Search Results (1,717)

Gender-based and sexual violence are major public health concerns, and norms about consent are central to their prevention. This study examines how attitudes toward sexual consent relate to digital sexual consent and to the occasional feeling of distrust in public consent campaigns and institutions. We conducted a cross-sectional online survey embedded in the evaluation of a municipal consent campaign in Zaragoza (Spain). Adults (N = 404; 56.7% women) completed a 14-item short version of the Sexual Consent Scale–Revised, two items on digital sexual consent, and three items on institutional reluctance (perceived “sermonizing” tone, distrust in effectiveness, and lack of personal identification with the message). Correlation and multiple regression models with robust standard errors were estimated, controlling for gender, age, education, income, relationship status, and social media use. Attitudes toward sexual consent were strongly and positively associated with digital sexual consent. Gender was the most consistent sociodemographic correlate: men showed less egalitarian attitudes than women across all consent measurements. Institutional reluctance was systematically related to less supportive consent attitudes: perceiving institutional messages as exaggerated or personally irrelevant predicted lower support for sexual and digital consent norms, whereas trust in the campaign’s effectiveness was associated with more egalitarian attitudes. The findings support the continuity between sexual and digital consent and highlight gender and institutional trust as key determinants for the prevention of gender-based and sexual violence. Public health and social policies should integrate digital consent into consent education and co-design campaigns that minimize defensive reactions and rebuild trust in institutions. Full article

Food waste in households means that there is a need to recognize the possibilities of balancing activities in the field of obtaining and managing food products. Activities in this area may concern giving away surplus food to others, purchasing local and organic products, limiting shopping activity. Generation Z, which was included in this research, uses new media, including mobile applications, to a greater extent than other generations. The main objective of the research is to recognize and present the food-sustainable behaviors and attitudes of Generation Z consumers. The study used the analysis of source data, which was the basis for formulating four hypotheses. They were verified in empirical studies conducted using the CAWI method. The collected material was analyzed using, among others, the proprietary index of environmentally and socially sustainable behaviors (ESRBI), the Mann-Whitney test. The studies showed that respondents assessed their food behaviors as irresponsible, with women’s assessment being higher than men’s. A positive correlation was demonstrated between the use of food saving applications and the value of the ESRBI index and individual sustainable behaviors. Respondents positively assessed the initiatives of local authorities and housing cooperatives in the area of creating places for sharing food and organizing community gardens. Full article

Background: Digitalization and artificial intelligence-supported clinical decision support systems (AI-DSS), defined here as tools that generate patient-specific alerts, risk estimates, prioritization prompts, documentation suggestions, or related recommendation outputs intended to support rather than replace professional nursing judgment, can improve clinical decision-making, yet they may also amplify technostress and burnout, with downstream effects on missed nursing care and implementation readiness. Methods: We surveyed 239 registered nurses from a tertiary-care hospital in Timișoara, Romania (January–March 2025), including critical care (n = 60) and general wards (n = 179). Measures included a 15-item technostress scale, eHEALS, Maslach Burnout Inventory–Human Services Survey (MBI-HSS), Safety Attitudes Questionnaire (SAQ) teamwork and safety climate subscales, a 10-item missed nursing care inventory, and a six-item AI-DSS acceptance scale reflecting perceived usefulness, trust, and stated willingness to use such tools if available as an attitudinal readiness outcome rather than as routine observed use. Multivariable regression, exploratory mediation models, cluster analysis, and exploratory ROC analysis were performed. Results: Higher technostress was associated with higher emotional exhaustion (r = 0.52) and more missed care (r = 0.41), whereas eHealth literacy correlated with higher AI-DSS acceptance (r = 0.35) and lower technostress (r = −0.34). In adjusted models, technostress (per 10 points) was associated with higher missed care (β = 0.28, p < 0.001) (equivalent to 0.14 points per 5-point increase) and higher odds of low AI-DSS acceptance (OR = 1.38, p = 0.001), while eHealth literacy was associated with lower odds of low acceptance (OR = 0.71 per 5 points, p < 0.001). Burnout and the safety climate statistically accounted for approximately 35% of the technostress–missed care association. Three workflow phenotypes were identified, with the high-strain/low-literacy cluster showing the most missed care (3.5 ± 1.8) and the lowest AI acceptance (19.7 ± 5.2). An exploratory in-sample ROC model for intention to leave achieved an AUC of 0.82. Conclusions: Higher technostress clustered with worse nurse well-being, more care omissions, and lower AI-DSS acceptance, whereas eHealth literacy appeared protective. Interventions combining digital skills support, usability-focused redesign, and a stronger safety climate may reduce missed care and support safer AI implementation. Full article

Background/Objectives: This study aimed to assess public stigma toward people with mental health problems and to examine the association between stigma and socioeconomic characteristics, personal mental health history, and contact with individuals with mental health problems. Methods: This observational, descriptive, and cross-sectional study was conducted among the general population in Spain using a sample of 404 participants, the majority of whom were women (71%), with a median age of 38 years (IQR = 26–49); most participants (86.4%) lived in urban areas. The participants completed a self-administered online questionnaire that explored socioeconomic variables and the Community Attitudes towards Mental Illness Scale (CAMI-S, Spanish version). Non-parametric tests (Mann–Whitney U, Kruskal–Wallis, and Spearman correlation), multiple linear regression, and statistical power analyses were performed. Results: The mean CAMI-S total score was 84.89 (SD = 11.122) out of 100, indicating relatively favourable attitudes toward people with mental health problems. Statistically significant associations (p-value ≤ 0.05) were found between CAMI-S scores and variables such as gender, age, place of residence, educational level, mental health disorder, and close contact with someone with mental health disorders. The regression model revealed four significant predictors of lower stigma: identifying as female (β = 2.523; p = 0.037), having a medium or higher educational level (β = 5.061; p = 0.002), experiencing a mental health diagnosis (β = 4.535; p = 0.014), and close contact (β = 4.183; p < 0.001). Conclusions: Social stigma toward people with mental health problems in Spain appears to be generally low, reflecting positive attitudes toward community integration. Being female, having higher education, and personal or close contact with mental health problems are associated with lower stigma. Full article

This study investigates European citizens’ perspectives on farmers’ roles, highlighting gender, age, education, political orientation, community size, social class, and attitudes towards the EU. This study was developed using 21,002 interviews with European Citizens from all 27 EU countries. A quantitative data analysis methodology was used from the European Eurobarometer 97.1 survey. Seven models were formulated and tested. It is shown that men prioritise economic growth and food stability, while women emphasise environmental protection and animal welfare. Younger individuals focus on rural job creation, whereas older citizens value food security. Higher education levels correlate with environmental and animal welfare concerns. Right-leaning citizens favour economic development, whereas left-leaning individuals prioritise ecological issues. Larger communities emphasise economic growth, while smaller ones focus on environmental preservation. Social class influences priorities, with higher classes concerned about sustainability and lower classes about job creation. Pessimistic views about the EU correlate with food safety concerns, while optimistic views align with environmental and animal welfare priorities. These findings suggest that aligning agricultural and food policies with citizens’ diverse needs can foster a more sustainable and resilient European food system. Full article

Background: The Karamoja sub-region of Uganda addresses significant challenges in water, sanitation, and hygiene (WaSH), deeply linked to public and environmental health and regional development. Objectives: This study applied a Knowledge, Attitudes, and Practices (KAP) survey within a One Health framework to assess WaSH conditions, hygiene behaviour, livestock management, and disease prevention in the Moroto and Napak districts. Methods: A total of 195 respondents were surveyed, providing insights into socio-demographic factors, hygiene practices, livestock management, and disease prevention. Results: Findings highlighted gender disparities, with women less likely to achieve good knowledge compared to men (OR = 0.04; p = 0.002), probably reflecting limited access to information in traditionally male-focused community settings, and their greater involvement in water collection tasks. Age significantly influenced WaSH knowledge, with older individuals (aged ≥ 30 years) showing higher odds of good knowledge (OR = 20.39; 95% CI: 2.74–151.83; p = 0.003), probably due to their roles in knowledge transmission within the community. Proximity to water sources shaped behaviours, with greater distances associated with improved attitudes (OR = 3.56; p = 0.002) but reduced hygienic practices (OR = 0.20; p = 0.01). Livestock ownership, particularly of small ruminants, strongly correlates with good hygiene knowledge (OR = 16.89; p = 0.02), probably due to interactions with veterinarians and authorities during vaccination campaigns. Integrated communication strategies, including community meetings, home visits, and radio outreach, were strongly associated with improved practices (e.g., home visits: OR = 30.78; p < 0.001). Conclusions: Despite progress, challenges such as water scarcity, waste management, and gender disparities persist. Improving water infrastructure, promoting equitable access, and integrating tailored communication strategies are essential for fostering sustainable development, health equity, and the empowerment of women in Karamoja. Full article

For vaccine-preventable diseases, vaccination uptake is among the best public health behaviors to prevent infection, disease and death. However, public confidence in this behavior has waned in recent years alongside the twin respiratory threats of influenza and COVID-19. Moreover, certain populations, such as emerging adults, may be amenable to vaccination attitude and behavior change as they navigate their path between adolescence and adulthood. The current investigation presents two studies that address influenza and COVID-19 vaccination uptake among emerging adults. First, among more than 2000 emerging adults during the years of 2022–2024, we examined rates of vaccination uptake and attitudes, as well as relationships of vaccine rates with other concomitant health behaviors. Second, we explored the efficacy of a classroom-based vaccination promotion experience in altering both attitudes and behaviors regarding vaccination uptake among 275 emerging adults at college. Results highlighted some health behaviors that are related to influenza uptake but not COVID-19 uptake. Moreover, results from Study 2 demonstrated that attitudes, but not behavior, seem to be most amenable to the classroom-based approach to encourage health behavior change, as a significant increase in positive attitudes toward both influenza and COVID-19 vaccines was observed. These findings are discussed further, considering theoretical and practical applications. Full article

Background: A paediatric cancer diagnosis is a profound stressor for the entire family system. Although coping strategies are well-studied, their link to the quality of the parent–child attachment relationship remains less explored. In this study, we investigated whether dyadic attachment dynamics—specifically closeness and conflict between parent and child—are associated with the use of adaptive or maladaptive coping strategies in caregivers of children undergoing active treatment for oncohaematological diseases. Methods: We conducted a multicentre, cross-sectional study across three Italian paediatric oncohaematology centres. A total of 165 caregivers of 91 paediatric patients aged 3–17 years completed self-report measures assessing parent–child relationship quality (Child–Parent Relationship Scale-CPRS), coping strategies (COPE-NVI), perceived social support (MSPSS), and resilience (RS-14). We tested whether the quality of the parent–child attachment relationship is associated with caregivers’ coping strategies. We hypothesised that Attachment Closeness would be associated with adaptive coping (Positive Attitude, Social Support, Problem Orientation), whereas Attachment Conflict would be associated with maladaptive coping (Avoidance). We conducted multiple linear regression models, adjusted for key covariates and with robust standard errors clustered at the family level, to test these hypotheses. Results: Higher levels of emotional closeness (CPRS) were significantly associated with greater use of adaptive coping strategies, specifically Positive Attitude (β = 0.20, p = 0.049) and Problem Orientation (β = 0.26, p = 0.002), even after controlling for sociodemographic factors, social support, and resilience. Conversely, higher levels of relational conflict were significantly associated with greater use of the maladaptive Avoidance strategy (β = 0.14, p = 0.015). The hypothesis linking closeness to Social Support seeking was not supported. Conclusions: The findings suggest that the parent–child attachment relationship is a significant correlate of caregiver coping strategies in caregivers of children with cancer. Interventions aimed at supporting the caregiver–child dyad by fostering emotional closeness and reducing conflict may promote more adaptive parental coping mechanisms, thereby enhancing family resilience and psychological adjustment throughout the treatment journey. Full article

Background: This study investigated the relationship between weekly structured physical exercise (PE) volume and type and the risk of eating disorders (EDs), with particular attention to age and sex differences. Methods: A total of 417 healthy adults (mean weekly PE: 256.19 ± 133.03 min) completed a self-report questionnaire covering personal information, weekly PE characteristics, and the Eating Attitudes Test-26 (EAT-26). Binary logistic regression was performed with the EAT-26 score as the dependent variable and PE volume, exercise type, age, and sex set as predictors. Results: The results of the binary logistic regression model were statistically significant (χ² = 16.784, p = 0.003). Sex emerged as the strongest independent predictor of ED risk (p = 0.003). Cross-tabulation confirmed a significant sex disparity, with females showing a threefold higher prevalence of at-risk EAT-26 scores (17.6%) compared to males (5.2%). No significant correlation was found between EAT-26 score and PE volume, nor were significant differences in ED risk observed across different types of structured exercise. Conclusions: When controlling for age, neither exercise volume nor type serves as a direct linear predictor of ED risk. Sex remains the strongest demographic predictor. Full article

Background: Dependent older adults experience a high burden of preventable oral conditions, particularly gingivitis, while caregivers’ preventive practices remain insufficiently explained by conventional single-factor models. This study aimed to develop and validate a theory-informed structural equation model (SEM) to explain how oral health literacy and psychosocial determinants shape preventive behaviors for gingivitis among caregivers of dependent older adults in Sisaket Province, Thailand. Methods: A cross-sectional analytical study was conducted among 420 caregivers selected using multistage random sampling. Data were collected using a validated questionnaire based on the Health Belief Model and Social Cognitive Theory, covering knowledge, attitude, perceived severity, perceived benefits, self-efficacy, preventive behaviors, and social support. Reliability was excellent. Descriptive statistics, Pearson’s correlation, and SEM with maximum likelihood estimation were applied. Results: The SEM demonstrated excellent fit (χ²/df = 0.80, p = 1.000; CFI = 1.000; TLI = 1.008; RMSEA = 0.000; SRMR = 0.092). Knowledge directly influenced attitude (β = 0.355, p = 0.013) and self-efficacy (β = 0.381, p = 0.003). Attitude (β = 0.406, p < 0.001), self-efficacy (β = 0.384, p < 0.001), and social support (β = 0.260, p < 0.001) were significant predictors of preventive behaviors. The model explained 68.3% of variance in behaviors, with knowledge exerting significant total effects through mediated pathways (β_total = 0.290, p < 0.001). Conclusions: A theory-based SEM effectively explains caregiver preventive oral health behaviors in a rural, resource-limited setting. Interventions should integrate literacy-focused education with strategies that strengthen attitudes, self-efficacy, and social support to achieve sustainable improvements in dependent older adults’ oral health. Full article

Background/Objectives: Professionalism reflects an individual’s connection, identity, and dedication to their profession. In nursing, it is associated with quality of care and professional respect, making its assessment essential for workforce development and management. However, valid and reliable instruments are needed to measure this construct across cultural contexts. Therefore, this study aims to evaluate the validity and reliability of the Portuguese version of the Nurses’ Professionalism Inventory (NPI). Methods: This methodological study used cross-sectional data collected from November 2024 to January 2025 in northern Portugal. Data were gathered from a convenience sample of 684 nurses who completed a sociodemographic questionnaire, the Portuguese NPI, the Conditions of Work Effectiveness Questionnaire II (CWEQ-II), and the Team Psychological Safety (TPS) scale. Confirmatory Factor Analysis (CFA) was conducted. Factor loadings and Average Variance Extracted (AVE) were used to assess validity. Internal consistency was evaluated using Composite Reliability, McDonald’s omega, and Cronbach’s alpha. Convergent validity was examined using Spearman correlations among NPI subscales, CWEQ-II dimensions, and TPS. Results: The Portuguese version of NPI preserved the original five-factor structure. The model showed acceptable fit indices (TLI = 0.90; CFI: 0.91; RMSEA = 0.10; SRMR = 0.08). All items had factor loadings above 0.50, except item 18 (0.42), which did not load significantly on any other factor; therefore, it was removed. This improved the AVE of the Professional Attitude subscale. The overall internal consistency was satisfactory, with all reliability coefficients ranging between 0.73 and 0.99. The correlations among the NPI subscales, CWEQ-II dimensions, and TPS were positive and statistically significant. Conclusions: This study demonstrates adequate measurement properties of the Portuguese version of NPI, supporting its use as a valid and reliable instrument. Full article

Background and Objectives: The improper disposal of expired and unused medications (EUM) poses significant environmental and health risks. Discarding EUM in household trash or drains leads to accidental poisoning, illegal trade, and ecosystem contamination. These persistent compounds often resist wastewater treatment, disrupting ecological balance and contributing to antimicrobial resistance, thereby increasing morbidity and mortality rates. This study aims to analyze the knowledge, attitudes and practices (KAP) and related factors of the Mexican population regarding the disposal of EUM. Methods: A cross-sectional, descriptive, and correlational study was conducted via an online survey of adults (18+) from October 2021 to October 2024. Results: Among 6080 participants (95.4% aged 18–59; 65.8% women), a medium level of KAP was observed. Notably, 51.5% did not use specialized disposal containers, only 15.5% knew container locations, and 30.5% correctly identified expiration dates. Significant associations emerged: lower education levels correlated with poorer disposal knowledge, while health-related backgrounds and postgraduate studies linked to positive attitudes and adequate practices. Ordinal logistic regression revealed that being elderly, belonging to a high socioeconomic class, having lower education levels, and lacking health-related studies were significantly associated with poor KAP regarding EUM disposal. Conclusions: Inadequate pharmaceutical disposal in Mexico compromises environmental and public health. Addressing this requires reinforced regulations, professionalized pharmacies, and a comprehensive approach to bridge knowledge gaps. Integrating digital tools—like real-time mapping and QR labeling—with accessible take-back schemes is vital in mitigating hazards and uphold the One Health triad. Full article

While environmental awareness is crucial for ecological governance, its sociocultural foundations across different macro-institutional contexts remain underexplored. This study compares the sociocultural correlates of environmental awareness in China and Singapore—two developmental states with state-centric governance but distinct institutional configurations. Integrating Sociocultural Theory and the Theory of Planned Behavior, this exploratory study analyzes World Values Survey data Wave 7 using ordered logistic and probit models. We identify three key patterns. First, both nations exhibit a pervasive “attitude-behavior gap,” with cognitive environmentalism significantly outpacing actual civic action. Second, universally, social trust is correlated with environmental attitudes, while political action and religiosity are positively linked to actual behavior. Third, distinct institutional mechanisms emerge: China reflects a “state-dependent environmentalism” where attitudes are associated with post-materialist values and institutional deterrence, and behavioral participation is strongly related to government trust. Conversely, Singapore displays an “institutionalized civic environmentalism,” where routine political action shows a strong positive association with environmental attitudes—an association neutralized in China. These findings demonstrate that pathways to ecological sustainability in developmental states are structurally divergent, necessitating context-specific governance interventions. Full article

Prosocial behavior is a core element of social harmony, and implicit prosocial attitudes, which may outperform explicit assessments in predicting real-world behavior, underscore their unique utility in prosocial and moral research contexts. Moreover, red songs, a distinctive musical form emerging in specific revolutionary and developmental periods of China, align with this prosocial potential, as they are characterized by lyrics advocating patriotism, collective memory, and emotional resonance. However, the specific effect of red songs on implicit prosocial attitudes, as well as the potential moderating role of music training experience in this relationship, remains underexplored. This study aimed to explore whether red songs enhance implicit prosocial attitudes compared to neutral songs, whether music training modulates this effect, and the underlying neural correlates using the Single-Category Implicit Association Test (SC-IAT) and event-related potentials (ERPs). A mixed-factorial design was used with 60 college students (30 with ≥5 years of music training, 30 without). Participants completed the SC-IAT (measuring implicit prosocial D-scores) while EEG data were recorded, while listening to red (“China in the Lantern Light”) and neutral (“Lake Baikal”) songs. ERP components (N1, P2, N3, LPCs) were analyzed. Behaviorally, no significant main effects of song type or music training were observed, but a significant interaction emerged (F(1, 58) = 4.09, p = 0.04): the music training group showed higher D-scores under red songs (M = 0.35, SD = 0.32) than neutral songs (M = 0.15, SD = 0.51), while the non-music training group exhibited the opposite non-significant trend. Neurally, repeated measures ANOVAs revealed a significant main effect of electrode site for N1 (F(4, 212) = 48.63, p < 0.001, partial η² = 0.48), with the largest amplitudes at FCz. Red songs elicited larger N1 amplitudes than neutral songs at Fz and FCz, and incongruent trials elicited larger N1 amplitudes at Pz. For P2, a main effect of condition was found (F(1, 52) = 7.02, p = 0.01), with larger amplitudes in incongruent trials, and a significant three-way interaction of song type, condition, and electrode site (F(4, 208) = 4.46, p = 0.006), with larger P2 amplitudes for red songs under incongruent trials at Fz. For N3, main effects of song type (F(1, 53) = 14.48, p < 0.001) and stimulus type (F(2, 106) = 8.32, p = 0.001) were observed; congruent trials elicited larger N3 amplitudes than incongruent trials at Fz and FCz. For LPCs, main effects of song type (F(1, 53) = 4.89, p = 0.03) and electrode site (F(4, 212) = 3.05, p = 0.047) were found, with the largest amplitudes at Pz and the smallest at FCz. Red songs enhance implicit prosocial attitudes specifically among individuals with music training, and are accompanied by multi-stage neurocognitive differences. These findings highlight the conditional effects of red songs and inform prosocial education. Full article

Objectives: As artificial intelligence (AI) technologies become increasingly integrated into healthcare systems, understanding healthcare professionals’ psychological responses—particularly AI-related anxiety—has become increasingly important for the safe and effective implementation of these technologies in clinical practice. This study aimed to examine the relationships between oncology nurses’ readiness for artificial intelligence, their attitudes toward artificial intelligence, and their levels of AI-related anxiety. Design: A descriptive, cross-sectional study. Setting: An oncology hospital within a state hospital in Istanbul, Turkey. Participants: A total of 207 oncology nurses working full-time in clinical settings. Methods: Data were collected using an online survey consisting of a demographic information form, the Medical Artificial Intelligence Readiness Scale (MAIRS-MS), the Artificial Intelligence Anxiety Scale (AIAS), and the General Attitudes toward Artificial Intelligence Scale (GAAIS). Spearman correlation analysis, general linear modeling, and conditional mediation analysis were performed using JAMOVI (v2.6.17). A p-value of <0.05 was considered statistically significant. Results: AI-related anxiety was significantly and negatively correlated with both readiness and attitudes toward AI. General linear modeling showed that attitudes toward AI significantly predicted anxiety (β = −0.327, p < 0.001), whereas readiness did not have a direct significant effect. Conditional mediation analysis demonstrated that attitudes fully mediated the relationship between readiness and AI anxiety. The indirect effect of readiness on anxiety through attitudes was stronger among nurses who had received prior AI-related education. While the indirect effect remained significant among untrained nurses, its magnitude was considerably smaller. The total effect of readiness on anxiety was significant only in the untrained group, suggesting that structured education redirects the impact of readiness primarily through attitudes. Conclusions: Attitudes toward artificial intelligence represent the key psychological mechanism linking readiness to AI-related anxiety among oncology nurses. Prior AI education appears to strengthen this relationship by enhancing the association between readiness and attitudes and by being associated with lower anxiety levels. Educational and implementation strategies that emphasize ethical awareness and the development of positive, informed attitudes—rather than focusing solely on technical competence—are likely to be more effective in reducing anxiety and promoting the safe and ethical integration of AI into oncology nursing practice. Full article