Britain’s capital? (c. AD 80–90)

This chapter describes London’s later Flavian architectural development, elements of which may have marked and celebrated the political maturity of the city. London’s first forum was probably built around the time of Agricola’s long governorship of Britain. Circumstantial evidence suggests that this building was erected c. AD 79/80. It could have accompanied the grant of formal urban status and the creation of the institutions of local self-government, although this remains uncertain. The contents of a legal judgement inscribed on a writing tablet suggests that London did not hold autonomous status in AD 76. Other public buildings and works included large public baths, one probably built c. AD 84 that has alternatively been identified as part of the governor’s palace. London may have benefitted from the architectural patronage of the emperor Domitian, executed on his behalf by the procurator, intended to grace Britain’s capital city following the completion of the conquest of the British Isles.

Conflicts, Confrontations and Conduits in Rural Environments: Is Resilience at Work in Gokwe South Rural District?

This article explores conflicts, confrontations and conduits for sustainable development in rural environments. Fragility and degradation with a slight resilience manifest heavily in Gokwe South Rural District (GSRD), Zimbabwe. The article notes rural development as a double-edged sword, bringing tremendous opportunities for innovation but also causing increased ecological degradation. As such, it often results in conflicts and confrontations among stakeholders. Like many Zimbabwean rural settlements, GSRD is experiencing serious land disputes. conflicts arise from the proposed changes, like extension of infrastructure, perceived by some stakeholders as contrary to their interests and wishes. Using focus group discussions and thematic analysis, a trend of how conflicts and confrontations emerged was established in GSRD. The findings show that land transition from rural to urban status without consultations instigates conflict between different development agencies and communities.

Urban Land Expansion Simulation Considering the Diffusional and Aggregated Growth Simultaneously: A Case Study of Luoyang City

Restricted by urban development stages, natural conditions, urban form and structure, diffusional growth occupies a large proportion of area in many cities. Traditional cellular automata (CA) has been widely applied in urban growth studies because it can simulate complex system evolution with simple rules. However, due to the limitation of neighborhood conditions, it is insufficient for simulating urban diffusional growth process. A maximum entropy mode was used to estimate three layers of probability spaces: the probability layer of cell transformation from non-urban status to urban status (PLCT), the probability layer for aggregated growth (PLAP), and the probability layer for diffusional growth (PLOP). At the same time, a maxent category selected CA model (MaxEnt-CSCA) was designed to simulate aggregated and diffusional urban expansion processes simultaneously. Luoyang City, with a large proportion of diffusional urban expansion (65.29% in 2009–2018), was used to test the effectiveness of MaxEnt-CSCA. The results showed that: (1) MaxEnt-CSCA accurately simulated aggregated growth of 47.40% and diffusional growth of 37.13% in Luoyang from 2009 to 2018, and the overall Kappa coefficient was 0.78; (2) The prediction results for 2035 showed that future urban expansion will mainly take place in Luolong District and the counties around the main urban area, and the distribution pattern of Luolong District will change from the relative diffusion state to the aggregation stage. This paper also discusses the applicable areas of MaxEnt-CSCA and illustrates the importance of selecting an appropriate urban expansion model in a region with a large amount of diffusional growth.

The intersectional impact of sex and social factors on subjective health: analysis of the Canadian longitudinal study on aging (CLSA)

Background Self-rated health (SRH) is a widely validated measure of the general health of older adults. Our aim was to understand what factors shape individual perceptions of health and, in particular, whether those perceptions vary for men and women and across social locations. Methods We used data from the Canadian Longitudinal Study on Aging (CLSA) of community-dwelling adults aged 45 to 85. SRH was measured via a standard single question. Multiple Poisson regression identified individual, behavioural, and social factors related to SRH. Intersections between sex, education, wealth, and rural/urban status, and individual and joint cluster effects on SRH were quantified using multilevel models. Results After adjustment for relevant confounders, women were 43% less likely to report poor SRH. The strongest cluster effect was for groupings by wealth (21%). When wealth clusters were subdivided by sex or education the overall effect on SRH reduced to 15%. The largest variation in SRH (13.6%) was observed for intersections of sex, wealth, and rural/urban status. In contrast, interactions between sex and social factors were not significant, demonstrating that the complex interplay of sex and social location was only revealed when intersectional methods were employed. Conclusions Sex and social factors affected older adults’ perceptions of health in complex ways that only became apparent when multilevel analyses were carried out. Utilizing intersectionality analysis is a novel and nuanced approach for disentangling explanations for subjective health outcomes.

Assessment of trace metal contamination by geochemical normalisation in sediments of two lagoons: A comparative study of the Kpeshie and Muni lagoons, Ghana

Heavy metal contamination status of bottom sediments of two lagoons was compared by the employment of Enrichment Factor (EF) analysis for Iron (Fe), Manganese (Mn), Cupper (Cu), Lead (Pb), Chromium (Cr), Nickel (Ni), Silver (Ag), Zinc (Zn) and Mercury (Hg). Kpeshie Lagoon recorded enrichment (EF ≥ 1) for Cd, Pb, Ag, Hg and Zn, whilst Muni Lagoon recorded enrichment for Cd, Mn, Ag, Hg and Zn as metals of anthropogenic influence. Kpeshie, situated in a highly urbanized area, has 75% spatial distribution of Pb enrichment. The assessment shows that Ag and Hg are the most enriched metals in the sediments of both Lagoons, reaching extremely severe levels. Only Mn showed statistically significant difference in mean concentration of metals for both Lagoons. Pearson correlation matrix indicated that Pb had a strong relation with Ag, Hg and Zn (r = 0.956; p < 0.05) which is significant in Kpeshie. It also had a strong association with Ag and Hg but not with Zn (r = 0.240) in the Muni. The study clearly delineates Pb as a pollutant that designates the urban status of Kpeshie. Its associated metals; Ag, Hg and Zn which may be coming from a common source are from industrialized zones.

Rural–urban differences in antibiotic prescribing for uncomplicated urinary tract infection

Objective: To examine rural–urban differences in temporal trends and risk of inappropriate antibiotic use by agent and duration among women with uncomplicated urinary tract infection (UTI). Design: Observational cohort study. Methods: Using the IBM MarketScan Commercial Database (2010–2015), we identified US commercially insured women aged 18–44 years coded for uncomplicated UTI and prescribed an oral antibiotic agent. We classified antibiotic agents and durations as appropriate versus inappropriate based on clinical guidelines. Rural–urban status was defined by residence in a metropolitan statistical area. We used modified Poisson regression to determine the association between rural–urban status and inappropriate antibiotic receipt, accounting for patient- and provider-level characteristics. We used multivariable logistic regression to estimate trends in antibiotic use by rural–urban status. Results: Of 670,450 women with uncomplicated UTI, a large proportion received antibiotic prescriptions for inappropriate agents (46.7%) or durations (76.1%). Compared to urban women, rural women were more likely to receive prescriptions with inappropriately long durations (adjusted risk ratio 1.10, 95% CI, 1.10–1.10), which was consistent across subgroups. From 2011 to 2015, there was slight decline in the quarterly proportion of patients who received inappropriate agents (48.5% to 43.7%) and durations (78.3% to 73.4%). Rural–urban differences varied over time by agent (duration outcome only), geographic region, and provider specialty. Conclusions: Inappropriate antibiotic prescribing is quite common for the treatment of uncomplicated UTI. Rural women are more likely to receive inappropriately long antibiotic durations. Antimicrobial stewardship interventions are needed to improve outpatient UTI antibiotic prescribing and to reduce unnecessary exposure to antibiotics, particularly in rural settings.

Success Rates for the Objectives of US State Cancer Control Plans: A First Look

Background A well-designed cancer control plan is an important tool for a nation, state, or community to address the burden of cancer. Furthermore, it provides the opportunity to devise and implement measurable objectives. However, there has been little to no assessment of the success rates of such objectives. Methods I compared the success rate of objectives between US states’ current plan and most recent past plan to determine the proportion of success in the United States overall. I also tested possible reasons for low success rates. Results The mean success rate was 20% for stringent successes (only exact matches between plans) and 28% for loose successes (exact and similar matches between plans). The magnitude of change in percentage between the baseline and target for loose objectives significantly predicted success (P = .0347). Higher change resulted in lower success. However, neither the number of objectives nor the level of overlap significantly predicted success rate. Nor was population size, region, or rural–urban status significantly related to success rate. The most successful states had high proportions of objectives that were measurable and a high number of overlapping objectives. Conclusion I found that objective success rates were low for cancer control plans. To improve success rates, I suggest that future cancer control plans ensure each objective has a measurable baseline and realistically attainable target.