Search Results (323)

Fast fashion is a rapidly expanding sector characterized by high production volumes, low costs, and short product lifecycles. While recent efforts have focused on improving sustainability within supply chains, consumer behavior remains a critical yet underexplored driver of environmental impacts. This study presents a web-based calculator tool designed to estimate both the carbon and plastic footprints associated with individual fast fashion consumption, with a particular focus on shopping behaviors, garment disposal, and laundry habits. Adopting a geographical perspective, the analysis explicitly considers the spatial dynamics of consumption and logistics within the urban context of Milan (Italy), a dense metropolitan area representative of high fashion activity and mobility. By incorporating user-reported travel patterns, logistics routes, and localized emission factors, the tool links consumer habits to place-specific environmental impacts. By involving over 360 users, the tool not only quantifies emissions and plastic waste (including microfibers) but also serves an educational function, raising awareness about the hidden consequences of fashion-related choices. Results reveal high variability in environmental impacts depending on user profiles and behaviors, with online shopping, frequent use of private vehicles, and improper garment disposal contributing significantly to emissions and plastic pollution. Our findings highlight the importance of integrating consumer-focused educational tools into broader sustainability strategies. The tool’s dual function as both calculator and awareness-raising platform suggests its potential value for educational and policy initiatives aimed at promoting more sustainable fashion consumption patterns. Full article

This study explored a competency-based soft-skills programme supporting evolving community pharmacy professionals’ roles and sustainable practice in Serbia. Four researchers with academic and practice backgrounds developed the programme using healthcare guidelines and the International Pharmaceutical Federation’s competency framework. The process involved defining objectives, selecting methods, designing and organising activities, accreditation, and evaluating outcomes based on the Kirkpatrick model. From January 2021 to March 2025, the “Galenika Academy” was implemented through webinars, accredited tests, onsite courses, and a mobile application. Satisfaction was assessed via a validated online questionnaire among participants attending ≥80% of sessions, following evaluation of attendance and test performance. The programme reached 5107 participants, 10,427 webinar views, and 8252 test completions. The “Galiverse” mobile app, launched in February 2023, had 5558 users by March 2025. The most attended webinar was “Burnout” (787). Average test success was 82.9%, with 95.3% for “Resilience” and 61.0% for “Team Management.” Satisfaction was 95.5% for content, 94.2% for quality, 92.3% for materials, 77.1% for the application, and 96.3% would recommend it. Among those reporting improved resilience, 96.9% believed it could positively impact pharmacy operations. Pharmacists found the programme relevant and effective. Further research is needed to evaluate its impact on practice and patient outcomes. Full article

Background/Objective: Penicillin allergy labels (PALs) contribute to broad-spectrum antibiotic use. Thorough documentation can help prescribers identify and remove unnecessary PALs. We aimed to improve documentation of PALs in three pediatric urgent care (PUC) clinics, using a nurse-initiated quality improvement (QI) approach. Methods: QI interventions included a survey to assess prescriber and nurse confidence, an online educational module, and an algorithm to aid in clarifying PALs. We measured the percentage of PALs with a clarified reaction severity as our primary outcome using annotated control charts. Descriptive and inferential statistics evaluated survey responses between nurses and prescribers. Results: Clarified PAL reaction severity had a sustained upward shift from 58.5% to 63.3% following implementation of our interventions. Of 129 nurses and prescribers, 87 (67.4%) respondents completed the survey. Prescribers and nurses reported feeling knowledgeable about PALs but experienced different challenges to clarifying PAL documentation. Prescribers reported time pressures as a barrier to PAL clarification more often than nurses (IQR [3, 4], p = 0.001). Nurses reported higher confidence in ability to document a PAL compared to prescribers (IQR [3.25, 5], p = 0.010). Respondents requested family education and practice guidance to aid PAL clarification. No consistent differences were noted in PAL documentation by sociodemographic characteristics. Conclusions: The nurse-initiated QI approach demonstrated improved PAL documentation in PUCs. Engaging nurses in antibiotic stewardship initiatives can provide new perspectives and broaden the approach to intervention design and implementation. Future efforts should focus on improving electronic health record and interprofessional workflow processes to build on these improvements. Full article

The nitrogen electroreduction reaction (NRR) has emerged as a promising and sustainable alternative to the Haber–Bosch process for NH₃ production. This study investigated the NRR in alkaline medium using Pd/C, Rh/C, and PdRh/C electrocatalysts, employing online electrochemical mass spectrometry (OLEMS) for gaseous-product detection and ultraviolet–visible spectroscopy to confirm NH₃ formation. To our knowledge, no previous reports have simultaneously detected H₂, N₂H, and N₂H₂ intermediates and monitored N₂ consumption as a function of applied potential for Pd and Rh catalysts. The bimetallic PdRh/C catalyst showed superior NRR performance compared with the monometallic catalysts, exhibiting higher faradaic charges, more pronounced generation of nitrogen intermediates, and selectivity for NH₃. This work provides key insights into the NRR mechanisms and underlines the strategic importance of the bimetallic catalyst design for more efficient, sustainable electrochemical NH₃ synthesis. Full article

Background: Despite the clinical efficacy of pre-exposure prophylaxis (PrEP) in preventing HIV, uptake remains suboptimal among men who have sex with men (MSM) in the United Kingdom (UK). Sustaining progress in the PrEP cascade requires more than biomedical availability; it demands effective, psychologically informed interventions that address persistent barriers. Psychological factors, such as medical mistrust, low PrEP self-efficacy, and identity-related processes, continue to undermine engagement. This study tested whether narrative persuasion and message framing could influence these barriers. Method: A sample of 253 MSM was recruited to participate in an online experiment and completed baseline measures of identity resilience before being randomly allocated to either the gain-framed (N = 122) or loss-framed (N = 124) narrative condition and then completing post-manipulation measures of medical mistrust and PrEP self-efficacy. After excluding 7 cases due to ineligibility, data from 246 participants were analysed using mediation analysis. Results: Participants in the gain-framed condition reported lower medical mistrust than those in the loss-framed condition. Medical mistrust was, in turn, associated with lower PrEP self-efficacy. Identity resilience was associated with lower medical mistrust and higher PrEP self-efficacy. Discussion: These findings provide novel causal evidence that gain-framed health narratives can reduce mistrust and indirectly enhance PrEP self-efficacy. Identity resilience also emerges as a key psychological factor influencing trust and behavioural confidence. Conclusions: Interventions to improve and sustain PrEP uptake should combine gain-framed, narrative-based messaging with strategies to bolster identity resilience. Such approaches may address psychosocial barriers more effectively and promote equitable PrEP uptake among MSM. Full article

Background: In recent years, there has been increasing interest in the application of repetitive Transcranial Magnetic Stimulation (rTMS) and transcranial Direct-Current Stimulation (tDCS) to enhance and rehabilitate the language abilities in individuals with neurodegenerative diseases. Objective: The aim of this narrative literature review is to investigate the usefulness of rTMS and tDCS to improve language abilities in people with Primary Progressive Aphasia (PPA). Methods: This narrative literature review was conducted through a search of the PubMed online database to identify studies investigating the effects of multiple sessions of rTMS or tDCS on language abilities in PPA patients, applied either as stand-alone interventions or in combination with language treatment. Results: Thirty-three studies fulfilled the inclusion criteria; five studies employed rTMS without language treatment; two studies applied tDCS as stand-alone intervention; twenty-two studies combined tDCS with language treatment; and four studies assessed the effects of tDCS during verbal task without language treatment. Conclusions: rTMS and tDCS applied with or without concomitant language treatment appear to be promising interventions for enhancing language abilities in PPA, with sustained effects reported over time. Further research is necessary to optimise stimulation protocols and to improve our understanding of their long-term effects. Moreover, randomised controlled trials (RCTs) with larger sample sizes are critically needed to clarify the true impact of brain stimulation in PPA, with a focus on changes in cognitive and functional performance, neural activity, and potential molecular correlates. Full article

Background: The purpose of this study was to evaluate Achilles tendon ruptures (ATR) in NHL players and the effects on return to play and player performance metrics. The incidence, mechanism of injury, management strategy, return to play (RTP), and post-injury were assessed from official online sports databases. Methods: A retrospective review of NHL players who sustained a partial or complete tear of the Achilles tendon from 2008 to 2024 was performed. Data were collected from NHL injury databases and media reports, and included player demographics, injury mechanism, treatment, and post-injury performance metrics. A Wilcoxon signed rank test was used to compare pre-injury and post-injury performance metrics, with significance set at p < 0.05. Results: Here, 15 NHL players with a mean age of 27.8 years were identified, with a prevalence rate of 0.125 injuries per 10,000 athletic exposures. Overall, 73.3% of ATRs were non-contact in nature, with 60.0% of ATRs occurring during off-season training. Fourteen players were managed with non-operative treatment, with no re-ruptures reported. The RTP rate was 93.3%, with players missing a mean number of 45.7 games. However, there was a deterioration in post-injury performance metrics, including games played per season, plus/minus rating, and time on ice per game post-injury. Conclusions: This study found that Achilles tendon ruptures are an uncommon injury in NHL players, with a prevalence rate of 0.125 injuries per 10,000 athletic exposures. A high RTP rate of 93.3% was observed in this cohort. However, there was a deterioration in post-injury performance metrics, including games played per season, plus/minus rating, and time on ice per game post-injury, highlighting the potential devastating sequelae of ATRs in elite NHL athletes. Full article

Sustainable education requires addressing the challenges posed by digital transformation, including technostress among university students. This study evaluates technostress levels in higher education through the validation of the TS4US scale and its implications for sustainable learning environments. A cross-sectional study was conducted with 328 university students from four districts in Lima, Peru, using an online survey to measure technostress. Confirmatory factor analysis (CFA) was performed to assess the psychometric properties of the TS4US scale, resulting in a refined model with two latent factors and thirteen validated items. Findings indicate that 28% of students experience high technostress levels, while 5% report very high levels, though no significant associations were found between technostress and sociodemographic variables such as campus location, employment status, gender, and academic level. The TS4US instrument had been previously validated in Chile; this study confirms its structure in a new sociocultural context, reinforcing its cross-cultural applicability. These results highlight the need for sustainable strategies to mitigate technostress in higher education, including institutional support, digital literacy programs, and policies fostering a balanced technological environment. Addressing technostress is essential for promoting sustainable education (SDG4) and enhancing student well-being (SDG3). This study directly contributes to the achievement of Sustainable Development Goals 3 (Good Health and Well-being) and 4 (Quality Education) by providing validated tools and evidence-based recommendations to promote mental health and equitable access to digital education in Latin America. Future research should explore cross-country comparisons and targeted interventions, including digital well-being initiatives and adaptive learning strategies, to ensure a resilient and sustainable academic ecosystem. Full article

Self-regulated learning (SRL) has been widely recognized as a critical skill for academic success in online and blended learning contexts. However, many students experience difficulty in effectively applying SRL strategies in the absence of structured instructional guidance. To address this challenge, this study developed and implemented a learning management system integrated with SRL support (SRL-LMS), specifically designed for the online component of a blended learning course. The SRL-LMS consisted of two sections: a conventional course content section and a SRL training section designed to support students in applying SRL strategies. A quasi-experimental design was adopted with 69 college students assigned to either an experimental group, with access to both course and SRL sections, or a control group, which accessed only the course section. Results indicated that students in the experimental group reported higher levels of self-regulation and showed more frequent and diverse application of SRL strategies compared to the control group. In terms of academic performance, the experimental group performed significantly better than the control group on the first exam, though no significant difference was observed on the second exam. These results highlight the effectiveness of structured SRL interventions within digital learning platforms for improving students’ self-regulatory behaviors. Future implementations should address cognitive load and incorporate strategic approaches to sustain student motivation. This study advances current SRL intervention designs and offers valuable insights for educators and instructional designers aiming to integrate targeted SRL supports in online and blended learning environments. Full article

Background: As COVID-19 transitions to an endemic phase, long COVID symptoms remain a significant public health issue affecting both physical and mental health. A notable proportion of college students report symptoms such as fatigue, cough, and brain fog persisting for weeks or months post-infection. Objectives: This study explored the prevalence and contributing factors of long COVID symptoms among both infected and uninfected students in medicine-related departments. Methods: A cross-sectional study was conducted using online self-reported questionnaires completed by 1523 undergraduate and graduate students in medicine-related departments at a medical university. Participants who had tested positive for COVID-19 within the past three months were excluded. The survey assessed long COVID symptoms, with comparisons conducted between infected and uninfected groups. Multivariate logistic regression identified risk factors associated with long COVID symptoms. Results: Of the 1118 participants, 47.5% of those with a prior COVID-19 diagnosis reported long COVID symptoms within the past month. Significant differences between the infected and uninfected groups were observed in physical, cognitive, and psychological health. Logistic regression identified that prior COVID-19 diagnosis had an association with the presence of long COVID symptoms (odds ratio = 1.48, p = 0.024) after adjusted model analysis. Meanwhile, higher anxiety levels (odds ratio = 1.09, p < 0.001) and a BMI ≥ 24 (odds ratio = 4.50, p < 0.01) were identified as significant risk factors for post-infection syndrome among previously infected students. Sex and exercise habits also influenced symptom prevalence. Conclusions: Since late 2023, with those experiencing cumulative infections surpassing half of Taiwan’s population, long COVID symptoms have persisted as a widespread concern affecting both physical and mental health, continuing into 2025. This study underscores critical risk factors and symptom patterns among students in medicine-related departments, reinforcing the urgency of sustained surveillance and targeted interventions to facilitate comprehensive recovery. Full article

Background: Musculoskeletal disorders significantly affect healthcare professionals, particularly physiotherapists, due to the physical demands of their work. The link between physical ailments and psychological distress is especially prominent in clinical settings. Objectives: To assess the prevalence of work-related low back pain (LBP), stress, anxiety, and depression among physiotherapists in Saudi Arabia, and to identify associated local risk factors. Methods: A cross-sectional study using convenience sampling included 710 licensed physiotherapists across Saudi Arabia. Participants completed an online survey containing demographic data and the validated measures, including the Visual Analog Scale (VAS) for pain, the Oswestry Disability Index (ODI), and the Depression, Anxiety, and Stress Scale-21 (DASS-21) for psychological distress. Data were analysed using descriptive statistics, chi-square tests, correlation, and regression analyses. Results: Of 710 responses, 697 were valid; 378 physiotherapists reported work-related LBP. The mean pain intensity was 4.6 (SD = 1.6), with 54.2% experiencing moderate to severe disability. Mental health results showed 49.7% had depressive symptoms and 33.9% experienced some level of anxiety. Significant correlations were observed between disability and psychological distress (anxiety: r = 0.382; depression: r = 0.375; stress: r = 0.406; all p < 0.001). Regression analyses indicated psychological distress significantly predicted disability, with R² values ranging from 0.125 to 0.248, being higher among inpatient physiotherapists. Conclusions: This study reveals a high prevalence of LBP and psychological distress among Saudi physiotherapists, with stress being the strongest predictor of LBP severity. Integrated ergonomic and mental health interventions, including workplace wellness programs and psychological support, are recommended to reduce risks and promote a healthier, more sustainable physiotherapy workforce. Full article

Background: Human activity is recognised as a major contributor to changes in Earth’s climate, land surface, oceans, ecosystems, and biodiversity. These alterations are largely due to greenhouse gas emissions, deforestation, mass pollution, and land degradation. In light of these environmental challenges, examining the psychological determinants of pro-environmental behaviour has become increasingly important. Study’s Aim: To provide a comprehensive model evaluating the structural relationships among biospheric values, green self-identity, green self-efficacy, and eco-anxiety to investigate the underlying mechanisms relating to the adoption of various pro-environmental behaviours (PEBs). Methods: An online self-report questionnaire was completed by 510 Italian participants (aged 18–55, M = 35.18, SD = 12.58) between November and December 2023. Data analysis was performed using R statistical software, employing Structural Equation Modelling. Results: The results indicate that eco-anxiety, green self-efficacy, and green self-identity are significant positive predictors of PEBs. Furthermore, green self-identity significantly influences eco-anxiety and green self-efficacy, while biospheric values are a major trigger for both green self-efficacy and green self-identity, but not for eco-anxiety. Conclusions: These findings suggest that while eco-anxiety can be an adaptive motivator for PEBs, biospheric values foster a green self-identity and self-efficacy, which in turn drive pro-environmental actions. The study concludes that encouraging biospheric values and strong green self-identity is crucial for promoting sustainable behaviours. Full article

Healthcare abuse is a critical human rights and public health issue, particularly impacting medical interns and trainees who are vulnerable to mistreatment during their formative professional years. This cross-sectional study, conducted from February to June 2024, evaluated the prevalence and psychological impact of harassment and discrimination among 463 healthcare interns in Saudi Arabia from various specialties, including medicine, nursing, pharmacy, and dentistry. Using a self-administered online questionnaire, we found that mistreatment was widely reported, with female interns experiencing significantly higher rates of sexual harassment and gender-based discrimination. Common perpetrators included residents, lecturers, professors, nurses, and patients, with incidents most frequently occurring in surgical and internal medicine departments. Despite high prevalence, only 9% of interns reported the abuse due to mistrust in reporting systems or failure to recognize the behavior as abuse. These experiences were associated with significant psychological distress, including frustration, reduced motivation to learn, and higher DASS scores, particularly among female interns. The study underscores the need for institutional reforms, including policy development, cultural change, and effective reporting systems to ensure a safe and supportive learning environment for future healthcare professionals. Addressing abuse in medical training is essential for individual well-being and the sustainability and integrity of healthcare systems. Full article

Background: Dog agility is a rapidly growing sport involving a partnership between a dog and the handler, running through an obstacle course. Despite its increasing popularity and physical benefits, research on handler injuries remains limited. This study aimed to assess injury epidemiology of athletes practicing dog agility. Methods: This cross-sectional study was conducted using a comprehensive online survey consisting of 124 items, available in both English and Italian. The questionnaire was divided into four sections: Introduction collected demographic data and medical history; Materials and Methods focused on agility-related activities; Results explored injuries sustained in the past 12 months; Discussion examined training habits unrelated to agility. Results: Among 389 participants, the most represented age group ranged between 30 and 40 years old. Overall, 7% reported upper limb injuries, while 27% experienced at least one lower limb injury. Additionally, 20% of participants used medication, and 25% reported at least one chronic illness. On average, handlers trained twice per week and competed in two events per month. Lower limb injuries were predominantly muscular (49%) or ligamentous (14%) and most commonly occurred on grass pitches (56%). These injuries were more common in participants with a higher BMI, those using dynamic handling styles, and those competing at higher levels. Conclusions: This cross-sectional study highlighted the importance of identifying risk factors associated with dog agility handlers. Lower limb injuries were the most common, often associated with increased physical demands and handling styles involving intensive running and correlated with reduced physical fitness. Athletic conditioning, including structured warm-up and cool-down practices, might help decline injury risks. Full article

Background/Objectives: Ancient grains are increasingly recognized for their nutritional value, environmental sustainability, and connection to traditional agriculture. This study examines Italian consumers’ awareness, purchasing habits, and willingness to pay (WTP) for ancient grain pasta, focusing on the influence of product origin, price, and flour type on preferences. Methods: An online survey was conducted with 3020 Italian household grocery shoppers. Descriptive statistics assessed awareness and purchasing behavior, while conjoint analysis (CA) evaluated the relative importance of key product attributes (origin, price, and flour type) in pasta choices. The sample was segmented based on consumer knowledge of ancient grains. Results: A significant portion of respondents reported familiarity with ancient grains, perceiving them as “less refined” and “more digestible”; pasta emerged as the most purchased product. CA results indicated product origin as the most influential factor, followed by price, with flour type having comparatively lower influence. Notably, consumers more familiar with ancient grains showed a slight preference for ancient flour types and were less sensitive to price. Conclusions: While origin and price are primary drivers for pasta choices, knowledgeable consumers show greater valuation for flour type and accept higher prices. These findings provide strategic insights for stakeholders seeking to promote traditional, sustainable agri-food products through targeted marketing and transparent value communication. Full article