Urban/rural variation in the influence of widowhood on mortality risk: a cohort study of almost 300,000 couples

Death of a spouse is associated with increased mortality risk for the surviving partner (the widowhood effect). We investigated whether the effect magnitude varied between urban, rural and intermediate areas, assembling death records (2001-2009) for a prospective cohort of 296,125 married couples in Northern Ireland. The effect was greatest during the first six months of widowhood in all areas and for both sexes. Subsequently, the effect was attenuated among men in rural and intermediate areas but persisted in urban areas (HRs and 95% CIs: rural 1.09 [0.99, 1.21]; urban 1.35 [1.26, 1.44]). Among women the effect was attenuated in all areas (rural 1.06 [0.96, 1.17]; urban 1.09 [1.01, 1.17]). The impacts of spousal bereavement varied between urban and more rural areas, possibly due to variation in social support provided by the wider community. We identify men in urban areas as being in greatest need of such support and a possible target for health interventions.

Urban/rural variation in the influence of widowhood on mortality risk

Death of a spouse is associated with increased mortality risk for the surviving partner (the widowhood effect), although the mechanisms driving the effect are poorly understood. After acute stress and grief have dissipated, mortality risk may be increased by loss of emotional and instrumental support for daily living and so we investigated whether social support at both the household and community levels moderated the influence of spousal bereavement on mortality risk.

We assembled death records from the Northern Ireland Mortality Study spanning almost nine years for a prospective cohort of 296,125 married couples enumerated in the 2001 Census. Presence of other adults within the household and urban/rural residence were used as measures of support at the household and community levels, with informal social support perceived to be strongest in rural areas. We used Cox proportional hazards models to estimate the effects of widowhood, sex, household composition and urban/intermediate/rural residence on all-cause mortality.

Elevated mortality risk during the first six months of widowhood was found in all areas and for both sexes (range of hazard ratios 1.24, 1.57). After more than six months the effect among men was attenuated in rural but not urban areas (HRs and 95%CIs 1.09 [0.99, 1.21] and 1.35 [1.26, 1.44] respectively). Among women the effect was attenuated in both rural and urban areas (HRs 1.06 [0.96, 1.17] and 1.09 [1.01, 1.17]). Mortality risk post bereavement was not associated with presence of other adults in the household.

We found some support for the hypothesis that informal social support is beneficial for reducing the impacts of spousal loss. Rural residence had a positive effect especially among men but presence of other adults in the household had no effect. The reasons for this discrepancy require further investigation and we identify men in urban areas as being at greatest risk in the long term.

Address inaccuracy in health registration data: determinants and impacts

Access to demographic data that are complete, accurate and up-to-date is fundamental to many aspects of public health, government and academic work and for accurate interpretation of other databases. Health registration data are the prime source of demographic information for health and social care systems; for example, as an indicator of need, as a source of denominators to convert number of events into rates, or in the case of the residential address information as the basis for generating the call-recall invitation letters that are used for most screening programs (e.g. breast, colo-rectal and AAA screening). However, list inflation (ghosts, duplicates or emigrants) and a degree of address inaccuracy are recognised caveats with the health registration data and a recent NILS-related study on breast screening suggests that improved address accuracy might be a fast and efficient means of increasing screening uptake rates in cities and amongst deprived populations. In NI these data are collated by the BSO who uniquely in the UK also have access to data relating to prescribing, dental registrations and use of A&E services. These can be used to supplement the standard demographic and address information by (i) indicating patients who are alive and resident in NI and (ii) providing an independent source of probably improved address information. This study will use the NI Unique Property Reference Number (UPRN), rather than the addresses per se which are difficult to work with, to compare the addresses registered in the BSO with those addresses in the enumerated 2011 census. Assuming that the census is a more accurate source of address information for individuals, a comparison of the health registration addresses with those recorded at the census, the aim of the proposed study will be to (i) characterise the amount and distributions of these differences, (ii) to see what proportion of those who do not attend for screening did not actually receive an invitation letter because the addresses were incorrect, (iii) to determine how much of the social gradient (and urban/rural differences) in screening uptake are due to address inaccuracies, (iv) a comparison of timing of address changes at the BSO will provide information on the delays in updating of addresses.

Regional and urban air quality modelling under a climate change scenario

The better understanding of the interactions between climate change and air quality is an emerging priority for research and policy. Climate change will bring changes in the climate system, which will affect the concentration and dispersion of air pollutants. The main objective of the current study is to assess the impacts of climate change on air quality in 2050 over Portugal and Porto urban area. First, an evaluation and characterization of the air quality over mainland Portugal was performed for the period between 2002 and 2012. The results show that NO2, PM10 and O3 are the critical pollutants in Portugal. Also, the influence of meteorology on O3, NO2 and PM10 levels was investigate in the national main urban areas (Porto and Lisboa) and was verified that O3 has a statistically significant relationship with temperature in most of the components. The results also indicate that emission control strategies are primary regulators for NO2 and PM10 levels. After, understanding the national air quality problems and the influence that meteorology had in the historical air quality levels, the air quality modelling system WRF-CAMx was tested and the required inputs for the simulations were prepared to fulfil the main goal of this work. For the required air quality modelling inputs, an Emission Projections under RCP scenarios (EmiPro-RCP) model was developed to assist the estimation of future emission inventories for GHG and common air pollutants. Also, the current emissions were estimated for Portugal with a higher detailed disaggregation to improve the performance of the air quality simulations. The air quality modelling system WRF/CAMx was tested and evaluated over Portugal and Porto urban area and the results point out that is an adequate tool for the analysis of air quality under climate change. For this purpose, regional simulations of air quality during historical period and future (2045-2050) were conducted with CAMx version 6.0 to evaluate the impacts of simulated future climate and anthropogenic emission projections on air quality over the study area. The climate and the emission projections were produced under the RCP8.5 scenario. The results from the simulations point out, that if the anthropogenic emissions keep the same in 2050, the concentrations of NO2, PM10 and O3 will increase in Portugal. When, besides the climate change effects, is consider the projected anthropogenic emissions the annual mean concentrations of NO2 decrease significantly in Portugal and Porto urban area, and on the contrary the annual mean PM10 concentrations increases in Portugal and decrease in Porto urban area. The O3 results are mainly caused by the reduction of ozone precursors, getting the higher reductions in urban areas and increases in the surrounding areas. All the analysis performed for both simulations for Porto urban area support that, for PM10 and O3, there will be an increase in the occurrence of extreme values, surpassing the annual legislated parameters and having more daily exceedances. This study constitutes an innovative scientific tool to help in future air quality management in order to mitigate future climate change impacts on air quality.

Urban Leptospirosis in Africa: A Cross-Sectional Survey of Leptospira Infection in Rodents in the Kibera Urban Settlement, Nairobi, Kenya

Leptospirosis is a widespread but under-reported cause of morbidity and mortality. Global re-emergence of leptospirosis has been associated with the growth of informal urban settlements in which rodents are thought to be important reservoir hosts. Understanding the multi-host epidemiology of leptospirosis is essential to control and prevent disease. A cross-sectional survey of rodents in the Kibera settlement in Nairobi, Kenya was conducted in September–October 2008 to demonstrate the presence of pathogenic leptospires. A real-time quantitative polymerase chain reaction showed that 41 (18.3%) of 224 rodents carried pathogenic leptospires in their kidneys, and sequence data identified Leptospira interrogans and L. kirschneri in this population. Rodents of the genus Mus (37 of 185) were significantly more likely to be positive than those of the genus Rattus (4 of 39; odds ratio = 15.03). Questionnaire data showed frequent contact between humans and rodents in Kibera. This study emphasizes the need to quantify the public health impacts of this neglected disease at this and other urban sites in Africa.

Urban logistics: how can it meet policy makers' sustainability objectives?

This paper discusses how urban freight activity can function such that it meets the urban sustainability objectives policy makers are now beginning to implement. It considers: the importance of urban freight transport in maintaining the economic vitality of the city; the negative impacts that it imposes; the concept of urban sustainability and the development of sustainability strategies; and the means and measures by which freight transport could be made more sustainable. It presents results from a project that investigated the current freight transport operations of seven different companies in three urban areas in the UK. The potential operational, financial and environmental effects of four policy measures on these operations are considered.

Literature Review WM9: Part I - urban freight transport, carried out as part of Work Module 1, Green Logistics Project

The review illustrates the importance of road movements in goods distribution in urban areas. It highlights the major economic, environmental and social impacts associated with this freight activity and reviews policy options available to those responsible for regulation. A wide range of possible solutions to problems posed by urban freight operations are also covered including approaches related to: consolidation, facilities, vehicle design, information capture and utilisation, and non-road modes.

Light goods vehicles in urban areas

The paper provides a review of the light goods vehicle (LGV) fleet and its activity, with specific reference to operations in urban areas, and sustainability issues associated with the ever-growing use of LGVs. Traditionally these vehicles have received little attention but are becoming an ever-more important element of urban freight transport both for goods collection and delivery and for the provision of a wide range of critical services. Relevant literature from the UK and elsewhere pertaining to LGV operations and their impacts has been identified and utilised. The paper identifies the impacts of LGV operations in terms of economic, social and environmental impacts and presents the range of measures being taken by policy makers and companies to address negative impacts.

Evaluating the use of an urban consolidation centre and electric vehicles in central London

The paper focuses on the role that can be played by urban consolidation centres (UCCs) in reducing freight traffic and its environmental impacts in towns and cities. It is based on the before and after evaluation of a trial led by a major stationery and office supplies company in which urban freight deliveries in central London made from a depot in the suburbs using diesel vehicles were replaced with the use of an urban micro-consolidation centre located in the delivery area together with the use of electrically-assisted cargo tricycles and electric vans. The results show that the total distance travelled and the CO2eq emissions per parcel delivered fell by 20% and 54% respectively as a result of this delivery system. However, the evaluation has also indicated that the distance travelled per parcel rose substantially in the City of London delivery area as a result of the electric vehicles having far smaller load limits in both weight and volume compared with diesel vans. But, at the same time, the trial system was able to virtually eliminate CO2eq emissions per parcel delivered in the City of London. The trial proved successful from the company's perspective in transport, environmental and financial terms. The company therefore decided to continue the operation beyond the end of the trial with it being officially launched during 2010.

Urban development modifies lake food webs in the Pacific Northwest

Thesis (Master's)--University of Washington, 2015

The role of urban consolidation centres in sustainable freight transport

The paper reviews the study and use of urban consolidation centres (UCCs) which are a freight transport initiative intended to reduce goods vehicle traffic, vehicle-related greenhouse gas emissions and local air pollution. An international literature review has identified 114 UCC schemes in 17 countries (12 in the European Union (EU) and 5 outside the EU) that have been the subject of either a feasibility study, trial or a fully operational scheme in the last 40 years. The period from 2006 to 2010 has been the most active 5-year period in terms of UCC study, trial and scheme generation since the first UCC study was carried out in the early 1970s. Five countries account for the majority of all the 114 UCC schemes identified: France, Germany, Italy, the Netherlands and the UK. The vast majority of UCCs serve either all or part of an urban area. Examples of UCCs serving a single property (such as an airport or shopping centre) and construction sites have also been identified. Key organizational, operational, and financial issues that are critical to the success of UCCs are discussed. The traffic and environmental impacts of UCC trials and fully operational schemes are also reviewed.

The role of urban consolidation centres in sustainable freight transport

The chapter considers the role that urban consolidation centres (UCCs) can play in helping to reduce goods vehicle traffic and its environmental impacts in urban areas. A UCC is a logistics facility that is situated in relatively close proximity to the area that it serves. Goods destined for this area are dropped off at the UCC, and are sorted and consolidated onto goods vehicles for delivery to their final destinations, often using environmentally friendly vehicles such as electric and gas-powered goods vehicles, and electrically-assisted cycles. The development of UCCs since their first appearance in the 1970s is reviewed and the various types of UCC categorised. The freight transport and logistics advantages offered by UCCs are discussed. Case studies of four recent UCC trials are included. The objectives, operational and financial aspects and impacts of these UCCs are compared and their critical success factors identified.

Understanding urban freight activity: key issues for freight planning

Using information gathered from some 30 UK surveys undertaken over the last 15 years, this paper provides planners with an understanding of road-based urban retail freight transport activity. The findings suggest that the average High Street business could expect up to 10 core goods and 7.6 service visits per week, in non-peak trading periods with 25% additional activity during the build up to Christmas. Vans (‘light goods vehicles’) were the dominant mode, responsible for 42% of delivery activity with a mean dwell time of 10 min. Where possible, load consolidation should be encouraged by methods such as Delivery and Servicing Plans and using out-of-town freight consolidation centres to bring in goods over the last mile in shared vehicles. Where this is not possible, loading bay monitoring and control, and preferred lorry routes can help manage the movement of vehicles in and out of dense urban areas. Service vehicle activity is a significant contributor to urban freight movements and often requires vehicles to be parked close to the premises being served. Centrally coordinating elements of service provision (e.g. for cleaning, equipment maintenance, recyclate collection), or providing improved, more flexible parking provision for service vehicles could be as or more beneficial in reducing overall freight impacts than focusing on core goods deliveries. In the case of the latter, ‘pay-as-you-leave’ car park charging systems could encourage short-stay service vehicles to park off-street.

Exploring the intangible impacts of cultural events on the creative sector: Experiences from the Cultural Olympiad programmes of Torino 2006 and London 2012

This paper engages with the debates around the Olympic legacy by exploring the qualitative, intangible impacts of the Cultural Olympiad programme on local small creative firms in Torino, Italy and London, UK. The research objectives are achieved through a qualitative study of local small creative firms’ perceptions of the impacts of the Olympic Games’ cultural programme on their activities. To achieve this, Torino 2006 and London 2012 are used as case studies. The findings of this exploratory study show that cultural events can impact the creative sector. They do this by providing opportunities for mutual learning and access to initiatives that may generate ideas and new skills, as well as contributing to the development of a creative field. The study also explores the weaknesses and missed opportunities linked to the Cultural Olympiad programme, as perceived by creative practitioners. These include the lack of information and failure to engage smaller businesses. Based on qualitative analysis and discussion, recommendations for future organizers and further research are provided.