Exploring the nexus of urban form, transport, environment and health in large-scale urban studies: A state-of-the-art scoping review.

BACKGROUND: As the world becomes increasingly urbanised, there is recognition that public and planetary health relies upon a ubiquitous transition to sustainable cities. Disentanglement of the complex pathways of urban design, environmental exposures, and health, and the magnitude of these associations, remains a challenge. A state-of-the-art account of large-scale urban health studies is required to shape future research priorities and equity- and evidence-informed policies. OBJECTIVES: The purpose of this review was to synthesise evidence from large-scale urban studies focused on the interaction between urban form, transport, environmental exposures, and health. This review sought to determine common methodologies applied, limitations, and future opportunities for improved research practice. METHODS: Based on a literature search, 2958 articles were reviewed that covered three themes of: urban form; urban environmental health; and urban indicators. Studies were prioritised for inclusion that analysed at least 90 cities to ensure broad geographic representation and generalisability. Of the initially identified studies, following expert consultation and exclusion criteria, 66 were included. RESULTS: The complexity of the urban ecosystem on health was evidenced from the context dependent effects of urban form variables on environmental exposures and health. Compact city designs were generally advantageous for reducing harmful environmental exposure and promoting health, with some exceptions. Methodological heterogeneity was indicative of key urban research challenges; notable limitations included exposure and health data at varied spatial scales and resolutions, limited availability of local-level sociodemographic data, and the lack of consensus on robust methodologies that encompass best research practice. CONCLUSION: Future urban environmental health research for evidence-informed urban planning and policies requires a multi-faceted approach. Advances in geospatial and AI-driven techniques and urban indicators offer promising developments; however, there remains a wider call for increased data availability at local-levels, transparent and robust methodologies of large-scale urban studies, and greater exploration of urban health vulnerabilities and inequities.

Commentary: A road map for future data-driven urban planning and environmental health research.

Recent advances in data science and urban environmental health research utilise large-scale databases (100s-1000s of cities) to explore the complex interplay of urban characteristics such as city form and size, climate, mobility, exposure, and environmental health impacts. Cities are still hotspots of air pollution and noise, suffer urban heat island effects and lack of green space, which leads to disease and mortality burdens preventable with better knowledge. Better understanding through harmonising and analysing data in large numbers of cities is essential to identifying the most effective means of disease prevention and understanding context dependencies important for policy.

Explaining the concept of maternal health information verification and assessment during pregnancy: a qualitative study.

BACKGROUND: Pregnant women use information sources for their own health and health of their children. However, despite the importance of trusting the information sources, pregnant women may not have the ability to verify the maternal health information, which could have negative consequences for their health. The purpose of this study was to explain the concept of maternal health information verification and assessment in pregnant women according to their experiences and perception. METHODS: This is a qualitative study that was conducted in 2017 in Tehran, Iran. The participants in this study consisted of 19 pregnant women who were selected by purposeful sampling. To collect data, semi-structured, in-depth and face to face interviews were conducted with participants and continued until saturation of data. Conventional content analysis method was used to analyze the data and to identify concepts and synthesize them into general classes. MAXQDA software version 10 was used to manage the data. RESULTS: In the process of data analysis, the concept of verification and assessment of maternal health information in pregnancy was explained in two main categories, including "Validity of information resources" and "Reliance on information resources." The category of Validity of information resources had two subcategories of valid and invalid sources, and the main category of Reliance on information resources had two subcategories of indicators of assurance, and confusion and trying to obtain assurance. CONCLUSION: The results indicated that pregnant women used various sources and indicators, as well as different evaluation methods to obtain information and verify it, especially when they are confused. Thus, health authorities and healthcare professionals should provide appropriate programs to familiarize mothers with credible sources, train pregnant women on standards and practices for judging the accuracy of information, and create a safe margin of information.

Prevalence of andropause among Iranian men and its relationship with quality of life.

INTRODUCTION: Andropause is a complicated process in men's life which can negatively affect their quality of life in both physical and psychological dimensions. OBJECTIVES: The aim of this study was to determine the prevalence of andropause among Iranian men age 40-85 years and its relationship with quality of life. MATERIALS AND METHODS: This was a cross-sectional study among 393 men attending ten urban healthcare centers in Ilam province in southwestern Iran. Study participants were recruited using proportional random sampling. The Male andropause symptoms self-assessment questionnaire (MASSQ) and SF-12 were used for data collection. Data were analyzed using SPSS version 22 (Chicago, IL). RESULTS: The mean (SD) of participants scores in MASSQ was 57.46 (17.56). Only 61 (15.5%) men were classified at "don't need testosterone" category based on MASSQ. There were significant associations between the eight aspects of HRQoL and the andropause severity (p < .001). Older age, lower education, having depression, coronary heart disease, and incontinence were associated with increased odds of andropause (p < .05). CONCLUSION: This study confirmed findings of previous studies regarding andropause and its relationship with men's quality of life. Future studies in this topic are needed to discover all the factors that may influence men andropause.

Postpartum Sexual Functioning and Its Predicting Factors among Iranian Women.

BACKGROUND: Many women experience sexual dysfunction following childbirth but this has not been well investigated in Iran. The aim of this study was to evaluate women's sexual function in the postpartum period in Iran. It also sought to determine predicting factors associated with their sexual function. METHODS: This was a cross-sectional study among 380 postpartum women attending 10 urban health centers in Ilam province in southwestern Iran. Participants were selected using random cluster sampling. Data was collected using the female sexual function index (FSFI) and a checklist of socio-demographic and maternal status for each of the women. Sexual dysfunction was classified according to an FSFI score of ≤ 28. Data were analysed using SPSS version 22. RESULTS: The majority of participants (76.3%) had sexual dysfunction. Primiparity (adjusted odds ratio (aOR): 1.78 (95% Confidence Interval (CI): 1.11, 2.94); P = 0.006) and exclusive breastfeeding (aOR: 2.47 (95% CI: 1.21, 5.03); P = 0.012) were associated with increased odds of experiencing sexual dysfunction in the postpartum period. Other factors such as age, type of delivery, education, time since delivery and family income did not predict women's postpartum sexual function. CONCLUSION: This study confirmed findings of previous studies on factors that may have an adverse effect on new mothers' sexual function in the postpartum period. However the effect of type of delivery on postpartum sexual function remains unclear.

Women`s sexual function during the postpartum period: A systematic review on measurement tools.

BACKGROUND: Sexual health is a critical component of overall well-being, yet discussions around sexual function, especially in the context of postpartum recovery, are often taboo or sidelined. The aim was to review measurement tools assessing women's sexual function/health during the postpartum period. METHODS: We did a systematic search according to preferred reporting items for systematic reviews and meta-analyses 2020 guidelines in different databases, including PubMed, Web of Science, Scopus, Embase, ProQuest and Open Access Thesis and Dissertations, and Google scholar search engine until June 2023. Also, the reference list of the related reviews has been screened. Eligible studies included observational studies or clinical trials that evaluated women`s sexual function during the postpartum period using existing tools. Data extraction covered study characteristics, measurement tools, and their validity and reliability. RESULTS: From 3064 retrieved records, after removing duplicates and excluding ineligible studies, and reviewing the reference list of the related reviews, 41 studies were included in this review. Tools measuring sexual function were developed from 1996 to 2017. Sexual activity questionnaire, female sexual function index (FSFI), sexual function questionnaire, short form of the pelvic organ prolapse/urinary incontinence sexual questionnaire, sexual health outcomes in women questionnaire, shorter version of FSFI, and sexual function questionnaire's medical impact scale and Carol scale. CONCLUSION: Sexual activity questionnaire, FSFI, sexual function questionnaire, short form of the pelvic organ prolapse/urinary incontinence sexual questionnaire, sexual health outcomes in women questionnaire, shorter version of FSFI, sexual function questionnaire's medical impact scale, and Carol scale are valid and reliable measuring tools to assess sexual function or sexual health during postpartum period, which can be used in primary studies according to the study aim and objectives.

Urban form and its impacts on air pollution and access to green space: A global analysis of 462 cities.

A better understanding of urban form metrics and their environmental outcomes can help urban policymakers determine which policies will lead to more sustainable growth. In this study, we have examined five urban form metrics-weighted density, density gradient slope, density gradient intercept, compactness, and street connectivity-for 462 metropolitan areas worldwide. We compared urban form metrics and examined their correlations with each other across geographic regions and socioeconomic characteristics such as income. Using the K-Means clustering algorithm, we then developed a typology of urban forms worldwide. Furthermore, we assessed the associations between urban form metrics and two important environmental outcomes: green space access and air pollution. Our results demonstrate that while higher density is often emphasized as the way to reduce driving and thus PM2.5 emissions, it comes with a downside-less green space access and more exposure to PM2.5. Moreover, street connectivity has a stronger association with reduced PM2.5 emissions from the transportation sector. We further show that it is not appropriate to generalize urban form characteristics and impacts from one income group or geographical region to another, since the correlations between urban form metrics are context specific. Our conclusions indicate that density is not the only proxy for different aspects of urban form and multiple indicators such as street connectivity are needed. Our findings provide the foundation for future work to understand urban processes and identify effective policy responses.

Retinopathy prematurity: a systematic review and meta-analysis study based on neonatal and maternal risk factors.

BACKGROUND: Retinopathy of prematurity is the abnormal development of retinal arteries in preterm neonates less than 32 weeks and weighing 1500 g, and less, which can lead to visual impairment during life and blindness. This study aims to investigate the relationship between some clinical characteristics of neonates and mothers with Retinopathy of prematurity in the world via a systematic review and meta-analysis. MATERIALS AND METHODS: The present study is a systematic review and meta-analysis on the relationship between maternal and neonatal clinical variables with Retinopathy of prematurity in the world from the beginning of 2000 to the end of 2020. Accordingly, all English articles published on the topic were searched in scientific databases of Web of Science, PubMed, Google Scholar, Science Direct, and Scopus. The articles were searched independently by two researchers. Statistical analysis of data was performed using fixed and random effects model statistical tests in the meta-analysis, Cochran, meta-regression, I2 index, Funnel plot, and Begg's by STATA software program, version 14. RESULT: A total of 191 studies with a sample size of 140,921 persons were including in the meta-analysis. Accordingly, Preterm delivery ≤28 weeks (OR:6.3, 95% CI:4.9-8.1), Birth Weight ≤1000 g (OR:5.8, 95% CI:4.8-6.8), Birth Weight ≤1500 g (OR:4.8, 95% CI:3.8-6.1), PROM (OR:1.2, 95% CI:1.0-1.4), induced fertility (OR:1.9, 95% CI:1.1-3.0) and Chorioamnionitis (OR:1.5, 95% CI:1.0-2.2) There was a statistically significant association with retinopathy. CONCLUSION: Based on the results of the present meta-analysis, the risk of retinopathy of prematurity in neonates born at 28 weeks and less, LBW (weight 1500 g and less), neonatal hypotension, chorioamnionitis, and induced fertility increases.

Association between Fear of COVID-19 with Self-care Behaviors in Elderly: A Cross- Sectional Study.

This study aims to determine the association between fear of COVID-19 with self-care in the elderly. This is a cross-sectional study, in which data were collected using the online survey method with three questionnaires: social demographic characteristics, fear of COVID-19, and elderly self-care. The 350 elderly people were selected by multi-stage sampling from the list of households registered in the integrated health system. According to the result, the mean (SD) age of participants was 69.91 (5.19) and two-thirds of them were married, also the majority of the participants (55%) had an education level less than a diploma. A direct and statistically significant correlation was observed between fear of COVID-19 and self-care. Linear regression analysis showed that the self-care rate decreases with increasing of the COVID-19 fear (B = -0.395, SE = 0.001, R2 = 0.154). The lowest scores were related to self-care which can be due to the restrictions applied and limited family relations during the COVID-19 epidemic. Therefore, it is recommended that purposeful training programs and appropriate psychological support interventions are developed to help overcome COVID-19 fear and help elderly people use preventative behaviors.

Evaluation of Psychometric Properties of the Persian Version of Brief Male Sexual Function Inventory: A Cross-Sectional Study.

INTRODUCTION: Male sexual dysfunction is a common problem, and there are many self-report questionnaires for measuring sexual function among men; however, the Brief Male Sexual Function Inventory (BSFI) is a tool that has 5 subscales, which is more complete than others. a validated self-report questionnaire, in the local language with modest expressions is required for men. AIM: To determine the validity and reliability of the Persian version of the BSFI among men. METHODS: This cross-sectional study was conducted on 200 males. The sampling process was performed in several stages from health centers. After the accomplishment of the standard process of back-translating the questionnaire from English to Persian, its face, content, and construct validity were evaluated. The collected data were analyzed using confirmatory factor analysis, multivariate analysis of variance, and Pearson correlation coefficient. To determine the reliability of the instrument, the test-retest method was used with 2 weeks interval and the Cronbach's alpha coefficient method was applied to check the internal homogeneity. MAIN OUTCOME MEASURES: Reliability (internal consistency and test-retest) and validity were assessed RESULTS: According to the research findings, confirmatory factor analysis had an acceptable fit. By modifying the measurement model and fitting the final model, the fitting indices were obtained as the following: Chi-square statistic = 21.63, NPAR = 36, P = .001 > 0.05; Tucker-Lewis index = 0.956; comparative fit indices = 0.976; Normed Fit Index = 0.952; and root mean square error of approximation = 0.068. These values indicated that the obtained model had a good fit for the data. Moreover, Cronbach's alpha and intra-cluster correlation coefficients of the whole questionnaire were calculated at 0.893 and 0.893, respectively (confidence interval between 0.811-0.950), showing the internal consistency of the items in the whole questionnaire and domain. CONCLUSION: The BSFI questionnaire showed a 5-factor structure similar to the original structure and the 11-item Persian version of the questionnaire of male sexual function can be considered a valid and reliable tool to assess the level of male sexual function. Rezaei N, Sharifi N, Fathnezhad-Kazemi A, et al. Evaluation of Psychometric Properties of the Persian Version of Brief Male Sexual Function Inventory: A Cross-Sectional Study. Sex Med 2021;9:100409.

The effect of sexual health education program on sexual function and attitude in women at reproductive age in Iran.

BACKGROUND: Female sexual dysfunction is a common and often distressing public health problem. This study aimed to determine the effect of the sexual health program on female sexual function and attitude in reproductive age in the west of Iran. MATERIALS AND METHODS: This was a field trial study. A total of 103 women attending health centers were assigned into two groups; an experiment and a control group. Data collection tool involved sociodemographic characteristics questionnaire, sexual female attitude questionnaire, and the Female Sexual Function Index (FSFI), which was completed by participants before and after the implementation of a sexual health education program. Data were analyzed using SPSS software version 22. RESULTS: The results revealed that after the intervention, female sexual function in the experiment group based on the FSFI tool was significantly improved (P < 0.01) in the domains of desire, arousal, orgasm, satisfaction, pain, and the total score compared with the control group. Besides, there was no significant difference between posttest mean score of sexual attitude in the experiment group and control group (P > 0.05). However, a significant difference was found in the mean score of sexual attitudes in the experimental group before and after the intervention (P = 0.004). CONCLUSION: The findings showed that sexual health program was effective in improving women's sexual function and attitude in the experiment group. It is recommended that the effect of other training methods remain to be addressed on women's sexual function and attitude.

The relationship between quality of life and methods of delivery: A systematic review and meta-analysis.

BACKGROUND AND AIM: Some physical, emotional and social changes arise in mothers during the postpartum periods which can affect the quality of life (QOL) of the mother and family. Given the importance of the quality of life in the postpartum period and its influencing factors such as method of delivery, the present study aimed at investigating the relationship between the quality of life and methods of delivery in the world, using a systematic review and meta-analysis method. METHODS: The present study is a systematic review and meta-analysis on the relationship between aspects of quality of life and method of delivery in the world conducted in Persian and English language articles published by the end of 2015. For this purpose, the databases of Medlib, SID, Scopus, ISI Web of Science, PubMed, Google scholar, Irandoc, Magiran and Iranmedex were searched using key words and their compounds. The results of studies were combined using the random effects model in the meta-analysis. Heterogeneity of studies was assessed using I2 index and Cochran test and data were analyzed using STATA Version 11.1 and SPSS Version 16. RESULTS: Based on the results of the meta-analysis of studies, the aspect of physical functioning had the highest quality of life mean score in women with vaginal delivery: 74.37 (95% CI: 67.7-81) and mental health had the highest QOL mean score in women with cesarean delivery: 65.8 (95% CI: 62.7-69). Also, based on the time elapsed since delivery, mental health had the highest mean score in less than 1 month, 2 months and 4 months' postpartum. Physical pain had the highest mean score 6 months after giving birth, and mental functioning in 8 months after giving birth. CONCLUSIONS: The results of the present meta-analysis showed that the mean scores for most dimensions of quality of life in women with vaginal delivery were higher than in women with cesarean delivery.

Maternal Health-Related Quality of Life and Its Predicting Factors in the Postpartum Period in Iran.

Background/Purpose. Postpartum period is accompanied by many physical, emotional, and social changes in women's health. The aim of this study was to examine the mothers' quality of life in postpartum period. In addition, it also sought to recognize the variables that predict their quality of life. Methods. This cross-sectional, descriptive study was undertaken among 380 women in 10 urban health centers in Ilam province in west of Iran. They were selected using proportional random sampling method. The SF-36 questionnaire was used to identify women's health-related quality of life (HRQoL). Data were analyzed using SPSS version 15. Results. Women who were employed, aged less than 30 years, had college degree, have no history of disease in pregnancy, and had given birth more than 3 months ago had higher quality of life scores. Independent predictors for lower physical HRQoL were being with history of disease in pregnancy; being with high school diploma or lower education; and giving birth less than 3 months ago. Also, independent predictor for lower mental HRQoL was being housewife. Conclusion. According to study findings, greater attention must be paid to providing postpartum healthcare for housewife and less educated women as well as those with history of disease in pregnancy.

Sleep disturbances and sexual function among men aged 45-75 years in an urban area of Iran.

BACKGROUND AND AIMS: Aging in men is associated with various physical and mental symptoms, including sleep problems and sexual dysfunction. The aim of this study was to determine the status of sleep disorders and sexual dysfunction in men aged 45-75 years in Ilam, Iran. MATERIALS AND METHODS: In this population-based cross-sectional study, 390 men aged 45-75 years were selected by cluster randomization in Ilam-Iran. Data were collected using 0-100 brief sexual function inventory and the sleep disorder questionnaires. RESULTS: Totally, 34.6% of men complained about sleep disorders: 17.4% about falling asleep, 12.8% about frequent nocturnal awakenings, 12.8% about waking up in the early hours in the morning and problem in falling asleep again, and 24.9% about fatigue and tiredness despite getting enough sleep. There was a significant relationship between all aspects of sexual function and the common problems related to sleep (p<0.001). The older, unemployed, illiterate men, those with inadequate income, those affected by chronic diseases, and/or urinary incontinence had significantly inferior sexual function compared with the others. CONCLUSION: According to the high prevalence of sleep disorders in men as well as its association with sexual dysfunction, adopting health measures in this regard is necessary.

Quality of life of postmenopausal women and their spouses: a community-based study.

BACKGROUND: Most women spend more than one-third of their lives after menopause. Due to physiologic changes in that period, menopause can cause a series of symptoms such as vasomotor symptoms, psychologic problems, and sexual dysfunction, which can affect the women's quality of life (QoL) and other family members, especially their spouse. OBJECTIVES: The present study aimed to determine the association between the QoL of postmenopausal women and their husbands. PATIENTS AND METHODS: This descriptive-inferential cross-sectional study was conducted according to the census of 2006 in Iran. A total of 400 postmenopausal women aging 50 to 59 years and their spouses in 80 cluster heads of Ilam City residents were selected and studied in collaboration with the Statistical Center of Iran. The required data were gathered using the short-form health survey (SF-36) questionnaire and demographic questionnaire developed by the researcher-trained interviewers. Data were analyzed by SPSS 18 through Kruskal Wallis test, Wilcoxon signed ranks test, and correlation. RESULTS: The participants' mean age was 54.2 ± 2.8 years for women and 61.1 ± 6.1 years for their spouses. More than half of the women (57%) and about one-third of men (32.8%) were illiterate. The employed educated women aging 50 to 54 years had a higher mean score of SF-36 domains. The difference in education was significant in all domains except for mental health. There was a significant difference in age in all domains except in general health. The mean score of all domains of QoL was significantly less in the illiterate men than in the literate ones (P < 0.05). The results of the present study showed a significant correlation (P < 0.05) between the couples' QoL, vasomotor symptoms, and aging. Spearman test showed a significant positive correlation in all domains of QoL between postmenopausal women and their spouses (correlation coefficient, 0.48-0.63). CONCLUSIONS: Based on the results of the present study and other performed studies in this regard, menopause, aging, vasomotor symptoms, and education had significant association with the QoL of postmenopausal women. The reduced QoL in postmenopausal women could eventually lead to the reduced QoL of their spouses. Therefore, it is necessary to plan for the education of these women and their husbands to broaden their understanding of the changes of menopause and ways to improve their QoL.

Predictors of health-related quality of life in postmenopausal women: a population-based study.

INTRODUCTION: There have been limited studies on quality of life and its predictors among postmenopausal women. Due to the importance of this subject in health promotion, this study was performed to assess quality of life and its predictive factors in postmenopausal women living in Ilam, Iran. METHODS: In this descriptive correlational study, 400 postmenopausal married women who aged 50-59 years old and lived in Ilam were recruited from 80 randomly selected clusters. The participants were interviewed by a female interviewer using the standard questionnaire of quality of life (SF-36). Data was analyzed by analysis of variance (ANOVA), student's t-test, and linear regression analysis in SPSS. RESULTS: Mean scores (standard deviation) of quality of life in 4 dimensions of physical functioning, general health, mental health, and vitality were 76.8 (19.2), 71.1 (29.2), 74.3 (18.8), and 73.1 (19.6), respectively (with possible range of 0-100). According to linear regression analysis, women with chronic diseases, vasomotor symptoms, or insufficient family income and divorced and widowed subjects had significantly lower scores in all the 4 dimensions of quality of life. Aging was associated with reduced quality of life only in physical functioning dimension (p < 0.001). Although in univariate analysis, quality of life was significantly lower among illiterate participants and those with more children and longer duration of menopause at least in one dimension, the differences were not found to be significant in linear regression analysis. CONCLUSION: Chronic diseases, vasomotor symptoms and insufficient income were strong predictors of all the 4 dimensions of quality of life of postmenopausal women. Therefore, interventions are necessary to improve quality of life and health among this group of individuals.