While atmospheric microplastics are known to be transported over long distances, their residence times and transport processes lack clarity. This study utilized natural radionuclides 7Be, 210Pb, and 210Po to explore the transport of atmospheric microplastics in Tianjin, a coastal city in Northern China. Microplastic concentrations ranged from 0.03 to 0.13 particles m-3 over the course of a year. The proportion of microplastic fragments in winter was significantly higher than that in other seasons, with median microplastic sizes in autumn and winter being larger than those in spring and summer. The atmospheric microplastic surface was rough, exhibiting irregular pores and multiple depressions and cracks. Microplastics experienced vertical mixing with the upper atmosphere in April and August and were influenced by rainfall in July. The residence time of atmospheric particles ranged from 9.47 to 22.85 days throughout the year, with an average of 14.41 days. The peak residence time of atmospheric particulates in November may be correlated with increased 210Po levels from coal consumption. Their prolonged atmospheric presence and rough surface allow microplastics to act as carriers for various chemical pollutants, underscoring the complexity and potential risks associated with their presence in the atmosphere.

Transportation is a significant social determinant of health and a barrier to treatment for many patients. Cancer patients are disproportionately affected, and it can be especially salient for patients undergoing several weeks of daily radiation treatment. A prospective survey pilot study at our institution examining financial toxicity related to transportation for patients undergoing radiation treatment showed a correlation between high transportation costs and financial stress. Furthermore, those living >10 miles from the radiation center were associated with worse financial toxicity. Previous programs implemented to address the transportation issue in oncology have been mainly inadequate or ineffective. These programs have been set back due to a lack of awareness and low utilization. The Health Equity Achievement in Radiation Therapy (HEART) adjustment from the proposed Radiation Oncology Case Rate (ROCR) payment model for radiation oncology will greatly alleviate transportation barriers for patients undergoing radiation treatment. The $500 per patient can be utilized for those patients at the highest risk, like those living far away from the radiation center.

BACKGROUND: Many climate mitigation policies to reduce transportation emissions have public health benefits related to ambient air pollution. However, few health analyses consider the equity implications of alternative policies. Equity can be conceptualized in many different ways that may be relevant to communities, decision-makers, and other stakeholders.
OBJECTIVE: To evaluate alternative transportation emissions reduction scenarios across the northeastern United States considering population exposure reductions and multiple equity constructs.
METHODS: We developed four quantitative indicators reflecting equity constructs that aligned with stakeholder perspectives, including racial/ethnic exposure inequities, proportion of benefits in environmental justice communities, distribution of benefits among participating states, and rural/urban share of benefits. We analyzed numerous transportation emissions reduction scenarios for directly emitted fine particulate matter (primary PM2.5) covering 12 Northeast states and the District of Columbia. We used the Community Multiscale Air Quality model with the decoupled direct method to estimate the reduction in population-weighted primary PM2.5 exposure and the impact on equity for each scenario.
RESULTS: Scenarios that yielded greater reductions in population-weighted primary PM2.5 exposure generally emphasized emissions reductions in urban areas or states with large urban centers, with a more than threefold difference in benefits across scenarios. The higher exposure-benefit scenarios typically also had greater reductions in racial/ethnic exposure inequities but led to higher between-state or rural/urban inequality. Scenarios that targeted uniform percentage emission reductions from light or heavy-duty trucks best addressed rural/urban inequalities but led to the smallest reductions in racial/ethnic inequity.
CONCLUSIONS: There are intrinsic tradeoffs among equity constructs, where focusing resources on distributing benefits across states or between urban and rural populations could come at the expense of less reduction in racial/ethnic exposure inequities or in environmental justice communities. Future health benefits analyses should incorporate multiple equity indicators that reflect different stakeholder perspectives and articulate the underlying constructs and tradeoffs.

Expanding road networks to accommodate various activities has significantly increased urban noise pollution, adversely affecting human health and quality of life. Numerous factors influence the noise level in urban areas, including road characteristics, traffic characteristics, surrounding buildings, and weather conditions. While previous studies have considered many of these factors individually, this study aims to integrate all relevant variables to comprehensively monitor and analyze their combined effects on noise levels. The objective is to determine the most influential factors that could be incorporated into effective noise reduction strategies. This research focuses on Cairo, one of the most densely populated cities in the world, where high noise levels are a persistent issue. A detailed case study of Tahrir Street in Dokki, Cairo, provides the basis for this investigation. One of the most crowded areas is El-Tahrir Street in Al-Dokki, which was selected as a case study in this research. This area experiences high traffic volume, with up to 1700 vehicles passing through within a 15-min interval. This significant traffic volume is the primary driver of the elevated noise levels in the area. Traffic and noise level monitoring was conducted using a field survey using the sound level meter. Consequently, a statistical analysis was conducted to investigate the correlation between different factors and the noise level and determine the most influential factors. The study revealed that traffic volume and congestion are the most significant factors influencing noise levels on Tahrir Street, exhibiting strong positive correlations (R = 0.38). Additionally, the study found an inverse relationship between vehicle speed and noise level due to high traffic volumes and identified that building characteristics and wind direction also play roles, albeit to a lesser extent.

UNASSIGNED: Autistic adults are significantly unemployed or underemployed even compared with other disability groups. Employment is a social determinant that, when satisfied, closely influences health-related quality of life. For autistic adults, environmental barriers to transportation can impact the ability to get to employment resulting in limited employment opportunities. This study provides a closer examination of the association between transportation use and employment status.
UNASSIGNED: To examine the use of different types of transportation and barriers to public transit by employed and unemployed autistic adults.
UNASSIGNED: The data were from a large statewide study conducted between May 2017 and June 2018 using the Pennsylvania Autism Needs Assessment (PANA), in which information about employment and transportation use was obtained from autistic adults who were residents of Pennsylvania. The study sample included 1120 autistic adults (Mage = 28.03 years, standard deviation = 9.84; 70% men; 82% non-Hispanic White).
UNASSIGNED: Participants who were employed were more likely to drive themselves than those who were unemployed (45% vs. 21%, p < 0.001), while they were less likely to take rides from others (62% vs. 75%, p < 0.001) or use service transportation (11% vs. 18%, p = 0.001). For barriers to public transit, the results identified that employed participants reported fewer barriers to public transportation than unemployed participants with a small effect size (1.98 vs. 2.54, d = 0.22).
UNASSIGNED: Employed autistic adults exercise more transportation independence. Unemployed autistic adults report more barriers to participation and lower ability to independently use public transportation. Future transportation and employment studies are necessary.
Why is this an important issue? Employment is important for income, quality of life, and the ability to get the supports or services a person needs. Autistic adults are more likely to be unemployed or underemployed when compared with neurotypical adults and people with other disabilities. There are many environmental barriers to participating in adult activities in the community, but issues with transportation are a primary barrier. In previous research, a high number of autistic adults (72%) reported that they had missed some of their desired activities due to lack of transportation. It is important to understand the relationship between transportation and employment to know how to overcome barriers and improve employment options for autistic adults who want to work. What was the purpose of this research? The purpose of this research was to look at transportation and employment status (i.e., employed or unemployed). Specifically, this study compared types of transportation used and perceived barriers to transportation between autistic adults who were employed and those who were unemployed. What did the researchers do? Information was collected from 1120 autistic adults through a large statewide survey, which included questions about employment and transportation. Information from autistic adults who were employed and those who were not employed was compared. What were the results of the study? Results of this comparison showed that participants who were employed were more likely to drive themselves and less likely to take rides from other people or to use service transportation. Those who were employed also reported fewer barriers to public transportation. Barriers such as crime, planning a trip, treatment by fellow passengers, cost, knowledge on how to use public transportation, and sensory overload were identified by more people who were unemployed than by people who were employed. How will these findings help autistic adults now or in the future? The study identified specific barriers to transportation for autistic adults who are unemployed. This information can help to guide supports and policies to reduce barriers for travel needed for employment. In addition, results of this study can help guide future research to develop or identify the transportation skills needed for travel to work for autistic adults.

BACKGROUND: As the aging population in the United States continues to increase rapidly, preserving the mobility and independence of older adults becomes increasingly critical for enabling aging in place successfully. While personal vehicular transport remains a popular choice among this demographic due to its provision of independence and control over their lives, age-related changes may heighten the risk of common driving errors and diminish driving abilities.
OBJECTIVE: This study aims to investigate the driving practices of older adults and their efforts to maintain safe and confident driving habits. Specifically, we sought to identify the factors that positively and negatively influence older adults\' driving performance and confidence, as well as the existing efforts put into sustaining their driving abilities.
METHODS: We recruited 20 adults aged ≥65 years who remained active drivers during the recruitment from the greater New York area. Then, we conducted semistructured interviews with them to examine their perceptions, needs, and challenges regarding safe and confident driving.
RESULTS: Our findings uncovered a notable disparity between older adults\' self-perceived driving skills and the challenges they face, particularly caused by age-related limitations and health conditions such as vision and memory declines and medication routines. Drawing on these findings, we proposed strategies to bridge this gap and empower older adults to drive safely and confidently, including fostering a realistic understanding of their capabilities, encouraging open dialogue regarding their driving, encouraging regular assessments, and increasing awareness of available resources.
CONCLUSIONS: This study uncovered a noticeable disparity between the perceived driving competence of older adults and the actual challenges they confront while driving. This divergence underscores a significant need for better support beyond the existing aid available to preserve older adults\' driving skills. We hope that our recommendations will offer valuable insights for practitioners and scholars committed to enhancing the overall well-being and quality of life for older adults as they age in their homes.

Outsourcing of health-commodity supplies to third-party logistics providers is one of the ways of reducing costs and/or improving service levels in the public sector. This paper evaluates three forms of outsourcing: full outsourcing of inventory management, partial outsourcing of specific activities, and contingent partial outsourcing of specific logistics activities. It notes that, in Africa, contracting-out supply logistics has mostly taken the form of partial outsourcing of transportation only or storage and transportation of specific health commodities to all or selected geographical regions. Partial outsourcing offers limited benefits since it cannot provide adequate pressures on public-sector logistics to be efficient or maintain uninterrupted supplies in times of catastrophes. Improvements in logistics performance achieved through partial outsourcing should not mask the need for more expansive arrangements that support not only partial outsourcing but also full outsourcing in situations of inefficiency and in times of supply-disruption catastrophe.

Telehealth use among individuals with and without transportation challenges remains understudied. This study aims to compare telehealth utilization and types of healthcare services between subjects with and without transportation challenges. Using data from the 2021 Medical Expenditure Panel Survey (MEPS), we identified telehealth use for office visits by adults (≥18 years old) in 2021, categorizing the type of healthcare services received, such as checkups and mental health counseling. Weighted logistic regression was employed to identify factors associated with telehealth usage. The total population analyzed was 204 621 985 (unweighted n = 17 674). The average (SD) age of the subjects was 49 (18) years old, and 53% were female. On average, individuals with transportation challenges had 1.40 telehealth visits, while those without such challenges had 0.87 visits (P = .03). Additionally, individuals with transportation challenges had more visits related to behavioral health compared to those without transportation challenges (22% vs 11%, P < .01). Those facing transportation challenges were 40% more likely to use telehealth compared to those without transportation challenges (OR = 1.40, P = .01). The findings suggest that telehealth could serve as a viable solution to overcome transportation barriers and improve access to care. However, it is crucial to assess access to care through telehealth to enhance the health outcomes for individuals facing transportation challenges.

Travel times between different locations form the basis for most contemporary measures of spatial accessibility. Travel times allow to estimate the potential for interaction between people and places, and is therefore a vital measure for understanding the functioning, sustainability, and equity of cities. Here, we provide an open travel time matrix dataset that describes travel times between the centroids of all cells in a grid (N = 13,132) covering the metropolitan area of Helsinki, Finland. The travel times recorded in the dataset follow a door-to-door approach that provides comparable travel times for walking, cycling, public transport and car journeys, including all legs of each trip by each mode, such as the walk to a bus stop, or the search for a parking spot. We used the r5py Python package, that we developed specifically for this computation. The data are sensitive to diurnal variations and to variations between people (e.g. slow and fast walking speed). We validated the data against the Google Directions API and present use cases from a planning practice. The five key principles that guided the data set design and production - comparability, simplicity, reproducibility, transferability, and sensitivity to temporal and interpersonal variations - ensure that urban and transport planners, business and researchers alike can use the data in a wide range of applications.

OBJECTIVE: Inconsistent access to healthcare for people with epilepsy results in reduced adherence to antiseizure medications, increased seizure frequency, and fewer appropriate referrals for epilepsy surgery. Identifying and addressing factors that impede access to care should consequently improve patient outcomes. We hypothesized that health insurance and transportation affect access to outpatient neurology care for adults living with epilepsy in the United States (US).
METHODS: We conducted a retrospective cross-sectional study of US adults with active epilepsy surveyed via the National Health Interview Survey (NHIS) in 2015 and 2017. We established whether patients reported seeing a neurologist in the past year and used multiple logistic regression to determine whether health insurance status and transportation access were associated with this outcome.
RESULTS: We identified 735 respondents from 2015 and 2017, representing an estimated 2.98 million US adults with active epilepsy. After adjusting for socioeconomic and seizure-related co-variates, we found that a lack of health insurance coverage was associated with no epilepsy care in the past year (adjusted odds ratio [aOR] 0.22; 95 % confidence interval [CI]: 0.09 - 0.54). Delayed care due to inadequate transportation (aOR 0.42; 95 % CI: 0.19 - 0.93) also resulted in reduced patient access to a neurologist.
CONCLUSIONS: Due to the inherent nature of their condition, people with epilepsy are less likely to have employer-sponsored health insurance or consistent driving privileges. Yet, these factors also impact patient access to neurological care. We must address transportation and insurance barriers through long-term investment and partnership between community, healthcare, and government stakeholders.