The Particulate Matter (PM), particles of variable but small diameter could penetrate the respiratory system via inhalation, causing respiratory and/or cardiovascular diseases. This study aims to evaluate the association of environmental particulate matter (PM2.5) and black carbon (BC) with respiratory health and physical activity in users traveling by transportation modes over four roads in Bogotá. This was a mixed-method study, in 300 healthy participants, based on a convergent parallel design. Including a descriptive qualitative component focused on asserting the individual perception of air pollution by semi-structured interviews and a cross-sectional study measuring the individual exposure to PM2.5 and BC to evaluate the pulmonary function by spirometry. The analysis included concurrent triangulation and a Poisson regression. This study provides integration of air pollution exposure variables and respiratory health effects in different transport microenvironments. To our knowledge, this is the first mixed-methods study focused on PM2.5, BC, and respiratory health effects in a city above 2.000 meters above sea level.

Objective: This study aims to identify the impact of nutritional factors on mechanical ventilation duration for critical patients. Patients and Methods: The current study was a single-center, prospective observational design which enrolled one-hundred critically ill patients who were admitted to an intensive care unit (ICU). It demonstrates purposive sampling and also performs the descriptive nutritional factors influencing the mechanical ventilation duration. Daily calories target requirement scale (DCRS), subjective global assessment form (SGA), dyspnea assessment form, and APACHE II have been used as methods in the study along with time to initial enteral nutrition (EN) after 24-hour admission and daily calories target requirement over 7 days to assess patients. Data is analyzed using the multiple regressions. Results: As a result, nutritional status monitoring, time to initial EN, calories and target requirements are statistically positive significance associated with the mechanical ventilation duration respectively (R = 0.54, R = 0.30, R= 0.40, p < 0.05). However, age, illness severity, and dyspnea scales are not associated with the mechanical ventilation duration (p> 0.05). Therefore, the nutritional status, malnutrition scores and calorie target requirements can be used to significantly predict the mechanical ventilation duration. The predictive power is 58 and 28.0% of variance. The most proper influencer to predict the mechanical ventilation duration is nutritional status or malnutrition scores. Conclusion: The research findings show that the nutritional status, time to initial EN, and calorie target requirement within 7 days of admission are associated with the mechanical ventilation duration in the critical patients. Therefore, it can be used to develop guidelines reducing the mechanical ventilation duration and to promote the ventilator halting for critical patients.

Surface urban heat island (SUHI) depicts the deteriorating thermal environment in high-density cities and local climate zone (LCZ) classification provides a universal protocol for SUHI identification. In this study, taking the central urbanized area of Guangzhou in the humid subtropical region of China as the study area, the maps or images of LCZ, land surface temperature (LST), SUHI and urban design factors were achieved by using Landsat satellite data, GIS database and a series of retrieval and classification algorithms, and the urban design factors influencing SUHI were investigated based on 625 samples of LCZs. The results show that in the summer daytime under the clear sky condition, the LST varied greatly from 26 °C to 40 °C and the SUHI changed in a wide range of -6 °C to 8 °C in the LCZs of the study area. Seven and five urban design factors influencing the summer daytime SUHI were identified for the two dominant LCZ of LCZs 1-5 (LCZ 1 to LCZ 5) and the mixed LCZ (containing at least three types of LCZs), respectively. The summer daytime SUHI prediction models were obtained by using the step-wise multiple linear regression, with the performance of R2 of 0.697, RMSE of 1.21 °C, and the d value of 0.81 for the model of LCZs 1-5, and the values of 0.666, 1.66 °C, and 0.76 for the model of the mixed LCZ, indicating that the models can predict the changes of SUHI with LCZs to a large and satisfactory extent. This study presents a methodology to efficiently achieve a large sample of SUHI and urban design factors of LCZs in the largely urbanized cities, and provides information beneficial to the urban designs and regenerations in the humid subtropical region.

Artificial intelligence (AI)-based models hold the potential to transform higher education if adopted properly and ethically. A prime example is ChatGPT with earlier studies indicating its widespread adoption in academia and by university students. The current study aimed to identify the factors influencing the attitude towards ChatGPT and its usage among university students in Arab countries. A previous survey instrument termed Technology Acceptance Model Edited to Assess ChatGPT Adoption (TAME-ChatGPT) was administered online using a convenience-based approach among the contacts of the authors. Confirmatory factor analysis (CFA) for the survey constructs was done using root mean square error of approximation (RMSEA), standardized root mean square residual (SRMR), comparative fit index (CFI), and Tucker-Lewis index (TLI). The final study sample comprised a total of 2240 participant divided as follows: Iraq (n=736, 32.9%), Kuwait (n=582, 26.0%), Egypt (n=417, 18.6%), Lebanon (n=263, 11.7%), and Jordan (n=242, 10.8%). A total of 1048 respondents heard of ChatGPT before the study (46.8%), of which 551 used ChatGPT (52.6%). The mean scores of TAME-ChatGPT constructs showed that the ease of ChatGPT use, positive attitude towards technology and social influence, higher perceived usefulness, the influence of behavioral/cognitive factors, low perceived risks and low anxiety were the determinants of positive attitude to ChatGPT and its use. For both the attitude and usage scales of TAME-ChatGPT, CFA collectively yielded satisfactory fit indices as indicated by low RMSEA and SRMR together with high CFI and TLI. Multivariate analysis showed that attitude to ChatGPT use was significantly influenced by country of residence, age, university type, and the latest grade point average of the students. The current study confirmed the validity of TAME-ChatGPT as a survey instrument to assess the possible determinants of ChatGPT use among university students in Arab countries. The study findings highlighted that successful adoption of ChatGPT in higher education could be dependent on perceived ease of use, usefulness, positive attitudes to technology, social influence, behavioral/cognitive factors, lower anxiety, and minimal perceived risks. The utility of ChatGPT in higher education requires policies that should be tailored for various settings, considering the differences observed in attitude towards ChatGPT among participating students in this study.

Introduction: This study explores exposure to misinformation, COVID-19 risk perception, and confidence towards the government as predictors to negative attitudes toward the COVID-19 vaccine. Methods: A cross-sectional survey was carried out from 30 June to 30 August 2021 involving 775 respondents. The survey instrument for the questionnaire is an adaptation from various different studies consisting of five main variables: 1) misinformation about vaccination; 2) risk perception toward COVID-19; 3) attitudes toward the vaccination programme; 4) intention to get vaccinated; and 5) public confidence in the government in executing the vaccination programme. Results: The results of this study indicate that higher exposure to misinformation led to higher levels of negative attitudes toward the COVID-19 vaccine. When the perceived risk of COVID-19 infection was high, mistrust of vaccine benefits was low but there were also higher worries about the future effects of the vaccine. Confidence in government was associated with lower negative attitudes toward the COVID-19 vaccine. Conclusion: The results of this study may help develop an understanding of negative attitudes toward vaccinations in Malaysia and its contributing factors.

The Gulf Cooperation Council (GCC), locally known as Khaliji, is a group of six Arab nations, including Saudi Arabia, Bahrain, Kuwait, Oman, Qatar, and the United Arab Emirates (UAE). Intimate partner violence (IPV) is a significant public health concern in the GCC region, but the research that synthesized the trend has received scant attention. The present narrative review examines existing research on the prevalence and frequency of IPV among Khaliji women in GCC nations. This review synthesized studies on physical violence, sexual violence, emotional abuse, and controlling behaviors perpetrated by an intimate partner. The prevalence rates of IPV among Khaliji women are observed to be high: women reported facing different types of abuse from their partners, namely physical (7% - 71%), sexual (3.7% - 81%), financial (21.3% - 26%) and psychological (7.5% - 89%), which is a culmination of controlling behavior (36.8%), emotional (22% - 69%) and social violence (34%). The extant studies in the GCC suggest that the most endorsed IPV was psychological abuse (89%) followed by sexual violence (81%). Qualitative content analysis of the associated factors resulted in four meaningful descriptors such as demographics of the victim, sociocultural factors, socioeconomic, and perpetrator-related issues. The study on IPV is still nascent and few. The way forward will require developing culturally appropriate interventions that address unique risk factors for IPV among Khaliji populations, strengthening institutional responses, and increasing awareness and social support for the victim of IPV.

Entrepreneurship education has become increasingly relevant. For some years now, the business environment for starting a new company in the Dominican Republic has been considered very propitious. This has generated that many universities have incorporated training in entrepreneurship in their study plans. This study aims to analyse whether the cognitive and affective components, the country's business environment, university training in entrepreneurship and attitudes towards entrepreneurship are antecedents of the entrepreneurial intention of university students. It also seeks to investigate the relationship between entrepreneurial intention and entrepreneurial behaviour of students. Data were collected through a structured questionnaire from a sample of 523 students who had taken courses on entrepreneurship. The data have been analysed through the SPSS and Smart-PLS programs. The results of this research highlight the importance of the affective component and attitudes towards entrepreneurship in the formation of students' entrepreneurial intentions. This reinforces the importance of cultivating positive attitudes through educational interventions. These results contribute to the understanding of the factors that drive entrepreneurial intentions among university students and provide a foundation for future research.

We aimed to assess awareness, knowledge, and attitudes of healthy pregnant women towards human papillomavirus (HPV), to estimate factors associated with a positive attitude towards HPV immunization and to assess the uptake of the vaccine among their children. A cross-sectional study was conducted at the University Clinic of Gynecology and Obstetrics, Belgrade, Serbia among pregnant women attending their regular gynecological check-ups at the 12th gestational week. Knowledge about HPV and HPV vaccine was assessed using a specifically designed 12-item and 5-item questionnaires. Out of total 265 included women, 79.3% had heard of HPV, and 37.5% knew that HPV vaccine exists. HPV vaccine knowledge score was associated with higher odds for a positive attitude towards vaccination of both female (OR = 4.10, 95% CI 1.50-11.29) and male (OR = 3.71, 95% CI 1.52-9.01) child. The number of children (OR = 1.32, 95% CI 1.04-1.67) and high vaccine knowledge score (OR = 1.64 95% CI 1.13-2.39) were independent predictors associated with willingness to vaccinate child against HPV. The gynecologist was the preferable point of reference for information seeking about the HPV vaccine. Despite relatively high HPV awareness and knowledge among pregnant women in Serbia, about one-third of them are HPV vaccine aware, and are willing to vaccinate their children against HPV.

Background: Maternal mortality remains dire in Nigeria, claiming 40,000 lives yearly due to pregnancy complications. Factors like limited healthcare access, poverty, and early marriage worsen the crisis. Despite efforts to improve skilled birth attendance, Nigeria struggles to meet MDG targets, underscoring the urgent need for more effective interventions. Objectives: The objective of the study is to assess and understand the knowledge of community members regarding the risk factors influencing maternal mortality in the Ede South Local Government Area of Osun State, Nigeria. Methodology: A descriptive cross-sectional study was conducted. The study methodology involves employing the Leslie Kish formula to select 185 participants from the Ede South Local Government Area in Osun State, Nigeria. The selection process involved the use of a systematic sampling technique to ensure a representative sample based on population demographics and characteristics, ensuring a balanced and accurate selection process. Quantitative data was collected through a self-administered questionnaire and analysed using SPSS version 21. Results: The study encompassed 185 participants. 64.9% females with a mean age of 27.3 + 8.3 years. Among them, 60.5% were single, 46.6% being students, 55.7% held a BSc degree, 64.9% were Yoruba and 61.1% identified as Christian. 91.4% were aware about maternal mortality, 74.6% recognized maternal deaths in reproductive-aged women. Participants identified that maternal deaths mostly occur during labour (91.4%). Direct causes, such as bleeding (88.1%), unsafe abortion (88.6%), infection (49.2%), and hypertension (64.9%), were recognized. Results indicated substantial awareness concerning specific risk factors: lack of education (98.9%), poverty (91.6%), poor health care services in facilities (94.0%), alcohol consumption (87.6%) and poor transportation (78.4%). Conclusion: Findings revealed good awareness of maternal deaths and critical factors such as ANC impact and direct causes of maternal mortality like bleeding and unsafe abortion. However, gaps persisted in SDG awareness, suggesting the need for targeted interventions to enhance overall understanding and address identified knowledge gaps.

Evaluating the efficacy of the traceability systems (TS) plays an important role not only for planning system implementation before development, but also for analyzing system performance once the system is in use. In the present work, we evaluate the traceability granularity using a comprehensive and quantifiable model and try find its influencing factors via an empirical analysis with 80 vegetable companies in Tianjin city, China. Granularity indicators were collected mostly by the TS platform to ensure the objectivity of the data, and the granularity score was evaluated by using a TS granularity model. The results show a clear imbalance in the distribution of companies as a function of score. The number of companies (21) scoring in the range [50,60] exceeded the number in the other score ranges. Furthermore, the influencing factors on traceability granularity were analyzed by using a rough set method based on nine factors pre-selected by using a published method. The results show that the factor “number of TS operation staff” is deleted because it is unimportant. The remaining factors rank according to importance as follows: Expected revenue &gt; Supply chain (SC) integration degree &gt; Cognition of TS &gt; Certification system &gt; Company sales &gt; Informationization management level &gt; System maintenance investment &gt; Manager education level. Based on these results, the corresponding implications are given with the goal of (i) establishing the market mechanism of high price with high quality, (ii) increasing government investment for constructing the TS, and (iii) enhancing the organization of SC companies.

In the past two decades, several floods have affected people and their properties in Burkina Faso, with the unprecedented flooding occurring in Ouagadougou in September 2009. So far, most studies have focused on Ouagadougou and surrounding localities and have paid little attention to other flood-prone regions in Burkina Faso. Specifically, there is a data and knowledge gap about the flood risk in the Haut-Bassins region, which in turn hampers the development of mitigation strategies and risk reduction measures in communities. This study demonstrates how data collected at the household level can be used to understand flood risk and its components at the village level in this data-scarce region. Using an indicator-based method, we analyze both flood risk and flood risk perception at the village level. Moreover, we determine the factors influencing flood risk perception at the household level using an ordered logit model. We find that 12 out of the 14 villages considered, experience high levels of flood risk. The management of runoff from the nearest urban areas and poorly designed civil engineering infrastructures, such as roads, were highlighted by the households as significant factors that increase their vulnerability. Hence, dependencies in space and between urban and rural areas may play a substantial role in modifying risk. The perceived flood risk consistently exceeds the estimated flood risk, with an insignificant positive correlation between both risk indices. Regression results indicate that flood risk perception is mainly influenced by informational and behavioral factors of the households. The findings of this study can provide valuable information to municipal and regional authorities involved in disaster risk management in the study area. Moreover, the method is transferable to other data-scarce regions

In recent years, the Chinese government pays more and more attention to agricultural development and ecological protection. While improving the cultivated land green use efficiency(CLGUE) is the key to promote the sustainable development of agriculture. This study aims to study the current situation and influencing factors of agricultural production from the perspective of green utilization efficiency of cultivated land. It takes 39 cities in the upper, middle and lower reaches of the Yangtze River basin in China as an example. The CLGUE values in those 39 cities from 2011 to 2020 were specifically measured, using the Super-SBM model, kernel density estimation and geographic detector method. Their temporal and spatial heterogeneity was described, and the influencing factors were detected at both single and interactive levels. The results showed that: （1）From 2011 to 2020, the green utilization efficiency value of cultivated land in the Yangtze River Basin showed an upward trend on the whole; （2）There is a clear spatial heterogeneity the CLGUE values in the Yangtze River Basin cities, as shown by: downstream region > midstream region > upstream region; (3) Cultivated land resource endowment, socioeconomic development, and agricultural production technology are important factors affecting the variability of CLGUE values. However, there are some differences in the degree and direction of influence of different influencing factors on different sample subgroups.

Cervical cancer is one of the ailments that endangers the health of women all over the world and causes infertility. Fortunately, this disease can be avoided. Both the results and participation rates of the current preventative strategy remain poor. Hence, preventative or early detection methods remain challenging and open. In gynecology and computer science fields, few studies on identifying cervical cancer are based on behavior risk factor and machine learning. Moreover, various social and behavioral aspects might often make it more difficult to detect cervical cancer especially in low‑ and middle‑income countries (LMICs). Accordingly, focus on predicting the presence of cervical cancer through behavioral risk factors is the basic structure of this research. We proposed an approach to classify cervical cancer from a social-behavioral perspective using logistic regression to predict cervical cancer. We got significantly improved outcomes than the existing methods. Moreover, we used feature engineering to formulate less dimensionality as a pre-processing step and optimized parameters to be prepared for classification phase. The results proved that using the logistic regression with regularization type L1 had a promising performance. The accuracy of Logistic Regression (LR) L1 was 97.2%. Such results support the proposed work as a reliable classification predictive tool.

This study aimed to identify and categorize the influencing factors on the purchase of dairy products among customers of dairy companies in Mashhad city. This study is a mixed research (qualitative and quantitative), conducted with the aim of identifying and categorizing the influencing factors on consumers’ purchase. Therefore, the theoretical foundations were examined in the initial step, after which the customers and their needs and demands were addressed in terms of the company and its products. In the qualitative part, interviews were conducted in the focus group (23 people in 5 groups) to identify and extract these factors using the theme analysis technique. The reliability of the interviews was confirmed by retesting and the reliability between two encoders. Sixty themes (factors) that affected the purchase of dairy products were collected. In quantitative part, 517 questionnaires were collected from 13 regions of Mashhad city to perform statistic tests. A questionnaire was designed using the extracted themes in the previous (qualitative) stage to assess customers’ feedback. The validity of the questionnaire was confirmed by content and structure validity (exploratory and confirmatory factor analysis), and its reliability was checked by Cronbach’s alpha. Fourteen components were obtained by exploratory and confirmatory factor analyses, after which the variables were labeled as intrinsic, psychological, and personality factors, the identity of the company, production power of the company, competitive power of the company, competitive prices, social awareness, and store capabilities. The construct validity was confirmed using confirmatory factors.

This systematic review followed the guidelines of the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) statement to synthesizes the existing literature with a goal to review current conceptual frameworks of mental health of forced migrants for further practice research priorities in social work. The search was done between January 2015 to January 2021. As a result, 29 studies met inclusion criteria. Medicalizing mental health issues by relying solely on the effectiveness of medicine was a controversial risk factor that negatively affected the daily life activities of refugees and reduced their willingness for seeking professional mental health services. Empowering vulnerable minorities by giving them back their power and agency to be able to speak for themselves and raise voices of trauma and recovery was the missing protective factor for sustainable mental health practice. The benefits of group-based interventions are highlighted in which communities and individuals address mental health issues as well as isolation through building collective identities and support networks. Information and communication technologies (ICTs) can add more strength to any kind of mental health intervention. Finally, the benefits of applying ecological perspective for the mental health of refugees, and its implications for a sustainable intercultural practice are discussed. Social workers in this model are the representatives of at-risk groups, thus need more agency and creativity in reflecting client’s concrete needs.

By repeated unloading and loading of the excavation dynamic and static loads, repeated train dynamic and static loads of multi-factors, the underpass tunnel, cross tunnel engineering influence area rock layer, the existing tunnel structure of the three constitutes a multifaceted structure, multi-factor interaction system. Existing tunnels into the prediction theory model of the new tunnel excavation process of dynamic and static loads, dynamic and static loads of existing tunnels are mostly analyzed individually, the results of synergistic analysis needs to be improved. Based on the theory of the current layer method, the paper comprehensively considers the stiffness of the existing tunnel, the stiffness of the new tunnel, the excavation method load and the existing tunnel load, coupled with Peck's empirical formula, the theoretical model of deformation prediction for excavation of a two-lane highway tunnel under the tunnel through the existing railroad is proposed, and verified and optimized by numerical calculations and monitoring data, which proves the applicability and reliability of the theoretical model in the similar strata and the project promotion.

Severe early childhood caries remains the most common chronic disease affecting children. Its multifactorial etiology has established a controversy about which risk factors were more significant to its development. Therefore our study aimed through meticulous statistical analysis to arrange the “well agreed upon” common risk factors in order of significance, to aid the clinician in tailoring an adequate preventive program for this affected age group. The study reshuffled the risk factors contributing to severe early childhood caries and placed them in the order of their significance as follows: snacking of sugary food several times a day, increased number of siblings to 3 or more, night feeding, child self-employed brushing, mother caries experience, 2 siblings, on demand feeding, once/day sugary food, sharing utensils, 1 Sibling, male gender, father’s education, late first child dental visit, brushing time, mother’s education, no dental visit, decreased brushing frequency & no night brushing.

Knowing professionals’ attitudes is the basis for the development of skills for dealing with drug dependence. These attitudes may affect patients’ clinical safety and the cost-benefit ratio of the interventions. The goal of this study was to assess emergency and mental health nurses’ attitudes and perceptions towards alcoholics. A multicenter prospective descriptive study was conducted in six hospitals with 167 emergency and mental health nurses. Nurses classified alcoholics as sick individuals, although there was a tendency to feel comfortable working with them. Results indicated that these professionals had a rejecting attitude towards moderate alcohol consumption. We found a significant association between the attitude of the nurse and gender, with the degree of rejection towards the alcoholic being higher in men than in women and with less punitive attitudes in professionals from 0 to 11 years of professional experience.

Psycho-social factors are key factors to the powerlessness of infant mothers who breastfeed. As the theory of planned behavior (TPB) is widely used to investigate the correlation between psycho-social factors and breastfeeding behavior, this study aims to examine the utility of TPB constructs to predict breastfeeding behavior and understand TPB-based psycho-social factors’ effectiveness on breastfeeding behavior. A narrative review consulting Web of Science, Scopus, Ebsco, PubMed, and PsycInfo in English and Chinese has been conducted, with the inclusion of twenty studies published between January 2000 and May 2022. It is reported that psycho-social factors based on TPB for breastfeeding such as affective attitude, instrumental attitude, subjective norm, perceived behavioral control (including self-efficacy), moral norm, breastfeeding knowledge, and self-identity can effectively explain the breastfeeding behavior. Future research should improve the theoretical model of TPB-based breastfeeding and implement more localized prediction and intervention studies on breastfeeding.

Indonesia is among the countries developing the concept of smart city. The national government envisions Indonesia 2030 which shall implement the smart city towards sustainable development. Many regions in Indonesia have already implemented the concept of smart city, but still on the level of smart government and smart technology, lacking on the smart citizen component of a smart city. This paper aims to analyze the citizens behavior of using technology on Sleman smart citizen 2021 through the lapor sleman mobile application. This research uses mixed method of quantitative and qualitative approaches in examining the data. The authors distributed 100 questionares and conducted interviews to the government which is department of communication and information, Sleman and the several community that ever use the lapor sleman application. The result of the study reveals the following: firstly, performance expectancy, social influence, and behavioral intention are three independent variables which affect the users’ behavior. Secondly, the behavioral intention has the biggest significant effect on users’ behavior. Thirdly, the citizen behavior of using technology has affect the making a smart citizen. Therefore, using technology in term of lapor sleman mobile application can make the citizens as active participants in public life, in terms of social cooperation, freedom of expression and flexibility. However, there are still many problems in the use of lapor sleman mobile application such as the limited access to only android smartphones, lack of technical know-how, and people’s reluctance to use the lapor sleman mobile application.

While obesity is recognized as a key global public health issue, there has been no research to date on the perceptions of care for people with this condition held by individuals in positions of organizational power. The aim of this study was therefore to describe the perceptions and experiences of clinical leaders and managers of providing care to inpatients with obesity at a metropolitan public health service. This study applied an interpretative phenomenological analysis (IPA) approach to qualitative research, conducting interviews with 17 participants. Their perceptions of care for inpatients with obesity encompassed both their personal understanding as an individual, and their observations about the organizational, patient and carer perspectives. Three overall themes were identified: 1) The problem of inpatients with obesity, 2) Inpatients with obesity as sources of risk and 3) Personal and professional perceptions of inpatients with obesity. While clinical leaders and managers were aware of potential impact of stigma and weight bias on the care given to this cohort, elements of implicit bias, stereotyping, ‘othering’ and ambivalence were frequently present in the data. Ongoing efforts to improve care for patients with obesity must therefore include efforts to address perceptions and attitudes at all organisational levels of the workforce.

Historic sites are important components of every city's cultural history because they preserve rich historical knowledge and distinctive values passed down from previous generations to the present. Due to the progress of urbanization and modernization, many historic sites face pressure from damage and transformation. In this paper, a method for assessing cultural heritage damage was developed to measure the extent of spatial damage in historic sites. Using sample data obtained in Xiyang, Qixian, and Xiaoyi, all historic cities in Shanxi Province, Mainland China, and combined weights were estimated using the Delphi technique and the CRITIC weight method. Following this, the Spatial Damage Degree Model (SDDM) based on K-means cluster analysis and K-nearest neighbor (KNN) classification was developed. The findings show that the model efficiently solves the problem of assessing spatial damage levels in historic sites. Through multiple linear regression analysis, it was shown that the damage to historic sites was predominantly caused by three factors: natural erosion, construction damage, and planning and policy. SDDM was used to calculate the spatial damage levels of historic sites, allowing conservators to fully comprehend the features and concerns related to historic sites. As a result, more scientific and rational preservation approaches may be developed, improving the efficiency of historic site restoration and conservation and encouraging the sustainable development of urban and rural heritage.

Microfinance institutions (MFIs) play an significant role in financial inclusion and poverty alleviation activities. A critical challenge facing MFIs is how on all to build its own capacity for sustainable and healthy development. By using the data from the pilot survey of 65 microcredit companies in Zhejiang of China, this paper explores the factors affecting MFIs activities by principal component analysis and analyzes the key Influencing factors and sustainable development performance with the analysis of variance and multi-regression model.The results indicate that four key factors of operational technology, external environment, financial condition and institution size have a significant positive effect on the economic sustainability performance of MFIs, while the adjusted institution size is insignificant positive effect on operational sustainability performance,which means that key factors of MFIs sustainability have a greater impact on economic sustainability performance than operational sustainability performance.

The African continent has the highest prevalence of hypertension globally, with South Africa reporting the highest prevalence in Southern Africa. While the influence of genetic variability in the pathogenesis of hypertension is well described internationally, limited reports are available for African populations. This study aimed to assess the association of genetic variants and essential hypertension in a cohort of two ethnic South African population groups. Two hundred and seventy-seven hypertensive and one hundred and seventy-six normotensive individuals were genotyped for 79 variants. Genotyping was performed using the Illumina GoldenGate Assay and allele-specific polymerase chain reaction. The association of variants was assessed using the Fisher Exact test under the additive and allelic genetic models, while multivariate logistic regression was used to predict the development of hypertension. Five variants (CYP11B2 rs179998, AGT rs5051 and rs699, AGTR1 rs5186 and ACE rs4646994) were significantly associated with essential hypertension in the cohort under study. Furthermore, AGTR1 rs5186 and AGT rs699 were identified as risk factors for the development of hypertension in both ethnic groups. In two ethnic South African populations an association was observed between Renin-Angiotensin-Aldosterone System (RAAS) related genes and the development of hypertension.

The increasing enrollments in the English Departments at Palestinian universities highlight the need to understand the attitudes and expectations of students, as these factors can significantly impact their motivation and proficiency in learning English as a foreign language (EFL). This study aimed to explore the attitudes and expectations of Palestinian first-year English majors in relation to EFL learning. A total of 244 students participated in the study, completing a questionnaire and participating in interviews to provide a comprehensive understanding of their perspectives. The results revealed a high level of enthusiasm among the students towards EFL, as evidenced by their strong attitudes and exceptionally high expectations. Moreover, the study identified specific student characteristics, including gender and the required hours dedicated to English learning, as well as the experience of studying abroad, which served as predictive factors for their attitudes and expectations. The findings emphasize the importance of regularly assessing the attitudes and expectations of learners in English departments to effectively cater to their needs and attract more students. By understanding the motivating factors and aligning instructional strategies accordingly, English departments can create a more engaging and tailored learning environment for students pursuing English as a foreign language.

Among the most popular learning management systems available worldwide is Moodle [1]. This current study examines how learners' attitudes toward English as a foreign language (EFL) and their language proficiency are affected by Moodle's interactive language learning activities. Thirty-three undergraduate students participated in this study. We investigated the effects of engaging language learning exercises that were practiced on Moodle using an experimental re-search design. To find out if the experimental and control groups differed significantly from one another on pre- and post-measures regarding the development of language skills and attitudes toward language classrooms, a number of statistical tests were employed. We conducted data analysis using SPSS software. Results demonstrated that there were differences favoring the ex-perimental group in the language skills developments and attitudes of learners toward the lan-guage classroom. There were no apparent differences in the forming structures, speaking, or listening of the control group's learners. On the other hand, there were notable differences in the overall score, writing and reading skills, and lexical item mastery. Additionally, significant dif-ferences in the language acquisition growth of the experimental and control groups were found using an Independent Samples T-test in the post-test, with the experimental group benefiting.

Asthma causes chronic coughing, wheezing, dyspnea, and chest pressure. This study assessed asthmatic patients' knowledge, attitudes and awareness of bronchial asthma and proper education on its meaning, risk factors, symptoms, diagnosis, management, and prevention practice. We performed a cross-sectional interventional asthma KAP survey in Erbil, Iraq. We adapted a validated study questionnaire from KAP studies in other nations to the Erbil situation and culture. In Erbil, Kurdistan, Iraq, two major hospitals' asthma clinics were studied. We chose 250 asthmatic ICU patients from October 2018 to July 2019. Health education was comprehensive. The health education program used a Kurdish PowerPoint with a printout. 25 groups got two-weeks of one-hour health education pre-intervention. Each group was questioned before, 2 and 12 weeks after health education. All data were analyzed by SPSS v26. The mean age of the respondent was 37.52±15.16 with 48.7 % respondent having a positive family history of asthma. After 2weeks of health education intervention, respondent have a higher knowledge score, positive attitudes compared to pre-education and after 12 weeks of education with a significant difference (P < 0.001) with improvised prevention practice. Health education programs led to considerable improvements in asthmatic patients' knowledge, attitudes, and practices regarding their condition. After receiving health education for a period of two weeks, the majority of the participants answered correctly regarding asthma, its causes, and the elements that trigger asthma attacks.

In the context of digital empowerment, the digital literacy level of tea farmers has a significant impact on the intelligent development and transformation of the tea industry. This study extends the original model of UTAUT theory by introducing Personal innovativeness theory and Self-efficacy theory, and constructs a new model to explore the influencing factors of moderate scale tea farmers' digital literacy improvement behavior. There are a total of 22 research hypotheses. Using structural equation modeling and collecting questionnaire data for analysis, the following research results were obtained: (1) Performance expectancy, social influence, effort expectancy, personal innovativeness and self-efficacy all significantly positively affect the willingness of tea farmers to improve their digital literacy, and then according to the path coefficient, in descending order, social influence (0.226)>self-efficacy (0.224)>effort expectancy (0.178)>performance expectancy (0.157)> personal innovativeness (0.155); (2) Facilitating condition and willingness to improve digital literacy have a significant positive impact on tea farmers' digital literacy improvement behavior，and then from the size of the path coefficient, the willingness to improve (0.271)>facilitating condition (0.106); (3) The willingness of tea farmers to improve their digital literacy plays a complete mediating role between personal innovativeness and self-efficacy on their digital literacy improvement behavior, and partially mediates between performance expectancy, social influence, and effort expectancy on their digital literacy improvement behavior, and according to the proportion of indirect effects, the order is effort expectancy (27%), performance expectancy (47%), and social influence (49%); (4) The gender and age of tea farmers have a significant positive moderating effect on the impact of performance expectancy on the willingness to improve digital literacy; age and experience have a significant positive moderating effect on the impact of effort expectancy on the willingness to improve digital literacy; the age of tea farmers has a significant positive moderating effect on the improvement of digital literacy behavior through facilitating condition. This study extends the applicability of the UTAUT theoretical model and proposes strategies to improve the digital literacy of tea farmers, providing practical guidance for tea farmers to improve their digital literacy and providing reference for research related to farmers' digital literacy.

Graphene hybrid-filler polymer composites have emerged as prominent materials that revolutionize heavy industries. This study encapsulates the in-depth analysis of different influential factors such as filler/graphene type, aspect ratios, dispersion methods, filler-matrix compatibility, fiber orientation, synergistic effects, different processing techniques, and post-curing conditions that affect the processing, properties and determine the resultant applications of graphene hybrid polymer composites. Additionally, it discusses the substantial role of graphene collaboration with other fillers such as carbon nanotubes, silica, nano-clays and metal oxides to produce functionalized hybrid polymer composites with synergistically enhanced tailored properties to offer solutions for heavy industries like aerospace, automotive, electronics, and energy harvesting. The review concludes with some suggestions and outlook on the future of these composite materials by emphasizing the need for continued research to fully optimize their potential.

The outbreak of COVID-19 in 2020 caused significant disruptions to global shipping and the world economy. This paper aims to investigate the impact of the pandemic on global shipping by analyzing the Baltic Dry Index (BDI). The BDI is a metric that reflects the worldwide shipping costs and directs related to supply and demand conditions, making it an indicator of economic production. The study utilizes data from 2019 to 2021, before and after the outbreak of COVID-19, and considers 13 independent variables, including raw materials, energy, stock market indexes, global port calls, and confirmed COVID-19 cases to investigate how to influent the BDI. The study employs stepwise regression to select variables and build models before and after the pandemic. The findings reveal that the key factors affecting the freight index BDI before the outbreak are: international scrap steel prices, iron ore prices, and the Commodity Research Bureau Index. However, after the COVID-19 outbreak, the factors affecting the BDI changed to the Shanghai Index, global port calls, and the number of confirmed COVID-19 cases.

Background: Health inequity (HI) remains a major challenge in public health. Improving the health of children with low socioeconomic status (SES) can help to reduce overall HI in children. Childhood obesity is a global problem, entailing several adverse health effects. It is crucial to assess influencing factors for adoption, implementation and sustainment of interventions. This review aims to identify articles reporting about influencing factors for the implementation of school-based interventions promoting obesity prevention behaviors in children with low SES. It aims to critically appraise the articles’ quality, assess influencing factors, categorize and evaluate them, and to discuss possible implications. Methods: A systematic search was conducted in 7 databases with the following main inclusion criteria: 1) school-based interventions and 2) target group aged 5–14 years. The Consolidated Framework for Implementation Research, its five domains (intervention characteristics, inner setting, outer setting, characteristics of individuals, process) along with 39 constructs within these domains were used to deductively analyze the data. We grouped the articles with regard to the characteristics of the interventions in simple and complex interventions. For each domain, and for the groups of simple and complex interventions, the most commonly reported influencing factors are identified. Results: 6452 articles were screened, and 16 met all eligibility criteria. Included articles applied mixed methods (n=10), qualitative (n=5) and quantitative design (n=1). Of these, five were considered to report simple interventions and eleven were considered to report complex interventions. In total, 295 influencing factors were assessed. Aspects of the inner setting were reported in every study, aspects of the outer setting were the least reported domain, and in the group of simple interventions not reported at all. In the inner setting, most reported influencing factors were time (n=7), scheduling (n=6) and communication (n=6). Conclusion: This review found a wide range of influencing factors for implementation. Most important influencing factors need to be assessed for every setting. Including all stakeholders involved in the implementation process enhances the prioritization of the most important influencing factors for the specific setting. More empirical research and practical guidance are needed to promote obesity prevention behaviors among children with low SES.

Street vended foods are ready-to-eat food and beverages prepared and/ or sold in the streets. This trade provides for 85-99% of total employment in most African countries and 50% or more is constituted by women. The preparation of street vended foods is normally under unsatisfactory conditions and these may lead to the contamination of food. This descriptive survey was conducted in Maseru around the taxi ranks amongst 141 participants (48 food handlers and 93 consumers) using a semi structured questionnaire, open ended questionnaire and observation checklist. Majority of the food handlers were females (n=35, 60%) and males constituted only (n=23, 40%). On average the vendor population that participated in this study was considered to have poor knowledge of food safety since they scored 49%±11. With regard to the consumers, 63% were males and 37% were females, and only 6% reported that they never buy street vended foods mainly due to the food safety issues and hygiene. Based on the results of this study, it is thus recommended that educational interventions be implemented. The observation study showed that they also operated under unhygienic conditions and 95% of food handlers had the incorrect knowledge that washing utensils with detergent leaves them free of contamination. Regarding the consumer perceptions, they highlighted that the trade has the potential to grow and be profitable on condition that hygiene is emphasized and infrastructure improved so as to provide safe quality food.

Eating disorders (EDs) refer to a group of diseases characterized by a strong tendency toward chronicity, often involving distortions in body image distortion and other related symptoms The prevalence of EDs has increased in recent years, specifically in athletic populations. Therefore, the purpose of this study was to analyse risky eating attitudes in a sample of 1102 subjects from Se-ville (Spain): 142 women and 960 men aged between 15-25 years old. An online survey, designed using Google Forms, consisted of three questionnaires (EAT-26, SCOFF, and BITE), were com-pleted individually and anonymously. With regards to the cut-off points, the percentage of posi-tive cases with significant scores was 11.43% for EAT-26, 31.22% for SCOFF and 4.36% for BITE. The study found that the probability of testing positive for EDs is significantly higher in women than in men (p < 0.001). Specifically, the risk attitude for EDs in female athletes measured by the EAT-26 test is three times higher than in male athletes, while the risk attitude measured by the SCOFF test is twice as high in females. Risk attitude for EDs in athletes measured by the BITE test is 8 times higher in females than in males. This study’s findings confirm several important as-sumptions made at the outset of the research. There is indeed a higher risk of EDs in athlete populations. Moreover, all three tests therefore show a higher frequency of possible events of EDs in women, with very similar percentages of difference between sexes. The tests also confirm the role played by the coaches in the prevention of EDs in sports and their capacity to reduce ab-normal food-related behaviours. Thus, the future inclusion of these tests in the screening of athletes is highly recommended.

The food system, the most important driver of planetary transformation, is in a deep crisis. Therefore, seeking a sustainable and socially-fair transition pathway becomes an issue of utmost priority for our own survival. The consideration of food as a commodity, a social construct that played a central role in driving this crisis, remains the uncontested narrative to lead the different transition pathways what seems rather contradictory. By exploring the normative values in the transition landscape, this paper seeks to understand how relevant is the hegemonic narrative of “food as commodity” and its alternative of “food as commons” to determine transition trajectories and food policy beliefs. Applying the Multi-level Perspective framework and developing the ill-studied “agency in transition”, this research enquired food-related professionals that belong to an online community of practice (N=95) on valuation of food dimensions and agency in food transitions to check whether the valuation of food is relevant to explain personal stances in transition. Results suggest the socially-constructed view of food as commodity is positively correlated to the gradual reforming attitude, whereas food as commons is positively correlated to the counter-hegemonic transformers regardless the self-defined position in the transition landscape (regime or niches). At personal level, there are multiple loci of resistance with counter-hegemonic attitudes in varied institutions of the regime and the innovative niches, many of them holding this discourse of food as commons. Conversely, alter-hegemonic attitudes are not positively correlated to this alternative discourse and they may inadvertently or purportedly reinforce the ‘‘neoliberal narrative’’. Food as commons, a different narrative whose rationale is explained in the paper, seems to be a relevant framework that could enrich the multiple transformative constituencies that challenge the industrial food system and therefore facilitate the convergence of movements that reject the commodification of food.

What drives an individual police officer to activate his body-worn camera (BWC)? Some evidence suggests officer attitudes and resistance to the technology contributes to the equivocal results in studies testing for BWCs effect on use-of-force, complaints, and other outcomes of interest. Leveraging a novel survey and administrative dataset, we investigate the predictors of BWC activation among 147 police officers in a single agency. With a test of three nested models, we find job function covariates offer robust predictive power of how often an officer activates her or his BWC. Neither demographic nor attitudinal measures significantly predict BWC activations, except for a negative relationship with how officers perceive BWC impacts on professional discretion. The study furnishes empirical support for understanding officers as Principled Agents: job function, guided by administrative policy is the most explanatory and parsimonious, while models of attitudes and demographics fail to improve upon the job function model.

The aim of the article is to verify differences in the perception of selected factors of sustainability among small and medium-sized enterprises (SMEs) in Central Europe. The subjects of analysis are factors such as corporate social responsibility (CSR), business risk sources (market, financial, personnel, and operational), reputation and social media, national support, social changes, and crisis events in business. The questionnaire was completed by 1,090 SMEs from the business environments of Visegrad Group countries. Statistical hypotheses were verified using Z-scores for two population properties. The most negatively perceived factors among owners and managers in the SME segment are national support and legislative changes. The most positively perceived factor is reputation and social media. The country of doing business is a significant factor. The perception of crisis events in business is most negative among Czech SMEs. More than 80% of Hungarian SMEs perceive their companies as sustainable. In comparison with Slovak and Polish SMEs, Hungarian perceptions are more positive in the context of sustainability. The country of doing business is the strongest factor in evaluating CSR indicators. The positive perception of CSR in Czech SMEs (43.9%) is lower than in other countries.

Domestic violence (DV) has been reported high in minorities across the US. Among minorities, refugees and immigrants encounter several barriers that may influence their responses and actions regarding DV. This scoping review examined three decades of literature (1980-2022) on resettled Afghan and Arab refugee women's attitudes and behaviors toward DV in their host countries, and to summarize research, practice, and policy recommendations. Based on Arksey and O'Malley model, our scoping review conducted extensive searches in SCOPUS, PubMed, PsychInfo, CINAHL, Web of Science, the Directory of Open Access Journals, and Embase databases. Searches identified articles that examined resettled Afghan and/or Arab refugees’ responses to DV in Western countries. The search identified 439 unique citations; 17 met the inclusion/exclusion criteria. Major themes included acculturative changes in refugee attitudes and behaviors and in stakeholders’ perspectives and roles. Significant acculturative attitudinal changes (acknowledgment, silence, justification, or disapproval of DV) contrasted with minimal behavioral changes (help-seeking behaviors, action plans, or barriers to actions) and with a resistance to change in stakeholders (cultural norms and beliefs, community patriarchal normalization of violence, service providers unfamiliarity with client diversity and refugee cultures) in supporting women decision-making regarding DV. Not a single article made explicit policy recommendations.

Measuring the impact of land use regulation on the land market involves identifying and classifying relevant impact factors related to the land market. The objective of this study was to identify land market impact factors in the context of the introduction of land use regulation in Nepal. A desktop review was carried out to identify preliminary set of impact factors, which were reclassified through intuitive analysis based on the degree of thematic closeness. Perspective-based impact factors were identified through the qualitative analysis of primary data collected through semi-structured interviews with the Nepalese land market stakeholders. These independently derived impact factors were compared with the desktop literature review impact factors resulting in fourteen land market impact factors across four dimensions, including transaction cost, valuation, mortgage availability, taxation, and compensation across the economic dimension; lot size, subdivision restrictions, and coordination across the institutional dimension; awareness, expectation and proximity across the social dimension; and risk reduction, quality of residential land, and suitability of zoning classification across the environmental dimension. There was significant overlap and commonality across factors identified from both the literature review and semi-structured interviews. The land market impact factors determined in the study may be adapted and generalized across other countries and could be utilized to better understand the impacts of land policy decisions on urban planning and development. Further research is recommended on the process to operationalize the use of these factors to quantify the impact of land use regulation on different land markets.

In order to better realize rural revitalization, this paper analyzes the spatial and temporal char-acteristics and influencing factors of agricultural surface source pollution in the Yangtze River Economic Belt from the three perspectives of government, enterprise and agriculture by using the spatial Durbin model and the dynamic GMM method in the period of 2006-2021, and further re-searches the threshold characteristics of the distortion of the factor market on the agricultural surface source pollution under the different strengths of environmental regulation. The results show that there is a positive spatial correlation between agricultural surface pollution in the Yangtze River Economic Belt, and government environmental regulation, input factor market distortion and labor force transfer all have a significant impact on agricultural surface pollution. Among them, factor market distortion has a significant spatial spillover effect on agricultural surface pollution in the Yangtze River Economic Zone, and has a significant single-threshold ef-fect on environmental regulation. Accordingly, the government should strengthen environmental regulation, continuously improve the agricultural factor market mechanism, and pay attention to the construction of talents to provide support for rural revitalization.

Background and Objectives: The aim of this study was to determine the job-related and individual features that influence BS and depression levels among dentists working in faculties, oral and dental health centres (ODHC) and private clinics. Materials and Methods: This prospective, cross sectional study was carried out on dentists working in different regions of Turkey. Data were collected using an on-line questionnaire created using Google Forms. The questionnaire consisted of demographic data, Maslach BS Inventory (MBI) and Beck Depression Inventory (BDI) sections. Demographics were age, height, weight, marital status, blood type, gender, monthly income, income satisfaction and having enough free time. The dentists were divided into 3 groups as faculty, private clinic and ODHC according to the institutions in which they worked. Results: Of the total 290 dentists enrolled in the study, there were 172 males and 118 females with a mean age of 36.98±5.6 years. 128 of the dentists worked in faculties, 72 in private clinics and 90 in ODHCs. It was observed that women's EE scores were higher than men's (P&lt;0.05). No statistically significant difference was found between the groups when comparing BS and depression scores according to marital status and blood group (P&gt;0.05). There was no significant relationship between emotional exhaustion (EE), depersonalisation (DP), personal accomplishment (PA) and depression scores according to age, BMI and work experience, age, work experience and BMI (P&lt;0.05). It was found that the EE scores of the dentists working in the faculty and private clinic were lower than those of the dentists working in the ODHC (P&lt;0.05). Monthly income was associated with depression (r = -0.35). Conclusions: This study showed that dentists working in ODHCs had more EE. These findings suggest that there is a need for improvement in the working conditions of dentists, particularly in ODHCs.

We aimed at developing and validating a scale on the beliefs and attitudes of mental health professionals towards services users’ rights in order to provide a valid evaluation instrument for training activities with heterogeneous mental health professional groups. Items were extracted from a review of previous instruments, as well as from several focus groups which have been conducted with different mental health stakeholders, including mental health service users. The preliminary scale consisted of 44 items and was administered to 480 mental health professionals. After eliminating non-discriminant and low weighting items, a final scale of 25 items was obtained. Exploratory and confirmatory factor analyses produced a four-factor solution consisting of the following four dimensions; system criticism/justifying beliefs, freedom/coercion, empowerment/paternalism, and tolerance/discrimination. The scale shows high concordance with our theoretical model as well as adequate parameters of explained variance, model fit, and internal reliability. Additional work is required to assess the cultural equivalence and psychometrics of this tool in other settings and populations, including health students.

Heat waves are a significant consequence of climate change threatening public health by increased morbidity and mortality. The aim of this study was to estimate individuals’ knowledge, attitudes and practice related to heat waves. We conducted an exploratory cross-sectional study in Greece during September 2023. We employed a convenience sample of 1055 participants. We used the heat wave knowledge, awareness, practice and behavior scale (HWKAPBS) to measure our outcome. We measured several socio-demographic variables, such as gender, age, educational level, etc. as potential determinants. Mean scores for the knowledge, awareness, practice and behavior factors were 12.5, 22.7, 22.2 and 12.1 respectively. Females had higher scores on the four factors compared with males. We found a positive relationship between self-perceived health status and awareness, practice and behavior about heat waves. Similarly, we identified a positive relationship between self-perceived financial status and awareness and behavior about heat waves. Increased age was associated with increased practice score, while increased educational level was associated with increased knowledge score. Additionally, behavior score was higher among participants in urban areas than those in rural areas. We found statistically significant positive correlations between the four factors. Levels of knowledge, awareness, practice and behavior about heat waves were high in our sample. Several socio-demographic variables affect participants’ knowledge, awareness, practice and behavior concerning heat waves.

Despite epidemiological findings of improvements in cardiovascular risk factors with a light-to-moderate intake of alcohol, many misconceptions remain regarding alcohol intake and the risks and benefits of consumption. We sought to examine physician attitudes and recommendations regarding alcohol intake in a cohort of Argentine physicians and to establish their sources of knowledge. An online national survey was distributed through the Argentine Federation of Cardiology (FAC) to cardiologists, internal medicine specialists, general and other subspecialty physicians in Argentina. The survey was completed by 745 physicians, of whom 671 (90%) were cardiologists. In total, 35% of physicians viewed moderate alcohol intake to be beneficial for cardiovascular health, 36% believed only wine offered such benefits, 24% viewed any intake to be harmful, and 5% had other opinions. More than half (57%) self-reported their knowledge to come from academic sources. Regarding knowledge of drinking guidelines, only 41% of physicians were aware of the concept of ‘standard drink’. Physicians were generally not comfortable converting ‘standard drinks’ into other metric units, however men tended to be more comfortable than women (p=0.052). Physicians were not satisfied with their knowledge of drinking guidelines (3.01 ± 2.73, on a 0-10 scale). Physicians were generally comfortable in counselling patients regarding safe-limits of consumption (6.22 ± 3.20, on a 0-10 scale). Argentine physicians were not satisfied with their knowledge of alcohol consumption guidelines or their understanding of the reported metrics. Only one-third of study participants viewed moderate alcohol intake as beneficial for cardiovascular health. This study shows the necessity to optimize the sources of knowledge.

The aim of the study was to determine the attitude of dentist toward learning communication skills and to recognize the factors influencing attitude toward learning communication skills. A cross-sectional study using a self-administered, 26-item, adapted Communication Skills Attitude Scale (CSAS) was carried out among dentist working in a public sector hospital in Qatar. Overall, two scores could be ascertained from the adapted CSAS: the mean positive attitude score (PAS) and negative attitude score (NAS). Non-parametric tests for statistical significance were utilized to assess relation between PAS and NAS scores and demographics. Fifty-nine dentists completed the survey giving an overall response rate of 53.6%. The mean (SD) PAS and NAS scores were 3.98 (SD=0.54) and 3.26 (SD=0.49) respectively. Female dentist was more positive towards learning communication skills than male. No statistically significant correlation was found between both PAS and NAS scores and respondents’ age. Dentists’ had both positive and negative attitudes towards learning communication skills. Considering the high NAS scores, it is recommended to introduce communication skills formal training sessions

In the context of sustainable development, integrating the work aspect into health promotion systems is essential, ensuring that employees maintain a healthy balance between their professional and personal lives, which respects and amplifies the potential of every individual. Lately, there has been a noticeable shift of medical professionals from the public to the private sector. This trend paints a bleak picture, highlighting the vulnerabilities of a system teetering on the brink of failure, with significant impacts on patient care. Among the myriad reasons behind this shift, burnout stands out prominently. Medical professionals face increasing pressures due to understaffing, limited organizational support, and insufficient resources, leading to feelings of cynicism, exhaustion, and detachment from their roles. Utilizing the Maslach et al. questionnaire, we assessed the risk of burnout among physicians in public hospitals to identify and underscore preventive measures and improvements, correlating our findings with key aspects of organizational empowerment. Our research indicates that enhancing interpersonal relationships and resources—both within teams and between the organization and its physicians—is crucial for the revival of the healthcare system. This approach aims at improving the delivery of healthcare services and offering appropriate recognition to healthcare professionals, aligning with the principles of sustainable employment.

Introduction: The attitudes of doctors and nurses toward patient safety is a significant factor in hospital safety climates and medical error rates. Yet, there are very few studies of patient safety attitudes in Saudi hospitals and none conducted in hospital emergency departments. Aims: The current study aims to investigate the discrepancy between the patient safety attitudes of doctors and nurses in a Saudi hospital emergency department. Materials and Method: The study employed a qualitative research designvia semi-structured interviews with Saudi and non-Saudi doctors and nurses working in a Saudi hospital emergency department to determine their attitudes and experiences about the patient safety climate. Results: The findings showed doctors and nurse held some similar safety attitudes, however, nurses reported issues with doctors with respect to their teamwork, communication, and patient safety attitudes. Moreover, several barriers to the patient safety climate were identified such as limits to resources, teamwork, communication, and incident reporting. Conclusion: The findings provide one of the few research contributions to knowledge on the differential patient safety attitudes of Saudi and non-Saudi doctors and nurses and suggest the application of such knowledge would enhance positive patient outcomes in emergency departments.

The supply chain has incorporated products by putting them into hair scarfs. This study introduces the use of mini chips in health and beauty products and can reduce fatigue through enhanced sleep patterns. The mini chip could be placed in the scarf and used as a prototype. RFID technology provides the supply chain with specific information that is used to identify products and make communication easier. (Muhammad, et. al. 2013) This paper presents a new tool herein referred to as a scarf prototype which is developed to analyse EMG (electromyogram), ECG (electrocardiography), EEG (electroencephalogram), and EOG (electro-oculogram) signals that focuses in the area of sleep disorders. The mini chips used can be used to determine a solution for sleep disruption by using automated analytics. This could lead to improvement in our understanding of sleep disruption and overall sleep physiology. Automated technology allows repeated measurements, evaluation of sleep patterns, and provide suggestions to improve a person’s quality of sleep. This analysis compares the use of polysomnography and the scarf prototype. The analytics provide models and shows correlation between variables, such as EMG, ECG, EEG, and EOG. This study shows that the results from the scarf prototype is just as reliable as the original method, polysomnography.

The present study explained factors influencing citizen satisfaction service in the Investment and One-Stop Service Agency of Tanah Bumbu Regency. In particular, this research analyses the level of citizen satisfaction and the extent to which Awareness, Rules, Organizational, Income, Skill-Ability, and Service Facility Factor influence Citizen Satisfaction. This study uses a mixed methodology with a sequential explanatory strategy. Using the incidental sampling with Slovin's Formula to calculate the number of samples is 93 respondents. The quantitative data were analyzed by the SmartPLS 3.0 program. The findings showed that the level of citizen satisfaction is included in the category "Satisfied". Furthermore, the variable of Citizen Satisfaction is influenced by variables of Awareness, Rules, Organizational, Income, Skill-Ability dan Service Facility Factor for 70,5%. Whereas Awareness, Rules, Organizational, and Skill-Ability Factor has a significant influence on Citizen Satisfaction. Besides, Income and Service Facility Factor do not have a significant influence on Citizen Satisfaction.

Transitioning towards sustainable food systems and sustainable diets is critical in reducing environmental impact and achieving the Sustainable Development Goals established by the United Nations General Assembly. This transition requires collaborative efforts across multiple stakeholders, including the general public’s knowledge and attitudes. To assess the knowledge and attitudes towards food sustainability we carried out a cross-sectional study among Kuwait University students with a total of 278 participants aged ≥18 years (78% females and 22% males). A validated questionnaire was used for this study. Most respondents (&gt;70%) recognized the concept of “local food” and “environmental impact.” The concept “green water-blue water” was least recognized among respondents (75%). Participants perceived that a sustainable diet was rich in vegetables, included plenty of fresh products and was affordable. Participants (&gt;66%) perceived that a positive impact of meat and its derivatives towards sustainability, a misconception most common among males. Overall, participants with more knowledge about environmental concepts showed favorable attitudes towards a sustainable diet. Women showed more interest in changing their current dietary habits towards food sustainability. In conclusion, despite participants’ positive attitude towards food sustainability, lack of understanding persists, necessitating public health interventions aimed at educating consumers about sustainable diets and its impact on the environment.

Driving factors of smart city construction are exploratively studied by grounded theory method based on text sources from journal papers in SCI and CSSCI databases. Initial scale of driving factors about smart city construction is obtained on the basis of above analyses. This paper modifies measuring items of the initial scale with a small sample pretest and reliability test, then forms final items by exploratory factor analysis. According to the above scale, questionnaires are designed to obtain empirical data, and confirmatory factor analysis is used to verify further validity and reliability of the scale. The results show that driving factors of smart city construction include three main dimensions: problem-oriented factors, business- or technology-driven factors and endogenous development requirements.

There is a noticeable absence of health education among college students. This study aimed to evaluate the extent of general nutrition knowledge among Chinese university students and explore its association with eating attitudes. Data were collected from a group of 273 students in Spring of 2023, using a valid and reliable research instrument consisting of three sections: demographic variables, the General Nutrition Knowledge Questionnaire (GNKQ), and the Eating Attitudes Test (EAT-26). The results were analyzed using SPSS, with correlations and t-tests to examine the relationships between nutritional knowledge and dietary attitudes. Furthermore, the present study employed the Random Forest (RF) algorithm, a machine learning technique, utilizing the Mean Decrease Impurity (MDI) method to investigate the influence of various features on participants' eating attitudes. The findings revealed that Chinese university students had an average accuracy of over 60% in their nutritional knowledge, but their understanding of the relationship between diet and disease still needs improvement. Moreover, male students had significantly lower nutritional knowledge than female students, and there was a positive correlation between nutritional knowledge and parents’ income. The study also found a significant correlation between the level of nutritional knowledge and eating attitudes. RF results indicated that family income level exhibited the most substantial impact on the eating attitudes of the participants. The study highlights the need for nutrition education curriculum developers to focus more on improving students' nutritional knowledge, with particular attention given to male students, low-income individuals, and those with an abnormal BMI.

University students, particularly those in the healthcare disciplines, constitute a category of particular interest in regard to COVID-19 vaccines and the attitudes to vaccination, as their future professional role will enable them to inform and educate citizens regarding vaccination. The objectives of the study were to investigate the vaccination coverage with a COVID-19 vaccine among students from different degree programs at the Medical universities in Bulgaria behaviors and attitudes toward vaccination with a COVID-19 vaccine. A prospective cross-sectional study in the period September 2021- March 2022 was conducted. Information on demographics, university program, year of study, general attitudes and behavior towards vaccines and attitudes and personal experience with COVID-19 and COVID-19 vaccines were collected. The chi-square test was used to test for associations and binominal logistic regression was used to identify possible predictors for vaccination. A total of 3050 students with a median age of 22 years, predominantly female took part in the study. Three-thirds of the students (73.5%) have been vaccinated against COVID-19. The main reasons for vaccine hesitancy in both group of students were the fear of side effects and the doubts about the safety of the vaccines although non-vaccinated students significantly more frequently express those fears. Respondents who considered to have: a) limited access to sufficient information to inform COVID-19 vaccine uptake; b) lack of public awareness and education campaigns about effectiveness and safety of COVID-19 vaccines; c) insufficient information about COVID-19 vaccines during the University education; and d) had a positive COVID-19 diagnosis were less likely to be vaccinated. Students who have not completed the mandatory immunization cycle according to country schedule were also less likely to have completed COVID-19 vaccination. The students showed an overall positive attitude towards the COVID-19 vaccines. Promoting informational campaigns that emphasize the vaccine's safety will be more effective to further increase the vaccination coverage with COVID-19 vaccines.

Healthy eating behaviour of women is critical not only for their health but also for their children's health and well-being. The present study examined the dietary pattern, nutrition knowledge and attitudes of working women in Western Province, Sri Lanka. In addition, identify the factors associated with Dietary Diversity Score (DDS). A cross-sectional study was conducted among 300 working women, aged 20-60 years, in Western Province, Sri Lanka. The data on so-cio-demography, dietary patterns, and nutrition-related knowledge and attitudes were collected. Overall, 38% of the women were overweight and 13% were obese. The median frequency of intake of chicken, fish, eggs, milk and milk products, green leafy vegetables and fruits were 2, 5, 2, 9, 5 and 10 respectively, per week. A large majority of the women (70%) had tea/coffee with sugar and snacks (60%) at least four times a week. Only a third of the women met the minimum DDS, while more than half of the women had good nutrition-related knowledge and attitudes. Multiple regression analysis showed that age and household income were significantly independently related to DDS, while attitudes were negatively associated. While there was a trend, the association of nutrition-related knowledge with DDS was not statistically significant (p=0.057). The overall F ratio (8.46) was highly significant (p=0.000) and the adjusted R2 was 0.093. The results demonstrated that a significant proportion of working women have good basic nutrition-related knowledge and attitudes, while two-thirds of them do not meet the minimum DDS. Furthermore, age, family income and knowledge were positively associated with DDS, while attitudes were negatively associated. Before designing any intervention, further research is needed using a qualitative approach to understand how nutrition knowledge and eating behaviour are related in this population group.

Recently, both global and domestic environmental events have been occurring more frequently, bringing catastrophic consequences to humans and the environment. These adverse events have caused widespread concern among the general public. In positive terms, these devastating events could potentially enhance people’s environmental awareness, which, in turn, could instill a greater sense of environmental responsibility. This study aims to investigate how university students concern themselves with global and domestic catastrophic environmental events and to examine how global and domestic environmental concerns mediate the effect of environmental knowledge and attitudes on university students’ environmental responsibility. Students of King Mongkut’s University of Technology Thonburi in Bangkok, Thailand were selected as the participants. A simple random technique was applied to select the research participants. Questionnaire surveys with 863 students were carried out during September–October 2019. A path analysis was performed to test how global and local environmental concerns mediate the effect of environmental knowledge and attitudes on university students’ environmental responsibility. The results demonstrated that domestic environmental concerns, taken alone, contributed less to the students’ sense of environmental responsibility. Domestic environmental concerns had a stronger effect on environmental responsibility when taken together with global environmental concerns. In addition, both domestic and global environmental concerns could help transform environmental knowledge and attitudes into environmental responsibility. Only environmental attitudes had no direct effect on responsibility. These results show that domestic and global catastrophic environmental events could raise students’ levels of concern for the environment, and, ultimately, enhance their sense of responsibility to protect the environment.

Objective: The goal of this study was to analyse the attitudes and perceptions of emergency and mental health nurses through the validation of the SM-GIBED scale in specialised care in Spain on alcoholics and other drug-dependent patients. Design and Setting: This cross-sectional study was developed using the Spanish hospital version of the Seaman-Mannello scale to denominate the SM-GIBED scale. Participants: 170 Emergency and Mental Health Nursing from five Spanish Hospitals. Intervention: Self-administered questionnaire to analiyse the perceptions and attitudes about the drug addict and the alcoholic. Primary and Secondary Outcome Measures: A descriptive and inferential analysis of the study variables was carried out. A psychometric analysis was performed to validate the scale. Results: A total of 170 questionnaires were collected from 257 healthcare workers. Overall, 99.1% of the participants had contact with drug-dependent patients during their professional experience. Nearly 75% had difficulties in treating them. The psychometric analysis of the SM-GIBED scale in the Spanish context obtained values of KMO = 0.655 and Bartlett's test p < 0.000. Cronbach's alpha of 0.738 was obtained from the reliability analysis. A reliability analysis of each of the SM-GIBED questions found no case with an alpha lower than 0.71. In conclusion, positive aspects include an ingratiating attitude and subject-to-subject communication when nurses self-define as empathic and non-paternalistic. Among the negative aspects, there is a lack of communication skills and assertiveness with these patients. This highlights a certain degree of resignation and dissatisfaction when working with drug addicts.

Despite numerous interventions to promote gender equality, sub-Saharan Africa has one of the highest prevalence rates of non-partner sexual assault in the world, thus constituting a major social and public health issue in the region. As social workers frequently provide services to this population, an exploratory cross-sectional study was conducted to explore rape myth acceptance among undergraduate social work students studying in Namibia. Findings revealed the positive influence of social work education in reducing rape myth acceptance as well as highlighted the influence of age, gender, country of origin, self-identification as a feminist, and religiosity on rape myth acceptance among this population.

The most prevalent musculoskeletal disorder of childhood with unclear aetiology is Growing Pains (GPs). Anatomic deformities and factors that change bone turnover are implicated in GPs pathophysiology. Perinatal risk factors alter the bone metabolism affecting the bone mineral density and content. The aim of our study was to analyze the relationship between GPs, knock knees and perinatal factors. The examined population consisted of 276 children aged 3-7 years. Among them 10 pairs of dizygotic twins were evaluated. The data were collected by using a combination of semi-structured questionnaires, clinical examinations and medical charts of the children and the obstetric history of the mothers. 78 children presented GPs meeting Peterson’s criteria. Genu valgum severity was a significant factor for GPs manifestation and for their increased frequency and intensity. Subsequently, perinatal factors regarding gestational age, Apgar score, head circumference (lower than 33cm) and birth length or weight (smaller than 50 cm and 3000gr, respectively) made a remarkable contribution to the development of GPs. Conversely, antenatal corticosteroid treatment, increased maternal age and maternal smoking during pregnancy were not predictive for the disorder. Our data are potentially supportive for the “bone strength” theory and for the contribution of anatomical disturbances in GPs appearance.

Background: Low-level physical activity (PA) among Chronic Low Back Pain (cLBP) is associated with various biopsychosocial factors. This research aimed to study the predictors of PA behavior among cLBP patients. Methods: In the present study 300 eligible patients with cLBP who referred to comprehensive health service centers in the Shahid Beheshti University of Medical Sciences (SBUMS) in Tehran, Iran were random selected.To diagnose the predictors of PA behavior, all the Theory of Reasoned Action (TRA) constructs were examined as risk factors to see if they influence on the probability of PA behavior occurrence and were interpreted through odds ratio (OR). SPSS version 19 was used to analyze the data. Results: Totally 280 cLBP patients with mean age of 57.07 ±13.09 years old participated in the study. This study showed that motivation to comply significant predictor the cLBP patients for subjective norm OR (%95CI): 2.095(0.116-2.792), p-value<0.001), intention was significant predictor for perform the PA behavior OR (%95CI): 1.431(0.138-1.538), p-value <0.001), behavior beliefs could predictor for attitude OR (%95CI): 1.276(0.106-1.355), p-value= 0.002). attitude, normative beliefs, subjective norm ,and evaluation outcome behavior could predictors the cLBP patients for intention to perform the PA behavior OR (%95CI): 1.188(0.032-1.312), p-value<0.001)., OR (%95CI): 1.158(0.076-2.208), p-value=0.003) ., OR (%95CI): 1.104(0.076-1.128), p-value<0.001) ., OR (%95CI): 0.814(0.301-1.440), p-value=0.007). Conclusions: This study showed that the cLBP patients who were normative beliefs and evaluation regarding PA behavior could effect on the intention to engage in greater PA than those via other constructs (attitude and subjective norm). This study showed that the cLBP patients who were normative beliefs and evaluation regarding PA behavior could effect on the intention to engage in greater PA than those via other constructs (attitude and subjective norm). This study showed that the cLBP patients who were normative beliefs and evaluation regarding PA behavior could effect on the intention to engage in greater PA than those via other constructs (attitude and subjective norm).

Background: The effect of velamentous cord insertion (VCI) on perinatal outcomes in twin pregnancies is unclear due to conflicting findings. This retrospective study aimed to examine VCI prevalence and related risk factors in twin pregnancies and its association with adverse perinatal outcomes. Methods: Women with twin pregnancies who delivered between January 2012 and December 2021 in a single tertiary hospital were included. The participants were divided into dichorionic (DC) and monochorionic diamniotic (MCDA) groups, and their maternal and fetal characteristics and VCI rates were compared. Logistic regression models were used to identify risk factors for VCI and VCI-related perinatal outcomes. Results: Among the 694 twin pregnancies included in this study, the VCI rate was significantly higher in MCDA than in DC twins. Body mass index and MCDA twins were significant risk factors for VCI, whereas assisted reproductive technology pregnancy was a significant protective factor against VCI. In DC twins, VCI did not affect perinatal outcomes. Conclusion: In MCDA twins, VCI was a significant risk factor for fetal growth restriction, twin-to-twin transfusion syndrome, and preterm birth at

Fossil-based plastics are significant contributors to global warming through CO₂ emissions. For more sustainable alternatives to be successful, it is important to ensure that consumers become aware of the benefits of innovations such as bio-based plastics, in order to create demand and a willingness to initially pay more. Given that consumer attitudes and (inaccurate) beliefs can influence the uptake such new technologies, we investigated participants’ attitudes towards fossil-based and bio-based plastic, their perceived importance of recycling both types of plastic, their willingness to pay, and their perceptions of bio-based plastic in four studies (total N = 961). The pre-registered fourth study experimentally manipulated information about bio-based plastic and measured willingness to pay for different types of plastic. The results suggest participants hold very favourable attitudes and are willing to pay more for bio-based products. However, they also harbour misconceptions, especially overestimating bio-based plastic’s biodegradability, and they find it less important to recycle bio-based than fossil-based plastic. Study 4 provided evidence that educating consumers about the properties of bio-based plastic can dispel misconceptions, retain a favourable attitude and a high willingness to pay. We found mixed evidence for the effect of attitudes on willingness to pay, suggesting other psychological factors may also play a role. We discuss how attitudes and misconceptions affect the uptake of new sustainable technologies such as bio-based plastics and consumers’ willingness to purchase them.

(1) Background: Sleep disordered breathing represent a growing public health concern, especially among children and adolescents. Full-night polysomnography is considered the gold standard for diagnosing obstructive sleep apnea. Our goals are to identify personal and environmental risk factors for the onset and persistence of sleep respiratory disorders. We also want to investigate the differences in neuropsychological profiles; (2) Methods: This is an observational, retrospective cohort study. We collected information on adenoidectomy or adenotonsillectomy. We reviewed the clinical history and preoperative visits and collected data through a telephone questionnaire. Pediatric Sleep Questionnaire (PSQ) and the Pediatric Quality of Life Inventory (PedsQL) are questionnaires used for screening sleep respiratory disorders in children. The data were statistically analyzed it using SPSS version 22.0 for Windows (SPSS Inc., Chicago, IL); (3) Results: The study involved 138 patients, but only 100 parents participated. A higher percentage of patients with sleep disordered breathing were observed to have mothers who smoked during pregnancy. A smaller proportion of patients with sleep disordered breathing had a habit of using a pacifier. A rise in physical results is associated with a reduction in the PSQ at follow-up (p=0.051). An increase of overall academic achievement is associated with an average decrease in the PSQ at follow-up (p&lt;0.0001). A more significant proportion of patients undergoing adenotonsillectomy were observed to have a history of prematurity and cesarean birth (4) Conclusions: These results provide essential information on the effectiveness and effects of adenotonsillectomy intervention compared to adenoidectomy intervention and the factors associated with SDB in children undergoing these interventions.

Business-to-business (B2B) manufacturing companies are increasingly confronted with transformative trends such as sustainability, digitalization, and servitization. These trends are changing how product portfolios are developed, and value contributions are assessed, and therefore have disruptive potential. Dealing with these disruptive factors in Product Portfolio Management (PPM) is a largely unexplored topic. This study presents an empirical-qualitative exploration that contributes significantly to the field. The aim is to clarify the extent to which disruptive factors influence the evaluation and shaping of the product portfolio in B2B manufacturing companies. The Gioia method was used to evaluate 21 semi-structured interviews with experts from leading B2B manufacturing companies. Eight overarching challenges in PPM resulting from the disruptive factors were identified. Based on the eight overarching challenges and their associated causal relationships, two aggregated dimensions of action were derived: (1) increasing speed and flexibility by using generative artificial intelligence (AI) in a defined PPM process and (2) adjusting the product portfolio evaluation to consider various strategic drivers. These two dimensions of action call for future research to overcome the disruptive factors in PPM.

The present research aimed to identify if consumption values influence the attitudes of Millennials who intend to purchase organic products. The research was quantitative, with a correlational scope and a cross-sectional design, and it was conducted on 509 Peruvian millennials. A questionnaire consisting of 23 questions was administered, and responses were quantified using a five-point Likert scale. The results were processed through an Exploratory Factor Analysis (EFA), Confirmatory Factor Analysis (CFA), and Structural Equation Modeling (SEM) conducted using Statistical Package for Social Sciences 24 and AMOS 24. The study identified that environmental attitudes of Millennials do influence their intentions to purchase organic products, and the antecedents of these attitudes are functional and social values, whereas emotional, conditional, and epistemic values do not. The study confirmed that consumption values, either as a second-order variable or as a single construct, do not influence the attitudes of Millennials who intend to purchase organic products, thus confirming that these dimensions should be measured independently.

Background: Acute kidney disease (AKD) is a known risk factor for increased mortality and evolution towards chronic kidney disease (CKD) in adults. The data regarding children are scarce. The purpose of our study is to explore the risk factor for AKD and impact of AKD following an acute kidney injury (AKI) episode in children on mortality and new-onset CKD. Methods: We retrospectively evaluated 736 children with ages between 2 and 18 years old with AKI admitted in a tertiary care hospital from the west Romania over a 9 years period. Results: AKD incidence following AKI was 17%. Patients that developed AKD were older, with higher baseline serum creatinine values, urea, C reactive protein and lower proteins, haemoglobin and sodium. They were more often exposed to sepsis, critical illness and nephrotoxic medications and presented certain susceptibilities like CKD, neoplasia, anemia, heart failure, arterial hypertension, stem cell transplant and female gender. AKI causes that increased the risk of AKD were intrinsic ones. AKD increased the overall mortality by three times. The factors that independently increased the risk of evolution towards CKD were AKD, acute tubular necrosis and higher baseline serum creatinine values. Conclusions: AKD is an independent risk factor for mortality and new-onset CKD in children.

Background: Condoms have proven to be an effective contraceptive barrier method of family planning and have played a vital role in preventing sexually transmitted diseases including HIV. However, existing evidence shows that utilization of condoms still remains low, especially among youth and adolescents. We aimed to determine the prevalence of condom use and associated factors among the students of Gulu university in Uganda. Methods: A cross-sectional study was conducted among undergraduate students of Gulu University between June and December 2023. The students were accessed from their respective faculties and chosen using a simple random sampling method. Data were collected using a pretested self-administered structured questionnaire. Condom use was defined as use of either male or female condom in the last sexual encounter in the previous six months. Results: A total of 404 participants, with a median age of 23 years (interquartile range (21.5-24) years) were enrolled in the study, 54.2%(n=219) of whom were male. Overall, 81.4%(n=329) of the participants were in senior classes (year 2,3,4, and 5) and 18.6%(n=75) were in their first year of study. The prevalence of condom use was 53.7%(n=217). Prevalence of condom use was 50.2%(n=109) among male and 49.8%(n=108) among female students. Year of study (senior class)(aPR = 1.4, 95% CI = 1.59, 3.54), having a sexual partner (aPR = 2.4, 95% CI = 1.89, 2.94), having a sexual partner within campus (aPR = 2.0, 95% CI = 1.69, 2.45), experience of condom bursting (aPR = 1.3, 95% CI = 1.08, 1.61), having sex in absence of condoms (aPR = 0.6, 95% CI = 0.44, 0.70), alcohol use (aPR = 1.2, 95% CI = 1.01, 1.45) were independently associated with condom use. Conclusion: Just over half of undergraduate students of Gulu university used condoms during sexual encounters. There should be heighten campaigns on condom use to prevent unintended pregnancies and sexually transmitted infections.

Cryptococcus neoformans is a facultative intracellular fungal pathogen. Ten-generation-old (10GEN) C. neoformans cells are more resistant to phagocytosis and killing by macrophages than younger daughter cells. However, mechanisms that mediate this resistance and intracellular parasitism are poorly understood. Here, we identified factors important for the intracellular survival of 10GEN C. neoformans, such as urease activity, capsule synthesis, and DNA content using flow cytometry and fluorescent microscopy techniques. Real-time visualization of time-lapse imaging was applied to determine the phagosomal acidity, membrane permeability, and vomocytosis (non-lytic exocytosis) rate in J774 macrophages that phagocytosed C. neoformans of different generational ages. Our results showed that old C. neoformans exhibited higher urease activity, and enhanced capsule formation, which was supported by an increased Golgi complex. In addition, old C. neoformans were more likely to be arrested in the G2 phase, resulting in the occasional formation of aberrant trimera-like cells. To finish, the advanced generational age of the yeast cells slightly reduced vomocytosis events within host cells, which might be associated with increased phagolysosomal pH and membrane permeability. Altogether our results contribute to a better understanding of the strategies used by old C. neoformans to resist phagosomal killing and suggest that old generation C. neoformans intracellular behavior may be driving cryptococcosis pathogenesis.

This research follows the publication of recent scoping and systematic reviews of existing literature on vaccine literacy (VL), its relationship to vaccine hesitancy (VH), and associated variables, such as vaccination beliefs, attitudes, and behaviors towards immunization. In this review, 17 articles were selected, published between December 2022 and November 2023, in which VL tools were used, most of which support the notion of a negative association between VL and VH, although not confirmed by others. Moreover, the definitions of the variables under consideration were not homogeneous between studies, some aimed to evaluate the association of VL with vaccine confidence, while others were more focused on outcomes such as willingness to be vaccinated or vaccine uptake. The complexity of the factors underlying VL, and the heterogeneity of the methods applied in the studies, in particular the limitations of cross-sectional surveys, still make it difficult to have a comprehensive understanding of the role of VL. Therefore, it is important to develop future assessment tools that consider not just the measurement of psychological factors connected to the motivational aspect of VL, but also those related to knowledge and competencies. For this purpose, a theoretical framework is proposed, where the positioning of VL at the intersection between antecedents and beliefs/attitudes leading to behaviors explains why and how VL serves as a tool and a critical, direct, or mediating driver of vaccination choices, overcoming VH and increasing vaccination rates, operating at personal, as well as at organizational and community level.

The role of natural factors mainly solar eleven-year cycle variability, and volcanic eruptions on two major modes of climate variability the North Atlantic Oscillation (NAO) and El Niño Southern Oscillation (ENSO) are studied for around last 150 years period. The NAO is the primary factor to regulate Central England Temperature (CET) during winter throughout the period, though NAO is impacted differently by other factors in various time periods. Solar variability indicates a strong positive influence on NAO during 1978-1997, though suggests opposite in earlier period. Solar NAO lag relationship is also shown sensitive to the chosen times of reference and thus points towards the previously proposed mechanism/ relationship related to the sun and NAO. The ENSO is influenced strongly by solar variability and volcanic eruptions in certain periods. This study observes a strong negative association between the sun and ENSO before the 1950s, which is even opposite during the second half of 20th century. The period 1978-1997, when two strong eruptions coincided with active years of strong solar cycles, the ENSO, and volcano suggested a stronger association, and we discussed the important role played by ENSO. That period showed warming in central tropical Pacific while cooling in the North Atlantic with reference to the later period (1999-2017) and also from chosen earlier period. Here we show that the mean atmospheric state is important for understanding the connection between solar variability, the NAO and ENSO and associated mechanism. It presents a critical analysis to improve knowledge about major modes of variability and their role in climate. We also discussed the importance of detecting the robust signal of natural variability, mainly the sun.

The present study identified the influence of green advertising and eco-labels on the attitude and environmental awareness of millennials who purchase ecological products in shopping centers in Ecuador. The research was quantitative, correlational and with a cross-sectional design. A total of 430 millennials participated in the study. A 20-question survey was applied in person outside the shopping centers of Quito and Guayaquil - Ecuador. The convergent and discriminant validity of the research model was verified using Confirmatory Factor Analysis (CFA) and Structural Equation Models (SEM). SPSS 20 and AMOS 24 programs were used for statistical analysis. The results show that green advertising influences environmental attitudes (β: 0,245) and awareness (β: 0,110) and specifically influences purchasing behaviour (β: 0,154) for green products. Although eco-labels do not directly influence purchasing behaviour (β: 0,128), they influence the attitudes (β: 0,406) and ecological awareness (β: 0,277) of millennials who buy organic products. This article is one of the first studies to identify the relationship between green advertising elements and green product purchasing behaviors among millennials in a developing country, concluding that marketing strategies based on green advertising and eco-labels have an impact on the attitude and environmental awareness of millennials, but only advertising directly affects purchasing behaviour while eco-labels do not. This research has social implications since it corroborates that millennials are concerned about environmental problems and are willing to contribute to sustainability.

Understanding morphological and genetic diversity of forest trees is essential to facilitate their conservation, sustainable management and genetic improvement for addressing the economic and environmental demands and challenges. We have examined variation in morphometric seed and pod traits and seed germination of multipurpose and widely distributed forest tree Albizia lebbek (Indian siris) from 12 provenances covering the species’ range in northern India and its relationships with bioclimatic factors. Highly significant inter-provenance variation was observed in seed size (seed length (SL), seed width (SW), SW/SL, SL×SW), seed mass (1000 seed weight), pod size (pod length (PL), pod width (PW), PW/PL), seed germination, number of seeds per pod, and insect infected seeds (IIS). The provenance effect contributed a major portion to the total phenotypic variance. Morphometric variation in all traits except for IIS was not clinal related to longitude, latitude, altitude or rainfall. There was an indication of the presence of ecotypic variation. IIS showed clinal variation with significant negative correlation with latitude. Most seed size and pod size traits showed positive correlations with several temperature bioclimatic factors and negative correlations with several precipitation bioclimatic factors. Our results have significance for genetic improvement, population genetics and genomics studies and conservation and sustainable management of A. lebbek genetic resources.

Solid waste management in Accra is a major challenge to the Metropolitan Authorities and inhabitants. The rapidly increasing population coupled with poor capacity of the municipal and private waste management companies to management waste effectively has created issues of environmental concern. Due to poor waste managements systems, most household dispose waste indiscriminately leading to floods and health issues. The study showed that about 60% of household waste is organic materials which has the potential to be converted to compost for agriculture purpose. Meanwhile plastics and rubbers which litters the environment as well as blocking major storm drains and gutters hence creating huge environmental hazard is made of 11% of the total component of most household waste generated daily. The study also revealed that among the methods of disposing waste, dumping waste in skip containers located at authorized places was the preferred means of disposing waste by household though others also dispose waste by other means such as burying and burning. Inadequate skip containers per population of household in an area coupled with irregularity of tracks picking these containers makes skip containers dumping site ugly scene, hence creating health issues. Among the constraints that impact negatively on sustainable waste management in Accra Metropolis, economic constraints was perceived as the main challenge which affect efficient waste management. Currently the country is going through serious economic challenges so government does not release money timely to fund projects which waste management is key. Most donor partners that use to support the government with funds have either reduced or redrawn their services as they have no confidence in the state of Ghana economy. Aside the constrains, the study also indicated that factors such as poor public attitude towards waste management, poor enforcement of sanitation by-laws, inadequate and untimely release of government funds were also seen as the main factors affecting waste management.

Neonatal mortality remains a public health concern and timely identification and prompt intervention in the delivery room could improve the outcome in neonatal morbidity and mortality. We performed a retrospective study to help us finding the profile of the high-risk newborn regarding the need for NICU admission, necessary to establish a protocol regarding the mobilization of human and material resources for the urgent management of these situations. All deliveries and neonates born in Maternity of Bihor County Emergency Clinical Hospital from Romania were reviewed, including relevant maternal, foetal and perinatal data to identify risk factors that result in birth of newborns needing resuscitation at birth between 2012-2019. The number of births showed a downward trend but around 90% of the births were on term. The incidence of neonatal emergencies is increasing, the most frequently were respiratory, sepsis and other infections, cardiovascular emergencies, and extreme prematurity. It is noted that in 2021 the incidence of these neurological emergencies increased by three times compared to previous years. The neonatal and maternal risk factors associated with admission to the NICU were mother's age over 35 years, low level of education, second/more gestation, weight under 2500 g, Apgar score under 7, premature rupture of membranes, macrosomia and mother's infectious pathology. Accurate identification of risk factors and anticipation at the birth of a high-risk neonate would result in adequate preparation and prompt resuscitation of neonates who need some level of intervention and thus, reducing neonatal morbidity and mortality.

The intestinal microbial community of aquatic animals is closely related to the environment and thus affects the health of aquatic animals. Here we investigated annual variation of intestinal bacteria community structures of Ruditapes philippinarum cultured using two different methods, bottom sown and raft hanging. Bacterial diversity of seawater and sediment in different seasons was examined as well. Correlation between R. philippinarum intestinal bacteria community structures and environmental factors was analyzed. The results showed that in the two aquculture areas where R. philippinarum was differentially cultured, bacteria community structure of seawater and sediment both altered with seasons. However, neither seasonal changes nor difference in culture methods could significantly affect the intestinal bacteria community structures of R. philippinarum. Additionally, in terms of the alpha diversity of intestinal bacteria communities, there was no significant difference in R. philippinarum cultured using the two methods. For benthic cultured clams, alpha diversity of the intestinal bacterial communities was often higher than that of the environmental bacterial communities. For raft hanging cultured calms, Alpha diversity of the intestinal bacterial communities was normally comparable with that of the environmental counterparts. Beta diversity analysis showed that the intestinal bacterial community structure of R. philippinarum was mainly determined by both deterministic and stochastic processes. Correlation analysis showed that the intestinal bacterial community structures of R. philippinarum were determined by a variety of environmental factors. For clams collected from the benthic culture area, the intestinal bacterial structure was more correlated with the physicochemical properties of sediment in comparing with those of seawater. For clams collected from the raft-culture area, the intestinal bacterial structure was mainly determined by the phsicochemical characteristics of seawater. This study helps us to better understand the bacterial community structure in complex aquaculture ecosystems, providing a reference for healthy shellfish aquaculture and ecosystem protection in aquaculture area.

This study seeks to interrogate the degree to which lecturers and students of higher institutions in Nigeria perceive the role of lecturers doubling as parents under the term lecturenting, i.e., a coinage used to refer to a person who performs the dual roles of lecturing and parenting students of higher institutions. The study is based on Professor Obiora Ike’s ideology of communication of values, normally applicable to traditionally homes only. The research used a quantitative survey of 266 undergraduates and 109 lecturers, totaling 375 respondents from two purposively selected higher institutions in Nigeria, namely: Edo state University Uzairue and Federal Polytechnic Auchi, both in Etsako West Local Government Area of Edo state, Nigeria. A questionnaire with a set of nine semi-structured questions was used to obtain data from the students during the school semesters between July 15 and August 31, 2022. The study was based on the value theory. Findings indicate that lecturers frequently engage in lecturenting which helped improve the academic performance of students but shows that students do not want lecturenting on their behavioral change. The study concludes that the more lecturers engage in Lecturenting, the more positive impact it will have on their students. It is recommended that lecturers should engage in the practice of lecturenting as it helps to improve student academic performance and that students should perceive lecturenting as positive as well as be favorably disposed to it and approach their lecturers for counselling frequently.

In the context of the new crown epidemic, remote physical training will already be in order under the guidance of the Ministry of Education. There is a global focus on current lifestyle behaviors and the future health and well-being of youth. Youth physical activity, aerobic activity and muscle fitness levels are declining.[1] Research on the effects of youth physical training and group attitudes is still in its infancy. This study conducted in-depth interviews with online physical training students, parents, teachers involved in the construction of online physical training, and sports practitioners through interview methods, documentation, and mathematical statistics. The results of the interviews were qualitatively coded using NVivo to summarize the attitudes of different subjects toward physical fitness training and the influencing factors, (1) students were basically satisfied with the teaching effect of online physical fitness training (2) parents thought the teaching effect of online physical fitness training was average (3) physical education teachers thought the effect of online physical fitness training was average (4) physical education practitioners thought the effect of online teaching was poor.

Scientific literature shows increased interest in the aged and the aging phenomenon. The Aging Attitudes Questionnaire - AAQ was validated for the Portuguese population to understand the importance of attitudes towards old age and their impact on the subjective well-being of the elderly. A sample of 400 subjects (from 18 to 93 years) answered a socio-demographic questionnaire, and the AAQ was composed of three subscales (psychosocial losses, physical change, and psychological growth). The CFA confirmed the tri-factorial structure with very good adjustment of the model to the data with the Cronbach alpha of the total scale scoring .84 and ranging from .65 to .77 for each factor. A total of 9 items were omitted both for poor factor loadings (<0.50. Notwithstanding, 3 items below the criteria were maintained, as they conceptually fit into the factor. Of the final 15 AAQp items, 5 belong to the Psychosocial Loss factor, 6 to Physical Change, and 4 to Psychosocial Growth. This tree factor model explained 50.1 % of the total variance. In conclusion, this study supports that AAQ has acceptable validity, confirming the composite reliability and the discriminant validity, but not the convergent validity. Through multi-group analysis, the invariance of the scale was confirmed. This validation is of pivotal importance once it allows measuring the attitudes towards aging, thus facilitating the promotion of wellbeing across the lifespan.

Abstract: Spinal disorders are some of the most prevalent health concerns, especially among stu-dents. Based on student demographics, this cross-sectional study evaluated the correlation be-tween functional tests (FT) and spinal range of motion (ROM). This study included 206 students from Vasile Alecsandri University of Bacău. Participants' assessments were conducted using the following tests: (i) Ott, (ii) Schober, (iii) Stibor, (iv) finger-to-floor distance, (v) lateral flexion of the cervical and lumbar spine, and (vi) flexion of the cervical spine. Correlation analyses were evaluated using Spearman correlation coefficient analysis. The results indicated a very strong re-lationship between lateral flexion of the lumbar spine on the left (LFLSL) and right (LFSR) for all departments (r = 0.85 to 0.97, p < 0.05). There was a stronger relationship between FT results and spinal ROM of physical education department students compared to students from other de-partments (n = 17, r = -0.38 to 0.93, p < 0.05). There was no statistically significant correlation be-tween FT and spinal ROM based on age (p > 0.05). The study results provide evidence of the pri-mary risk factors that predispose students to postural deviations. Practitioners and physiothera-pists can utilize these values as a reference for potential therapeutic interventions.

Aim: To analysis the relationship between healthy adults right ventricular diameter (RVD) and geographical factors. Location: China’s 22 provinces, municipalities and autonomous regions. Methods: Using correlation analysis the relationship between RVD and nine geographic factors, build predictive models by factor analysis. Results: There is significant correlation between RVD and geographical factors, and the annual average temperature is most relevant geographical factors, a predictive model was built by factor analysis: Ŷ = 19.46 + 0.0007072X1 + 0.001034X2 -0.05412X3 -0.001405X4 -0.0006351X5 + 0.02903X6 + 0.01243X7 -0.01033X8 + 0.03816X9 ± 0.63. Then using Kriging interpolation interpolate the geographical distribution of Chinese healthy adult right ventricular diameter reference value in ArcGIS software. Main Conclusion: If geographic factors can be derived in anywhere of China, RVD can be calculated by the model, you can also get RVD from geographical distribution.

Pakistan is under developing country and it has an unpredictable market nature of shareholder-investors observe the company’s performance. This research could help to companies in understanding financial behavior, attitude and investors’ satisfaction in stock trade. Financial behavior is comparatively new subject in Pakistan therefore; this study has examined the financial behavior and attitude of investors. The behavioral finance that has been attempted to understand the positive experiences influences investors’ financial behavior. This study has find out that investor satisfaction is strongest in influence of positive financial behavior of investor and trader in stock trading; positive experience and brokers suggestions are strengthens the investment decision of investors and increases behavior loyalty to prefer over competitor. The main purpose of research to determine the effect of financial behavior on investors’ attitude and behavioral loyalty and investors’ satisfaction to preference over competitor. The research framework links with experiences in stock trade for positive (negative) experiences, attitude and financial behavior is developed. The research framework is measured data from sample of Karachi and Karachi Stock Exchange; the data is analyzed in smart PLS based on PLS-SEM. This study focused on trading experience with company’s active investors and traders in banking industry in Pakistan. The future research could be research in other sectors with inter-related issue of investors and traders (brokers) in stock trade. This is the first study in this research area; this study will be determine the experiences with positive (negative) financial behavior, attitude, satisfaction and behavioral loyalty of investors and traders in stock trade. Therefore, adding in this area of study which will help understanding the investors and traders attitude, preference and financial behavior in financial market.

An important step towards COVID-19 pandemic control is adequate knowledge and adherence to mitigation measures, including vaccination. We assessed the level of COVID-19 knowledge, attitudes, and practices among residents from an urban informal settlement in the City of Nairobi (Kibera), and a rural community in western Kenya (Asembo). A cross-sectional survey was implemented from April to May 2021 among randomly selected adult residents from a population-based infectious diseases surveillance (PBIDS) cohort in Nairobi and Siaya Counties. Factors associated with the level of COVID-19 KAP, were assessed using multivariable regression methods. COVID-19 vaccine acceptance was 83.6% for the participants from Asembo and 59.8% in Kibera. The reasons cited for vaccine hesitancy in Kibera were safety concerns (34.0%), insufficient information available to decide (18.0%), and a lack of belief in the vaccine (21.0%), while the reasons in Asembo were safety concerns (55.0%), insufficient information to decide (26.0%) and lack of belief in the vaccine (11%). Our study findings suggest the need for continued public education to enhance COVID-19 knowledge, attitudes, and practices to ensure adherence to mitigation measures. Urban informal settlements require targeted messaging to improve vaccine awareness, acceptability, and uptake.

Herein, we examined the effects of weather parameters and individual clinicodemographic risk factors on hemorrhagic stroke (HS) incidence, severity on admission, and disability at discharge in a harsh desert climate. In a retrospective design we studied patients admitted to a stroke unit in Arab Emirates in 2016-2019. With a distributed lag nonlinear model we explored immediate and delayed effects of weather on stroke incidence. Supervised machine learning was used to build models predictive of scores in NIHSS and mRS scales. We assessed model performance by calculating ROC AUC, F1 scores, specificity, and sensitivity. HS risk increased after a significant change in any weather parameter. The risk was reduced below baseline after 1-week adjustment to environmental changes. Climate input from the previous 3 days yielded reliable classification models. Humidex was a better predictor of severity than air temperature, whereas body mass index, age, and time of day at stroke onset were the strongest clinical predictors. Weather parameters before admission were stronger predictors of disease severity than individual clinical factors. We addressed limitations of previous studies by analyzing a full set of climate parameters: ambient temperature, relative humidity, humidex, atmospheric pressure, and wind speed. Predictive models may help to optimize patient management and develop preventative strategies.

Food safety is a persistent global health challenge. Improper handling of foods increases the chances of food contamination, which may endanger the consumers’ health. The knowledge gap and improper hygienic practices of food handlers are the key factors for the transmission of foodborne diseases. This study aimed to investigate the level of food safety knowledge, attitudes, and practices among street food vendors in Dhaka City, Bangladesh. In this cross-sectional study, a randomly selected 350 street vendors from seven locations in Dhaka City were enrolled. Data were collected by trained interviewers using a questionnaire. Only 36.5% of the respondents had primary, and 48% had secondary education. The majority of the vendors who handled food in front of observers showed good handwashing practice. However, very few vendors showed positive attitudes for washing hands before handling raw or cooked food (3.7%), practicing good personal hygiene (1.2%), and other food safety attitudes (less than 1%). This study showed a significant correlation between the education level of the participants, work experience, and qualification of the head chef with knowledge about hand washing, wearing gloves, and food-borne illnesses. The study demonstrated that formal education played a significant role in vendors’ knowledge and practice of health safety measures of food handlers in preventing foodborne illness.

Poplars (Populus spp.) are of significant ecological and economic importance. Long-term breeding efforts were aimed mainly at obtaining fast-growing and productive plants and less considered resistance to pests. This study aimed to identify the patterns of susceptibility to Saperda carcharias (Linnaeus, 1758) (Coleoptera: Cerambycidae) among Populus hybrids and pure species, considering crossing combinations and some other traits. In our research, 35 clones of poplar species and hybrids of the Ukrainian and foreign selection from the Aigeiros, Tacamahaca, and Leucoides sections were tested in 2021 and 2023 in the plantation created in 2014 in Eastern Ukraine. S. carcharias preferred infesting clones with earlier foliage development, larger diameters, and height increments. Specifically, hybrids with American maternal lineage showed the highest susceptibility, whereas those with European maternal lineage or Asian origin displayed lower infestation levels or resistance, respectively. This variability suggests a complex relationship between genetic background and pest resistance, underlining the need for a deeper understanding of the factors influencing susceptibility to S. carcharias. Selecting native species clones or creating mixed clone plantations could enhance the resilience of poplar plantations to pest threats.

Superstar Learning System is an interactive information platform, where teachers and students can not only have an easy access to various learning resources, but also interact in the whole teaching and learning process. Although there have been a large number of studies devoted to the use of Superstar Learning System in education, very few of them explored its behavioral intention. In order to deal with this missing link in literature, we adopt a random sampling technique and a questionnaire survey to collect data. This study concludes that performance expectancy, effort expectancy, lecturer influence, peer influence, user innovativeness, interface simplicity, and multiple functions exert a positive influence on behavioral intention to use Superstar Learning System. We form a fit extended technology acceptance model (TAM) by including innovative constructs, i.e. lecturer and peer influences, user innovativeness, interface simplicity, and multiple functions. Interdisciplinary research is needed to explore an extended TAM to use Superstar Learning System in the future.

This research paper examines the role of mass media in fostering positivity for the purpose of nation building. The mass media, including television, radio, print, and online platforms, holds significant influence over public opinion and societal attitudes. However, in recent years, there has been a growing concern about the predominance of negative news and content, which can have detrimental effects on the overall well-being of individuals and the development of a cohesive society. This study explores strategies and approaches to enhance positivity in mass media for the betterment of nations. It investigates the potential benefits, challenges, and ethical considerations associated with promoting positivity through various media channels. This paper provides recommendations for media organizations, policymakers, and society at large to cultivate a more positive media landscape that contributes to nation building.

Purpose: This study aims to provide a foundational understanding of patient-centric perceptions of telemedicine implementation in rural Minnesota. Methods: This retrospective cohort study utilized a mail questionnaire to assess patient attitudes and behaviors regarding telemedicine during the emergency response to COVID-19. The target population was patients of a Primary Care clinic in eastern Minnesota. Descriptive statistics were used to assess respondents’ level of agreement with survey items scored on a 0-10 scale. Results: A majority of the respondents indicated that they were satisfied with using telemedicine (73.96%); that they gained an additional sense of control over their health condition due to the availability of telemedicine (52.08%); that they would support the use of telemedicine in the future (61.05%); that telemedicine increased access to care (65.63%); telemedicine was preferred over the clinic (61.46%), and that they would purchase new equipment to increase the utility of telemedicine services (54.17%). 51.04% of the respondents indicated a 10/10 level of satisfaction with telemedicine services. 48.96% indicated the strongest level of disagreement related to difficulty using telemedicine or a preference for in-person clinical appointments. Conclusions: Patients were found to have favorable perceptions of telemedicine overall. Though providers continue to recognize the benefit of face-to-face visits, their patients show an increased predilection for virtual care and telemedicine will likely remain an essential tool for providers to reach patients who would otherwise choose not to seek care.

To evaluate the impact of a new Substance Use Disorder (SUD) education program on medical students' representations, we selected the Substance Abuse Attitude Survey (SAAS) questionnaire, which we adapted to our curriculum and cultural context. To validate this adapted version, we conducted an exploratory factor analysis following the administration of our 29-items bSAAS questionnaire to 657 medical students in Belgium (response rate: 71,1%). 23 items correlated to 3 factors namely "Stereotypes and moralism", "Treatment optimism" and "Specialised treatment" were retained (70% of total variance explained, Cronbach's alpha= 0.80) and constituted the new questionnaire called beSAAS. The factor "Specialised treatment", stood out from previous studies which could be explained by our target population and the impact of the formal, informal, and hidden curriculum in medical education. This study highlighted certain factors influencing stereotypical representations such as age, gender, origin, and personal or professional experience with substance use. Our study allowed us to retain the beSAAS as a good questionnaire to evaluate SUD stigma and highlighted interesting findings to improve SUD training in medicine. Further studies are needed to complete its validity and reliability.

Despite intensive HIV education and prevention efforts in the past years, stigmatizing attitudes toward people living with HIV (PLWH) remain a major barrier to HIV prevention and treatment efforts in Vietnam. The purpose of this study was to examine the prevalence of stigmatizing attitudes regarding HIV and identifying correlative factors that impact perceptions of PLWH among women migrant workers working in the industrial zones (IZ) in Hanoi, Vietnam. A cross-sectional study was conducted among 1061 women migrant workers aged 18 to 29 from January to November 2020 in Hanoi, Vietnam. Stigmatizing attitudes toward PLWH were measured using a four-item scale. Multiple logistic regression was conducted to examine factors associated with stigmatizing attitudes. Over seventy-six (76.2 %) of the participants reported having at least one of the four stigmatizing attitudes. Greater levels of stigmatizing attitudes toward PLH were significantly associated with lower HIV knowledge, lower education and being Kinh (the ethnic majority in Vietnam). A high level of stigmatizing attitudes toward PWH among the study participants suggests that there is an urgent need for the development of appropriate culturally interventions and outreach education activities to reduce stigmatizing attitudes toward PWH among women migrant workers working in the IZs in Vietnam.Despite intensive HIV education and prevention efforts in the past years, stigmatizing attitudes toward people living with HIV (PLWH) remain a major barrier to HIV prevention and treatment efforts in Vietnam. The purpose of this study was to examine the prevalence of stigmatizing attitudes regarding HIV and identifying correlative factors that impact perceptions of PLWH among women migrant workers working in the industrial zones (IZ) in Hanoi, Vietnam. A cross-sectional study was conducted among 1061 women migrant workers aged 18 to 29 from January to November 2020 in Hanoi, Vietnam. Stigmatizing attitudes toward PLWH were measured using a four-item scale. Multiple logistic regression was conducted to examine factors associated with stigmatizing attitudes. Over seventy-six (76.2 %) of the participants reported having at least one of the four stigmatizing attitudes. Greater levels of stigmatizing attitudes toward PLH were significantly associated with lower HIV knowledge, lower education and being Kinh (the ethnic majority in Vietnam). A high level of stigmatizing attitudes toward PWH among the study participants suggests that there is an urgent need for the development of appropriate culturally interventions and outreach education activities to reduce stigmatizing attitudes toward PWH among women migrant workers working in the IZs in Vietnam.

In the twenty-first century– an era of increasing domestic and international tourism- there are boundless opportunities to encounter wild animals both in their home countries and ex situ in zoological facilities around the world. Tourism activity– especially at accredited zoos and sanctuaries –plays a crucial role in the conservation of wild animal populations, and influences the welfare of individuals within involved species. Unfortunately, not all zoos and sanctuaries prioritize the conservation and welfare of their animals, such as those who promote irresponsible and mutually-harmful visitor-animal encounters for economic profit. While the relationship between visitors and animals at zoological facilities has shifted over time to match evolving morals and sentiments towards animals, there is still a storied tendency of visitors preferring close encounters with charismatic wild species. Since the 1970s, researchers’ attention has increasingly focused on assessing the influence of the visitor effect, which refers to the impact that viewing, touching, feeding, holding, and riding captive wildlife has on the animals. Many wildlife attractions promote such encounters, despite research suggesting that close interactions with visitors can cause stress and harm to involved species. Such activities are further promoted through the “selfie tourism” phenomenon, in which visitors capture images of themselves in too-close proximity to wild animals to be shared on social media. In this commentary, we consider the challenge of “selfie tourism”, and how it can promote unethical relationships between humans and wildlife and lead to deleterious implications for the animals’ conservation and welfare.

To explore the relevant factors that affect the efficacy of consciousness-regaining therapy (CRT)for prolonged disorder of consciousness(pDOC),a retrospective analysis was conducted on the case data of 114 patients with pDOC admitted to department of functional neurosurgery of Tianjin Huanhu Hospital from January 2019 to January 2022. Basic information on the cases,data on pDOC disease assessment, consciousness-regaining therapy methods, and efficacy evaluation were collected. A total of 114 patients were grouped and compared based on the efficacy at the end of treatment. Among them, there were 61 cases in the ineffective group and 53 cases in the effective group. There was no statistically significant difference (P&gt;0.05) between the two groups in terms of gender, age, etiology, acute cerebral herniation, emergency craniotomy surgery, emergency decompressive craniectomy, time from onset to start of consciousness-regaining therapy , and duration of consciousness-regaining therapy(P&gt;0.05). However, there were statistically significant differences (P&lt;0.05) in terms of secondary hydrocephalus, , consciousness-regaining therapy methods, CRS-R grading before treatment, and GOSE score at 6 months after treatment. Binary logistic regression analysis showed that the type of therapy (OR=0.169, 95% CI: 0.057-0.508) was a related factor affecting the efficacy of consciousness-regaining therapy (P&lt;0.05).Compared with non-invasive therapy, personalized awakening therapy using various invasive consciousness-regaining therapy methods can help improve the efficacy of therapy for pDOC.

Worldwide initiatives currently aim to reduce free sugar intakes, but success will depend on consumer attitudes towards sugar and the alternatives. This work aimed to explore attitudes towards sugar, sweeteners and sweet-tasting foods in the general public of the UK, including attitudes towards personal consumption and related policies. Focus groups and interviews were conducted with 34 adults (7 males, ages: 18-65 years). Thematic analysis identified six themes: ‘Value’ (e.g. pleasure, emotions), ‘Angle’ (e.g. disinterest), ‘Personal Relevance’ (to be concerned and/or change one’s own behaviour), ‘Personal Responsibility’ (one has an active relationship with these food items), ‘Understanding’ (the acquisition, comprehension and application of information surrounding these food items) and ‘It’s Not Up to Me’ (a passive approach towards these food items, because intake is subjected to other factors). Both positive and negative attitudes towards sugar, sweeteners and sweet-tasting foods were expressed in all themes, largely dependent on the individual. Potential strategies for reducing free sugar intakes were also reported, but differences in likely value were suggested by different individuals. Future work should assess associations between attitudes and intakes. For greatest population benefit, evidence of the dominant attitudes in those in greatest need of reduced free sugar intakes would be of value.

Sustainability is a characteristic manifested in the ability to maintain the necessary level of performance for construction companies when risk factors arise during the implementation of investment and construction projects. The risk factors that arise during the implementation of in-vestment and construction projects differ in nature, degree of influence, and other characteristics. Ignoring these factors and measures to manage them often leads to critical consequences in the form of disruptions in the timing of work. Risk is a combination of the probability and consequences of the occurrence of adverse events. The article considers the concept of risk as a potential possibility of occurrence of adverse situations and related consequences when exposed to these factors. Risk factors are characterized by surprise, discreteness of changes, the presence of threshold values, upon reaching which a transition to a different mode of operation is required. The article discusses the risk factors arising at the construction stage, their classification. A methodology has been developed that includes conducting a survey in the form of a questionnaire in order to collect information about risk factors that affect the implementation of investment and construction projects. Experts with experience in the construction sector were involved in the survey. The processing of the survey results made it possible to assess the significance of various risk factors in investment and construction projects. Thus, statistical and expert methods were used in the study. The results showed that financial, technical, legal, economic, managerial and natural factors have the greatest impact on investment and construction projects. It is recommended to pay special attention to the listed factors when developing measures aimed at preventing risks and their consequences. The methodology described in the study can be used by construction companies in strategic planning. The analysis of the stability of construction companies, depending on their use of various ways to counteract risk factors, allowed us to develop a number of practical recommendations to reduce the impact of the studied factors on achieving the goals of investment and construction projects.

Background: Despite their generally favorable prognosis, hepatic fibrosis remains a possible complication for hepatitis B virus (HBV) inactive carriers. This study aimed to estimate the prevalence of significant fibrosis and associated risk factors among Omani HBV inactive carriers. Methods: A retrospective study was conducted of 200 Omani HBV inactive carriers visiting a tertiary hospital in Muscat, Oman, between January 2017 and December 2018. Significant fibrosis (stage F2 or higher) was identified using two-dimensional shear-wave elastography. Baseline clinical, laboratory, and radiological data were analyzed to determine associations. Results: Of the total sample, 106 patients (53%) were male, and the mean age was 44.6 ± 9.3 years. The prevalence of significant fibrosis was 20% (n = 40). Male gender (p = 0.007), age ≥60 years (p = 0.024), and fatty changes in liver ultrasound (p = 0.044) were found to be independent factors for significant fibrosis. Conclusion: the prevalence of significant fibrosis was relatively high among a sample of Omani HBV inactive carriers, with several sociodemographic and clinical risk factors identified. Periodic assessment of liver function is needed for patients with these risk factors; moreover, routine biochemical parameters could be useful predictors of disease prognosis. Further research is recommended to substantiate these findings.

Factors responsible of species distribution were intensively investigated in the past, including response at different spatial scales. The aim of the present research is to review the most relevant factors explaining chironomid species distribution focusing to factors operating at different spatial scales, such as latitude, longitude, altitude, water temperature, dissolved oxygen, nutrients acting at regional, country, water basin extension. Data including chironomid species abundances from different lentic and lotic waters from Italy and other surrounding countries were analyzed with different multivariate methods: partial canonical correspondence analysis and multiple discriminant analysis. Spatial analysis included univariate Moran’I correlograms, multivariate Mantel correlograms and Moran’s Eigenvectors Maps (MEM) calculation. The results confirmed previous conclusions, that is habitat type including different running waters reaches (kryal, krenal, rhthral, potamal) and different lake types is the most significant factor in separating chironomid assemblages and spatial factors act only as indirect influencers..

This study evaluated the impact of didactic videos and service user testimonial videos on mental illness stigma among medical students. Two randomized controlled trials were conducted in Nepal. Study 1 examined stigma reduction for depression. Study 2 examined depression and psychosis. Participants were Nepali medical students (Study 1:n=94, Study 2:¬n=213) randomized to three conditions: a didactic video based on the mental health Gap Action Programme (mhGAP), a service user video about living with mental illness, or a control condition with no videos. In Study 1, videos only addressed depression. In Study 2, videos addressed depression and psychosis. In Study 1, both didactic and service user videos reduced stigma compared to the control (F2,91=6.37, p=0.003). In Study 2 (depression and psychosis), there were no differences among the three arms (F2,210=2.07, p=0.13). When comparing Study 1 and 2, there was greater stigma reduction in the service user video arm with only depression versus service user videos with depression and psychosis (t(31)=-3.04, p=0.005). In summary, didactic and service user videos were associated with decreased stigma when content addressed only depression. However, no stigma reduction was seen when including depression and psychosis. This calls for different strategies based on types of mental illnesses. ClinicalTrials.gov identifier: NCT03231761

The coronavirus disease (COVID-19) pandemic is rapidly spreading across the world. In Democratic Republic of Congo (DRC), 11 out of 26 provinces have been affected on 19 June 2020. The purpose of this study was to assess the public views, attitudes and beliefs related to the COVID-19 pandemic among the population of an unaffected city.Methods: This is a descriptive observational study conducted in an unaffected city using a questionnaire. Findings: A total of 769 people participated. The average age was 36 ±14 years. The sex ratio (male: female) was 1.6. The majority of respondents (97%) is aware of the existence of the COVID-19 pandemic, it is well informed about the signs of the disease, its severity and barrier measures, however few of them have adopted the change in habit and behavior in respect of the barrier measures. Lack of water for handwashing is the most common difficulty in complying with barrier measures (71%). The COVID-19 is considered as an artificial virus designed to reduce the world population by 26%, God’s punishment (22%). Only 36% of the participants are in favor of vaccination against COVID-19. Vaccine is, a western conspiracy to spread COVID-19 in Africa (38%), testing it on Africans (35%), sterilize Africans’ people (12%).Conclusions: Cities not yet affected by COVID-19 in DRC are aware of the existence of the disease, but insufficiently prepared to deal with it. It is important to increase awareness on barrier measures, combating false information, and improving regular water supply for regular handwashing.

Background: Previous study of sexual minorities has documented both instability in the sex of sex partners and incongruity among all three dimensions of sexual orientation (attraction, behavior and identification), but no attempt has been made to relate the two. How, if at all, does past change affect present incongruity? This study attempts, for the first time, to examine this question. Method: Using a representative probability sample of the British population (n = 15,162), the current dimensions of sexual orientation were compared across changes in sex partner type—opposite-sex only (O/Sex), same-sex only (S/Sex), or both opposite-sex and same-sex (B/Sex)— over three time periods—before 5 years ago (Time 1), 5 years to 1 year ago (Time 2), and the past year (Time 3)—for the nonheterosexual population. Differences and trends in population-weighted percentage frequencies stratified by sex were assessed by t-test or inspection of 95% confidence intervals. Results: Overall incongruity and instability were high: 74% of men and 85% of women did not report congruent lifetime sexual attraction, behavior and identification; of persons reporting any same-sex sex partners at Time 1, 82% reported a different partner type at Time 3. Most change (80% for women, 84% for men) involved a single partner type transition (transience) rather than multiple changes (fluidity) and movement toward increased heterosexual orientation (69%; 65% to O/Sex partners. From Time 1 to Time 3, 19% of persons with S/Sex partners moved to O/Sex partners; 0.1% of persons with O/Sex partners moved to S/Sex partners. Instability moderately reduced already high incongruity for the majority moving toward increased heterosexual orientation, but increased already low incongruity for the minority moving toward increased same-sex orientation. Among presently S/Sex partnered persons (comprising 12% of sexual minorities), incongruity was reported by 1.4% of persons with stable partnership history and 11% of persons with unstable partnership history (p=.0052). For all except presently S/Sex partnered persons (comprising 88% of sexual minorities), incongruity was reported by 97% of persons with stable partnership history and 86% of persons with unstable partnership history (p=.0000). Conclusion: For most sexual minority persons, partner type instability contributed to a modest reduction of high sexual minority orientation incongruity after moving toward increased heterosexual practice. Among current S/Sex partnered persons, however, instability strongly increased incongruity between identification and behavior or attraction. These results are consistent with minority stress theory but inconsistent with homosexual immutability, and counsel caution regarding legal restrictions on support for sexual minority persons moving toward increased heterosexual partnership.

Abnormalities in male fertility constitute about 50% of all infertility causes. According to some data, the quality of human semen has deteriorated by 50-60 % over the last 40 years. A high-fat diet and obesity, the development of which is encouraged by the western lifestyle, affects the structure of spermatozoa, but also the development of the offspring and their health in later stages of life. In obese individuals, disorders on the hypothalamic-pituitary-gonadal axis are observed, as well as elevated oestrogen levels with simultaneous decrease of testosterone, LH and FSH hormone levels. Healthy dietary models clearly correlate with better sperm quality and a smaller risk of abnormalities in parameters, such as sperm count, sperm concentration and motility, as well as lower sperm DNA fragmentation. Apart from mineral components such as zinc and selenium, the role of omega-3 fatty acids and antioxidant vitamins should be emphasized, since their action will be based primarily on the minimization of oxidative stress and inflammation process. Additionally, the incorporation of carnitine supplements and coenzyme Q10 in therapeutic intervention seems also promising. Therefore, it is advisable to have a varied and balanced diet based on vegetables and fruit, fish and seafood, nuts, seeds, whole-grain products, poultry and low-fat dairy products.

Understanding vaccine hesitancy in organ transplant recipients (OTR) is critical, given clear, alt-hough attenuated, benefits from vaccination. Adult OTR were surveyed regarding vaccine-related values and a novel outcome variable called Vaccine Acceptance Composite Score (VACS) was built as the average Likert score of 7 domains of vaccination confidence. Of 46 OTR included (93.5% kidney transplant recipients), 32.6% were female, 13.3% Black, 6.77% Hispan-ic/Latino/a/x; median age was 58 years. Patients were most concerned about COVID-19 vac-cine-associated risks (46.3%), its potential effect on allograft (47.6%) and motives of government officials involved with vaccine policy (55.6%). Politically conservative patients were likely to have a significantly lower VACS, while those who lived with someone ≥65 had a higher VACS. The VACS was not significantly associated with race, income, religious beliefs, comorbidities, COVID-19 history, or influenza vaccination status. Higher VACS was significantly associated with ≥3 and ≥4 COVID-19 immunizations. This study highlighted political beliefs and elderly household members as correlates of vaccine acceptance among OTR. The VACS may be a useful tool to help standardize multifaceted analyses in vaccination-focused behavioral research, as well as identify individuals and groups at risk for vaccine hesitancy, who may benefit from tai-lored outreach and educational interventions.

Today, across the most critical problems faced by hospitals and health centers are those caused by the existence of patients who do not attend their appointments. Among others, this practice generates waste of resources and increases the patients’ waiting list. To handle these problems, hospitals are actively trying to implement methods to reduce the idle time caused by patient no-shows. Many scheduling systems developed require predicting whether a patient will show up for an appointment or not. Although, a challenging problem resides in obtaining these estimates precisely. The goal of this work is to analyze how objective factors influence a patient not to attending their appointment, to identify the main causes that contribute to a patient’s decision, and to be able to predict whether or not the patient will attend the scheduled appointment. As a result, the obtained model is tested on a real dataset collected in a health center linked to the University of Vale do Itajaí (UNIVALI), which includes 25 features and about 5000 samples. The algorithm that produced the best results for the available dataset is the Random Forest classifier. It reveals the best recall rate (0.91), since it measures the ability of a classifier to find all the positive instances and achieves a receiver operating characteristic curve rate of 0.969.