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Search Results (747)

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Keywords = demographic decline

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19 pages, 656 KiB  
Article
The Effect of Nutritional Education on Nutritional Status and Quality of Life in Patients with Liver Cirrhosis
by Seymanur Tinkilic, Perim Fatma Turker, Can Selim Yilmaz, Meral Akdogan Kayhan, Derya Ari and Dilara Turan Gökce
Healthcare 2025, 13(15), 1905; https://doi.org/10.3390/healthcare13151905 - 5 Aug 2025
Abstract
Objectives: This study aimed to evaluate the effect of nutritional education on nutritional knowledge, nutritional status, and quality of life in patients with liver cirrhosis. Methods: Thirty patients participated. At baseline, assessments were conducted to collect data on demographics, physical activity, anthropometric and [...] Read more.
Objectives: This study aimed to evaluate the effect of nutritional education on nutritional knowledge, nutritional status, and quality of life in patients with liver cirrhosis. Methods: Thirty patients participated. At baseline, assessments were conducted to collect data on demographics, physical activity, anthropometric and biochemical measures, dietary habits, 24 h food intake, nutritional status, quality of life, and nutritional knowledge. Participants received a 30 min face-to-face nutritional education session by a registered dietitian, repeated after one month. A follow-up phone call was conducted one month later to reinforce the education. Final evaluations were completed one month after the call. Results: A significant upward trend was detected in nutritional knowledge scores after the intervention period (from 7.4 ± 2.76 to 9.2 ± 3.45). The physical component of quality of life improved, while the mental component showed a slight decline. Dietary changes included reduced energy and protein intake among females and increased protein intake in males. In both genders, fat intake increased and carbohydrate intake decreased. Biochemical improvements were observed, including significant reductions in gamma-glutamyl transferase, aspartate aminotransferase, alanine aminotransferase, and triglycerides in females and alanine aminotransferase and gamma-glutamyl transferase in males. Conclusions: Structured nutritional education may improve nutritional knowledge, dietary behavior, and biochemical markers in cirrhosis patients. Longer follow-up durations may further enhance these improvements. Full article
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12 pages, 840 KiB  
Article
Baseline Knee Osteoarthritis and Chronic Obstructive Pulmonary Disease as Predictors of Physical Activity Decline: A Five-Year Longitudinal Study in U.S. Adults Using the Disablement Process Framework
by Saad A. Alhammad and Vishal Vennu
Healthcare 2025, 13(15), 1902; https://doi.org/10.3390/healthcare13151902 - 5 Aug 2025
Abstract
Background/Objective: Understanding how chronic conditions such as knee osteoarthritis (OA) and chronic obstructive pulmonary disease (COPD) influence long-term physical activity (PA) is essential for developing condition-specific rehabilitation strategies. This study aimed to examine whether baseline diagnoses of knee OA and COPD are independently [...] Read more.
Background/Objective: Understanding how chronic conditions such as knee osteoarthritis (OA) and chronic obstructive pulmonary disease (COPD) influence long-term physical activity (PA) is essential for developing condition-specific rehabilitation strategies. This study aimed to examine whether baseline diagnoses of knee OA and COPD are independently associated with the trajectories of PA decline over five years in U.S. adults, informed by the disablement process model. Methods: We analyzed data from 855 adults aged ≥45 years enrolled in the Osteoarthritis Initiative (OAI). The participants were categorized into three baseline groups, control (n = 122), knee OA (n = 646), and COPD (n = 87), based on self-reports and prior clinical assessments. PA was measured annually for five years using the Physical Activity Scale for the Elderly (PASE). General linear mixed models assessed changes in PA over time, adjusting for demographic, behavioral, and clinical covariates. Results: Compared to the controls, participants with knee OA had a significant decline in PA over time (β = −6.62; 95% CI: −15.4 to −2.19; p = 0.014). Those with COPD experienced an even greater decline compared to the knee OA group (β = −11.2; 95% CI: −21.7 to −0.67; p = 0.037). These associations persisted after adjusting for age, sex, body mass index, comorbidities, and smoking. Conclusions: Baseline knee OA and COPD were independently associated with long-term reductions in PA. These findings underscore the importance of early, tailored rehabilitation strategies, particularly pulmonary rehabilitation, in preserving functional independence among older adults with chronic conditions. Full article
(This article belongs to the Special Issue Association Between Physical Activity and Chronic Condition)
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20 pages, 357 KiB  
Article
The Association Between Physical Activity and Frailty: China Health and Retirement Longitudinal Study (CHARLS)
by Wupeng Yin, Ximeng Zhao, Ayodele Tyndall and Nan Hu
Int. J. Environ. Res. Public Health 2025, 22(8), 1219; https://doi.org/10.3390/ijerph22081219 - 4 Aug 2025
Abstract
Background: With China’s rapidly aging population, frailty has become a growing concern among older adults. Physical activity (PA) is known to mitigate frailty-related decline, yet few studies have examined these associations longitudinally. Methods: Using five waves (2011–2020) of CHARLS data, we analyzed Chinese [...] Read more.
Background: With China’s rapidly aging population, frailty has become a growing concern among older adults. Physical activity (PA) is known to mitigate frailty-related decline, yet few studies have examined these associations longitudinally. Methods: Using five waves (2011–2020) of CHARLS data, we analyzed Chinese adults aged 60+ to assess the association between frailty—measured by a frailty index (FI)—and PA across various types (light, moderate, vigorous, total, and leisure). A generalized linear mixed-effects model was used, adjusting for demographic, socioeconomic, and health-related factors. Results: All PA types were significantly associated with lower odds of concurrent frailty, including light (OR = 0.37), moderate (OR = 0.37), vigorous (OR = 0.40), total (OR = 0.23), and leisure PA (OR = 0.56). Lagged PA also predicted reduced frailty risk over time, except for light PA. Conclusion: Regular PA is linked to a lower risk of frailty among older Chinese adults. These findings underscore the importance of sustained PA as a strategy to promote healthy aging and inform public health interventions for this population. Full article
20 pages, 1801 KiB  
Article
Territorially Stratified Modeling for Sustainable Management of Free-Roaming Cat Populations in Spain: A National Approach to Urban and Rural Environmental Planning
by Octavio P. Luzardo, Ruth Manzanares-Fernández, José Ramón Becerra-Carollo and María del Mar Travieso-Aja
Animals 2025, 15(15), 2278; https://doi.org/10.3390/ani15152278 - 4 Aug 2025
Abstract
This study presents the scientific and methodological foundation of Spain’s first national framework for the ethical management of community cat populations: the Action Plan for the Management of Community Cat Colonies (PACF), launched in 2025 under the mandate of Law 7/2023. This pioneering [...] Read more.
This study presents the scientific and methodological foundation of Spain’s first national framework for the ethical management of community cat populations: the Action Plan for the Management of Community Cat Colonies (PACF), launched in 2025 under the mandate of Law 7/2023. This pioneering legislation introduces a standardized, nationwide obligation for trap–neuter–return (TNR)-based management of free-roaming cats, defined as animals living freely, territorially attached, and with limited socialization toward humans. The PACF aims to support municipalities in implementing this mandate through evidence-based strategies that integrate animal welfare, biodiversity protection, and public health objectives. Using standardized data submitted by 1128 municipalities (13.9% of Spain’s total), we estimated a baseline population of 1.81 million community cats distributed across 125,000 colonies. These data were stratified by municipal population size and applied to national census figures to generate a model-ready demographic structure. We then implemented a stochastic simulation using Vortex software to project long-term population dynamics over a 25-year horizon. The model integrated eight demographic–environmental scenarios defined by a combination of urban–rural classification and ecological reproductive potential based on photoperiod and winter temperature. Parameters included reproductive output, mortality, sterilization coverage, abandonment and adoption rates, stochastic catastrophic events, and territorial carrying capacity. Under current sterilization rates (~20%), our projections indicate that Spain’s community cat population could surpass 5 million individuals by 2050, saturating ecological and social thresholds within a decade. In contrast, a differentiated sterilization strategy aligned with territorial reproductive intensity (50% in most areas, 60–70% in high-pressure zones) achieves population stabilization by 2030 at approximately 1.5 million cats, followed by a gradual long-term decline. This scenario prioritizes feasibility while substantially reducing reproductive output, particularly in rural and high-intensity contexts. The PACF combines stratified demographic modeling with spatial sensitivity, offering a flexible framework adaptable to local conditions. It incorporates One Health principles and introduces tools for adaptive management, including digital monitoring platforms and standardized welfare protocols. While ecological impacts were not directly assessed, the proposed demographic stabilization is designed to mitigate population-driven risks to biodiversity and public health without relying on lethal control. By integrating legal mandates, stratified modeling, and realistic intervention goals, this study outlines a replicable and scalable framework for coordinated action across administrative levels. It exemplifies how national policy can be operationalized through data-driven, territorially sensitive planning tools. The findings support the strategic deployment of TNR-based programs across diverse municipal contexts, providing a model for other countries seeking to align animal welfare policy with ecological planning under a multi-level governance perspective. Full article
(This article belongs to the Section Animal System and Management)
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21 pages, 3463 KiB  
Article
Soil Sealing, Land Take, and Demographics: A Case Study of Estonia, Latvia, and Lithuania
by Kärt Metsoja, Kätlin Põdra, Armands Auziņš and Evelin Jürgenson
Land 2025, 14(8), 1586; https://doi.org/10.3390/land14081586 - 3 Aug 2025
Viewed by 57
Abstract
Soil sealing and land take are increasingly recognised as critical environmental and land use planning challenges across Europe. Although these issues have received limited attention in Baltic policymaking and the academic literature to date, available data indicate ongoing land consumption despite population decline. [...] Read more.
Soil sealing and land take are increasingly recognised as critical environmental and land use planning challenges across Europe. Although these issues have received limited attention in Baltic policymaking and the academic literature to date, available data indicate ongoing land consumption despite population decline. This study aims to analyse soil sealing patterns in Estonia, Latvia, and Lithuania between 2018 and 2021 using CLC+ Backbone data, linking them to demographic shifts and local planning frameworks. Results reveal that soil sealing increased in nearly all municipalities across the Baltic states, regardless of population trends. The analysis highlights that shrinking municipalities, constrained by limited resources and declining populations, are structurally disadvantaged in terms of land use efficiency, particularly when measured by sealed area per capita. Moreover, this study discusses emerging policy tensions, including the narrowing conceptual gap between land take and soil sealing in the proposed EU Soil Monitoring and Resilience Directive, as well as the risk of overlooking broader land artificialisation. The findings underscore the need for context-sensitive, multi-scalar approaches to land use monitoring and governance, particularly in sparsely populated and demographically imbalanced regions, such as the Baltic states. Full article
(This article belongs to the Special Issue Efficient Land Use and Sustainable Development in European Countries)
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9 pages, 206 KiB  
Article
Examining the Relationship Between Balance and Functional Status in the Geriatric Population
by Eleni Vermisso, Effrosyni Stamou, Garyfallia Tsichli, Ioanna Foteinou and Anna Christakou
Med. Sci. 2025, 13(3), 110; https://doi.org/10.3390/medsci13030110 - 2 Aug 2025
Viewed by 176
Abstract
Background/Objectives: Aging is associated with a gradual decline in physical capabilities, often leading to impaired balance and reduced functional status, which are major contributors to falls in older adults. Although many studies have assessed these variables independently, a limited amount of research has [...] Read more.
Background/Objectives: Aging is associated with a gradual decline in physical capabilities, often leading to impaired balance and reduced functional status, which are major contributors to falls in older adults. Although many studies have assessed these variables independently, a limited amount of research has explored the direct relationship between balance and functional status in a healthy geriatric population. The aim of this study was to investigate the relationship between balance and functional capacity and to assess the influence of demographic factors such as age, comorbidities, smoking status, and history of falls. Methods: A sample of community-dwelling older adults (19 women, 16 men) (n = 35), aged 60 years and above (M = 78 years; SD = 9.23) from Sparta, Greece, took part in the present study. Participants were assessed using three validated tools: (a) the Five Times Sit-to-Stand test, (b) the Timed Up-and-Go test, and (c) the Berg Balance Scale. Spearman’s rank correlation coefficient was used for statistical analysis (α = 0.05). Results: Age was positively correlated with poorer performance in the Five Times Sit-to-Stand (r = 0.40; p < 0.01) and the Timed Up-and-Go test (r = 0.47; p < 0.01) and negatively correlated with Berg Balance Scale scores (r = −0.51; p < 0.01). Comorbidities and smoking were also associated with the Berg Balance Scale. A strong negative correlation was observed between balance and the other two functional tests (Five Times Sit-to-Stand: r = −0.51; Timed Up-and-Go: r = −0.66; both p < 0.01). Conclusions: The findings highlight the importance of evaluating both balance and functional capacity in older adults as interrelated factors that can significantly influence quality of life and fall risk. Future research with larger and more diverse populations is recommended to confirm the present findings and to use exercise programs to prevent falls in the geriatric population. Full article
25 pages, 19905 KiB  
Article
Assessing Urban Park Accessibility via Population Projections: Planning for Green Equity in Shanghai
by Leiting Cen and Yang Xiao
Land 2025, 14(8), 1580; https://doi.org/10.3390/land14081580 - 2 Aug 2025
Viewed by 174
Abstract
Rapid urbanization and demographic shifts present significant challenges to spatial justice in green space provision. Traditional static assessments have become increasingly inadequate for guiding park planning, which now requires a dynamic, future-oriented analytical approach. To address this gap, this study incorporates population dynamics [...] Read more.
Rapid urbanization and demographic shifts present significant challenges to spatial justice in green space provision. Traditional static assessments have become increasingly inadequate for guiding park planning, which now requires a dynamic, future-oriented analytical approach. To address this gap, this study incorporates population dynamics into urban park planning by developing a dynamic evaluation framework for park accessibility. Building on the Gaussian-based two-step floating catchment area (Ga2SFCA) method, we propose the human-population-projection-Ga2SFCA (HPP-Ga2SFCA) model, which integrates population forecasts to assess park service efficiency under future demographic pressures. Using neighborhood-committee-level census data from 2000 to 2020 and detailed park spatial data, we identified five types of population change and forecast demographic distributions for both short- and long-term scenarios. Our findings indicate population decline in the urban core and outer suburbs, with growth concentrated in the transitional inner-suburban zones. Long-term projections suggest that 66% of communities will experience population growth, whereas short-term forecasts indicate a decline in 52%. Static models overestimate park accessibility by approximately 40%. In contrast, our dynamic model reveals that accessibility is overestimated in 71% and underestimated in 7% of the city, highlighting a potential mismatch between future population demand and current park supply. This study offers a forward-looking planning framework that enhances the responsiveness of park systems to demographic change and supports the development of more equitable, adaptive green space strategies. Full article
(This article belongs to the Special Issue Spatial Justice in Urban Planning (Second Edition))
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13 pages, 295 KiB  
Article
Benefits and Harms of Antibiotic Use in End-of-Life Patients: Retrospective Study in Palliative Care
by Rita Faustino Silva, Joana Brandão Silva, António Pereira Neves, Daniel Canelas, João Rocha Neves, José Paulo Andrade, Marília Dourado and Hugo Ribeiro
Antibiotics 2025, 14(8), 782; https://doi.org/10.3390/antibiotics14080782 (registering DOI) - 1 Aug 2025
Viewed by 237
Abstract
Context: Many patients at the end of life receive antibiotics to alleviate symptoms and improve quality of life; however, clear guidelines supporting decision making about the use of antibiotics are still lacking. Objectives: This study aimed to evaluate the benefits and harms of [...] Read more.
Context: Many patients at the end of life receive antibiotics to alleviate symptoms and improve quality of life; however, clear guidelines supporting decision making about the use of antibiotics are still lacking. Objectives: This study aimed to evaluate the benefits and harms of antibiotic use among patients under a palliative care community support team in Portugal. Methods: An observational, cross-sectional, retrospective study was conducted on 249 patients who died over a two-year period, having been followed for at least 30 days prior to their death. Data included patient demographics, clinical diagnoses, antibiotic prescriptions, and symptomatic outcomes. The effects of commonly prescribed antibiotics—amoxicillin + clavulanic acid, cefixime, ciprofloxacin, and levofloxacin—were compared using statistical analyses to assess survival, symptom intensity, and functional scales. Results: Adverse events, primarily infections and secretions, occurred in 57.8% of cases, with 33.7% receiving antibiotics. No significant difference in survival was observed across the antibiotic groups (p = 0.990). Symptom intensity significantly reduced after 72 h of treatment (p < 0.05), with ciprofloxacin demonstrating the greatest symptom control. The Palliative Outcome Scale decreased uniformly, with higher scores associated with amoxicillin + clavulanic acid (p = 0.004). The Palliative Performance Scale declined post-treatment, with significant changes noted for cefixime and ciprofloxacin (p < 0.05). Conclusions: Antibiotics may improve symptom control and quality of life in the end-of-life stage. While second-line antibiotics may offer additional benefits, the heterogeneity of the sample and limited adverse effect data underscore the need for further research to guide appropriate prescription practices in palliative care. Full article
9 pages, 999 KiB  
Article
Assessment of Long-Term Knowledge Retention in Children with Type 1 Diabetes and Their Families: A Pilot Study
by Lior Carmon, Eli Hershkovitz, David Shaki, Tzila Gratzya Chechik, Inna Uritzki, Itamar Gothelf, Dganit Walker, Neta Loewenthal, Majd Nassar and Alon Haim
Children 2025, 12(8), 1016; https://doi.org/10.3390/children12081016 - 1 Aug 2025
Viewed by 126
Abstract
Background: The education process for newly diagnosed Type 1 diabetes mellitus (T1D) patients and their families, primarily led by diabetes specialist nurses, is essential for gaining knowledge about the disease and its management. However, few assessment tools have been employed to evaluate long-term [...] Read more.
Background: The education process for newly diagnosed Type 1 diabetes mellitus (T1D) patients and their families, primarily led by diabetes specialist nurses, is essential for gaining knowledge about the disease and its management. However, few assessment tools have been employed to evaluate long-term knowledge retention among T1D patients years after diagnosis. Methods: We developed a 20-question test to assess the knowledge of patients and their families at the conclusion of the initial education process and again 6–12 months later. Demographic and clinical data were also collected. Statistical analyses included comparisons between the first and second test results, as well as evaluation of potential contributing factors. The internal consistency and construct validity of the questionnaire were evaluated. Results: Forty-four patients completed both assessments, with a median interval of 11.5 months between them. The average score on the first test was 88.6, which declined to 82.7 on the second assessment (p < 0.001). In univariate analysis, factors positively associated with higher scores included Jewish ethnicity, lower HbA1c levels, and shorter hospitalization duration. Multivariate analysis revealed that parents had lower odds of experiencing a significant score decline compared to patients. Cronbach’s alpha was 0.69, and Principal Component Analysis (PCA) identified eight components accounting for 67.1% of the total variance. Conclusions: Healthcare providers should consider offering re-education to patients and their families approximately one year after diagnosis, with particular attention to high-risk populations during the initial education phase. Further studies are needed to examine this tool’s performance in larger cohorts. Full article
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11 pages, 736 KiB  
Article
Size Structure of Hawksbill Turtles (Eretmochelys imbricata) from Taxidermied Specimens in Private Collections Captured Along the Western Coast of the Gulf of California
by Francisco Omar López-Fuerte, Roberto Carmona, Sergio Flores-Ramírez and Melania C. López-Castro
J. Mar. Sci. Eng. 2025, 13(8), 1473; https://doi.org/10.3390/jmse13081473 - 31 Jul 2025
Viewed by 152
Abstract
Human exploitation has been a major driver of marine turtle population declines, particularly affecting naturally scarce species such as the pantropical hawksbill turtle. Although hawksbill sea turtles have been documented in the Gulf of California since the early 20th century, data on their [...] Read more.
Human exploitation has been a major driver of marine turtle population declines, particularly affecting naturally scarce species such as the pantropical hawksbill turtle. Although hawksbill sea turtles have been documented in the Gulf of California since the early 20th century, data on their historical demography during periods of high exploitation in this region are nonexistent. We investigated the size structure of hawksbill turtles from the Western Central Gulf of California by examining a unique sample of decorative taxidermies, corresponding to 31 specimens captured during fishing operations near Santa Rosalía, Baja California Sur, Mexico, between 1980 and 1990. An analysis of the curved carapace measures revealed a length range (nuchal notch to posterior of supracaudals) of 29.5–59.5 cm (mean = 38.75 ± 6.67 cm) and a width range of 25.0–51.5 cm (mean = 33.63 ± 5.66 cm), with 87% of specimens having lengths between 30 and 45 cm. Based on the carapace length measurements, we estimated the ages to be between 7 and 20 years, indicating that the population included juveniles. Our findings provide baseline data for an understudied period and region, suggesting that this area previously served as an important juvenile habitat. These results contribute essential historical demographic information for conservation planning. Full article
(This article belongs to the Section Marine Biology)
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11 pages, 666 KiB  
Article
Low Hepatitis B Immunity Among Ukrainian Refugee Children and Adolescents in Poland: Need for Targeted Screening and Vaccination
by Lidia Stopyra, Karolina Banach, Magdalena Wood, Justyna Stala and Anna Merklinger-Gruchała
Vaccines 2025, 13(8), 816; https://doi.org/10.3390/vaccines13080816 (registering DOI) - 31 Jul 2025
Viewed by 234
Abstract
Background: The 2022 conflict in Ukraine triggered mass migration, leading to a significant influx of Ukrainian refugee children into Poland. This situation raises concerns about hepatitis B virus immunity, as Ukraine’s hepatitis B vaccination coverage has been inconsistent compared to Poland’s high vaccination [...] Read more.
Background: The 2022 conflict in Ukraine triggered mass migration, leading to a significant influx of Ukrainian refugee children into Poland. This situation raises concerns about hepatitis B virus immunity, as Ukraine’s hepatitis B vaccination coverage has been inconsistent compared to Poland’s high vaccination rates. Objective: To evaluate hepatitis B immunity and infection prevalence among Ukrainian refugee children residing in Southern Poland and to assess implications for vaccination strategies in the host country. Methods: A prospective cross-sectional study was conducted on 1322 Ukrainian refugee children (0–18 years) presenting to a pediatric infectious diseases department in Southern Poland between February 2022 and March 2024. Data on vaccination history, demographic characteristics, and selected laboratory parameters, including hepatitis B surface antigen and anti-HBs antibody levels, were collected. Protective immunity was defined as anti-HBs antibody levels ≥10 IU/L. Results: Among the participants (mean age 9.9 years; 50.2% female), 83.2% were reported as vaccinated according to national immunization programs, but only 64.9% demonstrated protective anti-HBs antibody levels. Protective antibody prevalence declined significantly with age, with less than half of adolescents aged 15–18 years showing immunity. Five children (0.4%) were diagnosed with chronic hepatitis B, four of whom were unvaccinated. Conclusions: This study identifies a significant gap in hepatitis B immunity among Ukrainian adolescent refugees residing in Southern Poland, with less than half possessing protective anti-HBs antibody levels. This immunity gap and the high risk of sexual transmission of the hepatitis B virus in adolescents highlight the urgent need for comprehensive surveillance, screening, and catch-up vaccination programs. Full article
(This article belongs to the Special Issue Vaccination, Public Health and Epidemiology)
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13 pages, 822 KiB  
Article
Analysis of Sequential Pneumococcal Vaccination Coverage in the Elderly Resident Population of the Viterbo Local Health Authority from 2018 to 2023
by Andrea Bongiovanni, Giulia Santolini, Francesco Vairo, Francesco Corea, Silvia Aquilani and Chiara de Waure
Vaccines 2025, 13(8), 807; https://doi.org/10.3390/vaccines13080807 - 30 Jul 2025
Viewed by 266
Abstract
Background: Pneumococcal disease is a significant health burden, particularly among older adults and individuals with chronic conditions. Sequential pneumococcal vaccination (PCV13 followed by PPSV23) has been recommended in Italy since 2017 for its demonstrated efficacy, safety, and cost-effectiveness in preventing invasive pneumococcal disease [...] Read more.
Background: Pneumococcal disease is a significant health burden, particularly among older adults and individuals with chronic conditions. Sequential pneumococcal vaccination (PCV13 followed by PPSV23) has been recommended in Italy since 2017 for its demonstrated efficacy, safety, and cost-effectiveness in preventing invasive pneumococcal disease (IPD). Nevertheless, limited data are available on the sequential pneumococcal vaccination coverage in Italy. This study aimed to evaluate the coverage and trends of sequential pneumococcal vaccination among individuals who turned 65 years old within the Viterbo Local Health Authority between 2018 and 2023. Methods: A retrospective cohort study was conducted using data from the Regional Vaccination Registry (AVR), a comprehensive digital vaccination dataset. Vaccination coverage was calculated based on individuals completing the sequential pneumococcal vaccination within two years after turning 65 years old. Trends as well as subgroup variations based on sex, citizenship, district of residence, and municipality size were analyzed. Results: Among 27,657 individuals who turned 65 years of age during the study period, only 2.32% completed the sequential pneumococcal vaccination. Coverage increased steadily from 2018 (0.60%) to a peak in 2020 (3.27%), followed by a plateau and a decline in 2023 (2.53%). Coverage varied across demographic and geographic subgroups: females (2.58%) had higher coverage than males (2.04%), Italian citizens (2.45%) exceeded foreign residents (0.64%), and residents in District C (3.03%) led over District A (1.08%). Smaller municipalities (≤10,000 inhabitants) showed higher coverage (2.52%) than larger ones (1.98%). Conclusions: Adherence to sequential pneumococcal vaccination has been very low throughout the considered study period. This is highly relevant information to consider in the view of new available pneumococcal vaccines for immunization of the elderly. Furthermore, geographic and demographic differences highlight the need for targeted public health interventions. Full article
(This article belongs to the Special Issue Vaccines and Vaccine Preventable Diseases)
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16 pages, 5304 KiB  
Article
Regional Youth Population Prediction Using LSTM
by Jaejun Seo, Sunwoong Yoon, Jiwoo Kim and Kyusang Kwon
Sustainability 2025, 17(15), 6905; https://doi.org/10.3390/su17156905 - 29 Jul 2025
Viewed by 420
Abstract
Regional shrinkage, driven by declining birth rates, an aging population, and population concentration in the capital region, has become an increasingly serious issue in South Korea, threatening the long-term sustainability of local communities. Among various factors, youth out-migration is a key driver, undermining [...] Read more.
Regional shrinkage, driven by declining birth rates, an aging population, and population concentration in the capital region, has become an increasingly serious issue in South Korea, threatening the long-term sustainability of local communities. Among various factors, youth out-migration is a key driver, undermining the economic resilience and vitality of local areas. This study aims to predict youth population trends across 229 municipalities by incorporating diverse regional socioeconomic factors and providing a foundation for policy implementation to mitigate demographic disparities. To this end, a long short-term memory (LSTM) model, based on a direct approach that independently forecasts each future time point, was employed. The model was trained using the youth population data from 2003 to 2022 and socioeconomic variables, including employment, education, housing, and infrastructure. The results reveal a persistent nationwide decline in the youth population, with significantly sharper decreases in local areas than in the capital region. These findings underscore the deepening spatial imbalance and highlight the urgent need for region-specific demographic policies to address the accelerating risk of regional population decline. Full article
(This article belongs to the Section Sustainable Urban and Rural Development)
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25 pages, 687 KiB  
Article
Inter-Municipal Planning as a Framework for Managing Policies for Inner Areas: Insights from the Italian Context
by Alessio Floris and Sergio Serra
Sustainability 2025, 17(15), 6896; https://doi.org/10.3390/su17156896 - 29 Jul 2025
Viewed by 143
Abstract
The socio-economic geography of the Italian territory is framed by strong imbalances in the settlement development, with consequent inequalities in terms of accessibility to essential services. These challenges are most critical in the ‘inner areas’, which are remote from metropolitan and urban centers [...] Read more.
The socio-economic geography of the Italian territory is framed by strong imbalances in the settlement development, with consequent inequalities in terms of accessibility to essential services. These challenges are most critical in the ‘inner areas’, which are remote from metropolitan and urban centers and affected by chronic demographic decline and depopulation. Both European and national policies have relied primarily on financial interventions, often implemented with limited integration into comprehensive urban and territorial planning frameworks. Using a case study methodology, this research examines the area-based strategies of the 72 pilot areas designated under the 2014–2020 program-ming cycle of the National Strategy for Inner Areas (SNAI). The main research question guiding this study is as follows: how does economic planning intersect with territorial governance in Italy’s inner areas, and what is the specific role of local autonomies and the management of core functions, particularly in relation to urban and regional planning? Through this lens, this study proposes a conceptual reframing of the inter-municipal ad-ministrative scale as a strategic framework for promoting more effective territorial policies. Full article
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18 pages, 4697 KiB  
Article
Audouin’s Gull Colony Itinerancy: Breeding Districts as Units for Monitoring and Conservation
by Massimo Sacchi, Barbara Amadesi, Adriano De Faveri, Gilles Faggio, Camilla Gotti, Arnaud Ledru, Sergio Nissardi, Bernard Recorbet, Marco Zenatello and Nicola Baccetti
Diversity 2025, 17(8), 526; https://doi.org/10.3390/d17080526 - 28 Jul 2025
Viewed by 366
Abstract
We investigated the spatial structure and colony itinerancy of Audouin’s gull (Ichthyaetus audouinii) adult breeders across multiple breeding sites in the central Mediterranean Sea during 25 years of fieldwork. Using cluster analysis of marked individuals from different years and sites, we [...] Read more.
We investigated the spatial structure and colony itinerancy of Audouin’s gull (Ichthyaetus audouinii) adult breeders across multiple breeding sites in the central Mediterranean Sea during 25 years of fieldwork. Using cluster analysis of marked individuals from different years and sites, we identified five spatial breeding units of increasing hierarchical scale—Breeding Sites, Colonies, Districts, Regions and Marine Sectors—which reflect biologically meaningful boundaries beyond simple geographic proximity. To determine the most appropriate scale for monitoring local populations, we applied multievent capture–recapture models and examined variation in survival and site fidelity across these units. Audouin’s gulls frequently change their location at the Breeding Site and Colony levels from one year to another, without apparent survival costs. In contrast, dispersal beyond Districts boundaries was found to be rare and associated with reduced survival rates, indicating that breeding Districts represent the most relevant biological unit for identifying local populations. The survival disadvantage observed in individuals leaving their District likely reflects increased extrinsic mortality in unfamiliar environments and the selective dispersal of lower-quality individuals. Within breeding Districts, birds may benefit from local knowledge and social information, supporting demographic stability and higher fitness. Our findings highlight the value of adopting a District-based framework for long-term monitoring and conservation of this endangered species. At this scale, demographic trends such as population growth or decline emerge more clearly than when assessed at the level of singular colonies. This approach can enhance our understanding of population dynamics in other mobile species and support more effective conservation strategies aligned with natural population structure. Full article
(This article belongs to the Special Issue Ecology, Diversity and Conservation of Seabirds—2nd Edition)
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