The Effects of Urban Neighborhood Environmental Evaluation and Health Service Facilities on Residents' Self-Rated Physical and Mental Health: A Comparative and Empirical Survey.

(1) Background: The neighborhood environment has been shown to be an essential factor affecting residents' quality of life and health, but the relationship between the characteristics of health service facilities and health levels is rarely known. (2) Methods: This study used a representative sample (n = 591, 303 women; 288 men, age 18-85 years, lived in Chengdu for an extensive time) of residents living in Chengdu City, China, and took spatial point data and empirical research data to construct an ordered logistic regression model. We contrastively analyzed the influence of different variables in the neighborhood environment and health service facilities on self-rated physical health (SRPH) and self-rated mental health (SRMH). (3) Results: The frequency of use and accessibility of multiple facilities in the health service facilities were significantly associated with self-rated health (SRH). Significant differences occurred between residents' perceived accessibility and actual accessibility of facilities in SRH. Comparing the results of SRPH and SRMH revealed that the influencing factors that affect the two vary. The factors that significantly affect SRMH include neighborhood physical environment evaluation; social environmental evaluation; the frequency of use of the parks and squares, and sports zones; and the accessibility of parks and squares, specialized hospitals, community hospitals, and pharmacies. However, the factors that significantly affect SRPH include the frequency of use of sports venues, general hospitals, and pharmacies and the accessibility of general hospitals. The social environment of the neighborhood is also a non-negligible part, and its interaction with the physical environment of the neighborhood affects the outcome of SRH. (4) Conclusions: Neighborhood environmental characteristics and the layout of health service facilities have significant differential effects on people's physical and psychological health, and this information is of great value in promoting healthy city development and improving the quality of life of urban populations around the world.

An equity and efficiency integrated grid-to-level 2SFCA approach: spatial accessibility of multilevel healthcare.

BACKGROUND: Equity of healthcare spatial access is essential for the health outcomes of medical investments and the welfare of populations, and efficiency of medical resource allocation is important for obtaining a supply-demand equilibrium with lower cost and higher outputs with limited inputs. However, the literature that involves both equity and efficiency in its analysis of healthcare spatial allocation is rare, and the spatial accessibility of multilevel healthcare is difficult to measure by traditional methods in a large region with diversified population distribution. METHODS: To assist in solving these issues, this paper aims to build an equity and efficiency integrated analytical framework by proposing a new "GTL-2SFCA" approach to analyze the spatial accessibility of multilevel healthcare; maximum and minimum floating catchments of different levels of healthcare were assigned to ensure a combination of universal search coverage and efficient hospitalization behavior simulation. RESULTS: The analytical framework was applied and tested in Hubei, China. Almost half of the residents (47.95%) and townships (44.98%) have access to both public general hospitals (PGHs) and primary healthcare centers (PHCs) services, 36.89% of the residents enjoy only one sufficient service, either PGHs or PHCs, and the remaining residents (15.16%) are faced with the risk of lacking access to both services. The results reveal that there are core-periphery effects of multilevel healthcare throughout Hubei and isolate clusters that have adequate access in the western region. The polarization effect of higher-level healthcare and the polycentric pattern of lower-level healthcare coexist. The multilevel healthcare shortage was identified in some areas in boundary and peripheral regions. CONCLUSIONS: This study integrates equity and efficiency into the GTL-2SFCA framework, enriches the FCA series methodologies and provides a more operational solution for evaluating the access of residents in more sophisticated spatial units to each level of healthcare. By more significantly differing and quantifying the catchment area and distance decay effect, this methodology avoids overestimating or underestimating accessibility and discovers some imperceptible spatial inequities. This study has application value for researchers and decision-makers in other scenarios and regions with significant heterogeneity in medical resources and where the population has greater mobility.

Target selection by gaze pointing and manual confirmation: performance improved by locking the gaze cursor.

Eye movement-based human-computer interactions are emerging in diverse scenarios. When selecting targets on a user interface, the method of combining fast gaze pointing with reliable manual action is becoming increasingly popular. However, this method suffers from noise in gaze pointing caused by eye jitters and users' habitual early move-away of gaze before manual actions. Here we propose a novel solution to mitigate these problems by locking the gaze cursor at the target for imminent manual selection. We compared this gaze-lock cursor with a conventional gaze cursor in a typing task with varying key sizes and key gaps. Results show that typing performance was significantly better with larger key size and gap. More importantly, the gaze-lock cursor significantly increased speed and decreased errors when compared to a conventional gaze cursor. Our findings demonstrate that the gaze-lock cursor is a promising tool for gaze interactions involving frequent target selections. Practitioner summary: Target selection by gaze pointing and manual confirmation suffers from eye jitters and users' habitual early move-away of gaze before manual actions. The performance of this method can be improved by applying the gaze-lock cursor we proposed, increasing target size or increasing the target gap. Abbreviations: WTC: warping to target center; ALCM: automatic lock of cursor movement; LCD: liquid crystal display; EWMA: exponential weighted moving average; ER: error rate; ET: execution time; ED: edit distance; CV: coefficients of variation; ANOVA: analysis of variance; GUIs: general user interfaces.

Spatial Equity of Multilevel Healthcare in the Metropolis of Chengdu, China: A New Assessment Approach.

The spatial equity of the healthcare system is an important factor in assessing how the different medical service demands of residents are met by different levels of medical institutions. However, previous studies have not paid sufficient attention to multilevel healthcare accessibility based on both the divergence of hierarchical healthcare supplies and variations in residents' behavioral preferences for different types of healthcare. This study aims to propose a demand-driven "2R grid-to-level" (2R-GTL) method of analyzing the spatial equity in access to a multilevel healthcare system in Chengdu. Gridded populations, real-time travel distances and residents' spatial behavioral preferences were used to generate a dynamic and accurate healthcare accessibility assessment. The results indicate that significant differences exist in the spatial accessibility to different levels of healthcare. Approximately 90% of the total population living in 57% of the total area in the city can access all three levels of healthcare within an acceptable travel distance, whereas multilevel healthcare shortage zones cover 42% of the total area and 12% of the population. A lack of primary healthcare is the most serious problem in these healthcare shortage zones. These results support the systematic monitoring of multilevel healthcare accessibility by decision-makers. The method proposed in this research could be improved by introducing nonspatial factors, private healthcare providers and other cultural contexts and time periods.

Spatio-Temporal Distribution, Spillover Effects and Influences of China's Two Levels of Public Healthcare Resources.

In China, upper-level healthcare (ULHC) and lower-level healthcare (LLHC) provide different public medical and health services. Only when these two levels of healthcare resources are distributed equally and synergistically can the public's demands for healthcare be met fairly. Despite a number of previous studies having analysed the spatial distribution of healthcare and its determinants, few have evaluated the differences in spatial equity between ULHC and LLHC and investigated their institutional, geographical and socioeconomic influences and spillover effects. This study aims to bridge this gap by analysing panel data on the two levels of healthcare resources in 31 Chinese provinces covering the period 2003⁻2015 using Moran's I models and dynamic spatial Durbin panel models (DSDMs). The results indicate that, over the study period, although both levels of healthcare resources improved considerably in all regions, spatial disparities were large. The spatio-temporal characteristics of ULHC and LLHC differed, although both levels were relatively low to the north-west of the Hu Huanyong Line. DSDM analysis revealed direct and indirect effects at both short-and long-term scales for both levels of healthcare resources. Meanwhile, the influencing factors had different impacts on the different levels of healthcare resources. In general, long-term effects were greater for ULHC and short-term effects were greater for LLHC. The spillover effects of ULHC were more significant than those of LLHC. More specifically, industrial structure, traffic accessibility, government expenditure and family healthcare expenditure were the main determinants of ULHC, while industrial structure, urbanisation, topography, traffic accessibility, government expenditure and family healthcare expenditure were the main determinants of LLHC. These findings have important implications for policymakers seeking to optimize the availability of the two levels of healthcare resources.

Altered Gravity Simulated by Parabolic Flight and Water Immersion Leads to Decreased Trunk Motion.

Gravity is one of the important environmental factors that influence the physiologies and behaviors of animals and humans, and changes in gravity elicit a variety of physiological and behavioral alterations that include impaired movement coordination, vertigo, spatial disorientation, and perceptual illusions. To elucidate the effects of gravity on human physiology and behavior, we examined changes in wrist and trunk activities and heart rate during parabolic flight and the activity of wrist and trunk in water immersion experiments. Data from 195 person-time parabolas performed by eight subjects revealed that the trunk motion counts decreased by approximately half during ascending legs (hypergravity), relative to the data acquired before the parabolic flights. In contrast, the wrist activity remained unchanged. The results from the water immersion experiments demonstrated that in the underwater condition, both the wrist and trunk activities were significantly decreased but the latter decreased to a much lower level. Together, these data suggest that gravitational alterations can result in differential influences on the motions of the wrist and the trunk. These findings might be important for understanding the degeneration of skeleton and muscular system and performance of astronauts in microgravity.