Search Results (638)

Background: Social and financial services are essential for the inclusion and well-being of people with disabilities (PWDs), who often rely on family caregivers to access these systems. In Saudi Arabia, where disability inclusion is a strategic goal under Vision 2030, understanding caregiver experiences is crucial to identifying service gaps and improving accessibility. Objectives: This study aimed to explore caregivers’ perspectives on awareness, perceived barriers, and accessibility of social and financial services for PWDs in Saudi Arabia. The analysis is grounded in Andersen’s Behavioural Model of Health Service Use and the WHO’s International Classification of Functioning, Disability and Health (ICF) framework. Methods: A cross-sectional survey was conducted with 3353 caregivers of PWDs attending specialised day schools. The survey collected data on demographic characteristics, service awareness, utilisation, and perceived obstacles. Exploratory Factor Analysis (EFA) identified latent constructs, and Structural Equation Modelling (SEM) was used to test relationships between awareness, barriers, and accessibility. Results: Findings reveal that over 70% of caregivers lacked awareness of available services, and only about 3% had accessed them. Key challenges included technological barriers, complex procedures, and non-functional or unclear service provider platforms. Both User Barriers and Service Barriers were negatively associated with Awareness and Accessibility. Awareness, in turn, significantly predicted perceived Accessibility. Caregiver demographics, such as age, education, gender, and geographic location, also influenced awareness and service use. Conclusions: There is a pressing need for targeted awareness campaigns, accessible digital service platforms, and simplified service processes tailored to diverse caregiver profiles. Inclusive communication, decentralised outreach, and policy reforms are necessary to enhance service access and promote the societal inclusion of PWDs in alignment with Saudi Arabia’s Vision 2030. Full article

Population aging poses significant challenges to the sustainability of pension systems. This study presents an integrated methodological approach that uniquely combines actuarial life-cycle modeling with agent-based simulation to assess the potential of Reverse Mortgage Loans (RMLs) as a dual lever for enhancing retiree welfare and supporting pension system resilience under demographic and financial uncertainty. We explore Reverse Mortgage Loans (RMLs) as a potential financial instrument to support retirees while alleviating pressure on public pensions. Unlike prior research that treats individual decisions or policy outcomes in isolation, our hybrid model explicitly captures feedback loops between household-level behavior and system-wide financial stability. To test our hypothesis that RMLs can improve individual consumption outcomes and bolster systemic solvency, we develop a hybrid model combining actuarial techniques and agent-based simulations, incorporating stochastic housing prices, longevity risk, regulatory capital requirements, and demographic shifts. This dual-framework enables a structured investigation of how micro-level financial decisions propagate through market dynamics, influencing solvency, pricing, and adoption trends. Our central hypothesis is that reverse mortgages, when actuarially calibrated and macroprudentially regulated, enhance individual financial well-being while preserving long-run solvency at the system level. Simulation results indicate that RMLs can improve consumption smoothing, raise expected utility for retirees, and contribute to long-term fiscal sustainability. Moreover, we introduce a dynamic regulatory mechanism that adjusts capital buffers based on evolving market and demographic conditions, enhancing system resilience. Our simulation design supports multi-scenario testing of financial robustness and policy outcomes, providing a transparent tool for stress-testing RML adoption at scale. These findings suggest that, when well-regulated, RMLs can serve as a viable supplement to traditional retirement financing. Rather than offering prescriptive guidance, this framework provides insights to policymakers, financial institutions, and regulators seeking to integrate RMLs into broader pension strategies. Full article

Marine biomass, particularly from waste streams, by-products, underutilized, invasive, or potential cultivable marine species, offers a sustainable source of high-value biopolymers such as collagen and chitin. These macromolecules have gained significant attention due to their biocompatibility, biodegradability, functional versatility, and broad applicability across health, food, wellness, and environmental fields. This review highlights recent advances in the uses of marine-derived collagen and chitin/chitosan. In alignment with the United Nations Sustainable Development Goals (SDGs), we analyze how these applications contribute to sustainability, particularly in SDGs related to responsible consumption and production, good health and well-being, and life below water. Furthermore, we contextualize the advancement of product development using marine collagen and chitin/chitosan within the European Union’s Blue bioeconomy strategies, highlighting trends in scientific research and technological innovation through bibliometric and patent data. Finally, the review addresses challenges facing the development of robust value chains for these marine biopolymers, including collaboration, regulatory hurdles, supply-chain constraints, policy and financial support, education and training, and the need for integrated marine resource management. The paper concludes with recommendations for fostering innovation and sustainability in the valorization of these marine resources. Full article

Ecosystem services—the benefits humans derive from nature—are foundational to environmental sustainability and economic well-being, with carbon sequestration and storage standing out as critical regulating services in the fight against climate change. This study presents a comprehensive financial valuation of the carbon sequestration, storage and product substitution ecosystem services provided by the Hungarian forest-based sector. Using a multi-scenario framework, four complementary valuation concepts are assessed: total carbon storage (biomass, soil, and harvested wood products), annual net sequestration, emissions avoided through material and energy substitution, and marketable carbon value under voluntary carbon market (VCM) and EU Carbon Removal Certification Framework (CRCF) mechanisms. Data sources include the National Forestry Database, the Hungarian Greenhouse Gas Inventory, and national estimates on substitution effects and soil carbon stocks. The total carbon stock of Hungarian forests is estimated at 1289 million tons of CO₂ eq, corresponding to a theoretical climate liability value of over EUR 64 billion. Annual sequestration is valued at approximately 380 million EUR/year, while avoided emissions contribute an additional 453 million EUR/year in mitigation benefits. A comparative analysis of two mutually exclusive crediting strategies—improved forest management projects (IFMs) avoiding final harvesting versus long-term carbon storage through the use of harvested wood products—reveals that intensified harvesting for durable wood use offers higher revenue potential (up to 90 million EUR/year) than non-harvesting IFM scenarios. These findings highlight the dual role of forests as both carbon sinks and sources of climate-smart materials and call for policy frameworks that integrate substitution benefits and long-term storage opportunities in support of effective climate and bioeconomy strategies. Full article

This article describes the design, methods, and baseline characteristics of the social needs assessment (SNA) of participants enrolled in an ongoing randomized clinical trial implementing a comprehensive approach to improving diabetes self-management and providing an intensive Diabetes Self-Management Education and Support (iDSMES) Program at St. Vincent’s House Clinic, a primary care practice serving resource-challenged diverse populations in Galveston, Texas. Standardized SNA was conducted to collect information on financial needs, psychosocial well-being, and other chronic health conditions. Based on their identified needs, participants were referred to non-medical existing community resources. A series of in-depth interviews were conducted with a subset of participants. A team member independently categorized these SNA narratives and aggregated them into two overarching groups: medical and social needs. Fifty-nine participants (with a mean age of 53 years and equal representation of men and women) completed an SNA. Most (71%) did not have health insurance. Among 12 potential social needs surveyed, the most frequently requested resources were occupational therapy (78%), utility assistance (73%), and food pantry services (71%). SNA provided data with the potential to address barriers that may hinder participation, retention, and outcomes in diabetes self-management. SNA findings may serve as tertiary prevention to mitigate diabetes-related complications and disparities. Full article

Background/Objectives: International students pursuing higher education in the United States face unique challenges that increase their risk of food insecurity, including limited financial resources, employment restrictions, and cultural barriers. While food insecurity among domestic students has been widely studied, limited research focuses on the lived experiences of international graduate students. This study explores the challenges, perceptions, and coping strategies related to food insecurity among international graduate students at a large public university in North Texas. Methods: This qualitative, ethnographic study involved 20 semi-structured interviews with international graduate students who were clients of the university’s food pantry. Participants were recruited using purposive convenience sampling. Interviews focused on students’ experiences with food access, financial constraints, campus resources, and cultural food preferences. Data were analyzed using thematic coding in MAXQDA. Two standardized food insecurity measures—the USDA and FAO scales—were also administered and analyzed using SPSS. Results: Findings revealed that 85% of participants experienced limited access to nutritious and culturally appropriate foods, with 70% reporting hunger due to financial constraints. Themes included lack of cooking skills, limited campus food options, difficulty accessing familiar groceries, and limited job opportunities. Students expressed that food insecurity significantly impacted their physical health, mental well-being, and social lives, though many continued to prioritize academics over personal nourishment. Conclusions: Food insecurity among international graduate students is multifaceted, shaped by financial, cultural, and institutional barriers. Addressing this issue requires culturally sensitive interventions, improved access to diverse food options, tailored student support services, and institutional efforts to better understand and meet the needs of international students. Full article

The global rise in urban-related health issues poses significant challenges to public health, particularly in cities facing socio-economic crises. In Lebanon, 70% of the population is experiencing financial hardship, and healthcare costs have surged by 172%, exacerbating the strain on medical services. Given these conditions, improving the quality and accessibility of green spaces offers a promising avenue for alleviating mental health issues in urban areas. This study investigates the psychological impact of nine urban public spaces in Beirut through a comprehensive survey methodology, involving 297 participants (locals and tourists) who rated these spaces using Likert-scale measures. The findings reveal location-specific barriers, with Saanayeh Park rated highest in quality and Martyr’s Square rated lowest. The analysis identifies facility quality as the most significant factor influencing space quality, contributing 73.6% to the overall assessment, while activity factors have a lesser impact. The study further highlights a moderate positive association (Spearman’s rho = 0.30) between public space quality and mental well-being in Beirut. This study employs a hybrid methodology combining Research for Design (RfD) and Research Through Designing (RTD). Empirical data informed spatial strategies, while iterative design served as a tool for generating context-specific knowledge. Design enhancements—such as sensory plantings, shading systems, and social nodes—aim to improve well-being through better public space quality. The proposed interventions support mental health, life satisfaction, climate resilience, and urban inclusivity. The findings offer actionable insights for cities facing public health and spatial equity challenges in crisis contexts. Full article

The development of stock markets is pivotal for economic growth, particularly through the mobilization of idle resources into productive investments. Despite recent reforms to enhance Uzbekistan’s capital market, public engagement remains limited. This study examines the behavioral determinants of stock market investment intention and participation among university students, employing the Theory of Planned Behavior (TPB) and Partial Least Squares Structural Equation Modeling (PLS-SEM). The model investigates the influence of digital literacy, financial literacy, social interaction, herding behavior, overconfidence bias, risk tolerance, and financial well-being on investment intention and behavior. A survey of 369 university students was conducted to assess the proposed relationships. The results reveal that risk tolerance, overconfidence bias, and herding behavior significantly and positively affect investment intention, while digital literacy demonstrates a notable negative effect, suggesting caution in assuming technology readiness automatically translates to investment readiness. Investment intention, in turn, strongly predicts actual participation and mediates several of these effects. Conversely, financial literacy, financial well-being, and social interaction showed no significant direct or mediating influence. Additionally, differences according to gender and academic background were observed in how intention translates into behavior. The findings underscore the need for integrated financial and behavioral education to enhance market participation and contribute to policy discourse on youth financial engagement in emerging economies. Full article

Background: In Canada, despite universal healthcare coverage, dental care remains predominantly privately financed, creating financial barriers that prevent many from accessing essential services. This case study is part of a larger initiative, the One Smile Research program, which evaluates the impact of cost-free dental care on the oral health and overall well-being of individuals who have been unable to access dental services in the past two years due to financial constraints. Participants in the program receive necessary dental care and attend follow-up appointments to assess the long-term effects of continuous cost-free care. Clinical Case: This mixed-methods case report focuses on a 26-year-old male participant and integrates a qualitative semi-structured interview with clinical and self-reported data, providing an in-depth understanding of his experiences. Results: Clinical outcomes demonstrated the effectiveness of the provided dental treatments, while self-reported measures indicated improved oral health, satisfaction with dental appearance, enhanced psychosocial well-being, increased self-esteem, reduced dental anxiety, and better oral hygiene habits. The qualitative interview identified three key themes reflecting positive experiences with the program: ease of admission, staff kindness, and overall well-being improvement. The integration of both quantitative and qualitative analyses revealed significant advancements in both objective and subjective measures, particularly regarding overall well-being. Conclusions: The continuity of cost-free dental care effectively addressed the participant’s oral health and overall well-being, with most benefits sustained even at the two-year follow-up. These individual-level outcomes offer preliminary insight into the potential advantages of universal dental coverage within the Canadian healthcare system. Full article

Background/Objective: Frontline healthcare staff who contend diseases and mitigate their transmission were repeatedly exposed to high-risk conditions during the COVID-19 pandemic. They were at risk of mental health issues, in particular, psychological stress, depression, anxiety, financial stress, and/or burnout. This study aimed to investigate and evaluate the occupational stress of medical doctors, nurses, pharmacists, physiotherapists, and other hospital support crew during the COVID-19 pandemic in Saudi Arabia. Methods: We collected both qualitative and quantitative data from a survey given to public and private hospitals using methods like correspondence analysis, cluster analysis, and structural equation models to investigate the work-related stress (WRS) and anxiety of the staff. Since health-related factors are unclear and uncertain, a fuzzy association rule mining (FARM) method was created to address these problems and find out the levels of work-related stress (WRS) and anxiety. The statistical results and K-means clustering method were used to find the best number of fuzzy rules and the level of fuzziness in clusters to create the FARM approach and to predict the work-related stress and anxiety of healthcare staff. This innovative approach allows for a more nuanced appraisal of the factors contributing to work-related stress and anxiety, ultimately enabling healthcare organizations to implement targeted interventions. By leveraging these insights, management can foster a healthier work environment that supports staff well-being and enhances overall productivity. This study also aimed to identify the relevant health factors that are the root causes of work-related stress and anxiety to facilitate better preparation and motivation of the staff for reorganizing resources and equipment. Results: The results and findings show that when the financial burden (FIN) of healthcare staff increased, WRS and anxiety increased. Similarly, a rise in psychological stress caused an increase in WRS and anxiety. The psychological impact (PCG) ratio and financial impact (FIN) were the most influential factors for the staff’s anxiety. The FARM results and findings revealed that improving the financial situation of healthcare staff alone was not sufficient during the COVID-19 pandemic. Conclusions: This study found that while the impact of PCG was significant, its combined effect with FIN was more influential on staff’s work-related stress and anxiety. This difference was due to the mutual effects of PCG and FIN on the staff’s motivation. The findings will help healthcare managers make decisions to reduce or eliminate the WRS and anxiety experienced by healthcare staff in the future. Full article

Emerging digital technologies are transforming how consumers participate in financial markets, yet their benefits depend critically on the speed, reliability, and transparency of the underlying platforms. Online stock trading platforms must maintain high efficiency underload to ensure a good user experience. This paper presents performance analysis under various load conditions based on the containerized stock exchange system. A comprehensive data logging pipeline was implemented, capturing metrics such as API response times, database query times, and resource utilization. We analyze the collected data to identify performance patterns, using both statistical analysis and machine learning techniques. Preliminary analysis reveals correlations between application processing time and database load, as well as the impact of user behavior on system performance. Association rule mining is applied to uncover relationships among performance metrics, and multiple classification algorithms are evaluated for their ability to predict user activity class patterns from system metrics. The insights from this work can guide optimizations in similar distributed web applications to improve scalability and reliability under a heavy load. By framing performance not merely as a technical property but as a determinant of financial decision-making and well-being, the study contributes actionable insights for designers of consumer-facing fintech services seeking to meet sustainable development goals through trustworthy, resilient digital infrastructure. Full article

Leadership is essential for promoting the circular economy (CE) by fostering systemic thinking, promoting resource efficiency, and driving innovative practices that close material loops and minimize environmental impact. In addition, the principles of CE recommend changing production chains to balance economic development, sustainability, and social well-being. This study examines a tertiary packaging company’s circular economy implementation, by using a framework and a circular business model canvas (CBMC) and by identifying the challenges and opportunities for improving environmental management. The method was a participatory research case study using interviews and frameworks. In the context of this company, servitization in logistics was highlighted as an alternative to overcome growth challenges and to add value; however, the company faces significant challenges in implementing it. In addition, it is necessary to increase consciousness among those involved about the concept of the CE and its benefits to improve operational efficiency and review product design to expand environmental management. This research concludes that servitization (as a circular economy strategy), environmental education, and innovation practices can help companies achieve greater financial performance in the packaging industry and contribute to sustainable development goals—SDG achievements. Full article

Background: The Kidney Disease and Quality of Life Short Form (KDQOL-SF™ 1.3) is widely used to assess health-related quality of life (HRQoL) in patients with end-stage renal disease. However, no prior validation had been conducted in Kazakhstan, where both Kazakh and Russian are commonly spoken. This study aimed to validate the Kazakh and Russian versions of the KDQOL-SF™ 1.3 and to identify predictors of HRQoL among hemodialysis patients in Kazakhstan. Methods: A cross-sectional survey was conducted among 217 adult hemodialysis patients from February to April 2025 using a mixed-methods approach (in-person interviews and online data collection). Psychometric testing included Cronbach’s alpha, floor and ceiling effect analysis, and Pearson correlations with self-rated overall health. Multiple linear regression was used to identify predictors of the Kidney Disease Component Summary (KDCS), Physical Component Summary (PCS), and Mental Component Summary (MCS) scores. Results: Both language versions demonstrated acceptable to excellent internal consistency (Cronbach’s α = 0.692–0.939). Most subscales were significantly correlated with self-rated health, supporting construct validity. Regression analyses revealed that greater satisfaction with care, better economic well-being, and more positive dialysis experiences were significant predictors of higher KDCS and MCS scores. Lower PCS scores were associated with female gender, comorbidities, and financial burden. Importantly, financial hardship and access challenges emerged as strong negative influences on HRQoL, underscoring the role of socioeconomic and care-related factors in patient well-being. Conclusions: The KDQOL-SF™ 1.3 is a valid and reliable tool for assessing quality of life among Kazakh- and Russian-speaking hemodialysis patients in Kazakhstan. Integrating this instrument into routine clinical practice may facilitate more personalized, patient-centered care and help monitor outcomes beyond traditional clinical indicators. Addressing economic and access-related barriers has the potential to significantly improve both physical and mental health outcomes in this vulnerable population. Full article

Background: Medication adherence is essential for managing chronic conditions, while non-adherence remains a widespread issue, leading to poorer health outcomes and higher healthcare costs. This study aimed to identify key adherence barriers, explore their relationship with patient satisfaction, and assess their impact on overall well-being among ambulatory patients in Albania. Methods: A cross-sectional study was conducted in three public urban health centers in Vlora, Albania, between November 2024 and January 2025. A total of 80 ambulatory patients were recruited using convenience sampling. Data were collected through face-to-face interviews using validated questionnaires, including the Adherence Barriers Questionnaire (ABQ), the Patient Satisfaction with Nursing Care Quality Questionnaire (PSNCQQ), and the Patient Health Questionnaire (PHQ-9) for depression screening. Results: The study included 80 ambulatory patients (mean age 66.7 years; 48.7% female), predominantly diagnosed with diabetes (42.5%) and rheumatic diseases (36.3%). All participants reported at least one adherence barrier, with 92.5% experiencing multiple barriers. The most common were financial burden (91.3%) and fear of side effects (77.5%). A significant positive correlation was found between adherence barriers and depression severity (ρ = 0.518, p < 0.0001), while patient satisfaction did not significantly influence adherence barriers (ρ = −0.217, p = 0.053) or depression severity (ρ = −0.004, p = 0.969). Multiple regression analysis showed that higher depression severity (p = 0.0049) was significantly associated with greater adherence barriers, while postgraduate education was associated with fewer barriers (p = 0.0175). Conclusions: Financial burden, fear of side effects, and psychological distress are key barriers to adherence among Albanian ambulatory patients. Although there are limitations inherent to the cross-sectional design and modest sample size, our findings highlight the potential benefit of routine mental health screening, targeted financial support, and improved patient education on medication management within primary care. These insights may help inform future research and interventions aimed at enhancing adherence and overall well-being. Patient satisfaction did not significantly impact adherence or depression. Targeted interventions focusing on financial support, mental health care, and patient education are needed to improve adherence and patient well-being. These findings underscore the need for integrated mental health and adherence support strategies within routine primary care services. Full article

A partially ordered set (or a poset, for short) is a set endowed with a partial order relation, i.e., with a reflexive, anti-symmetric, and transitive binary relation. As mathematical objects, posets have been intensively studied in the last century, coming to play essential roles in pure mathematics, logic, and theoretical computer science. More recently, they have been increasingly employed in data analysis, multi-criteria decision-making, and social sciences, particularly for building synthetic indicators and extracting rankings from multidimensional systems of ordinal data. Posets naturally represent systems and phenomena where some elements can be compared and ordered, while others cannot be and are then incomparable. This makes them a powerful data structure to describe collections of units assessed against multidimensional variable systems, preserving the nuanced and multi-faceted nature of the underlying domains. Moreover, poset theory collects the proper mathematical tools to treat ordinal data, fully respecting their non-numerical nature, and to extract information out of order relations, providing the proper setting for the statistical analysis of multidimensional ordinal data. Currently, their use is expanding both to solve open methodological issues in ordinal data analysis and to address evaluation problems in socio-economic sciences, from multidimensional poverty, well-being, or quality-of-life assessment to the measurement of financial literacy, from the construction of knowledge spaces in mathematical psychology and education theory to the measurement of multidimensional ordinal inequality/polarization. Full article