Search Results (583)

Food fraud represents a growing global challenge with significant implications for public health, market integrity, sustainability, and consumer trust. Beyond economic losses, fraudulent practices undermine the environmental and social sustainability of food systems by distorting markets, misusing natural resources, and weakening incentives for authentic and responsible production. Despite the establishment of harmonized frameworks of the European Union for official controls, the increasing complexity of food supply chains has exposed persistent gaps in fraud detection, particularly for high-value products such as those with PDO (Protected Designation of Origin) and PGI (Protected Geographical Ιndication) Certification. This study investigates the perceptions, attitudes, and experiences of frontline inspectors in Greece to assess current challenges and opportunities for strengthening official food fraud controls. Data were collected through a structured questionnaire, validated by experts and administered nationwide, involving 122 participants representing all major national food inspection authorities. Statistical analysis revealed significant institutional differences in perceptions of fraud prevalence, with mislabeling of origin, misleading organic claims, ingredient substitution, and documentation irregularities identified as the most common fraudulent practices. Olive oil, honey, meat, and dairy emerged as the most vulnerable product categories. Inspectors reported relying primarily on consumer complaints and institutional databases as key tools for identifying fraud risks. Food fraud was perceived to contribute strongly to losses in consumer trust in food safety and product authenticity, as well as to the erosion of sustainable production models that depend on transparency, fair competition, and responsible resource use. Overall, the findings highlight detection gaps, uneven resources across authorities, and the need for improved coordination and capacity-building to support more efficient, transparent, and sustainability-oriented food fraud control in Greece. Full article

This study provides a comprehensive long-term assessment of dithiocarbamate (DTC) fungicide residues in foods consumed in Brazil, analyzing nearly two decades of official monitoring data from the Pesticide Residue Analysis Program (PARA/ANVISA) from 2001 to 2023. By integrating fragmented annual reports into a single temporal framework, this study offers a novel evaluation of detection frequencies, residue levels, and regulatory compliance over time. Of the 21,274 samples analyzed, 23.90% contained residues of these fungicides. Papaya showed the highest detection frequency (92.59%) in 2005, while apple showed the highest average percentage of detections (51.68%). Lettuce showed the highest residual levels (10.05 mg kg⁻¹) in samples from the 2017–2018 cycle, despite the lack of authorization for the use of these products in this crop. Strawberries and carrots showed concentrations above the maximum residue limit (MRL), with excesses. Residues of unauthorized pesticides were also detected in crops such as guava, pineapple, and sweet potato. Temporal correlations between detections and residues indicated significant variations among the foods evaluated, with potatoes, strawberries, and lettuce showing the highest residual levels. An overall declining trend in detections and residue concentrations was observed throughout the analyzed period, potentially reflecting improvements in regulatory oversight, agricultural practices, and analytical sensitivity over time. From a public health perspective, the persistence of elevated residues and unauthorized uses highlights the need for continuous surveillance, strengthened enforcement, and risk communication strategies to ensure food safety and consumer protection. Full article

Interest in plant-based diets has grown expressively in different regions of the world. However, the missing regulation for meat analogs may mislead consumers by suggesting that these products are the same as the meat they are replacing. Therefore, this study aims to analyze the current global scenario of meat analogs, discuss consumption changes and their regulation, as well as pointing out future perspectives for the sector. A narrative literature review was performed using scientific papers from the Virtual Health Library (BVS), LILACS, PubMed (NIH), Embase, Web of Science, Scopus, and official documents. Included studies were aligned with the research theme, concentrating on countries with regulations for plant-based analog products and those lacking or pursuing such regulations. Additionally, studies were selected based on the following criteria: original or review studies from different countries, papers discussing meat analogs in terms of consumption, sensory attributes, market dynamics, sustainability, regulation, food safety; availability of full text; and publication dates ranging from 2015 to 2025. The data reveals that most of the assessed nations still lack specific regulations for meat analog products, adopting general labeling and naming standards that range from flexible approaches to strict restrictions. To conclude, the article highlights that meat substitutes are emerging as promising and sustainable options; however, their true consolidation is conditioned on the existence of more defined regulatory frameworks, increased consumer confidence, and market conditions that favor their large-scale adoption. Full article

Background/Objectives: Seasonal influenza imposes a significant burden on pediatric public health. Despite official recommendations and full insurance coverage, vaccination rates among children in Slovakia remain critically low. This study aims to analyze the attitudes, beliefs, and determinants of parental hesitancy regarding childhood influenza vaccination in the post-pandemic context. Methods: A single-center cross-sectional survey was conducted between February and March 2025 using convenience sampling among parents of children attending a pediatric immunoallergology center. An anonymous questionnaire collected data on demographics, risk perception, and attitudes. Data from 301 parents were analyzed using descriptive statistics, chi-squared tests, and odds ratios (OR) to identify key predictors of hesitancy. Results: Only 27.6% of parents expressed willingness to vaccinate their children, while 42.5% were opposed and 29.9% hesitant. Statistical analysis revealed no significant association between parental university education and vaccination intent (p > 0.05), indicating that vaccine hesitancy in this specific setting was present across all educational backgrounds. However, the source of information proved to be a critical determinant: consulting a pediatrician significantly increased the odds of acceptance (OR = 6.32; 95% CI: 3.54–11.28), whereas reliance on the internet and social media was a significant predictor of refusal (OR = 0.29; 95% CI: 0.17–0.50). The primary reported barrier was fear of adverse effects (70.4%), which significantly outweighed doubts about efficacy (30.2%). Conclusions: Parental hesitancy in Slovakia is a widespread phenomenon pervasive across all educational backgrounds, driven primarily by safety concerns and digital misinformation. The contrast between the protective influence of pediatricians and the negative impact of digital media underscores that clinical encounters are currently the most effective firewall against hesitancy. Public health strategies must therefore pivot from general education to empowering pediatricians with active, presumptive communication strategies. Full article

Purpose: Child sexual abuse (CSA) is a major public health and forensic concern, often involving delayed disclosure that limits evidence collection and affects judicial outcomes. This study analyzed disclosure patterns, victim–perpetrator characteristics, and forensic findings in CSA cases evaluated in Greece, contributing to the limited Southern European evidence base. Material and Methods: A retrospective review of 89 CSA cases (2014–2024) examined by a certified forensic physician at the Department of Forensic Medicine and Toxicology, National and Kapodistrian University of Athens, was conducted. Data from official medico-legal reports included demographics, abuse context, forensic findings, and disclosure interval. Statistical analyses explored factors associated with delayed disclosure (>7 days). Results: Victims were predominantly female (69.7%) with a mean age of 9.8 years. Most perpetrators were adult males, and over half of cases (53.9%) involved intrafamilial abuse. The mean delay in disclosure was 79 days; only 29.2% reported within one week. Recurrent abuse correlated with delayed disclosure (p = 0.006), while early disclosure was associated with biological evidence collection (p < 0.001). Physical injuries were observed in 23.6% of victims, genital findings in 17%, and anal findings in 3.4%. Conclusions: Delayed disclosure was common and significantly reduced the likelihood of identifying forensic evidence. The early application of trauma-informed examinations, which adopt a child-centered approach emphasizing safety, emotional regulation, and the prevention of re-traumatization, is essential for the medical and forensic evaluation of abused children. Adopting hospital-based multidisciplinary units could improve forensic documentation, interagency coordination, and psychosocial care in Greece. Full article

Background/Objectives: Dementia represents a growing public health challenge. The WHO Global Action Plan on the Public Health Response to Dementia emphasizes early detection, risk reduction, and innovation as key priorities. Mild Behavioral Impairment (MBI), defined as the emergence of persistent neuropsychiatric symptoms in older individuals, represents a potential marker of early neurodegeneration and possible window for early intervention. This review explores the role of MBI in dementia prevention, mapping current evidence within the WHO Global Action Plan framework. Methods: A comprehensive search was performed in PubMed, Scopus, and the official WHO website, during 1 September 2025–10 November 2025, without time restrictions. Eligible sources included original clinical studies, reviews, and policy documents addressing MBI, dementia prevention, and public health. Data were thematically synthesized according to the seven objectives of WHO: (1) dementia as a public health priority, (2) dementia awareness and friendliness, (3) dementia risk reduction, (4) dementia diagnosis, treatment, care and support, (5) support for dementia carers, (6) information systems for dementia, and (7) dementia research and innovation. Results: Accumulating evidence indicates that MBI assessment can capture early behavioral manifestations of neurodegenerative and other forms of dementia, correlating with fluid, neuroimaging and genetic biomarkers. Integrating MBI screening through the easy-to-administer MBI Checklist (MBI-C) into clinical and community-based care, including telemedicine pathways and research, may enhance early identification and personalized interventions, enrich the pool for clinical trials, and facilitate research in biomarker and therapy. MBI-related research further supports its integration in remote digital monitoring and population-based prevention. Conclusions: Embedding MBI-informed screening and interventions into national dementia strategies aligns with WHO objectives for early, equitable and scalable prevention and brain health. Full article

Municipal solid waste management (MSWM) remains a critical environmental governance challenge in rural and peri-urban regions of the Global South, where service delivery gaps exacerbate illegal dumping and public health risks. Geographic Information Systems (GIS) are increasingly promoted as decision-support tools to improve waste collection efficiency and environmental monitoring; however, their adoption in resource-constrained municipalities remains limited. This study investigates the institutional and policy barriers shaping GIS readiness in four rural municipalities within South Africa’s Vhembe District. Using a qualitative case-study design, semi-structured interviews were conducted with 29 municipal officials across managerial and operational levels, complemented by 399 community responses to an open-ended survey question. Thematic analysis, guided by Institutional Theory and the Technology Acceptance Model (TAM), identified five interrelated themes: waste production and disposal behaviours, collection and infrastructure constraints, institutional and operational challenges, policy and standardisation gaps, and technology readiness. The findings reveal that weak service reliability, fragmented governance structures, limited human and financial capacity, and inconsistent policy enforcement collectively undermine GIS adoption, despite its high perceived usefulness among officials. The study demonstrates that the effectiveness of GIS as an environmental management tool is contingent on institutional readiness rather than technological availability alone and highlights the need for integrated reforms in service delivery, institutional capacity, and policy implementation to enable GIS-supported sustainable waste management. Full article

Background/Objectives: Vaccination programs are highly effective public health interventions, yet parental hesitancy toward combination vaccines has led to growing demand for alternative vaccination schedules, defined in this study as parental requests to split or replace recommended combination vaccines with single-antigen vaccines for non-clinical reasons. While parental attitudes have been widely studied, little empirical evidence exists on the real-world use of single-antigen vaccines and their public health implications in countries with otherwise high coverage. This study examined the prevalence patterns and parental motivations for requesting such alternative vaccination schedules in Israel, where national guidelines recommend specific combination vaccines, including measles-mumps-rubella-varicella (MMRV) and the pentavalent diphtheria-tetanus-pertussis–inactivated polio–Haemophilus influenzae type b (DTaP+IPV+Hib) vaccines, but informal accommodations exist. Methods: A mixed-methods design was employed: a retrospective cohort analysis of vaccination data from 2018 to 2021 (before and during the COVID-19 pandemic) focused on measles (first dose at 12 months) and pertussis (four-dose primary series), followed by semi-structured interviews with Maternal and Child Health clinic providers, policymakers, and parents. Results: Alternative vaccination schedules involving single-antigen measles or pertussis vaccines are occasionally used despite official policy, accounting for less than 1% of vaccinations overall. Outcomes include delayed administration, lower uptake of combination vaccines, and incomplete protection in certain groups. Parents cited safety concerns, fear of immune overload, and mistrust of authorities. These concerns were often amplified by misinformation, while providers described balancing parental preferences with the need for adequate coverage. Conclusions: This study provides new evidence on how vaccine hesitancy translates into service utilization, highlights the tension between individualized parental decision-making and contribution to collective health, and underscores the need for communication, policy strategies and service designs that sustain high coverage while addressing community-specific concerns. Full article

Background: Driven by rapid urbanization, infrastructural development, socio-economic growth, and population increase, noise pollution has become a major public health and environmental policy challenge in Moroccan cities. However, current legislation and enforcement mechanisms remain insufficient to address rising exposure levels and associated health risks. Methods: This systematic review followed PRISMA guidelines to examine urban noise levels, health implications, the regulatory frameworks, and policy actions related to noise pollution in Morocco. Various databases were systematically searched (Scopus, Web of Science, Google Scholar), along with reports from international organizations and government bodies for studies published between 2003 and 2025. Eligible documents included peer-reviewed publications and official reports directly addressing Moroccan noise pollution, legislation, urban impacts, or health outcomes. Results: Twenty-three Moroccan studies and additional regional, European, and legislative sources were included. Findings show that average noise levels in Moroccan urban centers generally exceed international safety thresholds and are associated with cardiovascular risks, sleep disturbances, and psychological stress. The regulatory framework suffers from weak enforcement, limited monitoring protocols, and an absence of noise mapping. Tangier, Béni Mellal, Témara, Marrakech, and Casablanca exhibit significant environmental inequalities, particularly in low-income districts. Conclusions: Morocco’s current noise-management system is inadequate to address the growing health and environmental impacts of urban noise. Urgent actions are needed, including a dedicated noise-control law, systematic monitoring, noise mapping, and integration of public-health considerations into environmental governance. Policy reforms must prioritize vulnerable populations and align with international best practices. Full article

This scoping review examines public health communication across nine Eastern European and Central Asian states—Armenia, Azerbaijan, Belarus, Kazakhstan, Kyrgyzstan, Russia, Tajikistan, Turkmenistan, and Uzbekistan—highlighting how these systems have transitioned from Soviet-era legacies to contemporary practices. Eligibility criteria included the English- and Russian-language literature published from 1998 onwards, focusing on nine post-Soviet states. Sources of evidence comprised searches in Google Scholar, ScienceDirect, SSRN, Heliyon, MEDLINE/PubMed, and official government websites. Data were charted by three independent reviewers using a standardized form, with discrepancies resolved by senior reviewers. The review identifies persistent gaps in communication during health crises, with a particular focus on the COVID-19 pandemic, where centralized and hierarchical information flows often undermine transparency and responsiveness, as well as further increased health inequalities between rural and urban health outcomes. Despite ongoing reforms, the communication dimension of healthcare systems remains underdeveloped. Findings reveal that centralized and top-down communication remains a dominant feature across the region, hindering timely dissemination of information and limiting the capacity to counter misinformation, as both misinformation and disinformation sometimes emerge from the government. Ultimately, this review contributes a critical analysis of these systematic communication failures and underscores the need to strengthen public health communication and reduce health inequalities. To do it, governments must prioritize transparency, disclose decision-making processes, and rely on evidence-based messaging to build trust. Effective crisis response requires not only government leadership but also the active engagement of the medical and patient communities, supported by civil society and independent media. This review points out the need for more inclusive, transparent, and trust-oriented communication strategies to enhance public health preparedness and resilience in nine Eastern European and Central Asian contexts. Full article

Background/Objectives: Antimicrobial resistance (AMR) is a major global health issue. Since community pharmacists are frontline health officials regarding the provision and management of antibiotics, it is of great importance to study the knowledge, attitudes, and practices (KAPs) of pharmacists with respect to antimicrobial stewardship (AMS) to formulate specific interventions. In Jordan, where dispensing antibiotics without a prescription is a common situation, this study was designed to assess the KAPs of community pharmacists in southern Jordan on AMR and AMS, the gap in the knowledge base and the practice, and the effect of other variables on antimicrobial education and responsible dispensing. Results: Participant pharmacists (n = 383) confirmed a moderate or lack of knowledge in antibiotic choice, resistance mechanisms, and the basis of stewardship. Despite positive attitudes for AMS, important practice gaps occurred: 38.6% infrequently dispensed antibiotics without prescriptions, 67.4% mistakenly believed that antibiotics may cure viral infections (flu/common cold), and only 33.4% firmly rejected non-prescription antibiotic requests. Knowledge scores were significantly higher among bachelor’s degree pharmacists, public university pharmacists, and urban-working pharmacists. Practice scores were better among master’s degree holders and urban practitioners. Conclusions: This work indicates that the AMS knowledge and practices of pharmacists in the southern Jordanian community are lacking in a severe way, with almost 4 out of 10 having poor behaviors including dispensing non-prescription antibiotics. Full article

Stormwater systems can improve public health and environmental and social conditions in cities, but their effectiveness may be blocked by fragmented project plans and lack of stakeholder support. Systems thinking and institutional analysis were used to assess how these barriers can be addressed and how stormwater systems can become agents of change to support livable and healthy cities. Projects and professional activities were studied to assess stakeholder involvement from low-to-high levels of power and interest in projects. Community stakeholders were developers and social entrepreneurs, government stakeholders included elected officials and staff, and support groups represented engineers, public agency facilitators, and urban planners. Stormwater projects and systems are a focus for engineers, but they often lose their stormwater identify when they are combined with other development projects. The workplace for such projects is the public arena, where cities seek aspirational goals by applying integration through comprehensive planning. However, development projects sometimes fail to comply with the plans. Stormwater may provide the spark for multi-purpose projects as cities must sustain conveyance corridors for connectivity of major flows. However, fragmented project development spurred by rigid capital improvement programs and lack of a path to develop stormwater system connectivity through comprehensive planning and development present barriers. Effective governance is the core issue, and most power is with elected officials, who require public support. The analysis shows need for a road map to utilize stakeholder power to promote stormwater advances by raising awareness and developing practical approaches that work in the spheres of comprehensive planning and capital improvement programming. The road map could be supported by an integrated body of knowledge to frame stormwater management as a combination of urban planning, engineering, and public administration and to encourage these communities to develop a cooperative road map through work among their professional associations. Full article

Iron deficiency anemia remains a major public health concern in Brazil, particularly among children, pregnant women, and women of childbearing age. This scoping review aimed to map the trend line of public policies on iron supplementation and food fortification implemented between 1977 and 2025. The review followed PRISMA-ScR guidelines and the Joanna Briggs Institute methodology, and included searches in PubMed/MEDLINE, Scopus, Web of Science, Embase, Google Scholar, and official government documents. Three main strategies were identified: iron supplementation, mandatory food fortification, and nutrition education. Key milestones included the National Iron Supplementation Program, the 2002 ANVISA Resolution (RDC No. 344/2002) mandating wheat and corn flour fortification, and the launch of the NutriSUS program in 2014. Despite important normative and programmatic advances, persistent critical issues remain, including low adherence, inadequate monitoring, data discontinuity, and bureaucratic barriers. Strengthening intergovernmental coordination, improving information systems, and adopting more bioavailable iron compounds are essential to increase the effectiveness of public policies aimed at preventing and controlling iron deficiency anemia in Brazil. Full article

Through a series of over 100 bilingual interviews with Hispanic San Antonians, the COVID-19 Oral Historias Project documents the Latino/a/e community’s experiences through the pandemic by sharing individual stories, amplifying local voices, and creating compassion in a fragmented time. The present article documents the project itself, contextualizing its creation, detailing its methodology, highlighting the most common themes across interviews, and pointing out its novel contributions. While the interviewees’ experiences are inarguably diverse, narrative threads were found throughout the corpus, united by the duality of the narrators’ experiences; throughout this period, they simultaneously negotiated community norms and official health directives, local and international anxieties, and hopelessness and hope. The project is unique in (1) its language use, privileging minoritized ways of speaking (Spanish and Spanglish); (2) its size, with over 100 interviews; and (3) its clearly delimited scope, with all respondents living in San Antonio. This massive, unified resource creates a public collection of bilingual stories, highlighting non-hegemonic voices that are of value to the community itself, as well as to the recorded history of the pandemic, filling in historical gaps and providing real, lived accounts of this period that might otherwise be lost over time. Full article

Mental disorders encompass conditions that affect cognition, emotions, and behavior, representing a major public health challenge. In Colombia, there are no studies that estimate the burden of disease caused by mental and behavioral disorders. This study aimed to determine the burden of disease attributable to these conditions in the departments of Colombia in 2022. A burden of disease analysis was conducted using official national data sources, including the Individual Health Service Delivery Records and death certificates from the Vital Statistics System, consolidated by the Ministry of Health and Social Protection within the Integrated Social Protection Information System. Estimation methods followed the World Health Organization’s Global Health Estimates framework. Disability-Adjusted Life Years were used as the summary measure, integrating mortality and non-fatal outcomes to quantify the overall population impact. A total of 296,010.6 Disability-Adjusted Life Years were estimated (95% UI: 279,343.2–312,678), representing a rate of 572.7 (95% UI: 540.5–605) per 100,000 population. Anxiety accounted for 47.26%. Women represented 60.86% of the total burden, with 180,157.6 (95% UI: 165,046.3–195,268.9). Overall, 99.27% of the burden from mental and behavioral disorders was due to Years Lived with Disability, underscoring the substantial impact on quality of life, particularly among women. Full article