Environmental Determinants Research Articles

Meta-analysis unravels common responses of seed oil fatty acids to temperature for a wide set of genotypes of different plant species

Temperature is the main environmental determinant of seed oil fatty acid Q9 composition. There are no models describing common responses of main seed oil fatty acids to temperature in plants. The aim of thus work was to investigate common responses of seed oil fatty acids to minimum temperature during grain filling across species and genotypes. A database consisted of 164 genotypes of 9 species, sunflower, rapeseed, soybean, maize, flax, chia, safflower, olive and camelia, grown under a wide range of environmental conditions, was created and analyzed applying meta phenomics tools. Four widely sown species of the database was used to develop several common seed fatty acid responses and validate some models, and the other species were used to validate the General Model. The minimum temperature during grain filling responses of fatty acids in the General Model were close to responses found in genotypes of five independent species used to validate the model. Dissections of the general model by selecting the appropriate data allowed unraveling previously unknown features of the response of fatty acid to the minimum temperature during grain filling. The response of fatty acids to temperature for any species was unaffected by experimental conditions (field or controlled conditions) during the oil synthesis stage. The oleic acid trait did not affect the response to temperature of fatty acids synthesized downstream and upstream of it. Traits such as high stearic or high linoleic did not affect the response of fatty acids synthesized upstream or downstream of the trait. The established models and new knowledge could be applied to design cost effective and timely experiments to assess the potential responses of seed oil fatty acids to temperature of previously untested genotypes.

Diversity and Distribution of Bacterial and Parasitic Tick-Borne Pathogens in Armenia, Transcaucasia

Background: Variations in the distribution and prevalence of pathogens in ticks can have significant consequences for human health. Information on these variables in Transcaucasia is scarce, so the aim of our study was to conduct a large-scale study to detect selected tick-borne infectious agents in Armenia. Methods: Overall, 209 adult ticks were collected from different hosts including 4 samples from human clothes. We tested ticks using high-throughput microfluidic single-cell real-time PCR to detect 42 genospecies of pathogens. We used GIS to determine biotic and abiotic factors governing the prevalence of pathogens and applied statistical analyses to test the association between prevalence of pathogens depending on hosts, locality and environment. Results: From 209 samples, 134 were positive to targeted pathogens. Anaplasma phagocytophilum Foggie, 1949 was the most prevalent case (44%). The highest overall prevalence was observed in ticks from sheep (74%), followed by cows (67%) and calves (60%). The highest multiple infection rates were also detected in sheep (40%) and calves (40%) followed by cows (28%). One statistically significant association was found among co-infections (P<0.05). The prevalence of pathogens varied according to locality. The abundance of Anaplasma spp. is significantly correlated with “slope” and “vegetation” factors. Similar patterns were detected for other pathogens. Conclusion: This was the first large-scale survey of multiple tick-borne pathogens in Armenia and Transcaucasia. The results of this study shed light on spatial variations in pathogen infection rate among adult ticks found on hosts and underline a number of environmental determinants of pathogen distribution among ticks.

Environmental health and human health-unifying strategies, conceptual framework and green prescriptions: a review

The intricate relationship between environmental conditions and human health is increasingly acknowledged as a critical area of public health research. As global challenges such as climate change, urbanization, and biodiversity loss become more pronounced, understanding the connections between these environmental factors and health outcomes is essential for developing effective public health strategies. This analysis delves into the complex interactions that exist between environmental influences and health, emphasizing the urgent need for integrated approaches that simultaneously promote ecological sustainability and enhance community well-being. Environmental degradation has significant implications for human health, with many deaths linked to preventable environmental health risks. These risks encompass a wide range of issues, including air and water pollution, exposure to hazardous substances, and the impacts of climate change, all of which disproportionately affect vulnerable populations. A conceptual framework is proposed to elucidate the multifaceted connections between environmental exposures, health determinants, and health outcomes, enabling a clearer understanding of how these elements interrelate. Cohesive strategies, such as the one health approach, advocate for collaboration across various sectors, including public health, veterinary health, and environmental management, to address the shared challenges of health and environmental degradation. Additionally, the principles of planetary health highlight the interdependence of ecosystems and human well-being, underscoring the need for sustainable management of natural resources to safeguard health outcomes. This article also explores the concept of "green prescriptions," which involve recommending nature-based interventions to enhance physical, mental, and social well-being. These prescriptions have demonstrated effectiveness in promoting health while fostering a sense of environmental stewardship. By synthesizing current evidence and successful case studies, this review emphasizes the significance of adopting a holistic perspective that integrates environmental considerations into healthcare practices. Ultimately, fostering collaboration among various stakeholders will contribute to the development of resilient communities that are better equipped to navigate the intertwined challenges of health and environmental sustainability.

Alleviating the public health burden of hypertension: debating precision prevention as a possible solution

ABSTRACT Hypertension is a major global health concern, with deaths attributed to the condition expected to increase to 1.57 million by 2034, particularly affecting low-and-middle-income countries such as those within sub-Saharan Africa. Non-communicable diseases, with hypertension as a core contributor, account for 74.36% of global deaths. The burden of hypertension in sub-Saharan Africa is significant, with an estimated 10–20 million people currently affected. Systemic barriers, such as fragmented health services and socioeconomic inequalities, coupled with shifts in greater salt-intake, ultra-processed foods, more sedentary lifestyles, and overburdened healthcare services, have exacerbated elevated blood pressure and poorer management of people living with hypertension in sub-Saharan Africa. Most public health strategies focus on detecting, treating, and controlling hypertension through lifestyle modifications and medication. However, evidence suggests only 10% of population hypertension is well managed. This indicates a growing need to shift towards preventative efforts. Precision prevention, a tailored health intervention approach utilising individual and population-specific factors – genetic, environmental, and social determinants – offers a potential alternative. Precision prevention aims to deliver the right preventative measures to the right population at the right time, promising to enhance intervention efficiency and health outcomes. This paper highlights various intervention levers, including environmental, biological, and behavioural modifications, examines case studies from high-income countries, and discusses the potential for implementing precision prevention in South Africa. While precision prevention shows promise, we also discuss the significant barriers to its implementation in LMICs such as those within sub-Saharan Africa.

(Dis)connected by design? Using participatory citizen science to uncover environmental determinants of social connectedness for youth in under-resourced neighbourhoods.

Social isolation and loneliness are a growing public health concern. Inadequacies in neighbourhood social infrastructure can undermine social connectedness, particularly for youth, who are dependent on their local environments yet often marginalized from public spaces and city planning. Integrating citizen science with participatory action research, the Youth.hood study set out to explore how neighbourhood built environments help or hinder social connectedness from the understudied perspective of youth in under-resourced and racialized communities. Youth (n = 42) from three neighbourhoods in Vancouver, Canada were recruited to: (1) Assess environmental assets and barriers to connectedness in their neighbourhoods using a digital photovoice app; (2) Analyze and prioritize their collective data into themes; and (3) Design and advocate for environmental improvements through a participatory workshop and forum with residents, city planners, and elected officials. Data on participant characteristics and neighbourhood perceptions were collected via an online survey and analyzed descriptively. Participatory analysis was conducted with youth using methods from thematic analysis, photovoice, and design thinking. Youth captured 227 environmental features impacting their connectedness. The most frequently reported assets were parks and nature (n = 39, 17%), including formal and informal green spaces, and food outlets (n = 25, 11%). Top barriers included poor neighbourhood aesthetics (n = 14, 6%) and inadequate streets and sidewalks (n = 14, 6%). Thematic analysis with youth underscored four themes: (1) Connecting through mobility: The fun and functionality of getting around without a car; (2) The power of aesthetics: Mediating connections to people and place; (3) Retreating to connect: Seeking out social and restorative spaces for all; and (4) Under-resourced, not under-valued: Uncovering assets for sociocultural connection. Youth described their local environments as affording (or denying) opportunities for physical, emotional, and cultural connection at both an individual and community level. Our findings extend evidence on key environmental determinants of social connectedness for youth, while highlighting the potential of community design to support multiple dimensions of healthy social development. Additionally, this work demonstrates the resilience and agency of youth in under-resourced settings, and underscores the importance of honouring assets, co-production, and intergenerational planning when working to advance healthy, connected, and youthful cities.

Disentangling the Complex Effects of Seasonal Drought, Floor Mass, and Roots on Soil Microbial Biomass in a Subtropical Moist Forest

Severe seasonal droughts driven by global climate change significantly alter the cycling of carbon and nutrients in forest ecosystems, while the investigation into the impacts of floor mass and plant roots on soil microbial biomass within the context of recurrent seasonal droughts is still rare. To investigate the environmental determinants governing soil microbial biomass with the escalating severity of seasonal droughts, we conducted a study in a montane subtropical moist evergreen broad-leaved forest in southwestern China from June 2019 to May 2023. The study results revealed that soil microbial biomass, as well as soil moisture, floor mass, and plant roots, showed an apparent single-hump modal within one year. In the comparative analysis of the soil microbial biomass fluctuation amplitudes across control and watered plots, a discernible disparity was observed, indicating significant differences in microbial biomass dynamics between the respective experimental conditions. The pooled data revealed a statistically significant influence of seasonal drought, floor mass, plant roots, and their reciprocal interactions on the soil microbial biomass, highlighting these factors as pivotal determinants of microbial community dynamics. This study elucidates the interactive regulatory mechanisms by which seasonal drought, floor mass, and plant roots collectively modulate soil microbial biomass within tropical and subtropical forests, offering insights into the complex ecological processes governing microbial community dynamics. This interactive regulation might influence the trajectory of plant species and soil microbial communities, facilitating their adaptive development and evolutionary responses.

Dietary intake and sleep in late childhood - do shorter children have distinct patterns?

The exceptional growth rate during adolescence demands increased dietary intake. We aimed to compare diet and lifestyle of pre-adolescents with height and weight below the 10th percentile, with those of pre-adolescents of higher height and weight. This case-control study included healthy pre-pubertal girls (≥9 years) and boys (≥10 years). The case groups included 31 girls and 32 boys with height and weight <10th percentile, and weight percentile ≤height percentile. The control groups comprised 24 girls and 24 boys, with height ≥25th percentile, BMI 5th-85th percentiles. Participants completed 3-day food diaries and lifestyle-related questionnaires. Energy intake/estimated-requirement and protein/body-weight were comparable in the case and control groups, both in boys and girls. In boys, fat (P = 0.050) and carbohydrate (P ≤ 0.001) intakes/body-weight were higher in the case group versus controls; and iron (P < 0.001), zinc (P = 0.005), vitamin A (P < 0.001), calcium (P = 0.005), and vitamin C (P = 0.034) consumption were lower. In girls, carbohydrate/body-weight was higher in the case group compared to controls (P = 0.007); micronutrient intake was comparable, and lower than recommended. Compared to controls, short and thin boys reported less sleep during weekdays (P < 0.001). Relatively short, thin pre-adolescents may have distinct dietary intake and sleeping patterns compared to taller peers, especially boys. Nutrition is a key environmental determinant of childhood growth. Not much is known about late nutritional impact on growth in children whose anthropometric indices are below the 10th percentile. We compared food diaries and lifestyle questionnaires of pre-pubertal pre-adolescents with height <10th percentiles and weight≤height for age and sex, with those of peers with indices in higher percentiles. We found distinct differences in micronutrient intakes and sleep duration in the shorter boys, but no energy deficit in either sex. We suggest that diet and lifestyle parameters should be evaluated in children with relatively low anthropometric indices, to ensure optimal growth.

Molecular and Environmental Determinants of Addictive Substances

Knowledge about determinants of addiction in people taking addictive substances is poor and needs to be supplemented. The novelty of this paper consists in the analysis of innovative aspects of current research about relationships between determinants of addiction in Polish patients taking addictive substances and rare available data regarding the relationships between these factors from studies from recent years from other environments, mainly in Europe, and on the development of genetic determinants of physiological responses. We try to explain the role of the microelements Mn, Fe, Cu, Co, Zn, Cr, Ni, Tl, Se, Al, B, Mo, V, Sn, Sb, Ag, Sr, and Ba, the toxic metals Cd, Hg, As, and Pb, and the rare earth elements Sc, La, Ce, Pr, Eu, Gd, and Nd as factors that may shape the development of addiction to addictive substances or drugs. The interactions between factors (gene polymorphism, especially ANKK1 (TaqI A), ANKK1 (Taq1 A-CT), DRD2 (TaqI B, DRD2 Taq1 B-GA, DRD2 Taq1 B-AA, DRD2-141C Ins/Del), and OPRM1 (A118G)) in patients addicted to addictive substances and consumption of vegetables, consumption of dairy products, exposure to harmful factors, and their relationships with physiological responses, which confirm the importance of internal factors as determinants of addiction, are analyzed, taking into account gender and region. The innovation of this review is to show that the homozygous TT mutant of the ANKK1 TaqI A polymorphism rs 1800497 may be a factor in increased risk of opioid dependence. We identify a variation in the functioning of the immune system in addicted patients from different environments as a result of the interaction of polymorphisms.

Spike and Slab Regression for Nonstationary Gaussian Linear Mixed Effects Modeling of Rapid Disease Progression

ABSTRACTSelect measures of social and environmental determinants of health (referred to as “geomarkers”), predict rapid lung function decline in cystic fibrosis (CF), defined as a prolonged decline relative to patient and/or center‐level norms. The extent to which hyper‐localization, defined as increasing the spatiotemporal precision of geomarkers, aids in prediction of rapid lung decline remains unclear. Linear mixed effects (LME) models with specialized covariance functions have been used for predicting rapid lung function decline, but there are few options to properly incorporate spatial correlation into the covariance functions while inducing simultaneous variable selection. Our innovative Bayesian model uses a spike and slab prior for simultaneous variable selection and offers additional advantages when coupled with nonstationary Gaussian LME modeling. This model also incorporates spatial correlation through an additional random effect term that accounts for spatial correlation based on ZIP code distances. We validated the model with simulations and applied it to real CF data from a Midwestern CF Center. We demonstrate how a combination of demographic, clinical, and geomarker variables can be selected as optimal predictors using Bayesian false discovery rate controlling rule. Our results indicate that incorporating spatiotemporal effects and geomarkers into this novel Bayesian stochastic LME model enhances the dynamic prediction of rapid CF disease progression.

Environmental determinants of West Nile virus vector abundance at the wildlife-livestock interface.

The diversity and abundance of vectors are essential parameters in the transmission dynamics of West Nile virus (WNV) between its avian reservoirs and clinically susceptible mammalian species. Knowing the determinants of vector abundance could be thus useful in preventing West Nile fever (WNF) cases and associated socio-economic impact. We designed a survey at the wildlife-livestock interface to test the hypothesis that variations in environmental favourability between anthropized and wild scenarios modulate WNV vector abundance and transmission risk. In a continental Mediterranean region where WNF has recently emerged, we selected nine sampling sites and allocated three areas to every site with a decreasing gradient of wildlife-livestock interaction: A1-a horse farm where interaction is maximal; A2-a zone of intermediate interaction 500-1000 m from the farm; and A3-an entirely wild zone of low interaction 1-5 km from the farm. At a fortnightly frequency, we estimated mosquito abundance at each of the 27 study sites in May-December 2018 and April-July 2019. We estimated bird and mammal abundance, collected meteorological information and characterised mosquito habitat at the site scale. Thereafter, we studied the determinants of Culex spp., Culex pipiens sensu lato (s.l.) Linnaeus, 1758 (Diptera: Culicidae) and Culex theileri Theobald, 1903 abundance by constructing negative binomial generalised linear mixed models. We identified 20 mosquito species, with a notable predominance of Culex spp. and, particularly, of Cx. pipiens s.l. We found differences in the spatiotemporal distribution of Culex spp. abundance and confirmed our hypothesis by finding important effects of local environmental variations in abundance. The accumulated rainfall in fortnights 4-14 and the mean temperature of the two fortnights before sampling were positively and statistically significantly associated with the abundance of Cx. pipiens s.l. (Z = 13.09, p < 0.001, and Z = 9.91, p < 0. 001, respectively) and Culex spp. (Z = 13.35, p < 0.001, and Z = 6.99, p < 0.001, respectively), while the mean temperature of the two previous fortnights was a positive statistically significant predictor (Z = 14.69, p < 0.001) of the abundance of Cx. theileri. The farm environment was the most conducive predictor to hosting Culex spp. compared with wild settings. Our results indicate that continental Mediterranean environments are favourable for WNV circulation and maintenance, especially the environment of anthropized rural settings such as farms. These results will have an impact on the spatiotemporal risk prediction of WNF emergence in continental Mediterranean environments.

Looking back at the TEDDY study: lessons and future directions.

The goal of theTEDDY (The Environmental Determinants of Diabetes in the Young) study is to elucidate factors leading to the initiation of islet autoimmunity (first primary outcome) and those related to progression to type 1 diabetes mellitus (T1DM; second primary outcome). This Review outlines the key findings so far, particularly related to the first primary outcome. The background, history and organization of the study are discussed. Recruitment and follow-up (from age 4 months to 15 years) of 8,667 children showed high retention and compliance. End points of the presence of autoantibodies against insulin, GAD65, IA-2 and ZnT8 revealed the HLA-associated early appearance of insulin autoantibodies (1-3 years of age) and the later appearance of GAD65 autoantibodies. Competing autoantibodies against tissue transglutaminase (marking coeliac disease autoimmunity) also appeared early (2-4 years). Genetic and environmental factors, including enterovirus infection and gastroenteritis, support mechanistic differences underlying one phenotype of autoimmunity against insulin and another against GAD65. Infant growth and both probiotics and high protein intake affect the two phenotypes differently, as do serious life events during pregnancy. As the end of the TEDDY sampling phase is approaching, major omics approaches are in progress to further dissect the mechanisms that might explain the two possible endotypes of T1DM.

New insights of emerald geographic origin determination based on the infrared spectroscopy of D2O and HDO molecules

Emerald geographic origin determination in laboratories typically relies on the microscopic features of inclusions, ultraviolet through visible and near-infrared (UV-Vis-NIR) spectroscopy, and trace element chemistry measured by laser ablation–inductively coupled plasma–mass spectrometry (LA-ICP-MS). Infrared (IR) spectroscopy, a non-destructive technique, has played a minor role in this process. This work conducts a systematic examination of emerald samples from twelve origins, encompassing spectroscopic, and trace element analyses. For the first time, IR absorptions related to D2O and HDO molecules within the 2600–2850cm–1 range for from multiple origins (333 emerald samples) were recorded, assigned, and classified. These IR absorptions, controlled by the concentrations of deuterium (D) and alkali metals (primarily sodium) within channels, reveal three distinct patterns and derived four groups that serve as strong evidence for origin determination. Emeralds from Zambia group display the most prevalent HDO-dominant IR-pattern I characterized by the pronounced absorption peak of Type II HDO at 2672cm–1; Panjshir (Afghanistan) and Swat (Pakistan) emeralds exhibit the transitional type IR-Pattern II with overall five peaks and obvious 2808cm–1 peak; D2O-dominant IR-Pattern III is featured by marked absorption band at 2740cm–1, and can be further subdivided into two subtypes (IIIa and IIIb). IR-Pattern IIIb is currently only found in Nigerian emeralds, characterized by strong broad band of Type I D2O due to enriched deuterium and obvious absorption of Type I HDO at 2685cm–1 due to depleted sodium. Furthermore, this research updates the classification of UV-Vis-NIR spectra, unveils the trace element features, and presents effective compositional diagrams. This contribution enriches and expands existing techniques and provides new insights for emerald origin determination.

Distribution of evapotranspiration components along vertical layers and their controls in dry days of larch plantation in the Liupan Mountains of northwest China

Precise quantification of forest evapotranspiration (ETf) including transpiration from tree (Tt), shrub (Ts), and herb (Th) layers, as well as evaporation from litter (El) and soil (Es) layers, and elucidating their responses to environmental conditions and stand structures are crucial for forest water management in water-limited forests. In this study, we observed the Tt, Ts, Th, El, and Es, reference evapotranspiration (ETo), soil volumetric water content (SWC), litter water content (LWC), leaf area index (LAI) in tree, shrub, and herb layers, and canopy shade (Ksc) from tree layer of the Larix principis-rupprechtii plantation during the dry days from May to October of 2021 and 2022 to elucidate the distribution of evapotranspiration along vertical layers and their environmental and structural determinants. The results indicated that the contributions of Tt, Ts, Th, El, and Es to ETf during the dry days in 2021 (2022) were 42.1 % (44.7 %), 9.2 % (8.1 %), 8.2 % (8.6 %), 15.0 % (13.1 %), and 25.5 % (25.5 %), respectively. Although Tt and Ts demonstrated quadratic relationships with ETo, Th, El, and Es exhibited linear relationships. All ETcs demonstrated a saturated exponential relationship with either SWC or LWC. Furthermore, Tt, Ts, and Th showed a saturated exponential relationship with their respective LAI, whereas El and Es exhibited a cubic relationship with LAI in tree layers. All understory ETcs (Ts, Th, El, and Es) decreased exponentially with the Ksc. The multi-factor models of evapotranspiration component (ETc) from different vertical layers, which coupled the impacts of environmental conditions and vertical structure, were developed, and provided superior accuracy (R2 = 0.78–0.88, NSE = 0.78–0.86, RSME = 0.03–0.16). Such insights deepened the understanding of vertical structural distribution and multi-factor responses of ETcs in forest ecosystems and hold the potential to inform and optimise forest water management strategies.

Adult Sex-Ratio Bias Does Not Lead to Detectable Adaptive Offspring Sex Allocation Via Nest-Site Choice in a Turtle With Temperature-Dependent Sex Determination.

Sex-ratio theory predicts that parents can optimise their fitness by producing offspring of the rare sex, yet there is a dearth of empirical evidence for adaptive sex allocation in response to the adult sex ratio (ASR). This is concerning, as anthropogenic disruption of the sex ratios of reproductive individuals threatens to cause demographic collapse in animal populations. Species with environmental sex determination (ESD) are especially at risk but may possess the capacity to adaptively influence offspring sex via control over the developmental environment. For example, reptiles with temperature-dependent sex determination (TSD) could conceivably choose nest sites with thermal characteristics that produce offspring of the rare sex. To test this hypothesis, we seeded three secure outdoor ponds with different sex ratios (~M:F 3:1, 1:1, and 1:3) of adult painted turtles (Chrysemys picta), a reptile species with TSD. We then quantified nesting traits that could influence nest temperature and thus offspring sex ratio, including nesting date, nest depth, and nest canopy cover. We found no directional relationship between the ASR treatments and any measured nest traits and thus rejected our hypothesis. Interestingly, increased maternal body size was associated with reduced nest canopy cover, and this trend was more pronounced in the biased ASR treatments. If adaptive sex allocation occurs in this system, it instead may manifest via maternal epigenetic predisposition of offspring sex or in response to a phenomenon other than the ASR.

Determinants of self-reported sexually transmitted infections among reproductive age women in Senegal: evidenced by Senegal demographic and health survey.

Globally, access to sexual and reproductive health is a significant public health issue for women of the reproductive age group. Senegal is a low-income country with limited access to reproductive health services, such as in the prevention and treatment of STIs. The prevention and treatment of STIs is one of the goals set by the government to decrease reproductive health-related morbidity and mortality among women. So, the main objective of this research was to evaluate the prevalence's and determinant of self-reported sexually transmitted infections among reproductive-age women. Data from the 2023 Senegal Demographic and Health Survey datasets were used for secondary data analysis. A total of 16,583 women of reproductive age participated in the study. Bivariate analysis was employed in order to select the factors for multivariate analysis. In the multivariate analysis, variables with p < 0.05 significance levels were considered to be significant predictors of sexually transmitted infections among reproductive-age women. Finally, the percentage and odd ratio, together with their 95% confidence intervals, were reported. The prevalence of sexually transmitted infection among women was 3.21% with a 95 CI. [2.95-3.49] in the last 12 months. Being between the age range of 20 and 44 years old; attending higher education [AOR: 2.70, 95% CI (1.74, 4.19); P = 0.0001]; women who were never in union [AOR: 0.09, 95% CI (0.046, 0.17); P = 0.001] were positively associated with sexually transmitted infections among women. In contrast to this, living in Louga [AOR: 0.41, 95% CI (0.23,0.69); P = 0.001]; Fatick [AOR: 0.33, 95% CI (0.18,0.61); P = 0.0001]; Kolda [AOR: 0.23, 95% CI (0.11,0.49); P = 0.0001]; Kedougou [AOR: 0.34, 95% CI (0.17,0.68); P = 0.002]; and Sedhiou [AOR: 0.43, 95% CI (0.23,0.79); P = 0.007] and women who had history terminated pregnancy [AOR: 1.27, 95% CI (1.03,1.58); P = 0.023] were negatively associated with sexually transmitted infections among women. Women's sexually transmitted infection has been associated with sociodemographic and geographic determinants such as the age of the woman, region, educational status, marital status, and history of terminated pregnancy. Therefore, to prevent the spread of sexually transmitted infections among women, the governments of Senegal and other concerned stakeholders should give special attention to women by addressing sociodemographic and geographic determinants.

Intersecting social and environmental determinants of multidrug-resistant urinary tract infections in East Africa beyond antibiotic use

The global health crisis of antibacterial resistance (ABR) poses a particular threat in low-resource settings like East Africa. Interventions for ABR typically target antibiotic use, overlooking the wider set of factors which drive vulnerability and behaviours. In this cross-sectional study, we investigated the joint contribution of behavioural, environmental, socioeconomic, and demographic factors associated with higher risk of multi-drug resistant urinary tract infections (MDR UTIs) in Kenya, Tanzania, and Uganda. We sampled outpatients with UTI symptoms in healthcare facilities and linked their microbiology data with patient, household and community level data. Using bivariate statistics and Bayesian profile regression on a sample of 1610 individuals, we show that individuals with higher risk of MDR UTIs were more likely to have compound and interrelated social and environmental disadvantages: they were on average older, with lower education, had more chronic illness, lived in resource-deprived households, more likely to have contact with animals, and human or animal waste. This suggests that interventions to tackle ABR need to take account of intersectional socio-environmental disadvantage as a priority.

School canteens healthier for children and the planet in the Valencian Region

Abstract Issue SchoolFood4Change (SF4C), an EU Horizon 2020 project in 12 EU countries, aims at making school meals healthier for children and the planet through innovative and sustainable food procurement, promotion of planetary health diets and cooking, and a Whole School Food Approach. In the Valencian Region two subsequent market dialogues (MDs) were organised to explore a new school food procurement and feeding model. Description In our context, most children have lunch at school daily. SF4C sees schools as catalysts for a systemic change. Two intersectoral MDs were conducted with the participation of public authorities, food procurers, cooks and schools. The first one MD1, 23 attendees, used a gamification dynamic through building blocks. MD2, 58 participants, used a World Cafe methodology to analyse nutritional, environmental, educational, social and economic determinants. Results MD1 highlighted the need to increase food education in the curricula, value regional products and cuisine, improve culinary training and reduce food waste. It suggested establishing percentages of local and organic products in tenders and improving communication between the public administration and the educational community. MD2 emphasised the objective of promoting the Mediterranean diet and sustainability in canteens. To that end, participants identified the importance of establishing requirements in public tenders, annual planning of procurement, optimising logistics and integrating the canteen into the educational project. This would enhance predictability, economic sustainability, and social support for a new innovative model. Lessons Structured interaction between stakeholders was essential to devise innovative and sustainable solutions. The creation and dynamization of intersectoral working groups is an effective public health strategy to build networks for the co-creation of viable alternatives to achieve a healthier and more environmentally sustainable school feeding. Key messages • Structured interaction in intersectoral working groups is an effective public health strategy for the co-creation of viable alternatives to make school feeding healthier for children and the planet. • Tailored innovative and sustainable solutions entail a framework for structured discussions, specific context analysis, negotiations between stakeholders and locally adaptation of good practices.

Physical activity promotion in Aged care: a participatory approach

Abstract Introduction Aged care facilities (ACF) constitute an increasingly important, yet challenging setting for health promotion - given it is a highly sedentary pseudo-total institution characterized by structured daily routines within a paradigm of care for residents perceived as fragile and vulnerable. A participatory approach with residents, significant others, staff, and management might be a promising pathway to address intrapersonal, sociocultural, organizational, environmental, and political determinants of physical activity in this specific context. We will present processes and results from a research project, funded by the German Ministry of Health (2019-2023), on physical activity promotion in ACFs. Methods Our co-creation approach involved residents, significant others, staff, and management from seven nursing homes in Southern Germany. Methods included 800hrs on-site observations, semi-structured interviews (n = 31), Photovoice (n = 27 participants, n = 169 photos), as well as future workshops (n = 14) for intervention co-development (n = 14) and co-evaluation workshops (n = 7). Data analysis used reflexive thematic analysis with MaxQDA20. Results Implemented interventions (n = 57) addressed individual, social, environmental, and organizational factors. Activity promotion was integrated into care concepts and mission statements, staff work descriptions, as well as informal internal routines. Of the interventions implemented, 33% were rated as more successful, 43% as successful, and 19% as less successful than anticipated. Conclusions Participation can initiate structural and cultural change towards physical activity. However, the analyses also emphasized the critical role of staff training, along with the involvement of significant others and external service providers, as essential components for achieving sustainable change. Key messages • Participatory approaches integrate physical activity into aged care, fostering cultural shifts for resident well-being. • Success requires staff training, engaging residents’ support networks, balancing empowerment with protection.

Strategies to address common sleep disorders among middle-aged and older adults

Abstract Obstructive sleep apnea (OSA) is an underdiagnosed and prevalent condition in middle-aged and older adults, with a disproportionate burden of OSA in marginalized populations. Lack of appropriate and timely treatment puts many at risk of poor quality of life, comorbidity, motor vehicle crashes and increased health care utilization. Furthermore, social and environmental disparities were acknowledged as contributing to sleep health disparities, OSA health literacy and adherence to OSA treatment. This presentation will overview the social and environmental determinants of OSA prevalence and management. The presenter will also cover strategies to improve access and waiting time for OSA diagnosis and treatment in middle-aged and older adults, such as screening for OSA in general and marginalized populations, alternative at-home OSA detection solutions, involvement of alternative care providers in OSA care, alternative OSA targeted therapies, including accessible self-administered interventions, health equity interventions targeting OSA, and promotion of sleep-centered lifestyle approaches, including weight loss, diet and exercise.

Exploring the perceived dynamic system driving inequities in the community obesogenic environment

Abstract Introduction Persons in socioeconomically disadvantaged situations (PSEDS) are more susceptible and disproportionally exposed to obesogenic environments, resulting in poorer dietary outcomes and lower levels of physical activity. This study aimed to map the complex dynamic system within the community obesogenic environment driving unhealthy eating and insufficient physical activity among PSEDS in Flanders, and to identify potential local actions. Methods Participatory group model building (GMB), a qualitative system dynamics method, was used to engage PSEDS (n = 7), local decision makers (n = 7) and local stakeholders (n = 5) in two Flemish municipalities. A two-day GMB session was held in each municipality during which a causal loop diagram (CLD) was created and potential local actions were identified by considering causal pathways and reinforcing loops in the system. Results The CLD was designed around two main variables (i) healthy eating and (ii) physical activity among PSEDS. Seven sub-systems could be identified: 1) social environment, 2) facilities and activities, 3) mobility options, 4) information, 5) affordability, 6) safety (specifically for physical activity), and 7) industry and advertisement (specifically for eating behaviour). Several actions to improve the local environment to promote eating behaviour and physical activity among PSEDS were identified. Conclusions The CLD illustrates the complex interactions between individual and environmental determinants contributing to inequalities in eating behaviour and physical activity by including multiple perspectives of community members in socioeconomically disadvantaged situations, local decision makers and local stakeholders. Both the participatory GMB approach and the final CLD visualization can provide the basis for planning local actions for promoting healthy eating behaviour and physical activity among PSEDS. Key messages • Group model building is an effective approach to explore and understand a dynamic complex system through a shared understanding among diverse stakeholders. • A systems approach is valuable to provide a more comprehensive and context-specific understanding of the perceived factors contributing to inequities in the obesogenic environment.