Search Results (5,924)

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

Pediatric palliative care (PPC) aims to enhance the quality of life of children with life-limiting conditions and their families through individualized, interdisciplinary support. Among this population, children with neurological diseases represent a substantial and growing group, often facing prolonged disease courses, cognitive impairment, and high prognostic uncertainty. Effective communication is central to PPC; however, it remains deeply influenced by cultural, religious, and spiritual frameworks that shape family perceptions of illness, suffering, and decision-making. This narrative review explores communication strategies in PPC, with a specific focus on children with neurological conditions, highlighting conceptual foundations, cross-cultural variations, and emerging best practices. Key findings highlight the importance of culturally humble approaches, family-centered communication models, and structured tools, such as co-designed advance care planning and dignity therapy, to enhance communication. Additionally, the review highlights the presence of ethical and interdisciplinary challenges, particularly in neonatal and neurology settings, where misaligned team messaging and institutional hesitancy may compromise trust and timely referral to palliative care. Future research, policy, and clinical education priorities should advocate for models that are inclusive, ethically grounded, and tailored to the unique trajectories of neurologically ill children. Integrating cultural competence, team alignment, and family voices is essential for delivering equitable and compassionate PPC across diverse care settings. Full article

This convergent mixed-methods study explores the lived experiences of Black women DEI leaders at predominantly white institutions within the context of an increasingly contentious national discourse surrounding diversity, equity, and inclusion (DEI) in higher education. Conducted prior to the 2024 election, a period marked by escalating resistance to DEI efforts, this research explores how America’s racial reckoning influenced institutional DEI initiatives and shaped the realities of those leading this work. Data were collected through a climate survey of 20 DEI administrators and semi-structured interviews with three senior-level Black women DEI leaders. The survey findings suggest that institutional commitments to DEI were largely reactive, emerging as crisis responses to national calls for racial justice. These efforts resulted in the short-term elevation of Black women into leadership roles, often without sustained structural support. The interview data revealed that Black women senior DEI leaders routinely encounter discrimination, marginalization, and the paradox of hypervisibility and invisibility within their roles. This study concludes with implications and suggestions for institutional policy and structural reform aimed at fostering more equitable and sustainable DEI leadership environments. Full article

Unemployment and weak economic productivity are significant global issues, particularly in West Africa. Recently, through diverse mechanisms, remittances and foreign direct investment (FDI) have been sources of foreign capital flow that have positively influenced many less developed economies, including ECOWAS (ECOWAS stands for Economic Community of West African States). Nevertheless, these financial flows have exhibited significant inconsistencies, primarily resulting from economic downturns in migrants’ destination countries, with remarkable implications for beneficiary economies. This study, therefore, examines the effect of remittances and FDI on employment in ECOWAS. Specifically, the study assesses the effects of the inflow of remittances and FDI on employment using panel dynamic ordinary least squares (PDOLS) and also investigates the shock effects of remittances and FDI by employing Panel Vector Error Correction (PVECM), which involves variance decomposition. The results show that foreign direct investment (FDI) positively and significantly affects employment. Other variables that show a significant relationship with employment are wage rate, education expenditure, and interest rate. The variance decomposition result revealed that external shocks on remittances and FDI have short- and long-term effects on employment. The above findings imply that foreign direct investment has a far-reaching positive impact on the economy-wide management of the West African sub-region and thus calls for relevant policy options. Full article

In the context of increasing Artificial Intelligence integration in higher education, understanding the factors influencing university teachers’ adoption of AI tools is critical for effective implementation. This study adopts a perception–intention–behavior framework to explores the roles of perceived usefulness, perceived ease of use, perceived trust, perceived substitution crisis, and perceived risk in shaping teachers’ behavioral intention and actual usage of AI tools. It also investigates the moderating effects of peer influence and organizational support on these relationships. Using a comprehensive survey instrument, data was collected from 487 university teachers across four major regions in China. The results reveal that perceived usefulness and perceived ease of use are strong predictors of behavioral intention, with perceived ease of use also significantly influencing perceived usefulness. Perceived trust serves as a key mediator, enhancing the relationship between perceived usefulness, perceived ease of use, and behavioral intention. While perceived substitution crisis negatively influenced perceived trust, it showed no significant direct effect on behavioral intention, suggesting a complex relationship between job displacement concerns and AI adoption. In contrast, perceived risk was found to negatively impact behavioral intention, though it was mitigated by perceived ease of use. Peer influence significantly moderated the relationship between perceived trust and behavioral intention, highlighting the importance of peer influence in AI adoption, while organizational support amplified the effect of perceived ease of use on behavioral intention. These findings inform practical strategies such as co-developing user-centered AI tools, enhancing institutional trust through transparent governance, leveraging peer support, providing structured training and technical assistance, and advancing policy-level initiatives to guide digital transformation in universities. Full article

Background/Objectives: Despite growing interest in oral frailty as a public health issue, no nationwide study has assessed regional differences in oral frailty awareness, and the factors associated with such differences remain unclear. This study investigated regional differences in oral frailty awareness among older adults in Japan and identified the associated individual- and municipal-level factors, focusing on local policy measures and community-based oral health programs. Methods: A cross-sectional analysis was conducted using data from the 2022 wave of the Japan Gerontological Evaluation Study. The analytical sample comprised 20,330 community-dwelling adults aged ≥65 years from 66 municipalities. Awareness of oral frailty was assessed via self-administered questionnaires. Individual- and municipal-level variables were analyzed using multilevel Poisson regression models to calculate prevalence ratios (PRs). Results: Awareness of oral frailty varied widely across municipalities, ranging from 15.3% to 47.1%. Multilevel analysis showed that being male (PR: 1.10), having ≤9 years (PR: 1.10) or 10 to 12 years of education (PR: 1.04), having oral frailty (PR: 1.04), and lacking civic participation (PR: 1.06) were significantly associated with lack of awareness. No significant associations were found with municipal-level variables such as dental health ordinances, volunteer training programs, or population density. Conclusions: The study found substantial regional variation in oral frailty awareness. However, this variation was explained primarily by individual-level characteristics. Public health strategies should focus on enhancing awareness among socially vulnerable groups—especially men, individuals with low educational attainment, and those not engaged in civic activities—through targeted interventions and community-based initiatives. Full article

Family empowerment is a key component of effective family-centered practices in healthcare, mental health, and educational services. The Family Empowerment Scale (FES) is the most commonly used instrument to evaluate empowerment in families raising children with emotional, behavioral, or developmental disorders. Despite its importance, the FES for diverse populations, especially Latinx parents, has rarely been evaluated using innovative psychometric approaches. In this study, we evaluated key dimensions and psychometric evidence of the Family Empowerment Scale (FES) for 96 Latinx parents of children with intellectual and developmental disabilities (IDD) in the United States using an exploratory graph analysis (EGA). The EGA identified a five-dimensional structure, and EGA models outperformed the original CFA 3-factor models for both parents of children with autism and other disabilities. This study identified distinct, meaningful dimensions of empowerment that reflect both shared and unique empowerment experiences across two Latinx parent groups. These insights can inform the design of culturally responsive interventions, instruments, and policies that more precisely capture and boost empowerment in Latinx families. This study contributes to closing a gap in the literature by elevating the voices and experiences of Latinx families by laying the groundwork for more equitable support systems in special education and disability services. 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

Background/Objectives: Strengthening antimicrobial stewardship (AMS) programs is an invaluable intervention in the ongoing efforts to contain the threat of antimicrobial resistance (AMR), particularly in low-resource settings. This study evaluates the impact of the Telementoring, Education, and Advocacy Collaboration initiative for Health through Antimicrobial Stewardship (TEACH AMS), which uses the virtual Extension for Community Healthcare Outcomes (ECHO) learning model to enhance AMS capacity in Kenya, Ghana, and Malawi. Methods: A mixed-methods approach was used, which included attendance data collection, facility-level assessments, post-session and follow-up surveys, as well as focus group discussions. Results: Between September 2023 and February 2025, 77 virtual learning sessions were conducted, engaging 2445 unique participants from hospital-based AMS committees and health professionals across the three countries. Participants reported significant knowledge gain, and data showed facility improvements in two core AMS areas, including the implementation of multidisciplinary ward-based interventions/communications and enhanced monitoring of antibiotic resistance patterns. Along those lines, participants reported that the program assisted them in improving prescribing and culture-based treatments, and also evidence-informed antibiotic selection. The evidence of implementing ward-based interventions was further stressed in focus group discussions, as well as other strengthened practices like point-prevalence surveys, and development or revision of stewardship policies. Substantial improvements in microbiology services were also shared by participants, particularly in Malawi. Other practices mentioned were strengthened multidisciplinary communication, infection prevention efforts, and education of patients and the community. Conclusions: Our findings suggest that a virtual case-based learning educational intervention, providing structured and tailored AMS capacity building, can drive behavior change and strengthen healthcare systems in low resource settings. Future efforts should aim to scale up the engagements and sustain improvements to further strengthen AMS capacity. Full article

The green transformation of traditional energy structures and the development of the new energy industry are crucial drivers of sustainable development in the country. The ASEAN Plan of Action for Energy Cooperation (2016–2025; APAEC [2016–2025]), established in 2016, has significantly promoted the growth of the new energy sector and enhanced energy structures across Association of Southeast Asian Nations (ASEAN). This initiative has also inspired these countries to develop corresponding industrial policies aimed at supporting the new energy vehicle (NEV) industry, resulting in significant growth in this sector within the ASEAN region. This paper analyzes the factors influencing the development of the NEV industry in the context of ASEAN’s new energy policies, drawing empirical insights from data collected across six ASEAN countries from 2013 to 2024. Following the implementation of the APAEC (2016–2025), it was observed that ASEAN countries reached a consensus on energy development and cooperation, collaboratively advancing the NEV industry through regional policies. Furthermore, factors such as national governance, financial development, education levels, and the size of the automotive market positively contribute to the growth of the NEV industry in ASEAN. Conversely, high energy consumption can hinder its progress. Additionally, further research indicates that the APAEC (2016–2025) has exerted a more pronounced impact on countries with robust automotive industry foundations or those prioritizing relevant policies. The findings of this paper offer valuable insights for ASEAN countries in the formulating policies for the NEV industry, optimizing energy structures, and achieving low-carbon energy transition and sustainable development. Full article

Based on a comprehensive review of the current research status of ecological compensation both domestically and internationally, combined with field survey data, this study delves into the issue of multi-stakeholder participation in the ecological compensation mechanisms of the Xin’an River Basin. This research reveals that the joint participation of multiple stakeholders is crucial to achieving the goals of ecological compensation in river basins. The government plays a significant role in macro-guidance, financial support, policy guarantees, supervision, and management. It promotes the comprehensive implementation of ecological environmental protection by formulating relevant laws and regulations, guiding the public to participate in ecological conservation, and supervising and punishing pollution behaviors. The public, serving as the main force, forms strong awareness and behavioral habits of ecological protection through active participation in environmental protection, monitoring, and feedback. As participants, enterprises contribute to industrial transformation and green development by improving resource utilization efficiency, reducing pollution emissions, promoting green industries, and participating in ecological restoration projects. Scientific research institutions, as technology enablers, have effectively enhanced governance efficiency through technological research and innovation, ecosystem value accounting to provide decision-making support, and public education. Social organizations, as facilitators, have injected vitality and innovation into watershed governance by extensively mobilizing social forces and building multi-party collaboration platforms. Communities, as supporters, have transformed ecological value into economic benefits by developing characteristic industries such as eco-agriculture and eco-tourism. Based on the above findings, further recommendations are proposed to mobilize the enthusiasm of upstream communities and encourage their participation in ecological compensation, promote the market-oriented operation of ecological compensation mechanisms, strengthen cross-regional cooperation to establish joint mechanisms, enhance supervision and evaluation, and establish a sound benefit-sharing mechanism. These recommendations provide theoretical support and practical references for ecological compensation worldwide. Full article

Background: Chlamydia trachomatis is the most prevalent bacterial sexually transmitted infection (STI) globally, linked to severe complications such as pelvic inflammatory disease and infertility. In the Brazilian Amazon, socioeconomic vulnerability and the absence of screening policies exacerbate risks, particularly among female sex workers (FSWs). Objective: This study aimed to determine the seroprevalence of anti-C. trachomatis IgG antibodies among FSWs in five municipalities of Pará State, Brazilian Amazon, and identify epidemiological factors associated with infection. Methods: A retrospective cross-sectional study (2005–2007) included 348 FSWs recruited via convenience sampling. Sociodemographic and behavioral data were collected through questionnaires, and blood samples were analyzed by ELISA for anti-C. trachomatis IgG. Statistical analyses included Fisher’s exact tests, odds ratios (ORs), and 95% confidence intervals (CIs), using SPSS 21.0. Results: Overall seroprevalence was 93.9% (327/348; 95% CI: 83.1–90%). Significant associations included a household income of 1–3 minimum wages (98.4%; p = 0.0002), sexual partners from the same region (98.8%; p = 0.0421), and age >42 years (96.3%). Most reported inconsistent condom use (43.7%), multiple monthly partners (54.6%), and illicit drug use (53.4%). Discussion: The extremely high seroprevalence reflects chronic C. trachomatis exposure, driven by socioeconomic deprivation and limited healthcare access. Comparisons with global data underscore the urgent need for screening policies, absent in Brazil for FSWs, and highlight the vulnerability of this population. Conclusions: The findings reveal an alarming burden of C. trachomatis exposure among Amazonian FSWs. Integrated strategies, including routine screening, sexual health education, and inclusion of FSWs in priority health programs, are critical to reduce transmission and associated complications. Full article

This paper investigates how governance frameworks shape sustainable tourism outcomes in protected areas by comparing Tara National Park (Serbia) and Triglav National Park (Slovenia). Both parks, established in 1981 and classified under IUCN Category II, exhibit rich biodiversity and mountainous terrain but differ markedly in governance structures, institutional integration, and local community engagement. Using a qualitative, indicator-based methodology, this research evaluates ecological, economic, and social dimensions of sustainability. The findings reveal that Triglav NP demonstrates higher levels of participatory governance, tourism integration, and educational outreach, while Tara NP maintains stricter ecological protection with less inclusive management. Triglav’s zoning model, community council, and economic alignment with regional development policies contribute to stronger sustainability outcomes. Conversely, Tara NP’s centralized governance and infrastructural gaps constrain its potential despite its significant conservation value. This study highlights the importance of adaptive, inclusive governance in achieving the Sustainable Development Goals (SDGs) within protected areas. It concludes that hybrid approaches, combining legal rigor with participatory flexibility, can foster resilience and sustainability in ecologically sensitive regions. Full article

It is well-established that principal leadership significantly influences student learning in developed countries, yet much less is known about how leadership practices manifest in complex systems like China’s, where rapid modernization intersects with deep-rooted educational traditions. In particular, Chinese principals face multiple challenges in balancing the implementation of educational reform policies, high parental expectations, and their own educational ideology, all within limited resources. The current study examines these challenges in Shenzhen, a city which typically manifests them through its rapid development. Specifically, we took a phenomenographic approach and interviewed the principals and staff from five prestigious primary schools to extract the key components behind the diverse school leaders’ styles and practices. Results showed that, the Chinese leadership practice model consists of five key components: mission setting, infrastructure reconstruction, teacher development, learning improvement, and educators’ networking. Although the first four components in this model align with established theories in developed countries, networking was identified as a distinctive and critical element for securing resources and fostering collaboration. These findings may broaden the scope of leadership theories and underscore the need to contextualize leadership practices based on local challenges and dynamics. It also offers practical insights for school leaders on navigating challenges to improve teacher and student outcomes. Full article

Understanding the carbon emission efficiency of apple production (APCEE) is critical for promoting green and low-carbon agricultural development. However, the spatiotemporal dynamics and driving factors of APCEE in China remain inadequately explored. This study employs life cycle assessment, super-efficiency slacks-based measures, and a panel Tobit model to evaluate the carbon footprint, APCEE, and its determinants in China’s two major production regions from 2003 to 2022. The results reveal that: (1) Producing one ton of apples in China results in 0.842 t CO₂e emissions. Land carbon intensity and total carbon emissions peaked in 2010 (28.69 t CO₂e/ha) and 2014 (6.52 × 10⁷ t CO₂e), respectively, exhibiting inverted U-shaped trends. Carbon emissions from various production areas show significant differences, with higher pressure on carbon emission reduction in the Loess Plateau region, especially in Gansu Province. (2) The APCEE in China exhibits a W-shaped trend (mean: 0.645), with overall low efficiency loss. The Bohai Bay region outperforms the Loess Plateau and national averages. (3) The structure of the apple industry, degree of agricultural mechanization, and green innovation positively influence APCEE, while the structure of apple cultivation, education level, and agricultural subsidies negatively impact it. Notably, green innovation and agricultural subsidies display lagged effects. Moreover, the drivers of APCEE differ significantly between the two major production regions. These findings provide actionable pathways for the green and low-carbon transformation of China’s apple industry, emphasizing the importance of spatially tailored green policies and technology-driven decarbonization strategies. Full article