Effective Transportation Demand Management: The Results of Combining Parking Pricing, Transit Incentives, and Transportation Management in a Commercial District of Portland, Oregon

The Lloyd District is a high-density commercial and residential district located a short distance from downtown Portland, Oregon. Parking and transportation problems in the District have been a source of increasing contention for nearly a decade. As a result. in September of 1997. the City of Portland implemented a Lloyd District Partnership Plan, which consists of a number of elements aimed at curbing SOY use for the commute to and from the District. This plan included parking pricing in the form of meters, w\u27here on-street parking had previously been free: discounted transit passes: and other transportation demand management (TOM) strategies. This research assesses the effects of these strategics on travel and parking behavior, with an emphasis on the relationship between parking pricing and mode choice. A random sample of I 000 employees in the Lloyd District was surveyed about their travel and parking behavior before and after the installation of the new meters. This research finds that during the one year that had elapsed between the implementation of the Lloyd District transportation management programs and the survey information collected by this study, the drive-alone mode for the trip to work by employees in the Lloyd District had decreased by 7 percent. For the District as a whole. the drive-alone commute share is now about 56 percent. The program·s strategies that have emerged as the most significant in effecting this decrease arc the installation of the meters and the discounted transit pass program

Evaluation of the Lloyd District Parking Programs, City of Portland: The Impacts of Parking Pricing and Transportation Management Association Programs in a High-Density, Mixed-Use District

This is the final report of the Lloyd District transportation management program and the subsequent survey. During the one year that had elapsed between the implementation of the Lloyd District transportation and management programs and the survey information collected in this study, the drive alone mode for the trip to work by employees in the Lloyd District had decreased by 7 percent. For the District as a whole, the drive alone commute share is about 56 percent. These are remarkable achievements

Kennedy, 60 Minutes, and Roger Rabbit: Understanding Conspiracy-Theory Explanations of The Decline of Urban Mass Transit

This paper will review the history of the GM Conspiracy Myth, as well as what legal theorists refer to as the facts in the case. The legal explanation of what really happened goes only so far, though. The whole story about the decline of mass transit in the U.S. is a story about the failure of public policy and about conflict among competing constituencies in the transportation policy process. This paper will very briefly discuss this failure and this conflict and will then conclude with a consideration of - or at least a hypothesis for - the endurance of the GM Conspiracy Myth

Effects of Light Rail Transit in Portland: Implications for Transit-Oriented Development Design Concepts

In the Portland, Oregon, region many local planners have embraced the neotraditional planning concept in the form of transit-oriented development (TOD). One of the primary components of transit-oriented development, light rail transit (LRT), has been in place in Portland long enough to provide data for analysis. Because neotraditional planners often emphasize LRT as a crucial element in decreasing auto use and in encouraging high-density development, this paper examines the effects of LRT in the Portland region including mode share, density, and property values. The empirical analysis provides evidence that light rail alone has not been sufficient to have an appreciable impact on development patterns, residential density, auto ownership, and transit modal behavior, although there has been some positive effect of rail on single-family property values. There has also been less of a decline in transit use and slower growth in two-car households in the LRT corridor as compared to a parallel bus corridor. The small positive effects of LRT may indicate the beginning of a self-selection in housing location choice wherein persons desiring rail transit choose to live where it is available. This assessment of the evidence in terms of impacts on development trends indicates the extent to which consumer preferences have responded to LRT investments. This kind of assessment is needed to provide the basis for estimating travel mode shares and market shares for dispersed and concentrated development forms. Examination of data suggests that it may be advisable for planners to entertain more modest expectations of LRT

Light Rail Transit Impacts in Portland: The First Ten Years

This paper examines how the first decade of light rail transit (LRT) in the Portland region has affected auto ownership, mode share, density, and property values. The empirical analysis provides evidence that light rail has had some positive effect of rail on single-family property values, transit use, and slower growth of two-plus car households in the outer part of the LRT corridor as compared to an outer part of a parallel bus corridor. These effects may be the result of households self-selecting to make housing location decisions where LRT is located, rather than current households changing mode. This assessment of the evidence indicates the extent to which consumer preferences have responded to LRT investments. This kind of assessment is needed to provide the basis for estimating travel mode shares and market shares for dispersed and concentrated development forms. Examination of data suggests that it may be advisable for planners to entertain more modest expectations of LRT

Neighborhood Livability in Northwest Portland: A Case Study of Portland\u27s Northwest District

Portland\u27s Northwest Neighborhood District ( the District ) has a unique character, reflecting its special role in Portland\u27s economic history and its geographical location relative to the downtown area, the Willamette River and the West Hills. Current tensions between the District\u27s function as a close-in, high density residential area and its commercial activities are the most recent iteration of tensions that have existed from the time the area was first settled. This study examines the impacts of retail and residential land use in the District and how this mixture of residential/retail affects the residential livability

Travel and Parking Behavior in the United States

This paper looks at the connection between the regulation of parking by cities, transit service levels, and travel and parking behavior in the United States. Travel behavior information comes from the 1990 Nationwide Personal Transportation Survey (NPTS) and the Federal Urban Mass Transportation Administration’s 1990 Section 15 Report. Data on the current state of parking programs in place in central business districts of the U.S. is identified through telephone interviews of local officials responsible for parking policies from the twenty cities identified in the NPTS. The travel behavior analyses and the data from the parking officials interviews were combined with data from the Federal Highway Administration’s Journey-to-Work data to group cities according to their parking policies, transit service, and ridership levels on a continuum of “Transit-Accommodating Cities” and “Auto-Accomodating Cities”. A key finding is that cities with interventionist parking policies, high parking prices and limited supply, frequent transit service, and a high probability that travelers will pay to park are the most likely to have high transit ridership figures

Optimizing Retention in a Pragmatic Trial of Community‐Living Older Persons: The STRIDE Study

Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/155912/1/jgs16356.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/155912/2/jgs16356_am.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/155912/3/jgs16356-sup-0001-supinfo.pd

Antimicrobial resistance among migrants in Europe: a systematic review and meta-analysis

BACKGROUND: Rates of antimicrobial resistance (AMR) are rising globally and there is concern that increased migration is contributing to the burden of antibiotic resistance in Europe. However, the effect of migration on the burden of AMR in Europe has not yet been comprehensively examined. Therefore, we did a systematic review and meta-analysis to identify and synthesise data for AMR carriage or infection in migrants to Europe to examine differences in patterns of AMR across migrant groups and in different settings. METHODS: For this systematic review and meta-analysis, we searched MEDLINE, Embase, PubMed, and Scopus with no language restrictions from Jan 1, 2000, to Jan 18, 2017, for primary data from observational studies reporting antibacterial resistance in common bacterial pathogens among migrants to 21 European Union-15 and European Economic Area countries. To be eligible for inclusion, studies had to report data on carriage or infection with laboratory-confirmed antibiotic-resistant organisms in migrant populations. We extracted data from eligible studies and assessed quality using piloted, standardised forms. We did not examine drug resistance in tuberculosis and excluded articles solely reporting on this parameter. We also excluded articles in which migrant status was determined by ethnicity, country of birth of participants' parents, or was not defined, and articles in which data were not disaggregated by migrant status. Outcomes were carriage of or infection with antibiotic-resistant organisms. We used random-effects models to calculate the pooled prevalence of each outcome. The study protocol is registered with PROSPERO, number CRD42016043681. FINDINGS: We identified 2274 articles, of which 23 observational studies reporting on antibiotic resistance in 2319 migrants were included. The pooled prevalence of any AMR carriage or AMR infection in migrants was 25·4% (95% CI 19·1-31·8; I2 =98%), including meticillin-resistant Staphylococcus aureus (7·8%, 4·8-10·7; I2 =92%) and antibiotic-resistant Gram-negative bacteria (27·2%, 17·6-36·8; I2 =94%). The pooled prevalence of any AMR carriage or infection was higher in refugees and asylum seekers (33·0%, 18·3-47·6; I2 =98%) than in other migrant groups (6·6%, 1·8-11·3; I2 =92%). The pooled prevalence of antibiotic-resistant organisms was slightly higher in high-migrant community settings (33·1%, 11·1-55·1; I2 =96%) than in migrants in hospitals (24·3%, 16·1-32·6; I2 =98%). We did not find evidence of high rates of transmission of AMR from migrant to host populations. INTERPRETATION: Migrants are exposed to conditions favouring the emergence of drug resistance during transit and in host countries in Europe. Increased antibiotic resistance among refugees and asylum seekers and in high-migrant community settings (such as refugee camps and detention facilities) highlights the need for improved living conditions, access to health care, and initiatives to facilitate detection of and appropriate high-quality treatment for antibiotic-resistant infections during transit and in host countries. Protocols for the prevention and control of infection and for antibiotic surveillance need to be integrated in all aspects of health care, which should be accessible for all migrant groups, and should target determinants of AMR before, during, and after migration. FUNDING: UK National Institute for Health Research Imperial Biomedical Research Centre, Imperial College Healthcare Charity, the Wellcome Trust, and UK National Institute for Health Research Health Protection Research Unit in Healthcare-associated Infections and Antimictobial Resistance at Imperial College London

Surgical site infection after gastrointestinal surgery in high-income, middle-income, and low-income countries: a prospective, international, multicentre cohort study

Background: Surgical site infection (SSI) is one of the most common infections associated with health care, but its importance as a global health priority is not fully understood. We quantified the burden of SSI after gastrointestinal surgery in countries in all parts of the world. Methods: This international, prospective, multicentre cohort study included consecutive patients undergoing elective or emergency gastrointestinal resection within 2-week time periods at any health-care facility in any country. Countries with participating centres were stratified into high-income, middle-income, and low-income groups according to the UN's Human Development Index (HDI). Data variables from the GlobalSurg 1 study and other studies that have been found to affect the likelihood of SSI were entered into risk adjustment models. The primary outcome measure was the 30-day SSI incidence (defined by US Centers for Disease Control and Prevention criteria for superficial and deep incisional SSI). Relationships with explanatory variables were examined using Bayesian multilevel logistic regression models. This trial is registered with ClinicalTrials.gov, number NCT02662231. Findings: Between Jan 4, 2016, and July 31, 2016, 13 265 records were submitted for analysis. 12 539 patients from 343 hospitals in 66 countries were included. 7339 (58·5%) patient were from high-HDI countries (193 hospitals in 30 countries), 3918 (31·2%) patients were from middle-HDI countries (82 hospitals in 18 countries), and 1282 (10·2%) patients were from low-HDI countries (68 hospitals in 18 countries). In total, 1538 (12·3%) patients had SSI within 30 days of surgery. The incidence of SSI varied between countries with high (691 [9·4%] of 7339 patients), middle (549 [14·0%] of 3918 patients), and low (298 [23·2%] of 1282) HDI (p < 0·001). The highest SSI incidence in each HDI group was after dirty surgery (102 [17·8%] of 574 patients in high-HDI countries; 74 [31·4%] of 236 patients in middle-HDI countries; 72 [39·8%] of 181 patients in low-HDI countries). Following risk factor adjustment, patients in low-HDI countries were at greatest risk of SSI (adjusted odds ratio 1·60, 95% credible interval 1·05–2·37; p=0·030). 132 (21·6%) of 610 patients with an SSI and a microbiology culture result had an infection that was resistant to the prophylactic antibiotic used. Resistant infections were detected in 49 (16·6%) of 295 patients in high-HDI countries, in 37 (19·8%) of 187 patients in middle-HDI countries, and in 46 (35·9%) of 128 patients in low-HDI countries (p < 0·001). Interpretation: Countries with a low HDI carry a disproportionately greater burden of SSI than countries with a middle or high HDI and might have higher rates of antibiotic resistance. In view of WHO recommendations on SSI prevention that highlight the absence of high-quality interventional research, urgent, pragmatic, randomised trials based in LMICs are needed to assess measures aiming to reduce this preventable complication