Search Results (1,964)

Background/Objectives: Children with developmental disabilities (DD) may experience feeding problems that increase their risk of malnourishment. However, data concerning factors linked to feeding problems in children with DD are lacking. The present study aimed to investigate feeding problems and their associated factors in children with DD who are fed orally. This cross-sectional study included data from 160 children with DD aged 2–18 years, recruited from 9 disability centers and schools located in Madinah, Saudi Arabia. Methods: A total of 666 envelopes were distributed randomly to children to take home. Caregivers were asked to provide sociodemographic, health, and nutrition information. Feeding problems were assessed using a validated screening tool for eating/feeding problems (STEP-AR), which included 17 items divided into 5 subdomains (Aspiration risk, Food refusal, Food selectivity, Nutrition behaviors, and Skill). Phone interviews were conducted with caregivers within two weeks of data collection for dietary assessment. Results: The most frequently reported feeding problems involved feeding skills and food selectivity, with 39.3% unable to feed themselves, 33.1% showing overeating behavior, and 31.2% exhibiting pica-like behavior. Chewing difficulties (28.7%), limited food intake (25.6%), and swallowing challenges (21.2%) were moderately reported, while aspiration-related problems were less common. Multiple linear regression analysis revealed significant positive associations between feeding problems and caregiver education level, family income, caregiver’s relationship to the child, and the child’s living arrangement. Dietary intake was not associated with feeding problems. Conclusions: The findings of this study indicate a range of feeding problems and key sociodemographic factors associated with feeding problems in children with DD. These results highlight the need for targeted interventions such as behavioral support and caregiver education to effectively address and manage feeding challenges in children. Full article

One of the challenges post-COVID-19 is reducing the negative impacts on quality of life, performance, and independence in activities of daily living. Assessing functional dependence in adults one year after acute infection can help to understand the long-term consequences, evaluate the impact on quality of life, plan rehabilitation and healthcare, identify the most vulnerable groups, measure the socioeconomic impact, and support public policies and clinical decisions. Objectives: The objectives of this study are as follows: (a) to assess the prevalence of functional dependence in Brazilian adults with COVID-19; (b) to analyze the association between the study variables; and (c) to determine the factors associated with functional dependence. Methods: This was an observational, cross-sectional study with 987 adults (18 to 59 years old) living in the State of Paraná (Brazil) hospitalized for COVID-19 between March and December 2020. Data were collected by telephone 12 months after the acute infection using an instrument to retrieve sociodemographic and health information, and a functional dependence scale to assess dependence before COVID-19 retrospectively (using participant recall information) and at the time of the interview. Data were analyzed using penalized logistic regression after imputing missing data. Data were analyzed using penalized logistic regression after imputing missing data. Results: Functional dependence after COVID-19 was 5.0% and was associated with low levels of education, not having a partner, living with someone, not owning a home, experiencing job changes, requiring care, obesity, smoking, multimorbidity, ICU admission in the acute phase, use of invasive ventilation, or having Long COVID. Individuals who required care or used invasive ventilation support were, respectively, 9.3 and 6.5 times more likely to develop dependence after COVID-19. Despite adjustment for multiple factors, the magnitude of the observed effects warrants cautious interpretation, as unmeasured or residual confounding effects may still be present. Sample recall bias due to collection after 12 months and the presence of the alpha variant without COVID-19 vaccination coverage may limit data generalization. Conclusions: The results highlight the need to emphasize the public health implications of identifying functional dependence. In this vein, it is necessary to implement preventive measures, identify and monitor more vulnerable groups, plan rehabilitation programs, and develop public health policies. Full article

Background: A childhood burn presents new and unfamiliar challenges to patients and their parents during recovery. These injuries can negatively impact activities such as independence in self-care, participation in physical activity, and social interaction. As such, pediatric burn patients are at risk of poorer quality of life (QoL) outcomes after their burn. In this longitudinal, observational cohort study, we examined the social, demographic, and clinical factors that were associated with a poor QoL at 12 months postburn for pediatric patients aged > 2 years with non-severe burns in Western Australia. Methods: Inpatients were recruited from the pediatric burn unit at Perth Children’s Hospital in Western Australia between February 2021 and September 2022. Demographic and family information (age, sex, postcode, parental education, languages spoken at home) and clinical data (burn cause, TBSA%, location, surgical interventions, length of stay) were collected at baseline. At 6 and 12 months, caregivers completed the Brisbane Burn Scar Impact Profile (BBSIP). Results: A total of 37 caregivers completed the Brisbane Burn Scar Impact Profile (BBSIP). For the child’s QoL, 57% of caregivers reported that some impact remained for overall QoL, 32% for sensory intensity, 46% for sensitivity, 22% for daily living (22%), and 19% for emotional reactions. Parent worry was impacted in 46% of caregivers. Being female was associated with greater long-term impacts, particularly in overall functioning and parental worry. The burn location also influenced outcomes, with injuries to the upper limbs linked to higher sensory intensity and emotional impact. Children from culturally and linguistically diverse (CaLD) backgrounds, indicated by those speaking a language other than English at home (LOTE), demonstrated significantly greater effects across several domains, including overall impact, daily living, appearance, and parent worry. Conclusions: A substantial proportion of children continued to experience impacts from non-severe burns across multiple domains, indicating that even small-area burns can have lasting effects. The factors associated with worse scores were the child being female, the families being linguistically diverse, and upper body burns. Full article

Introduction: The COVID-19 pandemic had significant effects on mental health and lifestyle behaviours, especially among university students who experienced academic disruptions, social isolation, and fewer social interactions. Alcohol consumption has long been part of student culture. Still, the influence of post-pandemic academic reintegration on drinking patterns and psychological distress remains relatively unexplored, particularly in countries like Portugal, where student traditions heavily shape consumption habits. This study aimed to describe the prevalence of alcohol consumption, depression, anxiety, and stress in a sample of Portuguese university students during the post-pandemic academic period, and to explore associations with sociodemographic variables. Methods: A cross-sectional study was conducted in November 2021 with 90 students from a private higher education institution in northern Portugal. Data were collected via an online questionnaire including sociodemographic information, the Alcohol Use Disorders Identification Test (AUDIT), and the Depression, Anxiety and Stress Scale (DASS-21). Result: The majority of the participants were not at risk of alcohol addiction (95.3%). In total, 15.1% of students reported anxiety symptoms ranging from severe to extremely severe. A binomial logistic regression was performed to ascertain the effects of being away from home and psychological distress (DASS-42 score), on the likelihood that participants were at risk of alcohol addiction (Level 3 and 4 in the AUDIT scale). The logistic regression model was statistically significant, χ²(2) = 9.20, p = 0.010. Living away from home was associated with a substantially lower likelihood of high-risk status (B = −2.79, p = 0.034), corresponding to an odds ratio of 0.06, indicating a strong protective effect. DASS-42 total score was positively associated with high-risk status (B = 0.04, p = 0.039), such that higher psychological distress increased the odds of being classified as high risk. Conclusions: The findings reveal a low prevalence of alcohol risk but heightened symptoms of anxiety, depression, and stress. Psychological distress notably increases the likelihood of hazardous alcohol use, emphasising the importance of targeted mental health and alcohol-use interventions among university students. Full article

Higher education institutions face a critical methodological challenge in pursuing net-zero commitments: Within the amount ofhe emissions related to Scope 3, including indirect emissions from water consumption, waste disposal, business travel, and mobility, employees commuting represents 50–92% of campus carbon footprints, yet reliable quantification remains elusive due to fragmented data collection and governance silos. The present research investigates how purposeful integration of the Home-to-Work Commuting Plan (HtWCP)—mandatory under Italian Decree 179/2021—into the Climate Neutrality Plan (CNP) could constitute an innovative strategy to enhance emissions accounting rigor while strengthening institutional governance. Stemming from the University of Genoa case study, we show how leveraging mandatory HtWCP survey infrastructure to collect granular mobility behavioral data (transportation mode, commuting distance, and travel frequency) directly addresses the GHG Protocol-specified distance-based methodology for Scope 3 accounting. In turn, the CNP could support the HtWCP in framing mobility actions into a wider long-term perspective, as well as suggesting a compensation mechanism and paradigm for mobility actions that are currently not included. We therefore establish a replicable model that simultaneously advances three institutional dimensions, through the operationalization of the Avoid–Shift–Improve framework within an integrated workflow: (1) methodological rigor—replacing proxy methodologies with actual behavioral data to eliminate the notorious Scope 3 data gap; (2) governance coherence—aligning voluntary and regulatory instruments to reduce fragmentation and enhance cross-functional collaboration; and (3) adaptive management—embedding biennial feedback cycles that enable continuous validation and iterative refinement of emissions reduction strategies. This framework positions universities as institutional innovators capable of modeling integrated governance approaches with potential transferability to municipal, corporate, and public administration contexts. The findings contribute novel evidence to scholarly literature on institutional sustainability, policy integration, and climate governance, whilst establishing methodological standards relevant to international harmonization efforts in carbon accounting. Full article

Indoor air quality (IAQ) is a critical determinant of respiratory health and plays an essential role in asthma management. Exposure to indoor pollutants such as particulate matter (PM_2.5), volatile organic compounds (VOCs), and biological allergens can exacerbate asthma symptoms. This pilot quasi-experimental, one-group pretest–posttest study evaluated the combined effect of high-efficiency particulate air (HEPA) purifiers and tailored asthma education on the IAQ and asthma outcomes of 30 adults diagnosed with asthma. Indoor PM_2.5, total VOCs (tVOC), temperature, and relative humidity were monitored using low-cost air quality monitors across three home locations for 30 days, and participants completed baseline and follow-up assessments of asthma control (ACQ) and quality of life (AQLQ). The intervention reduced PM_2.5 concentrations from 21.32 µg/m³ to 18.19 µg/m³ (p < 0.001), while tVOC levels increased slightly from 237.05 ppb to 251.81 ppb (p = 0.02). The median ACQ scores improved from 1.17 to 0.50 (p < 0.001), the proportion of participants with well-controlled asthma (ACQ ≤ 0.75) rose from 30% to 66.7%, and the median AQLQ scores increased from 5.75 to 6.30 (p < 0.001). Participants in the intervention experienced significantly improved asthma control, quality of life, and indoor PM_2.5 levels, which underscores the significance of integrating environmental and educational strategies in adult asthma management. Full article

The aim of this research is to elaborate on the activities of non-formal experiential learning in agritourism developed by an organic family farm in Thessaloniki, Greece. Based on a qualitative approach, in-depth interviews with the owners of the farm and a Business Model Canvas (BMC) approach to this case study, the results indicate that workshops, seminars on nutrition, environmental conservation activities, plant identification, hands-on activities for children and cooking lessons with chefs are some of the non-formal learning tools. The aforementioned activities, on the one hand, raise gate sales for the family and, on the other hand, promote knowledge and awareness towards the contemporary environmental challenges that the rural areas and our food chain are facing. Future development strategies were also identified through the BMC, such as the adoption of digital educational tools, and ‘Do It Yourself’ kits for growing microgreens at home, while the need for official certification and support of multifunctional farms by the Ministry of Rural Development was also highlighted. Full article

Background: Early childhood caries (ECC) compromise the nutrition, growth, and quality of life in young children, and their relationship with breastfeeding practices remains disputed. Aim: To determine if prolonged breastfeeding increases the risk of dental caries in children aged under 71 months. Material and Methods: A systematic review of PubMed, Multidisciplinary Digital Publishing Institute, and Evidence-Based Dentistry, was conducted through August 2025, including observational studies, randomized trials, narrative reviews, and meta-analyses on breastfeeding and ECC. Results: Thirty-one studies involving 28,000 children were included. Exclusive breastfeeding for under six months halves ECC probability (OR 0.53–0.58), whereas breastfeeding beyond 12 months and nocturnal feeds increase probability by 60–86% (OR 2.35–7.14). Parental factors—high plaque levels, feeding-to-sleep, and skipped post-feed cleaning—strongly predict ECC (OR 8.51–75.6). Interventions combining feeding counseling with home visits or visual aids reduce ECC incidence by 22–32% (RR 0.68–0.78). Conclusions: Exclusive breastfeeding through six months is protective against ECC, but prolonged or nocturnal feeding heightens risk. Integrating structured oral health education into breastfeeding promotion is recommended. Full article

Worldwide the adoption of electric vehicles (EVs) is recognized as a key strategy for reducing transport-related greenhouse gas (GHG) emissions, a major contributor to global warming and climate change. The objective of this pilot study is to examine the key variables that might have influenced electric vehicle (EV) purchase decisions among current EV owners and how they are aligned or different for the prospective EV owners in North Carolina (NC). By adopting a web-based survey for data collection, the study specifically aims to identify economic, demographic, environmental, and commuting behaviors, along with existing government policies and incentives that might motivate consumer choices regarding EV adoption. Most existing EV owners who participated in the survey identified themselves as college-educated White men with USD 100 K or higher income, have more than two cars, commute more than 30 min, and live in single-family homes with EV charging. In contrast, among non-EV owners who plan to adopt an EV within the next three years, a significant proportion are non-White, women, and earn USD 50,000 or less annually. While home charging is important to both current EV owners and non-EV owners, EV incentive policies and proximity to public changing stations are found to be more important to non-EV owners’ decision to adopt EVs. A reasonable conclusion from this research is that expanding EV-friendly policies, incentives, and infrastructure will encourage first-time EV ownership in NC while providing deeper insights into the dynamics of sociodemographic among both EV owners and non-EV owners. Full article

Objectives/Background: In this study, we aimed to examine the associations of participation in leisure dance activity with perceived health status, happiness level, and perceptions of leisure, and the relevance of demographic characteristics to these associations. Moreover, we sought to explore ways of revitalizing leisure dance activity. Methods: We used data from the 2022 Korea National Leisure Activity Survey organized by the Korean Ministry of Culture, Sports, and Tourism. The 2022 Korea National Leisure Activity Survey was conducted from September to November 2022. The survey was conducted among 10,046 Koreans aged ≥15 who lived in 17 cities and provinces across the country. The participants were informed about the survey schedule in advance, and interviews were conducted at the participants’ homes using tablet PCs. Random telephone verification was performed on the recovered questionnaires to ensure the accuracy of responses. Questionnaires that passed the first verification were subjected to secondary verification by a computerized program, and questionnaires that did not pass the verification were supplemented and re-examined. The collected data were entered electronically through an encoding process, and only the data that passed the final test were compiled in the multi-stage verification process. The data were analyzed using frequency analysis, chi-squared tests, and multivariate logistic regression analysis. Results: Of the 1004 participants, 655 (6.5%) participated in leisure dance activity. Women, individuals in their twenties and thirties, college graduates or those with lower-level educational qualifications, and unmarried individuals were more likely to participate in leisure dance activities. In addition, leisure dance activities were found to be likely to increase happiness levels and leisure life satisfaction, and leisure expenses were likely to be low. Conclusions: Schools should provide high-quality dance education and enhance the professionalism of physical education teachers in the management of dance classes. This is because dance-related experiences in childhood can increase the likelihood of engaging in dancing in adulthood. Efforts are also needed to increase men’s awareness of and participation in leisure dance activities and to lower barriers to entry. The convergence of dance, games, and technology can make this possible. Full article

Parental educational anxiety poses a significant risk to children’s academic development. This two-stage study first establishes Parental Mathematics Education Anxiety (PMEA) as a unique construct and then examines the complex effects of a positive suggestion intervention. Study 1, a questionnaire-based investigation, revealed that PMEA is a significant and independent negative predictor of children’s mathematics achievement, distinct from parents’ general state anxiety or their own mathematics anxiety. It also identified socioeconomic factors, such as family income and parental education, as key drivers of PMEA. Study 2 employed an experimental design to test an intervention, revealing that the effectiveness of positive suggestions is not universal but is significantly moderated by the three-way interaction of PMEA level, child type (with/without math learning difficulties), and suggestion frequency. Notably, for non-math-difficult children, frequent positive suggestions from high-anxiety parents were found to be potentially detrimental (a “backfire effect”), whereas for math-difficult children in high-anxiety homes, a higher frequency of suggestion was necessary to yield benefits. These findings deepen the understanding of PMEA’s mechanisms and underscore the necessity of moving beyond one-size-fits-all approaches toward differentiated, context-aware intervention strategies in family education. Full article

Household bread and bakery product waste constitutes a growing issue in Algeria, with significant economic, environmental, and socio-cultural implications. This research is situated within the framework of sustainable food systems and responds to recent transformations in domestic food practices, driven by increased female labor force participation, time constraints, and the widespread availability of industrial bread, which have reshaped household food management and traditional home bread-making practices. The study aims to (1) review traditional Algerian breads, emphasizing their culinary, nutritional, and cultural significance; (2) examine household behaviors during the month of Ramadan in the city of Constantine, focusing on patterns of consumption, purchasing, waste generation, and strategies for reusing leftovers; and (3) assess the economic implications of these practices using the FUSIONS methodology and explore their contribution to household-level food sustainability. Methodologically, a cross-sectional exploratory survey was conducted among 100 married women, the majority of whom were middle-aged (62%; range: 27–71 years; mean age: 52.0 ± 10.21), well-educated (59% with a university degree), economically active (68%), and living in medium-sized households (63%). The findings reveal pronounced contrasts across bread categories. Industrial breads, particularly baguettes, are characterized by high daily purchase frequencies (4.16 ± 1.31 units/day) and the highest waste rates (12.67%), largely attributable to over-purchasing (92%) and low perceived value associated with subsidized prices, with convenience (100%) remaining the primary factor explaining their dominance. In contrast, traditional breads exhibit minimal waste levels (1.63%) despite frequent purchase (3.85 ± 0.70 loaves/day), reflecting more conscious food management shaped by strong cultural attachment, higher perceived value, and dietary preferences (100%). Modern bakery products, along with confections and pastries, the latter representing of 58% of total household food purchases, comprise a substantial share of food expenditure during Ramadan (2.16 ± 0.46 loaves/day and 12.07 and 7.28 ± 2.50 units/day, respectively), while generating relatively low levels of food waste (5.69%, 4.19%, and 0%, respectively). This suggests that higher prices and symbolic value encourage more careful purchasing behaviors and conscious consumption. Freezing leftovers (63%) emerges as the most commonly adopted waste-reduction strategy. Overall, this work provides original quantitative evidence at the household level on bread and bakery product waste in Algeria. It highlights the key socio-economic, cultural, and behavioral drivers underlying waste generation and proposes actionable recommendations to promote more sustainable food practices, in line with the United Nations Sustainable Development Goal 12 on responsible consumption and production. Full article

Introduction: This document presents recommendations of the Polish Respiratory Society on discharge instructions following hospitalization for an exacerbation of chronic obstructive pulmonary disease (COPD). Methods: The Delphi method was applied to achieve consensus among independent experts. Results: Fourteen recommendations were formulated. Experts emphasized that discharge summaries require clear graphical and editorial design to ensure readability for both patients and healthcare professionals. The involvement of a multidisciplinary team was recommended to provide coherent and comprehensive documentation. Discharge instructions should be discussed with the patient during hospitalization and supplemented with standardized educational materials provided separately. These materials should cover inhaler technique, smoking cessation, physical activity, pulmonary rehabilitation, and vaccination. For patients with respiratory failure, home oxygen therapy or non-invasive ventilation must be addressed. Discharge recommendations should highlight modifications in baseline COPD treatment and management of comorbidities. A personalized action plan for future exacerbations is essential, and dietary consultation is advised. Finally, discharge summaries should specify follow-up appointments and include prescriptions for inhaled medications. Conclusions: The Polish Respiratory Society recommends that discharge instructions be provided to all patients hospitalized for a COPD exacerbation. Full article

Toxoplasmosis is a parasitic disease associated with significant morbidity and mortality. This cross-sectional study aimed to determine the prevalence, associated risk factors, and ocular health outcomes related to Toxoplasma gondii seropositivity in 161 residents from four Quilombolas communities in the northern region of Tocantins, Brazilian Legal Amazon. Peripheral blood samples were collected and tested by Enzyme-Linked Immunosorbent Assay (ELISA) for Immunoglobulin G (IgG) and/or Immunoglobulin M (IgM) and Polymerase Chain Reaction (PCR), while a standardized form was used to collect sociodemographic, health, and behavioral data. Statistical analysis, conducted using Epi-Info 3.3.2, considered T. gondii seropositivity as the primary outcome, with a significance level less than 5% (p ≤ 0.05). An overall seroprevalence of 62.11% (100/161) was observed. Key risk factors significantly, as measured by the Odds Ratio (OR), associated with T. gondii seropositivity included being elderly (OR: 4.07, CI: 2.05–8.06, p < 0.01), having cats (OR: 5.56, CI: 2.74–22.27, p < 0.01), a low parental education level (OR: 2.97, CI: 1.46–6.02, p < 0.01), children playing on the ground (OR: 2.50, CI: 1.30–4.82, p < 0.01), and having a home vegetable garden (OR: 3.80, CI: 1.94–7.47, p < 0.01). Regarding ocular health, no conclusive direct association was established between T. gondii seropositivity and specific ocular manifestations when analyzed for children and the elderly separately. Observed ocular problems in the grouped population were primarily linked to age-related comorbidities rather than parasitic infection. High rates of T. gondii seropositivity, driven by specific environmental and socioeconomic factors, highlight the vulnerability of these communities, emphasizing the need for targeted preventive strategies. Full article

Heart failure (HF) and chronic kidney disease (CKD) are prevalent conditions in older adults, often coexisting and significantly increasing the risk of hospitalization, cardiovascular events, and mortality. Traditional hospital-based care, while essential for acute management, is often insufficient to ensure continuity of care and optimal long-term outcomes. Home-based care, although promising for improving quality of life and reducing hospital-acquired complications, faces challenges related to treatment adherence, monitoring, and caregiver support. Recent evidence highlights the potential of multidisciplinary, patient-centered care models integrating physicians, nurses, pharmacists, and family caregivers. Technological innovations, including telemedicine, remote monitoring, mobile health applications, and artificial intelligence, have shown efficacy in early detection of clinical deterioration, improving adherence, and reducing cardiovascular events in HF and CKD patients. Structured patient education, caregiver training, and proactive follow-up are key elements to optimize transitions from hospital to home and to improve long-term outcomes, including reduced rehospitalizations and better quality of life. Future care strategies should focus on personalized, integrated approaches that combine technology, education, and multidisciplinary collaboration to address the complex needs of HF and CKD patients, while mitigating healthcare costs and enhancing overall patient well-being. Full article