Search Results (2,603)

Based on survey data from the National Ecological Civilization Pilot Zone (Jiangxi), this study divides rural residents’ self-reported policy compliance in household waste classification (PC) into habit-based policy compliance in waste classification (HPC) and decision-based policy compliance in waste classification (DPC). The integration of a random forest model with Shapley Additive Explanations (SHAP) is utilized to identify the key predictors of each compliance type and to reveal the non-linear predictive contributions and marginal effects through which these factors respectively affect HPC and DPC. Furthermore, fuzzy-set qualitative comparative analysis (fsQCA) is used to uncover the multiple configurational pathways driving each type of compliance. Research indicates the following: (1) The key predictive factors of HPC and DPC are different. (2) Subjective norms (SUN), information interaction (II), and social norms (SON) exhibit significant nonlinear predictive contributions to HPC; policy identification (PI), SON, and procedural fairness (PF) show nonlinear trends in their contributions to the predictive probability of DPC. (3) There are five configuration paths for HPC and four for DPC. This study not only deepens the understanding of rural residents’ HPC and DPC but also provides practical guidance for governments to formulate differentiated and efficient measures to encourage compliance with waste classification policies. Full article

While drone delivery has gained significant scholarly and industrial interest, rural residents’ acceptance of these systems remains underexplored, despite the region’s acute logistics challenges and service inequities. Using survey data from rural U.S. residents, this study first estimates an ordered logistic regression (OLR) model to identify factors associated with five-level drone delivery acceptance. The study then compares OLR, multinomial logistic regression (MNL), Random Forest (RF), XGBoost, and LightGBM under matched feature sets to evaluate whether nonlinear machine-learning models improve prediction beyond the interpretable statistical baseline. Open-ended responses are coded into LLM-derived sentiment labels and added as supplementary predictors to test whether unstructured feedback improves acceptance prediction. Results show that willingness to pay is the strongest predictor of acceptance, while equitable same-day delivery demand and post-pandemic attitude adjustment are also positively associated with higher acceptance. Household disability status and urban accessibility are not significant after adjustment. In the five-level analysis, OLR provides a strong ordinal baseline, while XGBoost and other tree-based models improve selected class-level prediction metrics. In the binary high-acceptance analysis, machine-learning models show stronger predictive performance, especially when structured predictors are combined with sentiment features. This study contributes to rural drone-delivery literature by linking service equity, perceived value, and LLM-derived sentiment within a comparable statistical and machine-learning framework for rural service design. Full article

Background/Objectives: HIV testing is essential for early HIV diagnosis, timely treatment initiation, and HIV prevention. Despite Thailand’s long-standing HIV prevention programs and universal access to HIV testing services, nationally representative evidence on lifetime HIV testing among Thai adults remains limited. This study aimed to estimate the prevalence of lifetime HIV testing and identify factors associated with lifetime HIV testing among Thai adults. Methods: This study was a secondary analysis of data from the 6th Thai National Health Examination Survey. A total of 11,843 Thai adults aged 20–59 years were included. Descriptive statistics were used to estimate the prevalence of lifetime HIV testing. Survey-weighted logistic regression analyses were performed to examine factors associated with lifetime HIV testing. Results: The overall prevalence of lifetime HIV testing was 41.9%, with a prevalence of 42.4% among males, and 41.4% among females. Individuals aged 30–39 years (AOR = 1.64, 95% CI: 1.43–1.87) and 40–49 years (AOR = 1.67, 95% CI: 1.41–1.99), those with secondary education (AOR = 1.64, 95% CI: 1.43–1.87) or certificate/higher education (AOR = 1.74, 95% CI: 1.48–2.05), those currently living with a partner (AOR = 1.60, 95% CI: 1.43–1.79), participants with higher monthly income (10,000–24,999 THB: AOR = 1.13, 95% CI: 1.01–1.27; ≥25,000 THB: AOR = 1.39, 95% CI: 1.13–1.70), residents in the Northern region (AOR = 1.74, 95% CI: 1.45–2.09), and those who had a relative or acquaintance living with HIV/AIDS (AOR = 1.46, 95% CI: 1.34–1.59) were more likely to have lifetime HIV testing. In contrast, Muslim participants (AOR = 0.72, 95% CI: 0.57–0.90), residents of rural areas (AOR = 0.88, 95% CI: 0.79–0.97), residents in the Central (AOR = 0.82, 95% CI: 0.69–0.98) and Southern regions (AOR = 0.83, 95% CI: 0.72–0.94), and those with higher HIV-related stigma (AOR = 0.91, 95% CI: 0.84–0.99) were less likely to have lifetime HIV testing. Conclusions: Lifetime HIV testing among Thai adults remained suboptimal, with geographic and sociodemographic disparities. Full article

Pediatric dental diseases, notably dental caries, malocclusion, and dental trauma, remain a significant public health challenge in China, exerting considerable impact on children’s oral and general health. Despite growing societal demand for pediatric dental care, China faces a critical shortage and uneven geographic distribution of pediatric dentists, alongside persistent urban–rural disparities in access to oral health services. These challenges underscore the urgent need for educational reforms, workforce policy adjustments, and assessment of the strengths and limitations of recent training initiatives to enhance pediatric dental service delivery. This narrative review aims to: (I) describe the current structure of pediatric dental education in China and recent reforms, notably the integration of degree education with standardized residency training; (II) summarize the epidemiological burden of dental diseases among Chinese children, together with contributing social and geographic factors; (III) outline national policy initiatives targeting children’s oral health and existing gaps in implementation; and (IV) discuss innovations in dental education, including student-centered pedagogies and humanities integration. This review provides a comprehensive overview of pediatric dentistry in China and offers strategic recommendations to strengthen workforce training, expand service access, and reduce the burden of pediatric oral diseases. Full article

Although significant progress has been made in reducing salt consumption over the past decade, most Croatian adults still exceed the recommended intake. This study aimed to identify demographic, socioeconomic, lifestyle, and clinical factors associated with high salt intake in the general adult population of Croatia. We included a random sample of 1067 adults with reliable 24-h urine samples. A structured questionnaire was used to collect sociodemographic, lifestyle, and clinical data. Anthropometric and blood pressure (BP) measurements were performed. Laboratory analyses included the measurement of sodium, potassium, and creatinine in adequate 24-h urine samples, as well as relevant cardiometabolic and kidney-related biomarkers. Participants consuming > 10 g/day of salt were older and had higher systolic blood pressure, fasting glucose, serum uric acid, and triglyceride levels, lower HDL cholesterol levels, and greater BMI. High salt intake was more common among men, ex-smokers, participants with diabetes, and those with lower socioeconomic status (SES). In multinomial logistic regression analysis, male sex, diabetes, higher systolic BP, more frequent processed meat consumption, lower fish consumption, residence outside the Adriatic region, and higher ePWV were associated with high salt intake. High salt intake was associated with lower socioeconomic status, residence in rural and continental areas, obesity, former smoking, and less favorable dietary patterns. Conversely, lower salt intake was associated with residence in the Adriatic region and dietary patterns characterized by more frequent consumption of fish and olive oil. Full article

Spatial imagery (SI) provides an important framework for understanding how rural spatial transformation affects residents’ spatial cognition and supports sustainable rural planning. However, existing studies have mainly examined static spatial sections, with limited attention to longitudinal changes in residents’ SI, especially in micro-community spaces. This study takes Naobao village as a case and uses cognitive maps (CMs) and interviews to compare residents’ CM drawing processes, SI elements, and SI structures between the old and new villages. The results show that: (1) The old village follows a point-and-line-to-area CM drawing pattern, while the new village shows an area-oriented pattern from local areas to the whole. (2) In terms of SI elements, districts and paths dominate in the old village, whereas districts and landmarks are more prominent in the new village. (3) Regarding SI structure, the old village is mainly characterised by sequential CMs with relatively higher-level structures, while the new village is dominated by spatial CMs with relatively lower-level structures. This study developed a three-dimensional SI framework within the context of rural spatial transformation, which expands the theoretical framework and applicability of the SI model and provides guidance for spatial planning, community renewal, and sustainable development in similar rural tourism destinations. Full article

In the context of rural construction, studying particle diffusion alongside residents’ satisfaction with rural external heated kangs provides important support for upgrading heating facilities and improving domestic infrastructure in the northwest arid regions of China. This study takes a single rural household equipped with an external fire kang in Baoji as the research object. From the perspectives of operational and service management in human settlements, the spatio-temporal diffusion characteristics of particulate matter in the outdoor combustion port, living room, and bedroom during the winter heating period are continuously monitored, and data on resident satisfaction are collected through a questionnaire. The results show that, during the external kang’s heating period, the spatial concentrations of particulate matter decrease in the following order: combustion port > living room > bedroom. Concentrated morning and evening kang heating creates a typical bimodal distribution of outdoor particulate matter concentration, with peaks at 8:00 am and 8:00 pm. During the ignition period, coarse particles (PM₁₀) are mostly released, while the proportion of fine particles (PM_2.5, PM_1.0) increases during the stable combustion period. During the sealing period, the concentration of fine particles doubles. After extinguishing, PM₁₀ decays rapidly due to gravity deposition, while PM_1.0 shows a longer environmental retention time due to its slow diffusion. The core diffusion process of the particulate matter mainly occurs within a distance of 5–15 m from the combustion port. The resident satisfaction survey shows moderate comprehensive satisfaction with external heated kangs, at 3.10 points on a 5-point scale. Addressing existing problems and proposing relevant strategies, this study provides a theoretical basis and technical support for the rational transformation of external heated kangs in the arid areas of Northwest China. Full article

Global demographic shifts and rising population mobility have created a profound decoupling between dynamic population distributions and static public service facility configurations. This socio-spatial mismatch is particularly acute in less-developed counties, where the widespread “multi-local living” practices among rural residents have rendered traditional planning models based on static administrative quotas ineffective. This study uses Pucheng County, China, as a case study; we integrate mobile phone signaling data with complex network analysis to construct population flow networks that capture actual service demand and usage preferences. A demand-driven improvement of the traditional Optimal Supply–Demand Accessibility (OSD) model is proposed through flow-based supply adjustment coefficients and determines the coverage and accessibility of public service facilities at the county level to achieve optimization of their layout. The findings reveal: (1) Villages are classified into five types (high-inflow, inflow, balanced, outflow, high-outflow). (2) Within a 30 min walking radius, the service coverage rates of the three facility types improved by an average of 25 percentage points, with medical and elderly care facilities showing significantly greater improvements. (3) Accordingly, a “precise gap-filling + medical-care integration + mobile services” allocation model is proposed. The study provides a transferable framework for improving public service accessibility in regions characterized by high population mobility and service underprovision. Full article

Sustainable tourism in oasis landscapes requires governance approaches that go beyond generic destination-growth models and standardized sustainability checklists. In living cultural landscapes such as Al-Ahsa Oasis, tourism development is inseparable from water systems, palm-grove agriculture, rural livelihoods, heritage values, climate stress, visitor behavior, and institutional accountability. This paper develops a governance framework for sustainable tourism in Al-Ahsa Oasis, Saudi Arabia, a UNESCO World Heritage cultural landscape. Methodologically, it is a conceptual framework-development study based on structured critical review and contextual synthesis. It critically interprets international sustainable tourism, heritage management, visitor management, and sustainable investment frameworks in relation to recent Al-Ahsa-specific evidence on rural tourism, resident satisfaction, farm-tourist behavior, rural lodges, land-cover change, and World Heritage governance. The study proposes a six-dimensional framework structured around cultural landscape stewardship, water-sensitive ecological governance, agricultural landscape continuity and rural accommodation regulation, community benefit and local enterprise, climate-responsive visitor management and interpretation, and monitoring and institutional accountability. These dimensions are treated as interdependent governance fields rather than separate checklist categories. The framework is further operationalized through an indicator and governance matrix linking suggested indicators, data sources, governance mechanisms, and responsible actors. The paper contributes by reframing sustainable oasis tourism as an adaptive governance problem rather than a technical exercise in applying predefined criteria. It provides an evidence-informed basis for planning, monitoring, stakeholder deliberation, policy refinement, and future empirical testing in Al-Ahsa and comparable arid cultural landscapes. Full article

Complete neighbourhoods, places where residents can meet their daily needs on foot, have become a central component of healthy and sustainable urban planning. Yet most assessment frameworks are calibrated for dense metropolitan environments, leaving rural and peri-urban municipalities without operational tools suited to their territorial needs. This article presents MilieuxVie, an open-source, browser-based interactive mapping application developed for the Laurentides health region of Québec (76 municipalities, 11 land-based unorganised territories, 2 indigenous territories and 4 aquatic administrative units; 93 territorial units in total; ~680,000 inhabitants). The tool evaluates the spatial accessibility of 12 service categories drawn from the Vivre en Ville (2026) complete-neighbourhood framework and OpenStreetMap data, using 2026 residential parcels from the provincial property assessment roll as origin points and weighting results by number of dwelling units. Three adaptive radius tiers (dense, intermediate, rural), based on residential dwelling-unit density (dwellings per km² of residentially designated urban land), scale the distance standards to settlement density. Because thresholds are scaled to settlement density, scores express context-relative service proximity rather than a uniform pedestrian standard and should not be read as directly comparable absolute accessibility across rural, peri-urban, and urban settings. A dedicated urban perimeter mode further disaggregates analysis to sub-municipal built-up zones, aligning the tool with Québec’s provincial Government land-use planning guidelines (GLPG). Gap analysis outputs identify which service types fall below the 70% coverage target, helping elected officials and planners identify where to focus further analysis. Results illustrate the scope of accessibility deficits across the region and highlight the analytical limits of uniform distance thresholds when applied beyond metropolitan contexts. Scores differ significantly across different settings (Kruskal–Wallis p = 0.006); the adaptive radius tiers narrow but do not close the structural gap, with rural municipalities scoring significantly lower than dense ones. The tool is freely available and requires no software installation, making it directly deployable by local planning offices. Full article

With the intensifying global climate change and the full implementation of China’s “dual-carbon” strategy, the green and low-carbon transition in rural areas has become a core issue in urban and rural construction. As China’s most economically developed and highly urbanized region, the Yangtze River Delta (YRD) holds typical demonstrative significance in the research and practice of green and low-carbon rural construction. This study retrieves 4166 core documents from the China National Knowledge Infrastructure (CNKI), Web of Science (WoS), and Scopus published between 1997 and 2025 to perform multi-database bibliometric analysis and knowledge mapping analysis. CiteSpace and VOSviewer are employed to conduct a comparative analysis of domestic and international literature and to delineate the knowledge evolutionary trends, core research hotspots, and research trajectories in this field. The findings reveal that the research on green and low-carbon rural construction in the YRD has experienced three stages. The first stage involves the introduction of foundational low-carbon concepts, the second stage centers around green transition and policy response, and the third stage is driven by the national rural revitalization and “dual-carbon” strategies. Moreover, five principal research directions have been determined, including spatial planning based on “low-carbon control units”, excavation of green wisdom from traditional villages, discussion of passive green strategies, retrofitting of existing rural residences and integration of low-carbon technologies, and precision rural construction based on industry–space synergy. Consequently, by constructing a dual-thread evolutionary framework integrating the natural ecosystem with the social system, this study systematically extracts the theoretical contributions, paradigm characteristics, and transferable empirical models from the research on green and low-carbon rural construction in the YRD, and proposes a future agenda to facilitate the shift in research paradigm from “problem solving” to “forward planning”. Ultimately, this study aims to offer a demonstrative “YRD solution” for the sustainable development of rural areas in China and beyond. Full article

Background: This up-to-date narrative review examines the associations of low environmental exposure to toxic trace elements—arsenic (As), cadmium (Cd), lead (Pb), and mercury (Hg)—on pregnancy. While high levels are known to be harmful, the impact of low levels has not been fully analyzed. The aim was to summarize global data on As, Cd, Pb, and Hg levels in maternal and cord blood of healthy pregnant women, compare their distribution, and assess associations with demographic factors, lifestyle, and pregnancy outcomes. Methods: A systematic literature search was conducted in PubMed, Cochrane Library, and Scopus for studies published between 1 January 1990 and 14 May 2025. The review was conducted in accordance with PRISMA 2020 guidelines. A total of 824 records were assessed for eligibility, and 656 were excluded based on predefined criteria. Exclusion criteria encompassed in vivo or in vitro studies, non-English written publications, treatment-based studies, and studies involving occupationally exposed pregnant women. Inclusion criteria included original full-length research papers with cross-sectional, prospective cohort, or case–control designs; studies measuring As, Cd, Pb, and/or Hg in maternal and/or cord blood; and studies examining associations with demographic, lifestyle, and pregnancy outcomes. The review was not registered, and no external funding was received. Given the narrative synthesis approach of the review, a formal risk-of-bias assessment was not undertaken. Results: A total of 168 studies were included: 32 reported findings on As, 55 on Cd, 78 on Pb, and 64 on Hg, with 26 addressing all four elements. No meta-analysis was performed; results were summarized narratively. Results show that As and Cd levels are higher in maternal blood, whereas Pb and Hg, including methylmercury, are higher in cord blood. Key factors include smoking, rural residence, and fish or seafood consumption, linked to higher Cd, Pb, and Hg levels, respectively. Interpretation: Low Pb levels show the strongest associations with adverse pregnancy outcomes, while As shows the weakest. Pb’s effects may relate to passive placental diffusion, unlike other elements. Further studies are needed. Full article

Household food safety refers to consumer practices that reduce microbial contamination, cross-contamination, temperature abuse, and foodborne disease risks during food storage, preparation, cooking, and leftover handling. Rural households may be particularly vulnerable because of limited access to standardized food safety education and the persistence of experience-based practices. This study examined progressive changes in household food safety handling knowledge and behaviors associated with cumulative exposure to a continuous tracing intervention among rural residents in China. A two-month quasi-experimental repeated-measures study without a non-intervention control group was conducted in rural households in Liaoning, Jilin, and Heilongjiang provinces. A total of 139 households completed all intervention activities and four assessment waves, yielding 556 valid questionnaires. The intervention consisted of 10 rounds of paper-based and video-based materials targeting food safety knowledge, risk awareness, and self-efficacy. Outcomes were measured at baseline, after four intervention rounds, after eight rounds, and after ten rounds. Food safety behavior scores increased from 9.76 at baseline to 11.66, 13.33, and 14.72 after successive intervention stages. Knowledge scores increased from 13.71 to 17.35, 19.34, and 21.43, respectively. Pairwise comparisons showed significant differences between all assessment waves for both outcomes. Analyses accounting for the repeated-measures structure showed a positive association between food safety knowledge and self-reported handling behavior. Both online and offline delivery channels were associated with improvements in knowledge and behavior, while between-channel differences did not appear to be the primary driver of the observed changes. However, causal interpretation should be cautious because the study lacked a non-intervention control group, and testing effects, maturation, seasonal influences, and social desirability cannot be ruled out. Full article

Background: Intestinal parasitic infections are common in tropical settings and may influence immune regulation, allergic responses, and respiratory health. In children with sickle cell disease (SCD), respiratory morbidity is multifactorial, and the contribution of intestinal parasites remains uncertain. This study assessed whether documented intestinal parasitic infections, particularly helminth infections, were associated with asthma-like respiratory phenotypes and clinical morbidity in children with SCD in French Guiana. Methods: We conducted a multicenter cross-sectional analysis of children and adolescents younger than 18 years with confirmed SCD who were being followed by the pediatric SCD centers of Saint-Laurent-du-Maroni, Cayenne, and Kourou between January 2022 and December 2025. Clinical, respiratory, and parasitological data were extracted from routine-care medical records. Intestinal parasitic infection was defined as at least one documented stool parasitology result identifying Strongyloides stercoralis, hookworm, or Entamoeba histolytica, according to the variables consistently available in the database. Respiratory outcomes included physician-diagnosed asthma, bronchial obstruction, bronchodilator reversibility, and an asthma-like respiratory phenotype. Results: Among 233 included children, 105 (45.1%) had at least one documented intestinal parasitic infection and 82 (35.2%) had a helminth infection. Hookworm was the most common parasite (75/233, 32.2%), followed by Entamoeba histolytica (33/233, 14.2%) and Strongyloides stercoralis (24/233, 10.3%). An asthma-like respiratory phenotype was observed in 32/105 infected children (30.5%) versus 44/128 non-infected children (34.4%). Bronchial obstruction and bronchodilator reversibility were also similar between groups. After adjustment for age, sex, genotype, hydroxyurea treatment, rural residence, site of follow-up, and environmental tobacco smoke exposure, intestinal parasitic infection was not associated with asthma-like respiratory phenotype (adjusted OR: 0.94, 95% CI: 0.51–1.72; p = 0.844), recurrent hospitalization, or history of acute chest syndrome. Conclusions: In this routine-care multicenter pediatric SCD cohort from French Guiana, intestinal parasitic infections were common but were not associated with respiratory phenotype or selected morbidity outcomes. Because testing and respiratory assessment were not systematic, these findings should be interpreted as showing that routine parasitological status alone could not identify children with respiratory morbidity. Prospective studies with standardized repeated parasitological, immunological, environmental, and respiratory assessments are needed. Full article

Background/Objectives: The aim of this study was to examine the discrepancy between nutrition-related knowledge (NRK) and nutrition-related practice (NRP) among 1440 Polish school-aged students (10–18 years), according to BMI status, and to identify factors associated with this discrepancy. Methods: This cross-sectional study was conducted via the CAWI method using an author-developed, non-validated questionnaire. Questions assessing NRK and NRP were thematically aligned and referred to the recommendations of the Polish Healthy Eating and Lifestyle Pyramid for Children and Adolescents (aged 4–18 years). Results: Students with excess weight scored significantly lower in nutritional knowledge (NRK: 46%) and practices (NRP: 30%) than those with underweight or normal weight (NRK: 52–53%, NRP: 33–34%). Higher NRK was associated with older age, female sex, larger urban residence (for students with overweight and obesity), and higher maternal/legal guardian education level (for students with normal/underweight body weight). Better NRP was associated with higher NRK and higher physical activity, while rural or small-town living was positively associated with healthier dietary practices and maintenance of normal BMI. Conclusions: The present study confirms that nutritional knowledge is a necessary but insufficient condition for shaping appropriate dietary behaviors among adolescents with different BMI statuses; lifestyle factors, practical food-related skills—including self-assessment of knowledge and adherence to dietary recommendations—and the broader environmental context plays a crucial role. These findings highlight the need for targeted nutrition education programs that expand not only knowledge but also practical skills among students. Full article