How Are We Doing? A Look at the Practice of Planning for Sustainable Development

The concept of sustainable development poses special challenges in the land use planning field as planning is fundamentally connected to the core themes found in the sustainability literature. These themes, often referred to as the three E's are: environmental protection, social equity, and economic development. From a local planning perspective, the themes are all affected by "what gets built and where." In the field of planning, present unsustainable land use patterns are noted as an indicator of larger societal sustainability problems. Calthorpe, for example, asserts that "[s]ettlement patterns are the physical foundation of our society and like our society, they are becoming more and more fractured" (Calthorpe 1993:16). Land use planning is also seen as the principal forum for addressing sustainability concerns and promoting fundamental sustainable principles (Beadey 1995; Rees 1995; Thomas 1994). Rees, for example, notes: In this increasingly fragmented and specialized world, planning is the one academic discipline and professional pursuit that explicitly attempts to be holistic or at least integrative at the level of society as a whole. At its best, planning provides a context in which the specialized knowledge of other disciplines comes together and begins to make unified sense. (Rees 1995:355) The primary manner in which planning can bring together and put into action the themes of sustainability is in the community comprehensive plan. The comprehensive planning process and subsequent plan provide a vehicle for the embodiment of sustainable development themes on a community level

Factors associated with risk of evacuation failure from Hurricane Isabel in North Carolina, 2003

Important differences in evacuation exist across households. This study describes associations between social factors and evacuation from Hurricane Isabel by residents of North Carolina in 2003. Census blocks in three affected counties were stratified by flood zone and 30 census blocks were selected probability proportionate to population size from each flood zone. Within selected blocks, 7 random interview locations were chosen using a geographic information systems-based site selection tool. Risk differences and 95% confidence intervals for evacuation were calculated. High levels of neighborhood social cohesion, markers of territoriality (e.g., no trespassing signs), membership in church or civic organization, volunteerism, neighbors’ evacuation, and longer length of residence were associated with reduced hurricane evacuation. Differential levels of social capital, social cohesion, and related social factors contributed to differential rates of evacuation from Hurricane Isabel. Those who reported closer relationships with neighbors and were active volunteers in the community may be more susceptible to evacuation failure and should receive targeted messages regarding evacuation from officials

Coastal Ecosystems and Tsunami Protection after the December 2004 Indian Ocean Tsunami

An exploratory study was conducted on the role of coastal ecosystems in protecting communities from the December 2004 Indian Ocean tsunami, focusing on mangrove forests on the Andaman coast of Thailand and how well villages were undertaking environmental conservation. Remote sensing analysis identified predisaster mangrove change and postdisaster structural damage and landscape changes. Field data from five sites (20 villages), gathered via the VIEWS (TM) data collection system, validated and supplemented this analysis. Key informants at several of these villages were also interviewed. A preliminary comparison of villages that otherwise faced similar tsunami exposure suggests that the presence of healthy mangroves did afford substantial protection. Village performance in mangrove conservation and management efforts, and thus the presence of healthy forests, is influenced by both social capital and the design of external aid delivery programs

Planning for Sustainability in Small Municipalities: The Influence of Interest Groups, Growth Patterns, and Institutional Characteristics

How and why small municipalities promote sustainability through planning efforts is poorly understood. We analyzed ordinances in 451 Maine municipalities and tested theories of policy adoption using regression analysis.We found that smaller communities do adopt programs that contribute to sustainability relevant to their scale and context. In line with the political market theory, we found that municipalities with strong environmental interests, higher growth, and more formal governments were more likely to adopt these policies. Consideration of context and capacity in planning for sustainability will help planners better identify and benefit from collaboration, training, and outreach opportunities

Impact of opioid-free analgesia on pain severity and patient satisfaction after discharge from surgery: multispecialty, prospective cohort study in 25 countries

Background: Balancing opioid stewardship and the need for adequate analgesia following discharge after surgery is challenging. This study aimed to compare the outcomes for patients discharged with opioid versus opioid-free analgesia after common surgical procedures.Methods: This international, multicentre, prospective cohort study collected data from patients undergoing common acute and elective general surgical, urological, gynaecological, and orthopaedic procedures. The primary outcomes were patient-reported time in severe pain measured on a numerical analogue scale from 0 to 100% and patient-reported satisfaction with pain relief during the first week following discharge. Data were collected by in-hospital chart review and patient telephone interview 1 week after discharge.Results: The study recruited 4273 patients from 144 centres in 25 countries; 1311 patients (30.7%) were prescribed opioid analgesia at discharge. Patients reported being in severe pain for 10 (i.q.r. 1-30)% of the first week after discharge and rated satisfaction with analgesia as 90 (i.q.r. 80-100) of 100. After adjustment for confounders, opioid analgesia on discharge was independently associated with increased pain severity (risk ratio 1.52, 95% c.i. 1.31 to 1.76; P < 0.001) and re-presentation to healthcare providers owing to side-effects of medication (OR 2.38, 95% c.i. 1.36 to 4.17; P = 0.004), but not with satisfaction with analgesia (beta coefficient 0.92, 95% c.i. -1.52 to 3.36; P = 0.468) compared with opioid-free analgesia. Although opioid prescribing varied greatly between high-income and low- and middle-income countries, patient-reported outcomes did not.Conclusion: Opioid analgesia prescription on surgical discharge is associated with a higher risk of re-presentation owing to side-effects of medication and increased patient-reported pain, but not with changes in patient-reported satisfaction. Opioid-free discharge analgesia should be adopted routinely

Plan integration for resilience scorecard: evaluating networks of plans in six US coastal cities

<p>Planning for hazard mitigation is frequently detached from other planning activities that influence development patterns in hazardous areas. Consistent integration of mitigation reduces hazard vulnerability for people and the built environment. We apply a plan integration for resilience scorecard in six US coastal cities to evaluate the integration of local networks of plans and the degree to which they target areas most vulnerable to flooding hazards. We find that plan integration scores vary widely across the six cities, and that some plans actually increase vulnerability in hazard zones. Policies also frequently support mitigation in areas with low vulnerability, rather than in areas with high vulnerability. The plan integration for resilience scorecard can generate information to improve hazard planning by allowing planners to identify conflicts between plans, assess whether plans target areas that are most vulnerable, and better inform decision makers about opportunities to mainstream mitigation into multiple sectors of planning.</p