Search Results (1,424)

Low uptake of pre-exposure prophylaxis (PrEP) for HIV prevention among Black women has been partly attributed to barriers related to patient-provider communication. The goal of this paper was to investigate the association between exposure to the #ShesWell campaign and Black women’s communication about PrEP with a healthcare provider (HCP). We conducted a cross-sectional survey of 403 sexually active, Black women after the initial phase of #ShesWell and used multivariable regression models to analyze whether exposure to #ShesWell was associated with talking to an HCP about PrEP or intention to discuss PrEP with an HCP in the future. Approximately 33% of women surveyed reported exposure to #ShesWell. Campaign exposure was significantly associated with talking to an HCP in the past year about PrEP (OR = 4.96, p = 0.001) and intention to discuss PrEP with an HCP in the next six months (B = 0.29, p = 0.038). Stronger beliefs that doctors should initiate sexual health conversations were positively associated with past PrEP conversations (OR = 2.32, p < 0.001) and future intention (B = 0.11, p = 0.029). Greater comfort discussing prevention (B = 0.35, p < 0.001), self-efficacy discussing PrEP (B = 0.29, p = 0.001), and concern about getting HIV (B = 0.51, p < 0.001) were also associated with intention to discuss PrEP with an HCP. Findings highlight the potential for communication campaigns to motivate patient-provider communication about PrEP, addressing a reported barrier to PrEP uptake among Black women. Full article

Background: This study examines current trends in Canada using data from the Canadian Joint Replacement Registry (CJRR) and includes a national survey to understand the varied uptake of cement for femoral stem fixation. Methods: The survey was available online and the website link was distributed to all orthopaedic surgeons through the Canadian Orthopaedic Association between September and December 2022. The CJRR obtained data from the Canadian Institute for Health Information (CIHI), and information pertaining to patients 55 years of age and older who underwent hemiarthroplasty for hip fracture in Canada between April 2017 and March 2022 was used. Results: Most respondents practiced in an academic community setting (52%). Only 53% of respondents reported using cement, and 71% indicated that cemented fixation was the best practice. The main reasons for using uncemented stems were less operative time (23%), cement disease concerns (11%), and surgeons’ comfort (10%). Similarly, CJRR data showed only 51% cemented fixation among 42,386 hemiarthroplasties performed between 2017 and 2022. The proportion of cemented implants varied by province, but overall, the increase in the use of cement from 2017 to 2022 was from 42.9% to 57.7%. Conclusions: This study demonstrates variability in the use of cement for femoral fixation despite solid evidence showing improved outcomes using cement. Some of the main reasons in favour of uncemented stems include operative time, surgical training, and concerns about cement disease. Establishing clear position statements and guidelines supporting cemented fixation may be prudent to build universal consensus on this practice. Full article

Background and Objectives: Depression is a leading cause of disability globally, with treatment challenges including limited access, stigma, and poor adherence. Gamification, which applies game elements such as points, levels, and storytelling into non-game contexts, offers a promising strategy to enhance engagement and augment traditional treatments. Our research is the first study designed to explore the implementation of gamification within the Malaysian context. The objective was to explore the feasibility of implementation of gamification as an adjunctive treatment for adults with depression. Materials and Methods: Focus group discussions were held with five mental health professionals and ten patients diagnosed with moderate depression. The qualitative component assessed perceptions of gamified interventions, while quantitative measures evaluated participants’ depressive and anxiety symptomatology. Results: Three key themes were identified: (1) understanding of gamification as a treatment option, (2) factors influencing its acceptance, and (3) characteristics of a practical and feasible intervention. Clinicians saw potential in gamification to boost motivation, support psychoeducation, and encourage self-paced learning, but they expressed concerns about possible addiction, stigma, and the complexity of gameplay for some patients. Patients spoke of gaming as a source of comfort, escapism, and social connection. Acceptance was shaped by engaging storylines, intuitive design, balanced difficulty, therapist guidance, and clear safety measures. Both groups agreed that gamification should be used in conjunction with standard treatments, be culturally sensitive, and be presented as a meaningful therapeutic approach rather than merely as entertainment. Conclusions: Gamification emerges as an acceptable and feasible supplementary approach for managing depression in Malaysia. Its success depends on culturally sensitive design, robust clinical oversight, and seamless integration with existing care pathways. Future studies should investigate long-term outcomes and establish guidelines for the safe and effective implementation of this approach. We recommend targeted investment into culturally adapted gamified tools, including training, policy development, and collaboration with key stakeholders to realistically implement gamification as a mental health intervention in Malaysia. Full article

Traditional Chinese villages, which have long supported villagers’ comfort level of daily activities, are increasingly affected by global climate change and rural reconstruction, prompting growing research interest in their outdoor microclimate design. This systematic review aims to synthesize and evaluate the outdoor microclimate spatial design mechanism studies in traditional Chinese villages noted for their uniqueness and complexity. Following the PRISMA method, this study was carried out on November 27, 2024, by retrieving studies from the Scopus and CNKI databases and applying predefined inclusion and exclusion criteria; 42 empirical studies were systematically reviewed. It identifies current research trends, summarizes concepts, frameworks, indicators, and methodologies with a focus on the design mechanisms considering scales, contexts, and user groups, and outlines directions for future research. The findings reveal a growing number of publications, with case studies predominantly concentrated on three concepts: physical microclimates, human comfort, and behavioral responses, characterized as distributed in south-east areas. Based on these concepts and their correlations, this study proposes a classification framework based on multiple scales, contexts, and user groups. Within this framework, the study found that relative humidity and PET (physiological equivalent temperature) emerge as the most commonly used indicators, while field measurements, simulations, surveys, and observations are identified as the primary methods. The review further reveals that unique outdoor spatial design characteristics shape physical microclimates, human comfort, and behavior indicators influenced by contexts and users from the macro to the micro scale. Future research should advance existing studies by enriching the current contextual framework and explore more microclimatic factors. This review offers a comprehensive overview and actionable insights for outdoor microclimate design, policymaking, and the promotion of climate adaptation and villagers’ public health in different traditional rural settings. Full article

Background: Despite their high prevalence and potential for significant morbidity, hemorrhoidal symptoms remain underreported and undertreated. Misconceptions and stigma may delay care-seeking behaviors and negatively influence patient outcomes. Methods: We conducted a cross-sectional, questionnaire-based study in Romania to assess public awareness, attitudes, and barriers related to hemorrhoidal disease. The survey included 185 participants and evaluated variables such as symptom severity, understanding of the condition, perceived stigma, and willingness to consult a physician. Results: Only 30.8% of participants had sought medical advice for hemorrhoidal symptoms. Younger age (p < 0.001), male sex (p = 0.013), and lower levels of perceived severity were significantly associated with reluctance to seek medical care. The most frequently reported barriers were embarrassment and fear of invasive diagnostic procedures. Colonoscopy and digital rectal examination were identified as major deterrents by 39.5% and 38.9% of respondents, respectively. Educational level influenced both the perceived understanding of the disease (p = 0.001) and comfort in discussing anal symptoms (p = 0.002). Gender preference for physicians was significantly associated with respondent sex (p = 0.007) but not with education or age. Conclusions: Hemorrhoidal disease remains a stigmatized and underestimated condition. Public health efforts should prioritize educational interventions, destigmatization campaigns, and improved physician–patient communication to facilitate earlier diagnosis and better disease management. Full article

Developing stretchable strain sensors that combine both high sensitivity and a wide linear range is a critical requirement for health electronics, yet it remains challenging to meet the practical demands of daily health monitoring. This study proposes a novel heterogeneous surface strategy by in situ silver deposition on modified PDMS followed by MXene spray coating, constructing a multilevel microcrack strain sensor (MAP) using silver nanoparticles and MXene. This innovative multilevel heterogeneous microcrack structure forms a dual conductive network, which demonstrates excellent detection performance within GF_max = 487.3 and response time ≈65 ms across various deformation variables. And the seamless integration of the sensor arrays was designed and employed for the detection of human activities without sacrificing biocompatibility and comfort. Furthermore, by adopting advanced deep learning technology, these sensor arrays could identify different joint movements with an accuracy of up to 95%. These results provide a promising example for designing high-performance stretchable strain sensors and intelligent recognition systems. Full article

The human circadian rhythm is connected to the body’s endogenous clock and can influence people’s natural sleeping habits as well as a variety of other biological functions. According to research, various electric light sources in interior locations can disrupt the human circadian rhythm. Many psychological studies, on the other hand, reveal that different colors can have varied connections with and a variety of effects on people’s emotions. In this study, the effects of light source attributes and interior space paint color on human circadian rhythm were studied using 24 distinct computer simulations. Simulations were performed using the ALFA plugin for Rhinoceros 6 on an unfurnished bedroom 3D model at night. Results suggest that cooler hues, such as blue, appear to have an unfavorable effect on human circadian rhythm at night, especially when utilized in spaces that are used in the evening, which contradicts what psychologists and interior designers advocate in terms of the soothing mood and nature of the color. Furthermore, the effects of Correlated Color Temperature (CCT) and the intensity of a light source might be significant in minimizing melanopic lux to prevent melatonin suppression at night. These insights are significant for interior designers, architects, and lighting professionals aiming to create healthier living environments by carefully selecting lighting and color schemes that support circadian health. Incorporating these considerations into design practices can help mitigate adverse effects on sleep and overall well-being, ultimately contributing to improved occupant comfort and health. Full article

Since the start of the energy crisis in 2020, the Dutch government has introduced various programmes aimed at alleviating energy poverty among low-income households. This research examines the effects of three specific interventions—energy coaching, home renovations, and white goods schemes—on a range of energy poverty-related aspects, including living comfort, physical and mental health, energy costs, financial concerns, social connection, neighbourhood involvement, and sustainable behaviour. While previous studies have mostly investigated these interventions in isolation, this research offers a comparative analysis to explore how their impacts differ and how they may complement one another. This research, comparing an intervention group and control, shows that energy coaches, renovations, and white goods schemes each have positive effects on various aspects of energy poverty. However, the nature and magnitude of these effects differ by type of support measure. Renovations are the most effective overall, significantly improving living comfort, physical health, and reducing energy costs. White goods schemes primarily reduce moisture and mould in dwellings and have a notable positive impact on mental health. Energy coaches contribute to improved living comfort, lower energy costs, and uniquely enhance community involvement. The complementary nature of these interventions highlights the potential added value of integrated or combined approaches to tackling energy poverty. Full article

This study examines diurnal surface temperature dynamics across major Moroccan cities during the growing season and explores the interaction between urban and vegetated surfaces. We also introduce the Urban Thermal Impact Ratio (UTIR), a novel metric designed to quantify urban thermal comfort as a function of the surface urban heat island (SUHI) intensity. The analysis is based on outputs from a land surface model (LSM) for the year 2010, integrating high-resolution Landsat and MODIS data to characterize land cover and biophysical parameters across twelve land cover types. Our findings reveal moderate urban–vegetation temperature differences in coastal cities like Tangier (1.8 °C) and Rabat (1.0 °C), where winter vegetation remains active. In inland areas, urban morphology plays a more dominant role: Fes, with a 20% impervious surface area (ISA), exhibits a smaller SUHI than Meknes (5% ISA), due to higher urban heating in the latter. The Atlantic desert city of Dakhla shows a distinct pattern, with a nighttime SUHI of 2.1 °C and a daytime urban cooling of −0.7 °C, driven by irrigated parks and lawns enhancing evapotranspiration and shading. At the regional scale, summer UTIR values remain below one in Tangier-Tetouan-Al Hoceima, Rabat-Sale-Kenitra, and Casablanca-Settat, suggesting that urban conditions generally stay within thermal comfort thresholds. In contrast, higher UTIR values in Marrakech-Safi, Beni Mellal-Khénifra, and Guelmim-Oued Noun indicate elevated heat discomfort. At the city scale, the UTIR in Tangier, Rabat, and Casablanca demonstrates a clear diurnal pattern: it emerges around 11:00 a.m., peaks at 1:00 p.m., and fades by 3:00 p.m. This study highlights the critical role of vegetation in regulating urban surface temperatures and modulating urban–rural thermal contrasts. The UTIR provides a practical, scalable indicator of urban heat stress, particularly valuable in data-scarce settings. These findings carry significant implications for climate-resilient urban planning, optimized energy use, and the design of public health early warning systems in the context of climate change. Full article

This study assessed the baseline indoor environmental quality (IEQ) of secondary school classrooms in Tanzania by measuring temperature, relative humidity, noise, lighting, and indoor air quality. Objective measurements were conducted using calibrated sensors in 14 classrooms across five schools, with data collected during occupied school hours and additional noise measurements during unoccupied periods. All classrooms are naturally ventilated through operable windows and doors. The findings reveal a pattern of cumulative IEQ deficiencies: classroom temperatures frequently exceeded the recommended 20–24 °C range, reaching means as high as 30.4 °C, while relative humidity varied widely, with levels occasionally surpassing 65%. Noise levels consistently exceeded the World Health Organization (WHO)’s recommended 35 dBA threshold, with significant differences observed between occupied and unoccupied periods (p = 0.02). Light distribution was uneven, with significantly higher lux levels near windows than at classroom centers (p < 0.001), and artificial lighting was generally insufficient due to infrastructure limitations. Although CO₂ concentrations remained below the 1000 ppm threshold, indicating adequate ventilation, particulate matter levels were often elevated, with PM2.5 reaching up to 58.80 µg/m³ and PM10 up to 96.90 µg/m³, exceeding health-based guidelines. Together, these findings suggest that students are exposed to multiple environmental stressors that may impair health, comfort, and academic performance. This study provides a critical baseline for future research and context-specific interventions aimed at improving learning environments in Tanzanian schools and similar settings in East Africa. Full article

Obstructive sleep apnea (OSA) is a prevalent and heterogeneous sleep disorder associated with significant health and societal burdens. While continuous positive airway pressure (CPAP) remains the gold standard treatment, its limitations in adherence and patient tolerance have highlighted the need for alternative therapies. Positional therapy (PT), which targets apneas that occur predominantly in the supine position, has emerged as a promising option for individuals with positional OSA (POSA). This narrative review synthesizes the current literature on PT, examining its clinical indications, typologies, comparative efficacy with CPAP, oral appliances, and hypoglossal nerve stimulation, as well as data on adherence and barriers to long-term use. Traditional methods such as the tennis ball technique have largely been replaced by modern vibrotactile devices, which demonstrate improved comfort, adherence, and comparable short-term outcomes in selected POSA subjects. While PT remains inferior to CPAP in reducing overall AHI and oxygen desaturation, it performs favorably in terms of mean disease alleviation (MDA) and sleep continuity. Importantly, treatment effectiveness is influenced by both anatomical and non-anatomical traits, underscoring the need for accurate phenotyping and individualized care. PT should be considered within a broader patient-centered model that incorporates preferences, lifestyle, and motivational factors. Further research is needed to validate long-term efficacy, optimize selection criteria, and integrate PT into personalized OSA management strategies. Full article

This study provides user-centered insights into how inclusive forest design can support the physical, emotional, and social well-being of older adults. It operationalizes universal design principles in natural settings and confirms their relevance through empirical evidence. With the acceleration of global population aging, adapting forest recreation environments to meet the specific needs of older adults is increasingly urgent. This study investigates how infrastructure influences both participation and emotional well-being among older visitors to forest recreation areas. Data were collected from 446 participants aged 65 and older, using a structured survey distributed through in-person contact and digital snowball sampling. Participants reported their infrastructure preferences and their emotional responses related to forest visits. The findings show that older adults highly value site cleanliness, shaded seating, accessible restrooms, and clear signage. Expectations varied significantly according to health status, age group, and visitation frequency. Emotional well-being was positively associated with both comfort and visit frequency. These results demonstrate how inclusive infrastructure plays a vital role in supporting older adults’ access to and enjoyment of forest environments. The study affirms that universally designed forests not only reduce barriers but also promote psychological health and active aging, contributing to developing more equitable and sustainable nature-based recreation areas. Full article

As the demand for energy-efficient homes continues to rise, the importance of advanced mechanical ventilation systems in maintaining indoor air quality (IAQ) has become increasingly evident. However, challenges related to energy balance, IAQ, and occupant thermal comfort persist. This review examines the performance of mechanical ventilation systems in regulating indoor climate, improving air quality, and minimising energy consumption. The findings indicate that demand-controlled ventilation (DCV) can enhance energy efficiency by up to 88% while maintaining CO₂ concentrations below 1000 ppm during 76% of the occupancy period. Heat recovery systems achieve efficiencies of nearly 90%, leading to a reduction in heating energy consumption by approximately 19%. Studies also show that employing mechanical rather than natural ventilation in schools lowers CO₂ levels by 20–30%. Nevertheless, occupant misuse or poorly designed systems can result in CO₂ concentrations exceeding 1600 ppm in residential environments. Hybrid ventilation systems have demonstrated improved thermal comfort, with predicted mean vote (PMV) values ranging from –0.41 to 0.37 when radiant heating is utilized. Despite ongoing technological advancements, issues such as system durability, user acceptance, and adaptability across climate zones remain. Smart, personalized ventilation strategies supported by modern control algorithms and continuous monitoring are essential for the development of resilient and health-promoting buildings. Future research should prioritize the integration of renewable energy sources and adaptive ventilation controls to further optimise system performance. Full article

This review investigates the role of building windows in supporting occupant well-being through access to natural views and daylight. This review synthesizes recent interdisciplinary research from environmental psychology, building science, and human physiology to examine how windows impact cognitive performance, psychological restoration, and circadian health. Drawing on 304 peer-reviewed studies from 2000 to 2024, the review identifies two core pathways: visual effects—related to daylight availability, glare control, and view quality—and non-visual effects—linked to circadian entrainment and neuroendocrine regulation via ipRGCs. These effects interact yet compete, necessitating a multi-objective optimization approach. This paper evaluates commonly used metrics for visual comfort, circadian-effective lighting, and view quality and discusses their integration in design frameworks. The review also highlights the potential of adaptive facade technologies and artificial window systems to balance human-centered lighting goals with energy efficiency. A research roadmap is proposed to support future integrative design strategies that optimize both visual and non-visual outcomes in diverse architectural contexts. Full article

Indoor radon constitutes a public health issue in various regions across the United States as the second leading cause of lung cancer following tobacco smoke. The U.S. Environmental Protection Agency advises radon mitigation interventions for residential buildings with indoor radon concentrations exceeding the threshold level of 4 pCi/L. Despite considerable research assessing the technical effectiveness of radon mitigation systems, there remains a gap in understanding their broader influence on occupant behavior and preferences in residential design. This study aims to investigate the impact of residing in radon-mitigated homes within the Commonwealth of Kentucky—an area known for elevated radon concentrations—on occupants’ preferences regarding healthy home design attributes. The objectives of this research are twofold: firstly to determine if living in radon-mitigated homes enhances occupant awareness and consequently influences their preferences toward health-related home attributes and secondly to quantitatively evaluate and compare the relative significance homeowners assign to health-related attributes such as indoor air quality, thermal comfort, and water quality relative to conventional attributes including home size, architectural style, and neighborhood quality. The overarching purpose is to explore the potential role radon mitigation initiatives may play in motivating occupants towards healthier home construction and renovation practices. Using choice-based conjoint (CBC) analysis, this paper compares preferences reported by homeowners from radon-mitigated homes against those from non-mitigated homes. While the findings suggest a relationship between radon mitigation and increased preference for indoor air quality, the cross-sectional design limits causal interpretation, and the possibility of reverse causation—where health-conscious individuals are more likely to seek mitigation—must be considered. The results provide novel insights into how radon mitigation efforts might effectively influence occupant priorities towards integrating healthier design elements in residential environments. Full article