Development and validation of a prediction model for early screening of people at high risk for colorectal cancer

BACKGROUND Colorectal cancer(CRC)is a serious threat worldwide.Although early screening is suggested to be the most effective method to prevent and control CRC,the current situation of early screening for CRC is still not optimistic.In China,the incidence of CRC in the Yangtze River Delta region is increasing dramatically,but few studies have been conducted.Therefore,it is necessary to develop a simple and efficient early screening model for CRC.AIM To develop and validate an early-screening nomogram model to identify individuals at high risk of CRC.METHODS Data of 64448 participants obtained from Ningbo Hospital,China between 2014 and 2017 were retrospectively analyzed.The cohort comprised 64448 individuals,of which,530 were excluded due to missing or incorrect data.Of 63918,7607(11.9%)individuals were considered to be high risk for CRC,and 56311(88.1%)were not.The participants were randomly allocated to a training set(44743)or validation set(19175).The discriminatory ability,predictive accuracy,and clinical utility of the model were evaluated by constructing and analyzing receiver operating characteristic(ROC)curves and calibration curves and by decision curve analysis.Finally,the model was validated internally using a bootstrap resampling technique.RESULTS Seven variables,including demographic,lifestyle,and family history information,were examined.Multifactorial logistic regression analysis revealed that age[odds ratio(OR):1.03,95%confidence interval(CI):1.02-1.03,P<0.001],body mass index(BMI)(OR:1.07,95%CI:1.06-1.08,P<0.001),waist circumference(WC)(OR:1.03,95%CI:1.02-1.03 P<0.001),lifestyle(OR:0.45,95%CI:0.42-0.48,P<0.001),and family history(OR:4.28,95%CI:4.04-4.54,P<0.001)were the most significant predictors of high-risk CRC.Healthy lifestyle was a protective factor,whereas family history was the most significant risk factor.The area under the curve was 0.734(95%CI:0.723-0.745)for the final validation set ROC curve and 0.735(95%CI:0.728-0.742)for the training set ROC curve.The calibration curve demonstrated a high correlation between the CRC high-risk population predicted by the nomogram model and the actual CRC high-risk population.CONCLUSION The early-screening nomogram model for CRC prediction in high-risk populations developed in this study based on age,BMI,WC,lifestyle,and family history exhibited high accuracy.

Correlation between psychological traits and the use of smart medical services in young and middle-aged adults: An observational study

BACKGROUND Psychological problems affect economic development.However,there is a huge gap between mental health service resources and mental health service needs.Existing mental health service technology and platforms cannot meet all the diverse mental health needs of people.Smart medicine is a new medical system based online that can effectively improve the quality and efficiency of medical services and make mental health services accessible.AIM To explore the level of intelligent medical use among young and middle-aged people and its correlation with psychological factors.METHODS Convenience sampling was used to select 200 young and middle-aged patients with medical experience at the Third People's Hospital of Chengdu between January 2022 and January 2023 as the research subjects.The general condition Questionnaire,Eysenck Personality Questionnaire,Symptom Checklist-90,General Health Questionnaire,and Smart Medical Service Use Intention Questionnaire were used to collect data.Pearson’s correlation was used to analyze the correlation between the participants’willingness to use smart medical services and their personality characteristics,psychological symptoms,and mental health.RESULTS The results revealed that the mental health of young and middle-aged people was poor,and some had psycho-logical problems such as anxiety,depression,and physical discomfort.Familiarity,acceptance,and usage of smart healthcare in this population are at a medium level,and these levels correlate with psychological characteristics.Acceptance was positively correlated with E,and negatively correlated with P,anxiety,fear,anxiety/insomnia,and social dysfunction.The degree of use was negatively correlated with P,obsessive-compulsive symptoms,depression,anxiety,hostility,paranoia,and somatic symptoms.CONCLUSION The familiarity,acceptance,and usage of smart medical services among the middle-aged and young groups are related to various psychological characteristics.

Investigation of the Oral Health Status of Patients Based on Rehabilitation Nursing

Objective: To investigate the current situation of knowledge, attitude, and practice (KAP) of oral health among rehabilitation nursing patients, and provide some reference for implementing oral health intervention measures for rehabilitation nursing patients. Method: A total of 231 nursing patients in the rehabilitation department of a tertiary hospital in this city from January 2023 to October 2023 were selected as the research subjects. Their oral health knowledge, attitudes, and behaviors were investigated, and the oral health behavior habits of patients with different genders, education levels, and disease situations were compared. Result: The total awareness rate of oral health knowledge among patients was 73.16%, and the average score of oral health knowledge was 6.58 ± 1.25 points. The overall positive rate of oral health attitude among patients is 55.70%, and the average score of oral health attitude is 5.01 ± 1.04 points. The average score for oral health behavior is 16.87 ± 5.23 points. Only 8.48%, 3.3%, 1.3%, 2.6%, and 0.87% of patients seek timely medical treatment for bleeding tooth roots, gum swelling and pain, gum bleeding, tooth pain, and dental calculus, respectively;Only 5.19% of people change their toothbrush every 3 months, and only 10.39% use the vertical brush method to brush their teeth. The scores of oral health knowledge, attitudes, and behaviors of patients are related to age, educational level, disease type, and smoking situation. The oral health knowledge and attitude scores of elderly patients were lower than those of younger patients, and the difference was statistically significant (P P P P P < 0.05). Conclusion: The oral health status of rehabilitation nursing patients is not optimistic, with a moderate level of oral health knowledge, weak awareness of oral health, and a low qualification rate of oral health behaviors. Strengthening oral health education for rehabilitation nursing patients and incorporating oral health care procedures into rehabilitation nursing procedures is of great significance.

Research and Exploration of Ideological and Political Education in the Course of Pathophysiology

Course based ideological and political education (CIPE) is an important way to improve the quality of ideological and political work and talent cultivation. This study explores for the first time the implementation of ideological and political education in the teaching of pathophysiology courses, and also analyzes the evaluation of student psychological status and the importance of mental health education in the implementation of IPE courses. A survey was conducted on 211 students at Yangtze University to understand their motivation and behavior towards learning ideological, political, and pathophysiological courses. In addition, a questionnaire survey was used to explore the relationship between pathophysiology and ideological and political courses, as well as the importance of their satisfaction with the implementation of ideological and political courses in pathophysiology and mental health education. The research results indicate that factors such as educational background and gender differences affect the learning of CIPE. Graduate students are more interested in ideological and political courses, while female students find it difficult to study pathophysiology;In addition, the results of one-way ANOVA indicate that the implementation effect of IPE in pathophysiology courses depends on the level of interest in IPE and pathophysiology courses, the level of consideration for the importance of professional courses, the professional gains after studying pathophysiology, and the level of understanding of the relationship between IPE and CIPE. 81.04% of students believe that in the CIPE process, telling stories by teachers themselves is the most popular way of communication and education. This reflects the importance of mental health education from the perspective of CIPE. In addition, this study also indicates that PBL and flipped classroom teaching models are popular teaching models in CIPE. This study is beneficial for promoting the improvement and implementation of CIPE and mental health education in higher education curricula, thus providing valuable insights for educational decision-makers.

Research and Construction of Personalized Sleep Model Based on Questionnaire Data

The purpose of this study is to investigate the sleep habits, cervical health status, and the demand and preference for pillow products of different populations through data analysis. A total of 780 valid responses were gathered via an online questionnaire to explore the sleep habits, cervical health conditions, and pillow product preferences of modern individuals. The study found that sleeping late and staying up late are common, and the use of electronic devices and caffeine consumption have a negative impact on sleep. Most respondents have cervical discomfort and have varying satisfaction with pillows, which shows their demand for personalized pillows. The machine learning model for predicting the demand of latex pillow was constructed and optimized to provide personalized pillow recommendation, aiming to improve sleep quality and provide market data for sleep product developers.

On Students'Oral Communicative Ability of Dialogue

The present study presents a detailed report implemented to solve the problem that some of my students do not like the dialogue practice I assign them in class.It is hypothesized that the students' oral communication is increased by better-designed dialogue practice.This hypothesis is verified by a four-week practice of well-organized oral work activities.

Multi-center investigation of breast reconstruction after mastectomy from Chinese Society of Breast Surgery:A survey based on 31 tertiary hospitals(CSBrS-004)

Objective:Multi-center data on the current status and trends of breast reconstruction after mastectomy in China are lacking.Herein,we conducted a cross-sectional survey to investigate the current clinical practice pattern of postmastectomy breast reconstruction among Chinese female patients with breast cancer.Methods:A standardized questionnaire used to collect information on breast reconstruction among females diagnosed with breast cancer was distributed by 31 members of the Chinese Society of Breast Surgery between January 1,2018 and December 31,2018.Information was collected on tumor characteristics,treatment,mesh application,nipple-areola complex(NAC)preservation,postoperative complications,bilateral reconstruction,patient satisfaction and local recurrence.The overall rate of breast reconstruction was assessed,and the characteristics were compared across patient groups with different reconstruction approaches.Results:A total of 1,554 patients underwent breast reconstruction after total mastectomy,with a reconstruction rate of 9.6%.Among them,1,190 were implant-based,and 262 underwent autologous reconstructions,while 102 cases underwent a combination of both.Patients who underwent implant-based reconstruction were younger than those who received autologous reconstruction(40.1±4.6 vs.45.0±5.9,P=0.004).Compared to patients with autologous reconstruction,mesh application(25.5%vs.6.5%),NAC preservation(51.8%vs.40.5%)and reconstruction failure(1.8%vs.0)were more frequently reported among those with implant-based reconstruction.There was no significant difference in general satisfaction across three reconstruction approaches,though patients with autologous reconstruction reported the highest aesthetic satisfaction among the three groups(P=0.044).Conclusions:Implant-based breast reconstruction remains the dominant choice among patients,while autologous reconstruction was associated with higher aesthetic satisfaction.Our multi-center investigation based on the findings of the tertiary hospitals of Chinese Society of Breast Surgery may guide a future series of clinical studies on breast reconstruction in China.

Analysis of adversity quotient of nursing students in Macao:A crosssection and correlation study

Objectives: To investigate the adversity quotient (AQ) of Macao undergraduate nursing students and analyse its influencing factors.Methods:A cross-section design was used,and a convenience sample of nursing students(n=158 valid)was selected from a tertiary institute in Macao.In addition to demographic questions,the Chinese versions of the Adversity Quotient Scale,the Emotional Intelligence(EI)Scale,the Simplified Coping Style Questionnaire and the Parenting Styles Scale were used to assess the students'characteristics.Results:The average AQ score of the students was 116.72±11.39.AQ scores were negatively correlated with coping-negative,and maternal style(excessive interference,excessive protection)(r=-0.332,P<0.001;r=-0.167,P=0.036).Coping-negative entered the regression equation(F=19.154,P<0.001).The female nursing students had higher scores in ownership dimension of AQ than their male counterparts(31.98±3.26 vs.29.21±3.08,t=-4.442,P<0.001).Conclusions:The average AQ scores of Macao undergraduate nursing students were moderate.The female nursing students are more likely to attribute the cause of adversity to themselves,and specific psychosocial and cultural issues may be at play.There is a necessity for Macao nursing students to improve their ability to overcome setbacks.Special attention should be paid to the cultivation of students'positive coping styles.

Downtown Retailing Development Under Suburbanization——A Case Study of Beijing

The role of retailing has diminished in the center of cities of Western countries since its heyday in the 1920s. This trend was caused by violent transformations in the economic, social and locational contexts which involve resi- dential suburbanization, as well as new forms of commercial development out of town. As far as transforming China is concerned, the downtown retailing center has also come to turning point of development in the context of suburbaniza- tion. Based on the survey of Beijing residents’ shopping behavior, the present research tends to making clear the actual change and development problem of downtown retailing center. Combining with the macro retailing environment, re- lated influencing factors are further discussed too. Study results show that downtown retailing still plays an important part in resident’s shopping activity. However, with rapid urban sprawl, retailing in urban center has been greatly threatened by booming out-of-town commerce. In the course of such spatial change, the suburbanization of resident, the prevalence of new commercial forms and the change of consumers’ life style all have exerted their own pressure on downtown retailing. But for the special socioeconomic background of development and the support of government policy, it will still keep its vitality of retailing for a long period of time.

Associated factors of professional identity among nursing undergraduates during COVID-19:A cross-sectional study

Objectives Professional identity plays an important role in the long-term development of nurses,and it will change when public health emergency occurs.The objective of this study is to investigate the factors associated with the professional identity of nursing undergraduates in the epidemic of COVID-19.Methods A cross-sectional survey design with convenience sampling was used.A total of 3,875 nursing undergraduates were recruited from seven universities across China from March to April 2020.A general information questionnaire was used to collect students’information,and the Professional Identity Questionnaire for Nurse Students was used to survey their professional identity during the early and later stages of the first wave of the COVID-19 epidemic.Results The score of professional identity in the later stage(59.49±12.41)was higher than that in the early stage(56.96±12.61).The stepwise regression indicated that several factors were associated with professional identity,including gender,residential area,major,impact of the epidemic on intention to work after graduation,reasons for choosing nursing major and students’scores of professional identity in early stage.Conclusions Nursing educators can utilize the positive impact of responding to public health emergencies to increase the professional identity of students.Meanwhile,educators should give those students with lower professional identity more targeted education to cultivate their professional identity after the occurrence of public health emergencies.

Farmers′ Perception to Farmland Conversion: A Questionnaire Survey in Xining City, Qinghai Province, China

China is experiencing a fast process of farmland conversion which is conducted mainly by local governments to fuel economic development.Social tension is aroused and policy makers take great concerns on coordinating interests among different stakeholders,especially for increasing farmers′ interest.The purpose of this study is to get some insights related to land acquisition institution by exploring farmers′ perception to farmland conversion.Participatory Rural Appraisal(PRA) was applied for the investigation in peri-urban area,of Xining City,Qinghai Province,China.The total of 519 householders from 15 villages completed valid questionnaire survey from July to November,2012.The results indicate that farmland conversion has several impacts on farmers′ life.Most farmers are gradually adapting to city life.Higher living expenses and more income are perceived by farmers with average score of 4.21 and 2.69,respectively.The average scores of 2.38 and 2.46 are for improvement of life security and more job opportunities.Farmers expect to get some stable ways of compensation in addition to lump-sum compensation in cash.Stable subsidies every year and obtaining same number of land received strong proposal.And these two options are cited by 49.6% and 43.9% of respondents.Farmland conversion brings about cleaner living condition and more amenities,but lower air visibility and drier air.Results reflect landless farmers′ economic and life pressures and various demands.Local government should pay more attention to increase farmers′ income and improve rural security system.

How to improve patient satisfaction during midazolam sedation for gastrointestinal endoscopy?

To determine the procedure-related factors that affect sedation satisfaction and to make a suggestion to improve it.METHODSWe prospectively enrolled a total of 456 patients who underwent outpatient endoscopy procedures with midazolam sedation between March 2014 and August 2014. All patients completed both pre- and post-endoscopy questionnaires about sedation expectations and satisfaction.RESULTSThe study cohort included 167 (36.6%) patients who underwent esophagogastroduodenoscopy (EGD), 167 (36.6%) who underwent colonoscopy, and 122 (26.8%) who underwent a combined procedure (EGD and colonoscopy). Over 80% of all patients were satisfied with sedation using midazolam. In univariate and multivariate analyses, total procedure time in the EGD group, younger age (≤ 50 years), and longer colonoscopy withdrawal time in the colonoscopy group were related to decreased satisfaction with sedation. However, in active monitoring and intervention group, there was no decrease in grade of satisfaction despite longer procedure time due to more procedures during colonoscopy. Younger age (≤ 50 years), longer inter-procedure time gap, and colonoscopy withdrawal time were related to decreased satisfaction in the combined EGD and colonoscopy group.CONCLUSIONMidazolam is still a safe and effective sedative for gastrointestinal endoscopy. Satisfaction with sedation depends on several factors including age (≤ 50 years) and procedure time duration. To improve patient satisfaction with sedation, active monitoring of sedation status by the endoscopist should be considered for patients who require long procedure time.

HIV/AIDS related perception and behavior: A comparative study among college students of different majors in China

Objective:In order to carry out proper education and intervention of AIDS based on different features and demands of different majors,this study aimed to compare the difference of college students from six majors in China in the aspects of AIDS-related knowledge,attitudes and behaviors.Methods:A questionnaire survey was carried out among 18,644 students in 30 colleges/universities from 9 provinces of China,who were recruited through stratified cluster sampling.AIDS-related knowledge,attitude,condom-use intention,self-efficacy and sexual behavior of these students were investigated.Results:AIDS-related knowledge level of students majoring in education was the lowest while that of medical students was the highest as well as highest self-efficacy of condom use.Students of music or fine arts had the strongest intention to use condoms,while the students majoring in education had the weakest.The sexually active percentages of male students from different majors ranked as follows:music or fine arts(29.5%),minority nationality(12.2%),science&tech(10.9%),medicine(10.6%),educationmajor(10.0%),and liberal arts(8.2%).Among female students,the rank was music or fine arts(11.0%),science&tech(6.2%),education-major school(4.5%),minority nationality(4.5%),liberal arts(4.1%),and medicine(2.8%).Conclusion:It is urgent to enhance proper AIDS-related education and intervention based on the features and demands of students from different majors or universities,for example,to enhance comprehensive AIDS prevention education among students major in education and to increase behavioral skills to prevent sexually transmitted diseases among students from colleges or faculty of music or fine arts.

Abusive supervision and turnover intention: Mediating effects of psychological empowerment of nurses

Objective: This study aims to determine the mediating effects of psychological empowerment on abusive supervision and turnover intention as perceived by nurses to provide information to change the status of nurse turnover.Methods: A cross-sectional survey (a questionnaire examining perceptions of abusive supervision,measurement of psychological empowerment,and questionnaire for turnover intention) was used to collect data.A total of 1127 clinical nurses,who were recruited through convenience sampling,participated in the survey.Results: Nurses' average perceived abusive supervision,psychological empowerment,and turnover intention scores were 1.62 ± 0.95,3.24 ± 0.83,and 14.17 ± 3.78,respectively.Psychological empowerment was found to mediate the relationship between abusive supervision and turnover intention (P< 0.01).Turnover intention tends to be stronger and psychological empowerment reduced when nurse managers adopt an abusive leadership style.Conclusions: Nurses' psychological empowerment is an intermediary variable that predicts the relationship between abusive supervision and turnover intention.Nurse managers should manage abusive supervision to increase nurses' psychological empowerment and decrease turnover intention.

Nurses’perception on competency requirement and training demand for intensive care nurses

Objectives Various authors have explored the combination of competencies necessary for ensuring safe and quality care carried out by nurses in Intensive Care Units(ICUs).Nurses’perception of training is an element that must be studied in order to adopt appropriate educational measures.This study aimed to evaluate nurses’perception of the importance of intensive care training in Spain.Methods A descriptive,cross-sectional,multicentre study was conducted on a national level in Spain.Totally 85 ICUs took part in the study.The questionnaire used was developed using the Delphi method and had 66 items to investigate nurses’perception on competency requirements and training needs.The evaluation was conducted by a 10-point Likert scale.Results The sample was 568 Spanish nurses.Significant differences were found on an academic level,in terms of gender and hospital type,and in the professional experience of the nurse when it comes to evaluating the different training items;the differences in overall questionnaire scores among these groups were statistically significant(P<0.05).The nurses analyzed believe that previous training and professional experience in other care services are necessary before starting work in an ICU.Conclusion Implementation of training programs tailored to the needs of critical nurses had benefits for nurses and the health system.Nurses benefited from training focused on the skills and knowledge of each moment of their working life.Nurses have a different evaluation of their training needs throughout their professional cycle.Therefore,their training must be adapted to the professional stage of each nurse.

Nurse trainees' perception of effective clinical instructor characteristics

Objectives:Clinical education and experience in the clinical environment play an important role in shaping the clinical experience.Effective clinical teaching improves the clinical practice of the nursing trainees which in turn improves the quality of patient care.It mandates for the clinical instructor with desired qualities,to have a positive influence in clinical education.This study examined nurse trainees'perceptions of clinical instructor characteristics.Methods:The current study was conducted in a multi-cultural tertiary setting using a cross-sectional descriptive design.Using convenience sampling,302 trainees were chosen as participants for the study,and there were 296 respondents.The data were collected from the participants using the Nursing Clinical Teacher Effectiveness Inventory(NCTEI)tool.Results:The findings of the study revealed that the clinical instructors have scored high in personality(scoring percentage=84.0%)and relatively low in teaching ability(scoring percentage=81.3%).Also,the overall perception was almost the same among all the trainees though there was a slight variation in their rating of each dimension.Conclusions:Nursing trainees indicated the instructors as having good personality and relatively low teaching ability.This mandates the clinical instructors in the clinical environment to empower themselves in this area of improvement.This helps the teaching institutions to consider all the domains of effective clinical instructor characteristics while recruitment and also organize programs giving emphasis on building and developing these characteristics to create effective instructors.

Multidimensional health literacy profiles and health-related behaviors in the elderly:A cross-sectional survey

Objectives:To investigate health literacy profiles using a multidimensional tool in the elderly,analyze the factors related to health literacy,and explore the relationships between health literacy and health-related behaviors.Methods:A cross-sectional survey including 440 participants was conducted at a community health center and a village health center in Changsha,Hunan Province,between June 2020 and August 2020.We used the Health Literacy Questionnaire(HLQ)to assess the elderly’s health literacy.Sociodemographic data and health-related behaviors of them were surveyed with a self-designed questionnaire.Latent profile analysis,Pearson’s chi-squared and ordinal logistic regression were used to analyze the data.Results:The median age of the 440 respondents was 68 years.The participants had the lowest scores in the“appraisal of health information”subscale(2.22±0.52),followed by“navigating the healthcare system”subscale(2.89±0.81)of HLQ.Based on the analysis of three profiles,respondents who were 60 e74 years(OR=2.06,95%CI:1.23e3.42,P=0.006),living in urban areas(OR=3.28,95%CI:2.17e4.94,P<0.001),with secondary education or above(OR=2.86,95%CI:1.92e4.27,P<0.001),and having health insurance(OR=1.89,95%CI:1.02e3.51,P=0.042)were significantly associated with health literacy.Statistically significant associations were found between health literacy level and health-related behaviors,including medical service-seeking behavior(χ^(2)=25.14,P<0.001),exercising regularly(χ^(2)=34.08,P<0.001),and taking a medical examination in the past 12 months(χ^(2)=24.76,P<0.001).Conclusion:The multidimensional health literacy survey has identified the low health literacy level among the elderly in community settings.It revealed the relationships of sociodemographic character-istics,including age,education level and residence,with health literacy.These findings emphasized the importance of health literacy in promoting health behaviors,guiding a profound understanding of the Chinese elderly’s health needs and health literacy to develop community-based health promotion interventions.

Predictors of happiness among Iranian nurses

Objectives:This study aimed to assess happiness and its predictors among a group of Iranian hospital nurses.Methods:This cross-sectional study was done in 2016 on 620 hospital nurses who worked in five teaching hospitals affiliated to Kashan University of Medical Sciences,Kashan,Iran.Nurses were recruited through the census method.Data collection instruments were a researcher-made demographic and occupational characteristics questionnaire,the Oxford Happiness Inventory,and the Minnesota Job Satisfaction Questionnaire.Data analysis was done through stepwise multiple linear regression analysis.Results:Among 620 recruited nurses,422 returned their questionnaires completely filled.The mean of their happiness was 123.4±18.4 in the possible score range of 29-174.The significant predictors of happiness were satisfaction with mental health,monthly salary,satisfaction with salary,quality of life,current hospital ward,the length of working in the current ward,work shift,age,job satisfaction,and satisfaction with physicians'conduct and performance.These variables explained 50.3%of the total variance of happiness.Satisfaction with mental health had the greatest proportion in explaining the variance of happiness.Conclusion:Nurses in teaching hospitals in Kashan,Iran,have moderate happiness.Their happiness is affected by different factors,particularly by satisfaction with their mental health.Health policy-makers and authorities,in developing workforce-related plans and programs,need to pay special attention to nurses'happiness and its contributing factors.

Public Perceptions of Cryosphere Change and the Selection of Adaptation Measures in the rmqi River Basin

This study focuses on the characters of public perceptions on climate and cryosphere change,which are based on a questionnaire survey in the(U|¨)r(u|¨)mqi River Basin.In comparison with scientific observation results of climate and cryosphere change,this paper analyzes the possible impact of the change on water resources and agriculture production in the area.Perceptions of most respondents on climate and cryosphere changes confirm the main objective facts.For the selection of adaptation measures addressing the shortage of water resource,the results are as follows:most people preferred to choose the measures like "policy change" and "basic facility construction" which are mostly implemented by the government and the policy-making department;some people showed more preference to the measures of avoiding unfavorable natural environment,such as finding job in or migrating to other places.The urgency of personal participation in the adaptation measures is still inadequate.Some adaptation measures should be implemented in line with local conditions and require the organic combination of "resource-development" with "water-saving".

Travelers'attitudes toward carpooling in Lahore:motives and constraints

Traffic congestion has become a critical issue in developing countries,as it tends to increase social costs in terms of travel cost and time,energy consumption and environmental degradation.With limited resources,reducing travel demand by influencing individuals’ travel behavior can be a better long-term solution.To achieve this objective,alternate travel options need to be provided so that people can commute comfortably and economically.This study aims to identify key motives and constraints in the consideration of carpooling policy with the help of stated preference questionnaire survey that was conducted in Lahore City.The designed questionnaire includes respondents’ socioeconomic demographics,and intentions and stated preferences on carpooling policy.Factor analysis was conducted on travelers’ responses,and a structural model was developed for carpooling.Survey and modeling results reveal that social,environmental and economic benefits,disincentives on car use,preferential parking treatment for carpooling,and comfort and convenience attributes are significant determinants in promoting carpooling.However,people with strong belief in personal privacy,security,freedom in traveling and carpooling service constraints would have less potential to use thecarpooling service.In addition,pro-auto and pro-carpooling attitudes,marital status,profession and travel purpose for carpooling are also underlying factors.The findings implicate that to promote carpooling policy it is required to consider appropriate incentives on this service and disincentives on use of private vehicle along with modification of people’s attitudes and intentions.