Search Results (66)

Background: Cervical cancer poses a threat to the health of women globally. Adolescent girls are the primary target population for HPV vaccination, and guardians’ attitude towards the HPV vaccine plays a significant role in determining the vaccination status among adolescent girls. Objectives: This study aimed to explore the factors influencing guardians’ HPV vaccine acceptance for their girls and provide clues for the development of health intervention strategies. Methods: Combining the health belief model as a theoretical framework, a questionnaire-based survey was conducted. A total of 2157 adolescent girls and their guardians were recruited. The multivariable logistic model was applied to explore associated factors. Results: The guardians had a high HPV vaccine acceptance rate (86.7%) for their girls, and they demonstrated a relatively good level of awareness regarding HPV and HPV vaccines. Factors influencing guardians’ HPV vaccine acceptance for girls included guardians’ education background (OR = 0.57, 95%CI = 0.37–0.87), family income (OR = 1.94, 95%CI = 1.14–3.32), risk of HPV infection (OR = 3.15, 95%CI = 1.40–7.10) or importance of the HPV vaccine for their girls (OR = 6.70, 95%CI = 1.61–27.83), vaccination status surrounding them (OR = 2.03, 95%CI = 1.41–2.92), awareness of negative information about HPV vaccines (OR = 0.59, 95%CI = 0.43–0.82), and recommendations from medical staff (OR = 2.32, 95%CI = 1.65–3.25). Also, guardians preferred to get digital information on vaccines via government or CDC platforms, WeChat platforms, and medical knowledge platforms. Conclusions: Though HPV vaccine willingness was high among Chinese guardians, they preferred to vaccinate their daughters at the age of 17–18 years, later than WHO’s recommended optimal age period (9–14 years old), coupled with safety concerns. Future work should be conducted based on these findings to explore digital intervention effects on girls’ vaccination compliance. Full article

Background and Objectives: Orthodontic treatment aims to enhance dental aesthetics and function, yet many patients report dissatisfaction. This study was designed with the following objectives: To assess overall patient satisfaction during active orthodontic treatment; to identify key psychosocial and clinical predictors of satisfaction, including self-confidence, social experiences, and cost perception; to evaluate the impact of orthodontist–patient communication on satisfaction and perceived treatment outcomes; to explore the relationship between aesthetic improvement and willingness to undergo treatment again. Materials and Methods: A cross-sectional survey was conducted using structured questionnaires to assess satisfaction, pain perception, treatment expectations, and communication quality. Statistical analyses, including correlations and regression models, were used to identify predictors of satisfaction. The study included 450 orthodontic patients from the north-eastern region of Romania, undergoing active treatment at the time of data collection. Results: The strongest predictor of satisfaction was improved self-confidence and smile aesthetics (r = 0.62). Effective communication with orthodontists significantly increased satisfaction (r = 0.58, p = 0.002), while perceived high costs had a negative impact (r = −0.41). Pain and discomfort were common, with 90% of patients experiencing treatment-related pain, leading to reduced compliance. Social embarrassment due to braces also contributed to dissatisfaction (r = −0.47). Conclusions: Patient satisfaction with orthodontic treatment is primarily influenced by aesthetic improvements and effective communication. While enhanced smile perception boosts confidence, financial concerns and social discomfort may negatively affect the overall experience. Improving accessibility to treatment and providing comprehensive patient support are essential for optimizing patient satisfaction. Full article

Against the backdrop of rapidly expanding international trade and escalating environmental challenges, the development of green ports has emerged as a pivotal element of sustainable development. This study addresses the critical issues of insufficient corporate motivation for transformation and inadequate regulatory mechanisms by establishing a tripartite evolutionary game model involving government, customs, and port enterprises. Key findings demonstrate that customs supervision significantly reduces enterprises’ transition costs and enhances environmental compliance willingness, though its effectiveness depends on complementary government policies including environmental taxation and fiscal incentives. When regulatory intensity is weak, enterprises persist with conventional practices; conversely, strengthened supervision accelerates strategic convergence toward sustainable governance. This research provides a theoretical foundation for policymakers to formulate green port initiatives while offering practical guidance for enterprises to align with sustainability objectives, thereby contributing to environmentally responsible port development. Full article

As a key driver of the green and low-carbon transformation of the energy sector, clean heating technology plays a crucial role in advancing sustainable energy development. However, the research and development (R&D) of clean heating technology is hindered by conflicting interests among key supply-side stakeholders, including heating enterprises, commercial banks, and government departments. These conflicts create challenges for promoting the diffusion of clean heating technology. To address this issue, this paper develops a tripartite evolutionary game model involving these stakeholders, with the aim of exploring strategies to facilitate clean heating technology diffusion from the supply side. Through mathematical modeling and numerical simulations, we examine how variables such as cost, subsidies, and penalties affect the strategic decisions of these participants. The results showusing that (1) the cost of clean heating technology R&D significantly influences commercial banks’ willingness to collaborate with heating enterprises; (2) increasing credit penalties for non-compliance and enhancing returns from clean heating technology can motivate heating enterprises to engage in technology R&D; (3) enhancing economic penalties and strengthening informal regulations can improve cooperation between commercial banks and heating enterprises; (4) moderate subsidies can positively influence the strategies adopted by commercial banks and heating enterprises. Based on these findings, we propose policy recommendations to promote clean heating technology diffusion from the supply side. This study offers both theoretical support and practical guidance for advancing clean heating technology diffusion, which is strategically important for sustainable energy development. Full article

Urban areas are regarded as a sustainable form of settlement, while the planned and built environments of cities are considered essential for the development of healthier communities. Nonetheless, urban sprawl has caused disparities in the health of those living in cities vs. suburbs. One explanation for this disparity is the willingness of residents to comply with the recommendations and instructions of health care experts or public directives. Compliance is an essential part of what makes communities resilient. However, we know little about the factors that influence this compliance. To fill this gap, we examined data from Israeli municipalities in cities and suburbs about compliance with the government’s COVID-19 regulations. We investigated whether social and physical aspects of cities and suburbs explain differences in compliance. We researched how the residents’ economic, social, and cultural capital, as well as their spatial distribution, influenced their compliance during the pandemic. The results demonstrate the important role of the spatial distribution of these various forms of capital in the residents’ compliance. Specifically, those living in suburban areas benefited from their capital accumulation, making them more inclined to adhere to the health regulations. This new perspective on the dynamics between cities and suburbs may strengthen community resilience and help mitigate regional disparities. Full article

The present paper builds on previous research exploring the relationship between the need for cognitive closure (NCC) and employees’ compliance with harsh social power to propose a moderating role of perceived tightness within a work unit in organizational settings. Specifically, the study aimed to test the cross-level interaction between NCC and the perceived work unit tightness in fostering employee compliance with harsh power. Using a convenience sampling method, we enrolled 290 employees from pre-existing work units in Italian organizations in a cross-sectional study. We obtained employee scores on the NCC scale, willingness to comply with harsh social power tactics, and ratings of their perceived work unit tightness. Multilevel modeling was applied to test cross-level interaction. The model revealed a positive effect of NCC on the willingness to comply with harsh social power tactics when employees perceived their unit culture as tight. This study advances previous research by showing the role of tight culture in shaping the relationship between NCC and power compliance. Full article

Parental willingness is a prerequisite for childhood immunization. This study evaluated whether parental vaccination readiness and willingness, measured using the modified Japanese 7C Vaccination Readiness Scale, predicted vaccination behavior. In December 2021, 2 months before the approval of COVID-19 vaccines for children aged 5–11 years in Japan, 1190 parents of children in this age group were surveyed regarding their intention to vaccinate their children against COVID-19. The survey utilized an online version of the modified 7C Vaccination Readiness Scale, comprising seven components: Confidence, Complacency, Constraints, Calculation, Collective Responsibility, Compliance, and Conspiracy. The modified 7C components were analyzed for model fit and their association with parental intention using structural equation modeling. The scale demonstrated good model fit (goodness-of-fit index: 0.98), with high standardized factor loadings for parental readiness (factor loadings: 0.84). In January 2024, the same parents were surveyed about their children’s COVID-19 vaccination status (valid responses: 536). The relationship between the components of the modified 7C scale and actual vaccination behavior was examined. Parents with low readiness to vaccinate their children against COVID-19 exhibited a significantly higher non-vaccination rate. These findings suggest that the modified 7C scale could support the development of targeted interventions to improve childhood vaccination uptake. Full article

Background/Objectives/Methods: Atopic dermatitis (AD) impacts various aspects of patients’ lives including personal life, psychological aspects/disturbances (e.g., depression, anxiety, or even suicidal thoughts), school, and work-related activities, including career advancement. The aim of this narrative review is to present the latest information available on how to best approach AD patient management, as well as decisions regarding standard/advanced systemic therapy, by gathering evidence from the relevant medical literature (PubMed and other prominent medical databases). Results: Thus, AD patient management and decisions regarding advanced/systemic therapy are complex, requiring the consideration of multiple disease-related factors: age; disease severity; patient medical history and comorbidities; previous topical therapy use and any adverse reactions; treatment efficacy concerns; patient preferences, expectations and fears; pregnancy planning; ability and willingness to adhere to the treatment regimen; impact on related risks; and any associated psychological or psychiatric issues. Current guidelines and systematic reviews support the safety and efficacy of systemic therapy including conventional drugs (cyclosporine, methotrexate, and azathioprine), biologics (dupilumab and tralokinumab), and JAK inhibitors (baricitinib, upadacitinib, and abrocitinib) recommended for treating moderate and severe AD. Recently, additional biologics have been evaluated in clinical trials, including lebrikizumab, nemolizumab, eblasakimab, and OX40/OX40L, among others. Conclusions: The most recently suggested approach to treating AD patients suggests focusing on therapy that targets and achieves minimal disease activity (MDA), where therapy decisions are informed by both the patient and the clinician. Available data also indicate the importance of a personalized, stepwise, and multidisciplinary approach. This type of approach promotes patient compliance, satisfaction with therapy, and increased engagement, which all lead to better patient outcomes. Full article

Reuse of wastewater is a promising response to water scarcity. For peri-urban areas served by decentralized wastewater treatment plants, the delivery of treated wastewater to the households may be a viable option to promote reuse on a larger scale. Based on a case study in Eastern India, this paper explores if households would accept recycled water for non-potable purposes and if they would pay for it. While the respondents to household surveys had very positive views about recycling, they were not willing to pay much, even if they were from a middle-income class and could afford more. A closer analysis of the attitudes towards recycling indicated knowledge gaps about the risks and advantages of using recycled water. Full article

Medication adherence is important for the appropriate drug-based treatment in patients with chronic diseases, especially those with cardiovascular diseases (CVDs). The purpose of the present study was to evaluate medication adherence among patients with CVDs using subjective and objective measurements. We enrolled outpatients who visited Fukuoka University Chikushi Hospital from June to December 2022. As a subjective measurement, we used a self-reported questionnaire developed by Ueno et al., which consists of 12 questionnaire items grouped into the following four domains: medication compliance (subjective compliance), collaboration with health care providers (collaboration), willingness to access and use information about medication (willingness), and acceptance to take medication and how taking medication fits a patient’s lifestyle (acceptance). The pill counting method was used as an objective measurement to calculate the medication adherence rate; Poor Adherence was defined as a medication adherence rate of <100%. Ninety-four patients were analyzed. No statistically significant differences were observed between the patients in the Good and Poor Adherence groups classified by pill counting, an objective indicator; in the subjective evaluation index Ueno scale scores of subjective compliance, collaboration, willingness, and acceptance domains; and in the total score. A multivariate analysis revealed that obesity (odds ratio, 3.527; 95% confidence interval, 1.387–9.423; p = 0.008) was an independent factor associated with Poor Adherence. In conclusion, we found a discrepancy between subjective and objective measurements for the evaluation of medication adherence. Furthermore, obesity was an independent factor associated with poor medication adherence assessed by the pill counting method; thus, patients with CVD and obesity require a careful follow-up. Full article

We propose a composite index to measure and benchmark community participation in cross-border tourism development processes. The index synthesizes information regarding three dimensions of this construct, deemed as very important by the extant literature: residents’ engagement in the planning process and willingness to proactively welcome tourists and provide tourist services directly through sharing-economy platforms. The latter aspect is crucial to develop a local tourist supply able to combine environmental sustainability and financial feasibility in marginal areas, where public funding is scarce and private investments are unprofitable. This study offers a methodological innovation using response rates to open-ended questions to measure residents’ engagement in tourism planning. By applying the ELECTRE III algorithm, which is non-compensatory and ensures reliability in the presence of a high degree of uncertainty, survey information is aggregated in a single figure, which can be easily interpreted by destination managers and policymakers. After COVID-19, in readying for the next pandemic, decision makers should find our index as a very relevant and useful tool for tourism recovery and innovation planning, including compliance with measures to prevent the spread of future infections. We apply the proposed index to ten Croatian and Italian lands involved in a European development project. Data were collected through face-to-face interviews with residents, according to an availability sampling design. We obtained 879 valid questionnaires. The robustness of the resulting index is tested through an uncertainty and a sensitivity analysis. Full article

The greenhouse effect of atmospheric pollution is globally concerning. China is transitioning to market-driven emission reduction from policy-driven efforts. In 2021, key power industry emitters were included in the national carbon trading market. However, many companies lack willingness and understanding of carbon assets, hindering progress. Research on power companies in Beijing, a political and carbon market pilot region, is valuable. This study obtained data on the participation of Beijing’s power generation companies in the carbon market and the construction of their carbon management systems during the first compliance period through the distribution of surveys. The findings revealed that the implementation and preparation of carbon inventory, Chinese Certified Emission Reduction (CCER) development, the allocation of carbon management personnel, and training are key factors influencing the actual effectiveness of carbon management within companies. Based on the survey results and the impact pathways, this study outlines the preparatory work, system content, and construction steps for power companies to build a carbon management system. It summarizes five key areas of work for power companies in managing carbon assets: carbon inventory, carbon management personnel and mechanisms, carbon trading, carbon emission reduction, and carbon finance. This provides guidance to help power companies fulfill their obligations smoothly, add value to their carbon assets, and achieve low-carbon development goals. Additionally, it offers a reference for other industry enterprises that are about to enter carbon trading. Full article

The World Health Organization (WHO) recommends the use of annual mass drug administration (MDA) as the strategy for controlling and eliminating the five preventive chemotherapy neglected tropical diseases (PC-NTDs). The success of MDAs hinges on community acceptance, active participation, and compliance. This study aimed to explore the experiences and perceptions of community members, to obtain a more thorough understanding of their openness and willingness to participate in MDA and other NTD elimination activities. A mixed-methods approach was employed, utilizing qualitative and quantitative methods for comprehensive data collection. Eighteen key informant interviews (KIIs) and sixteen focus group discussions (FGDs) were conducted to explore community engagement, participation, medication utilization, and programme perception. Triangulation of findings from interviews and discussions with household survey results was performed to gain a deeper understanding of emerging themes. The household survey involved interviewing 1220 individuals (Abaji: 687; Bwari: 533). Audio tapes recorded KIIs and FGDs, with interview transcripts coded using Nvivo 12.0 software based on predefined themes. Descriptive analysis using SPSS version 21 was applied to quantitative data. Results indicated high awareness of mass drug administration (MDA) campaigns in both area councils (Abaji: 84.9%; Bwari: 82.9%), with a small percentage claiming ignorance (15.1%), attributed to lack of information or absence during health campaigns. Respondents primarily participated by taking medication (82.5%), with minimal involvement in other MDA campaigns. Perception of medicines was generally positive, with a significant association between participation level and performance rating (p < 0.05). The study recommends leveraging high awareness and community responsiveness to enhance engagement in various MDA activities, ensuring sustainability and ownership of the programme. Full article

Research Highlights: This study examined the emotional and cognitive health benefits of nature in comparison with working memory training. It considered the long-term effects, the application of mobile terminal technology, and routine-based approaches with the aim of integrating nature’s health benefits into people’s daily lives. Background and Objectives: Infectious diseases and aging may limit people’s activities indoors; the recovery effect of nature has been widely recognized, and terminal technology is developing rapidly. In this context, we want to explore the emotional and cognitive effects of viewing nature (VR) videos on mobile devices for a long time. Materials and Methods: The experiment employed a between-subjects design, with participants being randomly assigned to one of four groups: a forest VR video group, a water VR group, a working memory training group, and a control group. The participants watched the video three times a week for 20 min each for four weeks. The number of valid participants for compliance, preference, and willingness was 136, and the number of valid participants for the study of emotional and cognitive effects was 62. Brief Profile of Mood States (BPOMS) scales, running memory accuracy, shifting cost, etc., were used as indicators to reflect emotions and cognition. A repeated measures analysis of variance was performed on these indicators at four groups × two time points (pretest/post-test). Results: ① There were no significant differences in the participants’ adherence, preferences, and willingness to watch different natural videos and perform working memory training. ② Long-term home training (e.g., watching VR nature videos or working memory training) may have had a minimal effect on emotional responses to mobile terminals. However, home training may be more conducive to the stabilization of anger. ③ Watching forest VR videos had a positive effect on the updating function of the brain; watching water VR videos was beneficial for the shifting function and automatic processing speed; and working memory training had a positive effect on the updating and shifting functions. Conclusions: There were no significant differences in adherence, preference, willingness, and effects on emotion and cognition between long-term forest VR video viewing, water VR video viewing, and working memory training on mobile terminals. All three types of home training may be beneficial for the stabilization of emotion (especially anger), and all can have some positive effects on cognition. Full article

Direct assessments of executive functions (EFs) are increasingly used in research and clinical settings, with a central assumption that they assess “universal” underlying skills. Their use is spreading globally, raising questions about the cultural appropriateness of assessments devised in Western industrialized countries. We selectively reviewed multidisciplinary evidence and theory to identify sets of cultural preferences that may be at odds with the implicit assumptions of EF assessments. These preferences relate to motivation and compliance; cultural expectations for interpersonal engagement; contextualized vs. academic thinking; cultural notions of speed and time; the willingness to be silly, be incorrect, or do the opposite; and subject-matter familiarity. In each case, we discuss how the cultural preference may be incompatible with the assumptions of assessments, and how future research and practice can address the issue. Many of the cultural preferences discussed differ between interdependent and independent cultures and between schooled and unschooled populations. Adapting testing protocols to these cultural preferences in different contexts will be important for expanding our scientific understanding of EF from the narrow slice of the human population that has participated in the research to date. Full article