Characterizing "collateral damage" in men and women with metastatic breast cancer (mBC) from diverse racial and ethnic backgrounds in New York City.

PURPOSE: Patients from diverse racial, ethnic, and socio-economic backgrounds may be particularly vulnerable to experiencing undue social and financial burdens ("collateral damage") from a metastatic breast cancer (mBC) diagnosis; however, these challenges have not been well explored in diverse populations. METHODS: From May 2022 to May 2023, English- or Spanish-speaking adults with mBC treated at four New York-Presbyterian (NYP) sites were invited to complete a survey that assessed collateral damage, social determinants of health, physical and psychosocial well-being, and patient-provider communication. Fisher's exact and the Kruskal-Wallis rank-sum tests assessed differences by race and ethnicity. RESULTS: Of 87 respondents, 14% identified as Hispanic, 28% non-Hispanic Black (NHB), 41% non-Hispanic White (NHW), 7% Asian American Pacific Islander (AAPI), and 10% other/multiracial. While 100% of Hispanic, NHW, and AAPI participants reported stable housing, 29% of NHB participants were worried about losing housing (p = 0.002). Forty-two percent of Hispanic and 46% of NHB participants (vs. 8%, NHW and 0%, AAPI, p = 0.005) were food insecure; 18% of Hispanic and 17% of NHB adults indicated lack of reliable transportation in the last year (vs. 0%, NHW/AAPI, p = 0.033). Participants were generally satisfied with the quality of communication that they had with their healthcare providers and overall physical and mental well-being were modestly poorer relative to healthy population norms. CONCLUSIONS: In our study, NHB and Hispanic mBC patients reported higher levels of financial concern and were more likely to experience food and transportation insecurity compared to NHW patients. Systematically connecting patients with resources to address unmet needs should be prioritized to identify feasible approaches to support economically vulnerable patients following an mBC diagnosis.

Uptake and distribution of metal(loid)s in two rare species of saltmarsh, blackseed samphire, Tecticornia pergranulata, and narrow-leafed wilsonia, Wilsonia backhousei, in New South Wales, Australia.

The uptake and distribution of copper, zinc, arsenic, and lead was examined in two rare Australian saltmarsh species, Tecticornia pergranulata and Wilsonia backhousei. The bioconcentration factors and translocation factors were generally much lower than one, except for the Zn translocation factors for T. pergranulata. When compared to other Australian saltmarsh taxa, these species generally accumulated the lowest levels observed among taxa, especially in terms of their BCFs. Essential metals tended to be regulated, while non-essential metals increased in concentration with dose during transport among compartments, a pattern not previously observed in Australian saltmarsh taxa. The uptake of metals into roots was mainly explained by total sediment metal loads as well as more acidic pH, increased soil organic matter, and decreased salinity. The low uptake and limited translocation observed in these rare taxa may offer a competitive advantage for their establishment and survival in the last urbanised populations, where legacy metal contamination acts as a selective pressure.

Predicting physical distancing on recreational trails during COVID-19.

The emergence of Coronavirus 19 led to societal and behavioral changes, including intensified use of many public parks and trails for mental respite and leisure time physical activity. As visitors sought stress-relief in the great outdoors, they also encountered stressful situations as they navigated risk exposure. Recommendations to physically distance between parties was a key component to reduce risk, but compliance is unknown in the outdoor arena. This observational study of more than 10 000 trail user encounters documented distancing and enabled predictive analysis that revealed wider trails, smaller groups and signage led to greater distancing compliance. Managers and planners can integrate these findings immediately and in consideration of future trail designs to minimize risk exposure. Management implications: Select site features increase odds of distancing compliance and can inform management decisions and designs immediately and in addressing future use surges: wider trails, unpaved surfaces, and COVID-19 signage.As distancing compliance waned with time but signage increased compliance, innovative and dynamic signs may sustain compliance and multi-media communications should be considered.Both activity size and group type influence distancing so considering group size recommendations and activity separation are in order.

COVID-19 compliance among urban trail users: Behavioral insights and environmental implications.

Public green spaces provide physical and mental respite, which have become essential and elevated services during the COVID-19 pandemic. As visitation to public parks and recreation areas increased during the pandemic, the challenge of maintaining visitor safety and protecting environmental resources was exacerbated. A key visitor safety practice during the COVID-19 onset was maintaining a physical distance of six feet (1.8 m) between groups. A novel data set documented and compared physical distancing compliance and off-trail behavior on multiple-use trails across multiple states and within select U.S. communities, attending to the impact of select environmental factors. Nearly 6000 observations revealed physical distancing compliance varied and the environmental factors of trail width, density, and signage influenced its variability. Similarly, off-trail movement was related to trail width and density. Clearly the environment matters as people negotiate the 'new normal' of physical distancing during physical activity and outdoor recreation participation. Given the ongoing COVID-19 pandemic and likelihood of future health crises, this project provides important information and insight for trail and other public green space management, monitoring, and modelling moving forward. Management implications: As both trail width and visitor density impacted physical distancing, a combination of trail design that accommodates distancing requirements and density management practices that provide sufficient trail user spacing is essential to retain safe and active trail use.Off-trail movement was influenced by both trail width and density, so ensuring safe off-trail spaces exist and using durable off-trail materials can minimize disturbance and protect visitors.Signage is inconsistently significant to influence trail-compliant distancing behavior, but optimizing its placement and content may improve effectiveness.Compliant trail behavior varied by trail width, visitor density, and trail location; therefore, site-specific information is necessary to understand possible visitor behavior and design/implement mitigation strategies.

Cases and context: Mask-related behaviors among U.S. trail visitors during the COVID-19 pandemic.

The challenge of simultaneously providing outdoor recreation opportunities while protecting the public from SARS-CoV-2 virus and COVID-19 transmission, as well as future pandemics, remains foremost on managers' minds. Safe spaces and cultures are paramount for managers and visitors alike. Recommended protective measures against COVID-19 included physically distancing 1.8 m (six-feet) between parties and mask-wearing when distancing is not possible. Adoption of these protective measures is relatively unknown but essential to inform recreation management and planning through future health crises. Such adoption is likely influenced by both the pandemic context and site context, particularly related to visitor density. An observational study assessed mask-wearing behaviors among trail walkers on multiple trails in the United States from November 2020 through May 2021. Trained observers identified if walking groups were prepared to mask or had masks correctly worn as well as if encounters were compliant with the 1.8 m recommendations. Data collected across seven U.S. states enabled comparisons of mask-related behaviors across sites as well as considerations to: the influence of the pandemic context in terms of cases and vaccination rates, mask mandates, and trail density. Results from nearly 3000 encounters revealed significant variance in visible masks, low compliance of mask-wearing in encounters less than 1.8 m, significant influence of both COVID-19 cases and vaccination rates on mask wearing at half the sites, and no impact of state-level mask mandates when controlling for cases and vaccinations. Integrating public health data can inform predictions of compliant behaviors, or lack thereof, and needs exist to advance a safety culture.

Metal(loid) accumulation in the leaves of the grey mangrove (Avicennia marina): Assessment of robust sampling requirements and potential use as a bioindicator.

This study assessed the appropriate sampling design required for quantifying variability in metal accumulation in the leaf tissues of A. marina, a dominant mangrove inhabiting Australian estuaries, by applying a hierarchical nested sampling design to sample mangroves at various levels of biological and spatial hierarchies (leaf, branch, tree, site). It was revealed that most variation in metal accumulation occurred among trees and branches, with insignificant variation between sites and among leaves. We also examined the accumulation of metal (loid)s in the leaf tissues collected from six locations across the Georges River estuary in southern Sydney, which differ in metal contamination history. Prospect Creek and Salt Pan Creek were the most contaminated locations, which exceeded sediment quality guideline values for Cu (66.71 ± 2.18 µg/g), Zn (317.14 ± 46.14 µg/g) and Pb (81.02 ± 2.79 µg/g). All metal(loid) concentrations in leaf tissues were much lower than their concentrations in sediment, but essential metals exhibited greater mobility. Out of 10 metal(loid)s, Mn, Co and Pb in leaves showed linear relationships (R2 = 0.28-0.47) with sediment, indicating that mangrove leaves may be used as a bioindicator of environmental loads for these metals.

An integrated approach to monitoring and estimating COVID-19 risk exposure among leisure-time physical activity participants.

BACKGROUND: Leisure time physical activity (LTPA) provides both health benefits and risks, particularly during a pandemic. During the COVID-19 pandemic, significant increases in close-to-home LTPA raised concerns for public health and land managers alike. This project illustrates a novel, integrated monitoring approach to estimating COVID-19 risk exposure during trail-related LTPA, with implications for other public spaces. METHODS: COVID-19 risk exposure was conservatively calculated from the integration of in-person observations of LTPA trail groups and automated monitoring of trail traffic volumes in spring 2020. Trained observers tracked 1,477 groups. Traffic volume estimates and observed distance data were integrated, considering occlusion and total trail traffic volume. RESULTS: 70% of groups had one or more encounters. Among individual users, 38.5% were 100% compliant across all events observed but 32.7% were not compliant. Considering trail traffic volumes and annual daily traffic volume, exposure to risk of COVID-19 was conservatively estimated at 61.5% among individual trail users. CONCLUSIONS: Monitoring opportunities and challenges of health risk exposure exist. Adjusted exposure measures based on volume counts can approximate numbers of unique individuals exposed, inform management actions, efficacy and policy decisions.

Metal(loid) uptake and partitioning within the saltmarsh halophyte, Juncus kraussii.

An investigation was conducted over three estuaries in SE Australia with a gradient in metal(loid) contamination to assess metal(loid) (Cu, Zn, As, Se, Cd and Pb) accumulation and transport within the halophytic saltmarsh rush, Juncus kraussii. Sydney Olympic Park exhibited the most elevated metal(loid) contamination, followed by Hunter Wetlands and Lake Macquarie. J. kraussii exhibited a strong ability to restrict metal(loid) movement into the root system, with the exception of cadmium (BCFs < 1.0) and unrestricted flow from root to culm excepting Se, Cd (TFs < 1). Pb and Zn exhibited elevated translocation between roots and culms (TF 4.4 and 7.3, respectively). Despite barriers for uptake into the below-ground tissues, most metal(loid)s were accumulated to the roots with environmental dose (except for Cu and Cd) and linear relationships were present between the root and culm (for As and Se) and the sediment and culm (for As, Se, Cd, and Pb).

Accumulation and distribution of metal(loid)s in the halophytic saltmarsh shrub, Austral seablite, Suaeda australis in New South Wales, Australia.

We examined the patterns of uptake and partitioning of metal(loid)s in Suaeda australis from three highly urbanised estuaries (Sydney Olympic Park, Hunter Wetlands and Lake Macquarie) in NSW, Australia. Of these, Sydney Olympic Park was found to be the most contaminated estuary in terms of combined sediment metal(loid) load, followed by Hunter Wetlands and lowest in Lake Macquarie (via PERMANOVA). Uptake in roots was greater for the essential metals Cu and Zn along with the non-essential metal Cd and the metalloid Se (root BCFs >1) and lower for Pb and As (root BCFs <1). Substantial barriers for translocation from roots to stems were identified for all metal(loid)s (stem TFs; 0.07-0.68). Conversely, unrestricted flow from stems to leaves was observed for all metal(loid)s at unity or higher (leaf TFs ≥ 1). Strong linear relationships between sediment and root for Zn and Pb were observed, indicating roots as a useful bioindicator.

Effects of weather factors on recreation participation in a humid subtropical region.

This study examines effects of weather, temporal factors, and gasoline price on outdoor recreation participation by using a time series model. We obtained more than 5 years of daily outdoor recreation visitation data by using infrared mechanical counters on a section of the Florida National Scenic Trail (FNST). Results showed that days with daily maximum temperatures of 16-22 °C brought the largest number of visitors, which suggests this is the most comfortable range of daily maximum temperatures to recreate on the FNST. Daily maximum temperatures below 6 °C and above 31 °C and heat index values above 38 °C brought significantly lower visitor numbers, suggesting these values are temperature thresholds for this region in a recreation context. A seasonal autoregressive integrated moving average model showed significant negative effects of temperature, relative humidity, cold snaps, and gasoline price and a positive effect of weekends and public holidays on recreational visitations to this trail. Days with heavy rainfall (> 2.54 cm) or a high heat index (≥ 35 °C) were likely to negatively affect recreation participation not only on the same day, but also on the next normal weather day. These findings imply that managers of facilities that need staffing and other resources should expect to receive fewer visitors on days following adverse weather conditions, even if that day has normal weather conditions.

Experiential benefits, place meanings, and environmental setting preferences between proximate and distant visitors to a national scenic trail.

Effective management of conserved natural areas often requires a good understanding of recreation visitors who possess various values for those areas. This study examined differences in experiential benefits sought, place meanings, and environmental setting preferences between proximate and distant visitors to a publicly managed national scenic trail, which transects a variety of conserved public lands. Data were collected using on-site post-hike interviews with visitors at low, moderate, and high use trailheads. Proximate visitors sought mental and physical health more strongly than distant visitors, while distant visitors sought environmental exploration more strongly than proximate visitors. No significant difference in family bonding and achievement benefits existed between the two groups. Meanings related to place dependence, family identity, community identity, and place identity were more strongly ascribed by proximate visitors, and both groups rated ecological integrity meanings highly. Distant visitors showed stronger tendencies toward preferring a lesser level of trail development, lower level of encounters with other groups, and higher level of natural landscapes, which indicated an inclination toward natural settings. These findings indicate a managerially relevant role of the degree of proximity to environmental resources on individuals' recreation behaviors, meanings ascribed to the resources and setting conditions. Understanding differences and similarities between groups dichotomized by proximity to natural resources should advance more effective management of recreation and benefit opportunities for diverse visitor groups.

Identification of environmental, managerial, and sociodemographic correlates of hiker volume on the Florida National Scenic Trail.

PURPOSE: The purpose of this study was to identify the association of environmental, managerial, and sociodemographic variables with hiker volume on the Florida National Scenic Trail. DESIGN: Monthly hiker count data from 43 count stations along the Florida National Scenic Trail were used. For each station the characteristics of the built and natural environment as well as sociodemographic variables were computed within a Geographic Information System based on census, land use, and land cover data, together with managerial data. SETTING: Counts were performed on access points of the Florida National Scenic Trail located between the panhandle area in the northwest and the Everglades in the south. SUBJECTS: A total of 34,734 hikers were counted across the 43 stations over 12-month periods for years 2003-2004 and 2008-2009. MEASURES: Hiker volume was measured through infrared counters and registration cards at trail access points. ANALYSIS: A negative binomial regression with monthly hiker counts as response variable. RESULTS: Positive associations with hiker volume were observed for (population density per hectare) 2 (ß â€Š=  .207, p < .02), residential areas (ß â€Š=  .041, p < .0003), household income between $25,000 and $49,999 (ß â€Š=  .266, p < .0001), household income between $50,000 and $99,999 (ß â€Š=  .135, p < .0001), open water (ß â€Š=  .135, p < .0001), and station kilometers north (ß â€Š=  .003, p < .0001). Negative associations with hiker volume were observed for age <18 (ß â€Š=  -.305, p < .0001) and presence of trail fees (ß â€Š=  -.583, p < .0001). Positive and negative associations were observed for different categories in categorical variables including prominent vegetation type (p < .0001), trail management agency (p < .0001), and month (p < .0001). CONCLUSIONS: The correlates should be considered for the design, planning, and promotion of hiking trails in publicly managed areas to increase hiker volume.

Identifying differences between off-highway vehicle (OHV) and non-OHV user groups for recreation resource planning.

Off-highway vehicle (OHV) riding is among the fastest growing recreational activities in the United States. However, little research exists about the central components of outcomes-focused management (OFM) as it relates to motorized recreation. Utilizing a two-activity dichotomy, OHV and non-OHV centric user groups were compared on several key concepts associated with OFM, including desired experiences, perceived and desired recreation opportunity spectrum-type settings, and intentional behaviors (i.e., place-protective behavior, spending-time intentions) toward potential changes in settings. Results indicated that the two groups were different in terms of intensity and relative rankings of their perceived experiences and settings. Although both groups preferred social bonding, stress relief, nostalgia and learning experiences, the OHV user group ranked using equipment and achieving physical fitness experiences as more important than the non-OHV group. The non-OHV user group preferred enjoying nature and solitude/tranquility experiences more strongly than the OHV user group. Further analysis found that both groups perceived settings that they recreated in to be pristine and preferred such conditions, and both groups preferred moderate levels of rules and regulations. Finally, the OHV user group was more reactive to rules and regulations, while the non-OHV user group expressed stronger intentions to protect the environmental quality of recreation areas. The results suggest that planners and managers who understand OHV user's perceptions and behaviors could provide enhanced recreation opportunities potentially providing additional beneficial outcomes for motorized and non-motorized groups in spatially different zones. Additional implications for planners and managers and future studies are discussed.

Valuing nature-based recreation in public natural areas of the Apalachicola River region, Florida.

As more people visit natural areas for tourism and recreation purposes, it is becoming increasingly important to understand the value they place on these natural resources. Specifically, tourists to Florida have been increasingly interested in visiting natural areas, forests, parks, and preserves-highlighting the importance of this new and growing phenomenon. We analyze visitors' demand for nature-based recreation in the Apalachicola River region of Florida using the travel cost method. The results from a count data regression model reveal that on average visitors would pay 74.18 dollars per visit-day for nature-based recreation resulting in a total economic value of 484.56 million dollars attributable to nature-based recreation in the Apalachicola River region. Results of this study provide useful information for natural resources management in the region and a rationale to preserve Florida's unique ecosystems.