Search Results (994)

The growing concern over environmental sustainability has intensified the focus on consumers’ perceptions of eco-friendly food packaging, especially among younger generations. This study aims to investigate the attitudes, preferences, and barriers faced by Greek university students regarding sustainable food packaging, a demographic considered pivotal for driving future consumption trends. An online questionnaire assessing perceptions, preferences, and behaviours related to sustainable packaging was administered to students, with responses measured on a five-point Likert scale. Three hundred and sixty-four students took part in this survey, with the majority (60%) of them being female. Principal component analysis was employed to identify underlying factors influencing perceptions, and k-means cluster analysis revealed two consumer segments: “Innovatives”, including one hundred and ninety-eight participants (54%), who demonstrate strong environmental awareness and willingness to adopt sustainable behaviours, and “Sceptics”, including one hundred sixty-six participants (46%), who show moderate engagement and remain cautious in their choices. Convenience, affordability, and clear product communication emerged as significant factors shaping student preferences. The findings suggest that targeted educational campaigns and transparent information are essential to converting positive attitudes into consistent purchasing behaviours. This research provides valuable insights for policymakers and marketers looking to design effective sustainability strategies tailored to the student population. Full article

Background: Social and financial services are essential for the inclusion and well-being of people with disabilities (PWDs), who often rely on family caregivers to access these systems. In Saudi Arabia, where disability inclusion is a strategic goal under Vision 2030, understanding caregiver experiences is crucial to identifying service gaps and improving accessibility. Objectives: This study aimed to explore caregivers’ perspectives on awareness, perceived barriers, and accessibility of social and financial services for PWDs in Saudi Arabia. The analysis is grounded in Andersen’s Behavioural Model of Health Service Use and the WHO’s International Classification of Functioning, Disability and Health (ICF) framework. Methods: A cross-sectional survey was conducted with 3353 caregivers of PWDs attending specialised day schools. The survey collected data on demographic characteristics, service awareness, utilisation, and perceived obstacles. Exploratory Factor Analysis (EFA) identified latent constructs, and Structural Equation Modelling (SEM) was used to test relationships between awareness, barriers, and accessibility. Results: Findings reveal that over 70% of caregivers lacked awareness of available services, and only about 3% had accessed them. Key challenges included technological barriers, complex procedures, and non-functional or unclear service provider platforms. Both User Barriers and Service Barriers were negatively associated with Awareness and Accessibility. Awareness, in turn, significantly predicted perceived Accessibility. Caregiver demographics, such as age, education, gender, and geographic location, also influenced awareness and service use. Conclusions: There is a pressing need for targeted awareness campaigns, accessible digital service platforms, and simplified service processes tailored to diverse caregiver profiles. Inclusive communication, decentralised outreach, and policy reforms are necessary to enhance service access and promote the societal inclusion of PWDs in alignment with Saudi Arabia’s Vision 2030. Full article

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

Background: Despite their high prevalence and potential for significant morbidity, hemorrhoidal symptoms remain underreported and undertreated. Misconceptions and stigma may delay care-seeking behaviors and negatively influence patient outcomes. Methods: We conducted a cross-sectional, questionnaire-based study in Romania to assess public awareness, attitudes, and barriers related to hemorrhoidal disease. The survey included 185 participants and evaluated variables such as symptom severity, understanding of the condition, perceived stigma, and willingness to consult a physician. Results: Only 30.8% of participants had sought medical advice for hemorrhoidal symptoms. Younger age (p < 0.001), male sex (p = 0.013), and lower levels of perceived severity were significantly associated with reluctance to seek medical care. The most frequently reported barriers were embarrassment and fear of invasive diagnostic procedures. Colonoscopy and digital rectal examination were identified as major deterrents by 39.5% and 38.9% of respondents, respectively. Educational level influenced both the perceived understanding of the disease (p = 0.001) and comfort in discussing anal symptoms (p = 0.002). Gender preference for physicians was significantly associated with respondent sex (p = 0.007) but not with education or age. Conclusions: Hemorrhoidal disease remains a stigmatized and underestimated condition. Public health efforts should prioritize educational interventions, destigmatization campaigns, and improved physician–patient communication to facilitate earlier diagnosis and better disease management. Full article

Edible insects are emerging as a sustainable and eco-friendly alternative protein source, addressing global challenges in food security and environmental sustainability. This study investigates the willingness and acceptance of edible insects as sustainable alternative protein sources among Saudi participants, focusing on sociodemographic and attitudinal factors. A cross-sectional survey involving 2208 participants revealed that males and younger individuals (18–34 years) exhibited greater willingness to consume EIs, driven by environmental concerns, health benefits, and positive beliefs. Women and older participants showed higher levels of food neophobia, disgust, and uncertainty. Sociocultural barriers such as fear, a lack of familiarity, and perceptions of edible insects as unclean or forbidden were significant obstacles to acceptance and willingness. Interestingly, the education level did not significantly influence willingness, suggesting that cultural and religious norms may overshadow its impact. These findings underscore the need for targeted campaigns emphasizing the health, environmental, and sustainability benefits of edible insects, alongside culturally sensitive approaches to overcome psychological and social barriers. This research provides valuable insights to guide strategies for integrating EIs into Saudi diets as a step toward enhanced food security and environmental sustainability. 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

Background/Objectives: Breast milk donation is increasingly recognized as a vital public health resource, providing optimal nutrition for infants who cannot be breastfed by their biological mothers. Human milk banks play a crucial role in supporting infant health, particularly for preterm and medically vulnerable infants. Despite its recognized benefits, the practice of breast milk donation and utilization remains influenced by a complex interplay of individual, social, and cultural factors. Methods: This study systematically examines how demographic and sociocultural variables are associated with attitudes and behaviors related to breast milk donation. Data were collected from 1223 Israeli mothers via questionnaires distributed through WhatsApp groups between April and May 2025. By analyzing the questionnaire results, the research identified key predictors of willingness to donate and use donated milk, as well as patterns of awareness and perceived support within different population groups. Results: Higher education (χ² = 12.87, p = 0.0016) and settlement type (χ² = 83.096, p = 0.000) were significantly associated with greater willingness to donate breast milk. Income level had no effect on donation behavior, though higher-income participants were more open to its use (χ² = 86.838, p = 0.000). Lifestyle also influenced perceptions of social support (F(2, 1220) = 259.4036, p < 0.001) and cultural support (F(2, 1220) = 601.2383, p < 0.001) of milk donation and use. Significant correlation was found between perceived cultural and social support (t = 5.140, p = 0.000), emphasizing their interrelated influence on milk donation attitudes. Conclusions: The findings assist in guiding the development of public health policies, as well as targeted awareness campaigns, to promote equitable access to donor milk services across varied communities. From the public health perspective, the findings of this study can orientate campaigns that encourage both donation and use of breast milk focusing on segments of the population in which the level of awareness is relatively low. Full article

Once marketed as smoking cessation tools, e-cigarettes are used by adolescents mainly for entertainment, driven by aggressive marketing, appealing flavors, and safer alternatives to smoking. This study analyzes data from the National Youth Tobacco Survey (NYTS) to explore trends in adolescent perceptions and usage patterns of e-cigarettes from 2011 to 2023, focusing on their dual roles as cessation aids and recreational products. Cross-sectional data from the NYTS over four years (2011: N = 18,866; 2015: N = 17,711; 2019: N = 19,018; 2023: N = 22,069) formed the foundation of this study. This study investigated demographic trends, usage frequency, initial and future use patterns, and quitting behavior. Descriptive statistics and latent class analysis (LCA) were employed to examine adolescent e-cigarette use patterns, with statistical significance determined at p < 0.05. The reasons for using e-cigarettes have changed significantly over the years because of family or friends. In all years (2015–2023), use for smoking cessation dropped significantly (2.33% in 2023 vs. 6.95% in 2015). In 2023, 38% wanted to quit using e-cigarettes within 30 days, and 25% attempted to quit at least 10 times. Flavored e-cigarette users were more than twice as likely to consider quitting compared to those not interested in flavors (OR = 2.64). Our findings highlight a significant decrease in the use of e-cigarettes for cessation, with a corresponding increase in recreational use over time. These trends emphasize the urgency of implementing interventions to mitigate nicotine addiction and its associated health risks among adolescents. Adolescent e-cigarette use has transitioned from being primarily driven by cessation efforts to recreational purposes, largely influenced by appealing flavors and social factors such as peer influence, showing the need for stricter marketing regulations and targeted educational campaigns. Full article

The study examines how individual skills influence adolescents’ and young adults’ commitment to climate protection and global health. Based on 21st-century skills and transformative education, it focuses on competences in science, geography, mathematics, religion, ethics, and media. A representative online survey of 783 participants in Germany assessed topic relevance, information-seeking behavior, and active engagement. The results show that subject-specific skills significantly affect engagement, especially when closely related to the topics. Scientific, mathematical, and geographical competences enhance all three engagement dimensions. Media competence primarily increases perceived importance, while religious and ethical competences positively influence all areas. Structural equation modeling reveals a process: perceived relevance leads to information search, which then drives engagement. Thus, competences have both direct and indirect effects on active involvement. The findings highlight that long-term engagement is not only driven by campaigns but also by education that equips young people with the skills to recognize important issues, seek information, and take action independently. Full article

This paper analyzes the factors affecting the willingness to pay of urban households concerned with efficient waste management in Bangladesh. The multistage random sampling approach selected 1400 families from seven major cities in Bangladesh. This study addresses the socioeconomic and environmental factors that influence urban households’ willingness to pay for improved waste management services in Bangladesh. This study uniquely contributes to the literature by providing a large-scale empirical analysis of 1470 households using a logit model, revealing income, education, and environmental awareness as key predictors of WTP. Detailed survey data from respondents were then analyzed using a logit model based on the contingent valuation method. Indeed, the logit model showed that six variables (education, monthly income, value of the asset, knowledge of environment, and climate change) had a statistically significant effect on the WTP of the households. The results show that 63% of respondents were willing to pay BDT 250 or more per month. The most influential factors driving this willingness to pay were income (OR = 1.35), education level (OR = 1.45), and environmental awareness (OR = 3.56). These variables all contribute positively towards WTP. The idea is that families have some socioeconomic characteristics, regardless of which they are ready to pay for a higher level of waste collection. It is recommended that government interference be affected through various approaches, as listed below: support for public–private sector undertaking and disposal, an extensive cleaning campaign, decentralized management, cutting waste transport costs, and privatization of some waste management systems. These could be used to develop solutions to better waste management systems and improve public health. Full article

This study reports a successful selective waste collection initiative led by UFSC’s Araranguá campus in a municipality without a recycling system. The initiative, named “Recicla UFSC Ara”, was structured around three main components: (i) the installation of color-coded bins for recyclable waste (including paper, plastic, metals, and polystyrene) and non-recyclable waste in indoor and common areas; (ii) the establishment of a Voluntary Delivery Point (PEV) to gather specific recyclable materials, such as glass, electronics waste, plastic bottles, writing instruments, and bottle caps; and (iii) the execution of periodic educational community-focused campaigns aimed at encouraging participation from both the university and the broader local community. Recyclables were manually sorted and weighed during regular collection rounds, and contamination rates were calculated. Quantitative data collected from 2022 to 2025 were analyzed using descriptive statistics and one-way ANOVA to assess waste generation and contamination trends. Gathered recyclables were directed to appropriate partner institutions, including local “Ecoponto”, non-profit organizations, and corporate recycling programs. The study also conducted a literature review of similar university-led waste management programs to identify standard practices and regional specificities, providing a comparative analysis that highlights both shared elements and distinctive contributions of the UFSC model. Results demonstrate a significant volume of waste diverted from landfills and a gradual improvement in waste disposal practices among the university community. Targeted communication and operational changes mitigated key challenges, improper disposal, and logistical issues. This case underscores the role of universities as agents of environmental education and local sustainable development. Full article

The UN’s “Global Agenda for Change” focused on global challenges, with the aim of improving quality of life. The focus on People, Planet, Prosperity, Peace, Partnership, and Integrated Action (EU) orients its efforts towards socially needed change. Although the above perspectives, which ultimately shape the goals of sustainable development, refer in effect to the security of the functioning of societies and economies, this issue has not been sufficiently explored in the literature. Taking the above into account, this paper explains the aspect of people’s sustainable security and well-being, and also indicates the importance of determining the social competences needed for a broadly understood sustainable future, which is the main goal of this article. Considering the importance of sustainable awareness among the younger generation, who are responsible for the future modeling of the pace and direction of sustainable changes, the analysis of the literature in the practical findings was supported by qualitative and quantitative methods, as well as statistical analysis techniques using PQstat software, to ensure in-depth research. The results confirm that the studied population generally has good knowledge of the idea of sustainable development. Importantly, this population combines development in a sustainable direction with actions to strengthen people’s safety and well-being. It should be noted that the studied population is most strongly aware of the environmental pillar of sustainable development, suggesting potential to improve knowledge in this area—which is crucial for effective development towards a safe future and important for future decision-makers (the young generation). The findings can serve as a source of information for teams designing study programs and information campaigns on sustainable development in order to further strengthen social education in the studied area. Full article

Background: Multiple myeloma (MM) is a heterogeneous plasma cell malignancy with non-specific symptoms and disease heterogeneity at clinical and biological levels. This non-specific set of symptoms, including bone pain, anemia, renal failure, hypercalcemia, and neuropathy, can mislead diagnosis as chronic or benign conditions, resulting in a delay in diagnosis. Timely identification is paramount to prevent organ damage and reduce morbidity. Methods: In this review, we present an overview of recent literature concerning the factors leading to the delayed diagnosis of MM and the impact of delayed diagnosis. This includes factors relevant to physicians and systems, diagnostic processes, primary healthcare services, and laboratory and imaging data access and interpretation. Other emerging technologies to diagnose NCIs include AI-based decision support systems and biomarker-focused strategies. Findings: Delayed diagnosis can lead to presentation at advanced disease stages associated with life-threatening complications and shorter progression-free survival. Patients are often seen by many physicians before they are referred to hematology. Understanding of clinical red flags for MM in primary care is inadequate. Our findings indicate that limited access to diagnostic tests, inconsistent follow-up of MGUS/SMM patients, and a lack of interdepartmental coordination delay the diagnostic process. Conclusions: Multimodal tools for early diagnosis of MM. Educational campaigns to raise awareness of the disease, algorithms dedicated to routine care and novel technologies, including AI and big data analytics, and new biomarkers may serve this purpose, as well as genomic approaches to the premalignant MGUS stage. Full article

Background and objectives: ABs are widely used in dental practice in the treatment of odontogenic infections and as systemic prophylaxis in high-risk patients. However, AB overuse contributes to antimicrobial resistance (AMR), which is a major global concern. This study examined dental AB prescribing trends in Germany in 2024, focusing on the share of overall AB prescriptions, patient demographics, and commonly used agents. Methods: This retrospective cross-sectional study used data from the IQVIA Longitudinal Prescription Database (LRx), covering approximately 80% of prescriptions reimbursed by statutory health insurance funds in Germany. Patients with at least one AB prescription (ATC code: J01) issued by a dentist in 2024 were analyzed. Descriptive statistics covered age, sex, and prescribed substances. Results: In 2024, German dentists prescribed ABs to 2,325,500 patients, accounting for 13.9% of all patients in the database who received AB prescriptions. Dentists were the second-largest group of AB prescribers, surpassed only by general physicians. Amoxicillin (54.2%) was most frequently prescribed, followed by amoxicillin with clavulanic acid (24.5%) and clindamycin (21.0%). Dental patients receiving AB prescriptions were older (mean age: 49.8 years) than the general antibiotic patient population (44.7 years). Interestingly, dental AB prescriptions increased during the COVID-19 pandemic, in contrast to the sharp overall decline in AB prescriptions. Between 2015 and 2019, the proportion of dental antibiotic prescriptions showed a moderate upward tendency, followed by a marked increase during the COVID-19 pandemic and a subsequent decline. In contrast, the number of patients receiving antibiotic prescriptions from other medical disciplines decreased over the same period. One particularly notable finding was the extended use of clindamycin, a reserve AB with known side effects and resistance risks, in dentistry. Conclusions: Dentists are responsible for a significant share of AB prescriptions in Germany. The rise in dental AB prescriptions, particularly the frequent prescription of clindamycin, underscores the need for interventions such as updated clinical guidelines and awareness campaigns concerning AB-related risks and their mitigation directed at dentists. These could focus on microbial culture and sensitivity testing and patient adherence education and control for targeted AB interventions. Emphasizing preventive and alternative anti-infective treatment strategies in dentistry may also help to contain AMR. Full article

Walking and cycling, as active modes of transportation, play a vital role in advancing sustainable urban mobility by reducing emissions and improving public health. However, widespread adoption faces challenges such as inadequate infrastructure, safety concerns, socio-cultural barriers, and policy limitations. This study systematically reviewed 56 peer-reviewed articles from 2004 to 2024, across 30 countries across five continents, employing the Capability, Opportunity and Motivation-Behaviour (COM-B) framework to identify the main drivers of walking and cycling behaviours. Findings highlight that the lack of dedicated infrastructure, inadequate enforcement of road safety measures, personal and traffic safety concerns, and social stigmas collectively hinder active mobility. Strategic interventions such as developing integrated cycling networks, financial incentives, urban planning initiatives, and behavioural change programs have promoted increased engagement in walking and cycling. Enhancing urban mobility further requires investment in pedestrian and cycling infrastructure, improved integration with public transportation, the implementation of traffic-calming measures, and public education campaigns. Post-pandemic initiatives to establish new pedestrian and cycling spaces offer a unique opportunity to establish enduring changes that support active transportation. The study suggests expanding protected cycling lanes and integrating pedestrian pathways with public transit systems to strengthen safety and accessibility. Additionally, leveraging digital tools can enhance mobility planning and coordination. Future research is needed to explore the potential of artificial intelligence in enhancing mobility analysis, supporting the development of climate-resilient infrastructure, and informing transport policies that integrate gender perspectives to better understand long-term behavioural changes. Coordinated policy efforts and targeted investments can lead to more equitable transportation access, support sustainability goals, and alleviate urban traffic congestion. Full article