Search Results (3,096)

Objective: To evaluate the impact of urban–rural health insurance integration on the health outcomes and financial burden of rural older adults. Methods: Utilizing panel data from the China Health and Retirement Longitudinal Study (CHARLS) spanning 2013 to 2018, we employed a staggered difference-in-differences model coupled with propensity score matching (PSM-DID) for rigorous causal identification. Results: The policy significantly reduced out-of-pocket medical expenditures for rural households by approximately 5.6% (p = 0.034). Concurrently, significant improvements were observed in both physical health (a 0.092-point reduction in ADL impairment scores) and mental health (a 0.725-point reduction in CES-D depression scores). Mechanism analyses revealed that the integration did not significantly increase the probability of outpatient or inpatient visits—thereby ruling out supplier-induced demand and moral hazard—while effectively reducing the incidence of catastrophic health expenditure by 1.9% (p = 0.004). Heterogeneity analyses indicated that while the financial relief was universally distributed across varying educational levels, the policy dividends were predominantly captured by the younger-old demographic. Notably, the reduction in financial burden was not statistically significant for the oldest-old cohort (aged 75 and older). Conclusions: The urban–rural health insurance integration has achieved a dual dividend of financial protection and health enhancement without triggering the overutilization of medical services. Nevertheless, the unmet care expenses for older adults with severe disabilities underscore the urgent necessity for a secondary safety net, such as long-term care insurance. Full article

This study examines the relationship between emotional intelligence and enterprise risk management maturity among risk leaders in Indonesia’s financial services sector, adopting a workplace accountability perspective to explain how leadership behavioural competencies support effective risk ownership, risk communication, and accountable risk decision-making. Drawing on survey data from 280 board-level executives holding the Qualified Risk Governance Professional credential, the study measures emotional intelligence using the Bar-On EQ-i and enterprise risk management maturity using the RIMS Risk Maturity Model. The findings reveal a strong and positive association between emotional intelligence and enterprise risk management maturity, with interpersonal competence and adaptability exhibiting the strongest associations with ERM maturity, while no significant differences are observed across job roles or organisational size. By empirically examining the association between leadership emotional capabilities and the institutionalisation of risk governance, the study contributes to global management and the literature on risk by extending enterprise risk management research beyond technical frameworks and compliance models, particularly within emerging market contexts. The results suggest that emotional intelligence may represent a transferable governance capability that is relevant to organisations operating in complex, uncertain, and globally interconnected environments. Practically, the study suggests that emotional intelligence development may represent a useful complement to leadership and risk capability programmes aimed at supporting risk culture, cross-functional engagement, and accountability. Full article

Background: Despite being considered a country with a larger health workforce in Africa, the South African health workforce continues to experience shortages and a maldistribution of health workers across regions and sectors. Current projections suggest that the workforce is expected to decline further, especially among doctors, nurses and midwives, in large part, due to attrition—which could compromise the delivery of primary health and maternity services. These health workforce shortages and uneven distribution threaten the sustainability and effectiveness of health services in South Africa and drives the need to investigate the factors that may be influencing career choice and change decisions among health professionals in South Africa. Methods: A qualitative exploratory study, making use of purposive sampling and semi-structured interviews, was conducted to investigate the factors influencing career choice and change decisions among health professionals in South Africa. The participants were qualified health professionals in the fields of medicine, nutrition, pharmacy, nursing, and psychology working in the private, public, and academic sectors. Data was collected until saturation was achieved and then thematically analyzed using MAXQDA 24. Results: A total of 10 participants made up of three males and seven females were interviewed. These participants worked in different employment sectors with some having dual roles in private practice, public sector, and academia. The analysis revealed three major themes that capture the nature of and factors influencing career choice and career changes occurring in South Africa. The first theme related to factors influencing career choice (including altruism, family influence, personal experiences, financial/job security, academic achievement, career guidance, and opportunity for change). The second theme focused on career change dynamics (nature of career changes and career transitions occurring in the form of specialization, switching health professions, exiting health professions, adding non-health interests, and shifting focus areas). The third theme revealed factors influencing career change. These were categorized into personal and individual factors, workplace or job-specific factors, and administrative factors. This study has contributed to understanding the career choices and career changes taking place within the health professions in South Africa. It has also revealed a need for reforms in policy and practice for the current health professionals who have no intention of changing their careers while highlighting implications for future training of health professionals. Also, addressing the challenges of poor working conditions, lack of support, unemployment and placement delays, and other administrative barriers will help mitigate some of the issues leading to health workforce shortages and inequities in the South African context. Conclusions: The strongest motivator for choosing a career in health professions is the desire to care for others, while retention of the health workforce is challenged by personal, workplace, and administrative factors. Enhancing workplace conditions and support systems, implementing policy reforms, and minimizing administrative barriers is essential for achieving universal health coverage and sustaining a resilient health workforce in South Africa. Full article

Smart cities encounter numerous risks, including technical and non-technical risks, on account of exchanging large volumes of data for different services; therefore, understanding and assessing risks for their management becomes essential. In this paper, a risk assessment framework for smart cities, based on a BLOC-ICE systems approach, is proposed. The framework outcomes are analyzed based on the data collected from a sample smart city to understand the importance of risks and the ways to mitigate or avoid such risks. The analysis of risk in the framework is based on the Dempster–Shafer and Bayesian theories, which can be used to assess the risk and its impact based on a particular smart city environment. In this paper, the focus is on design phase risks. The outcome of the analysis shows that strategic risks, stakeholder engagement, regulatory compliance, business continuity, and financial risks are important during the design phase and decision makers should develop measures to address these risks, which, otherwise, can have consequential impacts during the development and operation phase. The paper also provides some research direction on risk assessment. Full article

This study investigates how eco-efficiency and socio-efficiency influence firms’ default risk across the European financial, industrial, and consumer service sectors from 2010 to 2024. This study aims to determine whether integrating environmental and social performance into corporate strategies mitigates financial distress over time. The Pooled Mean Group ARDL estimator was employed to capture the short- and long-term dynamics. The results indicate that higher eco- and socio-efficiency significantly reduce long-term default risk, particularly in the financial and industrial sectors. Short-term effects were found to be insignificant, suggesting that sustainability benefits gradually emerged. This study offers novel sector-specific evidence linking sustainability efficiency to default risk in European firms and provides insights into how environmental and social efficiencies enhance corporate resilience and financial stability. Full article

Accounting harmonization enables the comparison of financial reporting and enhances its usefulness. The IFRS was developed to achieve such harmonization in a globalized world. This study focuses on the impact of transitioning from IAS 17 to IFRS 16 within the European airline industry. We conducted a quantitative analysis using non-parametric statistical tests to evaluate the impact on financial and economic ratios and compare the periods before and after the change, covering the period from 2018 to 2024. Our results show that both financial ratios and economic ratios were significantly affected by IFRS 16 adoption; namely, in contrast to prior studies, we show that ROE is significantly and positively affected, an important contribution of this study. Additionally, the size and type of airline company (low-cost, full-service, and flag airline companies) maintain these impacts, representing an innovative approach to this study compared to previous research. Overall, by recognizing both assets and liabilities in financial statements, IFRS 16 allows stakeholders to gain an accurate understanding of a firm’s capital structure and performance. This study contributes empirical evidence to the prior literature about the benefits of the new lease accounting standard and to improving the scientific knowledge on this topic. Full article

Marine Protected Areas (MPAs) are key tools for mitigating the impacts of human activities on marine biodiversity and addressing climate change. Consequently, nations worldwide have committed to international targets to expand MPA coverage, leading to a rapid increase in protected areas and generating significant challenges for financing and effective management, particularly in developing countries. Under this scenario, multiple stakeholders, including local communities, academia, governments, and national and international organizations, are joining efforts to reduce financial gaps and strengthen MPA governance and management. In this study, we present the case of the Juan Fernández Archipelago in Chile, where multiple organizations collaborated to develop a socially robust and locally grounded governance system for a network of MPAs through a comprehensive community engagement process conducted on Robinson Crusoe Island between 2022 and 2024. As a result, a Functional Community Organization was established to co-manage the MPAs with the Chilean government, and three MPA management plans encompassing ~580,000 km² were approved. Among them, the management plan of the Multiple-Use MPA “Mar de Juan Fernández” was the first approved under the new Chilean Biodiversity and Protected Areas Service (Law 21,600), setting a national precedent for co-management. Our findings show that effective MPA governance depends not only on institutional design but also on the extent to which governance arrangements are socially embedded and locally legitimate. In this context, community-grounded and context-sensitive engagement processes facilitated high levels of participation, strengthened representation, and supported the co-production of knowledge, providing a strong foundation for the long-term implementation of conservation objectives. Full article

This paper documents a fundamental sectoral divergence in capital–employment relationships using UK quarterly data (2014Q1–2024Q4, N = 44). While manufacturing automation studies consistently find negative employment effects, we show that information-intensive service sectors (SIC J: Information and Communication; K: Financial and Insurance; M: Professional/Scientific/Technical) exhibit robust positive co-movement between capital formation and employment. Structural vector autoregression analysis reveals persistent positive employment responses following capital shocks, with effects peaking at 5–6 quarters and remaining significant through 10 quarters. This pattern holds across eight alternative specifications with varying lag structure, variable ordering, and subsample periods. Granger causality tests reveal bidirectional temporal relationships (capital → employment: F = 3.932, p = 0.028; employment → capital: F = 5.659, p = 0.007), indicating joint determination from anticipated demand growth rather than unidirectional technology-driven dynamics. This finding—while complicating causal interpretation—strengthens the contribution by providing honest empirical characterization of coordination mechanisms in information-intensive sectors. Our capital formation proxy measures all investment in AI-intensive sectors (buildings, equipment, conventional IT, emerging AI systems) rather than AI expenditure specifically, creating measurement ambiguity we acknowledge transparently. The sectoral focus (J+K+M sectors with 22–34% AI adoption rates exceeding the 15% economy-wide average) provides indicative evidence that patterns relate to advanced technology deployment, but measurement breadth prevents definitive AI-specific conclusions. The contribution lies not in establishing AI-specific causality—which aggregate time-series methods cannot achieve—but in documenting robust sectoral heterogeneity using methodology comparable to manufacturing displacement studies. The positive association in information-intensive services contrasts sharply with manufacturing’s negative relationship, suggesting technology–employment dynamics vary fundamentally across sectors with different task structures. Three limitations constrain interpretation: (i) recursive identification cannot definitively rule out common demand shocks, (ii) the 44-quarter sample provides limited statistical power for precise magnitude estimation, and (iii) external validity to other countries, time periods, or service sectors remains uncertain. The findings motivate sector-specific rather than economy-wide technology policy approaches, recognizing that extrapolating manufacturing evidence to service-dominated economies may systematically mischaracterize employment dynamics. Full article

Over the last two decades, social enterprises in Romania have taken on an increasingly important role in the production and provision of social goods and services for vulnerable groups. Although forms of the social economy have long existed in Romanian society, sustainability remains a constant concern, particularly in the context of dependence on European Union structural funds. This study identifies the multidimensional factors influencing the sustainability of social enterprises in Romania, combining a quantitative analysis of 121 certified social enterprises from the National Register (2016–2022) with qualitative case studies of 15 selected organisations. Revenue diversification was significantly associated with financial sustainability (β = −0.28, p < 0.01), whilst high dependence on EU funding (>50% of revenue) was negatively associated with long-term viability (HR = 2.18, p = 0.002). Participation in networks was associated with markedly higher five-year survival rates (87.2% for network members versus 69.5% for non-members). Six key sustainability strategies were identified: hybrid revenue models, integration into the value chain, community inclusion, adaptive leadership, strategic partnerships, and effective communication of results and impact. Environmental sustainability is addressed with preliminary proxy evidence from the qualitative component; systematic measurement of this dimension represents a priority for future research. The findings confirm the absence of an integrated support framework for the sustainable activities of the social economy and, in some cases, the limited capacity of public institutions to support vulnerable groups. Policy recommendations include phased funding mechanisms, transitional support instruments and the systematic development of regional ecosystems. Full article

Disability Enterprises have the potential to address employment barriers that people with an intellectual disability experience as they move into open employment. Disability Enterprises are able to facilitate this transition through strategic organisational design, but it is unknown the extent to which organisations are following what could be considered best practice. Utilising a survey and interview approach, we aimed to understand how well organisations align with the ‘WISE-Ability’ model and the ongoing challenges they face in supporting open employment pathways for people with a disability working at the enterprise. Staff (94) from Disability Enterprises completed a survey where they rated their own organisation against a number of criteria related to organisational design and operation related to transitioning supported employees to open employment. After completing the survey, organisational staff (19) participated in a semi-structured interview. Disability Enterprises provide training and life skills development options with the end goal of employment transition. Training is adapted to the needs of individuals and there is flexibility in the pace of learning and rostering of shifts. Disability Enterprises develop industry-specific work skills and independent life skills. Pathways to employment are offered in most cases; however, there is variation in the success and scale of employment pathways. Organisations continue to face challenges that exist in the disability service system and open labour market. Organisations are confident that they are able to offer a culture of support and respect, choice and variety of employment options, busy and quiet spaces, and areas for rest and accessible workspaces where individuals feel empowered and safe to try new tasks. Many organisations developed relationships with external stakeholders and employers to facilitate financial sustainability and employment pathways. However, organisations face challenges in the following areas: resourcing pathways to employment and offering certified training options for people working in a Disability Enterprise. Employment pathways were often carved out on a case-by-case basis relying on significant staff support and after-hour work. Full article

Digital financial services have expanded rapidly across emerging economies and are often presented as tools for advancing women’s economic inclusion. However, the extent to which digital finance is associated with lower gender inequality depends on the broader structural conditions in which women live and work. This study examines the relationship between digital financial participation, labor market integration, and gender inequality in Brazil using nationally representative microdata from the 2025 Global Findex survey. Three outcomes are examined: digital account ownership, use of any digital payment, and engagement in merchant digital payments. Multivariate logit models show moderate gender gaps at early stages of digital financial participation. However, these gaps are not uniform across the population. The interaction results show that gender differences are concentrated mainly among individuals outside employment and among those without internet access. Among employed and digitally connected individuals, the gender gap becomes small and statistically insignificant across the three outcomes. A nonlinear decomposition shows that observable socioeconomic characteristics explain only a small share of the aggregate gender gap, especially for account ownership and any digital payment use. Additional robustness checks using probit and complementary log-log models support the main pattern of results. This suggests that the gender gap cannot be explained only by differences in education, income, employment, or internet access, and may also reflect unobserved household, institutional, or social constraints. The findings suggest that digital finance alone does not equalize participation. Rather, women’s digital financial participation is closely associated with their position in the labor market and their access to digital infrastructure. Because the analysis is based on cross-sectional data, the results should be interpreted as conditional associations rather than causal effects. Digital financial expansion is therefore more likely to support gender inclusion when it is linked to broader policies that strengthen women’s labor force attachment, digital connectivity, and economic autonomy. Full article

This research investigates the factors influencing the behavioral intention and actual use of e-wallets among Generation Z by extending the UTAUT3 model to include personal innovativeness and perceived security. The study employs a quantitative approach using Partial Least Squares Structural Equation Modeling (PLS-SEM). Data were collected from 535 Generation Z e-wallet users between 15 January and 28 February 2026. The results reveal that traditional determinants such as performance expectancy, effort expectancy, facilitating conditions, and hedonic motivation do not significantly influence behavioral intention in a mature digital environment. In contrast, social influence, price value, habit, personal innovativeness, and perceived security significantly shape users’ intentions. Furthermore, the findings indicate that behavioral intention fully mediates the relationship between personal innovativeness and perceived security with actual usage behavior. This suggests that although users may possess innovative tendencies and perceive strong security, these factors influence usage only through the formation of intention. The study also shows that Generation Z demonstrates a strong ability to manage financial activities independently within digital platforms, reflecting high levels of digital and financial literacy. At the same time, users remain highly aware of potential risks, particularly regarding data privacy and transaction security, which significantly affect their intention to adopt e-wallet services. Additionally, actual usage behavior is primarily driven by habit and behavioral intention, indicating routinized usage patterns. Overall, this study highlights the critical roles of trust, social influence, and behavioral reinforcement in explaining technology adoption among Generation Z. Full article

Technical higher education in the Philippines is a government priority, as it equips learners with the technical knowledge and practical skills necessary to develop industry and technology-ready human capital. In parts of Mindanao, the Philippines, where socio-economic and technological challenges are significant, Industrial Technology Education (ITE) learners must be equipped with relevant, comprehensive knowledge of industry trends. A sequential explanatory mixed-methods design was employed in this research, combining quantitative surveys with qualitative interviews to provide a comprehensive analysis. Five hundred twenty-six learners participated in the survey, and six were selected for in-depth interviews. The findings highlight the significant impact of familial and peer support on fostering confidence, encouraging academic perseverance, and improving mental health. However, financial hardships and inadequate emotional support remain significant obstacles. The study emphasizes the importance of cultivating an inclusive campus atmosphere via awareness efforts, accessible services, and mentorship programs to guarantee fair educational opportunities. For this reason, the implementation of personalized education plans, flexible learning, digital access, academic and educational support, and an institutional support system is highly encouraged to address learners’ essential needs. The research findings also suggest integrating mentorship programs, adopting inclusive learning practices, developing an adaptable curriculum, and providing mental health support services for learners, particularly those with disabilities. By aligning the curriculum with industry specifications and standards and providing well-planned support frameworks, higher education institutions in Mindanao can produce graduates who are professionally qualified, highly skilled, well-mannered, and career-prepared, fully equipped to meet the demands of the dynamic workforce. Full article

Background/Objectives: Individuals living with Parkinson’s disease often rely on informal caregivers for daily support. Existing research on caregiving has largely been framed from a predominantly female perspective. However, caregiving roles are evolving, with an increasing number of men assuming these responsibilities. Despite this shift, the experiences of male caregivers remain underexplored. A deeper understanding of their perspectives is essential to inform more inclusive and effective caregiver support in Parkinson’s disease care. This study aimed to explore the lived experience of male caregivers supporting individuals with Parkinson’s disease. Methods: A secondary qualitative analysis was conducted using interviews with seven male caregivers supporting individuals with Parkinson’s disease. Data were analyzed using thematic analysis within a descriptive phenomenological framework. Results: Three overarching themes emerged. (1) Economic and employment challenges, including difficulties balancing work and caregiving, structural barriers to accessing services during working hours, and the financial burden of Parkinsons-related expenses, with financial stability acting as a buffer against stress; (2) Psychological and emotional dynamics, including self-doubt linked to gender norms, the influence of personal and partner attitudes on coping, and ongoing experiences of loss; and (3) Adaptation and coping, involving renegotiation of roles, maintenance of routines, and information seeking that was experienced as both empowering and anxiety-provoking. Conclusions: Male caregiving experiences were shaped by financial stability, personal beliefs and perspectives, and the ability to adapt to changing roles and responsibilities. These findings highlight the importance of recognizing gender-specific caregiving needs and incorporating targeted support for male caregivers into Parkinson’s disease care. Full article

Background/Objectives: This study examines the relationship between user preferences, spatial accessibility, and the financial sustainability of long-term care (LTC) systems, with a focus on Slovenia and the Posavje region. The analysis compares different care models, including long-term home care (LTHC), institutional care, and community-based housing solutions such as sheltered housing and “silver villages”. Methods: A mixed-methods approach was applied, combining qualitative interviews, survey data, spatial analysis, mobility-related operational assessment, and cost estimation. The survey included 1005 individuals, of whom 475 provided valid responses. Statistical analysis was conducted using chi-square tests and the Agresti–Caffo method to examine differences in care preferences and selected proportions across respondent groups. Results: Statistically significant differences in LTC preferences across age groups were identified. Most respondents preferred care options located close to their homes, with the majority unwilling to relocate more than 10 km and a substantial share preferring distances below 5 km. The findings further indicate that travel-related costs for care providers in rural areas are considerable and, in the Municipality of Krško, comparable to the estimated monthly housing costs in specialized community-based units. Cost comparisons suggest that reductions in travel-related operational costs could offset a substantial share of the estimated housing-related costs. Conclusions: The results indicate that sustainable LTC systems require not only adequate service capacity and funding but also spatially coordinated care models aligned with user preferences and long-term sustainability. The findings contribute to strategic LTC planning and support the development of integrated, community-based care systems in geographically dispersed regions. Full article