Abstract: The growth of the agricultural sector is known as an essential way to achieve development goals in developing countries. Urban agriculture is a way to reduce the vulnerability of urban populations of the world toward global environmental change. It is a sustainable and efficient system to respond to the environmental, social and economic needs of the city, which leads to urban sustainability. Today, many local and national governments are developing urban agriculture as an effective tool in responding to challenges such as poverty, food security, and environmental problems. In this study, we follow a perspective based on urban agriculture literature in order to indicate the urban agriculture’s benefits in environmental planning strategies in non-western countries like Iran. The methodological approach adopted is based on qualitative approach and documentary studies. A total of 35 articles (mixed quantitative and qualitative methods studies) were studied in final analysis, which are published in relevant journals that focus on this subject. Studies show the wide range of positive benefits of urban agriculture on food security, nutrition outcomes, health outcomes, environmental outcomes, and social capital. However, there was no definitive conclusion about the negative effects of urban agriculture. This paper provides a conceptual and theoretical basis to know about urban agriculture and its roles in environmental planning, and also conclude the benefits of urban agriculture for researchers, practitioners, and policymakers who seek to create spaces in cities for implementation urban agriculture in future.
Abstract: Improving resources for medical autonomy of astronauts in prolonged space missions, such as a Mars mission, requires not only technology development, but also decision-making support systems. The Advanced Crew Medical System - Medical Condition Requirements study, funded by the Canadian Space Agency, aimed to create knowledge content and a scenario-based query capability to support medical autonomy of astronauts. The key objective of this study was to create a prototype tool for identifying medical infrastructure requirements in terms of medical knowledge, skills and materials. A multicriteria decision-making method was used to prioritize the highest risk medical events anticipated in a long-term space mission. Starting with those medical conditions, event sequence diagrams (ESDs) were created in the form of decision trees where the entry point is the diagnosis and the end points are the predicted outcomes (full recovery, partial recovery, or death/severe incapacitation). The ESD formalism was adapted to characterize and compare possible outcomes of medical conditions as a function of available medical knowledge, skills, and supplies in a given mission scenario. An extensive literature review was performed and summarized in a medical condition database. A PostgreSQL relational database was created to allow query-based evaluation of health outcome metrics with different medical infrastructure scenarios. Critical decision points, skill and medical supply requirements, and probable health outcomes were compared across chosen scenarios. The three medical conditions with the highest risk rank were acute coronary syndrome, sepsis, and stroke. Our efforts demonstrate the utility of this approach and provide insight into the effort required to develop appropriate content for the range of medical conditions that may arise.
Abstract: ASER Centre, the research and assessment arm of Pratham Education Foundation sees measurement as the first stage of action. ASER uses primary research to push and give empirical foundations to policy discussions at a multitude of levels. At a household level, common citizens use a simple assessment (a floor-level test) to measure learning across rural India. This paper presents the evidence on the applicability of an ASER approach to the health sector. A citizen-led assessment was designed and executed that collected information from young mothers with children up to a year of age. The pilot assessments were rolled-out in two different models: Paid surveyors and student volunteers. The survey covered three geographic areas: 1,239 children in the Jaipur District of Rajasthan, 2,086 in the Rae Bareli District of Uttar Pradesh, and 593 children in the Bhuj Block in Gujarat. The survey tool was designed to study knowledge of health-related issues, daily practices followed by young mothers and access to relevant services and programs. It provides insights on behaviors related to infant and young child feeding practices, child and maternal nutrition and supplementation, water and sanitation, and health services. Moreover, the survey studies the reasons behind behaviors giving policy-makers actionable pathways to improve implementation of social sector programs. Although data on health outcomes are available, this approach could provide a rapid annual assessment of health issues with indicators that are easy to understand and act upon so that measurements do not become an exclusive domain of experts. The results give many insights into early childhood health behaviors and challenges. Around 98% of children are breastfed, and approximately half are not exclusively breastfed (for the first 6 months). Government established diet diversity guidelines are met for less than 1 out of 10 children. Although most households are satisfied with the quality of drinking water, most tested households had contaminated water.
Abstract: Being a patient with a chronic disease is both a physical and emotional experience. The ability to recognize a patient’s emotional health is an important part of a health care provider’s skills. For the purposes of this paper, emotional health is viewed as the way that we feel, and the way that our feelings affect us. Understanding the patient’s emotional health leads to improved provider-patient relationships and health outcomes. For example, when a patient first hears his or her diagnosis from a provider, they might find it difficult to cope with their emotions. Struggling to cope with emotions interferes with the patient’s ability to read, understand, and act on health information and services. As a result, the patient becomes more frustrated and confused, creating barriers to accessing healthcare services. These barriers are challenging for both the patient and their healthcare providers. There are five basic emotions that are part of who we are and are always with us: fear, anger, sadness, joy, and compassion. Living with a chronic disease however can cause a patient to experience and express these emotions in new and unique ways. Within the provider-patient relationship, there needs to be an understanding that each patient experiences these five emotions and, experiences them at different times. In response to this need, the paper highlights a health promotion framework for patients with chronic disease. This framework emphasizes the emotional health of patients.
Abstract: Food insecurity (FI) influences may result in poor physical and mental health outcomes. Minor ethnic group may experience higher level of FI, and this situation may be related with higher depression prevalence. The aim of this study was to determine the association of depression with food security status in major (Azeri) and minor (Kurdish) ethnicity living in Urmia, West Azerbaijan, north of Iran. In this cross-sectional study, 723 participants (427 women and 296 men) aged 20–64 years old, from two ethnic groups (445 Azeri and 278 Kurdish), were selected through a multi stage cluster systematic sampling. Depression rate was assessed by “Beck” short form questionnaire (validated in Iranians) through interviews. Household FI status (HFIS) was measured using adapted HFI access scale through face-to-face interviews at homes. Multinomial logistic regression was used to estimate odds ratios (OR) of depression across HFIS. Higher percent of Kurds had moderate and severe depression in comparison with Azeri group (73 [17.3%] vs. 86 [27.9%]). There were not any significant differences between the two ethnicities in mild depression. Also, of all the subjects, moderate-to-sever FI was more prevalent in Kurds (28.5%), compared to Azeri group (17.3%) [P < 0.01]. Kurdish ethnic group living in food security or mild FI households had lower chance to have symptom of severe depression in comparison to those with sever FI (OR=0.097; 95% CI: 0.02-0.47). However, there was no significant association between depression and HFI in Azeri group. Findings revealed that the severity of HFI was related with severity depression in minor studied ethnic groups. However, in Azeri ethnicity as a major group, other confounders may have influence on the relation with depression and FI, that were not studied in the present study.
Abstract: Healthcare delivery systems around the world are in
crisis. The need to improve health outcomes while decreasing
healthcare costs have led to an imminent call to action to transform
the healthcare delivery system. While Bioinformatics and Biomedical
Engineering have primarily focused on biological level data and
biomedical technology, there is clear evidence of the importance
of the delivery of care on patient outcomes. Classic singular
decomposition approaches from reductionist science are not capable
of explaining complex systems. Approaches and methods from
systems science and systems engineering are utilized to structure
healthcare delivery system data. Specifically, systems architecture is
used to develop a multi-scale and multi-dimensional characterization
of the healthcare delivery system, defined here as the Healthcare
Delivery System Knowledge Base. This paper is the first to contribute
a new method of structuring and visualizing a multi-dimensional and
multi-scale healthcare delivery system using systems architecture in
order to better understand healthcare delivery.
Abstract: Practicing recurring resistance workout such as may cause changes in human muscle. These changes may be because combination if several factors determining physical fitness. Thus, it is important to identify these changes. Several studies were reviewed to investigate these changes. As a result, the changes included positive modifications in amplified citrate synthase (CS) maximal activity, increased capacity for pyruvate oxidation, improvement on molecular signaling on human performance, amplified resting muscle glycogen and whole GLUT4 protein content, better health outcomes such as enhancement in cardiorespiratory fitness. Sprint training also have numerous long long-term changes inhuman body such as better enzyme action, changes in muscle fiber and oxidative ability. This is important because SV is the critical factor influencing maximal cardiac output and therefore oxygen delivery and maximal aerobic power.
Abstract: High meat and especially red meat intakes are significantly and positively associated with a multiple burden of diseases and also high greenhouse gas (GHG) emissions. This study investigated population meat intake patterns in Hong Kong. It quantified the burden of disease and GHG emission outcomes by modeling to adjust Hong Kong population meat intakes to recommended healthy levels. It compared age- and sex-specific population meat, fruit and vegetable intakes obtained from a population survey among adults aged 20 years and over in Hong Kong in 2005-2007, against intake recommendations suggested in the Modelling System to Inform the Revision of the Australian Guide to Healthy Eating (AGHE-2011-MS) technical document. This study found that meat and meat alternatives, especially red meat intakes among Hong Kong males aged 20+ years and over are significantly higher than recommended. Red meat intakes among females aged 50-69 years and other meat and alternatives intakes among aged 20-59 years are also higher than recommended. Taking the 2005-07 age- and sex-specific population meat intake as baselines, three counterfactual scenarios of adjusting Hong Kong adult population meat intakes to AGHE-2011-MS and Pre-2011 AGHE recommendations by the year 2030 were established. Consequent energy intake gaps were substituted with additional legume, fruit and vegetable intakes. To quantify the consequent GHG emission outcomes associated with Hong Kong meat intakes, Cradle-to-ready-to-eat lifecycle assessment emission outcome modelling was used. Comparative risk assessment of burden of disease model was used to quantify the health outcomes. This study found adjusting meat intakes to recommended levels could reduce Hong Kong GHG emission by 17%-44% when compared against baseline meat intake emissions, and prevent 2,519 to 7,012 premature deaths in males and 53 to 1,342 in females, as well as multiple burden of diseases when compared to the baseline meat intake scenario. Comparing lump sum meat intake reduction and outcome measures across the entire population, and using emission factors, and relative risks from individual studies in previous co-benefit studies, this study used age- and sex-specific input and output measures, emission factors and relative risks obtained from high quality meta-analysis and meta-review respectively, and has taken government dietary recommendations into account. Hence evaluations in this study are of better quality and more reflective of real life practices. Further to previous co-benefit studies, this study pinpointed age- and sex-specific population and meat-type-specific intervention points and leverages. When compared with similar studies in Australia, this study also showed that intervention points and leverages among populations in different geographic and cultural background could be different, and that globalization also globalizes meat consumption emission effects. More regional and cultural specific evaluations are recommended to promote more sustainable meat consumption and enhance global food security.
Abstract: In order to address the social factors of elderly health care, researcher and community members have turned to more inclusive and participatory approaches to research and interventions. One such approach, community-based participatory research (CBPR) in public health, has received increased attention as the academic and public health communities struggle to address the persistent problems of disparities in the use of health care and health outcomes for several over the past decade. As Thailand becomes an ageing society, health services and proper care systems specifically for the elderly group need to be prepared and well established. The purpose of this assignment was to study the health problems and was to explore the process of community participation in elderly health care. Participants in this study were member of elderly group of Paisanee Ramintra 65 community in Bangkok, Thailand. The results indicated two important components of community participation process in elderly health care: 1) a process to develop community participation in elderly health care, and 2) outcomes resulting from such process. The development of community participation consisted of four processes. As for the outcomes of the community participation development process, they consisted of elderly in the community got jointly and formulated a group, which strengthened the project because of collaborative supervision among themselves. Moreover, inactive health care services have changed to being energetic and focus on health promotion rather than medical achievement and elderly association of community can perform health care activities for chronically illness through the achievement of this development; consequently, they increasingly gained access to physical, cognitive, and social activity.
Abstract: With the advancement of knowledge about the utility
and impact of sustainability, its feasibility has been explored into
different walks of life. Scientists, however; have established their
knowledge in four areas viz environmental, economic, social and
cultural, popularly termed as four pillars of sustainability. Aspects of
environmental and economic sustainability have been rigorously
researched and practiced and huge volume of strong evidence of
effectiveness has been founded for these two sub-areas. For the social
and cultural aspects of sustainability, dependable evidence of
effectiveness is still to be instituted as the researchers and
practitioners are developing and experimenting methods across the
globe. Therefore, the present research aimed to identify globally used
practices of social and cultural sustainability and through evidence
synthesis assess their outcomes to determine the effectiveness of
those practices. A PICO format steered the methodology which
included all populations, popular sustainability practices including
walkability/cycle tracks, social/recreational spaces, privacy, health &
human services and barrier free built environment, comparators
included ‘Before’ and ‘After’, ‘With’ and ‘Without’, ‘More’ and
‘Less’ and outcomes included Social well-being, cultural coexistence,
quality of life, ethics and morality, social capital, sense of
place, education, health, recreation and leisure, and holistic
development. Search of literature included major electronic
databases, search websites, organizational resources, directory of
open access journals and subscribed journals. Grey literature,
however, was not included. Inclusion criteria filtered studies on the
basis of research designs such as total randomization, quasirandomization,
cluster randomization, observational or single studies
and certain types of analysis. Studies with combined outcomes were
considered but studies focusing only on environmental and/or
economic outcomes were rejected. Data extraction, critical appraisal
and evidence synthesis was carried out using customized tabulation,
reference manager and CASP tool. Partial meta-analysis was carried
out and calculation of pooled effects and forest plotting were done.
As many as 13 studies finally included for final synthesis explained
the impact of targeted practices on health, behavioural and social
dimensions. Objectivity in the measurement of health outcomes
facilitated quantitative synthesis of studies which highlighted the
impact of sustainability methods on physical activity, Body Mass
Index, perinatal outcomes and child health. Studies synthesized
qualitatively (and also quantitatively) showed outcomes such as
routines, family relations, citizenship, trust in relationships, social
inclusion, neighbourhood social capital, wellbeing, habitability and
family’s social processes. The synthesized evidence indicates slight
effectiveness and efficacy of social and cultural sustainability on the
targeted outcomes. Further synthesis revealed that such results of this
study are due weak research designs and disintegrated implementations. If architects and other practitioners deliver their
interventions in collaboration with research bodies and policy
makers, a stronger evidence-base in this area could be generated.
Abstract: During the post-Civil War era, the city of Nashville,
Tennessee, had the highest mortality rate in the United States. The
elevated death and disease rates among former slaves were
attributable to lack of quality healthcare. To address the paucity of
healthcare services, Meharry Medical College, an institution with the
mission of educating minority professionals and serving the
underserved population, was established in 1876.
Purpose: The social ecological framework and partial least squares
(PLS) path modeling were used to quantify the impact of
socioeconomic status and adverse health outcome on primary care
professionals serving the disadvantaged community. Thus, the study
results could demonstrate the accomplishment of the College’s
mission of training primary care professionals to serve in underserved
areas.
Methods: Various statistical methods were used to analyze alumni
data from 1975 – 2013. K-means cluster analysis was utilized to
identify individual medical and dental graduates in the cluster groups
of the practice communities (Disadvantaged or Non-disadvantaged
Communities). Discriminant analysis was implemented to verify the
classification accuracy of cluster analysis. The independent t-test was
performed to detect the significant mean differences of respective
clustering and criterion variables. Chi-square test was used to test if
the proportions of primary care and non-primary care specialists are
consistent with those of medical and dental graduates practicing in
the designated community clusters. Finally, the PLS path model was
constructed to explore the construct validity of analytic model by
providing the magnitude effects of socioeconomic status and adverse
health outcome on primary care professionals serving the
disadvantaged community.
Results: Approximately 83% (3,192/3,864) of Meharry Medical
College’s medical and dental graduates from 1975 to 2013 were
practicing in disadvantaged communities. Independent t-test confirmed the content validity of the cluster analysis model. Also, the
PLS path modeling demonstrated that alumni served as primary care
professionals in communities with significantly lower socioeconomic
status and higher adverse health outcome (p < .001). The PLS path
modeling exhibited the meaningful interrelation between primary
care professionals practicing communities and surrounding
environments (socioeconomic statues and adverse health outcome),
which yielded model reliability, validity, and applicability.
Conclusion: This study applied social ecological theory and
analytic modeling approaches to assess the attainment of Meharry
Medical College’s mission of training primary care professionals to
serve in underserved areas, particularly in communities with low
socioeconomic status and high rates of adverse health outcomes. In
summary, the majority of medical and dental graduates from Meharry
Medical College provided primary care services to disadvantaged
communities with low socioeconomic status and high adverse health
outcome, which demonstrated that Meharry Medical College has
fulfilled its mission. The high reliability, validity, and applicability of
this model imply that it could be replicated for comparable
universities and colleges elsewhere.
Abstract: Exposure to ambient air pollution has been linked to a
number of health outcomes, starting from modest transient changes in
the respiratory tract and impaired pulmonary function, continuing to
restrict activity/reduce performance and to the increase emergency
rooms visits, hospital admissions or mortality. The increase of
allergenic symptoms has been associated with air contaminants such
as ozone, particulate matter, fungal spores and pollen.
Considering the potential relevance of crossed effects of nonbiological
pollutants and airborne pollens and fungal spores on
allergy worsening, the aim of this work was to evaluate the influence
of non-biological pollutants (O3 and PM10) and meteorological
parameters on the concentrations of pollen and fungal spores using
multiple linear regressions.
The data considered in this study were collected in Oporto which
is the second largest Portuguese city, located in the North. Daily
mean of O3, PM10, pollen and fungal spore concentrations,
temperature, relative humidity, precipitation, wind velocity, pollen
and fungal spore concentrations, for 2003, 2004 and 2005 were
considered. Results showed that the 90th percentile of the adjusted
coefficient of determination, P90 (R2aj), of the multiple regressions
varied from 0.613 to 0.916 for pollen and from 0.275 to 0.512 for
fungal spores. O3 and PM10 showed to have some influence on the
biological pollutants. Among the meteorological parameters
analysed, temperature was the one that most influenced the pollen
and fungal spores airborne concentrations. Relative humidity also
showed to have some influence on the fungal spore dispersion.
Nevertheless, the models for each pollen and fungal spore were
different depending on the analysed period, which means that the
correlations identified as statistically significant can not be, even so,
consistent enough.
Abstract: This paper systematically investigates the timedependent
health outcomes for office staff during computer work
using the developed mathematical model. The model describes timedependent
health outcomes in multiple body regions associated with
computer usage. The association is explicitly presented with a doseresponse
relationship which is parametrized by body region
parameters. Using the developed model we perform extensive
investigations of the health outcomes statically and dynamically. We
compare the risk body regions and provide various severity rankings
of the discomfort rate changes with respect to computer-related
workload dynamically for the study population. Application of the
developed model reveals a wide range of findings. Such broad
spectrum of investigations in a single report literature is lacking.
Based upon the model analysis, it is discovered that the highest
average severity level of the discomfort exists in neck, shoulder, eyes,
shoulder joint/upper arm, upper back, low back and head etc. The
biggest weekly changes of discomfort rates are in eyes, neck, head,
shoulder, shoulder joint/upper arm and upper back etc. The fastest
discomfort rate is found in neck, followed by shoulder, eyes, head,
shoulder joint/upper arm and upper back etc. Most of our findings are
consistent with the literature, which demonstrates that the developed
model and results are applicable and valuable and can be utilized to
assess correlation between the amount of computer-related workload
and health risk.
Abstract: The objective of this study was to examine the interaction between mode of illness onset and psychiatric comorbidity on the health outcomes of persons with ME/CFS. A total of 114 individuals with ME/CFS participated in this study. Individuals completed a battery of baseline measures including the fatigue severity scale and measures of disability. Findings indicated that those with sudden illness onset had more impaired physical health functioning. In addition, among individuals with sudden onset, those without psychiatric comorbidity had greater fatigue severity and lower overall physical health than those with psychiatric comordibity. In contrast, among individuals with gradual illness onset, those with psychiatric comorbity had higher fatigue severity than those without comorbid psychiatric disorders. The health outcomes of individuals who have ME/CFS with or without psychiatric comorbidity are impacted by the mode of illness onset and this suggest that it is important to examine these factors in future research.