Global climate change is expected to pose increasing challenges for cities in the following decades, placing greater stress and impacts on multiple social and biophysical systems, including population health, coastal development, urban infrastructure, energy demand, and water supplies. Simultaneously, a strong global trend towards urbanisation of poverty exists, with increased challenges for urban populations and local governance to protect and sustain the wellbeing of growing cities. In the context of these 2 overarching trends, interdisciplinary research at the city scale is prioritised for understanding the social impacts of climate change and variability and for the evaluation of strategies in the built environment that might serve as adaptive responses to climate change. This article discusses 2 recent initiatives of The Earth Institute at Columbia University (EI) as examples of research that integrates the methods and objectives of several disciplines, including environmental health science and urban planning, to understand the potential public health impacts of global climate change and mitigative measures for the more localised effects of the urban heat island in the New York City metropolitan region. These efforts embody 2 distinct research approaches. The New York Climate & Health Project created a new integrated modeling system to assess the public health impacts of climate and land use change in the metropolitan region. The Cool City Project aims for more applied policy-oriented research that incorporates the local knowledge of community residents to understand the costs and benefits of interventions in the built environment that might serve to mitigate the harmful impacts of climate change and variability, and protect urban populations from health stressors associated with summertime heat. Both types of research are potentially useful for understanding the impacts of environmental change at the urban scale, the policies needed to address these challenges, and to train scholars capable of collaborative approaches across the social and biophysical sciences.
City Planning ; Environment ; Environment Design ; Greenhouse Effect ; New York City ; Research ; Urban Health

BACKGROUND: Weight overestimation of Korean Americans may be associated with dietary habits and preferences for foods and tastes. METHODS: The subjects were 100 Korean Americans in New York City and LA and 100 Koreans in Seoul, who were 20-29 years old. Self-reported questionnaire consisted of age, height, weight, length of residence in US, preferences for 10 foods and 5 tastes, dietary habits and perception of self body image. Korean Americans were further divided into 3 groups according to length of residence in US. RESULTS: More Korean American women underestimated (27.3% vs. 5.8%), and less overestimated their body weights, than Korean women (31.8% vs. 53.8%, P=0.008). Korean Americans who overestimated their own body weights had significantly higher preference for salty taste and significantly lower dietary habit score regarding regular meals. CONCLUSIONS: Overestimation of self body size, rather than longer residence in US may be associated with the undesirable dietary habit and taste preference of Korean Americans, highlighting the importance of correct body image.
Asian Americans ; Body Image ; Body Size ; Body Weight ; Female ; Food Habits ; Food Preferences ; Humans ; New York City ; Surveys and Questionnaires

This study was conducted to compare the body image perception, weight control experiences and the eating disorders according to where they were born, and the length of residence in USA among Korean-American college students. Three hundred college students participated in the study: 144 males and 156 females, 122 America-born (AB) and 171 Korea-born (KB) who live in New York City and New Jersey. Subjects responded to a self-administered questionnaire. The results showed that the ratio of overweight (23.2%) and obesity (26.8%) of males was higher than females' (16.1% and 6.3%, respectively). There were no significant differences according to born-place or the length of residence in USA of KB. People who had tried to control their weight were 58%. The ratio of weight control experiences of females (72.4%) was higher than males' (42.4%) as well as people who were normal or underweight than who were overweight or obesity. There were no significant differences according to born-place or the length of the residence in the USA of KB. In body image perception, the subjects who were normal and underweight overestimated their body figure, and the subjects who were overweight and obese underestimated their body figure. The desired and ideal figure of female students was significantly thinner than the current figure and also that of male students. There were no significant differences according to born-place or the length of the residence in USA of KB. The ratio of eating disorder was 8.7%, and females had higher percentage than males. And shorter they lived in USA, the percentage of eating disorder was higher.
Asian Americans ; Body Image ; Eating ; Feeding and Eating Disorders ; Female ; Humans ; Male ; New Jersey ; New York City ; Obesity ; Overweight ; Surveys and Questionnaires ; Thinness ; Weight Perception

BACKGROUND: About 13,000 people immigrated to New York City from the Republic of Korea between 1986 and 1990, creating an important ethnic minority. METHODS: Using US-born Whites as a reference, age-adjusted proportional mortality ratios were computed for 314 men and 248 women of Korean ancestry born abroad who died in New York City in 1986-90. RESULTS: Males had a significant excess of viral hepatitis, cancer, stroke, and external causes: accidents, suicide, and homicide. They had significantly reduced proportional rates of AIDS and heart disease. Mortality patterns were similar for Korean women, who had significantly increased proportional rates of stroke and accidents, and reduced heart disease. Stomach and liver cancers were significantly elevated in both sexes, while female breast cancer was low. There were two male and one female tuberculosis deaths (4 to 7 fold increase), and one Korean woman died of childbirth complications (59-fold increase). CONCLUSIONS: Except for violent deaths, these observations resemble known mortality patterns in Korea.
Adolescent ; Adult ; Aged ; Child ; Child, Preschool ; *Emigration and Immigration ; *Ethnic Groups ; Female ; Human ; Infant ; Korea/ethnology ; Male ; Middle Age ; *Mortality ; New York City/ethnology ; Support, U.S. Gov't, P.H.S.

PURPOSE: Asian immigrant and Asian American women are less likely to use oral contraceptives (OCs) and tend to rely on low-efficacy methods of contraception. This contraceptive pattern remains poorly understood, in part, because no theory-driven measurement exists to assess psychosocial determinants essential in explaining behaviors related to OC use in this population. The current study aimed to evaluate the psychometric properties of a measure of attitudes and subjective norms toward OC use among Korean American women as a first step to determine whether the measure can be used in this population and, potentially, in other Asian ethnic groups. METHODS: The sample consisted of 329 Korean immigrant women living in New York City. The theory of reasoned action guided the development of the measure assessing attitudes and norms. Psychometric evaluation included item analysis, internal consistency estimates of reliability, and construct validity (i.e., factorial, discriminant, and predictive). RESULTS: All item-total correlations were above the recommendation of .30. The Cronbach's alpha for the attitudes and subjective norms measure was .88 and .86, respectively. Exploratory factor analyses revealed four interpretable factors, and confirmatory factor analyses confirmed that the factor structures derived from the exploratory factor analyses fit the data well. Discriminant and predictive validity of the measure were also established. CONCLUSIONS: The study provides support for the validity and reliability of the measure and its use for determining the degree to which Korean immigrant women intend to use OCs.
Adolescent ; Adult ; *Contraceptives, Oral ; Cross-Sectional Studies ; Emigrants and Immigrants/psychology ; Female ; *Health Knowledge, Attitudes, Practice ; Humans ; *Intention ; Korea/ethnology ; Middle Aged ; New York City ; Psychometrics/*methods ; Reproducibility of Results ; Surveys and Questionnaires/*standards ; Young Adult

A retrospective review of 4,721 human immunodeficiency virus (HIV)-infected patients, followed at St. Luke's Roosevelt Hospital Center, New York City, was conducted from January 1, 2005 to December 31, 2009. HIV-Hepatitis B virus (HBV) co-infection rate was 218/4,721, 4.6%. Among co-infected patients, 19 patients (19/218, 8.7%) died; 13 patients (13/19, 68.4%) died from non-acquired immune deficiency syndrome (AIDS) defining including 2 patients with liver failure. More non-survivors (5 patients, 5/19, 26.3%) had liver cirrhosis than those who survived (8 patients, 8/199, 4.0%; P = 0.002). There were more patients with positive HBV e antigen (HBeAg) among non-survivors, (12 patients, 12/19, 63.2%) than among survivors (74 patients, 74/199, 37.2%; P = 0.047). HIV-HBV co-infection is associated with increased overall mortality. Therefore, use of dual active antiretrovirals, particularly, tenofovir (TDF) based regimen for optimal suppression of HIV-HBV and immune restoration with prevention of high risk behaviors may contribute to improved outcomes.
Adenine/analogs & derivatives/therapeutic use ; Adult ; Anti-HIV Agents/therapeutic use ; Coinfection/drug therapy/mortality ; Female ; HIV Infections/complications/*diagnosis/drug therapy ; Hepatitis B/complications/*diagnosis/drug therapy ; Hepatitis B e Antigens/blood ; Humans ; Liver Cirrhosis/etiology ; Male ; Middle Aged ; New York City ; Organophosphonates/therapeutic use ; Retrospective Studies

OBJECTIVE: To assess the effect of lower limb strength on falls and balance in community-dwelling elderly persons by a health status questionnaire, evaluation of lower limb strength and balance. METHOD: A total of 86 subjects (age 69.8+/-5.3) were categorized into one of two groups, "Fallers" and "Non-fallers". Thirty one participants who had reported the experience of having fallen unexpectedly at least once in the past year were assigned into the group "Fallers", and the remaining 55 subjects having no fall history in the past year, "Non-fallers". A self-assessment questionnaire was taken. Lower limb strength was measured by a "Chair stand test". Balance was measured by the stability index of the fall risk test protocol of Balance System SD(R) (Biodex, New York, USA). The differences between the two groups were compared and the correlation between lower limb strength and balance were analyzed. RESULTS: The questionnaire demonstrated no significant differences between two groups. The "Chair stand test" showed a significantly less for the "Fallers" (p<0.05). The stability index was significantly greater in the "Fallers" group (p<0.05). There was a moderate negative correlation between the "Chair stand test" and the "Stability index" (R=-0.576, p<0.01). CONCLUSION: This study suggests that the "Chair stand test" is a useful screening process for lower limb strength which correlates to risk for falls and balance in the elderly.
Aged ; Humans ; Lower Extremity ; Mass Screening ; New York ; Self-Assessment ; Surveys and Questionnaires

OBJECTIVE: To investigate the changes of shoulder proprioception in normal subjects, according to the direction of the evoked fatigue on the shoulder muscle group. METHOD: 20 healthy volunteers (14 males and 6 females, age 20~35 years) with entirely normal shoulders participated in this study. Before fatigue exercises, the proprioception tests were performed during active reposition (ARP) and passive reposition (PRP) of dominant shoulder, using isokinetic dynamometer, System 3 Pro (Biodex medical system, New York, USA). Three trials each of active and passive repositioning (2degrees/sec) were recorded. We also estimated the results of the peak torque shoulder movements. The subjects performed maximal efforts with five repetitions on the direction of flexion, abduction, internal rotation and external rotation. The mean values of maximal concentric voluntary contraction (MVC: peak torque of each muscle group contraction) were recorded. We repeated fatigue exercises until the peak torque dropped to 30% three times consistently, then retested the proprioception of shoulder joints. We compared the proprioceptive changes of the shoulder with pre-fatigue test and post-fatigue test on the direction of shoulder movements. RESULTS: There were significant differences of shoulder proprioception between pre-fatigue test and post-fatigue test of ARP in shoulder abduction and external rotation (p<0.05). CONCLUSION: In our study, the proprioception of shoulder joint decreased more prominently on external rotation and abduction movements under severely provoked muscle fatigue around the shoulder joint.
Contracts ; Exercise ; Fatigue ; Female ; Humans ; Male ; Muscle Fatigue ; Muscles ; New York ; Proprioception ; Shoulder ; Shoulder Joint ; Torque

PURPOSE: In this study, relationships between symptom experience and quality of life in a cross-sectional sample of patients with Atrial Fibrillation (AF) were investigated. METHODS: This descriptive study involved a convenience sample of AF patients from S university hospital, C city. One hundred and two AF patients completed psychometric validated measures of AF related symptoms and quality of life. Descriptive statistics and Pearson correlation coefficients with SPSS WIN 14.0 were used for data analysis. RESULTS: Of 16 atrial arrhythmia-related symptoms, the patients reported 'tiredness' as the most frequent and 'shortness of breath' as the most severe. The level of overall quality of life for patients with AF was 53.92. There were significant differences in symptom frequency according to religion, New York Heart Association (NYHA) classification and left ventricular ejection fraction ; symptom severity according to monthly income and stroke ; quality of life according to age, job, alcohol intake, NYHA class and stroke. Quality of life for these patients was positively correlated with symptom frequency and symptom severity. CONCLUSIONS: This study demonstrated that patients with more frequent and severe symptoms perceive poorer quality of life than patients with less frequent and less severe symptoms. Symptom experience should be assessed early to improve quality of life for patients.
Atrial Fibrillation ; Heart ; Humans ; New York ; Psychometrics ; Quality of Life ; Statistics as Topic ; Stroke ; Stroke Volume

BACKGROUND/AIMS: Uninsured individuals have lower rates of screening colonoscopy (SC), and little is known regarding the pathology results obtained when they undergo colonoscopies. Since 2004, we have participated in a program that offers SC to uninsured New Yorkers; herein, we report our findings. METHODS: Uninsured, average-risk patients who were at least 50 years of age underwent SC at our institution between April 2004 and June 2011. We analyzed polyp pathology, location, size, incidence of adenomas, and incidence of adenomas with advanced pathology (AAP) with respect to ethnicity, gender, and age. RESULTS: Out of 493 referrals, 222 patients completed the colonoscopies. Polyps were identified in 21.2% of all patients; 14% had adenomas, and 4.5% had AAP. The rates of adenomas among African-Americans, Hispanics, and Whites were 24.3%, 12.1%, and 11.6%, respectively, and the corresponding rates of AAP were 10.8%, 3.5%, and 2.3%. Differences in the polyp type, location, and AAP did not reach statistical significance with respect to ethnicity or gender. Patients aged 60 and older were found to have a higher rate of advanced adenomas compared with younger patients (8.6% vs 2.6%, p=0.047). CONCLUSIONS: Further efforts to fund screening colonoscopies for uninsured individuals will likely result in the identification of advanced lesions of the colon before they progress to colorectal cancer.
Adenoma/diagnosis/epidemiology ; African Americans/statistics & numerical data ; Age Factors ; Aged ; Colon/pathology ; Colonic Neoplasms/diagnosis/epidemiology ; Colonic Polyps/diagnosis/epidemiology ; Colonoscopy/*statistics & numerical data ; European Continental Ancestry Group/statistics & numerical data ; Female ; Hispanic Americans/statistics & numerical data ; Humans ; Incidence ; Male ; Mass Screening/*statistics & numerical data ; Medically Uninsured/*statistics & numerical data ; Middle Aged ; Minority Groups/*statistics & numerical data ; New York City/epidemiology ; Program Evaluation ; *Urban Population