Urban Institutions Research Articles

Assessing citizen satisfaction of urban local government service and infrastructure in Bangladesh: A case study of Pabna municipality

The provision of essential services to residents heavily relies on the infrastructure and functioning of urban local government institutions. The satisfaction citizens have with these institutions is an important indicator of the effectiveness of governance mechanisms. This study aims to assess the degree of citizen satisfaction with urban local government services and infrastructure, specifically in the context of Pabna municipality in Bangladesh. A qualitative and quantitative research approach was employed, utilizing survey data from 120 structured questionnaires and 20 interviews. The study results show that a significant proportion of municipality residents (56%) express deep dissatisfaction with basic services and infrastructure performance. The municipality has failed to effectively deliver sanitation, disaster management, waste management, roads and bridges, traffic infrastructure, and public utilities services as required. The study also identified key challenges in delivering basic services, including poor infrastructure, a lack of initiatives, adequate resources, a large workforce, and sufficient equipment. The findings suggest that the municipality should prioritize sustainable city planning through democratic participation and consideration of residents’ perceived experiences to deliver a high degree of citizen satisfaction.

Promise Program Effects at a Large, Urban Institution: A Study of Miami Dade College’s American Dream Scholarship

College promise programs, or place-based scholarships, are aimed at helping students attend and afford higher education. The American Dream Scholarship (ADS), offered by Miami Dade College (MDC), is a promise program that covers tuition and fees for the first 60 credits of an associate degree for students residing in and graduating from high school in Miami-Dade County. In this study, we relied on Bourdieu’s (1986) sociological framework to conceptualize the impact of the ADS on MDC’s student body. We posed the research question of whether the scholarship had any effect on total first-time, full-time college enrollment at MDC. Utilizing data primarily from the Integrated Postsecondary Education Data System, we used two comparison groups of colleges that were untreated by any county-level promise program: 26 colleges in the Florida College System and 37 public institutions nationally with the same Carnegie Classification as MDC. We applied difference-in-differences analyses and event studies to explore our research question. Results suggest that compared to untreated institutions in the Florida College System and institutions with the same Carnegie Classification, MDC enrolled 18.5% and 32% more first-time, full-time degree-seeking undergraduates, respectively, after ADS’s inception. This enrollment increase demonstrates that ADS positively contributed to MDC’s programmatic goals to increase student enrollments.

An action research partnership in an urban Texas county to explore barriers and opportunities for collaborative community health needs assessments.

The Affordable Care Act mandated triennial community health needs assessments (CHNAs) for greater nonprofit hospital accountability in responding to community health needs. Over 10 years later, hospital spending on community benefits remains largely unchanged. While greater collaboration in CHNA implementation can increase hospital investment in community-based initiatives, nonprofit hospitals in conservative states are subject to policy, political, and economic factors that inhibit public health partnerships and magnify existing disparities in health care access. This participatory action research study explores the decision-making environment of collaborative CHNA implementation within a group of nonprofit hospitals in a north Texas urban county. In 2017 faculty from an urban anchor institution initiated an academic-community partnership with a coalition of nonprofit hospitals, public health departments, and academic institutions. An interdisciplinary research team engaged in multi-method document review and qualitative data collection to describe historical barriers for local CHNA processes and develop practical strategies for joint CHNA initiatives. Local CHNA documents were first reviewed through team-based content analysis and results applied to develop a qualitative study protocol. Key informants were recruited from county-based nonprofit hospitals, community-based nonprofit organizations, and public health systems. Seventeen senior- and mid-level professionals participated in semi-structured research interviews to describe their perspectives relating to CHNA-related planning and implementation decisions. Through iterative data collection and analysis, the research team explored CHNA-related knowledge, experiences, and processes. A constructivist lens was subsequently applied to examine historical barriers and future opportunities for local collaboration. Findings reveal CHNA implementation is a multi-stage cyclical process in organizational environments with accountability to a wide range of public and private stakeholders. This promotes varied levels of inclusivity and conservatism in data collection and community benefit implementation. Decisions to collaborate are hindered by competing priorities, including compliance with existing guidelines, administrative simplicity, alignment with health care service delivery, and efficient resource use. Efforts to promote greater CHNA collaboration may be facilitated through intentional alignment with organizational priorities and clearly communicated benefits of participation for leaders in both public and private nonprofit health systems. We consider implications for policymakers and health systems in restrictive political environments and advance a conceptual framework for greater CHNA collaboration.

Just Get in Line: Rural-Urban Differences in Access to Pediatric Renal-Bladder Ultrasounds

IntroductionHealth-care disparities in rural and underserved areas may be exacerbated by the pandemic, personnel challenges, and supply chain limitations. This study aimed to quantify current variation in rural and urban pediatric renal ultrasound availability. MethodsWe identified all hospitals statewide and contacted radiology departments posing as a parent trying to schedule an appointment for a routine pediatric renal-bladder ultrasound. Intervals between day of contact and first available appointment were compared between rural and urban institutions. ResultsWe were able to contact 42/48 (87.5%) rural hospitals, and 20/39 (51.3%) urban hospitals. Scheduling could not be completed in 5 rural and 7 urban hospitals. The median wait time for the 37 remaining rural and 13 remaining urban hospitals was similar: 7 (range: 0-21) days in rural hospitals and 6 (range: 0-17) days in urban hospitals (P = 0.81). If contact was made, the likelihood of scheduling within 7 d was similar in rural and urban areas (odds ratio [OR] = 0.23; 95% confidence interval [CI] 0.03-1.97; P = 0.18). However, patients were much more likely to have a completed call at a rural hospital (OR = 6.65; 95% CI: 2.3-19.2; P = 0.0005), and so in reality, patients were 2.89 times as likely to be able to schedule an renal-bladder ultrasound within 7 d at a rural compared with an urban institution (95% CI: 1.19-7.03; P = 0.019). ConclusionsWhile access to pediatric renal sonograms was similar within a week at rural and urban institutions once telephone contact was made, it was significantly more difficult to schedule appointments at urban institutions.

Historical Overview of Development’s Impact on Rural and Urban Governance in Iran

: The constitutional revolution in 1906 was the beginning of a new era for Iran. A national parliament was established for making laws that established modern institutions such as city and village councils and mayors over the decades. Urban governance was renewed and the land reforms in the 1960s transformed rural governance, changed landlord– peasant relations and reduced the traditional authority of village headman (kadkhodas) in village administration. The 1979 revolution introduced a new kind of local governance, Islamic councils for governing cities and villages. This article discusses the main changes and challenges of local governance in Iran by using theoretical concepts of dependent development. The changing pattern of authority and penetration of state bureaucracy through the creation of several rural and urban organizations before and after the Revolution of 1979 is discussed. The article also explains how the establishments of these rural and urban institutions have helped to increase the domination of the state officials within both cities and villages.

Hurdling Barriers: Exploring Inaccessibility in Higher Education Institutions for Mobility Assistive Device Users

This article explores the challenges faced by students with disabilities using mobility assistive devices (i.e. wheelchairs or crutches) in a large public sector urban higher education institution. Cities are characterized by rapid pace and complex infrastructure including buildings, roads, and public spaces that present unique obstacles that hinder these individuals' mobility and overall experience. For this qualitative study, the locale chosen was a large public sector university, and data was collected from 10 students with disabilities who use wheelchairs and other mobility assistive devices and reside in the campus student accommodation. The data was collected through in-depth interviews and analyzed using thematic analysis. The findings indicate that the infrastructure on campus is not accommodating for students with disabilities who use mobility aids, which directly and indirectly impacts their educational experiences. In addition, the university lacks a uniform policy for providing services and allocating resources for students with disabilities. The participants believe that the university is indifferent to their needs; however, the facilities and behaviors within departments vary and at times can be quite enabling. This study contributes to the ongoing dialogue on enhancing accessibility, inclusivity, and equity within our urban educational landscapes

Determination and Evaluation of Landslide-Prone Regions of Isparta (Turkey): An Urban Planning View

Landslides represent a significant hazard affecting human life and property and threaten the sustainability of human settlements. They are among the most critical threats after earthquakes in Turkey. In 2020, 107 landslide events occurred in Turkey. Implementing proper policies, strategies, and tools for landslide risk mitigation remains challenging for urban planning institutions. In the plan preparation phase, urban planners and plan-making authorities, agencies, or institutions may overlook landslide risks due to a lack of data or related studies. Therefore, this article aims to develop a novel spatial analysis for identifying landslide-prone areas at the provincial level from an urban planning perspective. The analysis is compared to the approved upper-scale plan, and the results are used to build a more robust understanding of landslide risks for sustainable urban development. Isparta Province is selected as the study area, as it has active landslide areas. The methods used include a literature survey including internet sources, newspapers, plans, articles, and other research projects and a case study utilizing a GIS spatial analysis. The spatial analysis using GIS is based on three landslide inventories currently available in Turkey. This spatial analysis is developed to determine landslide-prone regions by considering thematic layers, triggering factors, and vulnerability inputs. As a result of this analysis, five landslide-prone areas in Isparta Province are determined. When these regions are compared to the upper-scale plan that covers the province, it is found that land use and planning decisions have neglected landslide risks, and urban areas are at high landslide risk. Several specific principles and strategies, such as a spatial inventory database and an integrated planning approach including landslide-prone areas, are stated with a reliable spatial analysis to assess landslide-prone areas on a regional scale, which can be applied later in any city and region of Turkey.

Supporting pregnant and parenting students: Legal responsibilities and student rights

Countless pregnant and parenting students come to college and university campuses across the country every year. According to the Urban Institute, more than 5.4 million parenting students were pursuing higher education as of December 2022. Whether a first‐time freshman or a doctoral‐level graduate student, these students are owed a robust support system by universities and colleges striving to achieve inclusive, developmental, and academic excellence.

Moving With the Tide: Immigrant Reactions to State-Level Policy Changes

A wide range of sub-national immigration and immigrant-related policies have been adopted in the United States in the last two decades. Using data from the Urban Institute and IPUMS, the authors analyze the impact of state-level policy climates related to enforcement, integration, and public benefits on inter-state mobility for immigrants. The findings of the present analysis show that immigrants are responsive to changes in the state-level immigration policy climate. They are less likely to move out of states that are on balance more supportive of the foreign-born population and more likely to relocate from restrictive states. In addition, the policy impacts do not vary significantly by immigrants’ education, language fluency, or employment status, calling into question whether the policies miss their intended targets. These findings have implications for local governments and agencies in policy design and implementation as they continue to develop policies targeting the foreign-born population.

Catalysing the realisation of rainwater harvesting systems through participatory action research

Rainwater harvesting (RWH) is one the most salient methods in urban water management for creating an additional water supply in times of drought and combating urban floods in the face of climate change. Instalment of RWH systems has become compulsory by national legislation in Türkiye since 2021. However, previous research shows that there are a variety of barriers to implementing RWH, including legislative regulations, technical dimensions, financial mechanisms, societal adaptation and governance dynamics. Taking this as a point of departure, this research explores necessary actions to overcome those barriers in collaboration with relevant actors, aiming to catalyse the realisation of RWH systems throughout the research process. The research adopts a participatory action research (PAR) methodology, generating knowledge that is meaningful for urban planning systems and water management institutions involved in RWH installation and operation. The research explores the necessary actions through the case of Istanbul, the largest metropolis of Türkiye. Respectively, a set of workshops, focus groups, in-depth interviews, and group meetings were implemented in parallel processes with different actors from the public and private institutions at local, regional, and national scales. The findings highlight the need for (i) legislative actions for constructing a thorough regulatory framework, (ii) financial actions for introducing new incentives and pricing policies, (iii) technical actions for developing installation and operation standards, (iv) societal actions for igniting a cultural change for the use of RWH in the society and (v) governance actions for RWH systems. The research establishes a communicative environment that showcases the feasibility of collaboration and emphasizes the importance of its continuous implementation in establishing a decentralised governance mechanism involving all actors.

Supporting pregnant and parenting students: Legal responsibilities and student rights

Countless pregnant and parenting students come to college and university campuses across the country every year. According to the Urban Institute, more than 5.4 million parenting students were pursuing higher education as of December 2022. Whether a first‐time freshman or a doctoral‐level graduate student, these students are owed a robust support system by universities and colleges striving to achieve inclusive, developmental, and academic excellence.

A ‘Better Life for All in Bricks and Mortar’: The Spatial Rationalities of Container Urbanism in Accra

Alternative and often disruptive urban processes in the Global South, such as container urbanism, are gradually pushing urban planning institutions towards the margins of urban governance and transformation. Understanding how urban institutional actors perceive and respond to these emerging processes is thus crucial for unravelling the rationalities that actively transform the spatial configuration of cities. Drawing on the concept of spatial rationalities, this article examines the institutional dynamics of the unprecedented spatial diffusion of container urbanism in Accra, Ghana. The article makes two contributions to the literature. First, it shows that the continuation of a neoliberal urban governance agenda has shifted the institutional perception of container urbanism as a form of aberration. Second, it sheds light on how the actions by institutional actors to recuperate spatial order are often eclipsed by political interferences, creating an illusion of control in the management of urban space. Consequently, the article calls for a reassessment of impractical regulatory mechanisms that target container users and other informal modes of appropriating urban space with far-reaching consequences for urban citizenship and the right to the city.

Turkestan Urban Self-Government Institutions in the late 19th – Early 20th Century

At the end of the 19th and beginning of the 20th century, the process of urbanization was actively advancing in the Russian Empire. The city reform of 1870 expanded the competence and representativeness of city self-government, represented by the City Duma, with the aim of involving the propertied into the initiative of the urban community addressing urban improvement issues. The development of urban self-government institutions in several cities in Turkestan adhered to the general course of modernization in the Russian Empire, while also reflecting the specific administration and socio-cultural environment of the region.
 The author’s objective is to analyze the correlation between general imperial principles and regional specifics in the legal status and activity trends of city self-government bodies in Turkestan. In comparison with the general imperial practice, city self-government bodies were limited both in terms of spatial factors and in terms of their level of independence from the administration and the representativeness of the indigenous population. The Tashkent City Duma serves as a case to study that best aligns with the research objectives. The article examines the activities of the city self-government based on this example.
 The predominance of the indigenous population in most cities of the region was the main reason for the reluctance of local administration to extend the city self-government system to other cities. Nevertheless, even in its limited form, city self-government served as another platform for interaction between two cultures, “tradition” and “modernity,” and as an instrument for the gradual modernization of Turkestan cities.

Nurses' Perceptions of Intensive Care Unit Orientation Patient Education Pamphlet.

Critical illness is a stressful time for patients and their support networks. Although patient-directed educational material to improve the understanding of critical illness exists, both patients and staff members are often unaware of these resources or how to find them. We aimed to evaluate the impact of the implementation of the American Thoracic Society's (ATS) "Managing the Intensive Care Unity (ICU) Experience: A Proactive Guide for Patients and Families", an ICU orientation pamphlet, on nurses' perceptions of the availability and effectiveness of patient and family educational resources. In a safety-net urban institution, we surveyed medical ICU (MICU) nurses in February 2021 regarding their perceptions of the availability of patient and family educational materials and the time and quality of communication with families of critically ill patients. We then introduced the MICU nurses to the ATS ICU orientation pamphlet to complement patient and family education. Quick response (QR) codes were created, linking to the online versions of the ICU pamphlet, and made available in waiting rooms. Printed copies of the pamphlet were provided to families in the ICU introductory packet upon patient MICU admission. We informed nurses regarding the pamphlet content, website, and QR codes. A postintervention survey was administered 11 months after the initial survey. Changes between pre and postintervention responses were analyzed for significant differences. Debriefing sessions with the MICU nurses were conducted, and subsequent discussions identified opportunities to improve the available educational resources. At baseline, 28 of 67 (42%) MICU nurses responded to the survey. Although all nurses provided verbal education to patients and families, only 18% reported knowing about and using additional resources to supplement this education. The postintervention survey was completed by 39% of nurses; 39% of them reported using additional materials to supplement patient and family education. Reported awareness of the ATS ICU pamphlet increased from 4% before implementation to 23% after implementation (P = 0.04). MICU nurses offered suggestions to improve the pamphlet, which thematically fell into three categories: 1) opportunities to alter the ICU pamphlet, 2) opportunities to provide the pamphlet in varied formats, and 3) opportunities to add additional education topics. Informing nurses about the ICU pamphlet improved the acceptance and use of the materials, but it was still not accepted by many nurses. Barriers to ICU nurses using patient education resources should be explored to facilitate quality materials reaching patients and complementing patient communication. QR codes may have offered a way to disseminate educational materials to patients and families in a manner not previously considered. The process of evaluating the ICU pamphlet for our institution led to a broader discussion of additional needs for patient and family educational materials for our patient population. We encourage institutions to evaluate the sufficiency of their patient and family educational materials for similar local benefits.

Mechanically ventilated COVID-19 patients admitted to the intensive care unit in the United States with or without respiratory failure secondary to COVID-19 pneumonia: a retrospective comparison of characteristics and outcomes.

There is increasing heterogeneity in the clinical phenotype of patients admitted to the intensive care unit (ICU) with coronavirus disease 2019 (COVID-19,) and reasons for mechanical ventilation are not limited to COVID pneumonia. We aimed to compare the characteristics and outcomes of intubated patients admitted to the ICU with the primary diagnosis of acute hypoxemic respiratory failure (AHRF) from COVID-19 pneumonia to those patients admitted for an alternative diagnosis. Retrospective cohort study of adults with confirmed SARS-CoV-2 infection admitted to nine ICUs between March 18, 2020, and April 30, 2021, at an urban university institution. We compared characteristics between the two groups using appropriate statistics. We performed logistic regression to identify risk factors for death in the mechanically ventilated COVID-19 population. After exclusions, the final sample consisted of 319 patients with respiratory failure secondary to COVID pneumonia and 150 patients intubated for alternative diagnoses. The former group had higher ICU and hospital mortality rates (57.7% vs. 36.7%, P<0.001 and 58.9% vs. 39.3%, P<0.001, respectively). Patients with AHRF secondary to COVID-19 pneumonia also had longer ICU and hospital lengths-of-stay (12 vs. 6 days, P<0.001 and 20 vs. 13.5 days, P=0.001). After risk-adjustment, these patients had 2.25 times higher odds of death (95% confidence interval, 1.42-3.56; P=0.001). Mechanically ventilated COVID-19 patients admitted to the ICU with COVID-19-associated respiratory failure are at higher risk of hospital death and have worse ICU utilization outcomes than those whose reason for admission is unrelated to COVID pneumonia.

P118. A comparison of outcomes between obese and non-obese patients undergoing anterior cervical discectomy and fusion: a retrospective analysis of ten years of data from an urban academic institution

P118. A comparison of outcomes between obese and non-obese patients undergoing anterior cervical discectomy and fusion: a retrospective analysis of ten years of data from an urban academic institution

A retrospective chart review of central centrifugal cicatricial alopecia patients at a single urban institution

A retrospective chart review of central centrifugal cicatricial alopecia patients at a single urban institution

County- and state-level immigration policies are associated with Supplemental Nutrition Assistance Program (SNAP) participation among Latino households

The purpose of this study was to investigate the association between county- and state-level immigrant criminalizing and integrating policies and Latino household participation in the largest safety net program against food insecurity in the U.S., the Supplemental Nutrition Assistance Program (SNAP). Our outcome, county-level proportion of SNAP-participating Latino households, and county-level covariates were obtained from the American Community Survey 1-year county files (N = 675 counties) for 13 years (2007–2019). Our exposures were county-level presence of sanctuary policies and a state-level immigrant friendliness score, created based on 19 immigrant criminalizing and integrating state-level policies obtained from the Urban Institute's State Immigration Policies Resource. We classified every county in the sample as 1) sanctuary policy + immigrant friendly state, 2) sanctuary policy + immigrant unfriendly state, 3) no sanctuary policy + immigrant friendly state, and 4) no sanctuary policy + immigrant unfriendly state. Using multivariable generalized linear models that adjusted for poverty levels and other social composition characteristics of counties, we found that county-level SNAP participation among Latino households was 1.1 percentage-point higher in counties with sanctuary policies (B = 1.12, 95%CI = 0.26–1.98), compared to counties with no sanctuary policies, and 1.6 percentage-point higher in counties with sanctuary policies in immigrant friendly states (B = 1.59, 95%CI = 0.33–2.84), compared to counties with no sanctuary policy in immigrant unfriendly states. Local and state immigration policy, even when unrelated to SNAP eligibility, may influence SNAP participation among Latino households. Jurisdictions which lack sanctuary policies or have more criminalizing and less integrating policies should consider adopting targeted outreach strategies to increase SNAP enrollment among Latino households.

Reading comprehension of third grade students of rural and urban educational institutions in the Urabá area

The purpose of this article is to compare rural and urban educational institutions in the Urabá area, with respect to the reading comprehension of third grade students. The research is based on the holistic understanding of science, under a type of descriptive research with a contemporary, transectal field design, the population is made up of 100 students from the Río Grande rural institutions, Bartolomé Castaño from the rural areas and 100 from the urban schools, San Francisco de Asís and San Pedro Claver. To collect the data, the survey technique was used through a questionnaire instrument “Test to Know” from the Colombian Institute for the Evaluation of the Quality of Education (Icfes), with the endorsement and reliability given by the Ministry of Education. National (MEN). The results obtained showed that students from a rural context have a very low level of reading comprehension, in contrast to children from urban areas, who have a very high level of reading any type of text comprehensively.

Influence of Electrodiagnostic Studies on Surgery for Carpal Tunnel Syndrome: A Retrospective Analysis of Data from a Single Urban Institution.

Background: This study aimed to clarify the influence of preoperative electrodiagnostic (EDX) utilisation and its severity on surgically treated patients with carpal tunnel syndrome (CTS). Methods: This retrospective study analysed the data of patients who underwent CTS surgery at our facility from 2012 to 2022. Data regarding age, sex, affected side, diabetes mellitus, rheumatoid arthritis, haemodialysis and insurance type were collected, along with the following clinical information: utilisation of EDX, steroid injection, number of items of preoperative physical examination and history taking, intervals between symptom onset and the initial visit and between the initial visit and surgery, type of surgical procedure and surgery categorisation (primary or revision). EDX data (EDX severity, interval between EDX and surgery and concomitant nerve lesions) were also investigated. Univariate and multivariate analyses were conducted to assess the influence of EDX utilisation and severity on clinical parameters. Results: Of the 343 hands enrolled in our study, 304 (89%) underwent preoperative EDX assessment. EDX severity was classified as normal, mild, moderate or severe in 6 (2%), 18 (6%), 102 (34%) and 178 hands (58%), respectively. After the univariate and multivariable analyses, more items of preoperative physical examination and history taking were associated with non-EDX utilisation, whereas younger age, female sex and steroid injection were associated with milder EDX. Conclusions: Increased number of items of preoperative physical examination and history taking or steroid injection were independently associated with non-EDX utilisation or milder EDX, respectively, suggesting that when thorough clinical evaluation is conducted, hand surgeons may be less likely to request for EDX before surgery. Moreover, their treatment recommendation may be influenced by EDX severity. Level of Evidence: Level III (Diagnostic).