مرکز منطقه ای اطلاع رسانی علوم و فناوری مطالعات شهر ایرانی-اسلامی 2228-639X 14 53 2024 10 1 The Environmental Health Evaluation Model Based on Precision Medicine’s Omics مدل ارزیابی سلامت محیط بر مبنای امیکس‌های پزشکی فرادقیق 75 106 fa سارا دانشمند علم و صنعت ایران کاوه فتاحی دانشگاه شیراز 2023 11 3  <div class="Section1" dir="RTL"> The Environmental Health Evaluation Model Based on Precision Medicine’s Omics   Sara Daneshmand<a style="mso-footnote-id: ftn1;" title="" href="#_ftn1" name="_ftnref1">*</a>  Kaveh Fattahi<a style="mso-footnote-id: ftn2;" title="" href="#_ftn2" name="_ftnref2">**</a> Studies on the quality of life in the two fields of medical sciences and environmental sciences show that each one refers to an aspect of health and less interdisciplinary view has been formed. So far, a comprehensive framework for environmental health assessment with the aim of integrating and harmonizing assessment models has not been provided. Therefore, this study examines the dimensions and components of health in both areas and proposes an "environmental health evaluation model" using a mixed research method. This interdisciplinary model includes new dimensions of environmental health and by using quantitative health indicators, it paves the way for developing a "comprehensive environmental health measurement tool" and creating and improving healthy environments to enrich the quality of life.   Keywords: Quality of Life, Health, Transcendental Medicine, Deep Medicine, Precision Medicine, Omics, Health Evaluation.   Introduction: The matter of quality of life and its defining criteria and indicators has consistently intrigued scholars across diverse fields of study. Within the realm of architecture and urban planning, the assessment of quality of life typically aligns with environmental studies, involving the creation of specialized evaluation tools and models for appraisal. A prevailing characteristic of these models is a focus on health-related aspects when gauging quality of life. Given the shift in perspective on health from a pathogenic to a salutogenic approach, there is a pressing need to adapt and devise fresh assessment frameworks to evaluate the environmental health effectively. In today's research landscape, the realm of quality of life assessment based on health index has expanded significantly, encompassing various questionnaires like CDC HRQoL, EQ-5D, AQoL-8D, and HRQoL. This holistic approach has also seeped into the realms of architecture and urban design, where a noticeable surge in focus on health promotive and health-oriented design concepts can be observed over the past few decades. Numerous architectural theories and methodologies have emerged in this sphere recently, underlining a growing synergy between medical sciences (Rosen & Hoang, 2017; Richardson et al., 2010; Van Dillen et al., 2012) and environmental sciences (Collado et al., 2017; Hartig, 2017; Shu & Ma, 2018; Lin & Juan, 2024; Gashoot, 2023; Grigoryan, 2023; Morera-Balaguer et al., 2023; Thakur et al., 2023; Bower et al., 2019; Higuera-Trujillo, 2021; Assem et al., 2022).These intersectional studies deeply explore the profound impact of the environment on human health. However, there has been a scarcity of results presented within an interdisciplinary framework. Consequently, establishing a comprehensive framework that explores every aspect and layer of an individual's health within the reciprocal relationship between humans and the environment, and subsequently proposes a model or tool for assessing people's health across various spatial contexts encompassing both natural and man-made environments, proves not only highly influential in enhancing the users’ quality of life but also imperative given the significance of health within contemporary societies. The compilation of such an intricate framework necessitates a profound understanding and exploration of the topics at hand, which are delineated through three pivotal inquiries:   <p class="MsoListParagraphCxSpFirst" dir="LTR" style="mso-add-space: auto; text-align: justify; text-justify: kashida; text-kashida: 0%; text-indent: -18.0pt; line-height: normal; mso-list: l0 level1 lfo1; margin: 0cm 0cm .0001pt 1.0cm;">1-      What is the definition of health and what are its various dimensions and components? How have the approaches towards expressing these components evolved in medical and environmental sciences over time?  <p class="MsoListParagraphCxSpMiddle" dir="LTR" style="mso-add-space: auto; text-align: justify; text-justify: kashida; text-kashida: 0%; text-indent: -18.0pt; line-height: normal; mso-list: l0 level1 lfo1; margin: 0cm 0cm .0001pt 1.0cm;">2-      Can the health-related aspects of the environment be delineated through insights gained from recent medical studies?  <p class="MsoListParagraphCxSpLast" dir="LTR" style="mso-add-space: auto; text-align: justify; text-justify: kashida; text-kashida: 0%; text-indent: -18.0pt; line-height: normal; mso-list: l0 level1 lfo1; margin: 0cm 0cm .0001pt 1.0cm;">3-      Furthermore, how can we develop a comprehensive model to assess environmental health, and what specific criteria should be included in this model? Research method: This research explores the concept of health and its dimensions within both environmental and medical studies. Initially, a comparative analysis is conducted between detailed theories of both classic and novel medical science to develop a comprehensive structural model that integrates components and indicators from both perspectives. This model aligns the dimensions of environmental health with those of human health. Subsequently, the study establishes a hierarchical structure for a transcendental environment by correlating levels of transcendental medicine with advanced and contemporary approaches in environmental sciences. Combining the insights from the initial and subsequent analyses, the research introduces a proposed environmental health matrix. Utilizing the "space quality evaluation method," this matrix is further expanded into a detailed "environmental health evaluation model," consisting of four matrices.   Results In this article, the dimensions of environmental health, were extracted based on the correspondence between two theories of deep medicine and transcendental medicine (Tabei and Nabipour, 2020). They was followed by an exploration of the hierarchical structure of the transcendental environment, aligned with the environment-behavior model grounded in these medical theories. The table below provides a visual representation of the research findings in this context. </div> <span style="font-size: 12.0pt; font-family: 'Times New Roman','serif'; mso-fareast-font-family: Calibri; color: black; mso-ansi-language: EN-US; mso-fareast-language: EN-US; mso-bidi-language: AR-SA; mso-bidi-font-weight: bold;"> <div class="Section2" dir="RTL"> Table: Hierarchical structure of transcendental environment <img src="file:///C:\Users\Bayeh\AppData\Local\Temp\msohtmlclip1\05\clip_image002.gif" width="908" height="489" /> </div> <span dir="RTL" lang="AR-SA" style="font-size: 12.0pt; font-family: 'Times New Roman','serif'; mso-fareast-font-family: Calibri; color: black; mso-ansi-language: EN-US; mso-fareast-language: EN-US; mso-bidi-language: AR-SA;"> <div class="Section3" dir="RTL"> Discussion and conclusion After completing the comparison and juxtaposing process, a model is introduced for assessing the health of the environment. In developing this model, the physical dimension (O and G) and the psychological dimension (C) play crucial roles as two structural components of the matrix. Additionally, by incorporating time as a third dimension (T), evaluation matrices can be constructed. Following an analysis of all matrices and determination of their dimension values, it is recommended to supplement the matrices with necessary restoration values (R) to achieve the desired status. A comprehensive breakdown of the proposed model is provided in the table below.   Table: proposed details of environmental health evaluation model   <div dir="rtl" align="center"> <table class="MsoNormalTable" dir="rtl" style="margin-left: -8.65pt; border-collapse: collapse; mso-table-layout-alt: fixed; border: none; mso-border-alt: solid black .5pt; mso-yfti-tbllook: 1184; mso-padding-alt: 0cm 5.4pt 0cm 5.4pt; mso-table-dir: bidi; mso-border-insideh: .5pt solid black; mso-border-insidev: .5pt solid black;" border="1" width="634" cellspacing="0" cellpadding="0"> <tbody> <tr style="mso-yfti-irow: 0; mso-yfti-firstrow: yes; height: 137.6pt;"> <td style="width: 72.8pt; border: solid black 1.0pt; mso-border-alt: solid black .5pt; padding: 0cm 5.4pt 0cm 5.4pt; mso-rotate: 90; height: 137.6pt;" width="97"> The restorative physical dimension of the environment (Encounter with the external stimulus of the environment and environmental treatment) </td> <td style="width: 48.55pt; border: solid black 1.0pt; border-right: none; mso-border-right-alt: solid black .5pt; mso-border-alt: solid black .5pt; padding: 0cm 5.4pt 0cm 5.4pt; mso-rotate: 90; height: 137.6pt;" width="65"> Secondary physical-psychological dimension of the person (long time) </td> <td style="width: 49.6pt; border: solid black 1.0pt; border-right: none; mso-border-right-alt: solid black .5pt; mso-border-alt: solid black .5pt; padding: 0cm 5.4pt 0cm 5.4pt; mso-rotate: 90; height: 137.6pt;" width="66"> Secondary physical-psychological dimension of the person (midterm) </td> <td style="width: 49.65pt; border: solid black 1.0pt; border-right: none; mso-border-right-alt: solid black .5pt; mso-border-alt: solid black .5pt; padding: 0cm 5.4pt 0cm 5.4pt; mso-rotate: 90; height: 137.6pt;" width="66"> The primary psychological dimension of the person (short term) </td> <td style="width: 63.75pt; border: solid black 1.0pt; border-right: none; mso-border-right-alt: solid black .5pt; mso-border-alt: solid black .5pt; padding: 0cm 5.4pt 0cm 5.4pt; mso-rotate: 90; height: 137.6pt;" width="85"> The previous psychological dimension of the person </td> <td style="width: 63.8pt; border: solid black 1.0pt; border-right: none; mso-border-right-alt: solid black .5pt; mso-border-alt: solid black .5pt; padding: 0cm 5.4pt 0cm 5.4pt; mso-rotate: 90; height: 137.6pt;" width="85"> The previous physical dimension of the person </td> <td style="width: 45.25pt; border: solid black 1.0pt; border-right: none; mso-border-right-alt: solid black .5pt; mso-border-alt: solid black .5pt; padding: 0cm 5.4pt 0cm 5.4pt; mso-rotate: 90; height: 137.6pt;" width="60"> The physical dimension of the environment in the existing situation </td> <td style="width: 25.8pt; border: solid black 1.0pt; border-right: none; mso-border-right-alt: solid black .5pt; mso-border-alt: solid black .5pt; padding: 0cm 5.4pt 0cm 5.4pt; mso-rotate: 90; height: 137.6pt;" width="34"> spiritual dimension </td> <td style="width: 56.45pt; border: solid black 1.0pt; border-right: none; mso-border-right-alt: solid black .5pt; mso-border-alt: solid black .5pt; padding: 0cm 5.4pt 0cm 5.4pt; mso-rotate: 90; height: 137.6pt;" width="75"> Dimensions of environmental health </td> </tr> <tr style="mso-yfti-irow: 1; height: 73.75pt;"> <td style="width: 72.8pt; border: solid black 1.0pt; border-top: none; mso-border-top-alt: solid black .5pt; mso-border-alt: solid black .5pt; padding: 0cm 5.4pt 0cm 5.4pt; height: 73.75pt;" width="97"> Environmental GIS for restoration (R) </td> <td style="width: 211.55pt; border-top: none; border-left: solid black 1.0pt; border-bottom: solid black 1.0pt; border-right: none; mso-border-top-alt: solid black .5pt; mso-border-right-alt: solid black .5pt; mso-border-alt: solid black .5pt; padding: 0cm 5.4pt 0cm 5.4pt; height: 73.75pt;" colspan="4" width="282"> Combination variables (C) </td> <td style="width: 63.8pt; border-top: none; border-left: solid black 1.0pt; border-bottom: solid black 1.0pt; border-right: none; mso-border-top-alt: solid black .5pt; mso-border-right-alt: solid black .5pt; mso-border-alt: solid black .5pt; padding: 0cm 5.4pt 0cm 5.4pt; mso-rotate: 90; height: 73.75pt;" width="85"> Personal omics (<img src="file:///C:\Users\Bayeh\AppData\Local\Temp\msohtmlclip1\05\clip_image004.gif" width="22" height="21" />) </td> <td style="width: 45.25pt; border-top: none; border-left: solid black 1.0pt; border-bottom: solid black 1.0pt; border-right: none; mso-border-top-alt: solid black .5pt; mso-border-right-alt: solid black .5pt; mso-border-alt: solid black .5pt; padding: 0cm 5.4pt 0cm 5.4pt; mso-rotate: 90; height: 73.75pt;" width="60"> Environmental GIS (<img src="file:///C:\Users\Bayeh\AppData\Local\Temp\msohtmlclip1\05\clip_image006.gif" width="22" height="21" />) </td> <td style="width: 25.8pt; border-top: none; border-left: solid black 1.0pt; border-bottom: solid black 1.0pt; border-right: none; mso-border-top-alt: solid black .5pt; mso-border-right-alt: solid black .5pt; mso-border-alt: solid black .5pt; padding: 0cm 5.4pt 0cm 5.4pt; mso-rotate: 90; height: 73.75pt;" width="34"> --- </td> <td style="width: 56.45pt; border-top: none; border-left: solid black 1.0pt; border-bottom: solid black 1.0pt; border-right: none; mso-border-top-alt: solid black .5pt; mso-border-right-alt: solid black .5pt; mso-border-alt: solid black .5pt; padding: 0cm 5.4pt 0cm 5.4pt; mso-rotate: 90; height: 73.75pt;" width="75"> Components </td> </tr> <tr style="mso-yfti-irow: 2; height: 37.45pt;"> <td style="width: 72.8pt; border: solid black 1.0pt; border-top: none; mso-border-top-alt: solid black .5pt; mso-border-alt: solid black .5pt; padding: 0cm 5.4pt 0cm 5.4pt; mso-rotate: 90; height: 37.45pt;" rowspan="2" width="97"> Restorative properties of the environment </td> <td style="width: 147.8pt; border-top: none; border-left: solid black 1.0pt; border-bottom: solid black 1.0pt; border-right: none; mso-border-top-alt: solid black .5pt; mso-border-right-alt: solid black .5pt; mso-border-alt: solid black .5pt; padding: 0cm 5.4pt 0cm 5.4pt; height: 37.45pt;" colspan="3" width="197"> Compatibility matrix </td> <td style="width: 63.75pt; border-top: none; border-left: solid black 1.0pt; border-bottom: solid black 1.0pt; border-right: none; mso-border-top-alt: solid black .5pt; mso-border-right-alt: solid black .5pt; mso-border-alt: solid black .5pt; padding: 0cm 5.4pt 0cm 5.4pt; mso-rotate: 90; height: 37.45pt;" rowspan="2" width="85"> Correlation matrix. (Mental Correlation of a person with the environment) (Range of interaction with the environment) </td> <td style="width: 63.8pt; border-top: none; border-left: solid black 1.0pt; border-bottom: solid black 1.0pt; border-right: none; mso-border-top-alt: solid black .5pt; mso-border-right-alt: solid black .5pt; mso-border-alt: solid black .5pt; padding: 0cm 5.4pt 0cm 5.4pt; mso-rotate: 90; height: 37.45pt;" rowspan="2" width="85"> Desirability matrix. (The subjective desirable of the audience) (sensation range) </td> <td style="width: 45.25pt; border-top: none; border-left: solid black 1.0pt; border-bottom: solid black 1.0pt; border-right: none; mso-border-top-alt: solid black .5pt; mso-border-right-alt: solid black .5pt; mso-border-alt: solid black .5pt; padding: 0cm 5.4pt 0cm 5.4pt; mso-rotate: 90; height: 37.45pt;" rowspan="2" width="60"> Capacity matrix of the environment </td> <td style="width: 25.8pt; border-top: none; border-left: solid black 1.0pt; border-bottom: solid black 1.0pt; border-right: none; mso-border-top-alt: solid black .5pt; mso-border-right-alt: solid black .5pt; mso-border-alt: solid black .5pt; padding: 0cm 5.4pt 0cm 5.4pt; mso-rotate: 90; height: 37.45pt;" rowspan="2" width="34"> --- </td> <td style="width: 56.45pt; border-top: none; border-left: solid black 1.0pt; border-bottom: solid black 1.0pt; border-right: none; mso-border-top-alt: solid black .5pt; mso-border-right-alt: solid black .5pt; mso-border-alt: solid black .5pt; padding: 0cm 5.4pt 0cm 5.4pt; mso-rotate: 90; height: 37.45pt;" rowspan="2" width="75"> Suggested matrices </td> </tr> <tr style="mso-yfti-irow: 3; mso-yfti-lastrow: yes; height: 110.55pt;"> <td style="width: 48.55pt; border-top: none; border-left: solid black 1.0pt; border-bottom: solid black 1.0pt; border-right: none; mso-border-top-alt: solid black .5pt; mso-border-right-alt: solid black .5pt; mso-border-alt: solid black .5pt; padding: 0cm 5.4pt 0cm 5.4pt; mso-rotate: 90; height: 110.55pt;" width="65"> (range of active presence in the environment) </td> <td style="width: 49.6pt; border-top: none; border-left: solid black 1.0pt; border-bottom: solid black 1.0pt; border-right: none; mso-border-top-alt: solid black .5pt; mso-border-right-alt: solid black .5pt; mso-border-alt: solid black .5pt; padding: 0cm 5.4pt 0cm 5.4pt; mso-rotate: 90; height: 110.55pt;" width="66"> (range of compatibility with the environment) </td> <td style="width: 49.65pt; border-top: none; border-left: solid black 1.0pt; border-bottom: solid black 1.0pt; border-right: none; mso-border-top-alt: solid black .5pt; mso-border-right-alt: solid black .5pt; mso-border-alt: solid black .5pt; padding: 0cm 5.4pt 0cm 5.4pt; mso-rotate: 90; height: 110.55pt;" width="66"> (range of belonging to the environment) </td> </tr> </tbody> </table> </div>     With the space quality evaluation method, the matrix details are effectively presented based on their respective components. This, in turn, aids in illustrating the stages of environmental health evaluation through the utilization of these matrices.The diagram below shows the environmental health assessment model. </div> <span dir="RTL" lang="AR-SA" style="font-size: 12.0pt; font-family: 'Times New Roman','serif'; mso-fareast-font-family: Calibri; color: black; mso-ansi-language: EN-US; mso-fareast-language: EN-US; mso-bidi-language: AR-SA;"> <div class="Section4" dir="RTL"> Diagram: environmental health evaluation model   <img src="file:///C:\Users\Bayeh\AppData\Local\Temp\msohtmlclip1\05\clip_image008.gif" width="924" height="541" /> </div> The results of the research in response to the research questions have revealed insights into various dimensions and components of health as outlined in medical and environmental studies. While physical and psychological dimensions form the foundation of most theories, the spiritual dimension remains relatively unexplored due to its ethereal nature.   Through a holistic integration of medical and environmental sciences, a more nuanced understanding of environmental components has emerged, paving the way for a comprehensive analysis. By examining the cognitive-behavioral processes through the lenses of deep medicine and transcendental medicine, the study has successfully extracted dimensions of environmental health and components crucial for evaluation.    Introducing the space quality evaluation method has further enhanced the understanding of health dimensions, leading to the development of four matrices for environmental health assessment. This model not only unravels the intricate interplay between humans and their environment but also offers practical guidance for environmental designers to create healthier spaces, ultimately enhancing the quality of life for all inhabitants. This research sets the stage for future exploration in environmental health assessment tools, emphasizing the importance of incorporating current health indicators to enhance environmental quality. The proposed model holds the potential to usher in a new era of environmental design that prioritizes human well-being and fosters sustainable environments for generations to come.       References   Assem, H. M., Khodeir, L. M., Fathy, F. (2023) Designing for human wellbeing: The integration of neuroarchitecture in design – A systematic review, Ain Shams Engineering Journal. 14(6): 102102.   Bower, I, Tucker, R, Enticott, P.G. 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(2012) Greenspace in urban neighbourhoods and residents' health: adding quality to quantity. Journal of epidemiology and community health, 66(6), e8. https://doi.org/10.1136/jech.2009.104695.     <div style="mso-element: footnote-list;"> <hr align="right" size="1" width="33%" /> <div id="ftn1" style="mso-element: footnote;"> <a style="mso-footnote-id: ftn1;" title="" href="#_ftnref1" name="_ftn1">*</a> Corresponding Author: Assistant Professor, Department of Architecture, Shiraz University, Shiraz, Iran. daneshmand@shirazu.ac.ir </div> <div id="ftn2" style="mso-element: footnote;"> <a style="mso-footnote-id: ftn2;" title="" href="#_ftnref2" name="_ftn2">**</a> Assistant Professor, Department of Architecture, Shiraz University, Shiraz, Iran. ka_fattahi@shirazu.ac.ir </div> </div>    کیفیت زندگی با جنبه&zwnj;های سلامت «انسان» و «محیط» عجین شده&zwnj;است؛ اما مطالعات در دو حوزه علوم پزشکی و علوم محیطی نشان می&zwnj;دهد که هر یک از این دو حوزه، به جنبه&zwnj;ای از سلامت اشاره می&zwnj;کند و کمتر نگاه بین&zwnj;رشته&zwnj;ای شکل گرفته&zwnj;است. گرچه در دهه&zwnj;های گذشته نظریه&zwnj;پردازان معمار و شهرساز سعی کرده&zwnj;اند ویژگی&zwnj;هایی برای سلامت محیط بر شمارند؛ اما تاکنون چهارچوبی جامع که بتواند مدلی جهت ارزیابی سلامت محیط پیشنهاد دهد، ارائه نشده&zwnj;است. متعاقب یک چهارچوب ارزیابی یکپارچه، پژوهش فعلی با استفاده از روش تحقیق ترکیبی و با هدف ادغام و هماهنگ&zwnj;سازی مدل&zwnj;های ارزیابی موجود در زمینه&zwnj;های پزشکی و محیطی انجام می&zwnj;شود. این تلاش به&zwnj;دنبال توسعه یک چهارچوب بین&zwnj;رشته&zwnj;ای نوآورانه برای ارزیابی موثر سلامت کاربر در محیط است. برای دستیابی به اهداف پژوهش، این مطالعه به بررسی کامل ابعاد و مؤلفه&zwnj;های سلامت در علوم محیطی و پزشکی می&zwnj;&zwnj;پردازد. این مطالعه با ادغام نظریه&zwnj;های محیطی مرتبط و مدل&zwnj; ارزیابی کیفیت فضایی، در کنار نظریه&zwnj;ها و مدل&zwnj;های اخیر علوم پزشکی، یک «مدل ارزیابی سلامت محیط» مبتنی بر چهار ماتریس را پیشنهاد می&zwnj;کند. این مدل بین&zwnj;رشته&zwnj;ای ابعاد جدیدی از سلامت محیط را در&zwnj;بر&zwnj;می&zwnj;گیرد و به طراحان و کاربران محیط&zwnj;زیست در ارزیابی جنبه&zwnj;های سلامت محیط اطراف خود کمک می&zwnj;کند، بنابراین ایجاد، بهبود و پیشرفت محیط&zwnj;های سالم برای غنی&zwnj;سازی کیفیت زندگی را تقویت می&zwnj;کند. علاوه&zwnj; بر&zwnj; این، ترکیب شاخص&zwnj;های کمی سلامت ضروری مانند مقادیر عصبی، غدد درون&zwnj;ریز و سیستم ایمنی، فرصت&zwnj;هایی را برای تحقیقات آینده برای توسعه یک «ابزار جامع اندازه&zwnj;گیری سلامت محیط» باز می&zwnj;کند که معیارهای ارزیابی حیاتی را برای تجزیه و تحلیل ویژگی&zwnj;های سلامت محیط&zwnj;های اطراف ارائه می&zwnj;کند.

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