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Urban growth and decline occur every year and show changes in urban areas. Although various approaches to detect urban changes have been developed, they mainly use large-scale satellite imagery and socioeconomic factors in urban areas, which provides an overview of urban changes. However, since people explore places and notice changes daily at the street level, it would be useful to develop a method to identify urban changes at the street level and demonstrate whether urban growth or decline occurs there. Thus, this study seeks to use street-level panoramic images from Google Street View to identify urban changes and to develop a new way to evaluate the growth and decline of an urban area. After collecting Google Street View images year by year, we trained and developed a deep-learning model of an object detection process using the open-source software TensorFlow. By scoring objects and changes detected on a street from year to year, a map of urban growth and decline was generated for Midtown in Detroit, Michigan, USA. By comparing socioeconomic changes and the situations of objects and changes in Midtown, the proposed method is shown to be helpful for analyzing urban growth and decline by using year-by-year street view images., Competing Interests: The authors have declared that no competing interests exist.

A key challenge of environmental planning is to craft recommendations for future sustainable spatial development amid ubiquitous uncertainties. This paper aims to explore how different data uncertainties, usually unknown to the planner, may influence environmental planning recommendations. We apply a case study-based approach, in which we provide three illustrative examples of how data with different kinds and levels of uncertainty affect environmental assessments and, by that, the decision-support provided by environmental planning. The cases stem from different spatial levels in Germany and consider 'Regional soil-based climate change mitigation' in the region of Hannover, 'State-wide habitat conservation siting' in the federal state of Saxony-Anhalt, and 'National renewable energy planning'. Based on the three examples, we discuss implications for planning practice and derive recommendations for further research. The three cases studies illustrate the substantial effects of data uncertainty on environmental assessments and planning recommendations derived from those results. We identify four problem constellations of dealing with data uncertainty in environmental planning that relate to the severeness of uncertainty impacts, the responsibility of the decision-maker, and the kinds of impacts that wrong decisions may have. We close with recommendations for further research, among others to develop robust and pragmatic methods for identifying the uncertainty levels in environmental data and assessment results., Competing Interests: The authors have declared that no competing interests exist.

Background: Healthcare environment can affect health. Adverse events (AEs) are common because rapid changes in the patients' status can suddenly arise, and have serious consequences, especially in intensive care. The relationship between the design of intensive care units (ICUs) and AEs has not been fully explored. Hence, an intensive care room was refurbished with cyclic lightning, sound absorbents and unique interior, and exterior design to promote health., Aims: The aim of this study was to evaluate the differences between a regular and a refurbished intensive care room in risk for AEs among critically ill patients., Design: This study retrospectively evaluated associations of AEs and compared the incidence of AEs in patients who were assigned to a multidisciplinary ICU in a refurbished two-bed patient room with patients in the control rooms between 2011 and 2018., Methods: There were 1938 patients included in this study (1382 in control rooms; 556 in the intervention room). Descriptive statistics were used to present the experienced AEs. Binary logistic regressions were conducted to estimate the relationship between the intervention/control rooms and variables concerning AEs. Statistical significance was set at P < 0.05., Results: For the frequency of AEs, there were no significant differences between the intervention room and the control rooms (10.6% vs 11%, respectively, P < 0.805). No findings indicated the intervention room (the refurbished room) had a significant influence on decreasing the number of experienced AEs in critically ill patients., Conclusions: The findings revealed a low incident of AEs in both the intervention room as well as in the control rooms, lower than previously described. However, our study did not find any decreases in the AEs due to the design of the rooms., Relevance to Clinical Practice: Further research is needed to determine the relationship between the physical environment and AEs in critically ill patients., (© 2020 The Authors. Nursing in Critical Care published by John Wiley & Sons, Ltd on behalf of British Association of Critical Care Nurses.)

Background and Objectives: The Child Opportunity Index (ChOI) is a publicly available surveillance tool that incorporates traditional and novel attributes of neighborhood conditions that may promote or inhibit healthy child development. The extent to which ChOI relates to individual-level cardiometabolic risk remains unclear., Methods: We geocoded residential addresses obtained from 743 participants in midchildhood (mean age 7.9 years) in Project Viva, a prebirth cohort from eastern Massachusetts, and linked each location with census tract-level ChOI data. We measured adiposity and cardiometabolic outcomes in midchildhood and early adolescence (mean age 13.1 years) and analyzed their associations with neighborhood-level ChOI in midchildhood using mixed-effects models, adjusting for individual and family sociodemographics., Results: On the basis of nationwide distributions of ChOI, 11.2% ( n = 83) of children resided in areas of very low overall opportunity (ChOI score <20 U) and 55.3% ( n = 411) resided in areas of very high (ChOI score ≥80 U) overall opportunity. Children who resided in areas with higher overall opportunity in midchildhood had persistently lower levels of C-reactive protein from midchildhood to early adolescence (per 25-U increase in ChOI score: β = .14 mg/L; 95% confidence interval, .28 to .00). Additionally, certain ChOI indicators, such as greater number of high-quality childhood education centers, greater access to healthy food, and greater proximity to employment in midchildhood, were associated with persistently lower adiposity, C-reactive protein levels, insulin resistance, and metabolic risk z scores from midchildhood to early adolescence., Conclusions: Our findings suggest more favorable neighborhood opportunities in midchildhood predict better cardiometabolic health from midchildhood to early adolescence., Competing Interests: POTENTIAL CONFLICT OF INTEREST: The authors have indicated they have no potential conflicts of interest to disclose., (Copyright © 2021 by the American Academy of Pediatrics.)

Background: Exposure to green space has beneficial effects on several cognitive and behavioral aspects. However, to our knowledge, no study addressed intelligence as outcome. We investigated whether the level of urbanicity can modify the association of residential green space with intelligence and behavior in children., Methods and Findings: This study includes 620 children and is part of the East Flanders Prospective Twin Survey (EFPTS), a registry of multiple births in the province of East Flanders, Belgium. Intelligence was assessed with the Wechsler Intelligence Scale for Children-Revised (WISC-R) in 620 children (310 twin pairs) between 7 and 15 years old. From a subset of 442 children, behavior was determined based on the Achenbach Child Behavior Checklist (CBCL). Prenatal and childhood residential addresses were geocoded and used to assign green space indicators. Mixed modeling was performed to investigate green space in association with intelligence and behavior while adjusting for potential confounding factors including sex, age, parental education, neighborhood household income, year of assessment, and zygosity and chorionicity. We found that residential green space in association with both intelligence and behavior in children was modified by the degree of urbanicity (p < 0.001). In children living in an urban environment, multivariable adjusted mixed modeling analysis revealed that an IQR increment of residential green space (3,000-m radius) was associated with a 2.6 points (95% CI 1.4-3.9; p < 0.001) higher total intelligence quotient (IQ) and 2.0 points (95% CI -3.5 to -0.4; p = 0.017) lower externalizing behavioral score. In children residing in a rural or suburban environment, no association was found. A limitation of this study is that no information was available on school location and the potential for unmeasured confounding (e.g., time spend outdoors)., Conclusions: Our results indicate that residential green space may be beneficial for the intellectual and the behavioral development of children living in urban areas. These findings are relevant for policy makers and urban planners to create an optimal environment for children to develop their full potential., Competing Interests: The authors have declared that no competing interests exist.

Over the past few decades many corporate organisations have moved to open-plan office designs, mostly due to financial and logistical benefits. However, recent studies have found significant drawbacks to open plan offices and it is unclear how office designs can facilitate the best work output and company culture. Current design practice aims to optimise efficiency of space, but no previous research has tested the effect of office design experimentally in a working office. This paper describes an experiment comparing four different office designs (Open-plan, Zoned open-plan, Activity based, and Team offices) against a suite of wellbeing and productivity metrics in a real world technology company. Results suggest that two very different designs (Zoned open-plan and Team offices) perform well compared to Open-plan office designs. Zoned open-plan and Team office designs improved employee satisfaction, enjoyment, flow, and productivity, while Activity based and Open-plan designs performed poorly by comparison. The Open-plan office design was rated more poorly by employees, had higher levels of unsafe noise, and once employees no longer had to be in the Open-plan office design of the experiment, they spent more time at their desks., Competing Interests: Authors 1 and 3 (JP, MH) are employed by Booking.com. Booking.com fully funded this research, but did not have any influence over the study design, or decision to publish. Data collection and analysis was conducted using Booking.com data resources. The Booking Public Relations and Data Privacy teams checked the manuscript and submitted data for factual correctness and to ensure no commercially sensitive or PII information was released. Author 4 (WO) is employed by CBRE Consulting, and was contracted by Booking.com to manage the project. CBRE Consulting did not provide any funding, and had no influence over any stage of the project. Author 2 (EN) is employed by Learn Adapt Build, and was contracted by CBRE Consulting to advise on the data collection and analysis stages of the project. Learn Adapt Build did not provide any funding for any stage of the project. This does not alter our adherence to PLOS ONE policies on sharing data and materials.

Operating room renovation projects usually involve updated technology and processes that can create challenges for administrative leaders (eg, maintaining a surgery schedule during a move) and require staff member adjustments. The perioperative team of a large tertiary care and trauma center relocated from a 35-year-old suite to a new suite, which required years of planning, months of training, and weeks of organizing. This article discusses the processes and observations that helped ensure a smooth transition to the new space. Early planning allowed time for leaders to make equipment decisions, develop and test new processes, and train staff members. The actual move required detailed planning, thorough execution, patience, and flexibility to ensure a safe transition. Perioperative leaders balanced operational needs with relocation plans to maintain patient and staff member safety. Open, multidisciplinary communication combined with staff member participation and buy-in contributed to an efficient, safe move at this facility., (© AORN, Inc, 2020.)

Worldwide, growth in the older population creates a pressing need to develop supportive environments that enhance quality of life as people age. Too often, built environments present barriers and challenges to older adults that compromise independent living and adversely affect health and life outcomes. Designing homes, buildings, and neighborhoods with older adults, through exercises in participatory or co-design, could help ensure that environments are better able to facilitate healthy aging. However, while it is potentially advantageous to involve this age group in environmental design decisions, doing so can be difficult. Analysis of and guidance on effective ways to involve older adults in these activities could make the challenge easier. With this aim in mind, this article provides critical perspectives on eight "less traditional" engagement techniques-walking interviews, photovoice, photo-elicitation, Talking Mats ® , participatory mapping, drawing, model-making, and the "Design Fair". Insights into the strengths and limitations of these techniques, gained from observation of their use in participatory design activities, as well as feedback collected from older co-design participants, are presented. The article concludes by offering a number of practical recommendations for those interested in designing age-friendly homes and neighborhoods with older people.

Creating healthy, liveable cities is a common policy aspiration globally. However, little research has explored the capacity of urban policies to deliver this aspiration, or levels of policy implementation. This study aimed to develop policy-relevant indicators, to detect within- and between-city inequities in the implementation of Australian state government policy targets related to urban liveability. Seventy-three government policies were reviewed across Australia's four largest cities to identify measurable spatial policies that contribute to creating healthy, liveable neighbourhoods. Spatial indicators based on these policies were developed to assess and map levels of policy implementation at the metropolitan and sub-metropolitan level. Measurable spatial policies were identified for only three out of seven policy domains: walkability, transit access, and public open space. While there was significant variation between cities, policies were often inconsistent with evidence about how to achieve liveability. No Australian city performed well on all liveability domains. Even modest policy targets were often not achieved, and there were significant spatial inequities in policy implementation. With few exceptions, people living in outer suburbs had poorer access to amenities than inner-city residents. This study demonstrates the benefits and challenges of measuring urban policy implementation. Evidence-informed targets are needed in urban, transport and infrastructure policies designed to create healthy, liveable cities, to enable levels of (and inequities in) policy implementation to be assessed. Consistent standards for government spatial data would enable development of comparable indicators and cities to be directly compared., (Copyright © 2019 Elsevier Ltd. All rights reserved.)

Purpose of Review: To review the literature on built environment interventions to increase active travel, focusing on work since 2000 and on methodological choices and challenges affecting studies., Recent Findings: Increasingly, there is evidence that built environment interventions can lead to more walking or cycling. Evidence is stronger for cycling than for walking interventions, and there is a relative lack of evidence around differential impacts of interventions. Some of the evidence remains methodologically weak, with much work in the 'grey' literature. While evidence in the area continues to grow, data gaps remain. Greater use of quasi-experimental techniques, improvements in routine monitoring of smaller schemes, and the use of new big data sources are promising. More qualitative research could help develop a more sophisticated understanding of behaviour change.

This study utilized behavior-mapping to describe behavior and levels of activity in infants attending Early Childhood Education and Care (ECEC). Descriptive statistics were used to determine proportion of time spent in certain locations, body positions, activities and engagement with others. To establish whether location, the presence of equipment or engagement with others influenced levels of activity, a paired t-test was used. Results indicated that of all locations, infants spent the greatest amount of time in the meals area (35%), with half of this period spent physically inactive (sedentary). The indoor play area was where infants were most active. Infants also spent a significantly greater proportion of their upright time (64%) supported by either furniture or equipment than without (MD 28, 95% CI 13-44, p < 0.01). Interestingly, infants displayed more sedentary behavior when engaged with others than when not engaged (MD 21, 95% CI 6-36, p < 0.01). The environment, presence of others and equipment availability appear to influence activity levels of infants in ECEC centers. Findings suggest that time spent in meal areas, provisions of furniture/equipment, and opportunities for infants to play independently warrant further exploration to determine their influence on activity levels in typically-developing infants., (Copyright © 2019 Elsevier Inc. All rights reserved.)

Eco-engineering and the installation of green infrastructure such as artificial floating islands (AFIs), are novel techniques used to support biodiversity. The European Convention on Biological Diversity highlighted the development of green infrastructure as a key method of enhancement in degraded habitats. Research specifically on AFIs in marine environments has largely focused on their ecological functioning role and engineering outcomes, with little consideration for the social benefits or concerns. The aim of this study was to gain an understanding of public perception of coastal habitat loss in the UK and AFIs as a method of habitat creation in coastal environments. This was achieved via a survey, consisting of six closed and two open questions. Of the 200 respondents, 94.5% were concerned about the loss of coastal habitats in the UK, but less than a third were aware of habitat restoration or creation projects in their area of residence. There was a positive correlation between proximity of residency to the coast and knowledge of habitat restoration or creation projects. The majority of the respondents understood the ecological functioning role of AFIs and 62% would preferably want successful plant growth and avian species utilising the AFI. Nearly a third of the respondents had concerns about AFI installations, such as the degradation of the plastic matrix, long term maintenance and disturbance of native species. Despite 90.9% of the respondents supporting the installation of AFIs, the concerns of the public must be addressed during the planning stages of any habitat creation project., Competing Interests: The authors have declared that no competing interests exist.

Background: Neighbourhood environment characteristics have been found to be associated with residents' willingness to conduct physical activity (PA). Traditional methods to assess perceived neighbourhood environment characteristics are often subjective, costly, and time-consuming, and can be applied only on a small scale. Recent developments in deep learning algorithms and the recent availability of street view images enable researchers to assess multiple aspects of neighbourhood environment perceptions more efficiently on a large scale. This study aims to examine the relationship between each of six neighbourhood environment perceptual indicators-namely, wealthy, safe, lively, depressing, boring and beautiful-and residents' time spent on PA in Guangzhou, China., Methods: A human-machine adversarial scoring system was developed to predict perceptions of neighbourhood environments based on Tencent Street View imagery and deep learning techniques. Image segmentation was conducted using a fully convolutional neural network (FCN-8s) and annotated ADE20k data. A human-machine adversarial scoring system was constructed based on a random forest model and image ratings by 30 volunteers. Multilevel linear regressions were used to examine the association between each of the six indicators and time spent on PA among 808 residents living in 35 neighbourhoods., Results: Total PA time was positively associated with the scores for "safe" [Coef. = 1.495, SE = 0.558], "lively" [1.635, 0.789] and "beautiful" [1.009, 0.404]. It was negatively associated with the scores for "depressing" [- 1.232, 0.588] and "boring" [- 1.227, 0.603]. No significant linkage was found between total PA time and the "wealthy" score. PA was further categorised into three intensity levels. More neighbourhood perceptual indicators were associated with higher intensity PA. The scores for "safe" and "depressing" were significantly related to all three intensity levels of PA., Conclusions: People living in perceived safe, lively and beautiful neighbourhoods were more likely to engage in PA, and people living in perceived boring and depressing neighbourhoods were less likely to engage in PA. Additionally, the relationship between neighbourhood perception and PA varies across different PA intensity levels. A combination of Tencent Street View imagery and deep learning techniques provides an accurate tool to automatically assess neighbourhood environment exposure for Chinese large cities.

Background: A hospital is an unfamiliar place to patients because of its style, atmosphere, and procedures. These hospital characteristics cause patients to become confused about responding to protocols, which slows down the procedural flows. Some additional information technology infrastructure facilities and human resources may be needed to solve these problems. However, this solution needs high investment and cannot guarantee an accuracy of information sent to patients. To handle this limitation, EasyHos has been developed to help patients recognize their status (for example, "waiting for an appointment at 11am") during their stay in a hospital using all existing infrastructure and hospital data and without changing existing hospital's process., Objective: The objective of this study was to provide a design of the EasyHos system and the case study in hospitals in Thailand. The design is usable and repeatable for small- and medium-sized hospitals where internet infrastructure is in place., Methods: The EasyHos system has been designed based on existing infrastructure, hospital data and hospital processes. The main components include mobile devices, existing hospital data, wireless communication network. The EasyHos was deployed at 2 hospitals in Thailand, one small and the other with a medium size. The experimental process was focused on solving the problem of unfamiliarity in the hospital. The criteria and pretest conditions regarding the unexpected problem have been defined before the experiment., Results: The results are presented in terms of criteria, pretest conditions, posttest conditions in the hospitals. The posttest conditions show the experimental results and impact of the system on users such as hospital nurses/staff and patients. For example, the questions from patients were reduced by 83.3% after using EasyHos system while nurses/hospital staff had 5 min more to do their routine work each day. In addition, another impact is that hospitals can create new information values from existing data, which now can be visible and valuable to patients., Conclusions: Hospitals' unexpected problems have been reduced by the EasyHos system. The EasyHos system has been developed with self-service and patient-centered concepts to assist patients with necessary information. The system makes interaction easier for nurses/hospital staff members and patients working or waiting in the hospital. The nurses/hospital staff members would have more time to do their routine works. Hospitals can easily set up the EasyHos system, which will have a low or nearly zero implementation cost., (©Chalee Vorakulpipat, Ekkachan Rattanalerdnusorn, Soontorn Sirapaisan, Visut Savangsuk, Natsuda Kasisopha. Originally published in JMIR Mhealth and Uhealth (http://mhealth.jmir.org), 22.07.2019.)

Background: Designing healthy, liveable cities is a global priority. Current liveability indices are aggregated at the city-level, do not reflect spatial variation within cities, and are often not aligned to policy or health., Objectives: To combine policy-relevant liveability indicators associated with health into a spatial Urban Liveability Index (ULI) and examine its association with adult travel behaviours., Methods: We developed methods to calculate spatial liveability indicators and the ULI for all residential addresses in Melbourne, Australia. Associations between the address-level ULI and adult travel behaviours from the 2012-2014 Victorian Integrated Survey of Travel and Activity (VISTA) (n = 12,323) were analysed using multilevel logistic regression. Sensitivity analyses to evaluate impact of methodological choices on distribution of liveability as assessed by the ULI and associations with travel mode choice were also conducted., Results: Liveability estimates were calculated for 1,550,641 residential addresses. ULI scores were positively associated with active transport behaviour: for each unit increase in the ULI score the estimated adjusted odds ratio (OR) for: walking increased by 12% (95% Credible Interval: 9%, 15%); cycling increased by 10% (4%, 17%); public transport increased by 15% (11%, 19%); and private vehicle transport decreased by 12% (- 9%, - 15%)., Conclusions: The ULI provides an evidence-informed and policy-relevant measure of urban liveability, that is significantly and approximately linearly associated with adult travel behaviours in the Melbourne context. The ULI can be used to evaluate progress towards implementing policies designed to achieve more liveable cities, identify spatial inequities, and examine relationships with health and wellbeing.

Background: The increasing prevalence of obesity is a major public health problem in many countries. Built environment factors are known to be associated with obesity, which is an important risk factor for type 2 diabetes. Online geocoding services could be used to identify regions with a high concentration of obesogenic factors. The aim of our study was to examine the feasibility of integrating information from online geocoding services for the assessment of obesogenic environments., Methods: We identified environmental factors associated with obesity from the literature and translated these factors into variables from the online geocoding services Google Maps and OpenStreetMap (OSM). We tested whether spatial data points can be downloaded from these services and processed and visualized on maps. True- and false-positive values, false-negative values, sensitivities and positive predictive values of the processed data were determined using search engines and in-field inspections within four pilot areas in Bavaria, Germany., Results: Several environmental factors could be identified from the literature that were either positively or negatively correlated with weight outcomes in previous studies. The diversity of query variables was higher in OSM compared with Google Maps. In each pilot area, query results from Google showed a higher absolute number of true-positive hits and of false-positive hits, but a lower number of false-negative hits during the validation process. The positive predictive value of database hits was higher in OSM and ranged between 81 and 100% compared with a range of 63-89% for Google Maps. In contrast, sensitivities were higher in Google Maps (between 59 and 98%) than in OSM (between 20 and 64%)., Conclusions: It was possible to operationalize obesogenic factors identified from the literature with data and variables available from geocoding services. The validity of Google Maps and OSM was reasonable. The assessment of environmental obesogenic factors via geocoding services could potentially be applied in diabetes surveillance.

Background: Neighborhood environments have been regularly associated with the weight status. Although the evidence is mostly limited to adults residing in western urban settings, the weight status of older adults living in rural areas is also assumed to be significantly affected by their neighborhood environments. This study aimed to identify environmental attributes specific to rural areas that could affect the risk of longitudinal weight gain among older adults (≥ 65 years) in Japan., Methods: We examined five environmental attributes, i.e., land slope, public transportation accessibility, residential density, intersection density, and the availability of parks and recreational centers, measured by the geographic information system. Our analysis was based on 714 subjects participated in Shimane Community-based Healthcare Research and Education study in 2012 and 2015. Multinomial logistic regression model was conducted to examine the association between each neighborhood environmental attribute and weight change status (gain, loss and unchanged)., Results: We observed a significant increase in the risk of weight gain as the steepness of the neighborhood land slope increased. There was no significant association between other environmental attributes and risk of weight gain as well as weight loss among older adults., Conclusion: Living in hilly neighborhoods was associated with increased risk of weight gain among rural Japanese older adults. Future research should consider region-specific environmental attributes when investigating their effect on older adults' weight status.

Background: Workplace Ergonomics and Human Factors (E/HF) remains as relevant and important as ever to respond to contemporary workplace design challenges. Therefore, E/HF expertise must be involved in early and appropriate phases of the workplace design process, in order to leverage user needs and requirements to constrain the proposed design solution. In this process, design decisions are made., Objective: The aim of this article is to describe the use of a systems-theoretical framework as a guide in collaborative workplace design, focussing on planning and documenting which decisions and activities should involve E/HF expertise., Methods: As this is a conceptual paper, its method is to synthesise a framework from a combination of design process methodology-, general systems theory- and sociotechnical systems literature., Results: The framework organises the design decisions to be made into hierarchical abstraction levels and cross-cuts them into five perspectives from which the design problem can be viewed holistically., Conclusions: The ACD3 framework is intended as an enabler of many types of design, including the design of work systems. It provides a framework that allows all stakeholders to converge around design decisions that ensure that the work system is optimised to human characteristics and the activity to be performed.

Many communities have prioritized policy and built environment changes to promote active transportation (AT). However, limited information exists on the partnerships and processes necessary to develop and implement such policy and environmental changes, particularly among organizations in non-health sectors. Within the transportation sector, metropolitan planning organizations (MPOs) are increasingly recognized as organizations that can support AT policies. This study examined inter-organizational relationships among MPOs and their partners working to advance AT policies in six U.S. cities. In fall 2015, an average of 22 organizations in each city participated in an online survey about partnerships with MPOs and other organizations developing and implementing AT policies. Measures included organizational characteristics and relational attributes including: level of AT policy collaboration, information transmission, resource sharing, and perceived decisional power. Descriptive network analysis and exponential random graph modeling were used to examine organizational attributes and relational predictors associated with inter-organizational collaboration in each network. MPOs served as collaborative intermediaries, connecting other organizations around AT policies, in half of the cities examined. Organizations in each city were more likely to collaborate around AT policies when partners communicated at least quarterly. In half of the cities, the probability of AT policy collaboration was higher when two agencies exchanged resources and when organizations had perceived decisional authority. Network analysis helped identify factors likely to improve partnerships around AT policies. Results may contribute to best practices for collaboration among researchers, practitioners, policymakers, and advocates across diverse sectors seeking to promote population-level physical activity., (Copyright © 2018 Elsevier Inc. All rights reserved.)

Background: A growing number of studies observe associations between the amount of green space around a mother's home and positive birth outcomes; however, the robustness of this association and potential pathways of action remain unclear., Objectives: To examine associations between mother's residential green space and term birth weight within the Canadian Healthy Infant Longitudinal Development (CHILD) study and examine specific hypothesized pathways., Methods: We examined 2510 births located in Vancouver, Edmonton, Winnipeg, and Toronto Canada. Green space was estimated around mother's residences during pregnancy using Landsat 30 m normalized difference vegetation index (NDVI). We examined hypothesized pathways of: (1) reduction of environmental exposure; (2) built environment features promoting physical activity; (3) psychosocial conditions; and (4) psychological influences. Linear regression was used to assess associations between green space and term birth weight adjusting first for a comprehensive set of confounding factors and then incrementally for pathway variables., Results: Fully adjusted models showed non-statistically significant increases in term birth weight with increasing green space. For example, a 0.1 increase in NDVI within 500 m was associated with a 21.5 g (95% CI - 4.6, 47.7) increase in term birth weight. Associations varied by city and were most robust for high-density locations. For the two largest cities (Vancouver and Toronto), we observed an increase in birth weight of 41.2 g (95% CI 7.8, 74.6) for a 0.1 increase in NDVI within 500 m. We did not observe substantial reductions in the green space effect on birth weight when adjusting for pathway variables., Conclusion: Our results highlight the need to further characterize the interactions between green space, urban density and climate related factors as well as the pathways linking residential green space to birth outcomes.

Background: The built and natural environment and health are inextricably linked. However, there is considerable debate surrounding the strength and quality of the evidence base underpinning principles of good practice for built and natural environment design in promoting health. This umbrella review aimed to assess relationships between the built and natural environment and health, concentrating on five topic areas: neighbourhood design, housing, food environment, natural and sustainable environment, and transport., Methods: A structured search was conducted for quantitative systematic reviews and stakeholder reviews published between January 2005 and April 2016. Seven databases and the websites of 15 relevant and respected stakeholder organisations known to publish review-level documentation were searched. Searches were limited to English-language publications and duplicate references were removed. Evidence quality and strength was appraised using validated techniques. Findings were used to develop a diagram for each topic area, illustrating relationships between built and natural environment planning principles and health-related outcomes., Results: A total of 117 systematic reviews and review-level documents were eligible for inclusion. The quality of evidence was mixed; much of the evidence examined relied on findings from cross-sectional studies, making it difficult to draw clear causal links between built environment exposures and health-related impacts and outcomes. Fourteen actionable planning principles associated with positive health-related outcomes were identified across the five topic areas. For example, neighbourhoods that enhanced walkability, were complete and compact in design, and those which enhanced connectivity through safe and efficient infrastructure were associated with better health-related outcomes relating to physical activity, social engagement, mental health, perceptions of crime, and road traffic collisions. Evidence for the effectiveness of planning principles across different topic areas and on reducing health inequalities was sparse and inconclusive., Conclusions: Findings provide an up-to-date overview of relationships between the built and natural environment and health and present logical, evidence-based messages to aid communication between public health and planning professionals.

Integrated landscape initiatives typically aim to strengthen landscape governance by developing and facilitating multi-stakeholder platforms. These are institutional coordination mechanisms that enable discussions, negotiations, and joint planning between stakeholders from various sectors in a given landscape. Multi-stakeholder platforms tend to involve complex processes with diverse actors, whose objectives and focus may be subjected to periodic re-evaluation, revision or reform. In this article we propose a participatory method to aid planning, monitoring, and evaluation of such platforms, and we report on experiences from piloting the method in Ghana and Indonesia. The method is comprised of three components. The first can be used to look ahead, identifying priorities for future multi-stakeholder collaboration in the landscape. It is based on the identification of four aspirations that are common across multi-stakeholder platforms in integrated landscape initiatives. The second can be used to look inward. It focuses on the processes within an existing multi-stakeholder platform in order to identify areas for possible improvement. The third can be used to look back, identifying the main outcomes of an existing platform and comparing them to the original objectives. The three components can be implemented together or separately. They can be used to inform planning and adaptive management of the platform, as well as to demonstrate performance and inform the design of new interventions.

Transportation infrastructure has an enormous impact on sustainable development. To identify multiple impacts of transportation infrastructure and show emerging trends and challenges, this paper presents a scientometric review based on 2543 published articles from 2000 to 2017 through co-author, co-occurring and co-citation analysis. In addition, the hierarchy of key concepts was analyzed to show emerging research objects, methods and levels according to the clustering information, which includes title, keyword and abstract. The results expressed by visual graphs compared high-impact authors, collaborative relationships among institutions in developed and developing countries. In addition, representative research issues related to the economy, society and environment were identified such as cost overrun, spatial economy, prioritizing structure, local development and land value. Additionally, two future directions, integrated research of various effects and structure analysis of transportation network, are recommended. The findings of this study provide researchers and practitioners with an in-depth understanding of transportation infrastructure's impacts on sustainable development by visual expression.

Background: Identifying elements of one's environment-observable and unobservable-that contribute to chronic stress including the perception of comfort and discomfort associated with different settings, presents many methodological and analytical challenges. However, it also presents an opportunity to engage the public in collecting and analyzing their own geospatial and biometric data to increase community member understanding of their local environments and activate potential environmental improvements. In this first-generation project, we developed a methodology to integrate geospatial technology with biometric sensing within a previously developed, evidence-based "citizen science" protocol, called "Our Voice." Participants used a smartphone/tablet-based application, called the Discovery Tool (DT), to collect photos and audio narratives about elements of the built environment that contributed to or detracted from their well-being. A wrist-worn sensor (Empatica E4) was used to collect time-stamped data, including 3-axis accelerometry, skin temperature, blood volume pressure, heart rate, heartbeat inter-beat interval, and electrodermal activity (EDA). Open-source R packages were employed to automatically organize, clean, geocode, and visualize the biometric data., Results: In total, 14 adults (8 women, 6 men) were successfully recruited to participate in the investigation. Participants recorded 174 images and 124 audio files with the DT. Among captured images with a participant-determined positive or negative rating (n = 131), over half were positive (58.8%, n = 77). Within-participant positive/negative rating ratios were similar, with most participants rating 53.0% of their images as positive (SD 21.4%). Significant spatial clusters of positive and negative photos were identified using the Getis-Ord Gi* local statistic, and significant associations between participant EDA and distance to DT photos, and street and land use characteristics were also observed with linear mixed models. Interactive data maps allowed participants to (1) reflect on data collected during the neighborhood walk, (2) see how EDA levels changed over the course of the walk in relation to objective neighborhood features (using basemap and DT app photos), and (3) compare their data to other participants along the same route., Conclusions: Participants identified a variety of social and environmental features that contributed to or detracted from their well-being. This initial investigation sets the stage for further research combining qualitative and quantitative data capture and interpretation to identify objective and perceived elements of the built environment influence our embodied experience in different settings. It provides a systematic process for simultaneously collecting multiple kinds of data, and lays a foundation for future statistical and spatial analyses in addition to more in-depth interpretation of how these responses vary within and between individuals.

Background: There is insufficient evidence regarding the relationship of home environment with functional capacity among community-dwelling older people without disabilities. We conducted a population-based longitudinal cohort study and examined whether stairs in the home were associated with capability to perform instrumental activities of daily living (IADL) in community-dwelling high-functioning older adults., Methods: The target population was individuals aged 65 years or older living in two municipalities in Nara Prefecture in Japan. At the baseline survey, residents who were independent in IADL (n = 6722) were included as survey subjects. Subjects were divided into three groups according to their home type; one-storey residences, walk-up residences, or residences with an elevator. IADL was evaluated using the Tokyo Metropolitan Institute of Gerontology Index of Competence. Multiple logistic regression analyses stratified by gender were used to calculate the odds ratio (OR) and a 95% confidence interval (CI) for a decline in IADL, with one-storey residences as a reference. Age, studied area, marital status, working status, self-perceived economic status, body mass index, chronic diseases, smoking, drinking, eating habits, basic activities of daily living, cognitive functioning, depression, self-rated health, and social participation were used as covariates., Results: During the 3-year follow-up, 11.6% of the subjects showed a decline in IADL. After adjusting for covariates, women who lived in walk-up residences had a lower risk for IADL decline (adjusted OR = 0.72, 95% CI = 0.52-0.99), while living in a home with an elevator was not associated with IADL decline (adjusted OR = 0.94, 95% CI = 0.49-1.77). In contrast, there was no association between home type and IADL decline in men (walk-up residences, adjusted OR = 0.90, 95% CI = 0.71-1.14; residences with an elevator, adjusted OR = 0.82, 95% CI = 0.39-1.72)., Conclusions: The presence of stairs in the home was associated with prevention of IADL decline over a 3-year period in older women without disabilities. Although a barrier-free house is recommended for older people, our findings indicate that a home with stairs may maintain the capability to perform IADL among older adults without disabilities.

Architects shape future dwellings and built environments in ways that are critical for aging bodies. This article explores how assumptions about aging bodies are made manifest in architectural plans and designs. By analysing entries for an international student competition Caring for Older People (2009), we illustrate the ways in which aged bodies were conceived by future architectural professionals. Through analysing the architectural plans, we can discern the students' expectations and assumptions about aging bodies and embodiment through their use of and reference to spaces, places and things. We analyse the visual and discursive strategies by which aged bodies were represented variously as frail, dependent, healthy, technologically engaged and socially situated in domestic and community settings, and also how architects inscribed ideas about care and embodiment into their proposals. Through our analysis of these data we also attend to the non-representational ways in which design and spatiality may be crucial to the fabrication of embodied practices, atmospheres and affects. We end by reflecting on how configurations and ideologies of care can be reproduced through architectural spaces, and conclude that a dialogue between architecture and sociology has the potential to transform concepts of aging, embodiment and care., (Copyright © 2018 The Authors. Published by Elsevier Inc. All rights reserved.)

Background: Noncommunicable diseases and obesity are considered problems of wealthy, developed countries. These conditions are rising dramatically in developing countries. Most existing research on the role of the physical environment to support physical activity examines developed countries only., Objectives: This review identifies physical environment factors that are associated with physical activity in developing countries., Methods: This review is modeled on a highly cited review by Saelens and Handy in 2008. The current review analyzes findings from 159 empirical studies in the 138 developing countries., Results: Results discuss the association of physical environment features and physical activity for all developing countries and identify the patterns within regions. The review supports the association of traffic safety with physical activity for transportation. Rural (vs urban) residence, distance to nonresidential land uses, and "composite" features of the physical environment are associated with general physical activity. Rural (vs urban) residence is associated with physical activity for work., Conclusions: More research is needed on associations between the physical environment and physical activity in developing countries. Research should identify specific physical environment features in urban areas that are associated with higher activity levels.

Increasingly, health communication scholars are attending to how hospital built environments shape communication, patient care processes, and patient outcomes. This multimethod study was conducted on two floors of a newly designed urban hospital. Nine focus groups interviews were conducted with 35 health care professionals from 10 provider groups. Seven of the groups were homogeneous by profession or level: nursing (three groups), nurse managers (two groups), and one group each of nurse care technicians ("techs") and physicians. Two mixed groups were comprised of staff from pharmacy, occupational therapy, patient care facilitators, physical therapy, social work, and pastoral care. Systematic qualitative analysis was conducted using a conceptual framework based on systems theory and prior health care design and communication research. Additionally, quantitative modeling was employed to assess walking distances in two different hospital designs. Results indicate nurses walked significantly more in the new hospital environment. Qualitative analysis revealed three insights developed in relationship to system structures, processes, and outcomes. First, decentralized nurse stations changed system interdependencies by reducing nurse-to-nurse interactions and teamwork while heightening nurse interdependencies and teamwork with other health care occupations. Second, many nursing-related processes remained centralized while nurse stations were decentralized, creating systems-based problems for nursing care. Third, nursing communities of practices were adversely affected by the new design. Implications of this study suggest that nurse station design shapes communication, patient care processes, and patient outcomes. Further, it is important to understand how the built environment, often treated as invisible in communication research, is crucial to understanding communication within complex health care systems.

Contrary to lay conceptions, unattractive locations can under certain circumstances increase the perceived value of neighboring areas. This phenomenon is akin to a contrast effect. However, extant research on this type of contrast suffers from two limitations. First, the use of repeated measures may inflate the likelihood of observing a contrast effect. Second, there is a lack of meaningful comparisons for gauging the size of the effect. We designed three experiments to address these issues. In each, we assessed how much participants valued places located increasingly far from an unsafe housing block. Participants either rated several target locations or just a single one at a time. We also assessed whether the positiveness of the contrast effect due to the unsafe housing block would be able to compete with the positive effect of a nearby park. The results replicate past findings of a contrast effect in spatial context; they show that the effect generalizes to a different design; and they demonstrate that a contrast effect due to an unattractive location can indeed be as "beneficial" for some neighboring areas as the effect of a genuinely attractive location. (PsycINFO Database Record, ((c) 2017 APA, all rights reserved).)

Background: An enriched environment for residents with dementia may have a positive effect on the rest-activity rhythm. A small scaled homelike special care unit might be such an enriched environment. The present study shows whether the rest-activity rhythm of residents with moderate to severe dementia responds positively to a transfer from a regular Special Care Unit (SCU) to a small scaled homelike SCU., Methods: Initially, a group of 145 residents living in a regular SCU participated. Out of this group, 77 residents moved to a small scaled homelike SCU. This group was compared to the group of 68 residents that remained at the regular SCU. Rest-activity rhythm was assessed by means of actigraphy and observation scales before and after relocation., Results: No significant main effects nor significant interaction effects in intradaily and interdaily activity were found for the data of 38 residents in the small scaled homelike SCU and 20 residents of the regular SCU. The effect sizes, however, ranged from small to large., Conclusions: Considering the effect sizes, a new study with a larger number of participants is necessary before firm conclusions can be drawn., Trial Registration: Current Controlled Trials ISRCTN11151241 . registration date: 21-06-2017. Retrospectively registered.

Context: Ciclovias involve the temporary closure of roads to motorized vehicles, allowing for use by bicyclists, walkers, and runners and for other physical activity. Ciclovias have been held in urban and suburban communities in the United States and Latin America., Objective: We evaluated the first ciclovia held in a rural, predominantly Latino community in Washington State., Setting: Three blocks within a downtown area in a rural community were closed for 5 hours on a Saturday in July 2015., Outcome Measures: The evaluation included observation counts and participant intercept surveys., Results: On average, 200 participants were present each hour. Fourteen percent of youth (younger than 18 years) were observed riding bikes. No adults were observed riding bikes. A total of 38 surveys were completed. Respondents reported spending on average 2 hours at the ciclovia. Seventy-nine percent reported that they would have been indoors at home involved in sedentary activities (such as watching TV, working on computer) if they had not been at the ciclovia., Conclusion: Regularly held ciclovias, which are free and open to anyone, could play an important role in creating safe, accessible, and affordable places for physical activity in rural areas. Broad community input is important for the success of a ciclovia.

Objective: Older adults with knee osteoarthritis (OA) who live in environments with mobility barriers may be at greater risk of developing participation restrictions, defined as difficulties in engagement in life situations. We investigated the risk of participation restriction over 5 years due to self-reported environmental features among older adults with knee OA., Methods: Participants from the Multicenter Osteoarthritis (MOST) Study self-reported participation at baseline, 30 months, and 60 months using the instrumental role subscale of the Late Life Disability Index (LLDI). Data on self-reported environmental features were from the Home and Community Environment questionnaire administered in the MOST Knee Pain and Disability study, an ancillary study of MOST. The relative risks (RRs) of developing participation restriction at 60 months, indicated by an LLDI score <67.6 out of a possible 100, due to reported high community mobility barriers and high transportation facilitators, were calculated using robust Poisson regression, adjusting for covariates., Results: Sixty-nine of the 322 participants (27%) developed participation restriction by 60 months. Participants reporting high community mobility barriers at baseline had 1.8 times the risk (95% confidence interval [95% CI] 1.2-2.7) of participation restriction at 60 months, after adjusting for covariates. Self-report of high transportation facilitators at baseline resulted in a reduced but statistically nonsignificant risk of participation restriction at 60 months (RR 0.7, 95% CI 0.4-1.1)., Conclusion: Higher perceived environmental barriers impact the risk of long-term participation restriction among older adults with or at risk of knee OA. Approaches aimed at reducing the development of participation restrictions in this population should consider decreasing environmental barriers., (© 2017, American College of Rheumatology.)

Background: Previous studies found a complex relationship between area-level socioeconomic status (SES) and walkability. These studies did not include neighborhood dynamics. Our aim was to study the association between area-level SES and walkability in the city of Madrid (Spain) evaluating the potential effect modification of neighborhood dynamics., Methods: All census sections of the city of Madrid (n = 2415) were included. Area-level SES was measured using a composite index of 7 indicators in 4 domains (education, wealth, occupation and living conditions). Two neighborhood dynamics factors were computed: gentrification, proxied by change in education levels in the previous 10 years, and neighborhood age, proxied by median year of construction of housing units in the area. Walkability was measured using a composite index of 4 indicators (Residential Density, Population Density, Retail Destinations and Street Connectivity). We modeled the association using linear mixed models with random intercepts., Results: Area-level SES and walkability were inversely and significantly associated. Areas with lower SES showed the highest walkability. This pattern did not hold for areas with an increase in education level, where the association was flat (no decrease in walkability with higher SES). Moreover, the association was attenuated in newly built areas: the association was stronger in areas built before 1975, weaker in areas built between 1975 and 1990 and flat in areas built from 1990 on., Conclusion: Areas with higher neighborhood socioeconomic status had lower walkability in Madrid. This disadvantage in walkability was not present in recently built or gentrified areas.

Background: To investigate whether changing the play environment in primary schools to one that includes greater risk and challenge increases physical activity and reduces body mass index (BMI)., Subjects/methods: A 2-year cluster randomised controlled trial was undertaken in 16 New Zealand schools (years 1-8). Intervention schools (n=8) redesigned their play environments to encourage imaginative and independent free play by increasing opportunities for risk and challenge (for example, rough-and-tumble play), reducing rules and adding new playground components (for example, loose parts). Control schools (n=8) were asked to not change their play environment. A qualified playworker rated all school play environments at baseline and 1 year. Primary outcomes were moderate-to-vigorous physical activity (7-day accelerometry) and BMI z-score, collected in 840 children at baseline, 1 and 2 years. Data were analysed using generalised estimating equations., Results: Multiple changes were made to the school play environments resulting in a significant difference in overall play evaluation score between intervention and control schools of 4.50 (95% confidence interval: 1.82 to 7.18, P=0.005), which represents a substantial improvement from baseline values of 19.0 (s.d. 3.2). Overall, schools liked the intervention and reported many benefits, including increased physical activity. However, these beliefs did not translate into significant differences in objectively measured physical activity, either as counts per minute (for example, 35 (-51 to 120) during lunch break) or as minutes of moderate-to-vigorous physical activity (0.4, -1.1 to 2.0). Similarly, no significant differences were observed for BMI, BMI z-score or waist circumference at 1 or 2 years (all P>0.321)., Conclusions: Altering the school play environment to one that promoted greater risk and challenge for children did not increase physical activity, nor subsequently alter body weight. Although schools embraced the concept of adding risk and challenge in the playground, our findings suggest that children may have been involved in different, rather than additional activities.

This paper reviews the role of space in facilitating innovation. It draws on the sociology of space in exploring the social practices, institutional forces and material complexity of how people and spaces interact. We assess how space influences the development of innovative solutions to challenges in the health sector. Our aim is to advance an understanding of the social production of space for healthcare innovation. We draw empirical examples from the Innovation Hub at Groote Schuur Hospital in Cape Town to illustrate that innovation does not take place in an institutional vacuum, but requires space that facilitates interaction of different players. This paper demonstrates that space matters in promoting innovation, particularly through its influence on social relationships and networks. An attractive and novel space, which is different from the usual workplace, stimulates innovation, mainly through being a base for the creation of an ecosystem for the productive interaction of different players. The interaction is important in inspiring new ideas, facilitating creative thought processes, maintaining the flow of information and bringing innovation to life., (Copyright © 2017 Elsevier Ltd. All rights reserved.)

Background: Despite the detrimental effects of physical inactivity for older adults, especially aged residents of residential care settings may spend much time in inactive behavior. This may be partly due to their poorer physical condition; however, there may also be other, setting-related factors that influence the amount of inactivity. The aim of this review was to review setting-related factors (including the social and physical environment) that may contribute to the amount of older adults' physical inactivity in a wide range of residential care settings (e.g., nursing homes, assisted care facilities)., Methods: Five databases were systematically searched for eligible studies, using the key words 'inactivity', 'care facilities', and 'older adults', including their synonyms and MeSH terms. Additional studies were selected from references used in articles included from the search. Based on specific eligibility criteria, a total of 12 studies were included. Quality of the included studies was assessed using the Mixed Methods Appraisal Tool (MMAT)., Results: Based on studies using different methodologies (e.g., interviews and observations), and of different quality (assessed quality range: 25-100%), we report several aspects related to the physical environment and caregivers. Factors of the physical environment that may be related to physical inactivity included, among others, the environment's compatibility with the abilities of a resident, the presence of equipment, the accessibility, security, comfort, and aesthetics of the environment/corridors, and possibly the presence of some specific areas. Caregiver-related factors included staffing levels, the available time, and the amount and type of care being provided., Conclusions: Inactivity levels in residential care settings may be reduced by improving several features of the physical environment and with the help of caregivers. Intervention studies could be performed in order to gain more insight into causal effects of improving setting-related factors on physical inactivity of aged residents.

Objective: To determine whether neighbourhood walkability is associated with clinical measures of obesity, hypertension, diabetes and dyslipidaemia in an urban adult population., Design: Observational cross-sectional study., Setting: Urban primary care patients., Participants: 78 023 Toronto residents, aged 18 years and over, who were formally rostered or had at least 2 visits between 2012 and 2014 with a primary care physician participating in the University of Toronto Practice Based Research Network (UTOPIAN), within the Canadian Primary Care Sentinel Surveillance Network (CPCSSN)., Main Outcome Measures: Differences in average body mass index (BMI), systolic and diastolic blood pressure, fasting blood glucose, haemoglobin A1c (HbA1C), total cholesterol, high-density lipoprotein (HDL), low-density lipoprotein and triglyceride between residents in the highest versus the lowest quartile of neighbourhood walkability, as estimated using multivariable linear regression models and stratified by age. Outcomes were objectively measured and were retrieved from primary care electronic medical records. Models adjusted for age, sex, smoking, medications, medical comorbidities and indices of neighbourhood safety and marginalisation., Results: Compared with those in the lowest walkability quartile, individuals in the highest quartile had lower mean BMI (-2.64 kg/m 2 , 95% CI -2.98 to -2.30; p<0.001), systolic blood pressure (-1.35 mm Hg, 95% CI -2.01 to -0.70; p<0.001), diastolic blood pressure (-0.60 mm Hg, 95% CI 1.06 to -0.14; p=0.010) and HbA1c (-0.063%, 95% CI -0.11 to -0.021; p=0.003) and higher mean HDL (0.052 mmol/L, 95% CI 0.029 to 0.075; p<0.001). In age-stratified analyses, differences in the mean BMI were consistently observed for adults aged 18 to under 40 (-4.44 kg/m 2 , 95% CI -5.09 to -3.79; p<0.001), adults aged 40-65 (-2.74 kg/m 2 , 95% CI -3.24 to -2.23; p<0.001) and adults aged over 65 (-0.87 kg/m 2 , 95% CI -1.48 to -0.26; p=0.005)., Conclusions: There was a clinically meaningful association between living in the most walkable neighbourhoods and having lower BMI in adults of all ages., (Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.)

Objectives: To evaluate changes in bicycle use and cyclist safety in Boston, Massachusetts, following the rapid expansion of its bicycle infrastructure between 2007 and 2014., Methods: We measured bicycle lane mileage, a surrogate for bicycle infrastructure expansion, and quantified total estimated number of commuters. In addition, we calculated the number of reported bicycle accidents from 2009 to 2012. Bicycle accident and injury trends over time were assessed via generalized linear models. Multivariable logistic regression was used to examine factors associated with bicycle injuries., Results: Boston increased its total bicycle lane mileage from 0.034 miles in 2007 to 92.2 miles in 2014 (P < .001). The percentage of bicycle commuters increased from 0.9% in 2005 to 2.4% in 2014 (P = .002) and the total percentage of bicycle accidents involving injuries diminished significantly, from 82.7% in 2009 to 74.6% in 2012. The multivariable logistic regression analysis showed that for every 1-year increase in time from 2009 to 2012, there was a 14% reduction in the odds of being injured in an accident., Conclusions: The expansion of Boston's bicycle infrastructure was associated with increases in both bicycle use and cyclist safety.

Neighbourhood environments significantly influence health and well-being, especially as people age. Our study uniquely highlights how one microscale feature (benches) influence older adults experiences of mobility and well-being, from their perspective. We also explore how these experiences affect and are affected by the social environment of the neighbourhoods where older adults live. We conducted one-on-one seated and walk-along interviews with individuals aged 60+ that live in three adjacent neighbourhoods in Vancouver, Canada. We collected data at two time points (n = 28, 2012; n = 22, 2014). We found that benches positively contributed to older adults' mobility experiences by: (i) enhancing their use and enjoyment of green and blue spaces, (ii) serving as a mobility aid, and (iii) contributing to social cohesion and social capital. To address the increased needs of an aging demographic, urban planners might consider the quality and presence of microfeatures as part of an immediate and inexpensive strategy to create supportive neighbourhoods for people of all ages and abilities., (Copyright © 2016 Elsevier Ltd. All rights reserved.)

Investments in neighborhood built environments could increase physical activity and overall health. Disproportionate distribution of these changes in advantaged neighborhoods could inflate health disparities. Little information exists on where changes are occurring. This paper aims to 1) identify changes in the built environment in neighborhoods and 2) investigate associations between high levels of change and sociodemographic characteristics. Using Geographic Information Systems, neighborhood land-use, local destinations (for walking, social engagement, and physical activity), and sociodemographics were characterized in 2000 and 2010 for seven U.S. cities. Linear and change on change models estimated associations of built environment changes with baseline (2000) and change (2010-2000) in sociodemographics. Spatial patterns were assessed using Global Moran's I to measure overall clustering of change and Local Moran's I to identify statistically significant clusters of high increases surrounded by high increases (HH). Sociodemographic characteristics were compared between HH cluster and other tracts using Analysis of Variance (ANOVA). We observed small land-use changes but increases in the destination types. Greater increases in destinations were associated with higher percentage non-Hispanic whites, percentage households with no vehicle, and median household income. Associations were present for both baseline sociodemographics and changes over time. Greater increases in destinations were associated with lower baseline percentage over 65 but higher increases in percentage over 65 between 2000 and 2010. Global Moran's indicated changes were spatially clustered. HH cluster tracts started with a higher percentage non-Hispanic whites and higher percentage of households without vehicles. Between 2000 and 2010, HH cluster tracts experienced increases in percent non-Hispanic white, greater increases in median household income, and larger decreases in percent of households without a vehicle. Changes in the built environment are occurring in neighborhoods across a diverse set of U.S. metropolitan areas, but are patterned such that they may lead to increased health disparities over time., Competing Interests: The authors have no financial or competing interests to disclose., (Copyright © 2016 Elsevier Ltd. All rights reserved.)

The notion of age-friendliness is gaining increasing attention from policy makers and researchers. In this study, we examine the congruence between two types of age-friendly surveys: subjective assessments by community residents versus objective assessments by municipal officials. The study was based on data from 39 mostly rural communities in Manitoba, Canada, in which a municipal official and residents (M= 25 residents per community) completed a survey to assess age-friendly features in a range of domains, such as transportation and housing. Congruence between the two surveys was generally good, although the municipal official survey consistently overestimated communities' age-friendliness, relative to residents' ratings. The findings suggest that a survey completed by municipal officials can provide a reasonable assessment of age-friendliness that may be useful for certain purposes, such as cross-community comparisons. However, some caution is warranted when using only these surveys for community development, as they may not adequately reflect residents' views., (© The Author(s) 2014.)

Introduction: 'Green spaces' such as public parks are regarded as determinants of health, but evidence from tends to be based on cross-sectional designs. This protocol describes a study that will evaluate a large-scale investment in approximately 5280 hectares of green space stretching 27 km north to south in Western Sydney, Australia., Methods and Analysis: A Geographic Information System was used to identify 7272 participants in the 45 and Up Study baseline data (2006-2008) living within 5 km of the Western Sydney Parklands and some of the features that have been constructed since 2009, such as public access points, advertising billboards, walking and cycle tracks, BBQ stations, and children's playgrounds. These data were linked to information on a range of health and behavioural outcomes, with the second wave of data collection initiated by the Sax Institute in 2012 and expected to be completed by 2015. Multilevel models will be used to analyse potential change in physical activity, weight status, social contacts, mental and cardiometabolic health within a closed sample of residentially stable participants. Comparisons between persons with contrasting proximities to different areas of the Parklands will provide 'treatment' and 'control' groups within a 'quasi-experimental' study design. In line with expectations, baseline results prior to the enhancement of the Western Sydney Parklands indicated virtually no significant differences in the distribution of any of the outcomes with respect to proximity to green space preintervention., Ethics and Dissemination: Ethical approval was obtained for the 45 and Up Study from the University of New South Wales Human Research Ethics Committee. Ethics approval for this study was obtained from the University of Western Sydney Ethics Committee. Findings will be disseminated through partner organisations (the Western Sydney Parklands and the National Heart Foundation of Australia), as well as to policymakers in parallel with scientific papers and conference presentations., (Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/)

Objective: The overall aim of this review is to map the area around the topic of the relationship between physical space and learning and to then draw further potential implications from this for the specific area of health profession education., Methods: The nature of the review is a scoping review following a 5-step-model by Arksey & O'Malley. The charting of the data has been conducted with the help of the networked learning landscape framework from Nordquist and Laing., Results: The majority of the research studies on classroom-scale level have focused on how technology may enable active learning. There are no identified research studies on the building-scale level. Hence, the alignment of curricula and physical learning spaces has scarcely been addressed in research from other sectors. In order to 'create a field', conclusions from both case studies and research in related areas must be identified and taken into account to provide insights into health profession education. Four areas have been identified as having potential for future development in health profession education: (i) active involvement of faculty members in the early stages of physical space development; (ii) further development of the assessment strategies for evaluating how physical space impacts learning; (iii) exploration of how informal spaces are being developed in other sectors; and (iv) initiating research projects in HPE to study how informal spaces impact on students' learning., Conclusion: Potentially, the results of this scoping review will result in better future research questions and better-designed studies in this new and upcoming academic field of aligning physical learning spaces and curricula in health profession education., (© 2015 John Wiley & Sons Ltd.)