Search Results (2,981)

Background/Objective: Childhood obesity and mental health disorders in preschool-aged children represent critical public health challenges with a rising global prevalence, closely linked to lifestyle behaviors and the family environment. This cross-sectional study aims to investigate the combined influence of maternal sociodemographic, socioeconomic, anthropometric characteristics, and lifestyle factors on the physical and mental health status of preschool-aged children. Methods: Validated questionnaires were administered to assess dietary habits, psychosocial parameters (depression, anxiety, stress), and sociodemographic, socioeconomic, and anthropometric variables among 200 preschool-aged children and their mothers, who served as the primary informants. Results: Maternal obesity was associated with a higher prevalence of childhood overweight/obesity (36.7% vs. 18.5% in children of non-obese mothers, p = 0.009). Maternal psychological factors, specifically depressive symptoms (B = 0.998, OR = 2.712, 95% CI: 1.222–6.020, p = 0.014) and anxiety (B = 1.676, OR = 5.346, 95% CI: 2.471–11.565, p < 0.001), were independently associated with an increased likelihood of child anxiety. Anthropometric measures, including waist circumference (p = 0.032) and hip circumference (p = 0.031), primarily influenced children’s physical health, whereas maternal psychological factors predominantly affected their emotional well-being. Conclusions: The findings underscore the necessity for targeted interventions focusing on enhancing maternal nutrition and mental health literacy, aiming to promote healthy dietary patterns, physical activity, and lifestyle behaviors. Such interventions are pivotal for preventing childhood obesity and fostering overall well-being at the population level. Full article

Breast cancer remains a leading cause of global cancer burden, with marked differences in incidence across countries. While biological risk factors are well established, understanding the broader structural and sociocultural influences has been less comprehensive. In this study, we analyzed harmonized data from 183 countries (2017–2023), encompassing 33 variables and 7 subvariables related to demographics, nutrition, environment, health, and healthcare access, drawn from open-access international databases. Spearman correlation analysis identified strong positive associations between breast cancer incidence and discontinued breastfeeding, high LDL cholesterol, out-of-pocket healthcare expenditure, and educational attainment. Conversely, poor sanitation, lack of handwashing facilities, unsafe water, and certain nutritional deficiencies exhibited robust negative correlations, likely reflecting under detection and reporting limitations in lower-resource settings rather than true protective effects. These findings were further explored using multiple linear regression, which explained approximately 73% of the variance in global breast cancer incidence. The final model highlighted discontinued breastfeeding, prevalence of cocaine use, unsafe sanitation, high out-of-pocket healthcare expenditure, limited handwashing access, and high processed meat consumption as the most influential independent predictors. Receiver operating characteristic (ROC) analysis confirmed strong predictive value for discontinued breastfeeding and out-of-pocket expenditure, with sanitation and hygiene variables showing paradoxical inverse associations. Our results emphasize that breast cancer risk is shaped not only by individual behaviors and genetics, but also by larger-scale structural, socioeconomic, and environmental factors. These patterns suggest that targeted interventions addressing both lifestyle behaviors and systemic inequities—such as promoting breastfeeding, reducing financial barriers to healthcare, and strengthening public health infrastructure—could meaningfully reduce the global burden of breast cancer. In conclusion, this study underscores the importance of multisectoral, equity-focused prevention strategies. It also highlights the value of country-level ecological analyses in uncovering upstream determinants of cancer incidence and calls for further research to disentangle individual and contextual effects in cancer epidemiology. Full article

Lake Qinghai, the largest closed-basin lake on the Qinghai–Tibet Plateau, plays a crucial role in maintaining regional ecological stability through its hydrological functions. In recent decades, the lake has exhibited a continuous rise in water level and lake area expansion, sparking growing interest in the mechanisms driving these changes and their future evolution. This study integrates the Soil and Water Assessment Tool (SWAT), simulations under future Shared Socioeconomic Pathways (SSPs) and statistical analysis methods, to assess runoff dynamics and lake level responses in the Lake Qinghai Basin over the next 30 years. The model was developed using a combination of meteorological, hydrological, topographic, land use, soil, and socio-economic datasets, and was calibrated with the sequential uncertainty fitting Ver-2 (SUFI-2) algorithm within the SWAT calibration and uncertainty procedure (SWAT–CUP) platform. Sensitivity and uncertainty analyses confirmed robust model performance, with monthly R² values of 0.78 and 0.79. Correlation analysis revealed that runoff variability is more closely associated with precipitation than temperature in the basin. Under SSP 1-2.6, SSP 3-7.0, and SSP 5-8.5 scenarios, projected annual precipitation increases by 14.4%, 18.9%, and 11.1%, respectively, accompanied by temperature rises varying with emissions scenario. Model simulations indicate a significant increase in runoff in the Buha River Basin, peaking around 2047. These findings provide scientific insight into the hydrological response of plateau lakes to future climate change and offer a valuable reference for regional water resource management and ecological conservation strategies. Full article

Background: Type 2 diabetes mellitus (T2DM) is a global health concern driven by aging, lifestyle, and socio-economic disparities. Early detection is key, with tools like FINDRISC, QDScore, and CANRISK providing non-invasive screening. Yet, the combined effects of sociodemographic factors, healthy habits, and perceived quality of life on diabetes risk remain insufficiently studied in working populations. Objectives: To evaluate the association between sociodemographic variables, lifestyle habits (smoking, physical activity, adherence to the Mediterranean diet), and health-related quality of life (HRQoL) with the risk of developing type 2 diabetes, using three validated screening tools in a large cohort of Spanish workers. Methods: A cross-sectional study was conducted among 100,014 Spanish workers aged 18 to 69 years who underwent standardized medical evaluations between January 2021 and December 2023. Diabetes risk was assessed using the FINDRISC, QDScore, and CANRISK tools. Lifestyle variables and HRQoL (measured via the SF-12 questionnaire) were evaluated through validated instruments. Multivariate logistic regression models were used to examine the association of independent variables with moderate-to-high diabetes risk according to each score. Results: Among the strongest predictors, poor adherence to a Mediterranean diet (OR = 1.45, 95% CI: 1.32–1.58) and low physical activity (OR = 1.39, 95% CI: 1.27–1.52) were independently associated with higher diabetes risk. Poor HRQoL was also significant (OR = 1.33, 95% CI: 1.22–1.47). Conclusions: Sociodemographic factors, lifestyle behaviors, and perceived health status are independently associated with increased type 2 diabetes risk in Spanish workers. The integration of HRQoL assessments into occupational health surveillance may enhance early identification of at-risk individuals and guide tailored prevention strategies. Full article

Background: Self-medication (SM) among women during pregnancy poses a critical risk to maternal health, and SM is still commonly practiced in Saudi Arabia. Therefore, this study aims to assess the factors, attitudes, and prevalence of SM among pregnant women in the Ministry of Health (MOH) First Health Cluster. Methods: A cross-sectional design was used among 400 pregnant women who received care at primary, secondary, and tertiary healthcare levels. A structured tool was adopted and modified based on the literature review, expert and focus group interviews, and the experiences of the target participants. The dependent variables included history of illness, access to healthcare services, medication usage, and perception of SM, while the independent variables included socioeconomic status. Statistical Package for the Social Sciences (SPSS), Version 25 was used for analysis. Results: The prevalence of SM was 36.5%. Cough syrup and antipyretics were the most commonly used medications, while hair problems and weight loss were the most frequently reported reasons for SM. The primary sources of information guiding SM behavior were prior prescriptions and previous experience. Education level, occupation, age, number of pregnancies, and miscarriage history were all significantly associated with SM (p < 0.05). Conclusions: SM was found to be frequent among pregnant women in the First Health Cluster, highlighting the need for educational interventions and regulatory measures to reduce unsafe practices and improve maternal health. Full article

Objective: This study aimed to evaluate food insecurity and associated factors during and after remote learning among undergraduates at Brazilian public universities. Methods: This is a comparative study of two cross-sectional studies; the first had its data collection from August 2020 to February 2021, and the second from May 2023 to December 2023. The questionnaire contained socio-economic variables, the Brazilian Food Insecurity Scale, the Diet Quality Scale, and the Perceived Stress Scale. Results: In total, 4799 undergraduates of Brazilian public universities responded in the first study, and 2897 responded in the second. Food insecurity was present in 36.5% of the students in 2020/2021 and 35.9% of the students in 2023. In the correspondence analysis, low income, poor health, stress and poor diet were associated with food insecurity in 2020/2021. Low income, reduced income, poor health, stress and diet quality were associated with food insecurity in 2023. Logistic regressions demonstrated that the year of collection, whether during or after remote learning, did not significantly contribute to food insecurity. However, students from low-income families had the highest AOR for food insecurity; no change in income or weight and lower perceptions of stress were associated with a lower AOR for food insecurity. Full article

This study investigates the determinants of customers’ perception of business model innovation (BMI) and its impact on customer satisfaction (CS), customer loyalty (CL), and firm sustainability (FS) within Ecuadorian family economic groups (EFEGs). It also examines the moderating role of perceived BMI in the relationships between CS, CL, and FS. Data were collected through an online survey yielding 342 valid responses, using a structured instrument that included socio-demographic variables, perceived EFEG characteristics, and nine validated constructs. Reliability and validity were corroborated through exploratory and confirmatory factor analyses, while structural equation modeling (SEM) and multiple regression analyses were employed to test the proposed relationships. The results reveal that socially responsible consumption (SRC), technological/digital customer skills (TCS), value creation innovativeness (VCrI), value proposition innovativeness (VPI), and value capture innovativeness (VCI) significantly influence customers’ perception of BMI. In turn, BMI positively influences CS, CL, and FS, and moderates the relationships between CS and FS, and CL and FS, though it does not significantly moderate the CS–CL relationship. These findings are consistent with previous research on European family firms, emphasizing the relevance of innovation capabilities, entrepreneurial orientation, and socioemotional wealth in enhancing adaptability and performance in family-owned businesses. This study contributes novel empirical evidence on BMI in the context of an emerging economy dominated by family firms. It underscores BMI as a dynamic capability crucial for fostering customer engagement, improving competitiveness, and ensuring long-term sustainability. Managerial implications suggest that EFEG managers should prioritize digital integration, service innovation, and transparency to strengthen customer trust and loyalty. Future research should broaden the scope to include other Latin American contexts, integrate internal organizational perspectives, and explore intergenerational dynamics and digital transformation processes to deepen understanding of BMI in family business ecosystems. Full article

The Sohodol Gorges has become a location of interest for tourists seeking ecological experiences and outdoor activities. The main purpose of the present study is to evaluate the attitudes of Romanian tourists toward the development of geotourism in this region following the COVID-19 pandemic. In conjunction with the research questions, hypotheses, variables, and research methodology, the following research objectives were emphasized in this study of the Oltenia region: (1) investigate how certain socio-demographic variables, such as age, gender, level of education, and occupation, influence tourists’ perceptions of the various aspects of geotourism development in the Sohodol Gorges; (2) analyze the different dimensions of geotourism, including its economic, ecological, and socio-cultural impacts, thus contributing to a deeper understanding of how geotourism is perceived in the study area in the post-pandemic context. For a qualitative evaluation of the information presented in this study, the authors used a qualitative survey with open questions and closed questions as a data collection method. For data processing and analysis, the EViews version 12.0 software package was used, enabling complex statistical analyses such as multiple regressions and correlation coefficient determination. These techniques were essential for identifying and interpreting the relationships between demographic variables and tourist perceptions. The research results provide a detailed picture of the influence that demographic and behavioral factors have on tourists’ perceptions in the context of post-COVID-19 geotourism development in the Sohodol Gorges of Romania. Education level and age play a significant role in shaping economic and environmental perceptions, indicating that tourists with higher education levels are more aware of the economic and ecological impact of tourism. Full article

Brucellosis is caused by Gram-negative coccobacilli of the Brucella genus, with cattle mainly infected with Brucella abortus. The disease burden is a threat to socioeconomic development (agriculture/tourism) as well as to animal health, biodiversity and to human health due to the zoonotic nature of this pathogen. In South Africa (S.A), the prevalence of the disease in cattle and livestock in general is mostly unknown in communal farms. A cross-sectional study with a multistage sampling strategy was applied in communal areas from three district municipalities, i.e., Mopani, Capricorn and Sekhukhune of Limpopo province, South Africa. Sera (n = 1133) were collected and screened for antibodies against the Brucella species using the Rose Bengal Test (RBT) and confirmation of positive reactors with a Complement Fixation Test (CFT). The brucellosis seroprevalence was found to be 0.79% (95% CI: 0.38–1.45) by a CFT. Univariate analysis indicated that only the frequency of birth was significantly associated with CFT positivity (OR = 20; 95% Cl: 1.61–247.99; p = 0.039). The multivariable logistic regression model revealed that the frequency of birth, age, breed, gender, municipality and district were not statistically significant predictors at 0.05 level. However, some variables like cattle aged more than five years, had higher odds of CFT positivity compared to those younger than five years (OR = 5.66; 95% CI: 0.36–87.97), although the association was not statistically significant (p = 0.215). All positive reactors detected originated from the Mopani district municipality. Overall, the findings reveal a much lower seroprevalence of brucellosis in the communal farms of Limpopo province than previously assumed. We are of the opinion that the low seroprevalence is attributed to effective control strategies implemented by the Limpopo provincial veterinary services and hence provide important information to assist the regulatory bodies in the control and eradication of the disease. Full article

Palm trees, referred to here as vegetation cover (VC), provide essential ecosystem services in an arid Oasis. However, because of socioeconomic transformation, the rapid urban expansion of major cities and villages at the expense of agricultural lands of the Al-Ahsa Oasis, Saudi Arabia, has placed enormous pressure on the palm-growing area and led to the loss of productive land. These challenges highlight the need for robust, integrative methods to assess their impact on the agroecosystem. Here, we analyze spatiotemporal fluctuations in vegetation cover and its effect on the agroecosystem to determine the potential influencing factors. Data from Landsat satellites, including TM (Thematic mapper of Landsat 5), ETM+ (Enhanced Thematic mapper plus of Landsat 7), and OIL (Landsat 8) and Sentinel-2A imageries were used for analysis, while GeoEye-1 satellite images as well as socioeconomic data were applied for result validation. Principal Component Analysis (PCA) was applied to extract pure endmembers, facilitating Spectral Mixture Analysis (SMA) for mapping vegetation and urban fractions. The spatiotemporal change patterns were analyzed using time- and space-oriented detection algorithms. Results indicated that vegetation fraction patterns differed significantly; pixels with high fraction values declined significantly from 1990 to 2020. The mean vegetation fraction value varied from 0.79 to 0.37. This indicates that a reduction in palm trees was quickly occurring at a decreasing rate of −14.24%. Results also suggest that vegetation fractions decreased significantly between 1990 and 2020, and this decrease had the greatest effect on the agroecosystem situation of the Oasis. We assessed urban sprawl, and our results indicated substantial variability in average urban fractions: 0.208%, 0.247%, 0.699%, and 0.807% in 1990, 2000, 2010, and 2020, respectively. Overall, the data revealed an association between changes in palm tree fractions and urban ones, supporting strategic vegetation and/or agricultural management to enhance the agroecosystem in an arid Oasis. Full article

Southwestern China, characterized by highly undulating terrain and mountainous areas, faces frequent landslide disasters. However, previous studies in this region mostly neglected the role of extreme rainfall in landslide susceptibility assessment and the socio-economic risks threatened by landslides. To address these gaps, this study integrated 688 recorded landslides for Tengchong City in the southwest of China and 10 influencing factors (topography, lithology, climate, vegetation, and human activities), particularly two extreme precipitation indices of maximum consecutive 5 day precipitation (Rx5day) and maximum length of wet spell (CWD). These influencing factors were selected after ensuring variable independence via multicollinearity analysis. Four machine learning models were then built for landslide susceptibility assessment. The Random Forest model performed the best with an Area Under Curve (AUC) of 0.88 and identified elevation, normalized difference vegetation index (NDVI), lithology, and CWD as the four most important influencing factors. Landslides in Tengchong are concentrated in areas with low NDVI (<0.57), indicating increased vegetation cover might reduce landslide frequency. Landslide risk was further quantified via the Analytic Hierarchy Process (AHP) by integrating multiple socio-economic factors. High-risk zones were pinpointed in central-southern Tengchong (e.g., Heshun and Tuantian townships) due to their high social exposure and vulnerability. Overall, this study highlights extreme rainfall and vegetation as key modifiers of landslide susceptibility and identifies the regions with high landslide risk, which provides targeted scientific support for regional early-warning systems and risk management. Full article

Background: Atherosclerosis is a leading cause of cardiovascular morbidity and mortality worldwide. Although lipid-derived atherogenic indices are widely used for cardiovascular risk assessment, their relationship with sociodemographic factors, lifestyle behaviors, and health-related quality of life (HRQoL) in occupational populations remains insufficiently explored. This study aimed to evaluate the association between atherogenic risk, measured by total cholesterol/high-density lipoprotein cholesterol (TC/HDL-c), low-density lipoprotein cholesterol/high-density lipoprotein cholesterol (LDL-c/HDL-c), triglyceride/high-density lipoprotein cholesterol (TG/HDL-c), and atherogenic dyslipidemia (AD) and sociodemographic, lifestyle, and HRQoL variables in a large cohort of Spanish workers. Methods: We conducted a cross-sectional analysis of 100,014 Spanish workers aged 18–69 years, of whom 39.9% were women, with a mean age of 38.2 years (SD 10.2 or IQR) and 38.9 years (SD 10.3 or IQR) for men, during the health examinations carried out between 2021 and 2024. Sociodemographic variables included sex, age group, and occupational social class. Lifestyle factors comprised smoking status, adherence to the Mediterranean diet (MEDAS score), and physical activity (IPAQ categories). HRQoL was assessed using the 12-item Short Form Survey (SF-12), stratified into good vs. poor categories. Logistic regression models were applied to estimate odds ratios (OR) and 95% confidence intervals (CI) for moderate-to-high atherogenic risk across indices, adjusting for potential confounders. Results: Men exhibited a lower likelihood of moderate-to-high TC/HDL-c and LDL-c/HDL-c but a markedly higher probability of elevated TG/HDL-c and AD compared to women (OR range: 0.42–3.67, p < 0.001). A clear age-related gradient was observed across all indices, with participants aged 60–69 showing the highest risk (OR range: 2.28–7.84, p < 0.001). Lower social class, smoking, physical inactivity, poor diet, and poor SF-12 scores were significantly associated with increased atherogenic risk, with physical inactivity (OR up to 8.61) and poor diet (OR up to 4.98) emerging as the strongest predictors. Conclusions: Atherogenic risk in this large working cohort is strongly influenced by both traditional cardiovascular risk factors and HRQoL. Integrating lifestyle modification and quality-of-life improvement strategies into workplace health programs could substantially reduce the atherogenic burden. Longitudinal research is needed to confirm these associations and guide targeted interventions. Full article

The Blue Schools initiative integrates the ocean into classroom learning through project-based approaches, cultivating environmental awareness and a deeper sense of responsibility toward marine ecosystems and human–ocean interactions. Although the European Blue School initiative has grown steadily since its launch in 2020, its uneven uptake raises important questions about the territorial factors that influence certification. This study examines the spatial determinants of Blue School certification in Mallorca, Spain, where a bottom-up pilot initiative successfully certified 100 schools. Using Maximum Entropy (MaxEnt) modeling, we estimated the spatial probability of certification based on 16 geospatial variables, including proximity to Blue Economy actors, hydrological networks, transport accessibility, and socio-economic indicators. The model achieved strong predictive performance (AUC = 0.84) and revealed that features such as freshwater ecosystems, traditional economic structures, and sustainable public transport play a greater role in school engagement than coastal proximity alone. The resulting suitability map identifies over 30 high-potential, non-certified schools, offering actionable insights for targeted outreach and educational policy. This research highlights the potential of presence-only modeling to guide the strategic expansion of Blue Schools networks. Full article

Healthcare access is a fundamental human right, yet barriers often negatively impact health, particularly in developing countries like Pakistan, where maternal mortality remains a crisis. This study aimed to identify factors influencing healthcare access barriers among married women aged 15–49 years using spatial analysis. Methods: Data were drawn from the 2017-18 Pakistan Demographic and Health Survey (PDHS), which included an unweighted sample of 8127 women. Healthcare access barriers were identified as the outcome variable. Results: A spatial analysis using ArcGIS 10.7.1 and SaTScan identified clustered distributions, with concentration areas identified in Gilgit Baltistan, Khyber Pakhtunkhwa (KPK), Federally Administered Tribal Areas (FATA), Punjab, and Balochistan. SaTScan highlighted primary clusters in FATA, Southern KPK, Northern Balochistan, and Eastern Punjab. Geographically Weighted Regression identified women who had five or more living children, respondents who did not have four or more antenatal care (ANC) visits, respondents who experienced a lower income (wealth index), respondents who did not participate in decision-making, respondents with a primary education, and respondents who accepted domestic violence as the significant predictors of healthcare access barriers. Conclusions: To improve women’s healthcare access, integrated policy interventions are needed, addressing socioeconomic disparities, strengthening national health policies, empowering women, and expanding healthcare accessibility. Strengthening health insurance and economic empowerment is crucial for achieving Sustainable Development Goals. Full article

(1) Background: Extended endocrine therapy (EET) beyond five years can reduce distant recurrence in early-stage hormone receptor-positive (HR+) breast cancer. The Breast Cancer Index (BCI) predicts recurrence risk and EET benefits, yet racial/ethnic differences in its results remain unexplored. This study evaluates such differences in a diverse early-stage HR+ breast cancer population. (2) Methods: We retrospectively analyzed demographics, tumor characteristics and BCI scores of 159 women in Hawaii with early-stage HR+ breast cancer, self-identifying as Caucasian, Filipino, Japanese, Native Hawaiian, Other Asian/Pacific Islander, or Other. Tumor characteristics included size, grade, histology, lymph node/receptor status, Oncotype DX score, and laterality. Logistic regression used demographics and tumor features as predictor variables, with BCI’s benefit prediction and recurrence risk as outcome variables. (3) Results: Japanese and other Asian/Pacific Islander patients had significantly lower odds of high recurrence risk compared to Caucasian patients. Higher recurrence risk was associated with greater odds of predicted EET. Racial/ethnic differences in EET benefit prediction were not statistically significant. (4) Conclusions: No racial/ethnic differences in EET benefit prediction suggest BCI’s applicability in racially and ethnically diverse populations. Findings among Japanese and other Asian/Pacific Islanders point to potential biological or socioeconomic variation. Limitations include sample size and underrepresentation of certain groups. Future studies should address these gaps and adjust for known risk factors to further clarify BCI’s racial and ethnic implications. Full article