Background Effective persuasive messages can contribute to enhancing pandemic preparedness and public health. An essential requirement for this is an excellent understanding of the effects of exposure to persuasive messages on compliance with behavioral measures against the spread of respiratory viruses. This field study tested the effects of persuasive messages on compliance with two behavioral measures to prevent the spread of viruses that cause respiratory infections such as COVID-19 and the flu: coughing/sneezing into the elbow and staying home when ill with respiratory infection symptoms. Materials and methods A field study with an observational pre-post design was conducted at four educational institutions representing all common post-secondary school educational levels in the Netherlands. Data were collected among students and employees via online questionnaires before (n = 2096) and after (n = 1098) exposure to a set of persuasive messages with six different message framings. Two-way MANOVA, logistic regression analysis and repeated measures ANOVA were conducted. Results Exposure frequency, behavioral measure type, demographic characteristics, trust in government, prosocial orientation, perceived health, educational institution, and student/employee status showed significant multivariate main effects and univariate main and/or interaction effects on the outcomes (intention to comply, attitude, social norms, moral norm, self-efficacy, response-efficacy, and risk perception; p < .05). The odds of compliance with staying home when ill were lower than the odds of compliance with coughing/sneezing into the elbow, regardless of exposure frequency (p < .001). Conclusion In conclusion, messages positively influenced behavioral determinants – a critical prerequisite for behavior change and compliance. Findings also highlight that people are likely more willing to comply with measures that have less adverse personal and social impact. To enhance compliance more is needed, for instance explanations of the relevance and effectiveness of measures, and practical support to enact the measures. Practical and theoretical implications are discussed.

Introduction: Tax compliance is a critical determinant of revenue mobilisation, especially in developing countries where governments face persistent challenges of informality, weak institutions, and low taxpayer morale. While coercive, normative, and mimetic forces have been theorised to shape compliance through neo-institutional perspectives, the extent and nature of their influence remain fragmented across contexts and methods. This systematic review synthesises empirical evidence on how isomorphic forces affect tax compliance. Methods: The review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA 2020) framework. Searches were conducted across Scopus, Web of Science, Google Scholar, and ProQuest, supplemented with citation chaining. Inclusion criteria restricted the corpus to peer-reviewed empirical studies published in English between 2016 and 2025 that explicitly operationalised coercive, normative, or mimetic forces in relation to tax compliance. Fifty eligible studies were identified from an initial pool of 208 records. Data were extracted into structured matrices and synthesised thematically. Results: The findings reveal that coercive forces generally improve compliance, but their effects are fragile if applied in isolation and may backfire in high-trust contexts. Normative forces consistently foster voluntary compliance and often outperform coercion in sustaining long-term adherence. Mimetic forces, though underexplored, appear significant in digital and uncertain environments, where peer imitation and benchmarking strongly influence tax compliance behaviours. Cross-cutting evidence highlights that trust and coercion are complementary, compliance outcomes vary between filing and payment, and cultural and institutional settings condition the relative weight of different pressures. Conclusion: The review affirms the explanatory power of neo-institutional theory and extends the Slippery Slope Framework by demonstrating the interplay of coercive, normative, and mimetic influences. Policy implications point to the need for balancing enforcement with legitimacy-building, socialisation, and system design that makes compliance visible and easy to emulate. Key research gaps include the under-theorisation of mimetic mechanisms, the dominance of cross-sectional designs, and insufficient differentiation between compliance outcomes. Future studies should employ longitudinal approaches, develop clearer measures of peer influence, and investigate digital taxation as a new frontier for shaping taxpayer behaviour.

Introduction: Tax compliance remains a persistent challenge in developing economies, particularly among small and medium-sized enterprises (SMEs), which form the backbone of the private sector, yet they consistently exhibit low compliance rates (Nkundabanyanga et al., 2017; Musiimenta et al., 2020). While prior studies have applied single theoretical lenses such as deterrence (Allingham &amp; Sandmo, 1972) or behavioural intentions (Ajzen, 1985), these approaches provide only partial explanations of compliance behaviour. Objective: This article aims to develop an integrated framework that synthesises multiple theories to provide a more comprehensive understanding of SME tax compliance in developing contexts. Methods: A conceptual synthesis of six theories: Institutional Isomorphism, Comparative Treatment, Fiscal Exchange, Economic Deterrence, the Theory of Planned Behaviour, and Social Influence was undertaken through critical review and comparative analysis. Each theory’s assumptions, applications, and limitations were mapped, and complementarities were identified to construct a unified framework. Results: The proposed model positions taxpayer behaviour as a mediating mechanism linking institutional pressures, fairness perceptions, and behavioural-social dynamics to compliance outcomes. It demonstrates how compliance is shaped by coercive and normative pressures, perceptions of equity and reciprocity, attitudes and control beliefs, and the influence of peer networks. Discussion/Conclusion: By embedding institutional, behavioural and economic perspectives into one explanatory model, this framework advances theoretical coherence, generates new avenues for empirical testing, and provides policymakers with a practical guide for designing holistic compliance strategies. The study concludes that improving SME tax compliance in developing economies requires interventions that combine enforcement, fairness reforms, service provision, taxpayer education, and community engagement

Purpose This study examines the use of three types of nudge messages (reciprocity, social norm, deterrence) as a tool to positively influence tax compliance behaviour of small business owners. Motivation Tax revenues are the main source of government income for many economies and it is through this revenue that citizens can benefit from public goods and services provided by governments. Increasing the level of tax compliance is a step towards a fair allocation of the tax burden and distribution of resources. Design/methodology/approach Data were collected using an online field experiment conducted with small business owners in South Africa as participants. Main findings The experimental results show that nudge messages have an impact on tax compliance behaviour. Exposure to a social norm or a deterrence nudge message has a positive impact on tax compliance when compared with control conditions. The relationship between the social norm nudge message and tax compliance behaviour was statistically significant. However, the results indicate that the impact of nudge messages on tax compliance behaviour is not always positive, as the reciprocity nudge message showed a negative (boomerang) effect when compared with control conditions. Furthermore, the results show tax compliance differences between message types, with the tax compliance difference between the social norm nudge message and the reciprocity nudge message being statistically significant. A similar statistically significant difference was observed between the deterrence nudge message and the reciprocity nudge message. Practical implications/Managerial impact The findings of this study can assist tax authorities in both developing and developed countries with designing appropriate nudge messages. Contribution This study improves understanding of the impact of nudge messages on tax compliance behaviour in a developing country. It provides evidence of the relative strength of reciprocity, social norms and deterrence nudge messages in influencing tax compliance behaviour. Additionally, it seeks to add to the body of knowledge related to how the effectiveness of reciprocity, social norm and deterrence nudges may be affected by perceptions of corruption and attitudes towards tax. The study also contributes to the body of knowledge by considering business taxpayers rather than individuals not in business.

Purpose The purpose of this study is to investigate the Muslim employee's zakat compliance behaviour post COVID-19 in Malaysia that will help overcoming the low zakat collection issue. Guided by the extended theory of planned behaviour (ETPB), this study examines employment income zakat, which constitutes the largest source of zakat contributions in Malaysia. Design/methodology/approach The study employs purposive sampling to distribute a self-administered questionnaire to Muslim employees in Malaysia. A total of 391 usable responses were collected and subsequently analyzed using variance-based structural equation modelling (PLS-SEM). Findings Attitude, subjective norms, perceived behavioural control and past behaviour significantly influence the intention to pay zakat. Consequently, this intention drives employment income zakat compliance. Religiosity was not a significant predictor of intention to pay zakat. The results challenge common assumptions in the existing literature and offer a novel insight into zakat payment behaviour. The intention to pay zakat mediates the relationships between attitude, subjective norms, perceived behavioural control, past behaviour and compliance with employment income zakat. However, it does not mediate the relationship between religiosity and compliance. Originality/value This study extends the theory of planned behaviour (TPB) by investigating the influence of religiosity on the intention to pay zakat among Muslim employees. The study provides generalizable findings, as it does not focus on a specific locality or profession, and is conducted within a voluntary zakat system governed by a decentralized zakat institution. Additionally, it explores zakat compliance behaviour in the context of the post COVID-19 landscape which offers timely insights into behavioural responses during a period of economic uncertainty.

Assessing stakeholder engagement to the EU strategy for sustainable and circular textiles: A Systematic review integrating stakeholder and institutional theories.

To compare the efficacy, safety, and patient experience between cyanoacrylate tissue adhesive and conventional sutures for periorbital wound closure in children. A prospective comparative study evaluated 145 pediatric patients with periorbital trauma treated with tissue adhesive (n=70) or conventional suturing (n=75) based on clinical assessment from September 2023 to October 2024. Primary outcomes were wound healing grades (grade I/II/III) and complication rates; secondary outcomes included procedure time (median, seconds), pain scores (mean, Wong-Baker FACES), Frankl behavioral compliance scores (mean), and parental satisfaction. Statistical analysis used t tests, Mann-Whitney U tests, and χ 2 tests. The adhesive group had significantly shorter procedure time (184 vs. 692 s, P <0.001), lower pain scores (2.8 vs. 5.6, P <0.001), and higher compliance (Frankl 3.1 vs. 2.3, P <0.01). No significant differences were observed in grade I healing rates (97.1% vs. 93.3%) or complication rates (2.9% vs. 4.0%, P =0.24). In pediatric periorbital trauma, use of tissue adhesive was associated with reduced treatment time and pain scores, with similar healing outcomes compared with sutures, suggesting it may serve as a viable alternative.

The article examines the role of public administration in shaping citizens' tax culture in a digital environment, in which tax rules, electronic services, and public communications become part of daily interaction with the state. Tax culture is defined as an integrated set of knowledge, values, and behavioral practices that ensure voluntary and timely fulfillment of tax obligations, as well as the willingness to act with integrity even in the absence of direct control. It is specified that in the context of digitalization, such a culture is formed not only through regulatory requirements, but also through repeated experience of using digital channels, within which a citizen evaluates the clarity of procedures, the fairness of decisions, and the reliability of data protection. The conceptual logic of tax culture in the digital environment is presented, and the role of public administration as an entity capable of consistently transforming digital procedures into a tool for strengthening trust and compliance behavior, and not just a technical mechanism for administration, is outlined. The factors of the digital environment that accelerate or inhibit the formation of tax culture are characterized, in particular, by the simplicity of electronic procedures, the clarity of messages, the accessibility of consultations, the transparency of calculations, the quality of feedback, the availability of verified communication channels, the level of cybersecurity, and the real protection of personal data. The feasibility of combining preventive tools that support voluntary discipline with control measures that focus on abuses based on risk analytics is substantiated, provided that the principles of proportionality and a non-discriminatory approach are observed. It has been established that the use of AI-based technologies for risk analytics and communications increases the manageability of processes, but at the same time requires ethical guarantees, transparent rules, explainability of decisions, accountability, and mandatory human control in controversial cases. Digitalized methods of forming a tax culture are summarized, including integrated electronic services, convenient end-to-end scenarios of interaction between the payer and the administration, pre-filled declarations and automatic checking of typical errors, personalized reminders, secure digital identification, protected channels of official messages, and the use of analytics to improve the service and targeted response to risks.

`The levels of tax knowledge influence the tax compliance behaviour of small business owners (SBOs). In turn, tax compliance has a direct impact on the growth and sustainability of small businesses and by default has an unequivocal effect on the country’s sustainable development, employment creation, as well as the alleviation of poverty and inequality. The objective of this study is threefold: Firstly, to examine the levels of tax knowledge among South African SBOs; secondly, to explore the underlying reasons for any observed deficiencies in tax knowledge; and thirdly, to offer recommendations for enhancing tax knowledge among SBOs. Semi-structured interviews were utilised to obtain information from 25 SBOs and 22 tax practitioners in the Gauteng Province of South Africa. The study found that SBOs lack basic tax knowledge to be able to be compliant all by themselves. SBOs outsource tax compliance, leading to a lack of interest in understanding tax laws, which results in low tax knowledge. SARS’s unfriendly approach and perceived complexity of the tax system further decreases SBOs willingness to learn. SBOs lack awareness of educational opportunities, which consequently worsens their tax knowledge levels.

This study examines the Sales and Service Tax (SST) compliance behaviour of Malaysian Small and Medium Enterprises’ (SMEs) by integrating social-psychological (Tax morale, Capability to manage, Perceived ease of compliance) and economic factor (Compliance Cost) within a conceptual framework grounded in established behavioural theories. Survey data from 103 SMEs, analysed using SmartPLS 4, reveal that tax morale, compliance cost, and perceived ease of compliance significantly influence SST compliance, whereas capability to manage tax does not. Perceived ease of compliance fully mediates the effect of managerial capability on compliance. This finding offers a valuable theoretical foundation for future research across diverse contextual settings. Given its status as a newly established relationship, it is poised to make a significant contribution to the existing body of literature on tax compliance behaviour, particularly within the Malaysian cultural context. The findings underscore the central importance of perceived ease of compliance in shaping SMEs’ SST compliance behaviour.

The "Double Reduction" policy represents a major reform initiative in basic education. Its effective implementation faces complex social-psychological challenges. This study adopts a social-psychological perspective. We employ mixed research methods. The research examines the psychological mechanisms and optimization paths of policy implementation through questionnaire surveys (N=1847) and in-depth interviews (N=156).The findings reveal several key patterns. Policy implementation resistance stems from three levels: cognition, emotion, and behavior. The cognitive bias rate reaches 68.7%. Emotional anxiety intensity stands at 73.3%. Behavioral deviation rate measures 73.5%. These three factors interact to form a chain of implementation barriers. Social support system intervention experiments show important results. Emotional support demonstrates the highest efficacy at 4.5 points. Comprehensive intervention increases policy compliance from 61.8% to 89.3%. This represents a 44.5% improvement. Systematic intervention combining cognitive restructuring, emotional guidance, and behavioral correction produces measurable outcomes after 8 weeks. Cognitive accuracy reaches 87.6%. Negative emotional intensity decreases by 46.5%. Behavioral compliance improves by 47.2%.The research constructs a five-dimensional assessment model. This model is based on psychological well-being, satisfaction perception, behavioral intention, social support, and value identification. The Cronbach α ranges from 0.83 to 0.89. Analysis reveals that student participation shows the largest gap at 37.1%. Role clarity scores lowest at 45.8%.This study provides empirical evidence for psychological mechanism research in educational policy implementation. It offers theoretical guidance and practical pathways for optimizing the "Double Reduction" policy and constructing evaluation mechanisms.

Background: Money laundering undermines financial transparency and stability by disguising illegally obtained funds and integrating them into the legitimate economy. Its growing complexity poses global and national risks, including in Nepal, where regulatory efforts face challenges in enforcement, technology, and public awareness. Purpose: This study analyzes the insights of customers within the Kathmandu Valley on banks' implementation of anti-money laundering practices. Design/methodology/approach: This study utilized an exploratory research design to investigate the subject matter. Non-probability sampling methods were employed to gather data, resulting in a total of 408 samples collected through Kobo Toolbox. The data analysis employed both descriptive and inferential techniques, with descriptive analysis providing an overview of the basic features of the data and inferential analysis facilitating broader conclusions. The analytical process was conducted using Excel for data management and SmartPLS 4.0 for structural equation modeling, enabling a thorough examination of the relationships between variables. Findings: The results indicate that customer awareness, discomfort, and trust have a significant influence on attitudes, which in turn strongly predict customer acceptance of AML practices. Mediation analysis further confirms that attitudes significantly mediate all three relationships, highlighting their central role in shaping AML compliance behavior. Conclusion: This study concludes that customers' awareness of money laundering and terrorism financing, their trust in banking secrecy measures, and their levels of discomfort with AML requirements all play significant roles in shaping their acceptance of banks' AML practices. Notably, the research emphasizes the role of attitude as a mediating factor in this relationship. Customers' attitudes influence how their awareness, trust, and discomfort translate into acceptance of AML practices. Key Words: Anti Money Laundering, Know your Customers, Banks, Awareness, Trust, Discomfort, Acceptance

Government communication has increasingly shifted toward digital platforms, positioning social media as a strategic tool for public policy dissemination and behavioural influence. In Nigeria, the National Identification Number–SIM (NIN–SIM) registration policy relied heavily on social media to raise awareness and encourage compliance. However, empirical evidence explaining how such communication moves citizens from awareness to actual compliance remains limited. This study adopted a quantitative cross-sectional survey design. Data were collected from 371 residents of Lafia Metropolis, Nigeria, using a structured questionnaire. The instrument measured exposure to government social media messages, levels of policy awareness, perceived message effectiveness, and self-reported compliance behaviour. Data were analysed using descriptive statistics, including frequencies, percentages, mean scores, and standard deviations. Findings reveal high exposure to government social media communication, with 91% of respondents accessing NIN–SIM information online and 88% demonstrating clear policy understanding. Furthermore, 91% reported that social media messages influenced their decision to comply with the registration requirement. Despite these positive outcomes, structural challenges such as unreliable internet connectivity and high data costs (72%) and exposure to misinformation (69%) constrained communication effectiveness. The study confirms that government social media communication extends beyond awareness creation to actively shape compliance behaviour, consistent with the Technology Acceptance Model.

Graphical Abstract Highlight Research 1. Artisanal sero fisheries in Bone Regency were assessed within the context of sustainable fisheries governance and the blue economy framework. 2. Six latent variables, economic characteristics, perceptions of fishing techniques, social factors, institutional dynamics, policy understanding, and regulatory compliance, were analysed using Structural Equation Modelling (SEM). 3. Socioeconomic status, institutional trust, and policy knowledge were found to be the strongest predictors of fishers’ compliance with fisheries regulations. 4. Strengthening fisher participation, promoting sustainable fishing education, and integrating sero fisheries into coastal zoning are key strategies to enhance compliance and support blue economy resilience. Abstract This study examines the integration of traditional sero (staked weir) fisheries in Bone Regency, Indonesia, into the sustainable governance and blue economy frameworks. Despite their socio-cultural importance, these small-scale fisheries remain undervalued in policy discourse and local management plans. This research utilizes Structural Equation Modelling (SEM) to assess fishers' perspectives and the factors driving regulatory compliance across six latent variables: economic characteristics, fishing techniques, social aspects, institutional dynamics, policy knowledge, and compliance behavior. The measurement model was empirically distinct, with all Heterotrait-Monotrait Ratio (HTMT) values below the 0.85 threshold. Key findings indicate that Policy Knowledge (C) has the most potent positive effect on compliance, with β = 0.902. Additionally, Livelihood Resilience (B) significantly affects compliance (β = 0.760), whereas Socioeconomic Characteristics (X) have a substantial adverse direct effect (β =- 1.003). Together, these variables explain a significant proportion of the variance in compliance behavior, with an R2 of 0.915. The results indicate that higher income, institutional trust, and strong community ties enhance compliance by enabling fishers to adopt sustainable practices. Conversely, economic instability hinders the application of policy knowledge. The study concludes that involving fishers in organizations and strengthening institutional support are vital for aligning artisanal practices with the blue economy. Implementing coastal spatial planning and adaptive interventions will help balance ecological preservation with the economic well-being of coastal communities.

Background: Palatability is a crucial factor influencing adherence of medication in pediatric populations, especially for oral antibiotic suspensions. This study aimed to evaluate and compare the organoleptic properties of three co-amoxyclav 457 mg formulations: Product A (Advent), Product B (Comparator 1) and Product C (Comparator 2) in 55 healthy school-going children aged 6 to 9 years. Methods: Each product was administered at 15–20-minute intervals and responses were recorded using a structured questionnaire that included behavioural analysis, taste discrimination, ranking and compliance perception. Results: Product A showed the highest acceptability, with 94.5% of children displaying favourable facial expressions and 100% accepting the product. Based on taste, 91% rated product A as excellent or good, compared to 67% for product B and 82% for product C. Additionally, 85% of participants described product A’s taste as sweet, with a fruity orange aftertaste. Smell ratings were also highest for Product A, with 89% rating it excellent or good, versus 71% for product B and 73% for product C. Regarding aftertaste, 78% found product A sweet, while about 55% found products B and C sweet. Overall, 57% of children preferred product A and more than 90% assured they would complete the course if prescribed this formulation. Conclusions: These findings highlight the importance of organoleptic properties in pediatric antibiotic formulations. By considering organoleptic properties during prescribing, healthcare providers can significantly enhance adherence, leading to improved treatment outcomes and a reduced risk of antimicrobial resistance.

This study examines the relationship between tax knowledge and tax compliance behavior among start-up business owners in General Santos City, Philippines. Anchored on the Slippery-Slope Framework, the study adopts a quantitative, descriptive–correlational research design to determine whether taxpayers’ level of tax knowledge significantly influences their compliance behavior. Data were collected from 540 start-up business owners classified as “New Businesses” by the city’s Business Permits and Licensing Office using a validated and modified survey questionnaire. Descriptive statistics and Spearman's rank correlation were used for data analysis. Findings reveal that respondents possess a moderate level of tax knowledge and a very high level of tax compliance behavior. Results further indicate a positive, though statistically insignificant, relationship between tax knowledge and tax compliance behavior, suggesting that while tax knowledge contributes to compliance, it is not the sole determinant of compliance behavior. The study underscores the importance of strengthening tax education initiatives tailored to start-up enterprises to enhance voluntary and sustainable tax compliance.

This study provides a systematic literature review of recent developments in central tax administration, with a specific focus on digital tax transformation, compliance enhancement, and policy reform during the period 2020–2025. The main objective of this research is to synthesize existing empirical and theoretical studies to identify key trends, challenges, and best practices in modern tax administration systems. The novelty of this paper lies in its integration of global tax digitalization trends with compliance behavior theory to propose a new conceptual framework, namely the Integrated Digital Compliance Model (IDCM). This model emphasizes the interaction between digital infrastructure, taxpayer behavior, regulatory enforcement, and institutional capacity. The review findings indicate that the implementation of digital tax ecosystems—such as e-filing, e-invoicing, real-time reporting systems, and AI-driven compliance monitoring—has significantly improved voluntary compliance, reduced tax evasion, and lowered administrative and compliance costs for both tax authorities and taxpayers. Furthermore, the study finds that technology-driven enforcement mechanisms enhance transparency, data accuracy, and risk-based audit effectiveness. However, challenges related to data security, digital inequality, and institutional readiness remain critical issues, particularly in developing countries. This study contributes to the tax administration literature by identifying existing research gaps and proposing future research agendas. The findings are expected to provide practical insights for policymakers and tax authorities in designing effective, inclusive, and sustainable digital tax reforms in both developing and developed economies.

Purpose — This article aims to explore the implementation of knowledge management in a multinational telecommunications subsidiary to investigate the factors that influence performance and its impact. Design/methodology/approach — Adopting a qualitative research design, this study employs an instrumental case study approach. Data were generated through in-depth semi-structured interviews with individual taxpayers, corporate taxpayers, and tax officials, and triangulated with administrative records on tax filings and revenue before and after the Coretax rollout. The analysis is guided by an integrated behavioral framework drawing on the Technology Acceptance Model and the Theory of Planned Behavior. Findings — The results show a significant decline in tax compliance during the initial phase of Coretax implementation. While the system demonstrated high usability among corporate taxpayers and tax officials by improving reporting efficiency and integration, it simultaneously resulted in low ease of use and reduced behavioral control among individual taxpayers. Complex authentication procedures, an unintuitive interface, system instability, and limited transition assistance reduced user trust and delayed compliance behavior. These results suggest that the decline in compliance reflects behavioral and institutional inconsistencies, not technological failures. Practical implications — The study highlights the need for user-segmented and adaptive digital tax implementation strategies, emphasizing usability, behavioral readiness, digital literacy support, and institutional capacity building during transition periods Originality/value — This research contributes to digital tax administration literature by demonstrating that behavioral readiness and perceived control are more decisive for compliance outcomes than system sophistication, particularly in developing-country contexts. Paper type — Case study

BACKGROUNDPostpartum hemorrhoids are common complications in women after childbirth, with an incidence rate of 37.9%. Progesterone levels increase during pregnancy, which can lead to constipation. Abdominal pressure surges sharply during delivery, which can block the venous return of the rectum and result in hemorrhoids, pain, and edema. Tongyangxiao lotion and Ziyu ointment, traditional Chinese medicinal preparations, have the efficacy of subduing swelling, relieving itching, and promoting healing; however, their combined application in treating postpartum hemorrhoids is less studied.AIMTo investigate effects of Tongyangxiao lotion sitz bath therapy combined with Ziyu ointment on postpartum hemorrhoidal pain, edema, anxiety, and depression.METHODSA retrospective analysis was conducted at Hebei Hospital of Traditional Chinese Medicine on 268 patients with hemorrhoids (September 2023 to February 2025). They were divided according to treatment method into control (wet compress with magnesium sulfate + Ziyu ointment) and observation (Tongyangxiao lotion sitz bath therapy + Ziyu ointment) groups (n = 134 in each group). Degree of pain, comfort level, compliance behavior with medical care, psychological state, therapeutic effect, hemorrhoid edema score, incidence of adverse reactions, and hemorrhoid diameter were compared.RESULTSNo statistically significant difference was observed in the diameter of the hemorrhoids or edema between the two groups before treatment. Hemorrhoid diameter and degree of edema were significantly smaller in the observation group than those in the control group 14 days post treatment. No statistically significant difference was observed in the scores of the General Comfort Questionnaire (GCQ) dimensions and participants’ compliance before treatment. All GCQ dimension scores were significantly higher in the observation group than those in the control group 7 and 14 days post treatment. The compliance rate was significantly higher in the observation group than that of the control group. No statistically significant difference was observed in the incidence of adverse reactions between the two groups (P > 0.05).CONCLUSIONTongyangxiao lotion combined with Ziyu ointment can improve patients’ surface edema, postpartum hemorrhoid pain, treatment adherence, and comfort, reducing negative emotions. This is relatively safe and worthy of clinical promotion.

Biomedical waste (BMW) mis-segregation remains a persistent global challenge, threatening infection control, occupational safety, and environmental sustainability. Recognizing that waste segregation is ultimately a behavioral act, this study conceptually introduces Bhadran's Point-of-Generation Segregation Theory (PGST)-a proposed hybrid behavioral-systems model designed to measure, benchmark, and improve BMW management. To conceptualize and operationalize a framework that links micro-level staff behaviors to institutional waste outcomes and global performance classification. Methodology: PGST integrates six constructs - Segregation Accuracy, Occupational Hazard Risk, Environmental Contamination Potential, Irreversible Contamination Index, Segregation Compliance Behavior, and Training Effectiveness-and is anchored by Moment-Based Precision Behavioral Fidelity (MBPBF), which quantifies four behavioral elements (Cognitive Anchoring, Visual Discrimination, Repetition Reinforcement, and Error-Responsive Feedback). Behavioral metrics generate the Precision Behavior Score (PBS), Precision Change Score (PCS), Point-of-Generation Segregation Accuracy (PGSA), and Point-of-Generation Segregation Index (PGS Index). While PGSA feeds into the Waste Quality Metrics (WQM) composite and the Global Segregation Safety Scale (GSSS), a five-tier benchmarking tool from EcoPlatinum to EcoBlack, the PGS Index serves as an internal behavioural diagnostic index Results: Illustrative application of PGST suggests that higher behavioral precision was strongly correlated with segregation accuracy and overall institutional waste quality. The model demonstrates that the Precision Behavior Score (PBS), Precision Change Score (PCS), and Point of Generation Segregation Accuracy (PGSA) reliably predict Waste Quality Metrics (WQM) and placement on the Global Segregation Safety Scale (GSSS). These findings highlight that measuring behavioral fidelity at the point of generation provides actionable insights for training design, compliance audits, and evidence-based policy development, as part of a proposed theoretical framework pending empirical validation.