Search Results (581)

Background and Objectives: This study aimed to evaluate the treatment outcomes of adults with pulmonary drug-susceptible tuberculosis (DS-TB) in Lithuania over 22 years, and to examine associations between treatment outcomes, various risk factors, and temporal trends. Materials and Methods: A retrospective cohort analysis was conducted using data from the National Tuberculosis Information System from 2000 to 2021. A total of 18,697 adult patients with DS-TB were included. Patients were grouped into three time periods: Period I (2000–2007), Period II (2008–2015), and Period III (2016–2021). Treatment outcomes were categorized as successful (treatment completed with recovery) or unsuccessful (patients who encountered treatment failure, died during treatment, or converted to drug-resistant tuberculosis). Associations with individual risk factors, including smoking, alcohol use, comorbidities, and sociodemographic variables, were analyzed. Results: Treatment success rates improved steadily across the study periods: 82.3% in Period I, 84.4% in Period II, and 87.6% in Period III. Mortality rates declined over time but remained substantial: 17.1%, 15.2%, and 12.0% in Periods I, II, and III, respectively. Non-lethal treatment failures decreased slightly (0.6%, 0.4%, and 0.4%). Multivariate analysis identified significant associations between treatment failure and multiple risk factors, including low BMI, male gender, unemployment, homelessness, smoking, alcohol and substance use, and comorbid conditions such as cancer, cardiovascular disease, chronic lung disease, diabetes mellitus, HIV, and renal failure. Conclusions: Treatment outcomes for DS-TB in Lithuania have improved over the past two decades; however, certain modifiable risk factors—such as low BMI, homelessness, substance use, and comorbidities—remain strongly linked to treatment failure. To further improve outcomes, targeted interventions such as nutritional support, housing programs, and integrated addiction services should be prioritized for high-risk groups within national TB control efforts. Full article

Using panel data on 99 Italian provinces in the period between 2005 and 2020, the research investigates the effects of fundamental economic factors on the home sales at the provincial level, in order to build a forecasting model using a non-linear artificial intelligence approach (MLP-Multiple Linear Perceptron neural network). There are multiple objectives to this: (a) to test the hypothesis that national, regional and local fundamentals such as interest rates, income, inflation rate, unemployment and demography affect the activity’s degree of the housing market; (b) to verify the effectiveness of a neural network in describing the dynamics of the real estate market; (c) to build a simulation model capable of predicting the effect of changes in fundamentals, also due to economic policy measures, on the market. Empirical results show that neural networks offer better capabilities than linear models in representing the complex relationships between the economic situation and the real estate market. The study provides useful information for regulators to improve the effectiveness of monetary policy to stabilize real estate markets as well as for stakeholders to draw up scenarios of market development. Full article

Menopausal symptoms can substantially impair women’s quality of life, yet large-scale, population-based data from German-speaking regions are lacking. We used data of a cross-sectional online survey among 26,338 women in Germany, Austria, and Switzerland, using validated instruments such as the Menopause Rating Scale (MRS II), Insomnia Severity Index (ISI), and Alcohol Use Disorders Identification Test (AUDIT-C). Additional questions covered weight change, employment, nutrition, and physical activity. We investigated correlations and group differences using descriptive statistics and univariate tests. The average MRS score was 16.94, with 51% classified as severe discomfort and 15% as requiring treatment. Insomnia was common, with 90.3% reporting at least some degree of sleep disturbance and nearly half (48%) meeting criteria for clinical insomnia. Sleep problems were significantly associated with menopausal symptom severity. No correlations were found between MRS scores and reported nutrition and exercise. Unemployment and weight gain were significantly associated with higher symptom burdens. These findings highlight the considerable health burden faced by menopausal women in the DACH region and suggest a substantial unmet need for clinical and public health interventions. Full article

Interest in empirical studies of monetary policy has grown over the past decade, and particularly since the post COVID-19 pandemic period characterized by a surge in inflation rates in every corner of the globe. Against this backdrop, central banks’ traditional inflation forecast framework has been challenged, leading to renewed analysis of the monetary policy transmission mechanism. Focusing on Tunisia, an emerging small open economy subjected to external shocks, this study focuses on the role played by the monetary authority in the conduct of Tunisia’s monetary policy over the period from 2000 to 2024. This period is characterized by a deceleration of growth and an increase in inflation and unemployment. This work shows also how a VAR model with long-run restrictions justified by economic theory can be usefully applied in the analysis of monetary policy; the effects of the money market rate and other shocks; the relationship between prices and the nominal effective exchange rate; and the relationship between inflation and the output gap. Full article

Online work mediated by digital platforms is prevalent across various sectors, including food delivery, data entry, and professional services. Globally, gig work and the gig economy are growing with improved and increased Internet coverage and mobile phone sales. Sub-Saharan Africa (SSA) is no exception as the online economy expands, albeit unevenly across the many countries in the region. Given that the region is afflicted by poverty, unemployment, and underemployment (especially for youth), low rates of female workforce participation, and a dominant informal economy where labour standards are absent, it is appropriate to consider whether the gig economy can contribute to the Sustainable Development Goals linked to work. Drawing on secondary evidence, this review article considers the potential for the gig economy to contribute to jobs, income, employment standards, gender equity, and training and development. Despite the limited evidence from across the region and the evidence that many gig jobs are precarious and low-paid, it is suggested that gig working has the potential to contribute to the sustainable development of the region. Full article

Severe depression is shaped by complex interactions between public health crises and socioeconomic conditions, yet the spatial and temporal dynamics of these factors remain underexplored. This study investigates the impact of COVID-19 case rates, vaccination rates, and socioeconomic factors on severe depression rates across 1470 counties in the contiguous USA in 2021 and 2022. We combined Ordinary Least Squares (OLS) regression with Multiscale Geographically Weighted Regression (MGWR) to capture both global associations and local geographic variability. Results show that higher COVID-19 case rates in 2021 were associated with increased rates of severe depression in 2022, while higher vaccination rates during the same period were associated with decreased rates of severe depression. However, these associations weakened when using 2022 data, suggesting a temporal lag in the impact on mental health. MGWR analyses revealed regional disparities: COVID-19 case rates had a stronger impact in the Midwest, while vaccination benefits were more pronounced on the West Coast. Additional factors, such as unemployment, limited sunlight exposure, and the availability of mental health resources, also influenced outcomes. These findings underscore the importance of temporally and geographically nuanced approaches to public mental health interventions and support the need for region-specific strategies to address mental health disparities in the wake of public health crises. Full article

Suicide in Japan remains elevated and uneven across regions. We hypothesized that (H1) unemployment and (H2) living alone each increase suicide mortality, and that (H3) their combination yields more-than-additive risk, especially among middle-aged men. Using specially tabulated mortality data (2018–2022) from the Japan Suicide Countermeasures Promotion Center, we cross-classified deaths and denominators into 24 strata by sex, age (20–39, 40–59, ≥60), employment (employed/unemployed), and cohabitation (with others/alone). Five-year average rates per 100,000 were computed; between-group differences were tested with chi-square (Holm-adjusted contrasts). Additive interaction between unemployment and living alone was quantified with the Interaction Contrast (ICR) and Synergy Index (SI), and Akita rates were benchmarked against national strata. Prefecture-level quantification and national benchmarking are rarely reported in Japan. Rates differed significantly across employment-by-cohabitation groups in every sex-by-age stratum (p < 0.001). Unemployment and living alone each elevated risk, with the highest rate reported among unemployed men aged 40–59 who were living alone (317.1; >14× employed, cohabiting peers at 22.1). Additive interaction was strongest in men aged 40–59 (ICR = 198.3; SI = 3.05) and present in men aged 20–39 and ≥60; among women, interaction was most evident at the ages of 40–59 and sub-additive at ≥60. Compounded effects among men were consistently larger in Akita than nationally, whereas the largest absolute burden fell on unemployed men aged ≥60 who were living with others (203 deaths). The novelty of this investigation lies in quantifying additive interaction with national benchmarking and contrasting per capita risk with absolute burden to guide dual-track prevention. The findings are ecological. Full article

Background: Cerebral palsy (CP) is a static, non-progressive brain pathology that affects mobility and musculoskeletal health. Objective: This review aims to describe the pediatric orthopedic management strategy at one specialty center with focus on optimal lifelong mobility function for ambulatory CP. Methods: Beginning in the 1990s, a protocol was developed to proactively monitor children with surgical or conservative interventions. After three decades, we undertook a prospective institutional review, board-approved 25–45-year-old adults callback study. Inclusion criteria were all children treated through childhood who could be located and were willing to return for a full evaluation. Results: Pediatric orthopedic interventions focused on regular surveillance with proactive treatment of progressive deformities. When function was impacted, we utilized multi-level orthopedic surgery guided by instrumented gait analysis. Childhood outcomes of this approach were evaluated through retrospective studies. Results show high correction rates were achieved for planovalgus foot deformity, knee flexion contracture, torsional malalignments, and stiff-knee gait. Our prospective adult callback study evaluated 136 adults with CP, gross motor function classification system levels I (21%), II (51%), III (22%), and IV (7%), with average ages of 16 ± 3 years (adolescent visit) compared with 29 ± 3 years (adult visit). Adults in the study had an average of 2.5 multi-level orthopedic surgery events and 10.4 surgical procedures. Compared with adults without disability, daily walking ability was lower in adults with CP. Adults with CP had limitations in physical function but no increased depression. A higher frequency of chronic pain compared with normal adults was present, but pain interference in daily life was not different. Adults demonstrated similar levels of education but higher rates of unemployment, caregiver needs, and utilization of Social Security disability insurance. Conclusions: The experience from our center suggests that consistent, proactive musculoskeletal management at regular intervals during childhood and adolescence may help maintain in gait and mobility function from adolescence to young adulthood in individuals with CP. Full article

In Poland—especially in the less developed eastern regions—the level of health-enhancing physical activity (HEPA) remains below the WHO recommendations, and its determinants are not yet fully understood. The study was conducted as part of the international EUPASMOS PLUS project on a sample of 173 adult individuals living in eastern Poland. Physical activity was measured using accelerometers worn continuously for seven days (24/7). The duration of moderate and vigorous physical activity as well as episodes of physical activity lasting at least 10 min were analyzed. The median daily MVPA time was 50 min, and the median VPA time only 10 s, both below WHO recommendations of 150 min/week of MVPA or 75 min/week of VPA. Overall, more than 70% of participants did not meet the recommended levels. The level of HEPA was found to be below WHO recommendations, especially among men, individuals over 50 years old, and those who were professionally inactive. Higher physical activity levels were recorded among women and younger participants. Significant correlations were found between HEPA level and self-rated health status (ρ = 0.28–0.38, p < 0.001), as well as body mass index and waist circumference (ρ ≈ −0.20 to −0.30, p < 0.01). Although statistically significant, the effect sizes were small to moderate, indicating limited explanatory power. Unemployment negatively affected MVPA and VPA levels, while household size positively correlated with physical activity. Interventions promoting HEPA should consider demographic and regional diversity, with particular focus on less active groups such as older adults and the unemployed. It is also necessary to develop new screening tools aimed at easy and quick diagnosis of social groups that should be targeted by HEPA promotion strategies. Full article

The global energy landscape is transforming, driven by the urgent need to address climate change, reduce dependency on fossil fuels, and promote sustainable economic growth. Renewable energy sources (RESs) have emerged as a cornerstone of this transition, offering environmental benefits and significant potential to catalyze economic development. By harnessing inexhaustible natural resources, such as solar, wind, hydro, and biomass, renewable energy systems provide a pathway to achieving energy security, fostering innovation, and generating new economic opportunities. In this article, the economic effect on the RES sector development was examined. The authors defined the set from seven indicators: real GDP growth, unemployment rate, inflation rate, exports of goods and services, government debt, foreign direct investments, and labor cost index, which allowed them to evaluate the EU countries’ economic situation and rank the countries by economic stability level. The results, which were obtained using a multi-criteria evaluation method, show that the EU countries whose economies are the strongest according to the evaluated macroeconomic indicators are Luxembourg, Malta, Estonia, and Ireland. The countries with the lowest scores are Greece, Italy, and Spain. Seeking to evaluate the development level of the RES sector in all ranked EU countries, the analysis of RES sector development during the 2012–2022 period, using these RES indicators—share of renewable energy in gross final energy consumption by sector—in general, in transport, in electricity, and in heating and cooling, was carried out and, through a different multi-criteria method, the countries were ranked by RES development. After the analysis was carried out, it could be stated that the economic situation stability in the country does not directly affect the growth of the RES sector development, and the two rankings by different indicators are heavily uncorrelated. RES sector development can be affected by many other circumstances. RES development is still stagnating in some countries, despite macroeconomic stability, for several reasons: institutional and political barriers, differences in the availability of finance, infrastructure limitations, and technological and human resource shortages. Full article

Although there are still significant inequalities, women’s labor force participation has increased in many parts of the world. These disparities are linked to socio-economic, territorial, and institutional conditions, such as access to land, quality of infrastructure, and the availability of decent work in both urban and rural areas. To understand how these socio-economic and spatial factors interact with national economic and policy frameworks is essential for analyzing gender participation in work. In this study, we examine the structural, territorial, and socio-economic factors shaping female labor force participation in 49 countries between 2013 and 2022, covering Europe, Asia, Latin America, and Africa. We investigate the interaction between macroeconomic conditions, public investment in education, and spatial inequalities. In addition, we focus on how these factors work together within different institutional settings. The analysis also considers territorial aspects such as urban–rural differences, regional development issues, and land-related livelihoods. The data were collected from the World Bank’s World Development Indicators to build a balanced panel. We implemented a Bayesian hierarchical panel regression model to understand how economic, institutional, and spatial factors jointly influence women’s participation in the labor force across different national and regional contexts. For model specification, we used standardized predictors and country-level intercepts to allow the model to account for institutional differences. The results indicate that national income levels and female unemployment rates are the most important factors affecting participation. On the other hand, tertiary enrollment and public education spending have weaker or mixed effects. Notably, although more women now complete higher education, many, especially in non-OECD countries, still face barriers to entering formal employment. Furthermore, in many developing countries, women still encounter restricted access to formal and secure jobs, particularly in rural and less developed areas. These findings show that economic growth is not the only factor needed to achieve gender equality in the labor market. Sustainable progress requires plans that bring together labor reforms, better education, care services, and fair growth in all regions. It is also important to fix problems with land, close the gap between cities and villages, and address environmental challenges. By linking labor markets, education, and land-linked spatial constraints, the study informs SDGs 5 (Gender Equality), 8 (Decent Work and Economic Growth), and 10 (Reduced Inequalities). Full article

Identification of temporal relations among suicide mortality and economic/political implementations provides important information for not only planning suicide prevention but also socioeconomic/psychosocial measures. This cross-sectional observation study analyzed temporal fluctuations and causalities of suicide mortalities of working-age individuals, disaggregated by age/gender/social standing (employed/unemployed), in Japan from 2009 to 2024, using government databases, by joinpoint and vector-autoregressive analyses. Suicide mortality among total and employed females decreased until the COVID-19 pandemic outbreak but sharply increased, synchronized with the pandemic outbreak, before resuming a downward trend. Among males, the decreasing trends attenuated from 2016, followed by a transient increase in 2022. Unemployed males aged 40–69 exhibited four joinpoints: 2016 (decreasing–increasing), 2018 (increasing–decreasing), 2022 (decreasing–increasing), and 2023 (increasing–stable). In contrast, suicide mortality among unemployed females aged 40–69 sharply increased in 2022 and maintained the high level. Among individuals aged 30–39, suicide mortality reversed from decreasing to increasing in 2016 (males) and 2018 (unemployed females). Economic expansion was protective for employed individuals but had no significant effect on unemployed populations. The government management instability (AENROP) index was positively associated with suicide mortality among employed and unemployed males and employed females. Unemployed females aged 30–39 were sensitive to AENROP but not economic conditions, while those aged 40–69 were largely unaffected by either. Increasing employment of individuals with psychiatric disabilities was positively associated with suicide mortality among unemployed males (30–69) and females under 40. Positive impacts of the employment rates of individuals with psychiatric disabilities and unemployment enhanced from 2016 and 2022, respectively, whereas the impacts were inconstantly affected by political rather than economic factors. Suicide mortality among unemployed individuals has emerged as a critical public health concern in Japan, with rates more than doubling among males and tripling among females in the 2020s. These findings underscore the need for integrated suicide prevention policies that address both labor market vulnerabilities and psychosocial determinants. Full article

This paper examines a prospect scenario of adopting Child Development Accounts (CDAs) as a social welfare innovation in Jordan. CDAs are considered as an asset-building policy aimed at enhancing financial inclusion and socio-economic well-being. This paper discovers the feasibility of CDAs that have proven successful in several countries, as their potential in Middle Eastern countries, particularly in Jordan, remains unexplored. The application of CDAs in the social welfare system aims to support sustainable asset accumulation and improve the living standards of diverse segments in Jordan by integrating CDAs within the efforts made by Jordan to achieve financial inclusion, alleviate poverty, and supplement household income through asset development. There are opportunities to implement the program in Jordan, including expanding the scope of microfinance, public–private partnerships, and targeted programs for women, youth, and refugees. However, several challenges may hinder its application, including limited financial literacy, high unemployment rates, income inequality, regulatory obstacles, and difficulties in implementing social reforms. The paper contributes to the debate on social welfare policies adopted in developing countries by providing solutions based on global practices in CDA execution and has implications and recommendations for decision makers to achieve economic development. Future research in Middle East and North Africa (MENA) countries should target pilot projects and comparative studies to refine CDA strategies. Full article

The aim of this study, which was conducted on the basis of the convergence hypothesis, is to reveal the convergence problems of Turkey towards the European Union based on the basic indicators of the youth labor market. For this purpose, a large gender-disaggregated data set has been constructed with 29 observation units consisting of the European Union Average, European Union Countries, and Turkey, using the basic indicators of the youth labor market that point to the future, within Eurostat and Ilostat data. The clustering method, which is one of the advanced statistical techniques, was preferred to determine which countries are similar to each other and which are different from each other within the data set. In this study, where non-hierarchical and hierarchical clustering methods were used together, it was concluded that Turkey diverges from the developed countries of the European Union, such as Denmark, Germany, and the Netherlands, and is similar to countries such as the EU (27), Bulgaria, Czechia, and Italy. Along with this result, this study also reveals remarkable gender differences in the indicators for young men and young women in the youth labor market in Turkey, and that Turkey’s main convergence problem towards the European Union is realized in NEET rates. In this context, this study is completed with suggestions for various policy measures to address convergence problems, such as NEET, unemployment of young women, and low labor force participation rates of young women in Turkey, within the scope of sustainable development goals such as quality education and gender equality. Full article

Innovation-driven labor markets play a pivotal role in economic development, yet significant disparities exist in how efficiently countries transform innovation inputs into labor market outcomes. This study addresses the critical gap in benchmarking multi-stage innovation efficiency by developing an integrated framework combining Data Envelopment Analysis (DEA) Super Slack-Based Measure (Super-SBM) for static efficiency evaluation and the Malmquist Productivity Index (MPI) for dynamic productivity decomposition, enhanced with cooperative game theory for robustness testing. Focusing on the top 20 innovative economies over a 5-year period, we analyze key inputs (Innovation Index, GDP, trade openness) and outputs (labor force, unemployment rates), revealing stark efficiency contrasts: China, Luxembourg, and the U.S. demonstrate optimal performance (mean scores > 1.9), while Singapore and the Netherlands show significant underutilization (scores < 0.4). Our results identify a critical productivity shift period (average MPI = 1.325) driven primarily by technological advancements. This study contributes a replicable, data-driven model for cross-domain efficiency assessment and provides empirical evidence for policymakers to optimize innovation-labor market conversion. The methodological framework offers scalable applications for future research in computational economics and productivity analysis. Full article