Search Results (1,125)

Objective: This study aimed to explore the emotional, social, and ethical dimensions of early or presymptomatic diagnosis in individuals with Autosomal Dominant Polycystic Kidney Disease (ADPKD). Methods: A total of 118 participants diagnosed with ADPKD were recruited from a tertiary nephrology center in Türkiye. Data were collected via a 22-item structured and open-ended questionnaire. Chi-square and non-parametric statistical tests were used to assess associations between awareness, attitudes, and demographic variables. Results: Although only 10% of participants reported direct disadvantages from their diagnosis, such as difficulties in employment, insurance, or relationships, many voiced concerns about stigma and long-term uncertainties. Genetic awareness was significantly associated with increased likelihood of recommending family screening (p = 0.022), and higher educational attainment correlated with greater disease knowledge (p < 0.01). Despite emotional burden, 71.2% of participants reported adopting lifestyle modifications, and 79.6% expressed willingness to screen their children, though often with ethical hesitation. Conclusions: While early diagnosis of ADPKD may offer clinical benefits, it also introduces complex psychosocial and ethical dilemmas. These findings highlight the importance of integrating patient-centered counseling, clear communication strategies, and supportive policies to ensure informed decision making and mitigate potential harms. Full article

Understanding agricultural production dynamics is vital for addressing global food security in the least developed countries. In Senegal, the issues of rural development and enhancing agricultural productivity are still less understood. Using survey data (n = 600) from the Thiès region, this study aims to explore factors that influence agricultural productivity in Senegal. The multinomial probit model is estimated using maximum simulated likelihood (MSL) methods. This approach is necessary due to the presence of multiple-choice categories. The results highlight that young farmers aged 18–30 are less likely to achieve high production (>10 tons) compared to their older counterparts (p < 0.01). In contrast, older farmers (31–60) report higher income stability (p < 0.05). Education levels also impact production, with farmers having lower or upper secondary education being less likely to attain high production than illiterate farmers (p < 0.05). Receiving subsidies reduces the likelihood of high production (p < 0.01). Larger landholdings (>1 ha) correlate with lower production odds (p < 0.01), suggesting diminishing returns. Gender disparities are evident, with male farmers being 45.6% more likely to report income declines (p < 0.1). Marginal effects show that acquiring land through rental or purchase significantly boosts income (p < 0.01), while traditional ploughing increases the sown area (p < 0.01). Policymakers should enhance training in agriculture, improve subsidies, secure land tenure, and promote certified seeds to boost productivity. This study highlights the need for targeted policies on training, subsidies, land tenure, and sustainable practices to enhance Senegal’s agricultural productivity. Full article

Population aging and the digital revolution have converged, creating challenges and opportunities for the social inclusion of older adults. This study examined social media usage patterns among Brazilian older adults during the COVID-19 pandemic, exploring their associations with sociodemographic factors, health, and well-being. Through an online survey with 441 participants aged 60 or older, we found that WhatsApp^® and Instagram^® were the most utilized platforms, with a significant increase in usage during the pandemic. Higher educational attainment and income were associated with more frequent and diverse social media use, while the presence of comorbidities positively correlated with seeking health information online. Notably, greater engagement in social media was associated with an improved perception of well-being. The results highlight the potential of social media as tools for digital inclusion, access to information, and promotion of well-being for older adults, especially in crisis contexts. However, they also reveal socioeconomic disparities in access to and use of these technologies. These findings have significant implications for public policies on digital inclusion and health promotion, suggesting the need for targeted interventions to reduce digital inequality among older adults and maximize the potential benefits of social media for active and connected aging. Full article

Decentralized solar water disinfection systems (DSODIS) in continuous flow systems are alternatives for large-scale improved water access in rural contexts. However, DSODIS in rural Ghana are limited. An exploratory sequential mixed-methods design was used to explore the enablers of and barriers to, as well as reported barrier perceptions to, the effective implementation of DSODIS in the Sawla-Tuna-Kalba (STK) District of Ghana. The qualitative data (26 respondents) were analyzed thematically, and the quantitative data (1155 household heads) were subjected to Poisson regression analyses. Enablers were categorized into themes such as willingness to pay for DSODIS, household and community participation, and willingness to use water from DSODIS. Similarly, the barriers include environmental barriers, technological barriers, economic barriers, and political and legal barriers. Household characteristics such as main water source and income, age group, education, marital status, household size, being born in the community, and years living in the community are statistically associated with reported barrier perceptions. Households with unimproved water sources and high income (IRR = 1.432, p = 0.000) and improved water sources and high income (IRR = 1.295, p = 0.000) are 43% and 30% more likely, respectively, to report more barrier perceptions compared with households with unimproved water sources and low income. Females (IRR = 1.070, p = 0.032) are marginally more likely to report more barrier perceptions compared with males. The model output also indicates that household heads with higher educational attainment (IRR = 1.152, p = 0.001) are 15% more likely to report more barrier perceptions compared with those with no formal education. These findings provide valuable information for policymakers and stakeholders aiming to provide quality water in rural Ghana where centralized systems cannot be installed. Full article

Wealth and power have been recognized as being unequally concentrated within specific families. While research on social mobility has been limited to defined outcomes (e.g., occupation, income, and education) in specific contexts, the rise of big data has spurred broader network analysis. Using a comprehensive genealogical database of 30 million individuals in the Western Hemisphere, we analyzed how familial background, gender, and occupational domains influence the probability of individuals attaining “fame” in their lifetime. Individuals with famous parents are more likely to become famous themselves, especially males. Unexpectedly, we identified more than 10,000 famous individuals who are closely related, comprising 25.6% of all famous individuals in the entire dataset. While the underlying sample may have representativeness issues, the findings suggest that famous individuals are not isolated figures but often part of broader interconnected family networks. Full article

Online education provides a wide range of possibilities in order to setup active learning environments. Different dimensions related to the teaching/learning process are available in such environments, although the focus in this paper is set on just three. Those are the space where this process takes place, the time when this process is undertaken, and the language in which this process is carried out. Some combinations of those three dimensions were deployed in a course on computer science in the current academic year, and the results obtained were compared to those achieved in the previous academic year with a traditional environment. Results exhibited an increase of over 17% in academic performance, as well as an increase of over 16% in success rate, which may be due to the motivation of the learners with this innovative approach. A T-test was applied to the results in both years, obtaining a p-value of 0.017, thus showing that the outcome obtained was statistically significant. However, the sample size was calculated considering the effect size attained, namely 0.64, as well as an alpha value of 0.05 and a power of 0.8, leading to the conclusion that the size of the sample involved, namely 30 learners, was not sufficient to detect the effect size desired. Therefore, further research should be carried out with larger groups. Full article

Background/Objectives: Vaccination rates in South Tyrol, Northern Italy, remain among the lowest in the country. This study investigated whether health literacy is associated with vaccine uptake in this multilingual region. Methods: A representative cross-sectional survey (n = 2090) was conducted using the validated European Health Literacy Survey Questionnaire (HLS-EU-Q16) to assess health literacy. Vaccine uptake was evaluated on a 4-point Likert scale and analysed by age group (18–54 years; ≥55 years). Associations were explored using ANCOVA and multivariate logistic regression models. Results: Among younger adults (18–54 years), higher health literacy was significantly associated with greater vaccine uptake, particularly when compared with individuals with missing health literacy data. Health literacy was not a significant predictor for vaccine uptake in the older age group (≥55 years). Instead, vaccine uptake correlated with trust in healthcare providers, the presence of chronic diseases, and educational level. Differences in health literacy were notable across language groups, but these did not interact with vaccination behaviour. Conclusions: Building trust and targeting individuals with lower educational attainment are key strategies for improving vaccination rates across language groups. Although health literacy plays a secondary role, efforts to enhance it, especially among the German-speaking population, are still warranted. Younger individuals with missing health literacy scores, often with a migration background and low trust in healthcare, should be prioritised in vaccination and health literacy campaigns. Full article

Toxic oil syndrome (TOS) is a multisystemic disease that emerged in Spain in 1981 due to the ingestion of aniline-adulterated rapeseed oil fraudulently sold as olive oil. Although neurological sequelae, including cognitive deficits, have been documented in long-term survivors, it remains unclear whether TOS leads to chronic or progressive neurodegeneration. In this case-control study, we measured blood concentrations of neurofilament light chain (NfL), glial fibrillary acidic protein (GFAP), and phosphorylated tau 217 (pTau217) in 50 individuals with clinically confirmed TOS and 50 matched healthy controls. Biomarkers were quantified using ultrasensitive immunoassay platforms (Quanterix SIMOA SR-X and Fujirebio Lumipulse G600II). Group differences were evaluated using non-parametric tests, and multiple linear regression was applied to assess associations between biomarkers and clinical variables. While NfL levels were slightly higher in TOS patients (p = 0.025), no significant group differences were observed for pTau217 or GFAP. Age was a consistent predictor of biomarker levels, particularly for GFAP and pTau217, and female sex was independently associated with higher GFAP concentrations. Lower educational attainment was linked to increased NfL levels. Clinical status (TOS vs. control) did not significantly predict biomarker concentrations in any model. These findings suggest no evidence of overt or ongoing neurodegeneration in long-term TOS survivors as detected by current blood biomarkers. However, the possibility of subtle, compartmentalized, or slowly evolving neurotoxic processes cannot be excluded. Future longitudinal studies incorporating serial biomarker assessments, advanced neuroimaging, and oxidative stress markers are warranted to clarify the long-term neurological consequences of TOS and to detect subclinical trajectories of delayed neurotoxicity in this population. Full article

This research investigates the role of fossil fuel energy, renewable energy, and education in terms of years of schooling and mean years of schooling on the economic growth of 19 selected Sub-Saharan African countries. The primary objective is to assess whether renewable energy and educational attainment serve as viable long-term drivers of economic development in a region still heavily reliant on fossil fuels. We employed the newly developed and robust econometric estimators, including “Residual Augmented Least Squares (RALS) co-integration”, to estimate long-term links among the facets of study. Moreover, “Pooled Mean Group–Autoregressive Distributed Lag model (PMG-ARDL) and Quantile Autoregressive Distributed Lag (QARDL)” econometric estimator was employed to estimate the long and short coefficients of the antecedents of study. The estimations obtained from the PMG-ARDL and QARDL estimators provide evidence that the coefficients of fossil fuel energy and renewable energy on economic growth are positive. But surprisingly, the magnitude of renewable energy is greater than fossil fuel energy in Sub-Saharan countries that still depend on fossil fuels. Moreover, human capital and capital stock boost economic growth in the countries studied. The outcomes reveal that not only quality but also quantity of education play a vital role in boosting economic development. To deepen the understanding of the observed effects, the study also explores the transmission channels through which renewable energy and education foster economic growth. Renewable energy contributes by lowering the marginal cost of electricity, encouraging green industrial transformation, and serving as a catalyst for technological innovation. Concurrently, improvements in education—measured by both expected and mean years of schooling—elevate labor productivity and facilitate the absorption and diffusion of new technologies across sectors, thereby stimulating sustained economic performance. The empirical results provide valuable insights for government officials and policymakers in specific Sub-Saharan African countries. Full article

This study aimed to investigate the association between socioeconomic status and the difference between the actual and ideal number of children. We used cross-sectional data from the National Fertility Survey for married couples conducted by the National Institute of Population and Social Security Research in 2015 and 2021. Combining files from both years, responses from a total of 12,632 couples were analyzed. A modified Poisson regression model was used to investigate associations between the outcomes and the socioeconomic characteristics of the studied couples. The two outcomes were having fewer children than ideal and having more children than ideal, and their proportions were 47.2% and 3.4%, respectively. Husbands and wives who were high school graduates were less inclined to have fewer children than ideal, and wives who were non-regular workers or unemployed were less inclined to have fewer children than ideal than wives who were regular workers. In addition, couples in the lowest household income group were significantly associated with a higher prevalence of having fewer children than ideal. These results showed being in the lower household income group was associated with a higher prevalence of having fewer children than ideal and suggested the need for support for low-income households. Full article

In recent years, entrepreneurial learning in higher education institutions has been promoted and supported to help students become job creators rather than job seekers. The main purpose of entrepreneurial learning is to develop entrepreneurial competencies in terms of knowledge, skills, and attitudes to attain the entrepreneurial goal of new value creation. This value extends beyond only economic value and job creation; it can, therefore, also benefit students who do not become entrepreneurs but who choose to think entrepreneurially. However, an enduring problem is ensuring that the entrepreneurial learning process is interactive, effective, and meaningful to the students. Correspondingly, self-directed learning (SDL) can be used in higher education to enhance entrepreneurial learning. This paper discusses the analyses of the role and importance of self-directed learning in the process of entrepreneurial learning for students in higher education institutions, informed by an exploratory systematic literature review. The findings reveal that SDL can play an important role in enhancing entrepreneurial learning by initiating the learning process to develop students’ entrepreneurial skills, mindset, motivation, creativity, and innovation, which serve as competencies for success as entrepreneurial thinkers. Based on the findings, the author concludes that SDL plays an important role in enhancing entrepreneurial learning in higher education institutions. Adopting SDL as a key strategy for teaching and learning in higher education can improve the effectiveness of entrepreneurial learning and help develop students into entrepreneurial thinkers. The practical implications are that the use of SDL in entrepreneurial learning can develop a spirit of creativity, create value on several levels, and empower students to become job creators instead of job seekers as higher education institutions prepare them for life after graduation. Full article

Mining has significantly shaped Eastern European economies, particularly during their transition from centrally planned to market-oriented systems. While abundant natural resources can lead to a “resource curse” that hinders economic growth, they also offer opportunities for sustainable development if managed effectively. This study investigates the dynamics of mineral resource rents in Eastern Europe, shaped by economic freedom, urbanization, educational achievement, and international trade, from 1990 to 2021. Using methods such as MMQR, AMG Robustness Analysis, CCEMG, fixed effects, cointegration, Granger causality, and unit root tests, the study provides a comprehensive analysis of these relationships. The findings reveal that educational achievement reduces reliance on mineral resource rents by fostering human capital and supporting economic diversification. Urbanization similarly decreases resource dependency by promoting innovation and technological advancement. Trade openness also shows a negative link with mineral rents, suggesting that global integration facilitates shifts toward more advanced, technology-driven sectors. Economic freedom presents mixed results, highlighting the need for strong governance to ensure sustainable and equitable outcomes. This study is novel in integrating these factors into a unified framework, specifically applied to Eastern Europe’s post-communist transition, a region often overlooked in global resource studies. The results contribute most directly to Sustainable Development Goal 4 on Quality Education by demonstrating how human capital development reduces resource dependence and promotes economic resilience, and to Sustainable Development Goal 8 on Decent Work and Economic Growth, by showing that trade openness and economic diversification can drive sustainable economic progress. Ultimately, the study offers actionable insights for balancing economic growth with environmental and social sustainability in transitional economies. Full article

Understanding the drivers of regional economic growth requires examining the mesoeconomic conditions that influence the ability of small firms to scale. This study investigates how the local composition of firms—by size and sector—along with socio-economic and geographic characteristics, affects the prevalence of Scaled Firms across U.S. labor market areas. Using cross-sectional data from 2022, the analysis applies a log-linear regression model to examine the relationship between the density of micro, midsize, and large firms and the share of Scaled Firms (defined as employing 5–99 workers) within industry sectors. Covariates include household wealth, educational attainment, unemployment, population diversity, and metropolitan classification. The results show that the presence of midsize and large firms, along with regional human capital and economic context, is significantly associated with higher levels of small firm scaling. These findings suggest that the mesoeconomic context plays an important role in shaping regional economic growth outcomes and that the composition of local firm ecosystems may influence a region’s capacity for resilience and inclusive development. Full article

Sinonasal cancer treatment confers extensive and diverse sequela, which may persist for months to years after treatment or manifest as late effects. Furthermore, recurrences are common for some subtypes and may occur beyond five years post-treatment of the initial malignancy. Altogether, these can place a substantial physical, psychosocial, and economic burden on the survivor. Due to the rarity of these cancers, there are limited data to comprehensively elucidate the landscape of treatment-related morbidity in the long term. Furthermore, survivors may lack awareness of the entirety of possible adverse effects, which may exacerbate their long-term psychosocial well-being and quality of life, and delay attainment of appropriate care. To enable the development of patient education strategies and provide clinicians with up-to-date, evidence-based information on the long-term and/or late morbidity associated with sinonasal cancer treatment, a comprehensive review was performed. There is a wide range of issues that survivors face, both due to the sinonasal cancer itself and as a result of the treatment, highlighting the need for multidisciplinary survivorship care. Importantly, survivorship care will greatly benefit from patient and public involvement, alongside input from medical, surgical, and allied health professionals, to ensure that all aspects of care are addressed throughout the survivor journey. Full article

This study examines the relationship between living arrangements and depressive symptoms among community-dwelling older adults in Japan, with a particular focus on gender differences. A cross-sectional survey was conducted in Ayase City, Kanagawa Prefecture, using mailed questionnaires, and the analysis was conducted on data from 1409 participants aged 65 and older. Logistic regression analysis was performed to assess the associations between living arrangements, social networks, social participation, and depressive symptoms, adjusting for sociodemographic and health-related factors. The findings indicate that older adults living alone and those co-residing with their children are particularly vulnerable. Those living alone were more likely to be women aged 75 and older, with economic difficulties, and exhibited higher rates of depressive symptoms and care needs. Similarly, older adults living with their children had a higher prevalence of depressive symptoms and care requirements despite experiencing fewer economic hardships. This group was also characterized by lower educational attainment. Additionally, gender-specific factors were identified in the relationship between social relationships, including living arrangements, and depressive symptoms. These results underscore the necessity of interventions that consider both living arrangements and gender-specific social factors to mitigate mental health risks among older adults. Full article