Abstract

This is a critique of ESARR4 and its main supporting documents. ESARR4 is the Eurocontrol Safety Regulatory Requirement Number 4 [Eurocontrol safety regulatory requirement ESARR4, Edition 1.0., Eurocontrol, Safety Regulation Commission, Brussels, 2001]: ‘Risk assessment and mitigation in ATM’, ATM standing for Air Traffic Management. It is demonstrated that ESARR4 and its supporting documents are defective. There is a lack of clarity about responsibilities for ATM safety. The claims ESARR4 etc. make for its proposed methodologies are overstated—not supported by sound evidence from real world hazard analysis. Serious negative effects from this defective document include mis-allocation of scarce safety resources and the diversion of attention away from real safety improvements—wasteful of regulators’ and managers’ time. Suggestions are made for repairing these deficiencies. The most important underlying change would be a refocusing on practical safety assessment based on methods that have already demonstrated their merits.

Abstract

The prime goal of the Air Traffic Management (ATM) system is to control accident risk. Some key questions are posed, including: What do design safety targets really mean and imply for risk modelling? In what circumstances can future accident risk really be modelled with sufficient precision? If risk cannot be estimated with precision, then how is safety to be assured with traffic growth and operational/technical changes? This paper endeavours to answer these questions by an analysis of the nature of accidents, causal factors and practical collision risk modelling. The main theme is how best to combine sound safety evidence and real world hazard analysis in a coherent and systematic framework.

Abstract

Introduction: Walking and cycling bring health and environmental benefits, but there is little robust evidence that changing the built environment promotes these activities in populations. This study evaluated the effects of new transport infrastructure on active commuting and physical activity. Study design: Quasi-experimental analysis nested within a cohort study. Setting/participants: Four hundred and sixty-nine adult commuters, recruited through a predominantly workplace-based strategy, who lived within 30 kilometers of Cambridge, United Kingdom and worked in areas of the city to be served by the new transport infrastructure. Intervention: The Cambridgeshire Guided Busway opened in 2011 and comprised a new bus network and a traffic-free walking and cycling route. Exposure to the intervention was defined using the shortest distance from each participant’s home to the busway. Main outcome measures: Change in weekly time spent in active commuting between 2009 and 2012, measured by validated 7-day recall instrument. Secondary outcomes were changes in total weekly time spent walking and cycling and in recreational and overall physical activity, measured using the validated Recent Physical Activity Questionnaire. Data were analyzed in 2014. Results: In multivariable multinomial regression models—adjusted for potential sociodemographic, geographic, health, and workplace confounders; baseline active commuting; and home or work relocation—exposure to the busway was associated with a significantly greater likelihood of an increase in weekly cycle commuting time (relative risk ratio=1.34, 95% CI=1.03, 1.76) and with an increase in overall time spent in active commuting among the least active commuters at baseline (relative risk ratio=1.76, 95% CI=1.16, 2.67). The study found no evidence of changes in recreational or overall physical activity. Conclusions: Providing new sustainable transport infrastructure was effective in promoting an increase in active commuting. These findings provide new evidence to support reconfiguring transport systems as part of public health improvement strategies. JP is supported by a National Institute for Health Research (NIHR) post-doctoral fellowship (PDF- 2012-05-157). EH is supported by an NIHR Public Health Research project grant (see below) and DO is supported by the Medical Research Council [Unit Programme number MC_UP_12015/6]. RM is funded by the Higher Education Funding Council for England. The Commuting and Health in Cambridge Study was initially funded under the auspices of the Centre for Diet and Activity Research (CEDAR), a UKCRC Public Health Research Centre of Excellence. Funding from the British Heart Foundation, Economic and Social Research Council, Medical Research Council, National Institute for Health Research and the Wellcome Trust, under the auspices of the UK Clinical Research Collaboration, is gratefully acknowledged. The study is now funded by the National Institute for Health Research Public Health Research programme (project number 09/3001/06). The views and opinions expressed herein are those of the authors and do not necessarily reflect those of the NIHR PHR programme or the Department of Health This is the final version of the article. It was first available from Elsevier via http://dx.doi.org/10.1016/j.amepre.2015.09.021 Document type: Article

Abstract

Background Transportation barriers prevent millions of people from accessing health care each year. Health policy innovations such as shared savings payment models (commonly used in accountable care organizations) present financial incentives for providers to offer patient transportation to medical care. Meanwhile, ridesourcing companies like Uber and Lyft have entered the market to capture a significant share of spending on non-emergency health care transportation. Our research examines the current landscape of innovative health care mobility services in the US. Methods We conducted an environmental scan to identify case examples of utilization of ridesourcing technology to facilitate non-emergency health care transportation and developed a typology of innovative health care mobility services. The scan used a keyword-based search of news publications with inductive analysis. For each instance identified, we abstracted key information including: stakeholders, launch date, transportation provider, location/service area, payment/booking method, target population, level of service, and any documented outcomes. Results We discovered 53 cases of innovation and among them we identified three core types of innovation or collaboration. The first and most common type of innovation is when a health care provider leverages ridesourcing technology to book patient trips. This involves both established and nascent transportation companies tailoring the ridesourcing experience to the health care industry by adding HIPAA-compliance to the booking process. The second type of innovation involves an insurer or health plan formally partnering with a ridesourcing company to expand transportation offerings to beneficiaries or offer these services for the first time. The third type of innovation is when a paratransit provider partners with a ridesourcing company; these cases cite increased flexibility and reliability of ridesourcing services compared to traditional paratransit. Conclusions Ridesourcing options are becoming a part of the mode choice set for patients through formal partnerships between ridesourcing companies, health care providers, insurers, and transit agencies. The on-demand nature of rides, booking flexibility, and integration of ride requests and payment options via electronic medical records appear to be the strongest drivers of this innovation. Document type: Article

Abstract

For infectious diseases caused by highly pathogenic agents (e. g., Ebola/Lassa fever virus, SARS-/MERS-CoV, pandemic influenza virus) which have the potential to spread over several continents within only a few days, international Health Protection Authorities have taken appropriate measures to limit the consequences of a possible spread. A crucial point in this context is the disinfection of an aircraft that had a passenger on board who is suspected of being infected with one of the mentioned diseases. Although, basic advice on hygiene and sanitation on board an aircraft is given by the World Health Organization, these guidelines lack details on available and effective substances as well as standardized operating procedures (SOP). The purpose of this paper is to give guidance on the choice of substances that were tested by a laboratory of Lufthansa Technik and found compatible with aircraft components, as well as to describe procedures which ensure a safe and efficient disinfection of civil aircrafts. This guidance and the additional SOPs are made public and are available as mentioned in this paper. Document type: Article

Abstract

On any given day, according to The Economist , over 4 million people take to the skies. A quarter of a million people are airborne at any moment.1 Health impacts of noise can begin even before birth, and with high levels and an increasing distribution of exposure, any associations between aircraft noise and morbidity are clearly of relevance to public health.2 3 Rosenlund et al (page 769) assess associations between blood pressure and aircraft noise by comparing two study populations, around Arlanda airport and in another part of Stockholm County. Noise contours are constructed over the region for maximum noise level (MNL) and an energy averaged level (FBN). Health outcomes of people living in proximity tend on … Document type: Article

Abstract

The Swedish code concerning car drivers’ responsibility to give way to pedestrians was strengthened in 2000. The primary aim of this study is to evaluate the short-term effects of the change in code. Another goal is to look at the effects of the reconstruction of four sites in Borås, Sweden. One site had changes made prior to the change of code, two test sites had countermeasures implemented during the study, and one comparison site was left unchanged. All the sites were chosen because schools were situated nearby. The focus of the evaluation was on children and elderly as pedestrians and cyclists."br/""br/"The goal of traffic calming of a 90 percentile driving speed below 30 km/h was not fulfilled at any of the test sites. A conclusion is that the height of a speed cushion is important. After the speed cushions were lowered from 70 mm to 55 mm, the 90 percentile speed increased from 34 km/h to 41 km/h. Sites with no speed cushions had much higher speeds."br/""br/"The design of an intersection influences road users’ behavior. At the site where one crosswalk was removed, pedestrians that were using the remaining marked crosswalk were given way to less frequently than at the other sites. At intersections where most pedestrians used marked crosswalks, the children benefited the most in mobility. At the intersection where pedestrians used marked crosswalks to a lower extent after reconstruction, children and the elderly had the smallest increase in frequency of being given way to. After reconstruction to a court-yard street, the pedestrians were given way to a lower extent compared with the other sites, though the vehicle speeds were the lowest observed at this study. At the sites were no physical changes were made, the change of code improved driver yield behavior, but no more towards children than other age groups.

Abstract

The potential contribution of Advanced Driver Assistance Systems (ADAS) to traffic safety policies is currently unknown. In this article we first investigate how different ADAS might contribute to public goals on road traffic safety, based on accident statistics in the Netherlands. Next, the societal costs of ADAS implementation are qualitatively assessed. Intelligent speed adaptation (ISA) appears to be one of the most promising devices in terms of cost-effectiveness, as compared to other ADAS applications. Finally, the acceptance among potential ISA users is explored based on a survey among potential ISA users. The study points out that although the advantages of ISA are recognised by car drivers, their willingness to purchase and use ISA is strictly conditioned by the costs and functionality of the system.

Abstract

Suicides and trespassing accidents result in more than 3800 fatalities in Europe, representing 88% of all fatalities occurring within the EU railway system. This paper presents a problem-solving model, which consists of a multistep approach structuring the analysis of a suicide or trespass-related problem on the railways. First, we present the method used to design, evaluate and improve the problem-solving model. Then we describe the model in detail: it comprises six steps with several subsequent actions, and each action is approached through a checklist of prompting questions and possible answers. At the end, we discuss the added value of this model for decision makers and its usability in the selection of optimal prevention measures.

Abstract

The European Road E12 through the community center of Storuman, Sweden was reconstructed in 1999 and 2000. Pedestrian walkways, traffic islands, chicanes of a type referred to as “Danish buns”, a roundabout and a two-directional cycle track along the E12 were installed. The purpose of the reconstruction was to improve safety for pedestrians and bicyclists, primarily for children, the elderly and the disabled, and to reduce the barrier effect of the E12 thoroughfare. In May 2000, the code governing the conduct of drivers at marked crosswalks in Sweden became stricter to improve safety and mobility for pedestrians. The combined effect of reconstructions and change of code was analyzed. Traffic behavior was studied at the intersection where the roundabout was constructed. Yield behavior towards pedestrians changed significantly. The difference was even greater with respect to yielding to child bicyclists – from 6% before to 84% after – even though the code change only related to pedestrians. Crash data analysis suggests a minor increase in fall injuries after reconstructions and change of code. Measures of speed, behavioral studies, questionnaires, face-to-face interviews and crash data analysis suggest that safety has increased not only along the E12 but also along adjacent roads. The final conclusion is that a bypass is not needed in a case like Storuman. Traffic calming of the main arterial through the town seems sufficient."br/""br