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45 pages, 767 KiB  
Article
The Economic Effects of the Green Transition of the Greek Economy: An Input–Output Analysis
by Theocharis Marinos, Maria Markaki, Yannis Sarafidis, Elena Georgopoulou and Sevastianos Mirasgedis
Energies 2025, 18(15), 4177; https://doi.org/10.3390/en18154177 - 6 Aug 2025
Abstract
Decarbonization of the Greek economy requires significant investments in clean technologies. This will boost demand for goods and services and will create multiplier effects on output value added and employment, though reliance on imported technologies might increase the trade deficit. This study employs [...] Read more.
Decarbonization of the Greek economy requires significant investments in clean technologies. This will boost demand for goods and services and will create multiplier effects on output value added and employment, though reliance on imported technologies might increase the trade deficit. This study employs input–output analysis to estimate the direct, indirect, and multiplier effects of green transition investments on Greek output, value added, employment, and imports across five-year intervals from 2025 to 2050. Two scenarios are considered: the former is based on the National Energy and Climate Plan (NECP), driven by a large-scale exploitation of RES and technologies promoting electrification of final demand, while the latter (developed in the context of the CLEVER project) prioritizes energy sufficiency and efficiency interventions to reduce final energy demand. In the NECP scenario, GDP increases by 3–10% (relative to 2023), and employment increases by 4–11%. The CLEVER scenario yields smaller direct effects—owing to lower investment levels—but larger induced impacts, since energy savings boost household disposable income. The consideration of three sub-scenarios adopting different levels of import-substitution rates in key manufacturing sectors exhibits pronounced divergence, indicating that targeted industrial policies can significantly amplify the domestic economic benefits of the green transition. Full article
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18 pages, 522 KiB  
Article
Entrepreneurial Competence in Higher Education: An Assessment of the Importance Attributed to It by Final-Year Undergraduate Students
by María Lambarri Villa, Janire Gordon-Isasi and Elvira Arrondo Diez
World 2025, 6(3), 110; https://doi.org/10.3390/world6030110 - 6 Aug 2025
Abstract
In an increasingly complex global context, higher education faces the challenge of preparing professionals who are innovative, committed, and socially responsible. Entrepreneurial competence is particularly prominent among the key skills required to meet this goal, given its significant personal and social impact. This [...] Read more.
In an increasingly complex global context, higher education faces the challenge of preparing professionals who are innovative, committed, and socially responsible. Entrepreneurial competence is particularly prominent among the key skills required to meet this goal, given its significant personal and social impact. This study examines how final-year undergraduate students at the University of Deusto (Spain) perceive the importance of entrepreneurial competence—defined as a set of transversal skills, knowledge, and attitudes enabling initiative and opportunity recognition across various contexts—rather than entrepreneurial competence strictly understood as business creation. The sample included 267 students from different faculties. Descriptive, comparative, and ordinal logistic regression analyses (SPSS) were used. The results show that, while entrepreneurial competence was given significant importance, it was ranked comparatively low relative to other competencies. Significant differences by gender were observed, with women rating entrepreneurial competence more highly than men. The faculty variable showed slight disparities, and there were no relevant differences between campuses. These findings highlight the need to reinforce the integration of entrepreneurial competence into educational curricula on a transversal basis, adapting the teaching of this competence to the sociocultural context of students, as well as the need to increase students’ awareness of the importance of entrepreneurial competence. It is proposed that further research should focus on the relationships between intrapreneurship, gender, and academic disciplines, in order to enrich entrepreneurial competence education and its impact on the employability and social commitment of students. Full article
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17 pages, 326 KiB  
Article
Remittances and FDI: Drivers of Employment in the Economic Community of West African States
by Grace Toyin Adigun, Abiola John Asaleye, Olayinka Omolara Adenikinju, Kehinde Damilola Ilesanmi, Sunday Festus Olasupo and Adedoyin Isola Lawal
J. Risk Financial Manag. 2025, 18(8), 436; https://doi.org/10.3390/jrfm18080436 - 6 Aug 2025
Abstract
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 [...] Read more.
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
(This article belongs to the Special Issue Macroeconomic Dynamics and Economic Growth)
41 pages, 1921 KiB  
Article
Digital Skills, Ethics, and Integrity—The Impact of Risky Internet Use, a Multivariate and Spatial Approach to Understanding NEET Vulnerability
by Adriana Grigorescu, Teodor Victor Alistar and Cristina Lincaru
Systems 2025, 13(8), 649; https://doi.org/10.3390/systems13080649 - 1 Aug 2025
Viewed by 309
Abstract
In an era where digitalization shapes economic and social landscapes, the intersection of digital skills, ethics, and integrity plays a crucial role in understanding the vulnerability of youth classified as NEET (Not in Education, Employment, or Training). This study explores how risky internet [...] Read more.
In an era where digitalization shapes economic and social landscapes, the intersection of digital skills, ethics, and integrity plays a crucial role in understanding the vulnerability of youth classified as NEET (Not in Education, Employment, or Training). This study explores how risky internet use and digital skill gaps contribute to socio-economic exclusion, integrating a multivariate and spatial approach to assess regional disparities in Europe. This study adopts a systems thinking perspective to explore digital exclusion as an emergent outcome of multiple interrelated subsystems. The research employs logistic regression, Principal Component Analysis (PCA) with Promax rotation, and Geographic Information Systems (GIS) to examine the impact of digital behaviors on NEET status. Using Eurostat data aggregated at the country level for the period (2000–2023) across 28 European countries, this study evaluates 24 digital indicators covering social media usage, instant messaging, daily internet access, data protection awareness, and digital literacy levels. The findings reveal that low digital skills significantly increase the likelihood of being NEET, while excessive social media and internet use show mixed effects depending on socio-economic context. A strong negative correlation between digital security practices and NEET status suggests that youths with a higher awareness of online risks are less prone to socio-economic exclusion. The GIS analysis highlights regional disparities, where countries with limited digital access and lower literacy levels exhibit higher NEET rates. Digital exclusion is not merely a technological issue but a multidimensional socio-economic challenge. To reduce the NEET rate, policies must focus on enhancing digital skills, fostering online security awareness, and addressing regional disparities. Integrating GIS methods allows for the identification of territorial clusters with heightened digital vulnerabilities, guiding targeted interventions for improving youth employability in the digital economy. Full article
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16 pages, 5304 KiB  
Article
Regional Youth Population Prediction Using LSTM
by Jaejun Seo, Sunwoong Yoon, Jiwoo Kim and Kyusang Kwon
Sustainability 2025, 17(15), 6905; https://doi.org/10.3390/su17156905 - 29 Jul 2025
Viewed by 466
Abstract
Regional shrinkage, driven by declining birth rates, an aging population, and population concentration in the capital region, has become an increasingly serious issue in South Korea, threatening the long-term sustainability of local communities. Among various factors, youth out-migration is a key driver, undermining [...] Read more.
Regional shrinkage, driven by declining birth rates, an aging population, and population concentration in the capital region, has become an increasingly serious issue in South Korea, threatening the long-term sustainability of local communities. Among various factors, youth out-migration is a key driver, undermining the economic resilience and vitality of local areas. This study aims to predict youth population trends across 229 municipalities by incorporating diverse regional socioeconomic factors and providing a foundation for policy implementation to mitigate demographic disparities. To this end, a long short-term memory (LSTM) model, based on a direct approach that independently forecasts each future time point, was employed. The model was trained using the youth population data from 2003 to 2022 and socioeconomic variables, including employment, education, housing, and infrastructure. The results reveal a persistent nationwide decline in the youth population, with significantly sharper decreases in local areas than in the capital region. These findings underscore the deepening spatial imbalance and highlight the urgent need for region-specific demographic policies to address the accelerating risk of regional population decline. Full article
(This article belongs to the Section Sustainable Urban and Rural Development)
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21 pages, 1133 KiB  
Article
Research on China’s Innovative Cybersecurity Education System Oriented Toward Engineering Education Accreditation
by Yimei Yang, Jinping Liu and Yujun Yang
Information 2025, 16(8), 645; https://doi.org/10.3390/info16080645 - 29 Jul 2025
Viewed by 175
Abstract
This study, based on engineering education accreditation standards, addresses the supply–demand imbalance in China’s cybersecurity talent cultivation by constructing a sustainable “education-industry-society” collaborative model. Through case studies at Huaihua University and other institutions, employing methods such as literature analysis, field research, and empirical [...] Read more.
This study, based on engineering education accreditation standards, addresses the supply–demand imbalance in China’s cybersecurity talent cultivation by constructing a sustainable “education-industry-society” collaborative model. Through case studies at Huaihua University and other institutions, employing methods such as literature analysis, field research, and empirical investigation, we systematically explore reform pathways for an innovative cybersecurity talent development system. The research proposes a “three-platform, four-module” practical teaching framework, where the coordinated operation of the basic skills training platform, comprehensive ability development platform, and innovation enhancement platform significantly improves students’ engineering competencies (practical courses account for 41.6% of the curriculum). Findings demonstrate that eight industry-academia practice bases established through deep collaboration effectively align teaching content with industry needs, substantially enhancing students’ innovative and practical abilities (172 national awards, 649 provincial awards). Additionally, the multi-dimensional evaluation mechanism developed in this study enables a comprehensive assessment of students’ professional skills, practical capabilities, and innovative thinking. These reforms have increased the employment rate of cybersecurity graduates to over 90%, providing a replicable solution to China’s talent shortage. The research outcomes offer valuable insights for discipline development under engineering education accreditation and contribute to implementing sustainable development concepts in higher education. Full article
(This article belongs to the Topic Explainable AI in Education)
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19 pages, 1760 KiB  
Article
A Multilevel Spatial Framework for E-Scooter Collision Risk Assessment in Urban Texas
by Nassim Sohaee, Arian Azadjoo Tabari and Rod Sardari
Safety 2025, 11(3), 67; https://doi.org/10.3390/safety11030067 - 17 Jul 2025
Viewed by 300
Abstract
As shared micromobility grows quickly in metropolitan settings, e-scooter safety issues have become more urgent. This paper uses a Bayesian hierarchical model applied to census block groups in several Texas metropolitan areas to construct a spatial risk assessment methodology for e-scooter crashes. Based [...] Read more.
As shared micromobility grows quickly in metropolitan settings, e-scooter safety issues have become more urgent. This paper uses a Bayesian hierarchical model applied to census block groups in several Texas metropolitan areas to construct a spatial risk assessment methodology for e-scooter crashes. Based on crash statistics from 2018 to 2024, we develop a severity-weighted crash risk index and combine it with variables related to land use, transportation, demographics, economics, and other factors. The model comprises a geographically structured random effect based on a Conditional Autoregressive (CAR) model, which accounts for residual spatial clustering after capture. It also includes fixed effects for covariates such as car ownership and nightlife density, as well as regional random intercepts to account for city-level heterogeneity. Markov Chain Monte Carlo is used for model fitting; evaluation reveals robust spatial calibration and predictive ability. The following key predictors are statistically significant: a higher share of working-age residents shows a positive association with crash frequency (incidence rate ratio (IRR): ≈1.55 per +10% population aged 18–64), as does a greater proportion of car-free households (IRR ≈ 1.20). In the built environment, entertainment-related employment density is strongly linked to elevated risk (IRR ≈ 1.37), and high intersection density similarly increases crash risk (IRR ≈ 1.32). In contrast, higher residential housing density has a protective effect (IRR ≈ 0.78), correlating with fewer crashes. Additionally, a sensitivity study reveals that the risk index is responsive to policy scenarios, including reducing car ownership or increasing employment density, and is sensitive to varying crash intensity weights. Results show notable collision hotspots near entertainment venues and central areas, as well as increased baseline risk in car-oriented urban environments. The results provide practical information for targeted initiatives to lower e-scooter collision risk and safety planning. Full article
(This article belongs to the Special Issue Road Traffic Risk Assessment: Control and Prevention of Collisions)
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25 pages, 12171 KiB  
Article
Multi-Strategy Fusion Path Planning Algorithm for Autonomous Surface Vessels with Dynamic Obstacles
by Yongshun Xie, Chengyong Liu, Yixiong He, Yong Ma and Kang Liu
J. Mar. Sci. Eng. 2025, 13(7), 1357; https://doi.org/10.3390/jmse13071357 - 17 Jul 2025
Viewed by 281
Abstract
Considering the complexity and variability inherent in maritime environments, path planning algorithms for navigation have consistently been a subject of intense research interest. Nonetheless, single-algorithm approaches often exhibit inherent limitations. Consequently, this study introduces a path planning algorithm for autonomous surface vessels (ASVs) [...] Read more.
Considering the complexity and variability inherent in maritime environments, path planning algorithms for navigation have consistently been a subject of intense research interest. Nonetheless, single-algorithm approaches often exhibit inherent limitations. Consequently, this study introduces a path planning algorithm for autonomous surface vessels (ASVs) that integrates an improved fast marching method (FMM) with the dynamic window approach (DWA) for underactuated ASVs. The enhanced FMM improves the overall optimality and safety of the determined path in comparison to the conventional approach. Concurrently, it effectively merges the local planning strengths of the DWA algorithm, addressing the safety re-planning needs of the global path when encountering dynamic obstacles, thus augmenting path tracking accuracy and navigational stability. The efficient hybrid algorithm yields notable improvements in the path planning success rate, obstacle avoidance efficacy, and path smoothness compared with the isolated employment of either FMM or DWA, demonstrating superiority and practical applicability in maritime scenarios. Through a comprehensive analysis of its control output, the proposed integrated algorithm accomplishes efficient obstacle avoidance via agile control of angular velocity while preserving navigational stability and achieves path optimization through consistent acceleration adjustments, thereby asserting its superiority and practical worth in challenging maritime environments. Full article
(This article belongs to the Section Ocean Engineering)
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25 pages, 1772 KiB  
Article
Navigating Structural Shocks: Bayesian Dynamic Stochastic General Equilibrium Approaches to Forecasting Macroeconomic Stability
by Dongxue Wang and Yugang He
Mathematics 2025, 13(14), 2288; https://doi.org/10.3390/math13142288 - 16 Jul 2025
Viewed by 275
Abstract
This study employs a dynamic stochastic general equilibrium model with Bayesian estimation to rigorously evaluate China’s macroeconomic responses to cost-push, monetary policy, and foreign income shocks. This analysis leverages quarterly data from 2000 to 2024, focusing on critical variables such as the output [...] Read more.
This study employs a dynamic stochastic general equilibrium model with Bayesian estimation to rigorously evaluate China’s macroeconomic responses to cost-push, monetary policy, and foreign income shocks. This analysis leverages quarterly data from 2000 to 2024, focusing on critical variables such as the output gap, inflation, interest rates, exchange rates, consumption, investment, and employment. The results demonstrate significant social welfare losses primarily arising from persistent inflation and output volatility due to domestic structural rigidities and global market dependencies. Monetary policy interventions effectively moderate short-term volatility but induce welfare costs if overly restrictive. The findings underscore the necessity of targeted structural reforms to enhance economic flexibility, balanced monetary policy to mitigate aggressive interventions, and diversified economic strategies to reduce external vulnerability. These insights contribute novel policy perspectives for enhancing China’s macroeconomic stability and resilience. Full article
(This article belongs to the Special Issue Time Series Forecasting for Economic and Financial Phenomena)
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20 pages, 1191 KiB  
Article
An Analysis of Factors Affecting University Reputation: A Case Study of Mongolian Universities
by Nyamsuren Purevsuren, Erdenekhuu Norinpel, Purevtsogt Nugjgar, Gerelt-Od Dolgor, Togtokhbuyan Lkhagvasuren, Heemin Park, Altanzul Altangerel and Chantsaldulam Ravdansuren
Sustainability 2025, 17(14), 6397; https://doi.org/10.3390/su17146397 - 12 Jul 2025
Viewed by 421
Abstract
A university’s reputation is a key indicator of the quality of its education, the competitiveness of its alumni, its institutional influence in society, and its degree of global recognition, including its ranking and rating among higher education institutions (HEIs) around the world. This [...] Read more.
A university’s reputation is a key indicator of the quality of its education, the competitiveness of its alumni, its institutional influence in society, and its degree of global recognition, including its ranking and rating among higher education institutions (HEIs) around the world. This not only enhances institutional standing and secures positions in international rankings but also promotes sustainable education practices. In addition, students, their parents, and their partners select universities due to their trust in the reliability of a university’s public reputation and ranking. This study proposes a model to assess a university’s reputation based on specific factors. In this research, the dependent variable is university reputation, the mediating variable is university social responsibility, and the independent variables include the teacher reputation, alumni reputation, research and innovation, and cooperation. A survey of 5902 respondents—including alumni, employers, and parents—offers diverse perspectives on university reputation. Data were analyzed using structural equation modeling tools (Smart PLS 4.1 and SPSS 25.0). The findings confirm that social responsibility has a strong and positive influence on university reputation. Furthermore, faculty and alumni reputation, research and innovation, and external collaboration directly enhance universities’ social responsibility. This suggests that social responsibility serves as a key mediating variable in the relationship between institutional capacity and reputation. This study represents the first empirical assessment of university reputation in Mongolia, addressing a notable gap in the literature. By incorporating context-specific insights and stakeholder perspectives, the research offers both theoretical contributions and practical implications. The results provide a foundation for developing regionally responsive strategies to improve the quality of higher education and advance sustainable development goals. Full article
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14 pages, 697 KiB  
Article
Disparities in Treatment Outcomes for Cannabis Use Disorder Among Adolescents
by Helena Miranda, Jhon Ostanin, Simon Shugar, Maria Carmenza Mejia, Lea Sacca, Mitchell L. Doucette, Charles H. Hennekens and Panagiota Kitsantas
Pediatr. Rep. 2025, 17(4), 74; https://doi.org/10.3390/pediatric17040074 - 10 Jul 2025
Viewed by 498
Abstract
Background: This study examined treatment outcomes for cannabis use disorder (CUD) among adolescents (12–17 years old) in the United States. Methods: Data from the 2018–2021 Treatment Episode Data Set-Discharges (TEDS-D) included 40,054 adolescents diagnosed with CUD. Descriptive statistics, Chi-square tests, and multivariable logistic [...] Read more.
Background: This study examined treatment outcomes for cannabis use disorder (CUD) among adolescents (12–17 years old) in the United States. Methods: Data from the 2018–2021 Treatment Episode Data Set-Discharges (TEDS-D) included 40,054 adolescents diagnosed with CUD. Descriptive statistics, Chi-square tests, and multivariable logistic regression assessed treatment outcomes and factors associated with treatment completion. Results: Only 36.8% of adolescents completed treatment. The most common reasons for not completing treatment were dropping out (28.4%) and transferring to another facility/program (17.0%). Males and Black non-Hispanic adolescents had lower odds of completing treatment (OR = 0.79, 95%CI: 0.75–0.84), while Hispanic (OR = 1.13, 95%CI: 1.08–1.18), Asian (OR = 1.56, 95%CI: 1.3–1.86) and Native Hawaiian/Pacific Islander adolescents (OR = 2.31, 95%CI: 2.04–2.61) had higher odds of completion compared to their White counterparts. Independent living arrangements, homelessness, arrests in the past 30 days and younger age (<15 years old) decreased the likelihood of treatment completion. Adolescents with co-occurring mental health and substance use disorders also had lower completion rates (OR = 0.79, 95%CI: 0.77–0.86). Referral from schools/employers and treatment settings were associated with a higher success, particularly with stays of 4–6 months and 7–12 months. Conclusion: This study highlights the need for targeted CUD treatment programs that support at-risk adolescents, especially those experiencing homelessness or facing legal issues. High dropout and transition rates suggest a need for continuity of care and program integration between facilities. Strengthening coordination among public health officials, community organizations, and stakeholders is essential to developing culturally responsive treatment interventions that address social determinants of health, substance use, and mental health in this vulnerable population. Full article
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16 pages, 376 KiB  
Article
Impact of the Digital Skills on Employability: Cross-Sectional Analysis
by Biljana Đorđević, Sandra Milanović Zbiljić and Marija Radosavljević
Economies 2025, 13(7), 196; https://doi.org/10.3390/economies13070196 - 8 Jul 2025
Viewed by 509
Abstract
Digital skills are increasingly vital for enhancing employability, as they equip individuals to meet the evolving demands of the modern workforce. Therefore, this paper examines the impact of digital skills on employability, focusing on the influence of both basic and above-basic levels of [...] Read more.
Digital skills are increasingly vital for enhancing employability, as they equip individuals to meet the evolving demands of the modern workforce. Therefore, this paper examines the impact of digital skills on employability, focusing on the influence of both basic and above-basic levels of information and data literacy, communication and collaboration, problem-solving, digital content creation, and safety skills, considered key components of digital competence. The research employs regression analysis using secondary data extracted from the Eurostat database. Based on data from 32 European countries, the findings indicate that three proxies for digital skills, communication and collaboration, digital content creation, and safety, significantly and positively influence employability. The contribution of this paper to the existing literature on digital skills and employability is twofold. First, by evaluating the influence of five categories of digital skills across different proficiency levels on employment rates, the study sheds light on which specific digital skills have the most substantial impact on employability in today’s labor market. Second, the findings provide a foundation for formulating recommendations aimed at enhancing the digital capabilities of the labor force. Full article
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10 pages, 218 KiB  
Article
Factors Associated with Employment in a Cohort of Patients with Systemic Sclerosis
by Cristina A. Vrancianu, Cristiana Grigore, Ioan Ancuta, Mihai Bojinca and Ana Maria Gheorghiu
J. Clin. Med. 2025, 14(13), 4764; https://doi.org/10.3390/jcm14134764 - 5 Jul 2025
Viewed by 331
Abstract
Background/Objectives: Systemic sclerosis (SSc) is a multisystemic chronic autoimmune disease, which leads to disability and possibly early retirement. The objective of our study was to explore the associations between employment status (ES) and demographic, clinical and functional features in a single-center EUSTAR cohort. [...] Read more.
Background/Objectives: Systemic sclerosis (SSc) is a multisystemic chronic autoimmune disease, which leads to disability and possibly early retirement. The objective of our study was to explore the associations between employment status (ES) and demographic, clinical and functional features in a single-center EUSTAR cohort. Methods: Consecutive patients with SSc examined between November 2011 and June 2023, who were under the age of retirement in our country (62 years for women, 65 for men at the time), were included. All patients underwent a comprehensive clinical assessment and filled in a work assessment questionnaire as well as two validated health-related questionnaires: the Scleroderma Health Assessment Questionnaire (SHAQ) and the Duruoz Hand Index (DHI). Associations between ES and potential predictors (education level, disease characteristics, work conditions, SHAQ and DHI) were tested using logistic regression adjusted for age and gender. Results: Ninety-one patients (mean ± SD age 53.7 ± 11.8 years, twenty-two with diffuse skin involvement, fifty-six with a history of digital of digital ulcers (DUs)), were included. Only 22 patients were still employed, while 69 were retired, of which 38 retired because of SSc. Among the employed, nine performed manual labor, nine spent many hours standing and three had to work in a cold environment. When potential predictors were tested separately, adjusted for age and sex, patients with higher education (OR (95% CI) 11.36 (2.03–63.36), p = 0.006) and no history of digital ulcers had higher odds of being employed. The presence of joint contractures and weightlifting as a work demand were associated with unemployment. In a multivariable model, higher education (OR 5.91, 95% CI 0.97–36.09, p = 0.054 and younger age (OR 0.90, 95% CI 0.85–0.96, p = 0.001) were independently associated with continued employment. High school education did not show a significant effect (OR 0.089, 95% CI 0.015–0.530, p = 0.008). Patients with a history of digital ulcers had the lowest employment rates compared to those with no digital ulcer history. No significant associations were found between employment status and SHAQ or DHI scores. Conclusions: SSc is associated with significant work disability and early retirement. Higher education, the lack of Dus and younger age were highly associated with staying employed. Given the rarity of SSc, we consider that our good sample size (n = 91) reflects disease prevalence, but results should be tested in other studies and the single center should be considered when interpreting generalizability. Full article
(This article belongs to the Section Immunology)
14 pages, 453 KiB  
Article
Ophthalmologists’ Evaluation by Physician Review Websites—Do Only Soft Skills Matter? A Cross-National Analysis of over 70,000 Patient Reviews
by Wojciech Janikowski, Agnieszka Jóźwicka, Janusz Skrzypecki, Aleksandra Pyziak-Skupień, Jacek P. Szaflik and Joanna Przybek-Skrzypecka
Healthcare 2025, 13(13), 1548; https://doi.org/10.3390/healthcare13131548 - 28 Jun 2025
Viewed by 344
Abstract
Background: Physician rating websites (PRWs) are increasingly used by patients to assess healthcare providers, yet little is known about the factors influencing patient feedback in ophthalmology across different healthcare systems. Objective: This study aimed to identify variables associated with patient reviews of ophthalmologists, [...] Read more.
Background: Physician rating websites (PRWs) are increasingly used by patients to assess healthcare providers, yet little is known about the factors influencing patient feedback in ophthalmology across different healthcare systems. Objective: This study aimed to identify variables associated with patient reviews of ophthalmologists, with a particular focus on soft skill-related feedback, and to compare trends between Polish and British healthcare systems. Methods: We analyzed data on 461 verified ophthalmologists—261 from ZnanyLekarz.pl (Poland) and 200 from Doctify.com (UK)—collected between March and July 2024 with the highest number of reviews. Physician characteristics, including sex, academic title, years of experience, practice setting, specialization, and online presence, were examined. Review content was categorized into soft skills, professional abilities, or both. Statistical and multivariate analyses were performed to determine factors influencing (a) soft review frequency and (b) the profile of a top-rated ophthalmologist, defined as one with the highest overall ratings and a minimum of 100 reviews. Results: We analyzed a total of 70,176 patient reviews—55,786 from a Polish physician rating website (PRW) and 14,390 from a British PRW. Polish ophthalmologists received significantly more reviews than their British counterparts, with a median of 141 reviews per physician compared to 44 in the UK (p < 0.001). Feedback focused on soft skills accounted for 74% of Polish reviews and 59% of British reviews. Key predictors of soft skill-focused reviews included female gender, higher average ratings, practice in pediatric ophthalmology, and affiliation with the private sector. In contrast, fewer soft reviews were associated with area of surgical expertise, public sector employment, and practicing in the UK. Academic title also influenced the content of reviews: physicians holding PhDs received more feedback focused on soft skills, while full professors received less and years of experience had no significant effect. In the multivariate model assessing predictors of being a top-rated ophthalmologist for the whole cohort, each additional review containing substantive content or soft skill-related feedback increased the odds by 29% and 14%, respectively (p < 0.001 for both). Conclusions: Patient reviews are largely influenced by perceived interpersonal qualities rather than professional credentials or clinical experience. The active solicitation of patient feedback, as implemented on Polish physician rating platforms, results in over three times the volume of reviews compared to the British approach, which relies on passive voluntary submission without direct prompts. Full article
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19 pages, 404 KiB  
Article
Sense of Mastery Explains Social Patterning of Health
by Shervin Assari, Babak Najand and Alexandra Donovan
Healthcare 2025, 13(13), 1511; https://doi.org/10.3390/healthcare13131511 - 24 Jun 2025
Viewed by 392
Abstract
Background: Social determinants of health—including both adversity and socioeconomic position—are known to shape physical health, health-related behaviors, and overall well-being. However, the psychological mechanisms that link these determinants to diverse outcomes remain insufficiently explored across international contexts. Objective: The objective of this study [...] Read more.
Background: Social determinants of health—including both adversity and socioeconomic position—are known to shape physical health, health-related behaviors, and overall well-being. However, the psychological mechanisms that link these determinants to diverse outcomes remain insufficiently explored across international contexts. Objective: The objective of this study is to test whether sense of mastery and control over one’s life mediates the associations between key stressors (childhood abuse, financial insecurity) and socioeconomic resources (education, employment, and marital status) with a wide range of outcomes spanning health, behaviors, and well-being. Methods: Using cross-sectional data from Wave 1 of the Global Flourishing Study (GFS), we analyzed responses from more than 200,000 adults in 23 countries. Predictors included exposure to childhood abuse, perceived financial insecurity, and indicators of socioeconomic position (education, employment, and marital status). Outcomes included self-rated physical and mental health, depression, anxiety, smoking, drinking, physical activity, life satisfaction, and happiness. Structural equation modeling (SEM) was used to evaluate both direct and indirect (mediated) effects through sense of mastery and control over life. Results: Stressors were associated with poorer health, higher engagement in risk behaviors, and lower well-being. In contrast, higher levels of education, employment, and being married were linked to more favorable outcomes. In all tested models, sense of mastery and control over life significantly mediated the effects of both stressors and socioeconomic resources on health, behaviors, and well-being outcomes. Conclusions: Sense of mastery and control over life may represent key psychological pathways linking both adversity and social advantage to diverse health-related outcomes. Interventions that enhance individuals’ perceived control may offer cross-cutting benefits to improve health, promote well-being, and reduce behavioral risk factors globally. Full article
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