Medical facilities help to ensure a higher quality of life and improve social welfare. The spatial accessibility determines the allocation fairness and efficiency of medical facilities. It also provides information about medical services that residents can share. Although critical, scholars often overlooked the level of medical facilities, the composition of integrated transportation networks, and the size of service catchment in the literature on accessibility. This study aims to fill this research gap by considering the integrated transportation network, population scale, travel impedance between medical facilities and residential areas, and the impact of medical facilities\' levels on residents\' medical choices. An improved potential model was constructed to analyze the spatial accessibility of medical facilities in Changning District of Shanghai, China. Interpolation analysis was conducted to reveal the spatial accessibility pattern. Cluster and outlier analysis and Getis-Ord Gi* analysis were applied for the cluster analysis. Results show that the spatial accessibility of medical facilities is quite different in different residential areas of Changning District, Shanghai. Among them, the spatial accessibility of medical facilities is relatively high in Hongqiao subdistrict, Xinjing Town, and part of Xinhua Road subdistrict. In addition, residents have overall better access to secondary hospitals than to primary and tertiary hospitals in the study area. This study provides a spatial decision support system for urban planners and policymakers regarding improving the accessibility of healthcare facilities. It extends the literature on spatial planning of public facilities and could facilitate scientific decision making.

As the population is aging rapidly, the irrationality of residential care facility (RCF) configuration has impacted the efficiency and quality of the aged care services so significantly that the optimization of RCF configuration is urgently required. A multi-objective spatial optimization model for the RCF configuration is developed by considering the demands of three stakeholders, including the government, the elderly, and the investor. A modified immune algorithm (MIA) is implemented to find the optimal solutions, and the geographic information system (GIS) is used to extract information on spatial relationships and visually display optimization results. Jing\'an District, part of Shanghai, China, is analyzed as a case study to demonstrate the advantages of this integrated approach. The configuration rationality of existing residential care facilities (RCFs) is analyzed, and a detailed recommendation for optimization is proposed. The results indicate that the number of existing RCFs is deficient; the locations of some RCFs are unreasonable, and there is a large gap between the service supply of existing RCFs and the demands of the elderly. To fully meet the care demands of the elderly, 6 new facilities containing 1193 beds are needed to be added. In comparison with the optimization results of other algorithms, MIA is superior in terms of the calculation accuracy and convergence rate. Based on the integration of MIA and GIS, the quantity, locations, and scale of RCFs can be optimized simultaneously, effectively, and comprehensively. The optimization scheme has improved the equity and efficiency of RCF configuration, increased the profits of investors, and reduced the travel costs of the elderly. The proposed method and optimization results have reference value for policy-making and planning of RCFs as well as other public service facilities.

Opioid overdose deaths quintupled in Massachusetts between 2000 and 2016. Potentially inappropriate opioid prescribing practices (PIP) are associated with increases in overdoses. The purpose of this study was to conduct spatial epidemiological analyses of novel comprehensively linked data to identify overdose and PIP hotspots.
Sixteen administrative datasets, including prescription monitoring, medical claims, vital statistics, and medical examiner data, covering >98% of Massachusetts residents between 2011-2015, were linked in 2017 to better investigate the opioid epidemic. PIP was defined by six measures: ≥100 morphine milligram equivalents (MMEs), co-prescription of benzodiazepines and opioids, cash purchases of opioid prescriptions, opioid prescriptions without a recorded pain diagnosis, and opioid prescriptions through multiple prescribers or pharmacies. Using spatial autocorrelation and cluster analyses, overdose and PIP hotspots were identified among 538 ZIP codes.
More than half of the adult population (n = 3,143,817, ages 18 and older) were prescribed opioids. Nearly all ZIP codes showed increasing rates of overdose over time. Overdose clusters were identified in Worcester, Northampton, Lee/Tyringham, Wareham/Bourne, Lynn, and Revere/Chelsea (Getis-Ord Gi*; p < 0.05). Large PIP clusters for ≥100 MMEs and prescription without pain diagnosis were identified in Western Massachusetts; and smaller clusters for multiple prescribers in Nantucket, Berkshire, and Hampden Counties (p < 0.05). Co-prescriptions and cash payment clusters were localized and nearly identical (p < 0.05). Overlap in PIP and overdose clusters was identified in Cape Cod and Berkshire County. However, we also found contradictory patterns in overdose and PIP hotspots.
Overdose and PIP hotspots were identified, as well as regions where the two overlapped, and where they diverged. Results indicate that PIP clustering alone does not explain overdose clustering patterns. Our findings can inform public health policy decisions at the local level, which include a focus on PIP and misuse of heroin and fentanyl that aim to curb opioid overdoses.

To evaluate flood-prone areas, correlation analysis of flooding factors for the quantitative evaluation of hazard degree was determined to assist in further disaster prevention management. This study used flood-prone areas in 35 villages over eight townships (Changhua, Huatan, Yuanlin, Xiushui, Puyan, Hemei, Dacun, and Erlin) in Changhua County as research samples. Linear combination was used to evaluate flood-prone environmental indices, and an expert questionnaire was designed by using the analytic hierarchy process and the Delphi method to determine the weights of factors. These factors were then used to calculate the eigenvector of a pairwise comparison matrix to obtain the weights for the risk assessment criteria. Through collection of disaster cases, with particular focus on specifically protected areas where flooding has occurred or is likely to occur, public adaptation and response capabilities were evaluated by using an interview questionnaire that contains the items of perceived disaster risk, resource acquisition capability, adaptation capability, and environment understanding and disaster prevention education. Overlays in a geographic information system were used to analyze the flood-risk degree in villages and to construct a distribution map that contains flood-prone environment indices. The results can assist local governments in understanding the risk degree of various administrative areas to aid them in developing effective mitigation plans.

Recent experience of hurricanes, particularly in the southeast United States, has heightened awareness of the multifaceted nature of and the challenges to effective disaster relief planning. One key element of this planning is providing adequate shelter at secure locations for people who evacuate. Some of these individuals will have \'special needs\', yet there is little research on the relationship with shelter space. This study designed a geographic information systems-based network optimisation methodology for the siting of special needs hurricane relief shelters, with a focus on the transportation component. It sought to find new locations for shelters that maximise accessibility by vulnerable populations, given capacity constraints, concentrating on the ageing population. The framework was implemented in a medium-sized metropolitan statistical area in the state of Florida where data suggest a possible deficit in special needs shelter space. The study analysed options for increasing special needs shelter capacity, while considering potential uncertainties in transportation network availability.

The objective of assisting with tasks and decisions during incident response is to reduce the risks to victims and rescue personnel while increasing the efficiency of the rescue operation. Handling uncertain information during urban search and rescue (USAR) missions represents additional stress to the decision-maker. The aim of this study is to identify the decision-making behaviour of rescuers during USAR missions to pinpoint trapped or buried victims in debris in order to design assistance technologies and decision-support systems that meet their needs. In 2010, a survey was conducted among 10-15 per cent of all German rescue personnel specialised in search tasks. One of the major results of this survey is that a subjective assessment of the reliability of information available from heterogeneous sources influences the rescuers\' actions and that there is no methodology for decision-making involving uncertain information. In addition, the study found that compliance with procedures does not require assistance.

This study examines associations of disaggregate land uses with self-reported walking for transportation among participants of the Multi-Ethnic Study of Atherosclerosis (MESA) in Forsyth County, NC and New York, NY. Network distance to each use (in miles), intensity (number of uses per 1/2-mile network buffer) of each use and diversity (number of different uses per 1/2-mile network buffer) of uses were calculated using Geographic Information Systems (GIS). Associations with odds of meeting recommended physical activity levels (150min/week) were examined after controlling for individual- and census-tract-level covariates. Greater distance to and lower intensity of pedestrian-oriented uses, specifically those for social interactions, were associated with lower odds of meeting recommendations in NY. Results suggest that land uses linked to social interactions may be useful for encouraging increased transportation walking.