HIV remains highly prevalent in sub-Saharan Africa, home to approximately 66 % of all people living with HIV and 85 % of children and adolescents living with HIV globally. The region also experiences the highest levels of armed conflict, resulting in a dual burden of violence and infectious diseases like HIV. Despite these challenges, few studies have explored the impact of war and armed conflict on HIV transmission among adolescents in sub-Saharan Africa. To address this gap in the literature, our study examines HIV risk behaviors among adolescents in both conflict and non-conflict zones of Nigeria. This was a cross-sectional study of adolescents aged 15-19 years, identified through the Nigeria HIV/AIDS Indicator and Impact Survey (NAIIS). We assessed the prevalence of HIV risk behaviors across the entire country, stratified by conflict zone status. Bivariate associations between risk behaviors and conflict status were evaluated using the chi-square test. To identify factors associated with HIV infection among adolescents, we employed survey-weighted logistic regression models, reporting adjusted odds ratios (AOR) and 95 % confidence intervals(CI). We analyzed 20,518,667 weighted records of adolescents aged 15-19 years, from both conflict (11 %) and non-conflict zones (89 %) of Nigeria. Despite the majority of adolescents residing in non-conflict zones, we found that high-risk behaviors for HIV, such as the non-use of condoms, were more prevalent in conflict zones. However, transactional sex and having two or more sexual partners were significantly higher among adolescents in non-conflict areas. Notably, the risk of HIV infection was over three times higher among adolescents who did not use condoms during sexual intercourse (AOR: 3.22, CI: 1.13, 9.19; p 0.029). Additional risk factors included younger age, educational status, engagement in transactional sex, and having multiple sexual partners. This study reports the risk behaviors that contribute to HIV infection among adolescents, particularly within conflict settings. Our findings highlight the link between conflict and heightened HIV risk behaviors among Nigerian adolescents. By identifying these factors and understanding the unique challenges faced by adolescents in conflict zones, more effective, youth-friendly reproductive health programs can be developed for regions impacted by war and conflict.

IntroductionSince the COVID-19 pandemic onset, preventive measures (e.g., social distancing, hand hygiene, mask usage) and vaccines have been pivotal in mitigating transmission and reducing public health burdens. Although adherence to these measures, influenced by factors such as ventilation and exposure duration, has been extensively validated, their long-term sustainability faces socio-economic challenges.ObjectivesTo investigate the association between risk perception and adherence to preventive behaviors and conduct a meta-analysis comparing these behaviors in vaccinated versus unvaccinated subgroups.MethodsA systematic review following PRISMA guidelines identified studies (2021–2024) analyzing risk perception and preventive behaviors. Potential biases were assessed using the MMAT tool. A meta-analysis calculated pooled effect sizes across subgroups.ResultsOf 1,594 screened studies, 10 met inclusion criteria (six for meta-analysis, n = 9,115). Populations included adults, students, and healthcare professionals across 24 countries. Most vaccinated individuals maintained preventive behaviors despite stable or declining risk perception, though social distancing and hand hygiene adherence decreased over time. Booster-vaccinated individuals exhibited higher compliance than partially vaccinated or unvaccinated counterparts. Unvaccinated individuals intending to vaccinate reported higher risk perception than those refusing vaccination. Meta-analysis revealed no significant difference in risk perception between vaccinated (70.3, 95% CI 60.8–79.8) and unvaccinated subgroups (70.8, 95% CI 61.9–79.6; I2 = 17.5%), suggesting limited influence on behavior maintenance.ConclusionWhile vaccination and preventive measures curbed COVID-19 transmission, risk perception alone does not robustly predict sustained adherence, potentially due to risk compensation. Future research should prioritize determinants of long-term behavioral retention in public health strategies.

Introduction: Sexuality is determined by multiple factors. The knowledge and perceptions of the individual's environment will determine their behavior in this regard. Identifying the perceptions in a population that attends higher education is important to carry out specific prevention activities, since the repercussions of their sexual behavior are decisive for the public health of populations. Objective: Determine what are the perceptions and the main sexual risk behaviors in American university students. Method: Systematic review. The search was carried out in the Cochrane, Medigraphic and PubMed databases with the search words sexual behavior, college students, finding 25,821 results, filtered by language (English or Spanish), access to full text, year of publication (2016- 2021), geographic area (American continent) and sample (university population), resulting in n=12 articles. Results: most of the authors agree that American university students, despite having knowledge regarding sexuality and Sexually Transmitted Infections (STIs), do not carry out preventive actions, with a beginning of sexual life approximately at the age of fifteen and multiple partners. simultaneous; condom use is predominant as a method of family planning and sexting as a risky sexual behavior has become more important in recent years. Conclusions: the high prevalence of risk behaviors and the low use of diagnostic tests supports the fact that America is one of the continents with the most annual diagnoses of STIs in the world, with consequences that can be of varying severity and even fatal.

Background: Cardiovascular disease (CVD) has remained the leading cause of death in the United States (US) for over a century. Despite progress in identifying risk factors and treatments, health disparities driven by social determinants of health (SDOH) remain underexplored. One key SDOH is the neighborhood and built environment, which influences cardiovascular (CV) health through behaviors and access to healthy food. This study examines how housing cost burden (HCB), a component of neighborhood and built environment, influences CV risk behaviors and outcomes in urban US zip codes. Methods: Health data for urban zip codes of the US was extracted from the CDC PLACES database, which utilizes data from the Behavioral Risk Factor Surveillance System (BRFSS). HCB prevalence for each zip code was obtained from the American Community Survey (ACS) and divided into the following quartile ranges to ensure even distribution: low (0–19.5%), moderate (19.6–25.2%), high (25.3–32.6%), and severe (>32.6%). Descriptive statistics in R summarized the prevalence of health risk behaviors (binge drinking, smoking, short sleep duration, no leisure physical activity [PA]) and outcomes (diabetes [DM], hypertension [HTN], obesity, coronary heart disease [CHD], and stroke [CVA]) within each group. Kruskal-Wallis tests with Dunn’s post-hoc and univariate analysis assessed associations between HCB and CV outcomes. Results: Increased HCB was associated with higher rates cigarette smoking, shorter sleep duration, and lack of PA in urban zip codes of the US, shown in Figure 1 (p < 0.001, Kruskal-Wallis test). Higher HCB was also linked to increased prevalence of DM, HTN, obesity, CHD, and CVA, and lower rates of binge drinking (p < 0.001, Kruskal-Wallis test). A univariate regression analysis showed a similar positive association between HCB and cigarette smoking, physical inactivity, short sleep duration, DM, HTN, obesity, and CVA (p<0.001). However, no significant association was found between HCB and CHD (p = 0.213, univariate analysis). Interestingly, limiting the analysis to zip codes with populations over 5,000 resulted in a significant positive association between HCB and CHD (p = 0.041, univariate analysis). Conclusion: HCB strongly correlates with CV risk behaviors and outcomes in urban US zip codes. These findings highlight the necessity of coupling social and medical care through approaches such as SDOH screening and public health interventions to advance equitable CV care.

Background/Objectives: Migrants are recognized as a vulnerable population for non-communicable diseases (NCDs) due to unique socio-cultural and environmental challenges associated with acculturation. Despite a growing migrant population, evidence on NCD risk among migrants in Japan is scarce. This study examined the prevalence, co-occurrence, and clustering of modifiable NCD risk factors among middle-aged foreign residents in Japan. Methods: A cross-sectional web-based survey was conducted among foreign residents aged 30–60 years (n = 384). Eight risk factors were assessed: tobacco use (including cigarettes, e-cigarettes, and chewable tobacco), harmful alcohol consumption, inadequate fruit and vegetable intake, frequent consumption of ultra-processed foods, insufficient physical activity (PA), poor sleep, high stress levels, and high BMI. Latent class analysis (LCA) was used to identify risk clusters, and associations with demographic and socioeconomic characteristics were examined. Results: The prevalence of risk behaviours was high, with 96% reporting inadequate fruit and vegetable intake, 55% poor sleep, and 50% insufficient PA. Risk factor co-occurrence was common: 32% reported three concurrent risks, 27.1% reported four, and 17.2% reported five or more. LCA identified two clusters. Cluster 1 (46.9% of participants) was characterized by tobacco and alcohol use, with inadequate diet and poor sleep. Cluster 2 (53.1% of participants) was defined by insufficient PA, inadequate diet, and poor sleep, but low tobacco and alcohol use. Cluster membership varied significantly by sex and employment. Conclusions: This study provides preliminary evidence of the high prevalence and clustering of modifiable NCD risk factors among middle-aged migrants in Japan. Findings highlight the need for comprehensive, multi-behavioral interventions tailored to migrant populations, while considering gender roles and occupational contexts.

Sharing needles, syringes and drug preparation paraphernalia among people who inject drugs poses a significant risk of transmission of blood-borne infections. To achieve and maintain the elimination of viral hepatitis by 2030, risk behaviour must be kept at a low level. The aim of this study was to assess changes in injecting risk behaviour among people who inject drugs in Oslo between 2002 and 2024. This was an analysis of eight cross-sectional studies among people who inject drugs in Oslo conducted in 2002, 2012, 2015, 2018, 2021, 2022, 2023 and 2024. We calculated prevalence estimates of recent (past 4 weeks) risk behaviour each year and used generalised estimating equations to identify factors associated with recent risk behaviour. A total of 1648 participants were included. The median age was 39.4 years, 71.7% were men and 54.2% reported daily injecting drug use. Recent sharing of needles/syringes decreased from 17.8% (95% CI 13.6, 22.5) in 2002 to 4.2% (95% C: 1.9, 7.8) in 2024. Recent sharing of needles/syringes was negatively associated with increasing age (every 10-year increment; aOR 0.62; 95% CI 0.50, 0.76) and was associated with daily injecting (aOR 2.07; 95% CI 1.38, 3.12) compared to less than daily and with mixed heroin and amphetamine as the drug most frequently injected (aOR 1.63; 95% CI: 1.04, 2.55) compared to heroin alone. A decline in the prevalence of recent risk behaviour among people who inject drugs in Oslo was observed between 2002 and 2024. Risk behaviour remains common among younger individuals.

Non-communicable diseases (NCDs) such as hypertension are now a major challenge in health development in Indonesia. Hypertension, or high blood pressure, is a chronic condition that occurs when blood pressure in the arteries is persistently elevated and is a major risk factor for heart disease, stroke, and kidney failure. Hypertension is a non-communicable disease that is a major health challenge, especially in the productive age group. The causes of hypertension in the productive age group are diverse, ranging from consumption of foods high in salt and fat, lack of physical activity, smoking habits, and psychological stress due to work pressure. Lack of awareness of early detection and low knowledge about a healthy lifestyle also exacerbate the situation. Lack of knowledge about how to prevent hypertension can influence attitudes towards hypertension prevention. This study aims to analyze risk behaviors and hypertension prevention efforts in the Tapos Community Health Center (Puskesmas) work area. Hypertension is a disease with the highest number of visits, so identifying risk behaviors and appropriate prevention strategies is necessary. This study used a descriptive analytical approach with qualitative methods through observation, interviews, and literature review. Data were obtained from a survey of the productive age population and the 2024 health profile of the Tapos Community Health Center (Puskesmas). Results indicate that poor stress management, unhealthy lifestyles, and low public awareness are the main triggers of hypertension. Control efforts focus on education, promoting a healthy lifestyle, and utilizing traditional herbal remedies (TOGA) as a non-pharmacological therapy.

Background: HIV-related risk behaviors are grossly under-reported in rural Pakistan despite their public health addresses. It is important to know its frequency in Malakand Division for prevention strategies. Material and Methods: A community-based cross-sectional study was conducted in eight districts of Malakand Division, Khyber Pakhtunkhwa, from January 2023 to December 2024. A random sample of 2,630 individuals (≥15 years) was surveyed through interviewer-administered home questionnaires on sexual practices, substance use, and socio-behavioural risks. Data were analyzed using SPSS v26, with results presented as counts and percentages. Results: The number of male participants was 1,595 (60.6%) and female participants were 1,035 (39.4%). Unprotected sex was 210/300 (70.0%) in Dir Upper and 150/250 (60.0%) in Shangla vs. 20/52 (38.5%) for Chitral). IV drug sharing was more prevalent in Chitral (10/52, 19.2%) than Swat district (38/480, 7.9%). Polygamous relations were seen in 15/100 (15.0%) of the Swat and 15/52 (28.8%) of Chitral group. Sex work was reported by 10/110 (9.1%) in Buner and 10/52 (19.2%) in Chitral. Highest rate of alcohol use was observed in patients from Dir Upper (120/300, 40.0%) followed by Shangla (90/250, 36.0%). Child marriage was prevalent in Shangla (35/250, 14.0%) and Chitral (8/52, 15.4%). Conclusion: HIV-related risk behaviours were regionally diverse; unprotected sex and substance use was common in Dir Upper and Shangla, whereas needle sharing and multiple partners was more prevalent among people from Chitral. Keywords: Adolescent, HIV Infections/ epidemiology, Pakistan, Risk-Taking, Sexual behavior, Substance-Related disorders, Unsafe sex.

Illicit drug use and associated health risk behaviors among sexual minority youth.

The perception of occupational risk was analyzed among automobile and motorcycle mechanics working in the informal sector of the municipality of Baranoa (Atlántico, Colombia). This observational, descriptive, and cross-sectional study (n = 33) was conducted during the first semester of 2025. A Likert-scale questionnaire (1–5) was applied, adapted from González (2015), consisting of 30 items across four dimensions: Risk knowledge (1–6), Workplace conditions (7–12), Safety practices (13–18), and Perceptions/attitudes (19–30). Mean scores were calculated for each dimension and overall. Reliability was adequate (overall α = 0.80; dimension α = 0.81–0.85). The overall mean score was 3.85 (SD = 0.46). By dimension: Risk knowledge = 4.05; Safety practices = 3.96; Workplace conditions = 3.84; Perceptions/attitudes = 3.70. Operational indicators: 72.7% reported receiving risk training; 63.6% reported use of PPE; 87.9% reported tool inspections; 48.5% perceived their trade as a health risk; and 36.4% reported stress due to working conditions. Internal consistency supported the reliability of the instrument. Findings revealed a moderate-to-high perception of occupational risk and basic preventive behaviors, with a gap between declared knowledge and personal risk assessment. The normalization of risk in informal contexts suggests the need to prioritize feasible and culturally appropriate control measures.

Objectives: To evaluate the awareness of precautionary measures, including risk factors, warning signs, and preventive behaviors, among myocardial infarction (MI) patients under the age of 40 years in Karachi, Pakistan. Methodology: This cross-sectional study was conducted from May to October 2023 across five major hospitals in Karachi. A total of 215 MI patients aged 18–40 years were recruited using purposive sampling. Awareness was assessed through a structured, validated questionnaire covering three domains: risk factors, warning signs, and preventive behaviors (e.g., medication adherence, lifestyle modification, smoking cessation). Participants achieving ≥70% correct responses were categorized as having good awareness. Data were analyzed using SPSS version 26, with Chi-square tests applied to assess associations between awareness and sociodemographic variables. A p-value ≤0.05 was considered statistically significant. Results: Of the 215 participants, most were male (77.7%) and married (91.2%), with nearly half (46%) belonging to the low-income group. Common comorbidities included hypertension (50.7%), diabetes (40.5%), and dyslipidemia (43.3%). Awareness of traditional risk factors such as high blood pressure (86%) and high cholesterol (77.7%) was high, whereas knowledge of physical inactivity (28.8%) and stress (53.4%) as risk factors was limited. While 95.8% recognized the importance of regular follow-up visits and 80% acknowledged dietary modification, only 28.8% emphasized physical activity. Awareness was significantly associated with education (p=0.001), socioeconomic status (p=0.002), and marital status (p=0.007), but not with age or gender. Conclusion: Although awareness of some conventional MI risk factors and warning signs was encouraging, considerable gaps remain regarding modifiable lifestyle-related behaviors among young MI patients. Targeted, culturally relevant health education programs are urgently needed to promote preventive practices and reduce the growing burden of premature myocardial infarction in Pakistan.

Background/Objectives: Skin cancer is the most common cancer worldwide, creating a significant burden on healthcare systems. According to the World Health Organization, 1.5 million new cases are reported annually, though the actual number is likely higher due to underreporting. The main risk factor is UV radiation, with additional contributors such as smoking, older age, and outdoor work. Basal cell carcinoma (70–80%) and squamous cell carcinoma are the most prevalent non-pigmented skin cancers. This study assessed the knowledge of patients undergoing surgical treatment for facial skin cancer regarding risk factors, prevention, treatment, and health-related behaviors. The goal was to guide educational strategies aimed at reducing disease incidence and improving outcomes. Methods: A cross-sectional study of 220 patients treated at the UCK Department of Plastic Surgery (April–August 2024) was conducted. Participants completed anonymous questionnaires on demographics, medical history, beliefs about lesions, and sun-protective behaviors. Clinical data included tumor location, size, histopathology, and excision completeness. Statistical significance was set at p < 0.05. Results: Patients were on average 71 years old; 61% had a secondary education. Sun protection habits varied by education and gender. SPF use was higher among those with higher education (79.55%) and among women (55.83%). SPF users had smaller lesion diameters (p < 0.001). However, 71% delayed seeking care for over a year, often due to misperceptions. Conclusions: There is a notable lack of awareness about skin cancer, especially prevention and early detection. Education and gender influence protective behaviors. Tailored educational initiatives may help reduce incidence and promote earlier diagnosis.

Objective: The present essay aimed to analyze the importance of emotional education in preventing risk behaviors among adolescents, considering the potential of virtual learning environments as mediators in this process. The research was based on the importance of addressing the emotional and social issues inherent to adolescence, a stage in which behaviors linked to substance use, violence, or self-harm often manifest. Methodology: A qualitative, documentary approach was employed, based on a review of scientific literature published between 2018 and 2025 in high-impact academic databases. The findings were organized around four thematic categories: emotional education in adolescence, technological resources applied to socio-emotional learning, innovative pedagogical strategies in digital environments, and school connectedness as a protective factor. Results: The results showed that programs focused on strengthening emotional intelligence contributed to improving students’ self-regulation, resilience, and responsible decision-making. Likewise, it was found that the use of resources such as virtual reality, gamification, MOOCs, and smart classrooms fostered student engagement and expanded access to socioemotional interventions in diverse contexts. However, limitations related to the digital divide, technological dependence, and exposure to misinformation on social media were also highlighted. Conclusions: The essay showed that combining emotional education with virtual environments is an effective way to improve psychological well-being and prevent risky behaviors in adolescents, provided that teacher training and inclusive educational policies are included.

BackgroundTimely malaria care-seeking and treatment is crucial to prevent severe illness and reduce onward transmission. This study assessed the time to care-seeking and identified its associated factors among febrile patients attending community-based malaria facilities in Myanmar and Thailand.MethodsLongitudinal data were collected from febrile patients suspected of malaria who sought care through Village Health Volunteers in Myanmar (December 2017–June 2021) and at malaria clinics and posts in Thailand (January 2018–June 2024). Standardized case record forms in local languages were used at diagnosis. Descriptive statistics and log-logistic Accelerated Failure Time (AFT) models were used to estimate Time Ratios (TRs).ResultsIn Myanmar (n = 2,960), the mean fever duration at diagnosis was 1.8 days (SD: 1.3). Longer time to care-seeking was associated with Shan ethnicity (TR: 1.48; 95% CI: 1.41–1.55), other ethnicities (TR: 1.24; 95% CI: 1.08–1.41), farmers (TR: 1.12; 95% CI: 1.0–1.25), uncertain malaria history (TR: 1.26; 95% CI: 1.09–1.47), and diagnosis with Plasmodium falciparum (TR: 1.10; 95% CI: 1.02–1.19) or P. vivax (TR: 1.23; 95% CI: 1.13–1.34). Shorter delays were associated with daily bed net use and diagnosis during the third or fourth quarters of the year. In Thailand (n = 15,576), the mean fever duration was 2.9 days (SD: 1.8). Longer delays were linked to farmers (TR: 1.07; 95% CI: 1.02–1.11), pre- or primary education (TR: 1.02; 95% CI: 1.00–1.04), uncertain malaria history (TR: 1.10; 95% CI: 1.06–1.14), diagnosis with P. falciparum (TR: 1.27; 95% CI: 1.09–1.46), P. vivax (TR: 1.20; 95% CI: 1.17–1.23), or other malaria species (TR: 1.32; 95% CI: 1.12–1.56), and diagnosis during the third (TR: 1.03; 95% CI: 1.00–1.05) or fourth quarters of the year (TR: 1.06; 95% CI: 1.04–1.09). Shorter care-seeking times were observed among non-agricultural occupations such as merchants and monks, individuals with prior malaria episodes, and occasional or daily bed net users.ConclusionsDelays in malaria care-seeking remain common in both Myanmar and Thailand. The identified risk factors, including ethnicity, occupation, malaria history, and preventive behaviors, should be considered in the design of targeted interventions to promote timely care-seeking in malaria-endemic settings.

Information, education, and communication programs to improve HIV knowledge and communication skills are critical to HIV responses. It is unclear if improved HIV knowledge translates to decreased HIV acquisition risks. We identified typologies of HIV knowledge to assess the relationship with HIV risk perceptions and prevention behaviors using data from reproductive-aged adults without previously diagnosed HIV at screening for entry into the RV393 HIV incidence cohort in Kisumu County, Kenya. Staff-administered questionnaires on sociodemographic characteristics, HIV knowledge, information sources (e.g., radio, television, community, school, etc.), and prevention/risk behaviors. HIV knowledge and information source typologies were identified using latent profile analysis (LPA). Mixture modeling was used to assess the relationship between typologies and perceived risk. Prevention/risk behaviors were compared and stratified by typology and risk perception (high or low/no risk). Of 926 participants in the analyses, 46.8% were female and 58.1% had at least a secondary education. LPA fit statistics suggested a three-class model (BIC = 7738; entropy = 0.793). Differences in latent profiles were characterized by engagement in community-sourced information. Across all classes, participants with high risk perception reported significantly greater numbers of sex partners and were more likely to exchange sex compared to those reporting low/no risk. HIV testing practices and consistent condom use were similar irrespective of typology. There was alignment between risk perception and risk/prevention behaviors, but knowledge and information typologies were not significantly associated with risk perception. Building knowledge alone may not be sufficient to improve outcomes, thus necessitating structural interventions that facilitate enabling environments for prevention services.

ObjectiveRisk perception is a key influencing factor on the adoption of preventative health behaviours. This study aimed to understand the role of health communication on how people perceived the risk of COVID-19 and influenced relevant health behaviours to minimise disease susceptibility during the COVID-19 pandemic among people with a chronic disease.DesignThis qualitative study involved a semi-structured interview of participants diagnosed with a chronic disease. In analysing interview responses, the Health Belief Model was utilised as a sensitising framework to facilitate analysis and explore themes within the domains of the model.SettingInterviews were completed between August and December 2020 through online platforms with individual participants.ParticipantsParticipants were Australian residents aged ≥18 years with self-reported chronic disease(s). Ninety interviews were completed, and a sample of 33 participants were enrolled for analysis.ResultsTwo main themes were identified: cues to action and perception of the threat of infection. Many participants had implemented external cues to preventative behaviours, including, but not limited to, social distancing, hand hygiene and, in some cases, mask use, mirroring enforced government restrictions. Individuals also had several social motivators from family, particularly those working in the health field, and the wider community to employ the enforced preventative behaviours. However, despite having a chronic disease, many participants did not recognise themselves as being susceptible to COVID-19. Rather, they were more concerned for others that they characterised as being at high risk, including the elderly. Geographical location also played a role in risk prevention behaviour; owing to low case numbers in rural and remote areas, the risk of susceptibility was not perceived to be high.ConclusionsThese findings demonstrate the need to clearly communicate the risk of infection to allow individuals to make informed decisions on preventative behaviours. This has ongoing relevance to future emergencies, including future pandemics/epidemics, and highlights the greater challenge if similar public health measures are contemplated again.

Long-term exposure to particulate matter (PM2.5) primarily affects the respiratory and cardiovascular systems, resulting in millions of premature deaths per year. However, the influence of PM2.5 risk perception on health decisions and preventive behaviors remains a research gap. Thus, this study examined such risk perception and associated sociodemographic factors in urban Thailand. For this purpose, a cross-sectional survey of 921 participants was conducted from March–May 2024 in urban Bangkok and Chiang Mai, Thailand. PM2.5 risk perception (13-item scale) was measured as self- administered the online survey. Binary logistic regression was also employed to test the association between sociodemographic factors and PM2.5 risk perception as well as the association between risk perception and preventive behaviors. Based on the findings, the majority of the participants agreed on their susceptibility to and the severity of PM2.5, while the sociodemographic factors showed that in urban Chiang Mai, females with higher education and income, who obtained information from various news channels, were more likely influenced by their PM2.5 risk perceptions. Regarding their PM2.5 preventive behaviors, the participants reported staying indoors, limiting outdoor activities, using air purifiers, and wearing N95 masks. The implication of the findings is that more education and information campaigns should be implemented to drive policies, raise awareness, and eliminate PM2.5-specific dust pollution sources.Supplementary InformationThe online version contains supplementary material available at 10.1038/s41598-025-18218-0.

ABSTRACTIntroduction:Colon cancer is a global health issue of importance and ranking among the top causes of cancer-related deaths. The purpose of this study is to evaluate colon cancer awareness and understanding of the risk factors and effects of daily habits on colon health among a sample of participants in the West Bank, Palestine.Materials and Methods:The study was cross-sectional in nature, conducted between May and August 2024, with an online questionnaire being distributed via social media to the selected 600 participants of 18 and above—the questionnaire assessed: demographics, colon cancer awareness, symptoms awareness, and attitude toward prevention. Statistical analysis involved descriptive statistics, means, and nonparametric tests to assess differences.Results:This study assessed the knowledge and awareness of colon cancer among 600 participants in the West Bank, of whom 84.1% were female and 46.8% aged 20–29. Findings revealed that 73.7% correctly identified the colon as part of the large intestine, while 62.3% recognized colon cancer as the second leading cause of cancer-related deaths. Notably, 70.2% acknowledged that colon cancer could develop without symptoms, and 91% mentioned the fecal occult blood test. Most participants (87%) recognized smoking as a risk factor, with 98% aware of a sedentary lifestyle; however, knowledge of diabetes and hereditary factors was lower, at 88% and 83%, respectively. Demographic comparisons indicated that females outperformed males in all knowledge categories (P < 0.05). Age-related scores were the highest in the 30–39 age group for daily habits (72.5) and 40–49 for colon cancer knowledge (80.3), but these differences were not statistically significant. Participants from camps had the highest scores across categories, though again, differences were not significant (P > 0.05). Education level influenced results, with Master’s degree holders scoring the highest in daily habits (82.3) and total scores (77.0). Overall, the study highlights critical gaps in knowledge about colon cancer, emphasizing the need for targeted educational interventions.Conclusion:Although participants demonstrated considerable understanding toward colon cancer and risk factors, gaps remain for understanding: screening methods and diabetes. The findings indicate a need for public health intervention campaigns directed to create awareness toward early detection and encourage healthier lifestyles.

PurposePhysical literacy (PL) during early childhood is crucial for establishing a foundation for lifelong physical activity and holistic development. However, China currently lacks a developmentally appropriate and culturally relevant PL framework for preschool-aged children. This study aimed to develop such a framework using a modified Delphi method and determine the relative importance of its components through the Analytic Hierarchy Process (AHP).MethodThe study employed a multi-phase design comprising a literature review, expert interviews, and two rounds of Delphi surveys with 40 experts across relevant fields. Items were retained if they met the 80% agreement threshold or were justified based on expert consensus and developmental relevance. The AHP was conducted using YAAHP software to calculate the relative weights of indicators at all levels.ResultsThe finalized framework comprises four core dimensions—motivation and confidence, physical competence, knowledge and understanding, and physical activity participation—encompassing 15 first-level and 49 second-level indicators. Dimensional weights were relatively balanced, with motivation and confidence (25.68%) and physical activity participation (25.52%) slightly exceeding physical competence (25.38%) and knowledge and understanding (23.42%).ConclusionThis study presents the first national PL framework specifically designed for Chinese preschoolers. It provides theoretical grounding and practical guidance for future PL assessments and early intervention strategies. The inclusion of risk prevention behaviors and 24-h movement behaviors—physical activity, sedentary behavior, and sleep—marks a significant advancement over existing models.

Background: Cardiovascular diseases (CVD) remain the leading cause of death in both Poland and worldwide. Despite a decline in CVD-related mortality observed in Poland since 1991, national rates still exceed the European Union average. Methods: The aim of this study was to assess the prevalence of cardiovascular risk factors and the level of health awareness among Polish Armed Forces personnel, including both soldiers and civilian employees. A total of 308 participants (82.00% soldiers) underwent anthropometric measurements, lipid profile testing, and completed a structured questionnaire. Results: The results indicate a high prevalence of modifiable risk factors, such as overweight (30.30%), low physical activity (21.20%), and tobacco use (21.20%). Additionally, 54.00% of respondents reported experiencing stress, and 17.00% had elevated cholesterol levels. Statistically significant associations were found between selected parameters and gender, age, service corps, and occupational status. Despite a moderate level of knowledge regarding CVD, the majority of participants expressed a willingness to expand their understanding. Conclusions: The findings highlight the importance of early prevention and health education on cardiovascular diseases, especially in military environments where stress and lifestyle factors may contribute to increased risk.