Search Results (1,251)

Background: Addressing undernutrition and malnutrition requires a multi-pronged approach targeting different populations with appropriate interventions. Knowledge and perception (K&P) of Individuals and communities about nutrition to human health relationship/continuum is a prerequisite for addressing malnutrition in rural and mountain communities. Assessing K&P is essential for developing strategic interventions to up-scaling K&P of communities and achieving nutrition security. Homestead gardens are a proven intervention for achieving nutrition security for all family members of gardeners. Methods: This paper includes homestead gardeners from the Himalayan Mountain Region (HMR) as respondents. We developed a scale to assess the K&P of respondents, based on ratings from 20 judges. A total of 134 issues/items have been retained in the scale from macronutrients, micronutrients, minerals, and vitamins. A framework has also been developed and adopted for the study. A knowledge and perception index (KPI) has been developed based on the respondents’ responses. We have reviewed and analysed the national policy interventions for augmenting the K&P of the study community to achieve nutrition security. Results: The nutrition K&P of respondents are inadequate and far from the desirable level. Policy review and analysis indicate that the creation of K&P in the community to contribute to self and family nutrition security was previously highly neglected. Conclusions: The policy process of national, state, and county/district-level development sectors in developing countries under the HMR may take the initiative to ensure self-nutrition security by creating K&P of the community on nutrition issues. The designed scale is prudent requires testing and validation for measuring farmers’ K&P on nutrition, which may be adopted in future studies and policymaking not only nationally but also from an international perspective. Full article

Adverse drug reactions (ADRs) significantly affect patient safety and healthcare spending worldwide. Hospital pharmacists are uniquely positioned to address ADRs due to their crucial role in medication management. However, underreporting remains a global concern, especially in developing countries, where pharmacovigilance systems are inadequately developed. Therefore, this pilot study aimed to evaluate and compare the knowledge, attitudes, perceived barriers, and facilitators regarding ADR reporting by hospital pharmacists in a developed (US) and a developing (Pakistan) country. A cross-sectional survey was conducted, using a pre-validated questionnaire. The pharmacists, possessing a minimum of one year’s hospital experience, were selected via convenience sampling. Out of 151 respondents, included in the final analysis (US: n = 51; Pakistan: n = 100), the majority were female (62.3%), aged 29–35 years (38%), and possessed a Pharm. D degree (49.7%). The knowledge (US: 6.03 ± 0.27 vs. Pakistan:5.69 ± 0.25, p-value = 0.193) and attitude scores (US: 32.02 ± 0.73 vs. Pakistan: 32.63 ± 0.67; p-value = 0.379) exhibited no significant differences between the groups. Nonetheless, barriers at both the individual and systemic levels were more pronounced in the developing country. Important facilitators reported were mobile applications for ADR reporting, specialized training, and intuitive reporting tools. In conclusion, we found that pharmacists in both settings exhibit comparable knowledge and positive attitudes towards ADR reporting, though specific contextual barriers are present. Interventions customized to the local hospital infrastructure are crucial for enhancing ADR reporting, particularly in resource-constrained settings. Full article

The demand for sustainable animal production is increasing. Microalgae such as Chlorella and Spirulina show promise as sustainable and functional ingredients in animal (poultry) feed. However, little is known about consumer perceptions regarding the use of algae in broiler diets and potential effects of algae on chicken meat. Residents of Flanders (Belgium) were surveyed to evaluate consumer knowledge, attitudes and willingness to buy chicken meat produced with algae-supplemented feed. Demographic data were collected, and both descriptive and inferential statistics were applied to assess influencing factors (n = 275 respondents who purchase chicken meat). While most respondents (69.6%) had tasted macroalgae (seaweed), only 11.4% and 24.6% indicated having tasted Chlorella and Spirulina before, respectively. Health, taste and safety were the most important drivers for consuming algae. Meat quality was the most important factor when purchasing chicken meat, while organic production was least valued. Regarding algae-fed chicken, 72.5% expressed willingness to purchase meat labeled as such, and 83.7% would buy algae-fed chicken regardless of its color. Sustainability beliefs significantly influenced willingness to accept a yellower meat color (β = 0.42 to 0.66, p < 0.001). Educational level and age also played a role, with higher-educated consumers showing greater acceptance. The influence of age was also related to the price of the meat, with consumers over 30 expressing a greater willingness to pay more than young people (under 30). Despite limited general knowledge about microalgae, the consumers surveyed are open to the idea of algae-fed chicken meat, particularly when it is framed as more sustainable. Clear ingredient labeling and consumer education may further support market acceptance. Full article

The environmental detriments of the growing global production and overconsumption of beef, including greenhouse gas emissions, deforestation, and biodiversity loss, are well-documented. However, public awareness of how dietary choices affect the environment remains limited. This study examines sustainability views on beef consumption and the potential for behavioral change as a step toward more sustainable intake levels. An observational web-based survey was conducted (n = 1367) to assess respondents’ current beef intake frequency, views on beef consumption related to planetary health, tropical deforestation, greenhouse gas emissions, and climate change, and willingness to modify beef consumption behavior. Chi-square tests were used for group comparisons, and weighted average scores were applied to rank levels of resistance to reducing beef intake. Environmental concern related to beef consumption was associated with greater beef cutback intentions and lower long-term intake reduction resistance amongst beef eaters. Beef eaters who strongly agreed that global beef consumption negatively impacts the environment were considerably more likely to express intentions to reduce their long-term beef intake compared to those who strongly disagreed (94.4% vs. 19.6%). Overall, 76.6% of beef eaters indicated wanting to eat less beef or phase it out entirely (30.7% reduce, 29.4% minimize, 16.6% stop), with only 23.4% of them intending to keep their consumption unchanged. Compelling messages that help translate awareness into action, such as the #NoBeefWeek concept explored in this study, may support individuals in adopting more sustainable food choices. These cross-national findings provide evidence for a ‘knowledge–intent’ gap in sustainable diet research, with relevance for health communicators and policymakers. Future research could examine the factors and motivations influencing decisions to modify beef consumption, including the barriers to achieving sustainable consumption levels and the role of suitable alternatives in facilitating this transition. Full article

Background: Kidney transplantation from a living donor is considered the most beneficial form of treatment for end-stage renal failure, which, in addition to providing patients with better treatment results, significantly improves their quality of life. Understanding factors that influence the willingness to donate kidneys to strangers is critical in promoting and expanding the living donor pool. When considering the decision to become an altruistic kidney donor, individuals must evaluate multiple factors, including the identity of the recipient and their own perceived level of safety. This study aimed to assess the willingness of dialysis center employees to act as living kidney donors for a stranger. Methods: We conducted a cross-sectional study from February 2023 to June 2024 among dialysis specialists across Poland. The study involved 1093 people (doctors and nurses). The study used our survey questionnaire and standardized tools. Results: Nurses (vs. physicians) and those who advocated the regulation of unspecified living kidney donation in Poland, did not believe in the risk of organ trafficking, and would donate a kidney to a husband/wife or friend and accept kidney transplantation from a husband/wife were more likely to donate a kidney to a stranger. Furthermore, respondents who accepted a loved one’s decision to donate a kidney to a stranger were significantly more willing to donate a kidney to such a person themselves. Perceived self-efficacy was positively associated with the willingness to donate a kidney to a stranger. Conclusions: Less than half of healthcare professionals supported unspecific living organ donation in Poland, and nurses were more willing to donate than physicians. The factors supporting the decision generally included knowledge about organ donation and transplantation, a lack of fear of organ trafficking, and attitudes towards donation. Full article

Despite navigation advancements in enhanced sensor utilization and increased focus on maritime training and education, most marine accidents still involve collisions with high human involvement. Furthermore, navigators’ knowledge and application of the most often misunderstood Rule 10 Traffic Separation Schemes (TSS) according to the Convention on the International Regulations for Preventing Collisions at Sea (COLREG) represents the first focus in this study. To provide insight into the level of understanding and knowledge regarding COLREG Rule 10, a customized, worldwide survey has been created and disseminated among marine industry professionals. The survey results reveal a notable knowledge gap in Rule 10, where we initially assumed that more than half of the respondents know COLREG regulations well. According to the probability calculation and chi-square test results, all three categories (OOW, Master, and others) have significant rule misunderstanding. In response to the COLREG misunderstanding, together with the increasing density of maritime traffic, the implementation of Decision Support Systems (DSS) in navigation has become crucial for ensuring compliance with regulatory frameworks and enhancing navigational safety in general. This study presents a structural approach to vessel prioritization and decision-making within a DSS framework, focusing on the classification and response of the own vessel (OV) to bow-crossing scenarios within the TSS. Through the real-time integration of AIS navigational status data, the proposed DSS Architecture offers a structured, rule-compliant architecture to enhance navigational safety and the decision-making process within the TSS. Furthermore, implementing a Fall-Back Strategy (FBS) represents the key innovation factor, which ensures system resilience by directing operator response if opposing vessels disobey COLREG rules. Based on the vessel’s dynamic context and COLREG hierarchy, the proposed DSS Architecture identifies and informs the navigator regarding stand-on or give-way obligations among vessels. Full article

Background and Objectives: Investigating the adherence to antihypertensive medication and identifying patients with low adherence allows targeted interventions to improve therapeutic outcomes. Artificial intelligence (AI) offers advanced tools for analyzing medication adherence data. This study aimed to develop and validate several predictive models for non-adherence, using patient-reported data collected via a structured questionnaire. Materials and Methods: A cross-sectional, multi-center study was conducted on 3095 hypertensive patients from community pharmacies. A structured questionnaire was administered, collecting data on sociodemographic factors, medical history, self-monitoring behaviors, and informational exposure, alongside medication adherence measured using the Romanian-translated and validated ARMS (Adherence to Refills and Medications Scale). Five machine learning models were developed to predict non-adherence, defined by ARMS quartile-based thresholds. The models included Logistic Regression, Random Forest, and boosting algorithms (CatBoost, LightGBM, and XGBoost). Models were evaluated based on their ability to stratify patients according to adherence risk. Results: A total of 79.13% of respondents had an ARMS Score ≥ 15, indicating a high prevalence of suboptimal adherence. Better adherence was statistically associated (adjusted for age and sex) with more frequent blood pressure self-monitoring, a reduced salt intake, fewer daily supplements, more frequent reading of medication leaflets, and the receipt of specific information from pharmacists. Among the ML models, CatBoost achieved the highest ROC AUC Scores across the non-adherence classifications, although none exceeded 0.75. Conclusions: Several machine learning models were developed and validated to estimate levels of medication non-adherence. While the performance was moderate, the results demonstrate the potential of AI in identifying and stratifying patients by adherence profiles. Notably, to our knowledge, this study represents the first application of permutation and SHapley Additive exPlanations feature importance in combination with probability-based adherence stratification, offering a novel framework for predictive adherence modelling. Full article

Background: Prematurely born newborns with low birth weight constitute a group of patients who require special care from the first days of life. Prematurity and low birth weight affect about 13.4 million infants. Risk factors include placental disorders but also factors related to the mother, such as smoking, alcohol drinking, drug use, malnutrition, or certain diseases. It is imperative to educate women of reproductive age (15–49) about the basic factors influencing embryonic development, such as oral health, diet, medicine intake, and harmful habits. Even though most women are aware of the negative impact of harmful habits on the fetus, still too little attention is paid to oral health in pregnant women. Poor oral health may influence the well-being of the future mother, as well as of the child. Therefore, women of reproductive age and those who are pregnant must have adequate knowledge on this subject. The aim of this study was to assess the knowledge of Polish women of reproductive age (15–49) regarding oral health during pregnancy, including the impact of dental treatment, oral hygiene, and maternal oral conditions on pregnancy outcomes and the health of the newborn. Materials and Methods: This was a cross-sectional study of 508 women, in the reproductive age, whose age ranged from 18 to 49 years old. The surveys were conducted from April 2020 to November 2020. The questionnaire was originally developed based on the available literature and consisted of seven sections: basic information, general health and habits, pregnancy status and dental care, knowledge of treatment options during pregnancy, oral health status and its association with the risk of preterm birth, prematurity and the child’s oral health, and breastfeeding and oral development. Results: After excluding incomplete questionnaires, a total of 499 questionnaires were included in the analysis. Women participating in the study had a fairly good understanding of the impact of oral health on the fetus and the role of breastfeeding in the development of the stomatognathic system (from 50% to 70% correct answers). However, even though most respondents had completed higher education (344/68.94%), their knowledge of oral health, preterm birth, and low birth weight was very limited (including the impact of inflammation on the intrauterine development of the child or bacteria and transfer across the placenta). In these sections, the percentage of correct answers ranged from less than 20% to 50%. When analyzing knowledge by age, education, number of births, and place of residence, the highest levels of knowledge were observed among respondents with higher education, particularly those aged 27–32. Conclusions: Respondents had a fairly good understanding of the general impact of oral health during pregnancy and recognition of the importance of breastfeeding for infants. However, their knowledge about the impact of bacteria and inflammation in the mother’s oral cavity on prematurity and low birth weight was limited. Therefore, educating women of reproductive age and pregnant women on this topic is essential, as it may help reduce the adverse consequences of prematurity. Full article

Background/Objectives: A perineal incision (episiotomy) is a surgical procedure involving the controlled cutting of perineal tissues to widen the vaginal outlet during the second stage of labor. The aim of this study was to assess Polish women’s knowledge regarding perineal incision. Methods: This study was conducted using an unvalidated, anonymous questionnaire created in Google Forms. Results: Women with higher education, those who had undergone childbirth, and those who identified the Internet, medical personnel, medical personnel on social media, and medical journals as sources had significantly higher levels of knowledge. Respondents aged 25 years or younger had significantly lower knowledge levels compared to those aged over 26. Additionally, respondents living in cities with populations of up to 500,000 had significantly lower levels of knowledge compared to women living in larger cities. Conclusions: The level of women’s knowledge about perineal incision varies and is influenced by several factors. Significant determinants of higher levels of knowledge were higher education, having a history of obstetric delivery, being over 25 years old, and using information provided by medical personnel, including those present on social media. Full article

Teacher education plays a key role in promoting inclusion and educational equity, especially in contexts characterised by increasing socio-cultural diversity and technological advancement. In this framework, Universal Design for Learning (UDL) and digital technologies are presented as complementary and innovative strategies to create accessible, flexible, and motivating learning environments for all students. The study analysed the impact of UDL-focused learning activities and integrated Information and Communication Technologies (ICT). A comparative tool was applied before and after the intervention to measure the level of knowledge, perception, and digital competence of prospective teachers. Statistical analyses were carried out to evaluate the changes obtained. Findings reveal significant improvements in knowledge about UDL, as well as positive perceptions of ICT as a resource for inclusion. Participants demonstrated a greater understanding of UDL principles and strengthened their digital competences to design educational proposals adapted to diversity. The research confirms the value of integrating UDL and ICT in teacher training, fostering inclusive educational practices. It highlights the need to strengthen training programmes that respond to the current challenges of the education system. Full article

This paper analyzes the factors affecting the willingness to pay of urban households concerned with efficient waste management in Bangladesh. The multistage random sampling approach selected 1400 families from seven major cities in Bangladesh. This study addresses the socioeconomic and environmental factors that influence urban households’ willingness to pay for improved waste management services in Bangladesh. This study uniquely contributes to the literature by providing a large-scale empirical analysis of 1470 households using a logit model, revealing income, education, and environmental awareness as key predictors of WTP. Detailed survey data from respondents were then analyzed using a logit model based on the contingent valuation method. Indeed, the logit model showed that six variables (education, monthly income, value of the asset, knowledge of environment, and climate change) had a statistically significant effect on the WTP of the households. The results show that 63% of respondents were willing to pay BDT 250 or more per month. The most influential factors driving this willingness to pay were income (OR = 1.35), education level (OR = 1.45), and environmental awareness (OR = 3.56). These variables all contribute positively towards WTP. The idea is that families have some socioeconomic characteristics, regardless of which they are ready to pay for a higher level of waste collection. It is recommended that government interference be affected through various approaches, as listed below: support for public–private sector undertaking and disposal, an extensive cleaning campaign, decentralized management, cutting waste transport costs, and privatization of some waste management systems. These could be used to develop solutions to better waste management systems and improve public health. Full article

Upgrading the industrial structure is an essential step for economic growth and the transformation of old and new development drivers. Counties situated at the rural–urban interface hold a comparative advantage in industrial upgrading compared to cities, converting agricultural resource dividends into economic value. However, whether agricultural innovation talent can facilitate this process requires further investigation. Based on a sample of 1771 Chinese counties, this study employs a quasi-natural experiment using China’s “World-Class Disciplines” construction program in agriculture and establishes a difference-in-differences (DID) model to examine the impact of agricultural innovation talent on county-level industrial structure upgrading. The results show that agricultural innovation talent significantly promotes industrial upgrading, with this effect being more pronounced in counties with smaller urban–rural income gaps, greater household savings, and higher levels of industrial sophistication. Spatial spillover effects are also evident, indicating regional knowledge diffusion. Knowledge empowerment emerges as the core mechanism: agricultural innovation talent drives industrial convergence, responds to supply–demand dynamics, and integrates digital and intelligent elements through knowledge creation, dissemination, and application, thereby supporting county-level industrial upgrading. The findings highlight the necessity of establishing world-class agricultural research and talent incubation platforms, particularly emphasizing the supportive role of universities and the knowledge-driven contributions of agricultural innovation talents to county development. Full article

This study examines the awareness and implementation of Circular Economy (CE) principles within Chile’s mining sector, which represents the world’s leading copper producer. We employed a mixed-methods approach, combining quantitative surveys with qualitative semi-structured interviews, to evaluate perceptions and implementation levels of CE practices across diverse organizational contexts. Our findings reveal a pronounced knowledge gap: while 73.3% of mining professionals reported familiarity with CE concepts, only 57.3% could provide accurate definitions. State-owned mining companies demonstrated substantially higher CE implementation rates, with 36.5% participating in eco-industrial collaborations and 51% conducting environmental audits, compared to their private counterparts. Small enterprises (1–100 employees) exhibited particularly limited engagement, as demonstrated by 71.8% lacking established sustainability reporting mechanisms. A considerable implementation gap was also identified; although 94.8% of respondents considered CE principles integral to business ethics and 89.6% recognized CE as essential for securing a social license to operate, only 20.8% reported that their organizations maintained dedicated CE units. The research presents actionable recommendations for policymakers, including targeted financial incentives and training programs for small- and medium-sized enterprises (SMEs) in mining services, the establishment of standardized CE performance metrics for the sector, and the integration of CE principles into strategic management education to accelerate sustainable transformation within Chile’s critical mining industry. Full article

Urban pluvial flooding (UPF) is an increasingly critical issue due to rapid urbanization and intensified precipitation driven by climate change that yet remains understudied in the Caribbean. This study analyzes the effects of UPF resulting from the transformation of a natural karstic landscape into an urbanized area considering a sub-watershed in Chetumal, Southern Mexican Caribbean, as a case study. Hydrographic numerical modeling was conducted using the IBER 2.5.1 software and the SCS-CN method to estimate surface runoff for a critical UPF event across three stages: (i) 1928—natural condition; (ii) 1998—semi-urbanized (78% coverage); and (iii) 2015—urbanized (88% coverage). Urbanization led to the orthogonalization of the drainage network, an increase in the sub-watershed area (20%) and mainstream length (33%), flow velocities rising 10–100 times, a 52% reduction in surface roughness, and a 32% decrease in the potential maximum soil retention before runoff occurs. In urbanized scenarios, 53.5% of flooded areas exceeded 0.5 m in depth, compared to 16.8% in non-urbanized conditions. Community-based knowledge supported flood extent estimates with 44.5% of respondents reporting floodwater levels exceeding 0.50 m, primarily in streets. Only 43.1% recalled past flood levels, indicating a loss of societal memory, although risk perception remained high among directly affected residents. The reported UPF effects perceived in the area mainly related to housing damage (30.2%), mobility disruption (25.5%), or health issues (12.9%). Although UPF events are frequent, insufficient drainage infrastructure, altered runoff patterns, and limited access to public shelters and communication increased vulnerability. Full article

Background and Objectives: Physical activity represents a cornerstone in the management of diabetes mellitus; however, the majority of persons with diabetes remain insufficiently active. Current guidelines emphasise the need to educate individuals with diabetes on physical activity at each clinical visit. The aim of the study was to develop an adequate instrument and test diabetologists’ knowledge on physical activity and related guidelines in diabetes, as well as investigate their prescribing habits. Materials and Methods: The instrument was developed with four diabetologists using Delphi and RAND appropriateness methods, then distributed to diabetologist societies in 12 Southeast European countries for anonymous completion by their members. Data were analysed using Mann–Whitney U test and Pearson ${ x}^2$ test. Results: Out of 302 analysed respondents, 123 (41%) worked at university hospitals, at average four days a week in outpatient departments, mean number of patients was 16 a day; 95 (32%) had a PhD, and 105 (35%) university teaching positions. Median overall knowledge was 15 (Q1–Q3, 13–17) out of 22 maximum points. 26% diabetologists knew recommended level of physical activity for people with diabetes. Physical activity goals were discussed during check-ups in 53.0% of cases; re-education and goal adjustments were provided in 33.4% when health status changed; and clear instructions were documented in 25.5% of medical records. Conclusions: Diabetologists’ overall knowledge of physical activity was found to be at least satisfactory in 90% of participants. Knowledge of the guidelines is insufficient in 75% of participants. The prescribing habits are inadequate in half of the participants. Full article