In recent years, there have been several changes that deeply affected the port-city relationship, due to the evolution of maritime transports, traffic volumes and port infrastructures. Thanks to the expansion of the cruise and yachting sectors and the redevelopment of waterfront and port spaces, shared areas have assumed mixed functions and activities that are attractive for passengers/tourists but potentially also for other users, such as citizens. Often, the unplanned distribution of these heterogeneous functions and activities results in overlapping and intersecting flows of freights/passengers, with the generation of criticalities for vulnerable users. Commonly, each passenger/tourist, and generally more pedestrians, are independent decision-making units, and their route choices depend not only on their trip destination but also on the on the attractiveness of the existing activities, on the geometric characteristics of the path and, generally, on its Level of Service (LOS) and quality, contrary to freight routes, which are generally based on minimum generalized cost values. Thus, having a good non-motorized accessibility is a determining factor for port-city sustainable development. This paper focuses its attention on pedestrian flows in port-city areas and the construction of a methodological framework to evaluate nonmotorized accessibility. The framework analyses the quality of pedestrian displacements, both through the LOS and a utility measure, by taking advantage of Geographic Information System (GIS) tools. The methodology has been tested on the case study of Catania, a medium-sized city located in the south of Italy, whose port is located in an area that has a strategic role due to its proximity to the historic centre. The proposed framework can contribute to providing a guide to transport and urban planners, local and port authorities and decision-makers in port-city planning, identifying criticalities and solutions to enhance the non-motorized accessibility and sustainability of the port systems and urban areas.
Background: Partial adherence to antipsychotics is the most common cause of relapses and rehospitalization in patients with schizophrenia (SZ), leading to higher health care costs and psychosocial disability. The use of long-acting injectable (LAI) antipsychotics may improve therapeutic continuity and adherence to treatment. Objective: To assess the effectiveness of switching from oral antipsychotics (OAs) to long-acting antipsychotics. Methods: This 1-year mirror-image study evaluated the effect of switching from OAs to LAIs on the reduction of psychiatric hospitalizations and the improvement of global functioning in patients with schizophrenia. Differences in outcomes between second-generation (SGA) LAIs and first-generation (FGA) LAIs were also analyzed. Results: In all, 166 patients were included: 32.5% treated by FGA-LAIs and 67.5% by SGA-LAIs. There was an overall reduction of 71% in the average number of hospital admissions and an overall improvement of 29.3% in the Global Assessment of Functioning (GAF) score between the previous 12 months and the 12 months following the switching to LAIs. Patients who switched to SGA-LAIs had no significant differences in hospitalization occurrences but a significant improvement in GAF scores when compared with patients who switched to FGA-LAIs. Conclusion: Our results suggest that using LAIs could be the most adequate treatment choice for SZ patients with a high risk of relapse and low adherence rate. Patients with poorer social functioning may be ideal candidates for SGA-LAIs treatment. Our findings may be of particular interest from a clinical and health care management perspective.
Guaranteeing permeability between port and city areas is a complex issue since, in recent years, there have been deep changes, due to the evolution of maritime transport, traffic volumes and port infrastructures, which have profoundly influenced the port-city relationship. The recent growing of the cruise and yachting sectors, however, highlighted the huge possibilities of economic development related to these activities, especially in the areas of the cities located close the ports. In this light, it is essential to ensure good accessibility to the city from the port (and vice versa) and to ensure that urban routes within the areas close to the port offer visitors a pleasant experience, in terms of walkability and opportunities. In this paper a Walkability Comprehensive Index to evaluate the quality of facilities in proximity to port areas will be presented; the index will include evaluation concerning the accessibility of the facilities, their Level of Service and the Places of Interests for visitors entering the city from the port. The calculation of the index is based on a spatial analysis with data obtained through field surveys and by an open source approach. The methodology is applied to the case study of the Port of Catania, a coastal city located in the south of Italy. The comprehensive index provides with information on each arc of the road network, offering an aid for decision-makers in prioritizing intervention for the improvement of non-motorized infrastructure within the interface area between the port and the city.
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