertensi, menggunakan metode analisis regresi logistik ganda, dengan status hipertensi sebagai variabel dependen. Data variabel dependen dan variabel perancu yang merupakan data pengukuran tingkat individu diambil dari data SKRT 2004. Data sosiodemografi tingkat pengukuran ekologi sebagai variabel independen utama, diperoleh dari Profil Kesehatan Indonesia, Statistik Indonesia, Statistik Kesehatan, Statistik Kesejahteraan Rakyat, danData Departemen Dalam Negeri, unit pengamatan provinsi. Hasil penelitian ini menunjukkan prevalensi hipertensi di Pulau Jawa 41,9%, dengan kisaran di masing-masing provinsi 36,6%-47,7%. Prevalensi di perkotaan 39,9% (37,0%-45,8%) dan di perdesaan 44,1% (36,2%-51,7%). Kata kunci: Hipertensi, faktor sosiodemografiAbstractHypertension is a main risk factor of cardiovascular disease which is ranked as number one cause of death in the world. The increase of life expectancy and changes in life style have increased the prevalence of hypertension risk factor in both developed and developing countries. The objectives of this study are (1) To know the prevalence and distribution of hypertension in di Java island, in year 2004. (2) To know sosiodemographic factors related to hypertension. (3) To know the contribution of each sosiodemographic factor toward hypertension. The study used multilevel ecologic study design that integrated both individual and ecological level variables measurement. The analysis method used in this study was contextual analysis and multiple logistic regression with hypertension status as dependent variable. The individual level measurement of variables such as hypertension status and age, job, education and sex is taken from Household Health Survey (SKRT) 2004. The sosiodemographic data which was ecological measurement level served as the main independent variables were taken from Indonesian Health Profile, Indonesian Health Statistics, Public Welfare Statistics and data from Department of Internal Affair, particularly from Province Surveillance Unit. The study results showed that the prevalence of hypertension in Java Island was 41.9%, with range of prevalence in provincial level of 36.6%-47.7%. The prevalence in urban areas was 39.9% (37.0%-45.8%) and in rural areas was 44.1% (36.2%-51.7%)Keywords: Hypertension, sosiodemographic factors

scholarly journals An Analysis of Floral Consumption Values and Their Difference for Genders and Geographic Regions

2009 ◽  
Vol 19 (1) ◽  
pp. 101-107 ◽  
Author(s):  
Tzu-Fang Yeh ◽  
Li-Chun Huang
Keyword(s):  
Rural Areas ◽  
Consumer Choice ◽  
Urban Areas ◽  
Diagnostic Value ◽  
Female Consumers ◽  
Consumption Values ◽  
Study Results ◽  
Different Types ◽  
Consumer Choice Behavior ◽  
Consumption Value

Studying the value of consumption is believed to have diagnostic value in the analysis of consumer choice behavior and, therefore, is helpful in improving the efficiency of the market. The objective of this study was to identify the consumption value that consumers seek from floral products, while also clarifying the context of that consumption value. A total of 644 valid questionnaires from a consumer survey were used for the statistical analysis. The statistical results of the factor analysis revealed that sensory hedonics, emotion conditioning, curiosity fulfillment, monetary worth, and showing care to others were the main types of the consumption value in relation to floral products. Different consumer groups were found to emphasize different types of floral consumption value. Female consumers reveal a stronger demand for the value of emotion conditioning and curiosity fulfillment, while male consumers are more likely to seek the value of sensory hedonics. Consumers in rural areas reveal a stronger demand for the value of curiosity fulfillment and monetary worth, while the consumers in urban areas reveal a stronger demand for the value of emotion conditioning, with regard to the consumption value of flowers. The study results provide florists with the key value points as they seek to increase the attraction of floral products to consumers.

scholarly journals Spatial assessment of construction waste generated by residential buildings in rural areas

2017 ◽  
Author(s):  
Florin Constantin MIHAI
Keyword(s):  
Rural Areas ◽  
Urban Areas ◽  
Early Stage ◽  
Residential Buildings ◽  
Waste Stream ◽  
Construction Waste ◽  
Administrative Unit ◽  
Thematic Cartography ◽  
Illegal Disposal ◽  
County Scale

The management of construction waste it is at an early stage in urban areas and lacking in rural areas where this fraction is frequently uncontrolled disposed on public lands. Despite the fact some items of construction waste are considered inert for the environment (soil, concrete) it also contains hazardous items (paint additives, cans, and containers) or recyclables (plastics, metals, wood). Potential recovery of this waste stream is high if it is properly managed. The paper estimates the potential amounts of waste resulted from residential constructions across rural municipalities of Neamț County between 2002 and 2010. These statistical values are calculated at commune level (rural territorial administrative unit) in order to outline the disparities between various geographical areas using thematic cartography. This approach is correlated with demographic features in order to reflect such spatial patterns. The map of population density within built-up areas reveals where the construction sector is emerging at the county scale. Field observations highlight the existence of illegal disposal practices of construction waste in the proximity of settlements or water bodies. This waste stream should receive proper attention in following years in order to achieve recycling and recovery targets imposed by EU regulations.

scholarly journals Is there Failure to Screen for Hepatitis C in Newborns Suffering from Neonatal Abstinence Syndrome?

2017 ◽  
Vol 4 (suppl_1) ◽  
pp. S40-S41
Author(s):  
John Myers ◽  
Michael Smith ◽  
Claudia Espinosa ◽  
Charles Woods ◽  
Scott Duncan
Keyword(s):  
Hepatitis C ◽  
High Risk ◽  
Rural Areas ◽  
Urban Areas ◽  
Vulnerable Population ◽  
Neonatal Abstinence Syndrome ◽  
Hcv Rna ◽  
Older Individuals ◽  
Abstinence Syndrome ◽  
Data Set

Abstract Background Enormous advances in treating/curing patients suffering from Hepatitis C (HepC) infection have occurred; resulting in many states mandating screening for HepC for older individuals. Unfortunately, no protection of screening exists for newborns. In Kentucky, rates of HepC among pregnant women are the second highest within the U.S., which has been associated to high intravenous drug use. Infants born to those women are at risk of HepC infection and other conditions such as neonatal abstinence syndrome (NAS). The current study examined the rate of HepC screening in a high-risk cohort (newborns suffering from NAS) and it’s impact on policy-making for this vulnerable population. Methods Kentucky Medicaid records, from 2015, were obtained to develop a detailed demographic, behavioral, clinical, and diagnostic data set (n = 152,749). NAS was defined by ICD-9 code 779.5 and ICD-10 code P96.1. HepC screening was defined by CPT codes (CPT 87520 [HCV, direct probe], 87521 [HCV, amplified probe], and 87522 [HCV RNA, Quantitative] or antibody [CPTs 86803–4]). Initially a descriptive study was performed, then multiple logistic regression techniques were used to test what variables impacted the odds of not being screened for HepC. Results A total of 1234 newborns with NAS were identified. The majority showed signs of NAS within 24 hours (64%), were white (68%) and were admitted to the hospital for an average of 24.8 days. Only one-in-three newborns with NAS (n = 412, 33.4%) were screened for HepC. Non-Whites (OR = 1.58, 95% CI 1.45–1.71, P &lt; 0.001) and those living in non-urban areas (OR = 1.42, 95% CI 1.28–1.56, P &lt; 0.001) were the only study variables to significantly impact the odds of not being screened for HepC (for newborns suffering from NAS). Conclusion A high-risk and vulnerable population for HepC may not be getting screened for HepC and thus are being underserved by the health care system. Non-Whites and those in rural areas are the most affected. Solutions and policies need to be focused on this population and area where screening is lacking. Optimization of maternal screening for HepC is crucial in high-risk populations. Disclosures All authors: No reported disclosures.

Stereotactic body radiotherapy (SBRT) and medical inoperability of early stage non-small cell lung cancer

2006 ◽  
Vol 24 (18_suppl) ◽  
pp. 17074-17074
Author(s):  
K. N. Franks ◽  
A. Bezjak ◽  
S. Pearson ◽  
B. C. Cho ◽  
D. Payne ◽  
...  
Keyword(s):  
High Risk ◽  
Early Stage ◽  
Incidental Finding ◽  
Tumour Size ◽  
Performance Status ◽  
Alternative Therapy ◽  
Average Risk ◽  
Early Stage Nsclc ◽  
Co Morbidity ◽  
New Treatment

17074 Background: Early stage NSCLC is commonly diagnosed in elderly patients who often have significant medical co-morbidity. SBRT is emerging as a treatment alternative that can provide 80–97% local control for peripheral tumors. We performed a literature review and a retrospective review of 24 patients referred to Princess Margaret Hospital for consideration of SBRT to assess what criteria were used to determine patient selection for this new treatment. Methods: Published papers reporting treating stage I NSCLC with SBRT were reviewed. Clinical and demographic characteristics of patients referred for consideration of SBRT over the last 15 months were analyzed. All patients were assessed by experienced thoracic surgeons to determine their operability status. Patients were retrospectively scored as average or high risk for surgery on the basis of accepted PFT guidelines (FEV1 and DLCO <40% predicted); Charlson Index of Comorbidity (CCI) was calculated (score >2 associated with impaired survival). Results: Of 13 papers reporting Stage 1 SBRT results, 8 included details of medical inoperability. 2 papers had strict guidelines for PFTs, in addition to other criteria. In 6 studies reporting 276 pts, the most common reason for inoperability was non-specific medical comorbidity (60%). Our cohort (24 patients) referred for SBRT (median age 75, range 57–89) had a mean tumour size of 2.32cm (S.D. 1.11); 50% of patients had a good (0–1) Zubrod Performance status. Based upon PFT tests alone 10 patients (42%) were high risk and 5 (21%) average risk for surgery. The CCI score was ≥3 in 10 patients (42%). 3 patients who scored average risk and CCI ≤2 were deemed medically inoperable due a single severe medical comorbity. In 23/24 pts the surgeon recommended against surgery; one patient refused surgery. Conclusions: With an aging population and increased detection due to incidental finding or screening, it is important to know that there is effective alternative therapy for patients deemed too high risk for surgical resection. Comorbidity is an important factor influencing surgical mortality; defining explicit criteria for inoperability remains a clinical challenge. No significant financial relationships to disclose.

Assessing the First and Last Mile Problem for Intercity Passenger Rail Service

2018 ◽  
Author(s):  
Lisa Lorena Losada Rojas ◽  
Konstantina “Nadia” Gkritza ◽  
V. Dimitra Pyrialakou
Keyword(s):  
Public Transportation ◽  
Rural Areas ◽  
Urban Areas ◽  
Short Distance ◽  
Service Providers ◽  
Public Transit ◽  
Passenger Rail ◽  
Last Mile ◽  
Study Results ◽  
Rail Service

The first and last mile of a trip has been used to describe passenger travel with regards to getting to and from transit stops/stations. Solving the first and last mile (FMLM) problem extends the access to transportation systems and enlarges the number of passengers from a remote community, such as rural areas. The FMLM problem has been addressed in different public transit contexts, mainly within urban areas. However, it is also an important part of the journey in an intercity trip; yet, limited research efforts have been undertaken to examine the FMLM problem that intercity passenger train riders face. This paper fills in this gap and further, aims to identify the best strategies that could serve as a FMLM solution for short distance intercity passenger rail service (i.e., corridors that are less than 750 miles long according to the Passenger Rail Improvement and Investment Act, 2008). The Hoosier State Train (HST) service, a short-distance intercity passenger rail that connects Chicago and Indianapolis four days a week, was chosen as a case of study. The HST has four intermediate stops located in Indiana. For some of those intermediate stops HST is the only intercity public transit service offered to reach either Chicago or Indianapolis. In order to explore opportunities to enhance the HST ridership, an on-board survey was conducted in November and December 2016. The findings of this survey suggested that there are riders who travel from counties further away from a county with a station to reach and complete their journey on the train. Moreover, it was found that most of the respondents drove or rented a car, or were dropped off to reach a train station in Indiana. Unlike the results from the Chicago station, the majority of riders boarding the train from one of the Indiana stations did not use ridesharing services or public transportation. These findings suggest that there is a possible gap into the FMLM travel options for intercity rail riders and alternative options to fill this gap should be considered. This paper discusses the case study results of an accessibility analysis aiming to identify the areas in need of first/last mile service where there are no public transportation services and/or it is costly to reach a station from a desired origin. To that end, a cost surface for the different modes available in the area of study was created to determine the average travel cost to the nearest station. The analysis was carried out in ArcGIS using origin-destination data from the on-board survey, transportation network information from the U.S. Bureau Transportation Statistics, and general transit feed specification (GTFS) data. Subsequently, some of the best strategies identified were modeled around the station (e.g., shuttle buses to/from the station) in order to examine how the accessibility would increase after a strategy implementation. The results of this study may have far-reaching implications for planning strategies that can enhance access to the train stations. Finally, the FMLM strategies could assist intercity passenger rail service providers attract a larger number of passengers.

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