Search Results (136)

Hand hygiene (HH) is essential for preventing disease transmission, particularly in schools where children are in close contact with other children. This study evaluated a school-based intervention on observed HH practices and hand cleanliness in six primary schools in Guatemala. Hand cleanliness was measured using the Quantitative Personal Hygiene Assessment Tool. The intervention included (1) HH behavior change promotion through Handwashing Festivals, and (2) increased access to HH materials at HH stations. Handwashing Festivals were day-long events featuring creative student presentations on HH topics. Schools were provided with soap and alcohol-based hand rub throughout the project to support HH practices. Appropriate HH practices declined from 51.2% pre-intervention to 33.1% post-intervention, despite an improvement in median Quantitative Personal Hygiene Assessment Tool scores from 6 to 8, indicating cleaner hands. Logistic regression showed higher odds of proper HH when an assistant was present. The decline in HH adherence was likely influenced by fewer assistants and changes in COVID-19 policies, while improvements in hand cleanliness may reflect observational bias. These findings emphasize the importance of sustained behavior change strategies, reliable HH material access, and targeted interventions to address gaps in HH practices, guiding school health policy and resource allocation. Full article

The ability to effectively engineer robots with appropriate social behaviors that conform to acceptable social norms and with the potential to influence human behavior remains a challenging area in robotics. Given this, we sought to provide insights into “what can be considered a socially appropriate and effective behavior for robots charged with enforcing social compliance of various magnitudes”. To this end, we investigate how social robots can be equipped with context-inspired persuasive behaviors for human–robot interaction. For this, we conducted three separate studies. In the first, we explored how the android robot “ERICA” can be furnished with negative persuasive behaviors using a video-based within-subjects design with N = 50 participants. Through a video-based experiment employing a mixed-subjects design with N = 98 participants, we investigated how the context of norm violation and individual user traits affected perceptions of the robot’s persuasive behaviors in the second study. Lastly, we investigated the effect of the robot’s appearance on the perception of its persuasive behaviors, considering two humanoids (ERICA and CommU) through a within-subjects design with N = 100 participants. Findings from these studies generally revealed that the robot could be equipped with appropriate and effective context-sensitive persuasive behaviors for human–robot interaction. Specifically, the more assertive behaviors (displeasure and anger) of the agent were found to be effective (p < 0.01) as a response to a situation of repeated violation after an initial positive persuasion. Additionally, the appropriateness of these behaviors was found to be influenced by the severity of the violation. Specifically, negative behaviors were preferred for persuasion in situations where the violation affects other people (p < 0.01), as in the COVID-19 adherence and smoking prohibition scenarios. Our results also revealed that the preference for the negative behaviors of the robots varied with users’ traits, specifically compliance awareness (CA), agreeableness (AG), and the robot’s embodiment. The current findings provide insights into how social agents can be equipped with appropriate and effective context-aware persuasive behaviors. It also suggests the relevance of a cognitive-based approach in designing social agents, particularly those deployed in sensitive social contexts. Full article

Introduction: The COVID-19 pandemic highlighted the need for digital tools that support public health decision-making and behavior change. Dashboards became a primary method for communicating infectious disease data. However, their influence on preventive health behaviors (PHBs) is not well understood—especially among young adults. This group is less likely to adhere to PHBs, but highly familiar with online tools. Methods: Two experimental studies were conducted with young adult participants (200 in Study 1, 228 in Study 2) who viewed the same COVID-19 data in dashboards with or without actionable components. Participants were randomly assigned to different dashboard conditions to measure, on seven-point Likert scales, their PHB intentions and perceptions of behavioral control, attitudes, norms, and risk. The actionable dashboard interventions, designed using the theory of planned behavior, included dynamic behavioral guidance and risk level visualizations. Results: Actionable dashboards versus basic dashboards significantly increased PHB intentions (B = 0.84, p < 0.001, Study 1). Dynamic behavioral guidance was the key dashboard component influencing PHB intentions (B = 0.61, p = 0.005, Study 2). Parallel mediation analysis testing norms, attitudes, behavioral control, and perceived risk against one another found that only norms explained the link between the dashboard intervention and PHB intentions (B_boot = 0.18 and 0.19). Conclusions: Findings suggest that actionable dashboards can effectively promote PHB by influencing psychosocial beliefs. These dashboards provide context and guidance, making risky situations more manageable and directing individuals to appropriate preventive actions. Public health professionals should consider incorporating behavioral guidance into community health dashboards to improve their effectiveness. Full article

Background: The COVID-19 pandemic has sparked the need for appropriate government responses in health-disaster situations worldwide. This study analyzes the impact of governments’ non-pharmaceutical measures on the number of deaths from COVID-19. In particular, it further analyzes how trust in government moderates government measures. Through this analysis, this study aims to explore the government’s appropriate role in overcoming future health disasters by understanding the effectiveness of government measures in response to the COVID-19 pandemic. Methods: This study collected and analyzed national data provided by various international organizations for countries of the Organization for Economic Co-operation and Development (OECD). To estimate the relationship between various policy measures and COVID-19 related deaths, it employed panel data analysis using random effects, since only three years of data, ranging from 2020 to 2022, were utilized. Results: The main findings of this study are as follows. First, suppression measures which include measures that place relatively stronger restrictions on people’s behavior were directly related to decreases in the number of total deaths. However, mitigation measures which consisted of weak-intensity measures were directly related to increases in the number of deaths. Second, higher levels of trust in government were directly related to decreased numbers of deaths. Finally, the moderating effect of government trust on suppression measures was not tested, but the moderating effect on mitigation measures was confirmed. Conclusions: This study presents the following implications. First, governments’ non-pharmaceutical measures in times of pandemic need to consider various environmental factors of the country. Second, trust in government can be an important environmental condition in overcoming health-disaster situations. In particular, trust in government weakens the side effects that can be caused by government measures. Third, suppression methods that directly affect people’s movement and daily life had a positive association with decreases in the number of total deaths, and the correlations of these measures in overcoming the health-disaster situation were confirmed. Full article

Background: Prescribing antiviral agents for severe acute respiratory syndrome coronavirus 2 requires careful consideration based on the patient’s risk factors for severe disease progression and their vaccination status. However, effective interventions ensuring the appropriate use of antiviral agents by physicians have yet to be fully established. Thus, this study evaluated the impact of an educational film on antiviral prescription rates for coronavirus disease 2019 (COVID-19). Methods: This prospective, nationwide, web-based survey enrolled 1500 physicians. They were instructed to view a short educational film and assess the necessity of prescribing antiviral agents in 16 fictitious scenarios featuring adult patients with COVID-19 with varying risk factors for severe disease and vaccination statuses. We compared the antiviral prescription rates before and after viewing the educational film. Results: There was a significant increase in the antiviral prescription rates after viewing the educational film, particularly nirmatrelvir/ritonavir prescribed in cases involving immunocompromised patients (from 31.3% to 49.4%) and those with obesity (from 15.1% to 33.7%) who were unvaccinated and had no risk of drug interactions. However, viewing the educational film made little to no impact on the prescription rates for the patients with hypertension and hyperlipidemia or those with no underlying conditions. Conclusions: Short educational films may promote the appropriate use of antiviral agents for COVID-19. However, their impact on altering prescription behavior appears limited and varies according to the clinical context. Full article

Background/Objectives: The COVID-19 pandemic has had a profound impact on physical, mental, and social aspects of life worldwide. This study aimed to explore and compare differences in knowledge, awareness, behavior, and the psychological impact of the pandemic among students of biomedical faculties at the University of Zagreb. Methods: A cross-sectional study was conducted between 27 November 2020 and 19 January 2021 involving 518 students from the School of Dental Medicine, School of Medicine, Faculty of Pharmacy and Biochemistry, and Faculty of Veterinary Medicine. An anonymous online questionnaire was distributed, assessing participants’ knowledge about SARS-CoV-2, information sources, attitudes, and psychological responses. Data were analyzed using descriptive statistics and appropriate statistical tests. Results: The median knowledge score was 61.54%, with senior and female students demonstrating significantly more knowledge (p < 0.001 and p = 0.044, respectively). Students who consulted the scientific literature and official websites had higher knowledge levels (p < 0.001). Most participants used media and social networks for pandemic information, while scientific sources were underutilized. Psychological impacts were evident, with 46.3% expressing fear about the future and 25% reporting anxiety if they were to be infected. Additionally, those who engaged with the scientific literature were more likely to accept vaccination and showed lower levels of COVID-19 stigma. A majority (64.5%) believed that the media exaggerated the pandemic’s risks. Conclusions: Biomedical students demonstrated moderate knowledge about COVID-19, with a clear link between scientific literacy and more informed, less stigmatizing attitudes. This study underscores the importance of reliable information sources in shaping public health awareness and highlights the need for further education on COVID-19 symptoms and preventive measures. Full article

A novel time-dependent deterministic SEIRS model, extended with vaccination, hospitalization, and vital dynamics, is introduced. Time-varying basic and effective reproduction numbers associated with this model are defined, which are crucial metrics in understanding epidemic dynamics. Furthermore, a parameter identification approach has been used to develop a numerical method to compute these numbers for long-term epidemics. We analyze the actual COVID-19 data from the USA, Italy, and Bulgaria to solve appropriate inverse problems and gain an understanding of the time evolution behavior of the basic and effective reproduction numbers. Moreover, an insightful comparison of key coronavirus data and epidemiological parameters across these countries has been conducted. For this purpose, while the basic and effective reproduction numbers provide insights into the virus transmission potential, we propose data-driven criteria for assessing the actual realization of the transmission potential of the SARS-CoV-2 virus and the effectiveness of the applied restrictive measures. To obtain these results, we conduct a mathematical analysis to demonstrate various biological properties of the new differential model, including non-negativity, boundedness, existence, and uniqueness of the solution. The new model and the associated numerical simulation tools proposed herein could be applied to COVID-19 data in any country worldwide and hold a promising potential for the transmission capacity and impact of the virus. Full article

On 30 January 2020, the World Health Organization declared a public health emergency of international concern due to the rapid spread among humans, on a global scale, of SARS-CoV-2, the virus responsible for COVID-19. Although international authorities have recommended the use of common detergents known to be effective against coronaviruses, one of the practices implemented to control the expansion of the virus has been the massive use of disinfectants on indoor and outdoor surfaces, a modality that has raised concern in the scientific community because of its impact on the aquatic environment. Considering possible future scenarios related to ongoing global change, in which further public health emergencies may become more frequent, and given the need to contribute to the identification of eco-friendly alternatives or strategies to mitigate the environmental and human health impacts of the massive use of disinfectants, the aim of this study was to quantify the effects of a liquid surface detergent based on exhausted edible oils of vegetable origin (eco-product). This was done by exposing organisms representing the main trophic levels of the marine and freshwater environment to the eco-detergent before and after a five-day biodegradation process, together with studies on biological oxygen demand and microbiology. The results indicated that the eco-product has potential antimicrobial activity and can be considered as a suitable alternative, although the use of a standardized agent for the production phase of the eco-product in liquid form is recommended to further reduce the impact on the aquatic environment. However, massive and indiscriminate use is a behavior to be discouraged, and limited and restricted use to appropriate areas and contexts is recommended. Full article

This paper studies the dynamic behavior of a stochastic SEIRM model of COVID-19 with a standard incidence rate. The existence of global solutions for dynamic system models is proven by integrating stochastic process theory and the concept of stopping times, together with the contradiction method. Moreover, we construct appropriate Lyapunov functions to analyze system stability and apply Dynkin’s formula and Fatou’s lemma to handle stopping times and expectations of stochastic processes. Notably, the extinction study provides mathematical proof that under the given system dynamics, the total population does not grow indefinitely but tends to stabilize over time. The properties of the diffusion matrix are harnessed to guarantee the system’s stationary distribution. Conclusively, numerical simulations confirm the model’s extinction outcomes. Full article

Background: The COVID-19 pandemic has led to reduced physical activity and increased sedentary behaviors, negatively impacting mental and physical health. Engaging in physical activity at home during quarantine became essential to counteracting these adverse effects. To develop appropriate physical activity programs, assessing individuals’ fitness levels and the impact of inactivity is crucial. This study aims to compare motor abilities—including flexibility, balance, reaction time, cardiovascular endurance, and lower and upper limb strength—assessed both in-person and remotely, to determine the accuracy and repeatability of self-administered tests. Methods: A total of 35 young subjects (age 24.2 ± 1.97 years, BMI 22.4 ± 2.61 kg/m²) participated in this study. Each participant underwent a battery of motor ability tests designed to assess various fitness components. The tests were administered twice for each subject: once in a laboratory setting and once remotely at home. The sequence of tests was randomly assigned to ensure unbiased results. Both the in-person and remote assessments were used to evaluate the accuracy and reliability of self-administered tests. Results: The comparison of test results between the laboratory and remote settings revealed percentage differences ranging from 5% to 10%. This variation is considered an acceptable margin of error, suggesting that the tests conducted remotely were relatively accurate when compared to those performed in a controlled laboratory environment. Conclusions: The findings indicate that remote fitness testing is a promising method for evaluating motor abilities. With an acceptable margin of error, remote assessments can be effectively used to personalize training programs based on individuals’ physiological characteristics. This approach may be particularly beneficial during times of limited access to fitness facilities, such as during quarantine, or for individuals seeking more flexible fitness evaluation methods. Full article

The COVID-19 pandemic has considerably impacted the health and lifestyle of various populations worldwide, leading to decreased physical activity, increased sedentary behavior, and increased health problems. This study aimed to investigate Hong Kong young adults’ physical activity, related behaviors, and perceptions of body image during the pandemic. A cross-sectional online survey of young adults aged 18–29 was conducted from February to March 2021 using the well-validated Multidimensional Body Self-Relations Questionnaire (MBSRQ). Among 408 respondents, 52.5% had a normal weight in the BMI range, 45.1% engaged in ≥8 h of sedentary behavior daily, 77.2% engaged in no regular or inadequate physical activity (<2.5 h/week), and only 22.3% joined a fitness club. BMI, regular physical activity, and joining any fitness club/class were significantly associated with the most factors or additional subscales. A multiple linear regression model showed that the underweight respondents (reference group: normal) (β = −0.26, 95% CI: −0.41 to −0.12) were less likely to have high scores of fitness orientation. The respondents who engaged in regular physical activity <2.5 h/week (β = 0.42, 95% CI: 0.29 to 0.54), engaged in regular physical activity ≥2.5 h/week (β = 0.99, 95% CI: 0.84 to 1.14) (reference group: no regular physical activity), and joined a fitness club/class (β = 0.32, 95% CI: 0.18 to 0.45) were more likely to have a high score of fitness orientation. Local governments, non-governmental organizations, schools, and community centers should establish appropriate strategies and activities in order to sufficiently encourage and support young adults’ physical health and well-being. Full article

Recently, there has been a remarkable move towards interprofessional collaboration in response to the COVID-19 pandemic and the care of comorbidities. In Germany, there has been a gradual increase in interprofessional learning in medical and pharmacy education, aiming to enhance patient care. To adapt the pharmacy curriculum for collaborative practice between pharmacy and medical students, we developed an immersive interprofessional collaboration course for pharmacy students using adult and pediatric high-fidelity simulators (HFS) to assess and train medication consultation skills. In a randomized controlled trial, we investigated whether interprofessional training between pharmacy and medical students results in differences in pharmacy students’ performance of medication therapy consultation compared to the case of mono-professional training of pharmacy students only. Before and after inter/mono-professional training, each pharmacy student performed an objective structured clinical examination (OSCE) and completed a self-assessment questionnaire. Additionally, an attitude survey towards interprofessional learning was completed by pharmacy and medical students at the end of the training. As expected, interprofessional as well as mono-professional training showed a statistically significant increase in medication consultation skills. Of importance, the performance in the interprofessional training group was significantly better than in the mono-professional group, particularly in drug therapy counselling and consultation behaviors. There was a significant difference between the intervention and control groups in self-assessment scores, and all study participants had positive attitudes toward interprofessional collaboration and training. Therefore, interprofessional training using HFS has been shown to appropriately train pharmacy students for collaborative practice and consultation skills. Full article

Background and Objectives: Before COVID-19 vaccinations became available, adhering to non-pharmaceutical interventions (NPIs), like social distancing (SD), wearing masks, and hand hygiene, were crucial to mitigating viral spread. Many studies reported that younger individuals were more reluctant to follow these measures compared with older ones. We hypothesized that it would be worthwhile to find factors that influenced SD compliance among young people during the pre-vaccination phase of a pandemic. Materials and Methods: We analyzed data of adults aged 19–44 from the 2020 South Korean Community Health Survey and compared socio-demographic, health-related behavioral, and psychological factors between compliant and non-compliant cohorts. Results: A total of 59,943 participants were enrolled and we found that older age groups (30–39 and 40–44) and safety concerns (such as viral infection, virus-related death, economic damage, and transmitting virus to vulnerable people) were significantly associated with adherence to SD. Conversely, participants who were not living with a spouse, were unable to stay at home despite symptoms, smoked, drank, and had a negative attitude toward government policy statistically correlated with non-compliance. Conclusions: In times when NPIs were the primary defense against the pandemic, it is essential to identify factors that positively or negatively affect individual compliance with them, especially among young people. Using a large-scale, well-designed national survey, we could gain insights into the early recognition of risk factors for non-compliance and appropriate follow-up interventions (i.e., education campaigns, clear communication of public guidelines, and implementation of guidelines), which will help people to avoid suffering from other waves of future infectious diseases. Full article

Children with disabilities have higher prevalence estimates of obesity than typically developing children. The Healthy Caregivers–Healthy Children Phase 3 (HC3) project implemented an obesity prevention program adapted for children with special health care needs (CSHCN) that includes dietary intake and physical activity (PA) components. The primary outcome was a change in dietary intake, PA, and the body mass index (BMI) percentile. Ten childcare centers (CCCs) serving low-resource families with ≥30 2- to 5-year-olds attending were randomized to either the intervention (n = 5) or control (n = 5). The HC3 CCCs received (1) snack, beverage, PA, and screen time policies via weekly technical assistance; (2) adapted lesson plans for CSHCN; and (3) parent curricula. The control CCCs received a behavioral health attention curriculum. HC3 was delivered over three school years, with data collected at five different timepoints. It was delivered weekly for six months in year one. To ensure capacity building, the HC3 tasks were scaled back, with quarterly intervention delivery in year 2 and annually in year 3. Adaptations were made to the curriculum to ensure appropriate access for CSHCN. Given that the program was being delivered during the COVID-19 pandemic, special modifications were made to follow CDC safety standards. The primary outcome measures included the Environment and Policy Assessment and Observation (EPAO) tool, standardized dietary intake and PA assessments, and the child BMI percentile. CCCs are an ideal setting for targeting CSHCN for obesity prevention efforts as they provide an opportunity to address modifiable risk factors. Full article

Altruism plays an essential role in promoting vaccine uptake, an issue that came to the fore during the COVID-19 pandemic through discussions of herd immunity and altruistic motivations. In response, the primary objective of this cross-sectional survey was to explore how altruistic attitudes have evolved in the post-pandemic era and to assess their effectiveness in motivating vaccination behavior in different age groups. The study aimed to elucidate changes in altruistic motivations for vaccination and their implications for public health strategies. Using a representative sample of the adult population of South Tyrol, Italy, including 1388 participants, altruism was assessed in 2023 with the scales of the Elderly Care Research Center (ECRC) and the International Personality Item Pool (IPIP) subscale of the version 5F30F-R1. Its association with demographic variables, vaccination attitudes and personal beliefs in two age groups (18–69 years, 70+ years) was analyzed. The results reveal distinct predictors of altruism across these scales and age groups, suggesting a shift in altruistic attitudes towards vaccination when comparing data from a similar survey conducted in 2021 with the 2023 results. Consequently, the use of altruism scales for different age groups is warranted. This study highlights the need for further research in this field. It concludes that while promoting altruistic behavior to increase vaccine uptake appears to be effective primarily among the younger population, emphasizing personal safety is more appropriate for encouraging vaccination among older individuals. Full article