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"Koster, A"
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Perspectives on rural tourism geographies : case studies from developed nations on the exotic, the fringe and the boring bits in between
This book examines rural tourism across three different contexts, acknowledging the complexity of rural places. It applies a systematic comparative framework across nine case studies from Australia, Canada and Sweden. The case studies address the uniqueness of different rural spaces, while the framework incorporates many theoretical aspects from human geography including spatial, historic, institutional, demographic, socio-economic and network perspectives. In the course of applying this comparative case study framework, the book identifies numerous implications for planning and policy in rural settings. These contributions from international, expert authors help to identify the opportunities and challenges that affect rural regions, from places at the urban fringe to exotic remote spaces and taking in the `boring bits in between.' Both the analysis and the framework used will be of value to scholars and students of rurality, tourism, regional development, rural policy, geography, and destination management. Readers will gain a deeper understanding of the rural context in developed countries and a robust conceptualization of rural tourism geographies.
Book
PLACE-BASED POLICIES AND THE HOUSING MARKET
We study the economic effects of place-based policies in the housing market, by investigating the effects of a place-based program on prices of surrounding owner-occupied properties. The program improved the quality of public housing in 83 impoverished neighborhoods throughout the Netherlands. We combine a first-difference approach with a fuzzy regression-discontinuity design to address the fundamental issue that these neighborhoods are endogenously treated. Improvements in public housing induced surrounding housing prices to increase by 3.5%. The program’s external benefits are sizable and at least half of the value of investments in public housing.
Journal Article
تقييم السلامة الميكروبية لماء الشرب : عمليات التحسين والطرق
يقدم هذا الكتاب خلفية معرفية تستند على تقييم ماء الشرب وصلاحيته للاستهلاك الآدمي بالإضافة إلى أنه ينظر إلى التطبيقات الحديثة في مجال الحد من التلوث الميكروبي للماء وتحتوي فصوله الثمان على مواضيع متعددة وقيمة في مجال سلامة مياه الشرب وقياسات التقييم لنوعية مياه الشرب وتقييم المخاطر وفعالية المعالجة والكشف عن نوعية مياه الشرب خلال عمليات الخزن والتوزيع بالإضافة إلى الكشف عن مؤشرات التلوث الميكروبي لمياه الشرب وطرق التحاليل الميكروبيولوجية لفحص نوعية مياه الشرب.
Book
Covid-19 restriction policies and shopping streets
Policymakers around the world are enforcing mobility restriction policies such as lockdowns, facemask requirements and social distancing to curb the spread of Covid-19. While these policies are effective in preventing the spread of virus, the economic implications are not well understood. We contribute to the literature by examining the impact of these policies on the offline retail sector. Specifically, we measure the effects of these policies on the daily number of shoppers passing by, which we refer to as ‘footfall’, along major shopping streets in Netherlands. We rely on unique proprietary Wifi data to accurately measure footfall. Our findings imply that all these policies attribute to a non-trivial reduction in footfall levels along shopping streets. While lockdowns led to a 50% reduction in footfall along major shopping streets, shopping streets faced with facemask regulations also experience a 25% drop in human traffic. A reduction in footfall translates into a substantial reduction in retail income of between 12% and 25%.
Journal Article
Improvement in gait stability in older adults after ten sessions of standing balance training
Balance training aims to improve balance and transfer acquired skills to real-life tasks. How older adults adapt gait to different conditions, and whether these adaptations are altered by balance training, remains unclear. We hypothesized that reorganization of modular control of muscle activity is a mechanism underlying adaptation of gait to training and environmental constraints. We investigated the transfer of standing balance training, shown to enhance unipedal balance control, to gait and adaptations in neuromuscular control of gait between normal and narrow-base walking in twenty-two older adults (72.6 ± 4.2 years). At baseline, after one, and after ten training sessions, kinematics and EMG of normal and narrow-base treadmill walking were measured. Gait parameters and temporal activation profiles of five muscle synergies were compared between time-points and gait conditions. Effects of balance training and an interaction between training and gait condition on step width were found, but not on synergies. After ten training sessions step width decreased in narrow-base walking, while step width variability decreased in both conditions. Trunk center of mass displacement and velocity, and the local divergence exponent, were lower in narrow-base compared to normal walking. Activation duration in narrow-base compared to normal walking was shorter for synergies associated with dominant leg weight acceptance and non-dominant leg stance, and longer for the synergy associated with non-dominant heel-strike. Time of peak activation associated with dominant leg stance occurred earlier in narrow-base compared to normal walking, while it was delayed in synergies associated with heel-strikes and non-dominant leg stance. The adaptations of synergies to narrow-base walking may be interpreted as related to more cautious weight transfer to the new stance leg and enhanced control over center of mass movement in the stance phase. The improvement of gait stability due to standing balance training is promising for less mobile older adults.
Journal Article
High-risk pooling for mitigating risk selection incentives in health insurance markets with sophisticated risk equalization: an application based on health survey information
Background
Despite sophisticated risk equalization, insurers in regulated health insurance markets still face incentives to attract healthy people and avoid the chronically ill because of predictable differences in profitability between these groups. The traditional approach to mitigate such incentives for risk selection is to improve the risk-equalization model by adding or refining risk adjusters. However, not all potential risk adjusters are appropriate. One example are risk adjusters based on health survey information. Despite its predictiveness of future healthcare spending, such information is generally considered inappropriate for risk equalization, due to feasibility challenges and a potential lack of representativeness.
Methods
We study the effects of high-risk pooling (HRP) as a strategy for mitigating risk selection incentives in the presence of sophisticated– though imperfect– risk equalization. We simulate a HRP modality in which insurers can ex-ante assign predictably unprofitable individuals to a ‘high risk pool’ using information from a health survey. We evaluate the effect of five alternative pool sizes based on predicted residual spending post risk equalization on insurers’ incentives for risk selection and cost control, and compare this to the situation without HRP.
Results
The results show that HRP based on health survey information can substantially reduce risk selection incentives. For example, eliminating the undercompensation for the top-1% with the highest predicted residual spending reduces selection incentives against the total group with a chronic disease (60% of the population) by approximately 25%. Overall, the selection incentives gradually decrease with a larger pool size. The largest marginal reduction is found moving from no high-risk pool to HRP for the top 1% individuals with the highest predicted residual spending.
Conclusion
Our main conclusion is that HRP has the potential to considerably reduce remaining risk selection incentives at the expense of a relatively small reduction of incentives for cost control. The extent to which this can be achieved, however, depends on the design of the high-risk pool.
Journal Article
A new framework for disentangling different components of excess mortality applied to Dutch care home residents during Covid-19
Background
Vulnerable subgroups of the population, such as care home residents, often face elevated mortality risks during crises like pandemics or wars. To correctly model and interpret the excess mortality of vulnerable groups during crises, a distinction must be made between the pre-existing heightened mortality of the vulnerable group, the general population’s excess mortality during the crisis, and the crisis-specific excess mortality unique to the vulnerable group.
Methods
We introduce the concept of “excess excess” mortality, which captures the extra excess mortality experienced by vulnerable groups during crises, beyond what can be explained by their excess mortality due to being vulnerable and general population excess mortality. Using individual-level data from Statistics Netherlands, we model the excess excess mortality of Dutch care home residents aged 70 and older during the Covid-19 pandemic. We extend standard relative survival methods by incorporating multiple excess mortality components and use an additive hazards model to accommodate periods of negative excess hazard.
Results
The findings confirm the severe impact of the Covid-19 pandemic on care home residents. In general, men and older age groups experienced higher excess excess mortality, both in absolute and relative terms.
Conclusions
Our approach offers a new perspective on how to model and interpret excess mortality in vulnerable groups during a crisis and provides a methodological foundation for investigating excess excess mortality in other contexts.
Journal Article
Barriers and enablers of vigorous intermittent lifestyle physical activity (VILPA) in physically inactive adults: a focus group study
Background
Vigorous Intermittent Lifestyle Physical Activity (VILPA) refers to brief bouts of vigorous intensity physical activity performed as part of daily living. VILPA has been proposed as a novel concept to expand physical activity options among the least active. As a nascent area of research, factors which impede or encourage VILPA in physically inactive adults are yet to be explored. Such information is pertinent in the design of future interventions. We examined the barriers and enablers of VILPA among physically inactive adults using the Capability, Opportunity, Motivation, Behavior (COM-B) model as a conceptual framework.
Methods
We recruited a sample of self-identified physically inactive middle-aged and older adults (
N
= 78) based in Australia to take part in 19 online focus groups across three age groups: young-middle (age 35–44), middle (age 45–59) and old (age 60–76). We analyzed interviews using a critical realist approach to thematic analysis. Identified barriers and enablers were subsequently mapped onto the COM-B model components.
Results
The data generated 6 barriers and 10 enablers of VILPA that corresponded to COM-B concepts. Barriers included physical limitations (physical capability), perceptions of aging, need for knowledge (psychological capability), environmental constraints (physical opportunity), perceptions of effort and energy, and fear (automatic motivation). Enablers included convenience, reframing physical activity as purposeful movement, use of prompts and reminders (physical opportunity), normalization of taking the active option, gamification (social opportunity), sense of achievement, health improvements, personally salient rewards (reflective motivation), identity fit, and changing from effortful deliberation to habitual action (automatic motivation).
Conclusion
The barriers and enablers of VILPA span capability, opportunity, and motivation beliefs. Promoting the time-efficient nature and simplicity of VILPA requiring no equipment or special gym sessions, the use of prompts and reminders at opportune times, and habit formation strategies could capitalize on the enablers. Addressing the suitability of the small bouts, the development of specific guidelines, addressing safety concerns, and explicating the potential benefits of, and opportunities to do, VILPA could ameliorate some of the barriers identified. Future VILPA interventions may require limited age customization, speaking to the potential for such interventions to be delivered at scale.
Journal Article
Investigating the support for equitable admissions policies in health professions education: the Formal Consensus method
Higher education institutions increasingly aim to implement equity in admissions. However, there is no one-size-fits-all solution to determine which equitable admissions procedures are suitable in a specific context, nor which groups should be its beneficiaries. Therefore, we applied the Formal Consensus Method (FCM) to investigate the support amongst experts and stakeholders for different equitable admissions policies and target groups within the context of Health Professions Education in The Netherlands. We found majority support (median of ratings ≥ 7 on a scale of 1 to 9) in both groups for the target groups ‘applicants with a low or average socio-economic status’ and ‘applicants with an underrepresented migration background’. The majority of participants was also in favor of Contextualized Admissions, especially when used to increase enrolment of applicants with a low or average socio-economic status, with an underrepresented migration background, and asylum status holders. Lastly, both groups supported lottery with extra tickets for applicants with an underrepresented migration background. However, as the range of ratings fell outside the FCM prescribed range of 5-9, no case in which there was majority support could be defined as a ‘consensus’. The expert group proposed the use of Bonded Medical Places for applicants from the Caribbean parts of the Dutch Kingdom. The policies and target groups for which broad support was found, could contribute to equitable admissions, improved student diversity, and enhanced quality of health education and future care. Our application of the FCM in the area of equitable admissions policies may be useful for researchers in other countries where equity principles are not (widely) used in admissions decisions.
Journal Article
A flow based pruning scheme for enumerative equitable coloring algorithms
An equitable graph coloring is a proper vertex coloring of a graph G where the sizes of the color classes differ by at most one. The equitable chromatic number, denoted by \\[\\chi _{eq}(G),\\] is the smallest number k such that G admits such equitable k-coloring. We focus on enumerative algorithms for the computation of \\[\\chi _{eq}(G)\\] and propose a general scheme to derive pruning rules for them: We show how the extendability of a partial coloring into an equitable coloring can be modeled via network flows. Thus, we obtain pruning rules which can be checked via flow algorithms. Computational experiments show that the search tree of enumerative algorithms can be significantly reduced in size by these rules and, in most instances, such naive approach even yields a faster algorithm. Moreover, the stability, i.e., the number of solved instances within a given time limit, is greatly improved. Since the execution of flow algorithms at each node of a search tree is time consuming, we derive arithmetic pruning rules (generalized Hall-conditions) from the network model. Adding these rules to an enumerative algorithm yields an even larger runtime improvement.
Journal Article