Search Results (3,726)

The social acceptance of Renewable Energy Sources (RESs) is a decisive factor in the successful implementation of clean energy projects. This study explores the attitudes, demographic profiles, and common misconceptions of citizens in the Region of Epirus, Greece, toward photovoltaic and wind energy installations. Special attention is given to the role of education, age, and access to information—as well as spatial factors such as visual exposure—in shaping public perceptions and influencing acceptance of RES deployment. A structured questionnaire was administered to 320 participants across urban and rural areas, with subdivision between regions with and without visual exposure to RES infrastructure. Findings indicate that urban residents exhibit greater acceptance of RES, while rural inhabitants—especially those in proximity to installations—express skepticism, often grounded in esthetic concerns or perceived procedural injustice. Misinformation and lack of knowledge dominate in areas without visual contact. Statistical analysis confirms that younger and more educated participants are more supportive and environmentally aware. The study highlights the importance of targeted educational interventions, transparent consultation, and spatially sensitive communication strategies in fostering constructive engagement with renewable energy projects. The case of Epirus underscores the need for inclusive, place-based policies to bridge the social acceptance gap and support the national energy transition. Full article

Despite the extensive evidence supporting the effectiveness of cognitive stimulation, differences in results may be due to the influence of cognitive and non-cognitive aspects in people with dementia. The aim of this systematic review is to identify the most reliable variables in forecasting the effectiveness of cognitive stimulation in people with mild to moderate dementia. According to PRISMA guidelines, the research was conducted using five databases (PubMed, Scopus, Cochrane, Web of Science, APA PsycInfo), considering randomized controlled trials. A total of six studies were included. Different aspects moderating the gain resulting from cognitive intervention were collected and assessed in terms of demographic, cognitive, emotional, social, and quality of life parameters. People with dementia benefit more from cognitive intervention if they are female, if they have a low formal education level, a low baseline level of cognitive function, and lower depressive symptoms, and if caregivers actively participate in sessions. Quality of life, if low at baseline, also seems to improve following CST intervention. A deeper understanding of the cognitive and non-cognitive aspects ensuring improvement after cognitive stimulation may guide future research to develop more personalized interventions. Full article

The growing concern over environmental sustainability has intensified the focus on consumers’ perceptions of eco-friendly food packaging, especially among younger generations. This study aims to investigate the attitudes, preferences, and barriers faced by Greek university students regarding sustainable food packaging, a demographic considered pivotal for driving future consumption trends. An online questionnaire assessing perceptions, preferences, and behaviours related to sustainable packaging was administered to students, with responses measured on a five-point Likert scale. Three hundred and sixty-four students took part in this survey, with the majority (60%) of them being female. Principal component analysis was employed to identify underlying factors influencing perceptions, and k-means cluster analysis revealed two consumer segments: “Innovatives”, including one hundred and ninety-eight participants (54%), who demonstrate strong environmental awareness and willingness to adopt sustainable behaviours, and “Sceptics”, including one hundred sixty-six participants (46%), who show moderate engagement and remain cautious in their choices. Convenience, affordability, and clear product communication emerged as significant factors shaping student preferences. The findings suggest that targeted educational campaigns and transparent information are essential to converting positive attitudes into consistent purchasing behaviours. This research provides valuable insights for policymakers and marketers looking to design effective sustainability strategies tailored to the student population. Full article

Globally, technologically integrated housing solutions are increasingly relevant in addressing the challenges of aging populations and sustainable urban development. Drawing on the Technology Acceptance Model (TAM), this research investigates how perceptions of usefulness, ease of use, and attitudes influence relocation intention to smart retirement villages (SRVs), while also examining any significant differences between the socio-demographic variables and such intention. A total of 305 individuals aged 55 and above participated in an online survey, with data analyzed using IBM SPSS Statistics version 27 and AMOS-SEM version 25. The findings reveal that elderly individuals of Chinese ethnicity, those who are married, and those aged between 66 and 70 are more inclined to relocate to SRVs. Attitude and perceived usefulness significantly predict relocation intention, while perceived ease of use exerts an indirect effect through usefulness. These results highlight the importance of integrating user-centered technological design with socio-cultural and demographic considerations in the development of age-friendly built environments. The study offers insights for urban planners, policymakers, and developers seeking to create inclusive and sustainable smart housing solutions for aging populations. Full article

This article aims to analyze the role of migration in the process of the third demographic transition (TDT) in the context of key mediating determinants, such as migrants’ religiosity and economic conditions in the countries of origin and settlement. TDT refers to population changes resulting from migration as a demographic compensatory mechanism in countries with a low total fertility rate (TFR). The study is based on a network analysis of keywords in the scientific literature using the Scopus database and VOSviewer. The results point to three main research approaches to TDT—investigating quantitative population changes, the sociodemographic consequences of migration, and its effect on urbanization—and to the fact that economic and axionormative determinants are under-researched. This article contributes to TDT theory, pointing to the need for that theory to include cultural, economic, and axiological factors as key determinants influencing the permanence of TDT. Full article

The recent surge in the popularity of brachycephalic dog breeds has raised concerns about their predisposition to serious health issues linked to breed-specific morphological traits. This study examined the demographic characteristics, motivations, and awareness of owners regarding welfare issues in four brachycephalic breeds (French Bulldogs, Bulldogs, Pugs, Boston Terriers). Methods: A total of 497 owners of brachycephalic dogs examined over six years at an Italian university veterinary hospital were considered; a subset of 75 owners completed a structured questionnaire. Based on responses to a key multiple-choice question about the main reason for breed choice, owners were classified into three groups: trend-driven (aesthetics/fashion), value-oriented (intelligence/behavior), and indeterminate. Results: Gender distribution did not differ significantly compared to the overall population, but brachycephalic owners were significantly younger (p < 0.001). Value-oriented owners were significantly more likely (p < 0.01) to consult a veterinarian before acquisition and showed better understanding of typical respiratory issues, which did not affect their purchasing decision. Trend-driven owners were more influenced by public figures (p < 0.05) and less engaged in preventive care. Conclusion: Our findings highlight the need for pre-acquisition veterinary counseling. Veterinarians can also assist breeders by promoting awareness of the ethical risks of selecting extreme traits in dogs. Full article

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

The problem associated with the manifestation of burnout syndrome is the subject of ongoing interest. In recent years, occupational burnout has been actively studied among professionals in the helping professions (teachers, physicians, social workers, psychologists, prison officers, etc.). However, the phenomenon has been poorly studied among freelancers. Therefore, the aim of this study is to fill this gap by determining the level of burnout syndrome among Bulgarian freelancers and investigate the influence of some work environment factors on professional burnout in the sample. A survey of 1138 freelancers was carried out using the Burnout Self-Assessment Questionnaire developed by Maslach and a questionnaire developed in-house to explore the factors of the occupational environment and ask questions related to socio-demographic factors. Hypotheses are tested using correlation analysis and structural equation modelling. The study reveals high levels of emotional exhaustion (40.91%, n = 484). High values on the scale of depersonalization were reported for 26,3% of the respondents (n = 311). Only 3.1% of the respondents (n = 37) had high values on the reduced personal accomplishment scale. The high levels of burnout among freelancers could be influenced by the specific characteristics of their work environment and the nature of their tasks. Full article

Background: Social and financial services are essential for the inclusion and well-being of people with disabilities (PWDs), who often rely on family caregivers to access these systems. In Saudi Arabia, where disability inclusion is a strategic goal under Vision 2030, understanding caregiver experiences is crucial to identifying service gaps and improving accessibility. Objectives: This study aimed to explore caregivers’ perspectives on awareness, perceived barriers, and accessibility of social and financial services for PWDs in Saudi Arabia. The analysis is grounded in Andersen’s Behavioural Model of Health Service Use and the WHO’s International Classification of Functioning, Disability and Health (ICF) framework. Methods: A cross-sectional survey was conducted with 3353 caregivers of PWDs attending specialised day schools. The survey collected data on demographic characteristics, service awareness, utilisation, and perceived obstacles. Exploratory Factor Analysis (EFA) identified latent constructs, and Structural Equation Modelling (SEM) was used to test relationships between awareness, barriers, and accessibility. Results: Findings reveal that over 70% of caregivers lacked awareness of available services, and only about 3% had accessed them. Key challenges included technological barriers, complex procedures, and non-functional or unclear service provider platforms. Both User Barriers and Service Barriers were negatively associated with Awareness and Accessibility. Awareness, in turn, significantly predicted perceived Accessibility. Caregiver demographics, such as age, education, gender, and geographic location, also influenced awareness and service use. Conclusions: There is a pressing need for targeted awareness campaigns, accessible digital service platforms, and simplified service processes tailored to diverse caregiver profiles. Inclusive communication, decentralised outreach, and policy reforms are necessary to enhance service access and promote the societal inclusion of PWDs in alignment with Saudi Arabia’s Vision 2030. Full article

Population aging poses significant challenges to the sustainability of pension systems. This study presents an integrated methodological approach that uniquely combines actuarial life-cycle modeling with agent-based simulation to assess the potential of Reverse Mortgage Loans (RMLs) as a dual lever for enhancing retiree welfare and supporting pension system resilience under demographic and financial uncertainty. We explore Reverse Mortgage Loans (RMLs) as a potential financial instrument to support retirees while alleviating pressure on public pensions. Unlike prior research that treats individual decisions or policy outcomes in isolation, our hybrid model explicitly captures feedback loops between household-level behavior and system-wide financial stability. To test our hypothesis that RMLs can improve individual consumption outcomes and bolster systemic solvency, we develop a hybrid model combining actuarial techniques and agent-based simulations, incorporating stochastic housing prices, longevity risk, regulatory capital requirements, and demographic shifts. This dual-framework enables a structured investigation of how micro-level financial decisions propagate through market dynamics, influencing solvency, pricing, and adoption trends. Our central hypothesis is that reverse mortgages, when actuarially calibrated and macroprudentially regulated, enhance individual financial well-being while preserving long-run solvency at the system level. Simulation results indicate that RMLs can improve consumption smoothing, raise expected utility for retirees, and contribute to long-term fiscal sustainability. Moreover, we introduce a dynamic regulatory mechanism that adjusts capital buffers based on evolving market and demographic conditions, enhancing system resilience. Our simulation design supports multi-scenario testing of financial robustness and policy outcomes, providing a transparent tool for stress-testing RML adoption at scale. These findings suggest that, when well-regulated, RMLs can serve as a viable supplement to traditional retirement financing. Rather than offering prescriptive guidance, this framework provides insights to policymakers, financial institutions, and regulators seeking to integrate RMLs into broader pension strategies. Full article

Background/Objectives: Antibiotic prophylaxis is a key component of infection prevention strategies. This study aimed to evaluate whether the duration of antibiotic prophylaxis influences the incidence of HAIs in patients undergoing elective colorectal surgery. Methods: This prospective cohort study included 278 adult patients who underwent elective colorectal surgery at a single tertiary care center. Patients were categorized into two groups based on the duration of antibiotic prophylaxis: one day or more than one day. Data on demographics, clinical characteristics, perioperative variables, and infection outcomes were collected. Results: The overall incidence of HAIs was 16.9%, with no significant difference between patients receiving one-day versus extended antibiotic prophylaxis. However, traditional multivariate analysis showed that prophylaxis lasting more than one day was independently associated with a significantly lower risk of HAI (RR = 0.30, 95% CI: 0.12–0.75, p = 0.010) and surgical site infections (RR = 0.24, 95% CI: 0.08–0.72, p = 0.011). After adjusting for confounders using propensity score matching, this association was no longer statistically significant. No significant association was found between prophylaxis duration and urinary tract infections. Regarding antibiotic selection, first-generation cephalosporins were the most commonly used agents, accounting for 78.8% of prophylactic prescriptions. This was followed by fluoroquinolones (14.4%) and third-generation cephalosporins (5.0%). All patients received metronidazole, a nitroimidazole-class antimicrobial, in combination with the above agents. Conclusions: One day of prophylactic antibiotics may be sufficient in SSI prevention in patients undergoing elective colorectal surgery. The use of extended antibiotic prophylaxis beyond one day should be considered for high-risk patients at high risk of infection, particularly those requiring ICU care. Full article

The population dynamics of high-altitude mountainous areas are shaped by a complex interplay of socioeconomic and environmental drivers. Despite their significance, such regions have received limited scholarly attention. This research identifies and examines the principal determinants of population changes in the high-altitude mountainous zones of Sichuan Province, China. Utilizing a robust quantitative framework, we introduce the Sustainable Population Migration Index (SPMI) to systematically analyze the migration potential over two decades. The findings indicate healthcare accessibility as the most significant determinant influencing resident and rural population changes, while economic factors notably impact urban populations. The SPMI reveals a pronounced deterioration in migration attractiveness, decreasing by 0.27 units on average from 2010 to 2020. Furthermore, a fixed-effects panel regression confirmed the predictive capability of SPMI regarding population trends, emphasizing its value for demographic forecasting. We also develop a Digital Twin-based Simulation and Decision-support Platform (DTSDP) to visualize policy impacts effectively. Scenario simulations suggest that targeted enhancements in healthcare and infrastructure could significantly alleviate demographic pressures. This research contributes critical insights for sustainable regional development strategies and provides an effective tool for informed policymaking. Full article

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

Membranous nephropathy (MN) is the most prevalent cause of nephrotic syndrome (NS) in adults, and it can be primary (idiopathic) with an unknown cause or secondary due to a variety of conditions (lupus, infections, malignancies, medications, etc.). It progresses to chronic kidney disease (CKD) in up to 60% of patients, and 10 to 30% develop end-stage kidney disease (ESKD). This retrospective study examines the importance of specific factors, including baseline demographic and clinical data, kidney biopsy PH findings, and selected biochemical parameters, influencing MN outcomes after 10 years of follow-up. The cohort included 94 individuals in whom a diagnosis of MN was established by percutaneous biopsy of the left kidney’s lower pole at the University Clinical Center of Serbia (UCCS) between 2008 and 2013. According to the outcomes, patients were divided into three groups: the recovery (Rec) group, with complete remission, including normal serum creatinine (Scr) and proteinuria (Prt), the group with development of chronic kidney disease (CKD), and the group with development of end-stage kidney disease (ESKD). Nephropathologists graded pathohistological (PH) results from I to III based on the observed PH findings. During the follow-up period, 33 patients were in the Rec group, CKD developed in 53 patients, and ESKD developed in 8 patients. Baseline creatinine clearance levels (Ccr), Scr, and uric acid (urate) were found to be significantly associated with the outcomes (p < 0.001). The lowest values of baseline Scr and urate were observed in the Rec group. The presence of acute kidney injury (AKI) or CKD at the time of kidney biopsy was associated with the more frequent development of ESKD (p = 0.02). Lower Ccr was associated with a higher likelihood of progressing to CKD (B = −0.021, p = 0.014), whereas older age independently predicted progression to ESKD (B = 0.02, p = 0.032). Based on this study, it was concluded that the most important biochemical and clinical factors that are associated with the outcomes of this disease are the values of Scr, Ccr, and urate and the existence of CKD at the time of kidney biopsy. Unlike most previous studies, the presence of HTN had no statistical significance in the outcome of the disease. Full article

This study investigates the factors influencing school trip mode choice among senior high school students in the Chiang Rai urban area, Chiang Rai, Thailand, under normal and adverse weather conditions. Utilizing data from 472 students across six extra-large urban schools, a Multinomial Logit (MNL) regression model was applied to examine the effects of socio-demographic attributes, household vehicle ownership, travel distance, and spatial variables on mode selection. The results revealed notable modal shifts during adverse weather, with motorcycle usage decreasing and private vehicle reliance increasing, while school bus usage remained stable, highlighting its role as a resilient transport option. Car ownership emerged as a strong enabler of modal flexibility, whereas students with limited access to private transport demonstrated reduced adaptability. Additionally, increased waiting and travel times during adverse conditions underscored infrastructure and service vulnerabilities, particularly for mid-distance travelers. The findings suggest an urgent need for transport policies that promote inclusive and climate-resilient mobility systems, particularly in the context of Chiang Rai, including expanded school bus services, improved first-mile connectivity, and enhanced pedestrian infrastructure. This study contributes to the literature by addressing environmental variability in school travel behavior and offers actionable insights for sustainable transport planning in secondary cities and border regions. Full article