Analysis of Demographic Changes in Urban Decline and Shrinkage

This chapter is aimed to analyse the implications that demographic changes have on urban decline and shrinkage in a global environment. The analysis departs from the assumption that deindustrialization restructuring and demographic suburbanization processes contribute to economic urban decline and shrinkage. After reviewing the evolution of urban decline and shrinkage framed on a methodological approach, the study analyses in detail the different factors involved in any demographic and urban decline and shrinkage. It is concluded that deindustrialization restructuring, demographic decline, and suburbanization processes are crucial in urban shrinkage.

Workforce Diversity

The growing acceptance of marrying across racial and ethnic lines (as reflected in US census statistics) together with the growth of demographic changes across workplaces is fueling fears among some who see their culture being threatened and react by engaging in overt discrimination. One concern regards employers having access to databases containing talented individuals who are ready to work. Their choices hinge on the abilities required to further their enterprise. Paradoxically, a business's culture's greatest strength could be its greatest weakness when not consistent with sound business strategies. Moreover, when such a culture prevents a firm from meeting competitive threats, this can lead to the firm's stagnation and ultimate demise. Diversity has never been thought of as a strategy until now. This chapter explores workforce diversity.

Siting of Healthcare Care Facilities Based on the Purpose of Their Operation, Demographic Changes, Environmental Characteristics, and the Impact on Public Health

A contemporary approach to the spatial design of healthcare care facilities faces numerous challenges at the crossroads of multidisciplinary topics of architecture and urbanism, healthcare, security, and organisational sciences. Due to the unique combination of uses, users and architectural expression, they are defined as urban nodes. With their inclusion, architects facilitate a better placing of healthcare facilities, indirectly improving human health. The purpose of the article is to seek guidelines for the siting of healthcare facilities to provide suitable and equal healthcare to different social structures, and for the optimal and fair spatial distribution of healthcare services. The descriptive method was used to review literature on the siting of healthcare facilities based on the purpose of their operation, demographic changes, environmental characteristics, and the impact on public health. This method was selected as it facilitates data acquisition from various sources and a comprehensive understanding of the topic discussed. The results of the research show how important the impact of the healthcare care facilities siting on human health and the wider social significance of the topic discussed is. The findings may provide guidelines and proposals for future spatial decisions.

Forecast of the Impact of Electric Car Battery Performance and Infrastructural and Demographic Changes on Cumulative Accessibility for the Five Most Populous Cities in Poland

The purpose of this study is to compare (1) technological factors (the ranges offered by the batteries of three popular electric vehicles in Poland); (2) infrastructure improvements; and (3) demographic changes and their impact on accessibility in the context of the ranges of labor markets within the 30, 60, and 90 min isochrones in moderate driving mode for the five largest cities in Poland using cumulative accessibility. We conclude that technological developments result in a much greater improvement in accessibility than demographic and infrastructural change. This is already visible with the 30 to 60 min isochrones, in particular when using the BMW in Cracow (with a more than 36% improvement in accessibility). Even greater changes, reaching as much as over 90%, are observed for the 60–90 min isochrones. The analysis shows that the shift in electromobility may be constrained by parallel demographic processes, dispersion of population in suburban areas, and the development of road infrastructure. The novelty of the approach stems from the fact that it is based on three above mentioned key factors that influence the accessibility of labor markets for EV users in the largest cities up to 2030.

Updating estimates of the number of UK stroke patients eligible for endovascular thrombectomy: incorporating recent evidence to facilitate service planning

Introduction Endovascular thrombectomy (EVT) is a highly effective treatment for acute ischaemic stroke due to large arterial occlusion (LAO). To support decisions about service provision, we previously estimated the annual UK population eligible for EVT as ∼10% of stroke admissions. Since then, several trials have produced evidence that could alter these figures. We update our estimates considering information from studies and trials reporting 2018–2021 on incidence, presentation time and stroke severity and consider the possible impact of predicted demographic changes in the next 10–20 years. Patients and Methods We produce an updated decision tree describing the EVT eligible population for UK stroke admissions. One-way sensitivity analyses (using upper and lower confidence intervals for estimates at each branch of our decision tree) were used to identify where further research evidence is necessary to increase certainty around estimates for numbers of EVT eligible patients. Results The updated estimate for the number of UK stroke patients eligible for EVT annually was between 10,020 (no advanced imaging in early presenting patients) and 9,580 (advanced imaging in all early presenting patients), which compared with our estimates in 2017 is a minimal reduction. One-way sensitivity analyses established that enhanced evidence about eligibility for milder strokes, ASPECTS scores and pre-stroke disability are offset by evidence regarding a lower incidence of LAO. Importantly, predicted increases in life expectancy by 2040 may increase thrombectomy need by 40%. Discussion Information from additional randomised trials published during 2018–2020 with updated estimates of LAO prevalence had a minimal impact on overall estimates of stroke patients eligible for EVT in the UK. Ongoing research into the benefits of EVT for patients with mild stroke or European Stroke Journal For Peer Review lower ASPECTS scores has the potential to increase the estimates of the eligible population; future need for EVT will increase with the ageing population. Conclusion Our updated analyses show overall numbers eligible little changed, but evidence from ongoing trials and demographic changes have the potential to increase the need for EVT significantly.

Probabilistic Modelling of Demographic Changes in Singapore’s Neighbourhoods

Predicting the temporal evolution of the demography and the residents’ spatial movements would immensely aid the estate development and urban planning. The evolution of population in three townships of Singapore is simulated at neighbourhood scale using a novel agent-based probabilistic approach with inputs from large-scale survey and statistical data. The demographic changes due to age-dependent rates of death and fertility are studied by considering the inter-ethnic marriages that has a varying probability depending on the ethnicities of the male and female partners. The predicted changes in the age and household compositions and family types have been found to reflect the population trends in Singapore over the past years. The decline in family types that contain children and the structure of age composition over years underline the issue of prevailing low fertility rates. The strategies for incorporating the population relocation to consider the long-term spatial movement are also discussed. In Singapore’s context, we consider in the relocation model an added complexity of ethnic quota for the residential units developed by public housing board. The ethnicity dependent parameter coupled with other parameters that represent the number of children in a household besides their size, the household income, the proximity of children’s schools, and the places of employment could play a strong role in predicting the spatial evolution of the residents. These predictions can be used by the urban planners and policy makers to improve the quality of life in Singapore.

Lofty goals and strategic plans are not enough to achieve and maintain a diverse workforce: an American Association for the Surgery of Trauma Diversity, Equity, and Inclusion Committee conversation

The American Association for the Surgery of Trauma Diversity, Equity, and Inclusion (DEI) Ad Hoc Committee organized a luncheon symposium with a distinguished panel of experts to discuss how to ensure a diverse surgical workforce. The panelists discussed the current state of DEI efforts within surgical departments and societal demographic changes that inform and necessitate surgical workforce adaptations. Concrete recommendations included the following: obtain internal data, establish DEI committee, include bias training, review hiring and compensation practices, support the department members doing the DEI work, commit adequate funding, be intentional with DEI efforts, and develop and support alternate pathways for promotion and tenure.