Major Metropolitan Areas Research Articles

Transportation and Neighborhood Priorities of Californians with Disabilities: Focus Group Findings

We conducted a focus group comprising 20 adults with disabilities across California in November 2021 to understand how disability affects their choices and desires for transportation and neighborhood features. The focus group let us efficiently observe common responses on which participants could further build; though it is too small to be truly representative, it identifies issues to motivate further research and policymaking. Participants with various disabilities and from geographically diverse parts of California, including rural areas far from the major coastal metropolitan areas, uniformly wanted more dense mixed-use development to reduce the immediate burdens in transportation which they disproportionately face as people with disabilities and to move away from broader problems with car-oriented land use patterns. Many participants specifically asked for more street lighting, seating, and shade for users of all transportation modes, greater frequency and coverage of public transit, and similar support for infrequent but critical trips over longer distances. Drivers also wanted assurance that they would not be financially penalized for driving before policymakers implement adequate alternatives. All participants expressed hope that policymakers would implement their comments. We frame these findings by introducing the terms “immediate usability,”“cumulative usability,” and “availability,” to describe mobility for people with disabilities within the broader framework of accessibility, and by emphasizing the active roles these participants take in their respective communities.

Factors influencing residential location choice: learnings from the Indian context

PurposeThe purpose of the present study is to explore the factors that influence the residential location choice of households in the Indian context.Design/methodology/approachTwo sub-urban towns of Kolkata, i.e. Biddhanagar Municipal Corporation and Rajarhat Newtown, are taken as case studies. In total, 34 variables are considered related to the household's socioeconomic background (10), dwelling (3), travel (2) and level of importance of neighborhood characteristics (19). A revealed preference household survey is conducted, which resulted in the collection of 390 samples. Firstly, 19 level of importance variables are deduced to 3 latent factors using exploratory and confirmatory factor analysis. After that, a utility function is estimated using a multinomial logit regression to identify significant factors.FindingsThe results indicate the significance of car ownership, work travel time, work mode, monthly income, proximity to work, proximity to family/relative/friends, proximity to quality schools, quality of physical infrastructure such as water availability, power availability and housing typology among others in the residential location choice of households.Research limitations/implicationsKolkata, a major metropolitan area in eastern India, has been experiencing space constraints to cater to the housing demand of the ever-increasing population. Although satellite towns are being developed, the infrastructure landscape in such towns is uneven, resulting in more housing demand in one area than another. The study furnishes significant findings to develop more informed policies to attract households in low-demand areas and manage high-demand areas to achieve sustainable planning.Originality/valueConsidering the importance of geographical context, it is the first study on residential location choice, providing a perspective of household behavior from eastern India. It also shows the importance of physical infrastructure attributes in residential location choice for developing countries, which is seldom employed in the current practice. Moreover, previous studies (although few) done in India consider the objective value of location characteristics. The present study focuses on subjective value or the level of importance perceived by respondents.

Preferences and Expectations of Japanese Employees toward Telecommuting Frequency in the Post-Pandemic Era

Telecommuting has reached unprecedented levels in Japan, previously established due to the sudden outbreak of the COVID-19 pandemic; however, there is a lack of in-depth research on telecommuting frequency from the perspective of the post-pandemic era. Hence, this study investigated the relationship between employees’ expected levels of telecommuting allowed by the company and their preferred telecommuting frequency after the pandemic using an ordered response probit model with a correlation effect. Data were collected through an online questionnaire in three major metropolitan areas of Japan; the questionnaire included questions on sociodemographic, commuting, household, and work-related characteristics. The findings revealed that work-environment characteristics are prime factors influencing both expected and preferred telecommuting frequency; therefore, a telecommuting-oriented work environment is crucial for bridging the gap between employees and employers regarding telecommuting. Also, the results indicated that the preferred level of telecommuting is unattainable probably due to a lack of support from the company. Finally, a gap was identified between the expected telecommuting frequency that companies would allow and the preferred telecommuting frequency. This study provides implementations to achieve a work environment better adapted to the post-pandemic era and contributes to the establishment of future traffic forecasting models that enable effective mobility management through telecommuting.

What Patients Say About Their Orthopaedic Hand and Wrist Surgeons: A Qualitative Analysis of Negative Reviews on Yelp.

Background Patients often turn to online reviews as a source of information to inform their decisions regarding care. Existing literature has analyzed factors associated with positive online patient ratings among hand and wrist surgeons. However, there is limited in-depth analysis of factors associated with low patient satisfaction for hand and wrist surgeons. The focus of this study is to examine and characterize extremely negative reviews of hand and wrist surgeons on Yelp.com. Methods A search was performed using the keywords "hand surgery" on Yelp.com for eight major metropolitan areas including Washington DC, Dallas, New York, Phoenix, Los Angeles, San Francisco, Boston, and Seattle. Only single-star reviews (out of a possible 5 stars) of hand and wrist surgeons were included. The complaints in the 1-star reviews were then categorized into clinical and nonclinical categories. Result A total of 233 single-star reviews were included for analysis, which resulted in 468 total complaints. Of these complaints, 81 (18.8%) were clinically related and 351 (81.3%) were nonclinical in nature. The most common clinical complaints were for complication (24 complaints, 6%), misdiagnosis (16 complaints, 4%), unclear treatment plan (16 complaints, 4%), and uncontrolled pain (15 complaints, 3%). The most common nonclinical complaints were for physician bedside manner (93 complaints, 22%), financially related (80 complaints, 19%), unprofessional nonclinical staff (61 complaints, 14%), and wait time (46 complaints, 11%). The difference in the number of complaints for surgical and nonsurgical patients was statistically significant ( p < 0.05) for complication and uncontrolled pain. Clinical Relevance Patient satisfaction is dependent on a multitude of clinical and nonclinical factors. An awareness of online physician ratings is essential for hand and wrist surgeons to maintain and improve patient care and patient satisfaction. We believe the results of our study could be used to further improve the quality of care provided by hand and wrist surgeons.

Predictable and Unpredictable Components of Cape Town Winter Rainfall

Abstract In early 2018, due in part to a severe and extended meteorological drought, Cape Town was at risk of being one of the first major metropolitan areas in the world to run out of water. The magnitude of the crisis was exacerbated by the fact that such a prolonged and severe drought was both unanticipated and unpredicted. In this work, we analyze data from both observations and seasonal forecasts made as part of the North American Multimodel Ensemble (NMME) to better understand the predictability of rainfall in the Cape Town (CT) region. We find that there are statistically significant correlations between observed CT rainfall and sea surface temperatures in the tropical Atlantic (∼0.45) as well as a pattern of 200-mb geopotential height (z200) anomalies resembling the Southern Annular Mode (SAM; ∼0.4). Examination of hindcasts from the NMME demonstrates that the models accurately reproduce the observed correlation between CT rainfall and z200 anomalies. However, they fail to reproduce correlations between CT rainfall and the tropical South Atlantic. Decomposition of the correlations into contributions from predictable and unpredictable components indicates that CT rainfall in the models is dominated by unpredicted atmospheric variability (correlation ∼ 0.84) relative to predicted (correlation ∼ 0.14), which may be related to the failure to simulate the connection with the tropical Atlantic. Significance Statement Water crises are occurring with increasing severity and frequency around the globe. The ability to accurately forecast wet season rainfall would be invaluable to water managers and other decision-makers. Here, we explore the reasons behind the failure of a suite of operational seasonal forecast models to accurately predict rainfall in the Cape Town region of South Africa.

Spatiotemporal Event Studies for Environmental Data Under Cross-Sectional Dependence: An Application to Air Quality Assessment in Lombardy

We propose a twofold adjustment for Event Studies considering spatiotemporal data in a multivariate time series framework where the data are characterized by spatial and temporal dependence. The first adjustment consists of modeling the spatiotemporal dynamics of the data by implementing several geostatistical models capable of handling both spatial and temporal components, as well as estimating the relationship between the response variable and a set of exogenous factors. With the second adjustment, we propose to use cross-sectional-adjusted test statistics directly accounting for spatial cross-correlation. The proposed methods are applied to the case of NO2\\documentclass[12pt]{minimal} \\usepackage{amsmath} \\usepackage{wasysym} \\usepackage{amsfonts} \\usepackage{amssymb} \\usepackage{amsbsy} \\usepackage{mathrsfs} \\usepackage{upgreek} \\setlength{\\oddsidemargin}{-69pt} \\begin{document}$$_2$$\\end{document} concentrations observed in Northern Italy during the first wave of the COVID-19 pandemic. The key findings are as follows. First, all the considered geostatistical models estimate larger reductions in the major metropolitan and congested areas, while smaller reductions are estimated in rural plains and in the mountains. Second, the models are nearly equivalent in terms of fitting and are capable of identifying the true event window. Third, by using spatiotemporal models we ensure the residuals are uncorrelated across space and time, thus allowing Event Studies test statistics to provide reliable and realistic estimates. Fourth, as expected, all test statistics show significant reductions in NO2\\documentclass[12pt]{minimal} \\usepackage{amsmath} \\usepackage{wasysym} \\usepackage{amsfonts} \\usepackage{amssymb} \\usepackage{amsbsy} \\usepackage{mathrsfs} \\usepackage{upgreek} \\setlength{\\oddsidemargin}{-69pt} \\begin{document}$$_2$$\\end{document} concentrations starting from the first few days of lockdown. Supplementary materials accompanying this paper appear online.

Unlocking Drone Potential in the Pharma Supply Chain: A Hybrid Machine Learning and GIS Approach

In major metropolitan areas, the growing levels of congestion pose a significant risk of supply chain disruptions by hindering surface transportation of commodities. To address this challenge, cargo drones are emerging as a potential mode of transport that could improve the reliability of the pharmaceutical supply chain and enhance healthcare. This study proposes a novel hybrid workflow that combines machine learning and a geographic information system to identify the fewest locations where providers can initiate cargo drone services to yield the greatest initial benefits. The results show that by starting a service in only nine metropolitan areas across four regions of the contiguous United States, drones with a robust 400-mile range can initially move more than 28% of the weight of all pharmaceuticals. The medical community, supply chain managers, and policymakers worldwide can use this workflow to make data-driven decisions about where to access the largest opportunities for pharmaceutical transport by drones. The proposed approach can inform policies and standards such as Advanced Air Mobility to help address supply chain disruptions, reduce transportation costs, and improve healthcare outcomes.

Declining Trends in Crime Reporting and Victims’ Trust of Police in the United States and Major Metropolitan Areas in the 21st Century

Victims’ willingness to report crime and their opinions about the police are important indicators of police performance, police legitimacy, and trust in the justice system. This study examines two decades of trends in police notification and victims’ perceptions of the police in the United States and major metropolitan areas since 2000, using data from the National Crime Victimization Survey (NCVS). In contrast to previous studies indicating an increase in police notification in the 1980s and 1990s, the present study shows a progressive decline in police notification observed in the last two decades, especially since 2010. Furthermore, there has been a marked increase in victims’ mistrust of police responsiveness since the mid-2000s. Using multivariable regression models that control for potential changes in the characteristics of crime and survey methodology, we find that the victims’ rising distrust of the police is widespread in many metropolitan areas, in all racial/ethnic and socioeconomic groups, and especially so for victims of theft, burglary, and simple assault. In the discussion, we suggest that the changing policing strategies and the evolving economic, political, and social environments of the 21st century may help explain the trends identified by this research. Understanding victim reporting trends and victims’ opinions of the police may affect data and policy and help the justice system to better serve victims and enhance public safety.

Parental support for physical activity and children’s physical activities: a cross-sectional study

BackgroundPhysical activity (PA) in school-aged children is imperative for physical and mental development. However, there has been reduced PA among children in recent years owing to environmental changes, resulting in declining physical strength and athletic ability. Although parents’ and children’s PA has been found to be correlated, the specific parental caregiving attitudes associated with children’s actual levels of PA during school-age years remain unknown. Therefore, this study aimed to examine the relationship between parental support for PA and children’s levels of PA.MethodsIn 2017, a self-reported questionnaire survey was administered to 1,515 third-grade students (8–9 years old) and their caregivers in Nagoya, Aichi, a major metropolitan area in Japan. The main items surveyed included the attitudes of children and parents towards PA and the children’s actual PA level. Multiple regression analysis was conducted with parental involvement related to PA as the explanatory variable and children’s PA as the objective variable.ResultsIn total, 717 children with valid responses were included in the analysis. The mean age of the children was 9.08 ± 0.33 years; 366 (51.0%) were boys, and 351 (49.0%) were girls. For moderate-to-vigorous and vigorous PA, PA levels tended to be significantly higher in children whose parents provided logistic support such as enrolling their children in a sports club. However, for moderate PA and walking, PA levels tended to be significantly higher in children whose parents used community resources. Modeling and limiting sedentary activities were not associated with children’s PA.ConclusionsThe results of this study suggest that direct parental assistance for PA such as logistic support encourages children to engage in moderate-to-vigorous PA; in addition, parental use of community resources may encourage children to engage in moderate and light PA such as walking. Conversely, indirect and negative involvement such as modeling and limiting sedentary activities were not associated with children’s PA. Therefore, logistic support may need to be strengthened to encourage moderate-to-vigorous and vigorous PA, which is important for children’s health.

Understanding changes in travel patterns during the COVID-19 outbreak in the three major metropolitan areas of Japan

Unlike the lockdown measures taken in some countries or cities during the COVID-19 outbreak, the Japanese government declared a “State of Emergency” (SOE) under which people were only requested to reduce their contact with other people by at least 70%, while some local governments also implemented their own mobility-reduction measures that had no legal basis. The effects of these measures are still unclear. Thus, in this study, we investigate changes in travel patterns in response to the COVID-19 outbreak and related policy measures in Japan using longitudinal aggregated mobile phone data. Specifically, we consider daily travel patterns as networks and analyze their structural changes by applying a framework for analyzing temporal networks used in network science. The cluster analysis with the network similarity measures across different dates showed that there are six main types of mobility patterns in the three major metropolitan areas of Japan: (I) weekends and holidays prior to the COVID-19 outbreak, (II) weekdays prior to the COVID-19 outbreak, (III) weekends and holidays before and after the SOE, (IV) weekdays before and after the SOE, (V) weekends and holidays during the SOE, and (VI) weekdays during the SOE. It was also found that travel patterns might have started to change from March 2020, when most schools were closed, and that the mobility patterns after the SOE returned to those prior to the SOE. Interestingly, we found that after the lifting of the SOE, travel patterns remained similar to those during the SOE for a few days, suggesting the possibility that self-restraint continued after the lifting of the SOE. Moreover, in the case of the Nagoya metropolitan area, we found that people voluntarily changed their travel patterns when the number of cases increased.

Sustainable lifestyle: Urban household carbon footprint accounting and policy implications for lifestyle-based decarbonization

Cities, as the primary hubs of economic activities and the end-points of goods and services consumption, bear significant responsibility for the majority of global greenhouse gas emissions. Consequently, there is a pressing need for more granular data at the subnational level to formulate effective and feasible measures in line with current decarbonization targets. In this study, we present the carbon footprint embodied in household consumption behavior of 11 major metropolitan areas in Japan. Furthermore, our study innovatively introduces a temporal perspective, employing time organization as an insightful indicator to delineate the disparities in carbon footprints that arise from varying carbon intensities of distinct activities. The results are given from the following three aspects: 1) structural comparison of urban household carbon footprints; 2) time-based activity differences and drivers; and 3) inequality analysis among different activity-based carbon footprints. Here, we found that eating contributes most substantially to the carbon footprint. Conversely, transportation activities manifest the greatest regional inequality in carbon footprints. These findings provide indispensable evidence for the development of city-specific net-zero-emission goals within Japan. Furthermore, they exemplify the value of incorporating a temporal dimension into household carbon footprint analyses, thereby providing a broader perspective for future investigations in this field.

Urban intensity and flower community structure drive monkey beetle assemblage in Cape Town

Background: Urban landscapes present an important opportunity for pollinator conservation, but little is known about the status and distribution of pollinator populations in urban habitats in Africa. This represents a major gap in the development of a global understanding of urban pollinators – particularly from the rapidly urbanising context. This study uses a speciose clade of flower-visiting beetles (Coleoptera: Scarabaeidae: Hopliini) to explore patterns of pollinator distribution in a major metropolitan area in South Africa. Objectives: We investigated community composition across gradients of urban intensity (defined according to the percentage of soil-sealing within 1 km2 of each sampling location) and socio-economic status to determine pollinator responses to these urban landscape effects. Methods: A selection of 142 sites were surveyed twice in the austral spring seasons of 2018 and 2019. Data were collected on habitat structure, flower diversity, and pollinator diversity. Results: The study found that different feeding guilds of monkey beetles favoured different levels of urban intensity and that beetle richness significantly correlated with flower richness. It did not, however, correlate with diversity indicating that abundance is less impacted than the number of species present. Monkey beetles with moderate sensitivity to urban intensity benefitted from the presence of preferred species of flowers. Conclusion: Overall, the findings demonstrate the importance of plant community assemblage in supporting urban monkey beetles. We recommend landscaping with preferred flower species in urban parks to support urban pollinators.

VFR TRAVEL AND COVID-19 IMPACTS: THE SOUTH AFRICAN EXPERIENCE

COVID-19 had major negative consequences globally for travel for visits to friends and relatives (VFR), which is an under-researched segment of tourism. This paper responds to the need for extended research on VFR travel by examining the impacts of COVID-19 on the VFR sector and its spatial imprint in South Africa. VFR travel sector was second only to business travel in terms of the negative impacts of COVID-19 restrictions imposed in South Africa. An uneven geography is observed of the impact of COVID-19 on VFR travel mobilities. Using data on VFR trips and bednights the analysis discloses the greatest absolute declines in VFR travel occurred in South Africa’s major metropolitan areas. By contrast, in terms of the relative decline and local impacts for destinations of the COVID-19 hollowing out of VFR travel a different pattern emerges. The worst affected spaces were remote, mainly rural localities which are in South Africa’s poorest and most economically distressed areas.

Evaluation of Bus Rapid Transit System: Riyadh city, Saudi Arabia

Al Riyadh city, the capital of the Kingdom of Saudi Arabia, is experiencing significant economic and population growth, it is also a major metropolitan area in Saudi Arabia and in the Gulf regions. This has led to a high level of car ownership and use of vehicles, and this has led to the construction of a series of slow-moving roads and roads around the city. Traffic congestion is a major problem, where road behavior has an economic and psychological impact on people. The Riyadh Bus stations and Bus Rapid Transit (BRT) System Project is an integral part of the current Riyadh metropolitan area including the new Riyadh Metro. The main objective of this paper’s is to study the “Bus Rapid Transit” network in the city of Al Riyadh and to assess the functioning of this network using geographic information systems and the theory of graphs. A centralized geodatabase has been built for BRT lines and stations. A geometric network was conducted for BRT routes to facilitate moving from any location to another within Riyadh city. The assessment and evaluation of BRT routes focused on routes and station distribution regarding Riyadh city and how BRT solved population needs in Riyadh city. Using the powerful GIS network analysis functions, a navigation system was developed to assist passengers in planning their trips from one station to another giving detailed information about route directions and different BRT lines used. The study reinforces the value of good design techniques for accessible public transportation systems. The utilization of accessible vehicles, such as low-floor buses, is needed but lacking for such an accessible system, planners and operators should be aware.

Association of multi-criteria derived air toxics hazard score with lung cancer incidence in a major metropolitan area.

Lung cancer remains a major health problem world-wide. Environmental exposure to lung cancer carcinogens can affect lung cancer incidence. We investigated the association between lung cancer incidence and an air toxics hazard score of environmental carcinogen exposures derived previously under the exposome concept. Lung cancer cases diagnosed in Philadelphia and the surrounding counties between 2008 and 2017 were identified from the Pennsylvania Cancer Registry. Age-adjusted incidence rates at the ZIP code level were calculated based on the residential address at diagnosis. The air toxics hazard score, an aggregate measure for lung cancer carcinogen exposures, was derived using the criteria of toxicity, persistence, and occurrence. Areas with high incidence or hazard score were identified. Spatial autoregressive models were fitted to evaluate the association, with and without adjusting for confounders. Stratified analysis by smoking prevalence was performed to examine potential interactions. We observed significantly higher age-adjusted incidence rates in ZIP codes that had higher air toxics hazard score values after controlling for demographic variables, smoking prevalence, and proximity to major highways. Analyzes stratified by smoking prevalence suggested that exposure to environmental lung carcinogens had a larger effect on cancer incidence in locations with higher smoking prevalence. The positive association between the multi-criteria derived air toxics hazard score and lung cancer incidence provides the initial evidence to validate the hazard score as an aggregate measure of carcinogenic exposures in the environment. The hazard score can be used to supplement the existing risk factors in identifying high risk individuals. Communities with higher incidence/hazard score may benefit from greater awareness of lung cancer risk factors and targeted screening programs.

P-034 Clinical experience with expanded carrier screening results on a sperm donor applicant population

Abstract Study question What is the frequency of clinically significant results from expanded carrier screening (ECS) in a sperm donor applicant population and how should these be managed? Summary answer ECS results revealed clinically significant information for approximately 1 in 51 donor applicants, which warrant specific management considerations in the context of third-party reproduction. What is known already The American Society of Reproductive Medicine (ASRM) Practice Committee published guidance in January 2021 that outlines the recommended carrier screening approach for gamete donors. However, there is no additional direction related to results management including donor suitability, counseling, and informed consent. Prior studies have illustrated the high frequency of donors who are identified as carriers of one or more recessive disorders on an ECS panel; thus, excluding all prospective gamete donors identified as carriers for recessive conditions is not feasible or appropriate given the availability of reciprocal screening for the reproductive partner. Study design, size, duration A retrospective review of donor genetic screening records from July 2017 to December 2021 was performed. Relevant data was extracted and categorized by carrier screening result. Genetic counselors evaluated the health and reproductive risks to the potential donors (PDs) associated with being a carrier of a pathogenic mutation in each gene using published data, reference laboratory interpretations, and the professional health management guidelines. Participants/materials, setting, methods ECS was performed on sperm donor applicants as part of the routine donor qualification process. Testing was performed at an outside reference laboratory after participants provided written consent for genetic testing. The genes included on the ECS panel were analyzed using multiple methodologies. Specific methodologies varied based upon laboratory offerings at the time in which the potential donor entered the donor program. Main results and the role of chance A total of 966 PDs had ECS during the specified timeframe. Of these applicants, 19 total PDs (1.97%) were identified as having potentially significant health risks based on their ECS results. Of those 19 PDs, eleven were found to be either heterozygous or hemizygous for conditions that may convey significant health risks to carriers. Of these, nine were positive for a variant in a gene typically associated with an AR condition and two carried variants in genes associated with X-linked conditions. Eight additional PDs were found to be either compound heterozygous or homozygous for variants in a gene associated with an autosomal recessive condition. Limitations, reasons for caution Donor recruitment was limited to select major metropolitan areas in the U.S.; thus, donor applicants may not represent all ethnic groups or socioeconomic backgrounds. Additionally, this study described results from a single reference laboratory and does not illustrate the variation in ECS panels across genetic testing laboratories. Wider implications of the findings While this study examined ECS results in a donor applicant population, findings are also applicable to the general reproductive population and illustrate the necessity of informed consent and post-test counseling. In some cases, ECS may provide insight on potential future health risks and health management opportunities. Trial registration number Not applicable

The influence of socioeconomic characteristics on active travel in US metropolitan areas and the contribution to health inequity

Background: The prevalence of chronic disease in the US adult population varies across socioeconomic groups in the USA where approximately six in 10 adults have a chronic condition. Walking or cycling reduces the risk to many of these diseases and is influenced by the built environment, accessibility, and safety. Methods: We performed multivariate logistic and linear regression on the Health-Oriented Transportation model parameters using the 2009 and 2017 US National Household Transportation surveys, restricted to adults in major metropolitan areas. Model covariates included socioeconomic and environmental characteristics. Results: Using odds ratios (OR) adjusted for model covariates, we observe several significant variables in 2009 and 2017. Residents of households with no cars were more likely to walk or cycle than those with two cars; OR=5.4 (4.8, 6.0). Residents of households in a census block with population density greater than 2,5000 persons/square mile were more likely to walk or cycle than those with a population density of 2000–3999; OR=2.6 (2.3, 2.8). Individuals with a graduate or professional degree were more likely to walk or cycle than those with a high school degree; OR=2.1 (1.9, 2.2). Individuals that self-report as Black or African American, or Asian are less likely to walk or cycle than White; OR=0.60 (0.56, 0.66), OR=0.70 (0.65, 0.75). The proportional increase in all-cause mortality from estimated reductions in physical activity for African American, Asian, and Hispanic populations were 1.0%, 0.7%, 0.8%, respectively. Conclusions: Access to automobiles and the surrounding population density are primary factors in the decision to walk or cycle. After adjusting for these and other factors, members of low-income, low-education, Black or African American, and Asian populations in US metropolitan areas are less likely to walk or cycle than high-income, high-education, or White populations and the discrepancy in physical activity is likely to contribute to health inequity.

Multi-scale telecoupling effects of land use change on ecosystem services in urban agglomerations --A case study in the middle reaches of Yangtze River urban agglomerations

A systematic understanding of the influences of land use change/land cover change (LUCC) on ecosystem services (ES) is significant for maintaining sustainable development of ecosystems. Previous studies on the effects of LUCC on ES have been discussed at multiple dimensions and scales, but there is still a lack of systematic studies on the influences of LUCC and its telecoupling effects on ES at different spatial scales and in different levels of urban agglomerations from a systemic perspective. Therefore, this paper endeavours to fill in the blanks. On the basis of quantifying the spatial and temporal evolution characteristics of LUCC and ES in the middle reaches of Yangtze River urban agglomerations (MRYRUA) and its three major metropolitan areas (C-Z-T metropolitan; Wu-Han Metropolian; Poyang Lake Metropolian), a spatial self-lagging of X model (SLX) based on the gravitational spatial weight matrix is constructed to explore this problem. The results show that the overall land use intensity of the MRYRUA has increased by 0.07% from 1990 to 2020, with the largest increase in the C-Z-T metropolitan area. Carbon fixation, soil conservation, habitat quality and water purification service show different degrees of fluctuation within the three metropolitan areas, with the greatest fluctuation in C-Z-T metropolitan area. At different spatial scales, LUCC and its telecoupling effect have a significantly negative effect on ES, and with the expansion of the scale, the negative effect will be strengthened gradually, while the influences of LUCC and its telecoupling effects on ES differ significantly in different levels of urban agglomerations. This paper can provide a reference for the implementation of differentiated land use and ecological protection policies for different levels of urban agglomerations.

A Community-Based Survey of Colorectal Cancer Screening Behaviors in Chinese Immigrants Residing in a Major Metropolitan Area.

Colorectal cancer is a common cause of screening preventable death in Chinese immigrants, but colorectal cancer screening rates remain low in this population. This study evaluated factors associated with colorectal cancer screening behaviors in Chinese Americans living in New York City. Participants were foreign-born Chinese Americans, aged 50 years or older, who completed internet surveys between November 2020 and May 2021 regarding their colorectal cancer screening behaviors. Data were collected on demographics, health care utilization, participants' levels of health literacy, English proficiency, colorectal cancer perceptions and current colorectal cancer screening behaviors. Bivariate analyses using chi-square or t-tests were performed to examine associations between colorectal cancer screening behaviors and participant characteristics. 103 participants were surveyed with a mean age of 71.3 years. Most participants experienced high rates of socioeconomic disadvantage (i.e., less than a high school education, annual household income <$20,000, limited health literacy, and poor English proficiency). 92% were ever screened, 81% were up-to-date on screening, and 85% expressed intention to screen in the future. Almost all participants had a primary care provider and a language concordant provider. Individuals who intended to screen were more fearful of developing colorectal cancer (3.2 vs 2.8, p=0.02) and perceived a colorectal cancer diagnosis with greater severity (3.0 vs 2.7, p=0.07) than those without intention to screen. In our sample, Chinese immigrants were adversely impacted by multiple social determinants of health but reported high colorectal cancer screening rates. Community-based outreach is critical to ensuring cancer-screening engagement in medically vulnerable populations.

Sitting at the Head Table and Leading Change: AMDA’s 2023 Policy Initiatives

Sitting at the Head Table and Leading Change: AMDA’s 2023 Policy Initiatives