Automated data extraction from historical city directories: The rise and fall of mid-century gas stations in Providence, RI.

The location of defunct environmentally hazardous businesses like gas stations has many implications for modern American cities. To track down these locations, we present the directoreadr code (github.com/brown-ccv/directoreadr). Using scans of Polk city directories from Providence, RI, directoreadr extracts and parses business location data with a high degree of accuracy. The image processing pipeline ran without any human input for 94.4% of the pages we examined. For the remaining 5.6%, we processed them with some human input. Through hand-checking a sample of three years, we estimate that ~94.6% of historical gas stations are correctly identified and located, with historical street changes and non-standard address formats being the main drivers of errors. As an example use, we look at gas stations, finding that gas stations were most common early in the study period in 1936, beginning a sharp and steady decline around 1950. We are making the dataset produced by directoreadr publicly available. We hope it will be used to explore a range of important questions about socioeconomic patterns in Providence and cities like it during the transformations of the mid-1900s.

Users' Perceptions of Signage Systems at Three Portuguese Hospitals.

This article is a report on the quantitative data collected from patients, family members, and visitors using the outpatient areas of three hospitals in Portugal. It details the users' views regarding the existing signage and presents suggestions to improve the design and implementation of the signage systems. A questionnaire was used with 1,287 respondents. The results showed that almost all users had a positive opinion regarding the current signage. However, some of the users' answers and observed behaviors indicated that the majority tended to ignore the signs and preferred to ask staff for help. Additionally, when asked for suggestions, many of the respondents were able to point out existing problems that affected their wayfinding. Although the signage was generally evaluated as good, many of the users perceived a variety of problems and, as already mentioned, asked the staff for directions, which results in lost time and hidden costs for the institutions.

Patient satisfaction with antiretroviral therapy services and associated factors at Gondar town health centers, Northwest Ethiopia: an institution-based cross-sectional study.

BACKGROUND: The Human Immunodeficiency Virus (HIV) with which over 37 million peoples are living is the leading cause of morbidity and mortality worldwide. The rapid expansion of antiretroviral treatment has dramatically reduced HIV related deaths and transmissions. Patient satisfaction could be an indispensable parameter used to measure patients' desired fulfillment by the services. Hence, this study aimed to determine the level of patient satisfaction with antiretroviral therapy services and determinants at Gondar town health centers. METHODS: An institution-based cross-sectional study was conducted from November 1 to 30, 2018. The systematic random sampling technique was used to select 663 HIV/AIDS patients on antiretroviral therapy follow-ups. Data were collected using a pretested interviewer-administered questionnaire and patient medical document reviews. Summary statistics such as means, medians and proportions were calculated and presented in the form of tables, graphs, and texts. Bivariate and multivariable logistic regression analysis was fitted and adjusted odds ratio (AOR) with a 95% confidence interval (CI) was computed to assess the strength of association. Variables with p-value 0.05 at multivariable logistic regression considered significant determinants of patient satisfaction. RESULTS: The overall patient satisfaction with antiretroviral therapy services was 75.4% (95%CI, 71.9 to 79%). Patients' age 38-47 years (AOR = 5.90, 95%CI: 3.38,10.31) and ≥ 48 years (AOR = 2.66, 95%CI:1.38,5.12), absence of signs and directions to ART clinic (AOR = 0.53,95%CI:0.35,0.82), Azezo health center (AOR = 2.68,95%CI:1.47,4.66) and Teda health center (AOR = 4.44,95%CI:1.73,11.30), and travel that took more than 1 h (AOR = 0.56;95% CI:0.32,0.97) were determinants of patient satisfaction with the services. CONCLUSION: The overall patient satisfaction with antiretroviral therapy service was lower than the national target of 85% with the marked difference among health centers. Older age, absence of signs and directions to ART clinics, and longer travel from home to health centers were factors influencing patient satisfaction with antiretroviral treatments. This suggests that further improvement of accessibility is likely needed to increase patient satisfaction.

Implementing the Lever Sign in the Emergency Department: Does it Assist in Acute Anterior Cruciate Ligament Rupture Diagnosis? A Pilot Study.

BACKGROUND: Within the emergency department (ED) setting, anterior cruciate ligament (ACL) rupture is commonly misdiagnosed, leading to improper treatment and potential meniscal injury and total joint replacement. Utilizing traditional clinical tests to diagnosis ACL rupture leads to the correct diagnosis in about 30% of cases. The lever sign is a new and effective clinical test used to diagnose ACL rupture with 100% sensitivity. OBJECTIVE: We aim to study if the lever sign used in the ED setting is more sensitive to diagnose ACL rupture than traditional tests. METHODS: Patients between 12 and 55 years of age were examined utilizing either traditional methods or the lever sign. Diagnostic findings in the ED were compared with those of a sports medicine specialist using magnetic resonance imaging as the diagnostic standard. A survey was given to ED providers to collect data on diagnosis and physician confidence in diagnosis. RESULTS: The sensitivity of the lever sign was 100% (94.7% accuracy, 93.75% specificity), whereas the sensitivity of the anterior drawer/Lachman test was 40% (87.5% accuracy, 100% specificity). Physician confidence in diagnosis was higher utilizing the lever sign vs. the anterior drawer/Lachman test at 8.45 (±1.82) compared with 7.72 (±1.82) out of 10, respectively. There was no statistically significant association between diagnostic accuracy with either test and level of training of the ED provider. CONCLUSION: Implementation of the lever sign in the ED setting resulted in a higher sensitivity, higher physician confidence in screening test diagnosis, and a decrease in the number of undiagnosed ACL ruptures.

A pedestrian serious injury risk prediction method based on posted speed limit.

The purpose of this study was to develop a serious injury risk prediction algorithm for pedestrians, using data from the South Australian Traffic Accident Reporting System. Two algorithms were developed to estimate serious injury risk, using a logistic regression analysis of 6,868 vehicle-pedestrian crashes extracted from TARS data. In this study, an optimal model based on the best combination of risk factors according to the Akaike information criterion (AIC) was developed. Additionally, a secondary GPS model using only crash site characteristics that can be derived from GPS coordinates from the crash scene was also developed. The optimal model is based on site and environmental conditions that could be derived from GPS data (posted speed limit, distance from crash site, natural lighting conditions, road geometry, road horizontal alignment and road vertical alignment) as well as pedestrian age/gender, driver age/gender and vehicle model year. The second model only included features that could be derived from GPS data. The optimal model was reasonable in accuracy and gave an under-triage rate of 10% when the injury threshold was set to 15%, with a corresponding over-triage rate of around 60%. The GPS model, despite not being as accurate as the optimal model may be adequate in the absence of all the risk factors required for the optimal model, requiring an injury threshold of 20% to give an under-triage rate of 10%, with the corresponding over-triage rate being around 70%. Both models can potentially be used for serious injury risk prediction (SIRP) for pedestrians involved in a collision with a vehicle.

Rethinking safety in numbers: are intersections with more crossing pedestrians really safer?

OBJECTIVE: To advance the interpretation of the 'safety in numbers' effect by addressing the following three questions. How should the safety of pedestrians be measured, as the safety of individual pedestrians or as the overall safety of road facilities for pedestrians? Would intersections with large numbers of pedestrians exhibit a favourable safety performance? Would encouraging people to walk be a sound safety countermeasure? METHODS: We selected 288 signalised intersections with 1003 pedestrian crashes in Hong Kong from 2010 to 2012. We developed a Bayesian Poisson-lognormal model to calculate two common indicators related to pedestrian safety: the expected crash rate per million crossing pedestrians and the expected excess crash frequency. The ranking results of these two indicators for the selected intersections were compared. RESULTS: We confirmed a significant positive association between pedestrian volumes and pedestrian crashes, with an estimated coefficient of 0.21. Although people who crossed at intersections with higher pedestrian volumes experienced a relatively lower crash risk, these intersections may still have substantial potential for crash reduction. CONCLUSIONS: Conclusions on the safety in numbers effect based on a cross-sectional analysis should be reached with great caution. The safety of individual pedestrians can be measured based on the crash risk, whereas the safety of road facilities for pedestrians should be determined by the environmental hazards of walking. Intersections prevalent of pedestrians do not always exhibit favourable safety performance. Relative to increasing the number of pedestrians, safety strategies should focus on reducing environmental hazards and removing barriers to walking.

Bayesian approach to model pedestrian crashes at signalized intersections with measurement errors in exposure.

This study intended to identify the potential factors contributing to the occurrence of pedestrian crashes at signalized intersections in a densely populated city, based on a comprehensive dataset of 898 pedestrian crashes at 262 signalized intersections during 2010-2012 in Hong Kong. The detailed geometric design, traffic characteristics, signal control, built environment, along with the vehicle and pedestrian volumes were elaborately collected. A Bayesian measurement errors model was introduced as an alternative method to explicitly account for the uncertainties in volume data. To highlight the role played by exposure, models with and without pedestrian volume were estimated and compared. The results indicated that the omission of pedestrian volume in pedestrian crash frequency models would lead to reduced goodness-of-fit, biased parameter estimates, and incorrect inferences. Our empirical analysis demonstrated the existence of moderate uncertainties in pedestrian and vehicle volumes. Six variables were found to have a significant association with the number of pedestrian crashes at signalized intersections. The number of crossing pedestrians, the number of passing vehicles, the presence of curb parking, and the presence of ground-floor shops were positively related with pedestrian crash frequency, whereas the presence of playgrounds near intersections had a negative effect on pedestrian crash occurrences. Specifically, the presence of exclusive pedestrian signals for all crosswalks was found to significantly reduce the risk of pedestrian crashes by 43%. The present study is expected to shed more light on a deeper understanding of the environmental determinants of pedestrian crashes.

Accident severity levels and traffic signs interactions in state roads: a seemingly unrelated regression model in unbalanced panel data approach.

This study intended to investigate the interactions between accident severity levels and traffic signs in state roads located in Croatia, and explore the correlation within accident severity levels and heterogeneity attributed to unobserved factors. The data from 410 state roads between 2012 and 2016 were collected from Traffic Accident Database System maintained by the Republic of Croatia Ministry of the Interior. To address the correlation and heterogeneity, a seemingly unrelated regression (SUR) model in unbalanced panel data approach was proposed, in which the seemingly unrelated model addressed the correlation of residuals, while the panel data model accommodated the heterogeneity due to unobserved factors. By comparing the pooled, fixed-effects and random-effects SUR models, the random-effects SUR model showed priority to the other two. Results revealed that (1) low visibility and the number of invalid traffic signs per km increased the accident rate of material damage, death or injured; (2) average speed limit exhibited a high accident rate of death or injured; (3) the number of mandatory signs was more likely to reduce the accident rate of material damage, while the number of warning signs was significant for accident rate of death or injured.

Wildlife warning reflectors do not mitigate wildlife-vehicle collisions on roads.

Wildlife-vehicle collisions cause human fatalities and enormous economic and ecological losses on roads worldwide. A variety of mitigation measures have been developed over the past decades to separate traffic and wildlife, warn humans, or prevent wildlife from entering a road while vehicles are passing by, but only few are economical enough to be applied comprehensively. One such measure, wildlife warning reflectors, has been implemented over the past five decades. However, their efficacy is questioned because of contradictory study results and the variety of applied study designs and reflector models. We used a prospective, randomized non-superiority cross-over study design to test our hypothesis of the inefficacy of modern wildlife warning reflectors. We analyzed wildlife-vehicle collisions on 151 testing sites of approximately 2 km in length each. During the 24-month study period, 1984 wildlife-vehicle collisions were recorded. Confirmatory primary and exploratory secondary analyses using a log-link Poisson mixed model with normal nested random intercepts of observation year in road segment, involved species, and variables of the road segment and the surrounding environment showed that reflectors did not lower the number of wildlife-vehicle collisions by a relevant amount. In addition, variables of the road segment and the surrounding environment did not indicate differential effects of wildlife warning reflectors. Based on our results, we conclude that wildlife warning reflectors are not an effective tool for mitigating wildlife-vehicle collisions on roads.

Saving lives with public access defibrillation: A deadly game of hide and seek.

BACKGROUND: Early defibrillation is a critical link in the chain of survival. Public access defibrillation (PAD) programmes utilising automated external defibrillators (AEDs) aim to decrease the time-to-first-shock, and improve survival from out-of-hospital cardiac arrest. Effective use of PADs requires rapid location of the device, facilitated by adequate signage. We aimed to therefore assess the quality of signage for PADs in the community. METHOD: From April 2017 to January 2018 we surveyed community PADs available for public use on the 'Save a Life' AED locator mobile application in and around Southampton, UK. Location and signage characteristics were collected, and the distance from the furthest sign to the AED was measured. RESULTS: Researchers evaluated 201 separate PADs. All devices visited were included in the final analysis. No signage at all was present for 135 (67.2%) devices. Only 15/201 (7.5%) AEDs had signage at a distance from AED itself. In only 5 of these cases (2.5%) was signage mounted more than 5.0 m from the AED. When signage was present, 46 used 2008 ILCOR signage and 15 used 2006 Resuscitation Council (UK) signage. Signage visibility was partially or severely obstructed at 27/66 (40.9%) sites. None of the 45 GP surgeries surveyed used exterior signage or an exterior 24/7 access box. CONCLUSIONS: Current signage of PADs is poor and limits the device effectiveness by impeding public awareness and location of AEDs. Recommendations should promote visible signage within the operational radius of each AED.

What are the differences in driver injury outcomes at highway-rail grade crossings? Untangling the role of pre-crash behaviors.

Crashes at highway-rail grade crossings can result in severe injuries and fatalities to vehicle occupants. Using a crash database from the Federal Railroad Administration (N=15,639 for 2004-2013), this study explores differences in safety outcomes from crashes between passive controls (Crossbucks and STOP signs) and active controls (flashing lights, gates, audible warnings and highway signals). To address missing data, an imputation model is developed, creating a complete dataset for estimation. Path analysis is used to quantify the direct and indirect associations of passive and active controls with pre-crash behaviors and crash outcomes in terms of injury severity. The framework untangles direct and indirect associations of controls by estimating two models, one for pre-crash driving behaviors (e.g., driving around active controls), and another model for injury severity. The results show that while the presence of gates is not directly associated with injury severity, the indirect effect through stopping behavior is statistically significant (95% confidence level) and substantial. Drivers are more likely to stop at gates that also have flashing lights and audible warnings, and stopping at gates is associated with lower injury severity. This indirect association lowers the chances of injury by 16%, compared with crashes at crossings without gates. Similar relationships between other controls and injury severity are explored. Generally, crashes occurring at active controls are less severe than crashes at passive controls. The results of study can be used to modify Crash Modification Factors (CMFs) to account for crash injury severity. The study contributes to enhancing the understanding of safety by incorporating pre-crash behaviors in a broader framework that quantifies correlates of crash injury severity at active and passive crossings.

Stair-use interventions in worksites and public settings - a systematic review of effectiveness and external validity.

OBJECTIVE: We performed a literature review with the main aims to propose an updated overview of the effectiveness of stair-use interventions and to determine the most effective type of intervention. METHODS: We systematically searched stair-use interventions performed in worksites or public settings, published up to mid 2013. We used a harvest plot approach to visualize the findings in addition to a quantitative synthesis. We also assessed external validity using the Reach, Efficacy, Adoption, Implementation, Maintenance (RE-AIM) framework. RESULTS: Of 8571 articles identified, 50 were included. In worksites (25 studies) and public settings (35 studies), an increase in stair climbing was found during the intervention period in 64% and 76% of studies, respectively. Combining motivational and directional signs in worksites or conducting a second intervention phase in public settings increased stair climbing in 83% and 86% of studies, respectively. Elements of external validity were overall largely under-reported. CONCLUSION: There is evidence that stair-use interventions are effective to increase stair climbing in public settings, but evidence of such effect is limited in worksites. Issues regarding the best sequencing of interventions or the potential importance of environmental interventions should be addressed in future studies. Process evaluation should be an integral part of interventions.

Monitoring smoke-free laws in restaurants and educational institutions in Chennai, India.

BACKGROUND: Smoking tobacco affects the health of smokers as well as non-smokers who are exposed to secondhand smoke. The Government of India enacted the Cigarettes and Other Tobacco Products Act in 2003, which included a ban on smoking in public places and on sale of tobacco around educational institutions. We assessed the extent of compliance with these laws in restaurants and educational institutions in Chennai, Tamil Nadu, India. METHODS: We conducted a cross-sectional survey using an observation checklist in restaurants and educational institutions in Chennai. We used cluster sampling for restaurants and random sampling for schools and colleges. We collected data regarding the signage displaying prohibition of smoking as per the law and sale of tobacco products around educational institutions. We estimated the proportions for various indicators. RESULTS: Among the 400 restaurants surveyed, 371 (92.8%) did not have any signage displaying prohibition of smoking and of the 29 restaurants with signage, only 4 were as per the specifications. There were 62 (15.5%) smoking events in restaurants at the time of visit for survey. Among the 287 schools surveyed, only 8 (2.8%) had the signage displaying prohibition of smoking and 2 (0.7%) had the signage for ban on sale of tobacco products. Of the 54 colleges surveyed, 8 (14.8%) had the signage displaying prohibition of smoking and 7 (13%) had the signage for ban on sale of tobacco products. CONCLUSION: There was low compliance of smoke-free laws in restaurants and educational institutions in Chennai. We recommend a robust monitoring mechanism to ensure the enforcement of smoke-free laws in public places.

Providing a USSD location based clinic finder in South Africa: did it work?

A new mHealth service, Clinic Finder, was designed to provide a location-based service for any cellphone user in South Africa dialing a dedicated USSD string to find the nearest public primary health care facility. The service was funded by a European Union grant to Cell-Life to support the National Department of Health. Clinic Finder's aims were to provide a reliable and accurate service, and to assess both the most effective means of advertising the service as well as interest in the service. Users dialing the USSD string are asked to agree to geo-location (Vodacom and MTN users) or asked to enter their province, town and street (virtual network users and those choosing not to geo-locate). The service provider, AAT, sends the data to Cell-Life where an SMS with details of the nearest public primary health care facility is sent to the user by Cell-Life's open-source Communicate platform. The service was advertised on 3 days in 2014 using two different means: a newspaper ad on 20 May 2014 and Please Call Me ads on 30 July 2014 and 14 August 2014. 28.2% of unique users on 20 May 2014, 10.5% of unique users on 30 July 2014 and 92.8% of unique users on 14 August 2014 who agreed to geo-location successfully received SMSs. However, only 4.2%, 0.5%, and 2.4% of unique users responding to each advertisement who did not geo-locate then received an SMS. A small survey of users following the 20 May 2014 newspaper ad found overall interest in the idea of Clinic Finder, though unsuccessful users were more likely to dislike the service. The overall experience of using location based services and USSD for Clinic Finder suggests a need in the field of mHealth for wider availability of data on service usability and effectiveness.

How good is compliance with smoke-free legislation in India? Results of 38 subnational surveys.

BACKGROUND: India has been implementing smoke-free legislation since 2008 prohibiting smoking in public places. This study aimed to assess the level of compliance with smoke-free legislation (defined as the presence of no-smoking signage and the absence of active smoking, smoking aids, cigarette butts/bidi ends and smoking smell) and the role of enforcement systems in Indian jurisdictions. METHODS: This was a cross-sectional, retrospective review of reports and primary data sheets of surveys conducted in 38 selected jurisdictions across India in 2012-2013. RESULTS: Of 20 455 public places (in 38 jurisdictions), 10 377 (51%) demonstrated full compliance with smoke-free law. Educational institutions and healthcare facilities performed well at 65% and 62%, respectively, while eateries and frequently visited other public places (such as bus stands, railway stations, shopping malls, stadia, cinema halls etc.) performed poorly at 37% and 27%, respectively. Absence of no-smoking signage was the largest contributor to non-compliance across all types of public places. Enforcement systems were present in all jurisdictions, but no associations could be demonstrated between these and smoke-free compliance. CONCLUSION: Smoke-free compliance in public places in India was suboptimal and was mainly related to the absence of no-smoking signage. This warrants further pragmatic and innovative ways to improve the situation.

[Setting of logos on tobacco control information at outlets for retails and restaurants in 12 cities of China].

OBJECTIVE: To explore the setting of logos on tobacco control information at outlets for retails and restaurants in 12 selected cities of China. METHODS: For all the shops for retail of tobacco, alcohol, food and restaurants under survey in 333 blocks of 12 cities(Beijing, Tianjin, Shanghai, Qingdao, Hangzhou, Shaoxing, Suzhou, Nantong, Zhenjiang, Chengdu, Xining and Harbin), setting and contents of logos on tobacco control information, inside and outside them were examined. RESULTS: 45 700 objectives were included in the study. Among all types of retail shops, the identification rate of tobacco control information at the entrance and inside were 3.6% and 4.4%, with an overall identification rate as 7.0%. The overall rate at the entrance of all the restaurants was 4.6% which was larger than the ones at the retail shops. Our result showed that there were differences between cities and types of establishments and higher rates seen in the larger ones. Of all the places that having had placement of information on tobacco control, only 18.5% of them had put them both inside and outside. Slogans or images on "No Smoking" were the main forms of information but less than 10% of them would show signs as 'exclusive non-smoking'. CONCLUSION: Data from our survey showed that the identification rate of tobacco control information was at a low level in 12 cities, and differences were seen between cities, size of establishment, that called for improvement of the existing tobacco control policies in China.