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There has been a decline in the age at which girls experience menarche worldwide. Research suggests that exposure to endocrine-disrupting chemicals is linked to negative health consequences, including early onset of menarche. This systematic review examined the association between exposure to endocrine-disrupting chemicals (EDCs) and the early onset of menarche. Comprehensive searches of the PubMed, Embase, Web of Science, and Scopus databases were conducted to find relevant studies published from inception to November 2024. Exposure to certain EDCs, such as particulate matter and phthalates, showed significant associations with earlier menarche onset, while exposure to other EDCs (e.g., pyrethroids) was linked to delayed menarche timing. Overall, there were mixed findings in the relationships between various EDC exposures and menarche onset. Few studies investigated how exposure to EDCs and early menarche differed by race and ethnicity. This underscores the need for more studies that examine the relationship between early menarche onset and exposure to endocrine-disrupting substances. Education and policy approaches are also warranted to address this issue.

Electronic waste (e-waste) or discarded electronic devices that are unwanted, not working, or have reached their end of life pose significant threats to human and environmental health. This is a major concern in Africa, where the majority of e-waste is discarded. In the year 2021, an estimated 57.4 million metric tons of e-waste were generated worldwide. Globally, COVID-19 lockdowns have contributed to increased e-waste generation. Although Africa generates the least of this waste, the continent has been the dumping ground for e-waste from the developed world. The flow of hazardous waste from the prosperous ‘Global North’ to the impoverished ‘Global South’ is termed “toxic colonialism”. Agbogbloshie, Ghana, an e-waste hub where about 39% of e-waste was treated, was listed among the top 10 most polluted places in the world. The discard of e-waste in Ghana presents an issue of environmental injustice, defined as the disproportionate exposure of communities of color and low-income communities to pollution, its associated health and environmental effects, and the unequal environmental protection provided through policies. Despite the economic benefits of e-waste, many civilians (low-income earners, settlers, children, and people with minimal education) are exposed to negative health effects due to poverty, lack of education, and weak regulations. We critically examine the existing literature to gather empirical information on e-waste and environmental injustice. Comprehensive policies and regulations are needed to manage e-waste locally and globally.

Underserved communities face persistent challenges due to limited access to healthcare services. Digital volunteering offers opportunities for healthcare professionals to support these populations remotely. This study examined factors associated with healthcare workers’ intentions to participate in digital healthcare volunteering in Algeria. An extended technology acceptance model was used, incorporating perceived organizational support (OS), altruism, and social responsibility. A convenience sample of 142 healthcare workers completed a survey, and hierarchical regression analysis was conducted. Results indicated that perceived ease of use, social responsibility, altruism, perceived OS, and perceived usefulness were each significantly associated with intentions to engage in digital volunteering. The extended model explained 75.6% of the variance in intention, highlighting the relevance of psychological, organizational, and ethical factors. These findings provide insights for policymakers, healthcare organizations, and developers seeking to support digital volunteering initiatives. Limitations include the cross-sectional design and the use of convenience sampling, which may affect generalizability. Future research should consider longitudinal designs, larger and more diverse samples, and cross-cultural comparisons to validate and extend these findings.

The commentary elucidates the importance of Protection Motivation Theory (PMT) as a theoretical framework to encourage the practice of social distancing in rural areas as the world grappled with the pandemic of COVID-19 outbreak.

COVID-19 caused an increase in the demand for medications, which led to an increase in pharmaceutical waste and there is no doubt that this contributes to environmental pollution. Hence, it became necessary to search for how to protect and improve the environment by encouraging the behavior of medication waste reduction. Accordingly, this study aims to investigate the factors affecting intentions to reduce medication waste. Considering this, we develop an extended theory of planned behavior (TPB) framework by incorporating the constructs of moral obligation, environmental awareness, and medication waste risk perception. Using the convenience sampling method and based on a self-administered questionnaire, a total of 225 usable responses were collected in five Algerian cities. The results showed that positive attitudes (β = 0.316, p < 0.001), moral obligation (β = 0.291, p < 0.001), environmental awareness (β = 0.227, p < 0.001), perceived behavior control (PBC) (β = 0.151, p = 0.001), greater perceived risks (β = 0.127, p < 0.001), and subjective norm (β = 0.096, p < 0.05) significantly and positively influence the medication waste minimization intention. Furthermore, our analyses revealed that the extended TPB model explained 73.40% of the intention variance. In conclusion, we have explored the intentions, and there may be a gap between intent and actual behavior. Therefore, we recommend future studies to examine the factors affecting the actual behavior of medication waste reduction and to investigate environmental ethics and religious commitment as predictors of waste reduction intentions.

The rapid expansion of digital platforms has significantly influenced consumer purchasing behaviors, particularly in the agri-food sector. Therefore, this paper investigates the key factors driving customers’ intention to use green agri-food delivery apps (GAFDAs) by integrating trust and electronic word of mouth (eWOM) into the Theory of Planned Behavior (TPB) framework. Additionally, this study examines gender as a moderating variable, assessing whether its influence alters the relationships between key determinants and behavioral intention. Data were collected from 252 Algerian consumers, and the proposed model was tested using SmartPLS 4 and SPSS 26.0. The results confirm that attitude, subjective norms, perceived behavioral control (PBC), trust, and eWOM positively and significantly influence the intention to use GAFDAs, with PBC emerging as the strongest predictor. Moreover, gender moderates the effect of trust on behavioral intention, with trust significantly influencing men’s adoption decisions but not those of females. In contrast, subjective norms and PBC are stronger predictors for female consumers. These findings highlight the importance of gender-specific marketing strategies to enhance GAFDA adoption. This study contributes to the literature by extending TPB with trust, eWOM, and gender moderation, offering valuable insights for marketers, policymakers, and app developers promoting sustainable food consumption.

Mobile health apps have been widely considered in the healthcare sector as innovative channels to reach patients and their families. Accordingly, the aim of the chapter was to investigate factors that influence the customers' adoption of digital health apps in Algeria. The authors adopted an extende...

Black and Latinx communities have faced disproportionate harm from the COVID-19 pandemic. Increasing COVID-19 vaccine acceptance and access has the potential to mitigate mortality and morbidity from COVID-19 for all communities, including those most impacted by the pandemic.To investigate and understand factors associated with facilitating and obstructing COVID-19 vaccine access and acceptance among Black and Latinx communities.This community-partnered qualitative study conducted semistructured, in-depth focus groups with Black and Latinx participants from March 17 to March 29, 2021, using a secure video conferencing platform. Participants were recruited through emails from local community-based organizations, federally qualified health centers, social service agencies, the New Haven, Connecticut, Health Department, and in-person distribution of study information from community health workers. A total of 8 focus groups were conducted, including 4 in Spanish and 4 in English, with 72 participants from a diverse range of community roles, including teachers, custodial service workers, and health care employees, in New Haven, Connecticut. Data were analyzed from March 17 to July 30, 2021.Interviews were audio-recorded, transcribed, translated, and analyzed using an inductive content analysis approach. Themes and subthemes were identified on the acceptability and accessibility of the COVID-19 vaccine among participants who identified as Black and/or Latinx.Among 72 participants, 36 (50%) identified as Black, 28 (39%) as Latinx, and 8 (11%) as Black and Latinx and 56 (78%) identified as women and 16 (22%) identified as men. Participants described 3 major themes that may represent facilitators and barriers to COVID-19 vaccinations: pervasive mistreatment of Black and Latinx communities and associated distrust; informing trust via trusted messengers and messages, choice, social support, and diversity; and addressing structural barriers to vaccination access.The findings of this qualitative study may impact what health care systems, public health officials, policy makers, health care practitioners, and community leaders can do to facilitate equitable uptake of the COVID-19 vaccine. Community-informed insights are imperative to facilitating COVID-19 vaccine access and acceptance among communities hardest hit by the pandemic. Preventing the further widening of inequities and addressing structural barriers to vaccination access are vital to protecting all communities, especially Black and Latinx individuals who have experienced disproportionate death and loss from COVID-19.

PURPOSE: This formative research study describes the development and preliminary evaluation of a theory-guided, online multimedia psycho-educational program (PROGRESS) designed to facilitate adaptive coping among prostate cancer patients transitioning from treatment into long-term survivorship. METHODS: Guided by the Cognitive-Social Health Information Processing Model (C-SHIP) and using health communications best practices, we conducted a two-phase, qualitative formative research study with early stage prostate cancer patients (n = 29) to inform the Web program development. Phase 1 included individual (n = 5) and group (n = 12) interviews to help determine intervention content and interface. Phase 2 employed iterative user/usability testing (n = 12) to finalize the intervention. Interview data were independently coded and collectively analyzed to achieve consensus. RESULTS: Survivors expressed interest in action-oriented content on (1) managing treatment side effects, (2) handling body image and comorbidities related to overweight/obesity, (3) coping with emotional and communication issues, (4) tips to reduce disruptions of daily living activities, and (5) health skills training tools. Patients also desired the use of realistic and diverse survivor images. CONCLUSIONS: Incorporation of an established theoretical framework, application of multimedia intervention development best practices, and an evidence-based approach to content and format resulted in a psycho-educational tool that comprehensively addresses survivors' needs in a tailored fashion. IMPLICATIONS FOR CANCER SURVIVORS: The results suggest that an interactive Web-based multimedia program is useful for survivors if it covers the key topics of symptom control, emotional well-being, and coping skills training; this tool has the potential to be disseminated and implemented as an adjunct to routine clinical care.

BACKGROUND: Maternal mortality in Brazil remains a critical indicator of social and racial inequalities, reflecting structural failures in access to and quality of obstetric care. Black women, particularly those categorized as black or brown, are at a higher risk of dying during pregnancy, childbirth, or the postpartum period. This is the result of the intersection of institutional racism, poverty, and social vulnerabilities. This study aimed to analyze trends and associated factors of maternal mortality among black women in Brazil from 2000 to 2020. METHODS: This is a retrospective cohort analytical study using data from the Brazilian Mortality Information System. The sample included women aged 10 to 49 years whose underlying cause of death was classified under ICD-10 codes O00-O99. Descriptive and bivariate analyses were conducted, as well as Poisson and multinomial logistic regressions to estimate adjusted risk ratios according to skin color, education, region, type, and place of death. RESULTS: A total of 40,907 maternal deaths were identified, with 59.2% occurring among black women. The maternal mortality ratio was 39% higher among black women compared to white women and more than double among Indigenous women. Low education, residence in the North and Northeast regions, deaths outside hospital settings, and lack of formal investigation were independently associated with increased risk. Direct obstetric causes accounted for most deaths, with hypertensive disorders and puerperal complications being the leading conditions. CONCLUSIONS: Maternal mortality among black women in Brazil reveals deep structural inequalities. Urgent public policies that incorporate an intersectional perspective, addressing race, gender, and class, are necessary to reduce disparities and ensure equitable and dignified maternal healthcare.