Background: During the COVID-19 pandemic, mental health professionals were forced to find an appropriate way of working with patients that would ensure the continuity of therapy while considering the restrictions aimed at counteracting the spread of the virus. Online therapy has become an increasingly popular and common form of psychotherapeutic work. Emerging scientific studies have confirmed the positive effects of remote psychotherapeutic work. Nevertheless, modifying traditional and well-known forms of therapy or introducing completely new forms of remote therapy have been associated with several ethical concerns and challenges for psychotherapists. Objective: Due to the COVID-19 pandemic and the emerging epidemiological restrictions and recommendations, as well as new recommendations from psychotherapeutic associations, this study aimed to investigate the following: (1) Have psychotherapists experienced ethical dilemmas related to working online and face-to-face during the COVID-19 pandemic? (2) Was the occurrence of these dilemmas related to the therapists’ personal characteristics, such as age, sex, professional experience, or therapeutic approach? (3) What specific ethical dilemmas do psychotherapists point to in conducting online and face-to-face therapy during the COVID-19 pandemic? Methods: We conducted an international study with 177 psychotherapists from 4 European countries (Sweden, Poland, Germany, and Portugal) using a web-based survey. The psychotherapeutic approaches represented in the sample were cognitive-behavioral, integrative, psychodynamic-psychoanalytic, systemic, existential and gestalt, and Ericksonian therapy, among others. An interview comprising closed and open questions was used to collect data on psychotherapists’ personal characteristics, professional functioning, and ethical dilemmas encountered during online and face-to-face therapy. Results: Ethical dilemmas related to online therapy were reported by 58.7% (104/177) of therapists, while dilemmas related to face-to-face therapy were reported by 61% (108/177). The study showed that these dilemmas were independent of the personal and professional characteristics of therapists. Dilemmas related to online therapy were concern about online therapy, the issue of privacy and confidentiality of sessions, the effectiveness of online therapy, the issue of limitations that may hinder clinical work, and concerns related to the broader systemic and institutional context. In contrast, for the face-to-face form, ethical dilemmas mainly concerned health and safety, limitations in communication and quality of relationships due to wearing masks, and technical and logistical limitations. Conclusions: The issues considered here have not lost their relevance, because despite the lifting of restrictions related to the pandemic, some of the described dilemmas are similar to those related to coping with the risk and transmission of infection during face-to-face meetings. Moreover, the spread of online therapy means that the related ethical dilemmas are still relevant. The results indicate the direction of further consideration, the outcome of which should be specific ethical and legal guidelines that consider the concerns and dilemmas reported.

This research paper delves into the complex relationship between pro-environmental attitudes, dietary preferences, and packaging choices using a Virtual Reality (VR) restaurant scenario. The imperative is to address environmental concerns, particularly plastic waste and greenhouse gas emissions, as they pertain to sectors of the food service sector. This study seeks to understand the factors influencing environmental attitudes and behaviors, with a focus on dietary preferences and packaging choices using a VR restaurant scenario. This study explores connections between gender, education, interventions, and pro-environmental attitudes, as well as the correlation between vegetarian diets and sustainable behaviors. While the results suggest significant correlations between gender and pro-environmental attitudes and a potential connection between adopting vegetarian diets and pro-environmental attitudes, our study emphasizes the nuanced nature of these relationships. The findings underline the importance of interdisciplinary research and strategic interventions for fostering sustainable behaviors and reducing environmental impact. The use of VR simulation adds a novel dimension to understanding individuals’ choices in controlled environments, shedding light on the intricate dynamics of pro-environmental decision making. This paper contributes to the ongoing discourse on sustainable behavior by offering insights into the interplay between personal preferences, environmental awareness, and choices with significant environmental implications.

The importance of finding new, innovative ways of reducing greenhouse gas emissions has received increased attention. Climate labels are a means for this, where the life cycle emissions of a product are often given in combination with an icon. This article surveys the phenomenon of climate labels while varying their design to prompt more sustainable food consumption. Recipe boxes were selected as an example emphasizing the increasing popularity of shopping for groceries online. An online choice experiment was conducted where Danish respondents selected recipe boxes in two different scenarios: (a) the ‘all‐or‐nothing’ (binary) approach with a binary label on low‐emitting choices only and (b) the three‐tier rank‐order approach, where all meals are assigned a graphical rating. By assigning recipe boxes scores ranking from 0 to 2 based on the level of climate pollution, a measurement of the total score from a choice of recipe boxes made it possible to compare the effect of the two different approaches for climate labelling. Statistical tests indicated a significant difference between the two types of climate labels and their persuasive effect on consumer choice. They revealed that the three‐tier rank‐order approach results in more sustainable consumption than the binary approach. In demographics, younger individuals and females proved to be the most conscious in their choices.

As the food industry accounts for more than one-third of global anthropogenic greenhouse gas emissions, it is one of the largest contributors to climate change. Strategies for reducing CO2e (equivalent) emissions must be implemented to regulate the impact the food systems have on the climate. Environmental communication using climate labels and sharing information on carbon footprints can help reduce GHGs emissions from restaurant purchases on a systemic scale. The aim is to gain insights and study how a carbon label influences the concept of a climate-friendly restaurant and its capacity to bridge the gap between knowledge, awareness, and action. What are the motivations for restaurant employees to adopt climate-friendly behavior? How does the label’s use influence restaurants’ decision to track their carbon footprint over time, communicate the carbon footprint of dishes, and adapt menus to be more climate-friendly? The data were collected with semi-structured interviews with video communication with three restaurant chains, all using labels. The data collected via the interviews were examined using an inductive thematic analysis to identify key themes. The transcending transmission approach to communication was used to gain insights into instrumental and constitutive communication dynamics. As the theoretical framework, ‘symbolic interactionism’ helps untangle constitutive aspects of environmental communication surrounding climate labels to analyze the process of conceptualization through usage, co-creation, and interpretation. The analysis brought forward three main themes: the interactions between the scientific data accessible in the tool and the restaurants. Second, the diverse implications of sustainability marketing for motivating climate actions and what they look like. And finally, climate actions and how they are being apprehended and implemented by the restaurants. The promise of climate labels was discussed by elaborating on socio-cultural dynamics, sustainability marketing, and activism forces and impulses influencing the motivations for restaurants. We then discussed the capacity to transcend information into action through collaboration and inclusiveness to avoid greenwashing. Restaurants have a commercial interest in implementing climate labels in their business and an intrinsic desire to be a company that takes action for the planet because of the restaurants ‘employees’ convictions. However, restaurants find themselves in a tricky situation where they can be criticized if they take ‘wrong’ actions that can be considered greenwashing and criticized if they do nothing. The software enables restaurants to legitimize their actions and communicate them, making them resilient and evolving.

Background: This study examined the interplay between age, exercise, BMI, and cardiovascular health, addressing the growing global health concern of obesity and its link to heart disease. Methods: This research utilized data from an Italian dietary survey and the Dutch Longitudinal Internet Studies for the Social Sciences (LISS) panel. Statistical analyses included an ANOVA, linear regression, Mann–Whitney tests, regression with interaction terms, and stratified logistic regression to analyze the impact of age and exercise on BMI and cardiovascular risk. Results: This study revealed that BMI increased with age while exercise participation declined, particularly among women. Exercise consistently lowered BMI across all age groups, with no significant interaction between age and exercise. Additionally, age-related increases in cardiovascular risk factors were confirmed, with a higher susceptibility to heart disease in older age. Conclusions: These findings highlight the importance of maintaining physical activity to mitigate the risks of obesity and cardiovascular disease. The observed age-specific trends support the development of tailored prevention programs to promote healthier lifestyles across all age groups.

Background: Heart disease is the most prevalent cause of mortality around the world, with estimates up to 80 % being caused by modifiable risk factors. Counterfactual (CF) techniques on machine learning (ML) models based on mixed behavioral and clinical data enable generation of synthetic transitions from healthy to unhealthy (downward) or unhealthy to healthy (upward), in order to simulate pathways between the states. We used a public package to examine characteristics of the created new instances. Methods: Our methodology employs a 3×3×2 analytical framework, integrating three ML models [naive Bayes (NB), random forest (RF), and support vector machine (SVM)] with three distinct CF generation algorithms [multi-objective CF (MOC), Nested and Interpolated Counterfactual Explanations (NICE), and What-If analysis] across two health outcome scenarios (heart disease to healthy and healthy to heart disease). Results: Our findings reveal that the sensitivity of ML algorithms to the generation of CFs is relatively low, indicating robustness in the ML models’ performance irrespective of the CF methodology employed. Conversely, the choice of CF algorithm significantly influences the quality and characteristics of the generated CFs, particularly regarding the number of features altered. This result underscores the impact of CF methodologies on the interpretability and applicability of CFs in clinical settings, where understanding the minimal changes required to alter a health outcome is essential for targeted interventions. Our analysis of transitions from positive to negative health outcomes (Pos2Neg) and vice versa (Neg2Pos) unveils profound differences, highlighting the asymmetric nature of health state transitions. Conclusions: This research contributes to the burgeoning field of explainable artificial intelligence (XAI) in healthcare, providing valuable insights into how different ML and CF approaches interact and impact the utility of predictive models in clinical decision-making. Our work emphasizes the careful selection of CF algorithms to enhance the actionability and relevance of CFs in health outcome predictions, paving the way for more nuanced and effective patient care strategies.