An enzyme-linked immunosorbent assay (ELISA) to detect antibodies to Escherichia coli O157 lipopolysaccharide (LPS) was developed with sera from 63 children with confirmed recent E. coli O157 infection and from 256 age-stratified urban controls. The median ELISA values for control and case sera were 0.05 (interquartile range, 0 to 0.20; mean +/- standard deviation [SD], 0.15 +/- 0.22) and 1.41 (interquartile range, 1.11 to 1.59; mean +/- SD, 1.41 +/- 0.53), respectively (P < 0.001). With a breakpoint of 0.59 (mean ELISA value of the control sera + 2 SDs), the assay had a sensitivity, specificity, and positive and negative predictive values of 95, 94, 80, and 98%, respectively, for recent E. coli O157 infection. The O157 LPS assay and Vero cytotoxin (VT) 1-neutralizing-antibody (NAb) assay were used to compare the relative frequencies of O157 LPS antibodies and VT1-NAbs in an age-stratified urban population from Toronto, Ontario, Canada, and in 216 healthy family members from dairy farm in southern Ontario. The frequency of O157 LPS antibodies was about threefold higher in dairy farm residents (12.5%) than in urban residents (4.7%) (P < 0.01). Similarly, the frequency of VT1-NAbs was about sixfold higher in dairy farm residents (42.0%) than in urban residents (7.7%) (P < 0.001). These findings are consistent with a greater level of exposure of dairy farm residents to VT-producing E. coli (VTEC) strains. The high rate of seropositivity to VT1 in farm residents probably reflects the booster effect of repeated VTEC exposures and argues against a sustained generalized immunosuppressive effect of VT1. Seroepidemiological studies may help in assessing the level of exposure of different populations to VTEC strains.

In this study, an experiment was performed to assess the trip difficulty for urban residents of different age groups walking in various depths of water, and the data were corroborated with the real urban rainstorm waterlogging scenarios in downtown (Daoli district) Ha-Erbin (China). Mathematical models of urban rainstorm waterlogging were constructed using scenario simulation methods, aided by the GIS spatial analysis technology and hydrodynamic analysis of the waterway systems in the study area. Then these models were used to evaluate the impact of waterlogging on the safety of residents walking in the affected area. Results are summarized as: (1) for an urban rainstorm waterlogging scenario reoccurring once every 10 years, three grid regions would have waterlogging above 0.5 m moving at a velocity of 1.5 m/s. Under this scenario, waterlogging would accumulate on traffic roads only in small areas, affecting the safety and mobility of residents walking in the neighborhood; (2) for an urban rainstorm waterlogging scenario reoccurring once every 20 years, 13 grids experienced the same waterlogging situation affecting a larger area of the city; (3) for an urban rainstorm waterlogging scenario reoccurring once every 50 years, 86 grid regions were affected (waterlogging above 0.5 m moving at 1.5 m/s)...

Urban residents experience a wide range of traumatic events and are at increased risk of assaultive violence. Although previous research has examined trajectories of posttraumatic stress (PTS) through latent class growth analysis (LCGA) among persons exposed to the same index events (e.g., a natural disaster), PTS trajectories have not been documented among urban residents. The aims of this study were to conduct LGCA with a sample of trauma survivors from Detroit, Michigan (N = 981), and to explore predictors of trajectory membership. Participants completed three annual telephone surveys, each of which included the posttraumatic stress disorder (PTSD) Check-list-Civilian Version. Four PTS trajectories were detected. Although the majority evidenced a trajectory of consistently few symptoms (Low: 72.5 %), 4.6 % were in a trajectory of chronic severe PTSD (High), and the remainder were in trajectories of consistently elevated, but generally subclinical, levels of PTS (Decreasing: 12.3 %; Increasing: 10.6 %). Socioeconomic disadvantage (e.g., lower income), more extensive trauma history (e.g., childhood abuse), and fewer social resources (e.g., lower social support) were associated with membership in higher PTS trajectories, relative to the Low trajectory. The results suggest that efforts to reduce PTS in urban areas need to attend to socioeconomic vulnerabilities in addition to trauma history and risk for ongoing trauma exposure.

Patterns of poultry exposure in rural and urban areas in China have not been systematically evaluated and compared. The objective of our study is to investigate patterns in human exposure to poultry in rural and urban China. We conducted a two-stage household-based clustered survey on population exposure to live/sick/dead poultry in Xiuning and Shenzhen. Half of the rural households (51%) in Xiuning raised poultry, mostly (78%) free-range. Around half of those households (40%) allowed poultry to stay in their living areas. One quarter of villagers reported having contact with sick or dead poultry. In Shenzhen, 37% urban residents visited live poultry markets. Among these, 40% purchased live poultry and 16% touched the poultry or cages during purchase. Our findings indicated that human exposure to poultry was different in rural and urban areas in China. This discrepancy could contribute to the observed differences in epidemiologic characteristics between urban and rural cases of influenza A(H7N9) and A(H5N1) virus infection.

In recent years, medical and health care consumption has risen, making health risk an important determinant of household spending and welfare. We aimed to examine the determinants of medical and health care expenditure to help policy-makers in the improvement of China’s health care system, benefiting the country, society and every household. This paper employs panel data from China’s provinces from 2001 to 2011 with all possible economic variations and studies the determinants of medical and healthcare expenditure for urban residents. CPI (consumer price index) of medical services and the resident consumption level of urban residents have positive influence on medical and health care expenditures for urban residents, while the local medical budget, the number of health institutions, the incidence of infectious diseases, the year-end population and the savings of urban residents will not have effect on medical and health care expenditure for urban residents. This paper proposed three relevant policy suggestions for Chinese governments based on the findings of the research.

The study addresses governance challenges in public service delivery in China. It builds on the citizen scorecard survey conducted in five Chinese cities in 2006 to gauge citizens experience with public services, and demonstrates the usefulness of citizens feedback for policy development and implementation. The survey found that citizens were generally pleased with urban public services, but worried about the associated fees. Compared with the official urban residents, the urban poor and rural migrants in cities reported sharper utilization constraints, lower readiness to complain or pay informal fees, and a much larger income share spent on public services. The reported citizens perceptions sometimes diverged from the evidence and pointed to significant information asymmetries. Explaining the survey results, the study reveals problems of inadequacy, inequality and misaligned incentives in public resource allocation. The study presents several successful experiments reducing the dependence on user fees in basic education and primary healthcare. It recognizes that China has been undertaking comprehensive reforms to enhance equity and quality in public service delivery. Such reforms have included measures to strengthen the regulatory...

This study on Bangladesh Dhaka-improving living conditions for the urban poor reflects a comprehensive look at poverty in Dhaka with an aim to provide the basis for an urban poverty reduction strategy for the Government of Bangladesh, local authorities, donors, and NGOs. While the needs in Dhaka are enormous, this study focuses on analyzing those critical for the poor - understanding the characteristics and dynamics of poverty, issues of employment, land and housing, basic services, and crime and violence. This analysis will provide a platform for developing recommendations for policy reform as Dhaka endeavors to meet the growing challenges and urgent needs of the urban poor. Each chapter concludes with a set of recommended priorities for poverty reduction.

Performance benchmarking is a powerful tool to make service providers more accountable, and to measure progress while improving performance. This review examines the introduction of performance benchmarking in over 30 urban water utilities across Bangladesh, India, and Pakistan since 2003, with the support of their respective governments and the Water and Sanitation Program - South Asia. It focuses on the process of building systems for performance measurement, monitoring and analysis, and institutionalizing benchmarking as an integral part of operational practice in utilities and government, to support broader sector reforms. The findings reveal that most utilities are performing poorly, and just how dire the state of service provision really is across the towns and cities of South Asia: 1) no water utility in Bangladesh, India or Pakistan provides its customers with continuous water; the average is five hours a day; 2) water utilities do not serve at least a third of urban residents; 3) high nonrevenue water-frequently estimated above 40 percent-means a large volume of water is being lost through leaks...

Cities benefit from two key conditions, both with direct implications for social, cultural, and economic integration. One is a large middle class and a large sector of modest profit-making firms, distinct from a sharp concentration of incomes and profits. The other is a well-distributed urban economy: robust neighborhood sub economies preventing excessive economic concentration in the center, and good transportation for people and goods- not only to the center but also transversally. The urban economy is marked by capture at the top, poorer middle classes, larger destitute populations, and more crime and conflict. These challenges, though present in cities the world over, play out differently in smaller, prosperous cities in Europe and North America than in megacities in Asia, Africa, and Latin America. But cities today are also seeing a massive upgrading of infrastructure in city centers and high value neighborhoods. One outcome is widespread homelessness and destitution, even in cities where these problems had become rare by the mid- to late 20th century. The reasons for this juxtaposition vary enormously due to the differences among cities and among the national economies and societies in which they function. Some cities are sinking under the weight of the negatives...

This report presents the problem, describes the analytical framework, the African and World context and the characteristics that need to be present for a responsible and effective urbanization. Chapter one discusses the issues involved in measuring urban growth and density and the problem of under-measuring density. Chapter two introduces key aspects of the recent urbanization in Tanzania, including migration, structure of economy and employment and the estimation of the urban contribution to Gross Domestic Product (GDP). Chapter three discussed the backbone of any urbanization policy, land management and land markets, and how the government is in a position to drastically improve the main constraint of a healthy urbanization process by unleashing urban land supply and providing the urban actors with the most needed factor: serviced urban land. Chapter four discusses the universal provision of basic services and the general picture for rural and urban Tanzania at present. Chapter five discusses the need for substantial infrastructure to improve mobility and connectivity and the funding potential of the different players in the urbanization process...

This study responds to the need for information and analysis on the urban sector in Sudan, to inform the Bank's policy dialogue with the Government of Sudan (GoS) on urban and local government issues, and to inform the design of future Bank assistance. The first phase of this analytical exercise, which is the focus of this report, develops an overview of the urban landscape. The report is structured as follows: section two describes the evolution of the spatial system in Sudan and highlights key urbanization patterns and trends; section three provides an overview of the legal, institutional and financial composition of Sudan's urban areas; and section 80 outlines the key policy issues and recommendations. The report also draws on in-depth case studies of Nyala and Khartoum, which are included as annexes to the report.

This study responds to the need for information and analysis on the urban sector in South Sudan, to inform the Bank's policy dialogue with the Government of the Republic of South Sudan (GoSS) on urban and local government issues, and to inform the design of future Bank assistance. The first phase of this analytical exercise, which is the focus of this report, develops an overview of the urban landscape. A second phase of this analytical work is planned, that will build on the findings emerging from this first phase. The report is structured as follows: section two describes the evolution of the spatial system in South Sudan and highlights key urbanization patterns and trends; section three provides an overview of the legal, institutional and financial composition of South Sudan's urban areas; and section four outlines the key policy issues and recommendations. The report also draws on an in-depth case study of Juba, which is included as an annex to the report.

This policy note provides a summary of extensive analysis carried out on urban poverty in Indonesia today and a review of main urban poverty programs, with the objective of providing the basis for an urban poverty reduction strategy. A second policy note, 'Indonesia: evaluation of the urban Community-Driven Development, or CDD program, Program Nasional Pemberdayaan Masyarakat (PNPM)' summarizes a more detailed process evaluation that was carried out of this important program in parallel to the urban poverty analysis and program review. The PNPM-Urban evaluation covers issues related to internal efficiency, distills lessons learned, and identifies options for improving program effectiveness. The two pieces together provide context for the review of existing programs and strategic directions for addressing urban poverty, as well as more specific operational recom-mendations for enhancing impact of the PNPM-Urban Program. Section one includes this introduction and the analytical approach of the study, section two covers the analysis of poverty trends and characteristics...

The Local Health Commission (LHC) was established in 1940. Its significance lies in the fact that it adopted a public health-based approach to local governance and that it delivered health and welfare services to residents of the neglected black and multi-racial urban areas. Even though its mandate was the antithesis of the goals of urban apartheid, the LHC expanded its scope after the National Party came into power in 1948. This dissertation is firstly, an institutional history of the LHC. Secondly, it examines the ways in which black urban residents practiced in municipal institutions by demanding that the LHC not only fulfill its mandate but, that it also amend its programs in order to meet their needs. A third and final theme of this dissertation is the role of Advisory Boards in addressing the public health crises specifically, ways in which the ABs held the LHC accountable. By exploring the LHC through these three themes, this dissertation addressed larger historical questions: firstly, the role of white liberal bureaucrats in the development of public health and urban governance in South Africa and secondly, the nature of black people’s participation in state institutions before 1994.; Thesis (Ph.D, History) -- Queen's University...

Over the last decade, and particularly the last five years, state officials in Ghana’s capital city, Accra, have intensified their resolve to ‘modernize’ the city and make it a competitive destination for global investments. In the same period, exercises by city authorities to remove or at least suppress practices of ordinary residents in the informal sector have become more frequent and intensified. Groups such as street hawkers, market women, and slum dwellers have become the main target of periodic ‘decongestion exercises’. In this dissertation I investigate how the policies and practices associated with the ‘globalizing’ and ‘modernizing’ ambition of the state intersect with the interests of the majority of urban residents whose everyday social and economic practices are concentrated in the informal sector, a sector deemed to be deleterious to the desired image for the city. I argue that contemporary city-making in Ghana is driven mainly by a combination of economic, nationalist and individual interests. In examining how cultural and social locations such as gender and ethnicity mediate the relationship between the state and residents, I demonstrate how contemporary forms of neoliberal urban governance shape, and are being shaped by...

During Portuguese colonial rule biased service provision throughout the 20th century resulted in a city that today has spatially segregated water services distinguishable along racial lines. In 1975, a newly independent Mozambique lacked the financial and human resources necessary to extend its utility network to peri-urban residents. Water coverage rates and service levels could not keep up with population growth. Donor agencies and policymakers gave a great deal of attention to large scale-private sector participation but it was unable to overcome Maputo's infrastructure challenges. Today, less than 40 percent of Maputo residents have access to the utility network. Maputo's 'other private sector' - small, informal private-sector providers (SPSP) - serve over 150,000 residents with reliable standpipes and private connections and have contributed significantly to coverage goals. Sector planners knew less, however, about how they could contribute to future sector goals. This study aims to answer that question through a detailed analysis of their cost and price structures, investment profiles, and operating environment.; (cont.) We find that Maputo's SPSPs already contribute significantly to the sector's coverage, service, and financial sustainability goals. They should be viewed as an integral part of Maputo's water delivery system and not 'a problem' like much of the literature brands them. Their operations can be made more efficient...

This thesis offers an early look at a radical shift in Sri Lankan urban housing policy regarding slums in the capital city of Colombo. During the 1980s, the Sri Lankan government achieved widespread urban improvements by mobilizing community-led on-site slum upgrading. However, since the late 1990s, the government has attempted to persuade urban slum dwellers to relocate to nearby high-rise apartments and, thus, reclaim public land inhabited by low-income settlements in central Colombo city. This policy shift is surprising because: (1) Sri Lanka's previous 10-year slum upgrading program was described as "best practice" by donor agencies, and (2) most other countries have rejected the notion of high-rise for low-income city dwellers. Concurrent shifts in donor agency ideology and preconditions as well as overcrowded physical conditions in previously upgraded under-served settlements drove the government to seek new approaches to improve the lives of the urban poor. Moreover, beginning in the 1990s, there was a renewed perception that cities like Colombo needed to capitalize on its comparative advantages vis-à-vis the rest of the region in order to spur economic growth in the nation. The Sustainable Townships Programme (STP) and its pilot project...

EXECUTIVE SUMMARY Since the economic reform in the late 1970s, China’s economy has experienced consistently rapid growth, with a drastic change of production pattern and income distribution. The increasing income inequality, which is of importance to social justice and economic potential, has raised concerns in China. Because of rapid urbanization, millions of Chinese are flowing into cities from rural areas, so the income inequality within urban areas has received more research attention in recent years. Given the unique household registration system (Hukou) in China, the urban population can be divided into urban residents who are born in cities with urban Hukou and rural-urban migrants who are originally from rural areas with rural Hukou. The two subgroups have quite different characteristics and do not enjoy the same level of social benefits. Previous studies have not given enough focus on the migrant subgroup in terms of income inequality. To better understand income inequality issues in urban China, this study performs a comparative analysis between the two subgroups of urban residents and rural-urban migrants, seeking to answer the following questions: What are the income inequality levels between subgroups of urban residents and rural-urban migrants...

Because the urban environment is inherently stressful, urban residents need outlets for stress reduction and restoration. Exposure to nature in a variety of settings has been shown by researchers to reduce stress in humans. Little research, however, has been undertaken to quantify and describe the benefits of visiting public gardens. This research examines the relationship between a visit to an urban, public garden and stress reduction in urban residents. Through an on-site visitor exit survey, visitors to two urban, public gardens were questioned about their perceived stress levels before and after a garden visit. Respondents also were questioned about their reasons for visiting the gardens. The survey results indicate a reduction in stress in urban residents after a garden visit. Furthermore, urban residents identify relaxation, stress reduction, and inspiration as the three most important reasons for visiting the gardens. All three reasons are related to feelings or affects, suggesting that urban residents find the affective rewards of visiting public gardens to be more important than other, more tangible rewards. The results of this research will be useful in public garden administrators’ efforts to obtain funding from both public and private sources. The positive benefits available to the urban community as a result of a garden visit should be emphasized to funding sources as proof of public gardens’ significance to the community. Garden administrators can further use the research results in promoting gardens to the public...

OBJECTIVE: To compare physical activity and sedentary behavior patterns of rural-to-urban migrants in Peru versus lifetime rural and urban residents and to determine any associations between low physical activity and four cardiovascular risk factors: obesity (body mass index > 30 kg/m²), systolic and diastolic blood pressure, hypertension, and metabolic syndrome. METHODS: The PERU MIGRANT (PEru's Rural to Urban MIGRANTs) cross-sectional study was designed to measure physical activity among rural, urban, and rural-to-urban migrants with the International Physical Activity Questionnaire (IPAQ). RESULTS: The World Health Organization (WHO) age-standardized prevalence of low physical activity was 2.2% in lifetime rural residents, 32.2% in rural-to-urban migrants, and 39.2% in lifetime urban residents. The adjusted odds ratios for low physical activity were 21.43 and 32.98 for migrant and urban groups respectively compared to the rural group. The adjusted odds ratio for being obese was 1.94 for those with low physical activity. There was no evidence of an association between low physical activity and blood pressure levels, hypertension, or metabolic syndrome. CONCLUSIONS: People living in a rural area had much higher levels of physical activity and lower risk of being overweight and obese compared to those living in an urban area of Lima. Study participants from the same rural area who had migrated to Lima had levels of physical inactivity and obesity similar to those who had always lived in Lima. Interventions aimed at maintaining higher levels of physical activity among rural-to-urban migrants may help reduce the epidemic of obesity in urban cities.