Search Results (412)

Background: Cochlear implantation (CI) in pediatric patients with cochlear nerve deficiencies (CND) remains controversial due to a highly variable clinical population, lack of evidence-based guidelines, and mixed research findings. This study assessed current clinical perspectives and practices regarding CI candidacy in children with CND among hearing healthcare professionals in the USA. Methods: An anonymous 19-question online survey was distributed to CI clinicians nationwide. The survey assessed professional background, experience with aplasia and hypoplasia, and perspectives on CI versus auditory brainstem implant (ABI) candidacy, including imaging practices and outcome expectations. Both multiple-choice and open-ended responses were analyzed to identify trends and reasoning. Results: Seventy-two responses were analyzed. Most clinicians supported CI for hypoplasia (60.2%) and, to a lesser extent, for aplasia (41.7%), with audiologists more likely than neurotologists to favor CI. Respondents cited lower risk, accessibility, and the potential for benefit as reasons to attempt CI before ABI. However, many emphasized a case-by-case approach, incorporating imaging, electrophysiological testing, and family counseling. Only 22.2% considered structural factors the best predictors of CI success. Conclusions: Overall, hearing health professionals in the USA tend to favor CI as a first-line option, while acknowledging the limitations of current diagnostic tools and the importance of individualized, multidisciplinary decision-making in CI candidacy for children with CND. Findings reveal a high variability in clinical perspectives on CI implantation for pediatric aplasia and hypoplasia and a lack of clinical consensus, highlighting the need for more standardized assessment and imaging protocols to provide greater consistency across centers and enable the development of evidence-based guidelines. Full article

With the popularization of social media, information related to public health events has seen explosive growth online, making it essential to accurately identify informative tweets with decision-making and management value for public health emergency response and risk monitoring. However, existing methods often suffer performance degradation during cross-event transfer due to differences in data distribution, and research specifically targeting public health events remains limited. To address this, we propose the Label Confusion Domain Adversarial Network (LCDAN), which innovatively integrates label confusion with domain adaptation to enhance the detection of informative tweets across different public health events. First, LCDAN employs an adversarial domain adaptation model to learn cross-domain feature representation. Second, it dynamically evaluates the importance of different source domain samples to the target domain through label confusion to optimize the migration effect. Experiments were conducted on datasets related to COVID-19, Ebola disease, and Middle East Respiratory Syndrome public health events. The results demonstrate that LCDAN significantly outperforms existing methods across all tasks. This research provides an effective tool for information detection during public health emergencies, with substantial theoretical and practical implications. Full article

Background/Objectives: This retrospective multicenter study, conducted within the ORCHESTRA Project, investigated SARS-CoV-2 reinfections among 5777 healthcare workers (HCWs) from four University Hospitals (Modena, Verona, Padova and Trieste) in northern Italy, aiming to assess the risk of reinfection and its determinants, comparing the clinical characteristics of reinfections with those of first infections, and examining the impact of preventive measures and vaccination strategies. Methods: HCWs completed an online questionnaire between June and August 2022. The survey collected demographic, occupational, and clinical data, including information on first infections and reinfections. Statistical analyses were performed using SPSS 28.0, through bivariate and multivariate approaches. Results: Response rates were 41.8% for Modena, 39.5% for Verona, 17.9% for Padova, and 17.4% for Trieste. Among the respondents, 4.8% (n = 276) experienced 2 infections and 0.5% (n = 27) reported 3 infections, out of a total of 330 reinfection cases. Additionally, 43.0% (n = 2787) reported only one infection, while 51.5% were never infected. Reinfection rates increased across five study phases (based on the epidemiological context), likely due to the emergence of new SARS-CoV-2 variants. A booster vaccine dose significantly reduced reinfection risk. Higher reinfection risk was found among HCWs aged ≤30 years, those with chronic respiratory diseases, and those working in COVID-19 wards, particularly nurses and allied health professionals. Reinfections were associated with a lower frequency of symptoms both during the period of swab positivity and after a negative swab, as well as with a shorter duration of swab positivity. No significant differences in symptom duration were found between first infections and reinfections. Conclusions: Despite its limitations, the online questionnaire proved a useful tool. Natural infection and vaccination reduced both reinfection risk and symptom severity. Prior infections should be considered in planning vaccination schedules and prioritizing HCWs. Full article

Background/Objectives: Patients with an ileoanal pouch change their diet to manage their symptoms and will often resort to the internet for nutrition advice. Currently, no evidence-based dietary guidelines exist to inform online resources. Hence, this study aims to assess the quality of online nutrition information directed towards patients with an ileoanal pouch. Methods: A systematic Google search was conducted to identify consumer websites including information on nutrition for those with ileoanal pouches. Quality was assessed using the DISCERN instrument, and the readability of written content was assessed using the Flesch–Kincaid score. A summative content analysis was used to identify the frequency of particular topics. Websites were also assessed against standards from the National Institute for Health and Care Excellence (NICE) framework for shared decision-making support tools. Results: A total of 12 websites met the inclusion criteria. Mean total DISCERN scores across all websites are 33 out of 75, indicating that overall, the websites were of poor quality. The mean Flesch–Kincaid score was 57 out of 100, or “fairly difficult” in terms of readability. The main themes according to the content analysis were “general dietary advice for pouch”, “dietary strategies for symptom management”, “addressing risks associated with having a pouch”, and “optimisation of nutritional intake”. Overall, websites did not meet the standards for shared decision-making. Conclusions: Online nutrition information for patients with an ileoanal pouch is of poor quality and difficult to understand. There is a need for higher quality online resources for these patients, ideally co-produced with a multidisciplinary team and patient, to provide patients with good quality, understandable, and accessible nutrition information. Full article

Q Fever is a zoonosis caused by Coxiella burnetii that affects domestic and wild ruminants, leading to reproductive disorders. In humans, the disease can manifest with acute and chronic clinical manifestations. Veterinarians, as healthcare professionals in close contact with animals, serve both as the first line of defence in preventing infection at the animal–human interface and as an important sentinel group for the rapid detection of outbreaks. The aim of this study was to assess the knowledge, perception, and attitude of veterinarians in Southern Spain regarding Q Fever. To this end, an online survey was designed, validated, and conducted among veterinarians in the province of Malaga, with a final participation of 97 individuals, predominantly from the private sector (clinic, livestock, agri-food, etc.). The data obtained reflected a general lack of knowledge about the disease, particularly concerning its epidemiology and infection prevention. Regarding perception and attitude, a significant percentage of respondents stated they did not use protective equipment when handling susceptible animals and only sought information about the disease in response to outbreak declarations. The study emphasised the significance of promoting training in zoonotic diseases during and after graduation, the relevance of official channels in occupational risk prevention, and the utility of epidemiological surveys as a tool to identify and address potential gaps in knowledge related to this disease. Full article

In recent studies, public health has been considered a key stakeholder in climate mitigation and adaptation in cities since they are more exposed to the impact of climate change. Nurses represent a vast majority of public health professionals, playing a key role in health promotion that allows them to influence individuals, families, and communities in adopting healthier behaviours and decarbonized lifestyles. Therefore, the purpose of this study is to map the existing evidence on nursing interventions, which are being led or implemented to reduce the health risks related to climate change in urban areas. The present review follows the JBI methodological framework, including a search on PubMed, MEDLINE complete, CINAHL Complete, Scopus, Web of Science, SciELO (Scientific Electronic Library Online), BASE (Bielefeld Academic Search Engine), and RCAAP. Hand searched references were also considered, including quantitative, qualitative, and mixed-methods studies between January 2014 and October 2024, for a more contemporary perspective. A three-step search strategy and data extraction tool were used by two independent reviewers. Twenty-seven studies in English and Portuguese were eligible for inclusion, all targeting a population of professionals with nursing-related roles: two case studies, one Delphi panel, one descriptive study, one historical research paper, two using a methodological design format, four narrative reviews, one observational study, nine review articles, three scoping reviews, and three systematic reviews. Eight categories of nursing interventions that contribute to decarbonized lifestyles, reducing health risks in relation to climate change, were acknowledged. Nurses play a key role in empowering individuals, families, and communities, promoting climate awareness and literacy, supporting health policy change, advocating for the most vulnerable and engaging in environmental activism, using evidence-based research, and taking advantage of marketing strategies and social media. Full article

This study presents an advanced analytical method for the simultaneous quantification of malondialdehyde (MDA), a biomarker of oxidative stress, and diphenyl phosphate (DPhP), a metabolite of the organophosphate flame retardant triphenyl phosphate (TPhP), in human urine. The method integrates hydrophilic interaction liquid chromatography (HILIC), a type of liquid chromatography suitable for polar compounds, for MDA separation, and an online restricted access material (RAM), a preconcentration column, for DPhP isolation, achieving high specificity and sensitivity. Validation with certified urine samples confirmed its robustness across diverse analyte concentrations and complex biological matrices. The optimized clean-up steps effectively minimized carryover, allowing for high-throughput analysis. Application to 72 urine samples revealed a significant positive correlation (ρ = 0.702, p-value = 1.9 × 10⁻⁷) between MDA and DPhP levels, supporting a potential link between oxidative stress and TPhP exposure. The subset analysis demonstrated a statistically significant moderate positive correlation in women (ρ = 0.622, p-value = 0.020), although this result should be interpreted with caution because of the limited sample size (N = 14). This method provides a powerful tool for biomonitoring oxidative stress and environmental contaminants, offering valuable insights into exposure-related health risks. Full article

The construction industry is moving towards the era of industry 4.0; 5.0 with Building Information Modelling (BIM) as the tool gaining significant traction owing to its inherent advantages such as enhancing construction design, process and data management. However, the integration of BIM presents risks that are often overlooked in project implementation. This study aims to develop a novel amalgamated dimensional factor (Techno-organizational Aspect) that is set out to identify and align appropriate management strategies to these risks. Firstly, it encompasses an in-depth analysis of BIM and risk management, through an integrative review approach. The study utilizes an exploratory-based review centered around journal articles and conference papers sourced from Scopus and Google Scholar. Then processed using NVivo 12 Pro software to categorise risks through thematic analysis, resulting in a comprehensive Risk Breakdown Structure (RBS). Then qualitative content analysis was employed to identify and develop management strategies. Further data collection via online survey was crucial for closing the research gap identified. The analysis by mixed method research enabled to determine the risk severity via the quantitative approach using SPSS (version 29), while the qualitative approach linked management strategies to the risk factors. The findings accentuate the crucial linkages of key strategies such as version control system that controls BIM data repository transactions to mitigate challenges controlling transactions in multi-model collaborative environment. The study extends into underexplored amalgamated domains (techno-organisational spectrum). Therefore, a significant contribution to bridging the existing research gap in understanding the intricate relationship between BIM implementation risks and effective management strategies. Full article

Background: Understanding the determinants of children’s outdoor play is an important element for child development and broader public health outcomes. There is growing evidence that children’s opportunities for play, particularly outdoor risky play, are diminishing. Parents are concerned with keeping their child safe while affording them independence to play. This study explored parents’ attitudes to risky play and practices around children’s independent mobility in Ireland with the aim of informing public health strategies promoting healthy childhood environments. Methods: An online survey comprising validated scales and standardised questions was completed by a nationally represented sample of 376 parents of children up to 16 years. Data was analysed via descriptive statistics, chi-square tests, and regression analysis. Results: A total of 376 participants accessed the survey, of which 349 completed it. A total of 84% of participants were female. A total of 74% agreed that children need regular exposure to actual risk to develop risk management skills, and 71% trusted their children to play safely. Chi-square tests reveal significant associations between outdoor play in the rain and school travel (p < 0.01), and appropriate age to begin activities at home and in educational settings (p < 0.05). A moderate association was found between the method of school travel and children’s permission to play in the rain (Cramer’s V = 0.51). Respondents considered supervision to be a necessity to ensure their children’s safety. Overall, the results indicate that parents were risk-averse in three of the six categories of risky play, namely, play near dangerous elements, play with adult tools, and out-of-sight play. Conclusions: This study presents a descriptive analysis of findings from the Ireland State of Play Survey. Findings indicate that although parents recognise the benefits of risky play, there is some contradiction between parental attitudes and actual practices, with a lack of willingness or confidence in permitting their children to participate in all such activities. Full article

Background/Objectives: Childhood obesity is a global epidemic. Addressing the modifiable risk factors with effective policies is crucial for both prevention and intervention. This scoping review aims to provide a situational analysis of childhood obesity in Greece by mapping the available evidence on the prevalence of obesity among Greek children and adolescents and exploring the existing policies implemented to address this issue. Methods: A systematic literature search was conducted on 15 September 2023, using the PubMed, Scopus, and IATROTEK-online databases to identify studies related to childhood obesity and policies in Greece. Keyword groups were developed for “childhood obesity,” “Greece,” and either “prevalence” or “policies”. Additional sources, including Google and Google Scholar, were screened to ensure comprehensiveness. Results: A total of 66 studies were included: 61 on obesity prevalence (≤18 years of age) and 5 on existing policies tackling childhood obesity, all in Greece. The collective prevalence was observed to lie within the subsequent range of values: 2.8–21.2%. Regarding both genders, the observed prevalence ranged from 2.8% to 26.7% in males, and between 1.3% and 33.7% in females. The policies adopted in Greece cover various domains (healthy nutrition, public preferences, physical activity, school policies, and programs related to childhood obesity). Conclusions: Childhood obesity in Greece is a major challenge. Greece currently uses some policies and strategies to combat childhood obesity. There is still work to be done: policies play a pivotal role as a key tool to influence lifestyle habits on a broad scale and exert a considerable impact on the reduction in this prevalent health concern. Full article

This research explores how artificial intelligence (AI) can be leveraged to optimize packaging design, reduce operational costs, and enhance sustainability in e-commerce. As packaging waste and shipping inefficiencies grow alongside global online retail demand, traditional methods for determining box size, material use, and logistics planning have become economically and environmentally inadequate. Using a three-phase framework, this study integrates data-driven diagnostics, AI modeling, and real-world validation. In the first phase, a systematic analysis of current packaging inefficiencies was conducted through secondary data, benchmarking, and cost modeling. Findings revealed significant waste caused by over-packaging, suboptimal box-sizing, and poor alignment between product characteristics and logistics strategy. In the second phase, a random forest (RF) machine learning model was developed to predict optimal packaging configurations using key product features: weight, volume, and fragility. This model was supported by AI simulation tools that enabled virtual testing of material performance, space efficiency, and damage risk. Results demonstrated measurable improvements in packaging optimization, cost reduction, and emission mitigation. The third phase validated the AI framework using practical case studies—ranging from a college textbook to a fragile kitchen dish set and a high-volume children’s bicycle. The model successfully recommended right-sized packaging for each product, resulting in reduced material usage, improved shipping density, and enhanced protection. Simulated cost-saving scenarios further confirmed that smart packaging and AI-generated configurations can drive efficiency. The research concludes that AI-based packaging systems offer substantial strategic value, including cost savings, environmental benefits, and alignment with regulatory and consumer expectations—providing scalable, data-driven solutions for e-commerce enterprises such as Amazon and others. Full article

Exposure to fine particulate matter (PM2.5) has become an increasing public health concern, particularly in urban areas facing severe air pollution. In response, individuals are increasingly turning to real-time tracking systems and self-monitoring tools. This study aimed to examine the association between PM2.5 risk perception, self-monitoring behaviors, and anxiety levels in the general population of Thailand. A cross-sectional survey was conducted during the dry season using an online questionnaire, which included the 7-item Generalized Anxiety Disorder (GAD-7) scale. A total of 921 participants residing in Bangkok and Chiang Mai were included. Binary logistic regression analysis, adjusted for sex, age, marital status, monthly income, and years of residence, revealed a significant association between anxiety and perceived health risks of PM2.5 exposure (OR = 1.09; 95% CI: 1.06–1.13). Daily self-monitoring of air quality over the past two weeks was also significantly linked to higher anxiety levels compared to non-monitoring individuals: OR = 1.92 (95% CI: 1.11–3.33) for websites, OR = 1.65 (95% CI: 1.01–2.72) for mobile apps, OR = 1.72 (95% CI: 1.12–2.64) for air purifiers, and OR = 3.34 (95% CI: 1.77–6.31) for air quality detectors. Monitoring 4–6 days per week using apps and air detectors was similarly associated with increased anxiety (OR = 1.64 and 2.30, respectively). Heightened perception of PM2.5 health risks and frequent self-monitoring behaviors are associated with increased anxiety among urban residents in Thailand. Public health interventions should consider implementing targeted alert systems during high-pollution periods and prioritize strategies to reduce PM2.5 emissions to alleviate public anxiety. Full article

Background/Objectives: Anemia and undernutrition are severe public health concerns in Ethiopia. These are the two most common nutritional disorders in pregnant women and frequently coexist. However, to our knowledge, there is little evidence of the coexistence of anemia and undernutrition among pregnant women. Therefore, this study aimed to examine the prevalence of coexisting anemia and undernutrition (CAU) and associated factors among pregnant women. Methods: A community-based cross-sectional study was conducted from 1 to 25 June 2024, on 515 pregnant women in the Hawela Lida district of Sidama, Ethiopia. We utilized a multi-stage sampling method to choose eligible study participants. A pre-tested and structured questionnaire was used to collect data via the online Open Data Kit mobile tool. We controlled the effect of confounders and clustering by using a multi-level mixed-effect modified Poisson regression analysis model. Results: The prevalence of CAU among pregnant women was 25.4% (95% CI: 21.9–28.9). The prevalence of CAU was associated with household food insecurity (adjusted prevalence ratio [APR]: 2.17; 95% CI: 1.43–3.28), training on model family (APR: 0.66; 95% CI: 0.45–0.96), inadequate dietary diversity (APR: 1.51; 95% CI: 1.18–1.95), and having poor knowledge of nutrition (APR: 1.55; 95% CI: 1.06–2.26) at individual levels. Low community-level women’s autonomy (APR: 6.19; 95% CI: 3.42–11.22) and community-level road accessibility (APR: 0.65; 95% CI: 0.43–0.98) were the identified determinants of CAU at the community level. Conclusions: One in four pregnant women had CAU in the study area. Household food insecurity, inadequate dietary diversity, and poor nutrition knowledge were associated with an increased likelihood of CAU, while participation in model family training and improved road accessibility were associated with reduced CAU. We have also indicated that low community-level women’s autonomy significantly increased the risk of CAU. Therefore, inter-sectorial collaboration should be required to comprehensively address CAU’s determinants at different levels. Additionally, any CAU prevention and intervention programs should provide model family training explicitly targeting women with poor nutritional knowledge and low autonomy in healthcare decision-making. Full article

This study investigates how pandemic-induced emotional disruption has reshaped sustainable consumer behavior in the digital age, with a focus on the continued influence of safety measures in the restaurant industry. As societies transition beyond COVID-19 restrictions, health-related anxieties persist, driving consumers to prioritize hygiene and risk reduction in their decision-making. Drawing on large-scale data from TripAdvisor and OpenTable, we analyze the effects of digitally communicated safety protocols on restaurant booking behavior across major U.S. cities. Our findings reveal that safety communication remains a salient factor in consumer choice, even after the acute phase of the pandemic. This effect is particularly pronounced in lower-tier restaurants, where visible digital safety signals help build trust and compensate for weaker brand equity. Conversely, in upscale establishments, where baseline hygiene standards are presumed, the marginal benefit of safety signaling is reduced. The study also identifies enduring patterns of emotional expression and anxiety in online reviews, indicating the long-term psychological imprint of the pandemic on consumer sentiment. By situating safety communication as both a psychological reassurance mechanism and a strategic digital marketing tool, this research contributes to the emerging discourse on sustainable marketing in post-crisis contexts. The results offer theoretical and managerial insights into how businesses can integrate health assurance into long-term brand strategies, reinforcing trust and resilience in digitally mediated, post-pandemic consumption environments. Full article

This study investigates key factors influencing individuals’ intentions to incorporate digital assets into inheritance planning in Thailand. The research focuses on three primary determinants: demographic characteristics, knowledge of digital assets, and the perceived risks associated with their usage and transfer. Utilizing a quantitative research design, data were collected from 630 Thai respondents via a structured online questionnaire through convenience sampling. Binary logistic regression analysis was applied to identify statistically significant predictors. The results indicate that digital-asset knowledge, gender, age, income, saving behavior, and risk perception collectively account for a substantial variance in individuals’ intentions to use digital assets as part of their inheritance planning. Notably, knowledge and income positively influence adoption, suggesting that financial education and broader economic development may encourage increased usage. Conversely, factors such as age, gender, and perception of risks pose significant barriers, underscoring the need for targeted strategies to foster inclusivity. As digital assets transition from speculative tools to recognized financial instruments, their role in inheritance planning becomes increasingly relevant. This study contributes to a deeper understanding of this evolving financial landscape in the Thai context and offers insights applicable to other emerging markets undergoing similar digital transformations. Full article