Inner-city Areas Research Articles

How peri-urban areas can strengthen animal populations within cities: A modeling approach

We explore the extent to which inner-city fauna can be enhanced by source areas in peri-urban zones as a response to a decreasing quality and size of green habitats within cities. The objectives were to get a better understanding of the interaction between animal populations of urban and peri-urban areas, and the role of urban green structures within this relationship, and to find out the extent to which peri-urban areas can contribute to urban animal populations. We illustrate the idea of peri-urban support by using a simulation model for individual animal movement, applied in a particular case-study with butterflies as model species. Results show differences in accessibility of inner-city areas between model butterfly species that differ in mobility. The impact of peri-urban individuals on populations of inner-city habitats differed among several peri-urban source-scenarios: the enlargement of the inner-city butterfly population by peri-urban individuals was determined as 7–36% for ‘moderate dispersers’ and 19–56% for ‘good dispersers’. Results also show that well-connected habitat patches within existing urban green structures were more likely to be visited by peri-urban individuals than isolated habitat patches. We conclude that peri-urban nature areas, if large enough, can have a potentially positive influence on the presence of fauna in inner-city neighborhoods. In addition, results suggest that connectivity between inner-city and peri-urban habitat patches enhances contribution of peri-urban migrants to inner-city populations. By providing a range of different habitats, from inner-city up to peri-urban area, moderately mobile habitat specialists could better compete against the small set of successful habitat generalists that are increasing in urban environments all over the world.

Blackout 2003: Preparedness and Lessons Learned from the Perspectives of Four Hospitals

The blackout in North America of August 2003 was one of the worst on record. It affected eight US states and parts of Canada for >24 hours. Additionally, two large US cities, Detroit, Michigan and Cleveland, Ohio, suffered from a loss of water pressure and a subsequent ban on the use of public supplies of potable water that lasted four days. A literature review revealed a paucity of literature that describes blackouts and how they may affect the medical community. This paper includes a review of after-action reports from four inner-city, urban hospitals supplemented accounts from the authors' hospital's emergency operations center (EOC). Some of the problems encountered, included: (1)lighting; (2) elevator operations; (3) supplies of water; (4) communication operations; (5) computer failure; (6) lack of adequate supplies of food; (7) mobility to obtain X-ray studies; (8) heating, air condition, and ventilation; (9) staffing; (10) pharmacy; (11) registration of patients; (12) hospital EOC; (13) loss of isolation facilities; (14) inadequate supplies of paper; (15) impaired ability to provide care for non-emergency patients; (16) sanitation; and (17) inadequate emergency power. The blackout of 2003 uncovered problems within the US hospital system, ranging from staffing to generator coverage. This report is a review of the effects that the blackout and water ban of 2003 had on hospitals in a large inner-city area. Also discussed are solutions utilized at the time and recommendations for the future. The blackout of 2003 was an excellent test of disaster/emergency planning, and produced many valuable lessons to be used in future events.

The nutritional status of women in the first trimester of pregnancy attending an inner-city antenatal department in the UK

We have previously found high rates of poor iron and folate status in women who had delivered a low birthweight baby (LBW) in an ethnically diverse inner-city area of the UK. However, little was known of the nutritional status in the local general obstetric population. We therefore investigated biochemical measures of nutritional status in the first trimester of the first pregnancy. Routine blood samples collected at the antenatal booking clinic were analysed for haemoglobin (Hb), serum ferritin, red cell folate (RCF) (n = 100) and erythrocyte transketolase activation coefficient (ETKAC) for thiamin status (n = 90). We found 9% of women in our sample had a low Hb level, 10% had a low serum ferritin and only one had a low RCF. This is a substantially lower number of women with biochemical deficiencies than we found previously in women three months after delivering a LBW baby. However, 34% had low thiamin status. Thiamin status was negatively correlated with gestational age at birth (r = -0.407, p < 0.001). Differences in nutritional status were observed between ethnic and socio-economic groups. Hb levels differed between ethnic (p = 0.001) and socio-economic groups (p = 0.02), with Africans and women in manual occupations/unwaged having the lowest Hb levels. RCF levels also differed between groups (p < 0.001) with Caucasians and those in non-manual occupations having highest levels. ETKAC also differed between ethnic groups (p = 0.008) with Africans having the highest level indicating a poorer status. The study highlights the need to improve nutrition particularly in ethnic minorities and low income groups who are most at risk of adverse birth outcomes such as LBW.

The Genealogical Imagination: The Inheritance of Interracial Identities

The aim of this article is to examine ethnographically how ideas of descent, biology and culture mediate ideas about the inheritance of racial identities. To do this, the article draws upon interviews with the members of interracial families from Leicester, a city situated in the East Midlands region of England. The article focuses upon the genealogical narratives of the female members of interracial families who live in an ethnically diverse inner-city area of Leicester. Attention is paid to the ways in which the women mobilise and intersect ideas about kinship, ancestry, descent, belonging, place, biology and culture when they think about the inheritance of their own and/or their children's interracial identities. The article's emphasis upon the constitution of interracial identities contributes to the sociological study of race and genealogy by exploring the racialised fragmentation of ideas of inheritance and descent across racial categories and generations.

Attitudes Toward Antipsychotic Medication

Nonadherence to antipsychotic medication is a major cause of psychotic relapse and is strongly influenced by attitudes toward treatment. Although patient variables such as insight and symptoms that contribute toward attitudes have been identified, the contributions of relationship and service factors have not been adequately studied. To determine relations between clinical and service variables and attitudes toward medication in people with a diagnosis of schizophrenia and schizoaffective disorder. Consecutively admitted patients were approached to take part; 23 refused. Measures included symptoms, insight, drug adverse effects, self-reported adherence, attitudes toward treatment, perceived relationship with the prescriber, ward atmosphere, and admission experience. Data were analyzed by a proportional odds model and structural equation modeling to test predicted paths between experience of admission, relationship variables, attitudes toward treatment, and self-reported adherence to medication. Twenty-eight inpatient wards at 8 hospitals in North Wales and the Northwest of England. Sites included hospitals with inner-city and rural catchment areas. Patients Two hundred twenty-eight patients meeting DSM-IV criteria for schizophrenia or schizoaffective disorder, assessed during acute admission. Attitudes toward treatment and self-reported adherence to medication. The data fit a model in which attitudes toward treatment were predicted by insight, relationship with staff (especially the physician-prescriber), and the patient's admission experience (maximum likelihood chi(2)(49) = 89.3, P<.001). A poor relationship with the prescriber, experience of coercion during admission, and low insight predicted a negative attitude toward treatment. The quality of relationships with clinicians during acute admission appears to be an important determinant of patients' attitudes toward treatment and adherence to medication. Enhancing such relationships may yield important clinical benefits.

Infectious disease in pregnancy

Summary Despite the advent of antibiotics and improved diagnostic facilities, infectious diseases in pregnancy continue to be significant contributors to maternal and fetal morbidity and mortality. These are more common in the developing than the developed nations, where poverty, a lack of hygiene, a lack of medical resources and a lack of trained health-care workers are common. Although infectious diseases in pregnancy are not so common in the UK, there has been an increase in the incidence of syphilis, tuberculosis and HIV in pregnancy in inner-city areas. This has implications for health-care professionals, who require a knowledge of these conditions along with the other infectious diseases that are likely to influence maternal and/or fetal and neonatal health. This article discusses some of the significant infections encountered in practice and others that are not as common but require a higher index of suspicion and appropriate investigations to improve maternal and fetal outcomes.

Misunderstandings: a qualitative study of primary care consultations in multilingual settings, and educational implications

Patients in inner-city areas come from increasingly diverse language and cultural backgrounds. Neither communications training modelled on local English speakers nor the provision of interpreters offer adequate solutions. To identify how patients with limited English and culturally different communication styles consult with general practitioners (GPs) in English, and to develop training strategies from both good practice and observed misunderstandings. Randomly selected routine and emergency surgeries in 19 inner London general practices were video-recorded. The videos were viewed independently by 2 discourse analysts. Key consultations, across a wide range of English language ability, were selected and transcribed to analyse misunderstandings resulting from language/cultural differences. Of the 232 video recordings that were made, 20% were with patients with limited English and contained major and often extended misunderstandings. QUALITATIVE ANALYSIS: Four main categories of patient 'talk' contributing to misunderstandings are identified: (1) pronunciation and word stress; (2) intonation and speech delivery; (3) grammar, vocabulary and lack of contextual information; and (4) style of presentation. The importance of different styles of self-presentation by patients as the reason for misunderstandings is highlighted. On only 3 occasions were culturally specific health beliefs raised. It is routine for GPs in inner London practices to manage consultations with patients with culturally different communicative styles from their own. Specific training in identifying these problems and preventing/repairing them in the consultation is essential. This level of awareness-raising is more crucial than general discussions of culturally different health belief models.

Playing house: A ‘sideways’ glance at literacy and identity in early childhood

Drawing on theoretical perspectives related to play and identity, play as a literary and social text, and multimodality, I present an analysis of a play narrative centred on the theme of playing house. The narrative exemplifies the interconnections between literacy and identity in the social and cultural world of a young girl growing up in a multilingual, multi-literate household in an inner-city area of a western Canadian city. The example brings to the forefront how systematic examinations of children’s play narratives have the potential to contribute to current thought on literacy learning and self-construction in early childhood. Understanding the imagined identities children portray in play may be particularly revealing in terms of understanding how they position themselves in the world.

Revival of inner-city retail areas: The potential role of property owners

Little is known about the ownership structures and attitudes of property owners in non-central retail and business areas of inner cities in the UK. This paper reports the findings of a survey carried out in Cardiff which attempted to investigate these structures and attitudes. It is found that ownership is fragmented across a wide variety of local individuals and companies, and that attitudes range from apparently complete unconcern over the area's problems to a deep concern for the future.

Fear of Falling and Related Activity Restriction Among Middle-Aged African Americans

The prevalence of fear of falling and related activity restriction, and their joint distribution with falls and falls efficacy, have been inadequately addressed in population-based studies of middle-aged and African-American groups. The African American Health project is a population-based panel study of 998 African Americans born in 1936-1950 from two areas of metropolitan St. Louis (an impoverished inner-city area and a suburban area). Fear of falling, fear-related activity restriction, and 24 frailty-related covariates were assessed during in-home evaluations in 2000-2001. We found that 12.6% of participants reported having fear of falling without activity restriction, 13.2% had fear of falling with activity restriction, and 74.2% had no fear of falling. Neither fear of falling nor fear-related activity restriction varied significantly across three birth cohorts (1946-1950, 1941-1945, and 1936-1940). Lack of overlap of these two phenomena with having a fall in the past 2 years and low falls efficacy was considerable. When examined across three groups (no fear, fear without activity restriction, and fear with activity restriction), a consistent pattern of decreasing health status and social, emotional, and physical functioning was demonstrated. In this population-based sample of 49- to 65-year-old African Americans, fear of falling and fear-related activity restriction were surprisingly common and not well explained by prior falls or low falls efficacy. These phenomena were already evident by age 49-55. Further study is warranted, including detailed qualitative investigations examining the timing, precursors, and consequences of fear of falling and fear-related activity restriction in minority and majority populations.

Nurse Home Visitation Has Powerful and Enduring Effects

Community Pediatrics| March 01 2005 Nurse Home Visitation Has Powerful and Enduring Effects AAP Grand Rounds (2005) 13 (3): 26–27. https://doi.org/10.1542/gr.13-3-26 Views Icon Views Article contents Figures & tables Video Audio Supplementary Data Peer Review Share Icon Share Facebook Twitter LinkedIn MailTo Tools Icon Tools Get Permissions Cite Icon Cite Search Site Citation Nurse Home Visitation Has Powerful and Enduring Effects. AAP Grand Rounds March 2005; 13 (3): 26–27. https://doi.org/10.1542/gr.13-3-26 Download citation file: Ris (Zotero) Reference Manager EasyBib Bookends Mendeley Papers EndNote RefWorks BibTex toolbar search toolbar search search input Search input auto suggest filter your search All PublicationsAll JournalsAAP Grand RoundsPediatricsHospital PediatricsPediatrics In ReviewNeoReviewsAAP NewsAll AAP Sites Search Advanced Search Topics: home visits Sources: (1) Olds DL, Kitzman H, Cole R, et al. Effects of nurse home-visiting on maternal life course and child development: age 6 follow-up results of a randomized trial. Pediatrics. 2004; 114:1550–1559. (2) Olds DL, Robinson J, Pettitt L, et al. Effects of home visits by paraprofessionals and by nurses: age 4 follow-up results of a randomized trial. Pediatrics. 2004; 114:1560–1568. These 2 reports come from a research team that has been studying the effect of home visitation on maternal and child health for the past 25 years in a small community/ rural area (Elmira, NY), in an ethnically diverse metropolitan area (Denver, Colo), and in a predominantly black inner-city area (Memphis, Tenn). The first of these reports continues the follow-up of the study cohort in Memphis and examines whether the positive effects on mothers’ life courses and children’s cognitive and social development endure 4 years after the intervention (children at age 6). The mothers enrolled in the study were recruited from the obstetrics clinic of the Regional Medical Center in Memphis between 1990 and 1991. Women at <29 weeks gestation were recruited if they had no previous live births, no chronic illness detrimental to the fetus, and at least 2 of these 3 social characteristics: unmarried, less than 12 years of education, or unemployed. From 1290 consecutive women meeting these criteria, 1139 consented to participate, 693 were available for follow-up, 641 maternal assessments were completed, and 615 child assessments were completed. Maternal life course indicators included number and timing of subsequent pregnancies, education, employment, and durability of partner relationships. Child assessments included cognitive skills, language development and academic achievement, and social development. Mothers and infants were randomized into 4 treatment groups. For this report, 2 groups were compared. The intervention group of mothers received free transportation to their prenatal visits, nurse home visits during pregnancy, 1 postpartum nurse visit in the hospital, and nurse home visits until the child’s second birthday. Study mothers received a mean of 26 visits during their babies’ first 2 years. The control group received free transport to prenatal visits and developmental screening and referral for their children at 6, 12, and 24 months of age. The nurse-visited women had significantly fewer subsequent pregnancies (1.16 vs 1.38) and births (1.08 vs 1.28), less reliance on welfare (7.2 months vs 9 months), longer-relationships with current partners (54 months vs 45 months), and were more likely to enroll their children in pre-K programs (82% vs 75%). Nurse-visited children had significantly higher IQ’s (92.3 vs 90.2) and language scores (84.3 vs 82.1) and fewer significant behavior problems (1.8% vs 5.4%). The second report addresses the issue of paraprofessional versus nurse home visitation from pregnancy through child age 2 years. Paraprofessionals had a high school education but no college preparation in the helping professions, and strong “people skills.” Both paraprofessionals and nurses received 1 month of intensive training. The study population (n=735) in Denver included 3 arms with participants randomized... You do not currently have access to this content.

Outcome after Minor Traffic Accidents: A Follow-up Study of Orthopedic Patients in an Inner-City Area Emergency Room

This follow-up study of consecutive traffic accident victims aimed to characterize the variation in recuperation time, to estimate the incidence of delayed recovery, and to identify predictors of nonrecovery 1 and 6 months after the accident. This study included 318 of 811 consecutive patients. Whiplash type neck injuries (48%) were the most common, followed by other minor injuries (38%). Self-perceived recovery was reported by 31% and 56% of the patients at 1 and 6 months, respectively. With control for mutual confounding variables in a multivariate model, injury severity, working status, and education were associated, respectively, with 4.5-fold, 3.2-fold and 2.3-fold gradients in odds of recovery not reported at 1 month. At 6 months, only working status (odds ratio [OR], 3.2) and education (OR, 2.3) were associated with the risk of reporting nonrecovery. The authors concluded that social factors are important predictors of outcome 1 and 6 months after minor traffic accidents.

Reclaiming Urbanity: Indeterminate Spaces, Informal Actors and Urban Agenda Setting

This paper discusses the phenomenon of 'informal actors' influencing the agenda of urban planning and urban politics by means of temporary reappropriation and animation of 'indeterminate' spaces. The latter are spaces left out of 'time and place' with regard to their urban surroundings, mainly as a consequence of rampant deindustrialisation processes and the 'shrinking' city. The unclear and undetermined status of these urban 'no-man's-lands' may allow for the emergence of a non-planned, spontaneous 'urbanity'. This intervention may be based on different motives: marginal lifestyles, informal economies, artistic experimentation, a deliberately open transformation of public space allowing for equal access and equal representation or a high degree of social and cultural inclusion. These expressions of the 'lived' city at present constitute a pronounced paradox for established city planning and urban politics. Institutionalised stakeholders may occasionally appreciate their presence for their inherent potential to enhance attractiveness of and revitalisation of certain parts of the city. On the other hand, these sites and the actors involved also spatialise and visualise a resistance and temporary alternative to the institutionalised domain and the dominant principles of urban development. Urban restructuring in the post-Fordist city, foremost in the development of inner-city areas, is increasingly focused on a unidimensional logic of commodification, monofunctionality and control. Thus, the complex qualities of animated 'indeterminate' spaces are difficult to incorporate into planning procedures. They often become threatened in their existence and pushed to the margins. Nevertheless, the urban conflict around these sites and the appearance of 'non-planned' planners on the urban scene, may decisively alter the urban agenda and set the themes for further development, which takes their positive economic and social function and their key role in sustaining and renewing urban cultures into account. The paper discusses this phenomenon, illustrated with an account of three case studies in the cities of Helsinki, Berlin and Brussels. The comparative dimension allows for a subsequent discussion focusing on elaborating the conditions of 'success' for informal actors in urban development processes. The predominant question then is how these new forms of urbanism can be given a place in city planning in order to pay more justice to the social and cultural complexity that constitutes contemporary urbanity.

Calls to an Inner-City Hospital Breastfeeding Telephone Support Line

Support for breastfeeding mothers after they leave the hospital is often inadequate in low-income, inner-city areas where few resources are available. In becoming a Baby-Friendly Hospital, inner-city Boston Medical Center established a breastfeeding telephone support line to overcome this discrepancy. Records of support line calls for the first 5 years of operation were reviewed to record the level of need and determine reasons for use. A total of 1959 calls for 2482 reasons were received between January 1999 and December 2003. The most common reason for calling was "need help obtaining a breast pump" or "need information about breast pumps" (44%; 1096/2482), followed by "breast issue" (7%; 181/2482) and "milk supply question" (7%; 167/2482). The results indicate that inner-city women seek breastfeeding support and demonstrate a substantial need for breast pumps. These findings suggest that the lack of breast pumps may be a barrier to continued breastfeeding for inner-city breastfeeding women.

Recent life problems and non‐fatal overdose among heroin users entering treatment

To investigate the role of recent life problems in non-fatal overdose among heroin users entering various drug treatment settings. Cross-sectional data from a longitudinal study investigating drug treatment effectiveness. Five prison drug treatment services, three residential rehabilitation units, three residential detoxification units and 21 community drug treatment services located in rural, urban and inner-city areas of Scotland. Of a total of 793 primary heroin users commencing drug treatment during 2001-02, 337 (42.5%) were prison drug service clients; 91 (11.5%) were residential rehabilitation clients; 97 (12.2%) were residential detoxification clients; and 268 (33.8%) were community drug treatment clients. Univariate and stepwise multivariate logistic regression analyses examined associations between overdosing in the 90 days prior to treatment entry and basic demographic characteristics, recent drug use and recent life problems. Ninety-one study participants (11.5%) reported at least one overdose and 19 (2.4%) reported more than one overdose in the 90 days prior to treatment entry. A chi2 test revealed no significant difference in rates of recent overdosing between the four treatment settings (P = 0.650). Recent drug use and recent life problems-but not demographic characteristics-were associated independently with recent overdosing. However, recent life problems were not associated independently with recent overdosing among clients entering prison, clients entering residential rehabilitation or with multiple recent overdosing. Associations between recent life problems and recent overdose were evident, but varied by treatment setting. Treatment providers should identify and address heroin users' life problems as part of a broad strategy of overdose prevention.

The Camberwell Assessment of Need: comparison of assessments by staff and patients in an inner-city and a semi-rural community area

Aims and MethodThe aim of the study was to examine the association between the assessment of need by staff and by severely mentally ill patients using the Camberwell Assessment of Need in a semi-rural setting (Maidstone, n=50) and an inner-city area (Camberwell, n=127). Staff and patients were interviewed separately. We specifically examined differences in the total number of needs between Camberwell and Maidstone, differences in the number of unmet needs and differences in the level of agreement between staff and service users.ResultsPatients in Maidstone had fewer needs than those in Camberwell according to both staff (4.9 v. 5.8) and patients (4.2 v. 6.3), fewer unmet needs rated (staff, 1.1 v. 1.5; patients, 1.0 v. 1.9) and a greater level of concordance between staff and patients.Clinical ImplicationsThe needs of severely mentally ill patients were greater in the inner-city area compared with the semi-rural one. The fact that agreement between staff and service users was less in the inner-city area also suggests that more stable staff–patient relationships existed in the rural area.

1851年-1921年のバンコク旧市街地における土地の形成過程 : チャウプラヤー・デルタにおける居住空間の環境共生型計画 その1

1851年-1921年のバンコク旧市街地における土地の形成過程 : チャウプラヤー・デルタにおける居住空間の環境共生型計画 その1

Anarchy Is Order

Anarchy Is Order

Sanfte Gentrifizierung, Studentifizierung und Inseln ethnischer Konzentration in ostdeutschen Innenstadtrandgebieten?

The year 1997 marks a turning point in the development of east German inner-city fringe areas: many old residential quarters have registered clear increases in the number of inhabitants again after a phase of exodus. The time of the trend reversal coincides with the development of an excess supply of housing space and decreasing rents, which determine the situation of east German housing markets until today and allow a relatively large freedom of choice in the search for housing. Under these conditions the social contrasts between emptying areas and areas that receive immigrants are increasing. Simultaneously a cultural differentiation between individual urban sub-areas is emerging as a result of the development of characteristic milieus. The article aims to provide a deeper insight into the developments in old residential areas near the inner cities since the middle of the 1990's. Recent trends are considered by taking the social change in the inner-city fringe areas from the period of industrial expansion in Leipzig over a period eight years as a case in point.

What are drug users looking for when they contact drug services: abstinence or harm reduction?

Within the UK and in many other countries two of the most significant issues with regard to the development of health and social care services for drug users has been the growth of the consumer perspective and the philosophy of harm reduction. In this paper we look at drug users' aspirations from treatment and consider whether drug users are looking to treatment to reduce their risk behaviour or to become abstinent from their drug use. The paper is based on interviews using a core schedule with 1007 drug users starting a new episode of drug treatment in Scotland. Participants were recruited from a total of 33 drug treatment agencies located in rural, urban and inner-city areas across Scotland. Our research has identified widespread support for abstinence as a goal of treatment with 56.6% of drug users questioned identifying ‘abstinence’ as the only change they hoped to achieve on the basis of attending the drug treatment agency. By contrast relatively small proportions of drug users questioned identified harm reduction changes in terms of their aspiration from treatment, 7.1% cited ‘reduced drug use’, and 7.4% cited ‘stabilization’ only. Less than 1% of respondents identified ‘safer drug use’ or ‘another goal’, whilst just over 4% reported having ‘no goals’. The prioritization of abstinence over harm reduction in drug users treatment aspirations was consistent across treatment setting (prison, residential and community) gender, treatment type (with the exception of those receiving methadone) and severity of dependence. On the basis of these results there would appear to be a need for harm reduction services to be assiduous in explaining to clients the reason for their focus and for ensuring that drug users have access to an array of services encompassing those that stress a harm reduction focus and those that are more oriented towards abstinence.