Search Results (2,137)

With the advent of digitization, digital twin technology is gradually becoming one of the core technologies of the Industry 4.0 era, highlighting the increasing importance of digital twin project management. Despite its potential, DT projects face significant risks during implementation, stemming from technical, managerial, and operational complexities. To address these challenges, this study proposes an improved failure mode and effect analysis (FMEA) framework by integrating double hierarchy hesitant fuzzy linguistic term sets (DHHFLTSs) and the Technique for Order Preference by Similarity to Ideal Solution (TOPSIS). This framework converts qualitative assessments into quantitative metrics and calculates weights using a hybrid approach, enabling more precise risk prioritisation. Application of the model to an automotive manufacturing company’s DT project identified key risks, particularly in the iteration and upgrade phase, emphasising the importance of cross-departmental collaboration and robust digital infrastructure. The proposed model provides a systematic framework for enterprises to assess and mitigate risks, ensuring the successful deployment of DT projects. Full article

Background: During the COVID-19 pandemic, migrant populations remained under-immunized due to limited access to health care, language barriers, and vaccine hesitancy. The USAID-funded MOMENTUM Routine Immunization Transformation and Equity project supported the government in collaborating with various local health and non-health partners to identify and vaccinate migrants. This case study examines the roles of project partners and the strategies each entity implemented to increase COVID-19 vaccine uptake among migrants, as well as the perceptions regarding the effectiveness of these strategies. Methods: We designed a qualitative explanatory case study guided by the Behavioral and Social Drivers framework and RE-AIM implementation science frameworks. We conducted 31 focus group discussions and 50 in-depth interviews with migrants, project partners, community leaders, and government stakeholders in Tamil Nadu and Punjab. Results: In both states, partnerships with health departments, private employers, and community-based organizations were essential for identifying and vaccinating un- and under-vaccinated migrant groups. In Tamil Nadu, collaboration with the Department of Labor and mobile medical units facilitated vaccination camps at construction sites. In Punjab, religious institutions organized sessions at places of worship, and the Border Security Force enabled health workers to reach migrants living near the border. In both states, key strategies—involving influencers to discuss the importance of vaccine safety and value, bringing vaccination services to migrants’ workplaces and homes at flexible times and mandating workplace vaccination to encourage vaccination—shifted perceptions towards vaccination and increased vaccine uptake among migrants. Conclusions: The strategies and partnerships identified in this study highlight the broader implications for future public health interventions, demonstrating that collaboration with the private sector and faith-based organizations can enhance routine immunization efforts, particularly when localized to organizations that understand community needs and can address specific barriers and motivators. Full article

Representing and interpreting human opinions within an unstructured framework is inherently complex. Hesitant fuzzy linguistic term sets offer a comprehensive context that facilitates a nuanced understanding of diverse perspectives. This study introduces a methodology that integrates sentiment analysis with hesitant fuzzy linguistic term sets to effectively aggregate and compare news from diverse sources. By employing linguistic scales, our approach enhances the interpretation of various perceptions and attitudes, facilitating comprehensive knowledge extraction and representation. The main objective of this research is to conduct a comparative analysis of news coverage across European countries in relation to the Israel–Gaza war. This analysis aims to capture the multifaceted sensitivities surrounding the ongoing situation, highlighting how different nations perceive the conflict. Full article

Pertussis, or whooping cough, is a highly contagious respiratory infection caused by the Gram-negative bacterium Bordetella pertussis. Although traditionally associated with children, pertussis is increasingly prevalent among adults, particularly those with comorbidities or weakened immune systems, where it can lead to severe complications. Diagnosing pertussis in adults can be challenging due to its nonspecific symptoms, underreporting, and the limited sensitivity of available diagnostic tests. While treatment with macrolides is generally effective, it may not significantly alter the clinical course of the disease, and growing concerns about macrolide resistance are emerging. Vaccination remains the cornerstone of prevention, offering proven immunogenicity, efficacy, and safety. However, vaccination uptake remains low, partly due to limited patient awareness and insufficient prioritization by healthcare professionals. This review aims to provide clinicians with critical insights into pertussis epidemiology, vaccination strategies, and the latest guideline recommendations, empowering them to engage in meaningful discussions with adult patients and advocate for increased vaccination to combat this often-overlooked infection. Full article

Veterans often face transportation barriers, but advances in technology enable real-world testing of shared autonomous electric vehicles as potential energy-efficient solutions. While previous research has assessed civilians’ perceptions of autonomous vehicles (AVs), veterans—due to unique military experiences and health conditions—represent a distinct demographic. This study investigates veterans’ perceptions of autonomous shuttles (ASs) to assess whether these innovations may foster sustainable transportation behaviors. Leveraging data from the Autonomous Vehicle User Perception Survey (AVUPS), this study assessed AS perceptions among 77 veterans across four Florida cities before and after exposure. Results indicated significant increases in intention to use and total acceptance and a decrease in perceived barriers, with no change in well-being. Urban veterans showed improvements across multiple subscales, while rural veterans only showed reduced perceived barriers. Those with initially low total acceptance scores demonstrated greater improvements, particularly in intention to use and perceived barriers. The analysis of survey items showed increased trust, greater willingness to multitask, improved safety perceptions, and reduced concerns about declining driving abilities and hesitations toward AVs, with the latter three items remaining significant after correction. Overall, AS exposure positively influenced veterans’ perceptions, and the results point to the potential of ASs as a sustainable transportation option for veterans. Full article

Background/Objectives: Lyme disease (LD) is a major public health problem in Europe and the United States, with increasing incidence and not many prevention options. Vaccine hesitancy might be a significant barrier to successful vaccination campaigns having in mind previous vaccine development failures. This study aimed to evaluate the public’s perception of LD vaccination in Poland, assess willingness to vaccinate, and identify factors influencing vaccination attitudes. Methods: A cross-sectional survey was conducted among parents of children hospitalized at the University Children’s Hospital in Bialystok, Poland. The survey consisted of 29 questions regarding demographics, LD knowledge, vaccine attitudes, and perceived risks. Data were collected between January and December 2023 and analyzed using descriptive and inferential statistics to identify predictors of respondents’ positive vaccination attitudes. Results: A total of 503 valid responses were analyzed. Most respondents (72.4%) showed positive attitudes towards vaccination, while 18.5% were neutral and 9.1% were negative. Trust in health experts emerged as an important predictor of vaccination acceptance (OR 22.84; p < 0.001). More than 80% of participants recognized an LD vaccine as necessary, and 64.21% believed it would reduce their concerns about LD. Willingness to vaccinate was influenced by general positive vaccine attitudes, recognized danger of LD, and belief in the vaccine’s ability to ease fears. Notably, 40.8% of respondents were uncertain about vaccine risks, with this group tending to be younger, less educated, and expressing lower trust in medical professionals. Conclusions: Public perception of LD in Poland indicates a high acceptance of a potential LD vaccine. Still, addressing vaccine hesitancy remains critical, particularly among undecided or neutral respondents. Building trust in healthcare professionals and addressing safety worries are important to increasing future LD vaccine use. Full article

Advances in oncological treatments have improved the survival rates of cancer patients but have often resulted in significant physical changes that negatively impact their self-esteem and psychological well-being. Cancer patients frequently ask esthetic practitioners to perform procedures to address such changes. However, practitioners often hesitate to satisfy such requests due to lacking guidelines or recommendations. The use of botulinum toxins (BoNTs) for esthetic purposes has shown significant promise in improving the quality of life for cancer patients. This review explores the broad application of BoNTs in many medical branches, focusing on oncology. A substantial amount of literature shows that BoNTs are safe and effective as a type of adjunctive therapy compared to classical cancer treatments. We provide our expert opinion that the use of BoNTs for esthetic purposes is safe for cancer patients and even recommended for those whose mood is influenced by the worsening of their physical appearance. Careful patient selection and interdisciplinary collaboration are essential to the safe integration of BoNTs into cancer care. Full article

Background/Objectives: Influenza vaccination is the main method for preventing influenza. The objectives of this study are to evaluate the opinions of families on influenza vaccination and to determine the acceptance of influenza vaccination as a routine vaccine in children under 5 years of age. Methods: The method used was a descriptive cross-sectional study based on an ad-hoc survey. Between October 2023 and January 2024, an online survey was conducted among families with children between 6 months and 14 years of age attending paediatric consultations at a health centre. Results: A total of 388 families were surveyed. Out of these, 22.68% reported having ever vaccinated their children against influenza. The main reason for having them vaccinated was having received the recommendation from the paediatrician (68.18%). While 53.61% agreed with routine influenza vaccination, 53.09% did not intend to vaccinate their children against influenza in the 2023/24 period. The reasons for not vaccinating in 2023/24 were unawareness of the disease (29.41%), fear of unwanted effects of vaccination (27.94%) and lack of information about vaccination (19.61%). The reasons for vaccination in 2023/24 were protection of the child (81.87%), recommendation by the paediatrician (43.41%) and protection of the general population and susceptible persons (20.33%). Conclusions: Routine influenza vaccination is accepted by half of the parents. A lack of risk perception of the disease, concern about vaccine safety and lack of information are the main reasons for not vaccinating. It is essential to follow the health professionals’ recommendation to vaccinate. Full article

Background/Objectives: Vaccine hesitancy, recognized by the WHO as a significant global health threat, undermines vaccination efforts. This study aimed to adapt and validate the Parent Attitudes about Childhood Vaccines (PACV) Survey for Croatian parents to understand vaccine hesitancy better. Methods: A cross-sectional study with 1814 Croatian parents was conducted using the PACV survey, translated using a double-back translation method. The psychometrics of the questionnaire were examined, including content validity, dimensionality, construct validity, discriminant validity, and reliability. Confirmatory factor analysis (CFA) assessed the original model’s validity, but the original model fit poorly, prompting exploratory factor analysis (EFA) to identify latent factors. Reliability was measured using Cronbach’s alpha and McDonald’s omega. Results: EFA identified a five-factor model with factors labeled “Safety”, “Schedule”, “Attitudes”, “Behavior”, and “Trust”. Subsequent CFA confirmed this model with acceptable to good fit indices. Discriminant validity was also confirmed. Reliability analyses indicated high internal consistency, with total Cronbach’s alpha at 0.926 and McDonald’s omega at 0.931. Conclusions: The adapted PACV is a valid and reliable tool for identifying vaccine hesitancy among Croatian parents. This study revealed high vaccine hesitancy among Croatian parents, emphasizing the need for targeted interventions. Full article

Vaccine hesitancy, which refers to the reluctance to be vaccinated, poses a major risk to public health in preventing infectious diseases. This hesitancy has been evident for many years, especially regarding childhood vaccines. The main factors contributing to this hesitancy include religious or personal beliefs, concerns about safety and efficacy, and desire to receive more information from healthcare providers. This literature review examines hesitancy regarding COVID-19 vaccines in different population segments in Turkey. Hesitancy rates and reasons in the general population and specific groups such as pregnant women, parents, healthcare workers and students were presented based on published research articles. Approximately half of the Turkish population declared their hesitancy towards COVID-19 vaccines. A negative correlation was found between vaccine hesitancy and health literacy. The relationship between COVID-19 vaccine hesitancy and religiosity was also investigated. Age is another factor affecting this vaccine hesitancy. Older age was shown to be correlated with positive attitude towards COVID-19 vaccination. Moreover, participants with positive attitudes towards other vaccines, those with chronic diseases and those with a personal history of COVID-19 were more likely to have positive perceptions of COVID-19 vaccines. Higher life satisfaction and non-smoking status were associated with a higher likelihood of COVID-19 vaccine acceptance. Increased scientific data on the efficacy and side effects of COVID-19 vaccines and more information from healthcare professionals would likely reduce the hesitancy towards COVID-19 vaccines. Full article

Background: Vaccination is one of the most effective ways of protecting individuals against serious infectious diseases and their fatal consequences. Objectives: The aim of this scoping review was to synthesize data on parental attitudes toward vaccination and identify factors influencing the motivators and barriers to children’s vaccination based on Polish studies. Methods: The scoping review process and reporting were based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScRs) checklist. In the period between January 2014 and July 2024, the following databases were searched for publications: PubMed, Web of Science, Cochrane, Ebsco, and Scholar Google. Results: A total of 1531 potentially relevant records were reviewed, and 30 original publications from research samples collected in Poland were selected. According to the findings, vaccination rates varied between 100% and 70%, with parental acceptance levels for mandatory vaccination ranging from 99% to 65%. Parents most commonly cited the physician, the nurse, and the Internet as their primary sources of vaccination-related information. Moreover, parental primary motivators for vaccinating their children were prevention against infectious diseases, the opinion that vaccines are safe, and the belief that childhood vaccination is right and effective. The major barriers to vaccination were fear of vaccine side effects and the belief that vaccines are ineffective. Parents that were better educated, were of younger age, lived in cities, and had a higher income were much more likely to vaccinate their children. Conclusions: Understanding parental attitudes toward vaccination may help develop an educational program aimed at combating misinformation and increasing childhood vaccination coverage rates. Full article

Background: Immunization plays a substantial role in reducing the under-five mortality rate. However, Tanzania still has a significant number of zero-dose and under-vaccinated children and was ranked among the top ten African countries with the highest numbers of zero-dose children in 2022. The human-centered design (HCD) approach is more ethical and effective at addressing public health challenges in complex sociocultural settings. This study aimed to use the HCD approach to aid in identifying, prioritizing, and implementing community-centric interventions in Tanzania, particularly in the Ilala District of Dar es Salaam, to increase vaccine demand and close the zero-dose gap by at least 50%. Methods: The study involved co-creation workshops with 483 participants to identify, design, and test solutions. The study followed the UNICEF Journey to Health and Immunization framework to identify barriers and enablers influencing stakeholders in adopting and sustaining health- and immunization-related actions. Results: The study identified the causes of under-five defaulting and the zero-dose gap, i.e., the inadequate support of local community leaders in under-five vaccination sensitization and surveillance; poor infrastructure to new settlement areas; hesitancy and unwillingness of parents/guardians; absence of house numbers; limited/time-constrained availability of resources to facilitate mobile immunization services, etc. The participants were able to come up with 309 ideas, which were refined through multiple iterations using the impact–-effort matrix and skimmed down to three (3) solutions: (i) having health facilities to notify and alert local leaders about vaccination dates; (ii) using parents, kids, and grownups who got vaccinated to influence others; (iii) using local government leaders and house representatives for vaccine advocacy. Of these, the solution involving local government leaders and house representatives for vaccine advocacy was implemented. An advocacy strategy was used to enhance the collaboration of the District Commissioner, Council leaders, and community leaders. A home-to-home interpersonal sensitization approach accompanied by the household delivery of vaccination services was employed. The findings reveal that the HCD framework was impactful in increasing collaborations/cooperation with local government leaders and community ownership of the under-five vaccination initiative. As a result, 67,145 houses, equal to 104%, were reached, surpassing the initial target of 64,800 houses, and 131,088 families, equal to 83% of the targeted 156,995 households, were sensitized through a home-to-home campaign approach. This study demonstrates the effectiveness of the approach. Researchers and practitioners are encouraged to adopt the HCD approach when addressing public health challenges, especially in complex sociocultural settings. Full article

The fundamental notions of the intuitionistic hesitant fuzzy set (IHFS) and rough set (RS) are general mathematical tools that may easily manage imprecise and uncertain information. The EDAS (Evaluation based on Distance from Average Solution) approach has an important role in decision-making (DM) problems, particularly in multi-attribute group decision-making (MAGDM) scenarios, where there are many conflicting criteria. This paper aims to introduce the IHFR-EDAS approach, which utilizes the IHF rough averaging aggregation operator. The aggregation operator is crucial for aggregating intuitionistic hesitant fuzzy numbers into a cohesive component. Additionally, we introduce the concepts of the IHF rough weighted averaging (IHFRWA) operator. For the proposed operator, a new accuracy function (AF) and score function (SF) are established. Subsequently, the suggested approach is used to show the IHFR-EDAS model for MAGDM and its stepwise procedure. In conclusion, a numerical example of the constructed model is demonstrated, and a general comparison between the investigated models and the current methods demonstrates that the investigated models are more feasible and efficient than the present methods. Full article

Parents’ involvement in early childhood education is of great importance. In Greece, many educators still hesitate to involve parents in their school’s daily program. They also do not use pedagogical documentation in the educational process as it is not included in the official curriculum. Our main goal was to bring parents closer to the early childhood curriculum, in an active and participatory way, through the documentation process. The main research question referred to the way in which the systematic use of pedagogical documentation can help parents understand the kindergarten’s daily curriculum and participate in it in a new way, in a country where pedagogical documentation is not mandatory. We used collaborative action research between ten kindergarten educators from five schools and two researchers from the same university department. The methodological tools were a researchers’ diary, two digital questionnaires for the educators (pre-/post-implementation) and a post-implementation digital questionnaire for the parents. The results showed that the documentation helped the educators to bring the parents closer to the kindergarten’s daily program and made them feel as if they could participate in it creatively. Also, the documentation derived from the children, educators and parents constructed a community of relations, participation, shared values and learning among them. Full article