The Project Planning of Urban Decongestion

This study introduces a methodology for the evaluation, among a set of  possible plans and/or policies, of a transport system which could reduce the  effects of the network congestion on an urban area. Hence it is proposed a  procedure which contains a new element compared with the current  methodologies that is the final useris evaluation of the examined system by  turning to the application of the contingent valuation method, a technique like  stated preferences. The approach we propose is based on the necessity for a  determination of an optimal solution to the urban congestion to be established  on the politic acceptability by the final user. Solutions which result virtually  feasible for a public administration both on a technique and economic point of  view often meet hostility by individuals. Consequently, it would be interesting  for policy makers to adopt a process of valuation which could let to  understand the useris sensitivity and hostility towards specific configurations  of the system, chosen as solution to decongestion (traffic calming, roadpricing, auto-free zones) and consequently to make less unpleasant the  strategy to be carried out to control congestion (Harrington et al., 2001). In  this way, a user does not judge the implementation of a set of projects made  by a decision-maker as imposition and he is willing to pay in order to fulfil the  chosen scenario. Finally we describe an application of the proposed  methodology relating the definition of the integrated transport system in the  metropolitan area of Bari, chief town of Apulia. 

Effectiveness of Supported Employment for Veterans With Spinal Cord Injuries: Results From a Randomized Multisite Study

Ottomanelli L, Goetz LL, Suris A, McGeough C, Sinnott PL, Toscano R, Barnett SD, Cipher DJ, Lind LM, Dixon TM, Holmes SA, Kerrigan AJ, Thomas FP. Effectiveness of supported employment for veterans with spinal cord injuries: results from a randomized multisite study. Objective: To examine whether supported employment (SE) is more effective than treatment as usual (TAU) in returning veterans to competitive employment after spinal cord injury (SCI). Design: Prospective, randomized, controlled, multisite trial of SE versus TAU for vocational issues with 12 months of follow-up data. Setting: SCI centers in the Veterans Health Administration. Participants: Subjects (N=201) were enrolled and completed baseline interviews. In interventional sites, subjects were randomly assigned to the SE condition (n=81) or the TAU condition (treatment as usual–interventional site [TAU-IS], n=76). In observational sites where the SE program was not available, 44 subjects were enrolled in a nonrandomized TAU condition (treatment as usual– observational site [TAU-OS]). Interventions: The intervention consisted of an SE vocational rehabilitation program called the Spinal Cord Injury Vocational Integration Program, which adhered as closely as possible to principles of SE as developed and described in the individual placement and support model of SE for persons with mental illness. Main Outcome Measures: The primary study outcome measurement was competitive employment in the community. Results: Subjects in the SE group were 2.5 times more likely than the TAU-IS group and 11.4 times more likely than the TAU-OS group to obtain competitive employment. Conclusions: To the best of our knowledge, this is the first and only controlled study of a specific vocational rehabilitation program to report improved employment outcomes for persons with SCI. SE, a well-prescribed method of integrated vocational care, was superior to usual practices in improving employment outcomes for veterans with SCI

Hospital- and community-based interventions enhancing (re) employment for people with spinal cord injury:a systematic review

Study design: Systematic Review. Objectives: To investigate the effect of interventions enhancing (re) employment following spinal cord injury (SCI). Setting: Studies from multiple countries were included. Methods: MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials (CENTRAL), CINAHL, PsycINFO and SPORTDISCUS databases were searched. Randomized controlled trials (RCTs) and non-randomized studies (NRSs) describing a hospital- or a community-based intervention aiming at employment in a SCI population were selected. Quality appraisal was done using the SIGN methodology, and the quality of evidence was graded using the Grade approach. Data extraction was performed according to the Cochrane Handbook. Employment rate and duration were primary outcomes. Results: Only one RCT, including 201 patients describing an intervention over 1 and 2 years, was of sufficient quality. In this study, the employment rate was 26% after 1 and 31% after 2 years for competitive work, compared with 10% in the treatment as usual-intervention site (TAU-IS) control group and 2% in the treatment as usual observational site (TAU-OS) after 1 and 2 years. Other studies were of low quality and describe higher employment rates from 36 to 100%. Conclusions: Only one RCT was of sufficient quality and showed evidence that a vocational rehabilitation programme based on the principles of supported employment integrated in a multidisciplinary team enhances employment for SCI people. As the vast majority of studies included in this review are of low methodological quality, further research is needed