A Review of Research on Urban Playability from a Social Justice Perspective

Playability is an attribute that refers to the ability to stimulate individual responses or collective action in an immersive activity in an exploratory way. Playability is an important component of the enjoyment and well-being of urban dwellers, has the potential to stimulate urban vitality and is an important expression of the inclusiveness and equity of urban space. The pursuit of economic development and efficiency-oriented urban construction has led to the domination of urban space by overcrowded traffic, economy-oriented commerce and densely populated housing. Moreover, the existence of playable space has become a scarce resource and is seen as a site for the materialisation of social rights. As the haze of the COVID-19 pandemic fades and cities are again exposed to wider and more participatory use, determining how to adapt urban spaces to the playability needs of users of different ages, cultural backgrounds and social classes, and provide them with appropriate site use and experience, is becoming a hot issue of concern for building equitable and high-quality urban spaces. The study of the playability of urban spaces is highly complex, and the related research on social justice is cryptic. In order to better investigate the social equity aspects of urban playability, this paper integrates scientometric and manual methods to review the relevant research. This paper takes 2664 related papers from the Web of Science (WOS) core dataset from 1998 to 2022 as the research object and employs CiteSpace to organise the existing research results of playful urban spaces. Quantitative analysis is used to clarify the theoretical foundations, developments and research hotspots of urban spatial playability, while the manual collation and generalisation of the studies uncover the hidden issues of social justice research. Based on the proposed research method, we summarize the key three research stages related to urban spatial playability and social equity. We also discuss the development of urban spatial playability in the perspective of social justice from three aspects: micro, meso and macro. The results can help readers better understand the current status and development process of research on playful urban space. In particular, we clarify the issues related to social justice under the theme of the playability of urban spaces and provide directions for future research on building playful cities and promoting the development of urban socio-spatial equity.

Lessons for the Age of Consequences: COVID-19 and the Macroeconomy

Comparative empirical evidence for 22 OECD countries shows that country differences in cumulative mortality impacts of SARS-CoV-2 are caused by weaknesses in public health competences, pre-existing variances in structural socio-economic and public health vulnerabilities, and the presence of fiscal constraints. Remarkably, the (fiscally non-constrained) U.S. and the U.K. stand out, as they experience mortality outcomes similar to those of fiscally-constrained countries. High COVID19 mortality in the U.S. and the U.K. is due to pre-existing socio-economic and public health vulnerabilities, created by the following macroeconomic policy errors: (a) a deadly emphasis on fiscal austerity (which diminished public health capacities, damaged public health and deepened inequalities);(b) an obsessive belief in a trade-off between ‘efficiency' and ‘equity', which is mostly used to justify extreme inequality;(c) a complicit endorsement by mainstream macro of the unchecked power over monetary and fiscal policy-making of global finance and the rentier class;and (d) an unhealthy aversion to raising taxes, which deceives the public about the necessity to raise taxes to counter the excessive liquidity preference of the rentiers and to realign the interests of finance and of the real economy. The paper concludes by outlining a few lessons for a saner macroeconomics.

Experiences of accumulated stress among aging parent caregivers of adults with autism spectrum disorder

With the continuing increased incidence rate of autism spectrum disorder over the decades, there are increasing numbers of adults with autism who require varying levels of lifelong care, typically from parents. It is necessary to understand parents' lived experience of lifelong caregiving, and how their own aging process further impacts life quality. Furthermore, greater understanding of stressors, resources, appraisals, and coping among parent caregivers of children with "high functioning autism" who are transitioning into young adulthood is particularly necessary as services, needs, and experiences for both are nuanced due to functional status, deficits in the service system, and demographic disparities. Given lifespan aspects past research has not addressed, the study focused on development of a measure of parent accumulated stressors, and on interrelations of stressors, perceived social support, future time perspective, burden, satisfaction, and coping on health-related quality of life and meaning in life among 28 parents of young adults with autism. Although proposed quantitative analyses were not completed due to sample size, qualitative analyses on parent experiences and stressors revealed common themes of concern for child's future quality of life, complicated dynamics of providing help to their child overtime, and increased stress related to others' lack of understanding of their child. In total, 10 themes and multiple subthemes were identified in relation to aspects of accumulated stressors. Findings suggest parent stress with this specific population is complex, manifesting in nuanced ways at different life stages. Impacts of the COVID-19 pandemic are also explored, and implications for scientific advancement and clinical services are discussed. (PsycInfo Database Record (c) 2023 APA, all rights reserved)

Ethical moments and institutional expertise in UK Government COVID-19 pandemic policy responses: where, when and how is ethical advice sought?

Background:The emergency response to the COVID-19 pandemic has required a rapid acceleration of policy decision making, and raised a wide range of ethical issues worldwide, ranging from vaccine prioritisation, welfare and public health ‘trade-offs', inequalities in policy impacts, and the legitimacy of scientific expertise.Aims and objectives:This paper explores the legacy of the pandemic for future science-advice-policy relationships by investigating how the UK government's engagement with ethical advice is organised institutionally. We provide an analysis of some key ethical moments in the UK Government response to the pandemic, and institutions and national frameworks which exist to provide ethical advice on policy strategies.Methods:We draw on literature review, documentary analysis of scientific advisory group reports, and a stakeholder workshop with government ethics advisors and researchers in England.Findings:We identify how particular types of ethical advice and expertise are sought to support decision making. Contrary to a prominent assumption in the extensive literature on ‘governing by expertise', ethical decisions in times of crisis are highly contingent.Discussion and conclusions:The paper raises an important set of questions for how best to equip policymakers to navigate decisions about values in situations characterised by knowledge deficits, complexity and uncertainty. We conclude that a clearer pathway is needed between advisory institutions and decision makers to ensure ethically-informed debate.

Tracking the Transit Divide: A Multilevel Modelling Approach of Urban Inequalities and Train Ridership Disparities in Chicago

Using a multilevel modelling approach, this study investigates the impact of urban inequalities on changes to rail ridership across Chicago's "L” stations during the pandemic, the mass vaccination rollout, and the full reopening of the city. Initially believed to have an equal impact, COVID-19 disproportionally impacted the ability of lower socioeconomic status (SES) neighbourhoods' to adhere to non-pharmaceutical interventions: working-from-home and social distancing. We find that "L” stations in predominately Black or African American and Hispanic or Latino neighbourhoods with high industrial land-use recorded the smallest behavioural change. The maintenance of higher public transport use at these stations is likely to have exacerbated existing health inequalities, worsening disparities in users' risk of exposure, infection rates, and mortality rates. This study also finds that the vaccination rollout and city reopening did not significantly increase the number of users at stations in higher vaccinated, higher private vehicle ownership neighbourhoods, even after a year into the pandemic. A better understanding of the spatial and socioeconomic determinants of changes in ridership behaviour is crucial for policymakers in adjusting service routes and frequencies that will sustain reliant neighbourhoods' access to essential services, and to encourage trips at stations which are the most impacted to revert the trend of declining public transport use.

Confinement with No Rights. Perceptions of Inmates' Relatives Regarding Measures for COVID-19 Control Implemented in Mexican Prisons

Based on a participatory study design, this article describes how a group of family members of people deprived of liberty (PDL) experienced the COVID-19 control measures implemented in Mexico's prisons. We conducted 28 in-depth interviews and analyzed them using ATLAS.ti. We found that the measures implemented in Mexican prisons to avoid the spread of COVID-19 focused mainly on suspension of visitation and PDL confinement. The isolation imposed on PDL impacted their living conditions, making them more vulnerable to contracting COVID-19 due to lack of access to essential services, food, and hygiene supplies. Visit restrictions and PDL isolation also impacted PDL relatives' health and socioeconomic conditions. Our findings indicate that the consequences of COVID-19 control actions in Mexican prisons differ according to the gender and jurisdiction of PDL. Women in federal prisons were more isolated, while those in local ones were more deprived of basic supplies. Imprisoned women's isolation has especially severe effects on the mental and physical health of their elderly parents and children. The results show how the measures adopted to control COVID-19 outbreaks in Mexican prisons have exacerbated the preexisting systemic violence experienced by PDL and their families and how they have failed to prevent the spread of COVID-19 in these settings. These findings provide support for the health-informed penal reform of Mexican prisons.

East-west or up the urban hierarchy? Internal migration patterns in Slovakia since post-socialist transformation to COVID-19 pandemic

Changing spatial patterns of migration are closely related to the transformation of economy and society. Most current studies focus either on international migration or on the migration of particular urban regions. Our study evaluates migration trends in the entire national regional system, and thus it contributes to its comprehensive understanding. The study aims to evaluate the relationship of internal migration from economically lagging eastern to more developed western regions of Slovakia on the one hand, and migration between categories of regions according to the hierarchical position of their urban core on the other hand. The study follows the differential urbanization concept and analyses detailed data on individual migrations in Slovakia in 1996–2020. It thus covers the period from the post-socialist transformation to the COVID-19 pandemic. The results show the increasing intensity of east-west and up the urban hierarchy migration. Due to the significant polarization of migration between the eastern and western regional subsystems, we examined separately in both subsystems the migration excluding flows between the subsystems. The results revealed a concentration of population into metropolitan regions in both subsystems, although the intensity of the processes was lower and the onset of trends delayed in the eastern subsystem. A significant feature of development in the post-socialist period was intensive exurbanation in both subsystems. The study thus points to the importance of subnational and regional approaches to migration research, and reveals trends that can contribute to the explanation of migration development even in countries where such detailed migration statistics are not available. [ FROM AUTHOR] Copyright of Eurasian Geography & Economics is the property of Taylor & Francis Ltd and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full . (Copyright applies to all s.)

The pandemic within systemic injustice: Intersectional cultural dimensions of women's aging, health, and case stories of COVID-19

This book chapter delves into the intersectional cultural dimensions of COVID-19 and explores how pandemics expose and amplify past and current health inequities and disparities for minoritized women. In this chapter, the authors question how gender reflects and intersects with health determinants of oppressed and privileged identities to produce disparate health outcomes, affecting discourse, ideologies, and women's activity as they age. Additionally, issues of racism, classism, ageism, and other "isms" are examined to understand the challenges faced by aging women as they strive to stay healthy. The chapter concludes with case story narratives of women diagnosed with COVID-19, showing the virus' effect on marginalized women aging within a stratified society. © The Author(s), under exclusive license to Springer Nature Switzerland AG 2023. All rights reserved.

Medical Dental Integration in Wisconsin: Integrating dental hygienists into pediatric well child visits and prenatal care

Disparities exist in access to early oral health care, disproportionately impacting minority ethnic groups and populations with low socioeconomic status. Medical dental integration provides an opportunity to create a new dental access point for early prevention and intervention as well as care coordination. The Wisconsin Medical Dental Integration (WI-MDI) model expanded early access to preventive oral health services by integrating dental hygienists (DHs) into pediatric primary care and prenatal care teams to address oral health inequities with the goal of reducing dental disease. This case study will describe how DHs were incorporated into the medical care teams in Wisconsin and how legislation expanding scope of practice made this possible. Since 2019, five federally qualified health systems, one non-profit clinic, and two large health systems have enrolled in the WI-MDI project. Thirteen DHs have worked across nine clinics in the WI-MDI project and over 15,000 patient visits to a medical provider included oral health services provided by DHs from 2019 to 2023. Dental hygienists working in alternative practice models such as those demonstrated in the innovative WI-MDI approach are positioned to reduce oral health disparities through the provision of early and frequent dental prevention, intervention, and care coordination.

Public Health Data of the People, by the People, for the People: A Public Health of Consequence, June 2023

The author discusses a study by Krieger and colleagues, published within the issue which presents information on the alarming decreases in response rates across six national U.S. surveys in 2020 compared with those in 2019. Topics include people who were more likely to complete surveys than those who did, importance of the application of an equity-focused lens to data collection, and the impact of the COVID-19 pandemic on response rates.

Socio-economic and clinical drivers of COVID-19 mortality: An empirical analysis of the supply-side and demand-side moderators

The COVID-19 pandemic has disrupted everyday life globally, with severe consequences in several countries and regions. A key concern related to the COVID-19 pandemic is the wide variation in mortality across nations and sub-national locations such as states and counties. Anecdotal evidence, as well as evidence from CDC, indicates that the risk of spread as well as the risk of mortality from the pandemic is higher for regions with a population characterized by disadvantaged economic (income) and racial (underserved communities) and demographic profiles (age). Multiple studies have indicated that the most crucial step toward reducing mortality is expanding critical care capacity through procuring personal protective equipment (PPE) and ventilators and training critical care frontline employees. It is projected that with exponential growth in the pandemic spread, many regions would fall short of critical care capacity, increasing mortality.Furthermore, the pandemic has imposed high levels of constraints on resource availability, even in developed nations. Under resource constraints in critical care delivery, mitigation strategies need to account for the variation in observed cases and the disparity in mortality across locations. In my dissertation, I make a concerted effort to contribute toward understanding the sources of variation in mortality and propose a framework that enables pandemic preparedness and mitigation strategies that encapsulate the spatial and temporal variation in risk of mortality from COVID-19. The mitigation strategies are divided into supply-side and demand-side moderators of mortality. Accordingly, I focus on two mitigation strategies: (i) ICU capacity as a supply-side moderator and (ii) Vaccination coverage as a demand-side moderator. The overarching objective of my dissertation is to understand the role of supply-side and demand-side moderators of mortality, independently and jointly, of the association between socio-economic, demographic (henceforth referred to as social), and clinical risk factors and COVID-19 mortality. Much of the epidemiological literature on COVID-19 has focused on reducing the spread. However, the ultimate goal is to reduce mortality. There is a necessity in both practice and academic literature to understand actionable policies that can reduce mortality in general and spatial variation of mortality in specific. This dissertation research primarily leverages empirical methodology combining matching procedures with fixed effect modeling of panel data to test the hypothesized relationships of interest. (PsycInfo Database Record (c) 2023 APA, all rights reserved)

Vaccine ethics: An ethical framework for global distribution of COVID-19 vaccines

This paper addresses the just distribution of vaccines against the SARS-CoV- 2 virus and sets forth an ethical framework that prioritises frontline and essential workers, people at high risk of severe disease or death, and people at high risk of infection. Section I makes the case that vaccine distribution should occur at a global level in order to accelerate development and fair, efficient vaccine allocation. Section II puts forth ethical values to guide vaccine distribution including helping people with the greatest need, reducing health disparity, saving the most lives and promoting narrow social utility. It also responds to objections which claim that earlier years have more value than later years. Section III puts forth a practical ethical framework to aid decision-makers and compares it with alternatives. (PsycInfo Database Record (c) 2023 APA, all rights reserved)

The Other Side of the Balance Sheet: Work as a Fundamental Determinant of Health

The article discusses a study from Gaffney and colleagues, published within the issue which provides evidence for the fundamental role that workplace transmission played in differences in the risk of COVID-19 infection. Topics include the impact of occupational transmission of COVID-19;reasons for the denial on the role of work in the risk of disease, injury and death;and means by which work as a fundamental determinant of health can be targeted.

Dangerous liaisons? Applying the social harm perspective to the social inequality, housing and health trifecta during the Covid-19 pandemic

Global rates of excess mortality attributable to the Covid-19 pandemic provide a fresh impetus to make sense of the associations between income inequality, housing inequality and the social gradient in health, suggesting new questions about the ways in which housing and health are treated in the framing and development of public policy. The first half of the paper uses a social harm lens to examine the threefold associations of the social inequality, housing and health trifecta and offers new insights for policy analysis which foregrounds the production, transmission, and experience of various types of harm which occur within the home. The main body of the paper then draws upon the outcomes of an international systematic literature mapping review of 213 Covid-19 research papers to demonstrate three specific harms associated with stay-at-home lockdowns: (i) intimate partner and domestic violence, (ii) poor mental health and (iii) health harming behaviours. The reported findings are interpreted using a social harm perspective and some implications for policy analysis are illustrated. The paper concludes with a reflection on the efficacy of social harm as a lens for policy analysis and suggests directions for further research in housing studies and zemiology.

Declaration of Cuernavaca

The National Public Health Institutes (NPHI), members of the Latin American Regional Network of the International Association of National Institutes of Public Health, met face to face at the headquarters of the National Institute of Public Health of Mexico, in the City of Cuernavaca, from October 5 to 7, 2022, with the participation of the directors or their representatives of the NPHIs of Bolivia, Brazil, Colombia, Costa Rica, El Salvador, Mexico, Peru and Suriname and representatives of the South American Sub regional Program (SAM), and the Central American Sub regional Program (CAM) of the Pan American Health Organization (PAHO), the Organization of the Amazon Cooperation Treaty (OTCA), the Andean Health Agency/Hipolito Unanue Agreement (ORAS/CONHU) and the Central American Integration System (SICA/COMISCA), analyzing the role of the NPHI in combating health inequities;in confronting the global climate and environmental crisis;combating hunger, food insecurity and malnutrition;successes and challenges in responding to the Covid-19 pandemic;strengthening and continuous improvement of integrated disease surveillance and preparedness for health emergencies;as well as the various existing regional and sub-regional health cooperation programs, noticing that: 1. In the current scenario, the dominating development model is a generator of growing social inequalities, which determine serious inequities in the health conditions of our peoples. 2. Likewise, the current model of production and consumption, adopted at the global level, has increased hunger, food insecurity and malnutrition that possibly constitute nowadays the main health problem in our region. 3. The environmental crisis, which is also a product of the current global development model, has a significant impact on human and animal health and the interaction between both. 4. The NPHIs have played a role of major relevance in confronting the Covid-19 pandemic, not fully applying, however, their full potential for research and for proposing national plans for the disease control. 5. Health surveillance systems, in most of our countries, suffer from significant fragmentation between various sectors and within the health sector itself, implying, in any case, reactive actions that do not allow for anticipating the emergence of new pathologies or health emergencies. 6. The various regional and sub regional cooperation agencies and programs offer an enormous capacity for synergies and mutual cooperation.

Riding Fences

An introduction to journal is presented in which the author discusses articles within the issue on topics including differences in the receipt and delivery of extended school year services in the U.S., ways to sustain work experiences in rural communities and improve for youth with disabilities, and professional development model for secondary mathematics co-teaching.

Special Issue: Recent learnings and development in healthcare financing: A global perspective. (Special Issue: Recent learnings and development in healthcare financing: A global perspective.)

This special issue contains 11 s that discuss recent learnings and developments in healthcare financing from a global perspective. The s cover a range of topics such as the impact of mental illness on poverty and catastrophic health expenditure in India, financing challenges in the American healthcare industry, comparative analysis of health system financing in India and Saudi Arabia, and the contribution of the Ghana National Health Insurance Scheme to inequality in healthcare utilisation. Other s explore the influence of socio-economic status on health financing choices in Jambi Province, households' willingness to pay for community-based health insurance in Bangladesh, and changes in household expenditures during the first wave of COVID-19 in India. The issue also includes discussions on managing the provider-purchaser split in India and reconsidering patient value to create better healthcare.

[Age-specific regional characteristics of COVID-19 mortality in 2021]. / A COVID­19-halandóság életkor-specifikus regionális jellemzoi 2021-ben.

INTRODUCTION: In most countries, COVID-19 mortality increases exponentially with age, but the growth rate varies considerably between countries. The different progression of mortality may reflect differences in population health, the quality of health care or coding practices. OBJECTIVE: In this study, we investigated differences in age-specific county characteristics of COVID-19 mortality in the second year of the pandemic. METHOD: Age-specific patterns of COVID-19 adult mortality were estimated according to county level and sex using a Gompertz function with multilevel models. RESULTS: The Gompertz function is suitable for describing age patterns of COVID-19 adult mortality at county level. We did not find significant differences in the age progression of mortality between counties, but there were significant spatial differences in the level of mortality. The mortality level showed a relationship with socioeconomic and health care indicators with the expected sign, but with different strengths. DISCUSSION AND CONCLUSION: The COVID-19 pandemic in 2021 resulted in a decline in life expectancy in Hungary not seen since World War II. The study highlights the importance of healthcare in addition to social vulnerability. It also points out that understanding age patterns will help to mitigate the consequences of the epidemic. Orv Hetil. 2023; 164(17): 643-650.

Health Disparities and Comparison of Psychiatric Medication Use before and after the COVID-19 Pandemic Lockdown among General Practitioner Practices in the North East of England.

BACKGROUND: Psychiatric medications play a vital role in the management of mental health disorders. However, the COVID-19 pandemic and subsequent lockdown limited access to primary care services, leading to an increase in remote assessment and treatment options to maintain social distancing. This study aimed to investigate the impact of the COVID-19 pandemic lockdown on the use of psychiatric medication in primary care settings. METHODS: We conducted a retrospective claims-based analysis of anonymized monthly aggregate practice-level data on anxiolytics and hypnotics use from 322 general practitioner (GP) practices in the North East of England, where health disparities are known to be higher. Participants were all residents who took anxiolytics and hypnotics from primary care facilities for two financial years, from 2019/20 to 2020/21. The primary outcome was the volume of Anxiolytics and Hypnotics used as the standardized, average daily quantities (ADQs) per 1000 patients. Based on the OpenPrescribing database, a random-effect model was applied to quantify the change in the level and trend of anxiolytics and hypnotics use after the UK national lockdown in March 2020. Practice characteristics extracted from the Fingertips data were assessed for their association with a reduction in medication use following the lockdown. RESULTS: This study in the North East of England found that GP practices in higher health disparate regions had a lower workload than those in less health disparate areas, potentially due to disparities in healthcare utilization and socioeconomic status. Patients in the region reported higher levels of satisfaction with healthcare services compared to the England average, but there were differences between patients living in higher versus less health disparate areas. The study highlights the need for targeted interventions to address health disparities, particularly in higher health disparate areas. The study also found that psychiatric medication use was significantly more common in residents living in higher health disparate areas. Daily anxiolytics and hypnotics use decreased by 14 items per 1000 patients between the financial years 2019/20 and 2020/21. A further nine items per 1000 decreased for higher health disparate areas during the UK national lockdown. CONCLUSIONS: People during the COVID-19 lockdown were associated with an increased risk of unmet psychiatric medication demand, especially for higher health disparate areas that had low-socioeconomic status.

Racial-ethnic disparities in psychological distress during the COVID-19 pandemic in the United States: the role of experienced discrimination and perceived racial bias.

BACKGROUND: Research on mental health disparities by race-ethnicity in the United States (US) during COVID-19 is limited and has generated mixed results. Few studies have included Asian Americans as a whole or by subgroups in the analysis. METHODS: Data came from the 2020 Health, Ethnicity, and Pandemic Study, based on a nationally representative sample of 2,709 community-dwelling adults in the US with minorities oversampled. The outcome was psychological distress. The exposure variable was race-ethnicity, including four major racial-ethnic groups and several Asian ethnic subgroups in the US. The mediators included experienced discrimination and perceived racial bias toward one's racial-ethnic group. Weighted linear regressions and mediation analyses were performed. RESULTS: Among the four major racial-ethnic groups, Hispanics (22%) had the highest prevalence of severe distress, followed by Asians (18%) and Blacks (16%), with Whites (14%) having the lowest prevalence. Hispanics' poorer mental health was largely due to their socioeconomic disadvantages. Within Asians, Southeast Asians (29%), Koreans (27%), and South Asians (22%) exhibited the highest prevalence of severe distress. Their worse mental health was mainly mediated by experienced discrimination and perceived racial bias. CONCLUSIONS: Purposefully tackling racial prejudice and discrimination is necessary to alleviate the disproportionate psychological distress burden in racial-ethnic minority groups.