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ObjectivesUnderstanding the potential impact of physical characteristics of the urban environment on clinical outcomes on several mental illnesses.Materials and MethodsPhysical features of the urban environment were examined as predictors for affective and non-affective several mental illnesses (SMI), the number and length of psychiatric hospital admissions, and the number of short and long-acting injectable antipsychotic prescriptions. In addition, the urban features with the greatest weight in the predicted model were determined. The data included 28 urban features and 6 clinical variables obtained from 30,210 people with SMI receiving care from the South London and Maudsley NHS Foundation Trust (SLaM) using the Clinical Record Interactive Search (CRIS) tool. Five machine learning regression models were evaluated for the highest prediction accuracy followed by the Self-Organising Map (SOM) to represent the results visually.ResultsThe prevalence of SMI, number and duration of psychiatric hospital admission, and antipsychotic prescribing were greater in urban areas. However, machine learning analysis was unable to accurately predict clinical outcomes using urban environmental data.DiscussionThe urban environment is associated with an increased prevalence of SMI. However, urban features alone cannot explain the variation observed in psychotic disorder prevalence or clinical outcomes measured through psychiatric hospitalisation or exposure to antipsychotic treatments.ConclusionUrban areas are associated with a greater prevalence of SMI but clinical outcomes are likely to depend on a combination of urban and individual patient-level factors. Future mental healthcare service planning should focus on providing appropriate resources to people with SMI in urban environments.

BACKGROUND Applying health technologies, such as mobile applications (apps), is considered as a means of promoting health management. This research aimed to examine the consideration of developing mobile applications (apps), support diabetes mellitus type 2 (DM-2) self-management, via investigating the outcome of original articles. OBJECTIVE (1) To indicate the extend which mobile app developers considered features and specifications defined by the health technology guidelines. (2) To identify the bottlenecks of health technology guidelines by assessing and comparing them. (3) To provide a list of evidence-based recommendations for manufacturers in order to design and develop as well as verify the health mobile apps. METHODS This research is a combination of systematic literature review and meta-analysis as well as qualitative assessment. The systematic literature review and meta-analysis included the articles published within the last six years, to indicate time-related reliability to the content, indexed on Ovid, Embase, Engendering Village, and PubMed. In order to conduct a meta-analysis, the information derived from included articles was adopted in a framework made of qualitative assessment of the well-known health technology guidelines. These guidelines were published by The National Institute for Health and Care Excellence (NICE), World Health Organisation (WHO), Public Health England and the U.S. Food and Drug Administration (FDA). RESULTS After filtering all articles via a PRISMA flowchart, 37 articles were selected for further investigations. The results of the systematic literature review and meta-analysis indicated that almost all articles reported the significant role of apps in improving the health status of the users. Majority of studies were clinical trials conducted to measure the outcomes of interventions using a known mobile app. Technology-related limitations were having access to a smartphone and mobile markets, technology literacy, and malfunction of the systems. Combination of recommendations provided by included articles was conducting further studies with larger sample size to determine barriers and facilitators of available technologies integrated with mobile apps, aimed to provide patient-centred services, in a longer duration of the intervention implementation. On the other hand, the majority of articles did not report the use of any particular guideline. However, by comparing their findings with the results of the qualitative assessment of selected health technology guidelines, evidence-based documents were scarcely reported. Likewise, only a few numbers of articles briefly discussed cost-effectiveness. Almost none of them used an approved tool for evaluating the economic effect of mobile apps. CONCLUSIONS The majority of publications indicated lack of proper adherence to guidelines in designing and examining mobile applications, developed for supporting DM-2 self-management. Furthermore, a comparison of four included guidelines indicated insufficiencies in some perspectives such as safety of recorded information. The list of recommendations, produced by the results of included articles and highlights of included guidelines, facilitates producing standard mobile health apps by manufacturers.

Background:. Skin lesions and traumas can affect the skin by leaving scars. The purpose of this study was evaluating the results of a new technique in reconstructive surgery of scars on the nose. In this technique, extra skin remaining from reduction rhinoplasty is applied to the defect remained from removing the scar. Methods:. This is a retrospective cross-sectional study performed on 33 patients who underwent reduction rhinoplasty from 2013 to 2018 due to scars on the dorsal nasal skin. Five sets of standards, criteria, and questionnaires were used to evaluate the cosmetic outcomes, scars, and nasal function. These included the Cakir concept, visual analogue scale, patient reported outcome measurement, Stony Brook scar evaluation scale, and sino-nasal outcome test-22. Results:. According to the surface polygon concept, or Cakir concept, the number of affected polygons due to scars decreased in all included patients (P < 0.05). In addition, constant improvement in patients’ satisfaction, based on patient reported outcome measurement (P < 0.001) and visual analogue scale (P ≤ 0.05), as well as physicians’ satisfaction, based on Stony Brook scar evaluation scale, were determined. Furthermore, evaluating the patients’ breathing, based on sino-nasal outcome test-22 criteria (P < 0.09), indicated no adverse effects. Conclusion:. Excision of scars from dorsal nasal skin and conducting rhinoplasty surgery from the same access can be considered an option for reconstructing nasal scars.