California Planning Research Articles

Data acquisition process for VA and non-VA emergency department and hospital utilization by veterans with spinal cord injury and disorders in California using VA and state data

Context: To identify VA and non-VA Emergency Department (ED) and hospital utilization by veterans with spinal cord injury and disorders (SCI/D) in California. Design: Retrospective cohort study. Setting: VA and Office of Statewide Health Planning and Development (OSHPD) in California. Participants: Total 300 veterans admitted to the study VA SCI/D Center for initial rehabilitations from 01/01/1999 through 08/17/2014. Interventions: N/A. Outcome Measures: Individual-level ED visits and hospitalizations during the first-year post-rehabilitation. Results: Among 145 veterans for whom ED visit data available, 168 ED visits were identified: 94 (55.2%) at non-VA EDs and 74 (44.8%) at the VA ED, with a mean of 1.16 (±2.21) ED visit/person. Seventy-seven (53.1%) veterans did not visit any ED. Of 68 (46.9%) veterans with ≥ one ED visit, 20 (29.4%) visited the VA ED only, 34 (50.0%) visited non-VA EDs only, and 14 (20.6%) visited both VA and non-VA EDs. Among 212 Veterans for whom hospitalization data were available, 247 hospitalizations were identified: 82 (33.2%) non-VA hospitalizations and 165 (66.8%) VA hospitalization with a mean of 1.17 (±1.62) hospitalizations/person. One hundred-seven (50.5%) veterans had no hospitalizations. Of 105 veterans with ≥ one hospitalization, 58 (55.2%) were hospitalized at the study VA hospital, 15 (14.3%) at a non-VA hospital, and 32 (30.5%) at both VA and non-VA hospitals. Conclusion: Non-VA ED and hospital usage among veterans with SCI/D occurred frequently. The acquisition of non-VA healthcare data managed by state agencies is vital to accurately and comprehensively evaluate needs and utilization rates among veteran populations.

Racial and Ethnic Disparities in Hospital-Based Care Associated with Postpartum Depression.

To estimate racial and ethnic differences in rates of hospital-based care associated with postpartum depression. This is a retrospective cohort study using International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) diagnosis codes within data from the Office of Statewide Planning and Development in California. We included primiparous women who underwent delivery hospitalization from 2008 to 2012. The primary outcome was the first postpartum hospital encounter with a ICD-9-CM code for depression over a 9-month period after delivery. We examined the cumulative incidence of hospital-based care for postpartum depression by race/ethnicity. Logistic regression was used to estimate relative risk. The study cohort consisted of 984,167 primiparous women: 314,037 (32%) were non-Hispanic White; 59,754 (6%) were non-Hispanic Black; 150,855 (15%) were non-Hispanic Asian; 448,770 (46%) were Hispanic; and 10,399 (1%) were other races. The cumulative incidence of hospital-based care for postpartum depression was highest for Black women (39; 95% CI = 34-44 per 10,000 deliveries) and lowest for Asian women (7; 95% CI = 5-8 per 10,000 deliveries). Compared with White women, hospital-based care for postpartum depression was more likely to be provided to Black women (OR = 2.3; 95% CI = 1.9-2.7), whereas care was less likely for Asians (OR = 0.4; 95% CI = 0.3-0.5) and Hispanics (OR = 0.8; 95% CI = 0.7-1.0). Similar findings were observed after excluding women with antepartum depression, adjusting for sociodemographic and clinical variables, and stratifying according to care settings. Compared with White women, hospital-based care for postpartum depression more frequently impacts Black women. Identifying and improving inequities in access to and utilization of mental health care for postpartum women should be a maternal health priority.

Maternal Health after Stillbirth: Postpartum Hospital Readmission in California.

The aim of this study is to assess whether the risk of postpartum readmission within 6 weeks of giving birth differs for women who had stillbirths compared with live births. Using data from the Office of Statewide Health Planning and Development in California, we performed a population-based cohort study of 7,398,640 births between 1999 and 2011. We identified diagnoses and procedures associated with the first postpartum hospital readmission that occurred within 6 weeks after giving birth. We used log-binomial models to estimate relative risk (RR) of postpartum readmission for women who had stillbirth compared with live birth deliveries, adjusting for maternal demographic, prepregnancy, pregnancy, and delivery characteristics. The rate of postpartum readmission was higher among women who had stillbirths compared with women who had live births (206 and 96 per 10,000 births, respectively). After adjusting for maternal demographic and medical characteristics, the risk of postpartum readmission for women who had stillbirths was nearly 1.5 times greater (adjusted RR = 1.47, 95% confidence interval: 1.35-1.60) compared with live births. Among women with stillbirths, the most common indications at readmission were uterine infection or pelvic inflammatory disease, psychiatric conditions, hypertensive disorder, and urinary tract infection. Based on our findings, women who have stillbirths are at higher risk of postpartum readmissions within 6 weeks of giving birth than women who have live births. Women who have stillbirths may benefit from additional monitoring and counseling after hospital discharge for potential postpartum medical and psychiatric complications. · Women who have stillbirths are at nearly 1.5 times greater risk of postpartum readmission than women who have live births.. · Uterine infections and pelvic inflammatory disease, and psychiatric conditions are the most common reasons for readmission among women who had a stillbirth.. · Women who have stillbirths may benefit from additional monitoring and counseling after hospital discharge for potential postpartum medical and psychiatric complications..

464: Antepartum anemia and racial/ethnic disparities in blood transfusion in california

Non-Hispanic Black women experience the highest rate of severe maternal morbidity (SMM) in the United States, a risk persistent after controlling for socioeconomic status. Our objective is to assess whether racial/ethnic disparities of antepartum iron deficiency anemia (IDA) contribute to disparities in blood transfusion, the major component of SMM, at birth. Using data from the Office of Statewide Health Planning and Development in California, we performed a retrospective population-based cohort study using 2,802,622 vital records linked to birth hospitalization discharge data from 2007-2012. We estimated racial/ethnic differences in blood transfusion before and after adjusting for differences in IDA present on admission for birth. We then evaluated the association between IDA and blood transfusion in racial/ethnic groups separately. We estimated odds ratios and population attributable risks (PAR) using multivariable logistic regression models adjusted for the Obstetric Comorbidity Index, insurance, education, parity, and timing of prenatal care initiation. Black women had the greatest prevalence of IDA at hospital admission for birth (8.2%) and blood transfusion during hospitalization (4.3%). The elevated risk of blood transfusion in Black women was significantly reduced by adjusting for IDA (aOR 1.61 to aOR 1.33; Table 1). Adjustment for IDA had a minimal impact on disparities in blood transfusion for other racial/ethnic groups, particularly in Asian/Pacific Islander women (aOR 1.47 for confounders, aOR 1.45 for confounders and IDA). Among Black women, the PAR suggested that the absence of IDA in Black women correlates with a decrease in 28.4 blood transfusions per 10,000 births (Table 2). Treatment of antepartum IDA has the potential to reduce blood transfusions, the leading contributor to SMM, for all pregnant women. This reduction will be the highest among non-Hispanic Black pregnant women.View Large Image Figure ViewerDownload Hi-res image Download (PPT)

181 Geriatric Sepsis Remains a Rapidly Rising Source of Health Care Utilization and Admissions

Sepsis remains a major challenge in modern medicine. Despite significant attention and substantial research to improve patient care, outcomes are frequently poor, particularly in the geriatric population. Importantly, the incidence of sepsis continues to rise across the United States. Better characterization of increasingly susceptible groups is indicated to identify patients at risk of poor incomes, particularly in the emergency department (ED), where the majority of septic patients initially present. We sought to use California-wide population characteristics to describe changes in incidence and mortality specifically as they relate to age between 2008 and 2015 and better characterize high-risk populations. Multi-center retrospective longitudinal cohort study derived from data from the Office of Statewide Health Planning and Development (OSHPD) database in California. Institutional review board approval was obtained prior to investigation. The OSHPD database is a state-funded registry that receives data regarding ED visits, inpatient stays and discharge data. Inclusion criteria: adult patients (age ≥ 18 years), with a primary or secondary diagnosis of sepsis, severe sepsis or septic shock based on previously validated methodology. Incidence was calculated as the number of cases of sepsis per 1000 admissions whereas mortality was calculated as the proportion of admission. Age categories were defined as: 18 - 44, 45 - 64, 65 - 74, 75 - 84, and 85+. Microsoft Excel and SPSS, version 25, were used to analyze data. Descriptive statistics were used as indicated. A total of 1,566,283 patients with sepsis were identified between 2008 and 2015 from the OSHPD database. Patients older than 65 made up 60.3% of admissions for sepsis, despite representing approximately 12% of the population during this time period. Figure 1 shows a significant increase in the incidence of sepsis in all age groups with a decrease in mortality during this time period. The largest increase in incidence per 1000 admissions occurred in patients 75 - 84 years old and those 85+, from 83.3 to 111.8 and 100.2 to 133.3 over the 7-year time period, respectively. Other major associations with admission included multiple comorbidities, defined as a Charlson comorbidity score ≥ 3, particularly in the older age groups and nursing home status. Of patients 85+ years old, 18.5% were nursing home residents prior to admission whereas 37.3% were discharged to a nursing home. Geriatric sepsis remains a significant driver of health care utilization, resources and mortality despite increased sepsis awareness. Additional investigations into optimal care of the geriatric patient in the ED with sepsis are indicated.

Urologic Injury and Fistula After Hysterectomy for Benign Indications.

To explore the rates and risk factors for sustaining a genitourinary injury during hysterectomy for benign indications. In this population-based cohort study, all women who underwent hysterectomy for benign indications were identified from the Office of Statewide Health Planning and Development databases in California (2005-2011). Genitourinary injuries were further classified as identified at the time of hysterectomy, identified after the date of hysterectomy; or unidentified until a fistula developed. Of the 296,130 women undergoing hysterectomy for benign indications, there were 2,817 (1.0%) ureteral injuries, 2,058 (0.7%) bladder injuries and 834 (0.3%) genitourinary fistulas (80/834 of which developed after an injury repair). Diagnosis was delayed in 18.6% and 5.5% of ureteral and bladder injuries, respectively. Subsequent genitourinary fistula development was lower if the injury was identified immediately (compared with delayed) for both ureteral (0.7% vs 3.4% odds ratio [OR] 0.28; 95% CI 0.14-0.57) and bladder injuries (2.5% vs 6.5% OR 0.37; 95% CI 0.16-0.83). Indwelling ureteral stent placement alone was more successful in decreasing the risk of a second ureteral repair for immediately recognized ureteral injuries (99.0% vs 39.8% for delayed injuries). With multivariate adjustment, prolapse repair (OR 1.44, 95% CI 1.30-1.58), an incontinence procedure (OR 1.40, 95% CI 1.21-1.61), mesh augmented prolapse repair (OR 1.55, 95% CI 1.31-1.83), diagnosis of endometriosis (OR 1.46, 95% CI 1.36-1.56), and surgery at a facility in the bottom quartile of hysterectomy volume (OR 1.37, 95% CI 1.01-1.89) were all associated with an increased likelihood of a genitourinary injury. An exclusively vaginal (OR 0.56, 95% CI 0.53-0.64) or laparoscopic (OR 0.80, 95% CI 0.75-0.86) approach was associated with lower risk of a genitourinary injury as compared with an abdominal approach. Genitourinary injury occurs in 1.8% of hysterectomies for benign indications; immediate identification and repair is associated with a reduced risk of subsequent genitourinary fistula formation.

Severe Maternal Morbidity Among Stillbirth and Live Birth Deliveries in California.

To assess the prevalence and risk of severe maternal morbidity among delivery hospitalization for stillbirth compared with live birth deliveries. Using data from the Office of Statewide Health Planning and Development in California, we performed a population-based cross-sectional study of 6,459,842 deliveries between 1999 and 2011. We identified severe maternal morbidity using an algorithm comprising diagnoses and procedures developed by the Centers for Disease Control and Prevention and used log-binomial regression models to examine the relative risk (RR) of severe maternal morbidity for stillbirth compared with live birth deliveries, adjusting for maternal demographic, medical, and obstetric characteristics. We also examined severe maternal morbidity prevalence by cause of fetal death among stillbirth deliveries. The prevalence of severe maternal morbidity for stillbirth and live birth was 578 and 99 cases per 10,000 deliveries, respectively. After adjusting for maternal demographic, medical, and obstetric characteristics, the risk of severe maternal morbidity among stillbirth deliveries was more than fourfold higher (adjusted RR 4.77; 95% CI 4.53-5.02) compared with live birth deliveries. The severe maternal morbidity prevalence was highest among stillbirths caused by hypertensive disorders and placental conditions (24 and 19 cases/100 deliveries, respectively), and lowest among stillbirths caused by fetal malformations or genetic abnormalities (1 case per 100 deliveries). Women who have stillbirths are at substantially higher risk for severe maternal morbidity than women who have live births, regardless of cause of fetal death. The prevalence of severe maternal morbidity varies by cause of fetal death.

Urologic Injury and Fistula Following Hysterectomy for Benign Indications [37S

INTRODUCTION: Genitourinary injury is a rare but devastating complication following hysterectomy. Literature regarding this topic is limited, so we explored genitourinary injury rates (and risk factors for injury) in a population based dataset with long term follow-up. METHODS: All women who underwent a hysterectomy for benign indications were identified using data from the Office of Statewide Health Planning and Development in California from 2005-2011. Cases of genitourinary injury were identified (either identified intraoperatively or missed). RESULTS: Of the 296,130 women who underwent hysterectomy, 5,455 (1.8%) suffered at least one urologic injury: 2,817 (1.0%) ureteral, 2,058 (0.70%) bladder and 831 (0.3%) fistulas. Sustaining an injury increased the risk of future fistula (1.1% and 2.7% versus 0.3%, p<0.001), however immediate identification and repair of the injury decreased this risk for both ureteral (0.7% versus 3.4%, p<0.001) and bladder (2.5% versus 6.5%, p<0.001) injuries. Multivariate modeling revealed that concomitant POP repair (OR 1.12, p=0.019), a diagnosis of endometriosis (OR 1.40 p<0.001) and surgery at a facility in the bottom 25% of hysterectomy volume (OR 1.37, p=0.049) were associated with increased likelihood of injury, while vaginal (OR 0.85, p=<0.001) or laparoscopic (OR 0.81, p<0.001) approach and diagnosis of endometrial hyperplasia/abnormal uterine bleeding (OR 0.91, p=0.004) were associated with a decreased risk of injury. CONCLUSION: Benign hysterectomy carries a ∼1.8% risk of genitourinary injury. Although injury increases the chance of fistula formation, recognizing the injury immediately reduces this risk. We identify several factors that are associated with injury, providing insight where a higher index of suspicion might be held.

Effects of urbanization on regional meteorology and air quality in Southern California

Abstract. Urbanization has a profound influence on regional meteorology and air quality in megapolitan Southern California. The influence of urbanization on meteorology is driven by changes in land surface physical properties and land surface processes. These changes in meteorology in turn influence air quality by changing temperature-dependent chemical reactions and emissions, gas–particle phase partitioning, and ventilation of pollutants. In this study we characterize the influence of land surface changes via historical urbanization from before human settlement to the present day on meteorology and air quality in Southern California using the Weather Research and Forecasting Model coupled to chemistry and the single-layer urban canopy model (WRF–UCM–Chem). We assume identical anthropogenic emissions for the simulations carried out and thus focus on the effect of changes in land surface physical properties and land surface processes on air quality. Historical urbanization has led to daytime air temperature decreases of up to 1.4 K and evening temperature increases of up to 1.7 K. Ventilation of air in the LA basin has decreased up to 36.6 % during daytime and increased up to 27.0 % during nighttime. These changes in meteorology are mainly attributable to higher evaporative fluxes and thermal inertia of soil from irrigation and increased surface roughness and thermal inertia from buildings. Changes in ventilation drive changes in hourly NOx concentrations with increases of up to 2.7 ppb during daytime and decreases of up to 4.7 ppb at night. Hourly O3 concentrations decrease by up to 0.94 ppb in the morning and increase by up to 5.6 ppb at other times of day. Changes in O3 concentrations are driven by the competing effects of changes in ventilation and precursor NOx concentrations. PM2.5 concentrations show slight increases during the day and decreases of up to 2.5 µg m−3 at night. Process drivers for changes in PM2.5 include modifications to atmospheric ventilation and temperature, which impact gas–particle phase partitioning for semi-volatile compounds and chemical reactions. Understanding process drivers related to how land surface changes effect regional meteorology and air quality is crucial for decision-making on urban planning in megapolitan Southern California to achieve regional climate adaptation and air quality improvements.

Evolving the Evolving: Territory, Place and Rewilding in the California Delta

Current planning and legislation in California’s Sacramento-San Joaquin Delta call for the large-scale ecological restoration of aquatic and terrestrial habitats. These ecological mandates have emerged in response to the region’s infrastructural transformation and the Delta’s predominant use as the central logistical hub in the state’s vast water conveyance network. Restoration is an attempt to recover what was externalized by the logic and abstractions of this logistical infrastructure. However, based on findings from our research, which examined how people are using restored and naturalized landscapes in the Delta and how these landscapes are currently planned for, we argue that as mitigatory response, restoration planning continues some of the same spatial abstractions and inequities by failing to account for the Delta as an urbanized, cultural and unique place. In interpreting how these conditions have come to be, we give attention to a pluralistic landscape approach and a coevolutionary reading of planning, policy, science and landscapes to discuss the conservation challenges presented by “Delta as an Evolving Place”. We suggest that for rewilding efforts to be successful in the Delta, a range of proactive, opportunistic, grounded and participatory tactics will be required to shift towards a more socio-ecological approach.

Racial and Socioeconomic Disparities in Short-term Urethral Sling Surgical Outcomes

To evaluate the association of racial and socioeconomic factors with the risk of adverse events in the first 30 days following urethral sling placement. We accessed nonpublic data from the Office of Statewide Health Planning and Development in California from 2005 to 2011. All female patients who underwent an ambulatory urethral sling procedure in the entire state of California over the study period were identified (Current Procedural Terminology 57288). Our main outcome was any unplanned hospital visits within 30 days of the patient's surgery in the form of an inpatient admission, revision surgery, or emergency department visit. A total of 28,635 women who underwent outpatient urethral sling placement were identified. Within 30 days, 1628 women (5.7%) had at least 1 unplanned hospital visit. In the adjusted multivariate model, black race and Medicaid insurance status were both independently associated with increased odds of having an unplanned hospital visit (odds ratio 1.80, P < .01 and odds ratio 1.53, P < .01, respectively). This significance persisted even when controlling for patient comorbidities, demographics, and facility characteristics. We found that, similar to what has been reported in other fields, disparities in outcomes exist between socioeconomic and racial groups in the field of urogynecology.

Costs of coronary heart disease and mortality associated with near-roadway air pollution

BackgroundEmerging evidence indicates that the near-roadway air pollution (NRAP) mixture contributes to CHD, yet few studies have evaluated the associated costs. ObjectiveWe integrated an assessment of NRAP-attributable CHD in Southern California with new methods to value the associated mortality and hospitalizations. MethodsBased on population-weighted residential exposure to NRAP (traffic density, proximity to a major roadway and elemental carbon), we estimated the inflation-adjusted value of NRAP-attributable mortality and costs of hospitalizations that occurred in 2008. We also estimated anticipated costs in 2035 based on projected changes in population and in NRAP exposure associated with California's plans to reduce greenhouse gas emissions. For comparison, we estimated the value of CHD mortality attributable to PM less than 2.5μm in diameter (PM2.5) in both 2008 and 2035. ResultsThe value of CHD mortality attributable to NRAP in 2008 was between $3.8 and $11.5 billion, 23% (major roadway proximity) to 68% (traffic density) of the $16.8 billion attributable to regulated regional PM2.5. NRAP-attributable costs were projected to increase to $10.6 to $22 billion in 2035, depending on the NRAP metric. Cost of NRAP-attributable hospitalizations for CHD in 2008 was $48.6 million and was projected to increase to $51.4 million in 2035. ConclusionsWe developed an economic framework that can be used to estimate the benefits of regulations to improve air quality. CHD attributable to NRAP has a large economic impact that is expected to increase by 2035, largely due to an aging population. PM2.5-attributable costs may underestimate total value of air pollution-attributable CHD.

Collaborative Approaches to Flow Restoration in Intermittent Salmon-Bearing Streams: Salmon Creek, CA, USA

In Mediterranean-climate regions of California and southern Oregon, juvenile salmon depend on groundwater aquifers to sustain their tributary habitats through the dry summers. Along California’s North Coast streams, private property regimes on land have created commons tragedies in groundwater and salmon fisheries, both classic examples of commons that are often governed collectively and sustainably by their users. Understanding the linkages between salmon and groundwater is one major focus of salmon recovery and climate change adaptation planning in central California and increasingly throughout the Pacific Northwest. In this paper, I use extended field interviews and participant-observation in field ecology campaigns and regulatory forums to explore how, in one water-scarce, salmon-bearing watershed on California’s central coast, collaborators are synthesizing agency and landowner data on groundwater and salmon management. I focus on three projects undertaken by citizen scientists in collaboration with me and Gold Ridge Resource Conservation District staff: salmonid censuses, mapping of wet and dry stream reaches and well monitoring. I find that collaborative research initiated by local residents and agency personnel has, in some cases, created a new sense of ecological possibility in the region. I also consider some limitations of this collaborations, namely the lack of engagement with indigenous Pomo and Miwok tribal members, with the Confederated Tribes of Graton Rancheria and with farmworkers and other marginalized residents, and suggest strategies for deepening environmental justice commitments in future collaborative work.

Missing the Boat on Freshwater Fish Conservation in California

AbstractPopulation growth and increasing water‐use pressures threaten California's freshwater ecosystems and have led many native fishes to the brink of extinction. To guide fish conservation efforts, we provide the first systematic prioritization of river catchments and identify those that disproportionately contribute to fish taxonomic diversity. Using high‐resolution range maps of exceptional quality, we also assess the representation of fish taxa within the state's protected areas and examine the concordance of high‐priority catchments with existing reserves and among distinct taxonomic groups. Although most of the state's native fishes are found within protected areas, only a small proportion of their ranges are represented. Few high‐priority catchments occur within protected areas, suggesting that fish conservation will require active management and targeted river restoration outside of reserves. These results provide the foundation for systematic freshwater conservation planning in California and for prioritizing where limited resources are allocated for fish recovery and protection.

Relationship between hospital financial performance and publicly reported outcomes.

Hospitals that have robust financial performance may have improved publicly reported outcomes. To assess the relationship between hospital financial performance and publicly reported outcomes of care, and to assess whether improved outcome metrics affect subsequent hospital financial performance. Observational cohort study. Hospital financial data from the Office of Statewide Health Planning and Development in California in 2008 and 2012 were linked to data from the Centers for Medicare and Medicaid Services Hospital Compare website. Hospital financial performance was measured by net revenue by operations, operating margin, and total margin. Outcomes were 30-day risk-standardized mortality and readmission rates for acute myocardial infarction (AMI), congestive heart failure (CHF), and pneumonia (PNA). Among 279 hospitals, there was no consistent relationship between measures of financial performance in 2008 and publicly reported outcomes from 2008 to 2011 for AMI and PNA. However, improved hospital financial performance (by any of the 3 measures) was associated with a modest increase in CHF mortality rates (ie, 0.26% increase in CHF mortality rate for every 10% increase in operating margin [95% confidence interval: 0.07%-0.45%]). Conversely, there were no significant associations between outcomes from 2008 to 2011 and subsequent financial performance in 2012 (P > 0.05 for all). Robust financial performance is not associated with improved publicly reported outcomes for AMI, CHF, and PNA. Financial incentives in addition to public reporting, such as readmissions penalties, may help motivate hospitals with robust financial performance to further improve publicly reported outcomes. Reassuringly, improved mortality and readmission rates do not necessarily lead to loss of revenue. Journal of Hospital Medicine 2016;11:481-488. © 2016 Society of Hospital Medicine.

Collaboration and Equity in Regional Sustainability Planning in California: Challenges in Implementation

Regions across the United States have developed sustainability plans and programs funded through the U.S. Department of Housing and Urban Development’s Sustainable Communities Initiative (SCI). In California, this grant overlapped with a state mandate for regional sustainability planning, SB 375, legislation charging regions with developing long-range sustainability plans to reduce greenhouse gas emissions. Regional agencies lead sustainability planning efforts, yet little is known about how effective and equitable regions are in their engagement with sustainability planning. We examined how three federally funded SCI projects in California incorporate social equity and explore the process and outcomes. We focus on the conditions under which regional collaboration is most conducive to incorporating equity. We found that equity approaches vary greatly by region and are as much about process as product. Networks of information sharing, trust and relationships in regions awarded SCI grants have increased. However, regional sustainability planning processes are not without conflict as participants maneuver though historic institutional challenges.

Book Reviews

Planning Sustainable Cities and Regions: Towards More Equitable Development, Karen Chapple, NY, Routledge, 2015, 307 pp., US$155.00, ISBN 978-1-13-878966There have been a large number of books published on sustainability planning since the 1990s. For teachers or scholars of sustainability planning, one challenge is not a lack of choices but too many choices. This book by Karen Chapple, a Professor of the University of California, Berkeley, can be recommended. It distinguishes itself from competing choices by connecting 'planning dogmas' to 'changes that are occurring in our population, preferences, technology, and economy' (p. 14), and by presenting instructive real-world cases. It thus initiates intriguing discussions regarding how planning dogmas and practices have adapted to, and should adapt to the above changesChapters 1 and 2 serve as the introduction. They paint the big picture of contemporary cities/regions, their planning and the contexts where planning is embedded. The author argues that 'lively, safe, sustainable, and healthy' cities/regions are now commonly accepted across countries. But planning such cities/regions is a serious challenge. Planning as a profession has established paradigms regarding how to conceptualise and manage a series of relationships, 'between people and plans, economy and place, and the poor and their life changes', which have a lot to do with sustainability (p. 3). However, recent years have seen significant trends in population, preferences, technology and economy and this necessitates changes in planning paradigms so as to best deal with emerging opportunities and challenges. For instance, the US will become a country where the minority is the majority, where there are more millennials than baby boomers and where the youth is experiencing higher unemployment rates. This would engender challenges for planning and beyond where the region is a better unit of analysis and for interventions. Based on this, the author examines the evolution of regional sustainability planning in the US and surveys representative regional sustainability efforts outside the US. The introduction concludes with descriptions of sustainability planning in California and the San Francisco Bay Area, which the author treats as a leader.The main body (Chapters 3 to 13) has three parts: development, economic development and equity, which correspond to the triple bottom lines of sustainability. Each part re-conceptualises the aforementioned paradigms, supplemented by selected realworld cases. Part 1 describes the necessity and challenges faced by infill development and other planning and policy tools. It regards the former as one of the least challenging planning and policy tools. Each tool, however, says the author, can be instrumental and destructive to realising sustainability/ development goals. In San Francisco, for instance, the author shows that reactive infill development and mixed-income development have exacerbated gentrification rather than lessened it.Part 2 argues that developing high-quality jobs that match the skills of local disadvantaged workers should be at least equally important as those traditional approaches such as stimulating exports, promoting agglomerations and cultivating entrepreneurship. It uses various cases in California to back up this argument. Again, the author cautions readers that tools which work in Place A may not work in Place B. …

Licence to drill?

California plans to do away with the clinical licensing exam in favour of a more longitudinal approach to assessment.

Activity-specific ecological niche models for planning reintroductions of California condors (Gymnogyps californianus)

Ecological niche models can be a useful tool to identify candidate reintroduction sites for endangered species but have been infrequently used for this purpose. In this paper, we (1) develop activity-specific ecological niche models (nesting, roosting, and feeding) for the critically endangered California condor (Gymnogyps californianus) to aid in reintroduction planning in California, Oregon, and Washington, USA, (2) test the accuracy of these models using empirical data withheld from model development, and (3) integrate model results with information on condor movement ecology and biology to produce predictive maps of reintroduction site suitability. Our approach, which disentangles niche models into activity-specific components, has applications for other species where it is routinely assumed (often incorrectly) that individuals fulfill all requirements for life within a single environmental space. Ecological niche models conformed to our understanding of California condor ecology, had good predictive performance when tested with data withheld from model development, and aided in the identification of several candidate reintroduction areas outside of the current distribution of the species. Our results suggest there are large unoccupied regions of the California condor’s historical range that have retained ecological features similar to currently occupied habitats, and thus could be considered for future reintroduction efforts. Combining our activity-specific ENMs with ground reconnaissance and information on other threat factors that could not be directly incorporated into empirical ENMs will ultimately improve our ability to select successful reintroduction sites for the California condor.

Lessons from Renewables Planning in California and Suggestions to Korea

California has established aggressive Renewables Portfolio Standards (RPS) goals to increase the fraction of electricity generated from renewable energy resources and to decrease greenhouse gas emissions under AB 32. By 2010, 20% of California's electricity is required to come from renewables, and 33% has been proposed as a goal for 2020. Most of this new renewable generation will require the electric grid for delivering its electricity to customers. Renewable generators will be integrated into the electric grid at both the transmission and distribution levels, but most of them are expected to connect to the transmission system in locations remote from load centers and existing transmission infrastructure, thus requiring transmission extensions. Some of this renewable generation will exhibit properties quite different from traditional generation and loads, which pose special challenges for providing timely adequate grid delivery capacity, maintaining reliability, and avoiding economic inefficiencies. Finally, power flow constraints through transmission “gateways” into population centers must be relieved before the electricity from renewables can reach customers. In addition to constructing effective transmission interconnections between the renewable resource development areas and California's high-voltage electrical grid, it will be necessary to expand the transmission system capability between the backbone grid transmission gateways and from the transmission gateways to the local load centers. Meeting these challenges for the successful integration of renewables into the electric delivery system will require new or expanded capabilities for the grid. At higher RPS levels, the conventional “build” solutions alone will prove inadequate. New transmission technologies offer the prospect of providing a substantial portion of these new or expanded capabilities. In this report, we investigate how California is dealing with these challenges. We are covering current status, planning issues and operational issues of renewable energy. We hope this report is useful to whom studying renewable energy.