Research Team Recommendations Research Articles

The Resident or Community Partnership with Police in Addis Ababa City Administration

The future competition is anticipated to focus on Police Community Partnerships rather than physical material production in order to evaluate the Ethiopian community's participation in police member community partnership with police. This study was done to evaluate Police Community Partnerships procedures and issues specific to the Ethiopian population. The following particular goals were created: 432 police officers were chosen by the researchers using a scientific manner out of a total population of 13755 in order to evaluate the community partnership with police practices of police officers. The data was acquired using basic random sampling and purposeful sampling procedures, and structural equation modelling (SEM) was used to analyses both the quantitative and qualitative data. The main conclusions were that there were insufficient human resources, financial resources, and competent and accountable selectors. Additionally, there were insufficient background checks, physical and psychological examinations, assessments of applicants' potential for leadership, and the use of appropriate performance evaluation methods. According to the research team's recommendations, the Ethiopian community should work with all regional and local police commissioners, develop clear policies and standards, assign enough human resources, fulfil an adequate budget, and reject informal hiring practices. By working with accountable organizations, the Ethiopian community seeks to create a positive public impression of police officers, government support, and community perception to cooperate with all stakeholders during recruiting and selection.

Community and facility-level barriers to achieving UHC in Kono District, Sierra Leone and Maryland County, Liberia.

Universal Health Coverage (UHC) is achieved when individuals and communities receive the health services they need without suffering financial hardship. However, many countries face barriers to building health systems that enable the availability of affordable, accessible care. The goal of this study was to present a model of local monitoring of barriers and to provide a roadmap for designing interventions that improve access to and use of healthcare delivery systems. We conducted household, individual, and health facility surveys in seven catchment areas in Sierra Leone and Liberia between December 2019 and March 2020. A two-stage cluster sampling method was used to sample households and individuals, and all health facilities were included. We divide access barriers into demand (patient-side care seeking behavior), supply (availability of facilities and services), and their intersection (affordability, spending, and use rates). Among the 2,576 respondents within our 1,051 surveyed households, the propensity to seek care when ill was reported at 90% in Sierra Leone (n = 1,283) and 70% in Liberia (n = 806). We estimated that 31% of households spent greater than 10% of their total expenditure on healthcare in a month, and that 14.5% of households spent greater than 25%. Overall, the general service readiness index mean score for all health centers was around 70%. The greatest hindrance to service readiness was the availability of essential medicines, with facilities reporting an average score of 32% in Sierra Leone and 63% in Liberia. Our evidence suggests that the cost of care is both a barrier to care-seeking and a persisting problem among care-seeking patients. Lack of service availability (essential equipment and medicines), poses a risk to high-quality care. The research team recommends deploying interventions (visit cost subsidies, supply chain improvements) targeted at resolving these issues in order to advance the goal of achieving UHC.

Contextual factors influencing complex intervention research processes in care homes: a systematic review and framework synthesis.

BackgroundCare homes are complex settings to undertake intervention research. Barriers to research implementation processes can threaten studies’ validity, reducing the value to residents, staff, researchers and funders. We aimed to (i) identify and categorise contextual factors that may mediate outcomes of complex intervention studies in care homes and (ii) provide recommendations to minimise the risk of expensive research implementation failures.MethodsWe conducted a systematic review using a framework synthesis approach viewed through a complex adaptive systems lens. We searched: MEDLINE, Embase, CINAHL, ASSIA databases and grey literature. We sought process evaluations of care home complex interventions published in English. Narrative data were indexed under 28 context domains. We performed an inductive thematic analysis across the context domains.ResultsWe included 33 process evaluations conducted in high-income countries, published between 2005 and 2019. Framework synthesis identified barriers to implementation that were more common at the task and organisational level. Inductive thematic analysis identified (i) avoiding procedural drift and (ii) participatory action and learning as key priorities for research teams. Research team recommendations include advice for protocol design and care home engagement. Care home team recommendations focus on internal resources and team dynamics. Collaborative recommendations apply to care homes’ individual context and the importance of maintaining positive working relationships.DiscussionResearchers planning and undertaking research with care homes need a sensitive appreciation of the complex care home context. Study implementation is most effective where an intervention is co-produced, with agreed purpose and adequate resources to incorporate within existing routines and care practices.

Obstacles to recreational sports tourism for the Egyptian Triathlon Federation after the 25 January revolution

Recreational sports tourism is one sports tourism and defined as it is the movement of an individual from his permanent residence to another place within or outside the borders of the country in which he lives for no less than 24 hours, to enjoy watching sports events or practicing sports activities, for the duration of his residence if this residence is not a permanent residence. Recreational sports are those activities where the primary purpose of the activity is participation, with the related goals of improved physical fitness, fun, and social participation often prominent. Recreational sports are usually perceived as less stressful, both physically and mentally, for participants. There are lower expectations for both performance and commitment to sport in the recreational sphere. In theory, there is a clear demarcation between purely recreational pursuits and competitive sports, where the emphasis will be centered on the achievement of success and the attainment of physical skills through rigorous training. Aim of the study:  the idea of this study came to identify the obstacles to recreational sports tourism in the Egyptian Federation For triathlon after the 25th of January revolution. Methodology: The research community represents the trainers, administrators, workers, and pioneers of the Egyptian Triathlon Federation. The stratified random method, so that it constitutes an acceptable number to represent the research community, and the number of them reached (120) coaches, administrators, workers, and pioneers in the Egyptian Triathlon Federation. The duration is from 12 August 2021, 10 years after the January 25 revolution. Recommendations: Considering the objectives of the research and within the limits of the research community and the selected sample, and considering the results achieved, the research team recommends: The Ministry of Youth and Sports and the Olympic Committee hold specialized training courses in Recreational Sports Tourism and its importance to the economics of sports in Egypt. Raising awareness of the actual transformation of the sport from training and professionalism, Considering sports tourism as a service industry at the highest level. Providing an appropriate organizational structure within the Egyptian Triathlon Federation for sports tourism and recreation. Providing the necessary financial support for implementing the Federation's plan

Level of Factors impact on the Buyers’ Intention in Buying Private Health Insurance with the Case of Vietnam Non-Life Insurance Companies

The study aims to determine the influence of factors affecting the intention to purchase private health at non-life companies in Vietnam. The samples were surveyed from 500 people from many areas but mostly in Hanoi. The study identified and clarified 5 independent factors affecting the intention to buy private health at non-life health companies in Vietnam. The analysis results show 5 variables: Past experience, Perception of service quality of companies, Perceived behavioral control, Attitude towards risks and private health , and the variable Subjective norms on private health insurance affect people's intention to buy private health insurance. Several policies have been proposed to increase customers' intention to buy private health at non-life companies from the analysis. To raise customer's intention to purchase private health insurance, the research team recommends non-life company to improve service quality, especially after-sales service, the quality and expertise of staff, and the government to complete policies and legal framework on private health insurance. Moreover, the research team also recommend to renovate the quality of organizing the private health regime and form the basis of the entire population pathology record. Keywords : private health insurance, intention to purchase, non-life company. DOI: 10.7176/EJBM/12-27-06 Publication date: September 30 th 2020

Effect on Skin Microflora in Hygienic Bathing of Patients with Chlorhexidine Gluconate Disinfectant and Non-Rinse Product

Objective: The skin is one of the largest reservoirs of microorganisms (MO) in the human body, some of which are potential agents of Health care-associated infections (HAIs). The purpose of the present study is to provide a comparative microbiological analysis of the skin surface in patients before and after the application of the dry-bath method with an antiseptic agent-chlorhexidine gluconate (CHG) and with non-rinsing detergents. The method is innovative for the Republic of Bulgaria and has not been imposed and has not yet been implemented as a routine practice in hospitals. The purpose of this study is to demonstrate the bacterial contamination of the skin after a second day of hospital stay and the need to use agents containing sanitary disinfectant for patients. Methods: Methods based on bacterial culture using swabs were used. These are one of the most commonly used methods for isolating and identifying aerobic and optional anaerobic MO that are part of the skin flora. Results: The following bacteria were isolated in the microbiological examination of the skin surface: Coagulasenegative methicillin sensitive staphylococci (CNMSS), Coagulasenegative methicillin resistant staphylococci (CNMRS), Enterococcus, Methicillin-sensitive S. aureus (MSSA), Bacillus spp, Gram/-/bacteria, Streptococcus α-hem, Corynebacterium. Conclusion: The present studies demonstrate a significant decrease in microbial flora after CHG administration and a slight to no effect after applying non-rinsing detergents. The research team's recommendations are to apply products with CHG from nurse for hygiene of patients by the method of dry bathing at risk of HAIs.

The practice, adherence and contravention of human rights of public sectors governance in Amhara National Regional States, Ethiopia

One of the basic democratic values which will never be compromised is the human rights of citizens. Accordingly, the basic issues that expected to be seriously considered in public sector governance are the issues of human rights. Cognisant of this, the research investigates the practice, adherence and contravention of human rights during service delivery process of public sectors in ANRS. In achieving this basic objective, a mixed research approaches was used. To realise this, a combination of both probability and non-probability sampling techniques was applied. Finally, individual respondents were contacted from customers and authorities of public service providing institutions. The collected data were analysed using both qualitative and quantitative data analysis techniques. After an intensive investigation of primary and secondary data, the research team conclude that the place and adherence of human rights in public sectors were very fragile and hereof, the research team recommends that the public sectors need to develop a human rights-based services delivery approach.

Systems Thinking for Transitions of Care: Reliability Testing for a Standardized Rubric.

The purpose of this study was to develop a standardized rubric for systems thinking across transitions of care for clinical nurse specialists. The design was a mixed-methods study using the Systems Awareness Model as a framework for bridging theory to practice. Content validity was determined using a content validity index. Reliability was established using statistical analysis with Cronbach's α and intraclass correlation coefficient. Usability of the rubric was established using content analysis from focus group discussions about their experiences in using the rubric. Content validity was established with a content validity ratio of 1.0. Statistical analysis showed a high interrater reliability (α = 0.99), and sections of the rubric showed a strong degree of reliability with α's ranging from 0.88 to 1.00. Content analysis revealed several overall themes for usability of the rubric: clarity, objectivity, and detail. The area for improvement included adding more detail in the scholarly writing section. The research team recommends using the rubric to reflect application of systems thinking across transitions of care.

What structural factors influencing emergency and disaster medical response teams? A comparative review study.

INTRODUCTION:An important indicator increasing the survival chances of patients and injured people immediately after emergency and disaster is the rapid access to medical services. The establishment of Emergency and Disaster Medical Response Teams (EDMRTs) is one of the main strategies to improve response capacity and capability in the field of EDMRT. This study aimed to probe the structural factors influencing of EDMRTs.METHODOLOGY:In this study, a comparative review method was used. The current study was conducted between March 2017 and September 2018. For this, articles, books, formal reports, and information concerning the available websites regarding the structure of EDMRTs were analyzed. To access relevant scientific articles, an extensive search was carried out in several steps using divergent keywords in the Scopus, ProQuest, PubMed, ScienceDirect, and Google Scholar databases. After accessing the resources and documents, the process of analyzing and comparing different team structures was carried out using content analysis.RESULTS:Following the search of relevant databases and websites, the structure of EDMRTs in the United States, Australia, Japan, Turkey, New Zealand, Canada, and the World Health Organization were taken into consideration and compared. Two areas of “Organization and Management” as well as “Capacity and Capability Development” were explored along with multiple subsets.CONCLUSION:The results of this study revealed that the model and structure of EDMRTs have direct relationship with such elements as the structure of the disaster risk management system, risk assessment, impact of the hazards and medical needs of the affected area, population distribution, level of team activity, and timing of the teams' presence after disasters. The research team recommends designing and conducting studies for determine the roles and responsibilities of the teams.

Conformance to Evidence-Based Treatment Recommendations in Schizophrenia Treatment Services

To assess quality of health care provided in a representative Canadian mental health service using conformance to evidence-based treatment recommendations, and to examine differences from published US results. We used a cross-sectional cohort design involving a randomly selected sample of patients diagnosed with schizophrenia attending 1 of 3 mental health clinics in 1 Canadian regional health system. The sample size was calculated to detect differences with the US sample. Conformance criteria were based on a published protocol. Data were collected using patient interviews and a structured review of health records. Conformance to 9 key Schizophrenia Patient Outcomes Research Team recommendations was assessed. Conformance ranged between 58% and 90% for pharmacological recommendations, and 0% to 81% for psychosocial recommendations. No patients who met criteria for assertive case management had been referred to an assertive case management team. Significant differences in conformance rates to some treatment recommendations were found between Canadian and published US results. It proved possible to assess health care quality using process measures of conformance to treatment recommendations. Conformance to clinical recommendations for pharmacotherapy is higher than for psychosocial therapies. The absence of barriers to access for pharmacological therapies likely enhances the higher conformance to these recommendations. Limited or variable access to psychosocial services, specifically assertive community treatment, likely negatively affects conformance to psychosocial treatment recommendations. Methodological limitations preclude drawing conclusions on comparisons between Canadian and US services.

Cognitive Therapy of Schizophrenia

Back to table of contents Previous article Next article Book ReviewFull AccessCognitive Therapy of SchizophreniaTimothy B. Sullivan M.D.Timothy B. Sullivan M.D.Search for more papers by this authorPublished Online:1 Feb 2007https://doi.org/10.1176/ps.2007.58.2.277AboutSectionsPDF/EPUB ToolsAdd to favoritesDownload CitationsTrack Citations ShareShare onFacebookTwitterLinked InEmail It's hard to say how bad ideas, misinformed or misguided clinical saws, originate. One of the most enduring in psychiatry is the notion that talking to patients with schizophrenia about their symptoms or about their subjective experiences is potentially harmful. It is little wonder that so few medical students or psychiatric residents wish to specialize in work with patients who have seriously mental illness. There have been studies and reviews, most famously the Patient Outcomes Research Team recommendations ( 1 ), which have directed our attention to the lack of efficacy ( 2 ), obvious paucity of controlled observation, and insufficiently documented putative harm associated with "uncovering therapies," by which is meant psychoanalytic therapy and its congeners. Kingdon and Turkington lament the effect these proscriptions have unintentionally had on creative engagement of persons suffering from disorders such as schizophrenia. They note that "many practitioners continue to believe that the content of psychotic symptoms should be ignored and that any psychological work … is liable to lead to increased distress and exacerbation of symptoms, as a result of having opened up disturbing areas." Of course the problem with past, well-intentioned, and compassionate efforts by a legion of gifted therapists is that the therapeutic model, and the theory of mind supporting it, did not accurately reflect the nature of the disorder. It was not the effort to be empathic that was flawed but the various notions about how symptoms were produced or could be ameliorated. If you don't understand what you're treating, you will misdirect, misinform, and inevitably disappoint.Kingdon and Turkington set out to provide clinicians with a treatment model that will make the uncertain knowable and that which is alienating comfortable. They successfully present a cogent, approachable, and flexible model for psychotherapeutic engagement of persons suffering from serious psychotic illness. This is not a "manualized" treatment, and the authors explain why that approach is not appropriate. A careful exposition of the nature of the illness processes, and the theory of cognitive-behavioral therapy and its particular adaptation to this setting, is explicated. There are many clinical examples, guidelines, forms to use, and even patient handouts that can be copied and distributed are included. The succinct review of the psychology of schizophrenia is particularly useful, such as the discussion of "externalizing bias" and the central role of stigmatization in symptom development.The fourth chapter, on therapeutic engagement, and later chapters on work with delusions and hallucinations, are not only brilliantly executed but come as close as one can, in print, to detailed individual case supervision. Even experienced practitioners will find these presentations extremely helpful, because they reflect the careful thought of talented clinicians who have immersed themselves in their subject and achieved valuable insights.I do have one brief quibble. As a heuristic device, Kingdon and Turkington use four clinical subgroups to differentiate "types" of schizophrenia. In the context of the book, these subgroups are useful and unify their presentation. I am not sure I can agree that the subgroups encompass the range of patients I see.Reviewers will often say that the book they are reviewing belongs on everyone's shelf. I urge you to please buy and read this book. Our patients deserve our attention to these issues. Those of you who are talented clinicians but who avoid this population out of confusion or lack of confidence in your ability to help will, I assure you, find this book crucial. You will find yourself able to approach a person with schizophrenia with confidence, and it will change how you think about your work.Dr. Sullivan is chief of services for the seriously mentally ill at Saint Vincent's Catholic Medical Center, Westchester, New York, and assistant professor of psychiatry at New York Medical College, Valhalla.

Cognitive Therapy of Schizophreniaby David G. Kingdon and Douglas Turkington; New York, Guilford Press, 2004, 219 pages, $37

Back to table of contents Previous article Next article Book ReviewFull AccessCognitive Therapy of SchizophreniaTimothy B. Sullivan M.D.Timothy B. Sullivan M.D.Search for more papers by this authorPublished Online:1 Feb 2007https://doi.org/10.1176/ps.2007.58.2.277AboutSectionsPDF/EPUB ToolsAdd to favoritesDownload CitationsTrack Citations ShareShare onFacebookTwitterLinked InEmail It's hard to say how bad ideas, misinformed or misguided clinical saws, originate. One of the most enduring in psychiatry is the notion that talking to patients with schizophrenia about their symptoms or about their subjective experiences is potentially harmful. It is little wonder that so few medical students or psychiatric residents wish to specialize in work with patients who have seriously mental illness. There have been studies and reviews, most famously the Patient Outcomes Research Team recommendations ( 1 ), which have directed our attention to the lack of efficacy ( 2 ), obvious paucity of controlled observation, and insufficiently documented putative harm associated with "uncovering therapies," by which is meant psychoanalytic therapy and its congeners. Kingdon and Turkington lament the effect these proscriptions have unintentionally had on creative engagement of persons suffering from disorders such as schizophrenia. They note that "many practitioners continue to believe that the content of psychotic symptoms should be ignored and that any psychological work … is liable to lead to increased distress and exacerbation of symptoms, as a result of having opened up disturbing areas." Of course the problem with past, well-intentioned, and compassionate efforts by a legion of gifted therapists is that the therapeutic model, and the theory of mind supporting it, did not accurately reflect the nature of the disorder. It was not the effort to be empathic that was flawed but the various notions about how symptoms were produced or could be ameliorated. If you don't understand what you're treating, you will misdirect, misinform, and inevitably disappoint.Kingdon and Turkington set out to provide clinicians with a treatment model that will make the uncertain knowable and that which is alienating comfortable. They successfully present a cogent, approachable, and flexible model for psychotherapeutic engagement of persons suffering from serious psychotic illness. This is not a "manualized" treatment, and the authors explain why that approach is not appropriate. A careful exposition of the nature of the illness processes, and the theory of cognitive-behavioral therapy and its particular adaptation to this setting, is explicated. There are many clinical examples, guidelines, forms to use, and even patient handouts that can be copied and distributed are included. The succinct review of the psychology of schizophrenia is particularly useful, such as the discussion of "externalizing bias" and the central role of stigmatization in symptom development.The fourth chapter, on therapeutic engagement, and later chapters on work with delusions and hallucinations, are not only brilliantly executed but come as close as one can, in print, to detailed individual case supervision. Even experienced practitioners will find these presentations extremely helpful, because they reflect the careful thought of talented clinicians who have immersed themselves in their subject and achieved valuable insights.I do have one brief quibble. As a heuristic device, Kingdon and Turkington use four clinical subgroups to differentiate "types" of schizophrenia. In the context of the book, these subgroups are useful and unify their presentation. I am not sure I can agree that the subgroups encompass the range of patients I see.Reviewers will often say that the book they are reviewing belongs on everyone's shelf. I urge you to please buy and read this book. Our patients deserve our attention to these issues. Those of you who are talented clinicians but who avoid this population out of confusion or lack of confidence in your ability to help will, I assure you, find this book crucial. You will find yourself able to approach a person with schizophrenia with confidence, and it will change how you think about your work.Dr. Sullivan is chief of services for the seriously mentally ill at Saint Vincent's Catholic Medical Center, Westchester, New York, and assistant professor of psychiatry at New York Medical College, Valhalla.

Motivation and motoric tests in sports

Motivation in sport performance has been an interesting topic for many investigators during the past decade. This area can be considered from different viewpoints: motivation for participation in sport activity, achievement motivation, competitiveness etc. Motivation plays an important role in all out tests, as well as in sport activities and at all levels of competition. Motivation climate, or positive social environment may influence and modulate motivation of individuals involved in sports. Experience has shown that conventional encouragement and feedback during the test may affect its outcome. According to Wingate research team recommendations, verbal encouragement, as a motivation factor, was given to all examined subjects during Wingate anaerobic test, which is considered the most reliable test for assessing anaerobic capacity. The investigated group consisted of 30 young men--medical students, who were not actively involved in any programmed sport activity. The investigated group included second-year students of the Faculty of Medicine in Novi Sad chosen by random sampling. The Wingate anaerobic test was performed in all subjects, and changes of parameters when test was performed with verbal encouragement, were recorded The results show statistically significant increase of Wingate test parameters when conducted with verbal encouragement: anaerobic power (622/669 W); relative anaerobic power (7.70/8.27 W/kg); slope of the power (95.5/114 W/s); relative slope of the power (1.18/1.40 W/s/kg); anaerobic capacity (12.7/13.2 kJ) and relative anaerobic capacity (158/164 J/kg).

Laser Acupuncture in the Management of Depression

Introduction Traditional Chinese medicine (TCM) has long recognised the use of acupuncture in psychological medicine. Classically the acupuncture meridians or channels are each linked to particular emotions, for example, joy and sadness (heart channel), panic and anxiety (kidney channel), anger and frustration (liver channel). By correct diagnosis, acupuncture intervention can be useful in the restoration of emotional well-being. Today it is realised that this restoration of emotional health is due to neuromodulation at the higher centres. Results of the NIH funded depression study by Allen, Hitt and Schnyer (1998) were encouraging. The study demonstrated acupoint specificity (p < 0.05) for mood disorders. Unfortunately, the study was single blinded. This study is based on the NIH study. The research team hoped to reproduce the significant results achieved then. With laser as the modality, the advantages were obvious: non-invasive modality, randomised double blind control achievable, no infection risk and ease of training community-based doctors to utilise the technique. Method This pilot study utilised laser acupuncture in an outpatient population with mild to moderately severe depression with Beck Depression Inventory (BDI) scale of 12 to 30. Normal was less than or equal to BDI of 10. Recruitment was through family practices (called general practices in Australia) and newspapers. Recruits were each screened by a psychiatrist to confirm their suitability. They were then randomised into sham laser and true laser groups. Each patient received twice a week sessions for a month, followed by once a week sessions for another month. BDI scores were taken fortnightly to ensure none of the patients deteriorated. The acupuncturist was also blinded. BDIs were repeated at one month and three months post laser. Results Thirty patients were recruited and randomised into true and sham laser. Four patients were withdrawn, two from each arm of the study. The rest completed the laser sessions. Of those who completed the study, one patient did not respond to any of the post laser follow up BDI requests. Another patient did not complete the three-month follow up BDI. Results showed a markedly significant improvement in the active group (p< 0.001) at the end of the course of treatment with a sustained difference one month after treatment (p<0.05). Discussion The markedly significant results were unexpected. They do however make laser acupuncture a serious contender as a third standard management option in the treatment of depression in the community. Laser acupuncture could stand alone, or be used together with counselling, psychotherapy or drug therapy. These latter areas of mixed management need to be explored. In the National Institute of Mental Health Treatment of Depression Collaborative Research Programme over 30% of participants terminated treatment early due to adverse effects, lack of improvement or desire to change therapies. These were based on psychological and/or pharmacological treatments. Patients were obviously searching for more satisfactory treatments, non-chemical in nature and without adverse effects. An important point to note from this laser study is that the series of treatments maintained their significance for the month after completion. This suggested that follow-up or maintenance laser acupuncture sessions were important for patient well-being and the one month mark could be indicative of appropriate timing. The research team recommends larger and more specific studies to confirm these findings and explore the wider clinical implications. The team is keen to perform a multicentre study but is restricted by funding issues.

Quality of Service for Uninterrupted-Flow Pedestrian Facilities in Highway Capacity Manual 2000

The objective of the research described in this paper was to develop the basis for revised operational analysis procedures for transportation facilities with pedestrian users where flow is not interrupted by traffic control devices. This paper contains both new and revised level-of-service (LOS) tables for analyzing various types of uninterrupted-flow pedestrian facilities. It details the results of a review and synthesis of American and international literature as part of a Federal Highway Administration study of pedestrian and bicycle facilities conducted by North Carolina State University between 1995 and 1998. The year 2000 edition of the U.S. Highway Capacity Manual (HCM) will incorporate, either directly or indirectly, most of the revised and synthesized information described in this paper. The research team recommends that the HCM revise the pedestrian walkway level of service to reflect the current literature. Proposed revisions include a decrease in the threshold for LOS A from 130 to 60 ft2/ped (12 to 5.6 m2/ped) and a change in the capacity level from 6 to 8 ft2/ped (0.6 to 0.75 m2/ped). The incorporation of a simplified walkway platoon level of service is recommended. In addition, given the different expectations of acceptable levels of platooning in transportation terminals, different LOS criteria are recommended for these facilities. A method of analyzing pedestrians on shared pedestrian-bicycle paths has also been identified. Although developed in the Netherlands, the procedure has been validated on at least one trail in the United States and is therefore recommended for inclusion in the HCM.

Quality of Service for Interrupted-Flow Pedestrian Facilities in Highway Capacity Manual 2000

The objective of the research described in this paper was to develop the basis for revised operational analysis procedures for transportation facilities with pedestrian users where flow is interrupted by traffic control devices. The paper commences with some background information on pedestrian walking speeds at signalized crossings and on pedestrian noncompliance at these locations. Then both new and revised level-of-service (LOS) tables are provided for analyzing various types of interrupted-flow pedestrian facilities. Results are detailed of a review and synthesis of American and international literature as part of a Federal Highway Administration study of pedestrian and bicycle facilities conducted by North Carolina State University between 1995 and 1998. The year 2000 edition of the U.S. Highway Capacity Manual (HCM) will incorporate, either directly or indirectly, most of the revised and synthesized information described in this paper. The research team recommends that the HCM include some background information that will be helpful for analysts timing signals and performing other operations. The authors of this paper recommend assumed crosswalk walking speeds of 1.2 m/s for most areas and 1.0 m/s for crosswalks serving large numbers of older pedestrians. Another important recommendation was to use delay to pedestrians as the basis for level of service at signalized and unsignalized street crossings. The recommended threshold for LOS F at signalized crossings is 60 s or more of delay per pedestrian, whereas at unsignalized crossings it is 45 s or more of delay per pedestrian.