Search Results (43)

Background/Objectives: Metastatic bone disease (MBD) poses an increasing challenge in orthopaedic oncology due to prolonged survival. While clinical prognostic factors are well established, the role of socio-economic determinants remains unclear, particularly within universal healthcare systems. Methods: We retrospectively analysed 243 patients who underwent surgery for MBD (excluding spine) between 2005 and 2024 at a German sarcoma centre. Socio-economic indicators were derived from national databases and linked to patients’ residential districts. Survival was analysed using Kaplan–Meier estimates and Cox regression, adjusting for clinical confounders. Results: Median postoperative survival was 22 months. Several socio-economic indicators—income, education, and employment—were associated with survival in univariate analysis. In multivariate models, only residential area size remained independently significant (p = 0.047). Patients from villages (<2000 inhabitants) and large cities (>100,000) had poorer survival than those from small or medium-sized towns. This effect persisted after adjustment for tumour type, pathological fractures, and year of surgery. Conclusions: Within a universal healthcare system, residential area size was associated with survival after surgery for MBD, suggesting that regional disparities may persist despite equal formal access to care. Further studies integrating individual-level socioeconomic data are needed to identify mechanisms and guide interventions to reduce geographic inequalities. Full article

Objectives: A retrospective ecological study was conducted to analyze the relationship between the incidence of myocardial infarction with ST-segment elevation (STEMI) and various sociodemographic factors in municipalities within the Community of Madrid, a high-income and low-cardiovascular-risk European region. Methods: This study analyzed a database of patients registered in the regional network for STEMI care from January 2014 to December 2018. Thirty-four municipalities with populations greater than 10,000 inhabitants were included. The mean annual incidence of STEMI (iSTEMI) was estimated for each locality, and several variables of wealth, employment and social investment were obtained from public databases. Results: During the period of the study, 2561 confirmed STEMI cases were recorded in the selected localities, with an average incidence of 23 events per 100,000 inhabitants and year. The mean age was 62, with 83% of patients being male. Among municipalities included in the study, a significant direct correlation was found between iSTEMI and unemployment rate (r = 0.354, p = 0.04). A significant inverse correlation was found with all wealth-related variables, mainly with a composed deprivation (poverty) index (r = −0.624, p < 0.001) and the percentage of employees in the financial sector (r = −0.497, p = 0.003). No correlation was found between iSTEMI and the sociodemographic or public investment variables retrieved. Multiple regression analysis showed that the model best fitted when energy billed per inhabitant and mean income tax per taxpayer were introduced. Conclusions: Residents of areas with lower incomes and higher unemployment rates may be at a greater risk of STEMI. This should be taken into account when planning cardiovascular prevention and community health management. Full article

ADHD and misophonia are developmental neurological disorders that are currently increasing in prevalence due to excessive acoustic and visual pollution. ADHD, which is characterized by a lack of attention and excessive impulsive hyperactivity, and misophonia, which is hypersensitivity to sounds accompanied by a severe emotional and psychological reaction, are both affected by the user’s spatial environment to a great extent. Spatial design can contribute to increasing or decreasing these unfavorable sensory triggers that affect individuals with ADHD and/or Misophonia. However, the role of architectural spatial design as a therapeutic approach to alleviate the symptoms of Misophonia and ADHD has never been proposed before in the literature, despite its accumulative and chronic effects on the user’s experience in everyday life in terms of well-being and productivity. Therefore, the current work discusses this problem of neglecting the potential effect of architectural spatial design on alleviating Misophonia and ADHD. Thus, the objective of the current work is to propose customized architectural spatial design as a therapeutic approach to alleviate Misophonia and ADHD through adopting the compatible architectural trends of minimal and metaphysical architecture. The methodology of the current work includes a theoretical proposal of this customized architectural spatial design for alleviating these two special neurological conditions. This includes introducing and analyzing these two neurological conditions and their relation to and interaction with architectural spatial design, analyzing minimal and metaphysical architectural trends employed in the proposed therapeutic architectural design, and then proposing augmented and virtual reality as auxiliary add-ons to the architectural spatial design to boost its therapeutic effect. Minimal architecture achieves the “no emotion” criteria through reduced forms, patterns, and colors and adopts simple geometry and natural materials to reduce sensory stressors or stimuli, in order to alleviate the loss of attention and distraction prevalent in those with ADHD, as well as allowing the employment of acoustic materials to achieve acoustic comfort and noise blockage for Misophonia relief. Metaphysical architecture leads the hierarchy of sensory experience through the symbolistic, dynamic, and enigmatic composition of forms and colors, which enhance the spatial analysis and cognitive capacities of the inhabitants. Meanwhile, the use of customized virtual and augmented reality environments is an effective add-on to minimal and metaphysical architectural spaces thanks to its proven therapeutic effect in alleviating various neurological disorders and injuries. At this level of intervention, VR/AR can be used as an add-on to minimal-architecture design, to simulate varied scenarios, as minimal design offers a clean canvas for simulating these varied virtual environments. The other option is to build these customized VR/AR scenarios around a specific architectural element as an add-on metaphysical architecture design to lead the sensory experience and enable the user to detach from the physical constraints of the space. AI-generated designs were used as a proof of concept for the proposed customized architectural spatial design following minimal and metaphysical architecture, as well as to provide AR and VR scenarios as add-on architecture to enhance the therapeutic effect of these architectural spaces for Misophonia and ADHD patients. Furthermore, the validity of VR/AR as a therapeutic approach, alongside the customized architectural design, was discussed, and it was concluded that this study proves the need for extended clinical studies on its efficiency in the long run, which will be conducted in the future. Full article

Yazıköy, a rural settlement in southwestern Türkiye situated within overlapping cultural and natural protection zones, provides a critical case for analyzing the implications of heritage regulations on village life. This study examines how conservation policies shape livelihoods, land use practices, and community participation. Employing a mixed-methods design, the research draws on 114 household surveys and five semi-structured interviews conducted in 2024 with residents, local officials, and business owners. Findings show that heritage designation stimulates tourism, creating income and employment opportunities while simultaneously imposing regulatory constraints that delay infrastructure improvements and restrict new construction. Rising land values, the conversion of agricultural land for tourism-related uses, and the involvement of external investors illustrate the early stages of tourism-driven rural transformation. Moreover, age emerges as a critical determinant of participation: younger residents engage more actively with conservation and tourism initiatives, whereas older inhabitants experience barriers stemming from limited resources and access to information. Overall, conservation regimes safeguard cultural identity but constrain local agency. Reconciling protection imperatives with community-defined development requires inclusive planning and participatory governance. The Yazıköy case highlights how heritage policy, shaped by overlapping conservation regulations and tourism pressures, intersects with broader dynamics of rural gentrification, providing insights relevant to other rural heritage contexts. Full article

The Italian market for non-alcoholic beer is very small, with a volume per capita of around 0.7 L. However, there are interesting prospects for future growth for reasons ranging from strict traffic code rules on the quantity of alcohol ingested to simple curiosity. This research aimed to investigate the willingness of Italian consumers/potential consumers to pay for non-alcoholic beer. To accomplish this, a questionnaire was administered using the Google Forms application. Three hundred and ninety-two people participated in this survey voluntarily and without monetary compensation. A probit regression model was used to estimate the impact of certain sociodemographic characteristics (number of inhabitants of the place of residence, region of residence, age group, gender, education level, employment situation, and annual net income), participants’ consumption habits with respect to alcoholic beer, and participants’ knowledge of and preference for non-alcoholic beers with respect to willingness to pay for non-alcoholic beers. The prices respondents were willing to pay ranged from EUR 1.51 to 2.00 for a 33 cL glass bottle. Only two factors significantly affected (p < 0.1) non-alcoholic beer WTP, namely, “Age” and “Non-alcoholic beer color”. WTP decreased as the age of the respondents increased and was higher for the darker beer. Full article

Social cooperatives, which are an important pillar of the solidarity economy, have become increasingly popular and common in Hungary over the past 10 years, especially in disadvantaged settlements, where the administrative burden of public employment is outsourced to social cooperatives. Analyzing social cooperatives in small villages is a relevant topic for local economic development. Of the 3155 settlements in Hungary, 1162 have a population of less than 500 inhabitants, i.e., small villages. In the spatial structure of Hungary, small villages tend to be located on the periphery, which is both the spatial and socio-economical peripheral position, with mostly disadvantaged inhabitants with low educational attainment and high unemployment. In these settlements, local communities can better understand what hinders and what helps their economies to grow and improve living standards by assessing their economic base. With this new knowledge, local communities can achieve results through strategically designed programs and projects that social cooperatives can join and help achieve. The methodology of the study is field research; we interviewed managers of the social cooperatives to learn about its operations and difficulties. The study described well-run and successful social cooperatives. In small villages, these cooperatives can be an important source of employment, even if the number of people employed is low. The experiences of the field research are presented in the form of recommendations for policymakers, as social cooperatives can be an important instrument of employment policy. Full article

Background: Amidst current misinformation, media literacy is an essential competency for nursing professionals. This study aimed to analyze the level of media health literacy among Spanish undergraduate nursing students, stratifying the results by gender, region, and other associated factors. Methods: A cross-sectional study was conducted at five Spanish universities (N = 416) using the Spanish version of the Media Health Literacy (MeHLit-SV) Questionnaire. Results: Students presented an average media health literacy score of 48.73 points. The media health literacy level was significantly higher among students from universities in the central and northeastern regions of Spain (ANOVA Test, p = 0.0002), those who had previously studied in a city (ANOVA Test, p = 0.001), those who combined their studies with employment (ANOVA Test, p = 0.001), and those residing in communities with fewer than 500 inhabitants (ANOVA Test, p = 0.001). No differences were found based on gender. Conclusions: The media health literacy level of the students was deficient and varied according to socio-economic and socio-educational factors. Understanding the literacy level of future nurses and promoting the inclusion of this competency in their education will enable them to become leaders in improving the population’s health self-care. Full article

In this research, an analysis of the socio-environmental vulnerability in the urban area of the border municipality of Tijuana, Baja California (BC), in Mexico is carried out with data from the year 2020. Currently, this municipality is the most populated in the country, housing a population of just over 1.9 million inhabitants, characterized by being a city in constant urban growth due to its geographical location and various social, cross-border and productive dynamics directed by industrial development. However, Tijuana presents territorial problems related to lack of urban planning, overpopulation, urban marginalization, topographic conditions, urban waste management, air quality and lack of infrastructure and basic services. The proposed methodology develops a socio-environmental vulnerability index (SEVI), based on the evaluation of critical or extreme demographic and urban aspects, including social, economic, environmental and physical variables of the territory with the support of the Geographic Information System (GIS). This index is composed of a total of 19 indicators related to education, health, employment, housing conditions, infrastructure, population settlement, industrial concentration and some factors regarding environmental quality, especially focused on the disposal of urban solid waste (USW) in clandestine sites, garbage collection service coverage and flood risk. This analysis allowed us to determine the groups most vulnerable to socio-environmental risks in 692 Basic Geostatistical Areas (AGEB, the acronym in Spanish) of nine city delegations. The results of the research highlight that 14.78% of the population is between a situation of high and very high socio-environmental vulnerability, representing just over 284,000 inhabitants. It is concluded that the use of GIS in spatial planning allows us to identify risk areas and thereby promote more sustainable measures to ensure the well-being of the population. Full article

There has been a debate recently on how the population in traditional mining areas of Central and Eastern Europe faces precarity and marginalization. A spatial approach was employed in a Romanian context using available statistical data on a south Carpathian area (i.e., Gorj County). We also conducted surveys and in-depth interviews with residents in one of the rural communities of Gorj. Our findings highlight that a large number of rural localities in this county are technically, economically, and socially underdeveloped. Many inhabitants face a lack of financial resources and employment opportunities, which has led to the emigration of young people to larger Romanian cities or to other countries. We conclude that in order to avoid a much deeper social and spatial marginalization of local inhabitants, an integrated strategy is needed to target economic and social development, investment in infrastructure and public services, the promotion of employment and training opportunities, and to better integrate local culture and traditions into tourism. Full article

Employment significantly impacts the national economy and people’s livelihoods and affects millions of households. How to effectively and sustainably improve the quality of employment for the population has thus become a key issue facing China at present. In recent years, under the strategic background of “Digital China” and “Employment Priority”, the digital economy has brought about profound changes in the efficiency, dynamics, and distribution of social production. It affects the quality of employment by creating jobs, reshaping employment patterns, and improving labor quality, but its impact and transmission path are still unclear. This research employs a multi-dimensional evaluation approach to score the digital economy and employment quality at the provincial level in China, utilizing data from the country’s provincial panels between 2012 and 2022, and examines the feasibility and effect pathways of the digital economy in promoting sustainable improvement in the quality of residential employment. The empirical results provide ample evidence of the significant role played by the digital economy in the sustainable improvement of the employment quality of the inhabitants. Regions with more robust innovation environments tend to benefit more from this impact, and there are discernible regional variations in the impact. The upgrading of industrial structure mediates this process, and the influencing mechanism is regulated by the innovation environment—that is, the innovation environment exerts a facilitating influence on the process of industrial restructuring. The findings herein offer novel insights into the intrinsic mechanism of the digital economy in promoting sustainable improvement in the quality of residential employment. Full article

The recent release of 2020 U.S. Census data reflects the continued growth of the Hispanic/Latino population over the last four decades. The Hispanic/Latino population has increased by a factor of 3.25 since 1980, with nearly one in five inhabitants of the United States identifying as Hispanic or Latino. With these demographic changes, language maintenance figures have shown significant change as well. In every state, a language shift is evident, as all of the western states have lower measures of Spanish language maintenance among the Hispanic population than they did a generation ago. So, while Spanish language use is growing with regard to overall numbers in most of the Western United States, language shift is still a reality among the Latino population. Social variables such as education, income, and employment also show a different relationship with the Spanish language than they did 40 years ago. While there were strong negative correlations between Spanish language use and these variables in the previous generation, many (but not all) of these correlations have weakened, many to the point of no statistical significance in the data from 2020. Full article

The World Bank has reported that over one billion individuals have a disability, implying that almost fifteen percent of the global inhabitants are susceptible to undergoing levels of discrimination, especially in employment. This issue may prevail on a manufacturing shop floor, whereby a wave of standardisation dominates such as in the design of shop floor workstations. Despite advances made in the literature, people with disabilities are still siloed from manufacturing. Consequently, the aim of this research work was to analyse literature’s current state of the art on the design of workstations for operators with disabilities within the context of Industry 5.0, where sustainability, human-centricity, and resilience are upheld. The study employed a systematic review of 69 publications from Scopus and Google Scholar published between 2013 and 2023, adhering to the updated PRISMA guidelines to identify the major research gaps. The review contributes an understanding of the current academic and industrial limitations such as the absence of social applicability of Industry 4.0 technology, the rift between academic knowhow and industrial implementation, and the lack of alignment with the sustainable development goals (SDGs). Additionally, the review uncovered an absence in work bridging four disciplines together: workstation design, Industry 5.0, sustainability, and disability. An unprecedented understanding of the interdependency between all four disciplines within the remit of smart, sustainable, and inclusive manufacturing workstations is contributed. This review proposes directions amidst the four most relevant SDGs—SDGs 8, 9, 10, and 12 to the topic. Full article

In a globalised economy, metropolises seem to have an ‘extra gear’ compared to smaller urban centres: they attract the most skilled businesses, drive innovation in many fields and can count on material and immaterial assets that foster greater resilience to adverse events of various kinds. Against the dynamism of metropolises, which evolutionary paths do medium-sized cities (MSCs) follow? This paper focuses on the case of Northern Italy and explores employment trends between 2012 and 2020 in 189 MSCs with a population of between 20,000 and 200,000 inhabitants. The evolutionary trajectories of these cities and their varying specialisations are investigated over a period marked by a moderate recovery of the Italian economy following the Great Recession and by a further setback caused by the COVID-19 pandemic. In general, in terms of employment performance, the 189 cities in question were less dynamic than the metropolises, but it is nevertheless necessary to look at their individual circumstances in detail. Furthermore, this work shows significant differences between the MSCs of the Northwest and Northeast in terms of evolutionary trajectories and specialisation profiles. The most problematic situations also relate to cities with a hub status in the wider context and do not only concentrate where a production structure is present that is linked to industry. Full article

This paper extends current research on Human–Robot Interaction (HRI) within Human–Computer Interaction (HCI), focusing on how future virtual agents and communication robots can support the temporal structures and routines within the home. We recruited representatives from 15 households with varied compositions, ranging from single inhabitants to full nest families. Drawing upon P.G. Wodehouse’s The Inimitable Jeeves as an inspiration, the methodology sought to imitate the relationship between a recruitment agency worker (researcher) and an employer (participant) seeking to hire a personal assistant (e.g., a virtual agent or communication robot device) for their home. A ‘household audit’ comprising a guided household tour and an architectural survey was conducted to ascertain the nuanced spatiotemporal routines within the home. The study analysed the responses of participants using the Labovian narrative schema, a traditional method in linguistics research. The findings were then examined through the lens of Reddy et al.’s temporal features of work to understand how domestic work unfolds within the home from a temporal perspective. We argue that the temporal concepts discussed by Reddy et al. provided valuable insights into the temporal dynamics of everyday activities and could inform the design of virtual agents and communication robotic devices to fulfil their roles as domesticated ‘personal assistants’. Full article

The first desegregation efforts in the marginalised and segregated communities in the Pata-Rât area were carried out within the frames of two social housing projects (between 2014–2017 and 2020–2023). Although a housing first methodology would have been more adequate in the context of a marginalised community, given the shortcomings of the Romanian social assistance system, implementation was impossible. In this context, it was necessary to develop a system to access social housing but also to create a reasonably ‘fair process’ at the community level. Thus, in both interventions, the starting point for developing the social housing criteria was to survey the community in order to explore the community members’ preferences regarding the criteria to be considered in the selection of the beneficiary families for the social houses. The surveys covered all the inhabitants of the Pata-Rât area, that is 219 households in the first survey and 282 households in the second. The survey results served as the basis for the development of the criteria for accessing social housing. In this article, we present and discuss the results of the community surveys from 2016 and from 2020, the year of the pandemic outbreak. Differences were found in the prioritisation of criteria, with an increasing preference for those reflecting vulnerability/needs (e.g., number of children, years spent in the community, disability) and decreasing preference for the ones indicating family resources (e.g., employment, income, education). These differences reflect the increase in poverty and loss of resources occurring in the community during this period, due both to the COVID-19 pandemic, and to the relocation of the 35 better-off families in the first Pata-Cluj project. Full article