BACKGROUND: Highly resilient adolescents with type 1 diabetes have been proved to achieve within-target glycemic outcomes and experience high quality of life. The ecological resilience model for adolescents with type 1 diabetes was developed in this study. It aims to increase our understanding of how resilience is both positively and negatively affected by internal and environmental ecological factors.
METHODS: This cross-sectional study surveyed 460 adolescents with type 1 diabetes from 36 cities in 11 provinces, China. Participants completed self-report questionnaires on resilience, family functioning, peer support, peer stress, coping style, and demographics. Standard glycated hemoglobin tests were performed on the adolescents. Structural equation modeling was applied to analyze the data.
RESULTS: The ecological resilience model for adolescents with type 1 diabetes was a good model with a high level of variance in resilience (62%). Family functioning was the most important predictor of resilience, followed by peer support, positive coping, and peer stress. Moreover, positive coping was the mediator of the relationship between family functioning and resilience. Positive coping and peer stress co-mediated the association between peer support and resilience.
CONCLUSIONS: Family functioning, peer relationships, and positive coping are interrelated, which may jointly influence resilience. The findings provide a theoretical basis for developing resilience-promotion interventions for adolescents with type 1 diabetes, which may lead to health improvements during a vulnerable developmental period.

BACKGROUND: Malaria is a significant public health concern in the Kingdom of Saudi Arabia (KSA). This study aimed to investigate the spatiotemporal distribution of malaria in the KSA between 2017 and 2021.
METHODS: A spatial analysis was conducted using data for malaria cases stratified by Plasmodium species reported by the Ministry of Health for the period 2017-2021. Covariate data such as environmental, socioeconomic, and demographic factors were assembled from different publicly available sources.
RESULTS: A total of 13,852 cases were reported from 20 regions in the KSA during the study period. The study indicated a decline in the overall number of reported cases from 2715 in 2017 to 2616 in 2021, primarily driven by a decrease in Plasmodium falciparum infections. However, the number of Plasmodium vivax cases increased in 2021. Southern regions of the KSA remained at higher risk due to imported cases from neighboring Yemen. Socioeconomic and demographic factors, such as access to healthcare and education, were found to affect malaria transmission. Environmental factors, such as temperature and rainfall, were also identified as determinants of malaria risk.
CONCLUSIONS: This study showed significant spatial variation in malaria cases in the KSA that was related to underlying socioeconomic status and environmental factors. The findings of this study highlight the need for continued efforts to control and eliminate malaria in the KSA, particularly in regions with higher risk of malaria.

Health promotion has long recognized the ecological determinants of health, underscoring the interconnections between planetary health, economic systems and human health. Despite calls for synergy across them, these domains are governed by fundamentally divergent paradigms leading to unaddressed conceptual and institutional gaps. Sustainability, meanwhile, is reduced to personal responsibility and behaviour change. This qualitative research explores ecological determinants through a focus on sustainable consumption in the under-researched context of the global south where rapid modernization has profoundly impacted the natural environment. The article uses the theoretical framework of \'practice\'-namely, the social routines, values, conventions and norms that drive consumption-to critically examine everyday household sustainable consumption in India\'s southern state of Kerala. The findings show that in most households, sustainability is a health promotion practice. People practice sustainability fundamentally for its beneficial health outcomes. However, the institutional structures set up in favour of economic development continue to dominate society and is the paradigm that contextualizes everyday social life for consumers. The findings suggest that the practice of sustainable consumption is complex and caught in the space that is neither \'upstream\' or \'downstream\'; instead, the focus on the \'mid-stream\' reveals complex calculations that go into everyday negotiation of healthy living.
Consumerism is rapidly spreading through the global south. While the conveniences associated with easily available goods are appreciated, population health has been adversely impacted by attendant decline in ecosystems through the increase in plastics, waste and toxicity in the food chain. Health promoters, for decades, have sought to draw attention to the misalignment between the values that govern environment, economy, and health policies. This article investigates policy misalignment through the experiences of everyday consumers. Set in the context Kerala, in south India, which has recently seen rapid consumerism, the study shows that everyday consumption, even unsustainable ones, are part of meaningful social practices actively negotiated around health. Thus, people buy goods wrapped in plastic, despite its environmental impacts, because it is perceived as safer. Individuals act ‘unsustainably’ largely because they have little control over systemic factors—like urbanization, changes in social life, lack of government regulation and infrastructure—that shape their consumption practices. The study shows that initiatives that focus on knowledge and behaviour modification are not sufficient to ensure sustainable consumption. Instead, what is needed are institutional convergences across environment, economy and health priorities so that individuals can create new consumption practices that are both sustainable and healthy.

Health promotion has paid a lot of attention to the social determinants of health and to health equity but much less attention to the ecological determinants. Yet the most fundamental determinants of health are the natural systems that make the Earth liveable and are the source of our air, water, food, fuels and materials. Yet they are threatened by the very economic and social development that we have created to meet the social determinants of health. Moreover, the benefits and burdens of that development are inequitably distributed, resulting in both ecological and social injustice. In the past few years the new field of planetary health-\'the health of human civilization and the state of the natural systems on which it depends\'-has emerged, while WHO has confirmed that \'the source of human health [is] nature\'. So arguably the most important task facing health promotion in the 21st century is to turn its attention to planetary health: health promotion workers must become planetary health promoters. Local health promotion in the 21st century needs to incorporate the concept of planetary health promotion and its application in the creation of healthy \'One Planet\' communities and must become part of the emerging network of community organizations and individuals working to create sustainable, just and healthy communities.

Earth\'s life-supporting ecosystems are integral to human and planetary health. Ecosystem services connect ecosystem functions to human wellbeing. The complex, multifaceted socio-ecological challenges of ecosystem decline necessitate a transdisciplinary approach, including the active and meaningful engagement and participation of local communities. Communities uniquely possess expert local knowledge, which, when integrated into policy development and community planning, has the potential to enhance and sustain ecosystem benefits for health and wellbeing. Community-informed mapping tools provide an opportunity for integrating science, policy, and public participation in data collection. However, there is a dearth of community-informed mapping tools demonstrating the interconnection of the ecological and social determinants of health at a place-based level. This paper presents a study that employs a community-based participatory research approach to mapping local knowledge systems on EcoHealth. The study seeks to develop a community mapping tool for shared dialogue and decision-making on EcoHealth between local communities and policymakers. The participatory research methods used to explore community awareness and knowledge regarding ecosystem services, health, and sustainability in the local area are described. The process of co-producing a Community EcoHealth Toolkit, based on the integration of different knowledge systems into local policy and planning, is discussed.

OBJECTIVE: The Anthropocene is a new era in which human activity has been the dominant influence on climate and the environment. The negative impact humans have on the earth\'s systems pose significant threats to human health. Health promotion is a discipline well placed to respond to planetary health challenges of the Anthropocene. The overarching aim of this paper is to describe the elements of 21st century socio-ecological health and apply them in a revised socio-ecological framework for health promotion.
METHODS: A qualitative description study design was employed to explore the significance of ecological and cultural determinants of health and review models in contemporary health promotion to inform the development of a revised Mandala of Health. Purposeful sampling was used to recruit ten experts from across Australia including academics and practitioners working at the nexus of health promotion, environmental management and sustainability. Data were analysed thematically, using deductive and inductive methods.
RESULTS: A revised Mandala of Health could address existing gaps in health promotion theory and practice. Ecological and cultural determinants of health were considered essential components of health promotion that is often lacking in socio-ecological frameworks. Indigenous Knowledge Systems were considered immensely important when addressing ecological and cultural determinants of health.
CONCLUSIONS: A revised Mandala of Health could encourage development of contemporary health models, assisting health promotion to evolve with the health and environmental issues of the Anthropocene. This study highlights the need for more theoretical development and empirical research regarding ecological and cultural determinants of health in a health promotion context. SO WHAT?: In the context of the Anthropocene, this study highlights the potential gaps in health promotion theory and practice in terms of the natural environment and health and emphasises the need of a paradigm shift to embed ecological and cultural determinants with other determinants of health.

The determinants of biodiversity patterns in the subterranean habitat called Mesovoid Shallow Substratum (MSS) are not well-understood. In this study, thirty-three scree slopes at high altitudes were selected across the Sierra de Guadarrama National Park in central Spain to investigate the effect of ten environmental variables on the abundance and species diversity of the spider and springtail assemblages from the colluvial MSS. In each locality, a multiperforated PVC tube with a pitfall trap inside was buried up to 1 m deep, and generalized linear models and Mantel tests were used to analyze the effect of mainly climate- and habitat-related variables on the diversity patterns of both taxa. A total of 1143 individual spiders belonging to 54 species and 40 811 springtail individuals belonging to 62 species were collected. The analyses indicated that cold temperatures and the presence of forest cover on the surface significantly enhance richness and abundance in the two taxa. Environmental similarity also had a small positive effect on faunistic similarity. However, the effects of temperature and habitat detected on spider richness and abundance were stronger than on springtails, whereas the reverse was found regarding faunistic similarity. These results indicate that subterranean dwellers respond differently to the same environmental factors, which in turn, points to a different degree of affinity for the MSS. The MSS plays an important role in the survival of high mountain arthropod species, acting as a climate refuge, so the protection of this habitat should be prioritized.

The mating system is a central parameter of plant biology because it shapes their ecological and evolutionary properties. Therefore, determining ecological variables that influence the mating system is important for a deeper understanding of the functioning of plant populations. Here, using old concepts and recent statistical developments, we propose a new statistical tool to make inferences about ecological determinants of outcrossing in natural plant populations. The method requires codominant genotypes of seeds collected from maternal plants within different locations. Using extensive computer simulations, we demonstrated that the method is robust to the issues expected for real-world data, including the Wahlund effect, inbreeding and genotyping errors such as allele dropout and allele misclassification. Furthermore, we showed that the estimates of ecological effects and outcrossing rates can be severely biased if genotyping errors and genetic differentiation are not treated explicitly. Application of the new method to the case study of a dioecious tree (Taxus baccata) allowed revealing that female trees that grow in lower local densities have a greater tendency towards mating with relatives. Moreover, we also demonstrated that biparental inbreeding is higher in populations that are characterized by a longer mean distance between trees and a smaller mean trunk perimeter. We found these results to agree with both the theoretical predictions and the history of English yew.

Los Angeles County (LAC) low-income communities of color experience uneven asthma rates, evidenced by asthma emergency department visits (AEDV). This has partly been attributed to inequitable exposure to diesel particulate matter (DPM). Promisingly, public parks and open space (PPOS) contribute to DPM mitigation. However, low-income communities of color with limited access to PPOS may be deprived of associated public health benefits. Therefore, this novel study investigates the AEDV, DPM, PPOS nexus to address this public health dilemma and inform public policy in at-risk communities. Optimized Hotspot Analysis was used to examine geographic clustering of AEDVs, DPM, and PPOS at the census tract unit of analysis in LAC. Ordinary Least Squares (OLS) regression analysis was used to examine the extent to which DPM and PPOS predict AEDVs. Finally, Geographic Weighted Regression (GWR) was employed to account for spatial dependence in the global OLS model. Optimized Hotspot Analysis confirmed significant clustering of elevated AEDVs and DPM in census tracts with reduced PPOS. After controlling for pertinent demographic characteristics (poverty, children, race/ethnicity), regression analysis confirmed that DPM was significantly positively associated with AEDVs, whereas PPOS was significantly negatively associated with AEDVs. Furthermore, GWR revealed that 71.5% of LACs census tracts would benefit from DPM reductions and 79.4% would benefit from PPOS increases toward redressing AEDVs. This is the first study to identify AEDV reductions in census tracts with higher concentrations of PPOS. Thus, reducing DPM and increasing PPOS may serve to improve asthma outcomes, particularly in low-income communities of color.

Ecological determinants of sporotrichosis etiological agents remain poorly understood. For this reason, we performed explorations using local climate estimates to determine the temperature and humidity ranges of the environment where clinically relevant Sporothrix species occur and to identify what plant species are associated with them, using data collected from the published literature. We performed a literature search to identify all publications on environmental isolations of medically relevant species of Sporothrix in the PubMed, SCOPUS, and EMBASE databases. All those studies were included in the analysis where medically relevant species of Sporothrix have been isolated from soil samples, and described a specific geographical location that could be precisely georeferenced. We approximated temperature and humidity from local climate estimates, integrating geospatial data, temperature, and water vapor pressure from regions or provinces where medically relevant species of Sporothrix have been isolated from soil. Sporothrix spp. were more commonly isolated from soil of different regions or provinces of 16 countries. Most environmental isolates were identified as S. schenckii, whereas S. pallida, S. brasiliensis, S. globosa, and S. mexicana were rare. We estimate that medically relevant Sporothrix spp. grow in the soil at temperatures of 6.6 °C to 28.84 °C and 37.5% to 99.06% relative humidity. These findings indicate that sporotrichosis etiological agents grow in soil in ecological niches from soil with wide ranges of temperature and humidity, but they are also associated with a variety of plants, flowers, woody debris, reed leaves, corn stalks, leaves, and wood crumbs, potentially facilitating its establishment and proliferation in the environment.