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Despite the relevance of cities and city policies for health, there has been limited examination of large numbers of cities aimed at characterizing urban health determinants and identifying effective policies. The relatively few comparative studies that exist include few cities in lower and middle income countries. The Salud Urbana en America Latina study (SALURBAL) was launched in 2017 to address this gap. The study has four aims: (1) to investigate social and physical environment factors associated with health differences across and within cities; (2) to document the health impact of urban policies and interventions; (3) to use systems approaches to better understand dynamics and identify opportunities for intervention and (4) to create a new dialogue about the drivers of health in cities and their policy implications and support action. Beyond these aims SALURBAL, has an overarching goal of supporting collaborative policy relevant research and capacity -building that engages individuals and institutions from across Latin America. In this review we provide an update on the SALURBAL data resource and collaborative approach and summarize key findings from the first aim of the study. We also describe key elements of our approach, challenges we have faced and how we have overcome them, and identify key opportunities to support policy relevant evidence generation in urban health for the future.

The ever-increasing growth of urban population in worldwide and their unsustainable use of land resources have turned resource planning and management into one of the world's most important environmental challenges. In recent years, the concept of "urban ecosystem health" has been developed to monitor the impacts of human activities on Earth's ecosystems. The present research aims to investigate the ecosystem health status of the Sanandaj city by introducing a spatial decision support system. Urban health indicators were extracted from the Pressure-State-Impact-Response framework and the health status of 26 districts of Sanandaj city has been investigated. Finally, by weighing and integrating of 16 indicators, the total health score in each urban district has been obtained. The results showed that the health status in 9.2% of the areas of Sanandaj were in a very poor to poor, in 30.8% in a poor to moderate, in 52% of the areas in a moderate to strong, and 7.9% of the areas were in a strong to very strong health status. It seems that most of the efforts to restore the health of Sanandaj ecosystem should be focused first on 3, 5, Nanleh and Garizeh and then, on 4, 6, 9, 10, 11, 12 and Naysar districts. The model introduced in this study can be used to monitor the health status of any urban ecosystem which is the most important factor in maintaining the stability and sustainability of urban ecosystems. [ABSTRACT FROM AUTHOR]

Accelerated by the widespread use of social media, Internet rumors in major public health emergencies will destroy urban resilience. To find the path to improve the effectiveness of government rumor–refutation in major public health emergencies to enhance urban resilience, this paper creatively establishes an assessment research structure of the government's rumor–refutation effectiveness in major public health emergencies, and an assessment criteria system from four perspectives of source, message, channel, and reviewer is constructed, an assessment method incorporating multicriteria decision-making and machine learning methods, i.e., optimal clustering-VIKORSort with hesitant fuzzy linguistic term sets based on combinatorial weighting is proposed. Subsequently, all 102 cases of government rumor–refutation during the COVID-19 lockdown in Wuhan in 2020 are taken as alternatives and assessed. The results show that Wuhan's rumor–refutation effectiveness was not strong. Then, the investigated factors that constrain Wuhan's emergency rumor–refutation effectiveness are diversified. Furthermore, this paper assesses the rumor–refutation effectiveness in Shanghai during the 2022 epidemic, obtains similar problems to Wuhan, and demonstrates the generalizability and robustness of the proposed method. Finally, based on the results, this paper proposes suggestions for improving the government's rumor–refutation effectiveness in major public health emergencies to enhance urban resilience, which is a crucial contribution to combating Internet rumors and improving urban resilience in major public health emergencies. [ABSTRACT FROM AUTHOR]

Accurately measuring spatial inequities in the built environment is essential for meaningful research on how environmental factors influence health. This study aimed to (1) systematically identify how spatial inequities are measured in urban health research and (2) assess the conceptual clarity of studies on spatial inequities and inequalities. A scoping review of four electronic databases (PubMed, Web of Science, GreenFILE, and Global Health) was conducted. From 921 results, 44 full-text articles were reviewed. Studies most frequently measured access to green spaces (n = 20, 45.5%), food environment (n = 7, 15.9%), and walkability (n = 5, 11.4%). Most studies (n = 32, 73%) were conducted in high-income countries. The primary analytical approaches were descriptive (n = 11, 25%). Most studies (n = 43, 97.73%) contained misalignment between concepts they purposed to measure, and variables and analyses used. Concepts such as accessibility (n = 10, 22.72%), environmental justice (n = 5, 11.36%), and spatial equity (n = 3, 6.81%) were prevalent. This study's results highlight the need for conceptual clarity on spatial inequity and inequality within urban health research. This research highlights the reliance on descriptive methodologies and advocates for robust statistical approaches. With conceptual clarity and improved measurements, researchers and practitioners can better develop strategies to advance urban health policies with the goal of reducing health inequities. [ABSTRACT FROM AUTHOR]

Urban waterfront-built environments in cold regions are more conducive to public health than green spaces alone. However, their failure to meet health intervention expectations calls for further research to explore potential intervention pathways and mechanisms. This study conducted an in-depth investigation of Shenyang, a city in China’s cold region. A mechanistic model was developed to examine the impact of cold urban waterfront environments on health in both seasons, employing perceived behavioural control in terms of behavioural predisposition, behavioural enablement, and behavioural reinforcement as mediating factors. The results indicated that the perceived behavioural control of predisposition-mediated health outcomes was highest in winter, whereas behavioural reinforcement was highest in summer, leading to targeted health behaviour interventions. Comparison of indirect effect values and factor loadings for perceived control of health behaviours were conducted to screen health-oriented indicators and strategies across seasons. These findings offer insights into urban regeneration and public health management. [ABSTRACT FROM AUTHOR]

There is a critical lack of surgical data on individuals who live in urban slums, which hampers the allocation of healthcare resources and the provision of preventative measures. The complex interplay of factors affecting surgical care in slums, such as trust deficits, mental health concerns, and socioeconomic barriers, necessitates a distinct academic approach. We propose that researchers should consider "slum surgical health" as an area of study separate from urban health or slum health. From this perspective, we make a case for defining "slum surgical health" while presenting evidence from multiple countries that shows the unique challenges of providing surgical care in slum settings. We discuss a successful model that has deployed community health worker programs as intermediaries between slum dwellers and healthcare providers. This model, which achieved a 60% conversion rate from unmet to met surgical needs, demonstrates the potential of culturally sensitive, community-based approaches to address surgical inequities in urban slums. [ABSTRACT FROM AUTHOR]

Background: The co-occurrence of diabetes and mental disorders is an exceedingly common comorbidity with poor prognosis. We aim to investigate the impact of green space, garden space, and the natural environment on the risk of mental disorders among the population living with diabetes. Methods: We performed a longitudinal analysis based on 39,397 participants with diabetes from the UK Biobank. Residential green and garden space modeled from land use data and the natural environment from Land Cover Map were assigned to the residential address for each participant. Cox proportional hazards model was used to analyze the associations between nature exposures and mental disorders of diabetes. Casual mediation analysis was used to quantify indirect effect of air pollution. Results: During a mean follow-up of 7.55 years, 4513 incident mental disorders cases were identified, including 2952 depressive disorders and 1209 anxiety disorders. Participants with natural environment at 300 m buffer in the second and third tertiles had 7% (HR = 0.93, 95%CI: 0.86–0.99) and 12% (HR = 0.88, 95%CI: 0.82–0.94) lower risks of incident mental disorders compared with those in the first tertile, respectively. The risk of mental disorders incidence among diabetes patients will decrease by 13% when exposed to the third tertile of garden space at 300 m buffer. The natural environment and garden space individually prevented 6.65% and 10.18% of mental disorders incidents among diabetes patients. The risk of incident mental disorders was statistically decreased when exposed to the third tertile of green space at 1000 m buffer (HR = 0.84, 95% CI: 0.78–0.90). Protective effects of three nature exposures against depressive and anxiety disorders in diabetes patients were also observed. Air pollution, particularly nitrogen dioxide, nitrogen oxides, and fine particulate matter, significantly contributed to the associations between nature exposures and mental disorders, mediating 48.3%, 29.2%, and 62.4% of the associations, respectively. Conclusions: Residential green and garden space and the natural environment could mitigate mental disorders risk in diabetes patients, with air pollution playing a vital mediator. This highlights the potential for local governments to enhance the sustainability of such interventions, grounded in public health and urban planning, through strategic planning initiatives. [ABSTRACT FROM AUTHOR]

Background: Immunization clinics present an opportunity for passive screening for malnutrition among young children through plotting of growth charts. Passive screening for malnutrition can enable timely interventions and improve morbidity and mortality of under-five children. Therefore, we aimed to increase the plotting of growth charts (weight-for-age) to 90%, among under-five children attending immunization clinics in an Urban Health Centre (UHC) in south Delhi over three months. Methodology: A Quality Improvement (QI) initiative was undertaken in the immunization clinic of an urban primary health centre in southern Delhi, from January to March 2024. A multi-faceted QI team was formed. The baseline coverage of weight-for-age growth chart plotting in the immunization clinic was 31%. The process flow was mapped, and critical gaps identified by root cause analysis (Fish Bone technique). Change ideas were discussed and prioritized using a prioritization matrix to implement these through sequential PDSA cycles. The main change ideas implemented were training of health workers, allotting regular supervisors for the session, and appending a stamp for quick identification of underweight children. Run chart was used to assess the changes over time. We considered the outcome achieved if the plotting coverage was more than 90% sustained for at least six consecutive immunization sessions. Results: Multiple change ideas were implemented over a period of three months. The coverage of growth chart plotting increased to more than 90%. Lack of motivation among stakeholders was a challenge for some change ideas. Monitoring of immunization sessions for plotting of growth chart was continued post the implementation of all change ideas to assess sustainability which showed positive results. Post-implementation of the change ideas, a meeting was held with the members of the QI team to get feedback on this activity. Conclusion: There is potential for improving growth monitoring at immunization clinics, which can be beneficial in strengthening passive screening for malnutrition in primary care settings. Clinical trial number: Not applicable. [ABSTRACT FROM AUTHOR]

Background: Coronary heart disease (CHD) is the leading cause of death among adults in Germany. There is evidence that occupational exposure to particulate matter, noise, psychosocial stressors, shift work and high physical workload are associated with CHD. The aim of this study is to identify occupations that are associated with CHD and to elaborate on occupational exposures associated with CHD by using the job exposure matrix (JEM) BAuA-JEM ETB 2018 in a German study population. Methods: Cross-sectional data from 8,070 participants, members of the first sub-cohort of the Hamburg City Health Study (HCHS), was used. To classify occupations, we rely on standard occupational titles (ISCO-08). The level of exposure is assigned to each job using a JEM. CHD is measured by self-reported diagnosis. Absolute and relative frequencies were calculated. Using logistic regression, the association of CHD and standard occupation titles via ISCO-08 and the association of CHD and occupational exposures via JEM were calculated and adjusted for potentially confounding covariates. Multiple imputations with chained equations (MICEs) were applied for missing values. Sensitivity analyses were performed. Results: The CHD prevalence in the study population was 4.6% (95% CI 4.2–5.1). Occupations associated with CHD were Physical and Engineering Science Technicians, Other Health Associate Professionals, General Office Clerks, Secretaries (general), Material Recording and Transport Clerks, Hairdressers, Beauticians and Related Workers, Electronics and Telecommunications Installers and Repairers, Other Craft and Related Workers, Car, Van and Motorcycle Drivers, Mobile Plant Operators and Domestic, Hotel and Office Cleaners and Helpers. Among occupational exposures retrieved from the JEM, Environmental Demands showed an association with CHD in the crude model but not after adjustment. The results remained robust in sensitivity analyses. Conclusions: This study is the first to assess the association of a wide range of occupations and occupational exposures with CHD in a German study population. We found no association between occupational exposures and CHD after adjustment, but 11 occupations associated with CHD were identified. The results are limited by cross-sectional design, healthy worker effect (HWE), and small group sizes. Further studies with a larger sample and longitudinal design containing data on occupational history, occupational exposures and time of CHD diagnosis are needed. [ABSTRACT FROM AUTHOR]

Featured Application: This study demonstrates the use of EMG analysis combined with a personalised bike-fitting method to improve rider comfort and muscle efficiency for urban cyclists. The findings highlight the potential of this approach to optimise cycling ergonomics and reduce musculoskeletal strain, with possible future applications in clinical and recreational settings. This study investigates whether electromyography (EMG) analysis can reflect ergonomic improvements for commuter bike users by assessing muscle activity differences between comfort- and performance-oriented saddle positions. A cohort of 30 city bike riders underwent a comprehensive fitting procedure, where one position was individually established based on a comfort perception questionnaire and adjusted by a bike fitter. The aim was to compare the EMG activity of muscles involved in propulsion and lumbar spine stabilisation across different positions. The Statistical Parametric Mapping (SPM) method was also used to analyse muscle activity throughout the pedalling cycle. The results revealed that the customised position significantly reduced EMG activity in muscles, particularly during key pedalling phases, significantly improving rider comfort and muscle efficiency. SPM analysis highlighted decreased strain in the vastus lateralis and tibialis anterior, indicating improved muscular efficiency and enhanced comfort for urban cyclists. This underscores the importance of personalised bike fitting in promoting comfort and reducing the risk of injury, suggesting that EMG analysis is a valuable tool in both clinical and recreational bike-fitting practices. Future research should explore the long-term effects and potential applications of the proposed fitting method for other bicycle geometries whenever comfort and lower back stability are priorities. [ABSTRACT FROM AUTHOR]

Introduction: Emergency department boarding has escalated to a crisis, impacting patient care, hospital finances, and physician burnout, and contributing to error. No prior studies have examined the effects of boarding hours on resident productivity. If boarding reduces productivity, it may have negative educational impacts. We investigated the effect of boarding on resident productivity as measured by patients per hour and hypothesized that increased boarding leads to decreased productivity. Methods: This was a retrospective study at a quaternary, urban, academic Level I trauma center from 2017-2021 with a three-year emergency medicine residency of 10-12 residents per year and annual volumes of 80,000-101,000. Boarding was defined as the time between an admission order and the patient leaving the ED. We created a multivariable mixed model with fixed covariates for year, month, day of week, resident experience, shift duration, total daily ED patients, and with residents as repeated measures. The effect of boarding was estimated after covarying out all other factors. Results: All variables included in the model were significantly associated with changes in productivity. Resident experience has the largest effect such that for each month of residency experience, a resident adds 0.012 patients per hour (95% confidence interval [CI] 0.010-0.014). Isolating the effect of boarding demonstrated that for every additional 100 hours of boarding, a resident's productivity decreased by 0.022 patients per hour (95% CI 0.016-0.028). In the study, the median daily boarding was 261 hours; if this were eliminated (assuming a resident completes 100 10-hour shifts annually), a resident could be expected to see 56.9 more patients per year (95% CI 40.7-73.1). Conclusion: Hospital boarding significantly reduces resident productivity as measured by patients per hour. Further studies are warranted to determine the educational impact. [ABSTRACT FROM AUTHOR]

Sewage treatment helps to prevent many urban environmental and public health problems. This study proposes an alternative treatment plan for use in the event of a circumstantial failure of main treatment plants, before discharge into a river. A functional device was constructed to mix wastewater and raw river water in a single pipe, which is divided into five sections for measuring biochemical oxygen demand (BOD) and dissolved oxygen (DO). The test results showed that the amount of BOD can return to its original value, as in raw water, at distances ranging from 8 metres to 12 metres. On the other hand, the amount of DO requires a distance greater than 12 metres. Two regression equations were developed to predict the distance of impurities through the pipe in terms of BOD and DO, with coefficients of determination of 0.99 and 0.949, respectively. [ABSTRACT FROM AUTHOR]

Objective: This study examined the indirect effects of the number of Japanese municipal public health nurses (PHNs) on cancer standardized mortality ratios (SMRs), using cancer screening and diagnostic follow‐up rates as mediators. Design: Ecological study using municipalities as the unit of analysis Measurements: Aggregate, municipal‐level government data were analyzed using a linear model with empirical Bayes estimates of SMRs (EBSMRs) for gastric, colorectal, and lung cancers as the dependent variables, and the number of PHNs, cancer screening rate, diagnostic follow‐up rate, and adjustment variables as independent variables. Structural equation modeling (SEM) was used to examine the indirect effects of PHNs. Results: Cancer screening rates were significantly negatively associated with EBSMR, except for gastric cancer in women. No significant association was observed between the EBSMR and diagnostic follow‐up rates. SEM revealed a significant indirect effect of the number of PHNs, most of which was due to the cancer screening rate. Conclusions: From a population‐based public health perspective, increasing the number of PHNs and focusing on improving cancer screening rates may effectively reduce cancer SMRs. [ABSTRACT FROM AUTHOR]

Background: A high proportion of sexual minorities like Hijras/Eunuch engage in sex work and thus become a high-risk population for HIV and sexually transmitted infections (STIs). Hence, we conducted a study with objective to assess prevalence of high-risk behavior among self-identified Hijras/Eunuch and associated factors. Material and Methods: A cross-sectional study was conducted in a field practice area of Tertiary Care Hospital from December 2019 to December 2020. All participants in the age group of 18 to 45 years were interviewed. Univariate and bivariate analysis was done to determine the correlates. Results: Out of 163, 85% of participants were involved in high-risk sexual behavior and 46.63% did only sex work, 51.5% of participants had comprehensive knowledge about HIV/STI. On applying logistic regression, the factors associated with high-risk sexual behavior include 18–24 years of age group, history of addiction, practicing paid sex, using psychotropic substances, comprehensive knowledge regarding HIV/STI, and comprehensive exposure to preventive measures. Conclusion: Our study findings suggest the urgent need for appropriate preventive measures to understand and address sexual health and risk behavior vulnerabilities faced by Hijras to make significant progress against the HIV epidemic in the country. [ABSTRACT FROM AUTHOR]

We implemented a pilot study to investigate symptoms and functional outcomes of Asian Americans treated in urban community mental health centers for a diagnosis of schizophrenia spectrum disorder. Furthermore, we investigated whether these outcomes differed between East and Southeast Asians. We collected quantitative data from 75 participants recruited using a nonprobability sampling strategy from six urban community mental health centers. We used the Positive and Negative Syndrome Scale (Kay et al. in Schizophrenia Bulletin 13(2):261–276, 1987) and the Strauss and Carpenter Outcome Scale (Strauss and Carpenter in Archives of General Psychiatry 27(6):739–746, 1972) to measure their symptoms and functional outcomes. To compare the outcomes between East and Southeast Asians, we used a multivariable logistic regression model, which adjusted for the estimated effects of age, sex assigned at birth, and age at onset of illness for each outcome examined. The data shows that the treatment outcomes for this group are poor. Only a small number of participants experienced symptomatic remission (30.67%), role restoration (34.67%), and clinical recovery (21.33%). The majority of those who did not experience clinical recovery had difficulties sustaining symptomatic remission and restoring role functioning (54.67%). However, more participants achieved social restoration (68.00%). The results did not vary by national origin groups and sex assigned at birth. However, the participant's age, the age at which the illness began, or both determined whether the treatment outcomes were favorable. Findings underscore the need for interventions that improve symptom control to increase the likelihood of other favorable outcomes. [ABSTRACT FROM AUTHOR]

Stephen Smith launched a 40-year effort to bring trees to New York City streets in 1872, the year he founded the American Public Health Association (APHA). Smith argued that street trees would mitigate the adverse health effects of Manhattan's summer heat and help purify the air. The young APHA endorsed Smith's position and gave trees a prominent role in urban sanitation, but public health turned away from trees and urban reform movements as it adopted a biomedical public health model in the late 19th century. Nevertheless, Smith wrote and campaigned for a successful 1902 law requiring the New York City Parks Department to assume management of street trees in the name of public health. He then led a 1914 campaign to force the department to uphold his law. New York's street tree program has had an erratic trajectory, but it now generally follows Smith's vision. Public health could play a bigger role in creating greener cities and mitigating climate change with more field research and the health in all policies approach that Smith used to bring trees to Manhattan's streets in 1914. (Am J Public Health. 2025;115(1):66–74. https://doi.org/10.2105/AJPH.2024.307856) [ABSTRACT FROM AUTHOR]

ABSTRACT: Background: Family planning is a critical aspect of reproductive health, influencing individuals and couples; decisions regarding contraception. This study explores the pattern of usage of contraceptives viz. condom, injectables, centchroman tablets, oral contraceptive pills and sterilization, including tubectomy and vasectomy. Understanding these associations is vital for improving the role of counselling in family planning services. Objective: To assess the magnitude and pattern of contraception usage in an urban health centre in East Delhi. Methodology: Data were collected and analysed from the family planning counselling register from November 2022 till October 2023 among the couples coming to the family planning clinic of UHTC located in East Delhi. Information about demographic details, live issues, contraceptive being used, contraceptive recommended, client choice and outcome (whether they accepted the recommended contraceptive or not). Responses of beneficiaries were analysed to determine the magnitude and pattern of contraceptive usage. Results: Among 764 couples, the mean age of females and males was 30.36 years (±5.6) and 34.32 years (±6.2), respectively. Among all participants, 38.32% of couples had two children. The usage of condoms was reported by 40.6% of the participants. Out of the total participants, 58.6% received counselling for permanent methods. The unmet need was identified in 25.2% of the participants. Conclusion: The study underscores the importance of counselling in shaping family planning decisions. Insights gained in this study can help healthcare providers tailor counselling approaches to better address the diverse needs of individuals and couples. [ABSTRACT FROM AUTHOR]

The health of urban innovation ecosystems is crucial for smart and modern city construction. Considering the characteristics and formation mechanism of urban innovation ecosystems, an index system of health evaluation for smart cities is established. The combined DEMATEL-TOPSIS method was used to comprehensively evaluate the health of the innovation ecosystem in Wuhan from 2012 to 2020. Moreover, the cause-and-effect relationships among the indicators and the key impact factors are analyzed. The results show that per capita GDP, the number of users with fixed Internet broadband access, and road area per capita are the critical factors influencing the health status of urban innovation ecosystems. The centrality degrees are 1.640, 1.406, and 1.326, respectively, and the causality degrees are 1.264, 0.934, and 0.808, respectively. Through the analysis of closeness coefficients, it can be concluded that the health status of the innovation ecosystem in Wuhan is good and steadily increasing. Finally, policy recommendations for the health development of Wuhan's innovation ecosystem are proposed. [ABSTRACT FROM AUTHOR]

Urban agriculture (UA) is a longstanding practice in African cities, characterized by some distinctive features. In particular, the amount of land devoted to UA in these cities exceeds that used in Western countries, presenting challenges in areas such as land tenure. Beyond land tenure, UA also intersects with significant health concerns, as it contributes to food security, nutrition, and urban environmental health. However, the literature highlights a gap: urban planners in Africa often show limited interest in the connection between UA and health, despite its significance. This article addresses this gap by bringing together perspectives from architects, urban planners, geographers, economists, and sociologists to explore the links between human health and UA. The experts' points of view are contrasted with ideas drawn from surveys of urban farmers in Greater Lomé, Togo, and official urban planning documents. Methodologically, 11 experts were selected in Greater Lomé and interviewed virtually via Zoom 5.6.6, and their audio files were anonymized, transcribed, and manually coded. According to the experts, the impacts of UA practices on human health and the built environment in Greater Lomé are mixed. This study's key findings reveal that urban farmers identify a variety of challenges, including health-related difficulties, while experts tend to assume different health concerns, highlighting a disconnect between the two perspectives. The authors recommend developing joint planning guides in collaboration with experts from various fields in the cities concerned, in order to recognize local knowledge and integrate the perspectives of urban farmers into UA policies. [ABSTRACT FROM AUTHOR]

Background: Non-communicable diseases (NCDs) are the leading cause of global mortality. The WHO projects a rise in NCD-related deaths from 36 million in 2018 to 55 million by 2030, with developing countries being the most affected. Effective community-based primary health care (PHC) can reduce the burden of chronic diseases of lifestyle (CDLs). This study aimed to develop a risk assessment and health promotion framework to strengthen CDL prevention and control in Free State (FS) communities in South Africa. Methods: A convergent mixed-method design was used. Quantitative analysis identified CDL risk factors in rural and urban FS settings, while qualitative focus group discussions explored participants' knowledge of CDLs and their experiences with program implementation. Results: Key findings highlighted differences in risk profiles, CDL training needs for PHC teams, patient education gaps, and curriculum development. Step 1 of the framework development identified differences and similarities in the CDL risk profiles of the study populations. Step 2 identified CDL training needs for PHC teams, patient educational needs, and CDL curriculum development needs. Step 3 revealed three main barriers: resource constraints, patient non-compliance, and the lack of supporting healthcare services. In Step 4, the six focus areas identified (steps 1–3) were used to develop strategies for implementing a tailored, community-based, patient-centred approach. Conclusions: The results provide valuable insights for improving PHC responses in resource-limited settings. [ABSTRACT FROM AUTHOR]

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Significant environmental challenges, such as urban and industrial expansion, alongside vegetation preservation, directly influence the concentrations of critical air pollutants and greenhouse gases in cities and their surroundings. The urban development and expansion process is aptly captured by classifying land use and land cover (LULC). We aimed to analyze LULC changes in an Andean area, Ecuador, and to reveal the relations of LULC classes with three air pollutants ozone ( O 3 ), nitrogen dioxide ( N O 2 ), and sulfur dioxide ( S O 2 ), using remote sensing datasets (Sentinel-5P - Sentinel 1 - Sentinel-2) across different periods. Results showed that S O 2 is not a reliable indicator for assessing its behavior based on LULC classes, as it was difficult to distinguish between different land cover types using this pollutant. For N O 2 , the analysis showed a moderate distinction among LULC classes, suggesting some variability in its distribution across different land cover classes. On the other hand, O 3 analysis shows that all land cover classes are statistically distinguishable, demonstrating that urban, shrubland, green areas, and forest classes influenced ozone distribution. These findings emphasize the importance of accurate land cover classification in understanding air pollutants' spatial distribution and dynamics. This analysis is crucial for understanding the impacts of land use and land cover changes on urban health and well-being and the effects of rapid urban expansion. [ABSTRACT FROM AUTHOR]

Background: Period poverty or inadequate access of menstrual hygiene and education can be debilitating to women of reproductive age. The objective of present study was to have an insight into period poverty as well as determine association between last-year period poverty, menstrual knowledge and menstrual hygiene management (MHM) with socio-demographic variables. Methods: This analytical study was cross-sectional in design included females of reproductive age (20-49 years). Study was carried at a primary health centre in urban Lucknow. Data was collected on a pre-validated semistructured questionnaire. The data was collected and entered in M.S Excel. Chi-square was applied for analysis. Results: Prevalence of last year period poverty, poor menstrual knowledge and poor menstrual hygiene management was 29.7%, 17.7% and 42.3%, respectively. Significant association exists between period poverty and socio-demographic variables. Conclusion: Period poverty continues to be a challenging issue among females of reproductive age group. Increasing awareness about menstrual hygiene and MHM practices, and taking action to ensure adequate supply of period product is need of the hour. [ABSTRACT FROM AUTHOR]

In the age of stock planning, urban vitality is a key indication of a city's health and vitality. Using the central city of Tianjin as an example, the study uses multi-source data, such as Weibo check-ins, points of interest, etc., to quantify urban vitality. The Light GBM-SHAP model is chosen to measure the non-linear effects of each indicator on urban vitality in four dimensions: crowd vitality, economic vitality, facility vitality, and environmental vitality. The study also applies spatial visualization and spatial statistical analysis to analyze the vitality of the central city of Tianjin in terms of time and space scales. The findings indicate that: (1) There is clear temporal and geographical variation in the vitality distribution in Tianjin's core urban region. Over time, spring, particularly April, is marked by a surge of vitality brought on by the tourist season and holiday effects; there is a double-peak time in the morning and evening, and the nighttime vitality is particularly strong; and, in terms of space, urban vitality tends to decline from the Heping District outward. (2) Public facility density, living facility density, and building density are the three indicators that most strongly influence urban vitality; each indication has a negligible impact on the temporal dimension of urban vitality. (3) The indicators in Tianjin's core urban region have a substantial impact on urban vitality. Their threshold effect and non-linear influence are evident, and managing the indicators within a suitable range may effectively promote urban vitality. The study's findings might serve as a foundation for Tianjin's core city's urban planning and design. [ABSTRACT FROM AUTHOR]

Community-level emergency facilities are essential for disaster prevention and response, contributing significantly to urban health equity. This study aims to explore the multi-scale spatial pattern, multi-dimensional availability evaluation, and multi-scenario simulation optimization of nucleic acid testing sites during the later stage of COVID-19. At a macro scale, these sites demonstrated a "multi-core clustering" pattern, while at a micro-scale, they were community-centered, often located in areas with low traffic and better ventilation. Spatial accessibility analysis showed high accessibility in urban centers when only facility capacity was considered, though accessibility dropped relative to suburban areas when community population and time costs were included. Temporally, site availability followed an M-shaped distribution. This study optimized testing site locations, providing insights into equitable distribution and supply–demand balance for emergency facilities. [ABSTRACT FROM AUTHOR]

Urban agriculture along major highways often exposes food crops to heavy metal contamination, primarily from vehicular emissions. This review examines the origins, exposure pathways, and health risks associated with heavy metals in roadside vegetables. Sources include both tailpipe emissions, such as lead (Pb) and cadmium (Cd), and non-tailpipe emissions from tyre and brake wear, which release zinc (Zn) and copper (Cu). Contamination occurs through atmospheric deposition on plant surfaces and root uptake from polluted soils. A systematic synthesis of global case studies reveals alarming levels of heavy metals, often exceeding WHO/FAO thresholds. For instance, vegetables cultivated along the Accra-Tema motorway in Ghana contained cadmium levels up to 279 mg/kg, posing significant health risks. Similarly, roadside vegetables in India, Nigeria, and China demonstrated bioaccumulation of toxic elements, with health implications including carcinogenic and non-carcinogenic effects. The review highlights the direct and indirect exposure pathways for humans, such as dietary intake of contaminated vegetables, inhalation of particulates, and dermal contact. Health consequences include gastrointestinal distress, neurotoxicity, reproductive issues, and elevated cancer risks. To mitigate these risks, the review advocates for the prohibition of vegetable farming near high-traffic highways, along with the implementation of stringent monitoring programs to assess and control heavy metal levels. Future research should address ecological impacts and integrate diverse contamination sources to develop effective risk management strategies. This work is a critical resource for policymakers, researchers, and urban planners aiming to enhance food safety and public health in urban settings. [ABSTRACT FROM AUTHOR]

Simple Summary: The limited understanding of the fractionation of rare earth elements (REEs) in fish has hindered the effective use of biomonitoring to assess REEs contamination in aquatic environments. Guangzhou City, which faces widespread emissions of REEs, urgently needs biomonitoring of REEs. Therefore, this study took Guangzhou City as a case study and conducted wild fish collections to investigate the bioaccumulation and fractionation of REEs. Additionally, the associated health risks were evaluated to guide fish consuming. This study confirmed the different REEs bioaccumulation and fractionation among 11 fish species. The bioaccumulation of REEs was found to be a process that could mitigate REEs fractionation. The bioaccumulation and fractionation of REEs among fish with feeding behaviors and living habitats were determined to be specific, so that REEs bioaccumulation and fractionation could be used for tracing the environmental behaviors of fish. Food sources should be treated as the critical regulator in varying REEs bioaccumulation and differentiation. The overall low content of REEs in wild fish shows their consumption should not pose a relevant risk. In this study, the total content of REEs ranged from 1.32 to 67.74 μg/kg, with a predominant presence of light REEs. The ΔEu and ΔCe values, which exceeded and approached 1, respectively, indicated positive Eu anomalies and low Ce anomalies. Wild fish were categorized into high-, medium-, and low-REEs-bioaccumulation groups using cluster analysis. Higher LRs/HRs and ΔEu values, coupled with lower ΔCe values, in fish from the high-bioaccumulation group suggested that increased bioaccumulation mitigated fractionation. Omnivorous fish with higher REEs levels and lower LRs/HRs indicated broader feeding sources may enhance REE bioaccumulation and diminish fractionation. Elevated REEs concentrations and LRs/HRs in demersal fish highlighted a preferential accumulation of light REEs in the benthic environment. Smaller fish with higher REEs levels but lower LRs/HRs were likely associated with complex feeding sources. Regression analysis revealed that fish with lengths and weights of less than 18 cm and 130 g, respectively, were more susceptible to REEs bioaccumulation. Despite higher ADI values indicating a greater risk for children and Pelteobagrus fulvidraco, all ADI values within 70 μg/(kg·d) suggested that fish consumption poses no risk. This study confirmed that the fractionation of REEs in fish can be used to trace their bioconversion. [ABSTRACT FROM AUTHOR]

This study sought to understand the determinants of household's choices for fecal sludge (FS) emptying to help fighting against unhygienic/unsafe practices and environmental pollution. A cross-sectional mixed study used in the municipality of Yopougon (Abidjan, Côte d'Ivoire), involved surveys (559 household), and 24 semi-structured interviews. Adjusted odds ratios (aORs) from logistic regressions indicated the variables significantly associated with these practices while thematic content analysis helped assessing stakeholders' perceptions. Respondents (47.6%) reported unhygienic/unsafe emptying, mainly direct FS discharge into open drains or the immediate environment via illegal toilets/pits connections (38.1% out of 47.6%). Household heads with a high monthly income (aOR = 0.59; 95% CI 0.35–0.98; p = 0.04), house ownership (aOR = 0.27; 95% CI 0.15–0.47; p < 0.001) and distance to a water body (aOR = 0.03; 95% CI 0.009–0.12; p < 0.001) were the main explanatory variables, significantly reducing the likelihood of unsafe emptying. This likelihood increases when the household is close (≤ 100 m) to gully/gutter (aOR = 1.73; 95% CI 0.99–3.03; p = 0.05). Our recommendations for improving sanitation in low-income settings include reducing environmental pollution caused by unhygienic/unsafe emptying practices requires, enhancing and enforcing current regulations and making implementing texts effective, raising public awareness focusing on the benefits associated to hygienic sanitation practices, and subsidizing sanitation interventions for the poor that includes homeowners. [ABSTRACT FROM AUTHOR]

Introduction: Urban habitats, including green spaces, host diverse ecosystems where ticks and their hosts thrive, posing public health risks. Understanding the presence of ticks in urban areas is crucial for the effective management of those parasites. Methods: A three-year study (2021 - 2023) on the presence of ticks in urban green spaces was conducted in the city of Košice, Slovakia. A total of 3443 ticks were collected in woodland and scrubby vegetation areas located in the town by applying the flagging methods. Results: Three different species of ticks – Ixodes ricinus , Dermacentor reticulatus , and Dermacentor marginatus , were found in the urban spaces, while I. ricinus was the most prevalent tick species (64.7%), followed by D. reticulatus (35.2%). Dermacentor reticulatus , typically found in rural habitats, was detected right in the city centre, where its typical habitat is absent. Significant differences in tick abundance were observed between the scrubby areas (55.9%) and the woodland areas (44.5%), with D. reticulatus being predominantly found in the former. Monthly tick density varied across years, with D. reticulatus activity starting early in February. Discussion: The findings of the study highlight the importance of considering geographical and ecological factors in tick distribution studies, especially in urban settings. Effective public health management strategies should incorporate efforts aimed at understanding the presence and behaviour of ticks in urban environments, emphasising the need for monitoring those species and taking necessary measures, such as vegetation maintenance, in order to mitigate the tick-related risks in urban areas. [ABSTRACT FROM AUTHOR]

The social structure of India is rapidly evolving, towards modernization. The urban population of India is projected to approach 60 crores by 2036. Urban health resilience stands for building the capacity of urban systems to withstand and adapt to health-related stresses like natural disasters, man-made disasters, and pandemics like COVID-19 and the capability to recover from them by well-equipped hospitals, efficient emergency response mechanisms, and a network of well-trained and motivated healthcare professionals. Also, the involvement of communities is central to building urban health resilience. Strong policy frameworks are required for establishing a resilient urban health ecosystem. Addressing social determinants, such as income inequality, education, and housing, is also a basis of building urban health resilience. Some examples have been instrumental in designing a resilient urban health system like Singapore's Smart Nation Initiative, Copenhagen, Denmark's Model for Sustainable Urban Living internationally, Ahmedabad's Heat Action Plan and Kochi's Waterfront Development for Climate Resilience are excellent examples from our country. The suggested strategy for an urban resilient system is a Rapid, Extensive, Sturdy, Ingenious, Lucid approach with an International collaboration for an Enthusiastic, Non-latent, Continuous Early warning system (RESILIENCE). [ABSTRACT FROM AUTHOR]

Background: Instructional advance organizers are tools that help learners to learn and understand educational materials better. This study aimed to investigate the role of explanatory and visual advance organizers on the learning of health workers working in the Shirvan city health center. Method: This study was conducted as an interventional (quasiexperimental) study in health houses covered by the Shirvan County Health Center in 2023. The required sample was 120 staff entered the study using the census of the entire population and were randomly divided equally into three groups. In the two intervention groups, education was provided by the method of explanatory and visual advance organizers, and in the control group, education was provided in the form of lectures. Post-test questions were reviewed by five specialists in medical education, general practitioners, and infectious diseases. Results: Demographic variables in pre-test and post-test scores were not statistically significantly different except for marital status which had a statistically significant relationship with pre-test scores and educational status of individuals with diplomas with pre-test and post-test scores. There was a statistically significant relationship and difference in post-test scores in all three groups (P=0.00). Conclusion: Advance organizers help learners activate their prior knowledge and connect it with new knowledge. In addition, they can lead to meaningful learning, facilitate and increase motivation in learning. The group that was trained using visual advance organizers had significantly higher average learning scores than the other two groups. [ABSTRACT FROM AUTHOR]

Global challenges around biodiversity loss, climate change, and public health are heightening the importance of urban green spaces for supporting ecosystem services and human wellbeing. Trees, parks and forests integrated across cityscapes are proposed strategies to combat climate change and promote human health for current and future cities. This is true for small urban green spaces, perhaps just < 1 ha in size. Depending on their structure and size, these spaces can provide structural vegetation complexity, promote species diversity, regulate temperatures and offer human thermal comfort. These spaces also provide recreation opportunity, nature experience, sense of belonging, and restoration to people. As cities densify, it is crucial to understand where these dimensions intersect in theory and practice to design and manage small green spaces in particular, as these systems may be easier than large green spaces to implement in urban planning. In this paper, we narratively review known biophysical and ecological properties of green spaces that support biodiversity, promote temperature regulation and climate resilience, and may ultimately benefit residents' health through different use activities and multisensory experiences that promote restoration and wellbeing. Furthermore, we review how stakeholder engagement and participatory processes can guide equitable green space provision and design, and we use case studies and our own research as examples. In doing so, this paper aims to further the understanding of the social-ecological importance of small urban green spaces and calls for inter- and transdisciplinary research that generates insight to design, manage and protect these places in a changing climate. [ABSTRACT FROM AUTHOR]

The 2016 outbreak of Zika virus (ZIKV) infected millions and resulted in thousands of infants born with malformations. Though the clusters of severe birth defects resulting from this outbreak have subsided, ZIKV continues to be a concern throughout much of Latin America and the Caribbean. Travel and sexual intercourse remain the dominant transmission risk factors for women of reproductive age and their partners. This is particularly true for communities in Brooklyn, New York, that comprise large immigrant and foreign-born populations. Practitioners of public health understand little about how women at risk for ZIKV are most likely to receive information about the virus or who they trust most to provide that information. In the context of five focus group discussions, this study explored the knowledge and communication preferences of 20 women of reproductive age in Central Brooklyn. Results derived from a thematic analysis suggest that while most women are familiar with mosquitos as ZIKV vectors, knowledge of sexual transmission is considerably lower. Many respondents believe that only women who are pregnant or trying to become pregnant are at risk, and public health agencies, such as the U.S. Centers for Disease Control and Prevention, remain the most trusted sources of information. These findings can support more effective communication about the risks of ZIKV infection and other vector-borne diseases to women in New York City and similar urban communities. [ABSTRACT FROM AUTHOR]

Aim: To examine low birth weight (LBW) in First Nations babies born in a large metropolitan health service in Queensland, Australia. Materials and Methods: A retrospective population‐based study using routinely collected data from administrative data sources. All singleton births in metropolitan health services, Queensland, Australia of ≥20 weeks gestation or at least 400 g birthweight and had information on First Nations status and born between 2019 and 2021 were included. The study measured birthweight and birthweight z‐score, and also identified the predictors of LBW. Multivariate regression models were adjusted by demographic, socioeconomic and perinatal factors. Results: First Nations babies had higher rates of LBW (11.4% vs 6.9%, P < 0.001), with higher rates of preterm birth (13.9% vs 8.8%, P < 0.001). In all babies, the most important factors contributing to LBW were: maternal smoking after 20 weeks of gestation; maternal pre‐pregnancy underweight (body mass index <18.5 kg/m2); nulliparity; socioeconomic disadvantage; geographical remoteness; less frequent antenatal care; history of cannabis use; pre‐existing cardiovascular disease; pre‐eclampsia; antepartum haemorrhage; and birth outcomes including prematurity and female baby. After adjusting for all contributing factors, no difference in odds of LBW was observed between First Nations and non‐First Nation babies. Conclusions: First Nations status was not an independent factor influencing LBW in this cohort, after adjustment for identifiable factors. The disparity in LBW relates to modifiable risk factors, socioeconomic disadvantage, and prematurity. Upscaling culturally safe maternity care, focusing on modifiable risk factors is required to address LBW in Australian women. [ABSTRACT FROM AUTHOR]

Highway reclamation (i.e., the removal of highways or placing existing highways underground to create mixed-use urban areas) is being implemented around the United States, often touting co-benefits for population health. As part of the Bipartisan Infrastructure Law and the Inflation Reduction Act, the Reconnecting Communities and Neighborhoods grant program is a first-of-its-kind investment in launching even more highway reclamation projects. Depending on how the projects are implemented, these projects may create gentrification (i.e., the displacement of poor long-time residents by wealthier new people), thereby displacing the populations these projects are designed to protect. However, little work has systematically examined the extent to which highway reclamation projects provide the promised benefits for neighborhood environments (e.g., reduced air pollution), minimize gentrification, and improve health outcomes. This commentary proposes a framework by which the multidimensional impacts of highway reclamation can be evaluated, unlocking potential new structural pathways toward urban health equity. [ABSTRACT FROM AUTHOR]

Despite the relevance of cities and city policies for health, there has been limited examination of large numbers of cities aimed at characterizing urban health determinants and identifying effective policies. The relatively few comparative studies that exist include few cities in lower and middle income countries. The Salud Urbana en America Latina study (SALURBAL) was launched in 2017 to address this gap. The study has four aims: (1) to investigate social and physical environment factors associated with health differences across and within cities; (2) to document the health impact of urban policies and interventions; (3) to use systems approaches to better understand dynamics and identify opportunities for intervention and (4) to create a new dialogue about the drivers of health in cities and their policy implications and support action. Beyond these aims SALURBAL, has an overarching goal of supporting collaborative policy relevant research and capacity -building that engages individuals and institutions from across Latin America. In this review we provide an update on the SALURBAL data resource and collaborative approach and summarize key findings from the first aim of the study. We also describe key elements of our approach, challenges we have faced and how we have overcome them, and identify key opportunities to support policy relevant evidence generation in urban health for the future. [ABSTRACT FROM AUTHOR]

In highly urbanized and unequal Latin America, urban health and health equity research are essential to effective policymaking. To ensure the application of relevant and context-specific evidence to efforts to reduce urban health inequities, urban health research in Latin America must incorporate strategic research translation efforts. Beginning in 2017, the Urban Health in Latin America (SALURBAL) project implemented policy-relevant research and engaged policymakers and the public to support the translation of research findings. Over 6 years, more than 200 researchers across eight countries contributed to SALURBAL's interdisciplinary network. This network allowed SALURBAL to adapt research and engagement activities to local contexts and priorities, thereby maximizing the policy relevance of research findings and their application to promote policy action, inform urban interventions, and drive societal change. SALURBAL achieved significant visibility and credibility among academic and nonacademic urban health stakeholders, resulting in the development of evidence and tools to support urban policymakers, planners, and policy development processes across the region. These efforts and their outcomes reveal important lessons regarding maintaining flexibility and accounting for local context in research, ensuring that resources are dedicated to policy engagement and dissemination activities, and recognizing that assessing policy impact requires a nuanced understanding of complex policymaking processes. These reflections are relevant for promoting urban health and health equity research translation across the global south and worldwide. This paper presents SALURBAL's strategy for dissemination and policy translation, highlights innovative initiatives and their outcomes, discusses lessons learned, and shares recommendations for future efforts to promote effective translation of research findings. [ABSTRACT FROM AUTHOR]