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Are single entry communities and cul-de-sacs a barrier to active transport to school in 11 elementary schools in Las Vegas, NV metropolitan area?

ABSTRACT: Single entry communities (SECs) and cul-de-sacs minimize route choices and increase trip distance. Las Vegas' built environment facilitates the examination of these variables and active transport to school (ATS) rates. The purpose of this study was to examine the influence of SECs and cul-de-sacs on ATS rates in Las Vegas, NV elementary children. Parental-reported data was collected from 11 elementary schools on ATS rates (n = 1217). SECs and cul-de-sacs were quantified for each school zone. Logistic regression models were used to predict ATS. 23.9% of students reported ATS all of the time and 31.4% some of the time. SECs per school zone ranged from 0 to 25 (mean = 11.9). Cul-de-sacs ranged from 12 to 315 (mean = 138.3). Some ATS use was predicted by distance from school (p ≤ 0.001;OR = 0.61), parental education (high school: p = 0.004;OR = 0.53, some college: p = 0.001;OR = 0.50, 4 year degree: p = 0.004;OR = 0.52) and cul-de-sacs (p ≤ 0.001;OR = 0.99). A separate model using distance from school (p ≤ 0.001;OR = 0.61), parental education (high school: p = 0.002;OR = 0.51, some college: p ≤ 0.001;OR = 0.45, 4 year degree: p ≤ 0.001;OR = 0.45) and SECs (p ≤ 0.001;OR = 0.96) predicted some ATS. All ATS use was predicted by distance from school (p ≤ 0.001;OR = 0.58), parental education (Grades 9-11: p = 0.05;OR = 0.61, high school: p ≤ 0.001;OR = 0.45, some college: p ≤ 0.001;OR = 0.41, 4 year degree: p ≤ 0.001;OR = 0.38) and SECs (p ≤ 0.001;OR = 0.97). A separate model using distance from school (p ≤ 0.001;OR = 0.58), parental education (Grades 9-11: p = 0.041;OR = 0.59, high school: p ≤ 0.001;OR = 0.47, some college: p ≤ 0.001;OR = 0.44, 4 year degree: p ≤ 0.001;OR = 0.43) and cul-de-sacs (p ≤ 0.001;OR = 0.99) predicted all ATS. Current findings reveal that both SECs and cul-de-sacs were predictors of ATS beyond distance. Students with more SECs and cul-de-sacs in their school zone were less likely to utilize ATS.

SUBMITTER: Coughenour C

PROVIDER: S-EPMC5345953 | biostudies-literature |

REPOSITORIES: biostudies-literature

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Project description:BackgroundCurrently used pre-operative prediction scores for postoperative pulmonary complications (PPCs) use patient data and expected surgery characteristics exclusively. However, intra-operative events are also associated with the development of PPCs.ObjectiveWe aimed to develop a new prediction score for PPCs that uses both pre-operative and intra-operative data.DesignThis is a secondary analysis of the LAS VEGAS study, a large international, multicentre, prospective study.SettingsA total of 146 hospitals across 29 countries.PatientsAdult patients requiring intra-operative ventilation during general anaesthesia for surgery.InterventionsThe cohort was randomly divided into a development subsample to construct a predictive model, and a subsample for validation.Main outcome measuresPrediction performance of developed models for PPCs.ResultsOf the 6063 patients analysed, 10.9% developed at least one PPC. Regression modelling identified 13 independent risk factors for PPCs: six patient characteristics [higher age, higher American Society of Anesthesiology (ASA) physical score, pre-operative anaemia, pre-operative lower SpO2 and a history of active cancer or obstructive sleep apnoea], two procedure-related features (urgent or emergency surgery and surgery lasting ≥ 1 h), and five intra-operative events [use of an airway other than a supraglottic device, the use of intravenous anaesthetic agents along with volatile agents (balanced anaesthesia), intra-operative desaturation, higher levels of positive end-expiratory pressures > 3 cmH2O and use of vasopressors]. The area under the receiver operating characteristic curve of the LAS VEGAS risk score for prediction of PPCs was 0.78 [95% confidence interval (95% CI), 0.76 to 0.80] for the development subsample and 0.72 (95% CI, 0.69 to 0.76) for the validation subsample.ConclusionThe LAS VEGAS risk score including 13 peri-operative characteristics has a moderate discriminative ability for prediction of PPCs. External validation is needed before use in clinical practice.Trial registrationThe study was registered at Clinicaltrials.gov, number NCT01601223.

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Are single entry communities and cul-de-sacs a barrier to active transport to school in 11 elementary schools in Las Vegas, NV metropolitan area?

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