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Large‐scale estimations of flood losses are often based on spatially aggregated inputs. This makes risk assessments vulnerable to aggregation bias, a well‐studied, sometimes substantial outcome in analyses that model fine‐grained spatial phenomena at coarse spatial units. To evaluate this potential in the context of large‐scale flood risk assessments, we use data from a high‐resolution flood hazard model and structure inventory for over 1.3 million properties in Massachusetts and examine how prominent data aggregation approaches affect the magnitude and spatial distribution of flood loss estimates. All considered aggregation approaches rely on aggregate structure inventories but differ in whether flood hazard is also aggregated. We find that aggregating only structure inventories slightly underestimates overall losses (−10% bias), and when flood hazard data is spatially aggregated to even relatively small spatial units (census block), statewide aggregation bias can reach +366%. All aggregation‐based procedures fail to capture the spatial covariation of inputs distributions in the upper tails that disproportionately generate total expected losses. Our findings are robust to several key assumptions, add important context to published risk assessments and highlight opportunities to improve flood loss estimation uncertainty quantification. [ABSTRACT FROM AUTHOR]

Neighborhood environments are increasingly thought to affect emergency department (ED) use. However, because people decide where to live based on a range of factors, it can be challenging to identify the causal impact of living in higher-poverty neighborhoods on increased rates of ED visits. Our study leveraged the Moving to Opportunity for Fair Housing Demonstration Program, a social experiment beginning in 1994 that randomly assigned approximately 4,600 households that received federal housing assistance to different neighborhood conditions. We linked program participants in four states with an average of twelve years of administrative data on ED use (up to twenty-one years after randomization). Contrary to our expectations, we did not find a consistently significant connection between neighborhood poverty and overall ED use during this follow-up period. This result was observed for both adults and people who were children at the time of randomization, as well as for various classifications of ED visits. The findings can help direct future research that seeks to clarify the relationship between neighborhood environments and health care use. [ABSTRACT FROM AUTHOR]

Background: Emerging evidence suggests potential links between some dietary fatty acids and improved fertility, because specific fatty acids may affect prostaglandin synthesis and steroidogenesis. Objective: The objective of this exploratory study was to evaluate associations between total and specific types of dietary fat intake and 1) hormone concentrations and 2) the risk of sporadic anovulation in a cohort of 259 regularly menstruating women in the Bio-Cycle Study. Design: Endogenous reproductive hormones were measured up to 8 times/cycle for up to 2 cycles, with visits scheduled with the use of fertility monitors. Dietary intake was assessed with up to four 24-h recalls/cycle. Linear mixed models and generalized linear models were used to evaluate the associations between dietary fatty acids and both reproductive hormone concentrations and ovulatory status. All models were adjusted for total energy intake, age, body mass index, and race. Results: Relative to the lowest levels of percentage of energy from total fat, the highest tertile was associated with increased total and free testosterone concentrations (total: percentage change of 4.0%; 95% CI: 0.7%, 7.3%; free: percentage change of 4.1%; 95% CI: 0.5%, 7.7%). In particular, the percentage of energy from polyunsaturated fatty acids (PUFAs) in the highest tertile was associated with increases in total and free testosterone (total: percentage change of 3.7%; 95% CI: 0.6%, 6.8%; free: percentage change of 4.0%; 95% CI: 0.5%, 7.5%). The PUFA docosapentaenoic acid (22:5n-3) was not significantly associated with testosterone concentrations (P-trend = 0.86 in energy substitution models) but was associated with increased progesterone and a reduced risk of anovulation (highest tertile compared with the lowest tertile: RR: 0.42; 95% CI: 0.18, 0.95). Fat intakes were not associated with other reproductive hormone concentrations. Conclusions: These results indicate that total fat intake, and PUFA intake in particular, is associated with very small increases in testosterone concentrations in healthy women and that increased docosapentaenoic acid was associated with a lower risk of anovulation. [ABSTRACT FROM AUTHOR]

The United Teen Equality Center in Lowell, Massachusetts uses Street Outreach Workers (SWs) to intervene with individuals 13-23 years old who are involved in high risk behaviors or in need of assistance. Few studies have explored the perceptions of SWs by their target population (both individuals they have worked with and those who they have not yet worked with). To better understand how youth perceive the SWs and to contribute to the scant literature regarding their roles and impacts, we conducted a community-based survey to capture youth perspectives of, and experiences with SWs. Regardless of whether they had worked with a SW, youth respondents reported that their peers believed the SWs made Lowell a better place. Youth who had prior contact with a SW were more likely to respond that their peers view the SWs as helpful to youth and respected. Youth who had no prior contact with SWs were more likely to report that SWs were not present where they lived. Among youth who had worked with a SW 38% received help finding a job and 67% indicated that working with a SW made a difference in their lives. Approximately 82% of individuals who participated in mediation activities led by the SWs reported that it resolved their conflict. These results support the value of SWs in helping youth meet their needs and in mediating disputes. SWs should continue to connect with local agencies to address the needs of youth, especially employment, which was a priority. [ABSTRACT FROM AUTHOR]

This article reports that an elective training for medical students regarding the ways that adoption and foster care may affect patients they will see in their future medical practice is effective, perceived by students to be a valuable experience, and may contribute to good medical practice. As a follow-up to recommendations from a Massachusetts Task Force on Adoption-which identified the need to promote educational programs on adoption and foster care-weekly skills-building classes were designed to increase medical students' awareness of how frequently adoption and foster care may play a role in patients' lives. This course aims to increase students' ability to communicate with, and analyze and interpret information from members of adoption and/or foster care triads through a series of presentations by adoption and foster care experts, who include doctors with specialties in international adoption medicine, behavioral health issues of children who were adopted, specialized care for children in foster care, and family medical practice with expertise in the area of non-directive counseling; adoptive parents and people who were adopted; parents who have made adoption plans for their children; and foster parents. In addition, the classes also encourage medical students to reflect on their own beliefs and assumptions about adoption and foster care. [ABSTRACT FROM AUTHOR]

In 2018 and 2019 the City of Boston (Massachusetts, USA) conducted zero waste and carbon neutral planning efforts. Here we present the results of an accompanying analysis of the impacts of zero waste strategies on greenhouse gases (GHG) emissions associated with waste treatment. Emissions analysis in the waste sector is complicated by the contribution of significant indirect impacts that can exhibit temporal and spatial heterogeneity. For example, lifecycle GHG analysis of waste-to-energy combustion grants credits for the emissions avoided due to electricity generated from organic waste (biogenic carbon) that displaces electricity generation that could be carbon-emitting. As electricity grids decarbonize, this credit approaches zero. Long-term emissions planning needs to account for such dynamics to realistically assess the GHG mitigation potential associated with alternative waste management strategies. Here, we seek to capture these dynamics in a forward-looking analysis of waste sector emissions under a zero-waste strategy for the City of Boston. Using publicly available data sets such as EPA's Waste Reduction Model (WARM), we show that the implementation of zero waste strategies reduces the combustion of plastics and biomass in waste-to-energy (WtE) combustion facilities and associated GHG emissions. While WtE has been considered less-carbon intensive than other forms of waste treatment and fossil-based electricity generation, our analysis shows that more renewables will eventually eliminate the perceived GHG benefits associated with waste-to-energy combustion. While our approach provides policymakers with an understanding of the impacts of decisions in a dynamic context, we also identify common knowledge gaps in conducting forward-looking waste-GHG assessments., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2021 Elsevier Ltd. All rights reserved.)