Search Results (235)

Background: Gastrointestinal (GI) disorders associated with increased gastric acid secretion, such as gastroesophageal reflux, dyspepsia, bloating, and abdominal pain, significantly impair quality of life and present a substantial healthcare burden. Conventional therapies may have limited efficacy or undesirable side effects, underscoring the need for safe complementary approaches. This study systematically identifies and reviews the medicinal plants used in food supplements (FSs) marketed in Latvia for digestive health, focusing on the conditions linked to excess gastric acid. Methods: A structured literature search was conducted to identify European plant species with proven protective effects on the digestive system or the ability to influence gastric acid levels. A market analysis was performed using the Latvian Food and Veterinary Service FS Register. Results: A total of 218 FS-containing medicinal plants were identified, of which 15 species were included in at least ten products. The most frequently used plants were peppermint (Mentha piperita), artichoke (Cynara cardunculus), fennel (Foeniculum vulgare), Milk thistle (Silybum marianum), dandelion (Taraxacum officinale), chamomile (Matricaria chamomilla), psyllium (Plantago ovata), licorice (Glycyrrhiza glabra), caraway (Carum carvi), lemon balm (Melissa officinalis), and chicory (Cichorium intybus). Label claims most often referred to supporting digestion, relieving bloating, and maintaining normal GI function. However, the majority of claims lacked robust clinical substantiation, and were based primarily on traditional use. Discrepancies between product information and available scientific evidence highlight regulatory and consumer protection challenges. Conclusions: This work contributes to the critical evaluation of plant-based FSs for digestive health, emphasizing the need for standardized preparations, harmonized health claim assessment, and further clinical research to establish efficacy and safety. Full article

Tourism-driven growth in Zanzibar has intensified solid waste generation, creating critical environmental and resource management challenges for the hotel sector. This study provides the first comprehensive assessment of the volume, composition, and management of solid waste in Zanzibar’s hotels, establishing a quantitative basis for evidence-based sustainable practices beyond prior research on food waste. Ten hotels were examined through direct waste sampling, structured interviews, and field observations. Results show that hotels generate high levels of unsorted waste (2.45 kg/guest/day), with plastics posing major challenges under the prevailing linear disposal system. Findings reveal that waste patterns depend primarily on management, service, and collection practices, with no significant differences across hotel types or sizes. While the assessment covered the entire waste stream, a tailored circular economy framework is proposed for plastic waste, given its significant contribution to environmental pollution and ecological impact, providing a practical, structured guide for sustainable interventions across hotel operations. Achieving these outcomes requires collaboration, institutional support, and capacity building. By embedding waste audits, reduction strategies, and circular innovations into hotel operations, this framework charts a forward-looking pathway for coastal destinations to transform waste challenges into opportunities, promoting sustainable tourism, resource-use efficiency, and the transition toward a circular economy. Full article

In hospitals, IoT has facilitated connectivity between patients and medical services using historical health data. However, its adoption in hospital catering services has been slower. This work describes the implementation of an IoT system with a three-layer architecture: the first layer collects data on patient diets and environmental conditions from the food warehouse, the second layer processes this information, establishing rules and converting raw data into valuable information, and the third layer stores the data in the cloud, presenting it in a web application. A functional system was obtained that meets the needs of catering service personnel and the hospital in which it was implemented. Full article

Food loss and waste in school food services generate economic cost, environmental impacts, and social effects. Waste occurs in the final stages of the supply chain. It is particularly critical in educational institutions, leading to low nutrient intake during early stages of development and negatively impacting food security. Aiming to design a waste reduction strategy for the meal service of a preschool serving children aged 0–5 years, a descriptive observational study was conducted over a 6-month period. This study combined the measurement of the primary outcome (proportion of the served portion not consumed by food group) with the assessment of menu acceptability, the children’s food preferences, and the exploration of perceptions of both at-home caregivers and preschool professionals. Overall, the most frequent reasons for rejection were texture, preparation methods, and unfamiliarity with the food. The highest levels of waste were found in fruits and vegetables, with 17% left uneaten; protein-rich foods had a 15% waste rate, and cereals and tubers showed a 10% waste rate. Based on these findings, a family–school strategy is proposed that would increase household exposure to a wider variety of foods and establish periodic menu reviews to identify critical foods and ensure proper use in school food services. These results demonstrate that by enhancing food acceptance, we can decrease food waste, and in early stages, strengthen food security and nutritional use. Full article

This research study addresses the critical contradiction within global food systems: unsustainable consumption patterns and persistent food insecurity coexist and are exacerbated by food waste, which deepens socioeconomic inequalities and generates negative environmental externalities. In this scenario, higher education plays a central role in adopting comprehensive strategic frameworks to develop specialized human capital and influence society. This study analyzes a Service Learning model that integrates the CFS-IRA Principles to promote the SDGs and ensure responsible consumption. Based on a case study of the Food Bank Chair spanning 10 years and 212 projects, the implementation of this model was evaluated using the Working with People (WWP) method, which combines the development of postgraduate students’ skills with community service to address social problems. The results demonstrated the effectiveness of the SL-WWP model in strengthening students’ technical, social, and ethical competencies while reducing food waste. The evaluation showed strong alignment with key SDGs, with outstanding performance in governance, although the need to strengthen environmental and social criteria was identified. The originality lies in integrating the CFS-IRA Principles into an SL model that encourages innovative cooperation among universities, civil society, and public–private sectors, offering a replicable proposal for higher education institutions to establish themselves as agents of change towards sustainability. Full article

Background: Poor nutrition drives chronic disease, health disparities, and rising health care costs in the United States. Medically tailored meals (MTMs), designed by registered dietitians, are a Food-as-Medicine intervention with potential to improve outcomes and reduce costs. This review synthesizes evidence on the clinical, economic, and policy implications of MTMs. Methods: We conducted a narrative review of peer-reviewed studies, real-world program evaluations, and policy analyses. Sources included PubMed, Google Scholar, and grey literature from government, nonprofit, and industry organizations. Articles and reports were included if they examined MTMs in Medicare, Medicaid, or other high-risk populations. Results: Evidence demonstrates that MTMs improve health outcomes, reduce hospitalizations, and lower total cost of care. Case studies from Medicaid and Medicare Advantage plans, including those administered by Mom’s Meals^®, report reductions in emergency department visits, hospital readmissions, and total cost of care, alongside sustained high member satisfaction. Despite these findings, gaps in coverage and limited stakeholder awareness hinder broader access and adoption. Conclusions: Federal policy action can expand MTM availability and maximize utilization of existing benefits. Opportunities include establishing a Medicare Fee-for-Service demonstration, expanding and encouraging use in Medicare Advantage, and leveraging MTMs within Center for Medicare and Medicaid Innovation models. Broader implementation and utilization could reduce the nation’s chronic disease burden, advance health equity, and promote value-based care. Full article

The latest climate change predictions indicate that the sea level will accelerate in the coming decades as a direct consequence of global warming. This is expected to seriously threaten low-lying coastal areas worldwide, resulting in severe coastal flooding with significant socio-economic impacts, leading to the loss of coastal settlements, exploitable land, and natural ecosystems. The main objective of this study is to provide a first-order preliminary estimation of potential inundation extents along the northern coastline of the Amvrakikos Gulf, a deltaic complex formed by the Arachthos, Louros, and Vouvos rivers in Western Greece, resulting from long-term sea-level rise induced by climate change, using the integrated Bathtub and Hydraulic Connectivity (HC) inundation method. A 2 m resolution Digital Elevation Model (DEM) was used, along with local long-term sea-level projections, for the years 2050 and 2100. Additionally, subsidence rates due to the compaction of deltaic sediments were taken into account. To assess the area’s proneness to inundation caused or enhanced by sea-level rise, the extent of each land cover type, the Natura 2000 Network protected area, the settlements, the total length of the road network, and the cultural assets located within the inundation zones under each climate change scenario were considered. The analysis revealed that under the optimistic SSP1-1.9 scenario of the Intergovernmental Panel on Climate Change (IPCC), areas of 40.81 km² (min 20.34 km², max 63.55 km²) and 69.10 km² (min 41.75 km², max 88.02 km²) could potentially be inundated by 2050 and 2100, respectively. Under the pessimistic SSP5-8.5 scenario, the inundation zone expands to 42.56 km² (min 37.05 km², max 66.31 km²) by 2050 and 84.55 km² (min 67.54 km², max 116.86 km²) by 2100, affecting a significant portion of ecologically valuable wetlands and water bodies within the Natura 2000 protected area. Specifically, the inundated Natura 2000 area is projected to range from 37.77 km² (min 20.30 km², max 46.82 km²) by 2050 to 50.74 km² (min 38.71 km², max 62.84 km²) by 2100 under the SSP1-1.9 scenario, and from 39.34 km² (min 34.53 km², max 49.09 km²) by 2050 to 60.48 km² (min 49.73 km², max 82.5 km²) by 2100 under the SSP5-8.5 scenario. Four settlements with a total population of approximately 800 people, as well as 32 economic facilities most of which operate in the secondary and tertiary sectors and are small to medium-sized economic units, such as olive mills, farms, gas stations, spare parts stores, construction companies, and food service establishments, are expected to experience significant exposure to coastal flooding and operational disruptions in the near future due to sea-level rise. Full article

In the highly competitive restaurant industry, prioritising customer satisfaction is crucial for establishments pursuing differentiation and repeat business. Within this context, creating unique and memorable experiences has evolved from a marketing trend into a strategic imperative, compelling restaurants to deliver encounters that transcend mere functional service and quality. However, prior research has primarily examined quality factors and satisfaction in isolation, overlooking the mediating role of experiential realms in this relationship. This study offers a novel contribution by integrating service quality and experiential marketing within a single empirical model, addressing a gap in the hospitality literature. Specifically, few studies have empirically examined how tangible and intangible quality cues translate into the four experiential realms of the Experience Economy—aesthetic, escapist, entertainment, and educational—and how these, in turn, influence satisfaction and revisit intentions. Drawing on the Experience Economy framework, this study develops and tests a conceptual model linking quality antecedents—physical environment, food quality, and customer service—to the four experiential realms (aesthetic, escapist, entertainment, and educational) and subsequent satisfaction and revisit intentions. Using data collected from 312 restaurant customers, the hypotheses were tested through Structural Equation Modelling (SEM). The findings reveal that quality antecedents significantly influence experiential realms, which in turn enhance satisfaction and revisit intentions—offering a more nuanced mechanism than previously theorised. By being among the first to empirically test these relationships in the sit-down restaurant context, this study adds theoretical and practical insight into experience-based brand differentiation. Moreover, it provides actionable insights for restaurant managers seeking to transform quality delivery into memorable, loyalty-building experiences. Full article

On 25 April 2014, the municipal water source in Flint, Michigan, was switched to the Flint River. Failure to properly treat the water for corrosion resulted in lead contamination of the water system. Resident concerns were dismissed by local, state, and federal government agencies until community participatory and clinical pediatric research demonstrated the contamination, and the water was restored to the original source 18 months later. Recovery efforts established a public health registry, funded by the Centers for Disease Control and Prevention. A grant of public health authority and registry funding were awarded to Michigan State University in August 2017 to establish a health surveillance system and public health intervention to refer exposed individuals to community services. Community feedback requested tiered data-sharing consent options. Participants who consented to join the registry were presented with four consent questions: to be contacted about future research opportunities, to use survey data to make referrals to services on their behalf, to share with the registry their State of Michigan Department of Health and Human Services (MDHHS) program data, and to share Michigan Medicaid administrative data. This descriptive study found that most participants consented to being contacted for future research (88%), sharing data for referrals (84%), and sharing data from MDHHS programs (77%) with the registry. Among participants with Medicaid insurance, 74% consented to sharing Medicaid data. Consent increased with age and decreased with income and education. Consent was higher among participants reporting food insecurity in the last 12 months. Consent to share data was unexpectedly high in the context of environmental disaster, trauma, and government distrust. Further work is needed to explore whether participation in public health activities is positively impacted by the implementation of a tiered consent process to share data. Full article

This study analyses employment in the tourism sector and seeks to identify trends in the evolution of worker profiles and transformation of the structure and working conditions in Portugal’s tourism sector from 2012 to 2022. It aims to understand how profiles, qualifications, and working conditions relate to the spatial distribution among Portuguese tourist regions and the typology and scale of tourism businesses, contributing valuable insights to defining sector strategies. It applies a quantitative approach based on statistical data from the Portuguese Ministry of Labour, Solidarity, and Social Security, disaggregated by the three segments of economic activity in the tourism sector: accommodation and food services, recreational and cultural activities, and transport and logistics. Descriptive statistics, MANOVA, and ANOVA tests analyse differences based on establishment size, tourist regions, and activity segments. The results show significant employment growth, regional variations, high turnover, and an increase in fixed-term contracts. Weak but significant correlations link education, nationality, gender, and working hours, indicating potential inequalities. The study highlights gender and educational differences among workers, as well as disparities related to employment status and nationality. Full article

This study aimed to characterize access to food establishments through a meal delivery application in university and non-university settings within a Brazilian metropolis. This cross-sectional study used data from a leading meal delivery platform. All establishments delivering to four public and four private university campuses in Belo Horizonte, Brazil were identified. For comparison, one corresponding non-university location was selected for each campus (yielding eight campus–location pairs). Each location corresponds to a central address within the paired neighborhood that was entered into the app to simulate delivery availability. Pairing criteria were based on geographic region and income levels. Information on establishment categories (classified by keywords), delivery distances, delivery fees, and geographic centrality was collected and analyzed descriptively. The number of available establishments ranged from 7176 to 11,440 across the assessed locations. Most establishments were categorized under keywords referring to snacks (e.g., burgers, savory snacks, pizza), regardless of location. Delivery distances ranged from 0 to 19.6 km, with shorter distances observed for university addresses and corresponding locations situated in central neighborhoods of the city, and longer distances for peripheral areas. Only 4.7% of establishments offered free delivery, and higher delivery fees were more frequent in non-university locations. No significant differences were observed between public and private universities. Food establishments are widely accessible via the app; however, central areas tend to have broader service coverage. Regardless of whether the location is a university or non-university setting, or whether it is central or peripheral, there is a predominance of establishments classified under keywords associated with unhealthy food options. Full article

Background: Globally, socioeconomic disparities persist across the trajectory of chronic kidney disease and are pronounced among people with kidney failure. Unmet health-related social needs contribute to these disparities, but limited guidance exists about how best to address them. To guide implementation, we conducted a rapid scoping review to identify and characterize interventions that address health-related social needs among people with kidney failure. Methods: We adapted established scoping review methods to conduct a rapid review. We searched Embase, PubMed, CINAHL, SCOPUS, and PsychInfo for articles and conference abstracts published since 2013 that described interventions to address health-related social needs as identified in the Centers for Medicare and Medicaid Services’ Accountable Health Communities Health-Related Social Needs Screening Tool. We applied the RE-AIM framework (Reach, Effectiveness, Adoption, Implementation, Maintenance) to synthesize findings and characterize intervention components. Results: Our review identified three articles and five conference abstracts that described diverse interventions to address health-related social needs among people with kidney failure. Six targeted social support, one addressed food insecurity, and one addressed transportation needs. Two pilot studies to address social support reported high recruitment and retention rates. One study formally tested an intervention to address social support among adolescents with kidney failure and reported negative findings (no change in social exclusion). The level of detail about intervention implementation varied across studies, but none described excluded participants or intervention fidelity, adaptations, or cost. Conclusions: Despite recent attention, there remains a lack of evidence to guide interventions addressing health-related social needs among people with kidney failure. From limited available data, interventions to address social support may be feasible and acceptable. Full article

Understanding urban diversity is critical to inclusive planning for sustainable urban development. This study introduces a new Urban Diversity Index (UDI) based on global point-of-interest (POI) data for food-related establishments—defined here as facilities that offer food and beverage services, including various kinds of eating and drinking venues —covering 249 cities across 154 countries. The UDI integrates three components: Pielou’s Evenness Index (J′) to capture the balance of establishment types, a Coverage Ratio (C′) to measure global representativeness of establishment categories, and density (ρ′) to reflect spatial concentration. By applying concentric buffer analysis around city centers, we evaluate the spatial profiles of diversity in each city. Results show that while cities like London and Istanbul have similar index components, they exhibit significant differences in the spatial extent and pattern of high-diversity zones, reflecting their unique morphological and regulatory contexts. Furthermore, the analysis of “Peak Distance Buffer Zones”—areas where UDI remains above 95% of its maximum—reveals diverse urban forms, particularly in Asian megacities. Scatterplots of standardized UDI and peak distances identify distinct typologies of urban diversity structures. Notably, urban population size showed no significant correlation with UDI values. Overall, this study demonstrates the utility of globally standardized POI-based metrics in capturing the spatial heterogeneity of urban qualitative diversity and offers new insights into cross-city comparisons of urban complexity. Full article

This study aimed to evaluate the effects of the COVID-19 pandemic on food service operations in a Brazilian tourist area. It is a longitudinal observational study. Data collection was performed through telephone interviews with owners or managers of 54 food service establishments concerning the pre-pandemic period (T0) and two time points during the pandemic (T1 and T2). Findings revealed a reduction in the number of establishments providing on-site service at T1 compared to T0, followed by an increase at T2. A reduction in operating hours (56.7%) and profits (100%) affected more establishments at T1 than at T2 (26.7% and 76.7%, respectively) (p < 0.05). At T2, with the resumption of in-person activities, there was a significant decrease in the use of sales channels such as telephone (p < 0.001), messaging applications (p = 0.0012), and websites/apps/social media (p = 0.009) compared to T0 and T1. The pandemic also caused an increase in mask use by employees (p < 0.01) and the availability of hand sanitizer dispensers at establishments (p < 0.01) during T1 and T2. At T2, there was also an increase in the supply of disposable cutlery, cups (p = 0.02), and gloves for customers (p = 0.015) compared to the pre-pandemic period. Full article

Over recent decades, coastal wetlands in Jiangsu Province have faced multiple challenges, including overfishing, reclamation for aquaculture, wetland shrinkage, and biodiversity loss. Implementing wetland ecological restoration proves crucial for mitigating the degradation of coastal wetland ecosystems. Quantifying ecosystem service values and establishing rational ecological compensation standards provide essential references for ecological compensation research and alleviating human–land conflicts. The Jianchuan Ecological Restoration Project, located in Dafeng District of Yancheng City, Jiangsu Province, employs integrated wetland, woodland, and farmland construction to rebuild biodiversity, enhance water conservation capacity, and improve water purification functions, thereby significantly boosting regional ecological services. Results have demonstrated that the total ecosystem service value of this project reaches CNY 76.2896 million, with climate regulation representing the highest value (CNY 68.1496 million, 89.33% of total). Subsequent values include biodiversity maintenance (3.40%), water purification (3.31%), and food production (2.95%), while carbon sequestration/oxygen release (0.96%) and soil retention (0.05%) show relatively lower contributions. Notably, this project innovatively integrates carbon finance mechanisms through “carbon sink loans”, achieving efficient transformation of ecological value from “paper accounts” to market realization. This study establishes a scientific foundation for ecological restoration projects through ecosystem service-based value assessment and pathway exploration, offering both theoretical framework and practical references. Full article