Monday, March 25, 2024

Over half of global commutes are by car, says study

Explore the interactive map and learn how people get around in 794 cities

COMPLEXITY SCIENCE HUB

Cities moving — IMAGE:
FIND OUT HOW YOUR CITY COMPARES TO OTHERS AROUND THE WORLD BY CHECKING OUT THE MAP OF GLOBAL MOBILITY PATTERNS BASED ON THE DATA: https://vis.csh.ac.at/citiesmoving/
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CREDIT: CSH

What is the extent of car dependency around the world? Why should the best places to live be car-free? What are the best public transportation cities? A new study by Rafael Prieto-Curiel, from the Complexity Science Hub, and Juan Pablo Ospina, from EAFIT University, may provide some insights into these questions.

Prieto-Curiel and Ospina collected data on transportation modes across 794 cities in 61 countries, with a combined population of almost 850 million people. Their study describes how people commute in different parts of the world by modeling the use of modes of transportation in a city, such as cars, public transportation, and active mobility (walking and biking).

“The takeaway is clear: we drive too many cars, and the burden of cars in cities is huge and goes beyond the combustion of petrol. It is also the parking space required, the driving infrastructure, the noise they produce, the toxic materials used in manufacturing and road pavement, the crashes they cause, and others,” ponders Prieto-Curiel.

Globally, around 51% of commutes are made by car, according to the study published in Environment International. Across regions, the percentage varies greatly, with almost 92% of journeys being made by automobile in cities in the US and Canada. The percentage of commutes by car in Northern and Southern European cities ranges from 50% to 75%.

Check out the interactive visualizations – including a map of global mobility patterns – created by Liuhuaying Yang from the Complexity Science Hub, based on the data, and discover how your city compares to other locations around the world.

Europe: car-free and car-filled cities

Yet the study also shows that people in Europe commute in vastly different ways. Some cities rely heavily on cars, like Rome, Italy (66%); and Manchester, England (71%). Additionally, a large number of commutes are made by bike or foot in different parts of the old continent: from Copenhagen, Denmark (47%); Utrecht, Netherlands (75%); to Bilbao, Spain (66%); and Bolzano, Italy (58%).

Furthermore, public transportation is crucial in some European cities. For instance, public transit accounts for the majority of journeys in Paris, France (60%). It also corresponds to 45% in London, England. Eastern European cities also tend to rely more on public transportation, like Minsk, Belarus (65%); Prague, Czech Republic (52%); Warsaw, Poland (47%); and Budapest, Hungary (45%).

Asia: public transportation + walking and cycling

Similarly, public transportation accounts for a significant share of journeys in Southern and Eastern Asia, as shown in Hong Kong (77%); Seoul, South Korea (66%); Mumbai, India (52%); and Tokyo, Japan (51%). Additionally, Southern and Eastern Asia have the highest cycling share. In fact, there is a lot of walking and biking in big Asian cities, like Dhaka, Pakistan (58%); Beijing (53%) and Shanghai (47%), China; Tokyo, Japan (37%); and Mumbai (33%) and Delhi (33%), India.

Latin America and Africa

In cities in Latin America, commuting by car is not so frequent. Active mobility and public transport combine to a more balanced way of commuting. In Mexico City, for example, only 21% of the journeys are by car, but a vast metro system combined with other options, such as Bus Rapid Transit (BRT) and buses, take nearly half of the journeys in the city.

Commuting by car is also not common in African cities. However, in wealthier cities such as Cape Town, South Africa, car journeys are more frequent and, therefore, less sustainable. Prieto-Curiel argues that, except for the US, city size plays a significant role in determining transport patterns. According to the study, buses, metros, and trams are typically the most popular modes of transportation in large cities, as found in many European, Latin American, African, and Asian capitals.

US: cities designed for cars

“In contrast, the US exhibits minimal variation in modal share across cities of different sizes,” point out Prieto-Curiel and Ospina. “The majority of cities in the US have been designed with a strong reliance on cars for transportation. While cities like New York City and Boulder have developed alternative mobility options, most cities in the US heavily depend on cars.”

As the study shows, in the United States and Canada, nearly 92% of commutes are made by car. Public transit makes up 4.6%, and active mobility makes up 3.5%.

Although cars have long dominated the road, the desire to reduce automobile use is growing in the US. Cities that are dense and walkable, such as San Francisco, Boston, and New York, have dependable public transit systems.

New York City is the most car-free city in the US, with the highest public transportation share (25%). Moreover, walking and biking account for 8% of commutes, the study shows. In both San Francisco and Boston, public transit accounts for 8% of journeys. Walking and cycling account for 6% of commutes in San Francisco and 7% in Boston.

American college towns are known for their love of walking and cycling, as evidenced in Ithaca (20%), State College (10%), Iowa City (10%), Boulder (9%), and Madison (8%).

How about electric cars?

The popularity of electric cars is soaring around the globe, with China, Europe, and the US leading the way. However, Prieto-Curiel and Ospina warn that electric vehicles are not the answer for cities. They emphasize that electric cars will continue to bear the burden associated with motorized mobility. “We must take into account manufacturing, infrastructure demands, congestion, particle pollution produced by tire wear, and others,” says Prieto-Curiel.

The authors of the study point out that active mobility and public transit present numerous physical, mental, and environmental benefits as alternatives to driving. However, they acknowledge that it is a difficult endeavor.

“Changing travel behavior is exceptionally challenging,” say Prieto-Curiel and Ospina. In addition, active mobility and public transportation have significant obstacles. Active mobility in medium and large cities is difficult due to long-distance commutes. In contrast, public transportation requires a sufficient amount of passengers to provide frequent service, so it is strongly influenced by the density of the population.

About the study

The study “ABC of mobility” by Rafael Prieto-Curiel and Juan Pablo Ospina was published in Environment International (doi: 10.1016/j.envint.2024.108541).

The dataset with all the cities is available here.

Each disc is proportional to the city's population, and each colour represents a region. Visit https://vis.csh.ac.at/citiesmoving for an interactive version

CREDIT

Rafael Prieto-Curiel and Juan Pablo Ospina

____________________________________________________________________________________

About CSH

The Complexity Science Hub (CSH) is Europe’s research center for the study of complex systems. We derive meaning from data from a range of disciplines – economics, medicine, ecology, and the social sciences – as a basis for actionable solutions for a better world. Established in 2015, we have grown to over 70 researchers, driven by the increasing demand to gain a genuine understanding of the networks that underlie society, from healthcare to supply chains. Through our complexity science approaches linking physics, mathematics, and computational modeling with data and network science, we develop the capacity to address today's and future challenges.

CSH members are AIT Austrian Institute of Technology, BOKU, Central European University CEU, Graz University of Technology, Medical University of Vienna, TU Wien, University of Continuing Education Krems, VetMedUni Vienna, Vienna University of Economics and Business, and WKO Austrian Economic Chambers.

https://www.csh.ac.at/

JOURNAL

Environment International

DOI

10.1016/j.envint.2024.108541

METHOD OF RESEARCH

Computational simulation/modeling

SUBJECT OF RESEARCH

People

ARTICLE TITLE

The ABC of mobility

ARTICLE PUBLICATION DATE

15-Mar-2024

Special efforts needed to allow 988 and 911 Systems to work in concert

Report finds detailed planning and close cooperation is key to success

Reports and Proceedings

RAND CORPORATION

Getting the 988 and 911 emergency telephone systems to work in concert requires detailed planning and close cooperation, and such efforts may benefit from having one or two people at the local level who act as champions for interoperability, according to a new RAND report.

In order to make sure callers are routed to the appropriate system, efforts need to involve representatives from both 988 and 911 call centers, law enforcement, mobile crisis teams, peer support specialists, behavioral health specialists, and people who have lived experience

with crisis services, researchers say.

Local champions can aid such efforts by establishing priorities, convening local stakeholders,

brokering difficult conversations and charting an effective path toward interoperability.

“The 911 system essentially remains as the default people call when there is an emergency, even if there is a mental health component to the crisis,” said Stephanie Holliday, lead author of the report and a senior behavior scientist at RAND, a nonprofit research organization. “It’s critical that the 911 and 988 systems work together so that each call is handled appropriately.”

In the summer of 2022, the 988 national mental health emergency hotline launched, replacing what was known as the National Suicide Prevention Lifeline. The shift to 988 was intended to create an easy-to-market and easy-to-remember number that could be used by people experiencing any type of a mental health crises, in addition to suicide.

Although use of the 988 mental health hotline has risen sharply since its debut, several surveys show that many people are unaware of the service and are uncertain when to use it.

Without knowledge of 988, it is likely that many people will call 911 when faced with a mental health emergency. In addition, although about 95% of the calls to many 988 call centers are resolved over the telephone, there are situations that may require a public safety response, researchers say.

“For the system to work to its full potential, the two systems need to be interoperable -- to work together to make sure the proper resources are used, regardless of which number a caller uses,” Holliday said.

Some states have begun to adopt legislation to require coordination between 911 and 988 call centers. But there are many hurdles to overcome, including differences in culture and in organizational structure (911 often is organized at the local level, while 988 tends to be regional).

In order to learn how to best develop interoperability between 911 and 988 systems, RAND researchers examined efforts in three jurisdictions that have been early adopters of efforts to get the two systems to work together seamlessly.

They studied efforts in City of Sioux Falls and Minnehaha County in South Dakota, Orange County in New York, and Fairfax County in Virginia. The jurisdictions were chosen because they have worked to establish different models of 988/911 interoperability

Although sites varied with respect to their specific resources and models of 988/911 interoperability, there were some cross-site findings related to effective planning and implementation.

For example, planning and implementation should be collaborative, engaging a variety of contributors. Entities involved in planning should focus on developing shared language and mutual respect, even when their cultures differ.

“Interoperability requires more than protocols for transferring calls between 988 and 911 – it also must be considered within the larger continuum of crisis services available in a community,” Holliday said.

The process of assessing a caller’s needs and deploying the right resource -- be it phone counseling, emergency medical services, police or fire response -- requires procedures tailored to every jurisdiction’s governmental, geographic and population characteristics, researchers say.

Support for the research was provided by the Pew Charitable Trusts. The report, “The Road to 988/911 Interoperability: Three Case Studies on Call Transfer, Colocation, and Community Response,” is available at www.rand.org.

Other authors of the report are Samantha Matthews, Wendy Hawkins, Jonathan H. Cantor and Ryan K. McBain.

The RAND Social and Economic Well-Being division seeks to actively improve the health, and social and economic well-being of populations and communities throughout the world.

DOI

10.7249/RRA3112-1

METHOD OF RESEARCH

Case study

SUBJECT OF RESEARCH

People

ARTICLE TITLE

The Road to 988/911 Interoperability Three Case Studies on Call Transfer, Colocation, and Community Response

WOMEN'S HEALTH

Rheumatic diseases associated with childbearing problems

OXFORD UNIVERSITY PRESS USA

A new paper in Rheumatology, published by Oxford University Press, finds that rheumatic diseases can lead to reproductive problems, though some conditions have more detrimental effects than others.

Immune-mediated diseases are a varied group of conditions, but each display an aberrant activity of the immune system. Some diseases, such as juvenile idiopathic arthritis and type 1 diabetes, occur mostly before patients reach their reproductive years, but others show up later in life. Scientists have investigated systemic lupus erythematosus for its impact on reproductive health; the condition increases the risk for some adverse pregnancy outcomes, including pre-eclampsia, preterm delivery, C-sections, and low birth weight. But the impact of other autoimmune diseases—such as spondyloarthritides, psoriasis, or alopecia areata—on fertility and pregnancy is unclear or the research is inconsistent.

Researchers here used data from Finnish nationwide health registers to study the impact of immune-mediated diseases on reproductive health measures such as reproductive success, and for women, ever having experienced adverse maternal and perinatal outcomes. Out of all people in Finland born between 1964 and 1984, 7.9% of the women and 7.8% of the men had an autoimmune disease diagnosed before or during reproductive years.

The researchers found that many immune-mediated diseases had little impact on the number of children. However, women with selected immune-mediated diseases experience a higher prevalence of childlessness, with the top three diseases with largest differences being Addison’s disease (23.9% more childlessness), juvenile idiopathic arthritis (9.3%), and vitamin B12 deficiency anemia (8.6%). Several of the rheumatic diseases—particularly systemic lupus erythematosus, juvenile idiopathic arthritis, and seropositive rheumatoid arthritis—lead to higher rates of childlessness and fewer children. The investigation also revealed that, on average, people with rheumatic diseases had children earlier.

The risks for pre-eclampsia, low birth weight, preterm delivery, non-elective C-sections and need of neonatal intensive care were increased for many conditions. Systemic lupus erythematosus, Sjögren’s syndrome, type 1 diabetes, and Addison’s disease showed over two-fold risks for some of these outcomes. However, the risk of gestational diabetes was not higher for patients with any of the rheumatic diseases compared to the population.

Men with rheumatic conditions also had a higher prevalence of childlessness than controls (mean difference 4.7%), with most diseases showing no difference but some diseases resulting in much higher prevalence of childlessness, with the top three diseases being myasthenia gravis (20.1% more childlessness), Addison’s disease (16.4%), and vitamin B12 deficiency anemia (13.7%).

“Despite seeing an elevated risk for diverse childbearing problems in rheumatic and other immune-mediated diseases, many of the complications are still fairly rare,” said Anne Kerola, the lead author of the study. “Family planning should actively be discussed between patients, both men and women, with rheumatic diseases and their healthcare providers. Pregnancies in women with rheumatic diseases are carefully followed up to tailor medications appropriately, which helps reduce risks.”

The paper, “Patterns of reproductive health in inflammatory rheumatic diseases and other immune-mediated diseases: a nationwide registry study,” is available (at midnight on March 20th) at https://doi.org/10.1093/rheumatology/keae122.

Direct correspondence to:
Nina Mars
Institute for Molecular Medicine Finland (FIMM), HiLIFE
University of Helsinki
Tukholmankatu 8, Helsinki, FINLAND
nina.mars@helsinki.fi

To request a copy of the study, please contact:
Daniel Luzer
daniel.luzer@oup.com

JOURNAL

Rheumatology

DOI

10.1093/rheumatology/keae122

METHOD OF RESEARCH

Observational study

SUBJECT OF RESEARCH

People

ARTICLE TITLE

Patterns of reproductive health in inflammatory rheumatic diseases and other immune-mediated diseases: a nationwide registry study

ARTICLE PUBLICATION DATE

20-Mar-2024

COI STATEMENT

One of the authors has received speaker fees from Boehringer-Ingelheim and Sanofi; has participated in advisory boards of Pfizer, Gilead, and Boehringer-Ingelheim; and has received congress sponsorship from Abbvie. Another author has participated on the advisory boards of AbbVie and Amgen, received lecture fees from Boehringer-Ingelheim, Pfizer, and Abbvie, and received payment for travel expenses from Abbvie and Novartis. Another author has received lecture fees from Pfizer, Lilly, and Celltrion.

'3D mammography' almost halves the incidence of breast cancer between two screening tests

UNIVERSITY OF CÓRDOBA

Doctors Marina Álvarez and Cristina Pulido, in the Radiodiagnostic Unit at the Reina Sofía Hospital — IMAGE:
DOCTORS MARINA ÁLVAREZ AND CRISTINA PULIDO, IN THE RADIODIAGNOSTIC UNIT AT THE REINA SOFÍA HOSPITAL
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CREDIT: UNIVERSITY OF CÓRDOBA

Interval breast cancer is one that appears between two reviews of a screening program. That is, it is diagnosed after a test whose result was negative and before the next evaluation. For obvious reasons, it is a very reliable indicator of the effectiveness of early detection programs for this disease: if the number of cancers that appear after a screening is high, it is a sign that the program is not working. Conversely, if the number of tumors diagnosed after screening is low, it indicates that the program is fulfilling its function: to detect this disease at an early stage.

A clinical trial published by the University of Cordoba, the Maimonides Institute for Biomedical Research (IMIBIC) and the Reina Sofía Hospital in Cordoba, has revealed the effectiveness of breast 'tomosynthesis' in reducing by almost half the incidence of this type of cancer appearing between two rounds of screening, suggesting the advisability of including this test in a standardized way in breast cancer early detection programs.

It is a screening method complementary to traditional mammography, or '2D mammography' which, like the latter, uses x-rays. The difference is that tomosynthesis avoids the overlapping of structures and allows the lesions to be seen better when recreating a volumetric image, such that it is also known as' 3D mammography.' "Despite the fact that this technique has become widespread in diagnostic units, it is still not as standardized in screening programs," says Marina Alvarez, head of the Radiodiagnostic Unit at the Reina Sofía Hospital, one of the authors of the study and a nationally prominent figure advocating for the early diagnosis of breast cancer.

For two years, the study has worked with the population screening carried out by the Junta de Andalucía (regional government). Almost 24,000 women were examined only with 2D mammograms, while another group of 16,000 was also evaluated with breast tomosynthesis. According to the results of the work, in the first group the interval cancer rate was 1.8 per thousand people, while in the second it was 0.93. In other words, the likelihood of being diagnosed with an interval cancer was 49% lower in women who were also screened with the '3D mammogram'.

Other relevant results

As explained by the main author of the study, Cristina Pulido, the impact of tomosynthesis on the rate of interval carcinoma is even more evident in women with dense breasts, "an especially relevant fact" taking into account that "in this type of breasts, with a higher proportion of glandular tissue, it is more complicated to explore and assess the existence of lesions.

The results of the work also show that the interval cancers detected in women who have been screened with tomosynthesis are smaller than those detected in women screened with digital mammography, which is positive considering that the size of the tumors is closely related to the prognosis. This may be due to the greater diagnostic capacity of the method itself. If this technique allows for a more accurate detection of the lesions, it implies that the tumors that have gone unnoticed are smaller.

The work, in short, highlights the desirability of incorporating this test in a systematic way into the population programs for the early detection of breast cancer, an advance towards which significant steps are already being taken. "Many radiologists are already being trained in this technique. Andalusia has just renewed a significant number of mammograms with tomosynthesis, and this type of testing is already being recommended for screening," explains Dr. Álvarez.

In this way, it could further improve the diagnosis of a disease that, according to the Spanish Society of Medical Oncology, accounts for 28.9% of total cancers in women, and is the leading cause of death from cancer in this population. Despite this, survival and prognosis has improved exponentially thanks to medical advances. Everything indicates that science will continue to make progress against this disease in the years to come.
References

JOURNAL

European Radiology

DOI

10.1007/s00330-023-10546-x

ARTICLE TITLE

Interval cancer in the Córdoba Breast Tomosynthesis Screening Trial (CBTST): a comparison of digital breast tomosynthesis plus digital mammography to digital mammography alone

Is the secret to anxiety in young women hidden in our brain chemistry?

UNIVERSITY OF SURREY

The development of anxiety in girls and young women may stem from an imbalance between two crucial brain chemicals, Gamma-Aminobutyric Acid (GABA) and Glutamate, according to a new study from the University of Surrey. This discovery offers promising insights into potential treatment avenues for girls and women dealing with anxiety.

The study revealed that as young women mature, the levels of GABA (a calming brain chemical) increase, while those of glutamate, known for its role in boosting brain activity, decrease.

Dr Nicola Johnstone, a Research Fellow at the University of Surrey's School of Psychology and co-author of the study, said:

"Our research indicates that the equilibrium between GABA and glutamate in the dorsolateral prefrontal cortex serves as a vital indicator of anxiety levels. While glutamate propels brain activity, GABA acts as a brake. Our findings suggest that anxiety, often characterised by impaired rational thought, is intricately linked to the overactive braking system in the brain."

These revelations not only shed light on the underlying mechanisms of anxiety but also pave the way for targeted interventions that address the delicate balance of GABA and glutamate in the brain.

Dr Kathrin Cohen Kadosh, Associate Professor in Developmental Cognitive Neuroscience at the University of Surrey and co-author of the study, said:

"Grasping how key brain chemicals, GABA and glutamate, fluctuate during important growth stages like adolescence is vital for spotting and stopping anxiety disorders early. This study shines a light on the possibility of focusing on these brain chemicals for new treatments, particularly in young women."

By unravelling the mysteries of brain chemistry, the researchers aim to offer more effective treatments for anxiety, ultimately empowering girls and young women to lead healthier, more fulfilling lives.

The research used 81 participants from two age groups:

49 participants aged 10-12 years
32 participants aged 18-25 years

The team used a brain imaging technique called magnetic resonance spectroscopy to measure the levels of the brain chemicals in different areas of the brain.

The research has been published in Developmental Cognitive Neuroscience.

###

JOURNAL

Developmental Cognitive Neuroscience

DOI

10.1016/j.dcn.2024.101363

ARTICLE TITLE

Excitatory and inhibitory neurochemical markers of anxiety in young females

ARTICLE PUBLICATION DATE

1-Apr-2024

Laws that punish drug use during pregnancy likely lead to worse health outcomes for families

COLUMBIA UNIVERSITY'S MAILMAN SCHOOL OF PUBLIC HEALTH

March 18, 2024-- Contrary to some claims, laws that criminalize or otherwise punish drug use during pregnancy are more likely to worsen rather than improve health outcomes, according to a paper by researchers at Columbia University Mailman School of Public Health. The study is the first to systematically review the literature on punitive prenatal drug laws—an increasingly common state policy strategy for addressing rising rates of prenatal drug use. The findings are published in the International Journal on Drug Policy.

The authors collected data on the number of states with laws that explicitly allow criminal prosecution, involuntary commitment or that revoke custody rights following allegations of drug use during pregnancy. They then evaluated existing studies testing whether the enactment of such laws was associated health improvements, either for pregnant people themselves or their babies.

Of the 16 studies reviewed, the authors found that contrary to the intent of legislation, most evidence suggested that punitive laws either had no beneficial effects or made things worse. For example, four of the reviewed studies tested whether the adoption of punitive laws was associated with reductions in neonatal drug withdrawal syndrome (NDWS)—a condition that can occur after exposure to opioids and other drugs in utero. Two of the studies found little change while the two others found increased NWDS after a punitive law was adopted.

“There has been considerable concern from within legal, medical and public health communities that punitive prenatal drug policies might increase potential harms. Our findings support this premise and suggest that such approaches constitute ineffective policy,” said lead author Emilie Bruzelius, PhD, a postdoctoral research fellow in the Department of Epidemiology.

“Identifying effective policy strategies to support pregnant people with drug use disorder outside of the criminal-legal system is an important priority,” noted Silvia S. Martins, MD, PhD, professor of Epidemiology at Columbia Mailman School, and senior author.

Co-authors include Melanie S. Askari, Sandhya Kajeepta, Lisa Bates, Seth J. Prins (Columbia University Mailman School of Public Health), Kristen Underhill (Cornell University Law School), and Marian Jarlenski (Pittsburgh School of Public Health).

The study was supported by the National Institutes on Drug Abuse (R01DA045872 and R01DA053745 and T32DA031099).

Columbia University Mailman School of Public Health

Founded in 1922, the Columbia University Mailman School of Public Health pursues an agenda of research, education, and service to address the critical and complex public health issues affecting New Yorkers, the nation and the world. The Columbia Mailman School is the fourth largest recipient of NIH grants among schools of public health. Its nearly 300 multi-disciplinary faculty members work in more than 100 countries around the world, addressing such issues as preventing infectious and chronic diseases, environmental health, maternal and child health, health policy, climate change and health, and public health preparedness. It is a leader in public health education with more than 1,300 graduate students from 55 nations pursuing a variety of master’s and doctoral degree programs. The Columbia Mailman School is also home to numerous world-renowned research centers, including ICAP and the Center for Infection and Immunity. For more information, please visit www.mailman.columbia.edu.

JOURNAL

International Journal of Drug Policy

DOI

10.1016/j.drugpo.2024.104380

ARTICLE TITLE

Punitive legal responses to prenatal drug use in the United States: A survey of state policies and systematic review of their public health impacts

Study explores homeless women’s experiences of ‘period poverty’

UNIVERSITY OF SOUTHAMPTON

Research from the University of Southampton has identified common issues women face when experiencing periods while homeless.

A review of research published in Women and Health has found homeless women experienced practical challenges in managing menstruation alongside feelings of embarrassment and shame, with many ‘making do’ due to inadequate provision.

The researchers say it’s high time to address the provision of menstrual health resources as a basic human right.

Dr Stephanie Barker, a teaching fellow at the University of Southampton who co-led the review said: “So-called ‘period poverty’ is a global concern. Our findings highlight the need to stop gatekeeping and limiting access to menstrual health products. This is both a public health issue and a human rights one.”

The review of research evidence is the first to explore homeless women’s experiences of menstruation. The University of Southampton team identified and analysed nine studies on the topic conducted in the United Kingdom, the United States, Canada and Nepal. Three key themes emerged from the research.

The first is challenges in the logistics of managing menstruation while homeless. Finding a clean, private space to use and change menstrual products was a common issue. The few options available, such as public toilets, were described as unsanitary and not fit for purpose. The stigma attached to homelessness means women are often turned away from public and privately owned bathroom facilities.

Dr Polly Hardy-Johnson, also a teaching fellow at the University of Southampton and co-lead author on the paper, added: “Even as paying customers, women were subject to stigma around assumed drug use, limiting their access to bathrooms. Being able to pass as ‘not homeless’ was more difficult when women were unable to maintain menstrual health.

“Limited access to facilities led to infections and increased the need for costly laundry services, due to leakages and blood-stained clothing. There is a need for private, safe and clean locations for managing menstruation, as well as access to laundry facilities.”

Rough sleepers relied on service providers for menstrual products, but several studies noted that provision fell short and was sporadic. This meant women would sometimes forgo food to buy menstrual products or shoplift them.

The second theme was around feelings of embarrassment, shame and dignity linked to maintaining menstrual health. Women felt the need to hide that they were menstruating and felt judged when they could not maintain menstrual health, causing anxiety and discomfort.

Women reported services rationing free menstrual supplies, forcing them to have to ask staff (sometimes men) multiple times per day for tampons, sanitary pads, and other products.

The third theme was around women ‘making do’ to manage the challenges they were facing. Several women reported using sponges, clothes, and cut-up t-shirts as reusable ways of soaking up menstrual blood and avoiding leaks. Others used layered wads of toilet paper, and some reused soiled disposable menstrual products. To treat infections some women turned to cheap herbal remedies rather than more expensive treatments.

Studies also looked at what services the women found useful. The provision of menstrual health products and birth control products was useful, alongside sexual health services. Warm, welcoming cafes and day centres helped to soothe period pain and discomfort.

Shared information within the homeless community about the support available, showering facilities and the sharing of products helped to improve menstrual health management.

The research team found there is a lack of evidence on the experiences of homeless people who do not identify as women and who menstruate. To address this, the team has received £9.9K in funding from British Academy/Leverhulme Small Research Grants to better understand the menstruation needs of all people experiencing homelessness.

The project will conduct in-depth interviews and use creative ways to amplify marginalised voices, and co-create a policy brief with the homeless community and key stakeholders on improving access to menstrual healthcare.

The homeless period: a qualitative evidence synthesis is published in Women and Health and is available online.

Ends

Contact

Steve Williams, Media Manager, University of Southampton, press@soton.ac.uk or 023 8059 3212.

Notes for editors

The homeless period: a qualitative evidence synthesis is published in Women and Health and is available at: https://www.tandfonline.com/doi/full/10.1080/03630242.2024.2310716
For Interviews with Dr Stephanie Barker and Dr Polly Hardy-Johnson please contact Steve Williams, Media Manager, University of Southampton press@soton.ac.uk or 023 8059 3212.

Additional information

The University of Southampton drives original thinking, turns knowledge into action and impact, and creates solutions to the world’s challenges. We are among the top 100 institutions globally (QS World University Rankings 2023). Our academics are leaders in their fields, forging links with high-profile international businesses and organisations, and inspiring a 22,000-strong community of exceptional students, from over 135 countries worldwide. Through our high-quality education, the University helps students on a journey of discovery to realise their potential and join our global network of over 200,000 alumni. www.southampton.ac.uk

www.southampton.ac.uk/news/contact-press-team.page

JOURNAL

Women & Health

DOI

10.1080/03630242.2024.2310716

METHOD OF RESEARCH

Literature review

SUBJECT OF RESEARCH

People

ARTICLE TITLE

The homeless period: a qualitative evidence synthesis

Ice-ray patterns: A rediscovery of past design for the future

Research explores the geometric qualities of traditional Chinese window patterns and how they can be used in new structural designs.

XI'AN JIAOTONG-LIVERPOOL UNIVERSITY

Chinese ice-ray lattice, or "binglie" as it is called in Chinese, is an intricate pattern that looks like cracked ice and is a common decorative element used in traditional Chinese window designs.

Originally inspired by fragmented patterns on ice or crackle-glazed ceramic surfaces, the design represents the melting of the ice and the beginning of a thriving spring.

When Dr Iasef Md Rian, now an Associate Professor at Xi'an Jiaotong-Liverpool University's Department of Architecture, arrived in China for the first time in 2019, he was immediately captivated by the latticed window designs in the classical gardens of Suzhou.

"Classical gardens in China strike me as very different from the Western ones, which are more symmetrical and organised," he says. "Chinese gardens, however, have a more natural formation in their layout and design. The ice-ray window design is one of the manifestations."

Having focused on fractal geometry in architectural design for many years, Dr Rian felt an urge to explore the beauty in the patterns.

"My mind is always looking for this kind of inspiration source, so I was motivated right away to study the underlying geometric principles of the ice-ray patterns, he says."

Revealing the underlying rule

Dr Rian finds that the rule of creating ice-ray patterns is actually very simple.

He explains: "Take Type 1 as an example; a square is first divided into two quadrilaterals, and then each quadrilateral is further divided into two quadrilaterals. In each step, the proportions of the subdivided quadrilaterals are different, and this is how the random pattern is created using a simple rule.

"Through this configuration, Chinese craftsmen might have intended to increase its firmness so it can function as a window fence to provide protection. The random configuration of ice-ray lattices provides multi-angled connections, which transform the window into a collection of resultant forces and uniform stress distribution, in turn achieving a unique degree of stiffness.

"The microstructure of trabecular bone tissue in our own bodies serves as an excellent natural example of the potential of random lattices. It balances high stiffness, which contributes to strength, with a surprisingly lightweight structure."

Dr Rian recently published a paper in Frontiers of Architectural Research that explores the geometric qualities of ice-ray patterns and expands the possibilities of integrating random patterns into structural designs, especially the lattice shell design, which is often used in spherical domes and curved structures.

"In my research, I developed an algorithm to model the ice-ray patterns for lattice shell designs and assessed their feasibility and effectiveness compared to conventional gridshells. These gridshells, made from regular grids, contrast with continuous shells.

"While regular gridshells perform well under uniform loads, the ice-ray lattice offers strength under asymmetric loads. Some ice-ray patterns, resulting from optimisation, surprisingly provide better strength than regular gridshells under self-weight. There is also an additional aesthetic advantage when applying the ice-ray pattern to a lattice shell design.

"I extend the application of this pattern to curved surfaces, which helps to unlock its potential in the geometric, structural, and constructional aspects of lattice shell design," he says.

Dr Rian has also integrated ice-ray patterns and complex geometries into his teaching. In 2022, he organised a workshop for students to design ice-ray lattice roofs.

He explains that learning the concept of fractal geometry can really push the students' ideas toward a unique design.

"This is very different from what they've learned in high school. In learning to create this geometry system, they will also learn computational modelling and simulations. In the end, they'll get comprehensive knowledge of advanced architectural and digital design," he says.

Rediscovering traditional designs

To extend the research in this field, Dr Rian is investigating the effectiveness of complex geometry in various aspects like micro-scale material design and structural design.

He says: "For instance, in facade design, we usually use conventional or parametric geometry to design regular shapes. However, the random shapes designed with complex geometry can offer a more natural impression and daylight penetration."

He encourages design students and researchers to learn from the past.

"Any traditional design has a hidden rule in it. We can now use digital technologies and advanced tools to extend and expand the knowledge of traditional craftsmanship for contemporary design.

"There are many inspirations behind the traditional designs, and those principles can really inspire us designers to make innovative designs for the future," he says.