Post-war urban neighbourhoods in industrialised countries have been shown to negatively affect the lifestyles of their residents due to their design. This study aims at developing an empirical procedure to select locations to be redesigned and the determinants of health at stake in these locations, with involvement of residents’ perspectives as core issue. We addressed a post-war neighbourhood in the city of Groningen, the Netherlands. We collected data from three perspectives: spatial analyses by urban designers, interviews with experts in local health and social care (n = 11) and online questionnaires filled in by residents (n = 99). These data provided input for the selection of locations to be redesigned by a multidisciplinary team (n = 16). The procedure yielded the following types of locations (and determinants): An area adjacent to a central shopping mall (social interaction, traffic safety, physical activity), a park (experiencing green, physical activity, social safety, social interaction) and a block of low-rise row houses around a public square (social safety, social interaction, traffic safety). We developed an empirical procedure for the selection of locations and determinants to be addressed, with addressing residents’ perspectives. This procedure is potentially applicable to similar neighbourhoods internationally.
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Background: Urban slums are characterised by unique challenging living conditions, which increase their inhabitants’ vulnerability to specific health conditions. The identification and prioritization of the key health issues occurring in these settings is essential for the development of programmes that aim to enhance the health of local slum communities effectively. As such, the present study sought to identify and prioritise the key health issues occurring in urban slums, with a focus on the perceptions of health professionals and community workers, in the rapidly growing city of Bangalore, India. Methods: The study followed a two-phased mixed methods design. During Phase I of the study, a total of 60 health conditions belonging to four major categories: - 1) non-communicable diseases; 2) infectious diseases; 3) maternal and women’s reproductive health; and 4) child health - were identified through a systematic literature review and semi-structured interviews conducted with health professionals and other relevant stakeholders with experience working with urban slum communities in Bangalore. In Phase II, the health issues were prioritised based on four criteria through a consensus workshop conducted in Bangalore. Results: The top health issues prioritized during the workshop were: diabetes and hypertension (non-communicable diseases category), dengue fever (infectious diseases category), malnutrition and anaemia (child health, and maternal and women’s reproductive health categories). Diarrhoea was also selected as a top priority in children. These health issues were in line with national and international reports that listed them as top causes of mortality and major contributors to the burden of diseases in India. Conclusions: The results of this study will be used to inform the development of technologies and the design of interventions to improve the health outcomes of local communities. Identification of priority health issues in the slums of other regions of India, and in other low and lower middle-income countries, is recommended.
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The crossroads of living in cities on the one hand and ageing of the population on the other is studied in an interdisciplinary field of research called urban ageing (van Hoof and Kazak 2018, van Hoof et al. 2018). People live longer and in better health than ever before in Europe. Despite all the positive aspects of population ageing, it poses many challenges. The interaction of population ageing and urbanisation raises issues in various domains of urban living (Phillipson and Buffel 2016). According to the Organisation for Economic Co-operation and Development (OECD 2015), the population share of those of 65 years old is expected to climb to 25.1% in 2050 in its member states. Cities in particular have large numbers of older inhabitants and are home to 43.2% of this older population. The need to develop supportive urban communities are major issues for public policy to understand the relationship between population ageing and urban change (Buffel and Phillipson 2016). Plouffe and Kalache (2010) see older citizens as a precious resource, but in order to tap the full potential these people represent for continued human development (Zaidi et al. 2013), the world’s cities must ensure their inclusion and full access to urban spaces, structures, and services. Therefore, cities are called upon to complement the efforts of national governments to address the consequences of the unprecedented demographic shift (OECD 2015). Additionally, at the city level there is a belief to understand the requirements and preferences of local communities (OECD 2015). An important question in relation to urban ageing is what exactly makes a city age-friendly (Alley et al. 2007, Lui et al. 2009, Plouffe and Kalache 2010, Steels 2015, Moulaert and Garon 2016, Age Platform Europe 2018)? Another relevant question is which factors allow some older people in cities to thrive, while others find it hard to cope with the struggles of daily life? This chapter explores and describes which elements and factors make cities age-friendly, for instance, on the neighbourhood level and in relation to technology for older people.
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Background: The built environment is increasingly recognized as a determinant for health and health behaviors. Existing evidence regarding the relationship between environment and health (behaviors) is varying in significance and magnitude, and more high-quality longitudinal studies are needed. The aim of this study was to evaluate the effects of a major urban redesign project on physical activity (PA), sedentary behavior (SB), active transport (AT), health-related quality of life (HRQOL), social activities (SA) and meaningfulness, at 29–39 months after opening of the reconstructed area. Methods: PA and AT were measured using accelerometers and GPS loggers. HRQOL and sociodemographic characteristics were assessed using questionnaires. In total, 241 participants provided valid data at baseline and follow-up. We distinguished three groups, based on proximity to the intervention area: maximal exposure group, minimal exposure group and no exposure group. Results: Both the maximal and minimal exposure groups showed significantly different trends regarding transportbased PA levels compared to the no exposure group. In the exposure groups SB decreased, while it increased in the no exposure group. Also, transport-based light intensity PA remained stable in the exposure groups, while it significantly decreased in the no exposure group. No intervention effects were found for total daily PA levels. Scores on SA and meaningfulness increased in the maximal exposure group and decreased in the minimal and no exposure group, but changes were not statistically significant. Conclusion: The results of this study emphasize the potential of the built environment in changing SB and highlights the relevance of longer-term follow-up measurements to explore the full potential of urban redesign projects.
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from the article: Abstract Based on a review of recent literature, this paper addresses the question of how urban planners can steer urban environmental quality, given the fact that it is multidimensional in character, is assessed largely in subjective terms and varies across time. The paper explores three questions that are at the core of planning and designing cities: ‘quality of what?’, ‘quality for whom?’ and ‘quality at what time?’ and illustrates the dilemmas that urban planners face in answering these questions. The three questions provide a novel framework that offers urban planners perspectives for action in finding their way out of the dilemmas identified. Rather than further detailing the exact nature of urban quality, these perspectives call for an approach to urban planning that is integrated, participative and adaptive. ; ; sustainable urban development; trade-offs; quality dimensions
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Background: This study investigates patients’ use of eHealth services, their awareness of the availability of these services, and their intention to use them in primary care. It also examines patient characteristics and factors that influence the use of these services. Methods: A cross-sectional design using questionnaires was conducted. Based on the unified theory of acceptance and use of technology (UTAUT), the participants rated the two most common services. Descriptive analyses and linear correlation analyses were performed. A simple linear regression was conducted to identify factors influencing the participants’ intention to use eHealth services. Results: In total, 1203 participants with an average age of 43.7 years were surveyed. The participants’ usage rates varied, with the lowest at 2.4%, for measuring vital signs, and the highest at 47.4%, for booking appointments. The intentions to use the services ranged from 22.5%, for video consultations, to 46.6%, for prescription refill requests. Approximately 20% of the respondents were unaware of each service’s availability. Positive associations were found between all the constructs and the intention to use online services, with a younger age being the most significant factor. Conclusions: The use of and intention to use eHealth services varied greatly. The participants were often unaware of the availability of these services. Promoting the availability and benefits of eHealth services could enhance patient engagement in primary care settings.
MULTIFILE
In most countries, the demand for integrated care for people with chronic diseases is increasing as the population ages. This demand requires a fundamental shift of health-care systems towards more integrated service delivery models. To achieve this shift in China, the World Health Organization, the World Bank and the Chinese government proposed a tiered health-care delivery system in accordance with a people-centred integrated care model. The approach was pioneered in Luohu district of Shenzhen city from 2015 to 2017 as a template for practice. In September 2017, China's health ministry introduced this approach to people-centred integrated care to the entire country. We describe the features of the Luohu model in relation to the core action areas and implementation strategies proposed and we summarize data from an evaluation of the first two years of the programme. We discuss the challenges faced during implementation and the lessons learnt from it for other health-care systems. We consider how to improve collaboration between institutions, how to change the population's behaviour about using community health services as the first point of contact and how to manage resources effectively to avoid budget deficits. Finally, we outline next steps of the Luohu model and its potential application to strengthen health care in other urban health-care systems.
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The debate on tourism in cities, both academically and in practice, has for a long time taken place in relative isolation from urban studies. Tourism is mostly addressed as an external agent and economic force that puts pressure on cities rather than as an interdependent part of city systems. The recent debate on city touristification and excessive dependence on the visitor economy, as well as the associated processes of exclusion, and displacement of local city users, serves to highlight how tourism is an integral part of urban developments. A wider urban perspective is needed to understand the processes underlying the tourism phenomena and more transdisciplinary perspectives are required to analyze the urban (tourism) practices. The current article seeks to contribute to such a perspective through a discussion of the literature on urban and tourism studies, and related fields such as gentrification, mobilities, and touristification. Based on this, theoretical reflections are provided regarding a more integral perspective to tourism and urban development in order to engage with a transversal urban tourism research agenda.
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In a matter of weeks last year, discussions regarding tourism in cities changed from how to deal with overtourism to how to deal with ‘no tourism’. Shortly thereafter, a great number of posts on LinkedIn, websites, and blogs highlighted how the tourism crisis that resulted from the COVID-19 pandemic could help reinvent tourism, into something more equal, inclusive, and sustainable. And so, online – at leastin mypersonalonlinebubble – there seemedtobe a real momentum for proper, transformative changes in (urban) tourism. How can we rebuild urban tourism in a sustainable and resilient way?
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This article analyses four of the most prominent city discourses and introduces the lens of urban vitalism as an overarching interdisciplinary concept of cities as places of transformation and change. We demonstrate the value of using urban vitalism as a lens to conceptualize and critically discuss different notions on smart, inclusive, resilient and sustainable just cities. Urban vitalism offers a process-based lens which enables us to understand cities as places of transformation and change, with people and other living beings at its core. The aim of the article is to explore how the lens of vitalism can help us understand and connect ongoing interdisciplinary academic debates about urban development and vice versa, and how these ongoing debates inform our understanding of urban vitalism.
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