Urban Practice Areas Research Articles

Geographical Presence of Plastic Surgeons in Relation to Breast Surgeons in the United States for Breast Reconstruction.

Despite advancements in oncoplastic breast surgery, barriers to breast reconstruction remain, particularly in rural and suburban areas. We aimed to assess the presence of plastic surgeons performing breast reconstruction relative to breast surgeons or general surgeons performing breast cancer surgery within urban, suburban, and rural populations. Data were collected from the 2024 membership of the American Society of Breast Surgeons and American Society of Plastic Surgeons. Breast and plastic surgeons were totaled by state, and each breast surgeon's zip code was searched for proximity to a plastic surgeon performing reconstructive surgery within 10 or 20 miles. Zip codes were categorized by population density to determine surgeon distribution. There are 1.8 times more plastic surgeons than breast surgeons. In total, 14% of breast surgeons had no plastic surgeons within 10 miles and 7% had none within 20 miles, compared to 25% and 10% in 2018. In total, 43% of breast and plastic surgeons practice in urban areas, whereas only 25% of breast surgeons and 19% of plastic surgeons practice in rural areas. While access to breast reconstruction continues to improve, there are still disparities in rural areas. Efforts directed toward improving access to breast reconstruction in more rural areas should be pursued.

Implications for malaria transmission: a cross-sectional study on the bionomics and susceptibility of local malaria vectors in urban and periurban settings of Ndola district

ObjectivesTo assess vector behaviour and phenotypic resistance for effective vector control programming.DesignThis was a cross-sectional study.SettingThis study was conducted in the urban and periurban areas of Ndola district, Zambia.Participants/study unitsA...

Effect of Environmental Education on Public Recycling Behavior in Indonesia

Purpose: The purpose of this article was to examine effect of environmental education on public recycling behavior in Indonesia. Methodology: This study adopted a desk methodology. A desk study research design is commonly known as secondary data collection. This is basically collecting data from existing resources preferably because of its low cost advantage as compared to a field research. Our current study looked into already published studies and reports as the data was easily accessed through online journals and libraries. Findings: Recent research in Indonesia shows that environmental education significantly boosts public recycling behavior. Community workshops and interactive sessions have improved waste management practices in urban areas. These initiatives have increased recycling participation and enhanced public awareness. They also promote better waste segregation among households. Unique Contribution to Theory, Practice and Policy: Theory of planned behavior (TPB), social cognitive theory (SCT) & diffusion of innovations theory may be used to anchor future studies on the effect of environmental education on public recycling behavior in Indonesia. Practitioners are encouraged to design and implement tailored environmental education programs that leverage interactive and participatory learning techniques to foster recycling behavior. Policymakers should embed environmental education within formal education curricula and community outreach programs as a strategic tool to bolster recycling behavior.

Innovative Approaches by Non-State Actors in Household Waste Management in Mrican Village: Challenges and Opportunities

Household waste management in residential areas often faces significant challenges due to limited resources and minimal government intervention. This research explores innovative approaches applied by non-state actors in household waste management in Mrican Village, highlighting the challenges and opportunities arising from the Bendhung Lepen Community initiative. Using a qualitative research method with a case study approach, data was collected through in-depth interviews, participatory observation, and document analysis involving stakeholders such as community members, NGOs, and local government. This research emphasizes the urgency of implementing sustainable waste management practices in urban areas. The results of this study show that community-led waste management can be an innovation and a driver of neighborhood participation despite facing various obstacles, such as limited resources, community resistance, and weak collaboration with the local government. This study emphasizes the importance of the role of non-state actors in filling the void left by formal governance in waste management in residential areas. This research contributes significantly to the discussion on sustainable waste management in urban environments.

Evaluation of Effluent Quality Trends Before and After Filtration Through the Composite Filter from Shirere Wastewater Treatment Plant to River Isiukhu in Kakamega County, Kenya

The current stabilization ponds as wastewater treatment practices in urban areas have proven insufficient with continued discharge of untreated wastes into water bodies. Their challenge comes from inappropriate system selection and maintenance, improper design, construction mistakes, physical damage and hydraulic overload. Appropriate infrastructural technologies for waste removal that can be adopted in the drainage channels of effluents into water bodies are scarce. This study incorporates a reactor based composite filter of pumice and sand as an innovative approach for removing residual waste in effluents discharged from Shirere Wastewater Treatment Plant into River Isiukhu, Kakamega Municipality. The objective of the study was to evaluate the trend of effluent quality from Shirere wastewater treatment plant upto river Isiukhu before and after installation of composite granular filter. Effluents, drinking water from Shirere WWTP, Shikoye stream, River Isiukhu and protected spring along Shikoye stream, were collected using presterilized water sampling containers for microbial quality analysis at MMUST and KACWASCO laboratories. The measurements were carried out using UV-VIS spectrophotometer at 752 nanometer wavelengths. Research design was experimental. The average reduction of COD in the mid-season of June to August was 42.2 ±4.6%, being the highest. Concomitantly, the BOD removal by the filter in the season of June to August was19.6±7% and 15.6 ±3.5% for September to November. The average rate of TSS removal in June to August was 19.3±4.5% followed by 16.6±3.8% in September to November and 11.6±7% in March to May. The average rate of Nitrate removal in June to August was 41.8±7.6% followed by 30.0±2.2% for March to May and 25±8.6% for September to November. Phosphates had an average rate of removal in June to August at 31.9±2.7% followed by 20.6±4.8% for September to November and 20.0 ±4.3% for March to May. Specifically, for the first season of March – May 2021 at 200 mm filtration depth were carried out at effluent flow rate of 0.0032 and volume, 0.234 Concentrations of most parameters were above NEMA standards, like COD was 322mg/l yet maximum should be 100 mg/l. Therefore, it was concluded that silica pumice composite filter performance was achieved by big variations in the concentrations of COD, BOD, TSS, Phosphates and Nitrates at Shirere WWTP after filtration which was attributed to effective removing capacity. The effluent concentrations from sampling sites S1-S3 and S5-S7 were found to be above the NEEMA standards implying the high risk of using Isiukhu water and catchment area. Thus, this study recommended that, the composite filter reduced concentrations of all the parameters (COD, BOD, TSS, PO3, NO3) significantly from Shirere WWTP along Shikoye stream up to the confluence of river Isiukhu. Most of the parameters after filtration were ranging within the required standards of NEMA. The requisite measure of adopting new technology of composite filtration should be sustained.

Penerapan Sistem Hidroponik sebagai Upaya Mendorong Pertanian Berkelanjutan bagi Warga Kelurahan Nginden Jangkungan

Land scarcity in urban areas encourages people to look for efficient alternatives to plant cultivation. Hydroponics, as a soil-free cultivation technique, offers a potential solution. This activity aims to carry out socialization and training on hydroponics to improve knowledge and skills in independent plant cultivation that can support household food security in urban communities. The method used was socialization and hands-on practice of making simple hydroponic systems. The results of the socialization and training showed a significant increase in participants' knowledge of the principles of hydroponics. The evaluation percentage is 78% of residents of Nginden Jangkungan sub-district, Sukolilo sub-district, Surabaya city are able to independently apply the Hydroponic system in the yard of each house and can take economic benefits from farming through the hydroponic system, but in the application of this hydroponic system requires high production costs, so that people pay more attention to the use of input allocations used to get more added value. Hydroponics is one of the sustainable agricultural efforts in urban environments that have limited land with the introduction of hydroponic systems, socialization, and application practices in urban areas that have been implemented.

Can local food become an inclusive practice in urban areas? A community provisioning systems approach

In the context of crises such as the pandemic and the war in Ukraine, local food systems have emerged as a potential solution to the challenges of food sovereignty and sustainability. However, the adoption of local food as a widespread practice remains limited. The aim of this research is to identify the drivers that could lead to the widespread adoption of local food systems as an inclusive practice in urban areas. We adopt a systemic approach to analyze the dynamics of supply systems and communities in a city within the Paris region, combining geographic, ethnographic, and documentary data. Our findings reveal a tentative practice and a gap between the supply and the population’s usage patterns. Our research highlights how food behaviors are embedded within interacting systems. It calls on public authorities to make local food systems a significant focus for large-scale distribution and urges the economic sphere to rethink its business models and value chains.

Inappropriate antibiotic access practices at the community level in Eastern Ethiopia

Access to antibiotic medications is critical to achieving the Sustainable Development Goal for good health and well-being. However, non-prescribed and informal sources are implicated as the most common causes of inappropriate antibiotic access practices, resulting in untargeted therapy, which leads to antibiotic resistance. Hence, knowing antibiotic access practices at the community level is essential to target misuse sources. In this study, 2256 household representatives were surveyed between July and September 2023 to examine their antibiotic access practices. Of 1245 household members who received antibiotics, 45.6% did so inappropriately. Non-prescribed antibiotic access was more common among urban residents and individuals not enrolled in health insurance schemes. This means of antibiotic access was also more common among individuals concerned about distance, drug availability, and healthcare convenience at public facilities. In addition, women and rural individuals were more likely to get antibiotics from unauthorized sources. Unrestricted antibiotic dispensing practices in urban areas enabled their non-prescribed access, while unlicensed providers prevailed with this access practice in rural areas. In this regard, personal behaviors and healthcare-related gaps such as the lack of health insurance, inconvenience, and drug unavailability have led community members to seek antibiotics from unofficial and non-prescribed sources. Targeting the identified behavioral and institutional factors can enhance antibiotic access through prescriptions, hence reducing antibiotic resistance.

Cultural stewardship in urban spaces: Reviving Indigenous knowledge for the restoration of nature

Abstract Relationships to nature are important for the health and well‐being of peoples globally and should be actively protected. Indigenous Māori people in Aotearoa New Zealand recognize this important relationship to nature through narratives of lineage and express this through concepts such as kaitiakitanga; a cultural place‐based practice of stewardship that intertwines relationships of responsibility between people, nature and culture. However, many Māori now live outside of tribal areas in urban settings, putting relationships with nature into question. We asked how urban Māori people practice kaitiakitanga, and what factors might predict flourishing relationships with nature. We surveyed 214 urban Māori who shared their perceptions of kaitiakitanga, cultural practices and restoration activities. The data were analysed by identifying qualitative themes and using linear mixed effect models. Māori who were exposed to kaitiakitanga as children were more likely to attend marae and family restoration activities, and less likely to attend events led by local councils. Pressingly, young people in urban areas were more at risk of losing cultural knowledge and opportunities to practice cultural practices in urban areas. Age, distance from tribal area and early exposure all affected decision‐making and expression of kaitiakitanga in urban areas. Knowledge associated with kaitiakitanga can create inclusive and effective urban restoration activities. We suggest that partnership between Māori groups including local marae, and local councils, may provide accessible, best practice urban restoration models that attract local Māori and act to support cultural knowledge, in turn encouraging diverse pathways to nature restoration to develop in urban areas. Likewise, such partnerships will ensure that Māori in cities are supported to express and maintain cultural knowledge and practice into the future. Read the free Plain Language Summary for this article on the Journal blog.

Hall technique in children: A cross-sectional survey among Indian pedodontists

Background: Stainless steel crowns are considered to be a practicable alternative in the restoration of carious primary tooth. This study was done to assess Indian pediatric dentists’ knowledge, attitude, and practice of this technique and related factors with the use of the Hall technique (HT). Methods: A well-structured preused online questionnaire was sent to pedodontists practicing in India through various social media groups and emails. Descriptive statistics were used to characterize survey responses. A Chi-square test was employed to check the distribution of responders using the HT. Statistically P < 0.05 or less was considered statistically significant. Results: A total of 210 pedodontists participated in this survey. 66.20% of the participants have <10 years’ experience; majority of the participants are in private clinical practice in urban areas. 97.14% of Indian pedodontists are aware of HT, and 22.54% regularly practice HT. 37% of the participants has apprehension of change in vertical dimension due to ooclusal changes and 35% of the participants fear of pulpal damage due to Hall technique. A significant number of pedodontists who have passed master of dental surgery (MDS) in pediatric and preventive dentistry <10 years ago (P = 0.034*), those from academic institutions (P = 0.048*), and those from urban areas (P = 0.045*) practice HT. Conclusion: A substantial proportion of the respondents were familiar with the HT, but considerably less number of participants use it regularly in clinical practice. There is a scope for increased practice of this technique so that the children in need of treatment of multisurface carious lesions can benefit.

Analysis of Vehicle Emission Policies and Electric Vehicle Incentives on Air Pollution and Sustainable Transportation Use in Jakarta, Indonesia

This research investigates the impact of vehicle emission policies and electric vehicle incentives on air pollution perceptions and sustainable transportation use in Jakarta, Indonesia. Through a quantitative analysis employing structural equation modeling, survey data from diverse stakeholders are analyzed to assess the relationships between key variables. Findings indicate significant associations between stringent vehicle emission policies, electric vehicle incentives, lower air pollution perceptions, and increased sustainable transportation use. These results underscore the importance of comprehensive policy measures in promoting environmental sustainability and fostering sustainable transportation practices in urban areas.

Prevalence of motorcycle accidents among food delivery drivers and its relation to knowledge, attitudes, and practices in urban areas in Bangkok, Thailand.

Food delivery drivers are at increased risk of motorcycle accidents every year. This study investigated the prevalence of motorcycle accidents among food delivery drivers related to the knowledge, attitudes, and practices in urban areas in Bangkok, Thailand. This was a cross-sectional online survey on motorcycle accidents was distributed among food delivery drivers in urban areas in Bangkok, Thailand from February-March 2023. The study involved 809 participants aged 18 years. A binary logistic regression was conducted to test the association between variable factors and motorcycle accidents, and a Spearman's analysis was employed to test the correlations between motorcycle accidents and knowledge, attitude, and practice scores. The study found the prevalence of accidents associated with food delivery drivers was 284 (35.1%). The results of the binary logistic regression analysis found that those who drive on an average of more than 16 rounds per day were significantly associated with motorcycle accidents (OR = 2.128, 95%CI 1.503-3.013), and those who had followed improper driving practices were significantly associated with motorcycle accidents (OR = 1.754, 95%CI 1.117-2.752). The correlation analysis found the knowledge score positive significantly with the practice score (r = 0.269, p-value < 0.01) and the attitudes score positive significantly with the practice score (r = 0.436, p-value < 0.01). This study shows the knowledge level correlated with the practice score regarding such accidents. Therefore, our study needs more longitudinal study to identify which variable factors influence motorcycle accidents among FDDs. The current study suggests that the management of traffic safety on urban roads is significantly affected by food delivery services. Thus, this study can be used as baseline data to devise systematic measures to prevent motorcycle crashes of food deivery workers.

Infant and Young Child Feeding (IYCF) Practices in Rural and Urban Regions of Indonesia

Background. The global strategy on infant and child feeding recommends the best pattern of feeding for infants and young child feeding (IYCF) from birth to 24 months. Practices of proper feeding of children up to 2 years of age contribute to a child’s survival, growth, and development because they can prevent micronutrient deficiencies, morbidity, and obesity in later life. This study aims to determine the risk factors for the failure of IYCF practice in urban and rural Indonesia. Materials and Methods. The study used Indonesia Demographic and Health Survey (IDHS) 2017 data with a cross-sectional research design. The sampling technique used systematic probability proportional to size sampling. The number of samples was 4,869 children consisting of 2,424 children in urban and 2,445 children in rural. Bivariate analysis using chi-square test. Multivariate analysis using multivariate logistic regression. Results. The study found that most of the children in urban (79.3%) and rural (97.2%) did not practice IYCF under the recommendations. There is a difference in the proportion of IYCF practices between urban and rural areas (p &lt;0.001). The risk factors for the failure of IYCF practice in urban areas are socioeconomic, maternal age, and age at first marriage. The poorest socioeconomic is at risk of 2.4 times, maternal age &gt; 35 years are at risk of 1.5 times, age at first marriage is less than 21 years at risk of 2.1 times carrying out IYCF practices not according to recommendations compared to the comparison group. The risk factors for the failure of IYCF practice in rural are socioeconomic, maternal education, quantity, and quality of antenatal care (ANC). The poorest socioeconomic is at risk of 2.1 times, mothers with primary education are at 1.5 times, the quantity of ANC is not good at risk at 1.9 times, the quality of ANC is not good risk at 1.5 times practicing IYCF is not according to the recommendations compared to the comparison group. Conclusion. The practice of IYCF in Indonesia starting from giving early breastfeeding initiation, exclusive breastfeeding, and complementary feeding according to recommendations is still low. The priority of IYCF intervention through education and assistance to pregnant women needs to be a sustainable program.

Solutions for Addressing the Dermatologist Shortage in Rural Canada: A Review of the Literature.

In Canada, there is a maldistribution of dermatologists, with as many as 5.6 dermatologists per 100,000 population in urban areas and as low as 0.6 per 100,000 in rural areas. Considering trends of dermatologists to work in group practices in urban areas, and the low number of rural dermatologists, one solution may be to incentivize dermatologists to practice rurally. Several solutions using the following themes are discussed: dermatology program-specific incentives, dermatology practice-specific incentives, and other indirect incentives. The low number of dermatologists in rural areas in Canada is concerning and has negative consequences for access to care for patients in rural areas, ultimately resulting in worse patient outcomes. Future research is needed to evaluate the impact of these initiatives and assess future access to dermatological care.

Assessing the Microbial Contamination Levels in Milk Samples from Rural and Urban Areas: A Focus on Raisen and Bhopal Districts

AbstractThis study aimed to assess the level of microbial contamination in raw cow milk samples collected from farms in rural and urban regions of Raisen and Bhopal districts, Madhya Pradesh, India. Recent data are gathered to investigate the microbial quality of the milk samples directly, rather than relying on reported findings from other sources. The results reveal that both rural and urban milk samples exhibit significantly higher bacterial colony counts compared to acceptable limits for total viable count. The average total viable count for urban samples is 8.699 log CFU mL−1, with a standard deviation of 0.821 log CFU mL−1, using a sample size of 1 mL. Moreover, urban samples show a higher initial incubation count (8.728 ± 0.431 log CFU mL‐1), indicating potential unsanitary milk handling practices in urban areas. In contrast, rural milk samples demonstrate significantly lower bacterial counts (8.0778 ± 0.079 log CFU mL−1) and exhibit superior laboratory sanitization measures. Enteric bacteria such as Escherichia coli, Enterobacter species, Klebsiella species, and Shigella are found in both urban and rural milk samples after isolation. However, strains of bacterial culture specific to Pseudomonas and Salmonella species are exclusively detected in urban samples, suggesting a higher contamination level in urban areas compared to rural regions. These findings highlight the urgent need for improved milk production and handling practices in both rural and urban areas, particularly in urban settings where the contamination levels are found to be significantly higher. The results of this study contribute to the understanding of microbial quality in raw cow milk and emphasize the importance of implementing appropriate interventions to ensure the safety and quality of milk consumed by the population.

A study on nutritional status of preschool children and knowledge with special references to breastfeeding practice in urban area

Background: The nutritional status of preschool children is a critical indicator of their overall health and development. Breastfeeding provides best start of life to babies as well as improves the health of mothers and babies. Objectives were to assess the nutritional status of preschool children and to Investigate the impact of breastfeeding practices on children’s nutritional outcomes and breastfeeding practices of their mothers. Methods: This cross-sectional study was conducted in an urban slum area and involved a sample of preschool children aged 3 to 6 years. Complete enumeration of children of 3-6 years age group was done. Nutritional status was assessed through anthropometric measurements, including height, weight and mid upper arm circumference. Data on breastfeeding practices were collected through structured interviews. Data was analysed using MS excel and chi-square statistical tests was applied. Results: There were 334 study participants of which 7.5% had stunting and 62.87% were underweight. It was found that 18.56% had history of low birth weight. 90.12% were exclusively breastfed and breastfeeding was continued up to 2 years for 28.14% and more than 2 years for 71.86% children. It was also found that history of low birth weight of children is significantly associated with malnourishment (p≤0.05). Conclusions: The study revealed that a substantial proportion of preschool children in the urban area were experiencing malnutrition. The breastfeeding practices were fair among the mothers of the children. Targeted education and awareness programs to enhance the nutrition can improve the overall health of preschool children in the urban setting.

Envisioning sustainable sanitation planning: a unified approach of diffusion of innovation and theory of planned behavior in predicting ecosan toilet adoption in Arba Minch City, Ethiopia

This study explores the adoption of ecological sanitation (ecosan) toilets in Arba Minch City, Ethiopia, using an integrated approach combining the diffusion of innovation (DOI) model and the Theory of Planned Behavior (TPB). The research aims to understand the complex associations between DOI variables (relative advantage, complexity, compatibility, trialability, and observability) and TPB constructs (attitude, subjective norm, and perceived behavioral control) in predicting residents’ behavioral attitudes and intentions. Applying Structural Equation Modeling (SEM) and bootstrapping techniques, the study investigates direct and indirect effects, offering a comprehensive analysis of the adoption process. The objectives include examining the influence of TPB and DOI constructs on residents’ intentions, unraveling direct and indirect effects on these intentions, and investigating variations among users of different toilet types in the city. The result of the study shows that attitude and perceived behavioral control are central to shaping intentions, aligning with TPB principles. Contextual factors like compatibility, relative advantage, and trayability reveal nuanced insights, deviating from conventional patterns. The study identifies attitude as a key moderator between DOI constructs and behavioral intention, enriching our understanding of the adoption process. In conclusion, the integrated DOI and TPB model provides nuanced perspectives on factors influencing behavioral attitudes and intentions toward ecosan toilet adoption. The crucial roles of perceived behavioral control and attitude underscore the importance of tailored interventions. The study’s insights are relevant for policymakers, practitioners, and development organizations working on sustainable sanitation practices in urban areas, contributing to broader sustainable development objectives.

Social literacy practices of Afghan and Somali refugees in a transitional setting

The purpose of this paper is to explore the social literacy practices of Afghan and Somali refugees in a transitional context. Although refugees have been the subject of previous research in various domains, our understanding of their literacy practices in urban areas, particularly in Malaysia, is still limited. The lack of literacy research in this setting exposes a gap in the current literature aimed at better understanding refugee literacy practices in a transitional situation. Thus, this study examines urban refugee literacy experiences via the lens of literacy as a social practice. It was exploratory in nature and used a qualitative methodology. Face-to-face interviews with four refugees were conducted at two community centres to collect primary data. In addition, field notes based on community centre visits provided by the participants were used as a secondary data source in the study to understand the literacy experiences of the participants better. The findings indicated that participants enacted literacy practices in their transitional setting for three primary purposes: to increase their funds of knowledge, to enact personal agency, and for community building. These results challenge the stereotype that refugees are powerless and highlight avenues or ways in which refugee communities can be supported in a transitional context.

Practice of Family Planning Methods by the Eligible Couple in the Rajshahi City Corporation Area

This study investigates family planning practices among eligible couples in the urban setting of Rajshahi City Corporation, Bangladesh. The research aims to determine the prevalence and demographic factors associated with family planning, as well as the types and sources of family planning methods, decision-making processes, and challenges faced. Data was collected through a cross-sectional study, with 300 eligible couples participating. The findings reveal a commendable prevalence of family planning practices (88.0%) in the area, reflecting accessible and effective reproductive health services. Notably, a significant association was found between the sex of respondents and family planning practices (χ²= 25.549, p&lt;0.001), with a higher percentage of females (88.2%) actively practicing family planning. Female partners played a central role in decision-making, and small family sizes with shorter age gaps between children were observed. Challenges related to side effects (87.2%) and method-related problems highlighted the need for targeted interventions. Enhancing awareness and education programs, strengthening counseling services, and promoting male involvement. Collaboration with NGOs and healthcare providers is suggested to improve family planning services in urban settings, contributing to healthier demographics in Rajshahi City Corporation. These significant statistics underscore the importance of tailored strategies to enhance family planning practices in urban areas.

Micro-scale transformations in sustainability practices: Insights from new migrant populations in growing urban settlements

Micro-scale transformations in sustainability practices: Insights from new migrant populations in growing urban settlements