ABSTRACT
The rise of Transportation Network Companies (TNCs) over the last decade has significantly disrupted the taxi industry. Studies have shown that taxi ridership has plummeted, and their capacity utilization rates are lower than 50% in five major U.S. cities. Additionally, the COVID-19 pandemic has dealt a severe blow to the already struggling taxi industry. To monitor the evolution of the taxi industry and its impacts on society, our study evaluates changes in the utilization rates, fuel consumption, and emissions among Chicago taxis, using taxi data with rich information on trip profiles from pre-pandemic and pandemic times. Our findings indicate that the taxi utilization rate decreased during the pandemic. While fuel consumption and emissions per kilometer decreased thanks to the reduced traffic during the pandemic, the overall fuel consumption and emissions increased due to increased deadhead travel. The methods developed in this study can be applied to monitor and evaluate the impact of future disruptive events on urban mobility and transportation systems more effectively. By utilizing mobility data to better understand transportation systems, we can develop more efficient, sustainable, and resilient mobility solutions for smart cities. © 2023 ACM.
ABSTRACT
Background. Intranasal povidone-iodine (PI) is a recommended strategy for universal decolonization in high-risk patients (ICU and those with central venous or midline catheters) to reduce hospital-associated Staphylococcal infections. Few studies have evaluated implementation challenges and barriers to successful performance of inpatient intranasal decolonization programs. Methods. We surveyed adult acute care unit nurses at an academic medical center in March 2022, approximately 14 months after implementation of a universal decolonization standard operating procedure (SOP). The anonymous, voluntary REDCap survey evaluated domains focused on patient identification, education, training, resources, application, and patient acceptance using Likert scale ratings. Results. Among 248 respondents, most were new to nursing (54.4% with 0-4 years of experience) and worked in non-ICU units (61.5%). Only 60.5% reported receiving training on how to perform intranasal PI (hands-on 48.6%, computer/electronic module 25.7%, both 20.9%). Nurses who received training indicated moderate to strong confidence in their ability to perform intranasal PI decolonization (89.2%). A majority cited a good understanding of the rationale for use and identified patients appropriately. Low rates were reported for performing decolonization per the SOP (49%), with barriers including inadequate supplies (35.1%), lack of a readily available copy of the SOP (69%), difficulty swabbing with nasal devices in place (41.5%) and time constraints from other patient duties. Nurses perceived that only 49.2% of patients had a moderate or strong understanding of why PI decolonization was performed, and most were unwilling to undergo intranasal PI (59.1%). Other issues included tracking PI application within the electronic medical record (EMR), limited nurse knowledge of PI effectiveness, patient refusal despite education, and overall frontline personnel burnout. Conclusion. Gaps in nursing and patient education should be prioritized during and after implementation to improve fidelity, particularly with frontline burnout from COVID-19. Streamlined tracking and ordering of PI on the EMR may ease nursing workflow.
ABSTRACT
Background and Aims: Reliance on in-visit, opt-in screening for colorectal cancer (CRC) may be an obstacle to screening, especially during the COVID-19 pandemic and among low income and vulnerable populations. We aim to describe and evaluate the effectiveness of a CRC screening outreach campaign in a safety-net health system testing opt-out and opt-in text message outreach followed by mailed fecal immunochemical test (FIT) kits. Methods: From November 2020 to April 2021, the outreach campaign targeted patients ages 50-75 from 11 primary care clinics within the San Francisco Health Network who had previously completed a FIT test and were overdue for CRC screening. Patients were assigned to receive a language-concordant, pre-alert text message notifying that they would be mailed a FIT kit 1) unless they opted out of receiving a kit or 2) if they opted in to receiving a kit. The primary outcome was screening participation at 3 months after outreach. Results: A total of 371 patients were assigned to receive opt-out text messages and 522 received opt-in text messages. FIT kits were mailed to 96.5% (n = 358) of the opt-out group and 19.3% (n = 101) of the opt-in group. Screening uptake at 3 months was significantly higher in the optout group than in the opt-in group (58.8% vs. 18.0%, P < 0.001;difference = 40.8%, 95% confidence interval 34.8%-46.8%). Black/African American patients had lower screening rates (33.3% in opt-out group and 9.4% in opt-in group) compared to Hispanic/Latino (53.3% in opt-out group and 26.7% in opt-in group) and Asian (66.7% in opt-out group and 26.7% in opt-in group) patients. Conclusions: During the COVID-19 pandemic, optout text messaging followed by mailed FIT kits improved population-level CRC screening rates in a safety-net health system. Tailored initiatives are needed to address low screening rates for Black/African American patients.
ABSTRACT
This research uses a “migration with dignity” framework to look at the twin impacts of COVID-19 and discrimination on the Marshallese community in Springdale, Arkansas. Specifically, it focuses on the ways in which rights to non-discrimination, to basic quality of life, and to access services, especially healthcare, have not been adequately upheld. As the research was conducted in partnership with the Arkansas Coalition of Marshallese (ACOM), the paper also aims to examine some of the community-based work that has been addressing these issues. The research, based on interviews and desk research, found that almost all Marshallese community members interviewed expressed that they had not felt safe from COVID-19 and it had significantly impacted their lives. Many expressed that existing issues with limited access to healthcare or perceived discrimination in the healthcare system had been exacerbated by COVID-19. In particular, factors such as lack of translation of unemployment and COVID-19 documents into the Marshallese language, lack of paid sick leave, and multigenerational housing, all exacerbated the effects of the pandemic on Marshallese community members. General racial or cultural discrimination was an issue expressed by about half of the respondents, who shared varying stories of discrimination occurring in workplace and school settings, but almost none expressed fear over personal safety in Springdale. Community organizations and structures, specifically health clinics, community vaccine drives, and a community food pantry, were all mentioned as ways that the Marshallese community upheld rights to non-discrimination, basic quality of life, and right to access services. © Fuji Technology Press Ltd.
ABSTRACT
In this paper we present a deterministic discrete-time networked SEIR model that includes a number of transportation networks, and present assumptions under which it is well defined. We analyze the limiting behavior of the model and present necessary and sufficient conditions for estimating the spreading parameters from data. We illustrate these results via simulation and with real COVID-19 data from the Northeast United States, integrating transportation data into the results.
ABSTRACT
Résumé But de l’étude Plusieurs études ont confirmé l’impact du confinement sur la population, entraînant une rupture de soins, des effets somatiques et psychologiques. Notre étude s’intéresse aux effets indésirables et aux problèmes d’observance au cours d’immunothérapie orale (ITO) alimentaires pendant le confinement. Patients et méthodes Au total, 132 patients, majoritairement des enfants (95 %), avec un antécédent atopique (60 %) suivis pour une ITO ont été inclus dans 3 centres d’allergologie en Île-de-France, pendant le confinement lié à la pandémie SARS-Cov-2 du 16/03 au 11/05/20. Les aliments des ITO étaient principalement l’arachide (38 %), le lait de vache (24 %), la noisette (14 %), l’œuf (9 %), la noix de cajou et la pistache (8 %). Résultats Des effets indésirables ont été retrouvés chez 13 patients soit 10 % des cas. Ces réactions étaient principalement de grade 1 et 2 selon la classification de Ring et Messmer. Trois patients ont présenté des réactions de grade 3 et six patients ont utilisé l’adrénaline au domicile. L’observance était correcte dans 81 % des cas sans aucun oubli. Trois patients ont augmenté leur dose quotidienne sans avis médical. Nous n’avons pas retrouvé de différence significative dans l’analyse en sous-groupe comparant des enfants appariés en âge suivis en ITO en 2019 et en 2020 sur la même période dans le même hôpital. Conclusion Il n’y a pas eu d’augmentation des effets indésirables au cours d’ITO pendant la période du confinement. L’éducation thérapeutique au cours de l’ITO est primordiale et participe à réduire la survenue d’effets indésirables. Purpose of the study Several studies have confirmed the impact of confinement on the population, resulting in disruption of care, somatic and psychological effects. Our study looks at adverse effects and problems of adherence to oral immunotherapy therapy (OIT) during this period. Patients and methods A total of 132 patients, mostly children (95%), with an atopic history (60%) followed for an OIT were included in 3 allergology centers in Île-de-France, during the period of confinement from 03/16 to 05/11/20. The main food allergens used for OIT were peanut (38%), cow's milk (24%), hazelnut (14%), egg (9%), cashew nut and pistachio nut (8%). Results Adverse effects were found in 13 patients or 10% of the cases. These reactions were mainly grade 1 and 2 according to the Ring and Messmer classification. Three patients had grade 3 reactions and six patients used epinephrine at home. Adherence was correct in 81% of cases with no omissions. Three patients increased their daily dose without medical advice. No significant difference was found in the subgroup analysis comparing age-matched children followed up in OIT in 2019 and 2020 over the same period in the same hospital. Conclusion There was no increase in adverse events in OIT during the confinement period. Therapeutic education during OIT is paramount and helps to reduce the occurrence of adverse events.
ABSTRACT
The coronavirus disease (COVID-19) pandemic has significantly disrupted transportation and travel patterns across the US and around the world. A significant driving factor in the significant reduction in travel in the US was the declaration of varying state-, county-, and city-level stay-at-home orders with varying degrees of reduction. However, it is still not clear how significantly any one of those orders contributed to the reduction in travel. This article looks at continuous count data from the Minneapolis-St. Paul, Minnesota, area to quantify the disruption in terms of reductions in traffic volume as well as the abnormality of the disruption to travel patterns. A nearly 50% reduction in total traffic volume is found, and regional trends both in reductions and the gradual recovery toward normal travel patterns are identified. Furthermore, key dates are identified that led to significant reductions in travel, and this disruptive event is compared with other significantly disruptive events in Minnesota for context. It is found that although the stay-at-home order was a significant milestone in the fight against COVID-19, traffic volumes had already reduced significantly before the order went into effect, and traffic volumes had recovered significantly before the order expired. These findings will be helpful in understand the impact of stay-at-home orders on future outbreaks of COVID-19 or other pandemics. (C) 2021 American Society of Civil Engineers.
ABSTRACT
Rationale: The mechanism for spread of Coronavirus Disease 2019 (COVID-19) has been attributed to large droplets produced by coughing and sneezing. There is controversy whether smaller particles may transport Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2), the virus that causes COVID-19. Smaller particles, referred to as fine particulate matter (≤2.5 μm in diameter), can remain airborne for longer periods than larger particles and after inhalation will penetrate deeply into the lungs. Little is known about the size distribution and location of airborne SARS-CoV-2 RNA in a hospital setting. Methods: As a measure of hospitalrelated exposure, air samples of three particle sizes (>10.0 μm, 10.0-2.5 μm, and ≤2.5 μm) were collected at Veterans Affairs Boston Healthcare System from April to May 2020 (N=90 size-fractionated samples) using a custom-built cascade impactor. Locations included outside negative-pressure COVID-19 wards, a hospital ward not directly involved in COVID-19 patient care, and the emergency department. Results: SARS-CoV-2 RNA was present in 9% of samples and in all size fractions at concentrations of 5 to 51 copies m-3. Locations outside COVID-19 wards had the fewest positive samples. A non-COVID-19 ward had the highest number of positive samples, likely reflecting staff congregation. Among all locations, the probability of a positive sample was positively associated (r=0.95, p<0.01) with the number of COVID-19 patients in the hospital, which reflected (r=0.99, p<0.01) the number of new daily cases of COVID-19 in Massachusetts. Conclusions: More frequent detection of positive samples in non-COVID-19 wards than outside COVID-19 hospital areas indicates effectiveness of COVID-ward hospital controls in controlling air concentrations and suggests the potential for disease spread in areas without the strictest precautions. The positive associations noted between the probability of a positive sample, COVID-19 cases in the hospital, and cases in Massachusetts suggests that hospital air sample positivity was related to community burden. The finding of SARS-CoV-2 RNA in samples of fine particulate matter supports the possibility of airborne transmission over distances greater than six feet. The findings support guidelines that limit exposure to airborne particles including fine particles capable of longer distance transport and greater lung penetration.
ABSTRACT
PURPOSE OF THE STUDY: Several studies have confirmed the impact of confinement on the population, resulting in disruption of care, somatic and psychological effects. Our study looks at adverse effects and problems of adherence to oral immunotherapy therapy (OIT) during this period. PATIENTS AND METHODS: A total of 132 patients, mostly children (95%), with an atopic history (60%) followed for an OIT were included in 3 allergology centers in Île-de-France, during the period of confinement from 03/16 to 05/11/20. The main food allergens used for OIT were peanut (38%), cow's milk (24%), hazelnut (14%), egg (9%), cashew nut and pistachio nut (8%). RESULTS: Adverse effects were found in 13 patients or 10% of the cases. These reactions were mainly grade 1 and 2 according to the Ring and Messmer classification. Three patients had grade 3 reactions and six patients used epinephrine at home. Adherence was correct in 81% of cases with no omissions. Three patients increased their daily dose without medical advice. No significant difference was found in the subgroup analysis comparing age-matched children followed up in OIT in 2019 and 2020 over the same period in the same hospital. CONCLUSION: There was no increase in adverse events in OIT during the confinement period. Therapeutic education during OIT is paramount and helps to reduce the occurrence of adverse events.