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Encouraging sustainable mobility through sidewalk condition improvement is a critical concern for urban transportation. Sidewalk condition affects pedestrian safety, satisfaction, and mobility inclusiveness. Early sidewalk defect detection and repair ensure transport justice by addressing pedestrian inequality caused by walkability issues. This study presents novel Sidewalk Defect Detection Models (SDDMs) using computer vision to identify and delineate sidewalk defect boundaries accurately. The SDDMs provide a cost‐effective and efficient sidewalk inspection method, achieving high accuracy in recognizing defects for concrete and brick materials (mIoU of 0.91 and mAP of 0.99 for concrete, mIoU of 0.90, and mAP of 0.97 for brick). Integrated with Google Street View for data acquisition, it offers a rapid solution for monitoring sidewalk conditions remotely, promoting sustainability through timely repairs. This research provides significant advancements in urban planning and transport research, ultimately improving pedestrian safety and satisfaction. Thus, it makes human settlements more inclusive, safe, and sustainable. [ABSTRACT FROM AUTHOR]

Aims: This study aimed to investigate the association between the time to achieve walkability after cardiac surgery and the risk of cardiovascular disease after hospital discharge. Methods: We conducted a prospective cohort study involving 553 ambulatory patients aged 71.5 (range, 64.0–77.0) years who underwent cardiac surgery. All patients were divided into five groups based on the time to achieve walkability ≥100 m within 1, 2, 3, 4 or 5 days after cardiac surgery. We examined the risk of post‐cardiovascular disease outcomes, including readmission due to heart failure, ischaemic heart disease and other cardiovascular disease, according to the time to achieve walkability with reference to 5 days using the Fine and Gray regression model, considering competing risks. Results: In the survival curve analysis, we examined the time to experience post‐cardiovascular disease incidence after hospital discharge. During a median of 3.3 years of follow‐up, 118 patients developed cardiovascular disease. We observed a positive association between the time to achieve walkability and cardiovascular disease risk, particularly heart failure. The multivariate hazard ratios (95% confidence intervals) for heart failure readmission were N/A (not assessed due to the sample size being too small) for 1 day, 0.31 (0.10–0.99) for 2 days, 0.60 (0.21–1.79) for 3 days and 0.76 (0.22–2.72) for 4 days (P for trend = 0.032). Conclusions: The shorter walkability achievement time was associated with a lower risk of cardiovascular diseases, more specifically heart failure readmission, among patients who underwent cardiac surgery. The time required to achieve walkability is a useful predictor for cardiovascular diseases after hospital discharge. [ABSTRACT FROM AUTHOR]

Aim: To examine associations of neighborhood greenery, air pollution and walkability with cardiometabolic disease in adults aged ≥45 years in the Frankston–Mornington Peninsula region, Victoria, Australia. Methods: A cross‐sectional, ecological study design was used. We assessed mean annual neighborhood greenery using the Normalized Difference Vegetation Index; air pollution (fine particulate matter of diameter ≤2.5 μm [PM2.5] and NO2) using land‐use regression models; and walkability using Walk Score (possible values 0–100). Medically diagnosed diabetes (~95% type‐2), heart disease and stroke were self‐reported in the Australian Census (2021). Multivariable regression was used to model associations between environmental exposures and area‐level (neighborhood) cardiometabolic disease prevalence (age group ≥45 years), with socioeconomic status, age and sex as covariates. Air pollution was examined as a mediator of associations between greenery and disease prevalence. Results: Our sample comprised 699 neighborhoods with the following mean (SD) values: Normalized Difference Vegetation Index 0.47 (0.09), PM2.5, 8.5 (0.6) μg/m3 and NO2, 5.2 (1.6) ppb. Disease prevalences were: heart disease, mean 8.9% (4.5%); diabetes, mean 10.3% (4.7%); and stroke, median 1.2% (range 0–10.9%). Greenery was negatively associated with diabetes (β = −5.85, 95% CI −9.53, −2.17) and stroke prevalence (β = −1.26, 95% CI −2.11, −0.42). PM2.5 and NO2 were positively associated with diabetes (β = 1.59, 95% CI 1.00, 2.18; β = 0.42, 95% CI 0.22, 0.62) and stroke prevalence (β = 0.15, 95% CI 0.01, 0.29; β = 0.06, 95% CI 0.01, 0.10). The association between greenery and diabetes was partially mediated by PM2.5 (mediated effect −5.38, 95% CI −7.84, −3.03). Conclusions: Greenery and air pollutants were associated with lower and higher prevalence, respectively, of self‐reported diabetes and, to a lesser extent, stroke. These ecological findings require further exploration with stronger, longitudinal study designs to inform public health policy and directions. Geriatr Gerontol Int 2024; 24: 208–214. [ABSTRACT FROM AUTHOR]

The article is a critical review of the literature investigating the impact suburbanization has had since the mid‐20th century on the downtowns of Canadian mid‐size cities and the strategies deployed to revitalize these districts. It demonstrates that large city downtowns are more likely than their mid‐size city counterparts to enjoy conditions favourable to their success, hence the need to devise revitalization efforts tailored to the reality of mid‐size city downtowns. The article identifies revitalization strategies adopted over the last decades, which mostly failed to reverse the decline affecting these downtowns. It then concentrates on the present, and likely enduring, revitalization model, which emphasizes hospitality, recreation, culture, services, and walkability. The article refines the understanding of the differences between mid‐size and large city downtowns by concentrating on their specific dynamics and explores future revitalization options for mid‐size city downtowns. It discusses the present and likely enduring absence of alternatives to the present revitalization model and highlights its equity downsides as it challenges the downtown low‐income resident living environment. Key messages: There are important differences between large city and mid‐size city downtowns accounting for the need for adapted revitalization strategies.Few mid‐size city downtown revitalization efforts have been successful.There is a consensus, likely to endure, around the presently dominant revitalization model, which comes with downsides. [ABSTRACT FROM AUTHOR]

Summary: Background: Neighbourhood factors are associated with cardiovascular health in adults, but these relationships are under‐explored in youth. Objectives: To characterize the associations between neighbourhood factors and child and adolescent health among youth with obesity. Methods: Data were drawn from patient health records at a pediatric weight management clinic (n = 2838) and the Child Opportunity Index (COI). Exposures were area‐level neighbourhood factors (commute duration, walkability, greenspace and industrial pollutants). Outcomes included BMI relative to the 95th percentile (BMIp95) and blood pressure (continuous variables). Longitudinal models examined associations between COI indicators and outcomes. Results: Shorter commute duration (β = −4.31, 95% CI: −5.92, −2.71) and greater walkability (β = −4.40, 95% CI: −5.98, −2.82) were negatively associated with BMIp95. Increased greenspace availability was positively associated with BMIp95 (β = 1.93, 95% CI: 0.19, 3.67). None of the COI indicators were associated with cardiovascular outcomes in the full sample. Analyses stratified by sex and race/ethnicity showed similar patterns for BMIp95. For commute duration, there was a negative association with blood pressure for female, non‐Hispanic White and other race/ethnicity youth. Conclusions: Neighbourhood factors should be considered as contextual factors when treating youth with obesity. Additional research is needed to understand the relationship between neighbourhood factors and cardiovascular outcomes. [ABSTRACT FROM AUTHOR]

Background: We investigated the association of neighborhood walkability with accelerometer‐measured physical activity (PA) and sedentary behavior (SB) and examined whether objective and subjective measures of walkability resulted in similar findings. Methods: PA and SB from the first 7689 Maastricht Study participants ages 40–75 from 2010 to 2017 were measured using accelerometers for 7 days. Mean daily step count, light‐intensity PA, moderate‐ to vigorous‐ intensity PA (MVPA), and SB were calculated. Objective walkability was measured by the 7‐component Dutch Walkability Index within 500 m Euclidean buffers around residential addresses of participants. Subjective walkability was obtained from the Abbreviated Neighborhood Environment Walkability Scale. Linear regression models analyzed the associations of walkability with PA and SB, controlling for potential confounders. Results: Objective walkability was negatively associated with light intensity PA in the most walkable quartile (b = −14.58, 95% CI = −20.94, −8.23). Compared to participants living in the least walkable neighborhoods, those in the most walkable quartile had statistically significantly higher SB levels (b = 11.64, 95% CI = 4.95, 18.32). For subjective walkability, mean daily step count was significantly higher in the most walkable quartile (b = 509.60, 95% CI = 243.38, 775.81). Higher subjective walkability was positively associated with MVPA (b = 4.40, 95% CI = 2.56, 6.23). Conclusion: Living in a neighborhood with higher objective walkability was associated with lower levels of PA and higher SB levels while higher subjective walkability was associated with higher levels of PA. These results show discordant findings and thus, the effect of walkability on participant PA and SB within our sample is to be determined. [ABSTRACT FROM AUTHOR]

Objective: To examine if income inequality, social cohesion, and neighborhood walkability are associated with physical activity among rural adults. Data Source: Cross‐sectional data came from a telephone survey (August 2020–March 2021) that examined food access, physical activity, and neighborhood environments across rural counties in a southeastern state. Study Design: Multinomial logistic regression models assessed the likelihood of being active versus inactive and insufficiently active versus inactive in this rural population. Coefficients are presented as relative risk ratios (RRRs). Statistical significance was determined using 95% confidence intervals (CIs). All analyses were performed in STATA 16.1. Data Collection/Extraction Methods: Trained university students administered the survey. Students verbally obtained consent, read survey items, and recorded responses into Qualtrics software. Upon survey completion, respondents were mailed a $10 incentive card and printed informed consent form. Eligible participants were ≥18 years old and current residents of included counties. Principal Findings: Respondents in neighborhoods with relatively high social cohesion versus low social cohesion were more likely to be active than inactive (RRR = 2.50, 95% CI: 1.27–4.90, p < 0.01), after accounting for all other variables in the model. Income inequality and neighborhood walkability were not associated with different levels of physical activity in the rural sample. Conclusions: Study findings contribute to limited knowledge on the relationship between neighborhood environmental contexts and physical activity among rural populations. The health effects of neighborhood social cohesion warrant more attention in health equity research and consideration when developing multilevel interventions to improve the health of rural populations. [ABSTRACT FROM AUTHOR]

Walking School Bus (WSB) has been recognised as an innovative solution to promote walking to school, bringing a wide spectrum of benefits, including: health benefits from the physical exercise, social skills and traffic reduction. To facilitate the success of WSB, one vital element is its route planning, which directly affects the catchment for the service and the realisation of all the potential benefits. Previously, time has been the only factor that has been considered in WSB routing problems. Other important factors including air quality, safety and comfort will also be considered in this paper. Air quality along a WSB route is important to help realise the health benefits of walking. Traffic safety has been the biggest barrier to walking to school and must be addressed in planning a WSB route. Ensuring children have an enjoyable and comfortable experience is vital for the sustainability and success of WSB. A walking network is introduced to enable modelling pedestrian movements in detail, including walking movements on different sides of the road and crossing movements. This approach enables detailed route‐based analysis to assess the localised effect of air quality on pollutant dose. We define walkability as a measure of children's needs in safety and comfort, which can also be assessed in detail on each route. We propose a multi‐objective optimisation model to generate efficient WSB routes with three objectives representing the potential benefits of WSB: (1) to minimise time; (2) to minimise pollutant dose; and (3) to maximise walkability. We apply our model to a selected school in Bradford in the UK, generating three WSB lines following efficient routes. These lines go through a predetermined sequence of 'WSB Stops', with the final stop as the school. All children within the catchment area will be able to join a WSB within 1–2 min walk from their home to the nearest stop. Our multi‐objective WSB route planning model is highly transferable to any selected school in any WSB targeted area. Planners will be able to select a combination of WSB lines to offer, based on the requirement of coverage area and resource availability. [ABSTRACT FROM AUTHOR]

Background: Despite the links between neighbourhood walkability and physical activity, body size and risk of diabetes, there are few studies of neighbourhood walkability and risk of gestational diabetes (GD). Objectives: Assess whether higher neighbourhood walkability is associated with lower risk of GD in New York City (NYC). Methods: Cross‐sectional analyses of a neighbourhood walkability index (NWI) score and density of walkable destinations (DWD) and risk of GD in 109,863 births recorded in NYC in 2015. NWI and DWD were measured for the land area of 1 km radius circles around the geographic centroid of each Census block of residence. Mixed generalised linear models, with robust standard error estimation and random intercepts for NYC Community Districts, were used to estimate risk ratios for GD for increasing quartiles of each of the neighbourhood walkability measures after adjustment for the pregnant individual's age, race and ethnicity, parity, education, nativity, and marital status and the neighbourhood poverty rate. Results: Overall, 7.5% of pregnant individuals experienced GD. Risk of GD decreased across increasing quartiles of NWI, with an adjusted risk ratio of 0.81 (95% Confidence Interval (CI) 0.75, 0.87) comparing those living in areas in the 4th quartile of NWI to those in the first quartile. Similarly, for comparisons of the 4th to 1st quartile of DWD, the adjusted risk ratio for GD was 0.77 (95% CI 0.71, 0.84). Conclusions: These analyses find support for the hypothesis that higher neighbourhood walkability is associated with a lower risk of GD. The analyses provide further health related support for urban design policies to increase walkability. [ABSTRACT FROM AUTHOR]

Objective: This study examined associations among perceived neighborhood walkability, physical activity (PA), and obesity among United States adults. Methods: Data from the 2020 National Health Interview Survey were analyzed. Walkability was assessed using a summative scale and was categorized as low, medium, or high. PA was categorized as insufficient (0‐149 min/wk) or sufficient (150+ min/wk). Multivariable regressions estimated an association between obesity and BMI and PA/walkability. Mediation analysis was used to partition contribution of PA as a mediator. Effect modification by race and ethnicity in the association between walkability and BMI was explored. Results: The sample included N = 31,568 adults. Compared with those in low‐walkability neighborhoods, participants in high‐walkability neighborhoods had increased odds of sufficient PA (odds ratio [OR] = 1.48; 95% CI: 1.30‐1.69) and decreased obesity odds (OR = 0.76; 95% CI: 0.66‐0.87). PA partially mediated the association between walkability and BMI (23.4%; 95% CI: 14.6%‐62.7%). The association between walkability and BMI was modified by race and ethnicity (F[5,567] = 2.75; p = 0.018). Among White, Black, Hispanic, and Asian adults, BMI decreased with increasing walkability; among American Indian/Alaska Native and multiracial/other adults, BMI increased with increasing walkability. Conclusions: The findings highlight the importance of investing in the built environment to improve perceptions of walkability and promote PA and healthy weight, as well as developing interventions to target racial and ethnic disparities in these outcomes. [ABSTRACT FROM AUTHOR]

Old Indian cities are often less accessible due to temporal restrictions and ever‐rising pedestrian volume. In this research, the accessibility of the footpath‐level walkability condition of old core cities has been assessed through Architectural Planning Research, considering 32 footpath stretches in Central Kolkata, India, as a case. The research has considered 3 data sets, (a) 257 experts' opinions about universal mobility, (b) 18 variables for assessing accessibility conditions, and (c) peak hour pedestrian volume. IBM® SPSS® Statistics 26.0 version has been used to validate the findings of the research. It was found that mixed‐use buildings demarcate the edge of the footpaths in old cities. 50.6% of Indian experts have prioritized the "dimension of the footpath" while assessing universal mobility for pedestrians in the old cities of India. The average accessibility percentage for the entire surveyed stretch is negative which highlights the poor accessibility of the stretch. Pearson's correlation between footpath width and infrastructure score of 0.535 signifies the width of a footpath plays a significant role in determining the level of footpath infrastructure. Thus, the findings of this research can be used while preparing accessibility development plans for the study area and other areas of a similar genre. In this research, the accessibility of the footpath‐level walkability condition of old core cities has been assessed through Architectural Planning Research, considering Central Kolkata, India, as a case. The findings of this research prove the relationship between footpath width and the footpath infrastructure. [ABSTRACT FROM AUTHOR]

We analyzed the association between step counts and traffic safety indicators by multiple regression analysis. Results show that residents, especially older adults, in areas with many pedestrian streets, a high proportion of multilevel intersections, and a high proportion of three‐way intersections tend to walk more. In addition, these traffic safety indicators are found to be significantly more common in planned residential areas, especially in large‐scale developments and developments by public developers. In conclusion, this study evaluates the pedestrian‐friendly designs in existing planned residential areas and suggests the need to actively preserve and utilize these designs in future residential development. [ABSTRACT FROM AUTHOR]

Variation in the land use environment (LUE) impacts the continuum of walkability to car dependency, which has been shown to have effects on health outcomes. Existing objective measures of the LUE do not consider whether the measurement of the construct varies across different types of communities along the rural/urban spectrum. To help meet the goals of the Diabetes Location, Environmental Attributes, and Disparities (LEAD) Network, we developed a national, census tract‐level LUE measure which evaluates the road network and land development. We tested for measurement invariance by LEAD community type (higher density urban, lower density urban, suburban/small town, and rural) using multiple group confirmatory factor analysis. We determined that metric invariance does not exist; thus, measurement of the LUE does vary across community type with average block length, average block size, and percent developed land driving most shared variability in rural tracts and with intersection density, street connectivity, household density, and commercial establishment density driving most shared variability in higher density urban tracts. As a result, epidemiologic studies need to consider community type when assessing the LUE to minimize place‐based confounding. Plain Language Summary: A community's land use environment (LUE) describes its citizens ability to walk from place to place versus their reliance on vehicles for transportation. Some factors that might influence LUE include the street network, size of road blocks, density of walkable establishments (food stores, restaurants, schools, etc.), and the mixture of residential and commercial establishments. Existing objective measures of the LUE do not consider urbanicity, which can lead to differences due only to places being more or less rural. The Diabetes Location, Environmental Attributes, and Disparities (LEAD) Network created a national, census tract‐level LUE measure and assessed whether the LUE construct differed across LEAD community type groups (higher density urban, lower density urban, suburban/small town, and rural). We found that the LUE construct does vary across LEAD community type. Future epidemiologic studies examining the LUE need to consider urbanicity to account for these differences. Key Points: Variation in the land use environment (LUE) impacts the continuum of walkability to car dependency, which has effects on health outcomesWe assessed measurement invariance of a land use construct across levels of urbanicity using multiple group confirmatory factor analysisWe determined that measurement of the LUE does vary across urbanicity which can lead to place‐based confounding [ABSTRACT FROM AUTHOR]

Walk Score is widely used to measure the convenience of surrounding amenities and generally considers the physical characteristics of streets (density of crossings, distances, etc.). This article proposes an improved Walk Score evaluation method considering what pedestrians perceive through hearing and sight in the street environment. By using a traffic noise assessment model and a semantic segmentation model, the improved method incorporates traffic noise and vegetation coverage factors as penalties into the original Walk Score. Based on the proposed method, a case study was conducted in Nanjing, China. Compared with the original Walk Score: (1) the improved Walk Score results present more information about how the street environment affects walkability; (2) areas near downtown generally scored higher, while some traditional downtown areas scored lower, which is mainly because the latter areas have little vegetation along the streets; and (3) areas around urban viaducts and overpasses scored lower due to the additional penalty of traffic noise. With the support of the improved Walk Score evaluation method, urban planning and policymakers can develop more comprehensive solutions to improve urban walkability. [ABSTRACT FROM AUTHOR]

Aim: This study investigated neighborhood walkability using Walk Score® and social participation in districts within a city among older Japanese adults. Methods: This study was a cross‐sectional study using baseline data of older adults from the Keeping Active across Generations Uniting the Youth and the Aged study. In total, 2750 participants (1361 men and 1389 women, mean age 72.8 ± 6.4 years) were included in the analysis. The questionnaire included socioeconomic status, self‐rated health, medical history, depressive symptoms, instrumental activities of daily living and social participation. We used the Walk Score® as neighborhood walkability and a walk score <50 was categorized as a "car‐dependent" area and a score ≥50 as a "walkable" area. A Poisson regression analysis stratified by sex was performed to investigate the association of neighborhood walkability with social participation. Prevalence ratios were calculated and their 95% confidence intervals. Results: We found that dwelling in car‐dependent areas (prevalence ratio 0.78, 95% confidence interval 0.64–0.94) had a significant negative effect on women's social participation, unlike men. Conclusions: Our study showed that neighborhood walkability and social participation were associated with older Japanese women after adjusting for the covariates. These findings might provide helpful information for public health interventions targeted to promote social participation among older adults. Geriatr Gerontol Int 2022; 22: 350–359. [ABSTRACT FROM AUTHOR]

Urbanization and modernization of services in the world triggers decrement in the physical activities of citizens. The most common solution for this decrement is improving walking capacity in neighborhoods to engage the citizens in walking activity. In this research, a novel model is presented to quantify walkability based on several necessary criteria and indicators considering the physical and non‐physical conditions. For this model, promising sciences, including GIS, RS, and MCDM, are utilized to compute indicators and aggregate them in the form of a spatial index in a central region of Tehran, Iran, at the neighborhood scale. For evaluating the result, the obtained walkability level is compared to the physical structure of neighborhoods, previous works, housing price along with some other socio‐economic parameters, and municipal action plan in the neighborhoods. These evaluations show that the outcome of the proposed model is a robust tool for walkability planning. [ABSTRACT FROM AUTHOR]

In this article, we aim to address the problem of cooperative learning from adaptive neural formation control for a group of underactuated unmanned surface vehicles (USVs) with modeling uncertainties, where the formation errors are subject to prescribed performance constraints. A coordinate transformation is introduced to overcome the difficulties caused by off‐diagonal system matrix. Under limited communication range, the connectivity preservation as well as collision avoidance among the initial connected vehicles are achieved by guaranteeing the intervehicle distances converge to small neighborhoods of the desired distance. Meanwhile, the convergence of bearing angles to small neighborhoods of desired bearing angles avoids the possible controller singularity problem arising from underactuation and achieves the predefined formation shape. The prescribed performance constraints are imposed on the formation errors to improve the transient and steady‐state performances. Using the deterministic learning theory, the modeling uncertainties are locally accurately identified/learned by the localized radial basis function (RBF) neural networks (NNs) along the union of all vehicles' state orbits in a cooperative way. The learned knowledge is stored in constant RBF networks and is reutilized to develop experience‐based formation control protocol to improve the control performance including reduction of the computational burden. Simulations are carried out to verify the effectiveness of the proposed formation controllers. [ABSTRACT FROM AUTHOR]

Objective: The Neighbourhood Environments in Waterloo: Patterns of Active Transportation and Health (NEWPATH) study examined built environment influences on travel, physical activity, food consumption, and health. This collaboration between researchers and practitioners in health and transportation planning is the first, to our knowledge, to integrate food purchasing, diet, travel, and objectively measured physical activity into a trip‐destination protocol. This study simultaneously examines diet and physical activity relationships with BMI and waist circumference (WC). Methods: Individual diet and travel diary data were linked to objective built‐environment measures of walkability and retail food environments. BMI and WC were self‐reported (n = 1,160). Some respondents wore accelerometers to objectively measure physical activity (n = 549). Pathways from the built environment through behavior (walking and eating) to BMI and WC were assessed using path analysis. Results: Walkability was associated with lower BMI and WC through physical activity and active travel. Healthy retail food environments were associated with healthy eating and lower BMI and WC, whereas walkability and healthy retail food environments were insignificant (p < 0.05). Walkable neighborhoods had less healthy food environments, but active travel was not associated with healthy eating or caloric intake. Conclusions: Findings highlight the importance of neighborhood walkability and food environments in shaping physical activity, diet, and obesity. [ABSTRACT FROM AUTHOR]

Objective: This study evaluated associations between neighborhood‐level characteristics and gestational weight gain (GWG) in a population‐level study of 2015 New York City births. Methods: Generalized linear mixed‐effects models were used to estimate odds ratios (ORs) for associations between neighborhood‐level characteristics (poverty, food environment, walkability) within 1 km of a residential Census block centroid and excessive or inadequate GWG compared with recommended GWG. All models were adjusted for individual‐level sociodemographic characteristics. Results: Among the sample of 106,285 births, 41.8% had excessive GWG, and 26.3% had inadequate GWG. Residence in the highest versus lowest quartile of neighborhood poverty was associated with greater odds of excessive GWG (OR: 1.17, 95% CI: 1.08‐1.26). Residence in neighborhoods in the quartile of highest walkability compared with the quartile of lowest walkability was associated with lower odds of excessive GWG (OR: 0.87, 95% CI: 0.81‐0.93). Adjustment for prepregnancy BMI attenuated the associations for neighborhood poverty, but not for walkability. Neighborhood variables were not associated with inadequate GWG. Conclusions: These analyses indicate that greater neighborhood walkability is associated with lower odds of excessive GWG, potentially from differences in pedestrian activity during pregnancy. This research provides further evidence for using urban design to support healthy weight status during pregnancy. [ABSTRACT FROM AUTHOR]

Summary: We evaluated the epidemiological evidence on the built environment and its link to childhood obesity, focusing on environmental factors such as traffic noise and air pollution, as well as physical factors potentially driving obesity‐related behaviors, such as neighborhood walkability and availability and accessibility of parks and playgrounds. Eligible studies were (i) conducted on human children below the age of 18 years, (ii) focused on body size measurements in childhood, (iii) examined at least one built environment characteristic, (iv) reported effect sizes and associated confidence intervals, and (v) were published in English language. A z test, as alternative to the meta‐analysis, was used to quantify associations due to heterogeneity in exposure and outcome definition. We found strong evidence for an association of traffic‐related air pollution (nitrogen dioxide and nitrogen oxides exposure, p < 0.001) and built environment characteristics supportive of walking (street intersection density, p < 0.01 and access to parks, p < 0.001) with childhood obesity. We identified a lack of studies that account for interactions between different built environment exposures or verify the role and mechanism of important effect modifiers such as age. [ABSTRACT FROM AUTHOR]

Background: Extant evidence links neighborhood walkability with obesity‐related health in the general population. This association likely exists in cancer survivors, but research is limited. Furthermore, a disproportionate obesity burden in African American cancer survivors warrants subgroup‐specific analyses. Methods: This study analyzed data from 2089 African American cancer survivors participating in the Detroit Research on Cancer Survivors (ROCS) cohort. On the basis of built environment data summarized within 1‐km radial buffers around census block centroids, a multidimensional neighborhood walkability index (NWI) was constructed. Survivors' residential addresses at Detroit ROCS enrollment were geocoded, and addresses were linked to NWI scores via the census block of residence. At study enrollment, survivors reported height and weight; these data were used to calculate their body mass index (BMI). Associations between NWI quartiles and BMI overall and by cancer type, biological sex, and physical activity engagement were evaluated. Results: BMI was found to be inversely associated with increasing NWI quartile (P for trend <.01). This inverse relationship was observed in men (P for trend <.01) and in survivors reporting any regular physical activity (P for trend <.01). Conclusions: This study's findings suggest that among African American cancer survivors, higher neighborhood walkability is associated with lower BMI. As health care systems in the United States increasingly consider the role of the neighborhood environment in their patients' health, these findings provide additional evidence supporting health systems' incorporation of neighborhood walkability as an obesity‐related health indicator for this cancer survivor subgroup and potentially for cancer survivors from other vulnerable populations. This study evaluates the relationship between neighborhood walkability and body size in a population‐based sample of African American cancer survivors in Metropolitan Detroit. A cross‐sectional link between higher neighborhood walkability and lower body mass index is demonstrated. [ABSTRACT FROM AUTHOR]

Wumpurrarni [First Nations] do not like what Papulanyi have done to the land, and to our health. Wumpurrarni people can teach Papulanyi how to look after this country better than anyone else. I SQ: In contrast to Papulanyi/Western people, who have developed an almost complete multi-generational divorce from the outside world as if it has no relevance in day-to-day existence, Wumpurrarni/First Nations people of northern Australia live in socio-cultural harmony with the environment. Climate change: A Wumpurrarni-kari and Papulanyi-kari shared problem. [Extracted from the article]

Aim: Neighborhood environmental attributes are associated with physical activity and health status. We examined cross‐sectional associations of built and social environmental attributes with frailty among community‐dwelling mid‐to‐older aged adults in Australia. Methods: Data from 3419 adults aged 50–74 years living in 200 neighborhoods in Brisbane, Australia, were used. Frailty status was assessed by a frailty index comprising 32 items. The built environment attributes examined were residential density, street connectivity, land use mix, park area and bus stop density. Self‐reported levels of safety and social cohesion were used as social environmental factors. Associations were examined using multilevel logistic regression. Results: The prevalence of frailty was 12%. One standard deviation increment in street connectivity in a 1‐km network buffer around participants' homes and in a neighbourhood was associated with 23% and 13% higher odds of being frail, respectively. One standard deviation increment in land use mix at the neighborhood level was associated with 12% lower odds of being frail. Higher levels of safety and social cohesion were consistently associated with a lower odds of being frail. Conclusions: Consistent with previous studies, we found that social environmental attributes were relevant to residents' frailty status, whereas the relationships between built environmental attributes and frailty were not clear (frailty was associated with lower street connectivity but with higher land used mix). Community‐level initiatives to enhance safety and social cohesion might be effective to reduce frailty. Further research is required to explain the equivocal findings obtained for built environmental attributes and frailty. Geriatr Gerontol Int 2021; 21: 893–899. [ABSTRACT FROM AUTHOR]

Recently several light‐weight, long span floors are built (e.g. steel‐framed structural systems), where the design is governed by vibration control. In these cases the acceleration due to human‐ or machine‐induced vibration can be very high, which may cause human discomfort. Long rectangular plates subjected to concentrated loads are often investigated by a replacement beam with a so called "effective width", and the amplification factor is calculated according to a SDOF system, which in the case of resonance is equal to 1/2ξ, where ξ is the damping ratio. Since damping in lightweight, steel‐framed structural systems is very low (1–3%), dynamic amplification (calculated according to an SDOF system) can be rather high. However, the steady‐state dynamic response of beams and long plates subjected to periodic loads are significantly different. The steel‐framed floors are mechanically long even in that case when the ratio of the sides of the floor is around one due to the high orthotropy. For long plates, the response and the amplification factor are substantially different from those of beams. Hence, design based on effective width may lead to 2‐4 times higher acceleration than the real values. As an example the roof of a gymnasium under construction is examined, where different sport activities (walking, running, aerobic) will take place. The natural frequency of the floor supported by steel joists is small, close to the frequency of walking, therefore a detailed vibration analysis was performed. [ABSTRACT FROM AUTHOR]

Purpose: To develop a methodology for probing lipid droplet sizes with a clinical system based on a diffusion‐weighted stimulated echo–prepared turbo spin‐echo sequence and to validate the methodology in water–fat emulsions and show its applicability in ex vivo adipose‐tissue samples. Methods: A diffusion‐weighted stimulated echo–prepared preparation was combined with a single‐shot turbo spin‐echo readout for measurements at different b‐values and diffusion times. The droplet size was estimated with an analytical expression, and three fitting approaches were compared: magnitude‐based spatial averaging with voxel‐wise residual minimization, complex‐based spatial averaging with voxel‐wise residual minimization, and complex‐based spatial averaging with neighborhood‐regularized residual minimization. Simulations were performed to characterize the fitting residual landscape and the approaches' noise performance. The applicability was assessed in oil‐in‐water emulsions in comparison with laser deflection and in ten human white adipose tissue samples in comparison with histology. Results: The fitting residual landscape showed a minimum valley with increasing extent as the droplet size increased. In phantoms, a very good agreement of the mean droplet size was observed between the diffusion‐weighted MRI‐based and the laser deflection measurements, showing the best performance with complex‐based spatial averaging with neighborhood‐regularized residual minimization processing (R2/P: 0.971/0.014). In the human adipose‐tissue samples, complex‐based spatial averaging with neighborhood‐regularized residual minimization processing showed a significant correlation (R2/P: 0.531/0.017) compared with histology. Conclusion: The proposed acquisition and parameter‐estimation methodology was able to probe restricted diffusion effects in lipid droplets. The methodology was validated using phantoms, and its feasibility in measuring an apparent lipid droplet size was demonstrated ex vivo in white adipose tissue. [ABSTRACT FROM AUTHOR]

Introduction: Physical inactivity is a risk factor for many noncommunicable diseases. As reported by the World Health Organisation, 81% of children worldwide are physically inactive. Environmental factors, such as neighbourhood walkability, can shape people's physical activity (PA) behaviour. This study explored the association between neighbourhood walkability and after-school PA among Australian schoolchildren.Methods: The Department for Education and Child Development (DECD) distributed the survey to 189 schools across South Australia to assess the health and well-being of schoolchildren aged between 8 and 14 years. Neighbourhood was defined as an area corresponding to a four digit postcode, and its walkability was measured using Walk Score® . The association between neighbourhood walkability and after-school PA was analysed using multinomial logistic regression adjusted for age, gender, SEIFA score, number of days of TV watching, number of times of eating junk food, neighbourhood safety and children's weight status.Results: Children residing in highly walkable areas (walker's paradise) compared to car-dependent areas had higher odds (OR(95%CI)) of engaging in after-school PA three (1.216 (1.029, 1.436), P = .021), four (1.287 (1.064, 1.557), P = .009) and five times a week (1.230 (1.030, 1.133), P = .022) compared to children never participating in PA.Conclusion: Living in highly walkable areas (walker's paradise), compared to living in car-dependent areas was associated with higher levels of after-school PA. So what? Creating walkable neighbourhoods with greater access to amenities, services and public transportation may help increase after-school PA among schoolchildren. [ABSTRACT FROM AUTHOR]

This article examines the characteristics of residents moving into new rail transit neighborhoods using longitudinal, individual‐level data from the Housing Mortgage Disclosure Act. To disentangle the role of transit from other neighborhood amenities that may give rise to shifts in the socioeconomic or demographic profile of homebuyers, an exploratory text analysis is first performed on property advertisements in transit‐adjacent neighborhoods. This informs the creation of variables for our models that estimate the probability of an applicant applying for a loan by race and income, and highlights where light rail is most prominently advertised as an amenity. We do not find that the announcement of a new light rail line significantly alters the income profile of loan applicants. Rather, proximity to the center city is a more important determinant in attracting higher income applicants. We do find that the announcement of the transit line is significant in explaining changes in the racial profile of applicants. Postannouncement, White applicants are significantly more likely to apply for loans in transit‐adjacent neighborhoods, while Blacks are significantly less likely to. As for other amenities, the walkability of a neighborhood is significant in predicting where White applicants are more likely to apply for home purchase loans. [ABSTRACT FROM AUTHOR]

Summary: The lack of an active neighbourhood living environment can impact community health to a great extent. One such impact manifests in walkability, a measure of urban design in connecting places and facilitating physical activity. Although a low level of walkability is generally considered to be a risk factor for childhood obesity, this association has not been established in obesity research. To further examine this association, we conducted a literature search on PubMed, Web of Science and Scopus for articles published until 31 December 2018. The included literature examined the association between measures of walkability (e.g., walkability score and walkability index) and weight‐related behaviours and/or outcomes among children aged under 18 years. A total of 13 studies conducted in seven countries were identified, including 12 cross‐sectional studies and one longitudinal study. The sample size ranged from 98 to 37 460, with a mean of 4971 ± 10 618, and the age of samples ranged from 2 to 18. Eight studies reported that a higher level of walkability was associated with active lifestyles and healthy weight status, which was not supported by five studies. In addition to reviewing the state‐of‐the‐art of applications of walkability indices in childhood obesity studies, this study also provides guidance on when and how to use walkability indices in future obesity‐related research. [ABSTRACT FROM AUTHOR]

Summary: The lack of neighbourhood aesthetics (e.g. public art and well‐maintained properties) may reduce walkability in the neighbourhood and increase the risk of childhood obesity. In this study, a literature search was conducted in the Cochrane Library, PubMed and Web of Science for articles published before January 1, 2019 to analyse the associations between neighbourhood aesthetics and weight‐related behaviours and outcomes among children and adolescents aged <18. One cohort study and 24 cross‐sectional studies, conducted in 10 countries with a median sample size of 1124 were identified. Neighbourhood aesthetics was more commonly assessed by self‐reported or parent‐reported perceptions than objective measurements. Eighteen of the 25 included studies analysed physical activity (PA) as the outcome of interests, eight studies analysed active transport to school (ATS), and eight studies analysed weight status, including body mass index and overweight/obesity status. About two‐thirds of studies reported non‐significant associations when using PA and weight status as outcomes, and half of studies showed that neighbourhood aesthetics is associated with increased use of ATS. The rest of the studies reported mixed findings with slightly more studies showing neighbourhood aesthetics may promote PA or reduce weight. Better designed studies are necessary to achieve a robust understanding of this epidemiological relationship in the future. [ABSTRACT FROM AUTHOR]

Summary: As an important factor for neighbourhood walkability, the speed limit in the neighbourhood may influence children's physical activity (PA) outdoors, especially active transport, and further their weight status. This review aimed to systematically evaluate the association between neighbourhood speed limit and obesity‐related behaviours and outcomes among children and adolescents. PubMed, Embase and Web of Science were systematically searched for relevant studies published from the inception of the database to 1 January 2019. Sixteen studies were included, with 13 cross‐sectional studies and three longitudinal studies. Speed limit was measured as the percentage/number of high‐speed roads, perception of safe driving speed, perception of speeding and use of traffic‐calming tools in the neighbourhood. Eleven studies measured the use of active transport as the outcome of interest, and seven studies measured PA directly. Eleven studies revealed an association between a lower speed limit and increased PA, whereas one study showed a negative association, and three studies reported non‐significant associations. Only one study associated speed limit with weight status, which reported a non‐significant association. This review generally supported a negative association between speed limit and PA among children and adolescents. More studies are needed to examine their causality, as well as the association between speed limit and weight status, in order to increase the impact of this research area on public health policy making. [ABSTRACT FROM AUTHOR]

With the development of urbanization in China, obesity is becoming a serious problem, and the relationship between walking environments and obesity has attracted considerable interest. Using data from questionnaires (n = 418) gathered in 2017 from eight neighbourhoods in Guangzhou, China, a typical high‐density city, this study developed an Ordered Logit Model (OLM) to explore the effects of walking environments on the likelihood of residents becoming overweight or obese. The results demonstrate that body mass index (BMI) of individuals living in central urban areas is higher than those of suburban residents. After controlling for the effects of socio‐economic factors, it was found that the impact of walking environments at the scale of 1‐km buffer on individual BMI is the most significant. Variables of walkability, road network density, bus stop density, metro stop density, green coverage rate, and distance to the park have negative effects on BMI. Based on these findings, it is suggested that planning interventions should focus more on the areas through which residents walk in their daily travel routines. The selection of neighbourhoods surveyed and the sample size limit this study, but the conclusions do provide a scientific basis for the construction of neighbourhoods that encourage walking and decrease the probability of becoming overweight or obese. Key Messages: This study developed an Ordered Logit Model to explore the effects of walking environments on the likelihood of residents becoming overweight or obese at three spatial scales.The impact of walking environments at the scale of 1‐km buffer on individual BMI is the most significant.Urban planners should pay more attention to improving neighbourhood walking environments. [ABSTRACT FROM AUTHOR]

Determination of the span limit for walkability of trapezoidal steel profiles The use of higher‐strength materials in the production of steel profiles offers the possibility of higher load‐bearing capacities with the same cross‐section. Alternatively, component thicknesses can be reduced due to improved strength properties. With regard to the use of trapezoidal steel profiles, this progress enables the realisation of conventional span widths with profiled sheets with thin sheet thicknesses and thus allows a reduced use of materials. In general, free‐spanning profiles are not accessible. However, exceptions to this rule exist for assembly, maintenance and cleaning. The maximum span up to which a profile sheet may be walked upon for these purposes without load‐distributing measures is defined by the span limit of walkability. In German‐speaking countries, this constitutes an essential aspect in the design of roof structures made of trapezoidal steel profiles. The span limit of walkability of new types of trapezoidal steel profiles made of higher‐strength steels with thin sheet thicknesses were investigated within the scope of studies at RWTH Aachen University. Selected results will be presented in this article. [ABSTRACT FROM AUTHOR]

Keywords: ageing; high-density electromyography; motor neuron; motor unit; neuromodulation EN ageing high-density electromyography motor neuron motor unit neuromodulation 5137 5139 3 12/03/21 20211201 NES 211201 Persistent inward currents in motoneurons: role in normal motor behaviour and age-related cha... The world population is ageing. Motoneuron firing is not solely determined by ionotropic synaptic input, but also by complex factors, such as persistent inward currents (PICs). Thus, ingestion of tryptophan or tryptophan-rich proteins could lead to increases in serotonin synthesis and facilitate PICs in ageing motoneurons. [Extracted from the article]

Even within economically disadvantaged neighborhoods, programs fostering protective factors can shape youth outcomes. One positive youth development (PYD) program— Seeds of Change—employs teenagers in an urban neighborhood in Ohio and uses goats and community gardens to promote adolescent development. The current study used semi‐structured interviews with adolescents (N = 7, ages 16–20) to conduct a case study of the program. The case study describes youth's perceptions of the neighborhood, the program, and future directions; responses were analyzed using content analysis. Youth described that Seeds of Change enacts change on multiple levels of the social ecology by emphasizing individual growth, building a social support system with peers and adults, and increasing both tangible resources and positive relationships throughout the neighborhood. Seeds of Change promotes positive socialization, increases resources, and embodies multiple elements of effective PYD programming. [ABSTRACT FROM AUTHOR]

Objective: The media's framing of public health issues is closely linked to public opinion on these issues and support for interventions to address them. This study characterized geographic and temporal variation in the US media's framing of obesity across states from 2006 to 2015.Methods: Newspaper articles that mentioned the term obesity were drawn from Access World News (NewsBank, Inc., Naples, Florida), a comprehensive online database (N = 364,288). This study employed automated content analysis, a machine learning technique, to categorize articles as (1) attributing obesity to individual-level causes (e.g., lifestyle behaviors), (2) attributing obesity to environmental/systemic causes (e.g., neighborhood walkability), (3) attributing obesity to both individual-level causes and environmental/systemic causes, or (4) articles without any such attribution framework.Results: Nationwide across all years, a higher proportion of articles focused on individual-level attribution of obesity than environmental-level attribution or both. Missouri and Idaho had the highest proportions of articles with an individual framework, and Nevada, Arkansas, and Wisconsin had the highest proportions of articles with an environmental framework.Conclusions: This analysis demonstrates that US media sources heavily focus on an individual framing of obesity, which may be informing public perceptions of obesity. By highlighting differences in obesity media portrayal, this study could inform research to understand why particular states represent outliers and how this may affect obesity policy making. [ABSTRACT FROM AUTHOR]

Objective: Improving neighborhood walkability has been proposed as a policy intervention to reduce obesity. The objective of this study was to evaluate longitudinal relationships between neighborhood walkability and body weight among adults living in large urban areas.Methods: In this retrospective longitudinal study of United States military veterans using Department of Veterans Affairs health care, Veterans Affairs clinical and administrative data (2007-2014) were linked to environmental measures constructed from public (2006-2014) and proprietary (2008-2014) sources, and linear regression models with person fixed effects were used to estimate associations between walkability and BMI among 758,434 men and 70,319 women aged 20 to 80 years in 2009 to 2014.Results: Neighborhood walkability was associated with small reductions in BMI. Effects were most pronounced among men aged 30 to 49 and 50 to 64. For women, differences were largest in the two youngest age groups, 20 to 29 and 30 to 49, though only estimates for all women combined were statistically significant. For women aged 30 to 49, effect sizes grew when the sample was limited to those who remained in the same neighborhood during the entire follow-up period.Conclusions: Investments in the built environment to improve walkability may be a useful strategy for weight control in some segments of the adult population. [ABSTRACT FROM AUTHOR]

Background: As an accessible and inexpensive activity in daily life for employees, transport‐related walking is a promising focus of physical activity initiatives. The purpose of this study was to integrate worksite neighbourhood walkability with the theory of planned behaviour (TPB) to predict transport‐related walking in Chinese employees using a longitudinal design. Methods: A sample of 157 employees (Mage = 33.26 years; SD = 7.18) reported their social cognition and worksite neighbourhood environment perceptions at the baseline. Self‐reported transport‐related walking was measured at two time points, 1 month apart. Results: Path analyses revealed that intention had a direct effect on walking, while attitudes, subjective norm, and perceived behavioural control had indirect effects on walking via intention. Past behaviour had a significant effect on walking, attenuating the intention–behaviour effect substantially. However, there was no indirect effect from perceived worksite neighbourhood walkability on walking through the TPB constructs. Furthermore, perceived neighbourhood walkability did not moderate the intention–walking relationship. Conclusions: Perceived worksite neighbourhood walkability had limited effects on transport‐related walking, which seems to be a motivated and habitual behaviour. Habit‐based interventions may be a priority over social cognitive and environmental change interventions, and future experimental studies are needed. [ABSTRACT FROM AUTHOR]

Sprawl measures have largely been neglected in land‐use forecasting models. The current approach for land‐use allocation using optimization mostly utilizes objective functions and constraints that are non‐spatial in nature. Application of spatial constraints could take care of the contiguity and compactness of land uses and can be utilized to address urban sprawl. Because a land‐use model is used as an input to transportation modeling, a better spatial allocation strategy for more compact land‐use projections will promote better transportation planning and sustainable development. This study formulates a scenario‐based approach to normative modeling of urban sprawl. In doing so, it seeks to improve the land‐use projections by employing a spatial optimization model with contiguity and compactness consideration. This study incorporates urban sprawl measures based on smart growth principles together with a mixed‐use factor, and adjacency consideration of nearby land uses. The objective function used in the study maximizes net suitability based on imposed constraints. These constraints are based on smart growth principles that enhance walkability in neighborhoods, promote better health for residents, and encourage mixed‐use development. The formulated model has been applied to Collin County, TX, a fast‐developing suburban county located to the north of the Dallas–Fort Worth metroplex. The suitability of land cells indicates the probability of conversion, which is calculated using spatial discrete choice analysis with Moran eigenvector spatial filtering for vacant cells at a resolution of 150 × 150 m employing factors of the built environment, and socioeconomic and demographic characteristics. This study demonstrates how spatial proximity between land uses, which has been ignored to date, can be used to control sprawl, resulting in better mixing of different land uses based on constraints imposed in a spatial optimization problem. [ABSTRACT FROM AUTHOR]

Issue Addressed: Australians living in peri-urban areas are insufficiently active, sedentary and experience poorer health than people in major cities. There are health benefits attributable to active lifestyles that could contribute to the improved health and well-being of this population. To support the adoption of active lifestyles, it is important to understand the unique context in which behaviour occurs.Methods: The aim of this study was to identify characteristics of the social and physical peri-urban environment that may impact active lifestyles. Semi-structured interviews were conducted in peri-urban southern Queensland. Data were analysed by thematic analysis.Results: The natural environment, weather, distance, accessibility and walkability were features of the physical environment relevant to active lifestyles. Social factors included social capital and crime. Activity-supportive characteristics (eg, community spirit) were identified, in addition to active lifestyle barriers (eg, lack of public transport).Conclusions: Despite activity-supportive social and environmental characteristics, most participants reported inactive lifestyles. The barriers to active lifestyles in peri-urban environments may negate these activity-supportive features. Some barriers are difficult to modify (eg, distance and accessibility). However, some may be alleviated through the adoption of activity-supportive policy and urban design (eg, pedestrian mobility infrastructure). SO WHAT?: Strategies to support active lifestyles in peri-urban environments must take into account unmodifiable contextual barriers, whilst encouraging utilisation of existing activity-supportive infrastructure and resources. The enhancement of activity-supportive environments through improved neighbourhood walkability and the usability of public transport may encourage some peri-urban residents to undertake more active forms of transport and recreational physical activity. [ABSTRACT FROM AUTHOR]

Inference regarding the impact of urban areas on health is limited by cross‐sectional studies assessing few dimensions and ignoring area‐level socio‐economic status. This study simultaneously assessed several dimensions of the built environment against incident cardiometabolic risk (CMR) arising over 10 years. It tested the hypothesis that, accounting for local area relative wealth, features of the built environment would not predict incident CMR. Initially, disease‐free adults in a biomedical cohort in Adelaide, Australia, provided address and clinical data over three waves of follow‐up. CMR was defined as the count of five clinical CMR factors. Built environment measures were derived for urban form, and natural, and food environments. Local area wealth was expressed using the relative location factor index. Poisson growth models accounting for within‐suburb clustering, age, sex, and education were used to estimate associations between built environment measures and increasing CMR. Fitted linear trajectories had statistically significant mean values of intercepts and slopes. CMR trajectories were associated with age, male sex, and low education. In models including measures of the food, natural, and urban form environments, per standard deviation increase, only POS count predicted incident CMR, which was more strongly predicted by relative location factor. Not accounting for local area socio‐economic status may overestimate the strength of relationships between health and the built environment. Inequity in accessible POS is robustly related to incident CMR. [ABSTRACT FROM AUTHOR]

Summary: Built environment attributes may be related to cardio‐metabolic diseases (e.g. type 2 diabetes, heart disease and stroke) and their risk factors, potentially by influencing residents' physical activity. However, existing literature reviews on the built environment and health for the most part focus on obesity as the outcome and rely on cross‐sectional studies. This systematic review synthesized current evidence on longitudinal relationships between built environment attributes and cardio‐metabolic health outcomes among adults and on the potential mediating role of physical inactivity. By searching eight databases for peer‐reviewed journal articles published in the English language between January 2000 and July 2016, the review identified 36 articles. A meta‐analysis method, weighted Z‐test, was used to quantify the strength of evidence by incorporating the methodological quality of the studies. We found strong evidence for longitudinal relationships of walkability with obesity, type 2 diabetes and hypertension outcomes in the expected direction. There was strong evidence for the impact of urban sprawl on obesity outcomes. The evidence on potential mediation by physical activity was inconclusive. Further longitudinal studies are warranted to examine which specific built environment attributes influence residents' cardio‐metabolic health outcomes and how physical inactivity may be involved in these relationships. [ABSTRACT FROM AUTHOR]

Objective: The aim of this study was to examine 2-year changes in weight status and behaviors among children living in neighborhoods differing on nutrition and activity environments.Methods: A prospective observational study, the Neighborhood Impact on Kids study, was conducted in King County, Washington, and San Diego County, California. Children 6 to 12 years old and a parent or caregiver completed Time 1 (n = 681) and Time 2 (n = 618) assessments. Children lived in neighborhoods characterized as "high/favorable" or "low/unfavorable" in nutrition and activity environments, respectively (four neighborhood types). Child BMI z score and overweight or obesity status were primary outcomes, with diet and activity behaviors as behavioral outcomes.Results: After adjusting for sociodemographics and Time 1 values, children living in two of the three less environmentally supportive neighborhoods had significantly less favorable BMI z score changes (+0.11, 95% CI: 0.01-0.21; + 0.12, 95% CI: 0.03-0.21), and all three less supportive neighborhoods had higher overweight or obesity (relative risks, 1.41-1.49; 95% CI: 1.13-1.80) compared with children in the most environmentally supportive neighborhoods. Changes in daily energy intake and sedentary behavior by neighborhood type were consistent with observed weight status changes, with unexpected findings for physical activity.Conclusions: More walkable and recreation-supportive environments with better nutrition access were associated with better child weight outcomes and related behavior changes. [ABSTRACT FROM AUTHOR]

This essay defines walkable neighborhood systems, summarizes the negative impacts of suburbia on the economy as a whole, and presents indirect pricing as a major cause of suburbia. The paper proposes several pricing reforms and green mobility as solutions based on prices that reflect full costs. Several hypotheses are presented concerning the performance of walkable neighborhood systems and the concept of an inflection point for the takeoff of non-auto modes when density within a walkable area reaches economies of scale. It proposes research on old neighborhoods as a way to quantify relationships in the absence of pricing reforms. The paper discusses building types and high rise, and how at highest densities there may be diminishing returns. While it is natural for most scholars to study dominant land uses, there is a need to understand better dense walking neighborhoods as solutions to the costs of suburbia and to enhance their functioning to show a path to a sustainable future. [ABSTRACT FROM AUTHOR]

Introduction “Walkable” neighborhoods offer older adults opportunities for activities that may benefit cognition-related biological mechanisms. These have not previously been examined in this context. Methods We objectively assessed neighborhood walkability for participants (n = 146) from the Australian Imaging, Biomarkers and Lifestyle study with apolipoprotein E ( APOE ) genotype and two 18-month-apart brain volumetric and/or amyloid β burden assessments. Linear mixed models estimated associations of neighborhood walkability with levels and changes in brain imaging outcomes, the moderating effect of APOE ε4 status, and the extent to which associations were explained by physical activity. Results Cross-sectionally, neighborhood walkability was predictive of better neuroimaging outcomes except for left hippocampal volume. These associations were to a small extent explained by physical activity. APOE ε4 carriers showed slower worsening of outcomes if living in walkable neighborhoods. Discussion These findings indicate associations between neighborhood walkability and brain imaging measures (especially in APOE ε4 carriers) minimally attributable to physical activity. [ABSTRACT FROM AUTHOR]

Background and purpose Charcot−Marie−Tooth ( CMT) disease is the most common inherited neuropathy, but therapeutic options have been limited to symptom management. Past pharmacological trials have failed, possibly due to insensitive outcome measures ( OMs). The aim of the current study was to evaluate the validity and reliability of the 6-min walk test (6 MWT) and StepWatch™ Activity Monitoring ( SAM) with other previously validated OMs in CMT disease. Methods A prospective multicenter study was performed, consecutively enrolling 168 CMT patients (104 with CMT1A, 27 with CMT1B, 37 with X-linked CMT) from Italian centers specializing in CMT care. Results Statistical analysis showed that the 6 MWT was highly related with all previously used OMs. Some, but not all, SAM parameters were related to commonly used OMs but may provide more information about quality of life. Conclusions The current study demonstrated the validity and reliability of the 6 MWT and SAM as OMs for CMT. Moreover, SAM provides data that correlate better with quality of life measures, making it useful in future rehabilitation trials. [ABSTRACT FROM AUTHOR]

Are people who live in more walkable areas healthier and more satisfied with life? This study investigates that question by using the 2005 Behavioral Risk Factors Surveillance System ( BRFSS) survey, the largest telephone survey on health in the US (302,841 respondents from 989 metropolitan and micropolitan statistical areas [ MSA]; 177,524 respondents from 703 MSAs had complete data). Using multilevel random coefficient modeling, we found that people living in walkable areas reported being generally healthier than people living in less walkable areas. In addition, aside from higher self-reported health, people living in walkable areas also had a lower body mass index ( BMI). However, contrary to our prediction, people in more walkable areas were less satisfied with their lives than people in less walkable areas after controlling for various individual-level variables (age, gender, race, education, marital status, income, and unemployment). People who live in walkable areas are healthier but not happier than those living in less walkable areas. [ABSTRACT FROM AUTHOR]

OBJECTIVES: To evaluate the association between neighborhood walkability and depression in older adults. DESIGN: Cross-sectional analysis using data from Adult Changes in Thought (ACT), a prospective, longitudinal cohort study. SETTING: King County, Washington. PARTICIPANTS: Seven hundred forty randomly selected men and women aged 65 and older, cognitively intact, living in the same home for at least 2 years. MEASUREMENTS: Depressive symptoms were measured with the Center for Epidemiologic Studies Depression Scale. The Walkable and Bikable Communities Project provided objective data predicting the probability of walking at least 150 minutes per week in a particular neighborhood. ACT data were linked at the individual level via a geographic information system to this walkability score using buffer radii of 100, 500, and 1,000 meters around the subject's home. Multiple regression analysis tests were conducted for associations between the buffer-specific neighborhood walkability score and depressive symptoms. RESULTS: There was a significant association between neighborhood walkability and depressive symptoms in men when adjusted for individual-level factors of income, physical activity, education, smoking status, living alone, age, ethnicity, and chronic disease. The odds ratio for the interquartile range (25th to 75th percentile) of walkability score was 0.31 to 0.33 for the buffer radii ( P=.02), indicating a protective association with neighborhood walkability. This association was not significant in women. CONCLUSION: This study demonstrates a significant association between neighborhood walkability and depressive symptoms in older men. Further research on the effects of neighborhood walkability may inform community-level mental health treatment and focus depression screening in less-walkable areas. [ABSTRACT FROM AUTHOR]

The causes of obesity are complex and require multilevel, multicomponent interventions. Incorporating a health equity perspective is also needed because ethnic minorities have a higher prevalence of obesity and previous interventions targeting individual-level factors have not been as effective [4]. Addressing social determinants of health as described in Kumaniyka's equity-oriented obesity prevention action framework may help address obesity disparities [5]. [Extracted from the article]

Background Individuals living in unwalkable neighborhoods appear to be less physically active and more likely to develop obesity, diabetes mellitus, and hypertension. It is unclear whether neighborhood walkability is a risk factor for future cardiovascular disease. Methods and Results We studied residents living in major urban centers in Ontario, Canada on January 1, 2008, using linked electronic medical record and administrative health data from the CANHEART (Cardiovascular Health in Ambulatory Care Research Team) cohort. Walkability was assessed using a validated index based on population and residential density, street connectivity, and the number of walkable destinations in each neighborhood, divided into quintiles (Q). The primary outcome was a predicted 10-year cardiovascular disease risk of ≥7.5% (recommended threshold for statin use) assessed by the American College of Cardiology/American Heart Association Pooled Cohort Equation. Adjusted associations were estimated using logistic regression models. Secondary outcomes included measured systolic blood pressure, total and high-density lipoprotein cholesterol levels, prior diabetes mellitus diagnosis, and current smoking status. In total, 44 448 individuals were included in our analyses. Fully adjusted analyses found a nonlinear relationship between walkability and predicted 10-year cardiovascular disease risk (least [Q1] versus most [Q5] walkable neighborhood: odds ratio =1.09, 95% CI: 0.98, 1.22), with the greatest difference between Q3 and Q5 (odds ratio=1.33, 95% CI: 1.23, 1.45). Dose-response associations were observed for systolic blood pressure, high-density lipoprotein cholesterol, and diabetes mellitus risk, while an inverse association was observed with smoking status. Conclusions In our setting, adults living in less walkable neighborhoods had a higher predicted 10-year cardiovascular disease risk than those living in highly walkable areas.