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12 pages, 246 KiB  
Article
Tobacco-Free Schools in Practice: Policy Presence and Enforcement in Baltimore Schools
by Chidubem Egboluche, Rifath Ara Alam Barsha, Shervin Assari, Michelle Mercure, Marc Laveau, Oluwatosin Olateju and Payam Sheikhattari
Adv. Respir. Med. 2025, 93(4), 28; https://doi.org/10.3390/arm93040028 - 5 Aug 2025
Abstract
Background: School-based tobacco control policies are critical for preventing youth tobacco use. While many districts adopt formal policies to create smoke- and vape-free environments, the degree to which these policies are enforced at the school level may vary, influencing their effectiveness. Little is [...] Read more.
Background: School-based tobacco control policies are critical for preventing youth tobacco use. While many districts adopt formal policies to create smoke- and vape-free environments, the degree to which these policies are enforced at the school level may vary, influencing their effectiveness. Little is known about how consistently such policies are implemented across schools within urban school districts. Objectives: This study aimed to examine the existence and enforcement of school-level tobacco control policies in an urban public school system, using Baltimore City schools as a case example. Methods: We conducted a survey of school personnel from 20 high schools in Baltimore City in 2024. The survey instrument assessed the presence and enforcement of policies related to tobacco use prevention, communication, signage, disciplinary actions, and institutional support. Descriptive statistics (frequencies and percentages) were used to summarize responses. Spearman correlations were also used for bivariate correlations. Additional school-level and neighborhood-level contextual data were collected from the internet (neighborhood socioeconomic status and school performance). Results: While many policies existed across the 20 participating schools, their enforcement was widely inconsistent. Most schools reported the existence of policies prohibiting tobacco use in school buildings (60%) and vehicles (55%). However, few schools had visible tobacco-free signage (35%) or offered cessation programs (15%). Communication of policies to students (70%) and staff (65%) was the most commonly enforced aspect of tobacco control policies. Conclusions: Findings suggest that while tobacco control policies may be adopted across urban school systems, their enforcement at the school level remains uneven. Greater attention may be needed to support policy implementation and to reduce variability in school-level practices. Baltimore City serves as a useful case study to understand these challenges and identify opportunities for strengthening school-based tobacco prevention efforts. Full article
13 pages, 248 KiB  
Article
The Prevalence and Impact of Dentinal Hypersensitivity on Adults’ Quality of Life in Saudi Arabia
by Haya Alayadi, Omar Alsadon, Maram Ali Alwadi, Alaa A. Alkhateeb, Deema Alroweilly, Zainab Alassmi and Wedad Alshehri
Dent. J. 2025, 13(8), 353; https://doi.org/10.3390/dj13080353 - 4 Aug 2025
Abstract
Background: Dentinal hypersensitivity (DH) significantly impacts oral health-related quality of life. While global prevalence estimates range from 10–15%, region-specific data from Saudi Arabia remain limited. This study also aligns with Saudi Vision 2030’s mental health initiatives, as DH-associated anxiety impacts overall well-being. This [...] Read more.
Background: Dentinal hypersensitivity (DH) significantly impacts oral health-related quality of life. While global prevalence estimates range from 10–15%, region-specific data from Saudi Arabia remain limited. This study also aligns with Saudi Vision 2030’s mental health initiatives, as DH-associated anxiety impacts overall well-being. This study assessed DH prevalence and quality of life impact among Saudi adults. Methods: A cross-sectional online survey was conducted among 748 Saudi adults aged ≥ 18 years between April and May. Data were collected using a validated Arabic Dentinal Hypersensitivity Experience Questionnaire (DHEQ) alongside socio-demographic variables. Participants reporting DH symptoms within 12 months were included in impact analyses. Descriptive statistics and one-way ANOVA examined associations between DHEQ scores and participant characteristics. Results: Self-reported DH prevalence was 54.3% (n = 406), substantially exceeding global estimates. Among affected individuals, mean DHEQ score was 0.56 ± 0.19, indicating moderate-to-substantial quality-of-life impact. Functional limitations were most affected, particularly enjoyment of eating and drinking (0.72 ± 0.21). Significant associations were identified between higher DHEQ scores and age extremes (<18 and >35 years; p < 0.001), higher income levels (p = 0.032), fewer teeth (p = 0.040), and dental pain presence (p = 0.009). Sex, residence, education, and employment showed no significant associations. Conclusions: More than half of Saudi adults reported DH symptoms, representing a significant public health concern with substantial quality of life implications. Prevalence substantially exceeds global estimates, highlighting the need for targeted interventions. Age, income, tooth count, and pain presence emerged as key factors. These findings support developing population-specific prevention strategies, particularly targeting younger and older adults with tooth loss. Full article
(This article belongs to the Special Issue Dentinal Hypersensitivity)
16 pages, 1207 KiB  
Article
Study of Multi-Stakeholder Mechanism in Inter-Provincial River Basin Eco-Compensation: Case of the Inland Rivers of Eastern China
by Zhijie Cao and Xuelong Chen
Sustainability 2025, 17(15), 7057; https://doi.org/10.3390/su17157057 - 4 Aug 2025
Abstract
Based on a comprehensive review of the current research status of ecological compensation both domestically and internationally, combined with field survey data, this study delves into the issue of multi-stakeholder participation in the ecological compensation mechanisms of the Xin’an River Basin. This research [...] Read more.
Based on a comprehensive review of the current research status of ecological compensation both domestically and internationally, combined with field survey data, this study delves into the issue of multi-stakeholder participation in the ecological compensation mechanisms of the Xin’an River Basin. This research reveals that the joint participation of multiple stakeholders is crucial to achieving the goals of ecological compensation in river basins. The government plays a significant role in macro-guidance, financial support, policy guarantees, supervision, and management. It promotes the comprehensive implementation of ecological environmental protection by formulating relevant laws and regulations, guiding the public to participate in ecological conservation, and supervising and punishing pollution behaviors. The public, serving as the main force, forms strong awareness and behavioral habits of ecological protection through active participation in environmental protection, monitoring, and feedback. As participants, enterprises contribute to industrial transformation and green development by improving resource utilization efficiency, reducing pollution emissions, promoting green industries, and participating in ecological restoration projects. Scientific research institutions, as technology enablers, have effectively enhanced governance efficiency through technological research and innovation, ecosystem value accounting to provide decision-making support, and public education. Social organizations, as facilitators, have injected vitality and innovation into watershed governance by extensively mobilizing social forces and building multi-party collaboration platforms. Communities, as supporters, have transformed ecological value into economic benefits by developing characteristic industries such as eco-agriculture and eco-tourism. Based on the above findings, further recommendations are proposed to mobilize the enthusiasm of upstream communities and encourage their participation in ecological compensation, promote the market-oriented operation of ecological compensation mechanisms, strengthen cross-regional cooperation to establish joint mechanisms, enhance supervision and evaluation, and establish a sound benefit-sharing mechanism. These recommendations provide theoretical support and practical references for ecological compensation worldwide. Full article
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12 pages, 347 KiB  
Article
Public Preferences Regarding Equitable Healthcare Rationing Across Gender Identities in China
by Chau-kiu Cheung, Zenan Wu and Eileen Yuk-ha Tsang
Int. J. Environ. Res. Public Health 2025, 22(8), 1218; https://doi.org/10.3390/ijerph22081218 - 4 Aug 2025
Abstract
Public opinion on public healthcare rationing regarding gender identity is crucial for democratic policymaking because of public concern regarding sexual orientation, gender identity, and gender expression (SOGIE). Based on rationality theory, rationally equitable rationing depends on equity orientations and prioritizing public interest over [...] Read more.
Public opinion on public healthcare rationing regarding gender identity is crucial for democratic policymaking because of public concern regarding sexual orientation, gender identity, and gender expression (SOGIE). Based on rationality theory, rationally equitable rationing depends on equity orientations and prioritizing public interest over self-interest. Specifically, equity orientations include those toward equality, need, personal contribution, and social contribution. To project public preference for public healthcare rationing, this study involved 744 Chinese people in a web survey. These participants indicated their preferences for public healthcare rationing and self-interest, public interest, and equity orientations, including those based on contribution, equality, and need. Regression analysis based on the rationality framework showed that public healthcare rationing that was equal across SOGIE identities was predominantly preferable, based on rational equity. In contrast, public healthcare rationing without considering SOGIE was less preferable, and rationing unequally across gender identities was not preferred. These results imply that affirmative and egalitarian rationing is the most rationally equitable approach. Full article
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24 pages, 1376 KiB  
Article
Smart Agriculture in Ecuador: Adoption of IoT Technologies by Farmers in Guayas to Improve Agricultural Yields
by Ruth Rubí Peña-Holguín, Carlos Andrés Vaca-Coronel, Ruth María Farías-Lema, Sonnia Valeria Zapatier-Castro and Juan Diego Valenzuela-Cobos
Agriculture 2025, 15(15), 1679; https://doi.org/10.3390/agriculture15151679 - 2 Aug 2025
Viewed by 250
Abstract
The adoption of digital technologies, such as the Internet of Things (IoT), has emerged as a key strategy to improve efficiency, sustainability, and productivity in the agricultural sector, especially in contexts of modernization and digital transformation in developing regions. This study analyzes the [...] Read more.
The adoption of digital technologies, such as the Internet of Things (IoT), has emerged as a key strategy to improve efficiency, sustainability, and productivity in the agricultural sector, especially in contexts of modernization and digital transformation in developing regions. This study analyzes the key factors influencing the adoption of IoT technologies by farmers in the province of Guayas, Ecuador, and their impact on agricultural yields. The research is grounded in innovation diffusion theory and technology acceptance models, which emphasize the role of perception, usability, training, and economic viability in digital adoption. A total of 250 surveys were administered, with 232 valid responses (92.8% response rate), reflecting strong interest from the agricultural sector in digital transformation and precision agriculture. Using structural equation modeling (SEM), the results confirm that general perception of IoT (β = 0.514), practical functionality (β = 0.488), and technical training (β = 0.523) positively influence adoption, while high implementation costs negatively affect it (β = −0.651), all of which are statistically significant (p < 0.001). Furthermore, adoption has a strong positive effect on agricultural yield (β = 0.795). The model explained a high percentage of variance in both adoption (R2 = 0.771) and performance (R2 = 0.706), supporting its predictive capacity. These findings underscore the need for public and private institutions to implement targeted training and financing strategies to overcome economic barriers and foster the sustainable integration of IoT technologies in Ecuadorian agriculture. Full article
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26 pages, 1514 KiB  
Article
Measuring the Digital Economy in Kazakhstan: From Global Indices to a Contextual Composite Index (IDED)
by Oxana Denissova, Zhadyra Konurbayeva, Monika Kulisz, Madina Yussubaliyeva and Saltanat Suieubayeva
Economies 2025, 13(8), 225; https://doi.org/10.3390/economies13080225 - 2 Aug 2025
Viewed by 146
Abstract
This study examines the development of the digital economy and society in the Republic of Kazakhstan by combining international benchmarking with a context-specific national framework. It highlights the limitations of existing global indices such as DESI, NRI, and EGDI in capturing the structural [...] Read more.
This study examines the development of the digital economy and society in the Republic of Kazakhstan by combining international benchmarking with a context-specific national framework. It highlights the limitations of existing global indices such as DESI, NRI, and EGDI in capturing the structural and institutional dimensions of digital transformation in emerging economies. To address this gap, the study introduces a novel composite metric, the Index of Digital Economy Development (IDED), which integrates five sub-indices: infrastructure, usage, human capital, economic digitization, and transformation effectiveness. The methodology involves comparative index analysis, the construction of the IDED, and statistical validation through a public opinion survey and regression modeling. Key findings indicate that cybersecurity is a critical yet under-represented component of digital development, showing strong empirical correlations with DESI scores in benchmark countries. The results also highlight Kazakhstan’s strengths in digital public services and internet access, contrasted with weaknesses in business digitization and innovation. The proposed IDED offers a more comprehensive and policy-relevant tool for assessing digital progress in transitional economies. This study contributes to the literature by proposing a replicable index structure and providing empirical evidence for the inclusion of cybersecurity in national digital economy assessments. The aim of the study is to assess Kazakhstan’s digital economy development by addressing limitations in global measurement frameworks. Methodologically, it combines comparative index analysis, the construction of a national composite index (IDED), and statistical validation using a regional survey and regression analysis. The findings reveal both strengths and gaps in Kazakhstan’s digital landscape, particularly in cybersecurity and SME digitalization. The IDED introduces an innovative, context-sensitive framework that enhances the measurement of digital transformation in transitional economies. Full article
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16 pages, 291 KiB  
Article
General and Specific Social Trust as Predictors of Depressive Symptoms: Evidence from Post-Crisis Iceland
by Haukur Freyr Gylfason
World 2025, 6(3), 107; https://doi.org/10.3390/world6030107 - 1 Aug 2025
Viewed by 209
Abstract
Social trust has been linked to the development and severity of depression, but trust is a complex, multidimensional construct. This study examines the extent to which two distinct forms of trust, general trust and specific trust, predict depressive symptoms. Drawing on longitudinal data [...] Read more.
Social trust has been linked to the development and severity of depression, but trust is a complex, multidimensional construct. This study examines the extent to which two distinct forms of trust, general trust and specific trust, predict depressive symptoms. Drawing on longitudinal data from the Directorate of Health’s national surveys conducted in 2007 and 2009, the analysis includes responses from 3211 Icelanders selected through a stratified random sample. Depressive symptoms were assessed using the Depression, Anxiety, and Stress Scale (DASS), while specific trust captured trust in close relationships, and general trust measured broader perceptions of trustworthiness in others. The two forms of trust together explained 7.6% of the variance in depressive symptoms, with specific trust contributing a substantially greater share. Both remained significant predictors after controlling for prior depression and physical health. These findings highlight the protective role of specific trust and suggest that general trust, an indicator of broader social capital, may also help buffer against depression. The results underscore the relevance of trust as a public health resource and support continued research into social determinants of mental health in Iceland. Full article
21 pages, 316 KiB  
Article
Human Competencies: Amplifying Financial Reporting Quality in Indonesian Local Government
by Mediaty, Grace T. Pontoh, Nadhirah Nagu, Rahmawati HS, Anis Anshari Mas’ud and Rozainun Haji Abdul Aziz
J. Risk Financial Manag. 2025, 18(8), 424; https://doi.org/10.3390/jrfm18080424 - 1 Aug 2025
Viewed by 158
Abstract
This quantitative study examines the determinants of financial reporting quality in Indonesian local governments, focusing on good governance, regional financial accounting systems, internal control systems, organizational commitment, and information technology utilization, with HR competencies as a moderator. Data were collected via surveys from [...] Read more.
This quantitative study examines the determinants of financial reporting quality in Indonesian local governments, focusing on good governance, regional financial accounting systems, internal control systems, organizational commitment, and information technology utilization, with HR competencies as a moderator. Data were collected via surveys from 170 Local Government Work Units (SKPDs) across South Sulawesi Province, Indonesia. Employing Structural Equation Modeling (SEM), the findings indicate that good governance, regional financial accounting systems, internal control systems, organizational commitment, and information technology utilization all positively influence financial reporting quality. Crucially, human resource competencies were found to significantly moderate the relationship between the internal control system and organizational commitment with financial reporting quality. However, this moderating effect was not significant for the relationships involving good governance, regional financial accounting systems, and information technology utilization. These results highlight the essential role of human resource development and systemic enhancements in fostering greater financial accountability and transparency within the public sector. Therefore, policy recommendations should focus not only on enhancing individual competencies but also on synergistically strengthening systems and governance frameworks to achieve transparent and reliable public financial reporting. Full article
(This article belongs to the Special Issue Financial and Sustainability Reporting in a Digital Era, 2nd Edition)
19 pages, 950 KiB  
Article
How the Adoption of EVs in Developing Countries Can Be Effective: Indonesia’s Case
by Ida Nyoman Basmantra, Ngurah Keshawa Satya Santiarsa, Regina Dinanti Widodo and Caren Angellina Mimaki
World Electr. Veh. J. 2025, 16(8), 428; https://doi.org/10.3390/wevj16080428 - 1 Aug 2025
Viewed by 183
Abstract
Indonesia’s worsening air pollution and traffic emissions have thrust electric vehicles (EVs) into the spotlight, but what really drives Indonesians to make the switch? This study integrates Protection Motivation Theory with green branding and policy frameworks to explain electric vehicle (EV) adoption in [...] Read more.
Indonesia’s worsening air pollution and traffic emissions have thrust electric vehicles (EVs) into the spotlight, but what really drives Indonesians to make the switch? This study integrates Protection Motivation Theory with green branding and policy frameworks to explain electric vehicle (EV) adoption in Indonesia. Using a nationwide survey (n = 986) and partial-least-squares structural-equation modeling, we test how environmental awareness, consumer expectancy, threat appraisal, and coping appraisal shape adoption both directly and through green brand image (GBI), while perceived policy incentives moderate the GBI–adoption link. The model accounts for 54% of the variance in adoption intention. These findings highlight that combining public awareness campaigns, compelling green brand messaging, and carefully calibrated policy incentives is essential for accelerating Indonesia’s transition to cleaner transport. Full article
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30 pages, 1583 KiB  
Systematic Review
How Does Outdoor Spatial Design Shape the Microclimate, Comfort, and Behavior in Traditional Chinese Villages? A Systematic Review Across Scales, Contexts, and Users
by Zixi Wan, Huihui Liu, Yan Yu, Yan Wu, Mark Melchior, Pim Martens, Thomas Krafft and David Shaw
Sustainability 2025, 17(15), 6960; https://doi.org/10.3390/su17156960 - 31 Jul 2025
Viewed by 180
Abstract
Traditional Chinese villages, which have long supported villagers’ comfort level of daily activities, are increasingly affected by global climate change and rural reconstruction, prompting growing research interest in their outdoor microclimate design. This systematic review aims to synthesize and evaluate the outdoor microclimate [...] Read more.
Traditional Chinese villages, which have long supported villagers’ comfort level of daily activities, are increasingly affected by global climate change and rural reconstruction, prompting growing research interest in their outdoor microclimate design. This systematic review aims to synthesize and evaluate the outdoor microclimate spatial design mechanism studies in traditional Chinese villages noted for their uniqueness and complexity. Following the PRISMA method, this study was carried out on November 27, 2024, by retrieving studies from the Scopus and CNKI databases and applying predefined inclusion and exclusion criteria; 42 empirical studies were systematically reviewed. It identifies current research trends, summarizes concepts, frameworks, indicators, and methodologies with a focus on the design mechanisms considering scales, contexts, and user groups, and outlines directions for future research. The findings reveal a growing number of publications, with case studies predominantly concentrated on three concepts: physical microclimates, human comfort, and behavioral responses, characterized as distributed in south-east areas. Based on these concepts and their correlations, this study proposes a classification framework based on multiple scales, contexts, and user groups. Within this framework, the study found that relative humidity and PET (physiological equivalent temperature) emerge as the most commonly used indicators, while field measurements, simulations, surveys, and observations are identified as the primary methods. The review further reveals that unique outdoor spatial design characteristics shape physical microclimates, human comfort, and behavior indicators influenced by contexts and users from the macro to the micro scale. Future research should advance existing studies by enriching the current contextual framework and explore more microclimatic factors. This review offers a comprehensive overview and actionable insights for outdoor microclimate design, policymaking, and the promotion of climate adaptation and villagers’ public health in different traditional rural settings. Full article
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15 pages, 478 KiB  
Article
Towards Inclusive and Sustainable Nature Education in Austria: Evaluation of Organization, Infrastructure, Risk Assessment, and Legal Frameworks of Forest and Nature Childcare Groups
by Elisabeth Quendler, Dominik Mühlberger, Bernhard Spangl, Daniel Ennöckl and Alina Branco
Sustainability 2025, 17(15), 6965; https://doi.org/10.3390/su17156965 - 31 Jul 2025
Viewed by 127
Abstract
Early childhood forest and nature education plays a vital role in shaping values and promoting sustainability throughout life. Conceptualized in Denmark, forest and nature childcare groups have been established in Austria for over 20 years, contributing to mental well-being and supporting both Education [...] Read more.
Early childhood forest and nature education plays a vital role in shaping values and promoting sustainability throughout life. Conceptualized in Denmark, forest and nature childcare groups have been established in Austria for over 20 years, contributing to mental well-being and supporting both Education for Sustainable Development (ESD) and Early Childhood Education and Care (ECEC). With increasing demand for childcare and a growing disconnect from nature—factors linked to physical and mental health challenges—there is a pressing need to expand these groups and integrate them into formal legal frameworks. This study examines the organization, staffing, infrastructure, risk prevention, and hygiene of 79 Austrian forest and nature kindergarten groups, identifying key areas of improvement to ensure safe access for all children, including those in public childcare. A semi-standardized online survey of 72 groups was analyzed using descriptive and statistical methods, including a Spearman correlation, Kruskal–Wallis test, Chi-square test, and ANOVA. Results revealed three main infrastructure types—house, container/trailer, and tipi—with houses offering the most comprehensive facilities. The ANOVA indicated significant effects of sponsorship type (p < 0.01), caregiver numbers (p < 0.001), and their interaction (p < 0.05) on half-day care costs. Currently, legal frameworks exist only in Tyrol and Salzburg. Broader access requires standardized infrastructure and risk assessment guidelines, collaboratively developed with stakeholders, to ensure safety and inclusivity in Austrian forest and nature childcare groups. Full article
(This article belongs to the Section Sustainable Education and Approaches)
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16 pages, 4439 KiB  
Article
Baseline Assessment of Taeniasis and Cysticercosis Infections in a High-Priority Region for Taenia solium Control in Colombia
by Carlos Franco-Muñoz, María Camila Jurado Guacaneme, Sonia Dayanni Castillo Ayala, Sofia Duque-Beltrán, Adriana Arévalo, Marcela Pilar Rojas Díaz, Julián Trujillo Trujillo, Luz Elena Borras Reyes, Luis Reinel Vásquez Arteaga, Julio César Giraldo Forero and Mario J. Olivera
Pathogens 2025, 14(8), 755; https://doi.org/10.3390/pathogens14080755 (registering DOI) - 31 Jul 2025
Viewed by 259
Abstract
Coyaima is a town in the department of Tolima, Colombia, that was prioritized in a pilot program under Colombia’s National Plan for the Control of the Taeniasis/Cysticercosis Complex, focusing on this neglected health issue. The project engaged local indigenous communities, promoting education and [...] Read more.
Coyaima is a town in the department of Tolima, Colombia, that was prioritized in a pilot program under Colombia’s National Plan for the Control of the Taeniasis/Cysticercosis Complex, focusing on this neglected health issue. The project engaged local indigenous communities, promoting education and outreach within the One Health framework. The study included 444 randomly selected volunteers, who filled a Knowledge, Attitudes, and Practices (KAP) survey on the taeniasis/cysticercosis complex. The baseline study found no Taenia spp. eggs via microscopy on 383 stool samples examined, and no T. solium DNA was detected on human stool and soil samples by Copro-qPCR. However, seroprevalence was 8.5% for human cysticercosis and 14% for porcine cysticercosis, as detected by in-house ELISA testing for T. solium. Moreover, 57.9% of participants who provided a stool sample were positive for at least one parasite. Following the sampling and characterization activities, local health workers implemented mass treatment with Niclosamide, based on evidence of ongoing transmission, high porcine seroprevalence, poor basic sanitation, and the presence of free-roaming pigs reported in the KAP survey. These findings provide scientific evidence to apply national public health policies for controlling taeniasis/cysticercosis complex in Coyaima. Full article
(This article belongs to the Special Issue Recent Advances in Taeniasis and Cysticercosis)
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23 pages, 1447 KiB  
Article
Heat Risk Perception and Vulnerability in Puerto Rico: Insights for Climate Adaptation in the Caribbean
by Brenda Guzman-Colon, Zack Guido, Claudia P. Amaya-Ardila, Laura T. Cabrera-Rivera and Pablo A. Méndez-Lázaro
Int. J. Environ. Res. Public Health 2025, 22(8), 1197; https://doi.org/10.3390/ijerph22081197 - 31 Jul 2025
Viewed by 187
Abstract
Extreme heat poses growing health risks in tropical regions, yet public perception of this threat remains understudied in the Caribbean. This study examines how residents in Puerto Rico perceived heat-related health risks and how these perceptions relate to vulnerability and protective behaviors during [...] Read more.
Extreme heat poses growing health risks in tropical regions, yet public perception of this threat remains understudied in the Caribbean. This study examines how residents in Puerto Rico perceived heat-related health risks and how these perceptions relate to vulnerability and protective behaviors during the extreme heat events of the summer of 2020. We conducted a cross-sectional telephone survey of 500 adults across metropolitan and non-metropolitan areas of Puerto Rico, using stratified probability sampling. The questionnaire assessed heat risk perception, sociodemographic characteristics, health status, prior heat exposure, and heat-related behaviors. While most participants expressed concern about climate change and high temperatures, fewer than half perceived heat as a high level of personal health risk. Higher levels of risk perception were significantly associated with being male, aged 50–64, unemployed, and in fair health, having multiple chronic conditions, and prior experience with heat-related symptoms. Those with symptoms were nearly five times more likely to report high levels of risk perception (OR = 4.94, 95% CI: 2.93–8.34). In contrast, older adults (65+), despite their higher level of vulnerability, reported lower levels of risk perception and fewer symptoms. Nighttime heat exposure was widespread and strongly associated with heat-related symptoms. Common coping strategies included the use of fans and air conditioning, though economic constraints and infrastructure instability limited access. The findings highlight the disparity between actual and perceived vulnerability, particularly among older adults. Public health strategies should focus on risk communication tailored to vulnerable groups and address barriers to heat adaptation. Strengthening heat resilience in Puerto Rico requires improved infrastructure, equitable access to cooling, and targeted outreach. Full article
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17 pages, 1142 KiB  
Article
Logistical Challenges in Home Health Care: A Comparative Analysis Between Portugal and Brazil
by William Machado Emiliano, Thalyta Cristina Mansano Schlosser, Vitor Eduardo Molina Júnior, José Telhada and Yuri Alexandre Meyer
Logistics 2025, 9(3), 101; https://doi.org/10.3390/logistics9030101 - 31 Jul 2025
Viewed by 197
Abstract
Background: This study aims to compare the logistical challenges of Home Health Care (HHC) services in Portugal and Brazil, highlighting the structural and operational differences between both systems. Methods: Guided by an abductive research approach, data were collected using a semi-structured [...] Read more.
Background: This study aims to compare the logistical challenges of Home Health Care (HHC) services in Portugal and Brazil, highlighting the structural and operational differences between both systems. Methods: Guided by an abductive research approach, data were collected using a semi-structured survey with open-ended questions, applied to 13 HHC teams in Portugal and 18 in Brazil, selected based on national coordination recommendations. The data collection process was conducted in person, and responses were analyzed using descriptive statistics and qualitative content analysis. Results: The results reveal that Portugal demonstrates higher productivity, stronger territorial coverage, and a more integrated inventory management system, while Brazil presents greater multidisciplinary team integration, more flexible fleet logistics, and more advanced digital health records. Despite these strengths, both countries continue to address key logistical aspects, such as scheduling, supply distribution, and data management, largely through empirical strategies. Conclusions: This research contributes to the theoretical understanding of international HHC logistics by emphasizing strategic and systemic aspects often overlooked in operational studies. In practical terms, it offers insights for public health managers to improve resource allocation, fleet coordination, and digital integration in aging societies. Full article
(This article belongs to the Section Humanitarian and Healthcare Logistics)
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15 pages, 1293 KiB  
Article
Hesitant Minds in Vulnerable Times: COVID-19 Vaccine Hesitancy Among University Students in Ukraine
by Prince Yeboah, Afraa Razouk, Philip Skotzke, Werner Pitsch, Olena Chubuchna, Victoria Serhiyenko, Nataliia Slyvka, Serhii Holota, Muhammad Jawad Nasim, Ahmad Yaman Abdin and Claus Jacob
COVID 2025, 5(8), 122; https://doi.org/10.3390/covid5080122 - 31 Jul 2025
Viewed by 205
Abstract
COVID-19 vaccine hesitancy (VH), like attitudes towards other vaccines, is a critical global public health concern. Despite numerous studies covering psychological, sociodemographic, and other determinants of vaccine acceptance, resistance, and hesitance, few studies have reported these factors among students, particularly in politically unstable [...] Read more.
COVID-19 vaccine hesitancy (VH), like attitudes towards other vaccines, is a critical global public health concern. Despite numerous studies covering psychological, sociodemographic, and other determinants of vaccine acceptance, resistance, and hesitance, few studies have reported these factors among students, particularly in politically unstable settings like Ukraine. This cross-sectional, descriptive, and quantitative study assesses hesitancy towards COVID-19 vaccines, utilizing the 5Cs Model. Among 936 respondents surveyed in 2023, 64% received at least one shot of the COVID-19 vaccine (acceptant), 11% were still considering getting vaccinated (hesitant), and 25% refused vaccination (resistant). Vaccination behavior is significantly associated with the 5Cs. Higher collective responsibility significantly increased acceptance and reduced resistance, while higher constraints lowered the chances of being either acceptant or resistant. Confidence protected against resistance. Complacency, counterintuitively, reduced odds of resistance, pointing to differences between passive hesitancy and active refusal. Male gender and sources of information and misinformation influenced confidence. Collective responsibility was positively associated with official sources and negatively with conspiracy beliefs. Complacency increased with official sources, while constraints and calculation were least explained by predictors. Practical barriers should be tackled through improved accessibility and fostering collective responsibility via targeted communication strategies. These findings provide actionable insights for policymakers, healthcare providers, and academic institutions to enhance vaccine uptake among university students, particularly in crisis settings. Full article
(This article belongs to the Special Issue COVID and Public Health)
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