United States Cities Research Articles

Fine-scale spatial variability of heat-related mortality in Philadelphia County, USA, from 1983-2008: a case-series analysis

BackgroundHigh temperature and humidity conditions are associated with short-term elevations in the mortality rate in many United States cities. Previous research has quantified this relationship in an aggregate manner over large metropolitan areas, but within these areas the response may differ based on local-scale variability in climate, population characteristics, and socio-economic factors.MethodsWe compared the mortality response for 48 Zip Code Tabulation Areas (ZCTAs) comprising Philadelphia County, PA to determine if certain areas are associated with elevated risk during high heat stress conditions. A randomization test was used to identify mortality exceedances for various apparent temperature thresholds at both the city and local scale. We then sought to identify the environmental, demographic, and social factors associated with high-risk areas via principal components regression.ResultsCitywide mortality increases by 9.3% on days following those with apparent temperatures over 34°C observed at 7:00 p.m. local time. During these conditions, elevated mortality rates were found for 10 of the 48 ZCTAs concentrated in the west-central portion of the County. Factors related to high heat mortality risk included proximity to locally high surface temperatures, low socioeconomic status, high density residential zoning, and age.ConclusionsWithin the larger Philadelphia metropolitan area, there exists statistically significant fine-scale spatial variability in the mortality response to high apparent temperatures. Future heat warning systems and mitigation and intervention measures could target these high risk areas to reduce the burden of extreme weather on summertime morbidity and mortality.

Patrol officers' perceived role in responding to cybercrime

PurposeLittle empirical research exists regarding how local law enforcement has responded to cybercrime. This paper aims to understand: the law enforcement agencies that line officers believe should be primarily responsible for investigating cybercrime cases; their perceptions about their agency's current ability to respond to these offenses; and their beliefs regarding the best ways to improve the social response to cybercrime.Design/methodology/approachThe authors surveyed patrol officers in the Charlotte‐Mecklenburg and Savannah‐Chatham Metropolitan police departments.FindingsThe authors found that officers do not believe that local law enforcement should be primarily responsible for handling cybercrime cases and they have little information on how upper management is addressing cybercrime. Officers indicated that the best strategies to deal with cybercrime were greater care taken by citizens online and improvements to the legal system.Research limitations/implicationsLocal law enforcement agencies feel they are unable to fully address cybercrime. Although the findings were generally consistent across demographic and experiential characteristics and cities, two cities in the southeastern United States were surveyed.Practical implicationsAccording to these officers, they want citizens to be more careful online and for clarification of cybercrime laws and increased prosecutions. They do not favor local cybercrime units and additional computer training for line officers as much as scholars and police administrators advocate.Originality/valueThis paper studied the perceptions of patrol officers, who are the first responders to most crime scenes, on local law enforcement responses to cybercrime and the strategies they view to be most effective in combating cybercrime.

Has Ethno-Racial Segregation Increased in the Greater Paris Metropolitan Area?

Changes in the intensity of ethno-racial segregation in the greater Paris metropolitan area over the last three census periods are analyzed. First, immigrants strictly speaking (persons who themselves immigrated) were studied in terms of national origin; to this group were added all second-generation immigrants that could be identified by means of census information. Scale used is neighborhoods and municipalities in the greater Paris metropolitan area. Dissimilarity and isolation indices as well as concentrations by commune (municipality) show that the most intensely segregated immigrants are from North Africa, sub-Saharan Africa and Turkey, that segregation is increasing at a moderate rate, and that it is significantly more pronounced than socio-economic segregation while remaining well below racial segregation levels observed for United States cities. The vast majority of immigrants studied live in neighborhoods where they represent a minority, meaning they are living in residentially mixed situations, not ghettos.

Renegade Asset Markets

Local markets with tight land use controls result in prices rising relative to wages and affordability. Affordability is eased by unconventional but risky finance. Tight land use and loose financing in these renegade markets concentrates the impact of national or international shocks. A positive demand shock raises prices in these tight markets. If ongoing price momentum is expected, households switch to ownership and landlords reduce the rental stock. House prices, rents and occupancy rise and fall together in these markets. A five-equation sequential structure in land use, financial contracts, house prices, rents and vacancy for 17 United States cities confirms geographical concentration. Coastal California and South Florida are fundamentally risky markets. Discount rates there are three percentage points higher than the sample median. Two percentage points are attributable to land use and the other to unconventional finance. National and international financial crises are highly concentrated regionally.

Ozone and Survival in Four Cohorts with Potentially Predisposing Diseases

Time series studies have reported associations between ozone and daily deaths. Only one cohort study has reported the effect of long-term exposures on deaths, and little is known about effects of chronic ozone exposure on survival in susceptible populations. We investigated whether ozone was associated with survival in four cohorts of persons with specific diseases in 105 United States cities, treating ozone as a time varying exposure. We used Medicare data (1985–2006), and constructed cohorts of persons hospitalized with chronic conditions that might predispose to ozone effects: chronic obstructive pulmonary disease, diabetes, congestive heart failure, and myocardial infarction. Yearly warm-season average ozone was merged to the individual follow-up in each city. We applied Cox proportional hazard model for each cohort within each city, adjusting for individual risk factors, temperature, and city-specific long-term trends. We found significant associations with a hazard ratio for mortality of 1.06 (95% confidence interval [CI], 1.03–1.08) per 5-ppb increase in summer average ozone for persons with congestive heart failure; of 1.09 (95% CI, 1.06–1.12) with myocardial infarction; of 1.07 (95% CI, 1.04–1.09) with chronic obstructive pulmonary disease; and of 1.07 (95% CI, 1.05–1.10) for diabetics.We also found that the effect varied by region, but that this was mostly explained by mean temperature, which is likely a surrogate of air conditioning use, and hence exposure. This is the first study that follows persons with specific chronic conditions, and shows that long-term ozone exposure is associated with increased risk of death in these groups.

Childhood acute leukemias are frequent in Mexico City: descriptive epidemiology

BackgroundWorldwide, acute leukemia is the most common type of childhood cancer. It is particularly common in the Hispanic populations residing in the United States, Costa Rica, and Mexico City. The objective of this study was to determine the incidence of acute leukemia in children who were diagnosed and treated in public hospitals in Mexico City.MethodsIncluded in this study were those children, under 15 years of age and residents of Mexico City, who were diagnosed in 2006 and 2007 with leukemia, as determined by using the International Classification of Childhood Cancer. The average annual incidence rates (AAIR), and the standardized average annual incidence rates (SAAIR) per million children were calculated. We calculated crude, age- and sex-specific incidence rates and adjusted for age by the direct method with the world population as standard. We determined if there were a correlation between the incidence of acute leukemias in the various boroughs of Mexico City and either the number of agricultural hectares, the average number of persons per household, or the municipal human development index for Mexico (used as a reference of socio-economic level).ResultsAlthough a total of 610 new cases of leukemia were registered during 2006-2007, only 228 fit the criteria for inclusion in this study. The overall SAAIR was 57.6 per million children (95% CI, 46.9-68.3); acute lymphoblastic leukemia (ALL) was the most frequent type of leukemia, constituting 85.1% of the cases (SAAIR: 49.5 per million), followed by acute myeloblastic leukemia at 12.3% (SAAIR: 6.9 per million), and chronic myeloid leukemia at 1.7% (SAAIR: 0.9 per million). The 1-4 years age group had the highest SAAIR for ALL (77.7 per million). For cases of ALL, 73.2% had precursor B-cell immunophenotype (SAAIR: 35.8 per million) and 12.4% had T-cell immunophenotype (SAAIR 6.3 per million). The peak ages for ALL were 2-6 years and 8-10 years. More than half the children (58.8%) were classified as high risk. There was a positive correlation between the average number of persons per household and the incidence of the pre-B immunophenotype (Pearson's r, 0.789; P = 0.02).ConclusionsThe frequency of ALL in Mexico City is among the highest in the world, similar to those found for Hispanics in the United States and in Costa Rica.

Assessing the consistency of community structure in complex networks.

In recent years, community structure has emerged as a key component of complex network analysis. As more data have been collected, researchers have begun investigating changing community structure across multiple networks. Several methods exist to analyze changing communities, but most of these are limited to evolution of a single network over time. In addition, most of the existing methods are more concerned with change at the community level than at the level of the individual node. In this paper, we introduce scaled inclusivity, which is a method to quantify the change in community structure across networks. Scaled inclusivity evaluates the consistency of the classification of every node in a network independently. In addition, the method can be applied cross sectionally as well as longitudinally. In this paper, we calculate the scaled inclusivity for a set of simulated networks of United States cities and a set of real networks consisting of teams that play in the top division of American college football. We found that scaled inclusivity yields reasonable results for the consistency of individual nodes in both sets of networks. We propose that scaled inclusivity may provide a useful way to quantify the change in a network's community structure.

Clinical Depression and Condom Use Attitudes and Beliefs Among African American Adolescent Females

Depression, HIV, and other sexually transmitted diseases (STDs) are growing concerns among African American adolescent females. Theoretical models contribute to identification of mediators of condom use; however, minimal research has addressed the explicit relationship between clinical depression and condom use in African American adolescent females. The authors report results from quantitative surveys with clinically depressed (n = 64) and nondepressed (n = 64) African American adolescent females in two large metropolitan cities in the eastern United States. Theoretical mediators of condom use in the study sample-attitudes, subjective norms, perceived behavioral control, and intentions-were investigated. Significant differences existed between the groups in condom use frequency (U = 356.5, p = .037); however, there were no statistically significant differences in condom use attitudes and beliefs. Although clinically depressed and nondepressed African American adolescent females may hold similar attitudes and beliefs about condom use, differences in condom use frequency may be a psychopathologic occurrence.

Does Use of the Adjuvant! Model Influence Use of Adjuvant Therapy Through Better Risk Communication?

Adjuvant! is a model that provides recurrence and mortality risk predictions for patients with breast cancer considering adjuvant therapies. Although low-risk patients who saw Adjuvant! chose adjuvant therapy less frequently, whether this was because of educational or other aspects of the decision aid is unknown. The authors explored whether Adjuvant! affects choice of therapy through increased patient knowledge. A subset of data were analyzed from a cluster randomized trial in which oncology practices in 2 major United States cities were randomly assigned to use either Adjuvant! or an informational pamphlet to educate patients. Of 405 patients, 48 were low-risk, with 28 assigned to the decision aid and 20 to the pamphlet. Among the low-risk patients, using frequency tables and Fisher exact tests, the authors explored whether Adjuvant! was associated with more accurate patient estimates of survival; whether accuracy was associated with treatment choice; and whether, after controlling for accuracy, any remaining association was seen between Adjuvant! and treatment choice. Adjuvant! was associated with more accurate estimates of baseline prognosis compared with the pamphlet (57% vs. 25%; P = .04). Patients who had more accurate estimates of baseline prognosis were less likely to choose adjuvant therapy (62% vs. 89%; P = .04). After controlling for accuracy, no statistically significant association was found between the use of Adjuvant! and adjuvant therapy (P = .59 and P = .11 for inaccurate and accurate patients, respectively). Adjuvant! seems to influence patient choice through educational rather than other means of persuasion. However, many patients held inaccurate risk perceptions after viewing Adjuvant!.

Using Split Samples and Evidence Factors in an Observational Study of Neonatal Outcomes

During a few years around the turn of the millennium, a series of local hospitals in Philadelphia closed their obstetrics units, with the consequence that many mothers-to-be arrived unexpectedly at the city’s large, regional teaching hospitals whose obstetrics units remained open. Nothing comparable happened in other United States cities, where there were only sporadic changes in the availability of obstetrics units. What effect did these closures have on mothers and their newborns? We study this question by comparing Philadelphia before and after the closures to a control Philadelphia constructed from elsewhere in Pennsylvania, California, and Missouri, matching mothers for 59 observed covariates including year of birth. The analysis focuses on the period 1995–1996, when there were no closures, and the period 1997–1999 when five hospitals abruptly closed their obstetrics units. Using a new sensitivity analysis for difference-in-differences with binary outcomes, we examine the possibility that Philadelphia mothers differed from control mothers in terms of some covariate not measured, and perhaps the distribution of that unobserved covariate changed in a different way in Philadelphia and control–Philadelphia in the years before and after the closures. We illustrate two recently proposed techniques for the design and analysis of observational studies, namely split samples and evidence factors. To boost insensitivity to unmeasured bias, we drew a small random planning sample of about 26,000 mothers in 13,000 pairs and used them to frame hypotheses that promised to be less sensitive to bias; then these hypotheses were tested on the large, independent complementary analysis sample of nearly 240,000 mothers in 120,000 pairs. The splitting was successful twice over: (i) it successfully identified an interesting and moderately insensitive conclusion, (ii) by comparison of the planning and analysis samples, it is clearly seen to have avoided a exaggerated claim of insensitivity to unmeasured bias that might have occurred by focusing on the least sensitive of many findings. Also, we identified two approximate evidence factors and one test for unmeasured bias: (i) factor 1 compared Philadelphia to control before and after the closures, (ii) factor 2 focused on the years 1997–1999 of abrupt closures and compared zip codes with closures to zip codes without closures, (iii) and the test for bias focused on the years 1995–1996 prior to closures and compared zip codes which would have closures in 1997–1999 to zip codes without closures in 1997–1999—any ostensible effect found in that last comparison is surely bias from the characteristics of Philadelphia zip codes in which closures took place. Approximate evidence factors provide nearly independent tests of a null hypothesis such that the evidence in each factor would be unaffected by certain biases that would invalidate the other factor.

High‐Dose Daptomycin for Treatment of Complicated Gram‐Positive Infections: A Large, Multicenter, Retrospective Study

To evaluate the clinical response and safety of high-dose daptomycin for treatment of complicated gram-positive infections. Multicenter, retrospective, observational, case series analysis. Five academic medical centers in four major United States cities. Two hundred fifty adults, not undergoing dialysis, who received high-dose daptomycin (≥ 8 mg/kg/day) for at least 72 hours for complicated gram-positive infections between January 1, 2005, and March 1, 2010. Clinical and microbiologic outcomes were assessed at the end of high-dose daptomycin therapy. Safety evaluations were recorded for all patients, and when available, baseline, end-of-therapy, and highest observed serum creatine phosphokinase (CPK) levels were recorded. Methicillin-resistant Staphylococcus aureus (MRSA) and vancomycin-resistant Enterococcus faecium (VRE) were the primary organisms isolated. The median dose of daptomycin was 8.9 mg/kg/day (interquartile range [IQR] 8.0-10.0 mg/kg/day). The median duration of daptomycin during hospitalization for MRSA and VRE infection was 10 days (IQR 5-16 days) and 13 days (IQR 6-18 days), respectively. Among the 250 patients, high-dose daptomycin was primarily used as salvage therapy after vancomycin treatment (184 patients [73.6%]). Primary infections included complicated bacteremia (119 patients [47.6%]), endocarditis (59 [23.6%]), skin or wound (70 [28.0%]), and bone or joint (67 [26.8%]). Overall, clinical response and microbiologic success were assessed in 83.6% (209/250 patients) and 80.3% (175/218 patients), respectively. Isolates from 13 patients (5.2%) developed nonsusceptibility to daptomycin, with most of these patients having extended vancomycin exposure. Three patients (1.2%) developed an adverse event attributable to high-dose daptomycin therapy, with the event considered either mild or moderate in severity. The median end-of-therapy CPK level was 39 U/L (IQR 26-67 U/L). No significant correlation was found between daptomycin dose and highest observed CPK level. Daptomycin dosages of 8 mg/kg/day or greater may be safe and effective in patients with complicated gram-positive infections. Further clinical studies are warranted.

Assessing the association between brown rat (Rattus norvegicus) activity and food and harbourage characteristics in a residential community of a medium-sized United States city

Rattus norvegicus (brown rat) is a host for several zoonoses. The United States Centers for Disease Control and Prevention provides survey tools to ascertain prevalent rat food and harbourage (FAH) and activity (RA) to complement as integrated pest management strategies. The local health department in a medium-sized city assessed to what degree FAH surveys alone predicted where and when to deploy mitigating infestation interventions by determining (1) neighbourhood-specific food and harbourage prevalence; (2) neighbourhood-specific rat activity prevalence; and (3) whether food and harbourage survey alone could predict prevalent rat activity. A cross-sectional study design was used to collect data from lots (land parcels) in targeted survey areas. Area-specific survey means and proportions were compared and assessed for true differences. Multiple linear regression was used to construct an intervention decision tool. Investigators observed significantly different food and harbourage scores between control and target survey areas. The proportion of high activity scores was lower in control survey areas compared to the target survey area. FAH scores moderately predicted RA. FAH survey scores moderately predict rat activity in this community.

Mexican American Public Sector Professionals

Diversity among civil service employees, affirmative action, and workplace discrimination continue to be salient and potentially dynamic issues for public sector human resource managers. In an effort to better understand a fast-growing but rarely studied subgroup of the public workforce, this study compares Mexican American managers’ perceptions of affirmative action and workplace discrimination to those of their White and Black, non-Hispanic peers. Data for this study come from two large Southwestern United States cities, Phoenix, Arizona and San Antonio, Texas. Results from bivariate and multivariate analyses show that managers, as a collective group, do not believe affirmative action policies and workplace discrimination have affected advancement. However, when the data are disaggregated and reexamined by race or ethnicity, significant differences of opinion emerge. We find evidence that Mexican American managers perceive affirmative action policies and workplace discrimination differently than their peers.

Destination Branding and Images: Perceptions and Practices from Tourism Industry Professionals

The intensified competition among convention cities has created an increasing interest for cities to better understand how to market themselves as a convention destination. A city's image is one of the highest indicators of its success as a convention location. It becomes imperative for each city to specifically analyze its strengths and weaknesses. Because there is a lack of literature regarding medium-sized convention cities, this study compares Knoxville, Tennessee to other similarly populated cities in the southeastern United States. The perceived importance of city attributes and the tourism professional's perception of the strengths and weaknesses of the particular city as a convention destination are based on the years of experience of the tourism professional in the industry and participants' demographic characteristics. The sample of the study was industry professionals that attended the Tennessee Governor's Conference on Tourism held in Knoxville in September 2006. Implications from this study may be used to improve the competitive position of Knoxville as a convention destination.

Public Access Defibrillation

In the United States, 250,000 people die from a cardiac arrest every year. Despite a well established emergency medical response system, survival from out-of-hospital cardiac arrest remains poor in United States cities. Paramount to achieving successful resuscitation of a cardiac arrest victim is provision of early defibrillation. Among patients that arrest due to a ventricular fibrillation, the likelihood of survival decreases by 10% for every minute of delay in defibrillation. In 1995, the American Heart Association challenged the medical industry to develop a defibrillator that could be placed in public settings, used safely by lay responders, and provide earlier defibrillation to cardiac arrest victims. Over the last decade, there have been significant technological advancements in automated external defibrillators (AEDs), and clinical studies have demonstrated their benefits and limitations in various public locations. This article discusses the technologic features of the modern AED and the current data available on the use of AEDs in public settings.

Value Landscape Engineering: Identifying Costs, Water Use, Labor, and Impacts to Support Landscape Choice1

Rosenberg, David E., Kelly Kopp, Heidi A. Kratsch, Larry Rupp, Paul Johnson, and Roger Kjelgren, 2011. Value Landscape Engineering: Identifying Costs, Water Use, Labor, and Impacts to Support Landscape Choice. Journal of the American Water Resources Association (JAWRA) 47(3):635-649. DOI: 10.1111/j.1752-1688.2011.00530.x Abstract: We present a spreadsheet model that identifies the costs, water, labor, fertilizer, pesticides, fuel, energy, carbon emissions, and particulates required of and generated by a user-specified residential or commercial landscape over its economic life. This life includes site preparation, materials purchase, installation, annual maintenance and replacing landscape features that wear out or die. Users provide a variety of site-descriptive information and the model queries an extensive database of landscape data to calculate costs, required inputs, and impacts. We verified model results against observations of water, labor, fertilizer, and fuel use over eight years at three landscapes in the Salt Lake City, Utah metropolitan region. We use the model to show tradeoffs in costs and required inputs for a predominately cool-season turfgrass landscape typical for Salt Lake City and other high desert, intermountain western United States cities and potential modifications to that typical landscape. Results highlight strategies water conservation programs can use to encourage property owners to install and adopt water-conserving landscape features and practices. Residential and commercial landscapers, landscape architects, contractors, and property owners can also model current and proposed landscapes and use results to identify a low-cost, low-input landscape that achieves their client’s or their own goals and values.

Research Article: The Decline and Recovery of Intercity Bus Service in the United States: A Comeback for an Environmentally Friendly Transportation Mode?

The intercity bus sector in the United States (US) has experienced a dramatic recovery in recent years due to the expansion of new curbside operators—express operators linking major cities that do not use traditional stations. Curbside operators such as BoltBus, DC2NY Bus, and Megabus are infusing new life into this once-struggling sector, particularly in the Midwest and Northeast. This study explores two aspects of the changing role of the intercity bus. First, it evaluates the extent to which intercity bus service diminished after 1960 and its subsequent recovery starting in 2006. Drawing on newly collected data from 11,400 arrivals and departures from a representative sample of US cities between 1960 and 2010, it shows that US cities lost more than three quarters of their intercity bus services before the recovery began. Secondly, it shows how recent growth of curbside-bus operators is reducing fuel consumption by about 11 million gallons annually and reducing carbon emissions by an estimated 242 million pounds. This is the equivalent benefit of removing 23,114 vehicles from the road or having 66,041 people convert from conventional to hybrid cars. These findings suggest that the sector's recovery has significant and perhaps underappreciated environmental benefits. It also suggests that further expansion by the sector, nurtured by public policy, could be an effective strategy to promote more energy-efficient intercity travel. Environmental Practice 13:1–9 (2011)

Generation Y consumers’ selection attributes and behavioral intentions concerning green restaurants

The objectives of this study are to examine the Generation Y consumer segments’ selection attributes and behavioral intentions toward green restaurants. A survey was administered to college students between the ages of 17 and 30 at a university in a Southeastern United States city. This study identified four different consumer segments of Generation Y college students according to their food-related lifestyles. Across the four segments, there were significant differences in selection attributes. In addition, significant differences were identified between the four segments regarding their behavioral intentions toward green restaurants. Finally, the marketing implications for the target groups are discussed.

Determinants of Aggression Toward Sexual Minorities in a Community Sample.

OBJECTIVE: Sexual prejudice and masculine gender role stress were examined as mediators of the associations between adherence to different male gender norms and aggression toward sexual minorities. This study also sought to extend past research to a community sample and employ multiple methods to assess aggression. METHOD: Participants were 199 heterosexual men between the ages of 18-30 who were recruited from a large southeastern United States city. Participants completed measures of adherence to male gender role norms, sexual prejudice, masculine gender role stress, and aggression toward sexual minorities. RESULTS: Associations between adherence to the status and antifemininity norms and aggression toward sexual minorities were mediated by sexual prejudice, but not masculine gender role stress. The portion of unique association between adherence to the antifemininity norm and aggression toward sexual minorities was about three times larger than the portion mediated by sexual prejudice and masculine gender role stress. CONCLUSIONS: Findings provide the first multivariate evidence from a community-based sample for determinants of aggression toward sexual minorities motivated by gender role enforcement. These data support intervention programming and preventative intervention studies aimed at reducing sexual prejudice and facilitating less stereotypic attitudes about the male gender role, particularly surrounding the antifemininity norm.

ENERCA clinical recommendations for disease management and prevention of complications of sickle cell disease in children

Universal neonatal screening is performed in the United States, England, the Netherlands, and several cities in Belgium, with selective screening targeted on "high-risk" population in France (globally, one quarter of all the babies born in France are screened). Newborns diagnosed with a major sickle cell syndrome (SCD) should be referred to a designated pediatric sickle cell centre, and the parents are informed that their child has SCD; this may be in the sickle cell centre by an expert physician or in the community by an experienced nurse counsellor. The pediatric sickle cell centre should organize the care of the baby.