Search Results (210)

Background and Aim: Type 2 diabetes (T2D) continues to pose a significant public health challenge worldwide. Among therapeutic options, glucagon-like peptide-1 receptor agonists (GLP-1 RAs) have proven effective in optimizing glycemic control and improving cardiometabolic profiles. Semaglutide, now available in an oral formulation, represents a modern strategy to improve patient adherence while supporting glucose and weight regulation. This study primarily investigated the effects of oral semaglutide on key metabolic indicators and secondary endpoints included cardiovascular risk markers (blood pressure and lipid profile) and patient-reported quality of life (QoL). Study Design and Methods: A longitudinal, prospective observational study was conducted involving patients with T2D across two Italian healthcare facilities. Participants were assessed at baseline (T0) and at three subsequent intervals—6 months (T1), 12 months (T2), and 18 months (T3)—following the initiation of oral semaglutide use. Key Findings: Out of 116 participants enrolled, 97 had complete and analyzable data. Across the 18-month follow-up, significant improvements were observed in glycemic parameters, with a notable reduction in HbA1c levels (T0 vs. T3, p = 0.0028; p ≤ 0.05, statistically significant). Self-reported outcomes showed enhanced quality of life, especially in treatment satisfaction and perceived flexibility (T0 vs. T3, p < 0.001). Conclusions: Daily administration of 14 mg oral semaglutide in individuals with T2D resulted in substantial benefits in glycemic regulation, weight reduction, cardiovascular risk management, and overall patient satisfaction. These findings reinforce its potential role as a sustainable and effective option in long-term diabetes care from both a clinical and public health perspective. Full article

Urban forests, as a form of green infrastructure, play a vital role in enhancing urban resilience, environmental health, and quality of life. However, users perceive and utilize these spaces in diverse ways. This study aims to identify latent perception types among urban forest visitors and analyze their behavioral, demographic, and policy-related characteristics in Incheon Metropolitan City (Republic of Korea). Using latent class analysis, four distinct visitor types were identified: multipurpose recreationists, balanced relaxation seekers, casual forest users, and passive forest visitors. Multipurpose recreationists preferred active physical use and sports facilities, while balanced relaxation seekers emphasized emotional well-being and cultural experiences. Casual users engaged lightly with forest settings, and passive forest visitors exhibited minimal recreational interest. Satisfaction with forest elements such as vegetation, facilities, and management conditions varied across visitor types and age groups, especially among older adults. These findings highlight the need for perception-based green infrastructure planning. Policy recommendations include expanding accessible neighborhood green spaces for aging populations, promoting community-oriented events, and offering participatory forest programs for youth engagement. By integrating user segmentation into urban forest planning and governance, this study contributes to more inclusive, adaptive, and sustainable management of urban green infrastructure. Full article

At the Politecnica Salesiana University (UPS) in Guayaquil, Ecuador, urban mobility challenges were addressed with the aim of improving students’ quality of life and promoting sustainability. This study evaluated the technical, economic, and social feasibility of implementing a shared transportation (carpooling) system using a quantitative-descriptive approach. Surveys were applied to a stratified sample of 256 students to analyze transportation habits. Route planning was performed using ArcGIS software, and costs were calculated with Microsoft Excel. Social impact assessment involved focus groups and analysis of variables such as changes in mobility patterns, system acceptance, and perceived safety, comfort, and accessibility. Key indicators included the percentage of students willing to participate in the pilot (82.7%), satisfaction with travel time savings (85.7% fully satisfied), and positive perceptions of safety and comfort. The results suggest that the proposed system is not only economically viable but also widely accepted by students, contributing to reduced stress, travel time, and single-occupancy vehicle use. This study demonstrates the feasibility of shared transport in urban universities and provides a replicable model to guide sustainable mobility policies that improve safety, comfort, and efficiency in student commuting. Full article

This exploratory study investigated how health concerns related to chronic environmental contamination and how satisfaction with the human biomonitoring (HBM) process influence the perceived quality of life in the context of per- and polyfluoroalkyl substances (PFAS) contamination in the Veneto Region (Italy). We administered a questionnaire to 84 residents of the Red Area, where PFAS exposure is classified as most severe. The main findings revealed that satisfaction with HBM was positively correlated with perceived quality of life and showed a statistically significant but modest moderation effect on the relationship between PFAS-related health concerns and quality of life (explaining 17.4% of the variance). Particularly, it attenuates the negative effect that PFAS health concerns have on quality of life. Differences between subgroups revealed heightened concern regarding PFAS health risks among women vs. men and participants with children vs. those without. These results underscore the central role of relational and communication aspects of HBM programs to mitigate psychological distress and possibly contribute to higher perceived well-being. The study highlights the need for tailored public health interventions, including transparent communication, empathetic support, and community engagement, to address the psychosocial dimensions of environmental contamination. Full article

Studying consumers’ willingness to pay (WTP) for sustainable certification labels and preferences in consumption is a relevant issue for policymakers. Several studies have revealed a positive WTP a premium price for many certified products. The aim of this paper is to assess an overview of Italian consumers’ WTP for eight different sustainable certification labels and to collect information about their consumption preferences and perceptions in consumption. Participants were selected by stratified simple random sampling, using regional distribution, gender, and age as stratification criteria, to obtain a representative sample of n = 3600. Eight ordered logit models were estimated to understand how consumer sociodemographic characteristics influence the price premium. The results show important differences in WTP among different certification labels; a higher WTP emerged for ethical certifications than for environmentally focused labels. Younger individuals; women; and those with higher education, income and life satisfaction, as well as consumers in southern regions, were significantly more willing to pay premiums for certified products. However, a key finding for policymakers is that the stated price premium consumers are willing to pay falls significantly short of the actual higher costs of these products in supermarkets. Furthermore, insights into consumer perceptions and preferences revealed that quality and origin are perceived as key price drivers, while method of production holds less importance. It also emerged that consumers primarily seek a balance between quality and price, with only a small segment prioritizing certified products. Full article

Background/Objectives: Patients undergoing open aortic and valvular surgery often experience postoperative deconditioning, yet research on the role of inpatient cardiac rehabilitation (CR) in this population remains limited. This study aimed to examine the effects of inpatient CR on muscle strength, mobility, psychological well-being, and quality of life in patients recovering from open aortic surgery. Methods: We conducted a retrospective study using the medical records of patients who participated in inpatient CR after open aortic surgery. Functional and psychological outcomes were evaluated using the Medical Research Council (MRC) sum score, Timed Up and Go (TUG) test, Five Times Sit-to-Stand test (5STS), Six-Minute Walk Distance (6MWD), Berg Balance Scale (BBS), Modified Barthel Index (MBI), Patient Health Questionnaire-9 (PHQ-9), and the EuroQol-5D (EQ-5D). Pre- and post-rehabilitation scores were compared to assess changes in functional status, mobility, and quality of life. A post-discharge satisfaction survey was also analyzed. Results: A total of 33 patients were included. Significant improvements were observed in MBI (p < 0.001), MRC sum score (p < 0.001), 6MWD (p < 0.001), BBS (p < 0.001), TUG (p = 0.003), 5STS (p < 0.001), EQ-5D (p = 0.011), and PHQ-9 (p = 0.009) following inpatient CR. Patients with lower baseline mobility (6MWD ≤ 120 m) exhibited greater improvement in MBI (p = 0.034). Of the 33 patients, 26 completed the satisfaction survey; most reported high satisfaction, perceived health improvements, and willingness to recommend the program. Conclusions: Inpatient CR following open aortic and valvular surgery resulted in significant gains in muscle strength, mobility, psychological health, and overall quality of life. Patients with greater initial impairment demonstrated especially notable functional improvement, supporting the value of tailored CR in this population. Full article

This paper examines how artificial intelligence (AI) can be strategically deployed to enhance urban planning and environmental livability in Riyadh by generating data-driven, people-centric design interventions. Unlike previous studies that concentrate primarily on visualization, this research proposes an integrative appraisal framework that combines AI-generated design with site-specific environmental data and native vegetation typologies. This study was conducted across key jurisdictional areas including the Northern Ring Road, King Abdullah Road, Al Rabwa, Al-Malaz, Al-Suwaidi, Al-Batha, and King Fahd Road. Using AI tools, urban scenarios were developed to incorporate expanded pedestrian pathways (up to 3.5 m), dedicated bicycle lanes (up to 3.0 m), and ecologically adaptive green buffer zones featuring native drought-resistant species such as Date Palm, Acacia, and Sidr. The quantitative analysis of post-intervention outcomes revealed surface temperature reductions of 3.2–4.5 °C and significant improvements in urban esthetics, walkability, and perceived safety—measured on a five-point Likert scale with 80–100% increases in user satisfaction. Species selection was validated for ecological adaptability, minimal maintenance needs, and compatibility with Riyadh’s sandy soils. This study directly supports the Kingdom of Saudi Arabia’s Vision 2030 by demonstrating how emerging technologies like AI can drive smart, sustainable urban transformation. It aligns with Vision 2030’s urban development goals under the Quality-of-Life Program and environmental sustainability pillar, promoting healthier, more connected cities with elevated livability standards. The research not only delivers practical design recommendations for planners seeking to embed sustainability and digital innovation in Saudi urbanism but also addresses real-world constraints such as budgetary limitations and infrastructure integration. Full article

Background and Objectives: Chronic kidney disease frequently progresses to end-stage renal disease, requiring dialysis, which imposes significant physical, psychological, and social burdens. Age is a key factor influencing symptom experience and quality of life in dialysis patients, yet findings on its impact remain mixed. This study aimed to examine how age relates to a broad range of health domains—including fatigue, pain, cognition, mental health, sexual satisfaction, bowel control, visual impairment, social support, and quality of life—among hemodialysis patients. Materials and Methods: A cross-sectional study was conducted at a single dialysis center in Poland, involving 79 adult patients undergoing maintenance hemodialysis. Standardized, validated psychometric instruments were used, including the Modified Fatigue Impact Scale (MFIS), Perceived Deficits Questionnaire (PDQ), Pain Effects Scale (PES), Mental Health Inventory (MHI), Modified Social Support Survey (MSSS), Sexual Satisfaction Scale (SSS), Bowel Control Scale (BWCS), Impact of Visual Impairment Scale (IVIS), and WHOQOL-BREF for quality of life. Spearman’s or Pearson’s correlation coefficients were used to evaluate relationships between age and scale scores. Full and abbreviated versions of scales were also compared. Results: Age showed moderate positive correlations with fatigue (ρ = 0.44–0.53), cognitive deficits (ρ = 0.37–0.45), pain (r = 0.41), bowel control issues (ρ = 0.32), and visual impairment (ρ = 0.37), all statistically significant (p < 0.01). No significant associations were observed between age and mental health (MHI), perceived social support (MSSS), or quality of life (WHOQOL-BREF). Abbreviated versions of the scales showed strong correlations with their full versions (ρ > 0.9). Conclusions: While age is linked to increased symptom burden in select domains such as cognition, fatigue, and pain, it does not significantly affect mental health, perceived social support, or overall quality of life in hemodialysis patients. These findings support the use of age-sensitive, multidimensional assessments to inform individualized care strategies. Full article

Background and objectives: Duloxetine is widely used for the treatment of major depressive disorder (MDD), generalized anxiety disorder (GAD), and various types of neuropathic pain. While its efficacy is well documented in clinical trials, less is known about how it is perceived and utilized in routine psychiatric practice. To address this knowledge gap, we conducted a cross-sectional observational study involving 80 psychiatrists from Spain to assess real-world clinical attitudes toward duloxetine. Methods: Participants completed a 20-item multiple-choice questionnaire that examined familiarity, perceived efficacy in multiple conditions (MDD, GAD, neuropathic pain, somatization, and quality of life), and perspectives on tolerability, safety, adherence, and overall satisfaction. Results: Survey results indicated that a large majority of psychiatrists frequently prescribe duloxetine, particularly for patients with MDD and comorbid chronic pain. Notably, 94% rated it as either “more effective” or “much more effective” for diabetic peripheral neuropathic pain. Psychiatrists reported a high perceived efficacy of duloxetine: 94% rated it as “more effective” or “much more effective” for diabetic peripheral neuropathy, and 93% gave similarly positive ratings for general neuropathic pain. For somatization, 70% found it “effective” or “very effective”, and 83% observed improvements in quality of life for many of their patients. Psychiatrists generally reported favorable perceptions of duloxetine’s tolerability profile: 97.5% rated it as the antidepressant associated with the least weight gain, and 82.5% perceived fewer sexual side effects compared to other options. Sedation and gastrointestinal side effects were generally considered mild or less severe. In terms of treatment adherence, 69% rated it as “better” or “much better” than other antidepressants, and 80% found its combination with other antidepressants to be “favorable” or “very favorable”. Overall satisfaction was high, with 99% of psychiatrists reporting being either “satisfied” or “very satisfied” with its use. The side effect profile was generally viewed as manageable, with low perceived rates of weight gain, sedation, and sexual dysfunction. Furthermore, 96% of respondents expressed a willingness to recommend duloxetine to their colleagues. Conclusions: Psychiatrists reported highly favorable attitudes toward duloxetine, viewing it as a flexible treatment option in routine care. However, these findings reflect clinicians’ subjective perceptions rather than objective clinical outcomes and should be interpreted accordingly. Full article

The aim of this paper is to analyze how young people in Slovakia perceive individual attributes of quality of life and to highlight the positive correlation with ethical values acquired primarily through family upbringing and, significantly, through the national education system. Quality of life is understood as a multidimensional concept encompassing opportunities, fulfillment of human needs, and subjective well-being, including dimensions such as happiness and life satisfaction. These aspects are strongly influenced by ethical values, which are particularly shaped by compulsory ethics or religious education provided to children aged 6–15 within the Slovak national curriculum. To explore the link between ethically grounded education and perceived quality of life among youth, a questionnaire-based survey was conducted. The findings reveal significant correlations between ethical or religious education and various quality of life indicators, emphasizing the importance of ethical education in shaping socially responsible and value-oriented young citizens. This study contributes to understanding the cultural and educational context influencing youth perceptions of quality of life in Slovakia. Full article

Background/Objectives: Despite its well-established health benefits, adherence to the Mediterranean lifestyle (MedLife) has declined globally, including in its region of origin, alongside a significant shift toward ultra-processed food consumption. Understanding the factors associated with MedLife adherence is essential for developing targeted interventions and tailored policy recommendations. As part of the MEDIET4ALL PRIMA project, this cross-sectional study aimed to comprehensively examine geo-demographic, socio-economic, psychological, behavioral, and barrier-related factors associated with and potentially contributing to MedLife adherence. Methods: Data were collected from 4010 participants aged 18 years and above across ten Mediterranean and neighboring countries using the multinational MEDIET4ALL e-survey, which included the validated MedLife index, along with various other questionnaires. Results: Results indicate that only 22% of respondents demonstrated high adherence to the Mediterranean lifestyle (MedLife), with significant variability observed across countries, age groups, education levels, and health statuses. Spain had the highest proportion of participants with high adherence (38%). Factors associated with significantly higher adherence rates include older age, living in the Mediterranean region, higher education levels, a greater awareness of MedLife principles, lower perceived barriers, normal BMI, better health status, and stable economic and marital conditions (p-values ranging from 0.04 to <0.001). Additionally, individuals with high MedLife adherence exhibited more socially and physically active lifestyles and experienced less psychological strain (p < 0.001). Regression analyses identified MedLife awareness as the strongest positive predictor of adherence (β = 0.206), followed by social participation (β = 0.194) and physical activity (β = 0.096). Additional positive contributors include life satisfaction, sleep quality, living in the Mediterranean region, age, and education (β ranging from 0.049 to 0.093). Conversely, factors that are negatively associated with adherence include sedentary behavior, living environment, and barriers such as low motivation, taste dislike, price unaffordability, limited availability, and the time-consuming nature of preparing Mediterranean food (MedFood; β ranging from −0.036 to −0.067). Conclusions: These findings indicate that fewer than one in four adults across Mediterranean and neighboring countries demonstrate high adherence to MedLife, supporting prior evidence of suboptimal adherence even within Mediterranean regions. This study identified a range of behavioral, socio-demographic, and environmental factors—both positive and negative predictors—that can help guide the design of targeted, culturally adapted interventions to promote MedLife behavior. Future research should incorporate objective measurements and longitudinal monitoring to better understand underlying mechanisms, establish causality, and develop sustainable strategies for enhancing MedLife adherence in diverse populations. Full article

Background: Primary focal hyperhidrosis, characterized by excessive sweating primarily affecting the hands and axillae, can significantly impact quality of life. Bilateral thoracic sympathectomy is the gold standard treatment, providing permanent resolution of palmar hyperhidrosis. Most studies evaluating outcomes and patient satisfaction after sympathectomy focus on short- to medium-term follow-up, typically up to 5 years. This study aimed to assess anxiety, satisfaction, and sweat redistribution 20 years after bilateral endoscopic thoracic sympathectomy. Methods: Between January 2002 and December 2003, 106 patients with primary hyperhidrosis underwent bilateral endoscopic thoracic sympathectomy targeting ganglia T2–T3 at our center. The patients were contacted via telephone in 2023 and asked to complete the same survey they had filled out preoperatively and 12 months postoperatively. The survey evaluated sweat redistribution, anxiety, hyperhidrosis-related symptoms, and satisfaction. Anxiety, satisfaction, and perceived sweating were rated using a 5-point visual analog scale (VAS) ranging from 0 (unsatisfied/no symptoms) to 4 (very satisfied/severe symptoms). Results: Of the 106 eligible patients, 24 (22.6%) completed the survey. Most reported persistent anhidrosis (palmar or palmar–axillary) 20 years post-surgery. The survey results remained consistent with those at the 1-year follow-up. Significant sweat redistribution to the abdomen and back was observed. Patient satisfaction remained high, with no significant differences between the 1-year and 20-year assessments. Anxiety significantly decreased compared to preoperative levels (p < 0.001). Conclusions: Bilateral endoscopic thoracic sympathectomy is an effective long-term treatment for reducing excessive sweating. Patient satisfaction remains high over time, despite the persistence of compensatory sweating. Full article

Core stability is fundamental to posture, balance, and force transmission throughout the kinetic chain. Although traditionally associated with athletic performance, emerging research highlights its broader applicability to recreational fitness. This study investigates the effects of an eight-week core training program on muscle hypertrophy, static balance, and neuromuscular control in recreationally active, non-athletic adults. Participants will undertake a structured intervention comprising progressive triads targeting core stability, strength, and power. Assessment methods include surface electromyography (EMG), ultrasound imaging, three-dimensional force plates, Kinovea motion analysis, and the Satisfaction With Life Scale (SWLS) questionnaire. Expected outcomes include enhanced core muscle activation, improved static balance, and increased core-generated force during overhead medicine ball slam trials. Additionally, the intervention aims to facilitate hypertrophy of the transverse abdominis, internal oblique, and lumbar multifidus muscles, contributing to spinal resilience and motor control. This protocol bridges gaps in core training methodologies and advances their scalability for recreational populations. The proposed model offers a structured, evidence-informed framework for improving core activation, postural stability, muscle adaptation, movement efficiency, and perceived quality of life in recreationally active individuals. Full article

Background/Objectives: Breast cancer (BCA) is one of the most common cancers affecting women worldwide. Screening has been linked to up to a 33% reduction in breast cancer-related deaths by helping detect tumors at an early stage. The successful implementation of community-based breast cancer screening programs depends on understanding the attitudes of women within the target community. This study aims to systematically review the literature to assess the association between women’s attitudes toward breast cancer screening and their life satisfaction and general attitudes toward life. We also aimed to examine women’s attitudes toward breast cancer screening recommendations and the factors that influence these attitudes. Methods: A systematic review of English-language literature was carried out. PubMed and Scopus were searched up to November 2024 for studies that met the predefined inclusion criteria. Methodologic quality was assessed using the adapted Newcastle–Ottawa Scale for cross-sectional studies and the corresponding scale for cohort studies. Results: Eleven studies met the inclusion criteria. The percentage of women who had undergone at least one breast cancer screening ranged from 8.3% to 94.5%. Women’s attitudes toward and participation in breast cancer screening were linked to psychological, social, and demographic factors. Lower levels of life satisfaction, self-efficacy, and perceived control or mastery in life, along with higher levels of non-work-related stress, and higher levels of optimism, were associated with a lower likelihood of participating in breast cancer screening. Full article

Questionnaire data plays a key role in social research, especially when evaluating public attitudes using Likert-type scales. Yet, traditional analyses often merge some ordinal categories and exclude responses such as Don’t Know, No Answer, or Refused—risking the loss of valuable information. This study introduces BS-TOSIE (Belief Structure-Based TOPSIS for Survey Item Evaluation), a novel method that preserves and integrates all response types, including ambiguous ones. By combining the Belief Structure framework with the TOPSIS (Technique for Order Preference by Similarity to Ideal Solution) method, BS-TOSIE offers a structured approach to ranking and evaluating individual survey items measured on an ordinal scale, even in the presence of missing or incomplete data. Response distributions are transformed into a belief structure vector, enabling comparison against ideal and anti-ideal benchmarks. We demonstrate this approach using data from the Quality of Life in European Cities survey to assess perceptions of local governance in European cities. This study analyzes changes in citizen satisfaction with local public administration across five key dimensions—timeliness, procedural clarity, fairness of fees, digital accessibility, and perceived corruption—in 83 European cities between 2019 and 2023. The findings reveal persistent regional disparities, with Northern and Western European cities consistently outperforming those in Southern and Eastern Europe, although some cities in Central Europe show signs of improvement. Zurich consistently received high satisfaction scores, while other cities, such as Rome and Palermo, showed lower scores. Unlike traditional methods, our approach preserves the full spectrum of responses, yielding more nuanced and interpretable insights. The results show that BS-TOSIE enhances both the clarity and depth of survey analysis, making a methodological contribution to the evaluation of ordinal data and offering empirical insights into public perceptions of local city administration. Full article