Recent floods in America, Europe, Asia and Africa reminded societies across the world of the need to revisit their climate adaptation strategies. Rapid urbanization coinciding with a growing frequency and intensity of floods requires transformative actions in cities worldwide. While abandoning flood prone areas is sometimes discussed as a public climate adaptation option, little attention is paid to studying cumulative impacts of outmigration as an individual choice. To explore the aggregated consequences of households' outmigration decisions in response to increasing flood hazards, we employ a computational agent-based model grounded in empirical heuristics of buyers' and sellers' behaviour in a flood-prone housing market. Our results suggest that pure market-driven processes can cause shifts in demographics in climate-sensitive hotspots placing low-income households further at risk. They get trapped in hazard zones, even when individual risk perceptions and behavioural location preferences are independent of income, suggesting increasing climate gentrification as an outcome of market sorting.
Coastal areas around the world are urbanizing rapidly, despite the threat of sea level rise and intensifying floods. Such development places an increasing number of people and capital at risk, which calls for public flood management as well as household level adaptation measures that reduce social vulnerability to flooding and climate change. This study explores several private adaptation responses to flood risk, that are driven by various behavioral triggers. We conduct a survey among households in hazard-prone areas in eight coastal states in the USA, of which, some have recently experienced major flooding. While numerous empirical studies have investigated household-level flood damage mitigation, little attention has been given to examining the decision to retreat from flood zones. We examine what behavioral motives drive the choices for flood damage mitigation and relocation separately among property buyers and sellers. Hence, we focus on the drivers that shape demand for future development in flood-prone cities. We find that households' choices to retreat from or to avoid flood zones (1) are highly sensitive to information that provokes people's feelings of fear, and (2) rely on hazardous events to trigger a protective action, which ideally would take place well before these events occur. We highlight that major flooding may cause a potential risk of large-scale outmigration and demographic changes in floodprone areas, putting more low-income households at risk. Therefore, coordinated policies that integrate bottomup drivers of individual climate adaptation are needed to increase urban resilience to floods.
Purpose
The aim of this study was to explore the relationship between compliance with preoperative posturing advice and progression of macula-on retinal detachment (RD) and to evaluate whether head positioning or head motility contributes most to RD progression.
Methods
Sixteen patients with macula-on RD were enrolled, admitted to the ward, and instructed to posture preoperatively. The primary outcome parameter was compliance, which was defined as the average head orientation deviation from advised positioning. Secondary outcome parameters included the average rotational and linear head acceleration. The head orientation and acceleration were measured with a head-mounted inertial measurement unit (IMU). Optical coherence tomography (OCT) imaging was performed at baseline and during natural interruptions of posturing for meals and toilet visits to measure RD progression toward the fovea.
Results
The Spearman correlation coefficient with RD progression was 0.37 (
P
= 0.001,
r
s
2
= 0.13) for compliance, 0.52 (
P
< 0.001,
r
s
2
= 0.27) for rotational acceleration, and 0.49 (
P
< 0.001,
r
s
2
= 0.24) for linear acceleration. The correlation coefficient between RD progression and rotational acceleration was statistically significantly higher than the correlation coefficient between RD progression and compliance (
P
= 0.034).
Conclusion
The strength of the correlation between RD progression and compliance was moderate. However, the correlation between RD progression and rotational and linear acceleration was much stronger. Preoperative posturing is effective by reducing head movements rather than enforcing head positioning.
Translational Relevance
Monitoring the efficacy of preoperative posturing in macula-on RD using OCT and IMU measurements shows that a new and combined application of these technologies leads to clinically relevant insights.
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