Legal rights of client councils and their role in policy of long-term care organisations in the Netherlands

BACKGROUND: Legislation demands the establishment of client councils in Dutch nursing homes and residential care facilities. The members of those councils are residents or their representatives. Client councils have the right to participate in the strategic management of long-term care facilities. More specifically, they need to be consulted regarding organisational issues and a right to consent on issues regarding daily living of residents, including CQ-index research. CQ-index research concerns a method that measures, analyses and report clients' experiences about the quality of care. Research questions were: 'Do client councils exercise their rights to be consulted and to give their consent?' and 'What is the role of client councils in the process of measuring clients' experiences with the CQ-index and what is their opinion about the CQ-index?' METHODS: Postal questionnaires were sent to members of 1,540 client councils of Dutch nursing homes and residential care facilities. The questionnaire focussed on background information and client councils' involvement in decision-making and strategic management. RESULTS: The response rate was 34% (n = 524). Most councils consisted of seven members (range: 5 to 12 members). One out of four members participating in the client councils were clients themselves. Although councils have a legal right to be consulted for organisational issues like finance, vision, annual report, and accommodation, less than half the councils (31-46%) reported that they exercised this right. The legal right to consent was perceived by 18 to 36% of the councils regarding client care issues like food and drink, complaints registration, respectful treatment, and activities. For CQ-index research, only 18% of the client councils perceived a right to consent. Their rights to choose an approved contractor -who performs CQ-index research- and indicating improvement priorities, were hardly used. CONCLUSIONS: Client councils play a rather passive role in determining the policy on quality of long-term care. Therefore, specific attention and actions are needed to create a more proactive attitude in councils towards exercising their rights, which are already supported by legislation

Is the golden hour optimally used in South Africa for children presenting with polytrauma?

BACKGROUND: The major paediatric public health problem worldwide is injury or trauma. In 2004, 950 000 children died as a result of injury. OBJECTIVE: The aim of this study was to evaluate the logistics of medical care after paediatric polytrauma within the first hours after arrival into a trauma unit - the so-called Golden Hour. METHODS: Children presenting with polytrauma to the Trauma Unit at the Red Cross War Memorial Children's Hospital between May 2011 and August 2011 were considered for inclusion in the study. RESULTS: Fifty-five children were included in the final analysis. The median duration of stay in the Trauma Unit was 205 minutes (interquartile range 135 - 274). CONCLUSION: Several factors were identified that unnecessarily prolonged the time that patients stayed in the trauma unit following arrival in hospital for polytrauma management

Modelling pedestrian crossing choice on Cape Town's freeways: Caught between a rock and a hard place?

Pedestrians and freeways are not supposed to coexist in any proximity to each other, yet in Cape Town, South Africa, the Freeway Management System (FMS) has recorded an alarming increase in pedestrian activity on its freeways in recent years, with a similar trend in (fatal) freeway pedestrian crashes. This paper reports on the development of a series of discrete choice models for pedestrian crossing decisions in a highly volatile and vulnerable freeway crossing environment. We hypothesize that freeway pedestrian crossing is driven by personal factors and the perceived risks associated with completing the crossing using a footbridge or (illegally) at-grade. We test this assumption by making use of stated choice and risk perception data collected from (adult) participants intercepted along three Cape Town freeways. Estimating mixed logit and hybrid choice models we look at the role of random heterogeneity and latent risk perception in the choice to cross at-grade or using a footbridge. The model estimates confirm that, as expected, crossing choice is largely influenced by a combination of built environment, vehicular and pedestrian traffic, next to some socio-demographic factors, but also risk perception. The study brings to light the seemingly opposite effect of some of the factors on risk perception and crossing choice. We also show that risk perception really only influences crossing choice in terms of the perception of at-grade crossing risk, where the impact is however non-trivial. Finally, we look at the implied relative sensitivities of the choice attributes within and between the crossing alternatives, as well between the three estimated models, amongst others demonstrating the power of the hybrid choice model over the other two. The results of the study can inform opportunities to counter the upward trend of fatalities and provide suggestions for policy-making that would lead to improved freeway crossing safety

Incentivizing Off-Peak Minibus-Taxi Feeder Service: Driver Perspectives on Reform Approaches

Public transport reform efforts in Cape Town have previously focused on replacing unscheduled minibus-taxis with scheduled bus rapid transit services. However, this has proven more difficult and expensive than expected. As a result, the City has signalled its intention to use minibus-taxis as feeder services to scheduled trunk services within a hybrid public transport network. Earlier research in Cape Town has indicated that a potential problem within a hybrid system is a mismatch between the service spans of minibus-taxi feeders and those of trains and large buses. A range of policy interventions could lead to improved complementarity of service spans, including the introduction of a range of incentives, or off-peak minibus-taxi feeder services operating under contract to the City. Because these interventions will have varying implications for minibus-taxi business operations and driver remuneration, the success of efforts to reform the city’s public transport network will depend in large part upon the willingness of minibus-taxi drivers (as the key decision-makers with respect to the timing and frequency of service) and owners to provide complementary service under new ‘hybrid’ conditions. Measuring this willingness presents an important policy challenge; this paper presents results from a stated choice survey conducted to determine this willingness among drivers. Policy interventions are presented that are likely to extend minibus-taxi service hours and, in some cases, encourage shorter headways. The paper discusses implications of these interventions as well as driver acceptance. Because the cost of providing scheduled feeder services has proven more expensive than forecasted, any intervention must use limited financial resources efficiently. To assess interventions on this basis, the cost of each intervention to the public authority is estimated using the choice modelling results.Papers presented at the 38th International Southern African Transport Conference on "Disruptive transport technologies - is South and Southern Africa ready?" held at CSIR International Convention Centre, Pretoria, South Africa on 8th to 11th July 2019

Best-worst scaling approach to measure public transport user quality perceptions and preferences in cape town

Papers presented virtually at the 41st International Southern African Transport Conference on 10-13 July 2042Public transport plays an important role in human society. Even more so in the context of developing countries where a large share of trip makers are captive users of public transport trying to gain access to economic activities, schools and other social and cultural activities. User quality and user perceptions are essential indicators for service providers to understand their service offering better, also in a context of captivity. One needs to understand which external factors are essential and which ones are sufficient and the extent to which they are. Understanding the order and magnitude of the importance of these external factors is of great importance to service providers when wanting to improve user experiences, for planning purposes, for marketing purposes as well as for fare setting. Considering this, the primary focus of this research is to provide empirical evidence on the existence of a hierarchy in transportation needs. Such evidence is provided in this research by investigating the existence of a user quality pyramid on public transport modes as claimed in literature. We do this for the City of Cape Town using the Best-Worst Scaling (BWS) method, which measures consumer priorities in a manner that is robust and transparent, by compelling respondents to make trade-offs among items user experience and satisfaction. BWS is a survey technique of measuring individuals’ priorities as it identifies the extremes in a given list as best as well as worst items and is used in other disciplines where prioritisation of items is required to guide decisions. In this study, a total of 282 public transport users rank the best and the worst quality attributes in a given set. The research findings indicate that travel time followed by affordability are the most important quality attributes in regional public transport modes. Equally, in- vehicle security followed by service transfers are the least important public transport quality attributes. We use this to construct and critique the user quality pyrami

Challenges facing South African road authorities in the transition to new energy vehicle technology

Papers presented virtually at the 41st International Southern African Transport Conference on 10-13 July 2023.In the light of the general acceptance that climate change in the form of global warming is an unacceptable phenomenon, the South African government committed to reducing GHG emissions, embracing green mobility and introducing new vehicle technologies such as electric vehicles and hydrogen related technology. Road authorities are responsible for the upgrading, maintenance and operation of the country’s road network and need to take cognisance of the influence these technologies will have on the network. The aim of the paper is to evaluate the green mobility strategy from the perspective of a road authority and to highlight aspects to be addressed, such as the characteristics and operational requirements of new energy vehicles, possible impacts on road and traffic related standards and procedures, requirements of associated infrastructure such as charging and refuelling stations, establishment of a national charging station network, assessment of the impact on cost-benefit analysis methodology (specifically vehicle operating costs), the handling of emergencies involving new energy vehicles, and understanding the impact of a change in technology on funding, especially the fuel levy. The need to plan for the electricity requirements of electric vehicles is also discussed

A self-perception theory meta-analysis of the habit-breaking impacts of covid-19 travel restrictions in south african cities

In contrast to behavioural theories which argue that attitude informs intention and subsequently behaviour, ‘self-perception theory’ posits that, in instances of temporarily imposed restrictions or incentives, behaviour can inform attitude. If the experience of the new behaviour is positive, attitude may become more favourable, and as a result the changed behaviour may endure after the period of imposed change has lapsed. COVID-19 lockdowns in South Africa introduced a form of temporarily imposed travel restrictions. So, could COVID-19 lockdown regulations, which necessitated an increase in online activity, change attitudes towards remote activity participation? Further, could such a changed attitude lead to enduring trip substitution after restrictions are removed? Using the theoretical framework of self-perception theory, this paper undertakes a meta-analysis of four surveys to explore the prospects of enduring disruptions to pre-pandemic travel habits. The surveys were all conducted online at different lockdown levels, with small nonprobability samples. Age cohort analysis of the (n=300) fused dataset suggests that the experience of greater remote activity participation and trip substitution amongst the sample of adult South African respondents was positive, this experience made attitudes toward these behaviours more favourable, and intentions to break pre-pandemic travel habits have been formed.Papers presented at the 40th International Southern African Transport Conference on 04 -08 July 202