The Eco-Techno Spectrum: Exploring Knowledge Systems\u27 Challenges in Green Infrastructure Management

Infrastructure crises are not only technical problems for engineers to solve—they also present social, ecological, financial, and political challenges. Addressing infrastructure problems thus requires a robust planning process that includes examination of the social and ecological systems supporting infrastructure, alongside technical systems. An integrative Social, Ecological, and Technological Systems (SETS) analysis of infrastructure solutions can complement the planning process by revealing potential trade-offs that are often overlooked in standard procedures. We explore the interconnected SETS of the infrastructure problem in the US through comparative case studies of green infrastructure (GI) development in Portland and Baltimore. Currently a popular infrastructure solution to a wide variety of urban ills, GI is the use and mimicry of ecological components (e.g., plants) to perform municipal services (e.g., stormwater management). We develop the ecological-technological spectrum—or ‘eco-techno spectrum’—as a framing tool to bridge all three SETS dimensions. The eco-techno spectrum becomes a platform to explore the institutional knowledge system dynamics of GI development where social dimensions are organized across ecological and technological aspects of GI, exposing how governance differs across specific forms of ecological and technological hybridity. In this study, we highlight the knowledge system challenges of urban planning institutions as a key consideration in the realization of innovative infrastructure crisis ‘fixes.’ Disconnected definition and measurement of GI emerge as two distinct challenges across the knowledge systems examined. By revealing and discussing these challenges, we can begin to recognize—and better plan for—gaps in municipal planning knowledge systems, promoting decisions that address the roots of infrastructure crises rather than treating only their symptoms

Pilot project purgatory? Assessing automated vehicle pilot projects in U.S. cities

Pilot projects have emerged in cities globally as a way to experiment with the utilization of a suite of smart mobility and emerging transportation technologies. Automated vehicles (AVs) have become central tools for such projects as city governments and industry explore the use and impact of this emerging technology. This paper presents a large-scale assessment of AV pilot projects in U.S. cities to understand how pilot projects are being used to examine the risks and benefits of AVs, how cities integrate these potentially transformative technologies into conventional policy and planning, and how and what they are learning about this technology and its future opportunities and risks. Through interviews with planning practitioners and document analysis, we demonstrate that the approaches cities take for AVs differ significantly, and often lack coherent policy goals. Key findings from this research include: (1) a disconnect between the goals of the pilot projects and a city’s transportation goals; (2) cities generally lack a long-term vision for how AVs fit into future mobility systems and how they might help address transportation goals; (3) an overemphasis of non-transportation benefits of AV pilots projects; (4) AV pilot projects exhibit a lack of policy learning and iteration; and (5) cities are not leveraging pilot projects for public benefits. Overall, urban and transportation planners and decision makers show a clear interest to discover how AVs can be used to address transportation challenges in their communities, but our research shows that while AV pilot projects purport to do this, while having numerous outcomes, they have limited value for informing transportation policy and planning questions around AVs. We also find that AV pilot projects, as presently structured, may constrain planners’ ability to re-think transportation systems within the context of rapid technological change

Pilot project purgatory? Assessing automated vehicle pilot projects in US cities

Pilot projects have emerged in cities globally as a way to experiment with the utilization of a suite of smart mobility and emerging transportation technologies. Automated vehicles (AVs) have become central tools for such projects as city governments and industry explore the use and impact of this emerging technology. This paper presents a large-scale assessment of AV pilot projects in U.S. cities to understand how pilot projects are being used to examine the risks and benefits of AVs, how cities integrate these potentially transformative technologies into conventional policy and planning, and how and what they are learning about this technology and its future opportunities and risks. Through interviews with planning practitioners and document analysis, we demonstrate that the approaches cities take for AVs differ significantly, and often lack coherent policy goals. Key findings from this research include: (1) a disconnect between the goals of the pilot projects and a city\u27s transportation goals; (2) cities generally lack a long-term vision for how AVs fit into future mobility systems and how they might help address transportation goals; (3) an overemphasis of non-transportation benefits of AV pilots projects; (4) AV pilot projects exhibit a lack of policy learning and iteration; and (5) cities are not leveraging pilot projects for public benefits. Overall, urban and transportation planners and decision makers show a clear interest to discover how AVs can be used to address transportation challenges in their communities, but our research shows that while AV pilot projects purport to do this, while having numerous outcomes, they have limited value for informing transportation policy and planning questions around AVs. We also find that AV pilot projects, as presently structured, may constrain planners\u27 ability to re-think transportation systems within the context of rapid technological change

Subsidizing Religious Participation through Groups: A Model of the “Megachurch” Strategy for Growth

Either despite or because of their non-traditional approach, megachurches have grown significantly in the United States since 1980. This paper models religious participation as an imperfect public good which, absent intervention, yields suboptimal participation by members from the church’s perspective. Megachurches address this problem in part by employing secular-based group activities to subsidize religious participation that then translates into an increase in the attendees’ religious investment. This strategy not only allows megachurches to attract and retain new members when many traditional churches are losing members but also results in higher levels of an individual’s religious capital. As a result, the megachurch may raise expectations of members’ levels of commitment and faith practices. Data from the FACT2000 survey provide evidence that megachurches employ groups more extensively than other churches, and this approach is consistent with a strategy to use groups to help subsidize individuals’ religious investment. Religious capital rises among members of megachurches relative to members of non-megachurches as a result of this strategy

A screen of Crohn's disease-associated microbial metabolites identifies ascorbate as a novel metabolic inhibitor of activated human T cells.

Microbial metabolites are an emerging class of mediators influencing CD4+ T-cell function. To advance the understanding of direct causal microbial factors contributing to Crohn's disease, we screened 139 predicted Crohn's disease-associated microbial metabolites for their bioactivity on human CD4+ T-cell functions induced by disease-associated T helper 17 (Th17) polarizing conditions. We observed 15 metabolites with CD4+ T-cell bioactivity, 3 previously reported, and 12 unprecedented. A deeper investigation of the microbe-derived metabolite, ascorbate, revealed its selective inhibition on activated human CD4+ effector T cells, including IL-17A-, IL-4-, and IFNγ-producing cells. Mechanistic assessment suggested the apoptosis of activated human CD4+ T cells associated with selective inhibition of energy metabolism. These findings suggest a substantial rate of relevant T-cell bioactivity among Crohn's disease-associated microbial metabolites, and evidence for novel modes of bioactivity, including targeting of T-cell energy metabolism

Personal and Societal Health Quality Lost to Tuberculosis

BACKGROUND: In developed countries, tuberculosis is considered a disease with little loss of Quality-Adjusted Life Years (QALYs). Tuberculosis treatment is predominantly ambulatory and death from tuberculosis is rare. Research has shown that there are chronic pulmonary sequelae in a majority of patients who have completed treatment for pulmonary tuberculosis (PTB). This and other health effects of tuberculosis have not been considered in QALY calculations. Consequently both the burden of tuberculosis on the individual and the value of tuberculosis prevention to society are underestimated. We estimated QALYs lost to pulmonary TB patients from all known sources, and estimated health loss to prevalent TB disease. METHODOLOGY/PRINCIPAL FINDINGS: We calculated values for health during illness and treatment, pulmonary impairment after tuberculosis (PIAT), death rates, years-of-life-lost to death, and normal population health. We then compared the lifetime expected QALYs for a cohort of tuberculosis patients with that expected for comparison populations with latent tuberculosis infection and without tuberculosis infection. Persons with culture-confirmed tuberculosis accrued fewer lifetime QALYs than those without tuberculosis. Acute tuberculosis morbidity cost 0.046 QALYs (4% of total) per individual. Chronic morbidity accounted for an average of 0.96 QALYs (78% of total). Mortality accounted for 0.22 QALYs lost (18% of total). The net benefit to society of averting one case of PTB was about 1.4 QALYs. CONCLUSIONS/SIGNIFICANCE: Tuberculosis, a preventable disease, results in QALYs lost owing to illness, impairment, and death. The majority of QALYs lost from tuberculosis resulted from impairment after microbiologic cure. Successful TB prevention efforts yield more health quality than previously thought and should be given high priority by health policy makers. (Refer to Abstracto S1 for Spanish language abstract)

A social-ecological-technological systems framework for urban ecosystem services

As rates of urbanization and climatic change soar, decision-makers are increasingly challenged to provide innovative solutions that simultaneously address climate-change impacts and risks and inclusively ensure quality of life for urban residents. Cities have turned to nature-based solutions to help address these challenges. Nature-based solutions, through the provision of ecosystem services, can yield numerous benefits for people and address multiple challenges simultaneously. Yet, efforts to mainstream nature-based solutions are impaired by the complexity of the interacting social, ecological, and technological dimensions of urban systems. This complexity must be understood and managed to ensure ecosystem-service provisioning is effective, equitable, and resilient. Here, we provide a social-ecological-technological system (SETS) framework that builds on decades of urban ecosystem services research to better understand four core challenges associated with urban nature-based solutions: multi-functionality, systemic valuation, scale mismatch of ecosystem services, and inequity and injustice. The framework illustrates the importance of coordinating natural, technological, and socio-economic systems when designing, planning, and managing urban nature-based solutions to enable optimal social-ecological outcomes

Non-hispanic whites have higher risk for pulmonary impairment from pulmonary tuberculosis

<p>Abstract</p> <p>Background</p> <p>Disparities in outcomes associated with race and ethnicity are well documented for many diseases and patient populations. Tuberculosis (TB) disproportionately affects economically disadvantaged, racial and ethnic minority populations. Pulmonary impairment after tuberculosis (PIAT) contributes heavily to the societal burden of TB. Individual impacts associated with PIAT may vary by race/ethnicity or socioeconomic status.</p> <p>Methods</p> <p>We analyzed the pulmonary function of 320 prospectively identified patients with pulmonary tuberculosis who had completed at least 20 weeks standard anti-TB regimes by directly observed therapy. We compared frequency and severity of spirometry-defined PIAT in groups stratified by demographics, pulmonary risk factors, and race/ethnicity, and examined clinical correlates to pulmonary function deficits.</p> <p>Results</p> <p>Pulmonary impairment after tuberculosis was identified in 71% of non-Hispanic Whites, 58% of non-Hispanic Blacks, 49% of Asians and 32% of Hispanics (<it>p </it>< 0.001). Predictors for PIAT varied between race/ethnicity. PIAT was evenly distributed across all levels of socioeconomic status suggesting that PIAT and socioeconomic status are not related. PIAT and its severity were significantly associated with abnormal chest x-ray, <it>p </it>< 0.0001. There was no association between race/ethnicity and time to beginning TB treatment, <it>p </it>= 0.978.</p> <p>Conclusions</p> <p>Despite controlling for cigarette smoking, socioeconomic status and time to beginning TB treatment, non-Hispanic White race/ethnicity remained an independent predictor for disproportionately frequent and severe pulmonary impairment after tuberculosis relative to other race/ethnic groups. Since race/ethnicity was self reported and that race is not a biological construct: these findings must be interpreted with caution. However, because race/ethnicity is a proxy for several other unmeasured host, pathogen or environment factors that may contribute to disparate health outcomes, these results are meant to suggest hypotheses for further research.</p

Addressing disparities in maternal health care in Pakistan: gender, class and exclusion

Background: After more than two decades of the Safe Motherhood Initiative and Millennium Development Goals aimed at reducing maternal mortality, women continue to die in childbirth at unacceptably high rates in Pakistan. While an extensive literature describes various programmatic strategies, it neglects the rigorous analysis of the reasons these strategies have been unsuccessful, especially for women living at the economic and social margins of society. A critical gap in current knowledge is a detailed understanding of the root causes of disparities in maternal health care, and in particular, how gender and class influence policy formulation and the design and delivery of maternal health care services. Taking Pakistan as a case study, this research builds upon two distinct yet interlinked conceptual approaches to understanding the phenomenon of inequity in access to maternal health care: social exclusion and health systems as social institutions. Methods/Design: This four year project consists of two interrelated modules that focus on two distinct groups of participants: (1) poor, disadvantaged women and men and (2) policy makers, program managers and health service providers. Module one will employ critical ethnography to understand the key axes of social exclusion as related to gender, class and zaat and how they affect women’s experiences of using maternal health care. Through health care setting observations, interviews and document review, Module two will assess policy design and delivery of maternal health services. Discussion: This research will provide theoretical advances to enhance understanding of the power dynamics of gender and class that may underlie poor women’s marginalization from health care systems in Pakistan. It will also provide empirical evidence to support formulation of maternal health care policies and health care system practices aimed at reducing disparities in maternal health care in Pakistan. Lastly, it will enhance inter-disciplinary research capacity in the emerging field of social exclusion and maternal health and help reduce social inequities and achieve the Millennium Development Goal No. 5