Search Results (415)

Background: Promoting seasonal influenza vaccination among parents may help increase the coverage of seasonal influenza vaccination among both parents and children. This study aims to investigate determinants of behavioral intention to receive a seasonal influenza vaccination among parents of children aged 0–15 years to protect themselves. Methods: A cross-sectional survey was conducted among parents of children aged 0 to 15 years with administrative health records in Shenzhen, China, between September and October 2024. Participants were recruited through multistage random sampling. First, 10 community health centers were randomly selected in Shenzhen. Within each selected center, 200 parents were randomly selected. Multivariate logistic regression models were fitted. Results: Among 1504 parents, 47.6% intended to receive a seasonal influenza vaccination in the next year. After adjusting for significant background characteristics, parents’ intention to receive a seasonal influenza vaccination was associated with a higher intention to vaccinate their children against seasonal influenza (AOR: 20.39). At the individual level, eight items measuring illness representations of seasonal influenza were associated with higher odds of intending to receive such a vaccine (AOR: 1.15–1.25), including identity (identifying symptoms), timeline, negative consequences, personal and treatment control, concern, negative emotions, and coherence. At the interpersonal level, parents who had higher levels of general and family-oriented altruism (AOR: 1.10–2.47), better family harmony (AOR: 1.07), higher exposure to information related to seasonal influenza on social media (AOR: 1.24–1.38), and thoughtful consideration of information veracity (AOR: 1.33) were more likely to report an intention. Conclusions: There are strong needs to promote seasonal influenza vaccination among parents in China. Full article

Background/Objectives: First-year, first-generation college students who are also second-generation immigrants often face significant mental health challenges as they navigate both higher education and early adulthood. This study explored how mental health challenges are shaped by their intersecting identities and framed their experiences using Bronfenbrenner’s socio-ecological model. Methods: This study was conducted in the office of first-generation success at a 4-year R1 university, adopting a qualitative research approach and a small stories research design. A purposive sampling technique was implemented to sample first-year, first-generation students and second-generation immigrants. Two focus group discussions were conducted, each with groups comprising 11 participants (n = 22). The participants were between 18 and 19 years old. The data were analyzed using a thematic approach, with trustworthiness ensured through the establishment of credibility, dependability, confirmability, and transferability. Results: Two themes emerged: “Finding self” and “Balancing Competing Demands” within the first-year, first-generation population. Additionally, stress was identified in the second-generation immigrant group under the theme of “Cultural Expectations”. Conclusions: Framing the stories within the socio-ecological model illustrates the multi-layered mental health burden of this population group, particularly within the socio-political climate shaped by heightened immigration policy, restrictive enforcement practices, and public discourse surrounding immigrant communities. Recognizing their mental health as integral to their overall health and academic success highlights the need to broaden scholarly and clinical understanding of individuals and compounding contextual variables that may be related to adverse emotional states. Full article

Schools situated in indigenous territories have historically replicated Western Eurocentric spatial models, often excluding local cultural knowledge and practices. This exclusion has impacted students’ emotional well-being, learning quality, and the contextual relevance of pedagogical approaches. This study aims to explores the socio-ecological context of school spaces in Mapuche territories in La Araucanía, Chile, and examines how teachers perceive these spaces and their influence on emotional regulation and learning. Using a qualitative multi-case study design, data were collected from three schools in Cholchol, Nueva Imperial, and Toltén through land cover/use mapping within a 3 km radius and semi-structured interviews with 15 teachers. Analysis was conducted using constructivist grounded theory. The findings reveal that schools are embedded in landscapes comprising agricultural zones, water bodies, monoculture plantations, and nearby Mapuche communities. Teachers conceptualize school spaces beyond physical infrastructure, recognizing socio-ecological and cultural dimensions. However, school design remains predominantly Western and monocultural, with limited integration of Mapuche spiritual and territorial elements. The main contribution of this research is to provide empirical evidence that strengthening the connection between school spaces and their biocultural context can enhance students’ sense of belonging, emotional regulation, and learning. This study advances the topic by highlighting the critical role of teachers’ perceptions and the socio-ecological context in the design of intercultural and sustainable schools, offering a concrete framework for overcoming regulatory and architectural limitations that continue to impede the implementation of inclusive public policies in indigenous educational settings. Full article

Socio-ecological systems (SESs) exhibit nonlinear feedback across environmental, social, and economic processes, requiring integrative analytical tools capable of representing such coupled dynamics. This study presents a quantitative framework that integrates a compartmental model of a global human–ecosystem with two complementary optimization approaches (Fisher Information (FI) and Multi-Objective Optimization (MOO)) to evaluate policy strategies for sustainability. The model represents biophysical and socio-economic interactions across 15 compartments, incorporating feedback loops between greenhouse gas (GHG) accumulation, temperature anomalies, and trophic–economic dynamics. Six policy-relevant decision variables were selected (wild plant mortality, sectoral prices (agriculture, livestock, and industry), base wages, and resource productivity) and optimized under temporal (25-year) and magnitude (±10%) constraints to ensure policy realism. FI-based optimization enhances system stability, whereas the MOO framework balances environmental, social, and economic objectives using the Ideal Point Method. Both approaches prevent the systemic collapse observed in the baseline scenario. The FI and MOO strategies reduce terminal global temperature by 11.4% and 15.0%, respectively, relative to the baseline (35 °C → 31.0 °C under FI; 35 °C → 29.7 °C under MOO). Resource-use efficiency, measured through the resource requirement coefficient (λ), improves by 8–10% under MOO (0.6767 → 0.6090) and by 6–7% under FI (0.6668 → 0.6262). These outcomes offer actionable guidance for long-term climate policy at national and international scales. The MOO framework provided the most balanced outcomes, enhancing environmental and social performance while maintaining economic viability. Overall, the integration of optimization and information-theoretic approaches within SES models can support evidence-based public policy design, offering actionable pathways toward resilient, efficient, and equitable sustainability transitions. Full article

This study examines the perceived mental health of Ukrainian female forced migrants in Ireland through the lens of the socio-ecological model (SEM). Using binomial logistic regression on a 2023 online survey dataset (N = 656), it explores multi-level predictors across individual, relationship, community, and societal domains. Results indicate that individual-level factors explain the largest proportion of variance in perceived mental health (Nagelkerke R² = 0.399). Employment status, self-rated physical health, and coping strategies were key determinants: part-time employment and good physical health were associated with higher odds of good perceived mental health. In contrast, avoidant coping and worsening health were associated with poorer outcomes. Relationship-level factors (R² = 0.194) also contributed significantly; lack of social support and deteriorating family or friendship ties were linked to poorer mental health, whereas participation in refugee meetings was strongly protective. Community-level factors (R² = 0.123) revealed that unstable housing, living with strangers, and declining neighbourhood relationships were associated with reduced mental well-being. At the societal level (R² = 0.168), insufficient access to psychological support and excessive exposure to Ukrainian news were associated with poorer outcomes, while moderate news engagement was protective. The findings highlight the multifaceted nature of refugees’ perceived mental health, emphasising the interdependence of personal resilience, social connectedness, and systemic support. Full article

This narrative review synthesizes conceptual frameworks, empirical evidence, and pedagogical approaches that support the integration of systems thinking into sustainability education across K–12 and higher education. Publications were purposively selected based on conceptual significance, empirical rigor, pedagogical relevance, and contextual diversity, with searches conducted across Web of Science, Scopus, ERIC, and Google Scholar. The analysis identified several recurring instructional patterns, as follows: the use of feedback-loop reasoning to connect scientific and social systems; the role of conceptual modeling and visual representations; and the value of inquiry-based, project-based, and socio-scientific issue frameworks in promoting systems-oriented understanding. Across educational levels, the review highlights consistent evidence that systems thinking can be taught effectively when learning activities scaffold students’ construction of system models, encourage interdisciplinary reasoning, and explicitly address dynamic processes such as accumulation, time delays, and unintended consequences. Case examples from K–12 and teacher education illustrate how visual modeling, simulations, and carefully designed task structures foster deeper understanding of socio-ecological interactions. The review also identifies key implications for curriculum design, teacher professional development, and assessment, emphasizing the need for sustained integration rather than one-time activities. Overall, this synthesis demonstrates that systems thinking is a foundational competency for sustainability education and provides educators with practical frameworks, strategies, and examples for meaningful classroom implementation. The findings underscore the importance of aligning pedagogical design, curricular structures, and assessment practices to cultivate students’ ability to reason about complex systems. Full article

Riparian ecosystems provide key ecosystem services, yet their degradation is accelerating under growing human pressures. This study performs a systematic and bibliometric assessment to identify global trends in riparian restoration, specifying three objectives: (i) analyze the temporal evolution of scientific production, (ii) evaluate geographical patterns and North–South asymmetries, and (iii) identify dominant restoration approaches and research gaps. A total of 322 documents (1984–2025) were analyzed using productivity indicators, Lotka-based authorship patterns, co-authorship networks, keyword co-occurrence, and a logistic growth model fitted to annual publication counts, combined with descriptive statistics. Annual scientific output showed a steady 4% growth, while 78.2% of studies were led by institutions in the Global North, mainly in North America (39.1%), Europe (17.8%), and Asia (18.5%), highlighting geographical biases and limited representation of tropical regions. Restoration efforts were centered on natural regeneration and tree planting, with less emphasis on cultural ecosystem services and community participation. Despite scientific advances, challenges persist in adopting adaptive and socio-ecologically grounded approaches, especially in underrepresented regions. Strengthening science–policy links, promoting interdisciplinary collaborations, and expanding community involvement are essential to enhance riparian resilience and sustainability. We call for co-creation processes that integrate traditional knowledge and position local communities as partners in restoration efforts. Full article

Coastal landscapes are complex socio-ecological systems that undergo rapid transformations driven by both natural dynamics and human pressures. Their sustainable management depends on robust, cost-effective remote sensing methodologies for long-term monitoring and quantitative assessment of spatiotemporal change. In this study, we developed an integrated remote-sensing-based framework that combines historical aerial photograph interpretation, transition matrix analysis, and machine learning to assess coastal dune landscape dynamics over a seventy-year period. Georeferenced orthorectified and preprocessed aerial imagery freely available from the Italian Ministry of the Environment for the years 1954, 1986, and Google Satellite Images for 2022 were used to generate detailed land-cover maps, enabling the analysis of two temporal intervals (1954–1986 and 1986–2022). Transition matrices quantified land-cover conversions and identified sixteen dynamic processes, while a Random Forest (RF) classifier, optimized through parameter tuning and cross-validation, modeled and compared landscape dynamics within protected Long-Term Ecological Research (LTER) sites and adjacent unprotected areas. Model performance was evaluated using Balanced Accuracy (BA) to ensure robustness and to interpret the relative importance of change-driving variables. The RF model achieved high accuracy in distinguishing change processes inside and outside LTER sites, effectively capturing subtle yet ecologically relevant transitions. Results reveal non-random, contrasting landscape trajectories between management regimes: protected sites tend toward naturalization, whereas unprotected sites exhibit persistent urban influence. Overall, this research demonstrates the potential of integrating multi-temporal remote sensing, spatial statistics, and machine learning as a scalable and transferable framework for long-term coastal landscape monitoring and conservation planning. Full article

Background/Objectives: Despite substantial healthcare spending, U.S. mothers encounter fragmented support systems for infant feeding, care, and maternal mental health. While existing needs assessment instruments target parents of ill or preterm infants, no validated tool captures the full range of informational, psychosocial, and structural needs among mothers of healthy, full-term infants. This formative mixed-methods study sought to identify and prioritize maternal needs across multiple socioecological levels to guide the development of a comprehensive Maternal Needs Assessment Tool (MNAT). Methods: Guided by the socioecological model, six virtual focus groups were conducted with U.S. mothers of healthy infants < 2 years (analytic sample = 28). Thematic analysis in ATLAS.ti (Version 25) identified key needs, which informed the creation of a 10-domain Maternal Needs Assessment Ranking Questionnaire (MNARQ). Participants (n = 22) rated each domain’s importance on a five-point scale; weighted mean ranks were calculated in SPSS (Version 30). Results: Seven overarching themes across ten domains emerged: infant and young child feeding and care, maternal psychosocial wellbeing, parenting knowledge and skills, interpersonal and community support, institutional assistance, and work-policy environments. The highest-ranked domains of need were complementary feeding, child development, care and health, social norms, networking and support, maternal mental health, and breastfeeding guidance. Mothers described pervasive informational confusion, inadequate professional and peer support, and institutional barriers such as limited postpartum follow-up, inflexible daycare policies, and WIC hurdles in formula substitution for infants with allergies. Conclusions: Maternal needs encompass intersecting personal, social, and structural factors. Findings will inform the development and validation of a national Maternal Needs Assessment Tool to guide integrated maternal and child health programs. Full article

The socioecological system (SES) of the Qilian Mountains community—mountains, water, forests, fields, lakes, grasslands, and sands—faces considerable challenges from climate change and anthropogenic pressures. Here, we aimed to examine the coupled coordination relationships within the Qilian Mountains community. Using a comprehensive evaluation index system for the socioeconomic components of the life community, we analyzed the spatiotemporal evolution of the coupled coordination degree (CCD) from 2000 to 2023, identified key hindering factors, and forecasted future trends based on a grey prediction model. The overall CCD achieved a historic leap from near-disharmony to sound coordination. The findings reveal the following: (1) The overall CCD achieved a historic leap from near-disharmony to sound coordination from 0.340 to 0.523, indicating a transition into a synergistic development phase, though with persistent spatial disparities. (2) System coordination is primarily constrained by water, farmland, and grassland subsystems, with water supply–demand imbalance being the foremost regional obstacle. In the Hexi Oasis area, this manifests as a sharp contradiction between farmland expansion and agricultural water demand. In the Qinghai region, it is deeply intertwined with topography, water yield modulus, and the distribution of forested and aquatic areas. (3) GM(1,1) projections suggest a continued upward trajectory for CCD, yet also underscore the complexity and long-term nature of coordinated development. This study established a framework for socioecological system research in arid and vulnerable regions, with the conclusions providing a reference for optimizing national ecological security barrier construction and regional high-quality coordinated development. Full article

Introduction: The hub-and-spoke model (HSM) offers a methodological and hierarchical project management framework for efficient healthcare service delivery. The Commonwealth Partnerships for Antimicrobial Stewardship (CwPAMS) programme supports the development and implementation of antimicrobial stewardship (AMS) interventions to optimise the use of antimicrobials across eight African countries: Ghana, Kenya, Malawi, Nigeria, Sierra Leone, Tanzania, Uganda, and Zambia. Currently the second phase of the programme (CwPAMS 2.0) is being implemented, between March 2023 and March 2025, in which six countries are adopting the HSM to deliver AMS interventions. The aim of this study was to design a hybrid II monitoring, evaluation and learning (MEL) framework to assess the implementation and effectiveness of the HSM in delivering and adapting AMS interventions. Methods: A mixed-methods Hybrid II Implementation trial design was used to develop the MEL framework, guided by the Theory of Change, Socio-Ecological Theory, and Normalisation Process Theory and in alignment with the Reach, Effectiveness, Adoption, Implementation, and Maintenance (RE-AIM) framework. Data collection will be continuous and longitudinal (pre-, mid- and post-implementation). The evaluation framework has been designed to study implementation evaluation at three ecological levels: programme, partnership, and individual site level. Data collection will encompass mixed methodologies and include non-participant observations, formal and informal feedback (from individual key stakeholders and groups), knowledge tools and surveys, scored evaluations, pre-and post-assessments, semi-structured interviews, focus groups, and data collected during formal and informal meetings. This approach will facilitate continuous data collection for evaluation and help study the utilisation and adaptation of AMS interventions. Discussion: This study provides a protocol for developing and utilising an MEL framework to study the application of the HSM in delivering AMS interventions. Developing an evaluation framework requires meticulous planning and a robust implementation and evaluation protocol to ensure methodological rigour, transparency, and effective resource management throughout the project lifecycle. Despite comprehensive consideration of developing progress and programmatic indicators and measures across all domains, the study acknowledges limitations in definitively attributing causality to individual AMS interventions due to their complexity and varied implementation contexts. Full article

Background: The use of pesticides among smallholder farmers, agrochemical sellers, and agricultural officers involves a complex interplay of knowledge, economic factors, and regulatory frameworks. Therefore, this study explores the patterns, practices, and socio-environmental dynamics of pesticide use among smallholder farmers and agro-input sellers in Iringa and Njombe. Method: This study employed a qualitative, phenomenological design, guided by the socio-ecological model (SEM), to explore the lived experience of farmers, agro-dealers, and extension officers. It involved a total of 23 interviews performed in the Njombe and Iringa regions. Data were collected between October 2024 and March 2025, using a combination of in-depth phenomenological interviews, key informant interviews, and field observations, and were categorized into themes and subthemes analyzed using InVivo. Results: The study involved a total of 23 participants drawn from the Iringa and Njombe regions. The gender distribution was nearly balanced, with 52.1% male and 47.8% female respondents. The mean age of participants was 33 years (95% CI: 29.3–37.3). In terms of education, over half (52.17%) had completed primary school. The findings show that smallholders in Iringa and Njombe widely use mixed pesticides and fertilizers, rely on trusted brands, and adapt to climate impacts, but face challenges with regard to unsafe mixing, poor storage, fake products, and weak regulation, highlighting the need for better education, market oversight, and safer practices. Conclusion: Using the socio-ecological model, the findings indicate that pesticide use among smallholder horticultural farmers in Iringa and Njombe is influenced by a complex interaction of socio-economic constraints, market forces, climate variability, and institutional shortcomings. Although farmers have some awareness of safe practices, systemic barriers continue to limit the adoption of sustainable pesticide management. Full article

This paper proposes the “return-to-nature” as an operational design framework for integrating spontaneous habitats and informal green areas into contemporary urban landscapes. Using spatial analysis, field observations, and open-access ecological datasets, the study examines three sites in Eastern Rome—Ex Snia Viscosa, Parco della Serenissima, and the ZSC “Travertini Acque Albule”—to evaluate how low-maintenance, process-based landscapes can contribute to biodiversity networks and climate adaptation. The results reveal recurrent patterns, including the ecological value of unmanaged areas, the interaction between cultural heritage and spontaneous vegetation, and inconsistencies between formal protection boundaries and actual habitat distribution. Based on these findings, six operational principles are defined: access by least impact, differential maintenance, succession windows, interpretive minimalism, co-stewardship, and adaptive monitoring. The study also advances the idea of a Rome–Tivoli Greenway as a transferable Mediterranean model capable of applying these principles at a territorial scale. The findings show that spontaneous urban nature can function as ecological infrastructure, support community stewardship, and reduce management costs, while also presenting risks such as invasive species dynamics and potential conflicts over access. The paper concludes with policy mechanisms—adaptive maintenance regimes, stewardship agreements, and updated planning tools—to operationalise the proposed approach and support more resilient and biodiverse urban landscapes. Overall, the “return-to-nature” framework provides a transferable approach for cities seeking to enhance biodiversity, resilience, and socio-ecological integration through lighter and more adaptive design strategies. Full article

Background: Prostate cancer is a major public health concern in Ghana, where most cases present late and mortality remains high. Community education is essential for improving awareness and early detection. Traditional health talks are widely used, but interactive approaches such as board games have received little evaluation. Aim: To compare the effectiveness of a Social Cognitive Theory–Socioecological Model-based literacy board game (S-S-LIBOG) with a traditional health talk in improving prostate cancer knowledge, attitudes, and perceptions. Methods: A quasi-experimental, two-arm interventional study was conducted in a semi-urban Ghanaian cohort. Participants (n = 197) were allocated to either the board game arm (n = 80) or the health talk arm (n = 61) after accounting for attrition. A structured questionnaire measured knowledge, attitudes, and perceptions (KAP) before and after intervention. Statistical analyses at 5% alpha level included chi-square tests, two-proportion Z-tests, Wilcoxon signed-rank tests, and multivariate logistic regression. Results: Among participants, 29.4% were female, 64.5% male, and 6.1% other genders. Tertiary education was reported by 81.7%, secondary 9.6%, postgraduate 5.6%, and primary 3.0%. Ethnicities: Ewe 41.6%, Akan 26.9%, Northern 13.7%, Ga 6.6%, Guan 1.5%, others 9.6%. Rural dwellers: 29.9%. LIBOG improved ‘good knowledge level’ from 35.0% at baseline to 60.0% post-intervention, compared to 35.0% to 62.3% by the Health Talk (HT). S-S-LIBOG also narrowed gender, education, and lifestyle disparities in KAP, with males showing higher odds of positive attitude (OR = 4.16, p = 0.004) and perception (OR = 2.79, p = 0.047), and rural residents having increased odds of good knowledge (OR = 4.39, p = 0.041) post—its intervention. HT similarly equalized disparities, except for perception, which remained linked to education. The significant improvements in knowledge were (LIBOG: z = 2.85, p = 0.004; HT: z = 3.10, p = 0.002). Even though health talks achieved higher overall knowledge gains, no statistically significant difference in overall effectiveness was observed between the two methods (Wilcoxon W = 102.0, p = 0.107). Acceptability of the board game was high, with over 80% of participants reporting satisfaction. Conclusions: The S-S-LIBOG board game was not inferior to the traditional health talk, showing particular strengths in enhancing attitudes and perceptions. Its interactive and culturally adapted design makes it a feasible adjunct to conventional health education methods. Future studies should examine long-term impacts and application in more diverse populations. This study was retrospectively registered by the Pan African Clinical Trial Registry on 10 October 2025; with the Trial Registration number PACTR202510512711680. Full article

This study identifies the socio-ecological predictors at each level of the ecosystem that serve as risk or protective factors for the frequency of bullying, cyberbullying, and sexual harassment in U.S. schools, and examines how these predictors vary across the three behaviors, highlighting both common and distinct predictors. Using data from two waves (2018 and 2020) of the School Survey on Crime and Safety (SSOCS), a nationally representative cross-sectional survey of 5132 U.S. public elementary and secondary schools, we conduct a Generalized Ordinal Logistic Regression in hierarchical blocks of mesosystem-, exosystem-, and macrosystem-level factors to examine the relative contribution of each ecological level. We find that both mesosystem (teacher training, school size, school grade) and exosystem (neighborhood crime, parental involvement, and involvement of mental health & social services)-level factors play significant roles in predicting the frequency of bullying, sexual harassment, and cyberbullying. Urbanicity at the macrosystem-level is not a significant predictor of bullying and sexual harassment; however, schools in urban areas are less likely to have frequent and monthly cyberbullying and more likely to have occasional and no cyberbullying compared to schools in non-urban areas. We argue for the importance of multi-level interventions to address peer harassment in schools through evidence-based policies. Full article