The impact of neighborhood deprivation on patients' unscheduled out-of-hours healthcare seeking behavior: a cross-sectional study

Background: The use of unscheduled out of hours medical care is related to the social status of the patient. However, the social variance in the patient's preference for a hospital based versus a primary care based facility, and the impact of specific patient characteristics such as the travel distance to both types of facilities is unclear. This study aims to determine the social gradient in emergency care seeking behavior (consulting the emergency department (ED) in a hospital or the community-based Primary Care Center (PCC)) taking into account patient characteristics including the geographical distance from the patient's home to both services. Methods: A cross-sectional study, including 7,723 patients seeking out-of-hours care during 16 weekends and 2 public holidays was set up in all EDs and PCCs in Ghent, Belgium. Information on the consulted type of service, and neighborhood deprivation level was collected, but also the exact geographical distance from the patient's home to both types of services, and if the patient has a regular GP. Results: Patients living in a socially deprived area have a higher propensity to choose a hospital-based ED than their counterparts living in more affluent neighborhoods. This social difference persists when taking into account distance to both services, having a regular GP, and being hospitalized or not. The impact of the distance between the patient's home address and the location of both types of services on the patient's choice of service is rather small. Conclusions: Initiatives aiming to lead patients more to PCC by penalizing inappropriate ED use might increase health inequity when they are not twinned with interventions improving the access to primary care services and tackling the underlying mechanisms of patients' emergency care seeking behavior. Further research exploring the impact of out-of-hours care organization (gatekeeping, payment systems, ...) and the patient's perspectives on out-of-hours care services is needed

Disentangling agglomeration and network externalities : a conceptual typology

Agglomeration and network externalities are fuzzy concepts. When different meanings are (un)intentionally juxtaposed in analyses of the agglomeration/network externalities-menagerie, researchers may reach inaccurate conclusions about how they interlock. Both externality types can be analytically combined, but only when one adopts a coherent approach to their conceptualization and operationalization, to which end we provide a combinatorial typology. We illustrate the typology by applying a state-of-the-art bipartite network projection detailing the presence of globalized producer services firms in cities in 2012. This leads to two one-mode graphs that can be validly interpreted as topological renderings of agglomeration and network externalities

Online Store Locator: An Essential Resource for Retailers in the 21st Century

Most retailers use their websites and social media to increase their visibility, while potential customers get information about these retailers using the Internet on electronic devices. Many papers have previously studied online marketing strategies used by retailers, but little attention has been paid to determine how these companies provide information through the Internet about the location and characteristics of their stores. This paper aims to obtain evidence about the inclusion of interactive web maps on retailers’ websites to provide information about the location of their stores. With this purpose, the store locator interactive tools of specialty retailers’ websites included in the report “Global Powers of Retailing 2015” are studied in detail using different procedures, such as frequency analysis and word clouds. From the results obtained, it was concluded that most of these firms use interactive maps to provide information about their offline stores, but today some of them still use non-interactive (static) maps or text format to present this information. Moreover, some differences were observed among the search filters used in the store locator services, according to the retailer’s specialty. These results provided insight into the important role of online store locator tools on retailers’ websites

Scotland’s international competitiveness within Western Europe

The paper measures regional competitiveness of Scotland in comparison to ten EU regions and small countries using the International Benchmarking Index Family (‘IB Index Family’) developed by BAK Basel Economics.1 The IB Index Family contains an index with three dimensions of competitiveness: Performance, Attractiveness and Structural Potential. The Performance Index measures recent economic success; the Attractiveness Index measures how well a region is an attractive location to companies and highly-qualified individuals; and the Structural Potential Index estimates future potential economic growth based on current economic structure. The application of the IB Index Family provides a first-step into a more in-depth benchmarking of the competitiveness of a region, which is necessary when working towards detailed policy conclusions. The paper explains these measurement tools and applies them in a short benchmarking analysis of Scotland and ten EU regions and small nations (e.g. Ireland, Norway, Western Sweden etc.)

Information reuse in dynamic spectrum access

Dynamic spectrum access (DSA), where the permission to use slices of radio spectrum is dynamically shifted (in time an in different geographical areas) across various communications services and applications, has been an area of interest from technical and public policy perspectives over the last decade. The underlying belief is that this will increase spectrum utilization, especially since many spectrum bands are relatively unused, ultimately leading to the creation of new and innovative services that exploit the increase in spectrum availability. Determining whether a slice of spectrum, allocated or licensed to a primary user, is available for use by a secondary user at a certain time and in a certain geographic area is a challenging task. This requires 'context information' which is critical to the operation of DSA. Such context information can be obtained in several ways, with different costs, and different quality/usefulness of the information. In this paper, we describe the challenges in obtaining this context information, the potential for the integration of various sources of context information, and the potential for reuse of such information for related and unrelated purposes such as localization and enforcement of spectrum sharing. Since some of the infrastructure for obtaining finegrained context information is likely to be expensive, the reuse of this infrastructure/information and integration of information from less expensive sources are likely to be essential for the economical and technological viability of DSA. © 2013 IEEE

Location-based technologies for learning

Emerging technologies for learning report - Article exploring location based technologies and their potential for educatio

Collection and integration of local knowledge and experience through a collective spatial analysis

This article discusses the convenience of adopting an approach of Collective Spatial Analysis in the P/PGIS processes, with the aim of improving the collection and integration of knowledge and local expertise in decision-making, mainly in the fields of planning and adopting territorial policies. Based on empirical evidence, as a result of the review of scientific articles from the Web of Science database, in which it is displayed how the knowledge and experience of people involved in decision-making supported by P/PGIS are collected and used, a prototype of a WEB-GSDSS application has been developed. This prototype allows a group of people to participate anonymously, in an asynchronous and distributed way, in a decision-making process to locate goods, services, or events through the convergence of their views. Via this application, two case studies for planning services in districts of Ecuador and Italy were carried out. Early results suggest that in P/PGIS local and external actors contribute their knowledge and experience to generate information that afterwards is integrated and analysed in the decision-making process. On the other hand, in a Collective Spatial Analysis, these actors analyse and generate information in conjunction with their knowledge and experience during the process of decision-making. We conclude that, although the Collective Spatial Analysis approach presented is in a subjective and initial stage, it does drive improvements in the collection and integration of knowledge and local experience, foremost among them is an interdisciplinary geo-consensusPeer ReviewedPostprint (published version

Population need and geographical access to general practitioners in rural New Zealand

To use a geographical information system (GIS) approach to demonstrate the extent to which different areas in New Zealand vary in their geographical access to GPs, and to analyse the extent to which spatial access varies in relation to different population groups. Methods Three methods; population/GP ratios, least cost path analysis (LCPA), and an allocation method (which considered the capacity constraint of GPs) were used to demonstrate differences in geographic accessibility to GPs. Travel time, and distance to the closest GP, was calculated for every census enumeration district in New Zealand (n=38336)—thus enabling population-based accessibility statistics to be calculated and aggregated to the territorial local authority level. These calculations include the average travel time if everybody visited a GP once and the population more than 30 minutes from a GP. The composition of this population is analysed according to three criteria of need: the level of deprivation (NZDep2001), ethnicity (%Maori), and age (% <5 years, and %65 years and over). Results There are significant regional variations in geographical accessibility in New Zealand, and these differences are dependent upon the method to calculate accessibility. Ratio measures give a different picture of GP access than the other two indicators, reflecting the fact that TAs with similar ratios often have wide variations in travel times as well as the size and proportion of the population living more than 30 minutes from the closest GP. TAs with larger numbers and a higher proportion of their populations living in such areas tend to be more deprived and have a higher proportion of Maori, especially in the North Island. There appears to be no significant trend by age. Conclusion Given the health and service consequences of poor access, the results suggest that more attention needs to be paid to extending the spatial information base in primary care, in order to achieve more effective planning of services for disadvantaged populations

Knowing Your Population: Privacy-Sensitive Mining of Massive Data

Location and mobility patterns of individuals are important to environmental planning, societal resilience, public health, and a host of commercial applications. Mining telecommunication traffic and transactions data for such purposes is controversial, in particular raising issues of privacy. However, our hypothesis is that privacy-sensitive uses are possible and often beneficial enough to warrant considerable research and development efforts. Our work contends that peoples behavior can yield patterns of both significant commercial, and research, value. For such purposes, methods and algorithms for mining telecommunication data to extract commonly used routes and locations, articulated through time-geographical constructs, are described in a case study within the area of transportation planning and analysis. From the outset, these were designed to balance the privacy of subscribers and the added value of mobility patterns derived from their mobile communication traffic and transactions data. Our work directly contrasts the current, commonly held notion that value can only be added to services by directly monitoring the behavior of individuals, such as in current attempts at location-based services. We position our work within relevant legal frameworks for privacy and data protection, and show that our methods comply with such requirements and also follow best-practice