Urban Public Health Research Articles

Generating Realistic and Representative Trajectories with Mobility Behavior Clustering.

Accessing realistic human movements (aka trajectories) is essential for many application domains, such as urban planning, transportation, and public health. However, due to privacy and commercial concerns, real-world trajectories are not readily available, giving rise to an important research area of generating synthetic but realistic trajectories. Inspired by the success of deep neural networks (DNN), data-driven methods learn the underlying human decision-making mechanisms and generate synthetic trajectories by directly fitting real-world data. However, these DNN-based approaches do not exploit people's moving behaviors (e.g., work commute, shopping purpose), significantly influencing human decisions during the generation process. This paper proposes MBP-GAIL, a novel framework based on generative adversarial imitation learning that synthesizes realistic trajectories that preserve moving behavior patterns in real data. MBP-GAIL models temporal dependencies by Recurrent Neural Networks (RNN) and combines the stochastic constraints from moving behavior patterns and spatial constraints in the learning process. Through comprehensive experiments, we demonstrate that MBP-GAIL outperforms state-of-the-art methods and can better support decision making in trajectory simulations.

The relation between proximity to and characteristics of green spaces to physical activity and health: A multi-dimensional sensitivity analysis in four European cities

IntroductionNon-communicable diseases are the global disease burden of our time, with physical inactivity identified as one major risk factor. Green spaces are associated with increased physical activity of nearby residents. But there are still gaps in understanding which proximity and what characteristics of green spaces can trigger physical activity. This study aims to unveil these differences with a rigorous sensitivity analysis. MethodsWe gathered data on self-reported health and physical activity from 1365 participants in selected neighbourhoods in Porto, Nantes, Sofia, and Høje-Taastrup. Spatial data were retrieved from OpenStreetMap. We followed the PRIGSHARE guidelines to control for bias. Around the residential addresses, we generated seven different green space indicators for 15 distances (100–1500 m) using the AID-PRIGSHARE tool. We then analysed each of these 105 green space indicators together with physical activity and health in 105 adjusted structural equation models. ResultsGreen space accessibility and green space uses indicators showed a pattern of significant positive associations to physical activity and indirect to health at distances of 1100 m or less, with a peak at 600 m for most indicators. Greenness in close proximity (100 m) had significant positive effects on physical activity and indirect effects on health. Surrounding greenness showed positive direct effects on health at 500–1100 m and so do green corridors in 800 m network distance. In contrast, a high quantity of green space uses, and surrounding greenness measured in a larger radius (1100–1500 m) showed a negative relationship with physical activity and indirect health effects. ConclusionsOur results provide insight into how green space characteristics can influence health at different scales, with important implications for urban planners on how to integrate accessible green spaces into urban structures and public health decision-makers on the ability of green spaces to combat physical inactivity.

Variations of pollen concentration in urban alleys of park city and the transmission pattern during the period of high allergenic risk: Taking Qingyang District of Chengdu City as an example.

Pollen (spores and pollen) allergy caused by green areas is one of the most serious environmental epidemics endangering urban public health. The pollen allergy rate in China reached 17.8% in 2022, characterized by a wide age range of onset, severity and diversity of symptoms. The aims of this study were to verify the consistency of the prediction results of pollen concentration and the index of allergenicity of urban green zones (IUGZA) equation, and to clarify the dispersal pattern of tree pollen in the urban alleys of cities with high density of static wind. We selected representative high, medium and low allergenic areas based on the allergenic stress in urban alleys of Qingyang District, Chengdu calculated by IUGZA equation, and monitored the pollen concentrations by selecting points and indicator species within the three allergenic areas. There was a consistency in the variation of pollen concentration in urban alleys of the three areas, with the highest pollen concentration in March. Mean pollen concentration showed a pattern of spring > autumn > summer > winter. The main pollen sources belonged to Ginkgo, Platanus, Firmiana and Cedrus, accounting for 42.4%, 16.3%, 9.0% and 6.5% of the total pollen, respectively. Wind speed had the greatest effect on pollen concentration and its dispersal distance in the urban alley. The horizontal dispersal distance of pollen was up to 260 m, and the number of pollen showed a significant negative linear correlation with the distance away from the pollen sources. The concentration of exotic pollen collected at the high site (4.5 m above ground) was much lower than that at the near-ground site (1.5 m above ground), but without difference in the types of pollen. The results of allergenic risk predicted by the IUGZA equation were consistent with the actual measured pollen concentration, which could be used in high-density static wind city.

Güney Kore Yerel Yönetiminin Halk Sağlığı ve Sağlıklı Kent Planlama Politikalarının COVID-19 ile Mücadelede Etkisi

COVID-19, which spread all over the world and hit economies hard, caused great damage to the global system. States have tried many ways to overcome the COVID-19 virus using cutting-edge technologies, including quantum computers and artificial intelligence. However, considering the rate of the spread of the COVID-19 virus in states, rather than new technologies, the effectiveness of local governments has emerged. Compared to central governments, local governments have the capacity to effectively manage major crises because they are shaped more in line with the wishes of the people and have the capacity to produce faster solutions. When the local government structure of South Korea is examined, it will be seen that the technological advantage of South Korea progresses in harmony with the local government style and helps to effectively fight against COVID-19. The article analyses the impact of the structural and historical background of local governments in South Korea in the fight against COVID-19, and the contributions of local governments to urban planning and public health, and their roles in combating COVID-19. A qualitative method is used in this study and the aim of the study is to investigate the contributions of local governments in terms of urban planning and public health in combating COVID-19, based on the example of the South Korean local government.

Opportunities and challenges in delivering maternal and child nutrition services through public primary health care facilities in urban Bangladesh: a qualitative inquiry

BackgroundPublic primary health facilities are an important source of nutrition services for the urban areas in Bangladesh. We aimed to understand the challenges and facilitators of delivering maternal and child nutrition services through public sector from the perspectives of the users and service providers.MethodThe study was conducted in selected public primary health care facilities and their catchment area in Dhaka city from April-July 2019. We carried out 15 free listing exercises and 43 semi-structured interviews (SSI) with pregnant women and mothers of 0–24 months old children; 6 key informant interviews (KII) with facility managers and healthcare providers; and observed service delivery in 8 health facilities.ResultsFindings reveal that public primary health facilities address some economic and cultural barriers to access such as cost and provision of female service providers for maternal and child health services but challenges such as distance, waiting time, and cleanliness remained. In terms of service provision, there were gaps in provision of anthropometric measurement and counseling, and healthcare providers had inadequate training and therefore, knowledge of nutrition. The low priority given to nutrition services during program design hampered the delivery of nutrition services provided through urban public sector health facilities.ConclusionsThere were important gaps in terms of service provision and capacity of healthcare providers, and therefore, the quality of nutrition service provided through public primary health care facilities. To maximize the coverage of quality nutrition services in the urban areas, it is important to think through the design of nutrition service delivery and allocate adequate resources to fill the material and capacity gaps.

Associations between vacant urban lands and public health outcomes in growing and shrinking cities

Vacant urban land, although not officially designated as a green space, often exhibits a semi-wild natural state due to being left open to colonization by nature. Attention to the effects of vacant urban land on human health has increased due to both rising urban vacancy rates and non-communicable diseases (NCDs). However, relationships between many vacant land characteristics (such as vegetation coverage, size, duration, and location) and NCDs have not been comprehensively examined, especially comparing shrinking (depopulating) and growing (populating) cities. This study evaluates St. Louis, MO (shrinking), and Los Angeles, CA (growing) to explore these relationships using ordinary least squares (OLS) interaction analysis with a moderator approach. Results show that associations between vacancy rate, duration, location, and NCDs differ significantly between city types. Vegetation coverage and size are associated with specific NCDs, but there are no differences between city types. Unlike the largely dilapidated vacant lands in the shrinking city, which tend to harm public health, vacant lots in the growing city were more functional green spaces that can, in some cases, even mitigate NCDs. Interestingly, In St. Louis, the shorter the average duration of the vacant land, the greater the risk of NCDs in a shrinking city. This is because vacant land can be contagious to nearby lots if not treated, leading to more newly emerged vacant lands and reducing the average duration of vacant land. In such cases, census tracts with the lower duration of vacant lands in St. Louis tend to be areas facing persistent environmental degradation and high public health threats. Regarding location, vacant lands near industrial areas were linked to negative health outcomes in the Los Angeles (growing), while those near single-family and commercial areas posed higher risks of NCDs in the St Louis (shrinking). The findings aid decision-making for land supply regulation and regeneration as well as urban green space management to promote human health and well-being.

Long-Term Assessment of Bioclimatic Conditions at Micro and Local Scales in the Cities of the Western Part of the Balkan Peninsula during the 21st Century

Thermal comfort assessments at local or micro-scales within urban areas can provide crucial insights for the urban adaptation strategies pertaining to climate-conscious urban planning and public health. However, the availability of long-term or mid-term daily or hourly meteorological data sets from urban environments remains a significant challenge even in the 21st century. Consequently, this study aimed to assess the thermal conditions in cities across the western part of the Balkan Peninsula, encompassing five countries (Slovenia, Croatia, Serbia, Bosnia and Herzegovina, and Montenegro), by utilizing the Physiological Equivalent Temperature (PET) index. Meteorological data sets, comprising air temperature, relative humidity, wind speed, and cloudiness, were collected from 32 national meteorological stations/measurement locations spanning the period from 2001 to 2020. The PET calculations were conducted based on meteorological data measured three times per day (7 a.m., 2 p.m., and 9 p.m.). Upon conducting a spatial analysis of the meteorological stations, it was observed that most of them (25 stations) were situated within built-up areas or urban suburbs, rendering them highly relevant for local or micro-scale climate and bioclimate assessments. The findings revealed that urban locations exhibited slightly higher PET heat stress levels, particularly during the summer season and at 2 p.m. Moreover, higher average PET values were observed in both urban and non-urban stations situated within a continental climate during warmer periods, such as summer. In contrast, during the colder seasons, namely winter and spring, higher PET values were prevalent in the Mediterranean region. Furthermore, the PET frequency analysis revealed a greater prevalence of extreme and severe heat stress levels in stations within continental climates, particularly those located in urban areas, as compared to stations in Mediterranean climates. In contrast, during the winter and spring seasons, monitoring stations in close proximity to the Adriatic Sea, characterized by a Mediterranean climate, exhibited significantly lower levels of cold stress compared to inland stations. Evidently, in addition to the climatic characteristics and surrounding terrain, the urban morphology significantly impacts the thermal conditions within cities.

5.E. Workshop: Salutogenic Cities: European experiences in Urban Health

Abstract The Workshop titled “Salutogenic Cities: European experiences in Urban Health” - proposed and developed by the three EUPHA Section: Urban Public Health (URB), Public Mental Health (MEN) and Environmental Health (ENV) - is aimed to foster the dialogue between designers (architects and urban planners), Public Health experts (operators, professionals and epidemiologists), policy/decision makers and city users, to establish a multidisciplinary approach for understanding together how to create and manage healthy living outdoor urban environments. The Workshops mainly address both the “Climate emergency / Environment and health / Urban health” and the “Global health and Europe's role in global health” EPH23 conference topics. The Workshops purpose is to explore the link between the morpho-typological features of the urban environment and Public Health outcomes, that's crucial in the scientific scenario, taking into consideration the urbanization phenomena that characterizes contemporary society. Health is no longer a specifically individual health issue, but a collective priority strongly influenced by the environmental context and by strategies implemented by local Governments. Urban planning, at large and small scales, can be considered a key tool to protect and promote Urban Public Health. In this scenario, the COVID-19 emergency, has accelerated and emphasized several social, environmental and digital challenges, underling the focus on several aspects such as Urban mobility and walkable environment; Urban Green Spaces and ecosystem services assessment; Urban Health policies and actions. The Workshops program include inputs which they argue current experiences, emerging practices and scientific outcomes related to the Urban Health discipline. From methods, in “Improving health and wellbeing through health-centered, evidence-based urban planning methodologies” to actions, in “The urban burden of disease estimation for policy-making in 1000 European cities”. From epidemiological outcomes, in “Association between area-level walkability and glycated haemoglobin: a Portuguese population-based study” to hospitalizations implications, in “Daily temperature variability in cities and mental health-related hospitalizations”. Key messages • Explore the link between the morpho-typological features of the urban environment and Public Health outcomes, taking into consideration the urbanization phenomena that affect the contemporary society. • Establish a multidisciplinary approach for understanding together how to create and manage healthy living outdoor urban environments.

11.E. Workshop: Healthy Buildings: interdisciplinary perspectives

Abstract The Workshop titled “Healthy Buildings: interdisciplinary perspectives” - proposed and developed by the three EUPHA Section: Urban Public Health (URB), Public Mental Health (MEN) and Environmental Health (ENV) - is aimed to foster the dialogue between designers (architects and urban planners), Public Health experts (operators, professionals and epidemiologists), policy/decision makers and buildings’ users, to establish a multidisciplinary approach for understanding together how to create and manage healthy living indoor environments (both housing and complex constructions/public buildings). The Workshops mainly address both the “Climate emergency / Environment and health / Urban health” and the “Mental health” EPH23 conference topics. The Workshops purpose is to explore the relationship between housing conditions, Indoor Environmental Quality, and Mental Health implications on human well-being. In fact, time spent at home and in the indoor environment increased due to the recent COVID-19 lockdown period, and social-sanitary emergencies are expected to grow due to the urbanization phenomenon. Thus, the role of the physical environment in which we live, study, and work, has become of crucial importance, as the literature has recently highlighted. The Workshops program include inputs which they argue current experiences, emerging practices and scientific outcomes related to the Urban Health discipline. From Sustainable Development Goals framework, in “Urban environment, unhealthy buildings as a root of inequalities and importance of SDGs”, to Indoor Environmental Quality implications, in “Can housing conditions and features affect well-being? A review through Indoor Environmental Quality aspects and Mental Health implications”. From experience-based works related to specific functions, in “Can the built environment impact on the health and well-being of people with dementia? Evidence from Literature and Stakeholders Involvement”, to Indoor Air Quality emerging issue, in “Buildings, air quality and mental health conditions: a review of intervention studies”. Key messages • Explore the relationship between housing conditions, Indoor Environmental Quality, and Mental Health implications on users well-being. • Establish a multidisciplinary approach for understanding together how to create and manage healthy living indoor environments (both housing and complex constructions/public buildings).

Unplanned urbanization and health risks of Dhaka City in Bangladesh: uncovering the associations between urban environment and public health.

Dhaka City, the capital of Bangladesh, has experienced rapid and unplanned urbanization over the past few decades. This process has brought significant challenges to public health as the urban environment has become a breeding ground for various health risks. Understanding the associations between unplanned urbanization, the urban environment, and public health in Dhaka City is crucial for developing effective interventions and policies. This review paper aims to uncover the associations between unplanned urbanization and health risks in Dhaka City, with a specific focus on the urban environment and its impact on public health. The objectives of this study are to examine the health challenges faced by the city's population, explore the specific urban environmental factors contributing to health risks, analyze the socioeconomic determinants of health in unplanned urban areas, evaluate existing policies and governance structures, identify research and data gaps, and provide recommendations for future interventions. A comprehensive literature review was conducted to gather relevant studies, articles, reports, and policy documents related to unplanned urbanization, the urban environment, and public health in Dhaka City. Various databases and online resources were searched, and the selected literature was critically analyzed to extract key findings and insights. The findings reveal that unplanned urbanization in Dhaka City has led to a range of public health risks, including air pollution, inadequate water and sanitation, poor waste management, overcrowding, slums, and substandard housing conditions. These environmental factors are strongly associated with respiratory diseases, waterborne illnesses, and other adverse health outcomes. Socioeconomic determinants such as poverty, income inequality, and limited access to healthcare further exacerbate the health risks faced by the urban population. Unplanned urbanization in Dhaka City has significant implications for public health. Addressing the associations between unplanned urbanization, the urban environment, and public health requires comprehensive policies and interventions. Improved urban planning, enhanced infrastructure, and better policy governance are essential for mitigating health risks. Furthermore, addressing socioeconomic disparities and ensuring equitable access to healthcare services are crucial components of effective interventions.

A THEMATIC REVIEW ON RELATIONSHIP BETWEEN RECOVERY PERCEPTION TOWARDS PLACE ATTACHMENT IN URBAN ENVIRONMENT

Place attachment is often seen as a resource for coping with health recovery, especially in the post-pandemic period. The purpose of this review was to systematically review the variables, research frameworks, and interactions related to place attachment and recovery perceptions. This paper reviewed 53 papers from 2020 to 2023 on place attachment and recovery perception using ATLAS.ti. Existing research confirms that there are differences in the degree of attachment and recovery in different types of urban environments. This paper encourages the integration of information between different disciplines, such as urban planning specialists, environmental psychologists, and public health experts, to further improve the urban environment.

GIS-Based Interactive Technology in Demographic Record Management and Mapping Towards Sustainable Community

Management of demographic records plays a vital role in understanding and planning for the needs of community living. However, managing conventional records requires more time, cost, and energy without accurate assurance. As there are raising concerns in assessing community information for charity purposes, safety coordination, and crime prevention, especially during emergencies; integrating demographic data with spatial information is becoming significantly important. This paper aims to establish an accessible and visible digital platform of demographic information for respective sectors, namely, the KRT, Qariah group, NGOs, and representatives of CSR projects. The objective is to digitize interactive demographic record management and mapping through GIS-based technology. This study adopts a Geographical Information System (GIS) to digitize information using web GIS integrating with the Unmanned Aerial Vehicle (UAV) technology for data acquisition in the community sampling areas; Puncak Iskandar. The proposed system which leverages the power of spatial analysis and visualization, utilizes GIS technology to store, analyse, and visualize demographic records in a geographical context. It incorporates various demographic data sources, such as census data, health records, and administrative data in managing more efficient and effective data with lower cost, energy, time, and resources. Furthermore, the GIS-based system enables the identification of spatial disparities, inequalities, and interventions in demographic characteristics. Therefore, the integration of this system into community demographic management has provided a powerful platform for accessing and coordinating population dynamics, problem-solving, and sustainable development. The implementation in Puncak Iskandar enhances the accessibility, and visualization of demographic data, enabling policy-makers, researchers, and planners to make informed decisions based on a geographical perspective. The findings demonstrate the reliability of GIS-based demographic record management in a community living towards supporting evidence-based planning, resource allocation, and policy formulation for a wide range of applications, including urban planning, public health, and social services towards a sustainable future.

The Social Equity of Urban Parks in High-Density Urban Areas: A Case Study in the Core Area of Beijing

Urban parks beautify the environment and promote urban public health, and their spatial allocation is significant in maintaining environmental justice. However, the current allocation of urban parks focuses on quantity fairness and pays insufficient attention to accessibility and quality fairness. This study investigated the core area of Beijing and analyzed the fairness of urban park allocation based on park accessibility, area, and quality. We used big data crawling, the two-step floating catchment area method, comprehensive equity evaluation of parks, spatial autocorrelation, and non-parametric tests. The results showed inequality in terms of accessibility, area, and quality, with high spatial distribution in the north and low spatial distribution in the south. The accessibility, shortest distance, and total area of urban parks in high-income residential areas were 3.0, 2.1, and 1.8 times higher, respectively, than those of the low-income residential areas. This indicates that high-income groups have better accessibility, live closer to, and have access to larger urban parks. Middle-income and above groups had access to green space, whereas medium-to-low-income residential areas had poor access to parks, particularly high-quality parks. These findings provide decision-making and planning references for the optimal allocation and rational planning of urban parks.

Urban Public Space Initiatives and Health in Africa: A Mixed-Methods Systematic Review

Urban Public Space Initiatives and Health in Africa: A Mixed-Methods Systematic Review

Problems and Transformation Measures of Urban Parks in the Post-pandemic Era

The outbreak and spread of the COVID-19 pandemic shattered peoples peaceful lives, seriously threatened human lives, and sounded an alarm for urban development and public safety and health. In resisting the pandemic, a major public health emergency, public awareness of health has also been raised to an unprecedented level. This study takes Baishamen Park in Haikou city as an example to identify the current problems of urban parks and put forward some transformation strategies based on a pandemic-related perspective. The study discovers that currently, urban parks lack detailed designs for social distance requirements and psychological healing. The infrastructures and intelligent facilities in urban parks are not complete. Urban parks also fail to appropriately deal with visitors with different attitudes toward the infection risks. Then, the study puts forward some transformation strategies and designs, such as: planting some virus-inhibiting plants, adding disinfection facilities, introducing spray disinfection robots, and designing some facilities to control social distance. These transformation measures can be helpful for urban parks to meet the new needs of peoples recreation in the post-pandemic era.

S4-1 Learning from national initiatives from across the EU in HEPA policy monitoring and evaluation

Abstract The monitoring and evaluation of HEPA policy are essential steps towards developing the evidence base to understand the process and impact of policy implementation as well as guide future policy design. The policy development and implementation cycle can be strengthened through effective monitoring and evaluation tools, as well as multi-sectoral engagement. The promotion of physical activity often requires multiple sectors such as public health, sport, urban design etc., and working in diverse settings. In recent years, researchers and international organizations, such as WHO, have produced useful resources and guidance for monitoring and evaluating the impact of policy on a national level. The fast-growing interest in physical activity policy by national governments, for the purposes of increasing health and wellbeing can provide new opportunities for capturing the impact of HEPA policy and learning from other countries. The lack of available evidence on the process and effectiveness of HEPA policy remains a challenge when developing new policy. This highlights the need for sharing good practice from diverse policy contexts and HEPA settings. The symposium presentations will discuss policy monitoring and evaluation tools and case studies to investigate the different implementation aspects of national HEPA policy in four EU countries: Germany, Ireland, Slovenia and Wales. The goal of this symposium is to share lessons from the development of instruments used in (physical activity) policy monitoring and evaluation and to present real-world case studies of cross-sector collaboration. The high quality and diversity of the tools and projects presented in the four presentations, makes this symposium beneficial to both novice and experienced researchers, policy-makers and practitioners. The attendees can update their knowledge regarding different methods and instruments used in physical activity policy monitoring and evaluation and learn from engaging multiple sectors in HEPA such as urban design, sport, environment and public health. Reflections from this symposium will inform and enhance HEPA policy development and implementation in real-time and stimulate future research and practice in this field.

Unintended Pregnancy and Associated Factors among Pregnant Women Attending Antenatal Care Unit in Public Health Facilities of Dire Dawa City, Eastern Ethiopia, 2021.

Unintended pregnancy refers to a pregnancy that is either mistimed or unwanted. Unintended pregnancy has been a troubling public health and reproductive health issue, which imposes appreciable adverse consequences on the mother, child, and the public in general. Globally 121 million unplanned pregnancies occurred from 2015 to 2019. A significant proportion (61%) of these pregnancies ended in abortions each year. In Ethiopia, the challenges of unintended pregnancy and its related complications still exist because of the high rate of unmet need for contraceptives. In addition, no research has been conducted on unintended pregnancy among pregnant women in Dire Dawa city administration. To determine the prevalence of unintended pregnancy and associated factors among pregnant women attending antenatal care public health facilities in Dire Dawa in 2021. A facility-based cross-sectional study was conducted. After being chosen randomly, 382 pregnant women were interviewed at 9 urban public health facilities. A pretested questionnaire was used to collect data, entered into Epi Info 7, and exported into SPSS version 25 for analysis. The variables, which were significant at P ≤ 0.25 in bivariate analysis, were included in multivariable analysis. Statistical significance was declared at a P value <0.05 and a 95% CI. In this study, the prevalence of unintended pregnancy was 23.8% at 95% CI (19.8-28.3). The following factors were associated with unintended pregnancy: single women (AOR = 10.93, 95% CI 3.65-32.74), low family income (2000 ETB) (AOR = 4.01, 95% CI 1.73-9.28), parity 3 (AOR = 10.3, 95% CI 4.07-25.84), no history of family planning use (AOR = 5.91, 95% CI 2.46-14.21), and husband decision-making role on reproductive health (AOR = 2.956, 95% CI 1.048-8.340). Conclusion and Recommendations. The prevalence of unintended pregnancy was relatively high in this study. Efforts should be made to scale up women's decision-making power on family planning services and give support to empower women economically. There is the need to promote family planning services to minimize unintended pregnancy and to decrease parity and family size.

Townscape and Wayfinding: A Review of Existing Literature

Amidst the urban public health challenges in Malaysia, where obesity, cardiovascular diseases, and road traffic accidents are increasing, the importance of walkability in cities is gaining recognition. This paper provides an overview of the existing literature on the visual structure of townscapes and its impact on pedestrian navigation, investigating two main factors: environmental (visibility and saliency) and psychological (navigational competency). Urban visual studies and the theoretical progression are explained and compared. The review concludes that there is a general consensus on the significance of visual characteristics in orienting the urban environment. Specifically, the degree of permeability of the townscape visual scene and the availability of salient visual cues significantly influence wayfinding performance. Additionally, individual difference, including spatial ability, also reflects the utilisation of visual cues for wayfinding. However, further research is needed to explore a holistic approach encompassing the visual scene as a whole (gestalt) of the townscapes in the context of visual navigation.

Pregnancy-related Complications in Relation with Delivery Complication in Urban Public Health Center in 2019-2020: an Analytic Comparative Study

With a huge gap of knowledge and understanding created by the current pandemic especially in regards to maternal health, this research aimed to compare and analyze the correlation between pregnancy-related complication with delivery complication in an urban public health center before and during the pandemic. This is an analytic comparative study utilizing retrospective cohort approach. Medical records of pregnant women during 2019-2020 were obtained from Pagesangan public health center with approved ethics from Mataram University and related government agencies. Collected data were then analyzed for each year and then compared between 2019 and 2020 to see if there any significant differences between maternal health before and during the COVID-19 pandemic. Medical records of 653 pregnant women were collected in this study. 22 of 311 and 27 of 342 pregnancy-related complications were recorded in 2019 and 2020, respectively. While 68 of 311 and 70 of 342 delivery complications were recoded in 2019 and 2020, respectively. Analysis was done to obtain the relative risk (RR) of each year and then we compared the obtained RR of both year. In 2019, the RR of pregnany-related complication to delivery complication was 0,398 (95% CI 0,104-1,518) while in 2020 the obtained RR was 0,522 (95% CI 0,176-1,550). Pregnancy-related complications were not the risk factor of delivery complications in both year. However, a significant correlation was found between maternal age and pregnancy-related complication in 2020 while in 2019, gravidity was also found significantly related with delivery complications.

Risk factors for Lyme disease resulting from residential exposure amidst emerging Ixodes scapularis populations: A neighbourhood-level analysis of Ottawa, Ontario.

Lyme disease is an emerging health threat in Canada due to the continued northward expansion of the main tick vector, Ixodes scapularis. It is of particular concern to populations living in expanding peri-urban areas where residential development and municipal climate change response impact neighbourhood structure and composition. The objective of this study was to estimate associations of socio-ecological characteristics with residential Lyme disease risk at the neighbourhood scale. We used Lyme disease case data for 2017-2020 reported for Ottawa, Ontario to determine where patients' residential property, or elsewhere within their neighbourhood, was the suspected site of tick exposure. Cases meeting this exposure definition (n = 118) were aggregated and linked to neighbourhood boundaries. We calculated landscape characteristics from composited and classified August 2018 PlanetScope satellite imagery. Negative binomial generalized linear models guided by a priori hypothesized relationships explored the association between hypothesized interactions of landscape structure and the outcome. Increases in median household income, the number of forest patches, the proportion of forested area, forest edge density, and mean forest patch size were associated with higher residential Lyme disease incidence at the neighbourhood scale, while increases in forest shape complexity and average distance to forest edge were associated with reduced incidence (P<0.001). Among Ottawa neighbourhoods, the combined effect of forest shape complexity and average forest patch size was associated with higher residential Lyme disease incidence (P<0.001). These findings suggest that Lyme disease risk in residential settings is associated with urban design elements. This is particularly relevant in urban centres where local ecological changes may impact the presence of emerging tick populations and how residents interact with tick habitat. Further research into the mechanistic underpinnings of these associations would be an asset to both urban development planning and public health management.