A street-view-based method to detect urban growth and decline: A case study of Midtown in Detroit, Michigan, USA.

Urban growth and decline occur every year and show changes in urban areas. Although various approaches to detect urban changes have been developed, they mainly use large-scale satellite imagery and socioeconomic factors in urban areas, which provides an overview of urban changes. However, since people explore places and notice changes daily at the street level, it would be useful to develop a method to identify urban changes at the street level and demonstrate whether urban growth or decline occurs there. Thus, this study seeks to use street-level panoramic images from Google Street View to identify urban changes and to develop a new way to evaluate the growth and decline of an urban area. After collecting Google Street View images year by year, we trained and developed a deep-learning model of an object detection process using the open-source software TensorFlow. By scoring objects and changes detected on a street from year to year, a map of urban growth and decline was generated for Midtown in Detroit, Michigan, USA. By comparing socioeconomic changes and the situations of objects and changes in Midtown, the proposed method is shown to be helpful for analyzing urban growth and decline by using year-by-year street view images.

Uncertainties in land use data may have substantial effects on environmental planning recommendations: A plea for careful consideration.

A key challenge of environmental planning is to craft recommendations for future sustainable spatial development amid ubiquitous uncertainties. This paper aims to explore how different data uncertainties, usually unknown to the planner, may influence environmental planning recommendations. We apply a case study-based approach, in which we provide three illustrative examples of how data with different kinds and levels of uncertainty affect environmental assessments and, by that, the decision-support provided by environmental planning. The cases stem from different spatial levels in Germany and consider 'Regional soil-based climate change mitigation' in the region of Hannover, 'State-wide habitat conservation siting' in the federal state of Saxony-Anhalt, and 'National renewable energy planning'. Based on the three examples, we discuss implications for planning practice and derive recommendations for further research. The three cases studies illustrate the substantial effects of data uncertainty on environmental assessments and planning recommendations derived from those results. We identify four problem constellations of dealing with data uncertainty in environmental planning that relate to the severeness of uncertainty impacts, the responsibility of the decision-maker, and the kinds of impacts that wrong decisions may have. We close with recommendations for further research, among others to develop robust and pragmatic methods for identifying the uncertainty levels in environmental data and assessment results.

Neighborhood Child Opportunity Index and Adolescent Cardiometabolic Risk.

BACKGROUND AND OBJECTIVES: The Child Opportunity Index (ChOI) is a publicly available surveillance tool that incorporates traditional and novel attributes of neighborhood conditions that may promote or inhibit healthy child development. The extent to which ChOI relates to individual-level cardiometabolic risk remains unclear. METHODS: We geocoded residential addresses obtained from 743 participants in midchildhood (mean age 7.9 years) in Project Viva, a prebirth cohort from eastern Massachusetts, and linked each location with census tract-level ChOI data. We measured adiposity and cardiometabolic outcomes in midchildhood and early adolescence (mean age 13.1 years) and analyzed their associations with neighborhood-level ChOI in midchildhood using mixed-effects models, adjusting for individual and family sociodemographics. RESULTS: On the basis of nationwide distributions of ChOI, 11.2% (n = 83) of children resided in areas of very low overall opportunity (ChOI score <20 U) and 55.3% (n = 411) resided in areas of very high (ChOI score ≥80 U) overall opportunity. Children who resided in areas with higher overall opportunity in midchildhood had persistently lower levels of C-reactive protein from midchildhood to early adolescence (per 25-U increase in ChOI score: ß = .14 mg/L; 95% confidence interval, .28 to .00). Additionally, certain ChOI indicators, such as greater number of high-quality childhood education centers, greater access to healthy food, and greater proximity to employment in midchildhood, were associated with persistently lower adiposity, C-reactive protein levels, insulin resistance, and metabolic risk z scores from midchildhood to early adolescence. CONCLUSIONS: Our findings suggest more favorable neighborhood opportunities in midchildhood predict better cardiometabolic health from midchildhood to early adolescence.

Associations between healthcare environment design and adverse events in intensive care unit.

BACKGROUND: Healthcare environment can affect health. Adverse events (AEs) are common because rapid changes in the patients' status can suddenly arise, and have serious consequences, especially in intensive care. The relationship between the design of intensive care units (ICUs) and AEs has not been fully explored. Hence, an intensive care room was refurbished with cyclic lightning, sound absorbents and unique interior, and exterior design to promote health. AIMS: The aim of this study was to evaluate the differences between a regular and a refurbished intensive care room in risk for AEs among critically ill patients. DESIGN: This study retrospectively evaluated associations of AEs and compared the incidence of AEs in patients who were assigned to a multidisciplinary ICU in a refurbished two-bed patient room with patients in the control rooms between 2011 and 2018. METHODS: There were 1938 patients included in this study (1382 in control rooms; 556 in the intervention room). Descriptive statistics were used to present the experienced AEs. Binary logistic regressions were conducted to estimate the relationship between the intervention/control rooms and variables concerning AEs. Statistical significance was set at P < 0.05. RESULTS: For the frequency of AEs, there were no significant differences between the intervention room and the control rooms (10.6% vs 11%, respectively, P < 0.805). No findings indicated the intervention room (the refurbished room) had a significant influence on decreasing the number of experienced AEs in critically ill patients. CONCLUSIONS: The findings revealed a low incident of AEs in both the intervention room as well as in the control rooms, lower than previously described. However, our study did not find any decreases in the AEs due to the design of the rooms. RELEVANCE TO CLINICAL PRACTICE: Further research is needed to determine the relationship between the physical environment and AEs in critically ill patients.

Residential green space and child intelligence and behavior across urban, suburban, and rural areas in Belgium: A longitudinal birth cohort study of twins.

BACKGROUND: Exposure to green space has beneficial effects on several cognitive and behavioral aspects. However, to our knowledge, no study addressed intelligence as outcome. We investigated whether the level of urbanicity can modify the association of residential green space with intelligence and behavior in children. METHODS AND FINDINGS: This study includes 620 children and is part of the East Flanders Prospective Twin Survey (EFPTS), a registry of multiple births in the province of East Flanders, Belgium. Intelligence was assessed with the Wechsler Intelligence Scale for Children-Revised (WISC-R) in 620 children (310 twin pairs) between 7 and 15 years old. From a subset of 442 children, behavior was determined based on the Achenbach Child Behavior Checklist (CBCL). Prenatal and childhood residential addresses were geocoded and used to assign green space indicators. Mixed modeling was performed to investigate green space in association with intelligence and behavior while adjusting for potential confounding factors including sex, age, parental education, neighborhood household income, year of assessment, and zygosity and chorionicity. We found that residential green space in association with both intelligence and behavior in children was modified by the degree of urbanicity (p < 0.001). In children living in an urban environment, multivariable adjusted mixed modeling analysis revealed that an IQR increment of residential green space (3,000-m radius) was associated with a 2.6 points (95% CI 1.4-3.9; p < 0.001) higher total intelligence quotient (IQ) and 2.0 points (95% CI -3.5 to -0.4; p = 0.017) lower externalizing behavioral score. In children residing in a rural or suburban environment, no association was found. A limitation of this study is that no information was available on school location and the potential for unmeasured confounding (e.g., time spend outdoors). CONCLUSIONS: Our results indicate that residential green space may be beneficial for the intellectual and the behavioral development of children living in urban areas. These findings are relevant for policy makers and urban planners to create an optimal environment for children to develop their full potential.

The work environment pilot: An experiment to determine the optimal office design for a technology company.

Over the past few decades many corporate organisations have moved to open-plan office designs, mostly due to financial and logistical benefits. However, recent studies have found significant drawbacks to open plan offices and it is unclear how office designs can facilitate the best work output and company culture. Current design practice aims to optimise efficiency of space, but no previous research has tested the effect of office design experimentally in a working office. This paper describes an experiment comparing four different office designs (Open-plan, Zoned open-plan, Activity based, and Team offices) against a suite of wellbeing and productivity metrics in a real world technology company. Results suggest that two very different designs (Zoned open-plan and Team offices) perform well compared to Open-plan office designs. Zoned open-plan and Team office designs improved employee satisfaction, enjoyment, flow, and productivity, while Activity based and Open-plan designs performed poorly by comparison. The Open-plan office design was rated more poorly by employees, had higher levels of unsafe noise, and once employees no longer had to be in the Open-plan office design of the experiment, they spent more time at their desks.

Relocating to a New OR Suite: Practical Observations.

Operating room renovation projects usually involve updated technology and processes that can create challenges for administrative leaders (eg, maintaining a surgery schedule during a move) and require staff member adjustments. The perioperative team of a large tertiary care and trauma center relocated from a 35-year-old suite to a new suite, which required years of planning, months of training, and weeks of organizing. This article discusses the processes and observations that helped ensure a smooth transition to the new space. Early planning allowed time for leaders to make equipment decisions, develop and test new processes, and train staff members. The actual move required detailed planning, thorough execution, patience, and flexibility to ensure a safe transition. Perioperative leaders balanced operational needs with relocation plans to maintain patient and staff member safety. Open, multidisciplinary communication combined with staff member participation and buy-in contributed to an efficient, safe move at this facility.

Perspectives on "Novel" Techniques for Designing Age-Friendly Homes and Neighborhoods with Older Adults.

Worldwide, growth in the older population creates a pressing need to develop supportive environments that enhance quality of life as people age. Too often, built environments present barriers and challenges to older adults that compromise independent living and adversely affect health and life outcomes. Designing homes, buildings, and neighborhoods with older adults, through exercises in participatory or co-design, could help ensure that environments are better able to facilitate healthy aging. However, while it is potentially advantageous to involve this age group in environmental design decisions, doing so can be difficult. Analysis of and guidance on effective ways to involve older adults in these activities could make the challenge easier. With this aim in mind, this article provides critical perspectives on eight "less traditional" engagement techniques-walking interviews, photovoice, photo-elicitation, Talking Mats®, participatory mapping, drawing, model-making, and the "Design Fair". Insights into the strengths and limitations of these techniques, gained from observation of their use in participatory design activities, as well as feedback collected from older co-design participants, are presented. The article concludes by offering a number of practical recommendations for those interested in designing age-friendly homes and neighborhoods with older people.

Liveability aspirations and realities: Implementation of urban policies designed to create healthy cities in Australia.

Creating healthy, liveable cities is a common policy aspiration globally. However, little research has explored the capacity of urban policies to deliver this aspiration, or levels of policy implementation. This study aimed to develop policy-relevant indicators, to detect within- and between-city inequities in the implementation of Australian state government policy targets related to urban liveability. Seventy-three government policies were reviewed across Australia's four largest cities to identify measurable spatial policies that contribute to creating healthy, liveable neighbourhoods. Spatial indicators based on these policies were developed to assess and map levels of policy implementation at the metropolitan and sub-metropolitan level. Measurable spatial policies were identified for only three out of seven policy domains: walkability, transit access, and public open space. While there was significant variation between cities, policies were often inconsistent with evidence about how to achieve liveability. No Australian city performed well on all liveability domains. Even modest policy targets were often not achieved, and there were significant spatial inequities in policy implementation. With few exceptions, people living in outer suburbs had poorer access to amenities than inner-city residents. This study demonstrates the benefits and challenges of measuring urban policy implementation. Evidence-informed targets are needed in urban, transport and infrastructure policies designed to create healthy, liveable cities, to enable levels of (and inequities in) policy implementation to be assessed. Consistent standards for government spatial data would enable development of comparable indicators and cities to be directly compared.

Public perception of coastal habitat loss and habitat creation using artificial floating islands in the UK.

Eco-engineering and the installation of green infrastructure such as artificial floating islands (AFIs), are novel techniques used to support biodiversity. The European Convention on Biological Diversity highlighted the development of green infrastructure as a key method of enhancement in degraded habitats. Research specifically on AFIs in marine environments has largely focused on their ecological functioning role and engineering outcomes, with little consideration for the social benefits or concerns. The aim of this study was to gain an understanding of public perception of coastal habitat loss in the UK and AFIs as a method of habitat creation in coastal environments. This was achieved via a survey, consisting of six closed and two open questions. Of the 200 respondents, 94.5% were concerned about the loss of coastal habitats in the UK, but less than a third were aware of habitat restoration or creation projects in their area of residence. There was a positive correlation between proximity of residency to the coast and knowledge of habitat restoration or creation projects. The majority of the respondents understood the ecological functioning role of AFIs and 62% would preferably want successful plant growth and avian species utilising the AFI. Nearly a third of the respondents had concerns about AFI installations, such as the degradation of the plastic matrix, long term maintenance and disturbance of native species. Despite 90.9% of the respondents supporting the installation of AFIs, the concerns of the public must be addressed during the planning stages of any habitat creation project.

Built Environment Interventions to Increase Active Travel: a Critical Review and Discussion.

PURPOSE OF REVIEW: To review the literature on built environment interventions to increase active travel, focusing on work since 2000 and on methodological choices and challenges affecting studies. RECENT FINDINGS: Increasingly, there is evidence that built environment interventions can lead to more walking or cycling. Evidence is stronger for cycling than for walking interventions, and there is a relative lack of evidence around differential impacts of interventions. Some of the evidence remains methodologically weak, with much work in the 'grey' literature. While evidence in the area continues to grow, data gaps remain. Greater use of quasi-experimental techniques, improvements in routine monitoring of smaller schemes, and the use of new big data sources are promising. More qualitative research could help develop a more sophisticated understanding of behaviour change.

A Mobile-Based Patient-Centric Passive System for Guiding Patients Through the Hospital Workflow: Design and Development.

BACKGROUND: A hospital is an unfamiliar place to patients because of its style, atmosphere, and procedures. These hospital characteristics cause patients to become confused about responding to protocols, which slows down the procedural flows. Some additional information technology infrastructure facilities and human resources may be needed to solve these problems. However, this solution needs high investment and cannot guarantee an accuracy of information sent to patients. To handle this limitation, EasyHos has been developed to help patients recognize their status (for example, "waiting for an appointment at 11am") during their stay in a hospital using all existing infrastructure and hospital data and without changing existing hospital's process. OBJECTIVE: The objective of this study was to provide a design of the EasyHos system and the case study in hospitals in Thailand. The design is usable and repeatable for small- and medium-sized hospitals where internet infrastructure is in place. METHODS: The EasyHos system has been designed based on existing infrastructure, hospital data and hospital processes. The main components include mobile devices, existing hospital data, wireless communication network. The EasyHos was deployed at 2 hospitals in Thailand, one small and the other with a medium size. The experimental process was focused on solving the problem of unfamiliarity in the hospital. The criteria and pretest conditions regarding the unexpected problem have been defined before the experiment. RESULTS: The results are presented in terms of criteria, pretest conditions, posttest conditions in the hospitals. The posttest conditions show the experimental results and impact of the system on users such as hospital nurses/staff and patients. For example, the questions from patients were reduced by 83.3% after using EasyHos system while nurses/hospital staff had 5 min more to do their routine work each day. In addition, another impact is that hospitals can create new information values from existing data, which now can be visible and valuable to patients. CONCLUSIONS: Hospitals' unexpected problems have been reduced by the EasyHos system. The EasyHos system has been developed with self-service and patient-centered concepts to assist patients with necessary information. The system makes interaction easier for nurses/hospital staff members and patients working or waiting in the hospital. The nurses/hospital staff members would have more time to do their routine works. Hospitals can easily set up the EasyHos system, which will have a low or nearly zero implementation cost.

The linkage between the perception of neighbourhood and physical activity in Guangzhou, China: using street view imagery with deep learning techniques.

BACKGROUND: Neighbourhood environment characteristics have been found to be associated with residents' willingness to conduct physical activity (PA). Traditional methods to assess perceived neighbourhood environment characteristics are often subjective, costly, and time-consuming, and can be applied only on a small scale. Recent developments in deep learning algorithms and the recent availability of street view images enable researchers to assess multiple aspects of neighbourhood environment perceptions more efficiently on a large scale. This study aims to examine the relationship between each of six neighbourhood environment perceptual indicators-namely, wealthy, safe, lively, depressing, boring and beautiful-and residents' time spent on PA in Guangzhou, China. METHODS: A human-machine adversarial scoring system was developed to predict perceptions of neighbourhood environments based on Tencent Street View imagery and deep learning techniques. Image segmentation was conducted using a fully convolutional neural network (FCN-8s) and annotated ADE20k data. A human-machine adversarial scoring system was constructed based on a random forest model and image ratings by 30 volunteers. Multilevel linear regressions were used to examine the association between each of the six indicators and time spent on PA among 808 residents living in 35 neighbourhoods. RESULTS: Total PA time was positively associated with the scores for "safe" [Coef. = 1.495, SE = 0.558], "lively" [1.635, 0.789] and "beautiful" [1.009, 0.404]. It was negatively associated with the scores for "depressing" [- 1.232, 0.588] and "boring" [- 1.227, 0.603]. No significant linkage was found between total PA time and the "wealthy" score. PA was further categorised into three intensity levels. More neighbourhood perceptual indicators were associated with higher intensity PA. The scores for "safe" and "depressing" were significantly related to all three intensity levels of PA. CONCLUSIONS: People living in perceived safe, lively and beautiful neighbourhoods were more likely to engage in PA, and people living in perceived boring and depressing neighbourhoods were less likely to engage in PA. Additionally, the relationship between neighbourhood perception and PA varies across different PA intensity levels. A combination of Tencent Street View imagery and deep learning techniques provides an accurate tool to automatically assess neighbourhood environment exposure for Chinese large cities.

Analysis of infant physical activity in the childcare environment: An observational study.

This study utilized behavior-mapping to describe behavior and levels of activity in infants attending Early Childhood Education and Care (ECEC). Descriptive statistics were used to determine proportion of time spent in certain locations, body positions, activities and engagement with others. To establish whether location, the presence of equipment or engagement with others influenced levels of activity, a paired t-test was used. Results indicated that of all locations, infants spent the greatest amount of time in the meals area (35%), with half of this period spent physically inactive (sedentary). The indoor play area was where infants were most active. Infants also spent a significantly greater proportion of their upright time (64%) supported by either furniture or equipment than without (MD 28, 95% CI 13-44, p < 0.01). Interestingly, infants displayed more sedentary behavior when engaged with others than when not engaged (MD 21, 95% CI 6-36, p < 0.01). The environment, presence of others and equipment availability appear to influence activity levels of infants in ECEC centers. Findings suggest that time spent in meal areas, provisions of furniture/equipment, and opportunities for infants to play independently warrant further exploration to determine their influence on activity levels in typically-developing infants.

The Urban Liveability Index: developing a policy-relevant urban liveability composite measure and evaluating associations with transport mode choice.

BACKGROUND: Designing healthy, liveable cities is a global priority. Current liveability indices are aggregated at the city-level, do not reflect spatial variation within cities, and are often not aligned to policy or health. OBJECTIVES: To combine policy-relevant liveability indicators associated with health into a spatial Urban Liveability Index (ULI) and examine its association with adult travel behaviours. METHODS: We developed methods to calculate spatial liveability indicators and the ULI for all residential addresses in Melbourne, Australia. Associations between the address-level ULI and adult travel behaviours from the 2012-2014 Victorian Integrated Survey of Travel and Activity (VISTA) (n = 12,323) were analysed using multilevel logistic regression. Sensitivity analyses to evaluate impact of methodological choices on distribution of liveability as assessed by the ULI and associations with travel mode choice were also conducted. RESULTS: Liveability estimates were calculated for 1,550,641 residential addresses. ULI scores were positively associated with active transport behaviour: for each unit increase in the ULI score the estimated adjusted odds ratio (OR) for: walking increased by 12% (95% Credible Interval: 9%, 15%); cycling increased by 10% (4%, 17%); public transport increased by 15% (11%, 19%); and private vehicle transport decreased by 12% (- 9%, - 15%). CONCLUSIONS: The ULI provides an evidence-informed and policy-relevant measure of urban liveability, that is significantly and approximately linearly associated with adult travel behaviours in the Melbourne context. The ULI can be used to evaluate progress towards implementing policies designed to achieve more liveable cities, identify spatial inequities, and examine relationships with health and wellbeing.

Using data from online geocoding services for the assessment of environmental obesogenic factors: a feasibility study.

BACKGROUND: The increasing prevalence of obesity is a major public health problem in many countries. Built environment factors are known to be associated with obesity, which is an important risk factor for type 2 diabetes. Online geocoding services could be used to identify regions with a high concentration of obesogenic factors. The aim of our study was to examine the feasibility of integrating information from online geocoding services for the assessment of obesogenic environments. METHODS: We identified environmental factors associated with obesity from the literature and translated these factors into variables from the online geocoding services Google Maps and OpenStreetMap (OSM). We tested whether spatial data points can be downloaded from these services and processed and visualized on maps. True- and false-positive values, false-negative values, sensitivities and positive predictive values of the processed data were determined using search engines and in-field inspections within four pilot areas in Bavaria, Germany. RESULTS: Several environmental factors could be identified from the literature that were either positively or negatively correlated with weight outcomes in previous studies. The diversity of query variables was higher in OSM compared with Google Maps. In each pilot area, query results from Google showed a higher absolute number of true-positive hits and of false-positive hits, but a lower number of false-negative hits during the validation process. The positive predictive value of database hits was higher in OSM and ranged between 81 and 100% compared with a range of 63-89% for Google Maps. In contrast, sensitivities were higher in Google Maps (between 59 and 98%) than in OSM (between 20 and 64%). CONCLUSIONS: It was possible to operationalize obesogenic factors identified from the literature with data and variables available from geocoding services. The validity of Google Maps and OSM was reasonable. The assessment of environmental obesogenic factors via geocoding services could potentially be applied in diabetes surveillance.

La Ciudad de las Niñas y los Niños de Huesca, una oportunidad en el diseño de entornos y políticas públicas saludables / The City of Girls and Boys of Huesca (Spain), an opportunity for designing healthy environment and public policies

La Ciudad de las Niñas y los Niños es un proyecto internacional que pretende fomentar la autonomía y la participación infantil plena en la construcción de la ciudad. Tras aprobarse en 2011 en el pleno del Ayuntamiento de Huesca, se crearon el Consejo de las Niñas y los Niños y el Laboratorio de la Ciudad, órganos en los que hay representación de todos los colegios de Huesca. Para hacer explícito el trabajo sobre la salud se han incorporado actividades como «Caminos saludables», en la que se utiliza la técnica del mapeo de activos. Además del trabajo interdisciplinario entre distintas áreas del ayuntamiento, profesionales de los sectores educativo (colegios y universidad), sanitario y social, se observan impactos en el entorno físico urbano, con la remodelación de un parque, una calle y una plaza; y en los estilos de vida de los escolares, al aumentar el número de aquellos que van andando solos al colegio

The City of Girls and Boys of Huesca (Spain) is an international project that seeks to foster children's autonomy and full participation in the construction of the city. Following its formal approval at the City Council of Huesca, the Girls and Boys Board and the City Laboratory were created, both of which include children from all the schools of Huesca. To highlightthe work on health, activities such as "Healthy School Paths", in which the asset mapping technique is used, were incorporated. Besides the interdisciplinary work among different areas of the city council, professionals from education (schools and university), health and social services, effects on the urban physical environment, with one street, park and square remodelled; and on the children's lifestyles, with more children walking to school alone, have been observed

Hilly neighborhoods are associated with increased risk of weight gain among older adults in rural Japan: a 3-years follow-up study.

BACKGROUND: Neighborhood environments have been regularly associated with the weight status. Although the evidence is mostly limited to adults residing in western urban settings, the weight status of older adults living in rural areas is also assumed to be significantly affected by their neighborhood environments. This study aimed to identify environmental attributes specific to rural areas that could affect the risk of longitudinal weight gain among older adults (≥ 65 years) in Japan. METHODS: We examined five environmental attributes, i.e., land slope, public transportation accessibility, residential density, intersection density, and the availability of parks and recreational centers, measured by the geographic information system. Our analysis was based on 714 subjects participated in Shimane Community-based Healthcare Research and Education study in 2012 and 2015. Multinomial logistic regression model was conducted to examine the association between each neighborhood environmental attribute and weight change status (gain, loss and unchanged). RESULTS: We observed a significant increase in the risk of weight gain as the steepness of the neighborhood land slope increased. There was no significant association between other environmental attributes and risk of weight gain as well as weight loss among older adults. CONCLUSION: Living in hilly neighborhoods was associated with increased risk of weight gain among rural Japanese older adults. Future research should consider region-specific environmental attributes when investigating their effect on older adults' weight status.

Anatomy of resuscitative care unit: expanding the borders of traditional intensive care units.

Resuscitation lacks a place in the hospital to call its own. Specialised intensive care units, though excellent at providing longitudinal critical care, often lack the flexibility to adapt to fluctuating critical care needs. We offer the resuscitative care unit as a potential solution to ensure that patients receive appropriate care during the most critical hours of their illnesses. These units offer an infrastructure for resuscitation and can meet the changing needs of their institutions.