Study of citizen satisfaction and loyalty in the urban area of Guayaquil: Perspective of the quality of public services applying structural equations.

This study investigates the satisfaction and adequacy of citizens through the expected quality and perceived quality in the areas of planning and territorial viability, experience in the provision of municipal services and citizen experience in environmental issues, in order to provide tools for territorial decision making for the citizens' well-being. In our research PLS software is used for the analysis of hypotheses. A questionnaire was delivered to a sample of 521 citizens, representing the spectrum of the population, and the statistical study of the responses yielded results on citizen satisfaction and loyalty. Our research includes the study of moderating effects on the causal ratio of perceived value and satisfaction in territorial planning and viability, the perceived quality in the provision of municipal services and the perceived quality in the citizen experience in the environmental management of the territory on the value relationship perceived by the citizen and general satisfaction. A second objective of the study is to see if there are significant differences in the hypotheses raised by gender by performing a multigroup analysis. This difference has been appreciated in two of the hypotheses. The study shows that the policies exercised by the territorial managers of the different areas have a significant influence on the value perceived by citizens, satisfaction and loyalty, which shape their general well-being. Areas for improvement in territorial policies and municipal services such as citizen security, air quality, public lighting and sports services have been identified. Knowing these shortcomings allows politicians to focus their efforts on improving the quality of life in cities.

Advancing urban mental health research: from complexity science to actionable targets for intervention.

Urbanisation and common mental disorders (CMDs; ie, depressive, anxiety, and substance use disorders) are increasing worldwide. In this Review, we discuss how urbanicity and risk of CMDs relate to each other and call for a complexity science approach to advance understanding of this interrelationship. We did an ecological analysis using data on urbanicity and CMD burden in 191 countries. We found a positive, non-linear relationship with a higher CMD prevalence in more urbanised countries, particularly for anxiety disorders. We also did a review of meta-analytic studies on the association between urban factors and CMD risk. We identified factors relating to the ambient, physical, and social urban environment and showed differences per diagnosis of CMDs. We argue that factors in the urban environment are likely to operate as a complex system and interact with each other and with individual city inhabitants (including their psychological and neurobiological characteristics) to shape mental health in an urban context. These interactions operate on various timescales and show feedback loop mechanisms, rendering system behaviour characterised by non-linearity that is hard to predict over time. We present a conceptual framework for future urban mental health research that uses a complexity science approach. We conclude by discussing how complexity science methodology (eg, network analyses, system-dynamic modelling, and agent-based modelling) could enable identification of actionable targets for treatment and policy, aimed at decreasing CMD burdens in an urban context.

Almussafes evalúa los impactos en la salud de su plan de movilidad / Almussafes assesses the health impacts of its mobility plan

Buscar el bienestar de la población y la equidad en salud requiere actuar sobre los determinantes sociales de la salud (DSS). El enfoque de salud en todas las políticas es el más idóneo para ello, y la evaluación del impacto en salud, la técnica cada vez más extendida, como instrumento de ayuda en la toma de decisiones. El objetivo principal de este trabajo es hacer un análisis prospectivo del impacto que puede tener el Plan de Movilidad Urbana Sostenible de Almussafes en la salud y equidad en salud de su población. Para ello, se ha empleado la herramienta Fem Salut al nostre municipi? junto con técnicas participativas, poniendo en valor el papel tanto de profesionales y personal técnico municipal como de la propia ciudadanía. A partir del análisis de su discurso, y en base a la evidencia científica, se identificaron los principales impactos del Plan sobre los Determinantes Sociales de la Salud: disminución de la contaminación ambiental y acústica, incremento de los desplazamientos activos y del bienestar emocional, etc. También se recogieron recomendaciones de mejora para potenciar los impactos positivos y su distribución equitativa. La participación ciudadana es un elemento clave en la evaluación de impacto en salud (EIS) de las políticas no sanitarias, y el ámbito local ofrece una oportunidad única para incorporarla en el proceso de toma de decisiones. Con ello, es posible desarrollar políticas públicas saludables y equitativas

Seeking the well-being of the population and health equity requires acting on the social determinants of health. The Health in All Policies approach is the most suitable for this, and Health Impact Assessment is the increasingly widespread technique, as a tool to assist in decision-making. The main objective of this work is to perform a prospective analysis of the impact that the Sustainable Urban Mobility Plan of Almussafes can have on the health and health equity of its population. For this purpose, the tool Fem Salut al nostre municipi? has been used, together with participatory techniques, which highlights the role of both professionals and municipal technical staff, as well as the role of citizens themselves. From the analysis of its discourse, and based on scientific evidence, the most important impacts of the Plan on the social determinants of health were identified: decrease in environmental and noise pollution, increase in active mobility and emotional well-being, among others. Recommendations for improvement to enhance positive impacts and their equitable distribution were also collected. Community participation is a key element in HIA of non-health policies, and the local scope offers a unique opportunity to incorporate this into the decision-making process. With HIA, it is possible to carry out healthy and equitable public policies

Demographic and Socioeconomic Factors Associated with Urinary Stone Disease Management in a Large Urban US Population.

OBJECTIVE: To determine the influence of socioeconomic parameters on urinary stone surgeries. METHODS: A retrospective cohort study analyzed patients undergoing urolithiasis surgery in our community network hospital in North Carolina from 2005-2018. RESULTS: Of 7731 patients, 2160 (28%), 5,174 (67%), and 397 (5%) underwent SWL, URS, and PCNL, respectively. A higher proportion of Whites underwent URS (67%) and SWL (74%) than PCNL (56%); whereas a larger percentage of Blacks underwent PCNL (24%) than URS (20%) and SWL (15%) groups (P <.001). Private insurance payers were greater in the SWL (95%) group than URS (80%) and PCNL (81%) (P <.001). The distribution of median income was significantly different amongst the 3 surgeries with higher income classes overutilizing SWL and underutilizing PCNL compared to lower income classes (P <.001). In linear regression modeling, the proportion of SWL in a postal code was positively associated with median income (R2=0.55, P <.001); URS and PCNL were negatively associated with median income (R2=0.40, P <.001 and R2=0.41, P <.001, respectively). On multivariate logistic regression modeling, Blacks were significantly more likely to undergo PCNL than Whites (aOR 1.32, 95% CI 1.01-1.74 P <.050). Private insurance payers were more likely to undergo SWL (aOR 11.0, 95% CI 7.26-16.8, P <.0001) than public insurance payers. Patients in higher median income brackets are significantly less likely to undergo PCNL than those in the <$40,000 income bracket (P <.0001). CONCLUSION: Our study suggests that socioeconomic status impacts urolithiasis surgical management, underscoring disparity recognition importance in endourologic care and ensuring appropriate surgical care regardless of socioeconomic status.

Rapid urban health security assessment tool: a new resource for evaluating local-level public health preparedness.

Urbanisation will be one of the defining demographic trends of the 21st century-creating unique opportunities for sustainable capacity development, as well as substantial risks and challenges for managing public health and health emergencies. Plans and policies for responding to public health emergencies are generally framed at higher levels of governance, but developing, improving and sustaining the capacities necessary for implementing these policies is a direct function of local-level authorities. Evaluating local-level public health capacities is an important process for identifying strengths and weaknesses that can impact the preparedness for, detection of and response to health security threats. However, while various evaluations and assessments exist for evaluating capacities at other levels, currently, there are no readily available health security assessments for the local-level. In this paper, we describe a tool-the Rapid Urban Health Security Assessment (RUHSA) Tool-that is based on a variety of other relevant assessments and guidance documents. Assessing capacities allow for local-level authorities to identify the strengths and weaknesses of their local health security systems, create multiyear action plans and prioritise opportunities for improving capacities, effectively engage with development partners to target resources effectively and develop compelling narratives and a legacy of leadership. While the RUHSA Tool was not designed to be used in the midst of a public health emergency, such as the ongoing COVID-19 pandemic, it may also be adapted to inform a checklist for prioritising what capacities and activities a city needs to rapidly develop or to help focus requests for assistance.

The Use of Technology for Communicating With Clinicians or Seeking Health Information in a Multilingual Urban Cohort: Cross-Sectional Survey.

BACKGROUND: Technology is being increasingly used to communicate health information, but there is limited knowledge on whether these strategies are effective for vulnerable populations, including non-English speaking or low-income individuals. OBJECTIVE: This study assessed how language preferences (eg, English, Spanish, or Chinese), smartphone ownership, and the type of clinic for usual source of care (eg, no usual source of care, nonintegrated safety net, integrated safety net, private or community clinic, academic tertiary medical center, or integrated payer-provider) affect technology use for health-related communication. METHODS: From May to September 2017, we administered a nonrandom, targeted survey to 1027 English-, Spanish-, and Chinese-speaking San Francisco residents and used weighted multivariable logistic regression analyses to assess predictors of five technology use outcomes. The three primary predictors of interest-language preference, smartphone ownership, and type of clinic for usual care-were adjusted for age, gender, race or ethnicity, limited English proficiency, educational attainment, health literacy, and health status. Three outcomes focused on use of email, SMS text message, or phone apps to communicate with clinicians. The two other outcomes were use of Web-based health videos or online health support groups. RESULTS: Nearly one-third of participants watched Web-based health videos (367/1027, 35.74%) or used emails to communicate with their clinician (318/1027, 30.96%). In adjusted analyses, individuals without smartphones had significantly lower odds of texting their clinician (adjusted odds ratio [aOR] 0.27, 95% CI 0.13-0.56), using online health support groups (aOR 0.14, 95% CI 0.04-0.55), or watching Web-based health videos (aOR 0.31, 95% CI 0.15-0.64). Relative to English-speaking survey respondents, individuals who preferred Chinese had lower odds of texting their clinician (aOR 0.25, 95% CI 0.08-0.79), whereas Spanish-speaking survey respondents had lower odds of using apps to communicate with clinicians (aOR 0.34, 95% CI 0.16-0.75) or joining an online support group (aOR 0.30, 95% CI 0.10-0.92). Respondents who received care from a clinic affiliated with the integrated safety net, academic tertiary medical center, or integrated payer-provider systems had higher odds than individuals without a usual source of care at using emails, SMS text messages, or apps to communicate with clinicians. CONCLUSIONS: In vulnerable populations, smartphone ownership increases the use of many forms of technology for health purposes, but device ownership itself is not sufficient to increase the use of all technologies for communicating with clinicians. Language preference impacts the use of technology for health purposes even after considering English proficiency. Health system factors impact patients' use of technology-enabled approaches for communicating with clinicians. No single factor was associated with higher odds of using technology for all health purposes; therefore, existing disparities in the use of digital health tools among diverse and vulnerable populations can only be addressed using a multipronged approach.

Characteristics, source apportionment and health risks of ambient VOCs during high ozone period at an urban site in central plain, China.

On 3rd to May 24, 2018, volatile organic compound (VOC) samples were collected four times a day by using stainless steel canisters at an urban site in Zhengzhou, China. The concentrations, compositions, sources, ozone (O3) formation potential (OFP), and health risk assessment of VOCs were discussed based on the measurements of 103 VOC species. Results show that the average mixing ratio of VOCs was 29.11 ± 15.33 ppbv, and the dominant components comprised oxygenated VOCs (OVOCs) and alkanes, followed by halocarbons, alkenes, aromatics, and a sulfide. Various groups of VOCs had typical diurnal variation characteristics. Alkenes, alkanes, and aromatics contributed most to the OFP. Five sources identified by the positive matrix factorization model revealed solvent utilization as the largest contributor, followed by industrial production, long-lived and secondary species, vehicular emission, and biogenic emission. Solvent utilization and vehicular emission were important sources to OFP. During O3 episode days, the mixing ratios of alkanes, alkenes, halocarbons, OVOCs, aromatics, and TVOCs decreased to varying degrees; the source contribution of solvent utilization decreased significantly while industrial production showed the opposite trend. VOC species and sources posed no non-carcinogenic risk while five species and all sources except for biogenic emission had carcinogenic risks to exposed population. Industrial emission was the largest contributor to both non-carcinogenic and carcinogenic risks. These results will help to provide some references for O3 pollution research and prevention and control of pollution sources.

Occupational health in two centers for the sorting and collection of recycled materials in the Buenos Aires Metropolitan Area, Argentina, 2015. / Salud ocupacional en dos centros de clasificación y acopio de materiales reciclables en el Área Metropolitana de Buenos Aires, Argentina, 2015.

How can the health risks be estimated of workers who handle urban solid waste sorting recyclable materials? To answer this question, during 2015, field research was carried out with an ecoepidemiological perspective in two classification and collection centers (one urban and another peri-urban) located in the southern area of the Metropolitan Area of Buenos Aires, Argentina. In order to describe the work process, ethnographic techniques (interviews, participant observation), as well as other projective and body work techniques were utilized to characterize the conditions and environment of this nonclassical type of work using the framework of risks and demands recommended by the International Labor Organization. The demands tend to concentrate on the entry and exit of materials, the risks of the work object on the sorting of the materials, and the biological risks on the work environment. Within the work process, diversity and little planning were found. Therefore, the characterization of working conditions and environment was also an opportunity for reflexivity among workers and researchers regarding the creation and organization of the work environment and the embodiment of illness.

¿Cómo estimar los riesgos para la salud de las y los trabajadores que manipulan residuos sólidos urbanos separando y clasificando materiales reciclables? Para responder esta pregunta, durante 2015, se realizó una investigación en terreno con una perspectiva ecoepidemiológica en dos centros de clasificación y acopio (uno urbano y otro en un descampado periurbano) ubicados en la zona sur del Área Metropolitana de Buenos Aires, Argentina. Con el propósito de describir el proceso de trabajo, se utilizaron técnicas etnográficas (entrevistas, observación participante), proyectivas y de trabajo corporal, para caracterizar las condiciones y medio ambiente según riesgos y exigencias de la Organización Internacional de Trabajo para este trabajo no clásico. Las exigencias tenderían a concentrarse en el ingreso y salida de materiales, los riesgos del objeto de trabajo resultarían de la separación y, los riesgos biológicos, del ambiente de trabajo. Se encontró diversidad y poca planificación en el proceso de trabajo. Por ello, la caracterización de las condiciones y el medio ambiente de trabajo fue también una instancia de reflexividad entre trabajadores e investigadores sobre la creación-organización del ambiente de trabajo y la corporización de los padecimientos.

Prevalence of Asthma among Young Men Residing in Urban Areas with Different Sources of Air Pollution.

BACKGROUND: Asthma is a common respiratory disease, which is linked to air pollution. However, little is known about the effect of specific air pollution sources on asthma occurrence. OBJECTIVES: To assess individual asthma risk in three urban areas in Israel characterized by different primary sources of air pollution: predominantly traffic-related air pollution (Tel Aviv) or predominantly industrial air pollution (Haifa bay area and Hadera). METHODS: The medical records of 13,875, 16- 19-year-old males, who lived in the affected urban areas prior to their army recruitment and who underwent standard pre-military health examinations during 2012-2014, were examined. Nonparametric tests were applied to compare asthma prevalence, and binary logistic regressions were used to assess the asthma risk attributed to the residential locations of the subjects, controlling for confounders, such as socio-demographic status, body mass index, cognitive abilities, and education. RESULTS: The asthma rate among young males residing in Tel Aviv was 8.76%, compared to 6.96% in the Haifa bay area and 6.09% in Hadera. However, no statistically significant differences in asthma risk among the three urban areas was found in controlled logistic regressions (P > 0.20). This finding indicates that exposure to both industrial- and traffic-related air pollution is associated with asthma prevalence. CONCLUSIONS: Both industrial- and traffic-related air pollution have a negative effect on asthma risk in young males. Studies evaluating the association between asthma risk and specific air pollutants (e.g., sulfur dioxide, particulate matter, and nitrogen dioxide) are needed to ascertain the effects of individual air pollutants on asthma occurrence.

Can health and health equity be advanced by urban planning strategies designed to advance global competitiveness? Lessons from two Australian case studies.

BACKGROUND: The purpose of this article is to investigate whether the neo-liberal goal of global economic competitiveness when included alongside image-inspired social goals such as liveability and environmental goals such as sustainability can lead to policies that impact positively on health and health equity. The paper presents an analysis of the content and intent of strategic planning and transport plans from two Australian state governments. METHODS: The analysis was undertaken using a thematic document analysis of each plan and interviews with agents (n = 21) directly involved in the preparation of each document. FINDINGS: Key strategic documents formulated under a neo-liberal hegemony simultaneously provided and reduced opportunities to promote and advance health. The policies viewed goals like liveability and sustainability as means of enhancing their cities' image in global competition for exogenous capital flows. Although liveability has many definitions, one definition was able to be used in one jurisdiction as an avenue to include a broad array of social determinants of health into urban planning policy. However, a productivity or a narrowly focussed image narrative can undermine the social determinants of health credentials of liveability. Overemphasising immediate city problems like road congestion as mechanisms to enhance global competitiveness can undermine necessary long-term strategies for city planning that are known to improve liveability and human health. Even where liveability is at the fore, there is a high risk of exacerbating spatial inequities through liveability investments for competitive advantage because they tend to flow to parts of cities with the greatest connections to the global economy, not those with the greatest social need. CONCLUSIONS: A neo-liberal-inspired competitive city paradigm provides opportunities for the advancement of health in urban development. However, when driven by the goals of productivity and/or liveability as image enhancement it can potentially exacerbate health inequities.

Low proportions of folic acid deficiency after introduction of mandatory folic acid fortification in remote areas of northern Queensland, Australia: a secondary health data analysis.

Background: Australia implemented mandatory folic acid fortification of bread-making flour in 2009. Objective: To assess the impact of folic acid fortification in remote vs. regional urban areas and Indigenous vs. non-Indigenous populations in northern Queensland. Methods: Routinely collected data on folic acid measurements in remote areas and two regional urban centres in northern Queensland between 2004 and 2015 were analysed (n = 13,929) dichotomously (folic deficient vs. non-deficient). Results: Overall prevalence of folic acid deficiency was 3.2% (235/7282) in urban centres compared with 7.2% (480/6647) in remote areas (p < 0.001), and 9.3% (393/4240) in the Indigenous population compared with 3.2% (273/8451) in the non-Indigenous population (p < 0.001). Prevalence of folic acid deficiency dropped from 12.2% (n = 481) in 2004-2008 to 1.5% (n = 126) in 2010-2015 (p < 0.001). This translates into a relative risk reduction (RRR) of 88%. RRR was 79% (7.2% vs. 1.5%) in urban centres, 91% (17.3% vs. 1.5%) in remote areas, 92% (20.5% vs. 1.6%) in the Indigenous population and 80% (7.4% vs. 1.5%) in the non-Indigenous population (p < 0.001 for all). Conclusions: Substantial declines of folic acid deficiency to low and comparable proportions in former high-risk populations indicate that mandatory folic acid fortification of flour has had a population-wide benefit in northern Queensland.

'When the dog bites': What can we learn about health geography from newspaper coverage in a 'model city' for dog-bite prevention?

Despite calls for the adoption of 'One-Health' approaches, dog-bite injuries remain neglected in healthcare and public health, and our study may help to understand why. Media coverage can influence policy directions, including policies that address dogs. We collected articles (n = 65) published in two local newspapers, 2012-2017, then carried out an ethnographically-informed discourse analysis of the dog-bite reports. The newspapers portrayed dog-bites mainly as matters of public disorder, as opposed to priorities for healthcare and public health. Even as our study took place in a city that has shown dog-bite reductions without recourse to 'breed bans' or restrictions (i.e., breed-specific legislation), journalists still tended to emphasize dog breed as a narrative element in explaining dog-bite incidents. Nonetheless, the news coverage did not reproduce a 'nature versus nurture' dichotomy. Rather, the journalists presented dog breed, and presumably associated aggressive behaviour, as entanglements with social, economic, and cultural contexts. Meanwhile, the news stories reduced contextual complexity to geographic locations, as codes for community reputation, in attributing causality and morality.

Subscribers' perception of quality of services provided by Ghana's National Health Insurance Scheme - what are the correlates?

BACKGROUND: Ghana's National Health Insurance Scheme (NHIS) has witnessed an upsurge in enrollment since its inception in 2003, with over 40% of the Ghanaian population actively enrolled in the scheme. While the scheme strives to achieve universal health coverage, this quest is derailed by negative perceptions of the quality of services rendered to NHIS subscribers. This paper presents an analysis on perceptions of service quality provided to subscribers of Ghana's NHIS with emphasis on rural and urban scheme policy holders, using a nationally representative data. METHODS: The study used data from the 2014 Ghana Demographic and Health Survey. Ordered logistic regressions were estimated to identify the correlates of perceived quality of care of services rendered by the NHIS. Also, chi-square statistics were performed to test for significant differences in the proportions of subscribers in the two subsamples (rural and urban). RESULTS: Rural subscribers of the NHIS were found to identify more with better perception of quality of services provided by the NHIS than urban subscribers. Results from the chi-square statistics further indicated that rural subscribers are significantly different from urban subscribers in terms of the selected socioeconomic and demographic characteristics. In the full sample; age, out-of-pocket payment for healthcare and region of residence proved significant in explaining perceived quality of services rendered by the NHIS. Age, out-of-pocket payment for healthcare, region of residence, wealth status, and access to media were found to be significant predictors of perceived quality of services provided to both rural and urban subscribers of the NHIS. The significance of these variables varied among men and women in rural and urban areas. CONCLUSION: Different factors affect the perception of quality of services provided to rural and urban subscribers of Ghana's NHIS. Health financing policies geared toward improving the NHIS-related services in rural and urban areas should be varied.

Increases in statin eligibility to reduce cardiovascular risk according to the 2013 ACC/AHA cholesterol guidelines in the Africa Middle East region: a sub-analysis of the Africa Middle East Cardiovascular Epidemiological (ACE) study.

BACKGROUND: With development of cholesterol management guidelines by the American College of Cardiology/American Heart Association (ACC/AHA), more individuals at risk of cardiovascular disease may be eligible for statin therapy. It is not known how this affects statin eligibility in the Africa and Middle East Region. METHODS: Data were used from the Africa Middle East Cardiovascular Epidemiological (ACE) study. The percentage of subjects eligible for statins per the ACC/AHA 2013 cholesterol guidelines and the 2002 National Cholesterol Education Program-Adult Treatment Panel (NCEP-ATP III) recommendations were compared. Analyses were carried out according to age, gender, community (urban/rural), and country income categories based on World Bank definitions. RESULTS: According to the ACC/AHA recommendations, 1695 out of 4378 subjects (39%; 95% confidence interval [CI], 37-40%) satisfied statin eligibility criteria vs. 1043/4378 (24%; 95% CI, 23-25%) per NCEP-ATP recommendations, representing a 63% increase in statin eligibility. Consistent increases in eligibility for statin therapy were seen according to the ACC/AHA vs. NCEP-ATP guidelines across sub-groups of age, gender, community, and country income. Notable increases for statin eligibility according to ACC/AHA vs. NCEP-ATP were seen, respectively, in subjects aged ≥65 years (86% vs. 39%), in males (46% vs. 25%), in low-income countries (28% vs. 14%), and rural communities (37% vs. 19%). CONCLUSION: An increase in statin eligibility was seen applying ACC/AHA cholesterol guidelines compared with previous NCEP-ATP recommendations in the Africa Middle East region. The economic consequences of these guideline recommendations will need further research. TRIAL REGISTRATION: The ACE trial is registered under NCT01243138 .

Assessing the impact of converting roundabouts to traffic signals on vehicle emissions along an urban arterial corridor in Qatar.

The type of control at intersections has a major effect on the operation of any urban corridor. Different predefined procedures are available to calculate some of the main operational characteristics, such as capacity, delay, and level of service, in order to select the best type of control. However, there are other important factors that affect major arterials operational characteristics, factors that are not fully addressed, such as the impact of emissions. In this study, a microscopic simulation approach using VISSIM and MOVES was developed to assess the environmental effect of converting four three-lane roundabouts to signalized intersections along a heavily congested urban corridor in Qatar. A decision was made to switch all roundabouts to traffic signals for better operations. Preliminary results indicated that the signal control outperformed the roundabout in the range of 37% to 43% reduction in emissions. A more detailed analysis revealed that roundabout corridor operations' effects on emission rates are divergent from those of signalized corridors, particularly upstream and downstream of the intersections. Immediate roundabout upstream approaches are driver behavior dependent, characterized by substantial coasting at lower speeds and subsequent re-accelerating with less idling, described as acceleration events, which resulted in high emission rates, while signalized corridors are signal timing dependent, characterized by ample idling with less coasting and re-acceleration, resulting in reduced emission rates. The results also revealed that there was no significant difference between emission rates in the vicinity of the two types of control. Both recorded nearly the same emission rate. Implications: A microscopic simulation approach using VISSIM and MOVES was developed to assess the environmental effect of converting four three-lane roundabouts to signalized intersections along a heavily congested urban corridor in Doha, Qatar. Intersection geometries along with the control type have significant impact on emission rates and play a major role in assessing environmental impacts. US EPA MOVES was calibrated to Qatar conditions which can be used to estimate emission factors and quantify vehicular emissions along other corridors in the country. The results can also be beneficial for other countries within the region.

Salud ocupacional en dos centros de clasificación y acopio de materiales reciclables en el Área Metropolitana de Buenos Aires, Argentina, 2015 / Occupational health in two centers for the sorting and collection of recycled materials in the Buenos Aires Metropolitan Area, Argentina, 2015

RESUMEN ¿Cómo estimar los riesgos para la salud de las y los trabajadores que manipulan residuos sólidos urbanos separando y clasificando materiales reciclables? Para responder esta pregunta, durante 2015, se realizó una investigación en terreno con una perspectiva ecoepidemiológica en dos centros de clasificación y acopio (uno urbano y otro en un descampado periurbano) ubicados en la zona sur del Área Metropolitana de Buenos Aires, Argentina. Con el propósito de describir el proceso de trabajo, se utilizaron técnicas etnográficas (entrevistas, observación participante), proyectivas y de trabajo corporal, para caracterizar las condiciones y medio ambiente según riesgos y exigencias de la Organización Internacional de Trabajo para este trabajo no clásico. Las exigencias tenderían a concentrarse en el ingreso y salida de materiales, los riesgos del objeto de trabajo resultarían de la separación y, los riesgos biológicos, del ambiente de trabajo. Se encontró diversidad y poca planificación en el proceso de trabajo. Por ello, la caracterización de las condiciones y el medio ambiente de trabajo fue también una instancia de reflexividad entre trabajadores e investigadores sobre la creación-organización del ambiente de trabajo y la corporización de los padecimientos.

ABSTRACT How can the health risks be estimated of workers who handle urban solid waste sorting recyclable materials? To answer this question, during 2015, field research was carried out with an ecoepidemiological perspective in two classification and collection centers (one urban and another peri-urban) located in the southern area of the Metropolitan Area of Buenos Aires, Argentina. In order to describe the work process, ethnographic techniques (interviews, participant observation), as well as other projective and body work techniques were utilized to characterize the conditions and environment of this nonclassical type of work using the framework of risks and demands recommended by the International Labor Organization. The demands tend to concentrate on the entry and exit of materials, the risks of the work object on the sorting of the materials, and the biological risks on the work environment. Within the work process, diversity and little planning were found. Therefore, the characterization of working conditions and environment was also an opportunity for reflexivity among workers and researchers regarding the creation and organization of the work environment and the embodiment of illness.

Risk maps for cities: Incorporating streets into geostatistical models.

Vector-borne diseases commonly emerge in urban landscapes, and Gaussian field models can be used to create risk maps of vector presence across a large environment. However, these models do not account for the possibility that streets function as permeable barriers for insect vectors. We describe a methodology to transform spatial point data to incorporate permeable barriers, by distorting the map to widen streets, with one additional parameter. We use Gaussian field models to estimate this additional parameter, and develop risk maps incorporating streets as permeable barriers. We demonstrate our method on simulated datasets and apply it to data on Triatoma infestans, a vector of Chagas disease in Arequipa, Peru. We found that the transformed landscape that best fit the observed pattern of Triatoma infestans infestation, approximately doubled the true Euclidean distance between neighboring houses on different city blocks. Our findings may better guide control of re-emergent insect populations.

Evaluating gentrification's relation to neighborhood and city health.

Gentrification has been argued to contribute to urban inequalities, including those of health disparities. Extant research has yet to conduct a systematic study of gentrification's relation with neighborhood health outcomes nationally. This gap is addressed in the current study through the utilization of census-tract data from the Center for Disease Control's 500 Cities project, the 2000 Census and the 2010-2014 American Community Survey to examine how gentrification relates to local self-rated physical health in select cities across the United States. We examine gentrification's association with neighborhood rates of poor self-rated physical health. We contextualize this relationship by evaluating gentrification's relation with city-level self-rated health inequalities. We find gentrification was significantly and positively related with self-rated physical neighborhood health outcomes. However, the presence and magnitude of gentrification within a city was not associated with health outcomes for cities overall. Based on these findings, we argue that gentrification's health benefits for cities are limited at best, though gentrification does not appear to be associated with deepening city-level health inequalities, either.

Classification and Regression Tree Approach for Prediction of Potential Hazards of Urban Airborne Bacteria during Asian Dust Events.

Despite progress in monitoring and modeling Asian dust (AD) events, real-time public hazard prediction based on biological evidence during AD events remains a challenge. Herein, both a classification and regression tree (CART) and multiple linear regression (MLR) were applied to assess the applicability of prediction for potential urban airborne bacterial hazards during AD events using metagenomic analysis and real-time qPCR. In the present work, Bacillus cereus was screened as a potential pathogenic candidate and positively correlated with PM10 concentration (p < 0.05). Additionally, detection of the bceT gene with qPCR, which codes for an enterotoxin in B. cereus, was significantly increased during AD events (p < 0.05). The CART approach more successfully predicted potential airborne bacterial hazards with a relatively high coefficient of determination (R2) and small bias, with the smallest root mean square error (RMSE) and mean absolute error (MAE) compared to the MLR approach. Regression tree analyses from the CART model showed that the PM10 concentration, from 78.4 µg/m3 to 92.2 µg/m3, is an important atmospheric parameter that significantly affects the potential airborne bacterial hazard during AD events. The results show that the CART approach may be useful to effectively derive a predictive understanding of potential airborne bacterial hazards during AD events and thus has a possible for improving decision-making tools for environmental policies associated with air pollution and public health.