Search Results (200)

The COVID-19 pandemic and its associated lockdowns had widespread psycho-social implications globally. However, the unique experiences of young adults in under-researched rural communities, such as Lonely Park in South Africa’s North West Province, remain poorly documented. This study explores the psycho-social well-being of young adults aged 18–24 in the Lonely Park community during the national COVID-19 lockdown from 23 March 2020 to 30 April 2020, with a particular focus on their emotional, psychological, and social experiences. Using a qualitative, phenomenological design rooted in Bronfenbrenner’s Ecological Systems Theory (EST), data were collected from 14 purposively sampled participants through two focus group discussions. Thematic analysis was conducted following Braun and Clarke’s six-phase framework. Ethical clearance was obtained from the Health Research Ethics Committee, and participants provided informed consent. Two main themes emerged, (1) psychological and (2) social well-being. Six sub-themes were identified: (1) negative emotions linked to lockdown, (2) fear of COVID-19 and its consequences, (3) rumination and anxiety, (4) disruption of social and educational routines, (5) coping strategies, and (6) structural limitations of healthcare and support systems. Participants experienced intense fear, boredom, isolation, and a sense of helplessness. Yet, coping mechanisms such as communication, spirituality, exercise, and adherence to public health regulations provided resilience. Some reported depression and financial strain due to job loss and school disruptions. The findings highlight the complex interplay of psychological, emotional, and social stressors in rural young adults during the pandemic. Policymakers and mental health practitioners must prioritise targeted psycho-social interventions for youth in under-resourced rural settings. A call is made for culturally responsive mental health programmes that incorporate local voices, especially in rural African contexts. Full article

Background: Fundamental movement skills (FMS)—including muscular strength, endurance, and mobility—are linked to better health-related quality of life and higher physical activity in children. Rural children often score lower on FMS tests than urban peers due to resource limitations rather than ability. Thus, increasing access to FMS activities in under-resourced rural areas is essential. The primary objective was to test the feasibility of Hoosier Strength in a rural middle school sample, and the secondary objective was to observe the preliminary changes in FMS-related outcomes pre- to post-intervention and at follow-up. The exploratory objective was to explore how participants responded to different coaches on the Hoosier Strength coaching team (i.e., gender, coaching style during activities). Methods: This study used a Hybrid Type 3 design to evaluate feasibility and FMS outcomes, integrating qualitative and quantitative data. The four-week intervention included a test group (n = 24; 14 females, 10 males; mean age: females 12.4 ± 0.5 years, males 12.7 ± 0.4 years) and a control group (n = 12; 8 females, 4 males; mean age: females 12.9 ± 0.3 years, males 12.7 ± 0.3 years). Data analysis included descriptive statistics for feasibility indicators (Acceptability of Intervention Measures [AIM], Intervention Appropriateness Measure [IAM], and Feasibility of Intervention Measure [FIM]), linear regression for mobility and muscular endurance changes, t-tests for psychological need satisfaction and frustration, and regression analysis for squat knowledge and post-intervention confidence. Results: (1) There was high feasibility across the 4-week Hoosier Strength intervention and at follow-up; (2) there were no statistically significant changes in squat performance; (3) participants’ confidence in their ability to squat at the end of the intervention was significantly predicted by their squat knowledge at baseline; and (4) participants prioritized leadership and team management over tactical analysis, highlighting a preference for coaches who foster teamwork. Conclusions: The findings offer a transparent approach for evaluating the feasibility and preliminary outcomes of the Hoosier Strength intervention in an under-resourced rural middle school, thereby encouraging further investigation into strength training interventions in rural schools. Full article

Background/Objectives: In 2022, 2.2 million adolescents were diagnosed with substance use disorders, including 265,000 with opioid use disorder. The National Survey on Drug Use and Health revealed that 130,000 adolescents misused prescription pain medications, often obtaining them from friends or relatives. This age group perceives weekly heroin use as less risky than those younger or older. Methods: A questionnaire was developed for 7th to 12th graders in a rural Texas school district as part of a fentanyl awareness curriculum. The questionnaire included Likert scale, multiple choice, and yes/no questions. The participants were categorized into younger (grades 7th and 8th) and older students (grades 9th through 12th), and associations were explored between demographic characteristics, responses, and grade groups using chi-square tests. To assess confidence, behavior, and the impact of education, we used chi-square and Fisher’s exact tests. Results: The participants (n = 94; 85.11%) identified as Hispanic or Latino, with a smaller percentage identifying as White or more than one race. An association was found between feeling more in control of actions related to substances and fentanyl (p-value = 0.04) after receiving education. No association was found between education and confidence in identifying fentanyl. Conclusions: This study aligns with a surge in fentanyl-related overdose deaths in a high-intensity drug trafficking region. Recent fentanyl overdoses among school-age children prompted legislative changes in 2023, making this study valuable for understanding the epidemic within the geographical context. These results suggest that school-based education may play a role in strengthening adolescents’ behavioral intentions to fentanyl exposure, though additional efforts are needed to improve risk identification. Full article

Background/Objectives: Skipping breakfast is increasingly common among adolescents and has been associated with adverse health and academic outcomes. The average prevalence of breakfast skipping among adolescents is around 16%, although worldwide, it varies greatly across studies, ranging from 1.3 to 74.7%. This study aimed to assess the frequency of daily breakfast consumption and explore the factors associated with its omission in a stratified sample of Spanish adolescents. Methods: A cross-sectional study was conducted among 547 third-year secondary school students (aged 14–15) from both urban and rural areas in Castilla-La Mancha. Self-reported questionnaires were used to gather sociodemographic, psychosocial, and lifestyle data, including adherence to the Mediterranean diet (via the Kidmed questionnaire) and breakfast habits during school days. Descriptive, bivariate (Chi-square), and multivariate (binary logistic regression) analyses were conducted separately for boys and girls. Results: Findings showed a high prevalence of breakfast skipping one or more days (33.46%), with a significantly higher rate among girls (43.27%) than among boys (24.42%). Also, girls were more likely than boys to skip breakfast every day (14.18% vs. 6.87%, p < 0.001). In both groups, low adherence to the Mediterranean diet was strongly associated with skipping breakfast, along with higher screen time, shorter sleep duration, and being overweight/obese. Among girls, low olive oil consumption (OR 0.145 (CI 0.03–0.67) p 0.014) and poor Mediterranean diet adherence (OR 0.140 (CI 0.06–0.34) p < 0.001) were significant predictors. For boys, being overweight/obese (OR 2.185 (CI 1.06–4.52) p 0.035), low Mediterranean diet adherence (OR 0.136 (CI 0.06–0.32) p < 0.001), and not eating industrial pastries were associated factors (OR 0.413 (CI 0.20–0.88) p 0.022). Predictive models demonstrated good discriminatory power (AUC = 0.807 for girls; 0.792 for boys). Conclusions: Skipping breakfast is prevalent among adolescents, particularly girls, and is linked to poor dietary patterns and excess weight. These findings underscore the need for gender-specific nutritional interventions to promote regular breakfast consumption and improve dietary habits in adolescents. Full article

Objective: This study aimed to assess the prevalence of depression and anxiety among patients with acute leukemia in Vietnam and to identify associated sociodemographic and clinical factors. Methods: A cross-sectional study was conducted at the Hematology and Blood Transfusion Center of Bach Mai Hospital, a national tertiary care facility in Hanoi, Vietnam. A total of 82 patients diagnosed with acute leukemia were recruited using a convenience sampling method. Data on sociodemographic characteristics (e.g., age, gender, residence, education, occupation, marital status, and income) and clinical information (e.g., leukemia type, treatment stage, comorbidities, substance use) were collected. Depression and anxiety were assessed using the Beck Depression Inventory (BDI) and Zung’s Self-Rating Anxiety Scale (SAS). Multivariate logistic and Tobit regression analyses were applied to explore associated factors. Results: Participants had a mean age of 43.4 years (SD = 14.0), with 53.7% male and 69.5% residing in rural areas. Most were married (82.9%) and had completed high school (45.1%). Farmers constituted the largest occupational group (29.3%). The mean BDI score was 13.7 (SD = 9.8), and the mean SAS score was 39.2 (SD = 6.3). Overall, 50.0% of patients met criteria for depression, while 26.8% exhibited clinically significant anxiety symptoms. Among those with anxiety, 59.1% had mild symptoms, 22.7% moderate, and 18.2% severe or very severe. Patients with education above high school (OR = 7.32; 95% CI: 1.01–53.23), a spouse (OR = 25.10; 95% CI: 2.14–294.55), or comorbidities (OR = 8.05; 95% CI: 1.63–39.68) had significantly higher odds of depression. A higher income (>10 million VND/month) was associated with lower depression scores (Coef. = −6.05; 95% CI: −11.65 to −0.46). Regarding anxiety, the female gender was associated with higher odds (OR = 3.80; 95% CI: 1.21–11.93) and SAS scores (Coef. = 4.07; 95% CI: 1.64–6.51), while higher income predicted lower anxiety severity (Coef. = −3.74; 95% CI: −6.57 to −0.91). Conclusions: This Vietnamese hospital-based study highlights a high prevalence of depression and anxiety among patients with acute leukemia. Routine mental health screening and culturally appropriate psychosocial interventions are strongly recommended to improve patient well being. Full article

Limited access to education in rural areas of Senegal is a structural barrier to human development and equal opportunities. The Bicycles for Education project, promoted by the Utopia Foundation—Bicycles Without Borders (BSF), aims to improve the educational participation of young people aged 12 to 21 by providing bicycles to facilitate their travel to school. In this study, the GRITS research group from the University of Barcelona externally evaluates the impact of the project on improving access to education, reducing gender inequalities, and the associated socioeconomic as well as community benefits. A qualitative approach based on individual interviews (n = 23), focus groups (n = 6) and group interviews (n = 8) was used, with a total of 80 participants, including students, families, teachers, project coordinators, and institutional managers. The analysis was carried out through thematic coding and content analysis, identifying four main axes: educational impact, gender equity, economic effects, and community transformation. The results show that the provision of bicycles throughout the school year led to increased school attendance and punctuality, improvements in academic performance, a reduction in social inequalities, gender inequalities in access to education, and a decrease in household costs associated with transport and food. In addition, there has been a cultural transformation in the perception of cycling as a viable means of mobility and a change in those communities where the project has been running for more than a decade. Full article

Fruit and vegetables (F&V) are recommended for a healthy life. Adolescence is a critical period for the onset of eating disorders and future health. F&V consumption among adolescents is globally low, making this group a key target for diet/nutrition-related interventions. This cross-sectional study aimed to assess F&V consumption among secondary school students in the food-insecure communes of Boukombe (rural) and Natitingou (urban), Benin. Using probabilistic random sampling, 303 students completed F&V intake frequency questionnaires and 24-h dietary recalls on school and non-school days. Poisson models identified factors associated with F&V consumption. The results showed that only 8.8% (Boukombe) and 11% (Natitingou) of students consumed fruit at least twice per day, and over 80% of students had not eaten fruit in the preceding 24 h; 9.9% and 11.4%, respectively, consumed vegetables at least twice per day. On average, 45.5% of students in Boukombe and 68% in Natitingou consumed at least three types of vegetables on school days. The most commonly consumed fruits were oranges in Boukombe and lemons in Natitingou. Factors influencing fruit consumption included sex (p = 0.005), age (p = 0.04), and mothers’ occupation (p = 0.03) on school days/and school or non-school days, while commune (p = 0.00017) and ethnic group affected vegetable consumption. Such low F&V consumption among surveyed students is a matter of public health concern, as it is likely to affect their health―in terms of micronutrient deficiency―and intellectual performance. These results should incentivize nutrition researchers, project managers, public health officials, and policymakers to (re)design and implement broader measures targeting secondary school students’ dietary practices to increase their F&V consumption. Full article

This study examines students’ learning for action towards sustainability when addressing a local environmental problem related to mining through an Inquiry-Based Science Education (IBSE) approach. A total of 54 eighth-grade students (ages 13–15) from a rural middle school participated in this study. Data collection included written group productions and group interviews, which were analysed using inductive and deductive processes. The results revealed three levels of the students’ learning for action: “What” (problem identification), “Why” (reasons for action), and “How” (local action). All groups successfully identified the environmental problem, and 64% demonstrated understanding of the reasons for action, showing concern for future generations and environmental preservation. At the “How” level, 50% of the groups recognised the importance of local action, 34% actively planned and implemented actions, and 29% developed specific competences for action, including systemic thinking, argumentation, and communication skills. This research demonstrates that using the IBSE approach to address relevant local problems facilitates the development of action competences for sustainability. Digital technologies emerged as important tools for the students’ actions. The study also provides a framework for understanding and analysing students’ learning for action. Full article

Background: Adolescence is a pivotal developmental stage marked by physiological and behavioral changes that significantly influence dietary habits and long-term health outcomes. Objectives: This study aimed to examine the associations between socio-demographic characteristics, psychological factors, and dietary behaviors among school-aged children and adolescents in Romania. Methods: A cross-sectional study was conducted using a structured, self-administered questionnaire completed by 662 children and adolescents aged 6 to 18 years, enrolled in primary, middle, and high schools across urban and rural areas. The questionnaire evaluated nutritional intake, meal patterns, hydration habits, physical activity, screen time, and psychological factors such as fatigue, stress, and mood fluctuations. Body mass index (BMI) was calculated based on self-reported height and weight. Results: The analysis reveals significant gender differences in body mass index (BMI), weight-loss behaviors, and family structure. Female adolescents were more likely to be underweight (18.27%) compared to male adolescents (10.82%), while overweight prevalence was higher among male adolescents (18.66%) than female adolescents (11.68%) (χ² = 11.457, p = 0.009). Dietary patterns varied significantly across age groups, with high-school-aged children demonstrating lower vegetable consumption and increased autonomy over food choices. Primary school children exhibited higher intake of carbonated beverages (OR = 0.185, p = 0.002 for high school; OR = 0.116, p < 0.001 for middle school), whereas teenagers showed a preference for structured meals and lower fast-food intake. Meat consumption frequency correlated with greater diversity in protein sources (χ² = 48.77, p < 0.001), while chaotic eating behaviors were more prevalent among middle and high-school-aged children (OR = 2.291, p = 0.032 for middle school; OR = 2.225, p = 0.030 for high school). Hydration habits played an essential role in dietary quality, with school-age children consuming ≥ 3 L of water daily exhibiting healthier eating patterns (OR = 7.146, p = 0.001). Additionally, psychological factors such as fatigue and stress were significantly associated with unhealthy dietary choice. Conclusions: These findings highlight the need for targeted nutritional education, school-based interventions, and family-focused strategies to improve adolescent health behaviors. Full article

Rural public transport networks face significant challenges, often characterised by suboptimal service quality. With advancements in technology, various applications have been explored to address these issues. Autonomous Demand-Responsive Transits (ADRTs) represent a promising solution that has been investigated over recent years. Their potential to enhance the overall quality of transport systems and promote sustainable transportation is well-recognised. In our research study, we evaluated the viability of ADRTs for rural networks. Our methodology focused on two primary areas: the suitability of ADRTs (considering vehicle type, service offerings, trip purposes, demographic groups, and land use) and the broader impacts of ADRTs (including passenger performance, social impacts, and environmental impacts). Perceptions of ADRT suitability peaked for university precincts and 24/7 operations. However, they were less favoured by mobility-disadvantaged groups (disabled, seniors, and school children). We also examined demographic heterogeneity and assessed the influence of demographic factors (age, gender, education, occupation, household income level, and disability status) on the implementation of ADRTs in rural settings. The findings delineate the varied perceptions across these socio-demographic strata, underscoring the necessity for demographic-specific trials. Consequently, we advocate for the implementation of ADRT services tailored to accommodate the diverse needs of these demographic cohorts. Full article

Background: Children with disabilities, particularly in low- and middle-income countries (LMICs), face heightened risks of vaccine-preventable diseases due to a range of systemic and social barriers. Although immunization is a fundamental human right and a proven public health intervention, this vulnerable group is often overlooked in policy and practice. Understanding the factors compromising vaccine equity for these children is critical to reducing zero-dose prevalence and improving health outcomes. Methods: This scoping review examined peer-reviewed, gray literature from 2010 to 2024. Searches were conducted in PubMed, Google Scholar, and relevant organizational reports (WHO, UNICEF). Studies addressing children with disabilities and focusing on immunization barriers, interventions, or lessons learned were selected. English-language publications were screened in title/abstract and full-text stages. Key data extracted included population, barriers, and immunization outcomes. Since this review focused on articles in English, this is a key limitation. Results were synthesized thematically to identify recurring patterns and to guide improved interventions and policies. Results: Twelve articles met the inclusion criteria. Key barriers identified were inadequate healthcare infrastructure, insufficient provider training, limited follow-up services in rural regions, societal stigma, and pervasive misconceptions around both disability and vaccines. Factors such as maternal education, logistical support for caregivers, and using low-sensory, inclusive vaccination settings were consistently linked with better outcomes. Effective strategies included mobile vaccination units, tailored interventions (e.g., distraction or sedation techniques), school-based immunization programs, and robust community engagement to address stigma. Lessons learned underscored the importance of flexible, individualized care plans and empowering families through transparent communication. Conclusions: Children with disabilities continue to experience significant gaps in immunization coverage, driven by intersecting barriers at the individual, health system, and societal levels. Scaling tailored interventions, inclusive policies, strengthened infrastructure, and ongoing research can help ensure these children receive equitable access to life-saving vaccinations. Full article

This quasi-experimental study evaluated the effectiveness of two school-based interventions aiming to reduce academic stress and alleviate burnout symptoms. Using cluster sampling, a total of 128 middle schoolers (M_age = 13.48, 42.2% female) from two classes in rural Henan Province, China, participated in this study. One class served as the control group (n = 61), while the other class was randomly assigned to two intervention groups: the mandala-coloring group (n = 31) and the grit-enhancing group (n = 32). ANCOVA and ANOVAs were conducted to detect any significant changes. The results showed that academic stress was significantly reduced in the mandala-coloring group (F = 5.741, p = 0.004, and η²p = 0.085), while no significant changes were observed in academic burnout. In the grit-enhancing group, a significant within-group increase in grit levels was found. These findings suggest that mandala coloring may serve as a time-efficient method for alleviating academic stress among adolescents. Implications for addressing academic stress and burnout in school settings are discussed. Full article

The purpose of this study was to explore the development and relationship between mindfulness and executive function (EF) in students in grades 4–5 and investigate mindfulness training’s impact on mindfulness and EF in grade 4 students in rural China. Study 1 measured mindfulness and EF in Chinese students in grades 4–5. Differences in the level of mindfulness among children in grade 4 (n = 159) and grade 5 (n = 187) in rural China were analyzed by multi-factor analysis of variance. Correlation and hierarchical multiple regression analyses were used to explore the relationship between mindfulness and EF in grade 4 (n = 103) and grade 5 (n = 124). Study 2 included 45 4th graders with a general mindfulness level, with 21 children in the experimental group receiving 12 mindfulness training lessons. The mindfulness and EF scores of individuals in the mindfulness and control groups were tested before and after the intervention. Study 1 showed that 4th graders had significantly lower mindfulness scores than 5th graders. EFs in grades 4–5 were significantly correlated with mindfulness. Study 2 revealed that mindfulness training significantly improved the experimental group’s mindfulness and working memory. A non-significant improvement in inhibitory control and cognitive flexibility was observed. There was a significant difference in mindfulness in grades 4 and 5 of Chinese rural upper-grade elementary school. Children who perform well in mindfulness also perform well in EFs. Mindfulness training improved the mindfulness and working memory of 4th graders in rural China with a general mindfulness level. Full article

Vaccinations are among the most effective means of preventing hospitalizations related to infections. Despite this, high hospitalization rates for vaccine-preventable diseases strain available healthcare resources and imply deficiencies in primary care. Barriers to vaccinations exist, such as the recent pandemic, vaccine hesitancy, misinformation, and access to care. This study analyzes hospitalization rates due to vaccine-preventable conditions and identifies factors contributing to an increase in these rates in the southeast United States. This study used data from four different data sources. The data covers four pre-pandemic years (2016 to 2019) and the pandemic period (2020 to 2022). The analysis categorized the numbers and rates of hospitalizations for conditions with an available preventative vaccine across three age groups: pre-school aged children, school-aged children, and adults. Comparisons between school- versus non-school-mandated vaccines and a focus on differences between rural versus urban communities, as well as demographic characteristics (i.e., gender, race, and ethnicity), are included. Chi-squared tests were used to assess differences in this descriptive part of the analysis. Linear multiple regression was used to examine the independent influence of geographic location while accounting for potential longitudinal trends and the dimensions of the SVI, including socioeconomic status, household composition, disability, minority status and language, and household type and transportation. The dataset included data from 22,797,826 inpatient episodes, including 32,358 for which the principal reason for hospitalization was a vaccine-preventable condition, not including COVID-19. The analysis shows a consistent pattern characterized by higher rates of hospitalization for counties classified as rural. The pattern holds for preschool age (p < 0.001), school age (p = 0.004), and adults (p = 0.009). The differences are statistically significant in the white population (p = 0.008); in pre-school children, school-age children, and adults (p < 0.001); in females (p = 0.08 in pre-school, and p = 0.013 in adults); and black adults (p = 0.02). The regression results confirmed the findings of the descriptive analysis, indicating significantly higher rates in rural communities. Finally, the regression analysis also showed significantly higher rates associated with greater social vulnerability. This study highlights gaps in vaccination opportunities. These gaps can be seen geographically and in terms of social vulnerability, affected by factors such as poverty, language barriers, household composition, and access to care. Hospitalizations due to immunizable diseases were found to be higher in rural areas, particularly among adults. Communities with a high SVI show a significant increase in hospitalization rates. Community-engaged vaccination outreach programs and state policies could improve vaccination rates, and therefore, public health in rural areas, reducing hospitalizations, and lowering infectious disease risks in these areas. Full article

Rural Spain has strengths but also presents notable problems. Education is a necessary way to improve rural communities. A better educated population will ensure they do not disappear and enhance their quality of life. This article explores the educational potential of rural Spain by focusing on a practical case study at the Grouped Rural School (CRA) Las Cogotas in Ávila, Castilla and León. It highlights the strengths and challenges of rural areas, including depopulation, aging, and lack of services, and emphasizes the importance of education in addressing these issues. The study implements STEAM (Science, Technology, Engineering, Arts, and Mathematics) education through outdoor activities, utilizing local rural and natural resources to enhance students’ learning experiences and foster environmental stewardship. The methodology includes structured interviews and a Likert scale survey analyzed with the ATLAS.ti tool to evaluate the effectiveness of the activities. The results indicate that students developed a stronger connection to their environment and showed increased interest in STEAM subjects. The findings underscore the value of integrating rural resources into formal education to improve the quality of life and sustainability of rural communities. The article aims to highlight the educational resources that rural areas offer to develop STEAM education. Full article