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Objective Methods Results Conclusions This study aimed to explore the impact of physical activity on health among older adults in urban and rural areas in Taiwan.This study employed a cross‐sectional design and data were analyzed from 2015 to 2019 from the Hualien County Health Bureau. Participants were divided into urban (n = 4780) and rural groups (n = 4983), and logistic regression models were employed to examine how physical activity relates to their health condition in urban and rural older adults.Results indicated lower physical activity levels and higher unhealthy behavior rate in rural older adults compared to their urban counterparts. Rural older adults had higher rates of cardiovascular diseases and diabetes but lower rates of mental illness. Physical activity demonstrated greater physical health benefits for urban older adults than rural older people. Conversely, rural individuals who engaged in physical activity 150 min/week exhibited greater mental health benefits than their urban counterparts.Physical activity offers significant mental health benefits for both urban and rural older adults; however, notable improvements in physical health among urban older adults was found. If in the presence of unhealthy behaviors, regular physical activity may not effectively prevent chronic diseases. It is crucial to promote physical activity and healthy behaviors in rural areas. [ABSTRACT FROM AUTHOR]

Racial and ethnic minority adolescents living in urban settings experience sleep disparities. Few interventions have been developed to address these disparities. Guided by principles of participatory design and inclusion, our team developed a novel intervention that combined sleep hygiene education with mind-body integrative health (MBIH) practices to improve sleep quality among adolescents in New York City. The goal of this article is to describe our iterative development and design process, the final product, and future directions. Our participatory approach incorporated information from formative work with adolescents having lived experience, practitioners, and syntheses of published literature. The final intervention—Sleeping Healthy, Living Healthy—consists of six, 40-minute group sessions and one 20-minute individual session designed for high school students. Each session has a set of learning objectives, combining instruction, group activities, and discussions on sleep hygiene and MBIH topics. Our manualized intervention includes handouts created by a graphic design team that served as a review and reminder for home practice. We describe intervention implementation to two unique cohorts and detail our methods used to fine-tune the intervention between cohorts. Our partnership with and insights from both adolescents and practitioners serve as a guide for researchers aiming to use participatory methods to develop interventions to decrease health disparities in specific populations. [ABSTRACT FROM AUTHOR]

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Copyright of Environmental & Social Management Journal / Revista de Gestão Social e Ambiental is the property of Environmental & Social Management Journal and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background Urban farms are spaces designated for the cultivation of plants for food security, medicinal and curative purposes. Since the turn of the century, they have become more widespread and health benefits have been claimed; however, no consensus exists regarding this information. Hence, this study aims to provide information about the health effects of urban farming. Methods Protocol register number CRD42023448001. We followed the guidelines of Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement. Studies addressing urban farming interventions in any population group were included without age limitation of publication from PubMed, DOAJ, CAB Abstracts and NIH. Risk of bias was assessed using the Risk of Bias In Non-randomized Studies - of Interventions tool, and data were narratively synthesized. Results The search retrieved 2578 manuscripts, reduced to seven after screening. Urban farming's impact on health has been reflected in the physical domain by increasing self-reported health levels, physical activity, perceived general health, healthy eating and decreasing drug use. Parasites' presence has also been reported. In the mental aspect, urban farming is associated with relaxation and stress reduction. From a social perspective, urban farms provide a sense of belonging, personal growth and happiness. Conclusions The benefits of urban farming outweigh the disadvantages. Further research should be conducted to clarify the potential benefits of this practice. [ABSTRACT FROM AUTHOR]

Objective Data Sources/Study Setting Study Design Data Collection/Extraction Methods Principal Findings Conclusions To understand whether and how primary care providers and staff elicit patients' past experiences of healthcare discrimination when providing care.Twenty qualitative semi‐structured interviews were conducted with healthcare staff in primary care roles to inform future interventions to integrate data about past experiences of healthcare discrimination into clinical care.Qualitative study.Data were collected via semi‐structured qualitative interviews between December 2018 and January 2019, with health care staff in primary care roles at a hospital‐based clinic within an urban safety‐net health system that serves a patient population with significant racial, ethnic, and linguistic diversity.Providers did not routinely, or in a structured way, elicit information about past experiences of healthcare discrimination. Some providers believed that information about healthcare discrimination experiences could allow them to be more aware of and responsive to their patients' needs and to establish more trusting relationships. Others did not deem it appropriate or useful to elicit such information and were concerned about challenges in collecting and effectively using such data.While providers see value in eliciting past experiences of discrimination, directly and systematically discussing such experiences with patients during a primary care encounter is challenging for them. Collecting this information in primary care settings will likely require implementation of multilevel systematic data collection strategies. Findings presented here can help identify clinic‐level opportunities to do so. [ABSTRACT FROM AUTHOR]

Rehabilitation services are critical to improve health outcomes, particularly at community level within primary healthcare settings. As groups with an interest in the health system, rehabilitation service users' and caregivers' involvement in various aspects of health system strengthening is important for healthcare planning and evaluation. This study aimed to explore rehabilitation service users' perceptions of the rehabilitation services and their effect on their functioning in the Johannesburg Metropolitan District. A qualitative study was conducted using purposive sampling of participants attending rehabilitation at nine provincially funded clinics. Semi-structured interviews were conducted, and data were analysed using reflexive thematic analysis. The findings revealed the theme of happy with rehabilitation services and five associated categories, namely (1) service provider actions, (2) service organisation, (3) service user actions, (4) service access, and (5) service outcomes. The participants expressed overall satisfaction with their experiences of rehabilitation services, highlighting the importance of effective communication, patient-centred care, strong therapeutic relationships, and active patient engagement to achieve positive outcomes. This study provides the evidence for maintaining and extending rehabilitation at the PHC level in support of the health policy changes proposed for South Africa. [ABSTRACT FROM AUTHOR]

Background: Long-acting injectable cabotegravir plus rilpivirine (LAI CAB/RPV) has several potential benefits over daily oral formulations for HIV treatment, including the potential to facilitate long-term adherence and reduce pill fatigue. We aimed to assess facilitators of and barriers to LAI CAB/RPV implementation and delivery through the perspectives of physicians and clinical staff, and the experiences of LAI CAB/RPV use among people living with HIV (PLWH) at a Ryan-White supported safety-net clinic in North Texas. Methods: We conducted semi-structured interviews with recruited clinic staff (physicians, nurses, and support staff) involved with LAI CAB/RPV implementation and PLWH who switched to LAI CAB/RPV and consented to participate in individual interviews. Data were collected from July to October 2023. Our interview guide was informed by the Reach, Effectiveness, Adoption, Implementation, Maintenance (RE-AIM), and Proctor Implementation Outcomes frameworks. Qualitative data were analyzed using a rapid qualitative analysis approach to summarize key themes. Results: We recruited and interviewed 15 PLWH who transitioned to LAI CAB/RPV and 11 clinic staff serving these patients. PLWH conveyed that emotional and informational support from family or a trusted clinician influenced their decision to switch to LAI CAB/RPV. PLWH also reported that injectable treatment was more effective, convenient, and acceptable than oral antiretroviral therapy. Clinic staff and physicians reported that staff training, pharmacist-led medication switches, flexible appointments, refrigeration space and designated room for injection delivery facilitated implementation. Clinic staff cited medication costs, understaffing, insurance prior authorization requirements, and lack of medication access through state drug assistance programs as critical barriers. Conclusions: Our study offers insights into real-world experiences with LAI usage from the patient perspective and identifies potential strategies to promote LAI CAB/RPV uptake. The barriers to and facilitators of LAI CAB/RPV program implementation reported by clinic staff in our study may be useful for informing strategies to optimize LAI CAB/RPV programs. [ABSTRACT FROM AUTHOR]

Background: Routine health facility data are an important source of health information in resource-limited settings. Regular quality assessments are necessary to improve the reliability of routine data for different purposes, including estimating facility-based maternal mortality. This study aimed to assess the quality of routine data on deliveries, livebirths and maternal deaths in Kampala City, Uganda. Methods: We reviewed routine health facility data from the district health information system (DHIS2) for 2016 to 2021. This time period included an upgrade of DHIS2, resulting in two datasets (2016–2019 and 2020–2021) that were managed separately. We analysed data for all facilities that reported at least one delivery in any of the six years, and for a subset of facilities designated to provide emergency obstetric care (EmOC). We adapted the World Health Organization data quality review framework to assess completeness and internal consistency of the three data elements, using 2019 and 2021 as reference years. Primary data were collected to verify reporting accuracy in four purposively selected EmOC facilities. Data were disaggregated by facility level and ownership. Results: We included 255 facilities from 2016 to 2019 and 247 from 2020 to 2021; of which 30% were EmOC facilities. The overall completeness of data for deliveries and livebirths ranged between 53% and 55%, while it was < 2% for maternal deaths (98% of monthly values were zero). Among EmOC facilities, completeness was higher for deliveries and livebirths at 80%; and was < 6% for maternal deaths. For the whole sample, the prevalence of outliers for all three data elements was < 2%. Inconsistencies over time were mostly observed for maternal deaths, with the highest difference of 96% occurring in 2021. Conclusions: Routine data from childbirth facilities in Kampala were generally suboptimal, but the quality was better in EmOC facilities. Given likely underreporting of maternal deaths, further efforts to verify and count all facility-related maternal deaths are essential to accurately estimate facility-based maternal mortality. Data reliability could be enhanced by improving reporting practices in EmOC facilities and streamlining reporting processes in private-for-profit facilities. Further qualitative studies should identify critical points where data are compromised, and data quality assessments should consider service delivery standards. [ABSTRACT FROM AUTHOR]

Reasonably allocating medical resources can effsectively optimize the utilization efficiency of such resources. This paper took Taiyuan City as an example and established a model to evaluate the rationality of medical resource spatial allocation, incorporating two key dimensions: the spatial layout and the supply and demand of medical resources. In terms of the spatial layout, three indexes were included: Firstly, the service coverage rates of different levels of medical institutions, based on residents' medical orientations, were calculated using network analysis methods. Secondly, the Huff-2SFCA method was improved to calculate the accessibility of medical resources for four different modes of transportation. Then, the Health Resource Agglomeration Degree (HRAD) and Population Agglomeration Degree (PAD) were used to quantify the equity of medical resources. In terms of the supply and demand of medical resources, one index was included: the supply–demand ratio of medical resources during sudden public health events, which was calculated using the number of beds per thousand people as an indicator. These four indexes were weighted using the entropy weight method to obtain the rationality grade of medical resource spatial allocation in Taiyuan City. The study found that the rationality evaluation level of medical resource allocation in the central urban area of Taiyuan City followed a "concentrically decreasing" pattern. The rating ranged from "very reasonable" to "less reasonable", with the area of each level expanding gradually. The areas rated within the top two categories only accounted for 19.92% of the study area, while the area rated as "less reasonable" occupied 38.73% of the total area. These results indicate that the model accounted for residents' travel for various medical orientations and the availability of resources during public health emergencies. It considered both the spatial layout and supply and demand of medical resources, offering recommendations for the precise allocation of urban medical resources. [ABSTRACT FROM AUTHOR]

Dengue fever disease is an important health issue in the city of Jeddah, Saudi Arabia. Chemical pesticides play a vital role in dengue control, through combating the mosquito vector Aedes aegypti L. Standard methods recommended by the World Health Organization were applied in the current work to conduct resistance experiments in both adult and larval stages of Ae. aegypti mosquitoes against eight types of pyrethroid and organophosphorus pesticides used in control programs in Jeddah. The results prove that Ae. aegypti is resistant against the pesticides deltamethrin 0.05%, α‐cypermethrin 0.05%, fenitrothion 1% and temephos, is tolerant with some degree of resistance against cyfluthrin 0.15% and λ‐cyhalothrin 0.5%, as well as tolerant against malathion 5% and pirimiphos‐methyl 0.25%. On the other hand, the bacterial insecticide Bacillus thuringiensis ssp. israelensis (Bti) demonstrated high activity against the field strain of Aedes aegypti larvae, with a resistance ratio (RR) of 1.25. In general, we conclude from these findings that the continuous and frequent application of synthetic pesticides induces resistance in mosquitoes against pesticides. This, of course, forces us to reconsider the pesticides currently used in control programs and do our best towards finding alternative means to combat mosquitoes and the diseases that they can transmit. [ABSTRACT FROM AUTHOR]

Urban green spaces (UGSs) provide important support for the health of urban residents and the realization of sustainable urban development. However, the spatiotemporal pattern of urban resident exposure to UGSs in cities is unclear, especially at the national scale in China. Based on the annual 30 m resolution Normalized Difference Vegetation Index (NDVI) data of the Landsat satellite, we quantitatively analyzed the change in UGS coverage from 2000 to 2020 for 320 cities in China and combined it with population data to understand the changing patterns of urban population exposure to different UGS coverage. The results indicated that the average UGS coverage decreased from 63% to 44% from 2000 to 2020 in China, which could be divided into two stages: a rapid decline phase (2000–2014) and a progressive decline phase (2015–2020). Geographically, UGS coverage declined faster in southwestern and eastern cities than in other regions, particularly in medium-sized cities. We also found that urban pixel-based areas in cities with the highest UGS coverage (80–100%) decreased rapidly, and the proportion of the urban population exposed to the highest UGS coverage also declined significantly from 2000 to 2020. Urban pixel-based areas with low UGS coverage (20–40%) continued to expand, and there was a rapid increase in the proportion of the urban population exposed to low UGS coverage, with an increase of 146 million people from 2000 to 2020. The expansion of impervious surfaces had the most significant effect on the change in UGS coverage during different periods (2000–2020, 2000–2014, and 2015–2020). Natural factors such as precipitation, surface maximum temperature, and soil moisture also affected UGS coverage change. These findings provide insights into the impact of urbanization on the natural environment of cities, availability of UGS for residents, and sustainable urban development under rapid urbanization. [ABSTRACT FROM AUTHOR]

Background: Effective management of hearing loss in adults is fundamental for communication, relationships, employment, and learning. This study examined the rates and management of self-reported hearing loss in urban Aboriginal and Torres Strait Islander adults. Methods: A retrospective, observational study of Aboriginal and Torres Strait Islander people aged ≥15 years who had annual health checks at an urban Aboriginal and Torres Strait Islander primary healthcare clinic in Inala, Queensland, was conducted to determine self-reported hearing loss rates by age and ethnic groups stratified by sex. A medical record audit of patients who self-reported hearing loss from January to June 2021 was performed to identify current management approaches, and the proportion of patients that were appropriately managed. Results: Of the 1735 patients (average age 40.7 years, range 15.0–88.5 years, 900 [52.0%] women) who completed 3090 health checks between July 2018 and September 2021, 18.8% self-reported hearing loss. Rates did not differ between men and women. However, significant effects were noted for age, with rates increasing from 10.7% for patients aged 15–24 years to 38.7% for those aged ≥65 years. An audit of 73 patient medical records revealed that 39.7% of patients with self-reported hearing loss were referred to Ear, Nose and Throat/audiology or received other management. A total of 17.8% of patients owned hearing aids. Conclusions: Only 40% of Aboriginal and Torres Strait Islander adults who self-reported hearing loss were referred for management. Significant changes to clinical management and government-funded referral options for hearing services are required to improve the management of self-reported hearing loss in this population. Limited evidence on hearing loss in Aboriginal and Torres Strait Islander adults exists. In this primary care adult population, the rate of self-reported hearing loss was 18.8%. Only two in five adults received further action to manage their hearing loss with successful hearing outcomes evident. Hearing loss in Aboriginal and Torres Strait Islander adults is underreported, undermanaged, and requires urgent attention from health professionals and government policymakers to enhance its clinical management leading to improved quality of life. [ABSTRACT FROM AUTHOR]

Efficient solid waste management is crucial for urban health and welfare in the midst of fast industrialization and urbanization. In this changing environment, government authorities have a significant role in addressing and reducing the effects of solid waste. While waste separation at the source simplifies processes, manual sorting is a consequence of ignorance in numerous regions, which endangers the health of waste pickers. This study addresses the challenges by introducing the MSW-Net model, a hierarchical stacking model designed for the automated classification of municipal solid waste (MSW). Customized Convolutional Neural Network (custom CNN) and Bayesian-Optimized MobileNet models serve as the base models, with Gradient Boosting employed as the meta-classifier. The MSW-Net model, as proposed, exhibits exceptional performance, attaining 99%, 95%, and 96.43% accuracy rates over training, validation, and testing, respectively. Additionally, the model achieves precision, recall, and F1 scores of 96.42%, 96.43%, and 96.42% during the testing phase. Therefore, the proposed MSW-Net model performs better than the other existing models in sorting the waste. This could also aid the municipal authorities in classifying the waste with minimal human intervention. Implications: The MSW-Net model, featuring a hierarchical stacking approach with custom CNN and Bayesian-Optimized MobileNet base models, and Gradient Boosting as the meta-classifier, achieves remarkable accuracy in automated municipal solid waste classification. With performance metrics of 99% accuracy in training, 95% in validation, and 96.43% in testing, alongside precision, recall, and F1 scores around 96.42%, the MSW-Net model significantly outperforms existing models. This advancement promises to aid municipal authorities in efficient waste management, reducing reliance on manual sorting and thereby improving the health and safety of waste pickers. [ABSTRACT FROM AUTHOR]

Assessing healthy cities is a crucial strategy for realizing the concept of "health in all policies". However, most current quantitative assessment methods for healthy cities are predominantly city-level and often overlook intra-urban evaluations. Building on the concept of geographic spatial case-based reasoning (CBR), we present an innovative healthy city spatial case-based reasoning (HCSCBR) model. This model comprehensively integrates spatial relationships and attribute characteristics that impact urban health. We conducted experiments using a detailed multi-source dataset of health environment determinants for middle-layer super output areas (MSOAs) in Birmingham, England. The results demonstrate that our method surpasses traditional data mining techniques in classification performance, offering greater accuracy and efficiency than conventional CBR models. The flexibility of this method permits its application not only in intra-city health evaluations but also in extending to inter-city assessments. Our research concludes that the HCSCBR model significantly improves the precision and reliability of healthy city assessments by incorporating spatial relationships. Additionally, the model's adaptability and efficiency render it a valuable tool for urban planners and public health researchers. Future research will focus on integrating the temporal dimension to further enhance and refine the healthy city evaluation model, thereby increasing its dynamism and predictive accuracy. [ABSTRACT FROM AUTHOR]

Understanding the spatial distribution patterns of urban perception and analyzing the correlation between human emotional perception and street composition elements are important for accurately understanding how people interact with the urban environment, urban planning, and urban management. Previous studies on urban perception using street view data have not fully considered the actual level of attention to different visual elements when browsing street view images. In this article, we use eye tracking technology to collect eye movement data and subjective perception evaluation data when people browse street view images, and analyze the correlation between the time to first fixation, duration of first fixation, and fixation frequency of different visual elements and the six perceptual outcomes of wealthy, safe, lively, beautiful, boring, and depressing. Furthermore, this article integrates eye movement data with street view semantic data and introduces a novel method for predicting urban perception using a machine learning algorithm. The proposed method outperforms a comparative model that solely relies on semantic data, exhibiting higher accuracy in perception prediction. Additionally, the study presents a perceptual mapping of the prediction results, providing a visual representation of the predicted urban perception outcomes. As vision is the primary perceptual channel, this study achieves a more objective and scientifically reliable urban perception, which is of reference value for the study of physical and mental health due to the urban physical environment. [ABSTRACT FROM AUTHOR]

Urban planning has struggled to establish a consensus on what "good" planning looks like and instead grapples with balancing competing planning priorities and perspectives. This paper proposes that planners and planning scholars look to health equity as a guiding "north star." We justify this proposal by reviewing scholarship at the intersection of planning and public health. Drawing from empirical and theoretical work linking urban planning, health, and social equity, we recommend planners adopt participatory and anti-racist practices; implement cross-sectoral strategies beyond the professional boundaries of urban planning or public health; and learn from diverse data sources, research methods, and geographic contexts. [ABSTRACT FROM AUTHOR]

The global challenge of air pollution's adverse health effects, particularly highlighted in Dhaka, Bangladesh, underscores the significant impact of particulate matter (PM) exposure. This study aims to assess the current sources of PM2.5 emissions in different microenvironments around Dhaka and explore potential risk factors to assess individual 24 h exposure to PM2.5. A commercially available low-cost sensor was utilized for collecting data for 15 days under various environmental conditions. The average concentrations for PM1.0, PM2.5, and PM10 were 37.05 ± 24.36 µg/m3, 57.22 ± 40.75 µg/m3, and 69.22 ± 48.46 µg/m3, respectively. The highest PM2.5 concentrations were found (78.87 ± 53.69 μg/m3) in restaurants and residences (62.35 ± 41.70 μg/m3), while air-conditioned shopping malls exhibited the lowest concentrations (20.08 ± 15.57 μg/m3). Driving with windows closed and utilizing air conditioning resulted in a 33–52% reduction in PM2.5 concentrations inside the car. The Hazard Quotient (HQ) for PM2.5 varied by location, with a low level observed in the air-conditioned locations and a moderate level observed in restaurants and non-air-conditioned shopping malls. The significance of this study lies in its potential to inform public health strategies and urban planning initiatives aimed at reducing air pollution exposure in highly populated cities like Dhaka. [ABSTRACT FROM AUTHOR]

Urban slums are human habitats with poor habitation qualities that are vulnerable to infectious diseases and public health crises. Low coverage from formal healthcare services providers created opportunity for informal providers to thrive in urban slums. This study examined the nature of relationship between informal and formal healthcare services providers in urban slums and explored opportunities for strengthening collaborations between them. Reconnaissance research method, a qualitative research approach for exploring under-researched terrains, guided the interview of 104 slum healthcare stakeholders across eight purposively selected slums in Enugu and Onitsha cities, in southeastern-Nigeria. Findings show that informal healthcare service providers are dominant in urban slums, and many of them cooperate and compete with formal providers. Supervision of informal providers in slums is inadequate, and the formal providers report that the informal providers find acceptance, despite their lack of adequate training and professionalism. Authorities governing health systems in slums are encouraged to establish a mechanism to profile informal providers, delineate the scope of services, and bridge the gap through the creation of referral channels. Subsequent studies may explore what character any mechanism created to institutionalize the collaboration toward improving healthcare services delivery should take and what challenges could undermine it. [ABSTRACT FROM AUTHOR]

Existing literature has widely explored the individual roles of housing and neighborhood quality, and there is limited research examining their interactive effects on mental health. This 3-year cohort study utilized a longitudinal design to investigate the individual and interactive effects of housing and neighborhood quality on mental health among 962 community-dwelling adults in Hong Kong. Participants were asked to rate their residential qualities over the 3-year period. Mental health outcomes, including levels of psychological distress and common mental disorders (CMD), were assessed using the Revised Clinical Interview Schedule (CIS-R). Logistic regression and generalized linear models were used to examine the association between housing and neighborhood quality and CMD/psychological distress, adjusting for sociodemographic and residential characteristics and baseline mental disorders. Housing quality was associated with the 3-year CMD (adjusted OR 0.95; 95% CI 0.91 to 0.98). Likewise, neighborhood quality was associated with CMD over 3 years (adjusted OR 0.92; 95% CI 0.87 to 0.96). In a separate model including both quality measures, the effect of housing quality on CMD was attenuated, whereas the neighborhood impact remained significant (adjusted OR 0.92; 95% CI 0.87 to 0.98). Generalized linear models indicated that for participants residing in substandard housing, those with high neighborhood quality had lower CIS-R scores at follow-up compared to those with low neighborhood quality (p = 0.041). Better neighborhood quality alleviated the detrimental effects of poor housing quality on mental health. Planning for an enhanced neighborhood would improve population mental health in an urban environment. [ABSTRACT FROM AUTHOR]

Frailty is a dynamic condition encompassing physical, psychological, and social domains. While certain factors are associated with overall or specific frailty domains, research on the correlations between physical, psychological, and social frailty is lacking. This study aims to investigate the associations between physical, psychological, and social frailty in European older adults. The study involved 1781 older adults from the Urban Health Centres Europe project. Baseline and 1-year follow-up data were collected on physical, psychological, and social frailty, along with covariates. Linear regression analyzed unidirectional associations, while cross-lagged panel modeling assessed bi-directional associations. Participants' mean age was 79.57 years (SD = 5.54) and over half were female (61.0%). Physical and psychological frailty showed bi-directional association (effect of physical frailty at baseline on psychological frailty at follow-up: β = 0.14, 95%CI 0.09, 0.19; reversed direction: β = 0.05, 95%CI 0.01, 0.09). Higher physical frailty correlated with increased social frailty (β = 0.05, 95%CI 0.01, 0.68), but no association was found between social and psychological frailty. This longitudinal study found a reciprocal relationship between physical and psychological frailty in older adults. A relatively higher level of physical frailty was associated with a higher level of social frailty. There was no association between social and psychological frailty. These findings underscore the multifaceted interplay between various domains of frailty. Public health professionals should recognize the implications of these interconnections while crafting personalized prevention and care strategies. Further research is needed to confirm these findings and investigate underlying mechanisms. [ABSTRACT FROM AUTHOR]

Background: Lung cancer is the third most common cancer in the UK and the leading cause of cancer mortality globally. NHS England guidance for optimum lung cancer care recommends management and treatment by a specialist team, with experts concentrated in one place, providing access to specialised diagnostic and treatment facilities. However, the complex and rapidly evolving diagnostic and treatment pathways for lung cancer, together with workforce limitations, make achieving this challenging. This place-based, behavioural science-informed qualitative study aims to explore how person-related characteristics interact with a person's location relative to specialist services to impact their engagement with the optimal lung pathway, and to compare and contrast experiences in rural, coastal, and urban communities. This study also aims to generate translatable evidence to inform the evidence-based design of a patient engagement intervention to improve lung cancer patients' and informal carers' participation in and experience of the lung cancer care pathway. Methods: A qualitative cross-sectional interview study with people diagnosed with lung cancer < 6 months before recruitment (in receipt of surgery, radical radiotherapy, or living with advanced disease) and their informal carers. Participants will be recruited purposively from Barts Health NHS Trust and United Lincolnshire Hospitals NHS Trusts to ensure a diverse sample across urban and rural settings. Semi-structured interviews will explore factors affecting individuals' capability, opportunity, and motivation to engage with their recommended diagnostic and treatment pathway. A framework approach, informed by the COM-B model, will be used to thematically analyse facilitators and barriers to patient engagement. Discussion: The study aligns with the current policy priority to ensure that people with cancer, no matter where they live, can access the best quality treatments and care. The evidence generated will be used to ensure that lung cancer services are developed to meet the needs of rural, coastal, and urban communities. The findings will inform the development of an intervention to support patient engagement with their recommended lung cancer pathway. Protocol registration: The study received NHS Research Ethics Committee (Ref: 23/SC/0255) and NHS Health Research Authority (IRAS ID 328531) approval on 04/08/2023. The study was prospectively registered on Open Science Framework (16/10/2023; https://osf.io/njq48). [ABSTRACT FROM AUTHOR]

Firearm injuries are the leading cause of death among children and adolescents in the US. Safe storage of firearms in the home is one of the most effective ways of preventing firearm injuries in children. This feasibility study was conducted in both the pediatric and general Emergency Departments of a large urban academic medical center in a community with high rates of firearm injuries in children. The objective was to pilot a survey seeking to describe sociodemographic characteristics, firearm specific risk factors, and firearm storage practices of households with children in the community. One hundred participants completed a survey containing items regarding participant demographics, household features, firearm ownership, firearm characteristics, and storage practices. Descriptive statistics were used to define sociodemographic characteristics of the enrolled population, comparing those with firearms to those without, and to describe firearms and storage practices of firearm owners in households with children. Of 100 participants, 30 lived in households with firearms and children. Most firearms in homes with children were stored locked and unloaded most of the time; however, 30% of participants with firearms and children in the home reported not consistently storing a firearm locked and unloaded. The most common reason given for not storing a firearm in the safest manner possible was that storing a firearm locked and unloaded would make it difficult to access quickly. Engaging families with children in discussions around firearm prevention during Emergency Department visits is feasible and may have implications for future efforts to promote safe firearm storage practices. [ABSTRACT FROM AUTHOR]

Food insecurity, a critical social determinant of health, has been measured nationwide in the United States for years. This analysis focuses on food insufficiency, a more severe form of food insecurity, in New York City (NYC) and its association with self-reported physical and mental health conditions. Data from the 2017–2018 NYC Community Health Survey were used to estimate the prevalence of food insufficiency citywide, by neighborhood, and across selected socioeconomic characteristics. Multivariable logistic regression was used to explore the associations between food insufficiency and hypertension, diabetes obesity, and depression, adjusting for selected sociodemographic characteristics. Approximately 9.4% (95% CI:8.8-10.0%]) of adult New Yorkers aged 18 + reported food insufficiency, with neighborhood variation from 1.7% (95% CI:0.5-6.2%) to 19.4% (95% CI:14.2-25.8%). Food insufficiency was more prevalent among Latinos/as (16.9%, 95% CI:15.5-18.3%, p < 0.001), Black (10.1%, 95% CI:8.8-11.5%, p < 0.001) and Asian/Pacific Islanders (6.6%, 95% CI:5.4-8.1%, p = 0.002) compared to White New Yorkers (4.2%, 95% CI:3.5-5.1%). Prevalence of food insufficiency was higher among NYC adults with less than a high school education, (19.6%, 95% CI:17.7-21.6%), compared to college graduates (3.8%, 95% CI:3.2-4.4%, p < 0.001). In the adjusted logistic regression model, food insufficiency was associated with diabetes (OR = 1.36; 95% CI:1.12–1.65), hypertension (OR = 1.58; 95% CI:1.32–1.89]) and depression (OR = 2.98; 95% CI:2.45–3.59), but not with obesity (OR = 0.99; 95% CI:0.84–1.21). Our findings highlight food insufficiency at an important intersection of inequity and disease burden which is critical to informing public health interventions in the context of a large, densely populated metropolis like NYC. [ABSTRACT FROM AUTHOR]

Air quality forecasting is a critical environmental challenge with significant implications for public health and urban planning. Conventional machine learning models, although quite effective, require data collection, which can be hampered by issues relating to privacy and data security. Federated Learning (FL) overcomes these limitations by enabling model training across decentralized data sources without compromising data privacy. This study describes a federated learning approach to predict the Air Quality Index (AQI) based on data from several Internet of Things (IoT) sensors located in different urban locations. The proposed approach trains a model using data from different sensors while preserving the privacy of each data source. The model uses local computational resources at the sensor level during the initial data processing and training, sharing only the model updates to the central location. The results show that the performance of the proposed FL model is comparable to a centralized model and ensures better data privacy with reduced data transmission requirements. This study opens new doors to real-time, scalable, and efficient air quality monitoring systems. The proposed method is quite significant for smart city initiatives and environmental monitoring, as it provides a solid framework for using IoT technology while preserving privacy. [ABSTRACT FROM AUTHOR]

Air quality forecasting is crucial for public health and urban planning. However, traditional machine learning models face challenges with centralized data collection, raising privacy and security concerns. Federated learning (FL) offers a promising solution by enabling model training across decentralized data sources while preserving data privacy. This study presents an FL framework for predicting the Air Quality Index (AQI) using data from many Internet of Things (IoT) sensors deployed in urban areas. The proposed FL framework facilitates model training using diverse sensor data while maintaining data privacy at each source. Local computational resources at the sensor level are used for initial data processing and model training, with only model updates shared centrally, reducing data transmission requirements. The FL model achieved comparable accuracy to centralized approaches while enhancing data privacy. This work represents a significant advancement for smart city initiatives and environmental monitoring, offering a scalable, real-time, and privacy-aware framework for air quality monitoring systems that leverage IoT technology. [ABSTRACT FROM AUTHOR]

Background: Social innovation is often used as a mechanism to jump-start public–private partnerships to leverage resources to achieve social impact; the analysis of sustainability and the impact of corporate social responsibility (CSR) cannot be emphasized enough. Due to advances in the information and communication technology industry in Taiwan, this paper aims to explore whether these advancements drive CSR as a form of social innovation to meet health needs in Taiwan. Methodology: This paper uses a case study to look at CSR programs in the health sector in Taiwan. Corporations with diverse missions and different CSR approaches that are available on the internet are selected. The analysis of the case study takes a qualitative, exploratory approach to shed light on current initiatives. Results: The majority of CSR programs in Taiwan are private sector activities that emerged during the COVID-19 pandemic; current CSR activities in Taiwan are driven by awards, public relations, and external interests. Corporations in Taiwan have the potential to address the health care gaps of urban–rural health utilization among Taiwanese indigenous communities. It is recommended for corporations to (1) develop partnerships with public health experts or to (2) employ CSR personnel with health care backgrounds who can navigate the intersection between health, business, and policies to develop CSR strategies. Conclusions: Further evaluation of the projects mentioned in this paper to assess the direct and indirect impact on health outcomes could provide a more comprehensive understanding of the field of CSR in the health sector in Taiwan. [ABSTRACT FROM AUTHOR]

Objective: The objectives of this study were to assess the oral health status and parental perception of oral health needs of pediatric patients in an urban Craniofacial Center. Design: This research utilized a prospective cross-sectional matched study design. The data was collected prospectively via clinical oral examinations measuring dental caries experience and gingival health status. Parental perception of oral health was assessed through a validated questionnaire. Setting: The study was conducted at a Pediatric Dentistry Department and Craniofacial Center (CFC) in a large urban American city. Patients/Participants: Participants were recruited and enrolled from a CFC and Pediatric Dental Clinic. Main Outcome Measure(s): The outcome measures were the oral health status and parental perception thereof. Results: CFC patients' caries experience in primary teeth was significantly lower than that of a healthy matched cohort, but statistically similar in permanent teeth. CFC patients had significantly higher unmet dental treatment needs. CFC patients had poor oral hygiene and were shown to have significantly higher plaque levels and worse gingival health than that of a healthy matched cohort. Parental perception of oral health did not show a statistically significantly difference between the two groups. Conclusions: Patients in our study in an urban CFC were found to have a high unmet dental and poor oral hygiene. Despite the poor oral health status, parents of children with craniofacial anomalies did perceive their oral health as different from a matched cohort of patients without these conditions. [ABSTRACT FROM AUTHOR]

In the post-pandemic period, cities are committed to creating healthier and more healing urban environments. In high-density urban environments, urban complexes are increasingly assuming the function of enriching the external space and activating the vitality of cities, and their architecturally oriented public spaces have great potential for the promotion of residents' health. However, current research on public space and health has focused on green spaces and neighborhoods, and has not yet systematically sorted out the pathways that influence how building-oriented public space can contribute to health. In order to fill the gap, this study attempt to establish a model of health-promoting architecturally oriented public space, which can provide a reference for the similar projects. [ABSTRACT FROM AUTHOR]

Background: Increasing dietary diversity is a sustainable solution to combat micronutrient deficiencies. Given the large slum population in urban India, double burden of malnutrition, nutritional transition among slum-dwellers, and limited studies focusing on dietary intake and diversity among pregnant slum-dwellers, this study aimed to 1) describe macro- and micronutrient intakes and compare them with guidelines, 2) describe dietary diversity and intake of unhealthy foods and, 3) investigate the sociodemographic and lifestyle determinants of adequate dietary diversity among pregnant slum-dwellers in Pune, Maharashtra, India. Methods: This study presents cross-sectional data of 454 pregnant slum-dwelling women completing mid-pregnancy visit collected from a larger cohort study. Sociodemographic and lifestyle data were collected at baseline (< 12 weeks gestation). Dietary data (24-h dietary recall) were collected in mid-pregnancy (23 ± 2 weeks). Nutrient intakes were compared with the Estimated Average Requirements (EAR) for pregnant Indian women. Dietary diversity score (DDS, range 0–10) and unhealthy food (sweet snacks, sweet beverages, fried and salty food) group score (range 0–3) were calculated as per FAO guidelines. Multivariate logistic regression was conducted to examine determinants of adequate dietary diversity (DDS ≥ 5). Results: The average age of women was 25 (4.5) years. The median (Q1, Q3) total energy and protein intakes were 1771 (1456, 2185) kcal/d and 44.7 (34.7, 55.0) g/d, respectively. Total energy and protein were consumed as per EAR by 37% and 54% of women, respectively. Forty percent of women exceeded the recommended energy intake from carbohydrates. Diets of slum-dwelling women were lacking in multiple micronutrients (especially iron, zinc, riboflavin, thiamine, folate). The mean DDS was 4.2 ± 1.2 and 36.5% of the women had DDS ≥ 5. All women consumed mainly cereal-based starchy staples; 80% consumed pulses and legumes, and 60% consumed other vegetables. Fifty-nine percent of women consumed ≥ 2 unhealthy food groups. Higher educational and occupational status of the primary earning members of the family and lower parity were determinants of adequate dietary diversity. Conclusion: The diets of pregnant slum-dwelling women were lacking in numerous micronutrients. Dietary counselling programs need to be tailored to the socioeconomic backgrounds of pregnant slum-dwelling women and involve their family members to improve reach and effectiveness. [ABSTRACT FROM AUTHOR]

Academic Medical Centers (AMCs) and Federally Qualified Health Centers (FQHCs) are similarly tasked with managing the health of their local community, yet they each face unique challenges in their ability to do so. Integrating AMCs and FQHCs into novel care delivery models can leverage both organizations strengths, providing care in a comprehensive and sustainable fashion. Johns Hopkins Medicine (JHM) implemented this model with a large East Baltimore medical center, creating an AMC-FQHC collaboration focused on providing care to the East Baltimore patient population. This system provided various improvements in care delivery, including increased staffing, new wraparound services, improved access to funding dollars, and decreased out of pocket costs for patients qualifying for financial assistance. The academic missions of research and training were preserved, serving as the primary continuity clinic for several residency programs and as a community site for research. These changes resulted in more robust care for patients while improving the financial standing of the clinic. Through AMC and FQHC partnership, progress can be made toward providing holistic and financially sustainable primary care services in underserved areas while preserving the tripartite mission of academic medicine, with significant pedagogical and research opportunities. [ABSTRACT FROM AUTHOR]

To date, health in the context of climate change has mainly been considered from a biomedical perspective, whose pathogenic focus on health risks has primarily promoted curative and/or behavioral problem-solving strategies. This article therefore examines health in climate change from a perspective of Urban Public Health and political science, which has received less attention so far. The aim is to address existing constructions of health in climate change and their implications for dealing with the climate crisis, in particular regarding the design of urban environments. In doing so, it adopts a regulation-theoretical approach that allows for a theoretically grounded analysis of health in climate change, taking the triangle of nature, society and the individual as the object of research and revealing the significance of existing constructions of health--understood as a social relation--and its (re)production in climate change. This theoretical approach is extended to aspects of different spatial forms and the productions of space in social relations. The theoretical foundation makes it possible to recognize that there are understandings of health in climate change discourse that largely exclude the causes of climate change and thus make its treatment selective. As a result, broad socio-ecological transformation processes are obstructed, while the structural causes of climate change are preserved and stabilized despite their crisis character. An understanding of health that also sees health as a resource in a salutogenic sense and that strengthens the promotion of health by means of structural changes is being pushed into background. Positioning climate change as a public health issue requires a shift from curative, individual and behavioral interventions toward a focus on structural health promotion, especially through the development of health-promoting, just and climate-friendly urban environments. It also means that health must once again become more of a political issue and that existing boundaries between the private and public spheres must be questioned. [ABSTRACT FROM AUTHOR]

Stressors associated with urban habitats have been linked to poor wildlife health but whether a general negative relationship between urbanization and animal health can be affirmed is unclear. We conducted a meta-analysis of avian literature to test whether health biomarkers differed on average between urban and non-urban environments, and whether there are systematic differences across species, biomarkers, life stages and species traits. Our dataset included 644 effect sizes derived from 112 articles published between 1989 and 2022, on 51 bird species. First, we showed that there was no clear impact of urbanization on health when we categorized the sampling locations as urban or non-urban. However, we did find a small negative effect of urbanization on health when this dichotomous variable was replaced by a quantitative variable representing the degree of urbanization at each location. Second, we showed that the effect of urbanization on avian health was dependent on the type of health biomarker measured as well as the individual life stage, with young individuals being more negatively affected. Our comprehensive analysis calls for future studies to disentangle specific urban-related drivers of health that might be obscured in categorical urban versus non-urban comparisons. [ABSTRACT FROM AUTHOR]

Low-grade inflammation (LGI) mainly acted as the mediator of the association of obesity and inflammatory diet with numerous chronic diseases, including neuropsychiatric diseases. However, the evidence about the effect of LGI on brain structure is limited but important, especially in the context of accelerating aging. This study was then designed to close the gap, and we leveraged a total of 37,699 participants from the UK Biobank and utilized inflammation score (INFLA-score) to measure LGI. We built the longitudinal relationships of INFLA-score with brain imaging phenotypes using multiple linear regression models. We further analyzed the interactive effects of specific covariates. The results showed high level inflammation reduced the volumes of the subcortex and cortex, especially the globus pallidus (β [95% confidence interval] = −0.062 [−0.083, −0.041]), thalamus (−0.053 [−0.073, −0.033]), insula (−0.052 [−0.072, −0.032]), superior temporal gyrus (−0.049 [−0.069, −0.028]), lateral orbitofrontal cortex (−0.047 [−0.068, −0.027]), and others. Most significant effects were observed among urban residents. Furthermore, males and individuals with physical frailty were susceptive to the associations. The study provided potential insights into pathological changes during disease progression and might aid in the development of preventive and control targets in an age-friendly city to promote great health and well-being for sustainable development goals. [ABSTRACT FROM AUTHOR]

Background: Residents of rural areas have poorer health status, less healthy behaviours and higher mortality than urban dwellers, issues which are commonly addressed in primary care. Strengthening primary care may be an important tool to improve the health status of rural populations. Objective: Synthesize and categorize studies that examine interventions to improve rural primary care. Eligibility criteria: Experimental or observational studies published between January 1, 1996 and December 2022 that include an historical or concurrent control comparison. Sources of evidence: Pubmed, CINAHL, Cochrane Library, Embase. Charting methods: We extracted and charted data by broad category (quality, access and efficiency), study design, country of origin, publication year, aim, health condition and type of intervention studied. We assigned multiple categories to a study where relevant. Results: 372 papers met our inclusion criteria, divided among quality (82%), access (20%) and efficiency (13%) categories. A majority of papers were completed in the USA (40%), Australia (15%), China (7%) or Canada (6%). 35 (9%) papers came from countries in Africa. The most common study design was an uncontrolled before-and-after comparison (32%) and only 24% of studies used randomized designs. The number of publications each year has increased markedly over the study period from 1-2/year in 1997–99 to a peak of 49 papers in 2017. Conclusions: Despite substantial inequity in health outcomes associated with rural living, very little attention is paid to rural primary care in the scientific literature. Very few studies of rural primary care use randomized designs. [ABSTRACT FROM AUTHOR]

Urbanization is rapidly occupying green spaces, making it crucial to understand implicit conflicts between urbanization and greenness. This study proposes an ecological greenness index (EGI) and a comprehensive urbanization index (CUI) and selects Nanjing, a megacity in China, as the study area to research the spatial and temporal evolutionary trends of the EGI and CUI in the context of land use/land cover (LULC) changes from 2000 to 2020. Meanwhile, the conflicts and complex interaction characteristics of the EGI and CUI are discussed from both static and dynamic perspectives, and their driving mechanisms are investigated by combining specific indicators. The results demonstrate that over the past 20 years, LULC in Nanjing was dominated by cultivated land, forest land, and artificial surfaces. The encroachment of artificial surfaces on green space was strengthened, resulting in a decrease in the proportion of cultivated land from 70.09% in 2000 to 58.00% in 2020. The CUI increased at a change rate of 0.6%/year, while the EGI showed significant browning (change rate: −0.23%/year), mainly concentrated within the main urban boundaries. The relationship between the CUI and EGI made the leap from "primary coordination" to "moderate coordination", but there remains a risk of further deterioration of the decoupling relationship between the CUI and ecological pressures. The multi-year average contribution of the CUI to the EGI was 49.45%. Urbanization activities that dominate changes in greenness have changed over time, reflecting the timing of urban conflict management. The results provide important insights for urban ecological health monitoring and management. [ABSTRACT FROM AUTHOR]

Introduction: Community health centers (CHCs) provide historically marginalized populations with primary care, including cancer screening. Previous studies have reported that women living in rural areas are less likely to be up to date with cervical cancer screening than women living in urban areas. However, little is known about rural–urban differences in cervical cancer screening in CHCs and the contributing factors, and whether such differences changed during the COVID‐19 pandemic. Methods: Using 8‐year pooled Uniform Data System (2014‐2021) data and Oaxaca‐Blinder decomposition, the extent to which CHC‐ and catchment area–level characteristics explained rural‐urban differences in up‐to‐date cervical cancer screening was estimated. Results: Up‐to‐date cervical cancer screening was lower in rural CHCs than urban CHCs (38.2% vs 43.0% during 2014–2019), and this difference increased during the pandemic (43.5% vs 49.0%). The rural–urban difference in cervical cancer screening in 2014–2019 was mostly explained by differences in CHC‐level proportions of patients with limited English proficiency (55.9%) or income below the poverty level (12.3%) and females aged 21 to 64 years (9.8%), and catchment area–level's unemployment (3.4%) and primary care physician density (3.2%). However, Medicaid (–48.5%) or no insurance (–19.6%) counterbalanced the differences between rural–urban CHCs. The contribution of these factors to rural–urban differences in cervical cancer screening generally increased in 2020–2021. Conclusions: Rural–urban differences in cervical cancer screening were mostly explained by multiple CHC‐level and catchment area–level characteristics. The findings call for tailored interventions, such as providing resources and language services, to improve cancer screening utilization among uninsured, Medicaid, and patients with limited English proficiency in rural CHCs. The proportion of females who were up to date with cervical cancer screening was lower in rural community health centers (CHCs) than in urban CHCs, both before and during the COVID‐19 pandemic. Several factors contributed to the rural–urban difference, including proportion of patients with limited English proficiency, Medicaid or no health insurance, income below the federal poverty level at the CHC level, and unemployment rate and primary care physician density in the CHC's catchment area. [ABSTRACT FROM AUTHOR]

Activating social ties is a critical mechanism for satisfying individuals' social, emotional, and material needs. Researchers have offered a number of hypotheses around tie activation about when and why particular supporters step in to help, ranging from strategic activation via functional specificity to opportunistic mobilization. To date, few studies have examined multiple tie activation strategies in tandem. This project focuses on people facing complex, compounding health and social problems, who may have to rely on multiple forms of activation to get their support needs met. We draw on a sample of 92 participants who are affiliated with one of two Care Management programs in the Western United States. Using name generators in a survey, we elicit participants' social networks and find they utilize a number of methods to secure critical support needs, including calling on kin ties to borrow money and help with daily tasks, relying on strong and proximal ties for almost all types of support, and using functional specificity for health support. We then draw on qualitative interviews to gain a deeper understanding of the ways alters provide support and why egos elicit support from some alters and not others. Future research should continue assessing this population's social networks with the aim of leveraging social support to help manage chronic conditions, provide access to resources, and increase their sense of belonging. [ABSTRACT FROM AUTHOR]

This article explores the historical relationship between health and location in the United States, with a focus on urban areas. It discusses four books that delve into the impact of health care practices and policies on various communities throughout American history. The books emphasize the importance of considering cultural traditions and addressing disparities in health care delivery. The article also examines specific case studies, such as maternal and child health care programs in New York City and the development of culturally sensitive clinics in Miami. Overall, the article underscores the need for a nuanced approach to health care that takes into account the diverse perspectives and needs of different communities. [Extracted from the article]

Introduction: Od tribals who migrated to India during the Indo-Pakistan partition of 1947 were resettled by the Government of India in 1987 in the Bhatti Mines area near Delhi, India. However, in 1991, the area was declared a wildlife sanctuary, and the tribals were threatened with eviction a second time. We studied gender-based violence (GBV) in this community subjected to repeated displacement. Materials and Methods: A systematic randomized sample of 200 households was studied. The revised Conflict Tactics Scale (CTS2) questionnaire was used to identify victims of GBV. Correlation with age at marriage, education, household income, deprivation score, and alcoholism were investigated. Results: About 33% of women were married before the legal age for marriage - some as young as 10 years. Approximately 26% of households were multidimensionally deprived. About 50% of women reported GBV and 44% reported GBV in the preceding year. Low income and alcohol abuse were independently related to GBV. We did not find an association with underage marriage or the education of the partners. Discussion: GBV in the area far exceeded the national average of 30%. The relationship we found between GBV with poverty and alcoholism has been reported in studies from different parts of the world. It may be speculated that the increased GBV in this area could be the result of the hopelessness induced by repeated involuntary displacement suffered by this community. Methods to tackle the menace of GBV, even in the adverse circumstances of this community, are discussed. [ABSTRACT FROM AUTHOR]

The research on the thermal bioclimate is increasingly valuable in the context of climate change. Human well-being is threatened not only from direct exposure to extreme thermal conditions and complications from underlying health issues but also from disruptions of health and social services. This study aims at examining the thermal bioclimate in Greece. Data of ERA5-Land reanalysis dataset were used to estimate the Universal Thermal Climate Index (UTCI, in °C). The analysis covered a 30-year period (1991–2020) examining UTCI climatology and trends. Additionally, the intensity of two recent heatwaves which occurred in summers 2021 and 2023 was assessed. During the period 1991–2020, the UTCI equivalent temperature ranges between -49.8 °C and 51.9 °C [mean ± standard deviation (sd) = 13.3 ± 12.2 °C] classifying thermal stress from 'extreme cold stress' to 'extreme heat stress'. Across the country, the mean UTCI ranges from 7.5 °C to 17.8 °C (mean ± sd = 13.3 ± 2.1 °C), with a decrease of 0.5 °C per latitude degree. Mountainous regions exhibit the lowest UTCI equivalent temperatures, while inland plains display higher UTCI equivalent temperatures, especially in the eastern regions of the country. An increasing trend in mean annual UTCI (mean = 0.05 °C/year) is identified, more pronounced in higher latitude regions. Both the 2021 and 2023 heatwaves were exceptionally severe, with about 99% of the population to experience mean UTCI equivalent temperatures falling within stress categories of 'moderate heat stress' and above. The 2023 heatwave set a new record with the highest absolute maximum UTCI (52.1 °C) and number of heat stress hours compared to the period 1991–2020. The bioclimatic maps developed in this study analyze the spatial variability in the thermal conditions across Greece identifying high-risk areas. These findings can contribute to impact studies for tourism, energy efficiency, urban design and public health purposes. [ABSTRACT FROM AUTHOR]

The objective of this paper is to verify the effect of the location of health facilities on amenable and child mortality in the city of Salvador in Brazil. Based on the theory of local public goods, we consider that the provision of public health facilities affects the local health condition, and should therefore be decentralized to achieve better outcomes and avoid congestion costs. Panel data with mortalities data, socioeconomic variables, and the georeferenced location and internal structure of local health facilities for 163 neighbourhoods of the city were used to estimate a panel Poisson model. Simultaneity bias between mortality rate and location of health facilities was controlled using an instrumental variable based on the location of day-care centres, pre-schools, and public elementary schools. The results show that the homogenous spatial urban coverage of health care facilities contributes to reducing mortality. An increase of one unit in the coverage of public health facilities can reduce amenable mortality by 2.57% and under-five mortality by 23.06%. This effect may be greater for neighbourhoods with less unequal socioeconomic conditions. [ABSTRACT FROM AUTHOR]

Global environmental and health issues such as climate change and the COVID-19 pandemic have highlighted the weaknesses of current urban systems, including the poor availability and accessibility of green and public spaces in cities. Nature-based Solutions are configured as promising solutions to increase the resilience and health of the built environment by addressing climate and pandemic issues, promoting the psycho-physical well-being of users and proposing solutions for the protection of the environment and ecosystems. Following a systematic review of the scientific literature using the PRISMA methodology, this study aims to provide a taxonomic framework for Nature-based Solutions for the built environment that is applicable to the urban and building scales, highlighting key benefits in addressing pandemic and climate challenges and achieving urban resilience. This framework proposes a holistic and multifunctional approach that will prove to be a useful tool for researchers and policy makers to incorporate greening strategies into urban regeneration and redevelopment processes. The application of Nature-based Solutions still seems to be limited. It is therefore necessary to raise awareness of this issue among citizens and policy makers and to promote close co-operation between the different actors in territorial decision-making processes. [ABSTRACT FROM AUTHOR]

Improving street jogging environments can promote urban health and sustainability, especially within urban built-up areas. Public attention to the environment during jogging has not been sufficiently studied, and the recommended route data from the fitness app offers an opportunity for multiscale spatial exploration. Initially, by analyzing the recommendation reason text, the study identified 22 environmental factors and proposed the Environmental Factor Public Attention Intensity (EFPAI) for quantification, with subsequent comparisons to expert opinions. Further, by analyzing five types of data from the recommended routes, the relationships between EFPAI and jogging frequency, route shape, spatial distribution, and seasonal variations were uncovered. The study revealed: (1) discrepancies between expert opinions and public attention, with experts more likely to overlook factors such as slope, visual quality, width, and acoustic quality; (2) the public tends to notice factors like pedestrians, green spaces, waterfront spaces, landscapes, culture, sports facilities, and accessibility on routes with high jogging frequency; (3) EFPAI for traffic infrastructure, waterfront spaces, landscapes, residential areas, and campuses is associated with route shape; (4) EFPAI of certain environmental factors is influenced by urban geographical spatial factors, and substantial differences exist between different cities. Specific recommendations were provided from three different scales—site scale, street block scale, and urban scale—to guide the resolution of issues in planning and decision-making processes for urban renewal. [ABSTRACT FROM AUTHOR]

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Abstract Background Routine health facility data are an important source of health information in resource-limited settings. Regular quality assessments are necessary to improve the reliability of routine data for different purposes, including estimating facility-based maternal mortality. This study aimed to assess the quality of routine data on deliveries, livebirths and maternal deaths in Kampala City, Uganda. Methods We reviewed routine health facility data from the district health information system (DHIS2) for 2016 to 2021. This time period included an upgrade of DHIS2, resulting in two datasets (2016–2019 and 2020–2021) that were managed separately. We analysed data for all facilities that reported at least one delivery in any of the six years, and for a subset of facilities designated to provide emergency obstetric care (EmOC). We adapted the World Health Organization data quality review framework to assess completeness and internal consistency of the three data elements, using 2019 and 2021 as reference years. Primary data were collected to verify reporting accuracy in four purposively selected EmOC facilities. Data were disaggregated by facility level and ownership. Results We included 255 facilities from 2016 to 2019 and 247 from 2020 to 2021; of which 30% were EmOC facilities. The overall completeness of data for deliveries and livebirths ranged between 53% and 55%, while it was

Abstract Background Lung cancer is the third most common cancer in the UK and the leading cause of cancer mortality globally. NHS England guidance for optimum lung cancer care recommends management and treatment by a specialist team, with experts concentrated in one place, providing access to specialised diagnostic and treatment facilities. However, the complex and rapidly evolving diagnostic and treatment pathways for lung cancer, together with workforce limitations, make achieving this challenging. This place-based, behavioural science-informed qualitative study aims to explore how person-related characteristics interact with a person’s location relative to specialist services to impact their engagement with the optimal lung pathway, and to compare and contrast experiences in rural, coastal, and urban communities. This study also aims to generate translatable evidence to inform the evidence-based design of a patient engagement intervention to improve lung cancer patients’ and informal carers’ participation in and experience of the lung cancer care pathway. Methods A qualitative cross-sectional interview study with people diagnosed with lung cancer

Abstract Background Increasing dietary diversity is a sustainable solution to combat micronutrient deficiencies. Given the large slum population in urban India, double burden of malnutrition, nutritional transition among slum-dwellers, and limited studies focusing on dietary intake and diversity among pregnant slum-dwellers, this study aimed to 1) describe macro- and micronutrient intakes and compare them with guidelines, 2) describe dietary diversity and intake of unhealthy foods and, 3) investigate the sociodemographic and lifestyle determinants of adequate dietary diversity among pregnant slum-dwellers in Pune, Maharashtra, India. Methods This study presents cross-sectional data of 454 pregnant slum-dwelling women completing mid-pregnancy visit collected from a larger cohort study. Sociodemographic and lifestyle data were collected at baseline (