Accessible Locations Research Articles

Optimized demand-based charging networks for long-haul trucking in Europe

Abstract Battery electric trucks (BETs) are the most promising option for fast and large-scale CO2 emission reduction in road freight transport. Yet, the limited range and longer charging times compared to diesel trucks make long-haul BET applications challenging, so a comprehensive fast charging network for BETs is required. However, little is known about optimal truck charging locations for long-haul trucking in Europe. Here we derive optimized truck charging networks consisting of publicly accessible locations across the continent. Based on European truck traffic flow estimates for 2030 and actual truck stop locations we construct a long-term charging network that minimizes the total number of required locations. Our approach introduces an origin-destination pair sampling method and includes local capacity constraints to compute an optimized stepwise network expansion along the highest demand routes in Europe. For an electrification target of 15% BET share in long-haul and without depot charging, our results suggest that about 91% of electric long-haul truck traffic across Europe can be enabled already with a network of 1,000 locations, while 500 locations would suffice for about 50%. We furthermore show how the coverage of origin-destination flows scales with the number of locations and the size of the stations. Ideal locations to cover many truck trips are at highway intersections and along major European road freight corridors (TEN-T core network).

Potential for photosynthesis on Mars within snow and ice

On Earth, solar radiation can transmit down to multiple metres within ice, depending on its optical properties. Organisms within ice can harness energy from photosynthetically active radiation while being protected from damaging ultraviolet radiation. On Mars, the lack of an effective ozone shield allows ~30% more damaging ultraviolet radiation to reach the surface in comparison with Earth. However, our radiative transfer modelling shows that despite the intense surface ultraviolet radiation, there are radiatively habitable zones within exposed mid-latitude ice on Mars, at depths ranging from a few centimetres for ice with 0.01–0.1% dust, and up to a few metres within cleaner ice. Numerical models predict that dense dusty snow in the martian mid-latitudes can melt below the surface at present. Thus, if small amounts of liquid water are available at these depths, mid-latitude ice exposures could represent the most easily accessible locations to search for extant life on Mars.

On-device Training: A First Overview on Existing Systems

The recent breakthroughs in machine learning (ML) and deep learning (DL) have catalyzed the design and development of various intelligent systems over wide application domains. While most existing machine learning models require large memory and computing power, efforts have been made to deploy some models on resource-constrained devices as well. A majority of the early application systems focused on exploiting the inference capabilities of ML and DL models, where data captured from different mobile and embedded sensing components are processed through these models for application goals such as classification and segmentation. More recently, the concept of exploiting the mobile and embedded computing resources for ML/DL model training has gained attention, as such capabilities allow (i) the training of models via local data without the need to share data over wireless links, thus enabling privacy-preserving computation by design, (ii) model personalization and environment adaptation, and (iii) deployment of accurate models in remote and hardly accessible locations without stable internet connectivity. This work summarizes and analyzes state-of-the-art systems research that allows such on-device model training capabilities and provides a survey of on-device training from a systems perspective.

Comparing expedient and proactive approaches to the planning of protected area networks on Borneo

Protected areas are an important tool for wildlife conservation; however, research is increasingly revealing both biases and inadequacies in the global protected area network. One common criticism is that protected areas are frequently located in remote, high-elevation regions, which may face fewer threats compared to more accessible locations. To explore the conservation implications of this issue, we consider a thought experiment with seven different counterfactual scenarios for the Sunda clouded leopard’s conservation on Borneo. This allows us to examine two contrasting paradigms for conservation: “proactive conservation” which prioritises areas with high biodiversity and high risk of development, and “expedient conservation” which focusses on areas with the lowest development risk. We select clouded leopards as our focal species not only because of their emerging conservation importance, but also because, as top predators, they represent both keystone species and ambassadors for wider forest biodiversity. Furthermore, a published analysis of the likely impacts of forest loss in their habitat provides a benchmark for evaluating the modelled outcomes of alternative hypothetical conservation scenarios. We find that, across all metrics, expedient reserve design offered few benefits over the business-as-usual scenario, in contrast to the much greater conservation effectiveness of proactive protected area design. This paper sheds light on the challenging trade-offs between conservation goals and the competing land uses essential for the economic development and well-being of local communities.

Democracy in distress? Examining the impact of the COVID-19 pandemic on voter behavior in the 2020 general election in the Greater Boston Area

The conditions of a highly anticipated election during the COVID-19 pandemic present an opportunity to further understand how voting accessibility influenced voting behavior in the 2020 United States general election. At the time of the election, nonpharmaceutical interventions, such as wearing a facemask, physical distancing, and crowd avoidance, were the primary defenses against contracting and spreading the virus. In response to the pandemic, several states enacted emergency voting laws that extended early voting days, loosened restrictions on acquiring an absentee ballot, and provided accessible ballot drop-off locations to reduce health and safety barriers to voters during the pandemic. This study uses a mixed methods design to investigate the motivating factors of voting behavior among Democrat and Independent voters in the Greater Boston Area in the 2020 general election. Based on data from an original survey of 169 individuals and 56 follow-up interviews conducted in early 2021, we find that the predicted probability of being a convenience voter (voting by mail, early voting, ballot drop box, or dropping their ballot at their polling location) goes from 50 % (p < .001) among those who did not express safety concerns related to voting to 82 % (p < .0001), an increase of 32 %. These findings were further triangulated in follow-up interviews with the survey participants. In our follow-up interviews, we also found that electoral integrity was a concern among both traditional and convenience voters; many individuals made a plan to vote in person, vote early, or drop their ballot off at a polling site or drop box to ensure their vote was counted. More broadly, the implications of this research place importance on state election law and election administration in a time of crisis. We expect that in a future crisis, such as a natural disaster or disease outbreak, convenience voting such as extended early voting options, ballot drop boxes, and relaxed restrictions around absentee voting options, may reduce barriers to voting experienced during uncertain or unsafe conditions and facilitate institutional certainty.

Assessing the Availment and General Satisfaction of Student Services Offered by the University of Baguio: A Study of Student Perspectives

The research aimed to evaluate the utilization of student services at the University of Baguio and gauge overall satisfaction levels. Data was collected and analyzed using a survey questionnaire approach. The survey questionnaire was administered to the School of Criminal Justice and Public Safety students enrolled during the first semester of School Year 2023-2024. The study focused on students enrolled in the University of Baguio School of Criminal Justice and Public Safety, selected through random sampling. The findings indicate that services enhancing convenience, particularly those situated in easily accessible locations like the Admission and Records Center, Library, and Student Accounts Office, were frequently availed by respondents. Respondents were generally aware of the services provided by the university but tended to utilize them as needed. The study yielded a satisfactory outcome, reflecting that respondents actively engaged with and expressed contentment regarding the available services.

Older Adults' Perceptions of Cognitive, Physical, and Exergame Training: A Mixed Methods Investigation of a Four-Armed Randomized Controlled Pilot Trial.

Purpose: Although the health benefits of behavioral interventions for older adults are well studied, research focused on intervention acceptability in older adult populations is less established and is needed. This mixed methods study investigated older adults' perceptions of training interventions. Methods: Community-dwelling older adults (N = 41) were randomized into three groups (cognitive, physical, and exergame) and completed 20 in-lab training sessions over 10 weeks. At every fifth session, participants provided feedback on their perceived gains across functional domains, enjoyment of and motivation to complete training, and aspects they most and least enjoyed regarding study participation. Results: Based on the multivariate analysis of variance, perceived cognitive and everyday function gains did not vary by training group. However, physical and exergame groups perceived greater improvement in physical function than the cognitive training group (P < 0.001). Enjoyment of and motivation to complete training did not vary by training group. Exploratory qualitative coding results suggest that participants across groups most enjoyed social interaction and feelings of improvement. Participants least enjoyed traveling to the study site and engaging in aspects of training (e.g., specific games, structure or duration of training). Conclusion: These findings highlight the importance of incorporating meaningful social engagement and balancing the challenge of training components with goal attainment when working with older adults, regardless of the intervention type. Future research and practice should consider salient aspects of the participant experience (e.g., social connection, accessible locations or remote options) when designing interventions for older adults.

Retrieval of dominant methane (CH4) emission sources, the first high-resolution (1–2 m) dataset of storage tanks of China in 2000–2021

Abstract. Methane (CH4) is a significant greenhouse gas in exacerbating climate change. Approximately 25 % of CH4 is emitted from storage tanks. It is crucial to spatially explore the CH4 emission patterns from storage tanks for efficient strategy proposals to mitigate climate change. However, due to the lack of publicly accessible storage tank locations and distributions, it is difficult to ascertain the CH4 emission spatial pattern over a large-scale area. To address this problem, we generated a storage tank dataset (STD) by implementing a deep learning model with manual refinement based on 4403 high-spatial-resolution images (1–2 m) from the Gaofen-1, Gaofen-2, Gaofen-6, and Ziyuan-3 satellites over city regions in China with officially reported numerous storage tanks in 2021. STD is the first storage tank dataset for over 92 typical city regions in China. The dataset can be accessed at https://doi.org/10.5281/zenodo.10514151 (Chen et al., 2024). It provides a detailed georeferenced inventory of 14 461 storage tanks wherein each storage tank is validated and assigned the construction year (2000–2021) by visual interpretation of the collected high-spatial-resolution images, historical high-spatial-resolution images of Google Earth, and field survey. The inventory comprises storage tanks with various distribution patterns in different city regions. Spatial consistency analysis with the CH4 emission product shows good agreement with storage tank distributions. The intensive construction of storage tanks significantly induces CH4 emissions from 2005 to 2020, underscoring the need for more robust measures to curb CH4 release and aid in climate change mitigation efforts. Our proposed dataset, STD, will foster the accurate estimation of CH4 released from storage tanks for CH4 control and reduction and ensure more efficient treatment strategies are proposed to better understand the impact of storage tanks on the environment, ecology, and human settlements.

Digital Fracture Porosity Measurement using Digital Outcrop Modelling (DOM)

Abstract Fracture measurements for porosity calculations often experience problems such as barely accessible locations, limited area coverage, and a long time to carry out field data measurements. Therefore, refined alternative methods are necessary to obtain the most favourable data. This study demonstrates fracture measurements through application of Digital Outcrop Modelling (DOM) using the Structure from Motion (SfM) method to utilize digital photogrammetry techniques. This method was chosen because data collection can be done remotely using Light Detection and Ranging (LiDAR) or digital photogrammetry to obtain point cloud data that is used to perform three-dimensional outcrop modeling. In addition, SfM also produces high-resolution data without the need for experts, is cost-efficient and safer than other methods. Hand-held platform Canon 700D digital single lens reflex (DSLR) camera was used in this study to capture data from an area of a square meter located on the riverbed that requires detailed modeling. DOM using SfM is applied to conduct aperture measurements in fractures inside the scan window, later used as data for calculating basement fracture porosity predictions. Field data collection is also carried out to validate data generated by DOM. Calculations achieved from field data and DOM data will be compared to determine differences of the porosity prediction values. Field data collection was carried out on 3 scan windows, each one is an area of 1 m2 and in totals obtained 117 fracture data, consist of 44 extension joints, 34 release joints, 7 shear joints, and 32 non-systematic joints. In this study, 115 photos were taken from scanwindow 1, 162 photos from scanwindow 2, and 158 photos from scanwindow 3 to construct the DOM using agisoft metashape software. The difference in these values can be used as a correction formula or evaluation for further research. The results of measuring basement fracture porosity using data generated by DOM will remain in the range of less than 1%.

Influence of Quality, Price, Place, and Promotion on Coffee Purchases

This study investigates how product quality, price, place, and promotion influence consumer purchasing decisions for Fore Coffee in Buduran District. Using quantitative methods and a Probability Sampling approach with 96 respondents, data were collected via online questionnaires distributed through social media. Analysis using SPSS version 22 includes validity, reliability, and classical assumption tests, along with multiple linear regression analysis. Results confirm that higher product quality, competitive pricing, accessible locations, and effective promotions significantly impact consumer decisions. The findings suggest that Fore Coffee should prioritize maintaining high product standards, competitive pricing, convenient locations, and engaging promotional strategies to enhance consumer purchasing behavior in Buduran District, offering practical implications for marketing management strategies in the coffee industry. Highlights: Quantitative analysis: SPSS used for robust consumer behavior insights. Marketing influence: Product quality, price, place, promotion impact purchasing decisions. Recommendations: Enhance quality, pricing, and promotions for consumer engagement strategies. Keywords: Coffee industry, consumer behavior, marketing strategies, quantitative research, Fore Coffee.

Coupled CFD-FEM analysis of the damage causes of the retention bunker: a case study at hard coal mine

Underground coal storage bunkers serve as crucial infrastructural components in the coal mining industry, providing secure and accessible locations for the storage of mined coal. The interaction between stored coal and underground water in coal storage bunkers indeed poses significant challenges due to the unpredictable nature of the resulting coal-water mixture. This phenomenon is particularly prevalent in coal mines operating under water hazards, where groundwater infiltration into storage areas can lead to the formation of coal-water mixtures, altering the physical properties of the stored coal. The interaction between coal and water can result in the formation of coal-water mixtures (hydromixture), which exhibit complex rheological properties. These mixtures may vary in viscosity, density, and particle size distribution, making their behavior difficult to predict. Underground water may exert hydrostatic pressure on the stored coal, influencing its mechanical behavior and compaction properties. Changes in pressure can result in coal compaction or expansion, affecting bunker stability and the integrity of surrounding rock strata. The main goal of the paper was to determine the values of pressure field variations exerted by the flowing hydromixture within underground coal storage bunkers. This objective reflects a critical aspect of understanding the dynamic behavior of coal-water mixtures (hydromixture) under varying conditions, particularly in environments where water hazards pose significant challenges to storage and operational stability. The paper utilized computational fluid dynamics (CFD) methods to examine the changes in pressure within underground coal storage bunkers induced by the flow of coal-water mixtures. The examination of damage to an underground coal storage bunker due to stress distribution was conducted using the finite element method (FEM). This computational technique is widely utilized in engineering and structural analysis to model complex systems and predict the behavior of materials under various loading conditions The results of the CFD numerical simulation were compared with the mathematical models.

LGG-58. A MULTI-CENTER RETROSPECTIVE CASE SERIES OF SURGICAL OUTCOMES FOR INTRAVENTRICULAR JUVENILE PILOCYTIC ASTROCYTOMA

Abstract INTRODUCTION Juvenile pilocytic astrocytoma (JPA) is a common pediatric grade I astrocytoma. Prognosis is excellent with gross total resection (GTR) and 10-year survival rates of up to 95%. However, undesirable outcomes may occur, such as when tumors are in poorly accessible locations. Intraventricularly tumors present a unique surgical challenge due to their midline location in a fluid filled space with any intraparenchymal invasion involving critical neurologic structures. Here we retrospectively describe the clinical features of intraventricular JPA neoplasms from two centers to highlight the challenges in caring for this uncommon presentation. METHODS We retrospectively searched the electronic medical record from 2000-2023 for patients with neurosurgical treatment for intraventricular JPA at two centers. Intraventricular location was verified by a neuroradiologist. Data were collected on demographics, pathology, tumor location, extent of resection, adjuvant therapies, reoccurrence, progression, and neurological deficit. RESULTS We identified 28 surgical treated patients with intraventricular JPA. Females were 15/28 (54%) of patients with a mean age of 11.2±6.4 years. Most tumors presented in the 4th ventricle 15/28 (53.5%), followed by 9/28 (32%) in 3rd ventricle locations, and 4/28 (14%) in lateral ventricles. GTR was achieved in 12/28 patients (43%) and STR in 16/28 patients (57%). Progression/recurrence was noted in 8/28 (29%) and the 5-year PFS was 56% (10/18). Adjuvant treatment was used in 11/28 (39%) patients and repeat surgery was required in 4/28 patients (14%). Chemotherapy in 8/28 (29%) patients and radiation in 4/28 (14%) patients. A pre/post-operative neurological deficit was noted in 10/28 (36%) patients. A BRAF protein fusion was noted in 7 patients and 1 patient demonstrated a v600E mutation (some molecular data not available). Average follow up was 92 months with no deaths. CONCLUSION We observed that intraventricular JPA tumors commonly undergo subtotal resection with frequent progression/recurrence. Subsequently, recurrent surgeries and adjuvant therapies can be necessary.

Acceptability of digital vending machines to improve access to sexual and reproductive health in Brighton, UK: a qualitative analysis

IntroductionSexual health remains a public health priority and relies on widely available testing to enable prompt diagnosis and treatment. Technology-based approaches to distribute tests have potential to increase access and...

Exploring adolescent girls and young women's PrEP-user profiles: qualitative insights into differentiated PrEP delivery platform selection and engagement in Cape Town, South Africa.

Adolescent girls and young women (AGYW), a priority population for HIV prevention in Africa, show high interest but difficulty in sustained effective use of pre-exposure prophylaxis (PrEP). With ongoing PrEP scale-up focused on increasing access, it is important to understand what influences AGYW's choice of PrEP delivery platforms. The POWER implementation study in Cape Town provided PrEP between 2017 and 2020 to AGYW (16-25 years) from four differentiated delivery platforms: mobile clinic, government facility, courier delivery or community-based youth club. Healthcare providers at government and mobile clinics provided PrEP (initiation and refills) as part of comprehensive, integrated sexual and reproductive health services. Courier and youth club platforms provided light-touch PrEP refill services incorporating rapid HIV self-testing. We conducted in-depth interviews with a purposive sample of AGYW who had ≥3 months of PrEP-use and accessed ≥2 PrEP delivery platforms. The thematic analysis explored AGYW's preferences, decision-making and habits related to PrEP access to inform market segmentation. We interviewed 26 AGYW (median age 20) PrEP-users between November 2020 and March 2021. AGYW PrEP-users reported accessing different services with, 24 accessing mobile clinics, 17 courier delivery, 9 government health facilities and 6 youth clubs for their PrEP refills. Qualitative findings highlighted four potential behavioural profiles. The "Social PrEP-user" preferred PrEP delivery in peer spaces, such as youth clubs or adolescent-friendly mobile clinics, seeking affirmation and social support for continued PrEP use. The "Convenient PrEP-user" favoured PrEP delivery at easily accessible locations, providing quick (courier) or integrated contraception-PrEP refill visits (mobile and government clinic). The "Independent PrEP-user" preferred PrEP delivery that offered control over delivery times that fit into their schedule, such as the courier service. The "Discreet PrEP-user" highly valued privacy regarding their PrEP use (courier delivery) and avoided delivery options where unintentional disclosure was evident (youth club). Comfort with HIV self-testing had minimal influence on PrEP delivery choice. Market segmentation of AGYW characterizes different types of PrEP-users and has the potential to enhance tailored messaging and campaigns to reach specific segments, with the aim of improving sustained PrEP use and HIV prevention benefits.

Comparison of surface-wave techniques to estimate S- and P-wave velocity models from active seismic data

Abstract. The acquisition of seismic exploration data in remote locations presents several logistical and economic criticalities. The irregular distribution of sources and/or receivers facilitates seismic acquisition operations in these areas. A convenient approach is to deploy nodal receivers on a regular grid and to use sources only in accessible locations, creating an irregular source–receiver layout. It is essential to evaluate, adapt, and verify processing workflows, specifically for near-surface velocity model estimation using surface-wave analysis, when working with these types of datasets. In this study, we applied three surface-wave techniques (i.e., wavelength–depth (W/D) method, laterally constrained inversion (LCI), and surface-wave tomography (SWT)) to a large-scale 3D dataset obtained from a hard-rock site using the irregular source–receiver acquisition method. The methods were fine-tuned for the data obtained from hard-rock sites, which typically exhibit a low signal-to-noise ratio. The wavelength–depth method is a data transformation method that is based on a relationship between skin depth and surface-wave wavelength and provides both S- and P-wave velocity (Vs and Vp) models. We used Poisson's ratios estimated through the wavelength–depth method to constrain the laterally constrained inversion and surface-wave tomography and to retrieve both Vs and Vp also from these methods. The pseudo-3D Vs and Vp models were obtained down to 140 m depth over an area of approximately 900 × 1500 m2. The estimated models from the methods matched the geological information available for the site. A difference of less than 6 % was observed between the estimated Vs models from the three methods, whereas this value was 7.1 % for the retrieved Vp models. The methods were critically compared in terms of resolution and efficiency, which provides valuable insights into the potential of surface-wave analysis for estimating near-surface models at hard-rock sites.

The Moving Mountain: Performance for Mauna a Wākea during the Protect Maunakea Movement

Abstract: Between the period of July 2019 and March 2020, Kānaka Maoli (Native Hawaiian) kia‘i (protectors or guardians) blocked the access road up to Mauna a Wākea, Hawai‘i’s tallest peak, to protest and prevent the construction of the Thirty Meter Telescope (TMT). This proposed development, spearheaded by a conglomerate of international scientific organizations, has become the catalyst for the latest movement for reestablishing Hawaiian sovereignty after a long history of appropriation, desecration, and broken promises. For Kānaka Maoli the construction poses a threat to their sacred land, burial sites, and the delicate ecology of the mountain. During these protests, kia‘i demonstrated and reconfirmed their relationship to Mauna a Wākea through the mediums of music and dance in the newly created Mauna Protocol Ceremony performed at the protest site on Hawai‘i Island, public performance venues, and online. Performing for the mountain at accessible locations allowed more people to view and interact with Mauna a Wākea without having to be on location. It is through the Hawaiian concepts of ‘ike (know by doing), kū (stand firm), and hulihia (overturn) that I illustrate how kia‘i effectively transform secular spaces into sacred ones through the act of performance.

Tele-psychotherapy for individuals with obsessive-compulsive disorder during the COVID-19 outbreak: A qualitative study.

One way of delivering psychological services is tele-psychotherapy, which has attracted significant attention as a viable approach. This study aimed to identify important variables in the application of tele-counseling and psychotherapy for the treatment of patients with obsessive-compulsive disorder (OCD) in Isfahan, Iran. This research employed an exploratory qualitative methodology. The participants of this study consisted of all the clients with OCD and all the psychotherapists in the city of Isfahan. Purposive sampling was employed, and following a series of semi-structured interviews with 35 individuals with OCD and 11 counselors in this area, the sample size reached a saturation point. The data was analyzed by Braun and Clark's thematic analysis method. Based on the findings of Braun and Clark's analysis, three primary themes emerged concerning tele-counseling: opportunities, requirements, and challenges. According to the feedback received from therapists and clients, remote services could offer promising prospects to both groups by providing accessible locations and flexible time management. However, to get the full benefits of teletherapy, therapists should consider certain factors to enhance the therapeutic alliance. Moreover, there are challenges that need to be addressed.

Assessing vertical green walls for indoor corridors in educational buildings and its impact outdoor: A field study at the universities of Canada in Egypt

Developing Green Walls (GW) within the architectural realm involves integration of diverse functions to optimize the indoor performance of the GW, and outdoor in campus buildings. The methodology is fundamentally rooted in the selection and fulfillment of strategic incorporation of additional function-based GW design to various performance aspects through contextual design solutions. This approach is particularly crucial in the education sector, on utilizing GW to educate students as occupants in integrating gardening, ecology, botany, and beyond in their studies for decreasing the environmental pollution for new generations, to feel by environment indoor in accomplishing way for sustainability perceptions.The aim of the study is to assess the effective resources influencing vertical green walls needed for educational buildings to reduce the effect of indoor heat, to upgrade its air quality, simultaneously decreasing noise pollution to avoid the energy consumption. The Educational GW should be accessible easily, either by installing them naturally in accessible locations with appropriate heights or by designing the facilities to increase the student's integration with GW natural environment that will reflect on their academic progress and health. The study aims to assess the effect of green wall installation in the universities of Canada in Egypt campus in the heat gain reduction, energy consumption, CO2 emission reduction by using the Design-Builder simulation program to measure the effect of green wall installation in corridors and inner courtyard at the hottest period of the year (August 2:00 p.m.) and how it can decrease the cooling loads by 10.95 %:19.14 %, heating loads by 4.8 %:12.94 %, CO2 emission by 13 %:28.43 % and the monthly electricity bill by 35:41.5 % measuring the vertical greening cost in relative to short and long period as a needed sustainable technology to reduce building demand significantly.

Conflicting regional policy goals: accessibility and segregation in the Helsinki metropolitan area

ABSTRACT Regional land use, housing, and transport (MAL) agreements between the Finnish state and municipalities in growth regions guide urban policy in the Helsinki metropolitan area towards regional cooperation and densification. Alongside economic growth and connectivity goals, segregation prevention is a visible but ill-defined social sustainability goal in these agreements, and anti-segregation measures lean heavily on providing new social housing in accessible locations. This tool, in turn, leans on a combination of social mixing, a traditional preventive tool in fighting segregation, and a new tool, maximising spatial justice through transit-oriented development. We argue that there is a discrepancy between these goals: while on an individual level, public transport accessibility is meant to reduce transport poverty and provide equal opportunities for employment and services, accessible areas fare lower than others in socioeconomic status. Therefore, increasing social rental housing in areas with lower socioeconomic status may unintentionally amplify segregation. This article asks how actors of different governance levels view concentrating social housing in accessible locations as a risk to segregation. Interviews show a concern of social challenges not being sufficiently addressed.

Engaging the Great Circle: a qualitative study of the Confederated Tribes of Grand Ronde’s mobile medication unit

Background The Confederated Tribes of the Grand Ronde Community of Oregon began a Mobile Medication Unit (MMU) as part of their Great Circle Recovery Opioid Treatment Program (OTP) to address elevated rates of opioid use disorder (OUD) among American Indians and Alaska Natives in Oregon. The MMU provides methadone or buprenorphine for individuals with OUD, enrolled in the OTP, who are living either on the reservation or in surrounding rural communities. An implementation study describes the service through document review and qualitatively assesses patient and staff experiences and the perceived barriers and facilitators to mobile services. Methods Semi-structured qualitative interviews with patients (n = 11), MMU staff (n = 5), and the state opioid treatment authority (n = 1) gathered details on the initiative’s development and operations. Provider interviews probed implementation experiences. Patient interviews focused on their experiences with the MMU and staff, changes in quality of life and recommendations for enhancing treatment. Interviews were transcribed and analysed using a Thematic Analysis approach. Results Staff themes identified two driving forces (i.e. staff desire for an inclusive approach to wellness that is accessible to all community members; the catalysts for the MMU), two steps toward MMU development (i.e. Tribal approvals and support; the construction and maintenance of community relationships) and two perspectives on MMU implementation and impact (i.e. initial implementation barriers; facilitators and observations of how the MMU reduced stigma associated with agonist therapy). Patients’ themes noted the MMU’s professional and ‘caring’ environment, accessible rural locations and general suggestions including culturally responsive ancillary services. Conclusion The Great Circle MMU enhanced access to opioid agonist therapy for people with OUD (i.e. American Indians/Alaska Natives, and non-natives) living in rural communities. The Confederated Tribes of Grand Ronde operates the first Tribally owned OTP MMU, grounded in cultural humility and committed to Tribal members and the great circle of the larger community.