Search Results (1,368)

Background/Objectives: Inappropriate medication storage and disposal are recognized public health concerns and represent a relevant source of environmental exposure to pharmaceutical compounds, with potential implications for ecosystem and human health. Identifying population-level determinants of these behaviors is essential to support targeted interventions and risk mitigation strategies. Methods: A cross-sectional population-based study was conducted using a structured survey administered to Brazilian adults. The questionnaire assessed medication storage practices, disposal behaviors, and prior exposure to guidance on appropriate medication handling. Descriptive statistics were used to characterize the sample, and multivariate logistic regression analysis was performed to identify independent predictors of appropriate disposal practices. Results: A total of 475 participants were included in the analysis. Although awareness of the environmental impact of improper medication disposal was high, inappropriate practices remained prevalent. Multivariate logistic regression identified educational level as the primary independent determinant of appropriate disposal practices (p < 0.001), while no significant associations were observed for age or gender (p > 0.05). Lack of prior guidance was frequent and may represent a relevant population-level exposure influencing unsafe behaviors. Conclusions: The findings highlight a gap between awareness and practice and identify key sociodemographic determinants influencing medication disposal behaviors. From an environmental epidemiology perspective, improper disposal may contribute to the dissemination of pharmaceutical residues in water systems, representing an indirect but widespread exposure pathway. Targeted public health strategies focusing on high-risk groups are needed to promote safe medication handling and reduce environmental and health risks. Full article

Despite the success of antiretroviral therapy, people living with HIV remain at heightened risk of multimorbidity spanning cardiovascular, renal, hepatic, oncologic and neuropsychiatric domains. We investigate whether routinely collected electronic health record data (30 laboratory variables plus seven demographic/social descriptors) can support early, multi-label classification of recorded comorbidities in a real-world cohort of 2200 HIV-positive patients receiving continuous care at a major London hospital. We benchmark classical machine and deep learning models under two settings: a demographic-aware configuration that includes sensitive attributes (age, gender, race and continent of birth) and a demographic-unaware configuration that excludes them. XGBoost yields the best macro-$F_1$ performance, and demographic-aware variants consistently outperform their unaware counterparts. Permutation feature importance revealed physiologically coherent drivers (e.g., creatinine/eGFR for renal and cardiometabolic labels, hemoglobin for hematologic labels, albumin for respiratory labels) and suggested that the relative contribution of demographic variables varied across comorbidity categories. These findings indicate that (i) routinely collected EHR data contain informative patterns associated with the multi-label comorbidity profiles of people living with HIV and (ii) carefully governed use of demographic context can improve accuracy while motivating transparent consideration of fairness and bias. Full article

Cutaneous leishmaniasis (CL) is highly prevalent in northern Ethiopia but data on community knowledge, attitudes, and health-seeking behaviours remain limited. A cross-sectional survey was conducted between November and December 2022 in CL-endemic areas of Tigray using mixed sampling and a structured questionnaire administered to 512 households. Knowledge of CL transmission was poor: only 1% correctly identified sand flies as the vector, while 25% believed the disease was genetically acquired. Approximately 67% of participants perceived CL as stigmatizing, and 63.3% reported a preference for traditional or local treatments over biomedical care. Knowledge levels were higher among rural residents and in households with prior CL experience. Gender and education were significantly associated with treatment-seeking and prevention practices, and participants from households with previous CL episodes reported better practices overall. Despite this, most participants demonstrated limited knowledge, unfavourable attitudes and suboptimal treatment-seeking and prevention behaviours. These findings highlight a disconnect between high disease burden, perceived seriousness and stigma, and limited understanding of transmission and prevention. Targeted, community-based health education interventions are needed to improve awareness of transmission, reduce stigma, and enhance access to effective treatment in CL-endemic settings. Full article

Recidivism prediction is increasingly embedded in criminal justice decision-making, yet most deployed systems remain opaque and have been shown to exhibit discriminatory behavior against certain demographic groups. This paper presents a fairness-aware interpretable framework for recidivism prediction applied to three real-world datasets from Bulgaria, Greece, and Portugal. The classification core relies on a 1-Dimensional Convolutional Neural Network (1D-CNN), trained by a custom objective function that embeds the Equalized Odds fairness criterion as an L1-regularized penalty reflecting on gender-based disparities in false positive and false negative rates. Model-level interpretability is provided through Kernel SHAP, which decomposes individual predictions into additive feature attributions grounded in cooperative game theory. Experiments across prediction tasks, each evaluated over randomized runs, demonstrate that the baseline model exhibits statistically significant bias against the female group in all datasets. The fairness-constrained model substantially reduces these disparities across all tasks at a moderate and expected cost to classification accuracy. Kernel SHAP analysis reveals the relative contribution of static and dynamic offenders’ attributes to individual risk scores, supporting auditability and contestability. The proposed framework advances the integration of predictive performance, algorithmic fairness, and structural interpretability in criminal justice analytics. Full article

We present a transdisciplinary Teaching–Learning Sequence (TLS) for lower secondary school students that integrates climate change education with the promotion of gender equality in science. The TLS connects theoretical understanding with practical engagement through laboratory demonstrations, simulations, and accessible experiments. The sequence addresses key topics in sustainability education, including incoming and outgoing radiation, the greenhouse effect, energy transformations, and energy sources, through activities involving the electromagnetic spectrum, infrared imaging, selective transparency, absorption, and albedo. It also includes inquiry-based explorations of electromagnetic induction, miniature hydroelectric and wind power systems, Stirling engines, photovoltaic and concentrated solar technologies, and combustion-related CO₂ acidification. A distinctive feature of the TLS is the explicit integration of the social dimension of sustainability through discussion of the Matilda Effect and the historical case of Eunice Newton Foote, with the aim of challenging persistent gender stereotypes in STEM. The intervention was implemented with 12–13-year-old students and evaluated through pre- and post-tests, written explanations, closed-ended questions, drawings, and the Draw-A-Scientist Test. The results indicate a significant improvement in students’ understanding of climate-related scientific concepts and in their critical awareness of misinformation and climate denial strategies. While the sequence did not significantly increase students’ engagement in climate action, the gender-focused activities promoted strong critical reflection on stereotypes and on the role of women in science. Full article

Background/Objectives: Adolescent mental health problems have increased in recent years, with growing concern about the impact of digital behaviors such as problematic video game use and gambling. Internet Gaming Disorder (IGD) and Problem Gambling Symptoms may share psychological risk markers, but evidence in Spanish adolescents is limited. This study aimed to examine the relationship between IGD, problem gambling symptoms, and mental health, and to identify sociodemographic, psychological, and behavioral factors associated, including microtransactions and loot boxes. Methods: A cross-sectional study was conducted with secondary education students from Extremadura (Spain). The final sample included 343 participants. Measures included an ad hoc questionnaire on video game use, the IGDS9-SF, SOGS-RA, and the Strengths and Difficulties Questionnaire (SDQ). Descriptive analyses, Spearman correlations, and multivariable regression (Poisson and negative binomial) were performed. Results: IGD and gambling were positively correlated (Spearman’s ρ = 0.386, p < 0.001) and associated with higher mental health difficulty scores (IGD: ρ = 0.299, p < 0.001; gambling: ρ = 0.214, p < 0.001). Male gender was associated with both outcomes (IGD: incidence rate ratio [IRR] = 1.21 [95% Confidence Interval: 1.13–1.30]; gambling: IRR = 2.90 [1.85–4.60]). Microtransactions were associated with both behaviors (IGD: IRR = 1.17 [1.09–1.25]; gambling: IRR = 1.74 [1.19–2.54]), while loot box use was related only to IGD (IRR = 1.13 [1.05–1.21]). Total SDQ score was positively associated with both IGD (IRR = 1.02 [1.02–1.03]) and gambling (IRR = 1.10 [1.06–1.13]). Younger age was associated with higher IGD scores (IRR = 0.97 [0.96–0.99]). Conclusions: There are similarities in the associations among the examined factors and increased scores of IGD and gambling in adolescents, particularly male gender, higher mental health difficulties scores, and involvement in monetized gaming systems. School-based, family, and public health prevention strategies may benefit from addressing the importance of psychological well-being and increase awareness of the potential risks associated with digital gaming practices. Full article

Rural adolescents face persistent health inequities driven by limited access to preventive health education, intergenerational engagement, and resources that support lifelong wellness. This study evaluated the effectiveness of Active Aging for L.I.F.E., a school-based intergenerational health literacy program, in improving adolescents’ attitudes toward aging and health. The four-session program, delivered through a train-the-trainer model involving older adults and undergraduate students, was implemented in three rural schools during the 2024–2025 academic year. A total of 86 junior high and high school students participated, with 77 completing pre- and post-program surveys assessing attitudes toward aging, health consciousness, and intergenerational engagement. Paired t-tests and multiple regression analyses examined overall program effects and differences by sex/gender and age group. Students demonstrated significant improvements in aging attitudes, perceived relevance of aging topics, enjoyment of intergenerational interaction, and awareness of health-promoting behaviors across the lifespan. Several baseline sex/gender and age-based gaps in health-related perceptions were reduced following participation, with stronger future-oriented attitude shifts observed among younger adolescents. These findings suggest that brief, scalable intergenerational interventions embedded in rural school settings can support early prevention, health literacy, and community capacity building, offering a promising strategy for advancing rural public health outcomes across the life course. Full article

Herpes simplex virus encephalitis (HSVE) is the most common infectious encephalitis and is associated with high morbidity and mortality when not treated in time. Symptoms include fever, headache, fatigue, neurological deficits such as aphasia and epileptic seizures. While hemorrhagic transformation is a common complication in HSVE, intracerebral hematoma (ICH) as the initial or main presentation is rare. We present two patients with HSVE who displayed a large temporal hematoma as the main finding on cerebral imaging. We further conducted a systematic literature review to identify all published cases of ICH in HSVE. Forty-nine publications met the inclusion criteria, describing a total of 55 patients. In 38 of these, HSVE could be definitely confirmed by brain biopsy, autopsy or PCR. We analyzed these cases according to age, gender, lag from symptom onset to hospital admission, lag from hospital admission to detection of hemorrhage, location of encephalitis and hemorrhage, received treatment and outcome. With a median age of 45 years, this cohort is significantly younger than general HSVE populations described previously. In conclusion, our review shows that, albeit rare, awareness about ICH complicating HSVE is highly relevant as failure to recognize an atypical course of HVSE may result in a delay of effective antiviral treatment, which is related to an unfavorable or even fatal outcome. Full article

Environmental sustainability has become a critical priority for higher education institutions, which play a key role in promoting awareness and shaping students’ perceptions of sustainable practices. Understanding students’ awareness and perceptions is essential for evaluating the effectiveness of institutional sustainability initiatives. This study aimed to assess students’ awareness and perceptions of environmental sustainability at Prince Sattam bin Abdulaziz University and to examine the influence of demographic factors and the relationship between awareness and perception. A quantitative cross-sectional survey was conducted among 323 university students. Data were collected using a structured questionnaire measuring environmental awareness (18 items) and perception of sustainability practices (14 items) on a 5-point Likert scale. Composite scores were computed as the means of item responses. Descriptive statistics, independent t-tests, one-way ANOVA, and multivariable linear regression analyses were performed. Students demonstrated a moderate level of environmental awareness (mean = 3.116 ± 0.403) and moderate perceptions of sustainability practices (mean = 2.887 ± 0.199). Environmental awareness was significantly higher among female students and those in science-related disciplines (p < 0.001). Perception of sustainability was significantly associated with field of study and level of study (p < 0.001). In multivariable analysis, gender and field of study remained significant predictors of awareness, while gender, field of study, and level of study predicted perception. A significant but negative association was observed between awareness and perception of environmental sustainability (B = −0.496, p < 0.001). While students demonstrated a moderate level of environmental awareness, perceptions of sustainability practices were inconsistent. The findings highlight the need for enhanced sustainability education and engagement initiatives within universities. Future research should explore how awareness and perception translate into meaningful engagement with sustainability practices. Full article

Background: Antimicrobial resistance (AMR) poses an escalating threat to global health, agriculture, and the environment, demanding urgent multisectoral action under the One Health framework. Despite global awareness efforts, understanding of AMR among the general population remains insufficient, particularly in low- and middle-income countries such as Brazil. This study aimed to evaluate the knowledge, attitudes, and perceptions (KAP) of the Brazilian population regarding AMR. Methods: An online questionnaire was distributed through social media platforms between April and August 2025, resulting in 945 valid responses after data cleaning. Quasi-Poisson models were applied to identify demographic predictors of KAP scores while logistic regression models were used to assess the association between KAP scores and antibiotic use-related practices. Results: Education level was the strongest predictor of higher KAP scores, whereas age and gender showed inconsistent influence. Only 40.3% of respondents correctly identified antibiotics among commonly used medicines, and 25.9% reported proper disposal of antibiotic packaging. More than half (54.2%) were willing to pay more for antibiotic-free products, although only 26.7% had ever noticed such labeling. Network analysis of open-ended responses indicated that concerns about potential health risks and AMR awareness were the primary motivators for purchasing antibiotic-free products. Conclusions: These findings reveal significant gaps in public understanding of antibiotic use and resistance in Brazil, emphasizing the urgent need for targeted educational initiatives, improved public communication, and behavioral interventions to support antimicrobial stewardship and sustainable antibiotic use. Full article

For students in animal science-related disciplines, animal welfare education may be associated with their understanding of human–animal relationships and willingness to pursue animal-related careers. However, empirical research from developing countries such as China remains limited. To address this gap, we conducted a survey among undergraduates at Northeast Agricultural University to examine the associations of demographic characteristics, educational exposure, and animal-related experiences with animal welfare awareness and career aspirations. A total of 346 valid responses were obtained. The results showed that students who encountered animal welfare through school demonstrated significantly higher levels of self-reported animal welfare awareness (p < 0.001). Binary logistic regression further confirmed that the channel remained significantly associated with the level of awareness (OR = 8.714, p < 0.001). Furthermore, gender and pet-keeping experience were significantly associated with career aspirations in both univariate and logistic regression analysis. In addition, although 50.00% of respondents considered primary school to be the optimal stage for animal welfare education, 81.48% of those exposed through school channels reported their first exposure at university. These findings highlight the need for a progressive animal welfare education framework, transitioning from life education and human–animal relationship training at the primary level to professional practice education in higher education. This approach may help students develop more stable and scientifically informed understanding of animal welfare, as well as a stronger sense of professional identity. Full article

Aquatic recreation significantly enhances well-being; however, individuals experiencing functional limitations remain frequently marginalized from this form of tourism due to infrastructural and environmental barriers. This study investigates the perceived operational risks and apprehensions encountered by users with specific accessibility needs during yacht sailing, aiming to inform inclusive vessel design aligned with the social dimension of sustainable development. A survey of 277 participants with diverse, officially certified functional limitations was conducted to evaluate their maritime experiences and safety concerns. Participants identified a mean of 11 pre-voyage apprehensions out of 19 distinct risk categories. The most prevalent concerns included stumbling, slipping, or falling on board (79%), the risk of falling overboard (73%), and seasickness (70%), with an overall moderate severity ($\overline{X}$ = 2.2 on a 4-point scale). Crucially, severe safety concerns (e.g., vessel sinking or falling overboard) were significantly mitigated following practical sailing experience. Conversely, everyday functional and ergonomic challenges—such as moving between the deck and crew quarters ($\overline{X}$ = 2.6), operating rigging ($\overline{X}$ = 2.7), embarkation ($\overline{X}$ = 2.6), and utilizing sanitary facilities ($\overline{X}$ = 2.1)—persisted irrespective of experience level. Statistical analysis revealed that gender and age had negligible effects on concern levels. Extensive maritime experience reduced apprehensions regarding balance and swimming competencies, while concurrently increasing awareness of communication and comfort-related operational challenges. This study highlights a distinct divergence between initial psychological anxiety—which is largely mitigated by experience—and persistent architectural barriers inherent in standard yacht design. The results underscore that achieving meaningful inclusivity in water tourism requires prioritizing interior spatial layouts, accessible sanitary facilities, and barrier-free vertical circulation in naval architecture, rather than focusing exclusively on emergency safety systems. These insights directly support the advancement of Sustainable Development Goal 10 and the integration of universal and human-centered design principles within the maritime recreation sector. Full article

Ischemic Heart Disease (IHD) is the leading cause of cardiovascular mortality worldwide. Early detection of ischemic changes using electrocardiogram (ECG) signals is vital for timely intervention and enhanced clinical outcomes. However, the diagnosis of IHD varies significantly between men and women. Women often present with atypical symptoms, and their cardiovascular risk is frequently underestimated, which leads to delayed diagnosis. Also, existing approaches face challenges in subtle early-stage abnormalities, single-lead ECG presentation, and the limited interpretability of deep learning models. These cause significant challenges to the accurate diagnosis of IHD. To address these, this study proposes a gender-aware framework, Gender-Aware Morphology Encoder Network (GAMENet), for early ischemic heart disease detection using 12-lead ECG signals with clinical metadata. A novel GAMENet is developed using the PTB-XL database. The Adaptive Morphology Deviation Encoder (AMDE) through Morphology Segment Extraction (MSEG-R) using R-Peak anchoring, isolates clinically relevant waveform components (P-wave, QRS complex, ST-segment, and T-wave) from the preprocessed ECG signals. The feature vector of morphology features is passed through dense layers with dropout regularization and a SoftMax classifier. Statistical and comparative analysis ensures that the proposed framework enables accurate IHD classification and improved interpretability. Full article

Background/Objectives: Dengue prevention in rural Amazonian communities is shaped by knowledge, household feasibility, sociocultural dynamics, institutional continuity, and trusted communication. This study explored behavioral, sociocultural, and institutional barriers to dengue prevention and control in rural communities of the Peruvian Amazon. Methods: An exploratory qualitative study with an ethnographic orientation, informed by the Communication for Behavioural Impact (COMBI) framework, was conducted in three anonymized rural settlements in San Martín, Peru. The qualitative corpus included 120 adults, 84 in-depth interviews, six focus group discussions with 36 participants, 22 household and community observation records, 13 institutional communication materials, and seven local operational documents. Data were analyzed using an inductive thematic approach and triangulated across participant profiles, settlements, and sources. Results: Dengue was widely recognized as a mosquito-borne disease, but the central finding was a gap between general awareness and practical, routine application. Participants’ understanding of breeding sites, warning signs, and feasible source reduction was uneven. Prevention was mainly reactive, increasing after nearby cases, alerts, or fumigation, but weakening when risk was not visible. Irregular water supply, water storage, waste accumulation, gendered domestic labor, competing household priorities, reluctance to confront neighbors, and intermittent institutional action limited sustained prevention. Fumigation was perceived as the most visible institutional response, while communication was more credible when mediated by trusted local actors. Conclusions: Dengue prevention requires locally feasible household practices, safe water-storage guidance, trusted communicators, neighborhood coordination, continuous pre-outbreak engagement, and intersectoral support. Full article

Background: Human papillomavirus (HPV) causes nearly all cervical cancers and a growing share of HPV-related malignancies in both sexes, yet HPV vaccine knowledge and acceptance among medical students in Saudi Arabia, the next generation of clinicians shaping recommendations, remain poorly characterized across the full training continuum. Methods: We conducted a cross-sectional online survey of 300 medical students at the College of Medicine, Qassim University. A pre-validated questionnaire captured sociodemographic data, HPV knowledge (14 items), vaccine awareness, attitudes and behavioral intent (4 items), and barriers. Multivariable logistic regression assessed independent predictors of awareness, personal willingness, and intent to recommend the vaccine to family members and future patients. Results: A total of 91.7% of students had previously heard of HPV, and 79.3% had heard of the HPV vaccine. However, only 44.3% reached the predefined threshold for good knowledge, and 56.3% reported personal willingness to receive the vaccine. Willingness to recommend the vaccine to future patients was the most frequently endorsed intent (78.3%), followed by recommending it to a family member (73.3%), with male gender reported as the leading reason among decliners. After adjustment, each one-point increase in the knowledge score independently raised the adjusted odds of vaccine awareness (aOR 1.40, 95% CI 1.22 to 1.61), of recommending the vaccine to a future patient (aOR 1.28, 95% CI 1.13 to 1.45), of recommending it to a family member (aOR 1.19, 95% CI 1.06 to 1.33), and of personal willingness (aOR 1.16, 95% CI 1.04 to 1.29). Female gender was associated with higher odds of personal willingness (aOR 2.31, 95% CI 1.37 to 3.88), and senior training phase predicted vaccine awareness (aOR 2.71, 95% CI 1.33 to 5.52). Conclusions: Human papillomavirus vaccine knowledge independently predicted both awareness and behavioral intent among medical students at Qassim University. However, personal willingness to receive the vaccine lagged behind willingness to recommend it, particularly among male students. Embedding HPV prevention more explicitly into the medical curriculum, with particular emphasis on its relevance to male health, may help narrow this gap. Full article