Search Results (4,235)

Background/Objectives: Dental caries is the most prevalent oral condition worldwide. Consequences of untreated dental caries (CUDC) can range from pulp damage and soft tissue ulceration due to root debris to more severe issues, such as fistulas and abscesses. Rural communities might be more vulnerable to CUDC because of lower socioeconomic status, poorer access to healthcare, and lower education levels. The objective of this study was to evaluate and compare the prevalence of CUDC in rural and urban areas in schoolchildren aged 8 to 12 years in the State of Mexico. Methods: A cross-sectional study was conducted using the PUFA index, considering the presence of pulp involvement (P), soft tissue ulcerations due to root remnants (U), fistulas (F), and abscesses (A). The independent variable was the geographic area (rural or urban), and the covariates were nutritional status, hyposalivation, having one’s own toothbrush, and having received topical fluoride in the last year. Logistic regression models were fitted, calculating odds ratios (ORs) and 95% confidence intervals (CIs). Results: The prevalence of CUDC (PUFA > 0) was 42.9% in rural areas and 25.9% in urban areas. Residing in a rural area (OR: 2.15, 95% CI 1.38–3.34, p = 0.001), hyposalivation (OR: 1.93, 95% CI 1.11–3.37, p = 0.020), and professional fluoride application (OR: 0.15, 95% CI 0.07–0.32, p < 0.001) were associated with the prevalence of CUDC. Conclusions: To prevent caries and its clinical consequences due to the lack of treatment, it is important to promote timely care seeking and access to dental care services, considering the conditions of each geographic area. 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/Objectives: The COVID-19 pandemic caused pronounced disorder in healthcare delivery globally, including ophthalmology. Our study explores how ophthalmologists in Puerto Rico (PR) altered their practices during the pandemic, confronting obstacles such as resource shortages, evolving public health mandates, and unique socio-economic and geographic constraints. The study aims to enhance preparedness for future public health crises. Methods: We conducted descriptive analyses on four online surveys distributed at crucial time points of the pandemic (March 2020, May 2020, August 2020, August 2021) to all practicing ophthalmologists in PR (N ≈ 200), capturing data on closures, patient volume, personal protective equipment (PPE) access, telemedicine use, and financial relief. Results: Survey responses ranged from 41% (n = 81) to 56% (n = 111). By March 2020, 22% (24/111) of respondents closed their offices. By May 2020, 20% (19/93) of respondents maintained a closed office, while 89% (64/72) of open offices reported seeing less than 25% of their usual patient volume. Access to PPE was a challenge, with 59% (65/111) reporting difficulty obtaining N95 masks in March 2020. Telemedicine usage increased initially, peaking in May 2020 and declining in July 2020. By August 2021, all respondents were fully vaccinated and most practices returned to pre-pandemic levels. Overall, 86% (70/81) of respondents found the surveys to be useful for navigating practice changes during the pandemic. Conclusions: PR ophthalmologists showed adaptability during the COVID-19 pandemic to maintain care given limited resources. Guidelines from professional organizations and real time surveys play an important role in future crisis preparedness. 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/Objectives: The social importance of health literacy (HL) is widely understood, and its measurement is the subject of various studies. Due to the recent pandemic, several instruments for measuring HL about COVID-19 have been proposed in different countries, including the HLS-COVID-Q22 questionnaire. The diversity of cultures and languages necessitates the cross-cultural adaptation of this instrument. Thus, the present study translates, adapts, and validates the psychometric properties of the HLS-COVID-Q22 questionnaire to provide its cross-cultural adaptation from English to Spanish (Peru). Methods: As part of ensuring that the final questionnaire accommodates the cultural nuances and idiosyncrasies of the target language, the following activities were carried out: (a) a survey of 40 respondents; and (b) a focus group with 10 participants, followed by expert approval. In addition, the validity and reliability of the health instrument have been ascertained through a further pilot test administered to 490 people in the city of Tacna in southern Peru. Results: The resulting questionnaire helps measure HL in Peru, aiding better-informed decision-making for individual health choices. Conclusions: The presence of such a tool is advantageous in case of similar global health emergencies, when the questionnaire can be made readily available to support a promotion of strategies towards better self-care. Moreover, it encourages other Latin American stakeholders to adjust the instrument to their own cultural, language, and socio-economic contexts, thus invigorating the regional and global expansion of the HL study network. 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

Background: Cognitive decline is a growing public health concern in Latin America, driven by rapid aging, widespread micronutrient inadequacies, and socioeconomic disparities. Despite the recognized importance of nutrition, many older adults struggle to meet daily dietary micronutrients requirements, increasing the risk of mild cognitive impairment (MCI). This study aimed to establish expert consensus on the role of Multivitamin and Mineral supplements (MVMs) in promoting cognitive healthy aging among older adults in Latin America. Methods: A panel of nine experts in geriatrics, neurology, and nutrition applied a modified Delphi methodology to generate consensus statements. The panel reviewed the literature, engaged in expert discussions, and used structured voting to develop consensus statements. Results: Consensus was reached on 14 statements. Experts agreed that cognitive aging in Latin America is influenced by neurobiological, lifestyle, and socioeconomic factors, including widespread micronutrient inadequacies (vitamins B-complex, C, D, E, and minerals such as zinc, magnesium, chromium, copper, iron and selenium), which were identified as critical for global cognitive function and brain structures, yet commonly inadequate in the elderly. While a balanced diet remains essential, MVMs can be recommended as a complementary strategy to bridge nutritional gaps. Supporting evidence, including the COSMOS-Mind trials, demonstrate that MVM use improves memory and global cognition, and reduces cognitive aging by up to 2 years in older adults. Conclusions: MVMs offer a promising, accessible adjunct for cognitive healthy aging in Latin America’s elderly population, particularly where dietary challenges persist. Region-specific guidelines, public health initiatives, and targeted research are warranted to optimize outcomes and reduce health inequities. 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

This paper explores the intervening role in SEP performance of corporate environmental, cultural, and ethnic activities (ECEAs) and diversity, equity, inclusion, and social initiatives (DEISIs) on blockchain adoption (BCA) strategy, particularly useful in the Western Balkans (WB), which demands transparency due to extended fraud and ethnic complexities. In this domain, a question has been raised: In BCA strategies, is there any correlation between SEP performance and ECEAs and DEISIs in a mediating role? A serial mediation model was tested on a dataset of 630 WB and EU companies, and the research conceptual model was validated by CFA (Confirmation Factor Analysis), and the SEM (Structural Equation Model) fit was assessed. We found a statistically sound (significant, positive) correlation between BCA and ESG success performance, especially in the innovation and integrity ESG performance success indicators, when DEISIs mediate. The findings confirmed the influence of technology, and environmental, cultural, ethnic, and social factors on BCA strategy. The findings revealed some important issues of BCA that are of worth to WB companies’ managers to address BCA for better performance. This study adds to the literature on corporate blockchain transformation, especially for organizations seeking investment opportunities in new international markets to diversify their assets and skill pool. Furthermore, it contributes to a deeper understanding of how DEI initiatives impact the correlation between business transformation and socioeconomic performance, which is referred to as the “social impact”. Full article

In light of the increasing frequency and intensity of natural phenomena, whether climatic or telluric, the relevance of multi-risk assessment approaches has become an important issue for understanding and estimating the impacts of disasters on complex socioeconomic systems. Two aspects contribute to the worsening of this situation. First, climate change has heightened the incidence and, in conjunction, the seriousness of geohazards that often occur with each other. Second, the complexity of these impacts on societies is drastically exacerbated by the interconnections between urban areas, industrial sites, power or water networks, and vulnerable ecosystems. In front of the recent research on this problem, and the necessity to figure out the best scientific positioning to address it, we propose, through this review analysis, to revisit existing literature on multi-risk assessment methodologies. By this means, we emphasize the new recent research frameworks able to produce determinant advances. Our selection corpus identifies pertinent scientific publications from various sources, including personal bibliographic databases, but also OpenAlex outputs and Web of Science contents. We evaluated these works from different criteria and key findings, using indicators inspired by the PRISMA bibliometric method. Through this comprehensive analysis of recent advances in multi-risk assessment approaches, we highlight main issues that the scientific community should address in the coming years, we identify the different kinds of geohazards concerned, the way to integrate them in a multi-risk approach, and the characteristics of the presented case studies. The results underscore the urgency of developing robust, adaptable methodologies, effectively able to capture the complexities of multi-risk scenarios. This challenge should be at the basis of the keys and solutions contributing to more resilient socioeconomic systems. Full article

As China’s first systematic assessment of high-risk Amaranthaceae invaders, this study addresses a critical knowledge gap identified in the National Invasive Species Inventory, in which four invasive Amaranthaceae species (Dysphania ambrosioides, Celosia argentea, Amaranthus palmeri, and Amaranthus spinosus) are prioritized due to CNY 2.6 billion annual ecosystem damages in China. By coupling multi-species comparative analysis with a parameter-optimized Maximum Entropy (MaxEnt) model integrating climate, soil, and topographical variables in China under Shared Socioeconomic Pathways (SSP) 126/245/585 scenarios, we reveal divergent expansion mechanisms (e.g., 247 km faster northward shift in A. palmeri than D. ambrosioides) that redefine invasion corridors in the North China Plain. Under current conditions, the suitable habitats of these species span from 92° E to 129° E and 18° N to 49° N, with high-risk zones concentrated in central and southern China, including the Yunnan–Guizhou–Sichuan region and the North China Plain. Temperature variables (Bio: Bioclimatic Variables; Bio6, Bio11) were the primary contributors based on permutation importance (e.g., Bio11 explained 56.4% for C. argentea), while altitude (e.g., 27.3% for A. palmeri) and UV-B (e.g., 16.2% for A. palmeri) exerted lower influence. Model validation confirmed high accuracy (mean area under the curve (AUC) > 0.86 and true skill statistic (TSS) > 0.6). By the 2090s, all species showed net habitat expansion overall, although D. ambrosioides exhibited net total contractions during mid-century under the SSP126/245 scenarios, C. argentea experienced reduced total suitability during the 2050s–2070s despite high-suitability growth, and A. palmeri and A. spinosus expanded significantly in both total and highly suitable habitat. All species shifted their distribution centroids northward, aligning with warming trends. Overall, these findings highlight the critical role of temperature in driving range dynamics and underscore the need for latitude-specific monitoring strategies to mitigate invasion risks, providing a scientific basis for adaptive management under global climate change. Full article

Self-medication is a subject of global importance. If practiced responsibly, self-medication represents a part of self-care or positive care of an individual or a community in promoting their own health. However, today’s practices of self-medication are often inappropriate and irresponsible, and as such appear all over the world. Inappropriate self-medication can be connected with possible serious health risks and consequences. Therefore, it represents a global health issue. It can even generate additional health problems, which will eventually become a burden to healthcare systems and can induce significant costs, which also raises socioeconomic concerns. Hence, self-medication attracts the attention of researchers and practitioners globally in efforts to clarify the current status and define feasible measures that should be implemented to address this issue. This narrative review aims to give an overview of the situation in the field of self-medication globally, including current practices and attitudes, as well as implications for actions needed to improve this problem. A PubMed/MEDLINE search was conducted for articles published in the period from 1995 up to March 2025 using keywords “self-medication” or “selfmedication” alone or in combinations with terms related to specific subthemes related to self-medication, such as COVID-19, antimicrobials, healthcare professionals, and storing habits of medicines at home. Studies were included if self-medication was their main focus. Publications that only mentioned self-medication in different contexts, but not as their main focus, were excluded. Considering the outcomes of research on self-medication in various contexts, increasing awareness of responsible self-medication through education and informing, together with surveillance of particular medicines and populations, could lead to more appropriate and beneficial self-medication in the future. Full article

Central Asia (CA) faces growing Water–Energy–Food (WEF) Nexus challenges, due to its complex transboundary water management, legacy Soviet-era water infrastructure, and increasing climate and socio-economic pressures. This study presents the development of a System Dynamics Model (SDM) to evaluate WEF interdependencies across the Aral Sea Basin (ASB), including the Amu Darya and Syr Darya river basins and their sub-basins. Different downscaling strategies based on the area, population, or land use have been applied to process open-access databases at the national level in order to match the scope of the study. Climate and socio-economic assumptions were introduced through the integration of already defined Shared Socioeconomic Pathways (SSPs) and Representative Concentration Pathways (RCPs). The resulting SDM incorporates more than 500 variables interacting through mathematical relationships to generate comprehensive outputs to understand the WEF Nexus concerns. The SDM was successfully calibrated and validated across three key dimensions of the WEF Nexus: final water discharge to the Aral Sea (Mean Absolute Error, MAE, <5%), energy balance (MAE = 4.6%), and agricultural water demand (basin-wide MAE = 1.2%). The results underscore the human-driven variability of inflows to the Aral Sea and highlight the critical importance of transboundary coordination to enhance future resilience. Full article

Educational buildings, including schools, nurseries and universities, face stricter regulation and design control on indoor air quality (IAQ) and thermal conditions than other built environments, as these may affect children’s health and wellbeing. In this scoping review, wide-ranging health, performance, and absenteeism consequences of poor—and benefits of good—IAQ and thermal conditions are evaluated, focusing on source control, ventilation and air purification interventions. Economic impacts of interventions in educational buildings have been evaluated to enable the assessment of tangible building-related costs and savings, alongside less easily quantifiable improvements in educational attainment and reduced healthcare. Key recommendations are provided to assist decision makers in pathways to provide clean air, at an optimal temperature for students’ learning and health outcomes. Although the role of educational buildings can be challenging to isolate from other socio-economic confounders, secondary short- and long-term impacts on attainment and absenteeism have been demonstrated from the health effects associated with various pollutants. Sometimes overlooked, source control and repairing existing damage can be important cost-effective methods in minimising generation and preventing ingress of pollutants. Existing ventilation standards are often not met, even when mechanical and hybrid ventilation systems are already in place, but can often be achieved with a fraction of a typical school budget through operational and maintenance improvements, and small-scale air-cleaning and ventilation technologies, where necessary. Full article

Dark skies, a vital natural and cultural resource, have been increasingly threatened by light pollution due to rapid urbanization, leading to ecological degradation and biodiversity loss. As a key strategy for sustainable regional development, dark sky parks (DSPs) not only preserve nocturnal environments but also enhance livability by balancing urban expansion and ecological conservation. This study develops a novel framework for evaluating DSP suitability, integrating ecological and socio-economic dimensions, including the resource base (e.g., nighttime light levels, meteorological conditions, and air quality) and development conditions (e.g., population density, transportation accessibility, and tourism infrastructure). Using the Guangdong–Hong Kong–Macao Greater Bay Area (GBA) as a case study, we employ Delphi expert consultation, GIS spatial analysis, and multi-criteria decision-making to identify optimal DSP locations and prioritize conservation zones. Our key findings reveal the following: (1) spatial heterogeneity in suitability, with high-potential zones being concentrated in the GBA’s northeastern, central–western, and southern regions; (2) ecosystem advantages of forests, wetlands, and high-elevation areas for minimizing light pollution; (3) coastal and island regions as ideal DSP sites due to the low light interference and high ecotourism potential. By bridging environmental assessments and spatial planning, this study provides a replicable model for DSP site selection, offering policymakers actionable insights to integrate dark sky preservation into sustainable urban–regional development strategies. Our results underscore the importance of DSPs in fostering ecological resilience, nighttime tourism, and regional livability, contributing to the broader discourse on sustainable landscape planning in high-urbanization contexts. Full article