The Air-temperature Response to Green/blue-infrastructure Evaluation Tool (TARGET v1.0) : an efficient and user-friendly model of city cooling

The adverse impacts of urban heat and global climate change are leading policymakers to consider green and blue infrastructure (GBI) for heat mitigation benefits. Though many models exist to evaluate the cooling impacts of GBI, their complexity and computational demand leaves most of them largely inaccessible to those without specialist expertise and computing facilities. Here a new model called The Air-temperature Response to Green/blue-infrastructure Evaluation Tool (TARGET) is presented. TARGET is designed to be efficient and easy to use, with fewer user-defined parameters and less model input data required than other urban climate models. TARGET can be used to model average street-level air temperature at canyon-to-block scales (e.g. 100 m resolution), meaning it can be used to assess temperature impacts of suburb-to-city-scale GBI proposals. The model aims to balance realistic representation of physical processes and computation efficiency. An evaluation against two different datasets shows that TARGET can reproduce the magnitude and patterns of both air temperature and surface temperature within suburban environments. To demonstrate the utility of the model for planners and policymakers, the results from two precinct-scale heat mitigation scenarios are presented. TARGET is available to the public, and ongoing development, including a graphical user interface, is planned for future work

The 'Paris-end' of town? Urban typology through machine learning

The confluence of recent advances in availability of geospatial information, computing power, and artificial intelligence offers new opportunities to understand how and where our cities differ or are alike. Departing from a traditional `top-down' analysis of urban design features, this project analyses millions of images of urban form (consisting of street view, satellite imagery, and street maps) to find shared characteristics. A (novel) neural network-based framework is trained with imagery from the largest 1692 cities in the world and the resulting models are used to compare within-city locations from Melbourne and Sydney to determine the closest connections between these areas and their international comparators. This work demonstrates a new, consistent, and objective method to begin to understand the relationship between cities and their health, transport, and environmental consequences of their design. The results show specific advantages and disadvantages using each type of imagery. Neural networks trained with map imagery will be highly influenced by the mix of roads, public transport, and green and blue space as well as the structure of these elements. The colours of natural and built features stand out as dominant characteristics in satellite imagery. The use of street view imagery will emphasise the features of a human scaled visual geography of streetscapes. Finally, and perhaps most importantly, this research also answers the age-old question, ``Is there really a `Paris-end' to your city?''

Identifying safe intersection design through unsupervised feature extraction from satellite imagery

The World Health Organization has listed the design of safer intersections as a key intervention to reduce global road trauma. This article presents the first study to systematically analyze the design of all intersections in a large country, based on aerial imagery and deep learning. Approximately 900,000 satellite images were downloaded for all intersections in Australia and customized computer vision techniques emphasized the road infrastructure. A deep autoencoder extracted high-level features, including the intersection's type, size, shape, lane markings, and complexity, which were used to cluster similar designs. An Australian telematics data set linked infrastructure design to driving behaviors captured during 66 million kilometers of driving. This showed more frequent hard acceleration events (per vehicle) at four- than three-way intersections, relatively low hard deceleration frequencies at T-intersections, and consistently low average speeds on roundabouts. Overall, domain-specific feature extraction enabled the identification of infrastructure improvements that could result in safer driving behaviors, potentially reducing road trauma.Comment: 16 pages, 10 figures. Computer-Aided Civil and Infrastructure Engineering (2020

An urban ecohydrological model to quantify the effect of vegetation on urban climate and hydrology (UT&C v1.0)

Increasing urbanization is likely to intensify the urban heat island effect, decrease outdoor thermal comfort and enhance runoff generation in cities. Urban green spaces are often proposed as a mitigation strategy to counteract these adverse effects and many recent developments of urban climate models focus on the inclusion of green and blue infrastructure to inform urban planning. However, many models still lack the ability to account for different plant types and oversimplify the interactions between the built environment, vegetation, and hydrology. In this study, we present an urban ecohydrological model, Urban Tethys-Chloris (UT&C), that combines principles of ecosystem modelling with an urban canopy scheme accounting for the biophysical and ecophysiological characteristics of roof vegetation, ground vegetation and urban trees. UT&C is a fully coupled energy and water balance model that calculates 2 m air temperature, 2 m humidity, and surface temperatures based on the infinite urban canyon approach. It further calculates all urban hydrological fluxes, including transpiration as a function of plant photosynthesis. Hence, UT&C accounts for the effects of different plant types on the urban climate and hydrology, as well as the effects of the urban environment on plant well-being and performance. UT&C performs well when compared against energy flux measurements of eddy covariance towers located in three cities in different climates (Singapore, Melbourne, Phoenix). A sensitivity analysis, performed as a proof of concept for the city of Singapore, shows a mean decrease in 2 m air temperature of 1.1 °C for fully grass covered ground, 0.2 °C for high values of leaf area index (LAI), and 0.3 °C for high values of Vc,max (an expression of photosynthetic activity). These reductions in temperature were combined with a simultaneous increase in relative humidity by 6.5 %, 2.1 %, and 1.6 %, for fully grass covered ground, high values of LAI, and high values of Vc,max, respectively. Furthermore, the increase of pervious vegetated ground is able to significantly reduce surface runoff. These results show that urban greening can lead to a decrease in urban air temperature and surface runoff, but this effect is limited in cities characterized by a hot, humid climate.ISSN:1991-962XISSN:1991-961

A qualitative feasibility study to inform a randomised controlled trial of fluid bolus therapy in septic shock

© Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. Objective The Fluids in Shock (FiSh) Trial proposes to evaluate whether restrictive fluid bolus therapy (10 mL/ kg) is more beneficial than current recommended practice (20 mL/kg) in the resuscitation of children with septic shock in the UK. This qualitative feasibility study aimed to explore acceptability of the FiSh Trial, including research without prior consent (RWPC), potential barriers to recruitment and participant information for a pilot trial. Design Qualitative interview study involving parents of children who had presented to a UK emergency department or been admitted to a paediatric intensive care unit with severe infection in the previous 3 years. Participants Twenty-one parents (seven bereaved) were interviewed 16 (median) months since their child’s hospital admission (range: 1–41). results All parents said they would have provided consent for the use of their child’s data in the FiSh Trial. The majority were unfamiliar with RWPC, yet supported its use. Parents were initially concerned about the change from currently recommended treatment, yet were reassured by explanations of the current evidence base, fluid bolus therapy and monitoring procedures. Parents made recommendations about the timing of the research discussion and content of participant information. Bereaved parents stated that recruiters should not discuss research immediately after a child’s death, but supported a personalised postal’opt-out’ approach to consent. conclusions Findings show that parents whose child has experienced severe infection supported the proposed FiSh Trial, including the use of RWPC. Parents’ views informed the development of the pilot trial protocol and site staff training. trial registration number ISRCTN15244462—results

Maternal obesity support services: a qualitative study of the perspectives of women and midwives

Background - Twenty percent of pregnant women in the UK are obese (BMI ≥ 30 kg/m2), reflecting the growing public health challenge of obesity in the 21st century. Obesity increases the risk of adverse outcomes during pregnancy and birth and has significant cost implications for maternity services. Gestational weight management strategies are a high priority; however the evidence for effective, feasible and acceptable weight control interventions is limited and inconclusive. This qualitative study explored the experiences and perceptions of pregnant women and midwives regarding existing support for weight management in pregnancy and their ideas for service development. Methods - A purposive sample of 6 women and 7 midwives from Doncaster, UK, participated in two separate focus groups. Transcripts were analysed thematically. Results - Two overarching themes were identified, 'Explanations for obesity and weight management' and 'Best care for pregnant women'. 'Explanations' included a lack of knowledge about weight, diet and exercise during pregnancy; self-talk messages which excused overeating; difficulties maintaining motivation for a healthy lifestyle; the importance of social support; stigmatisation; and sensitivity surrounding communication about obesity between midwives and their clients. 'Best care' suggested that weight management required care which was consistent and continuous, supportive and non-judgemental, and which created opportunities for interaction and mutual support between obese pregnant women. Conclusions - Women need unambiguous advice regarding healthy lifestyles, diet and exercise in pregnancy to address a lack of knowledge and a tendency towards unhelpful self-talk messages. Midwives expressed difficulties in communicating with their clients about their weight, given awareness that obesity is a sensitive and potentially stigmatising issue. This indicates more could be done to educate and support them in their work with obese pregnant women. Motivation and social support were strong explanatory themes for obesity and weight management, suggesting that interventions should focus on motivational strategies and social support facilitation

Clinical audit of foot problems in patients with rheumatoid arthritis treated at Counties Manukau District Health Board, Auckland, New Zealand

<p>Abstract</p> <p>Background</p> <p>At diagnosis, 16% of rheumatoid arthritis (RA) patients may have foot joint involvement, increasing to 90% as disease duration increases. This can lead to joint instability, difficulties in walking and limitation in functional ability that restricts activities of daily living. The podiatrist plays an important role in the multidisciplinary team approach to the management of foot problems. The aim of this study was to undertake a clinical audit of foot problems in patients with RA treated at Counties Manukau District Health Board.</p> <p>Methods</p> <p>Patients with RA were identified through rheumatological clinics run within CMDHB. 100 patients were eligible for inclusion. Specific foot outcome tools were used to evaluate pain, disability and function. Observation on foot lesions were noted and previous history of foot assessment, footwear/insoles and foot surgery were evaluated.</p> <p>Results</p> <p>The median age of the cohort was 60 (IQR: 51–64) years old with median disease duration of 15 (IQR: 7.3–25) years. Over 85% presented with foot lesions that included corns and callus over the forefoot region and lesser toe deformities. Moderate to high disability was noted. High levels of forefoot structural damage were observed. 76% had not seen a podiatrist and 77% reported no previous formal foot assessment. 40% had been seen at the orthotic centre for specialised footwear and insoles. 27% of RA patients reported previous foot surgery. A large proportion of patients wore inappropriate footwear.</p> <p>Conclusion</p> <p>This clinical audit suggests that the majority of RA patients suffer from foot problems. Future recommendations include the provision of a podiatrist within the current CMDHB multidisciplinary rheumatology team to ensure better services for RA patients with foot problems.</p