Search Results (842)

Background/Objectives: Von Hippel–Lindau (VHL) disease is a rare autosomal dominant hereditary disorder. Central nervous system hemangioblastomas are one of the most common tumor types associated with VHL disease. Although these tumors are histologically benign, delayed diagnosis and treatment may result in severe neurological dysfunction, permanent disability, and even death. However, little is known about the experiences of patients with VHL disease. The aim of this study was to gain a better understanding of the illness experiences and psychological responses of patients with VHL disease accompanied by central nervous system hemangioblastomas. Methods: A qualitative study based on a semi-structured guide was conducted. Twelve participants were recruited. Data were collected through face-to-face interviews and analyzed using the constant comparative method. Results: Four themes and their subthemes were identified: 1. powerlessness—unpredictable disease progression and uncontrollable continuity; 2. negative emotional experiences—guilt and self-blame, depression, and low self-esteem; 3. compromise—acceptance of fate, positive outlook, and sense of hope; and 4. persistent worry—worries about family members, anxiety regarding finances and employment, and uncertainty regarding the future. Conclusions: This study identified four major themes in the illness experiences of patients with VHL disease accompanied by central nervous system hemangioblastomas, which provided deep insights into the care needs of individuals with VHL disease. Healthcare providers should develop effective measures to enhance patients’ ability to maintain a good quality of life and confront the future with resilience. Full article

With the ongoing advancement of urbanization, the renewal of old urban areas has emerged as a central front in enhancing urban quality, with street space improvement playing a pivotal role in advancing sustainable urban development. This study focuses on Chengdu, a highly urbanized megacity, employing a combination of multi-point continuous street view photography, spatial mapping, and landscape design interventions to systematically examine human activity patterns, commercial dynamics, and pathways for spatial optimization along the street-facing interfaces of old residential neighborhoods and their adjacent urban streets. The findings reveal that: (1) commercializing the street-facing façades enhances local employment opportunities; (2) window-type fences demonstrate superior adaptability by effectively balancing commercial accessibility with resident safety; and (3) a diverse mix of commercial types sustains the vitality of street-level economies in these areas. These results not only offer actionable spatial strategies for the renovation of old residential zones in Chengdu but also contribute transferable insights for urban regeneration efforts globally. Full article

This study investigates thermal stress and energy-related anxiety as lived, multidimensional manifestations of energy poverty in Western Macedonia, Greece, a coal phase-out region undergoing just transition. Using a 261-household survey, we construct a thermal stress index from four Likert-type items capturing seasonal thermal adequacy, energy anxiety, and restricted use of rooms. High thermal stress is defined as the upper quartile of the index. Descriptive results indicate that high thermal stress affects 27.2% of households, exceeding a 20% threshold, while energy-related anxiety and restricted room use are widespread. We then estimate logistic regression models to examine whether vulnerability characteristics (disability-related thermal/electric needs, single parenthood, dependent children, benefit receipt, elderly presence), financial stress indicators (arrears, energy debt, frequent forced reductions in consumption), and socio-economic controls (income, employment, tenure, age, gender) predict high thermal stress. Adjusted models show that vulnerability markers do not retain statistically independent associations once controls are included. In contrast, tenure and energy-related financial stress are significantly associated with the probability of high thermal stress. The findings highlight the importance of measurement choices and suggest that experiential indicators capture energy-poverty dynamics that are not reducible to income-based targeting, with implications for just-transition policy design and energy justice. Full article

With the steady of new-type urbanization, the urban–rural income gap has become an increasingly prominent issue in China. Nevertheless, limited attention has been paid to the spatial relationships among new-type urbanization, industrial structure upgrading, and farmers’ income in Northeast China. Taking Northeast China as the research area, this study constructs a multidimensional evaluation index for new-type urbanization and employs data panels spanning 34 regional areas spanning the years from 2012 to 2023. The Statistical Durbin Model is used to examine both the direct and spatial spillover effects of new-type urbanization on farmers’ income, while the mediating role of industrial structure upgrading is further explored. The empirical findings indicate that: (1) cities with relatively higher farmers’ income levels and more advanced new-type urbanization are mainly concentrated in Liaoning Province; (2) new-type urbanization significantly contributes to the growth of farmers’ income; (3) new-type urbanization exerts positive spatial spillover effects on farmers’ income in surrounding regions; (4) industrial structure upgrading serves as an important transmission channel through which new-type urbanization enhances farmers’ income; and (5) among the control variables, fiscal support for agriculture and the degree of agricultural economic growth exerts large beneficial influence on farmers’ income. These results provide empirical and theoretical support for promoting new-type urbanization as an effective approach to narrowing the urban–rural income gap and increasing farmers’ earnings. Accordingly, policy efforts should focus on accelerating the advancement of new-type urbanization in Northeast China, strengthening infrastructure development and the provision of public services, optimising industrial structures to enhance employment absorption capacity, expanding farmers’ income sources, and fostering coordinated and sustainable urban–rural development across the region. Full article

Ecosystem restoration is increasingly recognised as part of the global solution for building a resilient, low-emissions economy, with its associated employment opportunities helping to provide political legitimacy for government investment. In Aotearoa New Zealand, however, little is known about the employment effects of government-funded ecosystem restoration initiatives. This study addresses that gap by analysing project-level data from 359 “Jobs for Nature” projects to examine how funding levels and contextual factors influence direct employment outcomes. Multiple regression analyses build on one-way ANOVA tests to quantify the contribution of funding and contextual factors to employment outcomes and to assess their differential impacts across various settings (regions, agencies, project types, and durations). The analysis reveals that while funding is the primary driver of employment—with each additional NZD 100,000 creating approximately 0.7 full-time equivalent (FTE) jobs—contextual factors call for a more dynamic, targeted policy approach to maximise marginal employment returns. Three key policy implications are accordingly drawn: (1) direct more funding to regions with higher socio-economic deprivation; (2) preferentially support projects of medium-term duration; and (3) evaluate and replicate the practices of high-performing funding agencies. Full article

High variability in multi-product manufacturing environments and rapidly changing customer demands make decentralized coordination of work-in-process (WIP) and production resources increasingly important. However, the intrinsic rigidity of conventional centralized and monolithic manufacturing execution systems (MESs) renders them unsuitable for such highly dynamic environments. To address this limitation, this study proposes an agent-based distributed, decentralized MES architecture. The manufacturing execution process is realized through collaboration among constituent agents based on an employment network (EmNet). Specifically, three types of agents are introduced: WIPAgents (representing WIPs), PAgents (representing processing resources), and MHAgents (representing material-handling resources). Collaboration among agents (e.g., collaborator discovery, partner selection, and data sharing/exchange) is facilitated by a data-space-based collaboration platform which was introduced in our prior work. To validate the proposed architecture, we built a digital-twin-based simulation testbed and conducted simulation experiments. The experimental results confirm the validity and operational feasibility of the proposed architecture. Full article

Background: Anatomic pathology laboratories operate under conditions requiring high precision, strict documentation, biosafety protocols, and tight turnaround times. Evidence from Greece is limited, and joint assessment of burnout and leadership in this setting is rare. Objective: The aim of this study was to estimate burnout levels among anatomic pathology personnel in Attica and examine their association with perceived leadership style. Methods: A cross-sectional survey of public and private laboratories was carried out. The questionnaire included demographics and work characteristics, the Copenhagen Burnout Inventory (CBI), and the Multifactor Leadership Questionnaire Form 5X (MLQ-5X). Results: Burnout levels were moderate to low overall, with personal burnout highest, work-related intermediate, and colleague-related lowest. Women and employment type were associated with personal burnout (p < 0.05). Passive/avoidant leadership (including management by exception–passive and laissez-faire) showed positive associations with burnout, whereas transformational leadership and favorable leadership outcomes—particularly, perceived effectiveness and satisfaction with the leader—were inversely associated; transactional leadership followed the same direction but less robustly (p < 0.05 where supported). Conclusions: Burnout among anatomic pathology personnel in Attica is non-trivial and varies across domains. Leadership dimensions display differential links with burnout, indicating potentially modifiable organizational targets for intervention. Significance: To our knowledge, this is the first study in Greece and among the first in Europe to jointly apply CBI and MLQ-5X in anatomic pathology laboratories, offering practical evidence to inform leadership-oriented interventions. Full article

The sustainability of reservoir resettlement depends on the synergistic development of resettlers’ livelihoods and host regions; however, existing studies lack an integrated analytical framework. Combining the Sustainable Livelihoods Framework with synergistic development theory, this study establishes a dual-system evaluation model comprising the Regional Development Support (RDS) and Resettlers’ Livelihood Development (RLD) indices. Using survey data from 289 households across 10 counties in Zhejiang’s QC Reservoir project, we apply composite weighting, coupling coordination modeling, and spatial analysis to evaluate the levels of synergistic development and examine spatial patterns. The findings reveal that (1) there is significant gradient differentiation in the Synergistic Development Index (SDI), with scores ranging from 0.134 to 0.738; (2) spatial autocorrelation is weak (Moran’s I = −0.089), reflecting industrial heterogeneity; and (3) four distinct coordination types are identified, with employment–industry mismatch and ecological constraints being the primary limiting factors. This study provides a diagnostic framework for assessing resettlement outcomes and offers guidance for formulating differentiated policy interventions. Full article

Investors use information about companies’ social and environmental performance to make investment decisions, a strategy known as Environmental, Social, and Governance (ESG) investment analysis. ESG screening may offer a mechanism to incentivize corporations to improve their health impact. However, there has been limited investigation of the extent to which ESG investment frameworks capture corporate health impacts in major industries. In this study, we sought to characterize the extent to which ESG frameworks address the health-impacting activities of the food and beverage (F&B) industry. To do this, we conducted a deductive framework analysis during the period of September 2023 to March 2024. Specifically, we identified gaps in existing ESG frameworks by comparing the content of five ESG reporting standards and rating systems to the HEALTH-CORP-FB typology, an evidence-based typology that describes the health-impacting activities of the F&B industry across seven domains (Governance Practices, Political Practices, Preference and Perception Shaping Practices, Economic Practices, Employment Practices, Products and Services, and Environmental Practices). To further assess how ESG frameworks account for the health-impacting activities of the F&B industry, we classified health-focused ESG fields in the packaged foods subindustry by two attributes: relevance to the assigned HEALTH-CORP-FB activity (low, medium, high) and type of business operations addressed (e.g., process, performance). Results indicate that, on average, the ESG fields (n = 1348) covered 39% of the 89 HEALTH-CORP-FB activities (range across frameworks: 27–48%). Higher proportions of activities in the Governance, Environmental, Employment, and Economic Practices domains (range across domains: 43–87%) were represented than activities in the Products and Services, Preference and Perception-Shaping Practices, and Political Practices domains (17–36%). Fields assigned to the latter domains were also less likely to be deemed highly relevant and to measure corporate performance. We conclude that the ESG frameworks included in this study capture some of the activities of the F&B industry that affect population health and health equity; however, critical gaps remain. We discuss how integrating key health-focused ESG indicators (e.g., revenue generation from ultra-processed foods) into existing frameworks could enable investors, public health organizations, civil society, and shareholder advocates to strengthen the accountability of the F&B sector with respect to health. Full article

Background/Objectives: Financial toxicity (FT) refers to the financial burden directly or indirectly caused by a patient’s medical care. Patients with head and neck cancer (HNC) are particularly vulnerable to FT due to lower rates of return to work and higher out-of-pocket payments (OOPP). In this cross-sectional study, we assessed the amount and types of OOPP, as well as the prevalence of FT, in HNC patients who had completed curative radiotherapy. Methods: We included HNC patients who underwent curative-intent radiotherapy at four private clinics in Romania, within 12 months of completing treatment. Participants completed a 25-item questionnaire capturing sociodemographic information, insurance status, income, and OOPP. To assess subjective FT, we used the validated nine-item Financial Index of Toxicity (FIT), which measures three FT domains: financial stress, financial strain, and lost productivity. Each domain and the total score range from 0 to 100, with higher scores indicating greater financial toxicity. Descriptive statistics were used to summarize patient characteristics. Pearson’s chi-square, t-tests, and one-way ANOVA were used to assess statistical associations, with a significance threshold of p < 0.05. Results: Among 113 patients (mean age: 59), the majority were male (74.3%) and married (74.3%), with 40% having completed university or higher education. The most frequent tumor sites were the oropharynx (29 cases), larynx (22), and oral cavity (21). Concurrent chemoradiation was the most common treatment modality (47%). The mean total FT score was 18.8. Overall, 39.8% of patients experienced financial toxicity, and 29.2% scored above the mean in financial stress. Moderate financial strain (score > 21) was reported by 39.8% of participants, and approximately one-third reported loss of productivity. Transportation and nutritional supplements were the most common OOPP categories. Notably, 42% of patients spent at least 400 euros—equivalent to Romania’s monthly minimum income—on transportation during radiotherapy. FT was significantly associated with employment and marital status, but not with tumor site or treatment type. Conclusions: Among Romanian HNC patients treated with curative radiotherapy, we found substantial OOPP, particularly for transportation and nutritional supplements. While overall FT levels were moderate, divorced patients and those retired due to other chronic conditions were the most vulnerable to financial distress. Financial toxicity can directly affect treatment adherence, survival, and quality of life. By integrating financial counseling, social support, and broader coverage of treatment-related expenses, healthcare systems can mitigate FT for these patients. Full article

Global fishery resources are under increasing pressure from environmental change and institutional constraints. China’s seasonal fishing moratorium has contributed to resource recovery but has also created income and employment challenges for small-scale fishers. This study examines how livelihood capital structures shape annual livelihood portfolios under predictable closure constraints, using three representative fishing communities in Guangdong Province as case studies. A combination of data augmentation, regression analysis, and agent-based simulation was applied to analyze the relationships between capital endowments and behavioral responses. Results show that environmental and financial capital significantly increase the likelihood of maintaining capture as the primary livelihood, while psychological capital stabilizes decisions under uncertainty. Physical capital and social networks exhibit more variable effects, reflecting differentiated adaptive capacities. Simulations further reveal threshold effects and diminishing marginal returns in capital accumulation, with heterogeneous temporal impacts across capital types. Theoretically, the study extends the Sustainable Livelihoods Approach by incorporating environmental and psychological capital, thereby enriching the understanding of capital mechanisms in fisheries. Overall, the findings advance knowledge of how small-scale fishers adapt under institutional constraints and provide practical insights for policies aimed at aligning livelihood security with the sustainable use of marine resources. Full article

Faces are central to human interaction, serving as primary sources of identity, emotional cues, and social judgments. Facial attractiveness is strongly linked to perceptions of trustworthiness and moral goodness, leading to preferential treatment across education, employment, and legal contexts. Deviations from facial norms—such as asymmetry or visible differences—are, by contrast, often associated with negative traits, social avoidance, and dehumanisation. Across cultures and centuries, deliberate facial disfiguration has been used as a form of punishment for perceived moral or legal transgressions. Evidence from ancient Egypt, Mediaeval Europe, and early modern legislation, as well as modern acid attacks, indicates that intentional facial disfiguration has long served as a means of ongoing punishment through humiliation and identity disruption. Motivations for targeting the face may be rooted in its central role in identity, beauty, symmetry, and symbolic purity. Despite contemporary legal efforts to curb acid attacks and related violence, legislation specifically addressing intentional facial disfiguration remains limited. Modern psychological research confirms that acquiring a facial difference can severely impact quality of life, social functioning, and identity. This paper synthesises historical, cultural, and psychological perspectives on punitive facial disfiguration, highlighting its enduring role as a mechanism of social control. Future research should examine perpetrators’ decision-making, possible differences between different types of facial disfiguration, and the perceptual and emotional consequences of different facial injuries to inform prevention strategies and improve support for victims. Full article

Background: Patients presenting to the Emergency Department (ED) with amphetamine-type stimulant (ATS) use can exhibit a wide range of symptoms, ranging from mild agitation to life-threatening dysrhythmias. Early identification of patients at risk for more severe medical complications after ATS use is a key challenge in emergency care. Objective: To identify clinical and demographic predictors associated with a medical condition among patients presenting to the ED after ATS use. Methods: Retrospective cohort study of patients who presented to the ED with suspected ATS use at a large academic community hospital in Ontario from 1 September 2016 to 31 August 2017. Patients were screened using ICD-10 codes and included if they had a positive drug screen and clinical suspicion for ATS use. Our primary outcome was a composite of recognized complications of ATS toxicity. Predictor variables included age, sex, employment status, mental illness or substance use history, ED administration of benzodiazepines, antipsychotics, or physical restraints. Multivariable logistic regression was used to assess associations. Results: Of 1591 charts reviewed, 128 (8%) met the inclusion criteria. The median age was 29.5 years (interquartile range [IQR]: 23–36), and 50.8% were female. In adjusted analyses, benzodiazepine administration was significantly associated with a medical condition (Odds Ratio [OR] 3.33; 95% CI: 1.31–8.45; p = 0.011) as was employment status (OR 9.30; 95% CI: 1.00–86.03; p = 0.019). Conclusions: Benzodiazepine administration and unemployment were strong predictors of a medical condition among patients presenting to the ED after ATS use. These patients should undergo thorough physical examination and diagnostic testing to identify and manage potentially life-threatening conditions. Full article

This entry presents the history, geography, business, regulations, and the roles of gig workers, platform/algorithms, and employers, focusing primarily on the USA and the EU. The gig economy is informally referred to also as the fourth industrial revolution or the 1099 economy, emphasising sharing, freelance, or platform work; it is a complex and changing business model and regulatory environment. In practice, the gig economy refers to a tripartite relation between workers, platforms/apps, and employers, leading to a two-sided market, where algorithms match supply and demand for paid labour and clients. It is only recently that the gig economy has started to be conceptualised, and its implications, challenges, and impacts are captured in economic law and society, including the power dynamics related to the interplay between economics, technology, regulation, and communities. Conceptually, the gig economy is important, as small paid work has always been present in society for all types of workers and beneficiaries. This new business model of on-demand work has some perceived advantages, such as freedom of work, under-regulation, efficient use of capital, driving down costs, and improving services. However, there is a dualisation of anti-power between workers and non-employers that may lead to precarious work, less free workers, and shadow corporations that distort the market using game changers like digital management algorithms. Currently, the size of the gig economy comprises 154–435 million gig workers out of the world’s 3.63 bn workers, with a market size of USD 557 bn, and is still expanding. Full article

This study provides a structured and differentiated review of the literature on platform labour from the workers’ perspective, examining how platform-mediated work affects multiple dimensions of workers’ employment conditions and well-being as well as their subjective experiences. Platform labour is a new form of work where companies create online platforms which match consumers with service providers, thereby providing workers with a new type of employment opportunity, casually referred to as “being your own boss”, accompanied by a certain degree of flexibility and autonomy. However, it is important to note that this flexibility and autonomy is limited by factors such as algorithmic management, and it has also led to the spread of increased precarity and social inequality. Existing studies highlight that these effects vary substantially across types of platforms, worker groups and socio-institutional contexts. The subjective experience of platform workers is neither an absolute “good” nor “bad” experience, but is a function of their own unique work and life experiences and personal needs. Based on these themes, we suggest that attention to the needs of different groups of platform workers, their diverse identities and interests, and to labour equity and social protection is key to the sustainable development of the platform economy. Future research could further prioritise cross-regional differences, algorithmic governance (including emerging technologies), the effectiveness of regulatory and organisational innovations in advancing labour equity and social protection, and the long-term, intersectional effects of platform labour, with a view to promoting a more inclusive and sustainable platform ecosystem. Full article