Understanding Suicide and Help-seeking in Urban and Rural Areas in Northern Ireland

Funded by HSC R&D Division, Public Health Agency Why did we start? Most people who complete suicide are in contact with their family doctors or other services in the months prior to death. A better understanding of the nature of these contacts and the various pathways experienced by suicidal people should reveal the gaps and barriers to effective service provision. We also need better information about the difficulties experienced by family carers, both prior to the death and afterwards. Of particular interest to policy makers in Northern Ireland was a concern that people from rural areas may be at increasing risk of suicide. We were commissioned by the Health and Social Care R&D Division of the Northern Ireland Public Health Agency to address the gaps in our understanding of suicide in NI. What did we do? We undertook a mixed methods study in which we examined the records of 403 people who took their own lives over a two-year period between March 2007 and February 2009. We linked these data to GP records and then examined help-seeking pathways of people and their contacts with services. We did in-depth face-to-face interviews with 72 bereaved relatives and friends who discussed their understanding of the events and circumstances surrounding the death, the experience of seeking help for the family member, the personal impact of the suicide, and use of support services. Additionally, we interviewed 19 General Practitioners about their experiences of managing people who died by suicide.            

Macroinvertebrate Diversity in Urban and Rural Ponds: Implications for Freshwater Biodiversity Conservation

Ponds are among the most biodiverse freshwater ecosystems, yet face significant threats from removal, habitat degradation and a lack of legislative protection globally. Information regarding the habitat quality and biodiversity of ponds across a range of land uses is vital for the long term conservation and management of ecological resources. In this study we examine the biodiversity and conservation value of macroinvertebrates from 91 lowland ponds across 3 land use types (35 floodplain meadow, 15 arable and 41 urban ponds). A total of 224 macroinvertebrate taxa were recorded across all ponds, with urban ponds and floodplain ponds supporting a greater richness than arable ponds at the landscape scale. However, at the alpha scale, urban ponds supported lower faunal diversity (mean: 22 taxa) than floodplain (mean: 32 taxa) or arable ponds (mean: 30 taxa). Floodplain ponds were found to support taxonomically distinct communities compared to arable and urban ponds. A total of 13 macroinvertebrate taxa with a national conservation designation were recorded across the study area and 12 ponds (11 floodplain and 1 arable pond) supported assemblages of high or very high conservation value. Pond conservation currently relies on the designation of individual ponds based on very high biodiversity or the presence of taxa with specific conservation designations. However, this site specific approach fails to acknowledge the contribution of ponds to freshwater biodiversity at the landscape scale. Ponds are highly appropriate sites outside of protected areas (urban/arable), with which the general public are already familiar, for local and landscape scale conservation of freshwater habitats.

Children exposure to indoor ultrafine particles in urban and rural school environments

Extended exposure to ultrafine particles (UFPs) may lead to consequences in children due to their increased susceptibility when compared to older individuals. Since children spend in average 8 h/day in primary schools, assessing the number concentrations of UFPs in these institutions is important in order to evaluate the health risk for children in primary schools caused by indoor air pollution. Thus, the purpose of this study was to assess and determine the sources of indoor UFP number concentrations in urban and rural Portuguese primary schools. Indoor and outdoor ultrafine particle (UFP) number concentrations were measured in six urban schools (US) and two rural schools (RS) located in the north of Portugal, during the heating season. The mean number concentrations of indoor UFPs were significantly higher in urban schools than in rural ones (10.4 × 10(3) and 5.7 × 10(3) pt/cm(3), respectively). Higher UFP levels were associated with higher squared meters per student, floor levels closer to the ground, chalk boards, furniture or floor covering materials made of wood and windows with double-glazing. Indoor number concentrations of ultrafine-particles were inversely correlated with indoor CO2 levels. In the present work, indoor and outdoor concentrations of UFPs in public primary schools located in urban and rural areas were assessed, and the main sources were identified for each environment. The results not only showed that UFP pollution is present in augmented concentrations in US when compared to RS but also revealed some classroom/school characteristics that influence the concentrations of UFPs in primary schools.

Changes in the community structure of urban and rural forest patches in Baltimore from 1998 to 2015

Urban forests are often highly fragmented with many exotic species. Altered disturbance regimes and environmental pollutants influence urban forest vegetation. One of the best ways to understand the impacts of land-use on forest composition is through long-term research. In 1998, the Baltimore Ecosystem Study established eight forest plots to investigate the impacts of urbanization on natural ecosystems. Four plots were located in urban forest patches and four were located in rural forests. In 2015, I revisited these plots to measure abundances and quantify change in forest composition, diversity, and structure. Sapling, shrub, and seedling abundance were reduced in the rural plots. Alpha diversity and turnover was lower in the rural plots. Beta diversity was reduced in the rural plots. The structure of the urban plots was mostly unchanged, except for a highly reduced sapling layer. Beta diversity in the urban plots was consistent across surveys due to high species turnover.

Technologies for urban and rural internet of things

Nowadays, application domains such as smart cities, agriculture or intelligent transportation, require communication technologies that combine long transmission ranges and energy efficiency to fulfill a set of capabilities and constraints to rely on. In addition, in recent years, the interest in Unmanned Aerial Vehicles (UAVs) providing wireless connectivity in such scenarios is substantially increased thanks to their flexible deployment. The first chapters of this thesis deal with LoRaWAN and Narrowband-IoT (NB-IoT), which recent trends identify as the most promising Low Power Wide Area Networks technologies. While LoRaWAN is an open protocol that has gained a lot of interest thanks to its simplicity and energy efficiency, NB-IoT has been introduced from 3GPP as a radio access technology for massive machine-type communications inheriting legacy LTE characteristics. This thesis offers an overview of the two, comparing them in terms of selected performance indicators. In particular, LoRaWAN technology is assessed both via simulations and experiments, considering different network architectures and solutions to improve its performance (e.g., a new Adaptive Data Rate algorithm). NB-IoT is then introduced to identify which technology is more suitable depending on the application considered. The second part of the thesis introduces the use of UAVs as flying Base Stations, denoted as Unmanned Aerial Base Stations, (UABSs), which are considered as one of the key pillars of 6G to offer service for a number of applications. To this end, the performance of an NB-IoT network are assessed considering a UABS following predefined trajectories. Then, machine learning algorithms based on reinforcement learning and meta-learning are considered to optimize the trajectory as well as the radio resource management techniques the UABS may rely on in order to provide service considering both static (IoT sensors) and dynamic (vehicles) users. Finally, some experimental projects based on the technologies mentioned so far are presented.

Trois-Rivières : une ville dépossédée de sa région : étude de morphologie urbaine

Mémoire numérisé par la Division de la gestion de documents et des archives de l'Université de Montréal

A randomized controlled trial assessing the health economics of realtime teledermatology compared with conventional care: an urban versus rural perspective

A randomized controlled trial was carried out to measure the cost-effectiveness of realtime teledermatology compared with conventional outpatient dermatology care for patients from urban and rural areas. One urban and one rural health centre were linked to a regional hospital in Northern Ireland by ISDN at 128 kbit/s. Over two years, 274 patients required a hospital outpatient dermatology referral -126 patients (46%) were randomized to a telemedicine consultation and 148 (54%) to a conventional hospital outpatient consultation. Of those seen by telemedicine, 61% were registered with an urban practice, compared with 71% of those seen conventionally. The clinical outcomes of the two types of consultation were similar - almost half the patients were managed after a single consultation with the dermatologist. The observed marginal cost per patient of the initial realtime teledermatology consultation was f52.85 for those in urban areas and f59.93 per patient for those from rural areas. The observed marginal cost of the initial conventional consultation was f47.13 for urban patients and f48.77 for rural patients. The total observed costs of teledermatology were higher than the costs of conventional care in both urban and rural areas, mainly because of the fixed equipment costs. Sensitivity analysis using a real-world scenario showed that in urban areas the average costs of the telemedicine and conventional consultations were about equal, while in rural areas the average cost of the telemedicine consultation was less than that of the conventional consultation.

ALGUNOS FACTORES QUE INCIDEN EN LA VALORACION DEL SUELO URBANO

Este ensayo tuvo como finalidad primordial señalar la importancia que encierra, para fines planificadores, el conocimiento de la distribución de los valores del suelo dentro de un área urbana determinada. Asi tomada como el area de estudio; el distrito 1 o el Carmen, y localizada en la porción noroeste de la ciudad capital de Costa Rica, toda una serie de factores o variables que presentan gran relevancia en la fijación de valores para su suelo, fuero fijados y analizados, una vez caracterizada el area bajo análisis. En búsqueda de un modelo que se adapte a tal situación, se realizo una revisión bibliográfica y los principios modelo sobre el valor del suelo fueron presentados. Con los datos e informaciones recibidos en las diferentes instituciones mencionadas a lo largo del trabajo, y con el material recopilado en el campo, se llevo a cabo una cuantificación de los mismos, principalmente mediante el uso de un sistema de clasificación del dato esencial (valor del suelo) y, posteriormente, una serie de correlaciones –regresiones, simples y múltiples-, fue realizada con el fin de comprobarlas hipótesis planteadas y  con ello llegar a un análisis de los resultados obtenidos que permitiese brindar algunas recomendaciones al respecto. Otra finalidad de este consiste en demostrar la importancia del trabajo del geógrafo en el proceso  de la fijación de los valores para el terreno, sea urbano, sea rural, y cualquiera sea el fin que persiga: valores fiscales, valores reales, comerciales y, por qué no, hasta especulativos. SUMARY The main objetive of this investigation is to demonstrate the importance of the distribution of land values in an urban area in regards to the planning process. The chosen study area is the first district (Carmen) located in the northeast section of  the capital city of San José. Once the study area had been chosen, a series of factors and variables relavant to the fixation of land values, were chosen and analyzed. In the search for a model that could be adapted to the situation, a bibliographic revision was made concerning the topic of land values, and a list of possible land values, and a list of possible land value models was presented. In was possible to quantify the data information obtained from the different institutions mentioned in the investigation as well as from the material collected in the field; principally by means of a classification system of essential data ( land values), and later, series of simple and multiple correlation regressions were applied with the primary purpose being to confirm  the main hypothesis and then, arrive at an analysis of the obtained results that permit respective recommendations. Another purpose of the investigation consisted in demonstrating the importance of the geographer in the process of determining urban and rural land values and even for speculative purposes.

Diversity of sand flies in domiciliary environment of Santarém, state of Pará, Brazil: species composition and abundance patterns in rural and urban areas

This paper aimed to evaluate the richness, abundance and frequency of sand fly occurrence in rural and urban areas American visceral Leishmaniasis -AVL is endemic in the study area of Santarém municipality, Pará state. Sand flies were collected during 1995-2000, using CDC light traps placed in neighborhoods and rural areas of the municipality. A total of 53.454 individuals and 26 species of sand flies were collected. The most abundant species in both urban and rural environments was Lutzomyia longipalpis, vector of AVL in the area. The highest species richness by capture was in rural area. In all years sampled, the largest number of species of sand fly collected was always in rural areas. The species of sand flies in urban and rural area were similar in 11 species. In the rural area other 11 species were found, a total of 22 species. Shannon-Wiener index ranged from 0.12 to 0.84 at rural areas and 0.08 to 0.34 at urban ones. In general, rural localities showed higher diversity (H') of phlebotomines than urban ones. Individual-based rarefaction curves for each area demonstrated that urban localities had the lowest expected number of phlebotomine species and the richest rural ones reach higher expected values with lower amount of individuals than urban sites. The most frequent species were Lutzomyia longipalpis, Evandromyia carmelinoi and Bichromomyia flaviscutellata.

Discoloration and fungal growth on three fiber cement formulations exposed in urban, rural and coastal zones

Three formulations of fiber cement were evaluated for fungal colonization and color change after five years of exposure in aging stations located in urban (Sao Paulo), rural (Pirassununga) and coastal (Rio Grande) zones in Brazil. The lowest color change and fungal colonization were registered in Rio Grande, which has a temperate climate, as opposed to Sao Paulo and Pirassununga, which are tropical. The highest fungal colonization was recorded in Sao Paulo, one of the most air polluted cities in Brazil. Pirassununga samples had an intermediate fungal colonization, in spite of showing the highest color change with visible dark spots on the surfaces. These spots were identified as cyanobacteria, which significantly contributed to the darkening of the specimens. The fiber cement formulation, varying in proportion of organic fibers such as poly (vinyl alcohol) and cellulose, was less significant for fungal bioreceptivity than the characteristics of the exposure site. The most frequent fungal genus found in the tropical climate, in both urban and rural zones, and the main one responsible for the higher records in Sao Paulo, was Scytalidiurn sp. which was registered for the first time on this building material in Brazil. (C) 2010 Elsevier Ltd. All rights reserved.

Seroprevalence of Helicobacter pylori infection in chronic chagasic patients, and in the rural and urban population from Uberlândia, Minas Gerais, Brazil

As patients with chronic Chagas disease exhibit morphological and functional changes of the stomach (hypomotility and hypochlorhydria), malnutrition, immunological deficiency and high prevalence of peptic disease associated to Helicobater pylori infection, the purpose of this study was to evaluate if the prevalence of H. pylori infection in chronic chagasic is higher than in non-chagasic individuals in the urban and rural population from Uberlândia, MG, Brazil. Serological determination of IgG antibodies to H. pylori was performed using a second-generation ELISA. Thus, 598 people were evaluated: 128 chagasic (CG), 222 non-chagasic living in urban area (U-NCG) and 248 non-chagasic living in rural area (R-NCG). Regarding the age range from 21 to 50 years, the prevalence of H. pylori infection in the CG (85.1%) was significantly higher than in the U-NCG (56.3%, p < 0.01) and the R-NCG (67.4%, p < 0.05). In the patients over 50 years, the prevalence in the CG (86.4%) was similar to the U-NCG (78.8%) and R-NCG (86.1%). Similar results were also found between the U-NCG and R-NCG for all age ranges, with prevalence rates of 29.1% and 35.3% for the age range from 5 to 13 years, and 47.2% and 40% for that from 14 to 20 years, respectively. We conclude that chagasic patients showed a higher seroprevalence of H. pylori infection than non-chagasic individuals, in the age range from 21 to 50 years, and that the prevalence of this infection was similar in the studied urban and rural non-chagasic population.

Sandflies (Diptera: Psychodidae) in rural and urban environments in an endemic area of cutaneous leishmaniasis in southern Brazil

The high proportion of cases of cutaneous leishmaniasis reported amongst residents in the city of Bandeirantes, in the state of Paraná, Brazil, led the authors to investigate the phlebotomine fauna in both urban and rural environments. The sandflies were captured with automatic light traps from 07:00 pm-07:00 am fortnightly in 11 urban peridomiciles from April 2008-March 2009 and monthly in three ecotopes within four rural localities from April 2009-March 2010. In one of these latter localities, sandfly capture was conducted with white/black Shannon traps during each of three seasons: spring, summer and fall. A total of 5,729 sandflies of 17 species were captured. Nyssomyia neivai (46.7%) and Nyssomyia whitmani (35.3%) were the predominant species. In this study, 3,865 specimens were captured with automatic light traps: 22 (0.083 sandflies/trap) in the urban areas and 3,843 (26.69 sandflies/trap) in the rural areas. Ny. neivai was predominant in urban (68.2%) and rural (42.8%) areas. A total of 1,864 specimens were captured with the white/black Shannon traps and Ny. neivai (54.5%) and Ny. whitmani (31.4%) were the predominant species captured. The small numbers of sandflies captured in the urban areas suggest that the transmission of Leishmania has occurred in the rural area due to Ny. neivai and Ny. whitmani as the probable vectors.

Increasing political returns and rural-urban migrations

This paper analyzes the different equilibria in rural-urban migrationsand political redistribution that result from the interaction betweenincreasing political returns, the distribution of land, and creditmarket imperfections. Governments that put a special weight on thewelfare of urban workers when setting agricultural prices generate apolitical externality in the urban sector, giving peasants anincentive to migrate in anticipation of policy determination. Ifcredit markets are imperfect, land ownership confers higherproductivity to peasants, who require large price changes to migrate.In this context, land inequality would lead to large migrations and tolarge policy change, while an egalitarian land distribution would leadto no migration and to a small policy change. This interaction shedslight on the contrasting experience of Latin America and East Asia atthe outset of World War II.

Reduced cardiorespiratory fitness, low physical activity and an urban environment are independently associated with increased cardiovascular risk in children.

AIMS/HYPOTHESIS: To assist in the development of preventive strategies, we studied whether the neighbourhood environment or modifiable behavioural parameters, including cardiorespiratory fitness (CRF) and physical activity (PA), are independently associated with obesity and metabolic risk markers in children. METHODS: We carried out a cross-sectional analysis of 502 randomly selected first and fifth grade urban and rural Swiss schoolchildren with regard to CRF, PA and the neighbourhood (rural vs urban) environment. Outcome measures included BMI, sum of four skinfold thicknesses, homeostasis model assessment of insulin resistance (HOMA-IR) and a standardised clustered metabolic risk score. RESULTS: CRF and PA (especially total PA, but also the time spent engaged in light and in moderate and vigorous intensity PA) were inversely associated with measures of obesity, HOMA-IR and the metabolic risk score, independently of each other, and of sociodemographic and nutritional parameters, media use, sleep duration, BMI and the neighbourhood environment (all p < 0.05). Children living in a rural environment were more physically active and had higher CRF values and reduced HOMA-IR and metabolic risk scores compared with children living in an urban environment (all p < 0.05). These differences in cardiovascular risk factors persisted after adjustment for CRF, total PA and BMI. CONCLUSIONS/INTERPRETATION: Reduced CRF, low PA and an urban environment are independently associated with an increase in metabolic risk markers in children.

Rural-urban disparities in child nutrition in Bangladesh and Nepal

Background The persistence of rural-urban disparities in child nutrition outcomes in developing countries alongside rapid urbanisation and increasing incidence of child malnutrition in urban areas raises an important health policy question - whether fundamentally different nutrition policies and interventions are required in rural and urban areas. Addressing this question requires an enhanced understanding of the main drivers of rural-urban disparities in child nutrition outcomes especially for the vulnerable segments of the population. This study applies recently developed statistical methods to quantify the contribution of different socio-economic determinants to rural-urban differences in child nutrition outcomes in two South Asian countries – Bangladesh and Nepal. Methods Using DHS data sets for Bangladesh and Nepal, we apply quantile regression-based counterfactual decomposition methods to quantify the contribution of (1) the differences in levels of socio-economic determinants (covariate effects) and (2) the differences in the strength of association between socio-economic determinants and child nutrition outcomes (co-efficient effects) to the observed rural-urban disparities in child HAZ scores. The methodology employed in the study allows the covariate and coefficient effects to vary across entire distribution of child nutrition outcomes. This is particularly useful in providing specific insights into factors influencing rural-urban disparities at the lower tails of child HAZ score distributions. It also helps assess the importance of individual determinants and how they vary across the distribution of HAZ scores. Results There are no fundamental differences in the characteristics that determine child nutrition outcomes in urban and rural areas. Differences in the levels of a limited number of socio-economic characteristics – maternal education, spouse’s education and the wealth index (incorporating household asset ownership and access to drinking water and sanitation) contribute a major share of rural-urban disparities in the lowest quantiles of child nutrition outcomes. Differences in the strength of association between socio-economic characteristics and child nutrition outcomes account for less than a quarter of rural-urban disparities at the lower end of the HAZ score distribution. Conclusions Public health interventions aimed at overcoming rural-urban disparities in child nutrition outcomes need to focus principally on bridging gaps in socio-economic endowments of rural and urban households and improving the quality of rural infrastructure. Improving child nutrition outcomes in developing countries does not call for fundamentally different approaches to public health interventions in rural and urban areas.