Accessibility challenges for older adults and people with disabilities: An urban mobility perspective in the age of smart transport technologies

The calculation and distribution of CAV carbon emissions on urban transportation systems: A comparative analysis of renewable and non-renewable energy sources

To the Editor: The coronavirus disease 2019 (COVID-19) pandemic and social distancing are transforming the way we interact. Before the pandemic, national studies reported 1 in 4 older adults were socially isolated and more than 40% experienced loneliness. Decades of observational studies have demonstrated the long-term negative health outcomes of social isolation and loneliness.1, 2 The COVID-19 crisis has exacerbated these challenges, with worsening social isolation and loneliness among those who live alone or are frail and even declines in the well-being of older adults with previously active or healthy social lives. Community centers for older adults have closed, nursing homes have terminated visitation, and grandparents are unable to visit their grandchildren. Initial hopes that such restrictions would be temporary are now giving way to a need to prepare for managing the unintended consequences of prolonged social distancing and the associated impact on the health and well-being of older adults. We present an approach to identify older adults most at risk during prolonged distancing and suggest strategies that could ameliorate the effects of sustained social distancing. Although the term social distancing has been widely used during the COVID-19 pandemic to describe keeping space between ourselves and others outside of our homes, public health recommendations have increasingly shifted to using the term physical distancing. Regardless of terminology, the impact on well-being among older adults is variable due to differing abilities to maintain social connections while physical distancing. Individuals who are homebound, depressed, or cognitively impaired may struggle to adapt to physical distancing because of reliance on in-person care and interaction. In contrast, many older adults may successfully adjust to this new reality with support from community organizations, friends, family, and/or neighbors. Clinicians should monitor whether or not these support systems are sustained. This is certainly not the time to overhaul clinical measures or deploy lengthy surveys. However, we suggest assessing a few focused measures of social connections in addition to common geriatric assessments to identify individuals at risk who may have increasing difficulty finding help with activities of daily living or instrumental activities of daily living, or even maintaining essential needs (ie, food, water, and shelter). Each domain can be assessed through a single question. First, older adults should be assessed for loneliness. Contrary to common practice, it is best not to ask the direct question "Do you feel lonely?" due to concerns for underreporting and stigma with self-identifying as lonely.3 Instead, individuals should be asked if they feel isolated, they lack companionship, or feel left out, as is done in several loneliness questionnaires. These responses represent an overall indicator of whether social connections are adequate and may predict risks of future psychological distress. Loneliness is frequently unrecognized because it can occur even when older adults are married or surrounded by friends or family. Second, individuals should be assessed for their perceptions of social support by asking, "How many people do you feel you can depend on or feel close to?" Prior research suggests that the perception of social support can reduce stress.4 This may be particularly important during the COVID-19 pandemic to reduce feelings of worry, anxiety, or stress. Notably, only having one person to rely on may be a red flag for increased caregiver burden in the context of prolonged physical distancing. Third, older adults should be assessed for their access to phone or video communication technologies. Notably, access to communication can be augmented by living with individuals who can support their technology use or compensate for vision or hearing impairment to help them communicate with social contacts or healthcare providers. Individuals who feel lonely, perceive low resources for social support, and cannot use alternatives to in-person communication are at increased risk during prolonged physical distancing. Exceptions to physical distancing may exist for high-risk older adults. Geriatricians and families should develop or utilize decision tools to help balance the risk and benefits of physical distancing. Current challenges are increasing our reliance on technology. For example, active and passive technologies (ie, alerts and sensors, respectively) offer unique opportunities. However, many of these solutions need further evaluation and are not available, accessible, or acceptable to many older adults and their families.5 Addressing unmet social needs requires feasible strategies that occur at the person and population level.6 Health systems are increasingly engaging in efforts to address social needs. Telemedicine can provide a safe platform to assess salient geriatric issues (ie, safety, mobility, mood, medications, appetite, or bowel function) or COVID-19 symptoms and provide an avenue for counseling or discussion. Moreover, it can increase access to mental health resources for the lonely or those anxious about the uncertainty related to the duration of home confinement. However, clinicians should recognize that even among older adults capable of using this technology, this communication medium may be insufficient to meet the social needs of this population for prolonged periods. We therefore suggest clinicians take the lead on designating individuals who can visit older adults while balancing the risk of COVID-19 exposure and need for social support. Designated individuals might be people who are tested more frequently (assuming testing becomes more widespread) or who have been verified for appropriate use of personal protective equipment). In addition, connecting older adults with community resources (eg, Meals on Wheels) that have implemented precautions to mitigate viral transmission or that already existed virtually (eg, Friendship Line, Virtual Senior Center) can address certain needs. At the population level, strategies to address social isolation and loneliness is largely underfunded and understudied.1 We unfortunately cannot wait for evidence-based interventions to emerge as this crisis unfolds. However, we can learn from prior natural disasters including the Chicago heat wave of 1995 that took the lives of 465 primarily older mobility-impaired, socially isolated individuals in 1 week.7 Based on this event and existing research, we know strategies should increase awareness about social isolation and loneliness, harness enthusiasm for volunteerism, utilize health record data to target those in need, and support organizations that are meeting the needs of older adults while adapting to physical distancing. Various technologies to address social isolation and loneliness have been tested, although the evidence to support these interventions is largely "inconsistent and weak."1, 8 There is hope. A recently published randomized controlled trial of a video-conferenced behavioral activation intervention facilitated by a lay coach was able to increase social interactions and decrease loneliness among homebound older adults.9 We now have a unique opportunity to develop methods for check-ins by neighbors or to adapt programs akin to the Jersey, British Channel Islands, "Call & Check Visits," where postal workers support older adults on their delivery routes. A knock on the door or hello from a distance from a postal worker may provide an opportunity to monitor and support older adults in the community. In addition, advocating initiatives that promote community cohesion (ie, yard, porch, and balcony or terrace gatherings) could also be beneficial in that it may provide an opportunity for neighbors to monitor the well-being and functional status of older adults from a distance. Efforts akin to the UK "Campaign to End Loneliness" and AARP "Connect2Affect" are also important and can increase awareness and offer resources to support older adults during crisis. Striving for patient-centered solutions that effectively consider benefit and burden can potentially create connections that are sustained even after this crisis. Lastly, providers and policymakers should revisit the Federal Emergency Management Agency's "Whole Community Approach" and find ways for municipal leaders to exchange strategies and align needs with resources. The COVID-19 pandemic is a timely reminder of how social well-being has a powerful impact on health. Identifying older adults at risk for the immediate and unintended health consequences of physical distancing is critical. Comprehensive geriatric and social needs assessments should be a part of the medical record so that practices, health systems, and communities may seamlessly mobilize support for those in need when public health crises occur. Technology undeniably offers novel opportunities as well as nuanced challenges; it should not limit our imagination or constrain how we balance the risk and benefit of in-person interactions. Physicians and health systems in conjunction with public health and policymakers can be positioned to identify and address social needs, optimize health, and flatten the curve of this extraordinary pandemic. Addressing social isolation and loneliness under normal circumstances is challenging; nevertheless, the current constraints of physical distancing offer a unique opportunity to envision, pilot, or implement novel solutions that could have a lasting impact on the health and well-being of older adults. We are sincerely appreciative of Cynthia M. Boyd, MD, MPH, and Thomas E. Finucane, MD, for their critical review and insightful comments. Thomas K.M. Cudjoe was supported by National Institute on Aging (NIA) Grants for Early Medical/Surgical Specialists' Transition to Aging Research (GEMSSTAR) (R03AG064253). Ashwin A. Kotwal was supported by an NIA GEMSSTAR grant (R03AG064323). The authors have declared no conflicts of interest for this article. Manuscript concept and drafting: Cudjoe and Kotwal. Critical revision of manuscript for important intellectual content: Cudjoe and Kotwal. None.

Review question/objective The overall objective of this research is to undertake a systematic review of the effects of spending time outdoors in daylight on the psychosocial wellbeing of older adults and family carers. The specific objectives to be addressed are: Which aspects of psychosocial wellbeing are affected by spending time outdoors in daylight in older adults and family carers? To what extent is spending time outdoors in the daylight effective for improving aspects of psychosocial wellbeing in older adults and family carers? Inclusion criteria Types of participants This review will consider studies that include all older adults aged 55 years or more, including those living in a community setting or a residential aged care facility. In addition, this review will consider family carers, who are defined as unpaid relatives or friends of an older person, who help that individual with their activities of daily living. No further inclusion criteria will be applied. Types of intervention(s)/phenomena of interest The intervention or phenomenon of interest is spending time outdoors in daylight. ‘Outdoors in daylight’ is a broad term that encompasses all outdoor environments where participants are exposed, directly or indirectly, to daylight in a natural setting while participating in any type of outdoor activity. For our review, the definition of outdoor activity is simply ‘being outdoors’ in order to capture all types of engagement with outdoor environments. Studies will be excluded if they utilise artificial ‘bright’ light sources or modify the indoor environment to improve light exposure. An absence of activity or indoors activity with no exposure to daylight will be used as a comparator. Types of outcomes This review will consider studies that include objective and/ or subjective measures of the following outcomes: Older adults: • psychosocial well-being: o behavioural disturbances; o cognition; o mood levels; o quality of life; o satisfaction with service provision; and o social interaction. Family carer health: o carer satisfaction; and o carer stress.

Connected and autonomous vehicles (CAV) have seen a rapid development over the past decade. However, wide diffusion of high level CAVs is still decades to come, and will depend on many technological, policy and public acceptance factors. Merging a traditional Bass Diffusion Model with a discrete choice model in a system dynamics approach, this study modelled CAV diffusion from 2020 to 2070 in the UK, considering mode choices of CAV private car, CAV car/ride sharing and CAV bus, their possible impacts on road network performance and sustainability, and the feedback of these impacts to CAV diffusion. Results of this study suggest that without interventions CAV diffusion will start to increase rapidly from 2035, and reach market saturation of 98% in around 2057. CAV diffusion will lead to reductions in average travel time, average travel cost, carbon emission and traffic accident. Training campaign, which prepares the general public to be ready for CAVs, is more effective in accelerating CAV diffusion than marketing campaign, which mainly targets the innovators and early adopters. Promoting shared CAVs and CAV public transport can contribute to more sustainable and more affordable mobility with CAVs, although this may lead to smaller CAV market size in terms of CAV sale, and the market size may reduce at a higher rate than sustainability enhancement.

PurposeChina is experiencing tremendous changes of rapid urbanization and aging society. The development of age-friendly communities (AFCs) has been encouraged for improving health and well-being of older adults. Hence, this study aimed to deepen the understanding of AFCs in China and to investigate the integrated relationships between AFCs and the quality of life (QoL) of older adults, using a large-scale questionnaire survey.Design/methodology/approachA questionnaire survey was conducted in Hefei, China, to investigate the complicated relationships between the components of AFCs and the QoL of older adults. Ultimately, 1,383 valid questionnaires were collected from senior respondents aged more than 60 years. Several statistical methods, including reliability analysis, correlation analysis and structural equation modeling (SEM), were adopted to develop an integrated model for AFC components and the QoL of older adults.FindingsSix AFC components and four older adults' QoL factors were identified. The SEM results revealed integrated relationships between specific AFC components and the QoL of older adults: (1) physical QoL was affected by outdoor spaces, public transportation, housing and community and health services; (2) psychological QoL was predicted by most of the AFC components except community and health services; and (3) environmental QoL and social QoL were both influenced by outdoor spaces, communication and information and community and health services.Practical implicationsIn order to enhance the QoL of older adults, it is suggested that outdoor spaces need to be enlarged by fully using the facilities and playgrounds of middle schools and renovating the older buildings. The locations of public transportation stations are recommended to be revised to be within a 5-minute walking distance of senior residents. Improvements to the social environment of AFCs, by increasing the coverage of medical services and creating multiple approaches to recreational activities, are encouraged.Originality/valueThese findings have empirical significance for urban planners and policy-makers in regard to identifying major components of AFCs and understanding the effect of those components on the QoL of older adults.

With the ever fast developments of technologies in science and engineering, it is believed that CAV (connected and autonomous vehicles) will come into our daily life soon. CAV could be used in many different aspects in our lives such as public transportation and agriculture, and so on. Although CAV will bring huge benefits to our lives and society, issues such as cyber security threats, which may reveal drivers' private information or even pose threat to driver's life, present significant challenges before CAV can be utilised in our society. In computer science, there is a clear category of cyber security attacks while there is no specific survey on cyber security of CAV. This paper overviews different passive and active cyber security attacks which may be faced by CAV. We also present solutions of each of these attacks based on the current state-of-the-art, and discuss future improvements in research on CAV cyber security.

Background/Objectives: The progressive increase in the aging population highlights the need for interventions aimed at preserving cognitive health and overall well-being in older adults. This study aimed to assess the impact of a structured cognitive training program on psychological well-being, executive function performance, and Brain-Derived Neurotrophic Factor levels (BDNF) in older adults from a Mexican geriatric center. Methods: A quasi-experimental pretest-posttest design with a nonequivalent control group was conducted. Thirty-two older adults were assigned either to a cognitive stimulation intervention group or a control group. The intervention consisted of 120 individually structured sessions, each lasting approximately 60 min, delivered five times per week over 24 weeks. Independent neuropsychologists, blinded to group allocation, assessed executive function (BANFE-3), depressive symptoms (Yesavage Geriatric Depression Scale), autonomy in daily living (Barthel Index), and quality of life (WHOQOL-OLD) before and after the intervention. Serum BDNF levels were also measured. Results: The intervention group showed significant improvements in executive function, depressive symptoms, independence in daily activities, and quality of life, while the control group showed no changes. Additionally, the intervention group showed an increase in BDNF expression post-intervention. Conclusions: The cognitive stimulation program effectively improved cognitive performance, emotional well-being, autonomy, and quality of life in older adults. These findings highlight the importance of integrating structured cognitive stimulation into geriatric care. For nursing practice, this underscores the key role nurses can play in delivering cognitive interventions to promote cognitive health, independence, and emotional stability among institutionalized and non-institutionalized older adults.

In recent decades, many cities in the world has started to apply policies and development projects that aim to increase their citizens' convenience of life, which is considered one of the most basic criteria to a high quality living environment. The most obvious example is building subway, monorail, LRT (Light Rail Transit) as well as BRT (Bus Rapid Transit) systems to reduce inner city travel time, thus, enhance public transport convenience and quality of life. Especially, for an aging population country like Japan, the switch from using private transport to public transport is necessary in order to adapt to the current rapid change of its population's density and social structure. Actual urban public transport planning needs to select transport means that not only have appropriate speed and level of punctuality but also are compatible with the scale, structure and the demand of each city's population. Among the above requirements, everyday travel time is one of the most significant criteria to evaluate quality of life. Apart from travel speed and density of public transport terminals, walking time between home and stations crucially affects total travel time within urban areas. Because each person's commuting ability depends on age and physical ability, the sphere of walking should be carefully considered in public traffic transport network planning in order to enhance the living convenience. This research focuses on walkability and accessibility, aims to evaluate travel quality of each public transport in urban areas by using algorithmic models to analyze travelling time as well as physical and mental consumption index of public transport users. In addition, the study also conducts quantitative analysis on travelling quality in order to evaluate accessibility and applies the developed model to the central area of Utsunomiya City in order to verify the model. The algorithmic model analyzes three basic public transport means in the city, which are bus, BRT and subway systems. The model assumes that the researched urban area is 1200x1200m wide, public transport routes are arranged horizontally in the center of the area, and the walking routes are arranged horizontally and perpendicularly, which means the walking distances are measured by the Manhattan distance metric. The model will calculate total traveling time of pedestrians including walking time and public transports using time. The sphere of travelling is assumed to be among the three distances that are 1200m, 4800m, and 9600m. Using the total travelling time projected by the model, the study calculates total users' travel energy consumption by age. In addition, based on the algorithmic analysis of the central area of Utsunomiya City including JR Utsunomiya station as the centroid, the study analyzes the impact of walkability on people's travelling quality and research further on evaluating how convenient living environment in Utsunomiya city can be by the implementation of the three basic public transportation means. Based on the final result, the study elucidates the impact of station distribution in term of density and distance on users' travelling time. Especially, the study analyzes different levels of travelling quality by public transports between ages based on factors of walking speed, weight and resting metabolic rate. The study gives specific results in convenience level of each public transport means which can be used as a basis for establishing the assessments and selection of most suitable transports in urban planning.

With the development of society and the Internet and the advent of the cloud era, people began to pay attention to big data. The background of big data brings opportunities and challenges to the research of urban intelligent transportation networks. Urban transportation system is one of the important foundations for maintaining urban operation. The rapid development of the city has brought tremendous pressure on the traffic, and the congestion of urban traffic has restricted the healthy development of the city. Therefore, how to improve the urban transportation network model and improve transportation and transportation has become an urgent problem to be solved in urban development. Specific patterns hidden in large-scale crowd movements can be studied through transportation networks such as subway networks to explore urban subway transportation modes to support corresponding decisions in urban planning, transportation planning, public health, social networks, and so on. Research on urban subway traffic patterns is crucial. At the same time, a correct understanding of the behavior patterns and laws of residents’ travel is a key factor in solving urban traffic problems. Therefore, this paper takes the metro operation big data as the background, takes the passenger travel behavior in the urban subway transportation system as the research object, uses the behavior entropy to measure the human behavior, and actively explores the urban subway traffic mode based on the metro passenger behavior entropy in the context of big data. At the same time, the congestion degree of the subway station is analyzed, and the redundancy time optimization model of the subway train stop is established to improve the efficiency of the subway operation, so as to provide important and objective data and theoretical support for the traveler, planner and decision maker. Compared to the operation graph without redundant time, the total travel time optimization effect of passengers is 7.74%, and the waiting time optimization effect of passengers is 6.583%.

Quantifying the consumer’s dependence on different information sources on acceptance of autonomous vehicles

BackgroundSubjective well-being (SWB) in older adults is a key indicator of psychological health and quality of life. However, research on trajectories of SWB is quite limited, and little is known about the relationship between anxiety/depression and trajectories of SWB in older adults. This study aimed to identify the trajectories of SWB in older adults and examine the association between anxiety/depression and trajectories of SWB.MethodsA population-based cohort study, the National Health and Aging Trends Study in the United States from 2015 to 2022. SWB was assessed through 11 items, including positive/negative emotions (4 items), self-realization (4 items), self-efficacy, and resilience (3 items). Anxiety/depression symptoms were assessed by the Patient Health Questionnaire-4 (PHQ-4). The group-based trajectory modeling identified trajectories. The design-based weighted multinomial logistic regression was used to examine the association between anxiety/depression and SWB trajectories.ResultsOf 5,057 included older adults, 59.22% were aged between 60 and 74 years old, 55.5% were female, and 82.23% were non-Hispanic White. Four trajectories of SWB were identified: Group 1 (low, slightly-declining SWB, 8.7%), Group 2 (moderate, declining SWB, 25.4%), Group 3 (moderate, slightly-declining SWB, 42.2%), and Group 4 (high, slightly-declining SWB, 23.7%). Higher anxiety/depression scores were associated with low or moderate SWB trajectories: Group 1 (odds ratio, OR: 3.35, 95% confidence interval, CI: 2.73, 4.00), Group 2 (OR: 2.59, 95% CI: 2.20, 3.00), and Group 3 (OR: 1.80, 95% CI: 1.49, 2.18).ConclusionThe trajectories of SWB varied among older adults. Anxiety/depression was significantly associated with SWB trajectories. Evidence-based effective strategies for the management of anxiety/depression are needed to maintain SWB at a high level in older adults.What does this paper contribute to the broader global clinical community?•This study identifies four distinct trajectories of subjective well-being in older adults.•Anxiety/depression is significantly associated with subjective well-being trajectories.•Our study highlights the importance of screening and longitudinally tracking SWB in older adults.•Effective prevention and intervention of anxiety/depression is a high priority to maintain or improve SWB in older adults.

More travel, more well-being of older adults? A longitudinal cohort study in China

This paper investigates the potential impacts of dynamic wireless power transfer (DWPT) systems on the urban road network with a particular focus on charging and energy consumption implications. The paper is motivated by the recent advancement of connected and autonomous vehicle (CAV) technology and innovations on smart transportation infrastructure. An eco‐driving model aiming at energy consumption reduction is developed and a DWPT system layout suitable for charging eco‐driving CAVs at a signalised intersection is proposed. The idea is demonstrated in a simulated environment with different market penetration rate (MPR) of CAVs travelling through a signalized intersection equipped with the proposed DWPT system. The results suggest that as MPR of CAV increases, the energy savings for both CAVs and human‐driven vehicles (HVs) will increase significantly. At full MPR of CAVs, the reduction of average energy consumption of all types of vehicles can reach up to 62%. The average energy transferred and stored per battery electric vehicle can increase by up to 5% and 10%, respectively. These promising results indicate that a well‐designed DWPT system layout together with the eco‐driving behaviour of CAVs can have a positive impact on the urban transportation system in terms of resulting energy consumption and emissions.

Global aging has raised increasing concerns on the health and well-being of older adults. Public transport is a viable option to improve the mobility and quality of life among older adults. However, policies that promote the public transport use among older adults are rare. This study utilizes the eXtreme Gradient Boosting (XGBoost) decision tree to explore the non-linear associations of the built and social environment with bus use among older adults in China. The bus use of older adults was obtained from the Zhongshan Household Travel Survey (ZHTS) in 2012. Results show that non-linear relationships exist among all built environment and social environment characteristics. Within certain thresholds, the percentage of green space land use, land use mixture, bus-stop density, and dwelling unit density are positively related to bus use among older adults. Likewise, one social environment variable, the proportion of older adults in a neighborhood, is the key social environment variable. Furthermore, the dwelling unit density and proportion of older adults appear to have an inverse U-shaped relationship. Additionally, age, ownership of motorcycles, and distance from home to the nearest bus stop also show non-linearity. The findings presented in this paper facilitate effective planning interventions to promote bus use among older adults.

The article is devoted to the problems of effective management of urban transport and logistics systems. The aim of the article is to highlight the paradigm of effective management of urban transport and logistics systems. To achieve this goal, the following tasks were solved: to form the structure of the concept of transport and logistics system; to find out the essence of the city transport and logistics system; to systematize the risks that affect the efficiency of urban transport and logistics systems, and to explore the concept of managing these risks; provide modeling as a useful tool for designing and evaluating urban transport and logistics systems. The set goal has been achieved, and the tasks to achieve it have been completed. The goals of activities that can be achieved with the use of the city transport and logistics system were identified, in the context of which the factors influencing the city transport and logistics system are listed: mobility; environmental friendliness; viability; stability. The links between human security and the city's transport and logistics system have been identified. It was found that ICT and ITS allow to develop efficient and environmentally friendly urban delivery systems. An example of this is probabilistic or dynamic vehicle routing and scheduling with ITS-based time windows. The need for modeling for the public and private sectors is proved. It is shown that in the public sector, the risks associated with natural and man-made hazards in urban freight transport systems directly affect the public well-being and health of the population in emergencies. It has been proven that the public sector is interested in finding a reduction in damage to urban logistics facilities and rapid recovery from natural disasters in terms of delivery of goods needed to maintain a high quality of life in urban areas. The need to include uncertainty in the urban logistics model is described to ensure their good performance in the future. Various methods have been shown to account for uncertainties in supply chain modeling, such as scenario and contingency planning, decision trees, and stochastic programming. Simulation has been shown to be a useful tool for the design and evaluation of urban freight and logistics systems. It has been confirmed that urban transport systems need to be more resilient to limit the effects of natural disasters.