Search Results (5,160)

Public awareness and perception of human biomonitoring (HBM) and pesticide exposure are essential for informed decision-making and policy, yet understanding remains limited and often shaped by media and advocacy. This study combined three focus group discussions with Latvian citizens and an online content analysis of pesticide-related posts. Discussions explored understanding of HBM, attitudes toward chemical exposures, and support for related research, while content analysis identified commonly discussed pesticides and the role of non-governmental organisations (NGO) in shaping public opinion. Findings indicate low awareness and frequent misconceptions about HBM, often confused with wearable health technologies rather than a tool for assessing internal chemical exposure. Concerns were mainly linked to food additives and household chemicals, with less attention to pesticides. Glyphosate emerged as the most debated pesticide, largely driven by NGO activity and media coverage. Trust in government initiatives was mixed, with concerns about political influence, industry interests, and data privacy. Nevertheless, participants expressed strong support for further national research. Overall, the results highlight gaps in public understanding and the significant influence of media and advocacy. Strengthening risk communication, transparency, and public engagement is essential to build trust and support the development of Latvia’s HBM framework. Full article

Background: Mental health concerns are notably common among students attending universities in Saudi Arabia, and low engagement with psychological services has been widely documented in this population group. Telemental health has emerged as a promising alternative under Vision 2030’s digital transformation agenda, although the determinants of university students’ intentions to use these services have received limited empirical attention in Saudi Arabia. Objective: This study examined attitudes toward telemental health services, perceived barriers to seeking psychological help, and predictors of behavioral intentions to use telemental health services among university students in Saudi Arabia, based on the Technology Acceptance Model and Theory of Planned Behavior. Methods: A cross-sectional design was employed using an online, self-administered questionnaire. A total of 236 undergraduate students from three large universities in Riyadh were recruited using convenience sampling methods. We examined demographic variables, telemental health attitude variables (ease of use, usefulness, subjective norms, trust in telemental health, relative advantage, intentions, and attitudes), and barrier subscales (fear of stigma, trust in mental health professionals, difficulties in self-disclosure, perceived devaluation, and lack of knowledge) among university students. Descriptive statistics, Welch’s t-tests, and multiple linear regression analyses were conducted using SPSS (version 29). Results: Participants demonstrated moderately positive attitudes toward telemental health (M = 74.15, SD = 16.11) and reported moderate overall barriers (M = 50.76, SD = 14.44), with trust in mental health professionals being the most prominent barrier. The regression model explained 58.0% of the variance in behavioral intentions (F(19, 211) = 15.35, p < 0.001). Attitude was the strongest predictor (β = 0.534, p < 0.001), followed by trust in telemental health, sex, and difficulty in self-disclosure. Conclusions: Culturally tailored awareness campaigns, trust-building communication, and gender-sensitive service design are recommended to promote the adoption of telemental health by Saudi university students. These efforts align with Vision 2030’s digital health priorities and may support the equitable expansion of mental healthcare access in this population. Full article

Background: In March 2026, a meningococcal cluster centred on the University of Kent, England, caused two deaths and resulted in over 20 reported cases within the first week, including confirmed and suspected invasive cases. Subsequent UKHSA updates in early April 2026 reported 21 laboratory-confirmed MenB cases (18 linked to the outbreak strain) and two deaths, with the outbreak subsequently spreading to a second Canterbury university, Canterbury Christ Church University, and confirmed as Neisseria meningitidis serogroup B (MenB). Sub-Saharan Africa (SSA) bears a disproportionate global burden of meningococcal disease, yet university settings remain a critically understudied outbreak amplifier. This narrative review extracts epidemiological and policy lessons from the Kent event and applies them to the SSA context. Methods: We conducted a narrative review following the SANRA criteria, searching PubMed, Embase, Scopus, Google Scholar, and African Journals Online (2000–2026), with supplementary grey literature retrieved from World Health Organisation (WHO), Africa Centre for Disease Control, and United Kingdom Health Security Agency (UKHSA). Outbreak data were drawn from official UKHSA public-health statements (grey literature, archived), the University of Kent communications, and peer-reviewed expert commentary. Results: The Canterbury outbreak exposed six reproducible vulnerabilities: unprotected serogroup circulation (confirmed MenB, not covered for the current university-age cohort), nightlife-linked transmission amplification, delayed serogroup identification, poor student symptom-recognition, inadequate institutional response capacity, and, critically, multi-institutional spread via shared nightlife venues (confirmed extension to Canterbury Christ Church University within five days). Each vulnerability is demonstrably more severe in SSA universities, which face a broader multi-serogroup threat environment (NmA, B, C, W, X), virtually no university-entry vaccination requirement, and critical evidence gap of campus-specific meningococcal evidence in the published literature. Conclusions: This review proposes a five-pillar preparedness framework for SSA tertiary institutions, derived from a synthesis of the Kent outbreak and broader epidemiological evidence, intended to inform policy discussion and future research. Moreover, these should be embedded within a broader age-linked prevention strategy that begins before university entry, particularly during the transition into secondary school in high-risk settings. Priority measures include meningococcal vaccination at key educational transition points, prophylactic antibiotic pre-positioning, serogroup-capable surveillance, symptom-recognition training, and pan-continental alert A predominantly reactive response may carry substantial risk in SSA settings. Full article

Systemic lupus erythematosus (SLE) disproportionately affects women and often disrupts work, intimate relationships, and reproductive life. Although stigma is increasingly recognized in chronic illness, less is known about how it is experienced among women with SLE in China. Using an interpretive phenomenological design informed by health stigma theory, this qualitative study examined how stigma was produced, experienced, and managed in the everyday lives of 20 Chinese women living with SLE. Data were generated through semi-structured online interviews, chosen because of participants’ geographic dispersion and health-related constraints, and analyzed using an iterative thematic approach. The findings show that stigma operated through interconnected forms: visible bodily stigma linked to treatment-related appearance changes, invisible-symptom stigma that demanded ongoing credibility work, institutional stigma in employment, and gendered stigma in intimacy and motherhood. Participants responded through concealment, selective disclosure, and narrative labor: the work of presenting themselves as credible, responsible, and morally worthy despite social devaluation. These findings suggest that SLE stigma is not only interpersonal but also institutional and gendered, highlighting the need for stigma-sensitive clinical communication, workplace support, and reproductive counseling for women living with chronic illness. Full article

Background: The transition from the parenteral to subcutaneous application of systemic oncological therapy represents one of the most important innovations in modern oncology, as it affects the quality of life of patients as well as the organization of work and the management of health services. The introduction of this change requires effective leadership, interdisciplinary cooperation, and the adaptation of existing processes in healthcare organizations. Methods: We conducted a systematic review of the professional and scientific literature, considering the purpose and goal of this research. We used electronic databases: Wiley Online Library, PubMed, COBBIS.SI, and Google Scholar web browser. Papers from 2017 to 2025 were considered and processed using meta-synthesis. Results: Recent studies confirm that the subcutaneous administration of immunotherapy and targeted therapy is as effective and safe as parenteral immunotherapy, while significantly reducing treatment time and improving patient experience. Discussion: The transition to subcutaneous application provides an opportunity to transform oncology care. From a management perspective, the introduction of subcutaneous application requires systematic change management, staff training, process adaptation, and interdisciplinary cooperation. The sustainable implementation of innovations depends on organization, communication, and management support. Full article

The increasing prevalence of digital communication has made students a primary target for various cyber threats, including identity deception and impersonation techniques that can lead to data breaches and financial loss. In Saudi Arabia, where the youth population is digitally active and integrated into online learning environments, understanding their vulnerability to such threats is paramount. This paper investigates university students’ awareness, confidence, and behavioral responses to different types of spoofing attacks, including email, SMS, caller ID, and website spoofing, in Saudi Arabia. A survey was conducted to gather data from 1437 students at Saudi Electronic University, and it was analyzed using a quantitative research methodology and different statistical tests, such as Chi-square tests, Friedman tests, Kruskal–Wallis tests, correlation analysis, and regression models. The analysis results indicate that students exhibit a relatively high level of awareness. However, awareness and confidence vary across demographic groups, with significant differences associated with gender and age group. The results also reveal a significant gap between perceived confidence and detection ability in scenario-based assessments, highlighting that self-reported awareness does not necessarily translate into practical identification skills. The study emphasizes the importance of strengthening practical cybersecurity education, simulation-based training, and effective awareness delivery methods to improve students’ ability to recognize impersonation-based cyber threats in the Saudi educational sector. Full article

This study addresses second-home ownership not merely as a form of tourism accommodation or real estate investment, but as a home-building process intersecting with local life, belonging, daily practices, and sustainable destination governance. While the economic, environmental, and community impacts of second-homes have been extensively discussed in the literature, how individuals perceive their primary and secondary homes differently in terms of the bodily, material, vibrant, imaginary, and emotional dimensions of home has been examined in a limited number of studies. This research analyzes paired data obtained through a two-stage online questionnaire from 223 British participants who own a secondary home in the Mugla–Ortaca region and a primary home in the United Kingdom. The 18-item Home Scale was used as the measurement tool. Confirmatory factor analysis, reliability–validity analyses, measurement invariance, and paired-samples t-tests were applied. The findings show that the bodily home difference was not statistically significant at the conventional 0.05 threshold, whereas primary-home scores were significantly higher in the material, vibrant, imaginary, and emotional home dimensions. The small to small-medium effect sizes suggest that the results should be interpreted cautiously as an asymmetrical home-building process rather than as evidence of a hierarchical superiority of the primary home. The study proposes a planning approach that does not view second home owners as merely transient consumers in sustainable coastal–rural destinations, but rather considers social sustainability, service planning, seasonality management, and local community engagement channels together. Full article

This study examined rural pre-service teachers’ preferences for online learning platforms, Telegram, WhatsApp, and Moodle discussion forums in the Open Distance e-Learning environment. This group of students experiences digital illiteracy, limited access to assistive technologies, and network challenges, which may prevent them from optimally utilising formal learning platforms such as Moodle. They can, however, use Telegram and WhatsApp, as they regularly engage informally on these platforms. Against this backdrop, this study explored rural pre-service teachers’ experiences with Moodle and these social media platforms in an Open-Distance e-Learning space. This study employed a descriptive, qualitative case study with semi-structured interviews, guided by Siemens’ Connectivism theory. Fifteen student teachers from the College of Education in an ODeL institution were purposively sampled to provide in-depth insights into their lived experiences of platform use. The findings revealed that, although each platform served a unique instructional function, their perceived professionalism, safety, and interactivity differed substantially. Social media platforms such as Telegram and WhatsApp were lauded for their immediacy, accessibility, and low bandwidth usage, chiefly among rural pre-service teachers from economically disadvantaged communities. However, participants perceived these platforms as unprofessional, disruptive, and unsafe. Conversely, Moodle’s discussion forum was viewed as a credible, structured space that fostered academic discipline through the presence and guidance of lecturers. These contrasting perceptions highlight tensions between accessibility and academic regulation within ODeL environments. Although prior studies support incorporating social media platforms into LMSs, this research extends this discourse by emphasising the need to balance accessibility, interaction, and academic integrity within resource-constrained contexts. The study concludes that social media platforms and discussion forums can complement each other in ODeL, encouraging student interaction and inclusion, while discussion forums ensure educational rigour, safety, and institutional integrity. Full article

Background/objectives: The study aimed to identify the key methodological challenges and solutions related to recruitment and retention of rural-dwelling young adults into a randomized controlled trial that tests the feasibility of a digital healthy eating intervention (Veg4Me). Methods: Digital registration for a 12-week study was set up as a one-step process without researcher involvement. Participant registrations and recruitment rates were monitored daily using predetermined online preventative measures to identify fraudulent responses and to amend the digital registration process where necessary. Retention rates were monitored daily to identify any necessary amendments to the follow-up protocol. Results: During data collection, n = 279 fraudulent responses were identified from n = 536 total responses (52%). One month into recruitment, amendments were made to the registration process to reduce fraudulent responses. To address bot attacks, Qualtrics passwords and a two-factor authentication process were added to the Veg4Me landing page. Targeted recruitment strategies, such as unpaid social media posts, corresponded to peaks in recruitment. In the final recruitment month, a question was embedded within follow-up correspondence to encourage completion of the post-intervention survey. This resulted in an additional n = 8 (7%) participants completing the intervention. Conclusions: Empirical observations made in this study suggest that digital recruitment protocols without direct researcher involvement should consider multiple in-built strategies for identifying and preventing fraudulent responses. This includes a two-factor authentication process and minimizing the over-promotion of financial incentives in recruitment strategies. Recruitment strategies should consider the use of social media posts in local community groups, while the use of reminders and notifications could support retention. Full article

Background/Objectives: Multiple Traffic Light (MTL) front-of-pack (FOP) labels are being considered in Bahrain. We tested whether an adapted MTL label improves the nutritional quality of grocery purchases. Methods: In a two-arm randomized controlled intercept trial (January–May 2025), adults (≥21 years) responsible for household grocery shopping were recruited in high-footfall public venues and asked to complete a one-time shop on a tablet-based, purpose-built online grocery platform. The MTL label was adapted for Arabic reading direction and displayed per-serving nutrients and % recommended daily intake. Treatment effects were estimated using ordinary least squares regressions with robust standard errors and covariate adjustment. Results: Of 395 randomized participants, 360 were included in primary analyses (control n = 183; MTL n = 177). MTL exposure was not associated with a significant change in the primary outcome (basket weighted average MTL score per serving; β = 0.037; p = 0.64) or in per-serving calories and nutrients of concern (all p > 0.17). In the post-shop assessment, only 47.2% of participants correctly interpreted MTL labels, indicating modest objective label comprehension under the study conditions. Conclusions: These findings suggest that the impact of front-of-pack labels likely depends on both implementation features and consumer understanding, and that pairing labels with public communication and nutrition literacy initiatives may be necessary to maximize the effectiveness of labels in Bahrain and the wider Gulf region. Full article

The inner beauty functional food sector has grown rapidly in South Korea. These products are orally consumed bioactive formulations designed to improve skin health, hair vitality, and overall wellness. However, empirical evidence on consumption patterns and product format preferences across different demographic groups remains limited. This cross-sectional study examined consumption patterns, purchase channels, and product format preferences among 502 Korean adults who had experience with inner beauty functional foods. Chi-square analysis was used to examine differences in consumption reasons, duration of use, purchase channels, and product format preferences according to socio-demographic characteristics. Results showed that skin health was the dominant consumption motivation (47.6%), particularly among younger and female consumers, while weight management and hair and nail health were more prevalent among older adults. Online purchasing dominated (57.8%), with significant age- and education-based variation; consumers in their 20s purchased online at 67.5%, declining to 44.4% among those aged 40 and above. Capsule and tablet formats were most prevalent overall (41.6%), with males, married consumers, and graduate-degree holders showing significantly stronger preference for this format, whereas gummy and chewable formats were more frequently preferred by female consumers. These findings provide practical implications for inner beauty producers, food distributors, and nutrition educators seeking to align product development and communication strategies with the heterogeneous preferences of Korean inner beauty consumers. Full article

Background: Postpartum depression (PPD) is a common perinatal mental health disorder with important consequences for mothers and children. Early detection depends largely on primary and community healthcare professionals. This study assessed knowledge, recognition patterns, and screening practices related to PPD and examined factors associated with screening implementation. Methods: An exploratory cross-sectional online survey using convenience sampling was conducted between December 2025 and March 2026 among 154 healthcare professionals (74 community nurses and 80 physicians). Structured questionnaires assessed PPD knowledge, while physicians additionally reported screening and treatment practices. Group differences, correlations, and predictors of screening implementation were analyzed statistically. Results: Community nurses achieved higher overall knowledge scores than physicians (66.1% vs. 58.4%; p = 0.0038). Physicians more frequently distinguished baby blues from PPD (60.0% vs. 27.0%; p < 0.001). Awareness of validated screening tools among physicians was low, with only 10.0% recognizing the EPDS. Although physician knowledge correlated with screening frequency before correction for multiple testing (ρ = 0.27; p = 0.015), the association was not statistically significant after BH–FDR correction (q = 0.075). In multivariable logistic regression analysis, guideline awareness was not significantly associated with screening implementation (OR = 3.81; 95% CI 0.98–14.82; p = 0.053). Conclusions: Gaps remain in knowledge of PPD screening tools and treatment, particularly among physicians. The findings support the need for improved education, dissemination of clinical guidelines, and implementation support for standardized screening practices. However, given the exploratory convenience-sampling design and the lack of statistically significant adjusted associations, further longitudinal and implementation-focused studies are needed. Full article

The Therapeutic Shoe Benefit (TSB) allows Medicare insurance beneficiaries to reduce their diabetic foot ulcer risk by providing offloading shoes. Anecdotal evidence suggests that the process is cumbersome and that not all providers are aware of this benefit. This study evaluated TSB awareness across multiple healthcare disciplines and documented barriers to utilization. An online study surveyed healthcare providers practicing in the United States to determine familiarity with TSB and barriers to prescribing therapeutic shoes. The project was IRB-reviewed and received exempt status. The survey was sent to a wide variety of healthcare practitioners including: podiatrists, primary care providers, physical therapists, orthotist/prosthetists, specialty providers, and diabetes educators. This was done through targeted emails from professional organizations, word-of-mouth messaging through private practice groups, and marketing on LinkedIn. The survey was administered via Qualtrics with embedded branching logic used to gather data from the TSB’s three classifications of healthcare specialists: certifying physicians, prescribing practitioners, and suppliers. A total of 580 valid completions of the survey were analyzed. Irrespective of the TSB, podiatric physicians and medical professionals providing direct patient care recommend supportive shoes for patients with diabetes 98.2% (336/342) of the time. When asked about knowledge of the TSB, 522 or 90% of respondents indicated awareness of this Medicare benefit. Knowledge by specialty was hard to differentiate due to low responses by some specialties; however, prescribing podiatrists and prosthetic providers both responded with a familiarity rate above 92%. Common obstacles to providers prescribing shoes were: complexity of documentation (67.8%), challenges communicating with other providers (55.0%), and financial reasons/labor-to-reimbursement ratio (38.4%). TSB has the potential to reduce amputations and wound care costs. However, therapeutic shoes are underutilized with less than 20% of potential beneficiaries accessing this benefit. This research strengthens the argument that streamlining the process may increase access to therapeutic shoes. Full article

Geospatial Artificial Intelligence (GeoAI) enables the automated generation of built environment map features, such as building outlines/footprints, on a global scale. However, the integration of these AI-generated datasets into Volunteered Geographic Information (VGI) platforms like OpenStreetMap (OSM) risks incorporating ‘AI slop’, consisting of geometrically inconsistent/unreliable data, into the online map. While the OSM “Code of Conduct for Automated Edits” provides a policy framework for data ingestion, it lacks a machine-enforceable mechanism for real-time quality gating. This paper proposes a GeoAI-Gatekeeper to perform this task—an automated process that applies empirical Acceptable Quality Thresholds (AQT) to address the GeoAI data governance problem. Because the Gatekeeper utilizes an intrinsic, no-reference evaluation of geometric fidelity, it can assess incoming AI-generated data streams in real-time without requiring ground-truth benchmarks. Importantly, it focuses exclusively on the geometric validation of building footprints, acknowledging for now that semantic enrichment, such as tagging, remains a human-centric task. The presented GeoAI-Gatekeeper is a working prototype developed for a specific urban area, systematically triaging incoming AI-generated data into three tiers; Auto-Accept, Manual Review, and Reject. It provides a Web-GIS interface for Human-in-the-Loop (HITL) functionality to ensure the OSM community remains the final arbiter of acceptable data quality. Testing the Gatekeeper in Dublin (Ireland) demonstrates that our solution can auto-ingest 93.6% of features with a 14x reduction in human review effort while still adhering to OSM’s cartographic integrity standards. By implementing qualitative community guidelines into machine-enforceable thresholds, our approach introduces a viable methodology for next-generation hybrid VGI systems. Importantly, it ensures that the transition towards automated data ingestion reinforces, rather than undermines, the reliability of global crowd-source mapping datasets. Full article

Background/Objectives: Migraine is a common and disabling neurological disorder, and many individuals increasingly seek information online. With the growing use of large language models (LLMs), such as ChatGPT, for patient education, concerns have emerged regarding the quality and reliability of the responses they generate, particularly in Arabic, where evidence remains limited. This study aimed to evaluate the reliability, quality, and accuracy of Arabic-language responses to frequently asked questions (FAQs) about migraine. Methods: A total of 25 FAQs were selected using a multisource approach and entered into four LLMs (ChatGPT-4.1, Gemini 3 Flash, DeepSeek-V3.2, and Grok 4.1), generating 100 responses. Responses were evaluated by a panel of expert neurologists using the modified DISCERN (mDISCERN), Global Quality Scale (GQS), and an accuracy scale. Inter-rater reliability was assessed using the intraclass correlation coefficient (ICC). Results: Significant differences were observed between chatbots for mDISCERN and GQS (both p < 0.001), whereas accuracy did not differ significantly across models (p = 0.072). DeepSeek and Grok demonstrated the highest mDISCERN scores (34.07 ± 1.31 and 34.29 ± 2.59, respectively), while DeepSeek achieved the highest GQS (4.95 ± 0.13). The clearest between-model differences were observed in source transparency and communication of uncertainty. Inter-rater reliability was good across all instruments (ICC range, 0.799–0.831). Conclusions: Medical content generated by the chatbots was broadly comparable, whereas important differences were observed in how that content was communicated. These tools may support patient education; however, their use should remain guided by clinical oversight and professional judgment. Full article