Transit use reduction following COVID-19: The effect of threat appraisal, proactive coping and institutional trust.

Transit systems suffered from a significant demand decrease during COVID-19. Understanding the psychological motivators underlying reduced transit use can help transit authorities and operators to take proactive action towards returning to the "new normal" and increasing their preparedness towards future pandemics. This study is based on the protection motivation theory to understand the effect of threat appraisal, and coping appraisal and denial mechanisms on transit use reduction for commuting. The behavioral framework is validated by a survey of 856 transit users in Israel during August 2020, three months after the end of the lockdown and before the vaccine administration. The results show that: i) Skepticism, risk ubiquity, and personal immunity beliefs lead to maladaptive threat appraisal; ii) wearing masks and social distancing are antecedents of fear of infection while using transit and reduced transit use; iii) higher perceived threat deters transit use, while trust in transit operators motivates transit use; and iv) in a franchised transit system, trust in transit operators depends on the perceived level-of-service and trust in the ability of government authorities to regulate, monitor and enforce transit operators' preventive and protective actions.

Urban resilience as a mitigating factor against economically driven out-migration during COVID-19: The case of Eilat, a tourism-based city.

The COVID-19 pandemic has created an ongoing global crisis. The unprecedented shock has been particularly devastating for tourism-based cities and has tested their resilience. This study addresses the mitigating role of urban resilience in the interplay between acute crises and the phenomenon of urban outmigration. Leveraging a unique dataset collected during the first national lockdown that followed the outbreak of COVID-19 in the city of Eilat (Israel)-a geographically isolated single economic sector-based city with no feasible options to commute-we offer here a new conceptual framework and an empirical framework for measuring perceived resilience. Using validated psychometric questionnaires and employing the nested hierarchical modeling approach, we estimate the impact of perceived resilience on the decision to migrate from the city. We find that even though Eilat has all the attributes to experience significant out-migration, its residents are not inclined towards migration due to its prior investment in resilience measures, which strengthened the local community and created a unique credo shared by its residents. These findings call for policymakers to focus on long-term resilience schemes directed at increasing the appeal that cities have for their residents and ensuring their endurance in times of extreme hardship.

Recycling and consumption reduction following the COVID-19 lockdown: The effect of threat and coping appraisal, past behavior and information.

The COVID-19 pandemic has created sudden, rapid, and unprecedented change in almost every possible aspect of the general population's behavior. Despite its devastating consequences, the COVID-19 pandemic can alter individual behavior towards responsible environmental actions. This study provides an in-depth analysis of how the COVID-19 pandemic has changed pro-environmental beliefs and behavior. We compare pre-COVID-19 recycling and consumption reduction with post-COVID-19 intentions, focusing on the COVID-19 pandemic's role in catalyzing the change. The protection motivation theory is applied to investigate threat appraisal and coping appraisal as potential motivators for taking climate change more seriously and engaging in pro-environmental behavior. A tailor-made survey carried out during the national lockdown imposed in March-April 2020 in Israel served for the analysis. A generalized ordered probit estimated on a sample of 296 respondents served to validate the behavioral model. The results confirm that threat and coping appraisal are drivers of behavioral change towards pro-environmental behavior. The results show that: i) 40% of low-intensity recyclers are likely to increase recycling compared to 20% of high-intensity recyclers; ii) following the COVID-19 outbreak, 40% intend to consume less; iii) the changes are catalyzed by threat and coping appraisal; iv) taking climate change more seriously following the pandemic is a function of the individual's perceived association between COVID-19 and climate change, external knowledge, income loss due to the pandemic, self-resilience, and ecocentric beliefs; v) self-resilient attitudes lead to positive behavioral change, while anthropocentric beliefs impede changes towards sustainable behavior.

Reduction of Health Care-Associated Infections (HAIs) with Antimicrobial Inorganic Nanoparticles Incorporated in Medical Textiles: An Economic Assessment.

Health care-associated infections (HAIs) affect millions of patients annually with up to 80,000 affected in Europe on any given day. This represents a significant societal and economic burden. Staff training, hand hygiene, patient identification and isolation and controlled antibiotic use are some of the standard ways to reduce HAI incidence but this is time consuming and subject and subject to rigorous implementation. In addition, the lack of antimicrobial activity of some disinfectants against healthcare-associated pathogens may also affect the efficacy of disinfection practices. Textiles are an attractive substrate for pathogens because of contact with the human body with the attendant warmth and moisture. Textiles and surfaces coated with engineered nanomaterials (ENMs) have shown considerable promise in reducing the microbial burden on those surfaces. Studies have also shown that this antimicrobial affect can reduce the incidence of HAIs. For all of the promising research, there has been an absence of study on the economic effectiveness of ENM coated materials in a healthcare setting. This article examines the relative economic efficacy of ENM coated materials against an antiseptic approach. The goal is to establish the economic efficacy of the widespread usage of ENM coated materials in a healthcare setting. In the absence of detailed and segregated costs, benefits and control variables over at least cross sectional data or time series, an aggregated approach is warranted. This approach, while relying on some supposition allows for a comparison with similar data regarding standard treatment to reduce HAIs and provides a reasonable economic comparison. We find that while, relative to antiseptics, ENM coated textiles represent a significant clinical advantage, they can also offer considerable cost savings.

An Empirical Investigation of "Physician Congestion" in U.S. University Hospitals.

We add a new angle to the debate on whether greater healthcare spending is associated with better outcomes, by focusing on the link between the size of the physician workforce at the ward level and healthcare results. Drawing on standard organization theories, we proposed that due to organizational limitations, the relationship between physician workforce size and medical performance is hump-shaped. Using a sample of 150 U.S. university departments across three specialties that record measures of clinical scores, as well as a rich set of covariates, we found that the relationship was indeed hump-shaped. At the two extremes, departments with an insufficient (excessive) number of physicians may gain a substantial increase in healthcare quality by the addition (dismissal) of a single physician. The marginal elasticity of healthcare quality with respect to the number of physicians, although positive and significant, was much smaller than the marginal contribution of other factors. Moreover, research quality conducted at the ward level was shown to be an important moderator. Our results suggest that studying the relationship between the number of physicians per bed and the quality of healthcare at an aggregate level may lead to bias. Framing the problem at the ward-level may facilitate a better allocation of physicians.

From Research to Practice: Which Research Strategy Contributes More to Clinical Excellence? Comparing High-Volume versus High-Quality Biomedical Research.

The question when and to what extent academic research can benefit society is of great interest to policy-makers and the academic community. Physicians in university hospitals represent a highly relevant test-group for studying the link between research and practice because they engage in biomedical academic research while also providing medical care of measurable quality. Physicians' research contribution to medical practice can be driven by either high-volume or high-quality research productivity, as often pursuing one productivity strategy excludes the other. To empirically examine the differential contribution to medical practice of the two strategies, we collected secondary data on departments across three specializations (Cardiology, Oncology and Orthopedics) in 50 U.S.-based university hospitals served by 4,330 physicians. Data on volume and quality of biomedical research at each department was correlated with publicly available ratings of departments' quality of care, demonstrating that high-quality research has significantly greater contribution to quality of care than high-volume research.