Search Results (4,452)

This study examines the impact of personal remittances on housing prices in European Union (EU) countries, while also accounting for a broader set of macroeconomic, demographic, and structural variables. Using annual data for 27 EU countries from 2007 to 2022, we employ a comprehensive panel econometric approach, including cross-sectional dependence tests, second-generation unit root tests, pooled mean group–autoregressive distributed lag (PMG-ARDL) estimation, and panel causality tests, to capture both short- and long-term dynamics. Our findings confirm that remittances significantly and positively influence long-term housing price levels, underscoring their relevance as a demand-side driver. Other key variables such as net migration, GDP, travel credit to GDP, economic freedom, and real effective exchange rates also contribute to housing price movements, while supply-side indicators, including production in construction and building permits, exert moderating effects. Moreover, real interest rates are shown to have a significant long-term negative effect on property prices. The analysis reveals key causal links from remittances, FDI, and net migration to housing prices, highlighting their structural and predictive roles. Bidirectional causality between economic freedom, housing output, and prices indicates reinforcing feedback effects. These findings position remittances as both a development tool and a key indicator of real estate dynamics. The study highlights complex interactions between international financial flows, demographic pressures, and domestic economic conditions and the need for policymakers to consider remittances and migrant investments in real estate strategies. These findings offer important implications for policymakers seeking to balance housing affordability, investment, and economic resilience in the EU context and key insights into the complexity of economic factors and real estate prices. Importantly, the analysis identifies several causal relationships, notably from remittances, FDI, and net migration toward housing prices, underscoring their predictive and structural importance. Bidirectional causality between economic freedom and house prices, as well as between housing output and pricing, reflects feedback mechanisms that further reinforce market dynamics. These results position remittances not only as a developmental instrument but also as a key signal for real estate market performance in recipient economies. Full article

Background: Patient safety culture is critical for enhancing the quality and safety of healthcare. Studies in low- and middle-income countries have reported challenges in developing patient safety culture, especially in implementing nonpunitive responses to errors and event reporting. However, evidence from Laos remains limited. Objectives: This study aimed to assess patient safety culture in hospitals in southern Laos, using a validated survey tool to identify strengths and areas of improvement. Methods: A cross-sectional study using purposive sampling was conducted in four provincial and twenty-three district hospitals in southern Laos. Healthcare workers on patient safety committees responded to the Hospital Survey on Patient Safety Culture. The positive response rate was analyzed. Bivariate tests (chi-square/Fisher’s exact) were applied to compare positive response rates between hospital types and professions. Results: A total of 253 valid responses (75.5%) were analyzed. “Organizational Learning–Continuous Improvement” scored over 75% in both provincial and district hospitals. In contrast, “Nonpunitive Response to Error” and “Frequency of Events Reported” were scored <20% on average. Provincial hospitals scored significantly higher than district hospitals in supervisory support and handoffs. Conclusions: This study illustrated strengths in organizational learning while identifying nonpunitive responses and event reporting as critical areas of improvement for hospitals in Laos. To improve patient safety, hospitals in Laos must promote a culture in which errors can be reported without fear of blame. Strengthening leadership support and reporting systems is essential. These findings can inform strategies to enhance patient safety in other low-resource healthcare settings. Full article

Fintech and government effectiveness are encouraged to be considered in the campaign towards renewable energy transition. However, the literature on these factors is tilted towards their impact on carbon emissions and less on fintech and energy transition. To address this significant gap in the literature, this current study employs the Cross-Sectional Autoregressive Distributed Lag (CS-ARDL) to estimate the influence of fintech and government effectiveness on renewable energy transition and carbon emissions in selected Asian countries. The results reveal that in the long and short terms, government effectiveness encourages the transition to renewable energy; however, government effectiveness effect on carbon emissions is insignificant in both terms. Nevertheless, fintech is statistically not significant in affecting the renewable energy transition and carbon emissions. Based on the study findings, it is recommended that a strong governance system is required to achieve a clean energy transition. Full article

Objectives: In view of a lack of evidence on the subject, we aimed to perform a scoping review to understand the impact of health education among people attending mass gatherings. Methods: We followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) Guidelines. PubMed, EMBASE, Scopus, and Cochrane Library were searched from inception to March 2025 to identify eligible studies. Observational and interventional studies that reported the impact of health education on any health-related outcome among those attending a mass gathering were considered. A narrative synthesis of review results was performed to gather evidence. Recommendations were framed in the context of this evidence. Results: Of the 1731 records, only 17 studies met the inclusion criteria. These included cross-sectional (n = 10), pre-post design (n = 3), quasi-experimental (n = 2), randomized controlled trial (n = 1), and ethnographic (n = 1) studies. These studies involved participants attending hajj, umrah, and basketball events. The current evidence on health education in mass gatherings is highly varied in its objectives, intervention strategy, educational plan, mode of delivery, design, and reported outcomes. Most studies agreed that health education should be initiated by the country of origin and continued throughout the event. It is recommended that this education should be tailored to patient needs based on age, medical condition, and other personal factors, and given in the local language for better acceptability. Such sources can be provided in various forms, either online or offline, as per the participant’s convenience. Conclusions: The current evidence on the effectiveness of health education during mass gatherings, particularly in pilgrimage settings, is varied and inconsistent. Participant-tailored health education should be provided, preferably in the local language, through convenient formats. Full article

The proliferation of social media has paradoxically facilitated the widespread dissemination of fake news, impacting individuals, politics, economics, and society as a whole. Despite the increasing scholarly research on this phenomenon, a significant gap exists regarding its dynamics in developing countries, particularly how predictors of fake news sharing interact, rather than merely their net effects. To acquire a more nuanced understanding of fake news sharing behavior, we propose identifying the direct and complex interplay among key variables by utilizing a dual analytical framework, leveraging Structural Equation Modeling (SEM) for linear relationships and Fuzzy-Set Qualitative Comparative Analysis (fsQCA) to uncover asymmetric patterns. Specifically, we investigate the influence of news-find-me orientation, social media trust, information-sharing tendencies, and status-seeking motivation on the propensity of fake news sharing behavior. Additionally, we delve into the moderating influence of social media literacy on these observed effects. Based on a cross-sectional survey of 1028 Haitian social media users, the SEM analysis revealed that news-find-me perception had a negative but statistically insignificant influence on fake news sharing behavior. In contrast, information sharing exhibited a significant negative association. Trust in social media was positively and significantly linked to fake news sharing behavior. Meanwhile, status-seeking motivation was positively associated with fake news sharing behavior, although the association did not reach statistical significance. Crucially, social media literacy moderated the effects of trust and information sharing. Interestingly, fsQCA identified three core configurations for fake news sharing: (1) low status seeking, (2) low information-sharing tendencies, and (3) a unique interaction of low “news-find-me” orientation and high social media trust. Furthermore, low social media literacy emerged as a direct core configuration. These findings support the urgent need to prioritize social media literacy as a key intervention in combating the dissemination of fake news. Full article

This study intends to provide insights and challenges for the shape of the B movement, an emerging paradigm that fosters cross-sectoral partnerships and encourages ethical business practices through so-called purpose-driven businesses. Focusing on Italy, the first European country to adopt this managerial model, the research investigates Italian Benefit Corporations, known as Società Benefit (SB), and their most appealing sustainability claims from a consumer perspective. The analysis intends to inform theory development by assuming the cultural and creative industry (CCI) as a field of interest, utilizing a within-subjects experimental design to analyze data from a diverse consumer sample across various contexts. The results indicate that messaging centered on economic sustainability emerged as the most effective in generating positive consumer responses, highlighting a prevailing inclination toward pragmatic factors such as affordability, economic accessibility, and tangible benefits rather than social issues. While sustainable behaviors are not yet widespread, latent ethical sensitivity for authentic, value-driven businesses suggests that economic and ethical dimensions can be strategically synthesized to enhance consumer engagement. This insight highlights the role of BCs in catalyzing a shift in consumption patterns within ethical-based and creative-driven sectors. Full article

Where we find and form identity and belonging, meaning and purpose, is often entangled in the dynamics that play out between people and place, and for Aboriginal and Torres Strait Islander Peoples, the legacy and ongoing experience of invasion and colonisation. Place-based understandings of identity and its importance in shaping young people’s experience of what is possible and probable in their futures might be critical to framing cross-cultural work with young people impacted by violence and trauma. This paper draws on practitioner reflections of work with young Aboriginal women both on, and off Country, highlighting common and distinct themes related to identity formation and migration in navigating new futures. These include connection to Country and spiritual connection, family and kinship relationships, Women’s Business and felt cultural safety. The findings illustrate a meaningful parallel instructive to practice; for both young women and practitioners, access to cultural knowledge and connection is strengthened by endorsement and in turn strengthens understanding and experienced safety. This work emphasises the importance of creating culturally connected opportunities, sensitive to dynamics of place, to support positive identity expression and wellbeing. Full article

Although organizational resilience is well established, refining the systematic quantitative evaluation of health systems resilience (HSR) remains an ongoing opportunity for advancement. Research either focuses on individual HSR indicators, such as social welfare policy, public expenditure, health insurance, healthcare quality, and technology, or broadly examines socio-economic factors, highlighting the need for a more comprehensive methodological approach. This study employed the Slacks-Based Measure (SBM) within Data Envelopment Analysis (DEA) to analyze efficiency by maximizing outputs. It systematically examined key HSR factors across countries, providing insights for improved policymaking and resource allocation. Taking a five-year (2016–2020) dataset that covered 55 to 56 countries and evaluating 17 indicators across governance, health systems, and economic aspects, the paper presents that all sixteen top-ranked countries with a perfect efficiency score of 1 belonged to the high-income group, with ten in Europe, highlighting regional HSR differences. This paper concludes that adequate economic resources form the foundation of HSR and ensure stability and sustained progress. A properly supported healthcare workforce is essential for significantly enhancing health systems and delivering quality care. Last, effective governance and the equitable allocation of resources are crucial for fostering sustainable development and strengthening HSR. Full article

Background and Objectives: The uric acid to HDL-cholesterol ratio (UHR) has recently emerged as a promising biomarker reflecting systemic inflammation and metabolic disturbances. Elevated liver transaminases are clinical indicators of hepatic injury and underlying metabolic dysfunction. Many Middle Eastern countries face constrained clinical and laboratory resources, where access to comprehensive diagnostic tools may be limited. In such settings, identifying simple and easily accessible markers could offer significant practical value in detecting and monitoring health disorders. This study investigates the potential association between UHR and elevated liver transaminases levels in the Saudi general population. Materials and Methods: This retrospective cross-sectional study included 9618 subjects, and the association between the UHR and elevated liver transaminases, alanine transaminase (ALT), and aspartate transaminase (AST), was comprehensively analysed. In addition, the study assessed risk indicators including the prevalence ratio (PR) and odds ratio (OR) as well as the diagnostic accuracy of UHR and C-reactive protein (CRP) in detecting liver transaminases abnormalities, with analyses stratified by age and gender. Results: UHR was significantly elevated in subjects with increased ALT and AST activities, and this pattern was consistent across all age and gender categories. High UHR was significantly associated with elevated ALT (OR = 2.32, 95% CI: 2.12–2.53, p < 0.001) and AST (OR = 1.38, 95% CI: 1.25–1.52, p < 0.001), with stronger associations observed in males and for ALT activity. In addition, elevated UHR was more prevalent among individuals with increased liver transaminase activities. Receiver operating characteristic (ROC) analysis showed that UHR outperformed CRP in identifying elevated liver transaminases, with better discriminative ability for ALT than AST activity. Conclusions: These findings highlight a significant association between UHR and liver transaminase abnormalities in the general population, underscoring the potential utility of UHR as a simple and accessible indicator for liver function assessment in clinical settings. Full article

Background: Breast cancer is the most prevalent malignancy among women globally. In Romania, it is the most frequent form of cancer affecting women, with approximately 12,000 new cases diagnosed annually, and the second most common cause of cancer-related mortality, second only to lung cancer. Methods: This study looked at 79 breast cancer patients from Oltenia, concentrating on epidemiology, histology, diagnostic features, and treatments. Patients were chosen based on inclusion criteria such as histopathologically verified diagnosis, availability of clinical and treatment data, and follow-up information. The analyzed biological material consisted of tissue samples taken from the breast parenchyma and axillary lymph nodes. Even though not the primary subject of this paper, all patients underwent immunohistochemical (IHC) evaluation both preoperatively and postoperatively. Results: We found invasive ductal carcinoma to be the predominant type, while ductal carcinoma in situ (DCIS) and mixed types were rare. We performed cross-tabulations of metastasis versus nodal status and age versus therapy type; none reached significance (all p > 0.05), suggesting observed differences were likely due to chance. A chi-square test comparing surgical interventions (breast-conserving vs. mastectomy) in patients who did or did not receive chemotherapy showed, χ² = 3.17, p = 0.367, indicating that chemotherapy did not significantly influence surgical choice. Importantly, adjuvant chemotherapy and radiotherapy were used at similar rates across age groups, whereas neoadjuvant hormonal (endocrine) therapy was more common in older patients (but without statistical significance). Conclusions: Finally, we discussed the consequences of individualized care and early detection. Romania’s shockingly low screening rate, which contributes to delayed diagnosis, emphasizes the importance of improved population medical examination and tailored treatment options. Also, the country has one of the lowest rates of mammography uptake in Europe and no systematic population screening program. Full article

Background: Point-of-care ultrasound (POCUS) is gaining recognition as a valuable diagnostic tool in various fields of medicine, including pediatrics. Its application at the point of care enables real-time clinical decision-making, which is particularly advantageous in pediatric settings. Although global interest in POCUS is growing, many European countries—including Poland—still lack formal training programs for POCUS at both the undergraduate and postgraduate levels. Nevertheless, the number of pediatricians incorporating POCUS into their daily clinical practice in Poland is increasing. However, the extent of its use and perceived value among pediatricians remains largely unknown. This study aimed to evaluate the current level of POCUS utilization in pediatric care in Poland, focusing on pediatricians’ self-assessed competencies, perceptions of its clinical utility, and key barriers to its implementation in daily practice. Methods: This cross-sectional study was conducted between July and August 2024 using an anonymous online survey distributed to pediatricians throughout Poland via national professional networks, with a response rate of 7.3%. Categorical variables were analyzed using the chi-square test of independence to assess the associations between key variables. Quantitative data were analyzed using descriptive statistics, and qualitative data from open-ended responses were subjected to a thematic analysis. Results: A total of 210 pediatricians responded. Among them, 149 (71%) reported access to ultrasound equipment at their workplace, and 89 (42.4%) reported having participated in some form of POCUS training. Only 46 respondents (21.9%) reported frequently using POCUS in their clinical routine. The self-assessed POCUS competence was rated as low or very low by 136 respondents (64.8%). While POCUS was generally perceived as a helpful tool in facilitating and accelerating clinical decisions, the main barriers to implementation were a lack of formal training and limited institutional support. Conclusions: Although POCUS is perceived as clinically valuable by the surveyed pediatricians in Poland, its routine use remains limited due to training and systemic barriers. Future efforts should prioritize the development of a validated, competency-based training framework and the implementation of a larger, representative national study to guide the structured integration of POCUS into pediatric care. Full article

Background/Objectives: The social importance of health literacy (HL) is widely understood, and its measurement is the subject of various studies. Due to the recent pandemic, several instruments for measuring HL about COVID-19 have been proposed in different countries, including the HLS-COVID-Q22 questionnaire. The diversity of cultures and languages necessitates the cross-cultural adaptation of this instrument. Thus, the present study translates, adapts, and validates the psychometric properties of the HLS-COVID-Q22 questionnaire to provide its cross-cultural adaptation from English to Spanish (Peru). Methods: As part of ensuring that the final questionnaire accommodates the cultural nuances and idiosyncrasies of the target language, the following activities were carried out: (a) a survey of 40 respondents; and (b) a focus group with 10 participants, followed by expert approval. In addition, the validity and reliability of the health instrument have been ascertained through a further pilot test administered to 490 people in the city of Tacna in southern Peru. Results: The resulting questionnaire helps measure HL in Peru, aiding better-informed decision-making for individual health choices. Conclusions: The presence of such a tool is advantageous in case of similar global health emergencies, when the questionnaire can be made readily available to support a promotion of strategies towards better self-care. Moreover, it encourages other Latin American stakeholders to adjust the instrument to their own cultural, language, and socio-economic contexts, thus invigorating the regional and global expansion of the HL study network. Full article

The study investigates the contribution of technology (TECH), quantified by Internet penetration, in influencing tourism performance (TP) among the top ten touristic nations in Europe: France, Spain, Italy, Turkey, the United Kingdom, Germany, Greece, Austria, Portugal, and the Netherlands. Using panel data from 2000–2022, the study includes additional structural controls like environment quality, gross domestic production (GDP) per capita, exchange rate (ER), and safety index (SI). The Method of Moments Quantile Regression (MMQR) is employed to capture heterogeneous effects at different levels of TP, and Driscoll–Kraay standard error (DKSE) correction is employed to make the analysis robust against autocorrelation as well as cross-sectional dependence. Spectral–Granger causality tests are also conducted to check short- and long-run dynamics in the relationships. Empirical results are that TECH and SI are important in TP at all quantiles, but with stronger effects for lower-performing countries. Environmental quality (EQ) and GDP per capita (GDPPC) exert increasing impacts at upper quantiles, suggesting their importance in sustaining high-level tourism economies. ER effects are limited and primarily short-term. The findings highlight the need for integrated digital, environmental, and economic policies to achieve sustainable tourism development. The paper contributes to tourism research by providing a comprehensive, frequency-sensitive, and distributional analysis of macroeconomic determinants of tourism in highly developed European tourist destinations. Full article

Educational admission systems, particularly in developing countries, often suffer from opaque decision processes, unstructured data, and limited analytic insight. This study proposes a novel methodology that integrates structural causal models (SCMs), ontological modeling, and machine learning to uncover and apply interpretable knowledge from an admission database. Using a dataset of 12,043 records from Benue State Polytechnic, Nigeria, we demonstrate this approach as a proof of concept by constructing a domain-specific SCM ontology, validate it using conditional independence testing (CIT), and extract features for predictive modeling. Five classifiers, Logistic Regression, Decision Tree, Random Forest, K-Nearest Neighbors (KNN), and Support Vector Machine (SVM) were evaluated using stratified 10-fold cross-validation. SVM and KNN achieved the highest classification accuracy (92%), with precision and recall scores exceeding 95% and 100%, respectively. Feature importance analysis revealed ‘mode of entry’ and ‘current qualification’ as key causal factors influencing admission decisions. This framework provides a reproducible pipeline that combines semantic representation and empirical validation, offering actionable insights for institutional decision-makers. Comparative benchmarking, ethical considerations, and model calibration are integrated to enhance methodological transparency. Limitations, including reliance on single-institution data, are acknowledged, and directions for generalizability and explainable AI are proposed. Full article

Air pollution is linked to childhood mortality and morbidity in low- and middle-income countries globally. There is growing evidence linking air pollution to asthma and other respiratory diseases in children. Studies have shown that children are likely to experience asthma due to their narrow airways and their heightened sensitivity to environmental irritants. This study aims to investigate the relationship between ambient air pollution and respiratory diseases in children under the age of 5. The study will be conducted in the informal township of Alexandra, north of Johannesburg, South Africa. A quantitative approach will be used in this cross-sectional analytical study. Data will be collected using different tools that include a questionnaire to determine the prevalence of asthma and respiratory disease and potential risk factors. While environmental air pollution will be measured using Radiello passive samplers and Gillian pumps. Data will be analyzed using the latest version of the STATANow/MP 19.5 software. Furthermore, health risk assessment will be conducted for lifetime non-carcinogenic and carcinogenic risk estimation following the USEPA framework. The study will identify environmental triggers that exacerbate asthma and other respiratory conditions in other similar community settings and will contribute to the body of knowledge in public health. Ethical approval was obtained from the Research Ethics Committee, Faculty of Health Sciences at the University of Johannesburg. Full article