Search Results (426)

There are a range of factors that influence alcohol use in pregnancy and create risk of fetal harm. However, limited research has articulated the multilevel nature of these influences and their entanglement. The purpose of this narrative review is to analyze the types of factors that influence alcohol use and consider what factors need to be addressed in future health promotion and intervention efforts. Six databases were searched using EBSCOhost articles published between January and December 2023 on alcohol use in pregnancy and Fetal Alcohol Spectrum Disorder (FASD) prevention. English-language articles were screened for relevance and a subset of articles exploring the prevalence, influences, and risk-factors associated with pregnancy were included for analysis. Thirty-two (n = 32) articles were included in the review and categorized into five key areas of influence on maternal alcohol use: (1) informational factors; (2) stress-related factors; (3) social determinant of health-related (SDoH) influences; (4) preconception- and prenatal-health-related factors; and (5) structural factors. Future efforts to reduce alcohol use in pregnancy should address these five categories of factors through non-judgmental, health-promoting, trauma-informed, harm-reduction-oriented, and culturally safe education, programming, and policy. Full article

Background and Objectives: The COVID-19 pandemic placed substantial mental and physical burdens on healthcare workers, particularly nurses. In the post-pandemic period, sustained stress, elevated mental workload and disturbed sleep may continue to affect well-being and job performance. This study aimed to assess perceived stress levels, occupational stress, and sleep quality among Hungarian nurses, while identifying key demographic, occupational, and behavioral predictors. Materials and Methods: A cross-sectional, quantitative study was conducted from April to July 2022 among nurses employed in Hungarian general hospitals (N = 418). Data were collected via an online self-administered questionnaire. Stress and sleep quality were measured using the Perceived Stress Scale (PSS-14), Expanded Nursing Stress Scale (ENSS), and Groningen Sleep Quality Scale (GSQS). Statistical analysis included descriptive statistics, ANOVA, post hoc tests, t-tests, and Pearson’s correlation (p < 0.05). Results: The mean PSS-14 score was 27.82 (SD = 7.82), indicating moderate stress. Sleep quality was poor (mean GSQS = 7.29, SD = 4.28), with significant positive correlation with perceived stress (r = 0.442, p < 0.001). Low income, lower education, and high coffee or alcohol consumption, and multiple night shifts were significantly associated with higher stress and poorer sleep quality. Occupational stress and mental workload, as measured by ENSS, was highest in internal medicine (mean = 122.16, SD = 37.09; p = 0.033). The most burdensome ENSS subscale was “workload” (mean = 2.30, SD = 0.92), with “not enough staff to adequately cover the unit” identified as the most stressful item. Additional cognitive and emotional workload components included dealing with violent patients and a lack of emotional preparedness in supporting families. Conclusions: Post-COVID nurses in Hungary experience moderate stress and impaired sleep. Excessive workload, emotional demands, and shift patterns significantly contribute to psychological and cognitive strain. Institutional and policy-level interventions are needed to reduce occupational stress and promote workforce resilience. Full article

Packaging demand currently exceeds 144 Mt per year, of which >90% is conventional plastic, generating over 100 Mt of waste and 1.8 Gt CO₂-eq emissions annually. In this review, we systematically survey three classes of lignocellulosic feedstocks, agricultural residues, fruit and vegetable by-products, and forestry wastes, with respect to their physicochemical composition (cellulose crystallinity, hemicellulose ratio, and lignin content) and key processing pathways. We then examine fabrication routes (solvent casting, extrusion, and compression molding) and quantify how compositional variables translate into film performance: tensile strength, elongation at break (4–10%), water vapor transmission rate, thermal stability, and biodegradation kinetics. Highlighted case studies include the reinforcement of poly(vinyl alcohol) (PVA) with 7 wt% oxidized nanocellulose, yielding a >90% increase in tensile strength and a 50% reduction in water vapor transmission rate (WVTR), as well as pilot-scale extrusion of rice straw/polylactic acid (PLA) blends. We also assess techno-economic metrics and life-cycle impacts. Finally, we identify four priority research directions: harmonizing pretreatment protocols to reduce batch variability, scaling up nanocellulose extraction and film casting, improving marine-environment biodegradation, and integrating circular economy supply chains through regional collaboration and policy frameworks. Full article

The assessment of food system sustainability requires a profound understanding of the evolution of food production and consumption. Monitoring the transition towards healthier and sustainable diets is crucial for supporting future interventions. This study explores market sales data as an input to investigate and compare current dietary trends in the European Union Member States over 14 years. By analysing consumption trends of major food product categories, including animal-based and plant-based foods, we identified two distinct clusters of countries with opposite dietary patterns. Our analysis explored not only major food product categories essential for healthy living but also superfluous foods (i.e., discretionary) to provide a broader understanding of dietary habits. In particular, our results show that countries reducing consumption of animal-based foods also exhibit a reduction in consumption of discretionary products, such as alcoholic beverages and soft drinks, highlighting opportunities for synergies between environmental and health policies. This research provides valuable insights for policymakers and stakeholders aiming to promote the uptake of healthy and sustainable diets and supports the development of targeted strategies to support the transition towards more environmentally friendly and healthy food systems. Full article

This study assessed whether COVID-19 pandemic experiences were associated with excessive alcohol use during the first year of the pandemic in Iowa, a heavy-drinking midwestern US state. We analyzed survey data from 4047 adult residents of Iowa collected in August 2020, focusing on three pandemic-related stressors (e.g., emotional reactions to the pandemic; disruption of daily activities; and financial hardship) and salient social support. Using multiple logistic regression, we tested correlates of increased drinking, heavy drinking, and binge drinking, controlling for demographic characteristics and health status. We found that nearly half (47.6%) of respondents did not change their drinking compared to before the pandemic; however, 12.4% of respondents reported increasing their drinking and 5.3% reported decreasing their drinking. Emotional reactions to the pandemic and disruption of daily activities were associated with higher odds of increased drinking, and rurality was associated with lower odds of increased drinking. No pandemic-related stressor was associated with heavy or binge drinking, but social support was associated with lower odds of binge drinking. Thus, we concluded that some pandemic-related stressors may explain increased drinking but not heavy or binge drinking. Understanding the nuances of alcohol use can inform preventive interventions, policy decisions, and preparations for future catastrophic events. Full article

Motor vehicle crashes are a persistent cause of unintentional deaths in the United States. Scholarship on how manmade interventions and natural phenomena interact to effectuate such calamitous outcomes is longstanding. One manmade intervention of interest in the literature is daylight saving time (DST). Unfortunately, results on how the natural phenomena attributable to DST interact with driver behavior are inconsistent. To advance knowledge on DST-safety interactions, this study adopts a multilevel model approach to fatal motor vehicle crash outcomes in the contiguous United States. Results from a national analysis contextualize results from zonal analyses to unmask within- and between-time zone differences in DST-safety interactions. In the national analysis, motor vehicle crash fatalities decrease somewhat during DST (−0.10%). In the zonal analyses, motor vehicle crash fatalities decrease more so in the Central and Eastern time zones (−2.00% and −2.00%, respectively), but increase somewhat in the Pacific and Mountain time zones (+0.30%) during DST. The spatiotemporal context of the national analysis highlights specific policy implications from the zonal analyses to decrease the lethality of motor vehicle crashes. Specifically, interdictions to target alcohol and/or drug involvement in the northern latitudes of the Pacific and Mountain time zones during DST, the Central time zone at dawn or dusk before or after DST, and the northern latitudes in the Eastern time zone before or after DST are important. Generally, national DST-safety benefits mask zonal DST-safety costs in the Pacific and Mountain time zones. Full article

Introduction: Sexual minority men (SMM) are at increased risk for psychosocial stressor exposure, substance use, and poor mental health relative to heterosexual men. While the burden of mental health is growing in the United States, among SMM these trends are increasing at a greater rate, driving health disparities. Methods: Framed within a minority stress framework, these analyses examine how stressors explain substance use and poorer mental health over time. Participants were asked questions on stressor exposure (stigma, discrimination, internalized homophobia, perceived stress), mental health (anxiety, depression, PTSD), and substance use (alcohol to intoxication, club drugs, poly club drugs) over 36 months among 528 SMM in NYC. Results: Perceived stress increased frequency of all substance use, whereas discrimination decreased days of club and poly club drug use. Depression severity predicted increased days of club drug and poly club drug use. PTSD severity predicted increased days of club drug and poly club drug use. Conclusion: We are able to expand on the literature with granular substance use data to highlight associations with stressors and mental health. These findings support an increased need for systematic policy solutions and public health interventions to address drivers of substance use disparities among young SMM. Full article

Hand hygiene (HH) is essential for preventing disease transmission, particularly in schools where children are in close contact with other children. This study evaluated a school-based intervention on observed HH practices and hand cleanliness in six primary schools in Guatemala. Hand cleanliness was measured using the Quantitative Personal Hygiene Assessment Tool. The intervention included (1) HH behavior change promotion through Handwashing Festivals, and (2) increased access to HH materials at HH stations. Handwashing Festivals were day-long events featuring creative student presentations on HH topics. Schools were provided with soap and alcohol-based hand rub throughout the project to support HH practices. Appropriate HH practices declined from 51.2% pre-intervention to 33.1% post-intervention, despite an improvement in median Quantitative Personal Hygiene Assessment Tool scores from 6 to 8, indicating cleaner hands. Logistic regression showed higher odds of proper HH when an assistant was present. The decline in HH adherence was likely influenced by fewer assistants and changes in COVID-19 policies, while improvements in hand cleanliness may reflect observational bias. These findings emphasize the importance of sustained behavior change strategies, reliable HH material access, and targeted interventions to address gaps in HH practices, guiding school health policy and resource allocation. Full article

Obesity is a growing global health concern with widespread impacts on physical, psychological, and social well-being. Clinically, it is a major driver of type 2 diabetes (T2D), cardiovascular disease (CVD), non-alcoholic fatty liver disease (NAFLD), and cancer, reducing life expectancy by 5–20 years and imposing a staggering economic burden of USD 2 trillion annually (2.8% of global GDP). Despite its significant health and socioeconomic impact, earlier obesity medications, such as fenfluramine, sibutramine, and orlistat, fell short of expectations due to limited effectiveness, serious side effects including valvular heart disease and gastrointestinal issues, and high rates of treatment discontinuation. The advent of glucagon-like peptide-1 (GLP-1) receptor agonists (e.g., semaglutide, tirzepatide) has revolutionized obesity management. These agents demonstrate unprecedented efficacy, achieving 15–25% mean weight loss in clinical trials, alongside reducing major adverse cardiovascular events by 20% and T2D incidence by 72%. Emerging therapies, including oral GLP-1 agonists and triple-receptor agonists (e.g., retatrutide), promise enhanced tolerability and muscle preservation, potentially bridging the efficacy gap with bariatric surgery. However, challenges persist. High costs, supply shortages, and unequal access pose significant barriers to the widespread implementation of obesity treatment, particularly in low-resource settings. Gastrointestinal side effects and long-term safety concerns require close monitoring, while weight regain after medication discontinuation emphasizes the need for ongoing adherence and lifestyle support. This review highlights the transformative potential of incretin-based therapies while advocating for policy reforms to address cost barriers, equitable access, and preventive strategies. Future research must prioritize long-term cardiovascular outcome trials and mitigate emerging risks, such as sarcopenia and joint degeneration. A multidisciplinary approach combining pharmacotherapy, behavioral interventions, and systemic policy changes is critical to curbing the obesity epidemic and its downstream consequences. Full article

Background: Energy drinks (EDs) are non-alcoholic, functional beverages sold worldwide in more than 165 countries. These products are very popular and often consumed by children, teenagers, and young adults to improve physical performance, reduce drowsiness, and improve memory and concentration with increased intellectual effort. However, their consumption is associated with an increased risk of various health consequences. Objectives: The purpose of this non-systematic review was to discuss the components of EDs and their effects, summarize the AEs reported in the literature associated with the consumption of EDs, and briefly characterize the possible ED-related drug interactions. Methods: Scientific evidence was extracted by searching the databases PubMed and Google Scholar. In addition, the reference lists of the retrieved papers were reviewed and cross-referenced to reveal additional relevant scientific evidence. Results: The most common ingredients in EDs are caffeine, taurine, glucuronolactone, B vitamins, the vitamin-like compound inositol, and sweeteners (sugar, fructose, glucose–fructose syrup or artificial sweeteners). Although it is difficult to conclusively prove a cause-and-effect relationship between the consumption of EDs and the observed pathophysiological abnormalities, most scientific evidence (mostly clinical case reports) indicates that both occasional and especially chronic use of EDs is associated with the occurrence of numerous adverse effects (AEs). Among these, the best documented AEs are those on the cardiovascular system. It should also be noted that the components of EDs (primarily caffeine) may have drug interactions; therefore, EDs may be an important factor influencing the safety of pharmacotherapy in patients consuming EDs. Conclusions: Consuming energy drinks lead to various health problems and may interfere with pharmacotherapy due to the potential development of drug interactions. Due to the widespread availability of EDs, their suggestive advertising aimed at the youngest customers, and ambiguous regulations, new legislative policies are required to limit the widespread consumption of such products and their negative health effects. Full article

Background: Cancer survivors may continue to experience health issues that affect their quality of life and raise the risk of other chronic diseases. Methods: This study aimed to assess adherence to general health check-ups, cancer-specific screenings, and chronic disease management among five-year cancer survivors using nationally representative data from the Korea National Health and Nutrition Examination Survey (KNHANES) conducted between 2013 and 2021. A total of 2597 cancer survivors and 2458 matched non-cancer controls were selected via 1:1 propensity score matching based on demographic and lifestyle characteristics. We analyzed health behaviors (smoking and alcohol use), participation in general and cancer-specific screenings, and medication adherence for hypertension, diabetes, and dyslipidemia. Results: Compared to controls, cancer survivors, especially those diagnosed more than five years ago, were significantly less likely to participate in recommended cancer screenings (adjusted OR: 0.82, p = 0.014) and had lower adherence to treatment for hypertension (adjusted OR: 1.84, p = 0.004) and dyslipidemia (adjusted OR: 1.42, p = 0.026). However, cancer survivors were less likely to smoke or consume alcohol. Conclusions: These findings underscore the need for comprehensive survivorship care policies that integrate both cancer surveillance and chronic disease management. Full article

Engaging in nightlife activities is an essential form of leisure, especially among young people. However, it also presents considerable risks associated with the occurrence of various forms of violence. Recently, increasing attention has been directed toward sexual violence occurring in nightlife settings. Despite numerous preventive efforts, such as awareness raising, bystander intervention training, alcohol policies, and situational preventive measures, sexual violence remains a persistent issue in nightlife contexts. With the extended usage of smartphones, mobile apps represent a promising approach that complements sexual violence prevention. This article presents findings from a systematic literature review and an online overview of mobile apps aimed at the intervention and prevention of sexual violence, focusing on identifying features suitable for nightlife contexts. The literature review revealed limited academic resources addressing such mobile apps, with only six articles found across four databases. An online review highlighted a wide range of mobile apps that tackle violence. However, when it comes to sexual violence, only 18 apps explicitly focus on prevention or intervention. Although many apps address some aspects of the problem, we noticed a lack of a comprehensive approach that would target all relevant stakeholders. Based on the conducted mobile app’s feature assessment, we propose a set of functionalities that should be incorporated into a holistic mobile app for nightlife sexual violence prevention, which may complement existing educational, community-based, and structural prevention efforts. Full article

Sustainable aviation fuels (SAFs) are currently considered a key element in the decarbonization of the aviation sector, offering a feasible solution to reduce life cycle greenhouse gas emissions without requiring fundamental changes in aircraft or infrastructure. This article provides a comprehensive overview of the current state of SAFs, including their classification, production technologies, economic aspects, and environmental performance. The analysis covers both currently certified SAF pathways, such as HEFA and FT-SPK, and emerging technologies like alcohol-to-jet and power-to-liquid, assessing their technological maturity, feedstock availability, and scalability. Economic challenges related to high production costs, investment risks, and policy dependencies are discussed, alongside potential mechanisms to support market deployment. Furthermore, the article reviews SAFs’ emission performance, including CO₂ and non-CO₂ effects, based on existing life cycle assessment (LCA) studies, with an emphasis on variability caused by feedstock type and production method. The findings highlight that, while SAFs can significantly reduce aviation-related emissions compared to fossil jet fuels, the magnitude of benefits depends strongly on supply chain design and sustainability criteria. There are various certified pathways for SAF production, as well as new technologies that can further contribute to the development of the industry. Properly selected biomass sources and production technologies can reduce greenhouse gas emissions by more than 70% compared to conventional fuels. The implementation of SAFs faces obstacles related to cost, infrastructure, and regulations, which hinder its widespread adoption. The study concludes that although SAFs represent a promising pathway for aviation climate mitigation, substantial scaling efforts, regulatory support, and continued technological innovation are essential to achieve their full potential. Full article

Background/Objectives: Laryngeal cancer (LC) accounts for 1–3% of all malignant neoplasms. The aim of this study was to analyze temporal trends in the incidence and mortality of LC in Central Serbia over a 25-year period (1999–2023). Methods: Data on newly diagnosed cases and deaths, stratified by sex and age group, were obtained from the Serbian Cancer Registry. Crude, age-specific, and age-standardized incidence and mortality rates were calculated. Joinpoint regression analysis was used to estimate average annual percent changes (AAPCs) and assess their statistical significance. Results: The average annual age-standardized incidence rate (ASR-W) was 11.1 per 100,000 in men and 1.4 in women, with corresponding mortality rates of 5.4 and 0.5, respectively. The highest incidence was observed in the 60–69 age group for both sexes (61.1/100,000 in men; 7.4/100,000 in women), while the highest mortality was recorded in individuals aged ≥70 (35.7/100,000 in men; 3.8/100,000 in women). A statistically significant annual decline among men was observed in both incidence (ASR-W: −0.7%) and mortality (ASR-W: −2.0%). In contrast, trends among women were not statistically significant, indicating overall stability. Conclusions: Although the Cancer Registry in Serbia faces limitations primarily due to data quality issues, it is a key tool for understanding LC trends, guiding health policies, and effectively allocating resources. Given the substantially higher burden among men, it is essential to strengthen tobacco and alcohol control, improve occupational safety, and promote early detection and timely treatment to reduce the disease burden. Full article

Temperature increases due to climatic changes have been increasingly recognized as posing significant public health challenges, with wide-ranging socio-economic implications. This scoping review examines the relationship between high temperatures and violence against women (VAW) globally. Nine studies from both high-income and low- and middle-income countries were included in this review. The findings suggest an overall positive association between high temperatures and rates of VAW. Theoretical frameworks, including the temperature–aggression hypothesis and routine activity theory, offer insights into the mechanisms driving this relationship. Key risk factors such as socioeconomic status, urban heat island effects, rurality, patriarchal norms, and alcohol consumption were considered to be risk factors affecting rates of VAW. Despite growing evidence, research gaps persist, particularly in regions with high rates of VAW and in the form of qualitative studies that capture women’s lived experiences. The positive associations between temperature and VAW underscore the urgency of integrating gender-sensitive strategies into climate adaptation policies to mitigate the compounding risks of climate change and gender-based violence. Full article