Search Results (6,700)

One of the challenges post-COVID-19 is reducing the negative impacts on quality of life, performance, and independence in activities of daily living. Assessing functional dependence in adults one year after acute infection can help to understand the long-term consequences, evaluate the impact on quality of life, plan rehabilitation and healthcare, identify the most vulnerable groups, measure the socioeconomic impact, and support public policies and clinical decisions. Objectives: The objectives of this study are as follows: (a) to assess the prevalence of functional dependence in Brazilian adults with COVID-19; (b) to analyze the association between the study variables; and (c) to determine the factors associated with functional dependence. Methods: This was an observational, cross-sectional study with 987 adults (18 to 59 years old) living in the State of Paraná (Brazil) hospitalized for COVID-19 between March and December 2020. Data were collected by telephone 12 months after the acute infection using an instrument to retrieve sociodemographic and health information, and a functional dependence scale to assess dependence before COVID-19 retrospectively (using participant recall information) and at the time of the interview. Data were analyzed using penalized logistic regression after imputing missing data. Data were analyzed using penalized logistic regression after imputing missing data. Results: Functional dependence after COVID-19 was 5.0% and was associated with low levels of education, not having a partner, living with someone, not owning a home, experiencing job changes, requiring care, obesity, smoking, multimorbidity, ICU admission in the acute phase, use of invasive ventilation, or having Long COVID. Individuals who required care or used invasive ventilation support were, respectively, 9.3 and 6.5 times more likely to develop dependence after COVID-19. Despite adjustment for multiple factors, the magnitude of the observed effects warrants cautious interpretation, as unmeasured or residual confounding effects may still be present. Sample recall bias due to collection after 12 months and the presence of the alpha variant without COVID-19 vaccination coverage may limit data generalization. Conclusions: The results highlight the need to emphasize the public health implications of identifying functional dependence. In this vein, it is necessary to implement preventive measures, identify and monitor more vulnerable groups, plan rehabilitation programs, and develop public health policies. Full article

Background: Dementia is an increasing public health challenge in Mexico, yet recent national data on mortality patterns remain limited. This study examines temporal trends in dementia-related mortality and its sociodemographic and ecological characteristics among adults aged ≥65 years from 2017 to 2023. Methods: National mortality records from the General Directorate of Health Information were analyzed. Annual dementia-related mortality rates were calculated based on mid-year population estimates from CONAPO. Trends were assessed with regression analysis, including population offsets, and individual- and state-level characteristics were evaluated. Results: Between 2017 and 2023, dementia-related deaths increased from 761 to 1425, corresponding to an observed rise from 7.9 to 14.6 deaths per 100,000 inhabitants aged ≥65 years. Period trend indicated an average annual expected increase of 18.6% in dementia related mortality. A transient decline occurred in 2020–2021, coinciding with the COVID-19 pandemic. At the individual level, higher education was associated with greater odds of dementia certification, whereas Indigenous ethnicity appeared protective, which may reflect patterns consistent with diagnostic and reporting disparities. Higher state-level life expectancy correlated with higher dementia mortality, while greater population aging was inversely associated. Conclusions: Dementia-related mortality in Mexico shows a sustained upward trend with regional heterogeneity and apparent inequities in diagnosis and reporting. Strengthening mortality surveillance, improving certification quality, and integrating dementia indicators into national non-communicable disease registries are essential to guide equitable policy responses. Full article

The increasing momentum of agricultural digital transformation and green development necessitates investigations into how farmers’ digital literacy influences their engagement in green production behaviours, which is critical for achieving the high-quality development of modern agriculture. Utilising primary survey data collected from farmers in rural areas of Guizhou Province, China, this study investigated how digital literacy affects farmers’ green production behaviours. The findings are as follows: (1) Digital literacy exerts a significant positive impact on farmers’ adoption of green production behaviours. Regarding the hierarchical effect, the order of influence is as follows: digital security awareness > basic digital skills > digital application and innovation. (2) The facilitating effect of digital literacy is primarily achieved through two pathways: the peer effect and the guidance effect. (3) Farmers with higher education levels are more impacted by digital literacy than farmers with lower education levels. (4) The impact of digital literacy is more positively significant for young and older farmers than for middle-aged groups. Based on these research findings, it is recommended that future policy formulation and technology extension efforts should prioritise support for specific regions and groups, such as mountainous areas, small-scale operations, low-education backgrounds, and the elderly. Such targeted approaches are crucial for encouraging wider adoption of green production behaviours among farmers. Full article

Globalization, climate change and the energy crisis are having a negative impact on the agricultural sector. Moreover, in Greece, producers need to invest in modernizing their farms, introducing innovations, achieve digital transformation and increase productivity. Incentives are available for green investments, thus facilitating the adoption of innovations. This paper examines the attitudes and perceptions of winegrowers in Western Macedonia regarding environmental protection and organic farming. Specifically, with the help of the k-means algorithm, respondents are divided into two groups. The first group consists of producers who have a negative attitude towards environmental issues and have a lower level of education, while the second group consists of those who have a positive attitude. In the first group in particular, most respondents do not seem to have a good knowledge of environmental protection issues, believe that cross-compliance is very stringent and do not have a high level of education. This means that policy measures must be taken to adequately inform and educate farmers belonging to this group to achieve the goal of environmental protection. The results of the second group include producers with a positive attitude, who are expected to play an important role in the development of sustainable viticulture by creating conditions for a better future at an individual, regional and social level. Full article

Based on the interaction mechanism between higher education and industrial structure, this paper constructs an evaluation index system for the higher education development (HED) and the industrial upgrading (IU) by integrating their core characteristics. Using the entropy weight method, TOPSIS method, and coupling coordination model, as well as Kernel Density Estimation (KDE), it measures the comprehensive development levels and synergistic level of HED and IU in Chinese provinces (cities) from 2009 to 2020 and explores their spatiotemporal evolution characteristics. The findings reveal the following: (1) The overall level of China’s HED and IU shows an upward trend, but the absolute scores remain low, with significant regional disparities, and are divided into Balanced Development, Structural Imbalance, Industry-Supported, and Education-Supported. (2) The interaction between HED and IU is progressing toward a higher level, characterized by a reduction in low-value regions and a narrowing of regional disparities. However, the overall coordination remains in a “running-in stage”. (3) The eastern region has formed a virtuous cycle of interaction. The central region has achieved rapid improvement, benefiting from policy support, while the western region, constrained by resource limitations and policy lag, experiences slower progress in coordination. The northeastern region, lacking coupling momentum, exhibits long-term stagnation at a low level. Full article

Background: Integrity, encompassing honesty, accountability, and ethical conduct, is a cornerstone of the dental profession, essential for patient trust and safety. Despite its importance, academic dishonesty remains a pervasive issue in dental education globally. This review examines the prevalence, causes, and long-term career implications of academic dishonesty in dental education and explores institutional strategies to cultivate a culture of integrity. Method: The study was conducted using PubMed, Scopus, Web of Science, and Google Scholar to identify studies published between 1970 and 2025 on academic dishonesty in dental education. Search terms included dental students, cheating, plagiarism, and clinical falsification. Eligible studies reported prevalence, drivers, or consequences of dishonest behaviors. Data were extracted and thematically synthesized to highlight common patterns and professional implications. Results: Self-reported data indicate alarmingly high rates of cheating among dental students, ranging from 43% to over 90%. Common forms include exam fraud, plagiarism, and the falsification of clinical records. Key drivers include intense academic pressure, competitive environments, and a perception of weak enforcement. Such behaviors are not merely academic violations—they have profound professional consequences. A history of academic dishonesty can damage a student’s reputation, hinder licensure and credentialing processes, and limit postgraduate opportunities. Crucially, studies indicate that unethical behavior in school can normalize dishonesty, predicting a higher likelihood of future professional misconduct, such as insurance fraud or malpractice, thereby jeopardizing patient care and public trust. Conclusions: Academic integrity is a critical predictor of professional ethical conduct. Dental schools must move beyond punitive policies to implement proactive, multi-faceted approaches. This includes integrating comprehensive ethics curricula, fostering reflective practice, promoting faculty role modeling, and empowering student-led initiatives to uphold honor codes. Cultivating an unwavering culture of integrity is essential not only for academic success but for developing trustworthy practitioners committed to lifelong ethical patient care. Full article

This study reviews the current applications of generative artificial intelligence (GenAI) in architectural design education using the PRISMA framework. It compares these applications across the different design stages, namely the pre-design, concept generation, design development, and design production, to identify the current state of evidence and conceptual discussions reported in the literature. The study also discusses the associated opportunities and challenges in this regard. The findings indicate that there is a growing interest in integrating GenAI into architectural design education, especially in the early design stages. However, one of the most significant gaps in this regard lies in the lack of empirical evidence on the long-term impacts of GenAI on students’ critical thinking and problem-solving skills. Future research is needed to explore the integration of GenAI throughout the entire design process, including design development and refinement. There is also a need to incorporate the relevant ethical guidelines for AI-generated content into academic quality assurance systems and to strengthen institutional preparedness through targeted training and policy development. Full article

People with intellectual disabilities are disproportionately affected by diet-related health inequalities. This Perspective outlines a dual challenge: (1) intrinsic vulnerabilities—cognitive limitations, health-literacy constraints, and comorbidities—that impair individuals’ ability to make healthy dietary choices, and (2) extrinsic neglect—insufficient support in care environments, inadequate nutrition-related training among informal caregivers and support staff, and structural gaps in policy and services. We argue that this “double jeopardy” undermines nutritional equity and proposes strategies for person-centered nutrition education, caregiver empowerment, supportive food environments, and inclusive policy frameworks. Greater interdisciplinary collaboration and tailored research are urgently needed to ensure nutritional health as a right for people with intellectual disabilities. Full article

Background/Objectives: Gestational exposure to substances (GES) is associated with adverse developmental outcomes. Early identification is limited by reliance on self-reported data. This study assessed the incidence and predictors of discordance in GES reporting between birth certificates and Medicaid claims among Medicaid-covered births in Nevada from 2022 to 2024. Methods: A statewide, hospital-clustered, cross-sectional analysis was conducted using linked Medicaid billing and birth record data. Discordance was defined as GES identified in one source but not the other. Incidence per 1000 live births was stratified by demographic characteristics. Multilevel logistic regression assessed patient- and hospital-level predictors, with random hospital intercepts. Results: Among 50,394 live births, the discordance rate was 95.09 per 1000 (95% Confidence Interval: 92.5–97.7). Substantial disparities were observed by race/ethnicity, socioeconomic status, and geography, with higher discordance among White non-Hispanic mothers, those residing in rural or frontier counties, and individuals with lower educational attainment or living in lower-income areas. Modest but meaningful variation was also observed across hospitals, including differences by hospital size and teaching or research status. Conclusions: Findings highlight substantial discordance in GES reporting and underscore the limitations of single-source surveillance. Findings also have clear policy relevance, indicating that improved cross-system data integration would strengthen statewide surveillance, enhance early detection, and support more equitable resource allocation and intervention strategies. Full article

This study examined Croatian consumer attitudes towards fresh pork from the Black Slavonian pig, focusing on the following sustainability dimensions: environmental, social, economic sustainability, and animal welfare. A survey of 410 consumers was conducted in June 2021, using an online questionnaire assessing consumption habits, breed knowledge, and socio-demographic characteristics. Factor analysis identified four key dimensions: attention to animal welfare, support for local production and biodiversity, origin and information, and price and intrinsic quality. Cluster analysis revealed three distinct consumer segments: conscious consumers (32.4%), value-oriented consumers (37.3%), and uninvolved meat consumers (30.2%). Multinomial logistic regression showed that age, region, family economic status, and place of purchase significantly predicted cluster membership (Nagelkerke R² = 0.251, classification accuracy = 52.9%), while gender, education level, and household composition did not. Conscious consumers were characterised by older age, higher income, and a preference for direct purchasing channels, while value-oriented consumers favoured supermarkets and mid-range pricing. These findings highlight the need for improved consumer education, transparent labelling, targeted marketing strategies, and enhanced policy support to promote sustainable indigenous pig breed production and conservation. Full article

Background: Artificial intelligence (AI) is reshaping health sciences education worldwide, yet regional data from Latin America remain scarce. Understanding students’ AI literacy and perceptions is essential for developing informed curricular strategies. Methods: A cross-sectional online survey was conducted among 270 students from four Costa Rican universities across five health sciences programs. Descriptive and inferential analyses (ANOVA, Chi-square) examined AI knowledge, usage frequency, and perceptions of ethical integration in academic contexts. Results: Over 80% of respondents reported moderate or higher AI knowledge and frequent use of tools such as ChatGPT, mostly for academic support tasks. However, more than 90% had not received formal institutional training, and ethical awareness—particularly regarding misinformation and bias—was limited. Conclusions: Students demonstrate active engagement with AI despite minimal curricular exposure. These findings emphasize the need for structured AI training, faculty development, and equitable access policies aligned with global digital ethics frameworks to ensure responsible adoption within Costa Rican health sciences education. Full article

This study examines how Artificial Intelligence (AI) is reshaping the role of university teachers and transforming the foundations of academic work in the digital age. Building on the Dynamic Capabilities Theory (sensing–seizing–transforming), the article proposes a theoretical reframing of university teachers’ perceptions of AI. This approach allows us to bridge micro-level emotions with meso-level HR policies and macro-level sustainability goals (SDGs 4, 8, and 9). The empirical foundation includes a survey of 453 Ukrainian university teachers (2023–2025) and statistics, supplemented by a bibliometric analysis of 26,425 Scopus-indexed documents. The results indicate that teachers do not anticipate a large-scale replacement by AI within the next five years. However, their fear of losing control over AI technologies is stronger than the fear of job displacement. This divergence, interpreted through the lens of dynamic capabilities, reveals weak sensing signals regarding professional replacement but stronger signals requiring managerial seizing and institutional transformation. The bibliometric analysis further demonstrates a theoretical evolution of the university teacher’s role: from a technological adopter (2021–2022) to a mediator of ethics and integrity (2023–2024), and, finally, to a designer and architect of AI-enhanced learning environments (2025). The study contributes to theory by extending the application of Dynamic Capabilities Theory to higher education governance and by demonstrating that teachers’ perceptions of AI serve as indicators of institutional resilience. Based on Dynamic Capabilities Theory, the managerial recommendations are divided into three levels: government, institutional, and scientific-didactic (academic). Full article

This study aims to examine the relationships among environmental sensitivity, eco-anxiety, and sustainable consumption behavior, thereby revealing how these variables interact within the framework of sustainability psychology. Conducted with a sample of 406 university students in Türkiye, the research employed a quantitative and cross-sectional design, and the proposed relationships were tested using structural equation modeling (SEM). The findings indicate that environmental sensitivity significantly predicts sustainable consumption behavior both directly and indirectly through eco-anxiety. Eco-anxiety was found to play a partial mediating role in the relationship between environmental sensitivity and sustainable consumption. In addition, the moderating effect of gender was investigated, and no significant differences were observed between women and men regarding the structural paths of the model. Overall, the results demonstrate that sustainable consumption behaviors are shaped not only by cognitive processes but also by emotional mechanisms, suggesting that eco-anxiety, as a motivational emotional response, may strengthen sustainable behavior. This study contributes to the environmental psychology literature by theoretically and empirically highlighting the decisive role of emotional processes in shaping sustainable behavior. The findings also provide important practical implications for sustainability policies, environmental education, and communication strategies. Full article

This study examines consumer behavior, preferences, and knowledge regarding honey in Kosovo to inform more effective production, marketing, and policy strategies. Data were collected from 503 respondents through an online questionnaire and analyzed using a combination of artificial neural networks (ANN), decision tree modeling (CHAID), and ordinal logistic regression. The results show a high prevalence of honey consumption, strong preference for locally produced honey, and significant variability in consumer willingness to pay (WTP) based on knowledge, income, and trusted information sources. ANN identified recommendations and product familiarity as primary predictors of WTP, while the decision tree highlighted knowledge and income as key variables for segmentation. The ordinal logistic regression confirmed the importance of perceived quality and product attributes, particularly botanical and geographical origin, in shaping purchasing decisions. The use of complementary statistical models enhanced both predictive power and interpretability. The findings highlight the crucial role of consumer education and trust cues in fostering sustainable honey markets in Kosovo. Full article

The study investigates the presence of emerging contaminants in a river within a watershed located in the Brazilian semiarid region, specifically within the Caatinga biome, emphasizing the importance of environmental monitoring in areas that have historically been underrepresented in scientific research. The analysis focused on the associations between microplastics and pharmaceutical compounds, demonstrating that the discharge of untreated domestic effluents and the low efficiency of sanitation systems increase water resource contamination and threaten water security. The interdependence between these variables underscores the need for integrated public policies for waste management, complemented by environmental education strategies and technological innovations. The work makes an unprecedented contribution to expanding knowledge about emerging pollutants in semiarid environments, highlighting the urgency of holistic approaches, continuous monitoring, and strengthening environmental governance to ensure the sustainability and resilience of ecosystems like the Caatinga in the face of the challenges posed by global environmental change, urban growth, and those outlined in the Sustainable Development Goals. Full article