Search Results (4,775)

The COVID-19 pandemic exacerbated mental illness, accelerated cognitive decline, and deepened social inequalities. In low and middle-income countries (LMIC) such as Panama, it is unclear as to whether, and to what extent, the pandemic lockdowns affected cognitive, mental, and physical health of older adults. This study investigated changes in cognitive function, mental health, and physical health in a sample of Panamanian older adults assessed before and during the pandemic, and examined whether sociodemographic variables were associated with cognition and mental health. Participants completed in-person interviews between 2018 and early 2020 and a follow-up telephone interview between February and May 2021. Repeated measures analyses showed no significant changes in cognitive function or depression; however, participants reported fewer chronic illnesses. Linear regression analysis indicated that higher cognitive function during the pandemic was associated with younger age, higher education, and having sufficient income. An attrition analysis compared participants who completed both interviews to those who were lost to follow-up, revealing that participants who dropped out of the study had lower socioeconomic status and greater impairment at baseline. These findings highlight the need for targeted support for vulnerable older adults during public health crises. Full article

Background/Objectives: Pacifier use in infants has both beneficial and harmful implications, and dipping pacifiers in sweeteners is used by some parents to soothe infants. This study aimed to assess pacifier usage among mothers in Jeddah, Saudi Arabia, and to examine its association with child demographics, maternal socioeconomic status (SES), and maternal knowledge of the risks associated with dipping pacifiers in sweeteners. Methods: A cross-sectional study was conducted among mothers of healthy children aged 2 to 4 years during community-awareness events in Jeddah. Participants completed a validated Arabic questionnaire covering pacifier use patterns, feeding practices, SES background, and knowledge regarding the adverse effects of pacifier sweetening. Results: A total of 1438 mothers participated. The mean age of children was 34.3 ± 10.7 months, with 441 children (30.7%) reported as pacifier users. Among them, 202 (45.8%) used pacifiers both during the day and at night. Most children (35.6%) discontinued use between 4 and 6 months of age. Only 6.1% of mothers reported adding sweeteners to pacifiers. Pacifier usage was significantly higher among first-born children (37.6%, p < 0.001), those who received both bottle- and breastfeeding (65.5%, p < 0.001), and children enrolled in nursery (62.1%, p = 0.007). Most mothers (75.6%) were aware of the link between sweetened pacifiers and dental caries, and 69.4% of those who had this knowledge avoided giving their child a pacifier (p = 0.077). Conclusions: Birth order, feeding practices, and nursery attendance are key predictors of pacifier use. Enhancing parental awareness and education may support early interventions to promote healthier oral and feeding habits in young children. Full article

Human-Wildlife conflict (HWC) presents a growing challenge for wildlife conservation, especially as species recover and reoccupy human-dominated landscapes, creating tensions between ecological goals and local livelihoods. Such conflicts are increasingly reported across Europe, including Romania, involving semi-aquatic species like the Eurasian beaver (Castor fiber L.) and Eurasian otter (Lutra lutra L.). Enhancing coexistence with wildlife through the integration of conflict mapping, stakeholder engagement, and spatial analysis into conservation planning is therefore essential for ensuring the long-term protection of conflict species. A mixed-methods approach was used, including structured surveys among stakeholders, standardized damage report collection from institutions, and expert field assessments of species activity. The results indicate that while most respondents recognize the legal protection of both species, a minority have experienced direct conflict, primarily with beavers through flooding and crop damage. Tolerance varied markedly among demographic groups: researchers and environmental agency staff were most accepting, whereas farmers and fish farm owners were the least accepting; respondents with no personal damage experience and those with university or post-secondary education also displayed significantly higher acceptance toward both species. Institutional reports confirmed multiple beaver-related damage sites, and through field validation, conflict forecast zones with spatial clustering in Harghita, Brașov, Covasna, and Sibiu counties were developed. These findings underscore the importance of conflict forecasting maps, understanding the coexistence dynamics and drivers of acceptance, and the need to maintain high acceptance levels toward the studied species. The developed maps can serve as a basis for targeted interventions, helping to balance ecological benefits with socioeconomic concerns. Full article

Understanding the spatial dynamics and drivers of armed conflict is crucial for anticipating risk and informing targeted interventions. However, current research rarely considers the spatio-temporal clustering characteristics of armed conflicts. Here, we assess the distribution dynamics and driving factors of armed conflict from the perspective of armed conflict clusters, employing complex network dynamic community detection methods and interpretable machine learning approaches. The results show that conflict clusters vary in terms of regional distribution. Sub-Saharan Africa boasts the highest number of conflict clusters, accounting for 37.9% of the global total and covering 40.4% of the total cluster area. In contrast, South Asia and Afghanistan, despite having a smaller proportion of clusters at 12.1%, hold the second-largest cluster area, which is 18.1% of the total. The characteristics of different conflict networks are influenced by different factors. Historical exposure, socio-economic deprivation, and spatial structure are the primary determinants of conflict patterns, while climatic variables contribute less prominently as part of a broader system of environmental vulnerability. Moreover, the influence of driving factors shows spatial heterogeneity. By integrating cluster-level analysis with interpretable machine learning, this study offers a novel perspective for understanding the multidimensional characteristics of armed conflicts. Full article

Water-related ecosystem services provide a broad range of benefits, including the mitigation of extreme hydrometeorological events, the provision of water for various uses, the support of tourism, and the provision of cultural services. This study assesses the perceptions and accessibility of these services among communities located near the Alafiarou and Okpara dams in Benin and the Bagré dam in Burkina Faso. The methodology involved designing and implementing a questionnaire in KoboCollect, with trained agents deployed to conduct data collection at each of the three sites. Data analysis indicates that respondents identified biodiversity conservation and the provision of drinking water as the most crucial ecosystem services. Over two-thirds of participants reported observing both positive and negative changes in the services provided by rivers and in socio-economic activities since the construction of the dams. While the majority noted improvements in agriculture, irrigation, water quality, fisheries, and flow rates, other changes included biodiversity loss, a decrease in vegetation cover (notably trees and shrubs), an increase in the population of mosquitoes and other insects, and a decline in fishery resources downstream. Despite these challenges, local communities were strongly willing to participate in initiatives aimed at protecting and restoring river ecosystems and their related services. Full article

Background: Concerns over women’s mental health have intensified globally, especially among mothers managing dual careers and family responsibilities. Positive Psychology Interventions (PPIs), such as gratitude journaling and well-being workshops, have demonstrated promise in enhancing mental health; however, their applicability in Arab contexts remains underexplored. This study aims to investigate the effectiveness of PPIs on mothers’ well-being, gratitude, depression, anxiety, and stress in Saudi Arabia. Methods: This quasi-experimental, one-group pretest–posttest study assessed the effects of a four-week PPI on 37 Saudi working mothers (aged 21–50 years) employed at a private school in Riyadh. The intervention included guided gratitude journaling thrice weekly and two workshops on positive psychology and gratitude. Pre- and post-intervention assessments used validated Arabic versions of the Depression Anxiety Stress Scale (DASS-21), WHO-5 Well-being Index, and Gratitude Questionnaire (GQ-6). Results: Significant improvements were found post-intervention: depression, anxiety, and stress scores decreased (p < 0.001), while well-being and gratitude increased (p = 0.001). However, participants with lower household income (<50,000 SAR) showed less improvement, indicating a potential moderating effect of socioeconomic status. Conclusions: The intervention demonstrated promising short-term improvements in mental health and well-being among Saudi mothers. The findings underscore the importance of culturally appropriate PPIs and highlight the need for further research using controlled, long-term designs. Limitations include the small, non-random sample, absence of a control group, and restriction to a single geographic region. Full article

Background/Introduction: Psychological inflexibility, which includes experiential avoidance, is a transdiagnostic process associated with multiple mental health issues in adolescence. Physical fitness (PF) has shown benefits for mental well-being, yet its specific relationship with psychological inflexibility remains understudied, particularly among youth. Objectives: To examine the association between components of PF and psychological inflexibility, measured by the Acceptance and Action Questionnaire-II (AAQ-II), in a representative sample of Spanish adolescents. Methods: A cross-sectional analysis was conducted using data from 631 adolescents (aged 12–17) participating in the Eating Healthy and Daily Life Activities (EHDLA) study. PF was assessed by the Assessing the Levels of PHysical Activity and Fitness (ALPHA-Fit) Test Battery (cardiorespiratory fitness, muscular strength, agility, and flexibility). Psychological inflexibility was measured using the AAQ-II. Generalized linear models (GLMs) were used to evaluate associations, adjusting for age, sex, body mass index, socioeconomic status, physical activity, sedentary behavior, sleep duration, and energy intake. Results: Unadjusted analyses showed weak but significant associations between psychological inflexibility and performance in the 20 m shuttle run test (p = 0.002), the 4 × 10 shuttle run test (p = 0.005), and the sit-and-reach test (p < 0.001). However, after adjusting for covariates, none of the PF components maintained a statistically significant association with the AAQ-II scores. Conclusions: In this adolescent sample, PF components were not independently associated with psychological inflexibility after adjustment for key confounders. These findings suggest that, while PF may contribute to general well-being, it is not a primary determinant of psychological inflexibility. Further longitudinal and intervention studies are needed to clarify the mechanisms linking physical and psychological health in youth. Full article

Hyperloop ultra-high-speed transport presents a transformative opportunity for future mobility systems in smart cities. However, assessing its socio-economic impact remains challenging due to Hyperloop’s unique technological, modal, and operational characteristics. As a novel, fifth mode of transportation—distinct from both aviation and rail—Hyperloop requires tailored evaluation tools for policymakers. This study proposes a custom-designed framework to quantify its macroeconomic effects through changes in gross domestic product (GDP) at the city level. Unlike traditional economic models, the proposed approach is specifically adapted to Hyperloop’s multimodality, infrastructure, speed profile, and digital-green footprint. A Poisson pseudo-maximum likelihood (PPML) model is developed and applied at two technology readiness levels (TRL-6 and TRL-9). Case studies of Glasgow, Berlin, and Busan are used to simulate impacts based on geo-spatial features and city-specific trade and accessibility indicators. Results indicate substantial GDP increases driven by factors such as expanded 60 min commute catchment zones, improved trade flows, and connectivity node density. For instance, under TRL-9 conditions, GDP uplift reaches over 260% in certain scenarios. The framework offers a scalable, reproducible tool for policymakers and urban planners to evaluate the economic potential of Hyperloop within the context of sustainable smart city development. Full article

Road networks are essential for access, resource distribution, and population evacuation during natural events. These challenges are pronounced in rural areas, where network redundancy is limited and communities may have social disparities. While traditional risk management systems often focus on the physical consequences of hazard events alone, specialized literature increasingly suggests the development of a more comprehensive approach for risk assessment, where not only physical aspects associated with infrastructure, such as damage level or disruptions, but also the social and economic attributes of the affected population are considered. Consequently, this paper proposes a Vulnerability Access Index (VAI) to support road network decision-making that integrates the social vulnerability of rural communities exposed to natural events, their accessibility to nearby critical infrastructure, and physical risk. The research methodology considers (i) the Social Vulnerability Index (SVI) calculation based on socioeconomic variables, (ii) Importance Index estimation (I_imp) to evaluate access to critical infrastructure, (iii) VAI calculation combining SVI and I_imp, and (iv) application to a case study in the influence area of the Villarrica volcano in southern Chile. The results show that when incorporating social variables and accessibility, infrastructure criticality varies significantly compared to the infrastructure criticality assessment based solely on physical risk, modifying the decision-making regarding road infrastructure robustness and resilience improvements. Full article

Background: School-based tobacco control policies are critical for preventing youth tobacco use. While many districts adopt formal policies to create smoke- and vape-free environments, the degree to which these policies are enforced at the school level may vary, influencing their effectiveness. Little is known about how consistently such policies are implemented across schools within urban school districts. Objectives: This study aimed to examine the existence and enforcement of school-level tobacco control policies in an urban public school system, using Baltimore City schools as a case example. Methods: We conducted a survey of school personnel from 20 high schools in Baltimore City in 2024. The survey instrument assessed the presence and enforcement of policies related to tobacco use prevention, communication, signage, disciplinary actions, and institutional support. Descriptive statistics (frequencies and percentages) were used to summarize responses. Spearman correlations were also used for bivariate correlations. Additional school-level and neighborhood-level contextual data were collected from the internet (neighborhood socioeconomic status and school performance). Results: While many policies existed across the 20 participating schools, their enforcement was widely inconsistent. Most schools reported the existence of policies prohibiting tobacco use in school buildings (60%) and vehicles (55%). However, few schools had visible tobacco-free signage (35%) or offered cessation programs (15%). Communication of policies to students (70%) and staff (65%) was the most commonly enforced aspect of tobacco control policies. Conclusions: Findings suggest that while tobacco control policies may be adopted across urban school systems, their enforcement at the school level remains uneven. Greater attention may be needed to support policy implementation and to reduce variability in school-level practices. Baltimore City serves as a useful case study to understand these challenges and identify opportunities for strengthening school-based tobacco prevention efforts. Full article

Background/Objectives: The two major subtypes of inflammatory bowel disease (IBD)—Crohn’s disease (CD) and ulcerative colitis (UC)—are known to increase the likelihood of developing colorectal cancer (CRC). While this relationship has been well studied in Western populations, evidence from East Asia remains limited and inconsistent. Using nationwide cohort data, this study explored the potential connection between IBD and CRC in a large Korean population. Methods: We conducted a retrospective cohort study using data from the Korean National Health Insurance Service–National Sample Cohort from 2005 to 2019. A total of 9920 CRC patients were matched 1:4 with 39,680 controls using propensity scores based on age, sex, income, and region. Overlap weighting and multivariable logistic regression were used to evaluate the association between IBD and CRC. Subgroup analyses were conducted to assess effect modification by demographic and clinical factors. Results: IBD markedly increased the likelihood of developing CRC (adjusted odds ratio (aOR) = 1.38; 95% confidence interval (CI): 1.20–1.58; p < 0.001), with the association primarily driven by UC (aOR = 1.52; 95% CI: 1.27–1.83). CD appeared unrelated to heightened CRC risk overall, though a significant association was observed among low-income CD patients (aOR = 1.58; 95% CI: 1.15–2.16). The UC–CRC association persisted across all subgroups, including patients without comorbidities. Conclusions: Our findings support an independent association between IBD—particularly UC—and increased CRC risk in Korea. These results underscore the need for personalized CRC surveillance strategies that account for disease subtype, comorbidity burden, and socioeconomic status, especially in vulnerable subpopulations. Full article

Background/Objectives: Dietary patterns have changed over time, characterising a process of nutritional transition that reflects socioeconomic and demographic inequalities among different populations. This study assessed changes in dietary consumption patterns and the associated social determinants, comparing two time periods in a sample of individuals from a state in the Northeast Region of Brazil. Methods: Data from the 2008–2009 and 2017–2018 Household Budget Survey for the state of Paraíba were analysed, totalling 951 and 1456 individuals, respectively. Foods were categorised according to the NOVA classification and compared based on sociodemographic and economic variables. To determine the factors that most strongly explain the contribution of each NOVA food group to the diet, beta regression analysis was conducted. Results: Differences were observed between the two periods regarding the dietary contribution of the NOVA food groups, with a decrease in consumption of unprocessed foods and an increase in ultra-processed foods. Living in urban areas, being an adolescent, and having an income above the minimum wage were associated with reduced intake of unprocessed foods in both periods. Additionally, being an adolescent and having more than eight years of schooling were associated with higher consumption of ultra-processed foods. Conclusions: The population under study showed changes in food consumption, reflecting a transition process that is occurring unevenly across socioeconomic and demographic groups, thereby reinforcing social inequalities. These findings can guide priorities in food and nutrition policies, highlighting the need for intervention studies to evaluate the effectiveness of such actions. Full article

Background: With China’s rapidly aging population, frailty has become a growing concern among older adults. Physical activity (PA) is known to mitigate frailty-related decline, yet few studies have examined these associations longitudinally. Methods: Using five waves (2011–2020) of CHARLS data, we analyzed Chinese adults aged 60+ to assess the association between frailty—measured by a frailty index (FI)—and PA across various types (light, moderate, vigorous, total, and leisure). A generalized linear mixed-effects model was used, adjusting for demographic, socioeconomic, and health-related factors. Results: All PA types were significantly associated with lower odds of concurrent frailty, including light (OR = 0.37), moderate (OR = 0.37), vigorous (OR = 0.40), total (OR = 0.23), and leisure PA (OR = 0.56). Lagged PA also predicted reduced frailty risk over time, except for light PA. Conclusion: Regular PA is linked to a lower risk of frailty among older Chinese adults. These findings underscore the importance of sustained PA as a strategy to promote healthy aging and inform public health interventions for this population. Full article

Cardiovascular disease (CVD) remains Europe’s leading cause of mortality, responsible for >45% of deaths. Beyond established risk factors (hypertension, diabetes, dyslipidaemia, smoking, obesity), psychosocial elements—depression, anxiety, financial stress, personality traits, and trauma—significantly influence CVD development and progression. Behavioural Cardiology addresses this connection by systematically incorporating psychosocial factors into prevention and rehabilitation protocols. This review examines the HEARTBEAT model, developed by Greece’s first Behavioural Cardiology Unit, which aligns with current European guidelines. The model serves dual purposes: primary prevention (targeting at-risk individuals) and secondary prevention (treating established CVD patients). It is a personalised medicine approach that integrates psychosocial profiling with traditional risk assessment, utilising tailored evaluation tools, caregiver input, and multidisciplinary collaboration to address personality traits, emotional states, socioeconomic circumstances, and cultural contexts. The model emphasises three critical implementation aspects: (1) digital health integration, (2) cost-effectiveness analysis, and (3) healthcare system adaptability. Compared to international approaches, it highlights research gaps in psychosocial interventions and advocates for culturally sensitive adaptations, particularly in resource-limited settings. Special consideration is given to older populations requiring tailored care strategies. Ultimately, Behavioural Cardiology represents a transformative systems-based approach bridging psychology, lifestyle medicine, and cardiovascular treatment. This integration may prove pivotal for optimising chronic disease management through personalised interventions that address both biological and psychosocial determinants of cardiovascular health. Full article

Biosphere Reserves (BRs), designated by UNESCO, are uniquely positioned to serve as model territories for sustainable development, as they aim to harmonize biodiversity conservation with the socio-economic vitality and cultural identity of local communities. This work examines the commitment of the Spanish Network of Biosphere Reserves to the United Nations 2030 Agenda and the Sustainable Development Goals (SDGs). Using a survey-based research design, this study assesses the extent to which the reserves have integrated the SDGs into their strategic frameworks and operational practices. It also identifies and analyses successful initiatives and best practices implemented across Spain that exemplify this integration. The findings highlight the need for enhanced awareness and understanding of the 2030 Agenda among stakeholders, alongside stronger mechanisms for participation, cooperation, and governance. The conclusion emphasises the importance of equipping all reserves with strategic planning tools and robust systems for monitoring, evaluation, and accountability. Moreover, the analysis of exemplary cases reveals the transformative potential of sustainability-oriented projects—not only in advancing environmental goals but also in revitalizing local economies and reinforcing cultural heritage. These insights contribute to a broader understanding of how BRs can act as dynamic laboratories for sustainable development and heritage preservation. Full article