Previous studies have suggested that the intrauterine system increases the risk of depression, particularly in adolescents. However, these studies relied on national registry data collected at a time when medical guidelines discouraged adolescent use of this contraceptive method. As a result, the adolescents who appeared in these registries represented an atypical group who had this contraceptive prescribed against medical recommendations. Consequently, unknown or unmeasured participant characteristics may have introduced confounding variables and influenced conclusions. Although prescription guidelines for intrauterine systems now include adolescents, selective prescribing may persist. If so, it could affect future studies on hormonal contraceptives, even though the decision is clinically sound. We thus aimed to explore current contraceptive prescription practices, investigating user characteristics, policies, and contextual factors that might influence prescribing the intrauterine system rather than other hormonal contraceptive products, or vice versa. We conducted focus group interviews with 23 healthcare professionals employed at six health centers in Norway, prescribing hormonal contraceptive drugs to adolescent women. We used thematic analysis to identify factors that can influence which products are recommended and requested. Our analysis generated three themes: "Old conceptions die hard" describes skepticism among family doctors and mothers regarding adolescent use of the intrauterine system, "Particular promotion of the intrauterine system to "vulnerable" adolescents" outlines the practice of healthcare professionals recommending this contraceptive method to individuals identified as vulnerable, and "What tips the scale: Pros, peeves and other people" discusses influences on adolescents' contraceptive choice. This exploratory study suggests that both prescription practices and personal preferences influence choice of contraceptive product, and that it is not arbitrary who has the intrauterine device inserted. Future quantitative research should incorporate the factors identified in this exploration, to minimize their confounding effects when aiming to draw causal conclusions on the effects of the intrauterine system on mental health.

To remain competitive while meeting sustainability goals, manufacturers' supply chain models subject to carbon regulation and serving eco-conscious markets need to adjust their production and abatement choices dynamically. However, existing models ignore how endogenous risk preferences and exogenous scenario uncertainty combine to drive these strategic shifts. This paper integrates Scenario Analyses and Risk Preferences – risk-averse, risk-neutral, and risk-seeking behaviours under optimistic, neutral, and pessimistic market scenarios – into a Repeated Carbon Game-theoretic (SA-RP-RCG) framework for a carbon-regulated supply chain model. This model applies repeated-game logic to decompose long-term dynamics into a series of non-convex Mixed-Integer Quadratically Constrained Programming (MIQCP) sub-problems, each of which performs an optimisation trade-off between profitability and emissions. Numerical results from the e-scooter industry show that production increases only when subsidies accompany moderate carbon taxes, thereby widening profit gaps in favour of carbon-efficient industry leaders, yet allowing mid-range manufacturers to narrow the gap if they invest early. Moderate risk tolerance yields stable performance, whereas excessive risk-seeking reduces returns for carbon-efficient manufacturers. Less carbon-efficient manufacturers can improve their position by adopting bolder strategies, such as risk-seeking. These findings help asymmetric manufacturers align their decisions with evolving market signals and policy interventions while selecting an appropriate risk posture.

Male urinary incontinence is a debilitating yet often overlooked condition. While medical treatments are available, some men may choose to manage the condition rather than opt for treatment. For these individuals, the choice of continence product is influenced by many factors including personal preference, comfort and discretion. The condom catheter, or external urinary catheter, is a non-invasive device designed to manage male urinary incontinence. It consists of a flexible sheath worn over the penis, that is connected to a drainage system. It is primarily indicated for patients with urinary incontinence who have the ability to void spontaneously but require continuous collection of urine for comfort, hygiene or skin protection. Condom catheters should be avoided for long-term use in patients with impaired sensation or high risk of skin breakdown without careful monitoring. Adverse effects are typically minor but can include skin irritation, maceration, pressure necrosis, allergic dermatitis and urinary tract infections. Rare complications include penile ischaemia, oedema and urethral injury from improper sizing or application. This article includes guidance for safe use such as appropriate sizing, secure but non-constrictive application, daily changes and regular inspection of penile skin. Proper hygiene, moisture control and patient or caregiver education on technique and complication recognition are essential. Overall, condom catheters offer an effective, low risk alternative to indwelling catheters improving comfort and quality of life for suitable patients.

To determine the prevalence of medical adhesive-related skin injury (MARSI) and its association with relevant clinical factors and medical devices in intensive care. An observational, cross-sectional, analytical study was conducted on 84 adult patients admitted to intensive care at the Clinical Hospital of the University of Chile. Data collection included sociodemographic characteristics, MARSI occurrence and types, use of medical devices including adhesive fixation products, medical history, nutritional status, risk factors for skin lesions, biochemical and haematological parameters and skin characteristics. Standardisation training was conducted for data collection, and analysis was performed using STATA v18 (α=0.05). The mean patient age was 63.02±16.0 years, and 53.6% were male. Nine MARSIs were observed in 9.5% (n=8) of patients. Skin stripping (1.2%) occurred in the cervical region, while skin tears (6.0%) affected the cervical region (1.2%), thorax (1.2%) and upper limb (3.6%). Irritant contact dermatitis was found in 3.6% of cases in the upper limb. The most frequently used medical device was the peripheral venous device (76.2%, n=64), and the most common fixation products were acrylic-based adhesives: transparent polyurethane film (88.1%, n=74) and elastic polyester non-woven wide-area fixation (67.9%, n=57). Transparent polyurethane film with acrylic adhesive was the most common adhesive implicated in MARSI, in 4.8% (n=4) of cases. A multiple logistic regression model identified two independent predictors: the chance of MARSI was significantly increased in type 2 diabetes (odds ratio (OR): 8.28; p=0.024; 95% confidence interval (CI): 1.31, 52.14) and reduced with elastic polyester non-woven wide-area fixation (OR: 0.116; p=0.035; 95% CI: 0.01, 0.86). These findings confirm that intensive care patients, particularly those with type 2 diabetes, are at increased risk of developing MARSI. The findings also enhance the understanding of MARSI epidemiology, facilitating evidence-based preventive strategies including the choice of fixation products in intensive care settings. Moreover, they underscore the need for clinical protocols to incorporate education on MARSI identification, standardised documentation and preventive measures.

There are livestock species such as rabbit, guinea fowl, and grasscutter in Sub-Saharan Africa which are traditionally consumed but have not received as much attention and support from policy and research compared to conventional livestock species such as cattle, sheep, goat, pig and poultry. Despite the growing interest in such neglected livestock species (NLS), evidence on their integration, production, and drivers of adoption remain sparse. This comparative study investigates the production characteristics, profitability, and determinants of farmers' choices between conventional and NLS production in Ogun and Oyo States, Nigeria. We conducted a quantitative survey of 183 smallholder livestock producers, selected using simple random and snowball sampling procedures across Ogun and Oyo States. Data were collected through questionnaires and analysed using descriptive statistics, logistic regression, and cost-benefit analysis. The findings show that women were disproportionately engaged in NLS production. Intensive and semi-intensive production systems were the most prevalent, driven by land scarcity and the adaptability of NLS to confined production environments. Feed emerged as the dominant cost component across both species, significantly impacting profitability. Logistic regression analysis showed that the choice of NLS production was positively and significantly associated with mode of land acquisition, profit, and access to credit. Profitability analysis revealed that NLS systems achieved a higher return on investment than conventional systems, offering a viable pathway for enhancing income, food security, and resilience among smallholders in the study areas. Conclusively, with an appropriate policy framework, neglected livestock species could contribute to a transformative shift in Southwestern Nigeria's livestock landscape.

Targeted universalism for long-acting PrEP: an urgent need to avoid risk targeting and build population-level impact.

ABSTRACT Rising deglobalization is reshaping consumer behaviour, yet existing research has primarily focused on global branding strategies in stable environments. Geopolitical disruptions and economic self-sufficiency movements influence consumer preferences, particularly toward foreign brands. This research integrates the perspectives of Social Identity Theory and deglobalization to examine how self-reliance influences the intention to buy local products. We argue that consumer boycotts and brand country image mediate the relationship between self-reliance and the intention to purchase domestic products. Based on survey data from 460 respondents from emerging markets, which were analyzed using PLS-SEM, the findings highlight that deglobalization strengthens self-reliance ideology, influencing low- and high-involvement product choices. Our findings suggest that global brands should align their strategies with rising nationalism by prioritizing local manufacturing to navigate shifting consumer preferences in emerging markets.

BackgroundTraditional lecture-based teaching methods often fail to stimulate curiosity, critical thinking, and reflective learning among public health students. To address these gaps, a blended pedagogical approach was implemented, integrating cinemeducation, entrepreneurship orientation by the University’s Innovation and Entrepreneurship Research Cell, and a field visit to a sanitary pad-making machine manufacturing unit. This approach aimed to enhance learning on menstrual hygiene, promote critical thinking, and expose students to real-world public health innovation.MethodsAn educational intervention was conducted with 40 Master of Public Health students at a Public Health Institute at Gujarat, India. A mixed-methods design was used, including a structured pre-session orientation, film-based learning, entrepreneurship orientation, and a field visit. Quantitative data were collected through structured Likert-scale questionnaires (supplementary file 1) measuring students’ perceptions of learning, critical thinking development, and innovation awareness. Descriptive statistics (mean, SD, 95% CI) were calculated. Qualitative data were obtained from audio-recorded Focus Group Discussions (FGDs), which were transcribed and analyzed using Braun and Clarke’s six-step thematic analysis. Themes were mapped to Kirkpatrick’s Four-Level Evaluation Model to assess educational impact.ResultsQuantitative findings demonstrated high levels of student endorsement of the blended learning approach, with consistently elevated mean Likert scores indicating positive post-intervention perceptions of engagement, critical thinking, and innovation awareness, with mean scores ranging from 4.3 to 4.9 (out of 5) and narrow confidence intervals, indicating strong student endorsement. Qualitative analysis revealed six major themes: (1) Access and affordability of menstrual hygiene products, (2) Cultural stigma and behavioral barriers, (3) Determinants of product choice, (4) The role of government and NGOs, and (5) The educational value of blended learning. (6) Entrepreneurship and Self-Help Groups for Health Solutions Students particularly valued the real-world exposure from the Innovation and Entrepreneurship Research Cell orientation and the manufacturing unit visit, which helped them understand entrepreneurship processes, supply chain challenges, and the socio-economic impact of innovation in public health.Supplementary InformationThe online version contains supplementary material available at 10.1186/s12909-026-09329-x.

Older adults are the fastest-growing group of cannabis consumers in the US, seeking relief from age-related ailments (eg, pain or difficulty sleeping) and improved quality of life. However, little is known about the motivations and factors that influence their use of edible cannabis and product choice. To explore the motivations of older adults in Colorado purchasing edible cannabis products to improve sleep, pain, or mental health concerns, and to understand how they perceive the benefits and drawbacks of different cannabinoid profiles: cannabidiol (CBD)-dominant, tetrahydrocannabinol (THC)-dominant, or a THC-CBD combination product. This community-based, qualitative study was study conducted in Colorado from November 2021 to November 2023 as part of a larger clinical trial. Individual interviews were audio-recorded, transcribed, and analyzed. Participants were a convenience sample of adults aged 60 years or older who were interested in using edible cannabis for sleep, pain, or mental health symptoms. Participants completed an in-person interview prior to purchasing 1 of 3 edible product types. Use of edible cannabis products. The primary outcomes were self-reported motivations for cannabis use and perceived benefits and drawbacks of different cannabinoid profiles, assessed through semistructured interviews conducted before product purchase. Among 169 participants (mean [SD] age, 70.8 [5.8] years, 89 female [54%]), 96 (57.5%) selected a THC and CBD combination product, 48 (28.7%) selected a CBD-dominant product, and 23 (13.8%) selected a THC-dominant product. Primary motivations for cannabis use included avoiding pharmaceuticals, exhausting other options, new or increasing problems, and evidence or claims of benefits. Evidence or claims of associated outcomes were seen as a benefit for all 3 product types. The most common drawback for THC and combination products was concern about getting high or being impaired, while limited efficacy was the most common drawback for CBD products. Combination products were perceived to offer dual benefits of THC-CBD, yet determining the ideal ratio was seen as a challenge. In this qualitative study, older adults were motivated to use cannabis as an alternative approach to address health concerns. These findings highlight the importance of physician awareness of older adults' motivations and concerns to support informed counseling and resources.

We model pragmatic mechanisms of referential communication and categorization in a multi-agent framework of emergent communication. Pragmatic theories and experimental work predict that speakers consider the context in their choice of referring expressions. In addition to this context-based reasoning, utility-based pragmatic reasoning about the listener's likely interpretation of an utterance influences the speaker's production choices. We aim to investigate these two factors and their role in referring expression generation and categorization in a computational model of language emergence and language use. We model communication in interaction and consider an efficiency tradeoff between speaker and listener utilities. Our results show that an emerging language becomes more effective, ambiguous, and efficient when speakers and listeners communicate in a shared context. This is achieved by an efficient tradeoff between production and comprehension where languages can afford to be simpler in production when they are sufficiently informative in context, placing more burden on the listener's side. We further demonstrate that incorporating utility-based pragmatics, as modeled with the Rational Speech Acts framework, improves the linguistic efficiency of language use only in languages that emerged with a shared context between interlocutors, but not in languages that emerged without such contextual information during training. We conclude that context-based pragmatics plays a role in referential communication and categorization by shaping an emerging language. Efficient reference in a communicative situation can benefit especially from utility-based pragmatics if the language that is being used has emerged in context. This might suggest that utility-based pragmatics hinges on mechanisms that naturally emerge when context is available during the evolution of a language. In summary, we show that human-like language and category systems emerge as an optimized tradeoff between speaker and listener needs in interaction, i.e., under efficiency considerations of simplicity and informativeness.

Cultivating demand: A systematic literature review on agroecology's role in consumer behavior

Technological choices in commodity pottery production: New perspectives from the Dayuancun workshop in the Late Western Zhou period

This study aimed to characterize cannabis product choices (cannabinoid content and formulation) among patients with rheumatologic conditions and their associations with patient factors, patient-reported perceived side effects, and positive impacts. An online survey (delivered from March to November 2022) was distributed by Alberta Health Services to patients with rheumatologic conditions in Alberta. Correlation matrices were used to analyze associations between cannabinoid content and formulations reportedly used with patient factors and patient-reported outcomes. Efficacy outcomes (eg, pain, sleep, mood) were grouped into a composite positive impact score, and side effects were grouped into central nervous system-activating, dampening, and sensory effects. Data from 1,436 respondents who indicated cannabis use and provided information on their rheumatologic condition, cannabinoid content, and formulations that they use were analyzed. Tetrahydrocannabinol (THC)-cannabidiol (CBD)-balanced products were associated with higher positive impact scores (adjusted odds ratio [aOR] 1.76, 95% confidence interval [CI] 1.18-2.63). THC-dominant products were also associated with high dampening (aOR 1.85, 95% CI 1.16-2.98) and sensory effects (aOR 2.16, 95% CI 1.27-3.70). Dried cannabis and edibles were associated with higher positive impact scores (dried cannabis: aOR 1.86, 95% CI 1.07-3.23; edibles: aOR 2.18, 95% CI 1.41-3.37). Dried cannabis was also associated with high dampening (aOR 1.98, 95% CI 1.19-3.27) and sensory effects (aOR 3.05, 95% CI 1.67-5.58). Cannabis product choice varied by age, gender, comorbidities, prior cannabis experience, frequency of use, reasons for use, access to cannabis prescription, and source of cannabis information. There is significant variability in cannabis products used by patients with rheumatologic conditions, who are influenced by patient-specific factors. Balancing THC and CBD content may facilitate positive impact while lowering the risk for side effects. Dried cannabis may pose more side effects compared to other formulations.

Adolescents\u2019 Interactions with Their Food Environment in Vietnam: A Participatory Video-Based Study on Factors Shaping Dietary Behavior

Aim. The present research explores the cognitive principles that underlie the selection of negation types in Jordanian Arabic (JA) while expressing futurity. Methods. Data was collected by asking speakers of Jordanian Arabic to perform an acceptability judgement task by rating according to a 5-point Likert scale the three negation types: preverbal (*mā*), postverbal (*…š*), and bipartite (*mā…š*). Results. Findings have shown a strong preference for preverbal negation with the proclitic mā, as opposed to the discontinuous (bipartite) negation construction with mā …… š which was consistently rated as the least acceptable, particularly when combined with the lexical future marker bedd- Postverbal negation with the enclitic …š was slightly less acceptable, while the discontinuous (bipartite) negation construction with mā …… š was least favored by the participants. Analysis of participants’ responses indicated that this preference is driven by verbal and cognitive economy; speakers favored forms that offer better processing efficiency and articulatory simplicity. This, in turn, challenges the phonologically based explanation for negation preference, as the preference forpreverbal negation was high even with labial initial verbs. Conclusions. The study provides evidence that the choice among negation types in Jordanian Arabic (JA) is neither arbitrary nor purely pragmatic; instead, it is governed by cognitive constraints of economy and processing efficiency. A significant preference for preverbal negation over bipartite negation was identified. It was established that the use of preverbal structures ensures early polarity identification and reduces working memory load, whereas bipartite structures increase processing complexity. These findings align with the Uniform Information Density (UID) hypothesis, confirming the influence of cognitive principles on syntactic choice across typologically diverse languages. The research demonstrates that processing efficiency principles are fundamental to speech production and take priority over phonological constraints. An exception occurs when bipartite negation is utilized to fulfill the pragmatic function of emphasis. Regarding language change, it is substantiated that preverbal negation is more resistant to transformation, while more complex bipartite structures are vulnerable to reduction. The author concludes that cycles of language change reflect underlying cognitive preferences for structures optimal for cognitive processing.

Abstract. Marine heatwaves (MHWs) are increasingly studied in climate sciences for their ecological impacts, for which accurate real-time bulletins and forecasts are essential. Yet, methodological choices in their detection affect metric estimates, underlining the need to better assess these sensitivities. This study provides a thorough assessment of the impact of sea surface temperature (SST) product choice on MHW statistics, focusing on the tropical Pacific. MHW detection was performed on six daily gridded SST datasets: four widely used blended satellite observational products, one ocean reanalysis, and a multi-dataset ensemble mean computed from the four observational products. Sensitivity to SST products was evaluated for six MHW metrics (MHW days per year, number of events per year, duration, maximum intensity, cumulative intensity and onset rate) and for the degree heating weeks (DHW), a widely used index for coral bleaching risk. Inter-product comparisons revealed a significant dispersion among MHW metric estimates. The reanalysis GLORYS12v1 detected fewer, longer and less intense MHWs while OISST detected more MHWs of shorter duration and higher intensity. likely related to the respectively weak and strong high-frequency SST variability (periods shorter than 2 weeks) of the two products. The sensitivity analysis showed that the onset rate was the most sensitive metric to SST product choice and the maximum intensity the most robust one. Metrics uncertainties were quantified inside seven regions of the basin and were largest in the western Pacific Warm Pool. Co-occurrence analyses of MHWs revealed that, over the basin, 10 % to 80 % of MHW days were detected simultaneously by all products, with the western Pacific Warm Pool showing the lowest agreement (10 %–40 %). Filtering MHWs by size also revealed that the detection of large-scale MHWs (>5°lon×5°lat) was more consistent across products than smaller-scale ones. Finally, over the studied period, inter-product differences tended to decrease with time. The DHW also revealed to be sensitive to SST products, with inter-product differences on DHW annual maximum reaching more than 1 °C weeks and percentages of bleaching alert days (DHW≥4 °C weeks) in common across products reaching 70 % at most across much of the basin. These findings contribute to a better understanding of how SST product choice affects the characterization of MHWs and DHW, and their associated uncertainties.

Artificial Intelligence play an important role in promoting sustainability within e-commerce. Gen Z are the chief dominator in digital world and aware about sustainability compare to other generational cohorts. Previous research focus on general consumer group, apparel and grocery yet online shopping behaviour in e-commerce among Generation Z are lacking. The main objective of this study is to analyse the impact of artificial intelligence in sustainable online shopping behaviour and eco-friendly product choices among Gen Z. The study suggests descriptive and quantitative approach of 100 respondents through convenience sampling. Independent variable includes artificial intelligence and dependent variable includes sustainable online shopping behaviour and eco-friendly product choices. Demographic variables were analysed by frequency and percentage. The internal consistency and reliability were measured by Cronbach’s Alpha which is 0.77 considered reliable for further analysis. Regression analysis reveal that model is statistically significant, the value R Square is low which show small proportion of the variation in sustainable online shopping behaviour and eco-friendly product choices is explained by AI. Additionally, Coefficient table reflects a moderate positive beta value, shows that AI has a positive impact on sustainable online shopping behaviour and eco-friendly product choices among Gen Z. This study has significant implications for businesses, policymakers and researchers. The purpose of the businesses is to enhance customer engagement in marketing strategies with sustainability also supports ethical use of AI and transparency in promoting sustainability for policymakers. Moreover, study provides valuable insights of artificial intelligence and sustainable online shopping behaviour for researchers. Keywords: Artificial Intelligence, Sustainability, Online shopping behaviour, Generation Z, E-Commerce

Consumer decisions play an important role in shaping sustainable consumption outcomes. This study focuses on green purchase intention among young adult consumers in Turkey and examines how cognitive factors, social factors, and consumer individual characteristics are related to intention formation, with green loyalty considered as a moderating element. The data was obtained from 200 young adults via online surveys and though social networks commonly used in Turkey, and analyzed using partial least squares structural equation modeling (PLS-SEM). The analysis shows that green purchase intention varies in relation to these factor groups, and that green loyalty influences the way several relationships operate within the model. The study contributes to ongoing discussions in consumer behavior and sustainable marketing by providing context-specific evidence relevant to organizations aiming to encourage eco-friendly product choices and more responsible consumption among younger consumers. This study is grounded in consumer behavior theory and uses selected elements of the theory of planned behavior and the attitude–behavior–context framework to organize the analytical framework. The findings offer insights that are relevant for both academic research and marketing practice within a sustainable consumption context.

ABSTRACT Understanding the drivers of organic food choices requires considering the multidimensional nature of pro-environmental attitudes, including cognitive and affective components, and their translation into purchasing behaviour. Using data from a representative sample of 2,962 Spanish organic consumers, we apply partial least squares structural equation modelling (PLS-SEM) to examine how these dimensions influence behaviour. Results show that the affective dimension plays a central role and is more influential than the cognitive dimension, although both are positive and significant. To explore heterogeneity across social environments, we use the pathmox algorithm to identify variations in structural relationships. The effects vary systematically with age, education, and living conditions. We identify four distinct social groups, showing that one-size-fits-all explanations overlook different social mechanisms. The affective dimension emerges as the key driver of sustainable product choice, with the strongest influence among younger, less-educated consumers.

The industrialization of global food systems has led to dietary changes that harm both health and the environment. If global food systems are to meet the needs of a growing population for healthy, environmentally sustainable, and affordable diets, substantial changes will be required. In this Review, we synthesize growing empirical evidence on the complexity of factors that influence consumer dietary and farmer production choices, especially the roles of public and private entities that shape food environments. We outline promising interventions to help facilitate beneficial global dietary transitions, including research and development for product innovation, regulation of food environments, and food assistance and food-as-medicine programs. Understanding and aligning the motives and incentives of various food system actors is essential to achieve improved health, environment, and equity outcomes.