Search Results (659)

Fertility is considered a significant demographic concern, especially in relation to climate change. This study examines how awareness of climate change, measured by five subscales—climate-friendly behavior, knowledge, personal concern, attitude, and multiplicative action—affects fertility intentions, emphasizing the mediating role of threat perception. Data were collected through an online survey administered to a sample of 817 Palestinian citizens aged 18–49 residing in the West Bank. Structural equation modeling (SEM) was utilized for the data analysis. The results revealed that climate change awareness does not directly affect fertility intentions. However, an indirect effect of climate change awareness on fertility intentions was observed, mediated by threat perception as an intervening variable. Individuals exhibiting increased awareness of climate change and perceptions of future risks demonstrated a greater likelihood of reducing their fertility intentions compared to others. Policymakers in the Palestinian territories should prioritize enhancing public awareness regarding climate change and its associated short- and long-term threats. Therefore, incorporating climate education and associated risks into fertility health programs is essential. Full article

The social acceptance of Renewable Energy Sources (RESs) is a decisive factor in the successful implementation of clean energy projects. This study explores the attitudes, demographic profiles, and common misconceptions of citizens in the Region of Epirus, Greece, toward photovoltaic and wind energy installations. Special attention is given to the role of education, age, and access to information—as well as spatial factors such as visual exposure—in shaping public perceptions and influencing acceptance of RES deployment. A structured questionnaire was administered to 320 participants across urban and rural areas, with subdivision between regions with and without visual exposure to RES infrastructure. Findings indicate that urban residents exhibit greater acceptance of RES, while rural inhabitants—especially those in proximity to installations—express skepticism, often grounded in esthetic concerns or perceived procedural injustice. Misinformation and lack of knowledge dominate in areas without visual contact. Statistical analysis confirms that younger and more educated participants are more supportive and environmentally aware. The study highlights the importance of targeted educational interventions, transparent consultation, and spatially sensitive communication strategies in fostering constructive engagement with renewable energy projects. The case of Epirus underscores the need for inclusive, place-based policies to bridge the social acceptance gap and support the national energy transition. Full article

Urban areas are at the forefront in addressing global challenges such as climate change and biodiversity loss. Among the key responses are nature-based solutions, which are increasingly being integrated into policy frameworks but which require strong community engagement for their effective implementation. This paper presents the findings of surveys conducted within the Place Lab in Katowice, Poland, an initiative developed as part of an international project and used as a participatory tool for co-creating and implementing green infrastructure. The project applies both place-based and people-centred approaches to support European cities in their transition towards regenerative urbanism. Place Lab activities encourage collaboration between local authorities and residents, enhancing awareness and fostering participation in environmental initiatives. The survey data collected during the project allowed for the evaluation of changes in public attitudes and levels of engagement and for the identification of broader societal phenomena that may influence the implementation of nature-based solutions. The findings revealed, for instance, that more women were interested in supporting the project, that residents tended to be sceptical of governmental actions on climate change, and that views were divided on the trade-off between urban infrastructure such as parking and roads and the presence of green areas. Furthermore, questions of responsibility, awareness, and long-term commitment were frequently raised. Building on the survey results and the existing literature, the study proposes a set of indicators to assess the contribution of citizen participation to the adoption of nature-based solutions. While the effectiveness of nature-based solutions in mitigating climate change impacts can be assessed relatively directly, evaluating civic engagement is more complex. Nevertheless, when conducted transparently and interpreted by experts, indicator-based assessment can offer valuable insights. This study introduces a novel perspective by considering not only drivers of engagement but also the obstacles. The proposed indicators provide a foundation for evaluating community readiness and commitment to nature-based approaches and may be adapted for application in other urban settings and in future research on climate resilience strategies. Full article

Background: It is estimated that in Italy, there were 364,000 new diagnoses of neoplasms each year and that the overall incidence of blood cancers was 10% of these. Leukemia and lymphomas represented the ninth and eighth places, respectively, among the causes of death from neoplasia. Hematopoietic stem cell transplantation represented an effective treatment option for many of these malignancies, and not only that: benign and congenital diseases could also be treated. Objective: To assess knowledge among the Apulian population regarding stem cell donation and factors that could influence this choice, focusing especially on the knowledge of the residents of Puglia, Italy on how stem cells were harvested and their functions, their reasons for joining the National Registry, and the reasons that hold them back from making such a choice. Study Design: An observational and cross-sectional study was conducted, through snowball sampling methodology, until data saturation. An online survey was conducted, which included several Italian associations. The questionnaire administered contained five main sections, such as sociodemographic data, knowledge of the existence of National Registries and their adherence, the nationwide presence of various associations that promote donation, knowledge with respect to the structure, use and functions of stem cells, sources of procurement, such as bone marrow, peripheral blood and umbilical cord, and related procedures, beliefs, attitudes, values, and opinions of the Italian population regarding the topic, and degree of information and education regarding bone marrow donation. Results: A total of 567 Apulian citizens were enrolled. Of these, 75.3% were female and 96.8% were aged between 18 and 65 years. Most of participants were single (46.9%) and married (47.3%) and had a diploma (44.4%), and less had a degree (35.8%). Significant differences were recorded between gender, singles, and married participants, and participants with a diploma or a degree and the items proposed. Conclusions: A true culture of donation in our region was not clearly spread. Although something has been accomplished in recent years in terms of deceased donor donation, still a great deal needs to be achieved for living donation, which encountered a great deal of resistance. It has been deemed necessary to seek winning solutions to this issue in terms of communication and information campaigns, raising awareness and empowering citizens to express consciously their concerns about organs and tissues and to stand in solidarity with those who suffered. Full article

Promoting domestic fire safety is crucial for preventing and effectively managing risky situations. This study evaluated the effectiveness of virtual environments (VEs) in fire drills to improve citizens’ knowledge and safe behavior in domestic settings. Conducted at the Citizen School for Risk Prevention (CSRP) in Zaragoza (Spain), the experiment involved 20 participants facing a simulated kitchen fire using a combination of physical and virtual extinguishing equipment. A theoretical session accompanied the drills to reinforce learning. Participants were divided into two groups: one completed the drill before and after the theoretical session, while the other completed it only afterward. Performance was assessed based on the ability to extinguish, control, or lose control of the fire. Surveys administered before, immediately after, and three months after training measured knowledge retention and behavioral changes. The results indicate a significant improvement in fire safety awareness and lasting adoption of safe practices. Participants also emerged as safety advocates. This study highlights the potential of combining theoretical instruction with immersive practical training and identifies strategies for replicating this approach in other prevention schools. Full article

Urban environments are increasingly challenged by rapid urbanisation and climate change, demanding strategic responses that are both adaptable and sensitive to local context. Typological classification offers a structured approach to understanding diverse urban contexts, enabling targeted interventions that support climate neutrality and livability. While global pressures are shared, their impacts differ widely across cities, highlighting the need for context-aware urban analytics to guide effective transformation. This paper presents a methodological perspective on a computational framework and workflow based on open source data, designed to support the classification and optimisation of urban environments across different urban contexts; it explores the framework’s potential and limitations, grounded in a review of relevant literature and available datasets. We propose a workflow encompassing four main steps: (1) classifying urban environments based on quantifiable characteristics, (2) identifying key performance indicators (KPIs) differentiated by urban typology, (3) proposing interventions to optimise urban environments according to underlying typological classification, and (4) validating the proposed solutions in simulated environments. The framework prioritises open data sources provided by public authorities as well as open science and citizen science initiatives. A more streamlined integration of data is proposed, facilitating both the classification and assessment of urban environments aligned with their primary typological designation. Full article

Background and aims: Pneumococcal infections, primarily caused by Streptococcus pneumoniae, pose significant global public health challenges, particularly in vulnerable populations. In Saudi Arabia, the introduction of pneumococcal vaccination has been a crucial step towards its prevention. However, gaps in public knowledge and attitudes toward the vaccine may hinder its effectiveness. Recent studies indicate a lack of awareness about the benefits of pneumococcal vaccination, suggesting a need for further investigation. This study determined the knowledge, attitudes, and practices (KAP) of Saudi residents regarding pneumococcal infection and vaccination. Study design and Methods: This observational cross-sectional study was conducted across Saudi Arabia from November 2024 to March 2025. Data were collected through a self-administered online questionnaire designed to evaluate KAP towards pneumococcal infection and vaccination. The sample size was calculated to be 385 participants. The questionnaire underwent expert validation and a pilot study to ensure clarity and reliability. The questionnaire was distributed via social media platforms to collect the data. Data management was conducted using Microsoft Excel, and statistical analysis was performed using Statistical Package for Social Sciences (SPSS) software version 26. Results: This study included 1230 participants of whom 630 (51.2%) were females and 1075 (87.4%) were Saudi citizens. Almost half of the participants (50.2%) were aged 18–30 years, and 498 (40.5%) were married. The average knowledge score was 58.6%, indicating a moderate level of understanding among the participants regarding pneumococcal infection. Also, the average attitudes score was 70.6%, reflecting a generally positive outlook towards the importance of pneumococcal vaccination and its potential to limit infection spread. In addition, the average practices score was 68%, indicating a fairly good level of behaviors regarding vaccination practices. Statistical analyses showed that demographic factors and clinical characteristics significantly shape individuals’ KAP towards pneumococcal infection and vaccination. Conclusions: This study highlights the critical need to improve KAP regarding pneumococcal infections and vaccinations among Saudi residents and could help in developing more targeted and effective public health interventions to protect Saudi residents from pneumococcal infections. Full article

Background/Objectives: This study aimed to evaluate a regional implementation project for rural emergency care (RuralRescue) and to examine how its components and outcomes may support personalized approaches in emergency medicine. While not originally designed as a personalized medicine intervention, the project combined digital, educational, and organizational innovations that enable patient-specific adaptation of care processes. Methods: Conducted in the rural district of Vorpommern-Greifswald (Mecklenburg–Western Pomerania, Germany), the intervention included (1) standardized cardiopulmonary resuscitation (CPR) training for laypersons, (2) a geolocation-based first responder app for medically trained volunteers, and (3) integration of a tele-emergency physician (TEP) system with prehospital emergency medical services (EMSs). A multi-perspective pre–post evaluation covered medical, economic, and organizational dimensions. Primary and secondary outcomes included bystander CPR rates, responder arrival times, telemedical triage decisions, diagnostic concordance, hospital transport avoidance, economic simulations, workload, and technology acceptance. Results: Over 12,600 citizens were trained in CPR and the responder app supported early intervention in hundreds of cases. TEPs remotely assisted 3611 emergency calls, including delegated medication in 17.8% and hospital transport avoidance in 24.3% of cases. Return of spontaneous circulation (ROSC) after out-of-hospital cardiac arrest (OHCA) was achieved in 35.6% of cases with early CPR. Diagnostic concordance reached 84.9%, and documentation completeness 92%. Centralized coordination of TEP units reduced implementation costs by over 90%. Psychological evaluation indicated variable digital acceptance by role and experience. Conclusions: RuralRescue demonstrates that digitally supported, context-aware, and regionally integrated emergency care models can contribute significantly to personalized emergency medicine and can be cost-effective. The project highlights how intervention intensity, responder deployment, and treatment decisions can be tailored to patient needs, professional capacity, and regional structures—even in resource-limited rural areas. Full article

Groundwater plays an important role in areas facing water scarcity, which can cause many problems if poorly managed. In Northern Cyprus, in the Güzelyurt region, where agriculture is thriving, excessive and inappropriate groundwater use has caused a sharp decrease in water levels and electrical conductivity in many coastal areas. This study explores this problem using system dynamics tools designed to analyze feedback loops and causal links. The qualitative system dynamics approach is employed to investigate complex systems by focusing on structural and behavioral patterns through qualitative elements such as feedback loops, causal relationships, and system archetypes, rather than relying solely on numerical data. For this purpose, group model building is used, for which a basic model is built using library studies, and then the model is developed and improved through numerous interviews and meetings held with policymakers, farmers, soil and water managers, university professors, and representatives from the local community. The study examines water management practices, including transferring water from Turkey to Northern Cyprus and allocating a portion for agricultural use in Güzelyurt. It also explores agricultural strategies and the employment of advanced irrigation methods. In the tourism and urban consumption sectors, raising public awareness and educating citizens about water scarcity linked to climate change are highlighted as essential measures in promoting sustainable water usage. Full article

The Sustainable Development Goals commit states to Universal Health Coverage (UHC) for all; yet displaced populations—including asylum seekers, refugees, internally displaced persons (IDPs), and undocumented migrants—remain systematically excluded from national health systems across southern and eastern Africa. This paper applies a whole-of-route, rights-based framework to examine how legal status, policy implementation, and structural governance shape healthcare access for displaced populations across South Africa, Kenya, Somalia, and the Democratic Republic of Congo (DRC). Drawing on 70 key informant interviews and policy analysis conducted between 2020 and 2025, the study finds that despite formal commitments to health equity, access remains constrained by restrictive legal regimes, administrative discretion, and fragmented service delivery models. Critical gaps persist in migration-sensitive planning, gender-responsive care, and mental health integration. The findings highlight the limitations of rights-based rhetoric in the absence of legal coherence, intersectoral coordination, and political will. To realise UHC in displacement contexts, health systems must move beyond citizen-centric models and embed migration-aware, inclusive, and sustainable approaches across all stages of displacement. Without such structural reforms, displaced populations will remain at the margins of national health agendas—and the promise of health for all will remain unmet. Full article

Soil literacy, defined as the combination of attitudes, behaviours, and competencies necessary to make informed decisions that promote soil health, is increasingly recognised as a crucial element for sustainable development. This article presents the outcomes of the Soil Literacy Think Tank established under the Soils for Europe (SOLO) project, which aims to identify research and innovation knowledge gaps to strengthen soil literacy in Europe. Drawing on literature reviews, stakeholder engagement, and interdisciplinary dialogue, the paper highlights 18 prioritised knowledge gaps across different topics. These include a lack of integrated pedagogical strategies, limited outreach to specific social groups, and underdeveloped communication methods linking soil knowledge to stewardship actions. The article proposes adaptive and inclusive approaches to soil education that respect multiple knowledge systems and values and emphasises the importance of embedding soil literacy into sustainability agendas and governance processes. By addressing these challenges, the paper contributes to broader efforts supporting the EU Soil Mission and the goals of World Soil Day by promoting public awareness, citizen engagement, and responsible soil care. Full article

Introduction: Lung cancer (LC) is the leading cause of cancer mortality and is responsible for 1.8 million deaths annually. The early identification of risk factors, particularly smoking, is essential in improving outcomes. Public health campaigns play a crucial role in raising awareness, but misinformation and resource limitations hinder their effectiveness. This study evaluates the impact of a public awareness campaign on Saudi citizens’ understanding of lung cancer (LC) risks and screening. Methods: An interventional study was conducted in Riyadh, Saudi Arabia, using pre- and post-campaign self-administered surveys. A total of 1,426 participants aged 18 or older were surveyed either before or after the campaign. A matching approach was used to control for confounding variables. Each participant may receive a maximum total score of 14 for their knowledge of lung cancer and a maximum total score of 10 for their awareness of lung cancer screening. Results: A total of 713 participants were surveyed pre-campaign, and 859 post-campaign). After matching, 308 participants remained for the analysis, with no significant demographic differences between those who were surveyed before and after the campaign. Post-campaign, awareness was significantly improved, which is reflected in an increase in accurate responses to key statements. The median knowledge scores increased from 11.0 to 23.0, indicating a substantial increase in understanding. Conclusions: The campaign effectively enhanced the awareness of LC risk factors and screening. However, new misconceptions regarding universal screening emerged, emphasizing the need for clear messaging. Future initiatives should address socioeconomic and gender disparities, promote collaborative decision-making, and implement long-term educational strategies. These findings align with previous research and highlight areas for improvement in public health outreach. Full article

This article summarizes the scope and content of the Special Issue (SI) entitled “Geographic Information Systems (GIS) and Cartography for a Sustainable World” and its contribution to the global discourse regarding sustainability concerns. At the heart of the discussion in this SI lies: (i) GIS, a valuable tool and a means for modeling, designing, and analyzing (spatial) data and processes related to the pursuance of sustainability objectives at both local and global scales; and (ii) Cartography as a discipline, which through maps and visualizations can convey the present state. The latter can play a vital role in educating, empowering, and raising public awareness with regard to sustainability concerns on the one hand, and can form a basis for policy-makers, scientists, and citizens for articulating effective sustainability strategies on the other. The fulfillment of the SI goals is attained through a collection of 26 papers that delve into and attempt to visualize sustainability achievements or concerns on a variety of themes in different parts of the world. More specifically, the content of this collection of papers can be categorized into the following sustainability-related themes: Urbanization, Transportation, Carbon Emissions Management, Infrastructure, Rural Development, and Climate Change. The main conclusion is that planning and implementing sustainability policies is a challenging and multi-level task, and must be carried out within a fully dynamic decision environment. Although some progress has already been made, more intensive and collective efforts from scientists, governments, the entrepreneurial community, and citizens are needed in order for the ambitious goals of Agenda 2030 to be reached. Full article

Critical thinking (CT) is widely recognised as a key competency in education for sustainable development (ESD). However, international research shows that many teachers feel unprepared to teach CT, especially within the ESD context. Despite its importance, few studies have explored how CT is actually practiced in ESD, particularly in primary and secondary education. This article presents a systematic literature review of 43 qualitative studies published between 1990 and 2021, following the PRISMA guidelines. This review aimed to (1) synthesise research on teachers’ understanding of CT in ESD and (2) identify teaching practices where CT is integrated into ESD. The findings reveal that the concept of CT is frequently used but is not clearly understood in the context of ESD. Most studies focused on critical rationality (skills), with fewer addressing critical character (dispositions), critical actions, critical virtue, critical consciousness, or critical pedagogy. This review highlights a need for broader engagement with these dimensions in order to foster ethically aware and responsible citizens. We argue for teaching approaches that involve students in interdisciplinary, real-world problems requiring not only critical reasoning but also action, reflection, and ethical judgment. Full article

This study examines the constrained social acceptance of small-scale geothermal energy in a rural sub-Saharan region, a critically understudied area, characterised by high energy poverty, heavy dependence on biomass, and suitable for geothermal energy exploration. Small-scale geothermal energy may offer an additional option for decentralised power supply through mini grids. The study investigates public awareness and knowledge level of geothermal energy technologies among the residents of Eka Awoke, Ikwo, Ebonyi State, Nigeria, to assess the potential of the deliberative process to enhance the social acceptance of geothermal energy technologies and the development of an improved participatory framework to aid the discussion. Citizen jury and survey methods, combining qualitative and quantitative research techniques, were employed. This study presents the first in-depth analysis of the social acceptance of small-scale geothermal energy for electricity supply in a rural African context. Pre-deliberative assessments revealed that 36% of the jurors had limited knowledge and expressed environmental concerns. The post-deliberative assessment revealed that over 80% of jurors reported improved understanding and views. The study demonstrates that citizen jury, when combined with surveyed results can serve as a powerful and scalable tool for advancing social acceptance of geothermal energy. These findings provide a solid foundation for policymakers, stakeholders, and energy providers to design more effective communication engagement strategies for sustainable energy transition in the community. Full article