Search Results (52)

Background: Drug use settings are critical determinants of overdose risk and other drug-related harms. Although sex differences in drug use patterns are well documented, less is known about sex differences in the types of locations where people use drugs. This study examined sex differences in drug use settings among people who use opioids. Methods: Data were from the baseline survey of the OASIS project, a community-based study conducted in Baltimore, Maryland (N = 869), focusing on 9 specific types of locations where participants reported drug use in the past 30 days: their own residence, someone else’s residence, street, alley, park, abandoned building, public restroom, car, and other locations. Bivariate and multivariable logistic regression models examined associations between sex and drug use settings, adjusting for age, race, education, homelessness, and frequency of drug use. Results: The sample included 346 women and 523 men. In adjusted models, women had significantly lower odds than men of using drugs on the street (aOR = 0.49, 95% CI 0.35–0.70), in alleys (aOR = 0.50, 95% CI 0.35–0.69), parks (aOR = 0.57, 95% CI 0.42–0.78), abandoned buildings (aOR = 0.53, 95% CI 0.38–0.75), cars (aOR = 0.55, 95% CI 0.41–0.73), and other locations (aOR = 0.59, 95% CI 0.37–0.94). Sex was not significantly associated with drug use at one’s own residence or someone else’s residence. Conclusions: Women who use opioids were significantly less likely than men to use drugs in public and semi-public settings, which may reflect gendered patterns of stigma, interpersonal violence, and safety concerns. Harm reduction programs should focus on making current drug use settings safer and developing additional safer settings with an emphasis on addressing barriers for women to access harm reduction services, including women-centered overdose prevention centers and household-based overdose response training. Full article

Adolescent vaping has become a persistent health and behavioural challenge in schools, yet many institutions lack reliable tools to detect and respond to concealed e-cigarette use. This study addresses this problem by evaluating the real-world performance of a low-cost “Internet of Things” (IoT) vape detection system deployed across 37 high-risk restroom and change-room locations at a large Australian Independent school. The aim was to determine whether an IoT-based environmental monitoring platform could accurately identify vaping events, support timely staff intervention, and provide actionable insights into student behaviour patterns. A longitudinal case study design was used, collecting continuous particulate matter (PM_2.5 and PM₁₀) data at one-minute intervals over an 18-month period, where PM₂.₅ and PM₁₀ refer to particulate matter with aerodynamic diameters ≤ 2.5 µm and ≤ 10 µm, respectively, reported in micrograms per cubic metre (µg/m³). Threshold-based alerting, cloud-based data processing, and school-led Closed-circuit television (CCTV) verification were combined to assess detection accuracy, temporal trends, and operational responses. The system recorded more than 300 vaping-related incidents, with clusters aligned to predictable times of day and higher prevalence among senior students. Operational detection performance was high, with alert events characterised by rapid, concurrent PM_2.5 and PM₁₀ excursions consistent with vaping-related aerosol profiles, although staff responsiveness declined over time due to alert fatigue and competing priorities. A major environmental smoke event demonstrated the need for context-aware logic to reduce false positives. The findings demonstrate that real-time aerosol monitoring is not only technically reliable but also highly effective in detecting vaping within school environments. These perspectives help explain why user engagement, alert fatigue, and institutional follow-through are as critical as sensor accuracy itself. Ultimately, the effectiveness of vape detection relies on strong organisational commitment, well-defined response workflows, and alignment with broader wellbeing and policy strategies. When these elements are in place, such systems can evolve from simple detection tools into intelligent, integrated components of school health governance. Full article

The transformation of public spaces to meet the need for shelter in the post-disaster situation is a practice observed in many countries. However, these temporary alterations are meticulously planned and executed within a defined timeframe following the disaster. This approach hinders the effective utilization of available space. The objective of the study is to reach design decisions by determining the adaptive use potential of sports facilities for temporary shelter in the post-disaster process. In addition, the study will reveal which adaptability strategies can be used to adapt spaces with different functions. The design decisions are reached by comparing sports facilities and temporary shelter needs programs based on eleven adaptability strategies (adjustability, versatility, transformability, scalability, portability, flexibility, expandability, dismountability, reuse, modularity, independence). The conversion of sports facilities into temporary shelters was achieved by employing adaptability strategies, thereby demonstrating the potential for a space with 15 different functions to undergo transformation. A transformability strategy has been employed, whereby changing rooms have been converted into laundry rooms, and grandstands into training areas. A scalability strategy has been employed to facilitate the reuse of cafe-restaurant areas as dining halls. The transformation of the playground into sleeping areas is facilitated by strategies of portability and dismountability. Flexibility and expandability strategies are employed in the transition from the first aid room to the infirmary area. A reuse strategy is employed for administrative units, parking areas, restrooms and prayer areas, ensuring that spaces with similar needs are utilized with minimal intervention. By examining a range of adaptability strategies, analogous adaptability applications can be developed for other public spaces. The study contributes a transferable, criteria-driven framework that supports decision-making for the adaptive reuse of public buildings in post-disaster contexts, offering a structured basis for extending similar transformations to other building typologies. Full article

This paper presents an analysis of user preferences regarding the use and design of toilets in densely populated buildings. Toilets are a necessary utility in all buildings, but little is known about users’ preferences, which often leaves building designers relying on the simple application of design codes or manufacturers’ instructions. The opportunity for this research was offered by the renovation of the sanitary facilities taking place in a large university building at the Iuav University of Venice. When the research was carried out, only half of the toilets of the building had been renovated, offering a unique opportunity to compare the preferences of users between the refurbished and the old toilets. Students enrolled in the undergraduate architecture program hosted in the building were surveyed with a questionnaire to monitor their preferences for using the toilets, comparing the old and new layouts and technical characteristics of the bathrooms. Simultaneously, on-site observations were conducted to measure the occupation of toilet blocks and compare the performance of the new versus the old layout. The results offer novel and detailed information on the use of bathrooms by a homogeneous group of users and their preferences concerning the design features of lavatory spaces, highlighting user-centered design priorities. The results contradict some commonplaces, for instance about the longer time spent in public restrooms by females. Also, results highlight the limited usage of urinals by males but evidence how the minority of males that do use them create an advantage for the whole male population. Full article

Accessible and inclusive community environments support physical activity and health equity for people with disabilities, yet gaps in design, maintenance, and communication limit safe, independent use. This statewide cross-sectional audit assessed park accessibility and usability and playground safety in publicly accessible, non-fee-based Delaware community parks with playgrounds. Fifty stratified sites were evaluated using the Community Health Inclusion Index and the America’s Playgrounds Safety Report Card by trained raters with strong interrater reliability. Descriptive analyses summarized accessibility, usability, communication, and safety features by county, with exploratory urban-suburban/micropolitan contrasts. Most sites provided wide, smooth paths, shade, and strong playground visibility, but foundational accessibility varied. Only 30% had a nearby transit stop, fewer than 10% of crossings included auditory or visual signals. Curb-ramp completeness was inconsistent, with detectable warnings frequently absent. Restrooms commonly lacked low-force doors or operable hardware, and multi-use trails often had obstacles or lacked wayfinding supports. Playground accessibility features were present at approximately two-thirds of sites, and 62% were classified as safe, although 10% were potentially hazardous or at-risk. Higher playground accessibility scores were strongly associated with lower life-threatening injury risk. Overall, gaps in transit access, pedestrian infrastructure, amenities, and communication support limit equitable, health-supportive park environments and highlight priority improvement areas. Full article

During the Coronavirus Disease 2019 (COVID-19) pandemic, global awareness of infectious diseases increased markedly. Many infectious diseases are transmitted through direct or indirect contact with biological fluids containing pathogens such as viruses and bacteria. This risk is particularly pronounced in environments used by large numbers of unspecified individuals. Public restrooms, therefore, raise significant hygienic concerns, as toilet seats may serve as vectors for indirect transmission. To mitigate this risk, this study proposes a novel toilet seat equipped with an automatic cleaning function. Specifically, after use, the seat surface is automatically wiped by a cleaning cloth, eliminating the need for manual cleaning by staff. A fundamental operational concept is established, emphasizing the determination of an appropriate cleaning initiation timing that allows the cleaning sequence to be completed without compromising user convenience. Based on this concept, a belt–pulley type prototype is developed, and the effectiveness of the proposed cleaning sequence is verified. Subsequently, the prototype is further improved through the introduction of a flexible-rack mechanism. The control methodology, including the design of the electronic circuitry, is described in detail. Using the improved prototype, extensive simulations and experimental evaluations were conducted. The results showed that battery capacity declined at an approximately constant rate of 3% per 10 cycles, with about 70% remaining after 100 cycles. In addition, a single reciprocating cleaning cycle removed over 95% of artificially applied stains across the entire toilet seat. Additional evaluation results are presented in detail. Full article

This exploratory study addresses the problem of limited research on quality assessments of newly emerging multi-use market formats that function as social hubs and their management as privately managed public spaces. Using Āgenskalns Market, a revitalised multi-use market hall in Riga, as a case study, the authors apply an assessment framework based on Yuri Impens’ study on covered food halls, incorporating quality criteria from Vikas Mehta’s Public Space Index and the UN-Habitat’s Site-Specific assessment methodology. Leclercq et al.’s works on privatisation of public spaces are integrated in the analysis of “publicness”. This framework evaluates user and observer perceptions across four dimensions: environmental quality and comfort, accessibility and amenities, social experience, and market offer. Data comprised an online survey of 318 respondents and 21 structured observations conducted during summer in 2024 and 2025. The preliminary results suggest users perceive the market as a well-maintained, aesthetically pleasing, accessible space, while identifying room for improvement regarding restroom facilities, indoor thermal regulation, noise mitigation, outdoor weather protection and parking arrangements. As for meaningful use and promoting sociability, findings highlight that flexible seating areas that allow high degrees of temporary personalisation and appropriation, alongside tailored programming and diverse activities beyond retail and dining, play an important role in attracting and retaining diverse audiences. While pricing concerns were noted for specific product groups, exclusionary effects appear to be counterbalanced by openness and inclusivity of cultural programmes and free events. The findings contribute to broader urban scholarship discussions calling for new typologies that better capture the changing character of public space use. This research suggests that private-public partnerships involving multiple stakeholders can enhance “publicness” by promoting inclusivity and social life through accessible infrastructure, diverse activities and free events, as well as enabling opportunities for temporary appropriation by users. Full article

The mosquito fauna was examined at the Mérida Zoological Park, a public site that is highly frequented and is a significant tourist attraction in the Yucatán Peninsula, in southeastern México. Between January 2023 and February 2024, 24 visits were made to the zoo to capture adult and immature stages of mosquitoes. Overall, 12 species belonging to five genera (Aedes, Anopheles, Culex, Ochlerotatus, and Uranotaenia) were documented. A total of 6601 adult mosquitoes of 10 species were captured by aspiration. The adult population of Culex quinquefasciatus Say was the most abundant, accounting for 80.84% (n = 5336) of the collection, while Aedes aegypti Linnaeus represented 11.53% (n = 761). The aviary was the site with the highest capture abundance (n = 2414) and species richness (n = 10). Aedes aegypti was abundant in the zoo restroom (n = 331) and had a higher proportion of blood-feeding females. A total of 1090 larvae and 160 pupae of nine species were collected from 26 mosquito breeding sites, accounting for 25% of positive containers (26/104). Aedes albopictus was frequently found in the larval stage (n = 43) compared to the adult stage (n = 3). The presence of mosquitoes with the potential to transmit pathogens poses a public health risk to zoo visitors and staff. Full article

Against the background of rapid global urbanization, the renewal and renovation of historic districts have become an increasingly important concern. As a city with a long and rich history, Beijing contains numerous historic districts that are in urgent need of systematic renewal and renovation. This study proposes a functional enhancement and renovation design methodology for urban historic districts based on space syntax theory and analytical methods, applying it to the Qianmen Historic District in Beijing. Through traffic flow and business format analysis, the research examines traffic patterns and business format distribution characteristics in the Qianmen area and ultimately guides the design based on these findings. Research indicates that restrooms and attractions in Beijing’s Qianmen historic district exhibit dispersed space distribution, broad service coverage, high metric step depth (447 m and 436 m, respectively), and low topological connectivity. In contrast, hotels and restaurants feature smaller service areas, lower metric step depth (395 m and 297 m, respectively), and higher topological connectivity. Based on these findings, this study proposes targeted design recommendations for Qianmen’s street renovations based on traffic flow analysis results. Considering the need for vehicle parking and pedestrian rest demands in urban functional renewal, rest seats and shared charging piles are set up on the streets with big pedestrian flow to meet the needs of pedestrians. Moreover, cycling routes are designed to connect big-traffic-flow streets with small-traffic-flow ones. These renewal measures aim to enhance the overall vitality of the Qianmen district. The renovation approach and methodology proposed in this study can serve as a reference for future updates and renovations of historic districts. Full article

Background: Gender-diverse populations in India, including transgender and non-binary individuals, experience systemic barriers to healthcare, with dentistry remaining particularly underexplored. Despite legislative protections, oral health professionals (OHPs) often lack the knowledge, sensitivity, and preparedness needed to provide inclusive care. This study aimed to benchmark gender sensitivity, inclusivity, and clinical preparedness of Indian OHPs using the novel Oral Healthcare Professional’s Gender Sensitivity, Inclusivity, and Preparedness (OHP–GSIP ©) tool. Methods: A descriptive cross-sectional survey was conducted among 3660 registered dental practitioners across six zones of India using probability proportional to size sampling. The prevalidated OHP–GSIP © scale assessed five domains: gender sensitivity, inclusive environments, diversity in practice, professional attitudes, and preparedness for transgender oral healthcare. Data were collected through a structured online questionnaire and analyzed with SPSS 17.0 using descriptive statistics, chi-square tests, correlation matrices, and multiple regression. Results: Participants demonstrated moderate LGBTQIA+ knowledge (mean = 6.52/10, SD = 1.78) and comfort in treating transgender patients (mean = 3.81/5, SD = 1.09). Structural inclusivity was limited: only 23.5% reported gender-neutral restrooms, and 17.5% used non-binary intake forms. Over 90% expressed willingness to employ or collaborate with transgender colleagues, though this did not significantly predict clinical comfort. Regression analysis showed inclusivity in practice (β = 0.38, p < 0.001), awareness of gender-affirming clinics (β = 0.29, p < 0.001), and LGBTQIA+ knowledge (β = 0.22, p < 0.001) as the strongest predictors of comfort in treating transgender patients, collectively explaining 41% of the variance. Conclusion: While Indian OHPs displayed generally supportive attitudes toward transgender individuals, substantial gaps persist in structural inclusivity, clinical preparedness, and knowledge. Bridging these gaps requires systemic reforms in dental education, policy, and practice environments. The OHP–GSIP © tool provides a benchmark for guiding curricular integration, institutional inclusivity, and policy advocacy toward equitable, gender-affirming oral healthcare. Full article

This paper presents the design, development, and evaluation of an embedded hardware and digital signal processing (DSP)-based real-time gesture-controlled system. The system architecture utilizes an MPU6050 inertial measurement unit (IMU), Arduino Uno microcontroller, and Python-based audio interface to recognize and classify directional hand gestures and transform them into auditory commands. Wrist tilts, i.e., left, right, forward, and backward, are recognized using a hybrid algorithm that uses thresholding, moving average filtering, and low-pass smoothing to remove sensor noise and transient errors. Hardware setup utilizes I²C-based sensor acquisition, onboard preprocessing on Arduino, and serial communication with a host computer running a Python script to trigger audio playing using the playsound library. Four gestures are programmed for basic needs: Hydration Request, Meal Support, Restroom Support, and Emergency Alarm. Experimental evaluation, conducted over more than 50 iterations per gesture in a controlled laboratory setup, resulted in a mean recognition rate of 92%, with system latency of 120–150 milliseconds. The approach has little calibration costs, is low-cost, and offers low-latency performance comparable to more advanced camera-based or machine learning-based methods, and is therefore suitable for portable assistive devices. Full article

Period poverty is a broad and complex issue that intersects with various areas, including health, education, infrastructure, and human rights, among others, affecting countless women and girls around the world. Despite remarkable technological, social, and economic advances this century, menstruation remains a taboo subject, which leads to widespread misinformation and stigma. Prejudice and a lack of access to knowledge and essential sanitation resources, such as clean water, hygiene products, and safe private spaces, heighten the vulnerability of those affected. Integrated and multisectoral approaches that involve legislature, health, education, and sanitation are necessary to face this public health issue effectively. These efforts involve developing and implementing comprehensive plans that unite government, society, and the private sector. Some examples of these actions include making information about menstruation and menstrual health available in schools, cutting taxes on feminine hygiene products, improving basic sanitation, building decent public restrooms, and providing free sanitary pads in schools and workplaces. These initiatives have the potential to promote menstrual health and dignity, ensuring that people who menstruate can manage their periods in healthy, safe, and supportive environments. This review aims to shed light on menstrual poverty in Brazil as a global issue and a human rights violation, especially when it comes to the rights to health, education, and dignity. It stresses that efforts to end this social stigma and align with the 2030 Agenda, which seeks to eliminate poverty and inequality worldwide, and provides a plan of action to tackle this stigma. 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

The transmission of infectious diseases via the use of public restrooms has been previously documented. The goal of this study was to compare bacterial contamination in public vs. household restrooms and, using quantitative microbial risk assessment (QMRA), to assess the probability of infection from fomite contact with selected high-touch sites within the restrooms. Fomite surfaces in four public and four household restrooms were sampled over a period of two months. The public restrooms were in an office building occupied by 80 individuals and were considered moderate usage. The toilet seat, toilet flush handle, countertops, and floor were sampled for heterotrophic, coliform, and Escherichia coli bacteria. The highest numbers of heterotrophic bacteria and coliforms were detected on the countertops, followed by the floor. The greatest numbers of E. coli were recovered from the countertops in the household restroom, but the greatest numbers in the public restroom were recovered from the toilet flush handle. Numbers of heterotrophic bacteria and coliforms were 10 to 100 times greater in household restrooms than in public restrooms. The QMRA suggested that the greatest risk of acquiring a norovirus infection involved the touching of the countertops in household restrooms and the toilet flush handles in public restrooms. Full article

Urban public toilets are essential for improving urban and rural living environments. Traditional evaluations have relied on statistical indicators such as total numbers and network coverage, but have overlooked population demand, limiting their ability to reflect actual service levels and optimize spatial allocation. This study assesses the public toilet service capacity according to spatial accessibility and offers insights into layout optimization. The main urban area of Kunming was considered as the case study. First, the Gaussian two-step floating catchment area (G2SFCA) method was used to calculate public toilet accessibility. The service level of public toilets at the community scale was assessed based on the calculation results. Finally, recommendations for the optimization of the spatial layout of public toilet provision are proposed based on the evaluation findings. Results indicate that (1) 57 communities lacked access to public toilets within a 5 min walk, while only two lacked access within 20 min; all communities had access within 30 min; (2) increasing stalls in old public toilets by 50% would meet the policy requirements for most residents; (3) transportation accessibility has a significant impact on residents’ convenience in accessing public toilets. Areas with lower transportation connectivity tend to have poorer toilet accessibility. The construction of new public toilets near road networks can effectively enhance overall restroom convenience for residents in the study area. By integrating public toilet accessibility with resident restroom demand, this study proposes targeted strategies for optimizing the spatial layout of urban public toilets, offering valuable insights and feasible solutions for improving the scientific and rational allocation of urban public resources. Full article