COVID-19 Pandemic Adversely Affects the Provision of Desired Newborn Circumcision: Perinatal Physician Perspectives

Over half of boys in the United States undergo circumcision, which has its greatest health benefits and lowest risks when performed during the newborn period under local anesthesia. The COVID-19 pandemic has affected delivery of patient care in many ways and likely also influenced the provision of newborn circumcisions. Prior to the pandemic, we planned to conduct a qualitative study to ascertain physician perspectives on providing newborn circumcision care. The interviews incidentally coincided with the onset of the pandemic and thus, pandemic-related changes emerged as a theme. We elected to analyze this theme in greater detail. Semi-structured interviews were conducted with perinatal physicians in a large urban city from 4/2020 to 7/2020. Physicians that perform or counsel regarding newborn circumcision and physicians with knowledge of or responsibility for hospital policies were eligible. Interviews were transcribed verbatim and qualitative coding was performed. Twenty-three physicians from 11 local hospitals participated. Despite no specific COVID-19 related questions in the interview guide, nearly half of physicians identified that the pandemic affected delivery of newborn circumcision care with 8 pandemic-related sub-themes. The commonest sub-themes included COVID-19 related changes in: (1) workflow processes, (2) staffing and availability of circumcision proceduralists, and (3) procedural settings. In summary, this qualitative study revealed unanticipated COVID-19 pandemic-related changes with primarily adverse effects on the provision of desired newborn circumcisions. Some of these changes may become permanent resulting in broad implications for policy makers that will likely need to adapt and redesign the processes and systems for the delivery of newborn circumcision care.

Physical inactivity in early pregnancy and the determinants in an urban city setting of Kuala Lumpur, Malaysia

Background Physical inactivity in pregnancy has been associated with excessive gestational weight gain, hypertensive disorders, gestational diabetes mellitus and postpartum depression. Despite these risks, physical inactivity level remains high especially in higher income countries. The prevalence of physical inactivity among women in Malaysia aged ≥16 years was 28.2% in 2019 exceeding men by 6.1%. However, little is known regarding the subpopulation of pregnant women especially in Kuala Lumpur which is the most urbanized and highly populated city in Malaysia. Therefore, the aim of this study is to measure the physical inactivity prevalence among first trimester pregnant women in Kuala Lumpur and to identify its determining factors. Methods This was a cross-sectional study in which 339 first trimester pregnant women were sampled from 13 maternal and child health clinics located in all four parliament districts of Kuala Lumpur. Self-administered questionnaires which contained the Malay version of the pregnancy physical activity questionnaire (PPAQ) were used. Descriptive analysis was conducted to determine the physical inactivity prevalence followed by simple and multiple logistic regression to identify the determinants of physical inactivity with significant level of 5%. Results The prevalence of physical inactivity was 38.3%. The highest activity was seen in the household activity domain, despite only 24.8% of the respondents were housewives/unemployed. There was little to no participation observed in the vigorous intensity category. The determinants of physical inactivity were primigravida (aOR 3.54 95% CI 1.40, 8.97), education level (aOR 3.77 95% CI 1.35, 10.52) and body mass index (aOR 0.88 95% CI 0.80, 0.97) which explained 22.6% variation of physical inactivity in the final adjusted model. Conclusion The prevalence of physical inactivity among first trimester pregnant mothers in this study was 38.3%, and the highest activity was seen in the household category. Health education on physical activity in pregnancy should be focused on those who are primigravida and have no tertiary education. The educational content should be updated and tailored to current pandemic situation where self-isolation is the new norm, by advocating for home-based, moderate to vigorous intensity physical activities.

Personal Exposure to Fine Particles (PM2.5) in Northwest Africa: Case of the Urban City of Bamako in Mali

Personal exposure to particulate matter (PM) from anthropogenic activities is a major concern in African countries, including Mali. However, knowledge of particulates is scant. This study was undertaken to characterize personal exposure to PM2.5 microns or less in diameter (PM2.5) in the city of Bamako in Mali. The exposure to PM2.5, through daily activities was observed from September 2020 to February 2021. Participants wore palm-sized optical PM2.5 sensors on their chest during their daily activities. The exposure levels in four different groups of residents were investigated in relation to their daily activities. The variation in PM2.5 concentration was measured during different activities in different microenvironments, and the main sources of exposure were identified. The highest average 10 min concentrations were observed at home and in bedrooms, while the participants were using specific products typically used in Africa, Asia, and South America that included insecticides (IST; 999 µg/m3) and incense (ICS; 145 µg/m3), followed by traffic (216 µg/m3) and cooking (150 µg/m3). The lowest average 10 min concentrations were also observed in the same microenvironment lacking IST or ICS (≤14 µg/m3). With no use of specific products, office workers and students were the least exposed, and drivers and cooks were the most exposed. The concentrations are up to 7.5 and 3 times higher than the World Health Organization’s yearly and daily recommended exposure levels, respectively, indicating the need to promptly elaborate and apply effective mitigation strategies to improve air quality and protect public health. This study highlights the importance of indoor air pollution sources related to culture and confirms previous studies on urban outdoor air pollution sources, especially in developing countries. The findings could be applied to cities other than Bamako, as similar practices and lifestyles are common in different cultures.

Parking Requirement of Institutional Land Use

Parking demand rates are one of the essential keys to urban city planning around the world. Most cities produced the most suitable parking rates, and models relied on their local conditions, regulations, and people’s habits. In Iraq, there is a lack of parking studies, and therefore, there is a lot of missing information which if be found, will be very valuable for better enhancing and managing the transportation network system. Institutional land use or Government Ministries are the land use type in which this research tries to find its parking generation rates. The goal is to produce models and rates for parking generation by using certain independent variables according to the characteristics of the land-use type. The research study area is the urban areas outside Baghdad CBD. Several sites were selected located in different parts of Baghdad. The number of study sites is three. The collected data about sites are the total number of site employees, site gross floor area, and maximum parked vehicles at each site for an Am and Pm period. Each site has a clear parking lot; besides, the sites were selected relied on particular criteria. The field survey was done at each site for defining days and times. The final stage is a data analysis and producing parking generation rates and models to determine the required parking demand for this land-use type. Statistical analysis of data, model generation, was done by the computer program (SPSS). It concluded that the institutional land use produced 0.94 spaces per 100 m2 of GFA and 0.1 spaces per employee.

ARCHITECTURAL HERITAGE IN THE CITY OF ‎NAZNRETH DURING THE OTTOMAN ERA 1517-‎‎1918‎

This study aims to show the urban aspects of the ‎Nazareth during the Ottoman era 1517 – 1918 in the ‎light of the Ottoman documents and the drawings and ‎pictures of European travelers and its role in its ‎transformation from a small village to an urban city and ‎then a district center. And learn about the interest that ‎the city of Nazareth purified from the Ottoman ‎government in this field. And that is through studying ‎the urban monuments in the city, such as: the houses, ‎Islamic and Christian religious places, the Saraiya, the ‎markets, the khans, Mary's well.‎ It began with a discussion of historical geography, and I ‎presented the descriptions of Arab and European ‎travelers to Nazareth, then the study touched on the ‎presentation of the architectural style in the city of ‎Nazareth, the presentation of the survey and ‎reconciliation process for some historical monuments in ‎Nazareth, and finally the conclusion.

Optimization of Low Site Density Area for 4G Network in Urban City

The development of telecommunications is currently growing rapidly, especially in urban areas. To obtain optimal data services for users, the performances of 4G network services must continue to be optimized. It is known that many users are scattered in urban areas, but sometimes it is not balanced with an even distribution of the site in this area. This condition occurs because the distribution of the site is not evenly optimal distributed, either due to licensing constraints, limited land access for site development, or in terms of plans that have not been made. Balanced with the requirement of a 4G network, which is required, this "empty space" condition or low site density condition must find a solution or optimize it. Many optimization methods can optimize the area with low site density possibility. This study will optimize the area by adding a new site proposal based on coverage planning. We need to analyze Reference Signal Received Power (RSRP) coverage signal distribution using Atoll Planning Software. After optimization, the RSRP level below or equal -80 dBm increased from 75.195% to 94.08%. Furthermore, the percentage calculation for inadequate coverage (below -80 dBm) decreased from 24.816% to 5.931%. This RSRP signal level also shows that the condition after optimization with a new site can improve the signal level condition from areas with low site density possibility.

ASSESSING SAFETY LEVEL OF UTM CAMPUS BASED ON SAFE CITY CONCEPTS

Safety is an important aspect in today’s living, in urban city, residential area, and also in campus area. Several initiatives were introduced to increase the safety level, and to prevent crime from happening in the campus area, known as Safe City Concept. These initiatives included the Safe City Index, Crime Prevention Through Environmental Design (CPTED), behavioural model, safe city urban area, safe city of smart city, and resident safety assessment. Some of this initiative focus on urban city area, or residential, besides only focus on crime prevention and not focus on the assessment of safety level for campus area. This study aims to assess the safety level for campus area, with case study of UTM Campus. To assess the safety level, a set 4 indicators, which is crime, environment, public health and emergency response, with 9 sub-indicators was identified in this study. These indicators and sub-indicators used to determine the safety level of campus area based on the Safe City Concept. The analysis used is spatial analysis on the indicator, and using weighted criteria matrix to evaluate safety level for each building in UTM campus. The results show that most the buildings in UTM are in good and high safety level, with 65% of buildings score more than 70%. For buildings was detected with highest score of 95% of safety level, while 3 buildings score lowest percentage of 53.7%. these results indicated that UTM campus area is a safe area, based on the Safe City Concept. These results can help authorities to use these indicators of Safe City Concept to assess the education campus area safety level.

Risk Perception and Knowledge, Attitudes, and Practices Against COVID-19 in a Hypertensive Population From a Semi-Urban City of Ecuador

Background: In an elderly population with hypertension, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is associated with a higher incidence of mortality and a protracted course of clinical symptoms.Objective: To assess the perceived risk of infection and complications due to COVID-19 in people with hypertension living in a semi-urban city of Ecuador.Methods: A cross-sectional telephone survey of adult outpatients with a previous diagnosis of hypertension in the semi-urban community of Conocoto in Quito, Ecuador was conducted from August to December 2020.Results: A total of 260 adult outpatients, aged 34–97 years, completed telephone surveys. Of total, 71.5% (n = 186) of respondents were women and 28.5% (n = 74) of respondents were men. Overall, 18.1% believe that their risk of infection is “very high,” 55.4% believe that their risk of infection is “high,” 21.5% believe that their risk of infection is “low,” and 5% believe that their risk of infection is “very low.” The perceived risk of complications, if infected by COVID-19, revealed that 21.9% believe that their risk of complication is “very high,” 65.0% believe that their risk of complication is “high,” 10.4% believe that their risk of complication is “low,” and 2.7% believe that their risk of complication is “very low.”Conclusion: Patients with hypertension are aware of the risks posed by COVID-19 infection and its impact on their health. However, the health system must educate the population on health practices and behaviors to avoid COVID-19 infection until the majority of the population of Ecuador can be vaccinated.