Bus Pass Research Articles

Barreiras econômicas na acessibilidade ao tratamento da tuberculose em Ribeirão Preto - São Paulo

A presente pesquisa objetivou analisar as barreiras econômicas na acessibilidade dos doentes aos Centros de Referência e Atenção à Tuberculose (TB) no município de Ribeirão Preto. Realizou-se inquérito de opinião a partir da adaptação do instrumento Primary Care Assessment (PCAT) com 100 doentes em tratamento e 16 profissionais de saúde dos Centros de Referência à TB em Ribeirão Preto. Aplicaram-se os testes Anova, Kruskall Wallis e Qui-quadrado. Predominaram doentes do sexo masculino e profissionais de saúde do sexo feminino. Identificaram-se diferenças entre os centros C e A, sendo que em C (p=0, 028) é oferecido o vale-transporte e em A (p=0,010) o paciente arca com os custos de deslocamento. O indicador consulta médica em 24 horas apresentou-se com nível satisfatório. Houve divergências entre os relatos dos doentes e dos profissionais de saúde em relação ao oferecimento de vale-transporte. O doente encontra barreiras para o tratamento, como gastos com transportes ou atrasos no emprego, acarretando prejuízos na renda familiar.

Free bus passes, use of public transport and obesity among older people in England

BackgroundAll residents of England aged 60 years and older became entitled to free travel on local buses on 1 April 2006. This study examines the impact of this policy on...

Influenza vaccine uptake: the case for universal flu vaccination of young children

![][1]</img> Summer has just started but it will not be long before the first older patients arrive in the surgery asking about their annual influenza vaccination. In UK general practice, the autumn seasonal flu vaccination for over 65s is a well-established routine, as widely-accepted as the free bus pass. In 2009/2010, uptake was 77% in Northern Ireland, 75% in Scotland, 72% in England, and 64% in Wales.1 Although one of the three papers on influenza vaccination in this issue of the BJGP reports that some social inequality in vaccine uptake persists — despite introduction of the Quality and Outcomes Framework, which boosted overall uptake and reduced variation between practices — even in the most socioeconomically deprived category, two-thirds (67%) of older patients in Scotland were vaccinated in 2006/2007.2 In contrast, research by Sampson et al found that influenza vaccine was given to only one in four of the at-risk children for whom seasonal influenza vaccination is recommended by UK national guidelines.3 For some parents, getting to the clinic for the offered appointment was an issue. Others intended to take their children but didn't get around to it, and a substantial number are unconvinced that their children would benefit from the vaccination.3 Some of this scepticism may reflect media-amplified concern about vaccine side effects and a suspicion that multiple vaccinations are harmful. It also appears that many parents think either that influenza vaccine … [1]: /embed/graphic-1.gif

Becoming Commuters: Teaching Students Traveling to Work Using Public Transportation

As a teacher of visually impaired students at the Arizona State School for the Deaf and Blind, I regularly traveled with my students to their off-campus jobs by school van. In my sixth year of teaching, I realized that transportation to the work site is also an important component of successful employment. During the five years before my epiphany, my students would pile into the large, accessible van owned by the school and be driven to their jobs at the local pizza shop, department store, or other workplace. I realized my students might be missing a learning opportunity by being driven to work when I participated in a summer orientation and mobility (O&M) internship at Perkins School for the Blind. There, I observed my Perkins students gain valuable information as they traveled on public buses. These students had to figure out what buses to take and how many stops were passed before their destination. They also needed to decide whether they had enough money on their bus cards to take the bus, or if they needed exact change. They had to speak assertively and organize their questions clearly. As the summer progressed, I began to think of how I could bring the model of instruction I had learned at Perkins back to my students in Arizona. My goal was to teach my students in Arizona consistent use of public transportation to get to their workplace. This article delineates the learning experiences that resulted from the regular use of bus transportation to and from the work site. The change from riding in the school van to using public buses was important for several reasons. When riding the van, the students paid little attention to the route or the direction of their travel unless the driver gave verbal directions. Using buses constantly enhanced the students' learning capacities in six areas, including directionality, advocacy, organization, motivation, safety, and involvement. The students were all high school or postgraduate students. Two of them had a good deal of usable vision and the other two had no light perception. They all communicated through speech, although each of them fell in the spectrum of mild to moderate mental retardation with a severe sensory impairment. DIRECTIONALITY AND ADVOCACY Directionality involves forming a mental image of how one will get from one place to another. In this case, the students needed to envision how they would physically get from the school to the local market where they worked. Before the trip, we modeled and practiced the following questions in the classroom: * What is the number of the bus you will take? * In what direction will that bus travel? * At what stop will you get off? When the students needed to take two buses, I also had them articulate the route they would travel to get to the second bus. They knew what buses they would be riding and in what directions the bus travels (east to west or north to south, for example). If the students understood they were heading east then north on the initial trip, then on the way back to school they could comprehend that they would be traveling south then west. These steps need to be repeated many times for the route to meaningful for the student. Life skills students also learned to advocate for themselves. Many had become so reliant on prompts that they had come to expect others to complete tasks or ask questions of others. Riding the bus provided experiences in advocacy. The students learned to be ready to ask short but pertinent questions and to provide information to the bus driver. When the bus pulled up, the first student to get on would ask whether it is the correct bus. If it was, then the student told the driver where they were getting off. The student round the slot for a bus pass and inserted the card. If taking two buses, he or she would ask for a transfer, which could be used for intrabus travel in the same direction. At first these steps were accomplished with the assistance of a teacher, mobility instructor, or paraeducator. …

Getting weary and pensionable

Mr Slop's age makes him a target for both tiredness and pension advisors as he moves relentlessly to the time he can get a free bus pass. With this in mind the Editor of the Bulletin, who probably has his bus pass already in his pocket, has commissioned Mr Slop to write some fine words on both subjects for the discerning readers of the Annals.

Body Language

Body Language

Social Experiment to Encourage Drive-Alone Commuters to Try Transit

This study reports on a social experiment conducted in summer 2008 to convert solo drivers to transit. During a 3-month period, which was a time of rising gas prices, drivers were offered a no-cost bus pass if they turned in their commuter parking permits. At the end of 3 months, participants could either regain their parking permits or purchase regular bus passes, which were subsidized at 50%. Of the 381 enrolled in the experiment, 70% continued to use transit (or alternative transportation) after the trial. Only 114 (30%) returned to parking, even as gasoline prices started to moderate. The experiment built on the experience of social marketing programs and other campaigns that have explicitly tried to change habitual driving habits. Typically, these studies track changes in participants’ attitudes and behaviors. Researchers measured the attitudes and behaviors of participants, as well as changes in those who sought information but did not sign up and those who did sign up but later retreated to solo driving. Heuristically, these groups were labeled seekers, keepers, and retreaters. The three groups were compared and contrasted to identify factors that facilitate or reduce the likelihood of choosing to commute by public transit. Further applications of the social experiment are warranted because it effectively recruited new transit riders and it also provided insights about the process of changing travel modes.

Who are the Chronically Homeless? Social Characteristics and Risk Factors Associated with Chronic Homelessness

This study explored the social characteristics and risk factors associated with chronic homelessness in order to develop a set of indicators as a basis for understanding and treating the chronically homeless. The sample consisted of 140 homeless, recruited from total of six sites. Variables in the analysis included age, gender, educational attainment, physical and sexual abuse, frequency of emergency room visits, history of drug use, alcohol use, and history of residential treatment. Variables were analyzed using independent samples t-tests and chi square test of independence. Results indicated that educational attainment, frequency of emergency room visits, transportation, criminal record, physical abuse, specific acts of sexual abuse, history of drug use, alcohol use, and residential treatment were all related to chronic homelessness. The chronically homeless were also more likely to utilize mental health services and bus passes, have their governmental benefits cutoff, and report paper work too difficult for government subsidies.

Where There's a Will, There's a Way

In the last three years, two of my close colleagues have died, one of whom was not yet 50, still at work, and a second aged 63 ‐ within two years of retirement. Professionally, both had been clinical directors in regional intensive care units. Like them, as an intensive care clinician, I was surrounded by death at work ‐ 25% of patients in my own unit died ‐ and saw death everyday. But it was always someone else, and seldom someone with whom I had a close personal and professional relationship. They were not the only colleagues who have died young ‐ in the week I write this, another contemporary’s obituary has appeared in the BMJ ‐ not that I turn to the ‘obits’ first! What all this does is bring home that it is not just patients who die ‐ we will too. We are not immortal, despite thinking that we are and, on occasion, acting like gods. So what is this all about? I doubt whether my two intensive care colleagues had thought too much about their deaths or about the aftermath ‐ or even what they might achieve after death. But the most recent death has made me think again whether I can be of use ‐ other than to provide the odd organ if I’m in the right state in the right place at the right time. Many of us will have drifted past the Intensive Care Foundation’s website and perhaps wondered how it has managed to raise the funds that have supported its own research programme ‐ a programme that had been ‘carechanging’ (viz ‘Tracman’, ‘ICON’), or fund its MSc fellow ‐ or even to support unusual research (‘Xtreme Everest’). The answer is that the projects were funded by industry, from the Intensive Care Society and from the money raised at sporting events that the ICF itself has organised (Snowdonia Xtreme Challenge). And these funds have taken some raising. Wealthy potential donors have been ‘wined and dined,’ with or without royalty ‐ but so far, they have been largely unimpressed with the Foundation as a worthy site for their largess. When pressed about the reasons why, they are unfortunately quite clear: the general intensive care clinical community at large (including intensive care patients) do not support the Society’s own research arm with financial help ‐ so why should they? This brings me to us, the Intensive Care Society membership and the intensive care community. Some of us are just old enough to have a bus pass... As I watched my former colleague carried into the crematorium, I realised that he was to be cremated in a cardboard coffin. ‘Eco ‐ like me,’ I thought. Then, uncharitably, ‘I wonder if he’s mean ‐ like me?’ And then ‐ ‘I wonder what I’d do with the money I’d save?’ As we were asked not to send flowers but to provide a donation (gift-aided ‐ good lad!) to his own ICU’s fund, I had the hopeful notion that he might even have left a small legacy to his unit’s own fund, perhaps from savings achieved... I wonder if we have ever even thought of leaving something ‐ a legacy ‐ to help the specialty ‐ or to the Intensive Care Foundation. I have now. And if we can put this sort of information in front of our rich donors, we may get more than the savings achieved by using an eco-friendly coffin.

Backward walking in Parkinson's disease

We walk backward on a daily basis, such as when backing away from the kitchen sink or stepping back from a curb as a swiftly moving bus passes. This task may be particularly difficult for individuals with Parkinson's disease (PD) who often fall as a result of moving or being perturbed in the backward direction. The aim of this study was to assess backward walking (BW) in individuals with PD. Both forward walking (FW) and BW were assessed in 78 people with idiopathic PD (H&Y range: 0.5-3) in the ON state, and 74 age- and sex-matched controls. In FW, those with PD had significantly shorter strides, lower swing percents, higher stance percents, and lower functional ambulation profiles than controls. Both groups walked significantly slower and with a wider base of support during BW than FW. Additionally, in BW those with PD walked significantly slower with shorter strides, lower swing percents, and higher double support and stance percents, and lower functional ambulation profiles compared with controls. Those with mild to moderate PD have impaired FW and BW, but differences between those with and without PD are more pronounced in BW.

Tratamento supervisionado em pacientes portadores de tuberculose utilizando supervisores domiciliares em Vitória, Brasil

To evaluate the use of family members as supervisors of directly observed therapy (DOT) in patients with tuberculosis. This was a prospective descriptive study involving patients diagnosed with pulmonary tuberculosis. The sample comprised 98 patients. A standardized protocol was implemented in order to train the patient and their families. After the training, the patient was allowed to choose either a family member or a health care worker as a supervisor. Absolute and relative frequencies were used in descriptive data analysis. A family member supervisor was chosen by 94 patients (96%). The cure rate was 99%. The partner was chosen by 49% of the patients, and other family members were chosen by 28%. The heath care team needed to take over DOT in 3% of the cases. Regular attendance at follow-up appointments was 67%. It was observed that 24% of the problems in this DOT model referred to the family supervisor forgetting to administer the medication or to the patient forgetting to take it; 39% of the patients forgot to take the medication for one day, and 31% forgot to take it for two days. There was change of supervisor in 9% of the sample, medication was lost by the patient sometime during treatment in 9%, and patient drug intolerance occurred in 8%. DOT supervised by a family member has proven an effective and low-cost technique. However, compliance is not due to one single factor but to the combination of strategies adopted: bus passes; educational measures and especially the individualized approach.

Impact of transit training and free bus pass on public transportation use by older drivers

Purpose The present pilot study examines the impact of group transit training for older adults in Victoria, British Columbia, Canada, between 2005 and 2006. Methods Data were collected from 41 participants, randomly assigned to three groups: 1) a control group that received no group transit training or free bus pass, 2) a group receiving group transit training only, and 3) a group receiving group transit training and a free bus pass. Participants were followed longitudinally for 1 year. Results No differences were found between groups in days or miles driven per week when comparing self-reported data prior to and 3 months following the intervention. However, there was a difference in self-reported bus use across groups; both groups who received group transit training used the bus more frequently, X 2 (2) = 10.89, p < .01. Conclusion This preliminary investigation suggests that transit training may be effective at increasing the use of public transportation for older adults.

Developing ecological footprint scenarios on university campuses

Purpose – The ecological footprint represents a simple way to assess the amount of materials consumed and waste produced by a given entity. The approach has been applied to countries, towns, households, and more recently university campuses. One of the challenges of using the ecological footprint at a university is the difficulty of determining how large the footprint should be. The authors have developed a calculator specific to the needs of a university campus, and applied it to the University of Toronto at Mississauga (UTM). Rather than focus on the overall size, the purpose of this paper is to instead create several scenarios to help communicate the relative impacts of alternative actions.Design/methodology/approach – An ecological footprint calculator appropriate to the campus was developed and applied to UTM. Three scenarios were then created: on‐campus electricity generation versus electricity purchased from the grid, current commuting patterns versus those expected if a student bus pass is adopted...

A call for greater flexibility in the use of public transport

This article, brought to you in association with Help the Aged, looks at the difficulties involved in using public transport for the older person. Help the Aged is calling for a flexible transport system which provides a free bus pass or travel tokens depending on what works for individuals.

Examining Transportation and Employment Outcomes: Evidence for Moving Beyond The Bus Pass

ABSTRACT This study of 62 low-income, primarily black, single mothers, in the Pittsburgh labor force, examined the relationship between transportation and employment outcomes through regression analyses. The study's unique Transportation Advantage measure enabled the quantification of mobility disparities between auto owners and those utilizing other travel modes. Results indicated that women with private vehicles reported higher Transportation Advantage and better employment outcomes than those with even the best public transportation services, which questions the efficacy of bus passes as the predominant travel intervention. In addition, there was evidence of transportation's mediating effect on the relationship between participants' human capital and their employment outcomes. The mobility status of the single mothers in this study had a greater impact on their employment outcomes than either education or work experience.

Mass transit trends and the role of unlimited access in transportation demand management

Current statistics regarding mass transit reveal transportation problems that can be addressed through comprehensive transportation demand management (TDM). Central to TDM is a public transit pass incentive program known as Unlimited Access. The discount bus pass program is shown to be an effective way of dealing with traffic congestion, parking shortages, and broader transportation issues. This study evaluates current transportation practices and policies, specifically the costs and benefits of parking versus the application of Unlimited Access programs at American universities. Case studies from universities in Utah illustrate national transportation problems, and demonstrate the potential to increase transit ridership.

Using conjoint analysis to assess depression treatment preferences among low-income Latinos.

The authors examined the feasibility of conjoint analysis for measuring the depression treatment preferences of low-income, low-literacy Latino primary care patients. Forty-two patients with depression (58 percent of those eligible for the study) completed a survey about preferences for treatment and strategies to reduce barriers to care. They preferred combined counseling and medication to either approach alone and preferred individual over group treatment but did not show a significant preference for treatment setting. The odds of treatment acceptance were increased by the availability of telephone appointments, bus passes, and help with making appointments. Although further validation is required, conjoint analysis appears to be feasible for assessing preferences regarding depression treatment in this underserved population.

Treating Children With HIV in Chicago

Treating Children With HIV in Chicago

Free Transit for Low-Income Youth: Experience in San Francisco Bay Area, California

In August 2002, AC Transit—the principal bus operator serving the eastern shore of the San Francisco Bay—began distributing free bus passes to low-income middle school and high school students in the transit service district. The program developed in response to grassroots community activism and growing political pressure to remove the burden of school transportation costs from low-income households. Advocates argued that school transportation costs were a barrier that prevented poor children from participating in after-school activities and, in severe cases, led to missed days of school. Funding for a pilot bus pass program was provided by the transit agency, the Metropolitan Transportation Commission, local agencies, and several nonprofit organizations. The University of California, Berkeley, was funded to carry out an evaluation of the program during the first year of the program. Before-and-after travel and activity surveys, interviews, focus group meetings, and analysis of attendance data were used in the evaluation. Findings after 1 year of implementation indicate that the free bus pass program increased student bus ridership and after-school participation but did not increase overall school attendance. Increases in bus use were greater among pass holders, in areas with high levels of bus service, and among high school students.

Extending the Theory of Planned Behavior: Predicting the Use of Public Transportation1

An expanded version of the theory of planned behavior (TPB) was used to predict and explain public transportation use. A pre‐post design was used to examine changes in university students’ bus ridership after the implementation of a universal bus pass (U‐pass) program. Bus ridership significantly increased after the U‐pass was implemented, and associated changes in attitudes and beliefs about transportation modes were found. In both phases, students’ public transportation use was well predicted by the original TPB. However, 2 additional constructs—a descriptive norm, and the interaction between intention and perceived behavioral control—significantly improved prediction in both phases of the study. These constructs might be useful additions to the original TPB, at least in this behavioral domain.